Health Imperatives Research Articles

Vaccination Across the Lifespan: A Public Health Imperative

Vaccination is an essential public health intervention, preventing infectious diseases, saving millions of lives globally, and reducing the burden on the healthcare system. Currently, vaccines prevent between 3.5 and 5 million deaths annually from diseases like diphtheria, tetanus, pertussis, influenza, and measles.1 It not only protects individuals but also contributes to herd immunity, safeguarding entire communities. Maintaining high vaccination coverage across all age groups reduces the burden of preventable illnesses and safeguards public health. Childhood immunization is a cornerstone of preventive healthcare, providing protection against various life-threatening diseases during the most vulnerable years of life. Key vaccines include the DTP, MMR, IPV, Hib, and pneumococcal. 2 Global immunization coverage has stagnated since 2022, with 14.5 million children missing all DTP doses and 6.5 million not completing follow-up doses. There is an urgent need for innovative solutions to meet the Immunization Agenda 2030 targets of 90% vaccination coverage. 3 Vaccination has a pivotal role in women's healthcare, especially during pregnancy. The CDC recommends the inactivated flu and Tdap vaccines for protection of both mother and baby, with the flu vaccine best administered by the end of October and Tdap between 27 and 36 weeks of gestation. The HPV vaccine is recommended for girls aged 9–14 (two doses) and women over 14 (three doses) to protect against cervical cancer and genital warts, but it should not be given during pregnancy due to insufficient safety data.4 Regular vaccinations are crucial for adults aged 50–64, including COVID-19, influenza, shingles, and Tdap/Td. Hepatitis B is recommended for those up to 59 years old, and MMR for those born in 1957 or later. For those 65 and older, COVID-19, influenza, pneumococcal, and shingles vaccines are essential, with an RSV recommended. Healthcare providers should be consulted to determine additional vaccines for older adults, as regular vaccinations are important to prevent serious health issues due to immune decline and chronic conditions. 5 A comprehensive vaccination strategy is important for community health, encompassing children, women, adults, and older adults. A strong public health infrastructure that guarantees vaccine access and affordability should serve as the foundation for this strategy. In order to improve vaccination coverage, public awareness campaigns must be customized to address the concerns of all age groups. Children's immunization programs must be implemented in schools and coincide with routine physical examinations while women, particularly those who are of reproductive age, require special attention. Adult immunization programs must to prioritize occupational health, and older people need to remain updated. Considering immunization as a top public health priority, policy makers and healthcare professionals must work together to ensure continuous monitoring and evaluation of vaccination campaign’s coverage and effectiveness in order to spot gaps and launch prompt interventions.

Exploring Community-Supported Agriculture through Maslow’s Hierarchy: A Systematic Review of Research Themes and Trends

Community-supported agriculture (CSA) has emerged as a pivotal model for sustainable and humanistic agricultural practices, emphasizing the symbiotic relationship between food production, consumption, and sustainable ecosystems. Despite the growing interest, a comprehensive analysis of research themes and trends within the CSA framework remains sparse. This paper undertakes a systematic review of CSA literature from 1999 to 2023, identifying evolving research hotspots, dominant themes, and prospective directions by keyword analysis to corroborate Maslow’s hierarchy of needs theory. The research analysis location is categorized into four temporal phases, revealing a geographical expansion from North America to encompass Asia, Africa, and other continents. This expansion corroborates Maslow’s theory, illustrating a global shift from fulfilling basic physiological needs towards recognizing sustainable practices, particularly in developing regions. The results of temporal trends (5 phases) and the hotspots of keyword analysis support each other by showing a societal shift from basic sustenance to a deeper understanding of nutrition and diet. Most of the recent research keywords are grouped into the “environment” and “health and education” categories, indicating an increasing emphasis on transforming the food system and nutrition education. This review suggests conducting an integrated analysis that links the various stages of the food supply chain with the criteria outlined in the Sustainable Agriculture Matrix (SAM). It highlights that the “environment” theme is a stage of building up esteem and self-realization that needs to be unfolded in the future, given that most research on community-supported agriculture (CSA) focuses on the “economy and society” aspect and consumption stage, which burnish self-morality in the theory of Maslow. Overall, this review proposes an analysis of the relevance among different subject categories and between food supply chain stages, which reveals that the trend of research under CSA development is accorded to the theory of Maslow’s hierarchy of needs and calls for a more holistic approach to agricultural research that considers ecological, health, and social imperatives.

Power, interests and representations in the construction of alcopop as public problem in Quebec, Canada

Alcopops are malt-based or spirit-based sugary beverages whose consumption has led to numerous policies in different Western countries. This article examines the representational and socio-political dynamics surrounding the sale of alcopops that led to restrictive policies in Canada (2017–2020). Using qualitative methods during this period, including interviews with key players in the field of alcohol policy, analysis of press articles and review of legislative documents, we trace the evolution of public and political discourse on alcopops. We shed light on the role of social actors—mainly public-health organizations and the alcohol industry—defending their own interests to influence policy-making. A multi-theoretical framework is used to analyze how alcopops emerged as a public problem. This framework integrates Herbert Blumer's theoretical perspective on social problems, Serge Moscovici's social representation theory and Stevens and Zampini’s political constellation model. Through an analysis of the socio-political context in Quebec, we reveal the complex interplay between public health imperatives and the interests of the alcohol industry. This should serve as a model to study public problems that lead to public policies implementation.

Alcohol consumption response to pandemic induced income shocks in India

The study assesses the impact of the Covid-19 pandemic on household consumption of alcohol in India, considering both income shocks and supply-side factors. based on a nationally representative household survey conducted by CMIE. Using a 2SLS panel regression model and employing an approach akin to difference-in-differences technique, our study finds that the pandemic induced lockdowns resulted in a sharp increase in the share of alcohol in total expenditure across rural and urban India, and for all income levels. Alcohol consumption varies by education level, by caste, religion, and severity of income shocks. The increased alcohol consumption during the pandemic, and more so among the households that faced a severe income shock, despite the supply restrictions, suggest the stronger impact of stress-response-dampening hypothesis and self-medication hypothesis compared to the income effect. Despite state-imposed supply restrictions, including temporary alcohol shop closures and subsequent reopening with higher taxes, the study raises concerns about a disproportionate rise in alcohol consumption among the most economically impacted. This underscores the need for balanced policy responses, considering both economic stressors and public health imperatives, and emphasizes targeted interventions to mitigate the consequences of increased alcohol consumption during crises.

Uterine fibroids and Black people of African descent globally: a scoping review protocol.

Evidence suggests that when adjusted for age and other factors such as Body Mass Index, age of first pregnancy, years since last pregnancy and alcohol consumption, Black women are three times more likely to suffer from fibroids compared with the general population. When compared with the general population, Black women experience larger uterine fibroids with an earlier onset and more frequent and severe symptoms debilitating symptoms. Reported symptoms include pelvic pain, bladder issues, and heavy and/or abnormal menstrual bleeding. For Black women in perimenopause or menopause, uterine fibroids are more likely to continue growing rather than slow or cease. To design empirical research that addresses the issue of uterine fibroids among Black people of African descent, it is important to understand the current state of literature on this issue. The objectives of this scoping review are to understand and describe the extent and type of literature available regarding Black people of African descent with uterine fibroids globally, to identify the gaps within existing literature, and to provide recommendations for future research. This scoping review will be conducted in accordance with JBI scoping review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. Eligibility criteria for this review include sources that involve Black people of African descent who have uterine fibroids. This review is global in context and does not include jurisdictional, geographical, regional or study setting restrictions. A comprehensive search strategy developed in collaboration with a health sciences librarian will be used to identify and retrieve relevant peer-reviewed and grey literature. Databases including CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), Gender Studies Database (EBSCO), Scopus (Elsevier) and LILACS (VHL) will be searched from inception to January 2024. Unpublished studies and grey literature searches will include The Society for Women's Health Research, Black Women's Health Imperative, ProQuest Dissertations and Theses Global (ProQuest), Open Access Theses and Dissertations (OATD.org) and Google search. All relevant sources will be uploaded to Covidence and undergo title and abstract screening by two independent team members. Selected sources will then undergo full-text review by two independent team members. Sources meeting the eligibility criteria will undergo extraction by two independent team members. Thematic analysis will be used to classify the extracted data points into categories according to the purpose or objective of the source, the methods used, the geographical region or jurisdiction of the source, key findings and recommendations. The synthesis of results will align with the review objective and question using charts or tables where necessary. This scoping review does not require ethical approval. Dissemination of the review results includes the publication of a full report in a peer-reviewed journal as well as presenting the review results at local, national and international conferences. The results of the scoping review will also be disseminated through community events and social media using infographics and brochures.

The dynamics embedded in COVID-19 pandemic responses in South Africa: Implications for public healthcare delivery

South Africa recorded the highest number of COVID-19 cases and deaths in Africa despite having what seemed to be one of the best government response mechanisms on the continent. This paper explores the responses of both the government and the citizens of South Africa to the COVID-19 pandemic. Through a literature review, the study established that the government's response to the pandemic was influenced by various factors, including the responsibility to protect citizens' lives, the need to defend the state's sovereignty, and compliance with global health imperatives. This was achieved through strict and coercive government measures, which left little room for public participation in decision-making. The findings also indicate public dissent towards government directives, which may be attributed to a lack of public awareness and preparedness in public health emergencies. The social contract theory provides a useful framework for analysing and understanding the actions of the government and citizens in response to COVID-19 in South Africa. Understanding these aspects is crucial for drawing informative lessons for effective public health and socio-economic interventions in future pandemics and health-related emergencies.

Reader Response: The Brain Health Imperative in the 21st Century—A Call to Action: The AAN Brain Health Platform and Position Statement

Reader Response: The Brain Health Imperative in the 21st Century—A Call to Action: The AAN Brain Health Platform and Position Statement

Author Response: The Brain Health Imperative in the 21st Century—A Call to Action: The AAN Brain Health Platform and Position Statement

Author Response: The Brain Health Imperative in the 21st Century—A Call to Action: The AAN Brain Health Platform and Position Statement

Mental health at work: societal, economic and health imperatives align; it's time to act.

The enormous impact of mental illness on work and productivity is a global challenge, with immense costs to wider society. Now is the time for action, with new international guidelines and an emergent consensus on occupational mental healthcare. Alongside governments, organisations and employers, psychiatrists have a leading role to play.

Decoding Waterpipe Tobacco Smoking: A Comprehensive Narrative Review Exploring Mechanics, Health Risks, Regulatory Challenges, and Public Health Imperatives.

Waterpipe tobacco smoking, commonly known as hookah or shisha, has witnessed a surge in popularity globally, particularly among young adults. However, this activity is associated with several issues related to health. This comprehensive narrative review aims to provide a valuable resource for researchers, policymakers, and public health professionals seeking to deepen their understanding of waterpipe tobacco smoking and implement evidence-based strategies to address its challenges. The present article focuses on an in-depth analysis of the health risks associated with waterpipe tobacco smoking. Basedon evidence from the current scientific literature, the review explores the impact of waterpipe smoking on respiratory health, cardiovascular outcomes, and the potential links to infectious diseases. Additionally, the review discusses the emerging evidence on the long-term health consequences, highlighting the need for continued research in this area. Also, it touches on the regulatory challenges surrounding waterpipe tobacco smoking, which were critically examined, emphasizing the gaps and inconsistencies in existing policies. Finally, the review underscores the public health imperatives necessitated by the rise of waterpipe tobacco smoking. The narrative concludes by proposing a holistic approach that integrates scientific evidence, regulatory frameworks, and public health initiatives to mitigate the growing impact of waterpipe tobacco smoking on population health.

Inaction in Urban Climate Policy Undermines Health.

This paper investigates the critical intersection of urban climate policy and public health, emphasizing the pressing need for integrated strategies to address the intertwined challenges of climate change and health in urban settings. Despite cities being central to global emissions and energy consumption, a significant gap exists in the incorporation of health considerations into urban climate strategies, as evidenced by the analysis of urban content in Nationally Determined Contributions (NDCs). The paper highlights the Coalition for High Ambition Multilevel Partnerships (CHAMP) initiative and the forthcoming Intergovernmental Panel on Climate Change (IPCC) Special Report as pivotal moments for integrating climate and health agendas. However, it also points out the underwhelming response from cities in adopting comprehensive climate strategies, which undermines potential public health benefits. With substantial investments required to bridge the gap in health-focused climate resilience, the paper calls for a redefined approach to urban climate policy. This approach should prioritize health outcomes, leverage opportunities like the 15-Minute City concept, and foster the development of infrastructures that support both climate resilience and public health. The upcoming NDC revision cycle is identified as a critical opportunity for embedding health imperatives into urban climate strategies, emphasizing the need for a holistic perspective that views urban areas as ecosystems where climate and health are intricately connected. This comprehensive view aims to promote policies that are mutually reinforcing, thus contributing to healthier, more livable cities.

India's Decision to Deny an Extension of Patent for Bedaquiline: A Public Health Imperative.

Tuberculosis (TB) remains a major global public health concern, which has become worse in low- and middle-income nations due to the rise of drug-resistant strains of the disease. Bedaquiline, a groundbreaking anti-TB drug, shows great promise for addressing multidrug-resistant TB (MDR-TB). However, the recent decision by India to reject the application for a patent extension on bedaquiline raises crucial questions regarding access to essential medicines and public health requirements. This article examines the significance of India's rejection of the patent extension for bedaquiline, outlining the global implications of this decision and its impact on intellectual property rights, access to medicines, and the future of drug development. India's stance serves as a model for other countries to prioritize public health in their patent-related decisions, underlining the need for a balanced approach to intellectual property rights, innovation, and affordability in the pharmaceutical sector. In the context of the ongoing battle against drug-resistant TB, India's decision on bedaquiline signifies the evolving landscape of pharmaceutical patent practices in the service of global public health.

Development and Validation of LC-MS/MS Method for the Determination of 1-Methyl-4-Nitrosopiperazine (MNP) in Multicomponent Products with Rifampicin-Analytical Challenges and Degradation Studies.

Rifampicin is an essential medicine for treating and preventing tuberculosis (TB). TB is a life-threatening infectious disease and its prevention and treatment are public health imperatives. In the time of a global crisis of nitrosamine contamination of medicinal products, patient safety and a reduction in the number of drug recalls at the same time are crucial. In this work, the LC-MS/MS method was developed for the determination of the 1-methyl-4-nitrosospiperazine (MNP), a genotoxic nitrosamine impurity in various products containing rifampicin at a 5.0 ppm limit level according to Food and Drug Administration (FDA). Extraction with neutralization was necessary due to the matrix and solvent effect associated with the complexity of the rifampicin product. The developed method was validated in accordance with regulatory guidelines. Specificity, accuracy, precision, limit of detection, and limit of quantification parameters were evaluated. The recovery of the MNP was 100.38 ± 3.24% and the intermediate precision was 2.52%. The contamination of MNP in Rifampicin originates in the manufacturing process of the drug. Furthermore, the results of the forced degradation experiments show that the formation of MNP is possible by two mechanisms: through degradation of rifampicin and the oxidation of 1-amino-4-methyl-piperazine. This article points out that it is necessary to monitor and describe degradation products and the mechanism of degradation of potentially affected active pharmaceutical ingredient (API) with respect to the formation of nitrosamines during stress testing, as it was done in the following work for rifampicin in multicomponent products.

The Brain Health Imperative in the 21st Century-A Call to Action: The AAN Brain Health Platform and Position Statement.

Brain health is crucial to optimizing both the function and well-being of every person at each stage of life and is key to both individual and social progress. As a concept, brain health is complex and requires a multidisciplinary collaborative approach between many professional and public organizations to bring into effect meaningful change. Neurologists are uniquely positioned to serve as specialists in brain health and to advance the newly evolving field of preventive neurology, which aims to identify individuals at high risk of brain disorders and other neurologic conditions and offer strategies to mitigate disease emergence or progression. For decades, the American Academy of Neurology (AAN) has demonstrated a commitment to brain health through its public outreach and advocacy. The AAN's Brain Health Initiative launched in 2022 with a strategic plan prioritizing brain health as a key aspect of public engagement and positioning the AAN and neurologists as champions of brain health in collaboration with a broad range of other brain health providers. In this study, we present (1) the new definition of brain health developed by the AAN for neurologists, patients, partners in health care, and the public; (2) the strategic objectives of the AAN Brain Health Initiative; and (3) the AAN Brain Health Platform and Action Plan framework, including key positions on brain health, its 3 ambitious goals, and a national brain health vision. The top-line priorities of the AAN Brain Health Action Plan highlight the need for research, education, public policy, and direct-to-public messaging across the individual's life span and will serve as a catalyst for future cross-disciplinary collaborations within each epoch and longitudinally. The AAN Brain Health Platform is designed to communicate the AAN's vision for brain health and provide a blueprint toward achieving the future of optimal brain health across the life span for all. Through this position statement, we call upon neurologists and other stakeholders in brain health to join our collective efforts to accomplish the ultimate goal of transforming the current trajectory of public health of an increasing burden of neurologic disorders-from both illness and injury-to achieving optimal brain health for all.

Judicial Review during the Covid-19 Pandemic

The public health crisis during the COVID-19 pandemic subjected judicial review to competing pressures. There was pressure for courts to be accommodating to governments both substantively and procedurally, for judicial review to be minimised and restricted and for powers to be broadly and generously construed. On the other hand, the unparalleled intrusions on individual freedoms and the need for hurried rule-making with little political scrutiny called for heightened vigilance and might have justified the courts developing a role acting in partnership with Governments in ensuring COVID-19 rules were lawful, reasonable and proportionate. The reported decisions in England, Wales and Scotland reveal the dominance of the first of these pressures and they paint a markedly deferential picture. Judicial rulings had negligible impact on COVID-19 restrictions. Courts did not act in partnership with the Government in shaping COVID-19 rules. The system of judicial review nonetheless had impact through what we described as its “second look” function: providing a mechanism for triggering public servants to look again at a decision and amended or change them to provide a sounder balance between public health imperatives and competing rights and interests.

PrEParing for the End of the HIV Epidemic—A Public Health Imperative

PrEParing for the End of the HIV Epidemic—A Public Health Imperative

SoundRunner: Out of the Starting Blocks

Abstract This paper presents a project in the art-science nexus. SoundRunner is a platform that exploits the potential of electroacoustic music to create an interactive sound- and music-making experience. The project investigates how data on running performance can be harnessed in real time to drive musical creation. A range of psychological indices (and associated analyses) is used to assess the effects of the SoundRunner platform on runners. Driven by health and well-being imperatives, the project served to augment running experience with unique sound and music. The paper discusses implications regarding running performance and the further technological development of SoundRunner.

A Brain Health Imperative.

A Brain Health Imperative.

Prevention is Better than Cure: A Public Health Imperative

In this brief article, I provide a personal perspective and selected literature review on the merits of giving greater attention to interventions that tackle the known social risk factors for common mental disorders. These include both universal actions targeted at the general population and more focused interventions aimed at high-risk subgroups. In practice, most effective efforts involve a combination of both strategies. Psychiatrists and other mental health professionals could have a key role in promoting prevention, working closely with governmental bodies, and nongovernmental organizations that may be in the best position to deliver the required interventions. Having evidence from gold standard randomized controlled trials may be ideal, but in practice, are extremely difficult to deliver in this field and their absence should not be taken as an excuse for inaction.

Seizures in Dementia are Associated with Worse Clinical Outcomes, Higher Mortality and Shorter Lifespans (P3-1.001)

<h3>Objective:</h3> To study impact of seizures on clinical and mortality outcomes in dementia patients. <h3>Background:</h3> Dementia and seizures are both public health imperatives. Seizures occur in 10–64% of those with dementia and accelerate cognitive decline. However, the impact of seizures on clinical and mortality outcomes in dementia patients has not been studied. <h3>Design/Methods:</h3> We analyzed longitudinal data from 39 Alzheimer’s disease Centers from 9/2005–12/2021, maintained by National Alzheimer’s Coordinating Center. We included patients with cognitive impairment at initial visit. We compared cognitive, functional and mortality outcomes among those with and without seizures. <h3>Results:</h3> At the initial visit, among 26,425 cognitively impaired patients, 374(1.4% point prevalence) had seizures. Seizure patients were significantly younger (62.91 vs 68.4 years, p&lt;0.001) at onset of cognitive decline. In multivariate regression analysis, dominant Alzheimer’s disease(AD) mutation(OR: 5.55, CI: 2.39–12.89, p &lt; 0.001), stroke (OR: 3.17, CI: 2.35–4.27, p &lt; 0.001), transient ischemic attack[TIA] (OR: 1.72, CI: 1.21–2.46, p = 0.003), traumatic brain injury[TBI] (OR: 1.92, CI: 1.48–2.50, p &lt; 0.001), Parkinson’s disease [PD] (OR: 1.79, CI: 1.07–2.98, p = 0.025), depression (OR: 1.61, CI: 1.30–1.99, p &lt; 0.001) and lower education (OR: 0.97, CI: 0.95–0.99, p = 0.043) were associated with seizures. Patients with seizures performed worse on mini-mental-status examination(18.50 vs 22.88, <i>p</i> &lt; 0.001) and Clinical-Dementia-Rating Sum-of-boxes(7.95 vs 4.28, p &lt; 0.001); and had more physical dependence(OR: 2.52, CI: 1.99–3.19, p &lt; 0.001) compared to those without seizures after adjusting for age and dementia duration using generalized linear model. Analysis of longitudinal mortality data showed that a higher proportion of seizure patients had died (OR: 1.56, CI: 1.27–1.91, p &lt; 0.0001),and they were younger at death(72.99 vs 79.72years, p &lt; 0.001). Multivariate survival analysis using Cox regression was conducted to study age at death and seizure status. We adjusted the model for sex, disease duration, stroke, TIA, TBI, depression, education and dominant AD mutation. Despite adjustment, patients with seizures were at a higher risk of dying at a younger age(hazard ratio: 1.76, CI: 1.49–2.08, p&lt;0.001). <h3>Conclusions:</h3> Our study shows that dementia patients with seizures have worse cognition and higher mortality rates at a younger age compared to dementia patients without seizures. Dementia patients with early onset of dementia, dominant AD mutation, stroke, TIA, TBI, PD, depression, and/or lower education are more likely to have seizures. Dementia patient with these risk factors may be routinely considered for EEG for early identification and treatment of seizures to improve outcomes. <b>Disclosure:</b> Dr. Zawar has nothing to disclose. Dr. Quigg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerebral Therapeutics. Dr. Quigg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerebral Therapeutics. Dr. Quigg has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Finnigen and Harrison. Dr. Quigg has received research support from NIH. Dr. Quigg has received publishing royalties from a publication relating to health care. The institution of Dr. Manning has received research support from Department of Defense. The institution of Dr. Kapur has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus. Dr. Kapur has received personal compensation in the range of $5,000-$9,999 for serving as an officer or member of the Board of Directors for Robert Wood Johnson Foundation . Dr. Kapur has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Kapur has received research support from NIH. Dr. Kapur has received intellectual property interests from a discovery or technology relating to health care. Dr. Kapur has a non-compensated relationship as a Chair, Board North America with International League against Epilepsy that is relevant to AAN interests or activities. Dr. Kapur has a non-compensated relationship as a Board of Directors with American Epilepsy Society that is relevant to AAN interests or activities.