Despite increasing research efforts, there is a lack of consensus on defining aging or health. To understand the underlying processes, and to foster the development of targeted interventions towards increasing one’s health, there is an urgent need: (1) to find a broadly acceptable and useful definition of health, based on a list of features (which may or may not be molecular); (2) to operationalize features of health so that it can be measured; (3) to identify predictive biomarkers and (molecular) pathways of health, and (4) to suggest interventions, such as nutrition and exercise, targeted at putative causal pathways and processes. Based on a survey of the literature, we propose to define health as a state of an individual characterized by the core features of (a) physiological function, (b) cognitive function and (c) physical function, amended, specifically in case of humans, by (d) lack of disease, and by (e) reproductive function. Often used concepts such as lack of frailty, allostatic load, or self-reported health (in case of human), and indices such as the Healthy Aging Index can be viewed as projections or surrogates of our definition. We further define aging as the set of all processes in an individual that reduce its “wellbeing”, that is, its health or survival or both. We define biomarkers of health by their attribute of predicting future health better than chronological age. We define healthspan pathways as molecular features of health that relate to each other, specifically by belonging to the same molecular pathway. Our conceptual framework may integrate diverse operationalizations of health and guide precision prevention efforts that are a key to reducing the need for medical and nursing care.

In 2014, a whistleblower reported that many U.S. veterans died while waiting for care at the Phoenix VHA. Problems with veteran’s care through 2018 reveal ongoing and systematic problem. In March 2018, the VA Inspector General identified critical deficiencies at the Washington, DC VA Medical Center including failures to track patient safety events accurately, ineffective sterile processing, and more than 10 thousand open or pending prosthetic / sensory aid consults. The VHA clearly has problems with access and quality in a budget-constrained environment. In this policy analysis, four separate interventions that address the gap between the magnitude as well as the use of the VHA’s fixed budget versus access and cost expectations are explored. These policy interventions include maintaining the status quo, returning to a “VHA-only” option, transitioning to a CMS central payer system, and consolidating care under the DoD TRICARE insurance plans. An objective evaluation suggests that extending TRICARE to veterans while phasing out the VHA’s care responsibilities, while politically unpalatable, would likely provide the best of four possible solutions under various criterion weighting schemes. A central payer solution under the CMS would also be viable consideration. A Friedman’s test with Wilcoxon rank sum post-hoc tests suggests that TRICARE patient perceptions of quality are superior to VHA and non-VHA / non-DoD (p<.001), that access provided by the TRICARE program is ranked second in terms of venue acceptance only to the CMS solution set based on primary provider acceptance, and that the cost per beneficiary of a TRICARE solution ($6.5K / beneficiary) is far better than a VHA-only solution ($14.0 K / beneficiary), the CMS central payer solution ($12.2K / beneficiary), or the status quo (between $12.2K and $14.0K / beneficiary). The intent of this paper is to provoke thoughtful consideration of solutions for providing access to high-quality healthcare for veterans within our outside of the VHA. In this policy analysis, separate interventions that address the gaps between cost, quality, and access are explored. These policy interventions include maintaining the status quo, returning to a VHA-only option, transitioning to a CMS central payer system, and consolidating care under TRICARE.

An ambitious citizen-science effort in the city of Indianapolis (Indiana, USA) led to the collection and analysis of a large number of samples at the property scale, facilitating the analysis of differences in soil metal concentrations as a function of property location (i.e., dripline, yard, and street) and location within the city. This effort indicated that dripline soils had substantially higher values of lead and zinc than other soil locations on a given property, and this pattern was heightened in properties nearer the urban core. Soil lead values typically exceeded the levels deemed safe for children’s play areas in the US (<400 ppm), and almost always exceeded safe gardening guidelines (<200 ppm). As a whole, this study identified locations within properties, and cities, that exhibited the highest exposure risk to children, and also exhibited the power of citizen science to produce data at a spatial scale (i.e., within a property boundary) that is usually impossible to feasibly collect in a typical research study.

Prevalence rates of anger and aggression are often higher in military personnel, so it is important to understand more about why this is and factors with which they are associated. Despite this, there is little evidence relating to anger and aggression in UK veterans who are seeking treatment for mental health difficulties such as PTSD. This study investigated the prevalence rates of anger and aggression in this population, as well as the associations between anger and aggression, and various sociodemographic, functioning and mental health variables. A cross-sectional design was used, with participants completing a battery of self-report questionnaires. Prevalence rates for significant anger and aggression were 74% and 28% respectively. Both women and those over 55 were less likely to report difficulties. Those with high levels of PTSD and other mental health difficulties were more likely to report anger and aggression. Other factors related to anger and aggression included childhood adversity; unemployment due to ill health; and a perceived lack of family support. Findings show that veterans who are seeking support for mental health are likely to experiencing significant difficulties with anger and aggression, especially if they have co-morbid mental health difficulties. The associations between anger and aggression and other variables has implications for the assessment and treatment of military veterans.

Background: Foodborne disease is a major public health concern in both developed and developing countries. China has established a nationwide Foodborne Disease Outbreak Surveillance System (FDOSS) for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in China. Each provincial Centers for Disease Control and Prevention (CDC) conducts the system working. Methods We reviewed foodborne disease outbreaks that occurred during 2011-2016 in Shandong Province from the FDOSS. The Wilcoxon test was used to compare the median number of ill persons in outbreaks. All data analysis was performed using Epi Info 7. Results: During 2011-2016, Shandong CDC received reports of 1043 foodborne disease outbreaks, resulting in 8078 illnesses, 2442 hospitalizations, and 17 deaths. Hotels were the most common setting. Among the 744 (71.3%) outbreaks with an implicated food or contaminated ingredient reported, 704 (94.6%) could be assigned to one of 17 predefined commodity categories. Of the 280 outbreaks with a known aetiology, 117(41.8%) were caused by poisonous plants and animals and their toxins, 39(13.9) were caused by nitrite, and 27(9.6%) were caused by vibrio parahaemolyticus. Conclusion: Timely investigation, disposal and reporting of foodborne disease outbreaks provides information that might help FDOSS to make full use of efficiency and FDOSS should be continued and strengthened even more in Shandong Province, such as an increase in diagnostic laboratory capacities.

The objective of the research was to evaluate the concentration of organochlorine pesticides in sediment of the Alvarado Veracruz lagoon system, Mexico. To define the risk that causes to the public health the consumption of organisms that inhabit in sediments of this ecosystem. In 20 out of 41 stations analyzed, 11 prohibited organochlorine pesticides were identified, such as hexachlorocyclohexane, lindane, aldrin, dieldrin, endrin, among others. The highest concentrations were: aldrin 46.05; β-HCH 42.11; α-HCH 38.44; γ-HCH (lindane) 34.20; δ-HCH 31.61; methoxychlor 29.40; heptachlor epoxide 25.70; heptachlor 24.11; dieldrin 22.13; endrin 21.23; and endrin aldehyde 12.40 ng g-1. Concentrations reported are prohibited in international standards. In Mexico it is necessary to establish permissible limits in the environmental legislation for this matrix. There is a strong need to demonstrate, with scientific studies, the level of concentration reported by impact of compounds widely used in agricultural-livestock activities.

National heatwave plans are aimed at reducing the avoidable human health consequences due to heatwaves, by providing warnings to and improving communication between relevant stakeholders. The aim of this study was to assess the perceptions of key stakeholders within plans in Belgium and the Netherlands on their responsibilities, the partnerships, and the effectiveness of the local implementation in Brussels and Amsterdam. Key informant interviews were held with stakeholders that had an important role in development of the heatwave plan in these countries, or its implementation in Brussels or Amsterdam. Care organisations, including hospitals and elderly care organisations, had a lack of familiarity with the national heatwave plan in both cities, and prioritised heat the lowest. Some groups of individuals, specifically socially isolated individuals, are not sufficiently addressed by the current national heatwave plans and most local plans. Stakeholders reported that responsibilities were not clearly described and that the national plan does not describe tasks on a local level. We recommend to urgently increase awareness on the impact of heat on health among care organisations. More emphasis needs to be given to the variety of heat risk groups. Stakeholders should be involved in the development of updates of the plans.

Interrelationships between traditional dental variables are becoming more evident in far reaching aspects of life such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life (QoL) in postmenopausal women (PMW) with poor oral health (POH) with QoL in PMW with good oral health. 200 randomly recruited PMW received a dental evaluation and completed Utian Quality of Life Survey. The participants were divided into POH and healthy groups based on dental exam. Mean scores were calculated for each QoL item, domain and the overall summary score. For each of the four parameters for periodontitis diagnosis, periodontitis patients’ QoL outcomes were compared to those of healthy patients using T-test with threshold of significance at p<0.05. QoL in all fields measured were significantly poorer in the POH compared to the healthy patients, occupational (19.95±5.35vs. 27.56±6.13), health (18.02±8.23 vs. 26.59 ±6.45), emotional (15.68±10.22vs. 21.15±9.15), sexual (6.2±5.98vs. 10.02±5.35), and total score (60.21±25.85 vs. 84.26±22.35). This study finds that PMW with POH, report significantly poorer quality of life. Clinicians caring for PMW should be aware of that oral health impacts QoL and make appropriate referral decisions for patients’ dental care. Keywords: Quality of Life, Oral Health, Post-menopause, Women

Particulate matter (PM) is one of the problems faced in environmental science. It has health effects on man and animals in both developed and developing countries. Research and efforts have been on it several years back. Policy statements and efforts have been published. This review paper is an added information on air pollution. In it, efforts were made in discussing these: classification, effects, methodology, case studies and source apportionment. It is hoped that this paper would contribute to existing knowledge on PM.

In Belgium, sex work was recently decriminalized to enhance street-based sex workers’ (SSWs) health. This qualitative study explores stakeholders' perceptions of the impact of the working environment on street-based sex workers’ occupational safety, health and well-being in Brussels. In-depth interviews with seven stakeholders directly involved with SSWs were conducted with data analyzed using qualitative content analysis. The analysis of study data resulted in one theme: “A power imbalance and a lack of concerted efforts among stakeholders are detrimental to the occupational safety, health, and well-being of street-based sex workers”. In Brussels, the majority of SSWs face various challenges due to structural vulnerabilities, thus limiting their choices regarding their work environment, and further compromising their health. Limited access to resources and severe constraints within their working environment contribute to a lack of safety and adverse health outcomes. A stigma mechanism fueled by ideology and personal interests prevent the enforcement of their rights regarding their working environment, safety and health promotion. The lack of involvement of key stakeholders, especially from the public sector, prevents the majority of SSWs in Brussels from benefiting from a sound working environment and the promotion of their health, safety and well-being.

The burden of bacterial bloodstream infections (BSIs) is rapidly increasing in Africa including Rwanda. This is a retrospective study investigates the diversity, distribution, and antimicrobial susceptibility profiles of BSIs bacteria in three tertiary referral hospitals in Rwanda between 2020 and 2022. A total of 1,532 blood culture tests were performed for visiting patients. Overall, the proportions of Gram-negative and Gram-positive bacteria were 48.2% and 51.8, respectively. Staphylococcus aureus was the predominant species accounting for 25% of all Gram-positive BSIs species and Klebsiella species representing 41% of all Gram-negative BSIs species. Antimicrobial susceptibility testing revealed that Amikacin exhibited the highest activity against Enterobacter spp., Serratia spp. and Escherichia coli in &gt;92% of cases and Klebsiella spp. in 75.7%. Meropenem and Imipenem were highly efficacious to Salmonella spp. (100% susceptibility), Enterobacter spp. (96.2% and 91.7%, respectively), and Escherichia coli (94.7% and 95.5%, respectively). The susceptibility of Enterococcus spp., S. aureus, and Streptococcus spp. to Vancomycin was 100%, 99.5% and 97.1%, respectively. Klebsiella spp. was highly sensitive to Colistin (98.7%), Polymyxin B (85.6%), Imipenem (84.9%), and Meropenem (78.5%). We recommend strengthening the implementation of integrated transdisciplinary and multisectoral One Health including AMR-stewardship for the surveillance, prevention, and control of AMR in Rwanda.

Transportation contributes significantly to greenhouse gas emissions, with electrification offering a promising solution. This study evaluates the degradation of State of Health (SOH) over 2.5 years for electrified buses under different charging protocols: DC Fast charging and Flash charging. The vehicles’ models, charging protocols, and financial implications are discussed. High-level simulations reveal that after 2.5 years, the Flash charging vehicle’s SOH reaches 88.93%, while the DC fast charging vehicle reaches 89.46%, showing a 0.47% difference. This slight variance is attributed to Flash charging vehicles avoiding full charge/discharge cycles, reducing battery aging impact. Considering this minimal SOH degradation difference, the choice between DC Fast charging and Flash charging primarily hinges on capital expenditure disparities. Flash charging, with its lower initial battery capacity and reduced capital costs, presents a compelling alternative for city busoperators seeking to electrify their fleets.

The paper proposes an approach to determine the optimal number of medical specialists in the region. According to the author's theoretical model, in order to maximize public welfare, the marginal contribution of the last physician recruited to the growth of the public utility function should be equal to the marginal cost of attracting him and providing conditions for his work. To empirically assess the contribution of physicians to the number of lives saved, the CVD mortality rate is modeled using the instrumental variable method. On average, a 1% increase in the number of cardiologists is associated with a 0.6% decrease in cardiovascular mortality. At the level of provision with cardiologists in the amount of 1 per 100 thousand people, their marginal contribution to the number of lives saved is not less than 129 per 100 thousand people, with a further decrease by 5 people with the increase in the level of provision by 1 unit. The use of the obtained results will increase the validity of managerial decisions and in determining the optimal level of doctors when choosing between alternative possibilities of spending money on hiring doctors of different profiles or other expenses, especially in the case of limited resources.

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.

The health of urban citizens is defined by how their living environments are planned, built, and operated. These complex relations between health and the characteristics of built environments require system-orientated thinking and transdisciplinary interventions, yet have mainly been addressed using conventionally narrow sector-based approaches. This paper investigates the opportunities and challenges of the Vietnamese Green Building Movement (GBM) based on a transdisciplinary approach, with attention to additional health benefits of green buildings that are currently under-researched, while highlighting building users’ perspectives. Focusing on the perspectives of high-rise building residents, the paper examines transdisciplinary insights collected from six thematic webinars, expert interviews, and, in particular, from a household survey conducted in Ho Chi Minh City, Vietnam. Among other findings on opportunities and challenges for the Vietnamese GBM, the paper points out a challenging mismatch between the high importance homebuyers place on green building health benefits, and the focus of GBM stakeholders on GB energy-saving benefits- which are not necessarily homebuyers’ most pressing concerns. With this evidence-based inquiry, the paper concludes that improved health and well-being should be considered co-benefits of green buildings, along with energy efficiency. Importantly, this paper also brings attention to the necessity of a systemic and transdisciplinary approach in both academic and practical efforts toward the implementation of SDG3- to “ensure healthy lives and promote wellbeing for all ages”- and SDG 11- “to make cities and human settlements inclusive, safe, resilient and sustainable”.

One in three people globally suffer from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all its forms. This literature review aims to understand the potential for impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We conducted a systematic search on PubMed and a rapid hand-search on Google Scholar to identify systematic reviews, meta-analyses, and randomized controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualized counselling and environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps.

During a sanitary crisis, excess mortality measures the number of all-cause deaths, beyond what we would have expected if that crisis had not occurred. The high number of COVID-19 deaths started a debate in Italy with two opposite positions: those convinced that COVID-19 deaths were not, by default, excess deaths, because many COVID-19 deaths were not correctly registered, with the most part attributable to other causes and to the overall crisis conditions, and those who presented the opposite hypothesis. We analyzed the curve of the all-cause excess mortality, during the period January 5, 2020 – August 28, 2022, compared to the curve of the daily confirmed COVID-19 deaths, investigating the association between excess mortality and the recurrence of COVID-19 waves in Italy. We compared the two curves looking for the corresponding highest peaks and we found that 5 out of the 6 highest peaks (83.3%) of the excess mortality curve have occurred, on average, just a week before the concomitant COVID-19 waves hit their highest peaks of daily deaths (Mean 6.4 days; SD 2.4 days). This temporal correspondence between the moments when the excess mortality peaked and the highest peaks of the COVID-19 deaths provides further evidence that the all-cause excess mortality wave has been mostly driven by COVID-19 deaths

Mounting evidence supports the connections between exposure to environment types––such as green spaces and biodiversity––and human health. However, the mechanistic links that connect biodiversity (the variety of life) and human health, plus the level of supporting evidence, are less clear. Here, we undertook a scoping review to map the links between biodiversity and human health and summarise the levels of associated evidence using an established weight of evidence framework. Distinct from other reviews, we provide additional context regarding the environment-microbiome-health axis, evaluate the environmental buffering pathway (e.g., biodiversity impacts on air pollution), and draw upon expert opinion to provide case studies on three underrepresented linkages. The case studies include (1) biodiversity and Indigenous Peoples’ health, (2) biodiversity and urban social equity, and (3) biodiversity and COVID-19. We observed a moderate level of evidence to support the environmental microbiota-human health pathway and a moderate-high level of evidence to support broader nature pathways (e.g., green space) to various health outcomes, from stress reduction to enhanced wellbeing and improved social cohesion. However, studies of broader nature pathways did not typically include specific biodiversity metrics, indicating clear research gaps. Further research is required to understand the connections and causative pathways between biodiversity (e.g., using metrics such as taxonomy, diversity/richness, structure, and function) and health outcomes. There are well-established frameworks to assess the effects of broad classifications of nature on human health. These can assist future research in linking biodiversity metrics to human health outcomes. Our case studies on underrepresented linkages highlight the roles of biodiversity and its loss on urban lived experiences, infectious diseases, and Indigenous Peoples’ sovereignty and livelihoods. More research and awareness of these socioecological interconnections are needed.

Globalized in 1995 through the TRIPs Agreement, humanity’s dominant mechanism for encouraging innovations involves 20-year product patents, whose monopoly features enable innovators to reap large markups or licensing fees from early users. Exclusive reliance on this reward mechanism in the pharmaceutical sector is morally problematic for two main reasons. First, it imposes a great burden on poor people who cannot afford to buy patented treatments at monopoly prices and whose specific health problems are therefore neglected by pharmacological research. Second, it discourages pharmaceutical firms from fighting diseases at the population level with the aim of slashing their incidence. These problems can be much alleviated by establishing a supplementary alternative reward mechanism that would enable pharmaceutical innovators to exchange their monopoly privileges on a patented product for impact rewards based on the actual health gains achieved with this product. Such an international Health Impact Fund (HIF) would create powerful new incentives to develop remedies against diseases concentrated among the poor, rapidly to provide such remedies with ample care at very low prices, and to deploy them strategically to contain, suppress, and ideally to eradicate the target disease. By promoting innovations and their diffusion together, the HIF would greatly enlarge the benefits, and thereby also the cost-effectiveness, of the pharmaceutical sector, in favor of the world’s poor especially.

Statistical data extracted from national databases demonstrate a continuous growth in the incidence and prevalence of chronic kidney disease (CKD) and the ineffectiveness of current policies and strategies based on individual risk factors to reduce them, as well as their mortality and costs. Some innovative programs, telemedicine and government interest in the prevention of CKD, did not facilitate timely access to care, continuing the increased demand for dialysis and transplants, high morbidity and long-term disability. In contrast, new forms of kidney disease of unknown etiology affected populations in developing countries and underrepresented minorities, who face socioeconomic and cultural disadvantages. With this background, we analyze in the existing literature the effects of social determinants in CKD, concluding that it is necessary to strengthen current kidney health strategies, designing in a transdisciplinary way, a model that considers demographic characteristics integrated into individual risk factors and risk factors population, incorporating the population health perspective in public health policies to improve results in kidney health care, since CKD continues to be an important and growing contributor to chronic diseases.

This study demonstrated that antibiotic residue in milk can be reduced when dairy farmers use Ethno-veterinary Practices (EVP) based on herbal alternatives to prevent and cure common clinical conditions in cattle instead of antibiotics. Of the 220 farmers selected for the study, 140 were trained and motivated to use validated herbal formulations, 80 were kept as control. Milk samples from the selected farmers (except Thirukanurpatti milk society) tested positive for antibiotic residue in the baseline survey. One year after interventions, the milk from 123 (87.86%) farmers out of 140, were without any detectable antibiotic residue, while samples from 11 farmers (7.85%) were low positive for either Beta-lactams or sulphonamides and 6 (4.29%) were positive for Beta lactams and/or sulphonamides. These 17 (11 + 6) farmers had used antibiotics along with herbal formulations. The milk samples from the control groups were positive for beta lactam and sulphonamide. There was suggestive significance of change in knowledge, attitude and practice of EVP among the farmers from Kerala and Tamil Nadu. A progressive reduction in the incidence of mastitis, enteritis, repeat breeding and cowpox were observed from 2016 to 2019 among the cows treated with EVP. Use of herbal alternative also resulted in a significant reduction in health care expenditure of cattle.

It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, inconsistency of the intervention across sites; and second, absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London. The project aimed to benefit maternal mental health, health literacy and social capital, and especially to engage local populations known to have reduced contact with statutory services. We evaluated the project using two studies with different designs, sampling frames and methodologies. In one the sampling frame and methodology were under community control, permitting comparison of change in outcomes from before to after participation in the project. In the other, the sampling frame and methodology were under researcher control, permitting a case-control design. The two evaluations led to different results however: participants in the community-controlled study showed benefits, while participants in the researcher-controlled study did not. The principal conclusions are that while there are severe challenges to evaluating a community-led health intervention using a controlled design, measurement of pre-/post-participation changes in well-defined health outcomes should typically be a minimum evaluation requirement, and confidence in attributing causation of any positive changes to participation can be increased by use of interventions in the project and in the engagement process itself that have a credible theoretical and empirical basis.

We describe how clinical researchers can exploit the Android cell phone as an economic platform for the gathering of data from clinical trial participants. The aim was to provide a solution with the shortest possible learning curve for researchers who are comfortable with setting up web pages. The additional requirement is that they extend their skills to the installation of a local webserver on the cell phone and then use four simple PHP templates to construct the clinical research data collection and processing forms. Data so collected is automatically written to local csv files on the cell phone. These csv phones can be retrieved from the device by the researcher simply by plugging the cell phone into their desktop PC and accessing the cell phone memory in just the same way as they would a USB memory stick. The results are presented as a list of recommended Android Apps along with settings that have proved to provide a stable combination likely to be easily used by clinical research participants. We have made a limited ‘user trial’ of this approach with satisfactory feedback received. We have concluded that this approach will reward researchers with a solution that is user friendly, will provide transcription free data and that is more than cost competitive with the conventional error prone/poor compliance ‘paper based participant form – researcher transcription’ cycle.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, it is worthwhile assessing its characteristics. The WAI was distributed online among the workers of a healthcare company; the results were compared with data contained in the workers' personal health records and with absence registers. 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in colleagues due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to overreport illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

The study of coordination practices in health policy and, especially in emergency situations is a central aspect. The COVID-19 pandemic has highlighted the need for further research on such practices, especially those that are deployed in complex and unforeseen situations to respond quickly while minimising errors. These dialogic coordination practices (DP) have been identified through case studies but have not been validated. The purpose of this study is to develop and validate a DP questionnaire for healthcare teams. The development of the items was based on a literature review and the content validation was carried out by means of a Delphi study. A total of 10 experts assessed the clarity and appropriateness of the items and their corresponding measurement scales. Consensus was reached after the second round, with a percentage of agreement greater than or equal to 90% for all items. The validation of these items constitutes a methodological innovation that responds to the call in the literature to open up new avenues for comparative studies, the possibility of generalising the findings obtained and the possibility of bringing together different approaches to the problem of coordination, key in health policy.

Wearable devices have become ubiquitous, collecting rich temporal data that offers valuable insights into human activities, health monitoring, and behavior analysis. Leveraging this data, researchers have developed innovative approaches to classify and predict time-based patterns and events in human life. Time-based techniques allow the capture of intricate temporal dependencies, which is the nature of the data coming from wearable devices. This paper focuses on predicting well-being factors, such as stress, anxiety, positive and negative affect, on the Tesserae dataset collected from office workers. We examine the performance of different methodologies, including deep learning architectures, LSTM, ensemble techniques, Random Forest (RF) and XGBoost and compare their performances for time-based and non-time-based versions. In time-based versions, we investigate the effect of previous records of well-being factors on the upcoming ones. The overall results show that time-based LSTM performs the best among conventional (non-time-based) RF, XGBoost, and LSTM. The performance even increases when we consider a more extended previous period, in this case, 3 past-days rather than 1 past-day to predict the next day. Furthermore, we explore the corresponding biomarkers for each well-being factor using feature ranking. The obtained rankings are compatible with the psychological literature. In this work, we validated them based on device measurements rather than subjective survey responses.

Cyber diplomacy is critical in dealing with evolving cybersecurity dangers and possibilities in the digital era. This article investigates the impact of Artificial Intelligence (AI), the Internet of Things (IoT), Blockchains, and Quantum Computing on cyber diplomacy. AI holds the potential for proactive threat identification and response, while IoT enables international information sharing. Blockchains enable secure data sharing and document verification, but they also pose new threats, such as AI-driven cyber-attacks, IoT privacy breaches, blockchain vulnerabilities, and the potential for quantum computing to break encryption. This article conducts case study reviews, in combination with secondary data analysis, and emphasises the value of international cooperation in developing global norms and frameworks to control responsible technology adoption. Cyber diplomacy can promote cybersecurity, protect national interests, and foster mutual trust among nations in the digital sphere by capitalising on possibilities and reducing threats.

The adoption of digital health technologies accelerated during Covid-19, with concerns over the equity of access due to digital exclusion. Using data from a text-based online mental health service for children and young people we explore the impact of the pandemic on service access and presenting concerns and whether differences were observed by sociodemographic characteristics in terms of access (gender, ethnicity and deprivation). We used interrupted time-series models to assess whether there was a change in the level and rate of service use during the Covid-19 pandemic (April 2020-April 2021) compared to pre-pandemic trends (June 2019-March 2020). Routinely collected data from 61221 service users were extracted for observation, those represented half of the service population as only those with consent to share their data were used. The majority of users identified as female (74%) and White (80%), with an age range between 13 and 20 years of age,. There was evidence of a sudden increase (13%) in service access at the start of the pandemic (RR 1.13 95% CI 1.02, 1.25), followed by a reduced rate (from 25% to 21%) of engagement during the pandemic compared to pre-pandemic trends (RR 0.97 95% CI 0.95,0.98). There was a sudden increase in almost all presenting issues apart from physical complaints. There was evidence of a step increase in the number of contacts for Black/African/Caribbean/Black British (38% increase; 95% CI: 1%-90%) and White ethnic groups (14% increase; 95% CI: 2%-27%) ), the sudden increase in service use at the start of the pandemic for the most (58% increase; 95% CI: 1%-247%) and least (47% increase; 95% CI: 6%-204%) deprived areas. During the pandemic, contact rates decreased, and referral sources change at the start. Findings on access and service activity align with other studies observing reduced service utilisation. The lack of differences in deprivation levels and ethnicity at lockdown suggests exploring equity of access to the anonymous service. The study provides unique insights into changes in digital mental health use during Covid-19 in the UK.

Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in 5 Spanish NHs. UI (measured with Minimum Data Set 3.0.), sociodemographic and health-related variables were collected. Chi- square (or Fisher’s) or Student’s t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6–77.2) and was significantly associated with frailty (PR 1.84; 95%CI 0.96–3.53), faecal incontinence (FI) (PR 1.65; 95%CI 1.02–2.65), anxiety (PR 1.64; 95%CI 1.01–2.66), physical performance (PR 1.77; 95%CI 1.00–3.11) and cognitive state (PR 1.95; 95%CI 1.05–3.60). Statistically significant differences between incontinent-continent groups were found for activities of daily living (ADL) limitations, mobility, quality of life, sedentary behaviour (SB) and handgrip strength. It can be concluded that 2/3 of the residents experienced UI, and its significant associated factors were mainly physical (SB, frailty, physical performance, ADL limitations, mobility, FI and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety and quality of life).

Avocado (Persea americana Mill.) plant fruits are well-known for their high nutritional value, unique test, and healthy oil. It has a history of about 10,000 years. Avocado fruit offers many health benefits, and its production is rapidly increasing. The Food and Agriculture Organization (FAO)’s recent data suggest that the Avocados produced in the world in 2019 was twice that of 2010 (3778010 tons). Avocado’s global Gross Production Value was about 5.812 billion USD in 2018, and it is likely to increase rapidly because of the increasing demand for Avocado fruits. Avocado oil is also used in the cosmetic industry because of its therapeutic properties, and it boosts the economic value of the Avocado industry. Avocado fruits have a rough green-gold skin; however, fruits are called ‘the green gold’ because of their massive global demand in the worldwide market and a lucrative business. The cultivation of Avocado has tremendous potential in increasing the rural economy, rural agriculture-based employment and reducing the poverty rate of growers. On the other hand, the Avocado industry is highly criticised because of deforestation, massive water utilisation, polluting water bodies with insecticides and fertilisers, posing a threat to other plant species, and environmental pollution. However, it doesn’t preclude the importance of Avocado. Cameroon’s average temperature is about 23 °C, which is considered optimal for Avocado propagation and commercial cultivation. Cameroon Association of Active Youths (CAMAAY) want to explore the possibilities of engaging Cameroon youths in Avocado cultivation. This review is aimed to provide an overview of Avocado. The review also highlights Avocado cultivation related issues from one health and sustainability perspective in line with the global goals.

Background: Cardiovascular diseases (CVDs) and their risk factors are increasing with associated disability and mortality burden globally, especially in low- and middle-income countries, including Cameroon. Physiotherapist-led health promotion (PLHP) interventions provide opportunities to improve health and reduce this burden. Understanding physiotherapists' practice, confidence, and perception is crucial for designing effective, context-specific PLHP interventions. Methods: This qualitative study explored physiotherapists' practice, perceptions, and confidence in delivering PLHP to pwCVDs in Cameroon. Results: Sixteen participants completed the interviews and analyses of the transcripts generated three main themes which included 1) Perception of Physiotherapists’ role in health promotion (HP), 2) Current practice of PLHP 3) Competence in delivery of PLHP. Physiotherapists believe that delivering HP interventions in practice is within their professional role. Current HP practice was limited to exercise, physical activity and dietary/nutritional interventions. Participants reported a lack of knowledge and formal training in PLHP delivery. Conclusion: Despite strong interest in HP, HP practice among physiotherapists is limited in scope, under-resourced and limited by a lack of confidence in delivering behavioural change interventions. These findings are relevant for the design of appropriate clinical training and policies for the care of pwCVDs.

The different sociocultural context and lifestyle may influence oral health. To evaluate the interference of these factors, we conducted a quantitative-qualitative cross-sectional study. The research was carried out in a private dental office, in an urban area, and in the Family Health Unit (USF), in a rural area. Fifty patients of each location participated on the research. A semi-structured questionnaire covering sociocultural profile, oral hygiene habits, drug consumption, use of medicinal plants, and antibiotics usage was applied. Also, laboratory tests to evaluate the tendency to have dental decay and Streptococcus sp colony counting was performed. There was no significant difference between patients in the two groups regarding gender, race, marital status, type of residence, number of residents in the same household, and type of employment. Private clinic participants were more prone to consuming alcohol and/or cigarettes and reported to brush the teeth more often. There was no association between salivary acidity and higher biofilm bacterial density. The usage of medicinal plants was more evident in the public service. Data presented here revealed that social inequality between private and public dental assistance are greater from the point of view of investment in public health for the population with difficult access and not from cultural or educational level diversity.

Compassion fatigue and burnout are two distinct forms of mental health distress faced by educational workers. Researchers have shown a high level of both phenomena across the field of education, however, a better understanding of what educational workers already do for positive mental and emotional health is needed. This research study examined three years of data, collected via survey, inquiring into the various interventions, namely supports and resources, that educational workers, specifically teachers, educational assistants, school leaders, and support administrators , use to support positive mental health. Quantitative data analysis via descriptive and inferential statistics revealed that educational workers relied heavily on their personal support network followed distantly by medical professionals and other interventions revealing a gap that needs to be addressed by employers. Qualitative thematic analysis revealed a trend towards increased use of environmental interventions to promote positive mental health. Suggestions for other interventions that might be helpful are provided.

Loneliness was one of the most prominent emotional experiences during social distancing due to the COVID-19 pandemic. This article aims to shed light on the experiences of loneliness and its relationship with mental health of adolescents in the Da Nang City during the COVID-19 pandemic. Data were collected online in early 2023 after 18 months Da Nang lifted its lockdown. The Strength and Difficulties Questionaire, the Multidimensional Scale of Perceived Social Support and the Negative Experience Scale were used to investigate loneliness among adolescents and effects of protective social factors. A total of 1,262 grade 6 to 12 students responded to the surveys. Results indicated that (1) loneliness was a more prominent emotion experienced by these adolescents during the COVID-19 lockdown; (2) factors contributing to loneliness were related to illness, social distancing, and a lack of care and attention from parents; (3) loneliness reported mostly was short in duration and mild at level, while there was a significant proportion of prolonged loneliness; and (4) Support from family and friends, however, could reduce the risk of mental health problems for the youngsters.

Background/Objectives: Peer relationships are critical in the development of positive mental health during childhood and adolescence. Attention-deficit/hyperactivity disorder (ADHD) symptoms can adversely affect the development of positive peer relationships, and thus, have significant long-term implications for mental health. This study explored long-term relationships between ADHD symptoms, peer relationships and mental health in Western Australian adolescents. Methods: Participants were 1246 Western Australian young people, n=507 males and n=739 females (mean ages 14.05 and 14.52 years respectively). Data were collected at three timepoints across three successive years. Participants completed measures of ADHD symptoms and existing peer problems in the first year; five measures of peer relationships in the second year; and four measures of mental health in the third year. Multiple regression and path analyses were used to determine whether ADHD symptoms predicted scores on the peer relationship and mental health measures, and whether peer relationships mediated links observed between ADHD symptoms and mental health. Results: ADHD symptoms significantly predicted both long-term problematic peer relationships and long-term adverse mental health outcomes. Three peer relationship variables were significant mediators of relationships between ADHD symptoms and mental health: sense of belonging, friendships and perceived isolation. Conclusions: ADHD symptoms significantly predict poor peer relationships and adverse mental health outcomes in Western Australian youth, regardless of whether a formal diagnosis has been assigned. Early interventions for young people with ADHD symptoms are needed for such individuals to enjoy positive mental health in their adult years.

Background: Leprosy control remains challenging in Brazil and has been aggravated by the Covid-19 pandemic. Objective: To analyze the impact of the Covid-19 pandemic on the epide-miological scenario of leprosy through the detection rate of new cases, risk of illness and hidden prevalence according to high-risk micro-region in Minas Gerais, Brazil. Methods: Ecological study conducted in the health micro-regions, using data on new leprosy cases diagnosed between 2015 and 2023. The annual detection rate of new cases, the Risk of Illness Index and the Hidden Preva-lence were evaluated. The time trend was evaluated by calculating the Annual Percentage Change (APC) of the detection rate, based on segmented linear regression. Results: A reduction in the detection of new cases was identified in most of the micro-regions evaluated. Minas Gerais and some micro-regions showed a positive increase in the variation of the overall detection rate in 2021. The reduction in hidden prevalence in certain micro-regions is linked to the reduction in diagnoses, especially those cases with installed physical disability. Despite the reduction in the risk of becoming ill with leprosy in some micro-regions, Minas Gerais showed an increase in risk. Conclusions: The pandemic has had a considerable and heterogeneous impact on the detection of new cases, as well as on the risk of becoming ill and the hidden prevalence, with repercussions for the control of the endemic in populations. There is a need to implement public health policies that prioritize the early identification of cases and ensure that vulnerable populations are monitored.

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

Purpose: Arab Americans are one of the largest ethnic groups in the United States. The mental health of Arab Americans and opinions on mental health, however, remain understudied despite higher rates of mental illness and lower rates of treatment. Unique cultural conceptualizations of mental illness may generate stigma, contributing to disparities in treatment. This study aimed to assess the attitudes and perspectives of Arab Americans regarding mental illness in order to address barriers to treatment. Methods:Using an anonymous bilingual Qualtrics survey, we assessed Arab and non-Arab participants (n = 294; ages 18+) on their conceptualizations of the causes of mental illness and on their stigma towards mental illness and mental health treatments. Comparisons were performed between Arabs and non-Arabs, as well as among Arabs. Results:Compared to non-Arabs, Arabs reported higher average mental illness stigma and were more likely to rate psychiatric medications as addictive and unhelpful. Among Arabs, being Christian, male, and older (>29 years old) were each associated with higher stigma. Arabs were less likely than non-Arabs to believe in a biological explanation for mental illness. Conclusion: Our results demonstrate higher levels of stigma towards mental illness among Arab Americans, especially Christian, male, and older Arabs, potentially related to a weaker belief in a biomedical model for mental illness. These are among the first findings describing mental illness stigma and beliefs about mental health in an Arab American community and may inform future interventions providing culturally competent care to Arab Americans.

Concerns regarding the safety of ethoxyquin (EQ) have gradually increased, highlighting the necessity of identifying safer and more effective antioxidants for use in animal feed. This study investigates the effects of a compound antioxidant (CA) as an alternative to ethoxyquin on feed oxidative stability, growth performance, antioxidant capacity, and intestinal health in broilers. A total of 351 one-day-old Arbor Acres Plus male broilers were randomly assigned to three treatments with nine replicates of 13 birds each. The experimental treatments included: CON group (basal diet), EQ group (basal diet + 200 g/ton EQ at 60% purity), and CA group (basal diet + 200 g/ton compound antioxidant, which comprises 18% butylated hydroxytoluene, 3% citric acid, and 1% tertiary butylhydroquinone). The experiment lasted for 21 days. Compared to the control group, supplementation with CA significantly reduced the acid value, peroxide value, and malondialdehyde content in the feeds after storage. Moreover, CA supplementation significantly decreased feed intake and the feed conversion ratio (FCR) without affecting weight gain of boilers, while also improving liver antioxidant capacity (increased T-AOC and SOD levels), intestinal antioxidant capacity (increased CAT, HO-1, and GPX7 protein expression), and enhancing the duodenal villus height-to-crypt depth ratio and jejunal villus height. Additionally, CA treatment reduced intestinal barrier permeability (decreased diamine oxidase activity and D-lactate levels), potentially by promoting the expression of Occludin, ZO-1, and Mucin2 protein. Furthermore, the addition of CA elevated the protein levels of NF-κB p50 along with its inhibitory factors, IκB and NF-κB p105, in the intestines of broilers, thereby enhancing immune regulatory capacity. This supplementation also led to an increased abundance of beneficial gut microorganisms, including Lactobacillus, Alistipes, Candidatus Arthromitus, and Turicibacter. In comparison to the EQ group, CA supplementation enhanced feed oxidative stability, decreased the FCR, and improved the intestinal morphology, barrier functions, and inflammatory status in broilers. These findings suggest that this compound antioxidant may serve as a healthier and more effective alternative to ethoxyquin.

Shiga toxin-producing Escherichia coli (STEC) is a significant public health threat due to its ability to cause severe gastrointestinal diseases in humans, ranging from diarrhea to life-threatening conditions such as hemorrhagic colitis and hemolytic uremic syndrome (HUS). As the primary reservoir of STEC, cattle play a crucial role in its transmission through contaminated food and water, posing a considerable risk to human health. This comprehensive review explores host-pathogen interactions during STEC colonization of the bovine gut, focusing on the role of gut microbiota in modulating these interactions and influencing disease outcomes. We integrated findings from published transcriptomics, proteomics, and genomics studies to provide a thorough understanding of how STEC adheres to and colonizes the bovine gastrointestinal tract. The insights from this review offer potential avenues for the development of novel preventative and therapeutic strategies aimed at controlling STEC colonization in cattle threby reducing the risk of zoonotic transmission.

(1) The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity and the frequency of non-sedentary behaviors of Portuguese, Italian and Spanish students attending, respectively, higher education in Portugal, in Italy and Spain; (2) Methods: 1354 Portuguese, Spanish and Italian students (21.2 ± 2.9 years) participated in the study. An online questionnaire was used to collect data and a priori power analysis statistical procedures were used using G∗Power (3.1.9.7) and one-way Anova; (3) Results: The highest levels of sedentary lifestyles are found among Spanish students, followed by the Portuguese and lastly the Italians. Regarding the levels of physical activity Spanish students perform more minutes of low and moderate activity compared to Italians and Portuguese. Italians students are the ones who perform more vigorous activity; (4) Conclusions: We can conclude that Spanish students have a higher level of sedentary lifestyle with the majority of physical activity being low and moderate, while Italians are those who have more time spent on vigorous physical activity and naturally a lower level of sedentary lifestyle. However, it is worth highlighting that all three countries reach the minimum levels of physical activity recommended by the WHO.

Economic, social, and environmental sustainability are the results of efforts aiming to improve all aspects of milk production, respecting animal welfare and improving herd health. An epidemi-ological study was designed to assess the role of contagious pathogens (S. aureus and S.agalactiae) in a cohort of 120 dairy herds located in the southern regions of Italy. Milk quality was assessed using certified methods, and the prevalence of mastitis pathogens in bulk tank milk was determined using quantitative polymerase chain reaction. Welfare scores were assessed using a scoring card that have more than 100 items, including animal-based measurements. Statistical analyses were performed using general lineal model and logistic regression procedures. The results showed that S. aureus had a significant negative effect on the amount of milk components delivered to the dairy plant, and on the level of welfare. Whereas, the presence of S.agalactiae did not show any significant association. The major risk factors associated with the presence of S.aureus were also identified to help prioritise control programs. These results support the “One Sustainability” approach im-plying that an increase of animal productivity is related to the improvement of animal health and welfare and potentially leading to the mitigation of greenhouse gas emissions.Economic, social, and environmental sustainability are the results of efforts aiming to improve all aspects of milk production, respecting animal welfare and improving herd health. An epidemi-ological study was designed to assess the role of contagious pathogens (S. aureus and S.agalactiae) in a cohort of 120 dairy herds located in the southern regions of Italy. Milk quality was assessed using certified methods, and the prevalence of mastitis pathogens in bulk tank milk was determined using quantitative polymerase chain reaction. Welfare scores were assessed using a scoring card that have more than 100 items, including animal-based measurements. Statistical analyses were performed using general lineal model and logistic regression procedures. The results showed that S. aureus had a significant negative effect on the amount of milk components delivered to the dairy plant, and on the level of welfare. Whereas, the presence of S.agalactiae did not show any significant association. The major risk factors associated with the presence of S.aureus were also identified to help prioritise control programs. These results support the “One Sustainability” approach im-plying that an increase of animal productivity is related to the improvement of animal health and welfare and potentially leading to the mitigation of greenhouse gas emissions.

Background: Health expenditure in Japan is rising due to an ageing society while simultaneously pressure is mounting to increase spending in other areas such as defense, all in the context of a stagnating economy. Easing pressures on the health care sector through smoking-related cost reductions could thus be a cornerstone to mitigate the looming fiscal threat. Public health policy has encouraged cessation, but this approach has seen limited success. Focusing on cessation alone therefore may not be a sustainable policy strategy and other, new solutions need to be found to reduce smoking-related costs. Methods: Using a status-quo simulation based on hospital resources data derived from the Japanese Ministry of Health, Labour and Welfare, we examine the impact of heated tobacco products (HTPs) on the prevalence of four smoking attributable diseases (chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD), stroke and lung cancer) and related direct health care costs. Base case scenario assumes a switching rate from combustible smokers to HTPs of 50%. A risk reduction rate of 70% was applied. A sensitivity analysis was performed to determine the impact of parameter changes on output. Results: Our results indicate that 50% of smokers switching to use HTPs instead of combustible tobacco products could reduce the number of patients of the four smoking attributable diseases considered by 12 million cases equivalent to 454 billion JPY in savings. Prefectures located in the north and south of Japan would benefit most. Conclusion: Considering the heterogeneous prevalence rates across population groups and prefectures, a one-size-fits-all, centralized approach to tobacco control is not effective. Health authorities should strategically use multiple interventions to address smoking related health risks and costs. Switching to HTPs should be encouraged in parallel to smoking cessation, and educational efforts should aim to increase the awareness on health risks, especially among younger people.

The COVID-19 pandemic has triggered seismic shifts in how we work, and organizations behave. It has caused many organizations to transition from an office-centric culture to more flexible ways of working. This shift is necessitated by health conditions and the need for controls. It is also driven by the assumption that remote work or working from home offer a certain assurance of safety for employees against the threat of infection in highly vulnerable office conditions. The shift to remote work has so far been mainly experimental as most businesses continue to learn about what works and what doesn’t. There is also the assumption that all that matters for the efficient operability of a remote work regime is the availability and effectiveness of computing technologies and internet connectivity. Thus, once those supplies are in place remote work is expected to be fully functional and without problems. As learning continues about what works and what doesn’t, it has also become increasingly clear that beyond the threat of covid-19 and the relative safety that individual homes may offer, there are other vulnerabilities which are ignored or underestimated in the process. In most instances, the home environment of the employee, the conditions under which employees operate from home and the health and safety such environments provide (or not) are either ignored or underestimated in discussions around remote work practices. This paper highlights remote work as an emergent practice while exploring associated, but ignored, health and safety issues in employee homes.

Wild-grown edible mushrooms are important in world diet, which are also efficient metal accumulators. Yunnan, southwest China is the main producing region with typically high geochemical metals. Environmental factors, bioaccumulation, distribution and human health risk of metals were examined in paired soil and Tricholoma matsutake (n=54). T. matsutake grows on acidified soils (pH=3.95–6.56) and metals showed strong heterogeneity with Fe, Mn, Zn and Cu ranged at 16–201, 0.046–8.58 g kg–1 and 22.6–215, 3.7–155 mg kg–1. High soil Fe content led to its great accumulation in T. matsutake (0.24–18.8 g kg–1). However, though soil Mn content was great higher than Zn and Cu, their concentrations in T. matsutake were comparable (21.1–487 vs. 38.7–329 and 24.9–217 mg kg–1). This suggested that T. matsutake prefers to accumulate Zn and Cu than Mn, and supported by bioaccumulation factor (BAF=0.32–17.1 vs. 0.006–1.69). Fe was mainly stored in stipe, while Mn, Zn and Cu were in cap, with translocation factor (TF) was 0.58 vs. 1.28–1.94. Therefore, stipe Fe showed the highest health risk index (HRI) at 1.28–26.9, followed by cap Cu (1.01–2.33), while 98–100% of Mn and Zn were risk-free. The higher concentration and greater risk of Fe was attributed to the significant effect of soil Fe content (R=0.34) and soil pH (R=–0.57). This study suggested that Fe as an essential mineral may exert toxic effects via T. matsutake consumption from geochemical high background areas.

Yoga promotes acceptance, compassion, physicality, active postures, mental and emotional awareness, and spiritual benefits. It involves breath techniques, postures, and body locks, maintaining balance and strength. It's based on ethical principles. Beyond simple performance, swimming is a catalyst for overall well-being. Complementarily, yoga serves as an invaluable adjunct for swimmers, enhancing flexibility, strength, and body awareness - a triad essential to aquatic excellence. The confluence of yoga and swimming, particularly through the practice of aqua yoga asanas, presents a new paradigm for both athletes and non-performers alike. Athletes who embrace the harmonious fusion of swimming and yoga unearth the potential for achieving not just athletic mastery but also a more balanced and fulfilling lifestyle. This blend provides a route not only to enhance performance in the water but also to elevate the overall quality of life. We examined the feasibility of incorporating yoga and swimming practice into Romanian subjects' lifestyles, designing a factor analysis in SmartPLS software, based on an online survey. The study assesses the participants' knowledge of yoga's theory and philosophy, as well as their perceptions of the swimming practice's benefits for social and health issues. According to our study, Romanian participants practice yoga and swimming as often as possible to reduce stress, improve concentration for work-related tasks, and improve joint elasticity, balance, and muscular tone. Thus, Yoga and swimming are substitutes for other approaches in prevention and therapy.

Orthodontic appliances may cause discomfort for patients. It could influence person‘s psychological well–being. The aim was to examine psychological health of patients wearing orthodontic appliances. It is important to analyze well-being of patients during orthodontic treatment because it is started in a young age and it may affect one’s psychological health. Therefore, for doctors and patients it is important to understand and take every aspect of the treatment into consideration when deciding when to start the treatment and what appliance to choose. 339 patients answered anonymous questionnaire. They were divided into four groups according to their age and type of appliance. Main reasons to seek treatment were crooked teeth and bad bite. Statistically signifi-cant difference was between women and men as women seeked treatment because of crooked teeth, meanwhile men indicated bad bite as main reason. 48.7% of subjects noted that they were feeling good during treatment, however, 4% of all patients noted that they were feeling bad. 45% of subjects stated that they felt unhappy at least sometimes. 43% of subjects felt stress. Even though patients indicated various negative aspects on their well-being during treatment, for the majority of the subjects end results significantly increased their psychological well-being.

The incidence of infections due to carbapenemase-producing Enterobacteriaceae (CPE) is rising worldwide. We present the case of a 48-year-old female patient, diabetic, with previous episodes of urinary tract infections that was admitted due to pyelonephritis, later identified to be caused by KPC and ESBL-producing Klebsiella pneumoniae. Both the patient and her family had no strong epidemiological link with the healthcare system, and for this reason, this case stands out in regional literature since similar reports are scarce and therefore constitutes a reason for alert in health institutions. Further studies are needed in order to ascertain the real incidence of these infections in community settings in Latin America and the Caribbean.

Cardiovascular diseases (CVDs) and associated risk factors are a growing concern in Cameroon. Physiotherapists (PTs) can play a crucial role in prevention and management. However, the extent of Cameroonian PT involvement in health promotion (HP) activities remains unclear. This study assessed Cameroonian physiotherapists’ current HP practices for people at risk of developing or living with CVDs (pwCVDs). A cross-sectional survey was administered online to PTs practising in Cameroon. Out of 181 PT responses, 95% reported providing a variety of HP activities, including weight management (74%), dietary advice (73%), physical activity (69%), smoking cessation (69%), stress management (61%), and sleep promotion (48%). While PTs were confident in lifestyle assessments, they felt less confident about sleep interventions. Strong beliefs, confidence, team support, and time allocation enhanced HP practice. However, preference for passive modalities, patient adherence issues, organisational challenges within healthcare services, role ambiguity among healthcare providers, inadequate training opportunities, and the absence of established guidelines for CVD prevention negatively affect HP practice. These findings highlight the challenges and opportunities for enhancing HP delivery within the physiotherapy profession in Cameroon. Strategic investments and concerted efforts are necessary to address barriers and leverage facilitators effectively for scaling up HP initiatives, given the significant burden of CVDs in the country.

The following article analyses the relationship between the mental health index and the variables of the Environment, Social and Governance-ESG model in the Italian regions between 2004 and 2023. First of all, a static analysis is proposed aimed at identifying trends relating to mental health in the Italian regions with indication of the regional gaps. Subsequently, a clustering with k-Means algorithm is proposed. Below is a comparison of 11 machine learning algorithms for predicting the performance of the mental health index. Finally, the article offers some economic policy suggestions. The results are critically discussed in light of the scientific literature.

The following article analyses the relationship between the mental health index and the variables of the Environment, Social and Governance-ESG model in the Italian regions between 2004 and 2023. The econometric analysis is aimed at investigating in detail the relationships between the mental health index and the individual components of the ESG model. The results are critically discussed

The application of antimicrobials in aquaculture primarily aims to prevent and treat bacterial infections in fish. Inappropriate use of antimicrobials in fish farming may result in the emergence of zoonotic antibiotic-resistant bacteria and subsequent transmission of resistant strains to humans via food consumption. From recently, AMR emerged as a significant public health concern in the aquaculture ecosystem and fisheries. The aquatic environment serves as a potential reservoir for resistant bacteria, with aquaculture practices providing an ideal breeding ground for AMR due to the excessive use of antimicrobials to prevent and treat diseases. The mutual inter-connection of intensive fish farming systems with terrestrial environments, food processing industry and human population creates pathways for the transmission of resistant bacteria, exacerbating the problem further. One Health concept, which recognizes the interconnectedness of human, animal and environmental health, enables a holistic approach to address the challenges posed by AMR. By understanding the evolution of such approach, the future of aquaculture, being the important source of a global animal protein supply, can be safeguarded. Risk mitigation strategies for AMR should be based on One Health concept to contribute to sustainable aquaculture practices that protect human and animal health, ensure food safety and protection of environment.

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.

Background: This longitudinal study aimed to investigate the relationship between self-reported chewing status and increases in waist circumference (WC) after 1 year in 10,870 Japanese adults who had received health checkups. Subsequently, 8,068 participants were included in the final analysis at follow-up. Methods: Chewing status was evaluated using a self-reported questionnaire at baseline; 1,080 (13%) respondents were diagnosed as having poor chewing status. We defined an increase in WC of ≥ 5 cm after 1 year as an unhealthy increase; in total, 613 (7.5%) respondents met this criterion. Results: After adjusting for age, gender, WC, body mass index (BMI), and chewing status, an increase in WC ≥ 5 cm was found to be positively associated with gender (females: odds ratios [ORs]: 1.206; 95% confidence intervals [CIs]: 1.008–1.443), WC (ORs: 0.967; 95% CIs: 0.954–0.981), BMI (≥ 25 kg/m2; ORs: 2.194; 95% CIs: 1.715–2.808), and chewing status (poor; ORs: 1.356; 95% CIs: 1.084–1.697). Conclusions: These findings suggest that self-reported poor chewing status is associated with increases in WC after 1 year in Japanese adults.

Background: Snus consumption is increasingly popular, mainly among the youth, due to the promotion of the tobacco industry and the lack of knowledge regarding its adverse effects. Even though some of its systemic complications are common knowledge, the oral consequences are rarely known. Aim: Therefore, the objective of this study is to evaluate the oral health effects of snus consumption among a highly exposed group of adolescent athletes. Design: Participants received an interactive presentation, followed by interviews and dental screenings by young doctors to establish trust. They were categorized into groups based on the frequency of snus usage. The oral hygiene habits and status, snus consumption habits and awareness about its adverse effects were evaluated. Results: Statistically significantly (p

Health care operations in many hospitals are experiencing increasing demand which is however hindered by the limited resources available. The imbalance between the demand and service provision capacity within the hospitals have resulted in long waiting times for service delivery due to overcrowding, high costs of treatment as well as low levels of patient’s satisfaction. The above problems are attributed to the development of hospital management information system. This dissertation is focused on investigating some of the causes of the increased cost and time consumption as well as low levels of patient’s satisfaction in the application of hospital management information system. The study used comparative design to make a comparison of the respondents from two different hospital facilities where 400 health workers were drawn for research. The questionnaire was used as a survey tool for the study that involved both qualitative and quantitative analysis. The results of the study indicate various playing factors that arise due to the development of the hospital management information system. These factors include the large functionality of the system, the need for training of the end users, the increasing ageing population, and delays. The identified factors play a significant role in the way the information system impacts the time taken, the cost involved, and patient satisfaction. Keywords: health, hospital, doctors, technology, information system, time, and cost.

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.

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

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

This case report utilized the primary data gathered from the extension program of the LORMA College of Medical Laboratory Science at the institution’s adopted locale. Arosip is a secluded, difficult-to-reach mountainous barangay in the municipality of Bacnotan, in the province of La Union, Philippines. The study subjects were forty-one (41) kindergarten to grade three students of Arosip Elementary School. Modified Kato-Katz technique was performed to the submitted stool samples. Among 41 participants, nine were screened positive for the helminthic ova of Ascaris lumbricoides, and Trichuris trichiura – yielding a total of 21.95% prevalence rate. Among those 9 participants, 6 (66.67%) were positive for Ascaris lumbricoides ova, and 3 (33.33%) were co-infected with both Ascaris lumbricoides and Trichuris trichiura ova. The findings were relayed and reported to the local government unit. The team recommends for a more comprehensive screening and monitoring of STH cases in the locale, a continuous stewardship of health programs including mass-deworming for the school children and awareness campaigns, and provision of health resources. Ultimately, interagency collaboration between the Department of Health, Department Education, and Local Government Unit remains highly warranted to satisfy the health inequities experienced by this disadvantaged remote community.

Background: Individuals living in rural areas often face challenges in accessing healthcare, increasing their risk of poor health outcomes. Farmers, a sub-population in rural areas, are particularly vulnerable to mental health issues and suicide, yet exhibit low rates of help-seeking behavior. The aim of our study was to develop an in-depth understanding of the issues influencing mental help-seeking among farmers living in rural areas from the perspectives of healthcare providers, as well as to explore the strategies providers use to navigate through these issues to effectively engage with this vulnerable population. Methods: We used a descriptive phenomenological approach to understand healthcare providers’ perspectives, experiences, and approaches to providing mental healthcare to farmer clients in rural areas. Semi-structured interviews were conducted with 21 participants between March and May 2023. Results: Our analysis yielded five thematic areas: (1) ensuring accessibility, (2) establishing relatability, (3) addressing stoicism and stigma, (4) navigating dual roles, and (5) understanding community trauma. Conclusions: Healthcare service delivery for farmers is multifaceted. This study fills a gap in knowledge by translating these the data to inform an evidence-based model and a list of recommendations for implementing agriculturally-informed practices in rural areas.

The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of Artificial Intelligence (AI) in analyzing pediatric voice as a biomarker for health. The included studies featured voice recordings from pediatric populations aged 0-17 years, utilized feature extraction methods, and analyzed pathological biomarkers using AI models. Data from 62 studies were extracted, encompassing study and participant characteristics, recording sources, feature extraction methods, and AI models. The review showed a global representation of pediatric voice studies, with a focus on developmental, respiratory, speech, and language conditions. The most frequently studied conditions were Autism Spectrum Disorder, intellectual disabilities, asphyxia, and asthma. Mel-Frequency Cepstral Coefficients were the most utilized feature extraction method, while Support Vector Machines were the predominant AI model. The analysis of pediatric voice using AI demonstrates promise as a non-invasive, cost-effective biomarker for a broad spectrum of pediatric conditions. However, further research and development are crucial to enhance the accuracy and applicability of these tools in clinical settings.

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

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.

Rationale - From the year 1 anno Domini until 1855 with the third Plague, major pandemics occurred on average every 348 years. Since then, they have occurred on average every 33 years, with Coronavirus disease 2019 (COVID-19) now underway.Even though current technologies have greatly improved the way of life of human beings, COVID-19, with more than 700 000 000 cases and 6 950 000 deaths worldwide by the end of 2023, reminds us that much remains to be done. Objective - Given the frequency and duration of recent pandemics, it might be wise to start thinking about preventative methods to minimize the impact of future pandemics. This report looks back at 18 months of COVID-19, from March 2020 to August 2021, with the aim of highlighting potential solutions that could prove practical, or even essential, for the future. Material - COVID-19 data, including case and death reports, were extracted daily from the Worldometer platform to build a database for macroscopic analysis of the spread of the virus around the world. Demographic data were integrated into the COVID-19 database for a better understanding of the spatial spread of the SARS-CoV-2 virus in cities/municipalities. Method - Without loss of generality, we only analyzed data from the top 30 (out of 200 and above) countries ranked by total number of COVID-19 cases. Statistics (regression, t-test (p < 0.05), correlation, mean ± std, etc.) were carried out with Excel software. Spectral analysis, using Matlab software, was also used to try to better understand the temporal spread of COVID-19. Results - A good linear correlation was observed between the number of cases and the respective number of deaths depending on the country, i.e. y = 0.0121x + 19559 with R² = 0.8042. The analysis then focused mainly on the number of cases.This study showed that COVID-19 mainly affects G20 countries. The most interesting result is that cities/municipalities with high population density are a powerful activator of the spread of the virus. The current demographic context seems to be becoming a societal problem that must be addressed adequately.Spectral analysis highlighted that the very first months of spread of COVID-19 were the most notable with a strong expansion of the SARS-CoV-2 virus. On the other hand, the following six months showed a certain stability due mainly to multiple preventive measures such as confinement, closure of non-essential services, wearing of masks, distancing of 2 meters, etc. Discussion - Analysis of case and death data showed that COVID-19 mainly affects G20 countries. Nevertheless, the most interesting result of this study is that cities and municipal areas with population densities of several thousand inhabitants per square kilometer largely favored the spread of the SARS-CoV-2 virus. It is believed that such a demographic context is becoming a societal problem that developed countries around the world will sooner or later face and therefore needs to be adequately addressed. Conclusion - COVID-19 has made us understand that it is time to act both preventatively and curatively. Phenomenological insights suggest that the next pandemic could occur in less than 50 years. It may be time to launch new societal projects aimed at relieving congestion in densely populated regions.

Retiring coal power plants can reduce air pollution and health damages. However, the spatial distribution of those impacts remains unclear due to complex power system adjustments and pollution chemistry and transport. Focusing on coal retirements in Pennsylvania (PA), we analyze six counterfactual scenarios for 2019 that differ in retirement targets (e.g., reducing 50% of coal-based installed capacity vs. generation) and priorities (e.g., closing plants with higher cost, closer to Environmental Justice Areas, or with higher CO₂ emissions). Using a power system model of the PJM Interconnection, we find that coal retirements in PA shift power generation across PA and the Rest of PJM region leading to scenario-varying changes in the plant-level release of several air pollutants. Due to air pollution chemistry and transport and socio-demographics, these changes in turn give rise to a reduction of 10 to 182 PM_2.5-attributable deaths in PJM across the six scenarios, with most reductions occurring in PA. Scenarios that reduce more coal power generation yield greater aggregate health benefits due to air quality improvements in PA and adjacent downwind regions. In addition, vulnerable populations—in both PA and Rest of PJM—benefit most in scenarios that prioritize plant closures in PA near Environmental Justice Areas. These results demonstrate the importance of considering cross-regional linkages and socio-demographics in designing equitable retirement strategies.

Being forced to live in an area following a catastrophic landslide may adversely impact people's mental well-being. Unprivileged communities such as Adivasis, Dalits, plantation workers, and people with low incomes in Kerala's hilly districts are forced to live in landslide-affected areas despite their fear. This paper examines the fears and concerns of landslide survivors from the marginalized sections of society from a broader framework of the political economy of mental health. This approach aligns with the assertion made by the World Health Organisation that individual factors do not solely determine mental health but are intricately linked to broader social, political, and economic circumstances. Data were collected through in-depth interviews with fatal landslide survivors and key informants [ ]. The study employed thematic data analysis from in-depth interviews of various fatal landslide survivors since 2018. The three major themes unveiled in the analysis are: 1. post-disaster fears, 2. The factors that triggered fear and concern and 3. Socio-economic marginality and mental health. The study asserts that individuals who are poor and unprivileged are highly susceptible to mental health issues associated with landslides.

A new trend in cow's milk has emerged in the market called type A1 and A2 milk. These products have piqued the interest of both consumers and researchers. Recent studies suggest that A2 milk may have potential health benefits, which is why researchers are investigating this product further. It is interesting to note that the A1 and A2 milk types have area-specific characteristics compared to breed-specific characteristics. Extensive research has focused on milk derivatives obtained from cow’s milk, primarily through in vitro and animal studies. However, few clinical studies have been conducted in humans, and the results have been unsatisfactory. New molecular techniques for identifying A1 and A2 milk may help researchers to develop new studies that can clarify certain controversies surrounding A1 milk. It is essential to exercise extreme caution when interpreting the updated literature. It has the potential to spread panic worldwide and have negative economic implications. Therefore, this study aims to investigate the new aspects of A1 and A2 milk in different research areas and clarify some aspects regarding these two types of milk.

It is concerning that Cameroon's urban centers are experiencing an alarming rise in air pollution as a result of urbanization, population growth, industrial activity, and transportation emissions. We examined the causes, health impacts, research methodology, case studies, and government measures to address the urgent issue of air pollution in Cameroon's urban regions. We have emphasized how Cameroon's air pollution levels have significantly increased as a result of causes like population expansion, urbanization, industrial emissions, and automobile exhaust A thorough discussion of the negative health impacts of extended exposure to air pollution is included, with special attention to the sensitivity of the old and young. These effects include respiratory disorders, cardiovascular ailments, and early mortality. We emphasized the pressing need for all-encompassing strategies to address air pollution, such as increased public awareness campaigns, stronger emissions regulations, the development of renewable energy sources, and better waste management. The techniques employed in studies on air pollution, like as epidemiological research and air quality monitoring, are also explained to provide light on the unique health dangers that Cameroonian urban dwellers must contend with. We emphasized in our conclusion the significance of joint efforts by legislators, medical professionals, and the general people to reduce air pollution and protect public health in Cameroon in order to create a cleaner and healthier future. In order to protect public health in the future, it is imperative that Cameroon's air pollution be addressed.

Machine Learning is increasingly and ubiquitously being used in the medical domain. Evaluation metrics like accuracy, precision, and recall may indicate the performance of the models but not necessarily the reliability of their outcomes. This paper assesses the effectiveness of a number of machine learning algorithms applied to an important dataset in the medical domain, specifically, mental health, by employing explainability methodologies. Using multiple machine learning algorithms and model explainability techniques, the project provides insights into the model workings to help determine the reliability of the machine learning algorithm predictions. The results are not intuitive. It was found that the models were focusing significantly on less relevant features and at times, unsound ranking of the features to make the predictions. The paper therefore argues that it is important for research in applied machine learning to provide insights into explainability of the models in addition to other performance metrics like accuracy. This is particularly important for applications in critical domains such as healthcare. A future direction is to investigate methods to quantify the effectiveness of the machine learning models in terms of the insights from their explainability.

Aims: The study aims to take the COVID-19 pandemic as an example to provide a scientific reference for diabetic patients’ self-health management and nurses’ work for these patients when facing future pandemics. Review Methods: It conducted a comprehensive literature search and analysed relevant texts. This article reviews the daily health management of diabetic patients in the context of the COVID-19 pandemic and the role that nurses should play in this process. Results: Diabetic patients face challenges in self-health management during the pandemic, including disruptions in healthcare access, increased mental problems, and unhealthy lifestyles. Nurses serve as the front-line interface between these patients and the healthcare system. Adopting telehealth and remote consultation has effectively bridged the gap created by social distancing measures. Conclusion: Daily self-health management can significantly improve glycemic control and reduce the risk of diabetes-related complications, which is vital during the pandemic when patients may be experiencing disruptions to their routine care. Moreover, empowering patients through educational initiatives led by nurses can bring better self-monitoring, medication adherence, and lifestyle modifications, all of which are crucial in mitigating the effects of diabetes on the body’s immune response, thus reducing the severity of COVID-19 if contracted.

The primary sources of particulate matter are linked to human activity. Certain particulate emissions, particularly those of a finer nature, can significantly impact human health, making them one of the most concerning pollutants. Ultrafine particles (UFP), which have a diameter of less than 100 nm, are of particular concern due to their impact on human health and the difficulty in controlling them. The concentration of ultrafine particles (UFP) in the workplace is a growing concern and is classified as an emerging risk. Workers may be exposed to UFP through inhalation, skin absorption, ingestion, or a combination of these routes. This study aims to determine the levels of UFP exposure among workers in environments with varying direct particle emission patterns. Measurements were conducted to compare the results with the levels recommended by the WHO. The study monitored industrial workplaces with direct particulate matter emissions, such as a carpentry and a bakery, as well as social sector sites without or almost without direct particle emissions, such as a school and a health clinic. One conclusion drawn from this study is that all tasks and occupations are susceptible to high levels of UFP, exceeding WHO recommended values in virtually all monitored environments. Therefore, monitoring and controlling UFP is crucial. Further in-depth studies on this subject are also necessary..

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.

Background and objectives: Effective management for chronic diseases, hereditary and rare diseases and Thalassaemia in particular constitutes an important indicator for the quality of healthcare systems. We aimed at assessing healthcare services in different countries by using publicly available health indicators and by surveying Thalassaemia patients and their caregivers. Materials and Methods: We reviewed official worldwide databases from the WHO, World Bank, and scientific resources and also used a structured patient tailored self-completed questionnaire to survey Thalassaemia patients and their caregivers in 2023. Results: A total of 2,082 participants were surveyed (mean age 27 years, males 42%). About 1 in 4 respondents had less than high school education, while 24% had a bachelor degree. About a third of respondents were married and had either full- or part-time employment. The vast majority (~80%) had initiated transfusion therapy between 1 – 4 years of age. Only 42% reported no delays in receiving blood transfusion, while 47% reported occasional delays and 8% serious delays. About half of patients reported being very satisfied (11%) or satisfied (38%) with the quality of provided services, while 1 in 3 patients reported being unsatisfied or very unsatisfied, and their access to treatment was difficult or very difficult due to traveling expenses and high cost of treatment. Conclusion: Important improvements in the care of Thalassaemia patients have been documented during the past decades. Nevertheless, our recent survey reveals many unmet needs where additional focus is required through national healthcare systems in order to address them effectively and achieve satisfactory patient outcomes.

Recent evidence suggests that the lower gut microbiome of ruminants presents roles in their health and environment, including the development of the mucosal immune system, milk production efficiency and quality and subsequent methane emissions. However, there are proportionately fewer studies on this complex microbial community in cattle and region-focus studies are non- existent. Herein, we present the research protocol of the GUTBIOME CY project pertaining to determine the composition of the lower gut microbiome in dairy cows situated in 37 farms across five districts of the island of Cyprus. Detailed questionnaires on animal husbandry and farming practices will be gathered from each farm. Faecal, milk (individual and bulk) and water samples will also be collected from cows and their offspring. Samples will be analysed using a combination of molecular biology and bioinformatics pipelines to define microbiome profiles and antimicrobial resistance (AMR). Information collected from the questionnaires will be use to test for associations between animal husbandry or farming practices and microbiome components and AMR. Collected samples will establish the first dairy cattle biobank in the country for contributing substantially towards scientific advancements in microbiome research and providing insights to all stakeholders, tailored to the unique agricultural context of Cyprus.

A temporary monitoring system was installed on the 175-years-old historical Széchenyi chain bridge under its reconstruction process. The bridge is in the downtown area of the capital city of Hungary and plays a significant role in city life of Budapest. Six-month-long measurements were conducted during the reconstruction process of the bridge, yielding crucial insights into the structural behaviour of the historical structure. Measurement results were evaluated; the findings encompass the rotation capacity of pins between chain elements, and structural response to temperature changes. This information helped the decision-making of designers and construction company during the reconstruction made between 2021 and 2023. For instance, daily temperature fluctuations result in increased bending moments in the chain elements, rising up to 158% compared to the values observed during a proof load test in 2018. Furthermore, the measurements reveal an approximate 42% increase in normal forces compared to the proof load test, which highlights the high sensitivity of chain bridges to temperature fluctuations, where geometric stiffness plays a crucial role. Reconstruction, reducing self-weight, notably intensifies the impact on normal forces and bending moments. These outcomes strongly emphasize the dominance of dead load and self-weight in the case of chain bridges.

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.

In this work, quiescence is added to the Susceptible-Infectious-Recovered (SIR) model with demography. In order to investigate consequences of quiescence in the infection process in more depth, we use stochastic simulations on the stochastic version of model that we built. This method provides a more accurate picture of the dynamics of infectious diseases by taking into consideration the inherent randomness in the disease processes. We examine the effects of quiescence on the number of infected people using simulations. The results, presented in histograms depicting the distribution of infected individuals, reveal a notable trend: the mean number of infected individuals is higher when quiescence is incorporated into the dynamics. These finding emphasizes the dynamic influence of quiescence on infectious disease spread. The higher mean number of infections during periods of quiescence highlights the need for public health strategies that are flexible enough to focused interventions during these times to reduce the possibility of an increase in infections.

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.

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.

Food fraud (often called fake food in South Africa), the deliberate misrepresentation or adulteration of food products for financial gain, is a growing problem in South Africa (SA) with severe public health and financial consequences for consumers and businesses. The recent public outcry against food fraud practices, especially in communities that have lost loved ones due to the consumption of allegedly unsafe foodstuffs, highlights the grave danger that food fraud poses to consumers and the potential for significant reputational damage to food manufacturers. Despite the risks, food fraud often goes undetected, as perpetrators are becoming increasingly sophisticated. The precise magnitude of food fraud remains obscure, as incidents that do not cause consumer illnesses are frequently unreported and, as a result, are not investigated. Food fraud costs the global economy billion annually. This cost is borne by consumers, businesses, and the government. Food fraud can occur at any stage of the food supply chain, from production to processing to retailing or distribution. This is due in part to the limitations of current analytical methods, which are not always able to detect food fraud. This systematic literature review of food fraud in SA looks at several factors that may be contributing to epidemic of food fraud (fake food), including lenient penalties, inadequate government commitment, a complex labelling regulations, emerging threats such as e-commerce, and a shortage of inspectors and laboratories. The review recommends establishing a single food control/safety authority, developing more food safety laboratories, and adopting innovative technologies to detect and prevent food fraud. SA faces a serious food fraud crisis unless decisive action is taken.

This paper exposes the initial part of a larger research on the impact of the automotive on human health and the quality of life and environment. After a brief introduction on the need for responsible and sustainable approaches and few questions on the subject, some considerations and statistical data are presented, based on a study of the literature on the impact of road traffic and vehicles noise and vibration on people's comfort and health and their quality of life. The research results show, based on official statistics, the significant harmful impact of noise and vibration from motor vehicles and road transport on people's health and quality of life, especially in urban areas during the day. Also, the significant increase in the number of electric and hybrid vehicles from one year to another, a reality and a necessity nowadays, and the awareness that electric vehicles are not perfectly quiet and comfortable, open new research opportunities and require the development of new standards, materials, tools, equipment and test methods in the field of NVH, in a sustained synergistic approach from all stakeholders, to meet the needs and demands of today's consumers, and to comply with existing regulations and standards on environmental protection and sustainable development.

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.

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.

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.

Contagious pathogens have very high costs for dairy herds, and they may have zoonotic and reverse-zoonotic potentials, and may contribute in spreading antimicrobial resistance. One of the most important risk factors for spreading these infections is milking, when liner contamination may transfer the pathogens from infected to healthy cows. There is no effective protocol for avoiding the transmission of infection out of the segregation of infected cows. Recently, the availability of elastomers including patented antimicrobial components in their formulations has opened the way to explore alternative methods to decrease infection risk. Two different types of elastomers (rubber and silicon) and 9 different receipts were challenged by three major mastitis pathogens (S. aureus, S. agalactiae, and E. coli). The results showed interesting and unexpected results. Indeed, for the first time to our knowledge, we have shown that basic rubber materials have intrinsic antimicrobial activity. Silicon elastomers did not exhibit the same levels of killing activity, although they did exhibit some antibacterial capacity. Generally, a significant decrease in bacterial survival curves was observed with the tested formulations. The results observed for the various products are likely due to the specific activity of the chemical components, as well as the diverse chemical reactions that occur during their production. The availability of new tools able to reduce the risks for the spread of infections and generally decrease the bacterial load at milking, would be an important step forward to achieve a higher global sustainability of dairy production from a One Health perspective.

This study aimed to assess the diagnostic accuracy of a mobile application by comparing its diagnoses to those of Orofacial Pain and Oral Medicine specialists and further imaging results (TMJ CBCT and MRI) in 500 patients with temporomandibular disorder (TMD). The research focused on three diagnostic categories: initial specialist diagnoses, final diagnoses after imaging, and the mobile app's diagnoses. The concordance rate, sensitivity, specificity, and positive predictive value of the diagnoses were examined, with further imaging serving as the gold standard. The mobile app demonstrated a high concordance rate compared to both final (0.93) and initial specialist diagnoses (0.86). Sensitivity, specificity, and positive predictive values also indicated strong reliability, affirming the app's diagnostic validity. Although the concordance rate was slightly lower when comparing the app's diagnoses to imaging results (CBCT and MRI), specialist diagnoses yielded similar results. The study suggests that user-friendly diagnostic mobile applications, based on the Diagnostic Criteria for Temporomandibular Disorders, could enhance the clinical management of TMD. Given the reliability of mobile applications for diagnostic purposes, their wider implementation could facilitate the provision of appropriate and timely treatments for patients with TMD.

Many relevant health social actors have voiced concerns about the danger of self-medication in times of growing use of over-the-counter medicines and, in some contexts, unregulated selling of them. Previous research has examined the incidence of parental self-medication as well as the use and abuse of antibiotics without professional advice. However, these studies have limited evidence on the role of family doctors and the perceived severity of self-medication in the case of parents. Based on Health Belief Model, our research tested the effects of exposure to medical information on the perceived level of self-treating the children without medical advice. Specifically, we aimed to assess whether exposure to information warning about the risks of treating children without a medical prescription influences parents' attitudes toward administering medicines to their children without medical advice. The results showed that our respondents evaluated the practices of self-medication negatively, especially when it came to treating their children without medical advice. However, their attitudes towards self-medication varied depending on their beliefs about administering certain medications. Additionally, the results showed that the perceived level of satisfaction with the family physician could be a significant factor in controlling and avoiding the treatment of children without professional advice.

Pasture-based production systems are predominant in major beef-producing countries, however, these systems lack validated protocols to assess animal welfare under commercial conditions. The objective of this study was to validate an animal welfare protocol for fattening Zebu cattle farms in tropical pasture systems. The initial protocol was developed with the participation of producers, professionals, the general public, and the Colombian health authority, through workshops with a participatory approach and collaborative knowledge management. The validation was carried out in 24 pasture-based commercial Zebu cattle farms in the middle Magdalena region of Colombia. Visits were made with an average duration of 2.5 hours, which included the evaluation of 788 fattening cattle. The protocol evaluated animal-based, resource-based, and livestock management indicators through a questionnaire-guided interview to evaluate cattle handling and health, animal-based measurements, and documentation management. A protocol validation process was carried out by selecting indicators that remained unchanged, adjusting those that were feasible to implement, and eliminating inadequate or unnecessary indicators. The application of the protocol demonstrated that there are valid and feasible measures to include in the evaluation protocols of pasture-based fattening systems. Likewise, the active participation of producers is crucial to achieving a greater commitment to the implementation of this protocol.

Background and Aims: Paramedics attend an unprecedented number of drug poisoning events daily in British Columbia (BC), Canada due to the ongoing public health crisis related to an increasingly toxic and unregulated supply of illicit drugs. Paramedics have the potential to support alternative models of care to reduce harm, but their perspectives towards harm reduction initiatives are polarized. Understanding the drug-related substance use content in paramedic curriculum documents is important for deploying effective harm mitigating programs. The objective of this study was to understand what drug-related substance use content currently exists within paramedic curriculum documents in British Columbia. Methods: We performed a document analysis of curriculum documents in BC’s paramedic training institutions, the primary program textbook, and the 2011 National Occupational Competency Profile (NOCP). We used the Checklist for Assessment and Reporting of Document Analysis (CARDA) tool to perform our analysis. We analysed and coded documents both inductively and deductively and subsequently combined, refined, and used the codes to inform the development of themes via reflexive thematic analysis. Results: Of the 44 documents analysed, 22 included codes relevant to the research questions. Paramedics are primarily taught to care for people who use drugs in an acute drug-poisoning response only, with little consideration of holistic care, and no meaningful mention of harm reduction. Some stigmatizing language was found within the content. Conclusions: Many opportunities to introduce holistic models of care for people who use drugs along the entire continuum of care are unaddressed by paramedic curriculum documents in BC. Curriculum developers should include people who have lived and living experience of drug use in the co-design of educational programs involving their care. Further qualitative analyses are required to evaluate the relationship between paramedic education and provider-based stigma.

Background: Informal caregivers' own quality of life, health status, and determinants are poorly understood despite their concerns for the health of the individuals they assist. Objectives: To compare the quality of life and the health determinants of older informal caregivers with those of older adults without caregiving responsibilities. Methods: An online survey was designed to investigate the quality of life and the health determinants of people aged 65 years and over, with a focus on informal caregivers. In addition to socio-demographic data, the number of informal caregiver and the Zarit scale of caregiver burden were collected. Quality of life (SF-12) and health determinants (access to technology and level of physical activity (IPAQ)) were assessed and compared between informal caregivers and the others. Results: A total of 111 participants (70 ± 3.83 years, 71.2% of women). The majority of respondents (91.8%) were Belgian. One third of the respondents identified themselves as informal caregiver and declared to have severe burden (61.9±15.2/88). Socio-demographic characteristics and access to technology were similar between informal caregivers and non-caregivers (p>0.05). However, informal caregivers have a lower SF-12 score in the mental score domain (44.3±10.2 vs; 50.7±7.0; p=0.004) and a lower level of physical activity (434±312 METS/min/week vs.1126±815 METS/min/week; p=0.01) than their peers. Conclusions: Informal caregivers reported lower quality of life and lower level of physical activity than their peers. Given the recognized importance of physical activity for overall health, this survey highlights the need to promote physical activity among older informal caregivers.

(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.

Healthcare workers have atypical working schedule and are exposed to experienced stress that led to poor sleep health and frequent mental complaints, particularly since the Covid-19 crisis. We conducted a cross-sectional study to determine the prevalence of poor sleep hygiene and mental complaints and their associations among healthcare workers. Usual sleep-wake timings were ex-plored during workdays and free days and used to compute sleep duration, sleep efficiency and social jetlag. Insomnia, sleepiness, anxiety and depressive symptoms, and fatigue were calculated using validated scales. A total of 1,562 participants were included (80.5% of women and mean age of 40.0). Among them, 25.9% slept less than 6 hours, 24.3% had a poor sleep efficiency, and 11.5% reported a social jetlag. A total of 33.9% of participants reported insomnia, 45.1% reported EDS, 13.1% reported fatigue, 16.5% reported depression and 35.7% reported anxiety. After ad-justment, sleep duration and sleep efficiency were associated with mental complaints. Social jetlag was associated with significant insomnia but not with anxiety or depression symptoms. Healthcare workers have a high prevalence of poor sleep hygiene and mental complaints. The promotion of sleep health through behavioral sleep strategies should be encouraged to ensure good health for these professionals.

Nurses focus more on curative aspects rather than health promotion and disease prevention, thus weakening primary health care and lessening engagement with the community. Providing a learning environment that can support the professional growth of nurses through engagement with local communities and educational institutions would strengthen primary health care in the community; however, this poses challenges due to the traditional mindset of nurses towards primary health care. This integrative review aimed to explore key features of the potential of the nursing center model as a contracting-out approach to strengthen primary health care services. This integrative review provides lessons for implementing the Nursing Centre model for any country, mainly where nurses are not fully utilized for health promotion and disease prevention.

Cardiovascular diseases (CVD) are prevalent and lead to high morbidity and mortality globally. Physiotherapists regularly interact with patients with or at risk of CVDs (pwCVDs). This study aimed to assess the nature of existing evidence, interventional approaches used, and the population groups included in physiotherapy-led health promotion (PLHP) for pwCVDs. The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Medline, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and PEDro databases were searched from inception until June 2023. Two reviewers independently screened the titles, abstracts, full text and conducted data extraction. All conflicts were resolved with a third reviewer. A total of 4992 records were identified, of which 20 full-text articles were included in the review. The studies had varied populations, including those with stroke, coronary artery diseases, peripheral artery diseases, hypertension, diabetes, and multiple CVD risk factors. The interventions ranged from exercise and physical activity programs, dietary interventions, education, and counselling sessions with various supplementary approaches. Most interventions were short-term, with less than 12 months of follow-up. Interventions were personalised and patientcentred to promote adherence and health behaviour change. Among the included studies, 60% employed experimental designs, with the remainder using quasi-experimental designs. Although a wide range of PLHP strategies have been used for pwCVDs, exercise and physical activity were employed in 85% of included studies. Other components of health promotion, such as sleep, smoking, and alcohol abuse, should be investigated within PLHP.

Workplace bullying is a prevalent issue with a significant impact on employees’ mental health. This study aimed to explore the relationship between workplace bullying and the prevalence of depression with a particular focus on the role of gender. A total of 12,344 Korean employees aged 19–65 years were included in the study. They completed questionnaires including the Korean version of the Occupational Stress Scale, the Oldenburg Burnout Inventory, and the Center for Epidemiologic Studies Depression Scale (CES-D). A score of 16 or higher in CES-D indicated depression. The association between workplace bullying and depression was analyzed using logistic regression analyses. The average CES-D scores were higher for both male and female employees who experienced bullying than for those who did not (p &lt; 0.001). The association between the experience of workplace bullying and the prevalence of depression was statistically significant for both genders, with a stronger correlation observed among male employees (p for interaction &lt;0.001). Organizations are urged to address workplace bullying, particularly for male employees, through the implementation of anti-bullying strategies and policies, as well as the provision of mental health resources and support.

To supply stable and high-quality power according to the advancement of industrial growth, electric power companies have performed maintenance of power facilities using various meth-ods. In the case of domestic power distribution facilities, there are limitations in performing di-agnostic management on all facilities owing to the large number of facilities; therefore, old fa-cilities are managed by the health index assessment method. The health index assessment com-prises only facility operation data and external environmental data and is managed only for four types of distribution facilities, including overhead/underground transformers and switchgear. In the case of extra high–voltage overhead wires, there is no standard for old replacement, despite the large number of wires, such as transformers and switchgear, and the large ripple effect of power failure in the event of a power outage. Therefore, in this paper, a health index assessment methodology for extra-high voltage overhead cables was developed. In this paper, we devel-oped an economic health index assessment methodology that additionally considers risk cost, which is different from the existing health index assessment method that uses only operational data and external environmental data to determine facility performance evaluation and aging replacement criteria. Using the health index assessment methodology developed in this paper, it is possible to expect a reduction in facility operating costs and investment costs from the per-spective of electric power companies through the replacement of old extra-high voltage over-head cables. In addition, from the perspective of consumers, it is expected to increase power re-liability and reduce the ripple effect of failure by preferentially replacing equipment with a high probability of failure.

Unnatural diet composition and frequent feeding regimes may play an aetiological role in the multiple diseases prevalent in captive cheetahs. This study investigated the responses of captive-born (hand-reared) cheetahs (n = 6) to a reduced feeding frequency schedule. During the 3-week treatment period, the study cheetahs were fed four once-daily meals per week and two daily rations six days a week, subsequently, during the control period of equal duration. Total weekly food intake was maintained throughout the study. Variations in body temperature (Tb), heart rate (HR), locomotor activity (LA), behaviour, faecal glucocorticoid metabolite concentration, and faecal consistency score (FCS) were measured. Less frequent feeding resulted in higher FCS (p < 0.01) and LA (p < 0.0001) and lower HR (p < 0.0001) among the studied cheetahs. The study found that their HR was higher when the cheetahs were fed (p < 0.0001) than on days when they were not. Additionally, Tb (p < 0.0001) and HR (p < 0.05) were higher during feeding, suggesting a psychological excitation to food consumption. The results of the FCS analysis indicate that the more natural feeding pattern could have benefited the studied cheetahs’ GI health without a significant behavioural or physiological stress response to the change in feeding frequency.

Microbiological control of dental pathologies presents a significant clinical challenge for dental surgeons, particularly considering drug-resistant microorganisms. To address this issue, Antimi-crobial Photodynamic Therapy (PDT) has emerged as an effective and complementary technique for microbial reduction. This therapy involves the application of a photosensitizer dye (PS) either topically or systemically, followed by exposure to low-power lasers with appropriate visible light wavelengths. PDT has found a valuable place in dentistry across various specialties, including surgery, periodontics, endodontics, dentistry, implantology, orthodontics, and pediatrics. In the realm of pediatric dentistry, managing microorganisms during dental treatments has become a major challenge.This article reviews the evidence supporting the potential of photodynamic therapy in combating bacteria, fungi, and viruses, with a particular focus on areas such as endodontics, restoration in deciduous teeth, implantology, and periodontics for bacterial control. Additionally, PDT has shown promise in stomatology, specifically in the treatment of mucositis and herpes. Considering its promising results and ease of application, photodynamic therapy presents an in-teresting alternative for clinical practice. However, it is important to note that specific protocols must be followed for each application, encompassing the type of photosensitizer, concentration, pre-irradiation time, light type, wavelength, energy, power, and mode of light delivery. Researchers have been steadily refining these protocols to facilitate PDT's integration into clinical practice.

Purpose: Hormone Replacement Therapy (HRT), an FDA-approved treatment for menopausal conditions was found to be associated with increased risk of endometrial cancer and reduced oestrogen. Studies showing benefits of HRT in preventing chronic diseases lead to development of clinical guidelines by American College of Physicians. This study aims to assess effectiveness of HRT treatments across cardiometabolic measures including Triglycerides (TG), Follicle-Stimulating Hormone, LDL cholesterol, HDL cholesterol, and Estradiol in menopausal women. It reports gaps in scientific knowledge and clinical practice to enhance current guidelines and policies.Methods: A systematic methodology designed and published in PROSPERO (CRD42022346057) to report network meta-epidemiology analysis was utilised. We used databases by PubMed, Web of Science, ScienceDirect, EMBASE and MEDLINE for studies published between 30th of April 1980-2022. Effects of HRT treatments were explored using a mixed treatment comparison (MTC) model. Fixed and random-effects models were used to address heterogeneity in published studies. Publication bias was assessed and corrected using funnel plots and Egger’s test.Results: Of 45 eligible studies, our findings indicate a significant statistical heterogeneity between HRTs and reduction of TG, SFH, LDL-C alongside increase of HDL-C and Estradiol among menopausal women. The analysis suggests a lack of direct evidence to support their efficacy in reducing TG, SFH and LDL-C levels or to substantiate HRT’s effectiveness in increasing HDL-C and Estradiol. The results showed no significant publication bias in the meta-analysis of included studies.Conclusion: Our findings demonstrate that use of HRT interventions among menopausal women may reduce TG, FSH and LDL-C levels and increase levels of HDL-C and estradiol via oral and oral + transdermal administration. Our study reaffirms efficacy of HRT in supporting favourable lipid profile in menopausal women whilst highlighting the need for robust and inclusive epidemiology studies and clinical trials to further develop clinical guidelines and policies.