Medication wastage and its impact on environment: evidence from Malaysia

The purpose of this study is to investigate the critical factors that have impact on environment causes of unused medication. The current study is a descriptive cross-sectional audit involving with patients based on a structured questionnaire format with answer sets. The data is analyzed using partial least square method. The results revealed that excess supplied, expired medicine, changed treatment and side effects have a significant impact on unused medication. In addition, overall unused medication has a significant relationship with environmental effect. In contrast, although excess supplied and side effects have not significant impact on environmental effect, but expired medicine and changed treatment have a significant impact on environmental effect. This survey results suggested; there are few factors which increased the volume of leftover medicine and it has led to an enhanced international awareness of the potential detrimental effects on the environment. More exertion is necessary to raise awareness of people in general as an initial step in promoting behavioral change in connection to medication wastage

Oral Doxycycline on the Level of Matrix Metalloproteinase 9 in Rat Models Experiencing Traumatic Brain Injury

  INTRODUCTION: Cerebral edema in traumatic brain injury (TBI) results from hyperpermeability of the bloodbrain barrier (BBB). One of the causes in BBB permeability disorders is the activation of matrix metalloproteinase 9 (MMP-9) which can be inhibited by the administration of doxycycline. Knowing the role of oral doxycycline administration as an inhibitor of MMP-9 activation on the level of MMP-9 in cerebral edema in traumatic brain injury. MATERIALS AND METHODS: This study was an experimental study in Wistar rats with a post-test control design consisting of one control group, one group with provoked brain injury, and one group with provoked brain injury followed by oral doxycycline administration. RESULT: There were significant differences in the level of MMP -9 between the control group, the provoked brain injury group and the provoked brain injury group followed by oral doxycycline administration with p-value = 0.01 (p<0.05). CONCLUSION: Oral doxycycline administration can inhibit the increase of MMP-9 levels in cerebral edema in traumatic brain injury in Wistar rats

Prevention Research Centers and COVID-19: Models of a Community-Engaged Response to a Public Health Emergency

For more than 30 years, the network of Centers for Disease Control and Prevention (CDC)–funded Prevention Research Centers (PRCs) has worked with local communities and partners to implement and evaluate public health interventions and policies for the prevention of disease and promotion of health. The COVID-19 pandemic tested the PRC network’s ability to rapidly respond to multiple, simultaneous public health crises. On April 28, 2020, to assess the network’s engagement with activities undertaken in response to the early phase of the pandemic, PRC network leadership distributed an online survey to the directors of 34 currently or formerly funded PRCs, asking them to report their PRCs’ engagement with predetermined activities across 9 topical areas and provide case studies exemplifying that engagement. We received responses from 24 PRCs, all of which reported engagement with at least 1 of the 9 topical areas (mean, 5). The topical areas with which the greatest number of PRCs reported engagement were support of frontline agencies (21 of 24, 88%) and support of activities related to health care (21 of 24, 88%). The mean number of activities with which PRCs reported engagement was 11. The PRCs provided more than 90 case studies exemplifying their work. The results of the survey indicated that the PRCs mobilized their personnel and resources to support the COVID-19 response in less than 6 weeks. We posit that the speed of this response was due, in part, to the broad and diverse expertise of PRC personnel and long-standing partnerships between PRCs and the communities in which they work

Reading and numeracy attainment of children reported to child protection services: A population record linkage study controlling for other adversities

Background: Maltreated children are at risk of poor educational outcomes, but also experience greater individual, family, and neighbourhood adversities that may obscure an understanding of relationships between child protection involvement and educational attainment. Objective: To examine associations between child protection involvement and 3rd- and 5th-grade reading and numeracy attainment, while controlling multiple other adversities. Participants and Setting Participants were 56,860 Australian children and their parents from the New South Wales Child Development Study with linked multi-agency records. Methods: Multinomial logistic regressions examined associations between level of child protection involvement (Out-Of-Home Care [OOHC] placement; substantiated Risk Of Significant Harm [ROSH]; unsubstantiated ROSH; non-ROSH; and no child protection report) and standardised tests of 3rd- and 5th-grade reading and numeracy. Fully adjusted models controlled demographic, pregnancy, birth, and parental factors, and early (kindergarten) developmental vulnerabilities on literacy and numeracy, and other developmental domains (social, emotional, physical, communication). Results: All children with child protection reports were more likely to attain below average, and less likely to attain above average, 3rd- and 5th-grade reading and numeracy, including children with reports below the ROSH threshold. Children with substantiated ROSH reports who were not removed into care demonstrated the worst educational attainment, with some evidence of protective effects for children in OOHC. Conclusions: A cross-agency response to supporting educational attainment for all children reported to child protection services is required, including targeted services for children in OOHC or with substantiated ROSH reports, and referral of vulnerable families (unsubstantiated and non-ROSH cases) to secondary service organisations (intermediate intervention).Kristin R.Laurens, Fahkrul Islam, Maina Kariuki, Felicity Harris, Marilyn Chilvers ... Sally A.Brinkman ... et al

Impacto de sulfentrazona, isoxaflutol e oxyfluorfem sobre a microbiota de dois solos florestais

Questões referentes à aplicação de herbicidas em pré-emergência das plantas daninhas na cultura do eucalipto merecem destaque devido ao impacto dessa prática no ambiente, principalmente sobre a atividade microbiana do solo e micro-organismos benéficos, como os fungos micorrízicos e os solubilizadores de fosfatos. Objetivou-se estudar o impacto da aplicação dos herbicidas sulfentrazona, isoxaflutol e oxyfluorfem sobre a colonização micorrízica, biomassa e atividade microbiana de dois solos florestais cultivados com eucalipto. O ensaio foi conduzido em casa de vegetação utilizando um solo argiloso e um solo francoarenoso distribuídos em vasos de 12 dm³. O esquema fatorial utilizado foi 4 x 3, sendo três herbicidas (sulfentrazona, isoxaflutol e oxyfluorfem) mais a testemunha e três avaliações (5, 20 e 70 dias após a aplicação - DAA), no delineamento inteiramente casualizado com quatro repetições. Após a aplicação dos herbicidas na dose recomendada para a cultura transplantaram-se as mudas do híbrido de Eucalyptus grandis x E. urophylla. Avaliaram-se a biomassa microbiana, a taxa respiratória do solo, o quociente metabólico e o potencial de solubilização de fosfato inorgânico aos 5, 20 e 70 DAA. Aos 70 DAA verificou-se a colonização micorrízica e a viabilidade de esporos. Os herbicidas sulfentrazona, isoxaflutol e oxyfluorfem, bem como o tempo decorrido da aplicação afetaram os indicadores microbiológicos de maneira diferenciada. No solo franco-arenoso, o sulfentrazona foi mais prejudicial à biomassa microbiana, à colonização micorrízica e aos micro-organismos solubilizadores de fosfato inorgânico. No solo argiloso, no entanto, a aplicação dos três herbicidas não afetou a biomassa microbiana, mas reduziu a colonização radicular do eucalipto por fungos micorrízicos arbusculares e o potencial de solubilização de fosfato inorgânico. O herbicida sulfentrazona se destacou por provocar aumento do número de esporos não viáveis de fungos micorrízicos arbusculares nesse solo

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe