Health Approach Research Articles

Digital health for early psychosis in Ghana: patient and caregiver needs and preferences

In West Africa, the long-term consequences of poor early psychosis recovery include poverty, neglect, and community ostracization. To understand the potential for digital health approaches to support early psychosis care in Ghana, we conducted a survey study among early psychosis patients and their caregivers about mental health needs, technology use and access, and interest in digital mental health. Hospital staff at Accra Psychiatric Hospital reviewed hospital medical records from January 2023 - December 2023 identifying young adults (≥18 years old) who had experienced psychosis symptoms for the first time within the prior five years. Trained data assessors contacted these individuals via telephone and invited them and their caregivers to participate; those providing informed consent were interviewed via phone in Twi or English. Overall, 256 individuals participated in the survey, including 121 young adults experiencing early psychosis and 135 caregivers of early psychosis patients. The majority (80%) of early psychosis patients and their caregivers expressed interest in digital mental health for early psychosis and had access to a mobile phone (91%) and necessary mobile infrastructure. Early psychosis patients were most interested in information about managing stress and improving mood via a digital resource (72%). Caregivers desired a digital tool to provide information about psychosis symptoms (86%). Our study among those experiencing early psychosis and their caregivers in Ghana suggests readiness and acceptability of digital mental health for early psychosis care.

Reimagining psychosis prevention: responding to the accessibility issues of At-Risk Mental State (ARMS) services through a selective public health approach.

At-Risk Mental State (ARMS) services aim to prevent the onset of first-episode psychosis (FEP) in those with specific clinical or genetic risk markers. In England, ARMS services are currently expanding, but the accessibility of this preventative approach remains questionable, especially for a subgroup of FEP patients and those from specific ethnic minority communities. This commentary outlines the key debates about why a complimentary approach to psychosis prevention is necessary, and gives details for an innovative public health strategy, drawing on existing research and health prevention theory.

Resistome and plasmidome genomic features of mcr-1.1-harboring E. coli: a One Health approach.

This study evaluated the phenotypic and genotypic traits of mcr-1.1-harboring Escherichia coli isolates from chickens, pigs, humans, and farm environments. The resistome and the mobile genetic elements associated with the spread of mcr-1.1 in Southern Brazil were also characterized. The 22 mcr-1.1-harboring E. coli isolates from different origins were selected for antimicrobial susceptibility testing and whole genome sequencing for characterization of the resistome, plasmids, and STs. All isolates presented several resistance genes and harbored the mcr-1.1 gene in a highly similar IncX4 plasmid. Furthermore, the mcr-1.1 gene co-occurred with the mcr-3.12 gene in a multidrug-resistant isolate from the farm environment. These findings demonstrate that the mcr-1.1 gene in E. coli isolates from Brazil is spreading mainly by horizontal transfer of the IncX4 plasmid. The co-occurrence of mcr-1.1 and mcr-3.12 highlights pig farming as an important reservoir of colistin resistance.

Identifying transdiagnostic psychological processes that can improve early intervention in youth mental health.

The aim of this viewpoint paper is to consider different psychological transdiagnostic processes that can inform the development of effective early intervention approaches in youth mental health before threshold diagnosis is attained. A transdiagnostic process is defined as a mechanism which is present across different disorders and is either a risk or a maintaining factor for the disorder. We consulted the literature with respect to processes across depression, anxiety and eating disorders. We suggest 38 unique transdiagnostic psychological processes. Each were defined to make them suitable for stakeholder consultation (e.g. people with lived experience) in developing transdiagnostic processes (targets) for youth early interventions. We recommend that the definitions of these processes are further developed in consultation with stakeholders, and that systematic reviews are conducted to further identify psychological processes that can inform essential ingredients of interventions that can then be tested for clinical impact in early intervention with youth.

Venoms and Extracellular Vesicles: A New Frontier in Venom Biology

Extracellular vesicles (EVs) are nanoparticle-sized vesicles secreted by nearly all cell types under normal physiological conditions. In toxicological research, EVs have emerged as a crucial link between public health and multi-omics approaches, offering insights into cellular responses to disease-causing injury agents such as environmental and biological toxins, contaminants, and drugs. Notably, EVs present a unique opportunity to deepen our understanding of the pathophysiology of envenomation by natural toxins. Recent advancements in isolating and purifying EV cargo, mass spectrometry techniques, and bioinformatics have positioned EVs as potential biomarkers that could elucidate biological signaling pathways and provide valuable information on the relationship between venomous toxins, their mechanisms of action, and the effectiveness of antivenoms. Additionally, EVs hold promise as proxies for various aspects of envenomation, including the toxin dosage, biological characterization, injury progression, and prognosis during therapeutic interventions. These aspects can be explored through multi-omics technology applied to EV contents from the plasma, saliva, or urine samples of envenomated individuals, offering a comprehensive integrative approach to understanding and managing envenomation cases.

Overview of Singapore’s One Health Strategy

The One Health approach integrates human, animal, and environmental health to address complex challenges like emerging zoonotic diseases and antimicrobial resistance (AMR). Singapore’s dense urban environment, biodiversity, and role as a global hub make it vulnerable to these health threats, necessitating a robust and coordinated One Health framework. This paper reviews Singapore’s One Health strategy, focusing on governance, surveillance, cross-sector partnerships, and public health infrastructure. A structured literature review, including peer-reviewed articles and grey literature, identified key strengths and gaps. Strengths include interagency coordination through the One Health Coordinating Committee, advanced surveillance systems like CDLENS and SIDPIC, and key institutions such as the National Centre for Infectious Diseases (NCID) and the National Public Health Laboratory (NPHL). However, gaps remain in multi-sector engagement, data-sharing mechanisms, and public awareness of One Health principles. To address these challenges, this paper recommends enhancing multi-sector collaboration, strengthening data-sharing networks, and increasing public education on One Health. Investments in preventive medicine, cross-border capacity-building, and leveraging artificial intelligence for predictive analytics are essential for bolstering Singapore’s health security. By addressing these gaps, Singapore can enhance its preparedness and serve as a global leader in One Health implementation.

Heat boost: therapeutic approach for skeletal muscle health and postprandial mechanisms in older adults.

Heat boost: therapeutic approach for skeletal muscle health and postprandial mechanisms in older adults.

Pathogenic Aspergillus spp. and Candida spp. in coastal waters from southern Brazil: an one health approach.

Aspergillus and Candida are ubiquitous fungi included in the group of high priority in the World Health Organization list of fungal pathogens. They are found in various ecosystems and the environmental role in increasing the resistance to antifungals has been shown. Thus, we aimed to determine the occurrence of Aspergillus spp. and Candida spp. pathogenic species in water samples from a coastal ecosystem from southern Brazil, and its antifungal susceptibility profile. Water samples were collected monthly at three environmental sites, over 25 months. Abiotic parameters of the water samples were analyzed as well as antifungal susceptibility. Aspergillus spp. and Candida spp. were detected in 44% (n = 33/75) and 40% (n = 30/75) respectively of the samples, totaling 67 and 96 isolates. Section Fumigati and C. parapsilosis were the most section/species isolated. Triazole resistance was detected in 3% of the Aspergillus spp. (2/67) and in 1% of the Candida spp. (1/96) isolates. Our study contributes with data showing that coastal aquatic environments can serve as a source of infection of resistant fungal isolates, proving the need for environmental surveillance and monitoring of fungal resistance in the One Health perspective.

Impact of the COVID-19 pandemic on the mental health of Nursing students: A systematic review and meta-analysis.

There is an increased prevalence of mental health problems in various population groups as a result of the COVID-19 pandemic and its consequences, especially regarding anxiety, stress, depression, fear, and sleep disturbances, require to be investigated longitudinally. This study aimed to determine the impact that the COVID-19 pandemic had on the mental health of Nursing students, as well as to examine other associated factors such as anxiety, fear, sleep disturbances, and coping strategies. This systematic review and meta-analysis were designed following the PRISMA guidelines and were registered in PROSPERO with code CRD42024541904. PubMed, Web of Science, CINAHL, and Scopus electronic databases were utilized. Keywords indexed in the MeSH thesaurus were used (COVID-19, nurs* student and mental health), following the Condition Context Population (CoCoPop) strategy. A total of 3866 studies were obtained of which 36 were selected for inclusion in the review. The Joanna Briggs Institute critical appraisal tool was used to assess the methodological quality of the selected studies, all of which were cross-sectional, finally including those with a cutoff point equal to or greater than 4 out of 8. The prevalence of total anxiety was found to be 33.6% in the meta-analysis. For depression, the prevalence was 37.92%, and for stress, it was 52.46%. The results of this study show increased levels of stress, anxiety, depression, fear, and sleep disturbances among Nursing students that coincide with the different waves of the pandemic, changes in the study methodology, and the increase or decrease in reports of cases of infection. A relationship is observed between variations in these variables and the implementation of protective measures and vaccinations in different countries. As the pandemic progressed, hygiene and prevention measures became more effective, and the lethality of the virus decreased. The prevalence of the negative psychological effects also decreased from the onset in 2020 until the end of 2022. Due to the impact of the pandemic on global health, preventive measures should include personal, family, emotional, economic, educational, professional, and mental health approaches.

Leveraging International Health Regulations (2005) to enhance health security in the Eastern Mediterranean Region: a retrospective analysis from 2016 to 2023

IntroductionThe WHO Eastern Mediterranean Region (EMR), consisting of 22 member states, faces significant health security challenges exacerbated by socioeconomic, political and environmental factors. This study aims to assess the efforts...

Integrated health and nutrition approaches to school feeding: maximising future human capital in Latin America and the Caribbean

Integrated health and nutrition approaches to school feeding: maximising future human capital in Latin America and the Caribbean

Network analysis of cross-income-level collaboration on multiple myeloma in sub-Saharan Africa

Cross-income-level collaboration (CILC) is crucial for developing global health approaches that benefit low- and middle-income countries (LMICs). Multiple myeloma (MM) is a representative example of a complex, understudied disease in sub-Saharan Africa (SSA). Based on publications, we developed a network analysis tool to assess scientific collaborations. Here, we present findings from a systematic analysis of publications retrieved from PubMed between January 2002 and June 2022. We evaluated individual institutional contributions and collaboration patterns using undirected weighted networks. Our findings reveal that intra-income-level collaborations dominate MM research in SSA, with high-income countries (HICs) primarily engaging with a few local institutions, mainly in South Africa and Nigeria. Increasing CILC is essential to advance research in this area. Our analysis tool provides insights into the collaboration strength, highlights gaps in the field and identifies leading institutions, ultimately aiming to support the development of more effective international collaboration and research strategies.

Identifying and Applying a Strength-Based Research Approach in Indigenous Health

Strength-based approaches are regarded as being effective in research with communities but there are minimal examples of application as a research approach, particularly in health, with Indigenous populations, and with youth. Systemic racism manifested through colonization, including in academic institutions, has contributed to historical and ongoing traumas by supporting the overuse of deficit-based approaches with Indigenous populations in many disciplines, including health. We present our creation and application of a strength-based methodological approach to research in health alongside Dene First Nation youth. It was developed on principles consistent with the strength-based paradigms in social work, psychology, and education. We share four main components of strength-based research approach: 1) identifying strengths, 2) prioritizing and creating descriptions of strengths, 3) refining strengths by gathering contextual examples, and 4) depicting strengths to plan future research. Each component included qualitative methods (such as asset-mapping, nominal group technique, storytelling interviews, and participatory 360-degree video) that reflected aspects of strength-based approaches and emphasized active participation, multiple knowledge sources, and empowerment. Utilizing this approach promoted connectivity to the larger environment, inclusivity of multi-knowledge sources, agency and voice, increased empowerment, and practicality in action. We share challenges and lessons learned from exploring a strength-based approach in health research and provide insights for researchers interested in applying a strength-based approach to research, particularly in Indigenous health.

Impact of urbanization on antimicrobial resistance in soil microbial communities

Soil is one of the most important reservoirs of antibiotic resistance, global threat that needs to be addressed with the One Health approach. Despite urban parks playing a fundamental role in urban ecosystems, the diffusion, maintenance, and human impact of antibiotic-resistance genes in this substrate are still poorly addressed. To fill in this gap, we adopted a molecular and culturomics approach to study antibiotic resistance in urban parks, accounting for the environmental matrix and the level of urbanization. A higher abundance of efflux-mediated mechanisms in undisturbed environments was observed, while antibiotic alteration or inactivation, and target replacement were more abundant in areas with a higher level of urbanization, also confirmed by significant correlations with anthropogenic features of the environmental matrix. Overall, this study highlights the crucial need to monitor antibiotic resistance in urban parks’ soil through a dual molecular and culturomics approach to fully understand and fight antibiotic resistance diffusion.

Achievement of one health multi-sectoral collaboration in containment of Rift Valley Fever outbreak, Sudan, Red Sea State 2019.

Rift Valley Fever is endemic in Sudan, with a notable outbreak declared in 2019, affecting multiple states. In this study, we examine the Red Sea State, Sudan's experience in applying the One Health approach, to contain Red-Sea RVF outbreak. A retrospective analysis of national and sub-national data and a review of literature were conducted to assess the application of One Health response and to derive lessons learned. The analysis revealed a total of 576 human cases and two deaths, with a case fatality rate of 0.35%, from 25 September 2019 to 25 January 2020. Most cases (99%) were from the Red Sea and River Nile States, and only six sporadic cases were from other five states. The Red Sea State reported 322 human and 74 animal cases, including 74 abortions and 12 animal deaths. Triggers and risk factors include floods, uncontrolled movement of animal, close contact with animals, poor disposal, and unsafe burial practices for animals. One Health approach was utilized all through the defeat of outbreak. A multi-sectoral response plan was implemented, leading to the declaration of the end of the outbreak in 2020 which was reviewed and lessons were derived. One Health approach provided a coordinated action between health, veterinary, and environmental authorities at national and subnational levels. Synergistic efforts have minimized risk of RVF spreading among human and animal. The experience was leveraged to strengthen response approaches for zoonotic diseases. Structural and capacity gaps and financial constraints were identified as implementation challenges.

L’ORA – A Living One Health Risk Assessment tool to assess the incursion risk of zoonotic diseases.

Abstract Safeguarding global health is a moving target, with changes in climate and human activity raising new threats to public health, animal health and animal welfare. Decision support in the context of health management requires tools capable of making sense of large volumes of complex and multidisciplinary evidence. A One Health living risk assessment tool, L'ORA, was developed to assess the incursion risk for zoonotic and animal diseases using a One Health approach and allowing for automatic updates of the risk assessment. L'ORA estimates the incursion risk as the resultant of four steps: 1) Disease occurrence in source areas based on the distribution of diseases worldwide; 2) Rate of incursion based on the individuals or products moved from source areas to target areas and their probability of infection or contamination and contact with susceptible hosts in target areas; 3) Extent of disease spread in target areas, considering both domestic and wild host populations, vectors if the disease is vector‐borne, and humans if the disease is zoonotic; and 4) Impact of the disease outbreak and concurrent control measures on public health, animal health and animal welfare, accounting for economic, societal, and environmental impacts. L'ORA is a decision support tool that was built as a generic tool comparing the relative risks of multiple diseases across multiple target areas. L'ORA monthly evaluates the incursion risk for each NUTS2 region in the European Union. Results can be used to identify areas of greater risk for each of the diseases to inform risk managers on where to focus attention and resources, and to inform, e.g., risk‐based surveillance.

Knowledge, attitude, and practice of One Health and zoonotic diseases among multisectoral collaborators in Bhutan: Results from a nationwide survey.

The One Health concept is increasingly employed to combat zoonotic diseases. This study assessed the knowledge, attitudes, and practices regarding One Health and zoonotic diseases among key sector professionals to identify gaps and opportunities for enhancing One Health strategies in Bhutan. A cross-sectional, facility-based study was used to conduct a nationwide online questionnaire survey using a validated and pre-tested questionnaire among professionals from the Ministry of Health, the Ministry of Agriculture and Livestock, and universities. Descriptive and summary statistics were calculated. Respondents were categorised into binary groups based on their knowledge, attitude, and practice scores relative to the mean. Multivariable logistic regression analyses were conducted to identify the demographic factors associated with knowledge, attitudes, and practices regarding One Health and zoonotic diseases. The survey achieved a 35% response rate, with 964 responses. The majority of respondents demonstrated above-average knowledge (63%), attitudes (50%), and practices (66%) regarding One Health. Professionals with master's degree or higher (Adjusted Odds Ratio [AOR] = 2.39; 95% Confidence Interval [CI] = 1.16-5.12) were more likely to have above-average knowledge. Regarding zoonotic diseases, approximately half of the respondents had above-average knowledge (51%), attitudes (52%), and two-thirds (66%) had above-average practices. Professionals with mid-level job experience (6-10 years; AOR = 2.13; 95% CI = 1.37-3.30 and 11 to 15 years; AOR = 2.11; 95% CI = 1.31-3.40) were more likely to possess above-average knowledge. Gaps in training, communication, funding, research, and collaborations were identified. Targeted educational interventions, enhanced communication, strengthened collaboration, expanded research, and improved funding are essential for improving One Health approaches and zoonotic disease prevention and control in Bhutan. Our study findings provide valuable insights that can inform global efforts to enhance One Health systems, particularly in regions where resources are limited but disease risks are significant.

Controlling cystic echinococcosis: outlook in the 21st centuryControle da equinococose/hidatidose cística: perspectivas no século XXI

Cystic echinococcosis (CE) is a serious public health problem in South America, one that the Pan American Health Organization (PAHO) has included in its Plan of Action for the Control of Neglected Infectious Diseases. A logical framework for CE control was defined: this includes establishing the objective to be achieved (eradication or elimination as a public health problem) and determining levels of endemicity which serve as a guide for establishing frequencies of intervention (high endemicity, endemic, and low endemicity, according to rates in the different hosts). There are two validated tools for CE control: systematic deworming of dogs using praziquantel (PZQ) and systematic vaccination of sheep with recombinant EG95 protein, or a combination of both tools. Complementary strategies include the development of sanitary infrastructure on ranches, health education, and active searches for asymptomatic cases followed by timely treatment.Decreased prevalence in dogs and sheep is associated with a loss of acquired immunity, making the animals susceptible to infection.Although ready-to-use tools are available, CE control continues to present difficulties. It is vital that the Veterinary Public Health Unit of PAHO's Pan American Center for Foot-and-Mouth Disease and Veterinary Public Health (PANAFTOSA/VPH-PAHO/WHO) provide support to national programs and local efforts under the CE Initiative for control and surveillance in South America, promoting novel strategies for disease control and early diagnosis of human cases, with a One Health approach.

Beyond Serology: A Meta-Analysis of Advancements in Molecular Detection of Brucella spp. in Seronegative Animals and Biological Samples.

Brucellosis is a zoonotic disease caused by Brucella spp., affecting various animals and humans, leading to significant economic and public health impacts. Traditional diagnostic methods, mainly serological, often fail to detect seronegative carriers, which continue to spread the infection. This review aims to highlight advancements in molecular diagnostics that address these limitations. A systematic search of PubMed, Web of Science and Scopus was conducted, focusing on studies using seronegative, PCR, qPCR and biosensor-based techniques. Data extraction and meta-analyses were performed, evaluating pooled detection rates and heterogeneity. Through analysis of existing studies, we review key molecular techniques, including PCR, LAMP and biosensor-based assays, which offer high sensitivity and specificity by detecting bacterial DNA directly, thus overcoming the challenges of antibody-based tests. Meta-analysis of detection rates across different studies showed significant variability, with rates ranging from 0.96% to 100%, highlighting differences in sample types, animal species and regions. The pooled detection proportion from random-effects models was 35.08%, indicating that many seronegative animals still carry Brucella spp. A forest plot analysis further confirmed heterogeneity in detection, underlining the importance of using molecular diagnostics alongside serological tests to identify hidden carriers. Innovations like nanoparticle-enhanced biosensors and CRISPR-Cas systems show promise for rapid, on-site diagnostics. The findings suggest that integrating molecular methods with traditional serology can improve surveillance and disease management. Future research should focus on developing portable, field-ready diagnostic devices and standardised protocols, along with exploring novel biomarkers to detect latent infections. A collaborative One Health approach, involving veterinary, public health and environmental sectors, is essential for comprehensive disease control and eradication efforts.

Wildlife policy, the food system and One Health: a complex systems analysis of unintended consequences for the prevention of emerging zoonoses in China, the Democratic Republic of the Congo and the Philippines

IntroductionEvolving human–wildlife interactions have contributed to emerging zoonoses outbreaks, and pandemic prevention policy for wildlife management and conservation requires enhanced consideration from this perspective. However, the risk of unintended consequences...