Unsafe Disposal Research Articles

Medical sharps in Portugal: a cross-sectional survey of disposal practices among the diabetic population

ObjectiveWe aim to determine the disposal site for biohazardous materials resulting from diabetes surveillance and therapy.DesignCross-sectional study.SettingFive Portuguese primary care facilities.ParticipantsWe randomly sampled diabetic patients representative of five primary care...

Global practices, geographic variation, and determinants of child feces disposal in 42 low- and middle-income countries: An analysis of standardized cross-sectional national surveys from 2016 - 2020.

BackgroundDespite considerable progress improving water and sanitation access globally, unsafe child feces disposal remains common in many low- and middle-income countries (LMICs), posing an important health risk. The present study characterizes the current prevalence of child feces disposal practices and child latrine use across low- and middle-income countries and investigates determinants associated with appropriate disposal practices.MethodsData for children ranging from 0 through 4 years of age were analyzed from standardized and nationally-representative surveys of 42 LMICs collected from 2016 to 2020 to assess child feces disposal practices. We report child feces disposal in three categories: disposal in any type of latrine, disposal in an improved latrine, and disposal through means other than in a latrine. Survey weighted multiple Poisson regression models were used to explore factors associated with these practices.ResultsData on 403,036 children (weighted N = 191 million) demonstrated that a minority (40.3%) of children have their feces disposed of in a latrine of any kind, and just 29% have feces disposed of in an improved latrine. Prevalence varied considerably by country and region. In adjusted analyses, both child feces disposal in any latrine and disposal in an improved latrine increased with child age, higher intra-country relative wealth, and urban living, and decreased with breastfeeding and shared sanitation facilities. Disposal in improved latrines additionally increased with access to higher levels of service for drinking water and higher mother's education. Nevertheless, the role of facility access alone was insufficient, as only about half of children with household access to any latrine or improved latrines had their feces disposed of in these facilities. Child latrine use among households with latrine access was also low and highly variable across countries.ConclusionsChildren's feces in LMICs are infrequently disposed of in any latrine type, and even less frequently in improved latrines. In order to minimize health risks in LMICs, increased effort must be undertaken not just to increase sanitation coverage but to address these common barriers to safe child feces disposal and child latrine use.

A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children.

Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea. We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors-specifically low maternal education-and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea. Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of cryptosporidiosis.

517-P: The Prevalence and Predictors of Improper Sharps Disposal among People with Diabetes in Saudi Arabia

Background: Diabetes often requires the use of sharp objects (e.g. needles, lancets, etc) to maintain optimal glycemic control. Improper disposal of sharps poses substantial threats to the environment and public health. Objectives: To estimate the prevalence, and identify predictors, of improper sharps disposal among people with diabetes (PWD) in Saudi Arabia. Method: We surveyed PWD, visiting a diabetes center in Riyadh, Saudi Arabia in Sep- Oct, 2021. We asked questions about sociodemographics, type and duration of diabetes, methods of sharps disposal, and whether the study participants had received instructions on proper sharps disposal. We defined “proper sharps disposal” as: dispensing sharps into a designated sharps disposal container or home-made sealed container. Results: Of the 293 PWD surveyed, 60% were women, 54% were ≥35 years old, and 53% had type 1 diabetes. Majority (80% and 72%) reported improper disposal of needles and lancets, respectively. Approximately, 56% of needle users and 61% of lancet users reported that they had never received instructions on safe sharps disposal. Receiving education on safe sharps disposal was associated with a 66% reduction in the risk of improper sharps disposal practice[OR (95% CI) : 0.34 (0.16-0.68) ] after adjusting for age, gender, type and duration of diabetes, income, education, and nationality of the study participants. Among those who improperly dispose their needles, 67% thought their way of sharps disposal was appropriate and 47% did not know what type of infections can be transmitted via needlestick injuries. Conclusion: Our findings highlight the high prevalence of unsafe sharps disposal practices among PWD, and how providing education on safe sharps disposal can help address this environmental and public health threat. Policies to reduce diabetes-related waste, unify the approach to proper sharps disposal, and educate PWD on how to safely dispose sharps are needed to achieve a sustainable and safe waste management system. Disclosure G.Alsuwailem: None. M.Barakeh: None. G.A.Almarshoud: None. A.Zawawi: None. R.A.Bakader: None. M.Al-sofiani: None.

Water quality index assessment for drinking and irrigation purpose for Wardha district

It is always said that groundwater is safe for consumption i.e. free from micro-organisms. But in many places, the groundwater is subjected to contamination due to human and industrial activities. The unsafe disposal of domestic and industrial wastes is found to be the main source for contamination of groundwater with micro-organisms, nitrates, etc. Therefore, it is inevitable to assess the quality of groundwater in terms of the Water Quality Index (WQI) before it is supplied to the end-user. Water Quality Index (WQI) is an index that converts complex data about water quality into the simplest form. This manuscript discusses the level of contamination of groundwater in the villages situated in the vicinity of Wardha River in Wardha District. Groundwater samples were collected during ninety days starting from 1st May 2021 to 30th July 2021. Analysis was carried out for the assessment of 12 parameters and their WQI. The results reveal that 40% of the 12 parameters assessed are higher values whereas, 60% of the 12 parameters assessed are reported safe values as per Indian Standards for Drinking Water. On the other hand, WQI for all the groundwater samples (barring very few) has shown bad quality.

Decontamination of industrial wastewater using microalgae integrated with biotransformation of the biomass to green products

Exponential growth in the industrial sector causes the accumulation of toxic wastewater in the ecosystem. The unsafe disposal of such wastewater not only adversely affects the freshwater resources but also pose negative impact on the environment and human health due to the presence of heavy metals, organic/inorganic pollutants, and high amount of nitrogen, phosphorus, and sulfur in it. It demands for the effective wastewater treatment that depends on the effluent quality, industrial process, chemical/energy requirement, economic viability, operational flexibitily, and residual utilization. However, conventional treatment methods are unable to meet all the requriements which demands for the eco-friendly and economical alternatives. Currently, paradigm shift from wastewater treatment and dispoal of, to its utilization in circular biorefinery context is underway. In this context, microalgae-based industrial wastewater is vital option due its pollutant accumulation ability, environmental sustainablity, biorefinery potential, and zero-waste process chain development. This review highlights the characteristics of different industrial effluents and overviews the axenic and binary algal-treatment systems. Economical and technological barriers are the major hindrance in the implementation of algal-based treatment methods; for which biomass valorization has been briefly discussed. This review highlights the need of developing closed-loop integrated processes for wastewater treatment and reuse in sustainable manner. Further research in the development of such schemes specially at large-scale level must be the focus of future studies.

Experimental and optimization studies on phycoremediation of dairy wastewater and biomass production efficiency of Chlorella vulgaris isolated from Ganga River, Haridwar, India.

Dairy wastewaters (DWW) are rich in several pollutants, including high biochemical oxygen demand (BOD) and chemical oxygen demand (COD), and their unsafe disposal may cause damage to the environment. In this study, Chlorella vulgaris (identified as NIES:227 strain based on 28s rRNA sequencing) was isolated from the freshwater habitat of the Ganga River at Haridwar, India, and further tested for its efficacy in treating DWW. The phycoremediation experiments were conducted using three different DWW concentrations (0, 50, and 100%), operating temperatures (20, 25, and 30°C), and light intensities (2000, 3000, and 4000lx) using response surface methodology. Results showed that after 16days of experiments, a significant (P < 0.05) reduction in BOD (96.65%) and COD (87.50%) along with a maximum biomass production of 1.757g/L was achieved using 57.72% of dairy industry wastewater, 24.16°C of reactor temperature, and 3874.51lx of light intensity. The RSM models had coefficient of determination (R2) values above 0.9459 with a minimum difference between measured and predicted responses. Therefore, the findings of this study suggest that the isolated C. vulgaris can be effectively used to treat dairy wastewater along with significant production of algal biomass which can be further used for the generation of low-cost biofuel and other materials.

Prevalence of and factors associated with acute diarrhea among children under five in rural areas in Ethiopia with and without implementation of community-led total sanitation and hygiene

BackgroundSince Ethiopia has been implemented the Community-Led Total Sanitation and Hygiene (CLTSH) approach to control incidence of diarrhea, few studies have compared the prevalence of diarrhea and associated factors in rural areas that have implemented this approach with those that have not implemented it, and none have examined it in the district of Menz Gera Midir in the Amhara Region of Ethiopia. This study addressed this gap.MethodA community-based comparative cross-sectional study was conducted among 224 children under five in three randomly selected rural kebeles (the smallest administrative units in Ethiopia) where CLTSH had been implemented and 448 similar children in three other randomly selected rural kebeles where CLTSH had not been implemented during February and March, 2020. Data were collected using a structured questionnaire and an on-the-spot observational checklist. Data were analyzed using three different binary logistic regression models with 95% confidence interval (CI): the first model (Model I) was used for CLTSH-implementing kebeles, the second model (Model II) for non-CLTSH-implementing kebeles, and the third model (Model III) for pooled analysis of CLTSH-implementing and non-implementing kebeles. To control confounders, each multivariable logistic regression model was built by retained variables with p < 0.25 from the bi-variable logistic regression analysis. From the adjusted multivariable analysis of each model, variables with p-values < 0.05 were declared factors significantly associated with acute diarrhea.ResultsThe prevalence of acute diarrhea among children under five from households in kebeles that had implemented CLTSH was 10.6% (95% CI:6.6–14.7%) and among those that had not implemented CLTSH 18.3% (95%CI:14.8–22.2%). In CLTSH-implementing areas, use of only water to wash hands (AOR: 3.28; 95% CI:1.13–9.58) and having a mother/caregiver who did not wash their hands at critical times (AOR: 3.02; 95% CI:1.12–8.12) were factors significantly associated with acute diarrhea. In non-CLTSH-implementing areas, unimproved water source (adjusted odds ratio [AOR]: 2.81; 95% CI:1.65–4.78), unsafe disposal of child feces (AOR: 2.10; 95% CI:1.13–3.89), improper solid waste disposal (AOR: 1.95; 95% CI:1.12–3.38), and untreated drinking water (AOR: 2.33; 95% CI:1.21–4.49) were factors significantly associated with acute diarrhea. From the pooled analysis, not washing hands at critical times (AOR: 2.54; 95% CI:1.59–4.06), unsafe disposal of child feces (AOR: 2.20; 95% CI:1.34–3.60) and unimproved water source (AOR: 2.56; 95% CI:1.62–4.05) were factors significantly associated with the occurrence of acute diarrhea while implementation of CLTSH was a preventive factor (AOR: 0.24; 95%: 0.20–0.60) for the occurrence of acute diarrhea.ConclusionThe prevalence of acute diarrhea among under-five children in Menz Gera Midir District was lower in kebeles where CLTSH had been implemented than in kebeles where CLTSH had not been implemented. Therefore, we recommend that governmental and non-governmental sectors increase implementation of CLTSH programs, including improving handwashing at critical times, promoting safe disposal of child feces and enhancing the availability of improved water sources.

Disposal of leftover and expired medicines by community pharmacies and their clients in Ghana.

Improper and unsafe disposal of expired and unwanted medicines could cause harm to both people and the environment and therefore it is of public health importance. The objective of the study was to determine the methods employed by community pharmacist and their clients in the disposal of unwanted and expired medicines. Furthermore, the role of the pharmacists in the assessment of clients left over medicines was also explored. A cross sectional study design was employed with a sample of 120 pharmacy staff and 200 clients. Semi structured questionnaires were developed and administered to the two groups. Ethical approval was obtained. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS v.24). Two hundred and eighty medicines were assessed from 131 respondents (65.5%) who brought their unused or left-over medicines to the pharmacy. These included analgesics 102(36.4%), antibiotics 50 (17.9%) and antacids 22 (7.9%). Disposal of expired and left-over medicines cited by respondents were the general-purpose bin 58(77.0%) and down the sink 11(14.3%). The majority 99(82.9%) of community pharmacies also disposed of solid dosage forms through the general-purpose bin. In addition, 90(75%) community pharmacies disposed of liquid waste in general purpose bin. Lack of enforcement of legislation was cited by community pharmacy staff as a barrier to the proper disposal of pharmaceutical waste. The predominant method of disposal of expired/unwanted medicines by community pharmacies and their clients was via the general-purpose bin. Implementation of interventions such as take back programmes that will enhance proper disposal of expired and left over medicines should be initiated.

E-waste Awareness and Management Among People Engaged in E-waste Selling, Collecting, Dismantling, Repairing, and Storing Activities in Addis Ababa, Ethiopia

Associated with the increasing demand and supply of short life-span electrical devices, e-waste generation is rapidly increasing. This created a special business for some informal groups: dismantlers, e-waste sellers, repairers, and storekeepers. The objective of this study was to assess the awareness, management strategies, and associated influencing factors among the central role players of the e-waste-related business. A cross-sectional study was used to assess the awareness and management of 345 purposely selected e-waste workers including all those who are actively engaged in e-waste buying, selling, dismantling, storing, and transferring. A questionnaire was used to obtain the required information. The findings show that about 92% of the dismantlers, 70% of the sellers, and 55% of the repair and maintenance workers have poor awareness. The awareness level of the respondents is strongly associated with the newness of the issue ( V = 0.64) and lack of concern ( V = 0.44), and moderately associated with educational status ( V = 0.31), their lack of access to information (0.31), job type (0.28) and income level (0.26). The e-waste management among the study groups was limited to unsafe disposal (50%), unsafe storage (36%), and transfer (14%) to other users. The analysis showed that there is a statistically significant association between their job type and management systems (chi2 (6) = 139, P &lt; .005, V = 0.45). Cramer’s V ( V = 0.45) shows a strong association between their job type and the e-waste management strategies. The awareness level of the respondents is very poor and influenced by several complex factors. During the study period, no study groups were practicing any of the proper e-waste management at all.

Assessment of Knowledge, Attitude and Practices towards the Disposal of Unused and Expired Medications among Students of Private Medical Universities in Lusaka, Zambia

Background: The disposal of unused and expired medications has been a concern in many countries in that, the pharmaceutical waste enters the ecosystem and eventually causes a negative impact on human health and environment. Aim: To assess the knowledge, attitude and disposal practices of unused and expired medicines by students in the private medical universities in Lusaka of Zambia. Method: A cross-sectional survey was conducted over a period of 8 weeks among 391 respondents from three private universities in Lusaka. Respondents were polled using semi structured questions that focused on their knowledge, attitudes, and disposal practices for unused and expired drugs. In order to analyze data, the statistical package for social sciences (SPSS) version 20 was utilized. Results: The mean age of the participants was 23 years (SD: ±3). Out of the 391 participants, 320 (81.8%) knew about medicine waste and 391 (100.0%) responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. The drug-take-back system was unknown to a vast percentage of the respondent 371 (94.9%). The majority 274 (70.1%) of respondents had unused medicine stored at home, with antibiotics 215 (56.0%) and analgesia 111 (28.4%) being the most prevalent types of drugs kept in the households. The most commonly used disposal practice for unused 126 (32.2%) and expired medicines 274 (70.1%) was throwing them in household garbage. Only 27 (6.9%) and 30 (7.7%) reported returning unused and expired medicines to the nearest pharmacy respectively. The majority of respondents believed the risk stemmed from the presence of an undesired drug in the home, the potential for harm to children, a lack of proper information on safe disposal practices, and the necessity for a take-back program. Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that unsafe disposal of unused and expired medicines is a public health problem and proposed the need to introduce drug take-back programs in the communities.

Knowledge, attitude, and practice of unused and expired medication disposal among second year medical students

Background: Medications are not only used for disease treatment, but also for diagnosis and prevention of the disease. Not all the prescribed drugs are used by the patients, due to lack of adherence to therapy, there are chances of stocking up the unused or expired drugs at home. It is important to provide practical and scientific guidelines for the safe disposal of expired, unused, and leftover medications. Most developing countries lack standard guidelines for the safe disposal of expired, unused, and leftover medications. There are very few studies conducted in this region to assess the knowledge of the safe disposal of unused drugs. Aims and Objectives: The present study was undertaken to assess the knowledge, attitude, and practice of disposal of unused or expired medications. Materials and Methods: This was cross-sectional, questionnaire-based study conducted among 2nd year undergraduate medical students at a Medical College in South India. The questionnaire included three parts: Part I includes demographic details of the students and questions on knowledge of safe disposal of expire/unused drugs, Part II includes questions on attitude towards the safe disposal of expired/unused drugs, and Part III includes questions on practices toward the safe disposal of expired/unused drugs. The responses received from the participant was analyzed using Microsoft Excel (2019 version), and the results are explained in frequency and percentage. Results: A total of 118 2nd year medical undergraduate students participated in the present study. Out of 118, 62 (52.5%) were female students and 56 (47.4%) were male students. Among all the participants, 98 (83%) of students said that they are aware of medicinal waste. In the present study, 73 (61.8%) students knew about the safe disposal of unused, expired, and leftover medications. Most of the students (93.2%), agreed that unsafe disposal of unused, expired, and leftover medications would adversely affect the environmental, animal as well as human health. And 50% of the students, strongly agreed that educational activities like drug take-back programs should be introduced among the public people. When the students were asked about their practice of keeping expired, unused, or left-over drugs at home, 66.1% (78) of the students said yes and 47.2% (40) of the students said they do not keep the leftover medicine at home. Topical formulations (63.5%) were the most common group of drugs that were stored. The majority of students (73%) reported that they would throw unused/expired medications in dust bins at home. Self-discontinuation is most the common reason for storing drugs in the majority of the study participants (39%). Conclusion: In the present study, the 2nd-year medical undergraduate students had awareness regarding the harmful events associated with improper disposal of unused or expired drugs. But due to lack of information or knowledge of safer methods available, majority of the students were following inappropriate methods for disposing leftover or expired medication at home. Indian Government should provide national level guidelines and conduct awareness programs, mediated through healthcare professionals to bring significant changes about the disposal of unused or expired medications.

Towards automated construction for safe disposal of materials waste in the Egyptian construction industry

The solid waste management (SWM) represents one of the most important challenges worldwide in the current period. Also, it contributes to large negative effect on the three aspects of sustainability which are environmental, social and economic sustainability. Approximately 50% of total annual global generated solid waste (SW) is from construction and demolition waste (CDW). The case of CDW in Egypt has become a major challenge, and Egypt encounters many challenges that obstacle the way for development of efficient SWM especially towards ensuring safe disposal of CDW. This paper aims to investigate: (1) the rising problem related to SW in Egypt showing its main causes; (2) CDW percentages in greater Cairo; (3) the unsafe disposal of CDW waste in Egypt through reviewing most recent research papers; and (4) automation in construction techniques that were previously implemented for better CDW management (CDWM). Findings and recommendations of CDWM improvement in Egypt from this study are expected to encourage research on automated construction technique towards ensuring safe disposal of CDW in Egypt which would be of great effect towards improving sustainability levels in the Egyptian construction sector.

Behavioral and environmental determinants of acute diarrhea among under-five children from public health facilities of Siyadebirena Wayu district, north Shoa zone, Amhara regional state, Ethiopia: Unmatched case-control study.

Acute diarrhea is a major public health problem in the world. Next to pneumonia, it is the leading cause of death in children under five years old. Globally, even though childhood diarrhea disease kills millions, the interaction of socio-demographic, behavioral, and environmental factors of acute diarrhea in children aged 6-59 months is not investigated yet in the current study area. To determine behavioral and environmental predictors of acute diarrhea among under-five children from public health facilities of Siyadebirena Wayu district, North Shoa, Amhara Regional State, Ethiopia, 2019. A facility-based unmatched case-control study was conducted from March 12, 2019, to May 12, 2019. A total of 315 under-five children were included in the study (105 cases and 210 controls). A systematic random sampling technique was used to select study participants. Data were collected by a structured questionnaire and analyzed by using SPSS. To analyze the data, bivariable and multivariable logistic regression analysis was used. The study showed that average family monthly income of 12-23 USD (AOR = 6. 22; 95% CI: 1.30, 29.64), hand washing practice of mothers/ care givers with water only (AOR = 3.75; 95% CI: 1.16, 12.13), improper disposal of infant feces (AOR = 11.01; 95% CI: 3.37, 35.96), not treating drinking water at home (AOR = 9.36; 95% CI: 2.73, 32.08), children consuming left-over food stored at room temperature (AOR = 5.52; 95% CI: 1.60, 19.03) and poor knowledge of the respondents about the risk factors for diarrhea were the determinants that significantly associated with acute childhood diarrhea. The potential predictors of childhood diarrhea morbidity were improper hand-washing practice, not treating drinking water at home, unsafe disposal of children's feces, children consuming left-over food stored at room temperature, and having poor knowledge about the major risk factors for diarrhea. Thus, awareness of the community on hygiene and sanitation focusing on proper handling of human excreta, safe water handling, proper hand washing practice, and proper management of leftover food should be enhanced to prevent children from acute diarrhea diseases.

The puzzle of garbage disposal in India

Safe garbage disposal is a challenge for every developing country. In India it’s become further difficult due to massive urbanization, poverty and population density. Lack of fund with municipalities and ill defined property rights offer an easy solution to poor households to throw the un-segregated waste in nearby drains/streets/open areas. This unsafe disposal of garbage is creating a challenge to environment by emitting high emission, marine life by choking rivers and sea, creating health externalities and even impacting tourism. Hence garbage disposal in sustainable way is taken care while drafting sustainable development goals. SDG 11.6 is specifically focused on working towards Sustainable cities and communities. To achieve this SDG, it is necessary to reducing the adverse per capita environment impact of cities. This can’t be achieving without the help of safe disposal of garbage. The current paper is focused on the behaviour of garbage disposal by Indian households and how it can be harmful for their own health. To achieve this aim, the study will be using NSS 76th round survey on “Drinking Water, Sanitation, Hygiene and Housing Condition.

Determinants of Unsafe Plastic Waste Disposal among Households in the Tamale Metropolitan Area, Ghana.

Background The global discourse on plastic waste generation and disposal has over the last two decades, gained traction with the aid of research-based evidence. Though observed globally, the situation is quickly deteriorating in developing countries such as Ghana. In Ghana and Africa as a whole, rapidly increasing population and rural to urban migration have been cited as factors that exacerbate the existing struggles with plastic pollution. This study aimed at identifying the determinants of unsafe plastic waste disposal among households. Methods The study was carried out in three communities in Tamale in the Northern Region of Ghana. Data were collected from 270 randomly selected households through household surveys, key informant interviews, and direct field observations. Results The study revealed that the majority (63.3%) of the total respondents used and disposed of their plastic waste “unsafely.” The analysis showed that the education level and household wealth were significant determinants of unsafe plastic disposal. Conclusion The study concludes that challenges of plastic waste management are not limited to economic, technical, and institutional factors, but social factors such as human behavior are key aspects of waste management that need attention. The study, therefore, recommends strict enforcement of sanitation by-laws, promotion of education, and provision of alternatives to plastics that will minimize the need for importing and manufacturing plastics, as potential steps towards addressing unsafe disposal of plastics in the domestic environment.

The potential for diversion of prescribed opioids among orthopaedic patients: Results of an anonymous patient survey.

Diversion of prescription opioid medication is a contributor to the opioid epidemic. Safe handling practices can reduce the risk of diversion. We aimed to understand: 1) if orthopaedic patients received instructions on how to safely handle opioids, 2) their typical storage/disposal practices, and 3) their willingness to participate in an opioid disposal program (ODP). Cross-sectional study of adult orthopaedic patients who completed an anonymous survey on current or past prescription opioid use, instruction on handling, storage and disposal practices, presence of children in the household, and willingness to participate in an ODP. Frequencies and percentages of responses were computed, both overall and stratified by possession of unused opioids. 569 respondents who reported either current or past prescription opioid use were analyzed. 44% reported receiving storage instructions and 56% reported receiving disposal instructions from a health care provider. Many respondents indicated unsafe handling practices: possessing unused opioids (34%), using unsafe storage methods (90%), and using unsafe disposal methods (34%). Respondents with unused opioids were less likely to report receiving handling instructions or using safe handling methods, and 47% of this group reported having minors or young adults in the household. Respondents who received storage and disposal instructions were more likely to report safe storage and disposal methods. Seventy-four percent of respondents reported that they would participate in an ODP. While many orthopaedic patients report inadequate education on safe opioid handling and using unsafe handling practices, findings suggest targeted education is associated with better behaviours. However, patients are willing to safely dispose of unused medication if provided a convenient option. These findings suggest a need to address patient knowledge and behavior regarding opioid handling to reduce the risk of opioid diversion.

At your disposal: A pilot for safely discarding medication in postoperative patients

BackgroundThe improper storage of and unsafe disposal methods for leftover and expired prescription medication represent a risk for diversion, misuse, and other public health issues. Health care providers are well positioned to offer education and resources for the safe disposal of medication. ObjectivesA quality improvement pilot was constructed to provide education and a medication disposal packet to patients who received a prescription for an opioid on discharge from Emory University Orthopaedics and Spine Hospital after surgery. Objectives were to assess the packet’s utility and to determine whether proximity of existing community takeback bins had any effect on packet usage. MethodsFive weeks after discharge, patients received an automated phone call to evaluate their use of the disposal packet. Call responses were the primary data point for determining success, with a goal of greater than 50% packet use. Demographic data were collected retrospectively to assess the count of medication disposal bins within the patient’s ZIP Code. ResultsOf a total of 532 unique patients, 239 responded to the automated survey, indicating how they planned to use the disposal packet provided to them on discharge. Of the 239 responses, 150 (63%) patients either used or planned to use the packet. In addition, a chi-square test of independence and a z test for the difference in proportion of packets used showed that the existence of 2 or more community takeback bins per ZIP Code was associated with packet nonuse (P < 0.05). ConclusionPublic health resources can help address medication disposal issues that contribute to environmental contamination, opioid misuse, overdose, and death. Emory University Orthopaedics and Spine Hospital outpatients have a need for safe medication disposal initiatives and education, especially in communities with fewer existing means.

Multi-Faceted Role of Silver and Gold Nanoparticles Synthesized from Biowaste and its in vitroAntibacterial, Antifungal and Antidiabetic Activities

Increasing global fish production, increasing the amount of waste generated, unsafe disposal of waste tissues like head, bones, skin, scales, fins etc., into land and open water reservoirs leads to environmental pollution. The role of nanobiotechnology in biowaste management is an innovative strategy to handle environmental issues. This study synthesized silver and gold nanoparticles from prawn heads using one millimolar AgNO3 and HAuCl4. Biosynthesized nanoparticles were characterized by UV -Visible spectroscopy, XRD, FTIR, SEM and EDAX. The maximum absorption spectrum was monitored at 437 nm for silver and 552 for gold nanoparticles. Antimicrobial activity was assessed using the resazurin assay method. MIC values obtained for the tested organisms revealed antimicrobial activities. P aeruginosa, K. pneumoniae, showed MIC at 15.6 µg for silver nanoparticles, and A. niger, A.flavus and C.albicans showed MIC at 125 µg for gold nanoparticles synthesized from the prawn head extract. IC 50 values of α- amylase activity were found to be 296 and 356 µg/ml for the silver and gold nanoparticles, respectively. IC50 values are about 705 and 2475 µg/ml for the silver and gold nanoparticles, respectively, in α-glucosidase activity. Conclusively silver and gold nanoparticles synthesized from prawn head extract (PHE) showed antibacterial, antifungal, and antidiabetic activities.

Prevalence and Determinants of Diarrheal Diseases among Under-Five Children in Horo Guduru Wollega Zone, Oromia Region, Western Ethiopia: A Community-Based Cross-Sectional Study

Background Diarrheal diseases are the leading cause of preventable death, especially among under-five children in developing countries, including Ethiopia. Although efforts have been made to reduce the morbidity and mortality resulting from diarrheal diseases, there is scarce information on the progress of the interventions against the burdens. Therefore, this study aimed to assess the prevalence of diarrhea and its associated factors in under-five children in Horo Guduru Wollega Zone, Oromia Region, Western Ethiopia. Methods A community-based cross-sectional study was conducted. Of 12,316 households, 620 households that had under-five children were selected by simple random sampling technique from randomly selected kebeles. Before data collection, a pretest of the structured questionnaires was done on nonselected kebeles. Binary logistic regression was used to assess the association of the diarrheal diseases with independent variables. Finally, the odds ratio along with a 95% confidence interval was used to report the significant association between the outcome variable and its associated factors. A P value of ≤0.05 was considered statistically significant Results The prevalence of diarrhea among under-five children was 149 (24%) (95% CI: 20.8, 27.3). Diarrhea was significantly associated with poor knowledge of mothers/caretakers on diarrhea prevention methods (AOR: 2.05, 95% CI (1.14, 3.69), being in the age group of 6–11(AOR = 1.546 (1.68, 3.52), and 12–23 months (AOR = 1.485 (1.84, 2.63)), families with poor wealth index (AOR: 2.41, 95% CI (1.29, 4.51)), children who were not vaccinated against measles (AOR: 4.73, 95% CI (2.43, 9.20)), unsafe child feces disposal (AOR = 3.75; 95% CI (1.91, 7.39)), inappropriate liquid waste disposal (AOR = 3.73 (1.94, 7.42)), and having two or more siblings (AOR: 3.11, 95% CI (1.81, 5.35)). Conclusion and Remarks. The prevalence of diarrhea among under-five children was high. There was a statistically significant association between diarrhea and age of the child (6–11 and 12–23), poor knowledge of mothers/caretakers on diarrhea prevention methods, families with poor wealth index, being unvaccinated against measles, improper liquid waste disposal, unsafe child feces disposal, and having at least two siblings. The findings have a significant policy inference for childhood diarrheal disease prevention programs. Therefore, educating mothers/caregivers on diarrheal disease prevention methods, child spacing, regular hand washing practice after disposing child feces, safely disposing liquid waste, and vaccinating all eligible children against measles should be a priority area of intervention for diarrheal disease prevention. Moreover, since these associated factors are preventable, the government needs to strengthen the health extension workers program implementations to reduce childhood diarrhea.