Background: Medication errors often stem from incomplete or incorrect transfer of drug information during reviews. To enhance medication review processes, a collaborative healthcare team, including a pharmacist in the surgical ward, is essential. This study aimed to identify the frequency and the kind of intentional and unintentional discrepancies related to the prescriptions within two surgical wards. Methods: A prospective observational study was conducted among adult patients admitted to two surgical settings. The patients were selected between May 30th and November 30th, 2021. The study followed a three-phase structure: patient selection, medication review to identify discrepancies and DRPs, and the detection of any such issues in the discharge letter. Results: The most frequent types of discrepancies collected were substitutions (60.9%) for the Endocrinological Surgery and omissions for General Surgery (53.4%). In Endocrinological Surgery, 45.9% of cases exhibited class C drug interactions. In General Surgery, class D drug interactions were predominantly observed (54.1%), with 93.3% attributed to drugs carrying an elevated risk of prolonging the QT interval. Conclusions: Frequently, the medication review process is superficially carried out, introducing errors that may adversely affect patient health. This study explores the potential positive impact of involving the clinical pharmacist in identifying and managing discrepancies and DRPs.

Background: This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students. Methods: We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman’s correlations were calculated and two multiple linear regression models were developed. Results: 68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder. Conclusion: To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling.

This paper describes the indoor air pollution in urban (Lahore, Faisalabad, Gujranwala, Rawalpindi and Karachi) Pakistani regions while considering the outdoor air and the health and wellbeing of the occupants present indoors. It also aims to assess previous methodological approaches Such as Air Conditioning Systems, used by developed countries to improve air quality to demonstrate the improvements that can be made in air quality in Pakistani urban areas. This research also investigates the causes, concentration and effects of poor air quality in Pakistani urban areas such as particulate matter (PM2.5), carbon oxides (COx), nitrogen oxides (NOx), sulphur oxides (SOx) and volatile organic compounds (VOC’s). The average concentration of these pollutants in Pakistan’s indoor air is, particulate matter (PM): [100 – 250 µg/m3 for PM2.5, 200 – 600 µg/m3 for PM10] 1 – 20 ppm for carbon monoxide (CO), nitrogen oxides (NOx): [50 – 100 µg/m3 for NO2, 20 – 40 µg/m3 for NO], 20 – 50 µg/m3 for sulfur dioxide (SO2), volatile organic compounds (VOCs): 0.1 – 0.5 ppm for formaldehyde, 5 – 10 µg/m3 for benzene and 20 – 30 µg/m3 for toluene. It should be noted that these concentrations can differ depending on the origin of pollution, location, and time of day. The literature review is made up of a combination of descriptive research methods that are used to inform the research background of ambient and indoor air quality, thus the literature review provides a theoretical and methodological background about the air pollution and its improvement in different parts of the world. According to the World Air Quality Index, Pakistan is the third most polluted country in terms of average PM2.5 concentration which is 14.2 times the WHO annual air quality guideline value. As a result, it is suggested that a PM2.5 concentration reduction program be implemented in urban Pakistani regions' indoor air.

Background: The COVID-19 pandemic led to rapid growth in telemental health services and investment in digital mental health technologies. Digital mental health technologies could expand access to mental health care amid increasing provider deficit by providing tools for expedited psychiatric symptom assessment and treatment augmentation. This systematic review explores the recent evidence for the use of scalable digital tools, including virtual reality, neurofeedback training, wearables, mobile apps, digital phenotyping, and machine learning for PTSD symptom assessment, diagnosis, and treatment. Methods: A PubMed search identified studies on digital technologies with current or future potential for scalability (accessible through a small, digital device without the virtual or in-person presence of a mental health care provider)–and PTSD diagnosis, symptom assessment, or symptom treatment as the primary outcome. Thirty-five studies inform this review. Results: Virtual reality exposure therapy is efficacious for combat-related PTSD treatment. Conclusions of studies investigating apps and neurofeedback training are limited by low sample size and methodological heterogeneity. Machine learning models demonstrate capability in detecting PTSD symptoms via passively collected data from smartphones, wearables, and actively collected data from patient speech, writing, and videos, but standardization of data collection and modeling are needed before application to clinical settings. Conclusions: Advancements in scalable digital tools could address barriers in healthcare access and improve patient engagement by providing asynchronous assessment and treatment augmentation. Future research utilizing diverse patient populations in standardized controlled trials is needed to determine evidence-based protocols for implementation.

Global public health systems have continuously faced challenges from the advent of novel infectious illnesses, necessitating quick and efficient actions to stop their spread.First discovered in Saudi Arabia in 2012, Middle East respiratory syndrome (MERS) is a viral respiratory disorder caused by the Middle East respiratory syndrome coronavirus (MERS-CoV). Since then, the nation has reported most cases and fatalities related to this sickness, with occasional outbreaks happening in other nations and regions. Severe sickness and high mortality are caused by MERS-CoV, especially in older persons and those with underlying chronic conditions. Through intimate contact, the virus can spread from people to dromedary camels and vice versa. It has sparked multiple epidemics both domestically and abroad in the Middle East, raising the possibility of fatalities and widespread transmission, especially in susceptible groups. The Riyadh region was the main target of the most current MERS-CoV outbreak in Saudi Arabia, which began in 2023 and ended on September 1, 2023, with 312 confirmed cases and ninety-seven fatalities. With the use of published studies and their contributions to the field, we hope to present a thorough overview of the MERS-CoV outbreak in Saudi Arabia in this review of the literature, including its epidemiological investigation, public health response, impact, and lessons learned. In addition to highlighting the importance and continued relevance of this problem, our work suggests ways to lower the risk of MERS-CoV transmission and avert further outbreaks.

This study aims to understand Filipino rice farmers’ aspirations, both farming and non-farming-related. Understanding aspirations can help the government and interested third-party entities to provide impactful initiatives to farmers. The Role Identity Theory guided our analysis in this study. This study is predominantly qualitative, with focus group discussion as the main method of collecting data. The research sites were in Kalinga, Nueva Ecija, Laguna, Quezon, Northern Samar, Zamboanga del Sur, Sultan Kudarat, and Agusan del Norte. Among the farming-related aspirations noted in this study relate to property, fair price, infrastructure, government support, and good governance. The non-farming related aspirations relate to infrastructure development; progress; government support and governance; love, passion, peace, and unity; wellness and long life.

This paper reports data from three sources showing young people’s positive responses to the population-wide Act-Belong-Commit mental health promotion campaign: (i) impact on 14-25 year old participants in a peer-educator workshop program; (ii) impact on 11-14 year old student participants in an adaptation of the campaign in secondary schools (the ‘Mentally Healthy Schools Framework’); and (iii) impact of the population wide media-based campaign on 18-24 and 25-34 year olds in the general population (versus those 35+ years). Overall, these findings support the conclusion that mental health promotion interventions can be based on underlying constructs relevant across the lifespan and then tailored for specific ages and settings rather than requiring the development of separate, distinct programs based on different constructs for younger age groups.

This study presents a comparative analysis of indoor air quality (IAQ) across health centers in Arakale, Iju, Owode, FECA, and Oba Ile, Ondo State, Nigeria. Particle count data were analyzed to identify common trends, similarities, and differences in IAQ parameters, with the aim of informing targeted interventions for improving indoor air quality in healthcare settings. The findings reveal consistent positive skewness in particle count distributions, indicating occasional spikes in pollution levels amidst generally lower concentrations. Fine particles in the size range of PC 2.5 were consistently dominant across all locations, emphasizing their significance in IAQ assessment. Similar variability in particle count data suggests comparable levels of fluctuations in IAQ among the health centers. However, variations in PCA patterns highlight unique factors influencing IAQ in specific locations, such as combustion sources and control strategies. Targeted interventions, including enhancing ventilation systems, controlling indoor pollution sources, and promoting smoking cessation programs, are proposed to mitigate health risks associated with indoor air pollution exposure. Ongoing monitoring and collaboration with environmental experts are crucial for assessing IAQ trends and implementing evidence-based interventions to safeguard the health of patients, staff, and visitors in healthcare facilities.

This research aimed to study and compare prevalence of work-related musculoskeletal (MSK) problem and perceived discomfort among port crane operators consisting of quay and rubber tyred gantry (RTG) cranes working in the Laem Chabang Deep-sea Port, Thailand. Direct interviews for a cross-sectional analysis was selected for this unique job with a small amount of sample size. A standardized modified version of the Nordic Musculoskeletal Questionnaire (NMQ) was lunched for 26 male participants, consisting of 11 quay and 15 RTG, where a priori power analysis using G*Power suggested the minimum as 24 for the hypothesis test. Socio-demographic characteristics showed no significant difference among them. The NMQ revealed lower back as the highest prevalent body part (76.9%) followed by neck, shoulders and upper back at the same percentage (23.1%) for all port crane group, with up to 96.2% reporting MSK problem over the past 12 months. And Borg scale rating, assessing the perceived discomfort, revealed lower back with the highest score (2.38) followed by upper back (0.65), shoulders (0.54) and neck (0.5). Remarkably, the comparation between the quey and RTG crane operators on the MSK prevalence (χ2 test) and perceived discomfort levels (Kruskal-Wallis test), regarding different 9 body parts, revealed a significant difference between the two on upper back with quay crane having more problem than the RTG at p < 0.05. while the rest of them were mainly in the same direction. MSK contributors such as: working awkward posture, mental stress, height, trolley distance and vibration are considerably the main causes of this. However, the larger in scale of exposure to those for the quey crane compared to the RTG might have led to the distinguishing MSK problem found in this study which require thoroughly deliberation for the particular solutions.

Introduction: Transforming growth factor beta receptor 2 (Tgfbr2) signaling regulates odontoblast differentiation, dentin mineralization, and the paracrine signaling that guides sensory innervation in developing mouse molars. We hypothesized that Tgfbr2 also regulates the neuro-pulpal responses to injury to activate axon sprouting and tertiary dentin secretion. Methods: We per-formed a timed deletion of Tgfbr2 using tetracycline-responsive Osterix-Cre;Tgfbr2f/f (Tgfbr2^cko) mice, which allowed them to develop normally. At 3 months, we drilled a shallow hole on the mesial side of the first mandibular molar (M1) in both control and Tgfbr2^cko mice. Hemi-mandibles were collected 4, 8, 21, and 56 days post-injury (dpi). In situ hybridization (ISH) for Sp7 was performed to confirm Osterix-Cre transcription. Microcomputed tomography (micro-CT) imaging and histology were used to examine the tertiary dentin, and immunofluorescence was used to visualize CGRP+ axons following the injury. Results: Tgfbr2 deletion was inferred by Sp7 ISH. Micro-CT and histology indicated a lower dentin volume in 21 dpi Tgfbr2^cko M1s compared to WT M1s, but the volume was comparable by 56 dpi. The duration of axon sprouting was longer in injured Tgfbr2^cko M1s compared to WT M1s. Conclusions: These results suggest that sensory afferents may support dentin repair in Tgfbr2-deficient odontoblasts.

Patients with a psychotic disorder frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aims to develop supportive tools for MHNs regarding oral health to increase sensitization among MHNs and to provide MHNs with knowledge to recognize (potential) oral health problems in patients with a psychotic disorder. We used a human-centered design in which the user, MHNs as well as experts by experience, were placed in the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problem as well as the needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHN, and intended outcomes of tools. A Multi Criteria Decision Matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. Most promising result was the development of a brochure with an awareness screener. The brochure with awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder, based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n=19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure include a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimize care processes for oral health tools in MHNs, should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account.

Climate change related increases in frequency and intensity of heatwaves affect viticulture, leading to losses in yield and grape quality. We assessed whether canopy architecture manipulation mitigates the effects of summer stress in a Mediterranean vineyard. Muscat of Alexandria grapevines were monitored during 2019-2020. Two canopy shoot positioning treatments were applied: Vertical shoot positioning (VSP); and Modulated shoot positioning (MSP), the west side upper foliage released to promote partial shoot leaning, shading the clusters. Clusters were sampled at pea size (PS), veraison (VER) and full maturation (FM). Measurements included rachis anatomy and hydraulic conductance, and aquaporins (AQP) and stress-related genes expression in cluster tissues. Results show significant seasonal and interannual differences in Kh and vascular anatomy. At VER, Krachis , Krachis+pedicels, and xylem diameter decreased but were unaffected by treatments. The Phloem/Xylem ratio was either increased (2019) or reduced (2020) in MSP, compared to VSP. Most AQP were down-regulated at FM in pedicels, and up-regulated at VER in pulp. A potential maturation shift in MSP was observed, confirmed by the up-regulation of several stress-related genes in all tissues. The study pinpoints the role of canopy architecture in berry water relations and stress response during ripening.

Organizations can play a significant role in the advancement of Sustainable Development, and companies with Quality, Environmental and Occupational Health and Safety (QEOHS) certified management systems address the three Sustainability Dimensions (economic, environmental and social). This research aims to map the present level of engagement of those companies in contributing and reporting to the 17 Sustainable Development Goals of The United Nations 2030 Agenda. The content of companies reports (available in web sites, by 31 December 2017) of a total of 235 Portuguese organizations with QEOHS certified management systems, was analyzed. The results show a moderate reporting of SDGs by those companies, with the top five being SDG 12 - Responsible consumption and production (23.8%), SDG 13 – Climate action (22.1%), SDG 09 - Industry, innovation, and infrastructure (21.3%), SDG 08 - Decent work and economic growth (20.0%) and SDG 17 - Partnerships for the goals (19.6%). The results of the statistical tests indicate that the communication of SDGs is more prominent in organizations (QEOHS) with higher business volume, that are members of the United Nations Global Compact Network Portugal, and that disclose their sustainability reports on their web site. This study can be useful for decision-makers that aim to support organizations to contribute to the Sustainable Development Goals.

(1) Background: COVID-19 had devastating effects on both physical and mental well-being, prompting the need for interventions. This study aimed to explore the impact of mindfulness-based stress reduction on mental health, mindfulness, and sleep disorders in COVID-19 survivors.; (2) Methods: In this interventional parallel study, the sample was selected university students in nursing and midwifery faculties using total population sampling. The intervention included providing counseling on mindfulness methods by trained experts. General health, mindfulness and sleep quality questionnaires were used for data collection. Data were analyzed using SPSS22, descriptive and interferential statistic. A significance level of 0.05 was considered; (3) Results: In this study, the mean age of the students was 20.29 ± 2.03 years. 69.5% of the participants were female and 96% were single. 71.3% were studying nursing and 67% had a history of Corona infection. The intervention was only effective on general health questionnaire and the mean score of this questionnaire was 1.7 higher than the control group; (4) Conclusions: the study indicated that MBSR intervention improves mindfulness, mental health, and sleep quality in COVID-19 survivors. Regular assessment and use of this intervention can help address long-term challenges and improve overall well-being.

The ongoing COVID-19 global pandemic is affecting every facet of human lives (e.g., public health, education, economy, transportation, and the environment). This novel pandemic and citywide implemented lockdown measures are affecting virus transmission, people’s travel patterns, and air quality. Many studies have been conducted to predict the COVID-19 diffusion, assess the impacts of the pandemic on human mobility and air quality, and assess the impacts of lockdown measures on viral spread with a range of Machine Learning (ML) techniques. This review study aims to analyze results from past research to understand the interactions among the COVID-19 pandemic, lockdown measures, human mobility, and air quality. The critical review of prior studies indicates that urban form, people's socioeconomic and physical conditions, social cohesion, and social distancing measures significantly affect human mobility and COVID-19 transmission. During the COVID-19 pandemic, many people are inclined to use private transportation for necessary travel purposes to mitigate coronavirus-related health problems. This review study also noticed that COVID-19 related lockdown measures significantly improve air quality by reducing the concentration of air pollutants, which in turn improves the COVID-19 situation by reducing respiratory-related sickness and deaths of the people. It is argued that ML is a powerful, effective, and robust analytic paradigm to handle complex and wicked problems such as a global pandemic. This study also discusses policy implications, which will be helpful for policymakers to take prompt actions to moderate the severity of the pandemic and improve urban environments by adopting data-driven analytic methods.

High levels of air pollution can contribute to high rate of the COVID-19 outbreaks. Air pollutants induce oxidative stress, inflammatory process, immune imbalance and coagulation at systemic level, making the organism susceptible to complications caused by various pathogens, including viruses, resulting in a possible important damage co-factor. Sperm cells are highly sensitive to the pro-oxidant effects of environmental pollutants, and may represent an important alarm bell indicating that the burden of environmental pressure in a certain area is causing damage to humans. A comparison of the maps of COVID-19 case fatality rates, male infertility rates and air pollution may suggest a way to understand the dynamics of the virus impact. Semen quality may be considered as an early and sensitive environmental marker, and also a potential susceptibility indicator to viral insults (including SARS-CoV-2 ) in heavily polluted areas. Therefore, assessing the burden of environmental exposure of a given population and its potential susceptibility to insults through early biological stress indicators may be helpful for predicting the risk of the adverse effects by the SARS-CoV-2 epidemic .

Air pollution, particularly fine particulate matter (PM2.5), poses a significant threat to public health, especially in rapidly urbanizing areas like Lagos State. Despite the severity of the issue, there is a lack of comprehensive data on PM2.5 levels and the Air Quality Index (AQI) in Lagos. This study leverages data from AirQo, an innovative air quality monitoring network using low-cost sensors, to provide a detailed assessment of PM2.5 concentrations and AQI across eight locations in Lagos State, Nigeria. This approach offers real-time, continuous monitoring, filling a critical data gap in the region's air quality management efforts. This study uses AirQo data to assess the concentration levels and spatial distribution of PM2.5 and AQI across the selected eight locations. Data on PM2.5 concentrations were obtained from AirQo sensors deployed across the eight strategic locations in Lagos. The spatial distribution of PM2.5 levels and AQI were analyzed, and the results were compared with national and international air quality standards. The findings revealed that PM2.5 levels (minimum – 6.28 µg/m3 (Ikeja) and maximum - 204.68 µg/m3 (Banana Island) in many areas of Lagos exceed annual WHO and national air quality guidelines, indicating significant health risks. The spatial analysis identified pollution hotspots, particularly in densely populated and industrial regions. The data suggested vehicular emissions and industrial activities as major contributors to high PM2.5 levels. This study underscores the severe air quality issues in Lagos State, emphasizing the need for immediate and targeted interventions to mitigate PM2.5 pollution. The use of AirQo sensors proved effective in providing accurate and timely data for air quality assessment. It is recommended that Lagos State implements stricter emission controls, promotes cleaner technologies, and enhances public transportation systems to reduce traffic-related pollution. Additionally, expanding the air quality monitoring network and incorporating more environmental data will provide a more comprehensive understanding of air pollution impacts, thereby facilitating better policy and public health decisions.

This brief report investigates the potential correlation between manual labor and opioid addiction, focusing on contributing factors such as chronic pain, regular exercise, healthcare access, and housing stability. Although manual labor is associated with higher rates of work-related injuries and chronic pain, the review finds no strong, direct correlation between manual labor and increased opioid addiction rates. The relationship is complex and influenced by a range of socio-economic factors. The findings highlight the need for further research, particularly longitudinal studies, to explore these dynamics in depth and develop targeted interventions for at-risk populations.

C-reactive protein (CRP) and leukocytes are blood biomarkers involved in "Inflamm-Aging", which is a risk factor for the onset and progression of age-related diseases. Studies show that higher serum concentrations of these biomarkers are associated with functional disability, increased risk of low muscle strength, decreased muscle mass and mortality in the elderly. The objective was to estimate the predictive power and discriminating criteria of C-reactive protein and leukocyte concentrations for the risk of adverse health factors in the elderly within 30 days after hospital discharge (HD). Prospective cohort study using exploratory methods and blood biomarkers with 135 older adults admitted to medical and surgical clinics at a government hospital. The elderly were monitored at home after 30 days of HD for adverse health factors (rehospitalization, falls, amount of medication consumed, disability in basic and instrumental activities of daily living and mortality). CRP> 2.4; ≥ 0.7 and> 24.7 mg / dL and leukocytes ≥ 6.410; ≥ 8.690 and> 8.310 mm³ were discriminant for rehospitalization, falls and mortality within 30 days after HD, respectively. The cut-off points described may be used as a reference in the screening of hospitalized elderly vulnerable to adverse health events after hospital discharge.

Objectives: Teachers’ intention understanding ability reflects their professional insight, which is the basis for effective classroom teaching activities. However, the cognitive process and brain mechanism of how teachers understand students' action intention in class are still unclear; Methods: This study used event-related potential (ERP) technology to explore the cognitive neural differences in intention understanding ability among teachers with different levels of knowledge and experience. The experiment used the comic strips paradigm to examine the ability of expert and novice teachers to understand students’ normative and non-normative classroom actions under different text prompts (“how” and “why”); Results: The results revealed that in the late time window, expert teachers induced larger P300 and LPC amplitudes when they understood students' classroom action intentions, while the N250 amplitudes induced by novice teachers in the early time window were significantly larger. In addition, for both types of teachers, when understanding the intentions behind students’ normative actions, the N250 amplitude was the most significant, while the P300 and LPC amplitudes were more significant for non-normative actions.; Conclusions: This study found that teachers at varying professional development stages had different time processing processes in intention understanding ability, which supported teachers' brain electrophysiological activities related to social ability.

Background: Historically, in the United States and globally, women have supported other women before, during, and after childbirth. Birth doulas are considered an important component to eliminating racial disparities in maternal morbidity and mortality. To address disparities in birth outcomes, Healthy Women Healthy Futures (HWHF) provides free birth and postpartum doula services to low-income women and communities of color in New York City. Methods: Secondary analysis of program data (n=364) collected between 2020 and 2021 was conducted. Univariate and multivariable analyses focused on: method of delivery, preterm birth, low-birthweight birth, breastfeeding, maternal-infant skin contact. The key exposure variable was total doula hours. Results: Clients who received prenatal doula support had low rates of preterm birth (8.8%) and low birthweight (7.1%), and high rates of vaginal delivery (69.1%), breastfeeding in the hospital (90.9%), and maternal-infant skin contact (78.2%). Multivariable analysis did not identify an association between number of doula hours and any of the five outcomes examined. Conclusion: While descriptive results point to positive birth outcomes, these effects did not persist in multivariable analyses. Data quality concerns from this intervention likely hindered the ability to detect a program impact, emphasizing the importance of funding to support data collection and management activities.

In the following article, we estimate the Renunciation of Healthcare Services-RHS in Italian regions in the context of the Environmental, Social and Governance-ESG model during the period 2004-2022. The data were acquired from the ISTAT-BES dataset. The data were analyzed using the following econometric techniques: Panel Data with Fixed Effects, Panel Data with Random Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Square-WLS,. Results show that RHS tends to growth with the E-Component, is negatively associated to the S-Component, and positively associate with the G-Component within the ESG model. Furthermore, a clusterization with the unsupervised k-Means algorithm is presented and the results are discussed with a confrontation between optimal and suboptimal k values optimized with the Silhouette Coefficient. Finally, a confrontation among eight different machine-learning algorithms is performed to predict the future value of RHS. Outcomes show that the Simple Regression Tree is the best predictive algorithm and that the level of RHS is predicted to growth on average of 4.4% for the Italian regions. Results are critically discussed.

Telemedicine has become an interesting research topic in recent years, especially since the start of the COVID-19 pandemic. This article conducts research using a systematic literature review to identify paradoxes in telemedicine services. The research method follows the steps in a systematic literature review, by accessing the Scopus journal database to search for relevant articles between 2018 and 2024. The selected articles were selected based on certain inclusion and exclusion criteria, resulting in 28 relevant articles which were then analyzed to understand findings related to paradoxes in telemedicine services. The research results show four main clusters of paradoxes in telemedicine research, namely health services, health quality, the COVID-19 pandemic, and technology. Each cluster shows complex opportunities and challenges in efforts to improve health services through telemedicine. Understanding the clusters for each article can then be mapped to the organizational categories in the Dynamic Equilibrium Model. In conclusion, this study provides a comprehensive insight into the paradoxes in telemedicine services, highlighting the importance of understanding the various aspects involved in the adoption and implementation of this technology. With a better understanding of this paradox, it is hoped that society and health practitioners can overcome the challenges and exploit the opportunities offered by telemedicine to improve the accessibility and quality of health services in the future.

People experiencing homelessness face challenges that result in poorer health outcomes compared to those in stable housing. This study provides the results from over 40 health measures that capture the general physical and mental health of a group of people experiencing homelessness aged 22 to 84 years, in an inner-city location, invited to participate in a comprehensive assessment of physical and psychological health. We found evidence of accelerated ageing, with 44.2% of people being clinically frail, 63% had poor functional movement, and 36% had pain associated with oral health. Additionally, 90.6% of participants showed health risks due to nutrition deficiencies, over half reported poor sleep quality, 55.3% reported having psychological distress, and almost half reporting fair or poor overall dental health. This study presents a path to providing a relatively easily implemented group of health assessments to help respond to a group of underlying causes for accelerated ageing, among a group of inner-city people experiencing homelessness. This work can be used to inform the prioritisation and development of community-based health services to address functional deficits that may contribute to accelerated ageing.

Grinding processes’ stochastic nature poses a challenge in predicting the quality of the resulting surfaces. Post-production measurements for form, surface roughness, and circumferential waviness are commonly performed due to infeasibility in measuring all quality parameters during the grinding operation. Therefore, it is challenging to diagnose the root cause of quality deviations in real-time resulting from variations in the machine’s operating condition. This paper introduces a novel approach to predicting the overall quality of the individual parts. The grinder is equipped with sensors to implement condition-based maintenance and is induced with five frequently occurring failure conditions for the experimental test runs. The crucial quality parameters are measured for the produced parts. Fuzzy c-means (FCM) and Hotelling’s T-squared (T2) have been evaluated to generate quality labels from the multi-variate quality data. Benchmarked random forest regression models are trained using fault diagnosis feature set and quality labels. Quality labels from the T2 statistic of quality parameters are preferred over FCM approach for their repeatability. The model, trained from T2 labels achieves more than 94% accuracy when compared to the measured ring disposition. The predicted overall quality using the sensors’ feature set is compared against the threshold to reach a trustworthy maintenance decision.

Background: Emerging and re-emerging infectious diseases that infect wildlife, such as African swine fever, avian influenza, and SARS-CoV-2, have highlighted the necessity for wildlife health surveillance (WHS) due to their direct and indirect impacts on wildlife species, ecosystems, domestic animals, and human health. While global policies and guidelines exist, a critical gap remains in local-to-national implementation of WHS systems. A group of local, national, and global actors in WHS have formed a working group to address this gap. Methods and Findings: The working group reports on a theory of change (ToC) developed to implement WHS from local to global scales. Through brainstorming, plenary exercise, and building on peer-reviewed science and existing surveillance systems, we identified six transformative pathways to be implemented via collaborations across scales and contexts: mindset change, policy and investment, user-driven science, user-driven technologies, capacity enhancement, and mobilization of a global community of practice. Interpretation: This ToC serves as a roadmap to develop effective WHS systems that support adaptive management and implementation. WHS is fundamental to understanding the impacts of health threats to biodiversity and human and domestic animal health. This ToC presents an approach to operationalize integration of wildlife health into collaborative One Health surveillance. Funding: The Science for Nature and People Partnership.

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

Achieving complete remission (CR) is crucial for acute myeloid leukemia (AML) patients undergoing curative therapy, but relapse often occurs within months, highlighting the need for strategies to prolong leukemia-free survival (DFS). Our phase III study compared the efficacy and safety of azacitidine (AZA) versus best supportive care (BSC) in elderly AML patients who achieved CR after intensive induction and consolidation therapy. This ancillary study (QOL-ONE Trans-2) evaluated biological changes in bone marrow using Next Generation Sequencing (NGS). We analyzed baseline, randomization, and 6-month post-remission samples from 24 patients (median age 71, 12 males). High-throughput NGS targeted 350 myeloid malignancy-related genes, considering variants with a Variant Allele Frequency (VAF) ≥ 4%. At diagnosis, all patients had 5 to 17 (median 10) mutations, with DNMT3A (42%), NPM1 (33%), and TET2 (33%) being most frequent. FANCA mutations in 4 patients were linked to a higher relapse risk (HR 4.96, p=0.02) for DFS at both 2 and 5 years. Further HLA-specific NGS analyses are ongoing to confirm these results and their therapeutic implications.

COVID-19 has brought unprecedented challenges and exacerbated existing work-related struggles resulting in heightened occupational stress and impacted work performance among health caregivers. This study utilised the transactional model of stress and coping to explore the coping strategies adopted by radiology health caregivers during the pandemic with the aim to provide baseline data for enhancing preparedness and development of interventions to support staff during future health crises. A qualitative, interpretative phenomenological analysis (IPA) methodology coupled with constructivist and interpretivist philosophical views were utilised in a multi-method context to conduct semi-structured interviews and focus group discussions among 24 radiology health caregivers in the eThekwini district of KwaZulu-Natal, South Africa. Data were transcribed verbatim and manually analysed using the IPA framework. The radiology health caregivers highlighted resilience, adaptability and identified emotion-focused and problem-focused coping as their mostly preferred strategies of dealing with COVID-19 related mental distress. These included accepting professional responsibilities and duties, social coping, spiritual therapy, adaptive behavioural coping, escape-avoidance and solution-oriented approaches. The findings can guide radiology departments in developing bespoke mental health interventions to support radiology health caregivers during any future health crises.

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.

Background: The COVID-19 pandemic has exacerbated existing healthcare disparities among American Indian/Alaska Native (AI/AN) populations, rooted in historical traumas and systemic marginalization. Methods: This study conducted at a single Indian Health Service (IHS) clinic in central Michigan examines the effectiveness of educational interventions in enhancing COVID-19 knowledge and attitudes among AI/AN populations. Utilizing a pre/post prospective study design, participants received either a video or infographic educational intervention, followed by a survey assessing COVID-19 knowledge and attitudes. Results: The results indicate significant improvements in knowledge and attitudes post-intervention, with both modalities proving effective. However, specific factors such as gender, political affiliation, and place of residence influenced COVID-19 attitudes and knowledge, emphasizing the importance of tailored interventions. Conclusions: Despite limitations, this study highlights the critical role of educational interventions in addressing vaccine hesitancy and promoting health equity within AI/AN communities. Moving forward, comprehensive strategies involving increased Indian Health Service funding, culturally relevant interventions, and policy advocacy are crucial in mitigating healthcare disparities and promoting health equity within AI/AN communities.

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.

This analysis investigates health outcomes by cause and income group across European and African countries, highlighting significant disparities tied to economic status. Low and lower-middle-income countries in Africa face a greater burden of disease, particularly in acute lower respiratory infections, diarrheal diseases, bacterial infections, HIV/AIDS, and maternal conditions. This is primarily due to limited access to clean water, sanitation, and healthcare services. In contrast, high-income African countries exhibit better health outcomes. European countries show variations: lower-middle-income nations suffer more fro4m acute respiratory infections and HIV/AIDS, while high-income countries report higher incidences of cancer and bacterial infections. These differences reflect disparities in healthcare quality and social determinants. The study emphasizes the need for targeted policy initiatives to address these disparities by focusing on socioeconomic factors and improving healthcare access and quality across all income groups.

Introduction: Patients’ satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients’ feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients’ satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients’ perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares—path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients’ experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients’ satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients’ satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.

Background: The link between nocturia and aging male symptoms (AMS) has not been scientifically established. This study aimed to measure the degree of severity of AMS that impact on the health-related quality-of-life (HRQoL) in adult males living with nocturia, and to determine the predictive values of nocturnal factors on AMS. Methods: It is an extended analysis of new data collected by using the Hong Kong Traditional AMS (HK-AMS) scale and Cantonese version of the Pittsburgh Sleep Quality Index (PSQI) in a recently published cross-sectional population-based survey. Results: Of the 781 respondents that have completed the set of questionnaires, 68% and 61% of men living with nocturia reported clinically significant (at moderate-to-severe levels) somato-vegetative and sexual AMS, whereas the prevalence and severity were increased with advancing nighttime voiding frequency. The nocturia-specific QoL (NQoL) score and nocturnal frequency were found to be significant predictive factors for composite, somato-vegetative and sexual AMS, in addition to age, global OSQI score, and certain metabolic diseases. Conclusions: Current findings suggested the inclusion of nocturia when measuring the male-specific HRQoL related to aging.

The combined ecological, geophysical, climatic, and social factors of the Northeast of Russia influence the organism from the early childhood being too intense for the functional systems. The purpose of the research is to study the emotional characteristics of adolescents of different ethnic groups in the northeast of Russia. Presented in the paper are results of the study that covered 826 adolescents (445 females and 381 males) at the age of 15–17, different by ethnic origin. We used standard methods of psycho-diagnostics. Our study has showed that the formation of the adolescents’ emotional sphere in the North is undoubtedly influenced not only by the climatic and socio-economic environmental factors but also by ethnic features. There are intergroup differences in the aggressiveness profile of older adolescents living in the remote settlement vs. the regional center. It is shown that high school students in the remote settlement of Evensk, compared to their peers in Magadan, regardless of gender and ethnicity, are characterized by more pronounced hostile and auto-aggressive reactions. In adolescents of the Aboriginal population, as compared with their age mate Caucasians, the indicators of impairment in the field of Neuro Psychic Adaptation, Situational and Personal Anxiety, and Social Frustration are significantly more pronounced.

Lower limb exoskeletons have the potential to reduce the prevalence of work-related musculoskeletal disorders; however, they often lack user-oriented control strategies. Human-in-the-loop (HITL) controls can adapt an exoskeleton’s assistance in real-time, to optimize the user-exoskeleton interaction. This study presents a HITL control for a knee exoskeleton to minimize the users’ physical effort, a parameter innovatively evaluated by their interaction torque with the exoskeleton (a muscular effort indicator) and metabolic cost. This work innovates by estimating the user’s metabolic cost within the HITL control through a machine-learning model. The regression model was able to estimate the metabolic cost, in real-time, with a root-mean-squared error of 0.66 W/kg and a mean absolute percentage error of 26%, making faster (10s) and less noisy estimations than a respirometer (K5, Cosmed) device. The HITL reduced the user’s metabolic cost and interaction torque by 7.3% and 32.3%, respectively, when compared to a zero-torque control. The developed HITL control surpassed both a non-exoskeleton and a zero-torque condition regarding the user’s physical effort, even for a simple task such as slow walking. Furthermore, the user-specific control enabled a lower metabolic cost than the non-user-specific assistance. This proof-of-concept demonstrated the potential for HITL controls in assisted working.

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.

This study examined the patterns of epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1) deposition in the small intestine and colon to evaluate the association between histopathological severity of EFEMP1 deposition and constipation and determine if amyloid transthyretin (ATTR) and EFEMP1 deposits can colocalize. In 40 older cases (≥80 years of age), EFEMP1 deposition in the small intestine initiated in the submucosal and subserous vessels, subserous interstitium, and serosa (early stage); progressing to the muscularis propria and peri-Auerbach plexus area (intermediate stage); and finally, spreading diffusely to areas, excluding the mucosa and muscularis mucosa (advanced stage). The colon had a similar pattern of progression. During the middle-to-advanced stages, amyloid formation was observed in some vascular and serous deposits. We identified a subgroup of cases in which EFEMP1 deposition was the only presumed cause of constipation. Additionally, we demonstrated the colocalization of ATTR and EFEMP1 deposition. Apple-green birefringence was detected under polarized light only in approximately one-half of the cases in the small intestine and one-third of the cases in the colon. These findings emphasize that EFEMP1 deposits may be associated with lower gastrointestinal pathological conditions. Given the challenges of histopathological diagnosis on Congo red-stained specimens, we recommend the combined use of elastic fiber staining and immunohistochemistry for EFEMP1 to prevent overlooking this deposition.

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.

Abstract: Transcription factors are crucial pre-transcriptional regulatory mechanisms that can modulate the expression of downstream genes by binding to their promoter regions. DOF (DNA binding with One Finger) proteins are a unique class of transcription factors with extensive roles in plant growth and development. Our previous research indicated a decrease in iron content in chlorotic bamboo leaves. However, to our knowledge, genes related to iron metabolism pathways in bamboo species have not yet been studied. Therefore, in the current study, we identified iron metabolism-related (IMR) genes in bamboo and determined the transcription factors that significantly influence them. Among these, DOFs were found to have widespread effects and potentially significant impacts on their expression. We identified specific DOF members in Dendrocalamus latiflorus with binding abilities through homology with Arabidopsis DOF proteins, and established connections between some of these members and IMR genes using RNA-seq data. Additionally, molecular docking confirmed the binding interactions between these DlDOFs and the DOF binding sites in the promoter regions of IMR genes. The co-expression relationship between the two gene sets was further validated using q-PCR experiments. This study paves the way for research into iron metabolism pathways in bamboo and lays the foundation for understanding the role of DOF transcription factors in D. latiflorus.

The effects of climate change health impacts on urban health care systems and vulnerable populations are a researched topic with foundations on urban risk management, urban health methodologies, and sustainable urbanization. As climate change is a dynamic and transformative global issue the gap between adaptation and mitigation efforts and urban planning relies, among other things, in the limitations of previous studies of risk management structures tailored to the existing strategy to calculate the uncertainties and predict their influence on urban systems and subsystems. Moreover, as climate and health is a well-researched issue, it is also complex as the methodologies and strategic approach to minimize health risks of climate change is intrinsically contingent to risk methodologies and policy-making processes that are efficient with support of knowledge-based information. This paper emphasis the need for focusing on urban health risk management methods that serves to identify potential opportunities, and then manage and take action to prevent adverse health effects. It also emphasizes the probability of events and their consequences, which are measurable both qualitatively and quantitatively.

Mental disorders impact a significant portion of the global population, presenting substantial challenges to healthcare systems due to high hospitalization costs and resource demands. This narrative review explores the economic implications of mental health disorders, focusing on hospitalization costs, the effectiveness of interventions, and the outcomes of recent research. Materials and Methods: A narrative review was conducted, sourcing articles from PubMed and Google Scholar published between 2014 and 2024. The search terms included combinations related to mental illness, costs, hospital care, and mental healthcare interventions. A total of 1,110 articles were initially identified, with 37 studies meeting the inclusion criteria after rigorous screening by two independent researchers. These studies included quantitative and qualitative data covering a range of outcomes such as hospital admission rates, consumer satisfaction, and quality of life. The findings of the present review reveal that mental disorders significantly increase hospitalization costs due to frequent admissions, extended stays, and the need for specialized treatments. Additionally, physical comorbidities in individuals with mental disorders lead to higher healthcare costs and resource use. Integrated care models, early intervention, and preventive strategies show promise in reducing these costs and improving patient outcomes. Conclusions: Our review emphasizes the critical need for integrated healthcare strategies that address both mental and physical health to reduce hospitalization costs and improve outcomes. Effective management of mental health disorders requires comprehensive approaches, including complex outpatient services and preventive care. Future research should focus on standardizing methodologies to provide clearer insights into the economic impact of mental health conditions and guide effective healthcare strategies.

Treatment efficacy for age-related macular degeneration relies on early diagnosis and precise determination of the disease stage. It involves analyzing biomarkers in retinal images, which can be challenging when handling a large flow of patients and compromise the quality of healthcare services. Clinical decision support systems offer a solution to this issue by employing intelligent algorithms to recognize biomarkers and specify the age-related macular degeneration stage through the analysis of retinal images. However, different stages of age-related macular degeneration may exhibit similar biomarkers, complicating the application of intelligent algorithms. This paper introduces an approach to overcome these challenges using hybrid and hierarchical classification. By leveraging the hybrid structure of the classifier, we can effectively manage issues commonly encountered with medical data sets, such as class imbalance and strong correlations between variables. The modifications to the intelligent algorithm proposed in this work for staging age-related macular degeneration resulted in an increase in average accuracy, sensitivity, and specificity by 20% compared to initial values. The Cohen’s Kappa coefficient used for consistency estimation between the regression model and expert assessments of the intermediate class severity was 0.708, indicating a high level of agreement.

This study examined the effect of the media usage environment, particularly TV and mobile devices, on advertisement acceptance, lifestyle, and psychological satisfaction. Hypothesis pathways and comparative structural mediating effects were analyzed. Media and Consumer Research public data were used for empirical analysis. A total of 6,640 people who participated in sports activities were included in the study. The results demonstrated that TV and mobile device usage environments had similar effects on advertisement acceptance. While TV did not influence the pursuit of personal life, mobile device use environments affected the pursuit of personal life. Mobile device use environments had a greater effect on individual psychological satisfaction than TV. Adoption had a mediating effect on the influence of media usage environments on the pursuit of personal life. The pursuit of a personal life had a significant mediating effect on the influence of media use environments on psychological stability. This study revealed no differences in the effects of new and traditional media on advertisement acceptance, while new media had a greater influence on lifestyle and psychological satisfaction.

Adverse childhood experiences (ACEs) refer to traumatic life events in childhood that comprise abuse (e.g., psychological, physical, sexual), neglect (psychological and physical), indirect violence or household dysfunctions. Studies have found ACEs to be related to severe short-, medium- and long-term consequences in victims’ health. The current work consists of a real-world, multicentric, prevalence study of health outcomes in children <16 years suspected of ACEs by physicians. It relies on electronic health records and healthcare registries from a Portuguese local healthcare unit between January 2001 and December 2021 (N=40 536). Three health outcome groups were analyzed: (1) traumatic injuries and intoxications (2) mental health disorders, and (3) physical disorders. Keywords and ICD-9, ICD-10, and ICPC-2 codes from were employed. Children suspected of ACEs represent 2% (n=918). Social problems, injuries and intoxications, mental health disorders, and physical disorders arise in higher percentages in suspected victims than in non-suspected individuals. Findings uncover that child victims of ACEs may be underdiagnosed. Given the severe consequences for their current and future health, this should be taken as a critical warning for healthcare professionals. Detection and reports in health units are fundamental for early treatment, aiming to avoid an escalation of damage and prevent re-victimization.

Diet-related diseases impact populations across the globe. While intertemporal preferences—a fundamental preference for the distribution of benefits across time—have been used to explain low-quality food choices, recent literature proposes another cause: inattention to future implications (or opportunity costs) of the options faced. Food choices tend to become habitual to conserve cognitive resources, rather than carefully modeling future health impacts. Both low discount rates for future benefits and attention to future health impacts predict healthier decisions. While intertemporal preferences are stable, attention may provide an opportunity to intervene in the decision process to promote healthier decisions. In this study, we test the impact of a simple message that highlights health during food choice on the healthiness of foods chosen and on health consideration and intertemporal preferences. Our results show that actively considering health outcomes and lower discount rates lead to healthier food choices. We find that messaging increases the consideration of health outcomes during food choice but does not affect intertemporal preferences, suggesting that simple prompts may be an effective way to promote decisions balancing short and long-term benefits by drawing attention to overlooked opportunity costs of choices.

Type 2 diabetes (T2DM) presents an enormous global healthcare challenge, especially among rural communities due to limited access. To overcome this, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. This cross-sectional study from rural South India aimed to evaluate the proficiency of 275 CHWs in diabetes screening and management. A customized questionnaire, developed through experts and government was used to evaluate the practice behaviours and knowledge. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results showed significant deficiencies of mean correct practice behaviours at 48 and 50% respectively. The identified gaps included diabetes diagnosis, HbA1c testing, diet, self-management, complications screening and risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management and calculation of diabetes risk assessment. Addressing these deficiencies requires a thorough needs assessment and tailored training for improved diabetes management by CHWs. Training of CHWs, should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.

Mpox, formerly known as Monkeypox, is a rare viral disease initially discovered in Africa in 1958. Since its first identification, several outbreaks have occurred in various African nations. Recently, the global community has witnessed a resurgence in the number of Mpox cases reported worldwide, prompting the World Health Organization (WHO) to declare the ongoing multi-country outbreak a public health emergency in July 2022. This study reports on the first cases of Mpox detected in Khartoum State, Sudan, outlining the epidemiology, preparedness, and public health response to this new challenge. A total of 55 suspected cases were identified, with two confirmed cases. The clinical manifestations observed in these cases align with the classic skin rash typical of Mpox, presenting alongside symptoms like fever, headache, and joint pain. The findings underscore the need for heightened surveillance, early detection, and timely intervention to prevent the domestic spread of Mpox and its potential impact on public health. Continued global efforts are needed to support effective screening, diagnostic, and control measures, ultimately enhancing preparedness and response in the face of this emerging disease.

Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in northern California. Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.

To examine the association of sleep quality and work from home with physical inactivity (PI) in leisure time during Covid-19 pandemic. A population-based household survey was conducted in two Bra-zilian municipalities from October to December 2020. Leisure-time physical activity (PA) was self-reported, and individuals who practiced less than 150 minutes of moderate PA or 75 minutes of vigorous PA weekly were classified as PI. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). WFH was assessed by: "Currently, how is your work routine regarding location? Associations were investigated using logistic regression and directed acyclic graphs (DAG) for the multivariate models. A total of 1,750 adults were interviewed, 69.1% were PI and 51.9% had poor sleep quality. Furthermore, 79.8% were not in WFH. In multivariate analysis, leisure PI was associated with poor sleep quality (OR:1.59: 95% CI: 1.02-2.48), and not being in WFH (OR:1.62: 95% CI: 1.05-2.50). When performing the combined analysis between these two factors, and who were not in WFH were four times more likely to be PI at leisure (OR=4.22;95%CI:2.05-8.65). The results indicate a high prevalence of PI, with poor quality sleep and non-WFH associated with leisure PI. These combined factors exacer-bated the occurrence of PI.

This study explores the multifaceted influence of litter size, maternal care, exercise, and aging on rats' neurobehavioral plasticity and dentate gyrus microglia dynamics. Body weight evolution revealed a progressive increase until maturity, followed by a decline during aging, with larger litters exhibiting lower weights initially. Notably, exercised rats from smaller litters displayed higher body weights during mature and aged stages. Dentate gyrus volumes showed no significant differences among groups, except for aged sedentary rats from smaller litters, which exhibited a reduction. Maternal care varied significantly based on litter size, with large litter dams showing lower frequencies of caregiving behaviors. Behavioral assays highlighted the detrimental impact of a sedentary lifestyle and reduced maternal care/large litters on spatial memory, mitigated by exercise in aged rats from smaller litters. Microglial dynamics in the layers of dentate gyrus revealed age-related changes modulated by litter size and exercise. Exercise interventions mitigated microgliosis associated with aging, particularly in aged rats. These findings underscore the complex interplay between early-life experiences, exercise, microglial dynamics, and neurobehavioral outcomes during aging.

: Healthcare workers are affected by mental health issues, burnout and turnover, and this burden is even greater during epidemics and pandemics, such as COVID-19. The purpose of this research is to provide an overview of the measures introduced or supported in the institutions of Quebec’s health and social services network during the COVID-19 pandemic with the aim of protecting healthcare workers’ mental health. An online questionnaire survey was administered in 2021 among human resources department personnel in health and social services network institutions involved in workplace mental health in Quebec. A total of 223 key informants representing 31 of the 34 public health and social services institutions in the province of Quebec in Canada responded to the questionnaire. Measures that focus on the needs of staff, involve all levels of authority and the ones that provide flexibility, support and recognition at work were more successful, according to the advisors surveyed. Future research into whether the same measures are considered effective or ineffective outside of a pandemic context is needed.

Introduction: Rural areas face additional challenges in preventing, preparing for, responding to, and recovering from disasters. This study aimed to understand how rural General Practitioners PHCPs perceive their roles, involvement, and capacity in disaster health management. Methods: For this qualitative descriptive research, semi-structured interviews were carried out with convenience and purposive samples of rural PHCPs before and during the COVID pandemic. Open, axial, and selective coding were employed to analyse the data inductively. Results: five interviews were conducted pre-COVID and ten interviews during the second and third waves of COVID. Identified themes were similar between the two periods. Rural PHCPs were underutilised due to a lack of awareness of their capacity and a lack of infrastructure and support for greater involvement. Conclusion: Rural PHCPs can be better integrated and supported in readiness for a whole of system response to future disasters.

Food production is a complex matter, affecting people’s lives, organizations’ profits, and the well-being of the whole planet and has multifaceted ethical considerations surrounding its production, distribution, and consumption. This paper addresses the pressing need to confront ethical challenges within the food system, encompassing issues such as environmental sustainability, food security, and individual food choices for better oral and systemic health of all individuals around the globe. From agricultural practices to global trade and food waste, ethical implications are addressed across various domains, highlighting the interconnectedness of ethical decision-making in the food industry. Central themes explored include the ethical dimensions of food production methods, the impact of global trade on food ethics, and the role of individuals in making ethically informed food choices. Additionally, the paper dives into the spiritual and physical significance of food, particularly through the lens of oral health as a gateway to holistic well-being. Recognizing the complexity of the food ecosystem, the paper calls for serious interventions in legislation and economics to promote ethical protocols and techniques for sustainability reasons. It emphasizes the importance of ethical considerations in food safety management systems, regulatory frameworks, and quality standards. Moreover, the paper underscores the need for a comprehensive approach to address ethical dilemmas and moral values inherent in the food industry and oral health policies, advocating for the adoption of the precautionary principle and ethical decision-making frameworks. The article aims to serve as a call to action for stakeholders across the food industry and the healthcare sector, to prioritize ethical practices, promote transparency, rearrange economic parameters and work towards a more sustainable and equitable food system for inner and outer oral and systemic health and human sustainability for all.

Nowadays, animal breeders look for effective innovations to care animal health. Use of probiotics, postbiotics, parabiotics and the other beneficial natural substances are dominated. Mundticin-like substance EM 41/3 is thermo-stable bacteriocin (postbiotic) with a broad antimicrobial spectrum. In this study its effect in broiler rabbits was assessed. Rabbits represent food-derived animal and they are also suitable animal model. The parameters tested were analyzed by validated methods. Administration of MLS EM 41/3 produced by non-autochthonous strain Enterococcus mundtii EM 41/3 lead to significant increase of parameter immunity-phagocytic activity, while it did not influence microbiota composition. It also did not influence blood biochemistry and no oxidative stress was noted. Moreover, higher growth parameters were noted and also stimulated hydrolytic activity. Finally, no negative influence on rabbit meat quality was noted. Postbiotic MLS EM 41/3 administration in feeding strategy seems to be contributing fact for rabbit health status maintaining.

The family context has been associated with children's weight status. This study aims to investigate the association between parents' adherence to the Mediterranean diet and family time with the weight status of children. The research is part of the BeE-school, a cluster randomized trial implemented in primary schools located in social vulnerable contexts. A total of 735 children (380 boys), aged 6 to 10, participated in the study. Anthropometrics were assessed during school time, weight status categorized, while parents self-reported sociodemographic variables, adherence to the Mediterranean diet (MEDAS questionnaire), and family time. Children from families with higher education levels whose parents have a high adherence to the Mediterranean diet, have lower odds to have overweight/obesity (odds ratio (OR) 0.301, 95% CI 0.143-0.634, p=0.002). Also, children from families with lower education levels who have more time together with their family, have lower odds to have overweight/obesity (OR 0.731, 95% CI 0.573-0.934, p=0.012). The family environment, mainly family time together and adherence to Mediterranean diet, exerts a significant influence on children’s weight status. Professionals working in children’s health should consider the family when fostering health-promoting behaviors.

Background: Numerous risk factors have been recognized as significant contributors to outdoor workers' heat stress and the risk of heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers' safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. Objective: To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. Methods: In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Results: Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. Conclusion: To advance construction workers’ safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments.

Water is one of the most critical factors affecting environmental health. For this reason, estimating and monitoring the behavior of water in nature and preventing water pollution before it occurs are advantageous to avoid problems that may occur in terms of environmental health. In order to predict the behavior of water, the hydrological cycle needs to be evaluated on a basin basis. At this point, hydrological models can be used to make mathematical representations of hydrologi-cal processes. These models play an essential role in predicting and monitoring problems such as poor water quality, pollution, particle and sediment transport, and proliferation of oil and petro-leum derivatives among frequently encountered issues in environmental health. In this study, a 2D surface water model was created using soil and water assessment tool (SWAT) to simulate the lotic ecosystem and existing water quality in Tatlıçay Basin and to propose solutions for im-proving environmental health in Cankiri provincial center in Türkiye. The accuracy of the input data and the validity of the model were checked with the calibration and validation studies by using the monthly or 3-monthly observation data of the General Directorate of State Hydraulic Works’ flow observation & water quality stations from 2016 to 2020. The aim was to provide the opportunity to produce fast, accurate, and practical solutions in the face of negative scenarios with this model. This modelling study obtained successful results in the calibration and valida-tion process with very few observed data. With this study, a significant contribution to the litera-ture on environmental health is made, as there aren't many examples of hydrological modeling from the Middle East.

Pancreatic cancer is a refractory cancer with limited treatment options. Various cancer types are resistant to the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Eugenol, the main component of clove oil, exhibits anticancer, anti-inflammatory, and antioxidant effects. However, no studies have reported that eugenol increases TRAIL sensitivity by upregulating death receptor (DR) expression. Here, we aimed to investigate eugenol as a potent TRAIL sensitizer. Increased apoptosis and inhibition of cell proliferation was observed in pancreatic cancer cells treated with eugenol and TRAIL compared with those treated with eugenol alone. Eugenol upregulated the expression of DR5, inhibited FLICE-inhibitory protein (FLIP), an anti-apoptotic protein, and increased p53, a tumor suppressor protein. In addition, eugenol induced the generation of reactive oxygen species (ROS) and caused endoplasmic reticulum (ER) stress. C/EBP-homologous protein (CHOP) knockdown using siRNA decreased the expression of DR5 and reduced the combined effects of eugenol and TRAIL. These results demonstrate that eugenol enhances TRAIL-induced apoptosis by upregulating DR5 through the ROS-mediated ER stress-CHOP pathway, enhancing ER stress by inducing p53 and downregulating FLIP expression. This suggests that eugenol has the potential to treat pancreatic cancer by increasing cell sensitivity to TRAIL.

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.

Adenomyosis, a benign gynecological condition characterized by the infiltration of endometrial tissue into the myometrium, poses significant challenges to women's reproductive health. Recently, the landscape of adenomyosis diagnosis transformed significantly, thanks to advancements in imaging technologies such as transvaginal ultrasound and magnetic resonance imaging. This lead to a noticeable shift in the demographic profile of patients diagnosed with adenomyosis, including younger women of reproductive age who frequently present with a diverse array of symptoms. Approximately 20% of women are affected by adenomyosis. Adenomyosis manifests with various subtypes, distinct epidemiological profiles, symptomatology, and treatment responses, necessitating tailored approaches for optimal management. Despite its clinical significance, adenomyosis remains understudied, resulting in a significant disparity in research and literature compared to other gynecological conditions. The severity of adenomyosis is compounded when coexisting with endometriosis, particularly deep infiltrating endometriosis (DIE), leading to exacerbated fertility issues and severe symptomatology. The wide range of symptoms, including adverse pregnancy outcomes such as pre-eclampsia, highlights its wider impact and emphasizes the need for increased awareness of the condition. Furthermore, Adenomyosis is frequently associated with treatment failure in endometriosis, contributing to dienogest resistance, elevated discontinuation rates, and persistent pain post endometriosis surgery. Additionally, the lack of specific treatments tailored to adenomyosis poses a considerable challenge in clinical management.

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.

The issue of antibiotic resistance represents a significant threat that extends beyond human health, encompassing animal welfare and the sustainability of the natural environment. The inappropriate use of antibiotics, poor sanitation and inadequate control measures, have contributed to the emergence of drug-resistant bacteria, which can spread at the human-animal-environment interface. The documented presence of antimicrobials in agriculture, veterinary medicine and human medicine has convinced all stakeholders of the need to contribute to the development of a "One Health" approach, which recognises the interrelationships between animals, humans and their environment and the need to adopt a common strategy encompassing these sectors to limit the spread of antimicrobial resistance (AMR). Although a number of countries have implemented integrated surveillance systems to monitor antibiotic use and antimicrobial resistance, available data suggest that the use of antibiotics in humans, animals and the environment is increasing worldwide. Consequently, the emergence of antibiotic-resistant pathogens is becoming a recurring concern. This review provides a comprehensive overview of the measures that are necessary to be taken and implemented in order to guarantee global health security.

Background: we aim to investigate attitudes toward vaccination, by analyzing empirical factors associated with vaccine acceptance in the Lazio region mpox vaccination (MpoxVax) campaign in Italy. Methods: all subjects who accessed to MpoxVax and signed the informed consent were prospectively enrolled in the MPOX-VAC Study and were asked to fill out an anonymous survey. Two endpoints were selected: ‘delayed acceptance’ and ‘early acceptance’, defined as access for vaccination &gt;60 and ≤30 days from the vaccination campaign starting (VCS), respectively. Results: over the study period 1717 individuals underwent vaccination: 129 (7%) &gt;60 [1588 (92.5%) ≤60] and 676 (60%) ≤30 days from VCS. A bisexual orientation, a lower education level and a worse perceived physical and mental health were associated with delayed access to vaccination. Being Pre-Exposure Prophylaxis (PrEP) users and, marginally, HIV positive, having a high perceived risk for mpox infection and reporting high-risk behaviors like the use of recreational drugs/chems, sex under the influence of drugs and/or alcohol and higher number of principal sexual partners, were associated with early access to vaccination. Conclusions: according to our data, risk awareness was a major determinant of early mpox vaccination acceptance. Conversely, worse perceived health status and a low educational level were critical factors associated with delayed vaccination.

In this study, Caciocavallo Ragusano, a typical cheese produced in Sicily Island (Italy), was ob-tained from milk of dairy cows fed with and without enriched olive cake (ECO and CTR, respec-tively) in order to evaluate nutritional, microbiological, volatile, and sensory differences in cheeses. ECO cheese showed greater (p < 0.05) MUFA and PUFA and polyphenols content, and lower SFA content than CTR cheese. Microbiological analyses revealed the absence of Salmonella, Listeria monocytogenes, Escherichia coli, and E. coli O157, and no significant differences in the vi-able counts of the remaining microbial groups analyzed, between samples. Thermophilic lacto-cocci were more prevalent in ECO cheese. The implementation of culture-independent method, such as PCR-DGGE analyses, revealed the presence of a more diverse microbial population in both cheeses. Regarding the volatile compounds profile, long-chain free fatty acids were more abundant in the ECO cheese resulting in a healthier free fatty acid profile. This study also showed that, especially for their appearance and taste, the consumers mostly appreciated the ECO cheese. Results showed that using enriched olive cake could enhance the sustainability and the quality of Ragusano cheese, improving not only the health of the consumers but also positively influencing tastes and acceptability.

Recent mental health research has highlighted inflammation's critical role in conditions like depression and bipolar disorder, examining correlations with markers such as calcium levels, thyroid function, and inflammatory markers. The study aims to compare unipolar and bipolar d depression samples in terms of socio-demographic and clinical features. Prospective enrollment of patients hospitalized at the University of Insubria Psychiatric Unit. Patients were administered psychometric questionnaires (Beck Depression Inventory-II, Mental Pain Questionnaire, Beck Anxiety Inventory, Clinical Global Impressions Severity scale, and Reasons for Living Inventory). Thirty-six patients (17 males, 19 females) were enrolled. A statistically significant association emerged between calcium levels and bipolar depression (Pearson Chi square=0.050) and between CRP and bipolar depression (Pearson Chi-square=0.017). Additionally, a statistically significant association was observed between the unipolar and bipolar depression subgroups and current substance abuse (p=0.0275) A statistically significant difference between the BRLF scores and UDD subgroup emerged (p=0.0126). The results of the pilot study revealed significant associations between calcium/CRP levels with depressive symptoms, particularly in bipolar depression. Further research on inflammatory markers is needed to refine diagnostic subtypes and therapeutic strategies.

Adolescence is a critical period for the development of self-perception, emotional well-being, and health-related behaviors. During this stage, adolescents undergo significant physical, emotional, and social changes that influence their overall health and interactions with their environment. This study analyzes the prevalence of behaviors related to self-perceived health, mood, and substance use among adolescents, identifies risk factors, and draws comparisons between different groups. It also examines how these factors interact with family and community dynamics to inform strategies for improving mental health care. Method: A descriptive cross-sectional study using questionnaires was conducted. Participants were adolescents aged 14 to 18 years from a school in the Baix Llobregat province of Catalonia. Descriptive and bivariate statistical analyses were performed using the chi-square test and p-value calculations with R Project software. Frequency and percentage analyses were employed to describe the health behaviors and emotional states of the participants. Results: The study reveals significant variations in adolescents' self-perceived health, emotional management, and substance use patterns. Adolescents with lower self-perceived health and negative mood states tend to exhibit higher rates of substance use, particularly alcohol and tobacco. Gender differences were observed, with girls generally reporting better health awareness and emotional regulation compared to boys. Conclusions: This study highlights the need for integrated approaches to family, community, and mental health care. Findings emphasize the importance of early intervention programs addressing emotional well-being and substance use in a holistic manner. Public health policies should prioritize comprehensive strategies involving schools, families, and communities to foster healthier behaviors and improve adolescent mental health outcomes.

Background: Mental capacity is a fundamental aspect that enables patients to fully par-ticipate in various healthcare procedures. To assist healthcare professionals (HCPs) in assessing patients' capacity, especially in the mental health field, several standardized tools have been developed. These tools include the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), and the Competence Assessment Tool for Psychiatric Advance Directives (CAT-PAD). The core dimensions explored by these tools include Understanding, Appreciation, Reasoning, and Expression of a choice. Objective: This meta-analysis aimed to investigate potential differences in deci-sion-making capacity within the healthcare context among groups of patients with bi-polar disorder (BD) and schizophrenia spectrum disorder (SSD). Methods: A systematic search was conducted on Medline/Pubmed, and Scopus. Addi-tionally, Google Scholar was manually inspected, and a manual search of emerging re-views and reference lists of the retrieved papers was performed. Eligible studies were specifically cross-sectional, utilizing standardized assessment tools, and involving pa-tients diagnosed with BD and SSD. Data from the studies were independently extracted and pooled using random-effect models. Hedges g was used as a measure for outcomes. Results: Six studies were identified, with three studies using the MacCAT-CR, two studies the MacCAT-T, and one the CAT-PAD. The participants included 189 individuals with BD and 324 individuals with SSD. The meta-analysis revealed that patients with BD performed slightly better, and the difference was statistically significant, compared to patients with SSD, particularly in the domain of Appreciation (ES=0.23, 95% CI: 0.01 to 0.04, p=0.037). There was no statistically significant difference between the two groups for Understanding (ES=0.09, 95% CI: - 0.10 to 0.27, p=0.352), Reasoning (ES=0.18, 95% CI: - 0.12 to 0.47, p=0.074), and Expression of a choice (ES = 0.23, 95% CI: - 0.01 to 0.48, p=0.60). In the sensitivity analysis, furthermore, when considering only studies involving patients in symptomatic remission, the difference for Appreciation also resulted in non-significant (ES=0.21, 95% CI: -0.04 to 0.46, p=0.102). (ES=0.21, 95% CI: -0.04 to 0.46, p=0.102). Conclusions: These findings indicate that there are no significant differences between patients with BD and SSD during remission phases, while differences are minimal during acute phases. The usefulness of standardized assessment of capacity at any stage of the illness should be considered, both for diagnostic-therapeutic phases and for research and advance directives. Further studies are necessary to understand the reasons for the overlap in capacity between the two diagnostic categories compared in this study.

The Galápagos archipelago is a vast reservoir of terrestrial and marine biodiversity, owing in large part to its relatively recent volcanic genesis and colonization by humans. This unique ecological system is particularly susceptible to human, animal, and environmental impacts. Climate change, globalization, and the blurring of human-domestic animal-wildlife interfaces are poised to bring new threats and challenges to the region. A One Health perspective that simultaneously considers human, animal, and environmental health is imperative in assessing and mitigating the challenges facing the Galápagos Islands.In Part I of this review, we provide the historical context for biodiversity in the archipelago; discuss the role of invasive species in habitat destruction, fragmentation, and competition with endemic species; and summarize the established and emerging infectious disease threats. We also discuss the imperative to implement research, surveillance, and preventative measures to identify and manage future threats from a One Health perspective, with a specific emphasis on implications for wildlife health. In Part II, we outline the socioeconomic context of life in the Galápagos Islands, evaluate the current and predicted effects of climate change, and discuss direct anthropogenic factors affecting Galápagos biodiversity, such as tourism, fishing, pollution, and the illegal wildlife trade. We also examine the impact of the COVID-19 pandemic in the region. Throughout this two-part review, we build a cohesive picture of One Health in the Galápagos Islands by integrating past work, current needs, and emerging threats. We also consider overarching goals for conservation, ecosystem management, and socioeconomic sustainability that have been previously defined by both governmental and non-governmental stakeholders, and we identify discrete, implementable, and interdisciplinary recommendations that will facilitate achievement of those goals.

This study aims to investigate whether 16 weeks of High-Intensity Interval Training (HIIT) implemented on Physical Education classes (PEC), can improve physical fitness in high-school adolescents This study was a two-arm randomized controlled trial design with adolescents (15-17 years old). Twelve classes were randomized to either a 16 weeks of HIIT (HIIT-G, n = 106 students) implemented on PEC warm-up or a control group (CG, n = 123 students) of usual PEC warm-up. The HIIT sessions ranged from 14 to 20 all-out bouts intervals, adopting a 2:1 work-to-rest ratio. Post-intervention measures revealed a significant difference between groups in CRF and girls from HIIT-G increased their cardiorespiratory fitness (CRF) with significant difference between female groups and a medium to large effect size. The main findings from this study indicate that brief whole-body HIIT of an extremely low volume, over 16 weeks, can improve CRF in adolescent girls.

Background: Since 2010, Burkina Faso has developed and initiated community-based management of childhood illnesses. Following the increased presence of community health workers and the adoption of free community health care, this study aims to assess community satisfaction with curative care administered by community health workers. Methodology: It was a descriptive and analytical cross-sectional study. Data were collected in the health districts of Boussé and Boussouma from 20 February to 30 March 2023 for quantitative data and from 12 to 30 January 2024 for qualitative data using a questionnaire (household survey) and an interview grid (focus groups). Analyses were conducted using SPSS IBM 25 and Nvivo 14. Results: Households benefit from oral curative care when using CHWs, but are not satisfied with the temporal accessibility of these community health workers. Temporal accessibility and awareness during care have a significant influence on household satisfaction. Conclusion: Curative care by community health workers is effective, but its use could be improved by addressing the unavailability of community health workers, inputs and better communication during care.

Assessing dietary inadequacies can contribute to understanding the nutritional vulnerabilities of a country. This study aimed to investigate nutrient intakes and micronutrient inadequacies in the Brazilian adult population, with an interest in different age subgroups. Cross-sectional study with 1812 individuals aged 19 to 65 years from a population-based study with a representative sample of Brazilian adults. Dietary intake was assessed by two 24-hour food recalls, and the probabilities of inadequate intake were estimated using the Dietary Reference Intake targets. Adequate macronutrient intake was over 99% for proteins, 84.7% for carbohydrates, and 80.7% for total fats. There was a high probability of inadequacy (above 90%) for vitamins D and E, but vitamin D inadequacy was very similar between sexes. In contrast, vitamin E was more likely to be inadequately consumed among women. A high probability of inadequacy (above 85%) of calcium and magnesium was found in the population, regardless of age group. Except for iron, the probability of inadequacy of other minerals increased with age. The results showed a relevant proportion of nutrient inadequacies, with those most at risk being women and older individuals, helping with better targeting and monitoring of public health policies that address nutritional problems in the population.

The initial emergence of COVID-19 was observed in China on November 17, 2019, marking the likely starting point of the outbreak. It is estimated that a minimum of 266 individuals were infected with COVID-19 in China during 2019. Subsequently, the virus gradually disseminated across the globe. As of now, the global count of COVID-19 infections stands at 704,753,890, with a total of 7,010,681 fatalities. This pandemic has not only posed a threat to public healthcare but has also resulted in psychological complications. This article focuses on the approaches taken by the government of Bangladesh to address such mental health issues.

Mortality rates in sub-Saharan Africa remains unacceptably high, and disproportionately affecting economically disadvantaged communities. And healthcare delivery which is considered a major contributor to this is challenged by the limited resources and high service costs, prompting many patients to opt for outpatient department services. This study addresses the need for a data-driven approach to healthcare policy formulation by proposing a model for the implementation of a data warehousing system that integrates outpatients into the national healthcare framework. By leveraging data warehousing, healthcare delivery can be made more efficient through a robust repository that supports decision-making and policy formulation. The research focuses on the outpatient department in resource-scarce settings, proposing a novel multidimensional data model and practical framework implementation. The benefits include improved patient experiences, cost-effective service delivery, and enhanced patient management through electronic health records. Additionally, mobile apps are explored for patient navigation and reminders to enhance treatment adherence. The study’s results indicate that data warehousing can significantly improve healthcare delivery by consolidating critical data and facilitating better planning, resource allocation, and policy formulation. Ultimately, this approach offers valuable insights for optimizing healthcare systems in resource-constrained environments, enabling data-driven policies, and improving health outcomes across sub-Saharan Africa.

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported even in specialized centers. Mobile health technologies have been used in research settings to overcome these limits with contrasting results. This study aims to evaluate the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Patients were randomly assigned to standard care or standard care plus mobile app (2:1). The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: Seventy-five subjects were prospectively enrolled. At six months of follow-up, the m-app group showed significantly lower dropout rates compared to standard care(p=0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86,95%C.I. 1.39-10.42,p=0.01). After one year of follow-up, we observed lower albeit non statistically significant dropout rates in the m-app compared to the standard care group(p=0.24). No differences were observed in terms of z-score BMI and percentage of BMI reduction between the two groups. Conclusion: our findings suggest that mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction.

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.

Insecurity, corruption, and rising unemployment have resulted in a mass exodus of young adult Afghans seeking asylum in western nations. This has depleted Afghanistan of generations of young people which are critical to rebuild the country. This study aimed to examine the characteristics of young adult Afghans with no immediate intentions of seeking international asylum; that is, individuals who intend to stay in Afghanistan. In a cross-sectional study conducted in Kabul, we surveyed 232 young adults between 18 and 35 years of age. Surveys included measures assessing standard socio-demographic and -economic factors, as well as health and psychological factors. Univariate logistic regression analyses suggest that participants with an intent to stay in Afghanistan are more likely to be financially stable, possess higher health-related quality of life, lower psychological distress, and higher levels of hope and optimism, as well as higher resilience. When controlling for all other variables in the model, only hope, optimism, and higher resilience remained as significant correlates of intending to stay. Our findings suggest that young people who intend to stay in their country look forward to a better future, which provides strong evidence for the need to strengthen the social contract by fostering resilience, hope and optimism in war-affected communities, in order to prevent a generation of talented young people from seeking asylum in western nations.

Coal mining activities frequently result in negative effects that spread to neighboring populations, affecting their general health and well-being. The lack of published research on these effects in the Limpopo province motivated the quest to have local communities assess how mining has affected their health. This study explored the perceived health and well-being outcomes of community members residing around a coal mine in the Limpopo Province, South Africa. The study was conducted in three sub-villages closest to Tshikondeni Coal Mine, namely, Mukomawabane, Bileni, and Mutele B. A qualitative methodology, adopting an exploratory design, was employed. Eighty-one participants, aged 18 to 80, were purposively sampled from the selected sub-villages. Data was collected through one-on-one unstructured interviews captured as field notes, complemented by audio recordings. Throughout the study, ethical research principles of approval and permission, informed consent, privacy anonymity and confidentiality as well as avoidance of harm and benefits were strictly adhered to. Content analysis was used to analyze the data. The findings of the study revealed that many members of the communities residing around the Tshikondeni coal mine are suffering from self-proclaimed respiratory-related conditions (fourteen Asthma, ten TB, three sinuses, three coughs, and one chest pain) perceived to be caused by coal dust. Participants expressed concerns about widespread deforestation from coal mine operations with resultant soil erosion and land degradation as well as the dam that the mine left unfenced, where their livestock is hunted and drowned by crocodiles. In addition, the study reveals twenty-four participants’ concerns about the non-compensation of their cracked houses resulting from mine blasting operations. This study highlights that communities closer to coal mines experience physical, mental, and social well-being challenges, emphasizing the urgent need for extensive research to validate the various self-proclaimed respiratory problems. The concerns of communities are justified as deforestation, soil erosion, and land degradation threaten food security due to the loss of soil fertility and reduced livestock grazing area subsequently impacting the community’s livelihoods. The non-compensation of cracked houses causes frustration, anxiety, sadness, and worry among community members, negatively impacting their mental health. The South African Department of Health, Environmental Affairs, and Mineral and Energy should work together, to ensure the implementation of policies to protect communities closer to mines against harmful mining operations, non-compliance, and negligence.

Taking due account of users' perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. 501 communications (73.4% complaints, 16% appreciations, 10.6% enquiries) sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure (ACASM) was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor-patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor-patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users' assessment of the quality of care.

Dust storms originating from Central Australia and western New South Wales frequently cause high particles concentration at many sites across New South Wales, both inland and along the coast. This study focussed on a dust storm event in February 2019 which affect air quality across the state as detected at many ambient monitoring stations in the Department of Planning, Industry and Environment (DPIE) air quality monitoring network. The WRF-Chem (Weather Research and Forecast Model – Chemistry) model is used to study the formation, dispersion and transport of dust across the state of New South Wales (NSW, Australia). Wildfires also happened in northern NSW at the same time of the dust storm in February 2019, and their emissions are taken into account in WRF-Chem model by using Fire Inventory from NCAR (FINN) as emission input. The model performance is evaluated and is shown to predict fairly accurate the PM2.5 and PM10 concentration as compared to observation. The predicted PM2.5 concentration over New South Wales during 5 days from 11 to 15 February 2019 is then used to estimate the impact of the February 2019 dust storm event on three health endpoints namely mortality, respiratory and cardiac diseases hospitalisation rates. The results show that even though as the daily average of PM2.5 over some parts of the state, especially in western and north western NSW near the centre of the dust storm and wild fires, are very high (over 900 µg/m3), the population exposure is low due to the sparse population. The top five Statistical Area Level 4 regions with the most impact in term of mortality, respiratory diseases hospitalisation and cardiac disease hospitalisation are Far West and Orana, Newcastle and Lake Macquarie, New England and North West, Sydney – Inner South West and either Central Coast (mortality) or Sydney – Parramatta (respiratory diseases hospitalisation) or Sydney – Inner West (cardiac diseases hospitalisation). Generally, the health impact is similar in order of magnitude to that caused by biomass burnings events from wildfires or from hazardous reduction burnings (HRBs) near populous centres such as in Sydney in May 2016. One notable difference is the higher respiratory diseases hospitalisation for this dust event (161) compared to fire event (24).

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epi-dural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a thera-peutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a signifi-cantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no sig-nificant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neo-natal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is as-sociated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both meth-ods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor du-ration and maternal outcomes.

(1) Background: Emotional resilience is defined as the capacity of individuals to cultivate positive emotions and effectively navigate through negative emotions in terms of stress or adversity. Recent research has focused on the significant impact of adolescents’ negative emotions, as opposed to positive emotions, on mental health. The examination of positive emotion provides a distinct viewpoint on the relationship between emotional resilience and mental health in adolescents. Consequently, the current research conducted two separate investigations to examine the impact of adolescent emotional resilience on mental health, as well as the mediating influence of positive emotion. (2) Methods: Study 1 comprised a cross-sectional analysis of 3086 Chinese adolescents, while Study 2 involved a longitudinal examination of 266 Chinese adolescents. (3) Results: Results indicated that emotional resilience was associated with enhanced levels of life satisfaction, self-esteem, and overall mental health, while also demonstrating a negative correlation with symptoms of depression and anxiety. Positive emotions were found to have a partial mediating effect on the relationship between emotional resilience and mental health. These results indicate that emotional resilience not only has a direct impact on mental health but also influences mental health indirectly through positive emotions. (4) Conclusions: The findings highlighted the role of emotional resilience in mitigating psychological problems and enhancing mental health in Chinese adolescents. The implications and limitations were discussed.

This study was designed to assess variation of possible phytochemical compounds in the ethanolic extracts of Gigantochloa scortechinii rhizome. Destructive sampling was done by using selective random sampling method on four consecutive rhizomes from healthy clumps and was conducted at two natural forests and one secondary forest (planted). Homogenized sample were extracted using solvent extraction (70% ethanol) method. Ethanolic extracts of G. scortechinii rhizome were qualitatively analyzed using GC/MS GC2010 Plus, Shimadzu to determine the composition of phytochemical compounds and identified using FFNSC 1.3, NIST11, PMW_tox2, and Wiley229 spectral library. A qualitative variation was observed with a total of 56 compounds were identified and differentiated between study site and rhizome age. Results revealed that G. scortechinii rhizome contains various phytochemical compounds with potential as a plant of phytopharmaceutical importance. This is the first finding on the spatial and age-related effects of phytochemical compounds in a consecutive rhizome and of G. scortechinii rhizome specifically.

Smartphone-based fundus camera and telemedicine are an opportunity for accessing ocular health inequalities in underresourced areas. The objective of this study is to evaluate the prevalence of retinal findings in a community in the Amazon and propose strategies to enhance ocular health. A cross-sectional study was conducted in a river side community. Retinal photos from the posterior pole and optic disc were captured using a portable fundus camera. All photos and data were analyzed remotely by a retina specialist. The final sample was 107 participants, aged 52±17. Retinal findings were detected in 37.4% (95%CI 28.7–46.8) of the sample, the three main retinal findings were epithelial changes (10.3%, 95%CI 5.6–17.1), chorioretinal scars (8.4%, 95%CI 4.2–14.8), and dry Age-related Macular Degeneration (7.5%, 95%CI 3.6–13.6). This study detected retinal alterations in similar prevalence of other underresourced areas. Telemedicine is an opportunity to address health inequities, especially in ophthalmology, through relatively low-cost portable devices, supporting clinical decisions in areas with low health access, however, maintaining assistance after implementation is a challenge. Enhancing medical education and training local non-specialized health professionals for risk assessment, device handling, and data base use is reasonable to ensure follow-up.

Since the 1970s, the usefulness of nailfold capillaroscopy (NFC) in the diagnosis of rheumatological disorders such as systemic sclerosis has been well known, and further studies also showed that NFC can detect non-rheumatic diseases such as diabetes, glaucoma, dermatitis, Alzheimer disease, and so on. In the past decade, the morphological changes in the nailfold capillary have been also reported in the unhealthy lifestyle habits such as smoking, inappropriate diets, sleep shortage, and even psychological stress which presents slow blood flow. Therefore, study in the relationships between the morphology of nailfold capillaries and lifestyle habits has high potential to understand the unhealthy state, or even predict the pre-disease condition. So, simple, inexpensive, and non-invasive methods such as NFC are constantly needed for routine health checkups. Thus, we undertook a systematic search in PubMed database, and summarized the studies reporting the assessment of morphological NFC in order to undertake a comprehensive review on the usefulness of NFC not only in clinical diagnosis, but also in unhealthy dietary lifestyle improvements. Here in this review paper, we finally summarized the dietary and lifestyle health promotion strategy judging from NFC- and the other relating-measurement from the viewpoint of healthy microvascular blood flow and endothelial function.

In this study was found that these cancers were attributable to risk factors such as cigarette smoking, second-hand smoke, alcohol intake, excess body weight, diet, and six cancer-associated infections. Several databases were reviewed including PUBMED, Google scholar, and Web of Science. The facts suggest that a number of individuals present risk factors for cancer, which can be modifiable.

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

The world health organisation (WHO) revealed approximately 280 million people in the world suffer from depression. Yet, existing studies on early-stage depression detection using machine learning (ML) techniques are limited. Prior studies have applied a single stand-alone algorithm which are unable to deal with data complexities, prone to overfitting and limited in generalisation. To this end, our paper examined the performance of several ML algorithms for early-stage depression detection using two benchmark social media datasets (D1 and D2). More specifically, we incorporated sentiment indicator to improve our model performance. Our experimental results showed that sentence bidirectional encoder representations from transformers (SBERT) numerical vectors fitted into stacking ensemble model achieved comparable F1 scores of 69% in dataset (D1) and 76% in dataset (D2). Our findings suggest that utilising sentiment indicators as additional feature for depression detection yields an improved model performance and thus, we recommend the development of depressive term corpus for future work.

Late January 2020, COVID-19 unexpectedly imposed world-wide limitations on daily life. Deemed a pandemic mid-March 2020, lockdowns were imposed for an indefinite period, including at academic institutions. Consequently, interest in digital literacy—an on-going and increasing concern of academic institutions in the 21^st century—exponentially heightened. Continuing meetings of academic groups now necessitated online communication. In the almost overnight closure of all non-essential services, academic units at one post-secondary institution expeditiously selected Zoom—a popular video conferencing application—as the preferred platform for meetings until social distancing was lifted. In contrast to this widely accepted use of Zoom for scheduled meetings, one unique health-related group at the institution, tailored to the 4Cs of 21^st century learning of critical thought, communication, cooperation and creativity, found social networking through a private Facebook group a more appropriate and satisfying group experience than likely possible with the Zoom app. Pros and cons of both online platforms are presented along with when each choice is warranted. In promoting digital literacy as the primary goal in online communication for academic meetings, private Facebook groups hold promise for collaborative online academic meetings with similar features to this health-related group.

Various environmental, food security and population health problems seem to be related to intensive agriculture production worldwide. This type of food production system impacted the loss of biodiversity and natural habitats; high usage rates of agrochemicals and natural resources had affected soil composition, human health, and nutritional plant quality in rural areas. Intercropping agroecological systems that respect agrobiodiversity could significantly benefit ecosystems, human health, and food security by modifying the nutritional profile and the content of some health-promoting bioactive compounds of the species cultivated in this system. Research on intercropping strategies focuses on the benefits they can offer to ecosystems and less on nutrient plant composition, leaving information scattered when this theme should be more studied due to the critical impact it could provide for human nutrition. Therefore, this review aims to collect viable details on the investigation status of nutrients and bioactive compounds profile in intercropping systems by verifying different regions of the world with unique mixed crops using plant species, along with the criteria for combining them, as well as the nutrients and bioactive compounds analyzed to show what intercropping systems can contribute to food availability and quality.

Background/Objectives: Adolescence represents a period of heightened vulnerability to risky sexual behaviours. In Portugal, adolescents are initiating sexual activity at increasingly younger ages. Yet, there are no studies evaluating their knowledge about sexually transmitted diseases and prevention methods at an earlier stage of their development. Study how middle school ad-olescents define their sexuality and assess their level of information regarding sexuality, STI, and prevention methods. Additionally, it explores adolescents' sources of information on sexuali-ty-related issues. Methods: A cross-sectional observational study was conducted involving the application of a questionnaire to 750 9th-grade students of Vila Nova de Gaia, Porto, Portugal. The questionnaire covered topics such as perceptions of sexuality, knowledge of sexuality and STI, methods of transmission prevention, and sources of information. Results: The mean age was 14.4 years, with 19.9% reporting having already initiated sexual ac-tivity. Overall, the knowledge about sexually transmitted infections is low, pointing to 7.08 out of a maximum score of 18. Condoms and immunisation are well-recognized preventive measures, but many misconceptions persist. Better knowledge is associated with better attitudes in the likelihood of having sexual intercourse. Conclusions: This study reveals adolescents' limited sexually transmitted infections knowledge, misconceptions about prevention, and reliance on peers and the internet over trusted sources, highlighting the need for comprehensive sexual education in middle school.

This study investigated changes in the average BMI of 5th and 6th grade elementary school students in Korea and provided foundational data to suggest the role of physical education for student health and set future directions. The 2019–2021 Physical Activity Promotion System (PAPS) of the Korean Ministry of Education was used. Data corresponding to 5th and 6th grade students (124,693 from 2019, 126,226 from 2020, and 117,809 from 2021) in 1,208 elementary schools in Korea were collected. The BMI was obtained by dividing weight by the square of height (㎏/m2). Repeated measures ANOVA was conducted for data analysis, and confidence intervals were modified through the Bonferroni correction for multiple comparisons. The Greenhouse-Geisser correction was used for effects test. The study findings are: First, the average BMI of 5th and 6th grade elementary school students in Korea increased significantly in 2021 compared to 2019 and 2020. Second, changes in the yearly average BMI showed a significant difference depending on gender and grade. Obesity among 5th and 6th grade elementary school students in Korea increased steadily in 2019–2021, which may be due to a decrease in students’ physical activity. Male students showed a steeper increase, regardless of grade.

Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers: (1) Background: It is important to get a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will inform the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences, based on trustable information.; (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized findings; (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed the identification of current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers.

People experiencing homelessness are at risk from a number of co-morbidities including traumatic brain injury, mental health disorders and various infections. Little is known about the rehabilitation needs of this population. This study took advantage of unique access to a specialist ‘Access’ GP practice for people experiencing homelessness and a local inclusion health initiative to explore the five year period prevalence of these conditions in a population of people experiencing homelessness, through electronic case record searches; and identify barriers and facilitators to healthcare provision for this population in the context of an interdisciplinary and multi specialist inclusion health team, through semi structured interviews with 12 staff working in primary and secondary care who interact with this population. The five year period prevalence of TBI, infections and mental health disorders was 9.5%, 4% and 22.8% respectively. Of those who had suffered a brain injury only 3, had accessed rehabilitation services. Themes from thematic analysis of interviews included: lack of resource, stigmatisation, under recognised multi-morbidity (including from brain injury) as barriers, trauma-informed, person-centred, adaptable, &amp; integrated and collaborative models of care as facilitators. The combination of quantitative and qualitative data suggests a potential role for rehabilitation medicine in inclusion health initiatives.

Background/ObjectivesMental health and substance use disorders (MHD, SUD) affect cardiac allograft and VAD recipients and impact their quality of life and compliance. Limited research on MHDs and SUDs in transplant and MCS candidates and recipients. This study compares the incidence of MHDs and SUDs in transplant list, VAD, and post-transplant patients with that in heart failure patients. MethodsStudy cohorts were derived from the TriNetX using ICD-10 codes. Differences in incidence were examined using the log-rank test. Adults with mental health disorders before the window of time were excluded. Propensity score matching was performed using TriNetX to balance demographic and medical comorbidities. Statistical significance was set at p<0.05. All comparisons were made between propensity-matched cohorts. ResultsTransplant waitlist patients showed a statistically significant increase in the incidence of anxiety, panic disorder, adjustment disorder, depression, mood disorder, alcohol use disorder, and eating disorder. Post-transplant patients showed a statistically significant increase in the incidence of depression and opioid use compared to the heart failure population. VAD patients showed a statistically significant increase in the incidence of depression and a statistically significant decrease in panic disorder and anxiety. ConclusionsThe results pave the pathway for further investigations on prevention and coping strategies because deterioration of mental health will significantly impact compliance with medications as well as patient survival and quality of life. The use of opioids for pain management in the early postoperative period should be further investigated to assess its impact on long-term substance use and addiction. .

Background: The enduring psychological effects of the COVID-19 pandemic continue to affect individuals long after the immediate health concerns have subsided. This research aims to identify specific groups within the Romanian population who are at a higher risk of experiencing mental health challenges that can interfere with everyday life and may lead to more serious mental health disorders. Methods: Conducted as a cross-sectional survey, this study evaluated the prevalence and intensity of psychological distress using the DASS-21 questionnaire. An online survey distributed via Google Forms also gathered socio-demographic data and COVID-19-specific information. Statistical analyses included the Shapiro-Wilk test, Fisher's exact test, and Z-tests with Bonferroni correction. Quantitative independent variables that lacked a normal distribution were compared between groups using either the Mann-Whitney U test or the Kruskal-Wallis H test. Results: Analysis of 521 questionnaires, filled out by a predominantly middle-aged cohort of 320 women and 201 men, revealed that 63.72% of participants worked outside the healthcare field. Those unemployed or retired reported significantly higher anxiety levels than individuals in other sectors. Moreover, living alone, experiencing the loss of close relatives (6.14%) or friends (33.59%), and undergoing hospitalization or reinfection due to COVID-19 were linked to significantly elevated distress scores. Conclusion. By identifying the segments of the population most vulnerable to psychological distress, as evidenced by higher scores among the unemployed, retirees, individuals living alone, and those directly affected by COVID-19 through personal health or loss, targeted initiatives for psychological screening and therapy can be established. Such measures are essential for enhancing the post-pandemic mental well-being of Romanians, addressing the specific needs uncovered in this study.

Keywords: Oral health, diabetes, periodontal disease, caries, periodontitis.

Many young people are reluctant to seek support for mental health concerns and a preference for self-reliance has been identified as a key barrier. Yet, the conceptualisation and measurement of self-reliance is not well understood. This study examines the meaning of self-reliance as it affects young people’s help-seeking, with an emphasis on the role of trust (both in self and in others). 30 Australian young people aged 18-25 years were interviewed. Reflexive thematic analysis, using both inductive and deductive approaches, was used to construct themes about the relationships between trust, self-reliance, and help-seeking for young people. Participants identified that both self-reliance and help-seeking exist on a continuum from insufficient self-reliance to extreme self-reliance and excessive help-seeking to unwillingness to seek help. Trust was a key component of self-reliance, and a balance between trust in self and trust in others is necessary for self-reliance to be adaptive and appropriate help-seeking to occur. To maintain this balance, young people felt that a level of self-awareness was necessary. A high level of trust in self is considered to increase self-reliance, whereas a high level of trust in others increases help-seeking behaviours. Understanding the role of trust in self-reliance informs developmentally appropriate ways to address self-reliance as a barrier to mental health help-seeking for young people.

This article evaluates the reliability and consistency of nutrition- and supplementation-related advice for pregnant women provided by ten selected health-related Internet portals. The portals were chosen based on their perceived reliability and prominence in Google searches, with representation from both English and Polish language sources. The evaluation criteria included the adherence of the presented information to official recommendations and its evidence-based character based on specific items representing dietary aspects important in pregnancy. While the overall reliability was deemed acceptable, significant variations existed both among the portals and specific evaluated items. Notably, HealthLine, Medline Plus, and NCEZ emerged as the most evidence-based, while WebMD and Medycyna Praktyczna were identified as less reliable. Despite a number of issues, the analysed portals remain valuable sources of nutritional information for pregnant women, offering user-friendly accessibility superior to alternatives such as social media, on the one hand, and scientific articles, on the other. Improved consistency and attention to detail, especially in relation to vitamin intake and supplementation, would improve the overall quality of health portals.