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Identifying critical periods of susceptibility for maternal exposure to biothermal stress and the risks of stillbirth and spontaneous preterm birth in Western Australia.
Get PDFA few studies investigated critical periods of temperature and the risks of stillbirth and preterm birth. This study aimed to identify critical periods of composite biothermal stress (Universal Thermal Climate Index, UTCI) for stillbirth and spontaneous preterm birth (sPTB). From the Midwives Notification System, 415 271 singleton births between January 1, 2000, and December 31, 2015, were linked to spatiotemporal UTCI in Western Australia. Covariate-adjusted weekly and monthly distributed lag nonlinear Cox regression from 12 weeks before conception to birth was performed. Relative to median exposure (14.2 °C), extreme UTCI levels (1st-10th and 90th-99th centiles) were associated with higher hazards of stillbirth and sPTB, especially stronger at lower than higher exposures. Critical susceptible periods at 1st centile (10.2 °C) exposure were found during gestational weeks 21 to 42, with the strongest hazard of 1.14 (95% CI, 1.03-1.27) in the 42nd week for stillbirth, and during gestational weeks 26 to 36, with the strongest hazard of 1.09 (95% CI, 1.06-1.12) in the 36th week for sPTB. Monthly exposure showed a similar pattern but with greater magnitude. Mid to late gestation showed critical susceptible periods of biothermal stress on the birth outcomes, suggesting further studies and timely climate-related health care interventions
A "Wise" Intervention to Increase Hand Hygiene Compliance of Nurses in Acute Care Units in US Hospitals: A Multiple Baseline Interrupted Time-Series Evaluation.
Get PDFThis study tested a 'wise' intervention (quick prompt of a specific psychological mec) in acute care hospital units to improve nurses' hand hygiene compliance (HHC). A multiple baseline design in two medical-surgical teaching hospitals in the United States. Hand hygiene data was collected using an electronic compliance monitoring system with sensors placed in doorways and on corresponding soap and alcohol-based hand rub dispensers. The outcome measure was the proportion of opportunities in which HH was undertaken by staff per week in each unit. A quick-and-easy psychological prime to reinvigorate professional identity. Interrupted time series analysis using a quasi-Poisson regression model with statistical process control charts for each unit. A statistically significant increase in HHC rates that was sustained for months post-intervention. However, the patterns by unit were not statistically significant once temporal trends were considered. Other factors, such as the unit type and the use of incentives could have impacted the results. These analyses suggest that the aggregate impact should not be taken as evidence of intervention effectiveness. This study therefore cannot be considered to have provided a strong foundation for use of a 'wise' intervention, despite its relatively small financial, logistical and psychological cost
Applying the Barker School concept of 'behaviour settings' to virtual contexts.
Get PDFPeople are spending more and more time interacting with virtual objects and environments. We argue that Roger Barker's concept of a 'behaviour setting' can be usefully applied to such experiences with relatively little modification if we recognize subjective aspects of such experiences such as presence and immersion. We define virtual behaviour settings as virtual environments where the partly or fully digital milieu is synomorphic with and circumjacent to embodied behaviour, as opposed to the fragmented behaviour settings of much-mediated interaction. We present two tools that can help explain and predict the outcomes of virtual experiences-the behaviour setting canvas (BSC) and model-and demonstrate their utility through examples. We conclude that the behaviour setting concept is helpful in both designing virtual environments and understanding their impact, while virtual environments offer a powerful new methodological paradigm for studying behaviour settings. This article is part of the theme issue 'People, places, things, and communities: expanding behaviour settings theory in the twenty-first century'
Impact of climate change and human actions on the turbidity of water from wetlands in Rukiga district in Uganda: implications for health and community involvement
Get PDFAbstract
Climate change has been a serious issue in many countries, including Uganda, and has led to water contamination, pollution, and even water scarcity. Wetlands have shown their capacity to maintain water quality and safety for the population’s health through their filtering function, but they are highly susceptible to agricultural activities and destruction. This study aimed to determine the status of fifteen wetlands in the Rukiga district and the impact of climate hazards and human activities on water quality in the area where a conservation project was implemented by three organisations. Eighteen-month records were obtained, and readings were taken to determine the turbidity level of the water from the different wetlands. The reading mean of each wetland was used to determine three water source categories: clear or non-turbid (read > 80), less turbid (read 50–80), and very turbid (read 0–50). Analysis was performed with SPSS V28.0, which included univariate and bivariate analyses. Observation and conversation notes with project staff and community members were taken. The study showed that 93.33% of the water sources from wetlands were turbid, and for some, the turbidity did not oscillate stably from one category to another. Only one water source (6.67%) was still clear (non-turbid) for 18 months. These communities mostly contain wetlands as the main sources of water, which is collected from streams. Wetlands are more susceptible to agricultural activities, and hills are deforested exposing to soil erosion leading to water contamination. In conclusion, most wetlands are destroyed and have lost their filtering capacity and exposing people to consumption of unsafe water. Climate hazards and agricultural activities contributed the most to this issue. Interactions between NGOs and communities are helpful in responding to this threat
Evaluation of Drug and Herbal Medicinal Promotions on Social Media During the COVID-19 Pandemic in Relation to World Health Organization Ethical Criteria and South African Health Products Regulatory Authority Guidelines in South Africa: Cross-Sectional Content Analysis.
Get PDFBACKGROUND: Consideration of ethics in the promotion of medications is essential to safeguard the health of consumers, particularly during health crises. The World Health Organization (WHO) and the South African Health Products Regulatory Authority (SAHPRA) have established stringent standards to ensure the integrity of pharmaceutical promotions and safeguard public health, including advertisements on the internet and social media platforms. However, the dynamic nature of online advertising poses challenges for monitoring and enforcing ethical standards. OBJECTIVE: The study aimed (1) to examine the COVID-19 drug and medicinal promotions across online platforms and social media from 2020 to 2022 in South Africa and (2) to ensure that drug promotions adhere to ethical guidelines outlined by the WHO and SAPHRA. METHODS: A cross-sectional content analysis was conducted to assess drug and medicinal advertisements across various internet and social media platforms. A systematic approach was used to identify and analyze promotional content, focusing on adherence to ethical guidelines outlined by WHO and SAPHRA. Data were collected and analyzed to determine the extent of compliance and identify any potential violations or areas for improvement. RESULTS: A total of 14 online drug advertisements were included in this analysis. Our findings show that most of the drugs advertised did not meet the regulations and guidelines provided by WHO and SAHPRA. There were omissions about active ingredients, proprietary names, adverse drug responses, precautions, and overdosage and adverse drug reactions. Traditional medicines were not fully consistent with the approved WHO ethical criteria data sheet. CONCLUSIONS: Our analysis highlights the critical importance of ensuring compliance with ethical guidelines in drug promotions on the internet and social media platforms. There is a need for continued vigilance and enforcement efforts to uphold ethical standards and protect the health of the public. Ongoing monitoring and collaboration between national drug regulatory agencies, pharmaceutical companies, and online platforms will be essential for promoting responsible advertising. In addition, safety monitoring and pharmacovigilance systems for herbal medicinal products are yet to be established
Author Correction: Rapid increase in the risk of heat-related mortality.
Get PDFCorrection to: Nature Communicationshttps://doi.org/10.1038/s41467-023-40599-x, published online 24 August 2023 The original version of this Article omitted from the author list the 17th author, “Multi-Country Multi-City (MCC) collaborative research network”, which is the consortium providing the mortality data. A list of consortium authors and their affiliations are provided in the HTML version of this Correction. Part of the Author Contributions statement was incorrectly given and should have read ‘A.M.V.C., E.M.F., B.A., M.D.S.Z.S.C., Y.L.G., Y.G., Y.H., V.H., J.K., E.L., D.R., N.R., N.S., S.S., A.U., A.G. and the MCC were involved in resources and data curation.’ In addition, the primary affiliation ‘Climate Research Foundation (FIC), Madrid, Spain’ for Dominic Roye was missing
A thematic analysis of tobacco industry responses to the Scottish Government's consultation on e-cigarette regulation.
Get PDFE-cigarette use is increasing rapidly across the world. Governments have begun to tighten regulation principally to prevent uptake by young people and non-smokers. As tobacco industry ownership of the e-cigarette market grows, it is important to be aware of how industry is seeking to influence the regulation of e-cigarettes. Using thematic analysis, this research examines the explicit arguments and implicit tactics used in responses from the tobacco industry and linked organizations to Scotland's 2022 consultation 'Vaping Products-Tightening Rules on Advertising and Promoting'. The themes that emerged in the analysis were compared to tactics and arguments identified in past research on the tobacco industry to look for continuations and divergences. While the research finds continuation of historic arguments and tactics being used in the submissions, it also highlights important novel tactics and framings employed by tobacco industry actors, including incorporating outdated data and calling for UK-wide policy despite this being a devolved issue. Policymakers must remain alert to the strategies being used by the tobacco industry, so they are able to prioritize public health rather than the interests of industries that put profit before health
Financing infectious disease services in hospitals: a common public good.
Get PDFNo other service loses as much money as the infectious disease clinical service in hospitals. Infectious disease consultations have lower reimbursement rates compared with other types of consultations. The precarious financing of infectious diseases is related to patients, physicians, and health systems
Parents' and informal caregivers' experiences of accessing childhood vaccination services within the United Kingdom: a systematic scoping review of empirical evidence.
Get PDFBACKGROUND: Despite repeated calls to action and considerable attention, childhood vaccination uptake has declined for a thirteenth consecutive year in the United Kingdom (UK). Increasingly, stakeholders are advocating for research which goes beyond vaccine hesitancy and explores service accessibility in greater depth. This scoping review aims to identify and critically assess how accessibility is being conceptualised and investigated with a view to informing future research. Research, that in turn, will dictate the interventions pursued to improve vaccination coverage. METHODS: A detailed search strategy was implemented across seven databases to identify research exploring parents' experiences of accessing childhood vaccination services within the UK. The analysis explored the studies in relation to their conceptualisation of access, methodology, reported results, and recommendations for research or practice using a combination of descriptive qualitative content analysis, typologies, and frequency counts. Methods and reporting adhered to the 'JBI Manual for Evidence Synthesis' and the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews'. RESULTS: Forty-five studies were included in the analysis. Studies claimed to consider only attitudinal constructs (4%) or did not discuss access at all (33%) despite findings, in part, including access related issues. Remaining studies used the term access in passing or ambiguously (24%), distinguished between attitudes and access in-text (27%), and a minority of studies utilised a theoretical framework which acknowledged accessibility (13%). The focus on access to information (92% of studies) was disproportionately large compared to other domains of accessibility such as availability (11%), affordability (13%), and proximity (16%). Of the seven identified intervention studies, five were centred on information provision. CONCLUSION: Accessibility is poorly conceptualised within most of the research conducted on childhood immunisation uptake within the UK. This, in part, is because exploring accessibility was not an explicit objective of many of the studies included in the review. It is vital that the accessibility of childhood vaccination services is given greater priority and appropriately defined in empirical research. Otherwise, researchers run the risk of limiting the scope of their findings based on their own conceptual ideas regarding the drivers of poor uptake rather than the lived reality of parents