Community-Based Strategies to Reduce Alzheimer's Disease and Related Dementia Incidence Among Rural, Racially/Ethnically Diverse Older Adults.

Purpose of Review: The purpose of this paper was to address the research question "What recent advances in Alzheimer's Disease and Related Dementias (ADRD) risk reduction strategies can be tailored for rural, racially/ethnically diverse populations?" A rural resident's life story that grounded the work is shared. Next, a brief description is provided regarding ADRD risk factors of importance in rural, multicultural settings. Gaps in U.S.-based research are highlighted. Policy actions and interventions that may make a difference in alleviating rural, ADRD-related disparities are offered. Recent Findings: More than a dozen factors, including lack of built environment, periodontitis, poor air quality, and sensory loss, were identified that are of particular relevance to rural groups. Evidence of importance to underserved residents has also emerged regarding the harmful effects of ultra-processed foods on brain health, benefits of even minimal physical activity, and importance of social engagement, on brain health. Summary: Resident-led initiatives will be key to creating change at the community level. Health providers are also called to assist in identifying and adapting culturally specific upstream approaches, in partnership with community stakeholders. These mechanisms are vital for decreasing ADRD burdens in underserved communities facing the largest disparities in preventive care.

Prevención cuaternaria desde la visión odontológica / Quaternary prevention from a dental point of view

Introducción: El personal de salud debe comprender que el paciente es la figura central en el proceso salud-enfermedad, por lo que, para pro- teger su salud y atender de manera eficaz la enfermedad, se debe partir desde los principios básicos de prevención. La frase «prevenir es mejor que curar¼ debe ser considerada una máxima en salud y una metodología para atender enfermedades desde factores de riesgo, hacer partícipe a los pacientes y a la población en general a llevar a cabo estilos de vida saludables, con actividades preventivas que incrementen su importancia en la atención médica. Conclusiones: La prevención cuaternaria es una forma nueva para llamar al viejo principio de la medicina «lo primero es no hacer daño¼, que da origen al principio bioético de la no male- ficencia, este concepto se refiere a todas aquellas valoraciones que se deben hacer ante cualquier tipo de intervención diagnóstica, terapéutica y preventiva. Esto tiene especial importancia en la población sana, en la cual la prevención será siempre la mejor herramienta, pero se debe siempre tener presente la prevención cuaternaria (AU)

Introduction: Health personnel should understand that the patient is the central figure in the health-disease process and that to protect their health and effectively treat the disease starting from the basic principle of prevention. The phrase «prevention is better than cure¼ from being considered a maxim in health and a methodology to address diseases from risk factors, involving patients and the general population to carry out healthy lifestyles, with preventive activities that increase its importance in medical care. Conclusions: Quaternary prevention is a new way to call the old principle of medicine «first do no harm¼, which gives rise to the bioethical principle of non-maleficence, this concept refers to all those assessments that should be made before any type of diagnostic, therapeutic and preventive intervention. This is especially important in the healthy population, in which prevention will always be the best tool, but quaternary prevention should always be kept in mind (AU)

Integrative prevention and coordinated action toward primary, secondary and tertiary prevention in workplaces: A scoping review.

BACKGROUND: Integrated approaches are valued in several occupational health strategic programmatic orientations. A better understanding of the use of integrative prevention in coordinating measures is needed to develop its use in workplaces. OBJECTIVE: Identify workplace integrative prevention approaches and definitions of prevention (primary, secondary and tertiary) in the literature. METHODS: A scoping review was conducted following Arksey and O'Malley (2005). The literature search was carried out in three databases without date restrictions. In order to be retained, the articles needed to address at least two levels of prevention using an integrative approach in a workplace setting. A qualitative analysis was conducted. RESULTS: The review yielded 16 published articles between 1995 and 2017. The articles addressed mental health, musculoskeletal disorder prevention and comprehensive approaches. Integrative prevention approaches are diverse and are not always named as such. Prevention definitions are not homogenous. CONCLUSIONS: This review identified some of the integrative prevention characteristics aimed at coordinated action for prevention in the workplace and to clarify measures taken at different levels of prevention. Further studies are needed to elaborate on the implementation of integrative prevention in the workplace.

Mitigating the Risk of COVID-19 Deaths in Cardiovascular Disease Patients in Africa Resource Poor Communities.

The novel coronavirus disease 2019 (Covid-19) pandemic has affected millions of patients in almost all countries with over one million cases recorded in Africa where it is a major health challenge. Covid-19 is known to have significant implications for those with pre-existing cardiovascular disease (CVD) and their cardiologists. Patients with pre-existing CVD are at increased risk of morbidity and mortality from Covid-19 due to associated direct and indirect life threatening cardiovascular (CV) complications. Mitigating the risk of such Covid-19 deaths in resource poor communities requires the institution of preventive measures at the primary, secondary and tertiary levels of preventive phenomenon with emphasis at the first two levels. General preventive measures, screening and monitoring of CVD patients for complications and modification of drug treatment and other treatment methods will need to be implemented. Health policy makers and manager should provide required training and retraining of CV health care workers managing Covid-19 patients with CVD, provision of health education, personal protective equipment (PPE), and diagnostic kits.

An Evidence-Based Strategic Approach to Prevention and Treatment of Dry Eye Disease, a Modern Global Epidemic.

Dry eye disease (DED) is an emerging health concern causing significant visual, psychological, social, and economic impact globally. In contrast to visual rehabilitation undertaken at late stages of DED, measures instituted to prevent its onset, establishment, or progression can alter its natural course and effectively bring down the associated morbidity. This review attempts to present the available literature on preventive strategies of DED at one place, including strategies for risk assessment and mitigation, targeting a wide range of population. A literature search was conducted using PubMed and an extensive literature review on preventive strategies for DED was compiled to put forth a holistic and strategic approach for preventing DED. This can be undertaken at various stages or severity of DED directed at different tiers of the health care system. Conclusion: This review intends to put emphasis on preventive strategies being adopted as an integral part of routine clinical practice by general ophthalmologists and specialists to tackle the burden of DED and improve the quality of the lives of the patients suffering from it.

Quinary Prevention and Bariatric surgery.

Obesity is a major pandemic with significant clinical and public health implications. Surgical modalities have emerged as an important means of treating obesity. Lack of awareness about the utility of other therapeutic options, and about the limitations of bariatric surgery, may lead to misuse of these interventions. This article describes quinary prevention in the context of bariatric surgery, i.e, the need to dispel misinformation, and promote accurate knowledge of the procedures. Optimal quinary prevention will help utilize this useful treatment modality, to ensure better outcomes in obesity management.

The case for implementing the levels of prevention model: Opiate abuse on American college campuses.

Opiate abuse in the United States is on the rise among the college student population. This public health crisis requires immediate action from professionals and stakeholders who are committed to addressing the needs of prospective, current, and recovering opiate users using comprehensive prevention methods. Such approaches have been used to deliver primary, secondary, and tertiary intervention to alcohol and other drug users but are underutilized in the case of opiate abuse among college students in the United States. There is a definite need for involving college campus faculty, staff, students, and others in efforts to prevent opiate abuse at all levels. Our recommendations include specific strategies to address this imminent issue using an innovative application of the traditional Levels of Prevention Model.

Prevention of hypoglycaemia, the ASAP (Anticipate, Suspect, Act, Prevent) strategy.

This article describes a simple framework to prevent hypoglycaemia. Four strategies of prevention are detailed, which correspond to four levels of prevention (primordial, primary, secondary and tertiary). This framework, given the mnemonic ASAP (As Soon As Possible) includes action to Anticipate and Avoid, and Suspect and Screen hypoglycaemia. It also enjoins us to Act and Assist persons with hypoglycaemia in a timely manner, while working to Prevent and Protect them by using safer glucose lowering drugs and insulins.

The role of social capital in three levels prevention of stroke / 中华行为医学与脑科学杂志

Social capital is an invisible capital form that promotes the efficient allocation and utilization of resources.It plays an active role in the prevention and control of chronic diseases.The purpose of this study is to investigate the effect of social capital on the three levels prevention of stroke by means of document retrieval.Social capital is associated with both morbidity and mortality of stroke.Social participation and social support at a high level can promote the rehabilitation of stroke patients,and have a beneficial effect on improving the quality of life and the ability of daily life.Social capital is correlated with stroke related behavioral factors,such as smoking,drinking,obesity,diet and physical activity.People with high social capital stock are more likely to choose healthy behavior patterns,thus reducing the risk of stroke.We should take full account of the social capital factors,and make more comprehensive and effective completion of the three levels of stroke prevention.

Combate aos problemas ligados ao álcool: projeto de intervenção integrada no concelho de Paredes de Coura / Combating alcohol-related problems: integrated intervention project in the municipality of Paredes de Coura

O álcool é uma SP, com propriedades aditivas, utilizada pelas mais diversas culturas ao longo da história da humanidade. Segundo a OMS (2015), foram identificados vários fatores de vulnerabilidade, ao nível do indivíduo e social, que afetam os níveis e padrões de consumo e a consequente magnitude dos problemas ligados ao álcool (PLA) na comunidade. No sentido de dar resposta a esta problemática, procedemos à elaboração de um projeto de intervenção centrado numa abordagem integrada. Este assenta em pressupostos estruturantes, que passam pela intervenção em quatro dos cinco níveis de prevenção epidemiológica, (prevenção primordial, primária, secundária e terciária), pela necessária articulação entre as Unidades Funcionais (UF) do Centro de Saúde (CS), bem como pelo estabelecimento/reforço das parcerias com entidades locais relevantes. A primeira fase da dimensão axiológica do projeto, o diagnóstico de situação, teve por base a análise documental e entrevistas com agentes relevantes na comunidade, tendo emergido quatro eixos organizativos da intervenção prioritária, nomeadamente a prestação de cuidados, organização e gestão de cuidados, adequação dos sistemas de informação e formação. Assim, no eixo de prestação de cuidados propõem-se três atividades, a saber: ao nível da intervenção em prevenção primordial/primária, um programa de promoção da saúde em SP, no Agrupamento de Escolas deste concelho; ao nível da intervenção em prevenção secundária, a implementação de Intervenções Breves (IB), nas UF do CS; em prevenção terciária, o acompanhamento dos doentes/famílias/comunidade com PLA, por uma equipa multidisciplinar, numa perspetiva de Redução de Riscos e Minimização de Danos (RRMD). Para o eixo organização e gestão de cuidados, pretende-se a definição das funções inerentes a cada uma das instituições que incluem este projeto. Com o eixo adequação dos sistemas de informação, pretende-se a inclusão das IB nas intervenções contratualizadas das UF, assim como a incorporação dos indicadores de avaliação PLA nos indicadores contratualizados para esta Unidade Local de Saúde (ULS). Pretende-se ainda o contacto com os Serviços Partilhados do Ministério da Saúde (SPMS), visando estudar a possibilidade da inserção do Alcohol Use Disorders Identification Test (AUDIT) no Sistema de Apoio à Pratica de Enfermagem (SAPE). Finalmente, no eixo formação, pretende-se assegurar aos respetivos atores a formação que colmate as suas necessidades, com vista à implementação das atividades planeadas neste projeto. Neste momento, foram já encetadas atividades inerentes à formação de professores para a implementação do programa de intervenção em prevenção Primordial/Primária, assim como à formação dos profissionais de saúde em IB na prevenção secundária. A implementação da atividade de acompanhamento de indivíduos, famílias e comunidade em PLA, respeitantes à prevenção terciária, já se encontra em implementação no terreno. Impõe-se, contudo, a consolidação dos desenvolvimentos. É de salientar a adesão da equipa multidisciplinar, num contexto de diversidade das intervenções propostas em tempo e espaço físico. Provavelmente, o facto de dar resposta a necessidades efetivamente sentidas pelos membros da equipa conformou um conjunto de medidas favoráveis à implementação do projeto.

Alcohol is an addictive psychoactive substance (SP), with addictive properties, used by many cultures throughout human history. According to the WHO (2015), many vulnerability signs were identified, socially and individually, that affect the levels and patterns of consumption and subsequent magnitude of the problems related to alcohol in communities. In order to tackle this problem, we have formulated an intervention project with an integral approach aimed to fight PLA. It consists of structural assumptions so as to intervene in four of the five levels of epidemiological prevention (primordial, primary, secondary and tertiary); and it recognizes the need to articulate between the Functional Units (UF) of the Medical Centres (CS) and also the importance of establishing/reinforcing partnerships with relevant local entities that will help solve and support this problem. The first phase of the practical dimension of the project, the diagnosis of the situation, was dedicated to documental research and interviews to relevant agents in the community, thus resulting in four organizational axis of the priority intervention: caregiving, organization and management of the care, suiting of systems of information and training. In the caregiving area, three activities were proposed: in what concerns the intervention in primordial/primary prevention, with a health/prevention program related to illnesses associated with Psychoactive Substances (SP), in the schools of this county; for the intervention in secondary prevention, with the implementation of Brief Interventions (IB), in the three UF of the CS; in tertiary prevention, with follow-ups of the ill, their families and community with PLA, by a multidisciplinary team, with the intention of Reducing Risks and Minimizing Damage (RRMD). In the area of organization and management of the care, the roles of each institution (UF and CS) included in this project were defined. In relation to the suiting of systems of information, we wish to include the IB in the interventions of the UF, as well as the incorporation of PLA evaluation indicators, in the indicators of this Local Health Unit (ULS). We also aim to contact the Shared Services of the Ministry of Health (SPMS), so as to assess the possibility of adopting the Alcohol Use Disorders Identification Test (AUDIT) in the Support System for the Practice of Nursing (SAPE). Finally, in what concerns training, we wish to ensure that the actors obtain a training that will minimize their needs, in order to implement the activities described in this project. At the moment, training for teachers has begun as a way to implement the Primordial/Primary prevention program, as well as training for health professionals in IB in secondary prevention. The implementation of follow-ups of the ill, their families and community with PLA in tertiary prevention is already in motion. However, consolidation of the development is required. We would like to stress the participation of the multidisciplinary team, in a context of diversity of interventions in time and space. Probably the need to solve problems felt directly by the members of the team, has made this project worth implementing.