To examine the perspectives of caregivers that are not part of the antibiotic stewardship program (ASP) leadership team (eg, physicians, nurses, and clinical pharmacists), but who interact with ASPs in their role as frontline healthcare workers.

Qualitative semistructured interviews.

The study was conducted in 2 large national healthcare systems including 7 hospitals in the Veterans’ Health Administration and 4 hospitals in Intermountain Healthcare.

We interviewed 157 participants. The current analysis includes 123 nonsteward clinicians: 47 physicians, 26 pharmacists, 29 nurses, and 21 hospital leaders.

Interviewers utilized a semistructured interview guide based on the Consolidated Framework for Implementation Research (CFIR), which was tailored to the participant’s role in the hospital as it related to ASPs. Qualitative analysis was conducted using a codebook based on the CFIR.

We identified 4 primary perspectives regarding ASPs. (1) Non-ASP pharmacists considered antibiotic stewardship activities to be a high priority despite the added burden to work duties: (2) Nurses acknowledged limited understanding of ASP activities or involvement with these programs; (3) Physicians criticized ASPs for their restrictions on clinical autonomy and questioned the ability of antibiotic stewards to make recommendations without the full clinical picture; And (4) hospital leaders expressed support for ASPs and recognized the unique challenges faced by non-ASP clinical staff.

Further understanding these differing perspectives of ASP implementation will inform possible ways to improve ASP implementation across clinical roles.

To report on the prevalence of different types of breast-milk substitutes (BMS) marketing and the compliance of such marketing with the ‘Control of Marketing of Infant and Young Child Food Act 2017’ (The Act) and the ‘International Code of Marketing of Breast-milk Substitutes (WHO Code)’ in Thailand.

Cross-sectional quantitative study, guided by the WHO/UNICEF NetCode Periodic Assessment Protocol.

Health facilities and retail outlets in Bangkok, Thai media.

Mothers of 0–2-year-old children, health professionals, promotions at retail outlets and health facilities, product labels, marketing on television and the internet.

Marketing to mothers was highly prevalent, mostly from electronic or digital media, while BMS companies provided items to health professionals to distribute to mothers. Promotional materials in health facilities displayed company brands or logos. At retail outlets, most promotions were price-related. Approximately two-fifths of labels contained nutrition or health claims. Television marketing was growing-up-milk (GUM) advertisements, while internet promotions were varied from price-related materials to product reviews. Most instances of non-compliant BMS marketing with the Act were advertisements to mothers, and most were infant formula. Most non-compliant BMS marketing with the WHO Code was mainly concerned GUM, which are not covered by the Act and appeared in the media.

BMS marketing does not fully comply with the Act or the WHO Code. The Thai government should conduct regular monitoring and enforcement activities, educate health professionals, and strengthen the Act’s provisions on the media and GUM to fully align with the WHO Code.

MIND-TD is a collaboration of healthcare professionals (HCPs) who are committed to raising awareness of tardive dyskinesia (TD), a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents. The MIND-TD questionnaire was developed to help HCPs screen for TD and facilitate discussion with patients.

In August 2020, an expert panel of 13 HCPs (4 psychiatrists, 6 neurologists/movement disorder specialists [MDSs], and 3 advanced practice providers [APPs]) met virtually to discuss potential screening questions for TD. This work was continued by 4 panelists (1 psychiatrist, 2 neurologists/MDSs, and 1 APP) who tested the questions in clinical practice for revision and refinement. The same group also worked with the sponsor to develop 2 additional sections that could be used to elicit more information from patients. The panel recognized the need for a tool that could facilitate telehealth screening for TD, including audio-only interactions. Therefore, practices from speech-language pathologists (eg, diadochokinetics) were used to refine the questionnaire.

Part 1 of the MIND-TD questionnaire includes a yes-or-no question for each of the 4 following topics: presence of extra or unwanted movements (Movement); feelings of embarrassment or self-consciousness (Impact); if anyone else has noticed the movements (Notice); and if movements interfere with everyday routines (Daily Activities). Part 1 can be administered by any trained medical staff, either in person or via telehealth (with video or audio-only). Routine administration is suggested in all patients who meet any of the following criteria: current or prior use of any first- or second-generation antipsychotic; use of an anticholinergic medication in conjunction with a current or past antipsychotic; or current diagnosis of TD. Part 2 of the MIND-TD questionnaire has 2 sections. The first (Thorough Interview) includes 9 items related to physical/functional difficulties (eg, eating, speaking, walking, and gripping objects) and 3 simple instructions for speech difficulties. The second section (Differentiate) includes checklists of characteristic movements for TD and drug-induced parkinsonism, along with an item related to akathisia and suggestions for observing abnormal or involuntary movements. Part 2 should be administered by the treating HCP in patients who have abnormal movements that may be related to TD. Part 2 requires visual observation of the patient, whether in-person or via video.

MIND-TD is a screening questionnaire that can facilitate a dialogue between HCPs and patients about the risks, symptoms, and impact of TD. The MIND questions can stand alone and be administered during in-person visits or telehealth visits (video or audio-only). The TD section can be used to gather more information about a patient’s abnormal movements.

Neurocrine Biosciences, Inc.

To assess the association between soybean consumption and anaemic status in Central Java, Indonesia.

As part of an overarching sanitation improvement intervention in Central Java, Indonesia, we conducted a cross-sectional study in four rural villages. The study consisted of a 24-h food recall, anthropometric measurements, blood Hb measurement and stool sampling to test for soil-transmitted helminth (STH) infection status. A binary logistic regression model was fitted to test the association between soybean consumption and anaemic status after adjusting for socio-demographic factors, STH infection, dietary diversity and anthropometric status.

This study took place in four rural villages of Wonosobo regency, Central Java, Indonesia.

Participants were rural villagers aged between 15 and 49 years.

A total sample size of 763 was attained, of which 231 were anaemic. The prevalence of anaemia was 30·2 % among men and women of reproductive age, and highest among young males. Consumption of soybean was high (79·8 %). After adjusting for covariates, the protective association between soybean consumption and anaemia was statistically significant (AOR = 0·53, 95 % CI = 0·30, 0·95, P < 0·05). There was a positive association with anaemia among underweight (AOR = 2·75, 95 % CI = 1·13, 6·69, P < 0·05) and those with high diet diversity (AOR = 1·40, 95 % CI = 1·00, 1·97, P < 0·05).

Our results were consistent with studies from other countries finding a protective association between soybean consumption and anaemia. This association appeared stronger for tofu than for tempeh. The prevalence of anaemia in rural Central Java is relatively consistent with nation-wide statistics indicating that interventions targeting anaemia are still largely required.

The spatial and temporal extent of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) environmental contamination has not been precisely defined. We sought to elucidate contamination of different surface types and how contamination changes over time.

We sampled surfaces longitudinally within COVID-19 patient rooms, performed quantitative RT-PCR for the detection of SARS-CoV-2 RNA, and modeled distance, time, and severity of illness on the probability of detecting SARS-CoV-2 using a mixed-effects binomial model.

The probability of detecting SARS-CoV-2 RNA in a patient room did not vary with distance. However, we found that surface type predicted probability of detection, with floors and high-touch surfaces having the highest probability of detection: floors (odds ratio [OR], 67.8; 95% credible interval [CrI], 36.3–131) and high-touch elevated surfaces (OR, 7.39; 95% CrI, 4.31–13.1). Increased surface contamination was observed in room where patients required high-flow oxygen, positive airway pressure, or mechanical ventilation (OR, 1.6; 95% CrI, 1.03–2.53). The probability of elevated surface contamination decayed with prolonged hospitalization, but the probability of floor detection increased with the duration of the local pandemic wave.

Distance from a patient’s bed did not predict SARS-CoV-2 RNA deposition in patient rooms, but surface type, severity of illness, and time from local pandemic wave predicted surface deposition.