Objectives: Our objective was to assess employer preparedness to protect their employees’ health and safety and promote their well-being in the face of potential disasters in a sample of Northeast United States employers. We developed survey instrument and index based on our model of Total Worker Health® (TWH) Employer Preparedness.Methods: We conducted a 40-question on-line survey with the membership of the Northeast Human Resources Association (US). Human resource managers reported their perceptions of their employers’ preparedness in seven domains: planning, human resources policies, hazard reduction, training, staffing, communications, and resources for resilience. Respondents were categorized by size, sector and reach and their responses scored.Results: Seventy-six individuals representing a diverse group of employers responded to the survey. Mean preparedness was “moderate,” with almost an equal number reporting a high level of preparedness as no preparedness. Employers were most prepared for severe weather events and least prepared for acts of violence. There were no significant differences by sector, size, or reach, although the healthcare sector was more prepared than others.Conclusions: There is a range of TWH® Employer Preparedness among Northeast US employers. The survey and model are important tools that can aid employers in the face of growing threats to “business as usual.”

The COVID-19 pandemic has brought about unprecedented changes to human lifestyles across the world. The virus and associated social restriction measures have been linked to an increase in mental health conditions. A considerable body of evidence shows that spending time in and engaging with nature can improve human health and wellbeing. Our study explores nature’s role in supporting health during the COVID-19 pandemic. We created web-based questionnaires with validated health instruments and conducted spatial analyses in a geographic information system (GIS). We collected data on people’s patterns of nature exposure, associated health and wellbeing responses, and potential socioecological drivers such as relative deprivation, access to greenspaces, and land-cover greenness. We applied a range of statistical analyses including bootstrap resampled correlations and binomial regression models, adjusting for several potential confounding factors. We found that respondents significantly changed their patterns of visiting nature as a result of the COVID-19 pandemic. People spent more time in nature and visited nature more often during the pandemic. People generally visited nature for a health and wellbeing benefit and felt that nature helped them cope during the pandemic. Greater land-cover greenness within a 250 m radius around a respondent’s postcode was important in predicting higher levels of mental wellbeing. There were significantly more food-growing allotments within 100 m and 250 m of respondents with high mental wellbeing scores. The need for a mutually-advantageous relationship between humans and the wider biotic community has never been more important. We must conserve, restore and design nature-centric environments to maintain resilient societies and planetary health.

COVID-19 severity is heterogeneously distributed over age strata, but current mitigation strategies are homogeneously applied to all population. Social-distancing and stay-home are effective conservative approaches but lack economic sustainability on long term. Conversely, herd-immunity is a nonrestrictive strategy which can cost remarkable number of human lives and can melt the healthcare system down. Here I propose an Age Adaptive Social Distancing (AASD) engineering strategy to mitigate COVID-19 outbreak. AASD is based on the scientific evidence that the fatality rate grows nonlinearly with age, hence also the containing strategy should adapt nonlinearly. Essentially, AASD suggests that ‘silent spreaders’ (age 0-39) should avoid/minimize direct and indirect contacts with individuals in ‘dangerous zone’ (age 40+). The rationale is: 0-19 should follow parents strategy, healthy 20-39 (low fatality rate) might conduct screened life under active surveillance, to sustain economy and acquire rational immunity; 40-59 should respect social distancing (waiting a therapy); 60+ should stay at home (waiting a vaccine). This might save human lives, reduce healthcare demand and improve economic sustainability. The final take-home message is that future studies should design precision and personalized strategies for specific contagious diseases that integrate different social constrains, active surveillance and contact tracing.

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

There is a need for developmental screening that is easily administered in resource-poor settings. 1) We hypothesized that known risk factors would predict failed developmental screening on an adapted screening tool in East African children living in poverty. 2) The sample included 100 healthy Ugandan children aged 6-59 months. We adapted a parent-reported developmental screener based on the Child Development Review chart. The primary outcome was failure to meet age-appropriate milestones for any developmental domain. Venous blood was analyzed for lead, and caregivers completed a demographics questionnaire. We used multivariate logistic regression models to determine if elevated blood lead and stunting predicted failure on the screener, controlling for maternal education level, age in months past the lower bound of the child’s developmental age group, and absence of home electricity. 3) In the sample, 14% (n=14) of children failed one or more milestones on the screener. Lead levels or stunting did not predict failing the screener after controlling for covariates. 4) Though this tool was feasibly administered, it did not demonstrate preliminary construct validity and is not yet recommended for screening in high-risk populations. Future research should include a larger sample size and cognitive interviews to ensure it is contextually relevant.

The ageing of workers is one of the most important issues for occupational health and safety in Europe. A number of intervention studies on health promotion for older workers were conducted in European workplaces between 2000 and 2015. This review gives an overview of these studies and considers perspectives for workplace health promotion.

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.

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.

Background: Youth experiencing homelessness (YEH) in East Asia Pacific (EAP) represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack of stable shelter, disrupted social networks, and limited access to mental health services elevate their susceptibility to adverse mental health, making urgent interventions essential to address their needs. Objective: To explore and provide systematic evidence on the types of mental health services and interventions for YEH in EAP and their impact on overall quality of life and wellbeing. Methods: Electronic databases(e.g., Medline, PsychInfo, PubMed, Scopus) were systematically searched(publication dates between 01/01/1990-13/05/2023), as well as additional online resources specific to homelessness. Articles were screened, and a critical appraisal assessed the quality of the included studies. Results: Eight studies with different interventions were identified in Indonesia(n = 2), Malaysia(n = 1), South Korea(n = 3), and The Philippines(n = 1). These were thematically clustered into six categories: art, cognitive behavioural therapy, life skills education, resilience enhancement, family strengthening and government interventions/services. Conclusion: This review highlights effective mental health interventions’ positive impact on YEH mental health outcomes and quality of life in EAP, stressing the urgent need to implement socio-culturally sensitive services. Future research should address knowledge gaps through comprehensive studies covering diverse EAP regions and populations, prioritising socio-culturally specific psychological measures.

People must have particular personality traits and social resources, also known as health literacy, in order to access, comprehend, and use information to make decisions about their health. Patients' ability to engage in complex disease management and self-care is strongly related to their level of health literacy. It can help us stay healthy by preventing illness and effectively managing existing illnesses. People with low health literacy (LHL) may find it difficult to manage their condition and prevent illness, which may lead to increased use of healthcare services. Furthermore, LHL is associated with increased hospitalizations, increased use of emergency care, decreased use of preventative services, and a worsened ability to understand labels and health messages, a worsened state of health, higher mortality, and more expensive medical care.

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

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

In this ‘New Normal' post-COVID-19 modern world, people's health is becoming increasingly important to track. An advanced technology that uses sensory instruments to track and record critical parameters and communicates with others is the need of the time. It's difficult to keep track of all of the medical parameters and post-operative data of people with non-communicable diseases like diabetes and heart disease on a continuous basis. The system discussed here to be designed for patients who are confined to their homes, particularly when going out and being exposed to the outer world is prohibited. This paper proposed a groundbreaking health management system based on the Internet of Things (IoT) for accessing patient medical parameters in both local and remote areas. When a person's wellbeing becomes urgent, this initiative seeks to send an emergency alert to family members or loved ones. A cloud server records data from the patient's temperature sensor and pulse sensor; the data is analyzed using support vector machine algorithms to identify irregular conditions, and an emergency message is sent to the rest of the family via a mobile application, as well as a warning message to the nearest hospital.

Background/Objectives: The World Federation of the Deafblind Global Report 2023 reports that many countries do not have a comprehensive identification, assessment, and referral system for persons with deafblindness, a combination of hearing and vision loss, across all age groups and geographic regions. The scan seeks to inform researchers, policymakers, and community-based organizations about the status of and gaps in sensory healthcare initiatives in Canada, with intent to raise awareness to enhance integration and coordination of eye and ear care services. Methods: We conducted an environmental scan of Canada’s healthcare system and current public health policies addressing vision and hearing care in Canada at federal and provincial levels. The scan was conducted using published literature searches from five scientific databases – Embase, Medline, PsycINFO, PubMed and CINAHL, in combination with the grey literature review of federal, provincial, and territorial government and non-profit organizations websites during April-October 2022. Out of 1257 articles screened, 82 studies included that met the inclusion/exclusion criteria. 13 reports were included in the grey literature search. Results: Thematic findings indicate stigma and discrimination towards individuals with disabilities and marginalized groups, including hearing, vision, or dual sensory loss, persist. Barriers to vision and hearing healthcare access include inadequate policies, underinvestment in vision and/or hearing services, limited collaboration and coordinated services between hearing and vision services, discrepancies in insurance coverages, and lack of health system support. Conclusions: This scan demonstrates the persistent barriers to vision and/or hearing services present in Canada, stemming from inadequate policy and limited-service coordination. Future work to address gaps, evaluate public education, and develop integrated sensory health care initiatives to enhance coordinate eye and ear care services as recommended in WHO Report on Hearing and Vision is imperative.

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.

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.

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy and may have their health affected by living and working conditions. This study analyzed and synthesized the scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7,363 drivers. The biological risks identified were age, gender, race/ethnicity, genetics, comorbidities, and were considered non-modifiable for chronic diseases. The behavioral risks, considered modifiable, were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the number of working hours per day, week and month; time away from home, risk of musculoskeletal injury, and opportunities for rest, hours of sleep and access to health services. The results were presented in two categories: 1) biological, behavioral and environmental risks, and 2) general recommendations to promote physical, cognitive and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

Aflatoxin being a serious threat to public health and international trade, necessi-tates a comprehensive understanding and calculated response with effective inter-vention strategies. This review methodically looks at several aspects of aflatoxin, starting with how it affects international trade laws through feed and feed ingre-dient regulations. Aflatoxin contamination poses serious challenges to world health and the economy, especially in areas that are already at risk. Examining the varia-bles affecting aflatoxin toxicity, the paper clarifies aflatoxin toxicity's complex me-tabolism and the resulting health effects of exposure. The serious repercussions of aflatoxicosis outbreaks and their connections to illnesses like Aspergillosis and cancer are highlighted by a detailed exploration of prospective decontamination techniques as well as strategies for detecting and capturing aflatoxin. A thorough knowledge of the factors that contribute to aflatoxin contamination demonstrates the intricate interactions between environmental variables, farming methods, stor-age circumstances, and different physical, biological, and nutritional components. Strong detection strategies are required due to aflatoxins’ significant effects on an-imal and human health. The paper describes complete preventative tactics that en-compass manipulation in management strategies. global trade and public health from this pervasive threat.

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.

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.

Health comprises physical, mental and social dimensions whose interactions influence users’ experiences. Health experiences are within the context of environments. These contexts are definitive contributors to experiences – primarily because of the link to social dimensions as human beings - psychological and economic. Therefore, the study aims to investigate health resort users’ psycho-social and socio-economic characteristics to improve their access to quality healthcare. The objectives are identifying the socio-economic characteristics of an inclusive health resort, analysing the psycho-social characteristics of the inclusive health resort user, and analysing the effects of users’ psycho-social and socio-economic characteristics on their access to healthcare. The study employs the mixed research method (qualitative and quantitative). The researchers engaged in a pragmatic research philosophy that underscores positivist and interpretivist paradigms. The data collection instruments include survey questionnaires, an interview guide with a digital recorder, a direct participant observation schedule, field notes and photographs. The data analysis process involves the clustering and categorisation of data and examining concepts and themes. The research findings show a correlation between the users’ socio-economic status and access to quality healthcare in an inclusive health resort. The result further reveals that psycho-social and socio-economic characteristics of health resort users are quality healthcare access predictors. Therefore, the users’ social, psychological, and economic status should play a vital role in the design of an inclusive health resort by all stakeholders.

Measles remains a highly contagious and potentially severe infectious disease, necessitating high vaccine coverage. However, misinformation and measles vaccine hesitancy/resistance posed significant challenges to achieving this goal. The COVID-19 pandemic further exacerbated these challenges, leading to a measles outbreak in Jordan in 2023. This study aimed to investigate the acceptance of the Measles-Rubella (MR) vaccine among parents in Jordan and identify its associated determinants. This cross-sectional questionnaire-based study was conducted using a previously Arabic-validated version of the Parental Attitudes towards Childhood Vaccines (PACV) survey instrument. Data collection took place in October 2023, and the final study sample comprised a total of 391 parents, with mothers representing 69.8% of the participants (n = 273). The majority of participating parents expressed either resistance (n = 169, 43.2%) or hesitancy (n = 168, 43.0%) towards MR vaccination, while only 54 participants (13.8%) expressed MR vaccine acceptance. Multivariate analysis revealed that trust in vaccine safety/efficacy, behavior, and having fewer offspring were significantly associated with MR vaccine acceptance. The current study revealed a concerning level of MR vaccine hesitancy/resistance among parents in Jordan. Urgent and targeted interventions are strongly recommended to address this issue, including mass campaigns aimed at building trust in the MR vaccine safety/efficacy. Additionally, there is an urgent need for effective public health initiatives to ensure sufficient measles vaccine coverage to prevent future outbreaks of this serious disease.

A systematic and comprehensive review of critical applications of Blockchain Technol-ogy with Differential Privacy integration lies within the privacy and security enhancement. This paper aims to highlight the research issues in the e-health domain (e.g., Electronic Medical Rec-ords) and to review the current research directions in Differential Privacy integration with Blockchain Technology.(1) Background: The current state of the art in the e-health domain is identified as follows: (a) healthcare information poses a high level of security and privacy concerns due to its sensitivity; (b) due to vulnerabilities surrounding the healthcare system, a data breach is common and presents a risk for attacks by an adversary; and (c) the current privacy and security apparatus needs further fortification. (2) Methods: The methodology uses a systematic literature review (SLR) to identify and select relevant research papers and academic journals in DP and BT. (3) Results: The results are categorized into: e-Health Record Privacy, Real-Time Health Data, and Health Survey Data Protection to identify inherent issues with Differential Privacy integra-tion with Blockchain and technical challenges.(4) Conclusion: This review thoroughly surveyed and summarized Differential Privacy mechanisms in EMR privacy, real-time health data, and health survey data protection while highlighting challenges.

Background/aim: Sexual harassment has become a serious social and public health problem in adolescence, causing adverse effects on mental health. Nevertheless, some behaviours arise that, due to their characteristics, might be misinterpreted as sexual harassment. A field study, a survey with a non-probabilistic accidental sampling, was designed in order to estimate the prevalence of sexual harassment victimization in the Spanish adolescent population, as well as to quantify the harms. Method: 1028 Spanish adolescents, 54.3% females and 45.7% males, aged 13-17 years (M = 15.21, SD = 1.03), responded to a diagnostic measure of sexual harassment victimization and an inventory measure of internalizing and externalizing Mental Health Problems (MHPs). Results: The results showed a significant prevalence of diagnosed sexual harassment victimization of school-aged adolescents, 24.1%, 95% [.215, 267], with adverse effects on internalizing and externalizing MHPs. As for the internalizing MHPs, the results showed moderate adverse effects on depression, anxiety, somatic burns, posttraumatic symptoms, and obsessive-compulsive symptoms; and mild adverse effects on social anxiety. With regard to externalizing MHPs, the results revealed moderate adverse effects on hyperactivity-impulsivity, anger control and antisocial behaviour; and mild adverse effects on attention problems, aggression and defiant behaviour. In addition, it was corroborated that sexual harassment victimization affects adolescent females to a greater extent, with the effect being significantly greater in internalizing than in externalizing MHPs. Conclusions: The results obtained are discussed and future lines of research and intervention are proposed to promote the implementation of prevention and intervention programs that address this phenomenon and, in turn, improve the physical, psychological, and social well-being of adolescents.

Despite air pollution being a leading cause of health issues in developing nations, public awareness and understanding of local air quality remains notably low. The present study assesses the perception, attitude, and environmental knowledge of local air pollution among adult urban residents (n=870) in a city with leading air pollution rates among cities of emerging economies: Astana, Kazakhstan. Structural equation modeling (SEM) was employed to investigate the causal relationship between perceived air quality, environmental literacy, and willingness to pay (WTP) for environmental protection. Findings indicate over 40% of residents neither consider the city being highly polluted nor recognize the association between air quality and adverse health outcomes, correlated with a generally low level of environmental literacy. The age, education, and health status of the participants significantly affected (p&lt;.001) their level of environmental knowledge and awareness. The SEM analysis indicates that knowledge is the major determinant in improving public awareness and perception of local air pollution (path value=0.626). Moreover, a close association between WTP and environmental attitude was also evident (path value=0.533). The findings of the present study may provide valuable insights for healthcare professionals, environmental researchers, and governmental institutions for implementing more effective public interventions to protect local air quality.

Collecting and recording physiological parameters and forwarding this data via telemedicine or remote surveys may significantly increase the health and safety of people working under extreme environmental conditions, like firefighters, mountain rescuers, disaster control employees, military personnel, etc. First, ruggedized systems, as small, lightweight, and flexible as possible, are needed to optimize the goal of increasing occupational health and safety of persons at risk and maximizing their performance during missions. Previous systems could only record a very limited number of parameters, and a few could forward the data online to return information to the user. Therefore, in order to record several meaningful, valid, and reliable physiological parameters synchronized, an extension of existing systems is required. This review highlights this problem and gives an overview of the historical development. The actual status of the systems available was listed and described comparatively. In the end, a proven, promising, and innovative solution is presented that can solve the problem and allow people to work more safely in extreme environments, which may represent the future.

Best practices in global health training prioritize leadership and engagement from investigators from low- and middle-income countries (LMICs), along with more conscientious community consultation and research that benefits local participants and autochthonous communities. However, well into the 20th century, international research and clinical care were rife with paternalism, extractive practices, and racist ideation, with race presumed to explain both vulnerability or protection from various diseases despite scientific evidence for more precise mechanisms for infectious disease. We highlight experiences in global research on health and illness among indigenous populations in LMICs, seeking to clarify what is both scientifically essential and ethically desirable in research with human subjects; we apply a critical view towards race and racism as historically distorting elements that must be acknowledged and overcome.

Methods to handle uncertainty in economic evaluation have gained much attention in the literature and the cost-effectiveness acceptability curve (CEAC) is the most widely used method to summarize and present uncertainty associated with program costs and effects in cost-effectiveness analysis. Some researchers have emphasized the limitations of the CEAC for informing decision and policy makers as the CEAC is insensitive to radial shifts of the joint distribution of incremental costs and effects in the North-East and South-West quadrants of the cost-effective plane (CEP). Furthermore, it has been pointed out that the CEAC does not incorporate risk-aversion in valuing uncertain costs and effects. In the present article we show that the cost-effectiveness affordability curve (CEAFC) captures both dimensions of the joint distribution of incremental costs and effects on the CEP and is therefore sensitive to radial shifts of the joint distribution on the CEP. Furthermore, the CEAFC also informs about the budget impact of a new intervention as it estimates the joint probability an intervention is both affordable and cost-effective. Moreover, we show that the cost-effectiveness risk-aversion curve (CERAC) allows to incorporate risk-aversion into the analysis and can therefore be used to inform decision-makers who are risk-averse. We use data from a published cost-effectiveness model of palbociclib in addition to letrozole versus letrozole alone for the treatment of oestrogen-receptor positive, HER-2 negative, advanced breast cancer to demonstrate the differences between CEAC, CEAFC and CERAC and show how these can jointly be used to inform decision and policy makers.

The COVID-19 pandemic has had devastating consequences for health, social, and economic domains, but what has received far less focus is the effect on people’s relationship to vital ecological supports, including access to greenspace. We assessed patterns of greenspace use in relation to individual and environmental factors and their relationship with experiencing psychological symptoms under the pandemic. We conducted an online survey recruiting participants from social media for adults in Korea for September–December 2020. The survey collected data on demographics, patterns of using greenspace during the pandemic, and major depression (MD) and generalized anxiety disorder (GAD) symptoms. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 2-item (GAD-2) were applied to identify probable cases of MD and GAD. A logistic regression model assessed the association decreased visits to greenspace after the outbreak compared to 2019 and probable MD and GAD. Among the 322 survey participants, prevalence of probable MD and GAD were 19.3% and 14.9%, respectively. High rates of probable MD (23.3%) and GAD (19.4%) were found among persons currently having job-related and financial issues. Of the total participants, 64.9% reported decreased visits to greenspace after the COVID-19 outbreak. Persons with decreased visits to greenspace had 2.06 higher odds (95% CI: 0.91, 4.67) of probable MD at the time of the survey than persons whose visits to greenspace increased or did not change. Findings suggest that barriers to greenspace use could deprive people of mental health benefits and affect mental health during pandemic; an alternative explanation is that those experiencing poor mental health may be less likely to visit greenspaces during pandemic. This implies the need of adequate interventions on greenspace uses under an outbreak especially focusing on how low-income populations may be more adversely affected by a pandemic and its policy responses.

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

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

Latin America and the Caribbean (LAC) is one of the worst-hit regions globally by COVID-19 pandemic. Yet, scarce literature exists that examines the research strategy of LAC in facing COVID-19. The present study aims to quantify and assess the production of COVID-19 publications in thirty-two countries in LAC during the first half of 2020. A Scopus/PubMed/LILACS search was performed to retrieve research articles related to COVID-19 published from January 1 to July 31, 2020. Subgroup analysis including only original publications was used to better ascertain the contribution of LAC countries, and standardization measures were applied to comparisons of country-specific contributions. We identified 1291 publications across the region. Overall, most articles in the region were non-original (81.6%), and the most productive countries were Brazil (43.9%), Mexico (9.14%), and Colombia (7.98%). This trend shifted to Chile after the standardization. Among original studies, the most common study design was cross-sectional (25.8%). LAC countries generate articles primarily pertaining to diagnosis and treatment (27.4%). In the subgroup analysis, however, epidemiology and surveillance was the most prevalent research focus (24.1%). LAC countries should perform more research with a higher level of evidence to inform health policy making to ease the burden of COVID-19 in the region.

There is a long trail of research studies testing the in vitro and in vivo efficacy of chloroquine and its derivatives in treating and preventing infection by various coronavirus species. More recent findings have highlighted the possibility of treating patients infected with the 2019 novel coronavirus, SARS-CoV-2. This review describes the mechanism of coronavirus infection, the mechanism of action of chloroquine, and summarizes the available literature highlighting the efficacy of chloroquine as an anti-coronavirus agent. These findings should encourage the wider scientific community to conduct thorough research on the possible efficacy of chloroquine and its derivatives in treating and preventing SARS-CoV-2 infection.

Health of migrant is a widely studied topic. It has been argued that migrant health may deteriorate over time. Though migrants are ‘a hard to reach’ population in survey data, this paper builds on a unique dataset provided by Médecins du Monde from five countries. We study self perceived health (SPH) in connection with socio-economic and demographic factors and length of stay. Results show different results for men and women. Asylum seekers compared to other documented migrants have a worse health. Migrants with better living conditions tend to be in better health. Employment and stable accommodation has a positive effect on SPH. Women from poorer countries have a better physical SPH after 3 months of residing in the host country. This paper contributes widely to knowledge of health of migrants. Contrarily to other evidence, health of migrants tends to improve for some migrants.

Replacement of fee-for-service with capitation arrangements, forces physicians and institutions to minimize health care costs, while maintaining high-quality care. In this report we describe how patients, their families (and caregivers) can work with members of the medical care team to achieve these twin goals of maintaining (and perhaps improving) high-quality care and minimizing costs. We describe how increased self-management enables patients and their families/caregivers to provide electronic patient-reported outcomes (i.e., symptoms, events) (ePROs) as frequently as the patient or the medical care team consider appropriate. These capabilities also allow greater reliance on the use of mobile technologies (mHealth) to provide ongoing assessments of physiologic measurements/phenomena. Remote surveillance of these communications allows longer intervals between (fewer) visits of patients to the medical-care team when this is appropriate and earlier interventions when that is appropriate. Systems are now available that alert medical care providers to situations when interventions might be needed.

The literature has addressed the negative impact of poor neonatal conditions (NC) across regions. This has drawn attention to the need to improve NC, particularly in Africa. NC research can make an important contribution. However, there is no study dedicated to this topic in Africa. Through a bibliometric analysis, we arrive at outputs that can inform scientists in planning ongoing or new NC research and those involved in developing and implementing strategies to combat poor NC. Using bibliometrics, the study identified the scientific knowledge on NC between 2000 and 2019, its visibility in the community, the main topics researched, and collaboration patterns.The results show that knowledge on NC has increased between 2000 and 2019, it is concentrated in a few African countries (Egypt, South Africa, Nigeria, Tanzania and Kenya), its visibility is below the world average, in general, maternal mortality is the most researched topic and collaborative activities are frequently, mainly international research collaboration (IRC), being the United States of America (USA) and the United Kingdom (UK) the main partners (they participated in 57% and 28% of all articles with IRC). The collaboration networks are fragile as 43%-67% of all links represent one article in 20 years.Ongoing or new research on NC in Africa should consider the main African players and their partners. There is a need to implement strategies to increase NC knowledge in other African countries, expand and strengthen the collaboration networks and diversify the sources of knowledge.

The process of managing people in an organised way to assist a company in achieving its goals is known as human resources management. an increase in workplace stress, which is detrimental to an employee's health and well-being as well as the performance of the organisation. Certain guiding concepts and precepts are evergreen and can support the development of human resources while ensuring the wellbeing of the individual and the company. In this study, we examine how the methods and practices of yoga might benefit public organisations by lowering employee stress levels and boosting their altruism and greedlessness.

The pervasive use of plastic for milk packaging has raised significant health concerns, despite its advantages in terms of cost-effectiveness, convenience, and durability. The potential correlation between cancer and plastic packaging is one of these concerns. This mini-review examines the health implications of plastic materials used in milk packaging, with a particular emphasis on their carcinogenic hazards. This work endeavors to summarize the current state of knowledge regarding the influence of plastic components on human health and underscore the importance of ongoing research in this field by utilizing insights from a comprehensive review article. Harmful chemicals have been observed to leach into milk from plastics used in milk packaging, including high-density polyethylene (HDPE), low-density polyethylene (LDPE), and polyethylene terephthalate (PET), particularly under conditions of protracted storage and heat. Bisphenol A (BPA), phthalates, and styrene are among the most prevalent leachates. These chemicals have been associated with a variety of health issues, such as an elevated risk of cancer, and are recognized for their endocrine-disrupting properties. BPA and phthalates, in particular, have the potential to disrupt hormone function, which may result in breast cancer, prostate cancer, and other hormone-related malignancies.This review emphasizes the significance of comprehending the precise components of plastics utilized in milk packaging and their potential health consequences. It advocates for more rigorous research to completely elucidate the long-term health impacts of these materials by emphasizing the current state of knowledge and regulatory initiatives. Additionally, it underscores the necessity of innovative packaging technologies to guarantee consumer protection and mitigate the risk of exposure to carcinogenic substances.

Background and Objectives: Down syndrome (DS) is the most common chromosomal disorder in the world. It is caused by the imbalance of the chromosomal constitution of 21, by free trisomy, translocation or mosaicism. Children and adolescents with Down syndrome have immune dysregulation and are more susceptible to infections. This study aims to evaluate hospitalizations of children and adolescents with DS in the pediatric ward of Botucatu Clinics Hospital (HCFMB), to classify the population of children included in the study regarding age, diagnosis, outpatient follow-up, length of stay and need for Intensive Care Unit (ICU). Thus, it will be possible to improve care for these children, aiming to reduce these hospitalizations. Materials and Methods: It was an observational, cross-sectional study, with retrospective data collection from the last 10 years of hospitalization, from January 2013 to December 2021, of children and adolescents with DS, in the pediatric ward, emergency room and ICU of HCFMB. Children hospitalized in this period in the pediatric ward and ICU, in the age range of 30 days to 15 years (age of acceptance for admission to this service) were included in this study. Those who at some point had the exclusion of the diagnosis of DS were excluded. The evaluation of comorbidities that culminated in the need for hospitalization in this population can be the focus of actions to improve diagnoses and conducts for this population, to prevent worsening and hospitalizations in future populations. Results: The statistical analysis of the data was performed. In this analysis, 80 children with DS were evaluated, with a total of 283 hospitalizations and it was noticed that 46 of them had more than one hospitalization in this period. The most prevalent age group was 1 to 3 years, and the main cause was due to problems in respiratory system (99 cases). Among respiratory causes, the main cause of hospitalization was due to pneumonia, in 50% of cases, followed by acute respiratory failure, in 14%. The average hospitalization time was 8 days and in 49 hospitalizations the children required the ICU. The main cause of hospitalization in the ICU was due to respiratory causes (36%), followed by cardiac malformations (14%). During the ICU hospitalizations, there were 13 deaths, and we observed a higher prevalence of heart conditions and, in some cases, positive urine cultures in these children. Conclusions: preventive actions, such as vaccinations and improved monitoring of these children, without outpatient follow-up or during hospitalization, should be carried out. Thus, it has been developed a proposal for a risk score for mortality in children and adolescents with DS admitted to the ICU, and those patients with five or more points should be monitored more closely. A meeting will be held with the genetics, cardiology, and pediatric ICU teams to discuss this score and propose a surveillance plan for these patients at the HCFMB and potentially for the pediatric community in the future.

The study examined the impact of social capital in moderating the effects of the Covid19 pandemic on workers' mental health. We posited that their level of social capital influences workers’ mental health during the Covid19 crisis. Data was sourced from a cross-sectional survey of 422 employees from various industries in Ghana, analyzed using partial least squares-based structural equation modelling (PLS-SEM). Results indicated that the pandemic adversely affected employees' mental well-being, increasing anxiety levels. However, a higher degree of social capital within the workplace buffered these negative effects, enhancing mental health during this period. Essentially, strong workplace relationships and networks mitigated the pandemic's impact on employees' mental health in Ghana. These findings underscore the importance of social capital in health outcomes, especially during crises. For industries in Ghana and beyond, the results emphasize the value of fostering strong social networks. In times of health crises, such as the Covid19 pandemic, robust social ties become crucial. As we navigate the aftermath of this pandemic and prepare for potential future crises, the lessons from this research highlight the need to integrate the knowledge gained from the Covid19 experience into our disaster response strategies. The role of social capital in such scenarios cannot be overstated

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.

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

Research into health, particularly social and psychological health, is crucial. Ultimately, an in-depth understanding of social and psychological health will more than promote well-being. Technology research is indispensable, particularly concerning health and the built environment, given the need to create holistic and supportive frameworks for well-being. Moreover, because literature reviews establish the foundation for academic inquiries, they provide valuable overviews for foresight into grey research areas, particularly multi-disciplinary research like health technology and the built environment. Hence, this study aims to discover the existing themes on health, technology, and built-environment nexus subjects while revealing the grey areas and suggesting proactive areas for future research. The objectives drove this aim to: 1. investigate the implications of technology for the social and psychological dimensions of health; 2. uncover the likelihood of a nexus between health, technology, and the built environment; and 3. highlight new research perspectives for the concluding seven years of the SDGs (2024–2030). The review results highlighted ten themes around which a nexus exists between health, technology, and the built environment; they also pointed out new research perspectives for the next seven years (up to 2023).

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition in children in Saudi Arabia based on the results of the national mental health survey. ADHD significantly impacts the child and their family dynamics, particularly causing increased stress and diminished life quality for parents. In Saudi Arabia, there is a research gap regarding the quality of life and coping mechanisms of parents managing children with ADHD. This study assesses levels of depression and anxiety, quality of life, and coping strategies used by parents of children diagnosed with ADHD. Methods: We conducted a cross-sectional online survey with 151 parents of ADHD-diagnosed children, utilizing the WHOQOL-BREF for life quality, the brief-COPE for coping strategies, and the Patient Health Questionnaire (PHQ): depression (PHQ9-9 items) and generalized anxiety (GAD7-7 items) modules. Results: Among the parents surveyed, 36% reported moderate to severe depression, while 39.1% experienced moderate to high anxiety levels. Quality of life positively correlated significantly with higher household monthly income (HHI), employment status, sibling count, and effective coping strategies. Conversely, a parent's age, educational level, and particularly maternal status were inversely related to anxiety levels, with fathers displaying higher maladaptive coping scores. Conclusion: The study sheds light on the considerable anxiety and depression experienced by parents of children with ADHD, significantly affecting their quality of life. Lower parents' quality of life is associated with high levels of depression, anxiety, and ineffective coping strategies. These insights highlight the critical need for interventions to aid parental mental health, thereby improving their overall quality of life amidst ADHD challenges.

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.

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.

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

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

The healthcare system is intricate and dynamic. For the purpose of organising and planning a system, where allocating funds appropriately is essential and therefore managerial skills play a critical role. A certain portion of each nation's GDP is allotted to the health sectors. Managers and decision-makers in the healthcare systems are using resources effectively, yet the quantity of funding they receive from the government or other stakeholders is insufficient sometimes. A sound understanding of both basic and advanced economics is necessary for the care management, to make cost-effective judgements in public health. Healthcare officials at all levels (regional, state, federal, or international), need to be knowledgeable about public health issues and the related modern economic climates. Business executives and healthcare managers need effective practical knowledge to handle partner-financial allocation (demand-supply chain) and handle economic volatility.

Despite great strides in the development of contraceptive technologies, the United States has one of the highest teen pregnancy rates in the world. Many investigators have aimed to examine the relationship between religion and the sexual health behaviors of college students to determine how social factors may influence the use of contraception amongst college students. Thus, we aimed to examine the differences in current contraceptive method and age of first contraceptive usage among sexually active female college students with different religious affiliations and strengths of religiosity. It was hypothesized that there would be no difference in current contraceptive methods among different religious affiliations and strengths of religions, and that there would be a difference in age of first contraceptive usage among different religious affiliations and strengths of religiosity. Two-hundred twenty-four college aged females completed a 20-question survey about sexual health and religious practices. Chi-squared tests were implemented to determine if the frequencies of responses across religious affiliations and strengths of religiosity. Significant differences in the frequency of responses for age of first contraceptive usage were observed across different strengths of religiosity (p=0.016) and for the self-perceived impact of religion on sexual health across different religious affiliations (p=0.033) and strengths of religiosity (p=0.005). All other differences were found not to be statistically significant. It was determined that increased strengths of religiosity resulted in delayed onset of contraceptive us-age and that both different religious affiliations and greater strengths of religiosity lead to different self-perceived impacts of religion on sexual health.

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

Achieving Universal Health Coverage (UHC) is a strategic objective of the Jordanian Government and has been prioritized in its strategies and plans. However, there are several challenges affecting primary health care in Jordan and the health system in general that prevent Jordan from achieving UHC. This paper highlights the importance of team-based care in the form of Family Health Teams (FHTs) to realize Jordan’s goal of achieving UHC. FHTs are a team-based approach that brings together diverse professionals to provide a comprehensive, efficient, patient-centered primary care system that meets the changing needs of Jordan's population and refugees. However, the implementation of FHT may encounter obstacles, including individual, organizational and institutional, and external barriers. To overcome such obstacles, several actions and processes need to be taken, including political commitment and leadership, implementing good governance and policy frameworks, allocating resources and funding, multisectoral collaboration, and engagement of communities and stakeholders. The successful implementation of FHTs requires participation from government officials, parliamentarians, civil society, and influential community, religious, and business leaders. A strategic policy framework, effective oversight, coalition building, regulation, attention to system design, and accountability are also essential. In conclusion, adopting the FHT approach in Jordan's Primary Health Care system offers a promising path towards achieving UHC, improving healthcare access, quality, and efficiency while addressing the unique challenges faced by the country's healthcare system.

The study investigated the impact of traditional medicine on life expectancy in Nasarawa State, Nigeria. The study adopted a quantitative research approach. Purposive or judgmental sampling was used to elucidate the data set used for the study. Cross-sectional data were gathered with the help of a well-designed questionnaire from a total of three hundred and fifty-seven (357) respondents who were available for the survey. The data set collected was analysed using descriptive and linear regression using Ordinary Least Squares (OLS). From the results, 53%, 87%, and 56% were male, below 50 years old, and in the low-income class, respectively, suggesting that the bulk of the respondents under investigation were male, young, and had rather modest incomes. Also, 53% were married, and all had one form of formal education. 67% of respondents acknowledge using traditional medicine; however, the majority of respondents preferred Orthodox medical care over alternative kinds of care. Traditional medicine (TM) and factors that contribute to the advancement of traditional medicine (FITM) have a negative impact on life expectancy, according to the regression analysis. On the other hand, TM has no statistically significant impact on life expectancy, despite FITM having a statistically significant effect at the 5% level. All available data, however, indicates that TM and FITM have an impact on life expectancy, either directly or indirectly. Based on the results, this study concluded that traditional medicine has the potential to significantly increase life expectancy in Nasarawa State and throughout Nigeria. The study recommends that traditional health professionals, stakeholders, and concerned government agencies should put efforts in place to improve and promote modern traditional medicine among the people, especially its effectiveness and medicinal quality, increase its accessibility to people, and efficiently regulate its prices to increase its affordability for low-income earners.

This study aimed to assess the feasibility of employing audio and vision technologies as an integrated monitoring system to monitor the health and behavior of pigs under different environmental conditions and to associate these factors. A total of 81 growing pigs ((Landrace x Largewhite) x Duroc) with distinct weight categories (10.47 ± 2.57 kg and 28.81 ± 5.03 kg) were distributed into two distinct housing conditions: Control (characterized by low NH3 levels and low stocking density) and Treatment (marked by elevated NH3 levels and varying stocking densities). Each house was installed with a SoundTalks monitor for automated daily evaluation of respiratory health status (ReHS), and a camera with a microphone to facilitate manual tracking of respiratory symptoms and behavioral patterns. Results showed that the Treatment group encountered significantly high room temperature, NH3 concentration, and carbon dioxide levels, resulting in compromised growth performance—a phenomenon further exacerbated in high stocking density conditions. Pigs within the treatment exhibited increases (p &lt; 0.05) in lateral and total lying behaviors, and incidences of ear and tail injuries, increases screaming frequency, conjunctivitis incidences, coughing frequency, elevated respiration rates, and a decrease in ReHS. The environmental conditions affect the behavior and health of the pigs. Moreover, the behavioral patterns of the pigs are associated with their health conditions. The SoundTalks system did not trigger any warnings during the experimental period. Nevertheless, trend analysis indicated a significant reduction in respiratory health in the treatment. In conclusion, this study underscores the efficacy of merging audio and visual technologies to holistically monitor pig health and behavior, enabling enhanced management strategies. Findings emphasize that monitoring the ReHS trend serves as a pivotal marker for identifying respiratory health problems, complementing the system's innate alarm functions.

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

Training researchers and stakeholders is crucial to mitigate the risks associated with toxins and venom. By sharing knowledge on the responsible use of toxins, venoms, chemicals, and data from biosecurity and cyberbiosecurity perspectives, we empower laboratorians to make informed choices. We need to remember that cultivating a culture of sustainable biosafety and biosecurity is vital for one health. This technical note highlights the essence of safeguarding biosecurity and cyberbiosecurity in toxin and venom research laboratories workshop designed and implemented to boost biosecurity.

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

Pediatric chronic pain is an important public health issue given its notable impact on numerous domains of living. Pediatric chronic pain is also often comorbid with emotional, developmental, or behavioral conditions which can lead to more severe negative outcomes and an even greater reduction in positive outcomes compared to those without comorbidities. Flourishing is a positive outcome that chronic pain status has been shown to impact. We explored flourishing in children aged 6-17 years living with chronic pain as well as those with chronic pain and comorbidities using data from the 2018/2019 National Survey of Child Health. There were significant associa-tions between chronic pain condition status and all demographic variables (sex, age, race/ethnicity, poverty level, parental education, health insurance status). Results of hierarchical logistic regression found that chronic pain condition status significantly predicted flourishing. Children with chronic pain were 2.33 times less likely to flourish, and children with chronic pain plus an emotional, developmental, or behavioral comorbidity were 13 times less likely to flourish than typical peers. Given their significantly lower likelihood of flourishing, there is an urgent need for interventions targeted at children experiencing chronic pain and mental health comor-bidities.

Fruits, vegetables, and spices are natural sources of bioactive phytochemicals such as polyphenols, carotenoids, flavonoids, curcuminoids, terpenoids, and capsaicinoids, possessing multiple health benefits and relatively low toxicity. These compounds found in the diet play a central role in organism development and fitness. Given the complexity of the whole-body response to dietary changes, invertebrate model organisms can serve as valuable tools to examine the interplay between genes, signaling pathways, and metabolism. Drosophila melanogaster, an invertebrate model with its extensively studied genome, has more than 70% gene homology to humans and has been used as a model system in biological studies for a long time. The notable advantages of Drosophila as a model system, such as their low maintenance cost, high reproductive rate, short generation time and lifespan, and the high similarity of metabolic pathways between Drosophila and mammals, have encouraged the use of Drosophila in the context of screening and evaluating the impact of phytochemicals present in the diet. In this chapter, we summarize and review the benefits of Drosophila as a model system for use in the study of phytochemical ingestion and describe the previously reported effects of phytochemical consumption in Drosophila.

Artificial Intelligence (AI) has become a hopeful tool for helping parents with different parts of raising children by giving them personalized tips, evidence-based methods, and timely solutions. This paper talks about the difficulties and possibilities of using AI to help parents. It also talks about the possible benefits and its impact on child psychology. There are a lot of ways that AI can help parents, from giving personalized advice that fits the needs of each family to intervening quickly when it spots early signs of developmental problems or parenting stress. AI makes it easier for parents to find tools, workshops, and interactive modules that are based on research. This gives parents the knowledge and trust they need to make choices about their child's growth that are based on facts. Also, AI-powered support can connect parents with similar problems, creating a sense of community and making it less embarrassing to ask for help with parenting or mental health. But there are a few problems that need to be carefully dealt with before AI can be used to help parents in a responsible and effective way. Data privacy and security are very important to protect families' safety and well-being. Important things to think about are the ethical use of data, transparency, and educated permission. Also, the accuracy and dependability of AI programs are very important when it comes to giving good advise and suggestions. To make sure everyone gets fair and equal help, efforts must be made to find and get rid of flaws. Also, AI shouldn't replace human sense and experience; it should add to them. When parents rely too much on AI, they might forget how important human contact and mental support are. To accommodate different parenting styles and views, it is important to be sensitive to culture and circumstances. In conclusion, AI-powered parenting support has a lot of promise to help parents be better parents and help children grow and learn. AI can be a useful tool for helping parents if it can solve problems related to data privacy, ethics, reducing bias, and working together with humans. Finding a balance between technology progress and human connection is important if AI is to be used to its fullest potential to give parents more power and help children grow in the best way possible.

The launch of Open AI's chatbot, ChatGPT, has generated a lot of attention and discussion among professionals in several fields. Many concerns and challenges have been brought up by researchers from various fields, particularly in relation to the harm that using these tools for medical diagnosis and treatment recommendations can cause. Additionally, it has been debated if ChatGPT is dependable, efficient, and helpful for clinicians and medical professionals. Therefore, in this study, we assess ChatGPT's effectiveness in providing mental health support, particularly for issues related to anxiety and depression, based on the chatbot's responses and cross-questioning. The findings indicate that there are significant inconsistencies and that ChatGPT's reliability is low in this specific domain. As a result, care must be used when using ChatGPT as a complementary mental health resource.

Background: To identify and appraise the impacts and effectiveness of counseling interventions based on the 5A model on indicators of physical activity in adults. Methods: In May, 2022, a systematic review was carried out. Searches were performed in Embase, Lilacs, Pubmed, Scielo, Scopus, Sportdiscus and Web of Science. To avoid potential losses searches also were made in Google Scholar and in reference lists. Assessment of studies, data extraction and synthesis took place independently by two researchers. Results: Four studies composed the synthesis, which involved people with an average age between 40 and 55 years, being women in the majority of the samples. It was observed that counseling was carried out in conjunction with other strategies, such as drawing up an action plan, sending text messages and offering educational material. Only one study showed a statistically significant difference between the intervention and control groups in the “daily number of steps” indicator. Conclusions: counseling based on the 5A model did not reflect significant findings in relation to physical activity. Considering that behavior change for many people is neither a simple nor a quick process and that the 5A model is promising for other behavioral indicators, we indicate the need to carry out new intervention studies, with an expanded focus in relation to themes related to physical activity (e.g., types, dos-es, risks, benefits, identification of barriers and assessment) and, in parallel, the offer of practices in the Primary Health Care setting.

Monkeypox is a zoonotic illness caused by the Orthopoxvirus monkeypox virus (MPXV). Since 1970, outbreaks of MPXV have occurred in several Sub-Saharan African countries. However, from May 2022 to April 2023, recent outbreaks of MPXV occurred in several countries outside of Africa, and these cases quickly spread to over 100 non-endemic countries on all continents. Because of this, in July 2022, World Health Organization declared monkeypox a Public Health Emergency of International. MPXV disproportionately affects men who have sex with men and members of the HIV-infected population. The current strategy for control and pre-exposure prophylaxis or post-exposure prophylaxis for people at high risk is vaccination. In this context, Peru has the fourth-highest number of MPXV cases in Latin America. Because of this, in this review, we describe public health indicators in Peru and reflect on the COVID-19 pandemic so that health authorities can join forces to identify and control MPXV transmission routes.

Carbapenems have long been considered as treatment of choice for Gram-Negative Bacteria (GNB) infections, and today the clinical utility of this class is threatened by the emergence and spread of resistance favored by its increasing use. According to the WHO, Acinetobacter baumannii, nosocomial infection agent, tops the list of priority antibiotic-resistant pathogens, considered to be the most risky for humans. This study sought to determine the prevalence of Acinetobacter baumannii strains producing carbapenemases in four health facilities in the Center and Littoral regions of Cameroon and the associated risk factors. An analytical cross-sectional study was conducted over a six-month period from January to June 2022. All Acinetobacter baumanii or suspected strains isolated from pathological samples at the bacteriology laboratory of different health facilities were systematically collected and underwent a re-identification. After successfully subculturing and growing on nutrient agar, re-identification and antimicrobial susceptibility Testing (AST) were performed using the VITEK 2 System and the Kirby-Bauer method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection and phenotypic characterization of carbapenemases was performed according to adequate standard procedures. A total of 168/226 clinical isolates of Acinetobacter baumannii were confirmed after re-identification of which 52.69% came from male patients, and 55.09% from participants aged between 10-39 years old and 46.71% from pus samples. A very high resistance rates to all families of antibiotics was noted except to colistin (10.2%). About 40.12% of these strains produced carbapenemases with 62.69% of class B and 37.31% of class A. In addition, frequent hospitalisation was significantly associated to the production of carbapenemase among Acinetobacter baumanii (Ajusted-OR=16.53, P-value<0.0001). This study highlighted the emergence of carbapenemase-producing Acinetobacter baumannii which is increasingly growing. Continuous drug-resistant monitoring and preventive measures could help to prevent and curb the dissemination of A.baumanii resistance genes, especially in hospital settings.

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

The goal of our article was to systematize studies that investigated the impact of living conditions in large national regions on individual alcohol consumption. We sought publications on the research topic in PubMed, Google Scholar, OpenGrey, Crossref and eLibrary databases from the moment they were created until December 31, 2021. After removal of duplicates and unsuitable publications, and full-text review of remaining published sources, the final sample included 81 publications. The majority of ultimately selected papers were published after 2010, represented the United States of America, and considered samples of children and youths, either the younger population or the general adult population. High quality was characteristic for 19 studies, while satisfactory quality was exhibited by 46 publications. The most consistent associations with individual alcohol consumption were revealed for the legislative environment (especially for integral scales and indices), alcohol pricing policy, the prevalence of alcohol consumption and binge drinking in the population, and unemployment rate. Among the shortcomings of the reviewed articles, we should mention the prevailing assessment of the impact of only one type of regional characteristics, as well as the lack of studies analyzing the interaction of environmental influence at the territorial level of different scales. Protocol PROSPERO CRD42021234874.

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

Sweet potatoes are a crucial crop for Asian and African countries. Its nutritional content and capacity to keep you healthy have increased in recent years. Moreover, sweet potatoes' fibre also keeps your gut happy. Most sweet potato varieties don't bloom. Due to pollination issues, sweet potatoes are also incompatible with each other. Sweet potato blooms are self-sterile, so they don't mix well in breeding programmes. Traditional and modern breeding procedures didn't always work with sweet potatoes, but some did. Using molecular biology methods, some individuals become more resistant to illnesses by eliminating particular genes. The crop's nature and growth should be improved. All of this should be done to acquire new characteristics in sweet potatoes by crossing them. Sweet potatoes are a superb tuberous crop, but they have issues with pollination and adjusting to new breeding procedures. Modern breeding and biotechnology methods can be used to get the most out of this crop. These are "chronological" ways to get the most out of farming.

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

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

Biosecurity is a tool used to alleviate the introduction, emergence and spread of diseases caused by infectious agents. It comprises different health-management activities that need to be followed to reduce the passage and dissemination of infectious agents within and among farms, poultry flocks, and humans, as well as within a country, among countries, or the whole globe. In terms of public health measures, biosecurity applies to practices that will reduce contact between poultry and humans and thereby reduce zoonotic disease transmission. Two of the common biosecurity measures are bioexclusion and biocontainment which themselves are further categorized as segregation/isolation, movement control and hygiene/sanitation/disinfection. Isolation is about putting poultry under an exclusively isolated environment where it lives alone without any interference from any source external to the poultry or at least under reduced and controlled interference. Movement/traffic control and sanitation measures are practices to follow the isolation of poultry or preparatory phase as in the case of sanitation of poultry houses before introduction of poultry. These techniques have been effective in controlling poultry diseases like avian influenza, exotic Newcastle, Marek’s disease, and any other diseases. Depending upon the underlying situation either bioexclusion or biocontainment measure will be used to control these infectious diseases of poultry.

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

The aims of this study were to assess oral health knowledge, attitudes, and practices among orthodontic patients between the ages of 15 and 17 years old compared to adolescents without orthodontic treatment. This cross-sectional study included 392 adolescents drawn from various French teaching hospitals. A closed-ended questionnaire was used to collect data. Adolescents undergoing orthodontic treatment had a higher knowledge of oral health than adolescents without orthodontic treatment. The majority of adolescents for both groups (69%) claimed to brush their teeth twice a day. Regarding complimentary dental material, 81.9% of adolescents without orthodontic treatment never used an interdental brush and 78.8% never used dental floss. For those undergoing orthodontic treatment, 48.5% never used interdental brush. Only 4% of adolescents without and 3% of adolescents with orthodontic treatment never consumed fizzy drinks, 4.9% and 3% never consumed sweets, 4% and 8.4% never ate fast-food. Adolescents without treatment consumed more sodas (p=0.04) and more fast food (p=0.03). Adolescents had insufficient knowledge of oral health. Health education programmes should be implemented to improve adolescents' knowledge and individual oral prophylaxis with interdental brushes.

Background: Menopause symptoms and hormone replacement therapy (HRT) are among the most common reasons patients seek gynecological advice. Although at least half of all women in developed countries will take HRT during their lifetime, the treatment is not without risk and guidance on HRT is mixed. Greater awareness of negative HRT health effects from extended use has piqued interest in ‘safer options’. Menopause reversal with autologous ovarian platelet-rich plasma (OPRP) has brought this restorative approach forward for consideration, but appropriateness and cost-effectiveness require examination. Methods: HRT and OPRP data from USA were projected to compare cumulative 1yr patient costs using stochastic Monte Carlo modeling. Results: Mean±SD cost-to-patient for HRT including initial consult plus pharmacy refills was estimated at about USD 576±246/yr. While OPRP included no pharmacy component, an estimated 4 visits over 1yr for OPRP maintenance entailed ultrasound, phlebotomy/sample processing, surgery equipment, and incubation/laboratory expense, yielding mean±SD cost for OPRP at USD 8,710±4,911/yr (p<0.0001 vs. HRT, by t-test). Upper-bound estimates for annual HRT and OPRP costs were USD 1,341 and USD 22,232, respectively. Conclusions: While HRT and OPRP may have similar efficacy and safety for menopause therapy, they diverge sharply in cost-effectiveness. Most patients would likely find OPRP too complex, invasive, and expensive to be competitive vs. HRT. Although OPRP is an interesting and cautiously useful technique for selected menopause patients reluctant to use HRT, repurposing this infertility treatment for wider use appears inefficient compared to standard HRT currently available.

Background: The tsunami and earthquake occurred in 1927 and 2018 made life quality of Da’a Tribe women in refugee camps was affected by violence. It affects on women reproductive health in various aspects of life as high maternal mortality rate of 450 per 100 thousand live births and half of women victims of natural disasters have reproductive health problems such as anemia and malnutrition during pregnancy. The study objective is to explore the health quality of women related to the couple violence during the humanitarian crisis at refugees’ camps. Method: The population was 798 cases of violence. The 90 samples were selected by simple random sampling and calculated by Slovin method. Data analysis was done by descriptive qualitative and cross tabulation. The research location was Palu City. Results: The research findings showed that health quality of Da’a Tribe women after the couple violence is influenced by three factors, namely economic by 40%, psychological by 7%, violence during pregnancy 59.3%. Conclusion: Social life and women violence handling can be done by symbolizing the threat of criminal law for male perpetrators in accordance with applicable laws in Indonesia and improving the life quality of population, especially women in education and skills through empowering the family economy and increasing gender equality justice.

(1) Background: The Democratic Republic of the Congo (DRC) is heavily affected by malaria despite availability of effective treatments. Ignorance and unrecommended behaviour toward a suspected malaria case in households may contribute to this problem. (2) Method: In communities of one rural and one urban Health Centers in each of the 11 previous provinces of DRC, all households with a case of malaria in the 15 days prior to the survey were selected. The patient or caregiver (responder) were interviewed. Logistic regression was used to assess predictors of knowledge of recommended antimalarials and good behaviour in case of suspected malaria. (3) Results: 1,732 households participated; about 62% (1060/1721) of the responders were informed about antimalarials, 70.1% (742/1059) knew the recommended antimalarial and 58.6% (995/1699) resorted on self-medication. Predictors of knowledge of antimalarials were education to secondary school or university, information from media and smaller households. Predictors of good behaviour were catholic religion and smaller households. Receiving information from CHW failed to be determinants of knowledge or adequate attitude. (4) Conclusion: malaria control in DRC is hampered by ignorance and non-adherence to national recommendations. These aspects are influenced by unsuccessful communication, size of households and level of education.

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

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

Work-life after COVID-19 might never be the same again. After an economic crisis due to the pandemic, the Indonesian government is applying large-scale social restriction relaxation to allow companies to reopen. However, just after a few weeks of social relaxation, new clusters from offices are occurring. With many employees infected with COVID 19, concerns arise among employers; when is the best time for employees to get back to work after COVID-19 infection? This paper provides a general guideline to discontinue isolation in people with suspected or confirmed COVID-19 infection in non-healthcare establishments. According to the newest available evidence, commencing back to work should refer to a symptom-based strategy rather than a test-based strategy. In all circumstances, universal health protocol should be practiced at all times to minimize widespread transmission.

Background: The COVID 19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID 19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescent’s mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized, nonrandomized controlled trials; observational studies; and qualitative studies. Results: Of the 5,828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed and put up the major findings under the thematic areas of impact of pandemic on children and adolescent’s mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidence-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents.

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

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

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

It has been shown that assessing the capacity and quality of sports equipment is important to develop a better understanding of sport participation. Different organizations are involved in the provision of sports products and services. In this regard, policymakers need to design a framework to give people more access to sports facilities. It appears that geographical access to such facilities can affect differences in sport participation around the globe. In this study, Shiraz city districts and the Shiraz sports clubs list were collected. The list of sports clubs was matched with Shiraz districts in March 2020. The significance of the relationship between area, the population of each region, per capita construction budget, frequency of clubs, green area, number of parks, population to number of club’s ratio, and area to the number of club’s ratio indicators and the number of sports clubs were analyzed by SPSS version 22 Using the Spearman correlation coefficient test. There were statistically significant relationships between district and population of each region, District and sports club, District and Population to the number of clubs, area and green area, per capita construction budget and the number of parks, per capita construction budget and population of each region (p<0.05 for all). A significant correlation between the districts and the Population to the number of club’s ratio shows that there is no proper distribution of sports facilities in different urban areas. For this reason, in some areas, people may not have adequate access to sports facilities. Also, a significant correlation was observed between total area and green area, per capita construction budget and the number of parks and Per capita construction budget and the population of each region. So, the health level of the people who live in undeveloped districts is endangered and more attention should be paid to them.

The Sustainable Development Goals provide a global development agenda that is meant to be inclusive of all people. However, the development needs for vulnerable populations such as youth are not reflected within the policy agenda of some developing countries. One of the reasons for this is that research that explores health and wellbeing concerns for young people are sparse in the region and where they exist, the focus has been on marginalized subgroups. To address this gap, this cross-sectional study explored the health and wellbeing of youth in Kenya. We conducted 10 focus group discussions and 13 in-depth interviews with youth ages 15 to 24 years. A thematic analysis of the data revealed that structural factors are important influencers of youth perceptions and their social constructions of health and wellbeing. Kenyan youth are concerned about the health status and healthcare services in their communities, as well as issues of community trust of youths and perceived risks of political misuse and emotional suffering. Our findings suggest that youth transitioning into adulthood in resource constrained areas experience feelings of being powerless and unable to take charge over their own life. This impacts how they perceive and socially construct health and wellbeing.

Researchers’ attention has been turned on Health expenditure, Carbon emissions, and economic growth as they play a focal role in the current debate on environmental protection and sustainable development. Our paper endeavors to investigate the impact of economic growth and CO2 emissions on Health expenditure for two main countries in Asia (China and India) using a dynamic panel data model estimated employing the Generalized Method of Moments (GMM) for the period 1960–2019. Our empirical results show that there is a significant relationship between health expenditure, CO2 emissions, and economic growth. The empirical evidence indicates a significant positive impact of CO2 emissions on health expenditure whiles economic growth has a negative impact on health expenditure for both countries for the period under study. The population growth rate has transposed effect on India's health spending; on the other hand, its impact on China’s health spending is significantly positive. The strong observable correlation between health expenditure and economic growth is crucial for economic development.

Given the pace of SARS-CoV-2 transmission and its relatively high mortality rate, COVID-19, has the potential to become the most severe pandemic in recent times. This virus’s spread across international borders has triggered different responses in countries around the globe with a spectrum of mild, moderate to severe outcomes. Nigeria, Africa’s most populous country with many densely populated cities, presents a unique situation for the explosive spread of SARS-CoV-2. However, at the point of this writing, the number of reported confirmed infection and mortality is comparatively lower to other countries with dense urban populations. The exact reasons for this are not clear but include societal, political and infrastructural factors that will influence the course of the outbreak in Nigeria. In this perspective, we have described the ongoing COVID-19 outbreak and its associated peculiarities. We identify critical steps that remain to be taken to contain and control the outbreak in Nigeria.

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

The issue of when and how to return to business following COVID-19 lockdown is occupying the minds of policymakers, C-Suite executives and managers the world over. We are concerned by the extent to which it appears that these decisions are being taken on a wing and a prayer, while being pitched to the public as though they shouldn’t be questioned. In this paper, we compare the likely impact of COVID-19 infections from travellers coming from the main countries that visit Greece, to the revenues they generate for the Greek economy. We find that arrivals from some countries should be excluded but aren't, while arrivals from other countries that are excluded perhaps shouldn't be. We show that a rational choice around limitations on the reopening of tourist markets depends on the demand for travel to Greece. We conclude that the current policy is largely economically rational, with some exceptions, but also speculate that Greece may not be ready to handle the resulting infection load.

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

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

The Covid-19 started in China and took over the world, becoming a pandemic. Especially in Latin America, the coronavirus arrived on the continent in mid-February 2020. The South American continent is going through a delicate political, economic and social moment, which is reflected in the fragility of our health systems and science and to reduce the rates of contagion and not overburden health services, including hospitals. Nevertheless, several studies are being carried out in Brazil and worldwide, with the objective sought to understand the characteristics, and even, the cure of people infected by the coronavirus. Therefore, we must consider science-based strategies to combat the pandemic and promote a health system that takes care of the population that needs it.

Social distancing policies put in place during COVID-19 epidemic in addition to helping to limit the spread of the disease also contributed to improving urban air quality. Here we show a decrease in air pollutant concentration as a consequence of mobility reduction in São Paulo during the containment measure which began on 22^nd March 2020. When comparing to foregoing weeks to equivalent periods of 2019, the concentration of most air pollutants sharply decreased in the first days of mobility restriction, to then increase again after government officials downplayed the threat of the disease. This trend is also followed by a decrease in hospital admissions by SARS-influenza. Therefore, despite the great economic and social unrest caused by the pandemic, this unique situation shows that large-scale mobility reduction policy had a significant impact on air quality, benefiting, directly and indirectly, the public health system.

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

Neuropsin is a brain-expressed extracellular matrix serine protease that governs synaptic plasticity through activity-induced proteolytic cleavage of synaptic proteins. Its substrates comprise several molecules central to structural synaptic plasticity, and studies in rodents have documented its role in cognition and the behavioral and neurobiological response to stress. Intriguingly, differential usage of KLK8 (neuropsin gene) splice forms in the fetal and adult brain has only been reported in humans, suggesting that neuropsin may serve a specialized role in human neurodevelopment. Through systematic interrogation of large-scale genetic data, we review KLK8 regulation in the context of mental health and provide a summary of clinical and preclinical evidence supporting a role for neuropsin in the pathogenesis of mental illness.

Aim: The purpose of this examination is determining predictors to oral health behaviors predict in Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study were randomly selected conducted on 351 eligible four grade female students in the first district of Tehran, Iran in 2017. The random Multi‑stage random cluster sampling method was used to recruit students. The inclusion criteria were being graded, four female students (aged 9-11 years), or education at the fourth grade of one of the elementary schools studied in the first district of Tehran and, The health of the student from a physical and psychological of view. Logistic regression analysis was used to identify the variables that predict oral health behaviors. To assess the predictors of oral health behaviors, all the expanded Health Belief Model constructs with the construct of “Commitment to Plan of Action” from “Health Promotion Model were examined as risk factors to see if they influence on the probability of brushing behavior and dental floss behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 308 four grade female students with mean age of 9.32 ± 0.81 years old took part in the study. The total 31.8% of the students reported that they were brushing behavior less than twice a day and 55.2% students claimed, use of dental floss behavior once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P<0.001), Commitment to plan (OR=1.13, 95% CI=1.04-1.23, P<0.001) and Cues to action (OR=1.42, 95% CI=1.14–1.76, P=0.002) were the significant predicting variables which is the key factor of brushing twice a day, and use of dental floss once a day or more (OR=1.02, 95% CI=0.23-3.53, P=0.003). Conclusion: This study has shown the effectiveness of the health belief model with added commitment to plan construct to predict oral health behavior in female students. So, it seems that the model as a framework for designing training programs to improve students to improve oral health behavior can be used.

(1) Background: Travel medicine practice has not been a part of practice in the community pharmacies in Japan. However, it’s getting more common for pharmacists to run travel clinic in North America. With ongoing globalization, Japanese pharmacists might be practicing travel medicine in future. This descriptive study is to examine the current knowledge, attitudes, and practices among Japanese community pharmacists. (2) Methods: Invitation to the study was sent to all pharmacies or corporates listed on Nippon Pharmacist Association member list plus one another large size pharmacy chain that was not member of NPhA. Community pharmacists working under those companies received a weblink to the survey. The survey was conducted from June to July 2017 by online questionnaire. (3) Results: The self-declared knowledge level of infectious diseases as well as travel vaccinations was generally low. The frequency of correct answer of the antibiotic resistance in South East Asia was 48.5%. Knowledge level of qunine resistance to Plasmodium falciparum malaria in Ghana and Nicaragua was very low. (4) Conclusions: Japanese community pharmacists are not familiar with travel related infectious diseases and vaccines used in travel medicine. The knowledge on the antibiotic resistance in traveler’s diarrhea and malaria prophylaxis was all low that is consistent with low degree of exposure to travel health questions from patients in daily practice and low percentage of intention to earn travel health certificates.

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

The current crisis in psychopharmacology has a long history and needs to be addressed with innovative and effective strategies. Here we discuss some of the roots of this crisis and suggest that the therapeutic use of psychedelic drugs represents a promising and integrative treatment with enduring effects for mental health problems.

Background: A prospective study was conducted to follow-up how the living lifestyle of hikikomori could change the social, mental and physical health profile. Methods: A cohort consisted of 104 young people living as Hikikomori were interviewed at baseline, 6 months and 12 months by using the same set of questionnaires and anthropometric measurements. Results: Besides the high attrition of 30% in wave 2 and 25% in wave 3, almost half of the participants have recovered from hikikomori by returning to the workforce in society. The three domains of health profile of hikikomori were significantly improved over the follow-up period by: 1) increasing the social network scores from 2.791.80 to 3.091.87, 2) decreasing the perceived stress scores from 21.185.87 to 20.115.79, and 3) reducing blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Those variables were also predictable by lifestyle living with the hikikomori according to the Generalized Estimating Equation analysis, whereas the participants of current study had increased the practice of moderate-intensity exercises. Conclusion: Social work intervention was effective in helping the recovery of hikikomori while physical assessments followed by encouragement from social workers to do more exercises might enhance their awareness in health modification towards a better health.