Preventive Measures Research Articles

Epidemiological analysis of a 10-year retrospective study of pediatric trauma in intensive care

Pediatric trauma plays a crucial role in pediatric mortality, with traffic injuries and falls frequently cited as leading causes of significant injuries among children. A comprehensive investigation, including geographical factors, is essential for developing effective strategies to prevent injuries and alleviate the burden of pediatric trauma. This study involved a retrospective analysis of clinical data from pediatric patients admitted to our hospital’s intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. This retrospective study included 951 pediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 h). Among these patients, 422 (44.4%) underwent emergency surgery, and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 h. The mean duration of ICU stay was 6.24 ± 8.01 days, and the overall mean hospitalization duration was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0–6 years (70.7%), with males comprising 60.0% of patients. Injury incidents predominantly occurred between 12 and 6 PM (44.5%) and on non-workdays (37.6%). The most common locations where injuries occurred were roadsides (49%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, while 80 (8.41%) succumbed to their injuries. Traffic injuries remain the primary cause of pediatric trauma leading to ICU admission, underscoring the importance of using appropriate child restraint systems and protective gear as fundamental preventive measures. The increased incidence of injuries among children aged < 6 years and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that address these high-risk populations.

Seroprevalence and Risk Factors for Toxoplasma gondii Infection in Women of Reproductive Age in Nigeria in 2018.

Congenital transmission of Toxoplasma gondii can occur when a woman becomes infected for the first time during or just before pregnancy. Toxoplasma gondii in the fetus can lead to miscarriage, stillbirth, ocular or neurological abnormalities at birth, or progressive visual, hearing, motor, and cognitive deficiencies. The national seroprevalence of T. gondii infection in Nigeria was previously unknown. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey collected demographic, socioeconomic, and HIV-related data and stored blood specimens with consent for future analysis for other pathogens of public health importance. We evaluated toxoplasmosis seropositivity and risk factors in a sample of 44,269 women of reproductive age (WRA) between 15 and 44 years. The national T. gondii seroprevalence among WRA was 26.8% (95% CI: 25.8-27.7%). We found that WRA from all 36 states and the Federal Capital Territory had T. gondii exposure. Seroprevalence was higher in 25- to 44-year-olds than in 15- to 24-year-olds. A similar proportion of pregnant and nonpregnant women were seropositive. Increased odds of seropositivity were associated with unimproved toilet facilities and drinking water sources, being in a higher wealth quintile, and primary and secondary education compared with no education. Decreased odds of seropositivity were associated with living in an urban area and owning livestock. This study provides the first-ever national seroprevalence estimate for WRA in Nigeria. Although information on known risk factors for toxoplasmosis (e.g., consumption of undercooked meat, cat ownership) was not collected, future studies could further investigate potential risk factors to inform the development of effective toxoplasmosis prevention measures.

Unveiling human biomechanics: insights into lower limb responses to disturbances that can trigger a fall

IntroductionSlip-related falls are a significant concern, particularly for vulnerable populations such as the elderly and individuals with gait disorders, necessitating effective preventive measures. This manuscript presents a biomechanical study of how the lower limbs react to perturbations that can trigger a slip-like fall, with the ultimate goal of identifying target specifications for developing a wearable robotic system for slip-like fall prevention.MethodsOur analysis provides a comprehensive understanding of the natural human biomechanical response to slip perturbations in both slipping and trailing legs, by innovatively collecting parameters from both the sagittal and frontal plane since both play pivotal roles in maintaining stability and preventing falls and thus provide new insights to fall prevention. We investigated various external factors, including gait speed, surface inclination, slipping foot, and perturbation intensity, while collecting diverse data sets encompassing kinematic, spatiotemporal parameters, electromyographic data, as well as torque, range of motion, rotations per minute, detection, and actuation times.ResultsThe biomechanical response to slip-like perturbations by the hips, knees, and ankles of the slipping leg was characterized by extension, flexion, and plantarflexion moments, respectively. In the trailing leg, responses included hip flexion, knee extension, and ankle plantarflexion. Additionally, these responses were influenced by gait speed, surface inclination, and perturbation intensity. Our study identified target range of motion parameters of 85.19°, 106.34°, and 95.23° for the hips, knees, and ankles, respectively. Furthermore, rotations per minute values ranged from 17.85 to 51.10 for the hip, 21.73 to 63.80 for the knee, and 17.52 to 57.14 for the ankle joints. Finally, flexion/extension torque values were estimated as −3.05 to 3.22 Nm/kg for the hip, −1.70 to 2.34 Nm/kg for the knee, and −2.21 to 0.90 Nm/kg for the ankle joints.DiscussionThis study contributes valuable insights into the biomechanical aspects of slip-like fall prevention and informs the development of wearable robotic systems to enhance safety in vulnerable populations.

Development and application of a WebGIS-based prediction system for multi-criteria decision analysis of porcine pasteurellosis

Porcine pasteurellosis is an infectious disease caused by Pasteurella multocida (P. multocida), which seriously endangers the healthy development of pig breeding industry. Early detection of disease transmission in animals is a crucial early warning for humans. Therefore, predicting risk areas for disease is essential for public health authorities to adopt preventive measures and control strategies against diseases. In this study, we developed a predictive model based on multi-criteria decision analysis (MCDA) and assessed risk areas for porcine pasteurellosis in the Chinese mainland. By using principal component analysis, the weights of seven spatial risk factors were determined. Fuzzy membership function was used to standardize all risk factors, and weight linear combination was used to create a risk map. The sensitivity of the risk map was analyzed by calculating the mean of absolute change rates of risk factors, as well as calculating an uncertainty map. The results showed that risk areas for porcine pasteurellosis were predicted to be locate in the south-central of the Chinese mainland, including Sichuan, Chongqing, Guangdong, and Guangxi. The maximum standard deviation of the uncertain map was less than 0.01and the ROC results showed that the prediction model has moderate predictive performance with the area under the curve (AUC) value of 0.80 (95% CI 0.75–0.84). Based on the above process, MCDA was combined with WebGIS technology to construct a system for predicting risk areas of porcine pasteurellosis. Risk factor data was directly linked to the developed model, providing decision support for disease prevention and control through monthly updates.

Predictors of older adults’ health behaviours to prevent COVID-19 transmission: a multilevel analysis

ObjectivesWhile older adults showed higher mortality during COVID-19 pandemic, protective behaviours (knowledge regarding coping with COVID-19 symptoms and preventive behaviours) were highlighted to be important to prevent the spread of...

Identifying Population Segments by Differing Levels of COVID-19 Vaccine Confidence and Evaluating Subsequent Uptake of COVID-19 Prevention Behaviors: Web-Based, Longitudinal, Probability-Based Panel Survey.

The COVID-19 pandemic prompted the launch of the US Department of Health and Human Services' COVID-19 Public Education Campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death. Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors. Data were obtained from 5 waves (January 2021 to June 2022) of a web-based longitudinal, probability-based panel survey of US adults (N=4398) administered in English and in Spanish. Participants were recruited from NORC at the University of Chicago's national AmeriSpeak panel and were invited to participate across multiple waves. Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all 5 survey waves. A total of 6 segments (hardline nonintenders, prevention-compliant nonintenders, burned-out waiters, anxious waiters, skeptical confidents, and ready confidents) were identified, which differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the 6 segments (P<.001). Results were statistically significant for each segment (P<.01 for booster uptake among burned-out waiters; P<.001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among ready confidents. Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Specifically, we found that across respondent segments, the probability of vaccine and booster uptake corresponded with both COVID-19 vaccine confidence and mask use and social distancing compliance; more compliant segments were more likely to get vaccinated or boosted than less compliant segments given similar levels of vaccine confidence. These findings help identify appropriate audiences for campaigns. Results highlight the use of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.

Assessing the Benefit of Two Detection Approaches in Screening COVID-19 Using SARS-CoV-2 Antigen Rapid Diagnostic Tests among Intercity Public Bus Travelers.

The movement of people contributes to the spread of COVID-19 between communities. Hence, we evaluated the feasibility, acceptability, and impact of offering intercity bus travelers testing prior to their departure. We conducted baseline and endline surveys to map COVID-19 prevention practices in travel agencies in western Cameroon. As interventions, buses were randomly assigned to three study arms: 1) offering systematic COVID-19 rapid diagnostic testing (RDT) to all passengers (arm A); 2) offering testing to suspected cases (arm B); or 3) no testing (arm C). All travelers were called 7-10 days after their trip to identify potential cases. Fifty-five (90.2%) of the 61 travel agencies that were reached consented to participate in a baseline survey. Although only 27 (49.1%) of the agencies implemented at least one of the recommended COVID-19 preventive measures, 39 (70.9%) agreed to host a testing station. Six agencies were selected, and 669 buses were enrolled, including 223, 224, and 222 in arms A, B, and C, respectively. A total of 31,484 departing passengers were approached and 9,594 (30.5%) agreed to participate: 1,177 (12.3%) in arm A, 4,086 (42.6%) in arm B, and 4,331 (45.1%) in arm C. In all, 1,731 tests were performed, including 1,177 in arm A and 554 in arm B. Fourteen (0.8%) tests were positive, and two participants (14.3%) agreed to postpone their travel. Offering testing with antigen RDTs in travel agencies is feasible and acceptable. One-third of passengers consented, and testing did not delay any travels. Although this approach can detect COVID-19 cases, actions are needed to increase the proportion of positive cases postponing their travels.

Using System Dynamics for Local Authority Public Health practice in England

A key function of local authority public health teams in England is to undertake a regular health needs assessment of their population. This involves forecasting, among other things, prevalence and incidence of long term conditions and health care service demand. Over the last few years, Kent County Council Public Health has adopted the use of system dynamics modelling (SDM) to not only do this but generate scenarios to simulate the impact of different interventions across different cohorts defined by age groups and diagnosable conditions. These include “no conditions” as well as understand the combined effects of different interventions, demographic changes and wider health determinants. Risk factors, such as smoking, diet and physical activity, were calculated using local linked data for the incidence of single conditions, progression toward complex needs and levels of morbidity including frailty. These were used to create the dynamics of the model. Incidence, prevalence and mortality for each cohort were projected over 25 years with “do nothing” and “Better Health” scenarios. The size of the “no conditions” cohort increased, and the other cohorts decreased in size. The impact of the interventions on life expectancy at birth and healthy life expectancy was significant. SDM heavily influenced local authority commissioning decisions for health improvement services redesign such as smoking cessation, weight management as well as other secondary prevention measures such as hypertension management and cardiovascular disease screening delivered by General Practice and other health service partners.

Integrating Nursing Practice and Policy in Opioid Overdose Prevention: Analysis of the Opioid-Overdose Reduction Continuum of Care Approach Practice Guide.

To present a comprehensive analysis of the Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) Practice Guide 2023, evaluating its alignment with Russell and Fawcett's conceptual model of nursing and health policy and highlighting the implications for nursing practice and policy. This paper employs a policy analysis framework to evaluate the ORCCA Practice Guide, using Russell and Fawcett's conceptual model as a lens to assess the policy's structure and implementation. The analysis is framed by Russell and Fawcett's conceptual model, focusing on the dimensions of efficacy, effectiveness, equity and justice. This framework assesses how well the ORCCA's strategies align with these dimensions in the context of nursing and health policy. Key findings indicate that the ORCCA's strategies are integral to nursing practice, particularly in frontline interventions such as education, naloxone distribution and Medication for Opioid Use Disorder (MOUD) delivery. The integration of these strategies demonstrates a significant impact on the opioid crisis, enhancing the roles nurses play in opioid overdose prevention. The ORCCA Practice Guide represents a multifaceted approach to addressing the opioid crisis, with strong alignment to the conceptual model used for analysis. It underscores the essential role of nurses in implementing and refining opioid overdose reduction strategies. The study highlights the critical need for nursing involvement in policy formation and practice implementation, suggesting that nurses are key to advancing comprehensive opioid overdose prevention measures. This study addresses the problem of opioid overdoses and the need for effective interventions. The main findings show the importance of nurse-driven strategies in opioid crisis management. The research impacts public health policy and practice, particularly influencing how nursing approaches are integrated into overall health strategies for overdose prevention. No patients, caregivers, or members of the public were involved in conducting this analysis.

Awareness Regarding the Disease and Its Prevention amongst Women with Recurrent Urinary Tract Infection: A Cohort Study

Abstract Introduction: Urinary tract infection (UTI) is regarded as the most common bacterial infection in the community. This disease is more common in females and those in the perimenopausal age group are particularly vulnerable. One of the dreaded complications of UTI is its recurrence. Although the use of antibiotics is the primary modality of treatment of UTI, recurrence can be prevented by adopting behavioural and lifestyle changes and other non-antibacterial measures. Awareness regarding this amongst the patients is of paramount importance. Aims and Objectives: This study was undertaken to assess the knowledge regarding UTI and its preventive measures in a cohort of women with primary UTI attending various Urological clinics in an urban population. Methodology: One hundred and eighty patients with proven UTIs having no comorbid diseases and structural/functional abnormalities in the urinary system were included in the study. A structured questionnaire was prepared to assess the knowledge of patients regarding the basics of UTI and lifestyle modifications, including non-antibacterial measures that could potentially prevent the recurrence of UTI in them. The total scores obtained by patients were categorised into those with inadequate knowledge, moderate knowledge and adequate knowledge. The percentage of patients in each category was calculated. Results: While assessing the overall knowledge using the scale, it was observed that 80% of the patients had inadequate knowledge, while 16.67% had moderate knowledge. Only 3.34% had overall adequate knowledge on the questionnaire. The mean percentage of patients having adequate knowledge on the three subsets of questionnaire given was 18.0%, 8.45% and 7.45%, respectively. The overall mean percentage of adequate knowledge level was only 8.97%. Conclusions: Poor awareness on UTI and its preventive measures could be an important factor in averting recurrent UTI (RUTI) in the community women, particularly belonging to the perimenopausal age group. Since there is a strong correlation between knowledge and practice, educating these women with UTI regarding preventive measures could significantly reduce the incidence of RUTI.

ThP5.8 - Familial hepatocellular carcinoma: a model for studying preventive and therapeutic measures

Abstract Aims Limited attention has been given to the role of primary genetic factors in hepatocellular carcinoma (HCC) especially as familial clusters of HCC are mostly described in areas of endemic hepatitis B virus (HBV) infection. The aim of the study was to review the literature on familial hepatocellular carcinoma (FHCC) and give evidence to suggest that FHCC may be a good model for studying preventive and therapeutic measures for HCC Methods Electronic searches of the Medline (PubMed) data base were performed to identify original published case studies on familial HCC. Results 16 case studies on FHCC were reported between 1965-2016. Even in the presence of HBV infection, FHCC seemed statistically unlikely to occur by chance. Genetic contributions may explain healthy and unhealthy HBsAg carriers, the male sex being predominantly affected, and HBV being directly oncogenic and causing HCC in the absence of cirrhosis in the younger patients. The highest risk of HCC occurs when a hereditary component is acting in concert with environmental factors such as HBV infection through epigenomic alterations. A family history of HCC increases the risk of FHCC independently of hepatitis due to a multifactorial inheritance including DICER 1 germline mutation and altered liver zonation. Epigenetic studies on monozygotic twins with HCC will identify the susceptible loci which can be used therapeuticallym. FHCC is a prognostic factor for improved survival in early resectable tumours with no/minimal cirrhosis. Conclusions HCC lacks a strong hereditary component but HCC-prone families of the familial type may provide a powerful model for studying preventive and therapeutic measures.

Burden changes in notifiable infectious diseases in Taiwan during the COVID-19 pandemic.

This study aimed to assess the impact of the COVID-19 pandemic on the disease burden of Taiwan's notifiable infectious diseases (NIDs). We compared disease burdens between the pandemic and pre-pandemic year of 2020 (with non-pharmaceutical interventions (NPIs)) and 2010 (without NPIs), respectively, to understand the overall pandemic impact on NIDs in Taiwan. Forty-three national NIDs were analyzed using the Statistics of Communicable Diseases and Surveillance Report by estimating the premature death and disability via different transmission categories, sex, and age groups. The study evaluated the impact of diseases by assessing the years lost due to death (YLLs), the duration of living with disability (YLDs), and the overall disability-adjusted life years (DALYs) by measuring both the severity of the illness and its duration. Taiwan recorded 1,577 (2010) and 1,260 (2020) DALYs per million population and lost 43 NIDs, decreasing 317 DALYs per million population. Tuberculosis, HIV/AIDS and acute hepatitis B/D were the leading causes of DALYs, accounting for 89% (2010) and 77% (2020). Overall, this study provided the first insight of changes in disease burdens in NIDs between pre- and post-COVID-19 based on a nationwide viewpoint for further preventive measures and interventions to be focused on specific diseases by associated health administrations and policies.

Challenges and strategies in the preservation of historical and audiovisual archives

The conservation of historical and audiovisual archives is essential for preserving cultural heritage, collective memory, and national identity. These archives—comprising documents, photographs, films, videos, and other materials—serve as critical records of historical events, cultural traditions, and social practices. However, preserving such materials is fraught with challenges, including physical and chemical degradation caused by factors like humidity, temperature, light, and improper handling. Moreover, technological obsolescence poses a significant risk to digital media. To address these issues, conservation efforts must include both the restoration of damaged materials and preventive measures to mitigate future deterioration. This involves not only restoring old photographs and repairing films but also digitizing documents and creating controlled storage environments. Digital conservation, including the migration of obsolete formats to current technologies, is crucial for the longevity of audiovisual materials. Studies highlight various challenges faced in audiovisual preservation. Rasaki et al. (2023) identified obstacles such as technological obsolescence, inadequate storage conditions, lack of funding, insufficient management commitment, and a shortage of trained personnel in a Nigerian university library. Muhammad (2019) further pointed out systemic issues, including the absence of a national preservation policy and undervaluation of audiovisual materials. Evens and Hauttekeete (2011) discussed challenges in digital preservation, noting that underdeveloped policies leave archives vulnerable to deterioration and technological obsolescence. Baker (2021) documented a significant upgrade at the University of Kansas Libraries, showcasing the expansion of conservation facilities and the creation of specialized spaces for audiovisual preservation. Effective preservation requires a collective effort that includes governments, cultural institutions, and public education. Comprehensive preventive measures—such as managing environmental conditions, regulating light exposure, and protecting collections from pollutants and threats—are essential to ensure the accessibility and preservation of valuable cultural heritage for future generations.

Bridging Humanities and Science Education : The SCISSORS Project

As a reader, interested in education, you know that science education is more than just teaching scientific concepts and theories. It is about nurturing the students’ curiosity, motivation, and critical thinking skills. However, have you ever considered the connection between science and social competencies? This is where our innovative approach comes in. The purpose of this ebook is to lay the pedagogical foundation for an educational framework combining the sciences and the humanities, and achieve impact through collaborative research and educational activities. Designed for educators, principals of educational institutions and decision-makers seeking to implement a novel pedagogical program, this resource presents valuable materials. Through exploring research-based insights and good practices from Hungary, and Finland, the primary goal is to influence the perspective of teachers regarding the instruction of sciences combined with humanities. This ebook advocates for a paradigm shift where soft skills and critical, analytical thinking are not seen in contrast but as interdependent, fostering a symbiotic relationship for a more impactful and holistic education. Our educational framework offers a pathway for integrating the development of social competencies into the existing structures of diverse school systems, eliminating the necessity for additional staff. Implementing our approach is a preventative measure against burnout for science teachers and other educators and fosters creativity and self-reflection throughout the teaching and learning journey. This method empowers teachers to link natural scientific discoveries with social occurrences, rendering them tangible and comprehensible for students.

Trends of Toxoplasma gondii and common transfusable venereal infections among blood donors in Menoufia Province, Egypt

Blood transfusion has a hazard of transmission of many pathogens, including Toxoplasma gondii (T. gondii) and other venereal infections. It is crucial to conduct epidemiological surveillance to detect the prevalence of these pathogens. The study aimed to assess the seroprevalence of T. gondii and common transfusable venereal infections among healthy blood donors in Menoufia Province, Egypt, and identify associated risk factors. Four hundred twenty individuals were recruited between January and April 2023 for cross-sectional descriptive research from the blood banks of Menoufia University medical hospitals. Collected blood samples were screened for anti-T. gondii IgM and IgG, HBsAg, anti-HCV antibodies, HIV p24 antigen and anti-HIV antibodies, and anti-Treponema pallidum antibodies. 46 (11.0%) and 22 donors (5.2%) individuals tested positive for anti-T. gondii IgG with a 95% CI (8.3–14.6) and IgM with a 95% CI (3.5–8.1), respectively, while one patient (0.2%) was positive for both antibodies. Regarding venereal infections, 12 (2.9%) were positive for HBV, 6 (1.4%) were positive for HCV, 7 (1.7%) were positive for HIV, and none of the tested population showed positivity for syphilis. Female gender, consumption of raw meat, agricultural environment, poor awareness about T. gondii, and blood group type (especially AB and O groups) were identified as independent risk factors for T. gondii infection. The study highlights the importance of testing blood donors for T. gondii and common transfusable venereal illnesses. Starting health education programs and preventative measures, such as suitable meat handling and cleanliness practices, is critical for minimizing the occurrence of these illnesses. Larger-scale additional study is advised to confirm these results and provide guidance for public health initiatives.

Epidemiological Aspects and Pattern of Intoxication among Elderly in Khorasan-Razavi; Northeast of Iran.

This study aimed to assess the risk factors and clinical-epidemiological patterns of acute poisoning among elderly individuals to guide prevention strategies. The epidemiological, clinical data, manner and cause of poisoning, and outcome of the registered elder cases (≥ 60 years old) in the clinical toxicology department of Imam Reza Hospital of Mashhad University of Medical Silences (CTD-IRH-MUMS) were investigated for nine months. The sex and age distribution of the patients were compared with the general population of Khorasan-Razavi using direct standardization. Among the 3064 cases registered at the hospital, 124 elderly patients were included in the study. The majority (71.8%) were male, with a mean age of 69.47. Male gender was found to be a significant risk factor for poisoning among elderly individuals compared to the general population (OR = 2.62) (1.55-4.42) (p-value < 0.001), however, it was not significant for age. Substance dependency, particularly on opiates, was common among the patients (56.5%), with a higher prevalence in males. Substance overdose (35.4%) and suicide (23.3%) were the most common methods of poisoning, with varying frequencies between genders (p-value = 0.002). Male gender was identified as a risk factor for opiate intoxication (OR = 4.68, CI = 1.70-11.83, p-value < 0.05) but not for suicide attempts. The average hospital stay duration was similar between male and female patients. The mean length of hospital stay was 3.53 ± 4.02 days (median = 3.0, range = 0.5-26 days) and was similar in both sexes. In conclusion,male gender and opiate dependency were highlighted as key factors in the poisoning of elderly individuals. These findings emphasize the importance of addressing these factors in preventive measures.

Mental Health of Healthcare Workers during COVID-19 Pandemic: Systematic Review and Meta-analysis

Introduction Outbreaks of infectious diseases, such as COVID-19, can lead to psychological distress and symptoms of mental illness, especially among healthcare workers (HCWs) who are at high risk of contracting the infection. This current crisis, in particular, adversely affects mental health due to the rapid spread of the infection from person to person and the uncertainty underlying the treatment guidelines, preventative measures, and the expected duration of its prevalence, which could affect the psychological, emotional, and behavioral symptoms. The purpose of this systematic review and meta-analysis was to identify, evaluate, summarize and analyze the findings of all relevant individual studies conducted to assess mental health symptoms during the COVID-19 pandemic. Furthermore, it aimed to identify any gaps in the literature, which could identify the potential for future research. Methods This PRISMA systematic review and meta-analysis on SCOPUS, Web of Science, Google Scholar, PubMed, and Science Direct stated from 11th Feb, 2021 to 11th March, 2022. Following the search to identify relevant literature, one author in the article evaluated the studies in relation to the inclusion and exclusion criteria. The systematic review included 31 studies, the meta-analysis of anxiety prevalence analyzed 20 studies and the meta-analysis of severe anxiety prevalence assessed 13 studies. Results As per the results that were obtained, for HCW, the most prevalent mental health symptoms were sleep disturbance, depression and anxiety, with a prevalence level of 42.9%, 77.6% and 86.5%, respectively. As per the pooled analysis, anxiety prevalence was recorded as 49% (95%CI, 0.36- 0.62), while for severe anxiety, the number dropped to 8% (95%CI, 0.05–0.10). The highest pooled prevalence of anxiety was observed in Turkey at 60% (95%CI, 0.51- 0.70). Alternatively, the lowest pooled prevalence was observed in China, 36% (95%CI, 0.23–0.50) and India, 36% (95%CI, 0.13–0.62). Based on the review of the relevant articles, a few methodological gaps were identified (i.e., Population of the studies and countries). Conclusion This study’s review and meta-analysis provide relevant information pertaining to the mental health status of healthcare workers across the world in light of the COVID-19 pandemic. They experience and endure high levels of mental health symptoms, and thus, it is necessary to provide them with mental and psychological support in this context.

The Cardiac Manifestations of Post-streptococcal Infection in Paediatrics: Case Series

Introduction: Group A streptococcus (GAS) remains a global burden, particularly in developing countries, with long-term morbidity and mortality complications. Different strains and immune responses to GAS can lead to various disease patterns, from predominantly throat and skin manifestations to renal and cardiac involvement. Myocarditis associated with glomerulonephritis can progress to carditis, which may present with signs and symptoms similar to rheumatic heart disease. Although uncommon, this condition can deteriorate into dilated cardiomyopathy, potentially leading to cardiogenic shock and death, necessitating early recognition, intervention, and preventive measures. Case Presentation: We report three pediatric cases of post-streptococcal infection with cardiac manifestations. The first case involves an 8-year-old female with palpitations and a recurring cough, diagnosed with acute rheumatic carditis. The second case is a 10-year-old female presenting with hemoptysis and edema in the lungs and extremities due to acute rheumatic carditis and prior suspected vegetation. The third case is a 9-year-old male initially diagnosed with post-streptococcal glomerulonephritis (PSGN), who deteriorated into dilated cardiomyopathy with an ejection fraction of 32% and multiple organ dysfunction syndrome. All three patients recovered well, received prophylactic management, and were referred for further investigation. Conclusions: Identifying specific features on echocardiography can help differentiate between rheumatic heart disease (RHD) and PSGN-associated cardiac involvement. Additionally, echocardiography is a more readily available and cost-effective screening method, especially in endemic populations. Early recognition and management of post-streptococcal cardiac complications may prevent long-term morbidity and mortality.

WP4.14 - Association of Socioeconomical Status and Disparity In Paediatric Burn: Results From The Global Burden Of Disease Study 2019

Abstract Background Burn represents a significant contributor to both morbidity and mortality in the paediatric population and is closely related to socioeconomic and geographic factors but is often overlooked. This study aims to estimate the unbalanced distributions, temporal trends and quality of care in paediatric burn. Methods Data focusing on paediatric population (&amp;lt;20 years old) was sourced from the Global Burden of Disease (GBD) Study 2019 stratified by Socio-demographic Index (SDI) and WHO region, including incidence, mortality and disability-adjusted life-years (DALYs). Joinpoint regression analysis and principal component analysis were conducted to compute the temporal trend and quality of care (QCI) index respectively. Result In 2019, 3,719,806 paediatric burn cases were reported, resulting in 23,986 deaths and 2,240,311 DALYs globally. Over 40% of deaths and DALYs attributable to burn occur in the African region, despite the region accounting for around 20% of the total incidence. The age-standardised incidence rate (ASIR) from 2010-2019 was 0.419 per 100,000 but death (ASDR) and DALYs (ASDALYs) were reduced at the rate of 3.04 per 100,000 and 2.92 per 100,000 respectively. The global QCI for paediatric burn was 88 with a proportional trend observed across SDI quintiles Significant association in between SDI scores and gender disparity and quality of care was observed. Conclusion This study highlights the significant burden of paediatric burn and its disproportionate global distribution. Preventive measures, enhancing access to quality healthcare, and addressing the social and economic determinants of burn should be addressed in future studies.

Overhauling dental implications in a child with rare craniofrontonasal syndrome: a case report

Craniofrontonasal syndrome is an extremely rare X-linked dominant genetic disorder characterized by features such as hypertelorism, craniosynostosis, ocular anomalies, a bifid nasal tip, and longitudinal ridging with splitting of the nails. Heterozygous females are more severely affected, presenting frontonasal dysplasia and coronal craniosynostosis (fusion of the coronal sutures), while males typically only exhibit hypertelorism. This case report describes the dental management of a 9-year-old female with craniofrontonasal syndrome who was referred to the department of paediatric and preventive dentistry for pain in the lower right and left back tooth region. The patient exhibited a clinical spectrum including microcephaly, short neck, axillary pterygium, clinodactyly of the toes, longitudinal ridging with split nails, pectus excavatum, and underdeveloped female genitalia. Extraoral examination revealed hypertelorism, flat nasal bridge, low-set ears, strabismus, antimongoloid slant, and an indistinct philtrum. Intraoral examination showed a high palatal vault, crowding of the upper and lower arches during the mixed dentition period, multiple dental caries, and poor oral hygiene. An orthopantomogram confirmed delayed dental development. Dental treatment was carried out on a dental chair system using adequate behaviour management techniques with short appointments, keeping in mind the reduced cooperative ability of the child. The importance of this report stems from the limited dental literature available on the syndrome. Preventive measures along with home care instructions were emphasized to support professional care.