Prevention Practices Research Articles

Socioeconomic, Demographic, and Behavioral Factors Associated with Dengue Outbreak: An Observational Study from Eastern Uttar Pradesh, India.

Background: Clinical and epidemiological aspects of dengue have extensively been studied in India. However, limited data are available on social and behavioral aspects of dengue outbreak. We aimed to fill this gap and wish to study socioeconomic, demographic, and behavioral factors associated with dengue outbreak in the Gorakhpur region of eastern Uttar Pradesh, India. Methods: This retrospective observational study was conducted among dengue patients discharged from hospital. Data on sociodemographic, economic, and behavioral factors of dengue were collected telephonically using a structured questionnaire. Continuous and categorical variables were reported as mean ± SD and numbers (%), respectively. Logistic regression analysis was done to establish association between patient's characteristics, awareness, and preventive behavior. Results: Age group 19-45 years 156/232, males 159/232, urban residents 142/232, residing in pucca house 187/232, and from lower-income families 149/232 were mostly affected in this outbreak. Patients spent a median of Indian national rupees 20,000 on treatment. Only 10.8% of patients had Ayushman health insurance cards. Awareness about dengue infection was found in∼43% patients. Literates, middle income group, and professionals/semiprofessionals were significantly more aware about dengue disease, mosquito bite, and treatment than their counterparts. Travel history was significantly associated with dengue infection in the males of 19-45 years age group belonging to rural areas. Use of mosquito repellent, nets, wearing full sleeve clothes were significantly less in rural residents while barefoot walking was more frequently observed in this population. Use of mosquito repellent was significantly associated with income, and these were observed more in the middle-income group. Conclusion: People with low education level, residing in urban areas, residing in pucca houses, who travel frequently, and who belong to lower-income groups were majorly affected by this dengue outbreak. Less dengue awareness and not following preventive practices were found in them. Targeted health education campaigns in urban setting could prevent dengue and economic burden on these vulnerable groups.

Knowledge, attitude, and practice towards COVID-19 and associated factors among students in Ethiopia: Systematic review and meta-analysis.

The World Health Organization (WHO) has not confirmed the eradication of the COVID-19 pandemic or the development of a cure. Ongoing research is necessary to update public understanding, attitudes, and behaviors. Therefore, this study aims to evaluate the knowledge, attitudes, and practices related to COVID-19 among students in Ethiopia. To estimate the pooled proportions and associated factors of knowledge, positive attitude, and prevention practice toward COVID-19 among students in Ethiopia. The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered on the PROSPERO database. Data extraction was done using an Excel spreadsheet, and analysis was conducted using STATA. The quality of the articles was assessed using the Joanna Briggs Institute (JBI) grading approach. A narrative summary and random-effects model with a 95% confidence interval were used. Heterogeneity and publication bias were also assessed. The results were presented using a forest plot and tables. Out of 2089 studies reviewed, only 16 met the inclusion criteria. The pooled proportions of COVID-19 good knowledge, positive attitude, and good prevention practice among students in Ethiopia were found to be 62.68% [95% CI 50.96-74.40, I2 = 98.93%], 60.22% [95% CI 51.64-68.80, I2 = 97.68%], 48.47% [95% CI, 44.16-52.78, I2 = 91.45%] respectively. Factors that affected knowledge included marital status, family size, sex, study year, and residency. Knowledge and residency were identified as predictors of attitude. Determinants of practice included knowledge, attitude, sex, study program, and residency. The pooled proportion of students in Ethiopia with good knowledge, positive attitudes, and good practices regarding COVID-19 was low. Policymakers, the Ministry of Health, Public Health Institutions, and other stakeholders should intensify their efforts on COVID-19 and develop interventions aimed at females, rural residents, and extension students. The protocol was registered on the PROSPERO database with ID = CRD42023478234.

Polygenic Risk Score Implementation into Clinical Practice for Primary Prevention of Cardiometabolic Disease

Background: Cardiovascular disease is a leading cause of mortality globally and a major contributor to disability. Traditional risk factors, as initially established in the FRAMINGHAM study, have helped to stratify populations and identify patients for early intervention. Incorporating genetic factors enhances risk stratification tools, enabling the earlier identification of individuals at increased risk and facilitating more targeted and effective risk factor modifications. While monogenic risk variants are present in a minority of the population, polygenic risk scores (PRS) are collections of multiple single-nucleotide variants that collectively provide summative risk and capture a more accurate risk score for a greater number of people. PRS have demonstrated clear utility in cardiometabolic diseases by predicting onset, progression, and therapeutic response. Methods: A structured and exploratory hybrid search strategy was employed, combining keyword-based database searches and supplementary techniques to comprehensively synthesize the literature on PRS implementation in clinical practice. Discussion: A comprehensive overview of PRS in cardiometabolic diseases and their potential avenues for integration into primary care is discussed. First, we examine the implementation of genetic screening, risk communication, and intervention strategies through the lens of the American Heart Association’s implementation criteria, focusing on their efficacy, minimization of harm, and logistical considerations. Then, we explores how the varied perceptions of patients and practitioners towards PRS can influence both adoption and utilization. Lastly, we addresses the need for the development of clear guidelines and regulations to support this process, ensuring PRS integration is both scientifically sound and ethically responsible. Future directions: Initiatives aimed at advancing personalized approaches to disease prevention will enhance health outcomes. Developing guidelines for the responsible use of PRS by establishing benefits, while mitigating risk, will a key factor in implementation for clinical utility. Conclusions: For integration into clinical practice, we must address both patient and provider concerns and experience. Standardized guidelines and training will help to effectively implement PRS into clinical practice. Developing these resources will be essential for PRS to fulfill its potential in personalized, patient-centered care.

Suicide Prevention and Telehealth in Children's Hospital Emergency Departments.

Suicide is a leading cause of death among adolescents. Emergency department (ED) visits for mental health concerns are rising, and telehealth is increasingly used to provide emergency mental health care. We conducted a national survey to describe suicide prevention practices and tele-mental health care in children's hospital EDs. We conducted a cross-sectional survey of leaders at all 52 US EDs affiliated with dedicated children's hospitals (ie, hospitals that provide care only to children) to describe use of tele-mental health care and suicide prevention practices. Leaders from 41 EDs completed the survey (79% response rate). Tele-mental health care was used in 23 EDs (56%); there were no differences in ED structural characteristics between institutions with telehealth versus without telehealth. Among responding EDs, 40 (98%) reported they screen for suicide risk, and 29 (71%) reported they use a standardized approach to suicide prevention discharge planning. Risk reduction practices conducted at many but not all EDs included assessment of access to lethal means (n = 31, 86%), counseling on reduction of access to lethal means (n = 30, 73%) and providing patients with a list of professionals or agencies that they can contact in a crisis (n = 35, 85%). There were no differences in use of suicide prevention practices at EDs with versus without telehealth (P > 0.1 for all). Approximately half of children's hospital EDs use tele-mental health care, and hospitals with versus without tele-mental health care report similar rates of suicide prevention practice use. Opportunities exist to increase use of discharge safety practices.

Nurses' Perspectives on the Use of Prophylactic Dressings to Prevent Pressure Injury: A Qualitative Study.

To understand, from a nursing perspective, factors affecting the use of prophylactic dressings to prevent pressure injuries in acute hospitalised adults. Pressure injury causes harm to patients and incurs significant costs to health services. Significant emphasis is placed on their prevention. Relatively recently, prophylactic dressings have been promoted to reduce pressure injury development. However, in the acute care setting, information about the clinical use of these dressing is lacking. Qualitative, descriptive. Nineteen medical and surgical nurses participated. Semi-structured interviews were conducted and transcribed verbatim. Thematic analysis was performed using an inductive approach using NVivo software. Three themes were identified, reflecting factors that influenced and perpetuated indiscriminate use of prophylactic dressings: False sense of security; Convenience and task prioritisation; and Navigating challenges in evidence-based pressure injury prevention. The findings indicate inconsistent prevention practices, with prophylactic dressings often applied without justification or referral to research-based evidence to guide clinical decision-making. There was a prevailing attitude of 'job done' when a prophylactic dressing was applied. This study has identified several factors that perpetuate the inappropriate use of prophylactic dressings for pressure injury prevention that may be amenable to organisational change. The findings indicate that nurses often rely on these dressings as a shortcut due to time constraints, which led to missed skin assessments and low-value care. The research can be used to inform the development of clear guidelines on dressings within hospital settings which encourage assessment-based selection for their use, and process-based guidance for their application, skin surveillance, dressing inspection and removal. The Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guideline was followed. Neither patients nor the public were directly involved in this study.

Caracterização de medicamentos veterinários em fazendas leiteiras de Tupã, Brasil

Objective – This study aimed to characterize the profile of veterinary drug usage on thirteen dairy farms in Tupã, São Paulo. Methodology - Structured questionnaires were applied to milk producers in the region of Tupã - SP, investigating the types of drugs used, frequency of application and possible dosage deviations. Originality/relevance - The use of veterinary drugs in dairy cattle is a common practice for disease prevention and treatment. However, their inappropriate use can cause serious public health problems, such as the presence of residues in milk and increased microbial resistance. Results - The most frequently cited drugs were oxytetracycline (61.5%), silver nitrate and sulfadiazine (61.5%), ivermectin (46.2%) and oxytocin (46.2%). Most producers used therapeutic drugs sporadically, but 62.5% of those using oxytetracycline reported a repeated use throughout the year. Although prophylactic use of dewormers is common, only one producer reported excessive use of ivermectin. These findings reinforce the need for greater control and guidance in the use of veterinary drugs to ensure herd health, avoid chemical residues in milk, and prevent the emergence of microbial resistance. Social and environmental contributions - The study reinforces the importance of good practices in drug administration to ensure the sustainability of dairy production and food safety.

A narrative review on emerging issues about war-related trauma in perinatal women: good practice for assessment, prevention, and treatment.

Wars, in addition to causing death and destruction, have a negative impact on mental health, especially on perinatal women. The literature has identified psychological trauma as one of the most prevalent mental health issues associated with wars, but few studies have summarized how to assess, prevent, or treat this problem in perinatal women. To address this gap, the purpose of this study is to provide a narrative review of the current state of assessment, prevention, and treatment interventions of trauma among perinatal women living in war conditions or displaced as a result of a war. A literature search was performed in different research databases (e.g., Medline, PsycInfo). The search terms include a combination of trauma and stressor-related disorders and focused on diagnosis, prevention, and treatment. Most of the results were related to post traumatic stress disorder (PTSD) more than acute stress disorder, although there are not many assessments, and interventions (prevention or treatment) dedicated specifically to perinatal women affected by war conditions. Research in this area is still scarce. Recommendations for evidence-based practices in assessment and prevention and treatment interventions and future directions in research and clinical practice are provided. • The literature on trauma in perinatal women is sparse, and especially among perinatal women living in conditions of war. • This paper presents a narrative review of evidence-based assessment and treatment for perinatal women victims of war who experience trauma.

Management of Anal Dysplasia: A Pragmatic Summary of the Current Evidence and Definition of Clinical Practices for Prevention, Diagnosis, and Treatment.

Management of Anal Dysplasia: A Pragmatic Summary of the Current Evidence and Definition of Clinical Practices for Prevention, Diagnosis, and Treatment.

A quantitative survey on exposures, knowledge, attitudes, and practices (KAP) related to swine influenza among villagers in different regions of Thailand

This analytical cross-sectional study aimed to determine factors influencing knowledge, attitudes, and practices (KAP) toward the swine influenza virus (SIV) among pig farm owners, workers, and villagers in selected provinces of Thailand. This study was carried out from February to December 2022 in pig farms and villages across the provinces. A structured and standardized quantitative questionnaire was utilized to collect data on socio-demographic variables and KAP related to SIV from 215 participants. The quantitative data was analyzed in two steps using R software. The study findings showed that the average knowledge score on SIV was 6.92 out of 12, indicating moderate understanding of SIV in study participants. Attitudes towards SIV were generally positive, with an average score of 3.74 out of 5. Practices for SIV prevention averaged a score of 3.63 out of 5. Key factors associated with better SIV knowledge included higher education levels, higher monthly income, and direct involvement in vaccination processes. Moreover, those with higher education, employment on pig farms, and prior vaccination experience showed more positive attitudes towards SIV. Occupations related to pig farming and the availability of vaccination services significantly influenced SIV prevention practices. The findings highlighted that improved education and stronger connections with healthcare professionals and the pig farming sector may significantly enhance KAP regarding SIV among targeted populations. In contrast, participants with limited exposure to health services or pig farming activities, such as nearby villagers, require specialized educational interventions. This study recommends that local health authorities should develop and implement communication strategies and interventions focused on educating pig farm owners, managers, and villagers about SIV to mitigate the risks associated with SIV and other zoonotic diseases.

Using the Burning of Polymer Compounds to Determine the Applicability of the Acoustic Method in Fire Extinguishing

In order to achieve the objective of the work—an experimental study of the capabilities of the acoustic method for extinguishing organic compounds and for ensuring environmental monitoring—the effect of the combustion of various polymers on the acoustic parameters of the medium is considered. The negative effect of the combustion of organic substances on the medium is noted. The features of the use of fire extinguishing agents are analyzed, and it is noted that the acoustic method is a promising, inexpensive, and environmentally friendly approach for use in extinguishing fires. The ideas about the capabilities of this method using the combustion of various polymers were further developed, which is the novelty of the work. As the main results, it is proposed to use the angle of incidence, concentration of suspended particles, temperature, and wave resistance of the environment as special correction factors for acoustic sensors when monitoring in a smoky space. The possibility of using the combustion parameters of organic compounds to determine the properties of acoustic waves in a smoke-filled area is shown. The perspective of implementing the results obtained in the practice of fire prevention and liquidation was observed to increase the efficiency of fire extinguishing and increase the safety of the population and personnel of special services. The proposed approach can become part of the ecological and economic innovations of municipal communities and national strategies to achieve the goals of sustainable development.

Urinary incontinence in elite female powerlifters aged 20-30: correlating musculoskeletal exam data with incontinence severity index and survey data.

Urinary incontinence (UI) in the powerlifting community has been a hot topic due to its noticeability during competition and the burden it places on female athletes who experience it. UI is even experienced in those we least expect: young, high-performing, females with no history of pregnancy. Current studies have utilized primarily survey methodology, thus there is a lack of clinical information on this topic. Furthermore, the top athletes are underrepresentedbecause previous surveys were open to anyone reporting themselves as a powerlifter, regardless of competition level. The objectives of this study were to determine whether UI in elite female powerlifters is correlated with any musculoskeletal diagnoses and to further evaluate potentially contributing factors for UI within this group. Subjects underwent an osteopathic structural examination and then completed two surveys: the Incontinence Severity Index (ISI/Sandvik Test for Urinary Incontinence) and the Study Questionnaire. In total, there were 31 female participants, all of whom were in the top 2 % of powerlifters in the world between the ages of 20 and 30 years old (as of May 21, 2023) and reside in the United States. The survey results displayed a moderately positive relationship between age (rho=0.449, where rho refers to Spearman's rho), history of pelvic floor examination (rho=0.413), and self-care practice with ISI (rho=0.340). Other survey information such as weight class, height, best total in competition, number of years training, average duration of training day, confidence in ability to contract pelvic floor muscles, history of abdominal or pelvic surgery, history of urinary tract infection (UTI), and sexual activity status all had rho values less than 0.300. With atlantoaxial (AA) rotation to the right, there was an increase in ISI score (p=0.009). Similarly, with AA rotation to the left, there was a decrease in ISI score (p=0.030). All patients with severe ISI had nonphysiologic sacral dysfunctions (p=0.051). Severe ISI-scored participants were more likely to yield a dysfunctional clavicle upon screening (p=0.027). There was a strong correlation between increasing severity of UI and findings of a restricted right clavicle and/or AA rotation to the right (p=0.010). In addition, there were only two individuals with both a restricted right clavicle and AA rotation to the right, and these two individuals both scored severe on the ISI (p=0.012). A pelvic diaphragm dysfunction was present in 74.2 % of the participants. Extension diagnoses of the lumbar spine were found in those with mild UI over those with severe UI (p=0.012). Most other diagnoses were largely unremarkable due to a wide distribution across all ISI scores. Our study revealed a relationship between UI and somatic dysfunctions in this population. These findings may help providers, especially in the fields of primary care, sports medicine, and urogynecology, to expand treatment options for UI in this group in the future. Survey results yielded a positive relationship of moderate strength between age, history of pelvic floor exination, and engaging in leakage prevention practices with ISI. No survey category was found to have a relationship of high strength with ISI. These findings contribute to our knowledge on factors that do (or do not) contribute to incontinence severity.

Nurses’ Perception, Barriers and Associated Factors towards Hand Hygiene Practices for Prevention of Healthcare Acquired Infections in the Intensive Care Units

Introduction: Healthcare-Acquired Infections occur within 72 hours of hospitalization, surgical-related infections, and surgical site infections that develop 30 to 90 days after the procedure. They particularly impact critically ill patients due to their weakened immune systems, with hand washing being the most effective prevention method. Objective of the study: Assessing nurses’ perceptions, barriers, and the impact of socio-demographic factors towards hand hygiene practices in ICUs. Methods: The study included 65 ICU nurses from three referral hospitals, using a quantitative descriptive cross-sectional design and whole population sampling. The data were collected from 05th November 2021 to 11th Feb 2022. Data analysis was conducted with SPSS software version 21. Results: Seventy percent of participants viewed health-acquired infections (HAIs) as serious and susceptible, while 83.1% recognized the benefits of hand hygiene. The most commonly cited barrier to hand hygiene was allergies to products, reported by 32.3% of respondents. Positive perceptions of hand hygiene were significantly associated with the working institution and in-service training, with a P-value of less than 0.05. Conclusion: The study investigated nurses' perceptions, barriers, and factors influencing hand hygiene practices in ICUs. It revealed that allergies to hand hygiene products hinder the hand hygiene adherence, while institutional policies and in service training boost It. Recommendations: There is a need for conducting research using an observational checklist to assess HH adherence among ICU nurses, enhancing nursing education on HH, and improving in-service training for managerial teams in three hospitals.

Intensive care nurses’ knowledge of pressure injury prevention

BackgroundPressure injuries (PIs) remain a significant public health concern due to their high prevalence among critically ill patients admitted to intensive care units (ICUs). Despite advancements in science and technology related to PI prevention, the prevalence continues to rise. A key factor contributing to this rise is inadequate knowledge and limited use of evidence-based practices by nurses, resulting in prolonged hospital stays and poor patient outcomes. This study aimed to determine the knowledge of intensive care nurses regarding pressure injury prevention.MethodsA descriptive cross-sectional design was used to collect data from 101 nurses working in four ICUs at an academic hospital in Gauteng Province, South Africa. The revised Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0) was utilized to gather data from a convenience sample of intensive care nurses. Descriptive and inferential statistics were employed to analyze the data, with statistical tests including the Shapiro-Wilk test, univariate and multivariate linear regression, and Cronbach’s alpha coefficient tests. A p-value of less than 0.05 was considered statistically significant.ResultsThe mean knowledge score of the nurses (N = 101) was 42.16% (SD 12.09), indicating poor knowledge of PI prevention. The lowest scores were observed in the areas of “prevention of pressure injuries” (25%) and “classification and observation” (39.5%). Higher levels of education (14.00; 95% CI 2.90–25.11; p = 0.014), seniority (15.58; 95% CI 2.92–28.24; p = 0.016), and years of experience (6.38; 95% CI 9.70–5.45; p = 0.039) were statistically significant predictors of better prevention and management of PI.ConclusionThe findings of this study demonstrate that intensive care nurses have poor knowledge of prevention measures, classification, and observation of stages. This may hinder their ability to effectively utilize risk assessment tools in clinical practice. Improving training and providing intensive care nurses with adequate information about evidence-based practices to prevent PI could strengthen their contribution to patient safety. These findings underscore the need for continuous, mandatory training programs for intensive care nurses to stay updated with the latest evidence and practices in PI prevention.

Challenges and recommendations for overdose prevention and harm reduction in an era of fentanyl and xylazine: Perspectives of women with opioid use disorder and professionals.

The current qualitative study examines the perspectives of women with opioid use disorder (OUD) and professionals that serve them on barriers to engaging in overdose prevention and harm reduction practices and recommendations for improving engagement. Semistructured interviews (N = 42) were conducted with women with a history of OUD (n = 20), substance use disorder treatment professionals (n = 12), and criminal legal professionals (n = 10). The interviews were inductively coded to identify themes and subthemes regarding experiences with overdose and harm reduction practices. Themes included heightened vulnerability to overdose, harm reduction challenges faced by women with OUD, and recommendations for overdose prevention and harm reduction practices. Heightened vulnerability to overdose included concerns about toxic supply and concerns about women's drug use behaviors. Challenges to women's harm reduction engagement included lack of knowledge and education about harm reduction tools and strategies and continued stigma toward harm reduction practices. Finally, recommendations for improving harm reduction engagement included increasing accessibility of harm reduction tools, expanding harm reduction education, and shifting away from "abstinence-only" paradigms. Finding ways to teach women with OUD about harm reduction, more effectively distribute harm reduction tools to them, and reduce stigma among providers and professionals is essential to reduce overdose risk for women with OUD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study

A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study

Analysis of Infection Prevention Control Management of Central Sterile Supply Department (CSSD) Staff

Background: The Central Sterilization Supply Department’s (CSSD) main function is to clean, disinfect and provide sterile items for subsequent use by healthcare professionals in various hospital departments, including the ambulance. Materials and Methods: A survey of infection prevention control (IPC) knowledge, practice, and infrastructure adherence was conducted in a selected government super-speciality hospital's central sterilisation supply department (CSSD). The data were analysed, and a report with recommendations was presented to the institution's head. Results: The overall response showed good knowledge and practices with hospital environmental adherence to infection prevention control protocol with few infrastructure modifications facilitating the unidirectional flow pattern. Conclusion: This study was able to bring insights into the staff knowledge and practice towards IPC adherence

The promise of immunotherapeutic strategies to advance cancer treatment in pet dogs.

In this article, which is part of the Currents in One Health series, principles of immunotherapeutics are discussed and their clinical exploration in dogs reviewed with emphasis on their translatability for improving treatment of commonly diagnosed cancers. With increasing longevity and sustained quality of life in pet dogs through dietary, environmental awareness, and preventative medical practices, the geriatric pet population has continued to steadily grow and, consequently, so have age-related pathologies. Not surprisingly, cancer is the most common cause of mortality in elderly dogs, accounting for 1 in 4 deaths in dogs > 10 years of age. Importantly, some cancer types that arise spontaneously in pet dogs are similar to cancers afflicting people. The shared clinical and biological behaviors of certain cancers observed in pet dogs and people underscore the opportunity to leverage comparative oncology studies, which can accelerate the validation and clinical implementation of innovative therapies that can benefit pet dogs and ultimately guide these strategies toward clinical practice in people too. In the era of immunotherapy, the inclusion of pet dogs that develop cancers under an intact immune system affords a unique and high-value opportunity to study the evolving nature of cancers shaped by immunosurveillance pressures. Complementing these discovery efforts and through a comparative oncology approach, the exploration and clinical validation of novel immunotherapeutic strategies in pet dogs can be foundational for defining the safety and immune-activating potential of new anticancer immune approaches that hold promise to transform cancer treatment in both pets and people alike.

Embracing Complexity: Developing a Framework for Evaluating a Multi-Faceted Training and Technical Assistance System.

The benefits of training and technical assistance (TTA) have been well documented. There is limited literature that explores how complex systems of TTA are implemented and evaluated particularly in the violence prevention field. The Violence Prevention Practice and Translation Branch (VPPTB) within the Centers for Disease Control and Prevention's (CDC) Division of Violence Prevention funds multiple technical assistance providers who are tasked with building the capacity of program recipients to implement comprehensive approaches to prevent multiple forms of violence. VPPTB designed the Violence Prevention Technical Assistance Center (VPTAC) with the goal of implementing and evaluating comprehensive TTA efforts that integrates the work of multiple TTA providers to build the capacity of recipients to plan, implement, and evaluate violence prevention efforts. The VPTAC evaluation incorporates data from program recipients, TTA providers, and TTA modalities enabling the VPPTB staff to show improvement in technical knowledge, gather examples of enhanced implementation, and facilitate proactive TTA planning. An important step in the process of evaluating VPTAC from a system-level perspective required an expansion beyond evaluating a single TTA event, provider, or engagement. This is essential to understand how a diverse set of TTA activities and partners work together in their efforts to build capacity.

Aflatoxin awareness and preventive agricultural practices are key to adoption of biocontrol among maize smallholder farmers in Tanzania.

Aflatoxins are toxic secondary metabolites produced by Aspergillus species that infect staple foods like maize causing threat to public health and economic impacts. The use of atoxigenic Aspergillus species is considered one of the promising technologies to prevent aflatoxin contamination in maize. Tanzania approved the use of aflatoxin biocontrol (Aflasafe®) in 2018 and introduced it to eight districts. Adoption and effectiveness of this technology depend on many factors including application of pre- and post-harvest practices. There is scant information on awareness of biocontrol and factors which influence the adoption and effectiveness of this technology. A cross-sectional study was conducted in Tanzania to assess awareness and identify factors influencing adoption of the technology. Data was collected from 334 smallholder farmers in Kiteto and Chemba districts and analyzed using SPSS version 20; p-values < 0.05 using a two-tailed test were considered statistically significant. Results indicated 95.4% are not aware and that only 2.7% of the farmers had used biocontrol technology. The use of biocontrol was significantly associated with high income level (p = 0.001) and exposure to print media (p = 0.03) and radio (p = 0.008). The use of hybrid seed (p = 0.01), grazing (p = 0.017), and rotation of crops on yearly basis (p = 0.024) were also significantly associated with the use of biocontrol. Income limits the use of biocontrol, requiring government subsidies for Aflasafe and a premium market for aflatoxin-free maize. Aflatoxin awareness and sensitization on adherence to good pre-harvest practices should be emphasized to enhance adoption of the technology.

Identifying gaps in infection prevention and control practice in Australian residential aged care using scenarios

BackgroundOlder people living in residential aged care are vulnerable to infections. High quality infection prevention and control (IPC) practice is therefore vital in this setting. It is important to assess current IPC practice to identify areas where best practice is lacking, and where improvement efforts could most effectively be targeted. The aim of this study was to identify evidence-practice gaps in IPC practice in residential aged care. MethodsThis study used two scenarios to assess use of a range of standard and transmission-based precautions in residential aged care. Systematic methods were used to design the scenarios. Twenty-seven staff from four residential aged care facilities participated in semi-structured interviews. Participants were presented with the scenarios and asked what IPC actions they would take in everyday practice. Individual and team-based practice was explored. Participants reported practices were then compared to evidence-based practice. ResultsResults from both scenarios were combined and a total of 11 evidence-practice gaps identified. These included gaps in performing hand hygiene before touching a resident (for example, when helping a resident transfer) and not donning protective eyewear or face shield before taking a nasal/throat swab on the resident with suspected respiratory viral infection. ConclusionThe use of scenarios provided a practical and acceptable method to rapidly assess a range of IPC practices among a diverse group of participants. The IPC evidence-practice gaps identified will be used in the next phase of work where barriers to uptake of the identified IPC evidence-practice gaps will be explored.