Science topic

Preventive Medicine - Science topic

A medical specialty primarily concerned with prevention of disease (PRIMARY PREVENTION) and the promotion and preservation of health in the individual.
Questions related to Preventive Medicine
  • asked a question related to Preventive Medicine
Question
5 answers
Sepsis is a pervasive problem in hospital and other care facilities that causes an alarming amount of preventable deaths. Please review the attached document for more information on this problem to generate awareness and develop more scientific interest in eliminating the problem.
Relevant answer
Answer
Thank you, @ ,Beth Ann Fiedler ,Beth Ann Fiedler your information on this life-threatening emergency in developed and developing countries is apt. The threat of antimicrobial resistance in developing countries and upsurge of patients with pneumonia, UTI, malnutrition, immunodeficiency related diseases just to mention but a few coming down with sepsis is alarming. Sepsis is an important public health challenge, therefore creation of massive awareness Campaign on sepsis, and partnership with public health professionals, clinical experts, patient's advocacy groups and the public will cause more people to survive sepsis or avoid it entirely.
  • asked a question related to Preventive Medicine
Question
1 answer
I always read "the higher the score the better the health", however, it seems to me that it is not true by the way the two summary measures are constructed. Or maybe - highly plausible - I am missing something.
Following "Ware, J. E., Keller, S. D., & Kosinski, M. (1995). SF-12: How to score the SF-12 physical and mental health summary scales. Health Institute, New England Medical Center" and the Appendix in "González-Chica, D. A., Dal Grande, E., Bowden, J., Musker, M., Hay, P., & Stocks, N. (2017). Are we reducing the risk of cardiovascular disease and improving the quality of life through preventive health care? Results of a population-based study in South Australia. Preventive medicine, 99, 164-170." consequently, I can assume that the "healthiest" individual will get PCS= 56.57706 and MCS= 60.75781 since, for each item, indicator is not created for the response choice indicating the better health, thus s/he will have all the weights multiplied by zero and then the summary measures will coincide with the constant .
A second individual "less healthy", may have, however a higher PCS or MCS if, for instance, has for all the items the healthier answer except for one item (so all the weights will be multiplied by zero but one, assume MH3_1). This individual will have PCS = 3.46638 + 56.57706 .. Higher than the former individual the "healthiest" one .
Relevant answer
Answer
Theoretically that could happen. However most weights are negative So it would require many indicators to be at highest healthy category and one of the others to be not at highest but with a positive weight to get a score above the constant..
  • asked a question related to Preventive Medicine
Question
109 answers
Dear all
In this situations of carona pandemic what would be the role of Nutrition and nutritionists to combat this ?? Plz enlight if some approches can be made??
Relevant answer
Answer
may be the nutritionist can be help to formulated best formula for optimize the immune system.
  • asked a question related to Preventive Medicine
Question
103 answers
Does temperature have a role in control of viral transmission
Relevant answer
Answer
There is no established correlation between the variations in temperature and spread of coronavirus (COVID-19).
  • asked a question related to Preventive Medicine
Question
9 answers
Right now I'm working on Salvia Sclarea. But we can't get root cultures from 'em. Every time we try it, at first my protocol doesn't work but secondly cultures are getting rotten so easily. What can I add to the medium to prevent from that? Thank you!
Relevant answer
Answer
Add indole -3 -butyric acid for in vitro rooting, also add phluoroglucinol to the cultures and keep your cultures in dark conditions for continuous rooting. If your aim is to production of secondary metabolites from root cultures, You can opt hairy root cultures with the help of Agrobaceriun rhizogenes and do precursore feeding of various amino acids like Tryptophae . To prevent decay to roots please add antioxidants such as citric acid, ascorbic acid, PVP etc, many researchers also reported the application of silver thiosulphate. Regards: Mafat
  • asked a question related to Preventive Medicine
Question
5 answers
In noticing the amount of products that contain calcium, as well as that calcium is easily purchased by the ton as a food additive, I began to wonder if the calcium oxide in the hot chocolate that I drink was making more cracks in my back when I do yoga. Our skeleton is known to dissolve a little bit during exercise and I wonder if diets high in calcium and low in exercise may have something to do with the high incidence of arthritis.
Relevant answer
Answer
Extra calcium will be deposited almost every tissues in the body and damages considerably but most dangerous is renal (kidney) calcinosis which progresses almost without any sign and symptom until terminal kidney failure.
  • asked a question related to Preventive Medicine
Question
29 answers
Historically, countries around the globe have spent more on healthcare than on preventive population health through investments in public health infrastructure. These spending patterns still persist.
Do you think it is the time for governments to put more financial resources into preventive care so that most people do not experience preventable illness?
Relevant answer
Answer
Gulzar - the answer is 'of course'. This has been the case for several decades. The paradigm change has been called for - for decades. Acute, medical services are often reactive, expensive and, while benefiting the individual, often do little for community health and development overall. The Ottawa Charter's main aim of 're-orientating health services' has championed this reform and change in direction since the mid-80s - but this has not occurred wholesale. The problem being is that health promotion is at the behest of political agendas. Public health and its underpinning health policy (aligned to preventative healthcare) requires long-term planning and resourcing - and evaluation of success is often the same. Political parties are reluctant to commit to long-term planning and resourcing (let's say 10-year plans) because they may only be in power for a few years. They are far more inclined towards shorter-term outcomes i.e. acute, medical care outcomes i.e. reduced waiting times in hospitals - that are supported by short-term medical research measurements. Compounding this is that there are different forms of public health i.e. highly medicalised that are little different to acute services - through to chronic health models (self-management) through to 'up-streaming' population health.
I asked a question on RG 6-years ago on the difference between health promotion and health education. It is still an active thread - and has had over 530 answers and over 43,000 reads. Much of the content covers this 'tension' around reactive and preventative health reform.
  • asked a question related to Preventive Medicine
Question
13 answers
Successful and advanced preventive medicine depends on availability of accessible, correct information, which represents a defined point of time and collected from different resources. This usually requires working with huge numbers and data specially when it deals with communicable disease control and surveillance systems.
So the question is: Can using computers and new information knowledge, equipment and software systems truly improve the quality of services provided to the community and eventually enhance better health status ?
Relevant answer
Answer
The effectiveness of HIS for prevention depends not only on the actual performance of caregivers (in terms of their awareness of the importance of prevention) but also on the cultural context in which care is given. Patients with poor self efficacy and a low level of support by their peer group, and caregivers who see patients as passive objects rather than active subjects of their health maintenance can ruin the preventive instruments built into a HIS.
  • asked a question related to Preventive Medicine
Question
7 answers
Hello, everyone,
My name is Asahi Hishida, MD, PhD, MPH, a senior assistant professor of Dept. of Preventive Medicine, Nagoya University, Japan.
We are now working on the imputed GWAS data (imputed based on 1000G P3 using Minimac3) from one of the Japan’s largest genome cohort studies GWAS data (The J-MICC Study: http://www.jmicc.com/en/).
I posted this question today because I tried running your DosageConverter with my imputed GWAS file, and encountered the following error:
“Variant [1: xxxx] does not have R2 in the INFO column, although it is NOT GENOTYPED_ONLY!”
Here I have one question: it seems that our .vcf file doesn’t have R2 column as the software points out; can we solve this problem by adding the "Info" file of Minimac3, or are there any other problems or solutions?
We are now planning to build up our pipelines for gene-environment interaction analysis by using ProbAbel (http://www.genabel.org/packages/ProbABEL), and thus may need to convert our Minimac3 imputed GWAS.vcf files to MACH formatted files.
We appreciate if any experts related to this field could kindly give us any clues/solutions for this issue.
All the Best,
Asahi
Relevant answer
Answer
Thank you so much. I will try that and keep you posted. The trouble with proceeding with the dosage files is that I cannot manage to perform any quality filtering on them using plink. I use plink 1.9 and most of the quality filters like (maf/hwe/geno) do not work on a dosage file input. They need a .ped file as the input. My work around was to first convert my imputed vcf to a plink ped file, perform the filtering and then reconvert to a .vcf file format and run the dosage convertor tool. But then it showed the R2 column missing errror. But I think if I regenerate the .vcf files with the --recode-INFO-all option it will allow me to run them through the dosage convertor. Thank you for all your help. I really appreciate it.
Dnyanada
  • asked a question related to Preventive Medicine
Question
73 answers
Ayurveda, the ancient Indian System of Medicine based on the philosophy of total health and wellness is a science of life with a holistic approach considering physical, psychological, philosophical, ethical, and spiritual aspects of healthcare. Ayurveda is a very logical science based on basic scientific principles. The ancient wisdom of Ayurveda is based on time-tested theories proven by observation, trial and error and experimentation. Like most traditional medicine systems, it was developed and refined over thousands of years, using observation and experience. Ayurvedic therapies have been practiced for thousands of years much before the development of placebo controlled experiments. The science of Ayurveda does not only depend upon the symptoms but believes in a thorough examination to discover the root cause of the ailment and instead of suppressing the symptoms, Ayurvedic therapy focuses on finding the reasons for the underlying symptoms. Despite lack of much clinical research on Ayurveda, many of the system’s principles and practices are now recognized and used in conventional medical settings. Herbs used in Ayurvedic medicine, such as tumeric, ginger, and neem, are now recognized as beneficial for heart health and as antioxidant-boosters. There are many evidences, which support Ayurveda performances better than Western medicine, mainly in case of chronic diseases. In retrospection of these facts, do Ayurvedic medicines need modern scientific scrutiny and validation?
Relevant answer
Answer
No, there is no need to test ayurvedic medicines scientifically as Ayurveda is a 5,000 year old science.
  • asked a question related to Preventive Medicine
Question
3 answers
Nurse practitioners and physician assistants hold an important place in the healthcare system. Both nurse practitioners and physician assistants routinely serve the primary and preventative care needs of the patients.
Can a nurse practitioner do as a physician assistant if it is necessity? If not, why?
Relevant answer
Answer
Maybe this link could be interesting and useful for you.
  • asked a question related to Preventive Medicine
Question
4 answers
I am a WASH and urban development specialist living and working in East Africa. I am attempting to scope out “temporary” solutions to sanitation and waste challenges in large unplanned settlements in Dar es Salaam and Nairobi and am looking to receive feedback/critique/advice. I understand these solutions do not sound politically/technologically correct, but with local resource limitations, I seek to identify low-cost, non-motorised and intuitive methods that can be implemented quickly on the ground.
I am interested in what role a mix of powder soap, sand and ash could play in enabling schools to supply affordable options to their pupils to wash their hands. This is already a common practice in East Africa, but it is unclear what the optimal mix/composition of these three items should be. Does anyone else have recommendations on the optimal composition or an alternative item, that is free/locally sourced that could be mixed?  
Relevant answer
Answer
Dear Joshua,
A mixture of ash and soap may not produce the lather that is required to clean hands whereas a mixture of sand and soap may act well in removing dirt and probably germs...it has been used in Kenya for cleaning of hands among the mechanics/those who repair motor vehicles specifically to remove oil and grease from their hands. i am not sure about the scientific benefit of the same but you may test its efficacy. Soapy water ( a mixture of powdered soap+ water) is very common in Kenya and has been promoted as an alternative to sustaining soap provision in schools. you can read the following article for more information;
  • asked a question related to Preventive Medicine
Question
2 answers
Have you ever heard of medical or paramedical operators who are performing heart ultrasound scan ? I search about the best postures they can hold during this kind of medical exams ? Do you know of any survey ?
Relevant answer
No experiance 
  • asked a question related to Preventive Medicine
Question
4 answers
Aging is the natural process our bodies go through. Old people have many difficulties in their life. How can we delay the aging complications by a preventive nursing?
Relevant answer
Answer
Since aging is a life process that we cannot avoid, yes we can delay it. The most important thing to understand that is one need to implement the delaying acts while one is still young, so as to stay younger for longer. The following are the most effective ways of delaying the effects of aging:
1. Ensure that you eat nutritious diet that has less sugar, less fat and more protein
2. Moderate regular exercise. Do not strain your body
3. Strive to increase your knowledge. Learning something new keeps your mind active just as the exercise does to your body. Read a book or read it to some one.
4. As you get older try to be as independent as possible. Do things for yourself, this will increase your sense of self worth.
5. Interact with people that are positive and can bring the best in you. You also need to stay positive. Go out with friends 
6. Play games that are mind stimulating, such as chess, 30 seconds, scrabble etc. Pay attention to everything in your day, and in the evening try to recall what happened in the morning during the day and so forth.
All this can be applied to nursing an old person.
  • asked a question related to Preventive Medicine
Question
1 answer
I am just wondering if there have been any further developments since this paper, as this is fascinating and highly applicable on a population level.
Relevant answer
Answer
You can look in Social Science/Science Citation Index to find out who has cited this paper.  You can also do a bibliographic search for each author to find out if they have done anything further.
  • asked a question related to Preventive Medicine
Question
1 answer
I need some help in designing as better survey methodology to assess the Nutrition of Pregnant women
Relevant answer
Answer
It would be helpful to briefly describe the survey methodology you are trying to improve as well as how you will use the data.  There many good survey methods for assessing nutrition depending on what you want to know.  You can use diaries, frequency questions, pictorial scales, etc. 
  • asked a question related to Preventive Medicine
Question
2 answers
The fierce controversy now is that there should have been a wet lab experiment component to investigate the fate of donated anti-malaria drugs.
Relevant answer
Answer
Do you mean that the effect of the donated drugs on individuals who received them should have been measured?  Or do you mean there should have been a laboratory experiment with donated drugs?  Or do you mean that there should have been a measure of whether the drugs were actually used?
  • asked a question related to Preventive Medicine
Question
5 answers
Primary care environment to prevent depression from opportunistic approach. What is the quality of life implication of that?
Relevant answer
Juan, caro, permítame compartir con usted algunos enlaces que nos han guiado acá en Brasil sobre el tema:
  • asked a question related to Preventive Medicine
Question
5 answers
I am a current MD/PhD student and enjoy doing database research (basic stats, writing, editing, literature review, etc) and have used various databases to work from. 
I would love to speak with experts in the field who do preventive medicine or primary care research and are looking for additional help or just even someone to speak with. 
Relevant answer
Answer
I am working in preventive health care. I need to write a journal article. I have no stats skills myself or in any team member.
  • asked a question related to Preventive Medicine
Question
1 answer
The ambiguity and variability in existing literature on the magnitude of socio-economic inequality in self-reported morbidities makes it difficult to set priorities in health policies.
Relevant answer
Answer
Policy makers worth their salt would be able to MAKE SENSE  out of the SO CALLED ambiguity and variability in existing literature on the magnitude of socio-economic inequality in self-reported morbidities ; also THE constitutional obligation of the govt. concerned would also guide policy making ( as also will the political compulsions)
  • asked a question related to Preventive Medicine
Question
2 answers
Especially when using SPSS
Relevant answer
Answer
Kaell,
Thanks for the resources. It is a good starting point.
  • asked a question related to Preventive Medicine
Question
3 answers
The primary reason for tension headache is the exertion in the masticatory muscles. NTI appliances are contemporary devices for alleviating tension in the masticatory muscles and are very popular among the clinicians mostly because of the elaborate marketing propaganda. The stabilization splints are old fashioned appliances for treatment of tension in the masticatory muscles and have proven to be very effective. The NTI appliance is easy to use and requires little readaptation, the stabilization splint requires regular readjustments. The NTI appliances are factory made while the stabilization splints are manufactured individually for each patient.
Relevant answer
Answer
Please see my attachment. Thank you.
  • asked a question related to Preventive Medicine
Question
29 answers
In operations management, business organizations offer either product or service. Can we consider healthy practices as non-product medicine?
Relevant answer
Answer
If food is medicine, then healthy food, exercise and fresh clean air and water may be regarded as 'medicine' in that they contribute to health.  I am reminded 'Let thy food be thy medicine.'
  • asked a question related to Preventive Medicine
Question
35 answers
I need a simple protocol that can be used in large populations
Relevant answer
Answer
there is no test to prevent falls. there are plenty to differentiate fallers from non fallers. but you have exercises and rehab technics to reduce the risk of falling. and finally the best one is still to exercise regularly for general population. Falls according to some specific condition is a different situation which needs some disease driven therapy by physiotherapist.
  • asked a question related to Preventive Medicine
Question
11 answers
Computer vision syndrome (CVS) is a temporary condition resulting from focusing the eyes on a computer display for protracted, uninterrupted periods of time. Some symptoms of CVS include headaches, blurred vision, neck pain, redness in the eyes, fatigue, eye strain, dry eyes, irritated eyes, double vision, vertigo/dizziness, polyopia, and difficulty refocusing the eyes. These symptoms can be further aggravated by improper lighting conditions (i.e. glare  or bright overhead lighting) or air moving past the eyes (e.g. overhead vents, direct air from a fan). [Source: Wikipedia]
With the increasing access to digital devices, Computer Vision Syndrome is becoming a common ailment
Nowadays ours eyes do not get adequate rest as most of the time we are either on our computer, laptop, i-pad, mobile or watching television. Eye strain caused by excessive use of computer is called Computer Vision Syndrome or digital vision syndrome. It manifests as tiredness, inability to work for long hours, blurring of vision, double vision, watering, redness, itching and pain in eyes. These symptoms will be present in 95 per cent of people who use the computer for more than three hours a day.[Source: The Hindu]
Some Excerpts from the second article:
What To Do
Posture and Exercises
Good posture and regular exercises of back and cervical muscles are a must if you use the computer for more than three to four hours a day.
Lighting
The room should be well illuminated with the light source positioned in a way that light does not fall directly on your eyes or on the screen The light source should be behind the screen or on the ceiling and partially covered. anti-glare screens and spectacles can also help.
Dryness
Normally we blink 10 to 12 times a minute. When we watch TV our blink rate is 5 to 6 a minute and while working on the computer it further goes down to 3 to 4 times a minute. Reduced blinking causes evaporation of tears thereby increasing the osmolarity (concentration) of the tears. The hyperosmolar tears induce inflammation and tear film instability which in turn cause increase reflex lacrimation. In other words, the dry eye caused by Computer Vision Syndrome may present not only as dry eye but may present as watering and inflamed eye.
To overcome this, it is better to have the computer screen 20 to 40 degrees below the eye level. This causes partial closure of the eyes by the lids thereby decreasing the evaporative surface.
Your comments and views are welcome. Muchas Gracias !!
Relevant answer
Answer
According to the National Institute of Occupational Safety and Health, CVS affects approximately 90% of the people who spent three hours or more at day looking at a computer. The lighting, air quality, and the time spent focusing on a screen are the main factors that could bring about CVS. Taking breaks by closing your eyes or focusing on objects far away could help give the overused muscles a necessary time out. If giving your eyes a little breather is hard to remember you could set a reminder or timer. Some other variables to consider that could contribute to eyestrain is the environment.  If the room is really bright you could consider tinted glasses or maybe a certain pair of glasses just for computer use. If there is a lot of airflow that is drying out your eyes, some lubricating eye drops might help. Also make sure your settings are so that the font and screen lighting can be read with ease.
  • asked a question related to Preventive Medicine
Question
2 answers
See above.
Relevant answer
Answer
Dear Harriet, 
There are many resources available for individuals which are deaf under the IDEA legislation. ,I would recommend reviewing the legislation to determine what accommodations health care facilities have related to individuals which are deaf.  It is important to remember they are  hearing impaired and not blind so they can still read and understood the content of what is being stated.  I would recommend looking at the policies and then interviewing a couple of health care provided to determine what is in place.  You might want to visit http://www.ncdhhs.gov/dsdhh/
Michele
  • asked a question related to Preventive Medicine
Question
4 answers
The SCORE tables for the year 2011 only based on total cholesterol (and other risk factors) despite recognizing the huge impact of the concentrations of HDL in cardiovascular risk estimation. Moreover, for a given concentration of total cholesterol, LDLc calculation (therapeutic target) can change greatly depending on the concentration of HDL in the time.
Relevant answer
Answer
Juan, you can find the SCORE charts with HDL-C at the ESC website: HeartScoreW. The interactive tool for predicting and managing the risk of heart attack and stroke [Internet]. European Society of Cardiology. Available at: http://www.heartscore.org/Pages/welcome.aspx
The following paper has used and cites these charts: Brotons C, et al. Rev Esp Cardiol. 2014;67(2):94–100.
Best wishes,
Emilio Ros
  • asked a question related to Preventive Medicine
Question
14 answers
It is well understood that mosquitos lays eggs in stagnant water, I wonder if it can use wet surfaces for their reproduction.
Relevant answer
Answer
yes dear pankaj they can very well lay eggs on wet filter papers. i have used wet sterile whatman filter paper no 1 for egg laying by gravid anopheline females in test tubes or small bowls. you can try it but keep the tubes in a dark room and use loose cotton plugs to block the entrance of test tubes.
  • asked a question related to Preventive Medicine
Question
68 answers
Reducing Uric acid.
Relevant answer
Answer
Citric acid is the best remedy to lower Uric acid levels. I have tried this on many patients and there were best results. For the purpose, a person suffering higher levels of uric acid may take lime juice in warm water frequently during the acute problem, regular intake will help in chronic situation also.
  • asked a question related to Preventive Medicine
Question
3 answers
I am very interested in the reasons of preference for particular theoretical models /(combination of) theories in carrying out research on lifestyle counseling given by PCPs/ practice nurses/dieticians.
Relevant answer
Answer
In response to Nidal, I would suggest more contemporary models than the Health Belief Model, which has largely fallen out of usage in favour of models which consider other additional factors and their inter-relationships.
  • asked a question related to Preventive Medicine
Question
2 answers
Which tools and messages had you used and do you have a report of the process or the results?
  • asked a question related to Preventive Medicine
Question
5 answers
In my mind intestinal health plays a major role in Acidic disorders of the Stomach.
Relevant answer
Answer
Sure, for example spicy food can aggravate peptic ulcer disease.
  • asked a question related to Preventive Medicine
Question
1 answer
Using general theories from social science and medical science I want to work on a nursing research that could explore the relationship of disrupted circadian rhythm of shift workers in the Philippines and the interrelated factors that could increase the risk of having cardiovascular disease.
Relevant answer
Answer
Did you check the relevant literature first? I made some research in the past (sytematic Medline search) and I have not found any relationship of desynchronised circadian rhythm on cardiovascular risk. There was some evidence of risk of breast cancer or even obesity. That was 2 years ago though and I searched only Medline, systematically, but still.
  • asked a question related to Preventive Medicine
Question
4 answers
I am thinking of starting the tobacco cessation program that encourages the people to quit smoking and also help the person who wants to quit. In our country there are lots of rehabilitation centers for alcohol and other drugs but not a single clinic for tobacco cessation.
Can anybody suggest me some prototype of this kind of program so I can replicate it in my country or any program who will be interested in helping to establish such program in a resource poor country like mine?
Relevant answer
Answer
This new July 31, 2013 U.S. Gallup poll may be of interest to you, Dipesh. It looks at successful recovery from the the ex-smoker's perspective. It does so by asking the open-ended question, "Trying to be as specific as possible, what strategies or methods for quitting smoking were most effective for you?" While nearly half credit cold turkey, another 25 percent or so provide responses that fall within the historic yet evolving definition of "cold turkey," abrupt and complete drug cessation, without resort to cessation products or procedures.
Link to extracted Gallup table showing effective strategies: http://whyquit.com/studies/Gallup_Poll_July_2013.html
GSK, Pfizer and J&J would love for you to build your program around approved quitting products, GSK has spent billions over the past 39 years marketing and using its influence to make Nicorette a cornerstone of U.S. cessation policy yet, Yet, according to this poll only 1 percent of successful quitters credit nicotine gum for their success. I'm left wondering the percentage of that 1 percent who were still hooked on the cure, and whether any smoker has ever arrested their brain's dependence upon nicotine by continuing to replace it.
"Group pharma think" will encourage you to recommend costly approved products having 8-12 week treatment periods before product use ends and your program's participants attempt to adjust to natural brain dopamine pathway stimulation. The beauty of abrupt cessation education, counseling and support programs is that within 72 hours of ending use, participants both inhabit nicotine-free bodies and move beyond peak withdrawal.
Effective abrupt cessation programs provide intense up-front education and support during those first 3 critical days, keeping every participant on the exact same recovery page (ending all use at the first session). Joel Spitzer's 13 day programs always started on a Tuesday, with the first two-hour group session running a bit long. Participants returned for additional 2 hour sessions on Wednesday, Thursday and Friday and Monday, with graduation the following Monday (day 13). It allowed them to move beyond peak withdrawal prior to the weekend, with greater likelihood of alcohol use. It also forces almost immediate extinction of work related use cues,
Providing telephone support between sessions, with program content as presented in Joel's Library (http://whyquit.com/joel/) , at a very minimum you should expect at least 50 percent of participants to remain 100 percent nicotine free and graduate on day 13. Six month continuous cessation rates (not one puff) should never fall below 30 percent. If your budget allows, Joel discovered that regular follow-up reinforcement letters mailed after graduation, with periodic follow-up telephone calls, can substantially enhance six-month cessation rates (50% is not unusual, again, depending on the quality and intensity of follow-up). This link is to the collection of follow-up letters shared by Joel: http://whyquit.com/joel/#articles Again, if a not-for-profit program you're free to use and share them.
A few lessons I learned the hard way. If any participant relapses, as cold as this sounds, they cannot be permitted to remain in the group, but can attend a future group. Allowing them back will undercut the "same page" recovery and healing dynamics, as the group's focus will turn to the perpetual withdrawal and still complaining user. Also, no breaks during sessions, especially the first. And don't forget to collect all cigarettes at the end of the first session. Make them leave as new ex-smokers.
That first session is the most critical. There, I provide motivation by devoting at least half my time (normally more) to educating them as to how each puff further damages the body, why they need to quit and dependency basics. Accepting that their brain wanting disorder is no different from the wanting felt by other drug addicts greatly simplifies recovery's rules: that one is too many, while thousands never enough.
The second hour is devoted to destruction of false use rationalizations (the biggest being the fraud of "just one" and that nicotine is a stress-buster) and to how to quit. This short video by Spitzer presents his basic tips. At a minimum, each should be briefly reviewed: http://youtu.be/l27zWo7hbcY If desired, you can play any portion of any of Spitzer's nearly 200 videos via a laptop that ties the Internet to a wall projector. YouTube allows you to create links to the exact minute and second of any video that you wish to jump to. You could have pre-established links to every question or concern imaginable. After a few programs the facilitator will likely grow comfortable in sharing the answer themselves.
For example, this link jumps to the 12 minute and 49 second mark of Sptizer's video entitled "Why do smokers smoke?" There, he explains stress induced urine acidification and why smokers falsely believe that smoking is a stress-buster: http://youtu.be/S9AmZiI3rNI?t=12m49s
Dipesh, I sincerely hope you follow through with your dream of helping smokers quit, as the reach of a high quality program pumping out the most dependency recovery savvy ex-smokers your nation has ever seen is no different from the influence of any high quality university.
Again, I'm here and will gladly assist in anyway possible.
Regards,
John
  • asked a question related to Preventive Medicine
Question
13 answers
Several researchers from developing countries are not knowledgeable in Epidemiology and Research Methodology. It will result in a poorly conducted trial. Several important research questions are proved in wrong study designs and analysis.
Relevant answer
Answer
Nowadays, EDX is a pilot program of Harvard University, MIT and Berkerly to explore online education.
We have just finished an excellent course of Biostatistics and Epidemiology directed by Marcello Pagano and Francis Cook (Harvard University).
You can register for free and get another course, wait until this beautiful course (Health in Numbers) is available again, or in two more days will begin a course in Basic Statistic of Berkerley.
I hope this information help you.
  • asked a question related to Preventive Medicine
Question
5 answers
Whether the Medical Associations should focus on the welfare of the people
Relevant answer
Answer
They do focus on welfare. There r many wonderful things that they do. One of which is they run some of world,s most top notch journals. Isnt that a great service?
  • asked a question related to Preventive Medicine
Question
9 answers
Can any one suggest the suitable way to improve adherence for hypertensive medication among people in low resource setting?
Relevant answer
Answer
Using appropriate (i.e easily understood) visual aids, taking the time to explain to patients what hypertension is all about, how it affects them and their functionality and what the drugs do once inside their bodies. Demystifying hypertension and other chronic conditions empowers patients and is the key to participation in their own healthcare.
  • asked a question related to Preventive Medicine
Question
22 answers
I'm curious to know what nutritional and other scientists think about the current focus on vitamin D, the lack of clarity on the clinical determination of adequate vitamin D status, and current gaps in the research on vitamin D status of humans.
Relevant answer
Answer
I agree with what has been said. Although one feels that Vit D tretament is essential in many different clinical conditions there are not many definitive e vidence of its efficacy. The following is some of the literature published on this topic. Vitamin D and in particular its biologically most active metabolite, 1α,25-dihydroxyvitamin D3 (1α,25(OH)2D3), are central endocrine molecules that influence many aspects of human physiology, which are not only the well-known calcium and phosphorus up-take and transport controlling bone formation, but also the control of immune functions and of cellular growth and differentiation. Basically all actions of 1α,25(OH)2D3 are mediated by the transcription factor vitamin D receptor (VDR). The crystal structure of the VDR and detailed knowledge on its molecular interactions with the ligand provide significant insight into the mechanisms of vitamin D signaling. This applies also on the action of the huge number of synthetic 1α,25(OH)2D3 analogues, which have been developed with the goal of a therapeutic application in hyper-proliferative diseases, such as psoriasis, benign prostate hyperplasia and different types of cancer, in immune functions, such as autoimmune diseases and microbial infections, or in bone disorders, such as osteoporosis. Moreover, detailed investigations on many VDR target genes and in particular the recently available genome-wide view on vitamin D signaling allows a more complete view on the potential of the nuclear hormone.
Several studies have shown that vitamin D may play a role in many biochemical mechanisms in addition to bone and calcium metabolism. Recently, vitamin D has sparked widespread interest because of its involvement in the homeostasis of the cardiovascular system. Hypovitaminosis D has been associated with obesity, related to trapping in adipose tissue due to its lipophilic structure. In addition, vitamin D deficiency is associated with increased risk of cardiovascular disease (CVD) and this may be due to the relationship between low vitamin D levels and obesity, diabetes mellitus, dyslipidaemia, endothelial dysfunction and hypertension. However, although vitamin D has been identified as a potentially important marker of CVD, the mechanisms through which it might modulate cardiovascular risk are not fully understood.
Increasing bone mineralization abnormalities observed among people living with HIV (PLWHIV) result from various factors relating to the host, the virus, and the antiretrovirals used. Today, HIV infection is considered to be a risk factor for bone mineralization disorders.
In addition to its role in calcium homeostasis and bone health, vitamin D has also been reported to have anticancer activities against many cancer types, including breast cancer. The discovery that breast epithelial cells possess the same enzymatic system as the kidney, allowing local manufacture of active vitamin D from circulating precursors, makes the effect of vitamin D in breast cancer biologically plausible. Preclinical and ecologic studies have suggested a role for vitamin D in breast cancer prevention. Inverse associations have also been shown between serum 25-hydroxyvitamin D level (25(OH)D) and breast cancer development, risk for breast cancer recurrence, and mortality in women with early-stage breast cancer. Clinical trials of vitamin D supplementation, however, have yielded inconsistent results.
Both in vitro exposure to and chronic in vivo administration of calcitriol enhanced relaxations to acetylcholine and abolished exaggerated endothelium-dependent contractions in renal arteries of normotensive rats pre-exposed to Ang II or harvested from spontaneously hypertensive rats (SHR). Reactive oxygen species levels and expressions of AT(1)R, NAD(P)H oxidase subunits, SOD-1, and SOD-2 in SHR arteries were normalized by the chronic treatment with calcitriol.ConclusionIn vivo and in vitro activation of VDR with calcitriol improves endothelial function by normalizing the expressions of AT(1)R and radical generating and scavenging enzymes and thus preventing ROS over-production. Calcitriol is effective in preserving endothelial function in hypertension.
Data that vitamin D deficiency results in increased risks for asthma and allergies continues to accumulate. However, the optimal level of vitamin D that decreases both the risk for development and severity of these disorders remains elusive.
The majority of patients after allogeneic stem cell transplantation (HSCT) are expected to have vitamin-D deficiency early post-HSCT due to poor nutritional status and limited sun exposure. The importance of vitamin D in the immune system has been well defined over the past several years, as vitamin-D has demonstrated modulatory effects on the immune system through B- and T-lymphocyte, macrophage, monocyte and dendritic cell regulations, which are the effector cells involved in graft-versus-host-disease (GVHD) pathophysiology after HSCT. High dose early replacement of vitamin D might attenuate autoimmune reactions and may decrease the severity of GVHD.
Observational evidence links low maternal vitamin D status with an increased risk of non-bone health outcome in the mother (pre-eclampsia, gestational diabetes, obstructed labour and infectious disease), the fetus (gestational duration) and the older offspring (developmental programming of type 1 diabetes, inflammatory and atopic disorders and schizophrenia); but the totality of the evidence is contradictory (except for maternal infectious disease and offspring inflammatory and atopic disorders), lacking causality and, thus, inconclusive. In addition, recent evidence links not only low but also high maternal vitamin D status with increased risk of small-for-gestational age and schizophrenia in the offspring. Rigorous and well-designed randomised clinical trials need to determine whether vitamin D has a causal role in non-bone health outcomes in pregnancy
Higher insulin, homeostasis model assessment-insulin resistance, and hemoglobin A1c (HbA(1c)) as well as lower quantitative insulin-sensitivity check values were found in obese children with lower 25(OH)D concentrations even after adjustment for gender, age, and body mass index. Furthermore, 25(OH)D correlated significantly with adiponectin, but not with resistin. The results suggest that hypovitaminosis D is a risk factor for developing insulin resistance independent of adiposity.
Hypovitaminosis D is also an environmental risk factor for Multiple Sclerosis.
Clinical trials using these inhibitors are being conducted to determine their toxicity profiles and efficacies. In addition, nutraceuticals (such as isoflavones, curcumin, vitamin D, etc) have been shown to inhibit cancer growth through downregulation of Hh signaling. Expert opinion: Inhibition of Hh signaling is important for suppression of cancer growth, invasion, metastasis and recurrence in cancer therapy.
The incidence of vitamin D deficiency is rising worldwide, yet in the vast majority of patients, the condition remains undiagnosed and untreated. Current evidence overwhelmingly indicates that supplemental doses greater than 800 IU/day have beneficial effects on the musculoskeletal system, improving skeletal homeostasis, thus leading to fewer falls and fractures. Evidence is also accumulating on the beneficial effects of vitamin D on extraskeletal systems, such as improving immune health, autoimmune disorders, cancer, neuromodulation, diabetes, and metabolic syndrome. The cause-effect relationship of vitamin D deficiency with increasing incidences of nonskeletal disorders is being investigated. Published reports support the definition of sufficiency, serum levels of 25-hydroxyvitamin D [25(OH)D] greater than 30 ng/mL (75 nmol/L). To achieve this, most people need vitamin D supplementation ranging from 600 to 2000 IU/day; consumption up to of 5000 international units (IU) per day of vitamin D is reported as safe. Although light-skinned individuals need 1000 IU/day of vitamin D, elderly and dark-skinned individuals are likely to need approximately 2000 IU/day to maintain serum 25(OH)D levels greater than 30 ng/mL. Other vulnerable patients, such as the obese, those who have undergone bariatric surgery, and those with gastrointestinal malabsorption syndromes, may require higher doses of vitamin D to maintain normal serum levels and be healthy.