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PubMed2000

Difficulties of the staff posted for intensive pulse polio immunization in Delhi.

Forty three staff members present on 18 booths for intensive Pulse Polio Immunization were interviewed anonymously during the first round of the programme on 24th October, 1999 to find out their problems likely to affect successful implementation of the programme. The observation revealed some of the problems such as long distance between residence and the booth (46.5%), difficulty in locating the booth (72%), lack of training (90.7%), improper meals (69.7%) and lack of toilet facilities (37.2%). Suitable modifications should be made in light of the observations to secure full support of the staff for success of the programme.

Adult↗

PubMed2001

The patient's perspective of irritable bowel syndrome.

OBJECTIVE: The researchers wanted to understand how irritable bowel syndrome (IBS) affects patients' lives and their interactions with physicians and the health care system. STUDY DESIGN: A qualitative study was performed using focus groups of people with physician-diagnosed IBS. Immersion/crystallization was used to identify overriding themes. POPULATION: Adult volunteers with a previous physician diagnosis of IBS were included. OUTCOMES MEASURED: The outcomes were patient-reported symptoms, episode triggers, treatments, lifestyle changes, and interactions with their physicians that were related to IBS, and overriding themes identified from the focus groups. RESULTS: The subjects described IBS as a chronic episodic illness that affects their daily lives. Interaction with the medical community seldom clarified understanding of the condition or improved its management. Three overriding themes emerged from the groups: a sense of frustration, a sense of isolation, and a search for a niche in the health/sick role continuum. Frustration was evident in the perceived inability to control symptoms, prevent episodes, identify episode triggers, and obtain medical validation of the condition. The constant anticipation of the next IBS episode, the need for immediate access to toilet facilities, and the nature of the bowel symptoms often required withdrawal from social activities and resultant isolation. CONCLUSIONS: IBS is perceived as a chronic condition resulting in frustration and social isolation, and physicians are perceived to be providing inadequate medical information or support to patients with IBS.

Activities of Daily Living↗

PubMedDate not supplied

Continence for adults with urinary dysfunction.

Urinary incontinence is a common condition in the UK. A working group in Scotland constructed a best practice statement focusing on: promoting continence awareness; access to toileting facilities; assessment of urinary dysfunction; and continence care planning. Response to the statement has been positive, but the challenge will be to translate this into sustained practice development.

Humans↗

PubMed2002

Consumer-based approaches used in the development of an adaptive toileting system for children with positioning problems.

A research and development project was initiated to address concerns that existing commercial toileting systems are generally cumbersome to use, costly, and do not effectively support children in the best biomechanical and physiological position for independent toileting. Others have found that "homemade" adaptations are often necessary to improve the fit of these systems. To address these problems, a research and development project was initiated to develop a better toileting system. A multiphase research project involving a series of focus groups with parents, therapists, and other rehabilitation professionals (phase 1), classroom trials to evaluate a fitting prototype (phase 2), and home trials of a functional version (phase 3) was undertaken in the design of a better toileting system. Consumer feedback from these trials was used to develop a commercial version. This paper reviews each phase of the design process and discusses how consumer perspectives and clinical feedback were integrated into the design of the final product. In addition, features of the final product are described.

Child↗

PubMed2002

[Psychiatric patients at the police station in the southern South Holland region: assessment by the District Health Service forensic doctor].

OBJECTIVE: To describe the epidemiological characteristics of ambulant psychiatric patients who were either brought to the police station or who came by themselves, but who were not kept in a cell, as a basis for the development of a reception protocol. DESIGN: Descriptive. METHOD: The data from the medical records from 2000 kept by the forensic doctors employed by the district health services for the Southern South Holland region were inventoried. RESULTS: On request by the police, the forensic doctors examined 203 clients. The majority of these were middle-aged men who did have a place of residence. The reason for police involvement was bizarre or confused behaviour in public. Half of the patients had received or were receiving some form of psychiatric treatment from the mental health service. In approximately half of the cases the forensic doctor found a solution together with the police. In the other half of the cases the forensic doctor asked the crisis intervention team at the mental health service for an evaluation. Two thirds of these patients were hospitalised and one third was sent away. Because examination by both the forensic doctor and the mental health service psychiatrist and other procedures were lengthy (up to 6 hours), patients had to spend a long time in a holding cell at the police station that was not designed for stays of this length of time, and often lacked toilet facilities. CONCLUSION: The forensic doctor treated about half the clients without the need of assistance from the crisis intervention psychiatrist. The temporary accommodation for these confused clients was inadequate.

Adult↗

PubMed2002

[Dependence for daily life activities in the prison population in Western France].

OBJECTIVE: As the mean age of the penitential population rises and the duration of imprisonment grows longer, health services are confronted with the problem of prisoners dependent for daily life activities. The purpose of this study was to determine the number of prisoners dependent for daily life activities and quantify their dependency on human and material support. METHODS: A survey was conducted in the summer of 2,000 in the western region of France (19 prisons in the following regions: Pays-de-Loire, Brittany, Lower Normandy). RESULTS: Among the 4,168 persons incarcerated in these regions, 32 dependent prisoners were identified: 21 men (mean age 57 years) and 11 women (mean age 48 years). Among these persons, 19 suffered from major or moderate dependence (GIR 1-4). The main problems involved toilet facilities, dressing, transfers, and moving about. When human support was available, it was generally provided by other prisoners. Material help was scarce. DISCUSSION: The questions of prisoner's rights, human assistance, the status of caregivers, and the need for adapted architectural, material, and medical facilities are discussed. The information collected here provides a better knowledge of prisoners' needs for support and for changes which would be necessary in the prison environment.

Activities of Daily Living↗

PubMedDate not supplied

[Risk factors for Helicobacter pylori infection in children].

OBJECTIVE: To establish the seroprevalence of Helicobacter pylori infection in children and to identify risk factors for seropositivity.\par METHODS: A cross-sectional study established the seroprevalence of infection by Helicobacter pylori and afterwards a comparative study was performed amongst seropositive and seronegative children. A group of 228 children were cared for at the outpatient clinic of Instituto Materno Infantil de Pernambuco, from May to July 1999. Age, sex, indicators of environmental, social and economic conditions, health and nutritional status as well as children living in contact with dwellers with history of gastrointestinal pain or peptic disease were evaluated. All data was obtained through an interview with children's parents or caretakers. Nutritional status was evaluated by anthropometric index. \par RESULTS: Seroprevalence of infection caused by Helicobacter pylori was found in 32% (95% CI 26% - 38%); 25.8% (95% CI 17.8% - 33.8%) in preschool children and 39.4% (95% CI 30.4% - 48.4%) in school age children. Analysis of environmental variables demonstrated higher frequency of seropositivity in children living in houses without toilets or sanitary flush toilet facilities (p = 0.008), overcrowded (p = 0.05), lower family income (p = 0.03) and poor maternal education (p = 0.002). There were no statistically significant differences between the groups regarding health indicators, anthropometric indexes and children living with dwellers with history of gastritis or peptic ulcer.\par CONCLUSION: Seroprevalence of Helicobacter pylori infection was high in the studied population, being even higher among the school age group. A positive association between seropositivity and less favorable environmental variables was detected.

Brazil↗

PubMed1992

The nutritional situation in metropolitan Kuala Lumpur, with focus on squatters.

Kuala Lumpur is the capital city of Malaysia with an estimated population of 1.55 million. Approximately 12% of the population live in squatter settlements occupying about 7% of the city total area. The squatter settlements generally are provided with basic amenities such as piped water, toilet facilities and electricity. Health indicators for the overall population of Kuala Lumpur are better off than for the rest of the country; however, intra-city differentials prevail along ethnic and socio-economic lines. Malays and Indians have higher rates for stillbirths, and neonatal, infant and toddler mortality than the Chinese. The wide disparity in the socio-economic status between the advantaged and the poor groups in the city is reflected in the dietary practices and nutritional status of young children from these communities. The percentage of preschool children from urban poor households with inadequate intakes of calories and nutrients is two to three times higher than those from the advantaged group. Compared to rural infants, a lower percentage of urban infants are breastfed. A lower percentage of Malays from the urban advantaged group breastfed, compared with the urban poor group. The reversed trend is found for the Chinese community. Growth attainment of young children from the urban poor is worse than the urban advantaged, though better than the rural poor. Health and nutritional practices implications related to both undernutrition and overnutrition are discussed, to illustrate the twin challenges of malnutrition in the city.

Adolescent↗

PubMed1960

Work potential of the handicapped: the physician's role in evaluating it.

Even a severe physical defect may not be a handicap on some jobs; even a mild one may be a handicap on others. Physicians considering the employability of a disabled person must not only appraise the person but also must analyze the job. Job analysis must take into consideration the degree of exertion necessary, the emotional demands, working conditions (including accessibility of the place of work, of toilet facilities and the like) and job hazards. Appraisal of the person must include a medical examination, a review of the work history, consideration of socio-economic background, and psychological testing.

Disability Evaluation↗

PubMed2003

Comparative health survey of Luangpraot-Tanlium and Marialai communities Lat Krabang district, Bangkok.

The objective of the present descriptive study was to investigate the demographic and health status of Thai people in Luangpraot-Tanlium (LPT) and Marialai community (MRL) of Lat Krabang district in Bangkok. These two communities are the pilot project of the "Healthy Community" of Lat Krabang BMA hospital. The total number of households of LPT and MRL are 263 and 240, the population is 957 and 1057, males to female ratio was 1:1.2. The median household income of the residents in both communities is 9,000 baht/month/family. About 49 per cent of people have no health insurance and 22 per cent have social welfare (for underserved population). Both communities are comparable in terms of sex, age, marital status, contraceptive use, history of physical examination, chronic diseases and environmental sanitation. MRL has more trade certificate educational attainment, history of Pap smears and voluntary health insurance than LPT. LPT seemed to be prominent to have more governmental employees and governmental subsidised reimbursement for health care access. People of LPT required health and dental care more often from hospital health teams than MRL. They needed annual health check ups, care for chronic diseases and mosquito eradication. LPT also reported more garbage disposal using the burning method, greater use of rain and tap water and significant poorer sewerage and toilet facility systems when compared with MRL. The reported prevalence of chronic diseases are 1.7 fold higher in MRL than in LPT. Percentage of vaccination coverage (BCG, OPV&DPTI-II-III, HBVI-II-III, Measles vaccine) among children aged less than 1 year was 100 per cent and 1-5 years was 90 per cent (OPV & DPTIV-V).

Adolescent↗

PubMed2005

[Protection of hospital workers from risks of occupational exposure to biological agents].

BACKGROUND: Health care workers belong to a high risk occupational group in view of their permanent contact with biological agents. It is essential to take all available and effective technical, organizational and medical preventive measures to protect the exposed workers. METHODS AND MATERIALS: Activities aimed at protecting workers from risks related to exposure to biological agents, according to recommendations laid down in Directive 2000/54/EC, were assessed in a questionnaire survey carried out in 47 hospitals. RESULTS AND CONCLUSIONS: The following requirements were best satisfied by the hospitals under study: provision of workers exposed to biological agents with collective and personal protective measures; washing and toilet facilities; separate dinning rooms; registration of accidents involving handling of biological agents and including biological agents issues in the program of occupational training of workers. Most flaws and oversights were observed in regard to: biological agents risk assessment; appropriate marking of rooms where biohazard may occur; written procedures for safe handling of biological agents and the implementation of vaccination program against hepatitis B.

Biological Products↗

PubMed2006

Effect of wealth inequality on chronic under-nutrition in Cambodian children.

The problems of food insecurity and under-nutrition remain particularly severe in countries recovering from recent wars or civil unrest, where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. Using information on 3235 children aged 0-59 month(s) included in the 2000 Cambodia Demographic and Health Survey, this study examined how economic inequality was associated with inequalities in chronic childhood under-nutrition. An under-nourished (stunted) child was defined as having his/her height-for-age more than two standard deviations below the reference median. Household wealth status was measured by an index based on household ownership of durable assets. Binary and multinomial logistic regressions were used for estimating the effects of household wealth status on moderate and severe stunting. The results indicated that children in the poorest 20% households were more than twice as likely to suffer from stunting as children in the richest 20% households (odds ratio [OR]=2.54; 95% confidence interval [CI] 1.91-3.39). Adjusting for child's age, sex, birth order, and duration of breastfeeding; age of mother at childbirth, body mass index, and education; and household access to safe drinking-water, hygienic toilet facility, residence, and geographic region made little difference to this effect (OR=2.05; 95% CI 1.28-3.28). The adjusted effect of wealth status was somewhat stronger on severe stunting (relative risk ratio [RRR]=2.26; 95% CI 1.22-4.18) than on moderate stunting (RRR=1.89; 95% CI 1.12-3.20). The study concludes that wealth inequality is strongly associated with chronic childhood under-nutrition and emphasizes that reducing poverty and making services more accessible to the poor will be key to improving the health and nutritional status of children in Cambodia.

Cambodia↗

PubMed2006

[Social determinants, feeding practices and nutritional consequences of intestinal parasitism in young children].

INTRODUCTION: Studies on intestinal intestinal parasitism in children under 2 years of age have rarely been performed. The nutritional consequences and feasibility of parasite prevention justify the current study. OBJECTIVES: The study was undertaken with 3 goals: (1) to identify the prevalence of pathogenic intestinal parasites (PIP), (2) to determine the social factors, sanitary conditions and nutritional practices that predict PIP, and (3) to evaluate PIP effects on infant nutritional status. MATERIALS AND METHODS: All mothers with children under 18 months of age and living in an urban community of coastal Colombia were invited to participate in the PIP study. A fecal sample was obtained from each of 136 children; they represented 62% of the total 7-18 month-old population in the community. Presence of intestinal parasites was identified by direct microscopy and confirmed by a concentration test (Ritchie-Frick procedure). Logistic regressions were used to predict presence of PIP. The Z scores of length-for-age (< -2 SD-chronic malnutrition) and weight-for-length (< -2 SD-acute malnutrition) and covariance analysis were done to detect associations between intestinal parasitism and nutritional status. RESULTS: Of the 136 children, 30.6% were infected; 26.2% had helminth infections (A. lumbricoides, T. trichiura, S. stercoralis), 14.9% had protozoan infections (G. lamblia) and 11.8% had mixed infections. Wasting and stunting were present in 2.9% and 12.5%, respectively. Lack of sanitary toilet facilities and low maternal education were related to mixed infections and presence of helminths (p < 0.05). Weaned children were at greater risk of mixed infections (Odds Ratio (OR) 6.5; 90% CI: 1.9-21.5) and of G. lamblia infections (OR: 2.89; 90% CI: 1.0-8.34). Children infected with T. trichiura and with mixed infections were more likely to show wasting (p < 0.05). CONCLUSION: The high infections in young children indicate that they be included in periodic antiparasitic chemotherapy. Burden of disease associated to intestinal parasitism may be reduced if breastfeeding is continued beyond 6 months of age.

Animals↗

PubMed1991

Residential arrangements for adults with cerebral palsy--California, 1988.

In the United States, an estimated 274,000 persons have cerebral palsy (CP), a neurologic condition defined as a group of nonprogressive disorders in which an abnormality of the central nervous system can result in motor dysfunction (e.g., paresis, involuntary movement, and incoordination). CP is the third leading cause of the need for assistance with basic life activities and the fifth leading cause of activity limitation. An adult with CP may require adaptive housing to improve accessibility (e.g., to entrances and toilet facilities), attendant care to assist with activities of daily living, and/or nursing care to meet specific health-care needs. These needs can be met through a variety of residential accommodations. However, because the residential environment has a considerable impact on well-being and quality of life, the accommodations should be in the least restrictive environment and, when possible, community-based. This report summarizes an assessment of characteristics of adults with CP to determine which factors are associated with placement in a more restrictive environment.

Adult↗

PubMedDate not supplied

Shigellosis from swimming in a park pond in Michigan.

In July 1989 an outbreak of shigellosis occurred among visitors to a recreational park in Oakland County, MI. An epidemiologic investigation discovered an association between illness and swimming in a pond at the park, especially for those who had put their head underwater. No other factors were epidemiologically incriminated. A total of 65 cases were identified; nine were culture confirmed, all Shigella sonnei. Several water samples evaluated for fecal coliform counts shortly after the outbreak were found satisfactory. Cultures of water samples were negative for Shigella species. Inspection of the park's sewage disposal and toilet facilities found all equipment in proper working condition and no evidence of a sewage contamination event from these potential sources. No other commercial or residential sources of potential sewage contamination existed near the pond. Investigators concluded that Shigella contamination of the pond by a swimmer or swimmers on one or more occasions was a strong possibility. Factors supporting this conclusion included elevated incidence of S. sonnei in the community during the 2 months prior to the outbreak, greater use of the pond, warm water and air temperatures, and inadequate water exchange in the pond. This report adds one of the few documented outbreaks of shigellosis implicating bather contamination to the literature on the growing number of incidents that have been associated with recreational use of water.

Adolescent↗

PubMed1989

[Changes in sanitary conditions at elementary schools in Poland 1985-1988].

In the years 1985 and 1988 using a scoring system the health conditions were evaluated in a representative sample of 448 elementary schools in Poland for determining the changes occurring in them during that time. The evaluation included the environment, school building, school functioning and education organization. The study demonstrated unsatisfactory health conditions, especially in village schools, due mainly to poor lighting of schools, poor equipment with furniture, toilet facilities, conditions of feeding, and recreational facilities. During three years this situation was slightly improved, but is still far from satisfactory.

Child↗

PubMed1989

Household income and child survival in Egypt.

This article uses household-level economic and fertility survey data to examine the relationship between household income and child survival in Egypt. Income has little effect on infant mortality but is inversely related to mortality in early childhood. The relationship persists with other associated socioeconomic variables controlled. The mechanisms underlying the income effects are not evident from this analysis: income differentials in sources of household drinking water, type of toilet facilities, and maternal demographic characteristics do not explain the net impact of income on child mortality. The absence of effects on child survival of the size of the place of residence and the relatively weak effects of maternal schooling are also notable.

Child↗

PubMed1988

Nursing assessments in the inpatient geriatric population.

Thorough assessment is essential in caring for the institutionalized elderly who have difficulty with urine control. The assessment should include a physical examination, a functional assessment, and an evaluation of the environment. The physical examination should be completed in a timely fashion after incontinence develops in order to rule out treatable causes of urine loss. The examination includes a health history and physical examination, with special attention being given to the genitourinary system. A urine specimen should be obtained during the examination to rule out bladder infection. The functional assessment of the patient is one of the most important aspects of the patient assessment. This is particularly true for elderly inpatients because much of the incontinence found in nursing homes is attributable to functional deficits. The functional assessment should address the history of the patient's incontinence, the patient's cognitive abilities and potential for participating in continence care, the patient's mobility, and the patient's abilities related to activities of daily living. Deficits in any of these areas may contribute to or cause urinary incontinence. In addition to the physical examination and functional assessment of the patient, the environment should be evaluated. The visibility, location, and structure of the toileting facilities can serve to either promote or impair urine control. In addition to the physical facilities provided, the overall nursing care approach may foster or hinder the patient's ability to maintain urinary continence. Nursing assessment that addresses these three areas will provide information that is needed to develop a nursing care plan that will maximize the patient's potential for urine control.

Aged↗