This study evaluated the effects of replacing zinc bacitracin with a symbiotic diet on the biochemical profile, liver development, and Clostridium perfringens presence in laying hens at 90 weeks of age. A total of 198 Dekalb–White hens were assigned to six experimental diets: MBM (corn, soybean meal, and meat and bone meal), BAC (MBM + 0.05% zinc bacitracin), and SIMC (MBM + 0.1% symbiotic), provided from day 1 to 90 weeks. Additional treatments, SIMR and SIMP, received symbiotics from weeks 6 and 17, re-spectively. At 90 weeks, blood and tissue samples were analyzed. Results showed that symbiotic-treated hens had 20% heavier livers (P < 0.01) and lower concentrations of uric acid, total proteins, AST, ALT, and LDH (P < 0.01) compared to BAC-treated birds. Phosphorus, triglycerides, and HDL levels were better in symbiotic groups. C. perfringens counts and antibiotic resistance (ampicillin, erythromycin, aminoglyco-sides, lincomycin, tetracycline, bacitracin) were significantly higher in BAC groups (P < 0.01). Symbiotic supplementation improved intestinal health, reduced pathogenic bacterial colonization, and enhanced liver function compared to continuous antibiotic use, especially when administered from early life stages.

Global health is significantly impacted by antimicrobial resistance. Antibiotic misuse and overuse have resulted in the emergence of drug-resistant bacteria, viruses, parasites and fungi, which makes ordinary infections more difficult to cure and accelerates the spread of disease. The World Health Organisation has declared that antimicrobial resistance could result in up to 10 million deaths yearly by 2050, making it a worldwide health emergency. One of the greatest challenges to global health, food security, and development today, according to the World Health Organisation is the emergence of antibiotic resistance. Even though antibiotic resistance can arise naturally, improper usage of these medications and many other factors are accelerating its global spread. Antimicrobial resistance is frequently referred to as the "Silent Pandemic" and is a problem that requires current action and should be managed more effectively rather than considered as a future situation. This paper address a number of antimicrobial classes, global health, Onehealth and how drug resistance affects human health, and related risk factors. This review will also provide background information on the causes and processes of antimicrobial resistance in brief by identifying these characteristics, targeted interventions can be developed to lower the risk of illnesses that are resistant to antibiotics. It will also offer insights into new and emerging solutions that are being studied and may be created in the future to address the advancement of antimicrobial resistance.

BACKGROUND: Social determinants of health are conditions in the environments that significantly influence the health of individuals and communities. Various factors like income, socio-economic status, stress, customs, culture, healthcare services largely affect the health status of individuals and communities. OBJECTIVE: This study was carried out to identify the factors responsible for the social determinants of health among residents of Buari Ishola Isibo in Ede North Local Government Area, Osun State, Nigeria. METHODOLOGY: A descriptive cross – sectional study was utilized, and multi-stage random sampling method was employed in selecting 60 households of Buari Ishola Isibo in Ede North Local Government Area, Osun State, Nigeria. Questionnaire was used for data collection and data was analyzed using SPSS version 21. RESULTS: The respondents’ ages were between 15 – 60 years and above. 29 (48.3%) were between 31 – 60 years old, 31 (52.0%) were males, 40 (66.7%) were married, 57 (95.0%) were Islam and Yoruba. 29 (48.3%) earned 10,000 – 30,000 monthly, 23 (38.3%) had secondary school education, 39 (65.0%) were traders and 27 (45.0%) have 6 – 10 households respectively. Of the 60 respondents, 34 (56.7%) visit government health facility when they are sick, 21 (35.0%) make use of hand dug well in their compound as the source of their water supply, 27 (45.0%) uses flush water closet toilet as the means of disposing off their excreta, 36 (60.0%) lives in concrete with zinc roof house, 27 (45.0%) have between 6 – 10 rooms in their house, 55 (91.7%) sleep in a room and 21 (35.0%) make use of charcoal as source of fuel for their cooking. CONCLUSION: Poverty or lower income affects the health of individuals through a person’s health throughout their life span. Issues that affect social determinants of health of individuals and community in a negative way should be accosted with all seriousness.

Comprehensive studies into the various causes of this ubiquitous disease have been prompted by the worldwide increase in cancer incidence. There are many potential causes of cancer, but environmental factors are of particular concern now. This abstract explores the complex link between environmental factors and the growing cancer epidemic, shedding light on the role that our immediate environment plays in the emergence of cancers. The environment can contain carcinogenic agents that gradually influence the course of cancer, including air pollutants, water contaminants, workplace exposures, and industrial activities. The ways through which environmental carcinogens may cause DNA damage and unchecked cell proliferation are discussed in this abstract. Environmental justice and the moral necessity to reduce inequities in exposure and health effects are highlighted to underline the disproportionate impact on vulnerable groups. The study presented here highlights the need for preemptive action to reduce environmental risks. Society can reduce the hidden threat posed by environmental carcinogens through strict legislation, sustainable practices, and community-driven initiatives. In order to lessen the cancer burden and secure a healthier future for all, the authors of this abstract argue that there must be a concerted effort to create surroundings that promote health and well-being.

Recent years have seen an explosion of interest in the topic of gut health and food, revealing a complex interplay that affects many facets of human health beyond just digestion. This in-depth overview investigates crucial aspects of this connection, illuminating issues including the effects of processed meals, the advantages of fermented foods, individualized diets, and the harmonious relationship between gut bacteria and dietary components. In this article, we'll take a look at how processed foods affect your digestive system, and how their convenience might backfire by upsetting your body's delicate microbial balance. The effects of these diets have been studied, and the results suggest that there may be disruptions in microbial diversity, inflammation, and metabolic health. Instead, fermented foods are explored as potential allies in the fight for gut health. These foods' high probiotic content not only improves digestion and nutrition absorption, but may also have an effect on one's state of mind. There is growing evidence that eating fermented foods can help you maintain a healthy and robust gut microbiome. Recognizing that everyone has a different gut microbiota composition, the idea of individualized nutrition has come to the forefront. One novel strategy for improving digestive health is to provide nutritional advice based on a person's unique microbial profile. This paper looks at how microbiome testing can be combined with professional advice to create food programs that feed specific bacteria communities, improving both diversity and health. In conclusion, this review emphasizes the reciprocal interaction between dietary choices and the gut microbiota, and the significant impact that gut health has on numerous aspects of human health. The more we learn about the complexities of this interplay, the more we can take a holistic approach to nutrition, one that respects the uniqueness of each person's gut microbiome and encourages healthy eating habits. By taking a more all-encompassing view, we are reminded of the critical function of the gut microbiota in determining our health and of the significance of fostering this nuanced symbiotic connection.

Antimicrobial resistance (AMR) poses one of the significant challenges for the progress of modern medicine not only by its myriad manifestations on a microbiological plane but also due to its demand for a complex, multisectoral approach for its annulment. While some nations have been actively involved in the deployment of counter measures against AMR, the same have yet to be implemented in India. This can be attributed due to a combination of its epitomizing multivariate nature and the challenges encountered on a ground-level in policy implementation. This review surveys mechanisms and factors promoting incidence of AMR, potential Artificial Intelligence (AI) implementation alongside evaluating the efficacy of the One Health approach on national and state levels in curbing the rise of AMR.

Total edentulism is the loss of all teeth for any cause by a multifactorial process that involves biological and patient-related factors. Studies on edentulism and risk factors in Mexico are limited, and the epidemiological surveillance data is scarce and controversial since official governmental reports are not statistically representative of the country. We estimate the distribution for edentulism according to sociodemographic and socioeconomic variables in adults from a low-income state in 2003 and its progress in Mexico. We analyzed data from the National Performance Evaluation Survey in Oaxaca, Mexico, and the annual reports of the Epidemiological Surveillance System of Oral Pathologies in 2009-2019 using X². Oaxacan patients older than 75 y.o (17.9%, p<0.05), those with lower schooling (11.2%), and diabetes (14.5%) presented the highest percentage of edentulism. We do not observe differences in edentulism between sex or residence (p>0.05). From 2009 to 2019, country data reports the lowest rate of edentulism in adults over 20 y.o (0.32%; 95% CI 0.18%-0.48%) and the most affected population over 79 y.o. (7.29%; 95% CI 5.2%-9.30%). As it is a cumulative phenomenon, it is necessary to establish better surveillance, prevention, and treatment programs to improve the oral health of older thus reducing edentulism.

Hypertension is a chronic non-communicable disease which is one of the main causes of serious cardiovascular disease death in the community. The level of treatment and health control for hypertensive patients is still not optimal due to lack of information. Aim was to identify various current methods of health education by nurses and their impact on hypertensive patients. Method Literature review research. The literature was obtained from the Scopus, Sage and PubMed databases with the keywords "Intervention" OR "Methods" AND "Nursing" AND "Hypertension". There are seven literatures that are determined to meet the requirements of the inclusion criteria. Results found three types of health education methods performed by nurses: 1) direct health education methods; nurses meet and meet face to face with patients in the form of individual teaching or training, 2) indirect health education methods; nurses are not face-to-face but use telephone or mobile communication aids to convey information and send SMS about health, and use internet-based websites to convey health information, 3) combined health education methods; nurses face to face with patients and follow-up care is carried out by indirect health education methods. The impact of health education methods carried out by nurses on hypertensive patients is that the level of patient adherence increases in treatment, increased knowledge levels, better blood pressure control, healthy lifestyle practices, adherence to diet, improved quality of life, and positive nurse-patient feedback occurs. in fulfilling mutually agreed upon treatment appointments. Conclusion health education methods carried out by nurses have a very positive impact on disease management and prevention of risk factors for complications in hypertensive patients.

Culture, gender and religion are closely linked each other’s, profoundly affect the role of each person within the Society, and also affect the ability to access to the health resources. We are now living a worldwide crisis due to the SARS-CoV-2 pandemic. In order to appropriately tackle it, an alliance between science, politics and citizens is needed. In this article, we summarize current evidences of how religions can represent, on one hand, a risk moment for spreading the virus (in relation with overcrowded events), on the other, a precious opportunity to engage people, and in particular minorities, in fighting the pandemic. To win this fight, we need a multicultural approach that takes into account every aspect of human life, and among these religion, which influences so much culture, everyday life and well-being.

A strategy to propose solutions to health-related problems recognizes that people, animals, and the environment are interconnected. Fusarium and Neocosmospora are an example of this interaction due to the capable of infecting plants, animals, and human. This review provides information on various aspects of these relations and proposes how to approach fusariosis with a One Health methodology. Here we give a framework to understand infection pathogenesis, through the epidemiological triad and explain how the broad utilization of fungicides in agriculture may play a role in the treatment of human fusariosis. We assess how plumbing systems and hospital environments might play a role as a reservoir for animal and human infections. We explain the role of antifungal resistance mechanism in both humans and agriculture. Our review emphasizes the importance of developing interdisciplinarity research studies where aquatic animals, plants, and human disease interactions can be explored through coordination and collaborative actions.

Objectives: to assess the knowledge level of parents from the central region of Saudi Arabia about oral health and care of preschool children and its relation with sociodemographic variables, parents‟ self-perception toward their dental health, importance of teeth and frequency of dental visits. Methods: a random sample of 754 parents participated in this cross-sectional study and completed an internationally accepted questionnaire. Chi square test and logistic regression analysis were used to analyze the data (p<0.05). Results: mean knowledge score of the parents was 4.8 (out of 11). Less than 20% of the parents were knowledgeable about the best position for tooth brushing, the concentration of fluoride in a child‟s toothpaste, timing of first dental check-up, and best time to give a sugary snack. Mothers, parents with high educational level and family income, parents with positive attitude towards teeth and excellent self-perception of their dental health were significantly more likely to score higher (p<0.05). Conclusions: knowledge of parents about oral health and care of preschool children in the central region of Saudi Arabia was deficient. Gender, education level of parents, family income, attitude about teeth and self-perception of parents‟ own dental health were factors which influenced their knowledge. To improve parents‟ knowledge, role of health professionals should be improved and TV commercials directed toward the areas which had gaps in knowledge.

Introduction: Governance, the least studied health system component, comprises a system of rules and processes, and is a key determinant for effective decision making for health care planning. This study aims to identify institutional, legal and policy factors which are either barriers or facilitators for the implementation of integrated mental health in primary care in the India. Methods: Semi-structured interviews were conducted with 33 key informants at the district and national levels with policy makers, state level health care planners and district planners and managers in India. The data were analysed using thematic analysis using the qualitative software NViVO 10. Findings: Participants stated that a conducive environment for mental health service delivery is necessary at the legislative, policy and planning levels, to facilitate integration of mental health into primary care. Amongst other factors, the need for active involvement of civil society and service user organisations, strengthening mental health information systems, and building the non-technical skills of the mental health workforce, were identified as particularly necessary to deliver adequate mental health services.Conclusion: Amidst the favourable policy context supporting collaborative and integrated care in India, this study identified low resourcing, weak collaborations and inadequate information to be crucial for integrated mental health in India at present.

Phthalates are esters of Pthalic acid, compounds mainly used as plasticisers. Phthalates are widely used chemicals which are of significant research interest as their exposure causes various consequences for human health. There are several categories of phthalates extensively used in many commercial productions with diverse uses, physicochemical properties and toxicological effects. This chapter discusses the toxicity of Phthalates and its potential risks to human health.

The main goal of the study was to obtain objective measures of the impact of a complete pre-season of amateur football on the players’ physical activity parameters. 17 amateur football players (24.47 ± 4.53 years) enrolled in the same team agreed to participate. They were asked to wear one accelerometer on the right hip during each training practice. Moderate-to-Vigorous physical activity (MVPA), steps and metabolic-equivalent (METs), among other parameters, were obtained and analyzed. Results showed that players spent an average 54.86% of each training session in MVPA levels, for a total of 100.33 minutes every week (3 training sessions per week). Therefore, this group of amateur football players did not meet the requirements to obtain health benefits from their physical activity program: amateur football. This finding could be considered noteworthy because there are thousands of adults worldwide who play amateur football to maintain a healthy lifestyle. They should be aware that their weekly training load is not enough to help them meet the necessary requirements. They either need more practice time (90-minute sessions) or more sessions. The pre-season training program was rated as “somewhat hard” by the participants, and quadriceps and hamstrings were mentioned as the most exerted muscles

Abstract: Background: Ukrainian refugees fleeing the conflict between Russia and Ukraine may face significant challenges to their physical, psycho-emotional, social, and spiritual wellbeing. Aim: To identify the health needs of Ukrainian refugees seen in primary care facilities in Tenerife, Canary Islands, Spain. Methods: A mixed-methods design was employed. Quantitative data were obtained through a descriptive analysis of health records, while qualitative data were collected via focus group interviews and thematic analysis of testimonies. Results: The sample comprised 59 individuals (45.4% of all patients seen). Eight participants from five family groups took part in the focus group. The typical profile of a Ukrainian refugee in the Canary Islands is female (79.7%), relatively young, with a high socio-cultural background, generally in good health, travelling alone or with her minor children. The main reasons for consultation were routine health check-ups and control blood tests. The NANDA-I nursing diagnoses indicated a need for psycho-emotional care, with the most prevalent being Risk for Relocation Stress Syndrome (27.1%); Interrupted Family Processes, Disturbed sleep pattern, Risk for Impaired Resilience (13.6% each); and Anxiety (11.9%). Participants rated the healthcare system positively, but language barriers and long waiting times for access to specific services were noted as limitations. Their needs did not significantly differ from those of the local population. Conclusions: This study underscores the need for a tailored approach to refugee care, considering their unique circumstances and needs. Early provision of information about available healthcare services and protocols can facilitate access, manage expectations, and aid decision-making.

The gut microbiome known as the “hidden organ” in humans has received wide attention due to its pivotal role in human health, influencing various physiological functions and metabolic processes. Multiple factors influence the gut microbiome and diet emerging as a prominent determinant. Increasing evidence verifies different dietary patterns modulate gut microbial composition and its functionality. Asia, home to the world's largest population, showcases immense diversity, reflected in its complex dietary patterns influenced by tradition and modernization. A plethora of research evidence proves Asian diet confers beneficial effects on maintaining and improving health through favorable alteration of gut microbiome. Yet up to date, no comprehensive review exists on the influence of the Asian diet on gut microbiome. This review critically examines published data on dietary components from Eastern, Southeastern, Southern, Western and Central Asian diet and their interaction with the human gut microbiome across healthy and diseased states. It identifies strengths and limitations in Asian gut microbiome research. Asia experiences rapid dietary transitions demanding further investigation into their effects on the gut microbiota. However, evidence proves traditional Asian diets hold promise for developing personalized dietary interventions and therapeutics to promote gut health and prevent chronic diseases by modulating gut microbiome.

This study investigated the relationship between fundamental movement skills (FMSs) and health-related fitness (HRF) among first and second graders in South Korean elementary schools. It aimed to provide foundational data for developing physical education programs tailored to the motor development stages and fitness levels of younger elementary school students. In October 2023, FMSs (jumping, running, hopping, static balance, dynamic balance, overhand throwing, and kicking) and HRF (muscular strength, cardiorespiratory endurance, and flexibility) were evaluated among 291 first and second graders. The collected data were analyzed through frequency and multiple regression analyses performed using the SPSS software. The results revealed that higher scores in jumping and hopping are associated with greater muscular strength, cardiorespiratory endurance, and flexibility. Running had no significant effect on HRF elements. Higher scores in static balance (single-leg stance) were associated with increased muscular strength, cardiorespiratory endurance, and flexibility, but dynamic balance (balance beam walking) did not have a significant effect. Higher scores in overhand throwing were associated with greater muscular strength and cardiorespiratory endurance, but kicking did not show a significant association. Overall, these findings emphasize the importance of prioritizing jumping and static balance in physical education for the well-rounded health development of first and second graders.

Introduction: Rural Americans face significant health disparities due to limited access to healthcare services. Telehealth has emerged as a promising solution to mitigate these disparities by facilitating remote access to medical care. This paper comprehensively reviews the advantages, challenges, and implementation strategies of telehealth in rural areas.Method: A narrative review methodology was employed to synthesize existing literature and case studies on telehealth in rural settings. Databases such as PubMed, Google Scholar, and JSTOR were searched for relevant studies published in the last three decades. Keywords such as "telehealth," "rural health," and "healthcare disparities" guided the search process. The review focused on studies assessing the impact of telehealth on healthcare access, cost-effectiveness, and quality of care in rural areas.Results: The review findings indicate that telehealth significantly enhances healthcare access by reducing travel distances, increasing availability of specialist consultations, and promoting patient engagement. It improves chronic disease management and patient satisfaction by enabling convenient access to healthcare services at home. Despite initial setup costs and challenges such as broadband access and regulatory issues, telehealth demonstrates long-term cost savings through reduced travel expenses and improved healthcare efficiency. Quality of care is enhanced through improved communication between healthcare providers and patients, leading to better treatment adherence and health outcomes.Conclusion: Telehealth represents a transformative approach to address healthcare disparities in rural areas. It offers a cost-effective solution to improve access to healthcare services, enhance patient outcomes, and reduce healthcare costs in the long run. However, successful implementation requires addressing infrastructure challenges, refining reimbursement policies, and ensuring regulatory support. Future efforts should focus on expanding broadband infrastructure, refining policy frameworks, and conducting further research to optimize telehealth's impact on rural healthcare delivery.

Mental health in Puerto Rico is a complex and multifaceted issue that has been shaped by the island’s unique history, culture, and political status. Recent challenges, including disasters, economic hardships, and political turmoil, have significantly affected the mental well-being of the population coupled with the limitations in the accessibility of mental health services. Puerto Rico has fewer mental health professionals per capita than any other state or territory in the United States. This comprehensive review examines the impact of disasters on mental health and mental health services in Puerto Rico. Given the exodus of Puerto Ricans from the island, the review also provides an overview of mental health resources available on the island as well as the continental United States. The review identifies efforts to address mental health issues, with the intent of gaining a proper understanding of the available mental health services, key trends, as well as observable challenges and achievements within the mental health landscape of the Puerto Rican population.

Objective: The Covid-19 pandemic has raised significant concerns about public health, particularly in terms of mental well-being due to heightened fear and uncertainty. The findings of this study are based on a survey conducted to evaluate the mental health status of the general population in Croatia during the Covid-19 pandemic. Methods: A survey conducted randomly and cross-sectionally included 588 respondents from all 21 counties in Croatia. The survey gathered demographic data and assessed various factors related to pandemic response measures and mental health using the Mental Health Continuum-Short Form (MHC-SF) scale. Results: Despite feeling adequately informed about Covid-19 (76.0%), most respondents (60.8%) expressed concerns about their loved ones during the pandemic. There were significant numbers who felt there was no risk of infection (50.9%) or believed they would not get infected (40.2%), while 72.4% were content with government measures. Statistical analysis indicated that mental health was not significantly different between genders, but age-related differences were evident, with those under 21 experiencing the most distress. The lowest level of psychological and social well-being was observed in respondents who were unemployed. Conclusions: The study identifies vulnerable groups in the Croatian population during the pandemic, including younger individuals, those on parental leave, students, and the unemployed, who exhibited worse mental health. The importance of implementing targeted mental health interventions to support these vulnerable groups is highlighted by these findings.

Consumers often cite cognitive improvements as reasons for making dietary changes or using dietary supplements, a motivation that if leveraged could greatly enhance public health. However, rarely is it considered whether standardized cognitive tests that are used in nutrition research are aligned to outcomes of interest to the consumer. This knowledge gap presents a challenge to the scientific substantiation of nutrition-based cognitive health benefits. Here we combined qualitative consumer research and expert group methodology to (1) understand how consumers comprehend the potential benefits of nutrition for brain health, and (2) determine the alignment between consumers' articulated brain benefits and validated tests and tools. We derived a ‘Consumer Taxonomy of Cognitive and Affective Health in Nutrition Research’ which describes the cognitive and affective structure from the consumers' perspective. Experts agreed that validated tests exist for some consumer benefits including focused attention, sustained attention, episodic memory, energy levels, and anxiety. Prospective memory, flow, and presence represented novel benefits that require the development and validation of new tests and tools. Closing the gap between science and consumers, and fostering co-creative approaches to nutrition research, are critical to the development of products and dietary recommendations that support realizable cognitive benefits that benefit public health.

Background: Delivery of quality family planning services depends on availability of skilled health care providers, which is often a challenge in Low- and middle-income countries. This study evaluates the effects of a targeted training program on family planning services delivered by the Lady Health Workers (LHWs) in six districts of Punjab, Pakistan. The primary goal was to enhance the quality and accessibility of family planning services, recognizing the pivotal role of LHWs in community health. Methods: Using a robust panel data difference-in-differences (DiD) approach, we analyzed the electronic medical records (EMR) of 1,410 LHWs over a nine-month period. This timeframe in-cluded both pre-training (July to December 2022) and post-training (April to June 2023) phases. Our assessment focused on the impact of training on five outcome variables: the number of follow-up clients, the number of Intrauterine Contraceptive Device (IUCD) clients, the number of condom clients, the number of modern method clients, and the number of injection clients. We also con-sidered control variables such as LHW age, LHW education, the number of eligible couples in each LHW's catchment area, and a categorical variable for the districts. Results: The positive and statistically significant (p<0.05) coefficients across various service cat-egories – Follow Up Clients [Coeff: 1.00, CI: (0.30 - 1.70)], IUCD Clients [Coeff: 0.23, CI: (-0.01 - 0.46)], Condom Clients [Coeff: 1.41, CI: (0.97 – 1.86)], Modern Method Clients [Coeff: 1.82, CI: (0.96 – 2.68)], and Injection Clients [Coeff: 0.32, CI: (0.14 – 0.50)]. These findings indicate enhanced productivity among LHWs who have received training, with results significant at the 95% con-fidence interval (CI). Conclusion: The study highlights the effectiveness of targeted training programs in boosting family planning services at the community level and offers insightful implications for policy-makers and health practitioners. While focused on six districts in Punjab, these promising results emphasize the need for ongoing training and support for frontline health workers to bolster family planning initiatives.

This study aimed to expand and inform the growing body of research on Postpartum Depression, from a netnographic standpoint, for the social media platform of Pinterest. More specifically, it aimed to assess the type of content present on Pinterest regarding Postpartum Depression shared by women in 2018 and 2021, as well as examine the subjective experience of women who have experienced this mood disorder. Data were collected following a search using the keywords “Postpartum Depression” on Pinterest on two separate timestamps (2018 and 2021); pins were limited to those in English or French. Master themes were identified among all pins and those identified as “self-disclosure” were subsequently further analyzed. Self-disclosure data were separately analysed using thematic analysis, specifically adopting a deductive thematic approach for the 2021 data set stemming from the coding scheme created from analysis of the 2018 data. Major themes were identified, and an analysis of frequency was performed for each sub-theme, along with qualitative examples associated with each theme. A total of 483 Pinterest pins from two different time points of 2018 (169 pins) and 2021 (314 sample pins) were analyzed. Five primary categories were identified in both 2018 and 2021, with five additional categories being identified in the 2021 dataset. Comparative results from 2018 and 2021 self-disclosure pins show individuals’ varying yet similar subjective manifestations of PPD, the potential need to adopt a multidisciplinary treatment approach, and the societal fears, such as mental health stigma, that are playing a part in help-seeking behavior hesitancies. Our findings provide imperative insight into individuals’ subjective experiences with PPD; experiences that involve a sensitive and vulnerable topic. Netnographic research, along with Pinterest, must be taken into consideration for future work delving into women’s health issues, including those surrounding perinatal mental health.

Background: Patients’ effective hand hygiene helps to reduce healthcare-associated infections, prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. This study aimed to describe effective hand hygiene decisions based on the Health Action Process Ap-proach (HAPA) and whether this pattern is invariant for mental health. Methods: Data were collected cross-sectionally from patients who had previously been admitted to a hospital (N=279; study 1) and longitudinally from psychosomatic rehabilitation patients (N=1,073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding com-pliance, as well as social-cognitive variables of the HAPA, and mental health status were examined. Results: The trimmed HAPA framework fitted the data well (χ2=27.1, df=12, p<.01, CMIN/df=2.26, CFI=.97, RMSEA=.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior were found to be invariant with regard to mental health. Conclusion: The trimmed HAPA framework revealed to be a generic framework in explaining so-cial-cognitive processes relating to hand hygiene decisions. Helping individuals to perform hand hygiene recommendation requires intention formation and bridging the intention-behavior gap. This can be done by promoting planning and self-efficacy. All processes appear generic to partic-ipants with and without mental health challenges.

Dairy calves are susceptible to a great range of welfare and health issues up to the age of weaning. The aim of the current pilot study was to evaluate incidence of the main health disorders affecting dairy calves up to one year of age. The study was carried out at the Experimental Farm of the Research and Development Institute for Bovine Balotesti, Romania, were health data was collected for two consecutive years, between November 2017 and October 2019, from a number of 176 purebred Romanian Black and White calves. Diarrhea had the highest incidence in un-weaned calves (0-3months old), of 29.55±0.34%, significantly higher (p≤0.001) compared to 3-6 months (2.16±1.24) and 6-12 months age groups (5.88±2.17), respectively. Coccidiosis incidence was on average of 39.20±0.36% in un-weaned calves, 1.44±1.01% in the 3-6 months group and of 5.04±2.01% in the 6-12 months group, significantly higher (p≤0.001) in the 0-3 months age group, compared to older calves.

The persistent burden of chronic hepatitis B among ≤5-year-old children in Africa suggests missed opportunities for controlling mother-to-child transmission (MTCT) of the hepatitis B virus (HBV). This scoping review maps the evidence base on the risk of HBV MTCT, the status of HBV MTCT mitigation strategies including hepatitis B birth-dose vaccination, and the role of systems complexity on the suboptimal adoption and performance of hepatitis B birth-dose vaccination programs in Africa. Overall, 88 peer-reviewed and grey literature sources published between 2000–2022 were included in this review. The evidence base consistently argues for a growing risk of HBV MTCT amidst the HIV co-epidemic in the region. Without universal HBV screening programs integrated within broader antenatal care services, current selective hepatitis B birth-dose vaccination is unlikely to effectively interrupt HBV MTCT. We underscore critical health systems-related barriers to universal adoption and optimal performance of hepatitis B birth-dose vaccination programs in the region. To better conceptualize the role of complexity and system-wide effects on the observed performance of the program, we propose an adapted systems-based logic model. Ultimately, exploring contextualized complex systems approaches to scaling-up universal hepatitis B birth-dose vaccination programs should form an integral part of the regional research agenda.

The COVID-19 virus is spread to the respiratory system by minute airborne particles in contrast to large particle fomite transmission. Yet, an often-repeated health directive during the COVID-19 pandemic was to improve handwashing to limit the spread of the virus. Persistent handwashing can aggravate obsessive-compulsive disorder (OCD), diminishing mental health. Given that handwashing is unlikely to control the spread of COVID-19, it is pertinent to determine if the directive for handwashing to eradicate the COVID-19 virus increased the incidence of OCD and, as such, promoted negative mental health. This scoping review of the parameter, “handwashing, mental health, COVID-19, OCD”, conducted during July 2023, searched six relevant databases. The result was that negative mental health related to increased handwashing was evident both for those already diagnosed with OCD and regarding new cases of OCD throughout the duration of the pandemic. The conclusion is that health officials should update details of their health directives as information becomes available during a pandemic and, concerning COVID-19, the directive to concentrate on handwashing should have been relaxed once it was known that spread of the virus by fomite transmission was improbable. This likely would have reduced the incidence of OCD and improved mental health.

In order to cope with the challenges of physical and psychological aging in the indigenous people in Taiwan, most of the tribes in Taiwan set up cultural health stations for indigenous elderly. These community care facilities have practiced many health promotion activities, such as the reminiscence, life review, and arts activity. However, there was little exploration into the benefit of indigenous people’s practice the life review activity in Taiwan—the gap this study aimed to fill. This study adopts life review therapy through a set of innovative life review activity designs in indigenous older adults, including activity planning, and indigenous cultural elements. A qualitative study design using semi-structured interviews was used to obtain data from a purposive sample. Ten participants who assessed to the cultural health stations services and participated in the life review activities of the indigenous older adults in southern Taiwan were interviewed individually. The data were analyzed using Graneheim and Lundman’s qualitative content analysis. The theme—“experiences and benefits of participating”—and two categories with six subcategories emerged. The results demonstrated that the participation of the indigenous elderly in life review activities with cultural elements had obvious benefits for their mental health. Life review therapy can be incorporated as a supplementary LTC treatment for the indigenous people, thereby, promoting the positive emotions of the indigenous elderly.

This study analyzes the effect of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). A panel analysis was conducted by combining 21 years of data (from 2000 to 2020) from 38 OECD countries. Life expectancy and avoidable mortality were set as the dependent variables; gross domestic product and poverty gap were set as the independent variables; body mass index, consumption, smoking rate, healthcare personnel, number of beds in health service facilities, national medical expenses, and unemployment were set as control variables. First, economic growth and poverty gap significantly affect life expectancy and avoidable mortality. It has been confirmed that to resolve health inequality, growth during growth and distribution must be prioritized. Second, it has been confirmed that as the poverty gap increases, life expectancy increases and the avoidable mortality rate decreases. A mechanism different from the existence of a medical security system targeting the lowest class or an increase in the welfare of society worked. In conclusion, as a policy proposal to alleviate health inequality, this study suggests that policy intervention is necessary to block or alleviate the negative impact of income inequality in health care policies.

U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally-tailored, Spanish-language COVID-19 information on social media. From May 1, 2021-April 30, 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%), and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By June 9, 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mostly women aged 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9,718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos, trending topics, and music or audio-narration. This community-based model to engage Spanish-speaking audiences on social media with culturally-aligned content to counter misinformation shows promise for addressing public health threats.

As of July 7, 2022, the total number of confirmed cases caused by COVID-19 has reached 544,324 million, and the total number of 6.333 million deaths (WHO). Older people were globally the most vulnerable during the pandemic. This paper examined the mortality and psychological crisis of older people during the pandemic in four cities, namely Wuhan, Milan, London, and Hong Kong. The selection of cities was based on different degrees of social connectedness of older people and chronologically to cover the whole period of the outbreak from January 2020 to August 2022. Older people in Milan and Wuhan tended to rely on the close family relationship during times of crisis. Meanwhile, older people in Hong Kong and London were more dependent on social services. Both quantitative and qualitative approaches were employed to analyze the situations of older people under different government responses and the strengths and weaknesses of respective healthcare systems. Government reports and official statistics were used to illustrate the seriousness of each city's COVID-19 outbreak while stories reported by the press, NGOs, and journal articles were used to reflect the reactions of the older people. Interactions of social culture, health care provisions, and government responses to the pandemic were discussed from the perspective of health welfare regimes. On one hand, results showed that governments have not learned from the experiences of other countries. On the other hand, older people have not successfully coped with the life-threatening stress by breaking institutional boundaries and redefining cultural norms.

More than twenty-five years ago the Global Solar UV index (UVI) has been introduced as a simple means of visualizing the intensity of ultraviolet radiation and to alert people to the need for sun protection. In our survey among directors of 436 kindergartens in southern Germany we investigated the level of awareness and knowledge about the UVI as well as the practical consequences for sun protection in kindergartens. Less than half of the directors (n=208, 47.7%) had ever heard of the UVI, and only a small minority of them (n=34, 8.7%) used the daily UVI information to adapt sun protective measures in their kindergartens. Detailed knowledge about the UVI was a rarity among the respondents. The proportion of respondents with self-perceived detailed UVI knowledge was five times higher than actual knowledge assessed by an in-depth structured interview using open-ended questions about the UVI (14.2% vs. 2.8%). No clear relationship of UVI awareness, knowledge, and use to directors' age and gender was found. The UVI-related variables also showed no association with directors' knowledge of risk factors for skin cancer and their attitudes towards tanned skin. Overall, the results paint a sobering picture regarding the penetration of the UVI into sun protection policies of German kindergartens. Future public health campaigns should target increasing awareness and understanding of the UVI as well as its importance for sun protection of children.

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to Nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. Work Process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and Health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general.

Background: Supportive supervision has lately been gaining traction in various national health systems as an effective way of boosting the performance of community health workers in a constructive and sustainable way. However, not much is known about the basis/mandate of supportive supervision and its approach in maternal and child health programs in India. The current analysis contributes to a clearer understanding of the paradigms within which supportive supervision is envisioned to operate within India and identifies potential strengths and areas requiring attention. Method: Document analysis of implementation documents such as guidelines/ operational manuals/operationalization modules/ training modules of nationally implemented maternal and child health programs, with data extraction according to a pre-determined domain-based template. Results: Many of the documents reviewed do not mention supportive supervision at all. In the few documents where supportive supervision is mentioned, the paradigms within which it is supposed to operate (who will do it, when will it be done, how to do it, training and logistic support, reporting formats, etc.) have not been clearly identified in most programs. Conclusion: Even though supportive supervision is being increasingly identified as an effective way of performative improvement in national health programs in India, more effort needs to be put into identifying and enforcing the tenets of supportive supervision in practice, in order to bring about the desired change.

Medical records contain many terms which are difficult to process. Our aim in this study is to allow the visual exploration of the information in medical databases where the texts presents a large number of syntactic variations and abbreviations, through an interface which facilitates content identification, navigation and information retrieval. We propose the use of multi-term tag clouds as content representation tools and as assistants for the browsing and querying tasks. The tag cloud generation is achieved through a novelty mathematical method that allows related terms to remain grouped together within the tags To evaluate this proposal, we have used a database with 24,481 records. 23 expert users in the medical field were tasked to complete a survey to evaluate the generated tag clouds properties and we obtained a precision of 0.990, a recall of 0.870 and a F1score of 0.904 in the evaluation of the tag cloud as an information retrieval tool. The main contribution of this approach is that we automatically generate a visual interface over the text capable of capturing the semantics of the information and facilitating access to medical records.

The COVID-19 pandemic has contributed to mental health problems worldwide. Nurses are particularly prone to stress because they directly care for individuals with suspected or confirmed cases of COVID-19. The aim of this study is to explore the association between the mental health promotion strategies used by nurses during the coronavirus disease (COVID-19) outbreak and their symptoms of depression, anxiety, and stress, and to compare the strategies and symptoms of mental health nurses and non-mental health nurses. Cross-sectional study was conducted with a sample of 821 nurses. Portuguese nurses demonstrated high symptoms of depressive symptoms, stress, and anxiety. Healthy eating, physical activity, rest between shifts, maintaining social contacts, verbalizing feelings/emotions, and spending less time searching for information about COVID-19 are associated with better mental health. Mental health nurses have less depression, anxiety, and stress, and use more strategies to promote mental health than other nurses. We consider it important to promote nurses’ mental health literacy by encouraging them to develop skills and strategies aimed at improving their resilience and ability to deal with difficult situations while caring for the population.

Background: Recent disasters have demonstrated gaps in employers’ preparedness to protect employees and promote their well-being in the face of emergencies and disasters affecting the workplace and their communities. Total Worker Health (TWH), a comprehensive perspective developed by the National Institute for Occupational Safety and Health, is a helpful framework for addressing employer preparedness. It includes attention to health and safety at work, and the promotion of the health and well-being of the employee in the context of social determinants of health, such as work-life balance. Methods: TWH concepts, including the domains of TWH and the TWH Hierarchy of Controls, were investigated for their relevance to protecting employees and promoting their well-being during and after crises such as weather disasters, pandemics, and acts of terrorism. Building upon TWH concepts, an employer preparedness framework and model is proposed. Findings: The Model emphasizes upstream prevention, workplace-community linkages, social and economic impacts, and employer leadership through a cyclical planning process. Conclusions/Application to Practice: The Model can assist employers in advancing their preparedness for all hazards through self-assessment and planning agendas based upon the proposed domains.

Shelter-in-place aimed at slowing COVID-19 transmission has altered nature accessibility patterns, creating quasi-experimental conditions to assess if retracted nature contact and perceived nature deprivation influences physical and emotional wellbeing. We measure through survey methods how pandemic mandates limiting personal movement and outdoor nature access effect self-assessed nature exposure, perceived nature deprivation, and subsequent flourishing as measured by the Harvard Flourishing Index. Results indicate that perceived nature deprivation strongly associates with neighborhood nature contact, time in nature and access to municipal nature during the pandemic, after controlling for shelter-in-place mandates, job status, household composition, and sociodemographic variables. Our hypothesis that individuals with strong perceived nature deprivation under COVID-19 leads to diminished wellbeing proved true. Interaction models of flourishing showed positive modification of nature affinity with age and qualitative modification of nature deprivation with race. Our results demonstrate the potential of local nature contact to support individual wellbeing in a background context of emotional distress and social isolation, important in guiding public health policies beyond pandemics.

The School Fruit and Vegetables Scheme (SFVS) implemented by the European Union during 2009/10 aims to improve the diet of school children and to support agricultural markets and environmental sustainability. The objective of this study was to characterize the SFVS implementation in Spain (2009-2017). A descriptive, longitudinal, observational and retrospective study was carried out based on document analysis of annual strategies of the SFVS. We studied the average budget for the EU, the number of students enrolled, the cost of the SFVS by student and by day, the duration of the SFVS, the quantity of fruits and vegetables (FV) per student, the variety of FV, the inclusion of local, seasonal and organic foods, and the education activities (EA). The results were studied by autonomous community (AC). The budget increased from 7.4 million euros in 2009/10 to 14.4 in 2016/17. Since 2014/15, the increase came from EU funds, the number of students increased from 18% in 2009 to 20% in 2016. The quantity of FV went from 2,579 to 4,000 tons, duration increased from 9.8 to 19.6 days and the variety of fruits and vegetables increased from 20 to 21 and from 5 to 6 respectively. In AC there were important variations in EA, in the number of enrolled students (7.4% to 45.6%), in the cost per student (2.3€ to 28€) and in the duration in days (5.6 to 70 days). The inclusion of local, seasonal and organic foods was identified in 5 of the 8 years studied. The development and reach of the SFVS in Spain is still insufficient to influence dietary patterns and health in the school population. However, the SFVS has generated an economic market for agricultural production.

Non-typhoid salmonellosis is a common and problematic foodborne zoonotic disease in which pork and pork products can be an important potential source of infection. In order to prevent this disease important efforts to monitor the situation in the main source, livestock, are conducted in most developed countries. In the European Union EFSA and ECDC compile information at the member state level, even though important differences in production systems and surveillance systems exist. Here, Salmonella surveillance systems in one of the main sources of foodborne salmonellosis, swine, and humans in Spain were reviewed to identify potential gaps and discuss potential ways of integration under a One Health approach. Despite the extensive information generated through the surveillance activities source attribution can be only routinely performed through ad-hoc outbreak investigations, and national reports on human outbreaks do not provide sufficiently detailed information to gain a better understanding of the epidemiology of the pathogen. Human and animal monitoring of Salmonella would benefit from a better exchange of information and collaboration. Analysis of spatio-temporal trends in livestock and humans could help to identify likely sources of infection and to target surveillance efforts in areas with higher prevalence or where specific strains are found.

Migrants are mainly employed in "3D Jobs" dirty, dangerous, difficult, characterized by monotony, intense rhythms, in sectors at higher risk as construction, heavy industry, agriculture. Aim of this study is to elaborate a systematic review, in order to identify the main occupational risks and occupational diseases of this category. Research included articles published from 2013 to 2018 on the major online databases (PubMed, Cochrane Library and Scopus), using a combination of some keywords (migrant workers, expatriates, physical health, diseases, illnesses, travel, travelers, work and occupational). The online search indicated 1.109 references. We excluded 977 studies, because unrelated to physical health and 64 due to duplication. They were analyzed 68 articles, including 6 reviews and 62 original article. The main risk emerged are to developing infectious diseases, metabolic cardiovascular diseases and to manifesting a lower quality of life, in particular due to difficulties in accessing local health services. It will be crucial to implement the role of occupational medicine in order to introduce multilevel interventions designed to prevent work-related injuries and illnesses and to promote healthier working environments.

Admission and discharge diagnoses of in-hospital patients are often in discord. Incorrect admission diagnoses are related to increased cost of care and patient safety. Additionally, due to the seasonality of many conditions, this discord may vary across the year. In this paper, we used medical claims data to develop a methodological framework that examines these differences, for Medicare beneficiaries. We provide examples for pneumonia, a condition with seasonal implications, and aneurysm, where early detection can be life-saving. Following a Bayesian approach, our work quantifies and visualizes with time series plots the degree that any clinical condition is correctly diagnosed upon admission. We examined differences in weekly intervals, during a calendar year. The mean length of stay and hospital charges were furthermore compared between matching and non-matching {admission, discharge Dx} pairs, and 95% confidence intervals of the difference of means were estimated. We applied Statistical Process Control methods and then visualized differences, for the hospital charges and the length of stay, per week, with time series plots. Our methodology and the visualizations underline the importance of a rigorous and non-delayed diagnostic process upon admission since there are significant implications in terms of hospital outcomes and cost of care.

The purpose of this study was to report data analysis results from the International Health Regulations (2005) Ship Sanitation Certificates (SSC), recorded in the European Information System (EIS). International sea trade and population movements by ships can contribute to the global spread of diseases. SSC are issued to ensure the implementation of control measures if public health risk exists on board. EIS designed according to the World Health Organization (WHO) “Handbook for Inspection of Ships and Issuance of SSC”. Inspection data were recorded and SSC issued by inspectors working at European ports were analysed. From July 2011-February 2017, 107 inspectors working at 54 ports in 11 countries inspected 5579 ships. Of these, there were 29 types under 85 flags (including 19 EU flags). As per IHR (2005) 10,281 Ship Sanitation Control Exception Certificates (SSCEC) and 296 Ship Sanitation Control Certificates (SSCC) were issued, 74 extensions to existing SSC were given, 7565 inspection findings were recorded, and 47 inspections were recorded without issuing an SSC. The most frequent inspection findings were the lack of potable water quality monitoring reports (23%). Ships aged ≥12 years (Odds Ratio, OR = 1.77, 95%Confidence Intervals, CI = 1.37–2.29) with an absence of cargo at time of inspection (OR = 3.36, 95%CI = 2.51–4.50) had a higher probability of receiving an SSCC, while ships under the EU flag had a lower probability of having inspection findings (OR = 0.72, 95%CI = 0.66–0.79). Risk factors to prioritise the inspections according to IHR were identified by using the EIS. A global information system, or connection of national or regional information systems and data exchange, could help to better implement SSC using common standards and procedures.

Genomic medicine is moving from research to the clinic. There is a lack of evidence about the impact of genomic medicine interventions on health outcomes. This is due in part to a lack of standardized outcome measures that can be used across different programs to evaluate the impact of interventions targeted to specific genetic conditions. The eMERGE Outcomes working group (OWG) developed measures to collect information on outcomes following the return of genomic results to participants for several genetic disorders. These outcomes were compared to outcome intervention pairs for genetic disorders developed independently by the ClinGen Actionability working group (AWG). In general, there was concordance between the defined outcomes between the two groups. The ClinGen outcomes tended to be higher level and the AWG scored outcomes represented a subset of outcomes referenced in the accompanying AWG evidence review. eMERGE OWG outcomes were more detailed and discrete, facilitating collection of relevant information from health records. This paper demonstrates that common outcomes for genomic medicine interventions can be identified. Further work is needed to standardize outcomes across genomic medicine implementation projects and make these publicly available to enhance dissemination and assist in making precision public health a reality.

This article examines the transformative role of artificial intelligence (AI) in mental health, with a particular focus on its potential to break down barriers for men facing mental health challenges. Historically, men have been less likely to seek help for mental health issues due to societal stigma, cultural expectations, and a reluctance to express vulnerability. AI technologies, including chatbots, generative AI, and machine learning algorithms, offer innovative solutions to address these challenges by providing accessible, anonymous, and personalized support. This paper explores how AI-powered mental health applications can create safe spaces for men to engage with their emotions, seek help, and access resources tailored to their specific needs. Furthermore, it highlights the importance of integrating AI into traditional mental health care models to enhance outreach and reduce stigma. By fostering a more inclusive approach to mental health support, AI has the potential to empower men, promote emotional resilience, and ultimately improve mental health outcomes in this underserved demographic.

The healthcare sector in Kuwait has been nurtured for many decades by the government where the Ministry of Health (MoH) controls up to 80 percent of the country’s health services. General and specialized public hospitals represent a significant proportion of health expenditures in Kuwait; amidst dwindling health resources, a declining global oil market in an oil-dependent welfare state, and a heavy reliance on a non-national clinical workforce. Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This paper aims to analyze public health system efficiency and hospital performance in the State of Kuwait, where we begin by evaluating the input-oriented technical efficiency (TE) of MoH hospitals in 2015-2019 and identifying potential areas for efficiency improvement by exploring influencing institutional and environmental factors. Over the five years between 2015 and 2019, TE in MoH hospitals has decreased by an average of 2.98% solely based on technical regress, where the six MoH general hospitals reported a pooled mean efficiency of 86.58%, and the nine sampled MoH specialized hospitals had a five-year pooled average of 65.47% efficiency. MoH policymakers should focus on improving allocative efficiency in the public health system, and healthcare policy reforms should focus on strengthening management structures in Kuwait’s public hospitals to improve production efficiency and financial sustainability.

Functional health literacy is the ability to read, write, and speak about health. Functional health literacy events can nudge the development of children’s health identity when using valid and reliable reading materials that portray the “what, where, when, why, and with whom” to eat nutritious foods and be physically active. Children who lack social role models for healthy eating and physical activity may also lack development in language and motor skills. Therefore, literacy-rich environments are needed when developing cognitive-motor language skills with children. Children with obesogenic body frames can gain from the production of childcentric health narratives that draw upon the Habits of Mind and Habits of Health© Model to produce Electronic Texts for Health Literacy©. When health professionals plan and implement functional health literacy events so children can read, write, and speak about their own health, new behavioral patterns and routines emerge into performances of understanding. Constructivist pedagogical approaches can help children to create health narratives using multimodal language while practicing health literacy skills as a foundational impetus to health behaviors. Children who struggle with obesity can also gain social agency when writing with peer partners who serve as supportive collaborators when developing interactive health literacy.

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

Objective: To explore the acceptability and feasibility of conducting comprehensive, community-based, hy-brid (in-person and virtual) mental health screening and feedback with diverse youth in the community. Methods: The Screening and Support for Youth intervention provides comprehensive assessment and thera-peutic feedback in community settings including symptoms, diagnoses, functional impairment, suicide, and clinical risk. Symptom severity, seven diagnoses and suicidality were assessed with the Kiddie Computer-ized Adaptive Test. Functional impairment was evaluated by youth self-report on the Weiss Functional Im-pairment Rating Scale. Measures were scored according to nationally developed norms and an algorithm was developed to aggregate symptoms and functioning to determine clinical risk. The results were discussed with participants in a motivational interview to promote insight and engagement in an online intervention. Results: Methodological innovations included using a QR code for recruitment, integrated in-person and virtual participation, and expansion from in-person recruitment within the schools to virtual engagement with youth throughout the community. The final sample included disproportionately more Black or African American and Hispanic youth as compared to school and community statistics, suggesting that hybrid re-search may facilitate recruitment of diverse populations. Qualitative interviews indicated that the screening and feedback raised youth awareness of their wellbeing and/or distress, its impact on their functioning, and engagement with options for improving wellbeing. Conclusion: Hybrid research, developed as a necessity during the pandemic, proved advantageous to the feasibility and acceptability of community-based recruit-ment of at risk, minoritized youth.

AbstractIntroduction: Consistent utilization of institutional delivery service reduces maternal morbidity and mortality. However, service utilization could in turn influenced by the women’s satisfaction with the service provided by the health care providers. In addition, their satisfactions with the institutional delivery service remains understudied. Assessment of the maternal satisfaction with maternal health service is a major input to improve maternal health services. Objective: To assess the maternal satisfaction with maternal health service and its predictors among the women who gave birth in last 12 months in Darara district, Southern Ethiopia.Methods: A community-based cross-sectional study was done using a mixed method among the sample of 520 women in Darara district, South Ethiopia from June 1-30, 2023. A systematic and purposive sampling procedure was utilized to choice the study subjects. A structured, validated and pretested interview-administrated questionnaire and in-depth interview were utilized to collect the data. The data were entered into Epi data version 3.1 and analyzed using SPSS version 25. The chi-square (X²) test was utilized to determine the overall association between independent and dependent variables. Both bi-variable and multivariable binary logistic regression analyses were conducted. Important assumptions of the binary logistic regression were checked to be satisfied. The coding and analysis of the qualitative data were done using thematic content analysis technique by Atlas-Ti software and presented in narratives. Results: The total maternal satisfaction with maternal health service was 55.2% (95% CI = 50.8-59.4). The identified predictors of maternal satisfaction were distance from household to health post (AOR = 3.59; 95% CI= 1.71 - 7.55), absence of preparation of HEWs during procedure (AOR= 2.87; 95% CI = 1.74 - 4.74), acceptability of the HES by HHs (AOR= 2.18; 95% CI = 1.14 - 4.18), having a reliable communication method with HEWs (AOR = 3.47; 95% CI = 1.77 - 6.79) and received training on the model family (AOR= 2.48, 95% CI= 1.86 - 2.57). These quantitative results were supported by the individual, organizational, socio-demographic and cultural qualitative findings. Conclusions: This study indicated that 55.2% of women were satisfied with maternal service.Distance from household to health post, absence of preparation of HEWs during procedure, acceptability of the Health Extension Service (HES) by household, having a reliable communication method with HEWs and received training on the model family were significant predictors of maternal satisfaction. The interventions to increase maternal satisfaction with HES need to focus on household-based acceptability of them and their reliable communication method in planning and implementing the services. Similarly, expansion of training of model family in the community would increase maternal satisfaction levels.

Background: Atopic dermatitis is a chronic condition that significantly affects the daily life of those who suffer from it, requiring complex and personalized management with active participation of the patient in the management of their disease. Objective: to describe the design and development process of a mobile application, using the Design Thinking method, for the follow-up of patients with atopic dermatitis. Methods: User-centered design and prototype creation method, differentiating the phases of the empathize, define, idea, prototype, and test. A purposive snowball sampling was used to recruit patients with atopic dermatitis, family members, and health professionals. Three two-hour workshops were held, attended by 25 people. Results: the parameters to be monitored will include objective data (physical, behavioral, treatments, environmental, integration of daily routines) and subjective data (user experience). On the other hand, it will figure out behavior patterns, set up rewards, foster a feeling of community, and use notifications and a chatbot. Conclusion: The active integration of all stakeholders at each stage of the design and development of the digital solution has improved its relevance and acceptance, resulting in a tool that is expected to significantly improve the management of atopic dermatitis.

Abstract: Background: Viral hepatitis B and C (HBV and HCV) pose significant public health challenges globally, particularly in Nigeria, where access to healthcare and treatment affordability are major concerns. This study aims to identify sociodemographic and clinical predictors of health insurance coverage among patients with HBV and HCV in Nigeria. Methods: A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Par-ticipants included patients diagnosed with HBV, HCV, or both and are > 18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Logistic multivariate regression analysis was used to analyze the relationship between sociodemographic/clinical variables and health insurance status. Results: Out of 295 participants included in the final analysis, 67.1% had health insur-ance, primarily covering hepatitis screening and vaccination. Being aged 31-45 years (adjusted Odds Ratio [aOR]: 5.72, 95% Confidence Interval [CI]: 1.4 - 23.28, p = 0.02), having post-secondary education (aOR: 11.73, CI: 4.09 - 33.66, p < 0.001), and being HIV-positive (aOR: 2.86, CI: 1.02 - 8.02, p = 0.046) were significant predictors of health insurance coverage. Being unemployed significantly reduced the likelihood of having health insurance (aOR: 0.04, CI: 0.01 - 0.11, p < 0.001).Conclusions: This study reveals high insurance coverage among patients seeking viral hepatitis services in Nasarawa state, Nigeria and provides critical insights into the sociodemo-graphic predictors of health insurance coverage. It also highlights the need for the expansion health insurance benefit package that covers for viral hepatitis diagnosis and treatment, espe-cially for the younger adults, unemployed and less educated populations. This should be followed with adequate budgeting and policy implementation monitoring efforts, which are crucial for Nigeria's journey towards universal health coverage and elimination of viral hepatitis.

The aim of this study is to describe a research protocol of a multi-country randomized controlled trial to investigate the effect of a smartphone CBT stress management program on improving depression and other health- and work-related outcomes among hospital nurses in Vietnam and Thailand during the COVID-19 epidemic as a part of the COCONATS project. The study is a two-arm, parallel randomized control trial. Hospital nurses (N = 1,500) will be recruited in Vietnam and Thailand, and those who meet the criteria will be randomly allocated to the intervention or control (treatment as usual) group. A seven-week, seven-module smartphone-based stress management program will be developed to teach CBT skills. The intervention group will participate in the program for 10 weeks. Depression as the primary outcome will be measured using the DASS21 at baseline and in 3- and 6-month follow-up surveys. A mixed model repeated measures analysis will be used to test the intervention effect in the total combined sample, on an intention-to-treat basis. This is the first study to investigate the effectiveness of a self-guided smartphone CBT program on improving depression among hospital nurses using a RCT design in South-East Asian middle-income countries during the COVID-19 pandemic.

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

At present, there are no hardware or biochemical systems allow to assess the severity of post-COVID syndrome in vivo. The hardware of the proposed biotechnical system is based on routine transthoracic electrical impedance rheography, which makes it possible to register the frequency characteristics of the patient's bioimpedance response to controlled stress stimulation, thereby simultaneously fixing the characteristics of his productive heart, the state of the hemomicrocirculatory bed, the efficiency of the gas transport function of his blood, and also reliably assess personal reactivity and adaptive potential. Subsequent mathematical approximation of the obtained biometric data by an original neural network makes it possible to rank the results obtained and automatically generate a program of medical rehabilitation for a particular patient, depending on the severity of his post-COVID syndrome. The study results proved two reliable physiological signs confirming the presence of latent post-COVID complications: a decrease in the base impedance value for light exercise and an increase in the length of the systolic arc of the rheocardiogram.

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

Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions amenable to physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts amenable to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99%CI: 4.8–5.4; r² = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts amenable to physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs amenable to physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries Age-standardized YLD Rates significantly decreased (p < 0.01; r² = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs, globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced.

Is the amount of “greenness” within a 250-meter, 500-meter, 1000-meter or a 2000-meter buffer surrounding a person’s home a good predictor of their physical health? The evidence is inconclusive. We reviewed Web of Science articles that used geographic information systems buffer analyses to identify trends between physical health, greenness, and distance within which greenness is measured. Our inclusion criteria were: (1) use of buffers to estimate residential greenness; (2) statistical analyses that calculated significance of the greenness-physical health relationship; and (3) peer-reviewed articles published in English between 2007 and 2017. To capture multiple findings from a single article, we selected our unit of inquiry as the analysis, not the article. Our final sample included 260 analyses in 47 articles. All aspects of the review were in accordance with PRISMA guidelines. Analyses were independently judged as more, less, or least likely to be biased based on the inclusion of objective health measures and income/education controls. We found evidence that larger buffer sizes, up to 2,000m, better predicted physical health than smaller ones. We recommend that future analyses use nested rather than overlapping buffers to evaluate to what extent greenness not immediately around a person’s home (i.e., within 1,000-2,000m) predicts physical health.

Background: Online survey-based observational cross-sectional study aimed at elucidating experience and attitudes of unstructured population regarding diagnostic imaging. Methods: Invitations to participate were distributed using mixed-mode design to deidentified residents aged 18 years and older. Main outcome measures included morbidity structure and incidence of diagnostic imaging administrations. Results: Respondents (n = 1069) aged 44.3 ± 14.4 years; 32.8% suffered from cardiovascular diseases (CVD); 9.5% had chronic respiratory pathology; 28.9% considered themselves healthy. Respondents with COVID-19 history (49.7%) reported higher rates of computed tomography (CT) (p &lt; .0001), magnetic resonance imaging (MRI) (p &lt; .001), and ultrasound (p &lt; .05). COVID-19 history in CVD respondents shifted imaging administrations towards CT and MRI (p &lt; .05). Every tenth respondent received MRI, CT, and ultrasound on paid basis; 29.0% could not pay for diagnostic procedures; 13.1% reported unavailable MRI. Professional status significantly affected the pattern of diagnostic modalities (p &lt; .05). MRI and CT availability differed between respondents in urban and rural areas (p &lt; .0001). History of technogenic events predisposed responders to overestimate diagnostic value of fluorography (p &lt; .05). Conclusions: Preparedness to future pandemics requires development of community-based outreach programs focusing on people's awareness regarding medical imaging safety and diagnostic value.

Background: Artificial intelligence can help improve the quality of healthcare by analyzing vast amounts of data and providing more effective and personalized treatment plans. Researchers are working on developing AI-powered solutions that can help improve the outcomes of patients. Objective: To explore the potential of AI in improving healthcare outcomes and patient experience. Results: The study suggests that AI can improve healthcare efficiency and patient outcomes but cannot fully replace human healthcare professionals. AI can assist healthcare professionals in their work, leading to better resource utilization and improved patient care. However, there is still a need for human healthcare professionals to oversee AI systems and provide empathy and personalized care to patients. Conclusion: While there is immense potential for AI in healthcare, it is not yet feasible to replace human healthcare workers. Instead, it should be viewed as a tool that can help improve the efficiency and effectiveness of human healthcare.

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

The objective of this study was to analyze the effect of the COVID-19 pandemic on suicide rates among Brazilian residents, stratified by sex. This study evaluated the behavior of monthly suicide rates based on an interrupted time series analysis of the months preceding (from January 2017 to February 2020) and following (from March 2020 to December 2022) the first diagnosed case of Covid-19 in Brazil. We used an interrupted time series model (quasi-Poisson), accounting for the presence of serial autocorrelation in the residuals and seasonality.Among men, we identified an abrupt decrease (RR&lt;1, p&lt;0.05) in monthly suicide rates at the onset of the pandemic, followed by a progressive increase (RR&gt;1, p&lt;0.05). An exception to this trend occurred in the Northeast region and among elderly men, where there was an abrupt increase in suicide rates at the start of the pandemic. For women, a reduction in monthly suicide rates was observed during the early stages of the pandemic only in the Central-West and Northeast regions, as well as in the 20-39 age group.The pandemic's effect was not uniform across Brazilian men and women, according to stratification variables; however, we observed a progressive upward trend over the course of the pandemic.

Background: Cardiovascular diseases increasingly impact youth, with early development of risk factors such as obesity, hypertension, and inadequate nutrient intake. Proper nutrient intake and physical fitness are vital for reducing these risks, especially in pediatric populations. This study explores the connection between physical fitness, metabolic risk, and nutrient status among 1656 Chilean schoolchildren from diverse so-cio-economic backgrounds. Methods: Anthropometric measures included weight, height, skinfold thickness, waist circumference, and blood pressure. Physical fitness was assessed via handgrip strength, standing long jump, and a six-minute walk test. Nutrient intake was also evaluated, and a composite metabolic risk score was calculated based on waist circumference, skinfolds, and blood pressure. Results: Children from public schools exhibited higher obesity rates and waist circumferences than those from private schools. Physical fitness performance was strongly linked to cardiovascular health indicators: better fitness correlated with smaller waist circumferences, lower skinfold measurements, and healthier blood pressure levels. Children from private schools had better fitness test outcomes, indicating socio-economic disparities in access to physical activity and nutrient resources. Students with lower fitness and nutrient intake had higher metabolic risk scores, pointing to increased cardiovascular risk. Conclusions: Nutrient intake and physical fitness are essential to reducing cardiovascular risk in children. Significant differences in nutrient intake and fitness levels across socio-economic lines suggest that equal access to nutrition and physical activity programs in schools could benefit public health outcomes. Further research should investigate the lasting effects of nutri-ent-focused interventions on childhood metabolic health.

This research explores the role of transparency and traceability in the agricultural food supply chain. By utilizing blockchain's decentralized and secure features, stakeholders can improve information sharing from farm to consumer, transparency and traceability issues. Real-world examples illustrate blockchain's successful application in agriculture, boosting transparency, efficiency, and trust and create immutable records, enhance visibility, and provide reliable data, while combating fraud and promoting sustainability. It also examines blockchain's impact on food safety through IoT and smart contracts, highlighting successful implementations in supply chain management, the research underscores blockchain's potential to build consumer trust in food safety, quality, and origin.

Africa's health landscape is rapidly changing, requiring new solutions such as a focus on health literacy. However, there is currently a limited overview of the development and application of health literacy in African countries and societies. To inform progress, a scoping review was conducted, including a systematic literature search of research approaches, historical developments, geographic origins, target populations and settings, and topical interests. 336 articles were retrieved from six databases following PRISMA guidelines. Sources identified included reports, policy briefs, book chapters, and research publications. The analysis provided the most comprehensive overview of the current scope and scale of health literacy in Africa to date. The publications represented 38 of the 54 African Union countries and dated back to 2001, although most were published in the last decade. The content analysis identified 13 broad themes, including mental health, communicable diseases, non-communicable diseases, maternal health, digital health, information and communication, health care, prevention and health promotion, conceptual perspectives, cultural perspectives, outcomes and measurement. The stakeholder analysis revealed a wide range of actors involved in different settings, mostly in health care or community settings. These comprehensive and novel findings can be used to prioritize future actions for public and professional capacity building, policy development and improved practice to improve health literacy for all in Africa.

Brazilian garimpeiros are a highly hard-to-reach and mobile population, with little access to basic hygiene and health services, and have been crossing the border to work irregularly in gold mines in French Guiana since the 90s. This study aimed to characterize this population and identify their main health problems. A cross-sectional study was carried out in the municipality of Oiapoque-AP, with two surveys: before (2018) and after (2019) the implementation of Malakit. Individuals were recruited from resting places and submitted to a questionnaire with demographic variables, history and knowledge of malaria, and health issues in the mines. Simultaneously, a clinical evaluation was performed. The garimpeiros were mainly men from Maranhão, Pará, and Amapá, with a low educational level and worked on average for 10 years in the mining sites. The study population mentioned numerous health problems: malaria, followed by leishmaniasis, flu, body aches, headaches, and digestive problems. Other diseases mentioned were skin diseases, bat bites, hepatitis, and HIV infection. This vulnerable population is constantly subjected to heavy routines and exposed to different diseases and infections that can spread across borders. Knowledge of this is essential for developing public health policies that can be integrated into specific epidemiological situations.

Fluoride (iF) is important inorganic pollutant in groundwater in central México. The aim of this study was estimated environmental risk exposure of iF in residents of Jerez Zacatecas México. Fifty-five tap water samples were collected from households to determine iF concentrations using the ion-selective electrode method. Based on these environmental values, the Hazard Quotient (HQ) was estimated following the methodology of the Pan American Health Organization (PAHO). Subsequently, risk maps were generated from these values to visualize the spatial distribution of high-risk areas within the city. iF in tap water ranger in concentration from 1.3 – 7.3 mg/L (ppm). We estimated HQ in a range of 0.63 to 3.73. iF ex-posure in tap water is a health problem that must be addressed, carrying out risk communication actions that allow the population to take care of their health through simple actions, avoiding future health costs.

Substance abuse is a significant public health issue both globally and nationally. Substance abuse involves the detrimental or risky consumption of psychoactive substances, posing a significant global issue, particularly among the youth. In India, cannabis abuse is a major concern. Cannabis is consumed legally in many states as Bhang, also known as marijuana or weed, while Charas and Ganja are illegal under both international drug conventions and the Indian NDPS Act of 1985. The Cannabis users are at great risk of developing Cannabis use disorder which is a pattern of problematic cannabis use leading to clinically significant impairment or distress. It is the most widely used illegal substance worldwide, showing a high prevalence in India.

AbstractBackground: In digitalization era, health care system was conditioned with the health worker’s ability to adapt media of digital technology. Digital technology media was used to strengthening and fasted the health care for patient and community. Aims: This study aimed to explore the accurate information of health professional utilization digital technology during doing the job at the health facilities in Timor-Leste. Methods: This study was used correctional study with 56 respondents was participated in the study. Was collected the data from 1 to 30 February 2023. Was used questioner of google form based for data collection. Data collection was distributed via online with google form to social media as WhatsApp’s, email and face book and twitter to completed by respondents. The inclusive Criteria are: health professional living in Timor-Leste, to able response the questioner. Was used descriptive analysis in this study. Finding: This study was indicated that majority of health professional was participated in the study as 54,2% man then women have 45,8%. About 100% health professional used hand phone to facilitate their daily activities including related with their work activities. Other side indicated in digital technology tools use are able to use Microsoft word is 78,3%, able to use Microsoft Excel is 76,7% and able to use Power Point is 81,7%. E-mail use about 89,2%, WhatsApp’s use 81,7%, About 74,2% was used zoom/webinars/Google meet application, about 72,5% sad that they were used computer in the work place until now. Around 96.4% need to improve or deepen their knowledge and skills in using ICT in the future to facilitate they are activity. Conclusion: Majority of health professional in Timor-Leste was used the computer, internet, hand phone in daily activities. Majority need to gate the training to improve their knowledge, attitude and psychomotor in the future.

This review paper investigates the intricate relationship between sexuality and body dysmorphia, emphasizing its profound impact on mental health. Through a critical examination of existing literature, this study illuminates the complex psychological, societal, and cultural dynamics at play within this intersection. Special attention is given to the influence of media representations and societal beauty standards in shaping individual perceptions and experiences. Furthermore, the paper discusses various therapeutic interventions designed to address this interplay, underscoring the necessity for mental health practices that are both sensitive and adaptable to the nuances of these issues. Ultimately, this work enriches the discourse on body image and sexual health, offering critical insights for clinical interventions and highlighting areas for further research.

This article examines the intersection of race and disability in the context of health disparities. It highlights the unique challenges faced by individuals with disabilities who also belong to racialized minority groups, who experience a double burden of discrimination and marginalization. The article draws upon various conceptual models of disability, including the medical, social, and biopsychosocial models, to illustrate the multifaceted nature of disability and its impact on health outcomes. It then examine the specific health disparities faced by individuals with disabilities, including higher rates of chronic diseases, limited access to healthcare, and lower life expectancy. The concept of intersectionality is introduced to explain how race and disability interact and amplify each other, creating greater disadvantages for individuals at this intersection. This is further explored through discussions on social determinants of health (SDOH), such as poverty, food insecurity, and inadequate housing, which disproportionately affect racialized minorities with disabilities. The article concludes by suggesting directions for future research and policy interventions. It emphasizes the need for culturally sensitive research, long-term analyses, qualitative studies, and a focus on policy implications. Additionally, it calls for regional considerations, a more holistic understanding of health determinants, and an expansion of the intersectional approach beyond race and disability.

: A comprehensive analysis was performed, considering blockchain technology (BT) proprieties in digital health, addressing medico-legal, privacy, and regulatory considerations. Adherence to personal data protection and healthcare regulatory guidelines were analyzed and compared for GDPR (Europe), HIPAA (United States), CCPA (California), PIPEDA (Canada), Privacy Act of 1988 (Australia), APPI (Japan), and LGPD (Brazil). Issues such as Health Systems, Strengthening and aligning policy orientations and initiatives, and emphasizing the role of data analysis in shaping health policies were explored. The study addressed conflicts between the legal frameworks and blockchain, comparing and suggesting solutions like revision of laws and integration of com-pliance mechanisms. Additionally, it sought to enhance IT-health literacy by integrating healthcare and legal domains. Ongoing collaboration between legal, health, and IT experts is essential for designing systems that effectively balance privacy rights and data protection while maximizing the benefits of disruptive technologies like blockchain.

The current context has proved unequivocally that public health is one of the pillars of society, playing a determining role and being a balancing factor. This study aimed to provide additional evidence supporting the use of geographic information systems in and from public health. For the study, the authors use public data from the Transparency COVID-19 data set at the Romanian level, which they process with the QGIS application, to effectively determine the influence of the location of the vaccination centers, respectively the impact on the incidence of COVID 19. The research carried out, which generated 153 maps, allows the statement, that reports based on the geographical location of data collected from the public health system are easier to analyze and to evaluate the effectiveness of the decisions taken. By analyzing the evolution of some public health indicators, that are difficult to correlate through analytical relationships, this study offers, as the main finding, an additional argument for the use of geographic information systems in public health management. As the limitations of research in the simulation component are relevant, further research is needed to provide the necessary evidence to convince about the effectiveness of using geographic information systems to optimize outcomes in the public health system. For this reason, it is necessary that the data structures in the public system, to be built and collected in a comprehensive way, with an optimal level of granularity.

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) exert significant burdens on individuals and society, underscoring the importance of accurate predictions using advanced machine learning (ML) algorithms. Leveraging electronic health records (EHRs) and survey data, these algorithms offer potential in forecasting such mental health conditions. Yet, the precision of these predictions can be compromised by biases or inaccuracies inherent in subjective survey responses. In this research, we assess the reliability of four prominent ML algorithms—Random Forest, XGBoost, Logistic Regression, and Naïve Bayesian—in predicting MDD and GAD. Our dataset encompasses a rich array of information, from biomedical metrics and demographic details to self-reported survey insights. A focal point of our investigation is the algorithms' performance under scenarios with varying degrees of subjective response inaccuracies, such as memory recall biases or subjective interpretation. Our findings reveal that while all algorithms exhibit commendable accuracy with pristine survey data, their performance diverges when faced with erroneous or biased responses. Notably, XGBoost remains stable and excels in identifying true positive cases, even in the presence of such noise. These observations underscore the criticality of algorithmic resilience in mental health prediction, especially when relying on subjective data. The robustness of certain algorithms to noisy inputs positions them as more reliable choices for predicting mental health conditions based on self-reported data, emphasizing the need for careful algorithm selection in such contexts.

Cheese consumption provides humans with minerals, proteins, carbohydrates, and vitamins. In Mexico, several cheese varieties are produced, each with its texture, scent, and flavor. The artisanal cheeses made in the states of Tabasco and Chiapas —including, among others, the varieties named crema (cream), doble crema (double cream), oaxaca, panela, fresco, bola, poro, Cotija, and asadero— have a high demand in the domestic and foreign markets. The intensification of anthropic activity in these states causes an increased emission to the environment of contaminants like heavy metals, which could reach human foodstuffs through the food chains. In particular, heavy metal contents in cheeses consumed daily by these states' local population might represent a public health risk. Because of that, our objectives in this work were to determine the concentrations of lead, cadmium, nickel, copper, zinc, and iron in artisanal cheeses produced in the states of Tabasco and Chiapas, and to determine the values of the Hazard Quotient (HQ), Total Hazard Quotient (THQ), and Cancer Risk Total (CRT) for adult and young men and women. The results of our analyses of cheese samples from the states of Tabasco and Chiapas showed that the average concentrations (mg kg-1) of cadmium (0.0023±0.002, 0.0023±0.002 mg kg-1, respectively for each state), lead (0.0047±0.00, 0.0051±0.002), nickel (0.0039±0.0046, 0.0031±0.0039), copper (0.0199±0.021, 0.0202±0.022), zinc (0.1611±0.18, 0.194±0.21), and iron (61.84±4.23, 65.76±6.61 mg kg-1), the first three values lower than the limits established by the FAO/WHO and Codex Alimentarius. The value of THQ that we obtained was less than one, and that of CRT was within the limits established by the US-EPA, which means that the consumption of artisanal cheeses from Tabasco and Chiapas by humans does not imply a risk of disease or cancer.

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

This article focuses on the economic dimensions of maternal health, highlighting the benefits of investing in maternal healthcare and the policy implications for sustainable development. Through a comprehensive review of the literature, the article explores the economic impact of maternal health, including its effects on human capital, productivity, and healthcare costs. It emphasizes the importance of addressing social determinants such as access to healthcare services, education, employment, income, and geographical disparities. By prioritizing maternal health, societies can unlock the economic potential of women, promote inclusive growth, and reduce gender disparities. The article discusses policy interventions, including the importance of healthcare infrastructure, financial support for maternal healthcare, and promoting gender equality. It also emphasizes the need for future research to quantify the economic benefits and evaluate the cost-effectiveness of different interventions. Overall, the article underscores the economic imperative of investing in maternal health and provides valuable insights for policymakers and researchers seeking to enhance maternal health outcomes and promote sustainable economic development.

Recent studies have shown that the prevalence of vegetarianism among the general population in western societies ranges between 2% and 9%. Information regarding the prevalence of vegetarianism among exercisers is lacking. The aim of the present pilot study was to determine the prevalence of vegetarianism among regular exercisers in Greek gyms, as well as assess their dietary habits, exercise habits, and attitudes toward health and environmental issues. 291 regular gym clients completed an anonymous descriptive online questionnaire containing 65 questions divided into five sections (demographic characteristics, dietary habits, physical activity, dietary supplements, environment). Thirty responders (10.3%) identified themselves as vegetarians, spanning the entire spectrum of vegetarianism, from raw vegan to semi-vegetarian. Compared to omnivores, vegetarians had lower body weight, were more concerned about their health and convinced about the health benefits of their dietary choices, were surrounded by more vegetarians socially, consumed fast food and ate out less often, used more dietary supplements, and were better informed about what a sustainable diet is (all p < 0.05). Vegetarians did not differ significantly from omnivores in demographic characteristics, alcohol consumption, smoking habits, prevalence of psychogenic eating disorders, or exercise practices (except for practicing more yoga/Pilates). In conclusion, we report, for the first time, a considerable prevalence of vegetarianism among regular exercisers in gyms. Our findings demonstrate important similarities and differences between exercising vegetarians and omnivores (partly at odds with those seen in the general population) and highlight nutritional and environmental issues on which both groups should be better educated.

Tobacco use is bad for your health in many ways, not just your lungs. It affects many other parts of your body, including your nervous system. This abstract looks at the link between smoking and the nervous system and shows how smoking affects the nerve system in specific ways. There are a lot of different diseases and risks that can come from smoking. By weakening blood vessels and making it easier for blood clots to form, smoking makes the chance of having a stroke much higher. Using tobacco is also linked to a drop in brain function and memory problems, as well as a higher chance of neurodegenerative diseases like Alzheimer's disease and dementia. Also, people who smoke have a higher chance of getting multiple sclerosis, which is a long-term autoimmune disease that affects the central nervous system. It can also cause peripheral neuropathy, which can damage nerves and cause tingling, pain, and stiffness in the limbs. Nicotine, the substance that makes tobacco addicting, changes the brain's reward circuits. This makes it hard to stop smoking because it leads to addiction. In addition to these effects on the body, smoking also has effects on the mind. It makes mood disorders like sadness and anxiety more likely, making the symptoms worse and hurting general health. Understanding the effects of smoking on the brain is important for improving overall health and getting people to stop smoking. Public health efforts, education, and targeted interventions are needed to make people aware of these risks and help them make choices about smoking that are based on accurate information. By looking at how smoking affects the brain, we can try to make people's lives better and protect their and their communities' well-being.

Gastrointestinal diseases caused by parasites are frequently diagnosed in the clinical routine of domestic animals, especially dogs and cats. In general, they trigger factors that can affect individual health due to zoonoses. Therefore, this study aims to identify the main intestinal parasites obtained from the fecal samples of dogs and cats in the municipality of Jata, Brazil, and their associated risk factors. Between October 2020 and March 2022, fecal samples were collected from 359 dogs and 55 cats through spontaneous defecation and subsequently subjected to coproparasitological analyses using the Willis fluctuation and Hoffman spontaneous sedimentation techniques. The following parasitic species were identified: Ancylostoma, Toxocara, Trichuris vulpis, Dipylidium caninum; Giardia, Entamoeba, Cystoisospora, and Platynosomum fastosum. The risk factors associated with parasitism include age, average income of owners, access to garbage, sewage, waste, outdated deworming, and contact with animals. The results demonstrate the need to establish public policies and implement preventive and control measures to reduce the occurrence of parasites in animals and the exposure of humans to pathogenic agents.

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

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

Introduction: Parents’ behavior and practices affect many aspects of family life, including health, and many studies have proven that children's bad habits are associated with parents’ behavior and practices. Objectives: This study aimed to identify parents’ negative behaviors that might affect their families’ health and social development. Methodology: A descriptive cross-sectional study was conducted to examine the influence of parents’ behavior and practices on their family health, in which 192 respondents participated. Results: The results clarified the influence of parents on family health in several aspects. On the behavioral side, approximately 90% of the participants agreed that the behavior of parents may affect the behavior of their families, and the social and educational side results clarified the relationship between parents' illiteracy and support for the cognitive and social health of the family. Discussion: This study clarified that there is a significant relationship between illiterate parents and their ability to support their families, illustrating that the majority of participants thought that the development of the cognitive and social health of families depends on the presence of supportive parents, which has many implications for family social and psychological health. Conclusion: Parental behaviors and practices have a strong effect on their family’s health, which affects the development of the families’ cognitive and social health. Recommendation: The study recommends the need for supportive, friendly hospitals for family social health and the provision of specialized programs that support the family’s social and psychological health.

The allocation for the use of Deconcentration Funds focuses on the seven priority health programs listed in the Regulation of the Minister of Health for the Republic of Indonesia. Therefore, this study aims to formulate a budget allocation for deconcentration funds in the health sector. Secondary data were analyzed using reports from the Ministry of Health for five years (2014-2018) on the Human Development Index (HDI), population, area, number of health workers, as well as amount and percentage for the realization of deconcentration funds. The results showed that the variables which had a significant effect were the number of districts/cities, the area, and HDI, while those without a significant effect were population, the number of health workers, and the percentage of budget realization. Political factors and regional commitment to implementing as well as using the budget were shown to also affect the deconcentration of funds both from the central and regional sources. Generally, deconcentration funds are used for non-physical tasks, including coordinating and synchronizing planning, facilitation, technical guidance, training, outreach, supervision, investigations and surveys, direction, and control. Based on the results, the budget allocation for deconcentration funds for health development needs to be calculated according to regional capacities by considering the number of districts/cities, land area, and the HDI.

Depression continues to be a glaring global challenge. The most worrisome trend is eating up the youthful generation more than anyone could predict years back. As Addis & Martell (2004) note, these adolescents end up succumbing to conditions that can be traced wholly from depression. Behavioral activation can be a rewarding intervention that will go a long way in cutting down on these cases and ensure the youthful global population's lives are safeguarded if applied and monitored to ensure correct and collective implementation processes and systems. The insights and arguments presented in the research paper will focus on the utility of behavioral activation in reducing depression cases among adolescents.

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

Onions are an excellent source of a variety of essential antioxidants, polyphenols, and other phytonutrients. These onions were used to enhance the meal's flavour and aroma. Additionally, onions have long been recognised for their ability to change food texture, making it more pleasant for eating. Among the most significant phenolic compounds identified in onions was Quercetin, which has been proven to be very helpful for maintaining good health by reducing the risk of heart disease, cancer, and a number of other severe conditions. Polyphenol extraction is essential for the effective usage and research of these phytochemicals. Previously, the extraction process was complicated by a variety of traditional methods, but with the aid of contemporary technology, the procedure was simplified. Additionally, it was found that red onions had greater health benefits than yellow onions, which were the most commonly used kind at the time. Apart from their health benefits, polyphenols were well recognised for their industrial use in dyeing, polymer manufacturing, and resin synthesis.

Insects are the dominant group of organisms and act as indicators of biodiversity, ecosystem health, and landscape degradation. The research objective was to determine the spread of insects in the Mount Nona Ambon Protected Forest. The research was conduct in January - March 2020 using Pitfall traps, light traps, Sweep nets, Bait traps, namely detergent, sugar solution and tuna fish. The research was carried out in 2 ha as many as five lanes with a systematic inventory sampling method where the length of the line was 100 meters, 20 m wide and 20 m spacing between lanes. The analysis use descriptively quantitative by calculating the Diversity Index (H ') of Shannon Winner, Abundance Index (K), Dominance Index (C) and Evenness Index. The results of the study found 4063 individuals, 13 species in five orders. The Hymenoptera order dominated the spread of insects in the protected forest of Mount Nona, the Formicidae family with the smallest number of 12 individuals, namely Isodontia auripes from the order Hymenoptera family Sphecidae, and the largest number of them was Anoplolepis gracilipes with 401 individuals from the order Hymenoptera family Formicidae. The difference in insects' spread in the observation path is thought to be caused by differences in microclimate, altitude, vegetation cover, insect movement, light intensity and food availability.

The study aimed to assess the prevalence and correlates of heavy episodic drinking (HED) among adults in Ecuador. In the national cross-sectional 2018 Ecuador STEPS survey, 4,638 persons (median age=39 years, range 18-69 years) responded to a questionnaire, physical measures, and biomedical tests. Results indicate that 24.1% had past month HED, 36.7% among men, and 12.0% of women; 40.6% past month HED among past 12-month drinkers. In adjusted logistic regression analysis, male sex (Adjusted Odds Ratio=AOR: 3.12, 95% Confidence Interval=CI: 2.50-3.89), past smoking (AOR: 1.38, 95% CI: 1.09-1.76), and current smoking (AOR: 2.83, 95% CI: 2.15-3.83) were positively and persons aged 50-69 years (AOR: 0.50, 95% CI: 0.38-0.66) and having underweight (AOR: 0.28, 95% CI: 0.09-0.89) were negatively associated with HED. In addition, in sex-stratified analyses, among men, being African Ecuadorean or Mulato (AOR: 1.79, 95% CI: 1.10-2.91), and high physical activity (AOR: 1.41, 95% CI: 1.01-1.99) were positively associated with HED, and among women, being Montubia (AOR: 0.40, 95% CI: 0.17-0.93) was negatively and obesity (AOR: 1.61, 95% CI: 1.06, 2.44) was positively associated with HED. Almost one in four participants engaged in HED, and several sociodemographic and health indicators were identified that may facilitate public health interventions for reducing HED.

The Ijen volcano has Pleistocene age (294.00 ± 0.03 Ma), and this stratovolcano was very acidic crater water with a pH of 0-1. The acidic crater water seeps into the Banyupait river flow. Asembagus is a research area located on the northern slope of the Ijen volcano, and the Banyupait River drains this. The acidic river water flows from the Ijen Crater Lake, so the pH of the water river was very acidic. This study used several different analytic methodologies with some previous researchers, namely using the method of geological mapping, pH measurement, spectrophotometry, IRMS (Isotope Ratio Mass Spectrometer), and the technique of Induced Coupled Mass Spectrometry (ICP-MS). Besides, the petrographic analysis is used to determine the composition of rock minerals due to rocks interacting with acidic water. Banyupait River water in the Asembagus area has a pH of river water around 3-7.3, SO4 (220-683 ppm), and the type of water is meteoric water. Also, concentrations of Ca, K, Mg in the west Banyupait river irrigation water flow showed higher levels when compared to the eastern Banyupait River water flow. Likewise, REE elements from the Asembagus region showed lower concentrations compared to Ijen Crater water. This change in the level of chemical elements is caused by the acidity of the Banyupait River being diluted or mixed with water from other water. However, the spring was not affected by acidic water. The process of acidic water interaction with rocks can also be observed from rocks traversed by the Banyupait River flow. Chalcedony and hematite replace the primary minerals of basaltic rocks. This research is expected to improve the quality of water needed by the Asembagus community so that people can live healthily.

Public health agencies are increasingly using pathogen whole genome sequencing (WGS) to support surveillance and epidemiologic investigations. As access to WGS has grown, greater amounts of molecular data have helped improve our ability to detect outbreaks, investigate transmission chains, and explore large-scale population dynamics, such as the spread of antibiotic resistance. However, the wide adoption of WGS also poses challenges due to the amount of data generated and the need to transform raw data prior to analysis. This complexity means that public health agencies may need more advanced computational infrastructure, a broader technical workforce, and new approaches to data management and stewardship. As both a guide for how this development could occur, and a place to initiate discussion, we describe ten proposals for developing and supporting an informatics infrastructure for public health.

The purpose of this article is to review a two year long implementation of an electronic health record (EHR) system at the outpatient department of a private hospital in Kathmandu, possibly a first implementation of its kind in Nepal. Procedures: The strategy designed for EHR implementation was based on Professor John P. Kotter's work on successful change management. Main findings: We found that keeping a close watch on the social dynamics affecting adoption decisions among users of the system was crucial for implementing the EHR; this was partly because the project received limited support from an erratically changing hospital leadership and lacked an EHR system suited to the needs of the users. Conclusions: The implementation described in this article is a good lesson on moving from control to drift in information systems implementation, and we hope this work will be useful to health IT professionals working in the space of digital transformation in resource-constrained environments.

This research is part of the Doctoral thesis "Perceptions of university professors on Health Promotion and Sustainability: a research proposal based on Health Promoting Universities (HPU) / World Health Organization (WHO) ", University Fernando Pessoa (UFP) / Porto - Portugal, authored by Ivaní Nadir Carlotto: (1) Background: Universities are essential institutions for health promotion (HP). Bioethics, as a transversal discipline, seeks to analyse and systematise these values in an ethical way, strengthening the synergy between health and HP. Ecological models are a possibility to develop health actions in a holistic, sustainable and salutogenic way, stimulating positive aspects related to ethics, well-being and quality of life; (2) Methods: Exploratory-descriptive methodology and quantitative-qualitative approach. Sample: Teachers from 9 higher education institutions (HEI), random sample, probabilistic for convenience, CI = 95%, n = 1400 persons; (3) Results: Production of 6 main components through Factorial Analysis categorized and interpreted by Qualitative Content Analysis and MAXQDA® software; (4) Conclusions: Universities function as research and learning venues to strengthen HP's activities. Bioethics and HP aim to build qualified actions in health, to defend and promoting well-being, quality of life, equity, inclusion, sustainability and social justice, with the proper conceptual clarity that distinguishes it.

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

The goal of the project was to gain an understanding of the secondary school youth experience with food literacy and school gardens on their mental well-being. Over the course of five months, sixteen youth participated in a photovoice research project in which they expressed their personal experiences about food and gardening through photography and writing. The aspects of secondary school youths’ life experiences affected by exposure to food literacy and school gardens and their impact upon their well-being were identified. These included emotions and feelings, having a safe place, nutrition and relaxation. The youth explicitly connected relaxation with the themes of love and connectedness, growing food, garden as a place, cooking, and food choices. This was linked to nature, beauty, environment and sustainability. Youth clubs or groups were also identified as a key enabler for connection. Youth shared their food literacy experiences, observing that their engagement improved some aspect of their mental well-being. They identified food literacy and gardens as being the most important to mental well-being including: connecting, personal health and personal growth. The youth recognized that connecting comes from having community, relationships and respect. Fostering opportunities for food literacy such as growing and preparing food contributes to resiliency.

Context: A clinical video telehealth (CVT) program was implemented improve access and quality of dementia care to patients and their caregivers in rural areas. The program was offered as part of an established dementia clinic/geriatric primary care clinic in collaboration with five community-based outpatient clinics (CBOC’s) affiliated with the Tennessee Valley Healthcare System (TVHS) in middle Tennessee. Telehealth support was provided by a physician – social worker team visit. Methods: Telehealth training and equipment were provided to clinic personnel, functioning part-time with other collateral clinical duties. Patients and caregivers were referred by primary care providers and had an average of 1 to 2 CVT encounters originating at their local CBOC lasting 20 to 30 minutes. Clinical characteristics and outcomes of patients and caregivers receiving CVT support were collected by retrospective electronic medical record (EMR) review. Results: Over a 3-year period 45 CVT encounters were performed on patient-caregiver pairs, followed for a mean of 15 (1-36) months. Some 80% patients had dementia confirmed and 89% of these had serious medical comorbidities, took an average of 8 medications, and resided at a distance of 103 (76-148) miles from the medical center. Dementia patients included 33% with late stage dementia, 25% received additional care from a mental health provider, 23% took antipsychotic medications, 19% transitioned to a higher level of care, and 19% expired an average of 10.2 months following consultation. Caregiver distress was present in 47% of family members. Consult recommendations included 64% community-based long-term care services and supports (LTSS), 36% medications, and 22% further diagnostic testing. Acceptance of the CVT encounter was 98%, with 8770 travel miles saved. Conclusion: CVT is well received and may be helpful in providing dementia care and supporting dementia caregivers to obtain LTSS for high-need older adults in rural areas.

Background: To assess the incidence and characteristic of cataract surgery in Poland from 2010 to 2015 and to interpret these findings. Patients and methods: Data from all patients who underwent cataract surgery alone or in combined procedures in Poland between January 2010 and December 2015 were evaluated. Patient data were from the national database of hospitalizations maintained by National Health Fund, data on the population of Poland were obtained from Central Statistical Office of Poland. Results: In total 1,218,777 cataract extractions (alone or combined with other procedures) were performed in 1,081,345 patients during 2010 -2015. Overall, the incidence of cataract surgery increased from 5.22/1000 person-years in year 2010 to 6.17/1000 person-years in year 2015. Phacoemulsification was performed in 97.46% of cataract extractions, and 3.02% of cataract extractions were combined procedures. The rate of one-day procedures increased from 28.3% in year 2010 to 43.1% in year 2015. The probability of second-eye surgery 12 months after the first-eye surgery increased from 44% in 2010 to 73% in 2015 (log-rank test p<0.0001). Conclusion: In Poland, from 2010 to 2015 the total incidence of cataract surgery, the number of people who underwent surgery, and the numbers of one-day and combined cataract surgeries, increased significantly.

The number of families sheltered in the Paris region (France) increased by a factor of 5 between 1999 and 2009. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs and the developmental problems in children. This random survey was conducted in 17 languages among homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers and social hotels in the Paris region. The situation was particularly worrying regarding their food security. Indeed, only 14.0% of people were with food security, whereas 43.3% were with low food security and 9.8% very low food security (a situation where children are also affected). Stratified multivariate robust Poisson models showed that some characteristics can lead homeless families to be at higher risk of food insecurity and/or at higher risk of falling into very low food security, such as residential instability, single parenthood, having more than 3 children, depressive symptoms, housing in social hostels, difficult access to cheap or free food locally. These harmful situations are intolerable in such a wealthy region as the Paris region. They argue for a better detection of these families, a closer social follow-up and an increase in food aid.

This study investigated the psychosocial factors influencing substance abuse among undergraduates. The study was conducted in Ekiti State university Ado Ekiti. 150 participants who are undergraduates of the university were used in this research. They consist of 82 males and 68 females selected from all faculties in the institution. 3 questionnaires were administered to respondent to measure the factors influencing substance abuse and the level at which they are abused. Independent T-test, multiple regression and Pearson Correlation method were used to analyze the data collected. Five hypotheses were tested: hypothesis 1, 2, 3 and 4 were significant while hypothesis 5 was insignificant. It was observed that there was significant influence of religiosity on substance abuse among undergraduates, the result also revealed that there was a significant influence of self-esteem on substance abuse among undergraduates, it also revealed that religiosity and self-esteem jointly predicted substance abuse among undergraduates, likewise the result also show that there was significant influence of sex on substance abuse among undergraduates and finally the result revealed there was no significant relationship between religiosity and self-esteem among undergraduates. The results were discussed in line with relevant empirical literatures, while conclusion and recommendations subsequently followed.

Background: Injecting drug use is a global public health challenge with multifaceted consequences, not only for Injecting Drug Users (IDUs) but also for society at large. Their vulnerability necessitates a deeper exploration of their health information needs, aiming to leverage evidence-based research to shape effective interventions for their well-being. Method: This study employed a qualitative method to gain insights into disease conditions and health information needs of IDUs. Through purposive sampling, 71 in-depth interviews were conducted and thematically analyzed. Results: The study included 43 males and 28 females, predominantly aged 26-35 (59.2%) who had poor socioeconomic status. The most commonly reported disease conditions varied and included malaria, infections and diabetes. Findings revealed a complex understanding of their disease conditions and management practices. Participants emphasized a critical need for access to reliable and comprehensive health information, while also highlighting the significant barriers they face in obtaining this information. Additionally, their preference for receiving health information in video formats, written articles, and through outreach programs underscored their desire for knowledge to make informed decisions. As co-creators and stakeholders in their health, participants expressed a clear demand for sustainable and free healthcare, mosquito nets, and regular outreach programs. Conclusions: While drug use presents a significant public health issue, effective interventions for IDUs require a multifaceted approach that begins with understanding their perspectives and actively involving them as co-creators of their health solutions. Abandoning this population contradicts the Sustainable Development Goals' mandate to ensure no one is left behind. Thus, all stakeholders must prioritize inclusive and participatory approaches to address the complex health information needs of IDUs.