Integrating WASH and nutrition in market-based interventions: principles and results from the field

This paper outlines principles for integrating market-based approaches for improving WASH and nutrition. It draws on iDE’s experience implementing such programs, and specifically highlights learnings from iDE Bangladesh’s program Profitable Opportunities for Food Security (PROOFS), implemented in partnership with ICCO Cooperation, BoP Inc., and Edukans. PROOFS leverages market forces to increase food security, nutrition, and water and sanitation for smallholder farmers and base-ofpyramid consumers. The program recently concluded a pilot in which Nutrition Sales Agents added a set of WASH products to their existing “basket” of nutrition-related goods. The paper highlights principles for leveraging markets to achieve outcomes in WASH and nutrition. Specific insights involve aligning sales cycles, managing different sales and distribution channels, and ensuring that product margins provide profit opportunity for businesses and sales agents. These principles are underscored by observations from the WASH-Nutrition pilot, the final results of which will be available for the WEDC Conference

Incorporating a built environment module into an accelerated second degree community health nursing program

Environmental quality is a leading indicator of population health. Environmental health content has been integrated into the curriculum of an Accelerated Bachelor of Science in Nursing program for second-degree students through development of an environmental health nursing module for the final-semester community health nursing course. The module was developed through collaboration between two professional schools at Duke University (the School of Nursing and the Nicholas School of the Environment and Earth Sciences). It focused on the role of the built environment in community health and featured a mix of teaching strategies, including five components: (1) classroom lecture with associated readings, (2) two rounds of online small-group student discussions, (3) assessment of the built environment in local neighborhoods by student teams, (4) team presentation of the neighborhood assessments, and (5) individual student papers synthesizing the conclusions from all team presentations. The goal of the module was to provide nursing students with an organizing framework for integrating environmental health into clinical practice and an innovative tool for understanding community-level components of public health

Data_Sheet_1_Predictors of seasonal influenza and COVID-19 vaccination coverage among adults in Tennessee during the COVID-19 pandemic.docx

BackgroundThe COVID-19 pandemic has convoluted hesitancy toward vaccines, including the seasonal influenza (flu) vaccine. Because of COVID-19, the flu season has become more complicated; therefore, it is important to understand all the factors influencing the uptake of these vaccines to inform intervention targets. This article assesses factors related to the uptake of influenza and COVID-19 vaccines among adults in Tennessee.MethodsA cross-sectional, secondary data analysis of 1,400 adults was conducted in Tennessee. The adult sample came from two data sources: Data source 1 completed a baseline survey from January to March 2022, and data source 2 was completed from May to August 2022. Data on vaccine attitudes, facilitators and barriers, and communication needs were collected via random digit dial by Scientific Telephone Samples (STS). Two multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to predict sociodemographic and overall vaccine-related factors associated with receipt or non-receipt (referent) of COVID-19 and influenza vaccines.ResultsApproximately 78% of the adult sample had received the COVID-19 vaccination. A significant positive association for COVID-19 vaccine uptake was seen among those who were older (aged 50–65) (aOR = 1.9; 95% CI: 1.2–3.2), Black (aOR = 2.0; 95% CI:1.3–2.8), and had a college education and higher (aOR = 2.3; 95% CI: 1.5–3.6). However, there was a significant negative association for persons reporting they were extremely religious (aOR = 0.5; 95% CI:0.3–0.9). Over 56% of the adult sample had received the influenza vaccination this season. Those who had a higher annual household income ($80,000+) (aOR = 1.9; 95% CI: 1.3–2.6) and had health insurance (aOR = 2.6; 95% CI: 1.4–4.8) had a significant positive association with influenza vaccine receipt. However, those who were employed part-time or were unemployed had a significant negative association for influenza vaccine receipt (aOR = 0.7; 95% CI: 0.5–0.9). Both COVID-19 and influenza vaccine receipt had strongly significant positive trends with increasing belief in effectiveness and trust (p ConclusionStrategies to increase COVID-19 and influenza vaccination should be age-specific, focus on increasing geographical and financial access, and offer tailored messages to address concerns about these vaccines.</p

Additional file 1: Table S1. of Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates

Location of Clinic Visits by Region and State. (DOCX 31 kb

Additional file 1: Appendix S1. of A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-experimental study from Uganda

Pre-training facility assessment tool. Appendix S2. Quick Check + hospital assessment report of existing severe illness practices. Table S1. Characteristics of inpatient health facilities participating in SIMS intervention. Table S2. Diagnostic criteria for severe illness conditions covered in Quick Check + training program, as defined by the World Health Organization District Clinician Manual. Table S3a. Barriers to executing target behaviors*, as documented by hospital staff while formulating implementation plans and placed into COM-B domains. Table S3b. Intervention functions targeting identified barriers and facilitators as defined in the Behavioral Change Wheel framework. Table S4a Between-site variation in vital sign collection before and after SIMS introduction, by site. Table S4b. Between-site variation in impact of SIMS on vital sign collection, by vital sign. Figure S1. Diagram illustrating the conceptual model based on components of the COM-B model that was utilized to develop the SIMS intervention. Figure S2. Staggered, pre-post quasi-experimental study design utilized for implementation of SIMS intervention. Baseline period indicates time period following Quick Check + training and before SIMS intervention. Intervention period indicates time period during which SIMS intervention was implemented. Figure S3. Flow diagram for patients included in study (DOCX 607 kb

Rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction.

BACKGROUND: The appropriate treatment for patients in whom reperfusion fails to occur after thrombolytic therapy for acute myocardial infarction remains unclear. There are few data comparing emergency percutaneous coronary intervention (rescue PCI) with conservative care in such patients, and none comparing rescue PCI with repeated thrombolysis. METHODS: We conducted a multicenter trial in the United Kingdom involving 427 patients with ST-segment elevation myocardial infarction in whom reperfusion failed to occur (less than 50 percent ST-segment resolution) within 90 minutes after thrombolytic treatment. The patients were randomly assigned to repeated thrombolysis (142 patients), conservative treatment (141 patients), or rescue PCI (144 patients). The primary end point was a composite of death, reinfarction, stroke, or severe heart failure within six months. RESULTS: The rate of event-free survival among patients treated with rescue PCI was 84.6 percent, as compared with 70.1 percent among those receiving conservative therapy and 68.7 percent among those undergoing repeated thrombolysis (overall P=0.004). The adjusted hazard ratio for the occurrence of the primary end point for repeated thrombolysis versus conservative therapy was 1.09 (95 percent confidence interval, 0.71 to 1.67; P=0.69), as compared with adjusted hazard ratios of 0.43 (95 percent confidence interval, 0.26 to 0.72; P=0.001) for rescue PCI versus repeated thrombolysis and 0.47 (95 percent confidence interval, 0.28 to 0.79; P=0.004) for rescue PCI versus conservative therapy. There were no significant differences in mortality from all causes. Nonfatal bleeding, mostly at the sheath-insertion site, was more common with rescue PCI. At six months, 86.2 percent of the rescue-PCI group were free from revascularization, as compared with 77.6 percent of the conservative-therapy group and 74.4 percent of the repeated-thrombolysis group (overall P=0.05). CONCLUSIONS: Event-free survival after failed thrombolytic therapy was significantly higher with rescue PCI than with repeated thrombolysis or conservative treatment. Rescue PCI should be considered for patients in whom reperfusion fails to occur after thrombolytic therapy