RETRACTED ARTICLE: Silicotuberculosis as an occupational infection: rate,risk factors and control strategies

We, the Editor and Publishers of Archives of Environmental & Occupational Health, are retracting the following article:

Abdolmajid Ghasemian, Farshad Nojoomi & Hassan Rajabi-Vardanjani, ‘Silicotuberculosis as an occupational infection: rate, risk factors and control strategies,’ Archives of Environmental & Occupational Health, 2019, DOI: 10.1080/19338244.2019.1619505

We are now cognizant of a substantively similar version of this article that had previously been published in the journal New Microbes and New Infections.

We have been informed in our decision-making by the guidance of COPE Guidelines on Retractions.

The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as ‘Retracted’.     

Multi-criteria Mapping of Stakeholders’ Viewpoints in Five Southeast Asian Countries on Strategies to Reduce Micronutrient Deficiencies Among Children and Women of Reproductive Age: Findings from the SMILING Project

Background

Despite scientific evidence on the potential impact or importance of specific interventions to improve micronutrient status of vulnerable groups, political commitment and extensive support from national stakeholders is paramount to support introduction and implementation of these interventions at national level. In order to develop efficient nutritional strategies to improve the micronutrient status of children < 5 years of age and women of reproductive age that will be supported by a wide range of stakeholders, a better understanding of viewpoints on the nutrition politics and strategies is necessary. Multi-criteria mapping (MCM) was successfully used to assess the stakeholder’s viewpoint in a wide variety of contexts since the late 1990s.

Objective

The objective of the present study was to assess the viewpoints of stakeholders on a wide range of potential nutritional interventions in the five Southeast Asian countries participating in the SMILING project.

Method

MCM methodology was used to appraise the stakeholder’s viewpoints in five countries.

Results

The results show that the overall stakeholders’ preference was for actions already implemented in their country rather than for new, innovative options, even for supplementation. Indirect interventions such like food fortification (except in Indonesia), delayed cord clamping or food-based approaches were generally less favored by the stakeholders. However, the majority of stakeholders agreed that new approaches should be considered and put in place in the future provided that evidence of their impact was demonstrated, that they received adequate technical support for their implementation and their monitoring, and that they will be accompanied by strong advocacy among decision-makers, civil society and beneficiaries.

Conclusions for practice

To conclude, for the introduction of new, innovative strategies to reduce micronutrient deficiencies in South-East Asia, convincing stakeholders appears to be the first hurdle to be taken.

     

Factors contributing to and strategies to combat emerging arboviruses

ABSTRACT

Less than half a century ago infectious diseases appeared to be destined to be extinguished via as a culmination of medical triumphs. As focus turned towards combating non-communicable diseases, emerging and re-emerging diseases (EIDs) have bloomed from those ashes. Five epidemic mosquito-borne arboviruses (Yellow Fever virus (YFV), Dengue virus, West Nile virus, Chikungunya virus, and Zika virus) have emerged in the recent past. Arboviruses are of the utmost importance with respect to EIDs due to intensive growth of globalisation, arthropod urban fitness/adaption, and environmental changes. We focus on recent outbreaks of the arthropod borne viruses (arboviruses) Zika virus and YFV. Factors contributing to the blossoming of EIDs (environmental, globalisation, and urbanisation) and combating strategies (surveillance, containment, and prevention) will be discussed. Specifically, Zika virus and YFV will be used in the context of these factors and strategies. YFV is discussed in detail as it pertains to these factors and strategies in the United States (US), 2017 Brazil Outbreak, 2016 Africa Outbreak, and global risk. Vigilance is needed to focus on, prevent, and control the current and next arbovirus EIDs.     

Introducing alcohol-based hand rub for hand hygiene: the critical need for training.

BACKGROUND: Use of an alcohol-based hand rub for hand hygiene has recently been recommended by the Centers for Disease Control and Prevention. However, the proper technique for using hand rub has not been well described and is not routinely taught in hospitals. OBJECTIVE: To evaluate the impact of training on proper technique as outlined by the European Standard for testing alcohol-based hand rubs (European Norm 1500) in a clinical study. DESIGN, SETTING, AND PATIENTS: Prospective study including 180 healthcare workers (HCWs) in a 450-bed, university-affiliated geriatric hospital where alcohol-based hand rub was introduced in the late 1970s. INTERVENTION: Structured training program in hand hygiene with alcohol-based hand rub. Technique for using hand rub was tested by the addition of a fluorescent dye to the disinfectant and the number of areas missed was quantified by a validated visual assessment method. In addition, the number of bacteria eradicated was estimated by calculating the difference between the log(10) number of colony-forming units (cfu) of bacteria on the fingertips before and after the procedure, and reported as reduction factor (RF). MAIN OUTCOME MEASURE: Log(10) cfu bacterial counts on fingertips before and after training in the appropriate technique for using hand rub. RESULTS: At baseline, only 31% of HCWs used proper technique, yielding a low RF of 1.4 log(10) cfu bacterial count. Training improved HCW compliance to 74% and increased the RF to 2.2 log(10) cfu bacterial count, an increase of almost 50% (P<.001). Several factors, such as applying the proper amount of hand rub, were significantly associated with the increased RF. CONCLUSION: These results demonstrate that education on the proper technique for using hand rub, as outlined in EN 1500, can significantly increase the degree of bacterial killing.     

Probabilistic microsimulation to examine the cost-effectiveness of hospital admission screening strategies for carbapenemase-producing enterobacteriaceae (CPE) in the United Kingdom

Background

Antimicrobial resistance has been recognised as a global threat with carbapenemase- producing-Enterobacteriaceae (CPE) as a prime example. CPE has similarities to COVID-19 where asymptomatic patients may be colonised representing a source for onward transmission. There are limited treatment options for CPE infection leading to poor outcomes and increased costs. Admission screening can prevent cross-transmission by pre-emptively isolating colonised patients.

Objective

We assess the relative cost-effectiveness of screening programmes compared with no- screening.

Methods

A microsimulation parameterised with NHS Scotland date was used to model scenarios of the prevalence of CPE colonised patients on admission. Screening strategies were (a) two-step screening involving a clinical risk assessment (CRA) checklist followed by microbiological testing of high-risk patients; and (b) universal screening. Strategies were considered with either culture or polymerase chain reaction (PCR) tests. All costs were reported in 2019 UK pounds with a healthcare system perspective.

Results

In the low prevalence scenario, no screening had the highest probability of cost-effectiveness. Among screening strategies, the two CRA screening options were the most likely to be cost-effective. Screening was more likely to be cost-effective than no screening in the prevalence of 1 CPE colonised in 500 admitted patients or more. There was substantial uncertainty with the probabilities rarely exceeding 40% and similar results between strategies. Screening reduced non-isolated bed-days and CPE colonisation. The cost of screening was low in relation to total costs.

Conclusion

The specificity of the CRA checklist was the parameter with the highest impact on the cost-effectiveness. Further primary data collection is needed to build models with less uncertainty in the parameters.

     

Public knowledge,attitudes and behaviour regarding antibiotics

Objective: To assess public knowledge, attitudes and behaviour regarding antibiotics to provide information for a local health education policy.

Design: Postal survey to 605 patients registered with two general medical practices in Grampian, NorthEast Scotland (351 respondents, 59.3%) in February/ March 2000. Questionnaire topics covered attitudes, knowledge and behaviour towards antibiotic use.

Results: 326 (93%) bad experience of antibiotic use and 319 (81%) were happy to take antibiotics when necessary. 158 (45%) were concerned about antibiotic resistance. Few would expect antibiotics to treat a slight cold or heavy cold, but around half would expect antibiotics for very sore throats and influenza. 262 (75%) indicated they would ask a pharmacist for advice about the treatment of RTI. Most respondents experienced at least one episode of RTI during the review period. 280 (80%) provided details of their most recent episode; most self-treated, 57 consulted a doctor of whom 43 (75%) were prescribed antibiotics.

Conclusions: Antibiotic resistance is a matter of concern for the public. Mixed opinions about the use of antibiotics for common respiratory tract infection were heard. Encouragingly the majority of people suffering an RTI during the review period treated themselves with paracetamol-based products for symptom relief. Those who consulted a doctor were in the minority but were likely to be prescribed antibiotics. Future local health education initiatives should target antibiotic use for sore throats as well as colds and flu.     

Biotechnology Resources on the World-Wide Web

Abstract

The biotechnology industry is growing tremendously and there have been many recent significant advances in health care, genetics, immunology, and environmental science. The Internet is used increasingly as a medium for researchers, academics, and information providers to quickly access and disseminate biotechnology-related information. This article covers many Web-based resources available in this discipline, including: those providing general information; institutes and research centers; electronic journals; mailing lists and newsgroups; and reference tools. These sites will serve as useful starting points for those investigating specific biotechnology-related topics.     

Update on Clostridium difficile infections

Clostridium difficile infections (CDI) occur primarily in hospitalized patients with risk factors such as concomitant or recent use of antibiotics. CDI related additional costs are important for the global population and health-care facilities. CDI epidemiology has changed since 2003: they became more frequent boosted by large outbreaks, more severe, more resistant to antibiotic treatment, and spread to new groups of population without any risk factor. This is partly due to the emergence and worldwide dissemination of new and more virulent C. difficile strains such as the epidemic clone 027/NAP1/BI. The host immune response plays a central role in the pathogenesis of CDI and could also be involved in the occurrence of recurrent or severe forms. New guidelines including new molecular tests (NAAT) have recently clarified and simplified the diagnostic strategies for the microbiological diagnosis of CDI. The CDI incidence was proven to be related to the level of clinical suspicion and the frequency of microbiological screening for C. difficile. The current recommendations for the treatment of CDI mention oral metronidazole as the first line treatment for mild to moderate diarrhea. Oral vancomycin use should be restricted to severe cases. In the absence of consensus, the treatment of multiple recurrences remains a major concern. New and more targeted antibiotics and innovative therapeutic strategies (fecal transplantation, monoclonal antibodies, and vaccination) have emerged as new therapies for CDI.     

High Stability and Strong Fluorescence of Carbon Nanodots as Nanosensor for Hg2+ in Environmental Waters

Pollution of toxic heavy-metal ions such as mercury ions (Hg²⁺) is well known to severely threaten ecological environment and human health. Correspondingly, development of a fast and sensitive method for detecting heavy-metal ions is urgently needed and has been received widespread attention in recent years. In this study, carbon nanodots (CDs) with strong blue fluorescence were synthesized by a microwave-assisted hydrothermal method. The as-prepared blue fluorescent CDs not only have excellent stability (e.g. photostability, salt stability and pH stability), but also have extremely high selectivity and sensitivity for probing Hg²⁺ via fluorescence quenching. Specifically, fluorescence of CDs is gradually quenched along with the increase in Hg²⁺ concentration, and a low concentration of Hg²⁺ can be identified (with low detection limit, 15 nM). Therefore, the novel fluorescent CDs could be developed for detecting Hg²⁺ in aqueous conditions, and have great potential for fast probing Hg²⁺ in environmental samples.

     

A diagnostic algorithm for evaluating cases of potential macrocyclic lactone–resistant heartworm

Background

The emergence of macrocyclic lactone resistance in canine heartworm poses a substantial threat to what is currently the only effective, FDA-approved available method of prevention. Further study of the biotypes is necessary to understand the mechanism of resistance and evaluate novel prevention options. Identifying cases of drug-resistant infection remains problematic, however, especially when poor compliance and insufficient testing are concerns. Furthermore, a definitive demonstration of resistance requires experimental infection and treatment, which is prohibitively costly.

Methods

With the aim of identifying likely cases of macrocyclic lactone-resistant heartworm and preventing their continued spread, we describe an algorithm for determining the likelihood of drug resistance and appropriate treatment strategies for each case.

Results

This algorithm relies on the microfilarial suppression test (MFST), which has been used previously as an efficient and discrete measure of suspected resistance. By standardizing this method in a format that is readily available to practitioners, it could become possible to preliminarily survey the emergence and spread of resistance.

Conclusion

Heartworm isolates identified through this method can be used in research to better understand macrocyclic lactone resistance so prevention strategies can be adapted.

     

The Use of Single-Group Sessions in Discharge Planning

ABSTRACT

In recent years we are witnessing a growing demand in the health care system for improved economic efficiency and reduction in length of hospital stay. These facts have increased the pressure for planning effective short-term therapeutic methods that will assist the patient's return to family and community life. This situation led the social workers in the internal medicine units to initiate one-session group meetings for patients and families that would provide a response to the distress of primary caregivers and increase access to social work intervention of families with discharge needs.

A model of single-sessions intervention, which had been experienced for the first time in the Sheba Medical Center at Tel-Hashomer, will be presented and evaluated. The presented intervention enabled to reduce anxiety and increase the capabilities of family members to organize and cope with the situation. The intervention also enabled to identify families in need, to emphasize more on the discharge planning as part of the social work function in the hospital setting and help the multi-disciplinary team in the discharge process.     

Measuring Effects of Demographic Variables on Health Services Utilization

To predict demands for health services, planners must measure the impact of demographic change. This article presents a new method, the multi-sort technique, to improve analysis of the effects of multiple demographic variables. The technique is demonstrated in an analysis of the changing demand for physicians' services in Taiwan.

Multiple regression techniques, including those that utilize dummy variables, have been used to analyze effects of demographic variables, but interactions may be overlooked entirely or inadequately identified. Analysis of variance has proved useful in handling interactions, but uneven distribution of observations among cells creates orthogonality problems.

The multi-sort technique is an approximation procedure that simplifies computations while maintaining the analysis of variance approach. The procedure assigns cell weights in all evaluations according to the rules for evaluating main effects; thus the assessment of interactions is approximate but not tedious.

Comparison of computer results obtained by the new technique with those from certain multiple regression procedures indicates that the multi-sort technique offers more promise in the evaluation of demographic data than previous applications of analysis of variance would indicate. The study also gives practical suggestions for combining various techniques in a total analysis.

The Taiwanese data in this paper were obtained from a survey supported by The Agency for International Development.

     

Accelerating Early Language and Literacy Skills Through a Preschool-Home Partnership Using Dialogic Reading: a Randomized Trial

Background

This study tested a preschool-home partnership intervention, in which early childhood teachers encouraged the parents/caregivers of preschoolers to engage in dialogic reading at home. This was an experimental test of Bronfenbrenner’s hypothesis that parental involvement in early care and education programs should promote child development, as well as a test of a train-the-trainer approach to the dialogic reading intervention.

Objective

The current study focuses on testing the causality of parent involvement: (1) homework assigned to parents/caregivers will improve the early language and literacy skills of their 2?~?3-year-old children; (2) gains by children in the intervention group with low pre-test language and literacy score, low family literacy score, and high parents/caregivers’ extent of using dialogic reading strategies at home will show larger gains in literacy scores than their counterparts.

Methods

A sample of 12 early care and education programs, 18 early childhood teachers, 87 two–to three-year-old children and their parents/caregivers were followed for 18?~?20 weeks after assignment to the intervention group or the control group.

Results

The impacts of the six-week parent involvement intervention continued to grow during the six-week follow-up phase, and represented substantial gains of the intervention group in four aspects of early language and literacy skills.

Conclusion

This study provides evidence that a simple homework assignment intervention can be an effective tool to promote child development when parents/caregivers are engaged. The intervention also had ongoing influence on children’s early language and literacy skills, even after the intervention period had ended.

     

The Ethics of Care: Social Workers in an Influenza Pandemic

ABSTRACT

Many healthcare organizations and government agencies are making detailed preparations for the possibility of a pandemic of highly virulent influenza. All plans to date have recognized that there will undoubtedly be a greater need for medical resources than will be available. Thus, we will be faced with a situation in which not all will be offered curative care, even if they could benefit from it. Even if there were sufficient amounts of vaccines, hospital beds, ventilators, and antibiotics, there are still expected to be large numbers of deaths as well as stress due to the overwhelming nature of the pandemic. The challenges of caring for the incurable, the uncured, healthcare workers, and the survivors and their families will place almost unprecedented demands on mental health workers. In this article, I discuss these ethical and medical challenges and the role that social workers will be called on to play.     

Campaign Preparation for Complex Initiatives: A Person-Centered Approach to Audience Segmentation of Parents’ Antibiotic Stewardship

The evolution of antibiotic resistance is outpacing the speed at which new antibiotics will reach the marketplace. To slow the rate of resistance, people need to engage in antibiotic stewardship, which includes acts to prevent the spread of bacteria and judicious use of antibiotics to treat infections. This study identified the patterns and predictors of antibiotic stewardship behaviors of parents (N = 516) related to their children. The latent class analysis revealed three profiles of parental stewardship, labeled Stewards, Requesters, and Non-Stewards. The findings implied different campaign goals: to encourage Stewards to follow through on their intentions, to encourage Requesters to stop asking providers for antibiotics when their children have ear infections, and to influence Non-Stewards to accept medical advice when an antibiotic is not indicated and to dispose of leftover antibiotics. The covariate analysis provided theoretical insight into the strategies to pursue in campaigns targeting these three groups. For example, parents who perceived antibiotic-resistant infections as less serious health conditions, felt less worry when thinking about their child getting an antibiotic-resistant infection, and had stronger misattributions of antibiotics’ efficacy to treat multiple symptoms were more likely to be Requesters and Non-Stewards, instead of Stewards.     

New Program for Improving Care Suggested by AMA President

This retrospective study was designed to review the types and quantities of antibiotics prescribed in a University Hospital Emergency Room. The review also determined the percentage of patients who had cultures taken for a specific disease state and whether or not a follow-up visit was required.

Emergency Room medical records were reviewed to identify patients who were prescribed antibiotics during a one month period. Of 1,783 patients seen by physicians, 210 (11.8%) were prescribed antibiotic therapy.

Of the patients receiving antibiotics, 76 (36.2%) were classified as pediatric patients compared to 134 (63.8%) adults. The diagnoses most frequently prompting antibiotic therapy in adults were respiratory tract infections (23.9%) and urological infections (21.6%).

Otitis media was diagnosed most frequently in children (72.0%) who required antibiotic coverage. Ampicillin (30.9%), penicillin V (16.6%), and dicloxicillin (10.9%) were the antibiotics prescribed most often regardless of disease state or age.

Cultures were obtained in 22% of the pediatric patients as compared to 44% of the adult population. Over 95% of all of the patients were followed-up at a later date.

Significantly, the data identifies current trends in prescribing patterns of antibiotics and provides a basis for future drug utilization reviews in other drug categories.     

Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study

Background

Urinary infection in otherwise healthy women has largely been a straightforward matter of diagnosis by identifying bacteria in the urine, and then cure by appropriate antibiotics. Recent research has shown this to be over-simplified. Evaluation of methods of self-management of symptoms has been neglected.

Discussion

Firstly trial data show that women with what used to called 'urethral syndrome' (urinary symptoms but sterile urine) obtain relief from antibiotics. Other trial data have shown a surprisingly large placebo effect from the resolution of symptoms among women who feel their care has been 'positive'. In addition, data published this month in BMC Medicine show that non-steroidal anti-inflammatory (NSAID) drugs provide symptom relief to women with conventional infections (positive urine bacteriology) as much as antibiotics.

Conclusions

These recent findings provide an opportunity to consider how clinicians might change practice, and sets a new research agenda. We need to know (1) whether the effect of NSAIDs is replicable; (2) why some women in previous trials have had more symptoms if not treated with antibiotics sooner; (3) whether NSAIDs and antibiotics have an additive effect on relieving symptoms; (4) how we can harness the placebo effect better to assist out patients with this distressing and common complaint. See research article http://www.biomedcentral.com/1741-7015/8/30