Patient engagement is receiving a growing attention in the healthcare context. However, although worldwide healthcare stakeholders agree that patient engagement is a priority for quality and effective care, no shared recommendations on how to promote patient engagement are currently available. Based on these premises, a Consensus Conference (CC) was promoted to address four main issues: What is the definition of Patient Engagement? How measuring Patient Engagement? What are the most recommended methodologies and the tools to promote Patient Engagement? What is the role of new technologies in promoting of Patient Engagement? The consensus was obtained through an iterative process that began with a systematic synthesis of the available literature in each domain followed by plenary expert discussions. This CC - including the systematic analysis of internationals scientific evidences (2749 sources across the major international scientific databases) together with experiences of a multi-disciplinary consortium of investigators and key stakeholders - attempted to provide the first evidence-based Expert Consensus Statement for the promotion of Patient Engagement in chronic care. These recommendations should be envisaged as inspirational principles to promote a real eco-system of engagement and might orient health services research and interventions.

Objective: Taiwan Government’s organizations have endeavored to promote the applications of big data and open data. The “My Health Bank” is one of the measures promoted by the National Health Administration, Ministry of Health and Welfare. This study proposes the perspective of the “value co-creation” with the attempt to extend the concept of service ecosystem and apply it on the platform of My Health Bank to examine whether people (patients, families, and caregivers) can promote their health literacy? Method: This cross-sectional study, with people that have registered at “My Health Bank” as subjects. Complying with the inclusion criteria, 401 questionnaires were delivered, with 391 valid ones, excluding those incompletely and inaccurately filled. Result: That the affecting factors of the co-creation of values: age, education level, annual income, and platform operation show to be significant ( p＜0.05); and gender, occupation, and resource exchange do not reach the significant level (p＞0.1). Conclusion: We found My Health Bank changed the inertia of “value creation” in the traditional medical value, it allows the traditional medical and healthcare industry to expose to the impacts of the mega trend of the internet, the transformation of the platform in a necessary trend.

To understand the health impacts of “hikikomori” lifestyle and to establish its first comprehensive health profile, a cross-sectional study was designed to measure how well the cases of hikikomori youths of Hong Kong were living, in terms of social, mental and physical aspects. This study involved 104 eligible participants at age 19.02 year-old who had completed the set of questionnaires and a series of anthropometric and physical health measurements. Despite SF36 score of 84.0 indicated good physical functioning in general, participants were lived sedentarily with high incidence of hypertension at 15.4% and prehypertension at 31.7%. Occurrence of hypertension in cases living as hikikomori >6 months was 3-times higher than those newly onset cases. The blood pressure levels were correlated with age and all obesity index parameters measured including waist circumference and body mass index. Half of the hypertensive cases involved the elevation of systolic blood pressure, which suggested higher odds of cardiovascular complications. Participants were mentally stable living with moderate levels of perceived stress and state anxiety, but borderline clinical depression. In conclusion, the hikikomori lifestyle could be a risk behavior that may harm the younger generation physically by promoting obesity and hypertension and probably other chronic illnesses.

This paper outlines the ongoing development of a specialised mobile application to address the mental health needs of vulnerable populations in the European Union (EU). Conducted as a mixed-methods research within two EU Science and Technology Cooperation Actions, the study prioritises stakeholder feedback to identify features for initial testing and strategies to improve application uptake, using critical digital health analysis. With a focus on marginalised groups such as refugees, migrants and socio-economically disadvantaged individuals, the application aims to provide an accessible and culturally sensitive platform for mental health support, integrating evidence-based interventions such as cognitive behavioural techniques and mindfulness exercises. Key features include multilingual support, habit tracking, personalised recommendations for support and services, and real-time crisis intervention. Collaboration with stakeholders and ongoing rigorous usability testing are driving the refinement process to ensure usability, acceptability and effectiveness, underscoring the importance of user engagement in technology-based mental health interventions in the EU context and highlighting the importance of collaborative science and technology for societal benefit.

Colistin [polymyxin E] is a veterinary exclusive antimicrobial and one of the oldest antibiotics that is currently recognised as one of the highest priority critically important antimicrobials for humans. It is extensively used for multiple medical and non-medical purposes particularly for growth promotion, prophylaxis/metaphylaxis and therapeutic in food animals. As a result, colistin resistance was widespread along the food-chain linking to multidrug resistant bacterial infections in humans reflected by greater use of colistin in healthcare settings resulted in different types of bans/restrictions in food-producing animals, around the world. This report debates the testimonies of 23 countries representing the bulk of global food producing animal production, providing robust evidence on the essential need for colistin in animal production.

Social media addiction has attracted the attention of researchers especially during the COVID era because negative emotions generated from the pandemic may have increased social media addiction. The present study aimed to investigate the role of negative emotions and social media addiction on health problems during and after the COVID lockdown. A survey was conducted with 2926 participants aged between 25 and 45 years. The data collection period was between 2nd September and 13th October 2020. Partial Least Square Structural Equation Modeling was conducted for data analysis by controlling the respondents' working time, leisure time, gender, education, and age. Our study showed that social media addiction and time spent on social media impact health. Interestingly, while anxiety about COVID increased social media addiction, fear about COIVD reduced social media addiction. Also, long working hours contributed most to people’s health issues, and its impact on social media addiction and hours was much higher than negative emotions, where males faced more health challenges than females. The impacts of negative emotions generated by the COVID on social media addiction and health issues should be reconsidered. Government and employers' control of people's working time stress should prioritize solving social media addiction-related issues.

The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people’s daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress reactions related to the COVID-19 pandemic, the prevalence of symptom-defined post-traumatic stress disorder (PTSD), and factors associated with post-traumatic stress in the Norwegian population during the early stages of the COVID-19 outbreak. A survey was administered via social media channels, to which a sample of 4527 adults (≥18 years) responded. Symptom-defined PTSD was measured with the PTSD Checklist for the DSM-5. The items were specifically linked to the COVID-19 pandemic. We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Associations with PTSD were examined with single and multiple logistic regression analyses. The prevalence of symptom-defined PTSD was 12.5% for men and 19.5% for women. PTSD was associated with lower age, female gender, lack of social support, and a range of pandemic-related variables such as economic concerns, expecting economic loss, having been in quarantine or isolation, being at high-risk for complications from COVID-19 infection, and having concern for family and close friends. In conclusion, posttraumatic stress reactions were common in the Norwegian population in the early stages of the COVID-19 outbreak. Concerns about finances, health, and family and friends seem to matter.

Covid-19 restrictions impacted many people’s daily lives through infection, fear of infection and the implementation of restrictions on movement. Restrictions and fear of contamination impacted physical activity patterns activity and increased mental health issues globally across a variety of ages. This re-issue of a questionnaire sought to examine the impact of Covid-19 restrictions on frequency of physical activity, participation in sports, wellbeing and symptoms of anxiety and depression in Irish adolescents. 3,021 adolescents from 61 post-primary schools in the Republic of Ireland completed questionnaires. Consistent with a previous issue of the questionnaire, a minority of adolescents were found to meet the WHO’s physical activity guidelines (11.6% of males and 5.2% of females) although there were large decreases in 1^st year males and females. Adolescents reporting elevated symptoms of depression increased from 39% to 46% with almost 3 in 5 females reporting symptoms of depression ranging from mild to extreme. Highest levels of wellbeing were found in adolescents who participated in 3 or more sports, although there was an 8% reduction in the amount of adolescents who participated in 3 or more sports. There were no changes in physical activity levels overall, despite changes within sub-groups and patterns of physical activity. There was a clear increase in symptoms of depression, with females impacted more than males. Previously active individuals were more likely to increase activity and therefore report higher levels of mental health while those who were less active were more likely to decrease activity and report lower mental health.

The ongoing COVID-19 pandemic is shaking the foundations of public health governance all over the world. Researchers are challenged by informing and supporting authorities on acquired knowledge and practical implications. This commentary applies established theories of risk perception research to COVID-19 and reflects on the role of risk perceptions in these unprecedented times. Moreover, it calls for utilizing the knowledge on risk perception to improve health risk communication, build trust and contribute to a collaborating governance.

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge to come from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of ‘standard drink’. Physicians were generally not comfortable converting ‘standard drinks’ into other metric units, however men tended to be more comfortable than women (p=0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0-10 scale). Physicians were generally comfortable in counselling patients regarding safe-limits of consumption (6.22 ± 3.20, on a 0-10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

The Operational Remote Sensing (ORS) program leverages Landsat and MODIS data to detect forest disturbances across the conterminous United States (CONUS). The ORS program was initiated in 2014 as a collaboration between the US Department of Agriculture Forest Service Geospatial Technology and Applications Center (GTAC) and the Forest Health Assessment and Applied Sciences Team (FHAAST). The goal of the ORS program is to supplement the Insect and Disease Survey (IDS) and MODIS Real-Time Forest Disturbance (RTFD) programs with imagery-derived forest disturbance data that can be used to augment traditional IDS data. We developed three algorithms and produced ORS forest change products using both Landsat and MODIS data. These were assessed over Southern New England and the Rio Grande National Forest. Reference data were acquired using TimeSync to conduct an independent accuracy assessment of IDS, RTFD, and ORS products. Overall accuracy for all products ranged from 77.64% to 93.51% (kappa 0.09–0.59) in the Southern New England study area and 59.57% to 79.57% (kappa 0.09–0.45) in the Rio Grande National Forest study area. In general, ORS products met or exceeded the overall accuracy and kappa of IDS and RTFD products. This demonstrates the current implementation of ORS is sufficient to provide data to augment IDS data.

Prostate cancer (PCa) ranks as the second most fatal and sixth most prevalent cancer among males globally. This study focuses on leveraging deep learning networks to detect the Gleason grading of prostate cancer from histopathology images stained with Hematoxylin and Eosin (H&E). Six pathologists annotated the images, resulting in six distinct labels for each input image. A common ground truth label was established through majority voting approach. Subsequently, the dataset was trained using architectures: UNeT, UNeT++, DeepLabV3, DeepLabV3+, and GAN based segmentation network. Notably, GAN based network demonstrated superior performance, achieving an F1-score of 0.872 and a Jaccard Index of 0.777, outperforming the other architectures considered in this study.

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

Childbirth education classes represent an antenatal tool for supporting pregnant women and couples in increasing knowledge on pregnancy, delivery, breastfeeding, and newborn care. The aim of this study was to investigate the impact of the additional lesson to the prenatal course regarding the advantage of the vaccination on mitigation of maternal anxiety. An observational study was designed including participants in childbirth education classes, comparing courses enhanced by the extra lesson on vaccination during pregnancy versus those lacking it. Assessment of the impact of prenatal educational on vaccine was measured by using validated questionnaires (State-Trait Anxiety Inventory, STAI; Perceived Stress Scale, PSS; World Health Organization- Five Well-Being Index, WHO-5). A total of 145 pregnant women participated to the investigation by answering to the online survey. Of them, 33 patients (22.8%) belong to the course without lesson on vaccine, while 112 (77.2%) participated to online prenatal education inclusive of additional meeting on usefulness to get vaccinated during pregnancy. No statistical differences were found between study groups in demographics and perinatal outcomes. Participants to enriched course reported lower basal anxiety levels than those without lesson on vaccine (STAI-State, normal score <40, 30 vs. 19%, p-value 0.041; STAI-State, mild score 40-50, 78 vs 67%, p-value 0.037). With reference to the last two weeks, maternal wellbeing level was improved by the added class (score >13 as measurement of wellbeing: 62% vs 80%, p-value<0.05). Moderate perceived stress assessed by PSS was found in those pregnant women without prenatal education on vaccine (64 vs 50%, p-value 0.042). The introduction of a lesson regarding on vaccination during pregnancy in the program of prenatal education courses improves maternal anxiety levels and wellbeing, in addition to reducing perceived stress.

Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown higher prevalence of poor self-perceived health (P-SPH) in informal workers compared to formal. The study’s aim is to analyse the role of working conditions in the association between informality and SPH in urban working population in Peru. We conducted a cross-sectional study based on 3098 workers from the working conditions survey of Peru 2017. Prevalence of P-SPH and exposure to poor working conditions were calculated separated by formal and informal employment and stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with its prevalence ratios (PR) crude and adjusted for working conditions. Informal employment was 76% in women and 66% in men. Informal workers were more exposed to poor working conditions than formals and reported worse SPH. Workers in informal employment showed higher risk of P-SPH than formals: PR 1.38 [95% CI: 1.16 – 1.64] in women and PR 1.27 [95% CI: 1.08 – 1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions 1.23 [95% CI: 1.04 – 1.46]. The negative effect on informal workers’ health is partially explained by poor working conditions. However, there is a part of the effect explained by informality per se.

Diabetes and mental disorders have been recognized as two significant public health concerns globally. Recent research indicates that there is a bidirectional relationship between these two conditions, with each influencing the other's course and outcomes. Nutrition plays an essential role in the prevention and treatment of both mental disorders and diabetes. A comprehensive review of existing literature was conducted to examine the impact of anxiety and depression on the development of diabetes and the influence of diabetes on the occurrence of mental health disorders such as anxiety and depression. Additionally, the effects of nutrition on the prevention and management of mental disorders, diabetes, and related complications in at risk individuals were assessed. Our findings show that mental disorders, such as depression and anxiety increase the risk of developing type 2 diabetes and are associated with poorer glycemic control, increased diabetes-related complications, and higher mortality rates. Conversely, diabetes is also linked with an increased risk of developing mental health disorders, including depression, anxiety, and cognitive decline. The biological, psychological, and social factors that contribute to the comorbidity between these two conditions are complex and multifaceted. Therefore, an integrated approach to the management of both conditions is critical for improving patient outcomes and reducing the overall burden of disease. Nutritional interventions should be utilized to reduce the risk of diabetes in patients with anxiety and depression as well as enhance mental health in patients with diabetes.

An artificial intelligence (AI)-based conversational large language model (LLM) was launched in November 2022 namely, “ChatGPT”. Despite the wide array of potential applications of LLMs in healthcare education, research and practice, several valid concerns were raised. The current systematic review aimed to investigate the possible utility of ChatGPT and to highlight its limitations in healthcare education, research and practice. Using the PRIMSA guidelines, a systematic search was conducted to retrieve English records in PubMed/MEDLINE and Google Scholar under the term “ChatGPT”. Eligibility criteria included the published research or preprints of any type that discussed ChatGPT in the context of healthcare education, research and practice. A total of 280 records were identified, and following full screening, a total of 60 records were eligible for inclusion. Benefits/applications of ChatGPT were cited in 51/60 (85.0%) records with the most common being the utility in scientific writing followed by benefits in healthcare research (efficient analysis of massive datasets, code generation and rapid concise literature reviews besides utility in drug discovery and development). Benefits in healthcare practice included cost saving, documentation, personalized medicine and improved health literacy. Concerns/possible risks of ChatGPT use were expressed in 58/60 (96.7%) records with the most common being the ethical issues including the risk of bias, plagiarism, copyright issues, transparency issues, legal issues, lack of originality, incorrect responses, limited knowledge, and inaccurate citations. Despite the promising applications of ChatGPT which can result in paradigm shifts in healthcare education, research and practice, the embrace of this application should be done with extreme caution. Specific applications of ChatGPT in health education include the promising utility in personalized learning tools and shift towards more focus on critical thinking and problem-based learning. In healthcare practice, ChatGPT can be valuable for streamlining the workflow and refining personalized medicine. Saving time for the focus on experimental design and enhancing research equity and versatility are the benefits in scientific research. Regarding authorship in scientific articles, as it currently stands, ChatGPT does not qualify to be listed as an author unless the ICJME/COPE guidelines are revised and amended. An initiative involving all stakeholders involved in healthcare education, research and practice is urgently needed to set a code of ethics and conduct on the responsible practices involving ChatGPT among other LLMs.

The complex and interconnected challenges of climate change, water stress, disasters, and health crises have far-reaching implications for sustainable development and global sustainability agendas, such as the Sustainable Development Goals (SDGs). However, one critical issue that has been overlooked is the nexus between climate change impacts and mental health (CCMH). Recognizing and addressing the negative emotions associated with this global phenomenon is essential to fostering a holistic approach to climate action planning and building long-term resilience. In this assessment, we present a set of narratives to argue that CCMH research requires a collaborative, transdisciplinary approach that integrates socio-economic and socio-cultural complexities. For this assessment, we used a case study approach to elucidate that the mental health impacts of climate change are unequally distributed, disproportionately affecting vulnerable groups based on age, gender, race, and socioeconomic status. The assessment presented in this study concluded that adequate mental health support programs are limited due to sociocultural stigmas and limited socioeconomic resources in some regions. Existing climate-related mental health services mechanisms lack coordination and specific action plans, leaving affected populations underserved. Unlike traditional understandings of the climate-health nexus, this research calls for experts from multiple fields to work together and for enhanced attention to and investment in CCMH research to bridge the gap between scientific knowledge and practical solutions. Such solutions will lead to scalable and lasting change as communities can implement research findings to support those in need and enhance disaster resilience. Furthermore, by collectively recognizing the climate and mental health nexus, global commitments such as the SDGs and the Paris Declaration can advance awareness and action in climate-related mental health, ultimately promoting a healthier relationship between humanity and nature.

The quality and safety of fermented milk products, which make up a sizeable portion of human nutrition, are greatly influenced by both the milk itself and the starting cultures employed to ferment it. Lactic acid bacteria (LAB) create a variety of metabolites throughout the fermentation process, altering the organoleptic properties of the substrates. The final product’s nutritional value and digestibility are enhanced by fermentation of the raw materials, which also adds vitamins, vital amino acids, and fatty acids. The quality and safety of fermented milk products, which make up a sizeable portion of human nutrition, are greatly influenced by both the milk itself and the starting cultures employed to ferment it. The inhibition of the growth of pathogenic microbes, which lowers the likelihood of the emergence of foodborne diseases, is another crucial function of LAB. A variety of pathogenic bacteria are frequently present in raw (unpasteurized) milk, and other raw materials; these pathogenic bacteria should be removed during the fermentation process. As a result, a variety of LAB metabolites, such as hydrogen peroxide, organic acids, and bacteriocins, function as bio preservative agents, enhancing food safety and lengthening the shelf life of the finished products.

Exposure to air pollution have detrimental effects on the elderly, women, people with pre-existing medical conditions, people living in poverty and children. The aim of the study was to investigate the extent of community awareness and knowledge on the health risks associated with exposure to air pollution. A cross-sectional study design was used for the study, using self-administered questionnaires. A simple random sampling technique was used to select 376 respondents. Systematic sampling method was applied to select the households. SPSS version 26 was used to analyze data. Of 376 respondents, 221 were males and 154 females. 113 were aged between 23-47years and 353 were aware that if they don’t protect themselves against polluted air, they may get sick, with age and educational status associated with their awareness (p &lt; 0.05). About 361 knew what air pollution is and 188 think the air they breathe in Annadale is moderate. A total number of 278 said they feel sick/uncomfortable when the quality of air is bad. About 293 knew that people are exposed to air pollution by breathing contaminated air and 237 identified sewage smell as the main cause of air pollution. Respondents who identified internet and television as the main source of information were 199 and 177 respectively. Those who were not aware of actions implemented to reduce air pollution were 180. Based on the results of the study, respondents are aware of the dangers of exposure to polluted air, and it is necessary that air pollution risk communication strategies be implemented to empower residents.

Traditional Health Practitioners (THPs) are considered as the entry level of care in African societies and play an important role in the delivery of health services to the population. A phenomenological qualitative study was carried out among pur-posefully selected THPs in Mthatha to understand their roles and the challenges they face in providing maternal health services. The study included a focus group discussion with seven participants, which yielded three themes and seven sub-themes. The content analysis of descriptive data from the focus group discussion revealed threats posed by unregistered and counterfeit THPs to the lives of pregnant women in rural settings. THPs' wide range of services allowed pregnant women to receive prenatal, antenatal, and postnatal care in close proximity. This level of care, however, was characterized by high levels of secrecy and counterfeit practitioners who used human body parts, which jeopardized the practice and made it unpopular. Traditional health practice must be protected through registration of THPs and the establishment of functional referral pathways between THPs and conventional health services.

Coronavirus Disease 2019 (COVID-19) has become a global health threat and has placed an extraordinary demand for healthcare workers around the world. In this study, we aim to examine the prevalence of burnout, its associating factors, and experience among Malaysian healthcare workers through an embedded mixed-method study design. We found that more than half of Malaysian health care workers in this sample experienced burnout. Direct involvement in COVID-19 screening or treatment, having a medical condition, and less psychological support in the workplace emerged to be the significant factors for personal-, work- and patient-related burnout. Participants described workload, uncertainties from the pandemic, challenged work-family balance and stretched workplace relationships as the sources of burnout. Exhaustion appeared to be the major symptom and many participants utilized problem-focused coping to deal with the adversities experienced during the pandemic. Participants reported physical, occupational, psychological, and social-related negative impacts emanating from burnout. As the pandemic trajectory is yet unknown, the findings provide early insight and guidance for possible interventions.

The emission of sulphur dioxide (SO2) from mining activities presents a substantial risk to public health, especially in populations located near mine industrial regions. This study investigated the potential correlation between exposure to sulphur dioxide (SO2) and its effects on respiratory health in Kankoyo Township, Zambia. A variety of methodologies were employed in this study, encompassing community participation, expert interviews, spatial analysis, and a retrospective examination of health and SO2 data for Kankoyo spanning 15 years. The results of our research indicated a worrisome correlation between the community and the presence of SO2, which has had a significant impact on their lives. The expert interviews also emphasized the effects of SO2, with respiratory cases accounting for approximately 75% of the reported cases. Additionally, the clinic officer observed that asthma cases have decreased following the implementation of a monitoring station in the community. Furthermore, overall emissions of SO2 have decreased since the upgrade of the smelter operation. A probable association was identified in the retrospective analysis between exposure to SO2 and the occurrence of asthma, respiratory non-pneumonia, and pneumonia infections. The findings of the retrospective research revealed a substantial association between SO2 concentrations and the susceptibility of individuals aged 5 years and older to asthma, respiratory non-pneumonia, and pneumonia infections. The results of the spatial study indicated that Kankoyo exhibited a significant level of SO2 pollution, above the established limitations set by the Zambian Environmental Management Agency (ZEMA) by an alarming margin of 1713%. In response to the challenges identified, this study proposed several measures. These measures encompassed the implementation of a requirement for regulators such as ZEMA and local communities to have access to real-time pollution data from mines, to enhance transparency. Additionally, the deployment of affordable air quality sensors, the resolution of medication shortages, the establishment of specialized respiratory health clinics, the initiation of IT-driven public awareness campaigns, and the expansion of research to investigate additional pollutants and confounding factors were also recommended.

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

AbstractCurrently, public health researchers are investigating several complex and multi-faced health problems that require mixed-method approaches (MMA) to clearly understand problems and design proper intervention approaches and policy formulation. Besides, a comprehensive comprehension of the complex operation of society is vital. The MMA helps in having a broader understanding of the functioning and structure of the community at large. MMA deliberately integrates qualitative and quantitative approaches carefully to build on the merits of each other and confirm that the findings of research are closer to the truth. Therefore, public health scholars must have an excellent comprehension of the MMA and its philosophical foundations for discovering the complex conditions that challenge public health nowadays. However, public health researchers do not clearly understand the theoretical underpinnings and practical application of MMA, despite its popularity in developing countries. Therefore, this article aimed to provide comprehensive evidence on the theoretical underpinnings and practical application of MMA.

Domestic violence (DV) has been reported high in minorities across the US. Among minorities, refugees and immigrants encounter several barriers that may influence their responses and actions regarding DV. This scoping review examined three decades of literature (1980-2022) on resettled Afghan and Arab refugee women's attitudes and behaviors toward DV in their host countries, and to summarize research, practice, and policy recommendations. Based on Arksey and O'Malley model, our scoping review conducted extensive searches in SCOPUS, PubMed, PsychInfo, CINAHL, Web of Science, the Directory of Open Access Journals, and Embase databases. Searches identified articles that examined resettled Afghan and/or Arab refugees’ responses to DV in Western countries. The search identified 439 unique citations; 17 met the inclusion/exclusion criteria. Major themes included acculturative changes in refugee attitudes and behaviors and in stakeholders’ perspectives and roles. Significant acculturative attitudinal changes (acknowledgment, silence, justification, or disapproval of DV) contrasted with minimal behavioral changes (help-seeking behaviors, action plans, or barriers to actions) and with a resistance to change in stakeholders (cultural norms and beliefs, community patriarchal normalization of violence, service providers unfamiliarity with client diversity and refugee cultures) in supporting women decision-making regarding DV. Not a single article made explicit policy recommendations.

(1) Background: Psychological well-being (PWB) and female sexual health are two important areas for women’s quality of life and research, and they are closely related. The aim of this study was to conduct a systematic review of the existing literature to explore the association between PWB and sexual health in women. (2) Methods: This review was carried out following PRISMA. The inclusion criteria were studies with samples of adult women, that evaluated and associated sexual functioning and mental health. Scientific articles were identified on Web of Science, Scopus, EBSCO (PsycInfo, PsycArticles, and Psicodoc), ProQuest, and PubMed. The search was limited to years between 2010 and 2023. (3) Results: 14 selected articles were analyzed, in which population samples and variables related to mental and sexual health were examined. 42.9% of the studies included clinical samples, 71.4% focused on anxiety and depression as main mental health variables, and 50% examined female sexual functioning as a sexual health variable. (4) Conclusions: This review provides more up-to-date information about valuable insights into the possible determinants of female sexual health. The association between PWB and female sexual health has been demonstrated.

The relationship between child psychology and the widespread usage of mobile devices in the modern day is examined in "The Mobile Dilemma: Child Psychology and the Era of Technological Dependence." The abstract serves as a brief synopsis of the work, highlighting its important ideas and arguments. Concerns concerning the effects of excessive time spent on mobile devices on children's mental health and development have arisen in this age of technology dependency. The essay opens by pointing out the importance of investigating the psychological effects of kids' exposure to mobile gadgets. The effects of mobile phone addiction on learning, memory, and social and emotional health are investigated. The neurodevelopmental implications are explored further in the abstract, with a focus on the impact of mobile technology on brain plasticity and the formation of the developing brain. It offers advice on how to establish appropriate limits for children's screen time, encourages the development of digital literacy, and promotes responsible behavior.The pros and cons of using mobile devices in the classroom are also examined, along with their effects on students' ability to study and the risks and difficulties that could arise from implementing such a strategy. The emotional and social impacts of mobile device addiction are discussed in the abstract. This includes the impact on one's social life, empathy, ability to communicate, and sense of self-worth. The abstract also stresses the importance of interdisciplinary efforts involving parents, teachers, psychologists, and legislators to combat mobile device addiction through intervention and preventative techniques. Future directions are highlighted, with a focus on topics such as mobile technology development, digital well-being, privacy protection, mental health implications, screen time limits, digital literacy, and the impact of cultural and socioeconomic variables.

Caffeine is a naturally occurring alkaloid found in various plants. It acts as a stimulant, antioxidant, anti-inflammatory and even an aid in pain management, and is found in several over-the-counter medications. This naturally derived bioactive compound is the best-known ingredient in coffee and other beverages, such as tea, soft drinks, and energy drinks, and is the most widely consumed substance worldwide. Therefore, it is extremely important to research the effects of this substance on the human body. With this in mind, caffeine and its derivatives have been extensively studied to evaluate its ability to prevent diseases and exert anti-aging and neuroprotective effects. This review is intended to provide an overview of the effects of caffeine on cancer, cardiovascular, immunological, inflammatory, and neurological diseases, among others. The heavily researched area of caffeine in sports will also be discussed. Finally, recent advances in the development of novel formulations, in the form of dietary supplements of caffeine and nanocarriers, to enhance the bioavailability of caffeine and its beneficial effects will be discussed. On the other hand, caffeine may contribute to elevated blood pressure, anemia, and migraine.

Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus in how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist.

Adequate access to drinking water for hydration and hygiene depends on many factors, such as water quality, accessibility, continuity of supply, and available quantity. We developed the Drinking Water Security Index (DWSI) to assess relative multifactorial drinking water security at different spatial and temporal scales. We apply this new index in Sudan to assess historical and future drinking water security at state, local, and maternity levels. State-level analyses found that the Red Sea and River Nile states are most vulnerable, with the lowest DWSI for both historical and future periods. The 1 km2 pixel level analysis shows large differences in water security within the major states. Analyses at maternity level showed that nearly 18.97 million people are affected by the 10% of maternities with lowest DWSI, a number projected to increase by 60% by 2030. Current and future water security indexes of maternities providing Emergency Obstetric and Newborn Care, were assessed to identify those where urgent action is needed to ensure quality health care in water secure conditions. This work provides useful information for stakeholders in the health and drinking water sectors in Sudan, to improve public health, reduce preventable mortality, and make the population more resilient to projected environmental changes.

The presence of burnout, anxiety and depression among health professionals is a crucial issue that must be carefully addressed. The aim of the present study is to investigate levels of burnout, anxiety and depression among health professionals (medical and nursing staff) during the pandemic crisis, the association of burnout with anxiety and depression as well as the impact of occupational and demographic factors. One hundred twenty-five health professionals (medical and nursing staff) participated who were working in a public hospital in the broader area of Athens (sample of convenience). Specifically, 41 males and 84 females with the majority of them being in the category of 36-45 years of age. For the data collection, the Maslach Burnout Inventory (MBI) and the HADS questionnaire were used. The results showed that there was a statistically significant and negative correlation of emotional exhaustion to HADS total (r= -0,377, p=0,000) as well as HADS anxiety (r= -0,417, p=0,000). Also, there was a statistically significant and negative correlation of depersonalization to HADS total (r= -0,370, p=0,000) as well as HADS anxiety (r= -0,431, p=0,000). Moreover, there was a statistically significant effect (p<0,05) of occupational and demographic characteristics.

Pb found in rain water is not only caused by tin roof on houses but also caused by the pollution of industrial activities, vehicles and land clearing activity by fire. Pb pollutant dissolves and enters into rain water storages and it’s consumed as drinking. Pb can cause bad impact to human, for example disruption of enzyme, anemia and low intelligence. The purposes of this research are (1) to evaluate Pb, pH and turbidity level in rain water, (2) to analyze the effectiveness of mollusk sand filtration and the absorption of activity carbon to decrease Pb, turbidity and pH, and (3) to analyze the correlation of Pb, length of stay and smoking habit on public health. This research is an experimental by using pre and post test designs with control and observational by using cross sectional design. The research was conducted in urban and rural areas of Pontianak and Kubu Raya regency. The sampling was done in determining the number of samples of Pb, pH and turbidity in rain water. The analyzing the data by using computer program. The results show that: (1) the average of Pb, pH and turbidity level before treatment is considered high at 131.7 µg/L on Pb, turbidity at 20 NTU and low pH at 5.2. After the treatment was the Pb has decreased to 0.71 µg/L and turbidity has to 5.66 NTU, pH to 6.9 and (2) Rain water treatment is very effective to decrease Pb for 99.4% and turbidity for 72%, and (3) there is a correlation among Pb found in rain water, length of stay and smoking activity to public health. Recommends that: the residents of Pontianak and Kubu Raya to process rain water before consuming. The rain water treatment can be done by applying mollusk sand filtration and absorption of active carbon.

Background Although COVID-19 outcomes vary between and within countries, there is little published data on how aspects of social determinants of health (SDoH) affect COVID-19 outcomes in the African context. Objective The current study set to examine COVID-19 case and death rates and their correlates among African countries using data from different sources. Methods An ecological cross-sectional study comprising 28 African countries with a recent Demographic and Health Survey, DHS (2010-2018). Response variables were COVID-19 case and death rates (as of August 15, 2020). Covariates comprised three healthcare systems measures; rates of hospital beds (2005-2017), ventilators (2020) and doctors (2010-2018) per 10,000 population, and 9 broad topics common to multiple SDoH frameworks aggregated to the country level; geography (urban residence), wealth index, education, employment, crowding, and access to information. Rates per 10,000 population were calculated for healthcare measures and mapped for visualization. A Negative Binomial regression was used to assess whether aspects of SDoH are correlated with COVID-19. Results Our analysis indicated that 1 in 4 (25.1%) households in study countries are without clean water and handwashing access. Country-level health system capacity (hospital beds, ventilators, and medical doctors) varied considerably between the countries. Negative Binomial regression showed that the odds of COVID-19 morbidity and death was higher in countries with a high proportion of households without access to quality water and doctors per 10,000 people. Having a high proportional of educated women (1.003: 95% CI, 1.001 – 1.005), hospital beds per population and less people per room (0.959: 95% CI, 0.920 – 1.000) was negatively correlated with COVID-19 deaths while being insured and owning a mobile phone was correlated with illness. Conclusion Both aspects of SDoH and healthcare system contribute either negatively or positively to COVID-19 outcomes. Addressing healthcare system capacity and economic and environmental SDoH will be critical for mitigating the spread of COVID-19 and re-emerging diseases on the African continent.

Background: Mental health is a growing concern worldwide. It is not well understood whether Nepali workers, including international labour migrants from Nepal, are at higher risk of developing mental health problems. The purpose of our study is to determine the prevalence of and examine the risks factors for depression among returnee migrants and non-migrant working male adults in Nepal. Methods: A cross-sectional survey of a probability-based sample of 725 participants was conducted in February 2020. The sample was comprised of two groups based on migration status: returning migrants and non-migrants. Logistic regression was applied to investigate factors associated with symptoms depression.Results: The overall prevalence of depression was 10.1%. However, the prevalence of depression was lower (7%) among returnee migrants compared to non-migrants (13.7%). Participants in the lower income group were more at risk of depression (OR=5.38, 95% CI: 1.96-14.78) than those in the higher income group. Similarly, Buddhists and Christians were more likely to be depressed (OR=2.17, 95% CI: 1.02-4.64) than Hindus. Interestingly, participants having more than two children had a higher prevalence of depression (OR=5.14, 95% CI: 1.22-21.63) compared with those having no children. Unmarried participants were more likely to be depressed (OR=4.05, 95%, CI:1.10-14.93) than those who were married. Conclusion: The working Nepali adult male population in Nepal, including returning migrants, is at risk of depression, but this risk is lower in those in the higher income group, returnee migrants, married, Hindus and those with no children. This study highlights the need to monitor and develop national policies to ensure the mental health of Nepali male adult population, including returnee migrants.

Trans fatty acids (TFA) are a concern for public health due to their negative impact on cardiovascular health. This study aimed to assess the levels of TFA and other fatty acids in popular edible oils and fried foods commonly consumed in Tanzania. A total of 57 samples from 38 brands of edible oils and 20 samples of fried street foods and fast foods were collected in Dar es Salaam, Tanzania. Capillary gas chromatography was used to determine TFA levels, while nutritional labeling and other fatty acid classes were also evaluated. Among the analyzed edible oils, 21% exceeded the recommended TFA levels, primarily found in popular brands of margarine, industrially refined sunflower oils, animal butter, and peanut butter. Only two food items surpassed the 2% TFA limit, but a majority of the foods had high levels of saturated fatty acids and a fatty acid profile similar to palm oil. Additionally, only 22% of the edible oils provided TFA content information. These findings indicate the persistence of TFA levels beyond recommended limits and inadequate TFA nutritional labeling in Tanzanian food products. Urgent interventions are necessary to reduce TFA levels and improve nutritional labeling practices to safeguard public health.

Studies suggest that chronic psychological stress can lead to oral health deterioration, alter the immune response, and possibly contribute to increased inflammation, which can impact the physiological healing of periodontal tissues. This cross-sectional study seeks to assess and improve clinical understanding regarding the relationship between perceived stress, mindfulness, and periodontal health. A total of 203 people were analysed from December 2022 to June 2023. The Periodontal Screening and Recording (PSR), score and Bleeding Index (GBI), and Plaque Control Record (PCR) of every patient were registered. Subsequently, participants completed the Sheldon Cohen Perceived Stress Scale (PSS) and the Mind-fulness Awareness Attention Scale (MAAS) questionnaires. The collected data was analysed statistically, and correlations and dependencies were evaluated. The p-value was 0.004265 in Welch's t-test to assess the relationship between MAAS and the variable's presence or absence of periodontitis, highlighting that patients with periodontitis have significantly different MAAS scores compared to patients unaffected by periodontitis. The Pearson correlations between GBI and perceived stress, PCR and perceived stress, and PCR and MAAS resulted in p-values of 2.2-16, 3.925-8, and 2.468-8, respectively, indicating a statistically significant correlation in this case. Despite the limitations, the findings of this study suggest a significant relationship between psychological stress, mindfulness and periodontal tissue health. Clinical trials are necessary to incorporate the assessment of a patient’s psychological status as a new valuable tool in the management of periodontal health.

Growing evidence suggests sleep plays an important role in the development of healthy adolescents, with increased interest in the associations between sleep and mental health. Higher duration and quality of sleep has been suggested as a mechanism for increased wellbeing in adolescents. Cross sectional data was collected from 5,661 Irish adolescents. 55% of Irish adolescents reported meeting the guidelines for adolescents of 8-10 hours per night. This was found to decrease with age. Higher duration and quality of sleep was positively associated with wellbeing and negatively associated with symptoms of anxiety and depression. A higher frequency of physical activity was associated with longer duration and higher quality of sleep. 9-10 hours of sleep was associated with the highest levels of wellbeing and lowest symptoms of anxiety and depression. The relationship between physical activity and increased wellbeing may be impacted by physical activity leading to higher durations and quality of sleep.

One of the special trends in health care is the increasing availability of data and services to the cloud, especially for convenience (for example, providing a complete patient medical record without interruption) and savings (for example, economic issues). Management of health care data). However, there are limitations to using common cryptographic prototypes and access control models to address security and privacy concerns in an increasingly cloudy environment. In this paper, we explore the potential and capacity of using China's Blockchain technology to protect health care data hosted in the cloud. We also explain the real challenges of such an approach and further research is needed. Health care is a highly data-dependent domain, with large amounts of data being created, published, stored and accessed daily. For example, data are created when a patient undergoes a number of examinations (such as computed tomography or computed tomography scans) and the data need to be sent to the radiologist and then to a physician. The visit results are then stored in the hospital, and then need to be accessed later by another physician at another hospital within the network. It is clear that technology can play an important role in improving the quality of care for patients (for example, using data analytics to make informed medical decisions) and potentially costing more by allocating resources more efficiently in terms of personnel, equipment, etc. , Reduce. For example, paper-based data extraction is difficult to extract into systems (for example, it is costly and may involve data entry errors), archiving them and accessing them as needed is costly. These challenges may cause medical decisions to be incomplete, requiring repeated tests for missing information or missing data stored in another hospital in another state or country (at the expense of increased costs and no convenience). (For patients) and so on. Because of the nature of the industry, it is important to ensure the security, privacy and integrity of health care data. As a result, there is definitely a need for a secure and secure data management system.

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

OBJECTIVE: Analyzing the effects of different physical exercise programs on the anthropometric, cardiovascular, metabolic, and strength variables of the elderly participating in health care programs. METHODS: Controlled clinical trial, with 60 elderly participants from health care groups, allocated into four groups: Group of resistance exercises in open-air gyms – GT1 (n = 17); Group of aerobic and localized exercises - GT2 (n = 11); Group of resistance exercises at GT3 gym (n = 17); Control group: non-exercise practitioners - CG (n = 15). Anthropometric (BMI, % body fat, and waist circumference), cardiovascular (SBP, DBP, HR, and DP), metabolic (total cholesterol, triglycerides, and glycemia), and strength variables were evaluated before and after 16 weeks of intervention. Descriptive statistics, Shapiro-Wilk and Kolmogorov-Smirnov normality test, equal variance test, T-Student test, non-parametric Mann-Witney test, ANOVA One Way, multivariate data analysis using data mining and machine learning techniques, Pearson and Spearman correlation tests, Classical Clustering (Agglomerative Hierarchical Method); Principal Component Analysis (PCA), Z score, Fruchterman-Reingold algorithm, Euclidian Similarity Index and, Cohen’s equations were applied. RESULTS: To observe effect size, morphofunctional variables for the GT1 group show a small effect for fat percentage, WHR, and ULS and a medium effect for LLS. For the GT2 group, there was a small effect for fat percentage, WHR, and ULS and a large effect for LLS. For the GT3 group, there was a small effect for the percentage of fat and HC, a medium effect for ULS, and a large effect for LLS. A small effect for glycemia in GT1, a medium effect for glycemia and triglycerides for GT2, a small effect for total cholesterol for GT3, and a large effect for glycemia in CG, with this effect being an increase in this analyte. For the cardiovascular variables, there is a small effect for SBP and HR in GT1, a small effect for DBP, HR, and DP, and a large effect for SBP in GT2, a small effect for SBP, DBP, and HR in GT3 and small effects for SBP and HR in CG. The correlation between BMI (P = 0.0007) and Body Fat% (P = 0.007) with ULS. The variables TG, LLS, and ULS were the ones that differed most in each type of stimulus chosen as an intervention in the present study. CONCLUSIONS: The results of this study indicate that GT2 caused more significant percentage reductions in body mass and BMI. However, GT3 caused greater fat percentage reduction. The GT2 caused the greatest decrease in waist circumference, while the GT3 caused the largest decline in hip circumference. The three groups induced an increase in strength (ULS and LLS). However, in ascending order, GT1 caused the smallest increase, GT2 an intermediate increase, and GT3 the greatest increase in strength, with considerable effects in GT2 and GT3. Finally, GT2 caused a greater percentage reduction in systolic blood pressure (large effect) and double product (small effect) than the other groups. The three methods proved to be efficient, but with particularities that may reflect the choice of one over another due to health conditions, objectives to be achieved, or characteristics of the patient at the time of their choice by the prescriber.

The aim of the study was to evaluate the impact of probiotics obtained from agro-industrial substrates fermented with lactic acid bacteria and/or yeasts on the health and changes in the microbiota of the digestive tract of guinea pigs. Eighty male guinea pigs, Kuri breed, 30 days old and 250 g live weight, were randomly selected and divided into four groups of 20 animals each. T0, Control, T1, Lactobacillus acidophilus and L. bulgaricus. T2, Saccharomyces cerevisiae and Kluyveromyces fragilis and T3. L acidophilus, L bulgariccus, S cerevisiae and K. fragilis. T1, T2 and T3 contained molasses-vinasse substrate in their base, the dose administered was 0.75 mL/animal orally. The parameters evaluated were weight gain, occurrence of diarrhea and mortality, blood profile, macroscopic lesions in the digestive tract organs and changes in the microbiota of the stomach, caecum, small and large intestine. Treatments T1, T2 and T3 improved weight gain (p<0.05) and reduced the presence of guinea pigs with diarrhea (p<0.05) and there was no mortality; hematic indices did not vary significantly (p>0.05) between treatments; animals in the control group presented a greater amount (p<0.05) of macroscopic lesions in the digestive tract organs; in the T1, T2 and T3 group there was an improvement in the natural microbiota. It is concluded that the inclusion of microbial additive in young guinea pigs improves intestinal health, consequently, improves weight gain, reduces diarrhea and deaths, and normalizes the natural microbiota of the gastrointestinal tract.

Asthma causes chronic coughing, wheezing, dyspnea, and chest pressure. This study assessed asthmatic patients' knowledge, attitudes and awareness of bronchial asthma and proper education on its meaning, risk factors, symptoms, diagnosis, management, and prevention practice. We performed a cross-sectional interventional asthma KAP survey in Erbil, Iraq. We adapted a validated study questionnaire from KAP studies in other nations to the Erbil situation and culture. In Erbil, Kurdistan, Iraq, two major hospitals' asthma clinics were studied. We chose 250 asthmatic ICU patients from October 2018 to July 2019. Health education was comprehensive. The health education program used a Kurdish PowerPoint with a printout. 25 groups got two-weeks of one-hour health education pre-intervention. Each group was questioned before, 2 and 12 weeks after health education. All data were analyzed by SPSS v26. The mean age of the respondent was 37.52±15.16 with 48.7 % respondent having a positive family history of asthma. After 2weeks of health education intervention, respondent have a higher knowledge score, positive attitudes compared to pre-education and after 12 weeks of education with a significant difference (P < 0.001) with improvised prevention practice. Health education programs led to considerable improvements in asthmatic patients' knowledge, attitudes, and practices regarding their condition. After receiving health education for a period of two weeks, the majority of the participants answered correctly regarding asthma, its causes, and the elements that trigger asthma attacks.

The COVID-19 pandemic and increased rates of documented Emerging Infectious Diseases (EIDs) in human populations over the last century have drawn attention on understanding pathogens spill over to humans and their zoonotic origin. In this paper we argue that we need to change the thinking about the fundamental cause of zoonoses. Our premise is that deforestation is the primary cause of EIDs events and that, to prevent future pandemics, it needs to be addressed without further delays. Therefore, we review recent trends of proximate and underlying determinants of deforestation, forest degradation and related biodiversity losses while seeking to clarify their links to the determinants of EIDs events. Acknowledging the magnitude of the challenge, we propose responses to stop global deforestation from a trans-disciplinary, intersectoral perspective led by indigenous people. While we envisage that stopping deforestation is the most important approach with long term direct and indirect effects on human, animal and plants health, providing climate changes mitigation and preventing otherwise difficult to predict EID events, we argue that such an initiative may usefully be complemented by reducing contacts between humans and wildlife animals and regulating rather than banning markets where wild animals are sold alive.Finally, we discuss transformative changes to improve planetary-wide forests preservation, soil, plants, animal, and human protection, together with a further understanding of EIDs transmission dynamics, public health veterinary and human disease surveillance, for improved global collective preparedness and action for the management of zoonotic EIDs.

This comparative research paper examines the difference between sugarcane harvesting practices in Thailand and India. The objective of research was to investigate and compare current pattern of sugar harvesting and its impact of these approaches on labor health conditions in the sugarcane industry of both the countries as India and Thailand. Data were collected from target population groups (40 each) from study areas, namely Kanchanaburi and Saraburi provinces in Thailand and Beed District of Maharashtra state from India. The data showed that comparatively in Thailand, adoption of mechanized harvesting was seen more. However in India, mechanized harvesting was seen increasing but still people were largely involved in sugarcane harvesting and it had ill effects on the overall health of female workers specially. The result clearly indicated that there was drastic difference in harvesting system and labor health conditions in Thailand and India. The findings underscore the multifaceted impact of their occupation on various aspects of health including general well-being of female sugarcane cutters. The strenuous nature of sugarcane cutting, coupled with inadequate protective measures and limited access to healthcare has contributed to a range of health care challenges among female sugarcane cutters in India.

E-waste is considered the fastest-growing global waste stream and has become an emerging environmental challenge. The widespread usage of digital devices has generated a large amount of e-waste. According to the Ministry of Commerce, India annually generates ~14.5 lakh metric tons of e-waste and recycles only ~5 % of e-waste. Annually, the global production of e-waste has been expected to increase by 4–5 %. Advancements in IT and communication divisions have improved the usage of electronic equipment. Heavy metals such as (Pb), mercury (Hg), arsenic (As), tin (Sn), and organic chemicals such as polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), polybrominated biphenyls (PBBs), polybrominated dibenzo-p-dioxins (PBDDs), polybrominated diphenyl ethers (PBDEs) are subsequently released from e-wastes and contaminates soil and water sources. These toxic compounds are hazardous to human health and the environment. They are capable of entering various biological systems and causing alterations in respiratory functions of the lungs, DNA damage, impaired functioning of the thyroid, and increased risk of chronic diseases such as cancer and cardiovascular ailments. Such concerns raise the quintessential need to manage e-waste to prevent future hazards. This manuscript critically reviews the sources, health and environmental impact, disposal techniques, recycling, and regulation of e-waste.

Soil is a crucial component for plant growth, as it provides water, nutrients, and mechanical support. Various factors, such as crop cultivation, microflora, nutrient addition, and water availability, significantly affect soil properties. Maintaining soil health is important, and one approach is the introduction of native organisms with multifaceted activities. In this study, the effects of four native microbes (Trichoderma asperellum strain TAIK 1, Bacillus cabrialesii strain BIK3, Pseudomonas putida strain PIK1, and Pseudomonas otitidis strain POPS1) and their consortia on soil health, plant growth, and the incidence of stem rot disease caused by Sclerotium oryzae in rice are evaluated. Upon bioagent treatment of soil through seed treatment or soil application, variations in chemical properties of the soil were observed, viz., pH, Electrical Conductivity (EC), Organic Carbon (OC), available Soil Nitrogen (SN), Soil Phosphorus (SP), Soil Potassium (SK), and soil enzymes (urease, acid and alkaline phosphatase, dehydrogenase), compared to untreated soils. The treated seeds with the consortia of four native bioagents resulted in a significant increase in plant height (39.16%), number of panicles (30.29%), and average grain yield (41.36%) over control plants. Under controlled conditions, the bioagents-treated plants showed a 69.37% reduction in stem rot disease. The findings of this study indicate a positive correlation between soil properties and plant growth as well as a highly negative association with stem rot disease severity. The results suggest that using native bioagents as a management strategy can control stem rot disease and enhance crop productivity while reducing reliance on chemical interventions. These findings provide valuable insights for the development of sustainable agricultural practices that promote soil health, plant growth, and disease management.

Capturing atmospheric CO2 and storing it in natural rock systems (i.e., alkaline earth silicate and hydroxide minerals) through carbonation reactions is a promising greenhouse gas mitigation research, and largely depends on the use of hydrated ultramafic rocks (serpentinites), which are widespread in orogenic belts around the globe. The Jurassic ophiolites in the Southern Apennines represent a natural analogue and a great opportunity for the mineralogical sequestration of CO2. Serpentinites of the Pollino ophiolite Massif have been widely studied for their mineralogical, petrographic, and chemical characteristics, providing major findings on their impact on environmental and human health issues. Serpentinites here have been divided into cataclastic and massive types based on their structures and are characterized by pseudomorphic and vein textures. The mineralogy of the studied serpentinites consists of lizardite, antigorite, clino-crysotile, Cr-chlorite, magnetite, tremolite, actinolite, pyroxene and calcite, and the most commonly occurring serpentine minerals are polymorphs of serpentine including lizardite, clino-crysotile and antigorite. Systematic petrographic and mineralogical studies of serpentinites in ophiolites, such as those outcropping in the Southern Apennines can represent a starting point for the study of natural materials, which can be used for CO2 storage and sequestration. A particular attention must be given to those carbonate phases, produced by carbonation processes to check whether the serpentinites of the Pollino Massif can be used for the induced mineral Carbon Capture Storage (CCS). If successful, this technique and the Pollino Massif serpentinites can become highly significant in safeguarding the health of our planet's climate.

Bedbug (Cimex spp.) are a nuisance public-health pest that is on the rise globally, particularly in crowded cities such as Hong Kong. To investigate the health impacts of bedbug infestations among bedbug victims, online surveys were distributed in Hong Kong between June 2019 to July 2020. Data on sociodemographics, self-rated health, average hours of sleep per day, and details of bedbug infestation were collected. Bivariate and multivariable analysis were performed using logistic regression. The survey identified 422 bedbug victims; among them, 223 (52.9%) experienced ≥5 bites in the past month, most bites occurred on the arms (n=202, 47.8%) and legs (n=215, 51%), and the most common reaction to bites were itchiness (n=322, 76.3%), redness, and swelling of the skin (n=246, 58.1%), and difficulties sleeping or restlessness (n=125, 29.6%). Bites usually occurred during sleep (n=230, 54.5%). For impact on daily life in the past month, most bedbug victims reported moderate to severe impact on mental and emotional health (n=223, 52.8%) and sleeping quality (n=239, 56.6%). Lower self-rated health (aOR&lt;1) was independently associated with impact to physical appearance (p=0.008), spending money on medication or doctor consultation (p=0.04), number of bites in the past month (p=0.023), and irregular time of bites (p=0.003). Lower average hours of sleep per day (aOR&lt;1) was independently associated with impact on mental and emotional health (p=0.016). This study brings attention to the neglected issue of bedbug infestation by considering bedbugs as an infectious agent instead of a vector and providing empirical evidence describing its health impacts.

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

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

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

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

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

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

Background User fee exemption for maternal and child health care service policy was introduced with a focus on providing free caesarean sections (CS) in Nigeria from 2011 to 2015. This policy had a positive impact on access to facility-based delivery, but its effect on socioeconomic and geographical inequality remains unclear. This study’s main objective is to examine access to birth by CS in the context of free maternal health care. Specifically, the study examines socio-demographic and geographical inequality in access to birth by CS among women who gave birth between 2011 and 2015 under the free maternal health care policy using a population-based survey data obtained from two of the six main regions of the country. Methods Data were obtained from 1227 women who gave birth during the period the policy was in operation selected using cluster random sampling between May and August 2016. Adjusted and unadjusted binary logistic regression models were used to examine whether there is socio-demographic and geographical inequality in access to birth by caesarean section. Results The overall caesarean section rate of 6.1% was found but varies by income (14.1% in monthly income of over $150 versus 4.9% in income of $150 and below), education (11.8% in women with higher education versus 3.9% among women with secondary education and less) and place of residence (7.8% in urban areas versus 3.6% in rural areas). Women who earn a monthly income of $150 or less were 48% less likely to have a birth by CS compared to those who earn more. Compared to women who were educated to tertiary level, women who had secondary education or less were 54% less likely to have birth by caesarean section. Conclusion This study shows that inequality in access to CS persists despite the implementation of free maternal health care services. Given the poor access to facilities with capabilities to offer CS in most rural areas, free maternal healthcare policy is not enough to make birth by CS universally accessible to all pregnant women in Nigeria.

This review emphasizes the significance of dietary carotenoids in promoting skin health and appearance. The applications of carotenoids in health-promoting and nutrient products and their potential health effects are discussed. Food technology, health, nutrition, dermatology, and dermoaesthetics have recently focused on colorless carotenoids, particularly phytoene, and phytofluene, which have the unique ability to absorb UV radiation. These carotenoids, being significant components of the human diet, are readily bioavailable and have demonstrated various health-promoting actions in re-cent studies. Their distinct structures and properties, such as light absorption, oxidation sensitivity, stiffness, aggregation tendency, and even fluorescence in the case of phytof-luene, contribute to their potential benefits. Furthermore, it is recommended to assess the levels of these carotenoids to evaluate skin carotenoid status accurately.

Bacteria in the gut microbiome play an intrinsic part in immune activation, intestinal permeability, enteric reflex, and entero-endocrine signaling. Gut microbiota communicates with the central nervous system (CNS) through the production of bile acids, short-chain fatty acids (SCFAs), glutamate (Glu), γ-aminobutyric acid (GABA), dopamine (DA), norepinephrine (NE), serotonin (5-HT) and histamine. A vast number of signals generated in the gastrointestinal tract (GIT) reaches the brain via afferent fibers of the vagus nerve (VN). Signals from the CNS are returned to entero-epithelial cells (EES) via efferent VN fibers and communicate with 100 to 500 million neurons in the submucosa and myenteric plexus of the gut wall, which is referred to as the enteric nervous system (ENS). Intercommunications between the gut and CNS regulate mood, cognitive behavior, and neuropsychiatric disorders such as autism, depression, and schizophrenia. The modulation, development, and renewal of nerves in the ENS, and changes in the gut microbiome alter the synthesis and degradation of neurotransmitters, which ultimately influence our mental health. The more we decipher the gut microbiome and understand its effect on neurotransmission, the closer we may get to the developing of novel therapeutic and psychobiotic compounds to improve cognitive functions and prevent mental disorders. In this review, the intricate control of entero-endocrine signaling and immune responses that keep the gut microbiome in a balanced state, and the influence that changing gut bacteria have on neuropsychiatric disorders are discussed.

In conclusion, the present study demonstrated the safety of practicing WFM at different TOD. Furthermore, it appears that practicing WF in the evening is safer, as indicated by HRR60s, [Gl], and MBP findings. The utilization of digital biomarkers for monitoring health status during WFM has been shown to be efficient.

Very poor oral health, common among older adults, is associated with cognitive decline.This study aimed to investigate the association between denture use, chewing ability, and cognitive function in Korean middle-aged adults using samples representing middle-aged people at the national level. This longitudinal study included 9,998 middle-aged adults via Korea Longitudinal Study of Aging 7th special survey data. Denture use, chewing ability, health-related factors, and general characteristics were assessed by the Computer Assisted Personal Interview. After controlling general characteristics using a generalized estimating equation model, the association of denture use and MMSE scores with chewing ability of those with or without dentures and MMSE scores were analysed. Twenty-four percent of participants wore dentures among them, 35.1% complained of difficulty chewing when wearing dentures. Among participants who did not wear dentures, 16.4% complained of difficulty chewing. MMSE scores were lower among denture-wearers than non-denture wearers (β = -0.026, p < 0.001). In both groups, MMSE scores decreased with chewing difficulty and were significantly reduced among non-denture wearers (p < 0.05). Chewing ability was closely associated with cognitive function. Given the negative effect of difficulty chewing on cognitive function, maintaining chewing ability should be of great concern.

Introduction: Childhood obesity is becoming an emerging public health issue as it is associated with increased morbidity and premature deaths. Determinants like the child’s household characteristics, maternal weight before the preconception stage, and maternal weight in childhood are studied. There is no study available to understand the association between overweight women of reproductive age and overweight children under five years of age. Studying these determinants to understand the problem can help in framing policies to intervene in the issue. Methods: The data for the study was collected from the National Family Health Survey 5 (NFHS5). It has been sub-grouped into urban and rural categories. The percentage of women with high-risk Waist-Hip-Ratio (WHR) and the percentage of overweight women were independent variables whereas the percentage of overweight under-five children was dependent. Simple linear regression, multiple linear regression, and Pearson correlation coefficient analysis were done for the collected data. Results: Study shows the percentage of overweight women has increased by 4.1%, and the percentage of overweight children has increased by 2% during the NFHS5 (2019-21) compared to NFHS4 (2015-16). Pearson correlation coefficient (R) is 0.5662 and Ꞵ-coefficient for multiple linear regression is 0.1397 for central obesity in women (%) and percentage of overweight children. Conclusion: Central obesity in women is more common than the overweight. Overweight in women as well as in children under five is increasing. Central obesity in women shows a moderate positive relation with overweight in children under five years.

This study explores how young people’s mental health was affected by the COVID-19 pandemic using artwork and semi-structured interviews. This is important to understand so that policy and practice professionals can support those affected, prepare, and respond to future crises, and support young people who are isolated and restricted in other contexts. Co-designed participatory art workshops and interviews were conducted with 16–18-year-olds (N = 21) from the London-based Longitudinal cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP). Artworks and interview transcripts were qualitatively co-analysed with young people. From interviews, six themes were identified: adaptation, restriction, change, challenges, overcoming adversity, and lockdown life. From artwork, four themes were identified; trapped, negative mental wellbeing, positive emotions, and technology. Everyday factors such as home environment, relationships, hobbies, habits, and education or work were key determinants of how challenged and restricted participants felt, and their capacity to overcome this. This implies that young people’s mental health services should collaborate with other sectors to address wider life determinants in a holistic way, and that clearer guidance and support in these areas could mitigate the negative mental health impacts of major environmental changes on young people.

Mobile applications, websites and social media networks are nowadays widely used communication tools. With the emergence of communication-related technologies in our lives and, consequently, the rise of social networks and mobile applications, health-related applications, generically encompassed under the term digital health, have become popular among the population. Smartphones and artificial intelligence have become very useful tools for health-related interventions. Because they are very accessible and cost-effective. They are also able to serve a larger number of communities than traditional interventions. Nutrition is not a field that has remained on the sidelines, and numerous mobile applications and technological tools have emerged that are intended to help and support diets or in the process of recovering from disease. However, many of these applications have limitations that are important to consider. For this reason, the aim of this review was to analyze the most widely used tools currently in use, discuss their advantages and disadvantages, and propose hypotheses for improvement.

Poliomyelitis, commonly known as “polio” is a paralytic and perilous disease caused by the poliovirus. Due to its highly contagious nature, the virus was a challenge to the world in the late 1980s. . Since 1988 the collective work of the Global Polio Eradication Initiative (GPEI), Centre for Disease Control and Prevention (CDC), and World Health Organization (WHO) through immunizations, communication awareness, and monitoring have helped the world exonerate polio. The mission of polio-free Pakistan was herculean and had confronted enormous challenges in different ways but came out with positive results. In 2019, with only two remaining polio-endemic countries, Pakistan and Afghanistan, GPEI launched an “Endgame strategy 2019-2023” which aims to eradicate polio globally, with a targeted focus, especially on polio-endemic countries, the plan emphasizes the early detection of polio cases for complete eradication and to restrict the spread of polio. Pakistan has achieved a milestone in combating polio despite having a web of factors that have thwarted Pakistan’s polio eradication efforts, but this is not the end, the struggle continues until we really get an internationally verified certification of Polio free nation, for this WHO has designed a multidisciplinary strategy 2022-2026 to really end this polio for once and for all.

Background: Exercise is increasingly understood as an important resource for people with harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. Methods: This study analyzed self-reports from 1468 inmates in Norwegian prisons, compared them according to harmful substance use pre-incarceration, and explored changes in exercise and nicotine use during incarceration. Results were presented in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Inmates with harmful substance use reported higher rates of smoking, smokeless tobacco, and physical inactivity pre-incarceration than inmates without harmful use. However, inmates with harmful use also exhibited more behavioral changes: they adopted exercise, ceased smoking, and adopted smokeless tobacco at higher rates during incarceration than the non-harmful group. Conclusions: Exercise is being taken up by a significant proportion of inmates, and may in particular be a replacement behavior for substance use. However, unhealthy behaviors are also begun or maintained. If prisons were used as an arena to facilitate healthy behaviors, the public health benefits to a marginalized group such as substance-using inmates could be substantial.

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy in the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students' perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusion: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.

The purpose of this article was to check the relashionship of different types of physical activities, BMI, smoking and alcohol consumption (with control for age, sex and level of education) on health (physical and mental). The study was based on Belgium epidemiological data (10661 participants from 19 to 81 years old for whom we have health indicators over a period of 11 years) together with questionnaires about alcohol, tobacco consumption and the frequency of different types of physical activities. Descriptive statistics and regression analysis of epidemiological data was performed with use of STATA v.14. Our results indicate that the different categories of physical activities (PA) had some differences on health indicators impacts. Our findings confirm that leading a healthy life style (all types of physical activities and weight maintenance) is an important issue since it has a significant relationship with physical and mental health indicators, but outdoor physical activities and practicing leisure sport in group have shown slightly higher magnitude in association on general health. Magnitude of association of PA with physical and mental health indicators was similar to those observed with smoking and alcohol consumption.

Mentha is one of the predominant cash crops in India. However, it is a heavy feeder of nutrients. Organic sources of nutrients not only help in adequate nutrition but also maintain favorable physicochemical and biological soil environments. The present study was conducted to evaluate the response of different combinations of nutrients with microbial bio-fertilizer on mentha crops from 2020 to 2022. The experiment was carried out in the Randomized Complete Block Design with four replications and eight treatments viz; T1 - Control, T2 - RDF (N 75 kg ha-1, P2O5 20 kg ha-1), T3 - RDF + water soaking of roots, T4 - RDF + root soaking with bio-fertilizer, T5 - RDF + bio-fertilizer @ 10 kg ha-1, T6 - 100% N from FYM + water soaking of roots, T7 - 100% N from FYM + root soaking with bio-fertilizer and T8 - 100% N from FYM + bio-fertilizer @ 10 kg ha-1. The treatment T8 (100% N from FYM + bio-fertilizer @10 kg ha-1) significantly outperformed and recorded the highest growth and yield attributes viz; emergence count, stools count, plant height, leaf area index, leaf stem ratio, fresh and dry herb yield.

Bacteriological and physico-chemical analyses of fish pond water are very important in aquaculture as they give insights into likely threats to aquaculture and associated personnel. Bacteriological and physico-chemical profiles of selected fish ponds in the Ilorin West area of Kwara State, Nigeria, were investigated to evaluate the water quality of rearing enclosures. Physico-chemical analyses revealed quality parameters were within the recommended range for aquaculture. Following bacteriological analyses of static water pond culture, the TVC and TCC showed temporal variations, with concentration increasing with sampling time. However, the FCC showed fluctuation. Totally, 8 bacteria groups were isolated from both rearing enclosures. Of these, Gram-negative bacteria showed dominance. In which 5 Gram-negative (Escherichia coli, Proteus spp, Serratia spp, Enterobacter spp, and Pseudomonas spp) and 3 Gram-positive (Staphylococcus spp, Streptococcus spp, and Bacillus spp) were encountered. Estimates of bacteria occurrence in both rearing facilities respectively gave: Staphylococcus spp (20%), Streptococcus spp (12%), Proteus spp (8%) Enterobacter spp (20%), Serratia spp (16%), Bacillus spp (9%), Escherichia coli (8%), Pseudomonas spp (7%) from earthen pond water sampled. While Staphylococcus spp (18%), Streptococcus spp (16%), Proteus spp (8%), Enterobacter spp (22)%, Serratia spp (8%), Bacillus spp (15%), Escherichia coli (8%), Pseudomonas spp (6%) from concrete water sampled. Conclusively, although there is the presence of bacteria groups of public health concern, the static water exchange provides benefits of natural processing of wastes and restoration of the pond ecosystem. Notably, the presence of Escherichia coli indicates the presence of pathogenic organisms of enteric origin. The presence of these organisms has been associated with a lack of tentative pond management and effective biosecurity procedures.

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

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

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

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

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

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

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

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

Background: Immunization prevents over 4-6 million deaths each year worldwide. Ensuring mother satisfaction is an important means of preventing the death of children caused by communicable diseases. However, in Ethiopia, there is paucity of evidence on maternal satisfaction with immunization services. Thus, this study is aimed at assessing the level of maternal satisfaction with childhood immunization services and associated factors among children’s caregivers. Methods: A facility-based cross-sectional study was conducted among 556 systematically selected children’s caregivers in public health facilities at Gondar Town from May through June, 2022. Data were collected using a pretested structured questionnaire. P≤ 0.25 during the bivariate binary logistic regression analysis was included in the multivariate analysis. From the multivariable analysis, variables with p ≤ 0.05 were declared statistically significant. Results: The prevalence of maternal satisfaction towards childhood immunization services was 69.3%(95%CI: 65.5, 73.1%). Of mothers, 45.3% had adequate knowledge, while 43.9% had favorable attitude. Mothers 19-24 years old [AOR = 5.29; 95%CI:2.58,10.86], mothers who waited less than one hour [AOR = 3.03; 95%CI: 1.92,4.77], mothers less than thirty minutes waiting in health facility[AOR=1.98;95%CI:1.24,3.15], mother feel happy during service[ AOR=4.00; 95%CI: 2.53,6.34], mothers adequate knowledge [AOR=2.91; 95%CI: 1.79, 4.73] and had favorable attitude [AOR=3.64; 95%CI: 2.25, 5.91] were significantly associated with maternal satisfaction during childhood immunization services.Conclusions: The overall level of mothers’ satisfaction with childhood immunization services was considerably lower as compared with other studies. Thus, the town health office and concerned stakeholders need more efforts to improve mothers’ satisfaction with childhood immunization services.

The rate of fires, and particularly residential-fires, is a serious concern in industrialized countries. However, there is considerable uncertainty regarding the reported numbers of residential-fire incidents as official figures are based on fires reported to fire response agencies only. This population-based study aims to quantify the total number of residential-fire incidents regardless of reporting status. The cohort comprised linked person-level data from Fire and Rescue New South Wales (FRNSW) and health system and death records. It includes all persons residing at a residential address in New South Wales, Australia, that experienced a fire between 1 January 2005 – 31 December 2014. Capture-Recapture method was used to estimate the underreporting number of residential fire-related incidents. Over the study period, 43,707 residential-fire incidents were reported to FRNSW and there were 2,795 residential fire-related health service utilization of which 2,380 were not reported. Using Capture-Recapture method, the total number of residential-fire incidents was estimated at 267,815 to 319,719 which is more than six times the official records. This study found that 15% of residential-fire incidents that were identified in health administrative dataset were reported. The residential-fire incidents that were not reported occurred mainly in socio-economically disadvantaged areas among the males and adults.

This research was aimed to apply probiotics in aquaculture to improve fish health and growth performances of Nile tilapia. Fingerlings with a mean initial body weight of 11.43±1.27 and mean initial body length of 6.2±0.84 were stocked in 12 happas. Fish were fed four times daily with four different diets having 30% crude protein at 5% of their body weight and reared for two months. The four diets were control diet, diets treated with Saccharomyces cervisiae, Lactobacillus fermentum and their combinations at a dosage of (1.5×108CFU/ml). Growth performance and gut pathogenic microbial of fish were investigated. Accordingly results indicated that the highest performance interims of body weight gain (33.43±1.65g), daily growth rate (0.51±0.05g), feed conversion ratio (1.89±0.10), and protein efficiency ratio (1.78±0.09) was achieved in fish fed with L. fermentum whereas, the lowest performance (19.83±2.23, 0.33±0.04, 3.52±0.39, and 0.97±0.11) respectively was achieved in fish fed with control diet. Salmonella, Shigella, E. coli and, Proteus were detected in gut of fish. In conclusion, the present study confirmed that Nile tilapia fed with probiotics Lac-tobacillus fermentum and Saccharomyces cerevisiae based diets improved growth and health of Nile tilapia reared under pond culture condition.

China faces a persistent deficiency in feed protein resources. Enhancing the utilization efficiency of indigenous feed protein resources emerges as a viable strategy to alleviate the current deficit in protein feed supply. Corn gluten meal (CGM), characterized by high proportion of crude protein and glutamine, is predominantly employed in animal feed. Nonetheless, the water-insolubility of CGM protein hampers its protein bioavailability when utilized as feed material. This study aimed to augment protein bioavailability, liberate glutamine peptides from CGM, and produce gluta-mine-enriched CGM fermented feed. We executed a co-fermentation protocol using Bacillus subtilis A5, Lactobacillus 02002, and acid protease to generate the CGM fermented feed. Subsequent in vivo experiment with broilers were conducted to assess the efficacy of the fermented product. Findings revealed that the soluble protein, glutamine, small peptides, and lactic acid contents in the fer-mented feed increased by 69.1%, 700%, 47.6%, and 125.9%, respectively. Incorporating CGM fermented feed into the diet markedly enhanced the growth performance and intestinal health of broilers, positively modulated the cecal microbiota structure, and augmented the population of beneficial bacteria, specifically Lactobacillus. These results furnish both experimental and theoretical foundations for deploying CGM fermented feed as an alternative protein feed resource.

The study of the distribution and health risk assessment is meaningful to provide basic data for environmental management．To investigate the pollution of potential toxic organics and their health risk to human beings, water samples were collected at 7 sites of main surface water of Beijing during wet and dry seasons respectively. The targeted 92 organics were detected, including phthalates (PAEs), volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and phenols. The results showed that: there were 56 organics detected out, and the number ratios of detected compounds to the total compounds of the same kind increased as the following: VOCs, phthalates, phenols, PAHs. 8 VOCs were detected in wet season, and 3 in dry season. The concentration of 2,2-Dichloropropane was highest as 10.62ug/L, while the concentrations of other VOCs were below 5ug/L; There were 11 phthalates detected during dry season. The content of Bis(2-methoxyethyl) phthalate was highest as 188.47ng/L; 17 phenols were found in samples during wet season, and the highest concentration was 1244.73ng/L for 4-nitrophenol; PAHs could be detected in all samples, and the detected compounds and the corresponding average concentrations were higher in wet seasons than those in dry seasons, which indicated that non-point pollution was possibly the main pollution source. The health risk assessment of the detected 56 pollutants by using a model from US EPA showed that, the risk caused by the four kinds of toxic organics in this study was in the acceptable ranges.

We aimed at developing and validating a scale on the beliefs and attitudes of mental health professionals towards services users’ rights in order to provide a valid evaluation instrument for training activities with heterogeneous mental health professional groups. Items were extracted from a review of previous instruments, as well as from several focus groups which have been conducted with different mental health stakeholders, including mental health service users. The preliminary scale consisted of 44 items and was administered to 480 mental health professionals. After eliminating non-discriminant and low weighting items, a final scale of 25 items was obtained. Exploratory and confirmatory factor analyses produced a four-factor solution consisting of the following four dimensions; system criticism/justifying beliefs, freedom/coercion, empowerment/paternalism, and tolerance/discrimination. The scale shows high concordance with our theoretical model as well as adequate parameters of explained variance, model fit, and internal reliability. Additional work is required to assess the cultural equivalence and psychometrics of this tool in other settings and populations, including health students.

Growth hormone (GH) deficiency affects up to 1 in 4,000 children and is usually treated with daily injections of GH whilst the child is still growing. With children typically diagnosed around 5 years old, this can mean over 10 years of therapy, which can place a considerable burden on the child and parent. Over three-quarters of children are estimated to be not fully compliant with therapy, which can compromise their chances of attaining their target height. In recent years, interactive mobile health (smart phone or tablet) interventions using game-like concepts, so called ‘gamification’, have increased in popularity and have demonstrated success in promoting positive self-management behaviour in children with chronic conditions, such as diabetes. The application of gamified interventions has the potential to support adherence to therapy and positive behaviour in children with GH deficiency in a number of ways: 1) By providing education in a format that the child understands and accepts (e.g. using behavioural constructs to facilitate explaining why adherence is important); 2) By providing a mechanism to reduce the anxiety and stress associated with administering the injection (e.g. diversion with a virtual pet); and 3) By providing feedback to encourage on-going engagement (e.g. rewards, progression through levels).

Mental health issues can have significant impacts on individuals and communities and hence on social sustainability. There are several challenges facing mental health treatment, however, more important is to remove the root causes of mental illnesses because doing so can help prevent mental health problems from occurring or recurring. This requires a holistic approach to understanding mental health issues that are missing from the existing research. Mental health should be understood in the context of social and environmental factors. More research and awareness are needed, as well as interventions to address root causes. The effectiveness and risks of medications should also be studied. This paper proposes a big data and machine learning-based approach for the automatic discovery of parameters related to mental health from Twitter data. The parameters are discovered from three different perspectives, Drugs & Treatments, Causes & Effects, and Drug Abuse. We used Twitter to gather 1,048,575 tweets in Arabic about psychological health in Saudi Arabia. We built a big data machine learning software tool for this work. A total of 52 parameters were discovered for all three perspectives. We defined 6 macro-parameters (Diseases & Disorders, Individual Factors, Social & Economic Factors, Treatment Options, Treatment Limitations, and Drug Abuse) to aggregate related parameters. We provide a comprehensive account of mental health, causes, medicines and treatments, mental health and drug effects, and drug abuse, as seen on Twitter, discussed by the public and health professionals. Moreover, we identify their associations with different drugs. The work will open new directions for social media-based identification of drug use and abuse for mental health, as well as other micro and macro factors related to mental health. The methodology can be extended to other diseases and provides a potential for discovering evidence for forensics toxicology from social and digital media.

Access to health services compromises therapeutic adherence in patients with HTN, which is a risk factor for cardiovascular disease and premature death. The aim of the research is to determine the influence of access to health services on adherence to antihypertensive treatment during the COVID-19 pandemic. We included a cross-sectional analytical study. A survey was applied to 241 hypertensive patients at the Daniel Alcides Carrión Hospital, Callao-Peru. Data were analyzed using SPSS software. Absolute and relative frequencies were reported and the chi-square test was applied with a statistical significance level of p&lt;0.05. In addition, multiple logistic regression analysis was performed using the Stepwise method. An association was found between non-adherence to treatment and health expenses (ORa: 1.9 CI 95% 1.7-2.2), not receiving care due to lack of a doctor (ORa: 2.8 CI 95% 1.5-3.2), having difficulty with schedules (ORa: 3.7 CI 95% 2. 3-5.5), fear of receiving care at the hospital (ORa: 4.5 CI 95 % 2.7-6.8), trust in health personnel (ORa: 7.5 CI 95% 2.3-10.5) and considering that the physician does not have enough knowledge (ORa: 3.1 CI 95% 2.4-7.8). Therapeutic adherence was associated with physician availability for care, difficulty with schedules, fear of being seen in the hospital, trust in health personnel, and waiting time.

Objective. It is unknown whether the public accurately estimate socioeconomic health inequality and whether they wish to see it reduced or eliminated. Methods. Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We present perceived and desired lifespan ratios for each sample and for key socio-demographic variables. Results. The UK public estimated the lifespan of professionals to be 5.9% longer than routine workers (true value of 5.8%), and 67.8% (UK) and 53.7% (US) participants correctly identified that professionals live longer than routine workers. In both populations, the median respondent expressed equal ideal lifespans for routine workers and professional workers. Conclusion. The UK public appear well-appraised on the average lifespan for professionals and routine workers. Across nationalities and most socio-demographic groups, the median respondent was aware of social class inequalities in lifespan and preferred that they be eliminated.

Although it may seem paradoxical, primary care and mental health professionals develop prejudices and discriminatory attitudes towards people with mental health problems in a very similar way to the rest of the population. The main objective of this project was to design, implement and evaluate two awareness interventions respectively tailored to reduce stigma and discrimination beliefs and attitudes towards persons with a mental health diagnosis among primary care (PC) and mental health (MH) professionals. These interventions were developed by Obertament, the Catalan alliance against stigma and discrimination in mental health. The TLC3 (Targeted, Local, Credible, Continuous Contact) methodology was adapted to the Catalan PC and MH professional contexts. Activists with lived experience of mental health diagnosis carried out awareness-raising interventions in PC and MH health centres. The efficacy of these interventions was evaluated using two prospective double-blind cluster-wait-list-randomized-controlled trial experimental designs. Stigmatizing beliefs and behaviours were measured with the Opening Minds Stigma Scale for Health Care Providers in primary care centres and with the Beliefs and Attitudes towards Mental Health Service users’ rights in mental health centres. Positive reductions in both PC and MH professionals’ stigmatising beliefs and attitudes were found in the 1-month follow-up, although a ‘rebound effect’ at the 3-month follow up was also detected. This emphasizes the importance of the continuity of the presence of anti-stigma activities and messages. Attrition rates where high, which can hamper the reliability of the results. Further follow-up studies should enquiry effects of long-term interventions aimed at reducing stigmatising beliefs and attitudes among primary care and mental health professionals.

Migratory movements are a political, social and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence on IMW's experiences of sexual and reproductive health care in emergency and primary care settings. Methods: meta-synthesis of qualitative studies. Synthesis includes assembling and categorising findings based on the simili-arty in meaning. The search was conducted between January 2010 and June 2022 using PubMed, WOS and CINAHL databases. Results: of 131 articles found in the initial search, only 9 articles met the criteria and were included in the review. Four main themes were established: (1) The need to focus emergency care on sexual and reproductive health, (2) Unsatisfactory clinical experiences, (3) Forced reproduction, (4) Alternating between formal and informal healthcare services. Con-clusions: IMW’s attitudes towards sexual and reproductive health are influenced by culture, ed-ucational level, fear, barriers and the attitude of healthcare providers. Healthcare institutions need to be aware of the IMW’s experiences to understand the specific difficulties they face. IMW call for socially and culturally sensitive health care, cultural mediators, improved communication and safe environments that ensure confidentiality.

In Mexico, it is estimated that due to the economic system the overexploitation of natural resources, environmental impacts and health have been generated, with high rates of overweight and obesity. This review analyzes the impacts on food safety, environmental health, and the economy in Mexico before and during the COVID-19 contingency. Derived from the analysis, among the lessons learned we can include: the health contingency due to COVID-19 had negative repercussions on food security, environmental health and the economy, which require the promotion of public policies (health, environment and economy) and migrate to a health prevention system and an agroecological model, which includes multidisciplinary and intersectoral interventions (government, academia, researchers, civil society organizations, business groups and citizens themselves) to reform and enforce the right to enjoy adequate food and a healthy environment. The contingency due to COVID19 has shown us that this must go from an ideology to being a reality and the lessons learned will have to focus on promoting an innovative and ethical culture of generating an economy, with a gender balance, resilience to climate change, management transparent technology and a priority in health and this will lead to progress in the food security of the population.

The advent of the genome editing era brings forth the promise of adoptive cell transfer using engineered chimeric antigen receptor (CAR) T-cells for targeted cancer therapy. CAR T-cell immunotherapy is probably one of the most encouraging developments for the treatment of hematological malignancies. In 2017, two CAR T-cell therapies were approved by the U. S Food and Drug Administration; one for the treatment of pediatric Acute Lymphoblastic Leukemia (ALL), the other for adult patients with advanced lymphomas. However, despite significant progress in the area, CAR T-cell therapy is still in its early days and faces significant challenges, including the complexity and costs associated with the technology. B-cell lymphoma is the most common hematopoietic cancer in dogs, with an incidence approaching 0.1% and a total of 20-100 cases per 100,000 individuals. It is a widely accepted naturally occurring model for human non-Hodgkin’s lymphoma. Current treatment is with combination chemotherapy protocols, which prolong life for less than a year in canines and are associated with severe dose-limiting side effects, such as gastrointestinal and bone marrow toxicity. To date, one canine study generated CAR T-cells by transfection of mRNA for CAR domain expression. While this was shown to provide a transient anti-tumor activity, results were modest, indicating that stable, genomic integration of CAR modules is required in order to achieve lasting therapeutic benefit. This Commentary summarizes the current state of knowledge on CAR T-cell immunotherapy in human medicine and its potential applications in animal health, while discussing the potential of the canine model as a translational system for immuno-oncology research.

The Infectious and Tropical Diseases Department of University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast Track City commitment. A cross-sectional study was conducted, consisting of an anonymous, multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18-40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Individuals over the age of 40 and those who identified as heterosexual had the lowest level of knowledge about HIV transmission (7.9% and 30% respectively), undetectable=untransmittable (19.7% and 39.4% respectively) and PrEP (9.2% and 18.2% respectively). They were also less willing to cohabit with people with HIV (PLHIV). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. People over the age of 40 had the largest gaps in knowledge and would benefit the most from educational and prevention interventions.

The use of machine learning (ML) approaches to target clinical problems is called to revolutionize clinical decision-making. The success of these tools is subjected to the understanding of the intrinsic processes being used during the classical pathway by which clinicians make decisions. In a parallelism with this pathway, ML can have an impact at four levels: for data acquisition, predominantly by extracting standardized, high-quality information with the smallest possible learning curve; for feature extraction, by discharging healthcare practitioners from performing tedious measurements on raw data; for interpretation, by digesting complex, heterogeneous data in order to augment the understanding of the patient status; and for decision support, by leveraging the previous step to predict clinical outcomes, response to treatment or to recommend a specific intervention. This paper discusses the state-of-the-art, as well as the current clinical status and challenges associated with each of these tasks, together with the challenges related to the learning process, the auditability/traceability, the system infrastructure and the integration within clinical processes.

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

Numerous studies have shown that pesticide exposure is linked to adverse health outcomes. Nevertheless, in Bolivia, where there is an increasing use of pesticides, including those restricted or banned in industrialized nations, the literature is spare. To address knowledge gaps and guide future research in Bolivia, we conducted a scoping review crossing 22 years (January 2000 to December 2022). Our search identified 37 peer-reviewed articles and 27 reports/documents on Bolivian regulations. Most studies focused on farmers and revealed high pesticide exposure levels, assessed through biomarkers of exposure, susceptibility, and effect. Literature explored a range of health effects due to pesticide exposure, spanning acute to chronic conditions. Many studies highlighted the correlation between pesticide exposure and genotoxic damage, measured by DNA strand breaks and/or micronuclei formation, particularly in farmers without personal protection equipment (PPE), which increases the risk of developing chronic diseases, including cancer. Recent findings also showed the alarming use of banned or restricted pesticides in Bolivian crops. Despite existing Bolivian regulations, the uncontrolled use of pesticides persists, evidencing the harmful health effects on the population and increasing land and water pollution. These findings underscore the need for stringent enforcement of regulations and provide a scientific foundation for decision-making by relevant authorities.

Information and telecommunications technology (ITT) have expanded into many aspects of modern life and have positively affected human life even in the most remote areas of developing countries. The rapid growth in ITT has led to an improvement in the capacity of computers but simultaneously to a decrease in the product’s lifetime as a result of which increasingly large quantities of e-waste are generated annually. It contains hazardous components that if it is not properly managed, can have adverse environmental and health effects. The management of e-waste poses significant challenges in developing countries. Due to the lack of adequate infrastructure, e-waste is burned or dumped in open areas. Informal and inefficient recycling practices are generally employed which further exacerbate pollution and health risks. So, the implementation of e-waste management, adequate recycling, and waste disposal facilities have become crucial concerns. This article reviews the concept of e-waste generation, challenges, disposal, and its impact on human health & environment in detail.

Climate change (CC) poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, a climate-vulnerable nation, has experienced significant natural disasters in the past 42 years, impacting its health system. This study aims to assess Mozambique’s health sector vulnerability and adaptation needs to climate change. Following a methodology proposed by the World Health Organization and Intergovernmental Panel for Climate Change, a six-step vulnerability and adaptation assessment was conducted. The Health Vulnerability Index (HVI), integrating historical climate, epidemiological, and socio-economic data at the district level (n=162), was computed using exposure, sensitivity, and adaptive capacity dimensions. The Results revealed spatial patterns in exposure to climate variables, extreme weather events, and variations in sensitivity and adaptive capacity across the country. The HVI mirrored the exposure findings. Notably, high vulnerability was observed in several districts, while major urban centers displayed lower vulnerability. These findings highlight the country’s vulnerability to climate change and underscore the potential for adverse impacts on livelihoods, the economy, and human health. The study provides a foundation for developing strategies and adaptation actions.

Malaria is a constant reminder of the climate change impacts on health. Many studies have investigated the influence of climatic parameters on the of malaria transmission. Climate conditions can modulate malaria transmission through increased temperature, which reduces the duration of the parasite's reproductive cycle inside the mosquito. The intensity and frequency of the rainfall modulate the development of the mosquito population. In this study, the Liverpool Malaria Model (LMM) is used to simulate the spatio-temporal variation of the malaria incidence in Senegal. The simulations are based on the WATCH Forcing Data applied to ERA-Interim data (WFDEI) used as a point of reference, and biased-corrected CMIP6 models, separating historical and projections for 3 Shared Socio-economic Pathways scenarios (SSP126, SSP245 and SSP585). Our results highlight a strong increase in temperatures, especially towards eastern Senegal under the SSP245 but mainly the SSP585 scenarios. The ability of the LMM model to simulate the seasonality of malaria incidence is assessed. The model reveals a period of high malaria transmission between September and November with a maximum reached in October. Results indicate a decrease in malaria incidence in certain regions of the country for the far future and for the extreme scenario. This study is importance for the planning, prioritization, and implementation of control activities in Senegal.

This study aims to comparatively analyse the importance and performance of the health of Korean and Japanese adolescents during the prolonged coronavirus disease 2019 (COVID-19) pandemic. Data were collected from 1,341 sampled Korean and Japanese adolescents in September 2021 through online and offline surveys. The collected data were analysed with frequency analysis, reliability testing, t-test, and importance-performance analysis (IPA). The following results were obtained. First, adolescents in the two countries perceive various factors about health as important during the COVID-19 pandemic, but their performance is weak compared to their perceived importance. Second, Korean adolescents had greater perceived importance for all factors of health perception compared to their Japanese counterparts. Third, the difference in performance between Korean and Japanese adolescents was especially evident for ‘hygiene management’, and there were significant differences in performance in ‘disease management’ and ‘physical activity’. Fourth, in quadrant 4 of the IPA matrix, there were similarities and differences in a particular factor of health perception between Korean and Japanese adolescents. Based on these results, we proposed measures to emphasise the importance of health and enhance performance among Korean and Japanese adolescents.

Stunting in children is a serious problem of nutritional disorders and is strictly monitored by the Indonesian government, it is not only cause physical but also cognitive abnormalities in the form of less intelligence in children so that when they grow up, their productivity will decrease. The incidence of stunting in 2018 in Indonesia was 30.8 %, while in West Java was 29.92%, still at a moderate to high level, consequently, prevention and early detection efforts need to be carried out by various parties, including health professionals and health cadres. Therefore, the aim of this study was to examine the association between the socio demographic characteristics factors as well as the knowledge and motivation of health cadres in the stunting prevention in West Java. A correlational study with a cross-sectional approach was employed with the samples of health cadres from 8 districts/cities in West Java Province: Karawang, Tasikmalaya, Garut, Bandung, Subang, Sukabumi, Cianjur, and West Bandung. A total of 363 health cadres participated and the sampling technique used is the stratified method. The data were collected using a questionnaire developed specifically for this study and were analyzed using a correlation with Chi-Square test and presented in the form of a frequency distribution. The study findings found that majority of the health cadres have good knowledge of 81.27%, which was significantly influenced by education level and marital status with p &lt;0.05. Meanwhile, approximately half of the respondents had moderate motivation with 47.66%, while one-third or 39.12% had high motivation. This motivation was significantly influenced by education level, marital status, and age with p &lt;0.05. It was concluded that health cadres need to further enhance the roles and functions in the prevention and early detection of stunting in West Java by providing continuous guidance, stunting training prevention and award presentations.