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Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations. [ABSTRACT FROM AUTHOR]

Specialize? Diversify? Do patients care? The authors investigate the demand-side effects of a hospital's portfolio strategy, which entails decisions about the depth and breadth of its service offerings. Positing that both depth (focus) and breadth (related focus) signal expertise, the authors use both archival and experimental evidence to examine these effects. The archival study is based on Florida's State Inpatient Databases for 2006–2015 and spans all major departments in health care delivery. The empirical analysis exploits plausible exogenous variation from other health care markets and reveals that patient choice is positively influenced by a hospital's depth (focus) and breadth (related focus) of expertise in a department. Complementing the archival evidence, the authors also conducted online experiments to examine the signaling effects of hospital portfolio strategy on patient choice behavior. The results provide support for the idea that hospital portfolio strategy influences patients' perceptions of hospital expertise in focal and related areas and, subsequently, their choice behavior. The authors also highlight potential synergistic effects between focus and related focus and heterogeneity in the effects across departments, payer types, and hospital profit status. These findings underscore the need for managers to adopt a targeted approach to portfolio decisions in health care. [ABSTRACT FROM AUTHOR]

Background: Oral diseases are a significant global public health challenge. Current evidence indicates that several chronic conditions are individually associated with tooth loss. People are living with more than one chronic condition, known as multimorbidity (MM). Considering the common risk factors for oral and chronic diseases, this study aimed to evaluate the association between MM and tooth loss in the Chilean population. Methods: Cross-sectional study with secondary data from the latest Chilean National Health Survey (ENS 2016-17). The number of remaining teeth was classified into four groups: functional dentition (≥ 20 remaining teeth), moderate tooth loss (10 to 19), severe tooth loss (1 to 9), and edentulism (0). MM was defined based on the number of chronic conditions as a binary variable (MM≥ 2) and as a 4-level categorical variable (MMG0−G3), G0: none, G1: 1, G2: 2–4, and G3: ≥5 conditions. Stratified analysis by age group (< 65, ≥ 65 years) was performed. Mean and SD were calculated for crude and adjusted remaining teeth. Significance level was set to 0.05. Prevalence ratios were estimated with Poisson regression models with robust variance, crude and adjusted for sex, age, geographic area, and educational level. Logistic regressions models were fitted to calculate odds ratios as a sensitivity analysis. Results: Of 4,151 adults aged 17–98, 54.9% had MM and the prevalence of moderate, severe tooth loss and edentulism was 25.4%, 6.9% and 4.8% respectively. Adults aged ≥ 65 years with MM≥ 2 were 1.66 [1.04–2.66] times more likely to have severe tooth loss than those without MM. Adults aged < 65 years with MMG3 were 1.76 [1.12–2.77] times more likely to have moderate tooth loss and 2.55 [1.02–6.36] times more likely to have severe tooth loss than those without MM. Conclusions: In this study, we found statistically significant associations between the number of chronic conditions and moderate/severe tooth loss in both analyzed age groups. These findings highlight the need to provide oral health care for adults with multimorbidity using a person-centred model and to seek strategies to prioritize health care. [ABSTRACT FROM AUTHOR]

The revival of the transmission dynamics of mosquito-borne diseases grants striking challenges to public health intensified by climate change worldwide. This inclusive review article examines multidimensional strategies and challenges linked to climate change and the epidemiology of mosquito-borne diseases such as malaria, dengue, Zika, chikungunya, and yellow fever. It delves into how the biology, pathogenic dynamics, and vector distribution of mosquitoes are influenced by continuously rising temperatures, modified rainfall patterns, and extreme climatic conditions. We also highlighted the high likelihood of malaria in Africa, dengue in Southeast Asia, and blowout of Aedes in North America and Europe. Modern predictive tools and developments in surveillance, including molecular gears, Geographic Information Systems (GIS), and remote sensing have boosted our capacity to predict epidemics. Integrated data management techniques and models based on climatic conditions provide a valuable understanding of public health planning. Based on recent data and expert ideas, the objective of this review is to provide a thoughtful understanding of existing landscape and upcoming directions in the control of mosquito-borne diseases regarding changing climate. This review determines emerging challenges and innovative vector control strategies in the changing climatic conditions to ensure public health. [ABSTRACT FROM AUTHOR]

Background: The citizens' perspectives on health care are central to the assessment of the health care situation and to regional development. In Germany, however, strategic goals for health care delivery are planned based on population statistics and partly on regional morbidity. Saxony is a German federal state with high average age and low density of physicians which makes the population perspective on quality of health care especially intersting. No existing panel surveys cover issues related to the perceived quality of health care delivery on a regional level in Germany. Aim: We aim to conduct a longitudinal panel study of the perceived health status and perceived quality of health care of the Saxon citizens as a basis for the systematic derivation of health care goals/measures and target group-specific, regionally suitable prevention measures. Methods: With an anticipated 15% response rate, 15,000 potential participants have to be contacted to achieve a calculated sample size of about 2,250 participants. The questionnaire will be circulated every other year with the option for adaptations depending on insights of each panel wave. The study protocol was approved by the local ethics committee of the Technische Universität Dresden, Germany (ethical approval code BO-EK-320072022) and has been registered at the German Clinical Trials Register as the German WHO primary registry (study registration number DRKS00031229). Discussion and outlook: The results are intended to identify gaps in health care and to develop patient-centered health care goals for the region together with stakeholders in Saxon health care planning. At the same time, longitudinal data allow mapping of perceived health status and perceived health care trends. [ABSTRACT FROM AUTHOR]

Background: Homeless-experienced persons that present in the Emergency Department (ED) often fail to receive follow-up primary care. To inform implementation of a post-ED patient navigation model, we engaged homeless-experienced Veterans to identify barriers to primary care and the acceptability of a peer-led intervention within the ED. Methods: Between August and November 2023, 3 focus groups (n = 14) and 2 interviews were held (total n = 16) with homeless-experienced Veterans who sought care in the Department of Veterans Affairs' (VA) Greater Los Angeles (GLA) ED. We inquired about barriers to primary care post-ED visit, ways to improve connection, and the acceptability of a peer-led intervention. Fieldnotes were taken and coded using rapid qualitative methods. Results: Participants noted challenges receiving adequate information about and support connecting with primary care; challenges included lengthy appointment wait times, lack of knowledge regarding clinic walk-ins, and challenges with social needs. Recommendations for facilitating connection comprised support with patient navigation, including obtaining timely appointments, addressing social needs, and identifying healthcare priorities. Participants noted numerous benefits to having peers in the ED to assist with healthcare and resource connection. Conclusions: Data will inform future work to adapt and pilot a peer-led patient navigation model for homeless-experienced Veterans in VA GLA's ED. [ABSTRACT FROM AUTHOR]

Background: Following an earlier mixed-method survey in which we asked stakeholders to report on their perceptions of the progress made in relation to Canada's Framework on Palliative Care and Action Plan, the purpose of this study was to conduct an in-depth qualitative exploration of the factors influencing that progress, or lack thereof. Methods: This was a qualitative interview study conducted in Canada. Inclusion criteria included experience with palliative care in Canada in a professional or volunteer capacity. Interviews were conducted by telephone using an interview guide that asked specific questions in relation to the Framework on palliative care priorities (e.g., education, caregiver support, and equitable access). Data was analyzed using qualitative descriptive methods. Results: Thirty-five diverse stakeholders with extensive experience in palliative care were interviewed. In relation to palliative education, participants indicated that although there were excellent palliative care resources available across the country there was further need for embedding palliative care in undergraduate education and for mentored opportunities to engage in care across diverse contexts. The identification, development, and strategic positioning of champions was an important strategy for improving palliative care knowledge and capacity. The development of standard competencies was viewed as an important step forward; although, there was a need to include more members of the care-team and to create pathways for life-long learning. In relation to support for family caregivers, even as participants cited numerous community-based resources offered by not-for-profit organizations, they described significant barriers including a shortage of in-home support, lack of understanding of what caregivers do, and policy-based contractual and privacy issues. In relation to palliative care access, participants described a nurse-centered, consult-based, multi-site and multi-provider model of care that was facilitated by technology. Barriers to this model were systemic healthcare issues of siloed, fragmented, and for-profit care. Conclusion: Participants in this study had clear insights into the factors that would support or impede progress to the development of palliative care in Canada. Some of those factors were achievable within current health and educational systems. Other factors were going to require longer term and more comprehensive solutions. [ABSTRACT FROM AUTHOR]

This study examines cesarean section (C‐section) deliveries in Ghana from 2008 to 2017 in 10 regions, distinguishing between scheduled and emergency procedures. Scheduled C‐sections target specific maternal conditions, such as advanced age, multiparity, and medical history, while emergency C‐sections address acute fetal distress, preeclampsia, bleeding, and other urgent situations. The analysis reveals various regional patterns, with the Brong‐Ahafo Region showing a potential deceleration after 2017 and the Upper West Region indicating a possible acceleration. The high number of C‐sections in Greater Accra and Ashanti may be related to population density and health facilities. The study proposes empirical models, including linear, quadratic, and exponential components, emphasizing quasilinearity. The exponential model suggests transient and permanent phases of cesarean frequency, with the latter dominated by quasilinearity. Optimal parameter values are determined, which highlights the stability of the model. However, caution is advised when projecting too far into the future due to the inevitable slowing of observed trends. The findings offer insights for healthcare planning, resource allocation, and policymaking, emphasizing the need for region‐specific approaches and ongoing monitoring of cesarean dynamics to inform nuanced interventions. [ABSTRACT FROM AUTHOR]

Background: Asthma is a common chronic respiratory inflammatory disease that adversely affects patients' quality of life (QoL) and overall well-being. When asthma is not adequately controlled, there is a higher risk of exacerbations and hospitalizations, thereby increasing the direct and indirect costs associated with the treatment and productivity loss. Overreliance on SABA and underutilization of ICS in the management of asthma can result in suboptimal treatment and poor asthma control. Patients who visit the emergency department are more likely to have poorly controlled asthma. Ensuring that these patients are provided with an evidence-based treatment plan during discharge can help reduce the risk of future exacerbations and consequently reduce the burden on the UAE healthcare system. Methods: A joint task force comprising experts from the Emirates Society of Emergency Medicine (ESEM) and Emirates Thoracic Society (ETS) reviewed published evidence and updated guidelines in asthma management to optimize the post-discharge recommendations. Results: The ESEM-ETS experts' joint task force has developed a step-by-step plan for emergency department/hospital discharge, which is based on the GINA 2023 guideline recommendations and the medications available in the UAE. By adhering to this structured plan, emergency department physicians can play a crucial role in improving asthma care, long-term patient outcomes, and the utilization of healthcare resources. Conclusions: Prioritizing patient education and ensuring patients are equipped with the best-suited asthma treatment plans prior to discharge can help ED physicians improve patient outcomes and reduce healthcare resource utilization in UAE hospitals. [ABSTRACT FROM AUTHOR]

The Zika virus epidemic of 2015–16, which caused over 1 million confirmed or suspected human cases in the Caribbean and Latin America, was driven by a combination of movement of infected humans and availability of suitable habitat for mosquito species that are key disease vectors. Both human mobility and mosquito vector abundances vary seasonally, and the goal of our research was to analyze the interacting effects of disease vector densities and human movement across metapopulations on disease transmission intensity and the probability of super-spreader events. Our research uses the novel approach of combining geographical modeling of mosquito presence with network modeling of human mobility to offer a comprehensive simulation environment for Zika virus epidemics that considers a substantial number of spatial and temporal factors compared to the literature. Specifically, we tested the hypotheses that 1) regions with the highest probability of mosquito presence will have more super-spreader events during dry months, when mosquitoes are predicted to be more abundant, 2) regions reliant on tourism industries will have more super-spreader events during wet months, when they are more likely to contribute to network-level pathogen spread due to increased travel. We used the case study of Colombia, a country with a population of about 50 million people, with an annual calendar that can be partitioned into overlapping cycles of wet and dry seasons and peak tourism and off tourism seasons that drive distinct cyclical patterns of mosquito abundance and human movement. Our results show that whether the first infected human was introduced to the network during the wet versus dry season and during the tourism versus off tourism season profoundly affects the severity and trajectory of the epidemic. For example, Zika virus was first detected in Colombia in October of 2015. Had it originated in January, a dry season month with high rates of tourism, it likely could have infected up to 60% more individuals and up to 40% more super-spreader events may have occurred. In addition, popular tourism destinations such as Barranquilla and Cartagena have the highest risk of super-spreader events during the winter, whereas densely populated areas such as Medellín and Bogotá are at higher risk of sustained transmission during dry months in the summer. Our research demonstrates that public health planning and response to vector-borne disease outbreaks requires a thorough understanding of how vector and host patterns vary due to seasonality in environmental conditions and human mobility dynamics. This research also has strong implications for tourism policy and the potential response strategies in case of an emergent epidemic. Author summary: The Zika virus pandemic of 2015–16, which caused over 1 million human cases in the Caribbean and Latin America, was driven by a combination of movement of infected humans and presence of mosquito species, such as Aedes aegypti, that carry the disease. Both human mobility and mosquito vector densities vary seasonally, and the goal of our research was to analyze the interacting effects of disease vector presence and human movement across metapopulations on disease transmission intensity and the probability of super-spreader events. Specifically, we tested the hypotheses that 1) regions with the highest probability of mosquito presence will have more super-spreader events during dry months, when mosquitoes are predicted to be more abundant, 2) regions reliant on tourism industries will have more super-spreader events during wet months, as they are more likely to contribute to network-level pathogen spread due to increased travel. We used the case study of Colombia, a nation with a population of about 50 million people, whose annual calendar can be partitioned into overlapping cycles of wet and dry seasons and tourism and off-tourism seasons that drive distinct cyclical patterns of mosquito occurrence and human movement. Our approach combined spatial modeling of mosquito presence with network modeling of human mobility. We used a Maximum Entropy model to estimate the spatially and temporally varying habitat suitability for Aedes aegypti, the primary mosquito vector of Zika virus in Colombia, in terms of environmental factors such as temperature, precipitation, and vegetation coverage and human factors indicating land use and development, socioeconomic status, and prevalence of standing water that provides key habitat for juvenile mosquitoes. We also used airline travel data to develop metapopulation patch network models of the 1,123 municipalities of Colombia for each month of 2015 and 2016. We combined our vector habitat suitability and human mobility network models to simulate the Zika virus epidemic if it had begun in each month of 2015. Our results show that whether the first human case was introduced to the network during the wet vs. dry season and during the tourism vs. off-tourism season profoundly affects the severity and trajectory of the epidemic. For example, Zika virus was first detected in Colombia in October of 2015. Had it originated in January, a dry season month with high rates of tourism, it likely could have infected up to 30% more individuals and up to 40% more super-spreader events may have occurred. In addition, popular vacation spots such as Barranquilla and Cartageña have the highest risk of super-spreader events during the winter, whereas densely populated areas such as Medellín and Bogotá are at higher risk of sustained transmission during dry months in the summer. Our research demonstrates that public health planning and response to vector-borne disease outbreaks requires a thorough understanding of how vector and host patterns vary due to seasonality in environmental conditions and human mobility dynamics. [ABSTRACT FROM AUTHOR]

The article focuses on the increasing importance of men's health research and addressing health disparities, particularly in the United States. Topics include the impact of masculinity on health behaviors, the need for gender-sensitive healthcare approaches, and the vital role of organizations in promoting awareness and improving healthcare access for men across various populations.

This study aims to analyse age-specific all-cause mortality trends in the UK before and after COVID-19 emergence to determine if pre-pandemic trends contributed to increased mortality levels in the post-pandemic era. Statistical analysis of UK mortality data. We utilised age-structured population and mortality data for all UK countries from 2005 to 2023. Mortality rates were calculated for each age group, and excess mortality was estimated using the Office for National Statistics (ONS) method. Our most concerning finding is an increase in all-cause mortality rates for middle-aged adults (30–54 years) starting around 2012. The COVID-19 pandemic may have further impacted these rates, but the pre-existing upward trend suggests that current elevated mortality rates might have been reached regardless of the pandemic. This finding is more alarming than the slowdown in the decline of cardiovascular disease death rates for individuals under 75 noted by the British Heart Foundation. Our results highlight the importance of considering both immediate pandemic impacts and long-term mortality trends in public health strategies. This underscores the need for targeted interventions and improved healthcare planning to address both ongoing and future challenges. [ABSTRACT FROM AUTHOR]

The demand for mental health treatment on university campuses continues to increase. This report will outline sources of increased demand and how traditional campus-based models have managed it. It will then describe the University of Southern California's work mobilizing resources to develop a unique model for insurance based long-term care emphasizing the importance of collaboration between long-term and short-term resources. Finally, this report will suggest interventions that may help to ease the burden of increased demand for mental health treatment on campuses. [ABSTRACT FROM AUTHOR]

Objectives: The objective is to assess the interconnectedness of a network of health‐related quality of life (HRQoL) variables among people with HIV (PHIV) to identify key areas for which clinical interventions could improve HRQoL for this population. Methods: Between 2021 and 2023, we carried out a cross‐sectional study within the Spanish CoRIS cohort. We conducted a weighted and undirected network analysis, which examines complex patterns of relationships and interconnections between variables, to assess a network of eight HRQoL dimensions from the validated Clinic Screening Tool for HIV (CST‐HIV): anticipated stigma, psychological distress, sexuality, social support, material deprivation, sleep and fatigue, cognitive problems and physical symptoms. Results: A total of 347 participants, predominantly male (93.1%), currently working (79.0%), self‐reported homosexual (72.6%) and college‐educated (53.9%), were included in the study. Psychological distress showed the highest centrality in the network, indicating its strong connections with sleep and fatigue, cognitive problems and social support within the HRQoL network. Conclusions: Psychological distress, sleep and fatigue, cognitive issues and social support were identified as key factors in an HRQoL network, indicating that interventions focused on these areas could significantly enhance overall well‐being. [ABSTRACT FROM AUTHOR]

Background: Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well‐being and independence. Objective: To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: Empowering People to Independence in COPD). Design: Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: Phase 1: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. Phase 2: Rapid qualitative analysis. Phase 3: Intervention mapping and refinement. Setting: Ambulatory, virtual. Participants: Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders. Results: NGT sessions were conducted by constituency group with 37 participants (n = 7 patients, n = 6 family caregivers, n = 8 clinic staff, n = 9 clinicians, n = 7 health system leaders) (Phase 1). Participants generated 92 statements across five themes (Phase 2): (1) "Barriers to care", (2) "Family caregiver needs", (3) "Functional status and mobility issues", (4) "Illness understanding", and (5) "COPD care complexities". Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized "Functional status and mobility issues", family caregivers prioritized "Family caregiver needs", and clinicians and health system leaders prioritized "COPD care complexities". Intervention mapping (Phase 3) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities. Conclusions: Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges. Implications: Patient‐centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment. [ABSTRACT FROM AUTHOR]

Background: The global increase in life expectancy has significantly raised the elderly population. In Türkiye, the proportion of individuals aged 65 and over rose from 8.8% in 2018 to 10.2% in 2023. This demographic shift necessitates the planning of social and health services for the elderly. Ageism affects elderly health negatively and is prevalent in healthcare settings. This study aimed to determine the prevalence of ageism among resident physicians at Pamukkale University Hospital and identify factors influencing their preferences for providing healthcare to elderly patients. Methods: This cross‐sectional study was conducted at Pamukkale University Hospital between 6 June and 16 June, 2024. A total of 448 resident physicians were selected through simple random sampling. Data were collected using a self‐administered questionnaire, which included sociodemographic information, factors affecting ageism, and the Fraboni Scale of Ageism (FSA). Descriptive statistics, Chi‐square tests, and logistic regression were used to evaluate factors influencing healthcare preferences. Results: The FSA score averaged 71.89 ± 7.87, indicating a 20.1% (95% CI:16.48–24.10) prevalence of age discrimination among resident physicians. Logistic regression analysis revealed that male participants (odds ratio (OR) = 1.519, P = 0.042), those with moderate to very poor perceived knowledge of elderly health (OR = 2.418, P < 0.001), and higher FSA scores (OR = 1.046, P < 0.001) were more likely to prefer not providing healthcare services to elderly patients. Conclusions: Ageism among resident physicians is prevalent, impacting their willingness to provide care to elderly patients. Gender, perceived knowledge, and ageist attitudes influence their preferences for providing healthcare to elderly patients. Addressing these factors is crucial for improving healthcare services for the elderly. [ABSTRACT FROM AUTHOR]

Background: Until 2005, when a single dose of vaccine was implemented in one-year-old children, the Hepatitis A virus (HAV) was responsible for approximately 90% of acute hepatitis cases in the paediatric population in Argentina. However, despite vaccination success, sporadic outbreaks of HAV still occur among adults. This study aimed to assess the seroepidemiology of HAV in Argentina, analysing IgG and IgM antibodies against HAV in a large population, both vaccinated and unvaccinated. Methods: The study included 16,982 patients attending a hospital from 2001 to 2023. The cohort was divided into two groups: 16,638 individuals who were not reached by the vaccination program implemented in 2005 and 344 children who were covered by the universal vaccination. Results: Anti-HAV IgG was detected in 56.7% of cases. The rate was significantly higher in individuals born after 2005 (77.7%) compared to those born before (56.3%), p < 0.001. The age groups 19–40 and 41–60 years showed the anti-HAV IgG lowest rates. On the other hand, 100/3956 cases (2.5%) with suspected acute hepatitis were positive for Anti-HAVIgM. Notably, none of these were born after the mandatory vaccine rollout. Conclusions: The study of this large cohort contributes to the understanding of the seroepidemiology of HAV. Although the implementation of the vaccine achieved its main goal, the age segment between 19 and 60 years does not reach the estimated threshold to achieve herd immunity. These findings reveal the importance of targeting vaccination campaigns, provide essential insights for public health planning, and guide future immunisation strategies against HAV in Argentina. [ABSTRACT FROM AUTHOR]

Eating disorder (ED) research and practice have been shaped by prevailing stereotypes about who EDs are most likely to affect. Subsequently, the field has prioritized the needs and concerns of affluent, cisgender, heterosexual, white girls and women to the exclusion of others, especially people marginalized based on their race, ethnicity, sexual orientation, and/or gender identity. However, EDs exist across diverse groups and actually occur with elevated prevalence in several marginalized groups. Growing research points to differences in the drivers of EDs in such groups (e.g. desire to attain the curvy rather than thin ideal; dietary restraint due to food insecurity rather than weight/shape concerns), yet tools typically used for screening and intervention evaluation do not capture eating pathology driven by such factors. In this commentary, we describe gaps in existing ED assessment tools and argue these gaps likely underestimate EDs among marginalized groups, bias who is invited, participates in, and benefits from ED prevention programs, and obscure potential group differences in the efficacy of such programs. We also discuss the potential of these ramifications to exacerbate inequities in EDs. Finally, we outline recommendations to overcome existing gaps in measurement and, consequently, advance equity in the realm of ED prevention. [ABSTRACT FROM AUTHOR]

Long time series of vegetation monitoring can be carried out by remote sensing data, the level of urban greening is objectively described, and the spatial characteristics of plant pollen are indirectly understood. Pollen is the main allergen in patients with seasonal allergic rhinitis. Meteorological factors affect the release and diffusion of pollen. Therefore, studying of the complex relationship between meteorological factors and allergic rhinitis is essential for effective prevention and treatment of the disease. In this study, we leverage remote sensing data for a comprehensive decade-long analysis of urban greening in Tianjin, which exhibits an annual increase in vegetative cover of 0.51 per annum, focusing on its impact on allergic rhinitis through changes in pollen distribution. Utilizing high-resolution imagery, we quantify changes in urban Fractional Vegetation Coverage (FVC) and its correlation with pollen types and allergic rhinitis cases. Our analysis reveals a significant correlation between FVC trends and pollen concentrations, with a surprising value of 0.71, highlighting the influence of urban greenery on allergenic pollen levels. We establish a robust connection between the seasonal patterns of pollen outbreaks and allergic rhinitis consultations, with a noticeable increase in consultations during high pollen seasons. our findings indicate a higher allergenic potential of herbaceous compared to woody vegetation. This nuanced understanding underscores the importance of pollen sensitivity, alongside concentration, in driving allergic rhinitis incidents. Utilizing a Generalized Linear Model, significant features influencing the number of visits for allergic rhinitis (P < 0.05) were identified. Both GLM and LSTM models were employed to forecast the visitation volumes for rhinitis during the spring and summer-autumn of 2022. Upon validation, it was found that the R² values between the simulated and actual values for both GLM and LSTM models surpassed the 95% confidence threshold. Moreover, the R² values for the summer-autumn seasons (GLM: 0.56, LSTM: 0.72) were higher than those for spring (GLM: 0.22, LSTM: 0.47). Comparing the errors between the simulated and actual values of GLM and LSTM models, LSTM exhibited higher simulation precision in both spring and summer-autumn seasons, demonstrating superior simulation performance. Overall, our study pioneers the integration of remote sensing with meteorological and health data for allergic rhinitis forecasting. This integrative approach provides valuable insights for public health planning, particularly in urban settings, and lays the groundwork for advanced, location-specific allergenic pollen forecasting and mitigation strategies. Highlights: The incidence of allergic rhinitis is primarily determined by pollen allergenicity, followed by concentration. Utilizing high-resolution imagery, we quantify changes in urban Fractional Vegetation Coverage (FVC) and its correlation with pollen types and allergic rhinitis cases. Weaving together remote sensing, meteorological, and health data, we employed Generalized Linear Models and LSTM models to dissect the determinants of allergic rhinitis and to construct a daily predictive model for the incidence of allergic rhinitis consultations. [ABSTRACT FROM AUTHOR]

As healthcare systems grow increasingly complex, greater demands are placed on patients' abilities to find, understand, appraise, and use health information – often termed their 'health literacy'. Most health literacy research does not focus on information appraisal. When it does, there is a tendency to equate it with patients' assessment of credibility. This reproduces a healthcare-centric understanding of information appraisal where patient agency is omitted. This study explores how participants in a health information intervention practiced information appraisal. The intervention aimed to increase information uptake for people with low back pain by delivering health information to them through animations. This study draws on ethnographic participant observation of the encounters between the intervention and its participants, including 49 rapid interviews and semi-structured telephone interviews with 23 participants carried out in the spring of 2021. Inspired by a social practice approach, the study thoroughly grounds the health literacy subcategory of 'appraisal' in practice. It illustrates that participants appraised the information provided in the intervention according to several factors. These include relating the information to their personal health needs, interpreting the intended audience of the health animations, and prioritising their attention situationally between the animations and other immediate concerns. We suggest that information appraisal is a fundamental component of health literacy and should be considered key in research, policy and practice. To accommodate current healthcare ideals of patient centeredness, empowerment and informed choice, the complex and dynamic ways in which people appraise health information need be considered legitimate practices of health literacy. [ABSTRACT FROM AUTHOR]

Xylazine, a veterinary sedative, has emerged as a concerning element in the landscape of substance use in the United States. This integrative review synthesizes evidence from a systematic examination of 14 selected studies conducted between 2008 and 2023. The primary objective is to comprehensively understand the epidemiology and prevalence of xylazine use, particularly its involvement in drug-related deaths, regional variations, national impact, co-occurrence with opioids, and challenges associated with detection and intervention. The results underscore stark regional disparities in xylazine prevalence. West Virginia and Miami-Dade County have experienced alarming surges in xylazine-involved drug-related deaths. Nationally, its influence extends beyond regional boundaries, predominantly affecting white males in the Northeast. The co-occurrence of xylazine with opioids, especially fentanyl and heroin, significantly amplifies the risks of fatal overdoses. Detecting xylazine presents formidable challenges due to its frequent presence alongside other substances, necessitating enhanced surveillance and more effective detection methods. User perspectives emerge as pivotal, emphasizing the importance of user-informed harm reduction strategies. In conclusion, this review has significant policy implications. Tailored, region-specific strategies are imperative to address the diverse prevalence of xylazine use. A nationwide response is indispensable, prioritizing harm reduction initiatives, enhanced detection methods, and active user engagement. The multifaceted nature of the xylazine issue requires comprehensive approaches to mitigate its profound risks effectively. Policymakers are urged to consider regional disparities and the co-occurrence of xylazine with opioids when crafting targeted interventions. Immediate, user-informed harm reduction is vital to address the evolving landscape of xylazine use in the United States. [ABSTRACT FROM AUTHOR]

The authors call on researchers, public health professionals, medical providers, and policymakers to address the access of foster care youth to preexposure prophylaxis (PrEP) from a number of appropriate dimensions. Topics include independent yet interconnected dimensions of access suggested by R. Penchansky and J. W. Thomas, dimensions of preexposure prophylaxis access, and prioritizing HIV prevention strategies for foster youths.

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Background: Decentralisation has increasingly been adopted by countries as an important health sector reform aimed at increasing community participation in decision making while enhancing swift response at decentralised levels, to accelerate the attainment of health system goals. Kenya adopted a devolved system of government where health services delivery became a function of the 47 semi-autonomous county governments with planning and budgeting functions practised at both levels of government. This study sought to explore challenges facing health sector planning and budgeting and how they affect immunisation service delivery at the county level. Methods: Data were collected through 77 in-depth interviews of senior county department of health officials across 15 counties in Kenya. We applied an inductive thematic approach in analysing the qualitative data using NVIVO software. Findings: The study found a lack of alignment between planning and budgeting processes, with planning being more inclusive compared to budgeting. Inadequate capacity in conducting planning and budgeting and political interference were reported to hinder the processes. Limited budget allocations and delayed and untimely disbursement of funds were reported to affect execution of health and immunisation budgets. Low prioritisation of preventive health interventions like immunisation due to their perceived intangibility influenced resource allocation to the programs. Conclusion: The findings highlight the need for effective strategies to align planning and budgeting processes, increased technical support to counties to enhance the requisite capacity, and efforts to improve budget execution to improve budget credibility. Counties should plan to increase their funding commitment toward immunisation to ensure sustainability of the program as Kenya transitions from GAVI support. [ABSTRACT FROM AUTHOR]

Urban planning significantly influences the physical and health profile of urban environments. This paper explores the critical nexus between urban planning and public health, emphasizing the urgent need to integrate health considerations into the urban planning curriculum in India. Current urban planning courses often overlook public health aspects, resulting in a disconnect that could hinder the ability of urban environments to meet the health and well-being needs of their populations. Through a comprehensive review and analysis of curriculum data from selected Indian institutions of national importance—including the School of Planning and Architecture, Indian Institute of Technology Kharagpur, and National Institute of Technology, Bhopal—this study identifies significant gaps in the inclusion of health-related content in urban planning education. The analysis reveals a low occurrence of health-related themes within the planning curriculum, with essential topics like public health history, environmental health, and health impact assessments seldom addressed. To bridge these gaps, the paper suggests incorporating mandatory health-focused courses, such as Health Impact Assessments and public health fundamentals, into the curriculum. It also recommends interdisciplinary collaboration with public health professionals to enrich planning education. By restructuring the curriculum to include more comprehensive health-related education, future urban planners can be better equipped to create healthier and more sustainable urban environments, ultimately enhancing public health outcomes in rapidly urbanizing spaces. This research not only sheds light on current educational inadequacies but also proposes actionable steps towards a more holistic integration of health and urban planning disciplines. [ABSTRACT FROM AUTHOR]

Background: Reliable estimates of asthma prevalence are essential for developing effective public health policies. However, discrepancies in published results have posed challenges for public health planning in China. To address this issue, we conducted this study to provide a comprehensive assessment of the epidemiology of asthma prevalence in China. Methods: We conducted a thorough systematic review across multiple databases including PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu database. The search was limited to studies published in either Chinese or English up to August 31, 2023, that reported on asthma prevalence in China. We extracted relevant study characteristics and performed meta-analyses. The study protocol was registered with PROSPERO (CRD42023397949). Results: A literature search yielded 192 studies that met the inclusion criteria out of 17,152 articles. The overall prevalence of asthma in Mainland China was found to be 2.20% (95% confidence interval, CI: 1.96-2.47%; I2 = 99.8%), with the prevalence of ever asthma at 2.21%, current asthma at 2.16%, ever asthma-like symptoms at 14.36%, and current asthma-like symptoms at 3.01%. Using a random-effects model, the prediction interval ranged from 0.44 to 10.27%. Meta-analysis subgroups indicated that men or children and the elderly generally have a higher prevalence of asthma. In addition, the prevalence of asthma is higher in urban areas and in the East China. The prevalence of asthma has been on the rise over the past three decades, from 0.69% in 1984 to 5.30% in 2021. Projections suggest that the prevalence could reach 9.76% by 2050 for the Chinese population. Conclusions: Asthma remains less prevalent in China than in western countries, however its prevalence has been gradually increasing over the past thirty years. The disease burden shows notable variations based on sex, age, and geographic regions, indicating significant demographic and regional disparities. To guide decision-making priorities and direct future research, conducting high-quality epidemiological studies on asthma is crucial. Key message: •The overall prevalence rate of asthma in China is 2.20%, and a higher rate observed in males compared to females. •The prevalence rate of asthma varied across different regions of China. •There has been an increasing trend in asthma prevalence in China over the past three decades. •The prevalence of asthma in China is projected to reach 9.76% by 2050. [ABSTRACT FROM AUTHOR]

Background: There is growing global concern about poor mental health among adolescents in sub-Saharan Africa. In particular, adolescent girls face multiple challenges in managing menstruation which can impact both their health and wellbeing. In this study we address an evidence gap on the association of a broad range of menstrual-related factors with mental health problems amongst secondary school female adolescents in Uganda. Methods: We used baseline data from a cluster-randomised menstrual health intervention trial conducted in 60 secondary schools in two districts in Uganda. Baseline data were collected between March and July 2022, including socio-demographic characteristics, menstrual knowledge and attitudes, menstrual practices and self-efficacy, and mental health problems measured using the Strengths and Difficulties Questionnaire Total Difficulties score (SDQ-25). We used random-effects linear regression to estimate the adjusted mean difference (aMD) for the association between mental health problems (SDQ Total Difficulties Score) and menstrual-related factors, including the Menstrual Practice Needs Scale (MPNS) and the Self-Efficacy in Addressing Menstrual Needs scale (SAMNS)), accounting for school-level clustering and adjusting for prior confounders. Results: Among the 3841 female participants, there was strong and consistent evidence of associations between mental health problems and menstrual-related factors. Mental health problems were associated with poor knowledge about menstruation (aMD = 1.17, 95%CI 0.50, 1.84 <0.001), using disposable and reusable menstrual products compared to using just disposable products (aMD = 1.42, 95%CI 0.92, 1.92, p <0.001), and experiencing menstrual pain even when using an effective management method at last menstrual period (LMP) compared to those experiencing no pain (aMD = 1.60, 95%CI 1.19, 2.01, p <0.001). Mental health problems were also associated with greater unmet menstrual needs according to the MPNS (aMD = 4.40 95%CI 3.96, 4.84, p <0.001), and with lower menstrual self-efficacy measured by the SAMNS (aMD = 0.94 95% CI 0.51, 1.37, p <0.001). Conclusion: This study shows strong evidence that mental health problems reported by adolescent girls in Uganda are associated with poor menstrual health. The association between menstrual health and mental health provides evidence as to why menstrual health should be a public health priority. Trial registration: Trial registration: ISRCTN 45461276. Registered on 16 September 2021. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionHealth systems support community health and well-being, and while many commit resources to convening in support of community-engaged communication interventions, they currently lack tools to evaluate this effort. This report describes one health system’s mixed-methods stakeholder-engaged development of robust yet pragmatic convening assessment tools.Semi-structured interviews and web surveys with key stakeholders informed a taxonomy of quality convening and accompanying survey tool. Initial evidence of validity and item variability were assessed descriptively.A 3-item survey aligned with high-priority convening constructs was developed with adequate variability in initial item responses. A companion 21-construct taxonomy organized by domain and stakeholder also resulted.This project resulted in a taxonomy detailing the constructs of quality convening and an accompanying brief survey tool to meets the needs of groups convened by one health system. These tools provide a unique opportunity to measure the quality of community convening within the context of healthcare. [ABSTRACT FROM AUTHOR]

Background: With decades of containment efforts, the prevalence of C. sinensis infection in Korea has shown a declining trend. However, well-tailored intervention assessments remain challenging, particularly when considering the potential impacts of cohort variations in raw freshwater fish consumption behavior, a major transmission route to humans, on this observed decline. Methodology: We applied an age-period-cohort modeling approach to nationally representative C. sinensis infection prevalence data from 1981–2012 in Korea to assess age, period, and cohort effects on its secular trend and to project the age-stratified prevalence up to 2023. Principal findings: Our analysis suggests that both cohort and period effects have substantially contributed to the declining prevalence of C. sinensis infection in Korea. Age-stratified projections up to 2023 suggest a decline in prevalence across all age groups, while those aged over 40 are anticipated to maintain prevalences above the elimination threshold of 1%. Conclusions: Our study highlights the importance of incorporating cohort effects into intervention assessments aimed at controlling C. sinensis infection. The effectiveness of interventions remains evident in Korea despite adjusting for the cohort effect. This approach, applicable to other endemic countries, would provide valuable insights for intervention assessments and inform future public health planning to eliminate C. sinensis infection. Author summary: Clonorchis sinensis (C. sinensis) infection, a neglected chronic parasitic infection, continues to be a significant public health concern with severe implications. Despite ongoing containment efforts leading to a decline in prevalence in Korea, assessing interventions remains challenging, due to variations in infection risk across different birth cohorts, driven by generational differences in raw freshwater fish consumption. We applied the age-period-cohort modeling approach to nationally representative C. sinensis infection prevalence data from 1981–2012 in Korea. Our analysis showed both cohort and period effects have significantly contributed to the observed decline in the prevalence of C. sinensis infection in Korea throughout the study period. Notably, the effectiveness of interventions remains evident even after adjusting for the cohort effect. Projections of age-stratified prevalence up to 2023 suggest a downward trend across all age groups. However, those aged over 40 are expected to maintain a prevalence exceeding 1%, highlighting the imperative for ongoing sustained efforts toward disease elimination. The age-period-cohort modeling framework offers broad applicability in other liver fluke endemic countries, particularly where data on host reservoirs beyond humans is limited. This approach provides valuable insights for future public health planning and resource allocation, aiming to mitigate the disease burden in affected regions. [ABSTRACT FROM AUTHOR]

Background: Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. Purpose: The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. Methods: This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. Findings: The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups (P < 0.05), and we also found an interaction effect between grouping and time factors (P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group (P < 0.05). Conclusion: PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium. [ABSTRACT FROM AUTHOR]

The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs. [ABSTRACT FROM AUTHOR]

Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [https://rpubs.com/camhi/sysrev%5ftable]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries. [ABSTRACT FROM AUTHOR]

There is a dearth of HIV prevention behavioral interventions for transgender Latinas, despite this population's HIV risk. ChiCAS (Chicas Creando Acceso a la Salud) is an intervention to increase PrEP, condom, and gender-affirming hormone therapy (GAHT) use among transgender Latinas. To inform future work, semistructured interviews were conducted postintervention with 28 ChiCAS participants. Thematic analysis with inductive coding was used. Six themes emerged: (1) health-related priorities include sexual health and avoiding discrimination; (2) safe and collaborative community is of high importance; (3) interactive education with time for sharing stories and discussion was valued; (4) PrEP uptake was facilitated through awareness and health care navigation; (5) accessing GAHT depends on cost, clinic location, and individual goals; (6) ChiCAS could be improved with more PrEP/GAHT details and social connection. Interventions with goals similar to those of ChiCAS should prioritize building community, PrEP and GAHT education tailored to participants' needs, and emphasize health care options available locally. [ABSTRACT FROM AUTHOR]

Objective: To gather preliminary evidence on short- and long-term care priorities for people with lower extremity amputations. Design: A three-round modified Delphi study using semi-structured interviews. Participants: A convenience sample of 20 adult participants who had undergone lower extremity amputations at a tertiary public hospital. Main Measure: Consensus on each care priority was defined a priori as an agreement of more than 50%. Semi-structured interviews were conducted to understand the rationales for endorsing the care priorities. Results: Consensus was reached on 24 short-term care priorities and 12 long-term care priorities in the biomedical, practical and psychological and spiritual domains. The rationales for endorsing each of the care priorities generated three themes: preparedness; mental health, psychological and spiritual well-being; and participating in life, with respect and dignity. Conclusions: Our results highlight the substantial need to improve patient access to education and planning support prior to undergoing limb amputation, and optimising post-amputation rehabilitation programmes, enabling people with amputations to participate in meaningful life roles that provide them with purpose, dignity, and self-respect. The knowledge of care priorities revealed in this study may promote effective patient-centred care and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate how shared decision‐making (SDM) and the use of different types of outcome information are applied in routine care management for people with multiple sclerosis (MS) in an academic outpatient clinic. Methods: This qualitative study used the following: (a) observations of clinical encounters (N = 23) between patients and healthcare professionals (HCPs), (b) interviews with those patients (N = 17) and (c) interviews with those HCPs (N = 7). HCPs were not trained in SDM before the study. Audio recordings were transcribed literally. Transcriptions were analysed using qualitative thematic analysis. Results: Outcome information was hardly discussed with patients, apart from clinical outcome information at an individual level, such as MRI or lab results. This use of clinical outcome information did not automatically lead to a process of SDM. HCPs tended to implicitly present choices to patients after signalling and discussing 'problems'. In the interviews, patients indicated that they tended to consent to the advice given by HCPs and to prefer not too much change in treatment plans. However, they also emphasized the importance of being informed about available options with benefits and harms. We observed multiple discussions about patients' preferences, especially related to patients' experiences and priorities. Conclusions: Overall, SDM and the use of different types of outcome information did not seem to be enacted in routine care management for people with MS, mostly because choices were not explicitly mentioned or discussed. However, discussions about patients' experiences and priorities did take place. Training HCPs further and developing patient information seem reasonable steps to proceed. Patient or Public Contribution: People with MS contributed as research participants and provided us with their experiences in interviews. Furthermore, representatives of two patient organizations contributed to the study by reviewing the interview protocol for people with MS. [ABSTRACT FROM AUTHOR]

Background: Loss of the ability to perform activities of daily living (ADLs) leads to negative health outcomes such as reduced quality of life, institutionalization, and mortality. In Korea, the proportion of older adults with disabilities is increasing along with rapid population aging. Therefore, providing a comprehensive approach to the prevention and management of ADL limitations in people with disabilities is necessary. This can be accomplished by understanding the trends and factors affecting these limitations over time. Purpose: This study was developed to examine the longitudinal trend and factors affecting ADL limitations over time among people with disabilities in Korea. Methods: Data from 346 people with disabilities in the 2008–2020 Korean Welfare Panel Study were used. Bivariate analysis and a Kendall trend test were performed to determine the longitudinal trends for ADL limitations, and multiple logistic regression was used to evaluate whether relevant variables could predict these limitations. Results: The prevalence of ADL limitations among people with disabilities increased by 16.5% over the 12 years of the study. The highest rate of increase in these limitations over time was found in people with mental disorders (27.8%), those over 65 years of age (27.3%), and those with depression (25.6%). In multiple logistic regression, the odds ratios of the variables were slightly different at each survey wave. However, severe disability and low educational level were consistently found to be associated with ADL limitations over time. Conclusions: The findings provide evidence of a significant relationship between level of disability and/or educational status and ADL limitations in people with disabilities in Korea. To prevent the development of ADL limitations in people with disabilities, comprehensive identification of longitudinal trends and factors affecting ADL limitations is necessary. Early intervention, including integrated services such as home rehabilitation services to prevent ADL limitations, especially for disabled people with severe disabilities and low educational levels, has the potential to delay ADL limitations. [ABSTRACT FROM AUTHOR]

Consequences of brachial plexus injuries (BPI) would likely impact participation, but outcomes are not well understood. This exploratory study aimed to report the participation in productive, leisure and social roles for individuals following BPI. Fourteen male participants were diagnosed with a traumatic, BPI. Descriptive data reported included demographic, injury, surgical, and participation measures. Two-sample t-tests were conducted for comparative analysis with other studies following life altering conditions. Just over two-thirds reported feeling satisfied to very satisfied with their participation in everyday life. This long-term follow up study found on-going and profound impact on participation in a range of life situations for this diagnostic group. Participation in productive roles, home duties, and physical exercise were particularly impacted and need to be prioritized during rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Clinical care ratios are used to quantify and benchmark the activity of allied health professionals. This study aims to review previous recommendations and identify what variables may influence them. Method: Data was collected from the core allied health professions (audiology, nutrition and dietetics, occupational therapy, physiotherapy, podiatry, prosthetics and orthotics, psychology, social work and speech pathology) across eight Australian hospitals. Data for 113 staff who were casual or from smaller professions (audiology, podiatry, prosthetics and orthotics and psychology) were excluded due to insufficient numbers for analysis. The remaining data were analysed according to profession, seniority (tiers 1, 2 and 3) and employment status (permanent versus casual staff). A two-way ANOVA was performed to assess the association of clinical care ratios with tier, profession, employment status and gender. Results: Data from 1246 staff from the five larger professions at participating hospitals were analysed. There were no interactions between profession and gender (P = 0.185) or employment status (P = 0.412). The relationship between clinical care ratio and profession was modified by tier (interaction term, P = 0.014), meaning that differences in clinical care ratios between professions depended on the tier. Conclusion: This research has confirmed that clinical care ratios are a useful tool in workload management and determining staffing levels for allied health professionals. The recommendations from this research provide a starting point that can be finessed with reference to profession, model of care, workforce structure, governance and training requirements. This will lead to increased staff wellbeing and improved patient outcomes. What is known about this topic? Clinical care ratios are a useful tool to quantify, monitor and compare workloads of allied health professionals. What does this paper add? This paper confirms that clinical care ratios are a useful workforce planning tool and that when developing roles and models of care, clinical care ratios need to be incorporated into staffing requests and considered as part of workload management tools. What are the implications for practitioners? Clinical care ratios enable the quantification and benchmarking of direct and clinical support activity components of a workload and can be used when planning new services and reviewing current services. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the important role of nurse managers in ensuring that nursing staff feel supported • To identify how nurse managers can support staff when there are concerns about practice • To consider ways of fostering a climate of psychological safety in your practice. The nursing profession is under growing pressure and many nursing staff find it increasingly challenging to maintain standards and provide safe, effective and efficient care that meets the needs of patients. Nurses’ job satisfaction is predicated on feeling supported, including when there are concerns about practice – whether their own or that of their colleagues. This article discusses how nurse managers can support staff to challenge suboptimal practice, admit their own errors and learn from these by fostering a climate of psychological safety. This includes adopting a relational model of leadership; cultivating open communication; providing clarity on roles and expectations; ensuring transparency and fairness in performance management; having supportive ‘tough conversations’ with staff; demonstrating objectivity when investigating concerns; and promoting a ‘just culture’. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this analysis is to better understand laws and practices guiding prevention activities in childhood lead poisoning prevention programs funded by the Centers for Disease Control and Prevention (CDC). Methods: In 2022, CDC surveyed 62 funded programs using the Awardee Lead Profile Assessment. Information was collected about childhood lead poisoning-related laws and guidance, surveillance and prevention strategies, and program services including at what blood lead levels (BLLs) various activities are performed. Separately, CDC reviewed state health department websites to obtain information on which states implemented CDC's updated blood lead reference value. Results: Awardee Lead Profile Assessment results are only reported for 47 states, the District of Columbia, and Puerto Rico. Almost all programs (96%) have laws requiring reporting of BLLs, and 51% require BLLs be reported electronically to jurisdictional health departments. Most programs (80%) prioritize areas and populations that are high risk for lead poisoning prevention activities. Approximately half of the programs (51%) have a lead elimination plan or goal. Thirty-nine percent of the programs have already implemented policies, laws, or regulations to achieve lead elimination, and 74% are in the Northeast and Midwest regions of the country. As of March 2023, 71% of the programs have implemented CDC's updated blood lead reference value, and most (65%) did so via guidance for health care providers and laboratories for what BLL should initiate case management and other services for lead-exposed children. Conclusions: Almost all programs have mandatory BLL reporting laws, and about two-thirds of the programs updated their BLLs that trigger public health action. [ABSTRACT FROM AUTHOR]

Problem Many national child health guidelines in Malawi, Nigeria and South Africa are outdated and score poorly on rigorous methods and stakeholder participation. Approach In line with the World Health Organization's (WHO) emphasis on local guideline contextualization, the Global Evidence-Local Adaptation (GELA) project supported multistakeholder processes to adapt evidence-informed recommendations for child health in Malawi, Nigeria and South Africa. The GELA project team convened national steering groups, which conducted structured, iterative priority-setting exercises to identify priority topics. We identified appropriate source guidelines by systematically searching and screening available guidelines. We then matched recommendations in potential source guidelines to the relevant questions, and assessed the guidelines for timeliness and quality. Drawing on WHO's guideline process, we applied the GRADE-ADOLOPMENT process to develop contextualized recommendations from existing guidelines. If no source guideline or reviews were identified, we conducted new evidence syntheses. Local setting Malawi, Nigeria and South Africa are countries with varying health priorities and systems, all transitioning to universal health coverage. Guideline structures differ between countries, with processes largely led from national health ministries. Relevant changes National guideline groups, supported by GELA researchers and government-academic partners, developed five contextually-tailored child health recommendations. For most of these recommendations, additional evidence was required to inform contextually appropriate national decision-making. Formal capacity-building and on-the-job learning enhanced the competencies of national contributors and researchers in evidence-informed decision-making. Lessons learnt Developing context-relevant recommendations requires considerable resources and time. Further investment in strengthening local capacity is needed for sustainable national guideline development. [ABSTRACT FROM AUTHOR]

COVID-19 has changed the world in many ways, and while some families were divided by geographical distances and mandatory "stay-at-home" orders during lockdowns, others became fractured owing to decisions about vaccination. This novel exploratory qualitative study questions how family systems and COVID-19 attitudes influenced the vaccine decisions of 10 Australian First Nations individuals. Despite the significance of family in decision making, the advice of respected family members became insignificant when nonvaccination resulted in the undesirable consequences of coercive government mandates. The thematic analysis identifies themes of choice, repeated wrongs of the past, trust, relationships, isolation, and parenting anxiety. It also demonstrates the resiliency of First Nations families, evident in the creative ways family systems adapted during the pandemic. This study has implications for governments and health service planning toward community COVID-19 support systems in a postpandemic context and provides ideas for further research into First Nations service provision during health crises. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic impacted healthcare delivery, especially for people with chronic disease. We investigated telehealth use by persons with multiple sclerosis (MS) during the COVID-19 pandemic and their suggestions to improve their telehealth experience. Methods: From persons with MS, we collected data on demographic, disease-related and social determinants of health, telehealth use during the COVID-19 pandemic, satisfaction with telehealth, and suggestions to improve telehealth. We conducted univariate log-binomial regression to establish factors associated with telehealth use versus no use, summarised experiences and suggestions for improvement with frequency tables, and conducted thematic analysis on free-text suggestions for improvement. Results: Of 1,485 participants, 69.8% used telehealth during the first phase of the COVID-19 pandemic. Only small differences were observed for demographic, disease and social health determinants between telehealth users and non-users. Most participants who used telehealth had good or very good experiences (new providers:74.3%; existing providers:78.6%). The most common suggestion for improving telehealth experience was "guidance on preparing for telehealth sessions." Participants also wanted expansion in telehealth availability and utility. Conclusion: Persons with MS in Australia commonly used telehealth during the COVID-19 pandemic and were generally satisfied with their experiences. Implementing the suggested improvements will help optimise telehealth for persons with MS. Registration: N/A. IMPLICATIONS FOR REHABILITATION: Australians with multiple sclerosis (MS) had good or very good experiences of telehealth during the first year of the pandemic. Telehealth is a useful consultation tool for many rehabilitation professions and may be appropriate for use across the whole MS population. To improve the delivery of rehabilitation through telehealth, provision of better guidance on preparing for telehealth consultations and provision of digital equipment to monitor their health is wanted by persons with MS. Rehabilitation professionals and researchers should take opportunities to identify if proficiency in the English language and cultural background may influence experiences with telehealth in persons with MS. [ABSTRACT FROM AUTHOR]

Objectives. To describe how an innovative, community-engaged survey illuminated previously unmeasured pandemic inequities and informed health equity investments. Methods. The methodological approach of Massachusetts' COVID-19 Community Impact Survey, a cross-sectional online survey, was driven by key health equity principles: prioritizing community engagement, gathering granular and intersectional data, capturing root causes, elevating community voices, expediting analysis for timeliness, and creating data-to-action pathways. Data collection was deployed statewide in 11 languages from 2020 to 2021. Results. The embedded equity principles resulted in a rich data set and enabled analyses of populations previously undescribed. The final sample included 33 800 respondents including unprecedented numbers of populations underrepresented in traditional data sources. Analyses indicated that pandemic impacts related to basic needs, discrimination, health care access, workplace protections, employment, and mental health disproportionately affected these priority populations, which included Asian American/Pacific Islanders and parents. Conclusions. Equity-centered data approaches allow for analyses of populations previously invisible in surveillance data, enable more equitable public health action, and are both possible and necessary to deploy in state health departments. (Am J Public Health. 2024;114(S7):S599–S609. https://doi.org/10.2105/AJPH.2024.307800) [ABSTRACT FROM AUTHOR]

Pediatric acquired and congenital conditions leading to shoulder pain and dysfunction are common. Objective, quantitative musculoskeletal imaging-based measures of shoulder health in children lag recent developments in adults. We review promising applications of quantitative imaging that tend to be available for common pediatric shoulder pathologies, especially brachial plexus birth palsy and recurrent shoulder instability, and imaging-related considerations of musculoskeletal growth and development of the shoulder. We highlight the status of quantitative imaging practices for the pediatric shoulder and highlight gaps where better care may be provided with advances in imaging technique and/or technology. [ABSTRACT FROM AUTHOR]

Context: The connection between law and political determinants of health is not well understood, but nevertheless it is suggested that the two are inseparable, and this represents an upstream level with scope for influencing other determinants of health (particularly social determinants). Solidarity underpins European health care systems, and given its clear link with redistribution, it can be seen as a means for addressing health inequities. As such, solidarity may be seen as a political determinant of health in the specific context of European Union (EU) competition policy. Methods: A range of EU case law, treaty provisions, and European Commission publications relating to EU competition policy are analyzed. Findings: Solidarity is typically juxtaposed as antithetical to competition and thus as underpinning exceptions to the applicability of prohibitions on anticompetitive agreements, abuse of dominance, and state aid. Case law indicates an additional dynamic between definitions of solidarity at the EU and national levels. Conclusions: This analysis leads to two groups of considerations when framing solidarity as a political determinant of health in the EU competition policy context: first, the predominance of solidarity suggests it may shape competition reforms; second, the EU–member state dynamic indicates less EU-level reach into national competition reforms in health care than may be expected. [ABSTRACT FROM AUTHOR]

Background: Studies have highlighted lacunae in the effective implementation of Village Health Sanitation and Nutrition Committees (VHSNC) in India. The present study aimed to evaluate the routine functioning of VHSNC in two districts of Odisha. Methods: Our study included mixed-method research. The members of 467 VHSNCs were interviewed in two districts. The quantitative data was collected using a semi-structured questionnaire. Besides, we did 18 focus group discussions and 3 in-depth interviews to obtain the perceptions of the members of VHNSCs on the needs of the communities and the challenges. Conclusions: VHSNC is an effective mechanism of health governance, but there are challenges, such as a lack of knowledge about the functioning of its members, irregular meetings, delayed funds or improper documentation, and ineffective supervision. A comprehensive model of VHSNC implementation needs to be developed and delivered with continuous monitoring to make them function effectively. [ABSTRACT FROM AUTHOR]

In 2021, the Centers for Disease Control and Prevention (CDC) funded 67 health departments to implement community health worker (CHW) programs to enhance COVID-19 response. The CDC also funded a unique CHW-led Technical Assistance and Training (TTA) Center called Envision, which supported health departments to implement CHW programs and promote CHWworkforce sustainability. After 1 year, Envision evaluators interviewed Envision staff to assess barriers and facilitators in developing the Center and the degree towhich CHWleadership was operationalized. Thematic analysis revealed 3 themes regarding relationships, CHW values in practice, and operational challenges. Findings informed program updates. CHWs, funders, and policymakersmay learn fromthese experiences. [ABSTRACT FROM AUTHOR]

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Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a sample of 77,133 subjects primarily dealing with hypertension and diabetes, the study employed various analytical tools to identify factors associated with an increased risk of depression. Results: These factors included marital status (OR 1.47, 95% CI 1.40–1.54), residential district (OR 1.43, 95% CI 1.39–1.50), unemployment (OR 1.47, 95% CI 1.41–1.54), enrollment in the national basic living security program (OR 1.50, 95% CI 1.40–1.62), unmet healthcare needs (OR 2.32, 95% CI 2.14–2.51), fair subjective health status (OR 1.74, 95% CI 1.63–1.90), poor subjective health status (OR 4.33, 95% CI 4.05–4.63), and stress (OR 4.56, 95% CI 4.36–4.77). Notably, individuals with higher health literacy showed a significantly lower susceptibility to depression (OR 0.74, 95% CI 0.68–0.75), underscoring the importance of health literacy as a critical factor in mental health outcomes. Conclusions: Such initiatives could serve as effective preventive measures against depression in this vulnerable population. [ABSTRACT FROM AUTHOR]