Investigating Fish Contamination Scenario and Community Willingness to Adopt Consumption Advice Proposing an Advisory Model

Consumption advice to ensure the health and safety of fish consumers remains urgent to handle the ever-increasing panic over heavy metal toxicity. Moreover, studies of fish consumption rarely focus on the perceptions and awareness of consumers. Considering this, the present study examines the knowledge and perceptions of the risks and benefits of fish consumption among consumers of Laguna de Bay to explore their willingness to follow fish consumption advice. The seasonal variation in selected types of heavy metal contamination in two commercially important fish species, tilapia and mudfish, was analysed and a vulnerability map based on the risk‒benefit ratio was produced for Laguna de Bay. Furthermore, this study formulates fish consumption advice for consumers of fish in the area. Primary data on consumers’ perceptions were collected through a questionnaire, whereas heavy metal contamination data were compiled from the best available literature. We concluded that people’s willingness to adopt consumption advice is mostly dependent on their existing level of fish consumption. Moreover, consumption advice is formulated to indicate restrictions on consumption for the areas identified as vulnerable due to contamination. This empirical study can serve as a model for the future development of fish consumption advice in the region.

Feasibility of a community pharmacy antimicrobial stewardship intervention (PAMSI): an innovative approach to improve patients’ understanding of their antibiotics

Background Community pharmacy staff have an opportunity to play a pivotal role in antimicrobial stewardship (AMS) due to their expertise in medicines and accessibility to patients. Objectives To develop and test the feasibility of a pharmacy AMS intervention (PAMSI) to increase community pharmacy staff’s capability, opportunity and motivation to check antibiotic appropriateness and provide self-care and adherence advice when dispensing antibiotics. Methods The PAMSI was centred around an Antibiotic Checklist, completed by patients and pharmacy staff, to facilitate personalized advice to the patient, based on their reported knowledge. An educational webinar for staff and patient-facing materials were also developed. Staff and patients completing Antibiotic Checklists were invited to provide feedback via questionnaires. Results In February 2019, 12 community pharmacies in England trialled the intervention. Forty-three pharmacy staff evaluated the educational webinar and reported increases in their understanding, confidence, commitment and intention to use the tools provided to give adherence and self-care advice. Over 4 weeks, 931 Antibiotic Checklists were completed. Staff reported being more focused on giving advice and able to address patients’ knowledge gaps (mainly: likely symptom duration; alcohol and food consumption advice; possible side effects from antibiotics; returning unused antibiotics to the pharmacy), resulting in increased self-reported effective and meaningful conversations. Conclusions Implementation of a PAMSI is feasible and effectively promotes AMS. Pharmacy staff and commissioners should consider this within their AMS plans. An optional digital format of the Antibiotic Checklist should be explored, for patients who are not collecting their antibiotic prescriptions themselves, and to save printing costs.

Listeria Monocytogenes Prosthetic Joint Infection, Case Report and Review of the Literature

Background: Listeria monocytogenes causes bacteraemia in elderly and immunocompromised patients and rarely also in immunocompetent patients. In sporadic setting it can be challenging to diagnose. We present the first case of Listeria monocytogenes infection presenting as an acute infection of a prosthetic joint in an immunocompetent patient. Case summary: An immunocompetent patient presented with acute onset of right hip pain lasting for 3 days. The day before admission the patient had fever of 38.5°C and chills. The patient admitted having eaten raw meat some days prior to onset of symptoms. He had a prosthetic right hip implanted due to secondary arthritis 9 months prior to onset of hip symptoms. He was treated successfully with removal of mobile parts and appropriate antibiotic treatment. Conclusion: Sporadic focal infections with Listeria monocytogenes occur rarely and are often not diagnosed until the arrival of final culture results. Dietary history is also important when clinical history of patients is taken. Food consumption advice is important in immunocompromised, but also immunocompetent patients can get infected when eating raw food. Accurate diagnosis for orthopaedic samples is crucial. In order to successfully treat patients with a prosthetic joint infection, a tight collaboration between several specialists is needed.

Consuming sustainable seafood: guidelines, recommendations and realities

ObjectiveEncouraging people to eat more seafood can offer a direct, cost-effective way of improving overall health outcomes. However, dietary recommendations to increase seafood consumption have been criticised following concern over the capacity of the seafood industry to meet increased demand, while maintaining sustainable fish stocks. The current research sought to investigate Australian accredited practising dietitians’ (APD) and public health nutritionists’ (PHN) views on seafood sustainability and their dietary recommendations, to identify ways to better align nutrition and sustainability goals.DesignA self-administered online questionnaire exploring seafood consumption advice, perceptions of seafood sustainability and information sources of APD and PHN. Qualitative and quantitative data were collected via open and closed questions. Quantitative data were analysed with χ2 tests and reported using descriptive statistics. Content analysis was used for qualitative data.SettingAustralia.SubjectsAPD and PHN were targeted to participate; the sample includes respondents from urban and regional areas throughout Australia.ResultsResults indicate confusion around the concept of seafood sustainability and where to obtain information, which may limit health professionals’ ability to recommend the best types of seafood to maximise health and sustainability outcomes. Respondents demonstrated limited understanding of seafood sustainability, with 7·5 % (n 6/80) satisfied with their level of understanding.ConclusionsNutrition and sustainability goals can be better aligned by increasing awareness on seafood that is healthy and sustainable. For health professionals to confidently make recommendations, or identify trade-offs, more evidence-based information needs to be made accessible through forums such as dietetic organisations, industry groups and nutrition programmes.