Prevention of colorectal cancer by once-only sigmoidoscopy

It is expected that the projected increased usage of implantable devices in medicine will result in a natural rise in the number of infections related to these cases. Some patients are unable to autonomously prevent formation of biofilm on implant surfaces. Suppression of the local peri-implant immune response is an important contributory factor. Substantial avascular scar tissue encountered during revision joint replacement surgery places these cases at an especially high risk of periprosthetic joint infection. A critical pathogenic event in the process of biofilm formation is bacterial adhesion. Prevention of biomaterial-associated infections should be concurrently focused on at least two targets: inhibition of biofilm formation and minimizing local immune response suppression. Current knowledge of antimicrobial surface treatments suitable for prevention of prosthetic joint infection is reviewed. Several surface treatment modalities have been proposed. Minimizing bacterial adhesion, biofilm formation inhibition, and bactericidal approaches are discussed. The ultimate anti-infective surface should be “smart” and responsive to even the lowest bacterial load. While research in this field is promising, there appears to be a great discrepancy between proposed and clinically implemented strategies, and there is urgent need for translational science focusing on this topic.

https://www.mdpi.com/1422-0067/15/8/13849/pdf

Antibacterial Surface Treatment for Orthopaedic Implants

This research explores the medical care consumption and absenteeism decisions of employed individuals with acute illnesses in an effort to better understand behavior that may contribute to the upward spiraling costs of health care. The theoretical framework models the decisions to visit a doctor and/or to miss work during an episode of acute illness as the sequential choices of individuals solving a discrete choice stochastic dynamic programming problem. Using data from the 1987 National Medical Expenditure Survey (NMES), I estimate the structural parameters of an individual's optimization problem. Structural estimation, as opposed to conventional reduced form estimation methods that are prevalent in the health care literature, allows for the introduction and evaluation of the impact of new public policy initiatives relating to health care. The estimates allow for predictions of the change in physician services use and illness-related absenteeism that arise with improvements in access to health care through more complete health insurance and sick leave coverage.

A dynamic stochastic model of medical care use and work absence

Medicines and culture--a double perspective on drug utilization in a developing country.

Background: Few reports have addressed associations between family strengths during childhood and adolescent pregnancy and its consequences. We examined relationships among a number of childhood family strengths and adolescent pregnancy, risk behavior, and psychosocial consequences after adolescent pregnancy.

Methods: Our retrospective cohort of 4648 women older than 18 years (mean age, 56 years) received primary care in San Diego, CA. Outcomes included adolescent pregnancy and psychosocial consequences compared with number of the following childhood family strengths: family closeness, support, loyalty, protection, love, importance, and responsiveness to health needs.

Results: Of the cohort, 3082 participants (66%) reported 6 or 7 categories of childhood family strengths. Teen pregnancy occurred in 39%, 33%, 30%, 25%, 24%, 21%, and 19% of those with 0 or 1, 2, 3, 4, 5, 6, and 7 childhood family strengths, respectively (p for trend < 0.00001). When childhood abuse and household dysfunction were present, adjusted odds ratios (ORs) for adolescent pregnancy demonstrated an increasingly protective effect as numbers of childhood family strengths increased from 0 or 1 to 2 or 3, 4 or 5, and 6 or 7 (1.0 to 0.80), (1.0 to 0.80, 0.60, and 0.54, respectively). These findings were partly explained by progressive delays in initiation of sexual activity as the number of childhood family strengths increased. Adjusted ORs for psychosocial problem occurring decades later decreased as the number of childhood family strengths increased from 0 or 1 to 2 or 3, 4 or 5, and 6 or 7 (job problems, 1.0, 0.8, 0.6, 0.4; family problems, 1.0, 1.1, 0.7, 0.6; financial problems, 1.0, 0.9, 0.9, 0.6; high stress, 1.0, 1.1, 0.9, 0.8; uncontrollable anger, 1.0, 0.7, 0.7, 0.4).

Conclusions: Childhood family strengths are strongly protective against adolescent pregnancy, early initiation of sexual activity, and long-term psychosocial consequences.

http://theannainstitute.org/ACE%20folder%20for%20website/46%20Protective%20Fam%20Strengths%20Adols%20Preg%20Conseq.pdf

Mahesh S. Patel

Papers

Prevention and cure? Or: is an ounce of prevention worth a pound of cure?

Drug costs in developing countries and policies to reduce them

How much can the nhs afford to spend to save a life or avoid a severe disability