Effective Public Health Research Articles

Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis.

This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL) and psychological well-being of unaccompanied minors (UM). PubMed, Scopus, Embase, ProQuest, PsycInfo, PsycArticles, and Open Dissertations databases were used to identify quantitative and qualitative studies. The Effective Public Health Practice Project (EPHPP) and Critical Appraisal Skills Programme (CASP) tools were used for quality assessment. Narrative synthesis and qualitative research synthesis were carried out to collate the findings. 18 studies were included. Two studies examined QoL, and five studies examined acceptability of interventions. Most quantitative studies (n = 10) were appraised as methodologically weak. Trauma-Focused CBT appears to have the most evidence demonstrating effectiveness in ameliorating symptoms of post-traumatic stress disorder, depression, and anxiety. Promising findings (i.e., increased mindfulness and psychological flexibility) were observed for third wave interventions but further replication is required. The literature is tainted by under-powered studies, lacking blinding, and follow-up assessments. Female UM remain largely underrepresented. This review calls for a drastic augmentation of high quality quantitative and qualitative research focusing on augmenting QoL and examining acceptability rather than merely aiming for psychological symptom reduction in UM to enhance overall well-being and functionality. The research protocol was registered in PROSPERO (registration number: CRD42021293881).

Temporal trends in population attributable fractions of modifiable risk factors for dementia: a time-series study of the English Longitudinal Study of Ageing (2004–2019)

BackgroundInterest in modifiable risk factors (MRFs) for dementia is high, given the personal, social, and economic impact of the disorder, especially in ageing societies such as the United Kingdom. Exploring the population attributable fraction (PAF) of dementia attributable to MRFs and how this may have changed over time remains unclear. Unravelling the temporal dynamics of MRFs is crucial for informing the development of evidence-based and effective public health policies. This investigation examined the temporal trajectories of MRFs for dementia in England.MethodsWe used data from the English Longitudinal Study of Ageing, a panel study over eight waves collected between 2004 and 2019 (76,904 interviews in total). We calculated the PAFs for twelve MRFs (including six early- to mid-life factors and six late-life factors), as recommended by the Lancet Commission, and the individual weighted PAFs (IW-PAFs) for each risk factor. Temporal trends were analysed to understand the changes in the overall PAF and IW-PAF over the study period. Subgroup analyses were conducted by sex and socioeconomic status (SES).ResultsThe overall PAF for dementia MRFs changed from 46.73% in 2004/2005 to 36.79% in 2018/2019, though this trend was not statistically significant. During 2004–2019, hypertension, with an average IW-PAF of 8.21%, was the primary modifiable determinant of dementia, followed by obesity (6.16%), social isolation (5.61%), hearing loss (4.81%), depression (4.72%), low education (4.63%), physical inactivity (3.26%), diabetes mellitus (2.49%), smoking (2.0%), excessive alcohol consumption (1.16%), air pollution (0.42%), and traumatic brain injury (TBI) (0.26%). During 2004–2019, only IW-PAFs of low education, social isolation, and smoking showed significant decreasing trends, while IW-PAFs of other factors either did not change significantly or increased (including TBI, diabetes mellitus, and air pollution). Upon sex-specific disaggregation, a higher overall PAF for MRFs was found among women, predominantly associated with later-life risk factors, most notably social isolation, depression, and physical inactivity. Additionally, hearing loss, classified as an early- to mid-life factor, played a supplementary role in the identified sex disparity. A comparable discrepancy was evident upon PAF evaluation by SES, with lower income groups experiencing a higher dementia risk, largely tied to later-life factors such as social isolation, physical inactivity, depression, and smoking. Early- to mid-life factors, in particular, low education and obesity, were also observed to contribute to the SES-associated divergence in dementia risk. Temporal PAF and IW-PAF trends, stratified by sex and SES, revealed that MRF PAF gaps across sex or SES categories have persisted or increased.ConclusionsIn England, there was little change over time in the proportion of dementia attributable to known modifiable risk factors. The observed trends underscore the continuing relevance of these risk factors and the need for targeted public health strategies to address them.

Predicting Suicidal Ideation, Planning, and Attempts among the Adolescent Population of the United States.

Suicide is the second leading cause of death among individuals aged 5 to 24 in the United States (US). However, the precursors to suicide often do not surface, making suicide prevention challenging. This study aims to develop a machine learning model for predicting suicide ideation (SI), suicide planning (SP), and suicide attempts (SA) among adolescents in the US during the coronavirus pandemic. We used the 2021 Adolescent Behaviors and Experiences Survey Data. Class imbalance was addressed using the proposed data augmentation method tailored for binary variables, Modified Synthetic Minority Over-Sampling Technique. Five different ML models were trained and compared. SHapley Additive exPlanations analysis was conducted for explainability. The Logistic Regression model, identified as the most effective, showed superior performance across all targets, achieving high scores in recall: 0.82, accuracy: 0.80, and area under the Receiver Operating Characteristic curve: 0.88. Variables such as sad feelings, hopelessness, sexual behavior, and being overweight were noted as the most important predictors. Our model holds promise in helping health policymakers design effective public health interventions. By identifying vulnerable sub-groups within regions, our model can guide the implementation of tailored interventions that facilitate early identification and referral to medical treatment.

Impact of COVID-19 pandemic on routine childhood vaccinations

Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases. However, during the coronavirus disease 2019 pandemic, routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues. Governments and the United Nations have taken measures to re-establish routine pediatric vaccination, while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.

Technology-enhanced psychological assessment and treatment of distressing auditory hallucinations: a systematic review

PurposeAuditory hallucinations (“hearing voices”) are a relatively common experience, which is often highly distressing and debilitating. As mental health services are under increasing pressures, services have witnessed a transformative shift with the integration of technology into psychological care. This study aims to narratively synthesise evidence of technology-enhanced psychological assessment and treatment of distressing voices (PROSPERO 393831).Design/methodology/approachThis review was carried out according to the preferred reporting items for systematic reviews and meta-analyses. Embase, MEDLINE, PsycINFO and Web of Science were searched until 30th May 2023. The Effective Public Health Practice Project (EPHPP) tool assessed methodological quality of studies.FindingsSearching identified 9,254 titles. Fourteen studies (two assessment studies, twelve treatment studies, published 2010–2022, n = 1,578) were included in the review. Most studies were conducted in the UK, the USA or Canada. Technologies included avatar therapy, mobile apps, virtual reality, a computerised Web-based programme and a mobile-assisted treatment. Overall, technology-enhanced psychological assessments and treatments appear feasible, acceptable and effective, with avatar therapy the most used intervention. EPHPP ratings were “strong” (n = 8), “moderate” (n = 5) and “weak” (n = 1).Originality/valueTo the best of the authors’ knowledge, this is the first systematic review to investigate these technologies, specifically for distressing voices. Despite the relatively small number of studies, findings offer promising evidence for the clinical benefits of these technologies for enhancing mental health care for individuals with distressing voices. More high-quality research on a wider range of technologies is warranted.

Molecular Characterization and Antibacterial Resistance Determination of Escherichia coli Isolated from Fresh Raw Mussels and Ready-to-Eat Stuffed Mussels: A Major Public Health Concern.

Our study focused exclusively on analyzing Escherichia coli (E. coli) contamination in fresh raw mussels and ready-to-eat (RTE) stuffed mussels obtained from authorized and regulated facilities. However, it is critical to recognize that such contamination represents a significant public health threat in regions where unauthorized harvesting and sales practices are prevalent. This study aimed to comprehensively assess the prevalence, molecular characteristics, and antibacterial resistance profiles of E. coli in fresh raw mussels and RTE stuffed mussels. E. coli counts in fresh raw mussel samples ranged from 1 to 2.89 log CFU/g before cooking, with a significant reduction observed post-cooking. RTE stuffed mussel samples predominantly exhibited negligible E. coli presence (<1 log CFU/g). A phylogenetic analysis revealed a dominance of phylogroup A, with variations in the distribution observed across different sampling months. Antibacterial resistance was prevalent among the E. coli isolates, notably showing resistance to ampicillin, streptomycin, and cefotaxime. Extended-spectrum β-lactamase (ESβL) production was rare, with only one positive isolate detected. A variety of antibacterial resistance genes, including tetB and sul1, were identified among the isolates. Notably, virulence factor genes associated with pathogenicity were absent. In light of these findings, it is imperative to maintain rigorous compliance with quality and safety standards at all stages of the mussel production process, encompassing harvesting, processing, cooking, and consumption. Continuous monitoring, implementation of rigorous hygiene protocols, and responsible antibacterial drug use are crucial measures in mitigating food safety risks and combating antibacterial resistance. Stakeholders, including seafood industry players, regulatory agencies, and healthcare professionals, are essential to ensure effective risk mitigation and safeguard public health in the context of seafood consumption.

Evolving Epidemiology and Antibiotic Resistance in Enteric Fever: A Comprehensive Review.

Enteric fever, predominantly caused by Salmonella enterica serovar Typhiand Salmonella enterica serovar Paratyphi, remains a significant global health challenge. This comprehensive review examines the evolving epidemiology and antibiotic resistance associated with enteric fever. We provide an overview of the disease's definition and historical context, highlighting the substantial impact of antibiotic resistance on treatment efficacy. The review details the global burden, incidence trends, and risk factors of enteric fever while elucidating the pathogenesis and clinical manifestations of the disease. A critical analysis of antibiotic resistance mechanisms reveals the alarming rise of multi-drug resistant (MDR) and extensively drug-resistant (XDR) strains, complicating treatment regimens and underscoring the need for novel therapeutic strategies. Current treatment protocols, the role of empirical therapy, and the rational use of antibiotics are discussed in depth. Additionally, we explore prevention and control strategies, emphasizing the importance of vaccination programs, sanitation improvements, and effective public health interventions. The review concludes with recommendations for future actions, including enhanced surveillance, research and development of new antibiotics, expansion of vaccination efforts, and improved public health infrastructure. The findings highlight the necessity for updated clinical guidelines and sustained global efforts to address the challenges of enteric fever and its evolving antibiotic resistance patterns. Through coordinated action and continued innovation, it is possible to mitigate the impact of this enduring public health threat.

Hybrid Time Series Model for Advanced Predictive Analysis in COVID-19 Vaccination

This study aims to enhance the prediction of COVID-19 vaccination trends using a novel integrated forecasting model, facilitating better public health decision-making and resource allocation during the pandemic. As the COVID-19 pandemic continues to impact global health, accurately forecasting vaccination trends is critical for effective public health response and strategy development. Traditional forecasting models often fail to capture the complex dynamics of pandemic-driven vaccination rates. The analysis utilizes a comprehensive dataset comprising over 68,487 entries, detailing daily vaccination statistics across various demographics and geographic locations. This dataset provides a robust foundation for modeling and forecasting efforts. It utilizes advanced time series analysis techniques and machine learning algorithms to accurately predict future vaccination patterns based on the Hybrid Harvest model, which combines the strengths of ARIMA and Prophet models. Hybrid Harvest exhibits superior performance, with mean-square errors (MSEs) of 0.1323, and root-mean-square errors (RMSEs) of 0.0305. Based on these results, the model is significantly more accurate than traditional forecasting methods when predicting vaccination trends. It offers significant advances in forecasting COVID-19 vaccination trends through integration of ARIMA and Prophet models. The model serves as a powerful tool for policymakers to plan vaccination campaigns efficiently and effectively.

A Novel Web-Based Application for Influenza and COVID-19 Outbreak Detection and Response in Residential Aged Care Facilities.

The use of innovative digital health technologies in public health is expanding quickly, including the use of these tools in outbreak response. The translation of a digital health innovation into effective public health practice is a complex process requiring diverse enablers across the people, process, and technology domains. This paper describes a novel web-based application that was designed and implemented by a district-level public health authority to assist residential aged care facilities in influenza and COVID-19 outbreak detection and response. It discusses some of the challenges, enablers, and key lessons learned in designing and implementing such a novel application from the perspectives of the public health practitioners (the authors) that undertook this project.

Newborn screening in Mexico and Latin America: present and future

The first newborn screening (NBS) program to be implemented in Latin America was in Mexico in 1974, eleven years after the initial NBS programs in other parts of the world. In the last 50 years, progress has been made in implementing and expanding NBS in Mexico and across Latin America, yet children across the region do not fully benefit from this effective public health strategy. Here, we review the progress in the implementation of expanded NBS in Latin America with a focus on Mexico and the challenges faced by its complex healthcare system. In light of new technologies such as genomic sequencing and their potential utilization for NBS, we discuss what the future of NBS may be for Mexico and countries in Latin America and the Caribbean region, given economic and technological constraints.

Health outcomes in children with prenatal opioid exposure with and without neonatal abstinence syndrome in the first seven years of life: An observational cohort study.

Prenatal opioid exposure (POE) is a major public health consequence of the opioid epidemic. Long-term health outcomes associated with POE remain unclear, especially for children with POE without a diagnosis of neonatal abstinence syndrome (NAS). Here, we aimed to describe the health outcomes of children with POE and with POE and NAS compared to unexposed children during the first 7 years of life. In this retrospective observational cohort study, children born between 2015 and 2022 were identified from the Maternal and Infant Data Hub (MIDH), a data repository that continuously integrates maternal, neonatal, and pediatric records from two academic medical centers and one pediatric hospital system in the Midwest, USA. International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10 CM) chapters A00-N99 served as outcomes of interest. Annual incidence and crude incidence rate ratios were calculated to explore descriptive differences between the exposed and unexposed groups. The study included 22,002 children, 20,130 (91.5%) of whom were unexposed and 1872 (8.5%) were exposed. Of the 1872 exposed children, 371 (19.8%) received a diagnosis of NAS (POE + NAS) and 1501 were in the POE-NAS group. Across all 7 years, exposed children had a higher incidence of diagnoses in most ICD-10 CM chapters compared to unexposed children. A consistently higher incidence rate ratio of diagnosis was observed in both POE-NAS and POE + NAS groups (vs. unexposed) related to mental and behavioral disorders, eye diagnoses, and diseases of the musculoskeletal system and gastrointestinal systems. POE is associated with an increased risk of diagnoses in a number of ICD-10 CM chapters throughout childhood. These findings underscore the need for early screening and targeted interventions to support exposed children and improve their well-being. Further research is required to explore underlying mechanisms and develop preventive measures for at-risk populations. Understanding the conditions more often diagnosed in children with prenatal opioid exposure will help to improve care provided to this population. As a result of study findings, nurses who provide care to children with prenatal opioid exposure can prioritize their assessments and allocate time, resources, and education toward areas more likely to be affected.

Empowering public health: building advanced molecular surveillance in resource-limited settings through collaboration and capacity-building.

The rapid detection and continuous surveillance of infectious diseases are important components of an effective public health response. However, establishing advanced molecular surveillance systems, crucial for monitoring and mitigating pandemics, poses significant challenges in resource-limited developing countries. In a collaborative effort, research institutions from Benin joined forces with Mali's National Institute of Public Health to implement a state-of-the-art molecular surveillance system in Mali. This approach was characterized by collaboration, multidisciplinarity, and tutoring. Key activities included a comprehensive assessment of infrastructure and human resources through document reviews, interviews, and laboratory visits; the development and validation of Standard Operating Procedures (SOPs) for advanced molecular surveillance following an inclusive approach; capacity-building initiatives for 25 biologists in Mali on sequencing techniques; and international tutoring sessions for eight Malian professionals held in Benin. These collective efforts enabled Mali to establish an advanced molecular surveillance system aligned with the WHO's global strategy for genomic surveillance. This manuscript aims to share experiences, insights, and outcomes from this initiative, with the hope of contributing to the broader discussion on strengthening global health security through collaborative approaches and capacity-building efforts, particularly in developing countries.

Impacto e desafios da presença de animais silvestres no saneamento rural

In this article, we will explore the complex interaction between wild animals and rural sanitation, highlighting the different aspects of this relationship and analyzing its implications. Rural sanitation is a crucial area in ensuring the health and well-being of communities living outside urban centers. Encompassing a variety of activities and infrastructure, rural sanitation aims to provide safe access to drinking water, adequate sewage treatment and effective solid waste management. The relationship between rural sanitation and wild animals is close and their interactions can have significant consequences for both public health and the preservation of fauna. While rural sanitation seeks to ensure safe access to drinking water, effective sewage treatment and adequate solid waste management, the presence of wild animals can introduce additional challenges to these initiatives. The influence of wild animals in the context of rural sanitation is a crucial factor to be addressed in promoting public health and environmental sustainability in rural communities. Although these animals perform essential functions in natural ecosystems, their presence can pose significant challenges to sanitation practices, such as contamination of drinking water sources, inadequate management of solid waste and complexity in sewage treatment.

Artificial Intelligence Used for Diagnosis in Facial Deformities: A Systematic Review.

AI is included in a lot of different systems. In facial surgery, there are some AI-based software programs oriented to diagnosis in facial surgery. This study aims to evaluate the capacity and training of models for diagnosis of dentofacial deformities in class II and class III patients using artificial intelligence and the potential use for indicating orthognathic surgery. The search strategy is from 1943 to April 2024 in PubMed, Embase, Scopus, Lilacs, and Web of Science. Studies that used imaging to assess anatomical structures, airway volume, and craniofacial positions using the AI algorithm in the human population were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project instrument. The systematic search identified 697 articles. Eight studies were obtained for descriptive analysis after exclusion according to our inclusion and exclusion criteria. All studies were retrospective in design. A total of 5552 subjects with an age range between 14.7 and 56 years were obtained; 2474 (44.56%) subjects were male, and 3078 (55.43%) were female. Six studies were analyzed using 2D imaging and obtained highly accurate results in diagnosing skeletal features and determining the need for orthognathic surgery, and two studies used 3D imaging for measurement and diagnosis. Limitations of the studies such as age, diagnosis in facial deformity, and the included variables were observed. Concerning the overall analysis bias, six studies were at moderate risk due to weak study designs, while two were at high risk of bias. We can conclude that, with the few articles included, using AI-based software allows for some craniometric recognition and measurements to determine the diagnosis of facial deformities using mainly 2D analysis. However, it is necessary to perform studies based on three-dimensional images, increase the sample size, and train models in different populations to ensure accuracy of AI applications in this field. After that, the models can be trained for dentofacial diagnosis.

Intrapartum maternal glycaemic control for the prevention of neonatal hypoglycaemia: a systematic review and meta-analysis

BackgroundNeonatal hypoglycaemia is the most common metabolic disorder in infants, and may be influenced by maternal glycaemic control. This systematic review evaluated the effect of intrapartum maternal glycaemic control on neonatal hypoglycaemia.MethodsWe included randomised controlled trials (RCTs), quasi-RCTs, non-randomised studies of interventions, and cohort or case-control studies that examined interventions affecting intrapartum maternal glycaemic control compared to no or less stringent control. We searched four databases and three trial registries to November 2023. Quality assessments used Cochrane Risk of Bias 1 or the Effective Public Health Practice Project Quality Assessment Tool. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis was performed using random-effects models analysed separately for women with or without diabetes. The review was registered prospectively on PROSPERO (CRD42022364876).ResultsWe included 46 studies of women with diabetes and five studies of women without diabetes: one RCT, 32 cohort and 18 case-control studies (11,273 participants). For women with diabetes, the RCT showed little to no difference in the incidence of neonatal hypoglycaemia between tight versus less tight intrapartum glycaemic control groups (76 infants, RR 1.00 (0.45, 2.24), p = 1.00, low certainty evidence). However, 11 cohort studies showed tight intrapartum glycaemic control may reduce neonatal hypoglycaemia (6,152 infants, OR 0.44 (0.31, 0.63), p < 0.00001, I2 = 58%, very low certainty evidence). For women without diabetes, there was insufficient evidence to determine the effect of tight intrapartum glycaemic control on neonatal hypoglycaemia.ConclusionsVery uncertain evidence suggests that tight intrapartum glycaemic control may reduce neonatal hypoglycaemia in infants of women with diabetes. High-quality RCTs are required.

Parental acceptance of Silver Diamine Fluoride in two lower-middle-income countries: Iran and Tajikistan

BackgroundUsing Silver Diamine Fluoride (SDF) may be an effective public health approach for managing dental caries in children. Parental acceptance of SDF has rarely been investigated in low-income and middle-income countries (LMICs). The aim of this study was to evaluate parental acceptance of SDF to manage dental caries in children aged 2–12 in Iran and Tajikistan.MethodsThis cross-sectional study was conducted in the Kurdistan province of Iran and Khatlon region of Tajikistan, 2022–2023. Parents watched a video about SDF and its weaknesses and strengths as compared to conventional approaches before completing the questionnaire. We also reported Prevalence Ratios with 95% confidence intervals for the relationship between parental acceptance and associated demographic factors as well as dental attitude and experience.ResultsParticipants were 245 and 160 parents in Iran and Tajikistan, respectively. In both countries, a majority (Iran: 61.6%, Tajikistan: 77.9%) accepted SDF over conventional treatments for all primary teeth. The majority also accepted SDF only for posterior permanent teeth (Iran: 73.5%, Tajikistan: 78.7%). Black discoloration was the main reason for rejecting SDF. Overall, demographic factors and dental experience and attitude were not significantly associated with SDF acceptance.ConclusionsSDF was widely accepted by Iranian and Tajik parents. Establishing parental acceptance of SDF is an important step toward its application in LMICs where inexpensive solutions are needed.

Using Potential Years of Life Lost (PYLL) to Compare Premature Mortality between Romanian Counties to Confirmed COVID-19 Cases in 2020 and 2021.

This article examines the impact of the COVID-19 pandemic on potential years of life lost (PYLL) in Romania's counties in 2020 and 2021. PYLL highlights the burden of premature deaths in a community and is a useful tool for prioritizing community health issues. The study compares the PYLL variation between different counties, identifying disparities in premature mortality rates and highlighting areas that require specific public health interventions. The results indicate that COVID-19 has had a significant impact on potential years of life lost across the country. For the year 2020, the total number of deaths from confirmed COVID-19 cases was 19,455, of which 14,152 premature deaths caused 193,489 PYLL, with a crude rate of 1053.28 PYLL per 100,000 inhabitants. In 2021, there were 39,966 deaths from confirmed COVID-19 cases, with 28,777 premature deaths, 386,061 PYLL, and a crude rate of 2116.63 PYLL per 100,000 population. This study reveals significant variations only in some counties, based on BYLL rates, and in the two years analyzed. The proportion of premature deaths (<80 years) varied by county and gender. PYLL's analysis by gender shows that men experienced a higher number of premature deaths than women in most counties, and this trend persisted in both years. The results are presented in the form of thematic maps, highlighting standardized PYLL rates for both genders in each county, facilitating a visual understanding of regional disparities. The identified variations can serve as a basis for developing and implementing more effective public health policies, based on the specifics of each county.

Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States.

Despite the substantial evidence on the health effects of short-term exposure to ambient fine particles (PM2.5), including increasing studies focusing on those from wildland fire smoke, the impacts of long-term wildland fire smoke PM2.5 exposure remain unclear. We investigated the association between long-term exposure to wildland fire smoke PM2.5 and non-accidental mortality and mortality from a wide range of specific causes in all 3,108 counties in the contiguous U.S., 2007-2020. Controlling for non-smoke PM2.5, air temperature, and unmeasured spatial and temporal confounders, we found a non-linear association between 12-month moving average concentration of smoke PM2.5 and monthly non-accidental mortality rate. Relative to a month with the long-term smoke PM2.5 exposure below 0.1 μg/m3, non-accidental mortality increased by 0.16-0.63 and 2.11 deaths per 100,000 people per month when the 12-month moving average of PM2.5 concentration was of 0.1-5 and 5+ μg/m3, respectively. Cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality were all found to be associated with long-term wildland fire smoke PM2.5 exposure. Smoke PM2.5 contributed to approximately 11,415 non-accidental deaths/year (95% CI: 6,754, 16,075) in the contiguous U.S. Higher smoke PM2.5-related increases in mortality rates were found for people aged 65 above. Positive interaction effects with extreme heat (monthly number of days with daily mean air temperature higher than the county's 90th percentile warm season air temperature) were also observed. Our study identified the detrimental effects of long-term exposure to wildland fire smoke PM2.5 on a wide range of mortality outcomes, underscoring the need for public health actions and communications that span the health risks of both short- and long-term exposure.

Pendampingan dan penyuluhan imunisasi dasar lengkap

Introduction: Immunization is the most effective and efficient public health effort in preventing several dangerous diseases. The large role of immunization in saving the world community from pain, disability, and even death due to diseases that can be prevented by immunization such as Smallpox, Polio, Tuberculosis, Hepatitis B, Diphtheria, Measles, Rubella, Tetanus, Pneumonia, Meningitis, and encephalitis. Objective: to increase parents' knowledge through mentoring and counseling about the importance of complete basic immunization for babies at Posyandu Mekar Jaya Batu-batu environment, Darma sub-district. Method: Community service activities carried out include assistance and education regarding complete basic immunization for children. The media used is leaflet material.Implementation of community service uses the community outreach method, namely involving the community and students during the implementation process Result: From the results of the pre-test analysis, most mothers did not know about the importance of stimulation, early intervention detection and growth and development, but after counseling, the post-test results showed that almost all mothers understood the importance of complete basic immunization. Conclusion: From the community service activities that have been carried out at Posyandu Mekar Jaya in the Batu-Batu neighborhood, Darma Village by the community service team of STIKES Bina Generasi Polewali Mandar, it can be concluded that complete basic immunization assistance and counseling activities have been carried out for children and this activity has received a positive response. From partners, it can be seen that during counseling there is quite intensive communication interaction and increased knowledge and high awareness of carrying out complete basic immunization for their children through posyandu/puskesmas. Community service activities can be used as a reference or reference for respondents' knowledge about complete basic immunization for children

Demographic Profile, Clinical Features, Imaging, and Outcomes in Patients with Traumatic Brain Injury Presenting in Garhwal Himalayas in Tertiary Care Hospital

Abstract Introduction Traumatic brain injury (TBI) poses a significant global health challenge, accounting for over 50% of trauma-related deaths and emerging as a leading cause of mortality and disability. Objective This article studies the demographic characteristics, clinical features, imaging findings, and outcomes of TBI patients. Materials and Methods This was a retrospective observational study conducted on 490 patients with TBI. Data regarding age, gender, socioeconomic status, and residential location were extracted from medical records. Neuroimaging reports, including computed tomography (CT) scans results, were analyzed for structural and functional insights. Results The majority of TBI cases involved individuals aged 21 to 40, with a higher incidence in males. Road traffic accidents were identified as the most common mode of injury, followed by falls. Most of the patients had moderate Glasgow Coma Scale scores at admission. CT scans indicated skull fractures, cerebral edema, and subdural hematomas as common findings. Most patients did not require ventilator support, and the majority had a hospital stay of less than 10 days. At discharge, 89.8% exhibited favorable outcomes, while 4.3% experienced mortality during treatment. Follow-up data demonstrated an overall mortality rate of 8.8%, with 89.2% achieving complete recovery within a month. Conclusion The study underscores the importance of understanding the multifaceted aspects of TBI, emphasizing the need for integrated approaches in tertiary medical care to optimize patient outcomes and contribute to effective public health strategies.