Impact of helminth infection on childhood allergic diseases in an area in transition from high to low infection burden

BACKGROUND: The effect of helminth infections on allergic diseases is still inconclusive. Furthermore, the effect of helminth infections on childhood allergic diseases in a tropical area where prevalence of helminth infections has undergone dramatic changes is not well documented. OBJECTIVE: To investigate the relationship between allergic diseases and helminth infection in a cohort of schoolchildren in an area that has undergone dramatic changes in intensity of helminth infections. METHODS: Children attending grade 5 were recruited from 17 schools in Western Province of Sri Lanka. They were assessed for allergic diseases using the International Study of Asthma and Allergies in Childhood questionnaire. Their serum total IgE (tIgE) and allergen-specific IgE (sIgE) for five common aeroallergens were measured by ImmunoCAP® method and stools were examined for the presence of helminth infections. RESULTS: A total of 640 children (mean age 10 years) were recruited to the study. Of them, 33.7% had evidence of allergic disease and 15.5% had helminth infections. Majority of infections (68.9%) were of low intensity. A significant relationship between allergic disease and helminth infections was not observed, however, a trend toward protective role of helminth infections against allergic diseases was noted. Multivariate analysis showed helminth infections to be an independent predictor of high tIgE levels whereas allergic disease was not. Allergic sensitization (atopy) was a significant risk factor for allergic disease only among non-infected children (odds ratio 3.025, p = 0.022) but not in infected children. The ratio of sIgE to tIgE was higher in non-infected children. CONCLUSION: Though not significant, a reduced risk of allergy in helminth-infected children was observed in this population. A Decrease in intensity of helminth infections may have contributed to the reduced capacity of immune-modulation by helminths in this paediatric population

A Review of the Global Literature on Dental Therapists

OBJECTIVE: Access to adequate oral health care is deficient in many parts of the world. Many countries are now using dental therapists to increase access, particularly for children. To inform the discussion on dental therapists in the workforce, particularly in the United States, the W.K. Kellogg Foundation funded a review of the global literature to identify as many documents as possible related to the practice of dental therapists since the establishment of the School Dental Service in New Zealand in 1921. METHODS: Consultants in each of the countries considered to have a substantive literature on dental therapists were asked to participate in the research; seventeen in total. In addition to identifying and reviewing published articles, a focus of the research was on identifying \u27gray\u27 documents. Standard databases were searched for key words associated with dental therapists. In addition, searches were conducted of the governmental and dental association websites of all countries known to have dental therapists in their oral health workforce. RESULTS: Fifty-four countries, both developing and developed, were identified where dental therapists are members of the workforce. Eleven hundred documents were identified from 26 of these countries, with over 2/3 of them cited in the published monograph. Reliable evidence from the related literature and verbal communication confirmed the utilization of dental therapists in an additional 28 countries. Thirty-three of the countries were members of the Commonwealth of Nations, suggesting a mechanism of spread from New Zealand. Variable lengths of training/education existed for dental therapists with the tradition being 2 years postsecondary. In a few countries, the training of therapists and hygienists is now being combined in a three academic year program. Historically, dental therapists have been employed by government agencies caring for children, typically in school-based programs. Initiatives in some countries allow limited care for adults by dental therapists with additional training. CONCLUSIONS: The evidence indicates that dental therapists provide effective, quality, and safe care for children in an economical manner and are generally accepted both by the public and where their use is established, by the dental profession

Good on paper: the gap between programme theory and real-world context in Pakistan's Community Midwife programme

Objective To understand why skilled birth attendance—an acknowledged strategy for reducing maternal deaths—has been effective in some settings but is failing in Pakistan and to demonstrate the value of a theory-driven approach to evaluating implementation of maternal healthcare interventions. Design Implementation research was conducted using an institutional ethnographic approach. Setting and population National programme and local community levels in Pakistan. Methods Observations, focus group discussions, and in-depth interviews were conducted with 38 Community Midwives (CMWs), 20 policymakers, 45 healthcare providers and 136 community members. A critical policy document review was conducted. National and local level data were brought together. Main outcomes Alignment of programme theory with real-world practice. Results Data revealed gaps between programme theory, assumptions and reality on the ground. The design of the programme failed to take into account: (1) the incongruity between the role of a midwife and dominant class and gendered norms that devalue such a role; (2) market and consumer behaviour that prevented CMWs from establishing private practices; (3) the complexity of public–private sector cooperation. Uniform deployment policies failed to consider existing provider density and geography. Conclusions Greater attention to programme theory and the ‘real-world’ setting during design of maternal health strategies is needed to achieve consistent results in different contexts

Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Nutrition Reviews following peer review. The version of record Almiron-Roig, E., Galloway, C., Aitken, A. & Ellahi., B. (2016). Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK. Nutrition Reviews, 75(3), 188-213. DOI: 10.1093/nutrit/nuw058 is available online at: https://academic.oup.com/nutritionreviews/article-lookup/doi/10.1093/nutrit/nuw058Context: Dietary assessment in minority ethnic groups is critical for surveillance programmes and for implementing effective interventions. A major challenge is the accurate estimation of portion sizes for traditional foods/dishes. Objective: To systematically review published records up to 2014 describing a portion size estimation element (PSEE) applicable to dietary assessment of UK-residing ethnic minorities. Data sources, selection, extraction: Electronic databases, internet sites, and theses repositories were searched generating 5683 titles from which 57 eligible full-text records were reviewed. Data analysis: Forty-two publications aimed at minority ethnic groups (n=20) or autochthonous populations (n=22) were included. The most common PSEE (47%) were combination tools (e.g. food models and portion size lists); followed by portion size lists in questionnaires/guides (19%); image-based and volumetric tools (17% each). Only 17% PSEE had been validated against weighed data. Conclusions: When developing ethnic-specific dietary assessment tools it is important to consider customary portion sizes by sex and age; traditional household utensil usage and population literacy levels. Combining multiple PSEE may increase accuracy but such tools need validating

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Training videos available on national epidemiology website in Sri Lanka

The website contains a video training series related to epidemiology, diseases, vaccination, and other related topics

Establishment of a National Programme for Health Services (Systems) Research : final technical report

The table of contents for this item can be shared with the requester. The requester may then choose one chapter, up to 10% of the item, as per the Fair Dealing provision of the Canadian Copyright Ac