Coverage evaluation surveys following soil-transmitted helminthiasis and schistosomiasis mass drug administration in Wolaita Zone of Ethiopia-The Geshiyaro project.

INTRODUCTION: The Geshiyaro project aims to break transmission of soil-transmitted helminths and schistosomiasis in the Wolaita Zone of Ethiopia through a combination of two interventions: behavior change communication (BCC) for increased water, sanitation and hygiene (WaSH) infrastructure use alongside preventive chemotherapy (PC) using albendazole (ALB) and praziquantel (PZQ), targeted to reach 90% treatment coverage. Coverage evaluation surveys (CES) were conducted post-treatment, and the resultant survey coverage was compared to reported administrative coverage. This provided a secondary confirmation of the Geshiyaro project coverages, and is used to monitor the success of each Mass Drug Administration (MDA) round. METHODS: A community-based cross-sectional study was conducted in 13 woredas (districts) of the Wolaita Zone. All eligible individuals from the selected households were invited for an interview. The study design, sample size, analysis and report writing were conducted according to the World Health Organization (WHO) CES guidelines for PC. RESULTS: The study interviewed a total of 3,568 households and 18,875 individuals across 13 woredas in the Wolaita Zone. Overall, the survey coverage across all studied woredas was 81.5% (95% CI; 80.9-82.0%) for both ALB and PZQ. Reported administrative coverage across all studied woredas was higher than survey coverage, 92.7% and 91.2% for ALB and PZQ, respectively. A significant portion of individuals (17.6%) were not offered PC. The predominant reason for not achieving the target coverage of 90% was beneficiary absenteeism during MDA (6.6% ALB, 6.8% PZQ), followed by drug distributors failing to reach all households (4.7% ALB, 4.8% PZQ), and beneficiaries not informed of the program (1.3% ALB, 1.7% PZQ). CONCLUSION: Programmatic actions will need to be taken during the next MDA campaign to achieve the targeted Geshiyaro project coverage threshold across data collection and program engagement. Adequate training and supervision on recording and reporting administrative coverage should be provided, alongside improved social mobilization of treated communities to increase participation, and strengthened institutional partnerships and communication.

Moving Forward to the Future: A Review of Microbial Food Safety Education in China.

Millions of foodborne illness cases occur in China annually, causing significant social and economic burdens. Improper food handling has been observed not only among commercial food handlers but also among residential food handlers. It is critical to conduct a comprehensive scoping review of previous efforts to identify food safety knowledge gaps, explore the factors impacting knowledge levels, and synthesize the effectiveness of all types of food safety educational interventions for commercial and residential food handlers in China. This review aims to analyze food safety education studies published over the past 20 years and provide foundations for developing more effective food safety educational interventions in China. A total of 35 studies were included in this review. Most studies reported that Chinese commercial and residential food handlers had insufficient food safety knowledge, especially in the areas of foodborne pathogens and safe food-handling practices. The factors impacting food handlers' knowledge levels included education level, gender, income level, residency (rural vs. urban), the use of WeMedia, college students' major, and food safety training experiences. Food handlers in the following demographic groups tend to have lower levels of food safety knowledge: lower education levels, the elderly, males, lower-income levels, rural residents, those who do not use WeMedia, those without food safety training experience, or college students in nonbiology-focused majors. Many food handlers did not always follow recommended food safety practices, such as proper meat handling practices, handwashing practices, and cleaning and sanitation practices. Thirteen studies evaluated the effectiveness of educational interventions, and knowledge increases were reported after all interventions. The findings of this review provide guidance to researchers, educators, and government agencies in their future efforts to develop education programs emphasizing the importance of microbial food-safety content and behavior change regarding food safety and hygiene practices.

Effectiveness of Mass Media Campaigns to Improve Handwashing-Related Behavior, Knowledge, and Practices in Rural Bangladesh.

Water, sanitation, and handwashing interventions that use intensive interpersonal communication improve targeted behaviors, but are expensive at scale. Mass media is an alternative that could reach more people at lower cost but has rarely been rigorously evaluated. We assessed the effectiveness of a mass media campaign in improving handwashing knowledge and practices in rural Bangladesh. We conducted a cross-sectional assessment before the campaign among 8,947 households and again after 4 months of the campaign among 8,400 different households in the same areas. Trained enumerators conducted spot checks of water, sanitation, and hygiene facilities, and recorded reported knowledge and practices. We compared these outcomes after versus before the campaign using generalized linear models with robust standard errors. After the media campaign, caregivers were more likely to recall ≥ 3 messages regarding handwashing (prevalence ratio [PR] = 1.44, 1.34-1.55), sanitation (PR = 1.45, 1.35-1.55), and safe water (PR = 1.17, 1.08-1.26). After the campaign, the prevalence of using soap and water during handwashing demonstrations was higher among caregivers (PR = 1.15, 1.12-1.19) and children (PR = 1.31, 1.22-1.41). Hands were more commonly observed to be visibly clean among caregivers (PR = 1.14, 1.07-1.20) and children (PR = 1.13, 1.05-1.21). Soap and water was more commonly observed in handwashing stations near latrines (PR = 1.12, 1.06-1.19) and in cooking/eating places (PR = 1.09, 1.01-1.18). Our findings indicate improved handwashing knowledge and behaviors following a mass media campaign. This promising approach can be deployed to improve water, sanitation, and hygiene practices at scale and should be evaluated in other contexts.

An 11-week school-based 'health education through football programme' improves health knowledge related to hygiene, nutrition, physical activity and well-being-and it's fun! A scaled-up, cluster-RCT with over 3000 Danish school children aged 10-12 years old.

ObjectivesOur large-scale cluster randomised controlled trial aimed to investigate the effects on health knowledge and enjoyment of an 11 week 'health education through football' programme for children aged 10-12 years old. Methods 3127 Danish school children (49% girls) aged 10-12 years from a total of 154 schools located in 63% of the Danish municipalities (69 of 98) took part in the analysis. A 5:1 cluster randomisation was performed at school level for the intervention group (IG) or the control group (CG). The twice-weekly 45 min intervention was the '11 for Health in Denmark' programme, which includes health education, football drills and small-sided games. The health education element focused on hygiene, nutrition, physical activity and well-being. Outcomes: The participants completed a 34-item multiple-choice computer-based health knowledge questionnaire preintervention and postintervention. IG also evaluated whether the programme was enjoyable. Results Between-group differences (p<0.05) were observed in overall health knowledge in favour of IG (+7.2% points, 95% CI 6.1% to 8.4%, effect size, ES:0.59), with similar effects for girls (+7.4% points, 95% CI 5.9% to 9.0%, ES:0.57) and for boys (+7.0% points, 95% CI 5.3% to 8.7%, p<0.05, ES:0.51). Marked between-group differences were observed in favour of IG, for health knowledge related to hygiene (IG vs CG:+13.9% points, 95% CI 11.1% to 16.7%, ES:0.53), nutrition (+10.3% points, 95% CI 8.5% to 12.1%, ES:0.53), physical activity (+5.9% points, 95% CI 4.1% to 7.7%, ES:0.36) and well-being (+4.4% points, 95% CI 2.7% to 6.1%, ES:0.28). Both girls and boys gave the programme moderate to high scores for enjoyment (3.6±1.0 and 3.7±1.1, respectively). Conclusion Health education through sport, using the '11 for Health' model, was enjoyable for girls and boys aged 10-12 years old, and improved health knowledge related to hygiene, nutrition, physical activity and well-being.

Avaliação e medidas de prevenção e tratamento da xerose cutânea em idosos: uma revisão integrativa / Evaluation and measures for prevention and treatment of skin xerosis in elderly: an integrating review / Evaluación y medidas de prevención y tratamiento de la xerosis cutánea en idosos: una revisión integrativa

Objetivo: Analisar a produção científica em enfermagem acerca dos cuidados para a avaliação, prevenção e tratamento da xerose cutânea em idosos. Método: Revisão integrativa realizada nas bases Literatura LatinoAmericana e do Caribe em Ciências da Saúde, Biblioteca Virtual Scientific Eletronic Library Online, PubMed Central e Cumulative Index to Nursing and Allied Health Literature, no período de agosto a dezembro de 2017. Resultados: Foram analisados 14 artigos dos quais emergiram três categorias: A hidratação oral e tópica para o cuidado do idoso com xerose cutânea; A utilização de instrumentos e o cuidado a xerose relacionada aos pés; e por fim Medidas de higiene e processos de escolha/indicação de produtos. Conclusão: Os cuidados de enfermagem devem estar voltados à educação para o autocuidado com ênfase na hidratação dos pés bem como na indicação e orientação acerca do uso de produtos com a finalidade de minimizar as complicações oriundas da xerose

Objective: To analyze the scientific production in nursing about the care for the evaluation, prevention and treatment of cutaneous xerosis in the elderly. Method: Integrative review carried out in the Latin American and Caribbean Literature on Health Sciences, Virtual Electronic Library Online, PubMed Central and Cumulative Index to Nursing and Allied Health Literature, from August to December 2017. Results: Analyzed 14 articles from which emerged three categories: Oral and topical hydration for the care of the elderly with cutaneous xerosis; The use of instruments and care for xerosis related to the feet; and finally Hygiene measures and product selection / indication processes. Conclusion: Nursing care should focus on education for self-care, with emphasis on hydration of the feet as well as indication and orientation about the use of products in order to minimize complications from xerosis

Objetivo: Analizar la producción científica en enfermería acerca de los cuidados para la evaluación, prevención y tratamiento de la xerosis cutánea en ancianos. Método: Revisión integrativa realizada en las bases Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Biblioteca Virtual Scientific Eletronic Library Online, PubMed Central y Cumulative Index to Nursing and Allied Health Literature, en el período de agosto a diciembre de 2017. Resultados: Fueron se analizaron 14 artículos de los cuales surgieron tres categorías: La hidratación oral y tópica para el cuidado del anciano con xerosis cutánea; La utilización de instrumentos y el cuidado de la xerosis relacionada a los pies; y por último Medidas de higiene y procesos de elección / indicación de productos. Conclusión: Los cuidados de enfermería deben estar orientados a la educación para el autocuidado con énfasis en la hidratación de los pies así como en la indicación y orientación acerca del uso de productos con la finalidad de minimizar las complicaciones oriundas de la xerosis

Recomendaciones para la limpieza y desinfección en sitios de concentración de personas privadas de la libertad: penitenciarías, cárceles y centros de detención de migrantes, 11 de mayo del 2020 / Recommendations for the Cleaning and Disinfection of Sites Where People are Closely Confined and Deprived of Their Liberty: Penitentiaries, Prisons, and Migrant Detention Centers / Recomendações para a limpeza e desinfecção em locais de concentração de pessoas privadas de liberdade. Penitenciárias, cadeias, centros de detenção de imigrantes, 11 de maio de 2020

Proveer estaciones de lavado de manos a los privados de libertad y al personal de los centros penitenciarios para su uso constante. • Realizar lavado de las manos con agua y jabón durante 40-60 segundos frecuentemente y por lo menos en los momentos críticos (antes y después de comer; antes y después de preparar comida; después de ir al baño; antes y después de realizar una tarea de limpieza; antes y después de tocar dinero), secarse las manos con una toalla de papel y usar toalla de papel para cerrar el grifo. En caso de que no se encuentre disponible ni agua ni jabón, usar solución de gel de alcohol al 70%. • Asegurar la dotación permanentemente de agua segura, jabón, papel higiénico y papel toalla, para la higiene de manos, y pañuelos de papel para higiene respiratoria. • Evitar la sobrepoblación/hacinamiento en las celdas de la instalación penitenciaria correspondiente. • Asegurar la buena ventilación y luz natural de los espacios además de evitar condiciones de confinamiento. Esto puede incluir la apertura de ventanas al exterior cuando hay poca contaminación al aire libre. • Ofrecer dieta balanceada y asegurar la inocuidad de alimentos a los privados de libertad. • El personal de los centros penitenciarios con síntomas respiratorios no debe acudir a trabajar.

This technical note presents main considerations and recommendations regarding individual hygiene, self-care, and hand washing, and suggestions for cleaning and disinfecting places where people are confined and deprived of their liberty. Additionally, it contains recommendations for preparing 0.05% and 0.1% sodium hypochlorite solutions, depending on the needs for cleaning and prevention against SARS-COV-2 and other infectious agents.

Recomendações gerais: • Disponibilizar estações de lavagem de mãos para uso constante das pessoas privadas de liberdade e dos funcionários dos centros penitenciários. • Lavar frequentemente as mãos com água e sabão por 40 a 60 segundos e pelo menos nos momentos críticos (antes e depois de comer, antes e depois de preparar alimentos, depois de usar o banheiro, antes e depois de realizar uma tarefa de limpeza, antes e depois de tocar em dinheiro), secar as mãos com toalha de papel e usar toalha de papel para fechar a torneira. Se não houver água e sabão, usar álcool gel 70%. • Garantir o fornecimento permanente de água potável, sabão, papel higiênico e toalhas de papel, para a higiene das mãos, e lenços de papel para a higiene respiratória. • Evitar a superlotação nas celas da instalação prisional. • Garantir uma boa ventilação e iluminação natural dos espaços e evitar condições de confinamento. Isso pode incluir a abertura de janelas para ventilação, quando houver pouca poluição atmosférica externa. • Oferecer uma dieta balanceada e garantir a inocuidade dos alimentos servidos às pessoas privadas de liberdade. • Os funcionários dos centros penitenciários com sintomas respiratórios não devem ir ao trabalho.

Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic.

It is an ugly fact that a significant amount of the world's population will contract SARS-CoV-II infection with the current spreading. While a specific treatment is not yet coming soon, individual risk assessment and management strategies are crucial. The individual preventive and protective measures drive the personal risk of getting the disease. Among the virus-contracted hosts, their different metabolic status, as determined by their diet, nutrition, age, sex, medical conditions, lifestyle, and environmental factors, govern the personal fate toward different clinical severity of COVID-19, from asymptomatic, mild, moderate, to death. The careful individual assessment for the possible dietary, nutritional, medical, lifestyle, and environmental risks, together with the proper relevant risk management strategies, is the sensible way to deal with the pandemic of SARS-CoV-II.

Improving Complementary Food Hygiene Behaviors Using the Risk, Attitude, Norms, Ability, and Self-Regulation Approach in Rural Malawi.

The study evaluated the effectiveness of an intervention to improve complementary food hygiene behaviors among child caregivers in rural Malawi. Formative research and intervention development was grounded in the risk, attitude, norms, ability, and self-regulation (RANAS) model and targeted washing hands and kitchen utensils with soap, safe utensil storage, reheating of leftover food, and feeding of children by caregivers. Longitudinal research was applied at baseline and follow-up surveys among 320 caregivers. Determinants of selected behaviors were found, and interventions were developed based on the behavior change techniques aligned with these determinants in the RANAS model. The intervention was delivered over 9 months through group (cluster) meetings and household visits and included demonstrations, games, rewards, and songs. We randomly assigned villages to the control or intervention group. Follow-up results indicated a significant increase in three targeted behaviors (washing kitchen utensils with soap, safe utensil storage, and handwashing with soap) among intervention recipients. Several psychosocial factors differed significantly between the intervention and control groups. Mediation results showed that the intervention had a significant effect on these three targeted behaviors. For handwashing, feelings, others' behavior in the household, and remembering; for washing kitchen utensils, others' behavior in the household and difficulty to get enough soap; for safe utensils storage, others' behavior in the village and remembering mediated the effect of the intervention on the targeted behaviors. The study demonstrated that targeting food hygiene behaviors with a theory-driven behavior change approach using psychosocial factors can improve the behavior of child caregivers in rural Malawi.

Individual training for farmers based on results from protein and ATP rapid tests and microbiological conventional cultural methods improves hygiene in pig fattening pens.

Optimal hygiene management is an essential part of maintaining a high standard of health in conventional pig production systems and for the successful interruption of infection chains. Currently, efficiency assessments on cleaning and disinfection are only performed by visual inspection or are neglected completely. The aim of this study was to evaluate the available methods for on farm monitoring of hygiene, identify critical points in pig pens and use the data obtained for training purposes. In addition to visual inspection by assessing the cleanliness, microbiological swab samples, i.e., aerobic total viable count (TVC), total coliform count, methicillin-resistant Staphylococcus aureus (MRSA), and extended-spectrum ß-lactamases-producing bacteria (ESBL), swab samples for ATP as well as protein residues and agar contact plates combined with 3 different culture media, were applied and ranked according to their suitability for livestock farming. Samples were collected on at least 15 critical points from one representative pen on 6 pig fattening farms with various hygiene management practices after cleaning and disinfection. After the first sampling, farmers were trained with their individual results, and sampling was repeated 6 mo after training. Nipple drinkers, feeding tubes (external and inner surface), and troughs (external and inner surface) showed the greatest bacterial loads (TVC: 4.5-6.7 log10 cfu cm-2) and values for ATP and protein residues; therefore, these surfaces could be identified as the most important critical points. Spearman rank correlations (P < 0.01) were found between the different assessment methods, especially for the TVC and ATP (r = 0.82, P < 0.001). For rapid assessment on farms, ATP tests represented an accurate and cost-efficient alternative to microbiological techniques. Training improved cleaning performance as indicated by a lower rating for visual inspection, TVC, ATP, MRSA, and ESBL in the second assessment. The monitoring of cleaning efficiency in pig pens followed by training of the staff constitutes a valuable strategy to limit the spread of infectious diseases and antibiotic-resistant bacteria. Special attention should be paid to the sufficient hygiene of drinkers and feeders.

Special education of students with Down Syndrome for self-care / Educación especial de estudiantes con Síndrome de Down para el autocuidado / Educação especial de estudantes com Síndrome de Down para o autocuidado

ABSTRACT Objective: to analyze the care taught by teachers and parents and learned by students with Down Syndrome. Method: descriptive study with qualitative approach carried out in a special education school, based in the city of Manaus. Eleven students with Down Syndrome, 11 parents of students and 11 teachers from the school participated in the study. Data were collected from November 2017 to February 2018, through a semi-structured interview, and analyzed by the content analysis technique. The theoretical framework regarded Down Syndrome. Results: three thematic categories emerged: the care learned by the student; the care taught by the teacher and; the care taught by the parents. Conclusion and implications for practice: family and teachers play a facilitating role in the learning to care for themselves and in the socio-cognitive and affective development of the person with Down Syndrome. The care learned by the student involved dialogic communication for care through learning of good habits, autonomy, independence and healthy eating. The study shows that nursing has the role of teaching the family how to help the child's progress, which results in significant future changes.

RESUMEN Objetivo: analizar la enseñanza del cuidado realizado por profesores y padres y el aprendizaje de estudiantes con Síndrome de Down. Método: Estudio descriptivo con enfoque cualitativo, realizado en una escuela de educación especial, con sede en la ciudad de Manaos. Once estudiantes con Síndrome de Down, 11 padres y 11 profesores de la escuela participaron del estudio. Los datos se recopilaron de noviembre de 2017 a febrero de 2018, a través de entrevista semiestructurada, y se analizaron mediante la técnica de análisis de contenido. El marco teórico abordó el Síndrome de Down. Resultados: surgieron tres categorías temáticas: el cuidado aprendido por el estudiante; el cuidado enseñado por el profesor y; el cuidado enseñado por los padres. Conclusión e implicaciones para la práctica: familiares y profesores desempeñan un papel facilitador en el aprendizaje para el autocuidado y en el desarrollo sociocognitivo y afectivo de la persona con Síndrome de Down. El aprendizaje del estudiante involucró la comunicación dialógica para el cuidado a través del aprendizaje de buenos hábitos, autonomía, independencia y alimentación saludable. El estudio evidencia que la enfermería tiene el papel de enseñar la familia y ayudar el progreso del hijo, lo que resulta en cambios significativos futuros.

RESUMO Objetivo: analisar o cuidado ensinado por professores e pais e aprendido por estudantes com Síndrome de Down. Método: estudo descritivo de abordagem qualitativa, realizado em uma escola de educação especial, sediada na cidade de Manaus. Participaram do estudo 11 estudantes com Síndrome de Down, 11 pais dos estudantes e 11 professores da escola. Os dados foram coletados no período de novembro de 2017 a fevereiro de 2018, por meio de entrevista semiestruturada, e analisados pela técnica de análise de conteúdo. O embasamento teórico versou sobre a doença Síndrome de Down. Resultados: emergiram três categorias temáticas: o cuidado aprendido pelo aluno; o cuidado ensinado pelo professor e; o cuidado ensinado pelos pais. Conclusão e implicações para a prática: a família e os professores exercem um papel de facilitadores do aprendizado para o cuidado de si e no desenvolvimento sócio-cognitivo e afetivo da pessoa com Síndrome de Down. O cuidado aprendido pelo estudante envolveu comunicação dialógica para o cuidado por meio de aprendizagem de bons hábitos, autonomia, independência e alimentação saudável. O estudo evidencia que a enfermagem tem o papel de ensinar a família como ajudar no progresso do filho, o que resulta em mudanças significativas futuras.

Recomendaciones para los viajeros y público en general / Recommendations for travelers and the general public

Guía básica e inicial sobre los cuidados de higiene personal y ambiental que había que tener durante los primeros momentos de la pandemia.

Nutrition, Hygiene and Stimulation Education for Impoverished Mothers in Rural Uganda: Effect on Maternal Depression Symptoms and Their Associations to Child Development Outcomes.

Optimal nutrition improves child development, and impaired development is associated with maternal depression symptoms, in particular in low resource settings. In this follow-up of an open cluster-randomized education trial, we examined its effects among mothers in rural Uganda on their depression symptoms and the association of these symptoms to child development. The education comprised complementary feeding, stimulation, and hygiene. We assessed 77 intervention mothers and 78 controls using Beck Depression Inventory-II (BDI-II) and Center for Epidemiologic Studies Depression Scale (CES-D) scores. Child development was assessed with Bayley Scales of Infant and Toddler Development-III (BSID-III) composite scores for cognitive, language and motor development. Compared to controls, the intervention reduced depression symptoms' scores with mean (95% CI) differences: -8.26 (-11.49 to -1.13, p = 0.0001) and -6.54; (-8.69 to -2.99, p = 0.004) for BDI II at 20-24 and 36 months, respectively. Similar results were obtained with CES-D. There was a negative association of BDI-II scores and BSID-III cognitive and language scores at 20-24 (p = 0.01 and 0.008, respectively) and 36 months (p = 0.017 and 0.001, respectively). CES-D associations with BSID-III cognitive and language scores showed similar trends. BSID-III motor scores were associated with depression scores at 36 months for both BDI-II and CES-D (p = 0.043 and 0.028, respectively). In conclusion, the group education was associated with reduced maternal depression scores. Moreover, the depression scores were inversely associated with child cognitive and language development outcomes.

Estilo de vida e riscos à saúde de adolescentes e jovens / Lifestyle and health risks of adolescents and young people / Estilo de vida y riesgos para la salud de adolescentes y jóvenes

Objetivo: Descrever as condições do estilo de vida e riscos à saúde de um grupo de adolescentes e jovens participantes de um Núcleo de Atenção à Saúde do Adolescente (NASA). Métodos: Estudo descritivo de abordagem qualitativa realizado com 13 adolescentes e jovens cadastrados no NASA de um município da Baixada Litorânea do estado do Rio de Janeiro, por meio de questionários padronizados autoaplicáveis. Resultados: Foram identificados hábitos alimentares inadequados; precocidade das relações sexuais e uso irregular de preservativo; ausência de atividade física e situações constrangedoras vivenciadas na escola. Conclusão: O estudo aponta situações de riscos à saúde que demandam estratégias preventivas, sobretudo de promoção da saúde. Faz-se necessária a implementação de ações intersetoriais locais voltadas para a redução de vulnerabilidades com ênfase nos eixos temáticas de alimentação, sexualidade, atividade física, prevenção da violência e cultura da paz

Introduction: The occurrence of transmissible and non-communicable diseases related to lifestyle has acquired relevance in the juvenile phase. The objective was to describe aspects of the lifestyle of participants of a Teen Health Care Center. Materials and methods: Descriptive study of qualitative approach carried out with 13 adolescents and young people registered in the Adolescent Health Care Center of a city of Baixada Litorânea, state of Rio de Janeiro, Brazil, using standardized self-administered questionnaires. Results: Inappropriate eating habits; Precocity of the onset of sexual intercourse and irregular use of condoms; Absence of regular physical activity and embarrassing situations experienced at school were identified. Discussion: The commitment in these aspects of lifestyle indicates that there are situations of health risks that demand new preventive strategies besides the educational actions with the young public. Conclusions: There is a need for planning and implementation of local intersectoral actions at primary and secondary health care levels aimed at reducing youth vulnerabilities on inadequate feeding, sexual precocity, irregular physical activity and school violence

Introducción: La aparición de las enfermedades transmisibles y no transmisibles relacionadas con el estilo de vida ha obtenido relevancia en la fase juvenil. El objetivo fue describir aspectos del estilo de vida de participantes de un Núcleo de Atención a la Salud del Adolescente. Materiales y métodos: Estudio descriptivo del abordaje cualitativo realizado con 13 adolescentes y jóvenes registrados en el Núcleo de Atención a la Salud del Adolescente de un municipio de la Baixada Litoral del estado de Río de Janeiro, Brasil, por medio de cuestionarios estandarizados autoaplicables. Resultados: Se identificaron hábitos alimenticios inadecuados; Precocidad del inicio de las relaciones sexuales y uso irregular de preservativo; Ausencia de actividad física regular y situaciones embarazosas vivenciadas en la escuela. Discusión: El compromiso en estos aspectos del estilo de vida apunta que existen situaciones de riesgos a la salud que demandan nuevas estrategias preventivas además de las acciones educativas con el público joven. Conclusiones: Hay necesidad de planificación y realización de acciones intersectoriales locales en niveles de atención primaria y secundaria en salud que estén dirigidas a reducir las vulnerabilidades juveniles sobre alimentación inadecuada, precocidad sexual, actividad física irregular y violencia escolar

Intervenção educativa com agentes comunitários de saúde sobre giardíase em região de fronteira - Foz do Iguaçu / Educational intervention with health community agents regarding giardiasis in border region - Foz do Iguaçu

O objetivo deste estudo foi comparar o conhecimento prévio e a assimilação das informações sobre giardíase pelos Agentes Comunitários de Saúde (ACS) de Foz do Iguaçu após intervenção educativa. Trata-se de um estudo comparativo de abordagem quantitativa com 55 ACS, do distrito sanitário Norte de Foz do Iguaçu. Foi utilizado um questionário contendo 10 questões fechadas sobre a giardíase que foi aplicado em dois momentos sequenciais da pesquisa. Inicialmente, foi aplicado um questionário para a avaliação do conhecimento prévio dos ACS sobre a giardíase. Em seguida, foi ministrada uma palestra sobre a doença para esse público e, aplicado novamente o questionário para a avaliação da assimilação das informações sobre a giardíase. Os dados coletados foram analisados pelo programa BioEstat 5.0® e utilizado o teste de Poisson, com significância de 5%. Foram identificadas fragilidades no conhecimento dos ACS na avaliação prévia para as variáveis investigadas (p<0,05). Após a intervenção educativa, observou-se aumento na média de acertos em todas as variáveis estudadas (p<0,05). A intervenção educativa favorece conhecimento aos ACS, possibilitando mudança no panorama da giardíase e, consequentemente melhora na qualidade de saúde da população.

The objective of this study was to compare the prior knowledge and assimilation of information regarding giardiasis by the Health Community Agents (HCA) from Foz do Iguaçu after educational intervention. This is a comparative study of the quantitative approach using 55 HCA from the northern health district in Foz do Iguaçu. A questionnaire containing 10 yes-or-no questions about giardiasis that was applied in two sequential moments of the research. Initially, a questionnaire was applied for assessing the HCA's prior knowledge regarding giardiasis. Then, the subjects attended a lecture on the disease and then, the questionnaire was applied again for assessing the assimilation of information on giardiasis. The data collected were analyzed using BioEstat 5.0® and the Poisson test with 5% significance. Weak points in the knowledge of the HCA were identified in the previous assessment for the investigated variables (p<0.05). After the educational intervention, there was an increase in the average number of correct answers in all variables studied (p<0.05). The educational intervention favors the retention of knowledge by the HCA, allowing a change in the panorama of giardiasis and, consequently, an improvement in the health quality of the population.

Entre a ciência e a política: ensino, atendimento e pesquisa no Instituto de Higiene de São Paulo (1916-1951) / Between science and politics teaching, healthcare and research at Instituto de Higiene de São Paulo (1916-1951)

Esta pesquisa mostra o caminho percorrido pelo Instituto de Higiene de São Paulo para a sua consolidação no campo científico e político, entre 1916 e 1951. O personagem principal é o seu 3º diretor: o farmacêutico e médico Geraldo Horácio de Paula Souza, que teve destacada atuação nas negociações com a Fundação Rockefeller para a concretização do Instituto e, no gerenciamento daquele que se transformaria na Faculdade de Higiene e Saúde Pública da Universidade de São Paulo em 1945. A periodização é delimitada pelos primeiros acordos entre a Fundação Rockefeller e a Faculdade de Medicina e Cirurgia de São Paulo (1916) para a instalação do laboratório de higiene e a morte precoce de Paula Souza (1951), encerrando seus quase trinta anos à frente do antigo Instituto de Higiene. Esta consolidação se deu em três frentes de atuação: o ensino da higiene, a pesquisa científica na área e o atendimento à população, campos que deixaram legados para a saúde pública brasileira.

This research depicts the path taken by Instituto de Higiene de São Paulo, between 1916 and 1951, to consolidate itself in the scientific and political field. Our main character is the Institute's third director: Geraldo Horácio de Paula Souza. Being a pharmacist and a doctor, he played a major role negotiating with the Rockefeller Foundation for the consolidation of the Institute in Brazil, and also in the management of what would become the Faculdade de Higiene e Saúde Pública of the Universidade de São Paulo, in 1945. The timeline of our research is defined by the first agreements between the Rockefeller Foundation and the Faculdade de Medicina e Cirurgia de São Paulo (1916), for the creation of the laboratory of hygiene, and Paula Souzas's early death (1951) after leading the former Instituto de Higiene for almost thirty years. Such consolidation had three main areas of action: the teaching of hygiene, the scientific research on this field and providing healthcare for the population. Those three main areas left important legacies for the Brazilian public health.

Hospital Hygiene and Infection Prevention and Control in Italy: state of the art and perspectives.

Although hospital hygiene has a long history in Italy it is necessary to reflect about it because of the innovation in healthcare systems and because of the evolution due to European Union related activities. Different traditions exist in European countries about hospital hygiene and European Centre for Disease Prevention and Control (ECDC) adopted the term of "infection control and hospital hygiene" which includes all the engaged European healthcare professionals. We propose to modify hospital hygiene as "healthcare organisation hygiene" in order to focalise the attention to all care settings not only hospitals and to adopt the following definition: "all activities aimed to guarantee, in an appropriate, scientifically sound and efficient way, that structures and processes support healthcare practices in a safe comfortable and healthy environment both for patients, caregivers and healthcare workers". Hospital hygiene and its professionals, besides the long tradition, still remain a relevant pillar in guaranteeing quality and safety of healthcare in Italy.

Vocal Hygiene Education Program Reduces Surgical Interventions for Benign Vocal Fold Lesions: A Randomized Controlled Trial.

OBJECTIVES/HYPOTHESIS: Vocal fold polyps and nodules are common benign laryngeal lesions. Currently, the Japanese health insurance system covers surgical interventions. However, the establishment of more cost-effective conservative methods is required, because healthcare costs are viewed as a major concern, and the government and taxpayers are demanding more economical, effective treatments. In this situation, more suitable vocal hygiene education may be important for the success of cost-effective conservative treatment. In this study, we developed a novel reinforced vocal hygiene education program and compared the results of this program with those of previous methods of teaching vocal hygiene. STUDY DESIGN: Multicenter randomized controlled trial. METHODS: Patients who visited a National Hospital Organization (NHO) hospital for the surgical indication of hoarseness were included in the study. Before undergoing surgery, 200 patients with benign vocal fold lesions (vocal fold polyps/nodules) were enrolled and randomly allocated to the NHO-style vocal hygiene educational program (intervention group) or control education program (control group). Two months after enrollment, the patients in both groups underwent laryngeal fiberscopic examinations to determine whether the benign lesions had resolved or whether surgery was indicated for the vocal fold polyps/nodules. RESULTS: After 2 months, in the intervention group, the proportion of lesion resolution (61.3%) was significantly greater than that in the control group (26.3%) (P < .001, Fisher exact test). CONCLUSIONS: Our results clearly indicate that the quality and features of the education program could affect the outcome of the intervention. We found that a reinforced vocal hygiene education program increased the rate of the resolution of benign vocal fold polyps and nodules in a multicenter randomized clinical trial. LEVEL OF EVIDENCE: 1b Laryngoscope, 2593-2599, 2018.

Nivel de conocimientos clínico-epidemiológicos de la leptospirosis en estudiantes / Level of clinical-epidemiological knowledge of leptospirosis in students

Introducción: la incidencia de leptospirosis se ha elevado en los últimos años en la provincia de Guantánamo. Objetivo: caracterizar el comportamiento del conocimiento sobre las características clínico-epidemiológicas de la leptospirosis en los estudiantes de la carrera de Higiene y Epidemiología de la Facultad de Ciencias Médicas Guantánamo. Método: se realizó un estudio descriptivo de corte transversal durante el periodo comprendido entre abril de 2016 hasta marzo de 2017. El universo estuvo constituido por 380 estudiantes y se tomó una muestra de 114. Se estudiaron variables, tales como: nivel de conocimientos sobre concepto, vías de transmisión y medidas de prevención de la leptospirosis. Para el desarrollo de este trabajo se utilizaron métodos teóricos, empíricos y matemáticos entre los que se encuentra el histórico-lógico, análisis-síntesis, inductivo-deductivo, sistémico estructural y funcional, análisis de documentos, la encuesta, criterios de especialistas, entre otros. Resultados: se encontró un predominio de mediano conocimiento en los estudiantes encuestados sobre el concepto de leptospirosis y nivel de conocimiento sobre las vías de transmisión, en cuanto a las medidas de prevención el resultado general fue de bajo conocimientos. Conclusiones: se concluyó que los estudiantes del estudio no poseen los conocimientos suficientes acerca de la leptospirosis, por lo que resulta necesaria la pronta realización de acciones para evitar esta problemática()AU

Introduction: the incidence of leptospirosis has increased in the province of Guantanamo in recent years. Objective: to characterize the behavior of knowledge about the clinical-epidemiological characteristics of leptospirosis in the students of the Hygiene and Epidemiology career of the Faculty of Medical Sciences Guantanamo. Method: a cross-sectional descriptive study was carried out during from April 2016 to March 2017. The universe consisted of 380 students and a sample of 114 was taken. Variables were studied, such as: level of knowledge about the concept, transmission routes and measures for the prevention of leptospirosis. For the development of this work, theoretical, empirical and mathematical methods were used, including historical-logical, analysis-synthesis, inductive-deductive, structural and functional systemic, document analysis, survey, specialist criteria, among others. Results: a predominance of low knowledge was found in the students surveys about the concept of leptospirosis and level of knowledge about the transmission routes, in terms of prevention measures, the general result was low knowledge. Conclusions: it was concluded that the students of the study do not have sufficient knowledge about leptospirosis, so it is necessary to carry out emergent actions to avoid this problem(AU)