This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of adult individuals with excessive weight completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centred on the individual, a cluster analysis established three distinct intraindividual psychosocial and diet-related profiles: a group of healthy individuals with excess weight; a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile; and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles. Furthermore, individuals in the affected cluster had higher obesity. The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese.

Machine Learning (ML) approaches have been fruitfully applied to several classification problems of neurophysiological activity. Considering the relevance of emotion in human cognition and behaviour, ML found an important application field in emotion identification based on neurophysiological activity. Nonetheless, the literature results present a high variability depending on the neuronal activity measurement, the signal features and the classifier type. The present work aims to provide new methodological insight on ML applied to emotion identification based on electrophysiological brain activity. For this reason, we recorded EEG activity while emotional stimuli, high and low arousal (auditory and visual) were provided to a group of healthy participants. Our target signal to classify was the pre-stimulus onset brain activity. Classification performance of three different classifiers (LDA, SVM and kNN) was compared using both spectral and temporal features. Furthermore, we also contrasted the classifiers performance with static and dynamic (time evolving) features. The results show a clear increased in classification accuracy with temporal dynamic features. In particular, the SVM classifiers with temporal features showed the best accuracy (63.8 %) in classifying high vs. low arousal auditory stimuli.

Problem:Palestinian demographic landscape is undergoing an increase in the elderly population like many regions across the world. The elderly Palestinians face a unique challenges and problems of limited access to traditional care due to restricted movement, checkpoints, and also for limited healthcare resources. Therefore, the need arose to develop a sensitive and adaptable smart health monitoring system for Palestinian elderly to provide accurate and timely health data to improve well-being and prevent complications. Method: The proposed system (SHMS) leverages the Internet of Things (IoT) with appropriate sensors to track vital signs like heart rate, blood oximeter, body temperature and signal from a patient heart. Advanced algorithms analyze the data, generating alerts for potential health risks, triggering timely interventions, and enabling remote consultations. Results: This system has the potential to contributes to SDG 3 to significantly improve the health and well-being of elderly Palestinians by providing an accurate, low-power, and low-cost system for remote health monitoring. The system, being wearable, reads vital signs in real-time, overcoming geographical barriers and facilitating remote monitoring, especially in areas with limited healthcare centers and suffered from barriers along the way. The Doctor can suggest the patient’s prescription needed based on the momentary condition of the elderly and on previous readings of the sensors, if necessary. Which will also be notified via messages. Moreover, the doctor can take immediate intervention in case of an emergency. By implementing the system, it will be unnecessary for more than 50\% of the elderly to visit health care, thus reducing the cost to 50\%.}

Age-related macular degeneration (AMD) is an eye disease and the most common cause of vision loss in the Western World. In its advanced stage, AMD occurs in two clinically distinguished forms: dry and wet, but only wet AMD is treatable. However, the treatment based on repeated injections with vascular endothelial growth factor A (VEGFA) antagonists may at best stop the disease progression and prevent or delay vision loss but without an improvement of visual dysfunction. Moreover, it is a serious mental and financial burden for patients and may be linked with some complications. The recent first success of intravitreal gene therapy with ADVM-022, which transformed retinal cells to continuous production of aflibercept, a VEGF antagonist, after a single injection, has opened a revolutionary perspective in wet AMD treatment. Promising results obtained so far in other ongoing clinical trials support this perspective. In this narrative/hypothesis review, we present basic information on wet AMD pathogenesis and treatment, the idea of gene therapy in retinal diseases, update evidence on completed and ongoing clinical trials with gene therapy for wet AMD, and perspectives on the road to the clinic of “one and done” therapy for wet AMD to replace a lifetime of injections. Gene editing targeting the VEGFA gene is also presented as another gene therapy strategy to improve wet AMD management.

Breast cancer is an important disease that threatens the lives of women. The majority of breast screening health education is printed promotional material, which is ineffective in enhancing women’s knowledge on breast screening in Taiwan, and showed low breast cancer screening rate in women. This provided the impetus for us to carry out this study to understand the major barrier of women on breast cancer and screening procedures. This study used quasi-experimental design and purposive sampling. The study participants were 45–69 year-old women. Data collection was carried out before and after intervention. The health belief model was used as a research framework to examine changes in the study participants after multimedia health education intervention for detecting which factors most affect women's breast cancer screening behavior. Then we could make the policy for enhancing women's breast cancer screening in the future. Our study showed that after multimedia health education intervention, the scores of perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, cues to action, and self-efficacy in the experimental group were all significantly higher than the control group. We believe that the effectiveness of multimedia health education is better than traditional health education methods, and can enhance women to receive breast cancer screening.

Background: Passive drinking is prevalent in adolescents worldwide, but its prevalence and harm are understudied. Methods: Secondary students (n=5840, grades 7-12) from 23 selected schools in Hong Kong participated in the survey from 2015-16. Students reported the harm of passive drinking, perceived health status, Patient Health Questionnaire-2, Perceived Stress Scale-4, perceived happiness, family health, happiness, and harmony in the questionnaire. The associations were analyzed using multivariable logistic regression (odds ratio, OR) and linear regression (unstandardized coefficient, b), adjusted for confounders. Results: 29.1% (95% CI 27.8 to 30.5%) of students experienced passive drinking in the past 30-day. Past 30-day parental passive drinking was associated with a higher level of depressive symptoms (AOR 1.63, 95% CI 1.26 to 2.10), stress (adjusted b 0.76, 0.42 to 1.10), and lower level of perceived happiness (adjusted b -0.52, -0.72 to -0.33). Past 30-day parental passive drinking was associated with a lower level of family health (adjusted b -1.39, 95% CI -1.66 to -1.11), family happiness (adjusted b -1.36, -1.64 to -1.08), and family harmony (adjusted b -1.40, -1.70 to -1.10). Conclusion: Passive drinking was associated with poorer mental health, family wellbeing, and lower level of happiness among Hong Kong Chinese adolescents.

In the context of globalization One Health enables and concurs to the achievement of Global Health. One Health approach involves wide knowledge and understanding of its critical factors, next to an adequate implementation, also in farm animal sector. Moreover, animal farming and breeding shows particularities depending on country. Therefore, well-defined and specific strategies are still needed to be developed and adapted to the current conditions found in various countries for ensuring a well implementation, thus driving to better and healthier global outcomes and security. This paper will explore the One Health status in Romania, highlighting the current progress registered until now and the future perspectives based on its potential, in the context of the livestock farming framework and challenges. Our findings may help to disclose the challenges of putting in practice One Health in Romania, alongside to the pathways showing potential to enhance sustainability in livestock farming.

Inequality of health service for different specialty categories not only occurs in different areas inequality of health service for different specialty categories in the world, but also happens in the online service platform. In the online health community (OHC), health service was often of inequality for different specialty categories, including both online views and medical consultation for offline registered service. Moreover, how the factor city-level impacts the inequality of health service in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one largest OHC in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities of rich healthcare resources with the potential control cities. For the Gini coefficient of serviced patients in over 100 specialty categories, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. Similarly, for the Gini coefficient of online views, the average treatment effect of Level-1 cities is 0.573, which is 0.016 higher than that of the matched group. For each of the specialty categories, we also estimated the average treatment effect the specialty category’s Gini coefficient ( ) with the balanced covariates. The results support the argument that the total Gini coefficient of all the doctors in OHC shows that the inequality of health service is still very serious. This study contributes to the development of the theoretically grounded understanding of the causal effect of city-level on the inequality of health service in an online to offline healthcare service setting.

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags - applied either to the individual, their residential address, or phone number - can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic-supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic-supervisors generated hazard flags in 20% of cases (n=99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging, or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p

The serious impact of Adolescent’s Free Sex Behavior will affect their developmental task. Having proper education and having optimal sex counseling are related to sexual behavior in adolescents. The alternative for this phenomenon recently has involved adolescents participating as peer counselors because they are more susceptible to peer influence. Online peer counselor programs may promote progression into depth understanding of sexual behavior among adolescents. This paper provides an overview of the effect of peer counselors on reproductive health among adolescents. It describes many conceptual frameworks about free sex behaviors, risk factors among adolescents, and the role of peer counselors in improving health reproductive behavior among adolescents.

According to Young Minds [1] ‘everyone gets angry sometimes’. Their website offers a number of de-escalating strategies, including staying calm, managing responses and setting limits to help young people who most deem resistive. Yet, Young Minds are not alone because such logical advice is ubiquitous in the literature about challenging behaviour despite the fact that in our experience when faced with high states of arousal, most young people tend to act first and deal with the consequences later. It’s not that they are stupid or non-caring, but they are human capable of great feats as well as stupidity. The same is true for any claims that solution focused (SF) conversations can put right the several decades of psychological theory suggesting resistance requires logic and better cognition. By giving the correct thinking skills, young people will walk away from risk, avoid physical confrontation, handle challenging situations like logical thinkers, and generally discount that the process of growing up is part of the challenge. It is with this in mind that over recent years in our current SF practice (with staff group supervision) we have examined the concept of ‘resistance’ and how it can be put to use as a process of collaboration. To do this, we have revisited SF theory that preoccupied many of its pioneers during the 1980’s and 1990’s and attempted to make it useful for the early 2020’s for professionals having conversations with young people, who, in traditional models, are labelled challenging. We want to introduce key differences of solution focused practice and how Anita started to formulate a 6D-SF model (details, dynamics, dimensions, dispositions, dislocations, descriptions) for contemplating how groups of professionals relate to each other and are triggered by challenging behaviour. We do not claim to have proof, logic or exactness on our side, but we’re happy to suggest how our resistance mirrors what many of the staff teams feel and describe when working through their work.

This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management.

Education and awareness raising are the primary tools of global health policy to change public behaviour. Considering the limitations of awareness agenda and the lack of social research to inform alternative approaches, our objective was to generate new empirical evidence on the consequences of antibiotic-related awareness raising in a low-income country context. We implemented an educational activity in two Lao villages to share general antibiotic-related messages, but also to learn about people’s conceptions and health behaviours. Two rounds of census survey data enabled us to assess the activity’s outputs, its knowledge outcomes, and its immediate behavioural impacts in a difference-in-difference design. Our panel data covered 1,130 adults over two rounds, including 58 activity participants and 208 villagers exposed indirectly via conversations in the village. We found that activity-related communication circulated among more privileged groups, which limited its indirect effects. Among participants, the activity influenced the awareness and understanding of “drug resistance,” while effects on attitudes were minor. Evidence on behavioural impacts was sparse and mixed, but the range of possible consequences included a disproportionate uptake of antibiotics from formal healthcare providers. Our study casts doubt on the continued dominance of awareness raising as a behavioural tool to address antibiotic resistance.

The current study aimed to: i) Monitor levels of PM₁₀, at Shebika, Haram, Masfala, Azizia, Awali and Mina in Makkah city, KSA during the period of 01 Shawwal 1436H – 27 Rabi Al-Awwal 1437H, by using LVS instruments; and; 2) assess health risk (non-cancer and cancer risks) on humans (children and adult) exposed to PM₁₀ in ambient air of Makkah city.The results showed that: the high PM₁₀ levels were found in Haram site, while the lower levels were found in Awali site. These levels were lower than that set for PM₁₀ by PME (Daily limit of 340 µg/m³). Vehicles emissions and constructions sources may be the main source of PM₁₀ levels in Makkah city. The human health risk assessments showed that: the daily exposure doses of PM₁₀ were ranked in the order: D_ing > D_dermal > D_inh for children and adult in Makkah city. Ingestion of PM₁₀ particles was the main exposure pathway for both children and adults. The HIs and cancer risk values were within the safe level, indicating that (non-carcinogenic and carcinogenic) risks for humans exposed to PM₁₀ in Makkah city were negligible.

Introduction. Environmental Health in a Global World at New York University was re-designed as a class participatory effort, challenging undergraduate students to understand environmental hazards and the resultant adverse health outcomes by embracing the inherent complexity of environmental risks and proposing solutions. Methods. Following introductory lectures, students are placed into teams and assigned a specific perspective, or avatar, which includes learning to see the challenge from the perspective of a technical expert such as a biologist, an engineer, or an anthropologist. The teams then design specific systems maps to visualize the complex interactions that lead to adverse health outcomes after a given environmental exposure. The maps highlight potential leverage points, where relatively minor interventions can provide a disproportionate benefit in health outcomes. The teams then explore potential interventions and identify the potential unintended consequences of those actions, develop and advocate for innovative new strategies to mitigate risk and improve outcomes. Results and Discussion. Over the past 5 years we have taught this methodology to over 680 students with strong, student-oriented results. The teams created and presented more than 100 strategies, addressing a diverse set of environmental challenges that include water contamination, gun violence, air pollution, environmental justice, health security, and climate change. Developing the strategies helped the students understand environmental threats in a more holistic way, provided them with some agency in finding solutions, and offered an opportunity for them to improve their presentation skills. The responses in course evaluations have been enthusiastic, with many students reporting a deep impact on their college experience.

In the United States, obesity is prevalent, and it could be described as a pandemic. Obesity is excessive fat accumulation, leading to a BMI ≥ 30 (Fruh, 2017). Surveys conducted by the CDC show that the obesity prevalence in the US is on the rise, as several obese people rose from 30.5% to 41.9% between 1999 and 2020 (Bryan et al., 2021). During the same time, several people suffering from severe obesity rose from 4.7% to 9.2% (Bryan et al., 2021). Additionally, childhood obesity is on the rise. Statistics indicate that between 2017-2020 over 19.7% of children and adolescents aged 2-19 years had obesity. During the same period, obesity prevalence in children aged 2-5 years, 6-11 years, and 12-19 years olds was 12.7%, 20.7%, and 22.2%, respectively (Bryan et al., 2021). With so many people suffering from obesity, the WHO declared it a public health crisis (WHO, 2020). The COVID-19 pandemic further exacerbated the prevalence of obesity in the US. According to the surveys, there was a 4.4% increase in obesity between 2019 to March 2020 due to lifestyle changes that were put on people during the COVID-19 pandemic (Akter et al., 2022). Many comorbidities are associated with obesity. Without adequate health interventions, millions of people could suffer severe health disorders like respiratory problems, type II diabetes, psychological issues, gastrointestinal disorders, and cardiovascular diseases. It is also essential to develop health interventions to mitigate obesity due to its strain on the healthcare system. Research shows that people suffering from obesity spend $2,505 more than people with average weight on healthcare (Cawley et al., 2021). Obesity has financial ramifications in every healthcare category: inpatient, outpatient, and prescription drugs (Cawley et al., 2021). One essential action toward the efforts to mitigate the soaring obesity rates is understanding the demographic inequities across populations and how they can be resolved.

Under the dual background of underemployment and health inequality, this paper empirically analyzes the impact of education level on underemployed workers’ health based on CLDS2016 data. The results show that underemployment is significantly related to the decline of self-rated health, increased depression tendency, and morbidity in a certain period. The results indicate that underemployment can significantly reduce the health level of workers in the low education level group and the high education level group. However, it has no significant impact on workers’ health in the middle education level group; even if we change the measurement method of indicators and consider endogeneity, the research conclusion is still robust. Moreover, this kind of health inequality mainly comes from the difference in economic effect and leisure effect of underemployment to workers with different educational levels. This paper provides empirical support for increasing the labor protection mechanism of underemployed people and reducing the health inequality caused by educational level differences.

Livestock management is challenging for resource-poor (R-P) farmers due to unavailability of quality feed, limited professional advice and rumor-spreading about animal health condition in a herd. This research seeks to improve animal health in southern Africa by promoting sericea lespedeza (Lespedeza cuneata), a nutraceutical fodder legume. An automated geospatial model for precision agriculture (PA) can identify suitable locations for its cultivation. Additionally, a novel approach of radio frequency identifier (RFID) supported telemetry technology can track animal movement, and the analyses of data using artificial intelligence can determine sickness of small ruminants. This RFID-based system is being connected to a smartphone app (under construction) to alert farmers of potential livestock health issues in real-time so they can take immediate corrective measures. An accompanying Decision Support System (DSS) site is being developed for R-P farmers to obtain all possible support on livestock production, including the designed PA and RFID-based DSS.

Social Anxiety Disorder (SAD) is a common mental health condition characterized by an intense fear of social situations, leading to significant impairments in daily functioning. Traditional exposure therapies, including Cognitive-Behavioral Therapy (CBT), have shown efficacy in treating SAD but are often limited by logistical challenges and patient reluctance. Virtual Reality Exposure Therapy (VRET) has emerged as a promising alternative, providing a controlled and immersive environment for exposure to anxiety-provoking scenarios. This paper explores the integration of Generative Adversarial Networks (GANs) into VRET to enhance the personalization, realism, and adaptability of therapeutic scenarios. GANs, which consist of a generator and a discriminator network, allow for the creation of highly realistic virtual environments tailored to the specific fears and triggers of individual patients. By offering real-time adjustments and personalized exposure scenarios, GAN-enhanced VRET addresses key limitations of traditional therapies, increasing patient engagement and treatment adherence. This review synthesizes findings from key studies on GAN-enhanced VRET, evaluating its efficacy in reducing anxiety symptoms and discussing the potential for broader application across various anxiety disorders. The results indicate that GAN-enhanced VRET offers a significant advancement in the treatment of SAD, providing a more accessible, engaging, and effective approach to exposure therapy. Future directions include expanding accessibility through cost reduction, integrating additional AI techniques, and exploring applications beyond SAD to improve mental health outcomes across diverse patient populations.

Changing mobility patterns combined with changes in the climate present challenges and opportunities for global health, requiring effective, relevant and humane policy responses. This study used data from a systematic literature review that examined the intersection between climate change, migration and health. The aim of the present study was to synthesize policy recommendations in the peer-reviewed literature, regarding this type of environmental migration with respect to health, to strengthen the evidence-base. Systematic searches were conducted in four academic databases (PubMed, Ovid Medline, Global Health and Scopus) and Google Scholar for empirical studies published between 1990 – 2020 that used any study design to investigate migration and health in the context of climate change. Studies underwent a two-stage protocol-based screening process and eligible studies were appraised for quality using a standardized mixed-methods tool. From the initial 2,425 hits, 68 articles were appraised for quality and included in the synthesis. Among the policy recommendations, six themes were discernible: (1) avoid the universal promotion of migration as an adaptive response to climate risk; (2) preserve cultural and social ties of mobile populations; (3) enable the participation of migrants in decision-making in sites of relocation and resettlement; (4) strengthen health systems and reduce barriers for migrant access to health care; (5) support and promote optimization of social determinants of migrant health; (6) integrate health into loss and damage assessments related to climate change. The results call for transformative policies that support the health and wellbeing of people engaging in, or affected by mobility responses, including those whose migration decisions and experiences are influenced by climate change, and to establish and develop inclusive migrant healthcare.

In large-capacity energy storage systems, instructions are decomposed typically using an equalized power distribution strategy, where clusters/modules operate at the same power and durations. When dispatching shifts from stable single conditions to intricate coupled conditions, this distribution strategy inevitably results in increased inconsistency and hastened system aging. This paper presents a novel differentiated power distribution strategy comprising three control variables: the rotation status, the operating boundaries for both Depth of Discharge (DOD) and C-rates (C) within a control period. The proposed strategy integrates an aging cost prediction model developed to express the mapping relationship between these control variables and aging costs. Additionally, it incorporates the multi-colony particle swarm optimization (Mc-PSO) algorithm into the optimization model to minimize aging costs. The aging cost prediction model consists of three functions: predicting health features (HFs) based on the cumulative charge/discharge throughput quantity and operating boundaries, characterizing HFs as comprehensive scores, and calculating aging costs using both comprehensive scores and residual equipment value. Further, we elaborated on the engineering application process for the proposed control strategy. In the simulation scenarios, this strategy prolonged the service life by 14.62%, reduced the overall aging cost by 6.61%, and improved module consistency by 21.98%, compared with the traditional equalized distribution strategy. In summary, the proposed strategy proves effective in elongating service life, reducing overall aging costs, and increasing the benefit of energy storage systems in particular application scenarios.

Background As a major virus outbreak in the 21st century, the Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented hazards to mental health globally. Health care workers, patients with COVID-19 are experiencing post-traumatic stress disorders, anxiety, depression, and insomnia. Methods: A cross-sectional study using a questionnaire consisted of four parts: sociodemographic, current and previous health status, measures in a social isolation, and the Arabic version of Depression, Anxiety and Stress Scale (DASS-21). Results: We had 110 patients who completed the data. 89 (80.9%) of patients recovered from COVID-19. They ranged from 18-84 with a mean of 37.6 years (SD = 9.8 years). We had 33.6% of patients re-ported moderate to extremely severe depression compared to 18.2% with mild reported symptoms. The anxiety severity showed that (35.4%) out of patients had moderate to extremely severe anxiety, compared to (6.4%) who had mild anxiety. While stress severity showed that (22.7%) had moderate to extremely severe stress compared to (13.6%) who had mild stress. Conclusion: COVID-19 has caused a significant increase in the prevalence of mental health illness in the general population. Large systematic reviews are required to set the general overall of impact of this pandemic on mental health.

Background: The Second Victim Phenomenon (SVP) significantly impacts the well-being of healthcare professionals and patient safety. While SVP has been explored in various healthcare settings, there is limited data on its prevalence and associated factors among nurses in Austria. This study investigates the prevalence, symptomatology, and preferred support measures for SVP among Austrian nurses. Methods: A nationwide, cross-sectional, anonymous online survey was conducted using the SeViD questionnaire (Second Victims in German-speaking Countries), which includes the Big Five Inventory-10 (BFI-10). Statistical analyses included binary logistic regression and multiple linear regression using the bootstrapping, bias-corrected and accelerated (BCa) method based on 5000 bootstrap samples. Results: 928 participants responded to the questionnaire. Among the respondents, 81.58% (744/912) identified as Second Victims (SVs). The primary cause of becoming a SV was aggressive behavior from patients or relatives. Females reported a higher symptom load than males, and higher agreeableness was linked to increased symptom severity. Notably, 92.47% of SVs who sought help preferred support from colleagues, and the most pronounced desire among participants was to process the event for better understanding. Conclusions: The prevalence of SVP among Austrian nurses is alarmingly high, with aggressive behavior identified as a significant trigger. The findings emphasize the necessity for tailored support strategies, including peer support and systematic organizational interventions to mitigate the impact of SVP on nurses and to improve overall patient care. Further research should focus on developing and implementing effective prevention and intervention programs for healthcare professionals in similar settings.

User experience-related challenges play a significant part in user-technology interactions. However, design processes have not always kept up with the evolving needs of users in terms of technology interactions. This paper aims to present the design, structure and evaluation of an integrated mental health intervention platform (AMGR-I), emphasizing the importance of user-centred design and engagement in addressing the evolving needs of users in technology interactions, specifically focusing on individuals with mental health disorders. The AMGR-I pilot platform integrates community, e-learning, and care sub-platforms to provide a holistic approach to mental health intervention. The study utilizes participatory design research with targeted users to gather insights into user preferences and expectations. By involving the targeted audience in the design process, the platform’s user-centered design can be improved effectively. The platform recognizes the changing view of users, who now seek products that deliver pleasure, enjoyment, engagement, and embodiment. This research contributes to the field by highlighting the importance of user-centered design in the development of a comprehensive platform for mental health support.

Myocastor coypus is a pest animal present in Africa, Europe, North America, and Asia that causes agricultural and ecological damages. Moreover, it has to be considered as a potential risk for public health. Forty-four Nutrias from the “Parco Naturale La Mandria” (Piedmont region, Northwest Italy) have been analysed. A complete necropsy and a whole histological evaluation of liver, kidney and lung have been carried out on all the animals. Moreover, the positivity to Hepatitis E Virus (HEV), Encephalomyocarditis virus (EMCV), Francisella spp., Toxoplasma gondii and Neospora caninum have been investigated. None of the animal resulted positive for HEV, EMCV, Francisella spp. or Neospora caninum. Two animals tested positive for Toxoplasma gondii. A high presence of histological lesions has been identified in different organs, suggesting that lesions could be induced by different pathogens. As previously reported, Nutria can act as a host for several pathogens, including important agents for human and animal health, and surveillance is necessary, to fully understand the biological role and the importance of coypu as a disease reservoir in our country.

Suicide is a global public health concern that has enormous social and psychological 1 implications for individuals, families, and communities affected. While the rate of suicide in the 2 UK has remained steady over the years mainly due to the various approaches to detection and 3 management of suicidal ideation, it is still one of the main causes of mortality amongst people 4 between the age of 20 – 34 years. The recent global events such as the COVID-19 pandemic, global 5 warming, war, and various environmental catastrophes means that suicide and suicidal ideation 6 is expected to increase especially among younger people. Thus, evidence-based, population-wide 7 preventative approach will be needed to ameliorate the predicted increase in suicide. Also, to 8 understand the effects of some of the suicide prevention approaches, objective and universal risk 9 assessment approach is required. However, there is no universally accepted preventative approach 10 or tools of assessment. This review examines current advances in suicide prevention in the United 11 Kingdom. It examines the epidemiology, risk factors, as well as the strengths and limitations of 12 the various suicide risk assessment and prevention tools currently in use. We hope to obtain a 13 deeper understanding of how these approaches have evolved and their impact on enhancing mental 14 health and preventing suicide ideation in the UK. We present an in-depth review of existing suicide 15 prevention research and policies, while proposing areas for future research and improvement.16

The participation of civil society is essential for environmental health policies to be effective. The objective of this study was to know the perceptions of government officials, members of civil society, and academics about environmental health problems and its governance in Bucaramanga Metropolitan Area, Colombia. In the region there is a strong citizen movement that defends the moorland ecosystem (paramo) as source of drinking water, of large-scale mining projects. A multi-method study was carried out including the review of newspaper and scientific articles, a citizen survey, and interviews and focus groups with identified key stakeholders. The findings indicate that government officials prioritize their actions on issues related to air and water pollution and environmental education. In contrast, citizens prioritize water availability from the moorland ecosystem. There are some advances in the management of environmental health, mainly related to greater citizen awareness. The participation of civil society in the environmental health governance must be enforced to broaden the issues of interest and prioritize the activities in the short- and long-term policy planning. An experience between high school students and the academy that measures air pollutants can be the first meeting point with government officials in the pathway to improve the environmental governance in the territory.

Anthropogenic activities are the main cause of climate change globally. The World Health Organization (WHO) recognized that heating and precipitation are the reason for climate change due to anthropogenic actions over the past 30 years and claim 150,000 lives annually. Climate change is also affecting the atmospheres of polar regions. Numerous diseases are linked with climate change like cardiovascular mortality and respiratory illnesses. Due to climate change, lack of long-term and high-quality data sets, variations in drug resistance and immunity, the amplification or the resurgence of diseases, as well as many socio-economic factors, are uncertain.Potentially susceptible regions consist of the temperate latitudes, the regions near the Indian and Pacific oceans are affected due to the heavy rainfall where the heat of the cities could increase life-threatening climatic proceedings. The association between climate and health poses a risk to health under future guesses. Over the current decades, warming has contributed to increased mortality and morbidity in various provinces of the globe. The current study reviews the potential effects of climate change on temperature, human health, air quality, food & nutrition, livelihoods, and livestock & fisheries in detail.

ABSTRACT: Psychological vulnerability (PV) and low mental health literacy correlate negatively with higher education students' positive mental health and health behaviours. Levels of mental health literacy limit self-help, adaptative coping strategies and academic success. However, few studies examine the significant differences between students' PV, mental health literacy, positive mental health (PMH) and modifiable behaviours variables. Identifying modifiable vulnerability factors is essential when seeking and providing professional help. Method: A cross-sectional descriptive study was conducted to investigate the differences between modifiable behaviours and PV, mental health literacy, and PMH in higher education students. A sample of 3,600 undergraduate students was recruited, mostly female (78.8%), with an average age of 23 years (SD = 6.68). Results: The majority were women, did not exercise, were dissatisfied with sleep quality time per night (62.1% sleep less than 7 hours per night) and did not engage in leisure activities. Also, most respondents had PV and low literacy levels, particularly at F1, and 67.9% scored in the flourishing group. Results showed significant differences (p<0.001) between gender, age, sleep, exercise, diet, leisure activities and PV, and PMH and literacy. Conclusions: The results identified modifiable vulnerability factors that underpin the design of intervention-targeted programmes to promote literacy and PMH in higher education campuses in Portugal to foster students’ well-being and self-help strategies.

Although the universal health coverage (UHC) is pursued by many countries, not all countries with UHC include dental care as their benefits. Japan, with its long-held tradition of UHC, has covered dental care as essential benefit and majority of dental care services are provided to all patients with minimal copayment. Being under the UHC, the scope of services as well as prices are regulated by the uniform fee schedule and dentists submit claims according to the uniform format and fee schedule. The author analyzes the publicly available dental health insurance claims data as well as a sampling survey on dental hygiene and illustrates how Japan’s dental care is responding to the challenges of the population ageing.

Many governments particularly in Europe are designing social interventions for the first post COVID-19 emergency phase. Definition of a ‘best practice’ for restriction release is urgent. Although data uncertainty generate difficulties, we believe near term analysis must shift from attempting to understand the numerous ‘unknowns’ to the clarification and interpretation of the few ‘knowns’, to create stepping stones towards rapid evidence-based decision making.Here, open access data on COVID-19 severity in three European countries were analyzed. Spain’s data were more comprehensive than those from Italy and Germany. Overall, COVID-19 severity shows a remarkable nonlinear growth with age that is significantly higher in adult males. Hence, age-adaptive and gender-balanced social interventions might represent efficient repopulation options for public health policymakers. Furthermore, we urge wider governmental effort for open access to relevant data. Their analysis will allow consolidation of existing trends, validation of key observations and thus facilitation of timely decisions.

The aim of this study was to explore perspectives of occupation health personnels (OHPs) regarding education and training of mineworkers on occupational noise induced hearing loss (ONIHL) and its impact on mineworkers’ hearing. Qualitative, in-depth telephonic and face-to-face interviews were conducted with 16 OHPs comprising representatives from the state, employer and labour as well as audiologists and occupational health hygienists. Purposive and snowball sampling were utilized to recruit participants. Data were analysed using inductive thematic analysis. Findings revealed that mineworkers have a superficial awareness and knowledge of the impact of noise on their hearing and health. Moreover, OHPs are not knowledgeable on how mineworkers are educated on ONIHL and its latent consequences. Furthermore, language, low levels of education and literacy as well as the financial constraints were factors that had a negative impact on raising awareness and training mineworkers. There is a need to prioritize health literacy among mineworkers. Additionally, audiologists need to play an active role in educating mineworkers about the effects of excessive exposure to noise. There is a need to take into account literacy levels and language barriers in planning training material for mineworkers.

Background: Over the past few years there has been immense evolution in various areas particularly in the areas of digital technologies wherein the pace of change is very high. Industrial areas such as operations and supply chain management together with advanced technologies such as machine learning, big data analytics, artificial intelligence, as well as the Internet of Things, create completely different forms of operational models for various industries. In the area of healthcare too, these emerging computational sophistication is introduced to revolutionise the approaches to prevent, diagnose and treat diverse diseases and illnesses. Objective: The objective of this study is to provide an extensive review of the contemporary approaches utilizing data to cope with significant mental disorders. From over 60 relevant scholarly articles published between 2011 and 2023, it discusses how tools such as predictive modelling, social media analysis, data from smartphones, and chatbots help with issues such as early detection, telemonitoring, provision of psychological support, and individualised prevention. Method: An initial literature review to analyse over 60 research articles, which include empirical studies that were conducted between 2011 and 2023. The research assessed implemented novel digital approaches to mental health interventions including big data analytics for predicting condition status, machine learning for examining social media content, behaviour monitoring through smartphone sensors, and using conversational agents or chatbots. The following is an overview of general conclusions from experimental and descriptive secondary research studies published in professional outlets concerning possible advantages and disadvantages of data science applied to important concerns in mental health. Results: Research reveals that integrating subtle e-health tools in tandem with typical treatment approaches holds the potential to expand mental health services to more or less integrate them into clients’ day-to-day lives, and practically individualize effective treatments accordingly. Technological solutions for instance allow remote risk assessment, symptom monitoring and determination of treatment compliance. New lines of virtualized paradigm solve social challenges that interfere with the conventional provision and consumption of care. However, questions of privacy and the long-term effects as well as clinical adoption are yet to be solved in a analytically distinct manner.

Binge drinking is a pattern of alcohol abuse. Its prevalence and associated risk factors are not well documented. Heavy drinking, on the other hand, has a well-studied association with bereavement . This report uses a cross-sectional, population-based survey to estimate prevalence of bingeing and its association with new bereavement. Bingeing is defined as 4 or more drinks (women) or 5 or more drinks (men) in a 2-to-4-hour setting. For the first time, the Georgia Behavioral Risk Factor Surveillance Survey (BRFSS) included a bereavement item, ‘Have you experienced the death of a family member or close friend in the years 2018 or 2019?’. Methods: Georgia BRFSS is a complex sampling survey administered annually. It is designed to represent the 8.1 million persons in the U.S. state of Georgia aged 18 years and older. Alcohol consumption patterns are routinely measured in the common core. In the 2019 field survey, the state added a new item probing for bereavement in the prior 24 months predating the pandemic of COVID-19. Imputation and weighting techniques were applied to yield population prevalence rates of new bereavement, bingeing, and their co-occurrence with other high-risk health states. Models, adjusted for age, gender, and race were used to estimate the risk for other unhealthy behaviors posed by the co-occurrence of bereavement and bingeing. Results: In Georgia, bereavement is common (45.8 %), and alcohol consumption is common (48.8 %). Bereavement and alcohol use co-occurred among 1,796,817 persons (45 % of all drinkers). The subset of co-occurring bereavement and binging totaled 608,282 persons. Within this group, the highest rates of bereavement were associated with death of a friend / neighbor (30.7%) or 3 plus deaths (31.8%). Conclusions: While bingeing is a known risk to public health, its co-occurrence with recent bereavement is a new observation. Public health surveillance systems need to monitor this co-occurrence to protect both individual and societal health. In a time of global bereavement, documenting its influence on binge drinking can support the work towards Sustainable Goal #3 – Good health and Well-Being. Keywords: BRFSS, Binge Drinking, Population Survey, Bereavement, SDG#3. Mental Health

Background: Access to rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of “leaving no one behind” countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities. Methods: A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. 56 individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. 41 participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by participants. Results: A concept map of 11 clusters of indicators emerged from the analysis grouped into three broader themes: Governance and Leadership (3 clusters); Service Delivery, Financing and Oversight (6 clusters); and Human Resources (2 clusters). The RESYST was comprehensive and well aligned with the Convention. On average, there was a moderately positive correlation between importance and feasibility of the indicators (r=.58) with experts prioritizing the indicators contained in the clusters of the Governance and Leadership domain. Two of the most important indicators arose from the Service Delivery, Financing and Oversight domain and reflect the need to monitor unmet needs and barriers in access to rehabilitation. In total, 59 indicators achieved above average score for importance and comprised the two–tiered priority set of indicators. Conclusion: Concept mapping was successful in generating a shared model that enables a system’s view of the most critical legal, policy and programmatic factors that must be addressed when assessing country efforts to reform, upscale and improve rehabilitation services. The RESYST provides a data driven basis for the development of standardized data collection tools to facilitate comparative analysis of rehabilitation systems.

The aim of the scoping review was to map out studies that compared the effect of smoking tobacco and smokeless tobacco on periodontal health. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework. The search for articles was conducted in five electronic databases namely: Scopus, CINAHL, Web of Science, Medline, and PubMed. The search yielded two eligible articles for full-text screening. The two studies were cross-sectional in design, conducted in India and they both used bivariate analysis for comparison of the effects of tobacco smoking and the use of smokeless tobacco on the health of the periodontium without adjusting for confounders. The two studies used 10 measures to assess the health of the periodontium namely: Periodontal probing depth, clinical attachment level, gingival index, and periodontal index, plaque index score, debris index score, calculus index score, gingival inflammation, bleeding on probing and pocket depth. Periodontal probing depth, periodontal index, calculus index score and pocket depth worse for tobacco smoking when compared with smokeless tobacco users. Both studies seem to concur on worse pocket depths for tobacco smokers than for users of smokeless tobacco.

There is a disproportionate increase in the incidence of diet-related cardiometabolic disorders in racial and ethnic minority groups. This systematic review examines the extent to which diet-induced changes in health outcomes have been discussed by race or ethnicity in randomized controlled trials recruiting both minority and non-Hispanic White groups. Databases i.e. PubMed, Cochrane library and Web of Science were searched up to November 2019. Studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group vs. non-Hispanic Whites (n=29) were included in the review. Most studies were conducted in Black vs. White people testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black people compared to Whites particularly on DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability in most studies. Adequately powered studies are needed for accurate interpretation of race by diet effects. With emerging precision nutrition initiatives, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing nutrition-related health disparities.

Introduction: Type 2 diabetes (T2D) is a major driver of health care costs, thus treatments enabling T2D reversal may reduce expenditures. We examined the impact of a T2D continuous care intervention (CCI) on health care utilization. Previous research documented that CCI, including individualized nutrition supported by remote care, simultaneously reduced hemoglobin A1c and medication use and improved cardiovascular status after two years; however, the impact on utilization is unknown. Methods: This study used four years of data (two years pre-intervention, two years post-intervention) from the Indiana Network for Patient Care (INPC) health record. Two methods estimated the impact of CCI on utilization. First, an interrupted time series (ITS) including only CCI participants (n=193) compared post-intervention utilization to expected utilization had the pre-intervention trend persisted. Deviation from the trend was estimated non-parametrically for each 6-month interval after the implementation of CCI . Second, a 1:3 matched comparator group (n=579) was constructed and used for a difference-in-differences (DiD) analysis. The primary outcome was annualized outpatient encounters. Secondary outcomes included emergency encounters and hospitalizations. Results: In two years prior to intervention, CCI participants had a mean of 5.77 annualized encounters (5.62 outpatient, 0.04 hospitalizations, 0.11 emergency). The CCI group showed a reduction in outpatient utilization after intervention. In ITS analysis, 1.6 to 1.9 fewer annualized outpatient encounters occurred in each 6-month interval post-intervention relative to expected utilization based on pre-intervention trends (p<0.01 each 6-month period; 28-33% reduction). The DiD analysis suggested a larger reduction; 5 fewer annualized outpatient encounters in the quarter after intervention, diminishing to 2.5 fewer after 2 years (p<0.01 each quarter). The study was underpowered to draw conclusions about hospitalization and emergency encounters due to the limited number of CCI patients and the rarity of encounters. Conclusions: Outpatient encounters were significantly reduced for a T2D patient population up to 2 years after receiving an individualized intervention supporting nutrition and behavior change through remote care.

We aimed to explore student and staff perceptions and experiences of a pilot COVID-19 asymptomatic testing service (P-ATS) in a UK university campus setting. This was a mixed-method study comprised of an online survey, and thematic analysis of qualitative data from interviews and focus groups conducted at the end of the 12-week P-ATS programme. Ninety-nine students (84.8% female, 70% first year; 93.9% P-ATS participants) completed an online survey, 41 individuals attended interviews or focus groups, including 31 students (21 first year; 10 final year) and 10 staff. All types of testing and logistics were highly acceptable (virus: swab, saliva; antibody: finger prick) and 94.9% would participate again. Reported adherence to weekly virus testing was high (92.4% completed ≥6 tests; 70.8% submitted all 10 swabs; 89.2% completed ≥1 saliva sample) and 76.9% submitted ≥3 blood samples. Students tested to ‘keep campus safe’, ‘contribute to national efforts to control COVID-19’, and ‘protect others’. 31.3% had high anxiety as measured by the Generalized Anxiety Disorder scale (GAD-7) (27.1% of first year). Students with lower levels of anxiety and greater satisfaction with university communications around P-ATS were more likely to adhere to virus and antibody tests. Increased adherence to testing was associated with higher perceived risk of COVID-19 to self (virus) and others (antibody). Qualitative findings revealed 5 themes and 13 sub-themes: ‘emotional responses to COVID-19’, ‘university life during COVID-19’, ‘influences on testing participation’, ‘testing physical and logistical factors’ and ‘testing effects on mental wellbeing’. Asymptomatic COVID-19 testing (virus/antibodies) is highly acceptable to students and staff in a university campus setting. Clear communications and support for mental wellbeing is likely to be important for testing uptake and adherence. Strategies are needed to facilitate social connections and mitigate the mental health impacts of COVID-19 and self-isolation.

Poland suffered an epidemic of louse-borne typhus from 1916-1923, with 400,000 cases and more than 130,000 deaths. The causative factors were depressed economic conditions and a refugee crisis that engulfed Poland after World War I. The recognition of the epidemic in 1919 stimulated the creation of the League of Red Cross Societies (LRCS). However, the LCRS had limited resources and the Poles requested help from other governments and the League of Nations (LoN). The United States sent the American-Polish Relief Expedition to conduct delousing. However, the Polish-Soviet War of 1920 disrupted typhus control and exacerbated the refugee situation. The LoN belatedly organized an underfunded Epidemic Commission. The LCRS sent a research team that did ground-breaking work on the pathology of typhus. Into 1921, the epidemic continued, driven by refugees from typhus-stricken Russia. By 1924, typhus cases were finally approaching pre-World War I levels. Multiple factors lead to the amelioration of the epidemic. The repatriation of prisoners of war and displaced civilians had concluded by 1923. Also, there had been a steady influx of sanitary, food, economic, and medical aid from various organizations into Poland since 1919. Administratively, within Poland, the anti-typhus campaign was also conducted more effectively by the Extraordinary Epidemic Commissariat.

Spatial Data Infrastructures (SDI) support the harvesting, curating, storage, and sharing of data along with providing access to development, analytic, and visualization tools that enable the building of innovative applications to address broad or specific challenges. SDIs can be especially powerful in bringing together data and tools supporting a particular theme – and this paper discusses and demonstrates the value of an SDI focused on Health. Many potential benefits of a Health SDI are proposed, and the case of supporting emergency response efforts is developed in detail. Leveraging a Health SDI, a Health Risk Index was created that provides emergency response personnel (both Emergency Operations Managers and Emergency Medical Responders) key insights into the unique health risks the impacted population faces due to the disaster. In order to establish the Health Risk Index, datasets from multiple national and global sources representing health data and social data that influences health outcomes – typically called social determinants of health – are harvested, merged, and republished to support further efforts at advancing the Health Risk Index. Visualizations of the Health Risk Index at the global, national, and sub-national levels down to the address level are presented along with demonstrations of its use.

COVID-19 pandemic has the potential to adversely affect the mental health of healthcare workers (HCWs). The public healthcare system in Greece was already facing serious challenges at the outset of the outbreak following years of austerity and an escalating refugee crisis. The multi-center, cross-sectional study aims to assess the levels and associated risk factors of anxiety, depression, traumatic stress and burnout of frontline staff in Greece. A total of 464 HCWs in six reference hospitals completed a self-administered questionnaire comprising of sociodemographic and work-related information and psychometric scales. The proportion of HCWs with symptoms of moderate/severe depression, anxiety and traumatic stress were 30%, 25% and 33% respectively. Burnout levels were particularly high with 65% of respondents scoring moderate/severe in Emotional Exhaustion, 92% severe in Depersonalization and 51% low/moderate in Personal Accomplishment. Predictive factors of adverse psychological outcomes included fear, perceived stress, risk of infection, lack of protective equipment and low social support. The psychological burden associated with Covid-19 in healthcare professionals in Greece is considerable with more than half experiencing at least mild mental health difficulties. Findings signal the need for immediate organizational and individually tailored interventions to enhance resilience and support wellbeing under pandemic conditions.

This paper proposes a methodology for the development and its Verification and Validation(V&amp;V) of safety-rated software. The development methodology is based on the structured analysis and structured design methodology, which has been proven in the field of safety software development during long period. The suggested the development and the V&amp;V methodology additionally focuses on the quality attributes 3C+T (completeness, Correctness, Consistency and traceability), which are important criteria in IEC international standards. The software development life cycle is compiled from IEC international standardization, which are of the requirements analysis phase, design phase, implementation phase, testing phase, installation/commissioning phase, and operation &amp; maintenance phases. The activities of the development process method were defined from requirements analysis to implementation, and the activities of the verification and validation were defined to include the scope of the developer's activities and then to include the test phase, installation/commissioning phase, and operation phases additionally. In other words, testing phase performed by the developer was defined as informal testing, and testing performed by the verifier according to test criteria, test plans, and test procedures was defined as formal testing. According to proposed methodology, the requirements phase defines the sequence of Entity Relationship Diagram (ERD)-Context Diagram-Data Flow Diagram (DFD), functional decomposition process and defines operational scenario. In the design phase, module design such as task analysis and task allocation were defined. In the implementation phase, we listed the coding guidelines that must be followed for safety-related system. The test phase defined the test criteria, test plan, test procedure, and test result report activities. In the installation/commissioning and operation phases, recommendations for improving reliability, quality, and safety were proposed for deliverables such as user documentation and technical documentation.

A recent report from the American Heart Association in 2018 shows that over 103 million American adults have hypertension. The angiotensin-converting enzyme (ACE) (EC 3.4.15.1) is a dipeptidyl carboxylase that, when inhibited, can reduce blood pressure through the renin-angiotensin system. ACE inhibitors are used as a first-line medication to be prescribed to treat hypertension, chronic kidney disease, heart failure among others. It has been suggested that ACE inhibitors can reduce the symptoms in mouse models. Despite the benefits of ACE inhibitors, previous studies also have suggested that alterations in the ACE gene are risk factors for Alzheimer’s disease (AD) and other neurological diseases. In mice, overexpression of ACE in the brain reduces symptoms of the AD-model systems. Thus, we find opposing effects of ACE on health. To clarify the effects, we dissect the functions of ACE as follows: (1) angiotensin-converting enzyme that hydrolyzes angiotensin I to make angiotensin II in the renin-angiotensin system; (2) amyloid-degrading enzyme that can hydrolyze beta-amyloid and reduce amyloid toxicity. The efficacy of the ACE inhibitors is well established in humans, while the knowledge specific to AD remains to be open for further research. We provide an overview of ACE and inhibitors that link a wide variety of age-related comorbidities from hypertension to Alzheimer’s disease to aging. ACE also serves as an example of the middle-life crisis theory that assumes deleterious events during the midlife, leading to age-related later events.

Social media has become more popular in the last few years. It has been used in public health development and healthcare settings to promote healthier lifestyles. Given its important role in today's culture, it is necessary to understand its current trends and future directions in public health. This review aims to describe and summarize how public health professionals have been using social media to improve population outcomes. Additionally, it discusses potential future directions on how social media can be used to improve population health. The findings showed how social media has been used as a tool for research, designing and implementing health campaigns, messaging, and health promotion. In addition, social media integration with Artificial Intelligence (AI) and Generative Pre-Trained transformers (GPT) can have a big impact and offer an innovative approach to tackle the problems and difficulties in health informatics. These innovations might improve patient participation, individualized assistance, and care experiences. The research showed how likely social media will keep growing and evolving and, if used effectively, have the potential to help close public health gaps across different cultures and improve population health.

Urinary bladder cancer (UBC) is the most common malignancy of the urinary tract in humans, with an estimated global prevalence of 1.1 million cases over 5 years¹. Due to high rates of recurrence and resistance to chemotherapy, UBC is one of the most expensive cancers to treat, resulting in significant health care costs. There is, therefore, a critical need to develop innovative molecular and cellular tools to refine patient stratification and help predict response to treatment. Urine is an underused resource of biological components shed from bladder tumors, such as exfoliated cells and extracellular vesicles, that could serve as molecular fingerprints and provide valuable biological insights into tumor phenotype and mechanisms of resistance to chemotherapy. Additionally, characterization of urine-derived extracellular vesicles and cells could be used as reliable biomarkers for prediction of response to neoadjuvant therapy.

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.

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical, geographic variables, and neighborhood socio-economic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to patients who received home health care within the recommended first two days, patients who received delayed services (3-7 days after discharge) had higher odds of rehospitalization (OR 1.28, 95% CI 1.25-1.32). Among patients who received late services (8-14 days after discharge), the odds of rehospitalization were four times greater than for patients receiving services within 2 days (OR 4.12, 95% CI 3.97-4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

The identification of homogeneous flood regions is essential for regional flood frequency analysis. Despite the type of regionalization framework considered (e.g., region of influence or hierarchical clustering), selecting flood-related attributes to reflect flood generating mechanisms is required to discriminate flood regimes among catchments. To understand how different attributes perform across Canada for identifying homogeneous regions, this study examines five distinctive attributes (i.e., geographical proximity, flood seasonality, physiographic variables, monthly precipitation pattern, and monthly temperature pattern) for their ability to identify homogeneous regions at 186 gauging sites. We add an automatic component to enhance identification of homogeneous regions is proposed as an addition to the region of influence framework. Results are presented spatially for Canada to assess patterning of homogeneous regions. Memberships of two selected regions are investigated to provide insight into membership characteristics. Sites in eastern Canada are highly likely to identify homogeneous flood regions, while the western prairie and mountainous regions are not. Overall, it is revealed that the success of identifying homogeneous region is relevant to local hydrological complexities, to whether considered attribute reflects primary flooding mechanism, and to whether catchment sites are clustered in small geographic region. Formation of effective pooling groups affords the extension of record lengths across the Canadian domain (where gauges typically have <50 years of record), facilitating more comprehensive analysis of higher return periods floods need for climate change assessment.

The COVID-19 pandemic drew public attention back to the living conditions related to housing, access to green areas in close neighbourhood and nearby recreation. Several studies confirm that visiting green spaces improved the health and wellbeing in times of crisis. This representative study for the metropolitan area of Vienna, Austria’s capital, confirms the high relevance of contact with nature, particularly for citizens to cope with the negative consequences and perceived stress, anxiety, nervousness and many other negative symptoms experienced during the health crisis. It highlights the importance of nearby smaller but also medium to large scale green areas in cities for health and wellbeing of the population. Moreover, it specifically adds novel insights on age effects in use and perception of urban green spaces during COVID-19 pandemic. The online panel survey (n=1012) was conducted in summer 2021. In order to obtain a representative sample reflective of the population’s characteristics, a (stratified) random sample was selected by applying the quota method. The objective was to obtain a sample which represented gender, age and regional distribution of the population of the City of Vienna as well as the immediately surrounding local communities. Interestingly, particularly young people spent more time outside in green areas during the pandemic, discovered novel spaces for the first time and stated a high relevance of contact with nature for their wellbeing. Elderly people above sixty five, on the contrary, stayed more frequently at home. Significant differences are visible between the age groups also with regard to negative symptoms experienced in case of restricted access to green areas due to strict pandemic measures such as lockdowns and quarantine. All age groups, however, similarly acknowledged the importance of green areas for their physical, mental and emotional health in general during the pandemic.

The chlorophyll content and mineral compositions of plants are highly dependent on the species' physiological responses and environmental stress tolerance. The chlorophyll content is important for determining abiotic stress tolerance in tomatoes and peppers. Several studies found that foliar applications of specific components increased tomato and pepper output by increasing nutrient uptake. After transferring the seedlings to the incubator, three tomatoes (Mobil, Korall, and Tyking F1) and three pepper varieties (Carma, Fokusz, and Bobita F1) were sprayed. The following solutions were applied at a rate of 4 mL to each different plant: sodium bicarbonate (0.52%), 50 mg L-1 salicylic acid, and distilled water. A chlorophyll sensor (SPAD-502) was used to collect 5 measurements from each plant after 2 days and 8 days of spraying. Five plant sap samples were collected from ten plants after 38 days of transplantation. The calcium ion (Ca+2), potassium ion (K+), and nitrate (NO3-) contents (mg L-1) in plant sap were measured using three calibrated electronic sensors of the type (HORIBA instruments LAQUA-TWIN). The factorial analysis of two factors was used in data collection and statistical analysis. The first variable was the variety and the second was the spray treatment, and each record had five observations. The Tukey-Kramer test in Minitab 20 was used to assess differences in means between groups. Minitab 20's regression response optimizer was used to determine the maximum and minimum responses to calcium, potassium, nitrate, and chlorophyll content factors in each plant. Salicylic acid 50 mg L-1 produces the strongest multiple responses, particularly in tomato cultivars (Tyking F1 and Korall). The multiple minimum responses were for the variety (Mobil). Spraying (Mobil) with salicylic acid (50 mg L-1) and sodium bicarbonate (0.52%) produced unsatisfactory results. Salicylic acid 50 mg L-1 elicits also the most powerful multiple responses, particularly in the (Carma) pepper cultivar. The results revealed multiple minimum responses for the variety (Bobita F1). Finally, it is recommended that growers grow tomatoes (Mobil) without any supportive spraying treatment because the vigor of tomato (Mobil) seedlings was significantly higher in suboptimal environmental conditions. Gardeners should consider growing (Carma) pepper with a supportive spraying application of salicylic acid 50 mg L-1.

Prediabetes, a pivotal phase in glucose metabolism between normalcy and diabetes, exerts a profound influence on the aging process and the risk of age-related diseases. This comprehensive review delves into the intricate web of blood-based biomarkers that collectively expedite senescence, marking the transition from a state of health to age-related complications. Key findings underscore the significance of diverse biomarkers, such as telomere length, p16INK4a, senescence-associated secretory phenotype (SASP) factors, DNA methylation clocks, advanced glycation end products (AGEs), inflammatory and oxidative stress markers, circulating hormones, and additional factors like folate, B12, osteocalcin, and more. Not only do these biomarkers serve as indicators of senescence, but they actively fuel chronic inflammation, oxidative stress, and metabolic dysregulation, all of which contribute to accelerated aging. The implications of this understanding are profound, as prediabetes emerges as a critical period in an individual's life, influencing various physiological systems, including the vascular and neural systems, metabolic functions, hormonal regulation, and bone health. Recognizing the profound influence of prediabetes on senescence provides a foundation for personalized intervention strategies to mitigate age-related complications and promote healthy aging. Future research directions call for a more diverse array of biomarkers, in-depth exploration of their roles, and the development of tailored precision medicine strategies to ensure a holistic understanding and effective management of prediabetes-induced senescence and its implications for aging. This knowledge has far-reaching implications for public health and clinical practice, emphasizing the need for early detection and intervention in prediabetic individuals to enhance the quality of life in an aging population with diverse needs.

Background - Molecular profiles can predict which patients will respond to current standard treatment and new targeted therapy regimens. Using data from a highly diverse population of approximately three million in Southeast London and Kent, this study aims to evaluate the prevalence of IDH1 mutation and MGMT promotor methylation in the gliomas diagnosed in adult patients and to explore correlations with patients’ clinicopathological characteristics. Methods - Anonymised data on 749 adult patients diagnosed with a glioma in 2015-2019 at King’s College Hospital were extracted. Univariable and multivariable logistic regressions were used to estimate odds ratios (ORs) for expressing IDH1 mutation and MGMT promotor methylation, based on each patient’s age, sex, ethnicity, histology, tumour location and extent of excision. The Kaplan-Meier method was used to estimate the overall survival functions. Results - 19.5% of cases were IDH1 mutated. Being 39 years and younger (OR 5.48, 95% CI 3.17-9.47), from Asian/Asian British background (OR 3.68, 95% CI 1.05-12.97), having MGMT methylation (OR 15.92, 95% CI 7.30-34.75), an oligodendroglioma diagnosis (OR 7.45, 95% CI 2.90-19.13) and receiving a gross total/total microscopic excision (OR 1.95, 95% CI 1.24-3.08) were each univariately correlated with IDH1 mutation. MGMT methylation association persisted on adjustment (OR 14.13, 95% CI 3.88-51.43). MGMT promotor methylation was seen in 54.3 % of gliomas. In the univariate adjusted ORs, being younger than 39 years (OR 2.56, 95% CI 1.48-4.43), female (OR 1.52, 95% CI 1.11-2.08), having IDH1 mutation (OR 15.92, 95% CI 7.30-34.75) and an oligodendroglioma diagnosis (OR 6.20, 95% CI 1.33-28.88) were associated with MGMT methylation. Being female (OR 1.75, 95% CI 1.22-2.51) and having an IDH1 mutation (OR 15.54, 95% CI 4.73-51.05) persisted after adjustment for age, sex, ethnicity, histology, tumour location and extent of excision. IDH1 mutant and MGMT methylated gliomas were associated with frontal lobe location. Survival analysis showed that patients with both IDH1 mutation and MGMT methylation had a significantly better survival than those with either molecular marker alone. Over a 3-year period, women with unmethylated MGMT promotor generally had a better survival than men with unmethylated MGMT. Conclusion - This study showed that the molecular markers IDH1 mutation and MGMT promotor methylation were associated with age, sex, Asian/Asian British Ethnic Group, tumour histology, anatomical location and extent of excision. This study has demonstrated the importance of assessing glioma molecular markers in the clinical setting, and the need to stratify patients according to their clinicopathological characteristics.

Today, the various abilities that nurses require to meet patients’ healthcare needs adequately are all affected by AI-enabled systems. This research used an experimental study design in which 60 subjects were randomly assigned to either an experimental (AI image e-book guidance) group or a control (text paper guidance) group after meeting the admission conditions and agreeing to participate in the study. It was proven that providing AI image e-book guidance before surgery significantly changed the behavior of patients and promoted relief of urinary catheter discomfort through self-efficacy to reduce urinary catheter pain after surgery(p=0.000). It was found that providing AI image e-book guidance can shorten the time for health education and provide patients with repeated medical education and familiarity with health guidance, which can help to address the important clinical service demand issue and the shortage of nursing staff.

The environment impacts human health in profound ways, yet few theories define the form of the relationship between human physiology and the environment. Under current epidemiological constructs of causation, it is assumed that two complex systems (environment and humans) can transfer information directly. This is the underlying structure of the relationship when studies examine, for example, air pollution and brain health. In marked contrast, we conjecture that complex systems cannot interact directly, but rather such interaction requires the formation of an “interface”. Further, we contend that this dynamic, process-based interface incorporates components from all the interacting systems but exhibits operational independence. This property has many consequences, the foremost being that characteristics of the interface cannot be fully resolved by only studying the systems involved in the interaction. The interface itself must be the subject of inquiry. Without refocusing our attention on biodynamic interfaces, we cannot discern how our environment impacts health.

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at a university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% Confidence Interval (95% CI): 0.629 - 0.989) for the validation sample and 0.920 (95% CI: 0.891 - 0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

Orthobunyaviruses (order Bunyavirales, family Peribunyaviridae) in the Simbu serogroup have been responsible for widespread epidemics of congenital disease in ruminants. Australia has a national program to monitor arboviruses of veterinary importance. While monitoring for Akabane virus, a novel orthobunyavirus was detected. To inform the priority that should be given to this detection, a scoping review was undertaken to 1) Characterise the associated disease presentations and establish which of the Simbu group viruses are of veterinary importance; 2) Examine the diagnostic assays that have undergone development and validation for this group of viruses, and 3) Describe the methods used to monitor the distribution of these viruses. Two search strategies identified 224 peer-reviewed publications for 33 viruses in the serogroup. Viruses in this group may cause severe animal health impacts, but only those phylogenetically arranged in clade B are associated with animal disease. Six viruses (Akabane, Schmallenberg, Aino, Shuni, Peaton, and Shamonda) were associated with congenital malformations, neurological signs, and reproductive disease. Diagnostic test interpretation is complicated by cross-reactivity, the timing of foetal immunocompetence and sample type. Serological testing in surveys remains a mainstay of the methods used to monitor the distribution of SGVs. Due to significant differences in survey designs, only broad mean seroprevalence estimates could be provided. Further research is required to characterise the SGV detected and determine the disease risk posed by novel orthobunyaviruses and how they could challenge current diagnostic and surveillance capabilities.

Making life better for Indigenous peoples is a global priority. Although bullying and oral health have always been a topic of concern, there is limited information regarding the impact of this problem in the general population, with no evidence in this regard among the Australian Indigenous population. Thus, we aimed to quantify the relationship between bullying victimization and oral health problems by remoteness among 766 Australian Indigenous children aged between 10–15-year-olds using data from the LSIC study. Bivariate and multilevel mixed-effect logistic regression analyses were employed. Findings indicated children self-reported bullying more than parents reported their children were being bullied (44% vs 33.6%), with a higher percentage from rural/remote areas than urban areas. Parents reported oral health problem increases the probability (OR 2.20, p<0.05) of being bullied in Indigenous children living in urban areas. Racial discrimination, lower level of parental education and poor child oral hygiene increase the risk of bullying victimization. Parental happiness with life and a safe community was associated with a lower risk of bullying. Dental problems are linked with Australian Indigenous children experiencing bullying victimization. Cultural resilience and eliminating discrimination maybe two modifiable paths to ameliorating health issues associated with bullying in the Australian Indigenous community.

Prevalence estimates of Parkinson’s disease (PD) – the fastest growing neurodegenerative disease – are underestimated due to issues surrounding diagnostic accuracy, symptomatic undiagnosed cases, suboptimal prodromal monitoring, and limited screening access. Remotely monitored wearable devices and sensors provide precise, objective, and frequent measures of motor and non-motor symptoms. Here, we used consumer-grade wearable device and sensor data from the WATCH-PD study to develop a PD screening tool aimed at eliminating gaps between patient symptoms and diagnosis. Early-stage PD (n=82) and age-matched comparison (n=50) participants completed a multidomain assessment battery during a one-year longitudinal multicenter study. Using disease- and behavior-relevant feature engineering and multivariate machine learning modeling of early-stage PD status, we developed a highly accurate (92.3%), sensitive (90.0%), and specific (100%) Random Forest classification model (AUC=0.92) that performed well across environmental contexts. These findings provide robust support for further exploring consumer-grade wearable devices and sensors for global population-wide PD screening and surveillance.

Neuronal lesion or injury is a traditional approach to investigate neural circuit. Is any new neural pathway or new neurodegeneration related central nerve system injury? Spinal disc herniation can cause the spinal cord injury. However, the histological examination is still lack. It happened that a case of spinal disc herniation of a 10-year old dog was examined with NADPH diaphorase (N-d) histology. We did not find the N-d neurodegenerative aberrant in the tissue of the mid-rostral lumber segment besides the metamorphoses by the compression of the disc herniation. However, the severe neuropathological changes majorly occurred in the lumbosacral spinal cord. We found more diverse neurodegenerative alterations: the aging-related N-d body (ANB), megaloneurite and N-d homogeneous formazan globule in the lumbosacral spinal cord. We also found that a new circuit pathway (intermedial collateral pathway) showed by a megaloneurite between the lateral collateral pathway and the medial collateral pathway. The enormous notch caused by spinal disc herniation located at the mid-rostral lumber segments. The aging-related neurodegeneration occurred the specific lumbosacral segments. The homogeneous formazan globule was round or oval homogeneous N-d positivity which distributed in the gray matter and dorsal column. In the medulla oblongata, ANBs were revealed in the gracile nucleus, nucleus reticularis lateralis (ventrolateral spinal trigeminal nucleus) and middle of the spinal trigeminal nucleus.

Soybean a pulse of considerable nutritional value due to its high protein, fibers and polyunsaturated fatty acid (PUFA) contents, also contains phytoestrogenic compounds that definitely hinder its recommendation for general consumption. Contrarily to ancient times when soybeans were boiled, modern commercial soy-foods can contain up to 150 mg/100g of estrogenic isoflavones. Interestingly, current estimations of isoflavone intake in the literature do not distinguish between the origins of soy-food i.e. home-made or commercial. As a result, the isoflavone exposure in Asian countries may well be over-estimated. This study aims to demonstrate, based on step-by-step monitoring of isoflavones, that traditional and domestic treatments, leveraging isoflavones water-solubility, can indeed significantly reduce their content in soy-foods. Indeed, when compared to commercial foods, the isoflavone contents was found to be 20, 2.6, 4.5 and 9.8 times lower in “home-made” soy-juice, tofu, tempeh and miso, respectively. Additionally, water soaking was found to reduce the isoflavones levels in soy-textured-proteins by more than 70%. Hence, this simple process has the potential to help drastically reduce overall xenoestrogens exposure. This study could serve as a basis for establishing the isoflavones Reference Dose and issuing food safety guidelines.

Socioeconomic conditions and social attitudes are known to represent epidemiological determinants. Credible knowledge on socioeconomic driving factors of the COVID-19 epidemic is still incomplete. Based on a linear random effects regression, a predictive model is derived to estimate COVID-19 incidence in German rural districts from local socioeconomic factors and popularity of political parties in terms of their share of vote. Thereby, time series provided by Germany's public health institute (Robert Koch Institute) of weekly notified 7-day incidences per 100,000 inhabitants per district from the outset of the epidemic in 2020 up to December 1, 2021, have been used to construct the dependent variable. Local socioeconomic conditions including share of votes, retrieved from the Federal Statistical Office of Germany, have been used as potential risk factors. Popularity of the right-wing party Alternative for Germany (AfD) bears a considerable risk of increasing COVID-19 incidence both in terms of predicting the maximum incidences during three epidemic periods (alternatively, cumulative incidences over the periods are used to quantify the dependent variable) and in a time-continuous sense. Thus, districts with high AfD popularity rank on top in the time-average regarding COVID-19 incidence. The impact of the popularity of the Free Democrats (FDP) is markedly intermittent in the course of time showing two pronounced peaks in incidence but also occasional drops. A moderate risk emanates from popularities of the Green Party (GRÜNE) and the Christian Democratic Union (CDU/CSU) compared to the other parties with lowest risk level. Socioeconomic parameters like \emph{per capita} income, proportions of protection seekers and social benefit claimants, and educational level have negligible impact. To the contrary, incidence significantly increases with population density. In order to effectively combat the COVID-19 epidemic, public health policymakers are well advised to account for social attitudes and behavioural patterns reflected in local popularities of political parties, which are conceived as proper surrogates for these attitudes. Whilst causal relations between social attitudes and the presence of parties remain obscure, the political landscape in terms of share of votes constitutes at least viable predictive "markers" relevant for public health policy making.

As brachycephalic dog breed ownership increases, there is a growing concern for the welfare of these breeds due to extreme brachycephalism. Understanding the motivations and behaviours of those choosing to own these breeds is important if we wish to address these concerns. The aim of this study was to investigate how owners of brachycephalic and non-brachycephalic dog breeds use social media dog breed groups to discuss common health issues. The purpose of Facebook posts in relation to common health issues, owner awareness of health issues, and the role of Facebook facilitated social support were explored between brachycephalic and non-brachycephalic dog owners. Twelve Facebook breed groups were selected (brachycephalic breed groups, n=6, non-brachycephalic breed groups, n=6). Using key word searches we extracted the first twenty posts from each group. Thematic analysis revealed three overarching themes: advice seeking, advice giving and community bonding mechanisms. Whilst the purpose of posting did not differ between groups, non-brachycephalic owners appeared to display greater awareness of breed-specific health issues, whilst social support played a more prominent role in brachycephalic groups. This research highlights that social media groups can act as platforms for knowledge exchange and emotional support. These could be utilised by owners, veterinarians and welfare organisations to more effectively enhance dog health and wellbeing.

Condition monitoring of industrial robots has the potential to decrease downtimes in highly automated production systems. We suggest a new health indicator based on vibration data measurements and compare its performance with state-of-the-art health indicators regarding different criteria. This evaluation is based on different data sets from robot test rigs. We find that the proposed health indicator can detect different faults, has low temperature sensitivity and works in instationary velocity regimes. A discussion of the validity of the results rounds up our contribution.

This work presents a compilation of data obtained by clinical psychologists during the Covid-19 pandemic in Brazil. Through searches on social media with #Covid19 and #MentalHealth and the exchange of information on networks of professionals, it was possible to compile and group the main psychological symptoms presented during isolation. Information was clustered according to the period it appeared, in order to guide future situations. Moreover, to prepare a group of clinical psychologists to provide online assistance.

Abstract: The Mediterranean diet, a widely studied and highly beneficial diet, underpins my research. Initially, the Mediterranean diet included Wild Edible Plants (WEPs). According to numerous research reports, this diet 1) promotes health and longevity and 2) prevents various modern diseases, including coronary and Alzheimer’s disease. A vital component of this diet is consuming locally available green plants, which are rich in health-promoting substances. In Åhlberg (2021, 2022b), I presented evidence for 56 health-promoting substances that all green vascular WEPs contain. While reading research reports of these five species, I found eight more health-promoting substances that all green vascular wild edible plants have. This article adds eight new substances to the earlier 56, bringing the total to 64. This is a novel and groundbreaking finding for which I provide research evidence. Each WEP has 1) health-promoting substances that all green vascular plants share and 2) species-specific health-promoting substances. I present the latest research on five invasive wild edible plants (WEPs) species. Each contains at least 64 health-promoting substances and varying species-specific health-promoting substances. I also present the experimental research results showing how many of these substances prevent Alzheimer’s disease. Keywords: wild edible plants (WEPs); wild food plants; Mediterranean diet; functional foods; good health, longevity; Alzheimer’s disease; alimurgic plants; invasive species; sustainability

Background and Objectives: Chemokines have various biological functions and potential roles in the development or progression of neuroinflammatory diseases. However, the specific pathogenic roles of chemokines in age-related macular degeneration (AMD), the leading cause of blindness in older individuals, remain elusive. Chemokines interact with their receptors expressed in the endothelium and on leukocytes. The sulfation of tyrosine residues in chemokine receptors increases the strength of ligand–receptor interaction and modulates signaling. Therefore, in the present study, we aimed to construct a human recombinant sulfated CXCR3 peptide trap (hCXCR3-S2) and mouse recombinant sulfated CXCR3 peptide trap (mCXCR3-S2) to demonstrate in vivo effects in preventing choroidal neovascularization and chemotaxis. Materials and Methods: First, the effect of hCXCR3-S was validated in vitro. Interestingly, hCXCR3-S2 inhibited the migration and invasion of two human cancer cell lines. Subsequently, the in vivo efficacy of mCXCR3-S2 was investigated using a mouse model of neovascular AMD. Results: Intravitreal injection of mCXCR3-S2 attenuated choroidal neovascularization and macrophage recruitment in neovascular lesions. These in vitro and in vivo effects were significantly stronger with CXCR3-S2 than with wild-type CXCR3 peptides. Conclusion: These findings demonstrate that the sulfated form of the CXCR3 peptide trap is a valuable tool that could be supplemented with antivascular endothelial growth factors in AMD treatment.

Treatment with the anti-CGRP antibody fremanezumab is successful in the prevention of chronic migraine. In preclinical rat experiments, fremanezumab has been shown to reduce calcitonin gene-related peptide (CGRP) release from trigeminal tissues and the aversive behaviour to noxious facial stimuli, which are characteristic pathophysiological changes accompanying severe primary headaches. To further decipher the effects of fremanezumab underlying these antinociceptive effects in rats, immunohistochemistry and ELISA techniques were used to analyse the content and concentration of CGRP in the trigeminal ganglion as well as the ratio of trigeminal ganglion neurons immunoreactive to CGRP and CGRP receptor components 1-10 days after subcutaneous injection of fremanezumab (30 mg/kg) compared to an isotype control antibody. After fremanezumab treatment, the fraction of trigeminal ganglion neurons immunoreactive to CGRP and the CGRP receptor components calcitonin receptor-like receptor (CLR) and receptor activity modifying protein 1 (RAMP1) was significantly lowered compared to the control. The content and concentration of CGRP in trigeminal ganglia were not significantly changed. A long-lasting reduction of CGRP receptors expressed in trigeminal afferents may contribute to the attenuation of CGRP signalling and antinociceptive effects of monoclonal anti-CGRP antibodies in rats.

Migraine is a debilitating neurovascular disorder characterized by recurrent headache attacks of moderate to severe intensity. Calcitonin gene-related peptide (GGRP), which is abundantly expressed in trigeminal ganglion (TG) neurons, plays a crucial role in migraine pathogenesis. Cortical spreading depolarization (CSD), the biological correlate of migraine aura, activates the trigeminovascular system. In the present study, we investigated CGRP mRNA expression in TG neurons in a CSD-based mouse migraine model. Our in situ hybridization analysis showed that CGRP mRNA expression was observed in smaller neuronal populations. CSD did not significantly change the density of CGRP mRNA-synthesizing neurons in the ipsilateral TG. However, the cell sizes of CGRP mRNA-synthesizing TG neurons were significantly larger in the 48 h and 72 h post-CSD groups than in the control group. The proportions of CGRP mRNA-synthesizing TG neurons bearing cell diameters less than 14 μm became significantly less at several time points after CSD. In contrast, we found significantly greater proportions of CGRP mRNA-synthesizing TG neurons bearing cell diameters of 14–18 μm at 24 h, 48, and 72 h post-CSD. We deduce that the CSD-induced upward cell size shift in CGRP mRNA-synthesizing TG neurons might be causative of greater disease activity and/or less responsiveness to CGRP-based therapy.

A new treatment option for cluster headache (CH) prevention is needed. Monoclonal antibodies (mABs) against calcitonin gene-related peptide (CGRP) ligands are used as a preventative treatment for migraine. Considering the CGRP’s role in the CH attack’s ignition and upkeep, fremanezumab and galcanezumab have been evaluated for CH preventative treatment. However, only high-dose (300 mg) galcanezumab was proven for episodic CH prevention. We herein report 3 cases of migraine and comorbid CH with previous failures of preventive treatments. The 2 cases were treated with fremanezumab and the one with non-high-dose galcanezumab. All 3 cases showed good results not only on migraine but also on CH attacks. Our report suggested the efficacy of CGRP-mABs for CH prevention. Our cases differed from the cases in the phase 3 trials of CGRP-mABs for CH prevention in the following 2 points. First, the patients had both migraine and comorbid CH. Second, the combined use of CGRP-mABs with preventative drugs for CH, such as verapamil and/or prednisolone, was performed. Future accumulation of real-world data may prove the efficacy of CGRP-mABs for CH prevention.

Age-related macular degeneration is a progressive retinal disease that is associated with factors such as oxidative stress, decreased phagocytic activity, and inflammation. In this study, we evaluated the protective effects of SIG-1451, a non-steroidal anti-inflammatory drug developed for treating atopic dermatitis and known to inhibit toll-like receptor 4, on light-induced photoreceptor degeneration. SIG-1451 was intraperitoneally injected into rats once a day before exposure to 1000 lx light for 24 h; one day later, optical coherence tomography showed a decrease in retinal thickness, and electroretinogram (ERG) amplitude was also found to have decreased 3 d after light exposure. Moreover, SIG-1451 protected against this decrease in retinal thickness and increase in ERG am-plitude. One day after light exposure, upregulation of inflammatory response-related genes was observed, and SIG-1451 was found to inhibit this upregulation. Iba-1, a microglial marker, was suppressed in SIG-1451-injected rats. To investigate the molecular mechanism underlying these effects, we used lipopolysaccharide (LPS)-stimulated rat immortalised Müller cells. The upregu-lation of C-C motif chemokine 2　by LPS stimulation was significantly inhibited by SIG-1451 treatment, and western blot analysis revealed a decrease in phosphorylated I-κB levels. These results indicate that SIG-1451 protects photoreceptor cells by attenuating light damage progression through inhibiting inflammatory responses.

The retina is a complex and fragile photosensitive part of the central nervous system which is prone to degenerative diseases leading to permanent vision loss. No proven treatment strategies exist to treat or reverse the degenerative conditions. Recent investigations demonstrate that cell transplantation therapies to replace the dysfunctional retinal pigment epithelial (RPE) cells and or the degenerating photoreceptors (PRs) are viable options to restore vision. Pluripotent stem cells, retinal progenitor cells and somatic stem cells are the main cell sources used for cell transplantation therapies. The success of retinal transplantation based on cell suspension injection is hindered by limited cell survival and lack of cellular integration. Recent advances in material science helped to develop strategies to grow cells as intact monolayers or as sheets on biomaterial scaffolds for transplantation into the eyes. Such implants are found to be more promising than the bolus injection approach. Tissue engineering techniques are specifically designed to construct biodegradable or non-degradable polymer scaffolds to grow cells as a monolayer and construct implantable grafts. The engineered cell construct along with the extracellular matrix formed, can hold the cells in place to enable easy survival, better integration and improved visual function. This article reviews the advances in the use of scaffolds for transplantation studies in animal models and its application in current clinical trials.

Cellular oxidation is responsive to external and internal stimulation and is generated via signal molecules in defense mechanisms through networks of cell proliferation, differentiation, intracellular detoxification, bacterial infection, and immune reactions. Oxidative stress is not necessarily harmful per se; it depends on the balance between oxidation and antioxidation cascades, which are induced according to stimuli and can maintain oxygen homeostasis. The reactive oxygen species (ROS) that are generated during influenza virus (IV) infection have critical effects on both the virus and host cells. In this review, we outline the link between viral infection and ROS production, using IV as an example. We introduce the current state of knowledge on the molecular relationship between cellular oxidation mediated by ROS production and various effects of IV infection. We also summarize the potential anti-IV agents that act by targeting oxidative stress.

Chronic degeneration of the Retinal Pigment Epithelium (RPE) is a precursor to pathological changes in the outer retina. The RPE monolayer, which lies beneath the neuroretina, daily internalises and digests large volumes of spent photoreceptor outer segments. Impaired cargo handling and processing in the endocytic/phagosome and autophagy pathways leads to the accumulation of lipofuscin and N-retinylidene-N-retinylethanolamine aggregates and chemically-modified compounds such as malondialdehyde and 4-hydroxynonenal within RPE. These contribute to increased proteolytic and oxidative stress, resulting in irreversible damage to post-mitotic RPE cells and development of blinding conditions such as Age-related Macular Degeneration, Stargardt disease and Choroideremia. Here, we review how impaired cargo handling in the RPE results in their dysfunction, discuss new findings from our laboratory and consider how newly discovered roles for lysosomes and the autophagy pathway could provide insights into retinopathies. Studies of these dynamic, molecular events have also been spurred on by recent advances in optics and imaging technology. Mechanisms underpinning lysosomal impairment in other degenerative conditions including storage disorders, a-synuclein pathologies and Alzheimer’s disease are also discussed. Collectively, these findings help transcend conventional understanding of these intracellular compartments as simple waste disposal bags to bring about a paradigm shift in the way lysosomes are perceived.

Industrial fires at facilities including waste management sites, warehouses, factories, chemical works and fuel storage depots are relatively frequent occurrences. Often, these fires occur adjacent to urban communities and result in ground-level airborne pollutant concentrations that are well above guideline values. Land, water, livestock and crops may also be contaminated by the emissions and by firefighting activities. Moreover, impacted communities tend to have a higher proportion of minority ethnic populations, individuals with underlying health vulnerabilities, as well as those of lower socio-economic status. Nevertheless, this is an aspect of air quality that is under-researched, and so this review aims to highlight the public health hazards associated with industrial fires and the need for an effective, coordinated, public health response. We also review the range of monitoring techniques that have been utilised in such fires and highlight the role of dispersion modelling in predicting plume trajectories and in estimating population exposure. We recommend establishing 1-h guideline values for particulate matter to facilitate timely public health interventions and we highlight the need to review regulatory and technical controls for sites prone to fires, particularly in the waste sector.

During the pandemic, educational digitization experienced a significant increase. In Mexico, social service is a crucial component of technical and professional training, a phase during which individuals apply the knowledge gained throughout their university education. The aim of this study is to standardize a digital model for the management of social service in the health care sector within health care units. This study employed an analytical, observational, retrospective, and longitudinal approach, involving two groups of trainees: Group A (n=133), utilizing a Non-Digital Model, and Group B (n=50), employing a Digital Model. In Stage I. the model design underwent validation through the Delphi method with a panel of three experts. The model was implemented on a Classroom® digital platform with the integration of the elements 1) a monthly rotation rubric 2) care services rubric 3) clinical cases or nursing process rubric, and 4) innovation project rubric. The validation of the model achieved 100% agreement (K=1). The variables measured for each group included the school of origin, career, unit of assignment, timely enrolment, and timely delivery of rubrics on the platform. The difference between the two groups was measured using Chi-Square. To measure the impact, the difference in the timeliness of the products was considered. From the University of Quintana Roo, the difference was 20.3 vs 34%. According to the Unit of Attachment the most frequent was HGR No. 17 with Group A at 22.5 vs 52%. According to the product the least delivered was Product 4, with 69% vs 81%. Timely enrollment was observed in Group A at 89% vs Group B at 80% p=0.001. Overall timely delivery in Group A was 81% vs Group B at 91% p=0.001 in the first 6 months post-implementation. Demonstrating that the implementation of the digital platform was effective, representing a significant advance in the adaptation of medical education to the circumstances imposed by the pandemic, highlighting the feasibility and effectiveness of digital teaching methods in the training of health professionals.

This article explores the significant parallels between big tobacco companies and major social networking sites regarding their influence on public health and society. While acknowledging the fundamental differences in their products and services, the paper scrutinises both industries through five primary lenses: addiction, misinformation, lack of regulation, harm to public health, and youth targeting. Both industries exhibit addictive characteristics, have faced criticism for the spread of misinformation, operate with limited regulation and transparency, and have raised concerns about targeting young demographics. Moreover, the potential harm to public health is a significant concern, with tobacco leading to well-established physical health issues. At the same time, excessive social media use has been linked to psychological harm, particularly among young users. The comparison underscores the necessity for greater regulation and oversight of social media companies, highlighting the urgent need for more comprehensive policies to mitigate potential harm and safeguard public health in the digital age.

The second external cause of death from unintentional injuries is falls in people over 60, a worldwide public health problem. Associated factors are identified early in Primary Health Care. Thus, we analyze professional narratives about older adults/old age and the organization of services in the presence of fall-inducing frailty. A structured narrative was applied under the following stages: understanding the context; setting/plot/character analysis; and interpretive synthesis. Data were collected from August to November 2022, distributing 21 health professionals in three Narrative Focus Groups. In the analyses, the collective conceptions dialogued with Bourdieu’s Epistemology of field, habitus, and capital. Among the results, technical and common sense representations of older adults were simultaneously observed, along with the belief of old age as a problematic life stage. Care is centered on the installed disease/ailment. Encouraging autonomy and self-care emerges in integrative health practices, which older adults underestimate. Professionals access the lives of older adults according to their habitus, which, in turn, is structured (structuring) in the disputes for installed capital. Thus, the care provided disregards subjectivities and symbolic systems associated with falls.

Soft drinks exist in various forms and brands and are marketed by different brewery industries across the country. Nigeria been an underdeveloped country were aforesaid health problems are common, people tends to consume them lots believing it gives more energy. This study was therefore set to assess the sugar content from different soft drinks sold in Nigeria. Ten (10) soft drinks registered and licensed in Nigeria by their respective companies were purchased from a supermarket in Ihumudumu environment of Ekpoma, Nigeria. The sugar contents were assessed using standard methods. Result showed significant differences (p<0.05) in ranges of 0.36g/100ml (Limca) to 3.88g/100ml (Teem Bitter Lemon). Conclusively, the sugar contents were all below recommended value and it can be consumed by those who need low sugar in the body.

Migrant population have always been vulnerable for high burden of social exclusion, mental disorders, physical illness and economic crisis. The current COVID-19 pandemic has further created the frantic plight among them, particularly for the undocumented migrant workers in global south. We have conducted a mixed method study among the undocumented Myanmar migrant workers (UMMWs) in Thailand to explore how the COVID-19 disruption has impacted on their mental health and what are the coping strategies adopted by them. Following the onset of COVID-19 and the recent coup d'etat in Myanmar, our current study is the first attempt to understand the mental health status and predicament of this neglected migrant group. A total of 398 UMMWs were included in the online survey among whom 23 participated in qualitative interviews. The major mental health issues reported by the study participants were depression, generalised anxiety disorder, frustration, stress and panic disorder while loss of employment, worries about the pandemic, social stigma, refused access to healthcare, lockdown and fear of detention were the predominant contributing factors. In response, we identified two key coping mechanisms- coping at personal layer (listening to music, playing online game, praying, self-motivation) and social layer (chatting with family and friends, visiting religious institutions). These findings point to the importance of policy and intervention programs aimed to uphold mental health at such humanitarian conditions. Sustainable institutional mental health care support and social integration for the migrant workers irrespective of their legal status should be ensured.

The COVID-19 pandemic has become a public health emergency of international concern, which may affect lifestyle habits and mental health. Based on national health profile assessments, this study investigates perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5,599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April-June) compared to the second (October-December). Women, individuals <60 years, having a university degree, being white-collar workers and having unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits as well as more time in mentally passive sitting at home was associated with higher odds of mental ill-health (including health anxiety regarding one’s own and relatives’ health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results em-phasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics, and prevent health inequalities in society.

This paper applies conceptualization from Paulo Freire, Tracey Nicholls, and bell hooks to develop a framework to understand art- and media-based communication of knowledge. Increasing use of art and digital media in research and formal educational settings emphasize knowledge-communication intent, and the theory attempts to rationalize why individuals potentially devalue, discard, or misconstrue messaging. Drawing upon two case studies: children’s literature, and existing scholarship on true crime as a media genre, the framework proposes art and media consumption based on perceived task-applicability of art and media. Stemming from the complex nature of socially-imposed, self-determined, and art- & media-instated tasks that an individual may face throughout their lifetime, an individual may be drawn to Freirean power and privilege - even fictional depictions - as societal structures can grant power and privilege with universal task-applicability. Potential usage of this framework towards participatory, qualitative inquiries conclude the paper, in attempt to support future art and media designed with knowledge-communication intent.

SHANK3 encodes scaffold protein involved in postsynaptic receptor density in glutamatergic synapses, including those in the parvalbumin (PV)+inhibitory neurons – the key players in generation of sensory gamma oscillations, such as 40-Hz auditory steady-state response(ASSR). Here we describe a clinical and neurophysiological phenotype of a 15-years old girl (SH01) with microduplication of 16389 bp in 22q13.33, affecting the SHANK3 gene in comparison to typically developing children (n=32). EEG were recorded during the binaurally presentation of 40-Hz clicks’ trains lasting for 500 ms with inter-trial intervals 500-800 ms. SH01 was diagnosed with mild mental retardation and learning disabilities(F70.88) and had problems with reading and writing, as well as smaller vocabulary than TD peers. Her clinical phenotype generally resembled the phenotype of previously described patients with 22q13.33 microduplication. SH01 had mild autistic symptoms but below the threshold for ASD diagnosis. No seizures or MRI abnormalities were reported. While SH01 had relatively preserved auditory event-related potential(ERP) with slightly attenuated P1, her 40-Hz ASSR was totally absent significantly deviating from TD’s ASSR. Absence of 40-Hz ASSR in patient with microduplication, affected SHANK3 gene, indicates deficient temporal resolution of the auditory system, that might underlie language problems, and represent neurophysiological biomarker of SHANK3 abnormalities.

This review focuses on the emerging evidence for the association between estimated cardiorespiratory fitness (eCRF) and metabolic risk factors. Given the challenges associated with directly measuring cardiorespiratory fitness (CRF) in large populations, eCRF presents a practical alternative for predicting metabolic health risks. A literature search identified six relevant cohort studies from 2021 to 2024 that investigated the association of eCRF with hypertension, hyperglycemia, dyslipidemia, and obesity. The review findings highlight a consistent inverse relationship between higher eCRF and lower incidence of metabolic risks in line with CRF cohort studies. This review highlights the importance of low eCRF as a primordial indicator for metabolic risks and underscores the need for broader application. Future research directions should include exploring eCRF's predictive accuracy across diverse populations and health outcomes and testing its real-world applicability in healthcare and public health settings.

Therapeutic patient education (TPE) aims to empower the patients and their caregivers to effectively care for and manage their conditions. Such educational programs have been shown to improve health behaviors, disease outcomes and quality of life among different patient populations. The field of TPE has evolved extensively over decades, owing to interdisciplinary research. No study so far has been done to map this field, to identify the stakeholders and gaps requiring future research. By leveraging the theory of co-citation, Citespace was used to visualize the bibliographic data pertaining to TPE research. A total of 54,533 articles published in English language were analyzed to identify influential funders, regions and institutes contributing to this field. Besides these, important theoretical and empirical work that has shaped this field has also been mapped. Our analysis revealed several important insights. Most of the important theories which helped shape TPE were inspired from the social sciences. Five important themes of research were identified including disorders, study designs utilized in TPE research, scope of the TPE literature, and outcomes, and populations. The research focused on improving perceptions, behaviors, and attitudes for health promotion, reducing stigma as well as self-management and medication adherence. Most of the research was developed in the context of high income countries. The future research should more involve patients and use digital technology. Meta-analytical studies need to be done to identify the specificities of TPE interventions across different disorders. More research should involve low and middle income countries (LMIC) to ensure knowledge and technology transfer.

George Satayana stated that “those who do not learn from history are doomed to repeat it”. As our UK “good outcome” death toll of 20,000 from coronavirus (SARS CoV -2/ COVID -19) in 2020 has sadly been surpassed; never has a phrase been more pertinent. The last major pandemic on a similar scale to COVID-19 is “Spanish Flu” from 1918. We aim to delineate the timeline of events in response to the 1918 Spanish flu pandemic and compare this to the timeline of COVID 19 response, given that the NHS and WHO have since both been long established. In the last 102 years many changes have occurred. Health services across the world have significantly improved, with the advent of mechanical ventilation and antimicrobial treatments. Vaccination programmes against common pathogens have prevented many large-scale disease threats, however novel illnesses have also emerged. Worldwide communication through the Internet and many agencies including the World Health Organisation has improved, and the awareness and surveillance of disease is more prominent. Despite advances in healthcare and communication, the national and international timeline for public health intervention in the current COVID pandemic in comparison to the Spanish flu pandemic of more than 100 years ago is virtually identical. The World Health Organisation operates to promote global health and prevent spread of disease, with this in mind; should the WHO have intervened earlier?​ We need to learn quickly from this pandemic and improve planning for the future.

We investigate the relationship between social isolation and subjective health, considering that this relationship is potentially affected by endogeneity due to the presence of self-reported measures. Thus, if an increase in social isolation may impact the perception on health, alternative paths of causality may also be hypothesized. Using data from round 7 of the European Social Survey, we estimate an instrumental variable model in which isolation is explained as being a member of an ethnic minority and having experienced some serious family conflicts in the past. Our results confirm that changes in social isolation influence subjective general health. In particular, greater isolation produces a strong and significant deterioration of the perceived health status. With respect to the literature on social isolation and health, we try to advance it by supporting a path of causality running from social isolation to subjective health.

Mental health impacts of COVID-19 pandemic have received a great deal of attention by policymakers for the management of present and future cases of the pandemic, especially as new COVID-19 variant cases are on the rise. Thus, this study seeks to conduct a systematic review to address the following research questions: (1) What are the mental health impacts of COVID-19 in the empirical literature? (2) Which categories of people are at higher risk of the mental health impacts of the pandemic based on the extant literature? A sample of 35 studies out of 196 potential studies (from various databases, including Scopus, Google Scholar, , Research Gate, PubMed, , and libraries, from 2020 to 2022) were used after a comprehensive literature search and thorough assessment based on PRISMA-P guidelines. The study reveals that the pandemic has led to severe cases of mental health challenges such as depression, anxiety, post-traumatic stress disorder, psychological disorders, mood disorders, and insomnia. The review identified groups such as health workers, patients with pre-existing psychiatric or mental health issues, COVID-19 survivors, patients with underlying health conditions, and the elderly as the most vulnerable groups to mental health challenges from the pandemic.

Widespread patterns of poor dietary behavior are a key factor causing the increasing prevalence of chronic diseases around the world. Research provides initial insights into the potential of food literacy (FL) to empower individuals to improve their dietary behavior. Yet, studies on FL interventions in working adults are scarce. This study aimed to investigate the short- and long-term effects of a comprehensive 3-week workplace health promotion program (WHPP) on FL and dietary intake (DI) and to examine the association between FL and DI in a sample of 144 German office workers (30.0% female). Using two random intercept mixed linear regression models, we found significant strong improvements for both FL (β = 0.52, p &lt; .0001) and DI (β = 0.63, p &lt; .0001) after the WHPP when compared to baseline. Significant long-term improvements at 18 months where strong for FL (β = 0.55, p &lt; .0001) and small for DI (β = 0.10, p &lt; .0001). FL showed a significant moderate effect on DI across all measurement time points (β = 0.24, p &lt; .0001). Our study fills a gap of long-term findings in the literature on FL interventions, offers insights into underlying mechanisms, and provides recommendations for effective WHPPs.

Context: Mental and menstrual health, two emerging aspects of health critical to the female population, are bidirectionally linked. But there is limited empirical evidence that establishes the association between these entities. This essay aims to draw the attention of researchers to this healthcare niche. Evidence Acquisition: A systematic review was carried out on literatures sourced from medical databases (e.g. PubMed, Google Scholar, Scopus, Science Direct, and Web of Science), and gray sources—popular and reputable institutional and journalistic websites that publishes mental or menstrual health research. The key words used for the search are “Menstruation, menstrual hygiene, menstrual disorders, premenstrual syndrome, period poverty, menarche, menopause, mental health, mental disorder, mental illness, depression, anxiety, phobia, mania, mood, and affect”. The initial search generated 368 results. But after the duplicates were removed, the exclusion criteria (publication before 2000) was applied, and manual review of abstract (for relevance) was done, 21 publications from the databases and 5 from gray sources were included in this essay. Results: Associations were found between menstrual cycle irregularities and disorders; and mental disorders such as premenstrual syndrome, premenstrual dysphoric disorder, major depressive disorder, major anxiety disorder, psychotic disorder, bipolar disorder, borderline personality disorder, sleep disorder, substance use/abuse, and suicidal ideation and attempts.Few positive associations between mental and menstrual health were recorded, and several research and treatment gaps were identified. Conclusion: Research into the links between mental and menstrual health should not remain a fringe area of scientific curiosity, as it shows tremendous promise in improving healthcare offered to women/girls globally.

Background: Poor menstrual health literacy impacts adolescents’ quality of life and health outcomes across the world. The aim of this systematic review was to identify concerns about menstrual health literacy in low/middle (LMIC) and high-income (HIC) countries. Methods: Relevant social science and medical databases were searched for peer-reviewed papers from January 2008 to January 2020 identifying 61 relevant studies. Results: A thematic analysis of the data revealed that LMICs report detrimental impacts on adolescents in relation to menstrual hygiene and cultural issues, while in HICs, issues related to pain management and long term health outcomes were reported more frequently. Conclusions: In order to improve overall menstrual health literacy in LMICs and HICs, appropriate policies need to be developed, drawing on input from multiple stakeholders to ensure evidence-based and cost-effective practical interventions.

Patient engagement is receiving a growing attention in the healthcare context. However, although worldwide healthcare stakeholders agree that patient engagement is a priority for quality and effective care, no shared recommendations on how to promote patient engagement are currently available. Based on these premises, a Consensus Conference (CC) was promoted to address four main issues: What is the definition of Patient Engagement? How measuring Patient Engagement? What are the most recommended methodologies and the tools to promote Patient Engagement? What is the role of new technologies in promoting of Patient Engagement? The consensus was obtained through an iterative process that began with a systematic synthesis of the available literature in each domain followed by plenary expert discussions. This CC - including the systematic analysis of internationals scientific evidences (2749 sources across the major international scientific databases) together with experiences of a multi-disciplinary consortium of investigators and key stakeholders - attempted to provide the first evidence-based Expert Consensus Statement for the promotion of Patient Engagement in chronic care. These recommendations should be envisaged as inspirational principles to promote a real eco-system of engagement and might orient health services research and interventions.

Objective: To evaluate the direct costs of treating patients with neuromyelitis optica spectrum disorders (NMOSD) in outpatient care, from a hospital and Unified Health System (SUS) perspective. Methods: Observational study with data collection by microfunding, carried out with patients diagnosed with neuromyelitis optics, treated at a university hospital, in the city of Rio de Janeiro. Mann-Whitney tests were performed to measure cost differences between patient groups by disease severity and analysis perspective. Results: Nine individuals with a median age of 48 years (IQR 30 - 59 years) were included. The median total costs for patients with greater severity from the perspective of the SUS and the hospital were R$ 21,638.22 (IIQ: R$ 15,614.63; R$ 25,985.32) and R$ 32,094.11 (IIQ: R$ 25,610 .60; R$ 38,617.25) respectively. For patients with moderate severity the median was R$ 7,339.85 (IIQ: R$ 6,235.45; R$ 11,912.05) from the SUS perspective and R$ 11,505.80 (IIQ: R$ 7,339.85; R$ 22,424.76) from the perspective of the hospital, where the use of medications had a major impact. Conclusion: The main cost drivers were medicines, especially those used off-label, and procedures.

Human resources are the major input of health systems therefore the equitable distribution of human resources in health care remain critical in making progress towards the goal of universal health coverage and thus to sustainable development. The purpose of this study is to evaluate the health care human resources distribution across regions of Poland between 2010 and 2017 and estimate the level of equity. This research by applying to Polish conditions will allow to fill in the gap in existing literature. Data was derived from the Knowledge Database Health and Health Care of Statistic Poland and Polish Statistical Yearbook. In purpose to examine the distribution of health resources against population size and geographic size in Poland, the Gini coefficient calculated based on the Lorenz Curve was engaged. This study has several major findings. The amount of most types of human resources – as apart from internist, obstetrics and gynecology, occupational medicine - when expressed as number of them per 10,000 population or 1 square km increased in 2017 compared to 2010. Moreover, for most types of health care human resources the level of access slightly changed during analysied period as Gini coefficients decreased. However, the geographical distribution of all types of human resources is less equitable then in case of population distribution. The most troublesome is relatively lower equity in case of oncologist, family medicine and occupational medicine and cardiologist in both population and geographical distribution. Thus this research provides some implications for policy and practice. As the main reason to establish National Health Fund (which meant the centralization of the system) in Poland was to to eliminate regional differences in access to health care, thus this research confirms that still some more corrective actions, in this field, should be undertaken.

(1) Background: Metabolic syndrome is associated with cardiovascular complications. Therefore, this study aims to establish cut points for the conicity index based on the components of the metabolic syndrome and to associate it with characteristics sociodemographic, food consumption and occupational factors in Brazilian rural workers; (2) Methods: Cross-sectional study carried out with farmers. The receiver operating characteristic curve was calculated and the cutoff points for the conicity index were identified by the area under the curve, sensitivity and specificity. The variables included in the binary logistic regression analysis were selected by considering p &lt; 0.20 in the bivariate test; (3) Results: The cut points were similar in females according to both criteria, resulting in a single cut-off of 1.269. In males, the cut points showed differences, resulting in 1.272 according to the NCEP-ATP III and 1.252 according to the IDF. We have shown that younger people, those who work more than 40 hours a week and the lowest contribution of culinary ingredients are associated with increased odds of abdominal obesity. While the consumption of the products they sell or produce decreases these chances; (4) Conclusions: The conicity index showed high discriminatory power for the identification of abdominal obesity in rural workers.

According to several evidence, forest environmental seems able to provide beneficial effects on functional and psychological parameters, related to cardiovascular, metabolic, respiratory functions as well depression and anxiety. The aim of this study is to investigate the effect of a one-day forest walking in Selva di Castelfidardo (AN, Italy) on 37 participants aged 21-68, most of them living in either urban or suburban areas of large cities. We observed a statistically significant effect on sympathovagal balance by the means of heart rate, systolic and diastolic blood pressure, body temperature, skin temperature, skin conductance, HRV parameters (AVNN, SDNN, rMSSD, pNN50, LF, HF, LF/HF ratio), oxygen oximetry, PEF, FEV1. A significant difference was also detected on the Perceived Stress Scale responses (19.27 pre vs 13.81 post-immersion, p=<0,05; -28,3% variation). Our data contribute to increase the body of literature about the effect of forest walking, adding data on an Italian area qualified for forest bathing.

This study assessed health inequality trends and the degree of maternal healthcare services utilization in the DRC, using two consecutive Demographic and Health Surveys, 2007 and 2013-2014. First, we assessed the changes in the magnitude of inequality in the utilization of MHCS using logistics and regressions. Second, we analyzed the distribution of inequality in each MHCS utilization variable using the Gini coefficient and the Lorenz curve. Third, we used the Wagstaff two groups concentration indices comparison method to assess health inequality trends. Finally, we fitted the concentration curves to estimate the inequality in the utilization of MHCS to the economic condition of women. Women were less likely to have their first ANC visit within the first trimester, less likely to receive checkups during ANC visits, and less likely to attend more ANC visits when living in eastern DRC compared to western DRC. Women in rural areas were less likely to have their last birth by C-section, and less likely to receive PNC than women in urban areas. Women with middle, richer, and richest wealth indexes were more likely to complete more ANC visits, more likely to deliver by C-section, most likely to receive PNC, and more likely to receive ANC than those with lower wealth indexes. Over time, inequality in the utilization of MHCS decreased for ANC and PNC but increased for the delivery by C-sections. These findings suggest that innovative strategies are still needed to improve the utilization of MHC services among poorer, rural, and underserved women in post-conflict DRC.

The global centenarian population is expected to reach 3 million by 2050, yet little is known about the health status of centenarians in Sub-Saharan Africa. A case study examined the health conditions and functionality of nine Ethiopian centenarians. In-depth interviews revealed that all nine were Orthodox-Christians and lived with extended family; eight were male. Aside from minor health complaints, centenarians in rural Ethiopia perceived that their sensory/cognitive functionality was normal until their late 90s. Despite a lack of medical care, the centenarians included 2 survivors, 4 delayers, and 3 escapers. Centenarians in rural Ethiopia were embedded in closely-knit, religious, multigenerational households and communities and aspired to live resiliently. Findings call for consideration of the unique health status of centenarians in Global South nations in their own cultural context.

The study was geared toward isolating, characterizing and identifying bacterial pathogen in sachet water in addition to determines the bacterial count of the sachet water sold in Obi Local Government Area. Twelve sachet water samples from different companies were analyzed using standard microbiological methods. The microorganism found are Escherichia Coli, Staphylococcus aures, Salmonella spp, with Staphlococuss aureus showing the highest incidence (50%), observed by Escherichia coli (29.17%) and Salmonella spp with the lowest occurrence (20.8%). The presence of these microbes in drinking water possesses a threat to life. The findings consequently suggest that some of the sachet water sold in obi L.G. A are not healthy for human intake and are risky to health. Hence there's need for strict concern and routine monitoring by regulatory agencies to make sure that appropriate treatment is applied inside the manufacturing of exceptional and safe sachet drinking water. This study is aimed to analyze the bacteriological quality of some selected sachet water in Obi Local Government Area of Benue State, Nigeria.