Strong Prevention Measures Research Articles

Detection of IMP and VIM genes in Pseudomonas aeruginosa isolated from Egyptian patients

IntroductionMetallo-β-lactamase production among Pseudomonas aeruginosa is a major health problem worldwide. Pseudomonas aeruginosa acquire several mechanisms of resistance towards carbapenems through the production of metallo-β-lactamases, especially VIM and IMP. The problem of multi-drug-resistant Pseudomonas aeruginosa is increasing all over the world, reaching dangerous levels. The aim of this study was to detect the metallo-β-lactamases bla<sub>VIM</sub> and bla<sub>IMP</sub> genes in Pseudomonas aeruginosa strains in Suez Canal University Hospital in Ismailia, Egypt.Material and methodsA cross-sectional descriptive study was conducted on 65 Pseudomonas aeruginosa strains. Genotypic detection of bla<sub>VIM</sub> and bla<sub>IMP</sub> was reached by using polymerase chain reaction.ResultsOut of 65 Pseudomonas aeruginosa strains , bla<sub>VIM</sub> gene was present in four females and one male, with an age of 42.9 ±18.1; two cases were isolated from the Oncology Department, and one case each was present in the Burn Unit, Surgery Ward, and Intensive Care Unit. The bla<sub>VIM</sub> gene was expressed in four stains, while the bla<sub>IMP</sub> gene was not expressed in any strain.ConclusionsThe carbapenem resistance in our patients can be referred to as metallo-β-lactamases bla<sub>VIM</sub> type. The problem of metallo-β-lactamases and carbapenem resistance requires ongoing surveillance, strong preventive measures, and implementation of infection control policies and procedures. Also, routine diagnostic laboratory methods should be performed, and synthesis of antimicrobial products with new effecting mechanism should be implemented in hospitals.

Typhoidal Salmonella Trends in Thailand

.Typhoid and paratyphoid fever remain endemic diseases in Thailand with wide variation in subnational incidence trends. We examined these trends alongside contextual factors to study potential interactions and guide control strategies for this disease. Culture-confirmed typhoid and paratyphoid fever data from 2003 to 2014 were collected from the Ministry of Public Health website. Contextual factor data were collected from various sources including World Health Organization/United Nations Children’s Fund Joint Monitoring Program, United Education Statistical World Bank database, World Bank, Development Research group, and global child mortality estimates published in the Lancet. Typhoid fever exhibited a declining trend with peak incidence reported in 2003 at 8.6 cases per 100,000 persons per year. Incidence dropped to three cases per 100,000 persons in 2014. The trend in paratyphoid fever remained stable with the peak incidence of 0.77 cases per 100,000 persons observed in 2009. Subnational variations of typhoid were seen throughout the study period with the highest incidence observed in the northwestern region of Thailand. Increases in female literacy, and access to improved water and sanitation were observed with decreases in poverty head count ratio and diarrheal mortality rate per 1,000 live births. Case fatality remained consistently low at 0.4% or less in all years with reported deaths. At the national level, typhoid fever incidence has shown a notable decline; however, incidence appears to have plateaued since 2007 with access to improved water supply and sanitation above 80%. Eliminating this disease will require strong disease prevention measures in conjunction with effective treatment interventions.

Marine litter plastics and microplastics and their toxic chemicals components: the need for urgent preventive measures

Persistent plastics, with an estimated lifetime for degradation of hundreds of years in marine conditions, can break up into micro- and nanoplastics over shorter timescales, thus facilitating their uptake by marine biota throughout the food chain. These polymers may contain chemical additives and contaminants, including some known endocrine disruptors that may be harmful at extremely low concentrations for marine biota, thus posing potential risks to marine ecosystems, biodiversity and food availability. Although there is still need to carry out focused scientific research to fill the knowledge gaps about the impacts of plastic litter in the marine environment (Wagner et al. in Environ Sci Eur 26:9, 2014), the food chain and human health, existing scientific evidence and concerns are already sufficient to support actions by the scientific, industry, policy and civil society communities to curb the ongoing flow of plastics and the toxic chemicals they contain into the marine environment. Without immediate strong preventive measures, the environmental impacts and the economic costs are set only to become worse, even in the short term. Continued increases in plastic production and consumption, combined with wasteful uses, inefficient waste collection infrastructures and insufficient waste management facilities, especially in developing countries, mean that even achieving already established objectives for reductions in marine litter remains a huge challenge, and one unlikely to be met without a fundamental rethink of the ways in which we consume plastics. This document was prepared by a working group of Regional Centres of the Stockholm and Basel Conventions and related colleagues intended to be a background document for discussion in the 2017 Conference of the Parties (COP) of the Basel Convention on hazardous wastes and the Stockholm Convention on persistent organic pollutants (POPs). The COP finally approved that the issue of plastic waste could be dealt by its Regional Centres and consistently report their activities on the matter to next COP’s meetings.

Plaidoyer pour la mise en place d’une stratégie globale pour atténuer le « fardeau » des troubles schizophréniques

This article attempts to identify and put into perspective the different approaches that could globally prevent the suffering induced by schizophrenia, from the detection of early psychosis to the impact on individual and family functioning and emotional health. Schizophrenia causes, at the community level, a number of difficult consequences and associated costs, which likely could be reduced if specific strategies, already known and documented internationally, were applied. Two areas not explored in this article: the role of medication and the issue of suicide prevention. In the scope of screening and early treatment, genetic risk, as well as the predictive ability of the clinical criteria for individuals at “ultra-high risk” of developing schizophrenia justify an increased vigilance for the detection of symptoms in order for treatment to begin earlier and to be more effective. These risk factors should not be neglected as the benefits of early management impact the course of illness and functional outcome. At this stage of the emergence of the disorder, it is difficult to systematize a therapeutic protocol. Two options are open to the clinician: “wait and watch” given the lack of a conclusive diagnosis and a more pro-active intervention, focused on the therapeutic alliance and enhancing insight and awareness. The second approach seems more productive but requires transparency with the patient and family regarding the uncertainty of the clinical situation, and an attitude that favors sharing information, along the lines of early psych education. Once a pathological stage is reached, early and accurate clinical care is fundamental. They depend heavily on access to care, proximity and availability to clinics or out-reach teams, capable of a thorough diagnostic work-up. Yet conversely, the availability for early and accurate clinical care faces obstacles which are closely related to the pejorative view of psychiatry held by the general public, health care professionals, and public officials. This poor image of psychiatry is partly due to cases of clinical decompensation, dangerous in some instances, underscoring why it is be important to understand and anticipate the contributory factors to these outcomes in the first place so as to avoid them. In this sense, defending a complacent and conciliatory approach can be counter-productive. Following developments of recent decades in other chronic diseases (diabetes, cancer, AIDS, severe heart disease…), the implementation of systematic clinical programs, treatment protocols, psycho-education to reinforce adherence to therapeutic measures, their simplification, the support and appreciation of the role of caregivers, destigmatizing due to proximity of contact, and therefore an increase in the use of care. Similarly, the systematic search for side-effects of medication and pro-actively managing to minimize their occurrence strengthen compliance, a recognized factor of relapse prevention. Preventable comorbidities, addictions, and common physical illnesses are not systematically screened (neoplastic diseases, diabetes, hypertension, dental health, gynecology…) in this population and thus also represent significant potential for a better life expectancy. The tools of psychosocial rehabilitation, unfortunately, are too infrequently used in France. Their goal is to improve the functional outcome of patients, a determinant of social integration and to lessen the burden shouldered by family and other carers, and ultimately to reduce exacerbations of the illness due to situations of interpersonal stress. Work has also proven its worth as a protective factor, as well as strengthening a sense of self-efficiency, of self-esteem, of empowerment, of quality of life, helping attain recovery. It is clear that not all social and health care systems are primarily geared towards these objectives, although they have at their disposal, by the means described above, strong preventive measures for relapses. Beyond the issue of the implementation of clinical programs, the existing culture would benefit from being infused with a prioritization of resource deployment, with debates of these issues regarding parity for mental health services, advocated by users, and forging a place, for example, for the intervention of “peer supports”, sociologists, social workers, interested beyond the disease, in community environment, employment opportunities, and housing. Overall, this work argues for updating our conceptions of clinical care, supporting the systematic implementation of modern models of care, and expanding the scope of our concerns regarding patients’ lives.

Preventive measures against plague and the control of Chinese coolies in colonial Korea

This paper aims to examine the preventive measures taken against the plague in colonial Korea, particularly as applied to the control of Chinese coolies in 1911, soon after the annexation. The Government General of Korea began preventive measures with a train quarantine in Shin'uiju and Incheon in response to the spread of the plague to the Southern Manchuria. Shin' uiju had become urbanized due the development of the transportation network, and the seaport of Incheon was the major hub for traffic with China. Examining the transportation routes for the entry and exit of Chinese to and from Korea makes clear the reason why the Korea Government General initiated preventive measures in mid-January, 1911. The Government General of Korea tried to block the entry of Chinese through the land border crossing with China and through ports of entry, primarily Incheon. During the implementation of the preventive measures, quarantine facilities were built, including a quarantine station and isolation facility in Incheon. It was also needed to investigate the population and residential locations of Chinese in Korea to prevent the spread of plague. A certificate of residence was issued to all Chinese in Korea, which they needed to carry when they travelled. The preventive measures against plague which broke out in Manchuria were removed gradually. However, there was no specific measures against Chinese coolies, those who had migrated from China to work in the spring in Korea. Still the Government General of Korea had doubt about an infection of the respiratory system. As a result, the labor market in colonial Korea underwent changes in this period. The Government General recruited Korean laborers, instead of Chinese coolies whose employment had been planned. This move explains the Government General's strong preventive measures against plague and uncertainty in the route of plague infection, which influenced subsequent regulations on the prohibition of Chinese coolies working on the public enterprise sites and the improvement of labor conditions for Korean laborers.

Relapsing Fever Outbreak Investigation in Bahir-Dar, Amhara Region, Ethiopia

Introduction: Ethiopia is the main endemic focus of louse borne relapsing fever. Borrelia recurrentis is the etiologic agent for louse-borne relapsing fever and occurs as epidemic under conditions of poor socio economic status, overcrowding, poverty, draught and famine. Methods: Unmatched community based case control and descriptive cross sectional investigation were conducted. All patients from 15 October-15 November 2012 were included. Sixty eight patients matched with 136 controls that had no previous history of relapsing fever living in the same village. Study was conducted in in households with individuals who go to work on a daily basis and data was analyzed using Microsoft Excel and Epi-Info version 7.1.0.6.Results: Among all confirmed patients 100% (68), 92.6% (63), 94.1% (64) and 82.3% (56) presented with fever, head ache, chills and vomiting respectively. There was no death during the outbreak. Mean age of respondents was 21 years and their median age was 20 years (SD 7.14). Statistically significant associations were observed between 51 (75%) patients and 27.2% (37) controls who did wash their clothes at least weekly (AOR = 13.23, 95% CI [5.51-31.75]) and 79.4% (54) patients and 64% (87) controls who did not take body bath at least weakly (AOR = 8.01, 95%CI [3.51-18.29]) and the associations were statistically significant. Those not washing clothes and taking baths at least weekly had a 13 and 8 fold likelihood of acquiring relapsing fever compared to those who wash clothes and take baths respectively at least on a weekly basis. Conclusion: Poor personal hygiene was contributed to the outbreak. The outbreak was contained due to prompt interventions taken and strong preventive measures were recommended to prevent emergence of future outbreak of relapsing fever.

Pandemic A/H1N1 influenza: Transmission of the first cases in Spain

Pandemic A/H1N1 influenza emerged in Mexico at the end of March 2009. Since then, it is still important to provide evidences that contributed to the international spread of the virus and to ascertain the attack rate of this new strain of influenza among the first cases in Spain that led to identify the first transmission in Europe. Three pandemic A/H1N1 influenza groups related to an overseas flight were studied: 71 student group, 94 remaining passengers, and 68 contacts of confirmed cases. The attack rate with their 95% confidence interval (CI) among the student group and contacts was calculated. On April 26th, when the first cases were notified, strong preventive measures were implemented among the student group and the contacts of the confirmed cases. On 27th April, the first pandemic A/H1N1 influenza cases confirmed in Spain were three students that came back from Mexico by airplane. A student generated the first native case in Spain and one of the first cases in Europe. Similar attack rates were found between the student group (14.1%; CI: 12.1-16.1) and their contacts (13.2%; CI: 4.4-22.0), but no cases among remaining passengers were detected, suggesting low transmission risk during air travel. The first cases of pandemic A/H1N1 influenza in Spain were imported by airplane from Mexico. Preventive efforts to reduce the impact of the influenza influenced that primary and secondary rates were lower than first estimations by WHO.

Attitudes towards anti-terror measures: the role of trust, political orientation and civil liberties support

This article analyses Norwegian citizens' attitudes towards the use of strong prevention measures in the fight against terrorism. Norwegians stand out as being relatively supportive of such measures, despite having been relatively shielded from serious terrorism. Nevertheless, they are generally more critical towards keeping people in custody without trial. This analysis shows that trust, political orientation and civil liberties support have significant explanatory value, also when the effects of gender, age, education and occupational status are controlled for. However, trust turns out to be a complicated indicator; whereas high scores on social trust predict more sceptical attitudes, a strong belief in personal abilities and in the political system fosters attitudes that are less sceptical. The article concludes that the combination of low threat, limited previous experience and high levels of trust creates a favourable environment for preventive policies, and recommends a further exploration of these dimensions in different contexts.

Universal problems during residency: abuse and harassment

Perceived abuse or harassment during residency has a negative impact on residents' health and well-being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan. In 2007, a multi-institutional, cross-sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol-associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi-square analysis. A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol-associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%). Mistreatment during residency is a universal phenomenon. Deliberation on the occurrence of this universally wrong tradition in medical culture will lead to the establishment of strong preventive methods against it. Current results indicate that alcohol-associated harassment during residency is a Japanese culture-specific problem and effective preventive measures against this are also urgently required.

The potential demand for an AIDS vaccine in Thailand

The recent ongoing phase III clinical trial of a preventive vaccine in Thailand has prompted studies on potential demand for the vaccine among public, employers and households. This study aims to demonstrate the impact of HIV/AIDS, estimate the AIDS vaccine budget required and design the vaccination strategies for different population groups. The analysis is based on available secondary data and several assumptions on levels of secondary infections among various risk groups. Among 15 groups, we identified eight groups as potential vaccinees: Direct CSW, IDU in treatment, IDU out of treatment, male STD, transport workers, CSW indirect, conscripts and prisoners. The vaccine budget, excluding other operating expenditure, was estimated based on a single dose regimen ranging from 100 Baht (US$3) to 1000 Baht (US$29) per dose. A total of US$1.8–17.7 million is required for non-infected catch-up population and US$0.2–1.9 million for the maintenance population in the subsequent year. We foresee a relative inefficient and inequitable consumption of AIDS vaccine, which requires proper policy analysis and government interventions. Before vaccine adoption, strong preventive measures must be in place. AIDS vaccine could play an additional, not a substituting, role. A thorough understanding, a wide consultation with stakeholders and public debates are crucial steps for sound policy formulation.

Nuclear theft poses growing security threat

Without strong preventive measures, terrorists or rogue nations are likely to succeed in smuggling the essential ingredients of nuclear weapons—plutonium and highly enriched uranium (HEU)—from Russ...

Time trends in cancer mortality in Estonia, 1965-1989.

Mortality rates for cancer of all sites combined and for 12 selected sites or site groups in Estonia from 1965 to 1989 were studied to assess overall progress in controlling cancer. Between 1965-1969 and 1985-1989, age-standardized mortality (world population) increased by 12.0% among males and decreased by 5.1% among females. The changes in mortality for the age-groups 20-44, 45-64, and 65 and over were -0.3%, 23.5% and 5.8% among males and 0.9%, -7.0% and -4.4% among females, respectively. In males, the most marked rise in mortality occurred for cancers of the oral cavity and pharynx, intestine and larynx. In females, the most rapid increase was observed for cancers of the lung, oral cavity and pharynx and breast. The decline in stomach cancer and cervical cancer mortality reflects worldwide trends. However, the noticeable increase in mortality rates for most of the sites indicates a need for strong preventive measures, particularly anti-smoking campaigns. In general, the time trends in mortality from all cancers combined demonstrate that in Estonia, over the last 25 years, no progress against cancer has been achieved.