Prevention Management Research Articles

Can Outreach Training and Supportive Supervision Improve Competency in Malaria Service Delivery? An Evaluation in Cameroon, Ghana, Niger, and Zambia.

Outreach Training and Supportive Supervision (OTSS) of malaria services at health facilities has been adopted by numerous malaria-endemic countries. The OTSS model is characterized by a hands-on method to enhance national guidelines and supervision tools, train supervisors, and perform supervision visits. An independent evaluation was conducted to evaluate the effectiveness of OTSS on health worker competence in the clinical management of malaria, parasitological diagnosis, and prevention of malaria in pregnancy. From 2018 to 2021, health facilities in Cameroon, Ghana, Niger, and Zambia received OTSS visits during which health workers were observed directly during patient consultations, and supervisors completed standardized checklists to assess their performance. Mixed-effects logistic regression models were developed to assess the impact of increasing OTSS visit number on a set of eight program-generated outcome indicators, including overall competency and requesting a confirmatory malaria test appropriately. Seven of eight outcome indicators showed evidence of beneficial effects of increased OTSS visits. Odds of health workers reaching competency thresholds for the malaria-in-pregnancy checklist increased by more than four times for each additional OTSS visit (odds ratio [OR], 4.62; 95% CI, 3.62-5.88). Each additional OTSS visit was associated with almost four times the odds of the health worker foregoing antimalarial prescriptions for patients who tested negative for malaria (OR, 3.80; 95% CI, 2.35-6.16). This evaluation provides evidence that successive OTSS visits result in meaningful improvements in indicators linked to quality case management of patients attending facilities for malaria diagnosis and treatment, as well as quality malaria prevention services received by women attending antenatal services.

The FOODRUS index: Assessing suitability for effective food loss and waste prevention management under an integral perspective

The impact of food loss and waste (FLW) generation on food supply chains' (FSC) sustainability represents a challenge embodied in the Sustainable Development Goal (SDG) 12.3. This problem requires a methodology to measure such an impact in a rigorous, holistic, and standardized way that can be applied to any FSC. This paper aims to develop and validate a single index to assess the readiness of FSCs to implement FLW prevention strategies and measure their impact: the so-called FOODRUS index. The co-creation methodology followed incorporates experts and FSC stakeholders feedback. The index has been validated in 3 FSCs: The Slovak pilot scored 74.35%, the Spanish pilot reached 68.79%, and the Danish pilot was rated 61.14%. Its calculation, eased by the FOODRUS index self-assessment tool (described in the Appendix), allows quick diagnosis of the FSC capability to implement FLW prevention strategies considering both the knowledge provided by experts and the experience of the FSC stakeholders that participated in its co-creation process. In this way the FSC can assess its FLW prevention performance at a strategic and management level, with the aim of improving its sustainability impact.

Case Management in Prevention of 30-Day Readmission in Post-Coronary Artery Bypass Graft Surgery.

Thirty-day readmission is associated with increased morbidity and mortality among postoperative coronary artery bypass graft (CABG) surgery patients. Interventions such as case management and follow-up care may reduce 30-day readmission. The purpose of this article is to report a study on modifiable factors that may have significant implications for case management in the prevention of readmission after CABG surgery. The study population included all the adult patients who underwent first-time CABG surgery from January 1, 2013, to January 1, 2016, from a Mid-South hospital. A retrospective case-control study was employed to examine 1,712 patients who underwent CABG surgery. The results revealed that patients readmitted within 30 days had a significantly shorter length of stay (LOS) (6 days vs. 10 days; p < .0001), more days in intensive care unit (6 days vs. 4 days; p = .0391), and significantly higher diabetes/renal (4% vs. 1%), infection (17% vs. 2%), and respiratory-related diagnoses (10% vs. 1%; p < .0001). Among these factors, hospital LOS is a major factor that can be addressed through case management in addition to other modifiable risk factors. Understanding modifiable factors associated with higher readmission risk is crucial for effective intervention and case management planning.

Occupational Medicine, Go Above and Beyond.

The population of people in Japan over 65 years old is expected to exceed 30% by 2025. As the society ages, there are not only healthy workers and employers, but also an increasing number of diseased or injured workers. Falls, the most common occupational hazard, increase in incidence with age. The management of osteoporosis and prevention of bone fractures from falls are emerging in elderly female workers, to reduce the loss of work productivity. Rheumatoid arthritis is a representative musculoskeletal disease that causes functional decline because of joint damage mainly in working women, but appropriate treatment improves disease activity and work productivity in workers with rheumatoid arthritis. It is also important not only to digitize subjective information by converting it into digital form (digitization), but also to digitalize the physiological information related to health, labor and disease (digitalization). In the future, artificial intelligence (AI) will be able to analyze vast amounts of physiological information (big data) obtained from workers and patients via the Internet of things (IoT), which will improve the information value linked to health promotion and optimal treatment practices, and contribute to the Digital transformation (DX).

Key Performance Indicators in Occupational Health and Safety of Hospitals: A systematic review with meta-analysis protocol

Abstract Objective: The purpose for conducting the review is to examine studies which have been carried out on Occupational Health and Safety (OHS) in hospitals using Key Performance Indicators (KPIs). We will determine if these studies take into account institutional categories. Introduction: The developing application of KPIs in hospitals takes into account some particular conditions for OHS in the health sector. The application of KPIs in OHS of hospitals is connected to institutional directives for OHS. We will determine if these studies take into account institutional categories such as Protective and Preventive Services (PPS), Risk Assessment (RA) and Management Systems (OHSMS). Inclusion criteria: We will include studies which use KPIs in the evaluation of OHS in hospitals, (those related directly and indirectly to OHS). We exclude the following categories of study: Studies which use KPIs in hospital evaluations, but which are not oriented to OHS and studies which include KPIs in evaluating various organizations but not exclusively hospitals. Methods: We will conduct electronic searches for eligible studies within each of the following databases: PubMed, Scopus, Heal-link, Google Scholar. With the help of the JBI tool and using inclusion/exclusion criteria, two independent reviewers will determine which studies will be selected or not. Those studies which fulfill the inclusion criteria will be subjected to a post analysis data procedure. We intend to use mixed methods and workflow software. Results (as expected outcomes): Examination of the relationship between KPIs in OHS of hospitals and the institutional representations for OHS, using the Data Analysis methods. Conclusions: The conclusions will depend on the results of the relationship between KPIs in OHS of hospitals and the institutional representations.

Haemodynamic compensations for exercise tissue oxygenation in early stages of COPD: an integrated cardiorespiratory assessment study

BackgroundCardiovascular comorbidities are increasingly being recognised in early stages of chronic obstructive pulmonary disease (COPD) yet complete cardiorespiratory functional assessments of individuals with mild COPD or presenting with COPD risk...

Melatonin in hemicrania continua and paroxysmal hemicrania.

Hemicrania continua (HC) and paroxysmal hemicrania (PH) belong to a group of primary headache disorders called trigeminal autonomic cephalalgias. One of the diagnostic criteria for both HC and PH is the absolute response to the therapeutic dose of indomethacin. However, indomethacin is discontinued in many patients as a result of intolerance to its side effects. Melatonin, a pineal hormone, which shares similar chemical structure to indomethacin, has been reported to have some efficacy for HC in previous case reports and series. To our knowledge, there is no literature regarding the use of melatonin in PH. We aimed to describe the clinical use of melatonin in the preventive management of HC and PH. Patient level data were extracted as an audit from routinely collected clinical records in consecutive patients seen in outpatient neurology clinic at King's College Hospital, London, UK, from September 2014 to April 2023. Our cohort of patients were identified through a search using the keywords: hemicrania continua, paroxysmal hemicrania, melatonin and indomethacin. Descriptive statistics including absolute and relative frequencies, mean ± SD, median and interquartile range (IQR) were used. Fifty-six HC patients were included with a mean ± SD age of 52 ± 16 years; 43 of 56 (77%) patients were female. Melatonin was taken by 23 (41%) patients. Of these 23 patients, 19 (83%) stopped indomethacin because of different side effects. The doses of melatonin used ranged from 0.5 mg to 21 mg, with a median dose of 10 mg (IQR = 6-13 mg). Fourteen (61%) patients reported positive relief for headache, whereas the remaining nine (39%) patients reported no headache preventive effect. None of the patients reported that they were completely pain free. Two patients continued indomethacin and melatonin concurrently for better symptom relief. Eight patients continued melatonin as the single preventive treatment. Side effects from melatonin were rare. Twenty-two PH patients were included with mean ± SD age of 50 ± 17 years; 17 of 22 (77%) patients were female. Melatonin was given to six (27%) patients. The median dose of melatonin used was 8 mg (IQR = 6-10 mg). Three (50%) patients responded to melatonin treatment. One of them used melatonin as adjunctive treatment with indomethacin. Melatonin showed some efficacy in the treatment of HC and PH with a well-tolerated side effect profile. It does not have the same absolute responsiveness as indomethacin, at the doses used, although it does offer a well-tolerated option that can have significant ameliorating effects in a substantial cohort of patients.

The Effect of American Society of Anesthesiologists Score and Operative Time on Surgical Site Infection Rates in Major Abdominal Surgeries.

The objective of this study was to evaluate the influence of two crucial variables, the American Society of Anesthesiologists (ASA) score and operative time, on the occurrence of surgical site infections (SSIs) in the context of major abdominal surgical procedures. A cross-sectional research study involved patients undergoing various gastrointestinal surgical procedures. Surgical details, procedure duration, and ASA score were meticulously documented. Patients were observed for surgical site infections (SSIs) during their inpatient stay until discharge. Following their discharge, patients were monitored in the outpatient department for a minimum of 30 days post-surgery, and those who underwent mesh procedures were observed for one year. In the overall study population, surgical site infections were identified in 42 cases, constituting 6.7%. There was a significant association between ASA grade and the incidence of surgical site infections (p=0.001), indicating a higher prevalence of infections in cases with elevated ASA grades. Furthermore, a statistically significant association exists between the average duration of surgery and the occurrence of surgical site infections (p=0.001). The meansurgery duration for cases with infections is reported as 206.33 min, with a standard deviation of 103.73, while for cases without infections, the mean duration is 99.72 min, with a standard deviation of 79.71. In the multivariate analysis, it was found that an ASA score of 3 or higher and operative time exceeding 90 min were identified as independent factors for predicting the likelihood of surgical site infections. The significant associations identified between the American Society of Anesthesiologists (ASA) grade, average surgery duration, and SSIs underscore the importance of comprehensive preoperative assessment and procedural management in infection prevention.

Clinically-relevant Germline Variants in Children with Non-Medullary Thyroid Cancer.

The underlying genetic cause of non-medullary thyroid cancer (NMTC) in children is often unknown, hampering both predictive testing of family members and preventive clinical management. Our objectives were to investigated the potential heritability in the largest childhood NMTC cohort that has been genotyped to date. Nationwide retrospective cohort study. Tertiary referral centers. In total, 97 patients diagnosed with pediatric NMTC between 1970-2020 were included in this study. Germline whole genome sequencing (WGS). The main outcome measures were mutation detection yield in 1) clinically-relevant tumor predisposition genes, and 2) genes previously associated with NMTC. In total, 13 of 97 patients (13%) carried a germline (likely) pathogenic (P/LP) variant in a well-known tumor predisposition gene: APC (n=1), BRCA2 (n=2), CHEK2 (n=4), DICER1 (n=4), HOXB13 (n=1), , and MITF (n=1). In addition, one patient was diagnosed with Pendred syndrome (SLC26A4) and nine variants of high interest were found in other NMTC candidate susceptibility genes. The reported prevalence (13%) of germline variants in well-known tumor predisposing genes and the added value of a revised personal-/family history and histology led us to recommend genetic counseling for all childhood NMTC patients.The detected tumor predisposition syndromes are associated with a risk for second cancers which necessitates additional surveillance of the index patients and pre-symptomatic genetic testing of at risk family members.

Using Homeopathy Case Taking, a Qualitative Study Was Carried Out on Ninety Cases of Chronic Kidney Disease Without Dialysis to Determine Management Guidelines

Management of chronic kidney diseases (CKD) and prevention of ESRD is highly required for population health and economic burden. Various factors other than diabetes, hypertension and drugs, are interlinked to main factors as well as directly causation to chronic kidney diseases (CKD). A homeopathic approach to finding out factors will help the prevention of ESRD and the curative aspect of the CKD.

PDFID: A high-resolution flood inundation dataset with a long time series

Study regionPoyang Lake and East Dongting Lake, China. Study focusOn the basis of data on the extent of the inundation of water bodies, the water level, and DEM data, this study constructed an hourly flood inundation dataset (PDFID) for the East Dongting Lake and Poyang Lake regions with a 10 m resolution and a coverage area of >5000 km2 from 2012 to 2022 by using the RFim model and the U-net model. Validation of the results on Sentinel-1 SAR images and Sentinel-2 MSI optical images showed that the overall accuracy of the dataset ranged from 88% to 97%, with a kappa coefficient ranging from 0.601 to 0.932. The accuracy for the East Dongting Lake region ranged from 88% to 97%, with a kappa coefficient of >0.67, and for the Poyang Lake region, the accuracy ranged from 89% to 97%, with a kappa coefficient of >0.6. New hydrological insights for the regionFlood inundation datasets with a high spatiotemporal resolution and long time series enable us to analyze and comprehend floods’ processes, patterns, and dynamics, facilitating the enhanced development and management of flood prevention and mitigation strategies. However, they have yet to be made available. Thus, this study can provide a fundamental data source for analytical mining and predicting the flooding processes in basins.

Pressure, Opportunnity, Rationalization, dan Capability terhadap Terjadinya Fraud : Studi di Salah Satu Dinas Propinsi Sulawesi Selatan

This study examines the influence of Pressure, Opportunity, Rationalization, and Capability on Fraud within a department in South Sulawesi Province over two months, from December to January 2022. The department's entire staff constitutes the study population, with a saturated sampling method employed to ensure a representative sample. Field research methodology was utilized, employing quantitative data collection through questionnaire surveys. Data analysis was conducted using multiple linear regression with the assistance of statistical software.The results indicate that Pressure (Opportunity), Opportunity, Rationalization, and Capability significantly impact Fraud. The results indicate that Pressure (Opportunity), Opportunity, Rationalization, and Capability significantly impact Fraud. Practical recommendations for the study's subject include; conducting training on work ethics, stress management, and understanding of fraud prevention; implementing clear and stringent anti-fraud policies; enhancing communication and transparency throughout the organization; strengthening internal supervision mechanisms and fostering a work culture that values integrity and ethics.

Trauma and Percieved Internal Support of Police Officers in Kenya

Purpose: This paper explores how Police officers in Kenya and elsewhere in the globe play an irreplaceable role of ensuring security, law and order but are exposed to a wide range of potentially psychologically traumatizing events in the course of duty without adequate internal trauma informed support. This trauma potentiates them to develop Post Traumatic Stress Disorder which is associated with many dysfunctional behaviors like assault, homicide and suicide. &#x0D; Materials and Methods: Hermeneutic phenomenology approach is used to collect information from scholarly articles and media reports on the subject of police trauma and internal support. This data is then assessed to generate findings presented in this paper. Thirty case studies of Kenya police perpetrated assault, homicide or suicide are also selected randomly from the media to support the scholarly findings about work related police trauma and internal support.&#x0D; Findings: Kenyan police officers are exposed to traumatic events but police training and culture encourages hardiness, masculinity and repression instead of trauma informed coping. The case studies reveal that traumatized police officers in Kenya develop severe Post Traumatic Stress Disorder (PTSD) which then presents in various psychological disorders and deviance like assault (14%), murder (30%), suicide (90%) and homicide (17%).&#x0D; Implications to Theory Practice and Policy: Police management should put in place trauma informed curriculum in police training and practice. Psychological and situational mediators should also be established as a priority for trauma prevention, mitigation and stress management. Researchers should go beyond highlighting police psychological morbidity to investigate models and interventions that work to prevent and speedily resolve police trauma.

Operational Oceanography in Ports and Coastal Areas, Applications for the Management of Pollution Events

Maritime safety and the protection of the marine environment were the primary objectives of two European projects that the National Research Council of Italy had participated in, with numerical applications in two areas located in the northern part of Sardinia, Italy. Specifically, two operational Numerical Prediction Systems (NPS) for pollution risk management were developed; the first was applied to the area of the Bonifacio Strait and the Gulf of Asinara and the second to the port of Olbia. These systems are composed of many oceans and particle tracking numerical models. They are forced with meteorological and ocean data provided by the European Centre for Medium-Range Weather Forecasts and Copernicus Marine Service and their outputs have been compared with in situ measurements for preliminary calibration. A web graphical interface was ad hoc designed, specifically responding to projects’ needs, providing online access to a 3-day oceanographic forecast and advanced diagnostic variables like Oil Stranding Time, Risk Score and Water Age. These products, along with the interactive web platform, prove invaluable for marine spatial planning, prevention and emergency management at sea, for the use of competent governmental and local bodies.

Study of molecular characterization for diagnosis of chronic and recurrent dermatophytosis

Dermatophytes are the keratinophilic fungi which infect humans and is the most recurring type of disease. The high level of transmissibility creates an epidemiological risk and emphasises the significance of these illnesses. However, a growing number of reports describing dermatophytes can cause deep infections in diabetic and immunocompromised patients, by invading deep layers like the dermis and hypodermis. Despite the prevalence and significance of dermatophytes in clinical mycology, it is not always possible to accurately diagnose this specific infection due to its overlapping structures among species of dermatophytes. Since it is difficult to identify species that exhibit weak characteristics in the morphological highlights, identification of the dermatophyte is often relied on its morphological analysis, which is a laborious process and demands skill. The massive shift in genetic variation, the source of infection, and epidemiological research can be discovered using molecular approaches. Therefore, the development of an accurate laboratory test for dermatophyte species identification is essential for the prevention and efficient management of dermatophytoses. One such methodology allows use of PCR technology which has many methods for molecular level characterization which is rapid, efficient, and capable of producing DNA polymorphisms specific to various dermatophyte species based on distinctive band patterns seen by agarose gel electrophoresis. The RAPD-PCR approach will be used in this study protocol to molecularly characterize the dermatophytes for precise speciation of the sample. In addition to improving knowledge of fungal biology and pathology with a focus on adaptive mechanisms to combat difficult conditions from host counteractions, there is a need to improve awareness of the importance of these diseases through accurate epidemiological data. The advantages of molecular approaches for characterizing objects over traditional methods are their sensitivity and specificity.

Cancer therapy-related vaginal toxicity: its prevalence and assessment methods-a systematic review.

In 2020, almost 9 million women were diagnosed with cancer worldwide. Despite advancements in cancer treatment strategies, patients still suffer from acute and long-term side effects. This systematic review aims to evaluate the most frequently reported adverse effects in the genitourinary system and compare them across cancer types, treatment modalities, and evaluation methods. Pubmed Central, SCOPUS, and Cochrane Library were searched following the PRISMA guidelines to identify all prospective and retrospective observational cohort studies and randomized controlled trials assessing vaginal side effects of adult female cancer patients. The study quality was evaluated using The Newcastle-Ottawa Scale or the Risk of Bias 2 tool, as appropriate. The most prevalent population was breast cancer patients, followed by gynaecological cancer patients. Overall, the focus was on vaginal dryness, while vaginal stenosis was the primary outcome in gynaecological cancer patients. Significant discrepancies were found in the frequency and severity of the reported adverse events. Most studies in this review evaluated side effects using patient-reported outcome measures (PROMs). Genitourinary syndrome of menopause following cancer treatment is most frequently documented in breast and gynaecological cancer patients, often focussing on vaginal dryness and vaginal stenosis based on PROMs. This review provides a complete overview of the literature, but more high-quality clinical trials are necessary to draw firm conclusions on acute and chronic vaginal toxicity following cancer treatment. This review could help improve the current preventive and curative management options for genitourinary complications, thereby increasing the patient's QoL and sexual functioning.

Epidemiological Profiles of Acute Otitis Media at the Commune II Referral Health Center in the Bamako District

Acute otitis media is a very common condition in children under the age of 7, most of whom suffer their first episode before the first three years of life. Despite scientific advances in its therapeutic and preventive management, this condition remains frequent and cosmopolitan, particularly in otolaryngology (ENT) and pediatric wards. In view of the possibility of disabling complications, we set out to study the epidemiological and clinical profile of this condition for the first time in the ENT department of the Commune II Reference Health Centre in the District of Bamako, Mali. This is a descriptive, retrospective study, using routine consultation data from January to December 2022. Based on exhaustive sampling, we collected 568 cases of confirmed AOM, representing an incidence of 20.63%. Patient age ranged from 3 months to 83 years, with an average of 12.49 years. Overall, the 3-7 age groups predominated, with 30.63% of cases. However, patients under 2 years of age predominate in progressive forms of the various stages. This study shows that AOM is a frequent occurrence in our department, and highlights the need for good interdisciplinary networking between pediatricians and ENT specialists in the management of AOM, in order to avoid possible recurrences and functional sequelae.

The Core Curriculum in Cariology: Fiction or Reality? Challenges about Implementation

Introduction: The Core Curriculum in Cariology (CCC) was developed by ORCA and ADEE in 2010. This article summarizes challenges for the implementation of the CCC at university/country level identified at the “Education Platform” of the ORCA 2022 conference in Cagliari, Sardinia. Methods: Participants from universities from 3 European (Italy, Poland, and UK), 2 Asian (India and Russia), and 3 American countries (Brazil, Colombia, and USA) led the presentations, discussion, and generation of statements. Presentations were transcribed and summarized through qualitative content analysis. Key themes were identified, transformed into key topics, and sent to the panel for agreement. Results: Regardless of the wide variety of dental schools per country, from few (Poland n = 10) to many (India n = 318, Brazil n = 563) or from country/continent itself, frequent challenges to CCC implementation were highlighted. These included lack of agreement on a basic CCC as standard (96%), insufficient support or reimbursement for caries prevention and management (90%), separation between cariology and restorative dentistry (68%), focus on restorative/surgical management with prevention and nonoperative management being disconnected (73%). The group agreed that the integration of cariology and restorative dentistry remains essential to enhancing evidence-based decision-making, resulting in a shift of emphasis from cure to care. Conclusion: There is variation in the level of implementation of the CCC. A frequent challenge is the disconnect between cariology and restorative dentistry. The CCC should be disseminated and promoted as a uniform blueprint/framework to facilitate the implementation of a common cariology curriculum among universities within each country, as well as internationally.

Extra/ordinary medicine: Toward an anthropology of primary care

Primary care is at the forefront of healthcare delivery. It is the site of disease prevention and health management and serves as the bridge between communities and the health care system As ethnographers of primary care, in this article we discuss what is gained by situating anthropological inquiry within primary care. We articulate how anthropologists can contribute to a better understanding of the issues that emerge in primary care. We provide a review of anthropological work in primary care and offer empirical data from two ethnographic case studies based in the United States, one focused on social risk screening in primary care and the other examining the diagnosis and care of people with dementia in primary care. Through these cases, we demonstrate how research of and within primary care can open important avenues for the study of the multidimensionality of primary care. This multidimensionality is apparent in the ways the medical field addresses the social and structural experiences of patients, scope of practice and disciplinary boundaries, and the intersection of ordinary and extraordinary medicine that emerge in the care of patients in primary care.

Artificial Intelligence: A Promising Tool for Application in Phytopathology

Artificial intelligence (AI) is revolutionizing approaches in plant disease management and phytopathological research. This review analyzes current applications and future directions of AI in addressing evolving agricultural challenges. Plant diseases annually cause 10–16% yield losses in major crops, prompting urgent innovations. Artificial intelligence (AI) shows an aptitude for automated disease detection and diagnosis utilizing image recognition techniques, with reported accuracies exceeding 95% and surpassing human visual assessment. Forecasting models integrating weather, soil, and crop data enable preemptive interventions by predicting spatial-temporal outbreak risks weeks in advance at 81–95% precision, minimizing pesticide usage. Precision agriculture powered by AI optimizes data-driven, tailored crop protection strategies boosting resilience. Real-time monitoring leveraging AI discerns pre-symptomatic anomalies from plant and environmental data for early alerts. These applications highlight AI’s proficiency in illuminating opaque disease patterns within increasingly complex agricultural data. Machine learning techniques overcome human cognitive constraints by discovering multivariate correlations unnoticed before. AI is poised to transform in-field decision-making around disease prevention and precision management. Overall, AI constitutes a strategic innovation pathway to strengthen ecological plant health management amidst climate change, globalization, and agricultural intensification pressures. With prudent and ethical implementation, AI-enabled tools promise to enable next-generation phytopathology, enhancing crop resilience worldwide.