Human Development Research Articles

SRPK3 Is Essential for Cognitive and Ocular Development in Humans and Zebrafish, Explaining X-Linked Intellectual Disability.

Intellectual disability is often the outcome of neurodevelopmental disorders and is characterized by significant impairments in intellectual and adaptive functioning. X-linked intellectual disability (XLID) is a subset of these disorders caused by genetic defects on the X chromosome, affecting about 2 out of 1,000 males. In syndromic form, it leads to a broad range of cognitive, behavioral, ocular, and physical disabilities. Employing exome or genome sequencing, here we identified 4 missense variants (c.475C > G; p.H159D, c.1373C > A; p.T458N, and c.1585G > A; p.E529K, c.953C > T; p.S318L) and a putative truncating variant (c.1413_1414del; p.Y471*) in the SRPK3 gene in 9 XLID patients from 5 unrelated families. To validate SRPK3 as a novel XLID gene, we established a knockout (KO) model of the SRPK3 orthologue in zebrafish. The 8 patients ascertained postnatally shared common clinical features including intellectual disability, agenesis of the corpus callosum, abnormal eye movement, and ataxia. A ninth case, ascertained prenatally, had a complex structural brain phenotype. Together, these data indicate a pathological role of SRPK3 in neurodevelopmental disorders. In post-fertilization day 5 larvae (free swimming stage), KO zebrafish exhibited severe deficits in eye movement and swim bladder inflation, mimicking uncontrolled ocular movement and physical clumsiness observed in human patients. In adult KO zebrafish, cerebellar agenesis and behavioral abnormalities were observed, recapitulating human phenotypes of cerebellar atrophy and intellectual disability. Overall, these results suggest a crucial role of SRPK3 in the pathogenesis of syndromic X-linked intellectual disability and provide new insights into brain development, cognitive and ocular dysfunction in both humans and zebrafish. ANN NEUROL 2024;96:914-931.

PM2.5 Induces Developmental Neurotoxicity in Cortical Organoids

There is mounting evidence implicating the potential neurotoxic effects of PM2.5 during brain development, as it has been observed to traverse both the placental barrier and the fetal blood-brain barrier. However, the current utilization of 2D cell culture and animal models falls short in providing an accurate representation of human brain development. Consequently, the precise mechanisms underlying PM2.5-induced developmental neurotoxicity in humans remain obscure. To address this research gap, we constructed three-dimensional (3D) cortical organoids that faithfully recapitulate the initial stages of human cerebral cortex development. Our goal is to investigate the mechanisms of PM2.5-induced neurotoxicity using 3D brain organoids that express cortical layer proteins. Our findings demonstrate that exposure to PM2.5 concentrations of 5 μg/mL and 50 μg/mL induces neuronal apoptosis and disrupts normal neural differentiation, thereby suggesting a detrimental impact on neurodevelopment. Furthermore, transcriptomic analysis revealed PM2.5 exposure induced aberrations in mitochondrial complex I functionality, which is reminiscent of Parkinson's syndrome, potentially mediated by misguided axon guidance and compromised synaptic maintenance. This study is a pioneering assessment of the neurotoxicity of PM2.5 pollution on human brain tissues based on 3D cortical organoids, and the results are of great significance in guiding the formulation of the next air pollution prevention and control policies in China to achieve the sustainable improvement of air quality and to formulate pollution abatement strategies that can maximize the benefits to public health.

Distinct mechanisms for online and offline motor skill learning across human development.

The human central nervous system (CNS) undergoes tremendous changes from childhood to adulthood and this may affect how individuals at different stages of development learn new skills. Here, we studied motor skill learning in children, adolescents, and young adults to test the prediction that differences in the maturation of different learning mechanisms lead to distinct temporal patterns of motor learning during practice and overnight. We found that overall learning did not differ between children, adolescents, and young adults. However, we demonstrate that adult-like skill learning is characterized by rapid and large improvements in motor performance during practice (i.e., online) that are susceptible to forgetting and decay over time (i.e., offline). On the other hand, child-like learning exhibits slower and less pronounced improvements in performance during practice, but these improvements are robust against forgetting and lead to gains in performance overnight without further practice. The different temporal dynamics of motor skill learning suggest an engagement of distinct learning mechanisms in the human CNS during development. In conclusion, adult-like skill learning mechanisms favor online improvements in motor performance whereas child-like learning mechanisms favors offline behavioral gains. RESEARCH HIGHLIGHTS: Many essential motor skills, like walking, talking, and writing, are acquired during childhood, and it is colloquially thought that children learn better than adults. We investigated dynamics of motor skill learning in children, adolescents, and young adults. Adults displayed substantial improvements during practice that was susceptible to forgetting over time. Children displayed smaller improvements during practice that were resilient against forgetting. The distinct age-related characteristics of these processes of acquisition and consolidation suggest that skill learning relies on different mechanisms in the immature and mature central nervous system.

Intermittent preventive treatment for malaria in pregnancy and infant growth: a mediation analysis of a randomised trial

Intermittent preventive treatment for malaria in pregnancy (IPTp) can improve birth outcomes, but whether it confers benefits to postnatal growth is unclear. We investigated the effect of IPTp on infant growth in Uganda and its pathways of effects using causal mediation analyses. We analysed data from 633 infants born to mothers enrolled in a randomised trial of monthly IPTp with dihydroartemisinin-piperaquine (DP) vs. sulfadoxine-pyrimethamine (SP) (NCT02793622). Weight and length were measured from 0 to 12 months of age. Using generalised linear models, we estimated effects of DP vs. SP on gravidity-stratified mean length-for-age (LAZ) and weight-for-length Z-scores (WLZ). We investigated mediation by placental malaria, gestational weight change, maternal anaemia, maternal inflammation-related proteins, preterm birth, birth length, and birth weight. Mediation models adjusted for infant sex, gravidity, gestational age at enrolment, maternal age, maternal parasitaemia at enrolment, education, and wealth. SP increased mean LAZ by 0.18-0.28 Z from birth through age 4 months compared to DP, while DP increased mean WLZ by 0.11-0.28 Z from 2 to 8 months compared to SP among infants of multigravidae; at these ages, confidence intervals for mean differences excluded 0. We did not observe differences among primigravida. Mediators of SP included birth weight, birth length, maternal stem cell factor, and DNER. Mediators of DP included placental malaria and birth length, maternal IL-18, CDCP1, and CD6 at delivery. In high malaria transmission settings, this exploratory study suggests different IPTp regimens may influence infant growth among multigravidae, potentially through distinct pathways, in the exclusive breastfeeding period, when few other interventions are available. Stanford Center for Innovation in Global Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation.

Development of a TBXT-EGFP iPS Cell Model for Screening the Early Developmental Toxicity of Typical Environmental Pollutants

In our daily lives, we are inevitably exposed to a variety of environmental pollutants in numerous ways. Fortunately, recent years have witnessed significant advancements in the field of stem cell toxicology, which have provided new opportunities for research in environmental toxicology. Applying stem cell technology to environmental toxicology, overcomes some of the limitations of traditional screening methods and we can more accurately predict the toxicity of environmental pollutants. However, there are still several aspects of stem cell toxicology models that require improvement, such as increasing the throughput of detection and simplifying detection methods. Consequently, we developed an environmental pollutant toxicity detection model based on TBXT-EGFP iPS cells and screened the developmental toxicity of 38 typical environmental pollutants. Our results indicate that TBBPA-BDBPE, TBBPA-BHEE, DG, and AO2246 may interfere with the expression of TBXT, a critical marker gene for early human embryo development, implying that these environmental pollutants could lead to developmental abnormalities.

The role of lncRNA binding to RNA‑binding proteins to regulate mRNA stability in cancer progression and drug resistance mechanisms (Review).

Cancer is a disease that poses a serious threat to human health, the occurrence and development of which involves complex molecular mechanisms. Long non‑coding RNAs (lncRNAs) and RNA‑binding proteins (RBPs) are important regulatory molecules within cells, which have garnered extensive attention in cancer research in recent years. The binding of lncRNAs and RBPs plays a crucial role in the post‑transcriptional regulation of mRNA, affecting the synthesis of proteins related to cancer by regulating the stability of mRNA. This, in turn, regulates the malignant biological behaviors of tumor cells, such as proliferation and metastasis, and serves an important role in therapeutic resistance. The present study reviewed the role of lncRNA‑RBP interactions in the regulation of mRNA stability in various malignant tumors, with a focus on the molecular mechanisms underlying this regulatory interaction. The aim of the present review was to gain a deeper understanding of these molecular mechanisms to provide new strategies and insights for the precise treatment of cancer.

Human capital development practices and performance of business organizations in imo state

The study examined human capital development practices and performance of business organizations in Imo State. It specifically focused on the influence of developmental human capital development and collaborative human capital development practices on market share and customers’ satisfaction of business organizations. The study employed a descriptive survey research design. The population of the study was 96 (ninety-six) registered business organizations in Imo State. The entire population of the study was used due to its manageable size. Data was collected with a structured questionnaire designed by the researchers. The questionnaire was validated by two professionals in the field of measurement and evaluation of the principal researcher’s institution, and the reliability of the instrument was determined with test re-test which yielded a coefficient of 0.87. Data was collected through physical contact with the respondents. Data collected was analyzed with mean and standard deviation. Analysis of the data collected revealed that both developmental and collaborative human capital development practices have positive influence on both market share and customers’ satisfaction of business organizations. Thus, it was recommended that: management of organizations should prioritize the use of developmental human capital development approaches like training and development, performance appraisal, and performance counseling to prepare their employees for higher performance; and management of organization should encourage the use of collaborative human capital development practices like goal setting, role-clarification, and interpersonal relations to increase the productivity of their employees.

Anticipating prosperity: a systemic analysis of long-term economic trajectories

PurposeThis study introduces an innovative approach to long-term economic forecasting by integrating anticipatory governance (AG) and causal layered analysis methodologies. Focussing on emerging economies, with Vietnam as a case study, we explore potential economic trajectories to 2050.Design/methodology/approachThe research employs a mixed-method approach, combining quantitative economic projections with qualitative scenario building and analysis.FindingsOur findings reveal four distinct future scenarios, ranging from low growth to transformative change. The preferred scenario, characterized by adaptive change, projects a Gross National Income (GNI) per capita of $30,684 by 2050, with significant reductions in agricultural labour and improvements in human development indicators.Originality/valueThis study contributes to theoretical and practical domains by demonstrating the value of integrated foresight methodologies in economic planning. It offers policymakers a comprehensive framework for navigating complex, long-term economic challenges and opportunities. This research underscores the importance of adaptive governance and systemic thinking in achieving sustainable, inclusive economic growth in an increasingly uncertain global environment.

SMPD4 mediated sphingolipid metabolism regulates brain and primary cilia development.

Genetic variants in multiple sphingolipid biosynthesis genes cause human brain disorders. A recent study collected patients from twelve unrelated families with variants in the gene SMPD4, a neutral sphingomyelinase which metabolizes sphingomyelin into ceramide at an early stage of the biosynthesis pathway. These patients have severe developmental brain malformations including microcephaly and cerebellar hypoplasia. The disease mechanism of SMPD4 was not known and we pursued a new mouse model. We hypothesized that the role of SMPD4 in producing ceramide is important for making primary cilia, a crucial organelle mediating cellular signaling. We found that the mouse model has cerebellar hypoplasia due to failure of Purkinje cell development. Human induced pluripotent stem cells exhibit neural progenitor cell death and have shortened primary cilia which is rescued by adding exogenous ceramide. SMPD4 production of ceramide is crucial for human brain development.

From research to resources: developing a case-based learning curriculum for navigating clinical uncertainty

Purpose This study aimed at rethinking ways in which educators from different fields can collaborate to respond to the rapidly evolving demands of health professions education (HPE). The goal was to investigate how a research-to-resources approach can be applied to engage in knowledge translation (KT) of research findings for the benefit of introducing medical students to uncertainty in the clinical learning environment. Design/methodology/approach An interdisciplinary team of medical educators, human resource development (HRD) scholars and emergency medicine fellows engaged in iterative cycles of action research (AR) to develop, pilot and refine case-based learning resources on clinical uncertainty. The team leveraged prior research on physicians’ decision-making during COVID-19, experimented with generative AI tools, and collected feedback from medical students to guide resource development. Findings The findings of this study are twofold. On the one hand, the authors reflect on the lessons learned of developing case-based learning with the help of generative AI. While student feedback indicated that the case helped normalize and process experiences with uncertainty, key challenges included adapting research data to create relevant, sustainable learning resources and designing effective discussion prompts. On the other hand, the authors provide insights into the opportunities and challenges of our interdisciplinary collaboration. The authors show that knowledge utilization is not simple, but complex, and that more work needs to be done to effectively disseminate resources as part of the desired uncertainty curriculum. Practical implications This study attempts to apply a KT framework for bridging the research-practice gap in HPE through interdisciplinary collaboration and AR. It provides lessons learned for developing case-based curricula on complex topics like uncertainty. The findings highlight the need for adaptive KT processes when dealing with rapidly evolving healthcare contexts. Originality/value This paper offers a novel example of research-to-resource KT in medical education, integrating perspectives from HRD and leveraging emerging technologies. It contributes to understanding how interdisciplinary teams can collaborate to create timely, evidence-based educational resources for navigating uncertainty in professional practice. The study also provides insights into the challenges and opportunities of translating complex research findings into practical learning tools to tackle real-world challenges in HPE.

Public–private partnerships and human development

Abstract The restructuring of a state is crucial for promoting human development. For this reason, public–private partnerships (PPPs), the so-called “fourth revolution” in reinventing the state, have become a global strategy of choice. Yet, existing studies on PPPs mainly analyze their effect on growth or inequality, not human development. This article uses data from the human development index (HDI) database to investigate the impact of PPP projects on human development. With the increasing scale of public infrastructure investments and the need to improve public services, it is necessary to examine whether PPPs are justified in improving social welfare. We conducted the analysis for all low- and middle-income countries using propensity score matching (PSM) and multivariate analysis. Additionally, we present the HDI predictions. We believe that assessing the impact of public–private cooperation on increasing social welfare, reducing social exclusion, and implementing investments with a robust social impact is essential. Overall, we found a statistically significant effect of PPPs on human development, demonstrating that the growing scale of PPP investments in low- and middle-income countries enhances their HDI.

Factors Affecting Household Health Expenditures: Evidence from Iran

Abstract Background Productivity plays a crucial role in driving economic growth, and its primary determinant is human capital. Human capital, in turn, is influenced by health and education investments, leading both households and governments to allocate substantial resources toward these sectors. Understanding the factors influencing health expenses is vital for designing effective policies. Methods This study investigates the factors affecting health costs by analyzing data from various provinces in the Islamic Republic of Iran, spanning from 2006 to 2019. The data, sourced from the Statistics Center of Iran, was analyzed using the panel data approach to uncover the relationships between health expenditure and several key variables. Results The analysis revealed significant disparities in health expenditure among provinces. Sistan & Baluchestan had the lowest health expenditure per household, while Tehran reported the highest. Inflation emerged as a significant factor, having a negative impact on health expenses due to its influence on purchasing power. Conversely, the education and salary of household heads had a positive impact on health expenditure. Notably, economic growth did not exhibit a significant relationship with health expenses. Conclusions The study highlights the importance of education and income levels in shaping health expenditures, while inflation can curtail spending on health due to reduced purchasing power. Policymakers should consider these factors to ensure equitable and effective allocation of health resources. Key messages • Improving health and well-being, essential for comprehensive progress and human development, relies significantly on household health expenditure. • The efforts to enhance human capital should focus on reducing inflation.

Education’s primary motive of overall human development in India: Case based perspective of Dayalbagh Educational Institute

The Indian higher education system faces significant challenges in integrating value-based education, sustainability, and consciousness, often prioritizing academic achievements over holistic development. This case-based research explores how Dayalbagh Educational Institute (DEI) effectively addresses these challenges by incorporating sustainability, value, and consciousness into its educational framework. DEI was selected for its distinctive approach, which emphasizes moral and social responsibility, fostering not only academic success but also the ethical development of students. The study draws on document analysis and observations to illustrate how DEI’s educational practices serve as a model for other institutions. The research underscores the urgent need for educational reforms in India that go beyond traditional metrics of success, addressing the gaps in moral education and sustainable practices. By fostering critical thinking, ethical decision-making, and social responsibility, DEI demonstrates how an education system can prepare students for future challenges while promoting a deeper consciousness about their role in society. The findings suggest that integrating value-based education with sustainability and consciousness not only enhances students’ holistic development but also contributes to broader goals of national development. DEI’s model offers practical insights and evidence for other educational institutions to adopt similar strategies, ensuring that future generations are better equipped to address societal challenges with a strong ethical foundation. This research thus provides a comprehensive view of the essential elements needed in modern education to create responsible and conscious global citizens.

Nduga Human Development Index 35.19 / 0.35: PENA as an Alternative to Human Resource Development in Mountainous Papua

This study examines alternative strategies for human resource development in Nduga Regency, Mountainous Papua, where the Human Development Index (HDI) is still very low. The region faces significant challenges, including economic underdevelopment, low access to education, and ongoing conflict. This research focuses on the efforts of the Tunas Harapan Papua Care Foundation (Pena Papua) in improving access to education for students from underprivileged backgrounds. Through qualitative descriptive methods, data are collected through interviews, observations, and document reviews involving stakeholders from foundations, students, and local communities. The findings show that Pena Papua has contributed significantly to improving access to quality education and character development among students. However, cultural erosion, particularly the loss of mother tongues, was identified as a critical problem. The study concludes that although foundations have made significant progress in developing human resources, the preservation of cultural identity remains a challenge that must be addressed along with educational initiatives.

Long COVID prevalence differences across 27 European countries that participated in the 2021 Survey of Health, Ageing and Retirement in Europe

Abstract The COVID-19 pandemic caused a significant burden in Europe, with over 60% of infected individuals developing Long COVID symptoms. Variations in Long COVID prevalence across countries are linked to individual-level factors, but the influence of population-based country-level characteristics remains unclear. Thus, our objective was to assess how country-level characteristics related to: (i) the way European countries responded to the COVID-19 pandemic, (ii) their population-level health status, (iii) provision and access to healthcare services, (iv) human development, governance, and environmental risk factors, are associated with Long COVID. We used a sample of 4,004 middle-aged and older adults from 27 European countries who, in summer 2021, participated in Corona Survey 2 (from Survey of Health, Ageing and Retirement in Europe) and who reported COVID-19 infection one year prior to the survey. To assess the potential role of country-level characteristics, while controlling for key individual-level factors, we estimated three sequential multilevel random intercept logistic regression models. Approximately 70% of respondents who had COVID-19 also experienced Long COVID symptoms and there were significant cross-country differences in Long COVID rates, ranging from 32% to 89%. About 13% of the total variance in the risk of having Long COVID can be attributed to cross-country differences and the remaining 87% to individual-level factors. The individual-level characteristics also accounted for 6% of the observed cross-country differences in Long COVID rates (compositional effects) while the country-level characteristics further reduced this variance by over 50%. Both individual and country-level factors influence Long COVID occurrence, emphasizing the need for tailored recovery plans, healthcare planning and resource allocation at the national level to address this condition.

Effectiveness Of Team-Based Training Programs In Hospitals

The Effectiveness of Team-Based Training Programs in Hospitals aims to evaluate the effectiveness of team-based training programs in developing the competencies of health workers in hospitals. The research is based on the importance of collaboration between health professions to improve quality of care, but is often hampered by communication and coordination gaps. The research methodology involved systematically evaluating the training program qualitatively, measuring changes in trainees' competencies, and exploring participants' perceptions and experiences. The main objectives of the study were to evaluate the effectiveness of the program in developing health worker competencies, measure changes in participant competencies, explore participant perceptions and experiences, and provide recommendations for future program improvements. It is expected to provide valuable insights into the effectiveness of team-based training programs and identify areas that require improvement. This will be used to improve future training programs, with the ultimate goal of improving health worker collaboration and the quality of health services for patients. The implications of this study include contributions to human resource development in healthcare and the promotion of a culture of collaboration between healthcare professionals. The research findings from the study on the Effectiveness of Team-Based Training Programs in Hospitals indicate several positive outcomes. First, participants reported improvements in communication, particularly in emergency situations, where teams responded more swiftly and effectively. The program also led to enhanced coordination between shifts, reducing errors in patient care and improving the overall quality of services provided

Approaches to Dementia Control in a Community in Japan

Abstract Background In order to consider future dementia countermeasures in the community, we conducted a survey to understand the characteristics of the elderly living in the community. Methods A self-administered questionnaire survey was conducted in collaboration with Hanno-city, Saitama Prefecture, targeting all persons aged 65 years or older (excluding institutionalized residents) living in Hanno-city (aging rate: 32.0%). The questionnaire items included basic attributes, lifestyle, daily living conditions, and willingness to participate in activities. The survey was sent to 7,133 people, and 3,623 valid responses were received (valid response rate: 50.8%). Results Respondents were 1,135 males (51.2%) and 1,080 females (48.8%); 1,979 (54.6%) were aged 65-74 and 1,644 (45.4%) were aged 75 and over. The proportion of single-person households was 12.1%. 56.1% of the respondents had been living in the community for 30 years or more, and the overall membership rate of the residents’ association was high at 91.0%. A total of 691 (19.1%) of the respondents had seen someone suspected of having dementia. 1,178 (32.5%) answered ‘yes,’ 1,452 (40.1%) answered ‘no,’ and 881 (24.3%) answered ‘don’t know. There were 472 (8.1%) dementia supporters. Conclusions The membership rate of local residents’ associations was high at 91.0%, indicating that the community maintains relatively close relationships with its residents. Based on the National Dementia plan, further consideration will be given to long-term goals such as human resource development for each region and policies to support these goals. Main messages: In a mountainous district with an aging population similar to that of Japan as a whole, only about one-third of the respondents knew of a contact point for dementia-related issues. Based on the National Dementia Plan, the government will consider dementia policies, including long-term goals and policies to support these goals in the community. Key messages • In a mountainous district with an aging population similar to that of Japan as a whole, only about one-third of the respondents knew of a contact point for dementia-related issues. • Based on the National Dementia Plan, the government will consider dementia policies, including long-term goals and policies to support these goals in the community.

Training transfer in MSMEs of India: examining the role of performance coaching, HRD climate and employee agility

Purpose The relatively low emphasis on training is often attributed to concerns about the uncertain return on investment in training initiatives. However, there has been limited research conducted to understand the critical success factors for training effectiveness in these enterprises. The current research aims to address this gap by examining the role of training transfer factors in enhancing training effectiveness within micro, small and medium enterprises (MSMEs) in India. Influenced by the Learning Transfer System framework proposed by Holton et al. (2007), this study aims to focus on investigating the impact of performance coaching, human resource development (HRD) climate and employee agility on training transfer in MSMEs. Design/methodology/approach Data has been collected from 411 respondents working in MSMEs of India through validated survey instruments. MSMEs have been chosen owing to the increasing contribution of the sector to the Indian gross domestic product and the lack of sufficient management research in the sector. The statistical software SPSS-AMOS has been used to create structural equational modeling for testing the hypotheses. Findings The result shows that performance coaching is the most impactful factor for training transfer, followed by HRD climate and employee agility. Practical implications The result suggests MSME practitioners activate a positive coaching environment in the organization by following the best practices in performance coaching. Further, the research suggests practitioners to realize the significance of HRD climate and employee agility. Appropriate management practices have been suggested to groom and develop HRD climate and employee agility for higher training transfer. Originality/value To the best of the authors’ knowledge, the research is first of its kind to study the impact of performance coaching, employee agility and HRD climate on training transfer in MSMEs.

Health Impacts of Disasters and Social Indicators: An Ecological Study

Abstract The objective of this study is to investigate the correlation between certain social indicators and the mortality and morbidity in disasters recorded in the EM-DAT database within countries in the last decade. The correlation between the mortality and morbidity in disasters recorded in the EM-DAT database between March 1, 2014-2024 and the most recent data on Human Development Index (HDI), Gender Inequality Index (GII), Gini Coefficient (GC), Government Health Expenditure as a share of GDP (GHE/GDP) and Corruption Perception Index (CPI) were analyzed. During the period of the study, disasters from a total of 207 countries/regions were recorded in the database. The median (IQR) values of countries in disasters were found to be 35.1 (67.5) for death per million and 76.3 (783.0) for injury per million. The most frequent types of disasters, the most frequent cause of mortality and the most frequent cause of injury in each country were found to be floods, extreme temperatures, and epidemics, respectively. While there was no significant difference between the social indicators analyzed and the total number of deaths, there was a negative correlation between the number of injuries and the HDI, CPI, GHE/GDP values of the countries, and a positive correlation between the GC and GII values (for all tests, Spearman correlation test, p < 0.001). The correlation coefficient was interpreted as ‘weak’ in all other pairwise analyses except for the GHE/GDP value (moderate). Countries with social indicators closer to the positive threshold have been found to have less injuries in disasters. The possible reason for the insignificant correlation with the mortality is thought to be the difficulties in detecting mortality, especially in ‘extreme temperatures’, and the fact that it is mostly recorded in countries where social indicators are relatively more advanced. More research is needed to investigate the relationality between social indicators and disaster harms. Key messages • Disasters are critical mediators between social determinants and health. Addressing and reducing inequalities should remain on the public health agenda to prevent disasters and protect health. • Analysis of disasters shows that ‘extreme temperatures’, which cause the most deaths in some countries, are barely detected in developing countries. Disaster recording systems need to be strengthened.

Smoke-Free Policies and Cigarette Consumption Impact on Myocardial Infarction Mortality in Europe

Abstract Background Limited evidence exists on the association between smoke-free policies and per-capita cigarette consumption and mortality due to acute myocardial infarction (AMI) in Europe. Therefore, our study aimed to assess this association and evaluate influencing factors. Methods We conducted an interrupted time series analysis involving 27 European Union member states and the UK, examining per-capita cigarette consumption and AMI mortality. A multivariate meta-regression assessed potential influencing factors. Results Approximately half of introduced smoke-free policies were associated with level or slope changes, or both, in per-capita cigarette consumption and AMI mortality (17 of 35). Notably, the smoking ban in Poland in 2010 resulted in the most substantial level reduction in cigarette consumption (rate ratio (RR): 0.47; 95% CI: 0.41, 0.53), while the intervention in Bulgaria in 2012 led to the largest level reduction in AMI mortality (RR: 0.38; 95% CI: 0.34, 0.42). More recent policies or those from countries with lower human development indices were linked to greater decreases in cigarette consumption. Furthermore, smoking bans encompassing bars exhibited a stronger inverse association with both cigarette consumption and AMI mortality. Conclusions Our findings indicate the effectiveness of smoke-free policies in reducing per-capita cigarette consumption and AMI mortality. Continued monitoring and data collection on tobacco, prevalence, and consumption are crucial for concerted efforts to address its health impacts. Key messages • Smoke-free policies lower cigarette consumption, reducing heart attack deaths in Europe. • Monitoring tobacco data crucial for health efforts: Study shows smoke-free policies save lives.