Integrated disease management

Integrated disease management in organic farming combines the use of various measures. The usefulness of certain measures depends on the specific crop-pathogen combination. In many crops, preventative measures can control diseases without the need of plant protection products. However, for certain disease problems, preventative measures are not sufficient. For example, organic apple production strongly depends on the multiple use plant protection products

Multimodal interventions to enhance adherence to secondary preventive medication after stroke: a systematic review and meta-analyses

Summary: Introduction: Nonadherence to secondary preventative medications after stroke is common and is associated with poor outcomes. Numerous strategies exist to promote adherence. We performed a systematic review and meta-analysis to describe the efficacy of strategies to improve adherence to stroke secondary prevention. Methods: We created a sensitive search strategy and searched multiple electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, CENTRAL, and Web of Knowledge) for studies of interventions that aimed to enhance adherence to secondary preventative medication after stroke. We assessed quality of included studies using the Cochrane tool for assessing risk of bias. We performed narrative review and performed meta-analysis where data allowed. Results: From 12,237 titles, we included seventeen studies in our review. Eleven studies were considered to have high risk of bias, 3 with unclear risk, and 3 of low risk. Meta-analysis of available data suggested that these interventions improved adherence to individual medication classes (blood pressure-lowering drugs – OR, 2.21; 95% CI (1.63, 2.98), [P < 0.001], lipid-lowering drugs – OR, 2.11; 95% CI (1.00, 4.46), [P = 0.049], and antithrombotic drugs – OR, 2.32; 95% CI (1.18, 4.56, [P = 0.014]) but did not improve adherence to an overall secondary preventative medication regimen (OR, 1.96; 95% CI (0.50, 7.67), [P = 0.332]). Conclusion: Interventions can lead to improvement in adherence to secondary preventative medication after stroke. However, existing data is limited as several interventions, duration of follow-up, and various definitions were used. These findings need to be interpreted with caution

Exploring the Feasibility of Incorporating Sexual Education into Routine Adolescent Office Visits

Preventative sexual education can reduce the negative health outcomes of sexual behavior in adolescent populations.1 The objective of this pilot study was to determine if sexual education can be delivered as a scripted five-minute module during a routine adolescent office visit in a manner that is non-disruptive of clinic flow and acceptable to both patients and providers. • 85% of providers reported the intervention did not interrupt clinic flow • 86% of patients reported the intervention to be appropriate and 92% of providers were satisfied overall with the intervention These pilot data highlight that the incorporation of brief scripted sexual education into routine adolescent preventative office visits is both feasible and acceptable to patients and providers.https://jdc.jefferson.edu/cwicposters/1024/thumbnail.jp

Bad news: analysis of the quality of information on influenza prevention returned by Google in English and Italian

Information available to the public influences the approach of the population toward vaccination against influenza compared with other preventative approaches. In this study, we have analyzed the first 200 websites returned by searching Google on two topics (prevention of influenza and influenza vaccine), in English and Italian. For all the four searches above, websites were classified according to their typology (government, commercial, professional, portals, etc.) and for their trustworthiness as defined by the Journal of the American Medical Association (JAMA) score, which assesses whether they provide some basic elements of information quality (IQ): authorship, currency, disclosure, and references. The type of information described was also assessed to add another dimension of IQ. Websites on influenza prevention were classified according to the type of preventative approach mentioned (vaccine, lifestyle, hygiene, complementary medicine, etc.), whether the approaches were in agreement with evidence-based medicine (EBM) or not. Websites on influenza vaccination were classified as pro- or anti-vaccine, or neutral. The great majority of websites described EBM approaches to influenza prevention and had a pro-vaccine orientation. Government websites mainly pointed at EBM preventative approaches and had a pro-vaccine orientation, while there was a higher proportion of commercial websites among those which promote non-EBM approaches. Although the JAMA score was lower in commercial websites, it did not correlate with the preventative approaches suggested or the orientation toward vaccines. For each of the four search engine result pages (SERP), only one website displayed the health-of-the-net (HON) seal. In the SERP on vaccines, journalistic websites were the most abundant category and ranked higher than average in both languages. Analysis using natural language processing showed that journalistic websites were mostly reporting news about two specific topics (different in the two languages). While the ranking by Google favors EBM approaches and, in English, does not promote commercial websites, in both languages it gives a great advantage to news. Thus, the type of news published during the influenza season probably has a key importance in orienting the public opinion due to its high visibility. This raises important questions on the relationships between health IQ, trustworthiness, and newsworthiness

Preventative therapies for healthy women at high risk of breast cancer

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Naturopathic Physician Attitudes and Practices for Vaccination and Primary Care in the State of Vermont

Introduction: Recent increase in measles cases has sparked vaccination controversy. Naturopathic physicians (NDs) have been recognized as primary care providers by VT since 2012. It is not well understood how NDs address vaccination with patients. Our goal was to determine how Vermont NDs address vaccines and preventative care with their patients.https://scholarworks.uvm.edu/comphp_gallery/1234/thumbnail.jp

Traffic Control for Network Protection Against Spreading Processes

Epidemic outbreaks in human populations are facilitated by the underlying transportation network. We consider strategies for containing a viral spreading process by optimally allocating a limited budget to three types of protection resources: (i) Traffic control resources, (ii), preventative resources and (iii) corrective resources. Traffic control resources are employed to impose restrictions on the traffic flowing across directed edges in the transportation network. Preventative resources are allocated to nodes to reduce the probability of infection at that node (e.g. vaccines), and corrective resources are allocated to nodes to increase the recovery rate at that node (e.g. antidotes). We assume these resources have monetary costs associated with them, from which we formalize an optimal budget allocation problem which maximizes containment of the infection. We present a polynomial time solution to the optimal budget allocation problem using Geometric Programming (GP) for an arbitrary weighted and directed contact network and a large class of resource cost functions. We illustrate our approach by designing optimal traffic control strategies to contain an epidemic outbreak that propagates through a real-world air transportation network.Comment: arXiv admin note: text overlap with arXiv:1309.627

Emerging needs in behavioral health and the integrated care model

Medically vulnerable populations are constantly at risk of having poor health related outcomes, low satisfaction in the healthcare system and increased mortality. Studies have shown the increased prevalence rates of various medical comorbidities in patients with severe mental illness. These patients are obviously vulnerable because of their mental illness but they are also more likely to have severe cases of medical conditions commonly seen in the general population. Expenditures and utilization of resources is often inappropriate due to frequent visits for acute needs and low rates of preventative care and primary care appointments. My proposed model focuses on the implementation of the integrated care model which encourages collaboration between mental health professionals and primary care physicians through referral programs or integrated clinic settings. This model is initiated with education to both current clinicians as well as future clinicians through medical schools and residency programs. Once the education component has begun, the next steps are formal exploration, preparation, implementation and evaluation of the model in clinics. The aim is to improve health outcomes by increasing preventative care and using behavioral techniques to assist with adherence, increase satisfaction in the healthcare system and contain expenditures by utilizing primary care services instead of emergency services when appropriate