Preventive Medicine

2012 ◽  
Author(s):  
Martha P. Millman ◽  
Prathibha Varkey
Keyword(s):  
Risk Factors ◽  
Preventive Medicine ◽  
Host Susceptibility ◽  
Screening Tests ◽  
Practice Of Medicine ◽  
Target Disease ◽  
The Cost ◽  
Medical Access ◽  
Premorbid State

Preventive medicine is the practice of medicine that detects and alters or ameliorates host susceptibility in a premorbid state (eg, immunization), risk factors for disease in a predisease state (eg, increased cholesterol level), and disease in the presymptomatic state (eg, in situ cervical cancer). Not all disease is preventable because not all risk factors (or all individuals at risk) are known, the cost of screening everyone is not feasible, barriers to medical access exist, interval disease occurs, characteristics of the target disease vary, and screening tests and treatments are imperfect.

Risk aspects of a mission to a comet

1998 ◽  
Vol 212 (3) ◽  
pp. 149-155 ◽  
Author(s):  
R F Turner
Keyword(s):  
Risk Factors ◽  
Single Point ◽  
Space Science ◽  
The Sun ◽  
Scientific Instruments ◽  
Unit Test ◽  
Surface Conditions ◽  
Rosetta Mission ◽  
The Cost

Space science missions are rarely a repeat of a predecessor and thus in the wider view they do not have the benefit of heritage-related statistics. This paper discusses the cost and risk factors in gaining access to space and describes the challenges of the forthcoming Rosetta mission, which has the objective of conducting studies of a comet and its increasing activity as it moves towards the sun. It will fly in formation with the nucleus and later send a lander to its surface to conduct in situ measurements. Reference will be made to the further challenges for the scientific instruments faced by an eight-year period of inactivity during the cruise phase after launch. Statistics have a part to play at the component and unit test levels but are increasingly less relevant at instrument, spacecraft and mission levels. Ultimately the designer is faced with a string of single-point failure possibilities, commencing with the launch vehicle and culminating with the unknown surface conditions that will greet the lander.

scholarly journals Screening for Melanoma by Primary Health Care Physicians: A Cost—Effectiveness Analysis

1996 ◽  
Vol 3 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Afaf Girgis ◽  
Philip Clarke ◽  
Robert C Burton ◽  
Rob W Sanson—Fisher
Keyword(s):  
Cost Effectiveness ◽  
Screening Programme ◽  
Cost Effective ◽  
Economic Assessment ◽  
Screening Tests ◽  
Family Practitioners ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Primary Health Care Physicians ◽  
Melanoma Screening

Background and design— Australia has the highest rates of skin cancer in the world, and the incidence is estimated to be doubling every 10 years. Despite advances in the early detection and treatment of melanoma about 800 people still die nationally of the disease each year. A possible strategy for further reducing the mortality from melanoma is an organised programme of population screening for unsuspected lesions in asymptomatic people. Arguments against introducing melanoma screening have been based on cost and the lack of reliable data on the efficacy of any screening tests. To date, however, there has been no systematic economic assessment of the cost effectiveness of melanoma screening. The purpose of this research was to determine whether screening may be potentially cost effective and, therefore, warrants further investigation. A computer was used to simulate the effects of a hypothetical melanoma screening programme that was in operation for 20 years, using cohorts of Australians aged 50 at the start of the programme. Based on this simulation, cost—effectiveness estimates of melanoma screening were calculated. Results— Under the standard assumptions used in the model, and setting the sensitivity of the screening test (visual inspection of the skin) at 60%, cost effectiveness ranged from Aust$6853 per life year saved for men if screening was undertaken five yearly to $12137 if screening was two yearly. For women, it ranged from $11 102 for five yearly screening to $20 877 for two yearly screening. Conclusion— The analysis suggests that a melanoma screening programme could be cost effective, particularly if five yearly screening is implemented by family practitioners for men over the age of 50.

Should we change the focus of health promotion in sexual health clinics?

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 407 ◽  
Author(s):  
Rudiger Pittrof ◽  
Elizabeth Goodburn
Keyword(s):  
Risk Factors ◽  
Health Promotion ◽  
Cost Effectiveness ◽  
Reproductive Health ◽  
Sexual Health ◽  
Sexual And Reproductive Health ◽  
Health Clinics ◽  
Unknown Risk ◽  
Sexual Health Clinics ◽  
The Cost

The effectiveness of sexual behaviour change interventions in sexual health clinics is unknown. Risk factors for poor sexual and reproductive health such as depression, violence, alcohol and smoking in sexual health clinics are all common and can be identified easily in sexual health services. Targeting these risk factors could be as effective as traditional sexual health promotion and could have additional benefits. The authors propose a pilot to assess the cost-effectiveness and acceptability of incorporating screening and interventions for these risk factors.

scholarly journals Seawater Absorption and Adhesion Properties of Hydrophobic and Superhydrophobic Thermoset Epoxy Nanocomposite Coatings

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 272
Author(s):  
Ayman M. Atta ◽  
Mohamed H. El-Newehy ◽  
Meera Moydeen Abdulhameed ◽  
Mohamed H. Wahby ◽  
Ahmed I. Hashem
Keyword(s):  
Thermal Stability ◽  
Oleic Acid ◽  
Salt Spray ◽  
Adhesion Properties ◽  
In Situ Modification ◽  
Long Time ◽  
Seawater Environment ◽  
Thermoset Epoxy ◽  
The Cost

The enhancement of both thermal and mechanical properties of epoxy materials using nanomaterials becomes a target in coating of the steel to protect it from aggressive environmental conditions for a long time, with reducing the cost. In this respect, the adhesion properties of the epoxy with the steel surfaces, and its proper superhyrophobicity to repel the seawater humidity, can be optimized via addition of green nanoparticles (NPs). In-situ modification of silver (Ag) and calcium carbonate (CaCO3) NPs with oleic acid (OA) was carried out during the formation of Ag−OA and CaCO3−OA, respectively. The epoxide oleic acid (EOA) was also used as capping for Ca−O3 NPs by in-situ method and epoxidation of Ag−OA NPs, too. The morphology, thermal stability, and the diameters of NPs, as well as their dispersion in organic solvent, were investigated. The effects of the prepared NPs on the exothermic curing of the epoxy resins in the presence of polyamines, flexibility or rigidity of epoxy coatings, wettability, and coatings durability in aggressive seawater environment were studied. The obtained results confirmed that the proper superhyrophobicity, coating adhesion, and thermal stability of the epoxy were improved after exposure to salt spray fog for 2000 h at 36 °C.

scholarly journals Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK

2021 ◽  
Vol 10 (11) ◽  
pp. 2478
Author(s):  
Majid Moshirfar ◽  
David G. West ◽  
Chase M Miller ◽  
William B. West ◽  
Shannon E. McCabe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
High Myopia ◽  
Case Series ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Incidence Risk ◽  
Mechanical Devices

Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.

scholarly journals Black Soldier Fly Larval Valorization Benefitting from Ex-Situ Fungal Fermentation in Reducing Coconut Endosperm Waste

Processes ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 275
Author(s):  
Chung Yiin Wong ◽  
Kunlanan Kiatkittipong ◽  
Worapon Kiatkittipong ◽  
Seteno K. O. Ntwampe ◽  
Man Kee Lam ◽  
...  
Keyword(s):  
Principal Component ◽  
Correlation Study ◽  
Statistical Correlation ◽  
Waste Reduction ◽  
Ex Situ ◽  
Larval Feeding ◽  
Rhizopus Oligosporus ◽  
Black Soldier Fly ◽  
The Cost

Oftentimes, the employment of entomoremediation to reduce organic wastes encounters ubiquitous shortcomings, i.e., ineffectiveness to valorize recalcitrant organics in wastes. Considering the cost-favorability, a fermentation process can be employed to facilitate the degradation of biopolymers into smaller organics, easing the subsequent entomoremediation process. However, the efficacy of in situ fermentation was found impeded by the black soldier fly larvae (BSFL) in the current study to reduce coconut endosperm waste (CEW). Indeed, by changing into ex situ fermentation, in which the fungal Rhizopus oligosporus was permitted to execute fermentation on CEW prior to the larval feeding, the reduction of CEW was significantly enhanced. In this regard, the waste reduction index of CEW by BSFL was almost doubled as opposed to in situ fermentation, even with the inoculation of merely 0.5 wt % of Rhizopus oligosporus. Moreover, with only 0.02 wt % of fungal inoculation size to execute the ex situ fermentation on CEW, it could spur BSFL growth by about 50%. Finally, from the statistical correlation study using principal component analysis, the presence of Rhizopus oligosporus in a range of 0.5–1.0 wt % was regarded as optimum to ferment CEW via ex situ mode, prior to the valorization by BSFL in reducing the CEW.

scholarly journals Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050629
Author(s):  
Vanessa W Lim ◽  
Hwee Lin Wee ◽  
Phoebe Lee ◽  
Yijun Lin ◽  
Yi Roe Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
The Cost

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.

PRESIDENT'S MESSAGE

PEDIATRICS ◽  
1962 ◽  
Vol 30 (1) ◽  
pp. 157-158
Author(s):  
Carl C. Fischer
Keyword(s):  
Whooping Cough ◽  
American People ◽  
Practice Of Medicine ◽  
The Subject ◽  
The Government ◽  
The Individual ◽  
The Cost ◽  
Federal Assistance ◽  
Children Under 5

REGARDLESS of how we, as individual physicians, may feel about the role of the federal government in the individual practice of medicine, the time has long since passed when we can afford the luxury of ignoring it. In past years the influence of the government on medicine has been mostly in general areas and perhaps least of all in that of pediatrics; but under the present administration there has been a decided change. For this reason it seems necessary to me to call to the attention of all Fellows of the Academy the particular items in President Kennedy's message of February 26, 1962, which relate specifically to the practice of Pediatrics. These may be considered to be three in number: The first of these dealt with the subject of immunization. On this topic President Kennedy said: I am asking the American people to join in a nationwide vaccination program to stamp out these four diseases (whooping cough, diphtheria, tetanus, and poliomyelitis) encouraging all communities to immunize both children and adults, keep them immunized and plan for the routine immunization of children yet to be born. To assist the states and local communities in this effort over the next 3 years, I am proposing legislation authorizing a program of federal assistance. This program would cover the full cost of vaccines for all children under 5 years of age. It would also assist in meeting the cost of organizing the vaccination drives begun during this period, and the cost of extra personnel needed for certain special tasks.

Effects of Risk Factors on In Situ Expression of Proinflammatory Markers Correlated to Carotid Plaque Instability

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Manuela Montanaro ◽  
Manuel Scimeca ◽  
Nicola Toschi ◽  
Elena Bonanno ◽  
Erica Giacobbi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Plaque ◽  
Plaque Instability

scholarly journals Risk Factors for Hepatitis C Infection Among Sexually Transmitted Disease-Infected, Inner City Obstetric Patients

2003 ◽  
Vol 11 (4) ◽  
pp. 191-198 ◽  
Author(s):  
Youyin Choy ◽  
Lisa Gittens-Williams ◽  
Joseph Apuzzio ◽  
Joan Skurnick ◽  
Carl Zollicoffer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
High Risk ◽  
General Population ◽  
Inner City ◽  
Multiple Logistic Regression Analysis ◽  
Transmitted Disease ◽  
Screening Tests ◽  
Hepatitis C Infection ◽  
Sexually Transmitted

Objective:To test the hypothesis that our inner city obstetric patients who have been infected with sexually transmitted diseases (STDs) will have a higher prevalence of hepatitis C virus infection than the general population and to identify specific risk factors and high-risk groups.Methods:All patients in our prenatal clinic (July 1997–April 1999) who tested positive for one or more STDs were asked to return for hepatitis C antibody testing. Medical charts of all patients who returned for hepatitis C testing were reviewed.Results:A total of 106 patients with STDs were tested for hepatitis C. Positive screening tests for anti-hepatitis C antibody were found in 6.6% (7/106) of the patients (95% CI = 2.7–13.1%). This frequency is significantly higher than the hepatitis C prevalence (1.8%) in the general United States population (p= 0.006). Multiple logistic regression analysis confirmed only older age (p= 0.016) and positive HIV status (p= 0.023) to be significant predictors of hepatitis C infection.Conclusions:Inner city STD-infected obstetric patients are at high risk for hepatitis C infection compared with the general population. Increasing age and HIV-positive status are risk factors which are significantly associated with hepatitis C infection.

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