Important Public Health Challenge Research Articles

Less than human: dehumanisation of people who use heroin

PurposeStigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy.Design/methodology/approachA cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust.FindingsThere was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy.Social implicationsDehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to “rehumanise” PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work.Originality/valueThis is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy.

Prevalence and Determinants of Unintended Pregnancy among Women Receiving Antenatal Care Services: A Facility-Based Cross-Sectional Study in Ghana

Globally, unintended pregnancy represents an important public health challenge with significant social, economic and clinical repercussions which are worse in low-income and middle-income countries. Appropriate use of modern contraceptives averts significant proportions of unintended pregnancies and pregnancy complications. The objective of this study was to determine the prevalence and determinants of unintended pregnancy and explore modern contraceptive use among pregnant women
 
 A cross-sectional study was conducted among pregnant women receiving antenatal care at Korle-Bu Teaching hospital in Ghana using a face-to-face structured interview. Descriptive analysis was performed and multivariable logistic regression was used to assess the determinants of unintended pregnancy.
 
 Among the included 450 pregnant women receiving antenatal care, 155 (34.4%) had unintended pregnancy out of which 33 (21.3%) were using contraceptives prior to conception. In all, 14.2% (64/450) were using modern contraceptives. There was a significant difference between women and their partners regarding the perception of their index pregnancy as unintended (34.4% versus 31.6%, p-value <0.001). Significant determinants of unintended pregnancy include younger maternal age [aOR:5.706, 95%CI (1.860, 19.732)], unmarried status [aOR:5.238, 95%CI (2.882, 9.735)], previous childbirth [(aOR:2.376, 95%CI (1.460, 4.758], number of pregnancies ≥6 [aOR:2.640, 95%CI (1.210, 5.854)], number pregnancies ≤2 [aOR:0.417, 95%CI (0.252, 0.682)], previous caesarean birth [aOR:2.034, 95%CI (1.154, 3.306)] and contraceptive use prior to index pregnancy [aOR:2.305 95%CI (1.283-4.162)]. 
 
 The prevalence of unintended pregnancy remains markedly high while prior contraceptive use was relatively low among women receiving antenatal care. Evidence-based interventions including specialized client education are vital in improving optimal use of contraceptive services. We recommend further research including community-based qualitative studies to better understand the factors associated with contraceptive uptake and outcomes of unintended pregnancy.

Epidemiological and clinical characteristics of road traffic crashes related thoracic traumas: analysis of 5095 hospitalized chest injury patients

BackgroundRoad traffic crashes related (RTCR) chest traumas remain important global public health challenge. The impact of boosting market of automobile vehicles in China during last decade on thoracic injury needs to be defined. This study aimed to review and analyze the demographic and clinical characteristics of RTCR thoracic injuries in China.MethodsClinical records of patients with thoracic trauma admitted to thoracic surgery department between January 2003 and June 2020 were retrospectively retrieved and reviewed. Patients’ profiles and clinical characteristics were comparatively analyzed between road traffic crashes caused injury and other injury mechanisms, and in RTCR chest trauma patients before January 2011 (2003 group), and after January 2011 (2011 group), when is considered as the beginning year of Chinese household vehicle era.ResultsThe study included 5095 thoracic trauma patients with mean age of 50.2 years, of whom 79.4% were male. Most of the patients (70.3%, n = 3583) had rib fractures. Associated injuries were present in 52.0% of the patients, of them 78.5% (n = 2080) were extremity fractures. Road traffic crashes accounted for 41.4% (n = 2108) of the injuries, most of them (98.0%) were related to motor vehicles. In comparison with other chest trauma mechanisms, RTCR chest injuries affected females and older males more frequently, with a higher incidence of rib fractures and sternum fractures, and higher injury severity scores (ISS) (all p < 0.05). Surgeries were required in 1495 (70.9%) patients of the RRTCR chest traumas, while the majority of non-RTCR thoracic injuries were managed conservatively or with tube thoracostomy (30.2%, n = 901). RTCR chest traumas caused longer hospital stay (13.0 ± 9.6 days vs. 11.8 ± 7.4 days, p = 0.001), higher ICU usage (30.7% vs. 19.6%, p = 0.001), higher rate of ventilator support (12.9% vs. 7.5%, p = 0.001), and higher mortalities (3.8% vs. 1.6%, p = 0.005) than that of non-RTRA chest injuries. For RTCR patients, when compared with 2003 group, 2011 group had similar patterns in terms of accident category, associated injury and treatment. However, 2011 group had more females (38.5% vs. 18.0%, p = 0.001) and older males (50.6 ± 9.7 vs. 47.9 ± 17.2, p = 0.001), with a higher ISS (18.3 ± 10.2 vs. 17.1 ± 8.9, p = 0.004), and fewer were managed with chest tubes (25.0% vs. 29.2%, p = 0.031). Clinical outcomes were not significantly different between the groups in terms of hospital length of stay, intensive care unit (ICU) usage, ICU length of stay, duration of ventilator hours and mortality. However, the 2011 group had more patients requiring ventilator support (14.4% vs. 10.6%, p = 0.011).ConclusionsRoad traffic crashes remain to be the major etiology of thoracic injuries in China, which usually affects middle-aged males, causing rib fractures with concomitant injuries frequently occurring to other organ systems. Treatments mainly include tube thoracotomy and surgical procedures. Although the clinical characteristics and outcomes of traffic accident related chest traumas are largely unchanged in spite of the rapid increasing numbers of motor vehicles, variations in the pattern of injuries by gender, age, injury severity and ventilator usage may still provide important information for targeted management.

The role of airway remodeling in the pathogenesis and treatment of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is currently considered the third leading cause of death in the world. COPD represents an important public health challenge and a socio-economical problem that is preventable and treatable. The main cause of COPD is chronic inhalation of cigarette smoke, and other harmful constituents of air pollution, which cause epithelial injury, chronic inflammation and airway remodeling. Airway remodeling is most prominent in small airways. It is due to infiltration of the airways by inflammatory cells, such as neutrophils, eosinophils, macrophages, and immune cells, including CD8+ T-cells, Th1, Th17 lymphocytes, and innate lymphoid cells group 3. Fibroblasts, myofibroblasts, and airway smooth muscle (ASM) cells also contribute to airway remodeling by depositing extracellular matrix (ECM) proteins, which increase the thickness of the airway wall. Activated inflammatory cells, and structural cells secrete cytokines, chemokines, growth factors, and enzymes which propagate airway remodeling. Airway remodeling is an active process which leads to thickness of the reticular basement membrane, subepithelial fibrosis, peribronchiolar fibrosis, and ASM cells hyperplasia and hypertrophy. It is also accompanied by submucosal glands and goblet cells hypertrophy and mucus hypersecretion, and angiogenesis. Epithelial mesenchymal transmission (EMT) plays a key role in airway remodeling. In patients with COPD and smokers, cellular reprograming in epithelial cells leads to EMT, whereby epithelial cells assume a mesencymal phenotype. Additionally, COPD is associated with increased parasympathetic cholinergic activity, which leads to ASM cells hypercontractility, increased mucus secretion, and vasodilatation. Treatment of COPD is intricate because of the heterogeneous nature of the disease, which requires specific treatment of the pathophysiological pathways, such as airway inflammation, ASM cell hypercontractility, and parasympathetic cholinergic hyperreactivity. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 strategy report recommends personalized approach for the treatment of COPD. However, some patients with COPD are unresponsive to the standards of care. They may require a triple combination of LABA/LAMA/ICS. Single-inhaler triple therapy (SITT), such as fluticasone fuorate/vilanterol/umeclidinium has been shown to significantly improve symptoms and asthma control, reduce moderate and severe exacerbations, and to improve lung function.

DAMPAK DEPRESI ANTENATAL TERHADAP HASIL KELAHIRAN: SYSTEMATIC REVIEW

The Effect of Antenatal Depression to Birth Outcomes: A Systematic Review Background: Mental health problems is an important public health challenge. There are 10% of pregnant women with mental disorders, especially depression. Depression affects adverse birth outcomes such as premature birth, low birth weight, low APGAR score, small head circumference and small for gestational (SGA). Objective: The purpose of this study is to determine the effect of antenatal depression on birth outcomes. Method: This study use a systematic review method using PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocole) 2009. Results: From 836 documents, 5 studies were selected from Vietnam, Pakistan, Malaysia, The United States and Australia. 4 studies is a prospective cohort study design and 1 cross sectional study showing the negative effects of antenatal depression on birth outcomes. Conclusion: Antenatal depression has a negative impact on birth outcomes by increasing the risk of preterm birth (<37 weeks), increasing the risk of LBW birth (2500 grams), increasing the risk of a low APGAR score, and increasing the risk of having a small for gestational (SGA) baby.

Antibiotic Prescribing Practices in Primary Care Settings Using 2019 WHO AWaRe Framework

Background: Bacteria have ability to rapidly evolve, develop strategies to resist antibiotics, and reduce the effectiveness of antibiotics. The emergence and spread of antimicrobial resistance is an important global public health challenge to tackle. Studying antibiotic prescribing practices would allow rational use and preserve effectiveness of antibiotics.&#x0D; Objective: To study prescribing practices of antibiotics in out-patients in primary care settings using the WHO AWaRe framework.&#x0D; Methodology: A prospective cross-sectional study was conducted to evaluate prescribing practices of antibiotics in the primary care facility of three private hospitals using the WHO ‘core prescribing indicators’ and Access, Watch, and Reserve (AWaRe) classification. A systematic sampling technique was employed to collect the prescriptions at each hospital for three months. Descriptive statistics were applied to the collected data.&#x0D; Results: A total of 2685 prescriptions were systematically evaluated. 1280 encounters had at least one antibiotic (47.7%), of which 1041 consist of only one antibiotic (81.5%). Among 1280 antibiotic encounters, the average number of antibiotics per encounter was 1.2 and 14.6% were prescribed with a parenteral antibiotic. 26.6% and 78.6% antibiotics were prescribed using generic names and from the WHO Essential Medicines List, respectively. Amoxicillin/clavulanic acid, ceftriaxone, azithromycin, cefoperazone, and amoxicillin were the five most commonly prescribed antibiotics. According to the WHO AWaRe classification, a total of 27 specific antibiotics (Access 11, Watch 14, and Reserve 2) were prescribed. 38.4%, 53.7%, 0.3%, and 10.5% of antibiotics prescribed were from the ‘Access’, ‘Watch’, ‘Reserve’, and ‘Not Recommended’ categories, respectively. Third generation cephalosporins (24.0%) were prescribed in high rate among ‘Watch’ category. The most commonly prescribed ‘Access’ and ‘Watch’ antibiotics were amoxicillin/clavulanic acid (12.5%) and ceftriaxone (10.6%), respectively. Amoxicillin index was 19.5% and ‘Access-to-Watch’ index was 0.76, which were below the priority values.&#x0D; Conclusion: Except few indicators, still better prescribing practices of antibiotics are needed to fully meet the WHO recommendations. Antibiotic prescribing guidelines as per the WHO AWaRe framework, changes in prescription patterns and preference of “Access” over ‘Watch’ antibiotics are crucial to preserve effectiveness and promote rational use of antibiotics.

English

BACKGROUND With recent advancement in health facility, both in urban and rural population, ratio of elderly people has increased and due to this apart from physical illness, mental health is also emerged as an important public health challenge. Psychiatric disorders such as depression, anxiety, cognitive disorders and substance use disorders were commonly found in elderly specially living alone and in care homes. The primary purpose of this study was to compare mental health of elderly people living in care homes with those living with family in Kota (Hadoti region, Rajasthan). METHODS This is a cross-sectional comparative study that was carried out in 50 elderly people living in care homes and 50 elderly people living with family. Both groups were screened for psychiatric disorders using general health questionnaire (GHQ – 12). Comparison was made under various headings between these groups including severity. Obtained data were analysed by using proportion, mean, standard deviation, chi-square, and Pearson correlation. RESULTS No statistically significant difference was found in having psychiatric disorders on screening with GHQ - 12. Difference in these groups for prevalence and severity was not statistically significant for depression and anxiety although significant higher mean of total geriatric depression score (GDS) score in control (10.74 ± 2.56) than in cases (9.38 ± 2.36) and total Hamilton’s anxiety rating scale (HAM – A) score was seen in case group (24.53 ± 3.50) than in controls (23.15 ± 2.34). CONCLUSIONS In this study, it was found out that psychiatry morbidity was higher among elderly population living in old age home when compared to elders living with family in community. Possible reason for higher psychiatric morbidity in old age home group in our study appears to be because of lack of family support, pain of being separated from their children whom they cared and nurtured for their whole life. In psychiatric morbidity we found that depression was the most common disorder in elderly population in both groups. KEYWORDS Old Age Home, Mental Disorders, Depression, Anxiety

Self-reported Subjective Effects of Analytically Confirmed New Psychoactive Substances Consumed by e-Psychonauts: Protocol for a Longitudinal Study Using a New Internet-Based Methodology

BackgroundDuring the last few years, the continuous emergence of new psychoactive substances (NPS) has become an important public health challenge. The use of NPS has been rising in two different ways: buying and consuming NPS knowingly and the presence of NPS in traditional drugs as adulterants. The rise of NPS use is increasing the number of different substances in the market to an extent impossible to study with current scientific methodologies. This has caused a remarkable absence of necessary information about newer drug effects on people who use drugs, mental health professionals, and policy makers. Current scientific methodologies have failed to provide enough data in the timeframe when critical decisions must be made, being not only too slow but also too square. Last but not least, they dramatically lack the high resolution of phenomenological details.ObjectiveThis study aims to characterize a population of e-psychonauts and the subjective effects of the NPS they used during the study period using a new, internet-based, fast, and inexpensive methodology. This will allow bridging an evidence gap between online surveys, which do not provide substance confirmation, and clinical trials, which are too slow and expensive to keep up with the new substances appearing every week.MethodsTo cover this purpose, we designed a highly personalized, observational longitudinal study methodology. Participants will be recruited from online communities of people who use NPS, and they will be followed online by means of a continuous objective and qualitative evaluation lasting for at least 1 year. In addition, participants will send samples of the substances they intend to use during that period, so they can be analyzed and matched with the effects they report on the questionnaires.ResultsThe research protocol was approved by the Institutional Review Board of the Hospital del Mar Research Institute on December 11, 2018. Data collection started in August 2019 and was still ongoing when the protocol was submitted (September 2020). The first data collection period of the study ended in October 2020. Data analysis began in November 2020, and it is still ongoing. The authors expect to submit the first results for publication by the end of 2021. A preliminary analysis was conducted when the manuscript was submitted and was reviewed after it was accepted in February 2021.ConclusionsIt is possible to conduct an institutional review board–approved study using this new methodology and collect the expected data. However, the meaning and usefulness of these data are still unknown.International Registered Report Identifier (IRRID)DERR1-10.2196/24433

Systematic Review of Visceral Leishmaniasis in Central Africa

In underdeveloped countries, infectious diseases remain one of the most important public health challenges. Visceral leishmaniasis, also known as Kala-azar, is a lethal vector-borne parasitic disease with an increasing number of cases. However, it remains one of the most neglected diseases in the world. It is the most severe form of leishmaniasis and is endemic in 75 countries. Around 95% of the patients live in seven countries: Brazil, Ethiopia, India, Kenya, Somalia, South Sudan, and causes about 20,000-40,000 deaths per year of which 50-70% are children. In Central Africa, this pathology is little known and less documented, making it difficult to access information. We have performed this study to characterize the knowledge on the epidemiology of visceral leishmaniasis in Central Africa. We reviewed the literature on visceral leishmaniasis in Central Africa on the number of reported cases, identified parasites, reservoirs and vectors. The documents consulted came from WHO reports, publications of scientific journals, reports of research institutions and abstracts of scientific conferences consulted online on Pubmed and Google Scholar. The information covers the period from the first reporting of cases in each country until December 2020. The review of the situation of visceral leishmaniasis revealed that it is not a significant public health problem in Central Africa. However, a lot of work remains to be done especially surveillance and research in order to present the exact situation of the disease in this part of the continent. This work would include the underreporting of cases inherent to the weaknesses of the surveillance system in these countries, the clarification of the transmission dynamics of human visceral leishmaniasis, canine leishmaniasis, the identity of parasites and vectors.

Brain training using cognitive apps can improve cognitive performance and processing speed in older adults

Managing age-related decrease of cognitive function is an important public health challenge, especially in the context of the global aging of the population. Over the last years several Cognitive Mobile Games (CMG) have been developed to train and challenge the brain. However, currently the level of evidence supporting the benefits of using CMG in real-life use is limited in older adults, especially at a late age. In this study we analyzed game scores and the processing speed obtained over the course of 100 sessions in 12,000 subjects aged 60 to over 80 years. Users who trained with the games improved regardless of age in terms of scores and processing speed throughout the 100 sessions, suggesting that old and very old adults can improve their cognitive performance using CMG in real-life use.

Human umbilical cord mesenchymal stem cells in type 2 diabetes mellitus: the emerging therapeutic approach.

The umbilical cord has been proved to be an easy-access, reliable, and useful source of mesenchymal stem cells (MSC) for clinical applications due to its primitive, immunomodulatory, non-immunogenic, secretory and paracrine, migratory, proliferative, and multipotent properties. This set of characteristics has recently attracted great research interest in the fields of nanotechnology and regenerative medicine and cellular therapy. Accumulating evidence supports a pronounced therapeutic potential of MSC in many different pathologies, from hematology to immunology, wound-healing, tissue regeneration, and oncology. Diabetes mellitus, branded the epidemic of the century, is considered a chronic metabolic disorder, representing a major burden for health system sustainability and an important public health challenge to modern societies. The available treatments for type 2 diabetes mellitus (T2DM) still rely mainly on combinations of oral antidiabetic agents with lifestyle and nutritional adjustments. Despite the continuous development of novel and better hypoglycemic drugs, their efficacy is limited in the installment and progression of silent T2DM complications. T2DM comorbidities and mortality rates still make it a serious, common, costly, and long-term manageable disease. Recently, experimental models, preclinical observations, and clinical studies have provided some insights and preliminary promising results using umbilical cord MSCs to treat and manage diabetes. This review focuses on the latest research and applications of human-derived umbilical cord MSC in the treatment and management of T2DM, exploring and systematizing the key effects of both umbilical cord MSC and its factor-rich secretome accordingly with the major complications associated to T2DM.

Driving Laboratory Standardization of Bacterial Culture and Antimicrobial Susceptibility Testing in Veterinary Clinical Microbiology in Europe and Beyond

ABSTRACTGlobally, antimicrobial resistance is one of the most important public health challenges in which the clinical microbiology laboratory plays a critical role by providing guidance for antimicrobial treatment. Despite the recognition of its importance, there is still a real need for the standardized training of clinical microbiologists and harmonization of diagnostic procedures. This is particularly true for veterinary clinical microbiology, where additional challenges exist when microbiologists are trying to fulfill a professional role very similar to that of their colleagues working in human microbiology laboratories. The specific points that need addressing to improve the outputs of veterinary microbiology laboratories discussed here include (i) harmonization of methodologies used by veterinary laboratories for antimicrobial susceptibility testing (AST); (ii) specific guidelines for interpretation and reporting of AST results for animal pathogens; (iii) guidelines for detection of antimicrobial resistance mechanisms in animal isolates; (iv) standardization of diagnostic procedures for animal clinical specimens; and (v) the need to train more veterinary clinical microbiology specialists. However, there is now a plan to address these issues, led by the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT), which is bringing together experts in veterinary microbiology, pharmacology, epidemiology, and antimicrobial stewardship from Europe and wider afield. ENOVAT is aiming to work with project partners toward standardization and harmonization of laboratory methodologies and optimization of veterinary antimicrobial treatment. Ultimately, the project may provide a mechanism for standardization and harmonization of veterinary clinical microbiology methodologies that could then be used as a template for implementation at a wider international level.

A Public Health Informatics Solution to Improving Food Safety in Restaurants: Putting the Missing Piece in the Puzzle.

Foodborne illnesses remain an important public health challenge in the United States causing an estimated 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths per year. Restaurants are frequent settings for foodborne illness transmission. Public health surveillance - the continual, systematic collection, analysis, and interpretation of reports of health data to prevent and control illness - is a prerequisite for an effective food control system. While restaurant inspection data are routinely collected, these data are not regularly aggregated like traditional surveillance data. However, there is evidence that these data are a valuable tool for understanding foodborne illness outbreaks and threats to food safety. This article discusses the challenges and opportunities for incorporating routine restaurant inspection data as a surveillance tool for monitoring and improving foodborne illness prevention activities. The three main challenges are: 1) lack of a national framework; 2) lack of data standards and interoperability; and 3) limited access to restaurant inspection data. Tapping into the power of public health informatics represents an opportunity to address these challenges. Advancing the food safety system by improving restaurant inspection information systems and making restaurant inspection data available to support decision-making represents an opportunity to practice smarter food safety.

Obesity Associated Hypertension in University Staff at SMBBMU Larkana, Pakistan

Objectives: To determine the association of obesity and hypertension among the faculty members of ShaheedMohtarma Benazir Bhutto University Larkana.&#x0D; Methods: A cross-sectional descriptive study was conducted on 340 subjects from SMBB Medical University. A self-administered questionnaire, mercury sphygmomanometer, stethoscope, weighing and height scales were the research instruments, data was entered and analyzed using the statistical program for social sciences SPSS version 19.&#x0D; Results: A 340 subjects were included in the study. There were 123 (36.2%) female and 217 (63.8%) male participants, Prevalence of hypertension in the sample was 31.5% (27.6% in females and 33.6% in males) Hypertension was more comparatively more prevalent in overweight group (39.3%) and obese group (32.5%).&#x0D; Conclusion: Obesity is an important public health challenge in the study setting and its highly associated with HTN. Prevalence of Obesity and hypertension among university teachers was observed significantly higher compared to the general population. Measures to prevent the obesity and hypertension are strongly recommended.

Exploring the antidiabetic potential of compounds isolated from Anacardium occidentale using computational aproach: ligand-based virtual screening.

The online version contains supplementary material available at 10.1007/s40203-021-00084-z.

An audit of health student immunisation at a University Department of Rural Health reveals the imperative for a coordinated approach

ObjectiveStudent healthcare worker immunisation ensures the protection of students, their patients and the wider community. This audit assessed allied health students’ records of immunisation against national standards. MethodsThis audit examined clinical students’ immunisation records at a University Department of Rural Health and assessed their compliance with the national Australian Immunisation Handbook recommendations. Gaps in processes were assessed through a review of forms, guidelines and stakeholder feedback. ResultsAround one‐quarter (26%) of healthcare students provided evidence that they were immunised in line with national standards. Inconsistency of immunisation recommendations across universities, states and disciplines were identified. ConclusionsThis audit highlighted gaps in healthcare student immunisation assurance processes at both local and national levels, and we recommend key elements that would be required for a more consistent, streamlined and coordinated approach. Implications for public healthAs a pillar of communicable disease control, immunisation compliance continues to pose important public health challenges. Without further work towards coordination of healthcare students’ immunisation assurances, there is a risk of preventable morbidity and mortality in vulnerable communities, as well as suboptimal student and worker safety in an environment that poses high risks.

An Analysis of Anthropometric Measurements of Children Enrolled in Programs for Managing Acute Malnutrition, in Kwale County, Kenya

introduction: Malnutrition remains an important public health challenge in developing countries. Approximately, each year, 3 million children below 5 years old die due to malnutrition. Evidence- based nutrition programs depend on accurate estimates of malnutrition derived from anthropometric data collected from nutrition centers for therapeutic feeding. Anthropometric information can be used to determine an individual´s nutritional status and prevalence of malnutrition, and subsequently provide

In Vitro Preformed Biofilms of Bacillus safensis Inhibit the Adhesion and Subsequent Development of Listeria monocytogenes on Stainless-Steel Surfaces.

Listeria monocytogenes continues to be one of the most important public health challenges for the meat sector. Many attempts have been made to establish the most efficient cleaning and disinfection protocols, but there is still the need for the sector to develop plans with different lines of action. In this regard, an interesting strategy could be based on the control of this type of foodborne pathogen through the resident microbiota naturally established on the surfaces. A potential inhibitor, Bacillus safensis, was found in a previous study that screened the interaction between the resident microbiota and L. monocytogenes in an Iberian pig processing plant. The aim of the present study was to evaluate the effect of preformed biofilms of Bacillus safensis on the adhesion and implantation of 22 strains of L. monocytogenes. Mature preformed B. safensis biofilms can inhibit adhesion and the biofilm formation of multiple L. monocytogenes strains, eliminating the pathogen by a currently unidentified mechanism. Due to the non-enterotoxigenic properties of B. safensis, its presence on certain meat industry surfaces should be favored and it could represent a new way to fight against the persistence of L. monocytogenes in accordance with other bacterial inhibitors and hygiene operations.

Relación del sobrepeso y obesidad con el rendimiento laboral en trabajadores de una empresa metalmecánica en México

El sobrepeso y la obesidad son de los retos más importantes de salud pública mundial. México ocupa el primer lugar mundial en este rubro. En riesgos laborales, las empresas metalmecánicas ocupan el tercer lugar a nivel nacional. Objetivo: Determinar la relación entre rendimiento con sobrepeso y obesidad en los trabajadores de una empresa metalmecánica. Métodos: Estudio transversal, con la participación de 40 trabajadores del área de producción de una metalmecánica. Se aplicaron tres instrumentos: índice de masa corporal, cuestionario sociodemográfico - laboral y Nasa TLX. Se utilizó la Chi cuadrada, coeficiente de contingencia y odds-ratio. Resultados: El promedio etario de los participantes fue de 38 años (± 9). La escolaridad no mostró diferencias para primaria y secundaria trunca. Fue más prevalente el número de empleados con pareja estable. La antigüedad en el puesto fue en promedio de 7 años (± 3 años). No hubo asociación estadística (p &lt;0.05) entre sobrepeso, obesidad y rendimiento laboral, pero sí entre esfuerzo y frustración, y edad y antigüedad en el puesto. Conclusiones: A pesar del sobrepeso y la obesidad en los participantes (52 y 28% respectivamente), fue paradójico que se percibiera de forma destacada el esfuerzo y no su relación con estas variables. Es destacable lo irrelevante del rendimiento, lo que puede interpretarse como una muestra de lo disímbolo que resultan ser las interpretaciones sobre las actividades laborales, entre patrón y trabajador.

AGT M235T Polymorphism and Arterial Hypertension in Patients with Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) represents an important public health challenge. It is a major cause of chronic morbidity and mortality throughout the world. Arterial hypertension (AH) is considered one of the principal COPD-associated comorbidities. Objective: The study was aimed to assess the role of angiotensinogen (AGT) gene polymorphism in occurrence of AH in patients with COPD. Methods: The study was conducted among 96 patients of them, Group 1 (25 individuals with COPD), Group 2 (23 individuals with AH), Group 3 (28 individuals with COPD and AH). The control group consisted of the 20 healthy subjects. I/D genotypes of AGT were determined by polymerase chain reaction amplification. Plasma AGT activity was determined photometrically by a commercially available kit. Results: The results of the study have not demonstrated any significant impact of alleles of AGT genes on occurrence of such disease as COPD, AH and combinations thereof. However, analysis of odds ratio has demonstrated the presence of a trend towards a protective role of the M allele of the AGT gene concerning occurrence of COPD, AH and their combinations (OR=0.90, OR=0.71 and OR=0.56, respectively). At the same time, the presence of the T allele of the AGT gene may increase the risk for occurrence of the above mentioned disease (OR=1.11, OR=1.4 and OR=1.79, respectively). Conclusion: The study suggests that the presence of Т allele of the AGT gene at position 235 of the peptide chain both in homozygous and heterozygous state may increase the risk for AH in patients with COPD. Bangladesh Med Res Counc Bull 2020; 46(3): 176-183