- Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya. [Journal Article]
- IJInt J Environ Res Public Health 2018 Sep 13; 15(9)
- Exposure to fecal pathogens results in both acute and chronic sequalae in young children. Diarrhea causes nearly 20% of all under-five mortality, while even sub-clinical enteric infections may lead t...
Exposure to fecal pathogens results in both acute and chronic sequalae in young children. Diarrhea causes nearly 20% of all under-five mortality, while even sub-clinical enteric infections may lead to growth shortfalls. Stunting affects nearly 165 million children globally and results in lifelong and intergenerational effects for the world's poorest populations. Caregiver hygiene behaviors, such as those surrounding handwashing and food preparation, play a critical role in exposure to fecal pathogens; standard metrics to assess these behaviors are warranted to provide a means of quantifying the impact these behaviors have on enteric infections and to evaluate the success or failure of interventions and programs. This paper documents the development of three novel caregiver hygiene behavior measures: hygienic food preparation and storage, handwashing at key times, and provision of a safe play environment for children under two years. We developed these measures using formative qualitative work, survey creation and deployment theoretically underpinned by the COM-B model of behavior change, and exploratory and confirmatory factor analysis. The final measure for hygienic food preparation and storage includes 10 items across two factors; the final measure for handwashing at key times includes 15 items across three factors; and the final measure for safe play environment contains 13 items across three factors. Future researchers may employ these measures to assess caregiver behaviors in other populations, identify specific behavioral dimensions that should be the focus of interventions, and evaluate interventions and programs.
- Restored Self: A Phenomenological Study of Pain Relief by Cannabis. [Journal Article]
- PMPain Med 2018 Sep 12
- CONCLUSIONS: We propose the term Restored Self to conceptualize the effect of medical cannabis. Restored Self is the experience of regaining one's sense of self, sense of normality, and sense of control over one's life.
- Preemptive analgesia for postoperative pain relief in thoracolumbosacral spine operations: a double-blind, placebo-controlled randomized trial. [Journal Article]
- JNJ Neurosurg Spine 2018 Sep 14; :1-7
- CONCLUSIONS: The authors' study demonstrated that preemptive analgesia in thoracolumbosacral surgeries can significantly reduce analgesia requirements in the immediate postoperative period as evidenced by reduced request for opioid medication in both analgesia study groups who received a preoperative analgesic epidural. Nonetheless, the lack of differences in pain score and opioid dose at the PACU brings into question the role of preemptive epidural opioids in spine surgery patients. Further work is necessary to investigate the long-term effectiveness of preemptive epidural opioids and their role in pain reduction and patient satisfaction. Clinical trial registration no.: NCT02968862 (clinicaltrials.gov).
- Eating together as a social network intervention for people with mild intellectual disabilities: a theory-based evaluation. [Journal Article]
- IJInt J Qual Stud Health Well-being 2018; 13(1):1516089
- CONCLUSIONS: Our findings suggest that social network interventions for people with MID should be tailored to participants' pre-existing networks and related individual needs to be successful.
- Long-Term Safety and Efficacy of Minimally Invasive Lumbar Decompression Procedure for the Treatment of Lumbar Spinal Stenosis With Neurogenic Claudication: 2-Year Results of MiDAS ENCORE. [Journal Article]
- RAReg Anesth Pain Med 2018 Sep 07
- CONCLUSIONS: MILD showed excellent long-term durability, and there was no evidence of spinal instability through 2-year follow-up. Reoperation and spinal fracture rates are lower, and safety is higher for MILD versus other lumbar spine interventions, including interspinous spacers, surgical decompression, and spinal fusion. Given the minimally invasive nature of this procedure, its robust success rate, and durability of outcomes, MILD is an excellent choice for first-line therapy for select patients with central spinal stenosis suffering from neurogenic claudication symptoms with hypertrophic ligamentum flavum.
- Ensuring and Restoring Balance on Access to Controlled Substances for Medical and Scientific Purposes: Joint Statement from Palliative Care Organizations. [Journal Article]
- JPJ Pain Palliat Care Pharmacother 2018 Sep 10; :1-5
- The central principle of "balance" represents the dual obligation of governments to establish a system of control that ensures the adequate availability of controlled substances for medical and scien...
The central principle of "balance" represents the dual obligation of governments to establish a system of control that ensures the adequate availability of controlled substances for medical and scientific purposes while simultaneously preventing their nonmedical use, diversion, and trafficking, two primary goals of the international control system. On the one hand, although strong opioids, including morphine, are absolutely necessary for the relief of severe pain, legitimate access to opioids for pain treatment and palliative care is lacking in the majority of the world's countries. On the other hand, in a few high-income countries with higher consumption of prescription opioids, diversion and nonmedical use are increasingly prevalent. This report presents examples of unbalanced systems and a joint statement from global and regional palliative care organizations to promote development of balanced systems for optimal public health outcomes. Although nonmedical use of controlled substances poses a risk to society, the system of control is not intended to be a barrier to their availability for medical and scientific purposes, nor to interfere in their legitimate medical use for patient care. As representatives of palliative care organizations, we urge heads of state to act and to take measures to ensure and restore balanced systems in their countries and call on public health leaders and regulators to work together.
- Improving Health while Alleviating Hunger: Best Practices of a Successful Hunger Relief Organization. [Journal Article]
- CDCurr Dev Nutr 2018; 2(9):nzy057
- CONCLUSIONS: Samaritan Community Center has successfully implemented and adopted new programs and practices in order to improve the health of their clients. To our knowledge, this is the first case study to document best practices for making policy, systems, and environmental changes by a hunger relief organization to improve the nutritional quality of foods provided to their clients.
- The Surgical Experience Aboard USNS COMFORT (T-AH-20) during Operation Continuing Promise 2015. [Journal Article]
- ASAm Surg 2018 Aug 01; 84(8):1307-1311
- In 2015, the United States Navy hospital ship (USNS) COMFORT, deployed to 11 Caribbean and Latin American countries over a six-month period to provide humanitarian civic assistance. Personnel from th...
In 2015, the United States Navy hospital ship (USNS) COMFORT, deployed to 11 Caribbean and Latin American countries over a six-month period to provide humanitarian civic assistance. Personnel from the United States Navy and multiple nongovernmental organizations collaborated to offer surgical and medical care. Data from past deployments aid in planning for future missions by prioritizing finite resources and maximizing care. The data analyzed included all patients evaluated and treated by the Directorate of Surgical Services of the USNS COMFORT between April and September 2015. Comparative and descriptive statistics were performed to analyze patient demographics, surgical subspecialty performing the procedures, types of general and pediatric surgical procedures performed, operative times, and complication rates. Of the 1256 surgical cases performed aboard USNS COMFORT during CP15, 24.8 per cent were general surgery cases, followed by 16 per cent ophthalmology, 10.6 per cent pediatric surgery, 10 per cent plastic surgery, and eight additional specialties with <10 per cent of the cases each. Total operative time was 1253 hours with a total room time of 1896.5 hours. The identified complication rate was 1.99 per cent across all specialties. The USNS COMFORT platform offers the unique capability to provide humanitarian surgical assistance. Reporting these data demonstrate that there is a need for humanitarian assistance and this can be provided safely through the Continuing Promise mission. Future deployments may target resources toward the surgical services with higher volumes, which were general surgery, ophthalmology, pediatric surgery, and plastic surgery.
- Progress in voluntary medical male circumcision for HIV prevention supported by the US President's Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data. [Journal Article]
- BOBMJ Open 2018 Sep 01; 8(8):e021835
- CONCLUSIONS: Over 15 million VMMCs have been supported by PEPFAR since 2007. VMMC continues to attract primarily young clients. The non-trivial proportion of clients not testing for HIV is expected, and may be reassuring that testing is not being presented as mandatory for access to circumcision, or in some cases reflect test kit stockouts or recent testing elsewhere. While VMMC is extremely safe, achieving the highest possible follow-up rates for early diagnosis and intervention on complications is crucial, and programmes continue to work to raise follow-up rates. The VMMC programme has achieved rapid scale-up but continues to face challenges, and new approaches may be needed to achieve the new Joint United Nations Programme on HIV/AIDS goal of 27 million additional circumcisions through 2020.
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- A qualitative study of professional stakeholders' perceptions about the implementation of a stepped care pain platform for people experiencing chronic widespread pain. [Journal Article]
- BFBMC Fam Pract 2018 Sep 01; 19(1):151
- CONCLUSIONS: The findings provide professional insight into the key challenges of introducing a Pain Platform incorporating psychological support across primary and secondary care services within a local service. These included development of sustainable procedures and closer working relationships. Areas requiring future development are identified.