Programmatic norms change to eliminate violence against children: Insights for practitioners and researchers from a UNICEF global mapping study.

Interest in gender norms is rising within the field of global health and among its funders. With more resources available for norms change work, international institutions seek to develop thoughtful strategic and programmatic responses to a variety of issues, including violence against children. Yet changing deeply rooted gender norms requires sensitivity to local context. This can present a challenge for mid- to large sized organisations, as well as funders, who are typically required to develop strategies that encompass multiple contexts. This paper presents practical lessons learned from a mapping study of UNICEF's existing work to change discriminatory gender norms. As the world's leading children's rights organisation, preventing violence against children (0-9) and adolescents (ages 10-19) is a key component of UNICEF's work. This mapping formed the foundation of the institution's efforts to build out a coordinated strategy and programme of work around 'positive gender socialisation.' The mapping was unique in that it accounted for differences across and within regions and sought to develop an institutional programme of work based on local experience and existing priorities. The lessons learned are relevant to other organisations and practice-oriented research programmes embarking on work to change norms that lead to violence against children.

Oral morbidity and associated factors in Chilean preschoolers and schoolchildren: a preliminary review

Currently, the most prevalent oral pathologies in Chile are dental caries, periodontal diseases, and dentomaxillary anomalies, with dental caries being considered the most prevalent in childhood and a public health problem. In Chile, research on and diagnosis of these diseases in preschoolers and schoolchildren are varied over time, but there is no review of the existing studies relating these pathologies to the most common risk factors, such as socioeconomic level, rurality, and nutritional status. The objective of this preliminary review is to assess oral morbidity in preschoolers and schoolchildren associated with risk factors in Chile. A national study found that the prevalence of caries is 16.8% at two years, 49.6% at four years, 70.4% at six years, 62.5% at 12 years, and 73.9% at 15 years. In relation to the severity of caries, it found a DMF T of 0.5 at two years, a DMF T of 2.3 at 4 years, and a DMF T of 3.7 at six years in temporary dentition. In permanent dentition, that the same study found a DMF T of 0.15 at six years, a DMF T of 1.9 at 12 years, and a DMF T of 3.0 at 15 years. Regarding gingivitis, it found a prevalence of 32.6% at two years, 45% at four years, 55.1% at six years, and 66.9% at 12 years. As for dentomaxillary anomalies, 33.3% presented some degree of anomaly at four years, 38.3% at six years, and 53% at 12 years. Despite the above, there are various studies in specific localities that have found a higher prevalence and severity of oral diseases. However, it is necessary to carry out a systematic evaluation to determine the prevalence and severity for each of the most prevalent oral diseases, as well as to identify the risk factors for the incidence of said diseases.

Pigeons and their droppings as reservoirs of Candida and other zoonotic yeasts / La paloma y sus excrementos como reservorios de Candida y otras levaduras zoonóticas

Background. The importance of pigeons as reservoirs and carriers of Cryptococcus neoformans and other species of this genus is well-known; however, less is known about their role as reservoirs and carriers of other yeasts that impact public health. Aims. The present study was performed on Gran Canaria Island to define yeasts other than Cryptococcus spp. that have been reported to impact public health and which could be carried by pigeons. Methods. Samples were obtained from 83 pigeon lofts (Columba livia); moreover, 331 crop samples, 331 cloacal samples and 174 dropping samples were collected. In addition, 17 dropping samples were taken from a total of 17 public squares. Samples were inoculated on Sabouraud dextrose agar with chloramphenicol. Results. Different yeast species, i.e. Candida guilliermondii (24.36%), Candida kefyr (1.21%), Saccharomyces cerevisiae (2.43%), and Trichosporon asahii (1.21%) were isolated for the first time from the cloaca. The most frequently isolated yeast from the crop, cloaca and dropping samples from lofts was C. guilliermondii (30.46%, 24.36% and 49.37%, respectively). In addition, for the first time, C. kefyr (3.65%), Candida pelliculosa (2.43%), Candida rugosa (1.21%), T. asahii (3.65%), Trichosporon mucoides (3.65%) and Prototheca wickerhamii (1.21%) were obtained from crop samples; Candida pelliculosa (1.20%), T. asahii (9.63%) and T. mucoides (7.22%) were isolated from dropping samples in the lofts. Candida albicans was the most frequently isolated yeast in dropping samples collected in public squares. Conclusions. It can be assumed that pigeons and their droppings act as carriers and reservoirs of Candida spp. and other zoonotic yeasts (AU)

Antecedentes. Es bien conocido el papel que desempeña la paloma como reservorio y portadora de Cryptococcus neoformans y otras especies del género; sin embargo, se conoce poco sobre el papel que desempeña como reservorio y portadora de otras levaduras que repercuten en la salud pública. Objetivos. El presente estudio fue realizado en la isla de Gran Canaria para determinar otras levaduras diferentes del género Cryptococcus que podrían portar las palomas y que repercuten en la salud pública. Métodos. Se tomaron muestras en 83 palomares (Columba livia): 331 muestras de buche, 331 cloacales y 174 muestras de excrementos. También se tomaron 17 muestras de excrementos en 17 plazas públicas. Las distintas muestras se sembraron en agar glucosado de Sabouraud con cloranfenicol. Resultados. Se aislaron por primera vez de la cloaca diferentes especies de levaduras: Candida guilliermondii (24,36%), Candida kefyr (1,21%), Saccharomyces cerevisiae (2,43%), Trichosporon asahii (1,21%). La levadura más frecuentemente aislada de muestras de buche, cloaca y heces de palomares fue C. guilliermondii (30,46, 24,36 y 49,37%, respectivamente). A estas especies se suman otras aisladas por primera vez a partir de muestras de buche: C. kefyr (3,65%), Candida pelliculosa (2,43%), Candida rugosa (1,21%), T. asahii (3,65%), Trichosporon mucoides (3,65%) y Prototheca wickerhamii (1,21%). Se aislaron por primera vez de muestras de excrementos de palomares las especies C. pelliculosa (1,20%), T. asahii (9,63%) y T. mucoides (7,22%). Candida albicans fue la levadura más frecuentemente aislada de muestras de heces recogidas de plazas públicas. Conclusiones. Por todo ello, concluimos que la paloma y sus excrementos actúan como portadores y reservorios de especies de Candida y otras levaduras zoonóticas (AU)

Pigeons and their droppings as reservoirs of Candida and other zoonotic yeasts.

BACKGROUND: The importance of pigeons as reservoirs and carriers of Cryptococcus neoformans and other species of this genus is well-known; however, less is known about their role as reservoirs and carriers of other yeasts that impact public health. AIMS: The present study was performed on Gran Canaria Island to define yeasts other than Cryptococcus spp. that have been reported to impact public health and which could be carried by pigeons. METHODS: Samples were obtained from 83 pigeon lofts (Columba livia); moreover, 331 crop samples, 331 cloacal samples and 174 dropping samples were collected. In addition, 17 dropping samples were taken from a total of 17 public squares. Samples were inoculated on Sabouraud dextrose agar with chloramphenicol. RESULTS: Different yeast species, i.e. Candida guilliermondii (24.36%), Candida kefyr (1.21%), Saccharomyces cerevisiae (2.43%), and Trichosporon asahii (1.21%) were isolated for the first time from the cloaca. The most frequently isolated yeast from the crop, cloaca and dropping samples from lofts was C. guilliermondii (30.46%, 24.36% and 49.37%, respectively). In addition, for the first time, C. kefyr (3.65%), Candida pelliculosa (2.43%), Candida rugosa (1.21%), T. asahii (3.65%), Trichosporon mucoides (3.65%) and Prototheca wickerhamii (1.21%) were obtained from crop samples; Candida pelliculosa (1.20%), T. asahii (9.63%) and T. mucoides (7.22%) were isolated from dropping samples in the lofts. Candida albicans was the most frequently isolated yeast in dropping samples collected in public squares. CONCLUSIONS: It can be assumed that pigeons and their droppings act as carriers and reservoirs of Candida spp. and other zoonotic yeasts.

Non-typeable Haemophilus influenzae biofilm production and severity in lower respiratory tract infections in a tertiary hospital in Mexico.

Non-typeable Haemophilus influenzae (NTHi) is a common opportunistic bacterial pathogen that primarily infects the respiratory mucosa. This study was conducted to assess clinical and microbiological data related to disease severity in patients with lower respiratory tract infections caused by NTHi in a tertiary care hospital in Mexico. NTHi isolates were subjected to serotyping, antimicrobial susceptibility evaluationand analyses of ß-lactamase production, genetic relatednessand biofilm formation. Clinical and demographic data were retrieved from patients' records. The mean age of the patients was 40.3 years; the majority (n=44, 72.1 %) were male. The main comorbidities were arterial hypertension (n=22, 36.1 %) and diabetes mellitus (n=17, 27.9 %). NTHi isolates (n=98) were recovered from tracheal aspirate (n=57, 58.2 %), sputum (n=26, 26.5 %)and bronchial aspirate (n=15, 15.3 %) specimens. Low resistance to cefotaxime (n=0, 0.0 %), rifampin (n=1, 1.1 %) and chloramphenicol (n=3, 3.2 %) and greater resistance to ampicillin (n=30, 32.3 %) and trimethoprim-sulfamethoxazole (n=49, 52.7 %) were detected. ß-Lactamase production was found in 17 (17.3 %) isolates. Isolates displayed high genetic diversity, and only 10 (10.2 %) were found to be biofilm producers. The antimicrobial susceptibility patterns of biofilm-producing and non-producing isolates did not differ. Biofilm production was associated with prolonged hospital stay (P=0.05). Lower respiratory NTHi isolates from Mexico showed low antimicrobial resistance and weak biofilm production. Younger age was correlated with lower Acute Physiology and Chronic Health Evaluation II score (moderate, P=0.07; severe, P=0.03).

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain.

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude. STUDY TYPE: A sociological, interdisciplinary, multicenter and observational study. STUDY POPULATION: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. SAMPLE SIZE: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. STATISTICAL ANALYSIS: Student´s t test, χ(2) test and logistic regression analysis. RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001). CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

The level of acceptance of spanish medical students of the transplantation of solid organs from animals: a stratified and multicentre study.

INTRODUCTION: Research into the transplantation of solid organs from animals (xenotransplantation) is generating interest and curiosity given that this could be a way of resolving the shortage in transplant organs. However, the fact is that currently xenotransplantation is far from becoming a clinical practice. OBJECTIVE: To analyse the attitude of medical students from Spanish universities towards the donation of organs from animals and to determine the factors affecting their attitudes. TYPE OF STUDY: A sociological, interdisciplinary, observational and multicentre study in Spain. STUDY POPULATION: Students enrolled on the medical degree in Spain (n = 34 000). SAMPLE SIZE: A sample of 9598 students (a confidence level of 99% and precision of ± 1%) stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ xenotransplantation (PCID-XenoTx RIOS) which was self-administered and completed anonymously. RESULTS: A completion rate of 95.7% (n = 9275) was obtained. If the results of xenotransplantation were as good as in human donation, 81% (n = 7491) would be in favour, 3% (n = 308) against and 16% (n = 1476) undecided. The following variables affected this attitude: sex (P < 0.001); academic year (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); the opinion of one's partner (P < 0.001); the respondent's attitude towards organ donation (P < 0.001); religion (P < 0.001); and participation in altruistic activities (P < 0.001). The following variables persisted in the multivariate analysis: (1) being a female (OR = 1.794; P < 0.001); (2) academic year (OR = 2.487; P < 0.001); (3) having spoken about the issue with one's family (OR = 1.200; P = 0.019); (4) the favourable opinion of one's partner (OR = 1.526; P = 0.028); (5) an attitude in favour of donation (OR = 2.087; P < 0.001); (6) being an atheist/agnostic, (OR = 2.5; P < 0.001); and (7) a belief that one's religion is in favour of transplantation (OR = 1.317; P = 0.005). CONCLUSIONS: Spanish medical students have a favourable attitude towards xenotransplantation. This willingness and interest could be a decisive platform for the development and strengthening of research, both for centres with a pre-clinical xenotransplantation programme and new healthcare centres.