Chikungunya virus (CHIKV) is responsible for large periodic epidemics in both endemic and nonendemic areas where competent mosquitoes are present. Transmission of CHIKV by transfusion during ...explosive outbreaks has never been documented, and the true impact of CHIKV infection on blood transfusion during an outbreak is unknown. Considerations include not only transfusions in the active outbreak areas but also returning travelers to nonendemic areas. Because there are no documented cases of transfusion-transmitted CHIKV, there are no standard guidelines regarding transfusion policies during a chikungunya fever outbreak. We review current information from studies during outbreaks with the goal of estimating the potential effect of different blood safety interventions (eg, querying donors for possible CHIKV exposure, chikungunya fever–related symptoms, screening for CHIKV RNA).
•Current information regarding viral loads among presymptomatic, asymptomatic, and symptomatic CHIKV infected individuals is presented.•If transfusion is found to be a means of transmitting CHIKV, measures aimed at reducing the rate of transfusion transmission during an outbreak are reviewed.•Strategies regarding the return of traveling donors at risk for CHIKV infection are reviewed.
Seafarers' diets are often high in fat, sugar and calories, thus contributing to an increased risk of obesity, metabolic syndrome and cardiovascular disease. The multitude of obstacles to healthy ...eating in the on-board environment on merchant ships makes it essential to find new approaches for health promotion. This study explored seafarers' attitudes, the status quo of support measures and chances to improve nutrition on merchant ships from the perspective of crews and cooks.
In the course of the EU-funded project "e-healthy ship", European and Southeast Asian seafarers (N = 810) and ship cooks (N = 62) were examined by using two questionnaires on 68 ships of two German shipping companies.
Almost all seafarers (98.8%) considered a healthy diet important for their well-being and the majority of seafarers reported being open-minded about changing their eating habits (88.4%). However, European seafarers were less likely to respond that they are willing to eat less meat OR 0.11; 95%CI (0.07-0.17); p < .001, more vegetables OR 0.10; 95%CI (0.02-0.49); p = .005 and more fruits OR 0.11; 95%CI (0.02-0.61); p = .011 than their Southeast Asian colleagues. On the one hand, 82.3% of the ship cooks reported having taken part in at least one cooking course organized by their employer (1: 33.9%, 2: 25.8%, 3: 14.5%, 4 or more: 8.1%), on the other hand, slightly above half stated that the last of these courses had taken place more than 2 years ago. Furthermore, the ship cooks showed a positive attitude towards the use of a tablet-based digital platform that supports the ship cooks in daily and complex tasks (> 85% agreement).
To improve nutrition on board merchant ships, various parameters need to be adjusted, such as ensuring a demand-oriented food supply on board or supporting seafarers' healthy food choices through target group-specific nutrition education. Ship cooks would be able to play a crucial role if they receive support. The development of a tablet-based digital platform that supports the ship cooks in their daily tasks, offers training and empowers them to implement health-promoting measures themselves seems to be an accepted and promising approach.
Y después del ictus, qué hacemos para nutrirle? Ballesteros Pomar, María D.; Palazuelo Amez, Laura
Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral,
2017, Letnik:
34, Številka:
suppl 1
Journal Article
Odprti dostop
Las enfermedades neurológicas conllevan, a menudo, alteraciones en el nivel de conciencia o en los mecanismos de la deglución que hacen necesario un soporte nutricional artificial. Las guías ...internacionales recomiendan realizar un cribado de malnutrición a los pacientes con enfermedades neurológicas. La disfagia es un problema frecuente después de un ictus. Sin embargo, la disfagia es una patología tratable y la rehabilitación de la función deglutoria permite mejorar el estado nutricional de los pacientes. Los equipos sanitarios deber estar sensibilizados ante este problema, tanto para su diagnóstico, como para instaurar medidas de intervención nutricional. La presencia de disfagia debería valorarse en las primeras 24 horas tras un ictus y no retrasarse más de 72 horas, así como el cribado de desnutrición. Se revisan el enfoque diagnóstico y terapéutico así como las indicaciones de las distintas modalidades de tratamiento nutricional y la transición a la alimentación oral en el paciente con ictus.
Thermotolerant Campylobacters are one of the most important bacterial causative agents of human gastrointestinal illness worldwide. In most European Union (EU) member states human campylobacteriosis ...is mainly caused by infection with Campylobacter jejuni or Campylobacter coli following consumption or inadequate handling of Campylobacter‐contaminated poultry meat. To date, no effective strategy to control Campylobacter colonization of broilers during rearing is available. In this review, we describe the public health problem posed by Campylobacter presence in broilers and list and critically review all currently known measures that have been researched to lower the numbers of Campylobacter bacteria in broilers during rearing. We also discuss the most promising measures and which measures should be investigated further. We end this review by elaborating on readily usable measures to lower Campylobacter introduction and Campylobacter numbers in a broiler flock.
Fatalities due to road accidents remain a major challenge worldwide. In the recent years, Malawi, one of the developing African countries with a total population of about 19 million has also been ...witnessing a very high fatality rate of about 31 crash deaths per 100,000 population in 2016 compared to most of its neighbours in the region. This seems to be continuously increasing even with several intervention measures, such as, speed and alcohol impairment laws, and laws for mandatory seatbelt and helmet use. In view of this, the study attempted to investigate the trend of road fatalities in Malawi, such that effectiveness of the existing measures can be established. For this, archived crash data of road fatalities between years 2000–2021 were used to undertake intervention and trend analyses. The method of Cumulative Summation was used to identify intervention points in the series, followed by the Mann-Kendall statistic (τ) to determine the trend during the intervened period using the non-parametric Rank-Sum test to support the findings. The results showed that the trend has been decreasing in the early years of legislating policy measures 2000–2012 and, thereafter 2013–2021, increased significantly τ = 0.8333. This suggests that there was acceptance of the measures by the motorists/public in the early years of implementation 2000–2012, which might have been overshadowed by vehicle population growth and weak enforcement mechanism that have seen the trend increasing lately. The study therefore suggests that there is still a scope to review the intervention measures in their effective implementation as well as regular monitoring.
•From the intervention analysis using a cumulative summation (CuSum) method supported by a Rank-Sum test, it was identified that there was a change in the number of fatalities from 2004 to 2012.•The null hypotheses for the two intervention tests were found to be insignificant which supported the existence of interventions at 2004 and 2012.•The trend has been decreasing in the early years of legislating policy measures 2000–2012 and, thereafter 2013–2021, increased significantly τ = 0.8333.
United Nations Sustainable Development Goal 3 outlines the target of reducing premature mortality from non-communicable diseases by one third through prevention and treatment by 2030. In low and ...middle-income countries (LMICs) like Nepal, a significant number of people do not have accessible and affordable healthcare services available to them, leading to self-medication practices (SMP). Limited numbers of health professionals, ineffective regulation and easy availability of prescription medicines encourage the use of inappropriate SMP, which could result in health risks.
The objection of the study is to test the application of Analytical Hierarchy Process (AHP) for prioritizing the intervention measures for preventing inappropriate SMP.
The 25 experts were included in the study, out of which only 16 experts passed the consistency test. Data were collected using a structured questionnaire by the application of AHP model for ranking the intervention measures for preventing inappropriate SMP from March 2020 to May 2020. During this process, the purposively selected experts compared seven intervention measures based on three criteria: control use of prescription and non-prescription medicine, knowledge regarding the medicine and its use, and minimizing healthcare cost.
The criteria, “control use of prescription and non-prescription medicine” was judged 3.58 times and 1.53 times more important than to “minimize the healthcare cost” and “knowledge regarding the medicine and its use” respectively. “Regulation of prescription and non-prescription dispensing practice” was the most prioritized intervention measure to prevent inappropriate SMP with a priority score of 20.68% followed by the “accessibility of healthcare system” (19.27%) and “awareness program for the consumers” (17.13%).
The AHP method can be used in decision-making related to prioritizing the intervention measures to prevent inappropriate SMP. Among the seven intervention measures considered, “regulation of prescription and non-prescription dispensing practice” was the most preferred intervention measure to improve SMP followed by “access to healthcare” and an “awareness program”.
•Significant people use inappropriate self-medication practices due to lack of accessible and affordable healthcare service.•Analytical Hierarchy Process can be used for prioritizing intervention measures to control inappropriate self-medication.•Control use of medicine was given 3.5 times more importance than healthcare cost minimization.•Regulation of dispensing practice, healthcare service accessibility and awareness program were most prioritized measures.
Much of the research on climate change has focused on carbon reduction in cities or countries. However, more attention needs to be paid to how to achieve carbon neutrality in the urban design and ...planning stage, and the lack of quantitative analysis of carbon related to urban space makes it difficult to locate urban space and provide direct guidance for urban planning and design. This study proposed three optimization paths to achieve carbon neutrality in multi-scale urban building clusters. Firstly, we reconstructed the quantitative calculation system of urban building communities with the goal of carbon neutrality; secondly, we screened the carbon source reduction and carbon sink interventions that are suitable for multi-scale urban building communities; finally, we constructed a carbon emission and carbon sink calculation system of planning and design schemes based on the layout of relevant elements of planning and design schemes with a grid cell of 100 × 100 m. In practice, there was a gap of about 115,000 tons of CO
from the carbon-neutral target and 26% of carbon emission was distributed in the Xiajiabian Station TOD. In this study, nine types of carbon reduction measures were adopted to achieve carbon neutrality in the region, among which the highest carbon reduction was achieved by biomass energy measures, accounting for 29% of the total carbon reduction of 33,745.27 T. The objective of this study is to accurately and quantitatively assess the carbon targets of urban spaces at different scales and adopt effective measures to achieve carbon neutrality.
Background
Chinese government conducted unprecedented massive public health prevention interventions at the national level, which have effectively contained the spread of Coronavirus Disease 2019 ...(COVID-19) infections. Specifically, the outbreak in Wuhan has been effectively controlled. Meanwhile, the Chinese efforts to contain the virus have been widely recognized. Even the World Health Organization has praised the efforts of the Chinese government and advised other countries to learn from China's experience in the fight against COVID-19. However, the measures that have been conducted by China to effectively prevent the spread of COVID 19 in the country have not been rigorously analyzed. Therefore, this study aimed to explore the characteristics of China's control and prevention strategies, and identify the elements that changed the epidemiological curve of rapidly rising new confirmed cases of COVID-19.
Methods
Public health intervention measures and their effects on the spread of COVID-19 in terms of daily newly confirmed and cumulative cases were collected between January 20, 2020, and March 5. Notices of the Joint Prevention and Control Mechanism for COVID-19 of the State Council on Implementing Measures in Hubei were collected. Information obtained by relevant important documents and announcements was collected from the official website of the Chinese government. Additionally, from other media platforms, news, articles, and reviews were used to explain the intervention measure. Thus, using these data, we performed a retrospective description of the intervention strategies at three stages.
Results
The Chinese government adopted non-pharmacological interventions measures (NPIs) timely and efficiently. On February 20, the declining epidemic trend in China indicated that the three strictest disease prevention and control strategies issued by the Hubei Government had contributed to a smooth decline in the spread of the epidemic.
Conclusions
The NPIs taken by China play a decisive role to control the spread of novel coronavirus outbreaks. Further research and action are needed to ensure a sufficiently sensitive surveillance system and strong response mechanism, including the establishment of a highly accessible laboratory network, maintenance of awareness of both primary healthcare providers and the public, and regular training and exercise of local Centers for Disease Control and Prevention and general practitioners in the community-level.
Epidemiology and control of malaria in Colombia Rodríguez, Julio Cesar Padilla; Uribe, Gilberto Álvarez; Araújo, Roberto Montoya ...
Memórias do Instituto Oswaldo Cruz,
08/2011, Letnik:
106 Suppl 1, Številka:
suppl 1
Journal Article
Recenzirano
Odprti dostop
Malaria is currently one of the most serious public health problems in Colombia with an endemic/epidemic transmission pattern that has maintained endemic levels and an average of 105,000 annual ...clinical cases being reported over the last five years. Plasmodium vivax accounts for approximately 70% of reported cases with the remainder attributed almost exclusively to Plasmodium falciparum. A limited number of severe and complicated cases have resulted in mortality, which is a downward trend that has been maintained over the last few years. More than 90% of the malaria cases in Colombia are confined to 70 municipalities (about 7% of the total municipalities of Colombia), with high predominance (85%) in rural areas. The purpose of this paper is to review the progress of malaria-eradication activities and control measures over the past century within the eco-epidemiologic context of malaria transmission together with official consolidated morbidity and mortality reports. This review may contribute to the formulation of new antimalarial strategies and policies intended to achieve malaria elimination/eradication in Colombia and in the region.
PDF
