ABSTRACT
An outbreak of multidrug-resistant (MDR) Pseudomonas aeruginosa occurred in an acute care hospital in Japan, which lasted for more than three years. During January 2006 to June 2009, 59 hospitalised patients with MDR P. aeruginosa were mainly detected by urine culture in the first half, whereas isolation from respiratory tract samples became dominant in the latter half of the outbreak. Non-duplicate MDR P. aeruginosa isolates were available from 51 patients and all isolates were positive for bla(VIM-2). Pulsed-field gel electrophoresis (PFGE) analysis categorised the isolates into three major clusters; types A, B and C with eight, 19 and 21 isolates, respectively. The outbreak started with patients harbouring PFGE type A strains, followed by type B, and type C strains. Multivariate analysis demonstrated that patients with PFGE type C strains were more likely to be detected by respiratory tract samples (odds ratio: 11.87; 95% confidence interval: 1.21-116.86). Improved aseptic urethral catheter care controlled PFGE type A and type B strains and improvement in respiratory care procedures finally contained the transmission of PFGE type C strains.
Subject(s)
Cross Infection/epidemiology , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Molecular Typing , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa/classification , Pseudomonas aeruginosa/drug effects , Aged , Cluster Analysis , Cross Infection/microbiology , Electrophoresis, Gel, Pulsed-Field , Female , Genotype , Humans , Japan/epidemiology , Male , Molecular Epidemiology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/isolation & purification , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/microbiology , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiologyABSTRACT
INTRODUCTION: A febrile seizure is a benign condition. However, for parents, witnessing their child's FS can cause excessive anxiety. It is therefore important for pediatricians to provide appropriate information in order to reduce anxiety. In this study, we analyze whether work setting and years of experience influence the explanations given to caregivers. METHODS: Questionnaires were mailed to members of the Japan Pediatric Society, Tokyo Chapter (n=1 870). The Mantel-Haenszel test was used for dichotomous variables. Differences for continuous variables were evaluated at 95% confidence intervals. RESULTS: A total of 482 pediatricians participated. There were no significant differences in responses to any questions according to work setting. Responders with less than 20 years of experience reported a higher prevalence of febrile seizures than those in the more experienced group. Compared to the experienced group, more responders with less than 20 years of experience stated that they would administer antiepileptic prophylaxis and advise parents not to use antipyretics, and indicated that they did not know the FS treatment guidelines. CONCLUSION: The findings suggest the importance of promoting a better understanding of FS among less-experienced pediatricians and encouraging adherence to the guidelines to maintain a consistent level of support for parents and caregivers.
Subject(s)
Patient Education as Topic , Pediatrics , Seizures, Febrile/psychology , Workplace , Caregivers/psychology , Female , Humans , Japan , Male , Parents/psychology , Seizures, Febrile/therapy , Surveys and Questionnaires , Time FactorsABSTRACT
OBJECTIVE: To describe the prevalence of childhood obesity in a moderately industrialized province in Thailand and examine the influence of socioeconomic status (SES) on childhood obesity. DESIGN: Cross-sectional study. SUBJECTS: One thousand one hundred and fifty seven children in the second or third grade of kindergartens in Saraburi Province, Thailand. MEASUREMENTS: Height and weight were measured and the weight-for-height index with the Thai national standard was used for assessing nutritional status. A questionnaire was used for measuring parents' socioeconomic status. RESULTS: The prevalence of childhood obesity over 97th percentile for weight-for-height (>p(97)) was 22.7% in urban and 7.4% in rural areas. There were marked relationships between childhood obesity and parents' educational level and household income. CONCLUSION: Childhood obesity is an emerging health problem in developing countries, especially in urban areas. This study demonstrates a marked correlation between SES and prevalence of childhood obesity in an Asian developing country.
Subject(s)
Obesity/epidemiology , Child , Child Welfare , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Social Class , Surveys and Questionnaires , Thailand/epidemiologySubject(s)
Erectile Dysfunction/epidemiology , Adult , Age Factors , Aged , Humans , Japan/epidemiology , Male , Middle Aged , Prevalence , Surveys and QuestionnairesABSTRACT
To improve the quality of life in squatter settlements, the Zonal Improvement Program (ZIP), which aims to provide direct water connection and a private toilet to every housing unit, has been implemented in Metro Manila, Republic of the Philippines, since 1985. To estimate the impact of the program, particularly the improvement of the water supply, on diarrheal incidence among under-five-year-old children, a comparative survey between a ZIP area and a non-ZIP area was conducted. A significantly higher diarrheal incidence among under-five-year-old children was observed in the non-ZIP area. This may be attributed to the increase in water consumption as a result of the improvement of the water supply in the ZIP area. The Relative Risk (RR) of water consumption with diarrheal incidence was 2.67, indicating a positive association. A water supply that provides for consumption of 60 (lpcd) could be a possible appropriate measure to reduce diarrheal cases.