Hygiene Prevention Research Articles

Prisons confinées : quelles conséquences pour les soins psychiatriques et la santé mentale des personnes détenues en France ?

ObjectiveThe impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees’ access to medical services is already limited and overcrowding poses a threat of massive contagion. Beyond the health impact of the crisis, the tightening of prison conditions worries. On March 16, 2020, in France, the lockdown measures have been accompanied by specific provisions for prisons: all facilities have suspended visitations, group activities and external interventions. Over 10,000 prisoners have been released to reduce the prison population and the risk of virus propagation. These adjustments had major consequences on the healthcare system in French prisons. The objectives of this article are to describe the reorganization of the three levels of psychiatric care for inmates in France in the context of Covid-19 pandemic and to have a look at the impact of lockdown measures and early releases on mental health of prisoners. MethodsThis work is based on a survey conducted in April 2020 in France among psychiatric healthcare providers working in 42 ambulatory units for inmates and in the 9 full-time inpatient psychiatric wards exclusively for inmates called “UHSAs” (which stands for “unités hospitalières spécialement aménagées”, and can be translated as “specially equipped hospital units”). A review of the international literature on mental healthcare system for inmates during the Covid-19 epidemic has also been performed. ResultsThe Covid-19 epidemic has been rather contained during the period of confinement in French prisons but the impact of confinement measures on the prison population is significant. The three levels of psychiatric care for inmates have implemented specific measures to ensure continuity of care, to support detainees during Coronavirus lockdown and to prevent an infection's spread. Among the most important are: limitation of medical consultations to serious and urgent cases, creation of “Covid units”, cancellation of voluntary psychiatric hospitalizations, reinforcement of preventive hygiene measures and reshuffling of medical staff. Prolonged confinement has consequences on mental health of detainees. Currently, mental health workers are facing multiple clinical situations such as forced drug and substance withdrawal (linked to difficulties in supplying psychoactive substances), symptoms of anxiety (due to concerns for their own and their relatives’ well-being) and decompensation among patients with severe psychiatric conditions. Early releases from prison may also raise some issues. People recently released from prison are identified as at high risk of death by suicide and drug overdose. The lack of time to provide the necessary link between health services within prisons and health structures outside could have serious consequences, emphasizing the well-known “revolving prison doors” effect. DiscussionThe current lockdown measures applied in French jails and prisons point out the disparities between psychiatric care for inmates and psychiatric care for general population. Giving the high vulnerability of prison population, public health authorities should pay more attention to health care in prisons.

ПРО ДІЯЛЬНІСТЬ ВІДДІЛУ ПСИХОЛОГІЇ ІНСТИТУТУ ПЕДАГОГІЧНОЇ ОСВІТИ І ОСВІТИ ДОРОСЛИХ ІМЕНІ ІВАНА ЗЯЗЮНА НАПН УКРАЇНИ В УМОВАХ ЕПІДЕМІЧНОЇ ЗАГРОЗИ

Представлено результати діяльності відділу психології праці Інституту педагогічної освіти і освіти дорослих імені Івана Зязюна Національної академії педагогічних наук України в умовах епідемічної загрози. Подано інформацію про роботу вчених відділу в дистанційному форматі, зокрема про методичний посібник «Психологічна профілактика і гігієна особистості у протидії пандемії COVID-19», проведення семінару-практикуму «Психопрофілактика тривожних станів: практики, що підтримують внутрішні ресурси», та діяльність Психологічного консультативно-тренінгового центру тощо.

Review of swine flu positive cases in Kakinada-2018

Introduction: Influenza is known to cause annual seasonal epidemics. Swine origin influenza was first recognized in the border area of Mexico and United States in April 2009. 1 The currently circulating strain of Swine origin influenza virus of the H1N1 strain has undergone triple re-assortment and contains genes from the avian, swine and human viruses and is known for the rapidity with which it spreads to the community. 2 Materials and Methods: 400 cases suspected with influenza like illness from in and out patient units of department of Pulmonary Medicine, Government General Hospital, Kakinada were included in the study. 70 patients were subjected to RT-PCR. Medical records of 42 patients who were admitted, who were suspected clinically as H1N1 and confirmed by RT-PCR method, were examined thoroughly in the present study. An ethical committee approval and consent was taken from all patients before included in the study. Results: out of 400 cases 250 are of category A and 80 patients are of category B. Out of Category C patients, 42 are H1N1 positive by RT-PCR. Among 42 cases, most common affected age group is 51-60 years (37.40%). Males are more involved (52.38%). The common presenting symptoms were breathlessness, cough, and fever. 59.52% of positive cases were associated with various comorbidities. Conclusions: Most of patients with influenza like illness belongs category A and B. In our area H1N1 prevalence of is high in elderly age group and in males. Most of the patients recovered well with Oseltamivir and symptomatic treatment. Proper preventive measures, personal care and hygiene and isolation of patients and admission to designated swine flu ward can be helpful in preventing the spread of infection with in the community. Keywords: Influenza infection, H1N1, Swine flu.

BLADDER CATHETER-ASSOCIATED URINARY TRACT INFECTION: INTEGRATIVE REVIEW

Objective: To analyze, through literature, the main preventive measures recommended to reduce rates of bladder catheter-associated urinary tract infection. Method: It is an integrative literature review, which has as sample cohort, case-control and clinical trial studies, randomized or not, published in Portuguese, English or Spanish, in the period between 2009 and 2018. The collect and data analysis occurred in April and May 2019. Results: The publications emerged from studies performed in intensive and non-intensive care units, in different countries. Among the preventive measures, hand hygiene and shorter usage time of bladder catheter were highlighted. Conclusion: The present review allowed different national and international data to be analyzed, they corroborate preventive strategies adopted in the Brazilian context; however, the limitations of this study are in highlighting in literature only two preventive measures.

Effectiveness of Video and Poster Educational Programs in Dental Caries Prevention and Oral Hygiene StatusAmong Primary School Students

Abstract Objective: To analyze the effectiveness of video and poster performance as educational programs in oral health services in the prevention of dental caries and ensuring good oral hygiene through improving the school children behavior. Material and Methods: This study was carried out through using two educational materials (video and poster) as two educational methods. Questionnaire was used to evaluate knowledge, attitude, and practice. Microbial samples from saliva were collected to evaluate the reduction in Streptococcus mutans count and Lactobacillus count after the exposure to the video and poster educational materials. Results: The results of the present study revealed an improvement in KAP, as well as, a marked reduction in count of streptococcus mutans and Lactobacillus count after exposure to the tow different educational methods Conclusion: the use of video and poster as educational materials are effective in reduction of incidence of dental caries. Key Wards: Dental cries; Educational programs; Poster, Video

Psychological-pedagogical analysis of the problems caused by pandemic: Ukraine’s perspective

This article is a peer review on two editions (in Ukrainian and Russian languages) of the online educational material “Psychology and Pedagogy in Countering the COVID-19 pandemic” and “COVID-19 in the context of Philosophy, Psychology and Pedagogy", published upon the initiative of the National Academy of Educational Sciences of Ukraine. The developed by Ukrainian pedagogues, psychologists, physicians and social workers recommendations, aimed at maintenance of social stability in the conditions of global destabilization of socioeconomic reality caused by the COVID-19 pandemic ,can be valuable for foreign specialists. Part of the materials were prepared by the participants of all-Ukrainian Psycho-Pedagogical online campaign "ANTI-COVID-19 Assistance". Relevance of the presented materials is evident, since new challenges for practical psychology and social pedagogy were set by the pandemic, including psychological prevention and health hygiene in everyday life, rational humanization of society, and further democratization of separate individual and civilization as a whole. These and other issues are discussed in the educational material under consideration. Even though both versions were rushed at the height of the pandemic, they do not appear to be mal-prepared. This review is a small contribution to restoration of the scientific ties between Russian and Ukrainian scholars.

Risk assessment of the impact of atmospheric emissions from a preparation plant on population health

Introduction. Determining the relationship between the impact of environmental factors and the health status of the population based on the risk assessment methodology is an urgent problem of preventive hygiene. The city of Novokuznetsk in the Kemerovo region, which is a major center of the metallurgical and coal industry, is characterized by a particularly difficult environmental situation.The aim of the study is to assess the risk to population health from air pollution from the emissions of a coal-processing plant.Materials and methods. The work used the volume of maximum permissible emissions of the central processing plant “Abashevskaya”. Calculations of maximum and average annual concentrations of pollutants were performed using the “EcoCenter-Standard” program, based on “Methods for calculating the dispersion of emissions of harmful (polluting) substances in the air”. Population health risks were calculated in accordance with the “Guidelines for assessing public health risks from exposure to chemicals that pollute the environment”. The resulting risk values were compared with acceptable values. Also, the values of risk levels were determined considering background concentrations.Results. Priority pollutants were identified: nitrogen dioxide, nitrogen oxide, carbon monoxide, sulfur dioxide, carbon (soot), inorganic dust with a SiO2 content of less than 20%, inorganic dust with a SiO2 content of 20–70%, benzene, manganese and its compounds. The maximum and average concentrations of pollutants were determined and the MPC exceeded at the selected calculation points. It was found that the risk levels of immediate action are zero. The risk levels of chronic intoxication range from 3×10–8 (manganese and its compounds) to 0.003 (inorganic dust with a SiO2 content of less than 20%). The highest total level of risks of chronic intoxication (0.006) is observed in the Baidaevka district. This is due to the location of pollution sources. The highest hazard indexes are also observed in the neighborhood Baidaevka. The hazard coefficients for all substances do not exceed “1”, which indicates that the population is not significantly likely to develop harmful effects with daily intake of the substance during life, and such an impact is acceptable. According to the data obtained, soot and benzene as carcinogenic substances do not pose a danger. The total values of the risks of immediate action, chronic intoxication and carcinogenic risk do not exceed the acceptable level. The total values of the risks of chronic intoxication, taking into account background concentrations, exceed the acceptable level by 2.9–4.1 times.Conclusion. Emissions from the coal-processing plant contribute to air pollution in the city, without significantly affecting the health of the population. The use of the risk assessment methodology is necessary to identify the most unfavorable areas of the city and pollutants that contribute most to the health of the population.The authors declare no conflict of interests.

Comparative analysis of microbiota of oral fluid in patients with psychoneurological disorders using toothpaste with the enzyme «bromelain»

Relevance. The complex of actions for decrease in growth of diseases of the maxillofacial region includes the reorganization of the mouth, creating an individual program for hygiene and prevention. Among the large number of types of therapeutic and preventive hygiene products for patients with neuropsychiatric disorders, given the burdened somatic status, the program should include safe for use basic and additional means.Purpose. Comparative assessment of oral fluid microorganisms in patients with psychoneurotic disorders before and after 6 months of using toothpastes with the enzyme «bromelain».Materials and methods. A comparative analysis of the oral fluid microflora in patients with high intensity and activity of the cariosity, with positive (psychoneurological disorders) anamnesis and without comorbidities has been carried out. The mouths of all studied patients were sanitized, and a program of personal oral hygiene using hygienic toothpastes and with the enzyme «bromelain» was developed.Results. The conducted research does not prove the bactericidal effect of the enzyme «bromelain» on oral microflora, however, a significant decrease of the total number of viable bacteria, changes in the species composition, and the degree of hemolecular properties indicates an indirect bacteriostatic effect of this enzyme in the composition of the toothpastes, which can be considered as a positive effect on the decrease of caries activity in patients with «negative» dental status (caries intensity index > 9, hygiene index by the method of Yu.A. Fedorov and V.V. Volodkina > 2 points, 3rd degree of caries activity by T.F. Vinogradova), including in patients with psychoneurological disorders.Conclusion. The use of enzyme «bromelain» in toothpastes in patients with neuropsychiatric disorders contributes not only to the safe and intensive cleavage of soft plaque, but also to a positive effect on the microbiota of the oral fluid, which is a favorable prognostic criterion for reducing the activity of the carious process.

Genotyping, virulence genes and antimicrobial resistance of Campylobacter spp.isolated during two seasonal periods in Spanish poultry farms

Campylobacter spp. are the leading causes of bacterial human gastroenteritis worldwide; being poultry farms the main source of infections. In order to obtain information on prevalence and diversity of Campylobacter-infected flocks in the North of Spain, fourteen farms were studied between autumn and spring in 2014 and 2015, respectively. Moreover, virulence genes involved in pathogenicity and antimicrobial resistance were investigated. A survey about preventive hygiene practices at farms was performed to determine the risky practices that could contribute to the presence of Campylobacter in this step of the poultry food chain. Testing the presence of Campylobacter spp. showed 43 % of the farms were positive during autumn, whereas only 31 % were positive in spring. A very high prevalence within-flock was observed (43.1 % to 88.6 %) and C. jejuni was the most prevalent species in both periods. Genotyping by pulsed field gel electrophoresis (PFGE) showed a high heterogeneity among farms (309 isolates clustered into 21 pulsotypes). Virulence genes were present in all C. jejuni isolates while cdtA and cdtC were absent in C. coli. On the contrary, the latter showed higher antimicrobial resistance than C. jejuni. This study suggests that environment might be one of the main sources for Campylobacter transmission, as water supply seemed to be a clear cause of the contamination in a specific farm. However, in other farms other environmental factors contributed to the contamination, confirming the multifactorial origin of Campylobacter colonization in broilers. Therefore, biosecurity measures in farms are crucial to reduce Campylobacter contamination, which may have important implications for human and animal health.

Štamparovi pogledi na zdravstvenu edukaciju učenika u školama, studenata medicine i liječnika

Prosvjetiteljstvo i pučka prosvjeta bili su Štamparova opsesija od mladosti. Uz to, uvijek je pokazivao i veliko zanimanje za zdravstveni odgoj u školama, ali i za nastavu na medicinskim fakultetima te za trajnu edukaciju diplomiranih liječnika. Prvi je put predložen za fakultetskoga nastavnika već 1922. godine, ali je tek osnivanjem Banovine Hrvatske dobio dozvolu za rad na Medicinskom fakultetu u Zagrebu. Tada je već imao 51 godinu. Vrlo brzo, već 1940. postao je dekan Medicinskoga fakulteta u Zagrebu, ali je nažalost tu karijeru prekinuo Drugi svjetski rat. Tijekom rata bio je interniran u Austriji, a nakon rata nastavio je raditi kao fakultetski nastavnik i ravnatelj Škole narodnoga zdravlja, koju je od 1947. godine uključio u fakultetsku dodiplomsku i postdiplomsku nastavu. Od 1952. godine pa do kraja života u ljeto 1958. godine pet puta za redom biran je za dekana Medicinskoga fakulteta u Zagrebu. Osnivač je drugoga medicinskoga fakulteta u Hrvatskoj, onoga u Rijeci 1956. godine. U okviru Medicinskog fakulteta u Zagrebu sredinom pedesetih godina XX. st. otvara Višu školu za medicinske sestre. Uvodi i dvogodišnju školu za bolničare, nakon završenoga osnovnog školovanja. Iako se fakultetskom nastavom bavio samo 15 godina, uglavnom pred kraj života, ipak je pridonio i tom području, prije svega stalnim nastojanjima u afirmaciji preventivne medicine, higijene i socijalne medicine.

Occupational low-level exposure to hard metals: cobalt and tungsten biomonitoring as an effective tool to evaluate the effectiveness of industrial hygiene interventions for risk management

Purpose: The aim of the study was to assess the exposure to Cobalt (Co) and Tungsten (W) in a group of hard metal tool sharpeners through a combined approach of air and biological monitoring, and to evaluate the effectiveness of a control and improvement intervention carried out in collaboration with the medical officers of the local Health Protection Agency, by biomonitoring.Methods: We enrolled 132 workers from 17 companies of the province of Brescia, northern Italy. The study was performed in two phases: (1) an environmental and biomonitoring survey to assess the workers’ exposure to Co and W at their usual working conditions; (2) a further biomonitoring survey 3 months after the enforcement of a control and improvement intervention, to assess its effectiveness.Results: Workers were found to be exposed to low concentration of airborne dust containing Co and W but after the intervention we recorded a significant decrease of the urinary concentrations of both Co and W. The extent of the decrease was correlated to the number of preventive industrial hygiene interventions that were carried out.Conclusions: Biological monitoring of Co and W in the hard metal tools manufacturing industry is a sensitive and effective method to evaluate the effectiveness of prevention practices.

Questionnaire based evaluation of the motivation of surgically treated patients to participate in preventative hygiene measures.

Background: Nosocomial infections caused by antibiotic-resistant pathogens demonstrate the continued need for preventive hygiene management strategies. Information and training of patients in their personal hygiene is a current requirement of the German Society for Hospital Hygiene, and is recommended by the Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention beim Robert-Koch Institut, KRINKO) at the Robert Koch Institute.Aim: The aim of this study was to evaluate patients’ existing knowledge of hygiene and their motivation to actively participate in preventive hygiene measures.Methods: This study included 445 inpatients at the Polyclinic for Surgery of University Hospital Bonn. Subjects were interviewed over a 6-month period using a questionnaire comprising 21 questions on the topic of hygiene.Results: The majority of patients rated their subjective level of knowledge as intermediate (41%), 25% as poor and 35% as high. The respondents rated the active inclusion of patients in hygiene practices as highly relevant, and were willing to actively contribute to infection prevention, whereby the patients considered hand washing and hand disinfection in particular as important starting points. 78% of the respondents wanted more information on hygiene, particularly on wound and food hygiene. Targeted hygiene education provided by hospital staff had a positive effect on the patients’ subjective level of information, as well as on their confidence in physicians and nursing staff. Previous information via television or radio had a negative impact on the patients’ subjective information level and on their confidence in hospital staff. Conclusion: Most surgically treated patients are motivated to actively contribute to preventive hygiene measures. This represents an additional and important option for applying hospital hygiene more effectively and, above all, closer to the patient. Information and education should preferably be performed by healthcare professionals.

Primary care physician knowledge, attitudes, and diagnostic testing practices for norovirus and acute gastroenteritis.

BackgroundNorovirus is a leading cause of acute gastroenteritis (AGE) across the age spectrum; candidate vaccines are in clinical trials. While norovirus diagnostic testing is increasingly available, stool testing may not be performed routinely, which can hamper surveillance and burden of disease estimates. Additionally, lack of knowledge of the burden of disease may inhibit provider vaccine recommendations, which could affect coverage rates and ultimately the impact of the vaccine. Our objectives were to understand physicians’ stool testing practices in outpatients with AGE, and physician knowledge of norovirus, in order to improve surveillance and prepare for vaccine introduction.MethodsInternet and mail survey on AGE, norovirus, and future norovirus vaccines conducted January to March 2018 among national networks of primary care pediatricians, family practice and general internal medicine physicians.ResultsThe response rate was 59% (820/1383). During peak AGE season, physicians estimated they ordered stool tests for a median of 15% (interquartile range: 5–33%) of their outpatients with AGE. Stool tests were reported as more often available for ova and parasites, Clostridioides difficile, and bacterial culture (>95% for all specialties) than for norovirus (6–33% across specialties); even when available, norovirus-specific tests were infrequently ordered. Most providers were unaware that norovirus is a leading cause of AGE across all age groups (Pediatricians 80%, Family Practice 86%, General Internal Medicine 89%) or that alcohol-based hand sanitizers are ineffective against norovirus (Pediatricians 51%, Family Practice 66%, General Internal Medicine 62%). Concerns cited as major barriers to implementing a future norovirus vaccine included if the vaccine is not covered by insurance (General Internal Medicine 64%, Pediatricians 67%, Family Practice 74%) and lack of adequate reimbursement for vaccination (Pediatricians 43%, General Internal Medicine 46%, Family Practice 50%). Factors that providers believed were ‘not at all a barrier’ or ‘minor barrier’ to new vaccine introduction included the belief that “my patients won’t need this vaccine” (General Internal Medicine 78%, Family Practice 86%, Pediatricians 90%) and “my patients already get too many vaccines” (Family Practice 89%, General Internal Medicine 92%, Pediatricians 95%).ConclusionsPrimary care physicians had few concerns regarding future norovirus vaccine introduction, but have knowledge gaps on norovirus prevalence and hand hygiene for prevention. Also, physicians infrequently order stool tests for outpatients with AGE, which limits surveillance estimates that rely on physician-ordered stool diagnostics. Closing physician knowledge gaps on norovirus burden and transmission can help support norovirus vaccine introduction.

Prioritizing the Scale-Up of Evidence-Based Nutrition and Health Interventions to Accelerate Stunting Reduction in Ethiopia.

Despite some progress, stunting prevalence in many African countries including Ethiopia remains unacceptably high. This study aimed to identify key interventions that, if implemented at scale through the health sector in Ethiopia, can avert the highest number of stunting cases. Using the Lives Saved Tool (LiST), the number of stunting cases that would have been averted, if proven interventions were scaled-up to the highest wealth quintile or to an aspirational 90% coverage was considered. Stunting prevalence was highest among rural residents and households in the poorest wealth quintile. Coverage of breastfeeding promotion and vitamin A supplementation were relatively high (>50%), whereas interventions targeting women were limited in number and had particularly low coverage. Universal coverage (90%) of optimal complementary feeding, preventive zinc supplementation, and water connection in homes could have each averted 380,000–500,000 cases of stunting. Increasing coverage of water connection to homes to the level of the wealthiest quintile could have averted an estimated 168,000 cases of stunting. Increasing coverage of optimal complementary feeding, preventive zinc supplementation, and Water, Sanitation and Hygiene (WASH) services is critical. Innovations in program delivery and health systems governance are required to effectively reach women, remote areas, rural communities, and the poorest proportion of the population to accelerate stunting reduction.

Transvaginal ultrasound probes are human papillomavirus-free following low-level disinfection: cross-sectional multicenter survey.

To assess the frequency of detection of high-risk human papillomavirus (hrHPV) on transvaginal ultrasound (TVS) probes and keyboards and evaluate operator compliance with national recommendations for prevention of cross-infection during TVS. This was a multicenter observational survey involving 46 public and private centers, in the Paris region of France, in which at least five consecutive TVS examinations were performed per day. We audited 676 TVS procedures. We recorded preventive hygiene actions undertaken by the operator at three stages: (1) during TVS; (2) during probe disinfection; and (3) during preparation of the probe for the next TVS. After probe disinfection, we collected one sample from the bare probe and one from the ultrasound keyboard; following probe preparation for the next examination, an additional sample was obtained from the covered probe. The samples were tested for presence of hrHPV DNA using the Cobas® 4800 System. We did not detect hrHPV DNA in samples collected from uncovered or covered probes (0%; 95% CI, 0.00-0.55%). Keyboard samples were positive for hrHPV in two cases (0.3%; 95% CI, 0.04-1.07%). During TVS, the operator avoided touching the keyboard with a hand that had touched the patient's vulva in 86% of cases and held the probe with a gloved hand in 68%. Before probe disinfection, the operator wore new gloves, or performed hand disinfection in 8% of cases. The probe disinfection technique used was adequate in 87% of cases, not performed at all in 12% and insufficient in 1%. Before preparing the probe for the next scan, the operators disinfected their hands or used new gloves in 81% of cases. The probe cover and the coupling gel used complied with recommendations in 98% and 46% of cases, respectively. Of the seven preventive hygiene actions recommended in national guidelines, all were performed in 2%, three to six in 95% and two in 3% of observations. In four (9%) centers, disinfection was not performed in over half the observations. No evidence of hrHPV DNA was found on TVS probes and probe covers following low-level disinfection, despite suboptimal compliance with hygiene guidelines. Routine TVS practice could be made easier and safer with a global approach to probe disinfection and hand hygiene. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

1624. Primary Care Physician Knowledge, Attitudes, and Diagnostic Testing Practices for Norovirus and Acute Gastroenteritis

BackgroundNorovirus is a leading cause of acute gastroenteritis (AGE) across the age spectrum; candidate vaccines are in clinical trials. While norovirus diagnostic testing is increasingly available, stool testing may not be performed routinely, which can hamper surveillance and burden of disease estimates. Our objectives were to understand physicians’ stool testing practices in outpatients with AGE, and physician knowledge of norovirus, in order to improve surveillance and prepare for vaccine introduction.MethodsInternet and mail survey on AGE and norovirus conducted January to March 2018 among national networks of primary care pediatricians (Peds), family practice (FP) and general internal medicine (GIM) physicians.ResultsThe response rate was 59% (820/1,383). During peak AGE season, physicians estimated they ordered stool tests for a median of 15% (interquartile range: 5–33%) of their outpatients with AGE. Stool tests were more often available for ova and parasites, Clostridioides difficile, and bacterial culture (>95% for all specialties) than for norovirus (6–33% across specialties); even when available, norovirus-specific tests were infrequently ordered. Most providers were unaware that norovirus is a leading cause of AGE across all age groups (Peds 80%, FP 86%, GIM 89%) or that alcohol-based hand sanitizers are ineffective against norovirus (Peds 51%, FP 66%, GIM 62%).ConclusionPhysicians infrequently order stool tests for outpatients with AGE, and have knowledge gaps on norovirus prevalence and hand hygiene for prevention. Understanding the limitations of surveillance that relies on physician-ordered stool diagnostics, and closing physician knowledge gaps, can help support norovirus vaccine introduction.Disclosures All authors: No reported disclosures.

CORRELATION RELATIONS OF CARISES AND SOCIO-HYGIENIC FACTORS

There is a demand in statistical processing of questionnaire data and objective screening of children with the usage of correlation analysis as well as interview with parents in order to increase their awareness about caries prevention and lifestyle. The emergence of caries in children 7-12 years of age is influenced by socio-hygienic factors. During the interview with parents, the effect of a combination of factors was found (i.e. avoiding referring to a dentist for the purpose of prevention or professional hygiene, neglecting the additional hygienic tools and methods and low awareness about them, regularity and balance of nutrition, lack of awareness concerning etiology of caries appearance, referring to a dentist only in case of toothache, anxiety during a visit to a dentist. Interview with children showed the impact of a combination of factors on the occurrence of caries. Among them are evasion of referring to a dentist for the purpose of prevention, lack of awareness concerning etiology of caries appearance, referring to a dentist only in case of toothache, anxiety during a visit to a dentist, low awareness concerning additional hygienic tools and methods. The combined effect of parental awareness and habits on the development of caries in children is much higher than the effect of the respective peculiarities of children. Thus, the analysis of caries appearance factors in children aged 7-12 years reveals the existence of close relationships between the alimentary, behavioral habits of parents and the appropriate habits of children and the development of pathological changes in the oral cavity of children which leads to the propagation of carious lesions. This requires improvement of preventive work with parents aimed at formation of healthy lifestyle habits and oral health care in order to prevent pathology of oral cavity and masticatory apparatus.

Preventive hygiene protocol of University of Milan for women during pregnancy: A qualitative and quantitative bacterial plaque analysis prospective original study

IntroductionThe aim of this article is to describe the preventive hygiene protocol of University of Milan for women during pregnancy analyzing the bacterial plaque quantitatively and qualitatively. Materials and methodsA sample of 35 pregnant women following a protocol of periodic visits starting from the first month of pregnancy until the childbirth and in follow up controls were analyzed. Several samples (n = 4) of bacterial plaque for quantitative and qualitative analysis were taken, from the lingual surface of the lower first molar, during the first visit (T0), during the first trimester (T1), during the second or third trimester of pregnancy (T2), and one month after childbirth (T3). ResultsBy performing a quantitative analysis, it was calculated that the average plaque index (Fig. 1) was n = 48.1% (T0), n = 14.7% (T1), n = 18.4% (T2) and n = 18.9% (T3). The plaque index score presents a downward trend, passing from 48.1% (T0) to 18.9% (T3). The number of total cocci (Fig. 2) was n = 205.39 (T0), n = 57.5(T1), n = 74.6 (T2) and n = 75.4(T3). The number of total bacilli (Fig. 3) was n = 62.7 (T0), n = 23.1 (T1), n = 25.3 (T2), n = 27.1(T3). The total values of cocci and bacilli were correlated and the average trend of the various samples was calculated. By performing a qualitative analysis, the value of G+ cocci (Fig. 5) was n = 2.7 (T0), n = 1.4 (T1), n = 1.4 (T2) and n = 1.5 (T3). The value of G− cocci (Fig. 5) was n = 2.3 (T0), n = 0.7 (T1), n = 1.1 (T2) and n = 1.1 (T3). The value of G+ bacilli (Fig. 6) was n = 1.6 (T0), n = 0.9 (T1), n = 1.2 (T2) and n = 1.2 (T3). The value of G− bacilli (Fig. 6) was n = 1.3 (T0), n = 0.3 (T1), n = 0.7 (T2) and n = 0.7 (T3). ConclusionsThe preventive hygiene protocol used in the Dental Hygiene Department of the University of Milan, during the gestation period, is a suitable method for the control of the bacterial plaque. A considerably decrease of the plaque index and bacterial components between the first visit and the subsequent check-ups was calculated.

Preventive hygiene measures after reparative osteogenesis in patients with chronic generalized periodontitis

Abstract Relevance. Improving the efciency of dental orthopedic care for patients with generalized periodontal disease is an actual modern problem.Materials and methods. A comparative evaluation of the effectiveness of various types of toothpaste in the postoperative period of dental implantation due to partial absence of teeth, periodontitis of moderate severity during gum recession was carried out. In group I (group I, n = 32), patients used a paste containing sodium bicarbonate, in group II (n = 25) – without sodium bicarbonate. Postoperative complaints and symptoms of reactive inflammation were monitored for 10 days; before the operation, after 1, 3, 6 and 12 months after it – hygiene indices Silness J., Loe H., Muhllemen; PMA index.Results. In general, the duration of postoperative reactive inflammation in the groups did not have signifcant differences, but in terms of the relief of edema, bleeding and the severity of breath from the mouth, the best results were in the patients of the group. The hygiene indices before the operation and immediately after it were comparable, but a month after the surgical intervention in patients of group I, all the hygiene indices were better, over time these differences increased and had a reliable character. The Muhlemann index was more dependent on the use of single-stage implantation technology using growth factor, while the PMA index, on the contrary, reflected the effectiveness of not only surgical technology, but also the quality of postoperative hygienic and therapeutic measures.Conclusions. Studies have shown that the systematic use in the postoperative period of toothpaste containing sodium bicarbonate allows you to stop edema, bleeding and the severity of breath from the mouth, improves the performance of basic hygiene indices than other types of toothpastes.

Osposobljavanje liječnika medicine rada i stručnjaka zaštite na radu u SAD-u

SUMMARY: Professionals have been working in occupational safety and health (OS&H) in the United States since at least the advent of the Industrial Revolution. Formal educational in OS&H began in earnest with passage of the Occupational Safety and Health Act (OSHA) of 1970 that included provisions for funding training in OS&H disciplines. A study conducted by the National Institute for Occupational Safety and Health (NIOSH) in 2011 estimated that there were over 48,000 (2.3/10,000 working age adults) OS&H professionals working in the US. Employers surveyed in this study reported a need to hire over 25,000 OS&H professionals in the next 5 years. OS&H training programs were projected to graduate less than 13,000 students in that period. Core knowledge and skills in the various OS&H disciplines typically includes academic training in epidemiology, biostatistics, administration & management, behavioral health science, industrial hygiene, ergonomics, and foundation courses in occupational injury and disease prevention. Employers report interest in additional training in communication, technical writing, leadership, cross-disciplinary training, emerging hazards, and knowledge of regulations and compliance. Funding of OS&H programs has been a persistent challenge. A lack of student awareness of training and career opportunities poses additional challenges for recruitment of qualified applicants. While hiring demands and career prospects remain high for most OS&H disciplines, the support for training programs, and the supply of new graduates presents ongoing challenges for OS&H educators.