World Public Health Research Articles

Neurodevelopment in Preterm Neonates: A Comprehensive Approach to Quality of Life

Introduction: Prematurity constituted a significant challenge for world public health, being one of the main causes of neonatal mortality. The admission of preterm newborns (PNBs) to neonatal intensive care units (NICU) represented a crucial solution for their survival, although it implied separation from their families and exposure to adverse stimuli. In this context, Neurodevelopmental Centered Care (NCC) emerged as an innovative strategy that reorganized neonatal care towards a more humanized and patient-centered model.Development: NCC integrated practices such as the kangaroo method, non-pharmacological pain management and the active participation of families, promoting an environment that favored the neurodevelopment of the premature infant. These strategies demonstrated benefits such as reduced hospital stay and improved long-term neurological outcomes. However, their implementation was heterogeneous, facing barriers such as lack of specialized training, limited resources and resistance to change in health care teams. Models such as NIDCAP and the integrative approach of Altimier and Phillips offered effective frameworks to guide this care.Conclusions: The CCN was shown to be a key tool for improving the quality of life of RNP and their families. However, its mass adoption will require a coordinated effort that includes ongoing training, inclusive public policies, and adequate resources. The integration of families and an adapted NICU environment emerged as fundamental pillars for the success of this strategy

Clinical and angiographic characteristics of patients with familial hypercholesterolemia presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Familial hypercholesterolemia (FH) is a world public health problem that enhances the risk of premature coronary artery disease (CAD) with a high incidence of acute coronary syndrome. This study aimed to evaluate the clinical and angiographic characteristics of the patients with and without FH who had ST-elevation myocardial infarction (STEMI). It included 690 patients who presented with the first attack of STEMI and underwent primary percutaneous coronary interventions (PPCI). The patients were analyzed to diagnose FH according to the Dutch Lipid Clinic Network (DLCN) criteria. All angiograms were analyzed for the number of diseased vessels, Syntax score, thrombus burden grade, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade. The majority of patients were male (72.6%) with a mean age of 54 ± 12 years. Based on DLCN criteria, they were classified into unlikely/possible FH (86.1%) and probable/definite FH (13.9%) groups. Probable/definite FH patients were significantly younger, and higher incidence of males < 55 years compared with unlikely/possible FH patients (p < 0.001 for each). Moreover, probable/definite FH patients had a higher frequency of three-vessel disease (p = 0.007) and Syntax score (p < 0.001) with a moderate positive correlation with the DLCN score (r = 0.592, p < 0.001). Furthermore, probable/definite FH patients showed a higher thrombus burden and final TIMI slow/no-reflow when compared to the unlikely/possible FH patients (p = 0.006 and p = 0.027, respectively). Patients with probable/definite FH and LDL-C level were independent predictors of high thrombus burden besides males < 55 years, and the number of diseased vessels. In conclusion, STEMI patients with FH were younger males and associated with severe CAD with frequent multivessel CAD, high anatomical complexity of CAD, and frequent high thrombus burden. Furthermore, FH was one of the predictors of high thrombus burden.

Surgical Castration as an Alternative to Improve Systemic Treatment for Advanced Prostate Cancer: A Window of Opportunity for Developing Countries.

The Brazilian Public Health System (BPHS) serves approximately 71,730 patients with prostate cancer (PC) every year for which androgen deprivation therapy (ADT) is the primary treatment for patients with advanced hormone-sensitive prostate cancer (aHSPC). Androgen receptor pathway inhibitors (ARPIs) are not accessible through the BPHS. Using the BPHS as a model, this study assesses the long-term economic effect of surgical versus medical castration in aHSPC treatment to strategize cost reduction and the incorporation of ARPI in developing countries. Data of patients with aHSPC (ie, TxN1M0 ineligible for local treatment or TxNxM1) from the BPHS database were analyzed from January 1, 2011, to December 31, 2021, using the TECHTRIALS artificial intelligence platform. The main outcomes were quantitative and descriptive analyses as well as a cost analysis of surgical versus chemical castration. Of the 274,519 patients with aHSPC who received active treatment during the 11-year study period, 90% (n = 246,683) underwent chemical castration and 10% (n = 27,836) underwent bilateral subcapsular orchiectomy (BSO). The median duration of chemical castration was 28 months. The BPHS spent an estimated total of $665,552,091.40 US dollars (USD) on chemical castration and $5,939,348.47 USD on BSO, respectively. The cost per patient was $2,698 USD and $213.37 USD for chemical castration and BSO, respectively. Hypothetically, if all patients with aHSPC had undergone BSO, the total direct cost for the BPHS would have been $42,774,832.20 USD, saving $622,777,259.20 USD over 11 years, making it possible to offer low-dose abiraterone to 65% of aHSPC patients. On the basis of this extensive financial analysis from the world's largest public health system database, BSO appears to be a valuable alternative to chemical castration for treating aHSPC. In resource-limited environments, the cost savings from using BSO may allow access to drugs that will improve survival such as ARPIs.

Primary Care and Public Health - Both Essential for National Health Security and Population Health.

The COVID-19 pandemic was a stress test that revealed critical weaknesses in the foundation of the US health care delivery system, which left unresolved will ultimately lead to catastrophic population health consequences. Primary care and public health are the most fragile and important parts of that foundation. Collapse of either of these disciplines would lead to cascading failures harming the health of individuals and the health security of the nation. Primary care and public health are inextricably entwined as the cornerstones of health security and population health, and there is an urgent need to adequately fund both.As policy makers debate the importance of enhanced funding for either primary care or public health it would be good to consider the ways in which these disciplines are critical to securing the health of the nation as well as the ways in which they complement one another. Funding for both opens the door for greater integration that could build on the nascent synergies resulting in even stronger, more efficient and more sustainable foundation for the overall health care delivery system. Every day and in every corner of the world primary care and public health are already relying on each other in many ways. However, this relationship most often functions without formal acknowledgment. To better understand this intimate relationship, it is useful to first describe the core components of each.

The Glycemic Index of Gayam (Inocarpus fagifer Forst) Cookies as a High Dietary Fiber Food

The type 2 diabetes (T2D) is still one of the world's public health problems. It needs serious handling and prevention efforts in the nutritional aspect. The high prevalence of T2D is related to the low intake of dietary fiber. This type of food has a low glycemic index (GI). Gayam is a high-dietary fiber material that can be used for the manufacture of flour and as processed food material for the high-dietary fiber cookies. The objectives of this research were to study the GI evaluation of cookies from gayam flour. Cookies were tested for chemical composition, and glycemic index. The glycemic index evaluation test used 12 volunteers taken from the healthy group/nondiabetic, normal nutritional status (BMI: 18.5-22.9), and age 19-55 years. The results of this study indicate the dietary fiber content of gayam cookies was 4.57 g/100 g and included in the category of high dietary fiber food. The glycemic index of gayam cookies was 43 and the low glycemic index category. The obtained results show for the first time the potential of gayam cookies in hyperglycaemia management. The conclusion of this study was that gayam cookies has high dietary fiber content and low GI level. Gayam cookies can be used as an alternative snack to control blood glucose levels in the prevention of diabetes mellitus.

Trends in the impact of suicide compared to other external causes of death: From 1995 to 2020

BackgroundSuicide is one of the world's greatest public health problems. More than 700,000 people lose their lives to suicide every year. While funding for mental health waits to be increased, thousands of suicides occur every day. Material and methodsThis study aims to quantify the global impact of suicide compared to other external causes of death in terms of years of potential life lost (YPLL), and how this will change between 1995 and 2020. Our source of information is the World Health Organization (WHO) mortality database. We then use YPLL, a standard measure of premature mortality and burden of disease that brings precision to the assessment of the impact of different causes of death. This, combined with the compound annual growth rate (CAGR) as a way of expressing increase, gives us a better understanding of the real situation and trends of suicide compared to other external causes of death in different countries worldwide. ResultsBased on the available sources of information and the selection criteria, we obtained a sample of 69 countries. The CAGR for all causes per capita decreased over the observed period in 65 countries, and it increases in 4 countries. In contrast, the CAGR specifically for suicide decreased in 49 countries, while an increase was observed in 20 countries. ConclusionsPrevention of most external causes of mortality shows promising data in most countries. However, this is not the case for suicide. Thus, YPLL due to suicide have decreased to a comparatively lesser extent and have even increased in some countries, a very worrying situation that poses many clinical and epidemiological challenges.

Inhibition of the ATP synthase increases sensitivity of Escherichia coli carrying mcr-1 to polymyxin B.

Bacterial infections caused by multidrug-resistant (MDR) gram-negative strains carrying the mobile colistin resistance gene mcr-1 are serious threats to world public health due to the lack of effective treatments. Inhibition of the ATP synthase makes bacteria such as Staphylococcus aureus and Klebsiella pneumoniae more sensitive to polymyxin. This provides new strategies for treating infections caused by polymyxins-resistant bacteria carrying mcr-1. Six mcr-1-positive strains were isolated from clinical samples, and all were identified as Escherichia coli. Here we investigated several ATP synthase inhibitors, N,N'-dicyclohexylcarbodiimide (DCCD), resveratrol, and piceatannol, for their antibacterial effects against the mcr-1-positive strains combined with polymyxin B (POL). Checkerboard assay, time-kill assay, biofilm inhibition and eradication assay indicated the significant synergistic effect of ATP synthase inhibitors/POL combination in vitro. Meanwhile, mouse infection model experiment was also performed, showing a 5 log10 reduction of the pathogen after treatment with the resveratrol/POL combination. Moreover, adding adenosine disodium triphosphate (Na2ATP) could inhibit the antibacterial effect of the ATP synthase inhibitors/POL combination. In conclusion, our study confirmed that inhibition of ATP production could increase the susceptibility of bacteria carrying mcr-1 to polymyxins. This provides a new strategy against polymyxins-resistant bacteria infection.

Ten different viral agents infecting and co-infecting children with acute gastroenteritis in Southern Italy: Role of known pathogens and emerging viruses during and after COVID-19 pandemic.

Acute gastroenteritis (AGE) represents a world public health relevant problem especially in children. Enteric viruses are the pathogens mainly involved in the episodes of AGE, causing about 70.00% of the cases. Apart from well-known rotavirus (RVA), adenovirus (AdV) and norovirus (NoV), there are various emerging viral pathogens potentially associated with AGE episodes. In this study, the presence of ten different enteric viruses was investigated in 152 fecal samples collected from children hospitalized for gastroenteritis. Real time PCR results showed that 49.3% of them were positive for viral detection with the following prevalence: norovirus GII 19.7%, AdV 15.8%, RVA 10.5%, human parechovirus (HPeV) 5.3%, enterovirus (EV) 3.3%, sapovirus (SaV) 2.6%. Salivirus (SalV), norovirus GI and astrovirus (AstV) 1.3% each, aichivirus (AiV) found in only one patient. In 38.2% of feces only one virus was detected, while co-infections were identified in 11.8% of the cases. Among young patients, 105 were ≤5 years old and 56.0% tested positive for viral detection, while 47 were >5 years old with 40.0% of them infected. Results obtained confirm a complex plethora of viruses potentially implicated in gastroenteritis in children, with some of them previously known for other etiologies but detectable in fecal samples. Subsequent studies should investigate the role of these viruses in causing gastroenteritis and explore the possibility that other symptoms may be ascribed to multiple infections.

Psychometric properties of stigma and discrimination measurement tools for persons living with HIV: a systematic review using the COSMIN methodology

BackgroundThe development of antiretroviral therapy broadly extends the life expectancy of persons living with HIV (PLHIV). However, stigma and discrimination are still great threat to these individuals and the world's public health care system. Accurate and reproducible measures are prerequisites for robust results. Therefore, it is essential to choose an acceptable measure with satisfactory psychometric properties to assess stigma and discrimination. There has been no systematic review of different stigma and discrimination tools in the field of HIV care. Researchers and clinical practitioners do not have a solid reference for selecting stigma and discrimination measurement tools.MethodsWe systematically searched English and Chinese databases, including PubMed, EMBASE, CINAHL, Web of Science, PsycINFO, ProQuest Dissertations and Theses, The Cochrane Library, CNKI,, and Wanfang, to obtain literature about stigma and discrimination measurement tools that have been developed and applied in the field of HIV. The search period was from 1st January, 1996 to 22nd November 2021. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline (2018 version) was applied to assess the risk of bias for each involved study and summarize the psychometric properties of each tool. The modified version of the Grading of Recommendations Assessment, Development, and, Evaluation (GRADE) method was used to grade the evidence and develop recommendations.ResultsWe included 45 studies and 19 PROMs for HIV/AIDS-related stigma and discrimination among PLHIV. All studies had sufficient methodological quality in content validity, structural validity, internal consistency, and the hypothesis testing of structural validity. Limited evidence was found for cross-cultural validity, stability, and criterion validity. No relevant evidence was found concerning measurement error and responsiveness. The Internalized AIDS-related Stigma Scale (IARSS), Internalized HIV Stigma Scale (IHSS), and Wright's HIV stigma scale (WHSS) are recommended for use.ConclusionsThis study recommends three PROMs for different stigma and discrimination scenarios, including IARSS for its good quality and convenience, IHSS for its broader range of items, higher sensitivity, and greater precision, and WHSS for its comprehensive and quick screening. Researchers should also consider the relevance and feasibility of the measurements before putting them into practice.Systematic review registrationPROSPERO CRD42022308579

Possible Interaction Between Drugs for COVID19 And Cancer Therapy

At the end of 2019, a new disease was reported in Wuhan China and described such as severe acute respiratory syndrome (SARS). This new virus named SARSCoV-2 S is characterized by high infectivity among humans. Such disease can have no symptoms in some individuals, while in others can provoke flu like symptoms or acute respiratory distress syndrome, pneumonia, and death. At the end of January 2020, the World Health Organization and Public Health Emergency of International Concern declared a pandemic status. Many studies showed a high mortality rate in cancer patient infected by SARS-CoV-2 infection. In this context, the decision of a safe and effective treatment against COVID19 plays a crucial role crucial in these patients Therefore, important questions arose: Can the COVID19 therapies protect everyone and above all cancer patients? and which drug interactions can occur between cancer therapy and COVID19 treatment? In this regard, Covid-19 is a new disease and for this reason it will be necessary to modify constantly pharmacological treatment. In this scenario, the potential drug–drug interactions (DDI) in the cancer patients should be considered to evaluate the risks and benefits of drug combinations.

Deletion of the Mycobacterium tuberculosis cyp138 gene leads to changes in membrane-related lipid composition and antibiotic susceptibility.

Mycobacterium tuberculosis (Mtb), the main cause of tuberculosis (TB), has brought a great burden to the world's public health. With the widespread use of Mtb drug-resistant strains, the pressure on anti-TB treatment is increasing. Anti-TB drugs with novel structures and targets are urgently needed. Previous studies have revealed a series of CYPs with important roles in the survival and metabolism of Mtb. However, there is little research on the structure and function of CYP138. In our study, to discover the function and targetability of CYP138, a cyp138-knockout strain was built, and the function of CYP138 was speculated by the comparison between cyp138-knockout and wild-type strains through growth curves, growth status under different carbon sources, infection curves, SEM, MIC tests, quantitative proteomics, and lipidomics. The knockout of cyp138 was proven to affect the Mtb's macrophage infection, antibiotics susceptibility, and the levels of fatty acid metabolism, membrane-related proteins, and lipids such as triacylglycerol. We proposed that CYP138 plays an important role in the synthesis and decomposition of lipids related to the cell membrane structure as a new potential anti-tuberculosis drug target.

A Study of Methods for Predicting and Controlling Blood Glucose in Diabetic Patients

With the development of society and the improvement of people's living standard, diabetes has gradually become one of the world public health problems that endanger human life safety and affect the development of global economy. Type 1 diabetes is a chronic metabolic disorder that prevents the pancreas from producing insulin and requires lifelong treatment with daily insulin injections to prevent high blood sugar. The lack of insulin leads to the continuous high level of blood sugar in patients. The most important thing for patients is to monitor blood sugar changes and control blood sugar within the normal range. In this paper, a systematic literature search is carried out to study these two aspects, and key information such as the learning model adopted in the literature, the main results, the development of relevant technologies, and the limitations are summarized. From the perspective of glucose-insulin prediction model, due to the complex structure of physiological model, many parameters and difficult to identify, most of the modeling methods are data-driven. There is a great room for improvement in the research on how to mine and utilize existing models to effectively establish accurate glucose prediction models for different objects. From the perspective of control theory, after insulin injection, there is a certain delay in the reduction of blood glucose concentration, and the onset time is different depending on the injection site. The rapid development of deep learning and the increase in available data offer the possibility of addressing these challenges in the near future. When designing closed-loop glucose algorithms, consider using a variety of approaches to establish a personalized glucose control algorithm for each diabetic patient.

Deworming coverage and its determinants among 12-59 months old children in East Africa: A population-based study.

Intestinal parasitic infections are the world's largest public health issue, primarily in developing nations. The World Health Organization (WHO) recommends deworming as a preventative or therapeutic measure for all vulnerable people residing in endemic areas. Despite this issue, there is little data on the prevalence and associated factors of deworming drug use among children under five years of age in East Africa. This study aimed to evaluate the prevalence and contributing factors of deworming coverage among children under the age of five in East Africa using the most available national health survey data. Data from the Demographic and Health Survey, which included 103,865 weighted children between the ages of 12-59 months, were used in this investigation. Our outcome of interest was taking deworming medicine six months before the interview. A logistic regression model was then fitted. A cutoff P value of 0.2 was used in the binary logistic regression analysis. To identify significant variables, a 95% confidence interval and adjusted odds ratio (AOR) with a value < 0.05 were used. The prevalence of deworming in East Africa was 54.13% (95% CI: 53.83%-54.43%). The maternal age group of 24-34 years, and from 35-49 years (AOR = 1.37, 95% CI, 1.32,1.42), and (AOR = 1.71, 95% CI, 1.62,1.79), employed women (AOR = 1.62, 95% CI, 1.58,1.67), being from rural(AOR = 1.11,95% CI,1.07,1.15), unmarried mothers (AOR = 1.12,95% CI,1.09,1.15), mothers from poorer, middle, richer, and richest households (AOR = 1.16,95% CI, 1.12,1.21), (AOR = 1.23, 95% CI, 1.18,1.28), (AOR = 1.22,95% CI, 1.16,1.27), and (AOR = 1.27, 95% CI, 1.21,1.34) having at least one antenatal care follow up(AOR = 2.90, 95% CI, 2.63,3.16), health facility delivery(AOR = 1.69, 95% CI,1.64,1.75), mass media exposure AOR = 1.32, 955 CI, 1.29,1.36), having of 3-5 children (AOR = 0.89, 95% CI, 0.86,0.93), more than five children (AOR = 0.79, 95% CI, 0.73,0.86), and parity of 2nd or 3rd birth order (AOR = 1.05, 95% CI, 1.01,1.09) as compared to primi mothers were associated with the deworming among under five children in east Africa respectively. The under-five population in East Africa had a lower prevalence of deworming medication per the most recent DHS findings. Promoting mother and child health services (antenatal care, institutional delivery, family planning), as well as women's empowerment, should be prioritized.

Establishment of an Animal Model of Dog Bite Injuries.

Nowadays dog bite is becoming a world public health problem. Therefore, the study aimed to develop a dog bite animal model that is helpful to solve these problems. In this study, the skull of an adult dog was scanned. The three-dimensional model of the dog maxillofacial bones and dentition was built by MIMICS. Next, the model was printed with Co-Cr alloy by using selective laser sintering technology to develop the dog bite simulation pliers. Then, to simulate dog bite to most, the maximum bite force of the pliers was measured and actions contained in dog bite process was analyzed. Afterwards, according to action analysis results, rabbits were bitten by the prepared instrument in actions that simulate dog's bite. Finally, the reproducibility and controllability of this animal model of dog bite injuries was validated in an in vivo study. The results showed a reliable animal model of dog bite injuries has been developed in this study. The sites and severities of the injuries could be adjusted as the operator wishes and the animal model of dog bite injuries was highly repeatable. This study also indicates the feasibility of using digital technology in establishing animal bite models.

Biological Characteristics and Pathogenesis of Monkeypox Virus: An Overview.

Although the smallpox virus has been eradicated worldwide, the World Health Organization (WHO) has issued a warning about the virus's potential to propagate globally. The WHO labeled monkeypox a world public health emergency in July 2022, requiring urgent prevention and treatment. The monkeypox virus is a part of the Poxviridae family, Orthopoxvirus genus, and is accountable for smallpox, which has killed over a million people in the past. Natural hosts of the virus include squirrels, Gambian rodents, chimpanzees, and other monkeys. The monkeypox virus has transmitted to humans through primary vectors (various animal species) and secondary vectors, including direct touch with lesions, breathing particles from body fluids, and infected bedding. The viral particles are ovoid or brick-shaped, 200-250 nm in diameter, contain a single double-stranded DNA molecule, and reproduce only in the cytoplasm of infected cells. Monkeypox causes fever, cold, muscle pains, headache, fatigue, and backache. The phylogenetic investigation distinguished between two genetic clades of monkeypox: the more pathogenic Congo Basin clade and the West Africa clade. In recent years, the geographical spread of the human monkeypox virus has accelerated despite a paucity of information regarding the disease's emergence, ecology, and epidemiology. Using lesion samples and polymerase chain reaction (PCR), the monkeypox virus was diagnosed. In the USA, the improved Ankara vaccine can now be used to protect people who are at a higher risk of getting monkeypox. Antivirals that we have now work well against smallpox and may stop the spread of monkeypox, but there is no particular therapy for monkeypox.

Perspectives and Prospects on the Application of DNA Aptamer in SARS-CoV-2.

With the SARS-COV-2 spreading worldwide, COVID-19 has induced enormous disaster and challenges to the world public health since 2019. To development effective diagnostic and treatment methods for the SARS-CoV-2 is crucial for the control of the COVID-19 spreading. DNA aptamers, short single DNA oligonucleotides, have shown an immense application potential as molecular probes for early diagnosis and therapy of various diseases. Compared with antibodies, DNA aptamers are easier to synthesize, with high stability and low immunogenicity, which allows it to be widely and rapidly used in various bio-sensing and therapy to against COVID-19 since then. Thus, we here reviewed the development and prospected potential applications of DNA aptamers in diagnosis and treatment of SARS-COV-2.

The Validation of Beck's Depression Inventory in Patients With Systemic Diseases: A Psychometric Study at a Dental Institute.

Background Depression seriously threatens the world's public health, manifesting symptoms like loss of interest, fatigue, guilt, and impaired focus. Major depressive disorder is a common problem for those with chronic systemic illnesses. Since this illness has an impact on psychosocial well-being and interacts with anxiety and stress, it is crucial to assess psychological functioning. Depression-related issue has a negative impact on oral health and can cause cognitive dysfunction, social interaction problems, and low self-esteem. For the purpose of identifying and effectively managing depression in patients with systemic illnesses undergoing dental procedures, screening tools like the Beck's Depression Inventory (BDI) were used. The BDI's benefits include its strong internal consistency, sensitivity to change, broad concept validity, adaptable criteria validity for separating depressed and nondepressed people, and global dissemination. Materials and methods A cross-sectional prospectivestudy was carried out after receiving the necessary institutional ethical approvals, and the participant'sagreement was also obtained. The questionnaire was explained to the patients. The entire participation was voluntary. Results In the current study patient's agesranged from 34 years to maximum age of 83 years with a mean age of 59.70±13.16 years, with 40% of the population falling into the 51-65 years age group. According to the results, participants who had multiple systemic disorders were more likely to experience depression than people who had one systemic illness. The chi-square test showed no statistically significant results between the depression scores and the number of systemic diseases (p-0.574). Seventy-five per cent of individuals withdepression required tooth extractions. Conclusion Those with systemic disorders who were receiving dental care in the current study showed elevated levels of depression. An important finding was the correlation between depression and tooth extraction, highlighting the need for proactive mental health assessments in dental care. Tailored interventions can mitigate the impact, enhancing the holistic well-being of patients suffering from systemic diseases and depression.

Service-specific Readiness for Hypertension and Diabetes Care and Its Related Factors in Primary Health Facilities in Akwa Ibom State, Nigeria: A Comparative Service Availability and Readiness Assessment Study

Abstract Background: According to the global action plan of the World Health Organization (WHO), private and public health facilities (HFs) must possess at least 80% of affordable basic technologies and essential medicines to tackle the rising burden of hypertension and diabetes (H and D) globally. Literature regarding the realisation of this target is scarce in resource-poor settings like Nigeria. Objective: The objective of this study was to assess and compare the service-specific readiness for H and D care in selected urban and rural primary health-care (PHC) facilities in Akwa Ibom State, Nigeria. Materials and Methods: The WHO’s service availability and readiness assessment tool was adapted and deployed to assess readiness for H and D care in 214 PHCs randomly sampled from the entire 426 government-owned PHCs in the state. Results: A total of 214 PHCs were surveyed (urban, 51.4%). Overall, more urban than rural PHCs had essential drugs (4.8% vs. 0.9%), laboratory equipment (81.7% vs. 76.4%), and were ready for H and D care (23% vs. 11%). Availability of drug-revolving funds (odds ratio [OR] = 4.09; 95% confidence interval [CI] = 1.03–1.12) and the number of health workers (OR = 1.08; 95% CI = 1.03–1.33) were significantly associated with readiness. Conclusion: The level of readiness for H and D care was low in both urban and rural primary HFs. The correlates found to be associated with the readiness for H and D care are the availability of drug-revolving funds and the number of health workers.

In-silico genomic characterization of Staphylococcus haemolyticus on a global scale: lineages, resistome, and virulome

BackgroundStaphylococcus haemolyticus belongs to the Coagulase-Negative Staphylococci (CoNS), exhibiting the highest levels of antibiotic resistance within this group of bacteria. This species has been increasingly implicated in nosocomial and animal infections worldwide, with a prevalence of methicillin-resistant Staphylococcus haemolyticus (MRSH). Most information about this organism comes from regional analyzes or with the absence of typing data, thus not revealing the real role of S. haemolyticus strains in world public health. MethodsHere, we performed an enhanced global epidemiological analysis considering all available S. haemolyticus genomes from all continents, including genomes of nosocomial, environmental, and animal origin (n = 310). Furthermore, we added original genomic information from a clinical MRSH from the Brazilian Amazon region. The resistome and virulome of the genomes were associated with their mobilome, being inferred based on the presence of specific genes and databases such as CARD, VFDB, and PlasmidFinder, respectively. ResultsPhylogenetic analysis revealed three main groups, the main one covering most of the clinical clonal complex 3 (CC3) genomes in the world. The virulome of some genomes in this cluster showed the complete capsule operon (capA-capM). Importantly, this virulome trait could be associated with the mobilome, since the capsule operon, as well as a whole set of genes of the type VII secretion system, were observed in plasmids. In addition, the resistome of the main cluster (CC3) was larger, characterized mainly by the presence of the mecA gene, in addition to a set of other genes (aad, aac-aph, aph, erm), contrasting with the poor resistome of the other two clusters. Several insertion sequences were identified, some of them linked to specific clusters, and resistance genes, such as the rare cfrA (IS257). ConclusionsTherefore, successful lineages of CC3 S. haemolyticus causing human infections are widespread worldwide, raising concern about the impact of this scenario on public health.

SPIRITUALITY AS A TOOL IN COPING WITH COVID-19

COVID-19, in March 2020, was characterized as a pandemic, being a great challenge to the world public health, causing traumatic impacts on the mental health of the population, especially the elderly. Spirituality has presented itself as a relevant tool in the understanding of suffering and in the re-signification of life, especially for those who have adhered to social isolation or have been contaminated by the coronavirus. In this sense, the following question arose: Can spirituality contribute to the confrontation of the impacts of COVID-19 on the mental health of the elderly population? Thus, the present study aimed to investigate the contributions of spirituality to the mental health of the elderly in coping with COVID-19. For this, an integrative review was carried out with a qualitative approach during the period from March to September/2021. The articles were selected from the PUBMED, LILACS and Google Academic databases. As a result, 4084 articles were found; however, only 6 articles answered the research question, which became the final sample size. In this study, it was identified that spirituality contributes beneficially to the mental health of the elderly in facing the pandemic of COVID-19, suggesting that it minimizes possible negative impacts on their mental health, such as social isolation, awakening and strengthening feelings of hope, peace, comfort, faith, resilience and well-being, helping in the quality of life of individuals more vulnerable to the coronavirus, during and after the pandemic, in people over 60 years of age. Therefore, this study can direct the planning of actions in mental health, aiming at the application of spirituality as an aid tool in the treatment of COVID-19, mainly in the elderly.