Abstract Outbreaks of American Cutaneous Leishmaniasis (ACL) are triggered by the confluence of multidimensional biological, climate, and social factors: the eco-epidemiological momentum. Despite the diversity of epidemiological scenarios, there are common “Ingredients for the recipe” to make an ACL outbreak. To describe the “Where”, “When”, and “Why” of this momentum could contribute to the understanding of the causes of epidemics, preventing their occurrence, and to define better strategies to control them. Typically, due to sylvatic-rural transmission, most urban ACL are still related in time and space to peripheral city deforestations, riparian forest, and green patches within the cities. Therefore, the “Where” of the ACL outbreaks could be characterized in the space as an edge effect, and afterwards the “When” of this edge could be categorized as an ephemeral, transient or permanent. The “Why” question is far more complex, as it includes the exposure of humans to vector due to anthropic activities in each edge scenario. The evidence for ACL outbreak control strategies: barricading the edge by chemical and physical barriers, environmental management, and individual prevention, were reviewed. Answers to questions regarding these “Where”, “When”, “Why”, and “How to control” guided the content of the questions to be asked in the new focus of ACL transmission, not only to mitigate current transmission and prevent future outbreaks, but also to highlight the biological factors that might contribute to the possibility of an epidemic, and those conditions that modulate its actual probability, the climate and the social determination of risk. Keywords Eco-Epidemiology; Edge Effect; Phlebotominae; Urban Transmission

Abstract Background: There is an escalating burden of Non-communicable diseases (NCDs) in India. World Health Organisation (WHO) and the government of India aim to reduce the physical inactivity relatively by 10%, as it is a modifiable risk factor for NCDs. Patients and the general population are generally advised to do the physical activity by doctors and other health personnel through individual counselling and group health talks in the community. But whether they can follow the given advice or the knowledge provided alone was sufficient to translate it into practice was not studied. This study was done to explore the facilitators and barriers to physical activity in an urban resettlement colony in New Delhi (India). Methods: It was a qualitative study, where participants were interviewed face to face until theory saturation. Some interviews were conducted at the outpatient department and some participants in the community. Then a random visit was made to one of the residential colonies and a park to check the facilities present for physical activity at the community level. Interview contained open-ended questions and followed an interview guide. The audio was transcribed and the text was read multiple times for familiarisation. Quotations depicting facilitators and barriers for physical activity were identified. Following this, coding was done and meaningful themes were identified as thematic analysis. Results: Knowledge regarding the benefits of physical activity was present in all the participants. Five participants (36%) were regularly doing physical activity in the form of exercise/yoga/gym/brisk walking. The facilitators identified were motivation/will power, time management skills, knowledge and perceived benefits of physical activity, presence of disease and its management, a facility like a park/garden equipped with physical exercise equipment, convenient school timings. The barriers identified were lack of time, lack of indoor and outdoor spaces, lack of maintenance of parks/infrastructure, inadequate equipment for physical activity, unfavourable season/weather, physical restriction, unhealthy lifestyle and laziness. Conclusions: We conclude that simply having knowledge about the benefits of physical activity is not sufficient to translate it to practice. There should be an enabling environment and well-maintained facilities in the community, schools. Timings of school/work and motivation also play a major role. At a personal level, motivation needs to come from within and needs to be persistent. Keywords: Barriers; Control; Exercise; Facilitators; India; Non-Communicable Disease; Physical Activity; Prevention

<p class=MsoBodyTextCxSpFirst style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Abstract <p class=MsoBodyTextCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Introduction <p class=MsoBodyTextCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Family caregivers remain the pillar of support for children living with HIV/AIDS. Appreciating their roles and experiences is a significant aspect of family-centered care and has implications for improved care outcomes. This study therefore aimed at exploring the care related experiences of Ghanaian family caregivers of children living with HIV. <p class=MsoNormalCxSpFirst style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Methods <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> A descriptive qualitative study was conducted among family caregivers of children living with HIV accessing healthcare at the Princess Marie Louise Hospital, Accra. A total of 15 one-on-one interviews had been conducted by the time saturation of data was reached. Thematic content analysis was employed to unravel the data. <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Results <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Almost all (n=14,93.3%) of the caregivers were women, less than two thirds (n=10, 66.6%) of the caregivers were below forty years and (n=7, 46.7%) being the non-biological parent(s). Emergent themes were: social experiences (financial constraints, good family support, social isolation/secrecy); spiritual experience (Inner strength derived from increased faith in God); psychological experiences (inner satisfaction in performing caregiver roles; and anxiety over their children’s future); physical experiences (care being demanding); altered quality of life (mainly adverse changes); and health care related experiences (supportive staff a key motivator fostering caregiver role). <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Conclusion <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> The study found both positive and negative family caregiver experiences with regards to the care of their HIV-infected children. Healthcare providers must capitalize on the positive experiences to provide strength-based care, which involves incorporating the clients’ own strengths and capabilities as well as wider support network in the planning and delivering of services for children and adolescents living with HIV. Available social support from government and non-governmental organizations should also be sustained. <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Keywords: <span lang=EN-GB style=font-size:10.0pt;color:black;mso-themecolor: text1>Children Living with HIV/AIDS; Family Caregivers; Experiences <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> Abbreviations: <span lang=EN-GB style=font-size:10.0pt; color:black;mso-themecolor:text1>AIDS: Acquired Immune Deficiency Syndrome <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> ARVs: Antiretroviral drugs <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> ART: Antiretroviral Therapy <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> ChilHIV: Children living with HIV/AIDS <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> GAC: Ghana AIDS Commission <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> HAART: Highly Active Antiretroviral Therapy <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> HCPs: Health Care Providers <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> HIV: Human Immunodeficiency Virus <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> NACP: National AIDS/STI Control Programme <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> PLHIV: Persons living with HIV <p class=MsoNormalCxSpMiddle style=text-align:justify;text-justify:inter-ideograph; mso-mirror-indents:yes> UNICEF: The United Nations Children Fund WHO: World Health Organization

Background: The infection of Pseudomonas aeruginosa in Diabetic Foot Infection (DFI), is increasing in Gadarif Diabetic Center, Sudan. Aims: The objective of this study is to report on the frequency, antibiotic sensitivity of P. aeruginosa in patients with diabetic foot infection. Methods: Prospectively, three hundred and fifteen swabs were obtained from diabetic foot infection wound, collected from diabetic foot infection patients who attended Gadarif Diabetic Center during the years (2017-2018). The isolation and identification of P. aeruginosa was done and antimicrobial susceptibility test of commonly used antibiotics (Piperacillin, Ceftazidime, Gentamicin, Ciprofloxacin and Doxycycline) against P. aeruginosa was performed. Results: The present study included 315 bacterial wound swabs, there was 96.30% of bacterial isolates were P. aruginosa. The results of antimicrobial susceptibility test were found to be sensitive to Ciprofloxacin (81.84.4%) and followed by Ceftazidime (78.81.3%), piperacillin (69.71.9%), Gentamicin (66. 68.8%) and Doxycycline (12.12.5%). <p class=MsoNormalCxSpFirst style=margin-bottom:0in;margin-bottom:.0001pt; mso-add-space:auto;text-align:justify;line-height:150%;mso-mirror-indents:yes> Conclusion: The study agrees with previous studies in that, P. aeruginosa was an important causative agents responsible for diabetic foot infections in Gadarif Diabetic Center. Results of the antimicrobial sensitivity of P. aeruginosa isolates against commonly used antibiotics demonstrated the occurrence of resistance to various antipseudomonal agents (Ciproflopxacin, Piperacillin, Ceftazidime and Gentamicin). <p class=MsoNormalCxSpMiddle style=margin-bottom:0in;margin-bottom:.0001pt; mso-add-space:auto;text-align:justify;line-height:150%;mso-mirror-indents:yes> Abbreviations: ATCC: American Type Culture Collection; DFI: Diabetic Foot Infection; GDC: Gadarif Diabetic Centre; MR: Methyl Red; NCCLSs: National Committee for Clinical Laboratory Standards; OF: Oxidative/Fermentative; VP: Voges-Proskauer

Collective catering is important in the diet and nutrition of the population. However, the handling and production of these foods under unhygienic conditions could lead to food poisoning for consumers. In order to improve the microbiological quality of meals served in restaurants, surveys have been conducted with restaurant owners.