Evaluation of a reproductive health awareness program for adolescence in urban Tanzania-A quasi-experimental pre-test post-test research

Sub-Saharan Africa is among the countries where 10% of girls become mothers by the age of 16 years old. The United Republic of Tanzania located in Sub-Saharan Africa is one country where teenage pregnancy is a problem facing adolescent girls. Adolescent pregnancy has been identified as one of the reasons for girls dropping out from school. This study's purpose was to evaluate a reproductive health awareness program for the improvement of reproductive health for adolescents in urban Tanzania. A quasi-experimental pre-test and post-test research design was conducted to evaluate adolescents' knowledge, attitude, and behavior about reproductive health before and after the program. Data were collected from students aged 11 to 16, at Ilala Municipal, Dar es Salaam, Tanzania. An anonymous 23-item questionnaire provided the data. The program was conducted using a picture drama, reproductive health materials and group discussion. In total, 313 questionnaires were distributed and 305 (97.4%) were useable for the final analysis. The mean age for girls was 12.5 years and 13.2 years for boys. A large minority of both girls (26.8%) and boys (41.4%) had experienced sex and among the girls who had experienced sex, 51.2% reported that it was by force. The girls' mean score in the knowledge pre-test was 5.9, and 6.8 in post-test, which increased significantly (t=7.9, p=0.000). The mean behavior pre-test score was 25.8 and post-test was 26.6, which showed a significant increase (t=3.0, p=0.003). The boys' mean score in the knowledge pre-test was 6.4 and 7.0 for the post-test, which increased significantly (t=4.5, p=0.000). The mean behavior pre-test score was 25.6 and 26.4 in post-test, which showed a significant increase (t=2.4, p=0.019). However, the pre-test and post-test attitude scores showed no statistically significant difference for either girls or boys. Teenagers have sexual experiences including sexual violence. Both of these phenomena are prevalent among school-going adolescents. The reproductive health program improved the students' knowledge and behavior about sexuality and decision-making after the program for both girls and boys. However, their attitudes about reproductive health were not likely to change based on the educational intervention as designed for this study

Quality of Life and Affective Well-Being in Middle-Aged and Older People with Chronic Medical Illnesses: A Cross-Sectional Population Based Study

Background: There has been considerable research into the impact of chronic illness on health-related quality of life. However, few studies have assessed the impact of different chronic conditions on general quality of life (QOL). The objective of this paper was to compare general (rather than health-related) QOL and affective well-being in middle aged and older people across eight chronic illnesses.Methods and Findings: This population-based, cross-sectional study involved 11,523 individuals aged 50 years and older, taking part in wave 1 of the English Longitudinal Study of Ageing. General QOL was assessed using the CASP-19, happiness was evaluated using two items drawn from the GHQ-12, and depression was measured with the CES-D. Analysis of covariance and logistic regression, adjusting for age, gender and wealth, were performed. General QOL was most impaired in people with stroke (mean 37.56, CI 36.73-38.39), and least in those reporting cancer (mean 41.78, CI 41.12-42.44, respectively), compared with no illness (mean 44.15, CI 43.92-44.39). Stroke (mean 3.65, CI 3.58-3.73) was also associated with the greatest reduction in positive well-being whereas diabetes (mean 3.81, CI 3.76-3.86) and cancer were least affected (3.85, CI 3.79-3.91), compared with no illness (mean 3.97, CI 3.95-4.00). Depression was significantly elevated in all conditions, but was most common in chronic lung disease (OR 3.04, CI 2.56-3.61), with more modest elevations in those with osteoarthritis (OR 2.08, CI 1.84-2.34) or cancer (OR 2.07, CI 1.69-2.54). Multiple co-morbidities were associated with greater decrements in QOL and affective well-being.Conclusion: The presence of chronic illness is associated with impairments in broader aspects of QOL and affective wellbeing, but different conditions vary in their impact. Further longitudinal work is needed to establish the temporal links between chronic illness and impairments in QOL and affective well-being

Identification of epitopes recognised by mucosal CD4+ T-cell populations from cattle experimentally colonised with Escherichia coli O157:H7

Additional file 5. Sequence alignment of Intimin epitopes against Intimin sequences from non-O157 EHEC serotypes. Alignment of Intimin CD4+ T-cell epitope sequences with representative Intimin sequences from EHEC serotypes O145, O127, O26, O103, O121, O45 and O111. Percentage values indicate % similarity to the EHEC O157:H7 reference sequence

What matters for life satisfaction among the oldest-old? Evidence from China

The world population is aging rapidly and the well-being of older people is of great interest. Therefore, this study investigates the determinants of life satisfaction among the oldest-old (i.e. individuals aged 80 or over) in China. Materials and methods We use the 2011/2012 Chinese Longitudinal Healthy Longevity Survey data (n = 6530) for this paper. Logistic regression is used to analyse the effects of socio-demographic, economic, health, instrumental activities of daily living, family and community factors on life satisfaction and depression among the oldest-old in China. Results Our analysis confirms the significance of many factors affecting life satisfaction among the oldest-old in China. Factors that are correlated with life satisfaction include respondent’s sex, education, place of residence, self-rated health status, cognitive ability (using mini mental state examination), regular physical examination, perceived relative economic status, access to social security provisions, commercialized insurances, living arrangements, and number of social services available in the community (p<0.05 for all these variables). Although life satisfaction is negatively associated with instrumental activities of daily living (β = -0.068, 95%CI = -.093—.043), and depression (β = -0.463, 95%CI = -.644—.282), the overall effect of self-rated health status is positive (p<0.001). This confirms the primacy of health as the determinant of well-being among the oldest-old. Conclusions Majority of the oldest-old in China rated their life satisfaction as good or very good. Our findings show that health and economic status are by far the most significant predictors of life satisfaction. Our finding on the primacy of health and relative income as determinants of well-being among the oldest-old, and the greater influence of self-rated health status over objective health measures is consistent with the findings of many past studies. Our results suggest that efforts should be directed at enhancing family support as well as health and social service provisions in the community to improve life satisfaction of older people

A laboratory simulation of the mixing of coal mine-affected water with Fitzroy Basin river water

Coal mine-affected water (CMAW) releases contribute to the total wet season stream-flow in the Fitzroy River Basin. Using data from the QLD government ‘Fitzroy River’ website, the flow attributable to CMAW releases in the Mackenzie River sub-basin were calculated as 3.75% and 2.1% in the 2012-13 and 2013-14 wet seasons, respectively. This study used laboratory simulation to investigate the changes in copper (Cu) composition in river water when CMAW is released in the Mackenzie sub-basin. CMAW was collected directly from a mine’s on-site holding dam. CMAW from this dam can be released into a Mackenzie River tributary when certain water quality and flow conditions are met. In April 2015 this tributary was dry, so river water was collected further downstream in the main trunk of the Mackenzie River. Changes in water quality were monitored in eight different quantities of CMAW mixed with the river water (range = 0.2-10% CMAW). Electrical conductivity increased linearly with increasing % CMAW, whereas non-linear responses and possible chemical reaction (indicated by curve inflections) were observed for pH, TSS and alkalinity in the 0.4% and 2% mixtures. Two 5L mixtures of 0.4% and 2% CMAW in river water were continually mixed at a constant speed for three days. Nine DGT samplers were placed in each mixture; temperature, EC and pH were monitored daily. A 30-mL aliquot for total dissolved Cu, a 50-mL aliquot for total alkalinity, and three DGT samplers, were removed from each mixture at three time points (24, 48 and 72 h). The suspended particulate matter (SPM) in the initial samples and final mixtures were collected and are being characterised. Total dissolved Cu concentration in the mixtures was compared to the original waters (river water = 2.2 µg/L; CMAW = 0.97 µg/L). At t=0 h the 0.4% mixture had 1.7 µg/L of Cu, while the 2% mixture had 1.9 µg/L. After 24 h both mixtures had 2.1 µg/L. Cu concentration in the 0.4% mixture was 2.0 µg/L at 48 and 72 h. Cu concentration in the 2% mixture at t=48 h dropped to 1.6 µg/L. These changes over time may be significant for compliance monitoring during CMAW releases. Cu concentration in the SPM were: river water = 34 mg/kg, CMAW = 22 mg/kg, 0.4% CMAW = 34 mg/kg, and 2% CMAW = 30 mg/kg. Analyses of the DGT eluents are currently being verified. It is noted that the composition of the original water samples could vary from day-to-day, site-to-site and mine-to-mine, depending on different climatic and operational conditions. Hence, it is recommended that this investigation be repeated numerous times, controlling different variables. The current method could be improved to more closely represent in-situ river mixing conditions. Overall, the study provided a unique approach to determine the potential effects of releasing CMAW into the Fitzroy Basin river system. The preliminary findings were that Cu concentrations and other water quality parameters varied over the 72 hour mixing period. Cu concentrations were more variable in the 2% mixture. This indicates that the time of sampling and volume of release are important compliance monitoring considerations. This methodology could be applied or modified to study other toxicants of interest

The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study

OBJECTIVE: To describe the incidence, risks, management and outcomes of cardiac arrest in pregnancy in the UK population, with specific focus on the use of perimortem caesarean section (PMCS). DESIGN: A prospective, descriptive study using the UK Obstetric Surveillance System (UKOSS). SETTING: All UK hospitals with maternity units. POPULATION: All women who received basic life support in pregnancy in the UK between 1 July 2011 and 30 June 2014 (n = 66). METHODS: Prospective case identification through UKOSS monthly mailing. MAIN OUTCOME MEASURES: Cardiac arrest in pregnancy, PMCS, maternal death. RESULTS: There were 66 cardiac arrests in pregnancy, resulting in an incidence of 2.78 per 100 000 maternities (1:36 000; 95% CI 2.2-3.6). In all, 28 women died (case fatality rate 42%); 16 women arrested solely as a consequence of obstetric anaesthesia, 12 of whom were obese. Basic and advanced life support were rapidly delivered. Those who died were more likely to have collapsed at home. Perimortem caesarean section was performed in 49 women, 11 in the emergency department. The time from collapse to PMCS was significantly shorter in women who survived (median interval 3 versus 12 minutes, P = 0.001). Forty-six of 58 babies were born alive; 32 babies to surviving mothers and 14 to women who died. CONCLUSION: Cardiac arrest is rare in the pregnant UK population, however, nearly a quarter of cases are precipitated by obstetric anaesthesia, suggesting an opportunity to reduce the incidence further. Maternal survival rates of 58% were achieved with timely resuscitation, including PMCS, delay in which was associated with maternal death. Inpatient arrests were associated with higher survival rates than arrests that occurred outside the hospital setting. TWEETABLE ABSTRACT: 25% of cardiac arrest in pregnancy is caused by anaesthesia. Rapid perimortem section improves survival.</p

The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study

OBJECTIVE: To describe the incidence, risks, management and outcomes of cardiac arrest in pregnancy in the UK population, with specific focus on the use of perimortem caesarean section (PMCS). DESIGN: A prospective, descriptive study using the UK Obstetric Surveillance System (UKOSS). SETTING: All UK hospitals with maternity units. POPULATION: All women who received basic life support in pregnancy in the UK between 1 July 2011 and 30 June 2014 (n = 66). METHODS: Prospective case identification through UKOSS monthly mailing. MAIN OUTCOME MEASURES: Cardiac arrest in pregnancy, PMCS, maternal death. RESULTS: There were 66 cardiac arrests in pregnancy, resulting in an incidence of 2.78 per 100 000 maternities (1:36 000; 95% CI 2.2-3.6). In all, 28 women died (case fatality rate 42%); 16 women arrested solely as a consequence of obstetric anaesthesia, 12 of whom were obese. Basic and advanced life support were rapidly delivered. Those who died were more likely to have collapsed at home. Perimortem caesarean section was performed in 49 women, 11 in the emergency department. The time from collapse to PMCS was significantly shorter in women who survived (median interval 3 versus 12 minutes, P = 0.001). Forty-six of 58 babies were born alive; 32 babies to surviving mothers and 14 to women who died. CONCLUSION: Cardiac arrest is rare in the pregnant UK population, however, nearly a quarter of cases are precipitated by obstetric anaesthesia, suggesting an opportunity to reduce the incidence further. Maternal survival rates of 58% were achieved with timely resuscitation, including PMCS, delay in which was associated with maternal death. Inpatient arrests were associated with higher survival rates than arrests that occurred outside the hospital setting. TWEETABLE ABSTRACT: 25% of cardiac arrest in pregnancy is caused by anaesthesia. Rapid perimortem section improves survival.</p

Copper distribution in a river system that receives coal mine-affected water releases in the Fitzroy River Basin, Central QLD

The Mackenzie River sub-basin in the Fitzroy Basin (Central Queensland) is a turbid river system associated with significant coal mining. Coal mine-affected water (CMAW) releases do not occur during low flow conditions. Copper (Cu) is one of the heavy metals found in CMAW. The median annual dissolved Cu concentrations in the Mackenzie basin during low flow conditions in 2010-2014, calculated from data reported by the Fitzroy Partnership for River Health, were 3.0, 2.0, 1.5 and 1.2 µg/L (n = 43–264), respectively, with concentrations for 3 years being greater than the ANZECC (2000) toxicant trigger value for Cu (1.4 µg/L) for slightly-moderately disturbed freshwater systems. This study sought to determine the potential bioavailability and the distribution of Cu in the Mackenzie River environment. Two field trips were conducted: sediment core samples were taken in August 2014 and water samples in March 2015, both during low flow conditions and no recent CMAW releases. Three sites were sampled: one, in an upstream tributary, where no coal mining activity existed (called “Ref” site), and two downstream Mackenzie River sites (Site 5b and Site 6), that could receive cumulative mine-affected water releases, from numerous upstream coal mines. DGT-labile Cu (using DGT devices), total dissolved Cu (grab water samples filtered through 0.45µm at the site) and Cu in suspended particulate matter (retained on large diameter 0.45 µm filters, in field) were measured at each site. Triplicate DGT samplers were deployed for 48 h, and triplicate grab water samples were taken during deployment and retrieval of the DGT devices at each site. There was no significant difference in the total dissolved Cu concentration at deployment vs at retrieval at the Ref site and at Site 6 (furthest downstream). The average dissolved Cu concentration over 48 h at these two sites were 0.91 ±0.10 µg/L and 1.6 ±0.26 µg/L, respectively. In contrast a significant difference in the Cu concentration at deployment vs at retrieval was observed at Site 5b (2.1 ±0.14 µg/L vs 3.2 ±0.42 µg/L). Total dissolved Cu at Ref site was below the ANZECC (2000) trigger value, whereas concentrations at downstream sites were greater than the trigger value. The time-averaged DGT-labile (or potentially-bioavailable) Cu concentrations were low overall, being greatest at Site 5b (0.37 ±0.04 µg/L) and similar at Ref site and Site 6 (0.20 ±0.09 vs 0.18 ±0.01 µg/L, respectively). The Ref site had 4.3 mg/kg of particulate Cu on deployment and 1.3 mg/kg on retrieval; the respective values for Site 5b were 2.8 and 9.8 mg/kg, and for Site 6 were 1.2 and 2.1 mg/kg. Turbidity readings on retrieval were 27.4, 163 and 127 NTU at the three sites, respectively. A 10-cm sediment core from Ref site and a 12-cm core from Site 6 were analysed; Site 5b had rocks and pebbles and was unsuitable for coring. Cu concentration (<60 µm fraction) in the 2-cm core slices from Ref site ranged from 16.9-37.7 mg/kg dry weight (dw), and in Site 6 from 19.5-28.3 mg/kg dw. This preliminary study has demonstrated that total dissolved Cu in grab water samples may overestimate the potential impact of Cu on the aquatic environment. Cu distribution in different phases of the turbid Mackenzie River system indicated low bioavailable-Cu levels during low flow conditions. Comparative testing during CMAW releases is recommended. Cu concentrations (<60 µm fraction) in sediment cores were relatively low