Bladder and Bowel Symptoms, Dementia and Responsive Behaviors: An Integrative Review

Background: Dementia has become a worldwide healthcare and research focus. However, there is currently little research linking bladder and bowel symptoms with responsive behaviors in dementia. Aim: The aim of this integrative review was to identify research literature that explores the role of bladder and bowel symptoms as triggers of responsive behaviors  in persons with dementia. Design: This integrative review was informed by the method of Whittemore and Knafl and guidelines by Torraco. Methods: Electronic databases of Ovid Medline, Embase, PSYCInfo, Cochrane, EBSCO/CINAHL, Scopus, and Web of Science were searched. Five studies met inclusion criteria. They were assessed for quality using the Mixed Methods Appraisal Tool. Studies were compared, analyzed, and synthesized. Results: The categories developed were: (1) bladder and bowel symptoms examined, (2) relationship of behavior measurement to responsive behaviors, and (3) associations between incontinence and behaviors symptoms. Conclusion: The findings of this investigation demonstrate a limited understanding of the association between bladder and bowel symptoms with responsive behaviors. The conceptualization of behaviors as problems was evident in the studies. This conceptualization is not reflective of a contemporary view of behaviors as an expression of an unmet need. Future research is needed to understand the association between bladder and bowel symptoms and responsive behaviors

The African Field Epidemiology Network-Networking for effective field epidemiology capacity building and service delivery

Networks are a catalyst for promoting common goals and objectives of their membership. Public Health networks in Africa are crucial, because of the severe resource limitations that nations face in dealing with priority public health problems. For a long time, networks have existed on the continent and globally, but many of these are disease-specific with a narrow scope. The African Field Epidemiology Network (AFENET) is a public health network established in 2005 as a non-profit networking alliance of Field Epidemiology and Laboratory Training Programs (FELTPs) and Field Epidemiology Training Programs (FETPs) in Africa. AFENET is dedicated to helping ministries of health in Africa build strong, effective and sustainable programs and capacity to improve public health systems by partnering with global public health experts. The Network's goal is to strengthen field epidemiology and public health laboratory capacity to contribute effectively to addressing epidemics and other major public health problems in Africa. AFENET currently networks 12 FELTPs and FETPs in sub-Saharan Africa with operations in 20 countries. AFENET has a unique tripartite working relationship with government technocrats from human health and animal sectors, academicians from partner universities, and development partners, presenting the Network with a distinct vantage point. Through the Network, African nations are making strides in strengthening their health systems. Members are able to: leverage resources to support field epidemiology and public health laboratory training and service delivery notably in the area of outbreak investigation and response as well as disease surveillance; by-pass government bureaucracies that often hinder and frustrate development partners; and consolidate efforts of different partners channelled through the FELTPs by networking graduates through alumni associations and calling on them to offer technical support in various public health capacities as the need arises. AFENET presents a bridging platform between governments and the private sector, allowing for continuity of health interventions at the national and regional level while offering free exit and entry for existing and new partners respectively. AFENET has established itself as a versatile networking model that is highly responsive to members’ needs. Based on the successes recorded in AFENET's first 5 years, we envision that the Network's membership will continue to expand as new training programs are established. The lessons learned will be useful in initiating new programs and building sustainability frameworks for FETPs and FELTPs in Africa. AFENET will continue to play a role in coordinating, advocacy, and building capacity for epidemic disease preparedness and response

Rapid Influenza Antigen Test for Diagnosis of Pandemic (H1N1) 2009

We compared the QuickVue Influenza test with PCR for diagnosing pandemic (H1N1) 2009 in 404 persons with influenza-like illness. Overall sensitivity, specificity, and positive and negative predictive values were 66%, 84%, 84%, and 64%, respectively. Rapid test results should be interpreted cautiously when pandemic (H1N1) 2009 virus is suspected

Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health

The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries

A large and persistent outbreak of typhoid fever caused by consuming contaminated water and street-vended beverages: Kampala, Uganda, January - June 2015.

BACKGROUND: On 6 February 2015, Kampala city authorities alerted the Ugandan Ministry of Health of a "strange disease" that killed one person and sickened dozens. We conducted an epidemiologic investigation to identify the nature of the disease, mode of transmission, and risk factors to inform timely and effective control measures. METHODS: We defined a suspected case as onset of fever (≥37.5 °C) for more than 3 days with abdominal pain, headache, negative malaria test or failed anti-malaria treatment, and at least 2 of the following: diarrhea, nausea or vomiting, constipation, fatigue. A probable case was defined as a suspected case with a positive TUBEX® TF test. A confirmed case had blood culture yielding Salmonella Typhi. We conducted a case-control study to compare exposures of 33 suspected case-patients and 78 controls, and tested water and juice samples. RESULTS: From 17 February-12 June, we identified 10,230 suspected, 1038 probable, and 51 confirmed cases. Approximately 22.58% (7/31) of case-patients and 2.56% (2/78) of controls drank water sold in small plastic bags (ORM-H = 8.90; 95%CI = 1.60-49.00); 54.54% (18/33) of case-patients and 19.23% (15/78) of controls consumed locally-made drinks (ORM-H = 4.60; 95%CI: 1.90-11.00). All isolates were susceptible to ciprofloxacin and ceftriaxone. Water and juice samples exhibited evidence of fecal contamination. CONCLUSION: Contaminated water and street-vended beverages were likely vehicles of this outbreak. At our recommendation authorities closed unsafe water sources and supplied safe water to affected areas

Managed Aquifer Recharge as a Tool to Enhance Sustainable Groundwater Management in California

A growing population and an increased demand for water resources have resulted in a global trend of groundwater depletion. Arid and semi-arid climates are particularly susceptible, often relying on groundwater to support large population centers or irrigated agriculture in the absence of sufficient surface water resources. In an effort to increase the security of groundwater resources, managed aquifer recharge (MAR) programs have been developed and implemented globally. MAR is the approach of intentionally harvesting and infiltrating water to recharge depleted aquifer storage. California is a prime example of this growing problem, with three cities that have over a million residents and an agricultural industry that was valued at 47 billion dollars in 2015. The present-day groundwater overdraft of over 100 km3 (since 1962) indicates a clear disparity between surface water supply and water demand within the state. In the face of groundwater overdraft and the anticipated effects of climate change, many new MAR projects are being constructed or investigated throughout California, adding to those that have existed for decades. Some common MAR types utilized in California include injection wells, infiltration basins (also known as spreading basins, percolation basins, or recharge basins), and low-impact development. An emerging MAR type that is actively being investigated is the winter flooding of agricultural fields using existing irrigation infrastructure and excess surface water resources, known as agricultural MAR. California therefore provides an excellent case study to look at the historical use and performance of MAR, ongoing and emerging challenges, novel MAR applications, and the potential for expansion of MAR. Effective MAR projects are an essential tool for increasing groundwater security, both in California and on a global scale. This chapter aims to provide an overview of the most common MAR types and applications within the State of California and neighboring semi-arid regions

CDC's COVID-19 International Vaccine Implementation and Evaluation Program and Lessons from Earlier Vaccine Introductions.

The US Centers for Disease Control and Prevention (CDC) supports international partners in introducing vaccines, including those against SARS-CoV-2 virus. CDC contributes to the development of global technical tools, guidance, and policy for COVID-19 vaccination and has established its COVID-19 International Vaccine Implementation and Evaluation (CIVIE) program. CIVIE supports ministries of health and their partner organizations in developing or strengthening their national capacities for the planning, implementation, and evaluation of COVID-19 vaccination programs. CIVIE's 7 priority areas for country-specific technical assistance are vaccine policy development, program planning, vaccine confidence and demand, data management and use, workforce development, vaccine safety, and evaluation. We discuss CDC's work on global COVID-19 vaccine implementation, including priorities, challenges, opportunities, and applicable lessons learned from prior experiences with Ebola, influenza, and meningococcal serogroup A conjugate vaccine introductions

Study Protocol: Cannabis in the Closet? Older Persons' Perceptions of Stigma and their Influence on Use and Access to Medicinal Cannabis

Background: Cannabis has been used for medicinal purposes for millennia. Stigma associated with cannabis use may influence older persons access to cannabis, information seeking about cannabis, and/or use of cannabis. Scant research has sought to examine the impact of older persons’ perceptions of stigma on the ways they learn about and use medicinal cannabis, with important implications for their health. Methods/Design: In this qualitative descriptive study, we will seek older persons’ information needs and challenges accessing cannabis from older persons and professionals who work in the cannabis industry. Using open ended questions, we will survey and interview older persons who use cannabis or are considering using it about their perceptions of stigma, information seeking, choice of cannabis product, and preferred vendor. Professionals who work with cannabis will be interviewed for their experiences with older persons seeking information about and access to cannabis. Discussion: Findings will identify what information related to medicinal cannabis use older Canadians most urgently need, shed light on any stigma they fear and/or experience when searching for such information, and inform the development of information products and knowledge mobilization strategies tailored to older Canadians’ knowledge needs.&nbsp