Infrastructure, WASH Practices, and Health: a study of rural communities in São Tomé e Príncipe

Introdução: Melhorar os comportamentos de higiene e o saneamento (WASH) é uma maneira económica de reduzir os problemas que as doenças da pobreza e das doenças tropicais trazem, especialmente em comunidades pobres. Em setembro de 2016, um surto de infeções de pele foi acompanhado pela Organização Mundial da Saúde e os questionários aplicados evidenciaram que as questões de higiene em São Tomé e Príncipe merecem mais atenção, principalmente nas comunidades rurais da ilha. Assim, este estudo teve como objetivo caracterizar o comportamento de WASH e as infraestruturas relacionadas com três comunidades rurais, a fim de identificar áreas com maiores necessidades, explorando como os comportamentos em termos de WASH e outros fatores relacionam com alguns problemas de saúde relatados no último mês. Material e Métodos: Este estudo transversal ocorreu entre fevereiro e abril de 2019, no distrito de Lobata, em São Tomé e Príncipe, tendo-se recolhido uma amostra aleatória de dimensão n=162. Para a seleção aleatória usou-se a aplicação Random UX. Os dados foram recolhidos através de um questionário digitalizado no programa Qualtrics e aplicado a residentes adultos em três comunidades rurais: C - Canavial (n=56), P - Plancas (n=49) e I - Ilheu (n=57). Após uma análise exploratória de dados e testes de hipóteses (paramétricos e não-paramétricos), utilizaram-se modelos Log-lineares e de regressão logística simples e múltipla. Resultados: Encontramos diferenças significativas no uso de fontes naturais de água e na melhoria dos locais de lavagem de roupas entre as três comunidades. Relativamente as latrinas nota-se que faltam nas três comunidades. Canavial e Plancas parecem ter practices menos adequadas. Apenas 8.0% dos participantes no estudo relataram que têm acesso a caso de banho, com diferenças significativas por comunidade (8.9% C; 0.0% P e 14.0% I, p=0.015). Em termos de acesso a uma latrina há diferenças muito significativas entre as três comunidades (7.1% C; 22.3% P e 40.4% I, p<0.001). Em termos de água canalizada, as percentagens são também reduzidas (5.4% C; 0.0% P e 19.3% I, p=0.001). Também identificamos associações entre o uso de fontes naturais de água para beber e outros usos, e o uso de fontes naturais de água para limpar roupas e mais problemas de saúde no mês anterior à recolha de dados. O uso de recipientes fechados para o armazenamento de água foi associado a menos problemas de saúde, sendo um possível fator de proteção de reduzido custo que pode ser útil para intervir nessas comunidades. Conclusões: Neste estudo registou-se a falta de casas de banho, latrinas e água apropriadas em todas as comunidades e registam-se práticas menos adequadas de WASH, principalmente, em Canavial e Plancas. São necessárias mais pesquisas sobre a qualidade das fontes naturais de água, para entender melhor os riscos que esse tipo de armazenamento de água pode trazer a estas comunidades.Improving hygiene and sanitation (WASH) behaviors is an cost effective and sustainable way to reduce the problems that diseases of poverty and tropical diseases bring, especially in poor communities. In September 2016, an outbreak of necrotizing fasciitis was reported and monitored by the World Health Organization and subsequent inquiries suggested hygiene issues in Sao Tome and Principe that merit further attention, especially in the rural communities of the island. Thus, the aim of the study is to characterize the WASH behavior and related infrastructure of the three rural communities in order to identify areas of greatest need, exploring how WASH behaviors and other factors relate to some reported health problems. Materials and Methods: This cross-sectional study took place between February and April 2019, in the Lobata district of São Tomé and Príncipe, and a random sample size n = 162 was collected. For random selection the Random UX application was used. Data were collected through a digitized Qualtrics questionnaire and applied to adult residents in three rural communities: C - Canavial (n = 56), P - Plancas (n = 49) and I - Ilheu (n = 57). After an exploratory data analysis and hypothesis tests (parametric and non-parametric), a log-linear analysis and simple and multiple logistic regression models were developed and run. Results: We found significant differences in the use of natural sources of water and improved washing facilities between the three communities. Furthermore, a serious lack of appropriate latrines in all communities and sub-optimal WASH practices in Canavial and Plancas. Only 8.0% of study participants reported having access to bathrooms, with significant differences by community (8.9% C; 0.0% P and 14.0% I, p = 0.015). there were significant differences between the three communities in terms of latrine access (7.1% C; 22.3% P and 40.4% I, p <0.001). Regarding indoor plumbing, the percentages are also low (5.4% C; 0.0% P and 19.3% I, p = 0.001). We also identified associations between the use of natural sources of water (for both drinking and other uses) and the use of natural water sources to clean clothes with more health problems in the month prior to data collection. Finally, the use of closed bottles for water storage has been associated with fewer health problems, a possible low-cost protection factor that may be useful for intervening in these communities. Conclusions: In this study, a lack of adequate bathrooms, latrines and sources of clean water in all communities was identified, as well as less than adequate WASH practices, mainly in Canavial and Plancas. Further research on the quality of natural water sources is needed to better understand the risks that such types of water storage may bring to these communities

Recreation and alcohol consumption in Sub-Saharan Africa: addressing gender and age differences in urban areas (Praia, Cabo Verde)

Background: Reducing alcohol consumption and improving urban planning in African cities are public health priorities. The aim of this study was to explore gender and age differences in recreational activity participation and their link with self-reported alcohol consumption in three urban areas of Praia. Methods: A questionnaire was applied to a probabilistic sample of 1912 adults, with a median age of 35.0 (IQR: 26.0–48.8) years, living in informal, transition, and formal areas of the capital of Cabo Verde. Results: More than 80% of the participants reported rarely or never participating in recreational activities. Going daily or weekly to the café was the most reported recreational activity, regardless of the urban area. Participation in recreational activities was higher in men than women, decreasing with age in both cases. Alcohol consumption was significantly higher in men than in women (72.4% versus 47.4%, p < 0.001). Multiple logistic regression models showed that going at least once to the bar/nightclub (for men and women) and going to the café (for women) were associated with alcohol consumption. Furthermore, age (for women), in a protective way, and having children (for men) appeared to be associated with alcohol consumption. Conclusions: This study provides new data on the recreational environment in Praia and can contribute to the development of local and national public health policies and interventions in line with several SDGs to reduce alcohol consumption, enhance healthy leisure/recreation practices, and promote better living conditions for its inhabitants.info:eu-repo/semantics/publishedVersio

Restaurant menu design and more responsible consumer food choice: An exploratory study of managerial perceptions

The restaurant sector imposes substantial impacts on the environment and society. A large share of the sector's negative impacts is attributed to irresponsible consumer choice. To enhance sustainability of food service provision, consumer choice ought to be architected to make it more responsible. Restaurant menu can be (re-)designed to inform customers about the environmental and societal implications of their choice and thus ‘nudge’ selection of more benign food options. This study explores managerial opinions on the role of menu design in shaping more responsible consumer choice. It finds that while restaurateurs acknowledge rising customer awareness about the ramifications of their food choice on personal health and the environment, they are sceptical about the use of menu design as a means to positively affect consumer choice. The lack of internal resources to implement and maintain the required menu changes, inconstant customer demand, organisational and operational complexities represent the key barriers

DPEP1 Inhibits Tumor Cell Invasiveness, Enhances Chemosensitivity and Predicts Clinical Outcome in Pancreatic Ductal Adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers worldwide. To identify biologically relevant genes with prognostic and therapeutic significance in PDAC, we first performed the microarray gene-expression profiling in 45 matching pairs of tumor and adjacent non-tumor tissues from resected PDAC cases. We identified 36 genes that were associated with patient outcome and also differentially expressed in tumors as compared with adjacent non-tumor tissues in microarray analysis. Further evaluation in an independent validation cohort (N = 27) confirmed that DPEP1 (dipeptidase 1) expression was decreased (T: N ratio ∼0.1, P<0.01) in tumors as compared with non-tumor tissues. DPEP1 gene expression was negatively correlated with histological grade (Spearman correlation coefficient = −0.35, P = 0.004). Lower expression of DPEP1 in tumors was associated with poor survival (Kaplan Meier log rank) in both test cohort (P = 0.035) and validation cohort (P = 0.016). DPEP1 expression was independently associated with cancer-specific mortality when adjusted for tumor stage and resection margin status in both univariate (hazard ratio = 0.43, 95%CI = 0.24–0.76, P = 0.004) and multivariate analyses (hazard ratio = 0.51, 95%CI = 0.27–0.94, P = 0.032). We further demonstrated that overexpression of DPEP1 suppressed tumor cells invasiveness and increased sensitivity to chemotherapeutic agent Gemcitabine. Our data also showed that growth factor EGF treatment decreased DPEP1 expression and MEK1/2 inhibitor AZD6244 increased DPEP1 expression in vitro, indicating a potential mechanism for DPEP1 gene regulation. Therefore, we provide evidence that DPEP1 plays a role in pancreatic cancer aggressiveness and predicts outcome in patients with resected PDAC. In view of these findings, we propose that DPEP1 may be a candidate target in PDAC for designing improved treatments

Multi-center feasibility study evaluating recruitment, variability in risk factors and biomarkers for a diet and cancer cohort in India

<p>Abstract</p> <p>Background</p> <p>India's population exhibits diverse dietary habits and chronic disease patterns. Nutritional epidemiologic studies in India are primarily of cross-sectional or case-control design and subject to biases, including differential recall of past diet. The aim of this feasibility study was to evaluate whether a diet-focused cohort study of cancer could be established in India, providing insight into potentially unique diet and lifestyle exposures.</p> <p>Methods</p> <p>Field staff contacted 7,064 households within three regions of India (New Delhi, Mumbai, and Trivandrum) and found 4,671 eligible adults aged 35-69 years. Participants completed interviewer-administered questionnaires (demographic, diet history, physical activity, medical/reproductive history, tobacco/alcohol use, and occupational history), and staff collected biological samples (blood, urine, and toenail clippings), anthropometric measurements (weight, standing and sitting height; waist, hip, and thigh circumference; triceps, sub-scapula and supra-patella skin fold), and blood pressure measurements.</p> <p>Results</p> <p>Eighty-eight percent of eligible subjects completed all questionnaires and 67% provided biological samples. Unique protein sources by region were fish in Trivandrum, dairy in New Delhi, and pulses (legumes) in Mumbai. Consumption of meat, alcohol, fast food, and soft drinks was scarce in all three regions. A large percentage of the participants were centrally obese and had elevated blood glucose levels. New Delhi participants were also the least physically active and had elevated lipids levels, suggesting a high prevalence of metabolic syndrome.</p> <p>Conclusions</p> <p>A high percentage of participants complied with study procedures including biological sample collection. Epidemiologic expertise and sufficient infrastructure exists at these three sites in India to successfully carry out a modest sized population-based study; however, we identified some potential problems in conducting a cohort study, such as limited number of facilities to handle biological samples.</p

Metabolites of Purine Nucleoside Phosphorylase (NP) in Serum Have the Potential to Delineate Pancreatic Adenocarcinoma

Pancreatic Adenocarcinoma (PDAC), the fourth highest cause of cancer related deaths in the United States, has the most aggressive presentation resulting in a very short median survival time for the affected patients. Early detection of PDAC is confounded by lack of specific markers that has motivated the use of high throughput molecular approaches to delineate potential biomarkers. To pursue identification of a distinct marker, this study profiled the secretory proteome in 16 PDAC, 2 carcinoma in situ (CIS) and 7 benign patients using label-free mass spectrometry coupled to 1D-SDS-PAGE and Strong Cation-Exchange Chromatography (SCX). A total of 431 proteins were detected of which 56 were found to be significantly elevated in PDAC. Included in this differential set were Parkinson disease autosomal recessive, early onset 7 (PARK 7) and Alpha Synuclein (aSyn), both of which are known to be pathognomonic to Parkinson's disease as well as metabolic enzymes like Purine Nucleoside Phosphorylase (NP) which has been exploited as therapeutic target in cancers. Tissue Microarray analysis confirmed higher expression of aSyn and NP in ductal epithelia of pancreatic tumors compared to benign ducts. Furthermore, extent of both aSyn and NP staining positively correlated with tumor stage and perineural invasion while their intensity of staining correlated with the existence of metastatic lesions in the PDAC tissues. From the biomarker perspective, NP protein levels were higher in PDAC sera and furthermore serum levels of its downstream metabolites guanosine and adenosine were able to distinguish PDAC from benign in an unsupervised hierarchical classification model. Overall, this study for the first time describes elevated levels of aSyn in PDAC as well as highlights the potential of evaluating NP protein expression and levels of its downstream metabolites to develop a multiplex panel for non-invasive detection of PDAC

Real-time monitoring of concrete–lattice-girder slabs during construction

This paper reports on the instrumentation, monitoring and some preliminary results from a real-time monitoring scheme of a hybrid concrete-lattice-girder slab flooring system. One of the key benefits of this monitoring project is improved understanding of in situ structural behaviour. Sensors were embedded in both the precast and in situ components of the floor system and were used to monitor various aspects of the behaviour of the floor during the manufacturing, construction and operational phases. Concrete strains and temperatures were measured, while environmental conditions were also monitored to assess their effects on the floor structure. The information from the real-time monitoring offered the opportunity to compare actual and predicted behaviour using structural codes, such as Eurocodes. Results on the early-age behaviour of the floor slab during the construction phase (strain, thermal cracking, restraint factors) are described in this paper