A combined field study of Buruli ulcer disease in southeast Benin proposing preventive strategies based on epidemiological, geographic, behavioural and environmental analyses

Buruli ulcer is a neglected tropical disease caused by M. ulcerans, an environmental mycobacterium. This cutaneous infectious disease affects populations with poor access to sanitation, safe water and healthcare living in rural areas of West and Central Africa. Stagnant open bodies of surface water and slow-running streams are the only risk factor identified in Africa, and there is no human-to-human transmission. Appropriate and effective prevention strategies are required for populations living in endemic areas. Based on a multidisciplinary approach in an area in which Buruli ulcer is endemic in South Benin, we investigated the link between all human-environment interactions relating to unprotected water and behaviors associated with Buruli ulcer risk likely to affect incidence rates. We characterised the sources of water as well as water bodies and streams used by communities, by conducting a prospective case-control study directly coupled with geographic field observations, spatial analysis, and the detection of M. ulcerans in the environment. A full list of the free surface waters used for domestic activities was generated for a set of 34 villages, and several types of human behaviour associated with a higher risk of transmission were identified: (i) prolonged walking in water to reach cultivated fields, (ii) collecting water, (iii) and swimming. Combining the results of the different analyses identified the risk factor most strongly associated with Buruli ulcer was the frequency of contact with unprotected and natural water, particularly in regularly flooded or irrigated lowlands. We confirm that the use of clean water from drilled wells confers protection against Buruli ulcer. These specific and refined results provide a broader scope for the design of an appropriate preventive strategy including certain practices or infrastructures observed during our field investigations. This strategy could be improved by the addition of knowledge about irrigation practices and agricultural work in low-lying areas.

Information Sourcing and Managing Behavior of Dairy Entrepreneurs of Kerala

The study was conducted in Kerala state to comprehend the information sourcing and managing behavior of dairy entrepreneurs; by examining the frequency of contact with the information sources, available sources of training, ICT utilization, market orientation and scientific orientation. The data was collected by survey using a structured schedule and the results were exhibited in tables. The overall frequency of contact was found to be medium for majority of the dairy entrepreneurs; the results exhibiting a similar trend also in market orientation. The preferred training centers by most of the entrepreneurs were dairy cooperatives due to their proximity and flexibility. The modern day information tools like android mobiles and television were the preferred ICT sources. Scientific orientation was higher for majority of the dairy entrepreneurs signifying an encouraging impact of the information management. The multiple linear regression model showed that while experience was negatively correlated; annual income, overall frequency of contact and market orientation were positively correlated and significant with scientific orientation. Among the three geographic regions, highland entrepreneurs had high scientific orientation. Nevertheless, overall results suggest the need for extension support and training interventions to improve the information sourcing and managing behavior of dairy entrepreneurs of the state.

Źródła i formy kontaktów z bliskimi mężczyzn odbywających karę pozbawienia wolności

Social support is essential for mental and physical health and plays an important role in reducing the risk of returning to prison. The main sources of prisoners’ social support are relatives with whom they have the right to communicate using a variety of forms. The frequency of contact depends on the type of prison. However, little research examines prisoners’ communication with their relatives. The study was conducted on 478 men between the ages of 16 and 68 (M = 35,2; SD = 9,7), who were serving a prison sentence in one of five penitentiary facilities. The analysis revealed that the majority of incarcerated men had contact with their relatives, usually in a form of phone calls. The majority of them had contact with a mother. The study also demonstrated that the percentage of contacts with relatives decreased with age and time spent in prison.

AGRICULTURAL EMERGENCY: IDENTIFYING RISK BASED ON AGRICULTURAL HEALTH NURSING

Objective: The aim of the study was to identify the integrated emergency risks of farmers based on nursing models in the agricultural area of Lumajang, Indonesia.Materials and Methods: A quantitative design with a descriptive approach was performed through the identification of threats, vulnerabilities, and capabilities in 357 farmers in integrated emergency response with cluster sampling techniques. Data was collected through questionnaires, interviews, and focus group discussions. Data analysis was carried out using the Job Safety Analysis scoring method of the Australian and New Zealand Standard on Risk Management. Results: The emergency risk of farmers based on agricultural nursing was the high category, the highest threat was direct contact with chemicals (95%), the highest contact chemicals are insecticides (57%), frequency of contact once a week (44%), and the highest vulnerability not having employment insurance (97%), the length of farming > 10 years (65%) and the length of work in 1 month 10-20 days (48%), long work on land 8-10 hours (5%) and no holiday in a month (20%), while the capability of farmers in first aid to accidents was low (44%).Conclusion: The emergency risk of farmers in Lumajang was high and the capability for emergency-response based on agricultural nursing was low. Keywords: Threats, vulnerabilities, capabilities, emergencies, farmers, agricultural nursing

Predictors of Caregiver Burden Among Carers of Suicide Attempt Survivors

Background: Family members often provide informal care following a suicide attempt. Carers may be vulnerable to caregiver burden. Yet, little is known about what contributes to this. Aims: To determine the predictors of caregiver burden in those carers who support people who have attempted suicide. Method: An online survey of 435 participants assessed exposure to suicide, caring behaviors, and psychological variables and caregiver burden. Results: A multivariate model explained 52% of variance in caregiver burden. Being female, closeness to the person, impact of suicide attempt, frequency of contact pre-attempt, and psychological distress were positively associated with caregiver burden. Confidence in supporting the person after suicide attempt, perceived adequacy of healthcare the person received and the support the carer received, and suicidal ideation of the carer were negatively associated with caregiver burden. Moderation analysis suggested that carers with high levels of distress reported negative association between suicidal ideation and caregiver burden. Limitations: The cross-sectional online survey design of self-identified carers is a limitation of the study. Conclusion: Carers are highly distressed, and if unsupported report increased suicide ideation. In their caring roles they may have contact with support services, thus attending to their needs may ameliorate caregiver burden and associated negative outcomes.

Social relationships and the risk of incident heart failure: Results from a prospective population-based study of older men

Background Limited social relationships, particularly in older adults, has been implicated as a risk factor for cardiovascular disease. However, little is known about the associations between poor social relationships and heart failure incidence. Methods Prospective study of socially representative men aged 60-79 years drawn from general practices in 24 British towns and followed up for a maximum of 18 years. 3698 participants with no previous diagnosis of heart failure were included. Information on social relationships was based on a combination of marital status, living circumstances, and social contacts with friends and family. These provided information on contact frequency, contact satisfaction, and a social relationship score (low to high) combining frequency and satisfaction with contact. Heart failure included both incident non-fatal heart failure and death from heart failure. Results Among 3698 participants, 330 developed heart failure. Men with low compared to high frequency of contact with family and friends had an increased risk of incident heart failure (hazard ratio (HR) 1.59, 95%CI 1.15-2.18); this remained statistically significant after adjustment for social class, behavioural and biological risk factors. Low compared to high scores for satisfaction with contacts was associated with increased risk of heart failure (adjusted HR = 1.54; 95%CI 1.14-2.07). Lower social relationship scores (combining frequency and satisfaction with contact) were associated with greater risk of incident heart failure (adjusted HR = 1.38, 95%CI 1.02-1.87). Marital status and living alone were not significantly associated with heart failure. Conclusion Weaker social relationships appear to increase the risk of developing heart failure in older age. Further research is needed to investigate pathways underlying these associations and to test whether interventions to strengthen social relationships can reduce the risk of heart failure.

Tracing Management and Epidemiological Characteristics of COVID-19 Close Contacts in Cities Around Chengdu, China

Introduction: Close contacts have become a potential threat to the spread of coronavirus disease 2019 (COVID-19). The purpose of this study was to understand the epidemiological characteristics of close contacts of confirmed or suspected cases of COVID-19 in the surrounding cities of Chengdu, China, so as to provide a basis for the management strategy of close contacts.Methods: Close contacts were determined through epidemiological investigation of indicated cases, and relevant information was entered in the “Close Contact Information Management System.” Retrospective data of close contacts from January 22 to May 1, 2020 were collected and organized. Meanwhile, the contact mode, isolation mode, and medical outcome of close contacts were descriptively analyzed.Results: A total of 986 close contacts were effectively traced, with an average age of (36.69 ± 16.86) years old, who were mainly distributed in cities of eastern Chengdu. The frequency of contact was mainly occasional contact, 80.42% of them were relatives and public transportation personnel. Besides, the time of tracking close contacts and feedback was (10.64 ± 5.52) and (7.19 ± 6.11) days, respectively. A total of seven close contacts were converted to confirmed cases.Conclusions: Close contacts of COVID-19 have a risk of invisible infection. Early control of close contacts may be helpful to control the epidemic of COVID-19.

Internet Use and Depressive Symptoms Among Older Adults in China

This study investigated the effect of using the Internet on depression symptoms of older Chinese, based on 7,801 adults aged over 60 years from the 2018 China Family Panel Studies. Results showed that the elderly who used the Internet reported lower depression scores, and the more frequent they use Internet, the lower their depression scores. Moreover, using the Internet for social contact and entertainment decreased the depression scores of the older adults, but when using Internet for learn, work, and commercial activity, the relief of depressive symptoms disappeared. Therelief of depression symptoms through Internet use were heterogeneous among different groups: the elderly aged 60–70, women, rural residents, and those with lower education attainment. Moreover, Internet use decreased the depression scores by increasing the frequency of contact with their children and increasing the importance of their enjoyment of life. According to the relief of depression by using Internet reasonably, policies should be designed to ensure that all ages could have easy access to the Internet.

Social Participation and the Risk for Developing Mild Cognitive Impairment and Dementia Among Older Adults

Introduction We aim to investigate the longitudinal associations between social participation and the risk of developing mild cognitive impairment (MCI|) and dementia over 5 years of follow-up among cognitively normal older adults. Methods A total of 2802 participants had complete follow-up data from Age-Gene/Environment-Susceptibility-Reykjavik-Study. Social participation was assessed by a questionnaire asking the frequency of contact with children, relatives, friends and neighbors. MCI and dementia were diagnosed according to international guidelines and by a team composed of a geriatrician, neurologist, neuropsychologist, and neuroradiologist. Logistic regression analysis was used to assess the associations. Results At baseline 8% (n=225) reported no social participation. Among cognitively normal participants at baseline, 5.6% (n=243) developed mild cognitive impairment and 2.4% (n= 103) developed dementia during a mean follow-up time of 5.2 years. After full adjustment with covariates including age, gender, education, marital status, vitamin D levels, depression and APOE ε4, those with no social participation at baseline were significantly more likely to develop MCI at follow-up (OR=1.953, P=0.001). However, social participation at baseline was not associated with higher dementia diagnosis at follow-up (OR= 1.490, P=0.194). Conclusions Community-dwelling old adults who are socially inactive are more likely to develop MCI than those who are socially active. Social participation might independently indicate impending changes in cognitive function among older adults.

Self- and Informant-Reported Loneliness and Cognitive Function: Evidence From Three HCAP Studies

Loneliness is defined as a distressing feeling that arises from the discrepancy between one’s desired and perceived social relationships. Theorists have posited that loneliness involves affective, cognitive, and behavioral components that can be noticed by close family or friends. Little is known about whether social withdrawal, a behavioral marker of loneliness observed by knowledgeable others, shares similar associations with cognition as self-reported loneliness. The present study examined whether self-reported and informant-rated loneliness are related to cognitive function in older adulthood. Data come from Harmonized Cognitive Assessment Protocol subsample included in three national aging studies from the US (HRS; N = 2,821, Mage = 75.8), England (ELSA; N = 896, Mage = 73.6), and India (LACI-DAD; N = 2,994, Mage = 69.3). Respondents reported on 1-item loneliness and informants rated the respondent’s withdrawal behavior. Regression models were used to analyze the association between both measures of loneliness and cognition, controlling for respondent (age, gender, education, race/ethnicity) and informant (age, gender, education, spouse, known years, frequency of contact) covariates. Meta-analysis showed that both respondent-reported and informant-rated loneliness were independently associated with lower cognitive functioning (memory, speed–attention–executive, visuospatial ability, and fluency) and global cognition (MMSE). The associations between observed withdrawal and cognition did not vary by informant-level characteristics nor the respondent’s cognitive impairment status. The present study indicates that withdrawal behavior observed by informants is associated with cognitive function, supporting psychosocial observations provided by knowledgeable others can be utilized in detecting cognitive function.