Cereulide and diarrheal toxin contamination in milk and milk products: a systematic review

Emetic and diarrheal toxins produced by endospore-forming Bacillus cereus causes a huge loss to dairy industry. Milk is the suitable medium for the growth of B. cereus. The pathogen is of particular concern in the dairy industry because in spite of aggressive cleaning practices performed by the dairy industry, it is impossible to destroy these hydrophobic spores which adhere to the pipelines of the dairy-processing plant and further these spores may also form biofilms in the milk. The reporting rate of illness caused by B. cereus is vague, usually due to the short duration of (<24?h) the diarrheal and emetic syndromes. The study of toxins production by B. cereus isolates is essential to better determine the methods of controlling these toxins in dairy industry.     

Increasing suction pressure during endotracheal suctioning increases the volume of suctioned secretions,but not procedure-related complications: A comparative study in open system endotracheal suctioning

ObjectivesTo compare the effect of three different suction pressures (80 mmHg, 150 mmHg, 250 mmHg) with the open system suction method in terms of the volume of secretions and complications development in intubated intensive care patients.Research methodology/designThis study was planned as a prospective, experimental, self-controlled design. The study sample included 47 patients. Data were collected using a data collection and patient follow-up form from patient records.SettingSingle adult intensive care unit in a university hospital.ResultsFifty five percent of the patients were male, 61.7% were older than 65 years and 38.32% had lung infection. The amount of suctioned secretions tended to increase significantly with increasing negative pressure and there was a significant difference between the pressures in terms of the median volume of suctioned secretions (p < 0.001). There was no significant difference between the suction pressures in terms of oxygen desaturation, hypertension rates (p > 0.05). Tachycardia, bradycardia, hypoxaemia, tracheal mucosal damage or mucosal bleeding were not observed during suctioning with three different suction pressures.ConclusionIt may be assumed that 250 mmHg suction pressure, via compliance with open system suction method related procedures, is being more effective and equally safe for secretion cleaning in comparison to the 80 and 150 mmHg suction pressures.     

Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia

In recent decades, most states’ Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution.     

The Association between Physical Education and Mental Health Indicators in Adolescents: A Cross-Sectional Study

Objective: To explore the associations between physical education attendance and mental health indicators. Methods: Using data from the Global Student Health Survey, the frequency of physical education attendance, suicidality-related indicators, loneliness, bullying, and anxiety were all assessed using a standardized self-reported questionnaire. Multivariable logistic regression was used to estimate the association between physical education attendance and mental health-related indicators. Results: The study included 276,169 participants from 71 countries (47.3% males, aged 11–18 years old). After controlling for sex, age, food insecurity, close friends, physical activity, sedentary time, others’ help, and parents’ understanding, physical education attendance was not signifi- cantly associated with suicidal attempts, suicidal ideation, and anxiety. However, compared with no physical education attendance, individuals attending physical education for 1, 2, as well as 5 or more days had significantly reduced odds/ratios of suicide; only 2 days of physical education attendance was associated with a lower odds ratio for suffering from loneliness. Even 1 day of physical education was associated with not being bullied by others. Conclusion: This study suggests that physical education attendance may not have an effective role in reducing mental health illnesses in children and adolescents. Future studies are encouraged to corroborate or negate our research discoveries by using better and further improved study designs.