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

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

Background: The potential of Artificial intelligent (AI) models to process and interpret large health datasets at scale could revolutionize public health and epidemiology, providing a foundation for public health. Ethics has been recognized as a priority concern in the development and deployment of AI. Because AI technology can jeopardize patient safety, privacy, and posing a new set of ethical problems that must be addressed. Objectives: We aim to provide a holistic view on what are the different ethical and legal principles that was addressed in the included studies regarding the use of AI in public health and what are the ethical challenges that can arise.Methods: Following PRISMA guideline, five bibliographic databases were used in our search: PubMed, Scopus, JSTOR, IEEE Xplore, and Google Scholar from 2015 to February 2022. Four reviewers carried out study selection and data extraction, and the data extracted was synthesized by a narrative approach. Results: This review included 23 unique publications out of a total of 1123 items that were initially identified. Different ethical principles regarding the uses of AI in public health and community health were identified and discussed distinctly in the current review. The common ethical and legal themes that this review focused on are equity, bias, privacy and security, safety, transparency, confidentiality, accountability, social justice, and autonomy. In addition, five ethical challenges were mentioned. Conclusion: Research regarding ethical and legal principles and challenges about using AI in public health specifically consider a new filed, because all previous themes are concerning the physical and patients’ area where it focuses only on the clinical settings.

This study uses explainable artificial intelligence to analyze major predictors of poor self-rated health, dementia and their comorbidity, which include various aspects of social support. Data came from the Korean Longitudinal Study of Ageing (2016-2018), with 5527 participants aged 56 or more. The dependent variables were: (1) poor self-rated health (SRH) with 5 categories (very good, good, middle, poor, very poor); (2) dementia (no, yes); and (3) their comorbidity with 4 categories (SRH very good, good or middle, dementia no; SRH very good, good or middle, dementia yes; SRH poor or very poor, dementia no; SRH poor or very poor, dementia yes). The 49 demographic, socioeconomic and health-related predictors were included. The accuracy and area under the receiver operating characteristic curve (AUC) were compared for logistic regression and the random forest. Logistic regression and the random forest registered similar AUCs with the range of 0.80-0.87. Based on random forest variable importance, 18 out of top-20 predictors were identical for SRH, dementia and their comorbidity: previous SRH, life satisfaction - health, age, body mass index, income, chronic diseases, life satisfaction - economic, life satisfaction - overall, grandchildren alive, friendship meeting, brothers/sisters alive, class identity, children alive, social activity - friendship, education, children in weekly contact, religion and drinker. However, some variations were found among the three dependent variables, i.e., previous SRH for comorbidity (1st) and SRH (1st) compared to dementia (11th), grandchildren alive for SRH (6th) and dementia (4th) compared to comorbidity (9th), chronic diseases for comorbidity (6th) compared to SRH (10th) and dementia (10th). In terms of Shapley Additive Explanation (SHAP) values, the probability of dementia is expected to decrease by 5.57% in case a predictor grandchildren alive is included to the model. This study highlights the importance of social support for the prediction of poor self-rated health, dementia and their comorbidity. Specifically, the promotion of family support and friendship activity for elders would be vital for the prevention and management of their self-rated health and dementia.

Background: Evidence suggests that children and young people (CYP) who present to the emergency department (ED) for mental health (MH) difficulties may have extended lengths of stay (LOS); however, there is a paucity of research in Australia regarding the factors associated with extended LOS. This study aimed to determine the factors associated with extended LOS for paediatric MH-related presentations to the EDs in South Western Sydney (SWS), a multicultural community in Australia. Methods: We analysed electronic medical records (eMR) of 7,409 MH-related ED encounters of CYP aged 0 up to 18 years from all six public hospitals in SWS from January 2016 to April 2022. Extended LOS was defined as encounters of more than 4 hours. We assessed factors associated with extended LOS using a multilevel logistic regression model, accounting for hospital-level clustering. Results: Approximately 57.6% of all ED presentations for paediatric MH involved extended LOS. ED presentations by adolescents (adjusted odds ratio (AOR) 2.23, 95% CI 1.20-4.17 for 12-14 years and AOR 2.69, 95% CI 1.44-5.00 for 15-17 years), and patients with a preferred language other than English (AOR 1.47, 95% CI 1.15-1.89) had increased odds of extended LOS compared to their counterparts. Deliberate self-harm related presentations, the most commonly presented MH condition, had higher odds of extended LOS than other MH-related presentations (AOR 1.77, 95% CI 1.59-1.98). Patients with MH presentations that required urgent evaluation (triage levels 1-2) had higher odds of extended LOS (AOR 1.38, 95% CI 1.15-1.65) compared to triage level 3, whereas those with triage levels 4-5 had lower odds (AOR 0.66, 95% CI 0.58-0.74). Further, patients with MH-related presentations that came by ambulance (compared to other mode of presentations) and presentations that happened at night and late at night (compared to early morning and daytime presentations). The odds of extended LOS were considerably lower during the COVID-19 period compared to the pre-COVID-19 period (AOR 0.74, 95% CI 0.67-0.82). Additionally, extended paediatric LOS for MH issues in the ED showed notable hospital-level heterogeneity. Conclusion: A large proportion of extended LOS in ED and sociodemographic disparities reflect inequality in access to paediatric MH care. Our findings highlight the need for equitable distribution of resources directed towards at-risk CYP to improve MH outcomes and reduce health system burden.

World statistics demonstrate that around 970 million people around the globe suffer from mental health problems (Ritchie & Roser, 2019), a major proportion of which comprised of adolescents and young adults (UNODC, 2018). Also, because of increased mental health issues the problems like substance use, suicide, depression, anxiety, and stress are also increasing (Armstrong, 2019; Bandelow & Michaelis, 2015; Ritchie & Roser, 2018; United Nations Office on Drugs and Crime [UNODC], 2019). It is thus a dire need to address the issue. The present coneptual paper proposed the role of transpersonal gratitude, emotional intelligence, and life contentment for reducing mental health risk among the adolescents and young adults.

Artificial intelligence (AI) has the potential to revolutionize research by automating data analysis, generating new insights, and supporting the discovery of new knowledge. The top 10 contribution areas of AI towards public health were gathered in this feasibility study. We utilized the “text-davinci-003” model of GPT-3, using OpenAI playground default parameters. The model was trained with the largest training dataset any AI had, limited to a cut-off date in 2021. This study aimed to test the ability of GPT-3 to advance public health and to explore the feasibility of using AI as scientific co-author. The AI was asked for input including scientific quotations and the human authors reviewed responses for plausibility. We found that GPT-3 was able to assemble, summarize, and generate plausible text blocks relevant for public health concerns, elucidating valuable areas of application for itself. However, most quotations were invented by GPT-3 and thus, invalid. Ac-cording to today’s rules, we conclude that AI can contribute to public health research as a team member. Nevertheless, good scientific practice needs to be also followed for AI contributions, and a broad scientific discourse on AI contributions is needed. Policies for good scientific practice should be updated timely following this discourse.

Objective: The main purpose of this study was to investigate the mental health of Cypriot citizens, living in the current difficult period of economic recession. Specific objective was to investigate the different factors (gender, age, socio-economic factors, etc.) that may affect the levels of emotional distress, anxiety and depression in visitors of the Rural Health Centre of Kofinou. Materials and Methods: The sample consisted of total 300 Cypriots who visited Kofinou Health Centre in the period between August and September 2015. For the middle-aged citizens the Greek version of the HADS scale (Hospital Anxiety Depression Scale) was administered to 150 persons (Michopoulos I., 2007), while for the visiting senior citizens (aged over 65 years) the Greek version of the GDS scale (Geriatric Depression Scale) was used (Fountoulakis K., et al., 1999). All analyses were performed with the social science analysis package SPSS (version 21). Results: HADS: A total of 150 people of average age 47±11,5 years (23-64), were 56% women, while the 77.3% stated they had drastic reduction of income as well as 46.7% suffered from chronic disease. The 36.6% and 28.7% of the visitors showed moderate and severe forms of anxiety and depression, accordingly. Higher emotional distress is associated with lower educational level (p<0,001). Moreover, patients with low income have higher levels of anxiety (p=0,003), depression (p=0,036) and total emotional distress (p=0,007), while those with chronic disease have a higher stress (p<0,001), depression (p<0,001) and total emotional distress symptoms (p<0,001) compared to non - patients. GDS: 150 patients out of which 77 were women (51.3%). The average age of participants was 72±5,5 years. 93(62%) participants declared a drastic reduction of income due to the financial crisis while 139 (92.7%) stated they had chronic disease. 53 participants (35.3%) think they have symptoms of depression after the economic crisis. The women showed higher level of geriatric depression symptoms than men (p<0.001). Higher levels of depression is associated with lower income (p=0.001). Conclusions: The study shows that stress levels, depression and emotional distress are increased in specific population groups. The main factors affecting the mental health of the participants are the presence of chronic disease, income and level of education.

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

Artisanal and small-scale gold mining (ASGM) has been an important source of income for communities in the Madre de Dios River Basin in Peru for hundreds of years. However, in recent decades, the scale of ASGM activities in the region has increased dramatically, and exposures to a variety of occupational and environmental hazards related to ASGM, including mercury, are becoming more widespread. The aims of our study were to: (1) examine patterns in the total hair mercury level of human participants in several communities in the region and compare these results to the 2.2 µg/g total hair mercury level equivalent to the World Health Organization (WHO) Expert Committee of Food Additives (JECFA)’s Provisional Tolerable Weekly Intake (PTWI); and (2), to measure the mercury levels of paco (Piaractus brachypomus) fish raised in local aquaculture ponds, in order to compare these levels to the EPA Fish Tissue Residue Criterion of 0.3 µg Hg/g fish (wet weight). We collected hair samples from 80 participants in four communities (one control and three where ASGM activities occurred) in the region, and collected 111 samples from fish raised in 24 local aquaculture farms. We then analyzed the samples for total mercury. Total mercury levels in hair were statistically significantly higher in the mining communities than in the control community, and increased with increasing distance away from the Madre de Dios headwaters (as the crow flies), did not differ by sex, and frequently exceeded the reference level. Regression analyses indicated that higher hair mercury levels were associated with residence in ASGM communities. The analysis of paco fish samples found no samples that exceeded the EPA tissue residue criterion. Collectively, these results align with other recent studies showing that ASGM activities are associated with elevated human mercury exposure. The fish farmed through the relatively new process of aquaculture in ASGM areas appeared to have little potential to contribute to human mercury exposure. More research is needed on human health risks associated with ASGM to discern occupational, residential, and nutritional exposure, especially through tracking temporal changes in mercury levels as fish ponds age, and assessing levels in different farmed fish species. Additionally, research is needed to definitively determine that elevated mercury levels in humans and fish result from the elemental mercury from mining, rather than from a different source, such as the mercury released from soil erosion during deforestation events from mining or other activities.

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

Global rapidly evolving events, e.g., COVID-19, are usually followed by countermeasures and policies. As a reaction, the public tends to express their emotions on social media platforms. Therefore, predicting emotional responses to events is critical to put a plan to avoid risky behaviors. This paper proposes a machine learning-based framework to detect public emotions based on social media posts in response to specific events. It presents a precise measurement of population-level emotions which can aid governance in monitoring public response and guide it to put in place strategies such as targeted monitoring of mental health, to react to a rise in negative emotions in response to lockdowns, or information campaigns, for instance in response to elevated rates of fear in response to vaccination programs. We evaluate our framework by extracting 15,455 tweets. We annotate and categorize the emotions into 11 categories based on Plutchik’s study of emotion and extract the features using a combination of Bag of Words and Term Frequency-Inverse Document Frequency. We filter 813 COVID-19 vaccine-related tweets and use them to demonstrate our framework’s effectiveness. Numerical evaluation of emotions prediction using Random Forest and Logistic Regression shows that our framework predicts emotions with an accuracy up to 95%.

Adolescence is a crucial phase marked by significant physical, psychological, emotional and social changes. India having the world's largest adolescent population, understanding and addressing their health needs are vital for the nation's social, political, and economic progress. The primary aim of this study is to examine the impact of key health policies on adolescent health outcomes in India. To achieve this objective, the research adopts a mixed-method approach, combining qualitative and quantitative analysis of health policies, strategies, and programs implemented since 2005 was conducted. Additionally, data from the most recent three Demographic Health Surveys (DHS) were analyzed and compared to assess changes in adolescent health indicators after the implementation of these policies/strategies. Major adolescent health policies in India were assessed, namely the Adolescent Reproductive and Sexual Health Strategy (ARSH 2005), Rashtriya Kishor Swasthya Karyakram (RKSK 2014), and School Health Programme 2020. All the strategies and programs aim to provide a comprehensive framework for sexual and reproductive health services, expand the scope of adolescent health programming, and address various health aspects. The SWOT analysis findings, highlighted strengths in targeted interventions, monitoring, and promotion, but weaknesses in awareness, societal barriers, and healthcare worker participation. Opportunities include female-friendly clinics and education about early pregnancy, while addressing substance abuse and training volunteers remain challenges. Family planning has improved, with higher contraception usage and a decrease in unmet needs. Violence reduced, and positive health behaviors increased, such as condom use. However, challenges remain, including limited access to health services, concerns about female providers, and low health insurance coverage. Nutrition indicators show a slight increase in overweight/obesity and anemia rates. Overall, progress has been made, but certain health aspects still require attention. Therefore, conducting targeted awareness campaigns, strengthening health worker and NGOs engagement, combating the increasing prevalence of overweight and obesity among adolescents are highly recommended. Further efforts are needed to achieve universal health coverage and improve adolescent health outcomes globally.

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.

(1) Background: There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. (2) Methods: 155 Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. (3) Results: Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. 4) Conclusion: This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

International migrants comprised 14% of the UK population in 2020, but migrant health in the UK has rarely been studied at a population level using primary care electronic health records (EHRs). Given the difficulty of determining migration status using EHRs, this study developed a migration phenotype and assessed its validity. We developed a phenotyping algorithm using codes for country of birth, visa status, non-English main/first language and non-UK origin. It was applied to a Clinical Practice Research Datalink (CPRD) GOLD database of 16,071,111 primary care patients between 1997 and 2018. We compared the completeness and representativeness of the identified migrant population to Office for National Statistics (ONS) country of birth and 2011 census data by year, age, sex, geographic region of birth and ethnicity. Between 1997-2018, 403,768 migrants (2.51% of the CPRD GOLD population) were identified using the phenotype. 178,749 (1.11%) of these migrants were identified by codes indicating foreign country of birth or visa status, 216,731 (1.35%) a non-English main/first language, and 8,288 (0.05%) non-UK origin. The cohort was similarly distributed compared to ONS migration statistics in terms of sex and region of birth. Recording of migration improved from identifying approximately one-tenth of the expected proportion of migrants according to the ONS in 2004 to a quarter in 2018. Younger migrants were better represented than those aged 50 and over. The migration phenotype identified a large number of migrants and can be used to undertake large-scale migration health research in CPRD GOLD to inform healthcare policy, practice and action. While the cohort was representative of the UK migrant population in terms of sex and region of birth, migration status was under-recorded in earlier years and older ages, and future studies for these groups should therefore be interpreted with caution.

Although health policy resides mainly with the government, industry can play an important role in building a health ecosystem. From March to May, we administered questionnaires to 1,200 individuals from the general Korean population asking about their perception of health-friendly labels, and if they would purchase such labeled products (foods, pharmaceuticals, etc.) and services (purifying water, preventing air pollution, etc.) at extra cost. The participants placed a high value on the importance of mental, social, spiritual, and physical health factors in terms of company’s products and services with a score of about 8 out of 10 (range, 7.74-8.33). Most respondents (72.4%) said they were interested in adopting health-friendly labels. When a health-friendly label is introduced (such as one by the Business for Social Responsiveness), 65.1% of the respondents said they intended to purchase the product or service, while 6.8% said they did not, and 75.0% said they were willing to pay extra for the health-friendly product or service. Multivariate logistic regression models showed urban residence, high education level, and good social health to be significantly associated with positive attitudes toward health-friendly labels. People with high income, no religion, or normal weight were more likely to say they intend to purchase products and services with health-friendly labels. They also had a more positive attitude toward paying more for such products and services, as did people with good spiritual health. This study provides data that illustrate the importance of health-friendly products and services to the general population and companies.

Students are regarded as frequent users of mobile phones which has proven to be a convenient and acceptable method to promote healthy lifestyle. Students usually engage in relatively high levels of risky behavior and make unhealthy lifestyle choices, a study that investigates how health students access health information is necessary. The study adopted a descriptive cross-sectional study which was undertaken among third-year nursing students from three nurses training institutions in Ghana. A total of 270 students participated in the study. Most of the respondents who were currently subscribers of the health messages reported that they usually received health information on reproductive health issues, nutrition, and practicing safe sex. Most of the health students revealed that they needed more information on safe sex, diet, managing weight, and stress management. The results also show that health students are likely to remember and share short messages with friends. The findings serve as an ‘eye-opener’ for health educators and mobile service providers concerning factors that should be taken into consideration when framing health text messages that will attract health students.

Objective: This study aimed to determine impact of eHealth literacy on health promotion activities and preventive health practice among adolescents. Methods: This cross-sectional study was conducted between March and May 2022 with 706 adolescents in Çorum, Turkey. A face to face questionnaire form including socio demographic characteristics, preventive health practices, eHealth Literacy scale and Adolescent Health Promotion Scale were used. The data of the research were analyzed with the SPSS 22.0 program. Percentage, mean, Pearson Correlation analysis and multiple regression analysis were used in the analyzes. The p<0.05 value was considered statistically significant in the evaluations. Results: In the study, 55.8% were female and the mean age of the whole group was 16.09±2.63 years. The mean score of eHealth Literacy scale was 29.40±6.29. The mean of the total scores obtained from the Adolescent Health Promotion Scale was 137.97±21.87. Among the adolescents 96.0% didn’t use alcohol and 81% didn’t smoke. The rate of annual weight measure was 68.8%. Measurements of annual blood pressure, annual blood iron, annual cholesterol, annual dental examination and regular exercise rate were below 50%. There was a significant positive correlation between eHealth literacy and the Adolescent Health Promotion Scale (p<0.001). Multiple linear regression analysis was performed to predict eHealth literacy using the variables of Adolescent Health Promotion and preventive health practices. eHealth literacy was positively and significantly predicts health promotion behaviors (β= 0.27, t (695)= 7.54, p<0.001). eHealth literacy increased annual weight measurement by more than 0.13 (β=0.13), the annual blood iron measurement by more than 0.16 (β=0.16), annual dental examination by more than 0.11 (β=0.11). Conclusions: Adolescents ehealth literacy was high and effected via health promotion activities and preventive health practices. Developing eHealth litracy interventions will be important for environments with a high concentration of adolescents (schools, courses). Also, primary health care services should be entegrated with school environment.

Fungi constitute a diverse group with highly positive and negative impacts in different envi-ronments, having several natural roles and beneficial applications in human life, but also caus-ing several concerns. Fungi can affect human health directly, but also indirectly by being detri-mental for animal and plant health influencing food safety and security. Climate changes are al-so affecting fungal distribution, prevalence, and their impact on different settings. Searching for sustainable solutions to deal with these issues is challenging due to the complexity of the inter-actions among fungi and agriculture, animal production, environment, and human health. In this way, the “One Health” approach may be useful to get some answers since it recognizes that human health is closely connected to animal and plant health, as well as to the shared environ-ment. This review aims to explore and correlate each of those factors influencing human health in this “One Health” perspective.

The aims of this study are to determine the oral health status of a rare sample of 19th-century migrant settlers to South Australia, how oral conditions may have influenced their general health, and how the oral health of this group compares with contemporaneous samples in Australia, New Zealand, and Britain. Dentitions of 18 adults and 22 subadults were investigated using non-destructive methods (micro-CT, macroscopic, radiographic). Extensive carious lesions were identified in 17 adults and 4 subadults, from this group 1 subadult and 16 adults had antemortem tooth loss. Sixteen adults showed evidence of periodontal disease. Enamel hypoplastic (EH) defects were identified in 14 adults and 9 subadults. Many individuals with dental defects also had skeletal signs of co-morbidities. South Australian individuals had the same percentage of carious lesions as the British sample (53%), more than other historic Australian samples, but less than a contemporary New Zealand sample. Over 50% of individuals from all the historic cemeteries had EH defects suggesting systemic health insults during dental development were common during the 19th century. The overall oral health of the South Australian settlers was poor but, in some categories, (tooth wear, periapical abscess, periodontal disease), better than the other historic samples.

Introduction: In recent decades, health literacy, in connection with a broad range of public 1 health terms, has become a burgeoning field. This study aims to explore trends and biases in this 2 area through a bibliometric analysis. Methods: A Random Forest Model was utilized to identify 3 keywords and other metadata that predict annual citations in the field. In order to supplement 4 this machine learning analysis, we have also implemented a bibliometric review of the corpus. 5 Results: Findings indicate a high positive coefficient for the keyword ’Covid-19’ and ’Male’, whereas a 6 negative coefficient was observed for ’Female’, suggesting potential biases. Evolving themes such as 7 Covid-19, Mental Health, and Social Media were discovered. A significant shift was noted in the main 8 publishing journals, while the major contributing authors remained the same. Discussion: The results 9 hint at the influence of the Covid-19 pandemic and potential gender biases on citation likelihood, as 10 well as changing publication strategies despite the fact that the main researchers remain as the ones 11 that have been studying health literacy since its creation.

ABSTRACT: Psychological vulnerability (PV) and low mental health literacy correlate negatively with higher education students' positive mental health and health behaviours. Levels of mental health literacy limit self-help, adaptative coping strategies and academic success. However, few studies examine the significant differences between students' PV, mental health literacy, positive mental health (PMH) and modifiable behaviours variables. Identifying modifiable vulnerability factors is essential when seeking and providing professional help. Method: A cross-sectional descriptive study was conducted to investigate the differences between modifiable behaviours and PV, mental health literacy, and PMH in higher education students. A sample of 3,600 undergraduate students was recruited, mostly female (78.8%), with an average age of 23 years (SD = 6.68). Results: The majority were women, did not exercise, were dissatisfied with sleep quality time per night (62.1% sleep less than 7 hours per night) and did not engage in leisure activities. Also, most respondents had PV and low literacy levels, particularly at F1, and 67.9% scored in the flourishing group. Results showed significant differences (p<0.001) between gender, age, sleep, exercise, diet, leisure activities and PV, and PMH and literacy. Conclusions: The results identified modifiable vulnerability factors that underpin the design of intervention-targeted programmes to promote literacy and PMH in higher education campuses in Portugal to foster students’ well-being and self-help strategies.

Resumo: Este estudo teve como objetivo avaliar a Saúde Mental Positiva (SPM) e a sua relação com características sociodemográficas, literacia em saúde mental e escala de vulnerabilidade psicológica (PVS) em estudantes universitários portugueses com idades compreendidas entre os 17 e os 62 anos. Foi realizado um estudo descritivo-correlacional. Uma pesquisa online foi realizada para avaliar variáveis ​​demográficas, e vários questionários foram aplicados para avaliar saúde mental positiva, vulnerabilidade psicológica e alfabetização em saúde mental. Os dados foram coletados de 1º de novembro de 2019 a 1º de setembro de 2020. No geral, 3.405 alunos participaram do estudo. Os resultados mostram que 67,8% dos alunos revelaram um alto nível de PMH, 31,6% apresentaram um nível médio de PMH e 0,6% apresentaram um nível baixo de PMH. Os estudantes do sexo masculino relataram maior satisfação pessoal (t (3170) = -2,39, p=0,017) e autonomia (t (3170) = -3,33, p=0,001), no PMH em relação ao sexo feminino. Alunos sem bolsa pontuaram mais alto (t (3.127) = -2,04, p=0,42) no PMH do que alunos com bolsa. Estudantes que não foram deslocados de casa relataram maior (t (3170) = -1,99, p=0,047) Autocontrole em PMH do que aqueles deslocados de sua casa. Estudantes universitários com resultados de PMH mais altos têm resultados de PVS mais baixos e resultados de Alfabetização mais altos. Os achados deste estudo contribuirão para identificar as necessidades de intervenção dos alunos na PMH. Estudantes universitários com resultados de PMH mais altos têm resultados de PVS mais baixos e resultados de Alfabetização mais altos. Os achados deste estudo contribuirão para identificar as necessidades de intervenção dos alunos na PMH. Estudantes universitários com resultados de PMH mais altos têm resultados de PVS mais baixos e resultados de Alfabetização mais altos. Os achados deste estudo contribuirão para identificar as necessidades de intervenção dos alunos na PMH.

Since the college years represent an important period for forming oral health behaviors during adulthood, it is important that college students establish proper oral health-promoting behaviors. Therefore, this study aims to identify the effects of oral health education experience, knowledge, and practice behaviors on oral health care self-efficacy among college students, as studies related to this topic are scarce. A total of 236 college students participated in a questionnaire survey comprising 21 questions. The collected data were analyzed through a chi-square test, independent-samples t-test, and logistic regression analysis using SPSS version 22.0. Participants with oral health education experience showed higher levels of oral health knowledge and practice behaviors than those who did not, and the odds of them having oral health care self-efficacy was 3.743 higher. Moreover, a one-unit increase in oral health knowledge and practice behaviors was associated with a 1.199 and 1.351 increase in oral health care self-efficacy, respectively. For oral health promotion among college students, oral health care self-efficacy reinforcement programs tailored to college students should be developed. These should focus on expanding oral health education opportunities to promote improvement in oral health care self-efficacy by strengthening oral health knowledge and the motivation to practice oral health behaviors.

Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social values of innovation. This vision prevails in sanitary crises, in which management is carried out based on the search for punctual, reactive, and technical solutions to remedy a specific problem without a systemic/holistic, sustainable, or proactive approach. This paper attempts to contribute to the literature on the epistemological orientation of innovations in the field of public health. Taking the Covid-19 and Ebola crises as examples, the primary objective is to show how innovation in health is oriented towards a techno-economic paradigm. Second, we propose a repositioning of public health innovation towards a social paradigm that will put more emphasis on the interaction between social and health dimensions in the perspective of social change.

Interprofessional learning (IPL) is essential to prepare healthcare trainees as the future public health workforce. WHIRL was an innovative IPL intervention that engaged multi-professional teams of volunteer healthcare trainees (n=20) to deliver health checks (n=464), including tailored advice and signposting, to employees in the UK construction industry (across 21 events, 16 sites, 10 organisations) as part of an ongoing research programme called Test@Work. Volunteers undertook a four-part training and support package of trainer-led education, observations of practice, self-directed learning and clinical supervision, together with peer mentoring. In a one-group post-test only design, IPL outcomes were measured using the Inventory of Reflective Vignette - Interprofessional Learning (IRV-IPL), and the psychometric properties of the IRV-IPL tool were tested. WHIRL demonstrably improved healthcare trainees’ interprofessional skills in all five areas of collaboration, coordination, cooperation, communication, and commendation. The IRV-IPL tool was found to be a valid and reliable measure of interprofessional competencies across three scenarios; before and after health promotion activities, and as a predictor of future health promotion competence. This industry-based workplace IPL programme resulted in attainment of health check competencies, and bridged the gap between research, education and clinical practice.

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

Background: The Covid-19 pandemic abruptly disrupted global healthcare systems, necessitating rapid adaptations. This study evaluates the impact on health systems and services in the aftermath of the first wave in the Indian context. It analyses the disruptions, adaptive measures, and changes made, as well as the challenges faced by healthcare providers and seekers. Valuable insights from this study will enhance the resilience and preparedness of healthcare systems for future challenges. Methods: The eligible studies included primary studies conducted in the Indian context that explore the impact of COVID-19 on health services provision, utilisation, and the well-being of healthcare providers and seekers. Electronic searches were conducted in six databases: PubMed, MEDLINE, Embase, Global Health, CINAHL, and the WHO database on COVID-19. The results were analysed using detailed narrative synthesis. Results: The review includes 38 articles, incorporating a total of 22,502 subjects. There has been a substantial impact on health service provision, particularly in outpatient departments (OPD) (n=19) and elective services (n=16), while emergency services continued at sub-optimal levels (n=20). Various adaptations and changes were implemented in precautionary measures, protocols, staff allocation and training, usage of personal protective equipment (PPE), preoperative, operative, and postoperative measures, as well as physical infrastructure and resources. Depression and stress (n=14), fear of contracting the infection (n=6), stigmatisation (n=5), and financial repercussions (n=5) significantly affected the mental health of healthcare providers, and healthcare seekers also faced significant challenges (n=11). Conclusion: The study reveals COVID-19's substantial impact on health services. The healthcare system responded by quickly adjusting staff management, resource allocation, and infection prevention measures. The study also highlights the mental health challenges faced by healthcare providers and the concerns of healthcare seekers regarding delays and suboptimal care. Looking ahead, the findings underscore the importance of preparedness for future pandemics, including improved healthcare infrastructure, resource optimisation, and comprehensive protocols. Lessons learned from COVID-19 should inform strategies to mitigate disruptions and ensure the well-being of healthcare providers and seekers in future outbreaks.

The present short communication aimed to determine the effects of vegetable cultivation on health. We conducted a qualitative study using responses to an open-ended question that was part of a survey on regional differences on vegetable intake. Participants in this study were residents of Gunma Prefecture, Japan, and were aged between 20–74 years. In the questionnaire, we asked: “Aside from increasing vegetable intake, how does vegetable cultivation affect your health?” We were able to categorize the answers into six subcategories related to physical health, mental health, and social well-being.

Concerning the hippocampal mechanisms that simultaneously function to map environmental position and to generate episodic memories, a developing consensus emerged by the early 21st century. The hippocampus was recognized as embodying the primary location of personal narrative development, with the ability to create stable and coherent narrative largely representing the mental health of individuals. Determining recent advances regarding the relationship among the hippocampus, narrative, and mental health, a limited, six-database review was conducted for peer reviewed articles published since 2019. Of the 127 records located, 14 reports were included for study. The results support the necessity of creating and maintaining a stable and coherent narrative as fundamental to human mental health such that facts will be distorted in personal accounts, sleep will be disrupted, and DNA altered to retain one’s personal narratives. With narrative development fundamental to human mental health, a goal of interventions concerning hippocampal function and positive health outcomes is enhancing personal narratives in providing individuals with the ability to construct and recall those that are robust and effective. One such intervention that has proven successful in this regard, the Health Narratives Research Process, is outlined with its most recent results presented, offering opportunity for further such research.

Under the dual background of underemployment and health inequality, this paper empirically analyzes the impact of education level on underemployed workers’ health based on CLDS2016 data. The results show that underemployment is significantly related to the decline of self-rated health, increased depression tendency, and morbidity in a certain period. The results indicate that underemployment can significantly reduce the health level of workers in the low education level group and the high education level group. However, it has no significant impact on workers’ health in the middle education level group; even if we change the measurement method of indicators and consider endogeneity, the research conclusion is still robust. Moreover, this kind of health inequality mainly comes from the difference in economic effect and leisure effect of underemployment to workers with different educational levels. This paper provides empirical support for increasing the labor protection mechanism of underemployed people and reducing the health inequality caused by educational level differences.

Abstract Issue Addressed: Men’s Sheds (‘Sheds’) have been identified as inherently health promoting and as potential settings to engage ‘hard-to-reach’ men in more structured health promotion initiatives. However, little is known about the sociodemographic or health and wellbeing characteristics of Shed members (‘Shedders’) on which such initiatives might be based. This study captures a baseline cross sectional analysis of Shedders (n=384) who participated in ‘Sheds for Life’, a health promotion initiative tailored to Sheds. Methods: Objective health measure, (body composition, blood pressure, blood lipids) captured via health screening as well as sociodemographic and health and wellbeing measures (physical activity, subjective wellbeing, mental health, social capital, cooking and diet) via questionnaires were assessed. Results: Participants were mostly over 65 years, retired with limited educational attainment. The majority were in the ‘at-risk’ categories for objective health measures, with most being referred to their GP following health screening. Older Shedders were also more likely to meet physical activity guidelines. Mental wellbeing was positively correlated with life satisfaction and increased social capital and these were also positively correlated with physical activity. Conclusions: Findings highlight the potential of Sheds in reaching a ‘hard-to-reach’ and ‘at-risk’ cohort of men. Despite a high prevalence of ‘at-risk’ objective health measures, participants report their health in positive terms. Future health promotion initiatives should capitalise on the inherent health promoting properties of Sheds. So what? Findings raise important implications for prioritising and designing health promotion initiatives in Shed settings.

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

Health literacy is an indicator of a society’s ability to make better health judgement for themselves and the people around them. This study investigates the prevalence of health literacy among Malaysian adults and provides an overall picture of the current health literacy state of the society. The study also highlights socio-demographics markers of communities with limited health literacy which may warrant future intervention. A population based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above participated in the study. The health literacy score was divided into three levels; limited, sufficient and excellent. Findings showed that majority Malaysian population has sufficient health literacy level, albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups are associated with respondents with older age, lower education level and lower household income. Overall health literacy state for Malaysia is categorized at a lower sufficient level. Health literacy improvements should focus on communities with limited health literacy level.

An evaluation of emerging issues in One Health (OH) in Sub-Saharan Africa was undertaken to map the existing OH initiatives in Sub-Saharan African (SSA) countries. Desk review, expert opinions survey, limited interviews and wider consultations with selected OH stakeholders were conducted. The strengths, weaknesses, opportunities and threats to OH initiatives were identified. OH influence, interest and impacts were evaluated. One Health is transiting from multidisciplinary to transdisciplinary concepts and OH viewpoint should move from ‘proxy for zoonoses’, to include issues of climate change, nutrition and food safety, social sciences, geography, policy and planning, economics, welfare and well-being, antimicrobial resistance (AMR), vector-borne diseases, toxicosis and pesticides issues. While the identified major strengths should be boosted, the weaknesses should be addressed.OH Networks in SSA were spatially and temporally spread across SSA and stakeholders were classified as key, latent, marginal and OH defenders. Imbalance in stakeholders’ representation led to hesitation in buying-in from stakeholders who are outside the main networks. Theory of change, monitoring and evaluation frameworks, and tools to standardized evaluation of OH policies is needed for sustained future of OH and the future OH engagement should be outputs and outcomes-driven and not activity-driven.National roadmap for OH implementation and institutionalization is necessary and proofs of concepts in OH should be verified and scaled-up. Dependence on external funding is unsustainable and must be addressed. Necessary policy and legal instrument to support OH nationally and sub-nationally should be implemented taking cognizance of contemporary issues like urbanization, endemic poverty and other emerging issues. Utilizing current technologies and OH approach to address ongoing pandemic of COVID-19 and other emerging diseases is desirable. Finally, OH implementation should be anticipatory and not reactive to significantly benefit budgeting and contain disease outbreaks in animal sources before the risk of spillover to human can be envisaged.

In August 4 2011, United Nations Environmental Program (UNEP) submitted an unprecedented, scientific, groundbreaking Environmental Assessment Report (EAR) of Ogoniland, to the Nigerian government. This was the outcome of a 14–month intensive evaluation of the extent of pollution. It was intended that UNEP’s recommendations would be implemented to restore the devastated environment, on the one hand, and on the other, counteract the numerous environmental health issues that have for decades, plagued Ogoniland. However, five years post EAR, and, despite the seriousness of the situation, no significant resolution has occurred, both on the part of the government, and on the part of Shell Petroleum Development Company (SPDC) or Shell. To date, millions of Niger Delta residents, particularly those living in the oil-bearing communities, continue to suffer severe consequences. Although, the assessment was conducted in Ogoniland, other communities in the Niger Delta are also affected. This article explores prevailing issues, using Ogoniland (a microcosm of the Niger Delta) as an example. A multidisciplinary approach for sustainable mitigation of environmental health risks in the Niger Delta is paramount, and Environmental Management tools offer valuable strategies. Adopting UNEP’s recommendations for addressing environmental health problems requires implementing the Environmental Management/Environmental Management System (EM/EMS) model.

(1) Background: With continuous globalization and modernization of people's lives, lifestyle has changed dramatically, with decreased physical activity and increased unhealthy eating patterns in many nations throughout the world. With the COVID-19 pandemic and changes taking place in people’s health and lifestyles around the world, the need for rehabilitation is expected to rise in the coming years.(2)Methods: This paper analyzes the integration model of sports and health care using theoretical analysis, literature reviews, logical reasoning, and other methods.(3)Results: The integration of sports and health care in China has entered the stage of practical implementation after many years of development, forming a few representative integration patterns. Governments, communities, community hospitals, hospitals, and third-party institutions are the main participants, with the community playing an important role in the integration. Pharmacies, sports venues, and schools with sufficient staff have a relatively low participation rate.(4)Conclusion: The grading treatment has been applied in health management and sports rehabilitation, based on the development of digital medicine, a government-led grading treatment model of "health management center" can promote the participation of multiple subjects in the integration of sports and health care, solving the problems existing in the current integration process to a certain extent.

The negative implications of climate change for human health are now well-established. Yet these have not been fully considered into climate change communication strategies. Research suggests that reorienting climate change communication with a health frame could be a useful communication strategy. We conducted a long-term and broad overview of existing scientific literature in order to summarize the state of research activity in this area, by extent and by nature. The methodology is based on a scoping review of scientific articles published on climate change communication and health between 1990 and mid-2016 indexed in the PubMed, ScienceDirect, and Web of Science databases. The screened citations were reviewed for inclusion and data were extracted and coded in order to conduct quantitative (e.g. frequencies) and qualitative (i.e. content analysis) analyses.Out of 2,866 identified published papers, only 24 articles were eligible for analyses. The main themes identified were effective communication of climate change (n=10, 41.7%), the role of health professionals (n=10, 41.7%) and the perception of climate change (n=4, 16.7%). We identified a large proportion of secondary research articles (n= 15, 62.5%) including reviews (n=5, 20.8%) and opinion articles (n=10, 41.7%). A significant share - 37.57% (n=9) - of the identified articles were classified as original research articles, suggesting that the number of publications in this area - particularly original research - has not grown rapidly.This scoping review identified several themes including effective communication of climate change, the role of health professionals, and the perception of climate change in the selected articles on the subject. The research literature on the communication of climate change and health is relatively recent and emerging: the first articles on the subject were published from 2008 onward only.

Zoonoses are diseases transmitted from (vertebrate) animals to humans. Control and prevention of these diseases require an appropriate way to measure health for prudent and well-balanced decisions in public health. We propose a framework that aims to explore, understand and open up a conversation about the non-monetary value of animals through environmental and normative ethics. As an example of its application, participants can choose what they are willing to give in exchange for curing an animal in hypothetical scenarios selecting a human health condition to suffer, the amount of money, and lifetime as a tradeoff. We believe that considering animals beyond their monetary value in public health decisions will contribute to a more rigorous assessment of the burden of zoonotic diseases, among other health decisions. This method might help us complement the existing metrics in health, adding more comprehensive values for animal and human health for the “One Health” approach.

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

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

Background: The COVID-19 pandemic has sped up digital health transformation across the health sectors to enable innovative health service delivery. Such transformation relies on competent managers with the capacity to lead and manage. However, the health system has not adopted a holistic approach in addressing the health management workforce development needs, with many hurdles to overcome. The objectives of this paper are to present the findings of a three-step approach in understanding the current hurdles in developing a health management workforce that can enable and maximise the benefits of digital health transformation, and to explore ways of overcoming such hurdles. Methods: A three-step, systematic approach was undertaken, including an Australian digital health policy documentary analysis, an Australian health service management postgraduate program analysis, and a scoping review of international literatures. Results: The main findings will guide the formulation of strategies in developing a digitally enabled health management workforce in the digital health era. Conclusions: With the ever-changing landscape of digital health, being able to lead and manage in times of system transformation requires a holistic approach to develop the necessary health management workforce capabilities and system-wide capacity. The evidence would support that this can be achieved with the required system, policy, educational and professional organizational enablers, which drive a digital health focused approach across all the healthcare sectors, in a coordinated and contextual manner.

Type 1 diabetes (T1D) has shown an increase in the incidence rate of about 3% per year over the last two decades. Continuous Insulin Subcutaneous Therapy (CSII) is widely used in the paediatric population with diabetes; however, it requires more preparation by the treating team and careful selection of potential users. Prescriptive provisions vary from Region to Region and the perspective of health workers still remains an unexplored area. The aim of the research project is to explore the representations of a group of diabetologists and psychologists working in pediatric diabetology on the national territory, regarding roles, functions and activities as part of a multidisciplinary team; their views on the potential benefits of CSII and the types of individuals applying for the use of technology. A socio-anagraphic data sheet was administered and two homogeneous focus groups were conducted by profession; they were audio recorded. The transcripts produced were analysed using the Emotional Text Mining (ETM) methodology. Each of the two corpus generated three clusters and two factors: for diabetologists, a focus on the patient in different levels of care emerged, collaborating both with other health professionals and with the territory, through the proposal of an intervention where the medical aspect is often represented by technology; also for psychologists there was a representation of interdisciplinary networking, with a greater focus on the processes inherent the management of pathology, from acceptance to the elaboration and integration of diabetes in the family narrative. The understanding of the representations of health professionals working in pediatric diabetes about new technologies can contribute to the consolidation of a network of professionals through a targeted work on possible critical issues emerged.

A small proportion of health care users are recognised to use a significantly higher proportion of health system resources, largely due to systemic, inequitable access and disproportionate health burdens. These high-resource health system users are routinely characterised as older, with multiple comorbidities, and reduced access to adequate health care. Geographic trends also emerge, with more rural and isolated regions demonstrating higher rates of high-resource use than others. Despite known geographical discrepancies in health care access and outcomes, health policy and research initiatives remain focused on urban population centers. To alleviate mounting health system pressure from high-resource users, their characteristics must be better understood within the context in which it arises. To examine this, a scoping review was conducted to provide an overview of characteristics of high-resource users in rural and remote communities in Canada and Australia. In total, 21 papers were included in the review. Using qualitative thematic coding, primary findings characterised rural high-resource users as those of an older age; with increased comorbid conditions and condition severity; lower socioeconomic status; and elevated risk behaviours.

Context: Mental and menstrual health, two emerging aspects of health critical to the female population, are bidirectionally linked. But there is limited empirical evidence that establishes the association between these entities. This essay aims to draw the attention of researchers to this healthcare niche. Evidence Acquisition: A systematic review was carried out on literatures sourced from medical databases (e.g. PubMed, Google Scholar, Scopus, Science Direct, and Web of Science), and gray sources—popular and reputable institutional and journalistic websites that publishes mental or menstrual health research. The key words used for the search are “Menstruation, menstrual hygiene, menstrual disorders, premenstrual syndrome, period poverty, menarche, menopause, mental health, mental disorder, mental illness, depression, anxiety, phobia, mania, mood, and affect”. The initial search generated 368 results. But after the duplicates were removed, the exclusion criteria (publication before 2000) was applied, and manual review of abstract (for relevance) was done, 21 publications from the databases and 5 from gray sources were included in this essay. Results: Associations were found between menstrual cycle irregularities and disorders; and mental disorders such as premenstrual syndrome, premenstrual dysphoric disorder, major depressive disorder, major anxiety disorder, psychotic disorder, bipolar disorder, borderline personality disorder, sleep disorder, substance use/abuse, and suicidal ideation and attempts.Few positive associations between mental and menstrual health were recorded, and several research and treatment gaps were identified. Conclusion: Research into the links between mental and menstrual health should not remain a fringe area of scientific curiosity, as it shows tremendous promise in improving healthcare offered to women/girls globally.

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

Along with environmental pollutions, urban planning has been connected to public health. The research indicates that the quality of built environments plays an important role in reducing mental disorders and overall health. The structure and shape of the city are considered as one of the factors influencing happiness and health in urban communities and the type of the daily activities of citizens. The aim of this study was to promote physical activity in the main structure of the city via urban design in a way that the main form and morphology of the city can encourage citizens to move around and have physical activity within the city. Functional, physical, cultural-social, and perceptual-visual features are regarded as the most important and effective criteria in increasing physical activities in urban spaces based on literature review. The environmental quality of urban spaces and their role in the physical activities of citizens in urban spaces were assessed by using the questionnaire tool and analytical network process (ANP) of structural equation modeling. Further, the space syntax method was utilized to evaluate the role of the spatial integration of urban spaces on improving physical activities. Based on the results, the consideration of functional diversity, spatial flexibility and integration, security, and the aesthetic and visual quality of urban spaces plays an important role in improving the physical health of citizens in urban spaces. Further, more physical activities, including motivation for walking and consequently, the sense of public health and happiness, were observed in the streets having higher linkage and space syntax indexes with their surrounding texture.

Since its initial outbreak in late 2019, the COVID-19 pandemic has profoundly affected the global community. In addition to the negative health consequences of contracting COVID-19, the implementation of strict quarantine and lockdown measures has also disrupted social networks and devastated the global economy. As a result, there is rising concern that the pandemic has taken a toll on the mental health of the general population. To better understand its impact, an increasing number of studies examined the effects of the pandemic on mental health and psychosocial implications of enforced quarantine and lockdown. In this article, we aim to review and summarize the findings from a variety of studies that have explored the psychosociological effects of the pandemic and its impact on the mental well-being of the general population. We will also examine how various demographic groups, such as the elderly and youth, can be more susceptible or resilient to the pandemic’s mental health effects. We hope to provide a broader understanding of the underlying causes of mental health issues triggered by the pandemic and provide recommendations that may be employed to address mental health issues in the population over the long-term.

Only 15% of the global population has access to occupational safety and health services. In Africa only 5% of employees working from major establishments, have access to occupational health services (OHS). Access to primary health care (PHC) services is addressed in many settings and inclusion of OHS in these facilities might increase efficiency in preventing occupational diseases. A cross-sectional study was conducted in four SADC countries aiming at assessing the availability of OHS at PHC facilities and the organization of OHS. We conducted a literature review to assess the provision and organization of OHS services. In addition to the review, a total of 23 doctors from PHC facilities were interviewed using questionnaires in order to determine the availability of OHS and training. Consultations with heads of ministries were done in four SADC countries. Results showed that in the SADC region, OHS are fragmented and lack a comprehensive approach. In addition, out of 23 PHC facilities only two (13%) provided occupational health and PHC. However, OHS provided at PHC facilities were limited to TB screening and audiometric testing. Our study showed a huge inadequacy of trained occupational health practitioners. This study supports the World Health Organization’s advocacy of integrating OHS at PHC level.

Chronic non-communicable diseases (NCDs) are major public health problems and a significant financial burden on public health systems. By 2030, mortality due to NCDs, such as cardiovascular diseases, cancer, respiratory diseases, and diabetes, is predicted to increase in Brazil. A peculiar aspect of NCDs involves their long-term and integrated care management. This paper proposes a chronic disease management platform based on artificial intelligence to deliver digital health services everywhere. The proposed platform is anchored and built with healthcare 4.0 technologies, such as wearable devices, the internet of medical things, and artificial intelligence cloud-based solutions that allow the deployment of a smart healthcare system. In addition, the paper presents the feasibility of the platform in a diabetes prediction study case. For the study case, an initial dataset was established with bio-impedance, oxygen concentration, pulse rate, skin impedance, and skin temperature attributes. A baseline was implemented with ten regression models to assess the prediction performance of the mean squared error, root mean squared error, and r-squared score to compare predictive findings with capillary blood glucose measurements. Results evidence that the decision tree regressor and three ensemble methods (bagging decision tree regressor, random forest regressor, and AdaBoost regressor) yielded improvement over the other models. Moreover, a comparison among those models revealed that the decision tree regressor outperforms them and presents promissory outcomes.

The WHO European Region defined the role of a new central professional for primary care, the Family and Community Nurse (FCN). The introduction of FCN in the framework of health policies highlight a key role of nurses in addressing the families’ and communities’ needs. A scoping review was conducted in order to identify and describe the available tools which has been adopted for the assessment of the community health needs by FNC. A comprehensive literature review on Embase, Cochrane Library, PubMed, CINAHL, Scopus and PsycInfo databases was conducted including all studies up to May 2021. A total of 1563 studies were identified and 36 of them were included. The literature review had made possible to identify studies employing twelve different community assessment's tools or modalities. Referring the WHO framework proposed in 2001 some common themes have been identified with an uneven distribution, as profiling the population, deciding on priorities for action and public healthcare programmes, implementing the planned activities, evaluation of health outcomes, multidisciplinary activity, flexibility and involving the community. To the best of our knowledge, this work is the first attempt to provide an overview of community assessment tools, keeping the guidance provided by the WHO as a reference.

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

The supply of mental health processes in primary care has gaps. This study aims to analyze the association of agreement criteria and flows between primary care teams and the Family Health Support Center (NASF) for mental health collaborative care, considering the difference between capital and non-capital cities in Brazil. This cross-sectional study was conducted based on secondary data from the Primary Care Access and Quality Improvement Program. Agreement criteria and flows were obtained from 3883 NASF teams of the matrix support or collaborative care. The Chi-square test and multiple Poisson regression were used; p &lt; 0.05 was considered statistically significant. Prevalence ratios of negative associations demonstrated protective factors for support actions: follow-up at Psychosocial Care Center, management of psychopharmacotherapy, offer of other therapeutic actions, care process for users of psychoactive substances, and offer of activities to prevent the use of psychoactive substances. Collaborative care in primary care was effective, and capital cities were a protective factor compared with non-capital cities.

Health literacy describes skills and competencies that enable people to gain access to, understand and apply health information to positively influence their own health and the health of those in the social environment. In an increasingly media saturated and digitized world, these skill sets are necessary for accessing and navigating sources of health information and tools, such as television, the Internet, and mobile apps. The concepts of Media Health Literacy (MHL) and eHealth Literacy (eHL) describe the specific competencies such tasks require. This article introduces the two concepts, and then reviews findings on the associations of MHL and eHL with several contextual variables in the social environment such as socio-demographics, social support, and system complexity, as a structural variable. As eHL and MHL are crucial for empowering people to actively engage in their own health, a growing body of literature reports of the potential and the effectiveness of intervention initiatives to positively influence these competencies. From an ethical standpoint, equity is emphasized, stressing the importance of accessible media environments for all - including those at risk of exclusion from (digital) media sources. Alignment of micro and macro contextual spheres will ultimately facilitate both non-digital and digital media to effectively support and promote public health.

Identifying health care equity indicators is an important first step in integrating the concept of equity into assessments of health care system performance, particularly in emergency care. We conducted a systematic review of administrative data-derived health care equity indicators and their association with socio-economic determinants of health (SEDH) in emergency care settings. Following PRISMA-Equity reporting guidelines, Ovid MEDLINE, EMBASE, PUBMED and Web of Science were searched for relevant studies. The outcomes of interest were indicators of health care equity and the associated SEDH they examine. Among 29 studies identified, 14 equity indicators were identified and grouped into four categories that reflect the patient emergency care pathway. Total emergency department (ED) visits and ambulatory care sensitive condition-related ED visits were the two most frequently used equity indicators. Despite some conflicting results, all identified SEDH (social deprivation, income, education level, social class, insurance coverage and health literacy) are associated with inequalities in access to and use of emergency care. In conclusion, the use of administrative data-derived indicators combined with identified SEDH could improve healthcare equity measurement in emergency care settings across health care systems worldwide.

Monkeypox, once a rare zoonotic disease, was endemic to some African countries since its original identification among humans in 1970. Since then, cases in non endemic regions were linked to returning travelers or those who had contact with transported animals. The causative agent, Monkeypox virus, belongs to Orthopoxviruses, the same family as Variola; the causative organism for smallpox. Although most Monkeypox outbreaks until recently were linked to zoonotic transmission, secondary human-human transmission in smallpox unvaccinated individuals was observed in a small proportion of overall cases. Smallpox was declared eradicated in 1980 and since its eradication, monkeypox virus is the most significant poxvirus to cause human disease. The 2022 monkeypox outbreak marks a significant paradigm shift in the human and poxvirus association, with new modes of transmission, concerns of viral evolution and entrenchment as a sexually transmitted disease. Monkeypox clinically resembles smallpox but is far milder. At this time there are no approved therapies for monkeypox and antiviral agents effective against smallpox are being utilized. Additionally, preventive strategies being utilized include smallpox vaccination like JYNNEOS and ACAM2000. In this narrative review, we discuss the virology, epidemiology, transmission, clinical manifestations, diagnosis, management and prevention strategies associated with monkeypox.

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

The research is carried out to assess factor affecting the health condition of the elderly people in the slum areas in Sylhet City. This research was quantitative type. In Quantitative approach, primary data were collected and used from the randomly selected elderly people in the Sylhet City slum areas. The secondary data were collected from many articles, documents, newspaper, magazine etc. By analyzing the survey data, it is illustrated that the slum dwellers are deprived from the basic needs. Meanwhile, elderly people can‟t fulfill their medical treatment due to their financial condition because of their work incompatibility. This study identifies the factor affecting health condition such as financial condition, lack of knowledge about proper medical facilities, communication gap between the authority and patient, unemployment, and so on. These factors also affect their health situation. Many diseases like asthma, heart disease are occurred. This study also mentions about the livelihood of slum people are so poor in condition. Due to financial condition, aged people can‟t take their proper treatment and their family member can‟t afford it. This study also understands that the people from slum areas are getting concerned about their medical care. They are easily going to the hospital and take their service because of low pricing. On the other hand, people are meanwhile stopped their treatment of financial situation. This study finds the health situation of elderly people at slum areas in metropolitan city and their consciousness.

Although the universal health coverage (UHC) is pursued by many countries, not all countries with UHC include dental care as their benefits. Japan, with its long-held tradition of UHC, has covered dental care as essential benefit and majority of dental care services are provided to all patients with minimal copayment. Being under the UHC, the scope of services as well as prices are regulated by the uniform fee schedule and dentists submit claims according to the uniform format and fee schedule. The author analyzes the publicly available dental health insurance claims data as well as a sampling survey on dental hygiene and illustrates how Japan’s dental care is responding to the challenges of the population ageing.

Background: Internal migrants had obstacles in accessing local public health services in China. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Methods: Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, demographic characteristics and public health services utilization. Results: Internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The broader and shorter they migrated, the less they used public health services. Compared to migration within the city, migration across provinces is negatively associated with health records (OR=0.88, 95% CI: 0.86-0.90), health education (OR=0.97, 95% CI: 0.94-1.00), and health education on NCDs (OR=0.92, 95% CI: 0.89-0.95) or through Internet channel (OR=0.96, 95% CI: 0.94-0.99). Conclusion: Public health services coverage for internal migrants has seen great improvement due to government subsides. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

The functioning of the parents’ emotional sphere is very important to a child’s mental and physical health. This study focused on investigating the association between mothers’ emotional intelligence (EI) and paediatric type I diabetes (T1DM) disease management in their children. We hypothesized that mothers’ EI is associated with T1DM outcomes. Mothers of children with T1DM aged 6-12 years were surveyed. One hundred and thirty-four mothers, the main caregivers of their diabetic children, provided measures of EI and completed a demographic questionnaire. The primary indicator of diabetes management was haemoglobin A1c (HbA1c; the main form of glycosylated haemoglobin). EI scales and subscales were associated with glycaemic management indices. Logistic regression analysis was applied for the assessment of the association between parents’ EI and their paediatric with T1DM disease management. The analysis demonstrated a statistically significant correlation between T1DM management and mothers’ ability to understand and control own emotions, to transform their own negative emotions into positive and to control own negative emotions. Mothers’ EI scales and subscales of understanding and regulating their own emotions, subscales of transforming their own negative emotions into positive ones and controlling their own negative emotions were statistically reliable predictors of glycaemic control in children with T1DM.

COVID-19 has proven to be detrimental across the globe, most notably affecting the United States at an alarming rate compared to comparable countries. The pandemic has had multifactorial implications on the way communities in the United States prevent, prepare for, and address the virus; however, the impact of the pandemic on rural health is less well understood. Historically, rural communities have faced a unique set of challenges regarding accessing and receiving adequate healthcare, addressing chronic illness, and eliminating health disparities closely associated with the population’s socioeconomic status; the pandemic has exacerbated these challenges. The purpose of the current study was to conduct a systematic review of the literature to evaluate the effect of the COVID-19 pandemic on rural populations both at the individual and community level. Results indicated that rural health disparities increased both at the individual and system-wide levels as a direct result of the pandemic. Budget cuts significantly affected the infrastructure of rural hospitals resulting in them being unequipped to handle such high volumes of COVID-19 cases. The lack of infectious disease specialists, access to larger medical centers with substantial numbers of ICU beds and ventilators, and an overall lack of preparedness overwhelmed rural communities. Although comorbidities such as diabetes and heart disease were associated with poorer health outcomes for a multitude of reasons, the lack of clinic and physician availability for routine care during the pandemic further exacerbated the clinical link from COVID-19 positivity to comorbidities. Furthermore, mental health deteriorated as substance use increased to a greater extent in rural communities compared to urban, during the pandemic. This study shows that health comorbidities, mental health, substance use, health literacy, access to healthcare, among others can serve as key indicators for improving healthcare in rural communities. Future studies should seek to identify key issues that disproportionately affected rural communities in comparison to their urban counterparts considering the pandemic, as well as identify gaps in the availability of rural health resources that can improve the lives of millions of Americans now and during the next pandemic.

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

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalised care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of six workshops in different locations of the city to encourage the sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighbourhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their own health and understanding their values and preferences. Qualitative results show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered amongst the reasons to visit health professionals. Some of the conclusions reveal that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognised the benefits of this new approach but required more time and incentives to dedicate the effort needed.

(1) Background: The aim of this study was to identify predictors of the unmet health care needs during the financial and recent health crisis in Greece. (2) Methods: Time series analysis was performed for the years 2008 through 2022 using the Eurostat database. The dependent variable was the percentage of people who reported unmet need for medical care. Demographic, socioeconomic and health data as well as health expenditures were used as independent variables. Correlation analysis and simple linear regression models were conducted to analyze the results. (3) Results: Unmet health needs in Greece increased from the start of the crisis until 2016, as a gradual de-escalation of the crisis is observed. However, in 2019 the country recorded the second highest level of unmet needs for medical care before the health crisis. People with limitations in usual activities, those who report bad/very bad health status, unemployed and with low-income increased the likelihood of unmet needs. Health expenditures (public or private) were also significant determinants of unmet healthcare needs. (4) Conclusions: The increased unmet health needs widen inequalities in health and healthcare access. Therefore, health policy should eliminate barriers which restrict the access to health and enhance healthcare services, developing conditions for citizens' well-being.

Postpartum depression (PPD) can predispose to physical and mental health problems in women. However, PPD is associated with health and perceived social support but their causal relationship is unclear. Therefore, this study intended to evaluate the association of PPD with insomnia, mental health, and physical health. Convenience sampling technique was used to collect data from 320 (52.8 %) young and middle aged postpartum women, in the outpatient departments of obstetrics and gynecology in Government Maula Bakhsh Hospital, District Head Quarter in Sargodha, Pakistan. The Edinburgh Postnatal depression scale, Pittsburg sleep quality index, Warwick-Edinburgh mental wellbeing scale, Patient health questionnaire, and Multidimensional scale of perceived social support were used to measure study variables. Results revealed a significant positive relationship of PPD with physical health (r= .45, p=.001), while a negative relationship with insomnia (r= -.24, p<.001), and perceived social support (r= -.38, p=.001). Results further confirmed that perceived social support played a moderating role (β = .97, p=.01) in the relationship between PPD and mental health among females. This study concluded that perceived social support has an important role in PPD and women’s health. The study also concluded that poor health is a risk indicator for identifying aid in the early stages of postpartum among women.

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

Milk and dairy foods are naturally rich sources of a wide range of nutrients, and when consumed according to recommended intakes contribute essential nutrients across all stages of the life cycle. Since then, seminal studies recommendations with respect to intake of saturated fat have been consistent and clear; limit total fat intake to 30% or less total dietary energy, with a specific recommendation for intake of saturated fat to less than 10% of total dietary energy. However, recent work has re-opened the debate on intake of saturated fat in particular, with suggestions that recommended intakes be considered not at a total fat intake within the diet, but at a food specific level. A large body of evidence exists examining the impact of dairy consumption on markers of metabolic health, both at a total dairy intake and also at a food level, with mixed findings to date, but suggests that the impact of saturated fat intake on health differs both across food groups and even between foods within the same good group such as dairy. Milk and dairy foods contain a range of nutrients and bioactive components in different levels, housed within very different food structures. The interaction of the overall food structure and the nutrients describes the concept of the ‘food matrix effect’ which has been well documented for dairy foods. Studies show that nutrients from different dairy food sources can have different effects on health and for this reason, they should be considered individually rather than grouped as a single food category in epidemiological research. This review examines the current evidence from randomised controlled trials and meta-analyses, with respect to dairy, milk, yoghurt and cheese on aspects of metabolic health, and summarises some of the potential mechanisms for these findings.

The use of biomarkers to measure immune responses in serum is crucial for understanding population-level exposure and susceptibility to human pathogens. Advances in sample collection, multiplex testing, and computational modeling are transforming serosurveillance into a powerful tool for public health program design and response to infectious threats. In July 2018, 70 scientists from 20 countries met to perform a landscape analysis of approaches that support an integrated serosurveillance platform, including the consideration of issues for successful implementation. Here, we summarize the group’s insights and proposed roadmap for implementation, including objectives, technical requirements, ethical issues, logistical considerations, and monitoring and evaluation.

There is increasing evidence that the non-cooperative models describe household structures in developing countries more succinctly compared with the unitary model. Domestic violence against women, which is pervasive in Nigeria even though likely to be under-reported, will need to be understood within the framework of non-cooperative relationship between couples. In this study, we identify factors of domestic violence against women within couples who were currently in marital or cohabiting partnerships. Also, we investigate whether domestic violence influences the decision of women to terminate pregnancies. We use data from the 2018 Nigeria Demographic and Health Survey (NDHS). Multivariate logistic regressions were used to model the predictors of domestic violence, and its influence on the decision to terminate pregnancies among married women. Of the 8,910 married women interviewed for domestic violence, 35.33% had ever experienced a form of domestic violence. We discover that women: with higher education, that is not poor, and resides in urban areas have 44%, 18% and 15% reductions in the odds of experience domestic violence respectively. On the other hand, women who are employed, own land, having husbands/partners that are employed in the agricultural sector, and drink alcohol have 1.16, 1.2, 2.07, and 2.8 times increased odds of experiencing domestic violence accordingly. Also, we uncover that currently married women experiencing domestic violence have 1.25 times increased odds of terminating pregnancies compared with their counterparts that are not experiencing domestic violence. Effectively, poverty, low levels of education, residing in rural areas, drinking habit of husbands/partners, employment, marital capital, and land ownership status of women are risk factors of domestic violence against married women in Nigeria but can be affected by policies and programmes. Importantly, public actions to contain domestic violence in order to improve maternal health should be implemented in the context of the dynamics of a non-cooperative relationship existing between married couples.

Background: India has one-fifth of the world's population and the number of people suffering from mental illness is assumed to be huge considering the contribution of mental disorders to the overall burden of the disease being 13.9 %. Objectives of Study: To estimate prevalence and patterns of mental illnesses to assess the current mental health services and systems in the Madhya Pradesh. Material and Methods: Multi-stage, stratified, random cluster sampling technique, with random selection based on probability proportionate to size at each stage. A total of 3240 individuals aged 18 years and above were interviewed. Both quantitative and qualitative methods were employed. A set of 10 instruments including Mini International Neuro-psychiatric Interview were utilized. Results: The overall weighted prevalence for any mental illness was 16.7% lifetime and 13.9% current. Treatment-gap for all mental health problems is as high as 91% in the state along with huge socioeconomic impact of mental illness. Conclusions: This huge burden of mental, behavioural and substance use disorders, in Madhya Pradesh, calls for immediate attention of political leaders, policy makers, health professionals, opinion-makers and society at large. It is hoped that the data from the study will inform mental health policy and legislation and help shape mental health care delivery systems in the country.

The microbioma is presently one of the hottest areas of scientific and medical research and exerts a marked influence on the host during homeostasis and disease. Fermented foods arise in the human relationship to the microbial environment. Further to the traditionally recognized effects of fermented foods and beverages on the digestive health and well-being there is now strong evidence on their general health benefits, namely the significance on the gut microbiota and brain functionality. We highlight the possibilities in this field, how little is still known, and call for a convergence of interdisciplinary research fields of One Health microbe-nutrition with fermented foods and gut-brain research. A consequence of civilisation, changes in present-day society in diets with more sugar, fat and salt, habits and lifestyle, contributes to the likelihood of an inflammatory microbiome, particularly the global epidemics of obesity and mental health. Although two recent papers claim that probiotics perturb rather than aid in microbiota recovery back to baseline after antibiotic administration in humans, consuming fermented foods has shown to reduce inflammation so improve gut health and the proper function of the body’s immune system.

The use of fluoride (F^-) for decreasing the prevalence and incidence of tooth decay was the greatest worldwide preventive public health measure of the 20th century. There have been controversial reports about the benefits of the use of F^-, because in small amounts it helps prevent dental caries, but in high concentrations it can be potentially toxic and harmful to dental and systemic health. Since the mid-20th century, F^- has been studied by toxicologists, looking at its deleterious effects in human populations. During the last decade, the interest on the undesirable effects has resurfaced because of the knowledge that it interacts with the cellular system, even in low doses, with a very small safety margin. Acute ingestion of toxic amounts of fluoride can cause corrosive gastric mucosa injury. Also respiratory effects such as bleeding, pulmonary edema, tracheostomy and shortness of breath, have been observed in individuals who inhale hydrogen fluoride. Some researchers had shown that F^- is an oxidizing agent and a well-known reversible enzymatic inhibitor that interferes with the enzyme activity of at least 80 proteins, can altered the intracellular redox equilibrium, lipid peroxidation, as well as, alteration in the gene expression and apoptosis induction. The primary purpose of this review is to examine findings of the action of inorganic F^-, and an overview of hard and soft tissue disturbances, known as fluorosis. The goal of this review is to enhance understanding of the mechanisms by which F^- affects cells with an emphasis on human tissue-specific events.

Introduction: The COVID-19 pandemic overwhelmed health systems globally, and affected delivery of other health services. We conducted a study in Uganda to describe interventions for continuity of access to other health services. Methods: We reviewed documents and interviewed 21 key informants. Thematic analysis was conducted to identify themes using the World Health Organization health system building blocks as a guiding framework. Results: Governance strategies included establishment of coordination committees and development and dissemination of guidelines. Infrastructure and commodities strategies included review of drug supply plans and allowing emergency orders. Workforce strategies included provision of infection prevention and control equipment, recruitment and provision of incentives. Service delivery modifications included designation of facilities for COVID-19 management, patient self-management, dispensing drugs for longer periods and leveraging community patient networks to distribute medicines. However, multi-month drug dispensing led to drug stock-outs while community drug distribution was associated with stigma concerns. Conclusions: Health service maintenance during emergencies requires coordination to harness existing health system investments. The service continuity committee coordinated efforts to maintain services and should remain a critical element of emergency response. Self-management and leveraging patient networks should address stigma to support service continuity in similar settings and strengthen service delivery beyond the pandemic.

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

The aim was to analyze the coping strategies used by primary health care (PHC) professionals. A cross-sectional, descriptive-analytical study was conducted with professionals working in primary health care units in São José do Rio Preto, a large city in the interior of São Paulo, Brazil. For data collection we used an instrument developed by the researchers, containing sociodemographic and professional variables, as well as the Problem Coping Modes Scale (EMEP). We evaluated 333 PHC professionals. A difference was observed between the scores of the four coping strategies (p<0.001), with the highest score for the problem-focused strategy (3.8) and the lowest score for the emotion-focused strategy (2.4). Physicians had the lowest scores in coping strategies focused on religious practices/fantastical thinking (p<0.001) and pursuit of social support (p=0.045), while community health agents had the highest scores in these coping strategies). Professionals working in PHC have different coping strategies for the problems and stressful situations experienced in the work environment. These strategies can involve more positive attitudes focused on confrontation and problem solving, to emotional responses that involve attitudes of avoidance and denial that involve attitudes of avoidance and denial of the problem.

Advances in machine learning (ML) and artificial intelligence (AI) are transforming the way we treat patients in ways not even imagined a few years ago. Cancer research is at the forefront of this movement. Infertility, though not a life-threatening condition, affects around 15% of couples trying for a pregnancy. Increasing availability of large datasets from various sources creates an opportunity to introduce ML and AI into infertility prevention and treatment. At present in the field of assisted reproduction, very little is done in order to prevent infertility from arising, with the main focus put on treatment when often advanced maternal age and low ovarian reserve make it very difficult to conceive. A shift from this disease-centric model to a health centric model in infertility is already taking place with more emphasis on the patient as an active participator in the process. Poor quality and incomplete data as well as biological variability remain the main limitations in the widespread and reliable implementation of AI in the field of reproductive medicine. That said, one of the areas where this technology managed to find a foothold is identification of developmentally competent embryos. More work is required however to learn about ways to improve natural conception, the detection and diagnosis of infertility, and improve assisted reproduction treatments (ART) and ultimately, develop clinically useful algorithms able to adjust treatment regimens in order to assure a successful outcome of either fertility preservation or infertility treatment. Progress in genomics, digital technologies and advances in integrative biology has had a tremendousimpact on research and clinical medicine. With the rise of ‘big data’, artificial intelligence, and the advances in molecular profiling, there is an enormous potential to transform not only scientific research progress, but also clinical decision making towards predictive, preventive, and personalized medicine. In the field of reproductive health, there is now an exciting opportunity to leverage these technologies and develop more sophisticated approaches to diagnose and treat infertility disorders. In this review, we present a comprehensive analysis and interpretation of different innovation forces that are driving the emergence of a system approach to the infertility sector. Here we discuss recent influential work and explore the limitations of the use of Machine Learning models in this rapidly developing area.

Animal products, in particular dairy and fermented products, are natural, major sources of lactic acid bacteria (LAB). Due to their antimicrobial properties, LAB are used in humans and in animals, with beneficial effects, as probiotics or in the treatment of a variety of diseases. In livestock production, LAB contribute to animal performance, health, and productivity. In the food industry, LAB are applied as bioprotective and biopreservation agents, contributing to improve food safety and quality. However, some studies have described resistance to relevant antibiotics in LAB, with the concomitant risks associated to the transfer of antibiotic resistance genes to foodborne pathogens, their potential dissemination throughout the food chain, and the environment. Here, we summarize the application of LAB in livestock and animal products, as well as the health impact of LAB in animal food products. In general, the beneficial effects of LAB on the human food chain seem to outweigh the potential risks associated with their consumption as part of animal and human diets. However, further studies and continuous monitorization efforts are needed to ensure their safe application in animal products and in the control of pathogenic microorganisms, preventing the possible risks associated with antibiotic resistance and, thus, protecting public health.

Little research has been done on occupational health ramifications of informal electronic waste (e-waste) recycling work, which is increasingly common in low- and middle-income countries, and very little is known about this in high-income countries. Our study evaluated informal and formal e-waste recycling workers in Chile, which was recently recognized as a high-income country. In 2017 we recruited 78 informal recycling workers from two cities, and 15 formal e-waste recycling workers from one recycling facility. Participants completed a questionnaire and health assessment regarding their involvement in, and potential impacts of, e-waste recycling, among other measures. Participants were primarily male, middle-aged, married with children, and had worked in e-waste recycling for an average of 12 years. Participants generally reported good health status, and chronic disease prevalence was similar to the national prevalence. Workers commonly reported exposures to several occupational stressors, including mental health stressors and noise, as well as insufficient income. Occupational injuries were common and use of safety equipment was low. No significant differences were found between informal and formal workers. Informal e-waste workers in Chile face occupational health challenges. The extent to which these issues impact the health of informal Chilean e-waste workers is unclear and warrants further research.

Erectile dysfunction (ED) is the inability to achieve or maintain an erection during sexual performance. ED is one of the most common and neglected complications of diabetes. Almost 35-75% of diabetic men around the world suffer from ED. Although the exact mechanism by which diabetes causes ED is not well understood. However, several studies suggested it may be related to damage to the nerve and vessels that supply the penis.

Mental health impacts of COVID-19 pandemic have received a great deal of attention by policymakers for the management of present and future cases of the pandemic, especially as new COVID-19 variant cases are on the rise. Thus, this study seeks to conduct a systematic review to address the following research questions: (1) What are the mental health impacts of COVID-19 in the empirical literature? (2) Which categories of people are at higher risk of the mental health impacts of the pandemic based on the extant literature? A sample of 35 studies out of 196 potential studies (from various databases, including Scopus, Google Scholar, , Research Gate, PubMed, , and libraries, from 2020 to 2022) were used after a comprehensive literature search and thorough assessment based on PRISMA-P guidelines. The study reveals that the pandemic has led to severe cases of mental health challenges such as depression, anxiety, post-traumatic stress disorder, psychological disorders, mood disorders, and insomnia. The review identified groups such as health workers, patients with pre-existing psychiatric or mental health issues, COVID-19 survivors, patients with underlying health conditions, and the elderly as the most vulnerable groups to mental health challenges from the pandemic.

Anthropogenic activities are the main cause of climate change globally. The World Health Organization (WHO) recognized that heating and precipitation are the reason for climate change due to anthropogenic actions over the past 30 years and claim 150,000 lives annually. Climate change is also affecting the atmospheres of polar regions. Numerous diseases are linked with climate change like cardiovascular mortality and respiratory illnesses. Due to climate change, lack of long-term and high-quality data sets, variations in drug resistance and immunity, the amplification or the resurgence of diseases, as well as many socio-economic factors, are uncertain.Potentially susceptible regions consist of the temperate latitudes, the regions near the Indian and Pacific oceans are affected due to the heavy rainfall where the heat of the cities could increase life-threatening climatic proceedings. The association between climate and health poses a risk to health under future guesses. Over the current decades, warming has contributed to increased mortality and morbidity in various provinces of the globe. The current study reviews the potential effects of climate change on temperature, human health, air quality, food & nutrition, livelihoods, and livestock & fisheries in detail.

Globally, humans are struggling with the double threat of communicable and non-communicable diseases, which are presenting new challenges to public health. Public health problems are generally studied and addressed at primary, secondary and tertiary levels. Most effective results are seen with primary interventions. Public health is becoming more aware of the importance of environment-gene interactions in the ontology of health and disease using epigenetics. Epigenetics is the study of altered gene expression without change in base pairs. Be it physical, social, behavioral, or economic factors; they all influence quality of life and health of individuals and populations. That environments are changing the human health phenotype and these changed phenotypes are heritable is of concern for the future of the human race. Knowing the causes of non-communicable human diseases using epigenetics will contribute to the development of new policies to encourage prevention using primary public health initiatives. Research and application of epigenetics shows great promise for improving population health. Continued advances in epigenetics will enhance how we understand and address the way environments are affecting the human health phenotype. For some time, health systems have been and continue to be tertiary in nature. Epigenetic changes can provide information necessary to better understand how social determinants of health can be used to build societies focused on equitable health for all people, rather than continuing to focus on treatment of diseases in the tertiary phase that leads to health disparities. Understanding mechanisms of social determinants of disease, will allow society to evolve in a health-oriented rather than a disease-oriented world. For this reason, we must enhance and apply epigenetics (physical, social, behavioral, economic) research to policy development. We will discuss how bringing social determinants together with biology can be used as new tools for public health policy.

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

This study assessed health inequality trends and the degree of maternal healthcare services utilization in the DRC, using two consecutive Demographic and Health Surveys, 2007 and 2013-2014. First, we assessed the changes in the magnitude of inequality in the utilization of MHCS using logistics and regressions. Second, we analyzed the distribution of inequality in each MHCS utilization variable using the Gini coefficient and the Lorenz curve. Third, we used the Wagstaff two groups concentration indices comparison method to assess health inequality trends. Finally, we fitted the concentration curves to estimate the inequality in the utilization of MHCS to the economic condition of women. Women were less likely to have their first ANC visit within the first trimester, less likely to receive checkups during ANC visits, and less likely to attend more ANC visits when living in eastern DRC compared to western DRC. Women in rural areas were less likely to have their last birth by C-section, and less likely to receive PNC than women in urban areas. Women with middle, richer, and richest wealth indexes were more likely to complete more ANC visits, more likely to deliver by C-section, most likely to receive PNC, and more likely to receive ANC than those with lower wealth indexes. Over time, inequality in the utilization of MHCS decreased for ANC and PNC but increased for the delivery by C-sections. These findings suggest that innovative strategies are still needed to improve the utilization of MHC services among poorer, rural, and underserved women in post-conflict DRC.

The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive-behavioral outcomes: Change Talk, Resiliency, Self-Efficacy/Independent Agency, Insight & Pattern Recognition, and Building Towards Sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20-minute audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<$20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved Change Talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive-behavioral indicators associated with health behavior change in both non-SDH and SDH individuals.

Metabolomics is an advanced technology, still under development, with multiple research applications, especially in the field of health. Individual metabolic profiles, the functionality of the body, as well as its interaction with the environment can be established using this technology. The body's response to various external factors, including the food consumed and the nutrients it contains, has increased researchers' interest in nutrimetabolomics. Establishing correlations between diet and the occurrence of various diseases or even the development of personalized nutrition plans, could contribute to advances in precision medicine. The interdependence between humans, animals and the environment are of particular importance today, with the dramatic emergence and spread of zoonotic diseases, food, water and soil contamination, and the degradation of resources and habitats. All these events have led to an increase of risk factors for functional diseases, burdening global health. Thus, this study aimed to highlight the importance of metabolomics, in particular of nutrimetabolomics, as a technical solution for a holistic, collaborative, and precise approach for the advancement of the One Health strategy.

Dust inhalation is a huge concern in the mining environment and within all its operations. In fact, dust to be one of the most serious occupational hazards in the mining industry. Coal and crystalline silica dust are the causes of serious, sometimes fatal lung diseases such as pneumoconiosis, which affects coal miners, as well as silicosis, tuberculosis, chronic bronchitis, emphysema, chronic obstructive pulmonary disease, and chronic renal disease, which affect coal and other types of miners. The resulting effects both affect workers and nearby communities. The mining industry has in the past, employed several approaches to reduce effects of dust. But these strategies have often been ineffective because the grass withers during the dry season and sprayed water is rapidly absorbed or evaporates. This paper endeavors to review information on dust in the mining environment and how it is a nuisance to workers and communities and establish what strategies exist for this.

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

This paper presents PrognosEase; a software that provides an easier way to produce different types of run-to-failure data mimicking real-world conditions to simplify prognosis studies in terms of data collection and improvement in ML degradation modelling process. Different types of degradation types made available to meet different types of applications. Besides, some primary ML tests were performed to ensure that complexity patterns of real systems could be observed in the training/testing predictions attitude. This paper also presents the impacts, limitations and potential improvements of the data generator.

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

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI’s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher–Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

Background. Perinatal depression is one of the leading causes of disability in perinatal women and is highly prevalent in disadvantaged communities in LMICs. However, care capacity remains low in most LMICs. As such, we decided to find and assess a screening program that addresses perinatal mental health problems in a resource-efficient manner. This leads us to a critically appraisal of the Perinatal Mental Health Project (PMHP), a screening program based in peri-urban Western Cape Town that stresses task sharing and stepped care intervention. Method. PubMed, Ovid Medline (1946 to 2018), and Google Scholar were searched for publications until March 2018, with data or evaluation of the PMHP. PMHP website publications were used for data and interpretation. The program’s viability was evaluated based on criteria published by UK National Screening Council. The program’s impact was analyzed using published patient outcome data. Access to care was evaluated at three barriers to accessing care proposed by Gjerdingen et al. (2007). The financial model was evaluated using the “four-pillars” of sustainable organization financial management proposed by León (2001). Findings. The PMHP’s screening program viability satisfies most criteria of the UK National Screening Council, and the program’s benefits outweigh its harms. Patient self-reports indicate successful impact with several highlights in accessibility. The program also demonstrates financial sustainability and potential for scaling-up. Interpretations. The operation model of the PMHP shows satisfactory viability and sustainability. With modifications fitting local context and government cooperation, this model offers promising potential in bringing public health and economic benefits.

The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal carers. Regardless of their health status, it is crucial to prioritize the well-being of older people. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.

Objective: To explore the effect of rural-urban residence on self-reported health status with UK cancer survivors. Design: A cross-sectional postal questionnaire that collected data on demographics, post-code and self-reported health status. Methods: Independent Samples t test was used to detect differences in health status between rural and urban respondents. Pearson’s χ2 was used to control for confounding variables and multivariate analysis was conducted using Stepwise linear regression. Setting: East Midlands of England. Participants: Adult cancer survivors who had undergone primary treatment in the last five years. Participants were excluded if they had recurrence or metastatic spread, started active oncology treatment in the last twelve months and were in receipt of palliative or end of life care. Main Outcome: Residence was measured using the UK ONS RUC2011 Rural-Urban Classifications and Health Status via the UK ONS self-reported health status measure. Results: 227 respondents returned a questionnaire. Forty-five per cent (N=103) were resident in a rural area and fifty-three per cent (N=120) in an urban area. Rural (4.11±0.85) respondents had significantly (p<0.001) higher self-reported health status compared to urban (3.65±0.93) respondents (MD 0.47; 95% CI 0.23, 0.70). Conclusion: Rural respondents had significantly higher self-reported health status compared to their urban counterparts. It is hoped that the results will stimulate further work in this area and that researchers will be encouraged to collect data on rural-urban residency where appropriate.

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

Background: Drinking and smoking have economic consequences and are the main risk factors of mortality and morbidity. Disease-specific deaths attributable to using substances present the primary health indicator in this study. This analysis focuses on mortality in productive age, 15 to 64 years since those deaths are considered the highest economic burden. Method: In the analytical part, data from the Registry of deaths of the Czech Republic for 1994 to 2017 were used. The number of deaths attributable to smoking and drinking was calculated using attributable fractions, based on literature review. This research aimed to reveal the gender differences in deaths attributable to drinking and smoking, according to age, and the differences in deaths regarding smoking or drinking. Results: The mortality attributable to smoking and drinking differs across age groups and genders. The highest median share of tobacco-related deaths is in the age group, 60—64 years. The highest median share of alcoholic deaths is in the age group of 50—54 years. Conclusions: There are significant differences between genders in both, smoking and drinking. A prevention program should be targeted to different age groups.

The participation of civil society is essential for environmental health policies to be effective. The objective of this study was to know the perceptions of government officials, members of civil society, and academics about environmental health problems and its governance in Bucaramanga Metropolitan Area, Colombia. In the region there is a strong citizen movement that defends the moorland ecosystem (paramo) as source of drinking water, of large-scale mining projects. A multi-method study was carried out including the review of newspaper and scientific articles, a citizen survey, and interviews and focus groups with identified key stakeholders. The findings indicate that government officials prioritize their actions on issues related to air and water pollution and environmental education. In contrast, citizens prioritize water availability from the moorland ecosystem. There are some advances in the management of environmental health, mainly related to greater citizen awareness. The participation of civil society in the environmental health governance must be enforced to broaden the issues of interest and prioritize the activities in the short- and long-term policy planning. An experience between high school students and the academy that measures air pollutants can be the first meeting point with government officials in the pathway to improve the environmental governance in the territory.

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