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Abstract Background Hepatitis D virus (HDV) is highly pathogenic, and clinical studies revealed that HDV infection aggravates the natural history of the underlying hepatitis B virus (HBV) infection by progression to cirrhosis that leads to early decompensation of liver function compared with HBV mono-infection. To determine the seroprevalence of HDV among HBsAg-seropositive patients and associated biochemical profiles at Maiduguri, Nigeria, a hospital-based cross-sectional study on 180 sera of patients positive for HBsAg by ELISA were evaluated for anti-HDV, hepatitis B envelop antigen, anti-HBs antibodies and liver enzyme profiles. Results HDV seroprevalence of 3.3% among 180 HBsAg-positive patients. Relatively higher seroprevalence of HDV was observed in males (4.3%) than in females (2.3%). The highest infection rate (20%) was obtained in patients ≥ 56 years. However, no significant association between positive anti-HDV seroprevalence and gender (p > 0.05). Of the 6 (3.3%) anti-HDV-positive patients, only 1 (16.7%) was positive for HBeAg while all were negative for anti-HBs antibodies. The mean level of liver enzyme level of AST and ALT of the anti-HDV-positive patients significantly differ from that of HBsAg mono-infected patients (p ˂ 0.05). However, no significant difference (p

Background Good subjective wellbeing (SWB) is a key societal aspiration. The study of SWB determinants is of increasing interest. The present study aimed to examine national inequalities in SWB, and trends in these inequalities, for England across five demographic (sex and age) and socio-economic (educational level, household income and living alone) characteristics. Method The relative index of inequalities (RII) and slope index of inequalities (SII) were calculated from repeated cross-sectional data from the Health Survey for England from 2010 to 2019 (excluding 2017 and 2018 as our outcome variable was not collected in these years), in a total of 90 236 participants aged 16+. SWB was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), treated as a dichotomous variable with high and low levels of SWB > 40 and ≤ 40, respectively. Results There were significant inequalities in SWB by income (RII from 1.086 to 1.116), educational level (RII from 0.893 to 0.941) and between people living alone or not (RII from 0.908 to 0.937). The RII and SII trends were not statistically significant. Conclusions Higher socio-economic status could play a protective role for SWB, and people in the most deprived socio-economic positions may be at higher risk for low SWB. These associations have remained stable over time. [ABSTRACT FROM AUTHOR]

In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Physical inactivity and sedentary behaviours are important risk factors for NCDs. No previous systematic reviews examining physical activity and sedentary behaviour among Ghanaians were identified. Therefore, this rapid scoping review was conducted to find and synthesise what is known about the epidemiology of physical activity and sedentary behaviour of children and adults in Ghana. MEDLINE was searched for eligible studies and a narrative synthesis was conducted based on 17 identified papers as well as the 2008 Demographic and Health Survey report. Little recent high-quality data on prevalence of physical activity or sedentary behaviour in Ghana was found. Existing nationally representative data is now more than ten years old. The data identified suggest that the majority of Ghanaian adults, aged 18+ years, are physically active, achieving or exceeding World Health Organisation (WHO) recommendations (84.3% according to data collected in 2007-2008). Studies reporting sedentary behaviour in adults further suggest that the majority of Ghanaians are minimally sedentary. The most consistent associations with physical activity were by gender (men achieved more than women), employment (the employed, particularly in skilled manual jobs, achieved more than the unemployed), urban or rural residence (rural inhabitants achieved more than urban inhabitants) and socio-economic status (lower physical activity with increasing socio-economic status). Meanwhile, the few existing studies of physical activity in children (all of which investigated children aged 12+ years) suggest that the proportion of children achieving WHO recommendations on physical activity may be lower than for adults. A similar gender trend exists for children as in the adult data, with boys achieving more physical activity than girls. Physical activity is accrued most frequently through active travel, and active occupations, while leisure time physical activity is low. This means that the Ghanaian population may be vulnerable to becoming increasingly inactive as work and travel become more frequently mechanised and sedentary. Key words: Ghana, review, non-communicable disease, Epidemiology, Physical activity, behaviour, INTRODUCTION Globally non-communicable diseases (NCDs) like cancers and cardiovascular diseases (CVDs) are the leading cause of death [1]. According to the World Health Organisation (WHO), low-and-middle-income countries (LMICs) are disproportionately [...]

Effective stormwater management can be used to regulate water quantity and quality for environmental sustainability, flood control, pollution reduction and other advantages of civil engineering infrastructures. Pollution of the environment and contamination of water sources can emanate from improper stormwater management. This study used a smallscale model of rainwater harvesting to analyze the design and model of urban stormwater management and treatment infrastructure for the neighborhoods in Abuja. The water quality of the treated stormwater retrieved has improved as a result of the usage of memory foam, alum, and chlorine to filter out contaminants and pathogens. With the fictitious stormwater treatment model created for this study, average values of the physicochemical parameters were collected from the stormwater discharge after it had been filtered and treated. The use of potash alum has had a variety of effects on the water's quality. From 697 mg.L-1 to 635 mg.L-1, the total dissolved solids dropped. The DO dropped from 5.87 mg.L-1 to 3.92 mg.L-1 as well. Additionally, the turbidity rose from 4.42 FNU to 4.58 FNU, and the salinity rose from 0.7 PSU to 1.44 PSU, respectively. pH decreases from 19.78 to 15.17 mg.L-1, BOD decreases from 8.35 to 6.51, and COD decreases from 2.55 to 1.9. Calcium hardness has decreased from 287 mg.L-1 to 265.83 mg.L-1. The conductivity increases marginally from 3.24 ms.cm-1 to 3.82 ms.cm-1. The Fe2+ and Zn2+ ions exhibit a little decrease from 0.143 mg.L-1 to 0.055 mg.L-1 and from 0.092 mg.L-1 to 0.045 mg.L-1, respectively. Due to inadequate or nonexistent drainage systems in the many states and villages throughout the country, stormwater run-off management and treatment in Nigeria have been a colossal failure. Effective stormwater management can be sustained by using legal and environmental laws. [ABSTRACT FROM AUTHOR]

A strategic shift towards sustainable, appropriate supply chain networks and data-driven decision-making in solid waste management in rural and urban areas can drastically reduce environmental pollution. This study utilizes a hybrid strategy of genetic algorithms and fuzzy logic to improve the supply chain network in solid waste management in Lagos State. In this research, four local governments in Lagos State are taken as a case study to help Identify solid waste in those selected areas, acquire data to better understand the supply chain network in solid waste management, and use the data acquired to model for the algorithm. A series of 30 iterations were carried out using a fitness parameter of frequency, price range, and means of disposal to determine who should be given utmost importance in the chain. Supply chains often exhibit inadequacies that may be enriched using Artificial Intelligence (AI) tools. The optimization model is flexible and useful, so everyone involved in the chain can coexist harmoniously. One of the reasons causing these inadequacies in proper waste management is a poorly planned supply chain network. It was concluded that the scavengers must be recognized as major participants in the movement of waste from houses to these provided refuse bins, with their frequency increased to 6 times daily with dustbins ranging from 9-20 be provided on each street which the private service participants (PSP). [ABSTRACT FROM AUTHOR]

Pollution abatement and flood control activities require effective water resource planning, engineering assessment, sophisticated technology, and appropriate hydraulic structure designs. This paper x-rays flood mitigation and pollution abatement strategies that can be adopted in the Kaduna metropolis in Nigeria. Analytical hierarchy process of design, questionnaires, engineering assessment approach, and standard method for estimation of the runoff discharge was adopted for this research. Estimating water balance components and QSWAT Hydrological Model can be used with the QGIS interface for a greener environment. Suitable hydraulic systems were designed for long-term flood control in the River Kaduna catchment area through an analytic hierarchy Process. Statistical analysis, manning equations, and rational methods were utilized for adequate assessment and planning. The hydraulic discharge capacity of culverts, open channels, and other hydraulic structures was carefully checked. Flooding greatly impacts infrastructural development, and inadequate drainage systems contribute to it. Mitigation strategies, adequate water resource planning, and management will greatly benefit from addressing flood-related issues in the study area. This research provides information on the flood vulnerability of infrastructures and mitigation strategies that can be adopted in the study area. Viable policies and management strategies can be utilized to avert losses traceable to floods in developing and developed countries. [ABSTRACT FROM AUTHOR]

Medical facilities, such as hospitals, clinics, and locations where diagnosis and treatment are administered, create dangerous waste that predisposes individuals to deadly infections. Medical waste management aims to improve health and prevent public health and environmental threats. Questionnaires, interviews, site visitations, and observations were utilized to determine the management strategies implemented in the three hospitals and evaluate the efficacy of waste management. The hospitals under review are Afe Babalola University Multi-system Hospital (AMSH), Ekiti State University Teaching Hospital (EKSUTH), and Federal Teaching Hospital Ido-Ekiti (FETHI). Statistical Package for the Social Sciences (SPSS) was utilized for the statistical analysis of the questionnaires, and the mean assessment was utilized to compute the waste per bed each day. The results revealed that the three hospitals' sharp, infectious, and pharmaceutical waste is the most sorted. All hospitals burn their medical waste in incinerators but dispose of the ashes in dumpsites. The mean evaluation of all hospitals' medical waste was weighed to establish the overall amount generated. The total amount of medical waste created at AMSH, EKSUTH, and FETHI is 31.5 kg, 53.6 kg, and 135.1 kg, respectively. The medical waste generated per bed per day in AMSH, EKSUTH, and FETHI is 0.61 kg, 0.74 kg, and 0.73 kg, respectively. It was determined that the proper management and disposal of waste is a critical obligation of healthcare facilities. There should be a provision for educating personnel about the consequences of inappropriately disposing of medical waste. [ABSTRACT FROM AUTHOR]

As urbanization and population increase in the megacity, there is a need for engineering intervention and strategic monitoring of groundwater around landfills for environmental sustainability, pollution reduction and public health. This study evaluated water's physical and chemical parameters in wells and boreholes near the Olusosun landfill in Lagos State to determine how they impact groundwater quality. An Atomic Absorption Spectrometer (AAS) was used to evaluate groundwater samples obtained from five locations within the dump site. Some water parameters, such as dissolved oxygen (DO), iron (Fe), lead (Pb), manganese (Mn), and magnesium (Mg), had concentrations that were higher than the WHO, NESREA, and Nigerian Standard for Drinking Water Quality (NSDWQ) standard limits in some sampling sites, with mean concentrations of 0.33 mg.L-1, 0.04 mg.L-1, 0.74 mg.L-1, and 0.74 mg.L-1, respectively. A small amount of lead was identified in the groundwater of the study area. A major source of air and groundwater pollution, the Olusosun landfill has a detrimental impact on the health of those who live there. Solid waste, groundwater interactions, and contaminated migration into the nearby neighbourhood were studied. It was observed that the degradation of waste products in dump sites releases harmful leachate into the groundwater. Even though some heavy metal concentrations in the study area are still within WHO, NESREA, and NSDWQ standard limits, investigations and further monitoring should be conducted regularly to assess the concentrations of heavy metals in groundwater. [ABSTRACT FROM AUTHOR]

Characterization and treatment of greywater are major environmental issues in most nations of the world. The research aims to characterize and evaluate recycling technologies using an analytical hierarchical process for Afe Babalola University Ado-Ekiti (ABUAD) community. A survey was conducted around ABUAD to determine the number of functioning boreholes and active water systems in the area, the total population of students was derived from the total head count of each room and student in each hostel, and a population projection for the next 3 years was conducted to determine the rate at which the student body will grow in terms of future water demands, and daily water volume and questionnaires were used to collect data. Before developing the small-scale model of the greywater filter system (consisting of activated carbon, shaft sand, pebbles, cotton fiber, and gravel), water grey samples were gathered from several ABUAD locations to evaluate the pollution level of each greywater source. A total of 88 students (43 males and 45 females) replied to the survey, revealing their high need for clean water and their dissatisfaction with the water supply in their respective hostels. The water quality tests conducted in the various locations of ABUAD reveal high levels of total dissolved solids (TDS) and turbidity, particularly in the girl's hostels, and the water was discovered to be predominantly alkaline. After passing a sample of greywater through the small-scale greywater filtering device, it was determined to be effective, since it produced clear, reusable water and a greywater filtration system in ABUAD will yield favorable outcomes. [ABSTRACT FROM AUTHOR]

Pollution of the environment and inappropriate management of medical wastes are major challenges facing developing countries and this must be tackled with recent technology for public health, enhanced natural ecosystems, and a better environment. This research is a two-step process that involves the assessment of the existing Hospital waste management practices in a multi-system Hospital in Ado-Ekiti, Nigeria. Excess air, kerosene (auxiliary fuel), single chamber, Batch-fed (Manual feeding), and controlled air incinerator were designed. Wastes were loaded once at the beginning of the combustion cycle followed by combustion, ash burnout, cool down, and ash removal to assist medical waste management. Findings revealed that personnel involved in handling medical waste were equipped with inadequate protective gear. Medical waste was handled together with municipal waste and both wastes were incinerated in an open dumpsite without engineered sanitary landfill at disposal locations constituting a nuisance with a high risk of pollution to the surrounding environment. The incinerator was designed for a waste load of 269 kg.day-1. It consists of four zones; the waste and combustion zone (2.7 m × 1.8 m × 1 m), the ash zone (0.23 m height), the combustion fumes and one-second retention zone (0.43 m height) as well as the excess air zone (0.46 m height). This low-cost medical waste incinerator has a lot of improvement, operational effectiveness, and efficiency to the currently available techniques. Viable recommendations made will improve the state of environmental health and reduce the harmful effects of medical waste. [ABSTRACT FROM AUTHOR]

This paper explores the deployment of multimodal elements as appraisal resources in #Endsars civil unrest-related memes in Nigerian social media space (WhatsApp and Twitter) to express affective meanings and intersubjective positioning. The study investigates how both verbal and non-verbal elements are deployed as appraisal resources to evaluate the trajectory of the protest. The data, which comprise thirty purposively selected Internet memes, collected between October and December, 2020, were analysed qualitatively. The study shows that the meme producers, through the use of multimodal concepts such as symbolic, analytical, action, reactional processes, offer and salience, among others, project various expressions of affect, judgement and appreciation of things to create important narratives in the memes. Thus, the verbal elements are graded/upscaled through the non-verbal elements in the memes to evoke specific reactions, positive/negative, which signal intersubjective positioning about the protest and relevant social actors. The study concludes that meme producers effectively utilize multimodal elements to interrogate various expressions of attitude and intersubjective opinions that Nigerians made about the protest and its management by the Nigerian government.

Olajumoke Arinola Oyebode, Nicolette Nadene Houreld Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, Gauteng, South AfricaCorrespondence: Olajumoke Arinola Oyebode, Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, Gauteng, South Africa, Tel + 27781519058, Email daramzjay09@gmail.comPurpose: Photobiomodulation (PBM) promotes diabetic wound healing by favoring cell survival and proliferation. This study aimed to investigate the potential of PBM in stimulating cellular migration, viability, and proliferation using the transforming growth factor-β 1 (TGF-β 1)/Smad signaling pathway.Methods: The study explored the in vitro effects of near infrared (NIR) light on cell viability (survival) and proliferation as well as the presence of TGF-β 1, phosphorylated TGF‐β receptor type I (pTGF-βR1) and phosphorylated mothers against decapentaplegic‐homolog (Smad)‐2/3 (p-Smad2/3) in different fibroblast cell models.Results: Results show a significant increase in cellular migration in wounded models, and increased viability and proliferation in irradiated cells compared to their respective controls. An increase in the presence of TGF-β 1 in the culture media, a reduction in pTGF-βR1 and a slight presence of p-Smad2/3 was observed in the cells.Conclusion: These findings show that PBM at 830 nm using a fluence of 5 J/cm2 could induce cell viability, migration and proliferation to favor successful healing of diabetic wounds. This study contributes to the growing body of knowledge on the molecular and cellular effect of PBM and showcases the suitability of PBM at 830 nm in managing diabetic wounds.Keywords: diabetic wound, photobiomodulation, wound healing, hyperglycemia, NIR light

Summary: Background: Current UK guidance recommends that adolescents with obesity attend a family‐based multi‐component obesity intervention. However, these programmes suffer from low recruitment and high rates of attrition. Understanding the views of adolescents is necessary for developing future interventions. The aim of this systematic review was to synthesize and explore the views of adolescents who have attended an obesity intervention. Methods: Published literature was identified by searching six databases. Studies of adolescents (12–17 years) who attended an obesity intervention were examined. Only studies that collected and analysed data qualitatively were included. Full texts were analysed using thematic synthesis. Results: Twenty‐eight studies were included. Thirty‐five analytical themes were developed that were broadly divided into seven domains. Key themes included ensuring adolescents receive a 'tailored intervention' that involves 'active engagement'. Support from professionals, family and peers were valued highly. Adolescents expressed 'prior fears of attending interventions' and wanted 'longer term support'. 'Enjoyment of sport and physical activity' was evident, and adolescents were strongly motivated by improving body image and social desirability. Discussion Considering the views of adolescents attending obesity interventions may help to inform policy makers in the development of future interventions. This may lead to an improvement in recruitment and attrition rates. [ABSTRACT FROM AUTHOR]

This study involved the development of a nanofluid and its experimental use during a machining operation for enhancement of the surface profile of a mild steel rod. Silica nanoparticles were made from coconut shell and rice husk using a chemical process, and then disseminated into distilled water to create the hybrid nanofluid. A control sample was used to compare the performance of the created nano machining fluid. The mild steel samples had a better surface roughness when nano machining fluids were used.

This research created a cutting tool made of recycled steel, palm kernel shell and alloy additives. Scrapped crankshaft and rod (100 kg) containing 0.5607% carbon were charged into an electric induction furnace with a maximum temperature of 3000℃ for melting. Before and after melting, the chemical composition of the charged components was determined using a UV-VIS spectrometer. Alloy additives were added in order to meet the carbon and other elements content of high Speed Steel materials. Samples were pulverized with carbon and heat treated. The performance of developed tool was evaluated using wear rate, toughness and micro structural analysis respectively. High proportion of carbide and strengthened martensite were obtained from the microstructure. The tool’s surface hardness and micro-hardness were 76.8 and 47.9 HB, respectively, while that of the control sample’s were 76.3 and 46.1 HB. Minimum wear rate and toughness of the 1ool were 1095x10-8m2/N and 15.01 J, while those of the control sample were 1.127x10-8 Cm2/N and 17 J respectively.

Background:There is a need for interventions to promote uptake of breast screening throughout Europe.Methods:We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122).Findings:In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ2=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ2=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01).Interpretation:Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities. [ABSTRACT FROM AUTHOR]

In this study, we identified bioactive compounds from the ethanolic extracts of the leaves, stem bark and root bark of Acalypha wilkesiana through GC-MS analysis and investigated the effects of these extracts on some of the enzymes linked to type 2 diabetes. Plant parts were extracted sequentially with ethyl acetate, ethanol and water. GC-MS analysis revealed the presence of long-chain alkyl acids, esters, ketones and alcohols including phytol and phytol acetate along with some secondary metabolites such as xanthone, vitamin E and various types of sterols including stigmasterol, campesterol and sitosterol. Ethanolic extracts of all the parts showed a dose- -dependent inhibition of α-glucosidase and α-amylase activity. The extracts also demonstrated anti-lipase activity. The ethanolic extract of root bark showed the highest inhibition of enzymes compared to other extracts. The EC50 values (concentrations for 50 % inhibition) of α-glucosidase, α-amylase and lipase inhibition were 35.75 ± 1.95, 6.25 ± 1.05 and 101.33 ± 5.21 μg mL-1, resp. The study suggests that A. wilkesiana ethanolic extracts have the ability to inhibit the activity of enzymes linked to type 2 diabetes. Further studies are needed to confirm the responsible bioactive compounds in this regard.

The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence). Technical considerations demonstrate that health examination surveys make an irreplaceable contribution to the local availability of primary health data that can be used in a range of further studies (e.g. normative, burden-of-disease, care cascade, cost and policy impact studies) essential for informing several phases of the health planning cycle (e.g. surveillance, prioritization, resource mobilization and policy development). Examples of the use of health examination survey data in the World Health Organization (WHO) European Region (i.e. Finland, Italy, Malta and the United Kingdom of Great Britain and Northern Ireland) and the WHO Region of the Americas (i.e. Chile, Mexico, Peru and the United States of America) are presented, and reasons why health provider-led data cannot replace health examination survey data are discussed (e.g. underestimation of morbidity and susceptibility to bias). In addition, the importance of having nationally representative random samples of the general population is highlighted and we argue that health examination surveys make a critical contribution to external quality control for a country's health system by increasing the transparency and accountability of health spending. Finally, we consider future technological advances that can improve survey fieldwork and suggest ways of ensuring health examination surveys are sustainable in low-resource settings., ((c) 2024 The authors; licensee World Health Organization.)

Background: Perinatal outcomes are poor among migrant women in vulnerable situations, but little is known about their health preconception. We investigated preconception health inequalities between migrant women in vulnerable situations and non-migrant women., Methods: This national cross-sectional study used data from the NHS Maternity Services Data Set (MSDS) version 1.5, incorporating NHS maternity services in England. All 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Migration category data were available for 66.2 % ( n = 432,022). Odds ratios were calculated comparing preconception indicators among probable migrants in vulnerable situations (English not their first language with complex social factors (CSF)), probable migrants not in vulnerable situations (English not their first language without CSF), probable non-migrants in vulnerable situations (English their first language with CSF) and probable non-migrants not in vulnerable situations (English their first language without CSF). CSF include recent migrants, asylum seekers, refugees, difficulty reading/speaking English; alcohol and/or drugs misuse; aged under 20; and/or experiencing domestic abuse., Findings: We identified 3.8 % (25,070 women) of the study population as probable migrants in vulnerable situations, 10.2 % (66,783 women) as probable migrants not in vulnerable situations, 5.6 % (36,433 women) as probable non-migrants in vulnerable situations, 46.5 % (303,737 women) as probable non-migrants not in vulnerable situations, and 33.8 % as having missing migration category data. Probable migrants in vulnerable situations ( n = 25,070) had over twice the odds of not taking folic acid preconception compared to probable non-migrants not in vulnerable situations (odds ratio 2.15, 95 % confidence interval 2.06-2.25). They had increased odds of previous obstetric complications and being underweight, but lower odds of physical and mental health conditions (apart from diabetes and hepatitis b), smoking and overweight or obesity., Interpretation: Inequalities exist across many preconception indicators, highlighting opportunities to improve preconception health in this population to reduce health inequalities and improve perinatal and neonatal outcomes., Funding: Medical Research Council., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Majel McGranahan reports financial support was provided by UKRI Medical Research Council. Danielle Schoenaker reports financial support was provided by NIHR Southampton Biomedical Research Centre. Helen Duncan reports a relationship with Office for Health Improvement and Disparities that includes: employment. Debra Bick reports a relationship with MASIC foundation that includes: board membership. HD is National lead for lifecourse intelligence at the Office for Health Improvement and Disparities, Department of Health and Social Care If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: Typical adolescent diets do not meet current dietary recommendations. There is a need to address these dietary patterns to reduce the risk of obesity and other diet-related diseases. Schools provide an opportune setting to do so, as students consume a substantial proportion of their daily dietary intake whilst at school. There is a developing evidence base on the use of choice architecture (food choice cues) to promote healthy eating in school contexts. It is necessary to understand the acceptability and feasibility of implementing such interventions. We aimed to explore these factors from the perspectives of secondary school caterers., Methods: We conducted qualitative interviews with caterers from secondary schools across the West Midlands, UK and national/regional catering representatives. A semi-structured topic guide and visual aid were used to guide interviews. Interviews were recorded and transcribed. Framework analysis was conducted in NVivo v12., Results: Twelve participants took part. Seven themes were identified and grouped into three categories: Acceptability (Suitability; Salient cues; Student engagement), Barriers (Catering decision drivers; Limits of influence), and Enablers (Perceived role; Opportunities). Caterers considered healthy food cues to be suited to adolescents as they require minimal reflective motivation. Salient cues included enhancing the placement, presentation and portability of healthy items, improving the dining environment and focusing pricing/incentive strategies on increased quantity. Student engagement was considered important. Some catering decision drivers conflicted with healthy food cues, and many felt that their role in healthy eating was limited due to the overwhelming influence of external food environments, adolescent resistance, and features of the secondary school canteen setting e.g. short duration of lunchtime, lack of space. However, caterers appeared motivated to implement healthy food cues and identified key opportunities for implementation, including integration into whole-school approaches to healthy eating., Conclusions: Interventions using healthy food cues appeared acceptable to secondary school caterers, key potential implementers of these strategies. Future interventions could incorporate strategies relating to placement, presentation and pricing to prompt healthy selections, and actions to engage the student body and improve the dining environment. Evaluations should consider potential impacts upon food purchasing, consumption and waste to address caterers' concerns about these issues., (© 2024. The Author(s).)

Problem: Although social media can be an accessible option for women to receive support, there is increasing awareness of the negative mental health impacts of social media use during the postpartum period. Idealistic portrayals on social media have been shown to lead to body dissatisfaction and low mood., Background: The beginning of a child's life is a period of significant physical, mental and social adjustment for a mother. Women often resort to online sources of information to navigate this time period., Aim: This study explored the content featured in prominent health and exercise Instagram account posts targeting pregnant and postpartum women., Methods: Popular individual health and exercise focused accounts targeting pregnant and post-partum women were identified on Instagram. Data about the account holder and content of posts were extracted. Data were analysed using inductive content analysis., Findings: Most included accounts belonged to American women aged 35-44 who were slim. Content analysis of 317 posts from 43 Instagram accounts unveiled six themes: reasons to exercise, weight management, guidance on doing exercise, eating well or not so well, fitting it all in, and comparison of body image., Discussion /conclusion: Content analysed was not representative of the general population. Included posts could shape beliefs that may lead to intrapersonal weight stigma. Consideration must be given to actions that could promote individuals of all body sizes being represented in the media relating to pregnancy and the postpartum period., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Neighbourhood effect on health outcomes is well established, but little is known about its effect on access to essential health services (EHS). Therefore, this study aimed to assess the contributing factors to access to EHS in slum versus non-slum settings., Methodology: The most recent data from 58 Demographic and Health Surveys (DHS) conducted between 2011 and 2018 were used, including a total of 157,000 pairs of currently married women aged 15-49 and their children aged 12-23 months. We used meta-analysis techniques to examine the inequality gaps in suboptimal access to EHS between mother-children pairs living in slums and non-slums. Blinder-Oaxaca decomposition technique was used to identify the factors contributing to the inequality gaps in each low- and middle-income country (LMIC) included., Result: The percentage of mother-child pairs living in slums ranged from 0.5% in Egypt to 63.7% in Congo. Meta-analysis of proportions for the pooled sample revealed that 31.2% [27.1, 35.5] of slum residents and 20.0% [15.3, 25.2] among non-slum residents had suboptimal access to EHS. We observed significant pro-slum inequalities in suboptimal access to EHS in 28 of the 52 LMICs with sufficient data. Of the 34 African countries included, 16 showed statistically significant pro-slum inequality in suboptimal access to EHS, with the highest in Egypt and Mali (2.64 [0.84-4.44] and 1.76 [1.65, 1.87] respectively). Findings from the decomposition analysis showed that, on average, household wealth, neighbourhood education level, access to media, and neighbourhood-level illiteracy contributed mostly to slum & non-slum inequality gaps in suboptimal access to EHS., Conclusion: The study showed evidence of inequality in access to EHS due to neighbourhood effects in 26 LMICs. This evidence suggests that increased focus on the urban poor might be a important for increasing access to EHS and achieving the universal health coverage (UHC) goals., (© 2024. The Author(s).)

Cardiovascular disease (CVD) is the leading cause of mortality globally, and is the second main cause of mortality in the UK. Four key modifiable behaviours are known to increase CVD risk, namely: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. Behaviours that increase the risk of CVD can spread through social networks because individuals consciously and unconsciously mimic the behaviour of others they relate to and admire. Exploiting these social influences may lead to effective and efficient public health interventions to prevent CVD. This project aimed to construct and validate an agent-based model (ABM) of how the four major behavioural risk-factors for CVD spread through social networks in a population, and examine whether the model could be used to identify targets for public health intervention and to test intervention strategies. Previous ABMs have typically focused on a single risk factor or considered very small populations. We created a city-scale ABM to model the behavioural risk-factors of individuals, their social networks (spousal, household, friendship and workplace), the spread of behaviours through these social networks, and the subsequent impact on the development of CVD. We compared the model output (predicted CVD events over a ten year period) to observed data, demonstrating that the model output is realistic. The model output is stable up to at least a population size of 1.2M agents (the maximum tested). We found that there is scope for the modelled interventions targeting the spread of these behaviours to change the number of CVD events experienced by the agents over ten years. Specifically, we modelled the impact of workplace interventions to show that the ABM could be useful for identifying targets for public health intervention. The model itself is Open Source and is available for use or extension by other researchers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Archbold et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Oxidative stress, an imbalance between pro-oxidant and antioxidant status, favouring the pro-oxidant state is a result of increased production of reactive oxygen species (ROS) or inadequate antioxidant protection. ROS are produced through several mechanisms in cells including during mitochondrial oxidative phosphorylation. Increased mitochondrial-derived ROS are associated with mitochondrial dysfunction, an early event in age-related diseases such as Alzheimer's diseases (ADs) and in metabolic disorders including diabetes. AD post-mortem investigations of affected brain regions have shown the accumulation of oxidative damage to macromolecules, and oxidative stress has been considered an important contributor to disease pathology. An increase in oxidative stress, which leads to increased levels of superoxide, hydrogen peroxide and other ROS in a potentially vicious cycle is both causative and a consequence of mitochondrial dysfunction. Mitochondrial dysfunction may be ameliorated by molecules with antioxidant capacities that accumulate in mitochondria such as carotenoids. However, the role of carotenoids in mitigating mitochondrial dysfunction is not fully understood. A better understanding of the role of antioxidants in mitochondrial function is a promising lead towards the development of novel and effective treatment strategies for age-related diseases. This review evaluates and summarises some of the latest developments and insights into the effects of carotenoids on mitochondrial dysfunction with a focus on the antioxidant properties of carotenoids. The mitochondria-protective role of carotenoids may be key in therapeutic strategies and targeting the mitochondria ROS is emerging in drug development for age-related diseases., (© 2024 The Author(s).)

Background: The prevalence of obesity is rising globally and effective strategies to treat obesity are needed. Intermittent fasting, a dietary intervention for weight management, has received growing interest from the general public, as well as healthcare professionals, as a form of lifestyle intervention., Methods: We executed a rapid review using PUBMED database to identify systematic reviews that examined the impact of intermittent fasting on metabolic indices, published between 2011 and 2022., Results: Intermittent fasting leads to weight loss of a similar magnitude to continuous energy restriction. Most of the evidence shows that intermittent fasting leads to greater fat loss as measured by fat mass (kg) or body fat percentage compared to an ad libitum diet, but fat loss attained during intermittent fasting is not significantly different to continuous energy restriction, although recent evidence shows intermittent fasting to be superior. There is mixed evidence for the impact of intermittent fasting on insulin resistance, fasting glucose and lipid profile. Some studies focused on populations of Muslim people, which showed that Ramadan fasting may lead to weight loss and improvement of metabolic parameters during fasting, although the effects are reversed when fasting is finished., Conclusions: Intermittent fasting is more effective than an ad libitum dietary intake, and equally or more effective as continuous energy restriction, for weight management. However, there is inconclusive evidence on whether intermittent fasting has a clinically beneficial effect on glucose and lipid metabolism., (© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Poor diets lead to negative health outcomes, including increased risk of noncommunicable diseases. Food systems, most notably agriculture, contribute to greenhouse gas emissions (GHGE) that lead to climate change. Meat consumption plays a role in both health and environmental burden. Consumption of meat alternatives may reduce these harms. The aim was to compare meat products and their plant-based alternatives on nutritional parameters, GHGE and price to examine if it is feasible and beneficial for policymakers and health professionals to recommend meat alternatives., Methods: Data on nutritional information and cost for 99 selected products were collected from five UK supermarkets. Estimates for GHGEs for 97 of these products were found through secondary articles. Median values for nutritional value, GHGE (kgCO 2 e) and price per 100 g were calculated to allow comparisons between meat products and their alternatives. Mann-Whitney U tests were used to look for significant differences for each nutrient, emissions and price., Results: Meat alternatives contained significantly more fibre and sugar and were significantly higher in price compared to the equivalent meat products. Meat alternatives had a significantly lower number of calories, saturated fat, protein and kgCO 2 e than meat products. There was no significant difference in the amount of salt between meat and meat alternatives., Conclusions: Overall, this paper found that meat alternatives are likely to be better for health according to most parameters, while also being more environmentally friendly, with lower GHGEs. However, the higher price of these products may be a barrier to switching to meat alternatives for the poorest in society., (© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Introduction: Tobacco taxation remains a poorly used intervention to control tobacco use in many low- and middle-income countries (LMICs) including Pakistan even after two decades of FCTC adoption. This study identifies gaps and implementation challenges in the current Tobacco Taxation and Pricing Policies (TTPP) in Pakistan, and highlights key policy implications and lessons for LMICs to strengthen tobacco control measures., Methods: We used qualitative document analysis to examine the policy documents to assess the TTPP against the WHO Framework Convention on Tobacco Control (FCTC) guidelines for the implementation of Article 6 of the FCTC. In addition, we used secondary data on tobacco tax and prices to assess the impact of TTPP on tobacco affordability in the country., Results: Although Pakistan taxes raw tobacco, cigarettes and other tobacco products (cigarillos, cigars, cheroots), the existing TTPP falls below the WHO FCTC requirements of: uniform tax level, simple tax structure and 70% share of excise tax in the price of a product's pack; among others. There are also multiple issues in tobacco tax administration such as lack of monitoring. This is leading to the availability of highly affordable tobacco products in the country., Conclusions: Pakistan does not have a clear strategy on using tobacco taxation and prices as a public health tool in the country. Existing TTPP face dual issues of flawed structure and poor administration translating into highly affordable tobacco products and low revenues in the country. There is a need to introduce multisectoral tobacco control policies in countries like Pakistan in the context of the tobacco sector political economy., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2023 Masud H. et al.)

Background: A team of volunteers, known as City Hosts, were recruited to support UK City of Culture 2021 awarded to Coventry. City Hosts held various roles facilitating cultural event delivery and promoting a positive experience for visitors. This study aimed to (i) understand how and to what extent the volunteering programme impacted volunteer subjective wellbeing, and (ii) explore the mechanisms of change and intermediate outcomes between volunteering and subjective wellbeing., Methods: This qualitative study comprised inductive and deductive analysis of data collected through semi-structured interviews, conducted between December 2021-May 2022 with City Hosts. This was complimented with secondary qualitative analysis of free text responses within Monitoring and Evaluation data collected from City Hosts in surveys conducted in August and November 2021, and April 2022., Results: Approximately 180 City Hosts responded to the free text questions in each survey and 27 completed interviews. Analysis of data collected from City Hosts suggested positive wellbeing impacts from volunteering and supported theorised pathways to improved wellbeing. Strengths of the City Host programme included (i) facilitating the full range of mechanisms of change that mediate improved volunteer wellbeing, particularly promoting social connections and developing a strong role and group identity and (ii) flexibility around what volunteers do, how much, and how often., Conclusions: This study offers lessons for others designing volunteering programmes who wish to promote wellbeing among associated volunteers. We also offer evidence that exposure to culture may be one mechanism by which volunteering can improve wellbeing., (© 2023. BioMed Central Ltd., part of Springer Nature.)