Preventive Actions Research Articles

Characterizing caregiver attitudes to optimize pediatric vehicular heatstroke campaigns

Objective Since 1998; approximately 1,000 US children have died due to pediatric vehicular heatstroke (PVH; i.e., children overheating in vehicles). As the frequency of cases have largely remained unchanged over time, there is a need for novel research that can inform effective PVH prevention efforts, such as awareness campaigns. The objective of this project was to characterize caregivers’ opinions about existing PVH campaigns and thoughts about what future campaigns should look like. Methods We conducted 4 virtual focus groups (16 participants total). Groups discussed broad childhood injury topics, as well as PVH. Groups also viewed existing communication campaigns for a variety of injury topics and provided their perspectives on what future campaigns focused on PVH should contain. All focus groups were recorded, transcribed, and de-identified. Two independent coders reviewed and coded transcripts, which were developed and applied using a directed-content approach. We then created code summaries, which were used to develop themes. Results Themes were: (1) PVH differs from other injuries, (2) Campaigns should be short, educational, practical, and include diverse populations/subjects, and (3) Campaigns should be placed where caregivers are with their children. Caregivers acknowledged they were misinformed about their PVH risk; providing them with real-world statistics changed their views about if they should adopt preventative actions. Participants voiced communicating this risk to caregivers with actions they can take to reduce their risk in future campaigns is important to promote widespread adoption of preventative measures. Conclusions Based on results, we recommend future campaigns consider the IDEA framework when developing novel PVH campaigns.

Prevalence and genotype distribution of high-risk Human Papillomavirus infection among Vietnamese women in Ho Chi Minh City, Viet Nam: A population-based cross-sectional study

IntroductionPersistent infection with high-risk Human Papillomavirus (HR-HPV) genotypes are wellknown to increase the risk of cervical cancer significantly. This study aims to determine the prevalence and distribution of high-risk HR-HPV genotypes among women in Ho Chi Minh City (HCMC), Viet Nam. MethodsA population-based cross-sectional study was conducted between June 2020 and September 2020 in all 24 districts of HCMC, Viet Nam. Socio-demographic and behavioral data were collected from 2478 women aged 25 to 65 who had sexual intercourse using a self-administered questionnaire. Vaginal swab specimens from all participants were collected to identify HR-HPV genotypes using Polymerase Chain Reaction (PCR) protocols. ResultsThe prevalence of HR-HPV infection was 3.5 % (87 women, including 20 cases infected with multi-genotypes), 3.1 % in urban and 0.4 % in rural areas. The most detected HR-HPV genotypes among positive cases were 58 (25.3 %), 52 (21.8 %), 16 (21.8 %), 68 (10.3 %), 51 (10.34 %) and 18 (9.2 %). The prevalence of multi-type HR-HPV genotypes was 0.81 %, of which the most common co-infection genotypes were 52 and 58 (20.0 %), 16 and 56 (10.0 %), and 16 and 39 (10.0 %). The percentages of one-, two-, three-, and four-genotypes of HPV among positive cases were 77.0 %, 16.1 %, 4.6 % and 2.3 %, respectively. ConclusionsOur findings explore a low prevalence of HR-HPV infection in Vietnamese women, of which genotypes 52 and 58 are more popular than 16 and 18. Continuously updated data on the genotype distribution of HPV are helpful for vaccine development and planning preventive activities to prevent HPV-related cancers.

Experiences of Racism in Health Care and Medical Mistrust Shape Cancer Prevention and Control Behaviors Among Black Residents of Black Hawk County, Iowa: A Qualitative Study.

Non-Hispanic Black Iowans have substantially higher incidence of and mortality from cancer than their non-Hispanic White (NHW) counterparts in all but the oldest age groups; rates are particularly high in Black Hawk County, which contains the city of Waterloo, a highly segregated city with a documented history of redlining and distinct racial differences in the social drivers of health. To gather perspectives on race, racism, healthcare, and engagement with cancer prevention and control behaviors, among Black individuals living in Black Hawk County, Iowa. We conducted semi-structured interviews with 20 individuals (10 male, 10 female), questions included experiences in healthcare and feelings towards the healthcare system, trust of the healthcare system, experiences of racism or other perceived biases within healthcare, and how experiences of racism/bias and/or feelings towards the healthcare system impact desire or ability to participate in cancer prevention and control activities. Almost all interviewees reported both positive and negative experiences in healthcare. Nine themes emerged from analysis of the interviews: everyday racism and racism in healthcare, medical mistrust, need for more Black healthcare professionals, communication with healthcare professionals, need to break down cultural stigma around cancer, need and desire for community education around health and cancer, ability to choose, self-advocacy, and social support. There are substantial barriers for Black individuals engaging with cancer prevention and control behaviors in Iowa. Multi-level interventions are needed to address structural, healthcare facility, and individual-level barriers to care; interventions may build on existing resiliencies within the community.

Welcoming pregnant women as a strategy for adherence to dental prenatal care and health promotion in early childhood

This research deals with implementing Dental Prenatal Care as a public policy in the Brazilian Unified Health System (SUS) to care for pregnant women and their future babies. The legal framework that assures pregnant women's rights of priority in accessing services is usually not enough to guarantee the health promotion coverage goals for this population group, who frequently have low adherence to dental care. Brazilian Unified Healthcare System (SUS) recommends monitoring pregnant women through eight mensal consultations during healthy pregnancy. Oral health is usually not monitored to the same extent, and many pregnant women still go through pregnancy without any dental consultation. This study was proposed to improve dental prenatal care and program adherence by mothers and children in the Basic Healthcare Unit Amaro José de Souza, in the municipality of Barueri, through the increased participation of the dental surgeon in the pregnant women welcoming team. A cross-sectional cohort study was designed to identify and meet the demands of low-risk pregnant women. For six months, all the women attending prenatal care at BHU Amaro José de Souza in Barueri were invited to participate and receive personal guidance from the multi-professional team. Information on dental health was investigated through questions targeting previous knowledge about the recommended moments for the first dental appointment of a child, the importance of exclusive nasal respiration, the identification of craniofacial asymmetries at birth, and general baby care. Attitudes and self-care were also investigated, including prenatal program adherence. Answers were collected in a Google Form platform and analyzed to characterize the group's literacy about prenatal care and breastfeeding and identify information needs about dental health care during pregnancy. At the same time, a welcoming expanded listening, educational, and preventive health action was developed: conversation and sharing experience groups were promoted monthly for pregnant women, breastfeeding mothers, and their families. 90 pregnant women out of the 104 attending the BHU in the six months of the research were invited, and 83 agreed to participate. All the participants declared at least one previous appointment with the healthcare team, 92.8 % of them, with a gynecologist. The nursing team was involved in 53.0 % of the appointments, but only 6.0 % were reported to have been conducted exclusively by a nurse. A dental surgeon appointment was mentioned by 30.1 % of the research participants. The dental health literacy investigation revealed that 57.8 % believed they should only take their babies to a dental appointment after teething, and 27.7 % were aware of the child's craniofacial asymmetries at birth. Only 28.9 % had previous knowledge about the importance of exclusive nasal respiration. Despite only 34.9 % having their first pregnancy, 78.3 % declared they would appreciate receiving information about pregnancy. After the guidance, 72.0 % of the pregnant women had undergone dental prenatal care. Workshops for pregnant women and breastfeeding mothers provided a convenient welcoming space, to listen and provide guidance to pregnant women and their families, in addition to demystifying the fear of dental care during pregnancy and breastfeeding. The intervention to guide pregnant women to perceive the BHU as an educational and health promotion space, not just a curative intervention, effectively increased adherence to dental prenatal care. The contact with the Specialist in Functional Jaw Orthopedics in this first phase of life facilitated dental health education and access to more complex cases. The prenatal program adherence, the pregnant woman’s self-care, and the care of the baby were favored by the welcoming, expanded listening, and personalized service.

On the Capabilities of the IREA-CNR Airborne SAR Infrastructure

In this work, the airborne Synthetic Aperture Radar (SAR) infrastructure developed at the Institute for Electromagnetic Sensing of the Environment (IREA) of the National Research Council of Italy (CNR) is described. This infrastructure allows IREA-CNR to plan and execute airborne SAR campaigns and to process the acquired data with a twofold aim. On one hand, the aim is to develop research activities; on the other hand, the aim is to support the emergency prevention and management activities of the Department of Civil Protection of the Italian Presidency of the Council of Ministers, for which IREA-CNR serves as National Centre of Competence. Such infrastructure consists of a flight segment and a ground segment that include a multi-frequency airborne SAR sensor based on the Frequency-Modulated Continuous Wave (FMCW) technology and operating in the X and L bands, an Information Technology (IT) platform for data storage and processing and an airborne SAR data processing chain. In this work, the technical aspects related to the flight and ground segments of the infrastructure are presented. Moreover, a discussion on the response times and characteristics of the final products that can be achieved with the infrastructure is provided with the aim of showing its capabilities to support the monitoring activities required in a possible emergency scenario. In particular, as a case study, the acquisition and subsequent interferometric processing of airborne SAR data relevant to the Stromboli volcanic area in the Sicily region, southern Italy, are presented

Evaluation of the Effect of a Mobile Application on Glycated Hemoglobin in Older Adults with Type 2 Diabetes Mellitus-Protocol of a Randomized Clinical Trial.

Digital educational technologies in health have been an important instrument for promoting learning, self-care, self-esteem, and security regarding prevention and health promotion actions that lead to changes in behavior, mainly for non-communicable disease patients, such as type 2 Diabetes Mellitus (DM 2). This study aimed to describe a protocol for evaluating the effect of an app for cell phones and tablets on the blood glucose of older adults with DM 2. The protocol will be used to compare the effectiveness of an application for mobile devices concerning the educational booklet in reducing Glycated Hemoglobin in older adults with DM 2 in Primary Health Care. This protocol is part of a Randomized Clinical Trial project entitled Effectiveness of a Mobile Device Application on Glycated Hemoglobin in Elderly People with Type 2 Diabetes Mellitus: a Randomized Clinical Trial. The protocol was structured in the following phases: (i) sample calculation, (ii) invitation to participate in the study according to the eligibility criteria; (iii) participant registration; (iv) randomization and allocation of participants into groups (double blinding); (v) application of the intervention; (vi) post-intervention procedures (post-test); (vii) data analysis. It is expected that encouraging studies on the impact of a mobile application will improve and enhance health education focused on self-care for older adults with DM 2, potentially influencing the local health system by reducing hospitalizations due to conditions that are sensitive to primary care, since health promotion and prevention of DM-related illnesses will be the main focus of the application and booklet developed.

Risk of opioid-related harms by occupation within a large cohort of formerly injured workers in Ontario, Canada: findings from the Occupational Disease Surveillance System

ObjectiveWorking-age individuals have been disproportionately affected by the opioid crisis, prompting interest in the potential role of occupation as a contributor. This study aimed to estimate the risk of opioid-related...

A-088 Clinically Significant Errors Using the Diazyme Total Bile Acid Assay on the Roche c502 Analyzer: Investigating a Result Error Identifies a Novel Large-Scale Testing Error Caused by Reagent Carryover

Abstract Background Thoroughly investigating single patient result errors may identify systemic, large-scale testing errors. The laboratory observed an event where a revision to a Total Bile Acid (TBA, Diazyme Laboratories, Inc.) patient result following a 22S quality control (QC) failure displayed a larger than expected difference (52 to 5mcmol/L). TBA is primarily used for diagnosis and monitoring of intrahepatic cholestasis of pregnancy with results >10mcmol/L considered elevated. Retrospective review of result revisions following QC failures (3/15/2017-5/30/2023) revealed that 50%(20/40) yielded result differences of >10mcmol/L(>20SD based on assay imprecision). The aim of this study was to apply a systematic approach to i) estimate the rate of TBA errors, ii) ensure accurate result reporting during investigation period, iii) perform root cause analysis (RCA), and iv) determine corrective and preventative action(s). Methods Residual samples from TBA testing (6/24-7/5/2023) were retested(n=158), differences >+/-3.0mcmol/L or 15% were confirmed on an alternate analyzer, and reports were revised. Automated repeat testing of TBA samples >10mcmol/L was operationalized 7/6/2023. Initial and repeat TBA results were compared(n=448) and results differing by >+/-20% were remeasured on an alternate analyzer. RCA was conducted using a fishbone diagram. NaOH reagent probe washes were implemented for TBA and the error rate was re-assessed. Assays run prior to TBA samples with errors (n=15) were identified. To assess reagent carryover a residual serum pool (TBA ∼5mcmol/L) was aliquoted into 5 tubes in a sample rack. The first sample in the rack was programmed to run an assay suspected of causing carryover followed by 4 TBA measurements. Mean±standard deviation(SD) TBA concentrations were calculated. TBA was also measured in the liquid reagent for amylase, lipase, acetylcholinesterase (ACE) and fructosamine. Results Initial TBA retesting yielded no errors when initial TBA was ≤10mcmol/L(n=51). For samples with TBA >10mcmol/L(n=107), 9(8.4%) had differences exceeding criteria with 8/9 being revised to ≤10mcmol/L. Analysis of automated patient repeat data showed a 3.8%(17/448) error rate when initial TBA >10mcmol/L. After NaOH reagent probe washes were implemented, the error rate decreased to 0.7%(3/448). Assays run directly before an erroneously high TBA result included: lactate, fructosamine, soluble transferrin receptor(STFR), lipase, and ACE. A serum TBA pool(mean±SD=5.1±0.4 mcmol/L,n=15) measured 37.6±1.2mcmol/L(n=3) and 6.7±0.7mcmol/L(n=3) after lipase and fructosamine, respectively. No other assays demonstrated carryover. TBA in lipase reagent compartment B and C was 653 and 649mcmol/L, respectively, and 653mcmol/L in fructosamine reagent compartment B. Conclusions A single patient TBA result revision was investigated and led to identification of reagent carryover causing erroneously high TBA results on the Roche c502 analyzer. Automatic, real-time, repeat testing was implemented to prevent reporting incorrect patient results until RCA could identify the cause. Occurrence rate of erroneous high TBA results decreased from 3.8% to 0.7% after implementation of NaOH washes on the instruments. Carryover experiments confirmed that lipase and fructosamine assays cause carryover when run prior to a TBA sample due to measurable TBA in the reagent. The lab is pursuing moving the fructosamine and lipase reagent to the Roche Cobas c701 to prevent the issue.

Salidroside may target PPARα to exert preventive and therapeutic activities on NASH.

Salidroside (SDS), a phenylpropanoid glycoside, is an antioxidant component isolated from the traditional Chinese medicine Rhodiola rosea and has multifunctional bioactivities, particularly possessing potent hepatoprotective function. Non-alcoholic steatohepatitis (NASH) is one of the most prevalent chronic liver diseases worldwide, but it still lacks efficient drugs. This study aimed to assess the preventive and therapeutic effects of SDS on NASH and its underlying mechanisms in a mouse model subjected to a methionine- and choline-deficient (MCD) diet. C57BL/6J mice were fed an MCD diet to induce NASH. During or after the formation of the MCD-induced NASH model, SDS (24mg/kg/day) was supplied as a form of diet for 4weeks. The histopathological changes were evaluated by H&E staining. Oil Red O staining and Sirius Red staining were used to quantitatively determine the lipid accumulation and collagen fibers in the liver. Serum lipid and liver enzyme levels were measured. The morphology of autophagic vesicles and autophagosomes was observed by transmission electron microscopy (TEM), and qRT-PCR and Western blotting were used to detect autophagy-related factor levels. Immunohistochemistry and TUNEL staining were used to evaluate the apoptosis of liver tissues. Flow cytometry was used to detect the composition of immune cells. ELISA was used to evaluate the expression of serum inflammatory factors. Transcript-proteome sequencing, molecular docking, qRT-PCR, and Western blotting were performed to explore the mechanism and target of SDS in NASH. The oral administration of SDS demonstrated comprehensive efficacy in NASH. SDS showed both promising preventive and therapeutic effects on NASH in vivo. SDS could upregulate autophagy, downregulate apoptosis, rebalance immunity, and alleviate inflammation to exert anti-NASH properties. Finally, the results of transcript-proteome sequencing, molecular docking evaluation, and experimental validation showed that SDS might exert its multiple effects through targeting PPARα. Our findings revealed that SDS could regulate liver autophagy and apoptosis, regulating both innate immunity and adaptive immunity and alleviating inflammation in NASH prevention and therapy via the PPAR pathway, suggesting that SDS could be a potential anti-NASH drug in the future.

Barriers and facilitators to skin cancer prevention among Hispanics: a qualitative study

BackgroundIn the past two decades, melanoma incidence among Hispanic people has risen greatly. This qualitative study explored Hispanic people’s perceived barriers and facilitators to skin cancer-related preventive behaviors.MethodsFive focus groups among Hispanic people (2 in Spanish and 3 in English; n = 34; 11 Spanish-preferring and 23 English-preferring) were conducted, where participants discussed their perceptions and behaviors relating to skin cancer, sun protection, and skin self-examination. Additionally, healthcare providers (n = 9) and Hispanic community leaders (n = 6) were recruited for individual interviews to complement the results of focus groups. A thematic analysis was conducted on all transcripts.ResultsPerceived barriers to sun protection included: 1) Low levels of knowledge and awareness/misperception; 2) low perceived importance or not a priority, 3) economic issues or limited access, 4) downsides/concerns about engaging in sun protection behaviors, and 5) Hispanic cultural norms (e.g., machismo). Facilitators to sun protection included: 1) relevance/care for family, 2) negative consequences of sun exposure, and 3) Hispanic cultural norms (e.g., familismo). Barriers to skin examination included: 1) low levels of knowledge and awareness, 2) lack of insurance coverage or access, and 3) difficulty or discomfort associated with practicing skin self-examination. Facilitators to skin examination included: 1) relevance/previous experience and 2) having insurance coverage or access.ConclusionsFuture interventions should focus on individual, community, and system-level strategies to address misperceptions in the Hispanic community, increase knowledge and awareness, address perceptions of cultures regarding skin cancer preventive activities, and emphasize the importance or priority of health issues related to skin cancer.

Enhancing infection control in dialysis at a resource limited public healthcare institute: A cross-sectional study on microbiological quality assessment of dialysis water and dialysate

PurposeTo evaluate the microbiological quality of dialysis water and dialysate samples from hemodialysis units at a tertiary care government hospital and to assess the use of culture, endotoxin and periodicity of testing these assays to guide the actions of monitoring the quality of hemodialysis fluids, implement preventive and corrective actions, and improve the safety and outcomes of the dialysis process. MethodsA cross-sectional study was conducted at a 250-bedded super-specialty government hospital with a 24/7 hemodialysis unit equipped with 40 dialysis machines. Dialysis water and dialysate samples were collected monthly and analysed for microbial contamination and endotoxin levels as per AAMI guidelines. Bacterial cultures were done using Reasoner's Agar plates, and endotoxin analysis was performed using gel clot assay. Interpretation of results was based on predefined thresholds. ResultsAmong the 740 samples processed for microbial culture 19.6 % and 80.4% were unacceptable and acceptable respectively.Among the acceptable samples 10.5 % were at action level. At the end of 2 days of incubation, 15.2%dialysis water samples and 5.1%dialysate samples had unacceptable levels of bacterial colonies and at 5days additional 10.6 % dialysis water samples and 7.7%dialysate samples were unacceptable. 21.5 % of the samples tested for endotoxin had unacceptable levels. ConclusionsRegular monitoring of water quality in government healthcare hemodialysis units is crucial for quality of care, timely preventive and corrective actions for mitigating adverse outcomes. Processing cultures for 5–7 days is essential for detecting all contaminated specimens. While there might be a link between endotoxin levels and bacterial contamination, both endotoxin testing and bacterial culture independently are vital for evaluating water quality in dialysis settings. A comprehensive approach integrating various testing methods is necessary to uphold patient safety and enable necessary improvements.

Combinations of multiple long term conditions and risk of hospital admission or death during winter 2021-22 in England: population based cohort study

ObjectiveTo describe which combinations of long term conditions were associated with a higher risk of hospital admission or death during winter 2021-22 (the third wave of the covid-19 pandemic) in adults in England.DesignPopulation based cohort study.SettingLinked primary and secondary care data from the General Practice Extraction Service Data for Pandemic Planning and Research (GDPPR) database, Hospital Episode Statistics, and Office for National Statistics death registry, comprising pseudoanonymised routinely collected electronic medical records from the whole population of England registered at a general practice, 1 December 2021 to 31 March 2022.Participants48 253 125 individuals, registered in GDPPR in England, aged ≥18 years, and alive on 1 December 2021.Main outcomes measuresAll cause hospital admissions and deaths associated with combinations of multiple long term conditions compared with those with no long term conditions, during the winter season (1 December 2021 to 31 March 2022). Overdispersed Poisson regression models were used to estimate the incidence rate ratios after adjusting for age, sex, ethnic group, and index of multiple deprivation.ResultsComplete data were available for 48 253 125 adults, of whom 15 million (31.2%) had multiple long term conditions. Rates of hospital admissions and deaths among individuals with no long term conditions were 96.3 and 0.8 per 1000 person years, respectively. Compared with those with no long term conditions, the adjusted incidence rate ratio of hospital admissions were 11.0 (95% confidence interval (CI) 9.4 to 12.7) for those with a combination of cancer, chronic kidney disease, cardiovascular disease, and type 2 diabetes mellitus; 9.8 (8.3 to 11.4) for those with cancer, chronic kidney disease, cardiovascular disease, and osteoarthritis; and 9.6 (8.6 to 10.7) for those with cancer, chronic kidney disease, and cardiovascular disease. Compared with those with no long term conditions, the adjusted rate ratio of death was 21.4 (17.5 to 26.0) for those with chronic kidney disease, cardiovascular disease, and dementia; 23.2 (17.5 to 30.3) for those with cancer, chronic kidney disease, cardiovascular disease, and dementia; and 24.3 (19.1 to 30.4) for those with chronic kidney disease, cardiovascular disease, dementia, and osteoarthritis. Cardiovascular disease with dementia appeared in all of the top five combinations of multiple long term conditions for mortality, and this two disease combination was associated with a substantially higher rate of death than many three, four, and five disease combinations.ConclusionsIn this study, rates of hospital admission and death varied by combinations of multiple long term conditions and were substantially higher in those with than in those without any long term conditions. High risk combinations for prioritisation and preventive action by policy makers were highlighted to help manage the challenges imposed by winter pressures on the NHS.

The prevalence of depression among patients with diabetic foot ulcers at King Khalid University Hospital, Riyadh, Saudi Arabia

ABSTRACT Background and Aim: The prevalence rates of depression and anxiety among diabetic patients with diabetic foot ulcers (DFU) vary from one study to the other. We aimed to determine the prevalence of depression and the associated risk factors among patients with DFU. Methods: We conducted a cross-sectional study using a self-reported questionnaire on adult patients aged 18 years old and above with DFU at our institution. We used the 9-item Patient Health Questionnaire to evaluate the presence of depressive symptoms. Results: A total of 75 patients, 56 (74.7%) males and 19 (25.3%) females, participated in the study; 33 (44.0%) were more than 60 years old. The prevalence of moderate to severe depression among our patients was 35 (46.7%). Patients who had DFU for more than 1 year had a higher proportion of moderate to severe depression (P = 0.032). There were no significant differences in the proportion of patients who had depression according to age groups (P = 0.456), gender (P = 0.095), level of education (P = 0.145), employment (P = 0.514), type of diabetes (P = 0.561), duration of diabetes (P = 0.704), level of HbA1c (P = 0.525), smoking history (P = 0.163), and previous history of DFU (P = 0.713). Logistic regression analysis showed that patients who had DFU for more than 1 year were three times more at risk to have moderate to severe depression (P = 0.049). Conclusion: Patients with DFU have a high frequency of moderate to severe depression regardless of age, gender, or other sociodemographic characteristics, with patients with long-standing DFU having triple the risk of depression as those with freshly diagnosed DFU. Diabetic persons should be thoroughly assessed to reduce the diabetes result, and preventative actions and patient education about DFU are crucial.

What factors are associated with children being taken into care by the state after initial contact with services? A survival analysis of Children’s Social Care data in Liverpool

BackgroundIncreasing numbers of children in the UK are being taken into care, with adverse consequences for children and unsustainable costs for local government. It is crucial that local authorities better...

Air Pollution Forecasting in a Regional Context for Sustainable Management

The aim of this research was to develop and apply a statistical model that can be used to forecast long-term daily maximum particulate matter with a diameter of less than 2.5 microns (PM2.5) concentrations. In order to predict the daily maximum PM2.5 concentrations in the northeastern region of Thailand, the extreme value theory was analyzed, and an appropriate distribution model was identified by employing the Generalized Pareto distribution (GPD). The data of daily maximum PM2.5 concentrations during the years 2021–2023 obtained from six stations was used. These stations are located in Khon Kaen, Loei, Nakhon Ratchasima, Nong Khai, Nakhon Phanom, and Ubon Ratchathani provinces. The results of this study reveal that the GPD is appropriate based on the results of Kolmogorov-Smirnov Statistics Test. Estimating the return levels during the following return periods: 2 years, 5 years, 10 years, 25 years, 50 years, and 100 years showed that the area in the upper northeastern region, particularly Loei and Nakhon Phanom, has daily maximum PM2.5 concentrations above 500 micrograms per cubic meter. These results can also be used as information to support decision-making when conducting response planning in high-risk areas, which can be helpful for efficient resource planning and prevention actions. Doi: 10.28991/ESJ-2024-08-05-024 Full Text: PDF

Risk Mitigation in Environmental Conservation for Potato Production in Cisangkuy Sub-Watershed, Bandung Regency, West Java, Indonesia

Potatoes are a crop that thrives in highland areas, and Bandung Regency is one of the major potato production centers in West Java. This production center is located in an environmentally focused village development area within the Cisangkuy Sub-Watershed of Bandung Regency. The purpose of this study is to identify risks arising from various risk sources and to formulate risk control strategies for potato production in this region. The method used is the house of risk (HOR) method. In farming activities, farmers must comply with environmental regulations. However, many farmers are still unaware of the importance of environmental sustainability, particularly in their use of chemicals. To actively engage in environmental management efforts, it is crucial to understand the characteristics of potato farmers in Bandung Regency, especially those located in the development area of environmentally focused villages within the Cisangkuy Sub-Watershed. The results of this study identified 33 risk events. The risk event with the highest impact is waterlogged plants (E10), with an impact value of 8.9. Based on the Pareto diagram, 16 priority risk sources need to be addressed. The most significant risk source identified is the use of uncertified seeds (A29). To mitigate risks in potato production, 21 preventive actions (PAs) have been proposed. One of the most effective strategies is for farmers to purchase seed potatoes directly from Balitsa (PA1), with an effectiveness ratio (ETD) of 4372. Another recommended strategy is to purchase certified seeds from other breeders (PA2). These strategies are prioritized to reduce the risks faced by potato farmers.

State-Level Childhood Lead Poisoning Prevention Policies and Practices in the United States: 2022-2023.

The purpose of this analysis is to better understand laws and practices guiding prevention activities in childhood lead poisoning prevention programs funded by the Centers for Disease Control and Prevention (CDC). In 2022, CDC surveyed 62 funded programs using the Awardee Lead Profile Assessment. Information was collected about childhood lead poisoning-related laws and guidance, surveillance and prevention strategies, and program services including at what blood lead levels (BLLs) various activities are performed. Separately, CDC reviewed state health department websites to obtain information on which states implemented CDC's updated blood lead reference value. Awardee Lead Profile Assessment results are only reported for 47 states, the District of Columbia, and Puerto Rico. Almost all programs (96%) have laws requiring reporting of BLLs, and 51% require BLLs be reported electronically to jurisdictional health departments. Most programs (80%) prioritize areas and populations that are high risk for lead poisoning prevention activities. Approximately half of the programs (51%) have a lead elimination plan or goal. Thirty-nine percent of the programs have already implemented policies, laws, or regulations to achieve lead elimination, and 74% are in the Northeast and Midwest regions of the country. As of March 2023, 71% of the programs have implemented CDC's updated blood lead reference value, and most (65%) did so via guidance for health care providers and laboratories for what BLL should initiate case management and other services for lead-exposed children. Almost all programs have mandatory BLL reporting laws, and about two-thirds of the programs updated their BLLs that trigger public health action.

Predictors of health preventive behavior among university students in the post-COVID-19 era in Wuhan via TikTok journeying

TikTok has become increasingly popular among young people in China and there is growing number of young people who start to pay great attention to their health through this platform. Wuhan is a significant location for this study, since it was the initial epicenter of COVID-19. However, little is known about the extent to which university students in Wuhan, China, rely on TikTok for health-related information and how this affects their preventive health actions in the post-COVID-19 era. Therefore, it is crucial to look into the direct effects of TikTok users’ search for health information and their actions to protect their health, as well as the mediating functions of e-health literacy and COVID-19 risk perception. The impact of TikTok as a social media platform on the health-related behaviors of university students was examined using the Media Dependency Theory which explains how media use can have significant effects on individuals’ attitudes, beliefs, and behaviors. 426 questionnaires were gathered by cluster sampling from a sample of Wuhan university students. Mplus8 was used to perform structural equation modelling, which looked at the relationships between these variables. The results showed a positive correlation between users’ TikTok health information seeking and their health preventive behavior (β = 0.303, p < 0.001). Furthermore, it was discovered that this relationship is mediated by e-health literacy and COVID-19 risk perception in series (β =0.029, p<0.001). The findings demonstrate how TikTok functions as a platform that supports university students’ efforts to protect their health. The results also imply that students’ post-COVID-19 preventive measures for health in search of health information on TikTok are significantly influenced by their e-health literacy as well as their perception of COVID-19 danger. By obtaining more accurate health-related information, university students are equipped with more health skills and have correct attitude towards the disease. In summary, these results advance the knowledge of how TikTok, a social media platform, affects the health-related behaviors of university students.

A preventive care approach for oral health in nursing homes: a qualitative study of healthcare workers’ experiences

BackgroundOral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers’ experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes.MethodsHealthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data.ResultsThemes generated in the analysis were:A structured process promotes communication and awareness and stresses the importance of oral health;Oral care for frail older adults is challenging and triggers ethical dilemmas;Unclear responsibilities, roles and routines in the organization put oral health at risk;Differences in experience and competence among healthcare staff call for educational efforts.ConclusionsThe structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents’ reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.

From regional signal to alert in addictovigilance

France has several monitoring systems that form the foundation of its health safety surveillance. This system is designed for the early detection of signals and their swift into an action system that enables timely, appropriate, and effective interventions to protect public health. These signals are considered alerts when sufficiently validated after an initial risk assessment and if they represent a potential threat to public health, necessitating an appropriate response. The French Addictovigilance Network (FAN) was established specifically to address complications associated with the use of psychoactive substances (PAS), both medicinal and non-medicinal, excluding alcohol and tobacco. This system, unique in Europe, provides information on one of the most complex vigilance systems due to its scope, and the risks associated with it are becoming an increasingly significant public health issue. FAN is at the forefront of identifying potential signals. It has been working closely with regional partners since 1990, particularly through a multi-source approach that combines data from various sources, in collaboration with local professionals. After outlining the missions of the addictovigilance centres and the general principles of signal detection in addictovigilance, this article will present recent examples involving similar products but different identifications or modes of consumption: synthetic cannabinoids, nitazene, pregabalin, methylphenidate. These examples demonstrate that while there are regional disparities, the risk of occurrence in other French regions should not be overlooked, and information should be rapidly communicated at the national level for preventive action.