Better Knowledge Of Causes Research Articles

Postmortem examination protocol and systematic re-evaluation reduce the proportion of unexplained stillbirths.

Background Stillbirth often remains unexplained, mostly due to a lack of any postmortem examination or one that is incomplete and misinterpreted. Methods This retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, Helsinki University Hospital, Finland, and comprised 214 antepartum singleton stillbirths from 2003 to 2015. Maternal and fetal characteristics and the results of the systematic postmortem examination protocol were collected from medical records. Causes of death were divided into 10 specific categories. Re-evaluation of the postmortem examination results followed. Results Based on our systematic protocol, the cause of death was originally defined and reported as such to parents in 133 (62.1%) cases. Re-evaluation of the postmortem examination results revealed the cause of death in an additional 43 (20.1%) cases, with only 23 (10.7%) cases remaining truly unexplained. The most common cause of stillbirth was placental insufficiency in 56 (26.2%) cases. A higher proportion of stillbirths that occurred at ≥39 gestational weeks remained unexplained compared to those that occurred earlier (24.1% vs. 8.6%) (P = 0.02). Conclusion A standardized postmortem examination and a re-evaluation of the results reduced the rate of unexplained stillbirth. Better knowledge of causes of death may have a major impact on the follow-up and outcome of subsequent pregnancies. Also, closer examination and better interpretation of postmortem findings is time-consuming but well worth the effort in order to provide better counseling for the grieving parents.

Sexual behaviour and knowledge of prevention of sexually transmitted infections among students in coeducational and non-coeducational secondary schools in Ibadan, Nigeria.

Introduction:Sexual interaction between students may be different in coeducational (CE) and non-coeducational (NC) schools. The objective was to compare sexual behaviour and knowledge of prevention of sexually transmitted infections (STIs) among senior secondary school students in CE and NC institutions in Ibadan, Nigeria.Method:A comparative cross-sectional study was carried out using a multistage sampling technique. A total of 510 respondents (250 from CE schools and 260 from NC schools) completed semi-structured self-administered questionnaires which included a 30-point STI knowledge scale with scores classified as good and poor. Chi-square statistics were significant at P ≤ 0.05.Results:The mean age of respondents was 15.9 ± 1.5 years, 47.5% were girls. There were no significant differences in sexual behaviour and knowledge of STIs between the students in the two types of schools. However, there were gender differences, as a significantly higher proportion of girls in CE than NC schools had ever had sexual intercourse with the opposite sex (25.6%-CE, 12.4%-NC) and had multiple sexual partners (29.0%-CE, 0%-NC). Girls in NC schools had better knowledge of causes and prevention of STIs than those in CE schools (28.8%-CE, 45.5%-NC). There were no significant differences in the sexual practices and knowledge of STIs among boys in the two types of schools.Conclusion:More girls in CE schools have had sexual intercourse compared to NC schools whereas girls in NC schools had better knowledge of the prevention of STIs. There is a need for strategies to increase reproductive health education in schools, particularly in CE schools.

Perception and knowledge regarding under-nutrition in children among anganwadi workers: a qualitative study in Berhampur of Ganjam district, Odisha

Background: Anganwadi centres (AWCs) remain hub for promoting nutrition in children. For an effective functioning of programs, Anganwadi workers (AWWs) need to have a sound knowledge and perception regarding under-nutrition. A qualitative study (Focus Group Discussion) was conducted with aim to assess perceptions and knowledge of AWWs regarding under-nutrition in 6 domains like about term under-nutrition in children, its causes, identification of it, its community management, advices to be given to parents and knowledge of program related to under-nutrition in their locality.Methods: 2 Focus group discussions (each consisted of 12 members and took around 40-45 minutes) were conducted in December 2018 among AWWs of Berhampur through purposive sampling. One author played role of facilitator who carried out discussions, another acted as recorder who took notes and sociograms were recorded by another author. Audio-visual recordings were done. Data were analysed and a report was created based on grounded theory.Results: Participants had fair knowledge of term under-nutrition. They had good knowledge of causes of under-nutrition in children and knew how to identify. But none of them had proper knowledge of community management of malnutrition (CMAM) in children. Though most of them have knowledge of screening of malnourished children and referral to Nutritional rehabilitation centre, they were unaware of other key components of CMAM. Many AWWs didn’t know much about programs for combating malnutrition; however they were well acquainted with ICDS and VHND.Conclusions: Quality training programs and more sensitisation should be done for Anganwadi workers. Specific training on CMAM should be carried out for them.

Awareness of Air Pollution and Related Health Risk in Traffic Police of Pune City-A Pilot Study

Objective Urbanisation is causing increase in air pollution. Exposure to air pollution has become inevitable and seem to be integral part of daily life. Few people like traffic police are exposed to air pollution for longer duration due to their type of job. Hence, they are more vulnerable to health hazards caused by air pollution. Awareness about air pollution and health hazards caused by it will help to plan preventive measures. Therefore, present study is planned to find out awareness of air pollution and related health risk in traffic police of Pune city. Method The questionnaire including questions about awareness of air pollution, associated symptoms and self-preventive measures against air pollution was constructed. The questionnaire was filled by the traffic policemen. Results Perception of air pollution is better in participants. 94% participants know that air pollution causes health hazard. 76% subjects take self-preventive measures. Participants were also having better knowledge of causes of air pollution. Only 20% participants had knowledge about air pollution monitoring system installed in city. Conclusion Traffic police of Pune city have good awareness regarding causes and levels of air pollution. Also, they know about health hazards due to air pollution and most of them take care in form of mask to avoid exposure to it. But they have got poor knowledge about air pollution monitoring system installed in city.

The One Health Concept: 10 Years Old and a Long Road Ahead.

Over the past decade, a significant increase in the circulation of infectious agents was observed. With the spread and emergence of epizootics, zoonoses, and epidemics, the risks of pandemics became more and more critical. Human and animal health has also been threatened by antimicrobial resistance, environmental pollution, and the development of multifactorial and chronic diseases. This highlighted the increasing globalization of health risks and the importance of the human–animal–ecosystem interface in the evolution and emergence of pathogens. A better knowledge of causes and consequences of certain human activities, lifestyles, and behaviors in ecosystems is crucial for a rigorous interpretation of disease dynamics and to drive public policies. As a global good, health security must be understood on a global scale and from a global and crosscutting perspective, integrating human health, animal health, plant health, ecosystems health, and biodiversity. In this study, we discuss how crucial it is to consider ecological, evolutionary, and environmental sciences in understanding the emergence and re-emergence of infectious diseases and in facing the challenges of antimicrobial resistance. We also discuss the application of the “One Health” concept to non-communicable chronic diseases linked to exposure to multiple stresses, including toxic stress, and new lifestyles. Finally, we draw up a list of barriers that need removing and the ambitions that we must nurture for the effective application of the “One Health” concept. We conclude that the success of this One Health concept now requires breaking down the interdisciplinary barriers that still separate human and veterinary medicine from ecological, evolutionary, and environmental sciences. The development of integrative approaches should be promoted by linking the study of factors underlying stress responses to their consequences on ecosystem functioning and evolution. This knowledge is required for the development of novel control strategies inspired by environmental mechanisms leading to desired equilibrium and dynamics in healthy ecosystems and must provide in the near future a framework for more integrated operational initiatives.

Practice of antimalarial prescription to patients with negative rapid test results and associated factors among health workers in Oyo State, Nigeria.

IntroductionContrary to World Health Organizations recommendations, health workers (HWs) still prescribe antimalarials to malaria rapid diagnostic test (mRDT)-negative patients, thus increasing overuse and the risk of parasite resistance to the antimalarials. The reasons for this are not clear. We identified factors associated with antimalarial prescription to mRDT-negative patients.MethodsWe conducted a cross-sectional study among 423 HWs. Data on socio-demographic characteristics, training, supervision experience and fever management practices were collected. We tested associations between independent variables and prescription of antimalarials to mRDT-negative patients using Chi square and logistic regression at p < 0.05.ResultsThe HWs were mostly community health workers (58.6%), with mean age of 41.0 (±8.8) years and 13.6 (± 9.0) years of professional practice. Females were 322 (76.1%) and 368 (87%) were married. Of the 423 HWs interviewed, 329 (77.8%) received training on mRDT use, 329 (80.6%) received supervision and 129 (30.5%) had good knowledge of causes of fever. Overall, 110 (26.0%) of the HWs prescribed antimalarials to mRDT-negative patients. A higher proportion of non-trained vs trained HWs [Adjusted Odds Ratio (aOR) = 4.9; 95% Confidence Interval (CI) (2.5-8.3)], and HWs having poor knowledge vs HWs having good knowledge of causes of fever [aOR = 1.9; 95% CI (1.0-3.5)], prescribed antimalarials to mRDT-negative patients.ConclusionHWs' lack of training on mRDT use and poor knowledge of causes of fever were associated with prescription of antimalarials to mRDT-negative patients. We recommend training on management of fever and mRDT use to reduce such inappropriate antimalarial prescriptions.

Coristoma ósseo mesentérico em uma porca

Background: Osseous choristomas represent the production of osseous tissue in abnormal regions, such as subcutaneous, fibrous or perivascular tissues, skeletal muscle and skin. These structures have been found in humans, dogs (lungs and dura mater), horses (large intestines) and cattle (lungs and mesenteric lymph nodes). They were also found in the mesenteric region and thoracic cavity of sows and piglets. The aim of this paper was to describe the macro and microscopic lesions found in a sow which died suddenly by a rare mesenteric osseous choristoma.Case: A lactating sow, parity four, from the Swine Department of the Federal University of Rio Grande do Sul (UFRGS), Brazil, showed appetite loss, hyperthermia (41.5ºC) and sudden death. The animal was submitted to necropsy at the Department of Veterinary Pathology, UFRGS. On external examination, the sow showed conjunctival and perioral cyanosis, proximal colon region with a firm structure with approximately 3.0 cm length in mesenteric area. Moreover, the colon was ruptured and fibrin deposition and intestinal content in abdominal cavity were observed. Fragments of organs were collected in 10% formalin, routinely processed for histology and colored with hematoxylin and eosin stain (H&amp;E). Histologically, it was found bone trabeculae with osteoid, periosteum, spaces with osteocids and endochondral ossification with bone marrow composed by adipose tissue and intense proliferation of conjunctive stroma. The mesenteric lymph nodes showed intense lymphoid hyperplasia with multifocal centrilobular necrosis. There was fibrin in serosa of colon, acute peri-spleen and acute fibrinopurulent perihepatitis.Discussion: Macroscopic and microscopic findings were consistent with mesenteric osseous choristoma. This condition is unusual in domestic animals, however it has been already described in pigs. Osseous choristoma could be related to previous mesenteric torsions, which could occur in growing phase, causing inflammation and hemorrhage, stimulating its generation. These structures may cause lesions in adjacent organs. The abrupt movements of the sow or intestinal peristalsis could have broken the bone, raising two tips, which in contact with the colon, ruptured it. Because of this, shedding of intestinal content was observed, which resulted in an acute peritonitis and sudden death of the animal. The annual mortality rates of sows (natural deaths or euthanasia) varies from 4.0 to 6.0%, but may be variable. Sow sudden deaths represent 17.5% of all sows and boars deaths, and gilts, pregnant and lactating sows are more susceptible. The most common causes of sow sudden death are gastrointestinal problems, such as ulcer, enteritis, torsions and ruptures; pneumonia; urinary infections, such as cystitis and pyelonephritis; heart failure; dystocia, and septicemia. However, one third of sudden death causes are not identified. The necropsy is the only way to identify the cause of death, through observation of macroscopic lesions and subsequent laboratory tests. Better knowledge of causes is important to establish control measures and possibly reduce culling of swine females. The causes of sudden death in sows should be better understood. Case reports of mesenteric osseous choristomas are rare in pigs, however it is not possible to assert if its occurrence is low, since few sudden deaths in sows are investigated.

Transfusion sanguine et inflammation

Transfusion of labile blood products (LBPs) generates occasional inflammatory : type, hazards; for a large part of these, no antigen/antibody conflict is thus, detected. Residual leucocytes used to account for a large part of such incidents – rarely accidents. Since, however, the systematic leukoreduction of LBPs, leucocytes are the less and less incriminated in adverse events. Platelets themselves proved capable of secreting copious amounts of inflammatory mediators, even in the absence of any deliberated stimulation. Meanwhile, even though exceptionally, inflammation can be observed after red blood cell transfusion. It has been noticed that the collection mode of cellular compounds, as well as the preparation and storage conditions are capable of inflicting lesions to the cell membranes and to activate those cells, and thus promoting inflammatory responses. Storage lesions as well as ageing of the stored cells alongside with cell apoplosis contribute to inflammatory responses. This present ‘State of the Art’ paper aims at encompassing the primary and secondary components of the LBPs, along with the various types of molecules displaying pro-inflammatory properties that can be encountered in transfusion. A better knowledge of causes of inflammatory transfusion-linked hazards is indeed instrumental to the implementation of safety measures aimed at reducing or suppressing these unwanted effects.

Nutritional status, complementary feeding practices and feasible strategies to promote nutrition in returnee children aged 6–23 months in northern Uganda

Objectives: The aim of this study was to assess the prevalence of underweight and wasting, feeding patterns, water use and sanitation patterns in children aged 6–23 months in returnee villages in northern Uganda, and then to identify feasible strategies to promote nutrition. Perceived understanding of the presentation and causes of undernutrition was also assessed.Design: This was a descriptive cross-sectional survey, carried out in May and June 2010.Setting and subjects: The study was conducted in the districts of Agago and Pader in northern Uganda in 219 children aged 6–23 months.Outcome measures: Weight and mid-upper-arm circumference were determined for underweight and wasting, respectively. Focus group discussions were held with adults to determine perceived understanding, presentation and causes of undernutrition.Results: Over 11% of the children were wasted. Those aged 6–11 months were the most wasted. Eighteen per cent of them were underweight. Those aged 12–17 months had the highest prevalence of underweight. Eighty-three per cent of the children were still breastfeeding and 47% were exclusively breastfed. The largest proportion (38.8%) of children ate twice daily and 4.1% had not eaten any food on the day prior to the visit. The water usage rate was 13.3 litres/person/day. The majority (57.5%) of households did not have their own pit latrines and disposed of faeces in the bush (87%). Communities had good knowledge of causes of undernutrition, its consequences and the required practices to prevent and control it.Conclusion: This assessment has informed the need for holistic approaches to address the challenge of undernutrition in children aged 6–23 months in returnee villages in northern Uganda. Interventions that target improvement in complementary feeding, particularly between the ages of 6–11 months, while also addressing pertinent issues of water and sanitation, hold the most potential to address the challenge.

P1-383 Sexual behaviour and knowledge of prevention of sexually transmitted infections among students in co-educational and non co-educational schools in Ibadan, Nigeria

Sexual interaction between students may be different in co-educational (CE) and non co-educational (NCE) schools. The objective was to compare sexual behaviour and knowledge of prevention of Sexually Transmitted Infections...