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Purpose: Essential oils from various plants have diverse therapeutic properties and are researched extensively. They have applications in medicine, aromatherapy, microbiology, agriculture, livestock, and the food industry, benefiting the population. Methods: This systematic review followed the PRISMA verification protocol. The study focused on the anti-inflammatory effects, nutraceutical properties, antioxidant and antibacterial activity of essential oils in lemon, orange, cumin, cinnamon, coriander, rosemary, thyme, and parsley. We also looked at their presence in the diet, their effect, their mechanism of action on health, and the most important active compounds. The search was conducted in the PubMed database for the last 12 years of publications, including in vitro, in vivo, and online cell model tests. Results: Essential oils have been shown to have multiple health benefits, primarily due to their antimicrobial and anti-inflammatory effects. The mechanism of action of cinnamon oil alters bacterial membranes, modifies lipid profiles, and inhibits cell division, giving a potential benefit in protection against colitis. On the other hand, a significant improvement was observed in the diastolic pressure of patients with metabolic syndrome when supplementing them with cumin essential oil. The antimicrobial properties of coriander essential oil, especially its application in seafood like tilapia, demonstrate efficacy in improving health and resistance to bacterial infections. Cumin essential oil treats inflammation. Parsley essential oil is an antioxidant. Orange peel oil is antibacterial, antifungal, antiparasitic, and pro-oxidative. Lemon essential oil affects mouse intestinal microbiota. Thyme essential oil protects the colon against damage and DNA methylation. Carnosic acid in rosemary oil can reduce prostate cancer cell viability by modifying the endoplasmic reticulum function. Conclusion and discussion: Essential oils have many therapeutic and antiparasitic properties. They are beneficial to human health in many ways. However, to understand their potential benefits, more research is needed regarding essential oils such as coriander, parsley, rosemary, cumin, and thyme. These research gaps are relevant since they restrict understanding of the possible benefits of these crucial oils for health-related contexts.

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Purpose of Review: Review international efforts to build a global public health initiative focused on toxoplasmosis with spillover benefits to save lives, sight, cognition and motor function benefiting maternal and child health. Recent Findings: Multiple countries' efforts to eliminate toxoplasmosis demonstrate progress and context for this review and new work. Summary: Problems with potential solutions proposed include accessibility of accurate, inexpensive diagnostic testing, pre-natal screening and facilitating tools, missed and delayed neonatal diagnosis, restricted access, high costs, delays in obtaining medicines emergently, delayed insurance pre-approvals and high medicare copays taking considerable physician time and effort, harmful shortcuts being taken in methods to prepare medicines in settings where access is restricted, reluctance to perform ventriculoperitoneal shunts promptly when needed without recognition of potential benefit, access to resources for care, especially for marginalized populations, and limited use of recent advances in management of neurologic and retinal disease which can lead to good outcomes. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00268-x.

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Purpose of Review: Review building of programs to eliminate Toxoplasma infections. Recent Findings: Morbidity and mortality from toxoplasmosis led to programs in USA, Panama, and Colombia to facilitate understanding, treatment, prevention, and regional resources, incorporating student work. Summary: Studies foundational for building recent, regional approaches/programs are reviewed. Introduction provides an overview/review of programs in Panamá, the United States, and other countries. High prevalence/risk of exposure led to laws mandating testing in gestation, reporting, and development of broad-based teaching materials about Toxoplasma. These were tested for efficacy as learning tools for high-school students, pregnant women, medical students, physicians, scientists, public health officials and general public. Digitized, free, smart phone application effectively taught pregnant women about toxoplasmosis prevention. Perinatal infection care programs, identifying true regional risk factors, and point-of-care gestational screening facilitate prevention and care. When implemented fully across all demographics, such programs present opportunities to save lives, sight, and cognition with considerable spillover benefits for individuals and societies. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00269-w.

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(1) Background: There is currently a global consensus that the quality of comprehensive care for acutely hospitalised elderly people should include addressing functionality and mobility, cognitive status, prevention of pressure ulcers, urinary incontinence, falls and delirium, as well as pain control and medication-related problems. The aim of this study is to develop and validate a clinical prediction rule for multimorbid patients admitted to an acute care hospital unit for any of the five adverse events included in our vulnerability pentad: falls, pressure ulcers, urinary incontinence, pain and delirium. (2) Methods: Longitudinal analytical clinimetric study, with two cohorts. The study population will consist of multimorbid patients hospitalised for acute care, referred from the Emergency Room. A clinical prediction rule will be proposed, incorporating predictive factors of these five adverse outcomes described. This study has received funding, awarded in November 2020 (PI-0107-2020), and was approved in October 2019 by the Research Ethics Committee ″Costa del Sol″. (3) Conclusions: Preventing adverse events in hospitalised patients is particularly important for those with multimorbidity. By applying a clinical prediction rule to detect specific risks, an estimate can be obtained of their probability of occurrence.

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Purpose of Review: Review comprehensive data on rates of toxoplasmosis in Panama and Colombia. Recent Findings: Samples and data sets from Panama and Colombia, that facilitated estimates regarding seroprevalence of antibodies to Toxoplasma and risk factors, were reviewed. Summary: Screening maps, seroprevalence maps, and risk factor mathematical models were devised based on these data. Studies in Ciudad de Panamá estimated seroprevalence at between 22 and 44%. Consistent relationships were found between higher prevalence rates and factors such as poverty and proximity to water sources. Prenatal screening rates for anti-Toxoplasma antibodies were variable, despite existence of a screening law. Heat maps showed a correlation between proximity to bodies of water and overall Toxoplasma seroprevalence. Spatial epidemiological maps and mathematical models identify specific regions that could most benefit from comprehensive, preventive healthcare campaigns related to congenital toxoplasmosis and Toxoplasma infection.

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Purpose of Review: Review work to create and evaluate educational materials that could serve as a primary prevention strategy to help both providers and patients in Panama, Colombia, and the USA reduce disease burden of Toxoplasma infections. Recent Findings: Educational programs had not been evaluated for efficacy in Panama, USA, or Colombia. Summary: Educational programs for high school students, pregnant women, medical students and professionals, scientists, and lay personnel were created. In most settings, short-term effects were evaluated. In Panama, Colombia, and USA, all materials showed short-term utility in transmitting information to learners. These educational materials can serve as a component of larger public health programs to lower disease burden from congenital toxoplasmosis. Future priorities include conducting robust longitudinal studies of whether education correlates with reduced adverse disease outcomes, modifying educational materials as new information regarding region-specific risk factors is discovered, and ensuring materials are widely accessible.

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INTRODUCCIÓN: el sobrepeso y obesidad infantil son problemas de salud pública en México, por lo que es necesario crear entornos que capaciten y motiven conductas positivas en relación a un estilo de vida saludable. OBJETIVOS: determinar la prevalencia de sobrepeso y obesidad. Describir la actividad física y sedentarismo con relación al nivel socioeconómico. MATERIAL Y MÉTODOS: se llevó a cabo un estudio descriptivo, observacional, transversal y prospectivo en 278 alumnos entre seis y 12 años de edad. Se calculó el IMC, se aplicaron cuatro cuestionarios: CVAFA, CCSNP, CNSE, AMAI 2018. RESULTADOS: la prevalencia de sobrepeso y obesidad fue de 42.7%. La actividad física vigorosa 49.6%. El 95% pasa dos horas diarias frente al televisor, 87% ocupa la computadora una hora diaria para tareas. El 32% toma siesta de 30 minutos. El nivel socioeconómico estuvo correlacionado a los primeros tres niveles. CONCLUSIONES: la prevalencia de sobrepeso y obesidad representa casi la mitad de la población estudiantil. La alimentación de tipo obesogénico da como resultado el IMC elevado, aunque el nivel socieconómico permitía obtener alimentos de buena calidad. La actividad física significativa sólo fue realizada por un bajo porcentaje de estudiantes. Las horas de descanso se encontraron adecuadas a su edad.

INTRODUCTION: Childhood overweight and obesity are public health problems in Mexico, so it is necessary to create environments that train and motivate positive behaviors in relation to a healthy lifestyle. OBJECTIVES: To determinate the prevalence of overweight and obesity. Describe physical activity and sedentary behaviors with socioeconomic status. MATERIAL AND METHODS: A descriptive, observational, cross-sectional and prospective study was carried out in 278 students between six and 12 years old. The BMI was calculated, four questionnaires were applied: CVAFA, CCSNP, CNSE, AMAI 2018. RESULTS: the prevalence of overweight and obesity was 42.7%. Vigorous physical activity 49.6%. A 95% spend two hours a day in front of the television, 87% use the computer an hour a day for homework. 32% nap for 30 minutes. The economic level is correlated to the first three levels. CONCLUSIONS: the prevalence of overweight and obesity represents almost half of the student population. The obesogenic type diet results in a high BMI, although the economic level allowed obtaining quality food. Significant physical activity was also performed by a low percentage of students. The hours of rest were found to be appropriate for their age.

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Introducción: El suicidio sigue siendo la primera causa demuerte externa en España como describe el último informede defunciones según la causa de muerte publicada por elInstituto Nacional de Estadística (INE) en diciembre de 20191.Según este informe los fallecimientos por suicidio registrados en el año 2018 se situaron en 3.539 fallecimientos. Diezpersonas se quitan la vida de forma voluntaria diariamente.La provincia de Málaga registró 134 muertes por suicidio enel mismo año, siendo por tanto una de las provincias conmayor incidencia en la comunidad autónoma de Andalucíay la octava a nivel nacional.Metodología. La muestra del estudio fueron de 135 profesionales. Se trata de un estudio transversal descriptivo deperiodo mediante encuesta, realizado entre los profesionales sanitarios de un Área Sanitaria de Málaga. Las creenciasactitudinales fueron valoradas a través del Cuestionariode Creencias Actitudinales sobre Comportamiento Suicida(CCCS-18) que incluye cuatro factores: legitimización delsuicidio, suicidio en enfermos terminarles, dimensión moraly propio suicidio, medidas con una escala de respuesta enpromedio de 1 a 7 puntos, identificando creencias estigmatizantes aquellas puntuaciones promedias inferiores a 3,5.Resultados. Un total de 135 profesionales completaronel cuestionario, siendo un 58,5 % enfermeras, 25,9 % facultativos y 15,6 % trabajadores sociosanitarios. La puntuaciónmedia de la escala CCCS-18 fue de 3,6 (DE: 1,17) puntos,hallándose diferencias significativas en función de la profesión (p: 0,043), con una media 3,22 (DE: 1,17) en facultativos,3,66 (DE: 1,02) en enfermeras y 3,99 (DE: 1,52) en trabajadores sociosanitarios. En análisis por factores, se hallaronpuntuaciones promedias en la muestra inferior a 3,5, tantoen factor “legitimación del suicidio” (media: 2,59; DE: 1,28),como en factor “propio suicidio” (media: 2,9; DE: 1,47).Conclusiones. (AU)

Introduction: Suicide continues to be the leading external cause of death in Spain, according to the latest report ondeaths by cause of death published by the National StatisticsInstitute (INE, for its initials in Spanish) in December 20191.According to this report, there were 3,539 deaths by suiciderecorded in 2018. Ten people voluntarily ending their liveseach day. Málaga province recorded 134 deaths by suicide in2018, being therefore one of the provinces with the highestincidence in the autonomous community of Andalucía andthe eighth nationally.Method. This descriptive, cross-sectional period-prevalencesurvey of health professionals was carried out in one MálagaHealthcare Area (Spain). The main outcome variable was attitudinal beliefs, which were evaluated using the Questionnaire onAttitudinal Beliefs towards Suicide Behavior (CCCS-18), whichincludes four factors: legitimization of suicide, suicide in terminating patients, moral dimension and suicide itself, measuredwith an average response scale of 1 to 7 points, identifying stigmatizing attitudes or beliefs those average scores lower than 3.5.Results. A total of 135 health professionals completedthe questionnaire, being 58.5% nurses, 25.9% doctors and15.6% social health workers. The mean score of the CCCS-18scale was 3.6 (SD: 1.17) points, finding significant differences depending on the profession (p: 0.043), with a mean 3.22(SD: 1.17) in physicians, 3.66 (SD: 1.02) in nurses, and 3.99(SD: 1.52) in social health workers. In analysis by factors,mean scores were found in the sample below 3.5 both in thefactor “legitimation of suicide” (mean: 2.59; SD: 1.28), andin the factor “own suicide” (mean: 2 , 9; SD: 1.47). (AU)

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Pandemics have historically had a significant impact on economic inequality. However, official inequality statistics are only available at low frequency and with considerable delay, which challenges policymakers in their objective to mitigate inequality and fine-tune public policies. We show that using data from bank records it is possible to measure economic inequality at high frequency. The approach proposed in this paper allows measuring, timely and accurately, the impact on inequality of fast-unfolding crises, like the COVID-19 pandemic. Applying this approach to data from a representative sample of over three million residents of Spain we find that, absent government intervention, inequality would have increased by almost 30% in just one month. The granularity of the data allows analyzing with great detail the sources of the increases in inequality. In the Spanish case we find that it is primarily driven by job losses and wage cuts experienced by low-wage earners. Government support, in particular extended unemployment insurance and benefits for furloughed workers, were generally effective at mitigating the increase in inequality, though less so among young people and foreign-born workers. Therefore, our approach provides knowledge on the evolution of inequality at high frequency, the effectiveness of public policies in mitigating the increase of inequality and the subgroups of the population most affected by the changes in inequality. This information is fundamental to fine-tune public policies on the wake of a fast-moving pandemic like the COVID-19.

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Suicide continues to be the leading external cause of death in Spain, according to the latest report on deaths by cause of death published by the National Statistics Institute (INE, for its initials in Spanish) in December 20191. According to this report, there were 3,539 deaths by suicide recorded in 2018. Ten people voluntarily ending their lives each day. Málaga province recorded 134 deaths by suicide in 2018, being therefore one of the provinces with the highest incidence in the autonomous community of Andalucía and the eighth nationally.

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We reviewed confirmed cases of pediatric invasive meningococcal disease in Tijuana, Mexico, and San Diego County, California, USA, during 2005-2008. The overall incidence and fatality rate observed in Tijuana were similar to those found in the US, and serogroup distribution suggests that most cases in Tijuana are vaccine preventable.

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Controversy exists regarding aortic root reconstruction in the management of acute type A aortic dissection (AAD). One hundred fifty-four patients (mean age 56.9 ± 11.3 years) with AAD had surgical repair between 1996 and 2007. Group 1 (n = 110) required no aortic root surgery. Seventy-one patients had ascending aortic replacement. The aortic valve was repaired in 37 patients (34%) and replaced in one. Group 2 (n = 44) had aortic root surgery. Thirty-four patients had composite root replacement, and seven had a valve-sparing root replacement. Root reconstruction and separate valve replacement was accomplished in three. Hemiarch replacement was included in 39 (35.4%) Group 1 patients and in 12 (27.9%) Group 2 patients. Forty-nine of the 154 patients presented in cardiogenic shock. Multiple risk factors for operative mortality were analyzed. The overall operative mortality was 9.7 per cent: 11 per cent for Group 1 and 6.8 per cent for Group 2 (P = NS). By multivariate analysis, preoperative shock (P = 0.03, odds ratio [OR] = 5.48), postoperative ventricular arrhythmias (P = 0.002, OR = 4.62), and packed red blood cell transfusion (P = 0.002, OR = 1.15) were independent predictors of hospital death. Prompt surgical treatment of AAD before cardiogenic shock ensues can improve the outcome of patients. When indicated, aortic root surgery can be performed without increased mortality and morbidity.

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OBJECTIVE: To understand the factors influencing health workers' choice to work in rural areas as a basis for designing policies to redress geographic imbalances in health worker distribution. METHODS: A cohort survey of 412 nursing and medical students in Rwanda provided unique contingent valuation data. Using these data, we performed a regression analysis to examine the determinants of future health workers' willingness to work in rural areas as measured by rural reservation wages. These data were also combined with those from an identical survey in Ethiopia to enable a two-country analysis. FINDINGS: Health workers with higher intrinsic motivation - measured as the importance attached to helping the poor - as well as those who had grown up in a rural area and Adventists who had participated in a local bonding scheme were all significantly more willing to work in a rural area. The main result for intrinsic motivation in Rwanda was strikingly similar to the result obtained for Ethiopia and Rwanda combined. CONCLUSION: Intrinsic motivation and rural origin play an important role in health workers' decisions to work in a rural area, in addition to economic incentives, while faith-based institutions can also influence the decision.

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Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analysing data obtained from contingent valuation questions for final year students from three medical schools and eight nursing schools, we find that there is substantial heterogeneity in the willingness to serve in rural areas. Using both ordinary least squares and maximum likelihood regression analysis, we find that household consumption and the student's motivation to help the poor are the main determinants of willingness to work in a rural area. We carry out a simulation on how much it would cost to get a target proportion of health workers to take up a rural post.

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BACKGROUND: In trauma patients surviving their initial injuries, infectious complications and multiple organ failure represent the major causes of death after the first 72 hours. Critically injured trauma patients frequently have bacteria recoverable simultaneously from multiple culture sites; the clinical significance of this event is unknown. The objective of this study was to identify the association between growth patterns of multiple site cultures and mortality among critically injured trauma patients. METHODS: We performed a retrospective chart review collecting demographic and medical data on admissions to a state-designated Level I trauma center from April 2000 to December 2002. The inclusion criteria were age >17 years, admission to the trauma intensive care unit (TICU), and simultaneous sampling of blood, sputum, and urine in the setting of fever of undetermined origin or alteration in the white blood cell count. Four mutually exclusive groups were developed according to the number of positive culture sites. We used standard statistical analysis and multivariate logistic regression. RESULTS: During the study period, 3,402 patients were admitted to the trauma service of whom 124 met the inclusion criteria. Eighty percent of these (99) were male, and the average age was 41 years. The median TICU stay was 17 days. The mortality rate was 24.2% (30 nonsurvivors). The survivors and non-survivors were comparable in injury severity score (ISS), initial base deficit, initial hematocrit, initial blood pressure, and hospital length of stay (p > 0.05), whereas age (p = 0.03), female sex (p = 0.04), and TICU stay (p < 0.01) were higher among non-survivors. More non-survivors showed growth of microorganisms in simultaneous blood, sputum, and urine cultures (p = 0.02). By multivariate analysis, adjusting for age, sex, and TICU length of stay, patients with growth of microorganisms in simultaneous cultures (blood, sputum, and urine) had a 3-fold greater mortality rate (OR, 3.20; 95% CI 1.05, 9.73). CONCLUSIONS: In this group of patients, growth of bacteria in simultaneous cultures was associated with higher mortality-a factor that may be considered a poor prognostic indicator. This factor requires further studies to explore the relation with survival in critically injured patients.

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Temporary abdominal closure (TAC) has increasingly been employed in the management of severely injured patients to avoid abdominal compartment syndrome (ACS) and as part of damage control surgery (DCS). Although the use of TAC has received great interest, few data exist describing the morbidity and mortality associated with its use in trauma victims. The main goal of this study is to describe the incidence of surgical complications following the use of TAC as well as to define the mortality associated with this procedure. A retrospective review of patients admitted to a state-designated level 1 trauma center from April 2000 to February 2003 was performed. Inclusion criteria were age >18 years, traumatic injury, and need for exploratory laparotomy and use of TAC. A total of 120 patients were included in the study. The overall mortality of trauma patients requiring TAC was 59.2 per cent. The most common causes of death were acute inflammatory process (50.7%), followed by hypovolemic shock (43.7%). The incidence of surgical complications was 26.6 per cent. Intra-abdominal abscesses were the most frequent surgical complication (10%). After multiple logistic regression analysis, increasing age and a numerically greater initial base deficit were found to be independent predictors of mortality in trauma patients that require TAC.

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