ЗАЛОГ КАК МЕРА ПРЕСЕЧЕНИЯ: ПРОБЛЕМЫ ПРИМЕНЕНИЯ

Osteonecrosis of the jaw (ONJ) risk in breast cancer patients after zoledronic acid treatment

BackgroundEven with the mild form of COVID-19, people need to practice the proper preventive measures to achieve health, safety and control spread of infection. Few studies assessed sound disinfection and rehabilitative knowledge. This study aims to assess the self-reported, knowledge of specific disinfection measures among post-recovery COVID-19 patients and identifying the most requested knowledge items regarding the prevention and post COVID rehabilitation measures.MethodsThis is an exploratory cross-sectional study using an electronically open survey. A pre-tested e-questionnaire was employed for data assembling. The sample size was calculated and a total of 417 people completed the questionnaire. Knowledge score was calculated for preventive and disinfection measures during and after COVID 19 infection. It comprised three sections: socio-demographics, study participants’ knowledge regarding precautions, disinfection, and rehabilitation measures, as well as sources of knowledge about COVID-19.ResultsAll participants infected with COVID-19 (82%) reported self-isolation for ten days after confirming the infection, with only 18% required hospitalization. Regarding the information needed by the participants, the highest requests were for the rehabilitation information after COVID-19 and preventive measures. Females under 30 years old and those with a college education or higher were significantly more likely to request rehabilitation information after COVID-19 (P-value 0.05). Nevertheless, males were significantly more interested in information regarding preventive measures; They were over 30 years old and had education below university (P-value 0.05). Participants (above 30 years old) had significantly higher knowledge of preventive and disinfection measures during and after COVID-19 infection (P = 0.030).ConclusionAfter the COVID-19 experience, most participants demonstrated a great desire for rehabilitation information and proper preventive measures. This paves the way for delivering self-management and rehabilitation knowledge and emphasizing the significance of various prevention modalities.

Coronavirus disease 2019 (COVID-19) pandemic has become a major public health issue globally. Preventive health measures against COVID-19 can reduce the health burden significantly by containing the transmission. A few research have been undertaken on the effectiveness of preventive strategies such as mask use, hand washing, and keeping social distance in preventing COVID-19 transmission. The main aim of this study was to determine the association of the preventive measures with the reduction of transmission of COVID-19 among people. Data was collected during January 06, 2021 to May 10, 2021 from 1690 participants in Bangladesh. A validated questionnaire was used to collect both the online and offline data. Chi-square test and logistic regression analyses were performed to determine the association among the variables. The prevalence of COVID-19 was 11.5% (195 of 1690) among the population. Age, gender, occupation and monthly income of the participants were significantly associated with the likelihood of following the preventive measures. The risk of infection and death reduced significantly among the participants following preventive measures (p = .001). The odds of incidence was lower among the participants using masks properly (OR: 0.02, 95% CI: 0.01–0.43), maintaining social distances (OR: 0.04, 95% CI: 0.01–0.33), avoiding crowded places (OR: 0.07, 95% CI: 0.02–0.19) and hand shaking (OR: 0.17, 95% CI: 0.09–0.41). This study suggests that preventive health measures are significantly associated with the reduction of the risk of infection of COVID-19. Findings from this study will help the policymakers to take appropriate steps to curb the health burden of COVID-19.

While malaria morbidity has sharply declined in several areas in Senegal, it remains an important problem in the southern part of the country, particularly among adolescents. Understanding adolescents' knowledge, attitudes, prevention and care-seeking practices is important to inform more targeted interventions aimed at optimizing adolescents' uptake of malaria prevention and control measures. This study assessed malaria-related knowledge, attitudes, and practices (KAP) among adolescents living in a highly persistent transmission area in Senegal. A community-based cross-sectional survey was conducted among 391 adolescents living in the Saraya health district. A multistage random sampling technique was used to select households. An electronic questionnaire developed on Open Data Kit (ODK), was used to collect data on socio-demographic characteristics, household assets, adolescents' knowledge of malaria, as well as their attitudes with regards to malaria prevention, and care-seeking behaviors. Bivariate and multivariate analyses were performed to assess factors associated with adolescents' KAP towards malaria. Nearly, one-third of the participants had good knowledge of malaria (34.4%) and good practice in regards to malaria preventive measures (32.8%) while 59.0% had a positive attitude and 73.8% had good care-seeking behavior regarding malaria. Multivariate analysis revealed that a primary (aOR = 5.43, p = 0.002) or secondary level of education (aOR = 10.41, p = 0.000) was associated with good knowledge of malaria transmission, signs, and prevention measures. Male individuals had lower knowledge compared to female ones (aOR = 0.40, p = 0.001). Individuals belonging to households from the highest wealth quintile were more likely to have a positive attitude towards malaria compared to those from households in the lowest wealth quintile (aOR = 3.49, p = 0.004). The odds of positive attitude towards malaria decreased among participants with koranic and primary education level, respectively (aOR = 0.14, p = 0.005) and (aOR = 0.24, p = 0.019). A positive attitude was 1.89 more likely to be (aOR = 1.89, p = 0.026) associated with good practice of prevention measures compared to adolescents who demonstrated negative attitudes. Individuals from households in the fourth (aOR = 0.42, p = 0.024), middle (aOR = 0.34, P = 0.005), and second (aOR = 0.42, p = 0.027) wealth quintiles were less likely to use malaria prevention measures compared to those from households in the highest wealth quintile. The study revealed that adolescents, generally have poor levels of malaria knowledge and low uptake of malaria prevention and control interventions. Targeted interventions for high-risk adolescents are needed, that focus on improving their knowledge of the disease and effective preventive measures, and on increasing their access to health care services and LLINs.

The objective of this study is to review ethical and clinical guidelines and position papers concerning the presymptomatic and predictive genetic testing of minors. The databases Medline, Philosopher's Index, Biological Abstracts, Web of Science and Google Scholar were searched using keywords relating to the presymptomatic and predictive testing of children. We also searched the websites of the national bioethics committees indexed on the websites of World Health Organization (WHO) and the German Reference Centre for Ethics in the Life Sciences, the websites of the Human Genetics Societies of various nations indexed on the website of the International Federation of Human Genetics Societies and related links and the national medical associations indexed on the website of the World Medical Association. We retrieved 27 different papers dealing with guidelines or position papers that fulfilled our search criteria. They encompassed the period 1991-2005 and originated from 31 different organizations. The main justification for presymptomatic and predictive genetic testing was the direct benefit to the minor through either medical intervention or preventive measures. If there were no urgent medical reasons, all guidelines recommend postponing testing until the child could consent to testing as a competent adolescent or as an adult. Ambiguity existed for childhood-onset disorders for which preventive or therapeutic measures are not available and for the timing of testing for childhood-onset disorders. Although the guidelines covering presymptomatic and predictive genetic testing of minors agree strongly that medical benefit is the main justification for testing, a lack of consensus remains in the case of childhood-onset disorders for which preventive or therapeutic measures are not available.

The article investigates the genesis of the notion of "coercion" in the activities of law enforcement agencies of Ukraine. The issue set by the author is to justify a new doctrine of law enforcement practices, to indetify a proper place of coercive measures. The research is based on a three-part classification of administrative coercion measures, which was based on the selection of the criterion of the purpose of applying the administrative coercion measure. Accordingly, the purpose of preventing possible offenses and the occurrence of dangerous consequences for society necessitates the application of administrative and preventive measures; the purpose of termination of unlawful actions causes the application of measures of administrative termination; and the purpose of punishing those guilty of administrative misconduct is to apply administrative liability measures. The study revealed that the solution of scientific discussions concerning the concept, features and classifications of administrative coercion measures is not facilitated by the current regulatory policy. More specifically, the Law of Ukraine "On the National Police" stipulates that in order to fulfill its tasks, the police take measures to respond to violations, and apply preventive and coercive measures within their competence. At the same time, the Parliament, having foreseen the preventive measures in police activity, de facto identified them with administrative and preventive ones, which are substantiated by Ukrainian doctrine; measures to respond to offenses with measures to suspend and secure proceedings in cases of administrative offenses and criminal proceedings, but coercion measures include only physical power (force), the use of special means and firearms. Therefore, applying the logic of the previous research publications, it was identified a system of measures: preventive measures (traditionally denoted as administrative preventive), measures to respond to offenses (traditionally referred to as general measures to stop offenses) and coercive measures (special measures to stop offenses). Accordingly, the formal definition of the term "force" is narrower than defined by administrative and legal doctrine in the context of coercion in the activities of law enforcement agencies.

BackgroundWith emphasis on policy implications, the main objective of this study was to estimate the numbers of two main groups affected by FGM/C in Norway: 1) those already subjected to FGM/C and therefore potentially in need for health care and 2) those at risk of FGM/C and consequently the target of preventive and protective measures. Special attention has been paid to type III as it is associated with more severe complications.MethodsRegister data from Statistics Norway (SSB) was combined with population-based survey data on FGM/C in the women/girls’ countries of origin.ResultsAs of January 1st 2013, there were 44,467 first and second-generation female immigrants residing in Norway whose country of origin is one of the 29 countries where FGM/C is well documented. About 40 pct. of these women and girls are estimated to have already been subjected to FGM/C prior to immigration to Norway. Type III is estimated in around 50 pct. of those already subjected to FGM/C. Further, a total of 15,500 girls are identified as potentially at risk, out of which an approximate number of girls ranging between 3000 and 7900 are estimated to be at risk of FGM/C.ConclusionReliable estimates on FGM/C are important for evidence-based policies. The study findings indicate that about 17,300 women and girls in Norway can be in need of health care, in particular the 9100 who are estimated to have type III. Preventive and protective measures are also needed to protect girls at risk (3000 to 7900) from being subjected to FGM/C. Nevertheless, as there are no appropriate tools at the moment that can single these girls out of all who are potentially at risk, all girls in the potentially at risk group (15,500) should be targeted with preventive measures.

The study of the prevalence of dentoalveolar anomalies and deformations, and the effectiveness of their treatment is an urgent problem, since it allows you to determine the need of the population for therapeutic and preventive orthodontic measures, calculate the necessary amount of orthodontic care, and determine the effectiveness of therapeutic and preventive measures (Sablina G.I, Kovtonyuk P.A., 2004). The exclusion of orthodontic care from dental care for children and adolescents and its transfer to the category of paid medical services has led to a sharp reduction in orthodontists working in children's dental institutions, and preventive work is not carried out among the children's team to prevent dentition. Over the past decades, many new methods and treatment tools have appeared in domestic orthodontics, allowing the orthodontist to carry out the necessary medical and preventive measures at the early stages of the formation of pathology. An algorithm will be developed for the treatment of patients with occlusion anomalies during the period of constant occlusion with the use of anthropometric measurements and an articulator at the final stage, which will increase the effectiveness of the treatment and achieve stable long-term results. A standardized examination of children with anomalies of the dentition will be carried out using the example of the Bukhara region. A comparison will be made of indicators of soft tissues of the oral cavity in children with abnormalities of the dentofacial system and a negative effect of occlusion pathology on the condition of the oral mucosa will be established.

Introduction The handling of hazardous drugs is a specific, significant and not well known risk that affects the work of nurses. Methods A survey of 786 Spanish nurses investigated how often nurses handle hazardous drugs, what training and skills they have to do so, what preventive measures are taken to avoid contact and what health problems may be related to their handling. Results The results obtained indicate regular contact of nurses with HDs in all care areas, significant lack of training and information and preparing some HDs in wards, rather than in BSC. Discussion The toxic effects of many drugs have been demonstrated by numerous research studies. Regulatory provisions make it mandatory to protect health care workers. However, the results show that the nurses’ information and training on the toxicity and health risks of the drugs they are using is deficient. Almost half of the nurses had no information about the toxicity of the medicines they handled and the preventive measures they should take. Less than half of the nurses surveyed had individual safety equipment at their workplace or used protocols for the safe handling of HDs. More than half of the nurses responded that they did not receive specific health surveillance. A high number of nurses reported having experienced health problems, among which the frequency of miscarriages is striking. Conclusion The results therefore suggest that more research, better prevention and control measures and specific health surveillance for all nurses handling HDs are needed.

Введение. На долю доброкачественной гиперплазии предстательной железы (ДГПЖ) приходится более 40,0 % от числа всех болезней мужчин старше 50 лет, что выводит данное заболевание в ряд первоочередных медицинских и социальных проблем. Тем более, по демографическим исследованиям ВОЗ население планеты стареет, соответственно прогнозируется рост заболеваемости этой патологией. ДГПЖ существенно снижает качество жизни мужчин, что связано с различными нарушениями мочеиспускания, общей астенизацией организма, с изменением психоэмоционального статуса и эректильными дисфункциями [4,17,21,68]. Несмотря на некоторые различия статистических данных, мы видим, какое широкое распространение имеет это заболевание и какое влияние оказывает на качество жизни, как симптомы нижних мочевых путей и сексуальные расстройства вследствие ДГПЖ влияют на психоэмоциональное состояние больного. Предлагаются методы улучшения качества жизни, дается обширная информация о современных достижениях в этой области. Очевидно, что для своевременной диагностики и разработки эффективных мер профилактики и реабилитации ДГПЖ необходимо углубленно изучить факторы риска развития данного заболевания, их взаимосвязь. Цель: Провести систематический поиск научной литературы, касающейся медико-социальных аспектов развития доброкачественной гиперплазии предстательной железы и ее влияния на качество жизни пациентов. Стратегия поиска. Поиск научных публикаций проводился в базах данных доказательной медицины (Guidelines, Medline,Web of Science, PubMed, CochraneLibrary), в электронных научных библиотеках (e-Library, CyberLeninka, сайты периодических медицинских изданий стран СНГ) и электронных библиотек диссертации (dissercat.com, medical-diss.com и пр). Всего было найдено 13530 литературных источников. После автоматического поиска и исключения дублирующихся публикаций, нами был выполнен поиск публикаций «вручную», который позволил выявить 70 литературных источников, включенных в настоящий обзор. Результаты: В настоящее время все больше внимания в литературе, особенно в зарубежной, уделяется проблемам ДГПЖ, факторам риска ее развития, влияние этих факторов на качество жизни мужчин. И это не удивительно, так как по многочисленным эпидемиологическим исследованиям ДГПЖ является одним из самых распространенных заболеваний мужчин и составляет по данным разных авторов в среднем 29- 30 % от общей обращаемости мужчин. Но надо сказать, что эти цифры относительны. Как подчеркивают многие исследователи, в том числе и зарубежные, нет своевременной диагностики этого заболевания, из-за низкой обращаемости мужчин, ввиду разных причин, и нет достаточной выявляемости на первичном врачебном уровне, так как основной поток пациентов идет через врачей общей практики. Другой момент роста заболеваемости ДГПЖ это недейственные меры профилактики, недостаточная оценка факторов риска возникновения этой патологии и их влияние не только на развитие заболевания, но и на прогноз в целом. Поэтому необходима разработка эффективных мер профилактики и реабилитации пациентов с гиперплазией предстательной железы. Выводы: Таким образом, по проработанным литературным источникам видно насколько много публикаций посвящены проблемам ДГПЖ, насколько актуальна она в связи с прогрессивным ростом заболеваемости. Проявления ДГПЖ в виде симптомов нарушения мочевых путей и эректильной дисфункций существенно снижают качество жизни, ведет к различным невротическим расстройствам мужчин. Очень интересны и доказательны данные зарубежных авторов о взаимосвязи симптомов нижних мочевых путей и эректильной дисфункции и их влияние на сердечно-сосудистую систему, особенно на раннюю диагностику их. Это дает возможность применить данные рекомендации для своевременной предварительной диагностики обоих состояний уже на первичном врачебном уровне. Необходимо, учитывая наиболее ценные доказательные данные литературных источников, разработать меры своевременной диагностики, профилактики и комплексной реабилитации пациентов с ДГПЖ. Introduction.More than 40.0% of all diseases in men over 50 years fall at the share of the benign prostatic hyperplasia (BPH) that brings this disease into line of primary medical and social problems. Moreover, according toWHO’s demographic researches the population of the planet grows old, thus rate of incidence of this pathology is predicted. BPH significantly reduces quality of men’s life which is connected with various inappropriate urination, general asthenization of organism, change of psychoemotional state and erectile dysfunctions [4,17,21,68]. Despite some differences in statistic data, we see what high incidence and what impact on quality of life this disease has, howlower urinary tract symptoms and sexual disordersdue to BPH influence psychoemotional state of the patient. Methods of improvement in quality of life are offered, extensive information on modern achievements in this area is given. It is obvious that for timely diagnostics and development of effective measures of BPH prevention and rehabilitation it is necessary to study intensively risk factors of development of this disease, their interrelation. Purpose: To carry out systematic search of scientific literature concerning medical and social aspects of development of benign prostatic hyperplasia and their influence on quality of life of patients. Search strategy: Search of scientific publications was carried out in the databases of evidential medicine ((Elsevier, Web of Science, PubMed, CochraneLibrary), in the electronic scientific libraries (CyberLeninka, websites of periodic medical publications of the CIS countries) and the electronic libraries of dissertations (dissercat.com, medical-diss.com, etc.). In total, it was found 13530 sources of literature. After automatic search and exception of the duplicated publications, we executed search of publications “manually” which allowed to reveal 70 sources of literature included in this review. Results: At the present time increasing attention in literature, especially in foreign one, is paid to BPHproblems, risk factors of its development, influence of these factors on quality of men’s life. And this is not surprising because according to numerous epidemiological researches BPHis one of the most frequent diseases of men and averages 29 - 30% of the totalappealability of men according to different authors. But it is necessary to tell that these figures are relative. Many researchers,including foreign ones, underline thatthere is no timely diagnosis of this disease because of low appealability of men in view of different reasons, and there is no sufficient detectability at the primary medical level as the main patient stream goes through general practitioners. Other moment of incidence rateof BPHis inefficient measures of prevention, insufficient assessment of risk factors of this pathology as well as their influence not only on development of disease, but also on the prediction in general. Therefore development of effective measures of prevention and rehabilitation of patients withprostatic hyperplasia is necessary. Conclusions: Thus, by the worked out sources of literature it can be seen how many publications are devoted to BPHproblems, how relevant it is in connection with progressive rate of incidence. Manifestations of BPHin the form of lower urinary tract symptoms and erectile dysfunction significantly reduce quality of life, lead to various neurotic disordersof men. Data of foreign authors on interrelation of lower urinary tract symptoms and erectile dysfunction and their influence on cardiovascular system, especially on their early diagnostics, are very interesting and evidential. It gives the chance to apply these recommendations for timely preliminary diagnostics of both states already at primary medical level. It is necessary, considering the most valuable evidential data of sources of literature, to develop measures of timely diagnostics, prevention and complex rehabilitation of patients with BPH. Кіріспе. Қуықасты безінің қатерсіз гиперплазиясы (ҚБҚГ) 50 жастан асқан ер адамдарда кездесетін барлық аурулардың 40,0%-дан астамын құрайды, бұл жәйт аталған ауру түрін бірінші кезектегі медициналық және әлеуметтік проблемалардың қатарына шығарады. Оған қоса, ДДҰ демографиялық зерттеулері бойынша ғаламшар тұрғындары қартаю үстінде, сәйкесінше, осы ауру түрімен ауыратындар санының өсуі болжанып отыр. ҚБҚГ ер адамдардың өмір сапасын айтарлықтай төмендетеді, бұл зәр шығарудағы түрлі бұзылыстармен, ағзаның жалпы әлсізденуімен, психоэмоционалдық жағдайының өзгеруімен және қозу әрекетінің бұзылуымен байланысты [4,17,21,68]. Статистикалық деректердегі біршама айырмашылықтарға қарамастан, біз бұл аурудың қалай етек жайып алғанын және ерлердің өмір сапасына қалай әсер ететінін, ҚБҚГ салдарынан болған төменгі несеп жолдары симптомдары мен сексуалдық бұзылыстардың науқастың психоэмоционалдық жағдайына қалай әсер ететінін көріп отырмыз. Өмір сапасын жақсарту әдістері ұсынылуда, бұл саладағы қазіргі заманғы жетістіктер туралы ауқымды ақпарат берілуде. ҚБҚГ-ні дер кезінде анықтау үшін және оның алдын алудың, одан сауықтырудың тиімді шараларын ойлап табу үшін аталған аурудың даму қаупін тудыратын факторларды, олардың өзара байланысын тереңірек зерттеу қажет екені анық. Мақсаты: Қуықасты безінің қатерсіз гиперплазиясының дамуындағы медициналық - әлеуметтік аспектілерге және олардың пациенттердің өмір сапасына тигізетін әсеріне қатысты ғылыми әдебиеттерді жүйелі түрде іздеу. Іздеу стратегиясы: Ғылыми жарияланымдарды іздеу дәлелді медицинаның дерекқорларында (Elsevier, Web of Science, PubMed, CochraneLibrary), электрондық ғылыми кітапханаларда (CyberLeninka, ТМД елдерінің мерзімді медициналық басылымдарының сайттары) және диссертациялардың электрондық кітапханаларында (dissercat.com, medical-diss.com және басқа) жүргізілді. Барлығы 13530 әдебиет көзі табылды. Автоматты іздеуден және қайталанатын жарияланымдарды шығарып тастағаннан кейін, жарияланымдарды «қолмен» іздеуді жүзеге асырдық, бұл бізге осы шолуға енгізілген 70 әдебиет көзін анықтауға мүмкіндік берді. Нәтижелері: Қазіргі кезде әдебиеттерде, әсіресе, шетелдік әдебиеттерде ҚБҚГ проблемаларына, оның дамуындағы қауіп факторларына, аталған факторлардың ер азаматтардың өмір сапасына тигізетін әсеріне барынша көп көңіл аударылуда. Және бұл таңқаларлық жағдай емес, өйткені көптеген эпидемиологиялық зерттеулер бойынша ҚБҚГ ер адамдардың ең көп таралған ауруларының бірі болып табылады және әртүрлі авторлардың деректері бойынша, дәрігерге көрінетін ер адамдардың шағымының орта есеппен 29-30%-ын құрайды. Бірақ бұл сандар салыстырмалы екенін айта кету керек. Бірқатар зерттеушілер, оның ішінде шетелдік зерттеушілер баса көрсеткеніндей, ер адамдар әртүрлі себептермен дәрігерге уақытылы қаралмайды, соның салдарынан бұл ауру дер кезінде анықталып отырған жоқ. ҚБҚГ ауруының өсіп отырғанының тағы бір себебі алдын алу шараларының пәрменсіз жүргізілуі, бұл патологияның пайда болуының қауіп факторларын және олардың аурудың асқынуына әсерін жете бағаламау, сол сияқты жалпы болжаудың да дұрыс жүргізілмеуі. Сондықтан қуықалды безінің гиперплазиясының алдын алудың және аталған ауруға шалдыққан пациенттерді сауықтырудың тиімді шараларын жасап шығару қажет. Қорытындылар: Осылайша, жұмыс жасалған әдебиет көздері бойынша ҚБҚГ проблемаларына қаншалықты көп ғылыми жұмыстардың арналғанын, аталған аурудың қарқынды өсуімен байланысты бұл проблеманың қазір қаншалықты өзекті болып отырғанын көрдік. ҚБҚГ-нің несеп жолдары жұмысының бұзылуы және қозу әрекетінің төмендеуі түріндегі көріністері ер адамдардың өмір сапасын айтарлықтай төмендетеді, әртүрлі невротикалық бұзылыстарға апарып соқтырады. Шетелдік авторлардың төменгі несеп жолдары симптомдары мен қозу әрекетінің бұзылуының өзара байланыстары және олардың жүрек-қантамыр жүйесіне, әсіресе жүрек-қантамыр ауруларының ерте анықталуына әсері туралы деректері өте қызықты әрі дәлелді. Бұл берілген кеңестерді аталған екі жағдайды да дер кезінде, алғашқы дәрігерлік деңгейде анықтау үшін қолдануға мүмкіндік береді. Пайдаланылған әдебиет көздеріндегі құнды дәлелдерді ескере отырып, ҚБҚГ ауруын дер кезінде анықтау, алдын алу және сол ауруға шалдыққан пациенттерді кешенді сауықтыру шараларын әзірлеу қажет.

One third of all occupation-related diseases are diseases of the skin, and in most of these cases the skin barrier is involved. Professions such as metalworkers, hairdressers, and health care and construction workers are mainly affected. Among them, contact dermatitis is the leading skin disease. It usually presents as hand eczema caused by or leading to impaired barrier function. All this significantly impacts the function of the hands, reduces the ability to work and especially impairs the patient's quality of life. Diagnostics and therapy are of great importance; in addition, prevention programs are meanwhile an important mainstay of the overall therapeutic concept. They comprise measures of secondary (outpatient) and tertiary (inpatient) prevention. Secondary prevention measures include occupation-tailored teaching and prevention programs, and the dermatologist's examination and report. In severe cases or if therapy is not successful in the long term, or if the diagnosis is not clear, measures of tertiary prevention may come into action. They are offered as an inpatient treatment and prevention program. The aims are prevention of the job loss, but especially to reach a long-term healing up and getting back to normal occupational and leisure life in the sense of attaining full quality of life. During the last years, research in Germany has shown that the different measures of prevention in occupational dermatology are very effective. This integrated concept of an in-/outpatient disease management reveals remarkable pertinent efficacy for patients with severe occupational dermatoses in at-risk professions.

To provide information about preventive measures and treatment seeking behaviour as well as an estimate of the malaria burden in different epidemiological settings for effective monitoring and evaluation of the ongoing efforts. Cross-sectional survey carried out in four areas representing different levels of transmission to explore the use of preventive measures, care-seeking behaviour and accessibility in addition to point prevalence was followed by a follow-up phase in which the health workers registered and reported all fever cases including malaria. The relation between the reported malaria incidence, the product of symptomatic/asymptomatic ratio and the prevalence of confirmed malaria cases was used to develop the equation that could predict the true malaria incidence. Thousand households and 3628 individuals were surveyed. The presence of any net varied between 6.6% and 40%; the percentage of people who reportedly slept under mosquito nets in the previous night varied between 35 and 80. Prompt use of medications ranged between 14 and 48% with a delay of more than 24 h noticed in different areas. The mean number of individuals per household who reported use of anti-malarial drugs in the last 2 weeks ranged between 0.6 (SD = 0.92) and 1.2 (SD = 1.1), with variable cost per treatment and affordability. The prevalence of asymptomatic parasitaemia, fever and confirmed malaria at time of the survey differed by area. The incidence of malaria during the follow-up period was estimated to be 8.5, 178.6, 23.7 and 10.3 episodes per 1000 population in Malakal, Elrank, Elhosh and El Matama, respectively. Based on this, a prediction equation was developed. We found suboptimal health care seeking behaviour, coverage and use of preventive measures with a high malaria burden. We developed a model for future estimation of malaria episodes.

To the Editor: Healthcare workers accounted for 21% of all cases of severe acute respiratory syndrome (SARS) during the 2002–2003 outbreak (1). We studied perceptions of risk for SARS infection and preventive measures among healthcare workers in Singapore, who handled cases of SARS and where >41% of the cases occurred among healthcare workers, and in Japan, a SARS-free country. A self-administered questionnaire was distributed to healthcare workers in various healthcare settings in Singapore (n = 15,025) and Japan (n = 9,978) from May to September 2003. Healthcare workers in Singapore were from 9 primary healthcare hospitals and 9 major institutional healthcare settings, including 3 tertiary hospitals where cases of SARS occurred among healthcare workers, 1 specialized women and children's hospital, 2 community hospitals, and 2 tertiary dental centers. In Japan, study participants were healthcare workers at 7 tertiary-level hospitals distributed throughout Japan. Four of these are university-attached, 2 are municipal hospitals, and 1 is a private hospital. A total of 10,511 (70% response) and 7,282 (73% response) valid questionnaires were returned in Singapore and Japan, respectively. A total of 43% and 45% of the healthcare workers in Singapore and Japan were nurses; others were doctors, physiotherapists, pharmacists, attendants, cleaning staff, and administrative or clerical staff. In terms of sociodemographic characteristics, the mean ages of the healthcare workers were 36.6 years in Singapore and 35.6 years in Japan, while the gender distribution was 82% female in Singapore and 70% female in Japan, respectively. Approximately half (57% and 45%, respectively) of healthcare workers in Singapore and Japan were married. A similar proportion (about two thirds) of healthcare workers in both countries felt at great risk of exposure to SARS. However, a higher proportion (76%) was afraid of contracting SARS in Singapore as compared to Japan (55%). Nearly all healthcare workers (96%) in Singapore felt that implementation of protective measures at work was generally effective, and 95% were satisfied with the explanation of their necessity and importance. Slightly fewer (93%) agreed that clear policies and protocols for everyone to follow were in place. In contrast, among Japanese healthcare workers, only 65% agreed that clear policies and protocols were in place, and many fewer (31%) felt that protective measures at work were generally effective (Table). Table Singaporean and Japanese healthcare workers' risk perceptions about severe acute respiratory syndrome (SARS) As to the national experiences with the SARS outbreak, healthcare workers in Singapore managed 238 cases of SARS, while those in Japan did not encounter any cases. Furthermore, preventive measures were strictly enforced and effective in Singapore, and the outbreak was contained successfully. In contrast, preventive measures were in place in Japan, but workers lacked confidence in an untested system (2). These differences are probable explanations for the varying responses in the Singaporean and Japanese healthcare workers. The perceived need for adherence to prescribed measures and willingness to follow protocols were quite different, given the difference in perceived risks. In SARS-free Japan, most healthcare workers were aware that institutional policies and protocols existed, but less than a third were confident of their effectiveness. The degree of implementation and adherence endorsed by healthcare workers was also lower in Japan. Infections of healthcare workers at the onset of an outbreak may be due to perceptions that recommended policies and measures are unnecessary or excessive. Thus, efforts to educate and communicate the rationale and importance of protective measures may be especially important when outbreaks seem distant and perceived danger is low. Healthcare workers in both Singapore and Japan perceived a risk for exposure to SARS at work, which reflected the global reach of the illness. However, in Singapore, where cases existed and where the disease was eventually contained, the perceived danger of contracting the illness was higher, and most healthcare workers were reassured by the preventive measures taken, which they viewed as effective. This situation was in contrast to the healthcare workers' perceptions of infection risk and confidence in preventive measures against SARS in Japan, where the measures for infection control were untested.

Background: The monkeypox virus causes the infectious illness known as "human monkeypox infection," which has significant health hazards for the public. The two major goals of the global response to the monkeypox outbreak were to improve knowledge and attitudes as well as to use preventative measures to stop the disease from spreading further. Aim of the study: was to evaluate the effect of nano-teaching sessions regarding human monkeypox infection on knowledge, attitude and preventive measures among pregnant women. Subjects and Methods: Research design: This study used a quasi-experimental design. Setting: The research was carried out at the prenatal care unit in Al-Nahal medical center that provides healthcare services to the population of Zagazig, Egypt. Subjects: 70 pregnant women were included in a purposive sample. Tools of data collection: three tools were used; a structured Interviewing questionnaire, attitude questionnaire regarding human monkeypox infection among pregnant women and preventive measures questionnaire regarding human monkeypox infection among pregnant women. Results: There was a highly statistical significant correlation between pregnant women’s preventive measures and their knowledge at pre and post nano-teaching sessions and their attitude after implementation of nano-teaching sessions regarding human monkeypox infection. Conclusion: Implementation of nano-teaching sessions had a highly statistically significant effect on improving pregnant women’s knowledge, attitude and preventive measures toward Human monkeypox Infection. Recommendations: Continuous campaigns to improve women's knowledge, attitude, and preventive measures are crucial because controlling outbreaks requires the substantial cooperation of a knowledgeable and aware society.

BackgroundIn the construction industry workers are frequently exposed to hazardous substances. To explore and describe construction workers’ barriers and motives to (not) work safely with hazardous substances, we examined their perspectives on the health risks, perceived barriers, and intention to use preventive measures with regard to silica dust. Specifically, we studied perspectives on the use of face masks, dust collection on power tools, and using a vacuum cleaner instead of a broom.MethodSemi-structured interviews (n = 13) and a pen and paper survey (n = 187) were administered on construction and training sites. Only executive workers could participate in the study. We approached the behaviour of using specific preventive measures as an emergent property of a complex network of interacting psychological variables. To analyse the structure of these ‘behavioural decision networks’ we applied a psychological network.ResultsThrough the exploratory semi-structured interviews, we identified themes relevant for our survey, like perceived exposure, risk being considered as part of the job, and perceived barriers like time, effort, and properties of the work environment. Construction workers were generally aware their health is at risk due to occupational exposure to silica dust. At the same time, they are not overly concerned about that risk. Network analysis suggests that concern does play a moderate role in the behavioural decision networks, suggesting that a lack of concern may encourage unsafe behaviour. Construction workers’ level of automaticity to use specific preventive measures was relatively low. Barriers to use preventive measures such as time and effort play a relatively key role in the networks. A general intention to work safely hardly played any role in the networks, while a specific intention to use preventive measures played a more prominent role. Age and work experience did not play a role in the network. Non-parametric tests and descriptive comparison of networks suggest differences in for example the relative importance of specific variables.ConclusionsFor two preventive measures, different variables may be more successful intervention points to foster safe work. Increasing levels of concern, improving automaticity of use, addressing specific intention to use preventive measures in risk communication, and offering preventive measures at time and location where relevant tasks are performed, are discussed as possible intervention points to foster working safely with silica dust in construction. Future studies should further substantiate these findings.