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Aim: Workers who are satisfied with their job are the cornerstones of healthy and productive companies. This study investigated factors associated with job satisfaction in the general working population. Methods: From the 2010 round of the Danish Work Environment Cohort Study, currently employed wage earners (N=10,427) replied to questions about work, lifestyle and health. Multinomial logistic regression controlled for sex, age, job group, smoking, body mass index, chronic disease and general health assessed the association between work factors and job satisfaction (very satisfied and satisfied, respectively, with unsatisfied as reference). Results: Psychosocial work factors - social support from superiors, social support from colleagues and influence at work - had the strongest association with job satisfaction. For example, for high social support from superiors, the odds ratio (OR) for being very satisfied with the job was 12.35 (95% confidence interval [CI] 8.71-17.51). With sedentary work as reference, the OR for being very satisfied with the job for 'standing and walking work that is not strenuous' was 1.57 (95% CI 1.06-2.33), while the opposite was seen for 'heavy and strenuous work' with an OR of 0.34 (95% CI 0.18-0.62). Only two out of five types of workplace health-promotion offers (physical exercise and healthy diet) were associated with job satisfaction. For example, for offers of physical exercise the OR for being very satisfied with the job was 1.84 (95% CI 1.33-2.55). Conclusions: While psychosocial work factors and to some extent physical work demands are important for job satisfaction, workplace health-promotion offers appear to play a minor role. © Associations of Public Health in the Nordic Countries Regions.

Objectives The purpose of this survey was to explore physicians' opinions to identify an adequate time range for clinical information to be provided with a referral that would help minimize wasteful retesting. Methods In 2011, we conducted a questionnaire survey of 193 physicians. Examining the degree of utilization of provided medical information, we determined the range of clinical information of referral documents. Results Less than three months of prescription history and blood sample test results in patient referral was most frequent. Less than one year of image information was most frequent. Most doctors answered there is no need to repeat the same type of blood test in their institute when they had information less than half a month old. Less than half to one month of image information was most frequent. Also, it appeared many doctors think “fundamentally they do not change their mind from their own medical department standpoint.” At the actual site, those who would even review referral clinical notes accounted for about 30% of all participants. Conclusions Medical referral eventually takes place after the establishment of mutual communication and should consider the workflow and system environment of the receiver of the information.

International policy for treatment of multidrug- and rifampin-resistant tuberculosis (MDR/RR TB) relies largely on individual patient data (IPD) from observational studies of patients treated under routine conditions. We prepared guidance on which data to collect and what measures could improve consistency and utility for future evidence-based recommendations. We highlight critical stages in data collection at which improvements to uniformity, accuracy, and completeness could add value to IPD quality. Through a repetitive development process, we suggest essential patient- and treatment-related characteristics that should be collected by prospective contributors of observational IPD in MDR/RR TB.

Background Community-based HIV testing services combined with the use of point-of-care tests (POCT) have the potential to improve early diagnosis through increasing availability, accessibility and uptake of HIV testing. Aim To describe community-based HIV testing activity in Catalonia, Spain, from 1995 to 2018, and to evaluate the impact of HIV POCT on the HIV continuum of care. Methods A community-based network of voluntary counselling and testing services in Catalonia, Spain has been collecting systematic data on activity, process and results since 1995. A descriptive analysis was performed on pooled data, describing the data in terms of people tested and reactive screening test results. Results Between 1995 and 2018, 125,876 HIV tests were performed (2.1% reactive). Since the introduction of HIV POCT in 2007, a large increase in the number of tests performed was observed, reaching 14,537 tests alone in 2018 (1.3% reactive). Men who have sex with men (MSM), as a proportion of all people tested, has increased greatly over time reaching 74.7% in 2018. The highest percentage of reactive tests was found in people who inject drugs followed by MSM. The contribution of community-based HIV testing to the overall total notified cases in the Catalonia HIV registry has gradually increased, reaching 37.9% in 2018, and 70% of all MSM cases. In 2018, the percentage of individuals with a reactive screening test who were linked to care was 89.0%. Conclusion Our study reinforces the important role that community-based HIV POCT has on the diagnosis of HIV in key populations.

There is now an extensive literature on the adverse effect of petroleum wealth on the political, economic and social well-being of a country. In this study we examine whether the so-called resource curse extends to the health of children, as measured by under-five mortality. We argue that the type of revenue available to governments in petroleum-rich countries reduces their incentive to improve child health. Whereas the type of revenue available to governments in petroleum-poor countries encourages policies designed to improve child health. In order to test that line of argument we employ a panel of 167 countries (all countries with populations above 250,000) for the years 1961–2011. We find robust evidence that petroleum-poor countries outperform petroleum-rich countries when it comes to reducing under-five mortality. This suggests that governments in oil abundant countries often fail to effectively use the resource windfall at their disposal to improve child health.

Objective To compare the birth characteristics of Syrian refugees with those of Turkish citizens. Methods In a retrospective study, data were obtained for singleton live births that occurred at a hospital in Bursa, Turkey, between June 1 and December 31, 2015. All Syrian refugees were eligible for inclusion; one Turkish citizen was included for each refugee. Results Overall, 545 Syrian refugees and 545 Turkish citizens were included. Cesarean delivery was undertaken for 176 (32.3%) Syrians and 235 (43.1%) Turks (P

Background: Nano-specific inhalation exposure models could potentially be effective tools to assess and control worker exposure to nano-objects, and their aggregates and agglomerates (NOAA). However, due to the lack of reliable and consistent collected NOAA exposure data, the scientific basis for validation of the existing NOAA exposure models is missing or limited. The main objective of this study was to gain more insight into the effect of various determinants underlying the potential on the concentration of airborne NOAA close to the source with the purpose of providing a scientific basis for existing and future exposure inhalation models. Method: Four experimental studies were conducted to investigate the effect of 11 determinants of emission on the concentration airborne NOAA close to the source during dumping of ~100% nanopowders. Determinants under study were: nanomaterial, particle size, dump mass, height, rate, ventilation rate, mixing speed, containment, particle surface coating, moisture content of the powder, and receiving surface. The experiments were conducted in an experimental room (19.5 m3) with well-controlled environmental and ventilation conditions. Particle number concentration and size distribution were measured using real-time measurement devices. Results: Dumping of nanopowders resulted in a higher number concentration and larger particles than dumping their reference microsized powder (P < 0.05). Statistically significant more and larger particles were also found during dumping of SiO2 nanopowder compared to TiO2/Al2O3 nanopowders. Particle surface coating did not affect the number concentration but on average larger particles were found during dumping of coated nanopowders. An increase of the powder's moisture content resulted in less and smaller particles in the air. Furthermore, the results indicate that particle number concentration increases with increasing dump height, rate, and mass and decreases when ventilation is turned on. Discussion: These results give an indication of the direction and magnitude of the effect of the studied determinants on concentrations close to the source and provide a scientific basis for (further) development of existing and future NOAA inhalation exposure models. Chemicals/CAS: silicon dioxide, 10279-57-9, 14464-46-1, 14808-60-7, 15468-32-3, 60676-86-0, 7631-86-9; Air Pollutants, Occupational; Silicon Dioxide

The patients with non small cell lung cancer (NSCLC) treated with definitive conformal radiotherapy (RT) were evaluated in terms of side effects and survival. Normal tissue complication probability (NTCP) was calculated for 68 patients treated between 2009 and 2012. Clinical and dosimetric factors were analyzed. The median dose of 63 Gy (range: 54 to 70 Gy) was given with conformal RT with blocks (n = 37), 3-dimensional conformal RT (3DCRT) (n =11), or intensity-modulated RT (IMRT) (n = 20). Acute grade 1 to 2 radiation pneumonitis (RP) was seen in 13% of the patients. No significant relationship was found between RP and treatment and dosimetric factors (p > 0.05). There was a positive correlation between median "mean lung dose" (MLD) (17 Gy), lung V30 (20.5%), and NTCP (14%) (p < 0.001). Median and 2-year overall survival (OS) and progression-free survival (PFS) were 27 and 18 months and 51% and 42%, respectively. In univariate analysis, significant dose range for survival was found between 59.4 and 63 Gy (p < 0.01). In multivariate analysis, response (p = 0.001), fraction dose of 1.8 Gy (p = 0.002), MLD 59.4 Gy (p = 0.01), and tumor biologically effective dose (BED)3(Gy) 5100.8 (p = 0.01) for PFS were found to be favorable factors. In our study, we found a linear correlation between NTCP and MLD for RP risk estimation in patients with NSCLC. Therapeutic dose range where MLD can be kept under 20 Gy with significant survival benefit was found between 59.4 and 63 Gy. Increased therapeutic efficacy will be possible using risk-adaptive RT techniques.

OBJECTIVES: Sepsis generates significant global acute illness burden. The international variations in sepsis epidemiology (illness burden) have implications for region specific health policy. We hypothesised that there have been changes over time in the sepsis definitional elements (infection and organ dysfunction), and these may have impacted on hospital mortality.DESIGN: Cohort study.SETTING: We evaluated a high quality, nationally representative, clinical ICU database including data from 181 adult ICUs in England.PATIENTS: Nine hundred sixty-seven thousand ive hundred thirty-two consecutive adult ICU admissions from January 2000 to December 2012.INTERVENTIONS: None.MEASUREMENTS AND MAIN RESULTS: To address the proposed hypothesis, we evaluated a high quality, nationally representative, clinical, ICU database of 967,532 consecutive admissions to 181 adult ICUs in England, from January 2000 to December 2012, to identify sepsis cases in a robust and reproducible way. Multinomial logistic regression was used to report unadjusted trends in sepsis definitional elements and in mortality risk categories based on organ dysfunction combinations. We generated logistic regression models and assessed statistical interactions with acute hospital mortality as outcome and cohort characteristics, sepsis definitional elements, and mortality risk categories as covariates. Finally, we calculated postestimation statistics to illustrate the magnitude of clinically meaningful improvements in sepsis outcomes over the study period. Over the study period, there were 248,864 sepsis admissions (25.7%). Sepsis mortality varied by infection sources (19.1% for genitourinary to 43.0% for respiratory; p < 0.001), by number of organ dysfunctions (18.5% for 1 to 69.9% for 5; p < 0.001), and organ dysfunction combinations (18.5% for risk category 1 to 58.0% for risk category 4). The rate of improvement in adjusted hospital mortality was significant (odds ratio, 0.939 [0.934-0.945] per year; p < 0.001), but showed different secular trends in improvement between infection sources.CONCLUSIONS: Within a sepsis cohort, we illustrate case-mix heterogeneity using definitional elements (infection source and organ dysfunction). In the context of improving outcomes, we illustrate differential secular trends in impact of these variables on adjusted mortality and propose this as a valid reason for international variations in sepsis epidemiology. Our article highlights the need to determine standardized reporting elements for optimal comparisons of international sepsis epidemiology.

Background There is limited information about the hazards of cigarettes, smokeless tobacco and waterpipe in the Middle East. The aim of this study was to determine the association between different types of tobacco use and earlier death in the Golestan Cohort Study. Methods The Study includes 50 045 adults (aged 40– 75 years) from north eastern Iran. The baseline questionnaire (2004–2008) assessed information about use of cigarettes, chewing tobacco (nass) and waterpipe. To assess the use of each type of tobacco compared with never tobacco users, we used Cox regression models adjusted for age, socioeconomic status, area of residence, education and other tobacco used, and stratified by sex, ethnicity and opium use. Results 17% of participants reported a history of cigarette smoking, 7.5% chewing tobacco (nass) and 1.1% smoking waterpipe, and these figures declined in the later birth cohorts. During a median follow-up of 8 years, 4524 deaths occurred (mean age 64.8 +9.9 years). Current (HR=1.44; 95% CI 1.28 to 1.61) and former (HR=1.35; 95% CI 1.16 to 1.56) cigarette smokers had higher overall mortality relative to never tobacco users. The highest cigarette-associated risk was for cancer death among current heavy smokers (HR=2.32; 95% CI 1.66 to 3.24). Current nass chewing was associated with overall mortality (HR=1.16; 95% CI 1.01 to 1.34), and there was a 61% higher risk of cancer death in people chewing nass more than five times a day. We observed an association between the cumulative lifetime waterpipe use (waterpipe-years≥28) and both overall (HR=1.66; 95% CI 1.11 to 2.47), and cancer mortality (HR=2.82; 95% CI 1.30 to 6.11). Conclusions Regular use of cigarettes, smokeless tobacco and waterpipe were associated with the risk of earlier death (particularly from cancer) in our cohort. © 2017, BMJ Publishing Group. All rights reserved.

To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions—Healthcare Technology Management database. Two hundred and one healthcare organisations were included in our study. Our study revealed that on average, there are almost 14 biomedical technicians (BMETs) per clinical engineer and one FTE per 1083.72 devices (SD 545.69). The results of this study also revealed that the total number of devices and the total technology management hours devoted to these devices positively affects the number of FTEs in a CED, whereas the hospital complexity, measured by healthcare organisation patient discharges matters inversely. The most important factor that matters in the number of FTEs in CEDs was the total technology management hours devoted to devices. A value of explained variance (i.e. R2) of 85% was obtained, indicating the strong power of the prediction accuracy of our multivariate regression model. © 2016 Informa UK Limited, trading as Taylor and Francis Group.

The aim of this study was to investigate the association between cardiorespiratory fitness (CRF) and cardiovascular risk factors (CVRF) in schoolchildren. A secondary aim was to evaluate the degree of association between overall and abdominal adiposity and CRF in a total of 1,875 children and adolescents attending public schools. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption. A CVRF (Z score) was calculated and participants were divided into tertiles according to low and high levels of overall (sum of the skinfold thicknesses) and abdominal adiposity. Schoolchildren with a high-level of overall adiposity demonstrated significant differences in seven of the 10 variables analyzed (i.e., systolic and diastolic blood pressure, triglycerides, triglycerides/high density lipoproteins [HDL-c] ratio, total cholesterol, glucose, C-reactive protein [usCRP], HDL-c, low density lipoproteins [LDL-c], and cardiovascular risk score). Schoolchildren with high levels of both overall and abdominal adiposity and low CRF had the least favorable CVRF score. © 2016, © The Author(s) 2016.

The purpose of this study was to determine quality of life, leisure time satisfaction, activity performance, and community participation and analyze the relationship between these determinants and community participation in both physically disabled individuals working in industrial environments and nonworking individuals who are physically disabled. Sociodemographic data was registered into a sociodemographic form. World Health Organization Disability Assessment Schedule 2.0 was used to assess community participation. Activity performance was evaluated with Canadian Occupational Performance Measure. Leisure Satisfaction Scale was used to determine leisure time satisfaction. Short Form-36 was used for evaluating quality of life. When the participants were compared in terms of working status, a significant difference according to their WHO-DAS-II total scores were found (p 0.05). This study shows that community participation was affected by working status, disability level, activity performance, leisure time satisfaction and quality of life. In this regard, occupational therapy and physiotherapy approaches were found necessary for developing community participation. We conclude that this study's results can be used as a guide for community participation in disabled people in community based rehabilitation politics. © 2016 Taylor & Francis Group, LLC.

Polychlorinated biphenyls (PCBs) were measured in ambient air samples (n = 48) that were collected for a 2- to 3-day period in each season (winter, spring, summer, fall) of 2013. The samples were collected on the Campus of Uludag University, which is in a semirural region. The samples were collected using a high-volume air sampler. The gas and particle phase concentrations of 87 PCB congeners (I 87PCB) pound were measured in these samples. The average gas and particle phase concentrations of the I 87PCB pound were calculated to be 293 +/- 257 and 52 +/- 56 ng/m(3), respectively. However, the results of short-term measurements showed that the variation among the measurements in the gas phase was up to 39-fold and up to 84-fold in the particle phase. These results demonstrated that the ambient air PCB concentrations were not stable and changed dramatically on a daily basis. Therefore, it was clear that a small number of samples could not be representative of the entire region. Furthermore, the obtained concentrations showed differences that depended on the meteorological conditions and long distance transportation. The sampling indicated that PCB homologues with 3 or 4 chlorines were dominant.

Durch veränderte Kundenansprüche, wachsenden Konkurrenzdruck und gesetzliche Regelungen sind Krankenhäuser gezwungen, patientenorientiert und wirtschaftlich zu handeln. Damit sind Patientenzufriedenheitsbefragungen aus dem Alltag von Krankenhäusern nicht mehr wegzudenken. Die Stiftungsklinik in Weißenhorn, die sich nach dem Modell ISO 9001 zertifizieren lässt, führt jährlich eine Patientenzufriedenheitsbefragung durch. Diese Arbeit beschäftigt sich mit der Frage, ob die guten Zufriedenheitswerte, die das Krankenhaus erzielt, auch Auswirkungen auf das Image des Krankenhauses in der Weißenhorner Bevölkerung haben. Der Fokus liegt auf der Abteilung für Orthopädie, Unfall- und Wiederherstellungschirurgie der Stiftungsklinik Weißenhorn. Zur Klärung dieser Frage wurden zum einen die Patientenzufriedenheitsstudie der Stiftungsklinik Weißenhorn aus dem Jahr 2015 analysiert, zum anderen eine Umfrage in Weißenhorn im Jahr 2016 durchgeführt. Die Patientenzufriedenheitsstudie, die anonym und freiwillig erfolgt, ergab, dass eine hohe Zufriedenheit der Patienten vorliegt. 98,9% der Patienten würden das Krankenhaus weiterempfehlen. Allerdings war die Rücklaufquote mit 4,4% sehr gering. Die Umfrage in Weißenhorn, bei der 153 Personen befragt wurden, ergab, dass eine hohe Annehmbarkeit des Krankenhauses und der Abteilung vorliegt. 92,8% kannten die Klinik und die Abteilung, 82,4% würden sich dort behandeln lassen. Die Angebote der Abteilung waren weitestgehend nicht bekannt, über die Hälfte kannte nur 4 der 11 Angebote. Interessant war, dass viele der Befragten ihr Wissen über die einzelnen Angebote der Abteilung hatten, da sie selbst Patient waren. Am zweithäufigsten hatten sie die Kenntnis durch Bekannte, lediglich 3,3% waren durch die Medien darüber informiert. Die Homepage kannten nur 20,9%. Damit ermöglicht diese Arbeit drei Aussagen: 1) Die guten Zufriedenheitswerte spiegeln sich in der hohen Annehmbarkeit der Bevölkerung wieder. 2) Die niedrige Rücklaufquote der Patientenzufriedenheitsbefragung der Stiftungsklinik von 4,4 % ermöglicht keine gesicherte Aussage über tatsächliche Zufriedenheitswerte aufgrund einer non-response-bias und es müssten andere Methoden eingesetzt werden, um aussagekräftigere Werte zu erhalten. 3) Wichtiger als Informationsplattformen wie die Homepage des Krankenhauses, wo man beispielsweise den Qualitätsbericht findet, sind Bewertungen von Bekannten oder eigene Erfahrungen. Die Besonderheiten im Angebot der Klinik und der Abteilung waren weitgehend unbekannt. Daher muss der Kundenbegriff kritisch gesehen werden

Objective: To investigate evidence on the use of social networks to collect data in scientific productions in the health area. Material and method: An integrative literature review from primary studies indexed in the SciELO, PubMed, LILACS, Scopus, and Web of Science platforms. Results: 16 scientific articles were selected, of which nine focused on the use of WhatsApp; five, on the use of Facebook; and two, on employing Twitter to collect data in scientific productions. Growth was noted on the number of investigations associated to the use of social networks, although an important paradigm still exists related to the use to generate scientific evidence, resulting in a still low number of investigations on this theme. Conclusions: The health area needs to approach evermore the development of research associated to social networks, given that this would enable a viable and rapid intervention in obtaining responses, besides being a low cost and very promising tool for data collection. RESUMEN Objetivo: investigar las evidencias del uso de redes sociales para recolectar datos en producciones científicas en el área de salud. Material y método: una revisión integrativa de la literatura a partir de estudios primarios indexados en las plataformas SciELO, PubMed, LILACS, Scopus y Web of Science. Resultados: se seleccionaron 16 artículos científicos, de los cuales nueve se centraron en el uso de WhatsApp; cinco, en el uso de Facebook; y dos, en empleo de Twitter para recolectar datos en producciones científicas. Hubo crecimiento en el número de investigaciones asociadas al uso de redes sociales, aunque aún existe un gran paradigma relacionado a su uso para generar evidencia científica, lo que resulta en un número aún reducido de investigaciones en esta temática. Conclusiones: el área de la salud necesita acercarse cada vez más al desarrollo de investigaciones asociadas a las redes sociales, pues esto posibilitaría una intervención viable y rápida en la obtención de respuestas, además de ser una herramienta de bajo costo y bastante promisoria para la recolección de datos. RESUMO Objetivo: investigar as evidências da utilização de redes sociais para coleta de dados em produções científicas na área da saúde. Material e método: uma revisão integrativa da literatura a partir de estudos primários indexados nas plataformas SciELO, PubMed, LILACS, Scopus e Web of Science. Resultados: foram selecionados 16 artigos científicos, dos quais nove apresentaram foco na utilização do WhatsApp; cinco, no uso do Facebook; e dois, no emprego do Twitter para coleta de dados em produções científicas. Houve um crescimento no número de pesquisas associadas à utilização de redes sociais, embora ainda exista um grande paradigma relacionado ao uso para a geração de evidências científicas, o que resulta em um número ainda reduzido de pesquisas nessa temática. Conclusões: a área da saúde precisa aproximar-se cada vez mais do desenvolvimento de pesquisas associadas às redes sociais, pois isso possibilitaria uma intervenção viável e rápida na obtenção de respostas, além de ser uma ferramenta de baixo custo e bastante promissora para a coleta de dados.

ObjectiveTo investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation in preterm neonates during the first 3 days of life.DesignCase–control study.SettingNeonatal intensive care unit of the Wilhelmina Children’s Hospital, The Netherlands.Patients57 FGR (birth weight MethodsThe correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated.ResultsFGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016).ConclusionFGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.

Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the American Journal of Sports Medicine, followed by the Journal of Knee Surgery, Sports Traumatology, Arthroscopy at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction. Copyright © 2019 by Thieme MedicalPublishers, Inc.

The aim of this study was to estimate the prevalence of binge drinking by regions in Spain and assess the effect of individual and contextual factors related to this drinking pattern in adolescents. A cross-sectional study was performed with data from the 2014 Spanish School Survey on Drug Use (ESTUDES) in students aged 14-18 years (N = 34,259). The outcome was binge drinking in adolescents during the last 30 days. Individual independent variables were socioeconomic variables and variables related to access to alcohol and its availability. Contextual variables consisted of adult alcohol consumption, public policies on alcohol, and socioeconomic factors. Multilevel Poisson regression models with robust variance were estimated, obtaining prevalence ratios (PR) and their 95% confidence intervals. The results showed that the prevalence of youth binge drinking by region of residence was similar for both sexes (r = 0.72). At the individual level, binge drinking was mainly associated with the perception of easy access to alcohol (PR: 1.38; 95% CI: 1.23-1.55), consumption in open areas [(PR: 3.82; 95% CI: 3.44-4.24) < once a month and (PR: 6.57; 95% CI: 5.85-7.37) = once a month], at least one parent allowing alcohol consumption (PR: 1.42; 95% CI: 1.37- 1.47), and receiving >30 euros weekly (PR:1.51; 95% CI: 1.37-1.67). Contextual variables were not associated with youth binge drinking when individual variables were considered. In conclusion, youth binge drinking was associated with individual variables related to high alcohol accessibility and availability, regardless of contextual variables. These variables explained the variability in binge drinking among Spanish regions. © 2018, Edita Socidrogalcohol. All rights reserved.

The aim of this study is to investigate vitamin D deficiency and the associated risk factors in pregnant women and their infants in the Black Sea region of Turkey. One hundred and twenty healthy pregnant women in the last trimester and their healthy newborn pairs were observed between June and August 2017 in Giresun province. The serum 25(OH)D3 and calcium levels were measured through the samples collected from maternal and neonatal cord blood. The effects of maternal lifestyle on the maternal vitamin D levels were assessed by multiple regression analysis. The mean concentrations of 25(OH)D3 were found to be 9.54 ± 6.35 ng/mL and 11.16 ± 6.52 ng/mL in the maternal and neonatal cord blood sera, respectively. Vitamin D deficiency (≤20 ng/mL) and severe vitamin D deficiency (≤5 ng/mL) were observed in between 94.2% and 24.2% of mothers and 90% and 10% of infants, respectively. The clothing style, the consumption of milk/dairy products and antenatal multivitamin supplement usage were found as significant factors on the serum vitamin D levels. Even during the Summer months, the vitamin D deficiency in mothers and infants was observed at high rates in the Eastern Black Sea region of Turkey. As a result, it has been concluded that routine maternal serum 25(OH)D3 measurements for clinical follow-up, vitamin D supplementation and regular consumption of dairy products should be recommended.Impact StatementWhat is already known on this subject? Vitamin D deficiency is a very important risk factor to be considered for maternal and infant health. In a large number of studies, it has been observed that the risk of a vitamin D deficiency in women during their pregnancy was found to be higher, depending on the various strong influences such as the demographic and maternal lifestyles. Whatthe results of this study add? A vitamin D deficiency associated with the demographic and lifestyle factors of pregnant women and their infants was investigated in Giresun province, located in the Eastern Black Sea region of Turkey. The results of this study add that a vitamin D deficiency in the maternal and in the infants may be observed at high rates in regions with mostly rainy weather, even during the Summer months. Whatthe implicationsareof these findings for clinical practice and/or further research? The vitamin D levels in infants can be determined indirectly by looking at the vitamin D levels in third trimester pregnancies. Furthermore, it is suggested as a non-invasive method to determine vitamin D levels by taking advantage of the maternal level, without measuring the vitamin D levels of infants. Thus, this will be effective to reduce health costs and to prevent the possible diseases affecting the future life of infants. Routine maternal serum 25(OH)D3 measurements for clinical follow-up, vitamin D supplementation and the regular consumption of dairy products should be recommended to pregnant women with risk factors, even in the Summer in the Black Sea Region of Turkey. In addition, further studies are needed to investigate the vitamin D deficiency associated with the demographic and lifestyle factors of pregnant women and their infants, especially for the different locations of Turkey. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Background Fathers whose infants are cared for in the neonatal intensive care unit have negative experiences and thus require support. Aim This study was carried out with the aim of performing a validity and reliability study of the Turkish version of the “Father’s Support Scale: Neonatal Intensive Care Unit” (FSS: NICU). Method The study included 165 fathers whose infants were hospitalised in the neonatal intensive care units of a university hospital and a state hospital in the west of Turkey. Findings The item-total score correlation values of the scale were between 0.26 and 0.73 and the Cronbach’s alpha coefficient was 0.91. It was found out that the test-retest reliability coefficients were between 0.78 and 0.92. The scale accounted for 48.38% of the total variance in three factors, as in the original version of the scale. Conclusion It was found that the Turkish version of the FSS: NICU was a valid and reliable measurement tool.

Daily behaviours such as active commuting to school (ACS) could be a source of physical activity, contributing to the improvement of youth cardiovascular health, however, the relationship between ACS and other aspects of a youth’s health, such as sleep duration and breakfast consumption, require further clarification. The aims of this study were therefore: 1) to analyse the prevalence of modes of commuting to school, sleep duration, and breakfast consumption by age groups and gender, and 2) to analyse the association between ACS, sleep duration recommendations, and breakfast consumption by age groups and gender. The percentage of students meeting sleep duration and daily breakfast recommendations was lowest in older adolescents, and highest in children (6.3% versus 50.8% p < 0.001, and 62.1%, versus 76.8%, p = 0.001, respectively). Young adolescents and girls who met the sleep duration recommendations were more likely to be active commuters than their counterparts (OR = 4.25; 95% CI = 1.81 to 9.92, p = 0.001 and OR = 2.89; 95%CI = 1.01 to 8.27, p = 0.04, respectively). Young adolescents (13-15 yr) and girls who met the sleep duration recommendations during school days displayed a positive association with ACS. There was no association between ACS and breakfast consumption for any of the age groups or gender. Children (10-12 yr) were those that best meet with the adequate sleep duration and breakfast consumption recommendations., This study was supported by a grant from the Spanish Ministry of Education, Culture and Sport [CAST17/00072]. Moreover, the study was partially supported by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES).

The objective of this work was the quantitative analyze of the medical survey for children at the Saint-André hospital in order to estimate if it was understood and if it could be included the patient’s computerized record. This study was realized from September 2018 to February 2019, by drawing lots of 20 child medical records by month. We took the medical survey in this patients records and collected for every question if there was or not an answer. From this data, we deduced the filling rate for every question, first by separating each month to see if there was an improvement, then by synthesizing the data. This study concluded that the question fill rate of the survey destined to the patient is good, but regarding the survey of for the student, the question fill rate is not. This allows an improvement of the medical care of the patients., L’objectif de ce travail était l’analyse quantitative du questionnaire médical enfant du service odontologie du CHU de Bordeaux à l’hôpital de Saint- André, dans le but d’estimer si le questionnaire médical était compris par les parents et s’il pouvait être intégré dans le dossier patient informatisé mis en place dans les services. Cette étude a été réalisée de septembre 2018 à février 2019, en tirant au sort 20 dossiers médicaux enfants par mois. Nous avons pris les questionnaires médicaux dans ces dossiers puis recueilli pour chaque question si oui ou non il y a eu une réponse. A partir de ces données, nous en avons déduit les taux de remplissage pour chaque intitulé, en séparant dans un premier temps chaque mois afin de voir s’il y avait une amélioration du taux, puis en synthétisant toutes les données. Cette étude a permis de conclure que si le taux de remplissage des questions destinées aux patients est correct, celui de celles destinées aux étudiants ne l’est pas. Une amélioration est à prévoir pour mieux compléter les dossiers car c’est un temps qui appartient à la prise en charge des patients.

The Ibero Latin American College of Dermatology, CILAD, the largest dermatologic organization in the region, was established in 1948 during the course of the V International Congress of Leprosy held in Havana, Cuba. Constituted in its beginning with fewer than 100 dermatologists from nine countries, its growth has been exponential, reaching now around 4000 members spread throughout Latin America, the Iberian Peninsula, and other regions of the world. In recent years, academic activity has been intense, such as the development of several institutional programs, like its community health care program, designed for geographic areas lacking dermatologic care in the Latin American region. This contribution presents a review of its history, noting the dermatologists and personalities who ennoble the institution. The multiple areas of interest of this growing dermatologic organization are described, and the projections toward the future are discussed.

Made available in DSpace on 2018-12-11T17:17:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-12-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Ministério da Ciência, Tecnologia e Inovação Ministério da Educação Species distribution models (SDMs) are widely used in ecology and conservation. Presence-only SDMs such as MaxEnt frequently use natural history collections (NHCs) as occurrence data, given their huge numbers and accessibility. NHCs are often spatially biased which may generate inaccuracies in SDMs. Here, we test how the distribution of NHCs and MaxEnt predictions relates to a spatial abundance model, based on a large plot dataset for Amazonian tree species, using inverse distance weighting (IDW). We also propose a new pipeline to deal with inconsistencies in NHCs and to limit the area of occupancy of the species. We found a significant but weak positive relationship between the distribution of NHCs and IDW for 66% of the species. The relationship between SDMs and IDW was also significant but weakly positive for 95% of the species, and sensitivity for both analyses was high. Furthermore, the pipeline removed half of the NHCs records. Presence-only SDM applications should consider this limitation, especially for large biodiversity assessments projects, when they are automatically generated without subsequent checking. Our pipeline provides a conservative estimate of a species' area of occupancy, within an area slightly larger than its extent of occurrence, compatible to e.g. IUCN red list assessments. Coordenação de Botânica Museu Paraense Emílio Goeldi, Av. Magalhães Barata 376, C.P. 399 Programa de Pós-Graduação em Ciência Ambientais Universidade Federal Do Pará, Rua Augusto Corrêa 01 Biodiversity Dynamics Naturalis Biodiversity Center, PO Box 9517 Marine and Coastal Management, Deltares, Boussinesqweg 1 Coordenação de Biodiversidade Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 EMBRAPA Centro de Pesquisa Agroflorestal de Roraima, BR 174 km 8, Distrito Industrial Herbario Amazónico Colombiano Instituto SINCHI, Calle 20 No 5-44 Department of Integrative Biology University of California Universidad San Francisco de Quito Colegio de Ciencias Biológicas Diego de Robles y Vía Interoceánica Coordenação de Pesquisas em Ecologia Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 School of Geography University of Leeds, Woodhouse Lane Department of Wetland Ecology Institute of Geography and Geoecology Karlsruhe Institute of Technology - KIT, Josefstr 1 Biogeochemistry Max Planck Institute for Chemistry, Hahn-Meitner Weg 1 Departamento de Botânica Instituto de Pesquisas Científicas e Tecnológicas Do Amapá - IEPA Campus Do IEPA da Fazendinha, Rodovia JK Km 10 AMAP IRD Cirad CNRS INRA Université de Montpellier, TA A-51/PS2, Bd. de la Lironde Science and Education Field Museum, 1400 S. Lake Shore Drive Coordenação de Dinâmica Ambiental Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 Jardín Botánico de Missouri Departamento de Ecologia Universidade Estadual Paulista - UNESP Instituto de Biociências - IB, Av. 24 A 1515 Centro de Biociências Departamento de Ecologia Universidade Federal Do Rio Grande Do Norte, Av. Senador Salgado Filho 3000 Divisao de Sensoriamento Remoto - DSR Instituto Nacional de Pesquisas Espaciais - INPE, Av. dos Astronautas 1758 Herbario Vargas Universidad Nacional de San Antonio Abad Del Cusco, Avenida de la Cultura, Nro 733 Departamento de Geografia Universidade Estadual Paulista - UNESP Instituto de Geociências e Ciências Extas - IGCe Departamento de Biologia Universidade Federal de Rondônia, Rodovia BR 364 s/n Km 9.5 Center for Tropical Conservation Duke University Nicholas School of the Environment Programa de Pós-Graduação em Biodiversidade e Biotecnologia - PPG-Bionorte Universidade Federal de Rondônia Campus Porto Velho, Km 9.5 Instituto Boliviano de Investigacion Forestal Santa Cruz, Av. 6 agosto 28 Km 14,Doble via La Guardia Casilla, 6204 Programa de Pós-Graduação em Ecologia e Conservação Universidade Do Estado de Mato Grosso Instituto de Investigaciones de la Amazonía Peruana - IIAP, Av. A. Quiñones km 2.5 Geography College of Life and Environmental Sciences University of Exeter Departamento de Ciencias Forestales Universidad Nacional de Colombia, Calle 64 x Cra 65 Agteca-Amazonica Facultad de Ciencias Agrícolas Universidad Autónoma Gabriel René Moreno Santa Cruz Prédio da Botânica e Ecologia Embrapa Recursos Genéticos Biotecnologia Parque Estação Biológica, Av. W5 Norte Projeto Dinâmica Biológica de Fragmentos Florestais Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 Centre for Tropical Environmental and Sustainability Science College of Science and Engineering James Cook University Laboratório de Ecologia de Doenças Transmissíveis da Amazônia (EDTA) Instituto Leônidas e Maria Deane Fiocruz, Rua Terezina 476 Programa de Pós-graduação em Biodiversidade Saúde Instituto Oswaldo Cruz IOC/FIOCRUZ Pav. Arthur Neiva, Térreo Av. Brasil 4365 Centro de Investigaciones Ecológicas de Guayana Universidad Nacional Experimental de Guayana Calle Chile, urbaniz Chilemex Laboratorio de Ecología de Bosques Tropicales y Primatología Universidad de Los Andes, Carrera 1 # 18a- 10 Programa de Pós-Graduação em Biologia (Botânica) Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 Institute of Biodiversity and Ecosystem Dynamics University of Amsterdam, Sciencepark 904 Programa de Ciencias Del Agro y El Mar Herbario Universitario (PORT) UNELLEZ-Guanare Endangered Species Coalition, 8530 Geren Rd MAUA Working Group Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 Inventory and Monitoring Program National Park Service, 120 Chatham Lane Center for Conservation Education Sustainability Smithsonian Conservation Biology Institute, 1100 Jefferson Dr. SW, Suite 3123 Biologia Vegetal Universidade Estadual de Campinas, Caixa Postal 6109 Institute of Molecular Plant Sciences University of Edinburgh, Mayfield Rd Royal Botanic Garden Edinburgh, 20a Inverleith Row Programa de Pós-Graduação em Ecologia Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo 2936 Forest Ecology and Forest Management Group Wageningen University Wageningen University and Research, Droevendaalsesteeg 3, P.O. Box 47 Natural Capital and Plant Health Royal Botanic Gardens Kew Ecosistemas Biodiversidad y Conservación de Especies Universidad Estatal Amazónica, Km. 2 1/2 vía a Tena (Paso Lateral) Museo de Historia Natural Noel Kempff Mercado Universidad Autónoma Gabriel Rene Moreno Santa Cruz, Avenida Irala 565 Casilla Postal 2489 Centro de Biociências Departamento de Botânica e Zoologia Universidade Federal Do Rio Grande Do Norte Campus Universitário Department of Biology University of Miami Coral Fairchild Tropical Botanic Garden Coral Instituto de Biociências Dept. Ecologia Universidade de Sao Paulo - USP, Rua do Matão, Trav. 14, no. 321 Diretoria de Pesquisas Científicas Instituto de Pesquisas Jardim Botânico Do Rio de Janeiro Escuela de Biología Herbario Alfredo Paredes Universidad Central, Ap. Postal 17.01.2177 International Center for Tropical Botany (ICTB) Department of Biological Sciences Florida International University, 11200 SW 8th Street, OE 243 Grupo de Ecología de Ecosistemas Terrestres Tropicales Universidad Nacional de Colombia Sede Amazonía Institute of Biological and Health Sciences Federal University of Alagoas, Av. Lourival Melo Mota, s/n Museu Universitário Centro de Ciências Biológicas e da Natureza Laboratório de Botânica e Ecologia Vegetal Universidade Federal Do Acre Universidad Regional Amazónica IKIAM, Km 7 via Muyuna Cirad UMR Ecofog AgrosParisTech CNRS INRA Univ Guyane Campus Agronomique Iwokrama International Programme for Rainforest Conservation Department of Biological Sciences Humboldt State University, 1 Harpst Street New York Botanical Garden, 2900 Southern Blvd Servicios de Biodiversidad EIRL, Jr. Independencia 405 Herbario Nacional de Bolivia Universitario UMSA, Casilla 10077 Correo Central Missouri Botanical Garden, P.O. Box 299 School of Environmental Sciences University of East Anglia Laboratoire Evolution et Diversité Biologique CNRS Université Paul Sabatier UMR 5174 EDB Department of Forestry Management Universidad Nacional Agraria la Molina, Avenido La Molina, Apdo. 456 School of Geosciences University of Edinburgh, 201 Crew Building, King's Buildings Biology Department Center for Energy Environment and Sustainability Wake Forest University, 1834 Wake Forest Rd Department of Anthropology University of Texas at Austin, SAC 5.150, 2201 Speedway Stop C3200 Andes to Amazon Biodiversity Program Madre de Dios Fundación Puerto Rastrojo, Cra 10 No. 24-76 Oficina 1201 Colegio de Ciencias Biológicas y Ambientales-COCIBA Galapagos Institute for the Arts and Sciences-GAIAS Universidad San Francisco de Quito-USFQ Department of Wildlife Ecology Conservation University of Florida, 110 Newins-Ziegler Hall Fundación Estación de Biología, Cra 10 No. 24-76 Oficina 1201 Embrapa Amazônia Oriental Trav. Dr. Enéas Pinheiro S/no Instituto de Ciencias Naturales Universidad Nacional de Colombia, Apartado, 7945 Amazon Conservation Team, Doekhieweg Oost #24 Facultad de Ciencias Forestales y Medio Ambiente Universidad Nacional de San Antonio Abad Del Cusco, Jirón San Martín 451 Laboratory of Human Ecology Instituto Venezolano de Investigaciones Científicas - IVIC, Ado 20632 Departement EV Muséum National d'Histoire Naturelle de Paris, 16 rue Buffon Instituto de Ciência Agrárias Universidade Federal Rural da Amazônia, Av. Presidente Tancredo Neves 2501 PROTERRA Instituto de Investigaciones de la Amazonía Peruana (IIAP), Av. A. Quiñones km 2 5 ACEER Foundation, Jirón Cusco No 370 Universidad Autónoma Del Beni José Ballivián Campus Universitario Final, Av. Ejercito Regional Norte Amazónico Centro de Investigación y Promoción Del Campesinado, C/Nicanor Gonzalo Salvatierra No 362 Environmental Change Institute Oxford University Centre for the Environment Dyson Perrins Building, South Parks Road School of Agriculture and Food Sciences ARC Centre of Excellence for Environmental Decisions CEED University of Queensland Instituto de Investigaciones para El Desarrollo Forestal (INDEFOR) Universidad de Los Andes, Conjunto Forestal, C.P. 5101 School of Environmental and Forest Sciences University of Washington University of Nottingham, University Park Geography and the Environment University of Texas at Austin, 305 E. 23rd Street, CLA building Laboratório de Ciências Ambientais Universidade Estadual Do Norte Fluminense, Av. Alberto Lamego 2000 Department of Biology University of Maryland GeoIS, El Día 369 y El Telégrafo, 3o Piso Environmental Science and Policy Northern Arizona University FOMABO Manejo Forestal en Las Tierras Tropicales de Bolivia Escuela de Ciencias Forestales (ESFOR) Universidad Mayor de San Simon (UMSS) Agricultural Services Ministry of Agro-Industry and Food Security Agricultural Services Ministry of Agro-Industry and Food Security Mauritius Herbarium Department of Bioscience Aarhus University, Building 1540 Ny Munkegade Ciencias Biológicas Universidad de Los Andes, Carrera 1 # 18a- 10 Medio Ambiente PLUSPRETOL Center for Conservation Education and Sustainability Smithsonian's National Zoo Conservation Biology Institute, National Zoological Park, 3001 Connecticut Ave Tropenbos International, Lawickse Allee 11 PO Box 232 Instituto de Biodiversidade e Floresta Universidade Federal Do Oeste Do Pará Campus Tapajós, Rua Vera Paz Department of Biology University of Missouri Facultad de Biologia Universidad Nacional de la Amazonia Peruana, Pevas 5ta cdra School of Anthropology and Conservation University of Kent, Marlowe Building Herbario Nacional Del Ecuador Universidad Técnica Del Norte Ecology and Biodiversity Group Utrecht University, Padualaan 8 Systems Ecology Free University, De Boelelaan 1087 Departamento de Ecologia Universidade Estadual Paulista - UNESP Instituto de Biociências - IB, Av. 24 A 1515 Departamento de Geografia Universidade Estadual Paulista - UNESP Instituto de Geociências e Ciências Extas - IGCe CAPES: 407232/2013-3-PVE CNPq: 407232/2013-3-PVE Ministério da Ciência, Tecnologia e Inovação: 407232/2013-3-PVE Ministério da Educação: 407232/2013-3-PVE

In today’s world, digitalization and automation are ubiquitous and different countries have different strategies for implementing information technology in health care. In Belgium, these plans include the dematerialization of prescriptions, following the implementation of a system of electronic prescribing. In the light of these changes, we studied the attitudes of patients toward a paperless prescription. We collected the opinions of 273 patients by survey. Older people, or people with more complex medical needs, expressed a clear desire to keep receiving a paper version of the prescription. Younger people foresaw practical advantages, and expressed a willingness to buy prescription-only medicines online. Knowledge about the planned changes was, however, limited. Privacy and autonomy issues were expressed by a large fraction of people. The problem of what happens when a third person wants to pick up medicines for a patient, a frequent occurrence, was often mentioned. We conclude that, at present, patients have inadequate knowledge and understanding about the planned changes. In light of these considerations and the recent technical problems encountered by the system, we feel that an updated risk/benefit analysis of the planned policy is urgently needed.

Background: Faced with the resurgence of malaria, malaria surveillance in the Peruvian Amazon incorporated consecutive active case detection (ACD) interventions using light microscopy (LM) as reactive measure in communities with an unusual high number of cases during high transmission season (HTS). We assessed the effectiveness in malaria detection of this local ACD-based strategy. Methods: A cohort study was conducted in June&ndash, July 2015 in Mazan, Loreto. Four consecutive ACD interventions at intervals of 10 days were conducted in four riverine communities (Gamitanacocha, Primero de Enero, Libertad and Urco Mira&ntilde, o). In each intervention, all inhabitants were visited at home, and finger-prick blood samples collected for immediate diagnosis by LM and on filter paper for later analysis by quantitative real-time polymerase chain reaction (qPCR). Effectiveness was calculated by dividing the number of malaria infections detected using LM by the number of malaria infections detected by delayed qPCR. Results: Most community inhabitants (88.1%, 822/933) were present in at least one of the four ACD interventions. A total of 451 infections were detected by qPCR in 446 participants (54.3% of total participants), five individuals had two infections. Plasmodium vivax was the predominant species (79.8%), followed by P. falciparum (15.3%) and P. vivax-P. falciparum co-infections (4.9%). Most qPCR-positive infections were asymptomatic (255/448, 56.9%). The ACD-strategy using LM had an effectiveness of 22.8% (detection of 103 of the total qPCR-positive infections). Children aged 5&ndash, 14 years, and farming as main economic activity were associated with P. vivax infections. Conclusions: Although the ACD-strategy using LM increased the opportunity of detecting and treating malaria infections during HTS, the number of detected infections was considerably lower than the real burden of infections (those detected by qPCR).

Active commuting to and from school (ACS) could help to increase daily physical activity levels in youth, however, this association remains unknown in Ecuadorian youth. Thus, the aims of this study were (1) to determine the patterns of commuting to and from school and (2) to analyze the associations between ACS, physical activity (PA), and sedentary habits in Ecuadorian youth. A total of 732 students (65.3% males), aged 10&ndash, 18 years (children = 246, young adolescents = 310, older adolescents = 162) from the central region of Ecuador participated in this study. A self-report questionnaire, including the usual mode and frequency of commuting, distance from home to school (PACO-Questionnaire), and PA and sedentary habits (YAP-Questionnaire), was used. Most of the sample lived &le, 2 km from school, however, they were mainly passive commuters (96%). The most common mode of commuting was by car (to school = 43.4%, from school = 31.6%, p &lt, 0.001). Children presented significantly higher scores (0&ndash, 4) in PA outside school and total PA compared with older adolescents (2.20 &plusmn, 0.97 vs. 1.97 &plusmn, 0.96, p = 0.013 and 2.30 &plusmn, 0.76 vs. 2.09 &plusmn, 0.74, p = 0.019, respectively), as well as the lowest scores in sedentary habits (1.51 &plusmn, 0.65, p &lt, 0.001). PA at school and total PA were positively associated with ACS (OR 3.137, 95% CI, 1.918 to 5.131, 0.001, and OR 2.543, 95% CI, 1.428 to 4.527, p = 0.002, respectively). In conclusion, passive modes of transportation were the most frequently used to commute to and from school in young Ecuadorians. PA at school and total PA were positively associated with ACS. Thus, interventions at school setting could be an opportunity to improve PA levels and additionally ACS in youth from the central region of Ecuador.

Background: Intestinal parasitic infections (IPI) lead to significant morbidity and mortality in pediatric and adult populations worldwide. Intestinal parasitism during pregnancy is of interest as it may affect the health of pregnant women and their offspring. This study determined the prevalence of IPI in pregnant women living in substandard conditions in three urban districts of Bogotá, Colombia. Associations between prevalence and sociodemographic factors, housing, and living conditions were also evaluated. Methods: In a cross-sectional and community-based study, pregnant women were recruited from three districts of Bogotá. A total of 550 participants answered a questionnaire; 331 of these also provided stool samples, with 233 providing one and 98 providing two stool samples. Questionnaire responses were associated with the presence of intestinal parasites, which was determined using a standard combined microscopy technique including direct wet mount and formol-ether concentration. Results were verified by supplementary examination of 48 stool samples by quantitative polymerase chain reaction (qPCR). Results: Among pregnant women who lived in selected poor residential areas in Bogotá, the overall prevalence of intestinal parasitism was 41% with 9% polyparasitism. Pathogenic parasites were present in 1.2% of the 331 participants including Giardia lamblia and Ascaris lumbricoides. Higher prevalence was found for parasites with debated pathogenicity, including Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), and Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex was also detected (1.5%). When comparing a subset of stool samples using the combined microscopy technique and qPCR, the latter detected a higher 58.3% overall IPI prevalence. Higher prevalence of infections by any intestinal parasite was found in participants who had never been dewormed (p = 0.01). Higher but not statistically significant associations were found between any parasite and women living with a partner, and intestinal polyparasitism and being from a minority group and not having a water sink. Conclusions: This first study of the prevalence of intestinal parasitism in Bogotá focused on pregnant women living in poverty, found a high prevalence of intestinal parasites of debated pathogenicity, and confirmed a low prevalence of pathogenic intestinal parasites. These results highlight the need for educational interventions to disrupt transmission routes for prevalent parasites. © 2018 The Author(s).

demirdal, tuna/0000-0002-9046-5666 WOS: 000440301200015 PubMed: 30249562 Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest (R), aspartate aminotransferase-to-platelet ratio index(A-PRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further. Roche PharmaceuticalsRoche Holding [ML21920] This study was financially supported by Roche Pharmaceuticals (Protocol No: ML21920).

Background: Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12‐month DSM‐IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proportion who (i) perceived a need for treatment; (ii) received any treatment; and (iii) received possibly adequate treatment. Methods: Data from 23 community surveys in 21 countries of the World Mental Health (WMH) surveys. DSM‐IV mental disorders were assessed (WHO Composite International Diagnostic Interview, CIDI 3.0). DSM‐IV included posttraumatic stress disorder among anxiety disorders, while it is not considered so in the DSM‐5. We asked if, in the previous 12 months, respondents felt they needed professional treatment and if they obtained professional treatment (specialized/general medical, complementary alternative medical, or nonmedical professional) for “problems with emotions, nerves, mental health, or use of alcohol or drugs.” Possibly adequate treatment was defined as receiving pharmacotherapy (1+ months of medication and 4+ visits to a medical doctor) or psychotherapy, complementary alternative medicine or nonmedical care (8+ visits). Results: Of 51,547 respondents (response = 71.3%), 9.8% had a 12‐month DSM‐IV anxiety disorder, 27.6% of whom received any treatment, and only 9.8% received possibly adequate treatment. Of those with 12‐month anxiety only 41.3% perceived a need for care. Lower treatment levels were found for lower income countries. Conclusions: Low levels of service use and a high proportion of those receiving services not meeting adequacy standards for anxiety disorders exist worldwide. Results suggest the need for improving recognition of anxiety disorders and the quality of treatment. The U.S. National Comorbidity Survey Replication (NCS‐R) is supported by the National Institute of Mental Health (NIMH; U01‐MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA). SEL (Sara Evans‐Lacko) currently holds a Starting Grant from the European Research Council (337673). The Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trust. Dr. Thornicroft is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust. Dr. Thornicroft acknowledges support from the following: the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust; the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit awarded to South London and Maudsley NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust; the European Union Seventh Framework Programme (FP7/2007‐2013) Emerald project.