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Background: The European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Considerable research has focused on explaining vaccination uptake in relation to socio-economic and demographic characteristics, health promotion and health behavior factors. Nevertheless, few studies have aimed to analyze between-country differences in the use of flu vaccination for the EU population. To address this gap, this study examines the socio-economic inequalities in the use of influenza vaccination for the population aged 15 years and over in all 27 EU Member States and two other non-EU countries (Iceland and Norway). Methods: Using data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals' characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake. Results: The main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners. Conclusions: Overall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens. [ABSTRACT FROM AUTHOR]

Background: Women with a history of gestational diabetes mellitus (GDM) are 12-fold more likely to develop type 2 diabetes (T2D) 4–6 years after delivery than women without GDM. Similarly, GDM is associated with the development of common mental disorders (CMDs) (e.g. anxiety and depression). Evidence shows that holistic lifestyle interventions focusing on physical activity (PA), dietary intake, sleep, and mental well-being strategies can prevent T2D and CMDs. This study aims to assess the effectiveness of a holistic lifestyle mobile health intervention (mHealth) with post-GDM women in preventing T2D and CMDs in a community setting in Singapore. Methods: The study consists of a 1-year randomised controlled trial (RCT) with a 3-year follow-up period. Post-GDM women with no current diabetes diagnosis and not planning to become pregnant will be eligible for the study. In addition, participants will complete mental well-being questionnaires (e.g. depression, anxiety, sleep) and their child's socio-emotional and cognitive development. The participants will be randomised to either Group 1 (Intervention) or Group 2 (comparison). The intervention group will receive the "LVL UP App", a smartphone-based, conversational agent-delivered holistic lifestyle intervention focused on three pillars: Move More (PA), Eat Well (Diet), and Stress Less (mental wellbeing). The intervention consists of health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), slow-paced breathing exercises, a step tracker (including brisk steps), a low-burden food diary, and a journaling tool. Women from both groups will be provided with an Oura ring for tracking physical activity, sleep, and heart rate variability (a proxy for stress), and the "HAPPY App", a mHealth app which provides health promotion information about PA, diet, sleep, and mental wellbeing, as well as display body mass index, blood pressure, and results from the oral glucose tolerance tests. Short-term aggregate effects will be assessed at 26/27 weeks (midpoint) and a 1-year visit, followed by a 2, 3, and 4-year follow-up period. Discussion: High rates of progression of T2D and CMDs in women with post-GDM suggest an urgent need to promote a healthy lifestyle, including diet, PA, sleep, and mental well-being. Preventive interventions through a holistic, healthy lifestyle may be the solution, considering the inextricable relationship between physical and psychological health. We expect that holistic lifestyle mHealth may effectively support behavioural changes among women with a history of GDM to prevent T2D and CMDs. Trial status: The protocol study was approved by the National Healthcare Group in Singapore, Domain Specific Review Board (DSRB) [2023/00178]; June 2023. Recruitment began on October 18, 2023. Trial registration: ClinicalTrials.gov NCT05949957. The first submission date is June 08, 2023. [ABSTRACT FROM AUTHOR]

The current research, guided by the intersectionality theory and the Institute of Medicine's healthcare access model, explored the determinants of preventive care utilization within the Asian American community. Analyzing data from the Asian American Quality of Life Survey (with a sample size of 2535), logistic regression models were employed, incorporating various factors: demographic variables, immigration-related variables, health and access, and patient–provider relationship. Results revealed that longer stays in the U.S., having health insurance coverage, having a usual source of care, and higher satisfaction levels with prior healthcare services were associated with increased odds of utilizing preventive healthcare. These findings contribute to our comprehension of preventive care utilization among Asian Americans and offer practical insights for targeted interventions in social work and public health and strategic healthcare planning. [ABSTRACT FROM AUTHOR]

Ayushman Bharat (PMJAY), a flagship initiative of the Government of India and the world's largest government health insurance program, aims to transform India's healthcare landscape by providing comprehensive medical cover to a significant portion of the population. This article explores the potential of PMJAY in not only bridging the financial gap for accessing healthcare but also in fostering social inclusion within the healthcare system. The article examines how PMJAY's focus on primary care and preventive healthcare can contribute to overall wellness and empower individuals to take charge of their health. It further discusses the challenges associated with implementing such a large-scale program and suggests potential solutions to ensure its long-term success. [ABSTRACT FROM AUTHOR]

Abstract Background The European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Considerable research has focused on explaining vaccination uptake in relation to socio-economic and demographic characteristics, health promotion and health behavior factors. Nevertheless, few studies have aimed to analyze between-country differences in the use of flu vaccination for the EU population. To address this gap, this study examines the socio-economic inequalities in the use of influenza vaccination for the population aged 15 years and over in all 27 EU Member States and two other non-EU countries (Iceland and Norway). Methods Using data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals’ characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake. Results The main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners. Conclusions Overall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens.

As society moves towards a preventative approach to healthcare, there is growing interest in scientific research involving technology that can monitor and prevent adverse health outcomes. The primary objective of this paper is to develop an Internet of Things (IoT) wearable system based on Fried’s phenotype that is capable of detecting frailty. To determine user requirements, the system’s architecture was designed based on the findings of a questionnaire administered to individuals confirmed to be frail. A functional prototype was successfully developed and tested under real-world conditions. This paper introduces the methodology that was used to analyze the data collected from the prototype. It proposes an interdisciplinary approach to interpret wearable sensor data, providing a comprehensive overview through both visual representations and computational analyses facilitated by machine learning models. The findings of these analyses offer insights into the ways in which different types of activities can be classified and quantified as part of an overall physical activity level, which is recognized as an important indicator of frailty. The results provide the foundations for a new generation of affordable and non-intrusive systems able to detect and assess early signs of frailty.

In Sub‑Saharan African (SSA) countries the main channels of morbidity and mortality are preventable and treatable diseases. Yet, SSA countries invest little in preventive healthcare. Literature has shown that providing health information can have an impact on health behaviors. The arrival of optic fiber submarine cables in 2010 brought broadband connectivity to Senegal, allowing access to healthcare information online. Using the Demographic and Health Surveys datasets combined with the Afterfibre database, and a difference‑in‑differences methodology, this study aims to assess the impact of the arrival of broadband internet on preventive health behaviors in Senegal. Broadband access is found to be positively associated with the use of bed‑ net, mixed results are found regarding the use of antenatal care and child immunization. If the positive impacts of internet access are confirmed, the expansion of broadband internet could be important to improve health. [ABSTRACT FROM AUTHOR]

Purpose – This article intends to analyse the explanatory power of the Travel and Tourism Competitiveness Index (TTCI) and some of its constituent factors on national success metrics in managing the initial surge of the COVID-19 pandemic. Design/methodology/approach – The authors study the outbreak control effectiveness of 132 countries during the first semester of 2020. The authors apply generalized linear regression models and weighted least squares models using 6 COVID-19-related dependent variables, 9 TTCI-related independent variables and 12 control variables. Findings – The results suggest that countries with superior TTCI values and selected constituent factors have the highest daily averages of coronavirus infections and fatalities per million and the highest speed rates of COVID-19 spread. The authors also find that these countries have the shortest government response time, the lowest daily average of the social restrictions index and the shortest time from the first case reported in China to the first case reported nationally. Originality/value – To the best of the authors' awareness, no previous study exists analysing the statistical relationship between the TTCIB and some of its constituent factors with the selected metrics of national success at managing the initial surge of the COVID-19 pandemic. This fact represents the primary evidence of this article's unique contribution. 研究目的 – 本文擬分析旅行及觀光競爭力指數、以及其部份構成因素，如何影響有關國家在新型冠狀病毒肺炎大爆發初期控制病毒傳播方面的成功指標。 研究設計/方法/理念 – 我們就132個國家於2020年上半年控制肺炎爆發方面的表現進行研究。我們以廣義線性回歸模型和加權最小平方法進行分析研究，當中使用了六個與新型冠狀病毒肺炎有關的因變數、九個與旅行及觀光競爭力指數有關的自變數、和12個控制變量。 研究結果 – 研究結果暗示、在擁有優越的旅行及觀光競爭力指數值和選定的構成因素的國家，以百萬人來計算，每日冠狀病毒感染及死亡的平均數字是最高的; 而且，新型冠狀病毒肺炎的傳播速度也是最高的。研究結果亦顯示、在這些國家，政府反應所需的時間是最短的，社會限制指數的日均值是最低的，以及首宗在中國被報導的個案與首宗在有關的國家被全國性地報導的個案之間的時間距是最短的。 研究的原創性/價值 – 盡作者們所知，從前似沒有相關的研究、以國家在新型冠狀病毒肺炎大爆發初期成功控制病毒傳播的選定指數、來分析旅行及觀光競爭力指數與其部分構成因素之間的統計關係; 這正是本文所作獨特貢獻的基本證據。

The current research, guided by the intersectionality theory and the Institute of Medicine’s healthcare access model, explored the determinants of preventive care utilization within the Asian American community. Analyzing data from the Asian American Quality of Life Survey (with a sample size of 2535), logistic regression models were employed, incorporating various factors: demographic variables, immigration-related variables, health and access, and patient–provider relationship. Results revealed that longer stays in the U.S., having health insurance coverage, having a usual source of care, and higher satisfaction levels with prior healthcare services were associated with increased odds of utilizing preventive healthcare. These findings contribute to our comprehension of preventive care utilization among Asian Americans and offer practical insights for targeted interventions in social work and public health and strategic healthcare planning.

Despite the great potential for healthcare professionals, individuals, and researchers, integrating healthcare information from personal health records (PHR) and electronic health records (EHR) systems is complicated because of structural- and semantic heterogeneity and -privacy. Healthcare data is an emotional issue because of fear of privacy violations. Blockchain technology enables a patient's data privacy, transparency, and immutability in cross-organizational processes where a patient regulates access to his data and is aware of its usage. At the same time, blockchain technology creates new challenges for e-healthcare systems, such as data privacy, observability, and online enforceability. In this paper, we propose a design and formalization of a secure blockchain-based, and patient-centric system with a definition of PHR requirements, an ontology for privacy-conflict resolution- and management mechanisms that takes into account the emotional aspects related to sharing sensitive healthcare records. Throughout this paper, we illustrate our ideas with a running case about preventive- and personalized healthcare.

(1) Background: The recent epidemiological events were high-stress level generators for humanity, particularly for pregnant women, influencing their attitude, behavior, and decisions regarding vaccination during pregnancy or regarding their future child. The aim of this study was to analyze the anti-pertussis vaccination decision-shaping factors in pregnant women during two epidemiological periods: the measles epidemic and the COVID-19 pandemic. (2) Methods: Two groups of pregnant women were invited to be part of a medical education program, having as the main theme the infectious disease risks and their prevention through vaccination. Before launching the program, participants received a 12-item questionnaire. From a total number of 362 pregnant women enrolled in the study, 182 participated in 2019, and 180 participated in 2022. (3) Results: The socio-demographic data revealed that the age of pregnant women participating in medical education programs increased in 2022 by 1.7 years (p < 0.01). In vitro fertilization was reported in a significantly higher proportion (20% in 2022 vs 9.8% in 2019, p < 0.01). Participation in community-initiated educational programs almost doubled during the pandemic time from 18.7% in 2019 to 33.9% in 2022 (p < 0.01). Pertussis vaccine acceptancy (VA) dropped from 85% in 2019 to 44.4% in 2022 (p < 0.01) (4) Conclusions: In this study, we reported fast-growing vaccine hesitancy and severe declared vaccine reluctance. The results of this complex long-term study, which evaluated pregnant women over several years, showed a five-fold increase in the percentage of pregnant women who disagreed with personal pertussis vaccination. This draws attention to the risks of pertussis epidemic outbreaks in pregnant women and their future infants in the first couple of months of life before the initiation of vaccination. [ABSTRACT FROM AUTHOR]

Objective: Hepatobiliary surgery bares obstacles to informed consent for the patients due to its complexity and related risk of postoperative complications. 3D visualization of the liver has been proven to facilitate comprehension of the spatial relationship between anatomical structures and to assist in clinical decision-making. Our objective is to utilize individual 3D-printed liver models to enhance patient satisfaction with surgical education in hepatobiliary surgery. Design, setting: We conducted a prospective, randomized pilot study comparing 3D liver model-enhanced (3D-LiMo) surgical education against regular patient education during preoperative consultation at the department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany. Participants: Of 97 screened patients, undergoing hepatobiliary surgery, 40 patients were enrolled from July 2020 to January 2022. Results: The study population (n = 40) was predominantly of male gender (62.5%) with a median age of 65.2 years and a high prevalence of preexisting diseases. Underlying disease, warranting hepatobiliary surgery, was malignancy in the majority of cases (97.5%). Patients in the 3D-LiMo group were more likely to feel very thoroughly educated and exhibited a higher level of satisfaction following surgical education than the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively). Applying 3D models was also associated with enhanced understanding of the underlying disease with regard to amount (100% vs. 70%, p = 0.020) and location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also demonstrated enhanced understanding of the surgical procedure (80 vs. 55%, n.s.), leading to better awareness for the occurrence of postoperative complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were similar. Conclusion: In conclusion, individual 3D-printed liver models increase patient satisfaction with surgical education and facilitate patients' understanding of the surgical procedure as well as awareness of postoperative complications. Therefore, the study protocol is feasible to apply to an adequately powered, multicenter, randomized clinical trial with minor modifications. [ABSTRACT FROM AUTHOR]

A painful lesson got from pandemic COVID-19 is that preventive healthcare service is of utmost importance to governments since it can make massive savings on healthcare expenditure and promote the welfare of the society. Recognizing the importance of preventive healthcare, this research aims to present a methodology for designing a network of preventive healthcare facilities in order to prevent diseases early. The problem is formulated as a bilevel non-linear integer programming model. The upper level is a facility location and capacity planning problem under a limited budget, while the lower level is a user choice problem that determines the allocation of clients to facilities. A genetic algorithm (GA) is developed to solve the upper level problem and a method of successive averages (MSA) is adopted to solve the lower level problem. The model and algorithm is applied to analyze an illustrative case in the Sioux Falls transport network and a number of interesting results and managerial insights are provided. It shows that solutions to medium-scale instances can be obtained in a reasonable time and the marginal benefit of investment is decreasing. [ABSTRACT FROM AUTHOR]

HPV is the most common cause of sexually-transmitted infections the world over. The aim of this study was to assess the impact of a healthcare quality improvement strategy designed to increase the rate of vaccination against HPV in women diagnosed with cervical lesions graded as CIN2 or higher (CIN2+) during routine screening. The Veneto Regional Health Service developed a 22-item questionnaire to measure the gap between ideal procedure and real practice regarding the offer of vaccination against HPV for women undergoing routine cervical screening. The questionnaire was administered to nine expert doctors, one at each of the region's Local Health Units (LHUs). An additional specific assessment concerned the quality of the related web pages available on the LHU websites. Strategies to close the gap between ideal procedure and real practice were decided collegially, and a checklist to support good practices was developed and shared with operators at the LHUs. Changes in practice were measured using data relating to women diagnosed with CIN2+ lesions extracted from the regional oncological screening database before and after the publication of a Regional Procedure on the topic. The LHUs differed considerably in how they managed each step, in terms of training for healthcare personnel, organization and assessment of the pathway from cervical screening to HPV vaccination, and in dedicated website communication. After implementing the quality improvement strategy, the proportion of women given a first dose of HPV vaccine within 3 months of being diagnosed with CIN2+ lesions at 1st-level screening rose to 50% (compared with 30.85% beforehand), and the median time elapsing between a diagnosis of CIN2+ lesion and a first dose of HPV vaccine dropped from 158 to 90 days. These findings underscore the importance of providing training to promote vaccination for general practitioners and other clinicians. The study also confirms the need for more efforts in communication to ensure that any citizen has the opportunity to access preventive healthcare. [ABSTRACT FROM AUTHOR]

Soft, stretchable, and flexible electrodes offer a unique and nonintrusive option to monitor essential biopotential signals from the skin, which can be related to the functioning and status of different organs including the heart. Such stretchable electrodes, by forming an intimate contact to the human skin, not only increase the signal-to-noise ratio of the recorded biopotentials and reduce eventual signal artifacts, but are also more pleasant to wear. We developed a stretchable electrode patch for electrocardiogram (ECG) monitoring utilizing the medical-grade, transparent, and stretchable material Styrene-ethylene-butylene-styrene (SEBS). Our fabrication process is compatible with standard micro- and nano clean room processes and could be up-scaled accordingly.

Background: The World Health Organization urges to integrate traditional medicine into health services particularly primary health care services. The aim of this study is to evaluate the knowledge and attitudes of residents on Traditional and Complementary Medicine (T&CM) and compare the ones in the department of Family Medicine with the others. Materials and Methods: A descriptive comparative study. Residents in a training and research hospital in Istanbul were divided into three groups as Family Medicine, Surgical specialities, and other Medical specialities. A questionnaire consisting of 23 questions was prepared and applied to the residents at the hospital, using a face-to-face interview technique. Results: In this study, 245 residents from different departments participated. Among them, 68.9% (n=169) stated that T&CM applications might contribute to modern medicine. It was determined that the most known applications were Acupuncture, Cupping therapy, and Hirudotherapy. Among the participants, 11.0% (n=27) of the residents had a certificate of a T&CM applications. According to 69.2% of the residents in Family Medicine the main role of T&CM is in wellness and preventive healthcare. Among the residents in the Family Medicine, the number of participants using T&CM applications in the treatment of their own health problems was found to be higher than the ones in the other medical and surgical specialities; 38.5%, 9.6% and 10.1%, respectively (p<0.001). Conclusion: Compared to other medical and surgical specialities, residents in family medicine seem to have a more positive attitude towards T&CM practices. Further education and training are required for resident physicians to enhance their understanding of the possible efficacy and adverse effects of T&CM practices. [ABSTRACT FROM AUTHOR]

Integrating personal health records (PHRs) and electronic health records (EHRs) facilitates the provision of novel services to individuals, researchers, and healthcare practitioners. Simultaneously, integrating healthcare data leads to complexities arising from the structural and semantic heterogeneity within the data. The subject of healthcare data evokes strong emotions due to concerns surrounding privacy breaches. Blockchain technology is employed to address the issue of patient data privacy in inter-organizational processes, as it facilitates patient data ownership and promotes transparency in its usage. At the same time, blockchain technology creates new challenges for e-healthcare systems, such as data privacy, observability, and online enforceability. This article proposes designing and formalizing automatic conflict resolution techniques in decentralized e-healthcare systems. The present study expounds upon our concepts by employing a running case study centered around preventive and personalized healthcare domains. [ABSTRACT FROM AUTHOR]

This paper provides highlights from an expert meeting to explore opportunities to reduce cancer risk and promote health at older ages. Factors that increase cancer risk among older adults include exposure to carcinogens from multiple sources, chronic conditions such as obesity and diabetes, and unhealthy behaviors. Emerging research points to chronic social stressors - social isolation, loneliness, and financial hardship - as being linked to accelerated biological aging and increased cancer risk later in life. Older adults may disproportionately encounter these stressors as well as barriers to preventive health care services, accurate health information, and environments that promote health. Researchers can use existing cohort studies of older adults to deepen our understanding of the relative benefit of modifying specific behaviors and circumstances. The evidence points to the value of comprehensive, transdisciplinary approaches to promote health and reduce cancer risk across the entire lifespan, extending through older adulthood. Clinical encounters with older adults provide opportunities for psychosocial and behavioral screening and counseling. In the presence of multiple morbidities, preventive health services may offer greater health benefits than cancer-screening tests. Strategies that involve families and caregivers, promote positive attitudes about aging, and engage many different community sectors have the potential to prevent or delay the development of cancer at older ages.

This paper provides highlights from an expert meeting to explore opportunities to reduce cancer risk and promote health at older ages. Factors that increase cancer risk among older adults include exposure to carcinogens from multiple sources, chronic conditions such as obesity and diabetes, and unhealthy behaviors. Emerging research points to chronic social stressors - social isolation, loneliness, and financial hardship - as being linked to accelerated biological aging and increased cancer risk later in life. Older adults may disproportionately encounter these stressors as well as barriers to preventive health care services, accurate health information, and environments that promote health. Researchers can use existing cohort studies of older adults to deepen our understanding of the relative benefit of modifying specific behaviors and circumstances. The evidence points to the value of comprehensive, transdisciplinary approaches to promote health and reduce cancer risk across the entire lifespan, extending through older adulthood. Clinical encounters with older adults provide opportunities for psychosocial and behavioral screening and counseling. In the presence of multiple morbidities, preventive health services may offer greater health benefits than cancer-screening tests. Strategies that involve families and caregivers, promote positive attitudes about aging, and engage many different community sectors have the potential to prevent or delay the development of cancer at older ages.

Abstract Background Removing financial barriers and making healthcare accessible to all who need it remains an essential component of the United Nations’ sustainable development goals. Pro-poor healthcare financing schemes are policies that enable patients to concentrate on obtaining absolute medical care when needed rather than worrying about the cost of care. The demand for health services in healthcare facilities has increased tremendously due to the increasing burden of communicable and non-communicable diseases. This potentially threatens the sustainability of pro-poor health financing schemes. This study seeks to synthesize literature and map evidence on the use of health promotion and disease prevention interventions as a strategy to sustaining pro-poor health financing schemes globally. Methods We will conduct a systematic scoping review utilizing the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. A comprehensive keyword search for relevant published articles will be conducted in MEDLINE through PubMed, Web of Science, Google Scholar, SCOPUS, CINAHL, and Science Direct from 1 January 2000 to the last search date in 2021. Limiters such as date and language (English) will be applied, but study design limitations will be removed during the search. Boolean term AND/OR Medical Subject Heading terms will also be included. The reference list of all included articles will also be searched for potentially eligible articles. Two investigators will independently screen the articles in parallel at the abstract and full-text stages using the eligibility criteria designed in a Google form. Charting of data will also be conducted independently by two investigators using a piloted data abstraction form and thematic analysis conducted. The emerging themes will be collated, summarized, and the results reported. Discussion We hope to provide evidence of diverse health promotion and disease prevention policies/strategies used by countries to sustain their pro-poor health financing schemes for possible adoption by other countries. We also anticipate finding research gaps for further studies to help find innovative contextualized health prevention and promotion strategies to sustain pro-poor health financing schemes especially those in LMICs. The findings will be comprehensively discussed and disseminated at conferences and publication in a peer-reviewed journal.

Introduction. The article provides a first insight into local and regional folk medicine traditions of Alar Buryats (once a part of Balagansk Buryats) nowadays inhabiting Alarsky District of Ust-Orda Buryat Autonomous Okrug (Irkutsk Oblast, Russia) and clustering with Buryats from the western coast of Lake Baikal, the latter therefore referred to as ‘western’ or ‘Cis-Baikalia’ (sometimes ‘northern’) Buryats. Healing practices of present-day Alar Buryats include richest experiences of previous generations, the former largely determined by a number of natural and geographic factors and conditions of the forest-steppe zone that resulted in consistent combinations of economic patterns, such as arable farming, semi-sedentary livestock breeding, seasonal hunting and fishing. Folk medicine of this sub-ethnic group retains strong ties to shamanic beliefs to have survived the long decades and centuries of persecution. The research topic proves interesting enough since the region under consideration — like the entire Baikal Region — is characterized by a lack of Tibetan medicine influence to have resulted from Orthodox Christianity’s resistance to the expansion of Buddhism. This factor made it possible to preserve the unique ancient traditional treatment techniques, while shamanic healing patterns based on a mythological worldview also constitute a large unexplored area of Baikalia at large. So, local healing traditions remain somewhat understudied. There are only fragmentary data in some works on this subject. Goals. The study aims to analyze the available data on traditional healing practices of Alar Buryats — publications, archival materials, and field notes. Results. The article classifies a set of animal and plant medicines, methods of psychological impact, irrational practices, preventive healthcare approaches and shamanic healing methods. Special attention is paid to etymologies of names of certain diseases and dialect medical terms. An effort is made to analyze the nature of some diseases and phenomena in comparison to healing traditions of other ethnic groups with due regard of modern medical knowledge.

Cardiovascular disease (CVD) is the leading cause of mortality globally, disproportionately impacting older adults. Plant-based diets (PBDs) have emerged as a dietary strategy to mitigate CVD risk, characterized by foods derived from plants and minimal to no animal-derived foods. This integrative review assesses the effectiveness of PBDs for improving CVD risk factors in older adults. A search was conducted in CINAHL, PubMed, and Medline databases for studies of PBDs and CVD risk factors in individuals aged 65 years and older. Quality assessment was performed using the Mixed Methods Appraisal Tool (MMAT). Seventeen publications were analyzed, 7 experimental and 10 non-experimental. All studies showed at least one positive association between PBDs and cardiovascular health in older adults. Findings highlighted significant associations between PBD adherence and reductions in key CVD risk factors, such as low-density lipoprotein cholesterol (LDL-C), blood pressure, and body mass index (BMI), alongside potential benefits in reducing coronary artery calcium and enhancing endothelial function and serum isoflavone concentrations. There is evidence for the potential of PBDs as an effective dietary strategy to prevent the onset and progression of CVD in older adults and reduce the risk of CVD mortality. This review indicates the need for further research. Larger randomized control trials focused on older adults may strengthen the evidence base and guide healthcare recommendations. PBDs should be considered as a part of holistic CVD prevention and management strategies for older adults, encouraging dietary patterns that are rich in fruits, vegetables, legumes, beans, nuts, seeds, and whole grains. [ABSTRACT FROM AUTHOR]

As society moves towards a preventative approach to healthcare, there is growing interest in scientific research involving technology that can monitor and prevent adverse health outcomes. The primary objective of this paper is to develop an Internet of Things (IoT) wearable system based on Fried’s phenotype that is capable of detecting frailty. To determine user requirements, the system’s architecture was designed based on the findings of a questionnaire administered to individuals confirmed to be frail. A functional prototype was successfully developed and tested under real-world conditions. This paper introduces the methodology that was used to analyze the data collected from the prototype. It proposes an interdisciplinary approach to interpret wearable sensor data, providing a comprehensive overview through both visual representations and computational analyses facilitated by machine learning models. The findings of these analyses offer insights into the ways in which different types of activities can be classified and quantified as part of an overall physical activity level, which is recognized as an important indicator of frailty. The results provide the foundations for a new generation of affordable and non-intrusive systems able to detect and assess early signs of frailty.

Abstract Background Minerals play an important role in children’s growth and cognition. In this study, our aim was to establish reference intervals of mineral level in Children of Liaoning province (China) and provide a reliable basis for future preventive healthcare guidelines. Methods Random samples of 2217 healthy children aged 0–15 years who were referred for routine hospital laboratory examinations in the cities of Shenyang, Fushun, Fuxin, Benxi, Chaoyang and Lingyuan were invited to participate in the study. Serum levels of Calcium (Ca), Iron (Fe), Zinc (Zn), Magnesium (Mg), Copper (Cu), Manganese (Mn), Selenium (Se), Mercury (Hg), Nickel (Ni), Cobalt (Co), and Lithium (Li) were determined by inductively coupled plasma mass spectrometer(ICP-MS). Results Sex-related significant differences in the serum concentrations of the Mg and Cu (P

Introduction: Disparities in cardiovascular care are well recognized, with socioeconomic status being one of the strongest determinants of cardiovascular disease outcomes. This study evaluates whether these disparities translate to coronary artery calcium (CAC) scan utilization. Specifically, we aim to describe regional variation and socioeconomic variables that impact CAC utilization across the United States relative to the prevalence of coronary artery disease (CAD) and related comorbidities., Methods: This cross-sectional study integrates county-level CAC utilization with CAD prevalence and publicly available socioeconomic variables including self-identified ethnicity, education, and adjusted gross income. CAC utilization rates were sourced from 2022 hospital commercial claims, outpatient Medicare service claims, and independent imaging center claims. Heart disease prevalence and socioeconomic variables were extracted from the Centers for Disease Control and Prevention and the National Center for Chronic Disease Prevention and Health Promotion. Adjusted gross income per capita was gathered from Internal Revenue Service data., Results: CAC utilization was evaluated across 808 counties within the United States, representing 600,379 claims. Median utilization was 1.62 scans per 1,000 persons with a range of 0.03 to 104.39. The West had the highest CAC scan utilization rate (median 3.09 scans per 1,000 persons) with a CAD prevalence of 548 per 100,000 persons. In contrast, the Midwest had the lowest utilization rate (median 1.24 scans per 1,000 persons) with a CAD prevalence of 635 per 100,000 persons. Socioeconomic factors that favor higher CAC utilization include a larger density of White/Caucasian ethnicity (p = 0.007) and a higher adjusted gross income per capita (p = 0.006). Counties with the lowest rates of CAC utilization have a higher population of African Americans (p <0.001) and a higher proportion of females (p <0.001)., Conclusion: This analysis highlights regional and socioeconomic differences in CAC utilization in the United States. Under-represented ethnicities such as African Americans have among the lowest rates of CAC utilization despite having a higher burden and mortality from heart disease. Discordance between CAC utilization, heart disease prevalence and socioeconomic status reveals a need for targeted interventions and policies aimed at mitigating structural barriers that perpetuate health inequities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

The COVID-19 pandemic has significantly shaped population dynamics and healthcare systems. Primary care clinics in Taiwan demonstrated remarkable resilience in managing the pandemic. This adaptability is reflected in rigorous screening processes, proactive vaccination efforts, and the seamless integration of telehealth services. Noteworthy shifts have been observed in the redistribution of primary care clinics and a decline in preventive healthcare measures. In response to these challenges, Taiwan has embraced a multifaceted approach, with telehealth services, home-based clinical care initiatives, community-based care, and innovative programs, like the Hospital at Home initiative, assuming central roles in mitigating the impact of the pandemic. These strategies underscore a forward-thinking healthcare delivery approach that prioritizes patient well-being. Critical solutions include ongoing reforms in clinical practices, the contingency plans for preventive healthcare, the promotion of telehealth services, the adoption of home-based clinical care, and the enhancement of the integration of practice. Taiwan's visionary initiatives, including digital intelligent healthcare approaches, serve as a robust foundation for building a resilient and patient-centered healthcare system. These concerted efforts and healthcare innovations are necessary for shaping a comprehensive, accessible, and responsive future. Taiwan is setting a noteworthy example for global healthcare systems to follow by prioritizing the well-being of the population., Competing Interests: Declaration of competing interest None, (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background: Periodontal disease, a chronic inflammatory condition affecting the gums and surrounding tissues, has long been recognized as a threat to oral health. However, emerging research increasingly reveals its profound implications for overall health. This editorial delves into the intricate connection between periodontal disease and systemic health, shedding light on the far-reaching consequences of untreated gum disease. Conclusion: The evidence presented underscores the urgency of addressing periodontal disease not only as an oral health concern but also as a critical component of comprehensive healthcare. By recognizing and addressing the link between periodontal disease and systemic health, healthcare professionals can better prevent and manage a myriad of conditions, ultimately improving patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Background: Removing financial barriers and making healthcare accessible to all who need it remains an essential component of the United Nations' sustainable development goals. Pro-poor healthcare financing schemes are policies that enable patients to concentrate on obtaining absolute medical care when needed rather than worrying about the cost of care. The demand for health services in healthcare facilities has increased tremendously due to the increasing burden of communicable and non-communicable diseases. This potentially threatens the sustainability of pro-poor health financing schemes. This study seeks to synthesize literature and map evidence on the use of health promotion and disease prevention interventions as a strategy to sustaining pro-poor health financing schemes globally. Methods: We will conduct a systematic scoping review utilizing the Arksey and O'Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. A comprehensive keyword search for relevant published articles will be conducted in MEDLINE through PubMed, Web of Science, Google Scholar, SCOPUS, CINAHL, and Science Direct from 1 January 2000 to the last search date in 2021. Limiters such as date and language (English) will be applied, but study design limitations will be removed during the search. Boolean term AND/OR Medical Subject Heading terms will also be included. The reference list of all included articles will also be searched for potentially eligible articles. Two investigators will independently screen the articles in parallel at the abstract and full-text stages using the eligibility criteria designed in a Google form. Charting of data will also be conducted independently by two investigators using a piloted data abstraction form and thematic analysis conducted. The emerging themes will be collated, summarized, and the results reported. Discussion: We hope to provide evidence of diverse health promotion and disease prevention policies/strategies used by countries to sustain their pro-poor health financing schemes for possible adoption by other countries. We also anticipate finding research gaps for further studies to help find innovative contextualized health prevention and promotion strategies to sustain pro-poor health financing schemes especially those in LMICs. The findings will be comprehensively discussed and disseminated at conferences and publication in a peer-reviewed journal. [ABSTRACT FROM AUTHOR]

Smoking cessation efforts can be greatly influenced by providing just-in-time intervention to individuals who are trying to quit smoking. Detecting smoking activity accurately among the confounding activities of daily living (ADLs) being monitored by the wearable device is a challenging and intriguing research problem. This study aims to develop a machine learning based modeling framework to identify the smoking activity among the confounding ADLs in real-time using the streaming data from the wrist-wearable IMU (6-axis inertial measurement unit) sensor. A low-cost wrist-wearable device has been designed and developed to collect raw sensor data from subjects for the activities. A sliding window mechanism has been used to process the streaming raw sensor data and extract several time-domain, frequency-domain, and descriptive features. Hyperparameter tuning and feature selection have been done to identify best hyperparameters and features respectively. Subsequently, multi-class classification models are developed and validated using in-sample and out-of-sample testing. The developed models obtained predictive accuracy (area under receiver operating curve) up to 98.7% for predicting the smoking activity. The findings of this study will lead to a novel application of wearable devices to accurately detect smoking activity in real-time. It will further help the healthcare professionals in monitoring their patients who are smokers by providing just-in-time intervention to help them quit smoking. The application of this framework can be extended to more preventive healthcare use-cases and detection of other activities of interest. [ABSTRACT FROM AUTHOR]

HPV is the most common cause of sexually-transmitted infections the world over. The aim of this study was to assess the impact of a healthcare quality improvement strategy designed to increase the rate of vaccination against HPV in women diagnosed with cervical lesions graded as CIN2 or higher (CIN2+) during routine screening. The Veneto Regional Health Service developed a 22-item questionnaire to measure the gap between ideal procedure and real practice regarding the offer of vaccination against HPV for women undergoing routine cervical screening. The questionnaire was administered to nine expert doctors, one at each of the region’s Local Health Units (LHUs). An additional specific assessment concerned the quality of the related web pages available on the LHU websites. Strategies to close the gap between ideal procedure and real practice were decided collegially, and a checklist to support good practices was developed and shared with operators at the LHUs. Changes in practice were measured using data relating to women diagnosed with CIN2+ lesions extracted from the regional oncological screening database before and after the publication of a Regional Procedure on the topic. The LHUs differed considerably in how they managed each step, in terms of training for healthcare personnel, organization and assessment of the pathway from cervical screening to HPV vaccination, and in dedicated website communication. After implementing the quality improvement strategy, the proportion of women given a first dose of HPV vaccine within 3 months of being diagnosed with CIN2+ lesions at 1st-level screening rose to 50% (compared with 30.85% beforehand), and the median time elapsing between a diagnosis of CIN2+ lesion and a first dose of HPV vaccine dropped from 158 to 90 days. These findings underscore the importance of providing training to promote vaccination for general practitioners and other clinicians. The study also confirms the need for more efforts in communication to ensure that any citizen has the opportunity to access preventive healthcare.

Although multiple studies have shown that resettled refugee women are less likely to receive preventative cancer screenings like pap smears and mammograms, a small number have demonstrated the opposite. This retrospective chart review, conducted between January 2017 and October 2018, compares pap smear and mammogram rates of patients seen in a refugee-specific OB/GYN clinic with patients from the general OB/GYN clinic at the same institution. Data from 298 patients (149 refugee and 149 general clinic patients matched by age and date-of-visit) were analyzed. Pap smear screening rates were 90.60% in the refugee group and 73.83% in the general group [p < 0.009, aOR 3.46 (1.36–8.81)], while mammogram screening rates were 36.84% and 38.60%, respectively (p = 0.46). The provision of holistic services meeting refugee women's unique needs can effectively increase pap smear screening rates. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs) are the largest cause of disability and death globally. The human and financial costs of NCDs have raised questions of sustainability for many health systems. Personalized, preventive health interventions are an innovative way to address NCDs, but it is difficult to measure their effectiveness using standard evaluation methods. This article describes a novel approach to evaluation by coupling transdisciplinary methods with realist theory to design and pilot a health outcomes evaluation for a personalized medicine approach to NCD prevention in Istanbul, Turkey. Research and practice stakeholders contributed to study design, research questions, validation of results, and recommendations through interactive workshops, consistent dialogue, and reflection. They co-created a customized outcome measurement framework and recommendations that promote sustainability and continuous improvement of future evaluations. The participatory methods helped resolve the dichotomy between patient, practitioner, and researcher focus in the evaluation and improved stakeholders' data literacy. This research contributes to the body of evidence advocating for the use of non-standard methods such as transdisciplinary research to evaluate the effectiveness of complex interventions. The results of the pilot evaluation are also presented as a case study.

Background: Minerals play an important role in children's growth and cognition. In this study, our aim was to establish reference intervals of mineral level in Children of Liaoning province (China) and provide a reliable basis for future preventive healthcare guidelines.Methods: Random samples of 2217 healthy children aged 0-15 years who were referred for routine hospital laboratory examinations in the cities of Shenyang, Fushun, Fuxin, Benxi, Chaoyang and Lingyuan were invited to participate in the study. Serum levels of Calcium (Ca), Iron (Fe), Zinc (Zn), Magnesium (Mg), Copper (Cu), Manganese (Mn), Selenium (Se), Mercury (Hg), Nickel (Ni), Cobalt (Co), and Lithium (Li) were determined by inductively coupled plasma mass spectrometer(ICP-MS).Results: Sex-related significant differences in the serum concentrations of the Mg and Cu (P < 0.05). Age-related significant differences were found in serum levels of Ca, Fe, Zn, Mg, Cu and Mn (P < 0.05) and the concentrations of 9 minerals (Ca, Mg, Cu, Mn,Se,Hg,Ni,Co and Li in serum varied from season to season (P < 0.05). The Spearman correlation matrix of 11 minerals was shown as a heat map, the correlations between Ca-Zn, Ca-Mg, Fe-Zn, Fe-Se, Mn-Ni, Se-Hg, Se-Ni, Hg-Ni, and Ni-Co, Ni-Li were the strongest compared with others.Conclusions: The reference intervals of serum 11 minerals for children should considering the sex, age and season, which may be useful for decisive diagnoses of abnormality of the 11minerals and the related diseases. [ABSTRACT FROM AUTHOR]

Abstract Background Understanding the features of preventive care uptake is critical for assessing the performance and viability of primary care in any healthcare system. There are gaps in previous studies that focused on primary healthcare features, challenges and way forward in Nigeria but were mainly public sector focused and do not characterize the features of preventive care. Since private healthcare sector remains the most accessed and utilized in Nigeria, this study sought to characterize the features of uptake of preventive care to better understand the current preventive healthcare landscape. Method A descriptive cross-sectional study, using survey questionnaire were randomly administered to adult patients attending the Family Medicine Out-Patient Department (OPD) at Nisa Premier Hospital, Jabi Abuja. The study was conducted over a three-month period. (January to June 2017). Data collected were analyzed using SPSS version 23 (IBM SPSS, Chicago, IL, USA). Descriptive statistics in the form of frequency and percentage were used to report the results. Results A total of 381 participants completed the survey. The results revealed that while an over overwhelming majority (> 90%) of participants indicated knowledge of benefits of preventive care, and preferred interventions aimed at preventing a disease before they occur, 48% preferred interventions aimed at reducing disease or injury impact or interventions aimed at ameliorating the impact of ongoing disease or injury with long lasting effect (43%). Unfortunately, less than 40% of respondents would visit the hospital when their health condition is not serious. Important barriers to uptake of preventive care were revealed as cost (45%), distance to the healthcare provider (36%) and lack of health insurance (33%), whereas poor education (19%), social norms (13%) as well as cultural and religious beliefs (10%) towards accessing certain health services appeared to be lesser barriers. Conclusion Although people are aware of the benefits of preventive care, its uptake will greatly be enhanced through improved health insurance coverage, refocusing primary healthcare functions on preventive rather than curative care and instituting policies that mandatorily prescribe uptake for the insured, both at the individual and the insurer’s level.

Seasonal influenza vaccination (SIV) of health-care workers (HCWs) is recommended in most countries to protect them and their patients from infection. Although SIV can reduce the risk of influenza complications among vulnerable patients, vaccination uptake is generally unsatisfactory. The present study aimed to assess the impact of different programs in promoting SIV uptake among HCWs during the season 2017/2018 in four teaching hospitals in Rome. A multicentric cross-sectional study was carried out, in order to describe the four different campaigns and to assess their impact by identifying and developing a set of indicators that provide information about the vaccination services, the percentage of invited HCWs, the vaccinators’ workforce and the vaccination coverage rates. The hospitals organized different strategies: Hospital 1, 3 and 4 organized educational courses for HCWs and actively invited every single HCW through e-mail. All the hospitals organized a dedicated unit for influenza vaccination, and Hospital 1 added on-site vaccination sessions that required a large number of staff. Hospital 1 and hospital 4 registered a comparable vaccination coverage rate, 12.97% and 12.76%, respectively, while it was 6.88% in Hospital 2 and 4.23% in Hospital 3. Our indicators demonstrated to be effective and useful for analyzing the different SIV campaigns. The results suggest that the best practice to promote SIV among HCWs should include multiple approaches. Among those, an easy access to the vaccination site seems to play a key role in determining a higher vaccination coverage.

The number of deaths of a mother and child caused by maternal and child healthcare (MCH) issues has been greatly decreased recently, but still, the number is extremely high especially in developing countries. Although the governments have been given a priority in this issue, the lack of financial and human resources brings a limit. Thus, the use of low-cost but appropriate technology is required. Portable Health Clinic (PHC), a telemedicine system developed for providing primary healthcare, is such a technology. This study aimed to address this MCH issue with the aid of a low-cost PHC service involving a continuum-of-care protocol to the rural communities of Bangladesh. Moreover, this study introduces a triage protocol to distinguish high-risk patients from the early stage of the continuum of care who need special care and refer to specialized physicians to prevent unwanted deaths. [ABSTRACT FROM AUTHOR]