Comprehensive Prevention Strategy Research Articles

2-Fold More Cardiovascular Disease Events Decades Before Type 2 Diabetes Diagnosis: A Nationwide Registry Study

BackgroundThe risk of cardiovascular disease (CVD) is increased in individuals with type 2 diabetes mellitus (T2DM), but it remains uncertain how long an elevated CVD occurrence precedes diabetes diagnosis. ObjectivesThe aim of this study was to investigate CVD occurrence 30 years before, and 5 years after, T2DM diagnosis compared with matched comparisons. MethodsThis combined case-control and cohort study included all individuals diagnosed with T2DM in Denmark between 2010 and 2015, as well as general population comparisons matched by age and sex. CVD was defined as myocardial infarction or ischemic stroke. Conditional logistic regression was used to compute ORs for CVD prevalence in the 30-year period before T2DM diagnosis. Cox proportional hazards regression models were used to compute HRs for 5-year CVD incidence after T2DM diagnosis. ResultsThe study included 127,092 individuals with T2DM and 381,023 matched comparisons. In the 30-year period before T2DM diagnosis, 14,179 (11.2%) T2DM individuals and 17,871 (4.7%) comparisons experienced CVD. CVD prevalence was higher in those with T2DM than the comparisons in the entire period before T2DM diagnosis, with ORs ranging from 2.18 (95% CI: 1.91-2.48) in the earliest period (25-30 years before diagnosis) to 2.96 (95% CI: 2.85-3.08) in the latest period (<5 years before diagnosis). After T2DM diagnosis, 5-year CVD incidence was similarly increased in T2DM individuals vs comparisons (HR: 2.20; 95% CI: 2.12-2.27). ConclusionsIndividuals with T2DM had 2-fold more CVD events than matched comparisons starting 3 decades before T2DM diagnosis. This indicates that comprehensive preventive strategies may be initiated much earlier in individuals at risk of T2DM.

Population health and public health: Commonalities and differences.

To explore the synergy between population health and public health by initiating a discourse about their interconnected roles, responsibilities, and approaches in achieving optimal health outcomes. Population health and public health, although distinct, are interconnected disciplines critical for enhancing health outcomes. Population health focuses on analyzing health determinants and outcomes within specific groups, employing data to guide targeted interventions and policies. Public health, on the other hand, prioritizes broader preventive measures and community-wide interventions to safeguard health. Both fields benefit from a transdisciplinary approach that integrates strategies to address and improve health. Such integration is essential for addressing health disparities and improving the efficiency of health systems. By combining the analytical strengths of population health with the implementation capabilities of public health, a more comprehensive framework can be developed. These collaborations will not only enhance the effectiveness of health programs but also promote health equity by leveraging collective expertise and resources. They will facilitate the development of interventions that are both preventive and responsive, capable of addressing the upstream determinants of health and the immediate needs of communities. Such transdisciplinary efforts were demonstrated within the oral health field during the COVID-19 pandemic. The synergy between population and public health can lead to robust health outcomes, fostering comprehensive health promotion and disease prevention strategies. By aligning research, practices, and policies, these integrated approaches will transcend traditional boundaries within the healthcare sector to build efficient health systems.

From Silos to Systems: Reimagining Zoonotic Neglected Tropical Disease Management through the Lens of One Health

Zoonotic neglected tropical diseases (zNTDs) pose significant global public health challenges, particularly in low-income and middle-income countries. Traditional siloed approaches to zNTD management have proven inadequate for addressing the complex interplay between human, animal, and environmental health factors. This review examined the limitations of fragmented strategies and explored the potential of integrated one-health approaches for more effective zNTD control. This narrative review covered publications from 2000 to 2023, sourced from databases including PubMed and Scopus, emphasizing studies that met inclusion criteria of peer-reviewed research focused on zNTDs through a One Health lens. A comprehensive analysis of the current literature and case studies was conducted to evaluate the multifaceted drivers of zoonotic pathogen spillover, assess the economic and health impacts of zNTDs, and identify successful implementation of the One Health strategy in endemic regions. This review highlights the inadequacies of siloed disease management approaches, which often lead to inefficient resource allocation and missed opportunities for synergistic intervention. Successful case studies have demonstrated the effectiveness of the One Health strategy in improving disease surveillance, enhancing cross-sectoral collaboration, and achieving sustainable health outcomes. The potential of emerging technologies and innovations to support integrated approaches has also been explored. Transitioning from siloed to systemic approaches in zNTD management requires overcoming institutional barriers, fostering cross-sector collaboration, and implementing multitiered frameworks that operate at the local, national, and global levels. Investing in cross-sectoral capacity development and leveraging technological innovations are crucial for building a workforce capable of addressing the complex challenges posed by zNTDs. Adopting the One Health principle offers a promising path toward more comprehensive, efficient, and sustainable strategies for zNTD prevention.

Developing a culturally-responsive training program: Workplace violence against physicians in Türkiye

Workplace violence against physicians is a critical issue in Türkiye, requiring comprehensive strategies for prevention and management. This paper outlines the development of a culturally-responsive training program aimed at equipping Turkish physicians with the skills and knowledge needed to effectively address workplace violence. The program is built on the findings from semi-structured interviews with Turkish physicians, a national survey of 136 healthcare workers, historical analysis of workplace violence against physicians in Turkish online newspaper archives, and a workshop with practicing physicians, medical professors, communication experts, and patients. The training program integrates cultural sensitivity and empirical evidence to create a robust framework for mitigating violence in healthcare settings. The training consists of 16 interactive units, each focusing on different aspects of workplace violence and its management specific to Turkish hospital settings. They incorporate real-life scenarios, practical suggestions, and legislative guidelines on effectively managing and mitigating violence. By simulating actual situations, the modules provide hands-on experience and practical knowledge. A crucial aspect of the training is its culturally-responsive approach, which addresses the unique cultural dynamics and sensitivities within Turkish healthcare environments. This program ensures that Turkish physicians can perform their duties without fear of violence while respecting and understanding the cultural values and dynamics of Turkish society. This culturally-responsive dimension is key to creating an effective and impactful training program that enhances the safety and well-being of healthcare professionals in Türkiye.

HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya

BackgroundThe HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study’s objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.MethodsDried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.ResultsOf the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).ConclusionsOur study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.

Prophylactic Unfractionated Heparin in Antepartum Hospitalizations: A Randomized Controlled Trial

(Obstet Gynecol. 2024;144(1):118–125. doi: 10.1097/AOG.0000000000005599) Obstetric venous thromboembolism (VTE) is a significant cause of maternal morbidity and mortality, particularly in cases of prolonged antepartum hospitalizations. Comprehensive thromboembolism prevention strategies have helped reduce maternal mortality from thromboembolism. Current recommendations emphasize expanded heparin prophylaxis during antepartum hospitalizations to mitigate VTE risks. However, there is a lack of data on how pregnancy-induced physiological changes affect unfractionated heparin (UFH) disposition, potentially necessitating higher dosing during pregnancy. Studies suggest pregnant patients may require increased heparin doses due to lower peak plasma concentrations and altered coagulation parameters.

Development of a Real-Time PCR Assay for the Detection of Francisella spp. and the Identification of F. tularensis subsp. mediasiatica.

Tularemia is an acute infectious disease classified as a natural focal infection, requiring continuous monitoring of both human and animal morbidity, as well as tracking of pathogen circulation in natural reservoirs and vectors. These efforts are essential for a comprehensive prevention and containment strategy. The causative agent, Francisella tularensis, comprises three subspecies-tularensis, holarctica, and mediasiatica-which differ in their geographic distribution and virulence. The ability to directly detect the pathogen and differentiate between subspecies has enhanced diagnostics and allowed a more accurate identification of circulation areas. Real-time PCR protocols for identification of F. tularensis subspecies tularensis and holarctica have been developed, utilizing specific primers and probes that target unique genomic regions. In this study, we present the development of a new real-time PCR assay for the detection of Francisella spp. and differentiation of F. tularensis subsp. mediasiatica. The specificity of the assay was tested on DNA from 86 bacterial species across 31 families unrelated to Francisella spp., as well as on DNA collections of F. tularensis subsp. mediasiatica and F. tularensis subsp. holarctica. The limit of detection (LOD95%) for real-time PCR in detecting Francisella spp. was 0.297 fg (0.145 genomic equivalents, GE) for holarctica DNA and 0.733 fg (0.358 GE) for mediasiatica DNA. The LOD95% for subspecies differential identification of mediasiatica was 8.156 fg (3.979, GE). The high sensitivity and specificity of these developed protocols enable direct detection of pathogens in biological and environmental samples, thereby improving the efficiency of tularemia surveillance in Kazakhstan.

Maternal Characteristics and Iron Intake as a Factors of Iron Deficiency Anemia among Pregnant Women

Pregnancy is a critical period for fetal growth and development, nutritional issues can significantly affect both maternal and fetal health. This phase is marked by increased nutritional needs to support fetal development and maintain maternal well-being. This study investigates the prevalence and risk factors of iron deficiency anemia among pregnant women in Parung Panjang District Health Center, Indonesia. A cross-sectional study was conducted on 92 pregnant women, examining various maternal characteristics and nutrient adequacy levels. The prevalence of anemia was found to be 36%. Parity emerged as a significant factor, with primipara mothers showing a higher anemia rate (46%) compared to multipara mothers (23.8%). Iron intake adequacy was also significantly associated with anemia status (p = 0.050). Women with insufficient iron intake had a higher rate of anemia (45.7%) compared to those with sufficient intake (26.1%). Other factors such as maternal age, education, and vitamin C intake did not show significant associations with anemia. These findings highlight the importance of targeted interventions for primipara mothers and emphasize the crucial role of adequate iron intake during pregnancy. The study underscores the need for comprehensive anemia prevention strategies in prenatal care.

The Catastrophic Failure Mechanisms and the Prevention of Dynamic Pressure-Related Hazards During Mining Under an Interval Goaf Through an Isolated Coal Pillar in Shallow and Closely Spaced Coal Seams

Given the potential for dynamic load-induced support crushing that may occur during mining under an interval goaf through an isolated coal pillar (ICP) in shallow closely spaced coal seams, this paper systematically explored this issue through a case study of the 30,103 working face at the Nanliang Coal Mine. We employed a combined approach of similarity simulations, theoretical analyses, numerical simulations, and field measurements to investigate the catastrophic failure mechanisms and prevention strategies for dynamic pressure-related hazards encountered when mining a lower coal seam that passes through an ICP. The findings indicated that the synchronous cutting instability of the interlayer effective bearing stratum (IEBS) and double-arch bridge structure of the ICP roof were the primary causes of dynamic load-induced support crushing at the working face. A mechanical model was developed to characterize the IEBS instability during mining under an interval goaf. The sources and transmission pathways of dynamic mining pressure during mining passing through the ICP were clarified. The linked instability of the double-arch bridge structure of the ICP roof was induced by IEBS failure. The UDEC numerical model was utilized to elucidate the instability of the IEBS during mining in the lower coal seam and to analyze the vertical stress distribution patterns in the floor rock strata of the interval goaf. A comprehensive prevention and control strategy for roof dynamic pressure, which includes pre-releasing concentrated stress in the ICP, strengthening the support strength of the working face, and accelerating the advancement speed was proposed. The effectiveness of this prevention and control strategy was validated through actually monitoring the characteristics of mining pressure data from the 30,103 working face following pressure relief. The findings provide valuable insights for rock stratum control of shallow and closely spaced coal seam mining under similar conditions.

Prior Musculoskeletal Injury and Components of Physical Fitness in Military Personnel: A Systematic Review with Meta-analysis.

Military personnel confront heightened risks of musculoskeletal injuries (MSIs) because of the demanding nature of their duties, contributing to restricted active duty and financial burdens. Although preventable factors like training and physical fitness influence some injuries, understanding the enduring effects of previous MSIs on physical fitness in military personnel remains a critical gap. This study aimed to systematically review and meta-analyze this impact. In accordance with PRISMA guidelines, a systematic review with meta-analysis was conducted, focusing on military personnel with and without a history of MSIs. Physical fitness components were assessed via observational studies, with isokinetic peak torque values as primary metrics. Quality assessments utilized the NIH Quality Assessment Tool and GRADE framework. Out of 36 papers, 6 met inclusion criteria, with 4 included in the meta-analysis. Across 1,267 participants, individuals with prior MSIs exhibited a significant reduction in the pooled effect size for isokinetic peak muscle force, with d+ = -0.25 (95% CI: -0.36 to -0.13), notably affecting knee and shoulder regions. These findings underscore the pervasive impact of MSIs on military personnel's physical performance, necessitating targeted interventions. Military personnel with prior MSIs exhibit enduring deficits in isokinetic peak muscle force, particularly in knee and shoulder regions. However, evidence on the impact of previous injuries on other physical fitness components remains limited. Further research is crucial to understanding the multifaceted impact of MSIs on diverse aspects of physical performance, informing comprehensive injury prevention strategies and optimizing performance outcomes among military personnel.

Managing acidic mine water pollution in karst regions based on hydrogeological structures

Acidic mine drainage (AMD) is one of the primary pollutants from abandoned mines. This type of pollution is characterized by its extensive area, prolonged duration, and challenging detection process, especially in karst region with intricate hydrological systems, thereby posing a significant threat to the sustainable development of the economy. This paper focuses on the pollution of acidic mine water in the karst region of Southwest China and adopts a comprehensive watershed pollution management strategy. Considering the unique hydrogeological structure of the karst mines, the active water cycle, and the sensitivity and fragility of the ecological environment, this study proposes a set of acid mine drainage pollution control methods based on hydrogeological structures. These include “zonal management, one policy per mine; source control, pollution reduction; and end-of-pipe treatment, standard discharge.” This study applies coal mine water prevention and control techniques to environmental management, developing a series of source control methods including “filling, isolating, blocking, intercepting, draining, and controlling”. It also integrates physical, chemical, and biological methods for the end-of-pipe treatment of acidic mine water. This approach has been successfully applied to the management of acidic mine drainage in the Yudong River basin in Kaili, Guizhou. Long-term monitoring of the "three-fields and four-water” revealed that rainfall significantly influences mine water quality. The study identified a “U-tube effect” whereby mine water exacerbates the pollution of karst water, leading to the development of a comprehensive prevention and control strategy termed the “three blocking (obstruction) and one guarantee” project. A comparative analysis of total iron content in the basin before and after treatment demonstrated a marked reduction, from 97.8mg/L to less than 0.3mg/L. This study provides a typical example for the prevention, control, and management of acid water pollution in karst areas across the watershed, and can serve as a reference for similar pollution management efforts.

Beyond the Liver: A Comprehensive Review of Strategies to Prevent Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, primarily developing in the context of chronic liver disease. Traditional prevention has focused on liver-specific interventions like antiviral therapies and surveillance. However, extrahepatic factors also significantly contribute to HCC risk. This review explores comprehensive strategies for HCC prevention, including both hepatic and extrahepatic factors. An extensive literature search of peer-reviewed articles up to October 2024 was conducted, focusing on studies addressing HCC prevention strategies. Studies that focused on both hepatic and extrahepatic factors were included. Data were extracted and synthesized to provide an overview of current prevention strategies and their effectiveness in reducing HCC incidence. Hepatitis B vaccination and antiviral treatments for hepatitis B and C significantly reduce HCC incidence. Lifestyle modifications-such as reducing alcohol consumption, maintaining a healthy weight through diet and exercise, and smoking cessation-are crucial in lowering HCC risk. Environmental measures to limit exposure to aflatoxins and other hazards also contribute to prevention. Regular surveillance of high-risk groups enables early detection and improves survival rates. Emerging strategies like immunotherapy and gene therapy show potential for further reducing HCC risk. A comprehensive approach combining medical interventions, lifestyle changes, and environmental controls is essential for effectively decreasing HCC incidence globally. Implementing these combined measures could significantly reduce the global burden of HCC.

Entomological surveillance of container-breeding mosquitoes focusing on Aedes (Stegomyia) (Diptera: Culicidae)vectors along altitudinal range in Nepal.

Mosquitoes are a significant public health concern due to their role in transmitting various diseases. This study aimed to investigate mosquitoes' diversity, abundance, and ecological aspects, mainly focusing on Aedes (Diptera: Culicidae)mosquitoes, in central Nepal. The research explored variations across regions, seasons, altitudes, and years. Fieldwork for mosquito collection was conducted between May 2022 and October 2023. Dipping and pipetting methods were employed to collect larvae and pupae, whereas Biogents-Mosquitaire trap captured adult mosquitoes. A total of 7,223 (3,640 larvae and 3,583 adults) mosquitoes, belonging to 8 genera and 18 species, were collected and analyzed. Additionally, a survey examined 5,941 wet containers of 20 different types to assess potential breeding sites. The study revealed Culex pipiens (Linnaeus, 1758)(34.13%) and Aedes albopictus (Skuse, 1895)(27.36%) as the most abundant species. Interestingly, larvae were predominantly Aedes spp. (66.13%), whereas only 13.76% of adults belonged to this genus. Mosquito abundance varied across locations and altitudes, with Siwalik region (331-700 m asl) exhibiting the highest numbers. The monsoon season showed the highest overall abundance (1,492). Used tires were identified as significant breeding sites for Aedes mosquitoes, and infestation rates were higher in shaded containers. Seasonal analysis showed the House Index (HI) reaching its peak (10.92%) and the Breteau Index (BI) reaching 23.08% during the monsoon. Conversely, the Container Index (CI) reached its highest point (37.67%) in the post-monsoon season. The results emphasize the need for comprehensive disease prevention strategies at local and national levels, including public awareness campaigns, to address mosquito-borne illnesses in this famous tourist region.

Cross-sectional study on urinary metal concentrations in young adult residents of Emirate of Sharjah, United Arab Emirates.

Human biomonitoring is crucial for regulatory toxicology, yet data on biomarker concentrations in the UAE are lacking. This study addresses this gap by analyzing urinary concentrations of 16 metals in UAE young adults, assessing correlations with personal characteristics, dietary patterns, and lifestyle habits. A cross-sectional pilot study was conducted among 144 randomly selected young adults (71 males and 73 females) from Sharjah, UAE, between January and March 2023. Participants provided urine samples, which were analyzed for 16 heavy metals using ICP-OES, and completed detailed questionnaires covering sociodemographic factors, lifestyle, and dietary habits. Descriptive statistics were used to summarize participant characteristics, and linear regression analysis was applied to explore associations between metal concentrations and factors such as gender, dietary habits, and exposure to environmental risks. Non-parametric tests, including the Mann-Whitney test, were used to assess differences by gender. Statistical significance was set at p < 0.05. Ethical approval was obtained, and informed consent was secured before participation. Significant findings include dietary influences on metal exposure, with rice consumption linked to higher metal concentrations. Sex differences were significant, with females showing elevated levels of arsenic, lead, and cadmium. Lifestyle factors, such as smoking and incense use, were correlated with increased barium and boron levels. This study highlights the significant role of dietary habits, especially the consumption of rice, in metal exposure among young adults in Sharjah. The findings highlight the urgent need for comprehensive human biomonitoring to understand environmental exposures and reform public health policies. The gender-specific differences in metal distribution suggest the necessity for targeted public health strategies. The study, however, is limited by its cross-sectional nature and the focus on a specific geographic area, warranting further research for broader generalizability. Future investigations, particularly on the impact of incense exposure on metal levels, are essential for developing comprehensive health interventions and preventive strategies in the UAE.

Spatiotemporal distribution and meteorological factors of hemorrhagic fever with renal syndrome in Hubei province.

Hemorrhagic fever with renal syndrome (HFRS) is a vital rodent-borne disease, and poses a serious public health threat in Hubei province. We aimed to explore the spatiotemporal distribution of HFRS in Hubei province during 2005-2022, and the effects of meteorological factors. Data on HFRS cases at the county level in Hubei province during 2005-2022 were obtained from the Chinese Center for Disease Prevention and Control Information System. The monthly meteorological data at the city level was extracted from the China Meteorological Data Sharing Service System from 2016 to 2020. Descriptive analyses, joinpoint regression model, spatial correlation analyses, Geodetector model and autoregressive integrated moving average (ARIMA) model were conducted to investigate the epidemic characteristics, temporal trend, spatial distribution, influencing factors of HFRS and predict its trend. A total of 6,295 cases were reported in Hubei province during 2005-2022, with an average incidence of 6/1,000,000. Most cases were males (74.52%) and aged 40-69 years (71.87%). The monthly HFRS cases showed two seasonal peaks, which were summer (May to June) and winter (November to December). The HFRS incidence remained fluctuating at a low level during 2005-2015, followed an increasing trend during 2015-2018, and then decreased during 2018-2022. Hotspots were concentrated in the center of Hubei province in all 3 periods, including Qianjiang, Tianmen and some counties from Xiangyang, Jingmen and Jingzhou cities. The distribution of HFRS had a positive association with wind speed, while a "V"-shaped correlation with mean temperature, with an explanatory power of 3.21% and 1.03% respectively (both P <0.05). The ARIMA model predicted about 1,223 cases occurred in the next 3 years. HFRS cases showed seasonal fluctuation and spatial clustering in Hubei province. Central plain areas showed high risk of HFRS. Wind speed and mean temperature had significant effects on the transmission of HFRS in Hubei province. The results alert health authorities to conduct disease-climate surveillance and comprehensive prevention strategies, especially in high-risk counties.

Health Related Quality of Life Among Private School Teachers in Chengalpattu District, Tamil Nadu, India-A Cross Sectional Study

Background: Teachers are the foundation of any civilized society, as they preserve information, wisdom, and ideals. The study was conducted to analyze the Health-Related Quality Of Life among private school teachers and associate the findings with various demographic and occupational parameters. Methodology: This cross-sectional study was conducted among 300 private school teachers in Chengalpattu district from March-to May 2024.Sample size was determined by multistage random sampling technique. A semi-structured questionnaire consisting of background, occupation related details, and SF-36 to assess the HRQOL were used to collect data. Data was entered in excel and analysed using SPSS version 26. Results: Out of 300 teachers,233 were female and 152 were above the age of 40. Most affected domains were Bodily Pain and General Health Perception. In both these domains, very low mean levels of quality of life were significantly associated with teachers age more than 40 years old, those who got monthly income of more than 40k, married, teaching experience more than 20 years, those who travelled more than 60 minutes to reach school and those who had comorbidities. Conclusions: At least one variable across all domains analysed was associated with lower quality of life scores. Administrators and policymakers must provide appropriate health education or health promotion programs and comprehensive prevention strategies for improving their HRQOL.

Association of relative handgrip strength on the development of diabetes mellitus in elderly Koreans.

Diabetes mellitus (DM) is a significant public health concern, particularly in the elderly population. Absolute handgrip strength (HGS) serves to quantify muscle strength. It is recommended that the risk of low muscle strength and increased body mass index be concurrently evaluated using relative HGS. There are currently insufficient evidence regarding the relationship between relative HGS and DM in the elderly Korean population. Therefore, the association between relative HGS and the development of DM in Korean elderly was investigated. Data from the Korean Longitudinal Study of Ageing were used to determine the odds ratio (OR) between relative HGS and DM during the follow-up period from 2006-2020 among Korean men and women aged ≥65 years without DM when they first participated in this survey. Analysis was conducted using the Generalized Estimating Equation method. Trend analysis was performed for DM development based on relative HGS. Among elderly males, higher relative HGS groups had reduced odds of developing DM (Middle tertile: OR 0.87, 95% CI 0.61-1.23, p = 0.419.) (Upper tertile: OR 0.82, 95% CI 0.56-1.18, p = 0.281.) Among elderly females, the reductions were similar. (Middle tertile: OR 0.82, 95% CI 0.66-1.03, p = 0.087.) (Upper tertile: OR 0.79, 95% CI 0.50-1.25, p = 0.306.) However, these differences were not statistically significant. Significant predictors of new-onset DM included age, BMI (overweight/obese), household income, alcohol consumption, hypertension, and chronic liver disease. Trend tests indicated a substantial decrease in the OR as the relative HGS increased for male and total groups (p for trend < 0.05). Relative HGS did not achieve statistical significance. Our findings indicate that BMI, particularly overweight and obesity, significantly predicts new-onset DM. However, trend tests indicated a substantial decrease in the OR as the relative HGS increased for male and total groups (p for trend < 0.05), even after adjusting for BMI categories. Despite the lack of statistical significance in some cases, the trend suggests that promoting resistance exercises to enhance HGS could be beneficial in DM prevention. Comprehensive DM prevention strategies should include managing obesity and chronic conditions for elderly.

Combating drug abuse through pharmacist-led public health campaigns strategic initiatives for global prevention

The global drug abuse crisis continues to pose significant public health challenges, necessitating comprehensive prevention strategies. Pharmacists, as accessible and trusted healthcare professionals, are increasingly recognized for their pivotal role in drug abuse prevention. This paper explores pharmacist-led public health campaigns and interventions designed to mitigate drug abuse, particularly through education, outreach, and collaboration with other healthcare providers. It examines core components of effective campaigns, including targeting at-risk populations such as youth and high-risk communities. Additionally, the paper discusses global prevention strategies, addressing the cultural, economic, and legal barriers that pharmacists face while highlighting opportunities for their leadership in international drug prevention efforts. The conclusion emphasizes the need for policy recommendations to enhance the pharmacist’s role in drug abuse prevention, alongside future directions leveraging digital health technologies and international collaboration to achieve more effective global outcomes.

Female Athlete Triad: Understanding the Interrelationship between Energy Availability, Menstrual Function, and Bone Health

The Female Athlete Triad (FAT) is a complex medical condition characterized by three interrelated components: low energy availability (EA) with or without disordered eating, menstrual dysfunction, and decreased bone mineral density (BMD). This syndrome is particularly prevalent among female athletes who engage in sports that prioritize leanness, endurance, and aesthetic performance, such as gymnastics, dance, and long-distance running. Prolonged exposure to inadequate caloric intake relative to energy expenditure can disrupt hormonal regulation, leading to irregular or absent menstrual cycles (amenorrhea) and compromising bone health. This cross-sectional study aims to investigate the prevalence and impact of low EA on menstrual function and BMD among 180 female athletes aged 18-30 years. Participants were divided into three menstrual status categories: eumenorrhea, oligomenorrhea, and amenorrhea. The study also categorized athletes into sports groups (aesthetic, endurance, and power sports) to identify patterns across different disciplines. Data collection included dietary intake records, exercise logs, menstrual history questionnaires, and DEXA scans to measure BMD at the lumbar spine and hip. Results indicate that 67% of participants exhibited low EA (&lt; 30 kcal/kgFFM/day), which was significantly associated with menstrual dysfunction (p &lt; 0.001). Among participants, 25% reported oligomenorrhea (irregular cycles), and another 25% experienced amenorrhea (absence of menstruation for more than three months). BMD analysis revealed that 30% of the athletes had osteopenia, while 5% were diagnosed with osteoporosis, highlighting the long-term risks associated with chronic low EA and menstrual irregularities. Notably, athletes engaged in aesthetic sports had the highest prevalence of low EA (80%) and menstrual dysfunction (45%), followed closely by those in endurance sports. These findings underscore the urgent need for targeted interventions to promote energy balance, safeguard reproductive health, and prevent bone deterioration among female athletes. Educational programs focusing on nutritional counseling, regular monitoring of menstrual health, and multidisciplinary care involving coaches, sports dietitians, and healthcare providers are essential to mitigate the risks of the Female Athlete Triad. Future research should further explore psychological factors influencing energy availability, including body image concerns and disordered eating patterns, to develop comprehensive prevention strategies.

Incidence of foodborne diseases in Ecuador.

Motivation for the study. In Ecuador, foodborne disease (FBD) incidence rates adjusted for population size have not been estimated, which will serve to identify priority geographic areas. Main findings. Between 2015-2020, 113,695 cases of FBD were identified, with "other food poisoning" and hepatitis A being most common. The highest incidence rates were found in the Amazon region. There is marked variability by geographic region in the incidence rates during the study period. Public health implications. It is necessary to optimize the registry system, establish detection and treatment protocols, analyze the causes related to the higher incidence of FBD in the Amazon region, and design a health promotion program focused on preventing contamination and establishing diagnostic and treatment protocols. In order to describe the incidence rates per 100 000 population of foodborne disease (FBD) cases during the period 2015-2020 in Ecuador, we carried out a secondary analysis of epidemiological surveillance records and population projections from the National Institute of Statistics and Census. A total of 113,695 cases were reported with an incidence of more than 100 cases per 100 000 population (2015-2019). In 2020, the records are considerably lower than those reported in previous years. Most cases were reported as "other food poisoning". The highest incidence rates of FBD were found in the Amazon region. In general, there is a marked annual variability in the incidence of FBD according to the geographic regions of Ecuador. In conclusion, FBD represent a public health problem in Ecuador. Comprehensive preventive strategies should be designed with special emphasis on the Amazon region.