Health Guidelines Research Articles

Isolation and identification of major cockroaches associated pathogenic bacteria in Bonga town, Ethiopia

Cockroaches are a reservoir of various pathogenic microorganisms that pose a significant risk to public health because of unsanitary living spaces, poor waste management, inappropriate food storage, limitations of public health guidelines, and education on hygiene practices. The aim of this study was to isolate and identify major pathogenic bacteria associated with cockroaches in Bonga Town, Kaffa Zone. A total of 300 cockroaches were collected from Restaurants, Houses, and Hospitals, with 100 specimens from each location. The collected cockroaches were then subjected to microbiological analysis in the laboratory to identify potential bacterial pathogens. The cockroaches were killed using cotton-soaked chloroform, surface-sterilized using 70 % ethanol, and dissected aseptically. The cockroaches were added to 2 mL of sterile normal saline and shaken thoroughly for two minutes. The cockroaches were taken out of the tubes, and the remaining liquid was centrifuged at 2000 rpm for 10 minutes. The supernatants were then removed, and the remaining sediments were used for culture. In each tube, a fixed volume of 1 mL of the sediments was cultured on various culture media separately. Different species of bacteria with similar morphological characteristics were identified on the external and internal surfaces of the cockroaches. These results indicate the morphological characteristics of the colonies grown on each agar plate in different settings (Hospital, Restaurants and Households). The specific characteristics of the colonies can help in identifying different bacterial species. The isolated pathogens were then identified using standard microbiological techniques, including gram staining, morphology, microscopic slides, and biochemical tests. The results revealed the presence of bacterial pathogens, including E. coli, Salmonella, Pseudomonas, Staphylococcus spp., Shigella spp., and Proteus spp. The bacterial species were predominantly found in Households and Hospital areas, while fewer were found in restaurant areas. The presence of these pathogenic bacteria in cockroaches highlights the potential risk of food contamination and subsequent human diseases. Therefore, further analysis and characterization of these pathogenic bacteria should be done at the molecular level, and more clinical evaluation must be undertaken after the final identification and characterization.

A comparative analysis of 24-hour movement behaviors features using different accelerometer metrics in adults: Implications for guideline compliance and associations with cardiometabolic health.

Movement behavior features such as time use estimates, average acceleration and intensity gradient are crucial in understanding associations with cardiometabolic health. The aim of this study was to 1) compare movement behavior features processed by commonly used accelerometer metrics among adults (i.e. Euclidian Norm Minus One (ENMO), Mean Amplitude Deviation (MAD) and counts per minute (CPM)), 2) investigate the impact of accelerometer metrics on compliance with movement behavior guidelines, and 3) explore potential variations in the association between movement behavior features and cardiometabolic variables depending on the chosen metric. This cross-sectional study collected movement behavior features (Actigraph GT3X+) and cardiometabolic variables. Accelerometer data were analyzed by four metrics, i.e. ENMO, MAD, and CPM vertical axis and CPM vector magnitude (GGIR). Intraclass correlations and Bland‒Altman plots identified metric differences for time use in single movement behaviors (physical activity, sedentary behavior), average acceleration and intensity gradient. Regression models across the four metrics were used to explore differences in 24-hour movement behaviors (24h-MBs; compositional variable) as for exploration of associations with cardiometabolic variables. Movement behavior data from 213 Belgian adults (mean age 45.8±10.8 years, 68.5% female) differed according to the metric used, with ENMO representing the most sedentary movement behavior profile and CPM vector magnitude representing the most active profile. Compliance rates for meeting integrated 24h-MBs guidelines varied from 0-25% depending on the metric used. Furthermore, the strength and direction of associations between movement behavior features and cardiometabolic variables (body mass index, waist circumference, fat% and HbA1c) differed by the choice of metric. The metric used during data processing markedly influenced cut-point dependent time use estimates and cut-point independent average acceleration and intensity gradient, impacting guideline compliance and associations with cardiometabolic variables. Consideration is necessary when comparing findings from accelerometry studies to inform public health guidelines.

Physical Activity and Its Effects on Cancer Prevention, Survival Rates, and Recovery

Introduction and Objective: Physical activity is any movement using skeletal muscles. It can be classified into four main categories: occupational, household, transport and recreational. These activities can also vary in intensity. This article aims to describe how physical activity affects cancer prevention, survival rates and recovery. Review and Methods: Review and summary of studies and meta-analysis of studies available in open-source format on Google Scholar and PubMed. State of Knowledge: Extensive research shows that regular physical activity reduces the risk of several cancers, particularly breast, colon, and endometrial cancers. Epidemiological studies consistently find that more active individuals have a lower incidence of certain cancers. Physical activity is also a useful adjunct to treatment, alleviating its negative effects. The protective effect of physical activity is believed to be dose-dependent, with greater benefits from higher frequencies, durations, and intensities. Recent studies suggest that physical activity may also improve survival rates in cancer patients, particularly for prostate, colorectal, and breast cancers. Conclusions: The current data strongly supports the inclusion of regular physical activity as a key component of cancer prevention strategies. It may also be beneficial for cancer patients to enhance their chances of survival. Public health guidelines stress the importance of exercise to lower cancer risk and improve overall health.

Medication management and electrocardiogram screening in children with attention deficit hyperactivity disorder.

To quantify the proportion of referrals sent to Crumlin Cardiology Department for cardiac screening prior to commencement or modifying attention deficit hyperactivity disorder medication and assess the number detected with a clinically significant abnormality. A prospective audit was performed over a 6-month period, from November 2021 to April 2022 inclusive. Referrals sent via outpatient department triage letters, electrocardiogram dept. email, and walk-in electrocardiogram service were screened for those pertaining to commencing or modifying medication for children with attention deficit hyperactivity disorder. Each referral was coded against National Institute for Health and Care Excellence guidelines to determine the degree of clinical details given. Reported abnormalities, recommended management, and correspondence were recorded. Ninety-one referrals were received during the 6-month audit period. More than half lacked a clinical indication for referral (53/91, 58.2%), with fewer than one third (26/91, 28.5%) meeting National Institute for Health and Care Excellence criteria for referral for cardiology. Eighty (80/91) referrals had clinical outcomes available for review (missing outpatient department information and age outside of service range accounted for eleven referrals with unavailable clinical outcomes). Of the eighty clinically reviewed referrals, seventy-two (72/80, 90%) were reported as normal with no cardiology follow up required. Eight referrals (8/80, 10%) were reviewed in the Cardiology Outpatient Department prior to commencement or modifying attention deficit hyperactivity disorder medication. Of these, only one (1/80 1%) had a clinically significant abnormality which was a potential contraindication to attention deficit hyperactivity disorder medication use, and this referral was appropriate as per National Institute for Health and Care Excellence guidelines. Routine screening prior to attention deficit hyperactivity disorder medication prescription in the absence of clinical indications (as per National Institute for Health and Care Excellence) contributed to delays in medication initiation among young people with attention deficit hyperactivity disorder. Unnecessary referrals have resource implications for cardiology clinical team. Improved adherence to National Institute for Health and Care Excellence guidelines would provide benefits for patients and clinicians.

Trace elements in liver and muscle tissues from wild waterfowls in Australia: Risk associated with human consumption in a global context

Trace elements in game meats remain a point of concern for both the public and policymakers alike due to the human health implications if levels present are above guideline limits. This study aimed to: (1) determine trace element concentrations (As, Cd, Hg, Pb Cr, Cu, Se, Zn) in edible portions (breast meat and liver) of the four most frequently hunted duck Anatidae species inhabiting wetlands in Victoria, Australia, to identify the risk to human health from consumption; (2) investigate landscape-scale variables that may influence the detected concentrations and; (3) review the studies available (n = 41) in duck liver and muscle tissues from the 1970s to 2024, to contextualise the detected concentrations found on a global scale. Our study shows that ducks in Victoria had trace element concentrations below tolerable daily intake (TDI) guidelines for human health with one exception: notably high Hg in a filter-feeding specialist, the Pink-eared duck (Malacorhynchus membranaceus). Yet, the only trace element concentrations that were influenced by proximity to populated centres, were As and Zn. Compared to international reports, Pb concentrations in livers and muscle of Victorian waterfowl were lower, however, Pink-eared ducks had higher Hg than other duck (Anas spp.) species. Review of the worldwide data indicate that Pb concentrations in liver tissues from all Anas species have declined from the 1970s to 2024. This is the first study to identify this trend at a global scale. International movements towards Pb-shot bans, along with phasing out of Pb in gasoline and paint are the most likely cause of declining concentrations in tissues of wild waterfowl. These findings strongly underscore the importance of legislative efforts to limit trace elements entering the environment.

Retrospective study on pain management pathway for patients with suspected renal/ ureteric colic in a U.K. accidents and emergency department: A quality improvement project

Background In acute settings around the globe, renal/ureteric colic remains one of the most common diagnoses for patients presenting with loin-to-groin pain. Even though management spans from medical expulsive therapies to surgical options, pain as a significant component of a patient’s presentation must be dealt with quickly, decisively, and safely, as it can be excruciating and its effects on overall health are dire. This study aimed to explore compliance with the National Institute for Health and Care Excellence (NICE) guidelines for pain management in patients with suspected renal/ureteric colic. It includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs), intravenous paracetamol, and opioids as first-, second-, and third-line analgesics, respectively, and does not offer antispasmodics. In the event of deviations from the standard, the aim was to put in corrective measures, followed by re-exploration of compliance with patient care. Methods This study involved a single healthcare facility with the study type being retrospective before interventions and prospective after interventions. In the first cycle, we retrieved and analysed 78 patients records whom had been suspected to have renal/ureteric colic between July and September 2022. The inclusion criteria were documented complaints of “flank/loin-to-groin pain” and diagnosis prior to performing diagnostic tests. We surveyed the first-, second-, and third-line painkillers issued, and whether an antispasmodic was given. We collected and entered data into a Microsoft Excel file and correlated it with NICE standards. Having found deviations from the standard, we conducted interventions, allowed time for clinicians to adapt, and re-explored compliance using patient case records [n=58] between February and May 2023. Results In the 1st cycle, 78 patients were suspected of having renal/ureteric colic. M: F = 1.2:1. Non-contrast computerized tomography of the kidney ureters and bladder (NC-CTKUB) confirmed 87% of patients with stones and 3% had no stones. NC-CTKUB was not performed in 9% of patients because they were young, and urinalysis showed no microscopic hematuria. One patient had discharged against medical advise before the NC-CTKUB was performed. Compliance with the NICE pain management guidelines for suspected renal/ureteric colic was full in 23% of cases but unsatisfactory in 78% of cases. In the 2nd cycle, M: F = 1.5:1, NC-CTKUB was not re-audited, as the first cycle study yielded excellent results, and our action plan resulted in an NICE pain management compliance rate of 56%. Although our interventions resulted in improvements of more than twice the initial results, work still needs to be performed. Conclusion Clinicians’ ability to correctly diagnose renal/ureteric colic is remarkable. However, the pain management compliance rate indicates room for improvement. This may be due to the limited awareness of the NICE guideline or the fact that the clinical team has an affinity for certain analgesics compared to others. We propose the need to consider select variables to existing standard guidelines to enhance compliance for improved patient care.

EP620 - Incidence of Perioperative hypothermia in elective surgeries at a district hospital in NHS - loop completion

Abstract Aim To investigate the incidence of peri-operative hypothermia (core temperature ≤ 36 ⁰C) in all elective surgical patients at a district hospital in NHS and compare the results to the previous study. To understand the contributing factors to hypothermia in the elective surgical patients. Methods Inadvertent perioperative hypothermia (IPH) is defined as a core body temperature <36.0°C. It is a common consequence of anaesthesia, which increases morbidity and potentially increases mortality. National Institute of Health and Care Excellence (NICE) Guideline 65 which summarises best practice for the prevention and treatment of hypothermia in adults undergoing surgery. Prospective analysis of 100 electively listed surgical patients at NMGH. We prospectively studied all the electively listed general surgery, breast, gynaecology, urology, orthopaedics patients from 1 July 2023 to 1 September 2023. Exclusion criteria – All emergency cases. Pre-operative temperature, pre-induction temperature, intra-operative, post-procedure, temperature in recovery and temperature post recovery were recorded. Temperature measurement was via tympanic or temporal thermometers. All statistical calculations were performed on the StatsDirect3 software. Results Preoperative 36.55, Pre-induction 36.55, Intra-operative 36.5, Postoperative is 36.5, Recovery 36.5 Post recovery is 36.6, Theatre temperature 19.5 Conclusion Statistically significant correlation was observed between the intraoperative temperature and the pre-induction temperature as well as the theatre ambient temperature (p < 0.0001). A theatre temperature of 18 °C has a predicted intraoperative temperature of 34.4 °C and a temperature of 19 °C has a predicted temperature of 36.3 °C. Median pre-induction temperature at NMGH is 36.5 °C and the predicted intraop temp is 36 °C. If the pre-induction temperature raises to 37.2 °C the predicted intraop temperature is 36.6 °C.

ThP8.11 - Causes of delay to surgical interventions in patients with transient ischaemic attack and stroke

Abstract Aims The UK National Institute for Health and Care Excellence (NICE) guidelines and vascular society of surgery Great Britain and Ireland (VSGBI) emphasize the importance of scheduling carotid endarterectomy (CEA) within 2 weeks of symptom onset to reduce the risk of recurrent stroke. However the National vascular Surgery report for 2023 showed that this target was met in only 52% of patients. This study aimed to examine the possible causes of these delays. Methods This study analysed patient or hospital-derived factors impacting the timing of surgical intervention for patients with symptomatic carotid disease. A retrospective database was established to gather data on CEAs performed during an 8-month interval (January to August 2023) at a major teaching hospital. Results 36 patients underwent CEA; 13 (36.1%) received the procedure within 2 weeks of symptom onset, while 23 (63.9%) experienced delays. The main reasons for not meeting the two-week timeframe were associated with surgical scheduling, patient presentation, and referral processes. Specifically, among the 23 patients facing delays, 10 (43.5%) were due to surgical scheduling, 6 (26.1%) encountered delays in presenting to medical services, 5 (21.7%) were affected by delayed patient referral or review, and 2 (8.7%) were from lack of patient fitness. None however ended up with recurrent stroke while awaiting surgery on best medical management. Conclusions Prompt surgical intervention can reduce the risk of recurrent strokes. 63.9% of CEAs encountered delays, primarily associated with surgical scheduling. Prioritised pooled lists may be the answer.

Alcohol Consumption and Cardiovascular Disease: A Narrative Review of Evolving Perspectives and Long-Term Implications.

Cardiovascular illnesses remain the primary cause of death, accounting for at least 17.9 million fatalities per year and posing a significant public health problem because of its extensive predominance and effect on healthcare systems. The etiology of cardiovascular disease is complex and involves several environmental and lifestyle factors. Alcohol use is a highly important determinant because of its dual-edged effect on cardiovascular health. Multiple studies indicate that moderate alcohol consumption may have certain advantages, such as slight enhancements in lipid profiles. Conversely, excessive alcohol intake is associated with serious negative consequences, including cardiomyopathy, hypertension, arrhythmias, and even mortality. The aim of this study is to provide a comprehensive analysis of the several effects of alcohol on cardiovascular health and their understanding within the medical field over time. It uses an interpretative narrative review methodology and analyzes studies that focus on genetic risk factors, gender differences, and shifts in paradigms in recent years. This article highlights the need for obtaining a thorough understanding of the effects of alcohol on cardiovascular health to support public health guidelines and clinical practice, and it underscores the significance of including alcohol consumption into the broader context of cardiovascular risk management and identifies important subjects for further study.

Educating adolescents on preventing substance use: The role of 24-h movement behaviors ─ data from 2021 Youth Risk Behavior Surveillance

BackgroundLittle is known about how adhering to the health guidelines for physical activity (PA), screen time (ST), and sleep duration (SD) relates to substance use in adolescents. Thus, this study aims to explore the potential association between adherence to the 24-h movement behavior (24-h MB) guidelines and substance use among adolescents. MethodsData from the 2019 Youth Risk Behavior Surveillance was analyzed. Participants reported their weekly PA, ST, SD, and substance use (alcohol and smoking) over the past 30 days. The mean age in the total participants was 15.56, and 48.03 % of the participants were females. Logistic regression was used in this study to explore the potential association between 24-h MB and substance use. Odds ratios (ORs) were reported alongside a 95 % confidence interval to enhance understanding of the observed association. ResultsOnly 2.22 % participants adhered to all three 24-h MB guidelines, while 47.99 % did not follow any guidelines. Notably, there was no significant difference in the odds of cigarette smoking between participants who followed none of the guidelines and those who followed some or all of them. Nevertheless, adherence to one or more guidelines was found to be associated with higher odds of abstaining from alcohol consumption compared to non-adherence (one guidelines: OR = 1.17 [1.08, 1.28], two guidelines: OR = 1.28 [1.13, 1.44]). ConclusionsAdhering to 24-h MB guidelines may reduce adolescents’ alcohol consumption, but the adherence was not significantly associated with smoking. Longitudinal studies are needed to confirm these findings. These results can inform adolescent health policies and interventions aimed at reducing substance use from the perspective of healthy time-use behaviors, which can be used for researchers and educator.

Protocols for transitioning to adult mental health services for adolescents with ADHD

BackgroundFor Attention Deficit/Hyperactivity Disorder (ADHD) youth transitioning from child to adult services, protocols that guide the transition process are essential. While some guidelines are available, they do not always consider the effective workload and scarce resources. In Italy, very few guidelines are currently available, and they do not adhere to common standards, possibly leading to non-uniform use.MethodsThe present study analyzes 6 protocols collected from the 21 Italian services for ADHD patients that took part in the TransiDEA (Transitioning in Diabetes, Epilepsy, and ADHD patients) Project. The protocols’ content is described, and a comparison with the National Institute for Clinical Health and Excellence (NICE) guidelines is carried out to determine whether the eight NICE fundamental dimensions were present.ResultsIn line with the NICE guidelines, the dimensions addresses in the 6 analyzed documents are: early transition planning (although with variability in age criteria) (6/6), individualized planning (5/6), and the evaluation of transfer needs (5/6). All protocols also foresee joint meetings between child and adult services. The need to include the families is considered by 4 out of 6 protocols, while monitoring (2/6), and training programs (1/6) are less encompassed. In general, a highly heterogeneous picture emerges in terms of quality and quantity of regulations provided.ConclusionsWhile some solid points and core elements are in common with international guidelines, the content’s variability highlights the need to standardize practices. Finally, future protocols should adhere more to the patients’ needs and the resources available to clinicians.

Wavelength-dependent photoelectrochemical sensor array based on Bi2WO6/TiO2 electrospun nanoheterojunction for multiple antioxidants identification and total antioxidant capacity analysis in natural tea

Evaluating total antioxidant capacity (TAC) have been playing a vital role in health guidelines, the analysis of nutritional composition in foods, and the diagnosis and treatment of oxidative stress-induced disease. However, numerous antioxidants with similar physicochemical properties make them very difficult to be discriminated because of the similarly analytical signal output. In this work, a novel wavelength-dependent and three-channel photoelectrochemical (PEC) sensor array based on Bi2WO6/Vo-TiO2 electrospun nanostructures was established for the identification of antioxidants in natural teas. The formation of heterojunction interfaces between Bi2WO6 nanosheet and Vo-TiO2 NFs, and the introduction of the oxygen vacancies in TiO2 NFs promoted the visible light absorption ability and electron transfer rate of Bi2WO6/Vo-TiO2 NFs, causing the differences of photocurrent response to different antioxidants under different wavelengths. Furthermore, excited wavelengths, antioxidant types, and photocurrent were regarded as three-factors of fingerprint to accurately discriminate five antioxidants via linear discriminant analysis (LDA). Finally, the PEC sensor array was able to estimate TAC in five actual tea samples (green, yellow, black, white, and dark teas). This development of LDA-assisted multiplex PEC fingerprinting sensor array showed a good promise for the identification and authentication of agricultural products, and the establishment of the database.

Initial assessment and management of adults with suspected acute respiratory infection: a rapid evidence synthesis of reviews and cost-effectiveness studies.

This work was undertaken to inform a National Institute for Health and Care Excellence guideline on the initial assessment of adults with suspected acute respiratory infection. To undertake a rapid evidence synthesis of systematic reviews and cost-effectiveness studies of signs, symptoms and early warning scores for the initial assessment of adults with suspected acute respiratory infection. MEDLINE, EMBASE and Cochrane Database of Systematic Reviews were searched for systematic reviews and MEDLINE, EMBASE, EconLit and National Health Service Economic Evaluation Database were searched for cost-effectiveness studies in May 2023. References of relevant studies were checked. Clinical outcomes of interest included escalation of care, antibiotic/antiviral use, time to resolution of symptoms, mortality and health-related quality of life. Risk of bias was assessed using the Risk of Bias in Systematic Reviews tool or the National Institute for Health and Care Excellence economic evaluations checklist. Results were summarised using narrative synthesis. Nine systematic reviews and one cost-effectiveness study met eligibility criteria. Seven reviews assessed several early warning scores for patients with community- acquired pneumonia, one assessed early warning scores for nursing home-acquired pneumonia and one assessed individual signs/symptoms and the Centor score for patients with sore throat symptoms; all in face-to-face settings. Two good-quality reviews concluded that further research is needed to validate the CRB-65 in primary care/community settings. One also concluded that further research is needed on the Pneumonia Severity Index in community settings; however, the Pneumonia Severity Index requires data from tests not routinely conducted in community settings. One good-quality review concluded that National Early Warning Score appears to be useful in an emergency department/acute medical setting. One review (unclear quality) concluded that the Pneumonia Severity Index and CURB-65 appear useful in an emergency department setting. Two poor-quality reviews concluded that early warning scores can support clinical judgement and one poor-quality review found numerous problems with using early warning scores in a nursing home setting. A good-quality review concluded that individual signs and symptoms have a modest ability to diagnose streptococcal pharyngitis, and that the Centor score can enhance appropriate prescribing of antibiotics. The cost-effectiveness study assessed clinical scores and rapid antigen detection tests for sore throat, compared to delayed antibiotic prescribing. The study concluded that the clinical score is a cost-effective approach when compared to delayed prescribing and rapid antigen testing. Several early warning scores have been evaluated in adults with suspected acute respiratory infection, mainly the CRB-65, CURB-65 and Pneumonia Severity Index in patients with community-acquired pneumonia. The evidence was insufficient to determine what triage strategies avoid serious illness. Some early warning scores (CURB-65, Pneumonia Severity Index and National Early Warning Score) appear to be useful in an emergency department/acute medical setting; however, further research is required to validate the CRB-65 and Pneumonia Severity Index in primary care/community settings. The economic evidence indicated that clinical scores may be a cost-effective approach to triage patients compared with delayed prescribing. Only systematic reviews were eligible for inclusion in the synthesis of clinical evidence. There was a great deal of overlap in the primary studies included in the reviews, many of which had significant limitations. No studies were undertaken in remote settings (e.g. NHS 111). Only one cost-effectiveness study was identified, with limited applicability to the review question. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR159945.

Balancing on a slack line - Staffs' experiences of talking about sexuality and sexual health with patients cared for in forensic psychiatry in Sweden.

Sexuality is a central part of being human, however, talking about sexual health is generally avoided in forensic psychiatry. The aim of this qualitative study was to explore how healthcare professionals experience talking about sexuality and sexual health with patients cared for in forensic psychiatry. Individual interviews were conducted with eighteen healthcare professionals from ten different forensic psychiatry care units in Sweden. The interviews were semi-structured, and the data was analyzed with qualitative content analysis. The findings showed the overarching theme "Balancing on a slack line". The conversations the healthcare professionals have about sexuality and sexual health with patients in this setting are affected by forensic psychiatry's dual mission; to provide care and at the same time protect patients and society. These conversations can be about opening up for having responsive conversations, but also closing conversations since the field of sexuality and sexual health is fraught with norms and preconceptions. To be able to conduct these conversations can be a challenge since the professionals can experience uncertainty due to a lack of competence, indicating that knowledge and resources are needed to facilitate conversations. In conclusion, the study indicates that there is a lack of support and structure for performing conversations about sexuality and sexual health in forensic psychiatry care, and there is a need for increased knowledge among healthcare professionals. In order to support staff, the forensic psychiatry services need to acknowledge the national guidelines for sexual and reproductive health and rights and to develop and adapt the local guidelines.

Evaluating Operation Good Food & Beverages, a Black Youth-Driven Public Advocacy Campaign.

Food and beverage (F&B) marketing practices that contradict health guidelines are particularly concerning for children and adolescents, who are developmentally more susceptible than adults to persuasive advertising and to Black communities, due to ethnically-targeted marketing, contributing to higher rates of obesity and other diet-related chronic diseases. Accordingly, here we evaluated Operation Good Food and Beverages (OGF&B), an online social marketing campaign calling for shifting toward more marketing of healthier F&B to Black youth and Black communities. OGF&B was developed and implemented by a multidisciplinary team of academic, advocacy, and advertising partners and active for four months in 2022 during the COVID-19 pandemic. Primary campaign components were social media content (e.g., TikTok, Instagram), and an informational website with a signable petition and a social media toolkit. Our mixed-methods evaluation used qualitative data to contextualize quantitative metrics like online impressions, website visits, and petition signatures. Qualitative data consisted of analysis of social media content and thematic elements from 15 interviews with campaign advisors, youth consultants, and influencers. The campaign achieved 3,148,869 impressions, 3,799 unique website visits, and 1,077 petition signatures. Instagram Reels and content featuring people had higher engagement. Instagram Reels received more likes than static posts or TikTok videos. Interviewees who participated mentioned personal values and community welfare as key motivations. Social media influencers who declined participation noted time constraints and lack of compensation as barriers. Despite pandemic-related restrictions that precluded in-person engagement, this brief campaign implementation period provided useful insights for leveraging OGF&B or similar campaigns.

"Life as We Knew It": Continued Challenges in Getting Up-to-Date COVID-19 Vaccinations Amongst Black and Latinx Michigan Residents.

Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination. Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted. Findings indicate participants' lack of confidence in the COVID-19 vaccine's efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial. There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.

Evaluation of the drug-drug interactions management system for appropriate use of nirmatrelvir/ritonavir: a retrospective observational study

PurposeWhile nirmatrelvir/ritonavir (NMV-r) has been positioned as a first-line treatment for mild to moderate COVID-19, it has multiple and significant drug-drug interactions (DDIs). The use of NMV-r in Japan has been limited compared to the United States. This study aimed to describe the distribution of DDIs with NMV-r and their management in patients with COVID-19 under the control of a management system for the appropriate use of NMV-r.MethodsA retrospective observational study was conducted at a Japanese university hospital. The management system included a flowchart for selecting antivirals and a list for reviewing DDI management, based on the National Institutes of Health guidelines and the guidance of the Japanese Society of Pharmaceutical Health Care and Sciences. Patients with mild to moderate COVID-19 and prescribed NMV-r or molnupiravir (MOV) were included. The primary outcome was DDI management practices, including the selected COVID-19 medications. The secondary outcome included the distribution of DDI classification and the 30-day all-cause mortality.ResultsThis study included 241 patients (median age of 60 years, 112 [46.5%] females), of whom 126 and 115 received NMV-r and MOV, respectively. Of the 241 patients, 145 (60.2%) received concomitant medications that have DDIs with NMV-r. All 30 patients with severe renal impairment or insufficient details on concomitant medications received MOV. Forty-nine patients with concomitant medications required alternative COVID-19 therapy consideration due to DDIs, of whom 42 (85.7%) patients received MOV. Eighty-one patients had concomitant medications requiring temporary adjustment, of whom 44 (54.3%) patients received NMV-r, and 42 of these patients temporarily adjusted these concomitant medications. Five patients with concomitant medications that can continued by monitoring the effects/adverse effects, of whom 4 (80.0%) patients received NMV-r. Seventy-six patients without concomitant medications requiring DDI management, of whom 71 (93.4%) patients received NMV-r. The 30-day all-cause mortality for eligible patients was 0.9% [95% confidence interval, 0.1–3.1].ConclusionsMost patients received appropriate antivirals according to the classification of DDIs, and most patients with concomitant medications requiring temporary adjustment received the recommended DDI management. Our management system is effective in promoting the use of NMV-r in the appropriate patients and managing problematic DDIs.

Description Of Nutritional Status In Students Mts Al-Amin Pakis

Adolescents are an age group that is vulnerable to experiencing malnutrition or excess nutrition problems. Teenagers generally carry out higher physical activity compared to other ages, so they require more nutritional fulfillment. However, the incidence of overnutrition in adolescents can also occur due to poor eating habits so that the amount of energy input is greater than the energy expended. The purpose of this study was to describe the nutritional status of students. This type of research is quantitative with an analytical descriptive design on 85 students of MTs Al-Amin Pakis. Data on nutritional status were obtained by measuring the height using a microtoise and the respondent's weight using a mechanical scale. Nutritional status is classified based on the value of the BMI/age z-score table for children aged 5-18 years from the 2011 Indonesian Ministry of Health guidelines. The results of the data analysis obtained the nutritional status category of junior high school students who were involved as the majority of respondents who were in the normal nutritional status category, namely 77 people (90.58%). However, there were still 8 students (9.41%) who were obese.

Health policies and guidelines to promote, protect and support early childhood development: A narrative review.

This comprehensive review examines the pivotal role of health policies and guidelines in promoting, protecting, and supporting early childhood development (ECD). Recognizing the multifaceted nature of ECD, the study explores key elements commonly found in policies that span health, education, social services, and community support. The focus is on creating an integrated approach that ensures the optimal well-being and growth of children during their formative years. The review highlights the significance of maternal and child health care, emphasizing contact toward prenatal and postnatal care for pregnant women and newborns. Nutritional policies center around supporting breastfeeding and ensuring access to nutritious food, laying the foundation for a healthy start in life. Early childhood education programs and parental education initiatives are crucial components, emphasizing cognitive, social, and emotional development from the earliest stages. The review underscores the importance of a holistic perspective, urging the integration of services across sectors to provide a comprehensive framework for ECD. Research-based policies, continuous monitoring, and evaluation mechanisms ensure evidence-driven decision-making and ongoing refinement of strategies. Additionally, the role of legislation and advocacy is highlighted in protecting the rights and well-being of children and advocating for ECD at various levels. In the end, this review highlights the importance of ECD guidelines and health policies as investments that not only help individual children but also enhance societal productivity and general well-being. By prioritizing the early years, policymakers can lay a strong foundation for future health, learning, and success.

Primary care physicians' knowledge and attitudes about obesity, adherence to treatment guidelines and its' association with confidence to treat obesity at the Saudi Ministry of Interior primary health care centers.

Many primary care physicians (PCPs) believed that managing overweight and obesity is essential to their jobs, however, many believe that they were doing it ineffectively, unsatisfying, and had negative attitudes. We conducted this study to explore the knowledge, attitudes and adherence to obesity management guidelines, identify potential barriers that may prevent adherence of PCPs to obesity treatment guidelines. We conducted this cross-sectional study and conducted a questionnaire sent via email to all PCPs in the Ministry of Interior centers in Riyadh, Al-Kharj, AlQassim, Wadi Ad Dawasir, Hail and Tabuk in Saudi Arabia. A total of 119 PCPs participated in the survey, 61 (51.3%) males and 58 (48.7%) females. All respondents (n = 119, 100%) answered correctly that obesity is a disease. Of PCPs surveyed, genetics accounted for 75.6% of the responses as the cause of obesity. 79.8% believed that the best way for patients with obesity to lose weight was to engage in regular physical activity. The majority of PCPs (87.4%) thought that treating obesity should be a top priority, and 88.2% would typically recommend obesity therapy to their patients. Around 68.9% of PCPs thought that it's their patients' responsibility to lose weight. The majority will recommend obesity treatment and 75.6% would talk to their patients about weight concerns, while 60.5% would refer their patients to obesity surgery. There was a positive significant association between higher knowledge and better attitude and better adherence to treatment guidelines. More experienced PCPs were more confident. The most common perceived barrier was the patients' lack of desire to follow obesity treatment. Primary care clinics and PCPs play a crucial role in diagnosing and treating patients with obesity, according to Ministry of Health guidelines on the prevention and management of obesity. PCPs must not only acknowledge obesity as a chronic illness and the possible long-term consequences it may cause, but also provide comprehensive, multi-component interventions that include lifestyle changes, medication, and appropriate referrals for bariatric surgery when needed. Healthcare professionals must form a cooperative relationship with obese patients to ensure that the patients follow treatment protocols.