568 resultados para Prevention
Resumo:
On average approximately 13% of the water that is withdrawn by Canadian municipal water suppliers is lost before it reaches final users. This is an important topic for several reasons: water losses cost money, losses force water agencies to draw more water from lakes and streams thereby putting more stress on aquatic ecosystems, leaks reduce system reliability, leaks may contribute to future pipe failures, and leaks may allow contaminants to enter water systems thereby reducing water quality and threatening the health of water users. Some benefits of leak detection fall outside water agencies accounting purview (e.g. reduced health risks to households connected to public water supply systems) and, as a result, may not be considered adequately in water agency decision-making. Because of the regulatory environment in which Canadian water agencies operate, some of these benefits-especially those external to the agency or those that may accrue to the agency in future time periods- may not be fully counted when agencies decide on leak detection efforts. Our analysis suggests potential reforms to promote increased efforts for leak detection: adoption of a Canada-wide goal of universal water metering; development of full-cost accounting and, pricing for water supplies; and co-operation amongst the provinces to promulgate standards for leak detection efforts and provide incentives to promote improved efficiency and rational investment decision-making.
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The purpose of this study was to understand referral linkages that exist among falls prevention agencies in a southern Ontario region using network analysis theory. This was a single case study which included fifteen individual interviews. The data was analyzed through the constant comparative approach. Ten themes emerged and are classified into internal and external factors. Themes associated with internal factors are: 1) health professionals initiating services; 2) communication strategies; 3) formal partnerships; 4) trust; 5) program awareness; and 6) referral policies. Themes associated with external factors are: 1) client characteristics; 2) primary and community care collaboration; 3) networking; and 4) funding. Recommendations to improve the referral pathway are: 1) electronic database; 2) electronic referral forms; 3) educating office staff; and 4) education days. This study outlined the benefit of using network analysis to understand referral pathways and the importance of implementing strategies that will improve falls prevention referral pathways.
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While bullying prevention programs appear to be decreasing the number of bullying incidents overseas, bullying prevention programs here in Canada have not been proving as effective. Evaluations of bullying prevention programs often focus on the outcomes and neglect to examine the training regimen for teachers. As teachers are on the front lines of bullying prevention programs, the current study explored teachers beliefs about the various types of bullying, their perceptions of their own abilities (e.g., teacher bullying prevention efficacy (TBPE), self-concept, and theory of mind) to implement bullying prevention initiatives, and how the school climate may influence their efficacy beliefs. Participants in the current study were 61 Canadian teachers (n = 51 women), predominantly from Ontario. Participating teachers represented all elementary division levels (primary, junior, and intermediate). Participants teaching experience ranged from zero years of teaching (pre-service) to 28 years of experience (M = 10.50, SD = 7.35). It was found that participants reported a relatively high TBPE score, which was related to their likely intervention in cyberbullying situations but not for other forms of bullying situations. It was found that teachers were most likely to intervene in physical bullying than verbal, relational, and cyberbullying, respectively. TBPE was influenced by the school climate. Teachers scores on the theory of mind scale was not a significant indicator of any teachers bullying beliefs. Analyses exploring the relationship between bullying beliefs and self-concept, morality predicted teachers TBPE scores and the likelihood of intervention. Teachers recommendations for bullying prevention training and school bullying prevention programs were explored. Results are discussed in terms of implications for practice and future research.
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The article focuses on keeping cattle calm and removing distractions that would scare cattle back from the chute.
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Chaque anne, environ 1 1,25 million dindividus subiront une chirurgie cardiaque. [1] Environ 36 000 chirurgies cardiaques sont effectues au Canada et 8000 procdures au Qubec (http://www.ccs.ca). Le vieillissement de la population aura pour consquence que la chirurgie cardiaque sera offerte des patients de plus en plus risque de complications, principalement en raison dune co-morbidit plus importante, dun risque de maladie coronarienne plus leve, [2] dune rserve physiologique rduite et par consquent un risque plus lev de mortalit la suite dune chirurgie cardiaque. Lune des complications significatives la suite dune chirurgie cardiaque est le sevrage difficile de la circulation extracorporelle. Ce dernier inclut la priode au dbut du sevrage de la circulation extracorporelle et stend jusquau dpart du patient de la salle dopration. Lorsque le sevrage de la circulation extracorporelle est associ une dfaillance ventriculaire droite, la mortalit sera de 44 % 86 %. [3-7] Par consquent le diagnostic, lidentification des facteurs de risque, la comprhension du mcanisme, la prvention et le traitement du sevrage difficile de la circulation extracorporelle seront dune importance majeure dans la slection et la prise en charge des patients devant subir une chirurgie cardiaque. Les hypothses de cette thse sont les suivantes : 1) le sevrage difficile de la circulation extracorporelle est un facteur indpendant de mortalit et de morbidit, 2) le mcanisme du sevrage difficile de la circulation extracorporelle peut tre approch dune faon systmatique, 3) la milrinone administre par inhalation reprsente une alternative prventive et thrapeutique chez le patient risque dun sevrage difficile de la circulation extracorporelle aprs la chirurgie cardiaque.
Resumo:
Les gouvernements mondiaux et les organismes internationaux ont plac une haute priorit dans la prvention de la transmission mre-enfant du VIH. Cependant, bien qu'il y ait eu des progrs normes rapports dans des nations industrialises, la situation dans les pays en voie de dveloppement est encore dplorable; on y constate un grand cart entre lengagement international pour rduire cette voie de transmission et l'accs aux interventions. Ceci peut tre attribu la situation conomique dplorable dans plusieurs pays en voie de dveloppement. Des interventions prioritaires en sant doivent donc tre soigneusement slectionnes afin de maximiser l'utilisation efficace des ressources limites. Lvaluation conomique est un outil efficace qui peut aider des dcideurs identifier quelles stratgies choisir. L'objectif de cette revue systmatique est de recenser toutes les tudes d'valuation conomique existantes qui ont t effectues dans les pays en voie de dveloppement sur la prvention de la transmission mre-enfant du VIH. Notre revue a retenu 16 articles qui ont rpondu aux critres d'inclusion. Nous avons conu un formulaire pour lextraction de donnes, puis nous avons soumis les articles un contrle rigoureux de qualit. Nos rsultats ont expos un certain nombre de dfauts dans la qualit des tudes choisies. Nous avons galement not une forte htrognit dans les estimations des paramtres de cot et d'efficacit de base, dans la mthodologie applique, ainsi que dans les carts utiliss dans les analyses de sensibilit. Quelques interventions comportant la thrapie la zidovudine ou la nevirapine court terme se sont avres rentables, et ont enregistr des valeurs acceptables de cot-utilit. Les rsultats des valuations conomiques analyses dans cette revue ont vari sur la base des facteurs suivants : la prvalence du VIH, la classification du pays selon le revenu, les infrastructures disponible, les cots du personnel, et finalement les cots des interventions, particulirement les prix des mdicaments.
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Mmoire numris par la Division de la gestion de documents et des archives de l'Universit de Montral.
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Les biofilms sont des communauts structures de micro-organismes enrobes dans une matrice extracellulaire. Les biofilms sont impliqus dans la persistance de plusieurs maladies infectieuses et la matrice extracellulaire du biofilm protge les bactries contre les cellules du systme immunitaire de l'hte, les antibiotiques et les dsinfectants. Rcemment notre laboratoire a dmontr que le zinc inhibe la formation de biofilm chez Actinobacillus pleuropneumoniae, une bactrie pathogne du porc. Le but de cette tude est d'valuer l'effet du zinc sur la croissance et la formation du biofilm chez diffrentes bactries pathognes du porc, telles que Bordetella bronchiseptica, Escherichia coli, Haemophilus parasuis, Salmonella, Staphylococcus aureus et Streptococcus suis. Les bactries ont t cultives dans des plaques de 96 puits sous condition optimale de formation de biofilm et les biofilms ont t colors au cristal violet. La prsence du biofilm a t confirme par microscopie confocale balayage laser laide du marqueur fluorescent FilmTracerTM FM 1-43. des concentrations micromolaires, le zinc inhibe faiblement la croissance bactrienne et bloque d'une manire dose-dpendante la formation de biofilm dA. pleuropneumoniae, Salmonella Typhimurium et H. parasuis. De plus, la formation de biofilm de E. coli, S. aureus et S. suis a t faiblement inhibe par le zinc. Nos rsultats indiquent que le zinc a un effet inhibiteur sur la formation de biofilm de la plupart des pathognes bactriens d'origine porcine. Cependant, le mcanisme sous-jacent de l'activit anti-biofilm du zinc reste tre caractris.
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Mild hypothermia (32 degrees C-35 degrees C) reduces intracranial pressure in patients with acute liver failure and may offer an effective adjunct therapy in the management of these patients. Studies in experimental animals suggest that this beneficial effect of hypothermia is the result of a decrease in blood-brain ammonia transfer resulting in improvement in brain energy metabolism and normalization of glutamatergic synaptic regulation. Improvement in brain energy metabolism by hypothermia may result from a reduction in ammonia-induced decrease of brain glucose (pyruvate) oxidation. Restoration of normal glutamatergic synaptic regulation by hypothermia may be the consequence of the removal of ammonia-induced decreases in expression of astrocytic glutamate transporters resulting in normal glutamate neurotransmitter inactivation in brain. Randomized controlled clinical trials of hypothermia are required to further evaluate its clinical impact.
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Lhypercholestrolmie familiale (FH) est un dsordre lipidique associ aux maladies cardiovasculaires les plus frquentes. La FH est cause par des mutations dans les gnes LDLR, APOB et PCSK9. Toutefois, chez 20% des patients souffrant de FH, aucune mutation dans ces gnes n'a t dtecte et ceci suggre que dautres gnes seraient lorigine de la FH. Actuellement, le seul traitement de la FH est une thrapie aux statines. En gnral les statines sont bien tolres, cependant, une monothrapie ne permet pas datteindre des niveaux thrapeutiques acceptables et dans bien des cas, une thrapie combine devient ncessaire. De plus, lintolrance aux statines est prsente dans environ 12% des patients. Dans les trois dernires dcennies, la survie des patients avec la FH a augmente de faon notoire mais on observe aussi lapparition dune calcification vasculaire svre chez certains dentre eux. Il est donc primordial de dvelopper des nouvelles approches thrapeutiques afin de prvenir ces complications tardives. Dans cette thse doctorat, nous prsentons ltude dune famille avec un phnotype de FH svre non caus par des mutations dans les gnes LDLR, APOB et PCSK9. Par des tudes biochimiques et par squenage dADN utilisant les technologies de nouvelle gnration (NextGenSeq), nous avons dcouvert une mutation dans le gne de lAPOE (Leu167del). Ceci nous permet de proposer le gne codant pour lAPOE comme le 4e locus responsable de la FH (FH4). Par la suite, nous avons effectu deux tudes de cohortes chez les patients atteints de FH. Premirement, dans ltude JUPITER, nous avons dmontr que la rosuvastatin augmente les niveaux sanguins de la protine PCSK9 et ceci limiterait lefficacit du traitement aux statines. Nous avons aussi tudi linfluence du mutant naturel R46L (perte de fonction de la PCSK9) dans la rponse aux statines. Deuximement, nous avons examin les effets de la perte de fonction de la PCSK9 sur le profil cardiomtabolique au sein dune population pdiatrique. Nous avons dtermin que le gnotype de lAPOE est dterminant dans ce profil cardiomtabolique. Enfin, nous avons tudi la calcification vasculaire chez les patients atteints de FH. Cette calcification vasculaire progresse de faon indpendante des niveaux de cholestrol srique et nest pas associe aux anomalies de lhomostasie du calcium. En utilisant des modles murins, nous avons dmontr que les souris Ldlr-/- et Tg(Pcsk9) dveloppent des calcifications vasculaires semblables celles observes chez lhomme. De plus, nous avons confirm limplication de la voie de signalisation LRP5/Wnt dans la pathophysiologie de la calcification artrielle. Avec une tude interventionnelle, nous avons trouv que linhibition de linterleukine 1 (IL-1) diminue fortement lapparition de calcifications vasculaire dans notre modle murin. En conclusion, nos tudes ont permis lidentification dun nouveau gne impliqu dans la FH, ont dmontr aussi que les statines augmentent les niveaux sriques de PCSK9 et que la perte de fonction de la PCSK9 altre le profil cardiomtabolique. Enfin, nous avons tabli que la calcification vasculaire reprsente une complication tardive chez les patients atteints de FH et que, dans notre modle murin, la calcification vasculaire peut tre retarde par linhibition dIL-1. Ces dcouvertes peuvent avoir dimportantes rpercussions cliniques chez lhumain.
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Se revisan diferentes formas en que la influencia social puede incidir sobre los comportamientos heterosexuales de prevencin de la transmisin del VIH de los jvenes y se presentan los resultados de algunos trabajos de las autoras, as como de otros investigadores, en que se analizan dichas relaciones. Se concluye resaltando: 1) la utilidad clnica de la evaluacin de las expectativas de autoeficacia para poder intervenir especficamente en aquellas reas en que los jvenes se perciban con menores capacidades para ser preventivos, 2) la relacin observada entre el uso de preservativo autoinformado y la creencia en su aceptacin por parte de los referentes sociales ms cercanos y 3) la conveniencia de que los jvenes posean suficientes habilidades de comunicacin que les permitan negociar con xito el uso del preservativo y les ayuden a compensar posibles influencias sociales en contra de su empleo
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Last years UN high level meeting sought to galvanise the international community into scaling up its response to the escalating global burden of non-communicable diseases. With resources tight, D Chisholm and colleagues examine which interventions should be given priority for action and investment
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The armed conflict in Colombia, which has generated over three million internally displaced persons, has dramatic humanitarian consequences and raises serious issues regarding the protection of displaced peoples rights. The underlying reasons for the displacement often lie in the dynamics associated with territorial control and land seizures undertaken for strategic, military or purely economic purposes. Domestic and international legal provisions have established the victims right to the restitution of their homes and property as the preferred remedy in cases of displacement. However, policies dealing with displacement, both those of the Colombian government and of several international institutions, fail to take this sufficiently into account. A comprehensive reparation policy for victims must necessarily entail the reversion of lands, territories and goods seized in Colombia under the pretext of the internal armed conflict.
Resumo:
Objective: To explore and define the utility of different strategies for primary prevention (ASA, diet, physical activity) and strategies of screening test (FOBT, sigmoidoscopy, colonoscopy, etc.) for colorectal cancer. Data source: Databases consulted were MEDLINE (1966 to 2006), DARE (1980 to 2006), Cochrane Central Register of Controlled Trials, Cochrane Collaborations Registry of Clinical Trials, Cochrane Database of Systematic Reviews and LILACS. Study selection: Studies such clinical trial, cohort and case-control studies of the effectiveness of tests for screening and primary prevention adenoma and colorectal cancer were identified by two reviewers. Data Extraction: The extraction of data and its evaluation is done in most of the process so paired. Limitations: Not strictly complies with the methodology of a systematic review and therefore reproducibility is questionable, the conclusions of this study should be extrapolated with caution. Conclusions: The major strategy of screening on the effectiveness of early detection of premalignant lesions or cancer is colonoscopy every 5 years, however it is necessary to evaluate this measure cost-effectiveness studies. For primary prevention, aspirin and cyclooxygenase-2 inhibitors reduce the incidence of colorectal adenomas. Aspirin can reduce colorectal cancer incidence. However, these medications may be associated with a significant risk of cardiovascular events and gastrointestinal bleeding. The balance between risks and benefits must be evaluated in future studies.
Resumo:
The object of this experience is to offer the students the opportunity to take part in the construction of a pedagogic strategy centred on the ludic, for the promotion of the integral health and the prevention of the disease with an educational community; directed to supporting and qualifying the well-being so much individually as group. The project is designed to five years, about interdisciplinary character (Speech Therapy, Medicine, Psychology, Nursery, Occupational Therapy), interinstitutional (Universidad del Rosario, Universidad de San Buenaventura y Universidad de Cundinamarca) and intersectorial (Education and Health). It considers the different actors of the educational community and school and the home as propitious scenes for the strengthening potential, beside being the fundamental spaces for the construction of knowledges and learnings concerning the integral health. To achieve the target, one has come constructing from the second semester of 2003, one pedagogic strategy centred on the ludic and the creativity, from which they are planned, they develop and evaluate the actions of promotion of skills, values, behaviors and attitudes in the care of the health and the prevention of disease, orientated to the early, opportune and effective detection of risk factors and problematic of the development that they affect the integral health. The above mentioned strategy raises a so called scene Bienestarpolis: A healthy world for conquering, centred on prominent figures, spaces and elements that alternate between the fantasy and the reality to facilitate the approximation, the interiorizacin and the appropriation of the integral health. Across this one, the children motivated by the adults enter an imaginary world in that theirs desires, knowledges and attitudes are the axis of his development. Since Vigotsky raises it, in the game the child realizes actions in order to adapt to the world that surrounds it acquiring skills for the learning. The actions of the project have involved 410 children and 25 teachers, of the degrees Zero, The First and The Second of basic primary; 90 parents of family, and an average of 40 students and 8 teachers of the already mentioned disciplines.
