Journal of preventive medicine and hygiene最新文献

Penicillin's discovery is widely attributed to Alexander Fleming (1881-1955) Professor of Bacteriology at St. Mary's Hospital in London in 1928, who observed the antibacterial effects of Penicillium mold. Fleming found that his "mold juice" was capable of killing a wide range of harmful bacteria, such as streptococcus, meningococcus and the diphtheria bacillus. He then set his assistants, Stuart Craddock and Frederick Ridley, the challenging mission of isolating pure penicillin from the mold juice. It shown to be very unstable, and they were only able to prepare solutions of crude material to work with. Fleming published his findings in the British Journal of Experimental Pathology in June 1929, with only a passing reference to penicillin's potential therapeutic benefits. However, over 30 years earlier, Italian physician Vincenzo Tiberio (1869-1915) had conducted controlled studies on the bactericidal effects of mold extracts, publishing results that went largely unnoticed by the scientific community.This article runs through a work plan timeline and significance of early antimicrobial discoveries, tracing the overlooked work of Tiberio, Fleming's breakthrough, the biochemical properties of penicillin, and the wartime efforts that enabled its mass production. The story of penicillin is not only one of scientific innovation but also of missed recognition, collaboration, and the complex interplay of chance and preparedness.

Introduction: Little research exists regarding pharmacy student vaping habits or differences among students from different countries.

Methods: A novel 19-item questionnaire was distributed in November 2023 to students at The University of Bath (United Kingdom) and The University of Texas at Austin (United States) to compare vape use and perceptions among pharmacy and non-pharmacy students from the two universities. All pharmacy students at both institutions were invited to complete the survey. A non-pharmacy student control group was identified through snowball sampling (i.e., the survey was distributed to a convenience sample of non-pharmacy students at each school, asking them to complete and distribute to peers). To incentivize participation, one respondent received a $100 reward. Data was analyzed using descriptive statistics. Chi-square and Wilcoxon Rank Sum tests were used to compare answers between pharmacy and non-pharmacy and UK and US participants. A p-value < 0.05 was deemed significant.

Results: Overall, 372 students completed the survey (25% pharmacy student response rate). Vape use significantly differed between pharmacy and non-pharmacy students (p = 0.03). Among 212 pharmacy students, 49% reported vape ever-use versus 59% of the 158 non-pharmacy students. Significant differences were found in harm perceptions; more pharmacy students believed vapes are cancer-causing, affect the health of others nearby, should be banned in public, and are ineffective for quitting cigarettes. Few differences were observed between UK and US students.

Conclusion: Pharmacy students were less likely to vape and exhibited heightened awareness of associated risks than non-pharmacy students. Few differences were observed between UK and US students surveyed.

The COVID-19 pandemic affected people with disabilities in different aspects, including their access to physical rehabilitation (PR). Despite a significant global surge in the need for PR, it has not been prioritized and is under-resourced, even in the non-COVID era, in many countries. This study aimed to explore the challenges of delivering PR services during the COVID-19 pandemic in Iran and potential solutions to these challenges. This qualitative study was done using a thematic approach from November 2023 to March 2024 in Iran. 45 PR professionals and faculty members from three fields-physiotherapy, occupational therapy, and orthotics and prosthetics-were interviewed in a semi-structured approach. Data analysis was done using Braun and Clarke's thematic analysis approach. The five control knobs (organization, regulation, financing, payment, and behavior) were used to study the challenges and proposed solutions. The main identified challenges included Iran's healthcare system's lack of preparedness, deficient infrastructure, limited remote rehabilitation options, restriction of in-person visits, lack of clinical guidelines, ambiguous pricing for telerehabilitation, financial hardships stemming from the pandemic, insufficient government support, reliance on out-of-pocket (OOP), patients' reluctance to pay for online services, delayed compensation for PR professionals, mental distress experienced by patients and service providers, resistance to new service modalities, and inadequate digital literacy. The key solutions included strengthening telerehabilitation infrastructure, developing clear clinical guidelines, increasing government financial support, improving payment structures, and fostering behavioral changes through increased awareness. The findings of this study underscore the importance of proactive planning, intersectoral collaboration, and the integration of PR services within the healthcare framework. The suggested solutions can inform policymakers to enhance the preparedness and responsiveness of health systems to future crises.

According to Regulation (EC) 178/2002, "any undertaking, whether for profit or not and whether public or private, carrying out any of the activities related to any stage of production, processing and distribution of food" must be classified as a "food business". A food business operator (FBO) is "the natural or legal person responsible for ensuring that the requirements of food law are met within the food business under their control". We analyzed the case of an Italian wholesale commercial intermediation company, purchasing a typically carbohydrate-rich local product from producers and reselling it to retailers, although never physically possessing it. In the marketing process, the company misleadingly emphasized the product's protein content, providing inaccurate nutritional information on the label, thus committing food fraud. Moreover, as required by European law, sanitary guarantees on the operating methods and traceability were not provided. To ensure food safety, every food business is subject to the obligation of registration (Regulation EC 852/2004), preparation of the self-control plan according to the principles of the HACCP system and traceability obligations (Regulation EC 178/2002). This case highlights the current general poor culture in food safety. It shows the urgent need for awareness-raising and training interventions to improve behaviors and clarify the qualifications and responsibilities of all parties involved, including FBOs and competent authorities, to prevent health risks and food fraud.

Background: Hemodialysis (HD) is the world's most prevalent kidney replacement therapy for end-stage renal disease patients. Hepatitis C virus infection (HCV) is highly prevalent in patients undergoing HD. There are no reports of the epidemiology of HCV viremia and HCV incidence rate based on prospective studies in HD units in Cameroon. This study evaluated the prevalence and incidence rate of HCV based on anti-HCV antibody (Ab) and HCV-RNA detection.

Methods: We conducted a controlled prospective study in three hemodialysis centers in Cameroon, from October 2021 to January 2023. The HEXAGON HCV rapid kit was used to detect anti-HCV Ab, and HCV-RNA was searched using the Xpert® HCV Viral Load technology. We performed a Wilcoxon test and the chi-square or Fisher exact test in statistical analyses.

Results: A total of 205 HD patients were enrolled with a mean age of 47.7 ±14.5 years and median hemodialysis duration of 36 months (IQR: 12-72). Anti-HCV Ab was positive in 59 patients, giving a prevalence of 28.8% (95% CI: 22.7-35.5). This Anti-HCV Ab infection was mainly found in patients with a relatively long period of HD (P = 0,00002). Of the 59 anti-HCV Ab-positive patients, HCV-RNA was detected in 42, with the HCV active infection prevalence of 71.2% (95% CI: 57.9-82.2). A high viral load (HCV RNA > 800,000 UL/ml) was detected in 31% (95% CI: 17.6-47.1). A total of 125 patients with a negative status at the start of the study (M0) were prospectively followed up. After seven months (M7), 15 [12%; 95% CI: 06.9-19.)] became HCV positive, with an incidence rate of 20.6 cases per 100 patients-years.

Conclusion: There is a high prevalence of HCV infection and HCV incidence rate in this study. Strategies aimed at decreasing HCV infection in HD centers in Cameroon are urgently needed.

Introduction: Fundamental care addresses the essential physical and psychosocial needs of patients and is critical for safe, high-quality nursing practice. Despite growing awareness of its value, it remains one of the most neglected areas in clinical care. The Fundamentals of Care (FoC) Framework provides a structured approach to support its delivery, yet its practical implementation remains limited and underexplored. This study aims to evaluate the effectiveness of integrating the FoC Framework into nursing practice to reduce patient length of stay in medical and surgical wards.

Methods: A quasi-experimental pre-post implementation study will be conducted over 15 months in one medical and two surgical wards. The FoC Framework will guide interventions targeting key needs (nutrition, elimination, mobility, and education) identified through focus groups with nurses, patients, and caregivers. Following framework introduction, a six-month phase of individualised care will be implemented. Data on interventions and outcomes will be collected daily via the Electronic Health Record, both before and after implementation. The primary outcome is length of stay; secondary outcomes include adverse events, readmissions, patient and nurse satisfaction, turnover intentions, complaints, discharge rates, needs assessments, frequency of interventions, and goal achievement. Analyses will use t-tests or Mann-Whitney tests. Multivariable regression models will be considered for adjusting for confounding factors.

Conclusion: This is the first protocol that will assess the implementation of the FoC Framework in clinical practice. Findings will contribute robust evidence on its potential to improve care quality, meet essential patient needs, enhance satisfaction among patients and staff, and reduce adverse outcomes.

Background: Due to the growing increase in the needs of health systems in the field of financial and human resources management, performance-based payment has been the subject of attention by health and welfare policymakers. This study aimed to compare the components of performance-based payment in selected countries.

Methods: This comparative study was conducted in 2021. The selection of countries was based on three measures: the type of health insurance system, the development of the performance-based payment system, and the state of economic development of the countries. The findings were organized using comparative analysis tables. The general framework of performance-based payment systems, including goals, activities and actions, people involved in the program, and the way of encouraging and punishing, was used for analysis.

Results: The findings of the study showed that in most of the programs, aspect of clinical quality has the highest weight. Other dimensions include patient experience and satisfaction, physician financial performance, and patients' access to services. In most programs, various risk adjustment methods such as exception reporting, combined payments, payment according to demographic characteristics, were used to reduce provider risk, and clinical service providers were actively involved in the program design progressive.

Conclusions: Despite the widespread use of performance-based payment programs in most countries, these programs face limitations and shortcomings. By linking incentives to individual, team, and organizational performance, a performance-based payment program can improve teamwork, and create integrated health care.

Introduction: This study aims to investigate the psychometric properties of the Home Health Care Survey of the Consumer Assessment of Healthcare Providers and System (HHCAHPS) in the Italian context.

Methods: This is a secondary analysis of data from the AIDOMUS-IT study. A total of 9,780 patients cared for by home healthcare services completed the HHCAHPS along with a measure of satisfaction for the care received. Structural validity was assessed with a confirmatory analytical approach (CFA). Construct validity was ascertained via hypothesis testing (convergent validity) by correlating the HHCAHPS scores with the scores derived from the measure of patient satisfaction for care. Internal consistency was assessed with the Omega (ω) coefficient.

Results: Structural validity was confirmed, with satisfactory fit indices of the CFA model specified according to the conceptualized three-factor structure ("care of patients", "communication with the providers", and "specific care issues"). Construct validity was confirmed with moderate correlations between the level of satisfaction for care and the factors "communication with the providers" (r = 0.39, p < 0.001), "care of patients" (r = 0.34, p < 0.001), and "specific care issues" (r = 0.19, p < 0.001). Internal consistency was satisfactory for the "specific care issues" factor (ω = 0.81), while it was at the threshold of acceptability for the other factors (ω = 0.60-0.62).

Conclusions: This study shows that the HHCAHPS is valid and sufficiently reliable when tested on the Italian population. Therefore, this tool can be supportive for promoting research and designing interventions to promote patient-centered care within home healthcare settings.

Introduction: Despite advances in the prevention of healthcare-associated infections (HAI) in recent decades, this once-almost-usual adverse event remains relatively common and still has a definite impact on patients and public health. In light of this, this study aimed to determine the HAI prevalence, to describe their main specificities and to identify their associated factors, in Southern Tunisia.

Methods: We conducted a cross-sectional study to assess HAI point prevalence in two university hospitals in southern Tunisia. The study was started on February 20^th to March 13^th, 2023.

Results: There were 1.028 patients included in the survey and (47.3%) of them were women (n=486). The median age was 48 years (Interquartile Range (IQR)=[30-65]) years. We noted 86 HAI in the two establishments visited, with a global HAI prevalence of 8.4%. Multivariate analyses showed that independent factors of HAI were immune suppression (AOR=2.5; p=0.004), hospital stay duration ≥ 6 (AOR=4.5; p<0.001), surgery 30 days prior to the study date (AOR=1.9; p=0.021), having central vascular catheter (AOR=2.44; p=0.032) and having intubation or endotracheal tube (AOR=3.5; p=0.002).

Conclusions: This study highlighted a relatively high prevalence of HAI in southern Tunisia. Therefore, urgent and ongoing corrective measures should be implemented, maintained and re-evaluated continuously in order to control HAI and promote care safety.

The changing scenarios in healthcare in recent years underscore the need to promote diverse, articulated, and complex care approaches capable of paying greater attention to people's vulnerability and responding to multiple care needs. A multidimensional approach to healthcare also suggests a review of the role that pharmacies can assume within the healthcare system, with particular regard to the possibility of creating a relational space with the citizen aimed at strengthening the fiduciary relationship with him or her and promoting greater user empowerment in therapy adherence. The promotion of this ethically relevant service could yield several benefits: greater protection of public health, rationalization of public spending, and shifts in the demand for healthcare services. This paper aims to illustrate some socially and ethically relevant aspects of collaboration between pharmacists, general practitioners, and pediatricians of free choice.