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Background: Hand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour-centered Design approach to explore the facilitators and deterrents to hand hygiene among healthcare providers in the Kampala Metropolitan area, Uganda. Methods: We conducted a formative qualitative study as part of a cluster randomised trial in 19 healthcare facilities (HCFs). The study used 19 semi-structured and 18 key informant interviews to collect data on hand hygiene status and facilitators and deterrents of hand hygiene. Research assistants transcribed verbatim and used a thematic framework aided by Nvivo 14.0. to undertake analysis. We used thick descriptions and illustrative quotes to enhance the credibility and trustworthiness of our findings. Results: About 47.4% of the HCFs had sufficient hand hygiene infrastructure, and 57.9% did not report total compliance with hand hygiene during patient care. The physical facilitator for hand hygiene was the presence of constant reminders such as nudges, while the biological included the frequency of patient contact and the nature of clinical work. The only biological deterrent was the heavy workload in HCFs. The executive brain facilitators included knowledge of workplace health risks, infection prevention and control (IPC) guidelines, and a positive attitude. A negative attitude was the executive brain deterrent to hand hygiene. Recognition, rewards, and fear of infections were the only motivated brain facilitators. Behavioural setting facilitators included proximity to functional hand hygiene infrastructure, the existence of active IPC committees, good leadership, and the availability of a budget for hand hygiene supplies. Behavioural setting deterrents included the non-functionality and non-proximity to hand hygiene infrastructure and inadequate supplies. Conclusions: The study revealed low compliance with hand hygiene during the critical moments of patient care and inadequacy of hand hygiene infrastructure. The deterrents to hand hygiene included a heavy workload, negative attitude, inadequate supplies, non-functionality, and long distance to hand washing stations. Facilitators included constant reminders, fear of infections, frequency of patient contact and nature of clinical work, positive attitude, knowledge of IPC guidelines, recognition and reward, good leadership, availability of budgets for hand hygiene supplies, availability and proximity to hand hygiene supplies and infrastructure and active IPC committees. Trial registration: ISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020. [ABSTRACT FROM AUTHOR]

Background Soil-transmitted helminths (STH) and schistosomiasis remain widely prevalent in Ethiopia. The aim of this study was to evaluate the prevalence of STH and schistosomiasis among schoolchildren in Gidi Bench district (Southern Nations, Nationalities, and People's Republic, Southwest Ethiopia) and the association with knowledge and health-related behaviors. Methods A cross-sectional study was conducted. Stool samples, analyzed by the Kato-Katz technique and a knowledge, attitudes and practices questionnaire, were collected. Results Out of 611 participants (mean age 12.8±3.1 y), 129 (21.1%) were infected with schistosomiasis and 382 (62.5%) had STH. More than 30% (n=195, 31.9%) were infected with a single intestinal parasite, while 138 (22.6%) and 47 (7.7%) were infected with two or three parasitic infections, respectively. Boys and those who did not participate in school clubs had higher infection rates (p=0.05). Lower parasitic infection was associated with using a latrine when available, washing hands and vegetables and wearing shoes regularly. Higher rates of infection were found among those who reported swimming and washing cloths and utensils in the river regularly. Conclusions Schistosomiasis and STH were highly prevalent among schoolchildren in Gidi Bench district. Infection rates were associated with gender, lack of knowledge on parasitic infections and unhealthy behaviors. Findings from this study may assist in decision making regarding disease prevalence and methods of control alongside mass drug administration. [ABSTRACT FROM AUTHOR]

Background. Behavior change has been a critical factor in slowing the spread of COVID-19. In South Africa where infection rates are high, research is needed on the protective behaviors adopted by youth who have low infection rates but are carriers of the virus. Aims. The purpose of this study is to (1) identify the protective behaviors young people adopted during the pandemic and (2) to estimate the probability of positive behavior change by demographic and socioeconomic characteristics. Methods. The study uses data from the South African National Income Dynamics—Coronavirus Rapid Mobile Survey 2020. The sample includes 985 (n) youth aged 15–24 years. The outcome of interest is behavior change due to the Coronavirus. Cross-tabulations and an adjusted binary logistic regression model showing odds ratios, are fit to the data. Results. Not all youth adopted protective behaviors. The most prevalent behaviors adopted include washing hands (67.75%) and staying at home (54.02%). Youth in households with six or more members are more likely to change their behaviors (ORs = 1.67 and 1.64, both p -values <.05). However, youth who do not have access to water to wash hands (OR = 0.71), reside in households with food insecurity (OR = 0.94), and those living in nonformal housing (OR = 0.69) are less likely to adopt behavior change. Conclusion. Due to the socioeconomic inequalities associated with behavior change, there is need for more tailored approaches to address youth living in impoverished households in the country. [ABSTRACT FROM AUTHOR]

Food poisoning is a major concern in catering services in Indonesia, with multiple outbreaks being reported in factories and offices. This study aimed to assess the level of food safety knowledge, personal hygiene practices, and microbiological quality of chicken and egg dishes at three catering companies in the Yogyakarta Special Region of Indonesia, which provide mass catering for workers. From March to July 2019, a cross-sectional study was conducted using validated questionnaires, observation checklists, and microbiological tests to measure the parameters of Escherichia coli and Staphylococcus aureus. Pearson and Rank-Spearman correlation tests, as well as independent sample t-tests, were used for statistical analysis. The study revealed that 75% of the subjects had limited knowledge of food safety, with only 5% having a good understanding. Furthermore, 95% of the subjects had not received any food safety training, resulting in poor hygiene practices among the food handlers. Although there was no significant correlation between food safety knowledge and hygiene practices (p>0.05), certain practices, such as appearance and hand washing, were significantly correlated with age. Employment duration was negatively correlated with food safety knowledge (p=0.027; r=-0.494). While chicken samples were free from E. coli and S. aureus, one egg sample was found to be contaminated with E. coli. The research emphasizes the significance of providing frequent food safety training to food handlers, ideally every year. Additionally, it recommends conducting larger sample studies and collaborating with government agencies for future research. [ABSTRACT FROM AUTHOR]

Exogenous factors have a great impact on the health of children living in a Roma community. Healthy nutrition, tempering procedures, observance of a daily routine and established hygiene habits predetermine the health status of children. Roma families have different attitudes and perceptions of the value of health. Some families have low health culture and are unwilling to accept the development of hygiene habits. The aim of the present study is to learn and analyze the factors influencing the health of children living in a Roma community aged 0-7 years.The object of research are 270 Roma from different Roma groups with children in their families aged 0-7 years. The survey method is essential for gathering empirical information from the field, along with in-depth interviews and expert opinions. Sociological and statistical methods have been used. Results and Discussion: The fact that only a third of Roma children are taught to wash their hands after performing physiological needs is alarming. Only 38.5% of older children in the family and 23% of younger children have acquired this habit. In the upbringing of children, no great importance is attached to the observance of a daily routine. Conclusion: Taking care of the body, maintaining good personal hygiene and building health habits in early childhood will prevent the development of many diseases. This is the responsibility of Roma parents, but health professionals can actively participate in this process. [ABSTRACT FROM AUTHOR]

We present a comprehensive review of the various challenges that individuals with visual impairment (VI) face during the COVID-19 pandemic. A structured review was done using online databases PubMed, EMBASE, and grey literature databases between 19 April 2021 and 4 August 2021, using search terms 'COVID-19', 'SARS-CoV-2', 'Coronavirus', or 'pandemic' combined with 'visually impaired', 'visual impairment', or 'Blind'. Studies included were written in English, published after the World Health Organization (WHO) declaration of the COVID-19 Pandemic (11 March 2020), and focused on the VI population during the pandemic. The initial search yielded 702 publications, of which 20 met our inclusion criteria and were included in analysis. Emotional distress from deteriorating mental health and social isolation were considerably higher in the VI population. For a community that relies on spatial awareness and touch, regulations related to social distancing and avoiding contact were considerable barriers. Further challenges were noted in accessing healthcare, care, receiving timely health information and changes in regulations, adequately sanitizing, using technology, and completing activities of daily living. In the unprecedented times of the COVID-19 pandemic, the VI community has faced unique challenges. A more holistic and inclusive approach needs to be adopted to ensure that more vulnerable populations are adequately cared for. [ABSTRACT FROM AUTHOR]

More than half of the population in impoverished areas around the world, which lack sufficient energy and water, do not have washing machines. Due to a lack of resources and economic reasons, the mechanical task of modern washing machines requiring electrical energy can only be done through hand washing. Additionally, water fetching and laundry work are predominately assigned to women due to socio‐cultural dynamics in disadvantaged areas. The repetitive motions involved in washing over extended periods of time, coupled with awkward body positions, often lead to musculoskeletal disorders in women. This study aims to improve women's work safety and living conditions through a product design for laundry washing. First, the ergonomic risk associated with women's body postures while washing clothes on the floor was evaluated to better understand the impact of the intervention and rapid upper extremity assessment (RULA) method was used for this purpose. Subsequently, the design process for a manual washing product, which operates without electricity, can handle bulk laundry and facilitates easier and more ergonomic work instead of directly scrubbing clothes, was initiated as a remedial intervention. Recognizing that laundry work is a multidimensional experience in women's lives beyond its ergonomic aspects, a holistic design methodology was adopted, incorporating various design approaches to create concepts that better integrate with the lives of woman users. Insights gained from these design approaches were then combined with the conceptual design method to generate design proposals. At the end of the study, the developed manual washing machine design performed improved RULA analysis scores and biomechanical loading outcomes compared to hand washing. [ABSTRACT FROM AUTHOR]

Background: The human hand has constant contact with the environment, hence requires regular hand hygiene. Hand hygiene has gained recognition because of the COVID-19 pandemic and is a largely effective, affordable preventive measure against infectious diseases. This study used both national and sub-national analyses to evaluate the effect of COVID-19 handwashing guidelines on instances of diarrhea in Ghana. Methods: Data on diarrhea cases spanning February 2018 and March 2022 were retrieved from the District Health Information Management System (DHIMS 2) using a data extraction guide. The data were summarized using descriptive statistics. The difference in diarrhea cases between the pre-COVID-19 and COVID-19 periods was measured using a two-sample t-test across Ghana's 16 administrative areas. Causal Impact package in R statistical software was employed to determine the impact of the introduction of COVID-19 hand hygiene protocols on diarrheal disease. Results: A total of 5,645,533 diarrheal cases reported between February 2018 and March 2022 through the routine MIS (DHIMS2) were examined. Fifty-three percent of the cases occurred before the introduction of the hand hygiene protocol. Descriptive statistics indicated a statistically significant decrease in average diarrheal cases during the hand hygiene implementation era (13,463 cases reduction, p<0.001). Sub-national analyses revealed significant reductions in various regions: Greater Accra, Ashanti, Ahafo, Central, Eastern, Northern, Upper East, Upper West, and Volta (p<0.05). Causal impact analysis confirmed 11.0% nationwide reduction in diarrheal cases attributed to the COVID-19 hand hygiene protocols (p<0.001). Conclusion: This study underscores the effectiveness of COVID-19 hand hygiene protocols in reducing diarrheal morbidity in Ghana, with varying regional impacts. These findings advocate for the sustenance of investments and commitments made at the COVID hand hygiene protocols, particularly in this era where the pandemic appears controlled. [ABSTRACT FROM AUTHOR]

In Fiji, 90% of the population has access to basic sanitation; however, there are still persistent health risks from endemic faecal-oral diseases such as typhoid fever. There is a need to assess the contribution of existing sanitation facilities in the faecal pathogen transmission pathway. This study was conducted as part of a larger planetary health study across 29 rural communities within five river catchments. This specific research aimed to characterise latrine front-ends, both infrastructure and usage behaviour, and to assess the faecal contamination levels on various frequently contacted latrine surfaces in rural Fiji. A sanitation survey, along with observation and latrine swab sampling, was conducted in households over three phases: baseline (n = 311) (Aug–Dec 2019), endline (n = 262) (Jun–Sep 2022) and an in-depth front-end study (n = 12) (Oct–Nov 2022). Of 311 households, almost all had pedestal-type latrines, predominately cistern-flush (83%), followed by pour-flush (13%), and then hole-type (pit) latrines (4%). Washable latrine floors had significantly higher E. coli densities (6.7 × 102 CFU/25 cm2) compared to non-washable floors (1.3 × 102 CFU/25 cm2) (p = 0.05), despite washable floors indicating improved latrines. The in-depth front-end analysis found that moist latrine surfaces had significantly elevated E. coli densities (1.2 × 103 CFU/25 cm2) compared to the dry ones (14.3 CFU/25 cm2) (p < 0.001), highlighting the importance of maintaining dry latrine surfaces. Latrine floors and mid-walls were the most frequently contaminated surfaces, emphasising the need to clean and disinfect these surfaces. Only 46% of the households reported always using soap for handwashing after defecation, exacerbating the risk of transmitting faecal pathogens. This study highlights that latrine cleanliness and hygiene are as crucial as latrine infrastructures for the effective disruption of faecal pathogens transmission during latrine use. [ABSTRACT FROM AUTHOR]

Infection control is crucial for high-quality patient care. One of the most effective and commonly used infection control procedures is hand hygiene which, it is known, requires repeated refresher training. There are many ways to educate healthcare professionals about hand hygiene, including the use of mobile applications (apps). Our aim is to review such hand hygiene apps, and to identify which have been available since 2021 and to assess their quality. We conducted a review using the PRISMA diagram to document our app selection process in the Google Play Store and Apple store in March 2024. For the evaluation of apps, we used the user version of the Mobile Application Rating Scale questionnaire (uMARS). Of 16 apps only five adhere to WHO hand hygiene guidelines. Timers were included in 12 of the 16 apps and reminders were included in 10 of 16 apps. The highest overall uMARS scoring app was Give Me 5–Hand Hygiene (4.31 ± 0.28), while Wash your hands! (1.17 ± 0.14) had the lowest score. We found that more than half of the apps were unavailable from the 2021 review. We believe that app-based education could effectively sustain hand hygiene knowledge in healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Students in school are more likely to be sick from communicable diseases like diarrheal illnesses, acute respiratory infections, and other illnesses linked to poor personal hygiene. Poor hygiene practices are common among school children and put their health at risk, which in turn has several consequences. These include significant school absences, transmission of infectious diseases to other students, and missed workdays for parents and guardians. However, there is limited evidence on the level of personal hygiene practice and its associated factors among school students. Thus, this study was aimed at determining personal hygiene practice level and its associated factors among elementary school grade (5–8) students in Fiche town, Oromia, Ethiopia, in 2022. Methods: A cross-sectional study design was conducted from April 29 to May 29, 2022, in Fiche town, Oromia regional state, among 534 elementary school students. A multi-stage probability sampling technique was used to select the individual students. A structured questionnaire was used to collect the data. The data was entered into epi-data version 4.6 and analyzed by SPSS version 26.0. Variables that scored a p-value less than 0.2 during bivariate analysis were included in multilevel logistic regression models to determine factors associated with personal hygiene practice. The odds ratio with a 95% confidence interval was estimated, and the level of significance was set at 0.05. Results: The magnitude of good personal hygiene (scored above the mean) was 59.2% (95% confidence interval (CI)) (55.1–63.0). A considerable proportion of students scored more than 50% in latrine use (62.5%), regular hand-washing (55.4%), and oral hygiene (55.20%) practices. Being female, having good personal hygiene knowledge, doing hygiene inspections at school, and having latrine accessibility was significantly associated with good personal hygiene among elementary school students. Conclusion: Considerable proportion of elementary school students in Fiche town have score poor personal hygiene practice. Interventions aimed that target improving knowledge of personal hygiene and hygiene inspection at school are crucial to enhance the personal hygiene among elementary school students. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between household water insecurity (HWIS), mother’s handwashing practices, and childhood diarrhea in the peri-urban and informal settlements of Hosanna town. A community-based cross-sectional study involving 424 mothers was carried out in Hosanna town, and the data were collected using a pretested structured questionnaire, HWISE Scale, and an observational checklist. Bivariate and multivariable logistic regression models were used to analyze the data. The study revealed that the prevalence of HWIS and diarrhea among under-five children was 68.6% and 16%, respectively. Only 42.2% of the mothers had good handwashing practices. Good knowledge of handwashing, positive attitudes toward handwashing, household water security (HWS), and the presence of handwashing facilities were significantly associated with good handwashing practices. Children aged 6-11 months, HWIS, uncovered and widemouthed water storage containers, unsafe child’s stool disposal practices, and hands not washed with soap after defecation, before preparing food, and feeding a child were significantly associated with the occurrence of diarrhea. The prevalence of diarrhea and HWIS was very high. The majority of the mothers had poor handwashing practices. Therefore, findings suggest interventions to improve HWS and mother’s handwashing practices, which could reduce the risk of diarrheal diseases. [ABSTRACT FROM AUTHOR]

To examine how public health policy was reinforced by peer workers who were called Public Health Ambassadors (PHAs) at a West Coast university during the COVID-19 pandemic. Descriptions of PHA community interactions were collected. Analyses were conducted using data from the 12-weeks of the 2020 Fall Quarter. In total, there were 5,112 interactions of which there were three types: (1) educational (4%), (2) noncompliance (90%), and (3) thanking (6%). About 1.3% of interactions were met with resistance. Overall, compliance with campus public health guidance was high. Trends suggest compliance fatigue may have occurred after the first four weeks as evidenced by increased noncompliance rates and test positivity rates. These results suggest the feasibility of the implementing US Centers for Disease Control and Prevention recommendations of using trusted messengers to reinforce critical behaviors to support community health. [ABSTRACT FROM AUTHOR]

Purpose Herpes Simplex Virus type 1 (HSV-1) is a highly contagious virus that manifests as a painful lesion and recurrences can be distressing to patients. The purpose of this pilot study was to determine if the use of a 70% ethanol alcohol hand sanitizer alters the duration, size of the lesion, level of pain upon administering treatment, and overall daily discomfort during outbreak. Methods This study was a double-blind randomized controlled trial (RCT) using 70% ethanol alcohol hand sanitizer for the experiment and medical grade mineral oil for the control group. The treatment and the control were dispensed in lip gloss applicators for applying medicament. Data was collected through the initial examination, a daily journal, photographs, and a reexamination day. Descriptive statistics and the independent sample t-test were used to analyze data (p=0.05). Results A total of 20 individuals completed the research study: ten in the experimental group and ten in the control group. The mean duration of HSV-1 lesions for the control group was 10.3 days while the mean duration of the HSV-1 lesions for the experimental group was 7.6 days. The mean size of lesions for the control group was 4.87 mm; the mean size for the experimental group was 4.25 mm. The mean pain score for the control group was 1.08 and the mean pain score for the experimental group was 2.74. The mean discomfort score for the control group was 1.33 while the mean discomfort score for the experimental group was 1.72. There was no statistically significant difference between the experimental and control groups in terms of duration, size of lesions, pain, and discomfort. Conclusion Based on the results of this pilot study, 70% ethanol alcohol hand sanitizer did not demonstrate statistical significance in the treatment and management of HSV-1 lesions. Additional research is needed with a larger sample size to determine if statistical differences can be measured. [ABSTRACT FROM AUTHOR]

This study aims to delve deeper into the relationship between the professional activities carried out in restaurant kitchens and some key air pollutants. The ultrafine particles (UFPs), nitrogen dioxide (NO2), ozone (O3), Total Volatile Organic Compounds (TVOCs) and formaldehyde (HCHO) indoor air concentrations were determined using real-time monitors. Simultaneously, the kitchen environment was characterized using video recordings with the aim to retrieve information pertaining to cooking, cookware washing and surface cleaning activities. Statistical analysis was carried out separately for the winter and summer campaigns. The obtained results confirmed that the professional activities carried out in restaurant kitchens had a significant impact on the concentrations of all the selected pollutants. Specifically, this study revealed the following key results: (i) indoor UFPs and NO2 concentrations were significantly higher during cooking than during washing activities (e.g., about +60% frying vs. handwashing and dishwasher running), mainly in the winter; (ii) washing activity had a statistically significant impact on the TVOC (+39% on average) and HCHO (+67% on average) concentrations compared to other activities; (iii) some specific sources of short-term pollutant emissions have been identified, such as the different types of cooking and opening the dishwasher; and (iv) in some restaurants, a clear time-dependent relationship between O3 and UFP, TVOC and HCHO has been observed, underlining the occurrence of ozonolysis reactions. [ABSTRACT FROM AUTHOR]

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Copyright of Mediterranean Nursing & Midwifery is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: Toxoplasmosis is a disease caused by the parasite Toxoplasma gondii, which can infect humans and animals, including dogs. Dogs become infected by accidentally ingesting the parasite's oocysts from the environment and eating infected rodents or other small animals. Following infection, dogs develop antibodies against T. gondii. The current study investigated the percentage of dogs living in Greece that have antibodies against the parasite as an indirect way to assess the level of environmental contamination with T. gondii oocysts. Blood samples were collected from 1282 dogs living in both urban and rural regions of Greece, including Attica and Thessaloniki. Overall, 47.6% of the dogs had antibodies against the parasite, indicating they had been exposed to T. gondii. Seropositive dogs were more commonly found in rural areas (53.8%) than in urban areas (43.9%) (p < 0.001). The findings of this study suggest that T. gondii infection is widespread in dogs across Greece, especially in rural regions, and the parasite is highly present in the environment, posing a potential risk for human exposure in these areas. Control measures are necessary to prevent dogs from being infected and to reduce this risk for dog owners. Dog owners should also follow basic hygiene practices, like washing their hands after petting their dogs, to protect themselves. Toxoplasmosis, caused by the protozoan Toxoplasma gondii, is a zoonotic disease that affects various animal species, including dogs, that can serve as sentinels for indirectly estimating the environmental contamination. The current study aimed to determine the seroprevalence of T. gondii IgG and IgM antibodies in dogs across different regions of Greece and assess their living area as a potential risk factor. In total, 1282 blood samples were collected from dogs in urban and rural areas of Greece, including Attica and Thessaloniki. Serum samples were tested for T. gondii-specific IgG and IgM antibodies using an indirect immunofluorescent antibody test. A chi-square test was performed to assess the association between seropositivity for T. gondii and geographical location (urban/rural). The overall T. gondii seroprevalence was 47.6%, while the seroprevalence of IgG and IgM antibodies was 34.3% and 22.2%, respectively. Dogs from rural areas exhibited a significantly higher seroprevalence (53.8%) than those from urban areas (43.9%) (p < 0.001), with the estimated odds ratio being equal to 1.49 (95% CI, 1.18 to 1.65) and the relative risk increased by 22.4%. Dogs in Greece are highly exposed to T. gondii, particularly in rural areas. Measures to prevent canine infections are necessary, and basic hygiene practices, such as hand washing after petting dogs, are required to reduce human infection risk and safeguard public health. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted the epidemiology of other infectious diseases. In particular, the respiratory syncytial (RS) virus infects almost all children during their first or second year of life. However, during the COVID-19 pandemic, many restrictions were enforced that isolated children from other children. Therefore, we hypothesized that the clinical features of RS virus infection were altered and conducted a study to evaluate these changes. This observational study included children below the age of six years who were admitted to the Tokyo Metropolitan Toshima Hospital. Their clinicodemographic data were extracted from medical records. The 369 children eligible for the study were assigned to three groups: "pre-pandemic" (group 1, n = 253); "during pandemic" (group 2, n = 77), and "post-pandemic" (group 3, n = 39). Logistic regression analysis revealed that compared to group 1, the odds ratio (OR) for oxygen use was significantly higher in groups 2 (OR 1.85. 95% confidence interval [CI] 1.06–3.23; p < 0.05) and 3 (OR 3.36, 95% CI 1.59–7.12; p < 0.01), and the use of mechanical ventilation was significantly higher in group 3 (OR 4.89, 95% CI 1.71–13.94; p < 0.01). This study highlights changes in the clinical features of RS virus infection during and after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Viral hepatitis is the main cause of infectious liver disease. During pregnancy, a risk of vertical transmission exists both during gestation and at birth. HAV, HBV, and HCV might progress similarly in pregnant and non-pregnant women. In this study, we found a prevalence of 0.22% of viral hepatitis in pregnant women, with a light preponderance of HCV over HAV and HBV. Here, it was observed that acute HAV infection is more symptomatic and has higher risks for the mother and fetus, in a similar manner to what has been reported for HEV. Histopathological alterations were observed in all except one placenta, indicating that it is an important tissue barrier. Regarding the Mexican strategies for viral hepatitis eradication, success may be related to vaccination at birth, whereas for HCV, the national program for eradication is aimed at treating the infection via direct-acting antiviral agents. The HBV strategy has positively impacted pregnant women and their children, diminishing the risk of vertical transmission. The HCV strategy is still in its early years, and it is expected to be just as successful. For acute hepatitis, HAV and HEV, programs promoting hand washing and those aimed at providing clean food and water are applicable as preventive strategies, alongside other programs such as vaccination. [ABSTRACT FROM AUTHOR]

Soil-transmitted helminthiases (STH) are among the neglected tropical diseases and infect more than 24% of the world population. The World Health Organization recommends regular monitoring of STH's prevalence and intensity following mass drug administrations to evaluate their effectiveness and inform future control strategies. This study evaluated the prevalence, intensity, and risk factors of STH infections among school children aged 6 to 14 years old in northwestern Tanzania. A cross-sectional study was conducted among 728 school children in the Kagera region in 2021. Participants were selected using a two-stage cluster sampling method. A questionnaire was used to collect data on the risk factors. Stool samples were examined using the Kato–Katz technique. The data were analysed using STATA. The overall prevalence of STH was 56.2% (95% CI: 52.5–59.8, 409/728). About 5.7% and 1.1% of the infected children had moderate-intensity infections with Ascaris lumbricoides and Trichuris trichiura, respectively. Risk factors included the mother's occupation as a farmer (aOR: 1.2, p = 0.002) and not washing hands with water and soap (aOR: 1.4, p = 0.035). Washing one's hands after using the toilet (aOR: 0.6; p = 0.024) is a preventive measure against STH infections. STH was prevalent in the study area. The mother's occupation (farmer) and the lack of handwashing with water and soap influenced STH transmission. Conversely, washing hands after visiting the toilet and after playing with soil reduced the risk of STH infection. [ABSTRACT FROM AUTHOR]

Coronavirus disease-19 (COVID-19) mitigation includes health screening procedures at entrances of public and private establishments. Conventional methods include manual operations on temperature and face mask checking, personal identification, and hand disinfection. In this paper, a gateway kiosk is designed by integrating and automating the primary screening procedures. It uses radio-frequency identification (RFID) for contactless access control and attendance, with an infrared thermometer for body temperature monitoring. Face mask detection is automated through artificial intelligence (AI), while proximity sensors activate the disinfection system. Internet-ofthings (IoT) interfaces these subsystems, and local access is available via an Internet browser. RFID overcomes the slower response rate of the quick response (QR) code-based solution. The repeated-measure analyses showed that the system's thermometer has only +0.28 °C error while its residual neural network-10 (ResNet-10) and MobileNetV2 models for detecting masked faces achieved a 98.2% accuracy. The system reduces the primary key performance indicators-service and queuing times by 56.86% and 79.95%, respectively. Its audio and visual notifications ensure the proper screening implementation, thus reducing unnecessary and risky interactions with entrance personnel. It improves the screening procedures by significantly reducing human interactions and enhancing queuing. [ABSTRACT FROM AUTHOR]

This paper presents a thorough evaluation of health outcomes linked to water-related challenges in Islamic nations across East Asia and Central Asia from 2020 to 2030. It has been examined carefully that the trajectory of deaths and disability-adjusted life years associated with unsafe water sources, lack of sanitation, and absence of handwashing facilities is showing a potential rise in negative health impacts due to water pollution. The direct health influences of water-related problems are thoughtful. The increase in deaths and DALYs due to poor water quality and sanitation leads to a higher occurrence of waterborne diseases such as cholera, diarrhea, and dysentery. These conditions not only cause instant health disasters but also subsidize to long-term health issues which include chronic gastrointestinal disorders and malnutrition that is particularly among susceptible populations like children and the elderly. Employing various predictive models including autoregressive integrated moving average, exponential smoothing, support vector machines, and neural networks. The study evaluates their predictive capabilities by using mean absolute percentage error. Support vector machines is found to be the most accurate in forecasting deaths and disability-adjusted life years which is outperforming autoregressive integrated moving average, exponential smoothing, and neural networks. This research aims to inform stakeholders by providing insights into effective strategies for improving water resource management and public health interventions in the targeted regions. [ABSTRACT FROM AUTHOR]

Background: Community Health Workers (CHWs) play a crucial role in outbreak response, including health education, contact tracing, and referral of cases if adequately trained. A pilot project recently trained 766 CHWs in Wakiso district Uganda on epidemic and pandemic preparedness and response including COVID-19. This evaluation was carried out to generate evidence on the outcomes of the project that can inform preparations for future outbreaks in the country. Methods: This was a qualitative evaluation carried out one year after the project. It used three data collection methods: 30 in-depth interviews among trained CHWs; 15 focus group discussions among community members served by CHWs; and 11 key informant interviews among community health stakeholders. The data was analysed using a thematic approach in NVivo (version 12). Results: Findings from the study are presented under four themes. (1) Improved knowledge and skills on managing epidemics and pandemics. CHWs distinguished between the two terminologies and correctly identified the signs and symptoms of associated diseases. CHWs reported improved communication, treatment of illnesses, and report writing skills which were of great importance including for managing COVID-19 patients. (2) Enhanced attitudes towards managing epidemics and pandemics as CHWs showed dedication to their work and more confidence when performing tasks specifically health education on prevention measures for COVID-19. (3) Improved health practices such as hand washing, vaccination uptake, and wearing of masks in the community and amongst CHWs. (4) Enhanced performance in managing epidemics and pandemics which resulted in increased work efficiency of CHWs. CHWs were able to carry out community mobilization through door-to-door household visits and talks on community radios as part of the COVID-19 response. CHWs were also able to prioritize health services for the elderly, and support the management of patients with chronic diseases such as HIV, TB and diabetes by delivering their drugs. Conclusions: These findings demonstrate that CHWs can support epidemic and pandemic response when their capacity is enhanced. There is need to invest in routine training of CHWs to contribute to outbreak preparedness and response. [ABSTRACT FROM AUTHOR]

Purpose: The Covid-19 epidemic has imposed profound changes on the practice of orthodontics. It was in this anxiety-inducing context that drastic measures were imposed on orthodontists. The main aim of this online survey is to highlight the measures that are still in place in French orthodontic practices three years after the emergence of the pandemic. Methods: A cross-sectional online survey was distributed to French orthodontists from march to June 2023. The questionnaire, consisting of 32 questions, was divided into five sections covering habits before and after the pandemic, and the feelings of professionals. Results: In this survey 230 complete answers were recorded. Three years later, the daily pace had returned to its pre-crisis level. Disinfection and aeration times were still present (p < 0.001). Orthodontists maintained and generalized the use of protective glasses (p = 0.17) and visors (p < 0.001). The same was true for the FFP2 mask and its frequency of change, as well as rigorous hand washing. Finally, the dedicated layout of the practices was maintained: protective screen, filtration system, supply of SHA, travel paths, removal of magazines (for all, p < 0.001). Conclusion: This study shows that the professional practices imposed by the Covid-19 crisis have been adopted by the majority of French orthodontists, and now appear to be anchored in their routine practice. Trial registration number: opinion n°2023–004, dated 01.25.2023. [ABSTRACT FROM AUTHOR]

Research often defines Work-integrated Learning (WIL) as an educational approach that provides students with work-based experiences. In this article, we argue that this approach definition of WIL is nonsensical and maintains a research terminology that fails to capture what WIL is, namely, a multidimensional learning phenomenon. Drawing on this argument, this article aims to explore and problematise how the term WIL is used in contemporary research. To achieve this aim, we draw on contemporary research and conduct a text analysis of 48 extended abstracts that were accepted for an international WIL conference in December 2022. The text analysis generated three recurring research phenomena that we relate to research. These are (i) WIL avoidance, when the WIL term is evaded although it could very well have been used, (ii) WIL washing, when the WIL term is used in a hollow manner, and (iii) WIL ambiguity, when the WIL term is used vaguely. We scrutinise how these research phenomena and the approach definition of WIL pose challenges to establishing a comprehensive research terminology that can bring about an increased understanding of what WIL is. Finally, we call for research to use a more careful and nuanced terminology that acknowledges WIL’s multidimensional nature. [ABSTRACT FROM AUTHOR]

The knowledge, attitudes, and practices (KAP) framework is often used in public health to explore people's adaptive behaviors and to guide intervention programs. Still, psychometric and structure-wise refinements could provide new insights, more aligned with an epidemiological view of people's role in disease transmission and containment. Our study aims to (1) develop a psychometrically adequate KAP instrument for measuring COVID-19 pandemic responses, and (2) test a structural configuration of KAP that can aid in estimating behavior-related epidemiological parameters in a population: (a) the average number of people that an infected person comes into contact with per unit of time, (b) the probability of each of these exposures to result in infection. One relates to behavioral prevention practices through social distancing or isolation and was measured by the Contact Practices subscale. The other links to health practices, like mask-wearing or hand-washing, being measured by the Probability Practices subscale. A first multi-mediation model suggests that Knowledge has both direct and indirect effects on Probability Practices, but only indirect on Contact Practices, mediated by Attitudes. Two distinct content areas emerged for measuring Knowledge: Preventive Measures, and Causes and Consequences. The final path model demonstrates an excellent fit, indicating that knowledge regarding Preventive Measures has effects on Practices, both directly and indirectly through Attitudes. Disease containment depends on balancing Probability Practices and Contact Practices as distinct but equifinal behavioral strategies, both amenable to attitude-centered intervention. Consistent with other infectious disease research, knowledge about prevention practices far outweighs specialized medical information in promoting adaptive timely responses. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 70% of diarrheal cases in Kenya are attributed to ingestion of contaminated food and water and costs an estimated $ 1 billion USD due to morbidity and cost of treatment. This study aimed to assess the levels of microbiological contamination of meat sold in selected butcheries in Nairobi and the handling practices of butcher shop attendants. Methods: A cross-sectional study design was used during which 200 meat samples were collected, and meat handling practices were observed. Total coliforms and Escherichia coli were enumerated using 3M™ Petrifilm® count plates. Additionally, quantification of tetracycline- and cefotaxime-resistant Enterobacteriaceae was done on agar plates containing the respective antibiotics. Bacterial species were confirmed by Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry. Results and discussion: Seventy two percent and 84% of the samples had E. coli and total coliforms respectively above the acceptable regulatory limits (i.e. E. coli >100 CFU/g, Total coliforms >361 CFU/g,) respectively as per the Kenya Bureau of Standards South African microbiological standards the European Union. Enterobacteriaceae resistant to tetracycline and cefotaxime were detected in 35% and 9.5% of the samples respectively. Eighty-five percent of the butcher shop attendants neither washed their hands before nor after handling the meat, 91% handled money while selling meat concurrently, and 99% did not wear gloves while handling meat. These poor meat handling practices coupled with the presence of microbial loads above the regulatory acceptable limits imply an increased risk of foodborne illness to consumers. Therefore, there is an urgent need for education of butcher shop attendants on appropriate handling of meat, highlighting the importance of good hygienic practices and their relationship to food safety, and provision of incentives for behavior change. This study is important and serves to inform policymakers in the identification of key control points for designing meat safety intervention(s). [ABSTRACT FROM AUTHOR]

To examine the association of health and hospital workers' fears of coronavirus disease 2019 (COVID‐19) with anxiety, anxiety sensitivity, depression, and sociodemographic variables during the COVID‐19 pandemic. A total of 527 participants (237 men/289 women) were included, 222 of the participants were doctors, 99 nurses, 22 assistant health personnel, and 182 hospital personnel without health education. Participants filled in the sociodemographic data form, Beck Depression Inventory, Beck Anxiety Inventory, Anxiety Sensitivity Index‐3, and Fear of COVID‐19 Inventory. In linear regression analysis, independent predictors of the fear of COVID‐19 were determined as Beck Anxiety Inventory (p < 0.001), Beck Depression Inventory (p = 0.001), and Anxiety Sensitivity Index‐3 Physical subscale (p = 0.001). The fear of COVID‐19 is associated with the physical subscale of anxiety, depression, and anxiety sensitivity. [ABSTRACT FROM AUTHOR]

The development of contactless methods to assess the degree of personal hygiene in elderly people is crucial for detecting frailty and providing early intervention to prevent complete loss of autonomy, cognitive impairment, and hospitalisation. The unobtrusive nature of the technology is essential in the context of maintaining good quality of life. The use of cameras and edge computing with sensors provides a way of monitoring subjects without interrupting their normal routines, and has the advantages of local data processing and improved privacy. This work describes the development an intelligent system that takes the RGB frames of a video as input to classify the occurrence of brushing teeth, washing hands, and fixing hair. No action activity is considered. The RGB frames are first processed by two Mediapipe algorithms to extract body keypoints related to the pose and hands, which represent the features to be classified. The optimal feature extractor results from the most complex Mediapipe pose estimator combined with the most complex hand keypoint regressor, which achieves the best performance even when operating at one frame per second. The final classifier is a Light Gradient Boosting Machine classifier that achieves more than 94% weighted F1-score under conditions of one frame per second and observation times of seven seconds or more. When the observation window is enlarged to ten seconds, the F1-scores for each class oscillate between 94.66% and 96.35%. [ABSTRACT FROM AUTHOR]

Background: Undergraduate training in hand hygiene is a keystone of infection control. Several studies have shown overconfidence effects in hand hygiene practices, which can impair metacognition. We hypothesized that overconfidence might be prevalent in the early education stages of nursing students and that these effects could be reduced through frequent interactive learning formats, such as learning groups. Methods: We conducted a multicenter cross-sectional questionnaire with 196 German nursing students, including general, surgical, and anesthetic nursing specializations. Results: Overconfidence was observed in nursing students across all specialties and years of education. The cluster analyses showed three different types of learners: two characterized by overconfidence and one demonstrating justifiable confidence. Furthermore, the moderation analysis indicated that providing feedback and promoting metacognition regarding students' learning achievements could mitigate overplacement, particularly through the frequent implementation of interactive teaching formats. Discussion: Despite some limitations, these findings highlight the prevalence of overconfidence effects in nursing students, the presence of different learning profiles, and the importance of incorporating feedback within interactive learning formats concerning hand hygiene. Accordingly, educators need to be trained and supervised to deliver these learning formats and provide feedback to students effectively. [ABSTRACT FROM AUTHOR]

Studies have indicated that men are less likely to engage in COVID-19- safety precautions such as mask wearing and social distancing compared to women, and men's adherence to masculine gender norms may contribute to this discrepancy. This systematic review sought to consolidate extant research exploring the relationship between men's adherence to masculine norms and their attitudes and engagement with COVID-19 safety precautions. A systematic search was conducted across APA PsycInfo, MEDLINE, and SCOPUS to identify data from quantitative and qualitative studies, written in English, using samples including adolescent or adult males. Of the 4,326 studies initially identified, 11 studies met the inclusion criteria (eight quantitative and three qualitative). A total number of 3,134 male participants were included, the majority of which were from North America. The meta-analysis revealed a negative relationship between men's adherence to masculine norms and wearing masks (r = −.52, n = 2,783) and general or mixed measures of COVID-19 precautions (r = −.18, n = 612). There was insufficient evidence to metaanalyse other specific relationships; however, the thematic synthesis revealed a limited quantity of evidence that reported mixed findings about whether or not masculinity is related the specific precautions of hand washing, social distancing, restricted travel, vaccinations, and staying at home. As the majority of studies were U.S. based and the concept of masculinity can vary by culture, further research is required to determine the cross-cultural validity of these findings. The present review provides valuable insight for policy makers looking to mitigate the spread of COVID-19. Public Significance Statement: The COVID-19 pandemic continues around the globe, and public health response strategies must continually be updated to ensure they remain efficacy. This review shows consistent evidence that men who adhere to traditional social norms around masculinity are less likely to engage in safety precautions that protect themselves and their communities from contracting COVID-19. This has serious implications including contributing to the longevity of the pandemic and associated financial, health, and well-being costs. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of novel infectious diseases has amplified the urgent need for effective prevention strategies, especially ones targeting vulnerable populations such as children. Factors such as the high incidence of both emerging and existing infectious diseases, delays in vaccinations, and routine exposure in communal settings heighten children's susceptibility to infections. Despite this pressing need, a comprehensive exploration of research trends in this domain remains lacking. This study aims to address this gap by employing text mining and modeling techniques to conduct a comprehensive analysis of the existing literature, thereby identifying emerging research trends in infectious disease prevention among children. Methods: A cross‐sectional text mining approach was adopted, focusing on journal articles published between January 1, 2003, and August 31, 2022. These articles, related to infectious disease prevention in children, were sourced from databases such as PubMed, CINAHL, MEDLINE (Ovid), Scopus, and Korean RISS. The data underwent preprocessing using the Natural Language Toolkit (NLTK) in Python, with a semantic network analysis and topic modeling conducted using R software. Results: The final dataset comprised 509 journal articles extracted from multiple databases. The study began with a word frequency analysis to pinpoint relevant themes, subsequently visualized through a word cloud. Dominant terms encompassed "vaccination," "adolescent," "infant," "parent," "family," "school," "country," "household," "community," "HIV," "HPV," "COVID‐19," "influenza," and "diarrhea." The semantic analysis identified "age" as a key term across infection, control, and intervention discussions. Notably, the relationship between "hand" and "handwashing" was prominent, especially in educational contexts linked with "school" and "absence." Latent Dirichlet Allocation (LDA) topic modeling further delineated seven topics related to infectious disease prevention for children, encompassing (1) educational programs, (2) vaccination efforts, (3) family‐level responses, (4) care for immunocompromised individuals, (5) country‐specific responses, (6) school‐based strategies, and (7) persistent threats from established infectious diseases. Conclusion: The study emphasizes the indispensable role of personalized interventions tailored for various child demographics, highlighting the pivotal contributions of both parental guidance and school participation. Clinical Relevance: The study provides insights into the complex public health challenges associated with preventing and managing infectious diseases in children. The insights derived could inform the formulation of evidence‐based public health policies, steering practical interventions and fostering interdisciplinary synergy for holistic prevention strategies. [ABSTRACT FROM AUTHOR]

Adolescence is a critical period of physical, cognitive, and social development that needs to be supported with healthy diets. Dietary behaviours of adolescents can be shaped by their nutrition‐literacy and their interaction with parents and peers as well as their school food environment. Therefore, the present study aimed to assess factors that influence dietary behaviours of adolescents in urban Ethiopia. Sex‐disaggregated, focused group discussions (n = 70) were conducted in 36 private and government schools (n = 12/city) among adolescents (n = 432) 15–19 years of age in Addis Ababa, Bahir Dar, and Dire Dawa. Photovoice was applied in a subgroup of participants (n = 216) to gain further insights into adolescents' perception of their school food environment. Key informant interviews were conducted among school principals (n = 36). Adolescents had a relatively good nutrition knowledge and recognised the importance of diverse diets, but misperceptions also existed. They identified fruit and vegetables as healthy foods, but their consumption was deterred by food safety concerns. The adolescents identified foods high in salt, fat, and sugar, including processed/packaged foods as unhealthy, but still consumed them frequently due to their taste, affordability, availability and accessibility in and around schools. Both undernutrition and overweight/obesity were linked to social exclusion and bullying in school. Effective behavioural change communication is required to address common misperceptions. School nutrition programs should integrate water, sanitation and hygiene programs to ensure food safety. Regulations promoting healthy eating while discouraging unhealthy dietary behaviours are vital. Interventions to make nutrient‐dense and healthy foods available, accessible, and affordable are urgently needed to improve the nutrition and health outcome of adolescents. Key messages: Adolescents had a relatively good nutrition knowledge, but misperceptions also existedFoods high in fat, sugar, and salt, but also processed/packaged foods were considered unhealthy, but were frequently consumedUnhealthy foods were widely available/accessible in the school food environmentComprehensive food safety and nutrition interventions are needed at schoolsRegulations for availability and advertising of unhealthy foods in and around schools are needed. [ABSTRACT FROM AUTHOR]

Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Background: Acute diarrhoeal diseases (ADD) account for a large number of preventable deaths in India, especially in children less than five years who are more at risk than adults with respect to the degree of dehydration and complications. (1) To measure the incidence of ADD among children under 5 years; (2) Determine risk factors associated among children; (3) Study treatment-seeking behaviour of their mothers. Community-based, prospective, longitudinal study conducted in an urban area of Goa. Material and Methods: 250 children enrolled in the study with their mothers by stratified random sampling technique, conducted house-to-house visits every three months and mothers were interviewed with pre-tested semi-structured questionnaire. The duration of study was one year from January to December 2018. Data entered using EpiData Entry Client®, Analysed using SPSS® software version 22. Student's t-tests and Chi-square tests were used. Results: The incidence of ADD was 0.124 episodes/child/year. Significant association was noted between ADD in children and certain socio-demographic factors like child's sex, birth order, birth weight, immunization status, malnutrition, mother's age group, mother's education, and mothers' hygiene practices. Conclusions: Efforts should be made to educate all mothers about the seeking timely treatment, awareness about home-based management and their types, awareness of ORS, zinc, importance of hygienic practices like hand washing for mother and child. [ABSTRACT FROM AUTHOR]

The importance of diarrhea risk associated with wastewater exposure in agriculture is almost unknown. This study aimed to examine diarrheal infection and risk factors among farmers using wastewater for irrigation in Addis Ababa. A cross-sectional study was employed among 380 farmers (190 exposed and 190 unexposed farmers). Among these, a cohort of 200 adults (100 wastewater-exposed, 100 unexposed farmers) aged 25–69 years were selected and followed up biweekly for two successive vegetables growing seasons to examine the incidence of diarrhea. The incidence rate of reported diarrhea was 12 episodes per 1,000 person-weeks at risk and a maximum of 17 episodes per 1,000 person-weeks at risk. Strongly associated risk factors include washing body and clothes with wastewater [AOR: 4.2, 95%CI (1, 11.2)], using working clothes at home [AOR: 4.7, 95%CI (0.25, 87)], and wearing protective cloth [AOR: 5.6, 95 CI (0.3, 70)]. Moreover, hand washing after work, washing feet and boots, and on-site hand washing were significant determinants of farmers’ diarrhea. Exposure to wastewater significantly contributes to the risk of diarrhea among adults. Significant determinants of diarrhea among farmers include washing the body and clothes with irrigation water, contamination with soil and irrigation water, and on-site hand washing. Increased risk factors include hand contamination, washing vegetables with irrigation water, eating raw vegetables, and using work clothes at home. [ABSTRACT FROM AUTHOR]

Background: Carbapenemase-producing Enterobacterales (CPE) are a group of Gram-negative bacteria causing global concern due to their resistance to carbapenems. In this report, we detail the learning points from a CPE outbreak in a tertiary neonatal unit (NU) in the UK. Methods: Routine surveillance screening (rectal swabs) of babies on the NU identified a potential cluster of CPE carriage. Samples were sent to a reference laboratory for confirmatory testing. Environmental screening and cot mapping were undertaken to determine movements of babies within the unit. Regular audits of cleaning standards, hand hygiene, and maternal hygiene when expressing breast milk were carried out. Results: The outbreak lasted 19 weeks. During the outbreak, there were 360 admissions, with 11 babies being colonised with the outbreak strain. Once the outbreak was declared, there were enhanced Infection Prevention and Control (IPC) precautions (including increased environmental and equipment cleaning frequency). CPE screening frequency was increased and cot capacity was reduced. Hand hygiene compliance improved from 92% at the start of the outbreak to 100% by its close. Cleaning standards remained compliant. Maternal hygiene standards varied from 78% to 100%, but no cross-infection links were identified. Environmental screening was negative. No route of cross-infection was identified. Notably, no babies developed invasive CPE infection. Conclusion: This is the first report of a CPE outbreak in a UK NU. Although no specific mode of cross-transmission was identified and the outbreak's end cannot be attributed to any single intervention, the bundle of interventions proved successful after a 5-month period. [ABSTRACT FROM AUTHOR]

Background: Pseudomonas aeruginosa is a major cause of morbidity and mortality in neonatal intensive care units (NICUs). Robust infection prevention and control is key to reducing risk. Aims: We describe lessons learnt from an NICU outbreak of P.aeruginosa in the main maternity hospital in the country. Methods: Cases were identified from clinical samples and active screening. Clinical information was collected from the electronic patient record. Infection prevention and control (IPC) practice observations were made using organisational checklists and unit observations. Microbiological testing was by conventional microbiological methods. Statistical analyses were performed using R program. Associations were assessed using the Mann–Whitney U or Fisher exact test. Isolates were typed by pulsed field gel electrophoresis; gel was analysed in Bionumerics software from Applied Maths, Belgium. Results: Five cases were identified – one was excluded as maternal acquisition. Typing showed a polyclonal outbreak. Widespread contamination of tap outlets of handwashing sinks in clinical areas was found. Main contributing factors were extensive misuse of hand wash sinks for waste disposal, improper sink cleaning, poor hand hygiene compliance and inadequate environmental cleaning. Discussion: Successful management required a multi-disciplinary approach. All potential water sources and moist environments within and outside the unit were investigated. Interventions successfully addressed the main contributing factors, supported by good communication and robust auditing. With a diverse workforce, the challenge was to ensure housekeeping staff understood handwash sink cleaning procedures; existing training programmes were delivered in multiple languages tailored to the workforce. [ABSTRACT FROM AUTHOR]

Introduction: Atypical or nontuberculous mycobacteria (NTM) are an environmental organism responsible for opportunistic infection. Rapid-growing NTM are more commonly associated with hospital-acquired infections. Many of the organisms responsible for diseases in immunocompromised patients and hospital-acquired infections originate from tap water, such as Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium gordonae, Mycobacterium simiae, Mycobacterium mucogenicum, Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus. NTM is a rare organism responsible for the injection abscess. Considering low incidents, not much clinical data are available for this condition. Here, we discuss such cases which can be helpful to spread awareness and provide data for future policy makers. Materials and Methods: This was a retrospective study. Data on patients with injection abscess were collected from the last 6 years. Detailed history and clinical examination findings were analyzed. Children with injection abscess were operated and their further management and outcome were studied. Results: A total of 13 cases with confirmed culture of NTM were treated over 6 years. The age ranged from 2 1/2 months to 5 3/4 years with male:female ratio of 7:6. All patients hailed from the same geographical area. All children were healthy with no history of any long-term or chronic illness, without additional symptoms and had received Bacillus Calmette-Guérin vaccination at birth. The total duration of illness varied from 1 to 5 months, with a mean of 3 months. All patients had a history of intramuscular age-appropriate vaccination as per the national immunization schedule. All patients were followed up to 6 months after intervention and none of our patients developed relapse. Conclusion: Patient who does not respond with optimum treatment should have a high suspicion of such opportunistic infection, which is crucial to their management. Hospital-acquired NTM infections often result from contaminated instruments or fluids. Adherence to strict aseptic precautions, hand hygiene and environmental precautions are the key to preventing these infections. In case of skin and soft tissue infections / abscesses, surgical intervention plays a significant role for managing the patient. [ABSTRACT FROM AUTHOR]

The Environmental Protection Agency (EPA)'s Worker Protection Standards is the primary set of legislation aimed at protecting farmworkers from occupational pesticide exposure in the United States. Previous studies suggest that worker adoption of Pesticide Protective Behaviors (PPBs) promoted by WPS is associated with lower urinary pesticide concentrations. However, adoption of PPBs is often outside of the control of individual farmworkers and dependent on workplace factors such as employer provisioning of Personal Protective Equipment (PPE) and access to trainings/resources. We conducted a mixed-method study including urinary pesticide biomonitoring, surveys, and interviews with 62 Latinx farmworkers in southwestern Idaho from April to July 2022. We integrated findings across the various data sources to identify emergent themes relating to farmworkers' perceptions of workplace compliance with WPS and potential implications for their pesticide risk perceptions, protective behaviors, and urinary pesticide concentrations. Participants reported some indications of poor workplace compliance with WPS regulations, notably inconsistent access to clean handwashing stations and notification of pesticide applications. Some farmworkers, particularly pesticide applicators, viewed herbicides to be categorically safer than other classes of pesticides such as insecticides; these perceptions appeared to influence protective behaviors, such as the relatively low use of PPE while applying herbicides. These findings are underscored by the higher concentrations of biomarkers of herbicides, but not insecticides, among pesticide applicators compared with non-applicators (e.g. median 2,4-D concentrations = 1.40 µg/L among applicators and 0.69 µg/L among non-applicators). Participants further reported concerns regarding the inadequacy of pesticide safety training, pesticide drift, and the lack of communication regarding pesticide applications on and near fields where they are working. Participants' perceptions that herbicides are categorically safer than other pesticide classes is in direct conflict with WPS training, raising concerns about discrepancies between WPS instruction and other on-the-job training, as well as the inadequate provisioning of PPE during the application of certain pesticides. Our findings also suggest that current WPS regulations may not sufficiently address farmworkers' concerns, particularly in regard to pesticide drift. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare Workers (HCWs) have borne the major brunt of the Coronavirus Disease-2019 (COVID-19) pandemic, being at the forefront. With the disease being enigmatic and no proven treatment or vaccine available during the initial stages, personal protection in general, and hand hygiene, in particular, have been the mainstays for protection against the disease, exposing HCWs to more wet work. Wet work exposure is considered a major risk factor for the occurrence of Hand Eczema (HE). Aim: To estimate the prevalence of hand dermatitis and ascertain the risk factors among HCWs exposed to wet work while caring for COVID-19 patients. Materials and Methods: A cross-sectional study was conducted among HCWs managing COVID-19 patients in a dedicated COVID-19 hospital from July to December 2020. The diagnosis of HE was based on medical history and clinical examination. Clinical features like itching, redness, scaling, clustered papulovesicles, hyperkeratosis, or fissuring largely confined to the hands, with none or only minor involvement of other areas, were used in diagnosing HE. An association of various wet work exposures with HE among study participants was analysed. Categorical variables were analysed using the Chi-square test, and a p-value <0.05 was considered statistically significant. Results: A total of 390 HCWs, of which 203 (52.1%) were females, participated in the study. The majority, i.e., 329 (84.4%) of participants, were in the age range of 21-35 years. A total of 244 (62.6%) HCWs were performing duties for 30-40 hours per week. Among all 390 HCWs studied, 102 (26.2%) were found to have features of HE. High frequency of alcoholic hand disinfectant use (>20 times daily) was significantly associated with the occurrence of HE. Similarly, the high frequency of hand washing with soap at work (>20 times) significantly increased the risk of developing HE. A prior history of atopic diathesis was found to be a significant risk factor for fresh episodes of HE. Conclusion: The present study concludes that intensive hand hygiene during the prevailing COVID-19 pandemic leads to the occurrence of HE among HCWs. [ABSTRACT FROM AUTHOR]

The English alternative embedded passive (AEP), or "needs washed" construction, is a noncanonical morphosyntactic feature found in some American and British Englishes. It involves a matrix verb surfacing immediately before a participle. Previous research has described this construction as only licit with matrix need, want, and like; however, isolated examples of the AEP with additional matrix verbs have surfaced. These rarely attested instances raise questions regarding the basic description of the construction and how matrix verb availability is constrained, as well as whether the AEP is truly the same feature across AmE and BrE varieties. This paper utilizes a large-scale grammaticality judgement survey to obtain as exhaustive a set of AEP matrix verbs as possible. Results show that far more verbs can be used in the AEP than previously attested. Acceptance is constrained by lexical semantics, verbal syntax, and verb productivity. This alternative view of the AEP as a more generalized phenomenon nevertheless shows a strong link between AmE and BrE varieties, as the constraints are nearly identical across the nations. The findings illustrate how attention to rarely attested or non-attested data can inform morphosyntactic and dialectological research. [ABSTRACT FROM AUTHOR]

Purpose: This mixed methods study aimed to assess the knowledge and skills related to infection prevention and control amongst visitors to long-term care homes following the removal of visiting restrictions during the Covid-19 pandemic. Methods: Forty visitors to residents in long-term care homes were recruited. Participants' knowledge of the Covid-19, infection prevention and control practices, and self-reported use of protective behaviours were assessed through questionnaires. Handwashing skills, donning and doffing of personal protective equipment and decision-making surrounding hand hygiene moments were assessed through laboratory simulation using observation checklists. Results: Participants' level of knowledge and perceived use of protective behaviours were high. However, no one accurately performed the handwashing steps, few (5.0%) performed all hand hygiene moments recommended, 35.0% donned personal protective equipment and only 12.5% doffed correctly. This is concerning because 90.0% of participants reported receiving infection prevention and control training. Conclusion: These findings suggest educational interventions, resources and policies are needed to strengthen infection prevention and control training for visitors' to long-term care. [ABSTRACT FROM AUTHOR]

Handwashing represents an important personal hygiene measure for preventing infection. Herein, we report the persistence of antibacterial and antiviral effects after handwashing with fatty acid salt-based hand soap. To this end, we developed a new in vitro test method to measure persistence, utilizing coacervation formed by anionic surfactants and cationic polymers to retain highly effective soap components against each bacterium and virus on the skin. Coacervation with fatty acid salts and poly diallyldimethylammonium chloride (PDADMAC) as a cationic polymer allowed the persistence of antibacterial and antiviral effects against E. coli, S. aureus, and influenza virus even 4 h after handwashing. Furthermore, we confirmed an increase in the number of residual components effective against each bacterium and virus on the skin. In summary, the current findings describe an effective approach for enhancing the protective effects of handwashing. [ABSTRACT FROM AUTHOR]

After the first generation of Pan-Africans formed at the beginning of the 20th century mainly by black Americans and Caribbeans, the second generation is formed with black Africans. These black Africans are inspired and influenced by the founding fathers of Pan-Africanism. Marcien Towa (1931-2014) is one of them. The philosopher is a key figure in the intellectual history of Africa who has contributed ardently, alongside other renowned intellectuals, to the writing of the modern history of Africa. His fight very legitimately was to wash the Africans of opprobrium (the stereotyped images of Africa and its inhabitants created by the colonizers). Through his criticism of Senghorian negritude, he makes a remarkable contribution to the reflection on the movement, a considerable contribution to the ideology of Pan-Africanism. [ABSTRACT FROM AUTHOR]

Abstract Background Students in school are more likely to be sick from communicable diseases like diarrheal illnesses, acute respiratory infections, and other illnesses linked to poor personal hygiene. Poor hygiene practices are common among school children and put their health at risk, which in turn has several consequences. These include significant school absences, transmission of infectious diseases to other students, and missed workdays for parents and guardians. However, there is limited evidence on the level of personal hygiene practice and its associated factors among school students. Thus, this study was aimed at determining personal hygiene practice level and its associated factors among elementary school grade (5–8) students in Fiche town, Oromia, Ethiopia, in 2022. Methods A cross-sectional study design was conducted from April 29 to May 29, 2022, in Fiche town, Oromia regional state, among 534 elementary school students. A multi-stage probability sampling technique was used to select the individual students. A structured questionnaire was used to collect the data. The data was entered into epi-data version 4.6 and analyzed by SPSS version 26.0. Variables that scored a p-value less than 0.2 during bivariate analysis were included in multilevel logistic regression models to determine factors associated with personal hygiene practice. The odds ratio with a 95% confidence interval was estimated, and the level of significance was set at $$\:\le\:$$ 0.05. Results The magnitude of good personal hygiene (scored above the mean) was 59.2% (95% confidence interval (CI)) (55.1–63.0). A considerable proportion of students scored more than 50% in latrine use (62.5%), regular hand-washing (55.4%), and oral hygiene (55.20%) practices. Being female, having good personal hygiene knowledge, doing hygiene inspections at school, and having latrine accessibility was significantly associated with good personal hygiene among elementary school students. Conclusion Considerable proportion of elementary school students in Fiche town have score poor personal hygiene practice. Interventions aimed that target improving knowledge of personal hygiene and hygiene inspection at school are crucial to enhance the personal hygiene among elementary school students.

Background: Infections are the leading causes of death in children. Most of these infections are transmitted through the hands of mothers, carers and health workers. Objective: To determine the pattern of home-based hand hygiene practices among mothers of young infants attending a tertiary facility clinic in relation to infections in their infants. Methods: A cross-sectional study of mothers of infants attending an immunization clinic was conducted using a self-designed, pretested questionnaire. Results: The mean age of the 203 mothers was 30.3 ±3.8 years. The majority of the mothers received counselling about hand washing as part of antenatal care (79.8%), had access to water at home (94.0%) and always washed hands with water and soap (48.3%). Although 149 (73.4%) knew hand sanitizers, only 28 (13.8%) used it. Close to half of their infants (46.3%) had various infections (diarrhoea, acute respiratory infections, and boils) within a month of the interview. Only counselling was associated with good quality hand washing practices (p< 0.0001) while the age of child less than 6 months and good quality of hand washing were associated with the absence of infections in the infants (p = 0.029 and (p

Abstract Food safety remains a critical issue with outbreaks of foodborne illness. The knowledge gap of food safety and improper hygienic practices of food handlers are the key factors for the transmission of foodborne diseases. This study was conducted to investigate the level of food safety knowledge and practices among street food vendors in Dhaka City, Bangladesh, and its implications on consumers’ health. This cross-sectional study was conducted among 350 respondents in seven areas of Dhaka City. Trained data collectors gather data by interviewing street vendors using a pretested questionnaire. Most of the vendors (98%) were male, with 48% having secondary education and 85% having no food safety training. Although about 89% of the vendors were found to practice hand washing, only a small proportion of them practised using hand gloves while handling raw products (5.6%), cleaning tables (2.2%), preparing foods (1.3%) or handling garbage (0.9%). The education level of the vendors and their work experience were significantly correlated with their hand washing practice, wearing hand gloves and their knowledge about food-borne illnesses. The study demonstrated that formal education played a significant role in vendors’ knowledge and practice of health safety measures for food handlers to prevent foodborne illness. Effective food safety training and monitoring are needed to increase vendors' knowledge and practices, and in reducing foodborne diseases.