scholarly journals A Population Perspective on Prevention of Dementia

2019 ◽  
Vol 8 (6) ◽  
pp. 834 ◽  
Author(s):  
Esmé Eggink ◽  
Eric P. Moll van Charante ◽  
Willem A. van Gool ◽  
Edo Richard
Keyword(s):  
Risk Factors ◽  
Health Care Systems ◽  
Population Level ◽  
Convincing Evidence ◽  
Middle Income ◽  
Effective Prevention ◽  
People With Dementia ◽  
Dementia Prevention ◽  
Wide Range ◽  
Care Systems

The global number of people living with dementia is expected to increase to 130 million in 2050. Based on extensive evidence from observational studies, it is estimated that about 30% of dementia cases may be attributable to potentially modifiable risk factors. This suggests that interventions targeting these factors could perhaps delay or prevent the onset of dementia. Since the vast majority of people with dementia live in low- and middle-income countries, such interventions should preferably be easy and affordable to implement across a wide range of health care systems. However, to date, results from dementia prevention trials do not provide convincing evidence that treatment of these risk factors reduces the risk of dementia. The current paper aims to give an overview of available evidence for the potential for dementia prevention. In particular, we discuss methodological issues that might complicate the development of effective prevention interventions and explore the opportunities and challenges for future dementia prevention research. Currently, several ongoing and planned trials are testing the effect of multi-domain interventions on dementia risk in high-risk populations. It is desirable that future dementia strategies also target the wider population, through interventions on the individual, community, and population level, in order to constrain the growing prevalence of dementia worldwide.

Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention

2017 ◽  
Vol 37 (03) ◽  
pp. 237-258 ◽  
Author(s):  
Amytis Towfighi ◽  
Valerie Hill
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Stroke Prevention ◽  
Health Care Systems ◽  
Dose Intensity ◽  
Lifestyle Changes ◽  
Theoretical Frameworks ◽  
Middle Income ◽  
Modifiable Factors ◽  
Care Systems

AbstractThe pathophysiology of stroke is well characterized, and 9 out of 10 strokes are due to modifiable factors. However, preventive strategies thus far have been relatively ineffective in curbing the global stroke burden, which is projected to increase given the aging of the world's population and epidemiological transition in many low- to middle-income countries. In this review we will summarize our current understanding of behavioral, environmental, and metabolic stroke risk factors not covered elsewhere in this issue. Specifically, we will review the evidence for environmental and household air pollution, smoking, and alcohol use. We will subsequently provide a conceptual framework for stroke prevention strategies, categorizing them as those aimed at changing health care systems and/or provider behavior and those targeting behaviors of patients and/or their caregivers, families, and support networks. The field of stroke prevention is relatively nascent, and little is known about how to optimize health care systems so that providers prescribe evidence-based care for stroke prevention, patients have access to care to receive such services, adherence and control of risk factors are optimized, and patients are empowered to manage their own risk factors and make lifestyle changes, including eating healthy diets (high in fruits, vegetables, and whole grains and low in sodium and sugar-sweetened beverages), engaging in regular physical activity, not smoking, and limiting alcohol consumption. In the next several years, we will likely develop a better understanding of which strategies are effective for modifying vascular risk factors, and how to design and implement successful interventions. Key questions to be answered include optimal theoretical frameworks, delivery models, team composition, timing, dose, intensity, and frequency, taking into account cultural, sociodemographic, and regional differences in patient populations.

scholarly journals Diabetes, pre-diabetes and their risk factors in Malta: a study profile of national cross-sectional prevalence study

2016 ◽  
Vol 1 ◽  
Author(s):  
S. Cuschieri ◽  
J. Vassallo ◽  
N. Calleja ◽  
N. Pace ◽  
J. Mamo
Keyword(s):  
Risk Factors ◽  
Health Care Systems ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Effective Prevention ◽  
Global Epidemic ◽  
Population Sampling ◽  
Care Systems ◽  
Nationally Representative

BackgroundType 2 diabetes mellitus constitutes a global epidemic and a major burden on health care systems across the world. Prevention of this disease is essential, and the development of effective prevention strategies requires validated information on the disease burden and the risk factors. Embarking on a nationally representative cross-sectional study is challenging and costly. Few countries undertake this process regularly, if at all.MethodThis paper sets out the evidence-based protocol of a recent cross-sectional study that was conducted in Malta. Data collection took place from November 2014 to January 2016.ResultsThis study presents up-to-date national data on diabetes and its risk factors (such as obesity, smoking, physical activity and alcohol intake) that will soon be publicly available.ConclusionThis protocol was compiled so that the study can be replicated in other countries. The protocol contains step-by-step descriptions of the study design, including details on the population sampling, the permissions required and the validated measurement tools used.

Adverse reactions with the use of non-steroidal anti-inflammatory drugs

2020 ◽  
pp. 35-50
Author(s):  
M. L. Maksimov ◽  
N. M. Kiseleva ◽  
D. G. Semenikhin ◽  
B. K. Romanov
Keyword(s):  
Risk Factors ◽  
Adverse Reactions ◽  
Effective Prevention ◽  
Chemical Structures ◽  
Wide Range ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Prevention Method ◽  
Effective Medication ◽  
Upper Gastrointestinal

Non-steroidal anti-inflammatory drugs (NSAIDs) are included in a pharmacological group of drugs with different chemical structures providing anti-inflammatory, analgesic and antipyretic actions, as well as antiplatelet action to a certain degree. Unfortunately, NSAIDs can cause a wide range of adverse reactions (AR) posing a serious risk to the health and life of patients. Therefore, the rational use of NSAIDs should include methods for effective prevention of drug complications. Many NSAIDs have a pronounced therapeutic effect, simultaneously causing many undesirable effects, so the drug shall be chosen considering the development of predicted side effects and modern algorithms. According to clinical recommendations, risk factors and administration of safer NSAIDs shall be considered as the main prevention method. Besides, it is possible to protect the patient from the upper gastrointestinal tract complications using proton pump inhibitors. It should be noted that there are no effective medication methods for kidney and liver protection to reduce the risk of NSAID-associated complications.

scholarly journals Combating escalating harms associated with pharmaceutical opioid use in Australia: the POPPY II study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025840 ◽  
Author(s):  
Natasa Gisev ◽  
Sallie-Anne Pearson ◽  
Timothy Dobbins ◽  
David C Currow ◽  
Fiona Blyth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Opioid Dependence ◽  
Service Use ◽  
Population Level ◽  
Ethics Committee ◽  
Adverse Outcomes ◽  
Opioid Use ◽  
Research Committee ◽  
Services Research ◽  
Wide Range

IntroductionOpioid prescribing has increased 15-fold in Australia in the past two decades, alongside increases in a range of opioid-related harms such as opioid dependence and overdose. However, despite concerns about increasing opioid use, extramedical use and harms, there is a lack of population-level evidence about the drivers of long-term prescribed opioid use, dependence, overdose and other harms.Methods and analysisWe will form a cohort of all adult residents in New South Wales (NSW), Australia, who initiated prescribed opioids from 2002 using Pharmaceutical Benefits Scheme dispensing records. This cohort will be linked to a wide range of other datasets containing information on sociodemographic and clinical characteristics, health service use and adverse outcomes (eg, opioid dependence and non-fatal and fatal overdose). Analyses will initially examine patterns and predictors of prescribed opioid use and then apply regression and survival analysis to quantify the risks and risk factors of adverse outcomes associated with prescribed opioid use.Ethics and disseminationThis study has received full ethical approval from the Australian Institute of Health and Welfare Ethics Committee, the NSW Population and Health Services Research Committee and the ACT Health Human Research Ethics Committee. This will be the largest postmarketing surveillance study of prescribed opioids undertaken in Australia, linking exposure and outcomes and examining risk factors for adverse outcomes of prescribed opioids. As such, this work has important translational promise, with direct relevance to regulatory authorities and agencies worldwide. Project findings will be disseminated at scientific conferences and in peer-reviewed journals. We will also conduct targeted dissemination with policy makers, professional bodies and peak bodies in the pain, medicine and addiction fields through stakeholder workshops and advisory groups. Results will be reported in accordance with the REporting of studies Conducted using Observational Routinely collected Data (RECORD) Statement.

Time-Based QoS Prediction and Rank Aggregation of Web Services

2019 ◽  
Vol 14 (4) ◽  
pp. 79-100
Author(s):  
V. Mareeswari ◽  
E. Sathiyamoorthy
Keyword(s):  
Web Services ◽  
Web Applications ◽  
Cloud Model ◽  
Health Care Systems ◽  
Rank Aggregation ◽  
Qos Prediction ◽  
Short Time Span ◽  
Wide Range ◽  
Care Systems ◽  
Commercial Applications

Everyday activities are equipped with smart intellectual possessions in the modern Internet domain for which a wide range of web services are deployed in business, health-care systems, and environmental solutions. Entire services are accessed through web applications or hand-held computing devices. The recommender system is more prevalent in commercial applications. This research predicts the preference of consumers and lists the recommended services in order of ranking for consumers to choose services in a short time span. This proposed approach aims to offer the exact prediction of missing QoS (quality of service) value of web services at a specified time slice. The uncertainty of QoS value has been predicted using the cloud model theory. The focus is to give the global ranking using the aggregated ranking of the consumer's ranking list, which has been obtained through the Kemeny optimal aggregation algorithm. In this work, multidimensional QoS data of web services have experimented and given an accurate prediction and ranking in the web environment.

scholarly journals Estimating risk and cost: An analysis of patients with risk factors for Type 2 Diabetes in rural Jalisco, Mexico

2019 ◽  
Vol 10 (3) ◽  
pp. 98
Author(s):  
Katie Morales ◽  
Emily Hall ◽  
Ella Harris ◽  
Alden Blair ◽  
Sharon Rose ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Health Care Systems ◽  
Retrospective Chart Review ◽  
Health Clinic ◽  
Middle Income ◽  
Borderline Hypertension ◽  
Life Years

The global age standardized prevalence of type 2 diabetes (T2DM) has doubled (4.7% to 8.5%) over the last three decades and is increasing more rapidly in low and middle-income countries (LMICs). The global economic burden of diabetes affects individuals and health care systems and is estimated to cost $825 billion USD a year. Within Mexico, T2DM is the second leading cause of mortality and the leading cause of morbidity using disability associated life years (DALYs). A retrospective chart review and cost analysis, analyzing those at risk of diabetes, was conducted at a rural community health clinic in Jalisco, Mexico. The goal was to project the cost of providing an appropriate scope of care and plan prevention-based population health programs. The results demonstrated that out of 264 charts reviewed, 218 (83%) had one or more diabetic risk factor. The estimated per patient per visit cost is $127.22 MP (Mexican Peso, 2018) and as the number of diabetes risk factors increases for an individual patient, the mean cost of their care to the system increases (p < .001). Those with at least one risk factor comprise the majority in both males and females with a median age of 36 and median BMI of 28, and this group also has the highest percentage of borderline hypertension (46%). This data demonstrates an opportunity to intervene in a group of young adults (ages 27-46) with a cluster of high-risk borderline risk factors and preventing them from developing obesity, hypertension and diabetes later in life.

scholarly journals Body mass index and mortality in relation to age and follow-up of 30 years in large Austrian cohorts

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Nagel ◽  
R S Peter ◽  
B Föger ◽  
H Concin
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Health Care Systems ◽  
Generalized Additive Models ◽  
Population Level ◽  
Additive Models ◽  
Calendar Time ◽  
Care Systems ◽  
Over Time

Abstract Background Obesity and its health consequences will dominate health care systems in many countries during the next decades. Prevention programs have been implemented. However, the optimum body mass index (BMI) in relation to all-cause mortality on population level is still a matter of debate. Material and Method Data 1/1989-6/2005 of the Vorarlberg Health Monitoring & Prevention Program (VHM&PP,) and 8/2005-12/2015 for Vorarlberg provided by the Main Association of Austrian Social Security Institutions were analyzed. In both cohorts, information was available on age, sex, measured height and weight as well as the date and cause of death. Generalized additive models were used to model the mortality rate as function of calendar time, age and follow-up. Results The VHM&PP cohort consisted of 85,488 men and 99,873 women and the later of 129,817 men and 152,399 women. In the second cohort, men (mean age 48 (SD16.9) vs. 45.3 (SD 15.5) and women (48.3 (SD 17.7) vs. 45.6 (SD 16.6) years) were slightly older than in the VHM&PP cohort. The average BMI was slightly higher in men (26.1 (SD4.0) vs. 25.7 (SD3.8) kg/m2) but not in women (24.6 (SD 4.8) vs. 24.7 (SD 4.9) kg/m2), respectively. In the VHM&PP cohort more ever smokers were found in both men (40.3 vs. 22.4%) and women (24.8 vs. 18.4%) than in the subsequent cohort. BMI optimum increased slightly between 1985 and 2015, from 24.9 (95%-CI: 24.0-25.9) to 26.4 (25.3-27.3) in men and from 22.4 (21.8-23.1) to 23.3 (22.5-24.5) kg/m2 in women. However, age and follow-up had major impact on the increase. In younger age the associations are quite stable, while in men over 50 years and in women over 60 years the BMI optimum decreased with length of follow-up. Conclusions Overall the BMI optimum increased slightly over time. However, age and follow-up had major impact on the association. These results suggest, that prognosis of obesity related diseases has improved over time. To detangle this further research is necessary. Key messages In Austria the BMI optimum increased slightly over time. Age and follow-up time had major impact on the association.

scholarly journals Information Security Risk Assessment in Hospitals

2017 ◽  
Vol 11 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Haleh Ayatollahi ◽  
Ghazal Shagerdi
Keyword(s):  
Risk Factors ◽  
Information Security ◽  
High Probability ◽  
Health Care Systems ◽  
Security Risk ◽  
National Interests ◽  
Information Technology Managers ◽  
Environmental Threats ◽  
Care Systems ◽  
Technology Managers

Background: To date, many efforts have been made to classify information security threats, especially in the healthcare area. However, there are still many unknown risks which may threat the security of health information and their resources especially in the hospitals. Objective: The aim of this study was to assess the risks threatening information security in the hospitals located in one of the northwest cities of Iran. Method: This study was completed in 2014. The participants were information technology managers who worked in the hospitals (n=27). The research instrument was a questionnaire composed of a number of open and closed questions. The content validity of the questionnaire was confirmed, and the reliability of the closed questions was measured by using the test-retest method (r =0.78). Results: The results showed that among the information security risks, fire found to be a high probability/high impact risk factor. Human and physical/environmental threats were among the low probability risk factors. Regarding the information security safeguards used in the hospitals, the results showed that the use of the technical safeguards was the most frequent one (n =22, 91.7%) compared to the administrative (n =21, 87.5%) and the physical safeguards (n =16, 66.7%). Conclusion: The high probability risk factors require quick corrective actions to be taken. Therefore, the underlying causes of such threats should be identified and controlled before experiencing adverse effects. It is also important to note that information security in health care systems needs to be considered at a macro level with respect to the national interests and policies.

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