Public Health

Background HIV infection continues to be a major global public health issue. UNAIDS estimates that 690 000 HIV-related deaths occurred in 2019. In Morocco The number of people living with HIV was estimated at 21,000 in 2018. HIV prevalence in Morocco remains low (around 0.1%) in the general population. It is much higher among female sex workers, men who have sex with men (MSM), people who inject drugs and migrants. In Casablanca the epidemic is concentrated among MSM. The aim of this study was to describe the epidemiologic, clinical and immuno-virological characteristics of people newly diagnosed with HIV infection managed in the Ibn Rochd teaching Hospital of Casablanca. Methods A cross-sectional study was performed including patients newly diagnosed with HIV infection and managed in the infectious diseases department from January 1st, 2017 to June 30, 2018. Data were collected from patient's medical records and were analyzed using SPSS 16. Main outcomes were presented as mean ...

Background: Asthma is among the most common chronic diseases in working-aged populations and occupational exposures are important causal agents. Our aims were to evaluate the best methods to assess occurrence, public health impact, and burden to society related to occupational or work-related asthma and to achieve comparable estimates for different populations. Methods: We addressed three central questions: 1: What is the best method to assess the occurrence of occupational asthma? We evaluated: 1) assessment of the occurrence of occupational asthma per se, and 2) assessment of adult-onset asthma and the population attributable fractions due to specific occupational exposures. 2: What are the best methods to assess public health impact and burden to society related to occupational or work-related asthma? We evaluated methods based on assessment of excess burden of disease due to specific occupational exposures. 3: How to achieve comparable estimates for different populations? We evaluated comparability of estimates of occurrence and burden attributable to occupational asthma based on different methods. Results: Assessment of the occurrence of occupational asthma per se can be used in countries with good coverage of the identification system for occupational asthma, i.e. countries with well-functioning occupational health services. Assessment based on adult-onset asthma and population attributable fractions due to specific occupational exposures is a good approach to estimate the occurrence of occupational asthma at the population level. For assessment of public health impact from work-related asthma we recommend assessing excess burden of disease due to specific occupational exposures, including excess incidence of asthma complemented by an assessment of disability from it. International comparability of estimates can be best achieved by methods based on population attributable fractions. Conclusions: Public health impact assessment for occupational asthma is central in prevention and health policy planning and could be improved by purposeful development of methods for assessing health benefits from preventive actions. Registry-based methods are suitable for evaluating time-trends of occurrence at a given population but for international comparisons they face serious limitations. Assessment of excess burden of disease due to specific occupational exposure is a useful measure, when there is valid information on population exposure and attributable fractions.

Background: With the recent advent of smart phones, usage of medical apps is on rise. Smart phones are powerful devices that combine the conventional functions of a mobile phone with advanced computing capabilities enabling users to access software applications commonly termed as ''apps''. Health care applications (apps) that are downloadable on to smart phones are increasingly becoming popular among clinicians.

ABSTRAK   Penggunaan produk-produk kosmetik ilegal yang memiliki kandungan senyawa berbahaya seperti rhodamin B, merkuri, hidrokuinon, dan timbal. Berdasarkan observasi terlihat bahwa remaja lebih mengutamakan kosmetik sebagai salah satu kebutuhan mereka, salah satu cara untuk mencegah dampak negatif dari efek samping zat berbahaya dalam kosmetik adalah dengan dilakukan dengan pemberian pengetahuan. Menggunakan pendekatan menggunakan media video dan metode Focus Group Discussion, peneliti ingin melihat seberapa besar pemahaman siswa SMA Negeri 1 Rungan tentang kandungan berbahaya dalam kosmetik. Menggunakan metode penelitian true experimental dengan pengambilan data memakai Pretest and Postest Control Group Design. Hasil data akan  dianalisis menggunakan uji Wilcoxon dan uji Mann Whitney. Dengan hasil data p 0,000 pada uji Wilcoxon, Hal ini berarti pengetahuan kelompok intervensi bertambah akibat memperoleh pendidikan. Pada uji Mann Whitney juga mendapatkan nilai p 0,000 yang menunj...

Antibiotic resistance (ABR) is a growing public health concern worldwide, and it is now regarded as a critical One Health issue. One Health’s interconnected domains contribute to the emergence, evolution, and spread of antibiotic-resistant microorganisms on a local and global scale, which is a significant risk factor for global health. The persistence and spread of resistant microbial species, and the association of determinants at the human-animal-environment interface can alter microbial genomes, resulting in resistant superbugs in various niches. ABR is motivated by a well-established link between three domains: human, animal, and environmental health. As a result, addressing ABR through the One Health approach makes sense. Several countries have implemented national action plans based on the One Health approach to combat antibiotic-resistant microbes, following the Tripartite’s Commitment Food and Agriculture Organization (FAO)-World Organization for Animal Health (OIE)-World He...

Social media has been embraced as a tool for public health promotion. However, effective strategies for harnessing the capabilities of social media remain unclear. For example, many state and local health departments have adopted Facebook and Twitter accounts, yet public engagement with these accounts varies. Several Web-based interventions for smoking cessation have been developed, but few tobacco prevention Web sites allow users to share links via social media. While YouTube videos with health messages have amassed millions of views, such as a popular video targeting soft drink consumption, their long-term impact is difficult to evaluate. In general, innovative approaches to disseminating health information must be developed to match the behavior and expectations of the public. 17 The potential for Web-based public health campaigns is tremendous. Nearly three quarters of Internet users conduct health-related searches each year. One third of US adults access health information through social media. Web sites can be practical and cost-effective platforms for spreading public health information, but traditional Web sites, often static and noninteractive, face challenges. With thousands upon thousands of health-related Web pages, the sheer volume of online content dilutes attention to any single health message. 8 This message may also be lost in the noise of misinformation available online. By enabling the person-to-person spread of information within networks of users, social media

This article highlights recent guidance from the National Institute for Health and Care Excellence (NICE). It highlights the organization's response to the COVID-19 pandemic and then provides a spotlight on workplace health in the context of long-term sickness absence and capability to work. It discusses some of the actions that need to be taken by a range of stakeholders in order to implement NICE guidance in this area and aid employees in ensuring good workplace health. The NICE guidance on workplace health, discussed in this article, predates the current pandemic. Comment is made specifically on fitness for work assessments, where the COVID-19 pandemic has posed a range of unique clinical challenges. In response to the coronavirus pandemic, the National Institute for Health and Care Excellence (NICE) has taken a number of actions. Details of public health guidance in development and any changes to schedules are available on the NICE website. Guidance in development has been reviewed so that therapeutically critical topics and those that affect people identified as extremely vulnerable to COVID-19 have been prioritized. NICE has also published a series of rapid COVID-19 guidelines covering management of symptoms and complications, managing conditions that increase risk, and the provision of various services during the pandemic.

Background: Public and Patient Involvement, Engagement and Participation research encompasses working with patients/service users (people with a medical condition receiving health service treatment), public members, caregivers and communities (who use services or care for patients). The Partner Priority Programme (PPP) was developed by the

Background:Emerging evidence describes impacts of the COVID-19 pandemic upon people living with dementia and their informal carers, however without evidence-based global comparisons to date. The aim of this international study was to explore and compare the impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries.Methods:People with dementia and informal carers from the UK, Australia, Italy, India, and Poland participated in remote semi-structured interviews. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.Results:Fifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support; (2) Technology and is...

Background Sudden public health restrictions can be difficult to comprehend for people with cognitive deficits. However, these are even more important for them to adhere to due to their increased levels of vulnerability, particularly to COVID-19. With a lack of previous evidence, we explored the understanding and changes in adherence to COVID-19 public health restrictions over time in people living with dementia (PLWD). Methods Unpaid carers and PLWD were interviewed over the phone in April 2020, shortly after the nationwide UK lockdown, with a proportion followed up from 24th June to 10th July. Participants were recruited via social care and third sector organisations across the UK, and via social media. Findings A total of 70 interviews (50 baseline, 20 follow-up) were completed with unpaid carers and PLWD. Five themes emerged: Confusion and limited comprehension; Frustration and burden; Putting oneself in danger; Adherence to restrictions in wider society; (Un) changed perception...

Background The Household Health Survey (HHS) was developed to understand the socioeconomic determinants of mental and physical health, and health inequalities in health and social care. This paper aims to provide a detailed rationale of the development and implementation of the survey and explore socio-economic variations in physical and mental health and health care. Methods This comprehensive longitudinal public health survey was designed and piloted in a disadvantaged area of England, comprising questions on housing, physical health, mental health, lifestyle, social issues, environment, work, and finances. After piloting, the HHS was implemented across 28 neighbourhoods – 10 disadvantaged neighbourhoods for learning (NfLs), 10 disadvantaged comparator sites, and eight relatively advantaged areas, in 2015 and 2018. Participants were recruited via random sampling of households in pre-selected neighbourhoods based on their areas of deprivation. Results 7731 residents participated in...

BackgroundHigh demand for health services is an issue of current importance in England, in part because of the rapidly increasing use of emergency departments (EDs) and GP practices for mental health conditions and the high cost of these services.AimTo examine the social determinants of health service use in people with mental health issues.Design and settingTwenty-eight neighbourhoods, each with a population of 5000–10 000 people, in the north west coast of England with differing levels of deprivation.MethodA comprehensive public health survey was conducted, comprising questions on housing, physical health, mental health, lifestyle, social issues, environment, work, and finances. Poisson regression models assessed the effect of mental health comorbidity, mental and physical health comorbidity, and individual mental health symptoms on ED and general practice attendances, adjusting for relevant socioeconomic and lifestyle factors.ResultsParticipants who had both a physical and mental...

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of ...

The biopsychosocial model of health in a limited life course perspective was tested among students in higher education using data from a nationwide cross-sectional survey of students on track to become teachers in Hungary. Health determinants were grouped into categories of biological, psychological, and social determinants and arranged in a temporal manner from childhood to the present. The model was tested by canonical correlation analysis followed by multivariate analysis of covariance. One composite outcome of health and six determinant groups were examined out of a total of 24 variables in both genders. Separate sets of health determinants were identified for men and women. The health of men was determined by fewer variables that were more proximal in time, more centred around physical activity, and less influenced by social relations. As opposed to that of men, women’s health was influenced by age; determinants were grouped around the ingestion of various substances and social...

Introduction Mental disorders constitute an increasingly important public health problem in the general population. Therefore, investigation of the determinants and state of mental health of those who will be treating patients, that is, future medical doctors, is justified. The paper gives an account of a mental health survey of medical students at a university in Hungary. Methods A representative sample of year I-V students (N = 100) filled an anonymous standardized self-administered questionnaire that included demographic and socioeconomic items, mental well-being characterized by a sense of coherence (SOC) and psychological distress, as well as health behaviour. SOC was measured by the 13-item Antonovsky questionnaire and psychological distress was measured by the 12-item general health questionnaire (GHQ). Models for estimating mental well-being in relation to various determinants were built by backward stepwise regression. Results Almost one-fifth of the students scored above the strict threshold on the GHQ indicating notable psychological distress. SOC showed significant positive correlation with perceived health and significant negative correlation with psychological distress. SOC and psychological distress were determined by different sets of explanatory variables in the regression models. Psychological distress and the use of sedative without medical prescription are inversely related to SOC; whereas social support and female gender show positive correlation to SOC according to our estimation. SOC, as expected, was a strong explanatory variable for psychological distress, forecasting an improvement in the GHQ score. Conclusion Psychological distress was significantly greater in our sample of Hungarian medical students than in the same age group of the general population. Psychological distress is strongly related to SOC and can be estimated by our proposed models. Both SOC and psychological distress can be used to characterize the mental health of future medical doctors, the improvement of which needs attention even during their training.

Background: Patient education plays a key role in health care. In our study, we created a new information guide for patients waiting for total knee (TKA) or hip (THA) arthroplasty. The goal of our study was to create patient education material that would reduce patients’ fear of surgery and improve their postoperative lifestyle. Methods: Patients in the intervention group (n = 44) received newly developed paper-based patient education material before surgery. The surgical fear questionnaire (SFQ) was used to assess fear reduction. A self-designed assessment questionnaire was used to measure the effectiveness of the leaflet among the intervention group patients. Results: The SFQ scores decreased significantly both in patients with TKA (median 37.50 IQR 30.00–40.00 vs. median 20.00 IQR 16.00–24.00) and THA (median 34.50 IQR 28.00–42.00 vs. median 20.00 IQR 16.00–22.00). A control group with TKA (median 37.50 IQR 30.00–40.00 vs. median 64.50 IQR 54.00–82.00) and THA (median 34.50 IQR 2...

Background: Diabetes Mellitus is one of the four major non-communicable diseases causing about 4 million deaths in 2017. By 2040, low income countries are projected to experience 92% increase in mortality due to diabetes. Undiagnosed diabetes poses a public health concern with costly public health implications especially in Africa. It is therefore crucial to examine the burden and risk factors for diabetes at national level to inform policy and national programs. Methods: Data from the 2015 Kenya national STEPs survey of adults aged 18-69 years were used. Pre-diabetes was defined as impaired fasting blood glucose level (6.1 mmol/l to < 7 mmol/l) while diabetes was defined as impaired fasting blood glucose level ≥ 7 mmol/l. Descriptive statistics were used to determine the prevalence of pre-diabetes and diabetes and logistic regression was used to identify associated factors. Results: Complete data for 4069 respondents (51% females), with 46% aged 18-29 and 61% in rural areas were analyzed. The age-standardized prevalence for pre-diabetes and diabetes were 3.1% (95% CI: 2.2, 4.0) and 2.4% (1.8, 3.0) respectively. Only 43.7% were aware of their glycemic condition, one in five of those who had diabetes had received treatment, and only 7% of those diagnosed with diabetes had their blood glucose under control. Primary education ((both incomplete (0.21, 95%CI 0.10-0.47) and complete (0.40, 95%CI 0.23-0.71)) were associated with lower odds of pre-diabetes. Older age (60-69 years, AOR; 5.6, 95%CI 2.1-15.1) and raised blood pressure (2.8, 95% CI 1.5-5.0) were associated diabetes while overweight/obesity among women was associated with diabetes. The overall diabetes prevalence in Kenya is consistent with what has been reported in other sub-Saharan African countries. Of concern is the higher prevalence of pre-diabetes and undiagnosed diabetes that can progress to complications in the absence of interventions and the low diabetes awareness and control. This is the first nationally representative study to identify important groups at risk of pre-diabetes and diabetes that can be targeted for screening, health promotion and treatment.

The number of people with overweight and obesity issues has been increasing rapidly worldwide. This increase is related to many factors including physical activity, social background, economic development, cultural practices, etc. This study examined the body mass index (BMI) of 25,373 children, aged 6-12 years, from four Asian cities to assess children's health status and the association of geographical location with BMI issues. BMI data were calculated and classified according to the WHO criteria. Differences in height, weight, and BMI were calculated for boys and girls from different cities. Cross-city analyses revealed significant differences: children from the cities in higher latitudes had the highest chances of problems with overweight and obesity, compared with those in latitudes close to equator. There were a greater number of obese boys than girls. The most rapid increase of overweight and obesity issues in children occurred from ages 8-10 years, suggesting that this was a critical period in their development. Our findings suggest a geographical trend of a gradual increase in overweight and obesity issues from south to north. Weight management and physical activity programs for children aged 8-10 years could be effective for easing the increase among overweight and obesity.

Background: Continuous positive airway pressure (CPAP) is considered the treatment of choice for obstructive sleep apnea (OSA), and studies have shown that there is a correlation between patient adherence and treatment outcomes. Newer CPAP machines can track adherence, hours of use, mask leak, and residual apnea-hypopnea index (AHI). Such data provide a strong platform to examine OSA outcomes in a chronic disease management model. However, there are no standards for capturing CPAP adherence data, scoring flow signals, or measuring mask leak, or for how clinicians should use these data. Methods: American Thoracic Society (ATS) committee members were invited, based on their expertise in OSA and CPAP monitoring. Their conclusions were based on both empirical evidence identified by a comprehensive literature review and clinical experience. Results: CPAP usage can be reliably determined from CPAP tracking systems, but the residual events (apnea/hypopnea) and leak data are not as easy to interpret as CPAP usage and the definitions of these parameters differ among CPAP manufacturers. Nonetheless, ends of the spectrum (very high or low values for residual events or mask leak) appear to be clinically meaningful. Conclusions: Providers need to understand how to interpret CPAP adherence tracking data. CPAP tracking systems are able to reliably track CPAP adherence. Nomenclature on the CPAP adherence tracking reports needs to be standardized between manufacturers and AHI Flow should be used to describe residual events. Studies should be performed examining the usefulness of the CPAP tracking systems and how these systems affect OSA outcomes.

Objective: Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the 'gate-keeper' CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. Methods: The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients' demographic and health status characteristics. Results: Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by their providers. The study suggested that the Dongguan model (based on insurance mandate and using family practice physicians as 'gate-keepers') seemed to work best in terms of improving access and quality for patients with chronic conditions. The study suggested adequately funded and well-organized primary care system can play a gatekeeping role and has the potential to provide a reasonable level of care to patients.

Background Trachoma, the leading infectious cause of blindness, is caused by the bacterium Chlamydia trachomatis (Ct). Despite enormous disease control efforts and encouraging progress, trachoma remains a significant public health problem in 44 countries. Ethiopia has the greatest burden of trachoma worldwide, however, robust data exploring transmission risk factors and the association between socio-economic status is lacking from some regions. This is the first study to investigate these factors in this South-Eastern region of Oromia, Ethiopia. Methodology/Principal findings A total of 1211 individuals were enrolled from 247 households in Shashemene Rural district in Oromia Region between 11th April and 25th June 2018, of whom 628 (51.9%) were female and 526 (43.4%) were children aged 1–9 years. Three standardised ophthalmic nurses examined each participant for the presence of active trachoma using the WHO simplified trachoma grading system. Conjunctival swab samples were collected...

Objective-Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Results-Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families.

Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma...

In this issue of the International Journal of Drug Policy, Cooper et al. report results from an ecological study that found that police crackdowns were not associated with elevated hospitalisations for injection-related abscesses and endocarditis in New York City (2005). This paper makes many insightful points in the discussion section related to possible explanations. We would like to discuss three important points regarding the intersection between law enforcement and public health as it pertains to illicit drug users in the US. First, this study adds to the literature documenting high health care utilisation and costs among injection drug users (IDUs), especially for potentially preventable conditions such as abscesses and endocarditis. This study documented 48,986 hospitalisations for abscesses and cellulitis and 5452 hospitalisations for endocarditis related to drug injection in New York City (NYC) over 5 years. The rates of hospitalisations for these conditions increased overall during the study period, despite studies suggesting that the number of IDUs in NYC declined during the same period . As the authors stated, costs at San Francisco General Hospital (SFGH) for 1326 hospital admissions in 1999 for IDU-related abscesses and cellulitis were nearly $10 million (Centers for Disease Control and Prevention, 2001). The hospitalisations documented in Cooper's study represent significant expenditures for hospital care which disproportionately impact hospitals serving poor, minority, and vulnerable patients that are already overburdened and strapped for resources. Second, these excessive costs are preventable. Interventions aimed at increasing receipt of timely and appropriate ambulatory care by IDUs have been successful in reducing hospitalisation rates and associated health care costs. In response to the high costs at SFGH, an outpatient clinic was opened devoted to ambulatory treatment of abscesses and cellulitis among IDUs. The design of the clinic is specifically tailored to the needs of active IDUs providing wound care along with referrals to substance abuse treatment and social services on a walk-in basis. In the first year of operations, the clinic resulted in a 47% decrease in surgical service admissions, a 34% reduction in ER visits, and estimated savings of over $8 million . Provision of timely

Legislation permitting non-prescription syringe sales (NPSS) was passed in 2004 in California as a structural intervention designed to expand access to syringes for injection drug users. As of December 2009, 19 of California's 61 local health jurisdictions (LHJs) have approved policies to authorize pharmacies to sell nonprescription syringes. The legislation faces termination in 2010 if current evaluation efforts fail to demonstrate outcomes defined in the legislation. Using qualitative methods, we examined the systems and procedures associated with implementation; identified facilitators and barriers to implementation among 12 LHJs, and documented the role of public health in initiating and sustaining local programs. We identified consistent activities that led to policy implementation among LHJs and discovered several barriers that were associated with failure to implement local programs. Factors leading to NPSS were public health leadership; an inclusive planning process, marketing the program as a public health initiative; learning from others' efforts, successes, and failures; and identifying acceptable syringe disposal options in advance of program implementation. Health departments that were confronted with political and moral arguments lost momentum and ultimately assigned a lower priority to the initiative citing the loss of powerful public health advocates or a lack of human resources. Additional barriers were law enforcement, elected officials, and pharmacy opposition, and failure to resolve syringe disposal options to the satisfaction of important stakeholders. The lessons learned in this study should provide useful guidance for the remaining LHJs in California without NPSS programs.

The neonatal mortality rate is still a significant public health problem in Sub-Saharan African countries and an indicator of the quality of prenatal and perinatal care. This study aimed to determine the neonatal intra-hospital neonatal mortality rate and the maternal and neonatal risk factors associated with neonatal mortality in Kyeshero Hospital. Methods: This research was a cross-sectional analytical study, which took place over a period of 12 months, from January 1 to December 31, 2021, at Kyeshero Hospital in Goma, Eastern Democratic Republic of Congo. The Intra-hospital neonatal mortality rate was 17.0%. The multivariate analysis showed various risk factors associated with newborns that low birth weight < 2500 gr ORa = 4.11 (2.17-7.77), Presence of cyanosis ORa = 3.88 (1.97-7.65), absence of reactivity ORa = 20.07 (8.07-49.55), and neonatal infection ORa = 4.78 (2.47-9.22) are real predictor factors of neonatal mortality. This study noted that neonatal mortality was influenced by neonatal factors. Proper care of the newborn should improve neonatal vital prognosis. The study of preventable causes of death and factors that lead to early neonatal death is fundamental to reducing the infant mortality rate in the world.

Introduction Improved hygiene and sanitation practices in educational settings are effective for the prevention of infections, controlling the transmission of pathogens, and promoting good health. Bangladesh has made remarkable advances in improving higher education in recent decades. Over a hundred universities were established to expand higher education facilities across the country. Hundreds of thousands of graduate students spend time in university settings during their studies. However, little is known about the sanitation and hygiene practice of the university-going population. This study aims to understand and uncover which factors influence students’ sanitation and hygiene behavior in university settings. Methods This study was conducted in a public university named Shahjalal University of Science and Technology located in a divisional city of Bangladesh. Based on the Integrated Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH), we adopted an exploratory qualita...

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Origin and spread of current novel coronavirus raised serious concerns among stakeholders around the globe. Different speculations which may unfold the mystery in the future are taking roots, but now there is no globally acceptable opinion about the origin and spread of this novel coronavirus. It is reported that Wuhan city of Hubei Province of central China was the epicenter of this outbreak of novel coronavirus. However, initial inadequate preventive measures allowed the infection to cross the borders of China and that pull the world into a drastic public health and economic crisis. This novel coronavirus disease now named as COVID-19 by World Health Organization (WHO) and the responsible coronavirus is named as 'severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)'. The spread of SARS-CoV-2 is alarming even after five months of inception and WHO further warns the world to be prepared for more intense spread of COVID-19.Different diagnostic tools to detect SARS-CoV-2 are being used around the globe, but the identification of asymptomatic carriers of the disease is a serious challenge in countering the COVID-19 pandemic. There is no specific treatment available, only preventive, symptomatic and supportive treatments are being used for clinical management of COVID-19. The available knowledge is limited therefore any escalation of information on the disease will help to combat with this global challenge of COVID-19. In this review, we have discussed and summarized the available multi-factorial information and recent updates on the SARS-CoV-2 which can support future research and may help in the strategic management of currentCOVID-19 pandemic. The articles available online before 30 April 2020 on bioRxiv, medRxiv, ChemRxiv, Google scholar and PubMed have been assessed for compilation of this review. Information on the official portal of WHO, CDC, ICMR etc were also assessed and used with due credit.

Background Our objectives were to compare safe sleep knowledge, attitudes and planned vs. actual infant sleep practices among expectant mothers before and after their infant's birth and to determine whether differences (if present) were associated with any demographic variables. Methods Study participants were surveyed at their 28-week prenatal and 6-week postpartum obstetric clinic visits from November 2019-February 2021. Due to COVID-19 pandemic cancellation of in-person postpartum visits, many participants received text messaging encouraging them to take the follow-up survey online. Frequency and comparative analyses were performed. Results 355 women (44%) completed both pre-and postnatal surveys. Many participants increased their safe sleep knowledge during the study. For example, of those who were unsure or thought it safe for a baby to sleep in a baby swing/bouncy seat, two-thirds (67/102, 66%) stated it was unsafe on the postnatal survey. In addition, many who were unsure or planned sleep practices considered unsafe prenatally reported utilizing safe sleep practices on their postnatal survey. For example, of those unsure or planning to use a crib bumper (17% of the total), almost all (88%) were not using one postnatally. Conversely, some participants who reported they would be following safe sleep practices prenatally were not doing so postpartum. For example, 13% of those stating they would place their child on their back reported using another sleep position on the postnatal survey. Certain demographics had higher proportions reporting this reversal for specific safe sleep practices. For example, non-Hispanic Whites (19%) as compared to other races/ethnicities (5%) and those with incomes ≥ $75,000 (21%) as compared with those with less income (9%) had higher proportions stating their infant would sleep in the same room but then reported postnatally they were sleeping in a different room, p = 0.0094 and p = 0.0138, respectively.

Objective:To determine the prevalence of obesity and body fat distribution of Moroccan women of childbearing age, using a panel of anthropometric measurements.Design and setting:A cross-sectional survey conducted in 1995 in an agricultural community, El Jadida province of Morocco. Weight, height, waist and hip circumferences and triceps, biceps, subscapular and supra-iliac skinfold thicknesses were measured. Body mass index (BMI), waist/hip ratio (WHR), sum of all and sum of trunk skinfold thicknesses were determined.Subjects:In total, 1269 women aged 15–49 years from urban and rural areas were surveyed.Results:The means of all anthropometric measurements including body fat were higher in urban than in rural women and increased with age. Trunk fat contributed 50% of total fat. Globally, 4.7% of women were underweight (BMI &lt; 18.5 kg m−2), 35.2% were overweight or obese (BMI ≥ 25 kg m−2), 10.1% were obese (BMI ≥ 30 kg m−2) and 16.8% had central obesity (WHR &gt; 0.85). The prevalen...

ObjectiveTo present the Mediterranean diet (MD) pyramid: a lifestyle for today.DesignA new graphic representation has been conceived as a simplified main frame to be adapted to the different nutritional and socio-economic contexts of the Mediterranean region. This review gathers updated recommendations considering the lifestyle, dietary, sociocultural, environmental and health challenges that the current Mediterranean populations are facing.Setting and SubjectsMediterranean region and its populations.ResultsMany innovations have arisen since previous graphical representations of the MD. First, the concept of composition of the ‘main meals’ is introduced to reinforce the plant-based core of the dietary pattern. Second, frugality and moderation is emphasised because of the major public health challenge of obesity. Third, qualitative cultural and lifestyle elements are taken into account, such as conviviality, culinary activities, physical activity and adequate rest, along with proport...

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Among the limitations of their study, the authors list the unavailability of German health data of sufficiently high quality (1). Indeed, the precise data sources for Germany remain largely unmentioned. The methods of the Global Burden of Disease (GBD) Study comprise the possibility to transfer data from other countries to Germany while considering national risk factors, which may lead to erroneous estimates. For this reason, in a comparison calculation we estimated the years of life lost (YLL) due to diabetes on the basis of the KORA-S4/F4 study. KORA is a population based, prospective cohort study that includes undiagnosed diabetes in addition to patients with diagnosed type 2 diabetes (2). When extrapolating the YLL which result from the KORA data for 2007 by means of an epidemiological model (3) to the age structure in Germany in 2010, the calculation shows 166 000 (95% CI 81 000-278 000) YLL due to diabetes for men and 137 000 (55 000 to 243 000) YLL for women. This tallies very well in the sex ratio as well as in the magnitude of the GBD estimates of 140 000 YLL and 110 000 YLL, respectively (1). These data and the prognoses from (3) stress the enormous individual and societal burden of diabetes in Germany

The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence on a worldwide basis to the BMJ Publishing Group Ltd and its Licencees to permit this article (if accepted) to be published in JECH and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence.

Assessment of diagnostic and prognostic scores is an important public health issue, and is needed to validate the performance of scores, to find out which of several scores does best, or to assess whether a given score improves after inclusion of additional variables. To make this decision, areas under the receiver operating curves (AROCs), sometimes called c-values, are widely used. As indicated by its name, AROC is the area under the ROC curve, that is the curve obtained by plotting the true positive rate (Sensitivity) against the false positive rate (1-Specificity) for all possible cut-offs of a given disease score. In logistic regression the AROCs can be calculated from all discordant pairs of subjects each consisting of one case and one non-case. The AROC is identical to the proportion of pairs for which the estimated probability of getting the disease is larger for the case than for the noncase (Table ). This has been extended to survival time analyses. The principal idea is to compare all pairs of individuals with either two events or with one event and one non-event, and the so called overall C accords to the proportion of comparisons where the predicted probability of survival is larger for the individual with the larger actual survival time (Pencina and D 0 Agostino 2004). Theoretically, AROCs range from 0 to 1. The worst value possible is 0.5, i.e., the model is no better than 1 Case 0.

Argentina&#39;s initial social policy response to Covid-19 focused on protecting employment, wages and basic living conditions. Key policies included cash transfers and food programs for vulnerable families, wage subsidies for private sector workers and subsidized loans for firms and self-employed workers. The government also dictated a set of new regulations on employment, prices and housing, among others, to reduce the social costs of the pandemic. This paper offers an overview of Argentine social policy response measures taken up until September 2020. It focuses on the social policy instruments specifically oriented to the most vulnerable workers and families, including a new cash transfer program for adults with no regular income (Emergency Family Income or IFE), reaching about 8.6 million people in the first round. Overall, Argentina&#39;s social policy response involved multiple instruments aimed to operate on several fronts; however, the social and economic costs remain very ...

This paper used Our World data for coronavirus disease-2019 (COVID-19) death count, test data, stringency, and transmission count and prepared a path model for COVID-19 deaths. We augmented the model with age structure-related variables and comorbidity via non-communicable diseases for 117 countries of the world for September 23, 2021, on a cross-section basis. A broad-based global quantitative study incorporating these two prominent channels with regional variation was unavailable in the existing literature. Old age and comorbidity were identified as two prime determinants of COVID-19 mortality. The path model showed that after controlling for these factors, one SD increase in the proportion of persons above 65, above 70, or of median age raised COVID-19 mortality by more than 0.12 SDs for 117 countries. The regional intensity of death is alarmingly high in South America, Europe, and North America compared with Oceania. After controlling for regions, the figure was raised to 0.213,...

The pro-inflammatory cytokine Interleukin-6 (IL-6) -and T-T-cells play a major role in the pathogenesis and prognosis of many respiratory tract infections. Our study aimed to evaluate the role of T-Lymphocyte and IL-6 in Chronic Obstructive Pulmonary Disease (COPD) patients post-exposure to Tobacco or Tuberculosis. A cross-sectional prospective study was carried out from February 2021 to July 2022. Participants were enrolled at the Yaoundé Jamot Hospital. The intervention group comprised patients with post-TB/AFO (Tuberculosis/Airflow obstruction) and those with COPD related to tobacco, healthy subjects served as control. Spirometry results were obtained from the medical records. T-lymphocyte and IL-6 concentrations were measured by flow cytometry and ELISA (Enzyme-linked immunosorbent Assay) respectively. 150 participants were enrolled, 90 COPD patients and 60 healthy people. The COPD patients consisted of 50 with a history of smoking (COPD/tobacco) and 40 with a history of tuberculosis (post-TB/AFO). The level of IL-6 and CD4 cells (cluster differentiation) was higher in COPD patients compared to the control group (p-value 0.0001 and 0.0006 respectively). CD8 counts were higher in COPD/tobacco than in post-TB/AFO (p = 0.0043). were not statistically different between COPD/tobacco and post-TB/AFO.

To determine the role of racial background, public health initiatives, and residence on the prevalence of orofacial clefts (OFCs) in New York City (NYC). Retrospective review of OFC cases from the New York State Congenital Malformations Registry. Patients born with an OFC and all live births to mothers residing in NYC between 1983 and 2010. Orofacial cleft birth prevalence by cleft type, race, and borough of maternal residence for each year and by time period around the implementation of public health interventions including folate supplementation. A total of 3557 cases were reviewed. The prevalence remained stable for cleft palate and cleft lip with or without cleft palate (CL ± P) in sequential time periods of the study. Among CL ± P cases, cleft lip prevalence decreased early in the study compared to increases in cleft lip and palate prevalence. For most years, the prevalence of OFCs was lower among African Americans than whites. A total of 12% to 26% of mothers in 4 of the NYC b...

Life expectancy at birth is one of the most critical indicators of a population's health, reflecting the cumulative effects of healthcare access, lifestyle, socioeconomic factors, and public health strategies (1). Between 2000 and 2022, life expectancy trends in Iraq were shaped by political instability, conflicts, economic sanctions, and evolving risk factors such as lifestyle-related diseases, environmental hazards, and fragmented health services. This article explores these trends, focuses on statistical data and regional comparisons, and recommends actions to address Iraq's public health challenges.

Promoting the use of contraception among adolescents is essential to improving their sexual and reproductive health. Teenage pregnancies are becoming more common, and the Nabdam area continues to have low rates of use of contemporary contraceptive methods. These

Background-Methamphetamine (METH) is an increasing popular and highly addictive psychostimulant with a significant impact on public health. Chronic METH exposure has been associated with neurotoxic effects, profound neuropsychological deficits, and impaired quality of life, but few studies have examined the effect of the drug on the ability to carry out everyday activities. We assessed the effect of METH dependence on everyday functioning using the UCSD Performance-Based Skills Assessment (UPSA-2), a performance-based measure designed to evaluate real-life skills. Method-UPSA-2 performance was quantified in 15 currently abstinent individuals with a history of METH dependence and 15 drug-free comparison subjects. The Positive and Negative Syndrome Scale (PANSS) and Wisconsin Card Sorting Task (WCST) were administered to assess psychopathology and executive function. Results-METH-dependent participants exhibited significant impairment on the UPSA-2 total score and several UPSA-2 subscales, including comprehension, finance, transportation, communication, and medication management compared to drug-free comparison subjects. Lower UPSA-2 scores were associated with impaired performance on the WCST, higher PANSS scores, and drug use at an earlier age. dependence may be associated with decreased everyday functioning ability potentially mediated by frontal cortex dysfunction or the emergence of psychopathology related to chronic drug use.

Bitki caylari (tibbi bitki caylari olarak da adlandirilmaktadir), saglik uzerine olumlu etkilerinden dolayi her yas grubu tarafindan tuketilmektedir. Bu calismada tuketici seviyesinde ambalajli ve/veya ambalajsiz olarak satisa sunulan farkli bitki caylarinin (kekik, nane, rezene, adacayi, ihlamur, hatmi, sinameki, defne, civanpercemi ve anason) hijyenik kalitesinin belirlenmesi amaclandi. Analiz edilen 120 ornegin %95, %90, %77.5, %74.16, %42.5, %14.17, %3.3 ve %2.5’inin sirasiyla toplam mezofilik aerobik bakteriler (TMAB), kuf-maya, Enterobacteriaceae, koliform, sulfit indirgeyen anaerob bakteriler, Staphylococcus-Micrococcus spp., Escherichia coli ve Salmonella spp. ile kontamine oldugu belirlendi. Ancak orneklerin hicbirinde Staphylococcus aureus ve Bacillus cereus tespit edilmedi. En yuksek ortalama TMAB (5.03 log10 kob/g) ve kuf-maya sayisi (4.78 log10 kob/g) nane orneklerinde, Enterobacteriaceae (4.19 log10 kob/g) ve koliform sayisi ise hatmi (3.87 log10 kob/g) orneklerinde bu...

A esquistossomose é considerada um problema de saúde pública que atinge todo o Brasil, a exemplo do município de Jequié, Bahia, o que expressa a importância da realização de estudos sobre sua incidência. O objetivo deste estudo foi analisar a prevalência da esquistossomose em Jequié-BA, relacionando-a às políticas públicas propostas pelo Ministério da Saúde. Trata-se de uma pesquisa epidemiológica, quantitativa, descritiva e exploratória com base em dados obtidos do Sistema de Informação de Agravos Notificáveis (SINAN), do Programa Especial de Controle da Esquistossomose (PECE), da Diretoria de Informação em Saúde (DIS)/Bahia, do Centro de Endemias da cidade de Jequié e da 13ª Diretoria Regional de Saúde (DIRES)/Bahia. Os dados, analisados com o emprego do Software Tabwin do Ministério da Saúde, demonstram que, entre 2001 e 2008, Jequié apresentou 13.408 casos de esquistossomose, sendo o ano de 2004 o de maior prevalência (29,5%). Embora tenha havido uma redução nos últimos dois anos (3,9% em 2007 e 3,5% em 2008) a taxa de positividade de esquistossomose da regional de Jequié, no período de 2001 a 2006, ultrapassou o percentual de 5% preconizado pelo Ministério da Saúde. Estes dados reforçam a necessidade de políticas públicas e medidas de controle da esquistossomose no município, com enfoque não apenas no tratamento medicamentoso, mas também em saneamento básico, educação ambiental e educação para a saúde. DESCRITORES: Esquistossomose. Planejamento. Gestão. Políticas de saúde.