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In 2008, the National Institutes of Health's (NIH) Undiagnosed Disease Program (UDP) was initiated to provide diagnoses for individuals who had long sought one without success. As a result of two international conferences (Rome 2014 and Budapest 2015), the Undiagnosed Diseases Network International (UDNI) was established, modeled in part after the NIH UDP. Undiagnosed diseases are a global health issue, calling for an international scientific and healthcare effort. To meet this demand, the UDNI has built a consensus framework of principles, best practices and governance; the Board of Directors reflects its international character, as it includes experts from Australia, Canada, Hungary, Italy, Japan and the USA. The UDNI involves centers with internationally recognized expertise, and its scientific resources and know-how aim to fill the knowledge gaps that impede diagnosis. Consequently, the UDNI fosters the translation of research into medical practice. Active patient involvement is critical; the Patient Advisory Group is expected to play an increasing role in UDNI activities. All information for physicians and patients will be available at the UDNI website. [ABSTRACT FROM AUTHOR]

The recent advances in machine translation (MT) offer an appealing and low-cost solution to overcome language barriers in multiple contexts (e.g., travelling, cultural interaction, digital content localisation). However, highly-technical domains typically exhibiting as long, complex, and specialised texts as the healthcare sector, pose multiple challenges to the effective and risk-safe use of MT. To examine how MT nowadays assists written/verbal health communication and because of the existing considerable heterogeneity in technological enablers, language pairs and user groups, training approaches, evaluation processes, and users" requirements, we propose in this paper a methodological multi-criteria literature review based on current guidelines in computer science research and grounded on a customised configuration of the PRISMA methodology, normally used to perform meta-analyses on clinical trials. The review focuses on language-to-language medical MT, covers the time period January 2015–February 2023, and only refers to articles written in English that are accessible via four scientific online digital libraries. Articles are ranked according to a meta-evaluation scoring method for MT scientific credibility along with a scoring for assessing the scope of MT in healthcare. Finally, a guideline to properly design a study about MT in healthcare is also proposed. The review included a final set of 58 articles from journals (n = 30) and conference proceedings (n = 28), considering 48 different language combinations. We identified a predominance of English-to-Spanish (n = 19) and English-to-Chinese (n = 16) implementations, mainly tailored to medical staff only (n = 14) or along with patients (n = 12). Included papers addressed clinical communication (n = 21) and health education (n = 37). Unidirectional real-time bilingual MT (n = 24) was the most frequent configuration. MT implementations were dominated by Google Translate (n = 22) often used as baseline, OpenNMT (n = 12), or Moses (n = 11). Training and evaluation approaches varied considerably, while deployment and pre-/post-editing were rarely described with an adequate level of detail. Even if a significant number of articles reported that the proposed MT solutions were effective when translating (bio)medical texts, only a subset of them complied with rigorous translation quality assessment criteria (e.g., use of automatic metrics better related to human ranking than BLEU or statistical significance testing). Nevertheless, MT can be a valid support/supplement in health communication but to cope with issues in fluency, accuracy, unnatural translations, domain-adequacy, and potential safety risks (for highly-sensitive documents), appropriate MT training is essential, along with in-domain human post-editing. The presence of in-domain training text corpora has also proven to be beneficial. Finally, guidelines about how to design studies on MT in healthcare are also proposed to engage more researchers in this field. • Machine Translation (MT) is a tempting low-cost solution to lower language barriers. • When used in the health sector, MT is effective for translating non-sensitive texts. • Even neural MT solutions still pose safety concerns in specialised medical contexts. • MT in healthcare is a valuable support but requires appropriate quality assessment. • Shared guidelines to design and evaluate studies on MT in healthcare are essential. [Display omitted] [ABSTRACT FROM AUTHOR]

In the late nineteenth century, the city of Melbourne, Australia, experienced unusually high tuberculosis mortality. Dr. William Thomson, whose statistical methods uncovered the epidemiological trend, argued that at least one in three of the adult population of Melbourne between the ages of twenty and forty-five died of tuberculosis. While Thomson's research challenged existing epistemologies of medicine, advocating sanitary rather than climatological aetiology, he was ultimately incapable of identifying the major factors in the spread of tuberculosis. Drawing on recent public health scholarship, which suggests a firm link between land use change and emerging infectious diseases, this paper examines the role of cultural, political, economic, and ecological activities of nineteenth-century Melbournians in constructing a niche suited to the success of Mycobacterium tuberculosis. Using epidemiological techniques, GIS, and historical records, this paper analyzes the city's ability to handle waste, stagnant water, and other vectors of disease, and considers how manipulations of the landscape to accommodate the growing city's sanitary and commercial needs exacerbated transmissibility of tuberculosis. It concludes that the imported characteristics of the British colonial city fostered land use change uniquely suited to the perpetuation of one of the most prolific diseases of the modern era. • Tuberculosis merits consideration as an ecologically-driven disease.. • Human niche construction has facilitated tuberculosis' spread.. • Melbourne's historical tuberculosis rate can be linked to the city's period of growth.. • Characteristics specific to British settler colonies led to tuberculosis mortality.. [ABSTRACT FROM AUTHOR]

This literature review systematically examines the impacts of violating planetary boundaries from 2009 to 2023, emphasizing the implications for human health. Planetary boundaries define safe operational limits for Earth's systems, and their transgression poses significant threats to environmental stability and public health. This paper reviews extensive research on the health effects of breaches in these boundaries, including climate change, biodiversity loss, freshwater use, and aerosol loading. The review integrates findings from numerous studies, providing a critical overview of health impacts across various global regions. The analysis underscores the intricate links between planetary boundaries breaching impacts, highlighting urgent policy and governance challenges. The study's outcomes aim to inform policymakers, businesses, and communities, promoting sustainable development and resilience in the face of escalating global challenges. [ABSTRACT FROM AUTHOR]

A significant body of literature has developed which examines why meat consumption continues to be so important to Americans. Our paper contributes to this literature by examining how fear of stigmatization may be a barrier to avoiding meat consumption. This is an important subject because there is evidence that suggests that individuals who avoid meat, especially vegans, are stigmatized for disrupting social conventions related to food. In this paper, we present data from a series of focus groups in which vegan, vegetarian, and omnivorous college students discussed perceptions of vegans and veganism. Our analysis shows that non-vegans anticipate stigma associated with eating like vegans. We identify two strategies by which non-vegans attempt to avoid this stigma: social and behavioral distancing. These results suggest that vegan stigma is a barrier that inhibits dietary shifts toward a plant-based diet. Our results are important because they can be used to improve the efficacy of public health initiatives focused on encouraging plant-based diet adoption and meat consumption reduction. [ABSTRACT FROM AUTHOR]

Abstract Regulatory policy to protect the public and the environment from radiation is universally based on the linear, no-threshold model (LNT) of radiation effects. This model has been controversial since its inception over nine decades ago, and remains so to this day, but it has proved remarkably resistant to challenge from the scientific community. The LNT model has been repeatedly endorsed by expert advisory bodies, and regulatory agencies in turn adopt policies that reflect this advice. Unfortunately, these endorsements rest on a foundation of institutional inertia and numerous logical fallacies. These include most significantly setting the LNT as the null hypothesis, and shifting the burden of proof onto LNT skeptics. Other examples include arbitrary exclusion of alternative hypotheses, ignoring criticisms of the LNT, cherry-picking evidence, and making policy judgements without foundation. This paper presents an evaluation of the National Council on Radiation Protection and Measurements' (NCRP) Commentary 27, which concluded that recent epidemiological studies are compatible with the continued use of the LNT model for radiation protection. While this report will likely provide political cover for regulators' continued reliance on the LNT, it is a missed opportunity to advance the scientific discussion of the effects of low dose, low dose-rate radiation exposure. Due to its Congressionally chartered mission, no organization is better positioned than the NCRP to move this debate forward, and recommendations for doing so in future reviews are provided. Highlights • The linear no-threshold (LNT) model of radiation effects has fractured the scientific community. • This paper analyzes the latest review of the LNT model, NCRP Commentary 27. • Expert reviews of the LNT model rely on institutional inertia and numerous logical fallacies. • Recommendations to advance this debate in an objective future review are provided. [ABSTRACT FROM AUTHOR]

There are many infectious diseases that can be spread by daily commuting of people and dengue fever is one of them. The absence of vaccine and irregularities in ongoing vector control programs make this disease the most frequent and persistent in many tropical and subtropical regions of the world. This paper targets to access the effects of daily commuting on dengue transmission dynamics by using a deterministic two-patch model fitted to observed data gathered in Cali, Colombia where dengue fever is highly persistent and exhibits endemo-epidemic patterns. The two-patch dengue transmission model with daily communing of human residents between patches (that is, between the city and its suburban areas) is presented using the concept of residence times, which certainly affect the disease transmission rates by inducing variability in human population sizes and vectorial densities at each patch. The same modeling framework is applied to two primary scenarios (epidemic outbreaks and endemic persistence of the disease) and for each scenario two coupling cases (one-way and asymmetric commuting) with different inflow and outflow intensities are analyzed. The concept of effective vectorial density , introduced in this paper, allows to explain in very simple terms why the daily commuting affects quite differently the dengue morbidity among human residents in both patches. In particular, residents of the patch with a greater share of incoming than outgoing commuters may actually “benefit” from inflow of daily commuter by avoiding a considerable number of infections. However, residents of the patch with a greater share of outgoing than incoming commuters, especially those who stay at home patch, incur more risk of getting infected. Additionally, the model shows that daily commuting enhance the total number of human infections acquired in both patches and may even provoke an epidemic outbreak in one patch while moderately lowering the level of the disease persistence in another patch. [ABSTRACT FROM AUTHOR]

Rumors can easily propagate through social media, posing potential threats to both individual and public health. Most existing approaches focus on single-language rumor detection, which leads to unsatisfying performance when these are applied to mixed-language rumor detection. Meanwhile, the type of mixed-language (mixture of word-level or sentence-level) is a great challenge for mixed-language rumor detection. In this paper, focusing on a mixed scene of Chinese and Tibetan, the research first provides a Chinese–Tibetan mixed-language rumor detection dataset (Weibo_Ch_Ti) that comprises 1,617 non-rumor tweets and 1,456 rumor tweets in two mixed-language types. Then, the research proposes an effective model with multi-extractors, named "MER-CTRD" for short. This model mainly consists of three extractors. The Multi-task Extractor helps the model to extract feature representations of different mixed-language types adaptively. The Rich-semantic Extractor enriches the semantic features representations of Tibetan in the Chinese–Tibetan-mixed language. The Fusion-feature Extractor fuses the mean and disparity semantic features of Chinese and Tibetan to complement feature representations of the mixed language. Finally, the research conducts experiments on Weibo_Ch_Ti. The results show that the proposed model improves accuracy by about 3%–12% over the baseline models, indicating its effectiveness in the Chinese–Tibetan mixed-language rumor detection scenario. [ABSTRACT FROM AUTHOR]

The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) is the federal government's largest form of food assistance, and a frequent focus of political and scholarly debate. Previous discourse in the public health community and recent proposals in state legislatures have suggested limiting the use of SNAP benefits on unhealthy food items, such as sugar-sweetened beverages (SSBs). This paper identifies two possible underlying motivations for item restriction, health and morals, and analyzes the level of empirical support for claims about the current state of the program, as well as expectations about how item restriction would change participant outcomes. It also assesses how item restriction would reduce individual agency of low-income individuals, and identifies mechanisms by which this may adversely affect program participants. Finally, this paper offers alternative policies to promote healthier purchasing and eating among SNAP participants that can be pursued without reducing individual agency. Health advocates and officials must more fully weigh the attendant risks of implementing SNAP item restrictions, including the reduction of individual agency of a vulnerable population. [ABSTRACT FROM AUTHOR]

• No data on burns from East African countries with low GDP. • Few burn dedicated data-registries. • Focus on pediatric and urban patients with burns from tertiary centers. Background: Burns are a global public health concern, with the majority of the disease burden affecting low- and middle-income countries. Yet, as suggested by previous publications, there is a widespread belief that literature about burns in low- and middle-income countries is lacking. Therefore, we aimed to assess with a scoping review, the extent of the literature output on burns in East Africa, and to investigate patient demographics, injury characteristics, treatment and outcomes, as reported from the existing publications. Methods: Studies discussing burns in East Africa were identified by searching PubMed / Medline (National Library of Medicine), EMBASE (Elsevier), Global Health Database (EBSCO), and Global Index Medicus on December 12, 2019. Controlled vocabulary terms (i.e., MeSH, EMTREE, Global Health thesaurus terms) were included when available and appropriate. No year restrictions were applied. Results: A total of 1,044 records were retrieved from the database searches, from which 40 articles from 6 countries published between 1993 and 2019 were included in the final review. No studies were found from five East African countries with the lowest GDP. Most papers focused on pediatric trauma patients or tertiary hospital settings. The total number of burn patients recorded was 44,369, of which the mean proportion of males was 56%. The most common cause of injury was scalds (61%), followed by open flame (17%). Mortality rate ranged from 0-67%. The mean length of stay in hospital was between 9-60 d. Conclusions: Burn data is limited in the East African region, with socio-economically weak countries being particularly underrepresented. This scoping review has identified the largest set of literature on burns in East Africa to date, indicating the importance of reviewing data at a regional or local level, as "global" studies tend to be dominated by high-income country data. Data collection in specific registries is needed to better characterize the exact burden of burn injuries in East Africa. [ABSTRACT FROM AUTHOR]

Lymphatic filariasis (LF) has been targeted for elimination as a public health concern by 2030 with a goal to keep the prevalence of LF infections under the 1% threshold. While mass drug administration (MDA) is a primary strategy recommended by WHO, the use of insecticide treated nets (ITN) plays a crucial role as an alternative strategy when MDA cannot be used. In this paper, we use imitation dynamics to incorporate human behavior and voluntary use of ITN into the compartmental epidemiological model of LF transmission. We find the equilibrium states of the dynamics and the ITN usage as it depends on epidemiological parameters and the cost of ITNs. We investigate the conditions under which the voluntary use of ITNs can keep the LF prevalence under the 1% threshold. We found that when the cost of using the ITNs is about 1 0 5 smaller than the perceived cost of LF, then the voluntary use of ITNs will eliminate LF as a public health concern. Furthermore, when the ITNs are given away for free, our model predicts that over 80% of the population will use them which would eliminate LF completely in regions where Anopheles are the primary vectors. [ABSTRACT FROM AUTHOR]

In Bangladesh, cholera poses a significant environmental health risk. Yet, information about the severity of cholera risk is limited as risk varies over time and changing weather patterns make historical cholera risk predictions less reliable. In this paper, we examine how households use geographically and temporally personalized cholera risk predictions to inform their beliefs and behaviors related to cholera and its aversion. We estimate how access to a smartphone application containing monthly cholera risk predictions unique to a user's home location affects households' beliefs about their cholera risk and their water use and hygiene behaviors. We find that households with access to this application feel more equipped to respond to environmental and health risks and reduce their reliance on surface water for bathing and washing – a common cholera transmission pathway. We do not find that households invest additional resources into drinking water treatment, nor do we find reductions in self-reported cholera incidence. Further, households with a static, non-personalized app containing public health information about cholera exhibit similar patterns of beliefs updating. Taken together, our results suggest that access to risk information can help households make safer water choices, yet improving design and credibility remain important dimensions for increasing application usability. • Satellite observations provide improved information for cholera risk. • Households in rural Bangladesh find improved information for cholera risk valuable. • Dynamic, personalized cholera risk information can change household water behaviors. • Households with a cholera early warning system reduce reliance on surface water. • Early warning system design affects sustained application use. [ABSTRACT FROM AUTHOR]

Conflicts are inevitable, and so are refugees. Due to conflicts in Ukraine, the global refugee population has reached new highs. As people continue to flee Ukraine amid the ongoing pandemic in droves, their exposure to COVID-19 and infectious diseases that are common among the refugee population, such as tuberculosis, is on the rise as well. Also factoring in the fact that Ukraine has a large population living with communicable diseases like HIV and hepatitis C, along with other non-communicable conditions like diabetes and cancer, there is a pronounced need to protect these refugees and local residents from potential public health crises. In this paper, we investigate the challenges that health and government officials face in addressing refugees' health needs and preferences. Furthermore, we discuss the imperative to provide timely and effective health services to refugees, such as psychoneuroimmunology-based interventions that could help address refugees' multifactorial and multifaceted health needs and requirements. While conflicts are inevitable, public health crises are not. In light of the renewed imperative to safeguard shared humanity and solidify global solidarity, collaborative actions are needed to ensure fair, kind, and true public health environments are available to refugees of the current conflict and beyond. [ABSTRACT FROM AUTHOR]

The overconsumption of sugar sweetened beverages is an increasing public health concern. Understanding the socio-cognitive determinants that drive such consumption could inform the development of interventions to reduce sugar sweetened beverage consumption. The aim of the present review and meta-analysis was to determine the strength of associations between socio-cognitive determinants and the amount and frequency of sugar sweetened beverage consumption among young people. A systematic review was conducted in accordance with PRISMA guidelines. A search was performed using the following databases: PsycINFO, MEDLINE, Scopus, ProQuest, and PubMed. The key search terms were: (1) children, adolescents, young adults; (2) sugar sweetened beverage consumption, choice or purchasing behaviour; and (3) socio-cognitive determinants related to sugar sweetened beverage consumption. The search identified 4325 papers, with 22 papers remaining after screening. Two separate meta-analyses were performed, one for amount (n = 14) and one for frequency (n = 8) of consumption. The most strongly associated determinants with amount of sugar sweetened beverage consumed were habit, intention to consume, and attitudes, whereas the most strongly associated determinants with frequency of consumption were intentions, injunctive norms, and descriptive norms. Comparisons between the meta-analyses revealed two distinct differences: injunctive norms were more strongly correlated with frequency of consumption, and self-efficacy with amount consumed. It was suggested that interventions that focus on multiple determinants, including components of the Theory of Planned Behaviour may result in the largest reductions in consumption. Specifically, focussing on changing attitudes, norms and habits, and increasing perceived behavioural control related to sugar sweetened beverages may be maximally effective in reducing consumption behaviour. [ABSTRACT FROM AUTHOR]

Persons with alcohol use disorders (AUDs) and substance use disorders (SUDs) appear to be heavily affected by cigarette smoking. In order to address the consequences of smoking in this population, an understanding of the current state of knowledge is needed. Epidemiologic research provides the opportunity to obtain detailed information on smoking behaviors in large community samples. The aim of this paper was to synthesize the epidemiologic evidence on smoking among persons with AUDs/SUDs and suggest directions for future research. Literature searches of Medline and PubMed were used to identify articles and additional articles were elicited from publication reference lists. To be included in the review, papers had to be published in English, analyze epidemiologic data, and examine an aspect of smoking behavior in persons with AUDs/SUDs. Twenty-nine studies met inclusion criteria and were included in the review. In summary, epidemiologic evidence to date suggests greater lifetime and current smoking, nicotine dependence, and non-cigarette tobacco use; lower quitting; and differences in quit attempts and withdrawal symptoms for persons with AUDs/SUDs compared to other people. Most studies examined nationally representative data and were conducted on persons in the United States and Australia. Few publications examined outcomes by demographics (e.g., gender, age) but these studies suggested that specific patterns differ by demographic subgroups. More research is needed on persons with AUDs/SUDs in order to develop the most effective public health and clinical interventions to reduce smoking behaviors, improve cessation outcomes, and reduce the harmful consequences of smoking for those with AUDs/SUDs. [ABSTRACT FROM AUTHOR]

Background and Introduction: Previous studies of soil eating, or geophagia, among pregnant women in sub-Saharan Africa indicate the practice is widespread. Various explanations have been explored to explain the global phenomenon of soil eating, with the most compelling explanation focused on clay's ability to prevent or treat intestinal infection. The urban South African context for clay eating is not well understood. This paper explores clay consumption amongst pregnant migrants who are nationals of countries where clay consumption may be common.Methods: I conducted in-depth interviews with a purposively selected group of Somali, Congolese, and Zimbabwean women (n = 23). Interviews included questions broadly related to maternal and infant nutrition. In addition, I conducted nine focus group discussions (n = 48) with adult Somali, Congolese (DRC), and Zimbabwean men (N = 3) and women (N = 6), segregated by country of origin and gender. This paper focuses specifically on responses related to geophagia.Results: While Somali women did not report consuming clay or charcoal, Congolese and Zimbabwean participants self-reported commonly consuming clay during pregnancy, and at times also when not pregnant. Despite having heard public health messaging that discouraged the practice, participants largely did not describe this consumption in terms of health, but rather in terms of craving and habit. Participants described continued consumption of clay in South Africa, and the only reason for ceasing consumption was in cases of severe constipation.Discussion: The widespread consumption of clay soil by Congolese and Zimbabwean women during pregnancy may be a mechanism through which identity was reasserted and reproduced in a foreign country. Participants' emphasis on clay consumption seemed related to the absence or expense of other craved foods, and perhaps also to feelings of loss in Cape Town. [ABSTRACT FROM AUTHOR]

This paper provides a critical review of recent research on the consumption of 'convenience' food, highlighting the contested nature of the term and exploring its implications for public health and environmental sustainability. It distinguishes between convenience food in general and particular types of convenience food, such as ready-meals, tracing the structure and growth of the market for such foods with a particular emphasis on the UK which currently has the highest rate of ready-meal consumption in Europe. Having established the definitional complexities of the term, the paper presents the evidence from a systematic review of the literature, highlighting the significance of convenience food in time-saving and time-shifting, the importance of recent changes in domestic labour and family life, and the way the consumption of convenience food is frequently moralized. The paper shows how current debates about convenience food are part of a longer discursive history about food, health and nutrition. It discusses current levels of public understanding about the links between convenience food, environmental sustainability and food waste. The paper concludes by making a case for understanding the consumption of convenience food in terms of everyday social practices, emphasising its habitual and routine character. [ABSTRACT FROM AUTHOR]

Just weeks away from the Opening Ceremony of the Beijing 2022 Winter Olympics, the United States, followed by Australia, the United Kingdom, and Canada, has declared a diplomatic boycott of the Games. A diplomatic boycott stipulates that while government officials of these countries will not attend the event, the athletes' scheduled attendance will largely remain intact. An unintended consequence of the boycotts is that they force the attending athletes to cope with the stress and distress associated with the 2022 Winter Olympics in an unfamiliar environment on their own. It is important to underscore that many of the challenges the athletes could face amid the Games are either deep-rooted or unprecedented, ranging from stressors fuelled by the nonstop media reports, the competitions, to the Omicron scares. These insights combined, in turn, underscore the imperative for effective and preemptive mental health support for Olympic athletes. To shed light on the issue, this paper highlights the reasons why timely solutions are needed to adequately safeguard Olympic athletes' mental health and overall wellbeing, and underlines promising technology-based solutions that can be cost-effectively designed and developed for the athletes. [ABSTRACT FROM AUTHOR]

People of all ages are increasingly consuming larger portions of food. Governments worldwide are involved in the regulation of many aspects of the food supply; however, policies and programs related to serving sizes for children vary or are not clearly communicated. This paper reviews U.S. federal and state government recommendations, policies, and laws related to serving size for children and suggests directions for future policy objectives and outstanding research needed to support the enactment of laws based on the best science. Specifically, this paper reviews federal dietary recommendations and requirements for nutrition programs, packaged food labels and restaurant menus; state regulation of retail environments and child care settings; food companies' self-regulatory options; and directions for future research and policy initiatives. The paper concludes that there are many opportunities for government to revise its policies and programs to better support healthy portion sizes for children and create a more transparent information environment to assist caretakers to do the same. [ABSTRACT FROM AUTHOR]

Gamification has drawn the attention of academics, practitioners and business professionals in domains as diverse as education, information studies, human–computer interaction, and health. As yet, the term remains mired in diverse meanings and contradictory uses, while the concept faces division on its academic worth, underdeveloped theoretical foundations, and a dearth of standardized guidelines for application. Despite widespread commentary on its merits and shortcomings, little empirical work has sought to validate gamification as a meaningful concept and provide evidence of its effectiveness as a tool for motivating and engaging users in non-entertainment contexts. Moreover, no work to date has surveyed gamification as a field of study from a human–computer studies perspective. In this paper, we present a systematic survey on the use of gamification in published theoretical reviews and research papers involving interactive systems and human participants. We outline current theoretical understandings of gamification and draw comparisons to related approaches, including alternate reality games (ARGs), games with a purpose (GWAPs), and gameful design. We present a multidisciplinary review of gamification in action, focusing on empirical findings related to purpose and context, design of systems, approaches and techniques, and user impact. Findings from the survey show that a standard conceptualization of gamification is emerging against a growing backdrop of empirical participants-based research. However, definitional subjectivity, diverse or unstated theoretical foundations, incongruities among empirical findings, and inadequate experimental design remain matters of concern. We discuss how gamification may to be more usefully presented as a subset of a larger effort to improve the user experience of interactive systems through gameful design. We end by suggesting points of departure for continued empirical investigations of gamified practice and its effects. [ABSTRACT FROM AUTHOR]

Rice, a staple diet across most countries, has been identified as one of the significant sources of arsenic accumulation, which occasions public severe health issues. Therefore, developing a rapid method for the selective detection of arsenic in rice is of great importance. Toward this goal, in this paper, an application of a fluorescent probe constructed from functionalized conductive polymer dots (FCPDots) was performed to discriminate arsenic in rice samples. In the presence of arsenic, the intense emission of the FCPDots probe at 395 nm under an excitation wavelength of 334 nm substantially decreased because of the formation of the As_S linkage. The probe represented an outstanding performance toward arsenic at linear concentrations between 0.25 and 2.00 nM with an excellent detection limit of 0.107 nM. As a final step, ICP-Mass analysis confirmed that the probe is applicable and reliable to detect trace amounts of arsenic in real samples. Interestingly, the FCPDots probe was able to detect arsenic rapidly, accurately, and selectively in several rice samples despite the heavy metal ions interferences. [Display omitted] • Functionalized conductive polymer dots (FCP Dots) used as novel fluorescence probe. • During the synthesis procedure, a simple hydrothermal method was utilized. • FCPDots probe successfully applied for the detection of As(III) in rice samples. • Results of As(III) analysis in rice sample are comparable to the ICP-Mass method. [ABSTRACT FROM AUTHOR]

Ischemic stroke (IS) is a significant global public health issue with a high incidence, disability, and mortality rate. A robust inflammatory cascade with complex and wide-ranging mechanisms occurs following ischemic brain injury. Inflammasomes are multiprotein complexes in the cytoplasm that modulate the inflammatory response by releasing pro-inflammatory cytokines and inducing cellular pyroptosis. Among these inflammasomes, the Absent in Melanoma 2 (AIM2) inflammasome shows the ability to detect a wide range of pathogen DNAs, thereby triggering an inflammatory response. Recent studies have indicated that the aberrant expression of AIM2 inflammasome in various cells is closely associated with the pathological processes of ischemic brain injury. This paper summarizes the expression and regulatory role of AIM2 in CNS and peripheral immune cells and discusses current therapeutic approaches targeting AIM2 inflammasome. These findings aim to serve as a reference for future research in this field. • The AIM2 inflammasomes are regarded as the key participants in the inflammatory response following ischemic stroke. • The pathological progression of ischemic brain injury involves aberrant expression of AIM2 inflammasomes in various cells. • Specific inhibitors directed towards AIM2 inflammasomes have the potential to serve as therapeutic agents for the management of neurological damage following an ischemic stroke [ABSTRACT FROM AUTHOR]

• Governments seek guidance on how to achieve the World Health Organization hepatitis C virus (HCV) incidence elimination target. • People who inject drugs (PWID) are a key risk group for HCV transmission. • Modeling can inform what intervention scale-up is required to achieve the WHO target of 80% incidence reduction by 2030. • Modeling indicates harm reduction alone is unlikely to achieve elimination targets among PWID. • Existing levels of testing and treatment are insufficient to achieve WHO elimination. • Models find that modest levels of HCV treatment, particularly combined with harm-reduction, can achieve elimination. • Models indicate network-based and prison-based prevention strategies could provide additional population benefits. In 2016, the World Health Organization issued global elimination targets for hepatitis C virus (HCV), including an 80% reduction in HCV incidence by 2030. The vast majority of new HCV infections occur among people who inject drugs (PWID), and as such elimination strategies require particular focus on this population. As governments urgently require guidance on how to achieve elimination among PWID, mathematical modeling can provide critical information on the level and targeting of intervention are required. In this paper we review the epidemic modeling literature on HCV transmission and prevention among PWID, highlight main differences in mathematical formulation, and discuss key insights provided by these models in terms of achieving WHO elimination targets among PWID. Overall, the vast majority of modeling studies utilized a deterministic compartmental susceptible-infected-susceptible structure, with select studies utilizing individual-based network transmission models. In general, these studies found that harm reduction alone is unlikely to achieve elimination targets among PWID. However, modeling indicates elimination is achievable in a wide variety of epidemic settings with harm reduction scale-up combined with modest levels of HCV treatment for PWID. Unfortunately, current levels of testing and treatment are generally insufficient to achieve elimination in most settings, and require further scale-up. Additionally, network-based treatment strategies as well as prison-based treatment and harm reduction provision could provide important additional population benefits. Overall, epidemic modeling has and continues to play a critical role in informing HCV elimination strategies worldwide. [ABSTRACT FROM AUTHOR]

Talking to children about their health-related understandings and experiences can provide valuable information for public health practitioners who seek to improve children's dietary behaviours. To date, however, research on children's food consumption has generally prioritized the views of parents and caregivers, rather than children themselves. This paper reports results from a qualitative study that explored preadolescent children's attitudes and perceptions towards health and nutrition. 38 children aged 11-12 years, across three state government schools, took part in an individual interview or group interview. Interviews were recorded, transcribed verbatim and analysed using thematic analysis techniques. Our results indicate that children inextricably linked the concept of health to diet and physical activity. They pondered the connection between different types of foods and physical implications for the body, emphasising nutrition and physical activity as a resource for preventing the onset of chronic disease and specifically the state of 'fatness'. Children collectively overemphasised the correlation between body size and health, and expressed that people should take responsibility for healthy choices to prevent fatness. In their discussions, they referred to aesthetic elements of the body and negative consequences of obesity. Overall, we argue that children's discourses of health and nutrition are potentially problematic. Results suggest that it is important to reshape these ideas to encourage children to develop more positive relationships with food and physical activity. [ABSTRACT FROM AUTHOR]

The relationship between eating a healthy diet and positive health outcomes is well known; nurturing healthy eating among children therefore has the potential to improve public health. A healthy diet occurs when one's usual eating patterns include adequate nutrient intake and sufficient, but not excessive, energy intake to meet the energy needs of the individual. However, many parents struggle to establish healthy eating patterns in their children due to the pressures of modern life. Moreover, healthcare providers often do not have the time or the guidance they need to empower parents to establish healthy eating practices in their children. Based on existing evidence from epidemiologic and intervention research, the Nurturing Children's Healthy Eating collaboration, established by Danone Institute International, has identified four key themes that encourage and support healthy eating practices among children in the modern Western world. The first - positive parental feeding - explores how parenting practices and styles, such as avoiding food restriction, allowing children to make their own food choices, and encouraging children to self-limit their portion sizes, can influence children's dietary intake. The second - eating together - highlights the link between eating socialization through regular family meals and healthful diet among children. The third - a healthy home food environment - explores the impact on eating practices of family resources, food availability/accessibility, parental modeling, and cues for eating. The fourth - the pleasure of eating - associates children's healthy eating with pleasure through repeated exposure to healthful foods, enjoyable social meals, and enhancement of the cognitive qualities (e.g. thoughts or ideas) of healthful foods. This paper reviews the evidence leading to the characterization of these nurturing themes, and ways in which recommendations might be implemented in the home. [ABSTRACT FROM AUTHOR]

Highlights • An ODE model of dengue is studied to assess the effect of active case finding (ACF). • Sensitivity results reveal that ACF of infected persons will reduce dengue prevalence. • Model is calibrated using dengue data from eight endemic states of India. • Future projections indicate that ACF of symptomatic patients will be effective in controlling dengue prevalence. • Integration of ACF with existing controls will accelerate dengue case reduction. Abstract Dengue control in India is a challenging task due to complex healthcare settings. In yesteryears, an amplification of dengue infections in India posed the need for introspection of existing dengue control policies. Prior understanding of the impacts of control interventions is necessary for their future implementation. In this paper, we propose and analyze a compartmental model of dengue to assess the impact of active case finding (ACF) on dengue disease transmission. Currently, primary prevention of dengue is possible only with vector control and personal protection from the bites of infected mosquitoes. Although a few experimental studies are performed to assess ACF in dengue disease, but this is the first attempt to represent and study the dynamics of disease using ACF as a control strategy. Local and global dynamics of the system are studied. We use sensitivity analysis to see the effects of controllable parameters of the model on the basic reproduction number and total number of infective population. We find that decrease in the biting rate of mosquitoes, and increase in the rate of hospitalization and/or notification, death rate of mosquitoes and ACF for asymptomatic and symptomatic individuals play crucial role for the reduction of disease prevalence. We calibrate our model to the yearly dengue cases in eight dengue endemic states of India. The results of our study show that ACF of symptomatic individuals will have significant effect on dengue case reduction but ACF of asymptomatic individuals cannot be ignored. Our findings indicate that the healthcare organizations must focus on ACF of symptomatic as well as asymptomatic individuals along with personal protection and mosquitoes control to achieve rapid reduction of dengue cases in India. [ABSTRACT FROM AUTHOR]

Combustible cigarettes remain the most harmful and addictive tobacco product, and reducing the prevalence of smoking continues to be a critical public health goal. While nicotine is the constituent primarily responsible for addiction to cigarettes, most of the harm associated with smoking comes from byproducts of tobacco combustion. Recently, two different approaches for reducing the harms of smoking have emerged, both of which focus on breaking the link between the addiction to nicotine and the harms caused by smoking. First, the addictive potential of cigarettes could be minimized by requiring a large reduction in the nicotine content of cigarettes. Evidence for a nicotine reduction policy thus far shows that the use of very low nicotine content cigarettes results in a reduction in the number of cigarettes people smoke per day and a reduction in cigarette dependence. Second, emerging alternative nicotine delivery systems (ANDS) like electronic cigarettes may provide sufficient nicotine to act as substitutes for cigarettes while delivering much lower levels of toxicants. Evidence suggests that the emergence of ANDS has increased the percentage of smokers who are able to quit. The present paper will briefly review the evidence for each of these approaches, and consider what contemporary reinforcement and addiction theories can tell us about their likely success. We argue that the most effective endgame approach is one that pursues both nicotine reduction and alternative nicotine delivery systems as complementary. [ABSTRACT FROM AUTHOR]

Several epidemiology studies have been conducted in Ohio communities where industrial facilities with manganese emissions are located. New information not addressed in the published papers for this research has been disclosed by U.S. federal agencies pursuant to the Freedom of Information Act. This paper describes the newly available information, presents statistical analyses of the new summary data, and explores how this information potentially impacts the conclusions of the published research. Based on a statistical analysis of the newly available data, we found very few, and no consistent, statistical differences for various illnesses, self-reported symptoms, and neuropsychological/neuromotor test results between one community with a manganese emission source and a control town that were part of the initial research. Further, we determined that the distribution of total suspended particulate manganese air concentrations did not correlate with the distribution of the more biologically relevant respirable manganese concentrations when data from two communities with potential manganese emissions were combined. These results are important, particularly in determining whether the studies should influence regulatory reference values related to manganese. We recommend that the full health effects data set associated with the published research be made available and re-evaluated to address the issues identified in this paper. ⁃ We provide new information related to several EPA sponsored Mn epidemiology studies ⁃ The new information potentially impacts conclusions of the EPA sponsored studies ⁃ The most recent of these studies did not consider all relevant Mn particle size data ⁃ The studies reported generally normal Mn blood levels and neurological effects ⁃ Re-evaluation of the data from the EPA sponsored studies is warranted [ABSTRACT FROM AUTHOR]

Exposure to particulate matter (PM) has been associated with a range of health impacts, including neurological abnormalities that affect neurodevelopment, neuroplasticity, and behavior. Recently, there has been growing interest in investigating the possible relationship between PM exposure and the onset and progression of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and multiple sclerosis. However, the precise mechanism by which PM affects neurodegeneration is still unclear, even though several epidemiological and animal model studies have provided mechanistic insights. This article presents a review of the current research on the neurotoxicity of PM and its impact on neurodegenerative diseases. This review summarizes findings from epidemiological and animal model studies collected through searches in Google Scholar, PubMed, Web of Science, and Scopus. This review paper also discusses the reported effects of PM exposure on the central nervous system and highlights research gaps and future directions. The information presented in this review may inform public health policies aimed at reducing PM exposure and may contribute to the development of new treatments for neurodegenerative diseases. Further mechanistic and therapeutic research will be needed to fully understand the relationship between PM exposure and neurodegenerative diseases. • PM, a constituent of air pollution, has negative health impacts on individuals. • Interest in studying the neurodegenerative exacerbations of PM exposure has grown. • This review provides an up-to-date understanding of PM-induced neurodegeneration. • This information can help develop future therapies for PM-induced neurotoxicity. [ABSTRACT FROM AUTHOR]

Highlights • We provide a graphical representation of the development of the comparator model for SoA. • We propose that a motor signal-model of SoA may be able to explain narrow SoA. • We show that standard experimental paradigms study only broad SoA. • We present results from two experiments, where we have failed to induce illusory narrow SoA in healthy participants. Abstract In this paper, we argue that the comparator model is not a satisfactory model of sense of agency (SoA). We present a theoretical argument and experimental studies. We show (1) most studies of SoA neglect a distinction between SoA associated with movements (narrow SoA) and SoA associated with environmental events (broad SoA); (2) the comparator model emerges from experimental studies of sensory consequences narrowly associated with movements; (3) narrow SoA can be explained by a comparator model, but a motor signal model is simpler and explain narrow SoA equally well; and (4) standard experimental paradigms study only broad SoA. Finally, we present results from two experiments, where we have failed to induce illusory narrow SoA in healthy participants. We believe our experimental approaches should have led to illusory SoA, if the comparator model of SoA was correct. The results challenge proponents of the comparator model of narrow SoA. [ABSTRACT FROM AUTHOR]

Introduction Direct health effects of extreme temperatures are a significant environmental health problem in Lithuania, and could worsen further under climate change. This paper attempts to describe the change in environmental temperature conditions that the urban population of Vilnius could experience under climate change, and the effects such change could have on excess heat-related and cold-related mortality in two future periods within the 21st century. Methods We modelled the urban climate of Vilnius for the summer and winter seasons during a sample period (2009–2015) and projected summertime and wintertime daily temperatures for two prospective periods, one in the near (2030–2045) and one in the far future (2085–2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the historical relationship between temperature and mortality for the period 2009–2015, and estimated the projected mortality in the near future and far future periods under a changing climate and population, assuming alternatively no acclimatisation and acclimatisation to heat and cold based on a constant-percentile threshold temperature. Results During the sample period 2009–2015 in summertime we observed an increase in daily mortality from a maximum daily temperature of 30 °C (the 96th percentile of the series), with an average of around 7 deaths per year. Under a no acclimatisation scenario, annual average heat-related mortality would rise to 24 deaths/year (95% CI: 8.4–38.4) in the near future and to 46 deaths/year (95% CI: 16.4–74.4) in the far future. Under a heat acclimatisation scenario, mortality would not increase significantly in the near or in the far future. Regarding wintertime cold-related mortality in the sample period 2009–2015, we observed increased mortality on days on which the minimum daily temperature fell below − 12 °C (the 7th percentile of the series), with an average of around 10 deaths a year. Keeping the threshold temperature constant, annual average cold-related mortality would decrease markedly in the near future, to 5 deaths/year (95% CI: 0.8–7.9) and even more in the far future, down to 0.44 deaths/year (95% C: 0.1–0.8). Assuming a “middle ground” between the acclimatisation and non-acclimatisation scenarios, the decrease in cold-related mortality will not compensate the increase in heat-related mortality. Conclusion Thermal extremes, both heat and cold, constitute a serious public health threat in Vilnius, and in a changing climate the decrease in mortality attributable to cold will not compensate for the increase in mortality attributable to heat. Study results reinforce the notion that public health prevention against thermal extremes should be designed as a dynamic, adaptive process from the inception. [ABSTRACT FROM AUTHOR]

Abstract Despite the influence of neo-Malthusian thinking in international development and environmental policy during the mid twentieth century, this story is often told from a US-centered perspective, with population control policies seen to roll out from the world geopolitical centers to the 'Global South' via the influence of large development institutions. Latin American perspectives on the population control question are seldom considered, except to suggest that the Catholic Church provided consistent, organized opposition to the expansion of family planning services. In this paper, using an political-intellectual history approach, I explore how the population question intersected with interrelated development issues in Latin America in the first half of the twentieth century: health and nutrition, food and agriculture, rural livelihoods, economic dependency, and women's rights. I focus on the relationship between public health crises and pro-natalist policies; the influences of the eugenics movement in supporting national population growth as a biopolitical strategy; anarcho-feminist thought that stressed the emancipatory potential of fertility control and new social roles for women; the Brazilian Josué de Castro's research on the causes of famine and malnutrition, which took a structuralist approach and explicitly rejected neo-Malthusian and other environmentally determinist approaches to understand the causes of poverty and hunger; and Latin American engagements with the international family planning and population control agenda in the 1960s. With this history in mind, we can trace alternative intellectual roots of political ecology's critique of neo-Malthusianism and other deterministic environment-development theories. [ABSTRACT FROM AUTHOR]

Objective This systematic review identified papers that described epilepsy misconceptions or stigma in sub-Saharan Africa (SSA) and research interventions focused on reducing these misconceptions. Materials and methods Publications in the English language from January 2000 to October 2017 that described original research conducted in SSA on misconceptions about epilepsy were utilized. Results Twenty-three publications were identified. Studies were from Nigeria (N = 4), Cameroon (N = 4), Uganda (N = 3), Zambia (N = 2), Ethiopia (N = 2), Tanzania (N = 2), Kenya (N = 2), Ghana, Zimbabwe, Benin, and Mali (N = 1 each). The studies included assessments of misconceptions among healthcare providers and medical students (N = 3), high school students (N = 2), teachers (N = 2), the general public (N = 10), people with epilepsy (N = 7), and traditional healers (N = 1). Only two studies had stigma-focused interventions. Majority of the studies reported limitations to socialization with people with epilepsy and various beliefs associated with epilepsy. Conclusions Epilepsy misconceptions, stigmatizing cultural beliefs, and perceptions were widely prevalent in SSA, and there are a few studies targeting epilepsy stigma. Existing stigma-reduction educational approaches may be impractical for general population implementation. Scalable approaches to reduce stigma are urgently needed within SSA. [ABSTRACT FROM AUTHOR]

Sea levels are projected to rise in response to climate change, causing the intrusion of sea water into land. In flat coastal regions, this would generate an increase in shallow water covered areas with limited circulation. This scenario raises a concern about the consequences it could have on human health, specifically the possible impacts on disease transmission. In this review paper we identified three categories of diseases which are associated with water and whose transmission can be affected by sea level rise. These categories include: mosquitoborne diseases, naturalized organisms ( Vibrio spp. and toxic algae), and fecal-oral diseases. For each disease category, we propose comprehensive adaptation strategies that would help minimize possible health risks. Finally, the City of Key West, Florida is analyzed as a case study, due to its inherent vulnerability to sea level rise. Current and projected adaptation techniques are discussed as well as the integration of additional recommendations, focused on disease transmission control. Given that sea level rise will likely continue into the future, the promotion and implementation of positive adaptation strategies is necessary to ensure community resilience. [ABSTRACT FROM AUTHOR]

This paper reviews the unique situation of perchlorate contamination in Chile, including its sources, presence in environmental media and in the human population, and possible steps to mitigate its health impacts. Perchlorate is a ubiquitous water contaminant that inhibits thyroid function. Standards for drinking water range from 2 to 18 µg L −1 in United States and Europe. A major natural source of perchlorate contamination is Chile saltpeter, found in the Atacama Desert. High concentrations of perchlorate have presumably existed in this region, in soils, sediments, surface waters and groundwaters, for millions of years. As a result of this presence, and the use of Chile saltpeter as a nitrogen fertilizer, perchlorate in Chile has been found at concentrations as high as 1480 µg L −1 in drinking water, 140 µg/kg −1 in fruits, and 30 µg L −1 in wine. Health studies in Chile have shown concentrations of 100 µg L − 1 in breast milk and 20 µg L −1 in neonatal serum. It is important to acknowledge perchlorate as a potential health concern in Chile, and assess mitigation strategies. A more thorough survey of perchlorate in Chilean soils, sediments, surface waters, groundwaters, and food products can help better assess the risks and potentially develop standards. Also, perchlorate treatment technologies should be more closely assessed for relevance to Chile. The Atacama Desert is a unique biogeochemical environment, with millions of years of perchlorate exposure, which can be mined for novel perchlorate-reducing microorganisms, potentially leading to new biological treatment processes for perchlorate-containing waters, brines, and fertilizers. [ABSTRACT FROM AUTHOR]

Recently, the online social networks (OSNs) have received considerable attentions as a revolutionary platform to offer users massive social interaction among users that enables users to be more involved in their own healthcare. The OSNs have also promoted increasing interests in the generation of analytical, data models in health informatics. This paper aims at developing an obesity identification, analysis, and estimation model, in which each individual user is regarded as an online social network 'sensor' that can provide valuable health information. The OSN-based obesity analytic model requires each sensor node in an OSN to provide associated features, including dietary habit, physical activity, integral/incidental emotions, and self-consciousness. Based on the detailed measurements on the correlation of obesity and proposed features, the OSN obesity analytic model is able to estimate the obesity rate in certain urban areas and the experimental results demonstrate a high success estimation rate. The measurements and estimation experimental findings created by the proposed obesity analytic model show that the online social networks could be used in analyzing the local spatial obesity problems effectively. [ABSTRACT FROM AUTHOR]

As some preventive medicine physicians have been denied medical licenses for not engaging in direct patient care, this paper attempts to answer the question, "Do preventive medicine physicians practice medicine?" by exploring the requirements of licensure, the definition of "practice" in the context of modern medicine, and by comparing the specialty of preventive medicine to other specialties which should invite similar scrutiny. The authors could find no explicit licensure requirement for either a certain amount of time in patient care or a number of patients seen. No physicians board certified in Public Health and General Preventive Medicine sit on any state medical boards. The authors propose that state medical boards accept a broad standard of medical practice, which includes the practice of preventive medicine specialists, for licensing purposes. [ABSTRACT FROM AUTHOR]

This paper provides new evidence on biased perceptions about the risks of smoking. It studies predictors of lung cancer risk perceptions. Lung cancer is one of the deadliest and most aggressive cancer types with 5-year survival rates of only up to 15%. A cross-sectional online survey in Berlin assessed lung cancer risk perceptions among smokers ( n  = 664), never smokers ( n  = 703), and former smokers ( n  = 501) in 2013. In addition to lung cancer risk perceptions, the survey measured many respondent characteristics, such as intention to quit smoking and a self-assessment of the likelihood of success in quitting. The findings show that 80% of all respondents overestimated lung cancer survival rates and suggest significant room for public health campaigns to educate smokers and nonsmokers about the deadliness of lung cancer. Multivariate linear regressions show that smokers who do not plan to quit estimate the 5-Year Lung Cancer Survival Rate to be 11% ( p  = 0.044) higher than other smokers. A reduction in risk perception biases may induce some smokers to alter their quitting intentions and others to successfully quit. [ABSTRACT FROM AUTHOR]

Arsenic contamination of drinking water, which can occur naturally or because of human activities such as mining, is the single most important public health issue in Bangladesh. Fifty out of the 64 districts in the country have arsenic concentration of groundwater exceeding 50 µg L −1 , the Bangladeshi threshold, affecting 35–77 million people or 21–48% of the total population. Chronic arsenic exposure through drinking water and other dietary sources is an important public health issue worldwide affecting hundreds of millions of people. Consequently, arsenic poisoning has attracted the attention of researchers and has been profiled extensively in the literature. Most of the literature has focused on characterising arsenic poisoning and factors associated with it. However, studies examining the socio-economic aspects of chronic exposure of arsenic through either drinking water or foods remain underexplored. The objectives of this paper are (i) to review arsenic exposure pathways to humans; (ii) to summarise public health impacts of chronic arsenic exposure; and (iii) to examine socio-economic implications and consequences of arsenicosis with a focus on Bangladesh. This scoping review evaluates the contributions of different exposure pathways by analysing arsenic concentrations in dietary and non-dietary sources. The socio-economic consequences of arsenicosis disease in Bangladesh are discussed in this review by considering food habits, nutritional status, socio-economic conditions, and socio-cultural behaviours of the people of the country. The pathways of arsenic exposure in Bangladesh include drinking water, various plant foods and non-dietary sources such as soil. Arsenic affected people are often abandoned by the society, lose their jobs and get divorced and are forced to live a sub-standard life. The fragile public health system in Bangladesh has been burdened by the management of thousands of arsenicosis victims in Bangladesh. [ABSTRACT FROM AUTHOR]

In Australia, children are not eating according to the Australian Dietary Guidelines despite the incorporation of numerous public health initiatives in the school setting. Literature regarding children's views about what influences their food choice is limited. Incorporating children in the creation of strategies to build healthy public policy aligns with the World Health Organisation (WHO) Ottawa Charter framework. In this qualitative study we used participatory action research to determine why children make the food choices they do. Five action cycles were used to collect data from school children and the school canteen. Two of the action cycles, which are the focus of this paper, used Discovery Days (where children worked in groups to design a canteen menu) to collect data from 100 students on each day across grades two to six. Each group recorded and presented the reasons they made the food choices for the menu. Each day was captured by video and audio recordings were transcribed then analysed using a Conventional Content Analysis to identify themes and then theoretical concepts. Emerging theoretical concepts describing children's decision-making criteria included pleasure, texture, social acceptability, versatility and eating context. Our study found children are reliable informants about factors that influence their food choice. Using theoretical concepts as reported by children could be the foundation required to build more effective programs to facilitate healthy decision-making, supportive environments and health policy in the school setting to create healthy food that is desirable to children. [ABSTRACT FROM AUTHOR]

The 1920–1935 epidemic of variola minor in England and Wales is a prime example of a major smallpox outbreak that spread in a national population with waning levels of vaccine-induced immunity. This paper examines the geographical course of the epidemic and the reasons why the disease was able to evade the (then) established protocols for smallpox control in many local government areas. The control issue is examined using archival records from the English county of Gloucestershire, where smallpox spread out of effective control in 1923. At the national level, our analysis demonstrates that the build-up (1920–1927) of the epidemic was characterised by a persistent core of reported cases of high intensity in the counties of central and northern England. Epidemic fade-out (1928–1935) was associated with an accelerated shift of disease activity to London and the southeast. Set against this national context, Gloucestershire represented a microcosm of the impediments to smallpox control in inter-war Britain. Here, a series of sociodemographic and administrative factors operated to impede disease control. Our study demonstrates the potential fragility of established disease control systems and the importance of professional and public cooperation, sometimes in the face of vehemently contested evidence over the nature of a disease and the means of its control, in attempts to limit the spread of epidemics. [ABSTRACT FROM AUTHOR]

The US has more firearms than any other country in the world and uses lead ammunition almost exclusively. Lead exposure is a significant public health concern and children are at the greatest risk given their exposure to take-home lead. Firearm-related take-home lead exposure may be one of the greatest influences on elevated pediatric blood lead levels. For this ecological and spatial investigation of the relationship between firearm licensure rates as a proxy for firearm-related lead exposure and prevalence of children with blood lead levels ≥5 μg/dL in 351 cities/towns in Massachusetts, we used 10 years of data (2010–2019). We examined this relationship against other known contributors to pediatric lead exposure including old housing stock (lead paint/dust), occupations, and lead in water. Pediatric blood lead levels were positively correlated with licensure, poverty, and certain occupations and negatively correlated with lead in water and police or firefighter employment. Firearm licensure was a major significant predictor of pediatric blood lead alone (β = 0.13; 95% CI, 0.10, 0.17) and across all regression models. The final model predicted over half the variation in pediatric blood lead (Adjusted R2 = 0.51). Negative binomial analysis found cities/towns with more firearms had higher pediatric blood lead levels (highest quartile fully adjusted prevalence ratio ((aPR) = 1.18; 95% CI, 1.09, 1.30) with a significant increase in pediatric blood lead per increase in firearms (p < 0.001). There were no significant spatial effects, suggesting that although there could be other factors impacting elevated pediatric blood lead, they are unlikely to influence spatial associations. Our paper provides compelling evidence of a potential and dangerous link between lead ammunition and child blood lead levels and is the first to do so using multiple years' worth of data. More research is required to substantiate this relationship on the individual-level and into prevention/mitigation. • Lead ammunition use puts children at great risk of take-home lead exposure. • Firearms licensure is significantly associated with pediatric lead levels. • Gun-adjacent occupations are significantly associated with pediatric lead levels. • Firearm licensure is extremely relevant when considering elevated child blood lead levels. [ABSTRACT FROM AUTHOR]

Ambient air pollution is a major public health concern impacting all aspects of human health. There is a lack of studies on the impact of ambient air pollution on health-related quality of life (HRQoL) of older Chinese adults. Our study answers two questions: How concentrations of ambient air pollutants are associated with HRQoL among older adults in China and, second, what are the possible mechanisms through which ambient air pollution affects HRQoL. From the 2018 National Health Service Survey, we sampled 5717 aged 65 years or older residents for the eastern province of Shandong, China. Data on individual exposures to PM 2.5 and PM 10 (particulate matter with diameter less than or equal to 2.5 μm and 10 μm) and sulfur dioxide (SO 2) were collected from the ChinaHighAirPollutants (CHAP) datasets. Mixed-effects Tobit regression models and mixed-effects ordered Probit regression models were employed to examine the associations of long-term exposure to ambient air pollution with the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) scale comprising mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Socioeconomic, demographic and behavioral factors relating to HRQoL were also examined. The results show that for each 1 μg/m3 increase, EQ-5D-3L scores fell 0.002 for PM 2.5 ; 0.001 for PM 10 and 0.002 for SO 2. Long term exposure to PM 2.5 , PM 10 and SO 2 were also associated with increased prevalence of pain/discomfort and anxiety/depression. The reduced HRQoL effects of ambient air pollution were exacerbated by higher socioeconomic status (affluent, urban and higher level of education). Our findings suggested that HRQoL of older Chinese adults was not only associated with demographic, socioeconomic, and health-related factors, but also negatively correlated with air pollution, especially through increased pain/discomfort and anxiety/depression. The paper proposes policy recommendations. [Display omitted] • Ambient air pollution was associated with lower HRQoL among older adults in China. • Long term air pollution was associated with increased prevalence of pain and anxiety. • The reduced HRQoL effects was exacerbated by higher socioeconomic status. [ABSTRACT FROM AUTHOR]

Wastewater management predominantly takes the form of On-Site Sanitation (OSS) in low- and lower-middle-income countries (LMICs). In India, households construct and operate OSS systems in the absence of regulatory oversight and seldom in compliance with the national technical standards – posing a risk to water sources and public health. The present paper reviews novel evidence on the quality of these systems from a multi-state survey of 3000 households in India to identify policy and practice interventions for creating sustainable urban sanitation futures. The paper argues for local and national governments to unlock the potential of OSS as a safe and long-term wastewater management solution through (1) re-envisioning the system design to simultaneously meet household and environmental needs, (2) fostering prefabrication of systems as a means to distribute the compliance responsibility optimally, and (3) updating technical standards for facilitating such a paradigm shift. • Septic tanks in urban India are non-compliant and fail to provide safe sanitation. • High urban densities preclude subsoil dispersion as scalable solution. • Wider adoption of prefabricated 'packaged' on-site systems can improve sanitation. • Standards for on-site system performance are key to facilitate the transition. • Greywater management needs mainstreaming within new systems, policy, and standards. [ABSTRACT FROM AUTHOR]

Access to information about environmental quality may facilitate low-cost preventive measures that protect human health. In this paper, we study the demand for information about environmental quality and the behavioral response to the information provided. With a field experiment conducted in Bihar (India), we estimate the price sensitivity of demand for diagnostic testing of drinking water wells for arsenic of natural origin – a serious threat to the health of tens of millions of villagers across South and Southeast Asia. Demand is substantial but sensitive to price; uptake falls from 68% to 31% of households over our price range (Rs. 10 to Rs. 50). We further assess how households respond to information regarding the contamination level in their wells. About one-third of households with unsafe wells switch to a safer water source. Finally, we demonstrate that households that received adverse test outcomes are more likely to selectively forget test results, and proactively remove evidence of their wells' arsenic status. [ABSTRACT FROM AUTHOR]

As head injuries and their sequelae have become an increasingly salient matter of public health, experts in the field have made great progress elucidating the biological processes occurring within the brain at the moment of injury and throughout the recovery thereafter. Given the extraordinary rate at which our collective knowledge of neurotrauma has grown, new insights may be revealed by examining the existing literature across disciplines with a new perspective. This article will aim to expand the scope of this rapidly evolving field of research beyond the confines of the central nervous system (CNS). Specifically, we will examine the extent to which the bidirectional influence of the gut-brain axis modulates the complex biological processes occurring at the time of traumatic brain injury (TBI) and over the days, months, and years that follow. In addition to local enteric signals originating in the gut, it is well accepted that gastrointestinal (GI) physiology is highly regulated by innervation from the CNS. Conversely, emerging data suggests that the function and health of the CNS is modulated by the interaction between 1) neurotransmitters, immune signaling, hormones, and neuropeptides produced in the gut, 2) the composition of the gut microbiota, and 3) integrity of the intestinal wall serving as a barrier to the external environment. Specific to TBI, existing pre-clinical data indicates that head injuries can cause structural and functional damage to the GI tract, but research directly investigating the neuronal consequences of this intestinal damage is lacking. Despite this void, the proposed mechanisms emanating from a damaged gut are closely implicated in the inflammatory processes known to promote neuropathology in the brain following TBI, which suggests the gut-brain axis may be a therapeutic target to reduce the risk of Chronic Traumatic Encephalopathy and other neurodegenerative diseases following TBI. To better appreciate how various peripheral influences are implicated in the health of the CNS following TBI, this paper will also review the secondary biological injury mechanisms and the dynamic pathophysiological response to neurotrauma. Together, this review article will attempt to connect the dots to reveal novel insights into the bidirectional influence of the gut-brain axis and propose a conceptual model relevant to the recovery from TBI and subsequent risk for future neurological conditions. [ABSTRACT FROM AUTHOR]

Background Plasmodium vivax infection remains a major public health problem, especially along the Thailand border regions. We examined the genetic diversity of this parasite by analyzing single-nucleotide polymorphisms (SNPs) of the P. vivax rhomboid-like protease 1 gene ( Pvrom1 ) in parasites collected from western (Tak province, Thai-Myanmar border) and eastern (Chanthaburi province, Thai-Cambodia border) regions. Methods Data were collected by a cross-sectional survey, consisting of 47 and 45 P. vivax -infected filter paper-spotted blood samples from the western and eastern regions of Thailand, respectively during September 2013 to May 2014. Extracted DNA was examined for presence of P. vivax using Plasmodium species-specific nested PCR. Pvrom1 gene was PCR amplified, sequenced and the SNP diversity was analyzed using F-STAT, DnaSP, MEGA and LIAN programs. Results Comparison of sequences of the 92 Pvrom1 831-base open reading frames with that of a reference sequence (GenBank acc. no. XM001615211) revealed 17 samples with a total of 8 polymorphic sites, consisting of singleton (exon 3, nt 645) and parsimony informative (exon 1, nt 22 and 39; exon 3, nt 336, 537 and 656; and exon 4, nt 719 and 748) sites, which resulted in six different deduced Pvrom1 variants. Non-synonymous to synonymous substitutions ratio estimated by the DnaSP program was 1.65 indicating positive selection, but the Z-tests of selection showed no significant deviations from neutrality for Pvrom1 samples from western region of Thailand. In addition McDonald Kreitman test (MK) showed not significant, and Fst values are not different between the two regions and the regions combined. Interestingly, only Pvrom1 exon 2 was the most conserved sequences among the four exons. Conclusions The relatively high degree of Pvrom1 polymorphism suggests that the protein is important for parasite survival in face of changes in both insect vector and human populations. These polymorphisms could serve as a sensitive marker for studying plasmodial genetic diversity. The significance of Pvrom1 conserved exon 2 sequence remains to be investigated. [ABSTRACT FROM AUTHOR]

What makes an individual, on any given occasion, able and willing to prepare a meal for themselves: that is, to cook? As home cooking has increasingly become the focus of public-health, nutrition, and policy interventions and campaigns, the need for a better understanding has become apparent. It is clear that cooking is not merely a matter of mechanical skill or rote training; beyond this, it is difficult to explain why similar individuals have such different capacities for setting and achieving food-related goals. This paper proposes a new paradigm for cooking and food provisioning - termed "food agency" - that attempts to describe how an individual's desires form and are enacted in correspondence with social environments: broadly, agency emerges from the complex interplay of individual technical skills and cognitive capacities with social and cultural supports and barriers. Drawing on a close reading of anthropological and sociological research into cooking, the authors propose that an individual's ability to integrate such complexity in regard to provisioning - to possess 'food agency' - is crucial. This argument is supplemented by empirical case studies from a large body of ethnographic observations and interviews with home cooks from the United States, conducted over the last decade. Overall, more food agency means the cook is more empowered to act. Adopting the paradigm of food agency into the consideration of everyday cooking practices has the potential to support transdisciplinary food scholarship integrating individual actions within a food system and thus inform nutrition and public health interventions related to meal preparation. [ABSTRACT FROM AUTHOR]

Urban parks play a key role in the provision of ecosystem services, actively participating in improving the quality of life and welfare of local residents. This paper reports on the application of an index designed to quantify the allergenicity of urban parks in a number of Spanish cities. The index, which records biological and biometric parameters for the tree species growing there, classifies parks in terms of the risk they pose for allergy sufferers, graded as null, low, moderate or high. In this initial phase, the index was applied to 26 green areas in 24 Spanish cities; green areas varied in type (urban park, historical or modern garden, boulevard, square or urban forest), size 1–100 ha), geographical location, species richness, number of trees and tree density (number of trees / ha.). The data obtained were used to calculate the percentage of allergenic species in each park, which varied between 17–67%; density ranged from 100 to 300 trees/ha. The index values recorded ranged from a minimum of .07 to a maximum of .87; a significant correlation was found between index value and both number of trees and tree density. Taking an index value of .30 as the threshold considered sufficient to trigger allergy symptoms in the sensitive population, 12 of the parks studied may be regarded as unhealthy at any time of the year. Corrective measures to mitigate the impact of pollen emissions include the implementation of nature-based solutions at various levels: planning and design, handling and management, and strengthening of urban green-infrastructure elements. The index proved to be a useful tool for environmental analysis, and complies with the principles of portability and scalability central to current and horizon scientific research. [ABSTRACT FROM AUTHOR]

Preconception health refers to the health of males and females at any point in time prior to a potential pregnancy. A goal of preconception health research is to use preventive behaviour and healthcare to optimize the health of future offspring that result from both planned and unplanned pregnancies. This paper briefly reviews evidence of the importance of various preconception health behaviours, and examines the extent to which specific preconception health behaviours have been included in recent studies of such knowledge, behaviours, and intentions. To describe this recent research in highly developed countries, a scoping review of the literature was completed of studies published within the past seven years. A total of 94 studies on preconception health were identified and reviewed: (a) 15 examined knowledge and attitudes, (b) 68 studied behaviours, (c) 18 examined interventions designed to improve knowledge or behaviour, and (d) no studies examined intentions to engage in preconception health behaviours. Over 40% of studies examining preconception health behaviour focussed exclusively on folic acid. Overall, folic acid, alcohol, and cigarettes have consistently been topics of focus, while exposure to harmful environmental substances, stress, and sleep have been largely neglected. Despite strong evidence for the importance of men's health during the preconception period, only 11% of all studies included male participants. Based on existing gaps in the research, recommendations are provided, such as including men in future research, assessing a wider variety of behaviours, consideration of behavioural intentions, and consideration of the relationships between preconception health knowledge, intentions, and behaviour. [ABSTRACT FROM AUTHOR]