Objectives: US community pharmacies are a unique and underused health service setting for identifying and potentially intervening with patients at risk of opioid overdose or opioid use disorder with evidence-based practices such as screening, brief intervention, and referral to treatment (SBIRT). The aim of our study was to assess the feasibility of implementing SBIRT in community pharmacies in an urban county in terms of engagement, reach, and equity across the cascade of pharmacy screening and care.
Methods: Patients aged 18 years or older receiving a schedule II or III opioid prescription at 1 of 17 participating community pharmacies in Allegheny County, Pennsylvania, were invited to engage in SBIRT as part of Project Lifeline-II from June 2020 through January 2023.
There is emerging recognition of the unique benefits of implementing screening, brief intervention, and referral to treatment (SBIRT) in pharmacy settings to identify patients who can benefit from services and connecting them to those services. This study describes Project Lifeline - a multipronged public health initiative to provide educational and technical support to rural community pharmacies implementing SBIRT for substance use disorder (SUD) and providing harm reduction support. Eight community pharmacies were recruited.
View Article and Find Full Text PDFDiarrhea continues to be a leading cause of death for children under-five. Amongst children treated for acute diarrhea, mortality risk remains elevated during and after acute medical management. Identification of those at highest risk would enable better targeting of interventions, but available prognostic tools lack validation.
View Article and Find Full Text PDFObjectives: To describe admission trends and estimate inpatient and post-discharge mortality and its associated exposures, among young infants (YI) admitted to a county hospital in Kenya.
Design: Retrospective cohort study.
Setting: Secondary level hospital.
Objectives: Accurate and timely diagnosis of common neonatal conditions is crucial for reducing neonatal deaths. In low/middle-income countries with limited resources, there is sparse information on how neonatal diagnoses are made. The aim of this study was to describe the diagnostic criteria used for common conditions in neonatal units (NNUs) in Nigeria and Kenya.
View Article and Find Full Text PDFBackground: Optimizing nutrition in very preterm (28-32 weeks gestation) and very low birth weight (VLBW; 1,000 g to <1,500 g) infants has potential to improve their survival, growth, and long-term health outcomes.
Aim: To assess feeding practices in Nigeria and Kenya for very preterm and VLBW newborn infants.
Methods: This was a cross-sectional study where convenience sampling was used.
J Am Coll Emerg Physicians Open
December 2021
Background: Firework-related injuries cause significant morbidity to persons in the United States and globally. Prior studies have shown that hands and eyes are frequently injured, with loss of hand function and blindness being common after serious injury. Many jurisdictions in the United States have relaxed laws governing sales of consumer fireworks in recent years.
View Article and Find Full Text PDFObjective: To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria.
Study Design: In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period.
Results: 2280 newborns were admitted.
Background: Optimal feeding of very low birthweight (VLBW <1500 g)/very preterm (gestation <32 weeks) infants in resource-limited settings in sub-Saharan Africa (sSA) is critical to reducing high mortality and poor outcomes.
Objective: To review evidence on feeding of VLBW/very preterm infants relevant to sSA.
Methods: We searched the Cochrane Database of Systematic Reviews, Embase, PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to July 2019 to identify reviews of randomised and quasi-randomised controlled trials of feeding VLBW/very preterm infants.
Safety professionals should speak up when secondary school teachers and FFA advisors consider fabricating and installing low-cost rollover protective structures (ROPS) as service learning projects for ag education students or as a service to the farm community. These projects are often motivated by the desire to address the continued occurrence of tractor rollovers, which are the most frequent cause of farm-related fatalities (NIOSH, 2018). These projects have also been made feasible by the availability of online plans for ROPS fabrication, including plans from the National Institute for Occupational Safety and Health (NIOSH) that are designed for specific makes and models of tractors.
View Article and Find Full Text PDFBackground: Exclusive breastfeeding up to 6 months of age is recommended by the World Health Organization as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. Breastfeeding can be adversely affected by individual, cultural and socio-economic factors. The study aimed to explore barriers of exclusive breastfeeding in the first 6 months of life among first-time mothers in rural Kenya.
View Article and Find Full Text PDFChronic wounds in patients suffering from type II diabetes mellitus (DMII) where wounds remain open with a complicated pathophysiology, healing, and recovery process is a public health concern. Normal wound healing plays a critical role in wound closure, restoration of mechanical properties, and the biochemical characteristics of the remodeled tissue. Biological scaffolds provide a tissue substitute to help facilitate wound healing by mimicking the extracellular matrix (ECM) of the dermis.
View Article and Find Full Text PDFReestablishing exclusive breastfeeding is the cornerstone of the 2013 World Health Organization (WHO) treatment guidelines for acute malnutrition in infants less than 6 months. However, no studies have investigated guideline implementation and subsequent outcomes in a public hospital setting in Africa. To facilitate implementation of the WHO 2013 guidelines in Kilifi County Hospital, Kenya, we developed standard operating procedure, recruited, and trained three breastfeeding peer supporters (BFPS).
View Article and Find Full Text PDFAs opposed to syndromic CNVs caused by single genes, extensive phenotypic heterogeneity in variably-expressive CNVs complicates disease gene discovery and functional evaluation. Here, we propose a complex interaction model for pathogenicity of the autism-associated 16p11.2 deletion, where CNV genes interact with each other in conserved pathways to modulate expression of the phenotype.
View Article and Find Full Text PDFBackground: The World Health Organization (WHO)/UNICEF Baby-Friendly Hospital Initiative step number five of the "Ten steps to successful breastfeeding" states "Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants." Urban mothers in Nairobi have low rates of exclusive breastfeeding after returning to work but there are no published data on rural Kenya mothers' infant feeding practices when working or schooling away from home.
Methods: We explored knowledge of, and attitudes to, the practice of giving expressed breastmilk in a mixed methods observational study of breastfeeding in rural Kenyan mothers.
Background: Exclusive breastfeeding for the first 6 months of life is currently recommended by the World Health Organization, but mixed feeding earlier than this commonly occurs in rural coastal Kenya. Mothers may receive conflicting advice on breastfeeding from various sources including health workers, relatives and community members. We aimed to find out how first-time mothers learn to breastfeed, who advises them on infant feeding and what advice they obtain in case of any breastfeeding problems.
View Article and Find Full Text PDFBackground: Ready-to-use therapeutic foods (RUTF) are lipid-based pastes widely used in the treatment of acute malnutrition. Current specifications for RUTF permit a high n-6 polyunsaturated fatty acid (PUFA) content and low n-3 PUFA, with no stipulated requirements for preformed long-chain n-3 PUFA. The objective of this study was to develop an RUTF with elevated short-chain n-3 PUFA and measure its impact, with and without fish oil supplementation, on children's PUFA status during treatment of severe acute malnutrition.
View Article and Find Full Text PDFBackground: Children presenting to hospital with recent or current Plasmodium falciparum malaria are at increased the risk of invasive bacterial disease, largely enteric gram-negative organisms (ENGO), which is associated with increased mortality and recurrent morbidity. Although incompletely understood, the most likely source of EGNO is the bowel. We hypothesised that as a result of impaired gut-barrier function endotoxin (lipopolysaccharide), present in the cell-wall of EGNO and in substantial quantities in the gut, is translocated into the bloodstream, and contributes to the pathophysiology of children with severe malaria.
View Article and Find Full Text PDFObjectives: To develop a predictive model of spatial release from masking (SRM) for cochlear implantees, and validate this model against data from the literature. To establish the spatial configurations for which the model predicts a large advantage of bilateral over unilateral implantation. To collect data to support these predictions and generate predictions of more typical advantages of bilateral implantation.
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