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To examine the association of colonization by Staphylococcus aureus and general population mortality, we followed 10,598 adults for 8.5 years on average. Methicillin-susceptible S. aureus colonization was not associated with death. Methicillin-resistant S. aureus carriage predicted death in a crude analysis but not after adjustment for socioeconomic status and co-morbidities.

Objectives: Asthma is the most common chronic pediatric condition (14%) and the leading cause of school absenteeism in the USA. However, little is known about asthma prevalence and distribution in schoolchildren in the Florida Keys region (Monroe County). Thus, the objectives of this study were to assess asthma prevalence, symptoms, cost and distribution in schoolchildren in the Florida Keys region and to pinpoint where asthma management services are most needed., Methods: Cross-sectional survey data on asthma prevalence, symptoms and socio-demographics was collected and analyzed by race, sex, grade and zip code. A total of 2313 parents of schoolchildren in the Florida Keys completed the adapted Harlem Empowerment Zone Asthma Initiative Questionnaire. The questionnaire was distributed to school principals, who sent them home with students to be filled out by parents or caregivers. We also analyzed data from the online Monroe County 2012 Florida Youth Tobacco Survey, the 2011 Florida CHARTS, the Medical Expenditures Panel Survey, and emergency departments (ED). Data were analyzed by race, sex, and grade., Results: In total 14.5% of respondents had been told their child had asthma and 9.6% reported their child had wheezing in the last 12 months. The prevalence was higher in the Lower Keys and Key West regions. Parents from households where anyone smoked cigarettes (OR 1.52, 95% CI 1.11-2.09) and those who had a male child (1.53, 1.17-2.00) more often reported that their child had asthma. The rate of asthma-related ED visits for Black non-Hispanic schoolchildren (1202 per 100,000) was substantially higher than the numbers for White (250.2 per 100,000) and Hispanic schoolchildren (325.1 per 100,000). Most of the direct cost of asthma was concentrated in children in grades four through seven ($1236.02-$2147.02 per child)., Conclusions: The asthma prevalence in a sample of schoolchildren in the Florida Keys region was comparable to the nationwide prevalence. Black non-Hispanic schoolchildren had more asthma-related ED visits that White and Hispanic schoolchildren. Most of the direct cost of asthma is concentrated in children in late elementary through early middle school grades. Interventions are needed, particularly targeting Black schoolchildren in late elementary through early middle school grades in Lower Keys and Key West region.

Aims: To examine the association between type II diabetes, prediabetes and undiagnosed diabetes with falls, physical limitations, confusion and memory problems, and to evaluate the effects of vitamins A, D and E levels on the associations., Methods: Data from 37,973 participants of the National Health and Nutrition Examination Survey was analyzed., Results: The participants' mean age was 46±17years, 20% had diabetes of which 17% were unaware of their condition (undiagnosed diabetes), and 21% had prediabetes. Diabetes was significantly associated with falls, difficulties in stooping, crouching, kneeling, completing house chores, getting in and out bed, standing and sitting for long periods, reaching over head, grasping, holding objects, and attending social events. The association between diabetes and confusion or memory problems was stronger for those diagnosed before age 40. Memory problems were reported only by people with diabetes with lower vitamin D levels. Vitamin A and E levels did not modify the association between diabetes and falls or any of the physical functions, confusion or memory problems. Prediabetes was only associated with difficulty standing for long periods., Conclusions: Diabetes was associated with falls, difficulties in physical functioning and attending social events. Vitamin D levels modified the effects on confusion and memory problems., (Copyright © 2015. Published by Elsevier Inc.)

Serotonin reuptake variation is linked to a functional polymorphism in the promoter region of the SLC6A4 gene on chromosome 17. It is plausible that variations in genetically determined SLC6A4 activity may modify the risk for alcohol dependence. To determine whether this allele is associated with alcohol dependence, the authors conducted a systematic review and meta-analysis. Twenty-five studies including 8885 participants were reviewed and analyzed. The meta-analysis was carried out using a random-effects model. Overall, the results did not support an association between alcohol dependence and the SLC6A4 promoter polymorphism for the dominant, recessive, and additive genetic risk models, respectively [odds ratio (OR)=0.99 (95% confidence interval (CI): 0.83, 1.18), OR=0.86 (95% CI: 0.71, 1.03), and OR=0.88 (95% CI: 0.69, 1.13)]. When effect modification was tested for sex, race/ethnicity, presence/absence of a psychiatric disorder, year of publication, and diagnostic criteria, none of the factors were found to be significantly associated with alcohol dependence. The findings in this meta-analysis suggest that the SLC6A4 promoter polymorphism is not associated with alcohol dependence.

The neurotropic parasite Toxoplasma gondii infects one third of the world population, but its effect on memory remains ambiguous. To examine a potential relationship of the infection with immediate and delayed memory, a population-based study was conducted in 4485 participants of the Third National Health and Nutrition Examination Survey aged 60years and older. Serum anti-Toxoplasma IgG antibodies were measured by enzyme immune assay and verbal memory was assessed using the Mini-Mental State Examination and the East Boston Memory Test. The prevalence of latent toxoplasmosis was 41%; in one way analysis of variance, anti-Toxoplasma IgG antibody levels significantly differed across tertiles for immediate (P=0.006) but not delayed memory scores (P=0.22). In multinomial logistic regression adjusting for covariates, Toxoplasma seropositivity was associated with lower immediate memory performance (OR: 0.65, 95% CI: 0.44, 0.97 for medium tertile and OR: 0.61, 95% CI: 0.37, 0.98 for highest tertile in reference to the lowest tertile), especially in non-Hispanic Whites (OR: 0.56, 95% CI: 0.36, 0.88 for medium tertile and OR: 0.51, 95% CI: 0.30, 0.87 for highest tertile in reference to the lowest tertile). However, no relationship with delayed memory was observed. In conclusion, latent toxoplasmosis is widespread in older adults and may primarily affect immediate rather than delayed memory, particularly in White Americans., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Research to date suggests that frailty is higher in women and is associated with functional difficulty. This study builds on the evidence by examining the association between frailty and functional difficulty between low- and higher-income groups and between older men and women in these income groups. Methods: This study adopted a cross-sectional design that complied with the STROBE checklist and included steps against confounding and common methods bias. The population was community-dwelling older adults aged 50 years or older in two urban neighbourhoods in Accra, Ghana. Participants were either in the low-income group in a low socioeconomic neighbourhood (n = 704) or the higher-income group in a high socioeconomic neighbourhood (n = 510). The minimum sample necessary was calculated, and the hierarchical linear regression analysis was utilised to analyse the data. Results: Frailty was positively associated with functional difficulty in the low- and higher-income samples, but this association was stronger in the higher-income sample. Frailty was positively associated with frailty in men and women within the low- and higher-income samples. Conclusion: The association of frailty with functional difficulty was consistent between low- and higher-income samples, although the strength of the relationship differed between these samples. In both income samples, the foregoing relationship was consistent between men and women, although the strength of the relationship differed between men and women. [ABSTRACT FROM AUTHOR]

Background: Globally, diarrhea continues to be the leading cause of morbidity and mortality for children under five, with an annual rate of 149 million cases of illness and 760,000 deaths. This study aimed to assess prevalence and contributing factors of diarrhea among children under-five years in Awi Zone, Northwest Ethiopia. Methods: A community based cross-sectional study was conducted on 1387 participants from February to June 2023. A multistage sampling method was conducted. Structured and pretested questionnaires were used to collect the data. Data were entered in to Epi data and exported to STATA for analysis. A multivariable logistic regression was performed to determine factors associated with diarrhea with p-value < 0.05. Results: The prevalence of diarrheal disease among children under five was 17.16%. Child’s age 12 to 23 months [AOR = 16.642; 95% CI: (3.119, 88.805)], protected drinking water [AOR: 0.629; 95% CI: (0.840, 0.928)], health insurance [AOR = 0.571;95% CI: (0.386, 0.844)], institutional delivery [AOR = 0.426, 95% CI: (0.256, 0.707)], water shortage [AOR = 1.570, 95% CI: (1.083, 2.277)], and vaccinated for measles [AOR = 0.124, 95% CI: (0.065, 0.236)] were associated with diarrhea. Conclusion: Age of children, source of drinking water, health insurance, place of delivery, family size, water shortage, liquid waste disposal, and measles vaccination were significantly associated with diarrhea among under five children. Interventions targeting improvements in drinking water sources, health insurance coverage, sanitation practices, and vaccination rates are crucial for mitigating the impact of diarrheal disease among children under five years in Awi Zone. [ABSTRACT FROM AUTHOR]

Introduction: Key populations (KPs) including female sex workers (FSWs) and men who have sex with men (MSM) in sub‐Saharan Africa are disproportionately impacted by HIV. Despite the increasing availability of pre‐exposure prophylaxis (PrEP), data on retention remain limited. This study assessed PrEP retention at 1 and 12 months among Rwandan FSWs and MSM. Methods: We analysed routine clinical data on adult FSWs and MSM receiving PrEP care from 11 health facilities in Kigali, Rwanda between 2019 and 2022. Retention was defined as attendance at regularly scheduled appointments for a PrEP refill. We used logistic regression to assess associations between demographic and clinical characteristics and retention at 1 and 12 months. Results: Among 2043 PrEP initiators, 1343 (66%) were FSWs and 700 (34%) were MSM. FSWs reported a median number of eight sexual partners in the prior 7 days, 70% reported condomless sex and 94% considered themselves at high HIV risk. About 1239 (92%) and 1032 (77%) were retained at 1 and 12 months, respectively. One‐month retention was lower among FSWs living with others (OR 0.59, 95% CI: 0.35−0.99; ref: living alone) or with low HIV risk perception (OR 0.12, 95% CI: 0.04−0.29). At 12 months, low HIV risk perception remained statistically significant (aOR 0.20, 95% CI: 0.12−0.32). At PrEP initiation, MSM reported a median of four sexual partners in the prior 12 months, 88% reported condomless sex and 72% considered themselves at high HIV risk. Retention rates were 96% at 1 month and 82% at 12 months. At 1 month, retention was higher among MSM with some education (OR 12.74, 95% CI: 2.74−70.93; ref: no education). At 12 months, retention was lower among MSM with part‐time employment (aOR 0.29, 95% CI: 0.11, 0.76), students (aOR 0.12, 95% CI: 0.04, 0.37) and unemployed (aOR 0.12, 95% CI: 0.05, 0.28); ref: full‐employed) and those unaware of PrEP at baseline (aOR 0.15, 95% CI: 0.10, 0.23). Conclusions: We observed very high rates of PrEP retention among Rwandan FSWs and MSM. Predictors of retention included living situation, employment status, HIV risk perception and low PrEP awareness, but differed between FSWs and MSM. These findings suggest that targeted awareness campaigns tailored to different KPs could improve PrEP retention in care. [ABSTRACT FROM AUTHOR]

The prevalence of disinfection by-products in drinking water supplies is a global concern due to their carcinogenicity. However, the monitoring of DBPs such as trihalomethanes (THMs) and haloacetic acids (HAAs) in drinking water supplies is non-existent in many developing Asian, South American, and African countries. The formation of THMs during disinfection arises from a reaction between the disinfectant and natural organic matter in the water, particularly, dissolved organic carbon (DOC). This reaction is hastened by increases in temperature, high levels of disinfectant doses or residual, elevated water pH, long disinfection contact times, and high DOC concentrations. However, the inclusion of a granular activated carbon adsorption process in the water treatment process is the most effective method for the removal of the main precursor (DOC) for the formation of THMs in treated water. The Barekese WTP, which disinfects with chlorine, has no adsorption process for DOC removal, and supplies over 80% of pipe-borne water to the city of Kumasi in Ghana, was assessed for the THM formation potential (THMFP). A THM predictive model was used to determine the potential THM concentration in the final water. The THMFP at the Barekese WTP ranged between 22.42 and 38.94 µg/L, which was below the 100 µg/L threshold set by the WHO. The lifetime average daily doses were 3.9494 × 10−4 µg/Kg/d and 3.9294 × 10−4 µg/Kg/d for male and female consumers, respectively. The lifetime integrative cancer risks associated with consumption of the water were 1.817 × 10−5 and 1.808 × 10−5 for males and females, respectively. The cancer risk posed was acceptably low. However, direct measurement of DBPs is required to corroborate these findings and verify the cancer risk posed to the consumers of treated water from the Barekese WTP to inform policies, regulations, public health interventions, and investment. [ABSTRACT FROM AUTHOR]

Background: Low-level viremia (LLV) (HIV-RNA 51–999 copies/mL) is associated with increased risk of non viral load suppression (HIV-RNA ≥ 1000 copies/mL). We assessed the association between differentiated service delivery model (DSDM) and LLV among people living with HIV (PLHIV) in Rwanda. Methods: We conducted a retrospective cohort analysis using routinely collected data of adults living with HIV from 28-healthcare facilities in Rwanda before and after the introduction of DSDM. Under DSDM, PLHIV initiated treatment within seven days of HIV diagnosis and medication pick-up up to six months for those with sustained viral load suppression suppression. Proportions of LLV at 6,12 and 18 months were quantified. Multivariable log binomial regression models were used to assess the effect of DSDM on LLV. To handle missing data, multiple imputations was performed. Results: Of 976 people living with HIV, 645(66.0%) were female and 463(47.4%) initiated treatment during DSDM. The median age was 37 (interquartile range: 32–43) years. LLV was 7.4%, 6.6% and 5.4%, at 6,12 and 18 months, respectively. Compared to those who initiated treatment before DSDM, starting treatment during DSDM increased six-month LLV [adjusted risk ratio (aRR) = 2.8: 95%CI (1.15–6.91)] but not at 12 [aRR = 2.3: 95%CI (0.93–5.75)] and 18 months [aRR = 0.3: 95%CI (0.09–1.20)]. Using imputed datasets, the association between DSDM and LLV persisted. Conclusions: DSDM was associated with increased risk of LLV at 6-months. possibly due to the minimal amount of time PLHIV had in pondering and accepting the HIV diagnosis. Continued support is needed among people receiving early antiretroviral therapy initiation to prevent development of LLV. [ABSTRACT FROM AUTHOR]

In the post-Cold War world order, the African Continent has been a stage for some of the most violent intra-state conflicts arising from natural resources and land distribution. These contestations have often been inter-communal and take the violent extremism route. The consequences of these devastating contestations have been apocalyptic in most of these conflicts. In Kenya's Mount Elgon Region, the emergence of extremism Sabaot Land Defence Forces and counter-extremist groups is rooted in a long historical struggle for equitable distribution of land rights. Despite efforts by state and non-state actors, sustainable peace remains a distant mirage. Socio-economic determinants have emerged as fundamental determinants in these extremist contestations, yet, extant literature has been silent on this subject matter. This paper sought to interrogate socio-demographic determinants as pathways for homegrown extremism in the Mount Elgon Region. Study findings revealed strong support for the interplay between ownership of land, source of income, level of education, and sustenance of homegrown extremism over land-use conflicts in the study area. The paper recommends the need for the Ministry of Lands to expedite the management of the historical land question to contain the socio-demographic determinants as pathways for homegrown extremism in the study area. The findings underscore the importance of land tenure security in pursuit of peaceful, just, and inclusive societies as advocated for in the Sustainable Development Agenda 2030. [ABSTRACT FROM AUTHOR]

Purpose: In the process of making agricultural production decisions in rural households, severe weather conditions, either extreme cold or heat, may squeeze the labor input in the agricultural sector, leading to a reallocation of labor between the agricultural and non-agricultural sectors. By applying a dataset with a wide latitude range, this study empirically confirms the influence of extreme temperatures on the agricultural labor reallocation, reveal the mechanism of farmers' adaptive behavioral decision and therefore enriches the research on the impact of climate change on rural labor markets and livelihood strategies. Design/methodology/approach: This study utilizes data from Chinese meteorological stations and two waves of China Household Income Project to examine the impact and behavioral mechanism of extreme temperatures on rural labor reallocation. Findings: (1) Extremely high and low temperatures had led to a reallocation of labor force from agricultural activities to non-farm employment, with a more pronounced effect from extreme high temperature events. (2) Extreme temperatures influence famers' decision in abandoning farmland and reducing investment in agricultural machinery, thus creating an interconnected impact on labor mobility. (3) The reallocation effect of rural labor induced by extreme temperatures is particularly evident for males, persons that perceives economic hardship or labor in economically active areas. Originality/value: By applying a dataset with a wide latitude range, this study empirically confirms the influence of extreme temperatures on the agricultural labor reallocation, and reveals the mechanism of farmers' adaptive behavioral decision and therefore enriches the research on the impact of climate change on rural labor markets and livelihood strategies. [ABSTRACT FROM AUTHOR]

In emerging economies like Kuwait, tourism funds national development and sustains local livelihoods. The rapid rise of tourism in several nations may have serious environmental effects due to increased energy usage that increases carbon dioxide (CO2) emissions and worsening global warming. Due to climate change’s growing effects on the environment, several efforts have been made by numerous countries worldwide to achieve carbon neutrality and environmental sustainability. Moreover, effective energy production prediction is crucial to establish an equilibrium between traditional and clean energy sources. However, there is a research gap investigating the environmental impacts of tourism within the framework of energy-economy-environment nexus in Kuwait’s context that propelled the development of this pioneering investigation. The present study’s objective is to determine how economic growth, energy consumption, and tourism affect carbon emissions in Kuwait. This study analyzes Kuwait’s time series data from 1995 to 2019 by using the autoregressive distributed lag (ARDL) method that analyzed the components’ relationships, allowing for long-term and short-term dynamics. The results show that increasing economic growth, energy consumption, and tourist arrivals increase CO2 emissions in Kuwait. This article proposes policies to achieve carbon neutrality in Kuwait by expanding renewable energy use and promoting sustainable tourism to boost the economy. [ABSTRACT FROM AUTHOR]

Background: In developing countries like Bangladesh, under-five children are mostly experiencing and suffering from common diseases like fever, cough, diarrhea, and acute respiratory infections (ARI). To mitigate these problems, it's crucial to spot prevalent areas and take proper action. This study investigates the spatial distribution and associated factors of prevalent childhood illnesses across Bangladesh. Methods and findings: This research comprised 8,306 children's information from the Bangladesh Demographic and Health Survey (BDHS) 2017–18. We performed chi-square, t-tests, binary logistic regression and spatial analyses in this work. BDHS survey data and GPS data were aggregated to identify common childhood illnesses among under-five children. Moran's index first mapped childhood illnesses. Afterward, Getis-Ord Gi* discovered hot and cold spots for illnesses. However, Kriging interpolation predicted child illnesses in unsampled areas. Here, 33.2% (CI: 32.2–34.3), 36% (CI: 35–37.1), 4.7% (CI: 4.3–5.2), and 12.9% (CI: 12.2–13.6) of children under five had fever, cough, diarrhea, and ARI, respectively. In the fortnight before to the survey, 47.3% (CI: 46.2–48.3) of under-5 children were ill. Common childhood illnesses are associated with children's (age, underweight status, etc.), mothers' (age, education, etc.), and household factors (residency, wealth index, etc.). Underweight status is associated with fever, cough and at least one disease. The unsampled north-western and south-western areas of Bangladesh had a higher prevalence of fever, cough, ARI and at least one common disease. Cough was most common in the central-northern region; fever was most common in the lower southern region; and ARI was most common in Bangladesh's south-east. Childhood diseases were more prevalent in Bangladesh's central-northern and southern regions. Conclusions: Our research demonstrates the regional clustering of common childhood diseases in Bangladesh. Policymakers should focus on these higher-prevalence regions, and the necessary preventive measures should be taken immediately. [ABSTRACT FROM AUTHOR]

This study was conducted in Ekpoma, a town dependent on rainwater and river water from nearby areas because of a lack of groundwater sources, and the physicochemical and bacteriological (heterotrophic plate count [HPC], total coliform count [TCC], and fecal coliform count [FCC]) properties of 123 stored river water samples grouped into five collection districts (EK1 to EK5). The results were compared with regulatory standards and previous regional studies to identify water quality trends. While most physicochemical properties met drinking water standards, 74% of samples had pH values > 8.5. Twenty-seven samples were fit for drinking, with EK4 having the highest number of bacterio-logically unsuitable samples. Ten bacterial species were identified, with Gram-negative short-rod species such as Escherichia coli, Klebsiella pneumoniae, and Salmonella typhimurium being predominant. HPC values varied from 367 × 10⁴ to 1320 × 10⁴ CFU/mL, with EK2 (2505 × 10⁴ CFU/mL) and EK5 (1320 × 10⁴ CFU/mL) showing particularly high counts. The TCC values ranged from 1049 × 10⁴ to 4400 × 10⁴ CFU/mL, and the FCC values from 130 × 10⁴ to 800 × 10⁴ CFU/mL, all exceeding WHO limits (1.0 × 102 CFU/mL). Historical data show no improvement in water quality, emphasizing the need for individuals to treat water properly before consumption. The findings provide baseline data for local water authorities and serve as a wake-up call for adequate water treatment, storage interventions, and community education on water security. Additionally, this study offers a practical process for improving the quality of water stored in similar regions. [ABSTRACT FROM AUTHOR]

Background: Diarrhea diseases continue to present a significant threat to the well-being of children under the age of five in Africa, thereby contributing substantially to both morbidity and mortality rates. The period spanning between January 2013 and December 2023 has witnessed persistent challenges in the fight against these diseases, thereby necessitating a thorough investigation into the factors that determine their occurrence. It is important to note that the burden of diarrhea diseases is not evenly distributed across the continent, with residence, socioeconomic, and environmental factors playing pivotal roles in shaping the prevalence and incidence rates. Consequently, this systematic review aimed to consolidate and analyze the existing body of literature on the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. Method: The systematic review employed a rigorous methodological approach to examine the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. A comprehensive search strategy was implemented, utilizing databases such as PubMed, Scopus, and Web of Science, and incorporating relevant keywords. The inclusion criteria focused on studies published within the specified timeframe, with a specific focus on the determinants of diarrhea disease among children under the age of five in Africa. The study selection process involved a two-stage screening, with independent reviewers evaluating titles, abstracts, and full texts to determine eligibility. The quality assessment, employing a standardized tool, ensured the inclusion of studies with robust methodologies. Data extraction encompassed key study details, including demographics, residence factors, socioeconomic influences, environmental variables, and intervention outcomes. Results: The search yielded a total of 12,580 articles across 25 African countries; however, only 97 of these articles met the inclusion criteria and were ultimately included in the systematic review. The systematic review revealed geographic and seasonal disparities in the prevalence of diarrhoeal diseases across different countries in Africa. Factors such as age-related vulnerabilities, gender disparities, maternal occupation, disposal of young children's stools, and economic status were identified as significant determinants of the prevalence of diarrhea disease. Conclusion: This systematic review provides a comprehensive understanding of the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. The nuanced analysis of residence variations, socioeconomic influences, environmental factors, and intervention outcomes underscores the complex nature of this issue. The findings highlight the necessity for region-specific and context-sensitive interventions to address the unique challenges faced by diverse communities. This review serves as a valuable resource for policymakers, healthcare professionals, and researchers, guiding the development of evidence-based strategies aimed at reducing the burden of diarrhea diseases and improving child health outcomes in Africa. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is a common inflammatory disease of airway affecting both adults and children. In a large number of cases asthma remains poorly controlled. There is a need to find an additional therapeutic demeanour alleviating symptoms and lowering the risk complications in a long-term. Recently, increasing number of studies has been examining dietary supplements in regards to their anti-inflammatory, immunomodulatory, anti-remodelling properties and their use in asthmatic patients. Aim of the Study: The aim of the study was to collect and analyse current literature regarding influence of different dietary supplements on the course of asthma in both adults and children. Methods and Materials: Extensive research was conducted using PubMed and Google Scholar, with the primary focus on literature from the past 5 years. Firstly, potential dietary supplements affecting course of asthma were collected. The names of the substances were juxtaposed with term “Asthma” to gather data regarding their effect on occurrence and control of asthma and potential mechanisms responsible for it. Additionally, references from selected articles were included in the analysis. Results: Dietary supplements show promising results in decreasing asthma symptoms and lowering inflammation of airway. However, our study revealed that in current state of knowledge there is a deficit of studies performed on humans, especially large-scale, prospective studies that assess the efficacy of different doses of dietary supplements. Thus, further research of dietary supplements in asthma is needed, especially large-scale randomised controlled trials. [ABSTRACT FROM AUTHOR]

As the aged population increases, the health of seniors (aged 60 years and over) is particularly important for the development of a healthy China, which makes it important to assess the health determinants for the elderly. This study aims to estimate the effect and pathway of microgeographic environment on the seniors' health and physical activities, and further investigate the urban–rural disparity in the relationship between the seniors' health and geographic environment. We collected data on 7155 elderly (≥ 60 years) from the Household Health Survey database of the Hebei Provincial Health Planning Commission, China. The geographic environment data, based on different radius buffers of respondents' residence, were collected from Baidu Maps. The green space data were obtained from the dataset provided by National Ecosystem Science Data Center, National Science & Technology Infrastructure of China. A series of multilevel generalized structural equation models were employed to examine the disparities in the effects of geographic environment on the seniors' health and physical activities. Built environment has significant direct and indirect effects on the health of the urban elderly, while its indirect effect on the rural elderly is significant. Green space is significantly and positively associated with the seniors' health, whereas its indirect effect is insignificant in rural areas. Environmental pollution has a negative correlation with seniors' health, and it also significantly restricts seniors from participating in outdoor physical activities. Physical activity has a significantly beneficial effect and a significant mediating effect on the health of seniors in both urban and rural area. The socioeconomic attributes, such as income, education and age, are significantly associated with the health of urban and rural elderly. The study finds that built environment, green space, environmental pollution and physical activities are crucial factors influencing the seniors' health, but there is significant urban–rural disparity in the health effects. The findings provide policy implications for the government to develop healthy neighborhoods and cities. [ABSTRACT FROM AUTHOR]

To comply with the United Nations Sustainable Development Goals (UN SDGs), in particular with SDG 3, SDG 11, and SDG 13, a reliable air pollution prediction model must be developed to construct a sustainable, safe, and resilient city and mitigate climate change for a double win. Machine learning (ML) and deep learning (DL) models have been applied to datasets in Macau to predict the daily levels of roadside air pollution in the Macau peninsula, situated near the historical sites of Macau. Macau welcomed over 28 million tourists in 2023 as a popular tourism destination. Still, an accurate air quality forecast has not been in place for many years due to the lack of a reliable emission inventory. This work will develop a dependable air pollution prediction model for Macau, which is also the novelty of this study. The methods, including random forest (RF), support vector regression (SVR), artificial neural network (ANN), recurrent neural network (RNN), long short-term memory (LSTM), and gated recurrent unit (GRU), were applied and successful in the prediction of daily air pollution levels in Macau. The prediction model was trained using the air quality and meteorological data from 2013 to 2019 and validated using the data from 2020 to 2021. The model performance was evaluated based on the root mean square error (RMSE), mean absolute error (MAE), Pearson's correlation coefficient (PCC), and Kendall's tau coefficient (KTC). The RF model best predicted PM10, PM2.5, NO2, and CO concentrations with the highest PCC and KTC in a daily air pollution prediction. In addition, the SVR model had the best stability and repeatability compared to other models, with the lowest SD in RMSE, MAE, PCC, and KTC after five model runs. Therefore, the results of this study show that the RF model is more efficient and performs better than other models in the prediction of air pollution for the dataset of Macau. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) infects 40 % of the world population and has been suggested to be associated with diabetes; however, no prospective study has ever examined diabetes mortality associated with the infection. A cohort of 14,404 non-diabetic adult participants aged 17-90 years from the Third National Health and Nutrition Examination Survey (1988-1994) was prospectively followed for mortality through 2006. CMV immunoglobulin G was measured by enzyme-linked immunosorbent assay and immunofluorescence assay. Diabetes death was assessed with death records from the National Death Index. Cox proportional hazards modeling was used to determine diabetes mortality risk associated with CMV infection, adjusting for socio-demographics, diabetes risk factors, and comorbidities. At baseline, 76.8 % of subjects were CMV seropositive, and after an average follow-up of 13.7 years, diabetes mortality rate per 10,000 person-years was 6.8 (95 % CI 5.7, 8.0). Among seropositive participants, the diabetes death rate (8.4, 95 % CI 7.0, 9.9) was more than four times the rate in seronegative ones (2.0, 95 % CI 1.1, 3.6) (P value for the difference <0.001). In the adjusted Cox proportional hazards analysis, CMV seropositivity more than doubled the risk of diabetes mortality (HR 2.06, 95 % CI 1.05, 4.06). CMV infection may thus predict future mortality from diabetes in non-diabetic people.

Purpose: Bone demineralization affects the skeletal system, including the temporal bone, which contains the cochlea and the vestibular labyrinth. However, research on the association of bone mineral density (BMD) with balance and hearing sensitivity is limited with conflicting results. Therefore, we examined the relationship in a population representative sample., Methods: We analyzed 8863 participants to the National Health and Nutrition Examination Survey (1999-2004) aged 40 years and older. Total and head BMD were measured by dual energy x-ray absorptiometry. Balance was evaluated using the Romberg Test of Standing Balance on Firm and Compliant Support Surfaces condition 4, also indicative of vestibular dysfunction. Hearing condition was self-reported. The associations of total and head BMD with balance and hearing were assessed using multiple and multinomial logistic regressions adjusting for covariates., Results: On multiple logistic regression, low total BMD was associated with balance impairment (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.43-4.75), especially in older adults (≥65 years old; OR, 3.72; 95% CI, 1.07-12.85). In multinomial regression, low total BMD was associated with report of significant hearing impairment in older adults (OR, 5.30; 95% CI, 1.20-23.26)., Conclusions: Low BMD is associated with balance and hearing impairments, especially in older adults., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Lead is often present in our environment, but its effect on thyroid function is still unclear. In this study, multiple linear regressions were performed between log-transformed blood lead levels and thyroid function parameters of 4652 adults from the 2007-2008 National Health and Nutrition Examination Survey. The models were adjusted for age, gender, race/ethnicity, smoking, alcohol consumption, body mass index, physical activity, iodine intake, medications, and bone mineral density. Blood lead concentrations (mean: 1.52 ± 1.20 μg/dL [range 0.18-33.12]) were inversely associated with total thyroxine (regression coefficients [β]: -0.22 [95% CI: -0.34, -0.09] in the general population, but were not correlated with thyroid stimulating hormone, total or free triiodothyronine, nor free thyroxine. Blood lead may have no effect on the thyroid function; however, it could be associated with decreased concentrations in thyroid-binding proteins.

Bacteria Borrelia burgdorferi s. l. and even more the protist Toxoplasma gondii Nicolle et Manceaux, 1908, are known to affect the behaviour and mental health of their animal and human hosts. Both pathogens infect a significant fraction of human population, both are neurotropic and survive in the host's body for a long time. While latent infections were thought to be clinically asymptomatic, recent studies suggest otherwise, revealing adverse effects on human health. It was hypothesised that the specific behavioural effects of these pathogens may be side effects of general health impairments in infected individuals. This hypothesis was tested using about one hour-long survey consisting of questionnaires and performance tests on a cohort of 7,762 members of the internet population. Results showed that individuals infected with T. gondii reported worse physical and mental health, and those infected with Borrelia spp. reported worse physical health than uninfected controls. Furthermore, infected and noninfected individuals differed in several personality traits, including conscientiousness, pathogen disgust, injury disgust, Machiavellianism, narcissism, tribalism, anti-authoritarianism, intelligence, reaction time, and precision. While the majority of behavioural effects associated with Borrelia infection were similar to those associated with Toxoplasma infection, some differences were observed, such as performance in the Stroop test. Path analyses and nonparametric partial Kendall correlation tests showed that these effects were not mediated by impaired health in infected individuals, contradicting the side effects hypothesis.

Objective: Thirty-five years after herpesviruses were suggested to induce atherosclerosis sero-epidemiological evidence on Herpes Simplex Viruses (HSV) remains sparse and controversial. We aimed to investigate the relationship between HSV-1 and HSV-2 infections and cardiovascular diseases (CVD)., Methods and Results: A population-based cross-sectional study was conducted among 14,415 participants (mean age 34.3 years, range 20-49) of the National Health and Nutrition Examination Survey 1999-2010. Serum IgG-antibodies to HSV were measured by enzymatic immunodot assay and CVD were self-reported. CVD prevalence was 1.8%; 51.3% of participants were infected with HSV-1, 7.5% with HSV-2, and 15.2% with both. After adjusting for demographics, socioeconomic status, comorbidities, STD, and CVD risk factors, seropositivity to HSV-2 was positively associated with CVD (Odds ratio [OR] 1.56, 95% confidence interval [CI]: 1.09-2.21, P = 0.014), but not with HSV-1 (OR 1.13, 95% CI: 0.79-1.62)., Conclusion: HSV-2 may be associated with premature CVD, but not HSV-1., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background and Objective: Probiotics may reduce the risk of atopy and asthma in children. However, results from clinical trials have been conflicting, and several of them may have been underpowered. We performed a meta-analysis of randomized, placebo-controlled trials to assess the effects of probiotic supplementation on atopic sensitization and asthma/wheeze prevention in children., Methods: Random-effects models were used to calculate pooled risk estimates. Meta-regression was conducted to examine the effect of potential factors on probiotics efficacy., Results: Probiotics were effective in reducing total immunoglobulin E (IgE) (mean reduction: -7.59 U/mL [95% confidence interval (CI): -14.96 to -0.22]; P = .044). Meta-regression showed that the reduction in IgE was more pronounced with longer follow-up. Probiotics significantly reduced the risk of atopic sensitization when administered prenatally (relative risk: 0.88 [95% CI: 0.78 to 0.99]; P = .035 for positive result on the skin prick test and/or elevated specific IgE to common allergens) and postnatally (relative risk: 0.86 [95% CI: 0.75 to 0.98]; P = .027 for positive result on skin prick test). Administration of Lactobacillus acidophilus, compared with other strains, was associated with an increased risk of atopic sensitization (P = .002). Probiotics did not significantly reduce asthma/wheeze (relative risk: 0.96 [95% CI: 0.85 to 1.07])., Conclusions: Prenatal and/or early-life probiotic administration reduces the risk of atopic sensitization and decreases the total IgE level in children but may not reduce the risk of asthma/wheeze. Follow-up duration and strain significantly modified these effects. Future trials for asthma prevention should carefully select probiotic strain and consider longer follow-up.

Objective: Asthma is the most common chronic condition in childhood and disproportionately impacts the poorer and ethnic minorities. The objectives of the study were to estimate the prevalence of asthma in Miami-Dade County (MDC) schoolchildren to aid case-finding and linkage to care., Methods: We used the CDC Youth Risk Behavior Surveillance System (YRBSS) definition of possible asthma ("Ever told by a doctor or nurse that they had asthma and still had asthma") and analyzed data from four sources. These included the: (1)-MDC YRBSS 2009, (2)-MDC Health Connect Asthma Survey of school nurses (>2008), (3)-parents' survey in the five HealthConnect survey elementary schools with highest asthma prevalence, and (4)-focus group with parents of asthmatic children., Results: (1)-MDC YRBSS data showed that 21.3% of high- and 21.4% of middle-school students had been diagnosed with possible asthma. Prevalence was the highest in African-American middle-school girls (26.9%). (2)-HealthConnect survey responders reported that 4.9% of the students in 131 MDC schools had possible asthma. Asthma prevalence was higher in elementary schools (median = 7.1%) and in low-income MDC zip codes. (3)-Of the parent survey responders, 24.9% indicated that their child had possible asthma, and 19.2% reported that their children had no usual source of care. (4)-Focus group participants reported frequent loss of Medicaid coverage for their children, landlords' indifference to the role of poorly maintained housing in asthma, and unmet needs regarding knowledge of health system navigation., Conclusions: Asthma may be common in MDC schoolchildren, particularly in poor communities. Formidable structural factors limit the caregivers' abilities to manage childhood asthma.

Background: Asthma affects more than 17 million people in the United States;1/3 of these are children. Children are particularly vulnerable to airborne pollution because of their narrower airways and because they generally breathe more air per pound of body weight than adults, increasing their exposure to air pollutants. However, the results from previous studies on the association between motor vehicle emissions and the development of childhood wheeze and asthma are conflicting. Therefore, we conducted a meta-analysis to clarify their potential relationship., Methods: MEDLINE, Highwire, and The Cochrane Library databases were searched for relevant studies. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) for the association between traffic air pollutants and wheeze or asthma were retrieved from individual studies and pooled to generate summary effect estimates (meta-OR) in STATA 11.1., Results: Nineteen studies were included in the meta-analysis. Exposure to nitrogen dioxide (meta-OR: 1.05, 95% CI: 1.00-1.11), nitrous oxide (meta-OR: 1.02, 95% CI: 1.00-1.04), and carbon monoxide (meta-OR: 1.06, 95% CI: 1.01-1.12) were positively associated with a higher prevalence of childhood asthma. Exposure to sulfur dioxide (meta-OR: 1.04, 95% CI: 1.01-1.07) was positively associated with a higher prevalence of wheeze in children. Exposure to nitrogen dioxide was positively associated with a higher incidence of childhood asthma (meta-OR: 1.14, 95% CI: 1.06-1.24), and exposures to particulate matter was positively associated with a higher incidence of wheeze in children (meta-OR: 1.05, 95% CI: 1.04-1.07)., Conclusions: Living or attending schools near high traffic density roads exposes children to higher levels of motor vehicle air pollutants, and increases the incidence and prevalence of childhood asthma and wheeze., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: Research on the respiratory effect of exposure to solder fumes in electronics workers has been conducted since the 1970s, but has yielded inconsistent results. The aim of this meta-analysis was to clarify the potential association., Methods: Effect sizes with corresponding 95% confidence intervals (CIs) for odds of respiratory symptoms related to soldering and spirometric parameters of solderers were extracted from seven studies and pooled to generate summary estimates and standardized mean differences in lung function measures between exposed persons and controls., Results: Soldering was positively associated with wheeze after controlling for smoking (meta-odds ratio: 2.60, 95% CI: 1.46, 4.63) and with statistically significant reductions in forced expiratory volume in 1 s (FEV1) (-0.88%, 95% CI: -1.51, -0.26), forced vital capacity (FVC) (-0.64%, 95% CI: -1.18, -0.10), and FEV1/FVC (-0.35%, 95% CI: -0.65, -0.05). However, lung function parameters of solderers were within normal ranges [pooled mean FEV1: 97.85 (as percent of predicted), 95% CI: 94.70, 100.95, pooled mean FVC: 94.92 (as percent of predicted), 95% CI: 81.21, 108.64, and pooled mean FEV1/FVC: 86.5 (as percent), 95% CI: 78.01, 94.98]., Conclusions: Soldering may be a risk factor for wheeze, but may not be associated with a clinically significant impairment of lung function among electronics workers.

Health effects of heavy metals have been widely investigated, but further evaluation is required to comprehensively delineate their toxicity. Using data from the 2007-2008 National Health and Nutrition Examination Survey, a multivariate logistic regression analysis was performed on 1,857 adults to examine the relationship between urinary heavy metals and various medical conditions. Cardiovascular diseases were correlated to cadmium (OR: 4.94, 95% CI: 1.48-16.56) and lead (OR: 5.32, 95% CI: 1.08-26.21). Asthma was related to tungsten (OR: 1.72, 95% CI: 1.15-2.59) and uranium (OR: 1.52, 95% CI: 1.01-2.28). Hepatotoxicity was associated with molybdenum (OR: 3.09, 95% CI: 1.24-7.73) and uranium (OR: 4.79, 95% CI: 1.74-13.19). Surprising inverse relationships occurred for excessive weight with lead (OR: 0.72, 95% CI: 0.52-0.98), reduced visual acuity with cobalt (OR: 0.65, 95% CI: 0.44-0.95) and cesium (OR: 0.52, 95% CI: 0.35-0.77). This study supports some previous evidence of potential relationships and provides insights for future research.

Background: Exposure to endotoxin has been widely investigated as a potential factor for asthma and associated symptoms in children with different results. To clarify a potential relationship, we performed the present meta-analysis to integrate the results of studies examining the association of endotoxin exposure with wheeze and asthma in children., Methods: A search for relevant studies and reviews was conducted in MEDLINE, Highwire, CINAHL, and The Cochrane Library databases. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) for endotoxin exposure and wheeze or asthma were retrieved and pooled to generate summary effect estimates in STATA 11.1., Results: Nineteen studies were included in the meta-analysis. The summary estimates suggested that endotoxin was positively associated with wheeze in infants and toddlers (meta-OR: 1.48, 95% CI: 1.10-1.98), but negatively related to asthma in school-aged children (meta-OR: 0.82, 95% CI: 0.69-0.97 for endotoxin concentration and 0.68, 95% CI: 0.50-0.93 for endotoxin load)., Conclusions: Based on the studies evaluated, endotoxin is a risk factor for wheeze in younger children, but a protective factor for asthma in older children. Thus, this study supports the "hygiene hypothesis."

Slum areas in Ethiopia have high poverty status. In addition, they possess poor water and sanitation accesses such as unsafe drinking water, a lower number of sanitation facilities and poor hygienic conditions. These scenarios are important in the occurrence of diarrhea among under five children's. However, there are many studies conducted on diarrhea among under five children in Ethiopia, unfortunately, the majority usually didn't give enough coverage for the burden of diarrhea among under five children in slum areas. This study aimed to determine the prevalence of diarrhea and associated factors among under five children in slum areas of Gondar City. This community-based cross-sectional study was conducted in slum areas of Gondar City among under five children from March 28 to April 28, 2023. A multi-stage sampling technique was used to collect a sample of 836 through interview-administered methods using a structured data collection tool. The collected data was manually checked for completeness, coded, and entered into EPI Info version 7.1.5.2 software. It was then exported to Stata version 14.1 software for descriptive analysis, as well as bivariable and multivariable binary logistic regression analyses, to identify factors associated with diarrhea among under five children. The prevalence of diarrhea among under five children at 95% confidence interval was 24.64% (CI 21.71–27.56). Mothers/caretakers age < 25 years (AOR = 1.88, 95% CI 1.16–3.06), mothers/caretakers age between 28 and 31 years (AOR = 1.82, 95% CI 1.08–3.05), mothers/caretakers who had no formal education (AOR = 3.18, 95% CI 1.86–5.41), mothers/caretakers who had primary education (AOR = 1.67, 95% CI 1.09–2.57), income level between 4877 and 5643 Ethiopian Birr (AOR = 1.81, 95% CI 1.04–3.15), family size greater than five (AOR = 1.54, 95% CI 1.00–2.36), flies around the house (AOR = 2.27, 95% CI 1.38–3.73), playground not clean (AOR = 2.70, 95% CI 1.62–4.50), breastfed for ≥ 1 year (AOR = 0.63, 95% CI 0.41–0.97), mothers/caretakers who did not wash their hands before food preparation and eating (AOR = 2.31, 95% CI 1.39–3.58), mothers/caretakers who did not wash their hands after visiting latrine (AOR = 1.60, 95% CI 1.07–2.38) were significantly associated factors with diarrhea among under five children in slum areas of Gondar City. The study indicates that the prevalence of diarrhea was higher among under five children in slum areas of Gondar City. The Gondar City Administration Education Bureau should give great emphasis on improving mother's and caretaker's education. In addition, the Gondar City Administration Health Bureau should educate mothers and caretakers about breastfeeding, sanitation, and hygiene in the slum areas of Gondar City. [ABSTRACT FROM AUTHOR]

Environmental air pollution presents a considerable risk to global respiratory health. If critical levels are exceeded, inhaled pollutants can lead to the development of respiratory dysfunction and provoke exacerbation in those with pre‐existing chronic respiratory disease. Over 90% of the global population currently reside in areas where environmental air pollution is considered excessive—with adverse effects ranging from acute airway irritation to complex immunomodulatory alterations. This narrative review provides an up‐to‐date perspective concerning the impact of environmental air pollution on respiratory health and function and describes the underpinning mechanisms that contribute to the development and progression of chronic respiratory disease. [ABSTRACT FROM AUTHOR]

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of global mortality. Despite clinical predictors (age, severity, comorbidities, etc.) being established, proteomics offers comprehensive biological profiling to obtain deeper insights into COPD pathophysiology and survival prognoses. This pilot study aimed to identify proteomic footprints that could be potentially useful in predicting mortality in stable COPD patients. Plasma samples from 40 patients were subjected to both blind (liquid chromatography–mass spectrometry) and hypothesis-driven (multiplex immunoassays) proteomic analyses supported by artificial intelligence (AI) before a 4-year clinical follow-up. Among the 34 patients whose survival status was confirmed (mean age 69 ± 9 years, 29.5% women, FEV1 42 ± 15.3% ref.), 32% were dead in the fourth year. The analysis identified 363 proteins/peptides, with 31 showing significant differences between the survivors and non-survivors. These proteins predominantly belonged to different aspects of the immune response (12 proteins), hemostasis (9), and proinflammatory cytokines (5). The predictive modeling achieved excellent accuracy for mortality (90%) but a weaker performance for days of survival (Q2 0.18), improving mildly with AI-mediated blind selection of proteins (accuracy of 95%, Q2 of 0.52). Further stratification by protein groups highlighted the predictive value for mortality of either hemostasis or pro-inflammatory markers alone (accuracies of 95 and 89%, respectively). Therefore, stable COPD patients' proteomic footprints can effectively forecast 4-year mortality, emphasizing the role of inflammatory, immune, and cardiovascular events. Future applications may enhance the prognostic precision and guide preventive interventions. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease(COPD) is a gradually worsening and fatal heterogeneous lung disease characterized by airflow limitation and increasingly decline in lung function. Currently, it is one of the leading causes of death worldwide. The consistent feature of COPD is airway inflammation. Several inflammatory factors are known to be involved in COPD pathogenesis; however, anti-inflammatory therapy is not the first-line treatment for COPD. Although bronchodilators, corticosteroids and roflumilast could improve airflow and control symptoms, they could not reverse the disease. The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling pathway plays an important novel role in the immune system and has been confirmed to be a key mediator of inflammation during infection, cellular stress, and tissue damage. Recent studies have emphasized that abnormal activation of cGAS-STING contributes to COPD, providing a direction for new treatments that we urgently need to develop. Here, we focused on the cGAS-STING pathway, providing insight into its molecular mechanism and summarizing the current knowledge on the role of the cGAS-STING pathway in COPD. Moreover, we explored antagonists of cGAS and STING to identify potential therapeutic strategies for COPD that target the cGAS-STING pathway. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems. Aim: To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis. Materials and Methods: Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor--Davidson resilience scale short form (CD RISC) for assessing resilience. Results: A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers. Conclusion: During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance. [ABSTRACT FROM AUTHOR]

Background: The mental health inequality between migrants and non-migrants was exacerbated by the COVID-19 pandemic. Identifying key determinants of this inequality is essential in promoting health equity. Methods: This cross-sectional study recruited Shanghai residents by purposive sampling during the city-wide lockdown (from April 29 to June 1, 2022) using an online questionnaire. Migration statuses (non-migrants, permanent migrants, and temporary migrants) were identified by migration experience and by household registration in Shanghai. Mental health symptoms (depression, anxiety, loneliness, and problematic anger) were assessed by self-report scales. The nonlinear Blinder-Oaxaca decomposition was used to quantify mental health inequality (i.e., differences in predicted probabilities between migration groups) and the contribution of expected correlates (i.e., change in predicted probability associated with variation in the correlate divided by the group difference). Results: The study included 2738 participants (771 [28.2%] non-migrants; 389 [14.2%] permanent migrants; 1578 [57.6%] temporary migrants). We found inequalities in depression (7.1%) and problematic anger (7.8%) between permanent migrants and non-migrants, and inequalities in anxiety (7.3%) and loneliness (11.3%) between temporary migrants and non-migrants. When comparing permanent migrants and non-migrants, age and social capital explained 12.7% and 17.1% of the inequality in depression, and 13.3% and 21.4% of the inequality in problematic anger. Between temporary migrants and non-migrants, age and social capital also significantly contributed to anxiety inequality (23.0% and 18.2%) and loneliness inequality (26.5% and 16.3%), while monthly household income (20.4%) and loss of monthly household income (34.0%) contributed the most to anxiety inequality. Conclusions: Significant inequalities in depression and problematic anger among permanent migrants and inequalities in anxiety and loneliness among temporary migrants were observed. Strengthening social capital and economic security can aid in public health emergency preparedness and promote mental health equity among migrant populations. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated studies that used the World Health Organization's (WHO) AirQ and AirQ+ tools for air pollution (AP) health risk assessment (HRA) and provided best practice suggestions for future assessments. Methods: We performed a comprehensive review of studies using WHO's AirQ and AirQ+ tools, searching several databases for relevant articles, reports, and theses from inception to Dec 31, 2022. Results: We identified 286 studies that met our criteria. The studies were conducted in 69 countries, with most (57%) in Iran, followed by Italy and India (~8% each). We found that many studies inadequately report air pollution exposure data, its quality, and validity. The decisions concerning the analysed population size, health outcomes of interest, baseline incidence, concentration-response functions, relative risk values, and counterfactual values are often not justified, sufficiently. Many studies lack an uncertainty assessment. Conclusion: Our review found a number of common shortcomings in the published assessments. We suggest better practices and urge future studies to focus on the quality of input data, its reporting, and associated uncertainties. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease (Covid-19) pandemic has stressed health care systems worldwide and community pharmacists who had to operate under challenging conditions. Since the Covid-19 pandemic started in December 2019, pharmacists worldwide have played a critical role in devising novel strategies to minimize and control the pandemic's effects. Even through the spread of the pandemic, pharmacies have progressed to provide essential health services to their communities. Community pharmacists are well positioned to provide high-priority pandemic interventions, including Covid-19 immunizations and testing. The importance of community pharmacists for the general population has been evident throughout this pandemicand in previous pandemics. Using an online questionnaire, this cross-sectional comparative study was conducted to assess, explore, and compare the perceptions and views of community pharmacists during the Covid-19 pandemic in Jordan and Kuwait. The study showed that both populations had positive perceptions of and trust in community pharmacists, suggesting that pharmacists prioritized their patients' care over business-related concerns, despite their belief that pharmacists used the Covid-19 pandemic to raise the prices of immuneboosting supplements and sanitizers. During the pandemic, study participants frequently visited community pharmacies and preferred pharmacies close to their residences. [ABSTRACT FROM AUTHOR]

Introduction: There is little HIV counselling that directly meets the needs of men in Eastern and Southern Africa, limiting men's knowledge about the benefits of HIV treatment and how to overcome barriers to engagement, contributing to poorer HIV‐related outcomes than women. Male‐specific approaches are needed to improve men's outcomes but may be difficult for healthcare workers (HCWs) to implement with fidelity and quality in low‐resource settings. We developed a male‐specific counselling curriculum which was implemented by male HCWs and then conducted a mixed‐methods quality assessment. Methods: We audio‐recorded counselling sessions to assess the quality of implementation (n = 50) by male HCWs from two cadres (nurse, n = 10 and lay cadre, n = 10) and conducted focus group discussions (FGDs) with HCWs at 6 and 9 months after rollout to understand barriers and facilitators to implementation. Counselling sessions and FGDs were translated, transcribed and analysed using thematic analysis adapted from WHO Quality Counselling Guidelines. We assessed if sessions were respectful, informative, interactive, motivating and included tailored action plans for overcoming barriers to care. All data were collected September 2021−June 2022. Results: All sessions used respectful, non‐judgemental language. Sessions were highly interactive with most HCWs frequently asking open‐ended questions (n = 46, 92%) and often incorporating motivational explanations of how antiretroviral therapy contributes to life goals (n = 42, 84%). Few sessions included individually tailored action plans for clients to overcome barriers to care (n = 9, 18%). New counselling themes were well covered; however, occasionally themes of self‐compassion and safe sex were not covered during sessions (n = 16 and n = 11). HCWs believed that having male HCWs conduct counselling, ongoing professional development and keeping detailed counselling notes facilitated quality implementation. Perceived barriers included curriculum length and client hesitancy to participate in action plan development. Findings were similar across cadres. Conclusions: Implementing high‐quality male‐specific counselling using male nurses and/or lay cadre is feasible. Efforts to utilize lay cadres should be prioritized, particularly in low‐resource settings. Programmes should provide comprehensive job aids to support HCWs. Ongoing training and professional development are needed to (1) improve HCWs' skills in tailored action plans, and (2) sensitize HCWs to the need for self‐compassion within male clients to promote holistic sexual health. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta-analysis aimed to: i) determine the pooled prevalence of acute diarrhea; and ii) synthesize and summarize current evidence on factors of acute diarrheal illnesses among under-five children in Ethiopia. Methods: A comprehensive systematic search was conducted in PubMed, SCOPUS, HINARI, Science Direct, Google Scholar, Global Index Medicus, Directory of Open Access Journals (DOAJ), and the Cochrane Library. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological quality of each included article was assessed using the Joanna Briggs Institute (JBI) quality assessment tool for cross-sectional and case-control studies. A randomeffect meta-analysis model was used to estimate the pooled prevalence of diarrheal illnesses. Heterogeneity and publication bias were assessed using I2 test statistics and Egger's test, respectively. The statistical analysis was done using STATA™ software version 14. Results: Fifty-three studies covering over 27,458 under-five children who met the inclusion criteria were included. The pooled prevalence of diarrhea among under-five children in Ethiopia was found to be 20.8% (95% CI: 18.69-22.84, n = 44, I2 = 94.9%, p < 0.001). Our analysis revealed a higher prevalence of childhood diarrhea in age groups of 12-23 months 25.42% (95%CI: 21.50-29.35, I2 = 89.4%, p < 0.001). In general, the evidence suggests that diarrheal risk factors could include: i) child level determinants (child's age 0-23 months, not being vaccinated against rotavirus, lack of exclusive breastfeeding, and being an under-nourished child); ii) parental level determinants {mothers poor handwashing practices [pooled odds ratio (OR) = 3.05; 95% CI:2.08-4.54] and a history of maternal recent diarrhea (pooled OR = 3.19, 95%CI: 1.94-5.25)}; and iii) Water, Sanitation and Hygiene (WASH) determinants [lack of toilet facility (pooled OR = 1.56, 95%CI: 1.05-2.33)], lack handwashing facility (pooled OR = 4.16, 95%CI: 2.49-6.95) and not treating drinking water (pooled OR = 2.28, 95% CI: 1.50-3.46). Conclusion: In Ethiopia, the prevalence of diarrhea among children under the age of five remains high and is still a public health problem. The contributing factors to acute diarrheal illnesses were child, parental, and WASH factors. A continued focus on improving access to WASH facilities, along with enhancing maternal hygiene behavior will accelerate reductions in diarrheal disease burden in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with autoimmune systemic inflammation. The evidence on the role of C-reactive protein (-CRP) in predicting mortality among people with COPD remains mixed. Methods: Data from the National Health and Nutrition Examination Survey (1999–2010) were linked with mortality files up to December 31st, 2019, from the National Death Index. Adults ages 20 years or older were included in the analytic sample to assess the relationship between physician-diagnosed self-reported COPD and mortality based on blood CRP levels. Multivariate complex samples Cox regression analyses were conducted to determine the hazards ratios (with 95% CI). Results: A total of 30,669 individuals comprised of the final sample with 2215 deaths observed upon follow-up for an average of 10.2 years. Compared to individuals without COPD or elevated CRP, individuals with COPD but without elevated CRP (HR = 1.25, 95% CI = 0.97–1.61) did not have a significantly higher risk of mortality. However, those with both COPD and elevated CRP had a significantly higher risk of mortality (HR = 2.70, 95% CI = 1.08–6.81). Age, health insurance status, and a history of comorbidities modified these relationships. Conclusions: Biomarkers such as CRP continue to show promise for long-term COPD-related outcomes. Additional prospective assessments of individuals with airway obstruction are warranted to understand if CRP levels predict the occurrence or worsening of COPD and if those relate to long-term health outcomes. [ABSTRACT FROM AUTHOR]