Prehabilitation and Nutrition in Hernia Surgery

2021 ◽  
Vol 05 (03) ◽  
pp. 260-267
Author(s):  
Ramiro Cadena-Semanate ◽  
Ramon Diaz Jara ◽  
Alfredo D. Guerron ◽  
Jin Yoo
Keyword(s):  
Nutritional Intervention ◽  
The United States ◽  
Negative Influence ◽  
Physical Conditioning ◽  
Hernia Surgery ◽  
Prophylactic Measures ◽  
Patient Optimization ◽  
Patients Experience ◽  
And Control ◽  
Wound Length

AbstractVentral hernia repair (VHR) is among the most frequently performed surgical procedures in the United States. Despite advancements in surgical technique, a significant number of VHR patients experience postoperative complications and hernia recurrence. A key strategy to reduce VHR morbidity is patient optimization before surgery with prehabilitation protocols. Prehabilitation aims to improve patients' functional status with physical conditioning, nutritional intervention, and psychological support. In other surgical disciplines, prompt preoperative action has proven to significantly reduce the negative influence of modifiable comorbidities and accelerate recovery. In this article, we review the literature to assess the applicability and benefits of prehabilitation in elective VHR cases. A review of the available evidence identified obesity, hyperglycemia, and smoking as significant modifiable risk factors that negatively affect VHR outcomes. Prehabilitation has the potential to mitigate and control these comorbidities. Physical conditioning with aerobic, resistance, and inspiratory muscle training is beneficial. Nutritional intervention to control diabetes and in severely malnourished patients is especially important in patients undergoing concomitant gastrointestinal procedures with VHR. Reasonable targets for prehabilitation protocols in elective VHR include a body mass index of 35 kg/m2, HbA1C of 6.5% and tobacco abstinence for at least 4 weeks. Prophylactic measures to minimize the rates of incisional hernia after primary laparotomy repairs include mesh reinforcement and a suture to wound length ratio of at least 4:1.

When Temporal Orbits Collide: Embodied Trans Temporalities in U.S. Prisons

Somatechnics ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 74-94 ◽  
Author(s):  
Rae Rosenberg
Keyword(s):  
United States ◽  
Case Studies ◽  
The United States ◽  
Industrial Complex ◽  
Prison Industrial Complex ◽  
Trans Women ◽  
And Control

This paper explores trans temporalities through the experiences of incarcerated trans feminine persons in the United States. The Prison Industrial Complex (PIC) has received increased attention for its disproportionate containment of trans feminine persons, notably trans women of colour. As a system of domination and control, the PIC uses disciplinary and heteronormative time to dominate the bodies and identities of transgender prisoners by limiting the ways in which they can express and experience their identified and embodied genders. By analyzing three case studies from my research with incarcerated trans feminine persons, this paper illustrates how temporality is complexly woven through trans feminine prisoners' experiences of transitioning in the PIC. For incarcerated trans feminine persons, the interruption, refusal, or permission of transitioning in the PIC invites several gendered pasts into a body's present and places these temporalities in conversation with varying futures as the body's potential. Analyzing trans temporalities reveals time as layered through gender, inviting multiple pasts and futures to circulate around and through the body's present in ways that can be both harmful to, and necessary for, the assertion and survival of trans feminine identities in the PIC.

A STRATEGY FOR MONITORING THE IMPACTS OF COMBINED SEWER OVERFLOWS ON THE OHIO RIVER

1994 ◽  
Vol 30 (1) ◽  
pp. 167-175
Author(s):  
Alan H. Vicory ◽  
Peter A. Tennant
Keyword(s):  
National Policy ◽  
The United States ◽  
Ohio River ◽  
Combined Sewer Overflows ◽  
Treatment Technology ◽  
Design Storm ◽  
Combined Sewer ◽  
Sewer Overflows ◽  
Definition Of ◽  
And Control

With the attainment of secondary treatment by virtually all municipal discharges in the United States, control of water pollution from combined sewer overflows (CSOs) has assumed a high priority. Accordingly, a national strategy was issued in 1989 which, in 1993, was expanded into a national policy on CSO control. The national policy establishes as an objective the attainment of receiving water quality standards, rather than a design storm/treatment technology based approach. A significant percentage of the CSOs in the U.S. are located along the Ohio River. The states along the Ohio have decided to coordinate their CSO control efforts through the Ohio River Valley Water Sanitation Commission (ORSANCO). With the Commission assigned the responsibility of developing a monitoring approach which would allow the definition of CSO impacts on the Ohio, research by the Commission found that very little information existed on the monitoring and assessment of large rivers for the determination of CSO impacts. It was therefore necessary to develop a strategy for coordinated efforts by the states, the CSO dischargers, and ORSANCO to identify and apply appropriate monitoring approaches. A workshop was held in June 1993 to receive input from a variety of experts. Taking into account this input, a strategy has been developed which sets forth certain approaches and concepts to be considered in assessing CSO impacts. In addition, the strategy calls for frequent sharing of findings in order that the data collection efforts by the several agencies can be mutually supportive and lead to technically sound answers regarding CSO impacts and control needs.

THE DEVELOPMENT OF ACCOUNTING AND INTERNAL CONTROL FOR THE NATIONAL LAND SYSTEM OF THE USA

1994 ◽  
Vol 21 (1) ◽  
pp. 189-213
Author(s):  
Michael P. Schoderbek
Keyword(s):  
United States ◽  
Internal Control ◽  
The United States ◽  
Record Keeping ◽  
Governmental Accounting ◽  
Land System ◽  
The Usa ◽  
And Control

This paper examines the early accounting practices that were used to administer the United States' national land system. These practices are of significance because they provide insights on early governmental accounting and they facilitated an orderly settlement of the western territories. The analysis focuses on the record-keeping and control practices that were developed to meet the provisions of the Land Act of 1800 and to account for land office transactions. These accounting procedures were extracted from the correspondence between the Department of the Treasury and the various land officers.

scholarly journals SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges

2021 ◽  
Vol 10 (1) ◽  
pp. 156
Author(s):  
Christopher J. Coke ◽  
Brandon Davison ◽  
Niariah Fields ◽  
Jared Fletcher ◽  
Joseph Rollings ◽  
...  
Keyword(s):  
Oral Health ◽  
Metabolic Diseases ◽  
The United States ◽  
Global Scale ◽  
The Novel ◽  
Periodontal Health ◽  
Dental Clinics ◽  
Dental Profession ◽  
Patients Experience ◽  
Taste And Smell

The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.

scholarly journals Social exclusion increases the executive function of attention networks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Huoyin Zhang ◽  
Shiyunmeng Zhang ◽  
Jiachen Lu ◽  
Yi Lei ◽  
Hong Li
Keyword(s):  
Social Exclusion ◽  
Executive Control ◽  
Brain Regions ◽  
Negative Influence ◽  
Future Research ◽  
Research Attention ◽  
Attention Network ◽  
Attention Networks ◽  
The Social ◽  
And Control

AbstractPrevious studies in humans have shown that brain regions activating social exclusion overlap with those related to attention. However, in the context of social exclusion, how does behavioral monitoring affect individual behavior? In this study, we used the Cyberball game to induce the social exclusion effect in a group of participants. To explore the influence of social exclusion on the attention network, we administered the Attention Network Test (ANT) and compared results for the three subsystems of the attention network (orienting, alerting, and executive control) between exclusion (N = 60) and inclusion (N = 60) groups. Compared with the inclusion group, the exclusion group showed shorter overall response time and better executive control performance, but no significant differences in orienting or alerting. The excluded individuals showed a stronger ability to detect and control conflicts. It appears that social exclusion does not always exert a negative influence on individuals. In future research, attention to network can be used as indicators of social exclusion. This may further reveal how social exclusion affects individuals' psychosomatic mechanisms.

scholarly journals Evaluation of Blood Stool Test Utilization for Colorectal Cancer Screening in Georgia, USA

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 569
Author(s):  
Benjamin E. Ansa ◽  
Nicollette Lewis ◽  
Zachary Hoffman ◽  
Biplab Datta ◽  
J. Aaron Johnson
Keyword(s):  
Colorectal Cancer ◽  
Insurance Coverage ◽  
The United States ◽  
Sociodemographic Factors ◽  
Behavioral Risk ◽  
Early Screening ◽  
Annual Percent Change ◽  
Crc Screening ◽  
Behavioral Risk Factor Surveillance ◽  
And Control

Colorectal cancer (CRC) is the third most prevalent cancer and the second most common cause of cancer-related deaths in the United States (USA). Early screening has been demonstrated to improve clinical outcomes for CRC. Assessing patterns in CRC screening utilization is important for guiding policy and implementing programs for CRC prevention and control. This study examines the trends and sociodemographic factors associated with blood stool test utilization (BSTU) for CRC screening in Georgia, USA. The Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed for Average Annual Percent Change (AAPC) in BSTU between 1997 and 2014 among adults aged 50+ who have had a blood stool test within the past two years, and logistic regression analysis of the 2016 data was performed to identify the associated sociodemographic factors. In Georgia, an overall decrease was observed in BSTU, from 27.8% in 1997 to 16.1% in 2014 (AAPC = −2.6, p = 0.023). The decrease in BSTU was less pronounced in Georgia than nationally (from 26.1% in 1997 to 12.8% in 2014 (AAPC = −4.5, p < 0.001)). BSTU was significantly associated with black race/ethnicity (Black vs. White (aOR = 1.43, p = 0.015)), older age (≥70 vs. 50–59 (aOR = 1.62, p = 0.006)), having insurance coverage (no vs. yes (aOR = 0.37 p = 0.005)), and lower income (≥USD 50,000 vs. <USD 25,000 (aOR = 0.70 p = 0.050)). These findings reveal a decrease over time in BSTU in Georgia, with existing differences between sociodemographic groups. Understanding these patterns helps in directing tailored programs for promoting CRC screening, especially among disadvantaged populations.

Animal Pain Scales in Public Policy

1990 ◽  
Vol 18 (1_part_1) ◽  
pp. 41-50
Author(s):  
F. Barbara Orlans
Keyword(s):  
Public Policy ◽  
Animal Welfare ◽  
The United States ◽  
Pain Scale ◽  
Laboratory Animals ◽  
Practical Applications ◽  
Animal Pain ◽  
Pain Scales ◽  
History Of ◽  
And Control

Pain scales classify the severity of pain inflicted on laboratory animals from little or none up to severe. A pain scale as part of public policy serves beneficial purposes that promote animal welfare. It can be used to educate people about the two alternatives of refinement and replacement, and the need to reduce animal pain. Furthermore, a pain scale has practical applications: 1) in review procedures for animal welfare concerns; 2) in developing policies on the use of animals in education; and 3) as a basis for collecting national data on animal experimentation, so that meaningful data can be collected on trends in reduction and control in animal pain. So far, only a few countries (including Sweden, the Netherlands, Canada and New Zealand) have adopted pain scales as part of their public policy. Most countries, including the United States, have not yet done so. The history of the development and adoption of pain scales by various countries is described and the case is presented for wider adoption of a pain scale in countries not currently using one.

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