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Abstract Background The advent of Personalized Medicine (PM) holds significant promise in revolutionizing healthcare by tailoring treatments to individual patients based on their data. However, its successful implementation requires the seamless integration of innovative technologies and presents formidable challenges in terms of sustainability. To tackle these challenges head-on, the International Consortium for Personalized Medicine (ICPerMed) was established, and the IC2PerMed project, as part of this consortium, seeks to foster collaboration between the European Union (EU) and China in the field of Personalized Medicine. Based on the results collected by the project, the objective of this study is to discern the key priorities for the implementation of Personalised Medicine concerning Information and Communication Technologies (ICT) and Big Data and digital solutions, with a particular emphasis on data management and protection. Methods A Delphi survey was conducted to gather expert’s consensus on the main priorities for actions on Information and Communication Technologies (ICT) and Big Data and digital solutions in the field of Personalized Medicine. Results The survey identified seven priorities in the area of Big Data and digital solutions, including data interoperability, standards, security measures, and international partnerships. Additionally, twelve priorities were identified for the innovation-to-market process, emphasizing cost-effectiveness, need assessment, and value definition in resource allocation. Conclusions The effective implementation of new technologies in Personalized Medicine research and practice is essential for the advancement of healthcare systems in both the European and Chinese contexts. The identified priorities play a pivotal role in promoting the sustainability of health systems and driving innovation in the implementation of Personalized Medicine. Addressing challenges related to data interoperability, standards, security, international collaboration, cost-effectiveness, and value assessment is of utmost importance in order to propel the progress of Personalized Medicine in healthcare systems.

Background: The advent of Personalized Medicine (PM) holds significant promise in revolutionizing healthcare by tailoring treatments to individual patients based on their data. However, its successful implementation requires the seamless integration of innovative technologies and presents formidable challenges in terms of sustainability. To tackle these challenges head-on, the International Consortium for Personalized Medicine (ICPerMed) was established, and the IC2PerMed project, as part of this consortium, seeks to foster collaboration between the European Union (EU) and China in the field of Personalized Medicine. Based on the results collected by the project, the objective of this study is to discern the key priorities for the implementation of Personalised Medicine concerning Information and Communication Technologies (ICT) and Big Data and digital solutions, with a particular emphasis on data management and protection., Methods: A Delphi survey was conducted to gather expert's consensus on the main priorities for actions on Information and Communication Technologies (ICT) and Big Data and digital solutions in the field of Personalized Medicine., Results: The survey identified seven priorities in the area of Big Data and digital solutions, including data interoperability, standards, security measures, and international partnerships. Additionally, twelve priorities were identified for the innovation-to-market process, emphasizing cost-effectiveness, need assessment, and value definition in resource allocation., Conclusions: The effective implementation of new technologies in Personalized Medicine research and practice is essential for the advancement of healthcare systems in both the European and Chinese contexts. The identified priorities play a pivotal role in promoting the sustainability of health systems and driving innovation in the implementation of Personalized Medicine. Addressing challenges related to data interoperability, standards, security, international collaboration, cost-effectiveness, and value assessment is of utmost importance in order to propel the progress of Personalized Medicine in healthcare systems., (© 2024. The Author(s).)

Abstract Background Pregnant women are a vulnerable population to COVID-19 given an increased susceptibility to severe SARS-CoV-2 infection and pregnancy complications. However, few SARS-CoV-2 serological surveys have been performed among this population to assess the extent of the infection in sub-Saharan countries. The objectives of this study were to determine SARS-CoV-2 seroprevalence among Beninese pregnant women, to identify spatial seropositivity clusters and to analyse factors associated with the infection. Methods A cross-sectional study including women in their third trimester of pregnancy attending the antenatal care (ANC) clinics at Allada (south Benin) and Natitingou (north Benin) was conducted. Rapid diagnostic tests (RDT) for detection of IgG/IgM against the SARS-CoV-2 spike protein were performed using capillary blood. Seroprevalence of SARS-CoV-2 antibodies and associations between SARS-CoV-2 serostatus and maternal characteristics were analyzed by multivariate logistic regression. Spatial analyses were performed using the spatial scan statistics to identify spatial clusters of SARS-CoV-2 infection. Results A total of 861 pregnant women were enrolled between May 4 and June 29, 2022. 58/861 (6.7%) participants reported having received COVID-19 vaccine. None of the participants had been diagnosed with COVID-19 during their pregnancy. SARS-CoV-2 antibodies were detected in 607/802 (75.7%; 95% CI 72.56%–78.62%) of unvaccinated participants. Several urban and rural spatial clusters of SARS-CoV-2 cases were identified in Allada and one urban spatial cluster was identified in Natitingou. Unvaccinated participants from Allada with at least one previous morbidity were at a three-times higher risk of presenting SARS-CoV-2 antibodies (OR = 2.89; 95%CI 1.19%-7.00%). Conclusion Three out of four pregnant women had SARS-CoV-2 antibodies, suggesting a high virus circulation among pregnant women in Benin, while COVID-19 vaccination coverage was low. Pregnant women with comorbidities may be at increased risk of SARS-CoV-2 infection. This population should be prioritized for COVID-19 diagnosis and vaccination in order to prevent its deleterious effects. Trial registration NCT06170320 (retrospectively registered on December 21, 2023).

Background: Knowledge of changes in the domains of physical activity (PA) during the transition period from primary to secondary education and the factors associated with these changes, are prerequisites for the design of effective PA promotion strategies. Therefore, the first aim of this study was to systematically review changes in general, leisure-time, school, transport, work, and home PA across the transition from primary to secondary education. The second aim was to systematically review the individual, social, and physical environmental factors that were associated with these changes. Methods: Records published up until September 2023 were retrieved from five electronic databases. We included longitudinal and cross-sectional studies that investigated general or domain-specific PA from 2 years before to 2 years after the transition from primary to secondary education. Information on source, study characteristics, sample characteristics, PA, and factors were extracted from the papers included. We reported the direction of change in general and domain-specific PA and the direction of association of the factors with change in general and domain-specific PA. Results: Forty-eight papers were included in the study. The evidence on changes in PA and associated factors was greatest for general PA. A limited number of the studies investigated the separate domains of leisure-time, school, and transport. Most studies on general and school PA reported a decline in PA, but there were no consistent results for the domains of leisure-time and transport. With respect to the associated factors, evidence was predominantly found for individual factors and to a lesser degree for physical environmental and social environmental factors. None of the factors were consistently associated with changes in general or domain-specific PA during the school transition. Conclusions: For the design of targeted PA promotion strategies, further studies are warranted to explore changes in the specific domains of PA across the transition from primary to secondary education, especially in the domains of leisure-time, transport, home, and work PA. In addition, the interactions between factors at different socioecological levels to influence changes in PA need to be addressed more in the future. Trial registration: PROSPERO CRD42020190204. [ABSTRACT FROM AUTHOR]

Background: Although exclusive breastfeeding is recommended for the first six months of life, research suggests that breastfeeding initiation rates and duration among Indigenous communities differ from this recommendation. Qualitative studies point to a variety of factors influencing infant feeding decisions; however, there has been no collective review of this literature published to date. Therefore, the objective of this scoping review was to identify and summarize the qualitative literature regarding Indigenous infant feeding experiences within Canada, the United States, Australia, and Aotearoa. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Reviews and the Joanna Briggs Institute Guidelines, in October 2020, Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for relevant papers focusing on Indigenous infant feeding experiences. Screening and full-text review was completed by two independent reviewers. A grey literature search was also conducted using country-specific Google searches and targeted website searching. The protocol is registered with the Open Science Framework and published in BMJ Open. Results: Forty-six papers from the five databases and grey literature searches were included in the final review and extraction. There were 18 papers from Canada, 11 papers in the US, 9 studies in Australia and 8 studies conducted in Aotearoa. We identified the following themes describing infant feeding experiences through qualitative analysis: colonization, culture and traditionality, social perceptions, family, professional influences, environment, cultural safety, survivance, establishing breastfeeding, autonomy, infant feeding knowledge, and milk substitutes, with family and culture having the most influence on infant feeding experiences based on frequency of themes. Conclusions: This review highlights key influencers of Indigenous caregivers' infant feeding experiences, which are often situated within complex social and environmental contexts with the role of family and culture as essential in supporting caregivers. There is a need for long-term follow-up studies that partner with communities to support sustainable policy and program changes that support infant and maternal health. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are a vulnerable population to COVID-19 given an increased susceptibility to severe SARS-CoV-2 infection and pregnancy complications. However, few SARS-CoV-2 serological surveys have been performed among this population to assess the extent of the infection in sub-Saharan countries. The objectives of this study were to determine SARS-CoV-2 seroprevalence among Beninese pregnant women, to identify spatial seropositivity clusters and to analyse factors associated with the infection. Methods: A cross-sectional study including women in their third trimester of pregnancy attending the antenatal care (ANC) clinics at Allada (south Benin) and Natitingou (north Benin) was conducted. Rapid diagnostic tests (RDT) for detection of IgG/IgM against the SARS-CoV-2 spike protein were performed using capillary blood. Seroprevalence of SARS-CoV-2 antibodies and associations between SARS-CoV-2 serostatus and maternal characteristics were analyzed by multivariate logistic regression. Spatial analyses were performed using the spatial scan statistics to identify spatial clusters of SARS-CoV-2 infection. Results: A total of 861 pregnant women were enrolled between May 4 and June 29, 2022. 58/861 (6.7%) participants reported having received COVID-19 vaccine. None of the participants had been diagnosed with COVID-19 during their pregnancy. SARS-CoV-2 antibodies were detected in 607/802 (75.7%; 95% CI 72.56%–78.62%) of unvaccinated participants. Several urban and rural spatial clusters of SARS-CoV-2 cases were identified in Allada and one urban spatial cluster was identified in Natitingou. Unvaccinated participants from Allada with at least one previous morbidity were at a three-times higher risk of presenting SARS-CoV-2 antibodies (OR = 2.89; 95%CI 1.19%-7.00%). Conclusion: Three out of four pregnant women had SARS-CoV-2 antibodies, suggesting a high virus circulation among pregnant women in Benin, while COVID-19 vaccination coverage was low. Pregnant women with comorbidities may be at increased risk of SARS-CoV-2 infection. This population should be prioritized for COVID-19 diagnosis and vaccination in order to prevent its deleterious effects. Trial registration: NCT06170320 (retrospectively registered on December 21, 2023). [ABSTRACT FROM AUTHOR]

Background: A nanny state imposes restrictions on people's liberty and freedom of action in order to advance their interest and welfare. The extent to which this is desirable, or even ethically acceptable, is debated in the literature. This paper formulates and tests the following hypothesis: the more of a nanny a state has been in the past, the more likely it is that the incumbent government will respond to a new, unknown threat with interventions of a paternalist nature, irrespective of other factors that might contribute to shaping government's response. This hypothesis is then taken to the data using the first wave of COVID-19 as an empirical test. Methods: Data are collected from secondary sources for a sample of 99 countries. Nanny statism is measured by the number of paternalist laws and regulations adopted by a country in the past. The response to COVID is proxied by the time of adoption of control and containment measures and their stringency. The public health outcome is measured by the COVID-19 death toll at the end of June 2020. These variables, plus several controls, are then used to estimate a set of linear and probit regressions and a proportional hazard model of the timing of adoption of control and containment measures. Results: An increase in nanny statism by 0.1 (on a scale from 0 to 10) on average increases the probability of adoption of control and containment measures by 0.077 (i.e. 7.7 percentage points). The central tenement of the hypothesis is therefore consistent with the empirical evidence. The linear and probit regressions also show that there is no evidence of a significant effect of nanny statism on the stringency of the measures adopted. Irrespective of stringency, however, early adoption of control and containment measures is found to reduce the death toll of COVID-19 in the first half of 2020: an increase in nanny statism by 0.1 reduces the COVID death toll by approximately 7%. Conclusions: A tradition of nanny statism potentially leads to a more timely and effective public policy response to a new, unknown crisis. Further tests of the hypothesis should look at the relationship between nanny statism and public health outcomes from natural disasters. [ABSTRACT FROM AUTHOR]

Background: Inequalities in immigrants' oral health are often masked in population-level data. Therefore, this paper was planned to assess the prevalence data on oral health diseases, namely dental caries, and periodontitis, among immigrants worldwide. Methods: Following a systematic search in Scopus, Embase, and PubMed for studies published between 2011 and 2023, 1342 records were identified. Following title and abstract screening, 76 studies remained for full-text eligibility-screening based on predefined inclusion criteria. Thirty-two studies were included in the review. Results: Dental caries figures were higher in immigrant populations compared to the local population, regardless of host countries, age, gender, or nationality. In children, the overall mean and standard deviation (SD) for decayed, missing, and filled teeth in the primary dentition (d3mft) was 3.63(2.47), and for D3MFT (permanent dentition), it was 1.7(1.2). Upon comparing overall mean caries counts in children and adults with their control groups in the included studies, untreated dental caries (D3T and d3t) constituted the dominant share of caries experience (D3MFT and d3mft) in immigrant children. For the local population, the highest proportion of caries experience was attributed to filled teeth (FT and ft). Dentin caries prevalence among immigrants ranged from 22% to 88.7% in the primary dentition and 5.6% to 90.9% in the permanent dentition. Gingivitis ranged from 5.1% to 100%. Oral health varied greatly between studies. Regarding oral health accessibility, 52% to 88% of immigrant children had never been to a dentist, suggesting a very limited level of accessibility to dental health services. Conclusion: It is imperative to develop interventions and policies that have been customized to address the oral health disparities experienced by immigrant populations. Additionally, host countries should actively implement measures aimed at enhancing the accessibility of oral health care services for these individuals. The utilization of available data is crucial in establishing a hierarchy of objectives aimed at enhancing the oral health of immigrant populations. Trial registration: The Scoping review protocol was registered at OSF Registries with registration number (https://doi.org/10.17605/OSF.IO/MYXS4). [ABSTRACT FROM AUTHOR]

Background: Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are not through choice and related to poverty. Many aspects of housing have all been shown to impact children/young people's health and wellbeing. However, the pathways linking housing and childhood health and wellbeing are complex and poorly understood. Methods: We undertook a systematic review synthesising qualitative data on the perspectives of children/young people and those close to them, from the United Kingdom (UK). We searched databases, reference lists, and UK grey literature. We extracted and tabulated key data from the included papers, and appraised study quality. We used best fit framework synthesis combined with thematic synthesis, and generated diagrams to illustrate hypothesised causal pathways. Results: We included 59 studies and identified four populations: those experiencing housing insecurity in general (40 papers); associated with domestic violence (nine papers); associated with migration status (13 papers); and due to demolition-related forced relocation (two papers). Housing insecurity took many forms and resulted from several interrelated situations, including eviction or a forced move, temporary accommodation, exposure to problematic behaviour, overcrowded/poor-condition/unsuitable property, and making multiple moves. Impacts included school-related, psychological, financial and family wellbeing impacts, daily long-distance travel, and poor living conditions, all of which could further exacerbate housing insecurity. People perceived that these experiences led to mental and physical health problems, tiredness and delayed development. The impact of housing insecurity was lessened by friendship and support, staying at the same school, having hope for the future, and parenting practices. The negative impacts of housing insecurity on child/adolescent health and wellbeing may be compounded by specific life circumstances, such as escaping domestic violence, migration status, or demolition-related relocation. Conclusion: Housing insecurity has a profound impact on children and young people. Policies should focus on reducing housing insecurity among families, particularly in relation to reducing eviction; improving, and reducing the need for, temporary accommodation; minimum requirements for property condition; and support to reduce multiple and long-distance moves. Those working with children/young people and families experiencing housing insecurity should prioritise giving them optimal choice and control over situations that affect them. [ABSTRACT FROM AUTHOR]

Background: Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector's post-disaster damage and loss assessment program. Methods: An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members. Results: A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study's purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues. Conclusions: The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area. Scoping review registration number: https://osf.io/nj3fk. [ABSTRACT FROM AUTHOR]

Background: Loss to follow-up in long-term epidemiological studies is well-known and often substantial. Consequently, there is a risk of bias to the results. The motivation to take part in an epidemiological study can change over time, but the ways to minimize loss to follow-up are not well studied. The Citizen Science approach offers researchers to engage in direct discussions with study participants and to integrate their opinions and requirements into cohort management. Methods: Guided group discussions were conducted with study participants from the KORA cohort in the Augsburg Region in Germany, established 40 years ago, as well as a group of independently selected citizens. The aim was to look at the relevant aspects of health studies with a focus on long-term participation. A two-sided questionnaire was developed subsequently in a co-creation process and presented to 500 KORA participants and 2,400 employees of the research facility Helmholtz Munich. Results: The discussions revealed that altruistic motivations, (i.e. supporting research and public health), personal benefits (i.e. a health check-up during a study examination), data protection, and information about research results in layman's terms were crucial to ensure interest and long-term study participation. The results of the questionnaire confirmed these aspects and showed that exclusively digital information channels may be an obstacle for older and less educated people. Thus, paper-based media such as newsletters are still important. Conclusions: The findings shed light on cohort management and long-term engagement with study participants. A long-term health study needs to benefit public and individual health; the institution needs to be trustworthy; and the results and their impact need to be disseminated in widely understandable terms and by the right means of communication back to the participants. [ABSTRACT FROM AUTHOR]

Background: Subjective wellbeing (SWB) and health are important facets of any person's life, and they tend to influence each other. This importance is reflected in the vastness of literature aiming to explore this association. However, most of this literature is based on sampling national population which may present different population characteristics to those of a province. Thus, the paper aims to investigate if the association between perceived health and SWB is moderated by population characteristics at a provincial level. We intend to add value to subjective wellbeing and health literature by reviewing the relationship between SWB and health in the Eastern Cape stratified by age, gender, rural and urban and different income classifications. Methods: Different population characteristics tend to associate to subjective wellbeing and health differently, therefore influencing how these two variables influence each other. Thus, the paper aims to investigate if the association between perceived health and SWB is moderated by population characteristics at a provincial level. Utilising the South African National Income Dynamics Survey from 2008 to 2017, this study examined the relationship between subjective wellbeing and health using a random effects model stratified according to aforementioned population characteristics. Results: A better perceived health status is associated with higher subjective wellbeing. A better subjective wellbeing is also associated with a higher health status. Determinants of subjective wellbeing and health associate with these variables differently besides income and employment which led to higher subjective wellbeing and health. Health associates to subjective wellbeing different across populations characteristics. Conclusion: Subjective wellbeing and health are interdependent as reflected in the World Health Organisation (WHO) and United Nation (UN) statements. Higher income and level of education and being employed is associated with both higher SWB and health. Therefore, improving these economic outcomes maybe associated with an improvement in well-being and health as desired by WHO and UN. Provinces differ, and different population characteristics tend to associate with subjective wellbeing and health differently, therefore influencing how these two variables influence each other. Health improvement policies must consider subjective wellbeing. Well-being improvement policies need to be cognisant of the differences in provincial and population characteristics. [ABSTRACT FROM AUTHOR]

Background: The infodemic accompanying the COVID-19 pandemic has led to an overwhelming amount of information, including questions, concerns and misinformation. Pandemic fatigue has been identified as a concern from early in the pandemic. With new and ongoing health emergencies in 2022, it is important to understand how pandemic fatigue is being discussed and expressed by users on digital channels. This study aims to explore and report on key narrative themes associated with expressions of pandemic fatigue by users on digital platforms. Methods: This paper describes the collection of publicly available data over a 3-month period from multiple online sources using the Meltwater and CrowdTangle platforms to source data from Twitter, Facebook, Instagram, YouTube, TikTok, Pinterest, Product Reviews, Twitch, blogs & forums. A comprehensive search strategy was developed and tested. A total of 1,484,042 social media posts were identified during the time-period that included the defined search terms for pandemic fatigue. These data were initially sorted by highest levels of engagement and from this dataset, analysts reviewed the identified posts to isolate and remove irrelevant content and identify dominant narratives. A thematic analysis was carried out on these narratives to identify themes related to expression of pandemic fatigue. Two researchers reviewed the data and themes. Results: The thematic analysis of narratives identified six main themes relating to expression of pandemic fatigue, and one theme of counter narratives against pandemic fatigue. Data volume increased concurrent with the time of the mpox emergency announcement. Emergent themes showed the different ways users expressed pandemic fatigue and how it was interlaced with issues of trust, preventative measure acceptance and uptake, misinformation, and being overwhelmed with multiple or sustained emergencies. Conclusions: This paper has identified the different ways users express pandemic fatigue on digital channels over a 3-month period. Better understanding the implications of the information environment on user's perceptions, questions, and concerns regarding pandemic and more broadly emergency fatigue is vital in identifying relevant interventions and, in the longer term, strengthening the global architecture for health emergency preparedness, prevention, readiness and resilience, as evidenced in this paper. There are clear pathways for further research, including incorporating additional languages and reviewing these themes over longer time periods. [ABSTRACT FROM AUTHOR]

Background: With the development of the economy, public health has become increasingly important. Therefore, it is important to establish a comprehensive and scientific the public health level index (PHL) system to measure public health level as a research priority. The current research has limitations in exploring the PHL system; therefore, the field still lacks a comprehensive indicator system to measure the level of public health. Therefore, this paper aims to develop a multi-level public health index system and utilizes China as a case study to evaluate its public health status. The objective is to offer insights and recommendations for the improvement of public health initiatives in China and other regions. Methods: Utilizing data from 2011 to 2020, a comprehensive PHL was developed to encompass three vital indices: the Public Health Service Index (PHS), the Public Health Resource Index (PHR), and the Population Health Level Index (PHL). Subsequently, the PHL, PHS, PHR, and PH were meticulously calculated using a comprehensive evaluation method. Amid the current disparity between public health and economic progress, both the spatial Durbin model and the spatial lag model were finally employed to examine the influence of economic level (EL) on PHL, thus affirming the consistent reliability and accuracy of PHS. Results: Our findings revealed the following: (i) the PHL, PHS, and PHR indices show increasing trends in China; (ii) both EL and PHL exhibit high-high clustering and low-low clustering states; (iii) the PHL in the area has a positive spatial spillover effect on the surrounding area; (iv) EL will result in the siphoning effect of PHL; and (v) EL can enhance PHL through urbanization, PH, and PHS. Conclusions: The PHL system constructed in this paper demonstrates multiple levels, pluralism, spatio-temporal comparability, and robustness. It can reflect not only the input and output of public health initiatives but also the interconnectedness and autonomy within the public health system. Therefore, it can be widely utilized in other areas of public health research. [ABSTRACT FROM AUTHOR]

Background: Limited research has been conducted on the forms, manifestations and effects of intersectional stigma among young HIV-positive men who have sex with men (MSM) and transgender women (TGW) in Zambia. In this study, we aimed to address this gap by elucidating the experiences of these in a small group of young, HIV + MSM and TGW in Zambia. Methods: We applied a mixed-methods design. Data were collected from January 2022 to May 2022. Qualitative data were collected using in-depth interviews while quantitative data were collected using a questionnaire. Qualitative transcripts were coded using thematic analysis while paper-based questionnaire data were entered into Kobo Connect. Descriptive statistics, using chi-squared tests were calculated using Excel. In this paper, we provide a descriptive profile of the sample and then focus on the qualitative findings on intersectional stigma, depression, and contemplation of suicide. Results: We recruited 56 participants from three sites: Lusaka, Chipata, and Solwezi districts. Participants' mean age was 23 years. The study found that 36% of all participants had moderate to significant symptoms of depression, 7% had major depression, 30% had moderate signs of anxiety, 11% had high signs of anxiety, 4% had very high signs of anxiety and 36% had contemplated suicide at least once. A greater proportion of TGW had moderate to significant symptoms of depression (40%) or major depression (10%) compared to MSM, at 33% and 6%, respectively (X2 = 0.65; p = 0.42). Similarly, more TGW (55%) had contemplated suicide than MSM peers (36%, X2=1.87; p = 0.17). In the qualitative data, four emergent themes about the forms, manifestations, and effects of intersectional stigma were (1) HIV, sexual orientation, and gender identity disclosure; (2) Dual identity; (3) Challenges of finding and maintaining sexual partners; (4) Coping and resilience. Overall, having to hide both one's sexuality and HIV status had a compounding effect and was described as living "a private lie." Conclusion: Effectively addressing stigmas and poor mental health outcomes among young HIV-positive MSM and TGW will require adopting a socio-ecological approach that focuses on structural interventions, more trauma-informed and identity-supportive care for young people with HIV, as well as strengthening of authentic community-informed public health efforts. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) are the primary cause of mortality globally. The prevalence of obesity is rising worldwide; there seems to be a significant positive association between obesity and CVDs. The distribution of fat in the abdominal area in the form of visceral (VAT) or subcutaneous adipose tissue (SAT) affects the risk of CVDs. The aim of the present study was to conduct a systematic review of the available literature regarding the association between the VAT-to-SAT ratio and CVDs. Methods: A comprehensive search strategy was used to retrieve all human observational studies indexed in PubMed, Scopus and Google Scholar databases/search engines (from Jan 2000 up to Oct 2023). The VAT-to-SAT or SAT-to-VAT ratio was an independent variable and various cardiovascular diseases, including hypertension, atherosclerosis, coronary heart disease, cerebrovascular disease and heart failure, were considered as outcomes of interest. Results: Out of 1173 initial studies, 910 papers were screened. Based on the inclusion criteria, 883 papers were excluded. Finally, 27 papers (18 cross-sectional and 9 cohort studies) published between 2010 and 2023 which met the inclusion criteria were reviewed. Conclusions: The distribution of abdominal fat seems to be associated with the risk of CVDs; the majority of the evidence suggests that a higher abdominal VAT-to-SAT ratio is associated with the development of CVDs. Therefore, this ratio can be used as a prognostic indicator for CVDs. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Extensive research has been conducted treating burnout as an independent variable and performance as a dependent variable to proffer possible solutions to burnout and job performance among academics. Despite this, the burnout crises persist and are exacerbated by the ongoing global proliferation of higher education. Acknowledging this, the current study explored whether performance may contribute to the emergence of burnout. Methods: The study's sample population comprised 689 academics from Jiangsu province, China. Key Performance Indicator (KPI) results served to measure performance. Psychological counselling and Burnout were calculated using mental health results garnered from the universities. Data was collected on respondents' demographic characteristics and work situations. The mean scores were 0.517 (SD = 0.5) for gender and 1.586 (SD = 1.103) for age. The relationship among performance, job burnout, and psychological counselling was analysed via a cross-sectional survey deploying grouped regression. Results: Academics' job performance was found to regulate their burnout (β = -0.058, P < 0.01). Higher performance of academics was significantly associated with lower job burnout and psychological counselling. Furthermore, psychological counselling significantly moderated job burnout (β = -0.012, P < 0.05) among academics without regulating their job performance. Conclusion: The paper supplements the discourse on job burnout and academic performance by suggesting a pre-counselling measure as a strategy to address the crises of burnout. The paper argued that the continued competence of employees should prevent burnout in Higher education and ensure better job performance. [ABSTRACT FROM AUTHOR]

Background: With the rapid development of China's chemical industry, although researchers have developed many methods in the field of chemical safety, the situation of chemical safety in China is still not optimistic. How to prevent accidents has always been the focus of scholars' attention. Methods: Based on the characteristics of chemical enterprises and the Heinrich accident triangle, this paper developed the organizational-level accident triangle, which divides accidents into group-level, unit-level, and workshop-level accidents. Based on 484 accident records of a large chemical enterprise in China, the Spearman correlation coefficient was used to analyze the rationality of accident classification and the occurrence rules of accidents at different levels. In addition, this paper used TF-IDF and K-means algorithms to extract keywords and perform text clustering analysis for accidents at different levels based on accident classification. The risk factors of each accident cluster were further analyzed, and improvement measures were proposed for the sample enterprises. Results: The results show that reducing unit-level accidents can prevent group-level accidents. The accidents of the sample enterprises are mainly personal injury accidents, production accidents, environmental pollution accidents, and quality accidents. The leading causes of personal injury accidents are employees' unsafe behaviors, such as poor safety awareness, non-standard operation, illegal operation, untimely communication, etc. The leading causes of production accidents, environmental pollution accidents, and quality accidents include the unsafe state of materials, such as equipment damage, pipeline leakage, short-circuiting, excessive fluctuation of process parameters, etc. Conclusion: Compared with the traditional accident classification method, the accident triangle proposed in this paper based on the organizational level dramatically reduces the differences between accidents, helps enterprises quickly identify risk factors, and prevents accidents. This method can effectively prevent accidents and provide helpful guidance for the safety management of chemical enterprises. [ABSTRACT FROM AUTHOR]

Background: Residents' adoption of preventive behaviours proved beneficial in preventing the large-scale transmission of the virus during the early stages of the COVID-19 outbreak. It is critical to investigate how social media triggers residents' preventive behaviour decisions during the COVID-19 outbreak. Methods: This paper selected online shopping as a specific preventive behaviour for empirical investigation. An online cross-sectional survey was conducted through the Sojump website from 1 to 15 March 2020, and a total of 1,289 valid questionnaires were collected from China. This paper uses multiple regression analysis to investigate the heterogeneous impacts of different information sources on residents' online shopping willingness and online shopping behaviour and the heterogeneous impacts of different information content in social media on the transformation of residents' online shopping willingness and online shopping behaviour. Results: The findings indicate that both official-media and self-media positively promote residents' online shopping willingness and behaviour, with official-media having a stronger promotional effect than self-media. Furthermore, official-media and self-media can collaboratively promote residents' online shopping willingness and online shopping behaviour. The ease-of-use and usefulness of information significantly promoted the transformation of residents' online shopping willingness. Conclusions: This study analyses the heterogeneous impacts of social media on residents' preventive behaviours from the perspectives of information source differentiation and information content differentiation, which enriches related studies and provides feasible paths for promoting residents' preventive behaviours. [ABSTRACT FROM AUTHOR]

Introduction: Problematic usage of the internet (PUI) is perhaps one of the most frequently studied phenomena of the 21st century receiving increasing attention in both scientific literature and the media. Despite intensive research there have been relatively few meaningful studies among elementary school students in Hungary and worldwide, who may be considered as a high-risk population with regard to problematic internet use. The aim of our study was to carry out a complex research focusing on the prevalence and risk factors of PUI among elementary school children aged 10–15 years (Grade 5–8). Methods: Demographics included were gender, age, place of stay, type of residence, family type, parental education, start of internet use, used devices, daily internet use, purpose of internet use, internet accounts, ways of keeping in touch with friends and sporting activities. PUI was evaluated using the paper-based version of the Potentially Problematic Use of the Internet Questionnaire. Results: Overall, 2000 paper-based questionnaires were successfully delivered and the final analysis included 1168 responses (overall response rate 58.4%). Mean age was 12.55 ± 1.24 years. Female gender (OR = 2.760, p = 0,006, CI 95% 0.065 to 0.384), younger age (11–12 years) (OR = 3.812, p < 0.001, 95% CI: 1.747–4.731), early exposure to the internet (OR = 3.466, p = 0.001, 95% CI 1.535–5.446), living in a small village (OR = 1.081, p = 0.002, 95% CI 1.041–1.186) urgency to answer online (OR = 4.677, p < 0.001, 95% CI: 2.714–6.639), decreased frequency of personal contact with friends (OR = 2.897, p = 0.004, 95% CI: 1.037–1.681), spending more than 6 h online (OR = 12.913, p < 0.001, 95% CI: 10.798–14.892), morning and nighttime internet use (OR = 3.846, p < 0.001, CI 95% 1.886–5.810) and never doing any sports (OR = 2.016, p = 0.044, 95% CI: 1.050–3.354) were independently associated with problematic internet use. Conclusions: Based on the results of our questionnaire survey more than 10% seemed to be problematic users in our study population, which is a relatively high rate. Early exposure to the internet as well as younger age were strongly related to this phenomenon. Duration of being online as well as daily time interval of internet use are important predisposing factors. Scarcely studied social factors such as being online at the expense of personal relationships and the lack of physical activity should be payed more attention to prevent the development of PUI. [ABSTRACT FROM AUTHOR]

Background and objectives: Aging poses a significant challenge worldwide, with China's aging status becoming particularly severe. What is the impact of Internet use on the health of the elderly? Existing studies have drawn conflicting conclusions that Internet use improves or harms health. The purpose of this study was to explore how Internet use affects the health of older adults, and the mechanisms and heterogeneity of these effects. Research design and methods: Based on Grossman's theory, this paper constructs a health production function model. Using the data of China Family Panel Studies (CFPS) from 2014 to 2020, we investigated the impact of Internet use on the health of older adults using fixed effect model and instrumental variable method. We also examined the mediating role of health information acquisition, lifestyle, and social interaction in these associations. Results: Internet use is positively associated with self-rated health and negatively associated with psychological sub-health level. Internet use promotes the health of older adults by facilitating access to health information, healthy lifestyles, and enhancing social interaction. And the impacts are heterogeneous at the individual and regional levels. Discussion and implications: We should progressively enhance the level of internet accessibility for older adults, while concurrently addressing and narrowing the 'digital divide'. By generating an abundance of superior health-related information, we can significantly improve health education tailored for the elderly. Additionally, it is crucial to offer extensive training opportunities designed to equip older adults with the necessary skills to proficiently navigate the internet. [ABSTRACT FROM AUTHOR]

Programs involving animals in therapeutic programs are becoming increasingly prevalent. These programs can vary greatly in their approach, scope, and objectives, and they can significantly impact the development of healthy children and those with various disorders. In this systematic review, we sought to investigate the psychological ramifications of animal-assisted activities (AAA), therapies (AAT), and interventions (AAI). We searched for relevant studies using the EBSCO Discovery Service search engine across 85 databases, utilising appropriate keywords. Our search generated 262 results, of which 21 were selected for inclusion after title and abstract screening, as well as full-text analysis. Our findings indicate that dogs and horses are animal-assisted programs' most commonly used animals. Additionally, autism, cerebral palsy, and ADHD were found to be overrepresented in these programs. Furthermore, the length of sessions and overall program duration exhibited considerable variation, regardless of patient age or disease type. The principal measures centred on the physiological variables related to the nervous system and motorium-related indicators. The studies were generally of exceptional methodological soundness. Frequently, the studies narrowed their scope to a single segment or just the child or adolescent, but the outcomes lacked contextual interpretation. Expanding the range of studies by comparing psychological and physiological indicators and conducting follow-up analysis with a longitudinal design would be beneficial. [ABSTRACT FROM AUTHOR]

Background: In Peru, HIV cases are highly concentrated among men who have sex with men (MSM). Despite the availability of anti-retroviral therapy, people living with HIV (PWH) have higher levels of oral diseases. Alcohol use disorder (AUD) is significantly present among PWH. Our overarching goal was to generate foundational evidence on the association of AUD and oral health in MSM with HIV and enhance research capacity for future intersectional research on AUD, oral health and HIV. Our specific aim was to implement an on-site electronic data collection system through the use of a REDCap Mobile App in a low-middle income country (LMIC) setting. Methods: Five validated surveys were utilized to gather data on demographics, medical history, HIV status, alcohol use, HIV stigma, perceived oral health status, and dietary supplement use. These surveys were developed in REDCap and deployed with the REDCap Mobile App, which was installed on ten iPads across two medical HIV clinics in Lima, Peru. REDCap app as well as the protocol for data collection were calibrated with feedback from trial participants and clinical research staff to improve clinical efficiency and participant experience. Results: The mean age of participants (n = 398) was 35.94 ± 9.13y, of which 98.5% identified as male, and 85.7% identified as homosexual. 78.1% of participants binge drank, and 12.3% reported being heavy drinkers. After pilot testing, significant modifications to the structure and layout of the surveys were performed to improve efficiency and flow. The app was successfully deployed to replace cumbersome paper records and collected data was directly stored in a REDCap database. Conclusions: The REDCap Mobile App was successfully used due to its ability to: (a) capture and store data offline, (b) timely translate between multiple languages on the mobile app interface, and (c) provide user-friendly interface with low associated costs and ample support. [ABSTRACT FROM AUTHOR]

Background: Female police officers are reported to encounter more bias, discriminatory practices, and inadequate support than their male counterparts and experience poorer health outcomes. This meta-ethnographic review looks beyond individual responsibilities to consider which aspects of policing impact the health and well-being of female police officers. Methods: Primary qualitative and mixed method studies published between 2000 and 2024 were included. ProQuest (all databases) and Ovid (Medline and Embase) were searched using terms related to health, wellbeing, females, police, and qualitative research. This was a cross-jurisdictional review, with no limit on country of study. In total, twenty-one papers met the inclusion criteria. A seven-phase inductive and interpretative meta-ethnographic technique was employed to synthesise, analyse, and interpret the data. Results: The data analysis revealed a distinct outcome that demonstrated a strong relationship and substantial impacts of organisational injustice on the health and well-being of female police officers. Our findings showed that organisational injustice, encompassing procedural, relational, distributive, and gendered injustice, significantly influences the health and well-being of female officers. Impacts on mental health were commonly discussed, followed by aspects influencing social health, workplace wellbeing, and physical health. Moreover, the effects of these four forms of organisational injustice and the associated cultural, systemic, and structural risk factors extend beyond the immediate health and wellbeing impacts on the individual female officer through impeding other aspects of their work life, such as career progression and work-life balance, that can further impact long-term health and well-being. Conclusion: This review highlights the importance of addressing organisational injustice and the cultural, systemic, and structural risk factors within policing to promote healthier and more inclusive workforces for female officers. Policymakers and practitioners should critically examine policies and practices that may appear gender neutral but disproportionately impact women, affecting the health and well-being of female police officers. By addressing these issues, transformative action can be taken to create safer, more supportive, and healthier working environments for female police officers. [ABSTRACT FROM AUTHOR]

Background: National legislative guidelines for sleep and rest are lacking in the Canadian licensed childcare sector. No review of Canadian legislation for licensed childcare facilities has focused on sleep. This paper provides a review of the Canadian provincial and territorial legislative landscape, regarding sleep, rest, and naps in licensed childcare centers. Methods: Childcare statutes and regulations for each province and territory were identified and downloaded on a particular date. Statutes and regulations were reviewed focusing on sections articulating licensed childcare facility mandates governing sleep, rest, naps, and sleep equipment. An excel file was used to facilitate systematic data retrieval and comparisons across provinces and territories. Two authors developed and discussed themes that summarized data from the documents. Results: No statutes indicated recommendations for sleep, rest, or naps. Only one regulation defined rest (Alberta). Our analysis of regulations identified four themes representing sleep, rest, and naps: programming (general programming, daily programming); space (dedicated space, amount of space, age-specific space); equipment (developmental appropriateness, acceptable sleep equipment, age-specific equipment); and safety (staffing during sleep/rest, sleep position, sleep monitoring, sleep equipment safety, prohibited practices). In Canada, minimal regulatory consistency is evident in required sleep programming, space, acceptability of sleep equipment, and sleep safety considerations. Most jurisdictions' regulations indicated necessity for developmentally appropriate rest or sleep areas and equipment, in particular for infants, but there was minimal consistency in defining infant age groups. Conclusions: Although we identified themes related to sleep across regulations, childcare regulations differ in their definitions of infants and specifications for children's sleep and rest in licensed Canadian childcare facilities. Without adequate definitions in legislative components of appropriate sleep duration linked to children's developmental stages, childcare facilities lack guidance to support healthy sleep for children in their care. Future research can examine translation of healthy sleep guidelines into government legislation and mandates for sleep, rest, and naps among young children in licensed childcare. [ABSTRACT FROM AUTHOR]

Background: The United Nations' 95-95-95 (95% of people with HIV being aware of their diagnosis, 95% of those aware of their diagnosis being on treatment and 95% achieving viral suppression) target aims to reduce morbidity and mortality of HIV. However, with 60% of new HIV infections occurring in sub-Saharan Africa (SSA), achieving this target in the region is challenging. Viral load (VL) monitoring is the gold-standard approach of assessing treatment efficacy, and its implementation into national health systems is a global health priority if elimination of HIV as a public health threat is to be achieved by 2030. This systematic review aims to investigate VL monitoring outcomes in SSA, and to identify gaps and possible interventions to help nations meet their 2030 targets. Methods: A literature search of three electronic platforms (MEDLINE, EMBASE and Global Health) was undertaken from 1 January to 9 August 2024 to identify studies published in English and conducted in SSA. The primary outcome was the proportion of people living with HIV (PLHIV) on antiretroviral therapy (ART) with routine VL monitoring at the recommended time points (initially, 6 months, 12 months and annually). Secondary outcomes reported proportions of PLHIV who received routine VL monitoring who went on to complete the cascade of care after identified virological failure [enhanced adherence counselling (EAC), switch to second-line ART, and finally viral suppression]. Results: The initial search identified 342 papers, of which 35 studies were included for narrative synthesis. Included studies reported on findings from 14 African countries and demonstrated extensive variation in rates of VL monitoring (range: 24.3-99.7%, mean: 63.8%). Results were more unfavourable in the latter steps of the viral load monitoring cascade, with a range of 0-88%, and a switch to second-line ART mean of 42% (range: 4.4-93%). Studies with additional support, and those with community-based models of care, had higher rates of VL testing and viral suppression. Conclusions: VL monitoring and management of virological failure are suboptimal in many SSA countries due to individual and health system-related challenges. Health system strengthening is vital to ensure the sustainability of HIV treatment programmes and the achievement of 95-95-95 targets by 2030. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease 2019 (COVID-19) is the latest evidence of an epidemic disease resulting in an extraordinary number of infections and claimed several lives, along with extensive economic and social consequences. In response to the emergency situation, countries introduced different policies to address the situation, with different levels of efficacy. This paper outlines the protocol for developing a model to analyze the burden of COVID-19 in Iran and the effect of policies on the incidence and cumulative death of the disease. The importance of the model lies in the fact that no study, according to the authors' best knowledge, tried to quantify the impact of the disease on Iran society and the impact of various implemented interventions on disease control. Based on a systematic review of COVID-19 prediction models and expert interviews, we developed a system dynamics model that not only includes an epidemic part but also considers the impact of various policies implemented by the Ministry of Health. The epidemic model estimates the incidence and mortality of COVID-19 in Iran. The model also intends to evaluate the effect of implemented policies on these outcomes. The model reflects the continuum of COVID-19 infection and care in Iran (of which some of its elements are unique) and key activities and decisions in delivering care. The model is calibrated and validated using data published by the Ministry of Health of Iran. Finally, the study aims to provide evidence of the impact of interventions intended to curb COVID-19 in Iran. Insights provided by the model will be necessary for controlling either future waves of the disease or similar future pandemics. [ABSTRACT FROM AUTHOR]

Background: Across the globe, racial and ethnic minorities have been disproportionately affected by COVID-19 with increased risk of infection and burden from disease. Vaccine hesitancy has contributed to variation in vaccine uptake and compromised population-based vaccination programs in many countries. Connect, Collaborate and Tailor (CCT) is a Public Health Agency of Canada funded project to make new connections between public health, healthcare professionals and underserved communities in order to create culturally adapted communication about COVID-19 vaccines. This paper describes the CCT process and outcomes as a community engagement model that identified information gaps and created tailored tools to address misinformation and improve vaccine acceptance. Methods: Semi-structured interviews with CCT participants were undertaken to evaluate the effectiveness of CCT in identifying and addressing topics of concern to underserved and ethnic minority communities. Interviews also explored CCT participants' experiences of collaboration through the development of new partnerships between ethnic minority communities, public health and academic researchers, and the evolution of co-operation sharing ideas and creating infographics. Thematic analysis was used to produce representative themes. The activities described were aligned with the levels of public engagement described in the IAP2 spectrum (International Association for Public Participation). Results: Analysis of interviews (n = 14) revealed that shared purpose and urgency in responding to the COVID-19 pandemic motivated co-operation among CCT participants. Acknowledgement of past harm, present health, and impact of social inequities on public service access was an essential first step in establishing trust. Creating safe spaces for open dialogue led to successful, iterative cycles of consultation and feedback between participants; a process that not only helped create tailored infographics but also deepened engagement and collaboration. Over time, the infographic material development was increasingly directed by community representatives' commentary on their groups' real-time needs and communication preferences. This feedback noticeably guided the choice, style, and presentation of infographic content while also directing dissemination strategies and vaccine confidence building activities. Conclusions: The CCT process to create COVID-19 vaccine communication materials led to evolving co-operation between groups who had not routinely worked together before; strong community engagement was a key driver of change. Ensuring a respectful environment for open dialogue and visibly using feedback to create information products provided a foundation for building relationships. Finally, our data indicate participants sought reinforcement of close cooperative ties and continued investment in shared responsibility for community partnership-based public health. [ABSTRACT FROM AUTHOR]

Objective: Multimorbidity is recognized as a serious health condition faced by a majority of older adults. Research investigating adaptive responses to multimorbidity, termed multimorbidity resilience, has been growing. This paper examines protective and risk factors, with a focus on health behaviours, socio-economic resources, and social support using an established measure of resilience (Connor-Davidson Resilience Scale) among older adults, focusing on older persons with two or more concurrent chronic conditions. Methods: Using Baseline (2011–2015), Follow-up One (2015–2018), and Follow-up Two (2018–2021) data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we tested hypotheses using 13,064 participants aged 65 years and older, who completed all waves and reported two or more of 27 chronic conditions, for the full sample of multimorbid individuals and three multimorbidity clusters: Cardiovascular/Metabolic, Musculoskeletal, and Mental Health. Associations between protective and risk factors and resilience were examined using linear regression to model the Connor-Davidson resilience scale, adjusting for illness context and social determinants of health. Results: Among all multimorbid individuals, the strongest associations with resilience were found for higher self-rated health, greater sleep satisfaction, better appetite, higher household income, more relatives and friends, being overweight (compared to normal weight), fewer housing problems, and fewer skipped meals. Weaker associations were found for non-smokers, less alcohol consumption, less pain, sedentary behaviour, being non-married (compared to married), and among Canadian born (compared to foreign). The analyses for the three multimorbidity clusters were largely replicated for the three multimorbidity clusters, but with some nuances depending on the cluster. Discussion: This research provides confirmatory evidence for several protective and risk factors affecting the ability to cope and recover from multimorbidity adversity among older adults. There are consistent patterns for the multimorbidity disease clusters, but some distinct relationships arise that are worthy of attention. The implications of the findings for modifiable health behaviours and socio-economic factors are discussed for their public health and clinical relevance. [ABSTRACT FROM AUTHOR]

Background: Adolescent mental wellbeing has been declining in the United Kingdom for over a decade. Expansion of services to support the mental wellbeing of young people is a public health priority and a core component of the National Health Service's Long-Term Plan. In this paper, we leverage secondary analysis of a very large longitudinal dataset (#BeeWell) to generate insights regarding different patterns of health behaviour, their covariates, and consequences for mental wellbeing one year later. Methods: A Latent Class Analysis was conducted using data on physical activity, sleep, and eating habits collected in 2021 from 18,478 Year 8 pupils from Greater Manchester (United Kingdom) to (1) identify distinct latent classes of adolescent health behaviour; (2) establish factors likely to be associated with latent class membership; and (3) determine whether latent class membership contributes to variance in self-reported mental wellbeing one year later. Results: A three-class solution was identified as an excellent fit to the data, discriminating between: the Wellness Weary (n = 2,717; 15%); the Balanced Bunch (n = 7,377; 40%); and the Green and Dream Team (n = 8,384; 45%). Several factors significantly influenced class membership. Most notably, socio-economic disadvantage and social media use were linked with less favourable health behaviour patterns, whilst cisgender heterosexual girls were likely to endorse healthier patterns. After adjusting for covariates, the Green and Dream Team reported significantly greater mental wellbeing than the Balanced Bunch one year later. However, there was no difference between the Balanced Bunch and the Wellness Weary, signalling that health behaviours may support mental wellbeing, but only among the healthiest young people. Conclusions: Beyond advancements in fundamental understanding, our findings yield significant translation opportunities through their use and application in health, education, and allied professional settings designed to support young people. [ABSTRACT FROM AUTHOR]

Background: Ensuring the availability of safe drinking water remains a critical challenge in developing countries, including Ethiopia. Therefore, this paper aimed to investigate the prevalence of fecal coliform and E. coli bacteria and, geographical, children availability, and seasonal exposure assessment through a meta-analysis. Methods: Two independent review groups extensively searched internet databases for English-language research articles published between 2013 and 2023. This systematic review and meta-analysis followed PRISMA guidelines. The methodological quality of each included study was evaluated using the STROBE guidelines. Publication bias was assessed by visual inspection of a funnel plot and then tested by the Egger regression test, and meta-analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. Subgroup analyses were also conducted to explore heterogeneity. Results: Out of 48 potentially relevant studies, only 21 fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of fecal coliform and E. coli was 64% (95% CI: 56.0–71.0%, I2 = 95.8%) and 54% (95% CI: 45.7–62.3%, I2 = 94.2%), respectively. Subgroup analysis revealed that the prevalence of fecal coliform bacteria increased during the wet season (70%) compared to the dry season (60%), particularly in households with under-five children (74%) compared to all households (61%), in rural (68%) versus urban (66%) areas, and in regions with high prevalence such as Amhara (71%), Gambela (71%), and Oromia (70%). Similarly, the prevalence of E. coli was higher in households with under-five children (66%) than in all households (46%). Conclusions: The analysis highlights the higher prevalence of fecal coliform and E. coli within households drinking water, indicating that these bacteria are a significant public health concern. Moreover, these findings emphasize the critical need for targeted interventions aimed at improving drinking water quality to reduce the risk of fecal contamination and enhance public health outcomes for susceptible groups, including households with under-five children, in particular geographical areas such as the Amhara, Gambela, and Oromia regions, as well as rural areas, at point-of-use, and during the rainy season. Registration: This review was registered on PROSPERO (registration ID - CRD42023448812). [ABSTRACT FROM AUTHOR]

Background: This paper focuses on the period from 2019 to 2021 and investigates the factors associated with the high prevalence of C-section deliveries in South India. We also examine the nuanced patterns, socio-demographic associations, and spatial dynamics underlying C-section choices in this region. A cross-sectional study was conducted using large nationally representative survey data. Methods: National Family Health Survey data (NFHS) from 2019 to 2021 have been used for the analysis. Bayesian Multilevel and Geospatial Analysis have been used as statistical methods. Results: Our analysis reveals significant regional disparities in C-section utilization, indicating potential gaps in healthcare access and socio-economic influences. Maternal age at childbirth, educational attainment, healthcare facility type size of child at birth and ever pregnancy termination are identified as key determinants of method of C-section decisions. Wealth index and urban residence also play pivotal roles, reflecting financial considerations and access to healthcare resources. Bayesian multilevel analysis highlights the need for tailored interventions that consider individual household, primary sampling unit (PSU) and district-level factors. Additionally, spatial analysis identifies regions with varying C-section rates, allowing policymakers to develop targeted strategies to optimize maternal and neonatal health outcomes and address healthcare disparities. Spatial autocorrelation and hotspot analysis further elucidate localized influences and clustering patterns. Conclusion: In conclusion, this research underscores the complexity of C-section choices and calls for evidence-based policies and interventions that promote equitable access to quality maternal care in South India. Stakeholders must recognize the multifaceted nature of healthcare decisions and work collaboratively to ensure more balanced and effective healthcare practices in the region. [ABSTRACT FROM AUTHOR]

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts. [ABSTRACT FROM AUTHOR]

Objective: This paper investigates the relationships between physical activity (PA), school bullying, emotion regulation self-efficacy (ERS), and interpersonal relationship distress (IRD) among junior high school students. It also examines the underlying mechanisms of school bullying to provide insights into reducing adolescent bullying and to lay the groundwork for preventing and controlling aggressive behaviors. Methods: A survey was conducted on 484 students (240 males, 12.18 ± 0.8 years) from 4 secondary schools using the Physical Activity Rating Scale (PARS), Emotional Management Self-Efficacy Scale (EMSS), Interpersonal Relationship Distress Scale (IRDS), and Campus Bullying Scale (CBS) to examine the effects among the variables. A stratified random sampling method was used to select the sample, and data were collected with a structured questionnaire. The data were analyzed using SPSS 24.0 and AMOS 24.0 statistical software. The analysis included Pearson correlation analysis, structural equation modeling, and bias-corrected percentile Bootstrap methods. Results: (1) PA negatively predicts IRD, which in turn has an indirect effect on bullying (PA → IRD → Bullying), ES = -0.063. Additionally, EM and IRD act as mediators between PA and school bullying (PA → EM → IRD → Bullying), ES = 0.025. (2) PA negatively predicts IRD, which has an indirect effect on being bullied (PA → IRD → Being bullied), ES = -0.044. EM and IRD serve as chain mediators between PA and being bullied (PA → EM → IRD → Being bullied), ES = -0.071. Conclusion: PA can positively predict bullying, but it can be mitigated through EM to reduce IRD, thereby decreasing the occurrence of campus bullying and being bullied. [ABSTRACT FROM AUTHOR]

Background: Tropical oils such as palm and coconut oils are renowned for their high saturated fat content and culinary versatility. However, their consumption has sparked debate regarding their health benefits and production concerns. The purpose of this review was to map existing evidence on the health benefits and challenges associated with the consumption of tropical oils. Method: The recommendations for conducting a scoping review by Arksey and O'Malley were followed. PubMed, Dimensions AI, Central, JSTOR Google, Google Scholar, and ProQuest databases were searched for relevant papers. The predetermined keywords used were Consumption" AND "Tropical oil," as well as "Health benefits" OR "Health challenges" AND "Tropical Countries." Peer-reviewed and grey literature published in English were eligible for this review. Result: Tropical oils, such as palm and coconut oils, provide health benefits including essential vitamins (A and E) that enhance ocular health, boost immunity, and support growth. They are also recognised for their role in managing high blood sugar, obesity, and cholesterol levels, while offering antioxidant and anti-inflammatory properties. These oils have wound-healing abilities and are commonly used in infant nutrition and traditional cooking. Nevertheless, prolonged and repeated use of tropical oils to high temperature can degrade vitamin E, whereas excessive intake may result in overdose. Health concerns include oxidative risks, diabetes, cancer, coronary heart disease, high blood pressure, and acrylamide formation due to production challenges excessive consumption. Additional issues include obesity, suboptimal oil production, misconceptions, regulatory obstacles, and preferences for alternative fats. Conclusion: This review suggest that tropical oils provide essential health benefits, including vitamins and antioxidant properties, but pose significant health risks and production challenges, particularly when exposed to high temperatures and through excessive intake. Guidelines on the consumption of tropical oils in the tropical regions are necessary to regulate their consumption. [ABSTRACT FROM AUTHOR]

Many researchers have studied the role of air pollutants on cognitive function, changes in brain structure, and occurrence of dementia. Due to the wide range of studies and often contradictory results, the present systematic review was conducted to try and clarify the relationship between air pollutants and dementia. To identify studies for this review, a systematic search was conducted in Scopus, PubMed, and Web of Science databases (without historical restrictions) until May 22, 2023. The PECO statement was created to clarify the research question, and articles that did not meet the criteria of this statement were excluded. In this review, animal studies, laboratory studies, books, review articles, conference papers and letters to the editors were avoided. Also, studies focused on the effect of air pollutants on cellular and biochemical changes (without investigating dementia) were also excluded. A quality assessment was done according to the type of design of each article, using the checklist developed by the Joanna Briggs Institute (JBI). Finally, selected studies were reviewed and discussed in terms of Alzheimer's dementia and non-Alzheimer's dementia. We identified 14,924 articles through a systematic search in databases, and after comprehensive reviews, 53 articles were found to be eligible for inclusion in the current systematic review. The results showed that chronic exposure to higher levels of air pollutants was associated with adverse effects on cognitive abilities and the presence of dementia. Studies strongly supported the negative effects of PM2.5 and then NO2 on the brain and the development of neurodegenerative disorders in old age. Because the onset of brain structural changes due to dementia begins decades before the onset of disease symptoms, and that exposure to air pollution is considered a modifiable risk factor, taking preventive measures to reduce air pollution and introducing behavioral interventions to reduce people's exposure to pollutants is advisable. [ABSTRACT FROM AUTHOR]

Background: Frequent consumption of Energy Drinks (EDs) is associated with numerous health problems, including overweight and obesity, particularly among children and adolescents. The extensive promotion, wide accessibility, and relatively low cost of EDs have significantly increased their popularity among this age group. This paper examines policies/programs that, directly and indirectly, contribute to reducing ED consumption in children and adolescents and shares global experiences to help policymakers adopt evidence-based policies. Methods: A systematic search was performed using PubMed, Scopus, and Web of Science databases from January 2000 to June 2024, along with reputable international organization websites, to find literature on policies aimed at reducing ED consumption among children and adolescents. All sources meeting the inclusion criteria were included without restrictions. Titles and abstracts were initially screened, followed by a full-text review. After evaluating the quality of the selected studies, data were extracted and, along with information from the selected documents, compiled into a table, detailing the country, policy type, and the effectiveness and weaknesses of each policy. Results: Out of 12166 reviewed studies and documents, 84 studies and 70 documents met the inclusion criteria. 73 countries and territories have implemented policies like taxation, sales bans, school bans, labeling, and marketing restrictions on EDs. Most employ fiscal measures, reducing consumption despite enforcement challenges. Labeling, access restrictions, and marketing bans are common but face issues like black markets. Conclusion: This scoping review outlines diverse strategies adopted by countries to reduce ED consumption among children and teenagers, such as taxation, school bans, sales restrictions, and labeling requirements. While heightened awareness of ED harms has reinforced policy efforts, many Asian and African nations lack such measures, some policies remain outdated for over a decade, and existing policies face several challenges. These challenges encompass industry resistance, governmental disagreements, public opposition, economic considerations, and the intricacies of policy design. Considering this, countries should tailor policies to their cultural and social contexts, taking into account each policy's strengths and weaknesses to avoid loopholes. Inter-sectoral cooperation, ongoing policy monitoring, updates, and public education campaigns are essential to raise awareness and ensure effective implementation. [ABSTRACT FROM AUTHOR]

Background: Common mental health problems, such as stress, anxiety and depression, are highly prevalent among workers and often lead to long-term absenteeism and work disability. Effective elements found in previous researched interventions were to explicitly focus on return to work (RTW) and not solely on symptom reduction, to take into account the employees' cognition towards RTW and to include the workplace environment. Based on these elements, a stepped-care approach was developed. The aim of this paper is to present the study design of a randomized controlled trial (RESTART), evaluating the effectiveness of the stepped-care approach on lasting RTW and the implementation process. Methods: RESTART is a randomized controlled trial with a 2 × 2 factorial design and a follow-up of one year. Employees eligible for this study are those who reported sick within 2 to 8 weeks with psychological distress based on a distress screener. Participants will be randomized to a group receiving a tailored e-Health app or usual care, as well as randomized to a group receiving a Participatory Approach (PA; conversational method) in the workplace or usual care. The PA will however only be provided in case of persistent sickness absence at 8 weeks. Measurements take place at baseline, after the e-Health intervention period (3 months), and after the PA intervention period (6 months) and 12 months. Primary outcome is lasting RTW, defined as full RTW in previous or equal work for at least four consecutive weeks. Secondary outcomes are (the severity of) stress-related symptoms, total number of sickness absence days, self-efficacy for RTW and self-reported health. A process evaluation including a realist evaluation will also be conducted. Discussion: Early intervention that focuses on RTW, the cognition towards RTW despite symptoms and involves the workplace environment, plays a crucial role in managing sickness absence among employees with psychological distress. If effective, the stepped-care approach is relevant for employees, employers and society as a whole. Trial Registration: ISRCTN: 90663076. Registered on 5 October 2023. [ABSTRACT FROM AUTHOR]

Background: Economic sanctions are defined as restrictions imposed by other countries against individuals, groups, or governments of other countries. These sanctions have a detrimental impact on the economies of countries and can also limit access to healthcare services for people as a secondary consequence. This study aims to systematically review the literature to examine the direct and indirect effects of economic sanctions on health through a narrative synthesis. Methods: This systematic literature review was limited to papers published between January 1990 and July 2023. Relevant documents published in English and Persian were searched for in databases including Cochrane Library, PubMed, Embase, Scopus, Web of Science, SID, Magiran, and Irandoc. The direct and indirect effects of sanctions on health were classified using two frameworks proposed by the World Health Organization (WHO): the Health System Building Blocks and "Social Determinants of Health". Results: Out of a total of 18,219 articles, 59 were selected based on inclusion criteria. The effects of sanctions were divided into direct and indirect groups. Direct effects encompassed seven main themes: access to essential medicine, medical products, vaccines and technologies; financing; health workforce; service delivery; research and health information systems; health outcomes; and financial risk protection. Indirect effects also were classified into six main themes: socioeconomic status; food and agricultural products; stress; early life conditions; high-risk behaviors and addiction; and transport. Most studies focused on the access to medicines, food, economic and social status. Conclusions: Economic sanctions have had profoundly negative impacts on all aspects of the healthcare system. The international community must address these effects on health and take necessary measures to prevent or mitigate them, particularly in ensuring the provision of basic and essential healthcare needs for individuals and communities. [ABSTRACT FROM AUTHOR]

Background: Large numbers of young people worldwide, especially in the Global South, wish to migrate but lack the capacity to do so, with potentially detrimental consequences for their well-being and mental health. Termed 'involuntary immobility', this phenomenon is numerically larger than migration, but remains for now a largely underexplored area of research. Focusing on young Senegalese living in Casamance, this paper contributes to the limited literature on the implications of immobility for subjective well-being. It does so by (i) considering different degrees and types of involuntary immobility and their intersections, (ii) laying out the implications of (interacting) social and spatial immobilities for well-being with particular attention to youth's agency in navigating a lack of capabilities, and (iii) by accounting for heterogenous experiences taking a gendered approach. Methods: For this study, 35 semi-structured interviews were conducted with 18- to 39-year-olds in Ziguinchor region, recruited through purposive and snowball sampling. Thematic analysis was employed on verbatim transcriptions of audio-recorded interviews. Results: Our study reveals a nuanced reality where aspirations to (temporarily) move abroad coexist with aspirations to stay in Casamance. Participants' life aspirations and overarching projects clash, however, both with a lack of capabilities to move abroad and to enact these locally. This pervasive immobility decreases life satisfaction and generates negative emotions, such as stress, anxiety, discouragement, and distress. Despite these obstacles, our findings also underscore the agency and resourcefulness displayed by the youth as they navigate their limited control over life choices and paths. Conclusions: Involuntary spatial immobility exacerbates the dominant experience of social immobility, magnifying its effect on youth's well-being, revealing a previously unacknowledged phenomenon. Our findings further emphasize the pressing need for a more cohesive alignment between migration policies and information campaigns on one hand and the real experiences and challenges encountered by their intended audience on the other. [ABSTRACT FROM AUTHOR]

Background: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major public health issues. Although the primary and secondary prevention of RHD through appropriate management of bacterial pharyngitis and ARF are well-described in the literature, few studies address the knowledge, attitude, and practice (KAP) of developing countries. We aimed to evaluate the KAP of the frontline physicians in Egyptian university hospitals regarding pharyngitis and ARF. Methods: We employed a cross-sectional design between September 1st, 2022, and January 31st, 2023 using a self-administered questionnaire in 21 Egyptian universities. The questionnaire was developed based on previous studies and recent guidelines and included four domains: sociodemographic data, knowledge, attitude, and practice regarding pharyngitis and ARF. We utilized both online (Google Forms) and paper surveys. Frontline physicians, including interns, residents, and assistant lecturers, were conveniently invited to participate. Furthermore, with the help of participating phycisians in recruiting their colleagues, we utilized the snowball method. Data were analyzed using IBM SPSS version 27 software. Results: The final analysis included 629 participants, of whom 372 (59.1%) were males and 257 (40.9%) had direct contact with ARF patients. Most participants (61.5%) had a fair knowledge level while 69.5% had a fair level of practice regarding ARF and pharyngitis. Higher satisfactory knowledge levels were noted regarding pharyngitis (17.1% vs. 11.3%; p-value: 0.036) and ARF (26.8% vs. 18%; p-value: 0.008) among physicians dealing directly with ARF cases compared to physicians in departments not dealing directly with ARF cases. Physicians in Cairo region universities had significantly higher levels of satisfactory knowledge about ARF compared to Delta and Upper Egypt region universities (p = 0.014). Delta region universities showed significantly lower levels of practice compared to Cairo and Upper Egypt region universities (p = 0.027). The most frequently recognized barriers against health promotion were low socioeconomic status (90.3%) and lack of adequate public education (85.8%). Conclusions: Despite the fair knowledge and practice levels towards bacterial pharyngitis and ARF among participants, many gaps were still identified that might contribute to RHD prevalence. Educational interventions should be implemented by updating the local guidelines in Egypt for diagnosis and management based on the most recent guidelines. [ABSTRACT FROM AUTHOR]

Background: Eating is fundamental not only to survival and health, but also to how humans organise their social lives. Eating together with others is often seen as the healthy ideal, while eating alone is highlighted as a risk factor for negative health outcomes, especially among older adults. This paper, therefore, investigates the relationship between the frequency and subjective experience of eating alone and food-related outcomes among 70- to 75-year-olds in Sweden. Methods: A survey was distributed to a nationally representative random sample of 1500 community-living in Sweden, aged 70–75 years. Two different constructs of eating alone (objective and subjective) were measured, along with the following food-related outcomes: a food index, intake of food groups, consumption of ready-made meals, number of main meals per day, and body mass index (BMI). Results: In total, 695 respondents were included in the final sample. A quarter of the respondents were categorised as eating alone, of which a small proportion reported that doing so bothered them. There were no associations between eating alone and food index scores, BMI, or intake frequencies of fruits and berries, or fish and shellfish. However, people eating alone were less likely to report eating three meals per day (OR: 0.53, CI: 0.37–0.76, p = 0.006), less likely to report higher intake frequencies of vegetables and snacks, sugary foods, and sweet drinks (adjusted OR: 0.68, CI: 0.48–0.95, p = 0.023 resp. OR: 0.59, CI: 0.43–0.81, p = 0.001), and more likely to report higher intake frequencies of ready-made meals (adjusted OR: 3.71, CI: 2.02–6.84, p < 0.001) compared to those eating together with others. The subjective experience of eating alone did not have an impact on food-related outcomes. Conclusion: Eating alone or with others played a role in participants' food intake, and seemed to influence aspects of the organisation of everyday eating routines rather than overall dietary healthiness or weight status. Our findings add to the previous body of research on commensality, eating alone, and health among the older population, providing insights into the development of future health policies and research. [ABSTRACT FROM AUTHOR]

Background: In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, "the Policy") was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors' awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. Methods: Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. Results: Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that "Hospitals should be good role models." Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. Conclusions: The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces. [ABSTRACT FROM AUTHOR]

Background: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits for Engaging Networked Game-based Exercise). CHALLENGE uses social media to supplement wearable activity monitors with the autonomy-supportive frame of a game. We hypothesize that CHALLENGE will engender playful experiences that will improve motivation for exercise and lead to sustained increases in step count. Methods: We will recruit 300 healthy, community dwelling older adult women on a rolling basis and randomize them to receive either the CHALLENGE intervention (experimental arm) or an activity monitor-only intervention (comparison arm). Participants in both groups will receive a wearable activity monitor and personalized weekly feedback emails. In the experimental group, participants will also be added to a private Facebook group, where study staff will post weekly challenges that are designed to elicit playful experiences while walking. Assessments at baseline and 6, 12, and 18 months will measure PA and motivation-related constructs. We will fit linear mixed-effects models to evaluate differences in step count and motivational constructs, and longitudinal mediation models to evaluate if interventional effects are mediated by changes in motivation. We will also conduct thematic content analysis of text and photos posted to Facebook and transcripts from individual interviews. Discussion: By taking part in a year-long intervention centered on imbuing walking behaviors with playful and celebratory experiences, participating older adult women may internalize changes to their identity and relationship with PA that facilitate sustained behavior change. Study results will have implications for how we can harness powerful and increasingly ubiquitous technologies for health promotion to the vast and growing population of older adults in the U.S. and abroad. Trial registration: ClinicalTrials.gov Identifier NCT04095923. Registered September 17th, 2019. [ABSTRACT FROM AUTHOR]

Background: Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. Methods: A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. Results: Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. Conclusions: Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S. [ABSTRACT FROM AUTHOR]

Background: This paper explores the feasibility of establishing a large-scale population-based cohort and biobank in Switzerland by assessing potential participants' needs, expectations, and concerns about such an infrastructure providing information on health, lifestyle, and exposure trajectories, the development of disease, and risk factors over time. Methods: We utilized a scenario-based questionnaire in the Swiss Health Study pilot phase (2020–2021), involving 1349 adults aged 20–69 from the cantons Vaud and Bern. We conducted descriptive statistics supported by R and qualitative content analysis of n = 374 open responses related to attitudes towards research. Results: We highlight the benefits and challenges of the scenario-based approach, discuss the sample represented in the pilot phase, and present implications for building a full cohort. We also report on participants' attitudes towards and previous experience with health research. We analyze references regarding informed consent and feedback, attitudes towards the Swiss Health Study, and recommendations on improving its scope, design, and instruments. Results indicate a high interest (90%) in participating in a national health study, with 85% of a random population sample willing to join a long-term cohort. Only 43% were familiar with biobanks, and 44% preferred general consent. Trust was high for Swiss-based public research but lower for researchers from other countries or private sector. Over 95% expressed willingness to complete online questionnaires, undergo physical examination, and donate biosamples. Almost all participants wanted to know the outcomes of the medical tests (99.5%) and the exposure to environmental stressors (95%) from their study center visit. Preferred tools for monitoring sleep, physical activity, and diet were known smartphone apps with automatic data management. Conclusion: Overall, the study reveals a positive attitude towards personalized health research, with a strong willingness to share data and samples. Key insights focus the meaning of informed consent for participation, the relevance of sampling and representativeness, as well as the significance and challenges of personalized feedback, especially regarding environmental health concerns. Findings emphasize participants' supportive yet reflexive stances, underscoring the importance of aligning research values with individual values in personalized health research. These insights contribute valuable considerations for refining the scope, design, and instruments of future cohort studies. [ABSTRACT FROM AUTHOR]

Background: Many studies have investigated the role of metals in various types of malignancies. Considering the wide range of studies conducted in this field and the achievement of different results, the presented systematic review was performed to obtain the results of investigations on the prevention and occurrence of various types of cancer associated with metal exposures. Methods: In this review, research was conducted in the three databases: Scopus, PubMed, and Web of Science without historical restrictions until May 31, 2024. Animal studies, books, review articles, conference papers, and letters to the editors were omitted. The special checklist of Joanna Briggs Institute (JBI) was used for the quality assessment of the articles. Finally, the findings were classified according to the effect of the metal as preventive or carcinogenic. Results: The total number of retrieved articles was 4695, and 71 eligible results were used for further investigation. In most studies, the concentration of toxic metals such as lead (Pb), chromium (Cr (VI)), arsenic (As), cadmium (Cd), and nickel (Ni) in the biological and clinical samples of cancer patients was higher than that of healthy people. In addition, the presence of essential elements, such as selenium (Se), zinc (Zn), iron (Fe), and manganese (Mn) in tolerable low concentrations was revealed to have anti-cancer properties, while exposure to high concentrations has detrimental health effects. Conclusions: Metals have carcinogenic effects at high levels of exposure. Taking preventive measures, implementing timely screening, and reducing the emission of metal-associated pollutants can play an effective role in reducing cancer rates around the world. [ABSTRACT FROM AUTHOR]

Background: Previous initiatives concerning adolescent sexual and reproductive health (SRH) education in Low-or-Middle Income Countries (LMICs) have been limited by cultural norms and misinformation perpetuated within families. Responding to the paucity of research on the implementation of SRH interventions in LMICs and limited knowledge regarding their mechanisms, this study undertakes a process evaluation of a parent-focused intervention to promote parent-adolescent communication about SRH in Uganda. Methods: This paper explores the implementation, contextual factors and mechanisms of impact of the intervention, using the Medical Research Council (MRC) guidelines for process evaluations. Implementation was evaluated through indicators of dose, fidelity and adaptations, acceptability and feasibility. The contextual factors and mechanisms of impact were evaluated to refine the intervention's causal assumptions. Data was collected during April - October 2021 in South-Western Uganda using a mixed-methods approach, including document analysis, intervention observations, interviews, focus group discussions and most significant change stories. Results: The acceptability of the intervention was related to its community engagement, the strong rapport with delivery agents, and individual characteristics of participants. Five contextual factors influencing implementation were highlighted; (i) cultural norms, (ii) perceptions about youth SRH, (iii) poverty, (iv) Covid-19 pandemic, and (v) prior research projects in the community. When considering the intervention's mechanisms of impact, four causal pathways were identified; (i) Awareness of SRH needs helped parents overcome stigma, (ii) Parenting skills training improved SRH communication, (iii) Group learning stimulated shared parenting, and (iv) Group learning improved co-parenting. Conclusion: The paper presented three key learnings and corresponding recommendations for future research. Firstly, implementation success was credited to meaningful community engagement which improved acceptability and uptake. Secondly, the complex influences of contextual factors highlighted the need for contextual analysis in research studies to inform intervention design. Finally, this evaluation recognised the interplay between mechanisms of impact and suggested further research consider such combined impacts when designing intervention content. [ABSTRACT FROM AUTHOR]

Background: Violence against women (VAW) research is a sensitive topic, which has been conducted mainly using face-to-face methods. The COVID-19 pandemic lockdown and restrictions on movement presented an opportunity to conduct VAW research using remote methods. We discuss how we adapted methods, reflect on lessons learned, and make recommendations highlighting key considerations when conducting remote research on a sensitive topic of VAW. Methods: We designed and conducted an exploratory qualitative study using remote methods with 18 men and 19 women, aged 18 years and older, who lived with their partner or spouse during lockdown in South Africa. The aim of the study was to explore experiences of COVID-19 lockdown, and its link to women and children's experiences of violence in the homes. Data presented in this paper draws from researchers' reflections drawn from debriefing sessions during the research process, and from participants' interview transcripts. Findings: Remote recruitment of participants took longer than anticipated, and we had to re-advertise the study. We could not ensure safety and privacy during interviews. Regardless of all the safety and privacy measures we put in place during the research process, some participants had an adult person present in the room during interviews, and the researchers had no control over interruptions. Rapport was difficult to establish without an in-person connection, which limited disclosure about violence experience (amongst women) and perpetration (amongst men). Conclusions: Given the methodological and ethical challenges which limited disclosure of VAW remotely, we conclude that telephone interviews used in our study impacted on the quality of study data. Therefore, we do not recommend VAW research to be conducted remotely, unless it is essential and participants are already known to the interviewer and trust has been established. [ABSTRACT FROM AUTHOR]

Background: This study examines how significant is the changes in child stunting in Sub-Saharan African countries (SSA). Then, it investigates factors that contributed to the reduction in child stunting in those countries. For each country, we distinguish the contribution of compositional effects and structural effect. Methods: This paper uses data from Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2000 and 2020. The z-test to compare two independent proportions was used to assess changes in child stunting and explanatory variables over the period. Recentred influence function (RIF) decomposition method was used to decompose changes in stunting over the year in each country, and to determine the contribution of each variable to the changes. Results: The prevalence of child stunting declines significantly in 11 countries over the year. The decline varies from 6.8% in Cameroun to 19% in Mali. The average year of education of the child's mother and father, and the proportion of households with access to an improved drinking water source have contributed to the reduction in child stunting. This result was found in all the countries. Improvements in living standards, child vaccination, antenatal care attendance, delivery to health care centres, maternal education, improved drinking water sources, and improved sanitation make the largest contribution to the composition component, hence reducing child stunting. Conclusions: This study sheds light on what has contributed to the achieved improvement in child nutritional status and suggests how to possibly accelerate the reduction in undernutrition in countries that lag. [ABSTRACT FROM AUTHOR]