The prevalence and under-reporting of needle-stick injuries among dental healthcare workers in Pakistan: a systematic review

Needlestick injuries (NSIs) are a major occupational health problem among dental healthcare workers (HCWs) in Pakistan, which places them at a significant risk of acquiring blood-borne infections. However, not all NSIs are reported, leading to an underestimation of the actual prevalence. The harmful impacts of NSIs on the healthcare delivery necessitate an urgent need to measure its actual prevalence. Objectives. The aim of this study was to review literature to estimate the prevalence and reporting rates of NSIs among dental-HCWs in Pakistan. Methods. 713 potentially relevant citations were identified by electronic databases and hand searching of articles. Nine primary studies were subsequently identified to be included in the review. Results. The results of the included studies indicate that the prevalence of NSIs among Pakistani dental-HCWs was between 30% and 73%. The rate of reporting of NSIs was between 15% and 76%, and the most common reason was found to be the lack of awareness regarding the reporting system, or of the need to report NSIs. Conclusion. It is evident from the review of the included studies that there is a significantly high prevalence and a low rate of reporting of NSIs among dental-HCWs in Pakistan, suggesting the need to setup an occupational health department in dental settings, for preventing, managing, recording, and monitoring NSIs

Understanding working-class learning with Bourdieu: Yorkshire, 1820-1900

Working-class adult learning was a significant feature of political agitation, industrial religion, and civic associations between 1820 and 1900. The importance of learning was such that all working-class political movements had stated educational aims, and most religious denominations used adult education to retain the loyalty of their congregations. The educational efforts of so many impoverished adults initially seem to challenge Pierre Bourdieu’s theory that social inequalities are reproduced because individuals in subordinate groups are discouraged from acquiring cultural capital. Nevertheless, working people saw knowledge as socially valuable, and generally prioritised forms of cultural capital that Bourdieu regards as ‘legitimate’. Therefore, using Bourdieu’s conceptual tools to understand adult education offers a way of understanding the complexities of motivations to learn as well as the methods and impact of learning for working people. Research has demonstrated the dialectical nature of the relationship between learning and political agitation before 1850. Historians tend to overplay the significance of a subsequent shift towards individualist middle-class educational values after 1850. Using Bourdieu’s conceptual tools of habitus, capital, and field to analyse the working-class learning in mechanics’ institutes and mutual improvement societies in Yorkshire demonstrates that this is an oversimplification. Whilst working-class individuals and associations unconsciously recreated aspects of bourgeois culture in their learning, we should reject the implication that learners accepted the bourgeois logic of the social and political field

COVID-19-related school closures and patterns of hospital admissions with stress-related presentations in secondary school-aged adolescents: weekly time series

This study examines health service indicators of stress-related presentations (relating to pain, mental illness, psychosomatic symptoms and self-harm) in adolescents of secondary school age, using Hospital Episode Statistics data for England. We examined weekly time series data for three academic years spanning the time before (2018-2019) and during the COVID-19 pandemic (2019-2020 and 2020-2021), including the first lockdown when schools were closed to the majority of pupils. For all secondary school children, weekly stress presentations dropped following school closures. However, patterns of elevated stress during school terms re-established after reopening, with girls aged 11-15 showing an overall increase compared with pre-pandemic rates

Structure- and context-based analysis of the GxGYxYP family reveals a new putative class of glycoside hydrolase.

BackgroundGut microbiome metagenomics has revealed many protein families and domains found largely or exclusively in that environment. Proteins containing the GxGYxYP domain are over-represented in the gut microbiota, and are found in Polysaccharide Utilization Loci in the gut symbiont Bacteroides thetaiotaomicron, suggesting their involvement in polysaccharide metabolism, but little else is known of the function of this domain.ResultsGenomic context and domain architecture analyses support a role for the GxGYxYP domain in carbohydrate metabolism. Sparse occurrences in eukaryotes are the result of lateral gene transfer. The structure of the GxGYxYP domain-containing protein encoded by the BT2193 locus reveals two structural domains, the first composed of three divergent repeats with no recognisable homology to previously solved structures, the second a more familiar seven-stranded β/α barrel. Structure-based analyses including conservation mapping localise a presumed functional site to a cleft between the two domains of BT2193. Matching to a catalytic site template from a GH9 cellulase and other analyses point to a putative catalytic triad composed of Glu272, Asp331 and Asp333.ConclusionsWe suggest that GxGYxYP-containing proteins constitute a novel glycoside hydrolase family of as yet unknown specificity

Trends in survival of children with severe congenital heart defects by gestational age at birth: A population‐based study using administrative hospital data for England

BACKGROUND: Children with congenital heart defects (CHD) are twice as likely as their peers to be born preterm (<37 weeks' gestation), yet descriptions of recent trends in long-term survival by gestational age at birth (GA) are lacking. OBJECTIVES: To quantify changes in survival to age 5 years of children in England with severe CHD by GA. METHODS: We estimated changes in survival to age five of children with severe CHD and all other children born in England between April 2004 and March 2016, overall and by GA-group using linked hospital and mortality records. RESULTS: Of 5,953,598 livebirths, 5.7% (339,080 of 5,953,598) were born preterm, 0.35% (20,648 of 5,953,598) died before age five and 3.6 per 1000 (21,291 of 5,953,598) had severe CHD. Adjusting for GA, under-five mortality rates fell at a similar rate between 2004-2008 and 2012-2016 for children with severe CHD (adjusted hazard ratio [HR] 0.79, 95% CI 0.71, 0.88) and all other children (HR 0.78, 95% CI 0.76, 0.81). For children with severe CHD, overall survival to age five increased from 87.5% (95% CI 86.6, 88.4) in 2004-2008 to 89.6% (95% CI 88.9, 90.3) in 2012-2016. There was strong evidence for better survival in the ≥39-week group (90.2%, 95% CI 89.1, 91.2 to 93%, 95% CI 92.4, 93.9), weaker evidence at 24-31 and 37-38 weeks and no evidence at 32-36 weeks. We estimate that 51 deaths (95% CI 24, 77) per year in children with severe CHD were averted in 2012-2016 compared to what would have been the case had 2004-2008 mortality rates persisted. CONCLUSIONS: Nine out of 10 children with severe CHD in 2012-2016 survived to age five. The small improvement in survival over the study period was driven by increased survival in term children. Most children with severe CHD are reaching school age and may require additional support by schools and healthcare services

Umbrella systematic review finds limited evidence that school absence explains the association between chronic health conditions and lower academic attainment

INTRODUCTION: Absence from school is more frequent for children with chronic health conditions (CHCs) than their peers and may be one reason why average academic attainment scores are lower among children with CHCs. METHODS: We determined whether school absence explains the association between CHCs and academic attainment through a systematic review of systematic reviews of comparative studies involving children with or without CHCs and academic attainment. We extracted results from any studies that tested whether school absence mediated the association between CHCs and academic attainment. RESULTS: We identified 27 systematic reviews which included 441 unique studies of 7, 549, 267 children from 47 jurisdictions. Reviews either covered CHCs generally or were condition-specific (e.g., chronic pain, depression, or asthma). Whereas reviews found an association between a range of CHCs (CHCs generally, cystic fibrosis, hemophilia A, end-stage renal disease (pre-transplant), end-stage kidney disease (pre-transplant), spina bifida, congenital heart disease, orofacial clefts, mental disorders, depression, and chronic pain) and academic attainment, and though it was widely hypothesized that absence was a mediator in these associations, only 7 of 441 studies tested this, and all findings show no evidence of absence mediation. CONCLUSION: CHCs are associated with lower academic attainment, but we found limited evidence of whether school absence mediates this association. Policies that focus solely on reducing school absence, without adequate additional support, are unlikely to benefit children with CHCs. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=285031, identifier: CRD42021285031

‘No outlines’: From dystopia to heterotopia in Howard Jacobson’s J.

This article suggests that a dystopian reading of Howard Jacobson’s 2014 novel, J, is not necessarily the only way in which to reflect on both the inner and outer topographies of the narrative. In tilting the focus of enquiry, the article draws from Foucault’s brief, but intriguing, thoughts on heterotopia. It suggests that this kind of heterotopian thinking potentially opens up a deconstructive questioning of terms such as utopia and dystopia. In particular, the article teases out some of the ways in which Jewishness intersects with these themes. The analysis focuses on the section towards the mid-point of J when the protagonists, Kevern and Ailinn, visit the capital city of a bleak new world. It is a profoundly dislocated and disconcerting space, described as ‘a city seen through a sheet of scratched Perspex….it had no outlines’. Within this distorted setting, Jacobson presents a sustained exploration of Jewishness, an identity that is placed, simultaneously, at both the centre and the edges of the text