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170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

When considering potentials emergencies in the dental office, one usually first thinks about potential drug reactions or adverse response to underlying systemic diseases. The rare, but potential, emergencies arising from the office environment itself also exist. Toxic reactions to various chemicals found in the office must be considered also. Adequate ventilation helps prevent the long-term consequences of breathing nitrous oxide and chemclave exhaust. Care must be taken in obtaining complete medical histories. Identify patients with communicable diseases such as TB. The potential for transmission of these infections to office staff and other patients exists. Health histories must include the ability to identify patients with latex sensitivity. The increased use of latex products among health care workers has resulted in a higher incidence of latex sensitivity. The office staff must be prepared to recognize and quickly treat anaphylactic reactions. A latex-free environment must be provided for high-risk patients. Even with the use of universal precautions, blood contamination exposures and needle sticks will still occur. Protect office staff against hepatitis through the administration of a hepatitis prevention vaccine. Establish a protocol in advance for handling blood exposure incidents. Update the patient history to determine potential risk. The exposed individual must receive counseling as to the potential risk of HIV infection. If there is a potential risk of HIV contamination, the exposed individual must be offered the opportunity to initiate prophylactic chemotherapy within 1 hour of exposure. Even though occupational health and safety emergencies are rare, they must be considered and planned for. Contingency plans, such as providing a latex-free environment, must be available for preventing emergencies. The office staff must be prepared to treat immediate emergencies such as anaphylaxis and caustic material spills. Arrangements must be available to quickly handle exposure to communicable infections.
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PMID:Occupational health and safety emergencies. 755 95

A research conducted by the Louisiana public health condom distribution program concluded that switching from a cost-free to a minimal-charge status could decrease condom use. In 1993, Louisiana's Operation Protect started distributing free condoms at 93 public health clinics, 39 community mental health centers, 29 substance abuse treatment sites, and more than 1000 small businesses in areas with high rates of sexually transmitted diseases (STDs) and HIV. Later on, the program encountered some budget problems and began charging a small fee, up to 25 cents per condom. When the state evaluated the impact of transition on condom use among persons with two or more sex partners, there was a sharp decline in condom distribution as well as condom usage. Consequently, the state terminated the low-cost condom program and restarted the free distribution method, acknowledging the protective role of condoms against HIV and other STDs.
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PMID:Keep condom use high, retain no-charge status. 1232 20

Despite the considerable resources that have been dedicated to HIV prevention interventions and services over the past decade, HIV incidence among young people in the United States remains alarmingly high. One reason is that the majority of prevention efforts continue to focus solely on modifying individual behavior, even though public health research strongly suggests that changes to a community's structural elements, such as their programs, practices, and laws or policies, may result in more effective and sustainable outcomes. Connect to Protect is a multi-city community mobilization intervention that focuses on altering or creating community structural elements in ways that will ultimately reduce youth HIV incidence and prevalence. The project, which spans 6 years, is sponsored by the Adolescent Medicine Trials Network for HIV/AIDS Interventions at multiple urban clinical research sites. This paper provides an overview of the study's three phases and describes key factors in setting a firm foundation for the initiation and execution of this type of undertaking. Connect to Protect's community mobilization approach to achieving structural change represents a relatively new and broad direction in HIV prevention research. To optimize opportunities for its success, time and resources must be initially placed into laying the groundwork. This includes activities such as building a strong overarching study infrastructure to ensure protocol tasks can be met across sites; tapping into local site and community expertise and knowledge; forming collaborative relationships between sites and community organizations and members; and fostering community input on and support for changes at a structural level. Failing to take steps such as these may lead to insurmountable implementation problems for an intervention of this kind.
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PMID:Laying the foundation for Connect to Protect: a multi-site community mobilization intervention to reduce HIV/AIDS incidence and prevalence among urban youth. 1673 51

In 2003 the Centers for Disease Control and Prevention (CDC) launched a new HIV prevention strategy that focused prevention efforts on people living with HIV. In response to a Health Resources and Services Administration (HRSA)/Special Projects of National Significance (SPNS) initiative, a program development team in Philadelphia created the Protect and Respect program. The program integrates multiple-level prevention strategies and is tailored to address the strengths of HIV-positive women and the challenges they face to implementing behavior changes. The goal of Protect and Respect is to decrease sexual behavior that puts HIV-positive women at risk for sexually transmitted infections (STIs) and puts others at risk for HIV transmission. The three components of the program are: brief HIV prevention messages delivered by clinicians in the context of routine medical visits; a group-level intervention (GLI) delivered by a Health Educator; and a Peer-led support group. This paper details the process of developing the three program components and describes the valuable lessons learned through the development and implementation process.
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PMID:The Protect and Respect program: a sexual risk reduction intervention for women living with HIV/AIDS. 1760 2

Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher-community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project's experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions.
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PMID:Use of geographic information systems for planning HIV prevention interventions for high-risk youths. 1790 52

African American women, particularly those who live in inner-city areas, experience disproportionately high rates of sexually transmitted infections including HIV. As there are currently no preventive vaccines for HIV and most sexually transmitted infections, prevention efforts must focus on behavioral risk reduction. Thus, culturally tailored interventions for African American women are needed to reduce their incidence of sexually transmitted infections including HIV. One place to intervene with inner-city African American women is in primary care settings. Primary care settings have the potential to reach a wide range of women, including those who may not proactively seek sexually transmitted infection/HIV prevention services. However, in order to be feasible for use in clinical settings, sexually transmitted infection/HIV risk reduction interventions must be brief and easily adapted for use with diverse clients in varied practice environments. To date, few brief sexually transmitted infection/HIV prevention interventions have been designed for use with African American women in primary care settings. Only one of these, the "Sister to Sister: Respect Yourself! Protect Yourself! Because You Are Worth It!" intervention, has demonstrated effectiveness in reducing sexual risk behaviors and sexually transmitted infection incidence. This article describes this 20-minute, one-on-one nurse-led intervention for African American women and discusses considerations for its implementation in primary care and other clinical settings.
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PMID:Sexually transmitted infection/HIV risk reduction interventions in clinical practice settings. 1833 37

Nonheterosexually identified (NHI) women may be present, but not accounted for, in HIV and sexually transmitted infection (STI) prevention interventions. This study used quantitative and qualitative methods to examine the sexual risk behaviors and intervention needs of NHI women in Protect and Respect, a safer sex intervention for HIV-positive women. Study participants (n=32) were predominantly Black, low income, and between 28 and 51 years old. Although NHI participants were more likely than heterosexual participants (p < .05) to report obtaining their income from sex work, hustling, or selling drugs; and having a higher median number of male sex partners, qualitative analyses revealed that the intervention often neglected NHI women's experiences and unique safer sex needs. Heterosexist HIV and STI prevention programs may hinder NHI women's ability to protect themselves and their partners from reinfection and infection respectively. We discuss the implications of our research for future HIV/AIDS and STI research, services and interventions for NHI women.
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PMID:Present but not accounted for: exploring the sexual risk practices and intervention needs of nonheterosexually identified women in a prevention program for women with HIV/AIDS. 1904 9

It is estimated that tobacco use may cause death of 5 million people in 2008, which is higher than the number of deaths attributed to tuberculosis (TB), HIV/AIDS and malaria taken together. By 2030, the number of deaths related to the tobacco epidemic could exceed annually even 8 million. Despite many difficulties, a growing number of countries undertake intensive actions aimed at tobacco control. The objective of this paper was to discuss the major objectives of the MPOWER Report issued by the World Health Organization (WHO). The MPOWER package consists a set of six key and most effective strategies for fighting the global tobacco epidemic: 1) Monitoring tobacco consumption and the effectiveness of preventive measures; 2) Protect people from tobacco smoke; 3) Offer help to quit tobacco use; 4) Warn about the dangers of tobacco; 5) Enforce bans on tobacco advertising, promotion and sponsorship; and 6) Raise taxes on tobacco. It is proven that these strategies implemented in the compatible way, effectively decreases tobacco use. In addition, MPOWER comprises epidemiological data, information on implemented tobacco control measures and their efficiency. MPOWER is the only one document of a somewhat strategic nature that is a source of information on the spread of tobacco epidemic, as well as of suggestions concerning specific actions for supporting the fight against this epidemic.
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PMID:[MPOWER--strategy for fighting the global tobacco epidemic]. 1960 47

There has been a growing awareness of the importance of engaging communities in the development, testing, and eventual dissemination of biomedical strategies. Community engagement offers many benefits but comes with many challenges. This article will discuss these benefits and challenges and describe two examples of community engagement, Connect to Protect in the United States, and the South African Studies on HIV in Adolescents Project in South Africa, that represent investment in community engagement as preparation for biomedical HIV prevention clinical trials for youth.
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PMID:Community engagement and investment in biomedical HIV prevention research for youth: rationale, challenges, and approaches. 2057 25

Fifteen research sites within the Adolescent Medicine Trials Network for HIV/AIDS Interventions launched Connect to Protect community coalitions in urban areas across the United States and in Puerto Rico. Each coalition has the same overarching goal: Reducing local youth HIV rates by changing community structural elements such as programs, policies, and practices. These types of transformations can take significant amounts of time to achieve; thus, ongoing successful collaboration among coalition members is critical for success. As a first step toward building their coalitions, staff from each research site invited an initial group of community partners to take part in Connect to Protect activities. In this paper, we focus on these researcher-community partnerships and assess change in collaboration factors over the first year. Respondents completed the Wilder Collaboration Factors Inventory at five time points, approximately once every two to three months. Results across all fifteen coalitions show significant and positive shifts in ratings of process/structure (p<.05). This suggests that during the first year they worked together, Connect to Protect researcher-community partners strengthened their group infrastructures and operating procedures. The findings shed light on how collaboration factors evolve during coalition formation and highlight the need for future research to examine change throughout subsequent coalition phases.
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PMID:Connect to Protect Researcher-Community Partnerships: Assessing Change in Successful Collaboration Factors over Time. 2115 54


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