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Background: Behavioral factors, such as smoking, alcohol consumption, stress, poor diet, and physical inactivity, but also sleep deprivation and negative social connections, play a critical role in the development and progression of major chronic diseases. These include cardiovascular diseases, diabetes, chronic respiratory conditions, and cancers. Methods: The objective of this review is to explore the influence of these modifiable risk factors on the global burden of chronic diseases and assess the potential impact of public health interventions and policy changes. Results: The evidence highlights a significant association between behavioral risk factors and increased morbidity and mortality from chronic diseases. Public health interventions and policy changes targeting these modifiable behaviors have shown substantial potential in reducing the prevalence and impact of chronic conditions. Strategies such as smoking cessation programs, dietary improvements, physical activity promotion, and stress reduction are critical in mitigating these risks. Conclusions: Addressing modifiable behavioral factors is essential for the prevention and control of chronic diseases. Bridging the gap between current knowledge and effective implementation of interventions is crucial for improving population health outcomes. Public health strategies focused on modifying key behavioral risks can significantly reduce the burden of chronic diseases, thereby improving overall health and reducing healthcare costs. [ABSTRACT FROM AUTHOR]

Objective: To examine the landscape of preventive strategies and interventions directed to achieve oral health equity, with particular emphasis on the interplay between dental caries prevention, individual behaviors, and population-level strategies across various demographic and geographic regions. Methods: This scoping review was guided by Peters et al.'s framework, which incorporates four key concepts aimed at reducing caries: education for individuals and healthcare providers, behavioral modifications, addressing broader social determinants of health, and extending oral health education programs beyond traditional dental settings. A systematic search was conducted across five databases, from 2011 to 2022. Results: This review identified 107 studies highlighting three main themes: behavioral practices (N = 33), which focused on reducing the prevalence of caries, improving oral hygiene practices, and enhancing overall oral health knowledge; educational interventions (N = 39), which explored strategies to integrate oral health with broader public health initiatives; and dietary interventions (N = 35), which emphasized the critical relationship between diet and oral health. Conclusion: This SR highlights the critical need for comprehensive multilevel approaches that address the complex interplay between nutrition, oral health, and sociodemographic factors, while emphasizing the critical relationship between societal factors and individual health behaviors. Multifaceted interventions that include behavioral change, education, and dietary modifications are crucial for improving oral and overall health outcomes across diverse populations. Comprehensive strategies should prioritize medical-dental integration and data-driven approaches to effectively reduce oral health disparities for vulnerable populations, promoting long-term health equity. [ABSTRACT FROM AUTHOR]

This paper investigates adult smoking in Pakistan by examining demographics, psychometrics, and socioeconomic disparities among smokers aged over 20 years. A cross-sectional design was employed with a sample of 300 adult smokers, using purposive sampling for data collection through self-report instruments: The Cigarette Dependence Scale, Novaco Anger Scale, Kessler Psychological Distress Scale, and WHO Quality of Life Scale. Key demographic factors, including area, socioeconomic status, family system, and marital status, were analyzed to identify trends in smoking behaviors. The study highlights psychological factors such as nicotine dependence and health-related quality of life. Additionally, it emphasizes disparities in tobacco use across income levels and regions, underscoring the need for targeted interventions to improve access to cessation resources and public health campaigns. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy (DR) is one of the leading causes of blindness among diabetic patients, particularly in areas with an increase in diabetes epidemics, such as Saudi Arabia. Notwithstanding the significant public health implications, data on the prevalence and risk factors of DR in Saudi Arabia are few and scattered, limited to certain geographic areas. Our study objective is to conduct a systematic review of the literature and a meta-analysis of the prevalence and predictors for DR in Saudi Arabia, within both type 1 and type 2 diabetes. Methods: A systematic review and meta-analysis were constructed according to PRISMA guidelines. We searched PubMed, Embase, Web of Science, and Google Scholar electronic databases for studies published from 2000–2023. Any study related to the prevalence of diabetic retinopathy in T1DM or T2DM among adult patients aged ≥18 years that was conducted in Saudi Arabia was included. Pooling prevalence estimates were calculated using a random-effects model, and heterogeneity across the studies was tested by the I2 statistic and Cochran's Q test. Results: A total of 11 studies published between 2006 and 2019 met the inclusion criteria, with sample sizes ranging from 99 to over 50,000 participants. The overall pooled prevalence of DR was estimated to be 31% (95% CI: 24–39%), with substantial heterogeneity observed across studies (I2 = 99%). Prevalence estimates ranged from 16.7% to 69.8% and were influenced by variables such as study design, duration of diabetes, and glycemic control. Among individuals with type 2 diabetes, the pooled prevalence was 24% (95% CI: 20–28%). Poor glycemic control and longer diabetes duration were consistently identified as significant predictors of DR, while other factors, such as obesity and hypertension, were also associated with an increased risk of DR. Conclusions: The high prevalence of DR in Saudi Arabia highlights the critical need for focused public health initiatives, especially among those with type 2 diabetes. To minimize the effects of DR, early intervention, routine DR screening programs, and optimal diabetes control are essential. The increasing prevalence of DR in Saudi Arabia requires careful consideration of healthcare policy and resource allocation, which is made possible by our results. [ABSTRACT FROM AUTHOR]

Purpose: Despite the benefits of influenza vaccination, particularly for healthcare workers (HCWs) at higher risk, vaccination coverage among HCWs in China remains low. This study aims to provide updated insights into the knowledge, attitudes, practices, and barriers related to influenza vaccination among HCWs in China post-COVID-19 era, to inform strategies for improving vaccination rates and healthcare safety. Methods: A cross-sectional survey was conducted between December 2023 and January 2024 at two tertiary hospitals in Chengdu, China. Logistic regression analyses were used to identify factors associated with HCWs' influenza vaccination uptake for the 2023– 2024 season. Results: Of the 602 HCWs who completed the questionnaire (response rate: 86.0%), influenza vaccination uptake for the 2023– 2024 season was low at 14.1%, down from 31.2% in 2021– 2022 and 18.4% in 2022– 2023. Main reasons for vaccine hesitancy included mistrust of vaccines (56.0%), inconvenient access (52.0%), and concerns over time, cost, and information (57.6%). Although most HCWs acknowledged the protective benefits of vaccination, only one-third supported mandatory vaccination, with concerns about personal autonomy among opponents. Multivariable logistic regression analysis showed that HCWs were more likely to be vaccinated if they believed it was essential for their job [adjusted odds ratio (aOR): 2.21; 95% confidence interval (CI): 1.13, 4.30), recognized their higher risk (aOR: 2.37; 95% CI: 1.09, 5.15), and were aware of high-risk groups for influenza vaccination (aOR: 2.49; 95% CI: 1.41, 4.40) as well as the age group with a higher infection rate (aOR: 1.89; 95% CI: 1.01, 3.51). However, those favoring increased campaign visibility had lower vaccination rates (aOR: 0.38; 95% CI: 0.17, 0.82). Conclusion: The persistently low influenza vaccination rates among HCWs in China post-COVID-19 highlight significant gaps in healthcare risk management. Targeted interventions, including enhanced education and better vaccine access, are needed, along with further discussion on mandatory vaccination as a potential solution. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has drastically affected mental and physical well-being, leading to significant changes in daily habits and preferences. Given that pandemics require the tear down of most social ties and interactions to limit their inevitable spread, this study delved into the extent to which social infrastructures have been affected, focusing on behavioral shifts in essential services such as retail, recreation, groceries, pharmacies, public transport, parks and open spaces, workplaces, and residential areas. Notably, while most social infrastructures saw a decline in public usage, parks and open spaces experienced increased visitation despite public health measures aimed at minimizing social interactions. This striking increase in park and open space visitations has captured the interest of this study to observe the impact it had on the trajectory of the COVID-19 pandemic, as well as the underlying causes behind this trend. Since Europe was heavily affected by the pandemic, this study focused specifically on European countries over a two-year period (March 2020 to March 2022), covering the severe period of the pandemic. While parks and open spaces initially showed no direct influence on the pandemic trajectory, when closely observing visitation trends, both increases and declines, opposing insights were revealed. This study found that attempts to reduce park and open space visitation were significantly unsuccessful, leading to substantial increases in both the magnitude and duration of visits once restrictions were eased. This surge in park and open space attendance corresponded to notable spikes in new infections during periods of peak visitation. Therefore, urban planning and public health authorities must prioritize safely accommodating the increased park and open space demand while effectively minimizing virus transmission. This involves considering park sizes and proximity, along with implementing a balanced set of crucial public health strategies to support community well-being and resilience. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, non-therapeutic interventions (NPIs), such as traffic restrictions, work stoppages, and school suspensions, have led to a sharp decline in the concentration of air pollutants in the epidemic sites. However, few studies focused on the impact of air pollutant changes on the risk of nonaccidental death. Method: We selected Yancheng City, China, as the study site and applied a Generalized Additive Model (GAM) based on the quasi-Poisson distribution to evaluate the impact of atmospheric pollutants exposure on the nonaccidental death of local residents. The time span of this study was set from January 1, 2013, to December 21, 2022, that is, before and after the outbreak of COVID-19. Results: The concentration of some air pollutants has greatly varied after the outbreak of COVID-19, with a significant decline for PM2.5 (− 43.4%), PM10 (− 38.5%), SO2 (− 62.9%), and NO2 (− 22.6%), but an increase for O3 (+ 4.3%). Comparative analysis showed that PM2.5 contributed to an increased risk of nonaccidental death after the outbreak of COVID-19. With an increase in PM2.5 by 10 µg/m³, the excess relative risks (ER) of nonaccidental death of residents increased by 1.01% (95%CI: 0.19%,1.84%). The stratified analysis revealed that air pollutants impacted nonaccidental deaths in both men and women before the outbreak of COVID-19. After the outbreak of COVID-19, PM10 had a significant effect on male nonaccidental deaths. The concentrations of PM2.5, PM10, and SO2 increased by 10 µg/m³, the ER of PM2.5, PM10, and SO2 on female nonaccidental death increased by 1.52% (0.38%,2.67%), 0.58% (0.02%,1.13%), and 15.09% (5.73%,25.28%), respectively. Before the outbreak of COVID-19, five air pollutants had an impact on the death of residents from cardiovascular disease (CVD). After the outbreak of COVID-19, only PM10 significantly affected the death risk of CVD. In addition, we discovered that PM2.5, PM10, and SO2 significantly impacted the risk of death due to respiratory diseases before and after the outbreak of COVID-19. Conclusions: Air pollutants have different effects on nonaccidental deaths before and after the COVID-19 outbreak. A decrease in air pollutant concentration due to the NPIs for COVID-19 had a significant effect on the reduction of the risk of nonaccidental death. [ABSTRACT FROM AUTHOR]

Abstract Background Physical, mental and social components of well-being are known to be important to health. However, research on well-being often focuses on physical and mental well-being with little attention paid to social well-being. This research aims to develop and preliminarily validate the South Wales Social Well-being Scale (SWSWBS) to measure social well-being. Methods A non-experimental and cross-sectional design was applied with two phases: scale development and preliminary validation. Initially, 24 items were drawn from a Group Concept Mapping study exploring the concept of social well-being. These items were reviewed and reduced to 14 for preliminary validation among 103 university students and staff in health and social care disciplines. Construct validity (exploratory factor analysis and convergent validity) were tested. Reliability was demonstrated by internal consistency. Floor and ceiling effects were also evaluated. Results A 3-factor structure was identified and explored, which highlight the most important features of the social world a person inhabits: “Safe and inclusive interaction with others” (6 items), “Learning, helping, and feeling useful” (4 items), and “Security, worthwhile activities, family and friends” (4 items). The SWSWBS was correlated to the Warwick Edinburgh Mental Well-being Scale and the Four measures of Personal Well-being Scale to some extent. The Cronbach alpha coefficient was 0.85 for the sum score and 0.83–0.86 for individual items. The item-total correlation coefficients ranged between 0.08 and 0.65. The split half reliability coefficient was 0.78. There is absence of a floor effect, but most items had a ceiling effect. Conclusions Preliminary validation of the SWSWBS shows the scale has satisfactory psychometric properties with good validity, reliability, and reasonable variability. This study needs to be replicated with larger and representative populations to explore how the scale can be used alongside the Warwick Edinburgh Mental Well-being Scale to capture a holistic/multi-dimensional understanding of well-being.

Abstract Background This study aimed to evaluate the burden of chemical poisoning and its associated factors at the Chemical, Biological, Radiological, and Nuclear (CBRN) pilot surveillance sites in the Amhara region, Northwest Ethiopia. The analysis of burdens and contributing factors is intended to inform targeted interventions and enhance public health strategies. Methods A cross-sectional study was conducted at TibebeGhionComprehensive Specialized Hospital(TGCSH) and FelegeHiwot Comprehensive Specialized Hospital(FHCSH) in the Amhara region of Ethiopia from June to November 2021. Data were collected using structured tools and analyzed with SPSS version 26. Descriptive statistics assessed the burden of chemical poisoning, while Chi-square analysis identified significant factors associated with the burden of chemical poisoning. Results The study reported a total of 184 chemical poisoning cases at TGCSH and FHCSH in the Amhara region, with a case fatality rate of 17%. The most affected age group was 16 to 25 years, and females accounted for 60% of the cases. Geographic distribution showed that Bahir Dar had the highest incidence, contributing to 64.7% of the cases, while the South Gondar zone, particularly the Fogera district, accounted for 30.88%. Organophosphates emerged as the most prevalent toxic agents, responsible for 53% of the cases. Chi-square analysis highlighted several significant associations with a higher burden of chemical poisoning, including being female (X² = 4.463, p = 0.035), being 35 years or younger (X² = 4.629, p = 0.031), ingestion of rodent poison (X² = 4.154, p = 0.042), intentional poisoning (X² = 7.488, p = 0.006), and inhalation exposure (X² = 4.154, p = 0.042) and educational level (X² = 5.764, p = 0.016). Conclusions and recommendations The study reveals a significant burden of chemical poisoning in the Amhara Region, Ethiopia, with a 17% fatality rate, predominantly impacting young adults and females, particularly in areas with high pesticide use, such as Bahir Dar and South Gondar. Key issues include cases with no antidotes, inhalation exposure, and intentional poisoning. Recommendations: Implement stricter chemical regulations, limit pesticide sales, enhance community education on safe handling, and improve mental health support for high-risk groups. Develop sustained CBRN surveillance systems and conduct further research on regional disparities and chemical agent assessments.

According to the World Health Organization, health is one of the fundamental rights of every human being, regardless of race, religion, political beliefs, economic and social status. Although we tend to believe it, health is not self-evident and is also conditioned by the factors beyond our control. Today, we share many leading public health problems globally. In solving them, various interventions are carried out, often with the absence of targeted results. Improving and preserving health is a big challenge and is the responsibility of the individual, the health system and other participants and is the result of their interaction. But, is the action of these participants coherent? Is their interaction constructive? What to do to prevent destruction? These are just some of the questions that should be answered in order for interventions to adequately respond to the challenges.

Abstract Objective This systematic review examines the impact of COVID-19 on Health-Related Quality of Life (HRQoL) across different populations, focusing on demographic, socio-economic, and COVID-19-related factors. Methods A comprehensive search of PubMed from 2020 to 2022 was conducted, identifying 37 studies that met the inclusion criteria. Studies were assessed using the Appraisal Tool for Cross-Sectional Studies, Newcastle–Ottawa Scale, and Consolidated Health Economic Evaluation Reporting Standards tools. Data extraction included study characteristics, HRQoL measures, and health state utility values. Results Thirty-seven studies were conducted with a total of 46,709 individuals and 274 HSUVs ranging from 0.224 to 1. Research included Europe (n = 20), North America (n = 4), Asia (n = 11), South America (n = 1), and Africa (n = 1). Utility was measured using 15D (n = 3), EQ-5D-5L (n = 24), EQ-5D-3L (n = 8), VAS (n = 1), and TTO (n = 1). The review found significant decreases in HRQoL among COVID-19 survivors, particularly those with severe symptoms, due to persistent fatigue, breathlessness, and psychological distress. Quarantine and isolation measures also negatively impacted HRQoL, with increased anxiety and depression. Vaccination status influenced HRQoL, with vaccinated individuals reporting better outcomes. Socio-demographic factors such as age, gender, education, employment, marital status, and income significantly affected HRQoL, with older adults, females, and unemployed individuals experiencing lower HRQoL. Conclusions COVID-19 has profoundly affected HRQoL, highlighting the need for comprehensive post-recovery rehabilitation programs and targeted public health interventions. Addressing socio-demographic disparities is crucial to mitigate the pandemic’s impact on HRQoL. Policymakers and healthcare providers should implement strategies to support affected populations, emphasizing mental health support, social support systems, and vaccination programs.

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation.

Background Universal access to maternal, newborn, and child healthcare is essential for achieving Sustainable Development Goal 3, but the effectiveness of various incentive-based programs for pregnant mothers in low- and middle-income countries (LMICs) remains uncertain. Objective of this systematic review was to determine if incentive-based interventions influenced maternal and neonatal health outcomes. Methods We conducted a search in various databases from inception. All incentive-based interventional studies conducted on pregnant women in LMICs were included. Evidence from the included trials was synthesized using risk ratios (RRs) to compare the outcomes between groups receiving incentives and not receiving incentives. The meta-analysis was conducted using random-effects model. We assessed the quality of the included studies using the Cochrane Risk of Bias 2.0 tool and reviewed the collected data to determine its suitability for meta-analysis. This study is registered in PROSPERO (CRD42021247681). Results Of the 3,897 records that were identified, 11 met eligibility criteria, all of which exhibited varying degrees of risk of bias, ranging from high to some concerns. Analysis of maternal outcomes across studies revealed no significant differences in the likelihood of delivering at a healthcare facility (RR 1.13, 95% CI: 0.86 to 1.47) and in frequency of prenatal care (RR 0.99, 95% CI: 0.88 to 1.12) between intervention and control groups. However, high levels of statistical heterogeneity were observed for both outcomes indicating variability among study results. Similarly, analysis of tetanus vaccine coverage showed no significant difference between groups (RR 1.00, 95% CI: 0.92 to 1.08), with moderate statistical heterogeneity observed. Conclusion The maternal and neonatal outcomes examined in this review did not have any significant differences in intervention group when compared to the control group. The interventions to address maternal health concerns need to follow a multifactorial approach. There is a need for extensive primary research studies in the future.

Purpose: The purpose of this study is to ascertain the anthropogenic effects resulting from the extraction and processing of fluorite. Specifically, it aims to analyze and quantify the relationship between fluoride content in different areas influenced by industrial production and agricultural activities, and to examine the health effects arising from chronic fluoride exposure in affected populations in China with comperison of neighborhood country Pakistan. Methods: A cross-sectional survey was conducted with 579 participants, categorized into high, moderate, and low fluoride exposure groups. Participants completed a 35-item questionnaire covering environmental, medical, and industrial dimensions. Data were analyzed using SPSS 22, employing chi-square tests to determine significant associations between fluoride exposure and health outcomes. Results: High fluoride exposure was associated with significant health issues: 70% prevalence of dental fluorosis, 65% skeletal fluorosis, and 60% cognitive impairments. The study found inconsistent implementation of emission control technologies among industrialists, with only 70% fully adopting such measures. These findings underscore the need for better regulatory compliance and public health interventions. Conclusions: The study concludes that industrial and agricultural activities substantially contribute to fluoride contamination, causing severe health problems. Effective mitigation requires stringent regulations, advanced emission control technologies, and robust public awareness campaigns. Future research should involve longitudinal studies and include more stakeholders, particularly from the agricultural sector. [ABSTRACT FROM AUTHOR]

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the burden of chemical poisoning and its associated factors at the Chemical, Biological, Radiological, and Nuclear (CBRN) pilot surveillance sites in the Amhara region, Northwest Ethiopia. The analysis of burdens and contributing factors is intended to inform targeted interventions and enhance public health strategies. Methods: A cross-sectional study was conducted at TibebeGhionComprehensive Specialized Hospital(TGCSH) and FelegeHiwot Comprehensive Specialized Hospital(FHCSH) in the Amhara region of Ethiopia from June to November 2021. Data were collected using structured tools and analyzed with SPSS version 26. Descriptive statistics assessed the burden of chemical poisoning, while Chi-square analysis identified significant factors associated with the burden of chemical poisoning. Results: The study reported a total of 184 chemical poisoning cases at TGCSH and FHCSH in the Amhara region, with a case fatality rate of 17%. The most affected age group was 16 to 25 years, and females accounted for 60% of the cases. Geographic distribution showed that Bahir Dar had the highest incidence, contributing to 64.7% of the cases, while the South Gondar zone, particularly the Fogera district, accounted for 30.88%. Organophosphates emerged as the most prevalent toxic agents, responsible for 53% of the cases. Chi-square analysis highlighted several significant associations with a higher burden of chemical poisoning, including being female (X² = 4.463, p = 0.035), being 35 years or younger (X² = 4.629, p = 0.031), ingestion of rodent poison (X² = 4.154, p = 0.042), intentional poisoning (X² = 7.488, p = 0.006), and inhalation exposure (X² = 4.154, p = 0.042) and educational level (X² = 5.764, p = 0.016). Conclusions and recommendations: The study reveals a significant burden of chemical poisoning in the Amhara Region, Ethiopia, with a 17% fatality rate, predominantly impacting young adults and females, particularly in areas with high pesticide use, such as Bahir Dar and South Gondar. Key issues include cases with no antidotes, inhalation exposure, and intentional poisoning. Recommendations: Implement stricter chemical regulations, limit pesticide sales, enhance community education on safe handling, and improve mental health support for high-risk groups. Develop sustained CBRN surveillance systems and conduct further research on regional disparities and chemical agent assessments. [ABSTRACT FROM AUTHOR]

Introduction: Schistosomiasis, a tropical parasitic disease, affects 779 million people globally, with 85% of cases in Africa. The interplay between schistosomiasis and other sexually transmitted infections (STIs) can exacerbate health burdens, but most attention has focused on interactions with HIV, neglecting coinfections with other STIs. This systematic review and metaanalysis aims to understand the role Schistosoma infections play in STIs within schistosomiasis-endemic populations. Methods: The study is a systematic review and meta-analysis investigating the link between Schistosoma infections and STIs in endemic regions. It uses PRISMA guidelines, electronic databases, and Google Scholar to assess prevalence, associations, and heterogeneity, reducing bias using a Meta-Mar statistical tool. Results: A quantitative synthesis of 33 articles from 1975-2024 involved 22,587 participants from 13 countries, including regions in Africa, France, and China, examining coinfections of schistosomiasis and STIs, including HIV. The pooled estimates showed a significant risk association between schistosomiasis and STIs [RR (95% CI) = 1.18, (1.13-1.24); z/t = 7.55, p<0.0001] using a fixed effect model. Cochran's Q test (Tau2 = 0.5061, Chi2 = 476.65, df = 32, p<0.01) indicated significant heterogeneity. The Higgins I2 statistic of 93.0% (91.5%-94.7%), H = 3.86 (3.43-4.33), highlighted substantial variance between studies. Subgroup analysis showed West Africa [Weight IV = 1.7%, RR (95% CI) = 1.78 (1.28-2.47), I2 = 59%], East Africa [Weight IV = 10.5%, RR (95% CI) = 0.99 (0.86-1.13), I2 = 54%], and Southern Africa [Weight IV = 82.0%, RR (95% CI) = 1.16 (1.10-1.21), I2 = 97%] contributed significantly to the high heterogeneity in the pooled analysis. Females had a notably higher risk of STIs in the context of schistosomiasis (k = 17, RR: 1.30, 95% CI: 1.23-1.37, Q = 316.78, I2 = 94.9%), compared to males (k = 6, RR: 0.94, 95% CI: 0.77-1.15, Q = 53.44, I2 = 90.6%) and the combined group of females and males (k = 9, RR: 0.95, 95% CI: 0.88-1.02, Q = 16.38, I2 = 50.2%). Conclusion: The study found a high risk of coinfections between schistosomiasis and STIs, particularly in West and Southern Africa, confirming female genital schistosomiasis as a major risk for STIs. [ABSTRACT FROM AUTHOR]

Background: Physical, mental and social components of well-being are known to be important to health. However, research on well-being often focuses on physical and mental well-being with little attention paid to social well-being. This research aims to develop and preliminarily validate the South Wales Social Well-being Scale (SWSWBS) to measure social well-being. Methods: A non-experimental and cross-sectional design was applied with two phases: scale development and preliminary validation. Initially, 24 items were drawn from a Group Concept Mapping study exploring the concept of social well-being. These items were reviewed and reduced to 14 for preliminary validation among 103 university students and staff in health and social care disciplines. Construct validity (exploratory factor analysis and convergent validity) were tested. Reliability was demonstrated by internal consistency. Floor and ceiling effects were also evaluated. Results: A 3-factor structure was identified and explored, which highlight the most important features of the social world a person inhabits: "Safe and inclusive interaction with others" (6 items), "Learning, helping, and feeling useful" (4 items), and "Security, worthwhile activities, family and friends" (4 items). The SWSWBS was correlated to the Warwick Edinburgh Mental Well-being Scale and the Four measures of Personal Well-being Scale to some extent. The Cronbach alpha coefficient was 0.85 for the sum score and 0.83–0.86 for individual items. The item-total correlation coefficients ranged between 0.08 and 0.65. The split half reliability coefficient was 0.78. There is absence of a floor effect, but most items had a ceiling effect. Conclusions: Preliminary validation of the SWSWBS shows the scale has satisfactory psychometric properties with good validity, reliability, and reasonable variability. This study needs to be replicated with larger and representative populations to explore how the scale can be used alongside the Warwick Edinburgh Mental Well-being Scale to capture a holistic/multi-dimensional understanding of well-being. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cardiovascular disease (CVD) remains a major public health issue worldwide, disproportionately affecting socioeconomically disadvantaged populations due to the social determinants of health (SDOHs). In Western Romania, these populations are particularly vulnerable to CVD. This study aims to investigate the prevalence and impact of cardiovascular risk factors (CVRFs) among socioeconomically disadvantaged individuals in Western Romania and identify the primary CVRFs contributing to the high incidence of CVD within this population. Materials and Methods: A retrospective observational design was employed, utilizing data from the medical records of 1433 eligible individuals. The inclusion criteria were based on Eurostat's EU-SILC benchmarks, focusing on severe material deprivation, at-risk-of-poverty rates, and low work intensity. Data on demographics, familial and personal medical history, smoking status, blood pressure, glucose, cholesterol, triglycerides, and HbA1c levels were collected. Results: Of the 1433 subjects, 34.75% were male, with a median age of 52 years. Significant conditions included diabetes (7.39%), coronary disease (3.83%), arterial hypertension (35.58%), and dyslipidemia (21.28%). Median ages were higher for those with diabetes (65 vs. 51 years, p < 0.0001), coronary disease (64 vs. 51 years, p < 0.0001), arterial hypertension (65 vs. 43 years, p < 0.0001), and dyslipidemia (66 vs. 47 years, p < 0.0001). BMI (Body Mass Index) classifications showed 33.77% were overweight, 21.21% obese, and 15.07% morbidly obese. Smokers were younger than non-smokers (48 vs. 54 years, p < 0.0001). Conclusions: The findings highlight the significant prevalence of CVRFs among socioeconomically disadvantaged populations in Western Romania. Socioeconomically disadvantaged populations exhibit a significantly higher prevalence of cardiovascular risk factors such as diabetes, impaired glucose regulation, hypertension, and dyslipidemia compared to their before known status. [ABSTRACT FROM AUTHOR]

Evaluating stroke campaigns and associated behavioural changes is crucial to assess intervention effectiveness and inform future strategies. We aimed to evaluate patient's and bystanders' foreknowledge of stroke signs and symptoms and their response at stroke onset. We interviewed stroke patients using a validated questionnaire or their bystanders if the stroke patient had disabling stroke. The questionnaire was administered to 165 participants, 142 (86.1%) stroke patients and 23 (13.9%) bystanders. The mean age was 52.6 (SD = 11.7), and male–female ratio was 7:1. Among the participants, 33 (20.1%) had foreknowledge of stroke signs, and of these, 27 (16.5%) were aware of the stroke campaign in Qatar. The behavioural responses at stroke onset included; activating Emergency Medical Services (EMS) (n = 55, 33.3%), calling friends/relatives (n = 69, 41.8%), driving to hospital (n = 33, 20%), waiting for improvement in condition (n = 21, 12.7%). There was no association of ethnicity, marital status, or campaign awareness with EMS activation. Despite limited community awareness of stroke signs and campaign, help-seeking behaviour through EMS activation was generally high, underscoring the need for focused educational efforts and public health interventions. [ABSTRACT FROM AUTHOR]

Objective: This systematic review examines the impact of COVID-19 on Health-Related Quality of Life (HRQoL) across different populations, focusing on demographic, socio-economic, and COVID-19-related factors. Methods: A comprehensive search of PubMed from 2020 to 2022 was conducted, identifying 37 studies that met the inclusion criteria. Studies were assessed using the Appraisal Tool for Cross-Sectional Studies, Newcastle–Ottawa Scale, and Consolidated Health Economic Evaluation Reporting Standards tools. Data extraction included study characteristics, HRQoL measures, and health state utility values. Results: Thirty-seven studies were conducted with a total of 46,709 individuals and 274 HSUVs ranging from 0.224 to 1. Research included Europe (n = 20), North America (n = 4), Asia (n = 11), South America (n = 1), and Africa (n = 1). Utility was measured using 15D (n = 3), EQ-5D-5L (n = 24), EQ-5D-3L (n = 8), VAS (n = 1), and TTO (n = 1). The review found significant decreases in HRQoL among COVID-19 survivors, particularly those with severe symptoms, due to persistent fatigue, breathlessness, and psychological distress. Quarantine and isolation measures also negatively impacted HRQoL, with increased anxiety and depression. Vaccination status influenced HRQoL, with vaccinated individuals reporting better outcomes. Socio-demographic factors such as age, gender, education, employment, marital status, and income significantly affected HRQoL, with older adults, females, and unemployed individuals experiencing lower HRQoL. Conclusions: COVID-19 has profoundly affected HRQoL, highlighting the need for comprehensive post-recovery rehabilitation programs and targeted public health interventions. Addressing socio-demographic disparities is crucial to mitigate the pandemic's impact on HRQoL. Policymakers and healthcare providers should implement strategies to support affected populations, emphasizing mental health support, social support systems, and vaccination programs. [ABSTRACT FROM AUTHOR]

Climate change represents one of the most significant global health threats of the 21st century, with children being particularly vulnerable to its effects. This literature review examines the emerging risks posed by climate change on pediatric health, highlighting the multifaceted impacts on respiratory health, heat-related illnesses, vector-borne diseases, nutrition, mental health, and exposure to waterborne pathogens. Additionally, the review explores the disproportionate effects on children from marginalized communities, underscoring the urgent need for targeted interventions and policies. By synthesizing current research, this article aims to raise awareness among healthcare professionals and policymakers about the pressing need to protect pediatric populations from the evolving challenges of climate change.

The rapid spread of infectious diseases poses a critical threat to global public health. Traditional frameworks, such as the Susceptible–Exposed–Infectious–Recovered (SEIR) model, have been crucial in elucidating disease dynamics. Nonetheless, these models frequently overlook the strategic interactions between public health authorities and individuals. This research extends the classic SEIR model by incorporating differential game theory to analyze optimal control strategies. By modeling the conflicting objectives of public health authorities aiming to minimize infection rates and intervention costs, and individuals seeking to reduce their infection risk and inconvenience, we derive a Nash equilibrium that provides a balanced approach to disease management. Using Picard’s iterative method, we solve the extended model to determine dynamic, optimal control strategies, revealing oscillatory behavior in public health interventions and individual preventive measures. This comprehensive approach offers valuable insights into the dynamic interactions essential for effective infectious disease control.

Abstract Background Human papillomavirus (HPV) is increasingly recognized as a significant risk factor in the development of head and neck cancers (HNCs), with varying prevalence and impact. This study aims to systematically review and analyze the prevalence of HPV in HNCs in India, providing insights into regional variations. Methods A comprehensive literature search was carried out using PubMed, Embase, and Web of Science up to November 10, 2023. Inclusion criteria focused on original research reporting HPV-positive cases among HNC patients in India. We used Nested-Knowledge software, for screening, and data extraction. The modified Newcastle-Ottawa Scale was used for quality assessment of included studies. We pooled the prevalence of HPV among HNC patients and performed a random-effects model meta-analysis using R software (version 4.3). Results The search yielded 33 studies, encompassing 4654 HNC patients. The pooled prevalence of HPV infection was found to be 33% (95% CI: 25.8–42.6), with notable heterogeneity (I² = 95%). Analysis of subgroups according to geographical location indicated varying prevalence rates. Specifically, the prevalence was 47% (95% CI: 32.2–62.4) in the eastern regions and 19.8% (95% CI: 10.8–33.4) in the western regions. No evidence of publication bias was detected. Conclusion The observed considerable regional disparities on the prevalence of HPV in HNC patients in India emphasizes the need for integrated HPV vaccination and screening programs in public health strategies. The findings underline the necessity for further research to explore regional variations and treatment responses in HPV-associated HNCs, considering the impact of factors such as tobacco use and the potential benefits of HPV vaccination.

Background: Rabies remains a public health problem in middle-income countries like Iran, despite being preventable. This study aimed to evaluate the six-year incidence of animal bites in the southern Caspian Sea region from 2016 to 2022, and focus on estimating the direct costs of animal bite cases using the incidence-based method. Methods: A multicenter, registry-based study was conducted using surveillance data of animal bites. Results: Of the 40 922 cases reported during the study period, 65.9% were male and 34.1% were female. Animal bites were most frequent among individuals over 50 years of age (23.5%), while children under 10 years of age had the lowest frequency of animal bites (2.3%). Animal bites were most common in June. Dogs were responsible for 33 277 (81%) cases, cats for 5,624 (13.7%) cases, cows for 1054 (2.5%) cases, and other animals for the remaining cases. During the six-year study period, four deaths due to rabies were reported in the study area. The annual bite incidence rate was 386.3 per 100 000 people in northern Iran. The males-to-female ratio was highest in 2019 (M/F ratio = 2.4, 95% CI = 1.2-3.4). Conclusion: The elderly are at higher risk of animal bites, especially in rural areas. It is important to emphasize the use of protective clothing, washing wounds with soap water and rabies vaccination as initial treatment. Targeted vaccination efforts for eligible animals should be prioritized to minimize unnecessary financial burden. Educating farmers about rabies prevention programs, especially in cases of cow bites, is also important. [ABSTRACT FROM AUTHOR]

Accurate predictive modeling of pandemics is essential for optimally distributing biomedical resources and setting policy. Dozens of case prediction models have been proposed but their accuracy over time and by model type remains unclear. In this study, we systematically analyze all US CDC COVID-19 forecasting models, by first categorizing them and then calculating their mean absolute percent error, both wave-wise and on the complete timeline. We compare their estimates to government-reported case numbers, one another, as well as two baseline models wherein case counts remain static or follow a simple linear trend. The comparison reveals that around two-thirds of models fail to outperform a simple static case baseline and one-third fail to outperform a simple linear trend forecast. A wave-by-wave comparison of models revealed that no overall modeling approach was superior to others, including ensemble models and errors in modeling have increased over time during the pandemic. This study raises concerns about hosting these models on official public platforms of health organizations including the US CDC which risks giving them an official imprimatur and when utilized to formulate policy. By offering a universal evaluation method for pandemic forecasting models, we expect this study to serve as the starting point for the development of more accurate models.

BackgroundPublic health interventions aim to reduce the burden of chronic non-communicable diseases. Implementing evidence-based interventions that are proven to be successful and effective is widely recognized as the best approach to addressing public health challenges. To avoid the development and implementation of less effective or successful or even harmful practices, clear criteria for the assessment of practices, that consider different dimensions of the interventions in public health, are needed. The main aim of the research was to test our Criteria and assessment procedure for recognizing good practices in the field of public health by estimating the consistency between the evaluators and thereby gaining insight into the adequacy and reliability of the criteria as well as to check how the evaluators understand the criteria and methodology and if it is properly used in assessing the interventions.MethodsThe assessment of the interventions took place from 2021 to 2022. The individual evaluator’s scores on the scale from 1 to 5 for each specific sub-criterion were collected, which was followed by a panel discussion to reach a final score for each sub-criterion. The inter-rater agreement was measured using percent overall agreement and Fleiss’ kappa coefficient.ResultsWe found moderate inter-rater agreement on the level of the assessment criteria group. The lowest agreement was observed for the effectiveness and efficiency sub-criteria group, which also received the lowest scores from the evaluators. Challenges identified with the scoring process were due to the descriptive 1 to 5 scale and the varying specificity of the criteria.ConclusionThe results showed that studying consistency between evaluators can highlight areas for improvement or adjustment in the assessment criteria and enhance the quality of the assessment instrument. Therefore, such analysis would be useful part of both newly and well-established health promotion and prevention program registries.

During the pandemic outdoor activities were encouraged to mitigate transmission risk while providing safe spaces for social interactions. Human behaviour, which may favour or disfavour, contact rates between questing ticks and humans, is a key factor impacting tick-borne encephalitis (TBE) incidence. We analyzed annual and weekly TBE cases in Finland, Norway and Sweden from 2010 to 2021 to assess trend, seasonality, and discuss changes in human tick exposure imposed by COVID-19. We compared the pre-pandemic incidence (2010–2019) with the pandemic incidence (2020–2021) by fitting a generalized linear model (GLM) to incidence data. Pre-pandemic incidence was 1.0, 0.29 and 2.8 for Finland, Norway and Sweden, respectively, compared to incidence of 2.2, 1.0 and 3.9 during the pandemic years. However, there was an increasing trend for all countries across the whole study period. Therefore, we predicted the number of cases in 2020/2021 based on a model fitted to the annual cases in 2010–2019. The incidences during the pandemic were 1.3 times higher for Finland, 1.7 times higher for Norway and no difference for Sweden. When social restrictions were enforced to curb the spread of SARS-CoV-2 there were profound changes in outdoor recreational behavior. Future consideration of public health interventions that promote outdoor activities may increase exposure to vector-borne diseases. [ABSTRACT FROM AUTHOR]

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a powerful tool used by public health authorities to track SARS-CoV-2 infections in communities. In May 2020, the Houston Health Department began working with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. Data collected from the system are integrated with other COVID-19 surveillance data and communicated through different channels to local authorities and the general public. This information is used to shape policies and inform actions to mitigate and prevent the spread of COVID-19 at municipal, institutional, and individual levels. Based on the success of this monitoring and reporting system to drive public health protection efforts, the wastewater surveillance program is likely to become a standard part of the public health toolkit for responding to infectious diseases and, potentially, other disease-causing outbreaks. [ABSTRACT FROM AUTHOR]

The editorial in Frontiers in Epidemiology discusses the role of mathematical modelling in managing the COVID-19 pandemic, focusing on public health interventions, mobility data, and population heterogeneity. The authors reflect on the effectiveness of modelling during the acute phase of the pandemic and its relevance in the persistent phase. Different modelling approaches are explored, including the use of mobility data and digital contact tracing apps. The importance of realistic models that can adapt to changing public health needs and incorporate new data streams is emphasized. [Extracted from the article]

Objective: Obesity affects 14.7 million children and adolescents in the United States. Children's health behaviors are affected by parental health practices. Therefore, pediatric obesity interventions should include parents. The objective of this study was to assess the changes in self-reported health behaviors in a diverse population attending the TEEEN program, with motivational interviewing of child-parent dyads as a key component, for 1 year. Methods: Here we assessed the changes in Family and Nutrition and Physical Activity (FNPA) screening tool scores, a tool that assesses obesogenic behaviors, in the context of MI of child-parent dyads in a racially, ethnically, and socioeconomically diverse population who attended the TEEEN (Teens, Empowerment, Education, Exercise, Nutrition) program, a nonclinic and family-based behavior program in Massachusetts, for 1 year. Results: Participation in the TEEEN program, which includes MI of child-parent dyads, was associated with a significant increase in the overall FNPA score (median change= 4 points, P = .007). We observed that 76.5% of children experienced a decrease in BMI% and BMI z-score. The change in BMI% (median= −0.9, P = .006) and change in BMI z-score (median= −0.2, P = .008) were statistically significant. Conclusion: Participation in the TEEEN program seemed to be beneficial based on aspects of the FNPA screening tool and changes in weight parameters. The FNPA screening tool enhanced-motivational interviewing of child-parent dyads shows promise as an approach to address obesogenic behaviors. This study provides a detailed framework for medical providers to address pediatric obesity in a nonclinic setting with less time constraints.

To address existing gaps in public health practice, we used data from a 2014 internet panel survey of 954 Los Angeles County adults to investigate the relationships between psychosocial community characteristics (PCCs) and two key chronic disease-related dietary behaviors: fruit and vegetable (F+V) and soda consumption. Negative binomial regression models estimated the associations between 'neighborhood risks and resources' and 'sense of community' factors for each dietary outcome of interest. While high perceived neighborhood violence (p < 0.001) and perceived community-level collective efficacy (p < 0.001) were associated with higher F+V consumption, no PCCs were directly associated with soda consumption overall. However, moderation analyses by race/ethnicity showed a more varied pattern. High perceived violence was associated with lower F+V consumption among White and Asian/Native Hawaiian/Other Pacific Islander (ANHOPI) groups (p < 0.01). Inadequate park access and walking as the primary mode of transportation to the grocery store were associated with higher soda consumption among the ANHOPI group only (p < 0.05). Study findings suggest that current and future chronic disease prevention efforts should consider how social and psychological dynamics of communities influence dietary behaviors, especially among racially/ethnically diverse groups in urban settings. Intervention design and implementation planning could benefit from and be optimized based on these considerations.

Background: In the UK, the population of homelessness and housing insecurity is increasing among families headed by mothers. The unique stressors of housing insecurity and living in accommodations ill-suited to long-term dwellings increase mental distress for mothers and children. Community engagement interventions present a public health opportunity to alleviate adverse outcomes for vulnerable families. Aim: To synthesise and evaluate evidence of the impact of community engagement interventions in supporting the mental well-being of mothers and children living under housing insecure conditions. To synthesise the components of community engagement interventions as a public health intervention in alleviating mental well-being and non-health outcomes of mothers and children living under housing insecurity. Methods: A systematic search of five online bibliographic databases (MEDLINE, EMBASE, PsychINFO, Global Health and Child Development & Adolescent Studies) and grey literature (Carrot2) was conducted in May 2022. Primary studies with community engagement components and housing-insecure single-mother families were included. Intervention data was extracted using the TIDieR checklist and a community engagement keywording tool. The studies' quality was critically appraised using the MetaQAT framework. Results: Ten studies meeting inclusion criteria were identified, across two countries (USA & UK). Data from the studies reported positive significant effects for health and personal maternal outcomes in addition to higher positive effects for child health outcomes (e.g., decrease in depression symptoms). Interventions targeting social support and self-efficacy demonstrated potential to improve maternal and child outcomes via the maternal-child relationship. Community engagement at the design, delivery and evaluation intervention stages increased the level of community engagement, however there were tentative links to directly improving mental well-being outcomes. Conclusion: There is evidence to suggest that community engagement may be applied as an effective intervention in supporting the mental well-being of mothers and children living under housing insecurity. Proposed intervention effectiveness may be achieved via psychosocial pathways such as improved maternal self-efficacy and social support. However, more embedded long-term process evaluations of these interventions are needed to establish maintenance of these observed benefits and to understand to what extent the findings apply to the UK context. [ABSTRACT FROM AUTHOR]

Childhood is a pivotal phase of human development, entails rapid growth and evolving health requirements. This cross-sectional study examines the age and sex distribution of school children across five coastal localities. To address the unique health and well-being challenges faced by school children in different regions, this cross-sectional study explores the age and sex distribution of school children across five distinct localities: Koilpathu, Karaikalmedu, Nallathur, Varichikudy, and Kottucherry. It offers a comprehensive examination of school children, encompassing demographic profiles, anthropometric measurements, and a wide array of health-related data. Our analysis revealed shifting gender proportions across age groups, with females dominating in the younger years but males surpassing females as children grow older. Particularly intriguing were the 12-year age group's scarcity of females (0.3%) and the 13-year age group's exclusive female composition (6.07%). Regarding body mass index (BMI), boys generally exhibited values near reference standards in their early years, while girls displayed lower BMI values than the reference during pre-adolescence, signaling potential nutritional concerns. Malnutrition was less prevalent in younger age groups, but overweight and obesity became more common as children aged. Gender-specific health disparities were also evident, with females more susceptible to anemia, while males had a higher prevalence of color blindness and dental health issues. These findings underscore the importance of tailored interventions to address age and gender-specific health challenges among coastal school children. [ABSTRACT FROM AUTHOR]

Objectives: Identify patient-informed strategies through which an urban resident continuity clinic can implement the principles of community oriented primary care (COPC). Methods: As part of a larger sequential mixed methods study supporting implementation evaluation of a new urban academic medical center in Cleveland, Ohio, semi-structured telephone interviews using a descriptive phenomenological approach were conducted spring 2021 with patients to explore perspectives regarding community involvement by healthcare providers and what they want clinicians to know about their community. A constant comparative analysis of emerging themes was used to analyze the thematic contents of interviews. Results: Twenty-one participants completed interviews. Almost all thought clinicians’ community involvement is important. Thematic guidance from participants highlighted that clinicians should be: (1) knowledgeable about the Black experience, (2) seen in the community outside the clinic, and (3) aware that “knowing my community is knowing me.” Conclusions: Design with a target community in mind is a necessary but not sufficient step to implement COPC in practice. The visibility of clinicians in community settings is essential for COPC.

Background: Teenagers are at a turning point in people's physical and psychological maturity and are also in a critical period in reproductive and sexual health. It is reported that the initial age at first sexual behavior is younger than decades ago, which implies that the risky sexual behavior among teenagers may be on the rise. However, it is unclear about the changes of sexual knowledge and behaviors in recent years. Methods: Based on the national sentinel surveillance survey in 2011–2021 among students in Hangzhou, we selected out teenagers aged 10–19 years as our study sample. Demographic characteristics (gender, age, marital status, etc.), knowledge of HIV and sexual behaviors were collected. The sexual knowledge score and sexual behaviors were analyzed, and their influencing factors were explored. Results: In total, 1355 teenagers were incorporated in this study; the awareness rates of sexual knowledge in 2011, 2013, 2014 and 2021 were 74.9%, 71.8%, 89.3% and 95.8%, respectively, which showed an overall upward trend. The results of binary logistic regression showed that the survey year, whether students had received and participated in HIV-related publicity services and whether they had sexual behaviors, had a significant influence on whether the awareness rate ≥ 75%. The survey year and whether the awareness rate ≥ 75% had a significant influence on whether students had sexual behaviors. Conclusions: Both the average scores and awareness rates of teenagers' sexual knowledge showed an overall upward trend from 2011 to 2021. Teenagers' initial sexual behavior was at a low age, and the proportion of teenagers who had fixed, temporary and commercial heterosexual sex was still relatively high despite no significant increasing. Therefore, we should further strengthen health education on the risks of sexual behaviors from schools, families and health-related institutions to ensure teenagers receive HIV-related publicity services. [ABSTRACT FROM AUTHOR]

ABSTRACT The widespread existence of expired antigen testing kits in households and potential coronavirus outbreaks necessitates evaluating the reliability of these expired kits. Our study examined BinaxNOW COVID-19 rapid antigen tests 27 months postmanufacture and 5 months past their FDA extended expiration dates, using SARS-CoV-2 variant XBB.1.5 viral stock. We conducted testing at two concentrations, the limit of detection (LOD) and 10 times the LOD. One hundred expired and unexpired kits were tested at each concentration for a total of 400 antigen tests. At the LOD (2.32 × 102 50% tissue culture infective dose/mL [TCID50/mL]), both expired and unexpired tests displayed 100% sensitivity (95% confidence interval [CI], 96.38% to 100%), with no statistical difference (95% CI, −3.92% to 3.92%). Similarly, at 10 times the LOD, unexpired tests retained 100% sensitivity (95% CI, 96.38% to 100%), while expired tests exhibited 99% sensitivity (95% CI, 94.61% to 99.99%), demonstrating a statistically insignificant 1% difference (95% CI, −2.49% to 4.49%; P = 0.56). Expired rapid antigen tests had fainter lines than the unexpired tests at each viral concentration. The expired rapid antigen tests at the LOD were only just visible. These findings carry significant implications for waste management, cost efficiency, and supply chain resilience in pandemic readiness efforts. They also provide critical insights for formulating clinical guidelines for interpreting results from expired kits. In light of expert warnings of a potential outbreak of a severity rivaling the Omicron variant, our study underscores the importance of maximizing the utility of expired antigen testing kits in managing future health emergencies. IMPORTANCE The study examining the reliability of expired antigen testing kits in the context of COVID-19 has significant real-world implications. By demonstrating that these expired kits retain their sensitivity in detecting the virus, this work provides evidence that expired kits can still be utilized, reducing waste and optimizing resources in health care systems. These findings are especially crucial in light of potential future coronavirus outbreaks and the need to be prepared. The study's outcomes have the potential to contribute to waste management efforts, cost efficiency, and supply chain resilience, ensuring that diagnostic tests remain readily available for effective public health interventions. Furthermore, it provides critical insights for formulating clinical guidelines on interpreting results from expired kits, enhancing the accuracy of testing outcomes, and supporting informed decision-making. Ultimately, this work holds great importance in maximizing the utility of expired antigen testing kits, safeguarding public health, and enhancing pandemic readiness on a global scale.

Background: The COVID-19 vaccine supply shortage in 2021 constrained roll-out efforts in Africa while populations experienced waves of epidemics. As supply improves, a key question is whether vaccination remains an impactful and cost-effective strategy given changes in the timing of implementation. Methods: We assessed the impact of vaccination programme timing using an epidemiological and economic model. We fitted an age-specific dynamic transmission model to reported COVID-19 deaths in 27 African countries to approximate existing immunity resulting from infection before substantial vaccine roll-out. We then projected health outcomes (from symptomatic cases to overall disability-adjusted life years (DALYs) averted) for different programme start dates (01 January to 01 December 2021, n = 12) and roll-out rates (slow, medium, fast; 275, 826, and 2066 doses/million population-day, respectively) for viral vector and mRNA vaccines by the end of 2022. Roll-out rates used were derived from observed uptake trajectories in this region. Vaccination programmes were assumed to prioritise those above 60 years before other adults. We collected data on vaccine delivery costs, calculated incremental cost-effectiveness ratios (ICERs) compared to no vaccine use, and compared these ICERs to GDP per capita. We additionally calculated a relative affordability measure of vaccination programmes to assess potential nonmarginal budget impacts. Results: Vaccination programmes with early start dates yielded the most health benefits and lowest ICERs compared to those with late starts. While producing the most health benefits, fast vaccine roll-out did not always result in the lowest ICERs. The highest marginal effectiveness within vaccination programmes was found among older adults. High country income groups, high proportions of populations over 60 years or non-susceptible at the start of vaccination programmes are associated with low ICERs relative to GDP per capita. Most vaccination programmes with small ICERs relative to GDP per capita were also relatively affordable. Conclusion: Although ICERs increased significantly as vaccination programmes were delayed, programmes starting late in 2021 may still generate low ICERs and manageable affordability measures. Looking forward, lower vaccine purchasing costs and vaccines with improved efficacies can help increase the economic value of COVID-19 vaccination programmes. [ABSTRACT FROM AUTHOR]

Abstract Background In January 2020, an outbreak of atypical pneumonia caused by a novel coronavirus, SARS-CoV-2, was reported in Wuhan, China. On Jan 23, 2020, the Chinese government instituted mitigation strategies to control spread. Most modeling studies have focused on projecting epidemiological outcomes throughout the pandemic. However, the impact and optimal timing of different mitigation approaches have not been well-studied. Methods We developed a mathematical model reflecting SARS-CoV-2 transmission dynamics in an age-stratified population. The model simulates health and economic outcomes from Dec 1, 2019 through Mar 31, 2020 for cities including Wuhan, Chongqing, Beijing, and Shanghai in China. We considered differences in timing and duration of three mitigation strategies in the early phase of the epidemic: city-wide quarantine on Wuhan, travel history screening and isolation of travelers from Wuhan to other Chinese cities, and general social distancing. Results Our model estimated that implementing all three mitigation strategies one week earlier would have averted 35% of deaths in Wuhan (50% in other cities) with a 7% increase in economic impacts (16-18% in other cities). One week’s delay in mitigation strategy initiation was estimated to decrease economic cost by the same amount, but with 35% more deaths in Wuhan and more than 80% more deaths in the other cities. Of the three mitigation approaches, infections and deaths increased most rapidly if initiation of social distancing was delayed. Furthermore, social distancing of working-age adults was most critical to reducing COVID-19 outcomes versus social distancing among children and/or the elderly. Conclusions Optimizing the timing of epidemic mitigation strategies is paramount and involves weighing trade-offs between preventing infections and deaths and incurring immense economic impacts. City-wide quarantine was not as effective as city-wide social distancing due to its much higher daily cost than social distancing. Under typical economic evaluation standards, the optimal timing for the full set of control measures would have been much later than Jan 23, 2020 (status quo).

Abstract Background Eliminating Plasmodium vivax will require targeting the hidden liver-stage reservoir of hypnozoites. This necessitates new interventions balancing the benefit of reducing vivax transmission against the risk of over-treating some individuals with drugs which may induce haemolysis. By measuring antibodies to a panel of vivax antigens, a strategy of serological-testing-and-treatment (PvSeroTAT) can identify individuals with recent blood-stage infections who are likely to carry hypnozoites and target them for radical cure. This provides a potential solution to selectively treat the vivax reservoir with 8-aminoquinolines. Methods PvSeroTAT can identify likely hypnozoite carriers with ~80% sensitivity and specificity. Diagnostic test sensitivities and specificities ranging 50–100% were incorporated into a mathematical model of vivax transmission to explore how they affect the risks and benefits of different PvSeroTAT strategies involving hypnozoiticidal regimens. Risk was measured as the rate of overtreatment and benefit as reduction of community-level vivax transmission. Results Across a wide range of combinations of diagnostic sensitivity and specificity, PvSeroTAT was substantially more effective than bloodstage mass screen and treat strategies and only marginally less effective than mass drug administration. The key test characteristic determining of the benefit of PvSeroTAT strategies is diagnostic sensitivity, with higher values leading to more hypnozoite carriers effectively treated and greater reductions in vivax transmission. The key determinant of risk is diagnostic specificity: higher specificity ensures that a lower proportion of uninfected individuals are unnecessarily treated with primaquine. These relationships are maintained in both moderate and low transmission settings (qPCR prevalence 10% and 2%). Increased treatment efficacy and adherence can partially compensate for lower test performance. Multiple rounds of PvSeroTAT with a lower performing test may lead to similar or higher reductions in vivax transmission than fewer rounds with a higher performing test, albeit with higher rate of overtreatment. Conclusions At current performance, PvSeroTAT is predicted to be a safe and efficacious option for targeting the hypnozoite reservoir towards vivax elimination. P. vivax sero-diagnostic tests should aim for both high performance and ease of use in the field. The target product profiles informing such development should thus reflect the trade-offs between impact, overtreatment, and ease of programmatic implementation.

Objectives: The exact characteristics of a coronavirus disease 2019 (COVID-19) outbreak that trigger public health interventions are poorly defined. The aim of this study was to assess the critical timing and extent of public health interventions to contain COVID-19 outbreaks in Australia. Methods: A practical model was developed using existing epidemic data in Australia. The effective combinations of public health interventions and the critical number of daily cases for intervention commencement under various scenarios of changes in transmissibility of new variants and vaccination coverage were quantified. Results: In the past COVID-19 outbreaks in four Australian states, the number of reported cases on the day that interventions commenced strongly predicted the size and duration of the outbreaks. In the early phase of an outbreak, containing a wildtype-dominant epidemic to a low level (≤10 cases/day) would require effective combinations of social distancing and face mask use interventions to be commenced before the number of daily reported cases reaches six. Containing an Alpha-dominant epidemic would require more stringent interventions that commence earlier. For the Delta variant, public health interventions alone would not contain the epidemic unless the vaccination coverage was ≥70%. Conclusions: This study highlights the importance of early and decisive action in the initial phase of an outbreak. Vaccination is essential for containing variants.

Background: Twitter has become a dominant source of public health data and a widely used method to investigate and understand public health–related issues internationally. By leveraging big data methodologies to mine Twitter for health-related data at the individual and community levels, scientists can use the data as a rapid and less expensive source for both epidemiological surveillance and studies on human behavior. However, limited reviews have focused on novel applications of language analyses that examine human health and behavior and the surveillance of several emerging diseases, chronic conditions, and risky behaviors. Objective: The primary focus of this scoping review was to provide a comprehensive overview of relevant studies that have used Twitter as a data source in public health research to analyze users' tweets to identify and understand physical and mental health conditions and remotely monitor the leading causes of mortality related to emerging disease epidemics, chronic diseases, and risk behaviors. Methods: A literature search strategy following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extended guidelines for scoping reviews was used to search specific keywords on Twitter and public health on 5 databases: Web of Science, PubMed, CINAHL, PsycINFO, and Google Scholar. We reviewed the literature comprising peer-reviewed empirical research articles that included original research published in English-language journals between 2008 and 2021. Key information on Twitter data being leveraged for analyzing user language to study physical and mental health and public health surveillance was extracted. Results: A total of 38 articles that focused primarily on Twitter as a data source met the inclusion criteria for review. In total, two themes emerged from the literature: (1) language analysis to identify health threats and physical and mental health understandings about people and societies and (2) public health surveillance related to leading causes of mortality, primarily representing 3 categories (ie, respiratory infections, cardiovascular disease, and COVID-19). The findings suggest that Twitter language data can be mined to detect mental health conditions, disease surveillance, and death rates; identify heart-related content; show how health-related information is shared and discussed; and provide access to users' opinions and feelings. Conclusions: Twitter analysis shows promise in the field of public health communication and surveillance. It may be essential to use Twitter to supplement more conventional public health surveillance approaches. Twitter can potentially fortify researchers' ability to collect data in a timely way and improve the early identification of potential health threats. Twitter can also help identify subtle signals in language for understanding physical and mental health conditions. [ABSTRACT FROM AUTHOR]

Dr. Jo E Frencken is a stalwart in preventive dentistry and cariology. He has worked extensively in diagnosing, treating, and assessing outcomes related to dental caries. He developed the concept of a novel technique known as atraumatic restorative treatment (ART) in 1986 for caries management. ART for field settings, where only hand instruments are used for caries removal, is a benchmark discovery made in the field of dentistry. His idea of ART has been adopted by the World Health Organization and has been included as a part of the Basic Package for Oral Care (BPOC) and practiced globally. He has dedicated his research to dental public health, caries prevention, and treatment modalities in various settings for over 40 years., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, More et al.)

Background: Deliberate self-harm (DSH) by poisoning is a significant public health concern worldwide. This study aimed to analyze the demographic, socioeconomic, and psychological factors contributing to self-harm by poisoning in patients admitted to a tertiary care hospital in Sri Lanka., Methods: A cross-sectional study was conducted on 101 patients admitted to the hospital for poisoning-related self-harm. Data was collected through a structured questionnaire. Variables such as age, gender, educational background, employment status, income levels, substance abuse history, type of poisons used, sources of knowledge about self-harm methods, immediate stressors, and other few possible factors were analyzed., Results: The majority of patients, 55 (54.5%), were between the ages of 18 and 29. Fifty-five women (54.5%) slightly outnumbered 46 men (45.5%). More than half of the included patients had an educational background of up to ordinary level exam, while 58 were unemployed (57.4%), including dependents. Lower income levels were associated with higher rates of self-harm. Substance abuse, particularly alcohol, was prevalent in 34 (33.7%) of cases. The most commonly used poison was yellow oleander, reported in 38 (37.6%) of cases. The study also found that a majority, 53 (52.5%), learned about self-harm methods through community engagement. Immediate stressors, including arguments with parents, 29 (28.7%), and conflicts with spouses, 19 (18.8%), were significant triggers. Most patients, 76 (75.2%), were admitted to the hospital within six hours of poisoning. Half of the patients, 50 (50%), reported that immediate stressors directly related to the COVID-19 pandemic significantly influenced their decision to self-harm. Regarding patient outcomes, the study found that nearly all patients, 100 (99%), were successfully discharged from the hospital after treatment., Conclusion: This study provides valuable insights into the factors contributing to DSH by poisoning in a Sri Lankan context. Targeted interventions addressing the identified risk factors, along with broader public health strategies, are essential to reduce the incidence of self-harm., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethical Review Committee of the Faculty of Health Care Sciences, Eastern University Sri Lanka issued approval E/2022/52. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singhapathirana et al.)