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A wide variety of antibiotics and other pharmaceuticals are used in livestock production systems and residues passed to the environment, often unmetabolized, after use and excretion. Antibiotic residues may be transported from manure-treated soils via runoff and are also capable of reaching surface and groundwater systems through a variety of pathways. The occurrence and persistence of antibiotics in the environment is a concern due to the potential for ecological effects and proliferation of environmental antibiotic resistance in pathogenic organisms. In the present study, the occurrence and seasonal variation of 24 commonly-used veterinary antibiotics was evaluated in surface water adjacent to several livestock production systems using Polar Organic Chemical Integrative Samplers (POCIS). DNA Repair inhibitor Uptake rates for all compounds, nine of which have not been previously reported, were measured in the laboratory to permit estimation of changes in the time-weighted average (TWA) antibiotic concentrations during exposure. The antibiotics detected in POCIS extracts included sulfadimethoxine, sulfamethoxazole, trimethoprim, sulfamerazine, sulfadiazine, lincomycin, erythromycin, erythromycin anhydro- and monensin. The maximum TWA concentration belonged to sulfadiazine (25 ng/L) in the August-September sampling period and coincided with the highest number of precipitation events. With the exception of monensin that showed an increase in concentration over the stream path, none of the detected antibiotics were prescribed to livestock at the facility. The detection of antibiotics not prescribed by the facility may be attributable to the environmental persistence of previously used antibiotics, transfer by wind from other nearby livestock production sites or industrial uses, and/or the natural production of some antibiotics.External antiparasitic agents applied in bovine production represent a risk to consumers of meat products, especially if the conditions of their use are not strictly respected. The post-mortem control of residues in meat is an activity that must be updated and reinforced by the biomonitoring of live animals and the use of analytical tools to help identifying signs of early warning risks. The objective of the present study was to carry out a pre-slaughter biomonitoring approach in Aberdeen Angus cattle and crosses (n = 12) with the application of a commercial formulation of cypermethrin plus chlorpyrifos. This was performed with a single therapeutic dose applied on the backs of the cattle, through hematological, enzymatic, as well as hepatic and renal function analysis in plasma, and then quantifying the genotoxic effect on lymphocytes. Analytical measurements of plasma concentrations of cypermethrin plus chlorpyrifos at 24 h were negative and therefore a low absorption of the compounds was assumed. Measurement of acetyl cholinesterase showed no inhibition after exposure. The concentration of urea increased between 24 h and 168 h post application of the formulation, without showing any kidney damage. The rest of the parameters analyzed did not show any variations. This evaluation of hematological and biochemical effects and of cytokinesis-block micronucleus cytome assay in bovines is proposed as a pre-slaughter control of biomonitoring of the health status of animals, with a focus on food safety for meat consumers.Adequate environmental health services are critical for human rights, health, and development, especially in the context of forced displacement. There are more than 70 million forcibly displaced persons worldwide, most in protracted situations, having been displaced for more than two years. Some live in camps or informal settlements, but most live in urban areas. Environmental health services are important in the transition from emergency response to sustainable development in these settings, but evidence on environmental health in displaced populations is disparate and of variable quality. We conducted a systematic scoping review of environmental conditions, exposures, and outcomes in protracted displacement settings; obstacles to improvement in environmental health services; and recommendations made for improvement. We included 213 publications from peer-reviewed and grey literature databases. Data were extracted on environmental health topics including water, sanitation, hygiene, overcrowding, waste managent by preparing for long-term displacement from the early stages of a crisis.Increasing water consumption from various economic activities has posed increasing challenges for the sustainability of developing countries. In particular, China is facing a sharp conflict between rapid economic development and water shortage. Evaluating the decoupling state between economic growth and water consumption and exploring the driving factors behind this could serve to develop strategy to moving to economic growth without water use growth. To this end, this work uses the Tapio decoupling and LMDI decomposition methods to evaluate the decoupling performance between China's water consumption and economic growth at the national and provincial levels, and six driving factors are decomposed, namely water consumption intensity, industrial structure, economic development, water resource utilization rate, water resource endowment and population size. Results show that (1) Only two decoupling states, strong decoupling and weak decoupling, occurred at national level, and the decoupling index shows a decreasing trend. (2) 31 provinces showed only two states of strong decoupling and weak decoupling. More than 60% of the provinces showed strong decoupling after 2011, and the decoupling effect was significantly better than that of 2004-2011. (3) The effects of water consumption intensity and industrial structure drive the occurrence of decoupling. Economic level and population size have a positive incremental effect on water consumption. Finally, we propose policy recommendations such as developing water-saving technologies and optimizing industrial structure to promote water sustainability. The comprehensive methodology in this paper provides a theoretical reference for research in other countries or other environmental issues. Governments in various regions can formulate effective measures to achieve sustainable use of water resources, responding to the 2030 Agenda for Sustainable Development.Introduction Chest physiotherapy (CPT) may benefit children aged less then 5 years who suffer from lower respiratory tract infection (LRTI). However, its effects are technique-dependent. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI. Methods Children aged 5 months to 5 years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid®. Outcomes measured at pre-intervention and 2 hours post-intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score. Results All 30 enrolled patients had significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT. Conclusion Children receiving either manual or mechanical CPT showed improvements in respiratory distress symptoms with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements of moderately severe respiratory distress. The LEGA-Kid mechanical CPT method was superior in reducing RR.Introduction Singapore has had three medical schools since 2013. We undertook a cross-sectional quantitative national survey to determine the financial impact of medical education on medical students in Singapore. Methods All 1,829 medical students in Singapore were invited to participate in this study. Information on demographics, financial aid utilisation and outside work was collected and analysed. Results 1,241 (67.9%) of 1,829 students participated in the survey. While the overall proportion of students from households with monthly incomes SGD 75,000. There were significant differences in per capita incomes among the schools, with 54.5%, 23.3% and 7.8% of Duke-NUS Medical School (Duke-NUS), NUS Yong Loo Lin School of Medicine (NUS Medicine) and Lee Kong Chian School of Medicine (LKCMedicine) students, respectively, reporting a per capita income of less then SGD 1,000 (p less then 0.001). There were significant differences in financial support 75.0%, 34.1% and 38.8% of Duke-NUS, NUS Medicine and LKCMedicine students received financial aid, respectively (p less then 0.001). The top reasons for not applying for aid included a troublesome application process (21.4%) and the perception that it would be too difficult to obtain (21.0%). Conclusion Students in the three medical schools in Singapore differ in their financial needs and levels of financial support received. A national approach to funding medical education may be needed to ensure that financial burdens do not hamper the optimal training of doctors for Singapore's future.Using the National (Nationwide) Inpatient Sample (NIS), this Healthcare Cost and Utilization Project (HCUP) Statistical Brief presents statistics for three groups of inpatient stays for patients aged 18 years and older Those related to opioid use disorder and endocarditis (OUD-endocarditis stays)Those related to opioid use disorder but not endocarditis (OUD stays)Those related to endocarditis but not opioid use disorder (endocarditis stays)Depression in children and young people can have a devastating impact on their development, ability to function and attendance at school. The 2015 NICE guidance (NICE guideline CG28) on depression in children and young people recommends psychological interventions for people with mild or moderate to severe depression before pharmacological interventions are considered. Psychological interventions can be delivered as group interventions (e.g. group Cognitive Behavioural Therapy, CBT), using computers or other digital devices (e.g. computer CBT), as individual sessions (e.g. CBT) or as sessions involving family in addition to the child or young person with depression, either in joint sessions (e.g. family therapy) or in parallel (interpersonal psychotherapy, IPT, which includes some parent sessions, psychodynamic psychotherapy). The choice of therapy is based on the individual needs of the child or young person with depression, taking into account their history and presentation and the context in which treatmen specified in Table 1. For full details of the review protocol, see appendix A.With funding from the AHRQ Effective Health Care Program, the Pacific Northwest Evidence-based Practice Center produced two reports on telehealth (1) in 2016 an evidence mapon the impact of telehealth on patient outcomes7 and (2) in 2019 a systematic review of the evidence about telehealth for acute- and chronic-care consultations. In this commentary, we summarize evidence on selected topics from these reports that may be relevant in the context of the response to the COVID-19 pandemic.

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