Hygiene Education Research Articles

P-1313. Large Outbreak of Staphylococcus aureus and Bacillus cereus Caused by Ready-to-Eat Meals in Aomori, Japan

Abstract Background Ready-to-eat meals are a vehicle of multijurisdictional outbreaks of foodborne diseases worldwide. Ekiben is a type of ready-to-eat meal commonly sold at train stations and occasionally at markets in Japan. On September 17, 2023, the Hachinohe City Public Health Center (HCPHC) received numerous complaints from consumers in several prefectures who had eaten ekiben produced by Company A in Hachinohe, Aomori, Japan. Methods In collaboration with HCPHC, we conducted an epidemiological investigation, traceback/traceforward investigation, and an inspection of Company A. The local public health authorities performed microbiological tests of food and stool samples. Results A total of 554 symptomatic cases were identified in 29 prefectures. The highest proportion of symptoms was diarrhea (86%), followed by vomiting (61%), nausea (59%), and stomachache (51%). Company A produced 67 lunchboxes of which 23 types of lunchboxes occurred cases. 23 lunchboxes contained seafood as an ingredient but no common ingredients except for rice. The rice was self-produced and/or outsourced from Company B. Company A received triple the number of usual orders from retailers and trading companies due to an “Ekiben Fair” held on September 15 and 16. Company A could not prepare enough steamed rice for such an event on its own, so it outsourced the production of some rice to Company B, which shipped the rice at temperatures ranging from 42°C–49°C. Staphylococcus aureus with enterotoxin and Bacillus cereus with enterotoxin were detected from stool samples as well as steamed rice and other food samples with sufficient amounts of bacteria to cause the disease. Company A did not have an appropriate HACCP plan, operation manual, response plan, or processing records. The company had no records of hygiene training, hygiene education, health checks, or hand-injury records for its temporary workers. We concluded that the likely causative food was steamed rice that had been shipped at an improper storage temperature, and processing the lunchboxes. Conclusion We recommended that Company A store rice at the proper temperature, implement an appropriate HACCP plan, create a standard operation manual, maintain processing records, separate clean and contaminated areas, and prepare a response plan in case of unusual situations. Disclosures All Authors: No reported disclosures

P-1799. Impact of coronavirus disease 2019 on infectious disease treatment and infection control: Multicenter study in Japan

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic impacted infection control practices such as hand hygiene and antimicrobial use, but its specific effects remain unclear. Thus, in this multicenter study, we aimed to determine the pandemic's effect on these factors by comparing pre- and post-COVID-19 periods. (A) The number of inpatients by month during the study period. (B) The amount of hand sanitizer used per inpatient by month during the study period. The two solid lines show the regression lines in the pre- and post-COVID-19 periods. The dashed line in the post-COVID-19 period is an extension of the regression line in the pre-COVID-19 period. Methods Data on hand sanitizer use, antimicrobial use, positive blood cultures, and antimicrobial-resistant (AMR) organism detections were collected monthly from April 2015 to March 2023 at four Japanese hospitals. The pre-COVID-19 period data (April 2015 to March 2020) were compared to the post-COVID-19 period data (April 2020 to March 2023). Results Compared to pre-COVID-19, hand sanitizer use per inpatient and antimicrobial use, particularly broad-spectrum antimicrobials, increased significantly post-COVID-19. The proportion of positive blood cultures increased, but AMR organism detections remained unchanged, suggesting increased contamination rather than infection. Conclusion Ongoing antimicrobial use monitoring, hand hygiene education, and promotion of effective infection control and antimicrobial stewardship by infection control teams are crucial for prevention of future pandemics. (A) Total DOT (combined with all antimicrobials extracted in this study) by month. (B–F) DOT of individual antimicrobial agents by month. The two solid lines show the regression lines in the pre- and post-COVID-19 periods. Other antimicrobial agents are shown in Appendix Figure A.1. Abbreviations: CFPM, cefepime; CI, confidence interval; CTRX, ceftriaxone; DOT, days of therapy; MEPM, meropenem; SBT/ABPC, sulbactam/ampicillin; TAZ/PIPC, tazobactam/piperacillin. Disclosures Hiroshi Kakeya, MD, PhD, Asahikasei Phrma: Honoraria|GSK: Honoraria|MSD: Honoraria|Pfizer: Honoraria|Shionogi: Honoraria|Sumitomo Parma: Honoraria

P-367. Containment of an Outbreak of Carbapenem-Resistant Acinetobacter baumanii in a Burn Intensive Care Unit

Abstract Background Acinetobacter baumanii is a cause of serious infections in hospital settings. Carbapenem-resistant Acinetobacter baumanii (CRAB) is especially difficult to treat. Patients in a burn unit are particularly vulnerable to colonization and infection with few reports describing CRAB outbreaks in a burn intensive care unit and measures required for containment. This study highlights the infection control measures successful in controlling an outbreak. Methods After detection of a patient with CRAB in an urban burn unit in January 2023, all patients in the burn unit were screened for carbapenem resistant organisms. Six patients with CRAB were identified between January 2023 and May 2023. Whole genomic sequencing was used for confirmation of clonal relatedness. All patients with a positive CRAB culture of sterile or non-sterile sites are included in this retrospective study. Results Six patients ages 29-53 tested positive for CRAB between January 2023 and May 2023. Case 1 was admitted from a long term acute care facility, with sputum culture positive for CRAB. One had CRAB from a blood culture, and four in wound cultures. Longer length of stay, 80 days vs 13 days was seen with CRAB positive patients because of partial skin graft failure, slower to heal wounds, and barriers to placement. After judicious use of antibiotics, following infection control practices were implemented: 1. Screening for carbapenem resistant organisms (CPOs) on admission, weekly, and on discharge. 2. Fluorescent markers added to adenosine triphosphate (ATP) testing of environmental surfaces and equipment. 3. Double terminal cleaning of rooms with CRAB. 4. A cleaning process for every piece of equipment. 5. Hand hygiene education and proper use of personal protective equipment. With the above measures, no cases of CRAB were seen after May 2023. Conclusion The CRAB outbreak was associated with patients with burn wounds, antibiotic use, similarities in age and demographics, slower wound healing, partial skin graft loss, and longer length of stay. The control measures listed were successful in controlling the outbreak. Disclosures All Authors: No reported disclosures

P-338. Impact of an Educational Program on Hand Hygiene Practice and Healthcare-Associated Infections in a Tertiary Care Hospital in Rural South India

Abstract Background Effective hand hygiene is pivotal in averting healthcare-associated infections (HAIs), especially in resource-limited settings. This study aimed to evaluate baseline hand hygiene practices among healthcare providers (HCPs) and the impact of an educational intervention on reducing HAIs in a rural South Indian tertiary care hospital. Methods Over a 12-week period, an observational study was conducted across internal medicine, neurology, pulmonology, urology, pediatrics, and general surgery departments. Hand hygiene compliance among HCPs was meticulously observed, while HAIs were monitored using CDC definitions. Subsequent to the baseline assessment, a targeted hand hygiene education program was initiated, focusing on enhancing compliance among 190 nurses. Results A total of 1817 inpatients were enrolled in the study, with 55% male and 45% female, and age ranging from 1 to 90 years (median age: 50 years). Among the 1817 inpatients, HAIs exhibited varying incidence rates across departments. Notably, pneumonia was the most prevalent HAI in the internal medicine department (incidence: 1.8%), while urinary tract infections were prominent in neurology and pulmonology (incidence: 0.9%), and surgical site infections in urology (incidence: 0.7%). Hand hygiene compliance varied across departments, with internal medicine demonstrating the highest compliance (24.5%). Post-implementation of the education program, compliance significantly improved to 65.2%. Consequently, there was a notable decrease in HAI rates, with pneumonia cases in internal medicine decreasing by 30%, and urinary tract infections in neurology and pulmonology decreasing by 25%. Conclusion This study underscores the pivotal role of hand hygiene practices among HCPs in preventing HAIs, particularly in resource-limited settings. The implementation of targeted educational interventions resulted in a substantial improvement in compliance and a subsequent reduction in HAI incidence rates. These findings emphasize the ongoing need for concerted efforts to enhance hand hygiene practices and mitigate the risk of HAIs in rural healthcare settings. Further research and interventions are warranted to sustain these improvements and ensure optimal patient safety outcomes. Disclosures All Authors: No reported disclosures

Primary school children’s oral hygiene knowledge assessed with different educational methods: a cross-sectional study

BackgroundDifferent educational methods play an important role in oral hygiene education programs. This study aims to evaluate the impact of various educational methods on the oral hygiene knowledge of primary school children.MethodsA total of 490 primary school students participated in this cross-sectional study. The students were assigned to one of three groups: a verbal explanation group, an animation group, or a peer-led reels group. Before and after the intervention, the students completed questionnaires assessing their oral hygiene knowledge.ResultsA significant increase was observed in the post-educational knowledge levels of the children in three educational methods (p < 0.001). The study found that the main effect of educational methods was statistically significant (p < 0.001). However, effects of gender, and tablet/mobile phone use, respectively, were not statistically significant (p = 0.694, p = 0.641). The animation group (6.73) and the verbal expression group (6.57) had the highest post-training knowledge levels, respectively, while the peer-led reels group had the lowest (5.95) (p < 0.001).ConclusionsAll three educational methods are effective in promoting oral hygiene, but due to the accessibility and consumption of information in the current technological era, animation videos may be more useful and suitable for modern education.Trial registrationID: NCT06569745; Date: 21.08.2024; ‘retrospectively registered’.

Hygiene Education and Success for Resident Students in Cabins on the Natitingou University Campus in the Republic of Benin

Hygiene Education and Success for Resident Students in Cabins on the Natitingou University Campus in the Republic of Benin

Risk of Staphylococcus aureus nasal carriage among food handlers: implications for foodborne illnesses

The presence of microorganisms or their toxin in food materials is a predominant problem in the food industry, posing significant hazards to public health. Staphylococcus aureus, a bacterium commonly colonising human skin, nose, and gut, is a leading cause of foodborne infections. Asymptomatic carriers can contaminate food by touching it or through respiratory secretions, leading to staphylococcal food poisoning. This study aims to assess the prevalence and antibiotic resistance patterns of Staphylococcus aureus among food handlers. Nasal swabs from food handlers were analysed using standard microbiological techniques. The study found that 57% of restaurant workers and food handlers had Staphylococcus aureus in their nasal cavities. Among the participants, women had a higher prevalence at 94%, while men had a prevalence rate of 6%. The chi-square analysis revealed no significant differences in the occurrence of Staphylococcus aureus across different genders or age groups, indicating that neither gender nor age significantly influenced the prevalence. The age group with the highest prevalence rate was 23-28 years at 23.5%. Levofloxacin and Rifampicin showed the highest sensitivity rates (87%), while all isolates resisted Norfloxacin. These findings highlight the critical need for enhanced food hygiene education and the use of protective equipment among food handlers to prevent foodborne illnesses. Addressing antibiotic resistance is also fundamental for public health interventions

Efficacy of brief behavioral and sleep hygiene education with mindfulness intervention on sleep, social jetlag and mental health in adolescence: a pilot study.

Sleep is often compromised in adolescents, affecting their health and quality of life. This pilot-study was conducted to evaluate if implementing brief-behavioral and sleep-hygiene education with mindfulness intervention may positively affect sleep-health in adolescents. Participants in this community-based non-randomized cohort-study volunteered for intervention (IG)- or control-group (CG). Sleep was recorded during regular school-schedule for 3-school-nights and 2-non-school-nights with an FDA-cleared/EU-Medical Device Regulation(CE-2862) compliant home sleep test, and Questionnaires were utilized to evaluate chronotype, sleepiness, insomnia-, anxiety- and depression-symptoms. The four-week intervention included sleep-hygiene education, mindfulness- and breathing-practices for one-hour, twice weekly. Data was collected during the last-week of February and first two-weeks of March 2023 and repeated after intervention. Fifty-five participants completed the study, IG (86%) and CG (77%). Average age was 17.3-years and prevalence of severe social-jetlag (SJL) 72%. Participants who quit participation (n = 10) after baseline data-collection all females (3-IG/7-CG) in comparison to participants who completed the study were sleepierthan the IG and CG (+ 2.6-p = 0.04; + 3.8-p = 0.001), with more symptoms of insomnia- (+ 3.8-p = 0.002; + 4.7-p < 0.0001), and depression (+ 16.7-p < 0.0001; + 19.6-p < 0.0001), and report being later-chronotypes, (-18.2, p < 0.0001;-13.1, p < 0.0001). On average the IG advanced sleep-onset (32-min; p = 0.030), decreased SJL (37-min; p = 0.011) and increased total sleep time (TST, 29-min; p = 0.088)compared to the CG. Average sleep duration did not differ significantly comparing IG and CG after intervention. Stratifying participants with severe SJL (> 2-h) at baseline; 1) responders (61%) advanced sleep-onset on non-school-nights (96-min) and decreased SJL (103-min; p < 0.001) 2) non-responders (39%) increased sleep-duration on school-nights (36-min) and non-school-nights (63-min) but maintained severe-SJL. Teacher-lead sleep-education and mindfulness program can improve TST and SJL in adolescence.

Impact of clear aligners on gingivitis incidence and prevention strategies in adolescents and adults: a prospective observational study

ObjectiveThis study aims to analyze the differences in gingivitis incidence among adolescents and adults using clear aligners for orthodontic correction and to evaluate the effectiveness of prevention strategies on orthodontic outcomes.MethodsThis observational study included 120 patients undergoing clear aligner orthodontic treatment from June 2018 to September 2023. Participants were divided into an adolescent group (66 cases) and an adult group (54 cases), each further split into a study group and a control group. The control group patients maintained their daily lifestyle throughout the study period. The study group received personalized oral hygiene education and guidance on self-oral care techniques at each follow-up visit. Routine periodontal treatment and personalized oral hygiene education were provided, and the incidence of gingivitis was evaluated six months post-treatment. Statistical methods, including chi-square tests for categorical data, t-tests for continuous variables, and two-way ANOVA for group comparisons, were employed to ensure the robustness of the results.ResultsThe incidence of gingivitis was significantly higher in the adolescent group compared to the adult group (P < 0.05). Specifically, within the adolescent group, the study group exhibited a higher gingival index (GI) than the control group (P < 0.05), while the difference in the adult group was not significant.ConclusionDuring clear aligner orthodontic treatment, adolescents are more prone to developing gingivitis than adults. Additionally, basic periodontal therapy, as opposed to verbal oral health education alone, can moderately reduce the incidence of gingivitis in clear aligner patients during treatment.

Sleep hygiene education in older adults: effectiveness and association with comprehensive geriatric assessment

Objectives This study aimed to evaluate the results of sleep hygiene education via a comprehensive geriatric assessment. Method A cross-sectional research was conducted on insomnia outpatients at a tertiary hospital, and all participants received sleep hygiene education as well as a comprehensive geriatric assessment. Sleep parameters were assessed before and four weeks after education. Results The study included 141 participants. A significant improvement was obtained in all four scales’ scores before and after education (PSQI score 11 [8–13] vs. 5 [3–9], p < .001; SHI score 12 [8–16] vs. 4 [1–8], p < .001; ESS score 6 [3–8] vs. 2 [0–6], p < .001; Jenkins SS score 15 [10–19] vs. 7 [5–11], p < .001). Female gender ratios, as well as the presence and risk of malnutrition, differed between groups with and without the PSQI score improvement. In the regression analyses, female gender and the presence of malnutrition or malnutrition risk were evaluated as possible factors affecting the PSQI responses (respectively, OR: 3.48, CI 95%: 1.21–10.00, p = .020; OR: 0.29, CI 95%: 0.09–0.949, p = .041). Conclusion Sleep hygiene education and interdisciplinary interventions are crucial in the management of sleep disorders in older adults.

Water, sanitation, and hygiene among transgender population living in urban informal settlements: a qualitative study in Odisha, India

Background Access to safe drinking water, sanitation, and hygiene (WASH) is recognized as a fundamental human right. However, transgender people residing in low-resource settings such as urban slums encounter unique challenges in accessing WASH facilities. Aims To explore the WASH-related issues and health outcomes associated with these challenges among transgender people living in urban informal settlements in India. Materials and Methods A qualitative phenomenological approach was employed, involving in-depth interviews with 24 transgender people residing in urban informal slums in Odisha, India. The interviews were digitally recorded, transcribed, translated and analyzed using the thematic analysis methods. Results The findings reveal that transgender people faced significant challenges in accessing adequate sanitation facilities. Many of them used inadequate toilet facilities due to sex segregation, which exposed them to harassment and discrimination. Moreover, transgender people who engaged in sex work faced heightened risks of infections due to risky sexual practices driven by economic necessity and the need for gender validation. Despite these obstacles, transgender people have mobilized nonprofit organizations to address these issues comprehensively, prioritizing health and overall well-being. Conclusion The study underscores the critical need for improving sanitation infrastructure, regular maintenance, and comprehensive hygiene education tailored to the specific needs of transgender people. Efforts should prioritize enhancing sanitation facilities and promoting hygiene practices to mitigate health risks effectively. Additionally, awareness and education programs focusing on various aspects of hygiene, including hand hygiene, oral hygiene, and peri-anal hygiene, are essential to promote better health outcomes within the transgender community.

Effort-reward imbalance among dental and dental hygiene faculty and turnover intention.

The impact of effort-reward imbalance(ERI)onthedecision to leave academia among dental and dental hygienefaculty in the United States (US) has yet to be explored.This study examined the effect of effort, reward, and overcommitment on turnover intention to leave academia in dental and dental hygiene faculty in the US. Cross-sectional survey research design was conducted with a convenience sample of dental hygiene and dental faculty (n=273) currently teaching in the US. The survey included three sections: demographics, Teacher Effort-Reward Imbalance Questionnaire (Teacher ERIQ), and turnover intention scale-6 (TIS-6). Descriptive, correlation, and regression were used for analysis. The completion rate was 66.7% (n=182). About 67% of the sample reported sometimes or always considering leaving their job. The effort (M=49.53)-reward (M=46.86) ratio was 1.11 (SD±0.37) suggesting slightly more effort than reward. The TIS mean was 16.32 with scores of 18 or higher suggesting intent to leave. Regression analysis found that predictors of turnover intention were effort (β=0.315, t=3.821, p<0.001) indicating higher levels of perceived effort were associated with an increased turnover intention. Reward emerged as a significant negative predictor of TIS (β=-0.464, t=-7.449, p<0.001). The predictors of turnover intention for faculty weregreater effort with lower reward. These are areas institutions need to address to recruit and retain qualified dental and dental hygiene educators.

The use of individualised, media-based sleep hygiene education for professional female footballers.

Sleep hygiene can be defined as practicing habits that facilitate sleep; poor sleep hygiene is common among elite athletes, and improving this can be one way to enhance sleep indices. Given the large inter-individual variability of sleep, there is a need for further investigation into individualised sleep hygiene for elite female athletes, with consideration for the practical application of the method. Using a self-controlled time series design with repeated measures, n=16 professional female footballers completed a 9-week study during mid-season. Monitoring of sleep (actigraphy, self-report) occurred at week 1, 4, 7 and 9-a control period occurred at week 2 and 3, and a subsequent intervention period occurred at weeks 5 and 6. Based on baseline sleep monitoring, media-based messages were designed with the purpose of giving a singular sleep hygiene message; all participants received these individualised messages daily across the 2-week intervention period at a standardised time of 8.00p.m., with the intention of them actioning the sleep hygiene point. One-way analysis of variance with repeated measures was conducted to assess the differences between control period, intervention period and follow-up for each measured variable. Significant differences were observed post-intervention for sleep efficiency (p<0.001) and sleep latency (p<0.001), whereas the athlete sleep behaviour questionnaire score significantly improved in the follow-up period (week 9) post intervention (p=0.039). This is the first study to present this novel method of individualised sleep hygiene education for elite female athletes and is also the first study to demonstrate the use of sleep hygiene interventions to improve sleep factors for female athletes' mid-season. This demonstrates a promising, time-efficient approach to sleep hygiene education, with a potentially wide scope of application, as well as demonstrating there is indeed potential for elite female athletes to gain sleep improvements mid-season.

The study of the development of family hygiene education during the republic of China

Introduction: Family hygiene education relates between untidy living standards and sicknesses it offers more instructions how to avoid diseases. In the era of the Republic of China that characterized by tremendous social and political transformation, hygiene education (HE) became one of the important elements of public health. Objectives: The paper explores the transformation of family hygiene education in China, examining policies, practices, and community programs that influenced public health and individual health standards. Method: It adopted the historical analysis approach in records of educational curriculum, public health, and community papers would be analysed. Such sources prove useful in mapping the evaluation and results of the distribution of knowledge in the field of hygiene to communities and managing with threats pretended to their well-being. Result: According to research, family hygiene education played important role in tackling diseases and hygiene problems that were common at that time. The study found that hygiene programs significantly improved community health practices, increased health literacy among community members, and encouraged greater involvement in health-related matters. Conclusion: They used education to spread the concept of family hygiene as an essential instrument in developing public health and mapped out the principles from the República de China with appropriate social and historical contexts.. The present research offers important information on the evolution of hygiene education and its long-lasting relevance to people’s behavior

Sleep quality and mental health among medical students in Imphal, Manipur: A cross-sectional study

ABSTRACT Background: Sleep and mental health are deeply interlinked, with poor sleep quality, a common issue among medical students, having a profound impact on their mental well-being. Methods: A cross-sectional study was conducted among medical students in a tertiary care hospital in Imphal, Manipur. Data were collected using a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scale (DASS-21). Descriptive statistics, Chi-square test, and Pearson correlation test were applied, and P &lt; 0.05 was considered statistically significant. Results: A total of 425 respondents took part in the study, including 268 undergraduate and 157 postgraduate students. Most participants, 236 (55.5%) had poor sleep quality. Among the participants, 168 (39.5%) had depression, 167 (39.3%) had anxiety, and 95 (22.4%) had stress. Poor sleep quality was significantly associated with academic year among undergraduate students (P = 0.005), increased total screentime per day (P = 0.024), and increased screentime before sleep (P = 0.007). Depression, anxiety, and stress were significantly associated with younger age (P = 0.001), the undergraduate course being pursued (P = 0.001, 0.003, and 0.001), and increased screen time before sleep (P = 0.021, 0.046, and 0.039). Depression, anxiety and stress scores had a significant positive correlation with the global PSQI score. Conclusion: More than half of the participants experienced poor sleep quality, with four out of ten experiencing depression or anxiety, and two out of ten experiencing stress. Hence, medical institutes must implement sleep hygiene education and screen time reduction initiatives to enhance students’ sleep quality and overall well-being.

Impact of sleep hygiene education on sleep and nutrition in children aged 10-18 years.

Sleep quality has positive effects on children's sleep and eating habits. In turn, improvement in sleep quality is associated with sleep hygiene training. The aim of our study was to determine the impact of sleep hygiene education on sleep and nutrition management in children aged 10-18 years. In addition, we explored the association between sleep problems and eating behaviours in participants before and after the training programme. We conducted a quasi-experimental study between August 25 and December 27, 2023, in children aged 10-18 years who participated in the study on a voluntary basis with the consent of their parents. We collected data from a total of 80 children aged 12-18 years. The study investigated the relationship between sleep problems and eating behaviours. We randomly allocated participants to one of two groups, the training group or the waitlist group. We assessed the association between changes in sleep problems and changes in eating behaviours in the training group. The data were collected using a sociodemographic data form, the Children's Sleep Habits Questionnaire, and the Three-Factor Eating Questionnaire. In the study sample, the proportions of male and female participants (training group) were 60.0% and 40.0%, respectively. There was a statistically significant difference between the pretest and post-test scores in the Children's Sleep Habits Questionnaire and the Three-Factor Eating Questionnaire (P < .01) and significant differences in the changes in sleep and eating habit scores between groups between the pre- and post-sleep hygiene training timepoints (P < .01). Thus, we concluded that sleep hygiene training is associated with and has an impact on sleep and nutrition. We observed that in children aged 10-18 years, sleep problems were associated with their eating behaviours. Sleep hygiene education had a significant and favourable impact on sleep and nutrition outcomes. Thus, sleep hygiene training has an important effect on children's sleep and diet.

Sleep and circadian rhythms after traumatic brain injury.

Traumatic brain injury (TBI) is a serious public health concern and is one of the major causes of death and chronic disability in young individuals. Sleep-wake disturbances are among the most persistent and debilitating consequences of TBI and are reported by 50%-70% of TBI patients regardless of TBI severity. Excessive daytime sleepiness, fatigue, hypersomnia, and insomnia are the most common sleep disturbances in TBI patients. Post-TBI sleep-wake disturbances are often associated with pain, anxiety, depression, and posttraumatic stress disorder. They may exacerbate cognitive impairment following TBI, reduce community integration, and delay recovery and return to normal life. Changes in sleep architecture following TBI have been reported in the literature but cannot fully explain the extent and intensity of the sleep-wake disturbances reported by TBI patients. The alteration in the circadian timing system is another factor that may partially account for the presence of post-TBI sleep-wake disturbances. Current literature supports cognitive behavioral therapy and sleep hygiene education, light therapy, and certain pharmacologic interventions for treating sleep disturbances in TBI patients. Due to heterogeneous consequences of TBI, early screening and individualized approaches to treatment must be prioritized to improve sleep in TBI patients and consequently speed up recovery.

Non-pharmacological treatments for insomnia: a focus on components of cognitive behavioral therapy for insomnia

Insomnia is a prevalent disorder that affects 4% to 22% of the population in the United States. While cognitive behavioral therapy for insomnia (CBT-I) remains the gold standard for non-pharmacological treatment, accessibility barriers exist owing to a shortage of trained professionals and high costs. This review examines the efficacy of the individual components of CBT-I as stand-alone interventions to improve treatment accessibility, digital CBT-I, and other non-pharmacological interventions. Guidelines from organizations such as the American Academy of Sleep Medicine and, European Sleep Research Society, along with recent meta-analyses, support the effectiveness of these components as stand-alone treatments. Sleep restriction therapy and stimulus control therapy show promise as effective interventions. Although recommended by certain guidelines, relaxation therapy has yielded mixed results. Sleep hygiene education, a common component of CBT-I, has not demonstrated significant efficacy as a stand-alone treatment. Cognitive strategies have shown promise in recent studies. Sufficient clinical evidence supports the efficacy of digital CBT-I in treating insomnia. Internationally, various platforms for digital CBT-I have already been developed and are in use, and in South Korea, some digital CBT-I software programs have received digital therapeutic device approval in 2023. This review highlights the potential of individual components of CBT-I as effective stand-alone interventions for insomnia, as well as digital CBT-I, emphasizing their importance for improving the accessibility of non-pharmacological insomnia treatments in clinical settings where full CBT-I may not be available.

ОСВЕДОМЛЕННОСТЬ СТУДЕНТОВ КРАСНОДАРСКИХ ВУЗОВ О МЕРАХ ПРОФИЛАКТИКИ СТАФИЛОКОККОВОГО ТОКСИКОЗА

This article is devoted to the study of the level of competence of students of 4 universities of Krasnodar in relation to food poisoning caused by staphylococcal toxin. The work analyzes the awareness of students about the etiology, manifestation of the disease and prevention of this food poisoning. As is known, there is a certain correlation between non-compliance with the principles of rational nutrition among students, including the consumption of products with an indefinite shelf life and/or improper storage conditions, and an increased risk of staphylococcal toxicosis. Due to the increased academic load, the intensity of the educational process, and small breaks between academic classes, university students lack time for a full meal. In this regard, they can eat in public catering establishments that potentially do not fully comply with sanitary and epidemiological requirements and technological regulations for food production, which may pose a threat to their health. It should also be noted that the low degree of sanitary and hygienic education among students is one of the significant factors that determine the relevance of the problem of staphylococcal toxicosis among students. According to the results of the survey, deficiencies in students' knowledge were identified and the most vulnerable groups were identified. The results of the survey confirm the demand for preventive activities aimed at improving the awareness of university students about staphylococcal toxicosis.

The impact of an integrated intervention program combining drug therapy with water, sanitation, and hygiene (WASH) education on reinfection with intestinal parasitic infections among the Karen hill tribe in northern Thailand

BackgroundIntestinal parasitic infections (IPIs) are a major health problem among the Karen hill tribe in Thailand. This study aimed to evaluate the effect of an integrated intervention program of drug therapy combined with water, sanitation, and hygiene (WASH) education on reinfection with IPIs among the Karen hill tribe in an endemic area of northern Thailand.MethodsA quasi-experimental study was conducted in two Karen villages, involving 691 residents, in Omkoi District, Chiang Mai Province; one village was designated as the intervention group and the other as the control group. Baseline information was collected regarding the infections and participants’ knowledge, attitudes, and practices (KAP) related to prevention and control of IPIs. Detection of benzimidazole resistance linked to the beta-tubulin gene mutation in soil-transmitted helminths (STH) was performed using polymerase chain reaction (PCR) amplification and DNA sequencing. Mass drug administration (MDA) with albendazole was applied to both groups. The intervention group received WASH education, whereas the control group did not. Follow-up assessments were conducted at 3 and 6 months.ResultsBaseline data revealed a 36.0% (123/342) prevalence of IPIs in the intervention group and 36.8% (96/261) in the control group. The most common helminth and pathogenic protozoan were Trichuris trichiura and Giardia lamblia, respectively. No non-synonymous mutations in the beta-tubulin gene were found. Post-intervention at 3-month and 6-month follow-ups revealed that the prevalence of IPIs in the intervention group was significantly decreased to 23.6% (P = 0.002) and 23.1% (P = 0.002), and the prevalence of pathogenic IPIs was reduced from 9.4% to 3.9% (P = 0.013) and 2.4% (P = 0.002), respectively. In contrast, no significant changes in the prevalence of IPIs were observed in the control group. The intervention group showed significant improvements in KAP scores, which were significantly higher than those in the control group.ConclusionsMDA alone is not effective for controlling IPIs among the Karen people due to rapid reinfection related to behavioral factors and socioeconomic conditions. We demonstrated for the first time that integration of WASH education increased KAP scores and consequently significantly reduced IPI reinfection among the Karen hill tribe in northern Thailand.Graphical