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The Hearst Health Prize is the first national annual award for excellence in population health. The prize was established "to discover, support, and showcase the work of an individual, group, organization, or institution that has successfully implemented a population health program or intervention that has made a measurable difference" in health outcomes. Now, 5 years since the award's inception, this article reflects on how submissions for the prize collectively mirror - and may even predict - changes within the field of population health. It examines how the most successful programs demonstrated genuine, measurable improvements in health outcomes and/or health behaviors. In exploring the work of these outstanding programs, the aim of this article is to help disseminate best practices, advance the mission of the prize, and inspire improvements in population health practices.

Background Food access is an important aspect of health promotion for the elderly. The aim of this study was to investigate the relationship between distance to the nearest food store and diet variety in rural community-dwelling elderly Japanese. Methods This cross-sectional study analyzed data from 1,103 elderly participants surveyed by mail in rural areas of Japan. Diversity of food intake was assessed by diet variety score (DVS). Street network distance from home to food store was calculated and categorized by quartile using a geographic information system and analyzed in relation to diet by multivariable regression with the primary outcome as low DVS. Sub-analysis of the association with DVS was conducted for each food store category (convenience store, supermarket and small food store). The association between intake frequency of each food group and distance was also analyzed. Results Participants in the fourth quartile of distance to food store had significantly higher prevalence ratio (1.15, 95% CI, 1.01-1.32) for low DVS than those in the first quartile. There was a significant tendency between greater distance to food store and lower DVS (p for trend = 0.033). Supermarkets and convenience stores, in particular, showed significant associations. Greater distance was significantly associated with lower frequency of meat and fruit intake. Conclusions There was significant association between distance to nearest food store and diet variety in rural Japanese elderly. These findings suggest the importance of interventions for areas at high risk of low diet variety, such as places far away from food stores.

OBJECTIVES: America’s overdose crisis spurred rapid expansion in the number and scope of prescription drug monitoring programs (PDMPs). As their public health impact remains contested, little is known about PDMP user experiences and perspectives. We explore perspectives of PDMP end-users in Massachusetts. METHODS: Between 2016–2017, we conducted semi-structured qualitative interviews on overdose crisis dynamics and PDMP experiences with a purposive sample of 18 stakeholders (prescribers, pharmacists, law enforcement, and public health regulators). Recordings were transcribed and double-coded using a grounded hermeneutic approach. RESULTS: Perspectives on prescription monitoring as an element of overdose crisis response differed across sectors, but narratives often critiqued PDMPs as poorly conceived to serve end-user needs. Respondents indicated that PDMP: 1) lacked clear orientation towards health promotion; 2) was not optimally configured or designed as a decision support tool, resulting in confusion over interpreting data to guide health care or law enforcement actions; and, 3) problematized communication and relationships between prescribers, pharmacists, and patients. CONCLUSION: User insights must inform design, programmatic, and policy reform to maximize PDMP benefits while minimizing harm. Their collateral impact may be compounded by COVID-19.

The main aim of this paper is to argue for the centrality of ‘trust’ for the development and maintenance of health and wellbeing of individuals, communities and societies. I argue that public health practitioners and policy makers need to take ‘public trust’ seriously if they intend to both improve the public’s health and improve engagement between members of the public and public health systems. Public health practitioners implement a range of services and interventions aimed at improving health, but implicit within this is a requirement for individuals to trust the practitioners and the services/interventions, before they will engage with them. I then go on to provide an overview of the theory of trust within sociology and show why it is important to understand this theory in order to promote trust in public health services. I then draw on literature in three classic areas of public health - hospitals, cancer screening and childhood immunisation - to show why trust is vital in terms of understanding and potentially improving uptake of services. The case studies within this paper reveal that public health practitioners need to understand the centrality of building and maintaining trusting relationships with patients/clients because people who distrust public health services are less likely to use them, less likely to follow advice or recommendations and more likely to have poorer health outcomes.

Understanding COVID-19 vaccine acceptability among clients and staff of homeless shelters can inform public health efforts focused on communicating with and educating this population about COVID-19 vaccines and thus improve vaccine uptake. The objective of this study was to assess COVID-19 vaccine acceptability and uptake among people in homeless shelters in Detroit, Michigan. A cross-sectional study was conducted from February 9 to 23, 2021. Seventeen homeless shelters were surveyed: seven male-only, three male/female, and seven women and family shelters. All clients and staff aged ≥18 years and able to complete a verbal survey in English or with a translator were eligible to participate; of the 168 individuals approached, 26 declined, leaving a total sample of 106 clients and 36 staff participating in the study. The median client and staff ages were 44 and 54 years, respectively. Most participants (>80%) identified as non-Hispanic Black or African American. Sixty-one (57.5%) clients and 27 (75.5%) staff had already received or planned to receive a COVID-19 vaccination. Twelve (11.3%) clients and four (11.1%) staff were unsure, and 33 (31.1%) clients and five (13.9%) staff did not plan to get vaccinated. Reasons for hesitancy were concerns over side effects (29 clients [64.4%] and seven staff [77.8%]) and unknown long-term health impacts (26 clients [57.8%] and six staff [66.7%]). More than half of the clients had already received or planned to receive the vaccine. Continuing efforts such as vaccine education for hesitant clients and staff and having accessible vaccine events for this population may improve acceptability and uptake.

Domestic violence creates multiple harms for women's health and is a ‘wicked problem’ for health professionals and public health systems. Brazil recently approved public policies to manage and care for women victims of domestic violence. Facing these policies, this study aimed to explore how domestic violence against women is usually managed in Brazilian primary health care, by investigating a basic health unit and its family health strategy. We adopted qualitative ethnographic research methods with thematic analysis of emergent categories, interrogating data with gender theory and emergent Brazilian collective health theory. Field research was conducted in a local basic health unit and the territory for which it is responsible, in Southern Brazil. The study revealed: 1) a yawning gap between public health policies for domestic violence against women at the federal level and its practical application at local/decentralized levels, which can leave both professionals and women unsafe; 2) the key role of local community health workers, paraprofessional health promotion agents, who aim to promote dialogue between women experiencing violence, health care professionals and the health care system. Resumo A violência doméstica (VD) cria múltiplos agravos à saúde das mulheres e é um desafio para profissionais e para os sistemas de saúde. O Brasil aprovou recentemente políticas públicas (PP) para manejo e cuidado de mulheres em situação de VD. Considerando essas PP, este estudo objetivou explorar como a VD contra mulheres é usualmente manejada na atenção primária à saúde brasileira, por meio da investigação de uma unidade básica de saúde e de sua estratégia de saúde da família. Foi adotada metodologia de pesquisa qualitativa de cunho etnográfico, com análise temática de categorias emergentes, interrogando os dados com teoria de gênero e com a produção teórica do campo da saúde coletiva brasileira. A pesquisa de campo foi conduzida em uma unidade básica de saúde e em seu território adscrito, localizado na região sul do Brasil. O estudo revelou: 1) um hiato entre PP direcionadas à VD contra mulheres implantadas a nível federal e sua aplicação prática a nível local/descentralizado, que pode deixar tanto profissionais quanto mulheres em risco; 2) o papel chave de agentes comunitários de saúde, profissionais de promoção da saúde, que objetivam promover o diálogo entre as mulheres experienciando violência, profissionais de saúde e o sistema de saúde.

Introduction: Dentists play a fundamental role in the detection of lesions in maxillofacial complex through the appropriate examination. Identification, diagnosis and proper conduct of these professionals are configured as a differential in health promotion. The lack of familiarization of dentists with Oral Medicine is something already reported in the literature. This lack of affinity can lead to the adoption of erroneous behaviors regarding oral lesions, which generate unnecessary burdens on public health. Objective: To evaluate the level of knowledge on Oral Medicine of dentists who work in Primary Health Care in the city of Arcoverde, Pernambuco, Brazil. Methodology: This is an observational, inductive, statistical study with a quantitative approach. The research was carried out in Arcoverde-PE. The study population involves dentists working in the Basic Health Units of the city. The data were collected through a questionnaire prepared by the researchers, containing 27 questions about the most common oral lesions, clinical diagnosis and conduct towards specific clinical diagnoses. The level of knowledge was measured from the mean of correct answers by the professionals. Collected data were processed using the IBM SPSS 20.0® statistical program. Results: The sample obtained was thirteen dentists. The mean of correct answers on specific knowledge on Oral Medicine was 17 (± 3.109). As for the classification of general performance, most professionals (69.2%) performed regularly. As for specific knowledge about clinical diagnosis, the knowledge was classified as high for the majority (53.8%). In relation to specific knowledge about the appropriate behaviors in relation to injuries, the performance classification was low for most participants (84.6%). Conclusions: In general, dentists obtained a regular performance of knowledge on Oral Medicine. Further, research is recommended due to the scarcity of discussions on the topic in the literature. Uniterms: Dentists; Oral Medicine; Primary Health Care

OBJECTIVES To evaluate the effectiveness of a multi-component school-based intervention on physical activity (PA) and screen time (ST) among urban adolescents in Bangladesh. DESIGN Cluster-randomised controlled trial. METHODS Eight high schools were randomly assigned to either intervention group (IG) or control group (CG). Participants (n = 160 per group, 40 school) were in grades 8-9. A 12-week multi-component intervention was developed based on the WHO's Health-Promoting Schools framework. The IG received weekly supervised circuit exercise (30 min/week), health education session (10 min/week) with health educational materials, and lunchtime sports activities (20 min/week). The main outcome measures included self-reported PA, ST, knowledge on PA and SB, which were assessed at baseline, 8 and 12 weeks. Repeated measures ANCOVA was used to evaluate the intervention effects. RESULTS Total PA (MET-min/week) was increased from baseline to 8 and 12 weeks in the IG (3%-5%) but decreased in the CG (5%-3%) and significantly improved in the IG compared to the CG (p

Examine predictors of social media use among a nationally representative sample of adults with children in the household.Data were collected from the Health Information National Trends (HINTS) Survey from 2017 to 2020 (N = 3559). Multivariate logistic regression models assessed the association between sociodemographic variables and social networking site (SNS) use, SNS use to share health information, participation in online forum or support groups for health issues and watching health-related videos on YouTube.Older adults and men were significantly less likely to use social media (p.05). Non-Hispanic African American (aOR: 1.83; 95%CI: 1.30-2.57), Hispanic (aOR: 2.16; 95%CI: 1.56-2.99), and Asian (aOR: 2.82; 95%CI: 1.67-4.75) adults were more likely to watch health-related videos on YouTube.Racial/ethnic minorities with children in the household were more likely to seek health information on YouTube, highlighting opportunities to disseminate culturally relevant, accurate messages on the platform. Effective health communication targeted to specific demographics can help counter misinformation and promote health behavior particularly during public health emergencies.Providers need to foster trust so that patients are comfortable to ask questions in addition to seeking information online. Providers can direct patients to credible resources to counter misinformation exposure and promote healthy behavior.

Objectives Launched in 2011 by the Public Health Agency of Canada, the Canadian Diabetes Risk Questionnaire (CANRISK) is a self-assessment tool validated in a Canadian sample, but its uptake has never been assessed. We sought to determine the level of current use of the CANRISK tool, identify common facilitators and barriers to its use and recommend future improvements. Methods Ten professional allied health organizations across Canada were contacted for in-depth interviews. Contextual content and thematic analysis were used to analyze the qualitative data set. Results According to allied health professionals, the tool is widely used, appealing and needed, and is being used for risk screening and health promotion. Respondents also identified the need to provide support and next steps for users identified as high risk. Still, several barriers to implementation were found, including readability, offensive or confusing language and difficulty ascertaining body measurements. Conclusions The CANRISK is a valuable diabetes risk assessment tool in Canada, particularly for allied health organizations.

Lifestyle-related non-communicable diseases (NCDs) and their risk factors are unequivocally associated with SARS-CoV-2 susceptibility and COVID-19 severity. NCD manifestations and their lifestyle risks are associated with chronic low-grade systemic inflammation (CLGSI). This review supports that immuno-modulation with positive lifestyle change aimed at reducing SARS-CoV-2 susceptibility and COVID-19 severity, is a goal consistent with contemporary physiotherapy practice. Physiotherapists have a long tradition of managing a , thus, managing CLGSI is a logical extension. Improving patients' lifestyle practices also reduces their NCD risks and increases activity/exercise capacity, health and wellbeing - all principal goals of contemporary physiotherapy. The COVID-19 pandemic lends further support for prioritising health and lifestyle competencies including smoking cessation; whole food plant-based nutrition; healthy weight; healthy sleep practices; and stress management; in conjunction with reducing sedentariness and increasing physical activity/exercise, to augment immunity as well as function and overall health and wellbeing. To support patients' lifestyle change efforts, physiotherapists may refer patients to other health professionals. The authors conclude that immuno-modulation with lifestyle behaviour change to reduce susceptibility to viruses including SARS-CoV-2, is consistent with contemporary physiotherapy practice. Immuno-modulation needs to be reflected in health competencies taught in physiotherapy professional education curricula and taught at standards comparable to other established interventions. ispartof: Physiotherapy vol:114 pages:63-67 ispartof: location:England status: Published online

Background: Physical activity (PA) has substantial health benefits and is important in combatting chronic diseases, which have been associated with elevated levels of advanced glycation endproducts (AGEs). AGEs play a role in the aging process, and an association between PA and AGEs has been reported. We aimed to investigate the relationship between PA and AGE accumulation in a general population and in a population with chronic diseases.Methods: This large cross-sectional population study used data from adult participants in the LifeLines project, with participant information drawn from the LifeLines database as well data from patients with diabetes mellitus or renal and/or cardiovascular diseases. Tissue AGE accumulation was assessed non-invasively by skin-autofluorescence (SAF) using an AGE reader (DiagnOptics Technologies BV, Groningen, the Netherlands). PA was assessed using the short questionnaire to assess health-enhancing physical activity (SQUASH). Multivariate linear regression analyses were adjusted for age, body mass index, sex, and smoking status.Results: Data from 63,452 participants (general population n = 59,177, chronic disease n = 4275) were analyzed. The general population was significantly younger (43.58 +/- 11.77 years, mean +/- SD) and had significantly lower SAF (1.90 +/- 0.42 arbitrary units (AU)) compared to the population with chronic disease (age: 55.51 +/- 12.07 years; SAF: 2.27 +/- 0.51 AU). In the group with chronic disease, more hours of moderate to vigorous physical activities per week were associated with lower SAF (beta= -0.002, 95% confidence interval (95%CI): -0.002 to -0.001). For the general population, there was no association between hours of moderate to vigorous activity and SAF (beta= 3.2 x 10(-5), 95%CI: 0.000-0.001, p = 0.742). However, there was an association in the general population between total hours of PA per week and SAF (beta= 4.2 x 10(-4), 95%CI: 0.000-0.001, p < 0.001), but this association was not found in the chronic disease population (beta = -3.2 x 10(-4), 95%CI: -0.001 to 0.000, p = 0.347).Conclusion: Our study demonstrates that an inverse relationship exists between PA and AGE accumulation in the population with chronic disease. More hours of moderate to vigorous activity is associated with a significantly decreased SAF. More PA is associated with a lower SAF, even after adjusting for the established predictors (age, body mass index, smoking status, and sex). Our findings could help to promote health and prolong longevity.

Objectives: The Pasifika Prediabetes Youth Empowerment Programme (PPYEP) was a community‐based research project that aimed to investigate empowerment and co‐design modules to build the capacity of Pasifika youth to develop community interventions for preventing prediabetes. Methods: This paper reports findings from a formative evaluation process of the programme using thematic analysis. It emphasises the adoption, perceptions and application of empowerment and co‐design based on the youth and community providers’ experiences. Results: We found that the programme fostered a safe space, increased youth's knowledge about health and healthy lifestyles, developed their leadership and social change capacities, and provided a tool to develop and refine culturally centred prediabetes‐prevention programmes. These themes emerged non‐linearly and synergistically throughout the programme. Conclusions: Our research emphasises that empowerment and co‐design are complementary in building youth capacity in community‐based partnerships in health promotion. Implications for public health: Empowerment and co‐design are effective tools to develop and implement culturally tailored health promotion programmes for Pasifika peoples. Future research is needed to explore the programme within different Pasifika contexts, health issues and Indigenous groups.

Background Handwashing has long been promoted to maintain health and in preventing disease transmission. One of the most valuable ways to convey messages related to handwashing is through visual display, such as video for educational purposes and to enhance learning. Social media is an important and popular way to disseminate messages to a wide audience. Methods In this cross-sectional, descriptive study, two hashtags, #WashYourHands and #SafeguardSplash were used to select the sample of 100 from available TikTok videos. In order to code each video, the same coding categories were used for both hashtags, including (1) wetting and rinsing hands (2) lathering soap (3) time used for scrubbing (4) drying hands (5) mentions COVID-19 (6) mentions using hand sanitizer instead of soap (7) mentions how germs spread (8) mentions key times to wash hands (9) and actual depiction of washing hands. Additional descriptive categories were coded as well. The observations recorded were tabulated and descriptive statistics were performed. Independent one-tailed t-tests (α = .05) were calculated to determine if a video's hashtag had a significant association with its garnered views, likes, and/or comments. Results In total, the 100-video sample received 1,990,834,567 views, 40,355,468 likes, and 173,422 comments. Despite the fact that each hashtag made up an equal proportion (50%) of the total sample, videos with #WashYourHands accounted for 93.3% of the total views. Coverage of the important steps involved in handwashing, such as drying hands, was minimal as was relevant background information. Conclusion The results indicate that while this opportunity is being realized to some degree, the majority of videos did not cover topics related important concepts of hand hygiene. Given the high engagement of younger audiences with TikTok, this could be a powerful mechanism for demonstrating and encouraging proper handwashing, especially in a population with low rates of handwashing.

Post-stroke patients have risk factors for recurrent stroke. The main risk factor is hypertension. The purpose of this community service activity is to improve the ability of the community, especially post-stroke patients, to control hypertension as a risk factor for recurrent stroke through identification of risk factors, health education and the application of light activity and deep breathing exercises. Before education is given, post-stroke patients and their families are given prestest first and after education, posttest returns to evaluate the patient's understanding. The results of the activity, there was a significant difference between the knowledge before and after being given education to post-stroke patients and their families with p value

Introduction Knowing the information regarding the panorama of lymphoma diagnosis in patients treated in the Brazilian Public Unified Health System from the last 10 years is a challenge for Strategic Health Planning. Objective To characterize the Brazilian population with lymphoma treated in the Brazilian Public Unified Health System between 2008 and 2017 regarding staging, sex, residence site and mortality. Material and methods A descriptive, retrospective, and longitudinal trial with secondary data from DataSUS (SIA/SUS and SIM/SUS) obtained from patients with ICD-10 C81−85. Results There were 70,850 lymphoma cases between 2008 and 2017, of which 55% were male, the median age was 51 years, and 27% had Hodgkin Lymphoma. Most patients (56%) were treated outside the residence city. Sao Paulo State accounted for 25% of patients. Treatment initiation took more than 60 days in 27% of cases. A total of 45,601 deaths were due to lymphoma (12% Hodgkin Lymphoma and 88% Non-Hodgkin Lymphoma), with a median age 63 years, and were mainly males (55%). Staging data were inadequate in 23% of patients, and analysis was performed only on the valid records. Advanced disease was diagnosed in 58% of patients (60% male; 57% female) and was more common in Non-Hodgkin Lymphoma (62%) versus Hodgkin Lymphoma (49%). Discussion Late diagnosis interferes with mortality rates. Health promotion and cancer prevention campaigns, especially targeting the male public, and training for early diagnosis and early treatment are needed. Conclusion Effective measures for early diagnosis and treatment are urgently needed for lymphoma control.

Purpose This study aimed at gaining insight into parents' perceptions towards health behaviour in parenting and the impact of the school environment. Healthcare professionals experience barriers to discuss health behaviour in families where levels of overweight and obesity are elevated. There is a need to understand parents' perception and perceived significance of health behaviour. Design and methods Sixty-three semi-structured interviews were conducted with parents of children from three primary schools located in two different neighbourhoods in Zwolle, the Netherlands. Parents were asked to formulate their top three priority goals in parenting, additionally supplemented with 15 predetermined goals, including a health behaviour related goal. Parents ranked the goals in order of importance and gave an explanation. Finally, parents shared their opinions regarding the school environment in promoting health behaviour, according to the EnrG framework. Results In 8 out of 63 interviews, health was reported in the top three self-formulated goals. Other goals considered important were happiness and being respectful to others. When health was ranked as less important in parenting, routine of health behaviour, own beliefs and religion were given as explanations. The physical school environment and teachers were mentioned as important factors in promoting health behaviour. Conclusions Parents indicate health behaviour as a key-element in parenting, even when health behaviour is not considered as the most important priority. Practice Implications: Since school is perceived as a logical and powerful environment, healthcare professionals should collaborate with school staff to empower their own, teachers' and parents' roles to address health promotion.

BACKGROUND: It is unknown whether behavioral interventions to improve diet are effective in people with a genetic predisposition to obesity. OBJECTIVES: To examine associations between BMI genetic risk and changes in weight and workplace purchases by employees participating in a randomized controlled trial of an automated behavioral workplace intervention to promote healthy food choices. METHODS: Participants were hospital employees enrolled in a 12-mo intervention followed by a 12-mo follow-up. Hospital cafeterias utilized a traffic-light labeling system (e.g., green = healthy, red = unhealthy) that was used to calculate a validated Healthy Purchasing Score (HPS; higher = healthier). A weighted genome-wide BMI genetic score was generated by summing BMI-increasing alleles. RESULTS: The study included 397 adults of European ancestry (mean age, 44.9 y; 80.9% female). Participants in the highest genetic quartile (Q4) had a lower HPS and higher purchases of red-labeled items relative to participants in the lowest quartile (Q1) at baseline [Q4–Q1 Beta HPS, –4.66 (95% CI, –8.01 to –1.32); red-labeled items, 4.26% (95% CI, 1.45%–7.07%)] and at the 12-mo [HPS, –3.96 (95% CI, –7.5 to –0.41); red-labeled items, 3.20% (95% CI, 0.31%–6.09%)] and 24-mo [HPS, –3.70 (95% CI, –7.40 to 0.00); red-labeled items, 3.48% (95% CI, 0.54%–6.41%)] follow-up periods. In the intervention group, increases in HPS were similar in Q4 and Q1 at 12 mo (Q4–Q1 Beta, 1.04; 95% CI, –2.42 to 4.50). At the 24-mo follow-up, the change in BMI from baseline was similar between Q4 and Q1 (0.17 kg/m(2); 95% CI, –0.55 to 0.89 kg/m(2)) in the intervention group, but higher in Q4 than Q1 (1.20 kg/m(2); 95% CI, 0.26–2.13 kg/m(2)) in the control group. No interaction was evident between the treatment arm and genetic score for BMI or HPS. CONCLUSIONS: Having a high BMI genetic risk was associated with greater increases in BMI and lower quality purchases over 2 y. The 12-mo behavioral intervention improved employees’ food choices, regardless of the genetic burden, and may have attenuated weight gain conferred by having the genetic risk.

Background Increasing participation in the Australian National Bowel Cancer Screening Program (NBCSP) is the most efficient and cost-effective way of reducing mortality associated with colorectal cancer by detecting and treating early-stage disease. Currently, only 44% of Australians aged 50–74 years complete the NBCSP. This efficacy trial aims to test whether this SMS intervention is an effective method for increasing participation in the NBCSP. Furthermore, a process evaluation will explore the barriers and facilitators to sending the SMS from general practice. Methods We will recruit 20 general practices in the western region of Victoria, Australia to participate in a cluster randomised controlled trial. General practices will be randomly allocated with a 1:1 ratio to either a control or intervention group. Established general practice software will be used to identify patients aged 50 to 60 years old who are due to receive a NBCSP kit in the next month. The SMS intervention includes GP endorsement and links to narrative messages about the benefits of and instructions on how to complete the NBCSP kit. It will be sent from intervention general practices to eligible patients prior to receiving the NBCSP kit. We require 1400 eligible patients to provide 80% power with a two-sided 5% significance level to detect a 10% increase in CRC screening participation in the intervention group compared to the control group. Our primary outcome is the difference in the proportion of eligible patients who completed a faecal occult blood test (FOBT) between the intervention and control group for up to 12 months after the SMS was sent, as recorded in their electronic medical record (EMR). A process evaluation using interview data collected from general practice staff (GP, practice managers, nurses) and patients will explore the feasibility and acceptability of sending and receiving a SMS to prompt completing a NBCSP kit. Discussion This efficacy trial will provide initial trial evidence of the utility of an SMS narrative intervention to increase participation in the NBCSP. The results will inform decisions about the need for and design of a larger, multi-state trial of this SMS intervention to determine its cost-effectiveness and future implementation. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620001020976. Registered on 17 October 2020.

Background/purpose: Oral exercise is a training method for swallowing dysfunction in older adults. The study investigated the effect of oral exercise on tongue pressure in older adults in Taiwanese community day care centers over a 3-month period. Materials and methods: Participants over age 50 who were able to communicate and participating for the duration of the 12-week period were recruited from five community day care centers. A 15-min weekly group oral exercise activity was conducted. The tongue pressures were measured and multivariable linear regression models were used to assess the effect of oral exercise intervention on the participants’ tongue pressures. Results: A total of 66 older adult participants, among whom the mean age was 78.06 ± 10.74 years. Tongue pressure continued improving during the intervention period, and the mean tongue pressure at the end of the study was 20.63 ± 10.45 kPa, which was significantly higher than the baseline measurement (16.92 ± 10.62 kPa, p

Objectives Epidemiological data on cancer diseases are alarming. The workplace has become an increasingly important site for disseminating health information and implementing health promotion activities. Occupational medicine physicians (OMPs) have the opportunity to carry out primary and secondary preventive activities focused on civilization diseases, especially cancer. The aim of this study was to evaluate the potential of OMPs in cancer prevention, including the analysis of factors determining the implementation of preventive measures, as part of standard healthcare for employees. Material and Methods The study was conducted among 362 OMPs. The interviews were carried out by the computer assisted telephone interview (CATI) method. Results Over 60% of the surveyed OMPs are ready to implement cancer preventive activities among employees. The doctors with the longest seniority in occupational health services are more likely to declare unwillingness to implement cancer preventive activities. Patient’s consent, informing women about the program and adjusting the time of the medical visit are the most important conditions for introducing cancer prevention programs by OMPs. Neither seniority nor the number of examinations performed by a physician influenced the currently implemented cancer preventive activities as part of occupational health services (including the evaluation of cancer risk factors occurrence among employees). Conclusions In Poland, OMPs are willing to implement cancer preventive activities among employees, but their current activity in this area is limited and needs development. The most specific actions should be addressed to doctors with the longest seniority in occupational health services, who are frequently unwilling to implement cancer preventive activities. Strengthening the preventive potential of Polish occupational health services requires a systemic approach to the scope and way of action of healthcare professionals. Int J Occup Med Environ Health. 2021;34(6):723–36

In 2019, young Australians reported that two of their top concerns were 'climate change and the environment' and 'mental health'. The events of 2020/2021, such as the ongoing climate emergency, the Australian bushfires, and the COVID-19 pandemic, reflect the human-induced environmental issues young people are most worried about and have also exacerbated the mental health issues which they already reported to be at a crisis point back in 2019. Given experiences of mental illness in adolescence are associated with poorer mental health across the lifespan, it is becoming increasingly important to address ecological determinants of youth mental health in the Anthropocene. However, despite the inclusion of ecological determinants of health in seminal health promotion frameworks, health promotion has been described as 'ecologically blind', emphasising social determinants of health at the expense of ecological determinants of health. A socio-ecological model, which equally considers upstream social and ecological factors, should be applied to youth mental health issues. Using the Ottawa Charter for Health Promotion, we demonstrate how the ecological determinants of health may be incorporated into health promotion approaches targeting youth mental health. We also call for the health promotion sector to consider a number of actions to work towards achieving a transition to ecological determinants of health being at the forefront of health promotion activities. This commentary, written by young public health professionals, hopes to build on the momentum garnered by youth activists around the world and bring attention to the importance of ecological determinants of health for youth mental health promotion in the era of COVID-19 and the Anthropocene.

Objectives To analyze and compare the experience of climacteric symptoms and their associations with sociodemographic and health-related characteristics in two cohorts of Finnish women aged 52–56 years, born ten years apart and not now or previously on menopausal hormone therapy (MHT). Study design Nationwide population-based time-trend study with a large number of participants (n = 1986 + 1988). Main outcome measures The experience of climacteric symptoms was assessed by 12 commonly used menopause-related symptoms. Results Women aged 52–56 experienced more moderate or severe symptoms and fewer mild symptoms in 2010 than in 2000. Being unemployed or inactive was associated with more severe symptoms (P = 0.007), but employment status had no effect on the relative odds estimates. Conclusions The influence of the birth cohort and time-period effects as well as work-related factors on the experience of climacteric symptoms in women not now or previously on MHT needs further research, particularly since the change in the experience of symptoms found in this study occurred within only ten years.

Introduction Untreated dental caries is the most frequent childhood chronic disease worldwide. Silver diamine fluoride (SDF) offers a safe and effective alternative treatment, especially for children. Objective To inform the dental community about the efficacy of SDF in community dental caries programs and to advocate for its use as an affordable and equitable approach to promote health and well-being within the dental setting. Methods A summary of the literature shared during a webinar about the use and efficacy of SDF in community dental programs hosted by the Oral Health Working Group of the World Federation of Public Health Associations Results Based on the traditional “drill-and-fill” approach, the current treatment for severe caries is associated with pain, fear, and poor oral health outcomes in later life. Innovative approaches to prevent and control caries are needed. SDF offers an alternative treatment option for caries. It is a practical, affordable, and acceptable option for caries treatment, eliminating the need for general anaesthetic in young children, and improving long-term oral health outcomes. Conclusion SDF can improve oral health outcomes for community members, especially for individuals from low-socioeconomic settings.

Objective To assess the quality of national cancer screening program leaflets in Japan from the informed-decision perspective. Methods Cross-sectional content analysis of invitation leaflets issued by centralized organizations and used nationwide in Japan was conducted. Three members independently evaluated the materials using International Patient Decision Aids Standards six-item minimum criteria for qualifying patient decision aids. Patient public involvement Co-author KH is a cancer patient himself. We also sought feedbacks from three other cancer survivors and two bereaved family members. Results Inter-rater agreement was substantial (Fleiss’ kappa=0.62). The median score was 2 out of 6 (range: 2–3). All leaflets described the cancer (Q1: 7/7) and screening modality (Q2: 7/7). None stated not undergoing screening as an option. One stated another screening modality (Q3: 1/7). None stated both the positive and negative features of multiple options (Q4: 0/7. Q5: 0/7). One described the psychological and social experience of screening but only its positive side (Q6: 1/7). Conclusions There is room for improvement in the content of the public cancer screening invitation leaflets in Japan from informed-decision perspective. Practice implications Cancer screening leaflets should provide evidence-based, well-balanced, easy-to-understand information to educate people on cancer screening while maintaining people’s autonomy.

Introduction Osteoporosis is considered a healthcare problem due to the increased risk of fractures and high cost of care. In Colombia, the Ministry of Health introduced SISPRO, a tool to collect nationwide information from the health system. The information collected from SISPRO is available for scientific analysis. This article presents an analysis of the prevalence and characteristics of patients with osteoporosis using data from 2012 to 2018. Aim To estimate prevalence of osteoporosis between January 2012 to December 2018 and describe the patients’ demographic characteristics. Methods This is a descriptive epidemiological study using the International Statistical Classification of Diseases and Related Health Problems related to osteoporosis as search terms using the SISPRO database. Results National records report 249,803 patients over 50 years old diagnosed with osteoporosis. The estimated prevalence is 2440 cases per 100,000 inhabitants over 50 years old (based on a total population of 10,236,132), being more frequent in women (92% of cases), with a female/male ratio of 12.3:1. Conclusion This study shows a lower prevalence than previous estimates or projections. Given these findings we think it is necessary to act to promote health policies for patients with osteoporosis.

Purpose The absence of routine health check-ups during adolescence in low- and middle-income countries is a missed opportunity for prevention, early identification, and treatment of health issues, and health promotion. We aimed to codesign the content and delivery for routine adolescent health checkups in Zimbabwe, with adolescents and key adults in their lives. Methods We held participatory workshops with adolescents (16 workshops; 96 adolescents) and parents (8 workshops; 95 parents), and in-depth interviews with key informants including policymakers, programmers, and healthcare workers (n = 25). Analysis was iterative and the design of the checkups was refined based on participant preferences, document review of burden of disease data, and feasibility considerations. Results Participants overwhelmingly supported the introduction of routine health checkups. Reported facilitators to attendance included free cost and desire to know one’s health status. Barriers included tendencies for health service seeking only when ill, fear of diagnosis and judgment, and religious beliefs. Delivery preferences were by nonjudgmental medical professionals, in a youth friendly environment, and accompanied by youth engagement activities. Preferred location was schools for younger adolescents (10–14 years), and community settings for older adolescents (15–19 years). Prioritized content included sexual health, oral health, mental health, hearing, eyesight, growth and nutrition, anemia, immunization, and deworming, based on health burden and participant preferences. Discussion This study resulted in an outline design of two routine health checkups with stakeholders in Zimbabwe, in schools for young adolescents, and in community settings for older adolescents. Evidence of feasibility, effectiveness, and cost-effectiveness of such checkups is required.

Background: The provision of health information via whatsapp media can increase knowledge about pregnancy health. Furthermore, good knowledge can lead to awareness, which would eventually cause a pregnant woman to behave in accordance with their knowledge. Aim: To evaluate the effect of Whats-App reminder messages on pregnant women′ knowledge and behavior regarding antenatal health. Design: Quasi experimental research design was used in this study. Setting: It was conducted at Antenatal Clinics in Women Health Hospital, Assiut University. Sample: purposive sample of 100 pregnant women. Tools: Three tools were used in this study (1) structured interviewing questionnaire, (2) knowledge assessment tool, (3) healthy behaviors assessment tool. Results: There is highly statistical significance difference between pre &posttest regarding total knowledge about antenatal health and the healthy behaviors of studied women with p-value 0.001. Conclusion: There was an improvement in the knowledge regarding antenatal health and adherence to healthy behaviors of pregnant women after health promotion by whatsapp reminder messages. Recommendations: Health facilities should start utilizing whatsApp reminder as a policy to promote adherence of pregnant women with the healthy behaviors.

Handwashing is key to preventing the transmission of various infectious diseases of which school-aged children are particularly susceptible. Traditional, information-messaging campaigns may increase handwashing awareness but have had limited success in promoting behavior change. Behavioral economics “nudges,” which explicitly target the knowledge-behavior gap, is a promising alternative. We evaluate the impact of school-based nudges in the first fully powered cluster randomized controlled trial in the Philippines. Out of our sample of 132 eligible schools, we randomly assigned half to receive nudges, including contextual cues (painted footpath from toilet to handwashing station) and visible reminders (posters and eye sticker), and half to the control group. Four months after implementation, we measured handwashing with soap (HWWS) after toilet use among grades 1–6 students using direct observation and compared this outcome between treatment and control schools. We also assessed whether nudges increased soap availability. The intervention increased HWWS rates by 17.3% points (pp), [95% CI: 4.2, 30.4] in treatment schools from the control group mean of 11.7%. The effect size was comparable across gender and age groups. Access to functioning handwashing facilities with soap increased by 36% (+20.2 pp, 95% CI: 10.9, 29.4). Mediation analysis suggests the program simultaneously nudged students to wash hands with soap in classrooms that already had soap, and nudged teachers to provide soap where it was not already available. These findings demonstrate that behavioral nudges costing less than $70 per school can lead to significant increases in HWWS among students 4 months post-intervention.

Summary Objectives The aim of this study was to compare the effects of aerobic + interval exercise (AI) and aerobic exercise (AE) on the cardiovascular functional state in a female cohort. Equipment and methods Seventeen healthy adult females from the same health sport club participated in this study. An orthostatic manoeuvre was used to determine the state of the cardiovascular system before and 40 min after completion. During the procedure, a 12-lead electrocardiogram (ECG) was recorded for later analysis of heart rate (HR), ST-segment depression and arterial blood pressure (ABP). Results Comparing HR, ABP and ST-segment depression results before and after AE and AI, we found no significant differences for HR and ABP averaged data (P > 0.05) but ST-segment depression was significant higher in nine out of 37 ECG after the AI session (P Conclusion Serious ischaemic episodes in the myocardium during the orthostatic manoeuvre highlight the atypical physiological response of some participants to the high-intensity sprint-type workloads of the AI session. The orthostatic manoeuvre also revealed individual limitations for the high-intensity sprint-type tasks in the AI session.

This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article discusses the International Council of Nurses Global Nursing Leadership Institute and its integration of the SDGs into a global leadership and policy development program.

Weight bias and stigma exist in a variety of realms in our society (media, education, employment, and health care), and unfortunately many view it as a socially acceptable form of discrimination. Patients with obesity often avoid scheduling appointments for health promotion visits and routine care due to perceived weight bias and stigma from their health care provider. Within the health care setting, it is important that health care providers strategically focus on reducing obesity bias and provide high-quality obesity management. People-first language should be used and waiting rooms and examination rooms should be accommodating to people of all sizes.

Objective: To systematically review research into the use of humour‐based health promotion strategies for addressing public health issues during the past 10 years. Method: The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Results: Thirteen studies were included in the review. Mental health, breast and testicular cancer self‐examination, safe sex, skin cancer and binge drinking public health issues were targeted. Humour‐based strategies were used to influence health attitudes and behaviours, encourage interpersonal sharing to indirectly affect health behaviour, and investigate the level of threat and humour associated with positive outcomes. Findings provided some evidence to support the use of humour‐based strategies as determined by the right combination of audience characteristics, level of humour and amusement evoked, and message persuasion and behaviour change methods underpinning strategies. Conclusion: Methodologies varied limiting comparability, although overall results indicate that humour‐based health promotion strategies may be a useful tool for increasing awareness and help‐seeking behaviour for public health priorities, particularly those associated with stigma. Implications for public health: Humour interventions vary widely because there can never be a standardised approach to evoking humour. Further research examining humour and public health promotion is needed.

Malaria is a preventable, mosquito-borne parasitic infection that remains one of the leading causes of imported fever, hospitalization and death in travellers returning from Sub-Saharan Africa. Early symptoms of malaria infection can mimic other common conditions presenting to healthcare settings. A high index of suspicion and early diagnosis and management, alongside patient education and prevention methods, can greatly reduce morbidity and mortality from malaria worldwide. In this article we aim to cover the different types of malaria, individuals at particular risk of malaria acquisition, malaria prevention, treatment and key advances. We will focus on falciparum malaria as this causes the greatest morbidity and mortality.

Research and development of the COVID-19 vaccine give hope to all people to stop the COVID-19 pandemic in the world. This literature review explores the safety and efficacy of the COVID-19 vaccine used in Indonesia and discusses Indonesia's current vaccination process. The primary databases for the reviewed articles were PubMed and Mendeley. Others are official websites, such as World Health Organization (WHO); COVID-19 and National Economic Recovery Committee in Indonesia (KPCPEN); the National Agency of Drug and Food Control (NA-DFC–in Bahasa Indonesia: BPOM) of the Republic of Indonesia; the US Food and Drug Administration (FDA), Clinical Trials.gov, COVID-19 vaccine Tracker, the Indonesian regulations, and guidelines regarding COVID-19. The inclusion criteria of the searched articles were those published from December 2019 to April 30, 2021, and those which discussed vaccines' types, efficacy, and safety. Acceptance of the COVID-19 vaccination is quite high (65%). Refusal was related to vaccine safety (30%); effectiveness (22%); distrust of vaccines (13%); fear of side effects (12%); and religious reasons (8%). The COVID-19 vaccines planned by the Indonesia Government have gone through clinical trials phases I to III. The Coronavac vaccine efficacy showed seroconversion that occurred was 92.4% to 97.4%, and no severe side effects have been reported. The ChAdOx1 nCoV-19 efficacy was 66.7% to 76.0%, and none of the tested participants was hospitalized, serious side effects were very small (0.9% to 1.1%). The mRNA-1273 efficacy was 94.1%, and its reactogenicity was mild to moderate. The BNT162b2 efficacy was ≥ 92%, and no severe or specific safety concerns have occurred. The efficacy of the BBIBPCorV vaccine has not been established. Ongoing phase I, II, and III clinical trials will provide more information on safety and immunogenicity for the BBIBP-CorV. Three of the six vaccines have obtained EUA from BPOM and approval from the Indonesian Ulema Council (MUI). A health promotion program about the safety, efficacy, and the 'halal' of the COVID-19 vaccine; acceleration and ensuring access to the COVID-19 vaccination program are urgent to end this pandemic immediately.

The determinants of health are influenced by genetics, lifestyle, social environment, medical conditions, etc. As an informal system, social capital plays an increasingly recognized role in individual health. The purpose of this paper is to discuss the direct and indirect effects of social capital on individual health in China. Using cross-sectional data from the China Family Panel Studies 2016, this paper explores the effects of cognitive and structural social capital on individual health from a micro perspective. The results show that both types of social capital have significant positive effects on individual health, and this effect remains after endogeneity is considered. The two types of social capital show obvious heterogeneity in age samples, urban and rural samples and north–south samples. In addition, the mechanism analysis shows that the health promotion effects of the two types of social capital are mainly derived from the effects of informal finance and access to medical resources. Based on the above findings, this paper puts forward policy recommendations.

Young prisoners’ health needs represent a matter of constant importance for any prison administration. These are addressed through direct medical services, as well as through other activities of health promotion. If the medical services are provided by trained medical staff, health promotion is usually provided by non-medical staff, such as social workers, psychologists, educators etc. Also, because healthy behaviors are best promoted through social modeling, such activities require the involvement of all prison staff, including non-specialists such as guardians. Thus, for health promotion to be effective it needs to be approached by the whole prison staff, meaning that the medical and non-medical specialists, as well as other prison staff need to have a common understanding of young prisoners health needs and to work as a team. This can be done through prison staff training. The article addresses these issues by summarizing the Indonesia country reports of the project “Health Promotion for Young Prisoners” funded in the framework of the Public Health Program.

Background Obstetric fistula is one of themost serious and devastating childbirth-related injuries women suffer worldwide. This study investigated the association between delivery characteristics and the occurrence of obstetric fistula in Afghanistan. Methods The study analysed data from the 2015 Afghanistan Demographic and Health Survey. The association between place of delivery and assistance during delivery with experience of fistula symptoms was investigated by fitting two binary logistic regression models. Results Findings from this study revealed that 23.4% of the women surveyed ever heard about obstetric fistula and 3% reported symptoms of fistula. Women whose deliveries were assisted by traditional birth attendants were significantly more likely to experience fistula compared with those whose deliveries were assisted by doctors. Similarly, women whose deliveries were assisted by others were significantly more likely to experience fistula compared with women whose deliveries were assisted by doctors. Regarding place of delivery, women whose deliveries took place at a government hospital were less likely to experience fistula compared with those whose deliveries took place at home. Conclusions This study highlights the importance of skilled delivery in reducing the risk for obstetric fistula among women in Afghanistan. Therefore, it is important for the various stakeholders in Afghanistan's healthcare delivery system, including healthcare providers, local authorities and international non-governmental organisations, to collaborate and institute measures that will promote health facility deliveries and improve access to skilled delivery.

ISSUE ADDRESSED Prevention approaches specific to prenatal alcohol exposure (PAE) and foetal alcohol spectrum disorder (FASD) have been identified as urgently needed in Australia, including in Aboriginal and Torres Strait Islander communities. However, very little work has aimed to describe and evaluate health promotion initiatives, especially those developed in rural and remote areas. METHODS A series of television commercial scripts (scripts) were developed with health promotion staff at an aboriginal and Torres Strait Islander Community Controlled Health Service and piloted with 35 community members across six yarning sessions. RESULTS Scripts evoked responses in line with two predominant themes: "Strength" and "Community resonance." This process led to the development of a four-part television and radio campaign focusing on a life course approach to prevent prenatal alcohol exposure (PAE) - "Vision," "Future," "Cycle" and "Effect." CONCLUSIONS Intergenerational influences on PAE were key elements of scripts positively received by community members. Strengths of this work included a flexible approach to development, local aboriginal men and women coordinating the yarning sessions, and the use of local actors and familiar settings. SO WHAT?: Preventing PAE is extraordinarily complex. Initiatives that are culturally responsive and focus on collective responsibility and community action may be crucial to shifting prominent alcohol norms. Future work is necessary to determine the impact of this campaign.

BACKGROUND Health promotion is necessary to mitigate the negative consequences of colorectal cancer and its treatment. Rates of behavior modification are low in populations of cancer patients. Studies are needed to determine the factors, such as decisional conflict, which influence adoption of healthy behaviors following a cancer diagnosis. OBJECTIVE To examine the effects of information provision, decision self-efficacy, and decisional conflict on the adoption of healthy behaviors among patients with colorectal cancer. METHODS This cross-sectional study focused on 251 patients with colorectal cancer in South Korea. Information provision, decision self-efficacy, and decisional conflict were measured using validated instruments. Patients rated their decisional conflict related to the adoption of behaviors that include regular exercise and a balanced diet. RESULTS Most participants (73%) reported low satisfaction with the amount of information received. Of the participants, 64% had low decision self-efficacy, and 80% experienced decisional conflict. The perception of a higher level of information provision was associated with greater decision self-efficacy (odds ratio, 4.63; 95% confidence interval, 1.61-13.35). Higher decision self-efficacy was associated with lower decisional conflict (odds ratio, 5.19; 95% confidence interval, 2.33-11.59). CONCLUSION Receiving adequate information is important for promoting patients' confidence in making decisions about their health and reducing decisional conflict in the adoption of healthy lifestyle changes following a cancer diagnosis. IMPLICATION FOR PRACTICE Oncology nurses should assess patient information needs and promote decision self-efficacy, thus empowering patients diagnosed with colorectal cancer to make lifestyle decisions that improve their health and quality of life.

The COVID-19 pandemic has affected all countries irrespective of their state of development. In countries with traditional societies, religious leaders have been acknowledged as key stakeholders in community engagement activities, including disease prevention. A community-level prevention model was established in 2020 by the Health Promotion Bureau (HPB), Sri Lanka, which incorporated mobilisation of the clergy to support the prevention and response schemes to COVID-19 with non-governmental stakeholders. This model was part of a more extensive community engagement network established by the HPB in cooperation with the country offices for WHO and UNICEF. Building trust, empowering behavioural traits applicable to minimise risks from COVID-19, leadership and coordination, message dissemination, addressing stigma and discrimination, supporting testing procedures, contact tracing activities and vaccination, building community resilience, spiritual and psychosocial support, and welfare provision are some of the useful factors that were identified in the model. Furthermore, a much broader and holistic approach is needed to focus on health behaviours and social and cultural aspects in a multi-faceted nature. This paper highlights a novel COVID-19 prevention model with active involvement of religious leaders that can be implemented in low resource settings. Our experience from Sri Lanka demonstrates the feasibility of implementing this model to mitigate the disastrous situation following the COVID-19 outbreak.

Background: Pharmacists are increasingly called to integrate population health approaches into their role. Public health knowledge and skills are recommended to be incorporated into the pharmacy curricula and professional development to enable competence of pharmacists in this area. Aim: To describe the competencies required by pharmacists to contribute to the public health of populations. Methods: A scoping review of peer-reviewed and grey literature discussing competencies in both pharmacy and public health was conducted. Competencies were extracted into a matrix of pharmacy and public health competencies and inductive coding of themes was undertaken. Results: Analysis of 58 papers showed important themes of professionalism, communication and collaboration with communities and other health professionals. Pharmacist services providing health promotion, screening and disease prevention should be directed at community needs. Evolution of pharmacy competencies in global health, health informatics and disaster management are current topics. Conclusion: A public health perspective in all pharmacy competency domains may assist pharmacists to understand their responsibility in improving the health and wellbeing of communities and ensure the profession has a positive impact on local, national and global health indicators.

Purpose Incarcerated women are a vulnerable population in terms of sexual and reproductive health. In French Guiana, most incarcerated women come from unsafe environments and are incarcerated because of drug trafficking. Medical follow-up processes used in prison (medical assessment on arrival, and then two half-days per week upon request but without an obstetrician-gynecologist) does not allow for a thorough assessment of the impact of incarceration on women prisoners’ health to take place. In the absence of data, the purpose of this study was to describe incarcerated women’s experiences in relation to sexual and reproductive health. Design/methodology/approach Semi-structured interviews were conducted among French-speaking adult women who had been incarcerated for at least four months in a French Guianan prison. Menstruation, contraception, pregnancy, abortion, sexually transmitted infections and sexuality were described by means of interpretative phenomenological analysis. Findings A total of 14 women were interviewed. They suffered from menstrual cycle disorders, poor hygiene and menstrual insecurity. They appeared to have emotionally disinvested sexuality. However, intra-prison sexual activity existed for some (masturbation, conjugal prison visits, homosexual intercourse between fellow prisoners). Homosexual relations were a source of discrimination. Being pregnant while incarcerated was viewed negatively. A lack of knowledge about sexual and reproductive health and high-risk behaviors such as piercing and tattooing practices were widespread. Originality/value Incarceration is a vulnerable time for women’s sexual and reproductive health. Sexual activity exposes women to risks and discrimination that should be taken into account in a multidisciplinary approach adapted to the prison environment.

Men are more vulnerable to COVID-19 infections compared to women, but their risk perceptions around COVID-19 are persistently lower. Further, men often engage in less health promotion behavior because self-care in this capacity is seen as weak or less masculine. This combination has consequences for mortality; thus, a better understanding of men's COVID-19 cognitions and individual difference factors is critical. In a web-based survey conducted during the beginning stages of the pandemic in the U.S., we collected risk perceptions of various sexual and non-sexual behaviors from heterosexual (n = 137) and gay/bisexual men (n = 108). There were no significant sexual orientation differences for perceptions of COVID-19 risk from routine activities or in overall risk estimates. However, gay/bisexual men did report engaging in more precautionary behavior while socializing (i.e., masking, social distancing) and reported higher risk perceptions than did heterosexual men for nearly all intimate and sexual activities. A more nuanced understanding of cognitions around COVID-19 is needed to better understand motivation for-and especially motivation against-pursuing vaccinations and continuing precautionary behavior.

Objective:To evaluate the effectiveness of a nutritional intervention to promote fruit and vegetable (FV) intake.Design:A randomised controlled community trial was conducted to evaluate the effectiveness of a 7-month nutritional intervention and to promote FV intake, separately and together. All participants attended physical exercise sessions. The intervention was based on the transtheoretical model and Paulo Freire’s pedagogy. The interventions included group educational sessions, motivational cards and informational materials. The primary outcome was a change in FV intake (g/d), and secondary outcomes included stages of change, self-efficacy, decisional balance and knowledge on FV. All data were collected face-to-face; and FV intake was assessed using a validated brief questionnaire.Setting:Health promotion services of Brazilian Primary Health Care.Participants:3414 users of Brazilian Primary Health Care (1931 in the control group and 1483 in the intervention group (IG)).Results:At baseline, the average daily FV intake was 370·4 g/d (95 % CI 364·2, 376·6). The increase in FV intake (23·4 g/d; 95 % CI 6·7, 40·0) and fruit intake (+17·3 g/d; 95 % CI 5·1, 29·4; P = 0·01) was greater in the IG among participants in the lowest baseline intake. Participants in the IG also showed progression in the stages of change (P < 0·001), increased self-efficacy (P < 0·001) and improved knowledge of FV crops (P < 0·001).Conclusions:The nutritional intervention was effective in increasing FV intake and fruits intake among individuals with a lower intake at baseline and in maintaining FV intake among those who reported consuming FV as recommended (400 g/d).

Abses hepar adalah salah satu bentuk infeksi yang paling sering terjadi pada hepar. Salah satu bentuk abses hepar yang paling sering terjadi adalah abses hepar piogenik, yang umumnya ditemukan pada lobus kanan hepar. Kami melaporkan kasus abses hepar yang terjadi pada lobus kiri hepar, dengan keluhan yang tidak spesifik. Pasien datang hanya dengan keluhan perut yang membengkak, tanpa disertai keluhan lain. Pemeriksaan radiologis berupa CT-Scan mengkonfirmasi diagnosis abses hepar lobus sinistra. Pasien ditangani dengan tindakan drainase abses per laparoskopi. Tidak ada komplikasi yang ditemukan selama dan pasca operasi. Kasus ini menunjukkan bahwa diperlukan kecurigaan yang tinggi untuk abses hepar pada pasien dengan keluhan abdomen yang tidak spesifik. Drainase abses per laparoskopi yang dikombinasikan dengan terapi antibiotik merupakan pendekatan terapi yang aman dan efektif untuk kasus seperti ini.

Health facilities with referral status for COVID-19 cases, reported a decrease in non-COVID inpatients, compared to facilities with non-referral status. The decrease in bed utilization (BOR) was very significant in several health facilities including Langsa Hospital 10-15% before 65-75%,. This study aims to study the Determinants of Factors Affecting the Decrease in Bed Utilization (BOR) at Langsa Hospital during the COVID-19 Pandemic Period in 2021. The research approach uses descriptive qualitative data collection techniques through in-depth interviews and informants are determined by purposive sampling of key informants, namely 4 inpatients and 2 supporting informants. The total number of informants is 6 people. The research instrument is the researcher himself and data collection through interviews, documentation and field observations. Data analysis technique with taxonomy. The results of the study, namely the availability of services due to reduced facilities, hospital policies in implementing health care programs, priority to hospitals from patients in independent practice health care services and community stigma regarding the confirmation of COVID-19 status in each patient, were the driving factors for the decrease in BOR at Langsa Hospital in the 2021 COVID-19 pandemic. It is recommended that the Langsa Hospital management coordinate with IPSRS for the availability of facilities, the health promotion section conducts more effective promotion and socialization methods and nursing provides training on effective communication.