Search

Background Mothers who have children removed from their care often have complex needs. These women have poor health outcomes and are dying earlier than their peers from preventable and amenable causes. Yet there is little known about how health care services might mitigate these risks. This study aimed to listen to the voices of women who had children removed from their care to understand their experiences of health and healthcare. Methods We used a narrative approach to collect and analyse interview data with six mothers who had experienced child removal in England. Each participant was asked to reflect on their life and main health challenges. Results Three narrative subplots were developed to consolidate experiences of unmet health need: (i) 'on paper you're normal': narratives of complex need, (ii) 'in my family, everyone had issues': narratives of whole family need and (iii) 'I'm still mummy, no matter where they are': narratives of maternal identity and health. Conclusions Findings highlight limitations within current systems of support, including a culture of distrust and women falling between the gaps of services. Women's narratives illustrate opportunities for health intervention, especially immediately following child removal. [ABSTRACT FROM AUTHOR]

Background Obesity is the greatest health issue for this generation; schools have improved food offered within their grounds. The built environment surrounding schools and pupils' journeys home have not received the same level of attention. This review identified papers on impacts of hot food takeaways surrounding schools in the UK. Methods Methods were informed by the PRISMA (QUORUM) guidelines for systematic reviews. Searches were completed in 12 databases. Results A total of 14 papers were included and quality assured before data extraction. Three descriptive themes were found; descriptions of hot food takeaway's geography and impacts concerning schools, strategic food policy and pupils reported food behaviour. Conclusions Most included studies compared anthropometric measures with geographical location of hot food takeaways to find correlations between environment and childhood obesity. There was good evidence of more hot food takeaways in deprived areas and children who spend time in deprived neighbourhoods tend to eat more fast food and have higher BMIs. Few studies were able to quantify the correlation between school's environment and obesity amongst pupils. This lack of evidence is likely a factor of the studies' ability to identify the correlation rather than lack of a correlation between the two variables. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of publications seeking to understand the SARS-CoV-2 virus. A byproduct of the rush to understand COVID-19 has been the publication and subsequent retraction of papers promoting unfounded treatments, such as ivermectin—an anti-parasitic medication. This study aims to determine the impact retracted studies may have had on ivermectin prescription rates. TriNetX was used to gather anonymized patient data from 67 healthcare organizations both within the USA (36,711 patients; 91.6%) and abroad (3,266 patients; 8.14%) to obtain prescribing rates for ivermectin between April 2020–September 2022. Google Trends was used to gauge online interest in purchasing ivermectin in relation to prescribing rates. We found that ivermectin use largely increased following periods in which later-retracted journal articles were written touting its potential benefits. Multiple spikes in Google searches were observed, with the first three local peaks occurring within the first, second, and third publication 'clusters,' respectively. The maximum peak for searches occurred just one month after the maximum number of ivermectin prescriptions. This information is important for understanding how health-related misinformation spreads, and how to best minimize and counteract the impact of such misinformation in the future. [ABSTRACT FROM AUTHOR]

Background Suicide is a significant cause of death worldwide. Various purposes can explain why people choose to attempt or commit suicide such as mental-health disorders, income-related-factors, quality of life or issues related to social context. This study aims to identify an updated association between 'isolation' and suicides. Methods In this regard, we had made a systematic review of the most recent papers, published from January 2016 to March 2022, thought the most acknowledged databases. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. To the best of our knowledge, this issue is very important due to the indirect relationship between COVID-19 and suicides. Results Our analysis demonstrates that suicide and -social isolation and loneliness- have a positive and direct relationship although these findings varied slightly by areas. Moreover, most of the attention is focused on the youth during the most recent period and this is a real problem because economies cannot afford losing (young) population. Conclusions In order to prevent suicides, public policies should prevent suicidal thoughts that it could induce to terminate the lives of individuals in their most productive years and harmful outcomes to their families and friends. [ABSTRACT FROM AUTHOR]

Background Telehealth technologies are playing an increasing role in healthcare. This study aimed to review the literature relating to the use of telehealth technologies in care homes with a focus on teledentistry. Methods Khangura et al.'s (Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012; 1 :10) rapid review method included an electronic database search on Embase, PubMed, Web of Science and OpenGrey. Out of 1525 papers, 1108 titles and abstracts were screened, and 75 full texts assessed for eligibility. Risk of bias was assessed using the Mixed Methods Assessment Tool 2018. Results Forty-seven papers (40 studies) from 10 countries, published 1997–2021, were included in the review, four studies related to teledentistry. Whilst some preferred in-person consultations, perceived benefits by stakeholders included reduced hospitalization rates (n  = 14), cost-savings (n  = 8) and high diagnostic accuracy (n  = 7). Studies investigating teledentistry using intra-oral cameras reported that teleconsultations were feasible with potentially high diagnostic accuracy (n  = 2), cost-savings (n  = 1) and patient acceptability (n  = 1). Conclusion There is limited published research on teledentistry, but wider telehealth research is applicable to teledentistry, with findings suggesting that telehealth technologies play a role in care homes consultations that are acceptable, cost-saving and with potential diagnostic accuracy. Further research is needed on the mode, utility and acceptability of teledentistry in care homes. [ABSTRACT FROM AUTHOR]

Background Controversy has surrounded MMR vaccination in the aftermath of Wakefield's 1998 paper suggesting links between MMR and the development of pervasive developmental disorder in children. The paper sparked off media debate and contributed to a lack of parental trust in health-care providers and reduction in MMR uptake. This review aims to identify and evaluate research on the subject, with a view to present the reasons behind, and influences on parental decision-making in relation to MMR. Methods Systematic search strategy identified 14 relevant papers on which thematic analysis was performed. Results Themes identified were categorized as follows: perceptions of risk; roles and responsibility; experience and knowledge. There were limited changes in parental decision-making factors over the time period despite an increase in uptake. Many studies fail to differentiate between accepters and rejecters, making it difficult to draw out clear conclusions. Conclusion Policymakers need to adapt information provided to address these concerns. Future research should focus more on distinguishing between accepters and rejecters to determine which factors can alter outcome. [ABSTRACT FROM AUTHOR]

Background The term 'long COVID' describes ongoing symptoms and conditions experienced by people infected with SARS-CoV-2. This paper illustrates how a public health approach was used to influence and inform the development of post-COVID services across two Integrated Care Systems (ICSs). Methods A literature review was conducted between October and December 2020 to identify prevalence estimates for long COVID. The prevalence estimates were applied to locally available data on the susceptible population to estimate the number of people with long COVID. They were also used to develop a dashboard to predict fluctuations in the number of people experiencing persistent symptoms over time. Results A substantial number of people in each ICS may have experienced persistent symptoms or complications as a result of COVID-19. In Lancashire and South Cumbria, it is estimated that 33 000 people may have experienced post-COVID-19 syndrome since the beginning of the pandemic, which will include respiratory or cardiovascular complications. Conclusions The findings have been valuable in informing early service developments, engaging with managers and clinicians, and supporting applications for funding at a local level. Continued attention to emergent evidence on this topic will be vital in refining estimates and supporting service planning in the longer term. [ABSTRACT FROM AUTHOR]

A recently published correspondence proposed a solution for survival in the context of Indonesia using a spiritual-philosophical perspective to fight the pandemic crisis. However, such principle can be too exclusive and restrictive in its application to the pandemic crisis. One must also consider the alternative approaches in solving the crisis from a multidisciplinary and multisectoral approach. This paper proposes the principle of 'human dignity' as an inclusive approach to humanitarian crisis. [ABSTRACT FROM AUTHOR]

Background In 2010, 240 billion US dollars was invested worldwide to conduct research for health; unfortunately, 200 billion was misused in the production and reporting of the evidence researched. Universities could facilitate students to acquire leadership competencies to move well-conducted research findings into practical use; this could be an essential move to reduce the misuse of investment. Methods A literature review was done based on the Equator Network and Cochrane guidelines, followed by three Delphi rounds to select competencies. Results Eleven papers were analysed out of 1121 items and 39/78 identified competencies were prioritized to be presented in the Delphi. Four out of 12 participants accepted to be involved in this project, and 22 competencies reached consensus and stability after three rounds. This framework conceptualizes competencies as the knowledge, skills, attitudes and values. The competencies were framed in four domains: knowledge management, engage diverse others in public health initiatives, training and capacity building/change management and communication. Conclusion This framework offers guidance to universities when instructing students with leadership competencies for KT. This project emphasizes that effective leadership should include personal conscience and self-determination values. [ABSTRACT FROM AUTHOR]

This paper describes the potential impact of the coronavirus disease 2019 (COVID-19) pandemic on the readymade garment (RMG) workers of Bangladesh. It articulates the RMG workers' existing vulnerability during the COVID-19 pandemic based on currently available evidence and personal conversations/communications with RMG workers. COVID-19 has already impacted RMG workers' health (both physical and mental health status) and wellbeing, and resulted in loss of employment. We argue that the COVID-19 pandemic will have long-lasting effects on the garment workers, especially related to their health issues, financial hardship and inability to pay for essentials such as food, and future employment opportunities. The stakeholders (such as the international retailers/brands, Bangladesh Garment Manufacturers and Exporters Association, Government of Bangladesh) responsible for the global supply chain RMG factories should reconsider the health and overall wellbeing needs of the RMG workers during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background Esports fans are a target audience for gambling companies wanting to attract the next generation of bettors to their products. As with other sports, professional esports teams have commercial sponsorship arrangements. Our paper seeks to document the level of gambling sponsorship of the world's top esports teams. Methods A systematic review of the commercial arrangements between the top 20 esports clubs across three of the most followed esports titles was undertaken: Dota 2, League of Legends (LoL) and CS:GO. Data were scraped online relating to the top 20 teams competing at their respective major tournaments between October and November 2021. Results Half of the esports teams in Dota 2 and CS:GO's world championship events in 2021 were sponsored by gambling companies. Teams sponsored by gambling companies have a combined total of 25 868 912 followers across three major social media channels. No LoL teams were sponsored by gambling companies, yet sibling teams within the CS:GO and Dota 2 competitions were. Conclusion The relationship between gambling companies' sponsorship in esports should be considered in line with the calls for change in the relationship between football and gambling with gambling as a public health issue at its heart. [ABSTRACT FROM AUTHOR]

This paper is a response to the recent correspondence published in this journal where the author rightly stated that need to redirect one's perception on the different realities of life such as death. This paper discusses the difficulties associated with loss, grief and healing in the time of COVID-19 pandemic. This paper further adds the importance of accompaniment to people experiencing the complicated grief process. The COVID-19 pandemic is affecting the way one overcome grief where the bereaved are required to grieve without the support of usual social, cultural and religious rituals. [ABSTRACT FROM AUTHOR]

Serbia's regional influence in the western Balkans enhanced strategic geopolitical partnership with Russia and China during COVID-19 pandemic. This paper critically analyzes Serbia COVID-19 vaccine strategy to the public health in the western Balkans. Importantly, this paper proposes strategic policy by enhancing 'joint coordinated EU–US-western Balkans COVID-19 vaccine manufacturing production' to accelerate inoculation, address gaps on vaccine hesitancy and promote long-term post-pandemic recovery plan to build back together and achieve herd immunity. [ABSTRACT FROM AUTHOR]

Background Diabetes in pregnancy is associated with miscarriage, stillbirth, congenital abnormalities, macrosomia and perinatal mortality. The demographics of the population becoming pregnant has changed (more obese and older women). More women are therefore entering pregnancy with undiagnosed diabetes. Aim To review the literature on HbA1c as a screening tool to identify undiagnosed diabetes in the first trimester of pregnancy. Methods A systematic search of the evidence was undertaken using specific search criteria from Cochrane Library, EMBASE, Medline, NICE Guidance, PROSPERO and PubMed. The initial search identified 319 papers, based on the inclusion and exclusion criteria eight papers were critically appraised. Results There is limited evidence on the use of HbA1c as a screening tool for undiagnosed diabetes in the literature during the first trimester of pregnancy. Although HbA1c is considered a useful test for diabetes in the non-pregnant population the hormonal and metabolic changes that occur in pregnancy mean that there are many limitations in pregnancy. Furthermore, HbA1c levels are affected by iron deficiency which is common in pregnancy. Conclusions and recommendations There is insufficient evidence to suggest a change in practice to include offering HbA1c screening for undiagnosed diabetes in the first trimester. [ABSTRACT FROM AUTHOR]

This article reports and reflects on an element of a recent survey of UK public health professionals, specifically in relation to the Public Health Knowledge and Skills Framework (PHSKF) and the ethical requirements that underpin public health practice. Only 38.4% of respondents reported accessing the PHKSF and a mere 13.7% reported accessing the accompanying background paper on ethical public health practice. Given that ethical practice underpins the PHSKF, it is concerning that so few respondents are familiar with the PHSKF and one of the source documents. While issuing frameworks and guidance is one way to support public health practice, there is a further need for greater integration of skills and knowledge around ethical public health practice within education and training initiatives. [ABSTRACT FROM AUTHOR]

Background This paper aims to document the numerous health innovations developed in response to the COVID-19 crisis in the Eastern Mediterranean Region (EMR) using a scoping review approach. Methods A literature search was conducted using PubMed, the Eastern Mediterranean Health Journal, the Index Medicus for EMR to identify peer-reviewed articles between December 2019 and November 2020 and WHO and ministries of health websites for grey literature. Following an initial review, full-text screening identified studies reporting on health innovations in response to the COVID-19 pandemic in the region. Results This review describes 82 health innovations reported from 20 countries across the region: 80% (n  = 66) were digital and technology-based products and services including health care delivery (n  = 25), public health informatics (n  = 24) and prevention (n  = 17); 20% (n  = 16) were innovative processes including health care delivery (n  = 8), educational programmes (n  = 6) and community engagement (n  = 2). Conclusion The speed with which these technologies were deployed in different contexts demonstrates their ease of adoption and manageability and thus can be considered as the most scalable. Strengthened frameworks to protect users' privacy, documentation and evaluation of impact of innovations, and training of health care professionals are fundamental for promoting health innovations in the EMR. [ABSTRACT FROM AUTHOR]

Background Valuable learning derived from public health practice can be captured through practice-based case studies, also known as practice examples. Practice examples of participatory interventions supplement the evidence base by providing information on the complexities of implementation in communities. This paper reports on a Public Health England project to build a bank of community-centered practice examples based on robust processes of collection and curation. Methods The multidisciplinary project had three phases: (i) development and piloting a process to collect practice examples, (ii) refining review processes and gathering further examples via national and regional teams (iii) maintenance of an accessible collection on the library platform. Results The project resulted in a searchable collection of 55 practice examples illustrating participatory approaches in public health practice. The collection shows diversity in terms of settings, population, focus and type of approach used to work with communities. A secondary outcome was the development of generic guidance and templates for further collections on public health topics. Conclusions This project illustrates how information on the implementation of community-centered approaches in real-life contexts can be gathered and disseminated through a transferable process. Having collections of practice examples supports knowledge exchange in public health as learning is shared. [ABSTRACT FROM AUTHOR]

Background Chronic disease is a significant burden on the global population. The Helping Everyone Achieve Long Term Health (HEALTH) Passport is a paper-based approach previously utilized to help adults modify clinical risk factors through lifestyle, which may be effective in improving the long-term health of school-age children. This study investigates the feasibility of in-school use by engaging trainee teachers in primary and secondary education. Methods Two hundred and fifty six unique responses were collated to evaluate current teaching of the main health risk factors and HEALTH Passports specifically adapted for schools. Trainees attended workshops with pre- and post-questionnaires used to measure training efficacy and evaluate the Passports' suitability for in-school use. Narrative analysis of feedback was performed. Results Feedback received for both Passports was positive overall. Trainees highlighted the need for the Passports to be further age differentiated. Significantly increased confidence (P  < 0.01) in knowledge of exercise, type 2 diabetes, weight and blood pressure was shown. Confidence in smoking, drugs and alcohol knowledge was reduced highlighting the requirement for further teacher training. Conclusions The HEALTH Passport has potential as an intervention to improve health literacy in school-age children. Age adaptation is needed with references to weight measures removed. Emotional well-being should be focused on, and data management stringently assessed for child protection. [ABSTRACT FROM AUTHOR]

While attention to the ethical issues that migrants face in accessing tuberculosis care has increased in the last few years, most of the attention has focused on challenges that refugees face when emigrating. Less attention has been given to ethical challenges that arise in the context of providing tuberculosis treatment and care to non-refugee migrants in high-income countries (HIC), particularly those that do not face immediate danger or violence. In this paper, we analyze some of the ethical challenges associated with treating migrants with tuberculosis in the Canadian context. In particular, we will discuss (i) inter- and intra-jurisdictional issues that challenge quotidian public health governance structures, and (ii) the ethical imperative for the Canadian government and its provinces to clearly differentiate access to healthcare from a person's immigration status to help overcome power imbalances that may exist between public health workers and their clients. The arguments presented herein could potentially apply to other HIC with some form of universal health coverage. [ABSTRACT FROM AUTHOR]

Background South-East Asia is a densely populated region, comprising of 11 low- and middle-income countries and contributing to 39% of global suicides. There are serious challenges to suicide prevention in the region such as lack of high-quality suicide data, underreporting and poor quality of media reporting. The current report aimed to assess the variations in newspaper reporting of suicidal behavior in the World Health Organization–South-East Asian countries. Methods We analyzed the contents of nine research articles on media reporting of suicide, published from four South-East Asian countries (four from Bangladesh, three from India, one each from Indonesia and Bhutan) that used similar methods and presented results in a nearly similar fashion. Results Personal identifying information of the deceased was very frequently mentioned in the newspaper reports across the countries. Suicide notes were reported more commonly in India (9.5–18%) than Bangladesh (4.2–7.5%) and Indonesia (9.5%). No educative material was found in any of the newspaper reports of Bangladesh and Indonesia while it was rarely reported in Bhutan and India. Conclusion Our findings from the four South-East Asian countries suggest that there are variations between the countries while presenting the news reports of suicidal behavior. These findings would help to formulate and regulate the media guidelines for the specific country. [ABSTRACT FROM AUTHOR]

Background Waste pickers are considered a vulnerable population at risk for potential health damage. Taking into account the risk of hepatitis B or C infection in this population, the aim of this study was to show the prevalence of these diseases in waste pickers from South America, through a systematic review. Methods The search covered publications until February 2020, accessed through Google Scholar database. Epidemiological studies on hepatitis B or C focused on waste pickers in South America were included. All selected papers were evaluated for quality. Results Six studies composed this systematic review, all conducted in Brazil and using cross-sectional study. The prevalence of all makers (HBsAg or anti-HBc) for hepatitis B varied from 4.3 to 33.4% while for hepatitis C varied from 1.6 to 12.4%. Conclusion The lack of results showed the requirement for more research about hepatitis including this informal workers group. High prevalences of hepatitis B and C in waste pickers highlighted the need of increase preventive health protection as vaccination against hepatitis B; training on working conditions; and the use of individual protection. [ABSTRACT FROM AUTHOR]

The article discusses digital-based approach in the international traffic and international border control measures in containment and mitigation of COVID-19. Topics discussed include WHO interim position regarding proof of vaccination and guidance to standardization of paper of COVID-19; agreement reached with the European Parliament on the EU digital COVID certificate; and scientific, ethical and legal aspects of digitalization.

Background This paper concerns the spatial determinants of the first two waves of COVID-19 at the neighbourhood level. Methods Using data for the first and second waves of COVID-19 at the neighbourhood level in Barcelona, we analyse whether local characteristics acted in the same way during the two waves and identify typologies of areas depending on such determinants. Univariate and bivariate local Moran's I and count data models are used. Results Some structural effects at the neighbourhood level consistently either boost (e.g. population density) or reduce (e.g. income) COVID-19 cases. Other effects differ between the two waves (i.e. age composition, schools and transport infrastructures). Conclusions Since certain characteristics influenced the virus diffusion in opposite ways between the two pandemic waves, territorial heterogeneity alone is insufficient to explain COVID-19 outbreaks—individual behaviour also needs to be factored in. Consequently, both econometric and spatial analysis techniques are recommended for tracking the spatiotemporal spread of this disease and for monitoring the effectiveness of policy measures across heterogeneous neighbourhoods. [ABSTRACT FROM AUTHOR]

Background Child malnutrition remains a matter of concern in India as the current levels are high and the decline is slow. National Family Health Survey (NFHS–4, 2015-16) data, for the first time, provides credible, good quality data at district level on social, household and health characteristics. Methods Techniques of spatial analysis on data in respect of 640 districts were used to identify spatial characteristics of the nutrition levels for children in the 0–60-month age group. Further, the principal component analysis (PCA) was used to identify 7 important correlates of the malnutrition out of 21 relevant components provided in the NFHS-4. The paper further uses three techniques, ordinary least squares (OLS), spatial lag model (SLM) and spatial error model (SEM) to assess the strength of correlation between the malnutrition levels and the shortlisted correlates. Results The use of SLM and SEM shows improvement in the strength of the association (high R -square) compared to OLS. Women's height and Iodized salt in stunting, child anaemia in wasting, women's height and child anaemia in underweight were found to be significant factors (P  < 0.01) along with spatial autoregressive constant. Conclusions Such analysis, in combination with PCA, has shown to be more effective in prioritizing the programme interventions for tackling child malnutrition. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Public Health is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Supporting patients to access community-based support may be a key intervention to address the wider determinants of health. There is a lack of evidence synthesis around the most effective methods for linking individuals from health services to organizations within communities, especially those aimed at supporting families with young children. Methods Papers were identified from seven databases covering peer-reviewed and grey literature. The Effective Public Health Practice Project and the Critical Appraisal Skills Programme Qualitative quality appraisal tools were used to assess methodological quality. Thematic narrative data synthesis based on study quality was performed. Results Twenty-four unique publications were included in the review with a range of study designs and variable methodological quality. A broad typology of intervention processes for undertaking linking was developed defining three distinct approaches: signposting, referral and facilitation. Active processes, such as facilitation, appeared more successful at linking families to community support. Conclusions This was the first systematic review to focus on interventions that link families with young children to community-based support organizations. It identified a typology for linking interventions, and whilst there were limitations in the quality of evidence available, it showed a tendency for more active interventions to be more effective in linking families to community support. [ABSTRACT FROM AUTHOR]

Background Lowering the strength of alcohol products could lead to less alcohol being bought and drunk. In its prevention White Paper, the UK Government aims to promote a significant increase in the availability of alcohol-free and low-alcohol products by 2025. Methods Through descriptive analysis and ARIMA modelling of >4 million alcohol purchases from 69 803 British households, we study the potential impact of lower strength alcohol products in reducing household purchases of grams of alcohol over 2015–2019. Households are divided into predominantly beer, wine or spirits purchasers. Results Over 5 years, there were decreases in purchases of grams of alcohol within beer amongst beer-purchasing households and increases in purchases of grams of alcohol within wine and spirits amongst, respectively, wine- and spirits-purchasing households. Almost all the changes were due to beer-purchasing households buying less regular strength beer, and wine and spirits-purchasing households buying, respectively, more regular strength wine and spirits, rather than increases in purchases of no- and low-alcohol products. Conclusions In general, lower strength alcohol products have not contributed to British households buying fewer grams of alcohol over the 5-year follow-up period during 2015–2019. [ABSTRACT FROM AUTHOR]

Aims Decision makers in public health practice and policy rely on access to trustworthy, relevant, synthesized evidence. The second edition of the Cochrane Handbook for Systematic Reviews of Interventions ('the Handbook') reflects a major revision in guidance for authors of systematic reviews, incorporating a decade of methodological development and a number of significant changes to previous recommendations. This paper aims to highlight new guidance that addresses a number of key methodological challenges for authors of systematic reviews in public health. Results The revised Handbook includes guidance on framing public health research questions for synthesis, considering equity, intervention complexity, risk of bias assessment and synthesis methods other than meta-analysis. Reviews of public health interventions frequently encounter the types of methodological complexity addressed in this new guidance. Conclusion We hope that readers will find that the Cochrane Handbook includes detailed and thoughtful guidance on both conceptualizing and executing systematic reviews relevant to public health questions. Considering the available methods guidance will, we hope, provide support for authors of public health reviews to tackle the challenges they encounter, strengthen their analysis and provide useful answers to the important questions asked by stakeholders and users of public health evidence. [ABSTRACT FROM AUTHOR]

Background Blockchain technology has made great strides in many industries but has yet to impact the world of public health. Population health issues such as outbreak surveillance and controlled substance tracking during emergencies all require a secure, easily accessible database. While the healthcare industry is typically slow to adapt to change, blockchain technology lends itself well to many healthcare issues. Methods We utilized a 3D framework using difficulty, novelty and necessity to examine the adoption of blockchain technology in population health, based on the 2D framework of difficulty and novelty as driving factors for the development of foundational technologies in the world of business by Iansiti and Lakhani in The Harvard Business Review. Results We find that by implementing the third dimension of necessity into an evaluation framework, we can better predict the adoption of technology. We found how different areas of population health fit into the evaluation framework and how necessity can eliminate barriers from implementing novel technologies. Conclusion The byproduct of this paper will be the extension of the Iansiti and Lakhani framework. We will show that blockchain, in all of these domains, shows promise to improve population health as we move past COVID-19 and into the future of healthcare. [ABSTRACT FROM AUTHOR]

Background Smoking rates in Greece are the highest recorded among OECD countries, but the historical and life-course evolution of smoking patterns is largely unknown. The present paper addresses this gap. Methods We produce nationally representative life-course trajectories of smoking and related mortality of eight generations of Greek men and women. We estimate the smoking–mortality correlation conditional on several confounders and project the estimates forward. Results We show that smoking prevalence among Greek men has plateaued at >60% for all but the youngest generation. For women, smoking prevalence is relatively lower, lags by several generations and follows a hump-shaped pattern. Smoking-attributable mortality is currently peaking for men (nearing 40% of total deaths) and is rising for women. We estimate that it takes ~20 years of smoking to maximize the smoking–mortality correlation (at 0.48 for men and 0.32 for women). Based on this estimation, we forecast that mortality rates will begin falling within the current decade. Conclusions The breadth of the Greek smoking epidemic has been high by international standards, reflecting the ineffective tobacco control efforts in the country. While smoking popularity fell during the Great Recession, policy vigilance is necessary to prevent a relapse once the economy recovers. [ABSTRACT FROM AUTHOR]

Introduction Healthcare workers' work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study's quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Association of Southeast Asian Nations (ASEAN) centrality playing a significant role addressing COVID-19 relief. Topics include public health security among vulnerable communities in Southeast Asia through cross-border, inter-regional and joint multilateral cooperation; and COVID-19 emergency vaccine task addressing the gaps in global COVID-19 vaccine equity.

Suicide is a leading cause of death worldwide. Even before the emergence of the novel coronavirus SARS-CoV2 COVID-19 pandemic, suicide continued to be a major public health concern. Globally, someone dies by suicide every 40 s, and for each death, there are 20 more persons attempting suicide. A recently published article rightly stated the need for a 'population-based approach' to suicide prevention to mitigate suicide attempts. This paper further adds that there must be a stronger multi-agency or multi-sectoral approach to suicide prevention, intervention and postvention. This paper concludes with few suggestions on how to address the COVID-19-related suicide cases as the world continues to fight against the double pandemic. [ABSTRACT FROM AUTHOR]

Background In April 2020, Covid-19 brought NHS elective procedures to a halt. The aim of this paper is to produce accurate forecasts on the building backlog, highlight the state of waiting lists currently and propose solutions required to prevent a public health crisis. Method Using data published by NHS digital and NHS England on previous years, we have analysed and used this to produce estimates of cancellations and missed cases. We also analyse government data on waiting lists and show compliance or lack of with these. Results We show that compliance with waiting list times pre pandemic was falling year on year (83.2% in 2020 down from 87% in 2019). Every month that passes we estimate that 400 000 cases are not being performed. This may include urgent cancer care work in some trusts. Conclusions Waiting lists have been governed by strict rules since 2004. Given falling compliance with 18-week intention to treat we believe the scale of the backlog combined with NHS capacity diminished due to Covid-19 precautions is a public health crisis waiting to occur. We identify difficulties in resuming elective work and suggest strategies that could be employed to avoid a public health crisis. [ABSTRACT FROM AUTHOR]

Background During the coronavirus disease 2019 (COVID-19) pandemic, all European countries were hit, but mortality rates were heterogenous. The aim of the current paper was to identify factors responsible for this heterogeneity. Methods Data concerning 40 countries were gathered, concerning demographics, vulnerability factors and characteristics of the national response. These variables were tested against the rate of deaths per million in each country. The statistical analysis included Person correlation coefficient and Forward Stepwise Linear Regression Analysis (FSLRA). Results The FSLRA results suggested that 'days since first national death for the implementation of ban of all public events' was the only variable significantly contributing to the final model, explaining 44% of observed variability. Discussion The current study suggests that the crucial factor for the different death rates because of COVID-19 outbreak was the fast implementation of public events ban. This does not necessarily mean that the other measures were useless, especially since most countries implemented all of them as a 'package'. However, it does imply that this is a possibility and focused research is needed to clarify it, and is in accord with a model of spreading where only a few superspreaders infect large numbers through prolonged exposure. [ABSTRACT FROM AUTHOR]

Many of the academic papers that discussed the COVID-19 pandemic sought to present a reasonable analysis of the crisis and its underlying implications in government policies (for social and environmental reformations) and individual actions either in the present context or future. This paper attempted to contextualize the COVID-19 crisis through the lens of the Darwinian struggle for life and the philosophical notion of suffering while stressing the importance of defects admission. Generally, the author argues that these concepts are the primary roots of other dimensions of COVID-19-related studies. [ABSTRACT FROM AUTHOR]

In response to an article published in this journal where the authors systematically reviewed the impact of shifted norms and practices due to the COVID-19 pandemic on the mental health of people, this paper explores this aspect within a more specific set of the population—the law students. It addresses the impact of transition from physical face-to-face classes to a virtual online platform on their psychological wellness and coping mechanism. In the end, the paper mentions strategies that the law students may adopt amid the lack or absence of physical interaction with professors, classmates and friends. [ABSTRACT FROM AUTHOR]

Coastal communities have received little attention in the public health literature, perhaps because our mental maps tend to associate socio-economic deprivation and health inequalities with inner cities. Mapping a range of key health indicators at small area level, this paper reveals a distinct core-periphery pattern in disease prevalence, with coastal communities experiencing a high burden of ill health across almost all conditions included in the Quality and Outcomes Framework dataset. Other sources suggest poor outcomes for children and young people living in coastal areas. Low rates of participation in higher education contrast with high rates of hospitalisation for self-harm, alcohol and substance use. Reflecting a shift in the distribution of children living in poverty since the 1990s, this may be an early indicator of a future public health crisis in these communities. Exploring reasons for the health challenges facing the periphery, this perspective piece calls for more public health research that can accommodate the complex and interlinked problems facing coastal communities and a more concerted effort to align public health with economic, education, local government and transport policies at the national level. [ABSTRACT FROM AUTHOR]

Background The purpose of this paper is to discuss the history of cannabis, its benefits, risks and the federal re-legalization of cannabis for medical use in the USA. Methods Thirty-six states have legalized cannabis as a medicinal substance. Cannabis is a Schedule I drug, an illegal and controlled substance, making research on the substance challenging. Both the American Medical Association and the American Nurses Association have called for the re-scheduling of marijuana, so that research can be conducted, its benefits and risks discovered. Results Data are demonstrating that medical marijuana may be beneficial as a step-down drug, decreasing the use of opioids and benzodiazepines, as well as deaths related to their overdose. Studies have indicated that cannabis is a low-risk substance, when compared to alcohol and opioids. There appear to be specific conditions in which cannabis provides relief of symptoms which no other medications can provide. There is also evidence of cannabis's negative effects on the developing brain. Conclusion Cannabis should be rescheduled and researched, so that its risks and benefits can be identified. Its medicinal use should be monitored, and its availability protected in children, pregnant women and pets. [ABSTRACT FROM AUTHOR]

This paper reacts to the proposal of Virgilio Rivas with respect to the role of art as a response to the threat of meaning that was brought forth by the COVID-19 pandemic. It will be argued that the purported new normal in which changes in the ways of life of people had been expected never actually occurred post-pandemic as power and economic interests still dominate the global order. The pandemic, in this regard, was simply a short pause from the hegemonic relationship among nations in the global order. The paper maintains that, in the end, people must continue to pursue human decency. [ABSTRACT FROM AUTHOR]

Prisons offer policymakers an opportunity to address the pre-existing high prevalence of physical and mental health issues among prisoners. This notion has been widely integrated into international and national prison health policies, including the Healthy Prisons Agenda, which calls for governments to address the health needs of prisoners and safeguard their health entitlement during imprisonment, and the Sustainable Development Goals 2030 concerning reducing inequality among disadvantaged populations. However, the implementation of the austerity policy in the United Kingdom since the re-emergence of the global financial crisis in 2008 has impeded this aspiration. This interdisciplinary paper critically evaluates the impact of austerity on prison health. The aforementioned policy has obstructed prisoners' access to healthcare, exacerbated the degradation of their living conditions, impeded their purposeful activities and subjected them to an increasing level of violence. This paper calls for alternatives to imprisonment, initiating a more informed economic recovery policy, and relying on transnational and national organizations to scrutinize prisoners' entitlement to health. These systemic solutions could act as a springboard for political and policy discussions at national and international forums with regard to improving prisoners' health and simultaneously meeting the aspirations of the Healthy Prisons Agenda and the Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Background Exposure to cold is known to be associated with severe health impacts. The primary epidemiological evidence for this is the seasonal variation in mortality. However, there is a paucity of directly measured data for personal cold temperature exposure. This paper develops the concept of experienced temperature, and reports how it varies with season, demographics and housing factors. Methods This study uses data from 77 743 UK Biobank participants. A novel method to directly measure participant's exposure to low temperatures using a thermistor in a wrist-worn activity monitor is described. These readings are combined with demographic and housing factor variables in a multiple regression model to understand underlying relationships. Results The study reveals a significant difference in experienced temperature of ~1.8°C between the periods of coldest and hottest external temperature. A number of demographic differences were also observed—such as people of Chinese ethnic background experiencing 0.65°C lower temperatures than other groups. Conclusions This paper presents primary evidence for a seasonal variation in experienced temperature. This variation likely contributes to cold related mortality and morbidity. It is hypothesized that this relationship would be less strong in countries which suffer fewer impacts of cold winter temperatures. [ABSTRACT FROM AUTHOR]

Public health ethics is a distinct and established field, and it is important that its approaches and rationales are understood widely in the public health community. Such understanding includes the capacity to identify and combine principled and practical concerns in public health. In this paper, we present a background to the ideas that motivate public health ethics as a field of research and practice, and rationalize these through a critical ethico-legal approach to analysis. Two essential points of inquiry are identified and formulated to allow philosophical and practical agendas regarding public health to be combined. These come through asking the theoretical question 'what makes health public?'; and the practical question 'how do we make health public?'. We argue that these two questions require to be addressed if we are to achieve a robust and rigorous, ethical public health. [ABSTRACT FROM AUTHOR]

COVID-19 has already killed more than one million people around the world. The pandemic had a profound impact on the emotional, social and spiritual life of the public. Due to self-isolation, prohibition of mass-gatherings and quarantine protocols, hospitals and healthcare facilities are closed to visitors. Clergy members are unable to be physically present with sick in their final moments. Many families cannot say goodbye to their loved ones, many people cannot attend funeral rites and many people cannot perform their final mourning rituals. These complicated situations have not only distressed some family members but also someone who is close to death. In this time of crisis, it is important to implore the global community to reflect on the unique and unusual process of grieving. This paper is a response to the recent correspondence published in this journal where the author noted the changing landscapes of death and burial practices in the context of COVID-19. This paper further adds to the emerging and complicated process of death, dying and grief and ways of coping with loss in the context of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background This paper presents insights into patient experiences of changes in workforce composition due to increasing deployment in general practice of practitioners from a number of different professional disciplines (skill mix). We explore these experiences via the concept of 'patient illness work'; how a patient's capacity for action is linked to the work arising from healthcare. Methods We conducted four focus group interviews with Patient Participation Group members across participating English general practitioner practices. Thematic analysis and a theoretical lens of illness work were used to explore patients' attempts to understand and navigate new structures, roles and ways to access healthcare. Results Participants' lack of knowledge about incoming practitioners constrained their agency in accessing primary care. They reported both increased and burdensome illness work as they were given responsibility for navigating and understanding new systems of access while simultaneously understanding new practitioner roles. Conclusions While skill mix changes were not resisted by patients, they were keen to improve their agency in capacity to access, by being better informed about newer practitioners to accept and trust them. Some patients require support to navigate change, especially where new systems demand specific capacities such as technological skills and adaptation to unfamiliar practitioners. [ABSTRACT FROM AUTHOR]

Background For effective Public Health measures, factors that influence Knowledge, Attitudes and Practices (KAP) need to be understood. In this paper, we document the relationship between levels of education on the KAP towards COVID-19 among the population of Edo State, Nigeria. Methods A cross-sectional KAP questionnaire was delivered across 13 communities. The study population was dichotomized into those who had or had not completed secondary education. Chi-square tests were conducted to determine statistical significance. Results Of the 538 participants, 30% had completed secondary education. Those with secondary education were significantly more likely to recognize symptoms of COVID-19 (P  < 0.001). For attitudes, only one option showed a statistically significant association with 78.4% of those who did not complete secondary education having a high confidence in the church compared with 66% of those who had (P  = 0.022). For practices, those who have completed secondary education practiced all of the supplied measures more than those who had not, except for taking herbal supplements. Discussion Higher levels of education impacts on knowledge and practices but has less impact on attitudes regarding how well certain individuals/organizations can handle the pandemic. Findings highlighted the importance of tailoring public health communication and strategies to local populations to improve the efficacy. [ABSTRACT FROM AUTHOR]