The risk of 'zoonotic spillovers,' or the transmission of viruses from animals to humans, has been raised by climate change and the devastation of nature, as infectious disease experts have long warned. Even as the world works to stop the spread of the currently unfolding pandemic of coronavirus disease 2019 (COVID-19) and the breakout of monkeypox virus (MPXV), a new animal virus, the Langya henipavirus (LayV), has been discovered in humans in Eastern China. The scientists say there is little danger of the virus spreading among humans, but it shares genetic material with Hendra virus and Nipah virus, two other henipaviruses that infect humans and cause life-threatening respiratory diseases. Humans infected with LayV can expect to experience high body temperature, cough, weariness, poor appetite, muscle discomfort, myalgia, nausea and vomiting. It is likely that the virus will spread from animals to humans. Currently, the health authorities of Taiwan and other health organizations are tracking the progress of the ailment to ensure it does not reach humans. Researchers have examined 25 species of small wild animals for presence of the virus, and so far, shrews are the only ones that have tested positive for the virus's RNA. Based on these results, shrews are a possible candidate for the virus's natural reservoir. Too far, no therapies or vaccines have been developed and licensed for henipaviruses like the LayV. When other therapies fail to alleviate viral infections, ribavirin may be the next best thing. The need for novel vaccinations against the LayV infection and the timely delivery of these vaccines to areas at high epidemiological risk is real. To lessen the likelihood of a health calamity being caused by this newly developing virus, it is crucial to conduct active surveillance in a transparent and globally collaborative manner. The questions that have not been answered yet require additional study.

We previously proposed a public intervention framework concept that would allow people to resume personal and economic activities. We showed that intervention measures are used in a quantitative scale to reduce transmission probabilities and disease severity. In this article, we systematically examine the origin, assumptions, performance and limitations of epidemiological models from different views used in past review. We found that nearly all model assumptions fail to hold or are remote from reality; R0 does not exit or has no utility in guiding treatment options; personalized intervention measures are vitally important to COVID-19 due to its transmission characteristic; and current epidemiological models are unable to accurately assess the true benefits of personalized intervention measures. We suggest that poor performance of the models are attributed to flawed assumption that health/disease properties can be treated as transferable properties. The flaw creates a fiction that disease properties such as infection probabilities and death risks can be transferred from any vulnerable persons to anyone in the population and thus severely limit societal ability to fight the pandemic. We finally show that the benefits of personalized mitigation measures could be determined directly by using variable Ri values for infected persons (or nodes) together assessment of death rate and disability rate; the attempt of avoiding the disease by defeating all potential transmission probabilities is unrealistic; but mitigating disease severity for specific persons is more feasible and reliable. A most reliable strategy for reviving economy is using personalized protective measures and improving person health before effective vaccine is available.

The aim of this study was to investigate the spatio-temporal association between socio-economic deprivation and the incidence of COVID-19 and how this association changes through the seasons and due to the existence of restrictive public health measures. A retrospective observational study was conducted among COVID-19 cases that occurred in the Apulia region from 29 February 2020 to 31 December 2021, dividing the period into four phases with different levels of restrictions. A generalized estimating equations model was applied to test the independent effect of deprivation on the incidence rate of COVID-19, taking into account age, sex, and regional incidence rate as possible confounding effects and covariates such as season and levels of restrictions as possible modifying effects. The highest incidence rate was in areas with a Very High deprivation Index (DI) in winter (107.2 for 100,000 ab. ± 7.5), while in autumn, the highest Rate Ratio (RR) was estimated between Very High vs. Low DI (3.83, p<.001). During total lockdown, no RR between areas with different levels of DI was significant, while during soft lockdown, areas with Very High DI were more at risk than all other areas. The effects of social inequalities on incidence rate of COVID-19 change in as-sociation with the seasons and restrictions on public health. Disadvantaged areas showed a higher incidence rate of COVID-19 in the cold seasons and in the phases of soft lockdown.

Public trust in science was tested and relied on during the SARS-CoV-2 pandemic, which has shaped global events since the WHO declaration in March 11, 2020. Public trust has been impacted through the government recommendations and mandates informed by public health guidance, including non-pharmaceutical and pharmaceutical interventions. The free-flow of ideas and in-formation so essential to the functioning of science has faced unprecedented challenge from widespread censorship in both the media and in scientific journals. This has created a poisoned environment for the building of trust between science and society. Scientific norms and ac-countability must be restored in order to rebuild the vital relationship between scientists and the public they serve.

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.

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.

This study introduces and demonstrates a comprehensive, accurate, unbiased approach to robust quantitative comparison of Electronic Nicotine Delivery Systems (ENDS) appropriate for establishing substantial equivalence (or lack thereof) between tobacco products. The approach is demonstrated across a family of thirteen pen- and pod-style ENDS products. Methods employed consist of formulating a robust emissions surface regression model, quantifying the empirical accuracy of the model as applied to each product, evaluating relationships between product design characteristics and maximum emissions characteristics, and presenting results in formats useful to researchers, regulators, and consumers. Results provide a response surface to characterize emissions (total particulate matter and constituents thereof) from each ENDS appropriate for use in a computer model and for conducting quantitative exposure comparisons between products. Results demonstrate that emissions vary as a function of puff duration, flow rate, E-Liquid composition, and device operating power. Further, results indicate that regulating design characteristics of ENDS devices and consumables may not achieve desired public health outcomes; it is more effective to regulate maximum permissible emissions directly. Three emissions outcome measures (yield per puff, mass concentration and constituent mass ratio) are recommended for adoption as standard quantities for reporting by manufacturers and research laboratories. The approach provides a means of (a) quantifying and comparing maximal emissions from ENDS products spanning their entire operating envelope, (b) comparative evaluation of ENDS devices and consumable design characteristics, and (c) establishing comparative equivalence of maximal emissions from ENDS. A consumer-oriented product emissions dashboard is proposed for comparative evaluation of ENDS exposure potential. Maximum achievable power dissipated in the coil of ENDS is identified as a potentially effective regulatory parameter.

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.

Public health agencies are increasingly using pathogen whole genome sequencing (WGS) to support surveillance and epidemiologic investigations. As access to WGS has grown, greater amounts of molecular data have helped improve our ability to detect outbreaks, investigate transmission chains, and explore large-scale population dynamics, such as the spread of antibiotic resistance. However, the wide adoption of WGS also poses challenges due to the amount of data generated and the need to transform raw data prior to analysis. This complexity means that public health agencies may need more advanced computational infrastructure, a broader technical workforce, and new approaches to data management and stewardship. As both a guide for how this development could occur, and a place to initiate discussion, we describe ten proposals for developing and supporting an informatics infrastructure for public health.

The outbreak of Coronavirus disease 2019 (COVID-19) has posed a significant concern in many countries due to the rapid rate of transmission between humans. Taking advantage of the experience of the last epidemics in 2002 Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and 2012 Middle East Respiratory Syndrome Coronavirus (MERS-CoV), some regions of the world were well- prepared for the new outbreak. However, other countries needed to be adapted to the situation promptly. Many management strategies were established, and some restrictions were introduced in some regions. In this review, we aimed to determine countries’ public responses to the epidemic of COVID-19 and how they developed administrative approaches towards the outbreak.

To predict how the COVID-19 pandemic progresses, we developed a systematic method for predicting disease outcomes. In the method, we evaluate how personal disease outcomes are mainly affected by viral concentration and exposure time and four defense mechanisms: human innate immunity/host response, acquired immune response, inflammation resolution and micro circulation, and the available space in the thorax cage. By considering how pandemic measures affect viral exposure and those mechanisms, we found many pandemic measures are misused or abused to deliver long-term adverse impacts. We noted that lifestyles have been changed as a result of movement restriction measures. By using the method, we found that altered lifestyles are predicted to raise infection rate, disability and death risks in the future. We show that a person can use personal, environmental, emotional factors to reduce infection rate and death risk. To prove the validity of this finding, we extensively examined medical research models, holistic and reductionist models, epidemiological models, disease risk factors, etc, and found that population methods are unfit for studying holistic health, statistical population does not exist in most clinical trials, mathematical models were misused for studying disease properties for a population, mathematical equations for modeling personal diseases are beyond human ability to solve, statistical models are misused, population-derived treatments are inherently dangerous to patients, vaccines have limited benefits due to unique lung structure and rapid RNA mutation, and immune system damage is caused by fast viral replication rate. We found that altering biological properties to improve the defense mechanisms could prevent a super majority of deaths and prevent the virus from reaching a point to damage the immune system. For vulnerable persons, such measure is a viable strategy for surviving from the pandemic. As a whole, holistic personalized medicine is more powerful than population-based reductionist treatment by one to several orders of magnitudes. We urge people do their parts to force the medical establishment to abandon population treatment models that are responsible for failure of medicine and dissemination of misleading and factually wrong information on the effectiveness of medical treatments.

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

Infectious diseases, as COVID-19 is proving, pose a global health threat in an interconnected world. In the last 20 years, resistant infectious diseases such as SARS, MERS, H1N1, Ebola, Zika and now COVID-19 have been impacting global health defences, and aggressively flourishing within the rise of global travel, urbanization, climate change and ecological degradation. In parallel, this extraordinary episode in global human health highlights the potential for artificial intelligence (AI)-enabled disease surveillance to collect and analyse vast amounts of unstructured and real-time data to inform epidemiological and public health emergency responses. The uses of AI in these dynamic environments are increasingly complex, challenging the potential for human autonomous decisions. In this context, our study of qualitative perspectives will consider a responsible AI framework to explore its potential application to disease surveillance in a global health context. Thus far, there is a gap in the literature in considering these multiple and interconnected levels of disease surveillance and emergency health management through the lens of a responsible AI framework.

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.

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.

Much has been explored in the individual health issue, and most of them adopt the objective data such as laboratory tests or health services utilization to analyze individual health assessment. However, the factors influencing individuals in self‐assessed health is still unclean. The study considers that self‐assessed health is viewed as catalyst in health management and explores various dimensions associated with self‐assessed health. Totally, 800 participants who were randomly sampled from the citizen of Porter County, Indiana completed the Needs Assessment Citizen Survey in 2007.After adjustment for age, gender, education, income, and health coverage, life quality (β=1.5538, sdandard erro of β=0.8404), and Medicaid assistance (β= -0.7715, sdandard erro of β= 0.3958) are the main determinants of individuals’ self‐assessed health. The results suggest that public health officials should consider improving citizens’ self-assessed health by providing good living and socio-economic environment.

The main purpose of this research is to analyze the perception of climate change impacts on human health in Bangladesh through data from nationality representative surveys conducted in some district of Bangladesh. In Bangladesh there have a few research has been conducted on public perceptions about the impact of climate change on human health. A structured questionnaire method was conducted, and data collected from 615 respondents. The findings of this study reveal that out of 615 respondents, 76.0% of the respondents replied positively while remaining 24.0%, almost one-fourth of total respondents, indicated that they have not heard the term climate change before. Knowledgeable in climate change, 92.5% of respondents agreed that climate change has an impact on human health while only 7.5% respondents disagreed with this statement. 90.5% of respondents argued that they are agreed with the opinion that climate change is a serious threat to human health.

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.

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.

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.

The objective of this quantitative study was to examine the impact of selected factors on the level and state of public health in local self-government units in 2021, with the consideration of data from 2020 and 2019. This survey included 77 out of 145 local self-government units in the Republic of Serbia and examined six dimensions defined by the Law on Public Health: social care for the public health of the city/municipality in regard to the physical, mental, and social health of the population; health promotion and disease prevention; the environment and health; working environments and population health; the organization and functioning of the health system; and actions in emergency situations. The results of the Pearson correlation showed that there were statistically significant correlations between the effectiveness of the realized program budget and microbiologically defective drinking water samples from the so-called village water supply systems, defective samples of drinking water from public taps, unsatisfactory analyses of wastewater samples, the total number of air samples on an annual level for PM25s, and the number of mandated fines issued. The results of the logistic regression model showed that the local self-government units that received assistance from the Permanent Conference of Cities and Municipalities were 5.6 times more likely to perform analyses of their health status. Furthermore, we determined that the units of local self-governments that appointed a coordinator of the health council identified vulnerable groups in the analysis of the state of health four and a half times more often. In contrast, the units of local self-governments that prepared health status analyses could be used to identify vulnerable groups to a six times greater extent within the framework of the health status analysis. The results showed that in improving the state of public health at the local level, it is necessary to provide systematic institutional support to cities and municipalities in exercising their responsibilities. Based on these results, recommendations were made for the further development of support, i.e., the planning of further activities aimed at strengthening the capacity of the health councils and local self-government units in this area.

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 La Oroya metallurgical complex reveals a process of structural or power pathology, where economic and environmental social policies lead to a citizenry without systemic freedom, characterized by environmental contamination (PAMA executed on average 67%, some processes with 0%) and sanitary (plumbosis 8.39 to 10.28 μg / dL), the economic dependence of this industry is also observed, which caused the weakening of the communities to maintain autonomy over their own destinies.The Doe Run Peru, operated the metallurgical complex, creating added value to the extractive-export chain of mineral concentrate, but also took advantage of the legal loopholes, the little coordination between the State institutions and the little authority of the supervisory institutions to get the most out of it, complying with the law in some cases, but without moral quality in some others, such as health in the oroinos.Government institutions must have strong links that provide a normative framework with prospects with sustainable development, where the beneficiary is society and not only certain interest groups. The economic benefits of the metallurgical complex operation are multiple, which begin with labor, the purchase and sale of materials and services, the collection of taxes and energy.

Purpose: A novel coronavirus, SARS-CoV-2 was identified as the cause of COVID-19 eventually led to the declaration of Public health emergency of international concern and a pandemic by WHO due to its exponential global spread. Present study was conducted to investigate the impact of second wave of pandemic on mental wellbeing and social behaviors among university students of Pakistan during this crucial period of COVID-19 infection. Methods: A cross-sectional analytical study was designed to evaluate the psychosocial impact during the current COVID-19 outbreak among the students of The Islamia University of Bahawalpur, Pakistan. Snowball sampling or chain referral sampling procedure was adopted to recruit the participants in the study. Verbal informed consent was taken from all participants before recruitment in the study irrespective of their gender, age and socioeconomic status. Results: Mental health of university students during COVID-19 epidemic was affected to a varying degree revealing that 26.66% were recorded to have mild, 27.15% moderate and 17.04% suffering from severe anxiety out of total 1029 students. Students who were residing in urban areas with parents and having a steady family income were negatively associated and found protective factors against anxiety. However, having a relative or an acquaintance infected with COVID-19 was an independent risk factor for experienced anxiety. Positively associated factors with the level of anxiety symptoms included economic stressors, effects on daily-life, and academic delays whereas social support was negatively correlated with anxiety in COVID-19 related stressors. Conclusion: Public health emergencies and such pandemic are exerting serious psychological impacts on university students. It is recommended that the higher authorities should plan better policies to reduce this impact for the provision of high quality and timely crisis-oriented psychological services to university students.

Background: Epidemiological surveillance of nursing diagnosis is an approach anchored on a post-modern epidemiology focused on persons health-disease responses. Regarding to public health priorities, the population where our study occurred had as priority problem the arterial hypertension. Related to this chronical disease, nursing diagnoses about health-disease responses in primary healthcare has as major focus Therapeutic Regime Management. Our aim was to study the nursing diagnosis in this issue, from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17,7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology defended for the future.

1) Public health remains a tiny portion of the undergraduate pharmacy curriculum and the material is integrated into other modules. The objective of this study is to describe the UK undergraduate pharmacy curriculum, including its public health content; 2) Methods: A qualitative method (content analysis of websites) was used to describe the UK undergraduate pharmacy curriculum and teaching and learning policy. This involved selecting relevant concepts and then quantifying their presence and the relationships between them. The NVivo software was used to carry out ‘group queries’ and visualisation of results; 3) Results: Public health remains an optional module in the curricula of many UK schools of pharmacy. Several public health-related topics are often integrated into other modules, but UK undergraduate pharmacy curricula are still dominated by traditional pharmacy modules; and 4) Conclusions: Most of the curricula analysed were dominated by traditional pharmacy modules designed to enhance students' knowledge and skills. The skill set of UK pharmacy students with respect to macro-level public health activities needs to be improved in order to enhance pharmacists’ contribution to public health.

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

Introduction: In rural communities in regions with limited resources the provision of clean water remains challenging. Fecal contamination of water is very common and results in a high incidence of diarrhea, subsequent acute kidney injury and mortality particularly in the very young and old. Membrane filtration is a practical solution to this problem and recent innovation allows membrane filtration using recycled hemodialyzers. We, Easy Water for Everyone, have quantified the systematic effect on health outcomes. Material and Methods: Between 02/2018 and 12/2018, 4 communities in rural Ghana (in the Greater-Accra region) were each provided with a high-volume membrane filtration devices (NUF 500; NuFiltration using recycled hemodialyzers). Health data from montly household surveys and chart review in local healthcare facilities were collected with approval from Ghana Health Services. Specifically, data was collected on gastrointestinal disease, acute kidney injury and therapeutic interventions. Incidence rates for a five-months period before and after implementation of the device were calculated and compared to rates during the same months from 4 neighboring communities that were not yet provided with the device. Results: Acceptance of the devices and the purified water in the studied villages was good and self-reported data of 1130 villagers over 10 months from 9 studied communities in rural Ghana (11% younger than 5 years and 14 % older than 65 years) were included in this analysis. The overall monthly incidence rate of diarrhea showed a decline following the implementation of the device in the 4 study villages from a mean of 0.18 to 0.05 cases per person-month for a reduction in rates by 72% (rate ratio = 0.27). By contrast, the control group of 4 villages in the same region showed no decline in mean rates during the same months as the study period with mean rates changing not significantly from 0.11 to 0.08 cases per person-month. Discussion: Provision of a hemodialyzer membrane filtration device markedly improves health outcomes as measured by diarrhea incidence within rural communities. While our data awaits confirmation in a larger population and further statistical analyses accounting for village characteristics, seasonality and subject demographics, the obvious decline in incidence rates supports widespread use of hemodialyzer membrane filtration devices, particularly in rural regions. Rollout of the device in further sites will likely increase our understanding in terms of risk and other preventive factors modifying the incidence of diarrhea and subsequent acute kidney injury.

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

The emergence of COVID -19 pandemic has severely impacted individuals from all walks of life. The rapid spread of the disease to nearly all parts of the country has posed enormous health, economic, environmental and social challenges to the entire human population. In the absence of any effective drugs and vaccines for treatment, social distancing and other preventive measures are the only alternatives. Lockdown is among one of the options suggested by WHO to reduce spread of the virus. India was quick to close its international borders and enforce the world’s largest COVID lockdown on March 22, 2020. The present study attempts to highlight the impact of imposed nationwide lockdown on society and environment alike along with analysis of lifestyle changes. The study was based on an online survey using a structured questionnaire with over 1000 responders across the country. The pandemic situation demands a certain way of shaping the society to reduce virus spread and safeguard oneself. In this study, we analysed the changes that the society has undergone during lockdown to mitigate the spreading of the infection. We also addressed the changes that have become part of our lives during lockdown – hygiene and health consciousness, work from home (WFM), online teaching, digital shopping, changing internet habits and societal changes.

(1) Background: This paper investigates the epidemiological risk related to temperature before and during COVID-19 in Italy; (2) Methods: Deaths in 2015-2019 and temperatures were correlated. Excess and COVID-19 deaths were examined to estimate the relationships with temperatures; (3) Results: Annual deaths were higher during the cold months (+45,000, SD = 4,700, S = 21). The scenario worsened during COVID-19. Mortality was higher during minimum temperature periods, although the curve moderately rose in the warmest months (r = -0.75, 95% CI = [-0.87; -0.56], S = 23). COVID-19 deaths showed a decreasing seasonality. Monthly excess deaths during COVID-19 were high (+4,200, IQR = [2,800; 8,000], S = 28) with a doubt of seasonality. COVID-19 mortality was correlated with regional latitude (r = 0.86, 95% CI = [0.68; 0.94], S = 20). Discrepancies between COVID-19 and excess deaths were found. The exposed population was subject to aging; (4) Conclusions: The epidemiological risk in Italy is seasonal and geographically dependent. Low and very high temperatures can lead to mortality peaks. Therefore, COVID-19 and any other epidemiological risk must be evaluated in light of this evidence. Health systems need to be strengthened during cold and extremely hot periods. Future research should investigate these phenomena at the causal level.

Philip Morris International (PMI) has developed the Population Health Impact Model (PHIM) to quantify, in the absence of epidemiological data, the effects of marketing a candidate modified risk tobacco product (cMRTP) on the public health of a whole population. Various simulations were performed to understand the harm reduction impact on the U.S. population over a 20-year period under various scenarios. The overall reduction in smoking attributable deaths (SAD) over the 20-year period was estimated as 934,947 if smoking completely went away and between 516,944 and 780,433 if cMRTP use completely replaces smoking. The reduction in SADs was estimated as 172,458 for the World Health Organization (WHO) 2025 Target and between 70,274 and 90,155 for the gradual cMRTP uptake. Combining the scenarios (WHO 2025 Target and cMRTP uptake), the reductions were between 256,453 and 268,796, depending on the cMRTP effective dose. These results show how a cMRTP can reduce overall population harm additionally to existing tobacco control efforts.

Laws and regulations make powerful contribution in addressing multitudes of public health concerns. We examined the Public Health Act (PHA) in Malawi to understand its relevance to the ever-growing and changing threats posed by infectious and non-infectious diseases. The current Public Health Act of Malawi came into effect in 1948 to protect and preserve public health. The Act has undergone several amendments, the last one being in 1975. It draws much of its inspiration and standards from the 19th century British laws on insanitary housing, poor ventilation, and drainage. Such laws are silent on emerging major public health concerns including non-communicable diseases (NCDs) such as cardiovascular diseases and diabetes as well as road traffic injuries. This makes the Act outdated and ill equipped to address the 21st century public health concerns. Although supplementary legislation such as the HIV/AIDS Act and Mental Treatment Act have recently been enacted, they are yet to be consolidated into the Public Health Act. Consequently, existing policies and strategic plans that are meant to address gaps in public health and ensure coordinated effort lack support of laws and regulations. The Act also places great emphasis on mandatory vaccinations, quarantine and isolation against smallpox, a disease that has long been eradicated. Furthermore, although the Public Health Act outlines powers, duties and penalties, it fails to reinforce acceptable behaviour due to the insignificant penalties for noncompliance. There is a need for immediate and prompt revision and restructuring of the Public Health Act based on scientific evidence. Such laws require adequate consultation and interaction with key experts and stakeholders from a wide range of disciplines.

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.

As public health laboratories expand their genomic sequencing and bioinformatics capacity for the surveillance of different pathogens, labs must carry out robust validation, training, and optimization of wet- and dry-lab procedures. Achieving these goals for algorithms, pipelines and instruments often requires that lower-quality datasets be made available for analysis and comparison alongside those of higher-quality. This range of data quality in reference sets can complicate the sharing of sub-optimal datasets that are vital for the community and for the reproducibility of assays. Sharing of useful, but sub-optimal datasets requires careful annotation and documentation of known issues to enable appropriate interpretation, avoid being mistaken for better quality information, and for these data (and their derivatives) to be easily identifiable in repositories. Unfortunately, there are currently no standardized attributes or mechanisms for tagging poor-quality datasets, or datasets generated for a specific purpose, to maximize their utility, searchability, accessibility and reuse. The Public Health Alliance for Genomic Epidemiology (PHA4GE) is an international community of scientists from public health, industry and academia focused on improving the reproducibility, interoperability, portability and openness of public health bioinformatic software, skills, tools and data. To address the challenges of sharing lower quality datasets, PHA4GE has developed a set of standardized contextual data tags, namely fields and terms, that can be included in public repository submissions as a means of flagging pathogen sequence data with known quality issues, increasing their discoverability. The contextual data tags were developed through consultations with the community including input from the International Nucleotide Sequence Data Collaboration (INSDC), and have been standardized using ontologies, community-based resources for defining the tag properties and the relationships between them. The standardized tags are agnostic to the organism and the sequencing technique used and thus can be applied to data generated from any pathogen using an array of sequencing techniques. The list of standardized tags is maintained by PHA4GE and can be found at https://github.com/pha4ge/contextual_data_QC_tags. Definitions, ontology IDs, examples of use, as well as a JSON representation, are provided. The PHA4GE QC tags were tested, and are now implemented, by the FDA’s GenomeTrakr laboratory network as part of its routine submission process for SARS-CoV-2 wastewater surveillance. We hope that these simple, standardized tags will help improve communication regarding quality control in public repositories, in addition to making datasets of variable quality more easily identifiable. Suggestions for additional tags can be submitted to PHA4GE via the New Term Request Form in the GitHub repository. By providing a mechanism for feedback and suggestions, we also expect that the tags will evolve with the needs of the community.

Objectives Asylum seekers in Germany represent a highly vulnerable group from a health perspective due to a variety of risk factors. At the same time their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence on its actual impact on the use of medical services Study design Thus, the aim of this study is to examine the influence of the possession of the EHIC on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). For this purpose, a standardized survey was carried out to 260 asylum seekers in different municipalities of which some have introduced the EHIC for asylum seekers, while others have not. Methods Various CR were differentiated considering possible third variables as well as confounding factors. The period prevalence was compared between the groups "with EHIC" and "without EHIC" using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results Asylum seekers who are in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Their CR, however, does not differ significantly from the age-corrected CR of the autochtonous population. Taking into account relevant covariables, the possession of the EHIC can be viewed as an independent influencing factor on the asylum seekers' use of medical care. Conclusions The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers. Nevertheless, the ownership of the EHIC does not seem to lead to an overuse of medical services.

The is a sequential article to an initial review suggesting that Microbiome First medical approaches to human health and wellness could both aid the fight against noncommunicable diseases and conditions (NCDs) and help to usher in sustainable healthcare. This current review article specifically focuses on public health programs and initiatives and what has been termed by medical journals as a catastrophic record of recent failures. Included in the review is a discussion of the four priority behavioral modifications (food choices, cessation of two drugs of abuse, and exercise) advocated by the World Health Organization as the way to stop the ongoing NCD epidemic. The lack of public health focus on the majority of cells and genes in the human superorganism, the microbiome, is highlighted as is the “regulatory gap” failure to protect humans, particularly the young, from a series of mass population toxic exposures (e.g., asbestos, trichloroethylene, dioxin, polychlorinated biphenyls, triclosan, bisphenol A and other plasticizers, polyfluorinated compounds, herbicides, food emulsifiers, high fructose corn syrup, certain nanoparticles, endocrine disruptors, obesogens). The combination of early life toxicity for the microbiome and connected human physiological systems (e.g., immune, neurological), plus a lack of attention to the importance of microbial rebiosis has facilitated rather than suppressed, the NCD epidemic. This review article concludes with a call to place the microbiome first and foremost in public health initiatives as a way to both rescue public health effectiveness and reduce the human suffering connected to co-morbid NCDs.

Florida geologic units and soils contain a wide range in concentrations of naturally-occurring arsenic. The average range of bulk rock concentrations is 1 to 13.1 mg/kg with concentrations in accessary minerals being over 1,000 mg/kg. Soils contain natural arsenic concentrations of between 0.18 and 2.06 mg/kg with organic-rich soils having the highest concentrations. Anthropogenic sources of arsenic have added about 610,000 metric tons of arsenic into the Florida environment since 1970, thereby increasing background concentrations in soils. The anthropogenic sources of arsenic in soils include: pesticides (used in Florida beginning in the 1890’s), fertilizers, chromated copper arsenate (CCA)-treated wood, soil amendments, cattle-dipping vats, chicken litter, sludges from water treatment plants, and others. The default Soil Cleanup Target Level (SCTL) in Florida for arsenic in residential soils is 2.1 mg/kg which is below some naturally-occurring background concentrations in soils and anthropogenic concentrations in agricultural soils. A review of risk considerations shows that adverse health impacts associated with exposure to arsenic is dependent on many factors and that the Florida cleanup levels are very conservative. Exposure to arsenic in soils at concentrations that exceed the Florida residential cleanup level in residential environments does not necessarily pose a meaningful public health risk.

As the COVID-19 pandemic begins to abate and national public health systems are treating the SARS-Cov-2 virus as endemic, many public health measures are no longer mandated, but remain recommended with voluntary participation. One of these is the wearing of fitted face masks, initially mandated to contain, or at least slow, the spread of SARS-CoV-2 which is primarily transmitted via aerosols emitted while breathing, coughing, or sneezing. While the habit of once wearing fitted face masks recedes into memory for much of the population, so does the knowledge of the various types of masks that were once en vogue. To create a record for the future, this paper provides the first comprehensive documentation of the nature and range of fitted facemasks that circulated during the COVID-19 pandemic.

Objective: to assess level of trust in health services during COVID-19 pandemic in Brazil. Methods: Cross-sectional study, carried out between 2020 and 2021, among Brazilians over 18. A non-probabilistic sampling was used. Descriptive and inferential statistics were applied, using the Local Bivariate Moran’s technique was used to verify the existence of spatial dependence between the incidence and mortality of COVID-19 and trust in health services. Furthermore, multinomial regression was also used to analyze the factors associated with the confidence level, with the calculation of the Odds Ratio and with a confidence interval of 95%. Results: 50.6% reported trust in hospital services while 41.4% did not trust Primary Health Care services. With the application of the Local Bivariate Moran, both for the incidence and mortality of COVID-19, the trust in tertiary care and primary care services showed a statistically significant spatial association predominant in the Midwest (High-Low) and North (Low-High) regions of Brazil. The level of trust was associated with education, religion, region of the country and income. Conclusions: The level of trust in hospital services, more than Primary Health Care services, may be related to the population's culture of prioritizing the search for hospital care at the detriment of health promotion and disease prevention

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.

The state of community lock-down due to COVID-19 pandemic caused restricted movements of people. There are existing evidence of the negative impact of quarantine and isolation to the mental health of a person in different contexts. A scoping review of literature using Google Scholar was conducted to discover records about the public mental health while in a community quarantine due to COVID-19 pandemic. A methodological approach suggested by Arksey and O’Malley was utilized. It comprised (a) identifying the research questions, (b) identifying relevant literatures, (c) selecting literature, (d) charting the extracted data, and (e) summarizing, analyzing, and reporting the results. As of April 17, 2020, there were only 4 original articles found that discuss psychosocial aspect of the COVID-19 crisis. After an online survey, they present evidence that (1) there is an outward change in the people’s behavior toward self-care during the pandemic and (2) trusting the community governing bodies can minimize the level of anxiety and stress. Other literatures found are original articles in preprint (n=8), letters, commentaries, editorial (n=6), review paper (n=4), and WHO guideline (n=1). It is evident that the psychosocial aspect of COVID-19 crisis needs more attention from the scholars and a large research gap can be lessened trough expansion of online platforms.

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

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

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.

Let us all take a moment to talk, once again, about this new coronavirus pandemic that the world has been facing since November 2019 and about its global response. After a short period marked by the pandemic underestimation risk by most governments, the Western world went nuts and overreacted, most probably so as not to be accused of inaction. In many cases, the overall benefits of the chosen policies were not sufficiently questioned, which resulted in many side effects on global health .The medical motto “primum non nocere”, a moral principle everyone should at least consider following, was evidently not taken into account. It has been overlooked, and the virus has become an obsession, to the extent that nearly everything else, even the most valuable things in life, is still now under appreciated if not simply ignored. This review highlighted facts against this simplistic, one-dimensional view.

Background: With new challenges to the health system, many new competencies within the scope of teaching public health need to be addressed in medical schools’ curricula such as disaster risk management and health system science. The aims of this study were to identify the needs of public health competencies for medical doctors in Thailand and to assess the level of integration for technical collaboration in teaching public health. Method: A total of 17 out of 21 Thai medical schools participated in the national survey. Qualitative inquiries applied focus group interviews of community representatives from ten sample villages and in-depth interviews of representatives from stakeholder organizations particularly employers. The list of public health competencies framework recommended by WHO-SEARO was applied. Quantitative analysis applied descriptive analysis using STATA 15 and qualitative findings were validated by interrelating the meaning of themes from Word Clouds created in NVivo12. Data integration applied a mixed-method Quan-qual approach. Results: 17 medical schools returned the questionnaires (80.95 % yield). The most common regionally-defined public health competencies (in over 70% of schools) were shown to be: Biostatistics, Community Medicine, Epidemiology, Family Medicine, Medical Ethics and Professional Laws, Preventive Medicine, Health Promotion, Holistic Care, and Research. The curriculum in only one medical school lacked Health Economics, whilst Disaster Management was lacking in two other schools. Discipline-based subjects were found to be more prevalent than interdisciplinary competencies. A variety of methods were being applied for teaching public health. The majority of the schools applied lecture as the main teaching method and multiple-choice questions as the main assessment method. Thai communities expect the doctors to get in touch with the community more often, lead the primary health care team through training the health professionals and community health volunteers, and educate the community for better health. Conclusion: Human resource is the main challenge in addressing interdisciplinary competencies. It is necessary to establish a collaborating mechanism among the big and small medical schools and the faculties of public health to improve the teaching of public health to undergraduate students in medical schools. There is also a need to strengthen the health system science and leadership so that future MDs can lead health service delivery according to the needs of their employers such as the Ministry of Public Health and the Rural Doctors Association. The findings of this study may help to identify a national framework of public health core competencies for medical schools and create a common platform for interdisciplinary collaborations.

Background: Maternal near-miss refers to a situation where a woman who nearly died but survived from severe life-threatening obstetric complications that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. It has been estimated that up to 9 million women survive obstetric complications every year. According to studies done around the world most mothers suffer from Near Miss due to the factors which includes, low socioeconomic status, patient related, health provider related, and health related and health institution related issues. Objectives: The objective of the study was to determine the proportion of maternal near misses and its associated factors in Selected Public Health Institutions of Keffa, Bench-Maji and Sheka Zones of South Nations Nationalities and Peoples Regional state, South West Ethiopia, 2017. Methodology: Hospital based cross-sectional study design was employed and simple random sampling techniques (Lottery Method) was used to select the study institution and Systematic sampling technique was used to select 845 study participants every 5^th interval. Information was collected by using pre-tested and structured interviewer administered questioner. Using SPSS version 21 software, descriptive statistics and bivariate logistic regression analysis was done and variables with p-value <0.2 were transferred to multivariate analysis and during Multivariate logistic regression analysis Variables with P-value < 0.05 were considered as statistically significant and AOR with 95% CI were used to control for possible confounders and to interpret the result. The results were summarized by tables, graphs and charts. Result: There were 5530 Live Births, 227 Sever Acute Maternal Morbidity cases of this 210 were Maternal Near-Misses cases and 17 were maternal deaths, 364 Maternal Near-Misses Events. The overall Maternal Near-Misses Proportion is 24.85%. The maternal Near-Misses outcome ratio was 41 cases/1,000 live births (LB); mortality ratio was 12.35cases/1 maternal death and 74.8/1000LB of mortality index. Parity, residence, distance of living place from hospital, ANC Follow up, duration of labor, and administrative related problems were found to have statistically significant associations. Conclusion: The proportion of Maternal Near-Misses is relatively high when compared to other regional studies and efforts should be done to lower the near-misses.

We develop a mathematical model to provide epidemic predictions for the 2019-nCov epidemic in Wuhan, China. We use reported case data up to January 31, 2020 from the Chinese Center for Disease Control and Prevention and the Wuhan Municipal Health Commission to parameterize the model. From the parameterized model we identify the number of unreported cases. We then use the model to project the epidemic forward with varying level of public health interventions. The model predictions emphasize the importance of major public health interventions in controlling 2019-nCov epidemics.

Although previous studies have focused on the adverse effects of the COVID-19 pandemic on various professional groups (particularly in the health and nursing care sector), this study aims to close a research gap by assessing perspectives of students and young professionals in epidemiology and public health in Germany in terms of shifts in workload, work content, and related challenges caused by the pandemic. We conducted a cross-sectional survey between mid-February and mid-March 2022. Quantitative data were analyzed via standardized mean differences. Qualitative data based on answers to open-ended questions were analyzed via a qualitative content analysis. Overall, 172 individuals participated in this survey. Results indicate that students felt burdened the most by lack of exchange with other students and lecturers. Study participants employed in public health experienced changes in their employment, because they had changes in their work content- and administration-wise, which was accompanied with a high burden due to the workload. Multiple demands that can have an impact on both acquired skills and mental health during the professional qualification phase were mentioned by the participants. Therefore, more in-depth analyses are needed for investigating the impact the pandemic will have on the (future) public health workforce in the long run.

Objectives: Low and Middle Income Countries (LMICs) are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity (MMD). However, preventing MMD has received little attention in LMICs, especially in Sub-Saharan African Countries. Design: Narrative review which scoped the most recent evidence in LMICs about MMD determinants and appropriated them for potential MMD prevention strategies. Methods: MMD in LMICs is affected by several determinants including increased age, female gender, environment, lower socio-economic status, obesity, and lifestyle behavious, especially poor nutrition and physical inactivity. Results: MMD public health interventions in LMICs, especially Sub-Saharan are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent MMD clusters, especially hypertension, diabetes and cardiovascular disease, can provide an early prevention of MMD, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing MMD in LMICs.

We do this research to investigate the relationship between renewable energy, public health expenditure, logistics performance indices, and economic and environmental sustainability in the ASEAN member states, through the analysis of a panel data from 2007 to 2017. The study used secondary data, which is downloaded from the World Bank Website and employs SEM (Structural Equation Modelling) model for testing hypothesis. The results show that the usage of renewable energy in logistical operations would enhance the environmental and economic performance in terms of mitigating carbon emissions and greenhouse gas emissions. While, public health expenditure and environmental performance is negatively correlated, which confirms that greater environmental sustainability with lower carbon emissions and greenhouse gases will improve human health and economic growth. Moreover, greater public health expenditure and poor environmental performance has negative effect on economic growth, inefficiency and low productivity of labor slowdown to the economic activities. For another side, the usage of renewable energy and the adoption of green practices in international logistics will develop the environmental sustainability, establish better image of a country and attract foreign direct investment inflows, and also minimize carbon emissions and public health expenditure, spurring sustainable economic growth with better export opportunities in pro-environmental countries.

The COVID-19 pandemic has great adverse impacts on personal life, the U.S. economy, and the world economy. Freezing all human activities is not a sustainable measure. Thus we want to develop a public intervention framework that allows people to resume personal and economic activities. In this article, we examined transmission routes, disease severity, personal vulnerability, available treatments, and person-person interactions to establish a general public intervention framework. We divide people into risk groups, non-risk group and group that may serve as viral transmitters, explore interactions between individual persons within each group and between different groups, and propose interaction behavior modifications to mitigate viral exposures. For the non-risk groups, we identified preventive measures that can help them avoid the most serious exposures and infections that pose higher death risks. The invention measures for the vulnerable groups include prior-exposure measures, heightened protective measures, interaction behavior changes, post-exposure remedial measures, and multiple factors treatments to reduce death and disability risks. The multiple interventions and two-ways defensive behavior modifications are expected to result in reduced rate of detectable infections and lowered disease severity for the vulnerable groups. In this framework, most human activities and economic activities can continue as normal. With time passing, the population acquires population immunity against the COVID-19 virus. Implementation of this intervention framework requires considerable resources and governmental effects while the multiple factors treatment protocol requires the support of health care professionals.

This study examines whether government spending efficiency is associated with differential effects of public investment on debt-to-GDP ratio for a panel data consisting of 16 developing countries in Asia-Pacific region over the period 2007-2017. Public investment is central to implementing the UN 2030 Agenda for Sustainable Development — but high debt-to-GDP ratio poses a key risk. The empirical results indicate that public investment efficiency moderates debt-to-GDP ratio whereas public investment in the midst of public sector corruption accentuates debt-to-GDP ratio. The results have important policy implications.

Concurrent waves of Coronavirus disease, Ebola virus disease, avian influenza A and black fungus are jeopardizing the lives in some parts of Africa and Asia. From this point of view, this review aims to summarize both socio-economic and public health implications of these parallel outbreaks along with their best possible management approaches. Various online databases were used to collect the necessary information regarding these outbreaks. Based on the reports published and analyses done so far, the long-lasting damages caused by these simultaneous outbreaks on global socio-economical and public health status can be conceived from the past experiences of outbreaks, especially the COVID-19 pandemic. Moreover, prolonged restrictions by the local government may lead to food insecurity, global recession, and an enormous impact on the mental health of people of all ages, specifically in developing countries. Such overwhelming effects already have been reported to be declining national growth of the economy as well as increasing political insecurity and shortage of basic needs. Although various actions have already been taken including vaccination, clinical management, and further research, social distancing, and lockdown, etc. to improve the situation, the emerging variants and associated genetic mutations may make the containment difficult worsening the situation again. Considering the current mutational dynamics of the pathogens and the past experiences, perpetual preparedness along with updated clinical management backed by epidemiological studies and innovating scientific effort are inevitable to combat the simultaneous waves of multiple infectious diseases.

How can neuroscience help everyone to live and care for our confined brains? Understanding and studying human behaviour allows us to measure the impact of such confinement on each of us and to identify those who need help. The challenges are to understand the psychological repercussions following confinement and to understand how neuroscience and neurotechnology can be very interesting tools for dealing with the health crisis. Neuroscience is changing our traditional philosophical and ethical views by providing information about the biological basis of our moral behaviour. The exception of the brain is at the heart of neuroethical thinking and discourse. Neuroethics is an interdisciplinary discipline placed at the intersection between the human sciences and the neurosciences, and aims to help understand how knowledge and research in neurosciences and neurotechnologies will affect the future of society, their impact on humans, relationships, daily life, the labour market ... but also how they can help and provide solutions and answers to the questions of citizens in a health crisis. But it's a double-edged sword, collecting and analyzing brain data in real time seems to be increasingly simple and within everyone's reach, without having the hindsight of the real meaning of these data, allowing one day to read people's thoughts, control them and manipulate them. It is becoming clear that the boundaries between medical and non-medical uses of neuroscience and neurotechnology are becoming very porous, inviting us to reflect on neuroethical issues in order to put safeguards on these uses.

This paper surveys estimates of the transmission features of the novel coronavirus, and then proposes a model to address sample-selection bias in estimated determinants of infection. Containment assumptions of the infection forecasting models depend on assumed effects of policies and self-regulating behavior. In the commons dilemma of the pandemic, the perceived ‘low risks’ of unregulated marginal choices do not reflect the full social cost, implying non-pharmaceutical interventions (NPI) to reduce mortality can enhance social welfare. As more economic activity renews with liftings of restrictive NPI (RNPI), a critical question concerns the ability of milder NPI (MNPI) and voluntary precautions to mitigate the risk of greater infections and deaths while also limiting the pandemic’s economic damage and its social costs. Ineffective NPI could lead to continued COVID-19 waves and new types of crises, worsened expectations and delayed economic recoveries. From the central range of surveyed estimates of transmission and alternative herd-immunity-threshold estimates, a ‘worst-case’ virus guidepost suggests eventual deaths of around 25 to 41 million worldwide and 1.1 to 1.7 million in the U.S. needed to reach herd immunity with no vaccine or treatment. The most optimistic study surveyed (theoretical model from a non-reviewed preprint study) combined with the low end of the range of the estimated mortality rate suggests 6 to 9 million deaths worldwide and 250 to 370 thousand in the U.S. to reach herd immunity. Successes in the mix of NPI, treatments, and vaccine can limit the eventual global death toll of the virus. Improved estimation models for forecasting and decision making may assist in better targeting the local timings and mix of NPI. Diagnostic tests for the virus have been largely limited to symptomatic cases, causing possible sample selection bias. A recursive bivariate probit model of infection and testing is proposed along with several possible applications from cross-section or panel-data estimation. Multiple potential explanatory variables, data sources, and estimation needs are specified and discussed.

Our primary objectives were a) to determine the need for, and the availability of point-of-care testing (POCT) for infectious diseases and b) to recommend point-of-care testing strategies and spatial care paths (SCPs) that enhance public health preparedness in regional districts of Thua Thien Hue Province (TTHP), Central Vietnam, where we conducted field surveys. Medical professionals in 7 community health centers (CHCs), 7 district hospitals (DHs) and 1 provincial hospital (PH) participated. Survey questions (English and Vietnamese) determined the status of diagnostic testing capabilities for infectious diseases and other acute medical challenges in TTHP. Infectious disease testing was limited: 6 of 7 CHCs (86%) lacked infectious disease tests. One CHC (14%, 1/7) had two forms of diagnostic tests available for the detection of Malaria. All CHCs lacked adequate microbiology laboratories. District hospitals had few diagnostic tests for infectious diseases (Tuberculosis, Syphilis), blood culture (29%, 2/7), and pathogen culture (57%, 4/7) available. The PH had broader diagnostic testing capabilities but lacked preparedness for highly infectious disease threats (e.g., Ebola, MERS-CoV, SARS, Zika, and Monkeypox). All sites reported having COVID-19 rapid antigen tests; COVID-19 RT-PCR tests were limited to higher tier hospitals. We conclude that infectious disease diagnostic testing should be improved and POC tests must be supplied near patients’ homes and in primary care settings for the early detection of infected individuals and mitigation of the spread of new COVID-19 variants and other highly infectious diseases.

Background: Zika virus (ZIKV) infection has significantly affected Latin America in 2015–2017. Most studies have been reported from Brazil and Colombia, and only a few from Central America. For these reasons we analyzed the incidence, incidence rates and evolution of cases in Honduras from 2016–2017. Methods: Using epidemiological weeks (EW) surveillance data on the ZIKV epidemics in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental and municipal levels. Results: From 1 January 2016 to 31 December 2017, a total of 32,607 cases of ZIKV were reported (98.5% in 2016 for an incidence rate of 36.85 cases/100,000 pop; 1% confirmed by RT-PCR). The highest peak was reached on the EW 6°, 2016 (2,559 cases; 29.34 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortés (13,128 cases, 791.08 cases/100,000 pop in 2016). Discussion: The pattern and evolution of ZIKV infection in Honduras has been similar to that which occurred for chikungunya in 2015. As previously reported, infection with chikungunya involved predominantly the central and capital area of the country, reaching incidences there >750 cases/100,000 pop. Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.

Background: After serious epidemics of chikungunya (CHIKV) and Zika (ZIKV) in the Americas, dengue (DENV) have reemerged in most countries. We analyzed the incidence, incidence rates, and evolution of DENV cases in Honduras from 2015-2018 and the ongoing 2019 epidemic. Methods: Using epidemiological weeks (EW) surveillance data on the DENV in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental, and municipal levels. Results: From 1 January 2016 to 21 July 2019, a total of 109,557 cases of DENV were reported, 28,603 in 2019, for an incidence rate of 312.32 cases/100,000 pop this year; 0.13% laboratory-confirmed. The highest peak was reached on the EW 28°, 2019 (5,299 cases; 57.89 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortes (8,404 cases, 479.68 cases/100,000 pop in 2019). Discussion: The pattern and evolution of DENV epidemic in 2019 in Honduras has been similar to that which occurred for in 2015. As previously reported, this epidemic involved the north and central areas of the country predominantly, reaching municipality incidences there >1,000 cases/100,000 pop (1%). Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.

Background: The progression of periodontal diseases at national Portuguese level and its public awareness are of great interest, mainly due to the high burden of periodontitis. Objectives: To evaluate the prevalence progression of periodontal diseases in Portugal and correspondent public awareness, between 2004 and 2017, by using data from the Global Burden of Disease (GBD), Directorate-General of Health (DGH) and Google® Trends (GT). Methods: For the period 2004-2017, Portuguese national data of periodontal diseases prevalence were searched in the Institute for Health Metrics and Evaluation of GBD and DGH and for public awareness, GT comparison tool between Portuguese words for “Periodontitis”, “Gingivitis”, “Gums” and “Periodontal disease” trends was used. Results: For the period 2004-2017, the overall prevalence of periodontitis slightly increased from 11.3% to 11.7%. During that period the GT search term “Gums” (“Gengivas”) was the most relevant. It increased steadily over time while the search term “Periodontal disease” (“Doença periodontal”) decreased, being these search trends significantly correlated (

Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoid-ing masses, wearing face masks and adhering to hand hygiene recommendations became impera-tive. The current study aims to determine factors interrelating with hygiene behaviors. Methods: 4,049 individuals (1,305 male, 2,709 female, aged 18-80 years) were recruited from rehabilitation clinics or freely on the internet and surveyed via online questionnaire between May 2020 and August 2021. Socio-demographics, hygiene behaviors, emotions (fear), life-satisfaction, risk factors and disability as well as communication were assessed. Results: Prevalence for hygiene behaviors was: keeping the distance 84.9%, avoiding mass gatherings 84.6%, wearing face masks 96.5% and hand hygiene 80.7%. Hygiene behaviors were significantly related to fear with linear and quad-ratic associations. Conclusion: Individuals with disabilities, risk factors and psychological symp-toms are more compliant. Especially hand hygiene should be targeted to achieve higher compli-ance rates. A medium level of fear is more functional than too elevated fear. Behavioral interven-tions and targeted communication aiming at improving different behaviors in orchestration can help individuals to remain healthy and maintain a high life-satisfaction. Thereby, communication in the healthcare setting is imperative and all involved individuals should become more aware of this to ensure high hygiene standards and patient safety.

Managing household solid waste is an urban problem in recent years. To tackle this problem, recycling is one of the most effective methods applicable in waste management. Recycling in the city of Laramie in Wyoming has a history that dates to 1983 with the establishment of Ark Recycling center. Laramie officially started its curbside recycling services in September 2011 and In April 2012, the city declared its long-term goal to achieve 40% diversion rate by 2030. The study involved a mail-back survey to understand public participation landscape and factors affecting recycling behaviors and attitudes of residents in Laramie. Quantitative result of the survey responses, civic engagement score, recycling importance score recycling satisfaction and recycling behavior scores were created to understand these attributes. In addition, three key informant interviews were conducted to explore efforts of the city, the University of Wyoming and the Ark Regional Services. Findings of the study show that more than 80% of the survey respondents indicated environmental concern was the major motivation to join recycling with high level of recycling importance and satisfaction. The Study further uncovered hints that Laramie needs to introduce an aggressive educational policy, incentive policies and a Master Plan to meet its 40% waste diversion rate by 2030 by maintaining stronger public participation in its planning process and community outreach programs.

At present, the health systems of many countries face complex challenges even if their priority objectives remain the same - to provide sustainable health systems at the current and the prognostic demographic changes and requirements in a health system. The quality and the efficiency of healthcare delivery and their mutual conformity have been brought to public attention. Similarly, the quality and the efficiency of an entire process depends on the instrumentation and its procurement that represents a significant economic and procedural issue in the healthcare systems for a long time. Many reports of the public procurement processes and research studies declare this fact. The primary aim of this study is to evaluate the public procurement efficiency in the health system by means of the valuation approach, or savings’ estimates that are achieved by the public procurement. The savings were defined as a percentage difference between the estimated and the final contract price. The secondary objective is to examine an influence of selected variables on a creation of savings in the public procurement process by means of a regression analysis. The researched variables are as follows: time, method, procurement, NUTS level of procurement, Common Procurement Vocabulary Code, number of offers. The analysis results showed interesting findings. The number of offers has a significantly positive impact on the savings. It means that if the number of offers increases by one unit, the savings will increase by 15.6%. Also, time variable (year) has a positive impact on the savings. Consequently, it may be assumed that the public procurement process is improving from a time perspective. It may be partially caused by the fact that a new public procurement legislative has been valid since 2015. The NUTS level has also an impact on the savings in relation to the public procurement. The public procurements which took place at the level of a state were more beneficial as the public procurements at the regional level. Also, the procurement method was statistically significant parameter of a regression analysis. The competition actions together with a negotiation process created higher savings in comparison to tenders. In case of the CPV codes, the most significant savings were achieved in the group of ‘various medicinal products’. The study’s results provide a valuable knowledge for the creators of policies and a realization of the national strategic plans within the health system. Also, these results support a creation of national and international benchmarks in this area and a networking of international partnerships in the area of a public procurement that focus on a development of methodologies and comparative platforms creation.

Access to medicines is one of the essential problems in Public Health of low- and middle-income countries (LMICs). The World Health Organization (WHO) defines access to medicines as the possibility of "having continuously accessible and affordable medicines in public or private health facilities that are within a kilometer of the place of residence." Access to medicines, as defined by the WHO, is not fully guaranteed in many LMICs and even in many regions of high-resource countries. The WHO identifies several factors as determinants of limitations in the access to medicines: rational selection, affordable prices, sustainable financing, and reliable health services. The action on these factors makes it possible to improve universal access to medicines with consequent improvement in Public Health. Adequate access to antibiotics and vaccination will avoid a large part of the deaths caused by infectious diseases in the LMICs. However, the emergence of resistance and the difficulties in vaccination campaigns due to socio-political or cultural problems make it challenging to fight many easily treatable infectious diseases. The use and abuse of antibiotics are inevitably associated with the appearance of resistances that make them ineffective. Thus, whereas limited access to antibiotics raises mortality rates from infectious diseases, generalized open access to them ends up eliminating their clinical value. Moreover, the contraction of research in this field for many years has reduced the success in discovering new drugs. Additionally, local market regulations, inadequate selection, inaccessible prices, especially for those of second and third-generation, inefficient health systems, and difficulties of administration and control of prescription compliance, especially in the case of combined therapies, are additional obstacles to universal access to antibiotics. In order to simultaneously improve access to antibiotics and keep resistances under control, it is necessary to develop training and education activities at different social levels (from patients to various Health Care Providers) to complement the national or supranational strategic plans.

Little is known about family medicine academic staff in Taiwan, and basic data about this workforce may aid healthcare decision makers. We analysed data on Taiwan’s 13 medical schools collected by the Taiwan Association of Family Medicine from June to September 2019. Items included medical school names and total staff, and the gender, age, degree, working title (part-time/full-time), academic level, and sub-specialty of each current family medicine faculty member. A total of 116 family medicine faculty members were reported; most were male (n= 85, 73.3%). Ages ranged between 30 and 69 years, with a mean (SD) age of 43.3 (8.09). Faculty members with a master’s degree were the largest group (n= 49, 42.2%), and most were academic lecturers (n=49, 42.2%). Additionally, only about one-fourth (n=26, 22.4%) of family medicine faculty in medical schools were full-time, while the other three-fourths (n=90, 77.6%) were part-time faculty; most were located in northern Taiwan (n=79, 68.1%) and specialized in gerontology and geriatrics (n=55, 47.4%) and hospice palliative care (n=53, 45.7%). Our research provides the most complete census of family medicine academic physicians in medical schools in Taiwan. The results inform efforts to improve the establishment and development of family medicine departments in Taiwan.

Improving the effectiveness of health interventions is a major challenge in public health research and program development. A large body of literature has found low or no impact of health education and promotional interventions. We aim to develop a conceptual framework in support of intervention designs for preventive health behavior improvement programs and outcomes. The proposed approach is based on a narrative review of empirical literature assessing the limitations of less effective or ineffective field experiments regarding preventive health education and promotion interventions. We found three major limitations regarding the mental model’s balance of treatment and comparison groups, treatment groups’ willingness to adopt suggested behaviors, and the type, length, frequency, intensity, and sequence of treatments. To minimize the influence of these concerns, we propose a mental model-based repeated multifaceted (MRM) intervention design framework to provide an intervention design for improving health education and promotional programs.

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

Accounting information is a crucial management tool for Nigerian national development services. In every state or country, accounting is crucial to maintaining social peace, political stability, and economic sustainability. The explanation for this clear truth about the development of Nigeria is not plausible given the massive multi-sectoral scope of Nigerian economic activities in both the public and private sectors. For government national progress, reliable accounting information is essential. This research aims to explore the role of accounting on public sector accountability in Nigeria.

The striving for sustainable development has become the goal of actions undertaken not only by representatives of public authorities and institutions representing this sector, but also representatives of private entities who are increasingly recognizing the benefits and sources of long-term development based on the principles and objectives of sustainable development. These are mainly based on the pursuit of synergy in the three basic areas of activities, i.e., in the economic, social, and environmental dimensions as well as in the maintenance of natural resources. The implementation of these activities is connected with the necessity of incurring financial expenditures, which the government (public sector) does not have in the required value. Therefore, in the process of sustainable development for which the government is responsible, the active participation of the financial sector (banks) is necessary. Achieving results within the alliance of the concept of sustainable development requires the setting of a kind of contract, the parties of which are the government, society, and financial institutions. The purpose of the conducted research is to indicate by which means the government can stimulate economic growth towards its sustainable development.

The School Fruit and Vegetables Scheme (SFVS) implemented by the European Union during 2009/10 aims to improve the diet of school children and to support agricultural markets and environmental sustainability. The objective of this study was to characterize the SFVS implementation in Spain (2009-2017). A descriptive, longitudinal, observational and retrospective study was carried out based on document analysis of annual strategies of the SFVS. We studied the average budget for the EU, the number of students enrolled, the cost of the SFVS by student and by day, the duration of the SFVS, the quantity of fruits and vegetables (FV) per student, the variety of FV, the inclusion of local, seasonal and organic foods, and the education activities (EA). The results were studied by autonomous community (AC). The budget increased from 7.4 million euros in 2009/10 to 14.4 in 2016/17. Since 2014/15, the increase came from EU funds, the number of students increased from 18% in 2009 to 20% in 2016. The quantity of FV went from 2,579 to 4,000 tons, duration increased from 9.8 to 19.6 days and the variety of fruits and vegetables increased from 20 to 21 and from 5 to 6 respectively. In AC there were important variations in EA, in the number of enrolled students (7.4% to 45.6%), in the cost per student (2.3€ to 28€) and in the duration in days (5.6 to 70 days). The inclusion of local, seasonal and organic foods was identified in 5 of the 8 years studied. The development and reach of the SFVS in Spain is still insufficient to influence dietary patterns and health in the school population. However, the SFVS has generated an economic market for agricultural production.

The article analyses the main aspects of upstream social marketing for implementing of mobile government (MGov). The methodology of current research is based on the systematic literature review in the fields of MGov and social marketing. According to our findings, most researchers investigated MGov from the side of citizens (consumers) and emphasised the benefits to them while changing their attitudes and behaviours in employing mobile applications. However, as there is a lack of the researches from the side of governmental bodies, in this paper, we were contrary looking for new meanings, attitudes and values from their perspective. Limitations of employment of MGov occur due knowledge gap among decision makers and public policy formers (upstream audience). Therefore, we argue that upstream social marketing for the upstream audience would bring the success in faster MGov implementation. Specific social marketing would be mostly valuable on the municipal level that is the closest substance to the society. Thus, in our paper we emphasise the benefit of the MGov for the local upstream audience and propose possible external marketers as well as the motivating theses based on these 7P of marketing mix for the successful MGov on municipal level.

Objectives: Social distancing measures are currently implemented to control COVID-19 pandemic in many countries, including Saudi Arabia. The aim of this study was therefore to evaluate the awareness and adherence of the Saudi population to these measures. Methods: A web-based questionnaire was designed with 16 questions (8 questions related to demographics, 3 in relation to awareness about social distancing and 5 related to overall practice of social distancing). Results: 5105 participants completed the survey [58.4% female, 66.3% young individuals (aged 18-37 years), 55.8% bachelor degree holders, and 51.0% from the western region]. The Saudi Ministry of Health (MOH) was the main source of information about COVID-19 for most participants (78.2%). High awareness (81.3%) regarding social distancing was observed, associated mainly with female participants, those from the middle region and those with high education and income. Overall implementation of social distancing was satisfactory (score 3.13/5), with 37.8% never leaving home during the home-stay period. Better adherence to social distancing was observed for female participants, higher degree holders and those aged over 38 years. Conclusions: Organised plans by the Saudi MOH have been effective in raising awareness and improving practice of social distancing among public. However, the observed lower practice of social distancing by individuals with lower education and income indicates the need for targeted interventions to achieve better outcome.

The paper presents a theoretical and empirical assessment of this social phenomenon. The achieved scientific solution-result (Main Finding) is presented a theoretical model of the develop-ment of public citizenship in a sustainable environment has been created for the case of Lithuania. First of all, the paper discusses the conceptual issues of the expression of modernisation of civil society, highlighting and justifying the interaction of social changes and sustainable environment in economic, social, political, environmental and cultural aspects, presenting the case of Lithuania (The Case of Lithuania). On the other hand, following the United Nations Sustainable Development Strategy document, the field of progress and resilience of Lithuanian society in modern society is discussed, identifying and analysing various criteria that have been empirically tested. The authors noted that the democratic cube model was used to create a theoretical model of the development of public citizenship in a harmonious environment, and the HDI (human development index model) was also integrated. The model created by the authors systematically explains the analysis of the relationship between the expression of modernisation changes identified in the research and the formation of civil society; secondly, it substantiates the process of interaction between modernisation changes and public citizenship, discussing four fields of expression. Practical applicability of the model: it will help researchers to conceptually analyse and empirically study public citizenship; will help public policymakers and implementers to manage effectively, ensuring quality changes in society and managing new challenges, and it will also contribute to the conceptual formation of the country's long-term development strategy.

Academic failure, low attendance, financial difficulties, and mental illness are some of the major reasons most students drop out of high schools. We investigated how high school dropout risk is affected by socioeconomic, demographic, and institutional characteristics. Therefore, research design is composed of a literature review, Questionnaire surveys by interviewing each student. Besides, the analysis and statistical modelling, the Logistic Regression method was used. The results show that academic performance, job, lack of interest and low learning ability were the significant individual characteristics that affect the high school dropout. Moreover, parental characteristics, including financial condition, lack of awareness, and education, are significant factors associated with high school dropout rates. Some other related factors, such as adaptability and influence of the peer groups, abandoning school by siblings, and extra responsibility at home and a joint family system, are also some notable factors that significantly affect the dropout rate in schools Malakand District of KP province. This research study delivered the results that contribute to the literature in education to identify different factors like student's own, parental, institutional, and household characteristics, which affect a student being a dropout from high school in Malakand district Pakistan.

For the time being, public sector innovation gains new and complex forms of expression: managerial, institutional, technological or communication. This fact is also due to national and international important bodies’ interest for using innovation as resource and tool for public sector development. Characterised by complexity and adaptation, the innovative processes in the public sector embrace the form of medium and long term innovation strategies, holding high key socio-economic impact on the social utility of public sector innovation. The optimality of innovation strategies becomes a tool for improved decisions in public sector management, providing the methodology for their evaluation related to the objectives of development in the public sector.

Background: To assess the incidence and characteristic of cataract surgery in Poland from 2010 to 2015 and to interpret these findings. Patients and methods: Data from all patients who underwent cataract surgery alone or in combined procedures in Poland between January 2010 and December 2015 were evaluated. Patient data were from the national database of hospitalizations maintained by National Health Fund, data on the population of Poland were obtained from Central Statistical Office of Poland. Results: In total 1,218,777 cataract extractions (alone or combined with other procedures) were performed in 1,081,345 patients during 2010 -2015. Overall, the incidence of cataract surgery increased from 5.22/1000 person-years in year 2010 to 6.17/1000 person-years in year 2015. Phacoemulsification was performed in 97.46% of cataract extractions, and 3.02% of cataract extractions were combined procedures. The rate of one-day procedures increased from 28.3% in year 2010 to 43.1% in year 2015. The probability of second-eye surgery 12 months after the first-eye surgery increased from 44% in 2010 to 73% in 2015 (log-rank test p<0.0001). Conclusion: In Poland, from 2010 to 2015 the total incidence of cataract surgery, the number of people who underwent surgery, and the numbers of one-day and combined cataract surgeries, increased significantly.

Public participation is crucial in the process of urban governance in smart-city initiatives to enable urban planners and policy makers to take account of the real public needs. Our study aims to develop an analytical framework using citizen-centred qualitative data to analyse urban problems and identify the areas most needed for urban governance. Taking a Chinese megacity as the study area, we first utilise a web-crawling tool to retrieve public comments from an online comment board and employ the Baidu Application Programming Interfaces and a qualitative content analysis for data reclassification. We then analyse the urban problems reflected by negative comments in terms of their statistical and spatial distribution, and the associative factors to explain their formation. Our findings show that urban problems are dominantly related to construction and housing, and most frequently appear in industry-oriented areas and newly-developed economic development zones on the urban fringe, where the reconciling of government-centered governance and private governance by real estate developers and property management companies are most needed. Areas with higher land price and a higher proportion of aged population tend to have less urban problems, while various types of civil facilities affect the prevalence of urban problems differently.

Effectively responding to children’s nutritional status and eating behaviors in Mozambique requires a community-based care approach grounded in sound nursing research that is evidence-based. The Community Assessment, Intervention, and Empowerment Model (MAIEC) is a nursing theoretical model that bases clinical decision-making for community health nurses using communities as a unit of care. We used the MAIEC to identify a community-based nursing diagnosis to address children’s nutritional status and eating behaviors in Mozambique. Objectives: (1) To conduct a descriptive study of children’s nutritional status and eating behaviors in a school community in Mavalane, Mozambique, and (2) to identify a community-based nursing diagnosis using the MAIEC clinical decision-making matrix in the same school community. Method: A cross-sectional, quantitative study was conducted to assess the nutritional status of children using anthropometric data, including brachial perimeter and the tricipital skinfold, and standard deviation for the relation of weight-height, in a sample of 227 children. To assess community management of the problem and identify a community-based nursing diagnosis, we surveyed 176 parents/guardians and 49 education professionals, using a questionnaire based on the MAIEC clinical decision matrix as a reference. Results: Malnutrition was identified in more than half of the children (51.3%). We also identified a community-based nursing diagnosis of impaired community management related to the promotion of child health and healthy eating as evident by lack of community leadership, participation, and processing among more than 70% of the community members (parents/guardians and education professionals). Conclusion: A nursing diagnosis and diagnostic criteria for nutritional status and community management were identified. The need to intervene using a multidisciplinary public health approach is imperative, with the school community as the unit of care. In addition, reliable anthropometric data were used to complement the nursing diagnosis and guide future public health interventions.

There exists a compelling need to better understand the temporal dynamics of public sentiment towards COVID-19 vaccines in the US on a national and state-wise level for facilitating appropriate public policy applications. Our analysis of social media data from early February of 2021 and late March of 2021 shows that in spite of overall strength of positive sentiment, and increasing numbers of Americans being fully vaccinated, negative sentiment about COVID-19 vaccines still persists among sections of people who are hesitant towards the vaccine. In this study, we performed sentiment analytics on vaccine tweets, studied changes in public sentiment over time, conducted vaccination sentiment validation using actual vaccination data from the US CDC and Household Pulse Survey (HPS), explored influence of maturity of Twitter user-accounts and generated geographic mapping of sentiments by location of Twitter users. Furthermore, we leverage the emotion polarity based Public Sentiment Scenarios (PSS) framework which was developed for COVID-19 sentiment analytics, to systematically analyze directions for public policy processes to potentially improve the administration of vaccines. Application of the PSS framework provides important time sensitive insights for state and federal government agencies and associated organizations to better implement public policy processes for healthcare management, communication, transparency, motivation and societal operational policies such as social distancing. These insights are expected to contribute to processes that can expedite the vaccination program and move closer to the cherished herd immunity goal.

To effectively combat the COVID-19 pandemic, the state government of Bahia, Brazil, has distributed intensive and non-intensive care units along the nine regions that divide the state of Bahia, such that COVID-19 patients could be easily hospitalized in health care units located at the same regions where they live. However, the observed hospitalizations networks for COVID-19 patients shows that a considerable number of COVID-19 patients had to travel beyond their region of residence to be hospitalized. Hence, this study indicates that the current distribution of health care units in Bahia, Brazil, is not sufficient to effectively reduce the distances traveled by COVID-19 patients requiring hospitalization. We believe that such unnecessary travels to distant hospitals may put the sick patients as well as healthy people involved in the transportation process in risk, further delaying the stabilization of the COVID-19 pandemic in each region of the state of Bahia.

The purpose of this study is to explore conceptual approaches in co-production studies and to examine current research trends of the study. The conceptual paper includes research articles related to co-production in public administration field. By thoroughly scrutinizing 32 research works of co-production, this study highlights major loopholes in the field of the study. The contributions of the study are: (1) identifying two common characteristics of co-production, (2) categorising three types of co-producing by end-users, and (3) finding that goals and success of co-production are more beneficial for service providers though its initial approach is citizen-centric approach. We suggest that future studies should be (1) to focus on reasons for co-production failures or success, (2) to discover further hindrances for co-production in service production, (3) to examine influencing factors on service providers as well as institutional impacts on co-production process, and (4) to include practical assessment in co-production study.

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

Hospital indebtedness is a complex and very diverse phenomenon. Thus, the goal of this study is the comparison of the financial performance of public hospitals in accordance with their ownership and size. The results of the research lead to the conclusion that the vast majority of public hospitals are indebted, and their ownership structure does not affect their financial condition. What is more, the statistical analysis depicted that large Marshall hospitals are less indebted than poviat-commune ones. In the group of medium-size hospitals, the situation was the opposite. Moreover, the study did not confirm the significant relationship between the size or ownership and the financial status of the hospital. The analysis conducted in the article is aimed at filling in the gap in studies comparing the indebtedness between different types of public hospitals.

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

Harmful algal blooms (HABs) are natural events produced by massive concentration of toxic phytoplankton that can color red, ocher, brown or yellow large extensions of water, its intensity depends on the different species of phytoplankton involved in the proliferation. The spreading of these formations involves an interaction of biological, chemical, meteorological and anthropogenic factors. Several species with potential toxicity have been reported along Mexican coasts, such as Gymnodinium catenatum, Karenia brevis, Pyrodinium bahamense var. compressum. The toxic bloom not only causes an impact during the event, it produces negative effects afterward, such as accumulating deposits of organic matter, alterations of benthic community structure and composition, species presence/absence, and bioaccumulation of toxins in organisms such as bivalve molluscs mainly. Poisoning may occur by consuming contaminated seafood or by direct exposure to aerosols of the toxins, which can provoke diarrhea or even death. Due to the impact of this type of event on the economy, environment and public health, strategies for monitoring, prevention, and systematic mitigation have been implemented for the evaluation of HAB effects. The aim of this review was to determine the state-of-the art of HAB, their reports and effects on the environment and public health in Mexico.

Even though Greece is considered a vulnerable region in terms of climate hazards, public perception and attitude do not always identify climate change as an important environmental area of concern, especially when compared to socio-economic issues. The key issue of this paper is to investigate and analyse public perception in Greece as regards to climate change risk. Through a questionnaire survey this paper analyses trends that exist, peoples’ opinion and awareness with regards to climate risk and how willing they are to change current lifestyle, to pay or to act to minimize or to prevent the risk. Conventional wisdom of this paper is to highlight factors that influence individual perception and point out drivers of behavior change that can support efficiently future adaptation plans.

This study explored the living situations, financial conditions, religious obligations, and social distancing of Muslims during the covid 19 pandemic. In total, 20 Muslim community members living in the Kanto region were recruited, 15 of them were included in the in-depth qualitative and five in the focus group interviews. The Snowball method was used, and the questionnaires were designed into four themes. The audio/video interviews were conducted via Zoom and NAVIO was used to analyse the data thematically. The major Muslim events were cancelled, and the recommended physical distancing was maintained during the prayers at home and in the mosques. The Japanese government's financial support to each person was a beneficial step towards social protection, which was highlighted and praised by every single participant. Regardless of religious obligations, the closer of all major mosques in Tokyo demonstrates to the Japanese community how serious they are about adhering to the public health guidelines during the pandemic. This study highlighted that the pandemic has affected the religious patterns and behaviour of Muslims from inclusive to exclusive in a community and narrated the significance of religious commitments.

Millions of people use public transportation daily worldwide and frequently touch surfaces, thereby producing a reservoir of microorganisms on surfaces increasing the risk of transmission. Constant occupation makes sufficient cleaning difficult to achieve. Thus, an autonomous, perma-nent antimicrobial coating (AMC) could keep down the microbial burden on such surfaces. A photodynamic AMC was applied to frequently touched surfaces in buses. The microbial burden (colony forming units, cfu) was determined weekly and compared to equivalent surfaces in buses without AMC (references). The microbial burden ranged from 0 – 209 cfu/cm² on references and from 0 – 54 cfu/cm² on AMC. The means were 13.4 ± 29.6 cfu/cm² on references and 4.5 ± 8.4 cfu/cm² on AMC (p<0.001). The difference of microbial burden on AMC and references was al-most constant throughout the study. Considering a hygiene benchmark of 5 cfu/cm², the data yield an absolute risk reduction of 22.6 % and a relative risk reduction of 50.7 %. In conclusion, photo-dynamic AMC kept down the microbial burden, reducing the risk of transmission of microor-ganisms. AMC permanently and autonomously contributes to hygienic conditions on surfaces in public transportation. Photodynamic AMC therefore are suitable for reducing the microbial load and closing hygiene gaps in public transportation.

Despite the scientific and technological development, libraries of Jordanian universities suffer from an obvious lack of digital information resources, because for many reasons, the most important of these is the non-application of intellectual property legislation (IPL) related to these resources. This study investigated the reality of the application of intellectual property legislation related to digital information resources at the libraries of public universities in Jordan. The population study consisted of all employees of departments of digital information resources. The study sample was (74) employees. Texts of regulations for the intended libraries and the Jordanian copyright law No. (22) for the year (1992) were reviewed and analyzed. In addition, a questionnaire was developed regarding the actual application of intellectual property legislation relating to digital resources at the university libraries in Jordan. Results revealed that the application of IP legislation relating to digital resources at the libraries of public universities in Jordan was moderate and that the supervising to the libraries of universities from the National Library regarding the protection of intellectual property rights of digital resources was moderate. The study recommended the application of intellectual property legislation related to digital resources in the intended libraries, this could be achieved through including intellectual property legislation in the regulations of public services in the intended libraries, to provide for the terms of protecting IP rights for digital resources, improving the legislation, developing of the Jordanian copyright law to be compatible with digital information resources, providing the necessary support for these libraries, and emphasizing the role of the National Library.

SIGNIFICANCE Putting worth on research and selection of studies by importance are crucial in medical innovation. Practical applications include choosing personal study topics, publication review, study grant selection, and decisions of spending or misspending billions in public health. Multiple studies raised alarm that current methods perform poorly in reproducibility, prediction of best research and objectivity. I propose using the metrics how much disease burden is reduced and calculating objective, numerical research value. The concept is that worth of medical research is not subjective but can be reproducible and numerically quantified. The method increases transparency by giving decision makers an externally accountable proof, and frees peer reviewers to check scientific integrity. Its numerical form can capture small differences important in competition between studies. ABSTRACT Finding value and selecting knowledge by importance are crucial in medical innovation. Applications include individuals designing research, funding organizations selecting grants, journals – publications, institutions – priorities in public health and health policy, and decision makers spending or misspending billions of research funds. Currently finding value of knowledge is done by peer review together with checking scientific integrity. Multiple studies raised alarm that it performs poorly in prediction of highest citations, bias, transparency and quality. The resulting problems include perception of slow medical progress and wasting funds and time. I introduce a standard, objective and numerical method for finding value of medical research. It measures disease burden prevented by new knowledge contained in a study or a publication. In its simple form, it is calculated by multiplying disease prevalence, disease burden, and efficacy of the therapy. It can be modified for risk of failure, multi-disease effect and for ethical considerations. The process is described step-by-step in terms common in medical practice. A quick estimate is often sufficient. The advantage is objectivity, since it is calculated from real world data. This gives transparency and externally accountability of decision making. The second advantage is a numerical form. This can measure small differences in research value which, in sharp competition, determine which studies are selected. A researcher can calculate the value of own future effort. Institutions might ask to provide it at submission. The method is also applicable to broad policy analysis, objective evaluation of scientific achievement and bibliometric studies.

The epidemic of Coronavirus Disease 2019 (Covid-19) has brought many changes to people's life. This study aims to analysis Chinese people's psychological change and life after quarantining Wuhan and explore the influencing factors. Based on data from a web-survey after quarantining Wuhan (N=3268), the principal-component-analysis (PCA), multiple-linear-regression (MLR), propensity-score-matching (PSM) were used to explore the psychological change of people in China and the influencing factors. 83.3% of the respondents said that the impact of the epidemic on their life had increased after quarantining Wuhan. A considerable proportion of people's anxiety increased, being reflected in negative emotion, behavioral response and physiological response. The proportion of people who said their anxiety had increased in Wuhan was higher than that in other regions (p <0.05). The anxiety of people who were in medical isolation increased less than those who were not (p <0.05). All three aspects of people’s anxiety were positively related with time of medical isolation and degree of the attention on the epidemic (p＜0.05) except the effect of attention degree on the physiological response (p＝0.06). The measure of medical isolation at home should be advocated. Yet people should reduce the concern for the epidemic while paying attention to self-protection.

The global process of urbanization, and the modification of social interaction determined by the pandemic crisis poses the issue of the place of vulnerable users, and in particular children, within the contemporary city. This research aims to elaborate a theoretical and methodological framework, based on the concepts of affordance and capability, for analyzing the potential of public spaces to enable and support children’s independent activities. This potential, or meaningful usefulness, is expressed by the Index of Meaningful Usefulness of public Urban Spaces (IUIS). The latter is calculated via the tool ‘Opportunities for Children in Urban Spaces’ (OCUS). This methodology is applied to the analysis of significant public spaces within the historic center of the city of Iglesias in Sardinia, Italy. The results reveal adequate usefulness of the selected spaces, while underlining criticalities related to intrinsic spatial and physical attributes. The application to the case study confirms the validity of the theoretical and methodological framework embodied in the OCUS tool for supporting urban design and planning by orienting place-shaping processes towards the acknowledgement of children’s needs.

Frailty is an important age-associated risk-state. Despite this, many countries lack population estimates and large heterogeneity exists amongst studies. The Global Burden of Disease (GBD) study, provides comparable high-quality population-level data for 195 countries and territories. Frailty has never been measured in the GBD studies. This analysis applies the deficit accumulation model to construct a novel frailty index (FI) using the GBD 2017 dataset. Standard FI criteria were applied to all GBD categories such that selected items were health-related, age-correlated, sufficiently prevalent, did not saturate at an early age, had little redundancy/duplication, covered a range of systems, were plausible and were available serially for the same population. From all 554 GBD items, 36 were selected including 26 non-communicable diseases, 3 metabolic risks, 3 biological impairments, infectious diarrheal diseases, protein-energy malnutrition, injurious falls, and low physical activity. Variable face validity was displayed against a selection of established FIs. The mean GBD-FI score for the global population aged ≥70 years in 2017 was 0.16; scores were higher in females than males (0.16 vs 0.15, respectively). Deficits accumulated with age at an estimated rate of 0.026 per year. Adding the mean GBD-FI scores to a regression model including country-level variables for demographics (proportion ≥85 years, proportion female), healthcare quality (HAQ index), and development (SDI) increased the adjusted r2 value from 27.0% to 39.6% (p<0.001) for predicting country-level death rates from non-communicable diseases, suggesting that the GBD-FI is a useful predictor of mortality. Further analysis is required to compare the reliability and predictive validity of the GBD-FI with existing frailty tools

While it is not new that Nigeria is challenged by a huge infrastructure deficit, the COVID-19 pandemic has exposed the country’s comatose healthcare system. Given the country’s dwindling revenue, massive debt profile and the inability of the public-sector to efficiently manage public facilities in the country, this paper examines how the public-private partnership model of infrastructure procurement can be deployed as a solution for Nigeria’s healthcare crisis. In addition to the above, this paper takes a look at how a partnership with the private sector can aid Nigeria’s quest towards achieving healthcare-related Sustainable Development Goals. The paper also considers two healthcare-based projects as case studies to serve as lessons for future projects in the country. Among others, the paper recommends a holistic long-term solution for the country’s healthcare needs.

This article aims to understand the domains and conceptual uses of contagion, its modalities and its effects, in its different historical contexts and meanings, as an expression of the process of interdependence between the positions and the different points of view of different actors involved in multiple scientific, moral, social and political challenges. Another objective focuses on understanding the process of collective management of contagion, disease and health, where prevention is an essential element of its objectives and justifications, its discursive order, as well as its practical activities.

Background: Chronic lower limb ulcers (CLLU) have an important burden to the individual and the healthcare system. However, there is a lack of information about the cost of CLLU in Argentina.Objective: To determinate the number and cost of consultation and hospitalization associated to CLLU in a public hospital in Argentina. Methods: Retrospective observational study. Cost estimation were calculated based on days of stay, treatments and laboratory tests in a inpatient population and the number of consultations, treatments and laboratory tests, in a outpatient population. Results: In 2013 and 2014, the overall number of consultation with ICD-10 codes was 7,224 and the number of inpatient was 359. The mean age for male and female outpatient consultations was 59.53(±13.06) years and 59.04(±10.93), respectively. For CLLU male and female inpatient, the mean age was 63.9(±10.4) years and 54.5(±8.6) years, respectively. The length of stay was 22.88 days. There was a mean of 0.41 surgeries per patient where 25% were amputations. The mean annual cost in a single public hospital was US$4,053.65 per inpatient and US$3,589.24 per outpatient. Conclusion: Cost information allows new public health policies to reduce socioeconomic burden due to CLLU.

The article mounts an argument for public theology as an appropriate if not vital adjunct to contemporary education’s addressing of security issues in light of current world events with indisputable religious and arguably quasi-theological foundations. It will briefly expound on the history of thought that has marginalized theology as a public discipline and then move to justify the counter view that the discipline, at least in the form of public theology, has potential to address matters of such public concern in a unique and helpful way. The article will culminate with an exploration of Global Jihadism as a case study that illustrates the usefulness of public theology in understanding it better and so allowing for a response with potential to be more informed and security-assured than is commonly effected.

The article mounts an argument for public theology as an appropriate if not vital adjunct to contemporary education’s addressing of security issues in light of current world events with indisputable religious and arguably quasi-theological foundations. It will briefly expound on the history of thought that has marginalized theology as a public discipline and then move to justify the counter view that the discipline, at least in the form of public theology, has potential to address matters of such public concern in a unique and helpful way. The article will culminate with an exploration of Global Jihadism as a case study that illustrates the usefulness of public theology in understanding it better and so allowing for a response with potential to be more informed and security-assured than is commonly effected.

Nietzsche is almost always regarded as one of the thinkers who advocate extreme individualism, totally indifferent to or exclusively polemical towards the public human dimension. While this is very difficult to contradict, if we read his texts carefully we can see how his constant celebration of the individual runs parallel to an acute awareness of living in a new era, which he defined as ‘the century of the multitude and the masses’. The herd, conformism, mediocrity, public opinion: a civilisation in which community attempts suffocate all individual inspiration, and which therefore seems to row in the opposite direction. Although Nietzsche often uses collective life merely as a negative pole for more effectively emphasising the individual, his provocative words—pushed to the limits of the inexorable victory of the herd and of the paradoxical impossibility of all that is ‘public’—offer us a direct testimony of the tragic way of life of the man of his time. This provides us with an extremely clear and interesting phenomenological cross-section of the social sphere, as well as a very finely tuned and valuable seismograph for the continual monitoring of our everyday coexistence with and perception of the constantly incumbent dangers of its degeneration.