Objective. It is unknown whether the public accurately estimate socioeconomic health inequality and whether they wish to see it reduced or eliminated. Methods. Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We present perceived and desired lifespan ratios for each sample and for key socio-demographic variables. Results. The UK public estimated the lifespan of professionals to be 5.9% longer than routine workers (true value of 5.8%), and 67.8% (UK) and 53.7% (US) participants correctly identified that professionals live longer than routine workers. In both populations, the median respondent expressed equal ideal lifespans for routine workers and professional workers. Conclusion. The UK public appear well-appraised on the average lifespan for professionals and routine workers. Across nationalities and most socio-demographic groups, the median respondent was aware of social class inequalities in lifespan and preferred that they be eliminated.

Urbanization is a global phenomenon and as the economies are shifting from rural based subsistence to services based, the net flow of migration is inevitable. Unfortunately, In India, migration is very poorly understood. India is next to China in production of bricks, accounting for nearly 13% of global annual bricks’ production. The condition of brick-kiln workers is pitiable, especially due to poor care available. They are exposed to health hazards such as various communicable diseases, sexually transmitted diseases and occupational health hazards. The diseases such as respiratory problems, allergies, gastrointestinal ailments and malnutrition are frequent in these populations. This paper reflects upon various policies that exist for the welfare of unorganised sector but do these workers qualify for these benefits? This paper provides empirical basis for paradigm shift for policy formulation to provide safety nets for migrant population and have better urban planning for future.

Background: The COVID-19 pandemic has changed the way dentistry has been practiced world over , this study sought to assess the impact of the COVID-19 pandemic on the patterns of attendance for dental treatment in a large hospital in Kuwait compare them to data from the year prior to the pandemic Methods: A total of 176,690 appointment records of 34,250 patients presenting to the AlJahra specialist hospital, Kuwait for dental treatment from April 2019 to March 2021 were analyzed. Types of procedures and the departments to which they presented were analyzed and the patterns of attendance before and during the pandemic were compared; Results: While there was a significant reduction in the number of orthodontic, endodontic and periodontal procedures there was no impact on oral surgery, restorative procedures or pediatric dentistry; Conclusions: There has been a return in the numbers of patients availing dental treatment, however, there has been a definite shift in the use of certain dental procedures .

Several clusters and individual cases of acute —often severe— hepatitis have been reported in Europe —mainly in the United Kingdom (U.K.)—, the United States (U.S.) and recently in Asia since October 2021. Laboratory investigation of the common viral hepatitis agents (HAV, HBV, HCV, HDV and HEV) yielded negative results prompting the use of the term “acute non hepA–E hepatitis” to describe this condition. The cases were characterized by the manifestations of acute hepatitis (abdominal pain, vomiting, diarrhea, jaundice and very high levels of liver enzymes) affecting children with a median age of 3–4 years. The exact underlying etiology has not been revealed yet; however, a leading hypothesis is that an infectious agent is the culprit underlying cause or at least a risk factor for acute non hepA–E hepatitis occurrence. So far, laboratory testing has shown the presence of adenovirus serotype 41 (Ad–41) which is classified in group F of adenoviruses in about three-fourths of the reported cases. However, the definitive link between adenoviruses and acute non hepA–E hepatitis has not been fully elucidated, which necessitates further investigation of this possible correlation. As of the end of April 2022, more than 200 cases were reported worldwide, the majority of which were in Europe: the U.K. (n=114), Italy (n=17), Spain (n=13), Israel (n=12), the U.S. (n=9), Denmark (n=6), Netherlands and Ireland (n=4), Japan (n=3), Austria, Belgium, France, and Norway (n=2), Germany, Poland, and Romania (n=1). Possible cases are being evaluated in Illinois, Minnesota, North Carolina, Wisconsin states of the U.S., Canada, Singapore and Slovenia. Vigilant surveillance and epidemiologic investigation to identify further cases are warranted at the global level to delineate the features of this emergent public health issue. The possible role of environmental and toxic agents including foodborne toxins should not be overlooked as well. Specific guidelines for identification of further cases is necessary particularly in low-income settings where testing for adenoviruses is not considered routinely. Genetic analysis of Ad–41 isolates is recommended to assess the potential changes in virus genome with subsequent possible altered virus behavior. Immunopathogenesis is another possibility that should be examined as well considering the absence of virus detection in liver biopsies of the affected children in the U.S.

The relationship between the host and the microbiome, or the assemblage of microorganisms (including bacteria, archaea, fungi, and viruses), has been proven crucial for its health and disease development. The high dimensionality of microbiome datasets has often been addressed as a major difficulty for data analysis, such as the use of Machine Learning (ML) and Deep Learning (DL) models. Here we present BiGAMi, a bi-objective genetic algorithm fitness function for feature selection in microbial datasets to train high-performing phenotype classifiers. The proposed fitness function allowed us to build classifiers that outperformed the baseline performance estimated by the original studies by using as few as 0.04% to 2.32% features of the original dataset. In 19 out of 21 classification exercises, BiGAMi achieved its results by selecting 6-68% fewer features than the highest performance of a Sequential Forward Feature Selection algorithm. This study showed that the application of a bi-objective GA fitness function against microbiome datasets succeeded in selecting small subsets of bacteria whose contribution to understood diseases and the host state was already experimentally proven. Applying this feature selection approach to novel diseases is expected to quickly reveal the microbes most relevant to a specific condition.

The incidence and mortality rates of cervical cancer are rising among young women in Japan. In November 2021, the Japanese Ministry of Health, Labour and Welfare reinstated the active recommendation for the human papillomavirus (HPV) vaccine, which was discontinued in June 2013 due to reports of adverse reactions, including chronic pain and motor dysfunction, following vaccination. However, vaccine hesitancy among the younger generation remains, and it is essential to identify the barriers in vaccination uptake. Therefore, we aim to conduct a randomized study using different methods of providing educational contents to improve health literacy regarding cervical cancer and HPV vaccination among female students in Japan. Here, we present the results of our preliminary report and discuss current topics related to HPV vaccination in Japan. Data were collected from 27 female students—divided into three groups: no intervention, print-based intervention, and SNS-based intervention—using the Health Literacy Scale and Communicative and Critical Health Literacy scale. Our primary results indicate that participants’ knowledge and health literacy improved post intervention. Therefore, medical professionals must provide accurate scientific knowledge regarding routine HPV vaccination and the risk of cervical cancer to young women to improve their health literacy and subsequently increase the HPV vaccination rates.

Extremely low concentrations of ciprofloxacin may select for antimicrobial resistance. A recent global survey found that ciprofloxacin concentrations exceded safe levels at 64 sites. We assessed if national median ciprofloxacin concentrations in rivers were associated with fluoroquinolone resistance in Escherichia coli. Methods Spearman’s regression was used to assess the country-level association between the national prevalence of fluoroquinolone resistance in E. coli and the median ciprofloxacin concentration in the countries rivers. Results The prevalence of fluoroquinolone resistance in E. coli was positively correlated with the concentration of ciprofloxacin in rivers (ρ=0.36; P=0.011; N=48). Conclusions Steps to reducing the concentrations of fluoroquinolones in rivers may help prevent the emergence of resistance in E. coli and other bacterial species.

The aim was to evaluate levels of compassion fatigue in nursing professionals working in complex care units of a Brazilian university hospital. A cross-sectional, descriptive, and correlational study was carried out with nursing workers from complex care units of a University Hospital. Data were collected in the second half of 2019, in the pre-pandemic period of COVID-19, using the Brazilian version of the Professional Quality of Life Scale (ProQoL-BR). A total of 146 individuals partici-pated, including 41 (28.1%) nurses, 92 (63.0%) nursing technicians and 13 (8.9%) nursing assis-tants. It was observed that 26.1% presented high level of compassion satisfaction. For 17.5% there was level of burnout and 49.7%, medium level of burnout; and 22.0% with high and 46.1% with medium level of secondary traumatic stress. Twenty-eight (19.2%) professionals had compassion fatigue, of which 16 (57.1%) were nursing technicians. There is a high percentage of professionals with medium and high rates of burnout and secondary traumatic stress, a fact that is reinforced by the presence of compassion fatigue in almost one fifth of the studied individuals. These results highlights how much the health of these workers can be affected by living with traumatic patient experiences.

Purpose Violence against paramedics is a complex – but underreported – problem. Extant research suggests organizational culture may play a role in sustaining cultural norms that downplay the significance and limit reporting. Our objective was to qualitatively explore paramedics’ experience with violence, with particular emphasis on understanding how organizational culture contributes to under-reporting. Approach We surveyed paramedics from a single, large, urban service in Ontario, Canada, asking participants to describe their experiences with violence, including whether – and why or why not – the incidents were reported. Within a constructivist epistemology, we used inductive thematic analysis with successive rounds of coding to identify and then define features of organizational culture that limit reporting. Findings A total of 196 (33% of eligible) paramedics completed the survey. Fully 98% of participants disclosed having experienced some form of violence; however only a minority (40%) reported the incidents to management, or the police (21%). We defined a framework within which a lack of support from management, and consequences for offenders, implicitly positions the ability of paramedics to “brush off” violent encounters as an expected professional competency. Disclosing emotional or psychological distress in response to violent encounters invited questions as to whether the individual is personally suited to paramedic work. Originality While the extant research has indicated that underreporting is a problem, our findings shed light on why – a critical first step in addressing what has been described as a serious public health problem.

The transition of people from paediatric to adult diabetes services is associated with worsening glycaemia and increased diabetes-related hospitalisation. This study compared the clinical characteristics of those with and without mental health conditions among attenders at a diabetes young adult clinic diabetes before and after changes in service delivery. Retrospective review of 200 people with diabetes attending a Sydney public hospital over eight years corresponding to the period before (2012-2016) and after (2017-2018) restructuring of a clinic for young adults aged 16-25 years. Characteristics of those with and without mental health conditions (depression, anxiety, diabetes related distress, eating disorders), were compared. Among clinic attenders (type 1 diabetes n=184, 83.2%), 40.5% (n=89) had a mental health condition particularly, depression (n=57, 64%), which was higher among Indigenous than non-Indigenous people (5.6% vs 0.8% p=0.031) but similar between diabetes type. Over eight years, those with, compared with those without a mental health condition had higher HbA1c at the last visit (9.4%[79 mmol/mol] vs 8.7% [71 mmol/mol], p=0.027), the proportion with diabetic ketoacidosis (DKA 60.7% vs 42.7%,p=0.009), smoking (38.4 vs 13.6%,p=0.009), retinopathy (9.0 vs 2.3%,p=0.025), multiple DKAs (28.4 vs 16.0%,p=0.031) were significantly higher. Having a mental health condition was associated with 2.02 (95% Confidence intervals 1.1-3.7) fold increased risk of HbA1c ≥ 9.0%[75mmol/mol]. Changes to the clinic were not associated with improvements in mental health condition (39.0% vs 32.4%, p=0.096). In conclusion, we found that mental health conditions, particularly depression, are common in this population and are associated with diabetes complications. Diabetes type and clinic changes did not affect the reported mental health conditions. Additional strategies are required to reduce complication risks among those with mental health conditions. .

COVID-19 poses a significant burden to healthcare systems. Healthcare organisations with a better health innovation infrastructure have faced a reduced burden and achieved success in curbing COVID-19. In Saudi Arabia, digital technologies have played a vital role in fighting SARS-CoV-2 transmission. In this paper, we aimed to summarise the experience of optimising digital health technologies in Saudi Arabia as well as discuss capabilities and opportunities during and beyond the COVID-19 pandemic. A literature review was conducted up to September 2021 to retrieve peer-reviewed articles that critique the use of digital health technology platforms (DHTPs) in Saudi Arabia during the COVID-19 outbreak. A small but significant body of literature examined the digital response to the COVID-19 pandemic in Saudi Arabia. Health officials succeeded in optimising and maintaining a strategy to mitigate the spread of the virus via different digital technologies, such as mobile health applications, artificial intelligence, and machine learning. The quick digital response in Saudi Arabia was facilitated by governmental support and considering users and technology determinants. Future research must concentrate on establishing and updating the guidelines for using DHTPs.

Background: Endometriosis affects between 1% to 10% of women worldwide; it is associated with a significant burden on the woman, her relationships, productivity, mental health, family and society. Aim:To contribute to the current understanding of the impact of endometriosis on women’s lives by integrating qualitative research findings to explore the illness experiences of women living with endometriosis. Study design:Synthesis of qualitative data using Britten’s meta-ethnography.Methods:Six bibliographic databases (Medline, Embase, CINAHL, Web of Science, Scopus and PsycINFO) and Google Scholar were searched for peer-reviewed papers published in English language from inception of until August 6th 2021. Results: Fifteen studies were included in the data synthesis. The review included a total of 354 women from fourteen countries (including South Africa, Iran, England, Australia and United States of America), of age range 16-78 years. Subjects represented diverse ethnicities, cultures and native languages distributed across socioeconomic classes. Representation of all stages of endometriosis was included.Findings incorporate the following nine categories into a conceptual model: disease symptoms; health services experience; isolation and limited social participation; limited physical functioning; a coterie of emotions; sex and intimate relationships; infertility; work life and education; coping strategies and support. Diagnostic delays, persistent symptoms, healthcare costs and inadequate education to patients about the disease; all intersect into a web of struggles and incoherence for patients. Conclusion:Women with endometriosis living in various countries report similar illness experiences; although gender roles, culture and socio-economic status may act as mediating factors that shape an individual’s illness experience.

Research indicates that farmers’ demographic characteristics and production practices have safety and health implications. However, current systems do not identify organic farmers independently from conventional farmers, and literature on how organic and conventional farmers compare is very limited. We conducted a secondary analysis of 2012 Census of Agriculture data to compare organic and non-organic farms and principal operators (POs) in New Mexico (NM). Organic farms were smaller in size, and POs of farms with organic sales were significantly younger (55.8±9.5 vs. 60.5±5.5 years) and less experienced (19.5±6.8 vs. 25.2±6.8 years). Significant differences were also found in POs ethnicity, race, and primary occupation. More farms with organic sales had a female PO compared to farms with non-organic sales (27% vs. 19%). Other significant differences related to work arrangements, household income, living conditions, and access to Internet. National surveys and regional studies may not accurately typify and describe the local organic producer, which is essential in order to advance policy, develop health interventions, and properly address occupational safety and risk among organic farmers. This study makes a unique contribution to understanding the importance of surveillance and collecting place-based data that are specific to the organic producer.

The novel coronavirus disease (COVID-19) pandemic is provoking a prevalent consequence on mental health because of less interaction among people, economic collapse, negativity, fear of losing jobs, and death of the near and dear ones. To express their mental state, people often are using social media as one of the preferred means. Due to reduced outdoor activities, people are spending more time on social media than usual and expressing their emotion of anxiety, fear, and depression. On a daily basis, about 2.5 quintillion bytes of data are generated on social media, analyzing this big data can become an excellent means to evaluate the effect of COVID-19 on mental health. In this work, we have analyzed data from Twitter microblog (tweets) to find out the effect of COVID-19 on peoples mental health with a special focus on depression. We propose a novel pipeline, based on recurrent neural network (in the form of long-short term memory or LSTM) and convolutional neural network, capable of identifying depressive tweets with an accuracy of 99.42%. Preprocessed using various natural language processing techniques, the aim was to find out depressive emotion from these tweets. Analyzing over 571 thousand tweets posted between October 2019 and May 2020 by 482 users, a significant rise in depressing tweets was observed between February and May of 2020, which indicates as an impact of the long ongoing COVID-19 pandemic situation.

Background: Overcrowded housing, as well as inadequate sanitary conditions, contribute to making homeless people particularly vulnerable to the SARS-CoV-2 infection. We aimed to assess the seroprevalence of the SARS-CoV-2 infection among people experiencing homelessness on a large city-wide scale in France, taking into account different community settings. Methods: A consortium of outreach teams in 48 different locations including streets, slums, squats, emergency or transitional shelters and drop-in centres participated in the inclusion process. All participants consented to receive a validated rapid assay for immunoglobulins M (IgM) and G (IgG) antibodies and to answer a questionnaire on medical health conditions, comorbidities, historic of symptoms compatible with COVID-19, with a retrospective calendar of types of accommodation since COVID-19 crisis. Results: From June 01 to August 05, 2020, 1,156 homeless participants were enrolled in the study and tested. Seroprevalence of SARS-CoV-2 IgG/IgM antibodies was 5.6% (95%CI 2.3–7.0), with a range of 2.2% in people living on the streets to 8.1% in people living in emergency shelters (P=0.009). Around one third of the seropositive participants reported symptoms with COVID-19. Compared to the general population in Marseille (3.6%), the homeless population living in the same urban area experienced an significant increased risk of SARS-CoV-2 infection (|z|=3.65 > 1.96). Conclusion: These results highlight the need for organizing regular screening to prevent clusters forming in homeless accommodations and for providing basic resources for health maintenance.

With rapid advances in gene editing and gene therapy technologies, the development of genetic, cell, or protein-based cures to disease are no longer the realm of science fiction but that of today’s practice. The impact of these technologies are rapidly bringing them to the veterinary market as both enhanced therapeutics and towards modeling their outcomes for translational application. Simply put, gene editing enables scientists to modify an organism’s DNA a priori through the use of site-specific DNA targeting tools like clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9 (CRISPR/Cas9). Gene therapy is a broader definition that encompasses the addition of exogenous genetic materials into specific cells to correct a genetic defect. More precisely, the U.S Food and Drug Administration (FDA) defines gene therapy as “a technique that modifies a person’s genes to treat or cure disease” by either (i) replacing a disease-causing gene with a healthy copy of the gene; (ii) inactivating a disease-causing gene that was not functioning properly; or (iii) introducing a new or modified gene into the body to help treat a disease. In some instances, this can be accomplished through direct transfer of DNA or RNA into target cells of interest or more broadly through gene editing. While gene therapy is possible through the simple addition of genetic information into cells of interest, gene editing allows the genome to be reprogrammed intentionally through the deletion of diseased alleles, reconstitution of wild type sequence, or targeted integration of exogenous DNA to impart new function. Cells can be removed from the body, altered, and reinfused, or edited in vivo. Indeed, manufacturing and production efficiencies in gene editing and gene therapy in the 21^st century has brought the therapeutic potential of in vitro and in vivo reprogrammed cells, to the front lines of therapeutic intervention (Brooks et al., 2016). For example, CAR-T cell therapy is revolutionizing hematologic cancer care in humans and is being translated to canines by us and others, and gene therapy trials are ongoing for mitral valve disease in dogs.

The general purpose of the Design Thinking approach (concept taken over in Romanian without its translation and which involves conception-oriented thinking) is to support the conception and design of products, services, processes, strategies, spaces, architecture and experiences ideal for use optimal. Applying the approach leads to the development of practical and innovative solutions to the problems identified in the product and / or technology design departments of companies. As described in the article Design Thinking is a process springing from the user-centered conception-design paradigm. The objective of the article is to highlight the need to combine urban study within Design Thinking, in the case of all areas of conception-design of solutions.

Globally, football as a sport has recorded the highest rate of injury morbidity compared with other sports due to the high degree of contact between the players. Coaches play an important role in reducing injuries among the players. The objective of this study was to explore the pattern of football-related sports injuries among junior high school footballers in Dhaka, Bangladesh. A descriptive cross-sectional study was conducted between January 2019 to March 2019 in 20 junior high schools in Dhaka Metropolitan city. We observed 368 boys in the age range of 10 to 18 years old. A pre-structured questionnaire was provided to six trained junior physiotherapists to conduct the face-to-face interview with the boys in the school setting. Most students were from middle-income families. The injury prevalence of defenders was the most (157, 42.7%) followed by mid-fielders (132, 35.94%), forwards (63, 17.1%), and goalkeepers (16, 4.3%). Tackling was the main cause of injury in 21.1% of cases followed by foul play in 19.1% of the cases. In July, there were more injuries (69.0%) and associated muscle strain. Injured footballers did not visit sports physiotherapists as much as they did other health profession and the association was significant. When considering scientific knowledge, students were aware of fitness, flexibility & endurance (25.5%), sports massage (24.5%), the relation of body structure with sports Injury (21.2%), warm-up and/or cool down (19.6%). Based on the study, it was seen that students had no scientific knowledge of sports. As sports is a key activity for school-going children, comprehensive sports injury preventive knowledge is needed for students and sports teachers and coaches. Access to sports physiotherapists is also needed to prevent and manage sports injury at the field level and for rehabilitation.

Abstract Aim: To determine the efficacy of health beliefs model –based intervention in changing the belief related to substance use among university student in Mosul city-Iraq. Design: A randomized controlled trial. Methods: A probability (simple random sample) of (N=80) undergraduate student in different specialties would be selected. The study sample will be recruited from (4) colleges in the University of Mosul's Engineering, Sciences, Medicine and Education Colleges. The sample will be randomly assigned into experimental and control groups of (40) undergraduate student for each group. Such chosen is employed of pool of topics that have the criteria contain students who have using on (Smoking, Hookah, Drug abuse and Alcohol).For during from 25of October / 2019 till 1 of February/2021. Data is analyzed using the "Statistical Package for Social Science" (SPSS) software for Windows (V:26). Results: This finding indicated that before the intervention, mean scores for all concepts of HBM, add to Motivation, Control, and behaviors intensions of students they were almost equal. However, after the intervention were significantly different in the study group, while it was not significant in the control group. Conclusion:This study concluded that designing an HBM-based study could affect students' understanding and their behaviors in the field of substance abuse. Considering the positive correlation between construct of HBM, particularly in "perceived benefits and perceived severity" related to students’ beliefs. These beliefs implied a significant correlation with each other and with the attention to the prevention of addiction.

Bacground, the increasing number of elderly is a new challenge for health care systems around the world. The phenomenon of the complex health problems experienced by the elderly encourages families to bring the elderly to a nursing home. The purpose of this study was to describe the condition of the elderly living in nursing homes and their care needs. Methodology, this research design is a literature review, article search using 5 databases, namely Scopus, ProQuest, Pubmed, CINAHL and Scient Direct. Articles reviewed from 2019 to 2021. Protocol and evaluation of literature review using the PRISMA checklist, and the assessment guide using the Joanna Briggs Institute Guideline. Results, the health conditions of the elderly who live in the orphanage are mostly aged 60 years and over, physically experiencing disturbances in their daily activities and dependence. Psychologically experiencing anxiety, depression, loneliness and even mental disorders and socially need family support. The care needs of the elderly in nursing homes include services by competent and culturally sensitive staff and nurses, safe and comfortable nursing home environmental services, privacy needs and social interactions, spiritual needs services, social guidance services, and skills guidance services. Conclusion, based on the literature review, it can be seen that nursing services should be provided in a humanistic and holistic manner, the elderly are clients who have both bio-psycho-socio-cultural and spiritual needs. So that nursing services are aimed at meeting the needs of the elderly in a comprehensive manner.

Background Indicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. Despite being rapidly taken up by practitioners, datapoints from which to derive them were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define - for the first time - the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a two day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high, middle, and low income countries. Considering each of the six indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2-5 (intermediate) and >5 year (full) timeframes. We removed one of the original six indicators (one of two financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. Conclusions To track global progress toward timely access to quality SAO care, these indicators – at the basic level - should be implemented universally. Intermediate and full evolutions will assist in developing national surgical plans, and collecting data for research studies.

The purpose of this article was to check the effects on health of various types of physical activities, diet, BMI, smoking and alcohol consumption and their interrelationships with control for age, sex and level of education. The study was based on epidemiological data (9617 participants from 19 to 81 years old for whom we have health indicators over a period of 11 years) together with questionnaires about diet, alcohol, tobacco and the frequency of different types of physical activities. Descriptive statistics and non-parametric correlational analysis of epidemiological data was performed with use of SPSS v.19. Our results indicate the existence of the significant relationship between leading a healthy life style (type of physical activities, limitations of fats consume and weight maintenance). However, the different categories of physical activities were analysed separately and showed slight differences on health indicators impacts. Our findings confirm that leading a healthy life style (all types of physical activities, limitations of fats consume and weight maintenance) is an important issue since it has a significant relationship with physical and mental health indicators, but outdoor physical activities and practicing sport in group have shown slightly higher impact on health.

The negative effect of COVID-19 pandemic has reach world economy due to absence from work for SARS-CoV-2 infection in workers, among other things. However, some economic areas are essential to society and people must continue working outside home, to support economic reactivation; their serological profile could be different from global population. Cross-sectional study. Workers from health, construction, public transportation, public force, bike delivery messengers, independent or informal commerce areas, and residents of Bucaramanga or its metropolitan area were invited to participate. All participants self-completed a virtual survey and a blood test was taken to assess IgG and IgM with ARC COV2 test. Seroprevalence was estimated considering a complex survey design, correcting for finite population effect and adjusting for test performance. 7.045 workers were enrolled; 59.9% were women, most were residents of Bucaramanga and working in health occupations. Global adjusted seroprevalence was 19.5% (IC95% 18.6 - 20.4), being higher for Girón [27.9% (CI95% 24.5 - 31.30]). Workers with multiple contact with people during working hours or using public transportation to go to work had higher frequency of seropositivity for SARS-CoV-2. Seroprevalence among workers living in these four municipalities from the Colombian northeast area is still low.

Introduction: Road traffic accidents are a real pandemic and incur expenses amounting to 1-2% of every country’s GDP. AESLEME (Association for the Study of Spinal Cord Injuries) – devoted to teaching road safety and health to prevent road accidents – has celebrated its 30th anniversary. AESLEME’s instructors are health workers and people with spinal cord injuries caused by road accidents: their presentations – teaching road safety and sharing information on irreversible injuries – are enhanced by personal stories that help schoolchildren to acquire knowledge on this matter. However, until now, we had not assessed how far this acquisition of knowledge had reached. Methods used: Two multiple-choice tests were given to each of the 8,106 students (12-14 years) who took part. Of the four possible answers, only one of them was correct. The first multiple-choice test was taken before the presentation and the second was taken one month later. Results: After assessing the answers, there was a change in the tendency of the number of correct answers before/after answers for the multiple-choice test, and the number of correct one´s rose one month after the presentation. This increase is statistically significant (p<0.01) and represents a national increase of 61% in the number of correct answers, although this varies from 8% to 278% depending on the region. Conclusions: The assessment, involving over 8,000 people, showed that there has been an improvement in road safety knowledge thanks to education provided by AESLEME’s instructors, and a statistically significant increase was obtained throughout Spain, with an average of 61% (confidence level 95: 53% and 64%).

Background: Renewed measles outbreaks in recent years indicate that despite the routine availability of vaccines for a disease that is considered contagious, dangerous and deadly, many anti-vaccinationists do not vaccinate their children, which consequently endangers public health. This study aimed to investigate the factors that influence mothers to vaccinate their children, and whether the Health Belief Model (HBM) could predict compliance or non-compliance. Methods: This was a quantitative correlational research, utilizing a 40-item questionnaire administered to 181 mothers in Israel. Results: The findings indicated two main factors that affected mothers' intention to vaccinate their children against measles: first, their perception of the vaccine's advantages, and second, their perception of the severity of the disease. It was also found that the HBM variables significantly affected the intention to administer vaccines. Conclusion: Consequently, raising public awareness of the vaccine's advantages and importance to preventing mass infection, as well as attempts by the health system and practitioners to understand the motivations of anti-vaccinationists (including health beliefs and cultural sensitivities) could significantly increase the percentage of vaccinated children, and eradicate the measles epidemic.

Sexual education is a part of the teaching-learning process that addresses cognitive, psychological, physical and social aspects of sexuality. The purpose of sexual education is to provide people with knowledge, abilities, attitudes and values that will help them to have good sexual health, well-being and dignity. The objective of this study was to explore the experiences and opinions of primary school teachers regarding Sexual Education in school. A descriptive qualitative study was designed based on content analysis. Twelve open-ended interviews with primary school teachers were carried out, followed by inductive data analysis using ATLAS.ti software. Two key themes emerged from the analysis: ‘In search of a comprehensive approach to Sexual Education’ and ‘Barriers to Sexual Education in schools: From the lack of training to fear of the families’. We conclude that despite the efforts to implement a comprehensive approach to Sexual Education that recognises sexuality as a right, primary school teachers face difficulties in delivering Sexual Education in schools due to a lack of training and the fear that parents will reject their children being spoken to about sexuality.

Loneliness is a frequent negative feeling among older people. A programme aimed at alleviating loneliness among older people by promoting social capital, i.e. social support and participation, was conducted in primary health care centres in Spain. We aimed to explore participants’ experiences of loneliness and social participation before the programme, perceived programme effects and contextual influences. A descriptive-interpretative qualitative design was used. 41 persons were included comprising older people, health and social care professionals, and volunteers. Data were collected through three focus groups, 36 semi-structured interviews and participant-observation of the intervention. A thematic content analysis was applied. Older persons with diverse profiles of loneliness and participation decreased their loneliness, increased their knowledge and participation in local community assets, and developed companionship, a sense of belonging, peer support and friendship. Their mental wellbeing increased and participants could deal better with health or family problems. An empowerment process was observed. However, loneliness persisted among some widowed participants and health and social vulnerabilities hampered some impacts. Conflicts and exclusion were occasional unintended effects. The promotion of social capital in ageing to alleviate loneliness involves complex processes interrelated with health and socio-economic factors. Future programmes should be adapted to local contexts and participants’ characteristics.

Although it may seem paradoxical, primary care and mental health professionals develop prejudices and discriminatory attitudes towards people with mental health problems in a very similar way to the rest of the population. The main objective of this project was to design, implement and evaluate two awareness interventions respectively tailored to reduce stigma and discrimination beliefs and attitudes towards persons with a mental health diagnosis among primary care (PC) and mental health (MH) professionals. These interventions were developed by Obertament, the Catalan alliance against stigma and discrimination in mental health. The TLC3 (Targeted, Local, Credible, Continuous Contact) methodology was adapted to the Catalan PC and MH professional contexts. Activists with lived experience of mental health diagnosis carried out awareness-raising interventions in PC and MH health centres. The efficacy of these interventions was evaluated using two prospective double-blind cluster-wait-list-randomized-controlled trial experimental designs. Stigmatizing beliefs and behaviours were measured with the Opening Minds Stigma Scale for Health Care Providers in primary care centres and with the Beliefs and Attitudes towards Mental Health Service users’ rights in mental health centres. Positive reductions in both PC and MH professionals’ stigmatising beliefs and attitudes were found in the 1-month follow-up, although a ‘rebound effect’ at the 3-month follow up was also detected. This emphasizes the importance of the continuity of the presence of anti-stigma activities and messages. Attrition rates where high, which can hamper the reliability of the results. Further follow-up studies should enquiry effects of long-term interventions aimed at reducing stigmatising beliefs and attitudes among primary care and mental health professionals.

Background: COVID-19 crisis has changed the conditions of many throughout the globe. One negative consequence of the on-going pandemic is anxiety brought by uncertainty and the COVID-19 disease. Increased anxiety is a potential risk factor for wellbeing at work. This study investigated psychological, situational, and socio-demographic predictors of COVID-19 anxiety using longitudinal data. Methods: Nationally representative sample of Finnish workers (N = 1308) was collected before and during the COVID-19 crisis. Eighty percent of the participants responded to the follow-up study (N=1044). COVID-19 anxiety was measured with a modified Spielberger State–Trait Anxiety Inventory. Psychological and situational predictors included perceived loneliness, psychological distress, technostress, personality, social support received from work community, and remote working. Also, number of socio-demographic factors were investigated. Results: Perceived loneliness, psychological distress, technostress, and neuroticism were identified as robust psychological predictors of COVID-19 anxiety. Increase in psychological distress and technostress during the COVID-19 crisis predicted higher COVID-19 anxiety. Recent change in work field and decreased social support from work community predicted COVID-19 anxiety. Women and young people experienced higher anxiety. Conclusions: Different factors explain workers’ COVID-19 anxiety. Increased anxiety can disrupt wellbeing at work, emphasizing organizations’ role in maintaining an inclusive and caring work culture and providing technical and psychological support to workers during crisis.

School closures (SC) were adopted globally as a COVID-19 disease pandemic containment strategy. This extreme measure provoked a disruption of the educational system involving hundreds of million children worldwide. The return of children to school has been variable and is still an unresolved and contentious issue. Importantly the process has not been directly correlated to the severity of the pandemic s impact and has fueled the widening of disparities, disproportionately affecting the most vulnerable populations. Available evidence shows SC added little benefit to COVID-19 control whereas the harms related to SC severely affected children and adolescents. This unresolved issue has put children and young people at high risk of social, economic and health-related harm for years to come, triggering severe consequences during their lifespan. In this article we describe the process of SC and the reopening timetable across the globe. We highlight the data regarding the international state of educational systems around the world, putting emphasis on the rights of children to come back to school.

Background: Epidemiological surveillance of nursing diagnosis is an approach anchored on a post-modern epidemiology focused on persons health-disease responses. Regarding to public health priorities, the population where our study occurred had as priority problem the arterial hypertension. Related to this chronical disease, nursing diagnoses about health-disease responses in primary healthcare has as major focus Therapeutic Regime Management. Our aim was to study the nursing diagnosis in this issue, from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17,7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology defended for the future.

Background: Caring for a loved one can be rewarding but also associated with substantial caregiver burden, developing mental outcomes and affecting happiness. Eventually, these physical and psychological disorders can lead to an imbalance of the autonomic nervous system. Meditation has been found to offer multiple benefits to relieve these disorders and reduce the risk of cardiovascular disease. The aim of this study was to determine the effects of a four-week 16-hour presential meditation program on physiological and psychological parameters and vagal nerve activity in high-burden caregivers, comparing the results with those not receiving this program. Methods: A non-randomized repeated-measures controlled clinical trial was conducted, dividing participants between intervention and control groups by convenience allocation because random assignment was ethically inappropriate. Results: After the meditation program, the experimental group showed a significant reduction in anxiety levels (F= 24.92, p<0.001), a non-significant amelioration of depression levels (F= 1.75, p=0.19), and significantly improved heart rate variability (F= 8.40, p<0.05) and SDNN (F=15.59, p<0.05). Conclusions: Meditation can be a useful therapy to enhance the mental health and autonomic nervous system balance of informal caregivers, improving symptoms of physical and mental overload.

Self-perceived health is an important indicator of occupational health. This research explores the relationship between poor self-perceived health and exposure to psychosocial risk factors, taking into account potential socio-demographic, occupational and employment determinants. Using data from the First Survey of Occupational Safety and Health Conditions covering 1049 salaried workers in Guayaquil, Ecuador descriptive and stratified binary logistic regression analyses (Odds Ratios with corresponding 95% confidence intervals) were carried out. No significant relationship was found between exposure to psychosocial risk factors and the probability of presenting poor self-perceived health by socio-demographic, occupational and employment characteristics. Occupational exposure factors to psychosocial risks are predictors of self-perceived ill health and are related to the variables analyzed; the most frequently expressed factors among the respondents were Cognitive Demands (DGOG) and Job Insecurity (IL). The results have implications in terms of designing effective workplace interventions pursuant of ensuring the health and wellbeing of employee.

Background: The Royal College of Surgeons in Ireland - Bahrain (RCSI Bahrain) was closed due to COVID 19. The aim of this paper is to present our experience, in managing teaching and learning, during this pandemic. Methods: Following, ethical approval, several meetings were held with the senior faculty and student representatives to select alternative virtual approaches for teaching, learning and assessment with evidence-based instructional design. Informed consent was obtained from all study participants. All procedures were carried out in accordance with relevant guidelines and regulations. In alignment with global scenario, we decided upon early graduation for our students, and expedited the clinical examinations, with special permission from health and education ministries. Two major clinical examinations were redesigned to form a single hybrid clinical examination with two parts. Following all COVID 19 preventive measures, students were taken in groups of seven and simulated patients were substituted for real patients. No more than 40 students were present at any point of time, with no more than 10 examined in one block. 149 out of 152 RCSI students attended the clinical examinations and 524 students from the three RCSI campuses attended the written online examination. A structured survey was conducted to elicit students’ perceptions and participation was entirely voluntary. Results: 82% of students were happier to be joining the workforce early and, 22% expressed concerns. A comparison of student performance in these examinations against the equivalent components from semester one yielded no significant deviation in student performance, illustrating that the quality was consistent. Conclusion: We recommend that the government accredit online or distance learning programmes and explore appropriate methodologies for evaluation of online learning and assessment. Incorporating practical/clinical training, will continue to be a great challenge.

Currently, there are several challenges that Cloud-based health-care Systems, around the world, are facing. The most important issue is to ensure security and privacy or in other words to ensure the confidentiality, integrity and availability of the data. Although the main provisions for data security and privacy were present in the former legal framework for the protection of personal data, the General Data Protection Regulation (GDPR) introduces new concepts and new requirements. In this paper, we present the main changes and the key challenges of the General Data Protection Regulation, and also at the same time we present how the Cloud-based Security Policy methodology proposed in [1] could be modified in order to be compliant with the GDPR and how Cloud environments can assist developers to build secure and GDPR compliant Cloud-based health Systems. The major concept of this paper is, primarily, to facilitate Cloud Providers in comprehending the framework of the new General Data Protection Regulation and secondly, to identify security measures and security policy rules for the protection of sensitive data in a Cloud-based Health System, following our risk-based Security Policy Methodology that assesses the associated security risks and takes into account different requirements from patients, hospitals, and various other professional and organizational actors.

Hope is important in the rehabilitation of persons with schizophrenia, through scales to measure hope are not appropriate for this population. The purpose of this cross-sectional study was to identify the psychometric properties of the Schizophrenia Hope Scale-9 (SHS-9) using data from 83 people with schizophrenia in four mental health centers and 762 healthy persons from two universities in South Korea. The mean (standard deviation) SHS-9 score of the participants with schizophrenia and healthy participants was 11.24 (4.90) and 14.83 (3.10), respectively. Lower scores indicate a lower level of hope. The internal consistency alpha coefficient was 0.92 with a 4-week test-retest reliability of 0.89. Criterion-related construct validity was established by examining the correlation between the SHS-9 and the State-Trait Hope Inventory scores. Divergent validity was identified through a negative relationship of SHS-9 with the Beck Hopelessness Scale. The construct validity of the SHS-9 was confirmed through principal component analysis with extraction methods, which resulted in a one-factor solution, accounting for 49–60% of the total item variance.. This study provided evidence for the validity and reliability of the SHS-9; therefore, it could be used to measure hope in people with schizophrenia.

This review examines from a services perspective strategies for preparedness and response to mental health impacts of three types of climate-related events: 1) acute climate-related events such as hurricanes, floods and wildfires, 2) sub-acute or long-term changes in the environment such as drought and heat stress; and 3) the existential threat of long-lasting changes, including higher temperatures, rising sea levels and a permanently altered and potentially uninhabitable physical environment. Strategies for acute events include development and implementation of guidelines and interventions for monitoring and treating adverse mental health outcomes and strengthening individual and community resilience, training of non-mental health professionals for services delivery, and the mapping of available resources and locations of at-risk populations. Additional strategies for sub-acute changes include advocacy for mitigation policies and programs and adaptation of guidelines and interventions to address the secondary impacts of sub-acute events such as economic loss, threats to livelihood, health and well-being, population and family displacement, environmental degradation and collective violence. Strategies for long-lasting changes include implementation of evidence-based risk communication interventions that address the existential threat of climate change, promoting the mental health benefits of environmental conservation, and promoting positive mental health impacts of climate change.

The pandemic outbreak of COVID-19 had begun in March of 2020 on a global scale. This outbreak has originated numerous questions for society and many challenges for public managers. The disease is worrying because it has a high propagation velocity, high lethality levels, and there is no cure. Some groups are considered more vulnerable due to pre-existing disease conditions, age-range, and living conditions. In Latin American countries, people live in different conditions than those who live in countries located in the North hemisphere, such as climatic conditions, less favorable socioeconomic conditions, different educational levels, inequality, precarious urban infrastructure, etc. These factors generate even more concern and uncertainty about the pandemic than in developed countries. This study aimed, although preliminarily, to identify areas of great socio-spatial vulnerability and susceptibility of infection of people over 60 years old of COVID-19 in Brasília, Brazil. In this research, publicly available data and information about the population characteristics and social aspects were used, all connected directly to the census sectors. With the support of Geographic Information System (GIS), a matrix was used to cross-check the data and, thereby, achieve the objective of identifying the most vulnerable sectors for people aged over 60 years old. The results point out to more than 400 census sectors classified as Extremely Vulnerable in Brasília and it should be the object of special attention for public managers to do specific health care actions.

Social media, traditionally reserved for social exchanges on the net, has been increasingly used by researchers to gain insight into different facets of human life. Unemployment is an area that has gained attention by researchers in various fields. Medical practitioners especially in the area of mental health have traditionally monitored the effects of involuntary unemployment with great interest. In this work, we compare the feedback gathered from social media using crowdsourcing techniques to results obtained prior to the advent of Big Data. We find that the results are consistent in terms of 1) financial strain is the biggest stressor and concern, 2) onslaught of depression is typical and 3) possible interventions including reemployment and support from friends and family is crucial in minimizing the effects of involuntary unemployment. Lastly, we could not find enough evidence to study effects on physical health and somatization in this work.

The Body Mass Index (BMI) formula has been developed by Belgian mathematician Adolphe Quetelet and published in 1840 [1] as a law of nature and society, based on statistics about the weight and height of the population of that time, the first part of the 19^th century. He called it “social physics”. From then, for nearly two centuries, the BMI had been the most important formula describing the normal relations and ratio of weight to the square of the height for humans. The problem arises if the BMI formula, developed in the first part of the 19^th century is still good today when the type of work people perform is very different? In modern times, most people are less muscular than at the time when the BMI was developed because they do not work physically as heavy as at that time. In many cases, the Body Mass index can predict mortality, morbidity and illness but not always, for example cases such as (a) the obesity paradox for some cardiovascular problems and (b) the U shape mortality paradox as well as (c) false positive obesity diagnostic in regard to people who are strong and muscular, have low body fat percentage but are classified as obese by the BMI and (d) cases where BMI is normal but people have an “obese metabolism” (e) BMI normal but high fat percentage. The objective is to develop a formula good for all body types, a formula that makes the difference between fat and non-fat body weight such as muscle and body frame and quantifies the effect of strength and fitness, which BMI does not. Another objective is to develop a formula to predict the health risks and fitness status of people, better than BMI. The first generalizations of BMI using anthropometric metrics could be found in [2], where I discuss and analyze many formulae, developed, tested, and simulated by me, using similar new methods, accounting for body shape, physical shape and body function, making the difference between muscle mass and fat, fat and non fat body weight. Nearly all formulae and methods developed and proposed in this new model are new, never published before. Many experiments published before, in highly cited papers show that grip strength and muscle strength is a predictor of health, mortality, morbidity, endocrine and metabolic disease outside the BMI and anthropometric measures. The purpose of my formula is to explain the outcome of those experiments and create a formula which predicts these experiments [21-41].

Objective: The study investigated the benefit of practicing the art of bonsai and the well-being of practitioners. The art promotes relaxation, focus and art therapy that can have personal and emotional value in a self-help setting. When the bonsai tree is used as a healing object, it may improve the ability of the bonsai practitioner to adapt to adverse and stressful life events, such as the present global COVID-19 pandemic. Method: International bonsai artists (n = 255) participated in a study that examined the effect their bonsai had on their mental well-being. Semi-structured interviews were conducted with bonsai artists answering the question: “How has bonsai helped you?”. Results: Most participants acknowledged that being able to take care of their bonsais affected their mood in a positive manner. Discussion: Although the participants did not report overall improved mental health, participants expressed an improvement in their mood when being able to work on a bonsai tree. Conclusion: These findings are significant in that it can be useful in as a preventative and restorative manner in the mental well-being of people who practice the art.

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

Enterococci are gastrointestinal commensals whose hardiness allowed them to colonize very diverse environments, including soils, water, food and feed. This ability to overcome adverse conditions makes enterococci problematic once they colonize hospital niches. Together with the malleability of their genomes, the capacity to acquire and disseminate determinants of antibiotic resistance have contributed to convert what was once just another opportunistic pathogen into a first-class clinical problem. This review discusses the dimension of the emergence of enterococcal resistance to key antimicrobial agents, the dissemination of this resistance and its significance in terms of public health, with the aim of raising the awareness to the need to devise and implement monitoring programmes and effective antibiotic usage guidelines.

Consumption of milk contaminated with antibiotic residues above the maximum residue limit (MRL) causes direct toxicity to humans and the development of superbugs that leads to the failure of antibiotic therapy and threatens human life. Besides, long-duration exposure might alter the nature of gut microflora results in the enhancement of many diseases. Therefore, we examined 300 raw and processed packet milk samples using thin layer chromatography (TLC) and ultra high performance liquid chromatography (UHPLC) method against five veterinary antibiotics and assessed the risk for consumers in Chattogram, Bangladesh. Risk analysis was calculated by using hazard quotient on the basis of 165 ml per capita milk consumption. We found a total of 7% prevalence of antibiotic residues in raw milk samples which were higher (8%) in individual samples than the pooled samples (4%). However, we did not find any processed packet milk samples as positive. The mean concentration of oxytetracycline residue was detected 61.29 µg/l and amoxicillin was 124 µg/l in individual milk samples. Risk analysis showed the hazard quotient values of 0.0056 for oxytetracycline and 0.0017 for amoxicillin residue which was confirmed that, no significant health risk associated with the consumption of milk produced and marketed in the study area. Our study might fill the gap of knowledge to measure the safety status of milk regarding public health issues.

The emergence of COVID -19 pandemic has severely impacted individuals from all walks of life. The rapid spread of the disease to nearly all parts of the country has posed enormous health, economic, environmental and social challenges to the entire human population. In the absence of any effective drugs and vaccines for treatment, social distancing and other preventive measures are the only alternatives. Lockdown is among one of the options suggested by WHO to reduce spread of the virus. India was quick to close its international borders and enforce the world’s largest COVID lockdown on March 22, 2020. The present study attempts to highlight the impact of imposed nationwide lockdown on society and environment alike along with analysis of lifestyle changes. The study was based on an online survey using a structured questionnaire with over 1000 responders across the country. The pandemic situation demands a certain way of shaping the society to reduce virus spread and safeguard oneself. In this study, we analysed the changes that the society has undergone during lockdown to mitigate the spreading of the infection. We also addressed the changes that have become part of our lives during lockdown – hygiene and health consciousness, work from home (WFM), online teaching, digital shopping, changing internet habits and societal changes.

During the period of health emergency linked to the current COVID-19 pandemic, the management of children's oral health presents specific problems related to the infectious spread of the disease. These problems must be faced on the one hand by acting on the oral health prevention methods, and on the other by implementing specific protocols relating both to the conditions of oral pathologies that normally do not represent an emergency, and to those clinical situations that fall into the category of pediatric dental emergencies. In this perspective, in addition to defining rigorous and highly effective infection control protocols in the dental settings, it is of fundamental importance to work on remote communication and education aimed at maintaining the oral health of the children. This article, after an analysis of the risk factors from COVID-19 associated with pediatric dental treatment, presents a series of considerations on potential oral prevention strategies and on the management of emergency and non-emergency dental procedures in a context of disease transmission control, proposing new approaches and models of treatment based also on remote interaction techniques which will then retain their usefulness even at the end of the current emergency period.

The ongoing COVID-19 pandemic is shaking the foundations of public health governance all over the world. Researchers are challenged by informing and supporting authorities on acquired knowledge and practical implications. This commentary applies established theories of risk perception research to COVID-19 and reflects on the role of risk perceptions in these unprecedented times. Moreover, it calls for utilizing the knowledge on risk perception to improve health risk communication, build trust and contribute to a collaborating governance.

This review chronicles the indirect transmission method which seems to be overlooked by most people and makes attempts to clearly document the various transmission ways with a hope that such information may strengthen the knowledge base of researchers towards methods of eradicating the pandemic. Current knowledge of transmission and exposure of SARS-CoV-2 has been explained. Various researchers have put forward different ways of exposure and transmission. Literature does not reveal whether the indirect transmission route is the dominant one. However total lockdown could be a veritable means to reduce both direct and indirect transmission routes. In many countries where the indirect transmission has been reduced, the scourge of the virus is less. The work creates awareness on the need to watch out for those routes of transmissions that may not be popular and suggested key knowledge gaps that needs to filled.

On March 11^th 2020, the World Health Organization (WHO) declared the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV2) as a pandemic. Until an effective treatment or a vaccine is developed, the current recommendations are to contain the disease, and control its transmission. It is now clear that the primary mode of SARS-CoV2 transmission is aerosol/droplet spread, and by contacting virus contaminated surfaces acting as fomites (inanimate vectors). Furthermore, recent data indicate that the live virus particles are present in saliva, and, more alarmingly, asymptomatic individuals may transmit the infection. By virtue of the nature of the practice of dentistry where intrinsically, a high volume of aerosols are produced, as well as the close proximity of dentists and patients during treatment, dentists and allied dental staff are considered the highest risk health professional group for acquiring SARS-CoV2 during patient management. Therefore, several organizations and specialty associations have proposed guidelines and recommendations for limiting the transmission of SARS-COV2 from carriers to dentists and vice versa. This paper aims to provide a review of these guidelines, and concludes with a brief look at how the practice of dentistry may be impacted by COVID-19, in the post-pandemic era.

We report smooth weaning from mechanical ventilation in a patient with COVID-19. The use of the supraglottic airway device can cause fewer coughs in weaning from mechanical ventilation. This procedure avoids the aerosol-generating procedure, tracheal extubation, and is beneficial in terms of occupational health for health care workers.

The use of machine learning (ML) approaches to target clinical problems is called to revolutionize clinical decision-making. The success of these tools is subjected to the understanding of the intrinsic processes being used during the classical pathway by which clinicians make decisions. In a parallelism with this pathway, ML can have an impact at four levels: for data acquisition, predominantly by extracting standardized, high-quality information with the smallest possible learning curve; for feature extraction, by discharging healthcare practitioners from performing tedious measurements on raw data; for interpretation, by digesting complex, heterogeneous data in order to augment the understanding of the patient status; and for decision support, by leveraging the previous step to predict clinical outcomes, response to treatment or to recommend a specific intervention. This paper discusses the state-of-the-art, as well as the current clinical status and challenges associated with each of these tasks, together with the challenges related to the learning process, the auditability/traceability, the system infrastructure and the integration within clinical processes.

Background: It is well known the adverse effect of mercury exposure on pregnant women and newborns. Interactions between environmental factors and individual genetic susceptibility have been identified, particularly polymorphisms of codifying genes for the Glutathione S-transferase family (GSTs). Herein, we report a case series of patients with high Hg levels in biosamples. Case Series: Fourteen cases with high Hg levels were identified. Non-occupational or home exposure risk factors were identified. All mothers reported fish consumption during pregnancy. Almost 60% of the individuals were null for either one GSTs gene. To date, in the subsequent mother-child pairs toxicology controls no signs or symptoms of poisoning were identified and most of the mercury levels decreased and are below the accepted limit. Discussion: In this case series we found some similarities with the literature; among them, the relation of Hg ratio in maternal blood and umbilical cord, a possible exposure factor is the consumption of fish during pregnancy and, the high levels of Hg may be related with susceptibility biomarkers such as GSTs gene polymorphisms. This case series highlights the need to develop studies that evaluate the interactions between environmental factors and individual genetic susceptibility. Additionally, the importance of evaluating which Colombian fish species present the highest levels of Hg.

This study aimed to understand the status of knowledge, attitudes, and practices (KAP) of norovirus infection among primary and junior middle school students in Chizhou City, explore its influencing factors. A multistage stratified random sampling method was used to randomly select 1200 students from 8 primary and junior middle schools for the effective questionnaire survey in Chizhou City. A multivariate logistic regression analysis was used to analyse the possible influencing factors. Of 1176 participants, the average knowledge score of norovirus infection was (9.8 ± 3.6), and the scoring rate was 65.3%. The average attitude score was (11.6 ± 1.2), and the scoring rate was 96.3%. The average practice score was (10.4 ± 1.5), and the scoring rate was 86.9%. The difference in the average scoring rate among the three was statistically significant (P < 0.001). The four independent variables of county, education level, sex and age group statistically correlated with the knowledge score. Primary and junior middle school students in Chizhou City had a good attitude and practice compliance in the prevention and control of norovirus infection; however, their professional knowledge still needed further improvement.

Microplastics (of size < 5mm) pollution in our environment is of current concern by researchers, public media and non-governmental organizations. Implications by their presence in aquatic and soil ecosystems have been well studied and documented, but less attention has been paid on airborne microplastics (MPs). Studies concerning airborne microplastics started from 2016 and only a few (n=7) have been published till date. Although, studies may increase in the following years, since air is very important for human survival. Microplastics have been observed in atmospheric fallouts in indoor and outdoor environments using a sampling or vacuum pump, rain sampler and/or particulate fallout collector. Identification and quantification have been carried out by visual, spectroscopic and spectrometric techniques. Factors such as meterological, climatic and anthropogenic influence the distribution and movement of airborne MP. Human exposure may be through inhalation or dermal route with their potential biopersistence and translocation. Ingestion may cause localized inflammation and cancer due to responses by the immune cells, especially in individuals with compromised metabolism and poor clearance mechanisms. Ecological risks involve possible contamination of the ecosystem through a dynamic relationship of MPs in soil, water and air forming a MP contamination cycle. The present review aimed at providing a comprehensive overview of current knowledge or information regarding microplastics in air, identifies gap in knowledge and give suggestions for future research.

In the past ten years several novel hantaviruses were discovered in shrews, moles and bats, suggesting the dispersal of hantaviruses in many animal taxa other than rodents during their evolution. Interestingly, the co-evolutionary analyses of most recent studies have raised the possibility of non-rodents may have served as the primordial mammalian host and harboured the ancestors of rodent-borne hantaviruses as well. The aim of our study was to investigate the presence of hantaviruses in bat lung tissue homogenates originally collected for taxonomic purposes in Malaysia, 2015. Hantavirus specific nested RT-PCR screening of 116 samples targeting the L segment of the virus have revealed the positivity of two lung tissue homogenates originating from Murina aenea bat species. Nanopore sequencing of hantavirus positive samples resulted in partial genomic data from S, M and L genome segments. The obtained results indicate the first molecular evidence for hantavirus in Murina aenae bat species and also the first discovery of a hantavirus in Murina bat species. Sequence analysis of the PCR amplicon and partial genome segments suggests the identified virus may represent a novel species in Mobatvirus genus within Hantaviridae family. Furthermore, our results provide additional genomic data to help extend our knowledge about the evolution of these viruses.

In western societies about one in six employees works in shifts. Shiftwork is associated with a number of poor somatic and psychological health outcomes, especially sleep issues. Higher rates of absenteeism and accidents in the workplace are possible consequences. Still, prevention programs and treatment options that are specifically tailored to shift workers’ needs are rare. We devised a 4-week online sleep intervention (n = 21) and compared treatment outcomes to our outpatient treatment for shift workers (n = 12). Measures included the WHO-5, ISI, and ESS scales as well as sleep diaries. Shift workers reported worse symptoms of insomnia than other participants. Results show significant average increases in sleep efficiency (+ 7%) and total sleep time (+ 25 min.), as well as significant improvements regarding insomnia symptoms and wellbeing in the online sample. Rates of improvement did not differ between the online and outpatient samples. Sleep disorders affect a relevant part of the working population, especially shift workers. Online approaches to treatment of these issues seem feasible and effective. Randomized controlled trials are needed.

Objectives: The aim of this study was to describe potential factors contributing to neonatal mortality in Takeo, Cambodia through assessment of verbal autopsies collected following newborn deaths in the community. The mortality review was nested within a trial of a behavioral intervention to improve newborn survival, and was conducted after the close of the trial, within the study setting. The World Health Organization standardized definition of neonatal mortality was employed, and two pediatricians independently reviewed data collected from each event to assign a cause of death. Results: Thirteen newborn deaths of infants born in health facilities participating in a community based, behavioral intervention were reported during February 2015–November 2016. Ten deaths (76.92%) were early neonatal deaths, two (15.38%) were late neonatal deaths, and one was a stillbirth. Five out of 13 deaths (38.46%) occurred within the first day of life. The largest single contributor to mortality was neonatal sepsis; six of 13 deaths (46.15%) were attributed to some form of sepsis. Twenty-three percent of deaths were attributed to asphyxia. The study highlights the continuing need to improve quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.: The study highlights the continuing need to improve both intrapartum and postnatal quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.

Pb found in rain water is not only caused by tin roof on houses but also caused by the pollution of industrial activities, vehicles and land clearing activity by fire. Pb pollutant dissolves and enters into rain water storages and it’s consumed as drinking. Pb can cause bad impact to human, for example disruption of enzyme, anemia and low intelligence. The purposes of this research are (1) to evaluate Pb, pH and turbidity level in rain water, (2) to analyze the effectiveness of mollusk sand filtration and the absorption of activity carbon to decrease Pb, turbidity and pH, and (3) to analyze the correlation of Pb, length of stay and smoking habit on public health. This research is an experimental by using pre and post test designs with control and observational by using cross sectional design. The research was conducted in urban and rural areas of Pontianak and Kubu Raya regency. The sampling was done in determining the number of samples of Pb, pH and turbidity in rain water. The analyzing the data by using computer program. The results show that: (1) the average of Pb, pH and turbidity level before treatment is considered high at 131.7 µg/L on Pb, turbidity at 20 NTU and low pH at 5.2. After the treatment was the Pb has decreased to 0.71 µg/L and turbidity has to 5.66 NTU, pH to 6.9 and (2) Rain water treatment is very effective to decrease Pb for 99.4% and turbidity for 72%, and (3) there is a correlation among Pb found in rain water, length of stay and smoking activity to public health. Recommends that: the residents of Pontianak and Kubu Raya to process rain water before consuming. The rain water treatment can be done by applying mollusk sand filtration and absorption of active carbon.

Malaysia became the centre of international attention when it democratically removed a semi-authoritarian government of 62 years during its 14th general election this year. This electoral success has provided geriatric medicine in Malaysia with the unexpected ageing icon in the oldest prime minister in the world. Political change has led to a wave of optimism for the expansion of geriatric services in Malaysia, which has met with numerous challenges in the last two decades. The number of geriatrics specialists and services had already begun expanding under the previous government. However, existing geriatricians will need to reassess the landscape of delivery and access of care in our rapidly growing ageing population and develop new strategies to truly expand their services. In addition to unrelenting efforts in the recruitment and training of future geriatricians, the steady expansion of the geriatric workforce should take into account the inclusion of geriatric medicine in the undergraduate training curricula of all healthcare professionals. Expansion of geriatric services will also be a cost-effective strategy to reduce the growing national healthcare budget incurred by the growing needs of an ageing population.

The proportion of adults aged over 60 years in the world is expected to reach 20% by the year 2050. Ageing is associated with several physiological changes that increase the risk of malnutrition among this population. Malnutrition is characterized by deficiencies or insufficiencies of macro- and micronutrients. Malnutrition has detrimental effects on the health, wellbeing and quality of life of older adults. Nuts are rich in energy, unsaturated fats, protein, as well as other nutrients that provide a range of health benefits. While the effects of nuts on overnutrition have been studied extensively, very few studies have been specifically designed to understand the role of nuts in mitigating undernutrition in the elderly. Therefore, this review explores the potential role of nuts in improving the nutritional status of older adults who are at risk of undernutrition. Several properties of whole nuts, some of which appear important for addressing overnutrition, (e.g. hardness, lower-than-expected nutrient availability, satiety-enhancing effects) may limit their effectiveness as a food to combat undernutrition. However, we propose that modifications such as transforming the physical form of nuts, addressing the timing of nut ingestion, and introducing variety may overcome these barriers. This review also discusses the feasibility of using nuts to prevent and reverse undernutrition among older adults. We conclude with a recommendation to conduct clinical studies in the future to test this conceptual framework.

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge to come from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of ‘standard drink’. Physicians were generally not comfortable converting ‘standard drinks’ into other metric units, however men tended to be more comfortable than women (p=0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0-10 scale). Physicians were generally comfortable in counselling patients regarding safe-limits of consumption (6.22 ± 3.20, on a 0-10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

Disadvantaged circumstances in youth tend to translate into poor health development. Yet, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time, were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n=908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.

Population based studies have associated poor living conditions with the persistent disparity in the health of Aboriginal and non-Aboriginal Australians. This project assesses the applicability of the Health Community Assessment Tool and its role in improving the environment of a small community in the Midwest of WA. The action research cycles started with the initial reflection on the suitability of the HCAT version 2 for the local community context and whether it was fit-for-purpose. The researcher provided ‘critical companionship’, while the participants of the study were invited to be co-researchers (the Assessors) who critically examined the HCAT and assess the community. The relevant domains to the serviced town (an outer regional community) were pest control and animal management; healthy housing; food supply; community vibrancy, pride and safety; reducing environmental tobacco smoke; and promoting physical activity. The Assessors found the HCAT descriptors mostly aligned with their community context but found some of the items difficult to apply. Based on participant’s suggestions, some of the original scoring scales were reformatted. School attendance and illicit drug use were identified as a key outcome indicator for youth but were missing from the HCAT. The HCAT domains applied helped streamlining core business of agencies in the local community. The face validity of HCAT items were confirmed in this research with minor adjustments to reflect local context. Youth engagement to education is of high community concern and the development of an item would create similar interagency collaborative dialogues.

Prescribed fire, intentionally ignited low-intensity fires, and managed wildfires, wildfires that are allowed to burn for land management benefit, could be used as a land management tool to create forests that are resilient to wildland fire. This could lead to fewer large catastrophic wildfires in the future. However, we must consider the public health impacts of the smoke that is emitted from wildland and prescribed fire. The objective of this synthesis is to examine the differences in ambient community-level exposures to particulate matter (PM_2.5) from smoke in the United States from two smoke exposure scenarios – wildfire fire and prescribed fire. A systematic search was conducted to identify scientific papers to be included in this review. Web of Science Core Collection and PubMed for scientific papers, and Google Scholar were used to identify any grey literature or reports to be included in this review. Sixteen studies that examined particulate matter exposure from smoke were identified for this synthesis – nine wildland fire studies and seven prescribed fire studies. PM_2.5 concentrations from wildfire smoke were found to be significantly lower than reported PM_2.5 concentrations from prescribed fire smoke. Wildfire studies focused on assessing air quality impacts to communities that were nearby fires and urban centers that were far from wildfires. However, the prescribed fire studies used air monitoring methods that focused on characterizing exposures and emissions directly from and next to the burns. This review highlights a need for a better understanding of wildfire smoke impact over the landscape. It is essential for properly assessing population exposure to smoke from different fire types.

In this study, we attempted to verify the hypothesis that total metals bound to dust of different particle sizes may reflect pollution levels, but cannot predict its bioavailability and risks in human health assessments. Dust samples were collected using active sampling method; during the dry season months of November, 2014 to March, 2015 at different locations in Akure (7˚10ʹN and 5˚15ʹE). The samples were sorted into different particle sizes (< 10µm, 10 – 50 µm, >50µm), analyzed for some physicochemical properties and assessed for metals bioavailability using two-step physiological extraction method. The amount of metals (Cd, Cu, Cr, Ni, Pb, Zn and Mn) released in each particle sizes were determined using Perkin-Elmer 6000 Inductively Coupled Plasma - Atomic Emission Spectrometry (ICP-AES) analysis. The results showed that bioavailability of some metals (Cd, Ni, Pb, and Zn) decreases with increasing particle sizes, however, the reverse trend was observed for Mn, Cu and Fe concentrations. This may be attributed to some combination of physicochemical characteristics of the dust and metal speciation. Hence, it was concluded that metal bioaccessibility in dust can best be described by the knowledge of physicochemical characteristics. The exposure dose of the metals showed that cancer risks due to inhalation were very high when compared to other exposure routes (ingestion and dermal contact). The calculated non-cancer (HQ) and cancer risk (HI) for humans in the area showed values higher than unity, indicating possibility of the metals’ body burden.

Background: Human Immnodeficiency virus (HIV) continues to take a heavy toll on the lives of many people with worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region unexpressed. This pilot qualitative study sought to explore the experiences of people living with diagnosed HIV in Mogadishu and their resilience in access to care and social support. Method: Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving Antiretroviral therapy (ART) from the HIV clinic in Mogadishu. Participants were recruited through drug dispensers at the HIV clinic in Benader Hospital. These were tape recorded, transcribed and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouces or through health care contamination. They were very knowledgable about the realities of HIV, how the medication works, nutritional requirements and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organisations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainity of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechansms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people living with diagnosed HIV in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with diagnosed HIV infection and efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to the families and communities which creates a risk of self isolation and ill health. But affected individuals have developed resilient mechanisms of managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups and maintain utmost optimism about their prognosis.

(1) Background: There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. (2) Methods: 155 Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. (3) Results: Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. 4) Conclusion: This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

Green manure could improve soil nutrients and crop production, playing a significant role in sustainable agriculture. However, the impacts of green manure on crop health and the roles soil microbial communities play in the process haven’t been clarified clearly yet. In this study, we investigated soil microbial community composition and structure in four tobacco farmlands, which were treated with different green manure (control, ryegrass, pea and rape), using 16S rRNA gene amplicons sequencing. Results showed that green manure had significant impacts on soil properties, microbial communities and tobacco health. First, soil total C, N and Ca content increased significantly in groups treated with green manure than control. Second, soil community diversity was significantly higher in groups treated with green manure. Third, green manure especially ryegrass, decreased tobacco disease (bacterial wilt) rate dramatically, and the process might be mediated by soil microbial communities. On the one hand, several microbial populations were found to be potentially disease inducible or suppressive. For example, the abundances of Dokdonella and Rhodanobacter were positively correlated to tobacco disease rate, while Acidobacteira_Gp4 and Gp6 had negative correlations with tobacco disease. On the other hand, soil microbial communities were shaped by soil properties (e.g., pH, C and N content). In conclusion, our research showed that green manure could increase soil nutrients directly, and further improve tobacco health mediated by soil microorganisms, which may shed light on revealing interactions among soil properties, microorganisms and plants.

Objectives: The aim of this study is to understand the rationale for the lack of interest to perform regular opportunistic oral cancer screening (OCS) by primary care providers (PCPs) and the challenges they have in incorporating OCS into their annual examination protocol. Method: Sequential exploratory mixed methods were used. Both qualitative and quantitative data from PCPs working at Nebraska Medicine were obtained. One-on-one in-depth interviews were performed to identify PCP's perceptions and challenges in performing OCS. The themes identified in the qualitative study were used as a guide in the development of survey questionnaires. The survey was emailed to all the PCPs (N=100), whose information was available on the Nebraska Medicine publicly accessible website. Results: The response rate was 34%. Approximately 60% of the participants mentioned that they currently perform oral cancer screening, but only 3.8% of the providers answered that they were performing comprehensive oral cancer screening every time. Forty-eight percent of the providers identified time as the biggest challenge. Over 35.3% of the providers answered that they perform screenings for patients with a history of tobacco (i.e., smoking) or alcohol use. Conclusion: Around half of the participants identified lack of time as their primary challenge in performing OCS and lack of knowledge as their second main obstacle. Very few provided comprehensive OCS and visual examination of the oral cavity is the only step performed often.

Background and Objectives. To examine trends in the links between induced abortion and subsequent mental health problems for U.S. women approaching completed fertility. Materials and Methods. Panel data on a nationally-representative cohort of 3,842 ever-pregnant women assessed at mean ages of 15, 22, 28 and 37 years from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were examined for pregnancy outcome-related mental health disorders, with extensive adjustment for confounders including sociodemographic dif-ferences, mental health history, and unwanted pregnancies. Outcomes were defined using pub-lished diagnostic criteria or validated index for depression, anxiety disorder, post-traumatic stress disorder (PTSD), and suicide ideation (affective problems); alcohol abuse, drug abuse, opioid abuse, and cannabis abuse (substance abuse problems); and summary counts of affective problems, substance abuse problems and total disorders. Results were adjusted for abortion under-reporting using cross-wave analysis. Results. The relative risk of mental health disorder with exposure to induced abortion followed an inverted “V” pattern as women aged to midlife, increasing from Wave III (age 22; IRR 1.41) to Wave IV (age 28; IRR 1.67), then dropping sharply by Wave V (age 37; IRR 1.20). The population at-tributable fraction of mental health disorder due to abortion dropped from 18.1% at Wave IV to 8.0% at Wave V. Unlike previous Waves, at Wave V mental health risk was more strongly reduced by exposure to childbirth (IRR 0.70, 95% CI .63, .78, p < .001). Reduced relative metrics at Wave V were not due to reduced prevalence of mental health disorders for ever-aborting women, which increased from Wave IV to Wave V by 1.7%, but increased much more, by 20.5%, for never-aborting women. Conclusion. At midlife approaching completed fertility, differential negative psychological out-comes for ever-aborting U.S. women remained elevated but reduced from younger ages.

Diabetes and mental disorders have been recognized as two significant public health concerns globally. Recent research indicates that there is a bidirectional relationship between these two conditions, with each influencing the other's course and outcomes. Nutrition plays an essential role in the prevention and treatment of both mental disorders and diabetes. A comprehensive review of existing literature was conducted to examine the impact of anxiety and depression on the development of diabetes and the influence of diabetes on the occurrence of mental health disorders such as anxiety and depression. Additionally, the effects of nutrition on the prevention and management of mental disorders, diabetes, and related complications in at risk individuals were assessed. Our findings show that mental disorders, such as depression and anxiety increase the risk of developing type 2 diabetes and are associated with poorer glycemic control, increased diabetes-related complications, and higher mortality rates. Conversely, diabetes is also linked with an increased risk of developing mental health disorders, including depression, anxiety, and cognitive decline. The biological, psychological, and social factors that contribute to the comorbidity between these two conditions are complex and multifaceted. Therefore, an integrated approach to the management of both conditions is critical for improving patient outcomes and reducing the overall burden of disease. Nutritional interventions should be utilized to reduce the risk of diabetes in patients with anxiety and depression as well as enhance mental health in patients with diabetes.

The COVID-19 pandemic has caused significant medical and psychological challenges worldwide, and not only exceeded the capacity of hospitals and intensive care units but also an individuals’ ability to cope with life. Health-care workers have continued to provide care for patients despite exhaustion, fear of transmission to themselves and their family, illness or death of friends and colleagues, and losing many patients. They have also faced additional stress and anxiety due to long shifts combined with unprecedented population restrictions, including personal isolation. In this study, we study the effect of an app-based Yoga of Immortals (YOI) intervention on mental health of healthcare workers. In this study, the health care workers were digitally recruited, and their psychological parameters were measured using validated questionaries. The participants were randomly grouped into control and test groups. The validated psychological measures were the Patient Health Questionnaire-8 (PHQ-8), Insomnia Severity Index (ISI) and generalized anxiety disorder (GAD-7) scales. The digital YOI intervention significantly reduced the anxiety, depression symptoms, and insomnia in healthcare workers of all age groups. In contrast, there was no improvement in the control group. This study details the effectiveness of an app-based YOI intervention in healthcare workers.

Research question/problem: This comprehensive review and comparative analysis aims to investigate the significance of enhancing oxygen provision in the context of COVID-19, focusing on the implications for healthcare policies and services.Background/context: The study addresses the shift in the oxygen dissociation curve of blood in COVID-19 patients, emphasizing the impact on oxygen delivery to tissues and the challenges it poses for clinical management. It also explores the disruption of healthcare systems due to the pandemic and the integration of social determinants of health in clinical environments.Methodology: The research incorporates a thorough literature review, comparative analysis of diverse approaches to oxygen delivery, and examination of successful interventions through case studies and best practices. Data collection techniques include the review of scholarly articles, case studies, and policy documents.Results/Key findings: The study highlights the imperative for augmented oxygen supply and the significance of maintaining appropriate oxygen saturation levels, especially in the context of respiratory illnesses like COVID-19. It also emphasizes the positive correlation between increased oxygen saturation levels and life expectancy, indicating potential health benefits of enhanced oxygen availability.Conclusions/Implications: The findings underscore the need for a structured approach to oxygen therapy and the importance of equitable distribution of oxygen to underserved regions. The implications of the research extend to enhancing healthcare policies and services regarding oxygen provision during the COVID-19 pandemic, especially in rural and remote areas.

A well-prepared public health workforce is essential for reducing disease burdens and improving population health, requiring an education that addresses global and complex challenges. This paper examines the integration of the relational employability framework in public health education to cultivate critical global citizenship among students and graduates. Our research, conducted at Edith Cowan University in Perth, Western Australia, involved two case studies using qualitative interviews. Case Study 1, drawn from Cook’s doctoral research, explored student experiences with the relational employability framework within an undergraduate capstone unit. Case Study 2, a school-funded project, gathered graduate perspectives to inform ongoing curriculum development. The findings indicate that the relational employability framework enhances global competencies among students and graduates, through research skills development and critical reflective practice. Students reported improved awareness of their learning needs, self-confidence, and an increased ability to engage with diverse perspectives and societal challenges. Graduates highlighted the framework’s role in understanding ethical standards, conducting rigorous research and applying evidence-based practices in professional settings. Additionally, the framework supported the development of a reflective mindset, enabling graduates to make informed, value-based career decisions and advance their professional growth. The study suggests that adopting a relational employability approach can effectively prepare globally competent and reflective public health professionals. We advocate for the broader implementation of this framework in health education and higher education, offering practical recommendations for curriculum transformation. Such an approach will equip future professionals to contribute meaningfully to public health debates and embody the principles of global citizenship in their practice.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to under-stand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included par-ent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4,525 valid responses, 1,831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-report tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities high-light the need for a public health approach. This should include accessible support services, resili-ence building, targeted support for vulnerable families and gender-specific interventions.

Given the pivotal role played by the microbiome in skin health it is important to understand how its composition varies with age, gender and body site, and regular use of topical products. Four studies have been carried out to determine the effects of long term (4 week) use of different dexpanthenol containing topical products on the skin microbiome of a varied population with cosmetically dry skin. Skin microbiome composition was assessed before and after product usage. No significant changes in microbiome richness or diversity were found for the individual test products, however meta-analysis of the combined dataset did show changes in microbiome composition as a function of subject sex, age and body site. The work presented here demonstrates how the use of carefully formulated topical products on skin, when used in a way which is representative of real life usage conditions, can respect the microbial diversity present on skin across a widely varied study population.

Pakistan is confronted with a formidable challenge of high population growth, compounded by cultural norms prioritizing male offspring, leading to adverse implications for family planning (FP) efforts and demographic trends. Despite efforts to promote contraception, including a national family planning program, Pakistan continues to struggle with low and stagnant contraceptive prevalence rates and high unmet contraceptive needs among married women. The influence of gender composition on modern contraceptive uptake remains underexplored, necessitating research to elucidate its impact on reproductive behavior. This study was based on a secondary analysis of a facility-based cross-sectional survey conducted in six districts of Sindh and Punjab provinces in Pakistan. A subset of 495 married women of reproductive age (MWRA) seeking health services from March to June 2019 was used for this study. Logistic regression analysis was employed to examine the association between the gender composition of children and MWRA’s modern contraceptive uptake, adjusting for covariates such as province, age of women, and health facility type. The analysis revealed a significant association between the gender composition of children and modern contraceptive uptake among MWRA. As the number of daughters increased without sons, the likelihood of contraceptive uptake remained low (Adjusted odds ratio [AOR]: 0.12; 95% CI: 0.04–0.34, p < 0.000), while having at least one son substantially increased the odds of contraceptive use (AOR: 19.91; 95% CI: 8.00–49.50, p < 0.000). Notably, the gender composition of one daughter with two sons emerged as the most preferred gender composition, because the odds of contraceptive uptake were significantly increased. The findings highlight the pervasive influence of gender composition on reproductive decision-making in Pakistan, with a clear preference for sons driving modern contraceptive behavior among MWRA. These results underscore the need for targeted interventions to address gender norms and biases while promoting equitable access to FP services. Engaging men in FP initiatives is crucial for challenging traditional gender norms and fostering informed decision-making regarding contraception. Gender preference influences modern contraceptive uptake among MWRA in Pakistan, with a strong preference for sons driving reproductive behavior. Addressing gender norms and biases while promoting informed choice is essential for enhancing modern contraceptive uptake and achieving sustainable population growth. Targeted interventions, including male engagement strategies, are needed to challenge societal gender norms and empower individuals to make autonomous decisions regarding family planning.

Adolescent eating disorders pose a significant public health challenge, deeply affecting both physical and emotional well-being. Early diagnosis is important for improving treatment outcomes, though it remains complex due to multiple influencing factors. The family perspective is essential in this process, as it provides valuable insights into changes in adolescents’ habits and emotional health. Methods: A descriptive qualitative study was conducted in Madrid, Spain, between January and February 2023, using a phenomenological approach to explore the experiences and perspectives of family members of adolescents with eating disorders. Results: Four thematic blocks with their categories were identified: (T1) Diagnosis, (T2) Family (T3) Resources, and (T4) Treatment. Participants emphasized the need for early intervention and a multidisciplinary approach to the treatment of eating disorders. Family therapy was recognized as vital in treatment, and common dissatisfaction in the public health structure underscored the need for greater investment in research and access to specialists. Mental health nurse practitioners have an important role in providing comprehensive care and support as well as mental health literacy. Conclusions: A holistic patient-centered approach, including family involvement and appropriate support systems, is key to improving outcomes and quality of life of adolescents undergoing treatment for eating disorders. Improving healthcare resources and addressing the challenges faced by families is essential. In addition, mental health literacy is critical, as it enables families to understand the disease better, make informed decisions, and actively participate in the recovery process, contributing to improved therapeutic outcomes and quality of life for patients.

Background: Osteoarthritis (OA) is a common health condition that often requires procedures like total hip arthroplasty (THA). Rehabilitation plays a crucial role in managing OA, especially in supporting recovery and improving outcomes following THA. Given the rising demand for THA and the significant impact of OA on mobility and quality of life, effective rehabilitation strategies are essential. This study investigates the impact of virtual reality (VR) therapy on the psychological and functional outcomes of female patients undergoing rehabilitation post-THA. Methods: This pilot randomized controlled trial was conducted with 24 female patients aged 60 and older. Participants were randomized into two groups: a control group receiving 4-week standard rehabilitation and an experimental group receiving standard rehabilitation plus VR therapy. Psychological and functional statuses were assessed using the Hospital Anxiety and Depression Scale (HADS), Perception of Stress Questionnaire (PSQ), and various functional tests before and after the intervention. Results: The experimental group showed significant improvements in psychological outcomes, with a 53% reduction in overall HADS scores and a 43% reduction in PSQ scores. Functional improvements were also observed, with significant increases in Tinetti Test, Barthel Index, and Rivermead Motor Assessment scores. In contrast, the control group showed no significant changes in psychological parameters and less pronounced functional improvements. Conclusions: VR therapy effectively enhances psychological well-being and functional recovery in women undergoing rehabilitation post-THA. These findings suggest that integrating VR therapy into standard rehabilitation protocols could improve outcomes and should be considered in future rehabilitation strategies.

A vast amount of non-biodegradable waste is generated during mining and processing operations of dimensional stones such as marble. This, over the years has become a global nuisance by damaging the environment through means of more than one. Therefore it has become necessary to find a technique to safely dispose or reuse marble waste. This paper reviews the impact of replacement of the conventional materials by marble waste was studied in terms of fresh, mechanical and durability properties of concrete. The air pollution caused by the dust generated in the process of crushing and extracting marble can cause serious problems to the general physiological functions of plants and it affects human life as well. Therefore, the objectives of this study were to assess the air quality of areas with marble factories and areas without marble factories, where the concentration of particulate matter in terms of total suspended particles (TSP) was determined. This paper also reviews some eco-innovation options considering the pollution caused, consumption of water and electricity and the disposal of marble waste and their waste.

Background: Vitamin D is essential for bone health, influencing bone mineral density (BMD) and the prevention of bone-related disorders. Despite its importance, Vitamin D deficiency remains prevalent among young adults, raising concerns about its impact on skeletal health. Objective: This review aims to summarize the current understanding of Vitamin D's role in bone health, focusing on its effects on BMD in young adults, and to identify gaps in the existing literature. Methods: A comprehensive narrative review of recent studies and guidelines was conducted, covering Vitamin D synthesis, its impact on bone health, dietary recommendations, and public health implications. Data were sourced from PubMed, Google Scholar, and relevant clinical guidelines.

Approximately half of all women develop palpitations during pregnancy with a quarter experiencing arrhythmias. While most presentations are benign, some cases can result in sudden cardiac death or serious symptom development. Considering such clinical presentation, healthcare providers must acquire knowledge in this area to provide comprehensive prenatal, perinatal, and postnatal care. However, no study could be located that focused on women’s lived experiences of such complications during or in the post-pregnancy period. The study aims to share the results of a study that explored the lived experience of one woman who developed non-sustained ventricular tachycardia during her third pregnancy that lasted into the post-partum period. Using Narrative Inquiry self-study methodology, a woman’s experiences were explored to uncover the challenges she faced in coping with such complications during a period of transition for herself and her family. This methodology allowed for an in-depth understanding of how these complications could affect all aspects of her life. Four narrative threads were produced: 1) diagnostic challenges and delayed recognition; 2) impact on maternal identity and family dynamics; 3) navigating healthcare systems and treatment decisions; and 4) long- term adaptation and resilience. The intention was to add to this topic area to ensure future researchers, current and future healthcare providers, and patients have literature they can refer to when studying, providing care for, or experiencing similar health complications. Acquiring this knowledge can aid healthcare professionals to ensure appropriate care is provided, risks are minimized and their recovery is well supported.

Heat stress on workers wearing PPE(Personal protective equipment) in hot outdoor environments is of rising concern, especially in cases when rest breaks and clothing changes are impractical. Mist fan evaporative cooling could provide low-energy continuous cooling even during work activity. The cooling effect of a misting fan was compared to that of a fan alone, as well as natural convection. A thermal mannequin with heat flux sensors at 8 body locations was exposed to an outdoor misting fan while clothed in typical work clothes and PPE. Work clothes were dry or saturated with water to simulate sweat. The distance from the misting fan ranged from 4m (wetting common) to 7m (wetting unlikely). On average, the misting fan had a cooling effect of 0.31met (18.3W/m²) higher than natural convection when PPE with wet work clothes are worn, and 0.35met (10.63W/m²) higher when dry work clothes with PPE were worn. This equates to reducing thermal metabolic load from light industrial work to walking about in office work, or from standing to reclining. Under international standards for workers in hot environments based on metabolic rate and WBGT(wet bulb globe temperature), such as ISO 7243, this equate to an average of about a 0.35ºC (dry clothes with PPE) to 0.61ºC (wet clothes with PPE) increase in acceptable WBGT.

Migrate is a verb representing a process where the intention of providing social services to migrants is to reduce their instability and discomfort. Consequently, social service providers are inclined to view migrants as pitiful, often also those to be feared, with migrants learning to form negative views of themselves, decreasing their mental health. Considering migration as a verb neglects the noun initiating the migration when the migrant is heading to a person, place, thing, event, or idea. In viewing migration as noun-dependent, the migrant is identifiable as self-directed in seeking aid rather than pitiful or inciting fear. This study aims to examine the types of nouns migrants conceptualize for guiding their migration based on a Google Scholar search of “[noun-type] to which [whom] migrants head in their migration” for each noun type regarding the four most highly cited reports published since 2020. The purpose is to determine the social services applicable to migrants in their self-direction regarding theoretical foundations that contrast problem-focused with emotion-focused coping. Viewing such migration nouns as essential migration signifiers encourages migrants’ favorable identification. In recognizing the intended self-direction of the migrant, their mental health is improved and is supportable through relevant and appropriately available social services.

Physical inactivity is a leading risk factor for non-communicable diseases. Climate change is now regarded as the biggest threat to global public health. Electric micromobility (e-micromobility, including e-bikes e-cargo bikes and e-scooters) has the potential to simultaneously increase people’s overall physical activity while decreasing greenhouse gas emissions where it substitutes for motorised transport. The ELEVATE study aims to understand the impacts of e-micromobility, including identifying the people, places and circumstances where they will be most beneficial in terms of improving people’s health while also reducing mobility-related energy demand and carbon emissions. A complex mixed methods design collected detailed quantitative and qualitative data from multiple UK cities. First, a nationally representative (n=2000), city-wide (n = 1200) and targeted study area surveys have collected data on travel behaviour, levels of physical activity, vehicle ownership and use as well as attitudes towards e-micromobility. Then, to provide insights on an understudied type of e-micromobility, 49 households have been recruited to take part in e-cargo bike one-month trials. Self-reported data from participants are validated with objective data using methods such as GPS trackers and smartwatches recording of routes and activities. CO₂ impacts of e-micromobility use are also calculated. Participant interviews provided detailed information on preferences, expectations, experiences, barriers and enablers of e-micromobility.

Background: Human papillomavirus (HPV) poses a significant health burden, yet the vaccine which successfully prevents HPV and its associated cancers remains underutilized. Nurses play a crucial role in patient education and advocacy for HPV vaccination. This study explores how knowledge, along with cultural, religious, and social beliefs, shapes the attitudes of Israeli nurses and nursing students toward the HPV vaccine and their advocacy efforts. Methods: A cross-sectional study was conducted from August 2023 to January 2024 using an anonymous online questionnaire distributed via Facebook groups targeting Israeli nurses and nursing students. The questionnaire assessed demographic data, HPV-related knowledge, and attitudes toward HPV vaccination. Results: The study included 458 participants (229 nurses and 229 nursing students). Significant knowledge gaps were found, with 52% of participants incorrectly believing that the vaccine can cure existing infections and 47% mistakenly believing that it is administered in a single dose. Logistic regression revealed that nurses working in community settings were more likely to have positive attitudes toward HPV vaccination (OR=2.98, 95% CI: 1.84–4.85). Higher levels of HPV-related knowledge (OR=3.35, 95% CI: 2.10–5.35) and secular or traditional religious affiliations (OR=2.45, 95% CI: 1.52–3.97) were strongly associated with positive attitudes toward and advocacy for the vaccine. Conclusions: Targeted educational programs addressing knowledge gaps, especially those tailored to Israel's cultural and religious diversity, are crucial for empowering nurses and nursing students as advocates for HPV vaccination. Enhancing their understanding of HPV can increase vaccine uptake, reduce the incidence of HPV-related diseases, and strengthen public health initiatives in Israel.

People with aphantasia exhibit the inability to voluntarily generate or form mental imagery in their minds. Since the term “aphantasia” was proposed by Zeman et al. in 2015 to describe this, it has gained increasing attention from psychiatrists, neuroscientists, and clinicians. Previous studies have mainly focused on definition, prevalence, and measurement, its impacts on individuals’ cognitive and emotional processing, and theoretical frameworks synthesizing existing findings, which have contributed greatly to our understanding of aphantasia. However, there are still some debates regarding the conclusions derived from existing research and the theories that were constructed from various sources of evidence. Building upon existing endeavors, the current systematic review emphasizes that future research is much needed to refine definition and diagnosis of aphantasia, strengthen empirical investigations at behavioral and neural levels, and more importantly, develop or update theories. These multiple lines of efforts could lead to a deeper understanding of aphantasia and further guide researchers in future research directions.

Poor perinatal mental health can have significant and lasting impacts on a woman’s overall health and the well-being of her children and family. From conception, a baby's behavior, appearance, aversions, and interests can be influenced by the prenatal environment. Thus, the quality of prenatal care is crucial. Factors such as maternal stress, environmental conditions, cravings, mood swings, hormonal changes, and emotional experiences during pregnancy can profoundly affect the baby’s behavior once born. The baby's interaction with the external world begins from conception, not just at birth. For instance, maternal depression can negatively affect both the mental and physical health of the infant. Therefore, fostering a supportive environment for expectant mothers is essential for their health and that of their unborn child. Promoting the mother’s well-being through happiness and comfort is critical.This review paper aims to synthesize current research on maternal-fetal attachment during pregnancy, its evolution, and its postpartum effects on the mother-infant relationship. It will explore how these dynamics change over time, both during pregnancy and after delivery, to provide a comprehensive understanding of the factors influencing attachment and related outcomes. As Alan Soufre, a famous developmental psychologist would state, "Attachment would begin before birth. The mother’s emotional state can shape the child’s development trajectory long before the child is born."

Background: Menopause signifies the end of a woman's reproductive phase, characterized by the cessation of ovarian hormone production and the termination of menstrual cycles, typically occurring between the ages of 45 and 55. The transition involves a range of physical and psychological symptoms manifesting before, during, and after menopause. Method: This cross-sectional analytical study assessed the level of awareness regarding menopausal symptoms among women in Bharatpur-9, Chitwan. A non-probability sampling technique was used to select 257 respondents. Data were collected using a semi-structured interview schedule and analyzed with SPSS version 20.0. Results: Among the respondents, 53.3% were aged 40-49 years (Mean ± S.D.; 48.84 ± 6.27), and 69.3% experienced menarche between ages 13- 15. A majority (59.9%) had not yet reached menopause. Knowledge of menopausal symptoms was as follows: joint pain (90.7%), sleep problems (90.7%), irritability (90.7%), hot flushes (22.2%), anxiety (22.2%), sadness (22.2%), vaginal dryness (22.6%), loss of interest in sex (25.7%), palpitations (18.7%), and decreased visual acuity (9.3%). Statistical significance was found between awareness levels and factors such as religion (p=0.00), ethnicity (p=0.00), educational status (p=0.006), family type (p=0.043), cessation of menstruation (p=0.013), and cause of menopause (p=0.00). Overall, 53.7% of respondents had average knowledge about menopausal symptoms. Conclusion: The study concluded that over half of the respondents possessed average awareness of menopausal symptoms. Hence, there is a need for women to receive correct and comprehensive information regarding menopausal symptoms and their management.

Background and Objective: Although possible risk factors associated with maternal postpartum depression (PPD) have been elucidated, it is still unknown how some newborns characteristics could influence the appearance of PPD. Our research aimed to unravel the impact of newborn’s characteristics on PPD. Methods: The study was conducted in the Obstetrics &amp; Gynecology Department, from our University Emergency County Hospital, between August 2019 and April 2021. We included women in the 2 nd day of the postpartum period (n=904), divided into 2 groups: women with PPD (n=236) and control (women without PPD, n=668), by using the Edinburg Postpartum Depression Scale. Characteristic information on newborns (i.e., the months in which they were born, premature delivery, birth weight, or gender) were assessed. Results: Our findings suggest that the winter season (i.e. December and January, p=0.01) births and male newborns (p=0.02) were associated with the appearance of depressive symptoms during postpartum. Conclusions: Therefore, our study showed that women who give birth to male newborns in winter are likely to develop PPD. This should be considered by all public health systems in order to prevent such manifestations in certain groups of women.

Introduction: Adolescence is a critical period for the development of affectivity and sexual-ity. Adolescents begin to explore their sexual identity, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the 4th year of ESO, identifying risk factors, comparing behaviors and risks, monitoring these behaviors, analyzing pornography consumption, and evaluating the use of the in-ternet as a source of sexual information. Method: Descriptive cross-sectional study using questionnaires. Participants are 4th-year ESO students from a school in the Baix Llobregat province (Catalonia) aged between 14 and 18 years. Descriptive and bivariate statistical analyses were conducted using the Chi-square test and p-value calculations with R Project software. Frequency and percentage analyses were also used to describe the health behav-iors of the participants. Results: The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use man-agement vary between genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in age of initia-tion and frequency between boys and girls. Conclusions: The study on adolescent affectiv-ity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors in municipal public health.

This research explores the application of ARIMA (Autoregressive Integrated Moving Average) models and parallel computing techniques to analyze and forecast anemia diagnoses in children under 36 months in the Junín region of Peru. Using health data from 2023-2024, including insurance type, patient information, diagnosis dates, hemoglobin levels, and treatment details, we develop predictive models to understand trends and patterns in childhood anemia. The study aims to demonstrate the effectiveness of time series analysis and high-performance computing in addressing this critical public health issue. Results indicate improved forecasting accuracy and computational efficiency, potentially aiding in resource allocation and policy development for anemia prevention and treatment programs.

This six-year multicentre study investigated acute intentional poisoning with substances of abuse in adolescents to identify changes and patterns in substance use. Data from 568 adolescents were collected from three paediatric poison centres in Romania between January 2017 and December 2022. The study analysed the epidemiological and sociodemographic characteristics of the adolescents, including age, gender, place of residence, history of substance abuse, psychiatric history, and history of institutionalized care. The findings revealed that cannabis and new psychoactive sub-stances (NPSs) are the most commonly implicated substances, each with distinct profiles among adolescents. Cannabis was involved in 45.6% of cases, with a significant association with urban residency. NPSs were identified as the second most prevalent substance, accounting for 38.9% of cases. These were more prevalent in rural areas and among patients with psychiatric disorders. Cannabis and NPSs were also the most commonly implicated substances in acute intentional poisoning cases with substances of abuse. These substances have distinct profiles among adolescents, including age, gender, residency area, history of substance abuse, psychiatric history, and institutional care. These findings underscore the necessity of targeted public health interventions and integrated care approaches to address substance use and related mental health issues in adolescents.

Amid the array of challenges prompted by the COVID-19 pandemic, the policy response of governments proved vital. The U.S. states pursued varied policy approaches that demonstrated distinct divergences in impact. Particularly, contrasting state contexts produced markedly assorted frameworks for the delivery of public health services, which indicate potential effects for COVID-19 policy implementation. Using the rates of COVID-19 vaccinations as a measure of policy execution, the purpose of this study is to examine the political and administrative influences contributing to differences in COVID-19 public health policy outcomes among the U.S. states. Ordinary least squares (OLS) regression models included data sources of nationally representative information pertaining to state public health attributes of politics and administration during the height of the pandemic and vaccine campaign. The findings suggest that state political and fiscal orientations display significant associations with COVID-19 vaccination disparities, while other administrative indicators did not. The results signal important policy implications for the politics-administration dynamic within the COVID-19 pandemic and offer further understanding toward the roles of federalism and governance in future public health emergencies.

Some medical professional organizations have advocated for including the menstrual cycle as a vital sign in adolescence, but not in adulthood. However, documenting menstrual cycle patterns is not routine clinical or research practice. Vital signs are used to predict health outcomes, indicate needed treatment, and monitor a clinical course. They can help identify pathologies, affirm wellness, and are responsive to exposures. Here we review the scientific evidence showing how the menstrual cycle meets these criteria and should therefore be treated as a vital sign. Using key words and controlled vocabulary terms, we carried out multiple literature searches, prioritizing the inclusion of systematic reviews, meta-analyses, and clinical practice guidelines. This review describes how the menstrual cycle is a health indicator, can cyclically impact health conditions, and its associations with long-term post-menopausal health outcomes. We review exposures influencing the menstrual cycle, evidence underlying its use to optimize wellness, and available tools for documenting cycles. Supplementary materials include patient handouts on menstrual cycle tracking, and an index of related clinical practice guidelines and reviews by subject. The menstrual cycle is a vital sign from menarche through menopause, an underutilized but powerful tool for understanding gynecological and general health.

Accurate segmentation of skin lesions from dermoscopic images is crucial for early skin cancer detection, yet variations in lesion appearance and image artifacts present challenges. This study proposes two deep learning models, UCM-NetV2 and BNN-UCM-NetV2, to improve accuracy and computational efficiency. UCM-NetV2 enhances the UCM-Net architecture with a novel "cyber-structure" combining Multilayer Perceptron and CNN layers, improving prediction accu-racy without increasing the model's parameter count. BNN-UCM-NetV2 further optimizes for mobile deployment by binarizing activations and weights into 1-bit values, reducing computa-tional complexity and model size. Evaluations on the ISIC2017 and ISIC2018 datasets demonstrate that UCM-NetV2 outperforms existing methods in both accuracy and computational efficiency, achieving this with less than 0.04 GFLOPs. These models have the potential to make skin lesion analysis accessible to a broader population, particularly in resource-limited settings, allowing for proactive skin health monitoring and facilitating teledermatology. To foster further innovation in mobile health diagnostics, the source code for UCM-NetV2 will be available on GitHub: https://github.com/chunyuyuan/UCMV2-Net.

This study aimed to develop a state-of-the-art method for assessing chemical risks. The method combined desk research findings and the authors' practical knowledge to identify the major shortcomings in performing risk assessments at the workplace. Data were collected from nine SMEs across three sectors: agriculture, laboratory research, and conservation and restoration laboratories. The results of the discussions with the workers and on-site observations were used to develop the method to assess chemical risks. The method uses numerical factors to account for the level of conformity and the duration of exposure to support an estimation of the probability of an incident. The developed method was designed to enhance risk assessment practices and tackle common issues encountered by enterprises, including SMEs.

Patients who survived critical COVID-19 frequently reported post-acute sequelae of COVID-19 (PASC) such as psychosomatic and neurocognitive health problems. The goal of this study was to identify clinical risk factors and other predictors for such long-term consequences in severely ill COVID-19 patients. Adult COVID-19 intensive care unit (ICU) survivors from August 2020 to May 2021 were enrolled. A broad range of clinical, laboratory and chest computed tomography (CT) data was collected during ICU stay. The association between ICU predictors and psychosomatic, respiratory and neurocognitive assessments 12 months after ICU discharge was analyzed using univariate regression analysis. In 17 patients (mean age 58.9 ± 11.4 years), laboratory markers (CRP, lymphocytes, hemoglobin), ICU severity (SOFA, SAPS II, need for mechanical ventilation), complications (ARDS), and lung CT data (ground-glass opacity) were promising predictors of depressive and anxiety symptoms, fatigue, and sleep problems. Recovery of psychosomatic health such as fatigue, depression and anxiety correlated with lower levels of inflammation and high hemoglobin levels. ARDS, mechanical ventilation and worse SOFA and SAPS II scores were further risk factors for depressive and anxiety symptoms. Our study identified novel associations such as pulmonary ground-glass opacity being positively associated with depression, anxiety, fatigue, and insomnia levels.

Family planning (FP) services are crucial interventions for improving maternal and child health outcomes and promoting gender equity. However, ensuring equitable access to these services remains a significant challenge, particularly in countries like Pakistan, where sociocultural norms, economic disparities, and geographic barriers hinder FP uptake. This study utilized spatial analysis techniques, including hotspot analysis, to investigate geographic disparities in FP uptake in Pakistan using data from Pakistan Demographic and Health Surveys (PDHS) conducted between 2006 and 2017. ArcMap 10.1 was used for spatial analysis and Stata 12.0 for statistical analysis. Results revealed significant spatial variations in FP uptake, with urban areas generally exhibiting higher uptake rates than rural regions. Hotspot analysis identified dynamic changes in contraceptive prevalence rates (CPR), with significant clustering in some regions and dispersion in others. It also identified areas with high unmet need and their low intention to use FP services and preference for family size (&gt;3 children), highlighting the need for targeted behavioral change interventions. This innovative spatial approach provides nuanced insights for policymakers and program planners to develop targeted interventions based on localized data to improve FP service delivery, mitigate disparities, and ultimately advance efforts to improve maternal and child health outcomes. The application of geospatial analysis is an effective tool for enhancing program planning, evaluation, and resource allocation in diverse geographical contexts.

Non-invasive continuous health monitoring has become feasible with the advancement of biosensors. While monitoring certain biomarkers such as heart rate or skin temperature are now at certain maturity, monitoring molecular biomarkers is still challenging. Progress has been shown in sampling, measurement and interpretation of data towards non-invasive molecular sensors that can be integrated in daily wearable items. Towards this goal, this paper explores the potential of embroidered interdigitated transducer (IDT)-based sensors for non-invasive, continuous monitoring of human biomarkers, particularly glucose levels, in human sweat. The study employs innovative embroidery techniques to create flexible fabric-based sensors with gold-coated IDTs. In controlled experiments, we have shown the variation of glucose concentration in water can be wirelessly detected by tracking the resonant frequency of the embroidered sensors. The current sensors operate at 1.8GHz–2GHz and respond to the change of glucose concentration with a sensitivity of 0.17 MHz/(mg/dl). The embroidered IDT-based sensors with wireless sensing will be a new measurement modality for molecular wearable sensors. The establishment of a wireless sensing mechanism for embroidered IDT-based sensors will be followed by investigation of sweat for molecular detection. This will require adding functionalities for sampling and interpretation of acquired data. We envisage the embroidered IDT-based sensors offer a unique approach for seamless integration into clothing, paving the way for personalised, continuous health data capture.