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Floreani, Annarosa. "Preventative therapy in primary biliary cirrhosis." Clinics in Liver Disease 7, no. 4 (November 2003): 911–21. http://dx.doi.org/10.1016/s1089-3261(03)00094-1.
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Piché, Lyne, Jeffrey Mathesius, Patrick Lussier, and Anton Schweighofer. "Preventative Services for Sexual Offenders." Sexual Abuse 30, no. 1 (February 15, 2016): 63–81. http://dx.doi.org/10.1177/1079063216630749.
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The role of primary prevention of sexual offences is an understudied area. The current study examined a sample ( N = 100) of men charged or convicted of a sexual offence to determine their interest in interventions that could be offered prior to offending, reasons for not seeking out interventions in the past, and demographic information including onset of deviant sexual fantasy and interests. The majority indicated that preventative interventions, including individual and group treatment, would have been beneficial, but inaccessibility of interventions and fear of arrest prevented them from seeking services. The findings suggest that men who progress to committing a sexual offence are interested in preventative interventions but require information regarding availability of accessible support and the development of primary prevention structures to fulfill society’s desire to prevent sexual offending.
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Artha, Ketut Ary Diana, Ketut Suarjana, and Pande Putu Januraga. "The provision of promotive and preventative healthcare services by private primary care physicians in the era of the national health insurance program." Public Health and Preventive Medicine Archive 5, no. 2 (December 1, 2017): 140. http://dx.doi.org/10.15562/phpma.v5i2.29.
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Background and purpose: In addition to their duties in addressing the curative and rehabilitative needs of the community, private primary care physicians (PCP) play an important role in providing promotive and preventative healthcare services. This study aims to determine the behaviours, enabling and inhibiting factors involved with the provision of promotive and preventative services by PCP in the era of national health insurance (JKN) implementation.Methods: This research is a mix method study using a combination of quantitative and qualitative approaches. Quantitative surveys were conducted with all PCPs already in working collaboration with the Social Security Administering Agency (BPJS) in the Denpasar City area (61 people). Data analysis techniques used descriptive techniques in order to explore the kinds of promotion and preventative services provided by PCPs. Qualitative research was conducted through in-depth interviews of 8 informants selected by purposive sampling and analyzed thematically to discover the enabling and inhibiting factors of the provision of promotive and preventative services by PCPs.Results: The results showed that 91.8% of PCPs did perform promotive and preventative services in their practice site. PCPs who did not carry out promotive and preventative services demonstrate perceptions, beliefs and motivations categorized as low and weak as well as attitudes that do not support the implementation of such services. Enabling factors of promotion and preventative services by PCPs, include among others, quality of facilities and infrastructure, the receipt of awards from BPJS and capitation systems that benefit physicians financially. Inhibiting factors include a low willingness of the patient to carry out doctor's advice, limitations in the PCPs work time and limited funds to perform preventative/promotive services.Conclusions: Promotive and preventative services are not being optimally carried out by PCPs in Denpasar. This is due to the low willingness of the patients, the limited time of the doctor, and the limited allocated funds for promotive and preventative services and low capitation.
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Dieterle, Michael G., Krishna Rao, and Vincent B. Young. "Novel therapies and preventative strategies for primary and recurrentClostridium difficileinfections." Annals of the New York Academy of Sciences 1435, no. 1 (September 21, 2018): 110–38. http://dx.doi.org/10.1111/nyas.13958.
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Seidl Johnson, Anna C., Stephen A. Jordan, and Amanda J. Gevens. "Efficacy of Organic and Conventional Fungicides and Impact of Application Timing on Control of Tomato Late Blight Caused by US-22, US-23, and US-24 Isolates of Phytophthora infestans." Plant Disease 99, no. 5 (May 2015): 641–47. http://dx.doi.org/10.1094/pdis-04-14-0427-re.
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Late blight, caused by Phytophthora infestans, is one of the most economically important diseases of potato and tomato worldwide. Repeated preventative application of fungicides is the primary means of control on susceptible solanaceous host crops. For organic production, fungicide choices are limited, and little efficacy data on noncopper options is available on which to base control recommendations. Twelve fungicides, including organic and conventional selections, were evaluated for both preventative and postinfection control of a single infection cycle of late blight caused by isolates representing three recently identified P. infestans clonal lineages (US-22, US-23, and US-24) using a detached tomato leaf assay. A subset of the most effective fungicides was also tested for preventative control of a single infection cycle of late blight caused by an isolate of US-23 on potted whole tomato plants under laboratory conditions. Fungicide applications made 2 days after inoculation failed to significantly control late blight on detached leaves in all treatments, with the exception of Bravo Ultrex (US-23 only) and Phostrol (US-22 only). Preventative fungicide applications of Bravo Ultrex, Ridomil Gold SL, Revus, Zonix, and low and high rates of EF400 significantly controlled late blight caused by US-22, -23, and -24 isolates. Additionally, preventative application of Phostrol significantly controlled late blight caused by the US-22 isolate; and Phostrol, low rate of Mycostat, and high rate of Champ significantly controlled late blight caused by the US-23 isolate. Late blight caused by the US-24 isolate was significantly reduced compared with US-22 and US-23 isolates for all fungicide treatments applied after inoculation, as well as for all preventative fungicide treatments, with the exception of Bravo, Ridomil, and Revus. In whole-potted-plant assays with the US-23 isolate, late blight was significantly controlled by preventative application of Bravo Ultrex, Ridomil Gold SL, and high rate of EF400; disease was not significantly controlled by Zonix, low rate of EF400, Phostrol, or low and high rates of Champ. Based on these results, it is anticipated that currently available fungicides with suitability to conventional and organic systems can effectively control late blight caused by new clonal lineages of P. infestans when applied preventatively and that late blight caused by the US-24 clonal lineage may require less fungicide use than US-22 or US-23 to mitigate disease.
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Mullan, Leanne, Karen Wynter, Andrea Driscoll, and Bodil Rasmussen. "Preventative and early intervention diabetes-related foot care practices in primary care." Australian Journal of Primary Health 26, no. 2 (2020): 161. http://dx.doi.org/10.1071/py19183.
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The aim of this study was to identify current preventative and early intervention diabetes-related foot care practices among Australian primary care healthcare professionals. A survey was developed to obtain information about preventative and early intervention foot care actions, priorities of care, access and referral to expert multidisciplinary foot care teams and adherence to best-practice diabetes-related foot care recommendations. The survey was distributed to GPs and Credentialled Diabetes Educators (CDEs). Surveys were completed by 10 GPs and 84 CDEs. Only 45% of all respondents reported removing the shoes and socks of their patients with diabetes at a consultation. Eighty-one percent of participants reported having access to specialist multidisciplinary foot care teams. Those in urban settings were significantly more likely to report access than those in rural areas (P=0.04). Median scores indicated that participants did not often utilise specialist teams to refer patients with diabetes-related foot ulceration and Charcot’s neuroarthropathy. Only 16% of participants reported having access to specialist foot care telehealth services; patients with diabetes-related foot ulceration and Charcot’s neuroarthropathy were rarely referred to these services. This study is the first Australian study to elicit information about preventative and early intervention diabetes-related foot care practices by GPs and CDEs working in Australian primary care. In the presence of acute diabetes-related foot complications, primary healthcare practitioners are not always adhering to best practice foot care recommendations. Further studies are required to understand the reasons for this and ensure evidence-based best practice foot care delivery to people with diabetes.
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Koon, William, Ali Rowhani-Rahbar, and Linda Quan. "The ocean lifeguard drowning prevention paradigm: how and where do lifeguards intervene in the drowning process?" Injury Prevention 24, no. 4 (October 10, 2017): 296–99. http://dx.doi.org/10.1136/injuryprev-2017-042468.
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Drowning is a global health problem that can be addressed with multiple strategies including utilisation of lifeguards in recreational swim areas. However, few studies have described lifeguard prevention activities. We conducted a retrospective analysis using lifeguard activity data collected in real time with a Computer-Aided-Dispatch (CAD) system to characterise the nature of lifeguard primary and secondary drowning prevention at a popular ocean beach in California. Preventative actions constituted the majority (232 065/423 071; 54.8%) of lifeguard activities, while rescues represented 1.9%. Most preventative actions and rescues occurred during summer months, weekends and afternoons. Statistically significant geographical clusters of preventative actions were identified all over the beach, while rescue clusters were primarily restricted to two sites. Using the most reliable and valid collection system to date, these data show spatial and temporal patterns for ocean lifeguard provision of primary prevention as well as secondary drowning prevention (rescue).
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Primiero, Clare A., Tatiane Yanes, Anna Finnane, H. Peter Soyer, and Aideen M. McInerney-Leo. "A Systematic Review on the Impact of Genetic Testing for Familial Melanoma I: Primary and Secondary Preventative Behaviours." Dermatology 237, no. 5 (2021): 806–15. http://dx.doi.org/10.1159/000513919.
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<b><i>Background:</i></b> Increasing availability of panel testing for known high-penetrance familial melanoma genes has made it possible to improve risk awareness in those at greatest risk. Prior to wider implementation, the role of genetic testing in preventing melanoma, through influencing primary and secondary preventative behaviours, requires clarification. <b><i>Methods:</i></b> Database searches of PubMed, Embase, CINAHL, PsycINFO and the Cochrane Library were conducted for studies describing preventative behaviour outcomes in response to genetic testing for melanoma risk. Publications describing original research of any study type were screened for eligibility. <b><i>Results:</i></b> Eighteen publications describing 11 unique studies were reviewed. Outcomes assessed are based on health behaviour recommendations for those at increased risk: adherence to sun-protective behaviour (SPB); clinical skin examinations (CSE); skin self-examinations (SSE); and family discussion of risk. Overall, modest increases in adherence to primary prevention strategies of SPB were observed following genetic testing. Importantly, there were no net decreases in SPB found amongst non-carriers. For secondary preventative behaviour outcomes, including CSE and SSE, increases in post-test intentions and long-term adherence were reported across several subgroups in approximately half of the studies. While this increase reached significance in mutation carriers in some studies, one study reported a significant decline in annual CSE adherence of non-mutation carriers. <b><i>Conclusions:</i></b> Evidence reviewed suggests that genetic testing has a modestly positive impact on preventative behaviour in high-risk individuals. Furthermore, improvements are observed regardless of mutation carrier status, although greater adherence is found in carriers. While additional studies of more diverse cohorts would be needed to inform clinical recommendations, the findings are encouraging and suggest that genetic testing for melanoma has a positive impact on preventative behaviours.
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Kieliszek, Agata, Chitra Venugopal, Blessing Bassey-Archibong, Fred Lam, Sheila Singh, and Nikoo Aghaei. "STEM-01. TARGETING BRAIN METASTASIS-INITIATING CELLS: A PREVENTATIVE APPROACH." Neuro-Oncology 22, Supplement_2 (November 2020): ii196. http://dx.doi.org/10.1093/neuonc/noaa215.818.
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Abstract BACKGROUND The incidence of brain metastases (BM) is tenfold higher than primary brain tumors. BM commonly originate from primary lung, breast, and melanoma tumors with a 90% mortality rate within one year of diagnosis. Current standard of care for BM includes surgical resection with concurrent chemoradiation, but does not extend median survival past 16 months, posing a large unmet need to identify novel therapies against BM. METHODS From a large in-house biobank of patient-derived BM cell lines, the Singh Lab has generated murine orthotopic patient-derived xenograft (PDX) models of lung, breast, and melanoma BM that recapitulate the stages of BM progression as seen in humans. Using these three PDX models, we identified a population of “pre-metastatic” brain metastasis-initiating cells (BMICs) that are newly arrived in the brain but have yet to form detectable tumors. Pre-metastatic BMICs are not detectable in human patients but are important therapeutic targets with the potential to prevent BM in at-risk patients. RESULTS RNA sequencing of pre-metastatic BMICs from all three PDX primary tumor models with subsequent Connectivity Map analysis identified novel compounds that have the potential of killing all three types of BMICs. In particular, we identified two compounds that have selective killing of BMICs in vitro from all three primary tumor cohorts while sparing non-cancerous cells. We further characterized their ability to inhibit the self-renewal and proliferative properties of BMICs. Ongoing in vivo work will investigate the compounds’ preclinical utilities in preventing BM. CONCLUSION Identification of novel small molecules that target BMICs could prevent the formation of BM completely and dramatically improve the prognosis of at-risk cancer patients.
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Linville, Deanna, Erin Cobb, Tracy Lenee-Bluhm, Gabriela López-Zerón, Jeff M. Gau, and Eric Stice. "Effectiveness of an eating disorder preventative intervention in primary care medical settings." Behaviour Research and Therapy 75 (December 2015): 32–39. http://dx.doi.org/10.1016/j.brat.2015.10.004.
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Phillips, Lisa, Alison R. Yung, Narelle Hearn, Colleen McFarlane, Mats Hallgren, and Patrick D. McGorry. "Preventative Mental Health Care: Accessing the Target Population." Australian & New Zealand Journal of Psychiatry 33, no. 6 (December 1999): 912–17. http://dx.doi.org/10.1046/j.1440-1614.1999.00613.x.
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Objective: Preventative approaches to mental illness are becoming a focus of clinical and research settings. To date, however, few clinical programs have been established with this primary aim. This descriptive paper summarises patterns of referral to one service providing clinical care for young people known to be at high risk of developing a psychotic illness. Methods and results: A 20-month survey of referrals to the service revealed that most patients had a prolonged and circuitous route to assessment. Additionally, a lengthy time period elapsed between the onset of symptoms and initiation of help seeking. Conclusions: Information arising from this survey may influence the development of strategies to improve access to this service and others aimed at the prevention of psychosis. Further, this information may affect the development of generalised pre-ventative mental health services for young people.
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Tickner, Joel, and Sara Wright. "Primary Prevention of Chemical Contamination." NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 12, no. 4 (February 2003): 425–33. http://dx.doi.org/10.2190/2jaa-vwv1-1ga3-mg8k.
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The current approach to addressing health and ecosystem risks from biosolids, or sludge, requires identification of so-called “safe” or “acceptable” levels of exposure and installation of controls to achieve such levels. This end-of-the pipe approach is inconsistent with the public health concept of primary prevention. Following an overview of the limitations in current approaches to understand and address risks of biosolids contamination, we present a new, preventative paradigm for addressing the hazards of sludge. We conclude that given the disparate and widely distributed sources of contaminants in biosolids and the amount of uncertainty in information about health and environmental effects, we need a new approach to this and other environmental dilemmas. This approach is embodied in the concept of the precautionary principle and public health goal-setting.
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Hickey, Erin, Michelle Phan, Andrew F. Beck, Mary Carol Burkhardt, and Melissa D. Klein. "A Mixed-Methods Evaluation of a Novel Food Pantry in a Pediatric Primary Care Center." Clinical Pediatrics 59, no. 3 (January 23, 2020): 278–84. http://dx.doi.org/10.1177/0009922819900960.
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Evidence suggests that management of food insecurity in primary care may enhance preventive care delivery. This study assessed the impact of a food pantry in a pediatric primary care center over 22 months. Quantitative outcome assessments (number of children affected, number of referrals, and completion of preventative services) compared the child receiving food from the pantry to age-matched controls. Commonalities from interviews with pantry-using families were identified using thematic analysis. A total of 504 index patients received food from the pantry during an office visit. There were 546 in-clinic and community referrals. There was no significant relationship between accessing the pantry and preventative service completion by 27 months of age. Themes that emerged during interviews included the need for an emergency food source, facilitation of referrals, and increased trust in the clinic. An in-clinic food pantry is a feasible and family-welcomed approach to address food insecurity in pediatric primary care.
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Wesevich, Victoria, Amanada N. Kellen, and Lubna Pal. "Recent advances in understanding primary ovarian insufficiency." F1000Research 9 (September 7, 2020): 1101. http://dx.doi.org/10.12688/f1000research.26423.1.
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Primary ovarian insufficiency (POI) is an uncommon yet devastating occurrence that results from a premature depletion of the ovarian pool of primordial follicles. Our understanding of both putative and plausible mechanisms underlying POI, previously considered to be largely “idiopathic”, has been furthered over the past several years, largely due to advances in the field of genetics and through expansion of translational models for experimental research. In this review, our goal is to familiarize the multidisciplinary readers of the F1000 platform with the strides made in the field of reproductive medicine that hold both preventative and therapeutic implications for those women who are at risk for or who have POI.
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Zatarain, Lauren A., Derek K. Smith, Jie Deng, Jill Gilbert, Mary S. Dietrich, Kenneth J. Niermann, Sheila H. Ridner, and Barbara A. Murphy. "A Randomized Feasibility Trial to Evaluate Use of the Jaw Dynasplint to Prevent Trismus in Patients With Head and Neck Cancer Receiving Primary or Adjuvant Radiation-Based Therapy." Integrative Cancer Therapies 17, no. 3 (June 28, 2018): 960–67. http://dx.doi.org/10.1177/1534735418784363.
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Objective: This study was designed to assess the feasibility of using the Jaw Dynasplint System as an adjunct to conventional stretching exercises as a preventative measure against trismus in patients undergoing radiotherapy. Methods: Study participants (n = 40) were randomized using a permuted block design to conventional stretching or stretching plus use of the Jaw Dynasplint 3 times per day for 30 minutes. Patients were instructed to record maximum interincisal opening each day as well as logging use of the Jaw Dynasplint. Results: At 6 months after initiation of the preventative regimen, 50% of patients in the Dynasplint arm and 75% in the conventional stretching arm remained on their assigned therapy. Trismus was diagnosed in 2 patients in the control arm and in 4 patients in the Dynasplint arm. Only 25% (95% confidence interval = 11.1, 46.9) of patients in the Dynasplint arm used the device as prescribed. Conclusions: The addition of the Jaw Dynasplint decreased compliance compared with conventional stretching. It is unlikely that the prescribed regimen will prove efficacious as a preventative measure due to low compliance.
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Bhanu, Cini, Mary Elizabeth Jones, Kate Walters, Irene Petersen, and Claudia Cooper. "Routine health monitoring and preventative care for people with dementia in UK primary care." British Journal of General Practice 69, suppl 1 (June 2019): bjgp19X703097. http://dx.doi.org/10.3399/bjgp19x703097.
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BackgroundUK National Dementia Strategies prioritise fair access to dementia treatment for all. It has been shown that people from black and minority ethnic (BME) groups are diagnosed later and those are less likely to receive anti-dementia medication.AimIt is hypothesised that access to primary care services post diagnosis is also reduced in ethnic minority groups.MethodThe Health Improvement Network (THIN) database of UK primary care records was analysed between 2015 and 2016, all patients with dementia were identified, and health service use was compared. Annual GP consultations, blood pressure (BP), weight/body mass index (BMI), Quality and Outcomes Framework (QOF) dementia review, and flu vaccination recordings were compared between ethnic groups.ResultsOver 20 000 individuals with a dementia diagnosis aged 50–105 years were included. There was no significant difference between white, black, and Asian groups across all outcomes. Overall 80% received an annual BP check, 86% received at least one annual GP consultation, 68% received an annual dementia review, and 48% had a weight/BMI recorded. People with dementia who did not have cardiovascular risk factors were less likely to have their BP checked (59%) and be seen by a GP.ConclusionThere do not appear to be ethnic inequalities in primary care service use post-dementia diagnosis. The overall proportion receiving an annual dementia review and weight check was low, despite recommendations that a care plan should be reviewed annually (including nutrition as a key priority). Post-diagnosis support and preventative care should be prioritised in general practice for all people living with dementia.
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Sharma, Nila, Elizabeth Harris, Jane Lloyd, Sabuj Kanti Mistry, and Mark Harris. "Community health workers involvement in preventative care in primary healthcare: a systematic scoping review." BMJ Open 9, no. 12 (December 2019): e031666. http://dx.doi.org/10.1136/bmjopen-2019-031666.
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ObjectivesTo review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context.DesignSystematic scoping review.Data sourcesThe studies were gathered through searching Medline, EMBASE, EMCARE, PsycINFO, CINAHL and online portals of relevant organisations.Eligibility criteriaAll selected studies were original research studies which essentially evaluated preventive intervention undertake by CHWs in PHC. The intervened population were adults with or without diagnosed chronic health disease, culturally and linguistically diverse, or vulnerable due to geographic, economic and/or cultural characteristics that impede or compromise their access to healthcare.Data extraction and synthesisData extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was performed using effective public health practice project quality assessment tool.ResultsA total of 1066 articles were identified during the initial search of six bibliographic databases. After screening the title, abstract and full text, 37 articles met the selection and methodological criteria and underwent data extraction. A high-quality evidence-base supporting the positive impact of CHWs supporting patients’ access to healthcare and influencing positive behaviour change was found. Positive impacts of CHW interventions included improvements in clinical disease indicators, screening rates and behavioural change. Education-focused interventions were more effective in improving patient behaviour, whereas navigation interventions were most effective in improving access to services. Implementation was enhanced by cultural and linguistic congruence and specific training of CHWs in the intervention but reduced by short duration interventions, dropouts and poor adherence of patients.ConclusionThe evidence generated from this systematic scoping review demonstrates the contribution of CHWs to improving access to preventive care for patients from CALD and disadvantaged backgrounds by providing both education and navigational interventions. More research is needed on CHW training and the incorporation of CHWs into primary health care (PHC) teams.
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Campbell, David. "Aboriginal involvement in caring-for-country: an economic case study in primary preventative health." Australasian Psychiatry 23, no. 6 (October 23, 2015): 623–25. http://dx.doi.org/10.1177/1039856215612985.
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Mann, Jennifer, Rachel Quigley, Desley Harvey, Megan Tait, Gillian Williams, and Edward Strivens. "OPEN ARCH: integrated care at the primary–secondary interface for the community-dwelling older person with complex needs." Australian Journal of Primary Health 26, no. 2 (2020): 104. http://dx.doi.org/10.1071/py19184.
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Optimal care of community-dwelling older Australians with complex needs is a national imperative. Suboptimal care that is reactive, episodic and fragmented, is costly to the health system, can be life threatening to the older person and produces unsustainable carer demands. Health outcomes would be improved if services (health and social) are aligned towards community-based, comprehensive and preventative care. Integrated care is person-focussed in outlook and defies a condition-centric approach to healthcare delivery. Integration is a means to support primary care, with the volume and complexity of patient needs arising from an ageing population. Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) is a targeted model of care that improves access to specialist assessment and comprehensive care for older persons at risk of functional decline, hospitalisation or institutionalised care. OPEN ARCH was developed with primary care as the central integrating function and is built on four values of quality care: preventative health care provided closer to home; alignment of specialist and generalist care; care coordination and enablement; and primary care capacity building. Through vertical integration at the primary–secondary interface, OPEN ARCH cannot only improve the quality of care for clients, but improves the capacity of primary care to meet the needs of this population.
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Tiwari, Tamanna, Jennie Marinucci, Eric P. Tranby, and Julie Frantsve-Hawley. "The Effect of Well Child Visit Location on Preventative Dental Visit." Children 8, no. 3 (March 3, 2021): 191. http://dx.doi.org/10.3390/children8030191.
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Recent emphasis has been placed on the integration of dental and medical primary care in an effort to promote recommendations from both American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) that highlight the importance of preventing, intervening, and managing oral disease in childhood. The study aims to provide a population level insight into the role of location of service of medical well-child visit (WCV) and its association to preventative dental visit (PDV) for children between the ages of 0–20 years. Administrative claims data for 3.17 million Medicaid-enrolled children aged 0 to 20 years of age in 13 states in 2016 and 2017 were identified from the IBM Watson MarketScan Medicaid Database. Descriptive and survival analysis reveals most Medicaid enrolled children receive their WCV at an office and hospital, as compared to federally qualified health center, or rural or public health clinic. Further, this study demonstrates increased utilization of dental preventive services for children who receive a WCV. Hispanic children, female children, and children 5–9 years of age had a higher rate of PDV after a WCV at all three locations. This study contributes to the understanding of medical-dental integration among Medicaid-enrolled children and offers insight into the promotion of oral health prevention within medical primary care.
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Weinberg, Ashley. "The preventative impact of management coaching on psychological strain." International Coaching Psychology Review 11, no. 1 (March 2016): 93–105. http://dx.doi.org/10.53841/bpsicpr.2016.11.1.93.
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Objectives:The positive impact of coaching on a range of outcomes, including the well-being of those in receipt of it, has been highlighted by a number of published reviews (e.g. de Haan & Duckworth, 2013) and meta-analyses (e.g. Jones, Woods & Guillaume, 2015). The objective of this study was to assess the potential for coaching to act as a primary level intervention preventing deterioration in psychological health during organisational change.Design:A quasi-experimental longitudinal study was conducted using separate samples of managers (46 in the intervention groups and 30 in the control group) who either volunteered to receive coaching or were directed to do so by their employer.Methods:Psychological health (assessed using GHQ-12) and psycho-social aspects of the work environment were assessed pre- and post-intervention.Results:Symptoms of poor psychological health significantly increased in the control group, but not among managers in receipt of coaching. A significant negative relationship was noted between increased symptoms of strain and the number of coaching sessions attended.Conclusions:Consistent with the Conservation of Resources Model, the results indicate that coaching can have a protective effect on psychological health, however, its impact may be influenced by the number of coaching sessions and organisational factors.
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Brennan, Michelle, Paula M. O’Shea, and Eamon C. Mulkerrin. "Preventative strategies and interventions to improve outcomes during heatwaves." Age and Ageing 49, no. 5 (July 7, 2020): 729–32. http://dx.doi.org/10.1093/ageing/afaa125.
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Abstract Extreme weather events including recently experienced prolonged heatwaves are predicted to increase in frequency and intensity as a result of climate change. Vulnerable groups, and particularly older persons, are at increased risk of heat-related illness and mortality. Multimodal interventions that incorporate community, primary and secondary care programmes are required. Social programmes such as early warning systems, regional heat plans and community-led initiatives that specifically target the isolated, dependent older person are protective. Establishing clear and effective communication on health promotion and preventative measures is the key. Energy-efficient building design and eco-city planning are vital to reduce the impact of heatwaves at both a population and individual level. Anticipatory strategies should be adopted to ensure ample access to fluids, target barriers to increase oral intake and allow early identification of intercurrent illness, along with regular medication reviews. Prompt management of risk factors for the development of heat-related illness and treatment of complications such as heat stroke and cardiovascular events are keys to reducing the negative health impact of extreme heat in at-risk populations. Morbidity and mortality in heatwaves should be preventable. Evidence-based interventions are available to mitigate and prevent the negative health impact of extreme heat and should be implemented in all residential settings.
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Khoury, Zana, Mariam Maloyan, Kathleen Conroy, and Alexandra Epee-Bounya. "Improving delivery of preventative care services using population management strategies." BMJ Open Quality 11, no. 2 (May 2022): e001695. http://dx.doi.org/10.1136/bmjoq-2021-001695.
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BackgroundConsistent and timely delivery of comprehensive preventative care services is a challenge, particularly in underserved patient populations. Previous quality improvement (QI) research has focused on the development of bundled measures of preventative services delivery, but these bundles have not been studied on a population level. We aimed to improve preventative care service delivery on a clinic population level through the use of a bundled measure that includes immunisations, lead screening and use of screening tools among underserved patients under 2 years old.MethodsA QI study was conducted at a community-based academic primary care clinic. A population-level bundled measure was adapted from an existing tool. We used plan–do–study–act cycles to optimise results and tracked bundle outcome rates using a p-type statistical process control chart. Interventions included (1) staff education on measure components, (2) introduction of exam room-based phlebotomy to address lead screening completion rates and (3) population management strategies, including development of a patient registry and use of reminders and visit tracking to increase attendance at well-child visits.ResultsThe percent of bundle completion by 14 months of age increased from a baseline of 58%–77% following implementation of the QI initiatives. A mean shift was identified after the population manager began proactive targeted outreach for the 12-month visit.ConclusionTargeted systems for outreach aimed at bringing patients into the clinic and patient-centred strategies for visit completion are effective at ensuring timely delivery of comprehensive preventative care to an underserved paediatric population.
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Edmiston, E. Kale, Cameron A. Donald, Alice Rose Sattler, J. Klint Peebles, Jesse M. Ehrenfeld, and Kristen Laurel Eckstrand. "Opportunities and Gaps in Primary Care Preventative Health Services for Transgender Patients: A Systematic Review." Transgender Health 1, no. 1 (January 2016): 216–30. http://dx.doi.org/10.1089/trgh.2016.0019.
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Reyes, Antonio Jose, Amanda Sheena Hosein, Kanterpersad Ramcharan, and Sean Perot. "Anaphylaxis and other allergic reactions to food: a global challenge." BMJ Case Reports 13, no. 5 (May 2020): e231425. http://dx.doi.org/10.1136/bcr-2019-231425.
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We describe a case of a biphasic anaphylactic reaction that occurred in a young woman soon after the ingestion of soy milk that led to her hospitalisation. Early recognition and appropriate treatment led to a successful outcome of this life-threatening condition. Challenges encountered in the care of this common illness are highlighted. There is a need for an increase in public awareness on dangerous allergic reactions caused by allergens present in food products in public use, thereby facilitating primary preventative measures to minimise its occurrence. Healthcare stakeholders need to implement measures of contemporary preventative medicine and efficient therapeutic protocols to safeguard the public welfare concerning this global health problem where appropriate interventions can reduce morbidity and mortality. Trial registration numbers NCT02991885 and NCT02851277.
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Hughes, JD Matthew, Libni J. Eapen, and Jennifer Beecker. "Preventative and Personalized Approach to the Treatment of Malignant Melanoma: A Case Report." University of Ottawa Journal of Medicine 6, no. 1 (May 11, 2016): 49–52. http://dx.doi.org/10.18192/uojm.v6i1.1555.
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This case report is focused on malignant melanoma, a common potentially lethal skin cancer, and its unique management. In our patient’s case, the primary cutaneous melanoma occurred 28 years prior to presenting with axillary lymphadenopathy, which was later determined to be a metastatic focus of melanoma; subsequent nodules were found in his spleen. After completion of his treatment and routine screening, additional nodules were discovered in his chest. Primary and secondary prevention were important in the management of this patient, as well as personalization of his treatment.Cette étude de cas porte sur le mélanome malin, un cancer de la peau potentiellement mortel avec une gestion unique. Dans le cas de notre patient, le mélanome s’est présenté 28 ans avant la présentation d’une lymphadénopathie axillaire, ce qui a été démontré par la suite comme une zone étant métastatique du mélanome. Des nodules ont été découverts dans sa rate. Suite à la fin des traitements et des suivis de routine, des nodules additionnels ont été découverts dans sa poitrine. Des préventions primaires et secondaires sont importantes pour la gestion de ce patient ainsi qu’un traitement personnalisé.
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Burns, Penelope, Kirsty Douglas, Wendy Hu, and Peter Aitken. "The Future of Disaster Medicine is Based on Primary Care Involvement." Prehospital and Disaster Medicine 34, s1 (May 2019): s67. http://dx.doi.org/10.1017/s1049023x1900147x.
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Introduction:When disasters happen, people experience broad environmental, physical, and psychosocial effects that can last for years. Researchers continue to focus on the acute physical injuries and aspects of patient care without considering the person as a whole. People who experience disasters also experience acute injury, exacerbations of chronic disease, mental and physical health effects, effects on social determinants of health, disruption to usual preventative care, and local community ripple effects. Researchers tend to look at these aspects of care separately, yet an individual can experience them all at once. The focus needs to change to address all the healthcare needs of an individual, rather than the likely needs of groups. Mental and physical care should not be separated, nor the determinants of health. The person, not the population, should be at the center of care. Primary care, poorly integrated into disaster management, can provide that focus with a "business as usual" mindset. This requires comprehensive, holistic coordination of care for people and families in the context of their local community.Aim:To examine how Family Doctors (FDs) actually contribute to disaster response.Methods:Thirty-seven disaster-experienced FDs were interviewed about how they contributed to response and recovery when disasters struck their communities.Results:FDs reported being guided by the usual evidence-based care characteristics of primary practice. The majority provided holistic comprehensive medical care and did not feel they needed many extra clinical training or skills. However, they did wish to understand the systems of disaster management, where they fit in, and their link to the broader disaster response.Discussion:The contribution of FDs to healthcare systems brings strengths of preventative care, early intervention, and ongoing local surveillance by a central, coordinating, and trusted health professional. There is no reason to not include disaster management in primary care.
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Ali, Nazia. "Fungal Infections." InnovAiT: Education and inspiration for general practice 2, no. 6 (June 2009): 330–35. http://dx.doi.org/10.1093/innovait/inp008.
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Fungi are a common cause of skin infections. The pathogens involved are usually dermatophytes and yeasts. This article covers the common types of fungal infections and provides information on how they can be recognized and managed in a primary care setting. Providing patients with advice on the preventative measures that can be taken is essential to prevent recurrent infections.
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Endicott, Kendal M., Charles B. Drucker, Hakan Orbay, Joseph J. DuBose, Khanjan Nagarsheth, Shahab Toursavadkohi, and Rajabrata Sarkar. "Intraoperative Fragmentation and Retention of Endovascular Devices: Clinical Consequences and Preventative Strategies." Vascular and Endovascular Surgery 54, no. 2 (November 5, 2019): 118–25. http://dx.doi.org/10.1177/1538574419886193.
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Background: Expanded applications and increasing volumes of complex endovascular procedures have increased the risk of unintended intraoperative fragmentation and retention of catheters and sheaths. We describe a series of retained or fragmented endovascular devices, a quality improvement program to address this unmet need for improved detection of catheter fragmentation, and the results of this program. Methods: Cases utilizing endovascular devices that resulted in a retained catheter fragment were identified and analyzed during divisional quality improvement review. One consistent area of concern was operating room (OR) staff unfamiliarity with verifying the integrity of an endovascular device. In response, a slide-based training protocol of focused, endovascular nursing education was implemented. Following perceived lack of improvement after this approach, we developed a handheld visual reference display of the tips of common catheters and sheaths. Staff was surveyed before and after intervention to assess the educational value of the display and the impact on staff device familiarity. Results: All 4 described cases resulted in an unplanned return to the OR for retrieval of the fragmented catheter or sheath. No thromboembolic complications were observed, although associated intra-arterial thrombus was noted in 2 cases. Thirty-four OR nurses were polled to trial the visual reference display initiative, with 70% of those reporting primary surgical assignments outside of cardiovascular ORs. Introduction of the new visual reference display improved staff confidence in their ability to identify a broken device (2.4-3.7, P < .001). This improvement was most significant in OR staff with primary assignments in noncardiovascular services. Conclusion: Current OR standard operating procedures fail to address the potential for unintentionally retained catheters and wires during endovascular procedures. Our novel visual reference display of common endovascular items rather than conventional in-service training improved the ability of staff to identify device fragmentation at the time of the index procedure.
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Zalmanovitch, Yair, and Dana R. Vashdi. "The relationship between socio-economic factors and responsiveness gaps in primary, preventative and health promotion services." Health Expectations 18, no. 6 (July 2, 2014): 2638–50. http://dx.doi.org/10.1111/hex.12238.
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MARRELLI, TINA. "Focus on Safety at Home and Getting to That More Primary Care and Preventative Care Model." Home Healthcare Nurse 30, no. 9 (October 2012): 501–3. http://dx.doi.org/10.1097/nhh.0b013e31826bd0c4.
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Dawson, N., J. Richards, and K. Frost. "The Ububele Baby Mat Service – A primary preventative mental health intervention in a culturally diverse setting." Journal of Child & Adolescent Mental Health 29, no. 1 (April 13, 2017): 85–97. http://dx.doi.org/10.2989/17280583.2017.1297308.
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Fuchimoto, Y., K. hoshino, M. Tanabe, Y. Yamada, S. Naoki, T. Hibi, M. Shinoda, et al. "LIVING- RELATED PARTIAL LIVER TRANSPLANT FOR PRIMARY SCLEROSING CHOLANGITIS (PSC): POST-TRANSPLANT RECURRENCE AND PREVENTATIVE MEASURES." Transplantation Journal 90 (July 2010): 840. http://dx.doi.org/10.1097/00007890-201007272-01639.
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BANACH, J. L., and H. J. van der FELS-KLERX. "Microbiological Reduction Strategies of Irrigation Water for Fresh Produce." Journal of Food Protection 83, no. 6 (February 7, 2020): 1072–87. http://dx.doi.org/10.4315/jfp-19-466.
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ABSTRACT Irrigation water can be a source of pathogenic contamination of fresh produce. Controlling the quality of the water used during primary production is important to ensure food safety and protect human health. Several measures to control the microbiological quality of irrigation water are available for growers, including preventative and mitigation strategies. However, clear guidance for growers on which strategies could be used to reduce microbiological contamination is needed. This study evaluates pathogenic microorganisms of concern in fresh produce and water, the microbiological criteria of water intended for agricultural purposes, and the preventative and mitigative microbial reduction strategies. This article provides suggestions for control measures that growers can take during primary production to reduce foodborne pathogenic contamination coming from irrigation water. Results show that controlling the water source, regime, and timing of irrigation may help to reduce the potential exposure of fresh produce to contamination. Moreover, mitigation strategies like electrolysis, ozone, UV, and photocatalysts hold promise either as a single treatment, with pretreatments that remove suspended material, or as combined treatments with another chemical or physical treatment(s). Based on the literature data, a decision tree was developed for growers, which describes preventative and mitigation strategies for irrigation-water disinfection based on the fecal coliform load of the irrigation water and the water turbidity. It helps guide growers when trying to evaluate possible control measures given the quality of the irrigation water available. Overall, the strategies available to control irrigation water used for fresh produce should be evaluated on a case-by-case basis because one strategy or technology does not apply to all scenarios. HIGHLIGHTS
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Tognetti, Valdinéia Maria, Naiara de Paula Ferreira-Nobilo, and Maria da Luz Rosário de Sousa. "Clinical management of caries by public and private university dental students." Revista de Odontologia da UNESP 42, no. 6 (December 2013): 401–7. http://dx.doi.org/10.1590/s1807-25772013000600002.
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OBJECTIVE: The aim of this study was to verify the clinical approach knowledge of graduate students from two colleges (public and private) concerning dental caries. MATERIAL AND METHOD:A case report containing patient general data, photos, and radiographs were presented for the students, which responded tests and a discursive question. Discursive answers were analyzed according to content analysis technique, and posteriorly dichotomized for statistical analysis. (Chi-square, p<0.05). RESULT: Response rates (n=72) were 85.71% in the public college, and 92.30% in the private college. After x-rays evaluation and considering the diverse dynamics by which both schools perform their patient care management, it was observed that less than 10% of the public college students would perform conservative procedures in primary teeth, while at least 30% of private college students would decide for conservative procedures for all cases (p<0.001). Concerning the permanent dentition, the majority of the public college students would perform "conservative" approach. "Preventative-conservative practice" was similarly observed amongst public and private college students. CONCLUSION:Both in public and in private college were similar curative e approaches (primary teeth) and preventative +conservative (permanent teeth).
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Bäckman, Guy. "Health Policy in Finland." International Journal of Technology Assessment in Health Care 4, no. 3 (July 1988): 375–84. http://dx.doi.org/10.1017/s0266462300000337.
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AbstractThis article surveys attempts by the Finnish government to plan and budget health care since the Primary Health Care Act of 1972. A national board of health allocates approved resources to local authorities who develop plans for preventative and primary health care and hospital services. The acquisition of expensive technologies are debated at the national level. The author presents studies which suggest that there is a considerable need for expansion of both diagnostic and therapeutic technologies in Finland. These adjustments will be necessary to meet the needs of an economically, socially, and demographically changing country.
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Direito, Artur, Jonathan Rawstorn, Jacqueline Mair, Reza Daryabeygi-Khotbehsara, Ralph Maddison, and E. Shyong Tai. "Multifactorial e- and mHealth interventions for cardiovascular disease primary prevention: Protocol for a systematic review and meta-analysis of randomised controlled trials." DIGITAL HEALTH 5 (January 2019): 205520761989048. http://dx.doi.org/10.1177/2055207619890480.
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Objective Cardiovascular diseases (CVD) are a leading cause of mortality and disease burden. Preventative interventions to augment the population-level adoption of health lifestyle behaviours that reduce CVD risk are a priority. Face-to-face interventions afford individualisation and are effective for improving health-related behaviours and outcomes, but they are costly and resource intensive. Electronic and mobile health (e- and mHealth) approaches aimed at modifying lifestyle risk factors may be an effective and scalable approach to reach many individuals while preserving individualisation. This systematic review aims to (a) determine the effectiveness of multifactorial e- and mHealth interventions on CVD risk and on lifestyle-related cardiometabolic risk factors and self-management behaviours among adults without CVD; and (b) describe the evidence on adverse events and on the cost-effectiveness of these interventions. Methods Methods were detailed prior to the start of the review in order to improve conduct and prevent inconsistent decision making throughout the review. This protocol was prepared following the PRISMA-P 2015 statement. MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Cochrane Public Health Group Specialised Register and CENTRAL electronic databases will be searched between 1991 and September 2019. Eligibility criteria are: (a) population: community-dwelling adults; (b) intervention/comparison: randomised controlled trials comparing e- or mHealth CVD risk preventative interventions with usual care; and (c) outcomes: modifiable CVD risk factors. Selection of study reports will involve two authors independently screening titles and abstracts, followed by a full-text review of potentially eligible reports. Two authors will independently undertake data extraction and assess risk of bias. Where appropriate, meta-analysis of outcome data will be performed. Discussion This protocol describes the pre-specified methods for a systematic review that will provide quantitative and narrative syntheses of current multifactorial e- and mHealth CVD preventative interventions. A systematic review and meta-analysis will be conducted following the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions and reported according to PRISMA guidelines.
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Boyers, D., M. van der Pol, V. Watson, T. Lamont, B. Goulao, C. Ramsay, A. Duncan, L. Macpherson, and J. Clarkson. "The Value of Preventative Dental Care: A Discrete-Choice Experiment." Journal of Dental Research 100, no. 7 (February 4, 2021): 723–30. http://dx.doi.org/10.1177/0022034521989943.
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Scale and polish (SP) and oral hygiene advice (OHA) are commonly provided in primary care dental practice to help prevent periodontal disease. These services are widely consumed by service users, incurring substantial cost, without any clear evidence of clinical benefit. This article aims to elicit general population preferences and willingness to pay (WTP) for preventative dental care services and outcomes. An online discrete-choice experiment (DCE) was completed by a nationally representative sample of the UK general population. Respondents each answered 10 choice tasks that varied in terms of service attributes (SP, OHA, and provider of care), outcomes (bleeding gums and aesthetics), and cost. Choice tasks were selected using a pivoted segmented experimental design to improve task realism. An error components panel logit model was used to analyze the data. Marginal WTP (mWTP) for each attribute and level was calculated. In total, 667 respondents completed the DCE. Respondents valued more frequent SP, care provided by a dentist, and personalized OHA. Respondents were willing to pay for dental packages that generated less frequent (“never” or “hardly ever”) bleeding on brushing and teeth that look and feel at least “moderately clean.” Respondents were willing to pay more (+£145/y) for improvements in an aesthetic outcome from “very unclean” (−£85/y) to “very clean” (+£60/y) than they were for reduced bleeding frequency (+£100/y) from “very often” (−£54/y) to “never” (+£36/y). The general population value routinely provided SP, even in the absence of reductions in bleeding on brushing. Dental care service providers must consider service user preferences, including preferences for both health and nonhealth outcomes, as a key factor in any service redesign. Furthermore, the results provide mWTP estimates that can be used in cost-benefit analysis of these dental care services.
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Ralston, Katherine. "THE MANAGEMENT OF MIGRAINE IN PRIMARY CARE." Journal of Neurology, Neurosurgery & Psychiatry 86, no. 11 (October 14, 2015): e4.176-e4. http://dx.doi.org/10.1136/jnnp-2015-312379.82.
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Migraine is a common and debilitating neurological disorder. This study aimed to audit the management of adults with migraine in a Newcastle GP practice against NICE guidelines (2012) on the acute and prophylactic treatment of migraine.A search of practice records for patients with a new diagnosis of migraine between December 2013–14 identified 38 patients. Medical records were reviewed to determine if their management was consistent with NICE guidance.Acute treatment was indicated in 35 patients, with 27 (77%) receiving correct treatment. 1 patient (3%) received unrecommended treatment, while 7 (20%) received no treatment. Prophylactic treatment was given to 11/13 (85%) patients where it was indicated. Of these, 6 (55%) received first line treatment, 1 (9%) second line treatment and 4 (36%) unrecommended treatment. All patients should be followed up after treatment initiation. This occurred or was planned in 14/35 (40%) acute patients and 6/11 (55%) prophylactic patients.The majority of patients with migraine received the correct acute treatment, however over one third of patients received unconventional preventative medication and follow up was sporadic. A template prompting the correct management of migraine has been incorporated into the computer system following this audit to improve patient care.
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Aghaei, Nikoo, Fred Lam, Chitra Venugopal, and Sheila Singh. "37. IN VIVO FUNCTIONAL GENOMIC SCREEN TO IDENTIFY NOVEL DRIVERS OF LUNG-TO-BRAIN METASTASIS." Neuro-Oncology Advances 2, Supplement_2 (August 2020): ii6—ii7. http://dx.doi.org/10.1093/noajnl/vdaa073.025.
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Abstract Brain metastasis, the most common tumour of the central nervous system, occurs in 20–36% of primary cancers. In particular, 40% of patients with non-small cell lung cancer (NSCLC) develop brain metastases, with a dismal survival of approximately 4–11 weeks without treatment, and 16 months with treatment. This highlights a large unmet need to develop novel targeted therapies for the treatment of lung-to-brain metastases (LBM). Genomic interrogation of LBM using CRISPR technology can inform preventative therapies targeting genetic vulnerabilities in both primary and metastatic tumours. Loss-of-function studies present limitations in metastasis research, as knocking out genes essential for survival in the primary tumour cells can thwart the metastatic cascade prematurely. However, gene overexpression using CRISPR activation (CRISPRa) has the potential for overcoming dependencies of gene essentiality. We theorize that an in vivo genome-wide CRISPRa screen will identify novel genes that, when overexpressed, drive LBM. We have developed a patient-derived orthotopic murine xenograft model of LBM using primary patient-derived NSCLC cell lines (termed LTX cells) from the Swanton Lab TRACERx study. We are now poised to transduce LTX cells with a human genome-wide CRISPRa single guide RNA (sgRNA) library, and to subsequently inject the cells into the lungs of immunocompromised mice. We will then track the process of LBM using bioluminescent and MRI imaging until mice reach endpoint. Sequencing of primary lung tumours and subsequent brain metastases promises to uncover enriched sgRNAs, which may represent novel drivers of primary lung tumour formation and LBM. To the best of our knowledge, this study is the first in vivo genome-wide CRISPRa screen focused on identifying novel drivers of LBM, and can inform future preventative therapies to improve survival outcomes for NSCLC patients.
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Aghaei, Nikoo, Fred Lam, Chitra Venugopal, and Sheila Singh. "TAMI-03. IDENTIFICATION OF NOVEL DRIVERS OF LUNG-TO-BRAIN METASTASIS THROUGH IN VIVO FUNCTIONAL GENOMICS." Neuro-Oncology 22, Supplement_2 (November 2020): ii213. http://dx.doi.org/10.1093/neuonc/noaa215.892.
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Abstract Brain metastasis, the most common tumor of the central nervous system, occurs in 20-36% of primary cancers. In particular, 40% of patients with non-small cell lung cancer (NSCLC) develop brain metastases, with a dismal survival of approximately 4-11 weeks without treatment, and 16 months with treatment. This highlights a large unmet need to develop novel targeted therapies for the treatment of lung-to-brain metastases (LBM). Genomic interrogation of LBM using CRISPR technology can inform preventative therapies targeting genetic vulnerabilities in both primary and metastatic tumors. Loss-of-function studies present limitations in metastasis research, as knocking out genes essential for survival in the primary tumor cells can thwart the metastatic cascade prematurely. However, gene overexpression using CRISPR activation (CRISPRa) has the potential for overcoming dependencies of gene essentiality. We theorize that an in vivo genome-wide CRISPRa screen will identify novel genes that, when overexpressed, drive LBM. We have developed a patient-derived orthotopic murine xenograft model of LBM using primary patient-derived NSCLC cell lines (termed LTX cells) from the Swanton Lab TRACERx study. We are now poised to transduce LTX cells with a human genome-wide CRISPRa single guide RNA (sgRNA) library, and to subsequently inject the cells into the lungs of immunocompromised mice. We will then track the process of LBM using bioluminescent and MRI imaging until mice reach endpoint. Sequencing of primary lung tumors and subsequent brain metastases promises to uncover enriched sgRNAs, which may represent novel drivers of primary lung tumor formation and LBM. To the best of our knowledge, this study is the first in vivo genome-wide CRISPRa screen focused on identifying novel drivers of LBM, and can inform future preventative therapies to improve survival outcomes for NSCLC patients.
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Choudry, Fizzah A., Roshan P. Weerackody, Daniel A. Jones, and Anthony Mathur. "Thrombus Embolisation: Prevention is Better than Cure." Interventional Cardiology Review 14, no. 2 (May 20, 2019): 95–101. http://dx.doi.org/10.15420/icr.2019.11.
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Thrombus embolisation complicating primary percutaneous coronary intervention in ST-elevation myocardial infarction is associated with an increase in adverse outcomes. However, there are currently no proven recommendations for intervention in the setting of large thrombus burden. In this review, we discuss the clinical implications of thrombus embolisation and angiographic predictors of embolisation, and provide an update of current evidence for some preventative strategies, both pharmacological and mechanical, in this setting.
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Mullan, Leanne, Andrea Driscoll, Karen Wynter, and Bodil Rasmussen. "Barriers and enablers to delivering preventative and early intervention footcare to people with diabetes: a scoping review of healthcare professionals' perceptions." Australian Journal of Primary Health 25, no. 6 (2019): 517. http://dx.doi.org/10.1071/py19115.
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The aim of this study is to examine barriers and enablers to delivering preventative and early intervention footcare to people with diabetes, from the perspective of healthcare professionals within primary care. MEDLINE, CINAHL and Scopus databases, as well as Google Scholar, were searched in September 2018. Inclusion criteria included: English language, qualitative and quantitative studies, since 1998, reporting on barriers or enablers, as reported by primary care health professionals, to delivering preventative or early intervention footcare to people with diabetes. In total, 339 studies were screened. Eight studies met criteria. Perceived barriers to providing footcare included: geographical, administrative and communication factors; referral and care guideline availability and implementation challenges; limited availability of specialists and high-risk foot services; and limited resources including time and funding. Enablers to footcare were: implementation of footcare programs; education; clear definition of staff roles; development of foot assessment reminder systems; and reminders for people with diabetes to remove their shoes at appointments. Barriers and enablers to footcare are multifaceted. Healthcare professionals are affected by health system and individual factors. By implementing strategies to address barriers to footcare delivery, it is possible to improve outcomes for people with diabetes, thus reducing the effect of diabetes-related foot disease.
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Bauza, Valerie, Gloria D. Sclar, Alokananda Bisoyi, Ajilé Owens, Apurva Ghugey, and Thomas Clasen. "Experience of the COVID-19 Pandemic in Rural Odisha, India: Knowledge, Preventative Actions, and Impacts on Daily Life." International Journal of Environmental Research and Public Health 18, no. 6 (March 11, 2021): 2863. http://dx.doi.org/10.3390/ijerph18062863.
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We conducted 131 semi-structured phone interviews with householders in rural Odisha, India to explore participants’ COVID-19 related knowledge, perceptions, and preventative actions, as well as how the pandemic affected their daily life, economic and food security, and the village-level response. Interviews were conducted with 73 heads of household, 37 primary caregivers, and 21 members of village water and sanitation committees from 43 rural villages in Ganjam and Gajapati districts in Odisha state. The study took place between May–July 2020 throughout various lockdown restrictions and at a time when many migrant workers were returning to their villages and cases were rising. Most respondents could name at least one correct symptom of COVID-19 (75%), but there was lower knowledge about causes of the disease and high-risk groups, and overall COVID-19 knowledge was lowest among caregivers. Respondents reported high compliance with important preventative measures, including staying home as much as possible (94%), social distancing (91%), washing hands frequently (96%), and wearing a facial mask (95%). Additionally, many respondents reported job loss (31%), financial challenges (93%), challenges related to staying home whether as a preventative measure or due to lockdowns (57%), changes in types and/or amount of food consumed (61%), and adverse emotional effects as a result of the pandemic and lockdown. We also provide detailed summaries of qualitative responses to allow for deeper insights into the lived experience of villagers during this pandemic. Although the research revealed high compliance with preventative measures, the pandemic and associated lockdowns also led to many challenges and hardships faced in daily life particularly around job loss, economic security, food security, and emotional wellbeing. The results underscore the vulnerability of marginalized populations to the pandemic and the need for measures that increase resilience to large-scale shocks.
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Jahangiri, Mehdi, Rosanna Cousins, and Vahid Gharibi. "Let’s get back to work: Preventive biological cycle management of COVID-19 in the workplace." Work 66, no. 4 (September 17, 2020): 713–16. http://dx.doi.org/10.3233/wor-203217.
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BACKGROUND: The primary response to the coronavirus (COVID-19) pandemic has been to minimize social contact through lockdown measures. The closure of non-essential businesses to tackle the spread of the coronavirus has had negative consequences for the global economy, production, and employment. OBJECTIVE: To outline how known occupational health principles can be used for preventative management of the coronavirus in workplaces to support resumption of work. METHODS: A discussion of current knowledge of COVID-19, the cost of the lockdown strategy, and preventative biological cycle management. RESULTS: The evidence-based literature indicates that biological cycle management can control the risk of coronavirus infection, provide a suitable and sufficient exit strategy from lockdown, and support getting employees back to work. Adherence to personal protective equipment standards has been insufficient, indicating a need for workplace investment and education. CONCLUSION: Imposed restrictions on workplace operations can be lifted without compromising worker health and safety when a workplace commits to practicing the three principles of biological cycle management.
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Parizh, David, Enrico Ascher, Syed Ali Raza Rizvi, Anil Hingorani, Michael Amaturo, and Eric Johnson. "Quality improvement initiative: Preventative Surgical Site Infection Protocol in Vascular Surgery." Vascular 26, no. 1 (July 14, 2017): 47–53. http://dx.doi.org/10.1177/1708538117719155.
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Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. Summary background data: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications. Methods Retrospective review was performed between 2012 and 2016 for all surgical site infections after revascularization procedures of the lower extremity. A quality improvement protocol was initiated in January 2015. Primary outcome was the assessment of surgical site infection rate reduction in the pre-protocol vs. post-protocol era. Secondary outcomes evaluated patient demographics, closure method, perioperative antibiotic coverage, and management outcomes. Results Implementation of the protocol decreased the surgical site infection rate from 6.4% to 1.6% p = 0.0137). Patient demographics and comorbidities were assessed and failed to demonstrate a statistically significant difference among the infection and no-infection groups. Wound closure with monocryl suture vs. staple proved to be associated with decreased surgical site infection rate ( p < 0.005). Conclusions Preventative measures, in the form of a standardized protocol, to decrease surgical site infections in the vascular surgery population are effective and necessary. Our data suggest that there may be benefit in the incorporation of MRSA and Gram-negative coverage as part of the Surgical Care Improvement Project perioperative guidelines.
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Madeira, Newton G., Carlos Alberto Macharelli, José Figueiredo Pedras, and Maria C. N. Delfino. "Education in primary school as a strategy to control dengue." Revista da Sociedade Brasileira de Medicina Tropical 35, no. 3 (June 2002): 221–26. http://dx.doi.org/10.1590/s0037-86822002000300004.
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The proliferation of Aedes aegypti, a species of mosquito that is the vector of the dengue pathogen, is being augmented by the population's lack of care in allowing the formation of larval habitats. One form of controlling dengue is the distribution of information on the mosquito to improve awareness and to provide the means necessary for the elimination of its reproductive habitats. To evaluate a teaching method concerning the vector and dengue, students from the 5th and 6th years of primary education were compared before and after didactic intervention with a group of control students. The students who received intervention were more successful in identifying the stages of the cycle, biological and morphological characteristics of the adult insect and the importance of the mosquito in health issues. The didactic intervention was successful in developing knowledge leading to increased awareness of the importance of preventative measures that should be taken against the vector and the disease.
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Smithers, Hannah. "Routine asthma review." InnovAiT: Education and inspiration for general practice 7, no. 10 (August 27, 2014): 609–15. http://dx.doi.org/10.1177/1755738014546175.
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Asthma is the most common chronic condition seen in primary care and creates a significant work load in both primary and secondary care. Mortality and morbidity remain unacceptably high as the majority of both are avoidable with optimal use of preventative medicines. It is not only good practice to regularly review every patient with a long-term condition, but when coupled with self-management regular reviews improve clinical outcomes. All patients with asthma should therefore have the opportunity of a review at least once a year in primary care, which should be structured, patient-centred and promote self-management with the aim to minimise symptoms and enable patients to live a normal life. This article aims to provide a pragmatic approach to performing this review as a primary care clinician.
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Rowe, Leanne. "1997 Awards for Innovation and Excellence in Primary Health Care - Direct Care: Clockwork Young People's Health Service." Australian Journal of Primary Health 3, no. 4 (1997): 109. http://dx.doi.org/10.1071/py97045.
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The Program: The Clockwork Young People's Health Service provides a youth health service for Geelong involving many local General Practitioners(GPs), a community health nurse, and a psychologist. The Service is situated in a youth culture venue (The Courthouse Project) in central Geelong which is close to youth workers employed by the City of Greater Geelong and to the youth information centre. The 'drop in' service provides free, long individual consultations, discussion of preventative health issues, emotional and physical health, and education. The target age group is between 12 and 24 years. The Program was implemented between 1995 and 1996 and consolidation has occurred in 1997.
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Slabaugh, Kristen, Shannon Harris, and Samuel Wilcock. "Initiation of Standardized Depression Screening in College Health: A Quality Improvement Project." Journal of Doctoral Nursing Practice 11, no. 2 (October 2018): 143–50. http://dx.doi.org/10.1891/2380-9418.11.2.143.
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Background: Depression is a leading health concern in college health. An on-campus health clinic was identified as conducting complaint-based screening. U.S. Preventative Services Task Force recommends standardized screening in all primary care settings. Objective: To implement a quality improvement project for standardized screening and referral of depressive symptoms and identify factors related to mentoring program interest in a college health clinic. Methods: Demographic survey and Patient Health Questionnaire-2 (PHQ-2) were distributed to students who met inclusion criteria. Positive screens received further intervention with Patient Health Questionnaire-9 (PHQ-9) and immediate evaluation, encouragement of follow-up, or educational handout. Results: Of students receiving primary care services at a college health center, 221 completed demographic surveys, 165 completed the PHQ-2, and eight students received interventions for positive screens. Furthermore, 74.6% of students expressed interest in a mentoring program. Conclusions: The project demonstrates ease of standardized screening in the college health setting without excessive burden to staff or budget. This is a critical preventative care measure for improving early detection and management of depression at college health centers. Implications for Nursing: Initiation of standardized screening on college campuses is a worthwhile investment and should be implemented by registered nurses (RNs) and advanced practice nurses. Support program initiation should be considered to help students with unmanaged symptoms.