Clothes-borne transmission is an important way of spread of infection from patient to patient which is not interrupted by common cotton gowns. New barrier garments were designed from spun-bonded olefin that, in particle penetration tests, was 100 times better as a filter than cotton cloth. Three designs, a gown, a loose coverall and a close overall, were compared with each other and with conventional cotton gowns in experimental exercise and nursing procedures. Staphylococcus aureus from burned patients were used as markers. The close coverall was 4-7 times better than the loose coverall or gown in preventing the soiling of clothes worn underneath it, but appeared to permit substantially more transfer from garments underneath it to a mock 'patient' and to the air than did the looser garments. A cotton gown reduced the soiling of clothes underneath it by more than 10 times and the contamination of a mock patient by more than 30 times as compared with no barrier garment. The close coverall further diminished the contamination of clothes but not the transfer to the patient. The possible mechanisms for the discrepancy between particle transmission tests annd experimental porcedures are discussed.

Saplings of many canopy tree species in winter deciduous forests receive the major portion of their light budget for their growing season prior to canopy closure in the spring. This period of high light may be critical for achieving a positive carbon (C) gain, thus contributing strongly to their growth and survival. This study of saplings of Aesculus glabra and Acer saccharum in Trelease Woods, Illinois, USA, tested this hypothesis experimentally by placing tents of shade cloth over saplings during their spring period of high light prior to canopy closure in three consecutive years. Leaf senescence began 16 days (year 0) and 60 days (year 1) earlier for shaded A. glabra saplings than control saplings. No change in senescence occurred for A. saccharum. The annual absolute growth in stem diameter of both species was negligible or negative for shaded saplings, but positive for control saplings. Only 7% of the shaded A. glabra saplings were alive after 2 years, while all control saplings survived for 3 years; only 20% of the shaded A. saccharum saplings survived for 3 years, while 73% of control saplings were alive after the same period. Early spring leaf out is a critical mechanism that allows the long-term persistence of saplings of these species in this winter deciduous forest. Studies and models of C gain, growth, and survival of saplings in deciduous forests may need to take into account their spring phenology because saplings of many species are actually "sun" individuals in the spring prior to their longer period in the summer shade.

The role of plant allelochemicals on the oviposition behavior ofHeliothis virescens (F.),H. subflexa (Guenee), andH. zea (Boddie) was investigated in the laboratory using a "choice" bioassay system. Fresh young leaves of tobacco,Desmodium tortuosum (Swartz) de Candolle, groundcherry (Physalis angulata L.), and cotton (Gossypium hirsutum L.) squares (flower buds) were washed in methylene chloride or methanol, concentrated to 1 g equivalent of washed material, and applied to a cloth oviposition substrate. Each of the extracts-including groundcherry, a nonhost-stimulated oviposition byH. virescens. H. subflexa were stimulated to oviposit by groundcherry extract, its normal host, and extract from cotton squares, a nonhost. None of the extracts stimulated oviposition byH. zea, although all except groundcherry were from reported hosts. The sensitivity of the bioassay was confirmed by givingH. virescens andH. subflexa an opportunity to choose between extracts that showed stimulant qualities when tested independently versus only solvent-treated controls. In these tests, tobacco showed the highest level of stimulant activity forH. virescens; groundcherry exhibited the highest level of stimulation forH. subflexa.

Banana sap has some special properties relating to various phenomena such as browning of fruits after harvesting, permanent staining of cloth and fibers, and antioxidant and antibleeding properties. Analysis of banana sap using high-performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS) indicated the presence of phenolic and aromatic amino compounds of interest due to their special properties. With the online positive electrospray ionization mode (ESI), the possible structures of specific compounds were determined from the fragmentation patterns of each particular ion appearing in the mass spectra. The major compounds revealed from the sap of banana accessions, namely, Musa balbisiana , Musa laterita , Musa ornata , and Musa acuminata , and some cultivars were apigenin glycosides, myricetin glycoside, myricetin-3-O-rutinoside, naringenin glycosides, kaempferol-3-O-rutinoside, quercetin-3-O-rutinoside, dopamine, and N-acetylserotonin. The results indicated that there was a variety of phenolic and aromatic amino contents in many banana species. These compounds were reported to relate with biological activities. Moreover, the identities of these phytochemical compositions may be used as markers for banana diet, the assessment of physiochemical status, or the classification of banana clones.

Although behavioral and endocrine consequences of acute exposure to stressors have been extensively studied, little is known about how simultaneous exposure to two different stressors interacts to induce short- and long-term effects. In the present experiment we studied this interaction in adult male rats exposed to cat fur odor (impregnated cloth) or immobilization on boards either separately or simultaneously. We reasoned that exposure to the odor of a potential predator while immobilized, may potentiate its negative consequences as compared to exposure to only one of the stressors. Exposure to cat odor elicited the expected reduction of activity and avoidance of the area where the impregnated cloth was located. The endocrine response (plasma levels of ACTH and corticosterone, as a measure of the hypothalamic-pituitary-adrenal axis, HPA) was markedly greater after immobilization than after cat fur odor and no additive effects were found by simultaneous exposure to both stressors. Cat odor, but not immobilization, increased anxiety-like behavior as evaluated in the elevated plus-maze 7 days after the stressors, with no evidence of enhanced HPA activation. In addition, cat odor exposure resulted in long-lasting (8 days later) fear conditioning to the box containing a clean cloth, which was reflected by hypoactivity, avoidance of the cloth area and enhanced HPA activation. All these effects were similarly observed in rats exposed simultaneously to cat odor and immobilization. In rats only exposed to immobilization, only some weak behavioral signs of fear conditioning were found, but HPA activation in response to the context paired to immobilization was enhanced to the same extent as in cat odor-exposed animals, supporting a certain degree of endocrine conditioning. The present results did not reveal important behavioral interactions between the two stressors when animals experienced both simultaneously, whereas some interactions were found regarding HPA activation. Theoretical implications are discussed.

Complications after heart valve replacement remain a substantial source of morbidity and mortality despite continuing advances in surgical care and prosthetic design. Infectious endocarditis occurs in about 4 percent of patients and may appear early (within 60 days) or late after operation. Endocarditis of early onset is commonly due to staphylococcal, fungal or gram-negative organisms and is fatal in 70 percent or more of cases. Infection of late onset is more often of streptococcal origin and the mortality rate is lower, about 35 percent. With either type, prompt recognition, vigorous and appropriate antimicrobial therapy and early consideration of surgical intervention are crucial. The postperfusion and postpericardiotomy syndromes are relatively common and relatively benign syndromes associated with postoperative fever. Their recognition is important to prevent confusion with endocarditis or sepsis and thus to reassure the patient and physician. Treatment is primarily symptomatic. Intravascular hemolysis occurs with most prosthetic heart valves but is more common with certain prostheses and with paraprosthetic valve regurgitation, with significant hemolytic anemia in 5 to 15 percent. Oral iron replacement therapy is effective in the majority of patients, but occasionally blood transfusion or reoperation for leak around the prosthesis is necessary. Prosthesis dysfunction due to thrombus may be recognized clinically by recurrence of heart failure, syncope, cardiomegaly and altered prosthetic valve sounds or new murmurs. Hemodynamic studies verify the diagnosis, and prompt reoperation is indicated for this potentially lethal problem. Systemic embolization has decreased markedly with the introduction of cloth-covered prostheses and is frequently related to erratic or ineffective anticoagulant therapy. We continue to recommend anticoagulant therapy for all patients with prosthetic heart valves unless there is a major contraindication.

Posttraumatic stress disorder (PTSD) is characterized by stress-induced symptoms including exaggerated fear memories, hypervigilance and hyperarousal. However, we are unaware of an animal model that investigates these hallmarks of PTSD especially in relation to fear extinction and habituation. Therefore, to develop a valid animal model of PTSD, we exposed rats to different intensities of footshock stress to determine their effects on either auditory predator odor fear extinction or habituation of fear sensitization. In Experiment 1, rats were exposed to acute footshock stress (no shock control, 0.4 mA, or 0.8 mA) immediately prior to auditory fear conditioning training involving the pairing of auditory clicks with a cloth containing cat odor. When presented to the conditioned auditory clicks in the next 5 days of extinction testing conducted in a runway apparatus with a hide box, rats in the two shock groups engaged in higher levels of freezing and head out vigilance-like behavior from the hide box than the no shock control group. This increase in fear behavior during extinction testing was likely due to auditory activation of the conditioned fear state because Experiment 2 demonstrated that conditioned fear behavior was not broadly increased in the absence of the conditioned auditory stimulus. Experiment 3 was then conducted to determine whether acute exposure to stress induces a habituation resistant sensitized fear state. We found that rats exposed to 0.8 mA footshock stress and subsequently tested for 5 days in the runway hide box apparatus with presentations of nonassociative auditory clicks exhibited high initial levels of freezing, followed by head out behavior and culminating in the occurrence of locomotor hyperactivity. In addition, Experiment 4 indicated that without delivery of nonassociative auditory clicks, 0.8 mA footshock stressed rats did not exhibit robust increases in sensitized freezing and locomotor hyperactivity, albeit head out vigilance-like behavior continued to be observed. In summary, our animal model provides novel information on the effects of different intensities of footshock stress, auditory-predator odor fear conditioning, and their interactions on facilitating either extinction-resistant or habituation-resistant fear-related behavior. These results lay the foundation for exciting new investigations of the hallmarks of PTSD that include the stress-induced formation and persistence of traumatic memories and sensitized fear.

BACKGROUND

Cervical cancer is common among women worldwide. A multitude of risk factors aggravate the disease. This study was conducted to: (1) determine the prevalence and (2) make a comparative analysis of the socio-demographic and behavioural risk factors of cervical cancer and knowledge, attitude and practice between rural and urban women of North Bengal, India.

METHODS

Community-based cross-sectional study.

METHODS

A survey (first in North Bengal) was conducted among 133 women in a rural area (Kawakhali) and 88 women in an urban slum (Shaktigarh) using predesigned semi-structured questionnaires. The respondents were informed of the causes (including HPV), signs and symptoms, prevention of cervical cancer and treatment, and the procedure of the PAP test and HPV vaccination.

RESULTS

The prevalence of risk factors like multiparity, early age of marriage, use of cloth during menstruation, use of condom and OCP, early age of first intercourse was 37.2%, 82%, 83.3%, 5.4%, 15.8% and 65.6% respectively. Awareness about the cause, signs and symptoms, prevention of cervical cancer, PAP test and HPV vaccination was 3.6%, 6.3%, 3.6%, 9.5% and 14.5% respectively. Chi-square testing revealed that in the study population, significant differential at 5% exists between rural and urban residents with respect to number of children, use of cloth/sanitary napkins, family history of cancer and awareness regarding causes of cervical cancer. Regarding KAP, again using chi-square tests, surprisingly, level of education is found to be significant for each element of KAP in urban areas in contrast to complete absence of association between education and elements of KAP in rural areas.

CONCLUSIONS

A large number of risk factors were present in both areas, the prevalence being higher in the rural areas. The level of awareness and role of education appears to be insignificant determinants in rural compared to urban areas. This pilot study needs to be followed up by large scale programmes to re-orient awareness campaigns, especially in rural areas.

A facile and efficient electrochemical oxidation method to directly activated carbon cloth as an excellent electrode material for supercapacitors is reported. Flexible asymmetric supercapacitor devices based on activated carbon cloth anodes reach a remarkable energy density and excellent long-term durability.

Face masks and respirators are the most widely used intervention measures for respiratory protection. In the wake of COVID-19, in response to shortages and lack of availability of surgical masks and respirators, the use of cloth masks has become a research focus. Various fabrics have been promoted with little evidence-based foundation and without guidelines on design principles for optimal performance. In these circumstances, it is essential to understand the properties, key performance factors, filter mechanisms and evidence on cloth masks materials. The general community might also need to decontaminate and reuse disposable, single-use devices as a last resort. We present an overview of the filter materials, filter mechanisms and effectiveness, key performance factors, and hydrophobicity of the common disposable masks, as well as cloth masks. We also reviewed decontamination methods for disposable respiratory devices. As an alternative to surgical masks and respirators, we recommend a cloth mask made of at least three layers (300-350 threads per inch) and adding a nylon stocking layer over the mask for a better fit. Water-resistant fabrics (polyesters/nylon), blends of fabrics and water-absorbing fabrics (cotton) should be in the outside layer, middle layer/layers and inside layer, respectively. The information outlined here will help people to navigate their choices if facing shortages of appropriate respiratory protection during the COVID-19 pandemic.

Keywords: equipment evaluations; infection control.

OBJECTIVE

Deep infection after shoulder surgery is a rare but devastating problem. This study tested the hypothesis that the home application of a 2% chlorhexidine gluconate cloth before shoulder surgery would be more efficacious than a standard shower of soap and water at decreasing the preoperative cutaneous levels of pathogenic bacteria on the shoulder.

METHODS

This randomized, prospective study evaluated 100 consecutive patients undergoing shoulder surgery. Patients were randomly assigned to use 2% chlorhexidine gluconate-impregnated cloths (treatment group) or to shower with soap and water before surgery (control group). Cutaneous cultures were taken from the patients'shoulders in the preoperative holding area. Patients were monitored for 2 months postoperatively for clinical signs of infection.

RESULTS

In the treatment group vs the control group, the overall positive culture rate was 66% vs 94% (P = .0008), and the positive culture rate for coagulase-negative Staphylococcus was 30% vs 70% (P = .0001). The positive culture rate for Propionibacterium acnes was 46% in the treatment group vs 58% in the control group (P = .32). No infections occurred in any patients at a minimum of 2-months after surgery.

CONCLUSIONS

The use of the 2% chlorhexidine cloth was effective at decreasing overall bacterial culture rates before shoulder surgery and was particularly effective at decreasing the quantity of coagulase-negative Staphylococcus, a known causative agent of postoperative shoulder infections.

CONCLUSIONS

Use of chlorhexidine impregnated cloths prior to shoulder surgery may be a useful adjunct to presently used infection prevention strategies.

Five adhesive traps and the Nzi cloth-target trap were compared to determine their trapping efficiency and biases for stable flies, Stomoxys calcitrans (L.) (Diptera: Muscidae). Two configurations of the BiteFree prototype trap, constructed of polyethylene terephthalate, were most efficient for trapping stable flies, whereas the EZ trap was least efficient. The two Alsynite traps, Broce and Olson, were intermediate to the BiteFree prototype and EZ traps. All adhesive traps collected a ratio of approximately two males for each female. Approximately 50% of the flies collected on the adhesive traps, both male and female, were blood fed, and 20% were vitellogenic. The Nzi trap collected an older component of the stable fly population, 81% blood fed and 62% vitellogenic, but it was much less efficient than the adhesive traps. The effectiveness of the BiteFree prototype trap indicates that materials other than Alsynite are attractive to stable flies.

The purposes of this study were to (1) evaluate the reliability and reproducibility of chest expansion (CE) measurement on 2 different levels and (2) observe relationships between upper and lower CE measurements and lung function.

Fifty-three healthy subjects aged between 18 and 39 years were recruited. Chest expansion measurements were taken with a cloth tape measure at 2 levels of the rib cage (upper and lower). Reproducibility of the measurement was measured for 2 physiotherapists and on 2 different days. Lung function (ie, forced expiratory volume in 1 second [FEV1], forced vital capacity (FVC), vital capacity and, inspiratory capacity) was measured for all subjects by a spirometer (MEC Pocket-spiro USB100, Medical Electronic Construction, Brussels, Belgium).

Upper CE was less than lower CE (5.4 cm and 6.4 cm, respectively; P < .001). Intrarater and interrater reliability were good for upper and lower CE. Reproducibility between physiotherapists was verified for both CE measurements. Reproducibility between days was only verified for upper CE. Sex influenced lower CE. Upper and lower CE values were correlated (r = 0.747; P < .01). Lower and upper CE were significantly and positively correlated with all lung function parameters and inspiratory muscle strength (moderately and weakly, respectively) except to inspiratory capacity for upper CE (P = .051) and for FEV1/FVC for both CE measurements.

Upper and lower CE measurements showed good intra- and interrater reliability and reproducibility in healthy subjects. Although both measurements were correlated with lung functions (ie, FEV1, FVC, and vital capacity), the findings of this study showed that upper CE measurements may be more useful in clinical practice to evaluate chest mobility and to give indirect information on lung volume function and inspiratory muscle strength.

The Government of India has started a new scheme aimed at offering sanitary pads at a subsidized rate to adolescent girls in rural areas. This paper addresses menstrual health and hygiene practices among adolescent girls in a rural, tribal region of South Gujarat, India, and their experiences using old cloths, a new soft cloth (falalin) and sanitary pads. Qualitative and quantitative data were collected in a community-based study over six months, with a pre-and post- design, among 164 adolescent girls from eight villages. Questions covered knowledge of menstruation, menstrual practices, quality of life, experience and satisfaction with the different cloths/pads and symptoms of reproductive tract infections. Knowledge regarding changes of puberty, source of menstrual blood and route of urine and menstrual flow was low. At baseline 90% of girls were using old cloths. At the end of the study, 68% of adolescent girls said their first choice was falalin cloths, while 32% said it was sanitary pads. None of them preferred old cloths. The introduction of falalin cloths improved quality of life significantly (p<0.000) and to a lesser extent also sanitary pads. No significant reduction was observed in self-reported symptoms of reproductive tract infections. Falalin cloths were culturally more acceptable as they were readily available, easy to use and cheaper than sanitary pads.

During volcanic eruptions and their aftermath, communities may be concerned about the impacts of inhaling volcanic ash. Access to effective respiratory protection (RP) is therefore important for many people in volcanic areas all over the world. However, evidence to support the use of effective RP during such crises is currently lacking. The aim of this study was to build the first evidence base on the effectiveness of common materials used to protect communities from ash inhalation in volcanic crises. We obtained 17 forms of RP, covering various types of cloth through to disposable masks (typically used in occupational settings), which communities are known to wear during volcanic crises. The RP materials were characterised and subjected to filtration efficiency (FE) tests, which were performed with three challenge dusts: ashes from Sakurajima (Japan) and Soufrière Hills (Montserrat) volcanoes and aluminium oxide (Aloxite), chosen as a low-toxicity surrogate dust of similar particle size distribution. FE tests were conducted at two concentrations (1.5 mg/m3 and 2.5 mg/m3) and two flow rates (equivalent to 40 and 80 l/min through 15.9 cm2 sections of each RP type). Each material was held in a sample holder and PM2.5 dust concentrations were measured both outside the mask material and inside the sample holder to determine FE. A limited number of tests were undertaken to assess the effect on FE of wetting a bandana and a surgical mask, as well as folding a bandana to provide multiple filter layers. Overall, four RP materials performed very well against volcanic ash, with median FEs in excess of 98% (N95-equiv., N99-equiv., PM2.5 surgical (Japan), and Basic flat-fold (Indonesia)). The two standard surgical masks tested had median FEs of 89-91%. All other materials had median FEs ranging from 23 to 76% with no cloth materials achieving >44%. Folding a bandana resulted in better FE (40%; 3× folded) than single-layered material (29%). Wetting the bandana and surgical mask material did not improve FE overall. This first evidence base on the FE of common materials used to protect communities in volcanic crises from ash inhalation has been extended in a companion study (Steinle et al., 2018) on the total inward leakage of the best-performing masks when worn by human volunteers. This will provide a complete assessment of the effectiveness of these RP types.

MOF-derived ZnO@ZnO Quantum Dots/C core-shell nanorod arrays grown on flexible carbon cloth are successfully fabricated as a binder-free anode for Li-ion storage. In combination with the advantages from the ZnO/C core-shell architecture and the 3D nanorod arrays, this material satisfies both efficient ion and fast electron transport, and thus shows superior rate capability and excellent cycling stability.

Although textile-based triboelectric nanogenerators (TENGs) are highly promising because they scavenge energy from their working environment to sustainably power wearable/mobile electronics, the challenge of simultaneously possessing the qualities of cloth remains. In this work, we propose a strategy for TENG textiles as power cloths in which core-shell yarns with core conductive fibers as the electrode and artificial polymer fibers or natural fibrous materials tightly twined around core conductive fibers are applied as the building blocks. The resulting TENG textiles are comfortable, flexible, and fashionable, and their production processes are compatible with industrial, large-scale textile manufacturing. More importantly, the comfortable TENG textiles demonstrate excellent washability and tailorability and can be fully applied in further garment processing. TENG textiles worn under the arm or foot have also been demonstrated to scavenge various types of energy from human motion, such as patting, walking, and running. All of these merits of proposed TENG textiles for clothing uses suggest their great potentials for viable applications in wearable electronics or smart textiles in the near future.

Proximal humerus fractures and fractures of the humeral shaft are relatively rare in children. The incidence of the former is about 1 to 3 cases/1000 population per year, comprising fewer than 3% of all pediatric fractures. Fractures of the humeral shaft represent fewer than 10% of all humerus fractures in children. Both types of fractures in babies and young children can be treated nonsurgically, because of the joint's ability to remodel. Simple swaddling with a sling or swaddling cloth can be the solution. For older children, splints and braces may be necessary for short periods of time. Fractures can sometimes be a sign of parental child abuse, so suspicion should remain high when evaluating children with these injuries.

Three sites in south west Scotland, each having one deciduous and one coniferous woodland with populations of roe deer, were sampled over three years for Ixodes ricinus Linnaeus ticks using cloth drags. Nymphs and adult ticks were age graded by dissection of gut and Malpighian tubules and staining for lipid with Sudan red. Temperature and relative humidity were recorded in developmental and questing microclimates. Two annual cohorts of both nymphs and adults were found. For both instars one cohort became apparent in early spring and the other in autumn. The timing of the cohorts of nymphs corresponded to peaks of numbers questing, but neither females nor males had any clear seasonal pattern of questing. The maximum life of questing nymphs and adults was three to four months. Nymphs and adults were found questing at all months of the year and at temperatures ranging from 3.5 degrees C to 29.3 degrees C. Questing of larvae in summer peaks of numbers was positively correlated with temperature and negatively correlated with relative humidity. These results are explained by a descriptive model which invokes behavioural and morphogenetic diapause. Tests of the model are discussed and it is proposed that the main adaptive advantage of the complex life cycle is to permit moulting and oviposition to occur at favourable summer temperatures in ticks that have engorged at any time of the year.

There has been growing recognition of menstrual hygiene management (MHM) as a significant public health issue. However, research has predominately focused on the experiences of adolescent girls in school settings. The purpose of this research is to examine detailed accounts of menstruation for women in rural Odisha, India at various life stages with a view toward improving international monitoring of MHM. Focus group discussions and in-depth interviews were conducted to understand women's experiences of menstruation across four life stages (unmarried women, recently married women, married women, and older women). Thematic analysis was used to identify menstruation-related challenges and needs. We found women voiced needs that aligned with those captured by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) definition for MHM: access to clean materials, privacy for changing materials, soap and water for bathing, and disposal facilities for materials. However, we also found women require materials that are not only clean but comfortable and reliable; soap and water for more than bathing; privacy for the full spectrum of menstruation-related practices, not just when changing; and disposal facilities that are private and safe, not just accessible. Additionally, we identified needs that extend beyond the existing definition: pain management, social support, and an enabling sociocultural environment. Overall, women representing all life stages discussed menstruation challenges, including bathing, pain, and washing, drying, and storing cloth materials. Cloth management challenges were most acute for unmarried and recently married women, who were concerned that practices could reveal their menstrual status and harm their reputations, thus informing their preference for disposable materials, if attainable. We propose a revised definition of adequate MHM for this population that more comprehensively captures their needs. This definition may also prove useful for other populations, future research, creating measures of assessment, and guiding interventions and program priorities.

The aim of this work was to study the methanogenic metabolism of dog food, a food waste surrogate, in laboratory-scale reactors with different carbon-based conductive materials. Carbon cloth, carbon felt, and granular activated carbon all permitted higher organic loading rates and promoted faster recovery of soured reactors than the control reactors. Microbial community analysis revealed that specific and substantial enrichments of Sporanaerobacter and Methanosarcina were present on the carbon cloth surface. These results, and the known ability of Sporanaerobacter species to transfer electrons to elemental sulfur, suggest that Sporanaerobacter species can participate in direct interspecies electron transfer with Methanosarcina species when carbon cloth is available as an electron transfer mediator.

We assessed a pilot project by UNICEF and Hindustan Unilever Limited to improve the quality of drinking water for children in schools through adoption of improved drinking water practices among households in southern India. The intervention consisted of providing classrooms of 200 schools a commercial water purifier, and providing basic hygiene and water treatment information to students, parents, and teachers. We found no evidence that the intervention was effective in improving awareness or uptake of effective water treatment practices at home. A similar proportion of household members in the intervention and control groups boiled their water (P = 0.60), used a ceramic filtration system (P = 0.33), and used a cloth filter (P = 0.89). One year after the launch of the campaign, household ownership of the commercial purifier promoted at schools was higher in the intervention group (26%) than the control group (19%), but this difference was not statistically significant (P = 0.53).

A linked-registry was used to examine systematically, on a national basis, the leukemia incidence in Swedish men by industry and occupation. New associations were observed for chronic lymphocytic leukemia among cloth and pattern cutters and for chronic myelocytic leukemia among brewery workers and motor mechanics. A number of additional findings were consistent with previous observations in other countries. Although etiologic inferences are limited when using linked-registry data, this hypothesis-generating study may provide new clues to the occupational determinants of specific forms of leukemia.

BACKGROUND

The extent to which reproductive tract infections (RTIs) are associated with poor menstrual hygiene management (MHM) practices has not been extensively studied. We aimed to determine whether poor menstrual hygiene practices were associated with three common infections of the lower reproductive tract; Bacterial vaginosis (BV), Candida, and Trichomonas vaginalis (TV).

METHODS

Non-pregnant women of reproductive age (18-45 years) and attending one of two hospitals in Odisha, India, between April 2015 and February 2016 were recruited for the study. A standardized questionnaire was used to collect information on: MHM practices, clinical symptoms for the three infections, and socio-economic and demographic information. Specimens from posterior vaginal fornix were collected using swabs for diagnosis of BV, Candida and TV infection.

RESULTS

A total of 558 women were recruited for the study of whom 62.4% were diagnosed with at least one of the three tested infections and 52% presented with one or more RTI symptoms. BV was the most prevalent infection (41%), followed by Candida infection (34%) and TV infection (5.6%). After adjustment for potentially confounding factors, women diagnosed with Candida infection were more likely to use reusable absorbent material (aPRR = 1.54, 95%CI 1.2-2.0) and practice lower frequency of personal washing (aPRR = 1.34, 95%CI 1.07-1.7). Women with BV were more likely to practice personal washing less frequently (aPRR = 1.25, 95%CI 1.0-1.5), change absorbent material outside a toilet facility (aPRR = 1.21, 95%CI 1.0-1.48) whilst a higher frequency of absorbent material changing was protective (aPRR = 0.56, 95%CI 0.4-0.75). No studied factors were found to be associated with TV infection. In addition, among women reusing absorbent material, Candida but not BV or TV - infection was more frequent who dried their pads inside their houses and who stored the cloth hidden in the toilet compartment.

CONCLUSIONS

The results of our study add to growing number of studies which demonstrate a strong and consistent association between poor menstrual hygiene practices and higher prevalence of lower RTIs.