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Distribution and Influencing Factors of Airborne Bacteria in Public Facilities Used by Pollution-Sensitive Population: A Meta-Analysis.

ABSTRACT: The aim of this study was to support management of airborne bacteria in facilities used by pollution-sensitive individuals (in daycares, medical facilities, elder care facilities, and postnatal care centers). A field survey was conducted on 11 facilities from October 2017 to April 2018. Elder care facilities in industrial, urban, and forested areas were excluded. Two indoor, and one outdoor, measuring points were selected per facility. These points were located in areas most often used by the residents. Measurements were taken at random time-points before February 2018 and at specific times in the morning and afternoon thereafter. The relationships among bacterial counts, carbon dioxide concentrations, dust levels, temperature, relative humidity, and ventilation were examined. The pooled average bacterial counts at the daycares, medical facilities, elder care facilities, and postnatal care centers were 540.25 CFU m^-3, 245.49 CFU m^-3, 149.63 CFU m^-3, and 169.65 CFU m^-3, respectively. Considering the upper 95% confidence interval, the bacterial counts in many daycares may in fact be >800 CFU m^-3, which is the threshold set by the Korean Ministry of the Environment. The pooled average indoor: outdoor bacterial count ratio was 1.13. Indoor airborne bacterial counts were influenced mainly by their sources. This study found no significant correlations among indoor temperature, relative humidity, carbon dioxide concentration, dust levels, and airborne bacterial counts, unlike previous studies. Airborne bacteria management at daycares should be a top priority. The sources of airborne bacteria must also be identified, and a management plan must be developed to control them.

SUBMITTER: Cho EM

PROVIDER: S-EPMC6539986 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionThe early initiation of breast feeding is a high-impact intervention that gives newborns a better chance of survival. We assess the barriers and facilitators influencing the practice of early breast feeding of newborns in public primary healthcare facilities (PHCs) in Northeast Nigeria, to influence the planning of programmes targeted at improving newborn care in the region.MethodWe used an explanatory mixed-method approach. We conducted case observation of childbirths and newborn care for the quantitative arm, and interviewed mothers and birth attendants 1 hour after childbirth for the qualitative arm. The analysis for the quantitative arm was done with SPSS V.23. For the qualitative arm, we transcribed the audio files, coded the texts and categorised them using thematic analysis.ResultWe observed 393 and 27 mothers for the quantitative and qualitative arms of the study, respectively. The quantitative arm shows that 39% of mothers did not breastfeed their newborns within 1 hour of birth. The qualitative arm shows that 37% of mothers did not breastfeed within 1 hour of birth. Themes that describe the barriers to early breast feeding in public PHCs are: birth attendants' unwillingness or inability to accommodate mothers' safe traditional practices, ineffective rooming-in practices, staff shortages, lack of privacy in the lying-in ward and poor implementation of visiting-hour policy in public PHCs. The pregnant women denied safe traditional birth practices like chanting, praying or reading religious books during delivery are five times more likely not to breastfeed newborns within the first hour of birth (relative risk=4.5, 95% CI 1.2-17.1) compared with pregnant women allowed these practices.ConclusionStakeholders must increase their focus on improving breastfeeding practices in public PHCs. Instituting policies that protect mothers' privacy and finding innovative ways to accommodate and promote safe traditional practices in the intrapartum and postpartum period in PHCs will improve the early breast feeding of newborns in these PHCs.

Project description:BackgroundShared decision-making, a communicative process to reach decisions based on informed preferences, evidence, and co-created goals, improves care satisfaction and patients' quality of life. However, shared decision-making has not been widely implemented in long-term care facilities, and few studies have examined how to promote the shared decision-making practice. This study aimed to identify the influencing factors of shared decision-making based on the Person-centered Practice Framework in long-term care facilities.MethodsA total of 300 staff (nursing staff, social workers, and personal care workers) in 13 Korean long-term care facilities participated in this study. Data from 280 respondents were finally analyzed, excluding respondents with missing values. Data were collected using structured questionnaires that included items on shared decision-making, personal factors (e.g., knowledge about dementia, person-centered care education, person-centered attitude, communication behavior, and job tenure), and care environment factors (e.g., person-centered climate, staffing level, effective staff relationships, supportive supervisors, and power-sharing). Multilevel linear regression analyses were performed using Mplus Version 8.8.ResultsThe mean shared decision-making score was 35.78 (range 8-45). Staff with experience of person-centered care education (β = 0.198, p = 0.034), a higher person-centered attitude score (β = 0.201, p = 0.007), and a higher communication behavior score (β = 0.242, p < 0.001) were more likely to report a higher shared decision-making score. In addition, staff who viewed their care environment as more person-centered were more likely to report a higher shared decision-making score (β = 0.416, p < 0.001).ConclusionsThis study highlights that personal (e.g., person-centered care education, person-centered attitude, and communication behavior) and care environment (e.g., person-centered climate) factors could influence shared decision-making for long-term care residents. These findings could be foundational evidence for facilitating shared decision-making practice in long-term care settings.

Project description:BACKGROUND: Many bacteria of clinical importance survive and may grow in different environments. Antibiotic pollution may exert on them a selective pressure leading to an increase in the prevalence of resistance. OBJECTIVES: In this study we sought to determine whether environmental concentrations of antibiotics and concentrations representing action limits used in environmental risk assessment may exert a selective pressure on clinically relevant bacteria in the environment. METHODS: We used bacterial inhibition as an assessment end point to link antibiotic selective pressures to the prevalence of resistance in bacterial populations. Species sensitivity distributions were derived for three antibiotics by fitting log-logistic models to end points calculated from minimum inhibitory concentration (MIC) distributions based on worldwide data collated by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). To place bacteria represented in these distributions in a broader context, we performed a brief phylogenetic analysis. The potentially affected fraction of bacterial genera at measured environmental concentrations of antibiotics and environmental risk assessment action limits was used as a proxy for antibiotic selective pressure. Measured environmental concentrations and environmental risk assessment action limits were also directly compared to wild-type cut-off values. RESULTS: The potentially affected fraction of bacterial genera estimated based on antibiotic concentrations measured in water environments is ? 7%. We estimated that measured environmental concentrations in river sediments, swine feces lagoons, liquid manure, and farmed soil inhibit wild-type populations in up to 60%, 92%, 100%, and 30% of bacterial genera, respectively. At concentrations used as action limits in environmental risk assessment, erythromycin and ciprofloxacin were estimated to inhibit wild-type populations in up to 25% and 76% of bacterial genera. CONCLUSIONS: Measured environmental concentrations of antibiotics, as well as concentrations representing environmental risk assessment action limits, are high enough to exert a selective pressure on clinically relevant bacteria that may lead to an increase in the prevalence of resistance.

Project description:Emerging outbreaks of airborne pathogenic infections worldwide, such as the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, have raised the need to understand parameters affecting the airborne survival of microbes in order to develop measures for effective infection control. We report a novel experimental strategy, TAMBAS (tandem approach for microphysical and biological assessment of airborne microorganism survival), to explore the synergistic interactions between the physicochemical and biological processes that impact airborne microbe survival in aerosol droplets. This innovative approach provides a unique and detailed understanding of the processes taking place from aerosol droplet generation through to equilibration and viability decay in the local environment, elucidating decay mechanisms not previously described. The impact of evaporation kinetics, solute hygroscopicity and concentration, particle morphology, and equilibrium particle size on airborne survival are reported, using Escherichia coli MRE162 as a benchmark system. For this system, we report that (i) particle crystallization does not directly impact microbe longevity, (ii) bacteria act as crystallization nuclei during droplet drying and equilibration, and (iii) the kinetics of size and compositional change appear to have a larger effect on microbe longevity than the equilibrium solute concentration.IMPORTANCE A transformative approach to identify the physicochemical processes that impact the biological decay rates of bacteria in aerosol droplets is described. It is shown that the evaporation process and changes in the phase and morphology of the aerosol particle during evaporation impact microorganism viability. The equilibrium droplet size was found to affect airborne bacterial viability. Furthermore, the presence of Escherichia coli MRE162 in a droplet does not affect aerosol growth/evaporation but influences the dynamic behavior of the aerosol by processing the culture medium prior to aerosolization, affecting the hygroscopicity of the culture medium; this highlights the importance of the inorganic and organic chemical composition within the aerosolized droplets that impact hygroscopicity. Bacteria also act as crystallization nuclei. The novel approach and data have implications for increased mechanistic understanding of aerosol survival and infectivity in bioaerosol studies spanning the medical, veterinary, farming, and agricultural fields, including the role of microorganisms in atmospheric processing and cloud formation.

Project description:BACKGROUND:Physicians and nurses play vital roles in addressing palliative care (PC) needs of people living with HIV/AIDS (PLWHA). The healthcare workers' (HCWs) experiences determine the success of palliative care delivery. There is paucity of data on PC for PLWHA. For this reason, we assessed the knowledge, attitude and practice of PC for PLWHA and associated factors among health care professionals. METHODS:We conducted a cross-sectional descriptive study among HCWs in public health facilities in the Federal Capital Territory, Nigeria between February and May, 2017. Multistage sampling technique with proportionate-to-size allocation was used to determine facility sample size and HCWs per professional discipline. Data were collected with questionnaires adapted from Palliative Care Quiz for Nursing, Frommelt Attitude toward Care of the Dying and practical questions adapted from PC standard guidelines. Participants' knowledge, attitude and practice were assessed by awarding one (1) point for each correct answer; incorrect or "not sure" answers took a zero (0) score. Correct responses were summed up to get a total score for each participant. Descriptive statistics was done to describe frequencies and proportions displayed on tables. Linear regression was done to determine factors associated with HCW's knowledge, attitude and practice of PC for PLWHA. RESULT:With a 100% response rate, the mean age of the 348 participants was 37.5 years (SD: ±8.9), 201 (57.8%) were female, 222 (63.8) were nurses and 230 (66.0%) had a work experience of 10 years or less. Majority of the participants, 310 (89.1%) agreed that palliative care focuses on the relief and prevention of suffering and 319 (91.7%) believe that PLWHA required palliative care. Misconceptions about palliative care include "palliative care is disease-oriented and not person oriented", 252 (72.6%) believed; "palliative care is concerned with prolongation of life", 279 (80.6%); and "use of placebos is appropriate in the treatment of some types of pain", 252 (72.6%). Among the participants, 52% disagreed that "palliative care should be given only for dying PLWHA" while only 18 (5.2%) were right on "family should be involved in the physical care of the dying PLWHA". Majority of the participants, 292 (84.1%) initiated palliative care discussion during patients' diagnosis while 290 (83.6%) informed terminally ill patients about their diagnosis. Regarding psychological issues, 22 (6.3%) participants hid the truth from the patients while 196 (56.3%) provided emotional support to the patients. Morphine 240 (69.0%) and Pentazocine 194 (55.7%) were the most commonly used drugs for treatment of severe pain by participants across all centres. CONCLUSION:In-service training and undergraduate training on palliative care were associated with knowledge and practice of palliative care for people living with HIV/AIDS. We recommended continuous quality in-service training and education on palliative care for HCWs. While we ensure voluntariness of participation and other ethical principles, the high response rate could be as a result of more motivated health worker than the norm. The results are unlikely to be representative of doctors and nurses in primary health care centres.

Project description:Only about 39% of infants in low- and middle-income countries are exclusively breast-fed for the first six months. In particular, human immunodeficiency virus (HIV) positive women report confusion about the best feeding methods. Exclusive Breastfeeding (EBF) practices in HIV positive mothers are sub-optimal in Ethiopia. This study aimed to identify the main factors influencing EBF among HIV positive breast-feeding mothers. A facility based cross-sectional study was carried out from September 2017 to June 30 2018 among HIV positive mothers with infants aged 6-23 months. Thirteen public health facilities (7 health centers and 6 hospitals) that provided anti-retroviral treatment (ART) and Prevention of mother-to-child transmission (PMTCT) services, found in three districts of West, East and Kellem Wollega Zones, were randomly selected. Respondents were recruited by systematic random sampling techniques from these facilities using client registers as a sampling frame. Data were collected using face to face interviews with a pre-tested questionnaire. Data were entered into EPI info Version 3.5.1 and analyzed using SPSS Version 20 for windows. Candidate variables for the final multi-variable model were selected considering P≤ 0.05 at bivariable analysis. Associations were declared at P≤ 0.05 by assuming Confidence Intervals did not cross '1'with corresponding 95%. A total of 218 HIV positive mothers were included in this study. Of these, only 122 (56.0%) practiced EBF in the first six months. The proportion of study participants who initiated EBF within the first hour of delivery was 134 (61.8%). Mean age of study participants was 28.6years with SD ± 4. Mothers' having received advice on EBF [AOR 3, 95% CI (1.2-6.7)], disclosure of HIV status to someone close to them including their husband [AOR 6, 95% CI (1.2-29.6)] and believing HIV can be transmitted during delivery [AOR 5.2, 95% CI (1.1-24.0)] were found to increase the likelihood of EBF practices among the study participants (P-value ≤ 0.05). In this study, only just over half of the mothers practiced EBF for the first six months. Care providers should continue to encourage mothers to practice EBF in the first six months and to disclosure of HIV status to someone close to them including their partner. Efforts should be in place to curb the risk of HIV/AIDS transmission during delivery. Continues advise for mothers to practice EBF in the first 6 months is still needed.

Dataset Information

Distribution and Influencing Factors of Airborne Bacteria in Public Facilities Used by Pollution-Sensitive Population: A Meta-Analysis.

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