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With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts. [ABSTRACT FROM AUTHOR]

Background The recent emergence of Chikungunya Virus (CHIKV) in the Americas constitutes a major public health problem on this continent, where the mosquito vector is widespread. The rapid diagnosis of suspected cases is essential for the monitoring and control of this ongoing outbreak. However, this requires reliable tools that are difficult to establish in areas without specialized laboratories. Objectives The aim was to evaluate the performances of serum samples spotted onto filter paper for molecular and serological diagnosis of Chikungunya infection. Study design Analyses were performed from frozen sera and serum spotted onto filter paper provided from 121 Chikungunya suspected cases collected at a biological laboratory on Saint-Martin Island. Results This approach performed well in comparisons with standard methods, with a sensitivity of 100% and a specificity of 93.6% for the combined technical approaches (RT-PCR and serological results). Comparisons of serum samples spotted onto filter paper and frozen samples showed a concordance rate of 94.8% in molecular tests and 98.2% in serological tests. Conclusions This simple sampling technique could overcome the problems of the lack of efficient CHIKV diagnosis tools in remote regions, providing good results regardless of the molecular or serological approach used. This simple filter paper-based method can be used to diagnose both chikungunya and dengue infections, as previously demonstrated following transport at ambient temperature to specialized laboratories. Given the set-up costs and high performance of this method, it could be recommended for the monitoring and control of Chikungunya virus expansion in the Americas and in other affected regions. [ABSTRACT FROM AUTHOR]

Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices. [ABSTRACT FROM AUTHOR]

Abstract: Most paper industry waste is in the form of sludge from paper production and recycle process paper. There has been an increasing use of paper sludge in environmental restoration, a practice that requires particular attention. This issue presents a case which demonstrates how the biogas production related to this kind of recovery system can represent a problem for environmental protection and public health. The case history relates to a former quarry area restored by means of paper sludge. After the filling, a substantial quantity of biogas was produced, with an external diffusion to sensible target as well. Initial investigations showed that the area was characterized by a large amount of paper mill sludge made unstable by anaerobic conditions. To date there are no proven technologies for this kind of treatment. In this case, for safety and naturalization as agricultural area, new methods of bioremediation were used and, in particular, an innovative physical, mechanical and biological intervention, based on bio-stabilization of paper mill sludge. The treatment is site-specific, based on the in-site paper sludge biostabilisation. To complete the intervention and in order to demonstrate its validity an important monitoring activity was performed, testing all the phases affected by the biological transformation. [Copyright &y& Elsevier]

Abstract This article presents the World Health Organization's (WHO) recommendations on the use of measles vaccines excerpted from the WHO position paper on Measles vaccines: WHO position paper – April 2017, published in the Weekly Epidemiological Record [1]. This position paper replaces the 2009 WHO position paper on measles vaccines [2]. The position paper summarizes the most recent developments in the field of measles and includes removal of introduction criteria for the routine second dose of measles-containing vaccine (MCV2), guidance on when to vaccinate infants from 6 months of age, and guidance on re-vaccination of HIV-infected children receiving highly active anti-retroviral therapy (HAART). Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation table. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. Recommendations on the use of measles vaccines were discussed by SAGE in November 2013, October 2015 and October 2016; evidence presented at these meetings can be accessed at: www.who.int/immunization/sage/meetings/2013/november/presentations%5fbackground%5fdocs/en/ , www.who.int/immunization/sage/meetings/2015/october/presentations%5fbackground%5fdocs/en/ and www.who.int/immunization/sage/meetings/2016/october/presentations_background_docs/en/. [ABSTRACT FROM AUTHOR]

Abstract Currently, the standard method for identifying biological agents of potential threats to national security and public health, such as pathogens, virus, and toxins, mainly rely on microbiological cultivation. This method is time-consuming and it requires sophisticated equipment and well-trained personnel, which are often unavailable in remote areas or at point-of-need. Therefore, an alternative rapid, simple, and sensitive method for detecting bio-threat agents is in crucial need. We report a paper-based Vertical Flow Immunoassay (VFI) device that can overcome these limitations. The VFI device utilizes a nanoporous nitrocellulose membrane encapsulated in a stainless steel filter holder. As the sample is pushed through the membrane, which is pre-functionalized with capture antibody, a sandwich assay is formed and colorimetric signal is generated to reflect the presence of target antigens. Through theoretical analyses of antigen-antibody binding process inside a porous membrane, we identified two critical factors – membrane pore size and sample flow rate that can be optimized to improve the assay sensitivity. Then, the effects were demonstrated through experimental studies using Burkholderia pseudomallei (the causative agent of melioidosis) as a model pathogen. The B. pseudomallei VFI was based on an immunoassay targeting the B. pseudomallei surface capsular polysaccharide (CPS). The experimental results agreed well with the theory showing that increasing the flow speed (up to 1.06 mm/s) and reducing the membrane pore size (down to 0.1 µm) could improve the sensitivity by at least 5 times. The VFI's limit-of-detection for CPS spiked in buffer solution was determined to be 0.02 ng/mL. The developed VFI shows great potential as a point-of-care tool for detection of bio-threat agents in a variety of clinical and resource-restricted conditions. Graphical abstract fx1 Highlights • Paper-based vertical flow device was developed to detect bio-threat pathogens. • Limit-of-detection for B. pseudomallei surface capsular polysaccharide was 0.02 ng/mL. • Sample flow rate and membrane pore size was studied in theory and experiment. • Multiplexing diagnostic of melioidosis and anthrax was demonstrated. [ABSTRACT FROM AUTHOR]

Infectious diseases are a global concern for public health resulting in high rates of infection with subsequent health and socio-economic impacts through resulting morbidity and mortality. The emergence of such diseases has motivated researchers to develop cost-effective, rapid and sensitive analytical methods and devices to better understand the transmission routes of infections within populations. To this end, rapid and low-cost diagnosis and testing devices for infectious diseases are attracting increasing amounts of attention, e.g., through using paper-based analytical devices (PADs). In this paper, the recent development of PADs is critically reviewed both for the diagnosis of inviduals and population health, by using devices for testing wastewater. Finally, the review also focuses on PADs for the analysis of bacteria and viruses in wastewater, together with a discussion on thee future development of PADs for rapid diagnosis and wastewater surveillance. • The major infectious diseases and main diagnosis technology were summarized. • The current paper-based devices for infectious disease diagnosis and wastewater surveillance were reviewed. • The integrated paper-based devices for point-of-care diagnosis were discussed. • Artificial intelligence, big data analytics, and IoT technologies were discussed for the integration with paper sensors. [ABSTRACT FROM AUTHOR]

The RAD-AID Conference on International Radiology for Developing Countries is a yearly forum addressing global shortages of radiology that contribute to health care disparity. In this paper, the authors present key issues and consensus positions related to the planning, analyzing, implementing, and monitoring of radiology in limited-resource areas on the basis of presentations at the 2012 RAD-AID conference, to advocate for (1) economic development to build health care capacity, (2) multidisciplinary educational strategies, (3) innovative epidemiologic and infrastructural solutions tailored to community needs, (4) advanced technical solutions leveraging the widespread use of wireless telecommunications and phone-based portable devices, and (5) improved dialog across radiology and public health institutions for coordinating global health strategies. [Copyright &y& Elsevier]

This article presents the World Health Organization’s (WHO) recommendations on the use of cholera vaccines excerpted from the Cholera vaccines: WHO position paper, August 2017 , published in the Weekly Epidemiological Record (Cholera vaccine, 2017) [1] . This position paper replaces the 2010 WHO position paper on cholera vaccines (Cholera vaccine, 2010) [2] . It incorporates the most recent evidence on cholera vaccination and provides revised recommendations on the target populations for cholera immunization. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation table. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. Recommendations on the use of cholera vaccines were discussed by the Strategic Advisory Group of Experts (SAGE) in April 2017; evidence presented at these meetings can be accessed at: www.who.int/immunization/sage/meetings/2017/April/presentations_background_docs/en/ . [ABSTRACT FROM AUTHOR]

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparities. This white paper from the 2011 RAD-AID conference represents consensus advocacy of multidisciplinary strategies to improve the planning, accessibility, and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and health care disparities, including (1) economic development for radiologic service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. [ABSTRACT FROM AUTHOR]

The RAD-AID Conference on International Radiology for Developing Countries was an assembly of individuals and organizations interested in improving access to medical imaging services in developing countries where the availability of radiology has been inadequate for both patient care and public health programs. The purpose of the meeting was to discuss data, experiences, and models pertaining to radiology in the developing world and to evaluate potential opportunities for future collaboration. Conference participants included radiologists, technologists, faculty members of academic medical institutions, and leadership of nongovernmental organizations involved in international health care and social entrepreneurship. Four main themes from the conference are presented in this white paper as important factors for the implementation and optimization of radiology in the developing world: (1) ensuring the economic sustainability of radiologic services through financial and administrative training support of health care personnel; (2) designing, testing, and deploying clinical strategies adapted for regions with limited resources; (3) structuring and improving the role of American radiology residents interested in global health service projects; and (4) implementing information technology models to support digital imaging in the developing world. [Copyright &y& Elsevier]

Heavy metal pollution has shown great threat to the environment and public health worldwide. Current methods for the detection of heavy metals require expensive instrumentation and laborious operation, which can only be accomplished in centralized laboratories. Various microfluidic paper-based analytical devices have been developed recently as simple, cheap and disposable alternatives to conventional ones for on-site detection of heavy metals. In this review, we first summarize current development of paper-based analytical devices and discuss the selection of paper substrates, methods of device fabrication, and relevant theories in these devices. We then compare and categorize recent reports on detection of heavy metals using paper-based microfluidic devices on the basis of various detection mechanisms, such as colorimetric, fluorescent, and electrochemical methods. To finalize, the future development and trend in this field are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To identify the current challenges and opportunities in compensation and recognition for pharmacist-provided immunizations across the lifespan and to establish guiding principles for pharmacist-provided immunization compensation and recognition. Data sources: 22 stakeholders gathered on June 29, 2011, at the American Pharmacists Association (APhA) headquarters in Washington, DC, for a meeting on immunization compensation that was convened by APhA and the Academy of Managed Care Pharmacy. Participants included representatives from community pharmacy practices (chain, grocery, and independent), employers, national consumer health and advocacy organizations, national pharmacy and public health organizations, health plan representatives, pharmacy benefit managers, and health information technology, standards, and safety organizations. Key immunization leaders from TRICARE Management Activity, the Centers for Medicare & Medicaid Services, the National Vaccine Program Office of the Department of Health & Human Services, and the Centers for Disease Control and Prevention (CDC) also participated in the meeting. Summary: The increased numbers of pharmacists providing vaccination services and the availability of pharmacist-provided immunizations to populations in need of vaccines has continued to increase. This has resulted in a rise in the percentage of patients who receive vaccines at pharmacies. Pharmacists are now working to leverage their ability to identify people with key risk factors (e.g., diabetes, heart disease or previous myocardial infarction), encourage them to receive their CDC-recommended vaccinations, and administer the required vaccine. Challenges and opportunities in compensation and recognition for pharmacist-provided immunizations across the adult lifespan persist. Variability in state practice acts, reimbursement and compensation processes and systems, and mechanisms for documentation of vaccine services create substantial differences in how pharmacist-provided immunizations are delivered throughout the United States. Conclusion: Pharmacist-provided immunizations are clinically sound, are cost effective, are readily accessible, and support our nation's public health goals. Pharmacists have demonstrated that patient vaccination rates have improved through expansion of pharmacist-provided immunizations. The profession should continue efforts to collaborate with other immunization stakeholders and expand a pharmacist scope of practice that is built around a uniform and recognized standard of immunization provision and that supports the provision of all CDC-recommended vaccines through pharmacy-provided immunizations. [ABSTRACT FROM AUTHOR]

The 2010 RAD-AID Conference on International Radiology for Developing Countries was a multidisciplinary meeting to discuss data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services reduce health care quality. The theme of this year''s conference was sustainability, with a focus on establishing and maintaining imaging services in resource-limited regions. Conference presenters and participants identified 4 important components of sustainability: (1) sustainable financing models for radiology development, (2) integration of radiology and public health, (3) sustainable clinical models and technology solutions for resource-limited regions, and (4) education and training of both developing and developed world health care personnel. [Copyright &y& Elsevier]

Social media tools, including blogs, social networks, and media-sharing sites, help nutrition and dietetics practitioners reach broader audiences and connect directly with the public. In many ways, social media has transformed the practice of dietetics and has opened up new avenues for communicating food and nutrition information. Social media has been an effective tool for virtual nutrition counseling, patient education, peer-to-peer support, and public health campaigns. Increasingly, nutrition and dietetics practitioners are using social media to network and collaborate with colleagues, conduct a job search, stay current with new research, champion a cause, promote products or services, and build a business. The potential role of social media in the profession is far reaching, yet there are important guidelines to follow related to ethics and professionalism. When using social media, nutrition and dietetics practitioners must remember that they are governed by the same Code of Ethics that guides all other aspects of practice. In addition, it is critical to have a thorough understanding of all the factors related to social media professionalism, including disclosure rules from the Federal Trade Commission, patient/client privacy and confidentiality as covered by the Health Insurance Portability and Accountability Act, and copyright laws that protect intellectual property. In today’s digital age, it is essential for nutrition and dietetics practitioners to recognize the professional opportunities and challenges of social media. Failing to effectively and ethically use social media can reflect poorly on the individual practitioner and the profession. Certain violations may have legal implications. The purpose of this Academy of Nutrition and Dietetics practice paper is to provide guidance on social media’s relevance, potential applications, best practices, benefits, and risks. [ABSTRACT FROM AUTHOR]

This is an executive summary made by a group of experts named Latin American Academy for the study of Lipids (ALALIP). In the current clinical guidelines, atherogenic dyslipidemia (AD) is a poorly recognized entity. Due to the frequent lipid alterations associated with AD in Latin America (LA), we organized a group of experts named (ALALIP) to generate a document in order to analyze their prevalence and to offer practical recommendations. Methodology: using the Delphi methodology, we conducted a comprehensive literature review with emphasis on those publications related to LA. Subsequently, we developed key questions for discussion. As a convention, those recommendations that had a 100% of acceptance were considered unanimous, those with >80% were consensual, and those with <80% were in disagreement. Results: a systematic analysis of national health surveys and regional cohort studies showed a consistently high prevalence of the lipid abnormalities that define AD: low levels of high-density lipoprotein cholesterol (HDL-C) range from 34.1% to 53.3% and elevated triglycerides (TG) range from 25.5% to 31.2%. These abnormalities could be related to high consumption of food with a high caloric density, cholesterol and trans fats, a sedentary lifestyle and perhaps epigenetic changes Conclusions lipid abnormalities that define AD have a high prevalence in LA. The interaction between an unfavorable lifestyle, inheritance and epigenetic changes is probably their cause. It is important to design a global study of risk factors in LA to know its true prevalence in the region, its consequences and to derive from its treatment strategies. [ABSTRACT FROM AUTHOR]

Abstract: In this study, electrochemical immunoassay was introduced into the recently proposed microfluidic paper-based analytical device (μPADs). To improve the performance of electrochemical immunoassay on μPAD for point-of-care testing (POCT), a novel wax-patterned microfluidic paper-based three-dimensional electrochemical device (3D-μPED) was demonstrated based on the multi-walled carbon nanotubes (MWCNTs) modified μPAD. Using typical HRP-O-Phenylenediamine-H2O2 electrochemical system, a sandwich immunoassay on this 3D-μPED for sensitive diagnosis of two tumor markers simultaneously in real clinical serum samples was developed with a linear range of 0.001–75.0UmL−1 for cancer antigen 125 and 0.05–50.0ngmL−1 for carcinoembryonic antigen. In addition, this 3D-μPED can be easily integrated and combined with the recently emerging paper electronics to further develop simple, sensitive, low-cost, disposable and portable μPAD for POCT, public health and environmental monitoring in remote regions, developing or developed countries. [Copyright &y& Elsevier]

This article presented the World Health Organization’s (WHO) recommendations on the use of on Bacille Calmette-Guérin (BCG) vaccine excerpted from the BCG vaccines: WHO position paper – February 2018 published in the Weekly Epidemiological Record [1] . This position paper replaces the 2004 WHO position paper on Bacille Calmette-Guérin (BCG) vaccine [2] and the 2007 WHO revised BCG vaccination guidelines for infants at risk for human immunodeficiency virus (HIV) infection [3] . It incorporates recent developments in the tuberculosis (TB) field, provides revised guidance on the immunization of children infected with HIV, and re-emphasizes the importance of the birth dose. This position paper also includes recommendations for the prevention of leprosy. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation tables. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO’s current position on the use of vaccines in the global context. Recommendations on the use of cholera vaccines were discussed by the Strategic Advisory Group of Experts (SAGE) in October 2017; evidence presented at these meetings can be accessed at: http://www.who.int/immunization/sage/meetings/2017/october/presentations_background_docs/en/ [ABSTRACT FROM AUTHOR]

Foodborne pathogens are major public health concerns worldwide. Paper-based microfluidic devices are versatile, user friendly and low cost. We report a novel paper-based single input channel microfluidic device that can detect more than one whole-cell foodborne bacteria at the same time, and comes with quantitative reading via image analysis. This microfluidic paper-based multiplexed aptasensor simultaneously detects E. coli O157:H7 and S. Typhimurium. Custom designed particles provide colorimetric signal enhancement and false results prevention. Several aptamers were screened and the highest-affinity aptamers were optimized and employed for detection of these bacteria in solution, both in a buffer as well as pear juice. Image analysis was used to read and quantify the colorimetric signal and measure bacteria concentration, thus rendering this paper based microfluidic device quantitative. The colorimetric results show linearity over a wide concentration range (102 C F U / m L to 108 C F U / m L) and a limit of detection (LOD) of 103 C F U / m L and 102 C F U / m L for E. coli O157:H7 and S. Typhimurium, respectively. An insignificant change in colorimetric response for non-target bacteria indicates the aptasesnors are specific. The reported multiplexed colorimetric paper-based microfluidic devices is likely to perform well for on-site rapid screening of pathogenic bacteria in water and food products. [ABSTRACT FROM AUTHOR]

Aflatoxin B 1 (AFB 1) is a powerful carcinogen, and the pollution it causes has become a global public health safety issue. Therefore, microfluidic paper-based analytical devices (μPADs) with smartphones to read colorimetric signals were constructed for rapid AFB 1 detection. The colorimetric mechanism of μPADs was based on the common starch–iodine reaction, and the addition of gelatin/chitosan enhanced the colorimetric effect. During detection and analysis, the competitive analysis occurred in the process of AFB 1 monoclonal antibody's recognition of free AFB 1 and functionalized antigen. The glucose oxidase-labeled IgG was used as the secondary antibody. Hydrogen peroxide, an oxidation product of the glucose, caused a chroma change in μPADs. Simultaneously, the change in chroma was consistent with the change in AFB 1 concentration. Under the best optimized conditions, the limits of detection and quantitation of AFB 1 in the buffer were 9.45 and 12.00 ng mL−1, respectively. A comparison of the detection performance of commercial kits with that of the method introduced herein confirmed the superiority of our method in actual food samples with known AFB 1 concentrations. This colorimetric μPADs analysis met the detection requirements of some countries, such as China, and had great potential for development in the direction of daily extensive food safety control and environmental monitoring. [Display omitted] • Portable and low-cost smartphone-based microfluidic paper-based analytical devices (μPADs). • The colorimetric μPAD detection system can detect aflatoxin B1 as low as 9.45 ng mL−1 through Lab data analysis. • The colorimetric mechanism is based on the common starch–iodine reaction. • The addition of gelatin and chitosan mixture enhances the colorimetric effect. [ABSTRACT FROM AUTHOR]

Tetracyclines (TCs), as one of the broad-spectrum antibiotics, are widely used to treat bacterial infections. The residues of TCs in animal-origin foods and drinking water have raised safety concerns and affected the public health. Thus, there is a high demand to develop a simple and rapid method for the detection of TCs. In this work, we developed a ratiometric luminescence probe for the sensitive and visualized detection of TCs. Specifically, tannic acid-stabilized copper nanoclusters (TA-CuNCs) with blue emission at 433 nm were synthesized. The luminescence of TA-CuNCs attenuated partially by the europium ions (Eu3+) due to the aggregation-induced quenching. When TCs were added to the TA-CuNCs-Eu3+ system, the luminescence of TA-CuNCs at 433 nm can be further quenched by the inner-filter effect, and the characteristic luminescence of Eu3+ at 617 nm emerged due to the formation of Eu3+-TCs complex. The ratio of the luminescence at 617 nm–433 nm increased linearly to the concentration of TCs. Additionally, we demonstrated the detection of oxytetracycline in real samples such as tap and lake water, milk, pharmaceutical industry wastewater, honey and soil extract with high recovery rate (97.25%–103.44%). Furthermore, a portable paper device is fabricated by the luminescent probe to conduct the on-site analysis of TCs. [Display omitted] - A ratiometric luminescence sensing platform for tetracyclines (TCs) detection was developed based on the specific interaction between TCs, europium ions and tannic acid-stabilized copper nanoclusters. - The developed approach was capable of efficiently detecting of TCs in tap water, lake water and milk samples with high recovery rate. - A portable paper device is developed based on the luminescence changing on the paper to conduct the on-site analysis of TCs. [ABSTRACT FROM AUTHOR]

Abstract: This article presents the WHO recommendations on the use of rabies vaccines excerpted from the recently published Rabies vaccines: WHO position paper. This document replaces the WHO position paper entitled Rabies vaccines WHO position paper published in the Weekly Epidemiological Record in December 2007. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization, or SAGE. [Copyright &y& Elsevier]

Abstract: Objective: Citations by other researchers are important in the dissemination of research findings. We aimed to investigate whether preferential citation of statistically significant articles exists in the psychiatric literature. Study Design and Settings: We analyzed all original research papers published in 1996 in four psychiatric journals. Using a standardized questionnaire, from each paper, we extracted the primary outcome and its statistical significance. The number of citations, excluding authors'' “self-citations,” received by April 2005 was obtained. Regression analysis was used to relate citation frequency to statistical significance, adjusting for confounders. Results: Of 448 extracted papers, 368 used statistical significance testing and 287 (77.8%) reported P <0.05. The median number of citations for papers reporting “significant” and “nonsignificant” results was 33 vs. 16. After adjustment for journal, study design, reporting quality, whether outcome confirmed previous findings and study size, the ratio of the number of citations per article for articles reporting “P <0.05” on the primary outcome to those reporting “P >0.05” was 1.63 (95% confidence interval [CI]: 1.32, 2.02, P <0.001). Conclusion: Authors cite studies based on their P-value rather than intrinsic scientific merit. This practice skews the research evidence. Systematic study registration and inclusion in meta-analysis should be encouraged. [Copyright &y& Elsevier]

BACKGROUND: Surgery subinternship rotations are clinical rotations intended to provide senior medical students with experiential exposure and increased autonomy during the care of surgical patients in clinical settings. Due to the lack of guidelines from national surgical organizations, these rotations remain largely unstructured and unstandardized with wide variability in the goals and experiences they provide for medical students. METHODS: Through synthesis of the literature and by applying an iterative process among members of the subcommittee for surgery subinternship and the curriculum committee of the Association for Surgical Education (ASE) consensus recommendations were established. RECOMMENDATIONS: Five defined domains were identified as essential for establishing surgery subinternship rotations. These are: administrative structure, goals and objectives, curricular elements, instructional methods, and assessment tools. CONCLUSIONS: These recommendations should serve as a blue print for establishing a structured, educationally sound, and rewarding clinical rotation for medical students. Applying these recommendations may also provide educators with opportunities for scholarships and academic advancement. [ABSTRACT FROM AUTHOR]

The paper by ESMO “The current and future role of the medical oncologist in the professional care for cancer patients: a position paper by the European Society for Medical Oncology (ESMO)” conveys some important key messages for the whole oncology community. A working group (WG) involving 21 oncology and related societies would like to comment on the ESMO position paper from a multidisciplinary perspective. The letter focuses on the concept of multidisciplinarity and how collaboration is the ideal situation for the best care of patients: the guidance to the patient must be given in accordance with agreements based on the outcome of discussions within the multidisciplinary team. The commentary therefore wants to highlight those statements that the working group shares and supports, identifying the common ground from where to start a constructive dialogue. [ABSTRACT FROM AUTHOR]

• Au@Ag core-shell nanoparticles for highly sensitivite SERS assay. • Fabrication of Au@Ag-pLL on glass nanofibrous paper as SERS substrate. • A paper-based SERS nanosensor for the sensitive detection of methamphetamine in sewage. • Evaluation of community-wide illicit drugs consumption ifor wastewater-based epidemiology. Wastewater-based epidemiology (WBE) is a powerful technique for monitoring illicit drugs of abuse in the community. Here, we report upon a surface-enhanced Raman spectroscopy (SERS) sensor for the sensitive and selective detection of methamphetamine based upon the assembly of noble metal core-shell nanoparticles on a bespoke glassy nanofibrous electrospun paper matrix. The hierarchical structure of the fibrous paper, modified with the synthesized Au@Ag core-shells (Au@Ag) gave strong SERS signalling, enabling us to evaluate the community-wide prevalence of methamphetamine in wastewater treatment plants within Beijing. We show that, when normalized for the daily flow of the wastewater treatment plants and for population density, higher mass loads of drugs are generally found in sewage influent from urban areas, implying greater local methamphetamine usage than that in less populated areas. The user-friendly and disposable paper sensors demonstrate the applicability of rapid on-site illicit drug detection, illustrating the application to wastewater-based epidemiology, which has the potential to inform government agencies regarding societal interventions. [ABSTRACT FROM AUTHOR]

Objective: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools). Design: Cross-sectional telephone survey. Setting and Participants: Schools in Alberta, Canada. Principals from 357 schools. Main Outcome Measure: Barriers to adopting the nutrition guidelines. Analysis: A 19-question telephone survey, including open- and closed-ended questions, was used to obtain information regarding schools' characteristics and barriers to adopting the guidelines. Qualitative data were coded according to common themes a priori, based on constructs from the Diffusion of Innovations framework. Results: Schools reported many barriers related to the relative advantage, compatibility, and complexity of adopting the guidelines. Parents' resistance to change and cost were the key reported barriers. Lack of knowledge, student preferences, the physical location of the school, and barriers related to the provision of healthful food were also reported. Conclusions and Implications: Disseminating guidelines without providing adequate support for their implementation may not promote change within the school setting. School nutrition initiatives need to involve the parents and have access to sufficient financial and human resource support. [ABSTRACT FROM AUTHOR]

Abstract: Healthcare facilities from a number of countries have or are in the process of implementing smoke-free policies as part of their public health agenda and tobacco control strategy. Their main intent is to prevent the harmful effects of environmental tobacco smoke on employees and patients. However, these protection policies are often implemented before taking into account the specific needs of patients in psychiatric facilities and are clouded by a lack of knowledge, myths and misconceptions held by a variety of stakeholders. Consequently, the implementation of smoke-free policies tends to result in unintended and unfavourable consequences for this aggregate. Patients are forced to abstain from tobacco use during their hospitalization but have few options to address their dependence upon discharge. The development and implementation of such policies should not occur in isolation. It requires thoughtful consideration of the needs of the affected population. Recommendations are presented on the role of nurses in lobbying for policy changes. As well as strategies for policy makers and administrators that should accompany such a policy in psychiatry. [Copyright &y& Elsevier]

This article presents the World Health Organization's (WHO) recommendations for the use of varicella and herpes zoster vaccination from the WHO position paper on varicella and herpes zoster vaccines – June 2014, published in the Weekly Epidemiological Record [1] . This position paper summarizes the WHO position on the use of varicella and herpes zoster vaccines. The current document replaces the position paper on the use of varicella vaccines published in 1998 [2] . Footnotes to this paper provide a number of core references. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2014 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

This article presents the World Health Organization's (WHO) recommendations on the use of hepatitis E vaccine excerpted from the WHO position paper on hepatitis E vaccines – May 2015 recently published in the Weekly Epidemiological Record [1] . The current document is the first WHO position paper on hepatitis E vaccination and focuses primarily on the available evidence concerning the only hepatitis E vaccine that is currently licensed. The position paper gives consideration to the epidemiological features of the disease and assesses the use of the vaccine for public health benefits. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its October 2014 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

This article presents the World Health Organization's (WHO) recommendations for the use of vaccines against diseases caused by human papillomaviruses (HPV) from the WHO position paper on Human papillomavirus vaccines: WHO position paper – October 2014, recently published in the Weekly Epidemiological Record [1] . This position paper summarizes the most recent developments in the field of HPV vaccines and the WHO position on HPV vaccine schedules in females. This document replaces the first WHO position paper on vaccines against diseases caused by HPV published in 2009 [2] . Footnotes to this paper provide a number of core references. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2014 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

Abstract: This article presents the World Health Organization (WHO) recommendations on the use of pneumococcal vaccines excerpted from the Pneumococcal vaccines WHO position paper – 2012 recently published in the Weekly Epidemiological Record . The current document replaces the position paper on the use 7-valent pneumococcal conjugate vaccine published in 2007 . Incorporating the most recent developments in the field of pneumococcal vaccines this position paper focuses on the currently available 10-valent and 13-valent conjugate vaccines and their introduction and use in national immunization programmes. It also deals with the 23-valent polysaccharide vaccine, though in less detail than provided in the April 2008 position paper which remains valid . Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines worldwide. This paper reflects the recommendations of the WHO''s Strategic Advisory Group of Experts (SAGE) on immunization. Recommendations on the use of pneumococcal vaccines were discussed by SAGE at its meetings in November 2006 (conjugate vaccine) and April 2008 (polysaccharide vaccine) and most recently in November 2011. Evidence presented at these meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. [Copyright &y& Elsevier]

This article presents the WHO recommendations on the use of vaccines against tick-borne encephalitis excerpted from the recently published Vaccines against tick-borne encephalitis: WHO position paper. This is the first WHO position paper on the use of tick-borne encephalitis. It was published in the Weekly Epidemiological Record in June 2011. In this paper, footnotes provide a limited number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions; a more comprehensive list of references is offered in the Background document on vaccines and vaccination against tick-borne encephalitis available at http://www.who.int/immunization/sage/6_TBE_backgr_18_Mar_net_apr_2011.pdf. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO''s Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2011 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. [ABSTRACT FROM AUTHOR]

Abstract: This article presents the WHO recommendations on the use of cholera vaccines excerpted from the recently published Cholera vaccines: WHO position paper. This document replaces the WHO position paper on Cholera vaccines published in the Weekly Epidemiological Record in April 2001. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization (SAGE). [Copyright &y& Elsevier]

This article presents the World Health Organization's (WHO) recommendations for pain mitigation at the time of vaccination from the WHO position paper on reducing pain at the time of vaccination: WHO position paper—September 2015, recently published in the Weekly Epidemiological Record [1] . This position paper summarizes the evidence and integrates information pertaining to the reduction of pain, distress and fear during immunization across all age groups. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact, and on vaccination-related policy questions particularly concerning the use of vaccines in large-scale immunization programmes. They summarize essential background information and conclude with the current WHO position. This position paper addresses a cross-cutting issue which is relevant for all injectable vaccines and reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2015 meeting. The evidence presented at the meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

Abstract: This article presents the WHO recommendations on the use of pertussis vaccines excerpted from the recently published Pertussis vaccines: WHO position paper. This document replaces the WHO position paper entitled Pertussis vaccines: WHO position paper published in the Weekly Epidemiological Record in January 2005. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization, or SAGE. [Copyright &y& Elsevier]

In an age where technology is evolving at a sometimes incomprehensibly rapid pace, the liver community must adjust and learn to embrace breakthroughs with an open mind in order to benefit from potentially transformative influences on our science and practice. The Journal of Hepatology has responded to novel developments in artificial intelligence (AI) by recruiting experts in the field to serve on the Editorial Board. Publications introducing novel AI technology are no longer uncommon in our journal and are among the most highly debated and possibly practice-changing papers across a broad range of scientific disciplines, united by their focus on liver disease. As AI is rapidly evolving, this expert paper will focus on educating our readership on large language models and their possible impact on our research practice and clinical outlook, outlining both challenges and opportunities in the field. "To improve is to change; to be perfect is to change often." ― Winston S. Churchill [ABSTRACT FROM AUTHOR]

Abstract:: This article presents the World Health Organizations (WHO) recommendations onthe use of hepatitis A vaccineexcerpted from the WHO position paper on hepatitis A vaccines – June 2012 recently published in the Weekly Epidemiological Record [1]. The current document replaces the position paper on the use of hepatitis A vaccines published in 2000 [2] and incorporates the most recent developments in the field with particular consideration to changes in the epidemiological features of hepatitis A infection in several countries, increased supply of hepatitis A vaccines, and new evidence on their public health benefits. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated positionpapers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO''s Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its November 2011 and April 2012 meetings. Evidence presented at these meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. [Copyright &y& Elsevier]

BACKGROUND CONTEXT The U.S. opioid epidemic has been declared a national public health emergency with the HHS, FDA, and CDC all taking steps to address the alarming rates of opioid addiction and abuse. Since 2000, the annual death toll from an opioid associated overdose has increased by over 300%. In an effort to reduce the amount of opioids, physicians have used alternative approaches, which have proven to not only be effective, but also reduce the side effects such as nausea, constipation, and addiction. IV acetaminophen has been shown to successfully accomplish the reduction in opioid use, however, it is an expensive alternative. Testing the efficacy of IV acetaminophen versus its oral formulation will likely modify future postoperative pain management regimens while also addressing its cost-effectiveness. PURPOSE The objective of the study is to prospectively evaluate clinical outcomes and determine the cost effectiveness of IV versus oral (PO) acetaminophen following lumbar circumferential spine surgery. STUDY DESIGN/SETTING A prospective, single center, randomized controlled trial. PATIENT SAMPLE Patients between the ages of 18-80 who underwent circumferential lumbar fusion surgery were included in the study. Patients had failed conservative management for more than 12 months. Patients were excluded if they had already undergone lumbar surgery at the index level(s), were diagnosed with osteoporosis, had dysphagia prohibiting oral administration, or had a history of substance abuse. OUTCOME MEASURES Outcome measures included opioid equivalence, length of hospital stay, VAS measurements, and Oswestry Disability Index (ODI) scores. METHODS Patients were randomized to either the IV or PO acetaminophen treatment groups. Preoperatively, patients completed a baseline analgesic regimen questionnaire, surveys including VAS, SF-12, and ODI, and were administered their first acetaminophen dose within three hours of first incision. Postoperatively, patients received seven subsequent doses of their assigned acetaminophen, with access to supplemental analgesics if needed. Analgesic usage and VAS scores were monitored until discharge. Surveys were completed at six weeks and six months follow up. RESULTS Postoperatively, the daily morphine equivalence taken by the IV acetaminophen group was 66% less than the oral acetaminophen group (p<.05), with both the one and two-level cohorts also seeing significant differences between groups. When looking at the average length of stay between groups, the average time is not statistically significant. However, in the one-level group, it is notable that the average length of stay for four patients is only 2.5 days, while the PO patients stay for an average of 4 days. CONCLUSIONS In conjunction with an overall reduction in opioid usage, patient reported surveys indicate better improvement of pain management with the use of IV acetaminophen following circumferential lumbar spine surgery. Despite the large discrepancy between the two formulations in cost to perceived benefit ratio, by significantly reducing the opioid usage and, therefore, its costs due to associated side effects, that discrepancy becomes far less dramatic. Our findings suggest that IV acetaminophen is a safe and effective alternative to current opioid-based postoperative analgesic regimens with a promising answer to the national public health emergency plaguing communities across the U.S. [ABSTRACT FROM AUTHOR]

Previous studies find kidney stone formers (KSF) are at greater risk of developing cardiovascular disease (CVD). The underlying mechanisms are poorly understood, and many clinicians are unaware of this connection. We will: 1 Provide an up-to-date review of epidemiological data. 2 Clearly define CVD outcomes to understand conditions associated with kidney stone formation (KSF). 3 Review hypothesised biological pathways to further understand the relationship. Our systematic review is registered with PROSPERO (ID CRD42021251477). We searched epidemiological and biological data. The epidemiological search generated 669 papers, narrowed down to 15. There were 4,259,869 participants (230,720 KSFs). KSF was associated with 25% higher risk of coronary artery disease (CAD) (95% confidence interval (CI): 15, 35%), 17% higher risk of stroke/transient ischemic attacks (TIA) (CI:10, 25%) and 39% higher risk of arterial disease (AD) (CI: 17 65%). Significant heterogeneity was found. Female-identifying KSFs had a higher risk of stroke (ratio = 1.10) and CAD (1.20). The biological search generated 125 papers, narrowed down to 14. Potential underlying mechanisms were extracted and discussed, including intimal/medial vascular calcification, oxidative stress via osteopontin (OPN), cholesterol-induced pathology, and endothelial dysfunction. There is a significant association between KSF and CVD, supporting the consideration of KSF as a systemic, calcium-mediated disease. Clinicians will benefit from being aware of this connection. [Display omitted] • Largest systematic review on the topic of cardiovascular disease and kidney stones. • Increased risk of coronary artery disease, stroke, and peripheral arterial disease. • Relationship was stronger for female-identifying kidney stone formers. • First time epidemiological and biological review have been combined in this field. • Strengthened a poorly understood, clinically relevant relationship. [ABSTRACT FROM AUTHOR]

Background: There has been a recent resurgence of tuberculosis (TB) as a worldwide public health concern. It is a well-documented health problem in Haiti, where the reported prevalence is 123.9 per 100,000 population. While the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) policy papers for the eradication of TB recommend screening in shelters, prisons, and other congregate-living facilities, screening in institutional orphanages is not specifically mentioned.Methods: A total of 445 orphans with no documentation of Bacillus Calmette-Guerin (BCG) vaccine at six orphanages representing urban, suburban, and rural Haiti were screened for TB using standardized purified protein derivative (PPD). An inoculum of 0.1 cc was introduced intradermally, with site checks for induration at 48-72 hours after inoculation. Induration >5 mm was recorded as positive. Active cases of TB were defined by symptoms such as fever, night sweats, cough greater than 1 month, or signs of extrapulmonary TB (like scrofula or Pott's disease).Results: The number of positive PPD tests was 170 of the 445 children tested, or 38,202 per 100,000; there were 10 active cases. The overall prevalence of tuberculin positivity in the three orphanages with one or more active cases was 44%, compared to 13% in the three with no identified active cases.Conclusions: The data indicate that TB prevalence among the orphans screened was 1123 per 100,000. This is substantially greater than that reported for the general Haitian population. These data thus suggest children living in orphanages as a previously unidentified high-risk group for TB infection. Further investigation of TB is recommended for orphans in developing countries. [ABSTRACT FROM AUTHOR]

This paper describes the 30-year evolution of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) to provide evidence to support our perspective that SNAP-Ed has earned its position as a pillar of the public health infrastructure in the US. Legislatively designated as a nutrition education and obesity prevention program, its focus is the nearly 90 million Americans with limited income. This audience experiences ongoing health disparities and is disproportionately affected by public health crises. The SNAP-Ed program works to reduce nutrition-related health disparities at all levels of the Social-Ecological Model, follows a robust evaluation framework, and leverages strong partnerships between state-based practitioners, state agencies, and the US Department of Agriculture. The expansion of SNAP-Ed would enable the program to reach more Americans so that our nation can end hunger and reduce diet-related health disparities. [ABSTRACT FROM AUTHOR]

Health visiting has been described as the backbone of early years services across the UK and the safety net around all families. This paper explores the role of health visitors and the current context in England. Health visitors lead and deliver the Healthy Child Programme which is the national preventative public health programme covering pregnancy and the first five years of life. It aims to ensure that every child has the best start in life, regardless of where they live. With child health deteriorating, more children falling behind with their development, growing concerns about invisible vulnerable children, widening inequalities and soaring costs of late intervention, there is a clear imperative to act. Health visitors provide an important part of the solution; however, the service is facing significant challenges. When sufficiently resourced, health visitors play a crucial role in ensuring that families get good, joined up support – preventing, identifying and treating problems before they reach crisis point. The benefits of an effective health visiting service accrue to numerous government departments, contributing to a whole system response to address a multitude of policy priorities for babies, children and families across health, education and social care. [ABSTRACT FROM AUTHOR]