Implementation and effectiveness of the WHO Self-Help Plus (SH+) intervention in the Gaza Strip: a prospective hybrid type 1 non-randomised study.

Secure extended care units (SECUs) are low-secure locked inpatient units. They are considered the most restrictive intervention within the continuum of mental health rehabilitation programmes for patients within non-forensic public mental health services. Limited information about psychosocial and forensic aspects of patients referred to such units is available. This study explored the psychosocial and forensic characteristics and predictors of acceptance in an Australian SECU programme over a 5-year period (2019-2023). A retrospective study design investigated 121 consecutive referrals. The 98 first-time patient referrals were included in the main analysis. Descriptive statistics were used with non-parametric comparisons (Chi-square and Fisher exact test where appropriate). Logistic regression was undertaken to assess the influence of covariates. Referral from an inpatient mental health setting was the only predictor that influenced acceptance onto the SECU (OR 3.168, 95% CI: [1.129, 8.913], p = .029). More than four-fifths had a forensic history. Only 14 % had a history of youth offending, but 73% had a past conviction before referral. Sixty percent had a history of Family violence and two-thirds were on Bail. Services prioritised containment and abstinence, whereas patients sought skills development and employment. Patients had least contact with a Psychologist among all allied health disciplines before referral. The study provides evidence that the SECU is receiving patients with high forensic and psychosocial needs, which are unmet within community mental health programmes in the absence of medium and high-secure units. There is a need for a balanced approach between containment, rehabilitation, and community reintegration for this cohort.

Agricultural professionals often operate within distinct silos, missing opportunities for cross-sector collaboration that could enhance both practice effectiveness and community impact. This keynote presentation explored the surprising commonalities between urban agriculture practitioners and bovine veterinarians, two professions that, despite apparent differences, share fundamental values and face remarkably similar challenges. Through examination of three core pillars (professional stewardship focused on health, innovation through precision practice and community health education), this presentation demonstrated how both professions prioritize evidence-based care, preventive approaches and public service. The analysis revealed significant opportunities for professional collaboration including cross-sector continuing education, One Health research initiatives, joint policy advocacy, and integrated community health programs. By recognizing these shared values and building collaborative frameworks, urban agriculture practitioners and bovine veterinarians can enhance their individual effectiveness while contributing to more resilient, health-centered food systems. This presentation advocates for breaking down professional silos to create innovative partnerships that serve both professional development and community health outcomes.

Background: Work motivation is a crucial determinant of health workers’ performance, especially for community nursing coordinators who play a vital role in implementing community health programs at primary health care centers. Both intrinsic and extrinsic factors, including work environment, remuneration, and opportunities for self-development, are considered to influence work motivation. Objective: To analyze factors affecting work motivation among community nursing coordinators in Indramayu District, 2025. Methods: This quantitative study used a cross-sectional design involving all 49 coordinators through total sampling. Data were collected using a valid and reliable questionnaire (Cronbach’s Alpha=0.907) and analyzed using multiple linear regression. Results: Most respondents were female (69.4%) and aged 24–30 years (46.9%). Low work motivation was reported by 89.8% of coordinators. Significant predictors of motivation were work environment (p=0.000), remuneration (p=0.001, negative), and self-development (p=0.030). Collectively, these factors explained 86.7% of the variance in work motivation (R²=0.867). Conclusion: Work motivation among community nursing coordinators remains low. The dominant factors are work environment and self-development. Managerial strategies should focus on creating supportive work environments, expanding opportunities for professional development, and reviewing remuneration systems.

Older adults experience physiological decline that reduces balance ability and increases the risk of falls. Falls can lead to serious physical injuries, psychological impacts, decreased quality of life, and even mortality. Therefore, effective and applicable interventions are needed to prevent fall risk, especially in community settings. Objective: This study aimed to determine the effect of ankle strategy exercise on fall risk among older adults in Gaji Village, Kerek District, and to evaluate its role as a community-based nursing intervention. Method: This study employed a quantitative pre-experimental design with a one-group pretest–posttest approach. Participants were selected using purposive sampling based on inclusion criteria. Data were collected using the Berg Balance Scale (BBS) before and after the intervention. Data analysis was conducted using appropriate statistical tests to compare fall risk before and after ankle strategy exercise. Findings: The results showed a significant reduction in fall risk after the intervention. Most participants experienced improved balance performance, indicating that ankle strategy exercise effectively enhances postural stability in older adults. Implications: The findings suggest that ankle strategy exercise can be implemented as a simple, cost-effective, and non-pharmacological intervention in community nursing practice to prevent falls among older adults. This intervention is practical and can be easily adopted in community health programs. Originality: This study provides empirical evidence on the effectiveness of ankle strategy exercise in a rural community setting, highlighting its potential as a feasible and targeted balance training method for fall prevention among older adults.

The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) program is a Medicare Alternative Payment Model that launched in January 2023, based on the Global and Professional Direct Contracting Model that preceded it. The transition from that program to ACO REACH was unique in the Medicare portfolio in its focus on health equity and emphasis on capitated payments. We found that in the first year of ACO REACH, 132 participating ACOs cared for more than two million Medicare beneficiaries. Nearly nine in ten ACOs met quality cutoffs for Continuous Improvement/Sustained Exceptional Performance bonuses. The average Medicare spending benchmark was approximately $16,000 per beneficiary, and nearly three-quarters of participants had spending that was lower than their benchmark. ACOs with more experience and those with a higher proportion of medically complex beneficiaries (and thus higher benchmarks) had greater savings than newer ACOs and those with lower benchmarks.

Women's participation in family diet and health decisions is strongly associated with better family outcomes. We examined decision-making power among participants in a Community Health and Nutrition Program in Jordan, which sought to improve maternal, infant, and young child nutrition (MIYCN) and modern contraception through service-provider training and media campaigns. Cross-sectional surveys in Amman, Karak, and Zarqa governates enrolled 3518 pregnant/lactating women (PLW) in the program (2021-23). PLW respondents indicated whether receiving messages about MIYCN and contraceptive use changed their practices, and whether their decision-making was total, shared with other family members (husbands, mothers, mothers-in-law), or not possible for these choices. Results were analyzed using chi-square tests and multiple linear regressions. After receiving program messages, 78% of PLW changed ≥ 1 practice. Between 52.8% and 90.3% of PLW had decision-making power to accept or reject recommendations for the six targeted behaviors. Compared to Amman, Zarqa residence was negatively associated with decision-making power over women's dietary diversity (OR = 0.418, p < 0.05) and early initiation of breastfeeding (OR = 0.493, p < 0.05), while Karak residence was negatively associated with decision-making power over modern contraceptive use (OR = 0.419, SE = 0.116, p < 0.01). Number of children was positively associated with decision-making power over exclusive breastfeeding (OR = 1.18, p < 0.01). Nationality, age, and wealth were not associated with decision-making power over these practices. Decision-making power varied among PLW in the program: PLW living outside Amman and those with fewer children had less autonomy to change practices. Further research is needed to understand how to best support decision-making power among these populations. Trial Registration: Registered at clinicaltrials.gov (NCT05365698).

Dengue Hemorrhagic Fever (DHF) is an infectious disease that remains a health problem in Indonesia, including in the Simalingkar Community Health Center (Puskesmas) work area. Data shows an increase in cases from 87 cases in 2023 to 96 cases in 2024. This study aims to evaluate the implementation of the Dengue Fever Eradication Program (P2DBD) at the Simalingkar Community Health Center based on input, process, output, and outcome components. The research method used a descriptive qualitative approach with a purposive sampling technique with seven informants, including the head of the community health center, program manager, village official, neighborhood head, and jumantik cadres. Data were collected through in-depth interviews, observation, and documentation, then analyzed thematically. The results of the study indicate that from the input aspect, the availability of human resources, infrastructure, and funds is still limited, thus affecting program optimization. In the process, the implementation of PSN, larvasidization, fogging, counseling, epidemiological investigations, and larva examinations has not been consistent and the coverage is not evenly distributed. From the output, the achievement of activities has not met the ideal indicator such as Larvae Free Rate ?95%. In terms of outcomes, dengue fever case tracking has not been optimal, with some cases still not being reported promptly. The main inhibiting factors are minimal cross-sectoral coordination, low community participation, and logistical constraints.

The purpose of this analysis was to quantify hypertension (HTN) prevalence, awareness, treatment, and control in low-resource neighborhoods of Chicago, Illinois. Data were collected among a convenience sample of 11,167 adults screened between 2013 and 2019 at community events conducted through Keep Your Heart Healthy, a student-led community health program at a large academic medical center. HTN was defined as average systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or self-reported BP medication use. Awareness was defined as self-reported history of HTN; treatment was defined as self-reported BP medication use among those aware; and control was defined as SBP <140 mmHg and DBP <90 mmHg among those aware and treated. Descriptive statistics were used to estimate HTN prevalence, awareness, treatment, and control rates. HTN prevalence was 45.3% (95% CI: 44.3%-46.2%). Among those with HTN, 66.7% were aware, 65.3% of those aware were treated, and 48.3% of those treated achieved control. Overall, 21.0% (95% CI: 19.9%-22.2%) of adults with HTN were aware, treated, and controlled. Additionally, 29.6% of all participants met criteria for prehypertension (SBP 120-139 mmHg or DBP 80-89 mmHg). In conclusion, in low-resource communities of Chicago, only 21.0% of participants with HTN were aware, treated, and controlled, indicating significant gaps in HTN management. Findings are limited by convenience sampling, single-visit BP measurement, and missing data on medication use, which may lead to underestimation of treatment and control rates.

The pre-experimental study evaluated the effectiveness of a gamified educational intervention on knowledge regarding lifestyle modifications in polycystic ovarian disease among 60 pre university female students in Bengaluru. Knowledge was assessed using a structured questionnaire before and one week after a 60-minute gamified teaching session. Paired t-test analysis showed significant improvement in total knowledge scores from baseline to post-intervention. No significant association was observed between most demographic variables and baseline knowledge except paternal education and family income. The findings suggest gamified educational strategies can enhance adolescent awareness of lifestyle management in polycystic ovarian disease. Integrating such approaches into nursing education and community health programs may improve preventive health literacy.

Women who experience intimate partner violence (IPV) are highly susceptible to sustaining mild traumatic and hypoxic/anoxic brain injuries (mBIs), yet the cognitive and neurobehavioral consequences of IPV-mBI remain understudied. The current study examined the relationships between self-reported cognitive functioning and IPV-related mBI scores on neuropsychological test performance in women who experienced physical IPV. Participants included 48 women recruited from women's shelters and community health programs. All participants completed a neuropsychological battery, clinical interviews, and self-report questionnaires. Performance-based cognitive functioning was assessed through normed z-scores from six indices of neuropsychological tests of memory, learning, and cognitive flexibility. A cognitive composite score was also generated from all six indices. Self-reported cognitive functioning was measured using the cognitive subscale of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ-Cog), and an IPV-mBI frequency and recency score was calculated using the Brain Injury Severity Assessment (BISA). RPQ-Cog scores, BISA scores, and their interaction were entered into distinct hierarchical linear regressions with neuropsychological indices as the dependent variables. All analyses controlled for sociodemographic and psychological health variables that were significantly associated with neuropsychological test performance. There was a significant main effect of self-reported cognitive functioning on tests of immediate verbal memory (t(43) = -2.55, p = 0.015, 95% confidence interval [CI] [-0.50,-0.06]) and planning and initiation (t(42) = -2.03, p = 0.049, 95% CI: [-0.17,0.00]). There was a significant main effect of the IPV-mBI severity score on a test of cognitive switching (t(43) = -2.27, p = 0.029, 95% CI: [-0.78,-0.05]) and the global cognitive composite score (t(43) = -2.42, p = 0.020, 95% CI: [-0.36,-0.03]). There were no significant interactions between the RPQ-Cog scores and BISA scores on neuropsychological test performance. We found that among women who have experienced IPV, both self-reported cognitive problems and IPV-mBI history are independently related to poorer performance on neuropsychological tests. While further research is necessary, our findings suggest that women who have experienced physical IPV and endorse cognitive neurobehavioral symptoms or a history of IPV-mBI may benefit from comprehensive neuropsychological services to guide clinical care. Our findings also attest to the importance of developing screening measures for IPV-mBI history and ongoing neurobehavioral symptoms and implementing these measures in clinical settings.

Introduction: This systematic review and meta-analysis evaluated the effects of Baduanjin, a traditional Chinese mind-body exercise, on frailty and multidimensional health outcomes in older adults. Methods: Following PRISMA guidelines, we systematically searched multiple databases for RCTs on Baduanjin in frail adults aged ?60 years. Data were pooled using fixed- or random-effects models to calculate MDs or SMDs with 95% CIs. Heterogeneity was quantified by the I² statistic, with random-effects models applied if I² &gt; 50%. Publication bias was assessed by funnel plots and Egger’s test, with the trim-and-fill method used for adjustment when indicated. Results: Fifteen RCTs (n = 1,044) were included. Baduanjin significantly reduced frailty severity (SMD = -1.12; 95% CI: -1.59 to -0.65) and improved physical function outcomes, including grip strength (MD = 2.39 kg, 95% CI: 2.17 to 2.62, P &lt; 0.001), 6-minute walking distance (MD = 33.72 m; 95% CI: 12.47 to 54.97), and short-distance walk time, although the pooled effect (MD = -0.31 s; 95% CI: -0.57 to -0.06) was moderated by test distance with significant heterogeneity. Mental health improvements encompassed reduced anxiety/depression (SMD = -0.73; 95% CI: -1.11 to -0.35) and enhanced sleep quality (MD = -2.48; 95% CI: -3.21 to -1.76). Cognitive function (MMSE: MD = 2.81; 95% CI: 0.11 to 5.51) showed a statistically significant improvement, though with wide confidence intervals. Quality of life (SF-12/SF-36: SMD = 0.75; 95% CI: 0.48 to 1.02) also improved significantly. Conclusion: Despite methodological limitations in the included trials, pooled evidence suggests that Baduanjin may confer clinical benefits for managing frailty in older adults. Given its simplicity, safety, and adaptability, Baduanjin should be considered for integration into standard geriatric care and community health programs.

Modern society faces an increasing burden of lifestyle-related disorders, mental stress, and Non-Communicable Diseases (NCDs). Preventive healthcare strategies emphasize cost-effective, non-pharmacological approaches that promote long-term well-being. Yoga, an ancient mind-body discipline, integrates physical postures (asanas), breathing techniques (pranayama), meditation, and ethical lifestyle principles to promote holistic health. This paper explores the role of yoga and lifestyle management in preventive healthcare from physiological, psychological, and social perspectives. Drawing upon global health frameworks, including recommendations by the World Health Organization, the study highlights yoga as a sustainable strategy for reducing NCD risk, improving mental health, and enhancing quality of life. The paper concludes that integrating yoga into education systems, workplaces, and community health programs can significantly contribute to holistic and preventive healthcare.

Bacteriological Analysis of Communal Pump-Well Drinking Water in Linao East, Tuguegarao City: A Basis for Community Health and Sanitation Programs

Northern Uganda continues to experience high disease burdens and poor health outcomes shaped by poverty, geographic isolation, and long-standing health system constraints. Community health workers (CHWs) play an important role in rural districts by linking households to formal health services. In this study, CHWs refer to Village Health Team (VHT) members trained through the Laro Kwo Project in Pader District. However, limited research has examined how CHWs perceive community health priorities, barriers to care, and gaps between health knowledge and access. Understanding these perspectives is essential for designing responsive and sustainable community health programs. A qualitative descriptive study guided by interpretive principles was conducted across Pader District, Northern Uganda. Six focus group discussions were held between July 15 and 22, 2024 with 46 CHWs from six sub-counties, using a semi-structured guide covering eight domains related to community health, prevention practices, and program improvement. The guide was adapted from prior CHW-focused work and refined collaboratively with local partners. Data were documented through detailed field notes, translated, and analyzed inductively through iterative coding and thematic synthesis. Three overarching themes emerged: (1) experiencing health burden and community need, (2) barriers to access and systemic constraints, and (3) bridging health knowledge and everyday practice. CHWs identified malaria, maternal and child health complications, and a growing burden of non-communicable diseases as major community concerns. Persistent barriers to care included long distances to health facilities, medicine stockouts, and limited transportation. While communities demonstrated substantial knowledge of disease symptoms and prevention strategies, financial hardship and service limitations often prevented timely care-seeking and preventive action. CHWs' perspectives highlight a persistent gap between local health knowledge and access to care. Their recommendations emphasized priority health concerns and underscored the need for interventions that better align community knowledge with reliable and accessible services.

Saltpan workers face harsh socio-economic conditions that markedly increase their vulnerability to psychological distress, which in turn exacerbates their risk of developing Common Mental Health Disorders (CMDs). This study, based on a survey of saltpan workers in Marakkanam, and using binary logistic regression model revealed that 75.4% exhibited symptoms of CMDs. The analysis identified three key variables linked to CMD symptoms: debt repayment amount, gender, and caste. The findings highlighted a stark disparity in CMD prevalence among different groups within the community with marginalized groups such as women (91.3%) and Scheduled Castes (87.7%) experiencing a much higher incidence compared to men (49.5%) and Other Backward Classes (58.3%). The study also explored potential solutions by modeling various scenarios, revealing that reducing the debt repayment obligation from Rs. 4,965 to Rs. 2,921 and further to zero, decreased the prevalence of CMD symptoms to 57.5% and 29.6%, respectively. The findings underscore the intersectionality of gender, caste, and economic status in exacerbating CMDs among marginalized workers. Integrating economic support with mental health assistance is crucial, alongside targeted initiatives like community mental health programs, expanded social welfare schemes, and educational initiatives.

The increasing challenge of air pollution in cities requires smart methods to make proper predictions and manage the problem. Although machine learning and deep learning models have contributed greatly to weather and pollution forecasting, the main issue is the real-time flexibility, and scalability in the varying atmospheric conditions. This paper introduces a weighted Voting ensemble model that combines Gradient Boosting (×4), CatBoost (×3), XGBoost (×2) and LightGBM (×1) to improve the accuracy of Air Quality Index (AQI) forecasting. The full preprocessing (complete-case deletion, which retains extremes) and optimization of hyperparameters (GridSearchCV/Optuna, 5-fold CV) were used to enhance the robustness and generalizability of the model. The Taiwan Air Quality Dataset (2016-2024, [Formula: see text] hourly records from 74 stations), 6 major pollutants (PM2.5, PM10, [Formula: see text], [Formula: see text], [Formula: see text], CO), meteorological parameters (wind speed/direction), and 8-h averages) is used to model the data (spatial/temporal IDs are excluded, to allow deployment to a single station). Experimental validation of 60/16/24 splits (random + temporal validation) shows that the ensemble has validation MSE 0.6553 ([Formula: see text] 0.9969), which beats 15 baselines including the deep learning (LSTM MSE 45.4), but has temporal robustness (Δ [Formula: see text]= - 0.0037). Moreover, SHAP is implemented to offer explainability, as it gives more insights into the contribution of features in predicting AQI. The results indicate the promise of interpretable ensemble learning systems to underpin sustainable urban living, reinforce community health programs, and allow interventions in managing air quality in time.

This research set out to determine the role of aerobic exercises with music in reducing weight, psychological health, and physical fitness among obese women. Experimental approach was adopted and pre- post one group design. The sample consisted of fourteen (14) women between 25 and 30 years of age and who were not regular exercisers; they were selected in the Fitness Home Center in Maysan. The training regime was twelve (12) weeks with a frequency of 35 sessions a week, an intensity of 5075 percent of maximum heart rate. The program was made of aerobic exercises combined with rhythmic music. The findings showed statistically significant differences in the post-tests that favored the post-tests in the variables of body composition (weight, BMI, skinfold thickness), physical fitness variables (flexibility, agility, muscular endurance) and psychological variables (body image). The researchers concluded that music can be used in conjunction with aerobic exercise as an effective method to improve body composition, physical functions, and psychological health of the obese women. Such programs are suggested to be incorporated in fitness and community health programs.

Effectiveness of a technology-enhanced, integrated community health and wellness program for seniors: A non-randomized, cluster-allocated, quasi-experimental study.

Background, Community Health Workers (CHWs) play a crucial role in delivering health services, particularly in hard-to-reach areas; however, their performance is often hindered by excessive workloads, limited training, and inadequate supervision, thus supportive supervision is needed to provide guidance, emotional support, and continuous training in a conducive work environment. Objective of this study was to identify effective supportive supervision strategies to improve CHW performance through a scoping review. Methods involved article selection based on the PCC framework (Population: CHWs; Concept: supportive supervision strategies; Context: no geographical limitation), with data searches conducted in PubMed and Scopus databases using relevant Boolean search strings. Screening was performed according to inclusion criteria (relevant keywords, published within the last five years, full text, English language, aligned with PCC) and exclusion criteria (inaccessible, duplicates, or review articles), resulting in six articles analyzed using the PRISMA diagram. Results revealed that effective supportive supervision strategies include needs-based training, provision of motivation and moral support, structured performance monitoring and evaluation, constructive feedback, and strengthened communication and collaboration with stakeholders. The application of these strategies was found to improve CHW productivity, service quality, job satisfaction, and loyalty, while fostering a harmonious and sustainable work environment that ultimately supports the success of community health programs.