Antimicrobial Resistance Following Prolonged Use of Hand Hygiene Products: A Systematic Review

Background: This systematic review aimed to establish whether antimicrobial resistance (AMR) occurs following prolonged use of antimicrobial hand hygiene (HH) products, and, if so, in what magnitude. Methods: Key bibliographic databases were searched to locate items on HH use and AMR development from database inception to December 2020. Records were screened and full texts of all potentially eligible articles were retrieved and checked for inclusion. The following data from the included studies were abstracted: type of HH product used, including the name of antimicrobial agent, study setting, country, study year, duration of use and development of AMR including the organisms involved. Quality assessment was done using the Newcastle-Ottawa Scale (NOS). Results: Of 339 full-text articles assessed for eligibility, only four heterogeneous United States (US) studies conducted in the period between 1986 and 2015 were found eligible, and included. One hospital-based study showed evidence of AMR following long term use of HH products, two studies conducted in household settings showed no evidence of AMR, and another experimental study showed partial evidence of AMR. The overall certainty of the evidence was moderate. Conclusion: Prolonged use of HH products may cause AMR in health care settings, but perhaps not in other settings.

The Use of Complementary Medicine During Childbearing Years: A Multi-Country Study of Women From the Middle East استفاده ازطبمکمل دردورانباروری:یکمطالعهچند کشوری درزنان خاور میانهاستخدام الطب التكميلي خلال سنوات الإنجاب: دراسة متعددة البلدان لنساء من الشرق الأوسط

The prevalence of self-prescribed complementary medicine (CM) use is an area of concern across the Middle East. We conducted a descriptive qualitative study to describe women’s use of CM during their childbearing years in Egypt, Jordan, Saudi Arabia and Iran. The study conducted using face to face audio-recorded interviews with 70 participants. Our findings showed that women used several herbal plants to ease pain and discomfort during menstruation and/or during pregnancy and in postpartum care. Acupuncture, meditation, and massage were less likely to be used by women. The impact of CM was often described in relation to perceived usefulness and safety of herbs. Cultural beliefs and roles of women contributed to the use of herbs among women. Given the high use of herbal medicine, there is a need for discussion about the potential of adverse effects of some plants or their metabolites following self-medication during the childbearing years.

Trauma and Posttraumatic Stress in Unaccompanied Young Refugees During Their Flight: A Longitudinal Cross-Country Study

Background: Unaccompanied young refugees (UYRs) constitute an especially vulnerable population who report high rates of trauma and mental health problems. There is a significant gap in the literature on trauma and symptoms of posttraumatic stress disorder (PTSD) in UYRs who are still on the move and live in precarious circumstances such as refugee camps. This study therefore aimed at investigating pre- and peri-migration trauma of UYRs, longitudinal trajectories of PTSD, and the impact of gender, trauma, and daily stressors on PTSD over time. Methods: This longitudinal, mixed-method, and multi-country study was conducted in various settings (e.g. refugee camps) across nine European countries. A representative and heterogeneous sample of N = 187 UYRs (78.4% male) from 29 different countries was assessed via interviews at 3 time-points during a period of 27 months. Data was analyzed via growth curve modelling.Results: Prevalence rates of traumatic experiences ranged between 29.5-91.9%. PTSD scores were high but significantly decreased over time (b = -0.98; p = .004). Females reported higher PTSD compared with males at baseline (p = .002), but gender did not influence the longitudinal trajectory of PTSD. Pre-migration trauma had a significant effect on PTSD at baseline (b = 0.48; p = .042). More daily stressors resulted in higher PTSD across time (b = 0.13-0.26; p ≤ .001). Conclusions: The number of traumatic events pre- and peri- migration, daily stressors and PTSD in this heterogeneous sample are to say the least alarming. Humanitarian and political assistance is urgently needed to curb the oftentimes life-threatening conditions UYRs face during their migration.

Measuring Self-Reported Access to Assistive Technology Using the WHO Rapid Assistive Technology Assessment (rATA) Questionnaire: Protocol for a Multi-Country Study

In 2018, the World Health Assembly adopted a resolution on improving access to assistive technology (AT), and mandated the WHO to prepare a global report on assistive technology based on the best available evidence and international experience. As limited data on access to AT at country and global levels were available, there was a need to conduct representative population surveys in order to inform the development of the global report, national AT programs, and global initiatives. The objective of this protocol is to describe a multi-country study of access to assistive technology in six self-reported areas: use, source, payer, satisfaction, unmet need, and barriers. In collaboration with WHO Regional and Country offices, Member States, and other stakeholders, the Assistive Technology Access team in WHO coordinates the study. Data are collected through household surveys using the rapid Assistive Technology Assessment (rATA) questionnaire. Findings from the surveys will be published in the global report.

PERSPECTIVES ON MALAYSIA'S LACK OF IMPLEMENTATION OF GREEN BACK LANES

Malaysia has been utilising green back lanes since the ‘90s. In spite of the several benefits of these lanes, such as the formation of active spaces, decrease in runoff water, and visitor attractions, green back lanes are yet to be deployed in the residential regions of Malaysia, prompting the question as to why these lanes have not yet been installed extensively. The objectives of this research work were: to determine what experts opined regarding the installation of green back lanes in the country, study the scenarios which caused the absence of implementation, produce a report showing the outcomes and analysis, and offer suggestions. The researcher deployed the interview strategy for ascertaining the views and standpoints of architects, town planners, maintenance staffs, project managers, and marketers on the dearth of green back lane installation. The research emphasises on the aspects of cost, maintenance, and safety.

Globalization and life lost due to tuberculosis: evidence from a multi-country study

Background: Tuberculosis affects around 30% of the population of the world. Tuberculosis causes an increase in early mortality and thus has the potential to increase the number of years of life lost. Globalization directly or indirectly by affecting the factors that increase the susceptibility for tuberculosis infection has the potential to increase the spread and mortality due to tuberculosis. This study assessed the causal link between globalization and the years of life lost due to tuberculosis. Methods: Data from the Demographic and Health Survey (DHS) and World Bank for 2004 and 2005 were used for a number of covariates and possible mediators. Data from the Institute of Health Metrics and Evaluation (IHME) were used for the outcome variable and important globalization indicators. The primary health outcome that was studied is tuberculosis and the measure that was used to quantify tuberculosis mortality is the years of life lost (YLL). Path analysis was used. Results: The main independent variables of economic and social integration were not statistically significant. For every unit increase in the proportion of people that were using treated drinking water, there was a -0.0002 decrease in the YLL due to tuberculosis. For every unit increase in the proportion of people with earth floor, there was a 0.0002 units increase in YLL due to tuberculosis. For every unit increase in the proportion of people living using clean fuel, there was a 0.0004 decrease in the YLL due to tuberculosis. Conclusions: Social and economic globalization have no effect on the years of life lost due to tuberculosis, highlighting that globalization actually does not contribute to tuberculosis mortality. However, improving other important determinants such as sanitation, providing safe drinking water and clean households will reduce the mortality due to tuberculosis, highlighting the need to invest in them.

LESSONS LEARNED FROM REGISTRATION OF OCCUPANCY AND USE OF LIGHTING IN OFFICES, SCHOOLS, UNIVERSITIES AND INDUSTRY BUILDINGS, A CROSS COUNTRY STUDY

The paper presents a registration of occupancy and the use of (day)light in four buildings representing respectively offices, primary schools, universities, and industry buildings; it was done across Europe in 2020. A self-registration method was used, assisted with light technical measurements outdoors and indoors. In general, occupants consider the visual environment at the workplace when they are coming in or out of the room. It happens mainly at the beginning (adjustment of blinds and switching light on) and at the end of the working day (switching light off). In the primary school building, where users move in-out many times during the day, the adjustment happens more frequently. Also use of projector generates very low general light level; covering windows and switching off the electric light happens accordingly, but the pattern is not consistent. In general, the changes in the electrical lighting use follow the occupancy pattern, not the light levels.