Global emerge of zoonotic novel corona virus (COVID-19) became a pandemic and its effect to mankind is talk of the town now a days. This tiny, invisible enemy has affected every country in the world and almost every living directly or indirectly and nationwide complete lockdown has triggered a short-term environmental impact. Since 2003, corona virus came into existence in the form of Severe Acute Respiratory Syndrome (SARS) and more evolved Middle East Respiratory Syndrome (MERS) in 2012. This time, at the end of December 2019, outbreak of novel corona virus COVID-19 (also known as SARS-CoV₂, nCoV-2019) draw attention as global health emergency. World Health Organization (WHO) report says that the outbreak of this virus is so immense, it has already affected 35,57,235 people and caused death to 2,45,150 people worldwide and 46,433 Indians got affected with 1568 death as on 5^th May 2020 (2:00 am) and these numbers are increasing exponentially day by day. Virologist, micro-biologist and science community are hammering their head very hard to find out cure and vaccine against this powerful virus and to prevent mass demise of mankind. In order to curb the spread of COVID-19, Janta curfew on 22.03.2020 and nationwide complete lockdown was implemented in India for 21 days (phase-I, from 25.03.2020 to 14.04.2020) to stop community transmission of third stage, for 19 days (phase-II, 15.04.2020 to 03.05.2020) and 14 days (phase-III, 04.05.2020 to 17.05.2020) complete lockdown to minimize the community transmission effect. During complete lockdown and quarantine period a drastic change in Earth’s atmosphere, including reduction in emission of greenhouse gases, air pollution (~50% fall in air quality index), noise pollution, water pollution and solid waste pollution, have been recorded by government agencies as well as private agencies. In this paper we considered data of Janta curfew, phase-I and phase-II lockdown to link between geological and environmental aspect related to environmental impact due to emerge of COVID-19 and massive reduction in pollution level during complete lockdown in India. We propose future lockdown strategies to minimize the emission of greenhouse gas by ~100 Mt to ~200Mt (3.33% to 6.66%) of GHG_total per year by 2-4 days per month nationwide lockdown or ~70 Mt to ~140 Mt (2.33% to 4.66%) of GHG_total per year by 2-4 days per month complete lockdown of energy sectors only.

World Health Organization (WHO) has announced the monkeypox (MPX) epidemic a global public health emergency due to its re-emergence, remarkable increase in the number of MPX cases worldwide, and its potential spread. This paper introduces the symptoms, complications, and features of MPX; its transmission, diagnosis and testing, vaccines and treatment; MPX and sexually transmitted diseases, especially the human immunodeficiency virus (HIV); possible natural hosts or reservoirs of the monkeypox virus (MPXV). A useful tool for MPX and surgical safety recommendations are presented. The challenges in fighting the MPX epidemic, One Health strategy, and future research are discussed.

Australia’s mental health system is failing young people. Calls for accountability, strategic long-term policy planning, and regional leadership have been identified as solutions to guide mental health reform. Developing system dynamics models using a participatory approach (participatory systems modelling, PSM) is recognised as a useful method that can support decision-making for strategic reform. This paper reports evaluation findings of a youth mental health PSM process conducted in the Australian Capital Territory (ACT). Baseline and follow-up mixed-methods evaluation data were collected in 2022 across diverse stakeholder groups to investigate the feasibility, value, impact, and sustainability of PSM. Though youth mental health system reform was viewed as desirable and a necessity across all stakeholder groups, shared perceptions of disabling powerless was observed regarding their ability to influence current decision-making processes to improve the youth mental health system. This suggests greater accountability is required to support systemic reform in youth mental health. PSM offers promise in improving transparency and accountability of decision-making for youth mental health as exemplified in the ACT. However, more support and time are required to facilitate transformational change. Future research should investigate empowerment strategies to complement the implementation of findings from dynamic models developed through PSM, as well as the effectiveness of regional youth mental health policy decision-making supported by systems modelling.

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI’s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher–Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

The Sei Dareh Bridge is a cable-stayed bridge located in West Sumatra Province, Indonesia. The bridge, has a main span of 123 meters length and 9 meters wide, crosses the Batanghari River. Traffic load is transmitted through 4 prestressed cables to a 42.4 meter high pylon made of concrete. Bridge deck and traffic loads are directly supported by steel box girders as main beams that are reinforced laterally with cross beams IWF 800.300.16.24 and stringers IWF 350.350.12.19. This paper discusses static and dynamic testing on the bridge which aims to assess the feasibility before it is opened for public. Based on the test, it was concluded that the 73% static load could not be achieved because the deflection that occurred was beyond the allowable deflection. This is exacerbated by the sound of a loud clanging sound on the ST2-X1 prestressed cable when loading to 240 tons or 58% of the targeted load. In addition, this bridge is included in the "lazy bridge" category because it takes 24 hours to return to an undeformed condition after loading. As a recommendation for this bridge, it is necessary to carry out a structural health monitoring system (SHMS) regularly on the vehicle floor and cables.

While nursing is an ethical profession, unethical behavior among nurses is increasing worldwide. This study examined the effects of an ethics seminar on nurses' moral sensitivity and ethical behavior. A total of 37 nurses (17 experimental, 20 control) were recruited. The ethics seminar was held over a 6-month period from May to October, 2018, and comprised six sessions held once a month for two hours. Moral sensitivity and unethical behavior were measured at the start and end of the seminar. Moral sensitivity and unethical behavior showed a negative correlation (r= -.455, p<0.01). After the ethics seminar, the experimental group's moral sensitivity was significantly increased (t = -1.039, p = 0.314). The mean scores of unethical behavior at pre and post-test in the experimental group were 12.59 and 9.47, respectively. This was a statistically significant difference (t = 3.118, p = 0.004). There was no statistically significant difference in the mean score in both moral sensitivity and unethical behavior in the control group. We conclude that ethics seminars can enhance moral sensitivity and reduce the risk of unethical behavior among nurses. Regular ethics seminars and training must be provided to nurses as a matter of policy.

Abstract Background: Cluster randomized controlled trials are increasingly becoming popular in public health research interventions and health services research in primary health care design and use in low and middle-income countries. However, the majority of researchers in these trials did not account correctly for the effect of confounders and clustering in the design and analysis stages. Objectives: This article aimed to review the main implications of implementing a cluster randomized controlled trials design in public health research and emphasize the practical application of proper analytical methods and the performance of different statistical models. Methods: The practical application of various analytical methods is validated via the utilization of experimental data from a public health research case study. This article also demonstrated the performance of hierarchical models and made comparisons in terms of empirically precise effect size estimates. Results: Three hierarchical statistical models were provided with highly varied effect sizes during the analysis of the intervention effect on outcome, such as model 1 (AOR: 14.32; 95% CI: 3.75–54.68), model 2 (ARR: 3.52; 95% CI: 2.16–5.77), and model 3 (ARR: 4.79; 95% CI: 2.69–5.52).Conclusion: Inaccurate results and potentially misleading conclusions can arise from improper cluster randomized controlled trial designs and analyses. This article has shown that real-world data can be adjusted for the effects of confounders and clustering, and we advocate for the routine use of suitable design and analytical methods. This article concludes that researchers should be careful when selecting hierarchical models to analyze cluster randomized controlled trials.

This systematic review investigates the failure rate and marginal bone loss (MBL) of dental implants placed in Solid-organ transplant (SOT) patients compared to healthy controls. Three databases (PubMed, Web of Sciences and the Cochrane Library) were searched up to June 2020 (PROSPERO CRD42019124896). Case-control and cohort studies reporting data failure rate and marginal bone loss (MBL) of dental implants placed in SOT patients were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Four case-control studies fulfilled the inclusion criteria, all of low risk of bias. Meta-analyses revealed consistently lower implant failure rate than control populations at patient and implant levels. SOT patients had a significant difference of -18% (p-value <0.001) of MLB towards healthy patients. SOT status poses no serious threat to implant survival. Overall, this group of patients presented lower levels of dental implant failure rate and marginal bone loss compared to otherwise healthy patients. Further intervention trials with wider sample size and longer follow-ups are necessary to confirm these summary results.

Social connectedness connection is a core dimension of health and wellness among all populations, yet the experience of moving to, and living in, a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Illustrated in a model of socioecological connectednesssocial connection, Using hybrid (inductive/deductive) qualitative analysis, we identified seven themesdomains of social connection from the perspective of the interviewed participants: 1) Lens of the individual is a filter for the social world; 2) Immigrant experience colors everything; 3) Interpersonal support enhances quality of life; 4) Community belonging fosters a sense of connectedness; 5) Community capital boosts security; 6) Community navigation promotes integration; and 7) Social acceptance strengthens inclusion. In the healthcare field, we lack conceptual clarity of the distinct connectedness domains that drive positive health outcomes in immigrant populations. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of socioecological connectednesssocial connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. health. Additionally, our model of socioecological connectednessthese results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess connectedness social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.

The aim of this study is to determine the importance and effectiveness of different interventions aimed at improving social skills in people with autism spectrum disorder (ASD) through theatrical techniques. It aims to establish a direct relationship between the interventions and the benefits for socioemotional reciprocity, nonverbal communication behaviors used for social interactions and the development, establishment and understanding of interpersonal relationships. For this purpose, a systematic review of the literature published from 2011 to 2021 in the ERIC, Web of Science, EuropePMC, PubPsych, Índices-Csic, Redalyc, Roderic, Scopus, PubMed, Scielo and Dialnet databases was carried out, and a total of 29 articles were reviewed. The results indicate that theater creates a safe environment in which people with ASD can engage with their own emotions and those of others, thereby offering a therapeutic setting in which to promote communication, motor development and social coexistence. The implications and limitations of the study are discussed.

This study examined carbon footprint as an indicator of soil health at spatiotemporal scales with different land use types and varying soil depths in Morogoro, representing the eastern agroecological zone of Tanzania. Soils are highly weathered and acidic. The specific objectives were twofold: (1) To quantify soil organic carbon (SOC) at varying soil depths (0–15 cm, 15–30 cm) in contrasting land use types, including tractor cultivated, hand-hoe cultivated, ranch land, and reserved/bare land type; (2) To predict carbon management indices (CMI) of the studied land use types through regresses SOC, carbon pool index (CPI), and lability index (LI) at varying soil depths. Composite soil samples were based on transects of three main plots each (replicates) of 20 m by 50 m. Results showed that land use types and soil depths significantly (P <0.001) affected SOC (3.4%) and CMI (126.3). Hand hoe cultivated land at 0–15 cm recorded CMI of 259.8. Regression analysis showed an increase in CMI ranging from 97% to 99%, with standard error ranging from 2.177 to 46.096. Similar trends, but with disparity magnitudes in regressed parameters provide useful insight into transformations of organic carbon in contrasting land use types.

Improving access to sexual health services is critical in light of rising sexually transmitted infections (STIs). We evaluated a Hub and Spoke model for improving access to sexual health services in three general practices in Victoria, Australia. The primary outcome was the impact on HIV and STI (chlamydia, gonorrhoea, syphilis) testing. Segmented linear regression analysis was conducted to examine the trends in the total HIV/STI tests before (from January 2019 to June 2020) and post-implementation (from July 2020 to July 2021). We evaluated the feasibility and acceptability of integrating this model into the general practices using semi-structured individual interviews. There was a statistically significant rise in testing for HIV and STIs in all general practices: post-implementation, there was an increase of an average of 11.2 chlamydia tests per month (p=0.026), 10.5 gonorrhoea tests per month (p=0.001), 4.3 syphilis tests per month (p=0.010), and 5.6 HIV tests per month (p=0.010). Participants reported increases in knowledge level and confidence in offering STI testing and managing more variety of sexual health cases. This study demonstrated the feasibility of implementing a hub and spoke model to enable GPs to deliver sexual health care with support from a sexual health specialist service.

Despite the strong links between sleep, circadian rhythms, and mental health, sleep education has been neglected in mental healthcare provider training programs. The current pilot study examined the potential efficacy and acceptability of a sleep education workshop for trainee psychologists, called the Sleep Psychology Workshop. Eleven students completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the Sleep Psychology Workshop as part of their Health Psychology course, delivered as three, two-hour lectures (total six hours). Trainees’ sleep psychology knowledge quiz scores (% correct) demonstrated significant improvement from pre- (M = 60%, SD = .09) to post-workshop (M = 79%, SD = .08), t (6) = -5.18, p = .002. Trainees also reported increased self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep and circadian rhythm disturbances, along with increased confidence to manage insomnia disorder in clinical practice (all p<.02). Trainees also endorsed the workshop as an acceptable sleep education program for trainee psychologists via a post-workshop feedback survey, focus group, and six-month follow-up survey. This pilot study provides preliminary evidence for the Sleep Psychology Workshop as an effective and acceptable sleep education program for trainee psychologists.

A recent survey that determined heavy metal concentrations in an abandoned Hg mine in Palawan, Philippines, found the occurrence of Hg with As, Ba, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Sb, Tl, V, and Zn. While the Hg originated from the mine waste calcines as supported by previous studies, the critical knowledge about the origin of the other heavy metals remains to be unknown. Our study investigated the sources of heavy metal pollution surrounding the abandoned Hg mine; and assessed the soil and sediment quality, ecological risks, and health risks associated with these toxic metals. Multivariate analyses, such as hierarchical cluster analysis (HCA), principal component analysis (PCA), and Pearson correlation analysis, were used to identify the heavy metal sources from the results of a previous paper. Our results showed that Fe, Ni, Cr, Co, and Mn are associated with the ultramafic geology of the study, whereas As, Ba, Cd, Cu, Pb, Sb, Tl, V, and Zn are likely due to historical mining and processing of cinnabar from 1953-1976. The mine waste calcines were used as construction material for the wharf and as land filler for the adjacent communities. The modified contamination factor (mCdeg) showed that the coast of Honda Bay is highly contaminated, while the inland areas, including the rivers, are very- to ultra-highly contaminated. There is a considerable ecological risk associated with the heavy metals, wherein Ni, Hg, Cr, and Mn contribute an average of 46.3 %, 26.3 %, 11.2 %, and 9.3 % to the potential ecological risk index (RI), respectively. The overall mean hazard index (HI) for both adults (1.4) and children (12.1) exceeded 1, implying the probability of non-carcinogenic adverse effects. The mean total cancer risk over a lifetime (LCR) for both adults (1.19×10-3) and children (2.89×10-3) exceeded the tolerable threshold of 10-4, suggesting a potentially high risk for developing cancer mainly by Ni, Co, and Cr exposure.

Suicidal behaviour remains difficult to predict and prevent, even for experienced mental health care professionals. The known distal risk factors for suicidal behaviour are not sufficiently specific to fully understand the complex dynamic processes that precede a suicide attempt. Real-time mobile monitoring data can be used to analyse proximal risk mechanisms within the suicidal process. At the same time smartphone-based safety planning and self-monitoring may enhance a patient’s self-management skills thereby increasing their capacity to respond to a suicidal crisis and to become more aware of crisis symptoms. The current paper describes the theoretical and conceptual rationale for the CASPAR study which applies an innovative approach to the study of suicidal processes. It uses basic science approaches to inform the implementation of an innovative suicide prevention intervention. We aim to develop and implement mobile safety plan in conjunction with real-time monitoring in order to both directly implement suicide prevention interventions and to study the ongoing dynamics of individual suicidal behaviour by applying network analysis.

Children and young people (CYP) with neurodevelopmental disorders (NDDs) may be particularly vulnerable to adverse mental health effects due to the COVID-19 pandemic. We conducted a cross-sectional U.K parent-reported study from 2nd April-2nd June 2020, using the Strengths & Difficulties Questionnaire. CYP with NDDs (n=371) compared to neurotypical controls, had a higher prevalence of emotional symptoms (42% vs 15%), conduct problems (28% vs 9%), and lower prosocial behaviours (54% vs 22%). Those with attention-deficit/hyperactivity disorder showed inflated conduct, and those with autism spectrum disorder exhibited decreased prosocial behaviours. Females with ASD had higher emotional symptoms compared to males.

Ever since the tremendous success of the rapid vaccine development against COVID‑19, its availa-bility, distribution, and deployment have been a significant concern; however, evidence suggests that vaccine hesitancy has become a greater problem. Therefore, trust in vaccines is crucial and critically dependent on regimes' ability to communicate the benefits of immunization. This study investigated ideas on ways to reduce barriers to COVID-19 vaccination uptake. It explores methods to overcome COVID-19 vaccine barriers through qualitative research: interviews and group discussions involving healthcare providers, administration personnel, teachers, and individuals with chronic conditions across urban (Mombasa) and rural (Kilifi) Kenya. Audio-recorded discussions were transcribed and thematically analyzed across locations. Five themes emerged in our results regarding how to reduce barriers to the COVID vaccine in the context of Kenya, including awareness campaigns, engaging diverse stakeholders, using various communication techniques, capacity building to increase vac-cination centers and trained staff, and lastly, revising relevant government health policies and guidelines. These results indicate the importance of adopting multiple approaches, as no single strategy could boost vaccine acceptance. Moreover, this study provides recommendations for con-ceiving actionable interventions to potentially boost vaccine demand and maintain routine immun-ization in Kenya.

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalised care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of six workshops in different locations of the city to encourage the sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighbourhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their own health and understanding their values and preferences. Qualitative results show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered amongst the reasons to visit health professionals. Some of the conclusions reveal that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognised the benefits of this new approach but required more time and incentives to dedicate the effort needed.

This study aimed to investigate the ability of lactic acid bacteria to remove cholesterol in simulated gastric and intestinal fluids. The findings showed that the amount of cholesterol removed was dependent on the biomass, viability, and bacterial strain. Additionally, some cholesterol binding was stable and not released during gastrointestinal transit. The presence of cholesterol affected the fatty acid profile of bacterial cells, which could potentially influence their metabolism and functioning. However, adding cholesterol did not significantly impact the survival of lactic acid bacteria during gastrointestinal transit. Moreover, the study did not find significant effects of storage time, passage, or bacterial culture type on the cholesterol content of fermented dairy products. The researchers observed differences in cell survival among lactic acid bacteria strains in simulated gastric and intestinal fluids, depending on the environment. Furthermore, dry matter content, such as high milk protein, was more protective of bacterial cells during gastrointestinal transit than fat content. Future research should aim to better understand the impact of cholesterol on lactic acid bacteria metabolism and identify potential health benefits or risks.

The goal of this article is to provide a review of the experimental techniques and procedures using vibration methods for the Structural Health Monitoring (SHM) of Polymer-Matrix Composites (PMC). It aims to be a guide for any researchers to carry out vibration experiments. The linear methods are first introduced. But as PMC is a complex material, these classic methods showed some limits, such as low accuracy for small damages, and a high environmental dependency. This is why the nonlinear methods are secondly studied, considering that the complexity of PMC induces a nonlinear behavior of the structure after damage occurrence. The different damage mechanisms are well explained in order to evaluate the potential of each vibration method to detect them.

The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers' wellbeing using a holistic approach that goes beyond the simple prevention of occupational risks enables us to promptly identify problems in work organization and the company climate. Problems of this kind can be adequately managed by using a participatory approach. In this study participatory ergonomics groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the effort / reward imbalance model, and an improvement in psychological wellbeing assessed by means of the Goldberg anxiety / depression scale. Although the limited size of the sample calls for a cautious evaluation of this study, the GEP© strategy proved to be a useful tool due to its cost-effectiveness.

Among earth’s microbial populations are the genes, functional capacities, generational memory and sentient cognition that enable microorganisms to adapt and thrive in the full range of ecological conditions found on planet earth. In prior sequential publications, we considered fundamental properties (e.g., use of and responses to sound, light, vibrations) and features of microorganisms that cause them to be critical co-partners of human and other holobionts as well as the potential benefits for humanity that can be gained by fully applying quantum-related and novel capacities of microbial life. In this narrative review we: 1) discuss key concepts concerning a microbially-enhanced and sustainable future, and 2) focus on electric- and magnetic- based features of microorganisms that make them pivotal for myriad benefits ranging from beyond pharma-based health and wellness to free- and/or renewable energy and restorative agriculture to improved human networking. While the benefits are many, the risks posed by hazardous electric or magnetic field exposures to both holobionts and microbial communities are significant. This review concludes that microbes and their remarkable capacities offer both humanity and the planet a much brighter future if we reverse the demonization of microbes and wanton microbiome degradation that has predominated much of the past century.

: (1) Background: Healthcare workers (HCWs) are a well-known risk group for coronavirus infections with increased working hours in a potentially infectious environment. We evaluated both IgG and Neutralizing antibody levels, with IgG avidity index and persistence among health workers. (2) Methods: 1001 HCWs were tested for both IgG and Neutralizing antibodies. IgG avidity testing and one-year follow-up testing were done on selected HCWSs. (3) Results: COVID-19 IgG antibody levels were high among 299 (94.62%) HCWs with a history of COVID-19 infection (p &lt;0.0001) compared with 479 (69.92%) HCWs who were not infected with COVID-19 during the first and second wave. A total of 899 (89.81%) HCWs had more than 50% neutralizing antibodies while the remaining 102 (10.19%) HCWs had less than 50% of Neutralizing antibodies. The avidity index was maintained at almost 40% (Gray zone). Both antibody levels were found markedly increased after one year when compared to initial results. (4) Conclusions: Healthcare workers are at a 2.29-fold higher risk of infection; Two folds higher IgG levels in HCWs involved in COVID-19 duty and their persistence for a longer time than in other groups signifies IgG antibody role in the prevention of severe disease in HCWs involved in Covid-19 patient care.

Introduction: Oral health knowledge, beliefs and attitudes of parents have a direct influence on their child’s oral health maintenance, dietary habits and encourage healthy behaviors. The aim of this study was to assess the knowledge, and attitude of parents with regards to the oral health practice of their children and its associated factors. Methods: A self -administered structured questionnaire was administered to parents or guardians of learners aged 5 to 12 years at a low socio-economic rural primary school in the uGu district, KwaZulu Natal, South Africa to collect demographic variables, knowledge of dental health, use of toothbrush, use of toothpaste, dietary practices and dental visits; practice with respect to dental care and attitudes towards oral health. The questionnaire was translated from English to IsiZulu was used. Bivariate and multivariate logistic regressions were used to assess the association between parent’s sociodemographic factors with their oral health knowledge and practice scores. Results: One hundred and forty four completed survey instruments were received with an eighty percent (118) representation of mothers. Ninety five percent of the parents (136) had a positive attitude towards oral health with 86% (124) of the children brushed their tongue and 89% (128) of the children brushed their teeth happily. The mean knowledge score was 70% with a median of 72%. Children were significantly more likely to brush their tongues (AOR: 3.20 95% CI: 1.06-9.66) and were more likely to be happier when brushing their teeth (AOR: 4.65 95% CI: 1.41-15.38) when the caregivers were their mothers, and when parents had an above average knowledge score (AOR: 1.86 95% CI: 0.72-4.85) and had positive attitudes (AOR: 3.20 95%CI: 0.46-22.00). Conclusion: To reduce the gaps in knowledge, oral health promotion should be integrated into all point of care contact with parents at health facilities, increased community awareness and advertising campaigns as well as a more focused school health oral program that addresses primary prevention, screening and appropriate referrals to health facilities

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

Farmers’ conventional tillage (CT) and residue removal practices in rice-maize systems in South Asia’s Eastern Gangetic Plain (EGP) are input-intensive, costly and soil degradative. We conducted a rice-maize-mungbean (R-M-MB) system experiment with six tillage and three residue management treatments in Bangladesh representing the EGP. Maize yields were significantly (p≤0.05) higher under permanent (PB) or fresh (FB) beds and strip tillage (ST) than CT but no differences in mungbean yields. Rice yields under PB, FB and CT were similar, but significantly higher than under zero or minimum tillage and ST. Yields of all crops increased significantly (p≤0.05) with residue retention compared to no retention. Total system productivity was highest under PB followed by FB and ST. Compared with CT, gross margins in PB, FB and ST increased by 18, 13 and 11%, and soil organic matter (SOM) and total N contents across tillage treatments increased by 11-16% and 12-24%, respectively. After three years, SOM and total N and available P and S contents increased significantly (p≤0.05) by residue retention. Results demonstrate the potential of PB, FB and ST with residue retention, for improving the productivity, profitability and soil health under R-M-MB systems in Bangladesh and similar soils in the EGP.

BackgroundIt is unclear what underpins the large global variations in the prevalence of fluoroquinolone resistance in gram-negative bacteria. We tested the hypothesis that different intensities in the use of quinolones for food-animals plays a role. MethodsWe used Spearman’s correlation to assess if the country-level prevalence of fluoroquinolone resistance in human infections with Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa was correlated with the use of quinolones for food producing animals. Linear regression was used to assess the relative contributions of country-level quinolone consumption for food-animals and humans on fluoroquinolone resistance in these 4 species. ResultsThe prevalence of fluoroquinolone resistance in each species was positively associated with quinolone use for food-producing animals (E. coli [ρ=0.55; P<0.001], K. pneumoniae [ρ=0.58; P<0.001]; A. baumanii [ρ=0.54; P=0.004]; P. aeruginosa [ρ=0.48; P=0.008]). Linear regression revealed that both quinolone consumption in humans and food animals were independently associated with fluoroquinolone resistance in E. coli and A. baumanii. ConclusionsReducing quinolone use in food-producing animals may help retard the spread of fluoroquinolone resistance in various gram negative bacterial species.

Maternal obesity and over/undernutrition can have a long-lasting impact on offspring health during critical periods in the first 1000 days of life. Children born to mothers with obesity have reduced immune responses to stimuli which increase susceptibility to infections. Recently, maternal western-style diets (WSD), high in fat and simple sugars, have been associated with skewing neonatal immune cell development, and recent evidence suggests that dysregulation of innate immunity in early life has long-term consequences on metabolic diseases and behavioral disorders in later life. Several factors contribute to abnormal innate immune tolerance or trained immunity, including changes in gut microbiota, metabolites, and epigenetic modifications. Critical knowledge gaps remain regarding the mechanisms whereby these factors impact fetal and postnatal immune cell development, especially in precursor stem cells in bone marrow and fetal liver. Components of the maternal microbiota that are transferred from mothers consuming a WSD to their offspring are understudied and identifying cause and effect on neonatal innate and adaptive immune development needs to be refined. Tools including single-cell RNA-sequencing, epigenetic analysis, and spatial location of specific immune cells in liver and bone marrow are critical for understanding immune system programming. Considering the vital role of immune function plays in offspring health, it will be important to understand how maternal diets can control developmental programming of innate and adaptive immunity.

Life is supported by metabolism, a vital physiological activity. It guarantees enough energy available to power every cellular activity. The primary cellular substrate, glucose, is where the majority of the energy needed by the cell to support all other life activities and the growth of living creatures is derived. The quality of life is greatly impacted by any disease or flaw that alters the metabolism of glucose. There is no known cure for the metabolic illness known as diabetes. As diabetes is so varied, the only effective treatments would be based on precision medicine and a molecular strategy. This review covers a wide range of topics, including the ability to recognize the various forms of diabetes, the anthropogenic and genetic influence of the cause of diabetes, the severity of the various forms of diabetes, its potential existential risk, the disease burden, and clinical methods for diagnosing them. The most recent research goes on to recommend ways to ameliorate the disease, including diet-based management, biotherapies, and other individual lifestyle choices. Futuristic therapy using molecular biology approach was suggested. Recent research found a direct correlation between an individual's lifestyle and the rate of gene mutation in diabetes. There is an existential risk associated with the sickness as the rate of the spread of the disease among population globally is faster than the world's population growth rate. It is possible to think of diabetes as a silent pandemic.

Objectives: Low and Middle Income Countries (LMICs) are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity (MMD). However, preventing MMD has received little attention in LMICs, especially in Sub-Saharan African Countries. Design: Narrative review which scoped the most recent evidence in LMICs about MMD determinants and appropriated them for potential MMD prevention strategies. Methods: MMD in LMICs is affected by several determinants including increased age, female gender, environment, lower socio-economic status, obesity, and lifestyle behavious, especially poor nutrition and physical inactivity. Results: MMD public health interventions in LMICs, especially Sub-Saharan are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent MMD clusters, especially hypertension, diabetes and cardiovascular disease, can provide an early prevention of MMD, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing MMD in LMICs.

The rapid spread of COVID-19 worldwide was accompanied by intense fears, confusion, worries, anger and stress threatening people’s mental health. Unprecedented measures to slow down and prevent the transmission of COVID-19 have had various impacts on the population’s health behaviour and mental health. The main purpose of the present study is to investigate the lockdown’s effects on university students’ mental health in Romania. Based on a cross-sectional design, the survey data were collected from a sample of 722 participants (247 males; M = 21.1 years; SD ± 1.73). A path analysis was performed to verify the hypothesised direct and indirect effects included in the multiple mediation model. The findings showed a positive association between stress and boredom proneness, missing daily social interactions, spending more time on phone conversations and the increasing interest in following news about the pandemic. The path analysis revealed an excellent fit between the proposed multiple mediation model and the sample data. Boredom proneness and missing daily social interactions both affected stress, directly and indirectly, through more time spent on phone conversations. In addition, it was found that the increased interest in following news about the pan-demic mediated the relationship between boredom proneness and perceived stress. In terms of gender differences, our findings revealed that female students experienced significantly higher stress levels than male students, perceived to a greater extent the lack of daily social interactions and spent more time on phone conversations. Overall, the findings further extend the empirical evidence on university students’ mental health in the context of the COVID-19 pandemic. Therefore, universities need to organise support programmes focused on developing university students’ coping strategies to maintain their mental health even in adverse contexts.

Transporter associated with antigen processing 1 (TAP1) gene codes for a transporter protein, which is responsible for tumor antigen presentation in the MHC I or HLA complex. A defect in the gene results in an inadequate tumor tracking. TAP1 may also influence multi drug resistance, which is an extreme threat in providing treatment by drugs which are chemotherapeutic. The gene of TAP1 was analyzed bioinformatically. It gave us prognostic data as a confirmation of whether it should be used as a biomarker. The expression level and pattern analysis were conducted using ONCOMINE, GENT2 and GEPIA2 online platforms. Samples with different clinical outcomes were investigated for expression and promoter methylation analysis was done in cancer vs normal tissues using UALCAN. The copy number alteration and mutation frequency and expression in different cancer studies were analyzed using cBioPortal. The PrognoScan and KM plotter survival analysis of significant data (p-value<0.05) was representing graphically. Pathway and Gene ontology analysis of gene correlated to TAP1 gene was presented using bar charts. After arranging the data in a single panel and correlating expression to prognosis, understanding mutational and alterations and comparing pathways, TAP1 may be a potential novel target to evade a threat against chemotherapy and the study gives new aspects to consider for immunotherapy in human breast, lung, liver and ovarian cancer.

We do this research to investigate the relationship between renewable energy, public health expenditure, logistics performance indices, and economic and environmental sustainability in the ASEAN member states, through the analysis of a panel data from 2007 to 2017. The study used secondary data, which is downloaded from the World Bank Website and employs SEM (Structural Equation Modelling) model for testing hypothesis. The results show that the usage of renewable energy in logistical operations would enhance the environmental and economic performance in terms of mitigating carbon emissions and greenhouse gas emissions. While, public health expenditure and environmental performance is negatively correlated, which confirms that greater environmental sustainability with lower carbon emissions and greenhouse gases will improve human health and economic growth. Moreover, greater public health expenditure and poor environmental performance has negative effect on economic growth, inefficiency and low productivity of labor slowdown to the economic activities. For another side, the usage of renewable energy and the adoption of green practices in international logistics will develop the environmental sustainability, establish better image of a country and attract foreign direct investment inflows, and also minimize carbon emissions and public health expenditure, spurring sustainable economic growth with better export opportunities in pro-environmental countries.

Wearable antennas are increasingly vital in modern healthcare, facilitating continuous monitoring and communication for medical purposes. These antennas are integrated into wearable devices, allowing for the transmission and reception of vital health data, such as heart rate, body temperature, and blood pressure, to medical professionals or monitoring systems in real time. This instantaneous data transmission enables timely interventions, thus improving the quality of healthcare services. This review aims to comprehensively synthesize recent research from reputable databases, focusing on the functionality and effectiveness of wearable antennas in medical applications. The primary objectives of each study were categorized, including antenna design and integration, the performance of medical wearable antenna technology, safety considerations in wearable antenna biomedicine, and the use of antennas in clinical applications and their impact. This synthesis provides valuable insights for researchers and practitioners aiming to develop and deploy wearable antennas in medical settings, ultimately enhancing healthcare delivery and patient outcomes.

: This study investigates the workplace experiences of mothers of children with intellectual disabilities. These mothers may face challenges in balancing motherhood, disability, and employment. Therefore, it is important to understand the challenges they are facing and the mechanisms they use to cope with caregiving and work responsibilities in managing the stress that develops throughout this ongoing experience. The purpose of this research was to investigate the workplace experiences of single mothers of children with intellectual disabilities. A review of the literature was conducted. For this research, a qualitative methodology was adopted to gain an in-depth understanding of the mothers’ experiences. A narrative method was used for data collection. Thematic analysis was utilized to obtain a clear understanding. The findings suggest that mothers of children with intellectual disabilities face difficulties in balancing between caregiving for their child with a disability and their job responsibilities, in addition to showing that there is a lack of flexibility in the workplace, less awareness from colleagues and bosses of the challenges these mothers face, and a lack of organizational legislation that supports these mothers. According to our findings, workplaces should provide assistance to mothers of children with intellectual disabilities in order to ensure that they are not disadvantaged in their employment.

In recent years, the management of health systems is a main concern of governments and decision makers. Home health care is one of the newest methods of providing services to patients in developed societies that can respond to the individual lifestyle of modern age and the increase of life expectancy. The home health care routing and scheduling problem is a generalized version of the vehicle routing problem, which is extended to a complex problem by adding special features and constraints of health care problems. In this problem, there are multiple stakeholders such as nurses for which an increase of their satisfaction level is very important. In this study, a mathematical model is developed to expand traditional home health care routing and scheduling models to downgrading cost aspects by adding the objective of minimizing the difference between the actual and potential skills of the nurses. Downgrading can lead to a dissatisfaction of the nurses. In addition, skillful nurses have higher salaries and high-level services increase equipment costs and need more expensive trainings and nursing certificates. Therefore, downgrading can enforce hidden huge costs to the managers of a company. To solve the bi-objective model, an -constraint based approach is suggested and the model applicability and its ability to solve the problem in various sizes are discussed. A sensitivity analysis on the Epsilon parameter is conducted to analyze the effect of this parameter on the problem. Finally, some managerial insights are presented to help the managers in this field, and some directions for future studies are mentioned as well.

COVID-19 pandemic-related pressures on primary care may have driven inappropriate continuation of antibiotic prescriptions. Yet prescribing modality (repeat/non-repeat) has not previously been investigated in a pandemic context. Using the OpenSAFELY-TPP analytics platform, we analysed repeat/non-repeat prescribing frequency in monthly patient cohorts between Jan 2020–2022. In-depth analysis was conducted on Jan 2020 (“pre-pandemic”) and Jan 2021 (“pandemic”) cohorts. Per-patient prescribing and clinical conditions were determined by searching primary care record data using clinical code lists. Repeat prescribing was defined as >=3 prescriptions in a 6 month lookback period. Associations between demographics (e.g. age, sex, geography) and repeat/non-repeat prescribing were explored using unadjusted risk ratios. Antibiotic prescribing declined from May 2020; non-repeat prescribing declined more strongly than repeat prescribing (maximum declines -26% vs -11%, respectively). In the pandemic cohort, older patients were at higher risk of prescribing (especially repeat prescribing). The most common clinical conditions for repeat prescribing were COPD comorbidity and urinary tract infection. Comorbidities were more common among repeat vs non-repeat prescribed patients. In the pandemic cohort, vs pre-pandemic, repeat and non-repeat prescribing for comorbidities generally declined less compared with shorter-term conditions (infections, including COPD exacerbation/lower respiratory tract infection). Our findings inform ongoing development of stewardship interventions in England..

Relatives play an important role in mental health service users’ care. Interventions directed either at service users or their relatives may influence the other person as well. The project Activa’t per la salut mental (Get active for mental health) consisted of a series of four interventions addressed at people diagnosed with mental disorders and their relatives to help them in their recovery process, increasing their agency and quality of life. The objective of the present study is to evaluate the interaction of the participation of service users on their relatives’ outcomes and vice versa. The impact of the project was evaluated within an RCT. The treatment group had access to all the circuit interventions while the control group received treatment as usual and could only access one of the interventions. All participants were evaluated at baseline, six months, and twelve months after the end of the first intervention. Service users were evaluated with the Stages of recovery questionnaire, and relatives with the Family Burden Interview Schedule II and the Duke-UNC-11 questionnaires. The interaction between service users and their relatives was analysed by means of correlational analyses within the intervention group. Service users baseline characteristics influenced in the level of participation of relatives and vice versa. The results also indicated an interaction between service users’ recovery score changes on the change of care burden of relatives. Service users’ participation levels interacted with the decrease of relatives’ burden. These results can be extremely helpful in fostering interactive benefits in future projects addressing the wellbeing of mental health service users and their relatives. Future studies could use specific designs to explore the directionality of the causality of these effects.

(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance data of about 2 million individuals from Saxony, Germany, was conducted for the years 2010 to 2020. Only patients with an advanced stage, i.e. distant metastases were considered for the main analysis. Relative survival since metastasis and predicted survivor curves derived from a Cox model were used to assess potential differences in mortality. (4) Results: Relative survival was highest in the subgroup with sequential use of ICI and TT. All treatments except interferon had significant hazard ratios (HR) in the Cox model with time-dependent effects indicating a protective effect after treatment initiation (HR 0.01-0.146) but decreasing over time (HR 1.351-2.310). The predicted survivor curves revealed best survival under ICI-TT treatment and worst survival under TT treatment alone. (5) Conclusions: We found real-world evidence for survival benefits of patients with metastatic melanoma who received sequential ICI and TT treatment. It is conceivable that the observed high survival differences were overestimated due to bias, such as confounding by indication.

Visual impairment and blindness are a growing public health problem, as they reduce the quality of life of millions of people. The management and treatment of these diseases represent a scientific and therapeutic challenge, since the different cellular and molecular actors involved in the pathophysiology are still being identified. The visual system components, particularly the retinal cells, are extremely sensitive to genetic or metabolic alterations, and immune cells activated by insults contribute to biological events that culminate with vision loss and irreversible blindness. Several ocular diseases are linked to retinal cell loss, and diseases such as retinitis pigmentosa, age-related macular degeneration, glaucoma and diabetic retinopathy are characterized by pathophysiological hallmarks that represent possibilities to study and develop novel treatments for retinal cells degeneration. Here, we present a compilation of revisited information on retinal degeneration, including pathophysiologic and molecular features, biochemical hallmarks and possible directions for novel treatments, aiming to assist as a guide for innovative research. The expansion of knowledge of the mechanistic bases of the pathobiology of eye diseases, including information on the complex interactions of genetic predisposition, chronic inflammation, and environmental and aging-related factors will allow the identification of new therapeutic strategies.

In the author's opinion, many global problems that face humanity - in the fields of education, medicine, management etc can be tackled more effectively if the cyclic nature of self-reproducing systems – including living beings – is taken into account. Summarizing the main physiological findings of the last decades on "adaptation reactions", one can very roughly say that the way of action which is effective in the sense of productive activity of people happens at the same time to be healthy, and it gives the participants of the process the feeling of happiness. The present paper represents a very short overview of the contemporary concepts of the adaptation reactions based on the fundamental understanding of their cyclic nature due to general properties of self-reproducing systems. One interesting feature of self-reproduction cycles is its first "phase of orientation" which was not discussed in detail in the past but plays a key role in the whole cycle.

Appropriate diagnosis, treatment and care contributes to better service engagement, improvements to wellbeing, cost savings, reductions in morbidity and mortality for people with Alcohol Related Brain Damage. In the North-East of England large amounts of alcohol are consumed, reflected in the number of alcohol-related deaths in the region. However, the pathway for people with Alcohol Related Brain Damage to receipt of diagnosis, treatment and care is unknown and could be unwittingly influenced by stigma. Qualitative in-depth semi-structured interviews were completed with 25 health and social care professionals from organisations involved with people with Alcohol Related Brain Damage recruited via snowball-sampling. Interviews were recorded, transcribed verbatim, coded, and analysed. People with Alcohol Related Brain Damage were stigmatised both by society and professionals which inhibited entry into services therefore Alcohol Related Brain Damage remained underdiagnosed and misdiagnosed. There was no dedicated service but silos with revolving doors and underfunded generic care with long waiting lists typically excluding those with alcohol or neurological problems. Professionals need to be challenged on the assumption that Alcohol Related Brain Damage is self-inflicted via training aimed at challenging unconscious bias. Reducing stigmatising processes associated with Alcohol Related Brain Damage could counteract professionals’ reluctance to provide care.

Overweight and obesity adversely affect health-related quality of life (HRQOL) through day-to-day impairments of both mental and physical functioning. It is assumed that polyphenols within the Mediterranean diet may contribute to improve HRQOL. This investigation aimed at studying the effects of a polyphenol-rich ingredient on HRQOL in overweight and obese but otherwise healthy individuals. A randomized, double-blind, placebo-controlled study including 72 volunteers was conducted. Subjects were randomly assigned to receive for a 16-week period either 900 mg/day of the supplement or a placebo. Dietary recommendations were individually determined, and intakes were recorded; daily physical mobility was monitored. Improvement of HRQOL was set as the primary outcome and assessed at baseline and at the end of the investigation, using the Short-Form 36 (SF-36) Health survey. Body composition was analyzed using dual-energy X-ray absorptiometry (DXA). Physical activity level was calculated using International Physical Activity Questionnaire (IPAQ). After 16 weeks, despite there was no adherence to the Mediterranean Diet Serving Score (MDSS), supplemented individuals experienced significant HRQOL improvement (+5.3%; P=0.001), including enhanced perceived physical (+11.2%; P=0.002) and mental health (+4.1%; P=0.021) components; bodily pain, vitality, and general health, being the greatest contributors. Besides, body fat mass significantly decreased (-1.2 kg; P=0.033), mainly within trunk area (-1.0 kg; P=0.002). Engagement in physical activity significantly increased (+1308 Met-min/week; P=0.050). Hence, chronic supplementation with a nutritional diversity and dose of a Mediterranean diet-inspired polyphenol-rich ingredient resulted in a significant amelioration in both perceived physical and mental health, concomitant with the improvement of body composition, in healthy subjects with excessive adiposity.

The water quality index (WQI) and irrigational index for groundwater were studied in the northeastern section of the Manipur Valley in northeast India. Water samples were collected in 2022 during the pre-monsoon season. To compute the water quality index for drinking water, the basic chemical parameters of total hardness, pH, electrical conductivity, total dissolved solids, Ca2+, Na+, Fe, Mg2+, Mn, Cl-, and HCO3, were used. The assessment of bacteriological quality is also done, which is crucial for overall water quality evaluation, alongside physical and chemical analyze. For determining irrigation suitability, irrigational indices such as sodium absorption ratio, sodium percentage, and magnesium hazard were calculated. WQI, %Na+, SAR, magnesium hazard, permeability Index and total hardness indicate that most water samples are harmless for irrigation and drinking purpose. They have affirmative relationships indicating that these characteristics are interdependent. Approximately 25% of the Piedmont zone groundwater is found to be unfit for agricultural and drinking usage. The encrustation of gypsum, halite, and evaporation into the Disang shares accelerate the dissolution of ions in Piedmont water, resulting in quality degradation. According to Gibbs plots, Durov Scatter Plot, and Hill Piper Trilinear Diagram of water dominated the rock-weathering process, while hydro chemical facies progressed from the beginning to the intermediate stage of Chadha's graphical representation illustrates the progression of hydro chemical processes in surface water. Therefore, proper integrated water resource management and development are required for effective water resource utilization, particularly around the Piedmont zone. To prevent a water crisis, groundwater resources must be managed sustainably. The current study also concentrated on a bibliometric examination of groundwater management and access to gauge the state of the field.

This paper proposes a method for monitoring the structural health of concrete bridges in Iran. In this method, the bridge condition index (BCI) of bridges is determined by the analytical hierarchy process. BCI constitutes eight indices that are scored based on the experts' views, including structural, hydrology and climate, safety, load impact, geotechnical and seismicity, strategic importance, facilities, and traffic and pavement. Experts' views were analyzed by Expert Choice software, and the relative importance (weight) of indices were determined using the analytical hierarchy process (AHP). Then, the gave scores of experts were assigned to indices for various conditions. Bridge inspectors can examine the bridge, determine the scores of indices, and compute BCI. Higher values of BCI ​​indicate better conditions. Therefore, bridges with lower BCI take priority in maintenance activities. Five bridges in Iran, Semnan province, were selected as the case studies, and BCI calculation of these bridges was conducted.

Amid to the COVID-19 pandemic, digital health literacy (DHL) has become a significant public health concern. This research aims to assess information seeking behavior, as well as the ability to find relevant information and deal with DHL among university students in Pakistan. An online-based cross-sectional survey, using a web-based interviewing technique, was conducted to collect data on DHL. Simple bivariate and multivariate linear regression was performed to assess the association of key characteristics with DHL. The results show a high DHL related to COVID-19 in 54.3% of students. Most of the Pakistani students demonstrated ~50% DHL in all dimensions, except of reliability. Multivariate findings showed that gender, sense of coherence and importance of information were found to be significantly associated with DHL. However, a negative association was observed with students’ satisfaction with information. This led to the conclusion that critical operational and navigations skills are essential to achieve COVID-19 DHL and cope with stress, particularly to promote both personal and community health. Focused interventions and strategies should be designed to enhance DHL amongst university students to combat the pandemic.

Salmonella spp. contaminates egg and poultry meat leading to foodborne infections in humans. The emergence of antimicrobial-resistant strains limit the use of antimicrobials. We aimed to determine the effects of the food supplement, fermented defatted ‘alperujo’, a modified olive-oil by-product, on Salmonella Typhimurium colonisation in broilers. One hundred and twenty 1-day-old broilers were divided into four experimental groups: 2 control groups and 2 treated groups, and challenged with S. Typhimurium at day 7 or 21. On days 7, 14, 21, 28, 35 and 42 of life, duodenum and caecum tissue samples were collected for histopathological and histomorphometric studies. Additionally, cecum content was collected for Salmonella spp. detection by culture and qPCR, and for metagenomic analysis. Our results showed a significant reduction of Salmonella spp. in the cecum of 42-day-old broilers, suggesting that fermented defatted ‘alperujo’ stimulates Salmonella Typhimurium clearance in that cecum and may contribute to diminishing the risk of carcass contamination at the time of slaughter. Additionally, the improvement of the mucosal integrity suggests that enhancing intestinal health helps to limit Salmonella spp. colonisation in the host, mitigating production losses. These results could provide evidence that FDA would contribute to prophylactic and therapeutic measures to reduce salmonellosis prevalence in poultry farms.

BACKGROUND Epidemiological sciences have been evolving at an exponential rate paralleled only by the comparable growth within the discipline of data science. Digital epidemiological studies are playing a vital role in medical science analytics for the past few decades. To date, there are no published attempts at deploying the use of real-time analytics in connection with the disciplines of Dentistry or Medicine. AIMS AND OBJECTIVES We deployed a real-time statistical analysis in connection with topics in Dental Anatomy and Dental Pathology represented by the maxillary sinus, posterior maxillary teeth, related oral pathology. The purpose is to infer the digital epidemiology based on a continuous stream of raw data retrieved from Google Trends database. MATERIALS AND METHODS Statistical analysis was carried out via Microsoft Excel 2016 and SPSS version 24. Google Trends database was used to retrieve data for digital epidemiology. Real-time analytics and the statistical inference were based on encoding a programming script using Python high-level programming language. A systematic review of the literature was carried out via PubMed-NCBI, the Cochrane Library, and Elsevier databases. RESULTS The comprehensive review of databases of the literature, based on specific keywords search, yielded 491813 published studies. These were distributed as 488884 (PubMed-NCBI), 1611 (the Cochrane Library), and 1318 (Elsevier). However, there was no single study attempting real-time analytics. Nevertheless, we succeeded in achieving an automated real-time stream of data accompanied by a statistical inference based on data extrapolated from Google Trends. CONCLUSION Real-time analytics are of considerable impact when implemented in biological and life sciences as they will tremendously reduce the required resources for research. Predictive analytics, based on artificial neural networks and machine learning algorithms, can be the next step to be deployed in continuation of the real-time systems to prognosticate changes in the temporal trends and the digital epidemiology of phenomena of interest.

Data dealing with the assessment of heavy metal pollution in road dusts in Jeddah, Saudi Arabia and its implication to human health risk of human exposure to heavy metals, are scarce. Road dusts were collected from five different functional areas (traffic areas TA, parking areas PA, residential areas RA, mixed residential commercial areas MCRA and suburban areas SA) in Jeddah and one in rural area (RUA) in Hada Al Sham. We aimed to measure the pollution levels of heavy metals and estimate their health risk of human exposure applying risk assessment models described by USEPA. Using geo-accumulation index (I_geo), the pollution level of heavy metals in urban road dusts was in the following order Cd > As > Pb > Zn > Cu > Ni > Cr > V > Mn > Co > Fe. Urban road dust was found to be moderately to heavily contaminated with As, Pb and Zn, and heavily to extremely contaminated with Cd. Calculation of enrichment factor (EF) revealed that heavy metals in TA had the highest values compared to that of the other functional areas. Cd, As, Pb, Zn and Cu were severely enriched, while Mn, V, Co, Ni and Cr were moderately enriched. Fe was consider as a natural element and consequently excluded. The concentrations of heavy metals in road dusts of functional areas were in the following order: TA > PA > MCRA > SA > RA > RUA. The study revealed that both children and adults in all studied areas having health quotient (HQ) < 1 are at negligible non-carcinogenic risk. The only exception was for children exposed to As in TA. They had an ingestion health quotient (HQ_ing) 1.18 and a health index (HI) 1.19. The most prominent exposure route was ingestion. The cancer risk for children and adults from exposure to Pb, Cd, Co, Ni, and Cr was found to be negligible (< 1 x 10^-6).

Globally, anthropogenic sound and artificial light pollution have increased to alarming levels. Evidence suggests that these can disrupt critical processes that impact ecosystems and human health. However, limited focus has been given to the potential effects of sound and artificial light pollution on microbiomes. Microbial communities are the foundations of our ecosystems. They are essential for human health and provide myriad ecosystem services. Therefore, disruption to microbiomes by anthropogenic sound and artificial light could have important ecological and human health implications. In this mini-review, we provide a critical appraisal of available scientific literature on the effects of anthropogenic sound and light exposure on microorganisms and discuss the potential ecological and human health implications. Our mini-review shows that a limited number of studies have been carried out to investigate the effects of anthropogenic sound and light pollution on microbiomes. However, based on these studies, it is evident that anthropogenic sound and light pollution have the potential to significantly influence ecosystems and human health via microbial interactions. Many of the studies suffered from modest sample sizes, suboptimal experiments designs, and some of the bioinformatics approaches used are now outdated. These factors should be improved in future studies. This is an emerging and severely underexplored area of research that could have important implications for global ecosystems and public health. Finally, we also propose the photo-sonic restoration hypothesis: does restoring natural levels of light and sound help to restore microbiomes and ecosystem stability?

Punica granatum L., commonly known as pomegranate, is a typical fruit of Asia, Mediterranean countries, Middle East and USA areas. While in the ancient time pomegranate was considered an ornamental plant, nowadays numerous scientific studies have highlighted its antioxidant and anti-radical activities, up to consider pomegranate as a “superfood”. Pomegranate presents a high content of natural bioactive compounds (NBCs) and its consumption appears to exert numerous healthy beneficial effects, in particular, in several pathological conditions, namely in patients affected by metabolic syndrome, cancer, nephrolithiasis, urinary tract infections and neurodegenerative diseases. Moreover, recent studies pointed out the possible beneficial action of pomegranate on oral health. For these reasons, the utility of pomegranate in internal medicine and in dentistry represents a promising field, as it could permit the development of innovative natural adjuvant therapies, able to empower the standard pharmaceutical therapies.

The use of active video games or exergames has been booming recently, as they are motivating and promote exercise and healthy lifestyle habits for their users, and these immersive virtual reality (IVR) exercise programs could be compared to traditional physical exercise programs. A starting point for this would be to explore the physiological responses that can be generated by its use. Therefore, the main objective of this study was to evaluate the response across certain physiological parameters (heart rate, blood pressure and stress) after an IVR exergame exposure in a sample of healthy adults, and secondarily to explore its feasibility and usefulness as a tool to facilitate physical exercise. 37 healthy adults (22-54 years, 54.1% women) participated in the study. They carried out one exergaming session with the HTC Vive ProTM hardware. The primary outcome was evaluated using the concentration of cortisol, heart rate and blood pressure. Secondary outcomes were evaluated with safety using the Simulator Sickness Questionnaire (SSQ); usability evaluated with the System Usability Scale (SUS); personal experiences evaluated with Game Experience Questionnaire (GEQ) and perceived exertion through the Borg perceived effort scale. All participants completed the IVR session without significant adverse effects, and all physiological parameters analysed increased significantly in relation to pre-intervention levels. Perceived exertion corresponded to a moderate to intense exercise (6.30±0.50/10 on the modified Borg scale). All the sample considered the experience as good or very good and would recommend it. These findings support that our IVR session can be compared to a moderate to intense physical activity, as it involved similar perceived exertion with significant increases in heart rate, blood pressure and salivary cortisol levels.

The global burden of antimicrobial resistance is on the rise, resulting in higher morbidity and mortality in our communities. The spread of antimicrobial resistance in the environment and development of resistant microbes is a challenge to the control of antimicrobial resistance. Approaches, such as antimicrobial stewardship programmes, and enhanced surveillance, have been devised to curb its spread. However, particularly in lower- and middle-income countries, the overall extent of antimicrobial resistance, and knowledge on on-going surveillance, stewardship or investigation efforts, re often poorly understood. This study aimed to look at the efforts that have been undertaken to combat antimicrobial resistance in Uganda as a means of establishing an overview of the situation, to help inform future decisions. We conducted a systematic literature review of the PubMed database to assess the efforts that have been done in Uganda to investigate and combat antimicrobial resistance. A search combining keywords associated with antimicrobial resistance were used to look up relevant studies between 1995 and 2020 on surveillance of antimicrobial resistance in Uganda, and susceptibility of microbes to different drugs. The search yielded 430 records, 163 of which met the inclusion criteria for analysis. The studies were categorized according to country and region, the type of antimicrobial resistance, context of the study, study design and outcome of the study. Antibacterial resistance and antimalarial resistance had the most published studies while antiviral and antifungal resistance each were represented by very few studies. Most studies were conducted in humans and hospital settings, with very few in veterinary and One Health contexts. The results from our work can inform public health policy on antimicrobial stewardship as it contributes to understanding the status of antimicrobial resistance surveillance in Uganda, and can also help to guide future research efforts. Notably, a One Health approach needs to be followed with re-spect to surveillance of antimicrobial resistance to better understand the mechanisms of resistance transfer across the human-animal–environment interface, including additional investigation in antiviral and antifungal resistance.

Populations with healthcare needs often reside in post-conflict settings where basic services needed to maintain good health may be non-existent or hard to access. Therefore, there is a need for better identification and reallocation of resources as part of the post-conflict health rehabilitation effort. This study applies an asset-based approach to explore the more optimal design of health services and to identify the resource constraints for basic health service delivery to the most vulnerable communities in eastern Congo. We implemented the asset mapping in two phases. Firstly, we combined a qualitative survey with community walks to identify the assets already present in the communities. Secondly, we conducted group discussions to map out assets that are the core of Asset-Based Community Development (ABCD) practice. We finally documented all assets in a Community Asset Spreadsheet. Overall, 209 assets were identified as available and potentially valuable resources for the communities in eastern Congo. Among them, 60 were local associations, 24 were land and physical environment, 43 were local institutions, 46 were individuals, 32 to economy and exchange, and only 6 were related to culture, history, and stories. Drawing upon the findings from the qualitative survey, community walks, and group discussions, we conclude that an important number of resources were in place for basic health service delivery. By activating the existing and potential resources, the most vulnerable populations in eastern Congo might have the required resources for basic health service delivery. Our findings support the use of an asset-mapping research method as appropriate to identify existing and potential resources for basic health services in a post-conflict setting.

Animal products, in particular dairy and fermented products, are natural, major sources of lactic acid bacteria (LAB). Due to their antimicrobial properties, LAB are used in humans and in animals, with beneficial effects, as probiotics or in the treatment of a variety of diseases. In livestock production, LAB contribute to animal performance, health, and productivity. In the food industry, LAB are applied as bioprotective and biopreservation agents, contributing to improve food safety and quality. However, some studies have described resistance to relevant antibiotics in LAB, with the concomitant risks associated to the transfer of antibiotic resistance genes to foodborne pathogens, their potential dissemination throughout the food chain, and the environment. Here, we summarize the application of LAB in livestock and animal products, as well as the health impact of LAB in animal food products. In general, the beneficial effects of LAB on the human food chain seem to outweigh the potential risks associated with their consumption as part of animal and human diets. However, further studies and continuous monitorization efforts are needed to ensure their safe application in animal products and in the control of pathogenic microorganisms, preventing the possible risks associated with antibiotic resistance and, thus, protecting public health.

Introduction: In an era of increasing public awareness regarding the pivotal role of nutrition in the onset and progression of chronic degenerative diseases, there is a growing demand for information and assistance pertaining to the intricate relationship between diet and disease. Nutritional practices, therefore, emerge as a fundamental element in the prevention and management of these maladies, necessitating a proactive response from healthcare professionals (HCP). This study sought to evaluate the impact of participation in a Culinary Medicine (CM) program on Mediterranean diet adherence, food management skills, culinary proficiency, and counseling confidence among HCP. Methods: A mixed-methods pilot implementation program (PIP) was meticulously designed and executed, engaging a cohort of 20 HCP recruited from Hospital Clinic Barcelona. The program unfolded at the Alícia Foundation kitchen-lab and encompassed a series of interactive, hands-on sessions that delved into the realms of gastronomy, food management, culinary skills, and culinary diet therapy, with a specific focus on prevalent diseases and their prevention, treatment, and care. Tailored questionnaires were administered to all participants both before and after the PIP. Results: Of the 20 participants, 14 successfully completed the study, comprising 86% women, 86% aged above 40, 71% nurses, and 7% medical doctors. Interestingly, 86% of the participants had previously received nutrition training, whereas only 14% had received culinary training. Following the completion of the program, there was a remarkable improvement in adherence to the Mediterranean diet (p < 0.01). However, no statistically significant improvements were observed in food management and culinary skills or counseling confidence (p > 0.5). Despite the absence of statistical significance, there was a noteworthy trend towards greater advocacy for dietary changes before resorting to medication, along with enhanced confidence in providing nutritional and culinary guidance to patients. Conclusion: The findings from this study underscore the potential of hands-on CM training as a vital component of nutrition education for HCP. While statistically significant improvements in certain domains were not observed, the program did demonstrate its ability to influence attitudes, knowledge, and behaviors related to healthy cooking and eating for both HCP themselves and their patients. Given these promising trends, future studies with a larger sample size must be performed to further elucidate the impact of CM training on HCP and its potential benefits for public health.

Limited observational studies have described the relationship between sleep duration and overall diet. The present study investigated the association between sleep duration at weekdays and empirically derived dietary patterns in a nationally representative sample of UK adults, aged 19-64 years old, participating in the 2008-2012 UK National Diet and Nutrition Survey Rolling Programme. Survey members completed between three to four days of dietary records. Sleep duration at weekdays was categorised into tertiles to reflect short, normal and long sleep duration. Social jetlag was calculated as the difference between sleep duration at weekends and weekdays. The association between sleep duration/ social jetlag and dietary patterns, derived by principal components analysis, was assessed regressing diet on sleep whilst accounting for the complex survey design and adjusting for relevant confounders. Survey members in the highest tertile of sleep duration had on average 0.45 (95% CI -0.78, -0.12) lower healthy dietary pattern score compared to middle tertile (p =0.007). There was an inverted u-shaped association between social jetlag and a healthy dietary pattern, such that when sleep at weekends exceeded weekday sleep by 1h 45min, scores for indicating a healthy dietary pattern declined (p =0.005). In conclusion, long sleep duration at weekdays and an increased social jetlag are associated with a lower healthy dietary pattern score. Further research is required to address factors influencing dietary patterns in long sleepers.

(1) Background: Mindfulness-based interventions (MBIs) have shown interesting preliminary ef-fects over self-regulation processes in early adolescence. However, interventions usually integrate various types of practices with no clarity about the specific effect of each of them over attentional, emotional, and behavioral regulation. The objective of this research was to evaluate the effect of two MBIs, one focused on classic attentional practices and another one focused on the recognition and expression of emotions, over attentional, emotional, and behavioral self-regulation in early adolescents. (2) Method: An experimental method was carried out. A sample of 70 children be-tween 8 and 12 years old were randomized and assigned to three experimental conditions: 1) MBI with a focus on attentional practices, 2) MBI with a focus on recognition and expression of emotions, 3) control group, waiting list. The programs lasted 8 weeks, with a weekly 1-hour online synchronic session, plus home practices. Children were evaluated before starting the in-tervention and at the end of the 8-week program. The assessed variables were: 1) Mindfulness; 2) Emotional Regulation; 3) Attentional Regulation and 4) Behavioral regulation. (3) Results: Chil-dren that participated in both programs, increased their mindfulness and emotional and be-havioral regulation scores. Only children who participated in the program with a focus on at-tention showed significant changes in their ability to self-regulate attention. (4) Conclusions: online MBIs, with attention to external and internal stimuli practices, can be a good strategy to strengthen self-regulation skills of attention, emotions, and behavior in early adolescence.

Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2,888 study participants aged 50-60 years, 668 persons were categorised into the subgroups "never-athletes", "sports-dropouts", "always-athletes" and "sports-beginners". Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. 42.5% of "never-athletes" and 32.5% of "sports-dropouts" did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between "sports-dropouts" and "sports-beginners", whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualised lifestyle factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority children with obesity comorbidity. Families of Black, Asian and Minority Ethnicities (BAME) in the Northeast of England (n=180) were contacted, and families with a child diagnosed with obesity and comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems, respiratory disorder, or polycystic ovarian disease) were interviewed (n=11). Semi-structured interviews and qualitative thematic analysis included parents’ perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity. Parents’ perspectives and experience revealed eleven themes centred around living with a child with obesity, risks and impact of obesity diseases; access to lifestyle nutritional and physical activity, and ethnicity specific barriers. Parents revealed social disadvantage, fear of victimisation by social services, perceptions on their cultural and religious traditions when dealing with nutrition and exercise, and child’s weight racial stigmatisation. Parents reported closer bonding with their children than health authorities to protect from obesity consequences. Work pressure, time, and lack of professionals’ guidance were seen as barriers to healthy lifestyle, while support from friends and family bond in adopting healthy lifestyle behaviours were facilitators. Parents reported no awareness of health service provision of nutritional and physical activity obesity prevention programmes. Minority ethnic communities’ perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle nutrition and physical activity interventions are needed beyond those administered by the primary healthcare system.

As the first pilot ecological civilization zone in China, Fujian Province has an excellent ecological environment quality, and its ecological environment-related indices continue to be among the highest in the country. In order to investigate the causes of the excellent ecological quality in Fujian Province in the past 15 years, this paper selects MODIS images, land use data and provincial and municipal statistical yearbook data of Fujian province from 2005 to 2020 as data sources, evaluates the ecological system health of Fujian Province by remote-sensing ecological index (i.e. RSEI), constructs the land use intensity system of Fujian Province at the same time, and uses a coupled coordination model to analyze the coupling between RSEI and The coupled coordination model was used to analyze the coupling relationship between RSEI and land use intensity, and finally the spatial and temporal evolution of ecological health in Fujian Province from 2005 to 2020 was analyzed. The results show that the coupled coordination between land use intensity and ecosystem health in Fujian province showed a continuous increase between 2005 and 2020, especially in Ningde, where the increase was most significant, from 0.0993 to 0.963, this pattern of spatial distribution is lower in the south-eastern coastal region than in the north-western interior, higher in the south-western region than in the north-western region, and higher in the north-eastern region than in the south-eastern region. In terms of the type of role, the land use intensity of most cities in Fujian Province in 2005 played an obvious role in blocking the degree of ecosystem health, but as time changed, urban land use continued to be optimized and reached moderate or even high quality coordination with the quality of the ecological environment, but Xiamen City developed relatively slowly and its 2020 coupling degree value was 0.315, which was still in mild disorder. This study fills a gap in the research mechanism of the interaction between the degree of ecosystem health and land use intensity, and also provides a new perspective for the construction of ecological civilization and the assessment of the degree of ecosystem health in Fujian Province and the whole country.

In Low and Lower-Middle-Income countries, the prevalence of anemia in infancy remains high. In early childhood anemia cause irreversible cognitive deficits and represents a higher risk of child mortality. The consequences of anemia in infancy are a major barrier to overcome poverty traps. The aim of this study was to analyze based on a multi-level approach, different factors associated with anemia in children 6–23 m old based on recent available Standard Demographic Health Surveys (S-DHS). We identified 52 S-DHS that had complete information in all covariates of interest in our analysis between 2005 and 2015. We performed traditional logistic regressions and multilevel logistic regression analyses to study the association between hemoglobin concentrations and household, child, maternal, socio-demographic variables. In our sample, 70 % of the 6–23 m old children were anemic. Child anemia was strongly associated with maternal anemia, household wealth, maternal education and low birth weight. Children fed with fortified foods, potatoes and other tubers had significantly lower rates of anemia. Improving overall household living conditions, increasing maternal education, delaying childbearing and introducing iron rich foods at six months of age may reduce the likelihood of anemia at in toddlerhood.

This qualitative research study is a part of a larger research project exploring the experiences of young caregivers aged 5-26 years and their families navigating the COVID-19 pandemic between 2020 to 2023. Data was collected from 14 young caregivers who participated in baseline interviews. The central research question guiding this study: What was, is, and will be the impact of changing public health restrictions on young caregivers and their families during the pandemic and pandemic recovery? Seven themes emerged through analysis: 1) Navigating Care During the Height of Public Health Restrictions, 2) Neighbourhood and Built Environment During the Pandemic, 3) Perceptions Towards COVID and Public Health Restrictions/Efforts, 4) The Impact of Public Health Restrictions on Relationships, 5) Mental Health Challenges of Being a Young Caregiver During a Pandemic, 6) Navigating Formal Services and Supports and 7) Recommendations from Young Caregivers. The findings from this empirical research suggest that young caregivers found it easier to navigate their caregiving responsibilities when public health restrictions and work-from-home mandates were initially implemented, however, this later changed due to challenges in finding respite from caregiving, maintaining social connections with friends, creating personal space at home, and finding adequate replacements of programs once offered in-person.

This paper examines the importance of choice of cooking fuels in wellbeing, analysing relationships between the proportion of population with primary reliance on different types of fuels for cooking (predictor variable), and key wellbeing indices (outcome variables) - Personal Health, Social Life, Civic Engagement, Life Evaluation, Negative Experience. By combining two global datasets from Gallup and WHO, the study adds to current evidence by taking a global perspective. Controlling for demographic factors such as income per capita, age, education level, employment, etc., regression modelling of these relationships show that clean cooking fuels are influential in all of the key wellbeing indices with the exception of the Life Evaluation Index. Among the key wellbeing indices, Personal Health and Negative Experience Indices are the most strongly influenced by choice of clean cooking fuels. By adding access to electricity as an additional predictor variable, the analysis highlights the potential for integrating eCooking into national electrification plans as part of sustainable energy transitions, given that health outcomes (Personal health and Negative experience indices) appear to be as closely linked to choice of cooking fuels as to access to electricity.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

Smoking is a major risk factor for non-communicable diseases and remains a significant public health challenge in many lower- and middle-income countries (LMIC) including Namibia. The purpose of the study was to estimate the prevalence of smoking and its associated risk factors among HCWs and non-HCWs in Zambezi region. An exploratory cross-sectional survey was conducted between March and October 2020 among residents of the eight (8) constituencies of Zambezi region. Four hundred and sixty-one (461) respondents who had been residents of the selected constituencies for over five years and aged between 17-60 years were selected for the study. The main outcome measure was current cigarette smoking status. Descriptive statistics were used to summarize the socio-demographic characteristics of the respondents. We stratified data analysis by individual being health workers or non-health workers. A bivariate Pearson Chi-square test was used to determine the association between socio-demographic characteristics and the smoking status. Statistically significant variables in the bivariate analysis were used as predictors in the univariate and multivariate models. The response rate of potential participants was 95% (n=434). The mean (±SD) age of participant’s was 32.5 (± 11.34 years). Significant relationships were observed between smoking status and area of residency (constituency), gender, age category, level of education, age of onset of smoking and the daily smoking frequency. The majority of smokers (n=108) were none-HCWs with males being the majority (n=62). Age (p=0.001), education levels (p=0.001) and area of residency (p=0.022) were highly associated with smoking among none-HCW while marital status was associated with smoking among HCWs (p=0.013). In the final multivariate model, the odds of smoking among female non-HCWs were significantly lower (OR: 0.386; 95% CI: 0.228 – 0.655). Furthermore, the odds of smoking among this same group were lower among those who had secondary level education (OR: 0.178; 95% CI: 0.0659 – 0.483), post-secondary (OR: 0.117, 95% CI: 0.0412 – 0.330) and first stage tertiary (OR: 0.306: 95% CI: 0.106 – 0.881) compared to those who had primary school education. In conclusion, smoking prevalence among none HCWs and HCWs working in Zambezi included in the study was similar to that of the general Namibian population but higher than other neighboring countries within SADC. The results showed a need for the establishment of specific smoking related strategies that target HCWs to address smoking use parallel to the running of none HCWs which would ultimately decrease the smoking prevalence and improve health.

Policies to require front-of-package labels (FOPLs) on foods may help Indian consumers better identify foods high in nutrients of concern including sugar, saturated fat, and sodium, and discourage their consumption, outcomes critical for preventing rises in diet-related non-communicable disease. The objective was to test whether FOPLs helped Indian consumers identify ‘high-in’ foods and reduce intentions to purchase them. We conducted an in-person randomized experiment (n=2,869 adults between ages 18 and 60 years old) in six states of India in 2022. Participants were randomized to one of five FOPLs: a control label (barcode), warning label (octagon with “High in [nutrient]”), Health Star Warning (HSR), Guideline Daily Amount (GDA), or traffic light label. Participants then viewed a series of foods high in sugar, saturated fat, or sodium with the assigned FOPL, and rated product perceptions and label reactions. Fewer than half of participants in the control group (39.1%) correctly identified all products high in nutrient(s) of concern. All FOPLs led to an increase in this outcome, with the biggest differences observed for the warning label (60.8%, p<0.001) followed by the traffic light label (54.8%, p<0.001), GDA (55.0%, p<0.001), and HSR (45.0%, p<0.01). Relative to the control, only the warning label led to a reduction in intentions to purchase the products. The results suggest that warning labels are the most effective FOPL to help Indian consumers identify and avoid unhealthy foods.

The Sei Dareh Bridge is a cable-stayed bridge located in West Sumatra Province, Indonesia. The bridge, which crosses the Batanghari River, has a main span of 123 meters long and 9 meters wide. Traffic load is transmitted through 24 prestressed cables to a 42.4-meter-high pylon made of concrete. The bridge deck and traffic loads are directly supported by steel box girders as main beams that are reinforced laterally with cross beams IWF 800.300.16.24 and stringers IWF 350.350.12.19. This paper discusses static and dynamic testing on the bridge which aims to assess its feasibility before it is opened to the public. Based on the test, it was concluded that a static load of 73% could not be achieved because the deflection that occurred was beyond the allowable deflection. This is exacerbated by a loud clanging sound on the ST2-X1 prestressed cable when loading to 240 tons or 58% of the targeted load. In addition, this bridge is included in the "lazy bridge" category because it takes 24 hours to return to an undeformed condition after loading. As a recommendation for this bridge, it is necessary to carry out a structural health monitoring system (SHMS) regularly on bridge slabs and cables.

Background: Frail elderly patients are exposed to suffering the consequences of heart diseases that are not managed timely such as receiving anticoagulation to prevent stroke associated to atrial fibrillation (AF). Referral to the cardiological outpatient department can be cumbersome as it often requires repeated visits. The aim of this project was to use AF as a showcase to develop and implement CardioShare, a shared-care model where primary care leads patient management, using an easy-to-use compact Holter monitor device with asynchronous remote support from cardiologists. Methods: This complex intervention has been developed during a feasibility phase, tested in a pragmatic cluster-randomization trial (primary care clinic as clusters) and its implementation potential evaluated with an escalation test. Mixed methods were used to evaluate the impact of the intervention, comprising quantitative observations, semi-structured interviews, and workshops. Results: Between February 2020 and December 2021, 314 patients (30% frail) were included of whom 75% had AF diagnosed/not found within 13 days. More than 80% in both groups avoided referral to cardiologists. Patients felt safe and primary care clinicians satisfied. In the escalation test, 58 primary-care doctors used CardioShare to manage 93 patients over three months with remote support from four hospitals in the Capital Region of Denmark. Conclusions: CardioShare was successfully implemented for AF evaluation in primary care.

Background/Objectives: The aim of the project is a longitudinal assessment of body image and mental health in scoliosis females pre-, postoperatively and in a follow-up, and implementation (one group-CBT scoliosis sample, CBTSS) or not (second group-control scoliosis sample, CSS) of CBT interventions. A healthy female sample (HFS) was also selected for comparative purposes. Methods. 36 in total AIS patients participated in the 1st and 2nd study phases, whereas 23 were eligible in the follow-up. Regarding HFS, 18 participants were included in the study. The CBT intervention took place pre- and postoperatively, during the patients' stay in hospital. Participants completed the Spinal Appearance Questionnaire (SAQ), Body Esteem Scale (BES) and Strengths and Difficulties Questionnaire-25 (SDQ-25). Body image was also assessed using a virtual reality-based application “Avatar Scoliosis 3D”. Results: The difference between the desired and objective, actual body shape is significant preoperatively both in the CBTSS and CSS at p

Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional, a study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between April 27 and May 17, 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms in SSA and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, Central and Southern Africans, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments’ response and recovery strategies of any future pandemic.

Nowadays, mindfulness-based interventions (MBI) have experimented a remarkable development of studies among childhood and adolescent interventions. For this reason, dispositional mindfulness (DM) measures for children and adolescents have been developed to determine the effectiveness of MBI at this age stage. However, little is known about how key elements of DM (f. e., cognitive de/fusion or experiential avoidance that both conform psychological inflexibility) are involved in the mechanisms of the children and adolescents’ mental health outcomes. This research examined the mediating effect of cognitive fusion between DM and anxiety and other negative emotional states in a sample of 318 Spanish primary-school students (aged between 8 and 16 years, M=11.24, SD=2.19, 50.8% males). Participants completed the AFQ-Y, which is a measure of psychological inflexibility that encompasses cognitive defusion and experiential avoidance; CAMM (DM for children and adolescents), PANAS-N (positive and negative affect measure for children, the Spanish version of PANASC), and STAIC (an anxiety measure for children). The study accomplished ethical standards. As MBI relevant literature has suggested, cognitive defusion was a significant mediator between DM and symptoms of both negative emotions and anxiety in children and adolescents. However, experiential avoidance did not show any significant mediating relationship. Probably, it is needed improvement of the assessment of experiential avoidance. MBI programs for children and adolescents may include more activities for reducing the effects of the cognitive defusion on their emotional distress.

Abstract: Nutritional interventions have beneficial effects on certain psychiatric disorder symptomatology and common physical health comorbidities. However, studies evaluating nutritional literacy in mental health professionals (MHP) are scarce. This study aimed to assess the degree of self-rated training and literacy relating to nutrition in MHPs. We conducted a cross-sectional survey across 52-countries. Surveys were distributed via colleagues and professional societies. Data were collected regarding self-reported general nutrition knowledge, nutrition education, learning opportunities, and the tendency to recommend food supplements or specific diets in clinical practice. In total, 1056 subjects participated in the study: 354 psychiatrists, 511 psychologists, 44 psychotherapists, and 147 MHPs in-training. All participants believed the diet quality of individuals with mental disorders was poorer compared to the general population (p<0.001). The majority of the psychiatrists (74.2%) and psychologists (66.3%) reported having no training in nutrition. Nevertheless, many of them used nutrition approaches, with 58.6% recommending supplements and 43.8% recommending specific diet strategies to their patients. Only 0.8% of participants rated their education regarding nutrition as ‘very good’. Almost all (92.9%) stated they would like to expand their knowledge regarding ‘Nutritional Psychiatry’. There is an urgent need to integrate nutrition education into MHP training, ideally in collaboration with nutrition experts to achieve best practice care.

Real-world evidence (RWE) is increasingly involved in the early benefit assessment of medicinal drugs. It is expected that RWE will help to speed up approval processes comparable to RWE developments in vaccine research during the COVID-19 pandemic. Definitions of RWE are diverse marking the highly fluid status in this field. So far, RWE comprises information produced from data routinely collected on patient’s health status and/or delivery of health care from various sources other than traditional clinical trials. These sources can include electronic health records, claims, patient-generated data including in home-use settings, data from mobile devices as well as patient, product and disease registries. The aim of the present update was to review the current RWE developments and guidelines mainly in the U.S., the UK, Europe and Germany field during the last decade. RWE has already been included in various approval procedures of regulatory authorities reflecting its actual acceptance and growing importance in evaluating and accelerating new therapies. However, since the RWE research is still in a transition process and since a number of gaps in this field have been explored, more guidance and a consented definition are necessary to increase the implementation of real-world data.

Lactic acid bacteria are traditionally applied in a variety of fermented food products and have the capability to produce a wide range of bioactive ingredients during fermentation including vitamins, bacteriocins, bioactive peptides and bioactive compounds. The bioactivity and health benefits associated with these ingredients have gained interest in applications in the functional dairy market and have relevance both as components produced in situ and as functional additives. This review provides a brief description of the regulations regarding the functional food market in the European Union as well as an overview of some of the functional dairy products currently available in the Irish and European markets. A better understanding of the production of these ingredients excreted by lactic acid bacteria can further drive the development and innovation of the continuously growing functional food market.

Despite marked advancements, life expectancy (LE) growth in Saudi Arabia and the United Arab Emirates (UAE) has remained stagnant compared to other developed nations. This study aims to investigate the significant correlation between macroeconomic (ME), sociodemographic (SD), and health status-resources (HSR) factors and LE to formulate an explanatory model for Saudi Arabia and the UAE – a previously unexplored area. Utilizing an ecological, retrospective, time-series study design, we delved into secondary data on SD, ME, HSR, and LE of the UAE population spanning three decades (1980-2020). We employed the partial least squares-structural equation modeling for statistical analysis. Our analysis revealed significant direct impacts of HSR on LE for Saudi Arabia (Beta=0.958, p<0.001) and the UAE (Beta=0.716, p<0.001). Furthermore, we discerned a notable indirect influence of ME on LE, mediated through SD and HSR for Saudi Arabia (Beta=0.507, p<0.001) and UAE (Beta=0.509, p<0.001), along with a considerable indirect effect of SD on LE through HSR (Saudi Arabia: Beta=0.529, p<0.001; UAE: Beta=0.711, p<0.001). This study underscores the mediating role of a nexus of ME-SD-HSR factors on LE in Saudi Arabia and the UAE. Consequently, these findings signal an imperative need for holistically policy interventions addressing ME, SD, and HSR factors, aiming to alter health behaviors and improve LE projections for Saudi Arabia and the UAE in the long run.

Estimating the remaining useful life (RUL) of components is a crucial task to enhance the reliability, safety, productivity, and to reduce maintenance cost. In general, predicting the RUL of a component includes constructing a health indicator ( ) to infer the current condition of the component, and modelling the degradation process, to estimate the future behavior. Although many signal processing and data-driven based methods were proposed to construct the , most of the existing methods are based on manual feature extraction techniques, and need the prior knowledge of experts, or rely on a large amount of failure data. Therefore, in this study, a new data-driven method based on the convolutional autoencoder (CAE) is presented to construct the . For this purpose, the continuous wavelet transform (CWT) technique is used to convert the raw acquired vibrational signals into a two-dimensional image; then, the CAE model is trained by the healthy operation dataset. Finally, the Mahalanobis Distance (MD) between the healthy and failure stages is measured as the . The proposed method is tested on a benchmark bearing dataset and compared with several other traditional construction models. Experimental results indicate that the constructed exhibits a monotonically increasing degradation trend and has a good performance to detect incipient faults.

Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in Europe and in Veneto region of Italy, where it has become a serious problem for human health. The consumption of contaminated food and drinking water is considered one of the major source of exposure for humans. Worldwide epidemiological studies report the negative effects that PFAS have on human health, due to environmental pollution, including infertility, steroid hormone perturbation, thyroid, liver and kidney disorders and metabolic disfunctions. In vitro and in vivo researches correlated PFAS exposure to oxidative stress effects (in mammals as well as in other vertebrates of human interest), produced by a PFAS-induced increase of reactive oxygen species formation. The cellular antioxidant defense system is activated by PFAS, but it is only partially able to avoid the oxidative damage to biomolecules.

The prolonged lockdown imposed to contain the COVID-19 pandemic prevented many people from direct contact with nature and greenspaces, raising alarms for a possible worsening of mental health. This study investigates the effectiveness of a simple and affordable remedy for improving psychological well-being, based on audio-visual stimuli brought by a short computer video showing forest environments, with an urban video as a control. Randomly selected participants were assigned the forest or urban video, to look at and listen early in the morning, and filled questionnaires. In particular, the State-Trait Anxiety Inventory (STAI) Form Y, collected in baseline condition and at the end of the study, and the Part II of the Sheehan Patient Rated Anxiety Scale (SPRAS), collected every day immediately before and after watching the video. The virtual exposure to forest environments showed effective to reduce perceived anxiety levels in in people forced by lockdown in limited spaces and environmental deprivation. Although significant, the effects were observed only in the short term, highlighting the limitation of the virtual experiences. The reported effects might also represent a benchmark to disentangle the determinants of health effects due to real forest experiences, for example, the inhalation of biogenic volatile organic compounds (BVOC).

The study aimed to evaluate for the first time the degree of contamination of soil and crops with major and trace elements (Cd, Co, Cr, Cu, Ni, Pb, Zn, F, Na, Mg, Si, P, Cl, Fe, Al) in agricultural lands situated in the Lower Danube Basin, Galati and Braila counties (SE Romania), impacted by the steel industry. Soil samples from two depths (0–5 cm and 5–30 cm), as well as leaves and seeds of wheat, corn, and sunflower, were collected from 11 different sites. Along with elemental and mineralogical analysis, performed by HR-CS AAS, PIGE, SEM-EDX and ATR-FTIR, the soil pH, texture, organic matter, electric conductivity and CaCO3 content were investigated. The results showed that the levels of Cr (83.270–383.100 mg kg-1), Cu (17.110–68.151 mg kg-1), Ni (30.157–55.656 mg kg-1), and F (319–544 mg kg-1) in soil exceeded the Romanian regulations for sensitive use of the land. The pollution indices (Igeo, EF, PI, PERI) indicate that the soil is moderate to highly contaminated with Cr, Ni and Cu, while CSI and mERMQ indices suggested a relatively low risk for metal contamination. The concentrations of elements in plant tissues and bioaccumulation factors (BFs) show the soil-plant relation and health risk, but also the elemental selectivity of vegetal compartments. Thus, the results showed that wheat plants tend to exclude the bioaccumulation of certain elements in their tissues, while for Zn and Cu, the bioaccumulation pattern is different. In the case of corn, most BFs were below 1, indicating limited phytoaccumulation capacity. However, exceptions were observed for Cd, Zn, and Cu. Sunflower BFs indicate higher bioconcentration of Cu, Cd, and Zn in both the leaves and seeds compared to other elements. Chromium (Cr) contributes to non-carcinogenic dermal contact and ingestion hazards, with children being more susceptible to the adverse effects of this contaminant.

Low dietary intake of calcium, vitamin D, vitamin C and magnesium has been associated with increased risk of osteoporosis. The purpose of the study was to evaluate changes in several bone health indicators and metabolic biomarkers in postmenopausal women, with high osteopenia or osteoporosis, followed by a nutritional intervention program. 115 apparently healthy postmenopausal women (52±8 years old) were randomized into four groups: group I (n=40) received daily 1000 mg vitamin C, 100 mcg vitamin D3, 500 mg calcium(Ca) and 300 mg magnesium (Mg); group II (n=42) received daily 100 mcg vitamin D3, 500 mg Ca and 300 mg Mg; group III (n=18) received daily 5 mg bisphosphonates, 100 mcg vitamin D3, 500 mg Ca and 300 mg Mg; and group IV (n=15) received daily about 364 mg polyphenols via an innovative functional food (50 g olive paste enriched with mountain tea extract) along with 100 mcg vitamin D3, 500 mg Ca and 300 mg Mg. Groups I -III received supplementation for a year whereas group IV for 5 months. Changes in bone health indicators and metabolic biomarkers were assessed at the beginning and at the end of the study. Anthropometric indices and whole-body bone mineral density (BMD) were also evaluated at the beginning and at the end of the intervention period. The results revealed improved elevated levels of 25(OH)D3, in groups II, III and IV (+3,71% and +1.45% and +5.62% respectively). Significant positive changes were recorded, for whole-body BMD, in all four study groups. Significant beneficial changes for total cholesterol were observed in group IV (-2.07%, P&lt;0.05) and positive changes in group I for HDL biomarker (+61.62%, P&lt;0.05). Additional larger-scale clinical trials and intervention studies are considered essential, to fully investigate and elucidate associations between dietary components and biochemical indices of bone health.

Background: Demographic aging is a reality in developed countries, which poses a social challenge of great responsibility. Thus, numerous studies have been developed in an attempt to understand which factors best predict healthy aging. The aim of this study was to investigate and systematize literature on intervention programs that simultaneously include cognitive stimulation and physical activity, understand the importance of the use of new technology in these programs, and understand their impact on cognitive function in older adults, giving indications about their contribution to healthy aging. Methods: A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified from electronic databases such as PubMed, Scopus, Web of Science and Academic Search Complete. Results: Thirty-two articles, involving 2815 participants, were identified. All selected studies were randomized controlled studies. The studies were published between 2011 and 2020. All studies included a combination of cognitive and physical interventions. Many of the studies used technology to administer the cognitive stimulation program. Conclusions: Most of the analyzed studies use new technologies in physical and cognitive interventions, demonstrating that this new form of intervention exerts lasting and stable benefits in cognition.

This panel study investigates the relationship between green logistics indices, economic, environmental, and social factors in the perspective of Asian emerging economies. This study adopted FMOLS and DOLS methods to test research hypothesis, catering the problem of endogenity and serial correlation. The results suggest that logistics operations, particularly LPI2 (efficiency of customs clearance processes), LPI4 (quality of logistics services) and LPI5 (trade and transport-related infrastructure), are positively and significantly correlated with per capita income, manufacturing value added and trade openness. While, greater logistics operations are negatively associated with social and environmental problems including, climate change, global warming, carbon emissions, and poisoning atmosphere. In addition, human health is badly affected by heavy smog, acid rainfall, and water pollution. The findings further extend and reveal that political instability, natural disaster and terrorism are also a primary cause of poor economic growth and environmental sustainability with poor trade and logistics infrastructure. Further, the application of renewable energy resources and green practices can mitigate negative effects on social and environmental sustainability without compromising the performance of economic growth. There is very limited empirical work presented in literature using renewable energy and green ideology to solve macro-level social and environmental problems, while this study will assist the policymakers and researchers to understand the importance of green concept in improving countries’ social, economic and environmental performance.

Coffee production generates significant amounts of by-products, posing challenges for waste management in the industry. Recent research has revealed that coffee by-products are rich in bioactive compounds suitable to produce functional food ingredients and nutraceuticals. In this review, we explore biorefinery strategies for extracting and utilizing bioactive compounds from coffee by-products, including the production of bio-based chemicals and materials, as well as the extraction of phenolic compounds, antioxidants, and dietary fiber for food applications. We propose a stepwise approach for the development of functional food ingredients and nutraceuticals from coffee by-products, covering the identification of needs, comprehensive characterization, in vitro and in vivo research, unraveling the mechanism of action, food and nutraceutical formulation, sensory analysis, shelf-life stability, scale-up, randomized control trials, and biostatistic and bioinformatic integration. Additionally, we discuss the market potential, regulatory issues, and technological innovation surrounding the commercialization of coffee by-product-based products. Emphasizing the importance of regulatory compliance and sustainability in the coffee industry, this review highlights the potential of coffee by-products to be transformed from waste into valuable functional food ingredients and nutraceuticals, offering a promising avenue for waste reduction and promoting sustainability in the coffee industry.

Objective: To investigate whether the relationships between acute care occupational therapy (OT) and physical therapy (PT) utilization and community discharge are moderated by functional or physical performance at discharge among individuals hospitalized with traumatic brain injury (TBI). Setting: 14 acute care hospitals in the state of Colorado. Participants: We studied 5,599 adults hospitalized with TBI between June 2018 and April 2021. Design: In a secondary analysis of de-identified electronic health record (EHR) data, multivariable moderation logistic regression models were performed to calculate odds ratios (ORs) for the likelihood of community discharge among patients who utilized OT/PT services. Main Measures: Functional (activities of daily living [ADL]) and physical (mobility) performance at discharge, OT and PT utilization, and community discharge status. Results: Overall, 67% of patients discharged to the community. The mean age of the sample was 55 years (SD = 20 years). Most participants were male (64%) and non-Hispanic white (72%). Mean hospital length of stay was 6 days (SD = 6 days). Both OT and PT utilization (OT: OR= 1.21, 95% CI [1.11, 1.33]; PT: OR= 1.22, 95% CI [1.14, 1.30]) and discharge ADL and mobility scores (ADL: OR= 1.34, 95% CI [1.30, 1.39]; mobility: OR= 1.38, 95% CI [1.33, 1.42]) were significantly and positively associated with community discharge. The OT and PT utilization-by-discharge ADL and mobility interaction terms yielded slightly negative, but statistically significant moderation effects in both models (ORs= 0.99, 95% CIs [0.98, 1.00]); indicating the magnitude of the OT and PT utilization effect diminished as ADL and mobility scores increased. Several sociodemographic characteristics and clinical factors were also independently associated with community discharge in both models (p-values

This study examines the impact of chainsaw chain type and tree species on the concen-tration of inhalable wood dust generated during motor-manual harvesting in forested areas. The chainsaw chain is a critical component, contributing not only to productivity but also to the oper-ator's health and safety. Wood dust creation during harvesting operations poses significant risks and necessitates careful attention due to its potential health effects. We investigated the effects by conducting real-world measurements of inhalable dust within the operator's breathing zone during forestry work. Two different chain types were evaluated: the commonly used 3/8" pitch chain (conventional chain) and the 0.325" pitch chain. Additionally, measurements were taken for three tree species: beech, oak, and pine (including both live and standing dead trees after a fire). Results showed that, overall, using the conventional 3/8" chain type yielded the highest concentration of wood dust for all three tree species. Notably, the highest wood dust concentration was observed in the burned Pinus brutia cluster, also with the 3/8" chain pitch. These findings emphasize the im-portance of understanding how chain type and tree species contribute to wood dust levels and provide valuable insights for enhancing operator health and safety during motor-manual har-vesting operations

Currently, health tourists primarily rely on independent facilitators to manage and book their medical appointments and vacation plans. There is a notable absence of dedicated booking applications for health tourism packages. This paper proposes HealthTourismHub, an application designed to provide personalized packages that include medical appointments, accommodation options and recommended tourism activities. It also serves as a platform for medical experts and accommodation providers, allowing health tourists to discover and connect with them. To incorporate personalization, HealthTourismHub uses an ontology that organizes medical and tourism data, along with a reasoner that generates new knowledge. This approach enables the application to offer customized packages and identify the most suitable providers for each user. Providers are strategically paired and located in close proximity, with the package also including personalized tourism recommendations. A survey was conducted to assess the usability of the application and general perspectives towards health tourism, including motivations, concerns, and preferences. The results revealed an above-average SUS score, indicating that users found the application user-friendly and effective. Some areas for improvement were identified, such as error handling and additional functionalities. Nonetheless, HealthTourismHub shows great potential as a pioneer in the field of health tourism applications.

Prostate Cancer remains a prevalent health concern, emphasizing the critical need for early diagnosis and precise treatment strategies to mitigate mortality rates. Accurate prediction of cancer grade is paramount for timely interventions. This paper introduces an approach to prostate cancer grading, framing it as a classification problem. Leveraging ResNet models on multi-scale patch-level digital pathology and the Diagset dataset, the proposed method demonstrates notable success, achieving an accuracy of 0.999 in identifying clinically significant prostate cancer. The study contributes to the evolving landscape of cancer diagnostics, offering a promising avenue for improved grading accuracy and, consequently, more effective treatment planning. By integrating innovative deep-learning techniques with comprehensive datasets, our approach presents a step forward in the pursuit of personalized and targeted cancer care.

Introduction: Cervical cancer is the fourth most common cancer in women globally and the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Research has shown an association between low levels of risk perception and knowledge of the prevention, risks, signs, etiology, and treatment of cervical cancer and low screening uptake, as contributing to high rates of cervical cancer-related mortality. However, there is scant literature on the perspectives of a wider group of stakeholders (e.g., policymakers, healthcare providers (HCPs), and women at risk), especially those living in rural and semi-rural settings. Methods: We adapted Risso-Gill and colleagues’ framework for a Health Systems Appraisal (HSA), to identify HCPs' perspective of the extent to which health system requirements for effective cervical cancer screening, prevention, and control are in place in Tanzania. We adapted interview topic guides for cervical cancer screening using the HSA framework approach. Study participants (69 in total) were interviewed between 2014-2018 –participants included key stakeholders, HCPs, and women at risk for cervical cancer. The data was analyzed using reflexive thematic analysis methodology. Results: Seven themes emerged from our analysis of semi-structured interviews and focus groups: 1) knowledge of cervical cancer risk and the role of screening and preventive care/services (e.g., prevention, risks, signs, etiology, and treatment), 2) training and knowledge of HCPs, 3) knowledge of cervical cancer screening among women at risk, 4) beliefs about cervical cancer screening, 5) role of traditional medicine, 6) risk factors, and 7) symptoms and signs. Conclusion: It is evident that there is a low level of knowledge of cervical cancer risk and the role of screening and preventive services among stakeholders, HCPs, and women living in rural and semi-rural locations in Tanzania. There is a critical need to implement more initiatives and programs to increase the uptake of screening and related services and allow women to make more informed decisions on their health.

This study explores the elements that influence consumer vegetarian diet choices in parts of South Korean provinces. The study examines these explanatory variables: ethical-animal-welfare, health, environment, social issues , mood-emotion, and religious-beliefs with vegetarianism serving as the dependent variable. The Likert scale data from 264 respondents were analyzed using logistic regression analysis. Results show that health, ethical-animal-welfare ideals as well as environmental concerns emerge as significant variables influencing the decision to embrace a vegetarian diet. This shows that consumers (international students) in Korea are becoming more aware of and concerned about health, ethical and sustainable dietary choices. Secondly, health plays a crucial role in the vegetarian diet selection, indicating that health-conscious people are more inclined to choose a vegetarian lifestyle. Religious belief and mood have various degrees of influence on the vegetarian diet decision. The findings of this study have consequences for consumer behavior, marketing managers, and decision-makers. Businesses in the food industry, in particular, can gain from catering to the needs and tastes of consumers that prioritize ethical-animal welfare ideals, as well as those that value health and environmental sustainability. Creating and advertising vegetarian and vegan choices in local restaurants can effectively attract and serve this specific target demographic.

The ubiquitous presence of microplastics (MPs) in the environment poses a threat to ecosystems and increases concerns about their exposure to the human body. However, despite being consumed for health improvement, limited research has been conducted on MPs in functional foods. This study aimed to investigate the occurrence of MPs and the relation of the source of raw material or the manufacture in various omega-3 oil in the Korean market. MPs in omega-3 capsule and raw oil, sourced from both plant-based (PB) and animal-based (AB) sources, were investigated. We developed the method by direct filtration with acetone washing and analyzed MPs greater than 5 μm using microscope-Raman spectroscopy. The average number of MPs was found to be 1.2 ± 1.7 MPs/g for PB raw oil, 2.2 ± 1.7 MPs/g for AB raw oil, 3.5 ± 3.9 MPs/g for PB capsule oil, and 10.6 ± 8.9 MPs/g for AB capsule oil. Polypropylene and polyethylene terephthalate were major specious (83-95 %) found in omega-3 oil. The ratio of size range remained consistent across all groups, with a trend of higher detection rates as the size diminished. The results reveal that the main reason of MPs contamination is not the source of raw material but the manufacturing and packaging process for omega-3 oil.

Rare earth elements (REEs) are a type of new material resources, which have attracted significant attention in recent years. REEs have emerged as essential metals in modern-day technology due to their unique functions. Long-term large-scale mining and utilization of rare earths have caused serious environmental pollution and constitutes a global health issue, which raised concerns about human health safety. However, the toxicity profile of suspended particulate matter of REEs in the environment interacts with the human body in remain largely unknown. Studies have shown that REEs can enter the human body through a variety of pathways, leading to a variety of organ and system dysfunctions through changes in genetics, epigenetics, and signaling pathways. Through an extensive literature search and critical analysis, we provide a comprehensive overview of the available evidence, identify knowledge gaps, and make recommendations for future research directions.

Background: Perinatal exposure to pollutants could lead to side-effects in mothers and children, since this is a period of high vulnerability. Sparse and contradictory data are available on the impact of pollutants on breast milk. Objective: The present study consists of a scoping to review the recent research on the persistent presence of organic pollutants (POPs) and heavy metals in breast milk. Design: We performed a scoping review using two online databases to identify articles published from 1995 to 2023 on pollutants in breast milk, using the PRISMA Checklist. Results: A total of 54 articles were found relevant. POPs were present in breast milk in higher concentrations the longer the lactation period. In 3-year-old children, the presence of POPs correlated with the duration of breastfeeding. Estimated dietary exposure to Polychlorinated Biphenyls (PCBs) during pregnancy was positively associated with plasma concentrations in 3-year-old children, but not in pregnant women, suggesting transplacental transfer of these substances. Indeed, plasma concentrations were approximately 40% higher in children compared to pregnant women. In China, a clinical study assessed the risks of POPs in breastfed infants under 6 months of age. POPs decreased over time. Dichloro-Diphenyl-Trichloroethane (DDT) was present in infants living in coastal areas. Hexachlorobenzene (HCB) was the pollutant of greatest concern. Parity is a major determinant of POP levels in breast milk, as are heavy metals. Carcinogenic PAHs were found to a greater extent in obese mothers than in mothers with a normal body mass index. Discussion: POPs and heavy metals could be found in infant formula as well as maternal milk. furthers studies are needed to compare the concentrations between the two milks. Conclusions: Breastfeeding is the only food recommended by the WHO for optimal infant growth. It would seem advisable to pursue risk reduction policies to protect mothers and infants from contaminants in breast milk.

Background: There is a lack of knowledge about how nurses and general practitioners (GPs) collaborated during the COVID-19 pandemicin primary care settings. Our study examined the roles of primary care nurses during the pandemic’s first wave, between March and June 2020, in Switzerland. Methods: The study involved all eight general practices implementing of a nursing role to the practice’s team. Primary care practice staff members (nurses, GPs and medical assistants) have been involved on the development of a new organizational model. A mixed-methods design study collected quantitative data using daily activity monitoring and an electronic survey. Additionally, eight nurses and nine GPs participated in a focus group discussion and individual interviews. Results: GPs recognized the substantial contributions, versatility, and autonomy of the primary care nurses in their practices during the pandemic. Those nurses experienced their involvement positively, mainly thanks to their perceived autonomy. The distribution of activities between primary care practice professionals was heterogenous due to extrinsic and intrinsic factors. Conclusion: Both nurses and GPs agreed that there was added value in having primary care nurses ingeneral practices in time of crisis, and this agreement will bolster plans to integrate this workforce across the canton. The development of nurses’ roles in primary care during the pandemic was reliant on many factors, including practice organization and Switzerland’s healthcare reimbursement and payment system

Purpose：Herein, aimed to explore routines to improve students' physical health.Methods:We explored the integration of extracurricular fitness running "Lerun" into college physical education curriculum. Firstly, experimental and the referring groups were selected by experimental method, in which only the experimental group was intervened in combination with extracurricular fitness running "Lerun". After two experiments, the experimental and referring groups were compared in terms of physical fitness (speed, strength, endurance, flexibility, explosive force, etc.), sports skills, body shape, cardiopulmonary function, etc. Results:After T-test, significant differences (p<0.05) between these two groups prove that the students' physical health status of experimental group is better than that of the referring group. Conclusion：It manifests that integrating extracurricular fitness running "Lerun" into college physical education curriculum is an effective means to improve students' physical health.

Sleep is a fundamental human need: sleep disruption, in fact, causes an increase in the activity of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms and pro-inflammatory responses. Sci-entific literature is finally starting to pay attention to the central role of sleep-wake rhythm alterations for patients health. Oxaliplatin is used extensively for the treatment of gastrointestinal cancer and other malignancies, with increased frequency of use in recent years. This study aims to understand the effects of sleep-wake rhythm alterations on health and quality of life on cancer patients treated with oxaliplatin. Study has been conducted through the creation and distribution of questionnaires to patients to inves-tigate the potential alteration of the sleep-wake quality. Evaluating the influence of the collected variables on sleep quality, only liver and biliary tract and pancreas tumor lo-calization, in males, and previous difficulty sleeping, and anxiety, worries and stress, in females, resulted statistically significant. The results obtained may serve as foundation for designing awareness campaigns and updating of patients, healthcare personnel and caregivers, to improve health and quality of patients life.

Urban dust samples were taken from the playgrounds of 27 schools located in the urban area of the city of Murcia (S.E. Spain). Their color and degree of magnetism were determined, as well as their heavy metal content (Cd, Cu, Cr, Ni, Pb and Zn) to evaluate contamination by environmental and health indexes. The highest concentration of contaminants is found in dusts of dark color and medium and high magnetism. The concentrations of heavy metals in the dust were, in this order, Zn (453.74 mg kg-1)> Cu (77.44 mg kg-1)> Cr (67.93 mg kg-1)> Pb (55.72 mg kg-1)> Ni (18.56 mg kg-1)> Cd (0.42 mg kg-1). The analysis of the magnetic and non-magnetic fraction indicates that there is a concentration of all heavy metals in the magnetic fraction. According to the geoenvironmental indices used, the ecological risk presented by school playgrounds is moderate. As for the health indices, ingestion was the main route of exposure and entry of dust particles into the body, being the main health risk for adults and children for all metals. The Hazard Index (HI) values for all elements for both adults and children were less than 1, indicating that there is no risk of developing adverse health effects. As for the Cancer Risk (CR), the values of this index indicate that there is no risk. The objective of this study was to evaluate pollution in the playgrounds of schools in the city of Murcia.

Osteoporosis is characterized by low bone mass and structural deterioration of bone tissue with increased risk of fracture. The population that is most at risk for primary osteoporosis in-cludes post-menopausal women. Among different approaches, nutraceuticals are increasingly popular in developed countries since can contribute to bone health and can delay the onset of pathological bone loss. Our review covers three main aspects. Firstly, we discuss the current state of the two con-ditions, osteopenia, and osteoporosis. Secondly, we focus on the latest developments in natural Nutraceuticals and their effectiveness in reducing bone loss. Finally, we conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis to examine the pros and cons of Nutraceuticals assumption. Nutraceuticals hold great promise, but we must address challenges such as regulatory control and experimental evidence to fully realize their potential. Other challenges include identifying the source of raw materials, ensuring the purity of the compound, avoiding contamination or the presence of other active compounds, maintaining product quality, and preventing interactions with other elements or drugs. By addressing these challenges, the scientific community can ensure more reliable indica-tions for the use of Nutraceuticals and help people lead healthier lives.

Salmonella infection is one of major challenges to the poultry industry because of its pressing effects on health of poultry, food safety and human well-being that later may devastate economic losses to the poultry sector. The paper reviews public health implications and the use of antibiotics together with the risk of drug resistance. In recent years, the usage of probiotics in poultry industry has been growing to mitigate an increasing pressure to adopt sustainable farming practices. The mechanisms which probiotics may control Salmonella and important criteria for selecting effective probiotics in poultry are reported. Various studies highlighting the additional benefits of probiotics in poultry production in addition to Salmonella controls are also included. While probiotics offer promise in enhancing poultry health, challenges and limitations in their utilization must also be carefully considered.

Background: Several reports indicate that long stay at home for online schools due to the COVID-19 pandemic changed the normal physical activity and body weight of school-age students. Previous studies revealed that almost 50% of school students complained of increased or decreased more than 3 kg of weight due to lower physical activity. This study aims to provide insight about the Body Mass Index (BMI) among school students during COVID-19 pandemic. Methods: A retrospective matched-longitudinal study was conducted in 2022 based on previous data about BMI-for-age percentile in school-age students aged 6 to 18 years. These data were collected the year before and during COVID-19 pandemic (2019-2021). Results: All the included students were Arabic (N = 53,580) and were not diagnosed with chronic illness. The outcomes showed that the overall percentage of students with normal weight was 54%, 56%, and 53% during the 2019-2021 years, respectively. Overweight among students increased during the COVID-19 pandemic years, as almost 10% of the students were overweight in 2019 compared with 12% in 2020 and 2021 years. Besides, obese students also increased in the 2020-2021 period compared with the 2019 year (15-17% vs. 10%). In contrast, underweight trends among students declined, as 26% reported in 2019 compared to 17-18% in 2020 and 2021. Conclusion: There are significant variations in Arabic school-age students regarding their BMI values. Obesity was highly detected among children and adolescents during the COVID-19 pandemic years compared to 2019, while underweight cases declined.