Anthocyanins are among the best-known phenolic compounds and possess remarkable biological activities, including antioxidant, anti-inflammatory, anticancer, and antidiabetic effects. Despite their therapeutic benefits, they are not widely used as health-promoting agents due to their insta-bility, low absorption, and thus, low bioavailability and rapid metabolism in the human body. Recent research suggests that the application of nanotechnology could increase their solubility and/or bioavailability, and thus, their biological potential. Therefore, in this review, we decided to provide, for the first time, a comprehensive overview of in vitro and in vivo studies on nanocarriers used as delivery systems of anthocyanins, and their aglycones, i.e., anthocyanidins alone or com-bined with conventional drugs to the treatment or management of chronic diseases.

A human case of dengue virus 2 was detected from a febrile patient living in the Sare yoba, Kolda region (Southern Senegal). Phylogenetic analysis based on the partial sequence of the NS5 gene reveals that the virus belongs to the DENV2 Sylvatic genotype and is closely related to a strain (JF260983/ 98.98% identity) detected in Spain from a tourist who travelled to Guinee Bissau (bordering Kolda region) in 2009. This highlights a potential recent underreported circulation of sylvatic Dengue in the southern part of Senegal and calls for re-enforced integrated surveillance among humans, non-human primates and arboreal mosquitoes throughout a one-health approach.

This research is aimed at the knowledge of the effectiveness of the material resources in the sensa-tions of exploratory procedures in 365 older people who take part in the physical activity that the Sport Municipal Institute (SMI) offers in the different sports centers assigned to it in the city of Se-ville, using a descriptive design and with a questionnaire developed and validated previously by the Delphi method; showing the relationship between the basic emotions that seniors experience when handling sport, and the materials. So it is claimed that exist a relation between older people, which practice exercise with the materials that they use on it.

Psychiatric patients are particularly vulnerable to strong weather stimuli, such as foehn, a hot wind that occurs in the alps. However, there is a dearth of research regarding its impact on mental health. This study investigated the impact of foehn wind among patients of a psychiatric hospital located in a foehn area in the Swiss Alps. Analysis was based on anonymized datasets obtained from routine records on admission and discharge, including the Brief Symptom Checklist (BSCL) questionnaire, as well as sociodemographic parameters (age, sex, and diagnosis). Between 2013 and 2020 a total of 10,456 admission days and 10,575 discharge days were recorded. All meteorological data were extracted from the database of the Federal Office of Meteorology and Climatology of Switzerland. We estimated the effect of foehn on the BSCL items using a distributed lag model. Significant differences were found between foehn and non-foehn admissions in obsession-compulsion, Interpersonal Sensitivity, depression, Anxiety, Phobic Anxiety, Paranoid Ideation, and General Severity Index (GSI) (p <.05). Our findings suggest that foehn wind events may negatively affect specific mental health parameters in patients. More research is needed to fully understand the impact of foehn’s events on mental health.

On 17 June 2022, the U.S. FDA authorized the Pfizer-BioNTech and Moderna COVID-19 (SARS-CoV-2) vaccines for emergency use in children ages 6 months – 4 years. Seroprevalence has increased during the current Omicron variant wave for children under 5 years and the burden of hospitalization for this age group is similar or exceeds other pediatric vaccine preventable diseases. Research following the October 2021 approval of vaccines for children 5 – 11 indicates high prevalence of parental vaccine hesitancy and low uptake, underscoring the urgency of understanding attitudes and beliefs driving parental COVID-19 vaccine rejection and acceptance for younger children. One month prior to FDA approval, in the present study 411 U.S. female guardians of children 1 – 4 years from diverse racial/ethnic, economic, and geographic backgrounds participated in a mixed method online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Only 31.3% of parents intended to vaccinate their child, 22.6% were unsure, and 46.2% intended not to vaccinate. Logistic regression indicated significant barriers to vaccination uptake including: Concerns about immediate and long-term vaccination side effects for young children, the rushed nature of FDA approval and distrust in government and pharmaceutical companies, lack of community and family support for pediatric vaccination, conflicting media messaging, and lower socioeconomic status. Vaccine-resistant and unsure parents were also more likely to believe children were not susceptible to infection and that the vaccine no longer worked against new variants. Findings underscore the need for improved public health messaging and transparency regarding vaccine development and approval, the importance of community outreach, and increased pediatrician attention to parental concerns to better improve COVID vaccine uptake for young children.

Early disease detection in livestock allows for target treatment decreasing antibiotics use and allow advancements in precision veterinary medicine. MicroRNA (miRNA) -driven signaling cascades play a crucial role in the context of farm animal disease diagnostics and prediction, and their proper understanding remains a challenge. In livestock farm animals, only a small number of miRNAs have been fully validated with respect to disease conditions and physiological or behavioral traits. Low abundance of miRNAs in blood and bodily fluids, along with a small number of nucleotides, makes detection and discrimination tedious and challenging task in. miRNAs usually are homologous, owing to which detection specificity becomes next to impossible when screening for multiple miRNAs in the same analyte sample. Hence, a concurrent, multiplexing, approach becomes crucial for the development of on-farm point-of-care based detection systems. Comprehensive screening methods demand broad dynamic range and enhanced specificity. For on-farm handheld platform development, the ability to screen for multiple varieties of miRNA is essential. In this review paper, I provide an overview of the recent developments of miRNA sensing and the current bottlenecks in the realization of the sensors for detecting miRNAS as target analyte for various livestock disease detection applications. Due to the nascent stages of this research, the possibilities of exploiting miRNAs as a biomarker opens up ways to move from reactive to predictive possibilities in diseases detection in the modern digital livestock farming.

Health self-tracking is an ongoing trend as software and hardware evolve, making the collection of personal data not only fun for users but also increasingly interesting for public health research. In a quantitative approach we studied German health self-trackers (N=919) for differences in their data disclosure behavior by comparing data showing and sharing behavior among peers and their willingness to donate data to research. In addition, we examined user characteristics that may positively influence willingness to make the self-tracked data available to research and propose a framework for structuring research related to self-measurement. Results show that users' willingness to disclose data as a "donation" more than doubled compared to their "sharing" behavior (willingness to donate= 4.5/10; sharing frequency= 2.09/10). Younger men (up to 34 years), who record their vital signs daily, are less concerned about privacy, regularly donate money, and share their data with third parties because they want to receive feedback, are most likely to donate data to research and are thus a promising target audience for health data donation appeals. The paper adds to qualitative accounts of self-tracking but also engages with discussions around data sharing and privacy.

Today, the kennel is considered one of the crucial concerns of the human-animal relationship, since it is very often regarded as animal dump where dogs exile, thus representing a burden on society. Therefore, drawing up strategies for a new “kennel conception”, as an added value for human society, environment, and dogs is still an unmet need. Here, we described the activities of a shelter dog in southern Italy, which faithfully meets criteria aimed at One Health perspective. It normally relies on an initial careful assessment by veterinary behaviorist, in order to guarantee the most suitable life conditions for the animals in the kennels, increase the chances of adoption and enroll them in projects tailored to their predispositions. Accordingly, dogs housed there are normally included in training courses to increase the skills to be used in different human social contexts, like support to the inmates, rescue in the rubble, animal-assisted interventions, as well as zooanthropology educational programs. The main strength for this groundbreaking shelter relies on the environmental protection schedule, where the purposes, employing technically and economically sustainable tools, point towards the continuous improvement and minimization of the environmental impact, promoting joint integrative projects for a sustainable One Health framework.

The ageing transformation of digital health services faces issues of how to distinguish influencing factors, redesign services, and effectively promote measures and policies. In this study, in-depth interviews are conducted and grounded theory applied to open coding, main axis coding, and selective coding to form concepts and categories. Trajectory equifinality modeling clarified the evolution logic of digital transformation. Based on the theory of service ecology, a digital health service ageing model is constructed from the "macro-medium-micro" stages and includes governance, service, and technology transformation paths. The macro stage relies on organizational elements to promote the institutionalization of management and guide the transformation of governance for value realization, including the construction of three categories: mechanism, indemnification, and decision-making. The meso stage relies on service elements to promote service design and realize service transformation suitable for aging design, including the construction of three categories: organization, resources, and processes. The micro stage relies on technical elements to practice experiencing humanization, including the construction of three categories: target, methods, and evaluation. These results deepen the understanding of the main behaviors and roles of macro-organizational, meso-service, and micro-technical elements in digital transformation practice and have positive significance for health administrative agencies to implement action strategies.

The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than do non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with socio-cultural and religious practices. This paper aims to describe how first-or-second generation Pakistani-descent female adolescents, living in Canada, describe their perspectives on developing sexuality and well-being. In addition, this paper explicates female adolescents’ perceptions of their needs to support their sexuality while going through the adolescence stage. Using a qualitative interpretive descriptive design, individual interviews were conducted in combination with drawing timelines. A purposive sample of 21 female adolescents who were first- or second-generation Pakistani-descent was obtained. A thematic analysis approach was used for data analysis. Findings suggest that immigrant female adolescents encounter mental health concerns as a result of confusing messages they received from their parents related to sexuality. Also, discrimination, exclusion from sex education classes, and lack of knowledge on sexual health can result in social exclusion, avoidance of health care, and poor mental health outcomes such as depression and anxiety. These participants related experiences are potentially contributed by the lack of communication with parents about sexuality and lack of health care providers who can understand and speak to their needs and realities as immigrant individuals. Female adolescents expressed their need to break the silence around the topic of sexuality, to have a non-judgemental and blame-free attitude from adults, and for open, honest, and stigma-free conversations. This study provides preliminary qualitative evidence of the interplay between experiences of developing sexuality and overall well-being, particularly psychological wellbeing in female adolescent immigrants. It is crucial to involve, listen to, and incorporate adolescent girls’ voices when planning and implementing interventions to support healthy sexuality among immigrant adolescents.

This study aims to identify factors associated with anxiety levels of adults living in Singapore before the pandemic and during the COVID-19 outbreak. Data were collected using a cross-sectional web-based survey conducted from July to November 2020 accruing 264 eligible participants. Ordered logistic regression was used to assess Generalized Anxiety Disorder-7 (GAD-7), ranked as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21) before the pandemic and during the pandemic. About 74% of participants were female, 50% were aged 25-34, and 50% were married. The GAD-7 level went up from pre-pandemic for both moderate (from 12.5% to 16%) and severe GAD (from 2% to 11%). Alcohol consumption (AOR 1.79, 95% CI 1.04-3.06), loneliness (AOR 1.28, 95% CI 1.05-1.54), and difficulty in switching off social media (AOR 2.21, 95% CI 1.29-3.79) predicted increased GAD-7 levels. The quality of life (AOR 0.84, 95% CI 0.79-0.90) was significantly associated with decreased GAD-7 levels. The results heighten the awareness that early initiation of mental health support is crucial for the population in addition to the various financial support measures provided by the government as they are adapting to live with the COVID-19 pandemic.

Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited to the study. Participants completed an online survey of demographic, current pregnancy, and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for specific phobia, FoB were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis, and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research, to ensure the stability of these findings, is needed.

Antibiotics are in excessive use that has extensively increased antimicrobial resistance worldwide which has become the major public concern among the countries. To control this threat proper monitoring of the antimicrobial usage along with the increasing rate of antimicrobial resistance (AMR) is required. Further, surveillance of both the parameters is highly recommended for comparing the differences in distinct countries. Moreover, alternatives for antibiotics are also surveyed and are being researched for quick use in the near future. AMR is an issue that needs immense attention from various sectors. Thus, intervention of multisector is highly encouraged for better outcomes. One Health is one of the approaches that play a vital role in resolving this issue. In this research paper, six different European countries are discussed in terms of antimicrobial usage and AMR in the human and livestock sectors with the help of literature study and various reports published by different organizations. Data study has been conducted to collect the data for comparison study. Data sources of AMR and antimicrobial usage are analyzed and a thorough comparison of both antimicrobial use and AMR are conducted. Also, the application of One Health is studied for a balanced system. This article provides about various surveillance systems that are formed only to keep a track on the upcoming situation of AMR and the consumption of antimicrobials by the humans as well as animals. The article does not provide about all the details required to monitor the AMR issue but firmly allow the readers to get acknowledged with the broad information about the antimicrobial resistance across the six countries of Europe. The regular data collected by the different organizations play a vital role in monitoring the status of AMR and antimicrobial usage by humans and in live stocks. These annual reports have highly helped the government to decide for alternatives and have focused in many training activities to combat the AMR situation globally. AMR prevention is linked to the One Health concept. As antibiotic resistance genes persist on an interface between environment and animal and animal health, an approach is required in all three areas that stress the concept of 'One Approach to Health.'

Antimicrobial resistance (AMR) is an increasing hazard to human and animal health that necessitates an international response. Surveillance methods in high-income nations aided in the development of measures to combat AMR in animals. Demand for meat is increasing in countries making it critical to implement anti-AMR initiatives. Surveillance of AMR, on the other hand, is at best in its infancy, and the current evidence base for informing policymakers is geographically disparate. All of the isolates had high rates of AMR to medicines that are critical/highly important in human and animal medicine. A higher incidence of AMR was found in poultry farms. Our findings show that AMR, including MDR, is common in coli, Salmonella spp., commonly found in poultry. The study promotes the development of national policies, programs, and additional research based on a "One Health" approach that helps humans and animals, as well as the environment.

Epidemiology of Hymenopteran-related deaths in Europe due to bee, wasp and hornet stings (Cause Code of Death: X23) based on official registers from WHO Mortality Database is described. Over a 23-year period (1994-2016), a total of 1,691 fatalities were officially recorded, mostly occurring in Western (42.8%) and Eastern (31.9%) Europe. The victims tended to concentrate in: Germany (n=327; 1998-2015), France (n=211; 2000-2014) and Romania (n=149; 1999-2016). The majority of deaths occurred in males (78.1%), within the age group of 25-64 years (66.7%), and in an “unspecified place” (44.2%). The X23 gender ratio (X23GR) of mortality varied from a minimum of 1.4 for Norway to a maximum of 20 for Slovenia. The highest X23MR, expressed in terms of annual rates and per million inhabitants, were recorded in countries from Eastern Europe (0.35) followed by Western (0.28), Northern (0.23) and Southern Europe (0.2). The countries with the highest and lowest mean X23MR were Estonia (0.61), Austria (0.6) and Slovenia (0.55); and Ireland (0.05), United Kingdom (0.06) and the Netherlands (0.06), respectively. Country-by-country data show that the incidence of insect-sting mortality is statistically low, but not negligible.

The disruption in healthcare attention to people with alcohol dependence, along with psychological decompensation consequence of lockdown derived from COVID-19 pandemic, could have a negative impact on people who suffers from alcohol abuse disorder. Retrospective observational study of 9,966 men aged ˃16 years registered as having diagnosis of alcohol abuse disorder in the electronic medical records (EMR) of the Aragon Regional Health Service (Spain). Of those who were not infected during the study period (9,576), clinical (Glutamate-oxaloacetate -GOT-, Glutamate pyruvate -GPT-, creatinine, glomerular filtration, systolic blood pressure -SBP-, diastolic blood pressure -DBP-, total cholesterol, LDL, HDL, triglycerides, and body mass index -BMI-), pharmacological (dose per inhabitant per day -DHD- of drugs used in addictive disorders, benzodiazepines and antidepressants) and health resource use variables (primary and specialized care) were considered. Student´s T-test for matched samples was performed. After carrying out the Levene´s test, the Student´s T-test was used to analyze the changes in clinical variables between alcohol abuse disorder patients with and without COVID-19. Only creatinine and LDL show a significant but clinically irrelevant changes just after and 6 months after the end of strict lockdown. The total number of DHDs for all drugs included in the study (except for Benzodiazepines), decreased. In the same way, the use of health services by these patients also decreased. The impact of COVID-19 among this group of patients has been moderate. The reorganization of health and social services after the declaration of the state of alarm in our country, made possible the maintenance of care for this vulnerable patients.

A summer high school baseball tournament is held every mid-summer in Koshien Stadium. “Koshien Baseball” is very popular in Japan; however, it faces the problem of extremely high temperatures during games. Thus, high school players are threatened by the harsh environment. For this reason, Internet surveys were conducted twice to purposefully engage the same individuals. Then, information on their views regarding the Koshien tournament before and after the provision of information regarding environmental change in Japan was gathered. Using data, this study examined how their views changed after having the information. Compared with the view before, it was found that (1) respondents were more likely to agree that the management rule of the Koshien tournaments should be altered to protect player’s health, and (2) the impact of providing information is larger for female respondents, young people, and highly educated respondents.

(1) Background: in epidemiological terms, it has been possible to calculate the savings in health resources and the reduction in health effects of COVID vaccines. From the point of view of economic evaluation, some studies have estimated its cost-effectiveness with the vaccination showing highly favorable results, which in some cases is cost-saving; (2) Methods: a cost-benefit analysis of the vaccination campaign in the North Metropolitan Health Region (Catalonia). An epidemiological model based on observational data and before and after comparison is used. The information on the doses used and the resources assigned (conventional hospital beds, ICU, number of tests) has been extracted from administrative data from the largest Primary Care provider in the region (Catalan Institute of Health). A distinction is made between the social perspective and the health system; (3) Results: the costs of vaccination are estimated at 137 million euros (€48.05/dose administered). This figure is significantly lower than the positive impacts of the vaccination campaign, which are estimated at 470 million euros (€164/dose administered). Of these, 18% corresponds to the reduction of ICU discharges, 16% to the reduction in conventional hospital discharges, 5% to the reduction in PCR tests and 1% to the reduction of RAT tests. Monetization of deaths and cases with sequelae avoided account for 53% and 5% of total savings, respectively. The benefit/cost ratio is estimated at 3.4 from a social perspective and 1.41 from a health system perspective. The social benefits of vaccination are estimated at €116.67 per dose of vaccine given (€19.93 from the point of view of the health system); (4) Conclusions: the mass vaccination campaign against COVID is cost-saving. From a social perspective, most of these savings come from the monetization of the reduction in mortality and cases with sequelae, although the intervention is equally widely cost-effective from the point of view of the health system thanks to the reduction in the use of resources. It is concluded that, from an economic perspective, the vaccination campaign has high social returns.

The production of vaccines of biological origin presents a tremendous challenge for researchers. In this context, animal cell cultures are an excellent alternative for the isolation and production of biologicals against several viruses since they have an affinity with viruses and a great capacity for their replicability. Different variables have been studied to know the system's ideal parameters, allowing it to obtain profitable and competitive products. Consequently, this work focuses its efforts on evaluating an alternative for producing an anti-influenza biological from MDCK cells using SuperPro Designer v8.0 software. The process uses the DMEN culture medium supplemented with nutrients as raw material for cell development; the MDCK cells were obtained from a potential scale-up with a final working volume of 500 L, four days of residence time, inoculum volume of 10%, and continuous working mode with up to a total of 7400 h/Yr of work. The scheme has the necessary equipment for the vaccine's production, infection, and manufacture with yields of up to 416,698 units/h. In addition, it was estimated to be economically viable to produce recombinant vaccines with competitive prices of up to 0.31 USD/unit.

The adoption of health information technology (HIT) has increased considerably, contributing to better communication between physicians and patients and providing technological bases for learning and institutional improvement. This type of technology brings many challenges; therefore, understanding its adoption and assimilation is important to assess its potential for engendering desirable outcomes in health management. The assimilation of health information systems should be highlighted as their importance in health organisations is now recognised as a key facilitator assisting in providing better health outcomes. Thus, this study aimed to analyse HIT adoption based on models such as Technology, Organisation and Environment (TOE), which analyses at the organisational level, with other models, such as the Technology Acceptance Model (TAM), which analyses at the individual level, and the assimilation of the adopted technologies.

Since its adoption in September 2015, the 2030 Agenda has laid the foundations for a model of shared prosperity for a sustainable world. We are going through a complicated pandemic that shows profound inequalities affecting our economies, health, and quality of life. For this reason, our aim in this work is to make known the state of the art of scientific research related to inequality, poverty, and climate change and to propose lines of improvement that can contribute to achieving 3 of the 17 SDGs (End poverty-SDG 1-, Reduce inequality-SDG 10-, and Climate action -SDG 13-), proposed in the 2030 Agenda. To do so, we have used a systematic literature review methodology. The results show that poverty, inequality and climate change is a subject that has been little studied and articulated by researchers, with significant differences between the different areas studied. Topics related to sustainability and economics are those with the highest number of publications (51.7%). The rest are distributed among the 12 existing departments. Another relevant finding is that the effects of climate change are more pressing for more vulnerable populations, including impoverished women from rural areas and children from underdeveloped countries. This is a gender and social inequality that has been little addressed in climate change studies. Food security and energy poverty is another under-exploited aspect in this area. According to the results obtained in this work, we consider that the circular economy could improve these indicators, constituting a line of future research. Thus, one of its main objectives is to eliminate negative externalities, specifically existing social inequalities within the current linear economy model.

Physical inactivity increases the risk of many adverse health conditions, including the world’s major non-communicable diseases, such as coronary heart disease, type 2 diabetes, and breast and colon cancers, shortening life expectancy. There are minimal medical care and personal trainers’ methods to monitor a patient’s actual physical activity types. To improve activity monitoring, we propose an artificial-intelligence-based approach to classify the physical movement activity patterns. In more detail, we employ two deep learning (DL) methods, namely a deep feed-forward neural network (DNN) and a deep recurrent neural network (RNN) for this purpose. We evaluate the proposed models on two physical movement datasets collected from several volunteers who carried tri-axial accelerometer sensors. The first dataset is from the UCI machine learning repository, which contains 14 different activities-of-daily-life (ADL) and is collected from 16 volunteers who carried a single wrist-worn tri-axial accelerometer. The second dataset includes ten other ADLs and is gathered from 8 volunteers who placed the sensors on their hips. Our experiment results show that the RNN model provides the accuracy performance compared to the state-of-the-art methods in classifying the fundamental movement patterns with an overall accuracy of 84.89% and an overall F1-score of 82.56%. Our results indicate that the proposed method will provide the medical doctors and trainers a promising way to precisely track and understand a patient’s physical activities for better treatment.

Magnetic sensors are widely used in health management systems for turbomachinery, but their applications in the hot zone are limited due to the loss of magnetic properties by permanent magnets with increasing temperature. The paper presents and verifies models and design solutions aimed at improving the performance of an inductive sensor for measuring the motion of rotating objects operating at elevated temperatures (200-1000C), such as compressor and turbine blades. Physical, analog and mathematical models of the interaction of blades with the sensor were developed. A prototype of the sensor was made and its tests were carried out on the RK-4 rotor rig for the speed of 7000 rpm, in which the temperature of the sensor head was gradually increased to 1100C. The sensor signal level was compared to that of an identical sensor operating at room temperature. The heated sensor works continuously producing the output signal whose level does not change significantly. What is more, a set of six probes passed an initial engine test in an SO-3 turbojet. It was confirmed that the proposed design of the inductive sensor is suitable for blade health monitoring of the last stages of compressors, steam turbines as well as previous generation gas turbines operating below 1000C, even without a dedicated cooling system. In real-engine applications, sensor performance will depend on how the sensor is installed and the available heat dissipation capability

Health and wellness tourism should be particularly valued in the post-pandemic phase, as a stra-tegic product to enhance the population's well-being and quality of life indicators, at social, phys-ical, and environmental dimensions, with different proposals for specialized experiences that complement the destination's offer, positioning regions as health and wellness destinations. Thermal tourism should be encouraged, as a specific product, due to the innovation and diversi-fication observed in the services made available and the benefits recognized at different age levels of tourists and destinations communities. Considering the relevance of thermal springs and thermal tourists for tourism destinations image, positioning, and development, this research aims to identify the specific motivations of tourists to the practice of thermal tourism, to understand how the benefits that thermal tourists search for, and their sociodemographic profile influence the motivations, and how the motivations determine the travel characteristics. This research was de-veloped on the North and Centre of Portugal, for their relevance in the context of thermal springs and related tourism activities. To achieve the research objectives, a questionnaire survey was ap-plied to thermal tourists, through a non-probability by convenience sampling, using bivariate tests, such as Pearson’s chi-squared test, one-way ANOVA, and t-student. The results highlight that most respondents practiced thermal tourism due to leisure and relaxation benefits, such as the escape from daily stress, spend time with family, and being "pampered"; relaxation is the most valued motivation, followed by the search for psychological and physical wellbeing. The research found relations between the benefits expected by thermal tourists, and their travel characteristics such as the composition of the group, the general travel motivation, the thermal destination cho-sen, and the number of nights spent. In thermal tourism, new challenges emerge, demanding the development of strategies, products, and services responding to the needs of specific market segments.

Concurrent waves of Coronavirus disease, Ebola virus disease, avian influenza A and black fungus are jeopardizing the lives in some parts of Africa and Asia. From this point of view, this review aims to summarize both socio-economic and public health implications of these parallel outbreaks along with their best possible management approaches. Various online databases were used to collect the necessary information regarding these outbreaks. Based on the reports published and analyses done so far, the long-lasting damages caused by these simultaneous outbreaks on global socio-economical and public health status can be conceived from the past experiences of outbreaks, especially the COVID-19 pandemic. Moreover, prolonged restrictions by the local government may lead to food insecurity, global recession, and an enormous impact on the mental health of people of all ages, specifically in developing countries. Such overwhelming effects already have been reported to be declining national growth of the economy as well as increasing political insecurity and shortage of basic needs. Although various actions have already been taken including vaccination, clinical management, and further research, social distancing, and lockdown, etc. to improve the situation, the emerging variants and associated genetic mutations may make the containment difficult worsening the situation again. Considering the current mutational dynamics of the pathogens and the past experiences, perpetual preparedness along with updated clinical management backed by epidemiological studies and innovating scientific effort are inevitable to combat the simultaneous waves of multiple infectious diseases.

Brain, the most complex object known in the universe, uses few watts of power. To mimic it a nuclear power plant will be required and this power house controls the human body, single handedly. Surprisingly, “On the left side, nothing is right and on the right side there is nothing left”. Typically, there are two lateral halves of the brain: Left hemisphere and right hemisphere working distinctly. Left hemisphere is inclined towards logic; Right hemisphere is the root cause of imagination added with critical thinking. In situations like the current pandemic, COVID-19, it is the right half which tends to dominate the processing. This gives birth to mental stress, anxiety thus, aggravating the existing medical condition. Considering this pattern, a survey was conducted in Durg district of Chhattisgarh, which is one of the most hard hit epicentre of the COVID-19 second wave in India. According to this survey, it was revealed that largely women of all age groups (10-25, 26-40, 40 above) were right brained i.e. dominance of right over left hemisphere. Being more imaginative and creative thinkers they are more likely to suffer from mental issues than males. The aim of this research is to improve the mental wellbeing of the citizens in such threatening conditions. To prevent this situation awareness is a must and some stress relieving games have also been created.

The La Oroya metallurgical complex reveals a process of structural or power pathology, where economic and environmental social policies lead to a citizenry without systemic freedom, characterized by environmental contamination (PAMA executed on average 67%, some processes with 0%) and sanitary (plumbosis 8.39 to 10.28 μg / dL), the economic dependence of this industry is also observed, which caused the weakening of the communities to maintain autonomy over their own destinies.The Doe Run Peru, operated the metallurgical complex, creating added value to the extractive-export chain of mineral concentrate, but also took advantage of the legal loopholes, the little coordination between the State institutions and the little authority of the supervisory institutions to get the most out of it, complying with the law in some cases, but without moral quality in some others, such as health in the oroinos.Government institutions must have strong links that provide a normative framework with prospects with sustainable development, where the beneficiary is society and not only certain interest groups. The economic benefits of the metallurgical complex operation are multiple, which begin with labor, the purchase and sale of materials and services, the collection of taxes and energy.

The aim of this systematic review and meta-analysis is to evaluate the prevalence of depression, anxiety, insomnia, stress, PTSD, and distress in Chinese healthcare workers (HCWs) and the changes in prevalence before and after the peak incidence of COVID-19 in China. 20 cross-sectional studies assessing the aforementioned psychological outcomes were included. Eligible studies were searched from the following databases: PubMed, Scopus, and Web of Science. Comparative analysis based on the time period of the included studies was conducted to assess changes in prevalence before and after peak incidence. Additionally, subgroup analyses based on study quality, province, survey tools, gender and healthcare profession, frontline or non-frontline working status, and severity of psychological outcomes were conducted to evaluate the prevalence of outcomes across various study methods, geographic regions, and professions. The findings of this study suggest that the overall prevalence of depression, anxiety, insomnia, stress, PTSD, and distress before peak incidence were 36.2%, 34.2%, 22.4%, 31.3%, 9.8%, and 56.7% as opposed to 31.8%, 24.1%, 34.4%, 59.0%, 20.9%, and 40.7% after the peak. The higher prevalence of depression, anxiety, and distress prior to the peak incidence of COVID-19 in China and of insomnia, stress, and PTSD thereafter serve as evidence that the mental health decline of HCWs is dynamic and should be addressed with adaptive approaches that provide tailored treatments.

Aiming the characterization of road dusts on the surrounding villages of an active mine and to assess metal(loids) bioaccessible fractions, a dust samples survey was undertaken. To achieve these objectives, pseudototal element concentration, mineralogical composition, Enrichment factor and in vitro extraction UBM assay for both gastric (G) and gastrointestinal (GI) phases, were determined. Results obtained revealed that arsenic represents the higher risk to humans, with mean pseudototal values higher than the maximum reference value range. Enrichment factor points to As significant to very high enrichment in all villages. Particles enriched in As, Ca, Fe, Cu, Al, Ti were identified by SEM-EDS in weathered agglomerates, linked to mine wastes and long-distance transport, both by wind and/or traffic. Arsenic bioaccessibility fraction (%BAF) presents low values in the studied samples, possibly due to low Fe complexes solubility with adsorbed As, limiting arsenic release and reducing its bioaccessibility. Concentrations of Cd bioaccessible G and GI phases are within the reference values range, while for Cu are above and for Pb are lower, than reference value range. Results show that the pseudototal fraction risk is overestimated when comparing to BAF (bioaccessible fraction), nevertheless, total G and GI risk are above the carcinogenic target risk (1.00E-06) in most samples. Carcinogenic risk of the bioaccessible contaminants shows that As is the element that represents higher risk for developing cancer over a lifetime, being ingestion the main risk route.

This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to synthesizes the existing literature with a goal to review current conceptual frameworks of mental health of forced migrants for further practice research priorities in social work. The search was done between January 2015 to January 2021. As a result, 29 studies met inclusion criteria. Medicalizing mental health issues by relying solely on the effectiveness of medicine was a controversial risk factor that negatively affected the daily life activities of refugees and reduced their willingness for seeking professional mental health services. Empowering vulnerable minorities by giving them back their power and agency to be able to speak for themselves and raise voices of trauma and recovery was the missing protective factor for sustainable mental health practice. The benefits of group-based interventions are highlighted in which communities and individuals address mental health issues as well as isolation through building collective identities and support networks. Information and communication technologies (ICTs) can add more strength to any kind of mental health intervention. Finally, the benefits of applying ecological perspective for the mental health of refugees, and its implications for a sustainable intercultural practice are discussed. Social workers in this model are the representatives of at-risk groups, thus need more agency and creativity in reflecting client’s concrete needs.

This study examined the effect of an educational hybrid physical education (PE) intervention on cognitive performance and academic achievement in adolescents. A 9-month group-randomized controlled trial was conducted in 150 participants (age: 14.63 ± 1.38) allocated into control group (CG, n = 37) and experimental group (EG, n = 113). Inhibition, verbal fluency, planning and academic achievement were assessed. Significant differences were observed in the post-test for cognitive inhibition, verbal fluency in animals, and the average from verbal fluency in favour of the EG. With regard to the intervention, verbal fluency in animals, verbal fluency in vegetables, the average of verbal fluency, cognitive inhibition, language, the average of all subjects, the average of all subjects except PE, and the average from the core subjects) increased significantly in the EG. The last five variables (the academic ones and cognitive inhibition) also increased in the CG, in addition to mathematics. This study contributes to the knowledge by suggesting that both methodologies produced improvements in the measured variables, but the use of a hybrid program based on TPSR and gamification strategies produce improvements in cognitive performance, specifically through the cognitive inhibition and verbal fluency.

In the ongoing Covid-19 pandemic, if a preventive restriction (PR), intended to arrest the transmission of the virus, is effective we expect a decrease in the rate of transmission. If an effective PR is lifted or relaxed, the rate may show some increase. We test this expectation in the history of PR imposition and relaxation in all countries based on available public database. We found marginal or no negative correlation between standing stringency index of PR and change in slope of the local curve. A change in stringency index was significantly negatively correlated with change in slope, but change in stringency of PRs could explain only 6.1 percent of the variance in rates of transmission. The distribution of slope changes after imposing versus after relaxing PRs was highly overlapping with only a tail consisting of 4.5 % PR impositions being clearly non-overlapping with PR relaxation. Non-parametrically, only 9.4% of PR impositions were associated with a reduction in the slope above the expectation of a null hypothesis. In brief, globally, preventive restrictions have played a very small role in the pandemic process over the one year period. This feedback needs to be considered in making policy for disease prevention in the further course of the pandemic as well as in any future threats of respiratory disease epidemics.

Objective: (1) Describe the current literature on the relationship between EDS and SEP and (2) provide recommendations for consideration of SEP in sleep medicine and biomedical research. Methods: Databases Medline/Pubmed, Web of Science, Google scholar and Scopus were screened using PRISMA guidelines and 19 articles were included in the final synthesis. Results: All studies were cross-sectional. Among these studies, 21.05% (n = 4) are focused on children and adolescent and the lasting 88.95% (n = 15) focused on adults and old people. Age ranged between 8 and 17 years old for children/adolescent and ranged from 18 until 102 years old for adults. Main SEP measures presented in these studies were education, income, perceived socioeconomic status and employment. Sample size in these studies varied from N = 90 participants until N = 33865 participants. Overall, a lower educational level, a lower income and full-time employment were associated with EDS. EDS symptoms are prevalent in women, especially those with a low income or no job; and children and adolescents with difficult living conditions or people working part-time reported more sleep disturbances. Conclusions: SEP is already considered as an important determinant for many health outcomes, but if SEP is embedded in experimental design in psychosomatic research, biomedical research and clinical practice as a constant variable regardless of outcome; it will move forward future investigations.

Breast self-Examination (BSE) is the cheapest most recommended Breast Cancer (BC) preventive tool for resource-deprived settings. There is paucity in the attitude research domain and comparative gender assessments of the BSE knowledge, attitude and performance (KAP) literature. Purpose: The purpose of this study was to assess the combined and exclusive gender BSE attitude of undergraduate health trainees and to determine significant differences between scores of both genders. Methodology: participants included 5 undergraduate health trainee classes purposively sampled from 2 faculties. Online cross-sectional method was used to assess BSE attitude of 336 purposively sampled Kwame Nkrumah University of Science and technology (KNUST) College of Health Sciences (CoHS) students. Data was analyzed using descriptive and inferential statistical analyses. Main findings: Compared to the construction groups’ average norm of 101.17 (SD = 9.55), our study participants’ (SPs) BSE attitude was lower (92.51; SD = 11.80). However, using popular mid-point and 3- part attitude scoring methods, our SPs’ attitude scores were comparable to sub-regional and national findings. Moreover,the male participants scored a generally high BSE attitude but significantly lower compared to their female counterparts (p < 0.5). Recommendations: There is the need to adjust the curriculum of all health trainees in developing nations to reflect relevant BC preventive measures. Furthermore, BSE research, education as well as advocacy should involve more males as important BC BSE stake holders.

The functioning of the parents’ emotional sphere is very important to a child’s mental and physical health. This study focused on investigating the association between mothers’ emotional intelligence (EI) and paediatric type I diabetes (T1DM) disease management in their children. We hypothesized that mothers’ EI is associated with T1DM outcomes. Mothers of children with T1DM aged 6-12 years were surveyed. One hundred and thirty-four mothers, the main caregivers of their diabetic children, provided measures of EI and completed a demographic questionnaire. The primary indicator of diabetes management was haemoglobin A1c (HbA1c; the main form of glycosylated haemoglobin). EI scales and subscales were associated with glycaemic management indices. Logistic regression analysis was applied for the assessment of the association between parents’ EI and their paediatric with T1DM disease management. The analysis demonstrated a statistically significant correlation between T1DM management and mothers’ ability to understand and control own emotions, to transform their own negative emotions into positive and to control own negative emotions. Mothers’ EI scales and subscales of understanding and regulating their own emotions, subscales of transforming their own negative emotions into positive ones and controlling their own negative emotions were statistically reliable predictors of glycaemic control in children with T1DM.

Sustainable Development Goals (SDGs) envisaged under Agenda 2030 are a set of seventeen goals which envisage a holistic approach towards attaining certain targets keeping humankind and the planet at center. There are total 169 targets spread across seventeen goals covering wide ranging issues and challenges the world is facing in the twenty-first century. And they are to be achieved by 2030. Concerted efforts of all the stakeholders ranging from indigenous communities, common citizens, scientists, policy makers, world leaders are needed to achieve all the goals and targets Of the seventeen goals, at least seven goals are of interest to the ethnobotanists and are associated with traditional ethnobotanical knowledge. Therefore to achieve those set of goals, a thorough understanding is required to disentangle the intricacies involving traditional ethnobotanical knowledge, indigenous people as traditional knowledge holders and their future role. Understanding relationships between traditional ethnobotanical knowledge and indigenous communities, seeking cooperation from and establishing partnerships with them would help us design policies to achieve intended outcomes of SDGs. In this paper, particular attention is attracted towards the potential role of traditional ethnobotanical knowledge in achieving select sustainable development goals and targets.

Objective: We tested a model of individual health literacy information sharing with family members, personal preventive behaviours and family well-being during the Coronavirus Disease 2019 (COVID-19) pandemic in Hong Kong. Methods: We analysed data of 1501 randomly selected Chinese adults from a cross-sectional survey in Hong Kong from 9 to 23 April, 2020. Individual health literacy about COVID-19 with the items extracted from the questionnaire in World Health Organization Risk Communication and Community Engagement (RCCE) Action Plan Guidance for COVID-19 preparedness and response, COVID-19 information sharing with family members, preventive behaviours against COVID-19 and family well-being were measured. Structural equation modelling analysis tested the proposed model. Findings: COVID-19 information sharing with family members partially mediated the association between individual health literacy and personal preventive behaviours. The direct effect of 0.24 was shown, and the indirect effect through COVID-19 information sharing with family members was small at 0.03 (Z = 3.66, p < 0.001). Family well-being was associated with personal preventive behaviours against COVID-19. The model was adjusted for sex, age, and socioeconomic status factors and had good fit with RMSEA = 0.04, CFI = 0.98, TLI = 0.96, and SRMR = 0.02. Conclusion: COVID-19 information sharing with family members was a partial mediator between individual health literacy and personal preventive behaviours against COVID-19. Strategies for enhancing health literacy and preventive measures against COVID-19 are needed to promote family well-being in the pandemic.

Frequent employee resistance to innovation is one of the main barriers of change failure in a health care organization and one of the negative stimuli of employment relationships. Identifying the reasons of resistance is a topical issue for every organization, as the speed of change can affect their competitiveness. Consequently, it is helpful not only to know the causes of potential resistance but also to be ready to control any implicit opposition. The organizational climate and the attitude of the staff play an important role in understanding and accepting innovation. Purpose of the study is to develop a model, which would facilitate the choice of an appropriate strategy necessary to enable the health care organization to eliminate or at least to reduce resistance to often essential innovative changes. The article analyses the root causes of resistance and identifies strategies that help to mitigate or eliminate staff resistance for innovation. Use of suggested model can make easier reducing staff resistance to change processes and thus speed up the implementation of innovations. This methodology can be used to eliminate the reasons for staff resistance to change in health care institutions of different countries, but it was tested in Lithuania and achieved good enough results.

COVID-19 pandemic and its restrictive measures have present serious unprecedented challenges to human eating behavior. Given that Google Search has become a valuable information resource to examine, predict, and estimate human online interests and behavior, that somehow linked to real people concerns. This study aimed to investigate the features and evaluate the impacts of the COVID-19 pandemic and its lockdown on consumer worldwide interest in eating behavior and its related factors. Google Trends-Relative Search Volumes (RSV) of distinct keywords related to eating behavior, were obtained from a timeframe before and during the COVID-19 pandemic, from January 1, 2018, to December 13, 2020. During the global lockdown from March 11, 2020, to June 30, 2020, RSV curves exhibited a short-term fluctuation of interest in multiple keywords related to eating behavior and its related factors such as food purchasing, food security, food poisoning, panic buying, stocking up, health awareness and mental illness. Spearman’s correlation analysis showed a strong correlation between daily confirmed cases and examined keywords. Univariate repeated measures ANOVA following with Bonferroni Post-hoc test revealed that during the year with the presence of COVID-19 pandemic, people worldwide pay more concerns in each keyword (1) environmental and economic factors (unemployment: +269%, food shortage: +180%, food bank: +50%); (2) health- and food-safety concerns (immunity: +138%, vitamin C: +90%, vitamin D: +55%, zinc: +47%, food storage containers: +40%, food packaging: +31%); (3) food choices and interest (local meat: +84%, frozen food: +67%, CSA: +65%, flour: +66%, bread: +53%, soybean oil: +45%, local fruit: +43%, canned tomato: +42%, refrigerated food: +41%, canned meat: +39%, pancake: +37%, cookie: +29%, butter: +29%, canned fish: +29%, liquior: +20%); (4) social and individual factors (take-out: +128%, deliver: +53%), (6) lifestyle factors (stationary bicycle: +110%, dumbbell: +89%, yoga mat: +84%, treadmill: +65%, grocery store: +51%); (6) psychological factors (isolation: +113%). COVID-19 pandemic and its lockdown have had far-reaching effects on global concerns in many factors related to human eating behavior. Swift action is necessarily performed to strengthen the resilience of the food supply chain system, support and adapt to the new normal behavior, and mitigation the profound negative changes, especially targeting those in high-risks and vulnerable groups and food-insecure regions.

The COVID-19 pandemic caused by SARS-CoV-2 has been showing a speedy growth in the number of infected patients with a remarkable mortality rate, thus it has become a worldwide public health concern. From March 8, 2020, the disease was confirmed to start spreading in Bangladesh. Since then, people got infected so exponentially that the country positions at the list of top infected countries in the world. Therefore, the objective of this comprehensive review was representing overall scenario of COVID-19 in different sectors of Bangladesh, particularly prioritizing the health sector. Up to 14 September 2020, 339,332 confirmed cases and 4,759 deaths were reported. An alarming fact is that while the global mutation rate of coronavirus is 7.23 % in average, the rate is 12.6 % in Bangladesh. Although the government ruled preventive strategies such as nationwide lockdown, social distancing, contact monitoring, quarantine and isolation, it was difficult to implement those due to lack of public awareness, inappropriate attitudes and so on. Moreover, the overburdened healthcare system had a weak response at initial stage because of insufficient healthcare facilities. Consequently, this pandemic affected severely almost all the important sectors of the country, specifically the economy, agriculture and health sectors. Hence, focusing on healthcare system as well as maintaining social distance and other essential precautions can limit the spread of infection and help to alleviate the severity of the pandemic.

Purpose: A novel coronavirus, SARS-CoV-2 was identified as the cause of COVID-19 eventually led to the declaration of Public health emergency of international concern and a pandemic by WHO due to its exponential global spread. Present study was conducted to investigate the impact of second wave of pandemic on mental wellbeing and social behaviors among university students of Pakistan during this crucial period of COVID-19 infection. Methods: A cross-sectional analytical study was designed to evaluate the psychosocial impact during the current COVID-19 outbreak among the students of The Islamia University of Bahawalpur, Pakistan. Snowball sampling or chain referral sampling procedure was adopted to recruit the participants in the study. Verbal informed consent was taken from all participants before recruitment in the study irrespective of their gender, age and socioeconomic status. Results: Mental health of university students during COVID-19 epidemic was affected to a varying degree revealing that 26.66% were recorded to have mild, 27.15% moderate and 17.04% suffering from severe anxiety out of total 1029 students. Students who were residing in urban areas with parents and having a steady family income were negatively associated and found protective factors against anxiety. However, having a relative or an acquaintance infected with COVID-19 was an independent risk factor for experienced anxiety. Positively associated factors with the level of anxiety symptoms included economic stressors, effects on daily-life, and academic delays whereas social support was negatively correlated with anxiety in COVID-19 related stressors. Conclusion: Public health emergencies and such pandemic are exerting serious psychological impacts on university students. It is recommended that the higher authorities should plan better policies to reduce this impact for the provision of high quality and timely crisis-oriented psychological services to university students.

The present study is aimed to determine the predicting role of objective (lifestyle) and subjective factors of middle-aged women’s psycho-emotional health such as their attitude towards parents, attachment and separation types. Women who are overloaded with professional and family roles have high stress level, their indicators of psychological well-being and emotional level decrease when they have to give everyday care to their elderly parents. (2) Methods: Sample consists of 146 women aged 38 to 56 ( =41.1, ó=3.5), married (70.5%) and divorced (29.5%), having children of 14-28 years old; giving everyday care to elderly parents for more than 1.5 yrs. Some live separately (62.3 %), or have to cohabitate with parents (37.7%). All women evaluate their life situation as difficult and manifest signs of high psycho-emotional stress. We used methods adapted for the Russian-speaking sample: getting socio-demographic information, an interview; Attachment style and Interpersonal Guilt Questionnaires (study 1); Psychological Separation Inventory, Purpose-in-Life Test, projective methods of incomplete sentences and metaphors` analysis (study 2), mathematical statistics. (3) Results: A number of factors and indicators of women`s psycho-emotional health decrease in the situation of role overload have been identified. Among the factors there are four main types of women’s attitudes towards parents: strong (anxious), distancing, ambivalent, normative closeness, predicting low indicators of psycho-emotional health: dependence on the others` opinions and feedbacks in making decisions, a lack of meaningfulness of life; reduced sense of control over life are showing the decrease. Anxiety about future and neurotic symptoms (increased demands on oneself, irritability, reduced emotional background) distinguish these respondents. (4) Conclusions: The study confirms that middle-aged Russian women`s psycho-emotional health depends on contextual factors (difficult role-overloaded lifestyle) and factors integrating women`s attitudes towards parents, attachment and separation types. Among the most important risk factors there are a difficult life situation, conflict separation type and gilt.

Background: We aimed to assess the association between DII and PD and the mediation effect of DII in the association of PD with systemic inflammation. Using the National Health and Nutrition Examination Survey (NHANES) 2009-2010, 2011-2012 and 2013-2014, participants that received periodontal exam and provided dietary recall data were included. The inflammatory potential of diet was calculated via DII. Periodontitis was defined according to the 2012 case definition. The clinical outcomes of interest were mean periodontal probing (PPD), mean clinical attachment loss (CAL) and thresholds of PPD and CAL. White blood cells (WBC), segmented neutrophils and C-reactive protein (CRP) were used as proxies for systemic inflammation. The periodontal measures were regressed across DII values using adjusted multivariate linear regression. Adjusted mediation analysis appraised the influence of DII in the association of periodontitis and systemic inflammation. 10,178 participants were included. DII was significantly correlated with mean PPD, mean CAL, thresholds of PPD and CAL, WBC, segmented neutrophils and DII (p&lt;0.01). A linear regression logistic adjusted for multiple confounding variables confirmed the association between DII and mean PPD (B = 0.02, Standard Error [SE]: 0.02, p&lt;0.001) and CAL (B = -0.02, SE: 0.01, p&lt;0.001). The association of mean PPD and mean CAL with both white blood cells and segmented neutrophils were mediated by DII (from 2.1 to 3.5%, p&lt;0.001). In the 2009-2010 subset, the association of mean CAL with serum CRP was mediated by DII (52.0%, p&lt;0.01). In conclusion, inflammatory diet and PD may be associated. Also, the inflammatory diet significantly mediated the association of leukocyte counts and systemic inflammation with periodontitis.

Obesity is a serious problem of our society. A long-term positive trend in body weight gain continues to persist. Paediatric obesity arises from a changed lifestyle of children, characterised by an important restriction of their spontaneous physical activity. A lack of physical activity is one of the most important causes of paediatric obesity associated with a number of serious disorders. The paper evaluates the effect of physical activity on obesity in second stage pupils of elementary schools in the region of Ústí nad Labem. In their research survey, the authors determine the incidence of obesity and overweight as well as the relationship between physical activity and obesity in second stage pupils of elementary schools in the region of Ústí nad Labem. The data collection was based on questions of the CAV 2001 questionnaire and BMI-for-age. As revealed by the research survey, problems with obesity and overweight are present particularly in boys. Only a third of boys and girls engage in sufficient physical activity. At the same time, differences were shown in the study group where groups with higher BMI values had lower values of physical activity. Subsequently, a relationship was shown between those who use their bicycle as a means of transport and spend their leisure time bicycling at the same time. More than two thirds of the study subjects reported using a bicycle as a means of transport and using their bicycle in their leisure time as a means of being active; 93% of these subjects had normal body weight. Our results confirm the continued pandemic prevalence of obesity and indicate that appropriate physical activity should be included in the everyday life of children both at school and outside of school.

Understanding tourist behaviour during and after major tourism crises is essential to help destinations recover. The COVID-19 pandemic, a period of uncertainty and risk, makes it relevant to assess factors that influence travel intentions. There has been little research on tourist behaviour during health crises and, in particular, on perceived health risk and uncertainty effects on travel intentions. This study was carried out during the first months of the pandemic in Brazil and aims to investigate the role of health risk perception and intolerance of uncertainty on travel intentions for 2020 and 2021. We applied an online survey to 1,150 Brazilian participants from March to May of 2020. Our findings indicate that perceived COVID-19 severity, perceived probability of contracting it, and expected pandemic duration are significant predictors of travel intentions for both years. This paper sheds new light on tourist behaviour in the context of global health crises.

(1) Background: A global pandemic due to COVID-19 emerged in November 2019 and hit France in early March 2020. It not only resulted in a loss of lives but also in very strict confinement measures. The objective of this study was to understand what the determinants of the change in participants’ behavior and mental state were during the confinement. (2) Methods: An online survey was launched on April 23rd, 2020, and closed on May 7th, 2020. The final sample included 1454 participants from 24 to 65 years old. Descriptive and multivariate analyses were then performed. (3) Results: 28.7% reported having a more balanced diet, against 17.1% with a less balanced diet. 22.7% of respondents reported an increased alcohol consumption, as opposed to only 12.2% declaring a decrease and 11.2% of respondents increased their tobacco consumption, while 6.3% decreased it. 50.6% of the participants reported being more depressed, stressed, or irritable since the beginning of the lockdown. Confinement had a negative effect on every behavior studied in this survey, except for nutrition. We also found that negative mental state changes were strongly associated with nutrition, sleep, physical activity, and alcohol consumption changes.

Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011-2013) suggested that 58% of one-year-old children had BLLs > 50 ug/L. We aimed to investigate the prevalence of elevated BLLs (>50 µg/L and >100 µg /L) among 425 of these children at six-years-of-age in 2016-18 and to compare BLLs between age one-year and six-years and study sources of lead at six years. BLLs were analyzed by inductively coupled plasma mass spectrometry. Multiple linear regression and quantile regressions were used to study potential sources of lead. The prevalence of BLLs >50 µg/L in children was 59.5% [Geometric Mean (GM) 56.4 µg/L, 95% CI: 54.1 - 58.7] at six years of age compared to 54.8% [GM 56.5 µg/L, 95% CI: 53.4-59.6] at one year of age. The prevalence of children with BLLs >100 µg/L decreased from 14.4% at one year of age to 8.2% at six years of age. After adjustment for all other covariates, consumption of peanut more than once per month was significantly associated with a 22.0% (95% CI: 4.6, 42.5) increment in BLLs at six years compared with no consumption. Consumption of bushmeat killed by lead bullets at six years was associated with an increase in the higher percentiles of BLLs (P75) compared with the absence of this source. Other potential sources of lead associated with BLLs with marginal significance were consumption of rice, paternal occupational exposure, and the presence of activity with the potential use of lead. This prospective cohort confirms the persistently high prevalence of elevated BLLs in children residing in a rural region in the south of Benin as well as the presence of multiple and continuous sources of lead. These results highlight the need for prevention programs to reduce and eliminate lead exposure in children.

The current global COVID-19 pandemic is compounding on populations susceptible to tropical illnesses like dengue in different developing countries like Bangladesh. The growing concern is that Bangladesh is a dengue-endemic zone and the peak transmission occurs in the monsoon season (June to October). In the most recent monsoon, a total of 354 dengue cases have been confirmed until 27^th July 2020, data-driven from only 41 hospitals alone. A fifty-three-year-old male patient was found to be co-infected with COVID-19 and dengue fever. Concerns arise as hospitals are increasingly denying to admit the patients. Moreover, reports of the false-positive results in dengue screening tests recorded in different countries further exacerbate the issue. These conditions could postpone the early diagnosis of COVID-19 cases and aggravate the situation. In addition, the overwhelming wave of the dengue cases would be a challenge for the vulnerable health care system of the country which is already under strain due to the COVID-19 pandemic. Failure to establish and implement proper policies might lead to the dengue outbreak with the burdens of the concurrent COVID pandemic, resulting in the collapse of the health and social system, as well as the economic growth of the country.

Background: The associations between long-term exposure to particulate matters (PM) in residential ambiance and obesity are comparatively less elucidated among young adults. Methods: Using 2017 Community Health Survey data with aged 19−29 participants in 25 communities, Seoul, the relationship between obesity and long−term PM10 levels of living district was examined. We defined obesity as overweight (25≤BMI&lt;30) or obese (30≤BMI) using Body Mass Index (BMI) from self-reported anthropometric information. Analysis was conducted sampling weighted logistic regression models by fitting municipal PM10 levels according to individual residence periods with 10 years and more residing in a current municipality. Socio-demographic factors were adjusted over all models and age−specific effect was explored among aged 19–24 and 25–29. Results: Total study population are 3,655 [men 1,680 (46.0%) and aged 19–24 1,933 (52.9%)] individuals. Among the communities with greater level of PM10; 2001–2005, associations with obesity were increased for overall with residence period; 10 years ≤ [Odds ratio, OR 1.071, 95% Confidence interval (CI) 0.969–1.185], 15 years ≤ [OR 1.118, 95% CI 1.004–1.245], and 20 years ≤ [OR 1.156, 95% CI 1.032–1.294]. However, decreased associations were detected for PM10; 2006–2010, and age–specific effects were modified according to the residence period. Conclusions: Although currently PM10 levels are decreasing, higher levels of PM10 exposure at the residential area during the earlier life-time may contribute in increasing obesity among young adults.

This paper discusses the potential and limitations of the Normalized Difference Vegetation Index (NDVI) in environmental justice, health and inequality studies in urban areas. Very often the NDVI is correlated with socioeconomic and/or sociodemographic data to demonstrate the inequality in environmental settings that themselves influence individual health and questions of environmental justice. This paper addresses the limits of the NDVI for such applications and as well its potential, if applied properly. The overall goal is to make people of disciplines other than those that are geo-related aware of the characteristics, limits and potentials of satellite image-based information layers such as NDVI.

In many developed countries, mental health disorders have become problematic, and the economic loss due to treatment costs and interference with work is immeasurable. Therefore, we developed a method to assess individuals’ mental health using emotional components contained in their voice. We propose two indices of mental health: vitality, a short-term index, and mental activity, a long-term index capturing the trends in vitality. To evaluate our method, we used the voices of healthy individuals (n = 14) and patients with major depression (n = 30). The patients were also assessed by specialists using the Hamilton Rating Scale for Depression (HAM-D). A significant negative correlation existed between the vitality extracted from the voices and HAM-D scores (r = -0.33, p &lt; .05). We could discriminate the voice data of healthy individuals and patients having depression with a high accuracy using the vitality (p = .0085, area under the curve = 0.76). Further, we developed a method to estimate stress through emotion instead of analyzing stress directly from voice data. By daily monitoring of vitality using smartphones, we can encourage hospital visits for people before they become depressed or during the early stages of depression, to prevent adverse consequences of depression.

Low levels of physical activity (PA) and sedentarism are associated with the onset of different pathologies and health problems. Regular physical activity has been linked with being beneficial to the health of the general population. Within this framework of analysis, the aim of the present study is to analyse the existing association between the time spent doing physical activity and the expressed motives for doing so, from which the first innovative aspect of the paper emerges: the use of the time spent doing PA as a study variable of the phenomenon. The data analysed come from the latest special Eurobarometer survey about the sport and physical activity done in Europe. Using an exploratory factorial analysis and a structural equations model, we were able to find a six-dimensional factorial model that explains the reasons for doing PA, demonstrating that there is no relationship between the reasons for and time spent doing PA. Therefore, motivation is not a variable that explains the time spent doing PA and another type of variable must be used to explain the phenomenon if PA is to be incentivised.

Both intestinal schistosomiasis and giardiasis are co-endemic throughout many areas of sub-Saharan Africa, significantly impacting the health of millions of children within endemic areas. While giardiasis is not considered a neglected tropical disease, intestinal schistosomiasis is formally grouped within the NTD umbrella and, as such, receives significant advocacy and financial support for large-scale control, annually. Given the many epidemiological similarities between intestinal schistosomiasis and giardiasis, in this review, we critically discuss why disease surveillance and control activities for giardiasis are largely absent within low- and middle-income countries. With advances in new methods of parasite diagnostics and provision of existing anti-parasitic medications, better management of intestinal schistosomiasis and giardiasis co-infection could, not only be better understood but also, more effectively controlled. In this light, we appraise the suitability of a One Health approach for intestinal schistosomiasis, for if adopted more broadly, could also pave a way forward for more inclusive public health actions against giardiasis.

Students’ anxiety due to the COVID-19 pandemic was expressed by some medical students in the form of anger and mistrust. This study aims to explore the reasons for mistrust between students and faculty among medical schools in Egypt that have flared during the COVID-19 pandemic. This is a three-phase exploratory qualitative study depending on thematic emergence from appreciative interviews (AI) sessions. Students are revealed to be very well-educated regarding contemporary medical education concepts. The most important factors from the student perspective were the presence of a well-designed assessment system aligned with the learning outcomes and teaching methodologies and the presence of extracurricular activities and soft skills, respectively. A balanced student life respecting their mental health was found important to increase trust. A roadmap to breaking the mistrust must be planned on several pivots: curriculum structure, extracurricular life, communication strategies, and identifying student roles in their learning and in decision making.

The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The implications of the novel coronavirus and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific populations living in low income-countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.

Purpose: To explore the influence of education and other factors on an athlete’s decision to return to sport post-concussion injury, and whether general risk-taking tendencies are related to return to sport post-concussion decisions in these athletes. Participants and Methods: A self-administered electronic survey was designed to examine their decision-making process when faced with scenario-based questions regarding returning to sport post-concussion injury. Students from the Health Sciences and Medicine Faculty at Bond University were invited to participate. Participants were allocated to a concussion education or non-education group prior to commencement of questionnaire via the random generator on Qualtrics software function. The risk propensity scale was used to assess the risk aversion of each participant. Results: Sixteen respondents were randomized evenly to education and non-education groups. Seven (43.8%) had previously received concussion education training prior to completing the questionnaire, with one (14%) choosing to return to sport in the scenario-based questions. The education group reported two (25%) respondents return to sport, while three (75%) respondents out of four returned to sport with no education or previous concussion training. Influential factors that impacted the decision whether to return to sport or not included: game importance, concussion severity and symptoms, and various internal and external factors. Finally, there was a divergence in results from the risk propensity scale when deciding to return to sport and general risk-taking propensities. Conclusion: This study identified several influential factors including game importance, concussion severity and symptoms which play a significant role in the return to sport decisions post-concussion injury.

Introduction: Coronaviruses are zoonotic viruses that include human epidemic pathogens such as the Middle East Respiratory Syndrome virus (MERS-CoV), and the Severe Acute Respiratory Syndrome virus (SARS-CoV), among others (e.g., COVID-19, the recently emerging coronavirus disease). The role of animals as potential reservoirs for such pathogens remains an unanswered question. No systematic reviews have been published on this topic to date. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess MERS-CoV and SARS-CoV infection in animals and its diagnosis by serological and molecular tests. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Results: 6,493articles were retrieved (1960-2019). After screening by abstract/title, 50 articles were selected for full-text assessment. Of them, 42 were finally included for qualitative and quantitative analyses. From a total of 34 studies (n=20,896 animals), the pool prevalence by RT-PCR for MERS-CoV was 7.2% (95%CI 5.6-8.7%), with 97.3% occurring in camels, in which pool prevalence was 10.3% (95%CI 8.3-12.3). Qatar was the country with the highest MERS-CoV RT-PCR pool prevalence, 32.6% (95%CI 4.8-60.4%). From 5 studies and 2,618 animals, for SARS-CoV, the RT-PCR pool prevalence was 2.3% (95%CI 1.3-3.3). Of those, 38.35% were reported on bats, in which the pool prevalence was 14.1% (95%CI0.0-44.6%). Discussion: A considerable proportion of infected animals tested positive, particularly by nucleic acid amplification tests (NAAT). This essential condition highlights the relevance of individual animals as reservoirs of MERS-CoV and SARS-CoV. In this meta-analysis, camels and bats were found to be positive by RT-PCR in over 10% of the cases for both; thus, suggesting their relevance in the maintenance of wild zoonotic transmission.

The state of community lock-down due to COVID-19 pandemic caused restricted movements of people. There are existing evidence of the negative impact of quarantine and isolation to the mental health of a person in different contexts. A scoping review of literature using Google Scholar was conducted to discover records about the public mental health while in a community quarantine due to COVID-19 pandemic. A methodological approach suggested by Arksey and O’Malley was utilized. It comprised (a) identifying the research questions, (b) identifying relevant literatures, (c) selecting literature, (d) charting the extracted data, and (e) summarizing, analyzing, and reporting the results. As of April 17, 2020, there were only 4 original articles found that discuss psychosocial aspect of the COVID-19 crisis. After an online survey, they present evidence that (1) there is an outward change in the people’s behavior toward self-care during the pandemic and (2) trusting the community governing bodies can minimize the level of anxiety and stress. Other literatures found are original articles in preprint (n=8), letters, commentaries, editorial (n=6), review paper (n=4), and WHO guideline (n=1). It is evident that the psychosocial aspect of COVID-19 crisis needs more attention from the scholars and a large research gap can be lessened trough expansion of online platforms.

As the novel COVID-19 disease spreads around the world, the most affected population are those who suffer from the most common chronic diseases, such as obesity, hypertension, and type 2 diabetes, which are quite associated with the so-called age-related diseases. On the other hand, since the Spanish influenza outbreak, humanity has not experienced an infectious disease that synergizes so quickly with chronic diseases, making it mortal for those individuals with comorbidities. In this context, COVID-19 is challenging for health systems all around the world due to the high prevalence of chronic diseases. Nowadays, we are facing the beginning of a new era in which health infectious and chronic diseases meet. Therefore, epidemiologic and biomedical researchers must work together to solve further contingencies, and politicians should direct science-centered decisions on public health. In the present paper, we make an urgent call to learn from the COVID-19 lessons in order to mitigate the chronic diseases prevalence and to address the influence of the infectious diseases on the aging process; since we are about to begin the Decade of Healthy Aging.

The outbreak of Coronavirus disease 2019 (COVID-19) has posed a significant concern in many countries due to the rapid rate of transmission between humans. Taking advantage of the experience of the last epidemics in 2002 Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and 2012 Middle East Respiratory Syndrome Coronavirus (MERS-CoV), some regions of the world were well- prepared for the new outbreak. However, other countries needed to be adapted to the situation promptly. Many management strategies were established, and some restrictions were introduced in some regions. In this review, we aimed to determine countries’ public responses to the epidemic of COVID-19 and how they developed administrative approaches towards the outbreak.

Health locus of control is the set of beliefs a person has about his or her personal influence on health. The current study aimed at identifying types of locus of control in parents of leukemia children and possible association with depressive symptomatology and current life perception. 104 parents were recruited at the Haematology-Oncologic Clinic of Padua post 1 month from the leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD=5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD=3.82). After signing the informed consent, they filled in the Ladder of Life questionnaire, the BSI-18 and the Parents Health Locus Of Control (PHLOC). Paired-samples t-test (t= -14.42; df=103; p=0.0001) showed that parents of leukemia children were more inclined to have an external locus of control than an internal one. Hierarchical regression analysis model (R2=0.34; F=4.32; p=0.0001) identified health professional influence (ß= -0.28; p=0.004), current life perception (ß= -0.3; p=0.013) and future life perception (ß= -0.26; p=0.012) as significantly predictors on Parental depression. Improving trust in the medical staff care and parental life perceptions could be a preventive program to cope with parental depression symptomatology.

The present study was conducted to evaluate encapsulated essential oils as an alternative anticoccidial in coccidiosis vaccine challenged broiler chickens. A total of 600 day-old male broiler chicks were provided with no-added corn-soybean meal-based control diet or diets that contained either salinomycin or EO at 60 and 120 mg per kg of diet. On day 21, half of the control groups were orally challenged with a coccidiosis vaccine at 25 times higher than the recommended vaccine dose. During 22 to 28 days (i.e., one-week post coccidiosis vaccine challenge), the challenged chickens had decrease (P < 0.05) in body weight gain and feed intake but increase in feed conversion ratio compared with the non-challenged, naïve control chickens. However, dietary EO significantly counteracted (P < 0.05) coccidiosis vaccine-induced depression in body weight gain and feed intake. Increasing dietary EO linearly decreased (P < 0.05) the concentrations of the volatile fatty acids. Dietary SAL and EO affected gut morphology in chickens at 20 days posthatch. Increasing dietary EO linearly (P = 0.073) increased serum catalase activity. Collectively, our study shows that dietary EO increased coccidiosis vaccine-induced growth depression and altered gut physiology in broiler chickens.

In this review, we summarize the current state-of-the-art in the utilization of close-range sensing in forest monitoring. We include technologies, such as terrestrial and mobile laser scanning as well as unmanned aerial vehicles, which are mainly used for collecting detailed information from single trees, forest patches or small forested landscapes. Based on the current published scientific literature, the capacity to characterize changes in forest ecosystems using close-range sensing has clearly been recognized. Forest growth has been the most investigated cause for changes and terrestrial laser scanner the most applied sensor for capturing forest structural changes. Unmanned aerial vehicles, on the other hand, have been used to acquire aerial imagery for detecting tree height growth and monitoring forest health. Mobile laser scanning has not yet been used in forest change monitoring except for a few early investigations. Considering the length of the forest growth process, investigated time spans have been rather short, less than 10 years. In addition, data from only two time points have been used in many of the studies, which has further been limiting the capability of understanding dynamics related to forest growth. In general, method development and quantification of changes have been the main interests so far regardless of the driver of change. This shows that the close-range remote sensing community has just started to explore the time dimension and its possibilities for forest characterization.

Regular exercise can reduce depression. However, the uptake of exercise is limited in patients with end-stage renal disease undergoing hemodialysis. To address the gap, we designed a gamified non-weight-bearing exercise program (Exergame), which can be executed during hemodialysis treatment. The Exergame is virtually supervised based on its interactive feedback via wearable sensors attached on lower extremities. We examined the effectiveness of this program to reduce depression symptom compared to supervised exercise in 73 hemodialysis patients (age=64.5±8.7years, BMI=31.6±7.6kg/m2). Participants were randomized into an Exergame group (EG) or a Supervised-exercise group (SG). Both groups received similar exercise tasks for 4-week, 3-session per week, 30-min per session, during hemodialysis treatment. Depression symptom was assessed at baseline and 4-week using Center for Epidemiologic Studies Depression (CES-D). Both groups showed significant reduction in depression score (37%, p<0.001, Cohen’s effect size d=0.69 in EG vs. 41%, p<0.001, d=0.65 in SG) with no between-group difference for the observed effect (p>0.050). The EG expressed a positive exercise experience including fun, safety, and helpfulness of sensor-feedback. Together, results suggested that the virtually-supervised low-intensity Exergame is feasible during routine hemodialysis treatment. It is as effective as supervised-exercise to reduce depression symptom, while reducing burden of administrating exercise in dialysis clinics.

Road dust resuspension, especially the particulate matter fraction below 10 µm (PM10), is one of the main air quality management challenges in Europe. Road dust samples were collected from representative streets (suburban and urban) of the city of Viana do Castelo, Portugal. PM10 emission factors (mg veh-1 km-1) ranging from 49 (asphalt) to 330 (cobble stone) were estimated by means of the United Stated Environmental Protection Agency method. Two road dust fractions (< 0.074 mm and from 0.0074 to 1 mm) were characterised for their geochemical, mineralogical and morphological properties. In urban streets, road dusts reveal the contribution from traffic emissions, with higher concentrations of e.g. Cu, Zn, and Pb. In the suburban area, agriculture practices likely contributed to As concentrations of 180 mg kg-1 in the finest road dust fraction. Samples are primarily composed of quartz, but also of muscovite, albite, kaolinite, microcline, Fe-enstatite, graphite and amorphous content. Particle morphology clearly shows the link with natural and traffic related materials, with well-formed minerals and irregular aggregates. The hazard quotient suggests a probability to induce non-carcinogenic adverse health effects in children by ingestion of Zr. Arsenic in the suburban street represents a human health risk of 1.58 x 10-4.

This paper examines whether the Great Recession has altered the disparities of the US regional health care expenditures. We test the null hypothesis of convergence for the US real per capita health expenditure for the period 1980-2014. Our results indicate that the null hypothesis of convergence is clearly rejected for the total sample as well as for the pre-Great Recession period. Thus, no changes are found in this regard. However, we find that the Great Recession has modified the composition of the estimated convergence clubs, offering a much more concentrated picture in 2014 than in 2008, with most of the states included in a big club, and only 5 (Nevada, Utah, Arizona, Colorado and Georgia) exhibiting a different pattern of behavior. These two estimated clubs diverge and, consequently, the disparities in the regional health sector have increased.

Wearable sensors have the potential to enable comprehensive patient characterization and optimized clinical intervention. Critical to realizing this vision is accurate estimation of biomechanical time-series in daily-life, including joint, segment, and muscle kinetics and kinematics, from wearable sensor data. The use of physical models for estimation of these quantities often requires many wearable devices making practical implementation more difficult. However, regression techniques may provide a viable alternative by allowing the use of a reduced number of sensors for estimating biomechanical time-series. Herein, we review 46 articles that used regression algorithms to estimate joint, segment, and muscle kinematics and kinetics. We present a high-level comparison of the many different techniques identified and discuss the implications of our findings concerning practical implementation and further improving estimation accuracy. In particular, we found that several studies report the incorporation of domain knowledge often yielded superior performance. Further, most models were trained on small datasets in which case nonparametric regression often performed best. No models were open-sourced, and most were subject-specific and not validated on impaired populations. Future research should focus on developing open-source algorithms using complementary physics-based and machine learning techniques that are validated in clinically impaired populations. This approach may further improve estimation performance and reduce barriers to clinical adoption.

The vegan diet excludes animal-derived product consumption and health advantages had been reported when followed. However, heterogeneous eating habits, food availability, and sociocultural characteristics among regions could lead to different physiological results. The objective of this case-control cross-sectional pilot study was to analyze body composition, daily nutrients consumption, and basic serum biomarkers as a general overview of the health status of Mexican adults with a vegan diet for ≥3 years, randomly paired with omnivores. Body composition was assessed through bioelectric impedance analysis. Eating patterns were evaluated and daily nutrients intake was calculated. A complete blood count, glycated hemoglobin, cobalamin, and creatinine serum concentrations were analyzed. We hypothesized certain nutrient deficits and specific biomarker impairments originated from cultural particularities driving food selection in Mexicans following a plant-based diet. Body composition did not differ among groups. Lower protein, niacin, pantothenic acid, pyridoxine, cobalamin, calciferol, fluoride, iodine, and selenium intake yet greater fiber, folic acid, vitamin E, copper, and molybdenum were observed in the plant-based group when compared with controls. Vegans presented lower cobalamin and creatinine serum concentrations. Hematologic abnormalities were prevalent in vegans. Insufficient consumption of several nutriments was identified in both dietary groups, suggesting that the local diet may be unbalanced, affecting both vegans and non-vegan individuals. However, vegans might present additional deficiencies, especially vitamin B₁₂, with potential repercussions. Clinical and nutritional guidance is required in this particular population to avoid possible health adverse events.

Pre-diabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Pre-diabetes puts one at an increased risk of developing type 2 diabetes and heart disease Methodology: A cross-sectional study was carried out on 384 patients aged 20-70 years old, attending the dental clinics to assess the risk for diabetes, using the FINDRISC questionnaire, HbA1c blood test and a periodontal examination. Results: The mean age of participants was 38.90±10.74. 32.3% were categorized as no risk, 46.6% low risk, while 19% and 2.1% moderate and high risk of developing diabetes respectively. Tests for serum HbA1c Level showed 46.1 % had normal HbA1c followed by 18.0% and 3.6 % were pre-diabetic and diabetic respectively. 19.3% of participants had periodontal pockets measuring more than 4mm and 15.9% measuring more than 6mm. Conclusion: The study has proven to be useful in identifying patients at high-risk of developing diabetes. Controlling and managing periodontal disease could be a new aspect to include in the standards for diabetes care. Dental settings could be a successful platform to carry out the screening and risk stratification of pre-diabetic patients.

The variations in socioeconomic status (SES) between different social classes of a population correspond to differences in accessibility to all resources available and able to improve global health. While SES is now known as one of the main determinants for a good health and a good aging, its influence on sleep disorders (SD) is not well understood. SES is a concept, not directly observable but estimated using indicators like income, education, occupational status and area of living. This theoretical review explores some theories linking environment of people with occurrence of SD, with different patterns associated to SES. A model of interaction is proposed to summarize and conceptualizes these interactions and to promote more research on the topic.

This study aimed to investigate the airborne release of N-nitrosodimethylamine (NDMA) as a result of the dry heat cooking of some meats using charcoal grilling and pan broiling methods. Three types of meat, beef sirloin, pork belly, and duck, were chosen and cooked in a temporary building using the above methods. Air samples were collected in Thermosorb-N cartridges, which were qualitatively and quantitatively analyzed for NDMA using ultra-high performance liquid chromatography–mass spectrometry and high-performance liquid chromatography–fluorescence detection, respectively. Overall, the charcoal grilling method showed higher average NDMA concentrations than the pan broiling method for all types of meat. The highest average concentration was observed for charcoal-grilled beef sirloin (410 ng/m3) followed by pork belly, suggesting that meat protein content and cooking duration are important determinants of NDMA formation. Cancer risk assessment showed that the charcoal grilling of such meats can pose an additional cancer risk for restaurant customers.

Urban tree planting initiatives can experience high levels of mortality during establishment years. Mortality tied to the stresses of transplanting can be partially negated or exacerbated depending on the species selected, nursery materials used, site conditions present, and management practices employed. Past research has quantified post-planting survival, health, and growth. However, varying climates, species, land use types, and management practices warrant additional region-specific research. The purpose of this study is to assess the success of plantings along Florida highways and identify species, site, and management factors related to tree and palm health and establishment. Results show high annual establishment survival (98.5%) across 21 planting projects ranging from 9 to 58 months after installation, (n = 2711). For transplanted palms, the presence of on-site irrigation significantly improved establishment from 96.2% to 99.4%. No establishment differences were detected with regard to irrigation treatment for small-stature trees, shade trees, and conifers. Additionally, there were significant differences in tree health response among tree groups given species, management, and site factors.

1) Public health remains a tiny portion of the undergraduate pharmacy curriculum and the material is integrated into other modules. The objective of this study is to describe the UK undergraduate pharmacy curriculum, including its public health content; 2) Methods: A qualitative method (content analysis of websites) was used to describe the UK undergraduate pharmacy curriculum and teaching and learning policy. This involved selecting relevant concepts and then quantifying their presence and the relationships between them. The NVivo software was used to carry out ‘group queries’ and visualisation of results; 3) Results: Public health remains an optional module in the curricula of many UK schools of pharmacy. Several public health-related topics are often integrated into other modules, but UK undergraduate pharmacy curricula are still dominated by traditional pharmacy modules; and 4) Conclusions: Most of the curricula analysed were dominated by traditional pharmacy modules designed to enhance students' knowledge and skills. The skill set of UK pharmacy students with respect to macro-level public health activities needs to be improved in order to enhance pharmacists’ contribution to public health.

Shenzhen is China’s top ten clean air city and the cleanest air megacity. Even so, epidemiologic studies have shown ambient air pollution had significant adverse impacts on human health in this less polluted city. In this study, the concentrations of six criteria air pollutants (PM2.5, PM10, O3, NO2, SO2, and CO) from 2014 to 2017 were analyzed and compared to thresholds of both national and international air quality standards. The results showed concentrations of all air pollutants were below target values of current national air quality standard, but levels of particulate matter (PM) and O3 were still much higher than the recommended levels by the World Health Organization. Within national air quality standards, the number of over-limit days was rare with few variations between highly polluted and low pollution areas. The air quality improvement was slowing down recently. Our results suggest annual and daily thresholds for PM are too loose for air quality improvement in Shenzhen. Hence, we call for evaluation and establishment of tougher air quality standard.

Human-generated, natural occurrences and other actions connected with the petroleum industry have contributed expansively to the contamination of numerous areas of human habitant, thus effecting overwhelming challenges and constraints to sustainable human health, development and the biosphere. The sites commonly associated include derelict pits, hydrocarbon onshore release sites, and places to where oil slicks exuding from offshore releases are blown onshore. In diverse cases, remediation is pertinent to restore the affected ambient. This is required despite the complexity and intricate pore structure and fluid trafficking trajectories of soil which are not easily amenable to remediation. Due to the complex assemblage of contaminated soil, it is necessary to conduct an encompassing site assessment by considering the potential impact of the environment and human health prior to proper selecting and implementing of a desirable remediation process. There are extant remediation methodologies which are effective and efficient for the clean up of contaminated shorelines and other petroleum-contaminated sites involving inter alia agricultural activities. There are salient variations in the techniques to expunge contaminants regarding spatiotemporal and pecuniary costs or considerations due to the gross environmental hazards entailed. This study provides for the opportunity to harness and sustain the capacity for the mitigation of untoward impacts, and induce the latitude for an enabling condition in sustainable human health, environment and development in the petroleum industry and other anthropogenic activities.

Purpose: Young transgender and non-binary are exposed to situations of discrimination and have a greater risk of violence. The purpose of this study is to analyze which protective, violence and health and well-being factors have more influence on transgender and non-binary people compared to cisgender people. Method: The sample comprised 856 people between 14 and 25 years old. A survey including questions about sociodemographic information and protective, violence and health and well-being factors was designed ad hoc for this study. Results: The results show non-binary group received the least support from family and friends, higher risk of suffering cyberbullying and a higher feel isolated and unhappy. Non-binary and transgender have suffered more verbal attacks both inside and outside their school and physical attacks at school than cisgender young. Conclusions: These results are important and may contribute to promote public policies and clinical interventions to favor the integration of non-binary and transgender people in our society.

Background: There is lack of data on types of community first aids use and treatment given post injuries from many low-middle income countries, including India. Materials and Methods: A cross-sectional study was conducted among children up-to 18 years of age, in Ujjain district, India to understand types of first aid given and health seeking post injury. Results: A total of 1087 injuries, in 1049 children were identified in last one year, 729 (67%) received, first aid and 758 (72%) sought some healthcare. Children with burns received most (86%) first aid, while most children (84%) with road traffic accidents (RTA) sought health care. Most children (52%) sought healthcare from a private health set-up; most (65%) being transported within the golden hour; motorbikes being the most preferred (50%) mode of transport. Only 1% injured used ambulance services. Commonly reported first aid included: use of coconut oil on wounds from falls (38%) and burns (44%); antiseptic cream on wounds from RTA (31%), turmeric in falls (16%), and rubbing of metal on a bitten site (47%). Potentially harmful substances applied included lime, toothpaste, clay and mud. Conclusion: In most injuries, appropriate locally available substances, were used by the community. Our findings will help design community interventions to increase appropriate first aid in childhood injuries.

Precision medicine seeks to use genomic data to help provide the right treatment to the right patient at the right time. Next-generation sequencing technology allows for the rapid and accurate sequencing of many genes at once. This technology is becoming more common in oncology, though the clinical benefit of incorporating it into precision medicine strategies remains under significant debate. In this manuscript, we discuss the early findings of the impact of next-generation sequencing on cancer patient outcomes. We investigate why not all patients with genomic variants linked to a specific therapy receive that therapy and describe current barriers. Finally, we explore the current state of health insurance coverage for individual genome sequencing and targeted therapies for cancer. Based on our analysis, we recommend increased transparency around the determination of “actionable mutations” and a heightened focus on investigating the variations in health insurance coverage across patients receiving sequencing-matched therapies.

El Niño Southern Oscillation (ENSO) is an important of mode of climatic variability that through altering climate patterns exerts a discernible impact on ecosystems and society. For this reason, ENSO has attracted much interest in the climate and health science community with many analysts investigating ENSO health links through considering the degree of dependency of the incidence of a range of climate diseases on the occurrence of El Niño events. Because of the mounting interest in the relationship between ENSO as a major mode of climatic variability and health this paper presents an overview of the basic characteristics of the ENSO phenomenon and its climate impacts, discusses the use of ENSO indices in climate and health research and outlines the present understanding of ENSO health associations. Also touched upon are ENSO-based seasonal health forecasting and the possible impacts of climate change on ENSO and the implications this holds for future assessments of ENSO health associations. The review concludes that there is still some way to go before a thorough understanding of the association between ENSO and health is achieved with a need to move beyond analyses undertaken through a purely statistical lens with due acknowledgement that ENSO as a complex non-canonical phenomenon and that simple ENSO health associations should not be expected.

This study aimed to evaluate the relationship between various asbestos exposure routes and asbestos-related disorders (ARDs). The study population comprised 11,186 residents of a metropolitan city who lived near asbestos factories, shipyards, or in slate roof-dense areas. ARDs were defined from chest X-rays indicating lower lung fibrosis (LFF), pleural disease (PD), and lung masses (LMs). Of the subjects, 11.2%, 10.4%, 67.2% and 8.3% were exposed to asbestos via occupational, household, neighborhood, and slate roof routes, respectively. Regarding adjusted confounders and other exposure routes, the odds ratio (OR) of PD from household exposure (i.e., living with asbestos-producing workers) was 1.9 (95% confidence interval: 0.9–4.2), and that of LLF and PD from neighborhood exposure, or residing near asbestos factories) for <19 or >20 years, or near a mine, were 4.1 (2.8–5.8) and 4.8 (3.4–6.7), 8.3 (5.5–12.3) and 8.0 (5.5–11.6), and 4.8 (2.7–8.5) and 9.0 (5.6–14.4), respectively. The ORs of LLF, PD, and LM among those residing in slate-dense areas were 5.5 (3.3–9.0), 8.8 (5.6–13.8), and 20.5 (10.4–40.4), respectively. Substantial proportions of citizens residing in industrialized city have potentially been exposed to asbestos, and various exposure routes are associated with the development of ARDs. Notably, this may be the first finding of the health effects of slate roof exposure. However, given the limitations of this study, including potential confounders such as socioeconomic status, further research is needed.

Philip Morris International (PMI) has developed the Population Health Impact Model (PHIM) to quantify, in the absence of epidemiological data, the effects of marketing a candidate modified risk tobacco product (cMRTP) on the public health of a whole population. Various simulations were performed to understand the harm reduction impact on the U.S. population over a 20-year period under various scenarios. The overall reduction in smoking attributable deaths (SAD) over the 20-year period was estimated as 934,947 if smoking completely went away and between 516,944 and 780,433 if cMRTP use completely replaces smoking. The reduction in SADs was estimated as 172,458 for the World Health Organization (WHO) 2025 Target and between 70,274 and 90,155 for the gradual cMRTP uptake. Combining the scenarios (WHO 2025 Target and cMRTP uptake), the reductions were between 256,453 and 268,796, depending on the cMRTP effective dose. These results show how a cMRTP can reduce overall population harm additionally to existing tobacco control efforts.

Oilfield produced water (OPW) is used to boost freshwater sources for crop irrigation in California's agriculturally important Central Valley. OPW is known to contain salts, metals, hydrocarbons, alkylphenols, naturally radioactive materials, biocides, and other compounds from drilling and production processes. Less is known about the potential uptake and accumulation of these compounds in crops and soil irrigated with OPW. In this study 23 potted mandarin orange plants were irrigated 2-3 times weekly (depending on season) with water containing three different concentrations of the known OPW heavy metals barium, chromium, lead, and silver. Seven sets of samples of soil and leaves and all fruits were collected and processed using microwave-assisted digestion (EPA Method 3051A). Processed samples were analyzed using ICP-OES. ANOVA, ANCOVA, and Tukey’s honest significant difference test were used to examine the effects of metal concentrations in the irrigation water, sample number, and number of watering days on the metal concentrations in the soil, leaf, and fruit samples. Accumulation of barium in soil and leaves was strongly positively associated with sample and number of watering days, increasing nearly 2,000-fold. Lead also showed an upward trend, increasing up to 560-fold over baseline level. Chromium showed an increase in the soil that tapered off, but less consistent results in the leaves and fruit. The silver results were more volatile, but also indicated at least some level of accumulation in the tested media. The smallest absolute accumulation was observed for chromium. Concentrations in the fruit were highest in the peel, followed by pith and juice. Accumulation of all heavy metals was generally highest in the soil and plants that received the highest irrigation water concentration. Considering the potential for adverse human health effects associated with ingesting soluble barium contained in food and drinking water, and to a lesser extent chromium and lead, the study signals that it is important to conduct further research into whether OPW contaminants can enter the food chain and pose risks to consumers.

Electronic-health applications rely on large computer networks to facilitate patients' information access and to communicate various types of medical data. To examine the effectiveness of these networks, the traffic parameters need to be analysed. Due to quantity of the information carrying packets, examining each packet's transmission parameters individually is not practical, especially when a real time operation is needed. Sampling allows a subset of packets that accurately represents the original traffic to be formed. In this study an adaptive sampling method based on regression and fuzzy inference system was developed. It dynamically updates the number of packets sampled by responding to the traffic variations. Its performance was found to be superior to the conventional non-adaptive sampling methods.

Infant malnutrition remains as an important cause of death and disability, Haiti has the highest prevalence in America, so preventive strategies are needed. Our objective was to assess infant and young children malnutrition in Haiti and to study an association to World Health Organization (WHO) recommended feeding practices adherence. Cross-sectional study of children younger than 2 years old, recruited at Saint Espri Health Center, Port Au Prince (August to September 2014). We registered feeding practices, social and demographic data, and performed anthropometry (WHO-2006 standard). We evaluated 278 infants and young children, 8.08 ± 6.5 months old, 53.2% female. 18.35% had underweight; 13.31% were stunted and 13.67% had moderate or severe wasting. Malnutrition was associated to male gender, older age, lower education of mothers and higher number of siblings. The adherence to WHO recommended practices for breastfeeding was from 11.8 to 97.9% and was related to a lower prevalence of malnutrition. For complementary food, adherence was 9.7 to 90.3%, also associated to lower malnutrition. Conclusion: Prevalence of infant and young children malnutrition in this Haitian Health Center population was high, related to some risk factors. The adherence to WHO recommended feeding practices was associated to a better nutritional status.

Surgical smoke is produced by energy-based surgical instruments. The airborne volatile organic compounds (VOCs) from surgical smoke may have potential health risk. This study aimed to evaluate the evidence for the harmful effects on the operating theater staff. An internationally recognized evaluation model of health risk assessment (HRA) was adapted to preliminarily assess the health risks caused by VOCs in surgical smoke. Results of HRA indicated that non-carcinogenic risk indexes of VOCs did not exceed one, indicating that these pollutants didn't cause significant non-carcinogenic harm to the health of the operating theater staff. But the cancer risk indexes exposed to formaldehyde and benzene all exceed 10-5, which was higher than the suggested value of USEPA (10-6) and might cause potential harm to the health of the operating theater staff. Long-term exposure of such surgical smoke will be harmful to the health of the operating theater staff and have a great risk of cancer.

Globally, humans are struggling with the double threat of communicable and non-communicable diseases, which are presenting new challenges to public health. Public health problems are generally studied and addressed at primary, secondary and tertiary levels. Most effective results are seen with primary interventions. Public health is becoming more aware of the importance of environment-gene interactions in the ontology of health and disease using epigenetics. Epigenetics is the study of altered gene expression without change in base pairs. Be it physical, social, behavioral, or economic factors; they all influence quality of life and health of individuals and populations. That environments are changing the human health phenotype and these changed phenotypes are heritable is of concern for the future of the human race. Knowing the causes of non-communicable human diseases using epigenetics will contribute to the development of new policies to encourage prevention using primary public health initiatives. Research and application of epigenetics shows great promise for improving population health. Continued advances in epigenetics will enhance how we understand and address the way environments are affecting the human health phenotype. For some time, health systems have been and continue to be tertiary in nature. Epigenetic changes can provide information necessary to better understand how social determinants of health can be used to build societies focused on equitable health for all people, rather than continuing to focus on treatment of diseases in the tertiary phase that leads to health disparities. Understanding mechanisms of social determinants of disease, will allow society to evolve in a health-oriented rather than a disease-oriented world. For this reason, we must enhance and apply epigenetics (physical, social, behavioral, economic) research to policy development. We will discuss how bringing social determinants together with biology can be used as new tools for public health policy.

Artisanal and small-scale gold mining (ASGM) has been an important source of income for communities in the Madre de Dios River Basin in Peru for hundreds of years. However, in recent decades, the scale of ASGM activities in the region has increased dramatically, and exposures to a variety of occupational and environmental hazards related to ASGM, including mercury, are becoming more widespread. The aims of our study were to: (1) examine patterns in the total hair mercury level of human participants in several communities in the region and compare these results to the 2.2 µg/g total hair mercury level equivalent to the World Health Organization (WHO) Expert Committee of Food Additives (JECFA)’s Provisional Tolerable Weekly Intake (PTWI); and (2), to measure the mercury levels of paco (Piaractus brachypomus) fish raised in local aquaculture ponds, in order to compare these levels to the EPA Fish Tissue Residue Criterion of 0.3 µg Hg/g fish (wet weight). We collected hair samples from 80 participants in four communities (one control and three where ASGM activities occurred) in the region, and collected 111 samples from fish raised in 24 local aquaculture farms. We then analyzed the samples for total mercury. Total mercury levels in hair were statistically significantly higher in the mining communities than in the control community, and increased with increasing distance away from the Madre de Dios headwaters (as the crow flies), did not differ by sex, and frequently exceeded the reference level. Regression analyses indicated that higher hair mercury levels were associated with residence in ASGM communities. The analysis of paco fish samples found no samples that exceeded the EPA tissue residue criterion. Collectively, these results align with other recent studies showing that ASGM activities are associated with elevated human mercury exposure. The fish farmed through the relatively new process of aquaculture in ASGM areas appeared to have little potential to contribute to human mercury exposure. More research is needed on human health risks associated with ASGM to discern occupational, residential, and nutritional exposure, especially through tracking temporal changes in mercury levels as fish ponds age, and assessing levels in different farmed fish species. Additionally, research is needed to definitively determine that elevated mercury levels in humans and fish result from the elemental mercury from mining, rather than from a different source, such as the mercury released from soil erosion during deforestation events from mining or other activities.

Background: Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). Methods: A cross-national study was performed with different sources of data, using the administrative record linkage theory. We created a new data set using data from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. Result: The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. AM was significantly higher in economically weak countries, countries with political instability, countries with traditional religion, without achievement of UHC, and Sub-Saharan Africa (p<0.01). There was high disparity of AM between countries with and without UHC (F = male: 61.89, female: 51.85, p<0.001) and between groups with low and high income (F = male: 36.33, female: 42.39, p<0.001). UHC and political stability would significantly reduce AMR by > 0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70, in relation to countries without UHC, with political instability, and low economic status. Conclusions: Disparities in AM can be reduced after the achievement of UHC and economically productive activities for those adults affected by conflict and political unrest.

Background: Health insurance (HI) run by government is providing health care service to large population. Due to poor accountability, participation and sustainability, cooperative health insurance is becoming more popular and effective in low and middle income and some high-income countries too. In Nepal, there are public and cooperative HI is in practice. The aim of this study is to compare the effectiveness of public (government) and cooperative HI in relation to benefit packages, population coverage, inclusiveness, health care utilization, and promptness for treatment in these two health insurance models in Nepal. Method: This is an institution based concurrent mixed study consists of qualitative and quantitative variables from public and cooperative groups. We included all public HI operated by government hospitals and cooperatives groups those purchased hospital service in contract. Two separate study tools were applied to access the effectiveness of insurance models. The key questions were asked for the representatives of government and private health insurance. The numeric information consisted of in quantitative data and subjective response was included in qualitative approach. Descriptive statistics and Mean Whitney U test was applied in numeric data and qualitative information were analyzed by inductive approach Results: The study revealed that new enrolment was not increased, health care utilization rate was increased and the benefit package was almost same in both groups. The overall inclusiveness was higher for the government HI, but enrolment from the religious minority, proportion of negotiated amount during treatment were significantly higher (p<0.05). During illness, the response time to reach hospital was significantly faster in cooperative health insurance than government health insurance. Qualitative findings showed that level of participation, accountability, transparency and recording system was better in cooperative health insurance than public. Conclusion: Cooperative HI could be more sustainable and accountable to the community for all; low, middle and high-income countries.

Background: Physical and mental health of corporate employees is equally important, especially in international salespeople in the in vitro diagnostic (IVD) medical device industry. The rapid growth of the IVD market is driven by the increasing prevalence of chronic and infectious diseases. This study aims to identify the association of socio-demographic, occupational, organizational, and psychosocial factors with mental health outcomes for depression, anxiety, and somatic symptoms in Chinese IVD international salespeople. Methods: The study was a cross-sectional survey of ISs in IVD companies officially registered in China. An online survey was designed to collect data through email contact with IVD companies and social media between August 2022 and March 2023. Measured factors included effort-reward imbalance (ERI), health-promoting leadership (HPL), health climate (HC), inner strength (IS), and perceived social support (PSS). Mental health outcomes assessed using the Core Symptom Index (CSI) were depression, anxiety, and somatic symptoms. Results: A total of 244 salespeople responded to the survey. CSI scores indicated that 18.4% (n = 45) and 10.2% (n = 25) of the respondents had symptoms of major depression and anxiety, respectively. ERI was positively correlated, while the IS and PSS were negatively correlated with major depression, anxiety, and somatic symptoms (p < .01). Health climate was negatively correlated with major depression (p < .05). Education background was associated with somatic symptoms (p < .05). ERI, IS, and gender were significant predictors of major depression, anxiety, and somatic symptoms (p < .05). Conclusion: The prevalence of depression and anxiety in China’s IVD international salespeople was considered low compared with prevalence in Chinese populations during COVID-19, but higher than those before the pandemic. Effort–reward imbalance, inner strength, and gender were significant factors in major depression, anxiety, and somatic symptoms among IVD international salespeople.

Healthcare professionals and resource planners can use healthcare delivery process mining to ensure the optimal utilisation of scarce healthcare resources when developing policies. Within hospitals, patients' Length of Stay (LOS) and volume of admitted patients, in terms of number and characteristics (age, gender, and social deter-minants), are significant factors determining daily resource requirements. In this study, we used Coxian phase-type Distribution (C-PHD) based Phase-Type Survival (PTS) trees for analysing how covariates such as admission date, gender, age, district, and admissions source influence the admission rate and LOS distribution. PTS trees. This study used a two-year data set (2011-2012) of patients admitted to the Emergency Department at Mater Dei Hospital to generate models and an independent one-year data set (2013) of patients admitted to the Emergency Department at Mater Dei Hospital to evaluate. The PTS tree effectively clusters patients based on their LOS, considering the prognostic significance of different covariates related to patients' characteristics. Charac-terising these covariates provided meaningful results about LOS. Similarly, the PTS tree was used to effectively cluster patients based on the admission rate, considering the prognostic significance of these covariates.

Healthy aging among older adults requires the maintenance of good physical and cognitive activity. However, in the natural course of aging, older adults usually experience a decline in their physical and cognitive activity, causing an increasingly sedentary lifestyle. Some older adults may not have a choice but to become increasingly sedentary as they age due to injury or deteriorated physicality. As such they require a manner of assistive technologies to aid in their daily lives and activities to maintain healthy cognitive function. Social Robots are a newer form of assistive technology, specifically designed for social interactions and gameplay. As with other assistive technologies, compliance barriers to the acceptance and use of social robots and types of meaningful, seated activities among older adults are expected. To better explore this phenomenon, improve quality of life and understand what drives older adults to accept and use newer forms of technology like social robots, this research conjoins two conceptual frameworks: The Activity Theory of Aging (ATA) and the Unified Theory of Acceptance and Use of Technology (UTAUT). As social robots hold great promise for improving the quality of life for older adults, exploring what driving factors could enable their greater acceptance and use is essential to furthering this field of study within Australia.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder that poses significant challenges in treatment adherence. This systematic review aims to evaluate the effectiveness of mobile health (mHealth) interventions compared to conventional therapy in improving treatment adherence among COPD patients. A total of 13 randomized controlled trials and comparative cohort studies were included, all investigating the impact of mHealth interventions, such as medication reminders and remote monitoring, in adult COPD patients. Studies with participants under 18 years of age or those with severe comorbidities were excluded. The review identified 4,688 records through comprehensive searches in databases including MEDLINE, WEB OF SCIENCE, and SCOPUS. Of these, 13 studies met the inclusion criteria. Results showed that mHealth interventions improved treatment adherence in some studies, particularly in exercise and symptom monitoring . However, the evidence was inconsistent, and variations in outcomes were reported across different studies. The review concludes that while mHealth interventions show potential in enhancing treatment adherence in COPD patients, further high-quality research with larger sample sizes is required to confirm these findings and support the integration of mHealth into clinical practice. The need for more robust study designs is also emphasized to address current limitations in evidence.

Background/Objectives: Alcohol consumption during pregnancy poses notable risks to maternal and foetal health, yet its prevalence and impact in Nigeria remain understudied. This commentary article aims to review the current state of alcohol intake by expectant mothers in Nigeria and provide an overview of Foetal Alcohol Spectrum Disorder (FASD) and recommendations for addressing this public health issue. Methods: Drawing on existing literature, we highlight the prevalence of alcohol intake by expectant mothers in Nigeria and explore the socio-cultural factors influencing drinking behaviours during pregnancy. Results: Despite limited empirical evidence, anecdotal reports suggest that alcohol consumption during pregnancy is not uncommon in Nigeria, driven by factors such as social norms, lack of awareness, and limited access to prenatal care and education. The implications of prenatal alcohol exposure for maternal and child health are substantial, with potential consequences including FASD, birth defects, and mortality. Conclusions: We provide recommendations for policymakers, healthcare providers, and community stakeholders to enhance awareness, prevention, and support systems for pregnant women and their families. Key recommendations include implementing public health campaigns to raise awareness concerning the dangers of alcohol use by expectant mothers, integrating alcohol screening and counselling into routine prenatal care services, strengthening regulations on alcohol advertising and availability, and providing support services for women struggling with alcohol use disorders during pregnancy. By addressing the gaps in knowledge and practice surrounding alcohol consumption during pregnancy, Nigeria can take meaningful steps toward promoting maternal and child health and preventing the lifelong consequences of FASD and related conditions.

Obesity is a major public health concern globally, significantly increasing the risk of numerous metabolic and cardiovascular diseases. While lifestyle interventions remain the primary strategy for weight management, pharmacotherapy is increasingly recognized as an essential component for patients with obesity, especially when lifestyle modifications alone are insufficient. Glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed for the management of type 2 diabetes, have emerged as effective agents in promoting weight loss in both diabetic and non-diabetic populations. This literature review examines the efficacy, safety, and mechanisms of action of GLP-1 receptor agonists, focusing on liraglutide and semaglutide, in obesity treatment. Furthermore, it discusses the impact of GLP-1 receptor agonists on obesity-related comorbidities, their comparison with other pharmacological treatments, and future perspectives.

Which measure is the most effective for solving health disparities, biological or economic? It is indispensable to delve into the factors of health disparities to answer this question. Our last paper in this journal analyzed the multi-dimensional factors of psychological health disparity under COVID-19 in Japan. This paper extends the analysis to physical health to explore the issue and proposes the concept of psychosomatic health, bridging the physical and psychological dimensions. It was found that　the factors of physical health disparities were close to those of psychological health. According to this new analysis concerning psychosomatic health disparity, not only biological factors but also socio-economic-political factors are essential for the psychosomatic health disparities in the static analysis． In addition, the ethico-political factor of justice/fairness plays a critical role in the dynamic analysis concerning the suppression of the damage to well-being by COVID-19. The result suggests the importance of multi-dimensional communitarian interventions, utilizing the term in political philosophy: it evaluates societal-community intervention as well as biological, political, and economic measures. Therefore, this study implies that, on this empirical basis, public deliberation with the ethical dimension and counting the relative weight of these factors with the temporal dimension in allocating resources is proposed as a theoretically desirable method of the new comprehensive intervention.

Climate change poses a significant risk to the environment and public health, leading to extreme weather patterns, rising sea levels, and loss of biodiversity. The relationship between air pollution from African dust and climate change demonstrates its critical role in trapping heat in the atmosphere, resulting in heat-related illnesses, heart problems, and respiratory issues. This Research points to the detrimental effects of pollutants such as smog, dust, acid rain, and ozone depletion on ecosystems, highlighting the importance of using Geographically Weighted Regression modeling and MODIS-NDVI analysis to address air pollution. Particulate Matter (PM 2.5-10) and ozone levels can have negative impacts on respiratory and cardiovascular health. Proactive steps, such as implementing clean energy technologies and enforcing stricter pollution regulations, are necessary to protect public health. Acting is crucial to addressing these global challenges and creating a cleaner, healthier future for future generations, underscoring the need for climate justice commitment.

Substance abuse and psychiatric disorders are two prevalent and interrelated public health concerns that often coexist, leading to complex clinical scenarios. This comorbidity poses significant challenges in diagnosis, treatment, and understanding the causal relationships between the two conditions. Frequently, one disorder is neglected in favor of the other, and misconceptions abound regarding which condition precipitates the other. This article explores the common comorbidity of substance abuse and psychiatric disorders, delving into the prevalence, diagnostic challenges, treatment implications, and the bidirectional nature of causality. By examining current research and clinical practice, we aim to shed light on the misconceptions and emphasize the need for integrated approaches to effectively address both conditions concurrently.

This study investigates the impact of positive childhood experiences (PCEs) on the subjective well-being (SWB) of college students, with psychological resilience as a mediator. A total of 1104 students from four universities in Yunnan Province, China, participated in the study. Using the Positive Childhood Experiences Scale, the Connor-Davidson Resilience Scale (CD-RISC), and the Subjective Well-being Scale, data were collected and analyzed through descriptive statistics and mediation analysis using SPSS and the PROCESS macro. Results indicate that PCEs significantly enhance SWB, and this relationship is partially mediated by psychological resilience. Specifically, psychological resilience accounted for 49.4% of the mediating effect between PCEs and SWB. These findings highlight the importance of fostering resilience to improve well-being in educational contexts. The study provides practical implications for educational interventions aimed at promoting mental health and well-being among college students.

Background/Objectives: The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); Methods: In this multicentric study data were obtained by 3727 youths (1937 boys; 2225 children, 1502 adolescents. severe OB was defined as BMI &gt;99th percentile (BMI99), BMI97 ≥120% or BMI Z-score &gt; 3 (WHO tables). The continuous CMR Z-score (sum of residual standardized for age and sex of waist-to-height ratio, systolic and diastolic blood pressure, triglycerides, and HDL-Cholesterol x -1) and the cluster of at least two CMR factors (hypertension, high triglycerides, low HDL-Cholesterol and high waist-to-height ratio) were calculated; Results: Continuous CMR Z-score was significantly higher both in children or adolescents with severe OB defined by 120% BMI97 compared to BMI &gt;99th (p &lt;0.0001), while it was lower only in adolescents with severe OB defined by 120% BMI97 compared to BMI Z-score &gt;3 (p &lt;0.0001). Compared to BMI97 ≥120%, BMI Z-score &gt;3 had higher specificity, but lower sensitivity in identifying children and adolescents with clustered CMR factors; Conclusions: The definition of severe OB based on BMI97 ≥120% is superior to BMI99 but it is inferior to BMI Z score &gt;3 as far as the association between severe OB and CMR factors is concerned. Pediatricians should take into consideration the implications of the use of different BMI metrics in those countries that recommend the WHO system.