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Aim: There is both favorable and controversial evidence on the application of telemedicine in the emergency department (ED), which has created uncertainty regarding the effectiveness of these systems. We performed a systematic review of the literature on systematic reviews to provide an overview of the benefits and challenges to the application of telemedicine systems for the ED. Subject and methods: PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were explored for systematic reviews of telemedicine applications for the ED. Each review was critically appraised by two authors for data items to be extracted and evaluated. The most highly recommended technology, feasibility, benefits, and challenges to the application of telemedicine systems were studied and reported. Results: We identified 18 studies of varying methodological quality and summarized their key findings. Form these 18 studies, 12 papers yielded a high risk of bias in their investigation. Nine papers concluded that real-time video conferencing was the best method of delivery, eight papers found cost reduction as an outcome of implementing these systems, and six studies found technical and infrastructure issues as a challenge when implementing telemedicine for EDs. Conclusion: There is strong evidence suggesting that the use of telemedicine positively impacts patient care. However, there are many challenges in implementing telemedicine that may impede the process or even impact patient safety. In conclusion, despite the high potential of telemedicine systems, there is still a need for better quality of evidence in order to confirm their feasibility in the ED. [ABSTRACT FROM AUTHOR]

Aim: This paper investigates the effect of a religious holiday (Eid-ul-Fitr in Pakistan) on compliance behaviour instituted during the COVID-19 pandemic. Longstanding religion-based norms of behaviour during the Eid holidays (traveling to meet family members, praying in large gatherings, hugging) may counteract newly established (and weaker) norms of health-preserving behaviours. Method: We study the impact of Eid-ul-Fitr on compliance with COVID guidelines for a sample of university students. Our effects are identified by unprompted delays in fielding a survey measuring compliance with prescribed behaviours. Results: We find that compliance with guidelines declines immediately after the religious holiday in our sample of students, with no observable decline in other well documented predictors of compliance behaviour (risk perceptions, trust in the authorities). We find that this decline in compliance is largely attributable to male participants, with one important exception. We further confirm our results by conducting robustness checks incorporating matching techniques and a smaller follow-up study where we randomize invitations to the survey. Conclusion: We conclude that amid the pandemic, newly formed norms pertaining to healthcare guidelines (focusing on social-distancing) emerged, and were subsequently undercut by longstanding norms of behaviour following a religious celebration: Eid-ul-Fitr. This paper underscores the fragility of these newly emerged norms, especially when challenged by a more well-entrenched, traditional norm. [ABSTRACT FROM AUTHOR]

Aim: The aim of the paper is to enhance understanding of how members of the public make sense of the Covid-19 vaccines and to understand the factors influencing their attitudes towards such artefacts of pandemic governance. Methods: The paper draws on 23 online in-depth interviews with members of the UK public and builds on relevant literature to examine participants' perceptions of the benefits and risks of Covid-19 vaccines, the sources that have shaped their attitudes, and the level of trust they have towards the government's handling of the pandemic through vaccines. Results: The findings indicate that participants generally felt that the benefits of having the vaccine outweigh the risks and that Covid-19 vaccines are a crucial mechanism for enabling society to return to normal. Vaccine acceptance was, for some, strongly linked to a sense of social responsibility and the duty to protect others. However, some participants expressed concerns with regard to the side-effects of Covid-19 vaccines and their perceived potential impact on fertility and DNA makeup. Participants used various sources of information to learn about Covid-19 vaccines and understand their function, benefits, and risks. The majority of participants criticised the government's response during the early stages of the pandemic yet felt positive about the vaccine rollout. Conclusion: Just as with any other vaccination programme, the success of the Covid-19 immunisation campaigns does not only depend on the efficacy of the vaccines themselves or the ability to secure access to them, but also on a myriad of other factors which include public compliance and trust in governments and health authorities. To support an effective immunisation campaign that is capable of bringing the pandemic to an end, governments need to understand public concerns, garner trust, and devise adequate strategies for engaging the public and building more resilient societies. [ABSTRACT FROM AUTHOR]

Background: In Germany there is a large wealth gap between East and West Germans as well as a gap in life satisfaction, with people in East Germany reporting to be less satisfied. This paper intends to shed light on the role of the different levels of wealth and their association with life satisfaction. On a wider scale, this paper examines psychological consequences of wealth inequality between large societal groups. Method: Longitudinal data from the years 2007, 2012, and 2017 of the German Socio-Economic Panel (GSOEP) with a sample size of N = 5066 (Nfemale = 2522, Nwest = 3756, mage2007 = 50.46) was used. To test our hypothesis, multiple linear regression models as well as a fixed-effects regression model were run. Furthermore, to examine the development of wealth distribution between different birth cohorts in East and West Germany a latent growth curve model was calculated. Results: Net-worth was found to be a highly significant predictor for life satisfaction. This holds true for variance between respondents as well as for individual change over time within respondents. Additionally, the results show that the wealth gap between East and West Germans in total as well as within most of the birth cohorts increased. Conclusion: Due to their socialistic history and the related obstacles in acquiring wealth as well as the unbalanced distribution of GDR-assets after the reunification, East Germans are significantly less wealthy than West Germans. This has consequences on the mental well-being and the life satisfaction of East Germans. [ABSTRACT FROM AUTHOR]

Main: Electronic health record (EHR) applications are digital versions of paper-based patient health information. Traditionally, medical records are made on paper. However, nowadays, advances in information and communication technology have made it possible to change medical records from paper to EHR. Therefore, preserving user data privacy is extremely important in healthcare environments. The main challenges are providing ways to make EHR systems increasingly capable of ensuring data privacy and at the same time not compromising the performance and interoperability of these systems. Subject and methods: This systematic mapping study intends to investigate the current research on security and privacy requirements in EHR systems and identify potential research gaps in the literature. The main challenges are providing ways to make EHR systems increasingly capable of ensuring data privacy, and at the same time, not compromising the performance and interoperability of these systems. Our research was carried out in the Scopus database, the largest database of abstracts and citations in the literature with peer review. Results: We have collected 848 articles related to the area. After disambiguation and filtering, we selected 30 articles for analysis. The result of such an analysis provides a comprehensive view of current research. Conclusions: We can highlight some relevant research possibilities. First, we noticed a growing interest in privacy in EHR research in the last 6 years. Second, blockchain has been used in many EHR systems as a solution to achieve data privacy. However, it is a challenge to maintain traceability by recording metadata that can be mapped to private data of the users applying a particular mapping function that can be hosted outside the blockchain. Finally, the lack of a systematic approach between EHR solutions and existing laws or policies leads to better strategies for developing a certification process for EHR systems. [ABSTRACT FROM AUTHOR]

Aim: To examine the risk of non-steroidal anti-inflammatory drug-induced heart failure in patients with chronic kidney disease. Methods: Embase, Medline, CENTRAL, Web of Science, and Google Scholar were searched for papers published in English between 1st January 1999 and 31st May 2020. Papers were included if some participants had chronic kidney disease, were exposed to non-steroidal anti-inflammatory drugs, and where heart failure was measured as an outcome. Papers were assessed for risk of bias using the Cochrane Risk of Bias 2 tool for randomised controlled trials, and ROBINS-I for observational studies. Results: A total of 2480 independent papers were retrieved. Following abstract screening, 165 full texts were reviewed to identify seven eligible papers: two randomised controlled trials, four cohort studies, and one case-control study. For chronic kidney disease (stage 3–5), relative risk for heart failure ranged from 0.3 to 1.9 with 95% confidence interval 0.04 to 15.1. Results were not pooled due to study heterogeneity. We attributed bias to heterogenous populations studied, probable confounding due to partially adjusted risk estimates, and heterogenous measurement of the heart failure outcome. Conclusion: Overall, there are only a few studies to refute or support an increased risk of heart failure associated with taking non-steroidal anti-inflammatory drugs in patients with chronic kidney disease, and therefore no robust evidence was available. [ABSTRACT FROM AUTHOR]

Background: While it is a generally accepted fact that many gambling screening tools are not fit for purpose when employed as part of a public health framework, the evidence supporting this claim is sporadic. The aim of this review is to identify and evaluate the gambling screening tools currently in use and examine their utility as part of a public health approach to harm reduction, providing a holistic snapshot of the field. Methods: A range of index tests measuring aspects of problem gambling were examined, including the South Oaks Gambling Screen (SOGS) and the Problem Gambling Severity Index (PGSI), among others. This review also examined a range of reference standards including the Diagnostic Interview for Gambling Severity (DIGS) and screening tools such as the SOGS. Results: The present review supports the belief held by many within the gambling research community that there is a need for a paradigm shift in the way gambling harm is conceptualised and measured, to facilitate early identification and harm prevention. Discussion: This review has identified a number of meaningful deficits regarding the overall quality of the psychometric testing employed when validating gambling screening tools. Primary among these was the lack of a consistent and reliable reference standard within many of the studies. Currently there are very few screening tools discussed in the literature that show good utility in the domain of public health, due to the focus on symptoms rather than risk factors. As such, these tools are generally ill-suited for identifying preclinical or low-risk gamblers. [ABSTRACT FROM AUTHOR]

Aim: We conducted a systematic review and meta-analysis to analyse gender differences in COVID-19 vaccination intentions. Subject and methods: PubMed, Web of Science and PsycInfo were searched (November 2020 to January 2021) for studies reporting absolute frequencies of COVID-19 vaccination intentions by gender. Averaged odds ratios comparing vaccination intentions among men and women were computed. Descriptive analyses of the studies were reported. Results: Sixty studies were included in the review and data from 46 studies (n = 141,550) were available for meta-analysis. A majority (58%) of papers reported men to have higher intentions to get vaccinated against COVID-19. Meta-analytic calculations showed that significantly fewer women stated that they would get vaccinated than men, OR 1.41 (95% CI 1.28 to 1.55). This effect was evident in several countries, and the difference was bigger in samples of health care workers than in unspecified general population samples. Conclusion: This systematic review and meta-analysis found lower vaccination intentions among women than men. This difference is discussed in the light of recent data on actual vaccination rates in different countries. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to provide a synthesis of prior research of estimates of the willingness to pay (WTP) for chronic disease treatment and examines the impact of economic and political institutions, cultures, and other important factors on WTP. Subject and method: The paper applies meta-regression analysis to 1053 estimates of WTP from 188 medical treatment studies from 40 countries. Results: The results suggest that patients assign higher values for medical treatment in more capitalistic and more democratic countries. Cultural traits also appear to matter, with higher WTP in societies characterized by individualism and indulgence. Further, disease types matter. Compared to cancer, WTP is lower for diabetes, obesity, asthma, and heart disease treatment, but higher for amyotrophic lateral sclerosis therapy. GDP per capita is positively associated with WTP. The higher public health expenditure is in a country, the higher citizens value health benefits. If individuals expect to live longer, then they will spend less on their health. The published studies estimate a lower value than unpublished studies. Conclusion: This paper presents a comprehensive synthesis of estimates of chronically ill patients' WTP for medical treatment and identifies the key factors determining WTP through a meta-regression analysis. The main finding is that economic and political institutions, cultural traits, the types of disease, socio-economic characteristics, and valuation methods all influence WTP estimates. [ABSTRACT FROM AUTHOR]

Purpose: High physical fitness and good health are not only essential for the civilian population but also for persons working in physically and psychologically demanding professions, such as armed forces personnel. To date there is no scientific summary of studies dealing with the physical activity of daily life in armed forces personnel, but this is necessary for a targeted intervention. Methods: A systematic review was performed in the PubMed database (target date: 24 May 2020), using the search terms "military personnel" and "exercise" or "(physical) activity of daily life" including the assigned MESH words. Results: Seven original papers have focused on the daily physical activity of military personal, and they were all conducted in different countries. The activity of daily life was on average 11,540 steps per day. Conclusions: It could be shown that soldiers performed more physical activity than the civilian population and that the recommended 10,000 steps per day were slightly exceeded on average. However, the number of steps performed was very low in fields of activity with limited physical activity options, such as on board a ship. Altogether, it thus seems that additional health-promoting physical activity programs are not required for most of the soldiers, but that, in contrast, corresponding offers for physical activity alternatives, e.g., in the form of fitness equipment, are urgently required in specific task areas (e.g., on board ships). [ABSTRACT FROM AUTHOR]

Background: Chile, like many other countries, has seen major health reforms. It is now moving towards universal access using social protection strategies. It is essential at this point to have a clear view of the barriers to and facilitators of healthcare that Chile's population faces. Methods: We used ontological meta-analysis to formalize, standardize, and assess healthcare access in Chile by mapping the 200 research papers written about it. This methodology can be adapted to any other country to analyze its current situation. Results: The results highlight the frequent, infrequent, and absent research themes. Among some of the findings are the importance of improving access to healthcare using physical, virtual, and combined access, based on the resource conditions, type of care, and the adequacy of personnel providing care. Conclusions: This ontology and the analysis set the foundation for future research and establishment of policies in relevant areas where we are currently not paying enough attention. [ABSTRACT FROM AUTHOR]

Aim: Designing financial incentives for health behaviour change requires choices across several domains, including value (the size of the incentive), frequency of incentives, and direction (gain or loss). However, the rationale underlying complex incentive design is infrequently reported. Transparent reporting is important if we want to understand and improve the incentive development process. This paper describes a mixed methods approach for designing financial incentives for health behaviour change which involves stakeholders throughout the design process. Subject and methods: The mixed methods approach focuses on incentives for weight loss for men with obesity living in areas with high levels of disadvantage. The approach involves: (a) using an existing framework to identify all domains of a financial incentive scheme for which choices need to be made, deciding what criteria are relevant (such as effectiveness, acceptability and uptake) and making choices on each domain on the basis of the criteria; (b) conducting a survey of target population preferences to inform choices for domains and to design the incentive scheme; and (c) making final decisions at a stakeholder consensus workshop. Results: The approach was implemented and an incentive scheme for weight loss for men living with obesity was developed. Qualitative interview data from men receiving the incentives in a feasibility trial endorses our approach. Conclusion: This paper demonstrates that a mixed methods approach with stakeholder involvement can be used to design financial incentives for health behaviour change such as weight loss. Trial registration number: NCT03040518. Date: 2 February 2017. [ABSTRACT FROM AUTHOR]

Aim: The quality of workplace health promotion (WHP) is essential for the successful deployment of financial and human resources. The aim of this paper is to evaluate the measurement quality of a WHP instrument with 15 quality criteria over time. In addition, it examines whether the quality of WHP in the enterprises concerned changed over time and whether typical developments can be identified. Finally, the role of company parameters such as size and implementation phase are analysed in relation to how WHP develops over time. Subjects and methods: Evaluations of the quality of WHP collected between 2014 and 2021 were available at two and three measurement points for 570 and 279 enterprises, respectively. To assess the longitudinal measurement structure, confirmatory factor analyses were carried out followed by structural equation modelling to analyse causality. Cluster analysis was used to identify typical developments, and differences in company parameters were analysed with MANOVA. Results: The results prove that the 15 quality criteria can be used to evaluate the quality of WHP in enterprises in a valid and reliable manner, both cross-sectionally and longitudinally. The quality of WHP in the enterprises concerned remained relatively stable over approximately 12 years. The cluster solution revealed three different developments characterized by increasing, stable or decreasing quality. Conclusion: Measurements using a quality evaluation system permit a good assessment of WHP in enterprises. WHP quality also depends on company parameters; here more support should be provided to motivate enterprises in the long run, particularly in the sustainability phase. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to better understand the relationship between homicide and other public health outcomes, by studying their trends over time. Subject and methods: Research in both criminology and public health has long identified that crime and violence tend to cluster together with adverse phenomena in the social and health domains. However, such work has relied primarily on cross-sectional analyses. Here, we instead study trends over time. We take data from the Netherlands, between 2000 and 2020, and ask whether homicide shows similar trends over time as other public health phenomena – such as smoking behaviour, alcohol use, child mortality, adolescent pregnancies, and suicide. Results: We observe, first, that all of the phenomena – with the exception of suicide – declined over the period under study. We then employ a time series analysis to examine whether these trends arise independently, or whether they are the result of structural similarities between phenomena. Results showed that the decline in homicide rates is linked to a similar decline in adolescent pregnancies – the rates of these phenomena 'move together' during the period under study. Conclusion: This work shows that the phenomenon of homicide shares structural similarities with teenage pregnancies – a decline in one is linked to a similar decline in the other. More generally, the current work furthers our understanding of the place of homicide in the domain of (public) health. [ABSTRACT FROM AUTHOR]

Aim: Asians are the second largest and fastest growing non-European population in New Zealand but are under-researched in terms of their COVID-19 pandemic response. The paper aims to illustrates Asians' risk perceptions and knowledge of COVID-19, and self-protection practices to avoid infection and prevent community transmission. Subject and methods: An online survey was used to collect data and received 402 valid responses. Data analyses included: 1) a descriptive analysis by using Chi-square tests and a Kruskal-Wallis rank sum tests to explore associations between responses and the four demographic variables (i.e. age, gender, country of origin/ethnicity, and region); and 2) a correlation analysis between different survey objectives. Results: The descriptive analysis of the survey found that while ethnicity (within the Asian category) was the most influential variable that resulted in varying responses to many questions, gender and age were other two important variables in influencing the answering patterns. The correlation analysis found a positive correlation between the perceived 'dangerousness' of COVID-19 and respondents' overall compliance behaviour to New Zealand authorities' recommendations to prevent spread of COVID-19. Conclusion: The majority of the respondents provided correct answers to the questions about the vulnerable populations, symptoms, asymptomatic transmission and potential sequelae of COVID-19; however, their understanding of the availability of a cure for, and the incubation period of COVID-19 was not consistent with the official information. The research also found that the higher perceived dangerousness of COVID-19, the better compliance to self-protection practices among the surveyed population. [ABSTRACT FROM AUTHOR]

Objective: During the coronavirus pandemic lockdowns, general medical complications have received the most attention, and few studies have examined the association between the COVID-19 lockdown and eating disorders (ED). This study aimed to investigate the impact of the coronavirus lockdowns on ED symptoms severity and summarize factors associated with lockdowns that led to changes in eating disorders. Method: PubMed, Scopus, and Cochrane Library databases were searched for studies measuring the impact of coronavirus lockdowns on ED symptoms. Results: A total of 132 studies were retrieved, after abstract screening and removal of duplicates, 21 papers were full-text screened, and 11 eligible papers were identified. Factors associated with symptomatic deterioration in ED patients during COVID-19 lockdowns included disruption of lifestyle routine, social isolation, reduced access to usual support networks, limited or no access to healthcare and mental care services, and social anxiety. Discussion: Overall, the pandemic lockdowns were associated with worsening of eating disorders. This triggering environment can lead to increased anxiety and depression symptoms, change in dietary habits, and eventually result in worsening eating disorder symptoms. [ABSTRACT FROM AUTHOR]

Aim: Sexually transmitted diseases (STD) are one of the most common infections worldwide. The current study aimed to determine what the current STD prevention programs are and their effectiveness. Subject and methods: A systematic review of the literature was done for a period of 10 years (2009–2019) in two databases (PubMed and Cochrane) based on PICO strategy. Inclusion criteria were articles published in the English language only, involving clinical trials with control groups. In order to determine the quality of studies, two reviewers reviewed all qualifying papers independently. Twelve studies met our inclusion criteria. Results: Five of the studies were about tenofovir effectiveness, followed by three about community-based intervention, two regarding vaginal gel effectiveness and two about school-based intervention. The two studies on vaginal gel concluded no effectiveness. Conclusion: As a conclusion, community-based prevention programs targeting adolescent and tenofovir gel showed promising results but more studies and at different locations in the world are needed so that some recommendations can be made in the future. [ABSTRACT FROM AUTHOR]

Aim: With the COVID-19 pandemic, we witnessed an increase in purchases of certain products, such as toilet paper, disinfectants, or groceries. In the present study, we examined the individual and socio-psychological determinants of stockpiling behavior. For this purpose, we defined an explanatory model based on the Health Belief Model (HBM), which includes threat perceptions, barriers and benefits, and self-efficacy beliefs as main predictors of health-related behaviors, and extended the model to include social norms. Subject and methods: Participants were recruited via social media platforms and data collection was conducted via an online survey. The final sample included 861 German respondents (male = 199, female = 642, mean age = 36.76, SD = 12.38). Results: Perceived barriers of stockpiling, such as financial constraints or regulations in supermarkets, turned out to be the strongest predictors of stockpiling. Regarding the role of threat perception, the perceived severity of the disease in particular was positively related to stockpiling behavior. Finally, our results suggest a significant impact of social cues, showing that descriptive normative beliefs are associated with stockpiling behavior. Conclusion: Based on these findings, we propose targeted interventions to a) reduce perceived benefits of stockpiling and severity beliefs related to COVID-19, b) emphasize disadvantages of stockpiling, and c) reduce media exposure of stockpiling behavior to prevent panic buying. [ABSTRACT FROM AUTHOR]

Background: Literature on self-management innovations has studied their characteristics and position in healthcare systems. However, less attention has been paid to factors that contribute to successful implementation. This paper aims to answer the question: which factors play a role in a successful implementation of self-management health innovations? Methods: We conducted a narrative review of academic literature to explore factors related to successful implementation of self-management health innovations. We further investigated the factors in a qualitative multiple case study to analyse their role in implementation success. Data were collected from nine self-management health projects in the Netherlands. Results: Nine factors were found in the literature that foster the implementation of self-management health innovations: 1) involvement of end-users, 2) involvement of local and business partners, 3) involvement of stakeholders within the larger system, 4) tailoring of the innovation, 5) utilisation of multiple disciplines, 6) feedback on effectiveness, 7) availability of a feasible business model, 8) adaption to organisational changes, and 9) anticipation of changes required in the healthcare system. In the case studies, on average six of these factors could be identified. Three projects achieved a successful implementation of a self-management health innovation, but only in one case were all factors present. Conclusions: For successful implementation of self-management health innovation projects, the factors identified in the literature are neither necessary nor sufficient. Therefore, it might be insightful to study how successful implementation works instead of solely focusing on the factors that could be helpful in this process. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the impact, trends, and impact levels of factors affecting Pediculus capitis infestation in primary school students. Subject and methods: Among the papers reviewed, 226 were selected, as they contained information that suited the study objectives. Results: The factors whose trends have higher gradients have a higher impact on the infestation level. In order of impact, the gradients of hair washing frequency, health instructor involvement, bathing frequency, mother's and father's education, existence of bathing facility, family size, hairstyle, and family income trends are higher than hair length, and age and education trends. As a result, the factor impacts are diminished from the beginning to the end. The importance of the family size, father's and mother's education, bathing facility existence, health instructor involvement, and bathing and hair washing frequency factors, whose trends increased over time, is higher than family income, hairstyle and length, and age and education, whose trends remained constant or decreased. Based on the gradient of the factor level impact trends, it seems that hair washing frequency, father's and mother's education, and health instructor involvement are the factors with the greatest effects on infestation level, in that order. These are followed by the influence of family income and size, and hairstyle factors. The existence of bathing facilities, bathing frequency, hair length, and education factors have weaker effects. Conclusion: This work provides the importance and impact levels of factors affecting Pediculus capitis infestation levels in primary school students, which will help meet the needs of policymakers. [ABSTRACT FROM AUTHOR]

Aim: The Health Gym Program is the main health promotion strategy in the Brazilian public health system. This paper aims to measure the impact of the Health Gym Program on hospital admission expenses for stroke in the state of Pernambuco, Brazil. Subject and methods: This public health impact evaluation used a panel of socioeconomic, demographic, and epidemiological data from 2007 to 2019 for all 185 municipalities in the state of Pernambuco. The empirical strategy used pre-tests, ordinary least-squares econometric modeling, and quantile regression as a robustness test. Results: The municipalities that implemented the Health Gym Program spent an average of 21.04% less on hospitalizations for stroke than the municipalities that did not, and this result was statistically significant at the 1% level. Further, the density of program coverage within the municipality also impacts the reduction of expenses. This saving is directly proportional to the number of hubs of the program in the municipalities. An increase of one program hub for every 10,000 inhabitants results in a 4.57% reduction in expenditure on stroke hospitalizations in the municipalities. Conclusion: The presence of the Health Gym Program led to a reduction in expenses related to hospital admissions for stroke, which may indicate that this program effectively expands the scope of health promotion actions in primary healthcare. The evidence generated from this study can be used to implement evidence-based policies aimed at preventing and controlling chronic diseases in Brazil. [ABSTRACT FROM AUTHOR]

Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

Background: According to the World Population Outlook (2019), people over 65, usually accompanied by various chronic diseases, will make up 16% of the population in 2050. Therefore, the health problems of middle-aged and elderly people are becoming the focus of current global attention. Some scholars have found that the health of middle-aged and elderly people is related to the childhood socio-economic environment. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS) data, this paper innovatively constructed four measurement dimensions of health (namely, self-rated health, physical health, emotional health, and mental health). Moreover, logistic regression was used to explore the impact of childhood socio-economic environment (such as parent's education level, work experience, etc.) on the health status of middle-aged and elderly people. Results: Compared with a poor childhood social-economic environment, a good childhood socio-economic environment is more advantageous to the self-rated health of middle-aged and elderly people, especially a childhood socio-economic environment close to the medium level; the psychological health of middle-aged and elderly people who have experienced an adverse childhood socio-economic environment was better than those who did not; the childhood socio-economic environment has no apparent impact on the cognitive situation of middle-aged and elderly people. Conclusions: Some policy implications can be drawn. For example, the government should vigorously introduce policies to help migrant workers' children receive education in cities and provide special education guarantees for migrant workers' children. Societies and families should also pay more attention to the childhood socio-economic environment. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM) involves the cutting of the external female genital organs for non-medical purposes. It is a widespread public health problem in Nigeria as it affects the health of women and girls. The views of women about FGM are widely researched and known; however, very little empirical research has been conducted to understand the views of men. Aim: This study therefore sought to examine men's views with regard to the continuation of FGM and its associated factors in a rural Igbo community in Nigeria. Subject and Method: This paper reports the results of a survey of 215 men aged 18 and above living in Isuikwuato Local Government Area, Uturu in Nigeria. Bivariate and binary logistic regression were performed on 215 completed and returned questionnaires (86% response rate) using the Statistical Package for Social Science. This is the first study to investigate Nigerian Igbo men's views of FGM. Results: Descriptive statistics revealed that almost two-thirds of the sample (63.7%) thought FGM should be discontinued. Logistic regression found that owning a television and/or a radio and holding a Christian faith significantly predicted favouring the discontinuation of FGM. Conclusion: This study provides evidence to suggest that some Nigerian Igbo men's attitudes about FGM appear to be generally less than favourable. The major implication of these findings is that policy makers must place greater emphasis on addressing the economic and social development of rural areas in Nigeria if the harmful practice of FGM is to be reduced. [ABSTRACT FROM AUTHOR]

Background: Limited data regarding the effects of school-based obesity prevention programs focusing on the changes in obesity-related knowledge and behaviors in China are available. The objective of this paper was to evaluate the effects of a school-based comprehensive lifestyle intervention among Chinese kids against obesity (CLICK-Obesity) in primary schools in Nanjing. Methods: We designed a cluster randomized controlled trial in eight randomly selected urban primary schools among 4th graders between May 2011 to April 2012 in Jianye, an urban district of Nanjing. Each school was randomly assigned to either the intervention or control group (four schools in each group). Mixed regression models and generalized estimating equations (GEE) were used to adjust for individual-level covariates under cluster randomization. Results: In this study, 1178 students (96.2%; 665 boys and 513 girls, 544 in control and 634 in intervention) participated in the baseline survey with mean age 10.2 ± 0.5 years. At the end of one-year intervention, 1125 students (91.8%; 628 boys and 497 girls, 513 in control and 612 in intervention) were reassessed. Notably, we found that the intervention group improved the knowledge and awareness of obesity-related risk factors, presented a lower increase of consumption of red/white meat (with a mean difference of −180.9 g/week, 95% CI: −350.6 to −11.2, p = 0.040), a larger increase in the time spent playing ball (with a mean difference of 24.2 min/week, 95% CI: −5.3 to 53.7, p = 0.090), and a significant reduction in screen time (with a mean difference of −71.0 min/week, 95% CI: −125.3 to −16.6, p = 0.020) compared to the control group after cluster (school) adjustment. Conclusion: The school-based integrated intervention was successful to modify unhealthy lifestyle behaviors and had a potential effect on childhood obesity prevention in urban China. However, the long-term effects and cost-effectiveness need to be evaluated in through further study. [ABSTRACT FROM AUTHOR]

Aim: This study aimed at comparing health literacy measures, and their correlates, for the district of Favoriten to those of Vienna and Austria. The Viennese district of Favoriten was of particular interest, due to present characteristics, such as its high cultural and ethnic diversity as well as a relatively high unemployment rate. Subject and methods: This study was set up as a cross-sectional, paper-based self-completion random sample survey. For each sample representing Favoriten, Vienna, and Austria, 500 adults were randomly drawn from the population register. Results: Out of 1500 surveys sent out, 160 (10.7%) were included in the analysis. Regarding general health literacy, the sample of Favoriten scored highest (33.9; CI 95% 31.5, 36.3), followed by the samples of Austria (32.5; CI 95% 30.9, 34.2) and Vienna (31.5; CI 95% 29.6, 33.4). Higher household income (r = 0.46, p < 0.01), better education (r = 0.31, p = 0.09) and migration status outside the EU (d = −0.56, p = 0.12) showed moderately effect-sized associations to general health literacy in the sample of Favoriten, which was not the case for other characteristics such as age, gender, and employment status. Conclusion: In the light of previous studies, reporting on associations of health literacy measures with social determinants, such as migration and employment status, the sample of Favoriten might well have been expected to result in impaired health literacy measures. Our results do not support this assumption, though. Despite the limited external validity of this study, policymakers and practitioners may be advised to design health literacy measures in such a way that specifically reaches out to the socially disadvantaged target population and not focus merely on pertinent districts or regions. [ABSTRACT FROM AUTHOR]

Aim: In response to the SARS-CoV-2 emergency, the Competence Centre on digital health 'TrentinoSalute4.0' has developed TreC_Televisita, a tele visit solution that meets the needs of the Trentino healthcare system and maintains high-quality patient–doctor interactions while respecting social distancing. This paper highlights how 'TreC_Televisita' was integrated into the Trentino healthcare system and its potential to become a structural and durable solution for the future local healthcare service provisioning. Subject and methods: This paper presents the multifactorial context that TreC_Televisita has faced for its implementation and the strategies adopted for its structural integration into the healthcare system. The analysis focuses on the main issues faced for the integration of the tele visits (e.g. privacy, payments) and how the context of TrentinoSalute4.0 permitted responding quickly to its implementation during the pandemic. It also describes how TreC_Televisita fits into the healthcare continuum from the organisational and technological standpoint, the end-user perspective and the barriers that could hamper the solution scalability. Results: TreC_Televisita has demonstrated to be a technological solution that can be contextualised for different clinical domains beyond SARS-CoV-2. Moreover, it has shown its potential to scale up the solution beyond the COVID-19 emergency to the whole healthcare provisioning system in the long term. Conclusion: Being a positive experience in the first months of its implementation, the long-term goal is to transform TreC_Televisita into a structural pillar of the Trentino healthcare system, setting the bases for a sustainable, win–win situation for all the stakeholders involved in healthcare service provisioning. [ABSTRACT FROM AUTHOR]

Objectives: With the rapid development and spread of information technology, mobile healthcare (M-healthcare) is emerging as a feasible option for improved monitoring and treatment of patients with chronic diseases such as diabetes, particularly for those with limited access to medical institutions. Our study group has developed and evaluated an M-healthcare system that provides remote guidance for diabetic patients. This paper introduces the diabetic M-healthcare system and describes progress in implementation for remote and mobile healthcare in China. We provide evidence that this system improves diabetic patient management and can contribute to the establishment of a new model for patient-centered mobile healthcare. Target audience: The main groups that this paper is aimed at are doctors, nurses, nutritionists, and sportspersons engaged in the design of mobile medical systems, and computer engineers involved in the construction of intelligent medical software systems. Scope: The present article has as its scope designing the M-healthcare clinical follow-up system, identifying the advantages that the M-healthcare system has in comparison with traditional medical treatment, the clinical application effect of the M-healthcare system, and the development status of remote/mobile medical research in China and abroad. [ABSTRACT FROM AUTHOR]

Aim: As individuals adjust to new 'norms' and ways of living during the COVID-19 lockdown, there is a continuing need for up-to-date information and guidance. Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression. The aim of this study was to determine whether COVID-19 related media consumption is associated with changes in mental health outcomes. Methods: This paper presents baseline data from the COVID-19 Psychological Wellbeing Study. The cross-sectional study data was collected using an online survey following the Generalised Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), with some other basic information collected. Logistic regression analysis was used to examine the influence of socio-demographic and media specific factors on anxiety and depression. Results: The study suggested that media usage is statistically significantly associated with anxiety and depression on the GAD-7 and PHQ-9 scales with excessive media exposure related to higher anxiety and depression scores. Conclusion: This study indicated that higher media consumption was associated with higher levels of anxiety and depression. Worldwide it should be acknowledged that excessive media consumption, particularly social media relating to COVID-19, can have an effect on mental health. However, as this was a cross-sectional study we cannot infer any directionality as we cannot infer cause and effect; therefore, future research involving longitudinal data collection and analyses of variables over time is warranted. [ABSTRACT FROM AUTHOR]

Purpose: With the coronavirus disease 2019 (COVID-19) pandemic spreading across the world, protective measures for containing the virus are essential, especially as long as no vaccine or effective treatment is available. One important measure is the so-called physical distancing or social distancing. Methods: In this paper, we propose an agent-based numerical simulation of pedestrian dynamics in order to assess the behavior of pedestrians in public places in the context of contact transmission of infectious diseases like COVID-19, and to gather insights about exposure times and the overall effectiveness of distancing measures. Results: To abide by the minimum distance of 1.5 m stipulated by the German government at an infection rate of 2%, our simulation results suggest that a density of one person per 16m2 or below is sufficient. Conclusions: The results of this study give insight into how physical distancing as a protective measure can be carried out more efficiently to help reduce the spread of COVID-19. [ABSTRACT FROM AUTHOR]

Aim: US federal, state, and local governments implemented numerous COVID-19 shelter-in-place orders (lockdowns) starting in March 2020 to ensure social distancing regulations and help stop the spread of COVID-19. It is important to know how these lockdowns affected businesses, such as restaurants, in regions that vary in terms of poverty status and geography. In this paper, we analyze the differential changes in rural and urban restaurant visits by the restaurants' NAICS codes following the COVID-19 lockdowns. Our analysis contributes to the public policy literature and helps operational planning for food distribution during a pandemic. Methods: Since urban and rural consumer behavior and food resources are significantly different, it is crucial to conduct a comparative analysis. Our study applies a difference-in-differences model to capture the differential effects lockdowns have on urban and rural restaurants. Results: We find that restaurant visits declined significantly in both rural and urban counties after shelter-at-home orders. The decrease in total restaurant visits was almost twice as high in urban counties as in rural counties. We also find that visits to fast-food restaurants increased in rural counties during shelter-at-home orders. Conclusions: These results contribute to previous studies on the dearth of healthy food in rural and poorer regions, and inform important public policy response in the wake of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aim: COVID-19 has led to a global crisis not only in the health sector but also in the economic, social and education sectors, as well as the lives of common man. This paper reviews the origin, characteristics and transmission of the SARS-CoV-2 Virus and the preventive measures adopted by the world's nations to curb the effects of the pandemic. Subjects and methods: The temporal and spatial profile of the COVID-19 spread is highly dynamic and is progressively changing at a rapid pace. This article is an attempt to mitigate the pandemic threat by sharing the review outcome from an extensive literature survey on recent articles on COVID-19 and its impact. Results: Statistical analysis presented by the World Health Organization and other health organizations explicitly indicates that optimized support and care extended to infected persons is the key to therapy, and the clinical effectiveness of alternative techniques is still under study. Though there have been announcements on the discovery of drugs for the virus, the authenticity of these reports are yet to be verified. Conclusion: Based on the review, it can be inferred that it is important to boost one's immune system and to stay healthy by developing healthy habits of food intake, sleep, exercise, personal hygiene and so on. Practicing social distancing with a self-motivated attitude will help to control the virus to a large extent. The current situation also demands a great sense of responsibility of people towards society by protecting oneself from the virus in order to protect the society one lives in. [ABSTRACT FROM AUTHOR]

Purpose: Patient engagement has traditionally been limited to involving patients in decision-making regarding their healthcare choices. The goal of this paper was to assess patients' perspectives on how they might be involved as a research partner in the design and implementation of pharmacoepidemiology research studies. Methods: Qualitative research methods were used to elicit patient perspectives on their involvement in pharmacoepidemiologic research. A total of 20 patients participated in five focus groups held from April to August 2016. Each focus group represented one of five chronic conditions, namely: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV)/(AIDS), diabetes, mental health conditions, mild cognitive impairment/Alzheimer's disease (AD), and cardiovascular disease (CVD)/hypertension. A semi-structured field guide was used to elicit views on drug safety and effectiveness and to identify which aspects of the design and implementation of a research study individuals felt most comfortable contributing to. The discussions were audio-recorded, transcribed verbatim, and analyzed following a grounded theory approach to identify the key themes that consequently emerged. Results: For the most part, individuals equated safety with side-effects. There were several dimensions of effectiveness that corresponded with biological, clinical, and psychological aspects of well-being. Most individuals (84%) were comfortable deciding what information should be collected, and 74% felt they could help researchers select target outcomes to study. Fewer (58%) were confident they could advise on selecting comparator drugs. Conclusion: There is a need for training the patient community and for adapting existing patient engagement standards to expand patient involvement in pharmacoepidemiologic research. [ABSTRACT FROM AUTHOR]

Background: Undernutrition among children is a primary concern in sub-Saharan African countries such as Ethiopia. The objective of this paper is to measure the magnitude of undernutrition and associated factors among children under 2 years of age in the Jimma Zone of Southwest Ethiopia. Methods: A community-based cross-sectional study with stratified multistage sampling was conducted. Data were collected using a semi-structured questionnaire and anthropometric measurements. Bivariate and multivariable logistic regression models were fitted using SPSS 20.0 for Windows. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to measure the strength of the association between dependent and associated variables at a p value <0.05. Results: Among the study participants, 142 (25.4%) were stunted, 73 (13.1%) were underweight, and 54 (9.7%) were wasted. Older child age [AOR = 1.1, 95% CI (1.1, 1.2)], male sex [AOR = 2.601, 95% CI (1.681, 4.025)], and residing in an urban area [AOR = 0.526, 95% CI (0.323, 0.857)] were significantly associated with stunting. Independent predictors of wasting were younger child age [AOR = 0.894, 95% CI (0.833, 0.96)], living in a lowland area [AOR = 3.3, 95% CI (1.4, 8.1)], and living a in poor household [AOR = 6.2, 95% CI (2.2, 17.7)]. Underweight was significantly associated with male sex [AOR = 2.09, 95% CI (1.179, 3.703)], delayed initiation of breastfeeding [AOR = 2.1, 95% CI (1.0, 4.2)], and living in a poor household [AOR = 2.2, 95% CI (1.0, 4.6)]. Conclusions: Child malnutrition was found to be a moderate public health problem in the study area. Urban dwellers had higher levels of undernutrition than rural dwellers. Children living in lowlands had higher undernutrition than those living in highland areas. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to highlight current knowledge gaps that exist with regard to the factors which affect the supply chain, and the inventory management strategies that are utilized by hospital pharmacies in Canada which could lead to drug shortages. Subject and method: This research implements an optimal SLR (systematic literature review) method on drug shortages based on CHPSC (Canadian hospital pharmacy supply chain) literature and databases. This makes it possible to perform a wide review of Canadian hospital pharmacies and understand how continued disruption occurred in this process and caused drug shortages. Results and conclusion: The result of this research is contained in a systematic search methodology which consists of four main tasks, namely: a) building an optimal review process, b) defining search procedures, c) validating the search procedures, and d) conducting literature search. Furthermore, the researchers conducted a SLR which unveiled issues and factors such as raw materials availability and increases in demand which cause drug shortages. In conclusion, the proposed systematic methodology seeks to highlight possible solutions to the supply chain management issues which could cause drug shortages in Canada. Various solutions are proposed and explored, with the relevant information being obtained from studies conducted on how to mitigate the impact on supply chain management. [ABSTRACT FROM AUTHOR]

Aim: Owing to the COVID-19 pandemic, many companies shifted to telework, with few insights into its implementation, organisational conditions or the role of workplace health promotion and management. This study focused on a multifactorial investigation of conditions in companies which implemented and evaluated telework during the first lockdown in 2020 as well as on their future intentions to facilitate teleworking under health-promoting working conditions. Subject and methods: The research hypotheses relate to an extended technology acceptance model. In a mixed-methods design, expert interviews were fed into the development of an online questionnaire. Out of 1858 contacted companies representing a broad range of Austrian businesses, 192 responses (general management, workplace health managers, etc.) were analysed using descriptive and multivariate statistics. Results: The degree of implementation and claim to teleworking increased significantly during the first lockdown and did not return to pre-pandemic levels afterwards. Changes depended on preparation and experience: evaluation of teleworking and willingness to continue offering teleworking were conditional on preparation and the degree of implementation. Prerequisites for future intentions to implement health-promoting teleworking included readiness, general willingness and existing workplace health promotion/management structures. Conclusion: This paper demonstrates the potential of health-promoting organisational cultures for development processes – particularly in times of crisis. Anchoring health-focused structures in companies helps to create health-promoting frameworks. Health-promoting teleworking can be developed from workplace health promotion/management using established approaches. It is essential to build on in-house capacities and competencies to develop awareness for a holistic culture for health-promoting (tele)work and to encourage deliberations about potential measures. [ABSTRACT FROM AUTHOR]

Aims: Access to healthcare, especially among adolescents, is a public health issue with long-lasting health and socio-economic consequences. Adolescence is a distinctive growing period for developing healthcare behaviour that can either improve or worsen future health conditions. Hence, the need for quality healthcare behaviour among adolescents who usually constitute a large proportion of any country's population, is imperative. This paper thus examines the impact of medical aid coverage and other socio-economic factors in determining South African adolescents' utilisation of either private or public healthcare facilities in the event of illness. By extension, the study investigates the effects of pertinent parental characteristics on South African adolescents' choices of either private or public healthcare facilities. Subject and methods: Data come from the population-weighted 2018 General Household Survey (GHS). Units of analysis include adolescents within the ages of 10 and 19 years. The empirical analysis relies primarily on a regressions-based model and instrumental variable approach. Results: Result indicates that younger adolescents are more likely to use public healthcare facilities in the event of illness than older adolescents. However, adolescents who are medically covered are less likely to utilise public healthcare facilities in the event of illness. Further findings suggest that the likelihood of using public healthcare facilities is higher among adolescents who are black Africans, live in relatively poor households, large households and rural areas. Conclusion: Further implementation and review of any national health policy such as the National Health Insurance (NHI) scheme needs to address and take into consideration adolescents' healthcare utlisation and socio-economic variations in their healthcare utilisation. [ABSTRACT FROM AUTHOR]

Aim: The goal of this paper is to analyze the COVID-19 policies of 10 European countries, including Sweden, Finland, Norway, Italy, France, Germany, Poland, Belgium, the Netherlands, and Hungary, with a time-series policy analysis tool. Subject and methods: The results of the COVID-19 policy analysis are based on a single time-series indicator, or daily population mortality rate: the number of COVID-19 daily cumulative deaths divided by the population in millions. The lower the score, the better the policy. Although many experts believe that the COVID-19 policy outcome analysis is premature, time series analysis is an excellent analysis that can provide information on the progress and transition of policy outcomes. In other words, the proposed time series analysis tool allows policymakers to identify and quantify when mistakes were made during the on-going COVID-19 pandemic. Results: The COVID-19 policy analysis discovered many useful facts. Sweden failed due to the herd immunity approach. Hungary made a fundamental mistake in COVID-19 tactics. Countries such as Sweden, Hungary, Belgium, and Poland showed time-series changes that differed from the others. Conclusion: Public health interventions can play a key role in mitigating the COVID-19 pandemic. The proposed policy analysis tool, hiscovid demonstrated the effectiveness of the time-series score behavior for discovering when policymakers made mistakes. [ABSTRACT FROM AUTHOR]

Aim: International comparisons of public health measures relative to observed best practice are increasingly important for evaluating community health promotion strategies and policies such as meeting or not meeting public health guidelines. This study aimed to identify methods enabling robust evaluation with such binary effect measures at a population level. Subject and methods: Conventional efficiency comparisons of binary effect proportions are problematic due to a lack of consistency with alternate framing of resulting relative risks. In this paper, we illustrate such inconsistent efficiency measures comparing the proportion of school age children (9–11 years) meeting or not meeting integrated movement guidelines (IMGs) across the 12 countries from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) study. IMGs jointly consider physical activity, sleep and sedentary behaviours. An odds method is developed to enable consistent efficiency comparison with alternative framing of binary effects. Results: A novel odds solution to relative risk problems arising with conventional efficiency comparison of binary effects with alternative framing is shown to provide consistent efficiency measures relative to best practice. Furthermore, this technical advancement is shown to extend to consistent indirect comparison and evidence translation. Conclusion: Robust methods for international cross-country comparison of binary effect measures such as meeting or not meeting guidelines are identified with a novel odds ratio method. This novel solution is particularly important for health promotion evaluation of IMGs given the need for consistent comparison in evaluating practice evidence of what works now and consistent evidence translation of treatment effects as and when they emerge. [ABSTRACT FROM AUTHOR]

Aim: Suicide is one of the leading causes of death globally, inherently linked with mental health conditions. Existing studies have also found a significant association between suicide and chronic health conditions such as human immunodeficiency virus (HIV). Although there have been enormous studies on these global health issues, knowledge about their co-existence is elusive. This paper examines the link between HIV and suicide in 186 countries using geospatial techniques and spatial statistics. Subject and methods: We used country-level suicide and HIV data obtained from the United Nations Development Program database. The local bivariate spatial association technique was used to determine the covariation of HIV and suicide, while autoregressive models were used to estimate the unexplained country-level variables in the model. Due to evidence of spatial dependencies, we applied multiscale geographically weighted regression (MGWR) to examine the spatial variation in the predictor variables. The local bivariate spatial association technique was used to determine the covariation of HIV and suicide. Results: Analysis indicated that HIV significantly covaried with suicide in regions of Africa and Europe. Our result suggests that HIV is a significant driver of suicide among females in sub-Saharan Africa while it drives suicide among males in many regions including the country of South Africa, Lesotho, Swaziland, Oceania, and Southeast Asia. MGWR indicated that HIV was negatively associated with suicide in the Americas and European countries, but positively associated with suicide in Africa, the Middle East, and Oceania. Conclusion: There is a double burden of HIV and suicide in sub-Saharan Africa. Therefore, investment in both mental healthcare and access to antiretroviral drugs is essential in reducing suicide at both global and local levels. [ABSTRACT FROM AUTHOR]

Aim: Prostate cancer (PCa) globally impacts men of African descent disproportionately more than any other ethnicity. Studies focusing on PCa among the U.S.-based Nigerian immigrant men (NIM) are limited. The purpose of this study was to investigate the predictive effects of health beliefs on NIM's prostate cancer screening intention using select constructs of two health behavior models. Subjects and methods: This study consisted of (N = 130) U.S. NIM, aged 40 years and older, who were recruited from local nonprofit associations in New Jersey. Pen-and-paper questionnaire data were gathered using the Behavioral Intention Scale and the modified version of the Champion's Health Belief Model Scale for Prostate Cancer, along with demographic questions. Data were analyzed in SPSS 25.0. Multiple regression analysis was conducted to evaluate how well perceived susceptibility, benefits, and barriers predicted the intention to undergo screening for prostate cancer. Results: The model was significantly related to intention (R2 = 0.22, F (4,125) = 9.02, p < 0.001). Beta weights indicated that only perceived susceptibility and perceived benefit shared in the 22% of intention variability. Perceived susceptibility (β = 0.61, p < 0.001) and perceived benefits (β = 0.41, p < 0.001) were thus the variables that significantly contributed to the model. Conclusion: Continuous education and awareness of prostate cancer and the importance of screening, as well as a better understanding of health belief perceptions, remain strategies healthcare providers can utilize to reach at-risk minority populations. [ABSTRACT FROM AUTHOR]

Aim: A novel corona virus disease 2019 (COVID-19) was declared as pandemic by WHO as global level and local levels in many countries. The movement of people might be one influencing factor, this paper aims to report the situation COVID-19 and spreading in Thailand, including influencing factors of spreading and control. Subject and method: Infected, confirmed COVID-19 data were obtained from the official website of the Department of Disease Control, Ministry of Public Health. Tourist data was downloaded from Ministry of Tourism and Sports. Researchers analyzed the situation from the first found case in Thailand until 15 April 2020 with the timeline of important influencing factors. Correlation coefficients of tourist data and infected case was calculated by person correlation coefficient. Results: The number of infected cases was significant associated (correlation coefficient > 0.7) with economic factor, namely; number of visitors, generated income from both Thai and foreigner tourist (p value <0.01). The influencing factors of slow increased rate were the enforcement and implementation of both central and local government regulation, the strength of the Thai health care system, the culture and social relation, the partnership among various governmental and private sectors. Conclusion: We found that the number of tourist and their activities were significant associated with number of infected, confirmed COVID-19 cases. The public education and social supporting were the key roles for regulation enforcement and implementation. [ABSTRACT FROM AUTHOR]

Aim: Obesity is prevalent in Puerto Rico due to intersecting structural inequalities such as poverty and unemployment. At the same time, type 2 diabetes mellitus is also highly prevalent on the island due to similar structural factors. The role of food access and identity contributes to the ways in which the illnesses interact. The two illnesses furthermore form part of a syndemic in Puerto Rico. The island's status as a US territory leaves Puerto Rico with limited economic resources from the US government for necessary programs like Medicare. As such, this paper proposes that obesity and diabetes form a syndemic in Puerto Rico. Subject and methods: Interviews were conducted with 75 Puerto Ricans, recruited from the Centro de Diabetes Para Puerto Rico. Results: Thirty-six participants had obesity, and an additional 14 were overweight. Sixty-five participants had type 2 diabetes. Study participants perceived that Puerto Rico's subaltern status deleteriously affected obesity rates due to limited US federal assistance for health insurance and for imported fresh foods and vegetables. Diabetes was due to both weight mismanagement and a lack of healthcare providers. Conclusions: Obesity and diabetes form a syndemic in Puerto Rico through multiple and interacting structural factors, such as crime, unemployment, and a broken healthcare system. Puerto Rico's economic and healthcare crises leave the island in a difficult situation, unable to support itself and without the resources to improve its situation. [ABSTRACT FROM AUTHOR]

Background: The Comparative Risk Assessment (CRA) framework comprehensively evaluates the impact of exposure to risk factors on health populations using the counterfactual causal approach. Methods: We propose a framework, Comparative Disease Assessment (CDA), for assessing the impact of exposure to morbidity from some diseases on health outcomes, particularly death from other (relevant) diseases. This framework has been developed following the ideas of the CRA framework and using the widely accepted concept that exposure to morbidity is usually a risk factor for health outcomes (morbidity/mortality) related to other diseases. Our framework uses a counterfactual and not a categorical approach when attributing the burden of health outcomes to potential causes. Results: This paper describes the different steps and assumptions required to implement the CDA framework, and an illustrative example is used considering diabetes mellitus morbidity as a risk factor for death from heart diseases. Conclusions: One advantage of the CDA framework is that it can be applied using multi-causal death registries. Some assumptions are needed to implement it in order to avoid biases, but at least it can provide preliminary estimations of the impact of exposure to diseases as risk factors for deaths from other diseases. Another main advantage is that the burden of deaths is no longer attributed to a single cause, the underlying cause, as it is almost always done. Finally, this framework provides information on the pattern of comorbidity in a (sub)population of subjects who is about to die. These patterns can be used as a reference for alternative patterns of the general population or patterns of other specific subpopulations. [ABSTRACT FROM AUTHOR]

Aim: There is a growing population of lung cancer survivors who may have unmet physical, psychological, and practical needs as they transition from active treatment into recovery. The specific needs and best ways to meet them are unclear in this population. This paper describes the development and outcomes of a program aimed to transition patients to survivorship. Subject and methods: Patients with early-stage lung cancer were assessed for the presence and severity of unmet physical, psychological, and practical needs at the end of active treatment. Patients also attended a multidisciplinary clinic visit to create an individualized survivorship care plan and provide appropriate referrals. They were surveyed 3 months later to assess effectiveness of the program. Results: Eighty-four participants were enrolled in the program. All reported at least one unmet need, with a mean of seven unmet needs, particularly related to breathing, fatigue, pain, and fear/anxiety. Following program participation, there were fewer and/or less severe needs. Conclusions: The Bridge program identified and decreased the number and severity of unmet needs through connecting survivors to local resources. Challenges to program implementation included hesitancy of providers to refer, time constraints of survivors and staff, and lack of community resources, especially for identified mental health needs. [ABSTRACT FROM AUTHOR]

Background: In a global comparison, in 2006 Germany was the first in the world to switch naratriptan to an OTC medication but since then only almotriptan has been switched. Therefore, Germany has fallen behind recently because of the failure to carry out further switches. Objectives: The aim of this extensive evaluation of various surveys among pharmacies, physicians, patients and stakeholders was to investigate whether there is an obvious need for an Rx-to-OTC switch of further triptans. In addition, reasons for or against such a switch should be evaluated. Setting: The surveys were distributed in several ways. Most were based on online tools and were performed in 2017, 2018 and 2019. Methods: Several surveys have been initiated using different methodologies. The pharmacist surveys were only conducted digitally. The physician surveys were first digitally based on an online platform. A paper form could also be edited manually and returned by fax. The respective questionnaires consisted of 5 to 17 questions on the topic of switching and could all be answered in about 5 to 10 min. BAH Health Monitor hosted the patient surveys and included telephone interviews. The stakeholder survey was performed by personal interviews. The surveys on economic calculations among patients were conducted digitally. Main outcome measure: Sumatriptan and other Rx triptans are suitable and should be switched to OTC status. Results: Nine hundred forty pharmacists and pharmaceutical technical assistants took part in the initial pharmacist survey. In the subsequent pharmacist surveys, the volume of participants was even higher and reached almost 4000. For the physician survey, 540 answers were received, and the BAH Health Monitor addressed about 1000 telephone interviews. Within the stakeholder survey, 24 interviews were carried out with 32 participants from a range of professional backgrounds; most are part of the German switch process. Finally, the patient survey related to economic calculations was based on 175 answers. Seventy percent of the participating physicians < 50 years old supported a switch of further triptans. For the question about how safe OTC triptans are, 41% of the 3568 participants from the Marpinion pharmacy survey voted that they are safe. Conclusion: With a Rx-to-OTC switch of further triptans, patients would have an easier, faster and safe way to treat their migraine attacks. Impact of findings on practice statements: The outcome of these surveys and interviews provides information for all participants in the German switch process about their decision-making behaviour. Furthermore, it allows deeper insights into patients' needs and may help to fulfil them. The results can provide information about the German process and German needs worldwide and stimulate discussion about Rx-to-OTC switches. [ABSTRACT FROM AUTHOR]

Aim: Child malnutrition is also associated with higher incidence of morbidity and mortality. Therefore, it is imperative to have knowledge of its correlates and determinants. The objective of this paper is to examine the association between demographic and socioeconomic factors and child nutritional status in Bangladesh. Subject and methods: A secondary data analysis was conducted using the 2014 Bangladesh Demographic and Health Survey data. The surveys used a stratified two-stage cluster sampling. In the first stage, 600 enumeration areas (EAs) were selected with probability proportional to the EA size. In the second stage of selection, a fixed number of 30 households per cluster will be selected with an equal probability systematic selection from the household listing. The sample constitutes 17,886 ever-married women age 15–49, with 34.38% and 65.62% from urban and rural areas respectively. The anthropometric indicators height-for-age, weight-for-age and weight-for-height z-scores were used as the primary and secondary outcome measures. Results: Results show that age and birth order of child is negatively associated with height-for-age, weight-for-age, and weight-for-height z-scores. However, the size of the child at birth is positively allied with the three anthropometric indicators. Mothers' BMI and educational level are positively connected with the nutrition z-scores, but these factors have differential effects at different points of the conditional distribution of the anthropometric z-scores. Moreover, the economic status of a family is an essential factor in determining the z-score of height-for-age, weight-for-age, and weight-for-height of a child. Conclusion: The age, size of child at birth, mother's BMI and educational status, and wealth index are very important determinants of the z-score of the anthropometric indicators of a child. In order to improve the nutritional status of children in Bangladesh, the authors suggest that a joint effort by the government, non-governmental organizations, and the community is absolutely essential. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this paper is to investigate the implementation of value-based care principles in the context of frailty in the perioperative process, highlighting the importance of an integrative perspective considering medical and patient-centric outcomes as well as costs. Subject and methods: This mixed-methods study employs a sequential design. Qualitative observational data were used to identify needs and barriers for implementing value-based principles, and quantitative methods were subsequently used to demonstrate the value of employing such an approach using data gathered from n = 952 patients. Propensity score matching was applied to identify the frailty-associated costs of the inpatient setting for n = 381 non-frail and n = 381 (pre-)frail patients, in particular considering patient-centric outcomes. Results: The qualitative analysis identified three main challenges when implementing value-based principles in the context of perioperative care and frailty, namely challenges related to the cost, patient-centric, and integrative perspectives. In addressing these shortcomings, a quantitative analysis of a propensity score-matched sample of patients undergoing surgery shows additional frailty-associated costs of 3583.01 [1654.92; 5511.04] EUR for (pre-)frail patients and the influence of individual patient-centric attributes. Effect size Cohen's d was 0.26. Conclusion: The results demonstrate that frailty should be considered from an integrative perspective, taking cost, patient-centered outcomes, and medical outcomes into account simultaneously. The results also show the value of a research design which uses qualitative data for the identification of needs and barriers, as well as quantitative data for demonstrating the usefulness of the conceived value-based approach to perioperative care delivery. [ABSTRACT FROM AUTHOR]

Aims: Although ambient assisted living (AAL) environments and serious games for healthcare have been proposed as solutions to meet the changing demographics, the two approaches are rarely combined. We present the development and empirical evaluation of two serious games for healthcare in AAL. The first uses a cooking scenario for training of cognitive functioning. The latter uses a gardening scenario and motion capture for training agility and endurance. As the frequent lack of social acceptance is a major challenge in consumer health technology, we integrated methods of technology acceptance research by means of the UTAUT2-model and intention to use into the evaluation. Subject and methods: We developed both games utilizing user-centered and participatory design methods ranging from low-fidelity paper prototypes to usability and acceptance evaluations of functional prototypes. In the final evaluation, each game prototype was evaluated by 64 participants form different age groups. Results: The results show that although performance decreases with age, the performance attained in the games is not decisive for social acceptance measured as intention to use. However, user diversity factors shape the evaluation of the games, and older people and people with low technical competence are in danger of being excluded from using serious games for healthcare. Conclusion: Exercise games, if designed right, can mitigate the negative effects of demographic change. Nevertheless, user diversity needs must be considered to ensure that the games are usable and used by a broad audience. The article concludes with guidelines and open research questions for the design of serious games in AAL environments. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper was to investigate online health information seeking and health literacy among non-medical college students in Egypt and the differences between the two genders. Subjects and methods: A cross-sectional descriptive design was used to collect data from 600 students through a self-administered questionnaire. Results: Most of the students searched for health information on the internet (82.3%). 90.3% of them used their mobile phones and 97.8% sought data via Google. Skin and hair problems was the most searched for topic (83.3%), followed by reproductive health (79.7%). Students perceived that rapid and easy access to information were the main advantages of health information seeking online (98.5% and 95.5%, respectively), while the lack of reliability and scarcity of information in the Arabic language were the main disadvantages (78.2% and 60.5%, respectively). Only 31.2% of the sample achieved an adequate literacy level. Females in our sample had a higher frequency of online health information seeking and a higher level of health literacy. They also had a higher percentage of searching for health data on YouTube and seeking nutrition information. On the other hand, males used online health applications more frequently and were more interested in physical fitness and smoking. Females perceived the high cost as the main disadvantage of online health information seeking, while males were more concerned about the reliability of information. Health literacy was positively related to female gender and frequency of online health information seeking. Conclusion: Using the internet to deliver health information according to each gender's preferences and concerns can encourage students to search for health information online and, therefore, raise their health literacy level. [ABSTRACT FROM AUTHOR]