Hygiene Training Research Articles

Evaluation of Food Hygienic Practices Training on Knowledge, Attitude, and Practice: A Study on Traditional Rambak Production in Berkah Enterprise

Rambak (hide’s cracker) produced by small and medium-scale local communities still relies on production processes that have been passed down from generation to generation, resulting in minimal application of information and technology related to food safety. Thus, training in food hygienic practices needs to be carried out on different food handlers in order to provide an overview of the level of success of a program. This research aims to evaluate the impact of food hygienic practices training on knowledge, perception, attitude, and practice of food handlers in producing rambak. Training activities were carried out at the rambak production site involving 14 workers. The training process included presentations of raw materials (hides), rambak qualities, and good hygienic practices, then it was followed by demonstrations of good hygiene practices. Furthermore, the workers put into practice the work method demonstrated by the team. The assessment of knowledge, attitudes, and practices using questionnaire were carried out before and after the training. After training, the majority of rambak workers understand how to use raw materials and food hygiene practices, but they lack knowledge about packaging aspects and good rambak quality, such as washing fresh ingredients with tap water. Worker attitudes show that they have positive attitudes toward good hygiene practices, with the exception of touching food with bare hands. Food hygiene practice demonstrates that they had good hygienic practices, but they did not separate raw materials from cooked rambak. The effect of food hygiene practices training on internal characteristics demonstrates that workers' attitudes improved significantly (p<0,05), but not their knowledge and practice of hygienic principles. In summary, several aspects of worker characteristics need to be improved includes knowledge, attitude, and practice of food hygiene. The training effect improved rambak workers' attitudes but did not improve their knowledge or practice of hygienic principles

Peningkatan Higiene Sanitasi pada Proses Pengolahan Sajian Kuliner pada Kelompok Tani Mandiri

Purpose: The hygiene and sanitation training activities that have been carried out aime to educate Mandiri’s Farmers .Group so they know about hygiene and sanitation concepts and hygiene and sanitation applications, especially for culinary service processing, and minimize foodborne diseases. Methodology: The service is carried out by providing assistance to members of Mandiri’s Farmer Group. The method of community service activities is carried out by delivering material using the lecture method related to hygiene and sanitation in the processing of culinary products, as well as direct questions and answers or discussions regarding hygiene and sanitation in the processing of culinary products. Results: The training provided to improve knowledge, especially for Mandiri’s Farmer Group in Palembang City. The material presented was related to the introduction of hygiene and sanitation when processing culinary offerings, the importance of maintaining hygiene and sanitation in culinary offerings, and several types of diseases that can be contracted as a result of not maintaining hygiene and sanitation during the processing process.

Menstrual cups and cash transfer to reduce sexual and reproductive harm and school dropout in adolescent schoolgirls in western Kenya: a cluster randomised controlled trial

High rates of sexual and reproductive health (SRH) harms and interrupted schooling are global challenges for adolescent girls, requiring effective interventions. We assessed the impact of menstrual cups (MCs) or cash transfers conditioned on school attendance (CCTs), or both, on SRH and schooling outcomes in western Kenya. In this cluster-randomised Cups or Cash for Girls (CCG) trial, adolescent girls in Forms two and three at 96secondary schools in Siaya County (western Kenya) were randomised to receive either CCT, MC, combined CCT and MC, or control (1:1:1:1) for an average of 30 months. The CCT intervention comprised 1500KES (US$15 in 2016) via a cash card each school trimester. All four treatment groups received puberty and hygiene training. Assenting girls with parent or guardian consent who were post-menarche, not pregnant, area residents, not boarding, and had no disabilities precluding participation were eligible. Socio-behavioural risk factors and incidence of HIV and herpes simplex virus type 2 (HSV-2) were measured annually. School retainment and adverse events were monitored throughout. The primary outcome comprised a composite of incident HIV, HSV-2 and/or all-cause school dropout by school exit examination. The primary analysis was by intention-to-treat (ITT) using generalised linear mixed models, controlling for a priori selected baseline covariates. The trial is registered with ClinicalTrials.gov, NCT03051789. Between February 28, 2017 and June 30, 2021, 4137 girls (median age 17.1 [interquartile range (IQR): 16.3-18.0]) were enrolled and followed annually until completion of secondary school (median 2.5 years [IQR: 2.4-2.7]); 4106 (99.3%) contributed to the ITT analysis. No differences in the primary composite outcome between intervention and control groups were seen (MC: 18.2%, CCT: 22.1%, combined: 22.1%, control: 19.6%; adjusted risk ratio [aRR]: 0.97, 95% confidence interval 0.76-1.24; 1.14, 0.90-1.45; and 1.13, 0.90-1.43, respectively). Incident HSV-2 occurred in 8.6%, 13.3%, 14.8%, and 12% of the MC, CCT, combined and control groups, respectively (MC: RR: 0.67, 0.47-0.95, p=0.027; aRR: 0.71, 0.50-1.01, p=0.057; CCT: aRR: 1.02, 0.73-1.41, p=0.92; combined aRR: 1.16, 0.85-2.58, p=0.36). Incident HIV was low (MC: 1.2%, CCT: 1.5%, combined: 1.0%, and control: 1.4%; aRR: 0.88, 0.38-2.05, p=0.77, aRR: 1.16, 0.51-2.62, p=0.72, aRR: 0.80, 0.33-1.94, p=0.62, respectively). No intervention decreased school dropout (MC: 11.2%, CCT: 12.4%, combined: 10.9%, control: 10.5%; aRR: 1.16, 0.86-1.57; 1.23, 0.91-1.65; and 1.06, 0.78-1.44, respectively). No related serious adverse events were seen. MCs, CCTs, or both, did not protect schoolgirls against a composite of deleterious harms. MCs appear protective against HSV-2. Studies of longer follow-up duration with objective measures of health impact are needed in this population. Department of Health and Social Care, the Foreign, Commonwealth & Development Office, the Medical Research Council and Wellcome.

Evaluation of oral and dental health in Turkish and refugee pregnant women

ABSTRACT Objective: Oral hygiene habits and demographic characteristics of refugees and Turkish citizens among pregnant women were investigated. Materials and Methods: This cross-sectional study, conducted at our university hospital, focused on pregnant women and collected data on demographic features and oral health characteristics. Information was gathered through a questionnaire administered to female patients at the dental clinic. Results: The study involved 197 volunteers and revealed that refugees tend to have more children than citizens of the Republic of Turkey. While 7% of women experienced positive changes in toothbrushing habits during pregnancy, 93% faced negative changes. Citizens of the Republic of Turkey exhibit significantly higher rates of going to the dentist for prepregnancy checkups compared to refugees (P < 0.05). No differences were observed between refugees and citizens regarding tooth loss or receiving dental treatment during pregnancy. Conclusions: Optimal oral hygiene, through collaboration between dentists and gynecologists, should be integrated into the prenatal care protocol. All pregnant women should receive invitations for oral and dental health screenings and undergo oral hygiene training before pregnancy. Dental and oral hygiene screening should be an essential component of the prenatal care protocol.

Evaluation of Hygienic Practices and Microbiological Quality of Street Vended Fruit Salads in Morogoro, Tanzania

Street vended foods have gained popularity due to economic benefits. However, they have been recognized as a potential hazard to public health as a result of poor hygienic practices. The study was conducted to assess the hygienic practices and microbiological quality of street vended fruit salads vended in Morogoro Municipal, Tanzania. A total of 30 respondents were involved in the study to assess of quality of fruit salad vended by town street vendors (TSV), University cafeterias (UCV), and town restaurants vendors (TRV). The findings revealed that most vendors (86.3%) were unaware of food safety, 73.3% were unaware of food safety standards and laws, and every seller evaluated was unaware of food safety initiatives such as Good Manufacturing Practices (GMP) and Good Hygienic Practices (GHP) and had never implemented any of them. All vendors saw the doctor only when they were ill. Nevertheless, none of vendor had a quality registration certificate or had undergone training in food safety and hygiene. Most of the salad preparation settings (46.7%) did not adhere to the fundamental requirements of a food preparation facility, and the vending facilities were in disrepair. Piles of dirty were observed in the food salad preparation and vending premises and 80% of the vendors used uncovered waste bins that were observed to encourage pests such as flies and cockroaches in the premises. The total aerobic count (TAC) ranged from 3.92±0.31 to 4.29±0.21 log CFU/g. All fruit salad samples were contaminated with coliforms and the level of coliform count exceeded 1.4×104 MPN/g in fruit salad samples indicating poor hygiene and fecal contamination. Possible sources of contamination were found to be water quality, cross-contamination, food handling and preparation equipment, and environmental factors such as dust, pests, and air quality. According to the study's findings, the majority of fruit salad sellers in the study area did not adhere to hygienic practices, and the made fruit salads were of poor microbiological quality, putting consumers at risk for food safety.

Meat hygiene knowledge, handling practices and associated factors among meat handlers in Gedeo zone, Ethiopia

A cross-sectional study was conducted among 239 randomly selected meat handlers working in butcher shop in southern Ethiopia to assess factors associated with meat hygiene knowledge and practices. A binary logistic regression analysis with a 95% confidence interval (CI) and a p-value < 0.05 was used to identify factors that were significantly associated with good level of meat hygiene knowledge and practices. The findings revealed that 38.5% [95% CI: 32.2–44.8%] and 25.1% [95% CI: 19.7–30.5%] of meat handlers have good levels of meat hygiene knowledge and practices, respectively. Good level of meat hygiene knowledge was significantly (p < 0.05) associated with educational level, having meat hygiene training, and having regular supportive supervision by health workers, whereas good level of meat handling practice was significantly associated with work experience, educational level, have regular supportive supervision by health professionals, and having meat hygiene training. In conclusion, the majority of meat handlers have poor knowledge and practices regarding meat hygiene among meat handlers. Educational level, meat hygiene training, and supportive supervision by a health professionals were all independent predictors of meat hygiene knowledge and practice among meat handlers. As a result, health professionals should give regular training, butcher shop inspections, and supportive supervision for meat handlers in order to improve meat hygiene knowledge and practices among meat handlers.

Impact of the uninstructed use of a herbal, ayurvedic toothpaste on parameters of gingival health in periodontal aftercare patients: A randomized, double-blinded, two-arm parallel-group study.

The aim of this study was to evaluate the impact of the uninstructed use of a toothpaste containing herbal ayurvedic ingredients on parameters of gingival health in a cohort of periodontal aftercare patients affected by gingival inflammation compared to the use of a standard, non-herbal toothpaste. The monocentric, randomized, double-blinded, two-arm parallel-group intervention was performed in a cohort of 88 periodontal aftercare patients with clinical signs of gingival inflammation. At baseline, bleeding on probing (BoP), gingival index (GI) and Quigley-Hein plaque index (QHI) were recorded. Subsequently, the study patients were randomly provided with a herbal ayurvedic toothpaste (n = 44) or a conventional, non-ayurvedic control toothpaste (n = 44) and without additional oral hygiene training instructed to use it 2× daily for the next 28 days. On day 28, BoP, GI and QHI were recorded again. At baseline, there were no significant differences between both groups. On day 28, mean GI and BoP scores were significantly lower (p < 0.001) compared to baseline in both groups. Differences between the groups could not be verified. Mean QHI scores did not change significantly between day 0 and day 28 in both groups. The impact of uninstructed toothbrushing with an ayurvedic toothpaste on the manifestation of gingival inflammation in periodontal aftercare patients is not significantly different to the use of a conventional, non-herbal toothpaste.

Improving compliance with isolation measures in the operating room: a prospective simulation study comparing the effectiveness and costs of simulation-based training vs video-based training

Different isolation measures are required according to the routes of transmission of pathogens. Few studies have compared different forms of hygiene training in terms of efficiency and/or improvement of perception towards hygiene measures. This study aimed to evaluate the benefits of different forms of isolation training in the operating room, and their respective effects on the perception of hygiene measures by comparing simulation training with video-based training. This multi-centre, prospective, randomized, controlled trial compared hygiene knowledge, psychological safety and perception of training among healthcare workers after in-centre simulation training and conventional video-based training. Neither type of training led to a significant improvement in knowledge or perceived psychological safety (F=0.235, P=0.629, η2=0.003). Participants in the simulation group reported higher levels of willingness to speak up in the depicted scenario compared with participants who received video-based training. Participants perceived the simulation-based training significantly more positively than the video-based training. Clear definition of the goals of training based on the pre-existing level of knowledge of the participants is crucial. For future studies, it would be interesting to investigate the long-term effect and continuing benefits concerning the implementation of hygiene regulations after different types of training.

İstanbul İlinde Pastane ve Fırınlarda Üretilen Glutensiz Ürünlerde Gluten Varlığı

Gluten is a complex protein that forms the basis of bakery products, including pastry products, with its elasticity. Gluten proteins are constituted by gliadin and glutenin. Gliadin, which is in the water-insoluble protein group, is very difficult to digest. Many immune disorders influence a growing number of people in relation to the consumption of wheat flour-based foods. The aim of this study is to determine the status of gluten-free products with the legal limits of the gluten-free products sold in pastry shops and bakeries in Istanbul, Turkey. Ninety samples in total including gluten-free bread, cakes, cookies, snacks, and cereals were collected from various regions of Istanbul in November 2020. The samples obtained were examined by ELISA (Enzyme-Linked Immunosorbent Assay) for the presence of gluten. As a result, the presence of gluten was found to be lower than 5 ppm in 61 samples (67.7%), between 5-20 ppm in 8 samples (8.8%), and 20 ppm and above in 21 samples (23%). Within the scope of Turkish Food Codex Regulation on Food Labeling and Consumer Information Number 29960, some foods were inappropriate products which offered to consumption as gluten-free in patisseries and bakeries. It could be thought that risks might be reduced to the maximum extent with hygiene and sanitation training in food businesses, analysis in terms of gluten in raw materials and final products, control of contamination from raw materials, personnel and environment during the production phase, and gluten analysis at critical points.

Assessing the impact of hand hygiene training on medical students' knowledge: A study in a tertiary care hospital in West Bengal.

Background: Healthcare-associated infections (HAIs) continue to pose significant challenges to patient safety and healthcare systems worldwide. Poor hand hygiene among healthcare professionals remains a major contributing factor to the spread of HAIs. Despite its importance, hand hygiene compliance among healthcare workers, including medical students, remains low. Training programs to improve hand hygiene knowledge and compliance have been implemented globally. This study aimed to assess the impact of a hand hygiene training program on medical students at Burdwan Medical College &amp; Hospital in West Bengal.&#x0D; Methodology: A cross-sectional study was conducted involving 122 Professional MBBS students who were selected through purposive sampling. Written informed consent was obtained from each participant. The students' baseline hand hygiene knowledge was assessed using the WHO questionnaire before providing hand hygiene training. Post-training, the same questionnaire was used to evaluate the level of knowledge acquired. The data were analyzed using the student t-test to determine the statistical significance of the training program.&#x0D; Results: The mean pre-test score was 11.24±5.29, while the mean post-test score significantly increased to 17.34±5.4 (p&lt;0.001, 95% CI). This finding indicates a substantial improvement in hand hygiene knowledge among medical students after undergoing the training program.&#x0D; Conclusion: Regular and frequent training programs on hand hygiene, accompanied by monitoring and timely feedback, are crucial for increasing awareness and compliance among medical students. It is essential for medical colleges to establish an Infection Prevention and Control Committee to organize and oversee such training initiatives, which play a pivotal role in mitigating the risk of HAIs.&#x0D;

Reducing Vocal Fatigue While Preserving Realism During Video Game Voice-Overs Using the Vocal Combat Technique: A Randomized Controlled Trial

Vocal Combat Technique (VCT) teaches indirect and direct behavioral voice techniques to voice-over artists performing in violent video games. Although previous work on VCT has shown promise for mitigating dysphonia symptoms, a randomized clinical trial has yet to be undertaken. Therefore, we completed a randomized, controlled trial between a group of experienced video game voice-over actors receiving VCT and a control group comparison. A total of 24 video game voice-over actors completed this study. Participants were randomly assigned to receive VCT or indirect vocal hygiene training prior to completing an intensive 1-hour video game voice recording session. The primary outcome was a change in Voice Handicap Index-10 (VHI-10) preperformance/postperformance. Secondary measures included a modified version of the Evaluation of the Ability to Sing Easily (m-EASE), the Vocal Tract Discomfort Scale (VTDS), and questions regarding return to work. Participants were also rated on the realism of their vocal performance by a blinded video game director. The VCT group showed a significantly smaller change in VHI-10 and m-EASE scores postperformance, and a higher increased likelihood to return to work compared to the control group. There were no group differences for VTDS or realism ratings. Four participants from the control group exhibited outlier behavior with more pronounced phonotraumatic symptoms following performance than all other participants. VCT shows evidence of mitigating symptoms of dysphonia while preserving the realism of the vocal performance. More work is needed to understand performers at risk for more severe vocal symptoms following extreme voice-over work, so as to target them for preventative techniques and voice preservation.

Evaluation of the Effectiveness of Resonant Voice Therapy in Patients with Functional Voice Disorder

This study aims to determine the effectiveness of resonant voice therapy (RVT) in patients with functional voice disorder and to examine the subjective and objective voice changes after the therapy. This study adopted an experimental research design with a pretest-posttest control group. Thirty-four women participated in the study-17 in the experimental group and 17 in the control group. Voice hygiene training and RVT were applied to the experimental group. The Turkish version of the Voice Handicap Index (VHI-10) and GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain)scale were used for subjective voice assessment. Voice recordings were subjected to acoustic analysis on the PRAAT program. After an 8-week therapy program, the same process was repeated for post-test assessment. In the voice analyses performed after RVT, which was applied to patients with functional voice disorders, the results of the acoustic analysis showed statistically significant differences in jitter, PPQ5, RAP, shimmer, APQ11, and NHR parameters. Subjective voice analysis indicated a statistically significant decrease in VHI-10 scores from 20.88±5.33-9.06±3.3 in the experimental group. The GRBAS score was 4.29±1.2 before the therapy and 1.71±1.1 after the therapy, which is a statistically significant decrease. The results point out that RVT has been effective in improving the objective and subjective parameters of patients with functional voice disorders. RVT applied to patients with functional voice disorders provides significant improvement in acoustic and perceptual voice parameters. The RVT is an effective therapy method in the treatment of patients with functional voice disorders and should be considered as a therapeutic option.

Implementation of the risk-oriented model in the system of the professional hygienic training and certification in the Russian Federation (literature review)

The object of the study is the currently existing system of professional hygienic training and certification as an integral component of hygienic training and education of citizens.&#x0D; The purpose of the study is to substantiate the risk-based approach in the implementation of professional hygiene training and certification, and the attempt to integrate this legislatively fixed phenomenon into the structure of preventive measures.&#x0D; There were used the analytical method for evaluation of regulatory and legal documentation, documentation of the Federal Medical Institution “Center for Hygiene and Epidemiology in the Voronezh Region”, as well as literary sources on the subject of research of such information resources as Scopus, Web of Science, CyberLeninka, RSCI, eLibrary.RU mainly for the last 5 years (90% of the total number of cited sources). There was analyzed the experience of the existence of a risk-oriented approach in the implementation of activities in various areas (including the activities of Rospotrebnadzor bodies and subordinate institutions on the example of the Center for Hygiene and Epidemiology in the Voronezh Region), as well as to propose and test a risk-oriented model in the implementation of professional hygiene training and certification of employees in epidemiologically significant objects. The methodology of this procedure involves ranking the positions of personnel of epidemiologically significant facilities based on their attitude to the labour/technological process into 3 groups. In proportion to belonging to a particular rank group, the frequency, volume, and form of professional hygiene training and certification are reasoned. A methodology is proposed for the introduction of legally fixed components of the hygienic training system into the structure of preventive measures of Rospotrebnadzor bodies to get rid of formalization in the mode of constant monitoring of the level of knowledge of sanitary and epidemiological orientation of employees in epidemiologically significant facilities.&#x0D; Thus, the integration of the risk-oriented model into the system of hygienic training will in the future prevent a decrease in the quality of knowledge in the field of hygiene and epidemiology among employees in epidemiologically significant facilities and positively affect the sanitary and epidemiological situation in the country.

Characterisation of antibiotic resistant Staphylococcus species and molecular identification of mecA and toxic shock syndrome toxin-1 (tsst-1) genes of Staphylococcus aureus isolates from cows' milk

Staphylococcus aureus (S. aureus) is one of the most important causes of foodborne illness. Due to the interest of people to use traditional dairy products, especially milk, in the current descriptive study the frequency of S. aureus, antibiotic resistance pattern and presence of toxic shock syndrome toxin-1 gene (tsst-1 gene) in these isolated strains was investigated. Thirty-nine strains (26%) of S. aureus were identified from the samples studied, of which 6 (15.38%) were resistant to methicillin, and 9 (23.07%) were positive for mecA gene. Also, 31 (20.7%) coagulase-negative staphylococci isolates were identified. Out of the 39 strains of S. aureus, the presence of tsst gene was detected in 1 strain (2.56%). Therefore, S. aureus contamination indicates a risk to public health and can be significantly controlled using a high level of hygiene and professional training in the handling of raw milk.

Microscopic and Molecular Identification of Cyclospora cayetanensis and Cystoisospora belli in HIV-Infected People in Tabriz, Northwest of Iran.

Opportunistic pathogens such as Cryptosporidium, Cystoisospora belli, and Cyclospora cayetanensis cause various gastrointestinal and non-digestive disorders in people with HIV/AIDS. These symptoms are especially severe in HIV-infected people who have a CD4+ count of less than 200 cells/mL. This study aimed to determine the prevalence of C. belli and C. cayetanensis infections among people living with HIV in Tabriz, northwest of Iran. This descriptive study was performed on 137 people with HIV who had been referred to behavioral disease counseling centers in Tabriz. Then, after receiving written consent, fecal samples were collected and evaluated for the detection of parasitic infections using direct methods and modified acid fast staining, as well as polymerase chain reaction (PCR).From the 137 fecal samples collected (98 males and 39 females, between 20 and 40 years old), 1.5% were positive for C. cayetanensis and 2.9% were positive for C. belli. Due to the prevalence of C. cayetanensis and C. belli in people with HIV in Tabriz, essential measures, including personal hygiene training for infection control and prevention, seem necessary.

Clean hands, safe care: how knowledge, attitude, and practice impact hand hygiene among nurses in Najran, Saudi Arabia.

Healthcare-acquired infections are infections that patients acquire while receiving treatment for a medical or surgical condition and can occur in all care facilities. Hospital-acquired infections and the spread of antimicrobial resistance can be reduced by implementing proper preventive measures, including hand hygiene. This study aimed to assess nurses' knowledge and attitudes toward hand hygiene guidelines in Najran city, determine compliance levels, identify factors contributing to non-compliance, and provide recommendations for interventions to improve hand hygiene practices and reduce healthcare-associated infections risk. This cross-sectional study was conducted among nurses working in the selected government hospitals in Najran City, Saudi Arabia. A self-administered questionnaire was distributed among the targeted nurses using an online survey. The questionnaire includes socio-demographic characteristics such as age, gender, and marital status. The questionnaire had 25 items to measure knowledge, 10 to measure attitude, 6 to measure practices, and 4 to measure the impact of COVID-19 on hand hygiene practices. Among the 386 nurses recruited, 88.3% were females, and 25.6% were aged between 31 to 35 years old. Overall, good knowledge, positive attitude, and good practice levels were found in 42.5, 48.4, and 94%, respectively. The common factor influencing hand hygiene practice was the prevention of cross-infection (88.1%). The total knowledge score mean was 18 ± 3.4 (highest possible score: 25). The total attitude score mean was 37.5 ± 6.1 (highest possible score: 50). The total practice score mean was 26.9 ± 2.8 (highest possible score: 30). A higher score indicates higher KAP of hand hygiene. Factors associated with increased KAP were being older in age (Z = 6.446; p < 0.001), gender female (Z = 9.869; p < 0.001), being a Filipino nurse (H = 117.8; p < 0.001), working in a surgery department (H = 28.37; p < 0.001), having more than 10 years of experience (Z = 6.903; p < 0.001), living in shared accommodation (H = 87.22; p < 0.001), having associated chronic disease (Z = 4.495; p < 0.001), and receiving formal training in hand hygiene (Z = 2.381; p = 0.017). There was a positive highly statistically significant correlation between knowledge score and attitude score (r = 0.556), between knowledge score and practices score (r = 0.303), and between attitude score and practices score (r = 0.481). In light of the results, we can say that the nurses' knowledge, attitude, and practice in regards to hand hygiene were deemed acceptable. We noticed that female nurses who were older and had more experience, as well as those who had received formal hand hygiene training, displayed better KAP compared to their counterparts. Moreover, we found a significant and positive correlation between the scores for knowledge, attitude, and practice. Nonetheless, additional research is necessary to establish the extent of KAP concerning hand hygiene.

The Effect of Sleep Hygiene Education on Sleep Quality, Depression, and Fatigue of Hemodialysis Patients

Background: One of the conservative treatment methods for patients with end-stage renal failure is hemodialysis. Although hemodialysis contributes to patients’ lives, it has adverse emotional and psychological effects, including sleep problems, fatigue, and depression. Objectives: The present study aimed to examine the effect of sleep hygiene education on sleep quality, depression, and fatigue among hemodialysis patients admitted to hospitals affiliated with Zahedan University of Medical Sciences in 2021. Methods: This quasi-experimental study was conducted on 80 hemodialysis patients in Khatam Al-Anbia and Ali Ibne Abi Talib hospitals affiliated with Zahedan University of Medical Sciences in 2021. The participants were selected through convenience sampling and randomly assigned to intervention and control groups using permuted block randomization. The data were collected using a demographic information form, Pittsburgh sleep quality index (PSQI), Multidimensional Fatigue Inventory (MFI), and Beck Depression Inventory-II (BDI-II). The patients in the control group received routine care, and the patients in the intervention group attended a sleep hygiene education program in three consecutive face-to-face dialysis sessions using educational pamphlets for 40 to 60 minutes, depending on the patient’s tolerance. Two months after the training program, the quality of sleep, fatigue, and depression were measured for patients in both groups. The patients’ data were analyzed with SPSS software (version 25) using the paired samples t-test, independent samples t-test, chi-square test, and analysis of covariance (ANCOVA) at a significant level of 0.05 (P &lt; 0.05). Results: The mean scores of sleep quality for the patients in the intervention and control groups changed from 12.05 ± 2.18 to 10.85 ± 2.00 and from 10.28 ± 1.85 to 10.45 ± 1.85, respectively, and the paired samples t-test showed significant differences in both groups before and after the intervention, but the sleep quality scores increased for the patients in the intervention group (P = 0.001). Moreover, the mean fatigue scores for the patients in the intervention and control groups changed from 57.98 ± 13.48 to 52.25 ± 13.23 and from 48.88 ± 8.97 to 52.20 ± 8.80, respectively. The paired samples t-test showed significant differences in both groups before and after the intervention, but fatigue scores increased for the control group (P = 0.001). The data also indicated that the mean depression scores for the patients in the intervention and control groups changed from 24.20 ± 6.26 to 22.28 ± 5.26 and from 25.18 ± 7.70 to 25.68 ± 7.54, respectively. The independent samples t-test showed significant differences in both groups before and after the intervention (P = 0.001). By controlling the pre-test effect, the analysis of covariance (ANCOVA) revealed significant differences in the mean scores of sleep quality (P = 0.001), fatigue (P = 0.001), and depression (P = 0.001) in hemodialysis patients in both intervention and control groups after two months. Conclusions: The study’s findings indicated that sleep hygiene education significantly improves sleep quality, depression, and fatigue in hemodialysis patients. Given that sleep hygiene education is a simple and easy-to-use method, sleep hygiene training courses need to be organized and held for dialysis patients.

Assessment of Knowledge of Healthcare Professionals on Hand Hygiene Practices in Tertiary Care Hospitals: A Descriptive Cross-Sectional Study

Hand hygiene is one of the significant strategies to control and reduce infections, mortality, and healthcare cost in healthcare settings. Knowledge about hand hygiene practices helps to adopt optimal and validated techniques to prevent the transmission of infections. Therefore, the study was carried out to assess the healthcare professionals’ knowledge of hand hygiene practices in hospital settings. Objectives: To assess the knowledge of healthcare professionals regarding hand hygiene practices in hospitals. Methods: A descriptive cross-sectional study was carried out on healthcare professionals. After fulfilling the inclusion criteria, a total of 250 participants were selected by using convenient sampling techniques. The WHO questionnaire on Hand Hygiene Knowledge was used to fulfill the aims of the study. Descriptive statistics were utilized to analyze data. Results: The results of the current study showed that 59.2% of healthcare professionals had received formal training in hand hygiene in the last past 3 years. Overall moderate knowledge had been observed among healthcare professionals across the different departments. Conclusions: Having adequate knowledge related to hand hygiene practice cannot work alone to prevent the cross-transmission of germs. Proper surveillance and observation can increase compliance with hand hygiene. There is a strong demand to initiate different activities and workshops to train healthcare professionals on hand hygiene. As healthcare professionals are in close contact with patients in different departments even intensive care units. So, therefore, they need to be fully equipped with the basic knowledge and practice of HH.

Train-the-Trainers in hand hygiene facilitate the implementation of the WHO hand hygiene multimodal improvement strategy in Japan: evidence for the role of local trainers, adaptation, and sustainability

Background“Train-the-Trainers in hand hygiene” (TTT) is a standardized training to train infection prevention and control (IPC) practitioners with the aim to promote hand hygiene in health care according to the World Health Organization (WHO) multimodal improvement strategy. Little is known in the literature about the sustained impact of hand hygiene and IPC trainings adapted locally. The aim of this study is to describe the impact of three TTT courses conducted annually in Japan on the adoption of the WHO multimodal improvement strategy by local IPC practitioners who became a “trainer” after their first TTT participation as a “trainee”.MethodsThree TTT courses were conducted annually from 2020 to 2022 in Japan. A team “TTT-Japan” composed of more than 20 IPC practitioners who completed their first TTT participation adapted the original TTT program to reflect the local healthcare context in Japan, and subsequently convened the 2nd and 3rd TTTs. Pre- and post-course evaluations and post-course satisfaction surveys of the course participants were conducted to assess improvement in knowledge on hand hygiene and perception towards the course, respectively. Attitude and practice surveys of the TTT-Japan trainers were conducted to assess their perception and experience in hand hygiene promotion. The Hand Hygiene Self-Assessment Framework (HHSAF), a validated tool created by WHO to monitor the capacity of hand hygiene promotion at facility level, was applied at TTT-Japan trainers’ facilities to compare results before and after trainers’ engagement. We applied inductive thematic analysis for qualitative analyses of open-ended survey questions of the trainers’ attitude and practice surveys, and the Wilcoxon Sign Rank test for quantitive comparisons of pre- and post-data for the surveys and HHSAF.Results158 Japanese healthcare workers participated in three TTT courses, the majority of whom (131, 82.9%) were nurses. Twenty-seven local trainers were involved in 2nd and 3rd TTTs. The scores of pre- and post-course evaluations significantly improved after the course (P < 0.001) and the improvement was consistent across all three TTTs. Post-course satisfaction survey showed that over 90% of the participants reported that the course met their expectations and that what they learned in the courses would be useful for their practice. Trainers’ attitude and practice survey showed that more than three quarters (76.9%) of the trainers reported that their experience as a trainer had a positive impact on their practice at their own facilities. Qualitative analysis of the trainers’ attitude and practice survey revealed that trainers appreciated continuous learning as a trainer, and group effort to promote hand hygiene as the TTT-Japan team. The HHSAF institutional climate change element at the trainers’ facilities significantly improved after their engagement as a trainer (P = 0.012).ConclusionsTTTs were successfully adapted and implemented in Japan, leading to sustained hand hygiene promotion activities by local trainers over three years. Further research is warranted to assess the long-term impact on local hand hygiene promotion in different settings.

Bacteria and poisonous plants/fungi were the primary causative hazards of foodborne disease outbreaks: A five-year survey from Guangzhou, Guangdong

The burden of foodborne diseases is of serious concern. More effective and localized intervention policies for outbreak prevention and management are required; however, policy modification is hampered due to a lack of information on the epidemiological characteristics of outbreaks in Guangzhou. We collected data from 182 foodborne disease outbreaks reported in Guangzhou, China from 2017 to 2021 to investigate the epidemiological characteristics and associated factors. Nine outbreaks were serious enough to be labelled as level IV public health emergencies, all of which were associated with canteens. In terms of the number of outbreaks, morbidity and clinical medical needs, bacteria and poisonous plants/fungi were the primary causative hazards of outbreaks, and were found mostly in foodservice establishments (96 %, 95/99) and private homes (86 %, 37/43) respectively. Surprisingly, Vibrio parahaemolyticus was primarily identified in meat and poultry products rather than in aquatic products in these outbreaks. Patient specimens and food samples were among the most common sources of detected pathogens in foodservice establishments and private homes. Cross-contamination (35 %), improper processing (32 %) and equipment/utensil contamination (30 %) were the top three risk factors for outbreaks related to foodservice establishments, while accidental ingestion of poisonous food (78 %) was the most common risk factor in private homes. Based on the above epidemiological characteristics of the outbreaks, key foodborne disease intervention policy points should be to raise public awareness of harmful food and avoid risk behaviour, improve handler hygiene training, and strengthen the hygiene management and supervision of kitchens, especially canteens in collective units.