Leptospirosis is a zoonotic disease that is underreported in many countries, including Trinidad and Tobago, because of a low level of awareness of the disease. A knowledge, attitudes and practices (KAP) survey concerning leptospirosis was carried out on 800 households throughout Trinidad to determine the level of awareness of the disease in the country. Of the participants, 52.4% had heard of leptospirosis but approximately half of these did not know any signs or symptoms of the disease. Knowledge of leptospirosis was not related to level of education of people, but to geographical location. Approximately 82% of participants were involved in at least one risk activity, the most common of which was walking barefooted outdoors. The animal which most participants were in contact with was the dog. Of the 53% of participants who had seen a mouse or rat around the house, 5% utilized the free control services of the regional corporation. Approximately 66% of participants were not satisfied with the services provided by the regional corporation. There was a positive attitude towards general health and good sanitary practices among the Trinidad population, but there was also a lack of knowledge of leptospirosis. The low level of awareness of leptospirosis in Trinidad makes it a disease of public health importance, as it is often mistaken for dengue which is more well-known in the country.
BackgroundRecent regulatory changes in the system by which premises are licensed to sell alcohol, have given health representatives a formal role in the process in England and Scotland. The degree to which local public health teams engage with this process varies by locality in both nations, which have different licensing regimes. This study aims to critically assess the impact on alcohol-related harms - and mechanisms - of public health stakeholders’ engagement in alcohol premises licensing from 2012 to 2018, comparing local areas with differing types and intensities of engagement, and examining practice in Scotland and England.MethodsThe study will recruit 20 local authority areas where public health stakeholders have actively engaged with the alcohol premises licensing system (the ‘intervention’) and match them to a group of 20 lower activity areas using genetic matching. Four work packages are included: (1) Structured interviews and documentary analysis will examine the type and level of intervention activity from 2012 to 2018, creating a novel composite measure of the intensity of such activity and will assess the local licensing system and potential confounding activities over the same period. In-depth interviews with public health, licensing, police and others will explore perceived mechanisms of change, acceptability, and impact. (2) Using longitudinal growth models and time series analyses, the study will evaluate the impact of high and low levels of activity on alcohol-related harms using routine data from baseline 2009 to 2018. (3) Intervention costs, estimated National Health Service cost savings and health gains will be evaluated using the Sheffield Alcohol Policy Model to estimate impact on alcohol consumption and health inequalities. (4) The study will engage public health teams to create a new theory of change for public health involvement in the licensing process using our data. We will share findings with local, national and international stakeholders.DiscussionThis interdisciplinary study examines, for the first time, whether and how public health stakeholders’ involvement in alcohol licensing impacts on alcohol harms. Using mixed methods and drawing on complex systems thinking, it will make an important contribution to an expanding literature evaluating interventions not suited to traditional epidemiological research.
Structured physical activity interventions, nutrition interventions, and smoking cessation interventions delivered in a group setting can improve health factors or behaviors of the cardiovascular health of prisoners during incarceration. More high-quality research is needed to increase the evidence base on the effectiveness of these interventions in the correctional setting.
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