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Objective: Research shows that personal relevance may affect the impact of alcohol-related health information. This study explored alcohol consumption during the UK Covid-19 lockdown, and whether a message emphasising the effect of alcohol on the immune system was more effective in altering intentions to follow low-risk drinking guidelines than other messages about the effects of alcohol on health. Methods & Measures: From April to June 2020, 953 drinkers completed an online questionnaire, and were randomly allocated to exposure to a control condition or one of three messages emphasising the impact of alcohol on: the immune system; mental health; or physical health. Outcome variables were: concern about alcohol intake, and intention to adhere to low-risk drinking guidelines. Results: Pre-post ANCOVAs revealed that participants in the immunity message group had significantly stronger intention to adhere to low-risk guidelines than the control group (after controlling for initial intention). Concern for the effect of alcohol on health was not significantly affected. Conclusion: During Covid-19 lockdown, a message emphasising the impact of alcohol on the immune-system had a greater effect on intention to observe low-risk drinking guidelines than other messages. Contextually relevant messages could be used for alcohol health campaigns and for improving alcohol labelling. [ABSTRACT FROM AUTHOR]

Introduction: Air pollution is a major health risk factor. Ports might be an understudied source of air pollution. Methods: We conducted a spatial health impact assessment (HIA) of port-sourced air pollution for Barcelona for 2017 at the neighbourhood level. Total NO2 and PM10 and port-sourced NO2, PM10 and PM2.5 concentrations were available through the ADMS-Urban model. Population data, mortality and morbidity data, and risk estimates were obtained. We followed standard HIA methodologies and calculated relative risks and impact fractions for 1.35 million adults living in 73 neighbourhoods. Results: The city-wide mean total NO2 and PM10 concentrations were 37.88 μg/m3 (range: 19.61–52.17 μg/m3) and 21.68 μg/m3 (range: 17.33–26.69 μg/m3), respectively, of which 7% (range: 2–36%) and 1% (range: 0–7%) were port-sourced, respectively. The mean port-sourced PM2.5 concentration was 0.19 μg/m3 (range: 0.06–1.38 μg/m3). We estimated that 1,123 (PI: 0–3,060) and 1,230 (95% CI: 0–2,566) premature deaths were attributable to total NO2 and PM10, respectively, of which 8.1% (91; PI: 0–264) and 1.1% (13; 95% CI 0–29) were attributable to port-sourced NO2 and PM10, respectively. 20 (95% CI: 15–26) premature deaths were attributable to port-sourced PM2.5. Additionally, a considerable morbidity burden and losses in life expectancy were attributable to port-sourced air pollution. Neighbourhoods closest to the port in the south-east were most adversely affected, gradually decreasing towards the north-west. Conclusions: The port is an understudied air pollution source in Barcelona with strong health impacts. Cities need local insight into health risk factors, their sources, attributable burdens and distributions for defining targeted policies. [ABSTRACT FROM AUTHOR]

Chemical accidents significantly impact environmental and human health. However, studies investigating the impacts of such accidents have primarily focused on single-route exposures, potentially underestimating the extent of damage. This study aimed to conduct an aggregate risk assessment for multi-route exposure to hazardous chemicals to ensure systematic and rational management of the health impacts on residents exposed to chemical accidents, considering the behavior of a hazardous chemical from a chemical accident within environmental media. Drawing upon a real chemical accident that occurred in Siheung, Gyeonggi-do, in 2019, leakage of 500 L of toluene over an hour was assumed. Employing a multimedia environmental dynamics model, the time-dependent concentrations across various environmental media were calculated, and the average daily dose (ADD), hazard quotient (HQ), and hazard index (HI) for each exposure route included in the multi-route exposure assessment were derived. Health risks were deemed present if the calculated HQ and HI values exceeded the threshold of 1. The results indicated the highest ADD values among the 0–9 age group, with inhalation exposure registering the highest ADD across all exposure routes. However, no significant health risks were observed, with both HQ and HI values not exceeding 1. This aggregate risk assessment approach is proposed as an effective preliminary evaluation method for health impact assessments in areas affected by chemical accidents. [ABSTRACT FROM AUTHOR]

Severe airborne particulate matter (PM, including PM 2.5 and PM 10) pollution in India has caused widespread concern. Accurate PM concentrations are fundamental for scientific policymaking and health impact assessment, while surface observations in India are limited due to scarce sites and uneven distribution. In this work, a simple structured, efficient, and robust model based on the Light Gradient-Boosting Machine (LightGBM) was developed to fuse multisource data and estimate long-term (1980–2022) historical daily ground PM concentrations in India (LongPMInd). The LightGBM model shows good accuracy with out-of-sample, out-of-site, and out-of-year cross-validation (CV) test R2 values of 0.77, 0.70, and 0.66, respectively. Small performance gaps between PM 2.5 training and testing (delta RMSE of 1.06, 3.83, and 7.74 µgm-3) indicate low overfitting risks. With great generalization ability, the openly accessible, long-term, and high-quality daily PM 2.5 and PM 10 products were then reconstructed (10 km, 1980–2022). This showed that India has experienced severe PM pollution in the Indo-Gangetic Plain (IGP), especially in winter. PM concentrations have significantly increased (p<0.05) in most regions since 2000 (0.34 µgm-3yr-1). The turning point occurred in 2018 when the Indian government launched the National Clean Air Programme, and PM 2.5 concentrations declined in most regions (-0.78 µgm-3yr-1) during 2018–2022. Severe PM 2.5 pollution caused continuous increased attributable premature mortalities, from 0.73 (95 % confidence interval (CI) [0.65, 0.80]) million in 2000 to 1.22 (95 % CI [1.03, 1.41]) million in 2019, particularly in the IGP, where attributable mortality increased from 0.36 million to 0.60 million. LongPMInd has the potential to support multiple applications of air quality management, public health initiatives, and efforts to address climate change. The daily and monthly PM 2.5 and PM 10 concentrations are publicly accessible at 10.5281/zenodo.10073944 (Wang et al., 2023a). [ABSTRACT FROM AUTHOR]

Current prospective reports suggest a pandemic-related increase in adolescent mental health problems. We examine whether age-related change over 11–14 years accounts for this increase. Mothers and adolescents in a UK-based birth cohort (Wirral Child Health and Development Study; WCHADS; N = 737) reported on adolescent depression and behavioural problems pre-pandemic (December 2019–March 2020), mid-pandemic (June 2020–March 2021) and late pandemic (July 2021–March 2022). Analysis used repeated measures models for over-dispersed Poisson counts with an adolescent-specific intercept with age as a time-varying covariate. Maturational curves for girls, but not for boys, showed a significant increase in self-reported depression symptoms over ages 11–14 years. Behavioural problems decreased for both. After adjusting for age-related change, girls' depression increased by only 13% at mid-pandemic and returned to near pre-pandemic level at late pandemic (mid versus late – 12%), whereas boys' depression increased by 31% and remained elevated (mid versus late 1%). Age-adjusted behavioural problems increased for both (girls 40%, boys 41%) and worsened from mid- to late pandemic (girls 33%, boys 18%). Initial reports of a pandemic-related increase in depression in young adolescent girls could be explained by a natural maturational rise. In contrast, maturational decreases in boys' depression and both boys' and girls' behavioural problems may mask an effect of the pandemic. [ABSTRACT FROM AUTHOR]

Health Impact Assessment (HIA) is an evidence-based approach to assess the likely public health impacts of a policy or plan in any sector. Several HIA frameworks are available to guide practitioners doing a HIA. This systematic review sought to determine whether these support practitioners to meet best practice principles defined by the International Association for Impact Assessment. This was a systematic review. Three complementary search strategies were used to identify frameworks in June 2022. We used three databases to find completed HIAs published in the last five years and hand-searched their reference lists for frameworks. We also searched 23 HIA repositories using Google's Advanced function and contacted HIA practitioners via two international mailing lists. We used a bespoke quality appraisal tool to assess frameworks against the principles. The search identified 24 HIA frameworks. None of the frameworks achieved a 'good' rating for all best practice principles. Many identified the principles but did not provide guidance on how to meet them at all HIA steps. The highest number of frameworks were rated 'good' for ethical use of evidence and comprehensive approach to health (n = 15). Eight frameworks were rated as 'good' for participation, and two for equity. The highest number of frameworks rated 'poor' for sustainability (n = 11). There is marked variation in the degree to which HIA frameworks support the best practice principles. HIA practitioners could select elements from different frameworks for practical guidance to meet all the best practice principles. [ABSTRACT FROM AUTHOR]

We propose a general framework for estimating long-term health and economic effects that takes into account four time-related aspects. We apply it to a reduction in exposure to air pollution in the Canton of Geneva. Methodological developments on the evaluation of long-term economic and health benefits, with an empirical illustration. We propose a unified framework—the comprehensive impact assessment (CIA)—to assess the long-term effects of morbidity and mortality in health and economic terms. This framework takes full account of four time-related issues: cessation lag, policy/technical implementation timeframe, discounting and time horizon. We compare its results with those obtained from standard quantitative health impact assessment (QHIA) in an empirical illustration involving air pollution reduction in the canton of Geneva. We find that by neglecting time issues, the QHIA estimates greater health and economic benefits than the CIA. The overestimation is about 50% under reasonable assumptions and increases ceteris paribus with the magnitude of the cessation lag and the discount factor. It decreases both with the time horizon and with the implementation timeframe. A proper evaluation of long-term health and economic effects is an important issue when they are to be used in cost-benefit analyses, particularly for mortality, which often represents the largest fraction. We recommend using the CIA to calculate more accurate values. [ABSTRACT FROM AUTHOR]

Simple Summary: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Survival rates for children with ALL have improved, and today, more than 90% of children with ALL can be successfully treated. Acute pancreatitis (AP), which develops during chemotherapy for ALL can be a serious and fatal complication. It is a widely known toxicity, and several reports indicate that AP occurs with an incidence of 2–10% in patients treated for leukemia. It is mainly, but not exclusively, associated with the administration of asparaginase (ASP), which is one of the key components of multiagent chemotherapy used in ALL. The development of AP usually delays subsequent courses of chemotherapy and is the most common reason for the discontinuation of ASP, thus increasing the potential risk of leukemia relapse in children with ALL. Therefore, both the pathogenesis of AP in ALL and its impact on long-term outcomes remain to be thoroughly investigated. Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children receiving intensive chemotherapy for ALL. The group was divided into patients with at least one episode of AP and those who did not develop AP after treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for the development of AP (OR = 1.05; 95%CI = 1.006–1.098; p = 0.03). The overall mortality associated with AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) in both subgroups were 0.84 vs. 0.86, log-rank p = 0.65 and 0.75 vs. 0.80, log-rank p = 0.12, respectively. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent treatment phases. Only one patient re-exposed to ASP (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rank p = 0.27 and 0.63 vs. 0.79, log-rank p = 0.09, respectively). Conclusions: The incidence of AP in children with ALL is low and related to patients' age. The development of AP does not seem to influence p-DFS and p-EFS in children with ALL. Recurrence of AP after re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP does not improve either p-DFS or p-EFS in children with ALL. [ABSTRACT FROM AUTHOR]

Background During the 1997–2010 Labour government, several policies were implemented to narrow health inequalities as part of a national health inequalities strategy. Many of these policies are likely to have had a disproportionately large impact on people aged 65 and over. We aimed to understand the association between the health inequalities strategy period and inequalities in mortality at age 65–69. Methods We use population at risk and mortality data covering 1991–2019 to calculate mortality rate at age 65–69 at the Local Authority level. We use the 2019 Index of Multiple Deprivation to examine geographical inequalities. We employ segmented linear regression models with marginal spline terms for the strategy period and interact these with an indicator of deprivation to understand how inequalities changed before, during and after the strategy. The reporting of this study adheres to STROBE guidelines. Results Mortality rates in each deprivation quintile improved continuously throughout the period of study. Prior to the programme (1991–9) there was no significant change in absolute inequalities. However, during the strategy (2000–10) there was a significant decrease in absolute inequalities of −9.66 (−17.48 to −1.84). The period following the strategy (2011–19) was associated with a significant increase in absolute inequalities of 12.84 (6.60 to 19.08). Our results were robust to a range of sensitivity tests. Conclusion The English health inequalities strategy was associated with a significant reduction in absolute inequality in mortality age 65–69. Future strategies to address inequalities in ageing populations may benefit from adopting a similar approach. [ABSTRACT FROM AUTHOR]

The study investigated PM2.5 and heavy metal pollutant concentrations in Seoul and Wonju, South Korea, emphasizing the importance of considering PM2.5 chemical constituents for health impact assessments. While PM2.5 concentrations were similar between the two cities with slight variations, heavy metal concentrations differed significantly. Regional sources, PM2.5 composition, and meteorological conditions influenced these variations. Exposure to Fe was highest in all areas, with some heavy metals exceeding permissible levels, stressing the need to consider regional characteristics in assessments. Different heavy metals influence health risks differently in each city. When examining the HI (the summation of the hazard quotient for heavy metals), Seoul remained below an HI value of 1, while Wonju exceeded this threshold when exposed to CTE concentrations. In Seoul, As had a significant health impact of PM2.5, while in Wonju, Mn was more influential. Source apportionment confirmed different pollution sources in Seoul and Wonju, affecting the distribution of PM2.5 constituents in the atmosphere. Effective PM2.5 management requires a comprehensive approach considering chemical constituents and health impacts not just mass-based PM2.5 management, emphasizing regional-specific assessments and policy considerations to mitigate health risks. Therefore, tailored management strategies based on regional characteristics are necessary. [ABSTRACT FROM AUTHOR]

Introduction: Psychological distress in pregnant and postpartum women increased during the COVID‐19 pandemic. However, the impact of the pandemic in perinatal women at the end of the health emergency has been rarely studied. This study is aimed at investigating the psychological health of pregnant and postpartum women at the end of the COVID‐19 public health emergency, hypothesizing that the COVID‐19‐related fears influence perinatal psychological distress via the mediation of the COVID‐19‐related posttraumatic impact and loneliness. Methods: A total of 200 women in the perinatal period, of which 125 were pregnant and 75 were postpartum, participated in an online survey at the end of the COVID‐19 public health emergency in Italy. Depression, anxiety, stress, loneliness, posttraumatic impact of COVID‐19 pandemic and COVID‐19‐related fears were assessed. To test the hypotheses, robust serial mediation analyses were performed. Results: Increased levels of COVID‐19‐related fears were associated with an increase in perinatal depression, anxiety and stress indirectly through the serial mediation of COVID‐19 posttraumatic impact and loneliness. Loneliness played a stronger role in mediating the relationship between COVID‐19‐related fears and depression than anxiety and stress outcomes. Conclusions: This study should be considered exploratory for its methodological characteristics and nonreplicability of the pandemic condition. However, this study suggests the importance of assessing posttraumatic reactions to 'collective' crises in pregnant and postpartum women for research and clinical practice. In addition, it sustains the role of loneliness as a transversal construct that should be greatly considered in targeting psychological interventions for women in the perinatal period. [ABSTRACT FROM AUTHOR]

International studies have shown shifting demographic data and rising hospitalizations for alcohol-related cirrhosis (ARC), with a paucity of data from Australia. We examined hospitalizations, mortality and demographic data for people admitted with ARC over the last decade in Queensland, Australia. Data linkage study. A retrospective analysis of adults hospitalized with ARC during 2008–2019 was performed using state-wide admissions data. International Classification of Diseases, 10th revision, codes identified admissions with the principal diagnosis of ARC based on validated algorithms. Comorbidity was assessed using the Charlson Comorbidity Index. A total of 7152 individuals had 24,342 hospital admissions with ARC (16,388 were for ARC). There was a predominance of males (72.6%) and age ≥50 years (80.4%) at index admission. Females were admitted at a significantly younger age than men (59% of women and 43% of men were aged <60 years, P < 0.001). Comorbidities were common, with 45.1% of people having at least one comorbidity. More than half (54.6%) of the patients died over the study period (median follow-up time was 5.1 years; interquartile range 2.4–8.6). Women had significantly lower mortality, with 47.6% (95% confidence interval [CI] 45.0–50.2) probability of 5-year survival, compared with 40.1% (95% CI 38.5–41.6) in men. In multivariable analysis, this was attributable to significantly lower age and comorbidity burden in women. Significantly lower survival was seen in people with higher comorbidity burden. Overall, the number of admissions for ARC increased 2.2-fold from 869 admissions in 2008 to 1932 in 2019. Hospital admissions for ARC have risen substantially in the last decade. Females were admitted at a younger age, with fewer comorbidities and had lower mortality compared with males. The association between greater comorbidity burden and higher mortality has important clinical implications, as comorbidity-directed interventions may reduce mortality. [ABSTRACT FROM AUTHOR]

Childhood asthma is a major health issue in Australia, and traffic emissions play a causative role. Two urban planning policies that impact children's exposure to traffic emissions are considered in terms of the potential health risks to children in a Melbourne suburb with high truck volumes and hospital attendances for childhood asthma. Firstly, the health impact assessment component of the state planning approval of a major road project, and secondly, local government placement of childcare centres and schools in relation to freight routes. Three sources of air quality monitoring data were examined: (i) a Victorian EPA reference site; (ii) a site with planning approval for development into a childcare centre; and (iii) five sites within the boundary of the West Gate Tunnel Project, an AUD 10 billion road and tunnel project. The Australian Urban Research Infrastructure Network data was utilised to assess distances of childcare centres and schools from major truck routes. A range of cconcentration–response functions for childhood asthma (0–18 years) from international systematic meta-analyses and a smaller Australian cross-sectional study were applied to comparative elevations in fine particulate matter (PM2.5) and nitrogen dioxide (NO2) concentrations between the EPA reference monitor (used for project risk assessment) and local roadside data. It was found that comparative elevations in NO2 concentrations were associated with the following risk increases: developing asthma 13%, active asthma 12%, and lifetime asthma 9%. Overall, 41% of childcare centres (n = 51) and 36% of schools (n = 22) were ≤150 m to a high-density truck route. Truck emissions likely make a substantial contribution to childhood asthma outcomes in the project area. This study exemplifies how current practices may not be commensurate with guiding policy objectives of harm minimisation and equitable protection. [ABSTRACT FROM AUTHOR]

Black carbon (BC) is one of the most important climate forcers with severe health effects. Large uncertainties in radiative forcing estimation and health impact assessment arise from the fact that there is no standardized method to measure BC mass concentration. This study presents a 2-year comparison of three state-of-the-art BC measurement techniques at the high-altitude research station Pic du Midi (PDM) located in the French Pyrenees at an altitude of 2877 m above sea level. A recently upgraded Aethalometer AE33, a thermal-optical analyser Sunset and a single-particle soot photometer SP2 were deployed to measure simultaneously the mass concentration of equivalent black carbon (MeBC), elemental carbon (MEC) and refractory black carbon (MrBC), respectively. Significant deviations in the response of the instruments were observed. All techniques responded to seasonal variations in the atmospheric changes in BC levels and exhibited good correlation during the whole study period. This indicates that the different instruments quantified the same particle type despite the fact that they are based on different physical principles. However the slopes and correlation coefficients varied between instrument pairs. The largest biases were observed for the AE33 with MeBC values that were around 2 times greater than MrBC and MEC values. The principal reasons of such large discrepancy were explained by the mass absorption cross section (MAC) that was too low and C values recommended by the AE33 manufacturer and applied to the absorption coefficients measured by the AE33. In addition, the long-range transport of dust particles at PDM in spring caused significant increases in the bias between AE33 and SP2 by up to a factor 8. The Sunset MEC measurements agreed within around 17 % with the SP2 MrBC values. The largest overestimations of MEC were observed when the total carbon concentrations were below 25 µgCcm-2 , which is probably linked to the incorrect determination of the organic carbon (OC)–EC split point. Another cause of the discrepancy between instruments was found to be the limited detection range of the SP2, which did not allow for the total detection of fine rBC particles. The procedure used to estimate the missing mass fraction of rBC not covered by the measurement range of the SP2 was found to be critical. We found that a time-dependent correction based on fitting the observed rBC size distribution with a multimodal lognormal distribution is needed to accurately estimate MrBC over a larger size range. [ABSTRACT FROM AUTHOR]

The occurrence and spread of infectious diseases pose considerable challenges to public health. While the relationship between the built environment and the spread of infectious diseases is well-documented, there is a dearth of urban planning tools specifically designed for conducting Health Impact Assessments (HIAs) targeted at infectious diseases. To bridge this gap, this paper develops a comprehensive framework of an HIA for Urban Planning and Epidemic (HIA4UPE), formulated by considering the progression of public health incidents and the distinct transmission patterns of infectious diseases. This framework is designed to provide a comprehensive assessment by including a health risk-overlay assessment, health resource-quality assessment, health resource-equality assessment, and health outcome-impact prediction, enabling a multidimensional evaluation of the potential impacts of current environmental conditions or planning proposals on the incidence of infectious diseases. Furthermore, this paper advances the application of spatial analysis and computation, comprehensive assessment methodologies, and predictive analytics to conduct specific assessments. The theoretical framework and analytical tools presented in this paper contribute to the academic discourse and offer practical utility in urban planning and policymaking on epidemic prevention and control. [ABSTRACT FROM AUTHOR]

BackgroundCities often use non-native plants such as turf grass to expand green space. Native plants, however, may require less water and maintenance and have co-benefits for local biodiversity, including pollinators. Previous studies estimating mortality averted by adding green space have not considered the provision of native plants as part of the greening policies.AimWe aim to estimate premature deaths that would be prevented by the implementation of native-plants policy scenarios in the City of Denver, Colorado, USA.MethodsAfter conducting interviews with local expert stakeholders, we designed four native-plants policy scenarios: (1) greening 30% of all city census-block groups to the greenness level of native plants, (2) adding 200-foot native-plants buffers around riparian areas, (3) constructing large water retention ponds landscaped with native plants, and (4) greening parking lots. We defined the normalized difference vegetation index (NDVI) corresponding to native plants by measuring the NDVI at locations with known native or highly diverse vegetation. Using a quantitative health-impact assessment approach, we estimated premature mortality averted under each scenario, comparing alternative NDVI with the baseline value.ResultsIn the most ambitious scenario, we estimated that 88 (95% uncertainty interval (UI): 20, 128) annual premature deaths would be prevented by greening 30% of the area of census block groups with native plants. We estimated that greening 30% of parking-lot surface with native plants would prevent 14 annual deaths (95% UI: 7, 18), adding the native buffers around riparian areas would prevent 13 annual deaths (95% UI: 2, 20), and adding the proposed stormwater retention ponds would prevent no annual deaths (95% UI: 0, 1).ConclusionUsing native plants to increase green spaces has the potential to prevent premature deaths in the City of Denver, but results were sensitive to the definition of native plants and the policy scenario.

Legislation produced under the EU Commission's Better Regulation Agenda sometimes fails to achieve the Treaty obligation to ensure a high level of health protection in all EU policies and activities. Public health advocates have raised the question of whether EU law can be employed to challenge this apparent breach of Treaty obligations at the proposal preparation stage, compelling the Commission to amend prospective EU legislation so that it better protects health. This article will demonstrate that unfortunately this is not possible due to the justiciability of both Article 168 TFEU and the Better Regulation Agenda. However, this awareness can help public health advocates to re-focus their efforts on strategies that will likely have a greater impact in swaying the direction of EU health policy. [ABSTRACT FROM AUTHOR]

Objectives: Understanding and addressing how an individual?s social, political, economic, and cultural context affects their ability to achieve optimal health is essential to designing and implementing interventions. Before evaluating two parenting programs, in partnership with four children?s mental health organizations, we used the Health Equity Impact Assessment tool (HEIA) to identify groups that may experience unintended health impacts, as well as generated mitigation strategies to address these impacts. Methods: HEIA activities included a review of the published literature, a review of organizational documents, key informant interviews with staff (n = 12) and other related community service providers (n = 7), and a geographic information systems analysis. All sources of evidence were considered and analyzed using reflective thematic analysis. Summary reports were shared with all partners. Results: A range of groups were identified as at risk of experiencing unintended health impacts, including caregivers who are racialized, immigrants, Indigenous, living with mental health issues or addictions, dealing with intellectual challenges and/or low literacy levels, survivors of childhood trauma, single parent families, or families experiencing financial difficulties. Unintended health impacts were sorted into 6 main themes which fell under the overarching themes of accessibility of the programs and cultural appropriateness. Mitigation strategies as well as innovative strategies already being applied by participating organizations are discussed. Conclusion: Although this HEIA focused on parenting programs, the findings address equity issues applicable to the provision of a wide spectrum of children?s mental health services.

In big and industrial cities of developing countries, illness and mortality from long-term exposure to air pollutants have become a serious issue. This research was carried out in 2019–2020 to estimate the health impacts of PM10, NO2 and O3 pollutants by using AirQ+ and R statistical programming software in Arak, Isfahan, Tabriz, Shiraz, Karaj, and Mashhad. Mortality statistics, number of people in required age groups, and amount of pollutants were gathered respectively from different agencies like Statistics and Information Technology of the Ministry of Health, Statistical Center, and Department of Environment and by using Excel, the average 24-hour and 1-hour concentration and maximum 8-hour concentration for PM10, NO2 and O3 pollutants were gathered. We used linear mixed impacts model to account for the longitudinal observations and heterogeneity of the cities. The results of the study showed high number of deaths due to chronic bronchitis in adults, premature death of infants, and respiratory diseases in Mashhad. This research highlights the importance of estimation of health impacts from exposure to air pollutants on residents of the studied cities.

Abstract Background Overweight is a major risk factor for non-communicable diseases (NCDs) in Europe, affecting almost 60% of all adults. Tackling obesity is therefore a key long-term health challenge and is vital to reduce premature mortality from NCDs. Methodological challenges remain however, to provide actionable evidence on the potential health benefits of population weight reduction interventions. This study aims to use a g-computation approach to assess the impact of hypothetical weight reduction scenarios on NCDs in Belgium in a multi-exposure context. Methods Belgian health interview survey data (2008/2013/2018, n = 27 536) were linked to environmental data at the residential address. A g-computation approach was used to evaluate the potential impact fraction (PIF) of population weight reduction scenarios on four NCDs: diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) disease. Four scenarios were considered: 1) a distribution shift where, for each individual with overweight, a counterfactual weight was drawn from the distribution of individuals with a “normal” BMI 2) a one-unit reduction of the BMI of individuals with overweight, 3) a modification of the BMI of individuals with overweight based on a weight loss of 10%, 4) a reduction of the waist circumference (WC) to half of the height among all people with a WC:height ratio greater than 0.5. Regression models were adjusted for socio-demographic, lifestyle, and environmental factors. Results The first scenario resulted in preventing a proportion of cases ranging from 32.3% for diabetes to 6% for MSK diseases. The second scenario prevented a proportion of cases ranging from 4.5% for diabetes to 0.8% for MSK diseases. The third scenario prevented a proportion of cases, ranging from 13.6% for diabetes to 2.4% for MSK diseases and the fourth scenario prevented a proportion of cases ranging from 36.4% for diabetes to 7.1% for MSK diseases. Conclusion Implementing weight reduction scenarios among individuals with excess weight could lead to a substantial and statistically significant decrease in the prevalence of diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) diseases in Belgium. The g-computation approach to assess PIF of interventions represents a straightforward approach for drawing causal inferences from observational data while providing useful information for policy makers.

Background: Social prescribing link workers are non-health or social care professionals who connect people with psychosocial needs to non-clinical community supports. They are being implemented widely, but there is limited evidence for appropriate target populations or cost effectiveness. This study aimed to explore the feasibility, potential impact on health outcomes and cost effectiveness of practice-based link workers for people with multimorbidity living in deprived urban communities. Methods: A pragmatic exploratory randomised trial with wait-list usual care control and blinding at analysis was conducted during the COVID 19 pandemic (July 2020 to January 2021). Participants had two or more ongoing health conditions, attended a general practitioner (GP) serving a deprived urban community who felt they may benefit from a one-month practice-based social prescribing link worker intervention.. Feasibility measures were recruitment and retention of participants, practices and link workers, and completion of outcome data. Primary outcomes at one month were health-related quality of life (EQ-5D-5L) and mental health (HADS). Potential cost effectiveness from the health service perspective was evaluated using quality adjusted life years (QALYs), based on conversion of the EQ-5D-5L and ICECAP-A capability index to utility scoring. Results: From a target of 600, 251 patients were recruited across 13 general practices. Randomisation to intervention (n = 123) and control (n = 117) was after baseline data collection. Participant retention at one month was 80%. All practices and link workers (n = 10) were retained for the trial period. Data completion for primary outcomes was 75%. There were no significant differences identified using mixed effects regression analysis in EQ-5D-5L (MD 0.01, 95% CI -0.07 to 0.09) or HADS (MD 0.05, 95% CI -0.63 to 0.73), and no cost effectiveness advantages. A sensitivity analysis that considered link workers operating at full capacity in a non-pandemic setting, indicated the probability of effectiveness at the €45,000 ICER threshold value for Ireland was 0.787 using the ICECAP-A capability index. Conclusions: While the trial under-recruited participants mainly due to COVID-19 restrictions, it demonstrates that robust evaluations and cost utility analyses are possible. Further evaluations are required to establish cost effectiveness and should consider using the ICE-CAP-A wellbeing measure for cost utility analysis. Registration: This trial is registered on ISRCTN. Title: Use of link workers to provide social prescribing and health and social care coordination for people with complex multimorbidity in socially deprived areas. Trial ID: ISRCTN10287737. Date registered 10/12/2019. Link: https://www.isrctn.com/ISRCTN10287737 [ABSTRACT FROM AUTHOR]

Factors originating at the organizational, work, and individual levels are closely interrelated and intricately intertwined, affecting health rates. There was limited research on the interdependence and aggregate effects between multi‐source factors and occupational health and well‐being (OHW). It is challenging to achieve management goals. Therefore, considering cross‐level factors and across the "work environment‐stress‐exposure‐OHW" chain, individual vulnerability was considered. A Fuzzy Bayesian Belief Network (FBBN) driven by both domain knowledge and data was constructed to carve out the logic between multi‐source factors and OHW. Workers from four coal mines were surveyed twice in 6 months. 714 valid samples were included in the analysis. The interdependencies among multi‐source factors were identified by the Interpretive Structure Modeling method and the visual probability estimation was achieved based on FBBN. It revealed that the work and the organizational level were the root factors. Eight factors involved in work stress were mainly mediating, and actual exposure and individual vulnerability were direct factors. Pathway interventions and joint interventions were proposed. The prediction ability and scheme feasibility of FBBN were verified. The approach developed allows robust assessments of aggregate effects and obtains multi‐source factor importance. This study provides vital insights and evaluation tools for understanding workplace stress and OHW management. [ABSTRACT FROM AUTHOR]

The article examines the centrality of health equity to human rights and how and why equity has risen on the global health agenda and has become firmly embedded in health and human rights impact assessments. Topics discussed include equity and the nondiscrimination principle, the rise of equality on the global health agenda, and the promise of the impact assessment for rights and equity.

The COVID-19 pandemic led to significant burnout among nurses, resulting in a shortage of nursing staff. Issues related to nursing work have received significant attention recently, and only healthy nurses are capable of providing good quality patient care. The authors employed Bronfenbrenner's Ecological System Theory to analyze the impact of the COVID-19 pandemic on nurses and proposed specific strategies and recommendations to enhance the nursing workplace. Under the Ecological System Theory, several factors, including inadequate preparedness, dangerous working environment, work-family conflicts, discrimination due to public panic, and health damage, contribute to nurse burnout. Whether during or after the COVID-19 pandemic, it is necessary to provide education programs to enhance the professional abilities of nurses, foster policies that promote a positive practice work environment, implement a triage system based on the severity of patients, elevate the image of the nursing profession, monitor the health of nurses, and advocate for transformational leadership. The nursing workplace should help nurses gain greater confidence and improve their ability to handle various workplace challenges. In the future, medical institutions should provide a better work environment for nurses and expect the public to pay more attention to the development of the nursing profession. [ABSTRACT FROM AUTHOR]

Background: Data on the health-related quality of life (HRQoL) for invasive meningococcal disease (IMD) survivors, particularly among adolescents and young adults (AYAs), are limited. This study aimed to investigate the in-depth experiences and impacts of IMD on AYAs. Methods: Participants were recruited from two Australian states, Victoria and South Australia. We conducted qualitative, semi-structured interviews with 30 patients diagnosed with IMD between 2016 and 2021. The interview transcripts were analyzed thematically. Results: Of the participants, 53% were aged 15–19 years old, and 47% were aged 20–24. The majority (70%) were female. Seven themes relating to the participants' experience of IMD were identified: (1) underestimation of the initial symptoms and then rapid escalation of symptoms; (2) reliance on social support for emergency care access; (3) the symptoms prompting seeking medical care varied, with some key symptoms missed; (4) challenges in early medical diagnosis; (5) traumatic and life-changing experience; (6) a lingering impact on HRQoL; and (7) gaps in the continuity of care post-discharge. Conclusion: The themes raised by AYA IMD survivors identify multiple areas that can be addressed during their acute illness and recovery. Increasing awareness of meningococcal symptoms for AYAs may help reduce the time between the first symptoms and the first antibiotic dose, although this remains a challenging area for improvement. After the acute illness, conducting HRQoL assessments and providing multidisciplinary support will assist those who require more intensive and ongoing assistance during their recovery. [ABSTRACT FROM AUTHOR]

Due to major global urbanisation, a careful evaluation of plans (town planning and mobility) and projects (industrial and development) is required in order to measure their impact on health and environmental matrices. In Italy, Legislative Decree No 152/06 introduced two procedures: the EIA (Environmental Impact Assessment) and SIA (Strategic Impact Assessment). Their focus, however, does not consider human health. Recently, the Integrated Environmental and Health Impact Assessment (IEHIA) was introduced; this defines the parameters necessary to provide an EIA that includes human health as a factor. This systematic review was conducted, including both the population impacted by new facilities and the method used to define their impact. Our database search produced 724 articles, of which 33 were eligible. Studies included landfill plans, manufacturing industries, mobility policies, energy production, and the environmental health of an area. All studies show how an approach encompassing multiple parameters can analyse the impact of a new facility in a comprehensive manner. This review shows that the use of health-related environmental impact parameters is essential for the integration of a project into a community, and can allow a wider understanding of the possible impacts on human health, both direct and indirect. [ABSTRACT FROM AUTHOR]

The study of happiness was initially examined psychologically, then expanded to incorporate social and, finally, economic aspects to investigate the reasons for the disparities in happiness levels across countries. Numerous scholars from various fields of expertise have developed an interest in studying happiness as a topic, as it has become a global issue. The notable work of Easterlin known as "Easterlin Paradox" postulates that happiness varies linearly with income at a point in time, both within and across nations. However, the long-term growth rates of happiness and income are not significantly linked. The economics of happiness is a multidisciplinary study of the relationship between economic conditions and subjective well-being or happiness. Happiness economics can be examined from both a microeconomic and macroeconomic perspective, providing valuable insights into both individual well-being and societal gain. The economics of happiness has received a lot of attention recently, especially in terms of understanding the differences in life satisfaction between rich and developing countries. Wealthier countries are happier as a group than poorer countries; happiness seems to increase with wealth up to a limit, but not beyond it. Public policy has a substantial impact on happiness economics by changing the well-being of individuals and society through numerous mechanisms such as fiscal policy, public spending, health impact assessment, and family assistance. The expanding national emphasis on subjective well-being accentuates the need to include happiness in governmental decisions. [ABSTRACT FROM AUTHOR]

Objective: Climate change is recognised as the biggest threat to global health of the 21st century and impacts on health and wellbeing through a range of factors. Due to this, the need to take action in order to protect population health and wellbeing is becoming ever more urgent. Methods: In 2019, Public Health Wales carried out a comprehensive mixed-method Health Impact Assessment (HIA) of climate change. Unlike other risk assessments, it appraised the potential impact of climate change on health and inequalities in Wales through participatory workshops, stakeholder consultations, systematic literature reviews and case studies. Results: The HIA findings indicate potential impacts across the wider determinants of health and wellbeing. For example, air quality, excess heat/cold, flooding, economic productivity, infrastructure, and community resilience. A range of impacts were identified across population groups, settings, and geographical areas. Conclusion: These findings can inform decision-makers to prepare for climate change plans and policies using an evidence-informed approach. The work has demonstrated the value of a HIA approach by mobilising a range of evidence through a transparent process, resulting in transferrable learning for others. [ABSTRACT FROM AUTHOR]

About 11% of 12th graders have used delta‐8 tetrahydrocannabinol (THC) in the past year, according to an analysis of last year's Monitoring the Future Study which is conducted by the National Institute on Drug Abuse (NIDA). [ABSTRACT FROM AUTHOR]

Summary: Glucagon‐like peptide 1 (GLP‐1) receptor agonists are revolutionizing obesity and type 2 diabetes treatment, delivering remarkable weight loss outcomes. These medications, leveraging the effects of the insulin‐regulating hormone GLP‐1 via actions on peripheral and central nervous system targets, have raised hopes with their bariatric surgery‐rivaling results. However, questions remain about their long‐term safety and efficacy. Drawing from our expertise in obesity medicine and psychiatry, we reflect upon our experiences with the clinical use of these medications and delve into the nuanced challenges and risks they pose, particularly for those prone to disordered eating or those diagnosed with rare genetic diseases of obesity. We contend that effectively managing weight loss within this "danger zone" necessitates (1) proactive screening and continuous monitoring for disordered eating, (2) vigilant monitoring for appetite‐related maladaptive responses, including food aversion and dehydration, and (3) ongoing assessment for broader health impacts. A multifaceted, interdisciplinary approach that melds medical, psychological, dietary, and behavioral strategies is crucial to delivering tailored and thorough care to each patient. [ABSTRACT FROM AUTHOR]

Introduction: An unprecedented shortage of infant formula occurred in the United States (U.S.) in 2022 and posed widespread challenges to infant feeding nationwide. The purpose of this study is to investigate mothers' experiences during the 2022 infant formula shortage and its perceived impacts on infants' diet and health. Methods: Mothers (n = 45) of infants under 8 months old from Washington D.C. were invited to participate in a virtual study meeting during the summer of 2022. Mothers completed surveys regarding their demographics, infants' anthropometrics, infant feeding practices, information they have received about infant feeding, and knowledge about infant feeding practices. They then participated in a qualitative interview about their experiences during the infant formula shortage. Results: Overarching themes were: the shortage (1) had adverse impacts on mothers' mental and emotional health; (2) had significant financial and intangible costs; (3) led to changes in infant feeding practices; (4) social and family networks were helpful in navigating the shortage; and (5) mothers felt fortunate to have resources to breastfeed and/or obtain formula. Discussion: The infant formula shortage adversely impacted mothers' mental and emotional health, and was costly, in terms of financial and intangible costs. Findings demonstrate the need to develop clinical and policy approaches to support mothers in feeding their infants and provide education about safe infant feeding practices. Significance: An unprecedented shortage of infant formula occurred in the United States (U.S.) in 2022 and posed widespread challenges to infant feeding nationwide. Findings call attention to concerning impacts of the infant formula shortage on mothers' mental and emotional health and highlight the disproportionate adverse impacts on Black mothers and mothers from low-income households. Enhanced efforts to connect mothers with resources such as community health workers are needed to support mothers in providing their infants with proper nutrition, particularly during shortages or other unexpected crises that may pose a barrier to infant feeding. [ABSTRACT FROM AUTHOR]

Through their products and services, businesses have a meaningful impact on their customers' health. When markets reward products that induce unhealthy behaviors, like poor diet and limited physical activity, they fuel the chronic disease epidemic. For market mechanisms to reward positive, and to punish negative, influences on healthy behaviors, companies' influences will need to be measured. Inspired by the technique of health impact assessment, we propose an approach to measuring these influences, based on examining usage patterns and the activities that result from a given product or service and then mapping those experiences to a core set of health behaviors. [ABSTRACT FROM AUTHOR]

The health effects of air pollution remain a public concern worldwide. Using data from the Global Burden of Disease 2019 report, we statistically analyzed total mortality, disability-adjusted life years (DALY), and years of life lost (YLL) attributable to air pollution in eight East African countries between 1990 and 2019. We acquired ambient ozone (O3), PM2.5 concentrations and household air pollution (HAP) from the solid fuel from the State of Global Air report. The multilinear regression model was used to evaluate the predictability of YLLs by the air pollutants. We estimated the ratio rate for each health burden attributable to air pollution to compare the country's efforts in the reduction of air pollution health burden. This study found that the total number of deaths attributable to air pollution decreased by 14.26% for 30 years. The drop came from the reduction of 43.09% in mortality related to Lower Respiratory tract Infection (LRI). However, only five out of eight countries managed to decrease the total number of deaths attributable to air pollution with the highest decrease observed in Ethiopia (40.90%) and the highest increase in Somalia (67.49%). The linear regression model showed that HAP is the pollutant of the most concern in the region, with a 1% increase in HAP resulting in a 31.06% increase in regional YLL (R2 = 0.93; p < 0.05). With the increasing ground-level ozone, accompanied by the lack of adequate measures to reduce particulate pollutants, the health burdens attributable to air pollution are still a threat in the region. [ABSTRACT FROM AUTHOR]

Tobacco use is one of the main risk factors for non-communicable diseases. Avoiding youth initiation and treating addiction are fundamental public health issues to ensure better health. Among tobacco control policies, increasing tobacco price is the single most effective intervention. It reduces tobacco consumption, especially among youths, while representing a government financing source. This study aimed to assess the agreement with the proposal of a one-euro increase in tobacco price earmarked to health issues among students at Sapienza University. Two convenience samples were surveyed, five years apart, on World No Tobacco Days. Smoking habits, agreement with the proposal and reasons for it were collected. Results from the 208 questionnaires (107 in 2014, 101 in 2019) showed 46.6% of agreement with the proposal (53.3% in 2014, 39.2% in 2019, p = 0.044). Main predictive factor for agreement was being a non-smoker (OR = 6.33 p < 0.001), main reason (64.8%) was it could trigger smokers to quit or reduce consumption. Several factors might have influenced this finding, including the introduction of novel tobacco products and their increased advertisement on social media. In 2024, European Union is planning to update the Tobacco Taxation Directive which could greatly contribute to the reduction of non-communicable diseases and premature deaths. [ABSTRACT FROM AUTHOR]

Background. Health equity impact assessments (HEIAs) inform the reduction of health inequities by evaluating programs or policies that affect target populations. Local health departments (LHD) receiving funding through the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) Program conducted HEIAs for evidence-based strategies (EBSs). This paper describes the impact of HEIAs on the implementation of EBSs and highlights lessons learned during implementation of HEIA modifications. Methods. We conducted a content analysis using data from the HEIA Modification Tracker and focus groups to identify themes and lessons learned. Results. Fifteen HEIAs were conducted by five LHDs between 2016 and 2020. The most common modifications to EBS implementation were 1) increasing education and training for community members and 2) altering messaging mediums and language to reach intended audiences. Discussion. Health equity impact assessments serve as a systematic and tangible way to center health equity, reflect on past processes, and inform improvements. [ABSTRACT FROM AUTHOR]

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The article discusses the issue of health inequalities in the UK and the lack of effective mechanisms to address them. Both major political parties have expressed a commitment to tackling these inequalities, but little progress has been made since 2010. The article highlights the need for specific targets on reducing health inequalities and a focus on the wider determinants of health. It also emphasizes the importance of healthy urban development and the involvement of various actors in decision-making. The authors argue that central government needs to work with local and devolved governments to embed public health in major policy decisions and change incentive structures. [Extracted from the article]

Objectives: In 2008, an analysis investigating health impact assessment (HIA) practice found that only 6% of HIA-related peer-reviewed publications had a focus on low- and medium-developed countries, whereas 94% were conducted in countries with a high or very high development state. We aimed to update and deepen these observations. Methods: We conducted a systematic review, searching PubMed and Web of Science for HIA-related papers published in the scientific literature from June 2007 to January 2023. Only applied HIA and papers with HIA as a subject were included. Results: The search yielded 3,036 publications and the final selection consisted of 1,019 publications. The annual number of total publications increased considerably over the past 15 years. Whereas research-driven HIA (n = 460) showed a steep increase, step-by-step HIA (n = 71) did not show a clear trend. Conclusion: The gap between the number of HIA-related peer-reviewed publications focusing on low/medium and high/very high developed countries has diminished from 6/ 94 to 11/89. There is a growing tendency to apply the terminology HIA for health impact modelling studies and quantitative health risk assessments. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity (PA) results in extensive physical, psychological, and social benefits. Despite primary care being a key point of influence for PA behaviours in the UK, research indicates poor application of PA interventions in this context. To address this, the Royal College of General Practitioners' (RCGP) developed and implemented the Active Practice Charter (APC). The aim of the study was to evaluate the perceived impact and acceptability of the APC initiative from the perspective of primary healthcare professionals (PHPs). Methods: An online exploratory cross-sectional survey was designed to assess the perceived impact, experiences, and challenges of the APC initiative, from the perspective of PHPs. The survey was distributed by the RCGP via email to 184 registered APC practices across the UK. Results: Responses were reviewed from staff (n = 33) from 21 APC practices. Initiatives used by APC practices included: educational programmes, partnerships with PA providers, referral systems, and infrastructure investment. Perceived benefits included: increased awareness about PA, staff cohesion, and improved well-being. However, staff felt the APC had limited effect due to implementation barriers, including: a lack of engagement, time, resources, and funding. Conclusion: This is the first evaluation of any nationwide UK-based initiative engaging GP practices in promoting PA. Acknowledging the limitations in response rate, although support exists for the RCGP APC, the evaluation highlights challenges to its implementation. Nonetheless, the wide reach of the RCGP, combined with the cited staff and patient benefits, demonstrates the significant potential of the APC initiative. Given the need to address physical inactivity nationally, further development the APC offers a possible solution, with further research required to overcome the challenges to implementation. [ABSTRACT FROM AUTHOR]

The use of fossil fuel energy persists in all the continents of the world, especially in Africa. This study examined fossil fuel energy usage and its health implications in residents of Osun State, Nigeria. This was a cross-sectional study done across Osun State Nigeria. The study took place between January and June 2020. 1044 participants were recruited by multi-stage random sampling. Structured questionnaires were used to obtain necessary information from the study participants. The study data shows there were 534 females (51.1%). 601 (57.6%) relied solely on fossil fuel energy compared to 443 (42.4%) who use non-traditional energy sources. The proportion of people whose annual income is less than 56.6 USD (fifty thousand Naira based on the current official exchange rate as of Jan 2024) is far higher among those who use fossil fuel energy (88.0%) compared to those who use modern energy (59.1%). Electricity consumption accessibility was also more likely among those who used modern energy (91.9%) compared to 52.4% of those who use fossil fuel energy for daily energy needs. Reports of ill-health were significantly commoner among those who used fossil fuel than modern energy in the population including asthma illness (15.3% vs. 11.3%), cough (21.1% vs. 16.7%), catarrh (19.3% vs. 10.8%) and difficulty in breathing (9.3% vs. 6.3%) respectively. This study showed that fossil fuel energy use is very prevalent among residents of Osun State, Nigeria. And may be linked with many indices of poverty. It is associated with significant health impacts including respiratory diseases and poor quality of life. There is a need to encourage and implement policies toward effective and efficient energy use among residents in Osun State to reduce the associated long-term health impact. [ABSTRACT FROM AUTHOR]

Background: Overweight is a major risk factor for non-communicable diseases (NCDs) in Europe, affecting almost 60% of all adults. Tackling obesity is therefore a key long-term health challenge and is vital to reduce premature mortality from NCDs. Methodological challenges remain however, to provide actionable evidence on the potential health benefits of population weight reduction interventions. This study aims to use a g-computation approach to assess the impact of hypothetical weight reduction scenarios on NCDs in Belgium in a multi-exposure context. Methods: Belgian health interview survey data (2008/2013/2018, n = 27 536) were linked to environmental data at the residential address. A g-computation approach was used to evaluate the potential impact fraction (PIF) of population weight reduction scenarios on four NCDs: diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) disease. Four scenarios were considered: 1) a distribution shift where, for each individual with overweight, a counterfactual weight was drawn from the distribution of individuals with a "normal" BMI 2) a one-unit reduction of the BMI of individuals with overweight, 3) a modification of the BMI of individuals with overweight based on a weight loss of 10%, 4) a reduction of the waist circumference (WC) to half of the height among all people with a WC:height ratio greater than 0.5. Regression models were adjusted for socio-demographic, lifestyle, and environmental factors. Results: The first scenario resulted in preventing a proportion of cases ranging from 32.3% for diabetes to 6% for MSK diseases. The second scenario prevented a proportion of cases ranging from 4.5% for diabetes to 0.8% for MSK diseases. The third scenario prevented a proportion of cases, ranging from 13.6% for diabetes to 2.4% for MSK diseases and the fourth scenario prevented a proportion of cases ranging from 36.4% for diabetes to 7.1% for MSK diseases. Conclusion: Implementing weight reduction scenarios among individuals with excess weight could lead to a substantial and statistically significant decrease in the prevalence of diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) diseases in Belgium. The g-computation approach to assess PIF of interventions represents a straightforward approach for drawing causal inferences from observational data while providing useful information for policy makers. [ABSTRACT FROM AUTHOR]

Simple Summary: Invasive alien species are a global threat to biodiversity, ecosystem services (e.g., tourism and fisheries) and human health. Pufferfishes are notorious for their toxicity and may also display aggressive behavior, thus posing a threat to human health. In this work, we collected records of attacks, poisonings and fatalities, due to Lagocephalus sceleratus and Torquigener hypselogeneion, in the Eastern Mediterranean Sea, for the years 2004–2023. These records were retrieved from social media, and the grey and scientific literature, as well as from personal observations. Overall, 198 events impacting human health were documented: 28 records of physical attacks, at least 143 non-lethal poisoning episodes, and 27 human fatalities resulting from consumption. The number of recorded incidents greatly increased after 2019, especially with regards to poisonings, yet whether related to greater media attention, or to increased abundance is unclear. This is a baseline work for future monitoring and raising awareness. Thus, we urge the continuation of national campaigns to caution residents and tourists of these species' high toxicities and potential aggressiveness. The silver-cheeked toadfish Lagocephalus sceleratus (Gmelin 1789), and to a lesser degree the orange spotted toadfish Torquigener hypselogeneion (Bleeker, 1852), pose threats to human health from physical attacks and poisonings in the Eastern Mediterranean Sea. This study reviewed human health-related impacts resulting from these pufferfish, compiling and assessing records from online sources, the peer-reviewed literature, medical records, personal interviews, and observations across the Eastern Mediterranean in the years 2004 to 2023. A total of 198 events impacting human health were documented: 28 records of physical attacks, at least 144 non-lethal poisoning episodes, and 27 human fatalities resulting from consumption. The majority of the reported incidences occurred in Syria, Türkiye, and Lebanon. Most physical attacks occurred in summer, while most poisoning events occurred during winter. The number of recorded incidents greatly increased after 2019, especially with regard to poisonings, yet whether this is related to greater media attention, or to increased fish abundance is unclear. This is the first comprehensive study to collate findings on attacks, poisonings and fatalities caused by these pufferfish in the Mediterranean Sea, and may help in improving national health policies. We urge the continuation of national campaigns to caution residents and tourists of these species' high toxicities and potential aggressiveness. [ABSTRACT FROM AUTHOR]

The impact of community-wide teen pregnancy prevention initiatives (CWIs) on local U.S. birth rates among adolescents aged 15 to 19 years was examined using synthetic control methodology within a quasi-experimental design. CWIs were implemented in 10 U.S. communities from 2010 to 2015. Each initiative implemented evidence-based teen pregnancy prevention interventions at local organizations and enhanced best practices in adolescent reproductive health care at local health centers, while engaging diverse community sectors. The synthetic control method was used to estimate the impact of each CWI on overall and race- and ethnicity-specific teen births relative to rates in synthetic control communities. Additionally, we estimated the overall effect of CWIs across communities by pooling results from the 10 synthetic control case studies using the mean percentile rank. Pooled data across all 10 communities indicated an estimated average of 6.6 fewer births per 1000 teens per year overall during the initiative relative to each community's synthetic control (p =.001). By race and ethnicity, there were an estimated average of 6.4 fewer births per 1000 teens per year among Black teens (p =.03), 10.7 fewer births among Hispanic teens (p =.03), and 4.2 fewer births (p =.10) among White teens. Results from individual communities indicated an intervention effect on overall and/or race/ethnicity-specific teen birth rates in five communities. This study demonstrates the value of synthetic control methods in evaluating community-level outcomes of programmatic efforts. Findings indicate the CWIs had a positive impact on teen birth rates and have the potential to address racial and ethnic disparities in those rates. [ABSTRACT FROM AUTHOR]

Addressing current environmental, social, health, and democratic challenges requires projects and evaluations to be conceptualized differently. This article proposes a pathway to creating rapid impact assessment tools that consider the dimensions that matter the most to ensure positive impacts for a thriving future. This work is based on three premises for evaluation practice, which needs to: contribute to a positive ecosystem, adopt a holistic perspective, and engage participants in deliberative and democratic practices. We first review related evaluation approaches—health impact and environmental impact assessments—to learn from these experiences and avoid their pitfalls. Second, we present and illustrate how the Planetary Health Rapid Impact Assessment tools can be developed and used. This article, is intended to inspire and support policymakers, program designers, decision-makers, administrators, and evaluators willing to positively influence planetary health and introduce such tools in their projects. [ABSTRACT FROM AUTHOR]

Objective: Most podiatry‐led high‐risk foot services (HRFS) in Australia are located in metropolitan areas or large regional centres. In rural areas, where there are limited specialist services, individuals with diabetes‐related foot ulceration are more likely to undergo amputation. This study aimed to explore clinicians' perceptions of a recently implemented HRFS in rural New South Wales, Australia, and compare trends of amputation and hospitalisation prior to and post‐implementation of the service. Setting: Rural HRFS in Tamworth, New South Wales, Australia. Participants: Health professionals working within the HRFS were recruited to participate. Design: This was a multiple‐methods study. For the qualitative arm, semi‐structured interviews were conducted, which were analysed using a reflexive thematic approach. The quantitative arm of the study utilised a retrospective analytic design which applied an interrupted time series to compare amputation and hospitalisation trends pre‐ and post‐implementation of the HRFS utilising diagnostic and procedural ICD codes. Results: The qualitative arm of the study derived three themes: (1) navigating the divide, (2) rural community and rural challenges and (3) professional identity. Results of the interrupted time series indicate that there was a downward trend in major amputations following implementation of the HRFS; however, this was not statistically significant. Conclusion: Clinicians were aware of the inequity in DFD outcomes between rural and metropolitan areas and were committed to improving outcomes, particularly with respect to First Nations peoples. Future research will explore service use and amputation rates in the longer term to further evaluate this specialised multidisciplinary care in a rural community. [ABSTRACT FROM AUTHOR]

Background: Health Impact Assessment (HIA) systematically assesses the health impacts of policies, programs on a population, with a focus on the holistic well-being of individuals. This approach employs diverse methods to identify positive and negative health impacts, along with unintended consequences, offering recommendations for effective management. HIA considers economic, social, psychological, environmental, and organizational factors in community health. The process involves key steps like assessing baseline health, identifying impacts, quantifying and valuing them, ranking importance, and proposing management recommendations. HIA can be prospective, retrospective, or concurrent during implementation. Methodology: The systematic process included a detailed protocol for scoping review, comprehensive database search, and inclusion criteria for studies published in English from January 2020 to December 2023. Results: Its importance resides in enhancing decision-making by providing insights into health ramifications, fostering dedication to implementing recommendations, and tackling both immediate and indirect developmental effects on health. HIA engages in promoting democratic processes, fairness, sustainable development, and ethical use of evidence in conducting comprehensive impact evaluations. Despite global recognition, barriers like limited funding, insufficient evidence, and perceived time constraints exist. Solutions, such as creative funding, evidence consolidation, and long-term cost-effectiveness, show potential for overcoming these barriers. Conclusion: HIA serves as a valuable instrument for giving precedence to community health decision-making, nurturing fair and sustainable development. [ABSTRACT FROM AUTHOR]