Health Policy Development Research Articles

Social Comparison and Body Image in Teenage Users of the TikTok App.

The TikTok app is one of the video-based social media platforms that is currently trending and commonly used by teenagers. The data about teenage users of the TikTok app are limited. This study aimed to estimate the prevalence of TikTok app use among teenagers in Saudi Arabia and to investigate the association between TikTok app use and the social comparison and the body image of the study population. Further, to explore the potential associations between the social comparison and the body image of the TikTok app users and their different characteristics. This cross-sectionalsurvey study was conducted all over Saudi Arabia. The study included male and female teenagers, aged 12-19 years. The researchers used a structured, self-administered questionnaire to collect data, and it was disseminated using different social media platforms. The social comparison was measured using the questionnaire of the Iowa-Netherlands Comparison Orientation Measure, and the body image was measured using the Measurement of the Body Image Scale. The data were analyzed using the SPSS software version 26 (Chicago, IL: SSPS Inc.). Continuous variables were compared using the Student's t-test, Mann-Whitney U test, or Kruskal-Wallis tests, whereas categorical variables were compared using the Chi-square or Fisher's exact tests as appropriate. Spearman'srank correlation was applied to investigate the association between body image and social comparison scores among TikTok app users and non-users. This study included 384 Saudi teenagers. Females (n=260) outnumbered males (n=124) (67.7% and 32.3%, respectively), and the mean of their age was 16.3±2.0 years. The researchers found a high prevalence (343/384, 89.3%) of TikTok app use among the studied teenagers. There was a significantly high median of the social comparison score among the TikTok app users (33.0, IQR: 28.0-38.0) compared to the non-users (28.0, IQR: 26.0-34.0), p=0.005. TikTok app users also showed a significantly lower median body image score (64.0, IQR: 54.0-72.0) in comparison to the non-users (67.0, IQR: 58.0-73.0), p=0.037. The correlation between social comparison and body image among teenagers using TikTok showed a negative relationship, but it was not significant (p=0.110). However, a significant negative weak relationship was found between body image and comparison of abilities (rs coefficient=-0.113, p=0.037). The findings of the current study indicate a high prevalence of TikTok use among teenagers in Saudi Arabia. The use of TikTok was associated with a high social comparison and a negative body image, with more than half of the users expressing a negative body image. Comparison of abilities was associated with an increased level of body dissatisfaction. These findings emphasize the need for the development and implementation of public health policies and awareness programs to promote body acceptance, especially for young people across the country. Future studies should focus on the long-term impact of TikTok use on psychological health.

Perceptions of oral health promotion in primary schools among health and education officials, community leaders, policy makers, teachers, and parents in Gulu district, northern Uganda: A qualitative study.

One in every two cases of caries in deciduous teeth occurs in low- and middle-income countries (LMICs). The aim of the World Health Organisation's (WHO) Healthy Schools Program is to improve the oral health of children. This study explored perceptions of implementation of the Ugandan oral health schools' program in Gulu district, northern Uganda. Semi-structured interviews were conducted with a purposive sample of 19 participants including health and education officials, community leaders, policy makers, teachers, and parents. All interviews were transcribed verbatim and analysed thematically. Our study identified three themes: (1) components of oral health promotion, (2) implementation challenges of oral health promotion, and (3) development of an oral health policy. The components of oral health promotion in schools included engagement of health workers, the community, companies, skills-based education, and oral health services. Participants were concerned about insufficient funding, unsatisfactory skills-based education, and inadequate dental screening. Participants reported that there was an urgent need to develop oral health policy to guide implementation of the program at scale. Schools provided oral health promotion that aligned with existing features of the WHO's health-promoting school framework. Implementation of this strategy could be enhanced with increased resources, adequate oral health education, and explicit development of oral health policy.

Life expectancy tables for cats from the city of Buenos Aires

The aim of the present study was to develop the first life tables for the domestic feline population of the Autonomous City of Buenos Aires by constructing general cohort tables. To develop the life tables, data from felines received for final disposition at the Luis Pasteur Zoonosis Institute of the city from January 2018 to December 2021 were used. Of the 7945 cats that died in that period, the overall life expectancy at birth was 11.01 years (95% CI=10.55- 11.46 years). When life expectancy was analyzed according to sex, significant differences were found, being higher in females, 12.26 years (95% CI: 11.78- 12.73) than in males, 10.92 years (95% CI: 10.50- 11.35). According to neutered status, life expectancy at birth in the neutered, 13.19 years, was significantly higher than in the entire, 5.55 years (p-value=0.00001). Likewise, life expectancy among purebred cats was significantly higher, 14.81 years (95% CI: 14.51- 15.10), than for cross breed cats, 10.97 years (CI: 10.81- 11.13). Regarding the variations in mortality according to the warm or cold season of the year, no differences were observed between the two seasons. The most prevalent causes of death were related to urinary system failures and neoplasms, over 444 records analyzed. This study provides useful information for veterinary professionals and pet owners and is a valuable tool for the planning and development of effective health policies.

Life expectancy can increase by up to 10 years following sustained shifts towards healthier diets in the United Kingdom

Adherence to healthy dietary patterns can prevent the development of non-communicable diseases and affect life expectancy. Here, using a prospective population-based cohort data from the UK Biobank, we show that sustained dietary change from unhealthy dietary patterns to the Eatwell Guide dietary recommendations is associated with 8.9 and 8.6 years gain in life expectancy for 40-year-old males and females, respectively. In the same population, sustained dietary change from unhealthy to longevity-associated dietary patterns is associated with 10.8 and 10.4 years gain in life expectancy in males and females, respectively. The largest gains are obtained from consuming more whole grains, nuts and fruits and less sugar-sweetened beverages and processed meats. Understanding the contribution of sustained dietary changes to life expectancy can provide guidance for the development of health policies.

Public Health Responses to Homelessness During COVID-19 in Ireland: Implications for Health Reform

The intersection between health and homelessness is well documented and has been made more explicit since the onset of the coronavirus disease of 2019 (COVID-19). In the Global North, COVID-19 related public health responses targeting homeless populations have varied across countries, including greater national-level financial investment, temporarily housing those in congregate facilities in ‘self-contained’ accommodation, time-limited eviction moratoriums and dedicated health system interventions across homelessness and addiction services to enable social distancing and self-isolation. Yet questions remain about the immediate and longer-term outcomes of these newly implemented responses and whether they will be sustained. Such considerations are critical and timely in countries such as Ireland, where significant health reform is underway. In this paper, we use Ireland as a case study to explore whether and how public health responses to homelessness during COVID-19 hold important insights for the development of more effective health policy. Drawing on publicly available Irish data, we present a secondary analysis of COVID-19 infection rates amongst homelessness service users as well as trends in emergency accommodation usage between 2020 and 2021. Focusing specifically on public health measures implemented during the pandemic via the health and housing systems, respectively, we discuss how such interventions may have impacted on these homelessness figures in both intended and unexpected ways. We conclude by teasing out and unpacking relevant lessons for health reform.

Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)

Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018-20, and to evaluate point prevalence differences between countries and over time between 2013-15 and 2018-20. In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. The point prevalence of clinically relevant depressive symptoms in Europe in 2018-20 was 6·54% (95% CI 6·34-6·73), ranging across countries from 1·85% (1·53-2·17) in Greece to 10·72% (10·04-11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07-1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54-0·74) in Hungary to 1·88 (1·53-2·31) in Slovenia. This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.

Influence of oral health status and genetic polymorphisms on preterm birth – a preliminary study

Objective: To investigate risk variables related with inflammatory and infectious processes in pregnant women with obstetric complication and its association with oral condition and polymorphisms in a Curitiba Maternal and Child Health Cohort (COOSMIC). Methods: Retrospective cohort study was carried out considering gestational age (preterm and term) in a subsample database of pregnant women of COOSMIC. Saliva samples were collected, and a questionnaire was answered to investigate mother´s and children´s health in the first 1000 days of life. Thirteen single nucleotide polymorphisms in five inflammatory genes (IL4, IL6, IL8, IL17A, IL17RA), were genotyped. Results: Presenting the C allele (IL17RA - rs2241043 C>T) could be considered a risk factor in preterm group with inadequate oral health condition. In opposite, presenting the C allele (rs917864 T/C - IL17RA), associated with adequate oral condition, could be considered a protective aspect in term group. In term group with inadequate oral condition, presenting the T allele for IL6 (rs2069833 C/T) could be considered a risk factor. Conclusions: The oral condition (inadequate/adequate) analyzed with three SNPs proved to be an important indicator of risk or protection in pregnant women with preterm/term deliveries, but these results should be confirmed in other more robust samples to be used as risk markers and thus contribute to the advancement of clinical practices that have an impact on the development of future public health policies in this vulnerable group.

Impact of energy poverty on public health: A non-linear study from an international perspective

Research on energy poverty and its impact has been quite extensive, but the impact of such poverty on public health is still lacking. This paper thus presents the relationship between energy poverty and public health of 185 countries from 2000 to 2020 as well as the role of urbanization development levels in this nexus. To achieve this goal, this study uses a partial linear function coefficient (PLFC) method to analyze the relationship between them, which can also clearly exhibit the non-linear impact of energy poverty on public health. First, both linear and non-linear regression results show that energy poverty has significantly negative impacts on public health. Second, urbanization level plays a significant moderating effect in the energy poverty and public health nexus, meaning that energy poverty affects public health under the influence of urbanization. According to the PLFC model results, countries that exceed the threshold of urbanization have significantly reduced the adverse effects of energy poverty on public health. Third, this study investigates the heterogeneous impact of energy poverty across different regions, comparing the Sub-Saharan Africa region with other areas. The results reveal in the Sub-Saharan Africa region that affordable energy under the influence of urbanization provides a new pathway for improving public health in that region, whereas this effect is considerably smaller in other regions. Additionally, a series of tests confirm the robustness of the results. This paper offers a reference for the development and implementation of renewable energy-related public health policies.

7.I. Skills building seminar: Applying behavioural sciences to public health policy-making

Abstract The complexity of health issues, ranging from infectious diseases to chronic illnesses, calls for effective public health policies to improve health outcomes. Almost all public health strategies involve encouraging behaviour change. However, policy development and adoption often fail to consider the behaviour change principles that influence individuals’ decisions and actions related to health. This omission can lead to policies that are not feasible, acceptable, effective, sustainable, or equitable. Applying behaviour change principles in health policy development and adoption can lead to more effective policies that promote health behaviour change at the individual, community, and population levels. Examples of behaviour change principles include using evidence-based techniques to encourage healthy behaviours, addressing social determinants of health, and leveraging social networks. Also, communication between scientists and policy makers, including using effective communication tools such as policy briefs, plays an important role in informing political decision-making and creating impact for researchers. Incorporating behaviour change principles in health policy development and adoption require interdisciplinary collaboration, engagement with stakeholders, and attention to the cultural and social context. Aim This skills-building seminar seeks to contribute to capacity building in knowledge translation and evidence-informed decision-making in public health applying behavioural insights. More specifically, it will tackle two main questions: 1. What public health researchers need to know to impact policy? 2. How can using behaviour change principles in health policy help to bridge the implementation gap? Workshop structure This workshop will consist of two parts. In the first part, three presentations will set the scene. The first presentation will introduce the most recent advancements and future perspectives in applying behavioural insights and sciences to public health policy-making from the WHO perspective. The second presentation will highlight how behaviour change principles were used for the development and adoption of health policies in Canada. The third presentation will deal with behavioural insights for more effective communication between academics and policy makers, including a practical guide to develop effective and high-quality policy briefs. This will be followed by a reflections from representatives of academia/advisory bodies (Prof. Kim Lavoie, Co-Director, Montreal Behavioural Medicine Centre, Canada and Canada's COVID-19 Expert Advisory Panel) and WHO/Europe (Dr. Katrine Bach-Habersaat; Regional Advisor for Behavioural and Cultural Insights). Further to the reflection on the current knowledge base a structured interactive world-café methodology will be used to explore attendees’ opinions regarding the challenges and opportunities in public health policy-making to improve people's health and well-being. Key messages • Viewing policy development and adoption through the lens of behaviour change theory can help improve the effectiveness of policies and increase their impact. • By applying behaviour change principles, policymakers can better understand the motivations, barriers, and enablers of different stakeholders and tailor their policies accordingly.

Health and sustainability impacts of scenarios of replacement of beef by pulses in two EU countries

Abstract Background High consumption of red meat is an important cause of burden of disease and environmental degradation globally. To motivate changes in food consumption and production, policymakers need evidence on the overall impact of such changes on the health of citizens, and on all aspects of sustainability: environment, socioeconomics, and culture. Methods Using three different approaches, we compared the impact of four scenarios of replacement of beef consumption with pulses (a well-established plant protein source) in two EU countries, Portugal and Denmark. First, health impacts were quantified in disability-adjusted life years (DALY); second, sustainability impact was measured using various social, economic and environmental indicators. Finally, we used MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique), an interactive, iterative, multicriteria decision analysis approach, to create a quantitative value model. Results We estimated positive health impacts for all substitution scenarios in the two populations. Positive impacts were larger for Denmark and ranged from 5,9 DALYs (25% substitution of beef by pulses in Portugal) to 39,7 DALYs averted/100,000 people (100% substitution, Denmark). The two countries had positive economic impacts, but beef production was more resilient than pulses. Environmental and social impacts of beef production were consistently higher than pulses. The MCDA model included a set of 15 criteria within the four dimensions of analysis to assess the overall value of implementing each scenario. Conclusions Individually, each approach allowed us to compare health, sustainability and integrated impacts of different options for food substitutions relevant to the sustainability agenda. Together, they allowed us to create a platform for discussing the co-benefits of dietary changes in different contexts. Expanding this work to other dietary changes and countries will support further development of public health policies. Key messages • Different possible scenarios of substitution of beef consumption by pulses, an alternative plant-based protein source, will lead to overall positive health and sustainability impacts. • Quantitative measurements of the integrated health, environmental and socioeconomic impacts of dietary transitions will support development of public health policies towards sustainable diets.

An optimisation study to reduce greenhouse gas emissions from adults’ current diet in Italy

Abstract Background Trade-offs between health and sustainability dimensions should be addressed since environmentally sustainable diets can require a substantial dietary shift and result in nutrient deficiencies. The study aimed at modelling the current dietary consumption of the adult population in Italy to reduce diet-related greenhouse gas emission (GHGe) while complying with the National Recommended Energy and Nutrient Intake Levels (LARN), food-based dietary guidelines, and preferences. Methods Food consumption data from the Italian Nutrition & HEalth Survey (INHES) study (n = 8944, 53% females) have been used as reference diet. Through a non-linear programming model, two intermediate nutritionally adequate dietary scenarios, which alternatively minimised the impact on climate change or modifications in current food consumption, have been generated contextually to a final diet model combining both outcomes. Several constraints ranging from recommended dietary intakes to proper food associations and substitutions were applied to the model. Results The final modelled diet had an average energy content of 2100 kcal/d with carbohydrates, proteins, lipids, and fibers accounting respectively for 49%, 16%, 31%, and 4% of the total energy. The associated GHGe were 2.01 kg CO2 eq/d: 49% less than the current diet, 22% more than the balanced diet with the lowest GHGe, and 12% less than the balanced diet closest to actual food consumption. Wholegrain bread, peas, seasonal fruit and vegetables, chicken, tuna, whole milk and extra-virgin olive oil were the most represented products within each corresponding food group. Conclusions The study proposes a balanced and climate-friendly diet which simultaneously minimises changes in food preferences, reducing barriers towards more sustainable food choices. Diet optimisation can be a promising tool to support public health strategies by suggesting less environmentally impactful and culturally acceptable dietary shifts at the country level. Key messages • The present study provides a culturally acceptable and nutritionally balanced dietary scenario optimised for greenhouse gas emissions to be proposed as a model for the adult population in Italy. • The study contributes to the development of public health policies by supporting feasible dietary behavioural shifts towards healthy and sustainable dietary choices.

Exploring avoidable, preventable, treatable mortality trends and effect factors by income level

Abstract Background Avoidable mortality (AM) mean death caused by insufficient health policy and health care intervention, and is a rising public health issue. Income polarization in healthcare utilization is a significant concern. The aim of this study was to derive the trend and effect factors of AM, treatable mortality (TM), preventable mortality (PM) according to income levels in South Korea over the period 2008-2017. Methods This serial cross-sectional analysis was conducted using national health information data from 2008 to 2017. AM was classified based on criteria presented by the Office for National Statistics in 2011. Age-standardized AM was analyzed annually according to income levels. The odds ratio of AM was examined using multivariable logistic regression after adjusting health behaviors and clinical variables collected in 2016-2017. Results There were persistent income inequalities in AM, and the degree of inequality was larger in PM than in TM throughout the period. Medical benefit recipients had an AM of about 8.5 times higher than the highest income quartiles, and men were three times higher than women. In 2016-2017, compared to the highest income quartile, the risk of TM and PM of medical benefit recipients was about 10 times higher and 1.5 times higher in the first quintile. The risk of AM remained significantly higher in low-income levels even after adjusting for health behaviors and clinical variables. Conclusions While AM in South Korea has decreased over time, it remains high in low-income levels. There was a statistically significant difference in AM based on income level. Therefore, inclusion in health policy and services development and in health promotion programs is urgently required to address avoidable deaths and health inequalities for low-income levels. Key messages • AM in South Korea have declined over time, but, compared to the highest income quartile, the risk of TM and PM of medical benefit recipients was about 10 times higher. • Among health insurance eligible people, the first quintile, the more the proportion of TM and PM, and the highest income quartile, the lower the proportion of non-avoidable deaths.

Why so far ahead? Climbing the participation ladder in public health foresight

Abstract Issue In the Netherlands, the National Public Health Foresight Study (PHF) is published every 4 years, as starting point for national and local public health policy development. As these policies impact citizens’ health and lives, it is important to include their voices. We piloted an approach to strengthen this engagement to learn and to inspire PHF in other (country) settings. Problem description PHF is usually expert-based. Citizen engagement, beyond consultation, is not yet common practice. In the Dutch PHF-2024, we engage citizens both as advisors (citizen council, N = 30 and panel, N = 500) and as target group (focusgroups N = 40). Intentionally the scope is diffuse, allowing for unexpected input. What can we learn from this approach, and how do the citizens contribute to the PHF? Results - Citizens of all ages, backgrounds and education types are well able to discuss health (determinants), data and indicators; - They have intrinsic motivation to contribute to better knowledge, feel responsible for effective engagement and are eager to engage across different backgrounds and population groups; - Integration of outcome into the PHF process is valuable, enriching scientific with experiential knowledge and facilitating results communication; - Fundamental questions, e.g., about foresight time frames (“why look so far ahead as the world is in crisis right now!”) are raised by the citizens, showing that these need to be better addressed in order to make PHF relevant for a broader public. Lessons - More permanent engagement of the citizens is needed to enable learning and development; - earlier engagement in the PHF process may enable joint development of core questions and issues to be addressed; - The results are highly encouraging; piloting this approach in other foresight types and in various contexts is therefore needed to refine and further develop it. Key messages • Citizen engagement can and should be strengthened to include citizen voices in the PHF process, informing policies that impact on their lives. • Citizens of all backgrounds, with their experiential knowledge, can be valuable partners in PHF, that provide important input.

Impacts of climate change and environmental pollution: a public health foresight study

Abstract Background In the Netherlands, the National Public Health Foresight Study (PHF) is published every 4 years, as starting point for national and local public health policy development. A priority topic in the PHF2024 is climate change and living environment. The important transitions (energy, food, mobility, housing) that are required all require space and thus pose a societal challenge for the future quality of the living environment. Approach We use a mixed method approach to identify main trends and impacts on public health: - analysis of Demographic, Economic, Socio-cultural, Technological, Ecological and Political developments (DESTEP) based on a literature review and expert consultation; -organization of focus group discussions with young people (N = 41); -analysis of mortality data in relation to temperature; -evaluation of trend-scenarios. Results Direct and indirect health impacts of climate change will become more visible in the next 30 years. These need not all be negative. For example, an earlier edition of the PHF already showed that the increase in temperature may lead to less deaths in winter but more deaths in summer. In the PHF we will focus not only on adverse health consequences, but also identify opportunities for health improvement through climate mitigation and adaptation. Similarly we will look into related developments like energy and mobility transitions, that may (partly) result in health gains, depending on how they will be implemented and who will be affected. For example, we will look into possible improvement of air quality and its impact on health. The preliminary findings of our focus group study suggest, however, that young people are mostly pessimistic regarding developments in our living environment. This is particularly the case for climate change; young people fear that this may cause severe events. Nevertheless, they have high expectations regarding technological advancement in the energy sector. Key messages • Foresight studies should not focus on risk alone but also identify possible health promoting developments in the living environment. • Expert views and views of lay people, in particular youth, may not necessarily be identical. Both need to be addressed in foresight studies.

THE EFFECT OF AWARENESS OF THE COVID-19 PANDEMIC AND HEALTH LITERACY LEVELS ON HEALTHY LIFESTYLE BEHAVIORS

It can be argued that the COVID-19 outbreak has created awareness in terms of understanding the importance of health, hygiene, financial and spiritual well-being. In this study, it was aimed to determine the awareness levels of university students about the COVID-19 outbreak and whether their health literacy levels have an effect on their healthy lifestyle behaviors. The research population consists of students studying at Bilecik Seyh Edebali University. The convenience sampling method, which is a non-random sampling method, was used in the data collection. The sample size in this study was 457 individuals. The data obtained in the study were evaluated through the SPSS 22.0 statistical software in computer environment. When the regression analysis of the study was examined, a significant cause-and-effect relationship was found between following the news and developments, being affected by the work life, having concerns, taking precautions, health literacy and healthy lifestyle behaviors. Therefore, health literacy needs to be adapted and integrated into daily life in COVID-19 and similar infectious diseases. The findings of this study will provide valuable insights for the development of public health policies and health communication strategies. Strengthening health awareness and enhancing health literacy during and after the pandemic will be critical steps to promote and sustain healthy lifestyle behaviors. By implementing effective measures, society can strive for improved health outcomes and better preparedness for future health challenges.

Probability of outbreaks and cross-border dissemination of the emerging pathogen: a genomic survey of Elizabethkingia meningoseptica.

The emerging infectious agent Elizabethkingia meningoseptica is associated with life-threatening infections in immunocompromised individuals. However, there are limited data on its geographic distribution, phylogenetic evolution, pathogenesis, and transmission. In this study, we comprehensively analyze and compare the genomic features, evolutionary history, emergence date, and transmission networks of global E. meningoseptica. Geographical distribution reveals the presence of the emerging bacteria in Asia, Europe, and North America, three continents with similar latitudes. Phylogenetic analyses show no relationship between the strain's evolutionary history and its location, origin, or source, despite the presence of genetic diversity. Analysis of the emergence timeline suggests that America is the most likely source of E. meningoseptica with the common ancestor of this pathogen dating back 90 years. Putative transmission networks indicate that E. meningoseptica bacteria can spread within the same hospital and even across borders. Minor variations in resistance genotypes and virulence genes are observed, supporting existing evidence of inherent resistance and pathogenicity in E. meningoseptica. Additionally, minocycline and doxycycline demonstrate potent antimicrobial activity against this pathogen, making them promising candidates for treating E. meningoseptica infections. Our research highlights the potential for severe nosocomial outbreaks caused by E. meningoseptica with horizontal transmission occurring between countries worldwide. To prevent future outbreak infections, increased genomic surveillance of global E. meningoseptica populations is necessary. IMPORTANCE Elizabethkingia meningoseptica is an emerging infectious agent associated with life-threatening infections in immunocompromised individuals. However, there are limited data available on the genomic features of E. meningoseptica. This study aims to characterize the geographical distribution, phylogenetic evolution, pathogenesis, and transmission of this bacterium. A systematic analysis of the E. meningoseptica genome revealed that a common ancestor of this bacterium existed 90 years ago. The evolutionary history showed no significant relationship with the sample source, origin, or region, despite the presence of genetic diversity. Whole genome sequencing data also demonstrated that E. meningoseptica bacteria possess inherent resistance and pathogenicity, enabling them to spread within the same hospital and even across borders. This study highlights the potential for E. meningoseptica to cause severe nosocomial outbreaks and horizontal transmission between countries worldwide. The available evidence is crucial for the development of evidence-based public health policies to prevent global outbreaks caused by emerging pathogens.

Sentiment Analysis of Tweets on Menu Labeling Regulations in the US.

Menu labeling regulations in the United States mandate chain restaurants to display calorie information for standard menu items, intending to facilitate healthy dietary choices and address obesity concerns. For this study, we utilized machine learning techniques to conduct a novel sentiment analysis of public opinions regarding menu labeling regulations, drawing on Twitter data from 2008 to 2022. Tweets were collected through a systematic search strategy and annotated as positive, negative, neutral, or news. Our temporal analysis revealed that tweeting peaked around major policy announcements, with a majority categorized as neutral or news-related. The prevalence of news tweets declined after 2017, as neutral views became more common over time. Deep neural network models like RoBERTa achieved strong performance (92% accuracy) in classifying sentiments. Key predictors of tweet sentiments identified by the random forest model included the author's followers and tweeting activity. Despite limitations such as Twitter's demographic biases, our analysis provides unique insights into the evolution of perceptions on the regulations since their inception, including the recent rise in negative sentiment. It underscores social media's utility for continuously monitoring public attitudes to inform health policy development, execution, and refinement.

CROSS-BORDER CARE: A COMPARATIVE ANALYSIS OF MIGRANT HEALTH POLICIES IN TURKEY AND THE EUROPEAN UNION

This comparative analysis examines the health policies for migrants in Turkey and European Union (EU) countries, shedding light on the challenges and opportunities inherent in cross-border care. Migrant health policies play a crucial role in addressing the healthcare needs of diverse migrant populations and promoting public health equity. Drawing upon a review of existing literature, policy documents, and empirical data, this study elucidates the key features, strengths, and limitations of health policies targeting migrants in Turkey and selected EU member states. Through a comparative lens, it explores differences in access to healthcare services, eligibility criteria, service delivery models, and the integration of migrants into national health systems. Moreover, the analysis identifies common trends, best practices, and areas for improvement in migrant health policy development and implementation across the studied contexts. By critically evaluating policy approaches and outcomes, this study contributes to a deeper understanding of the complexities surrounding migrant healthcare and offers insights for enhancing policy effectiveness and promoting health equity for migrant populations.

Hotspots and Global Trends of Nursing Research on Telehealth From 2012 to 2021: A Bibliometric Analysis by CiteSpace.

Telehealth is commonly used in nursing in recent years; however, there is a lack of information on hotspots and global trends over time. This study aimed to analyze the bibliometric patterns of telehealth research in nursing. This is a descriptive bibliometric study. Data were obtained from Web of Science Core Collection. CiteSpace version 6.1.R6 was used to perform analysis. The co-occurrence and co-citation analyses were conducted. A total of 1365 articles were analyzed. A total of 354 authors and 352 institutions from 68 countries have contributed telehealth research in nursing. The most productive author was Kathryn H. Bowles with six articles. The United States with 688 articles and University of Pennsylvania with 22 articles were the most productive country and institution, respectively. The top 10 keywords on this research area were care, intervention, management, health, technology, quality of life, outcome, mobile application, telemedicine, and experience. In addition, the common themes on keywords were nurse practitioner student perception, hemodialysis patients, and heart failure. The study will help to finding potential collaborators, countries, and institutions for future researchers. In addition, it will guide researchers, practitioners, and scholars in further studies, health policy development, and evidence-based practice on telehealth in nursing.

Mapping loneliness through social intelligence analysis: a step towards creating global loneliness map

ObjectivesLoneliness is a prevalent global public health concern with complex dynamics requiring further exploration. This study aims to enhance understanding of loneliness dynamics through building towards a global loneliness map...