Health Organization International Research Articles

Specific ICF training is needed in clinical practice: ICF framework education is not enough

The use of a common language in interprofessional collaboration is essential. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has been identified as a unifying framework for interprofessional collaboration and the identification of client needs. Higher education institutions (HEIs) offer ICF framework education to students but is it enough to enable graduated professionals to implement the ICF in clinical work? In our experience, the ICF education provided by HEIs does not meet the requirements of clinical practice, which might be due to gaps in teaching ICF to students (education) and specific requirements for teaching ICF to professionals already working in rehabilitation (training). This paper discusses the need for the ICF training in practice and ways to address it. Although many rehabilitation center professionals had previously received ICF education provided by the HEIs, the rehabilitation centers felt the need to develop their own practical training materials that could be applied to their own environment. Overall, 18 different ICF-based materials were developed during the Erasmus+ project called INPRO to promote person-centered and interprofessional practice in the rehabilitation centers. The practical training using real cases was considered valuable. It could be further developed in cooperation with HEIs and vice versa. It could also be used to teach students, i.e., future colleagues. To deepen and broaden the integration of the different materials based on the ICF, it is important to continue the interactive discussion between HEIs and clinical practice, and between management and its staff.

The Current Landscape of Clinical Trials for Immunotherapy in Pancreatic Cancer: A State-of-the-Art Review.

Pancreatic cancer remains a lethal malignancy with a 5-year survival rate below 6% and about 500,000 deaths annually worldwide. Pancreatic adenocarcinoma, the most prevalent form, is commonly associated with diabetes, chronic pancreatitis, obesity, and smoking, mainly affecting individuals aged 60 to 80 years. This systematic review aims to evaluate the efficacy of immunotherapeutic approaches in the treatment of pancreatic cancer. A systematic search was conducted to identify clinical trials (Phases I-III) assessing immunotherapy in pancreatic cancer in PubMed/Medline, CINAHL, Scopus, and Web of Science, adhering to PRISMA Statement 2020 guidelines. The final search was completed on May 25, 2024. Ongoing trials were sourced from ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (ICTRP). Keywords such as "pancreatic," "immunotherapy," "cancer," and "clinical trial" were used across databases. Gray literature was excluded. Phase I trials, involving 337 patients, reported a median overall survival (OS) of 13.6 months (IQR: 5-62.5 months) and a median progression-free survival (PFS) of 5.1 months (IQR: 1.9-11.7 months). Phase II/III trials pooled in a total of 1463 participants had a median OS of 12.2 months (IQR: 2.5-35.55 months) and a median PFS of 8.8 months (IQR: 1.4-33.51 months). Immunotherapy shows potential for extending survival among pancreatic cancer patients, though results vary. The immunosuppressive nature of the tumor microenvironment and diverse patient responses underline the need for further research to optimize these therapeutic strategies.

Schistosomiasis diagnosis: Challenges and opportunities for elimination.

The roadmap adopted by the World Health Organization (WHO) for eliminating neglected tropical diseases aims to eliminate schistosomiasis, as a public health concern, by 2030. While progress has been made towards reducing schistosomiasis morbidity control in several sub-Saharan African countries, there is still more that needs to be done. Proper surveillance using accurate diagnostics with acceptable sensitivity and specificity is essential for evaluating the success of all efforts against schistosomiasis. Microscopy, despite its low sensitivity, remains the gold standard approach for diagnosing the disease. Although many efforts have been made to develop new diagnostics based on circulating parasite proteins, genetic markers, schistosome egg morphology, and their paramagnetic properties, none has been robust enough to replace microscopy. This review highlights common diagnostic approaches for detecting schistosomiasis in field and clinical settings, major challenges, and provides new and novel opportunities and diagnosis pathways that will be critical in supporting elimination of schistosomiasis. We searched for relevant and reliable published literature from PubMed, Scopus, google scholar, and Web of science. The search strategies were primarily determined by subtopic, and hence the following words were used (schistosom*, diagnosis, Kato-Katz, antibody test, circulating antigen, POC-CCA, UCP-LF-CAA, molecular diagnostics, nucleic acid amplification test, microfluidics, lab-on a disk, lab-on chip, recombinase polymerase amplification (RPA), LAMP, portable sequencer, nanobody test, identical multi-repeat sequences, diagnostic TPPs, REASSURED, extraction free), and Boolean operators AND and/OR were used to refine the searching capacity. Due to the global public health nature of schistosomiasis, we also searched for reliable documents, reports, and research papers published by international health organizations, World Health Organization (WHO), and Center for Disease control and Elimination.

Reassuring Quantitative Analysis of Glyphosate and Aminomethylphosphonic Acid Levels in Breast Milk Using Liquid Chromatography Mass Spectrometry.

Purpose: The World Health Organization's International Agency on Research for Cancer has determined that glyphosate is "probably carcinogenic to humans." There is a great public interest to investigate whether glyphosate are detected in breast milk. Thus, the goal of this study was to assess the concentration of glyphosate and its main metabolite in breast milk. Materials and Methods: Liquid chromatography was performed at 25°C using a Luna NH2, 50 × 2 mm, 3⎛ m (Phenomenex) analytical column. Electrospray ionization mass spectrometry was collected using negative ionization mode. The calibration curve for glyphosate ranged from 10 to 250 ng/mL. The detection limit was 1 ng/mL. Results: Breast milk samples were collected from 74 women, which included vegans (n = 26), vegetarians (n = 22), and nonvegetarians (n = 26). One of the 74 milk samples contained a detectable concentration of glyphosate and an additional 7 were found to contain aminomethylphosphonic acid. Conclusions: In breast milk samples collected mainly from women residing in urban regions of the United States, glyphosate detection was rare. Consistently, breastfed infants have a low or minimal risk of being exposed to glyphosate through ingestion of mother's milk. It is possible that the presence/absence and/or level of concentration of milk glyphosate depend on a place of residency and time of breastfeeding vis-à-vis time of its agricultural application.

Psychological and social interventions for the promotion of mental health in people living in low- and middle-income countries affected by humanitarian crises.

Because of wars, conflicts, persecutions, human rights violations, and humanitarian crises, about 84 million people are forcibly displaced around the world; the great majority of them live in low- and middle-income countries (LMICs). People living in humanitarian settings are affected by a constellation of stressors that threaten their mental health. Psychosocial interventions for people affected by humanitarian crises may be helpful to promote positive aspects of mental health, such as mental well-being, psychosocial functioning, coping, and quality of life. Previous reviews have focused on treatment and mixed promotion and prevention interventions. In this review, we focused on promotion of positive aspects of mental health. To assess the effects of psychosocial interventions aimed at promoting mental health versus control conditions (no intervention, intervention as usual, or waiting list) in people living in LMICs affected by humanitarian crises. We searched CENTRAL, MEDLINE, Embase, and seven other databases to January 2023. We also searched the World Health Organization's (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov to identify unpublished or ongoing studies, and checked the reference lists of relevant studies and reviews. Randomised controlled trials (RCTs) comparing psychosocial interventions versus control conditions (no intervention, intervention as usual, or waiting list) to promote positive aspects of mental health in adults and children living in LMICs affected by humanitarian crises. We excluded studies that enrolled participants based on a positive diagnosis of mental disorder (or based on a proxy of scoring above a cut-off score on a screening measure). We used standard Cochrane methods. Our primary outcomes were mental well-being, functioning, quality of life, resilience, coping, hope, and prosocial behaviour. The secondary outcome was acceptability, defined as the number of participants who dropped out of the trial for any reason. We used GRADE to assess the certainty of evidence for the outcomes of mental well-being, functioning, and prosocial behaviour. We included 13 RCTs with 7917 participants. Nine RCTs were conducted on children/adolescents, and four on adults. All included interventions were delivered to groups of participants, mainly by paraprofessionals. Paraprofessional is defined as an individual who is not a mental or behavioural health service professional, but works at the first stage of contact with people who are seeking mental health care. Four RCTs were carried out in Lebanon; two in India; and single RCTs in the Democratic Republic of the Congo, Jordan, Haiti, Bosnia and Herzegovina, the occupied Palestinian Territories (oPT), Nepal, and Tanzania. The mean study duration was 18 weeks (minimum 10, maximum 32 weeks). Trials were generally funded by grants from academic institutions or non-governmental organisations. For children and adolescents, there was no clear difference between psychosocial interventions and control conditions in improving mental well-being and prosocial behaviour at study endpoint (mental well-being: standardised mean difference (SMD) 0.06, 95% confidence interval (CI) -0.17 to 0.29; 3 RCTs, 3378 participants; very low-certainty evidence; prosocial behaviour: SMD -0.25, 95% CI -0.60 to 0.10; 5 RCTs, 1633 participants; low-certainty evidence), or at medium-term follow-up (mental well-being: mean difference (MD) -0.70, 95% CI -2.39 to 0.99; 1 RCT, 258 participants; prosocial behaviour: SMD -0.48, 95% CI -1.80 to 0.83; 2 RCT, 483 participants; both very low-certainty evidence). Interventions may improve functioning (MD -2.18, 95% CI -3.86 to -0.50; 1 RCT, 183 participants), with sustained effects at follow-up (MD -3.33, 95% CI -5.03 to -1.63; 1 RCT, 183 participants), but evidence is very uncertain as the data came from one RCT (both very low-certainty evidence). Psychosocial interventions may improve mental well-being slightly in adults at study endpoint (SMD -0.29, 95% CI -0.44 to -0.14; 3 RCTs, 674 participants; low-certainty evidence), but they may have little to no effect at follow-up, as the evidence is uncertain and future RCTs might either confirm or disprove this finding. No RCTs measured the outcomes of functioning and prosocial behaviour in adults. To date, there is scant and inconclusive randomised evidence on the potential benefits of psychological and social interventions to promote mental health in people living in LMICs affected by humanitarian crises. Confidence in the findings is hampered by the scarcity of studies included in the review, the small number of participants analysed, the risk of bias in the studies, and the substantial level of heterogeneity. Evidence on the efficacy of interventions on positive mental health outcomes is too scant to determine firm practice and policy implications. This review has identified a large gap between what is known and what still needs to be addressed in the research area of mental health promotion in humanitarian settings.

Implementation of the International Classification of Diseases 11th revision behavioural indicators for disorders of intellectual development with co-occurring autism spectrum disorder.

The classification of mental, behavioural and neurodevelopmental disorders in the World Health Organization's International Classification of Diseases 11th revision (ICD-11) includes a comprehensive set of behavioural indicators (BIs) within the neurodevelopmental disorders grouping. BIs can be used to assess the severity of disorders of intellectual development in situations in which standardised measures of intellectual functioning and adaptive behaviours are not available or feasible. This international study examines the implementation characteristics of the BIs and compares them to standardised measures for assessing the severity of intellectual impairment and adaptive behaviours in disorders of intellectual development and autism spectrum disorder (ASD). The clinical utility of the ICD-11 and the fidelity of its application in international clinical settings were also assessed. A total of 116 children and adolescents (5-18years old) with a suspected or established diagnosis of disorders of intellectual development were included across four sites [Italy (n=18), Sri Lanka (n=19) and two sites in India (n=79)]. A principal component analysis was conducted to evaluate the application of the ICD-11 guidance for combining severity levels. Assessment using the BIs showed a higher proportion of individuals classified with mild severity, whereas the standardised measures indicated a higher proportion of severe ratings. Additionally, individuals with co-occurring ASD tended to have more severe impairments compared with those without ASD, as indicated by both BIs and standardised measures. Overall, the BIs were considered clinically useful, although more time and consideration were required when applying the guidelines for individuals with a co-occurring disorder of intellectual development and ASD. The principal component analysis revealed one principal component representing overall disorders of intellectual development severity levels. The ICD-11 BIs can be implemented as intended in international clinical settings for a broad range of presentations of individuals with neurodevelopmental disorders. Use of the BIs results in similar severity diagnoses to those made using standardised measures. The BIs are expected to improve the reliability of severity assessments in settings where appropriate standardised measures for intellectual and adaptive behaviours are not available or feasible.

The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study.

Environmental and behavioral factors are responsible for 12.6 million deaths annually and contribute to 25% of deaths and chronic diseases worldwide. Through the One Health initiative, the World Health Organization and other international health organizations plan to improve these indicators to create healthier environments by 2030. To meet this challenge, training primary care professionals should be the priority of national policies. General practitioners (GPs) are ready to become involved but need in-depth training to gain and apply environmental health (EH) knowledge to their practice. In response, we designed the Primary Care Environment and Health (PCEH) online course in partnership with the Occitanie Regional Health Agency in France. This course was used to train GP residents from the Montpelier-Nimes Faculty of Medicine in EH knowledge. The course was organized in 2 successive parts: (1) an asynchronous e-learning modular course focusing on EH knowledge and tools and (2) 1 day of face-to-face sessions. This study assessed the impact of the e-learning component of the PCEH course on participants' satisfaction, knowledge, and behavior changes toward EH. This was a pilot before-and-after study. Four modules were available in the 6-hour e-learning course: introduction to EH, population-based approach (mapping tools and resources), clinical cases, and communication tools. From August to September 2021, we recruited first-year GP residents from the University of Montpellier (N=130). Participants' satisfaction, knowledge improvements for 19 EH risks, procedure to report EH risks to health authorities online, and behavior change (to consider the possible effects of the environment on their own and their patients' health) were assessed using self-reported questionnaires on a Likert scale (1-5). Paired Student t tests and the McNemar χ2 test were used to compare quantitative and qualitative variables, respectively, before and after the course. A total of 74 GP residents completed the e-learning and answered the pre- and posttest questionnaires. The mean satisfaction score was 4.0 (SD 0.9) out of 5. Knowledge scores of EH risks increased significantly after the e-learning course, with a mean difference of 30% (P<.001) for all items. Behavioral scores improved significantly by 18% for the participant's health and by 26% for patients' health (P<.001). These improvements did not vary significantly according to participant characteristics (eg, sex, children, place of work). The e-learning course improved knowledge and behavior related to EH. Further studies are needed to assess the impact of the PCEH course on clinical practice and potential benefits for patients. This course was designed to serve as a knowledge base that could be reused each year with a view toward sustainability. This course will integrate new modules and will be adapted to the evolution of EH status indicators and target population needs.

Immunization and Screening Methods for Cervical Carcinoma in Developing Nations: A Detailed Review

Objective: Cervical cancer remains a significant public health challenge in developing countries, disproportionately affecting women in these regions due to limited access to effective screening and vaccination programs. This review synthesizes the current literature on the implementation strategies, effectiveness, and challenges of cervical cancer screening and Human Papillomavirus (HPV) vaccination programs in developing countries, aiming to highlight successful models and identify gaps in current practices. Screening, for cervical cancer in developing countries faces numerous obstacles, including logistical challenges, lack of awareness, and insufficient healthcare infrastructure. Despite these hurdles, strategies such as single-visit approaches, leveraging low-cost HPV DNA testing, and utilizing mobile health units have shown promise in increasing screening coverage and early detection rates. The prerequisites for effective screening highlighted include affordability, cultural acceptability, and the ability to implement large-scale screening with limited resources. HPV vaccination presents a primary prevention measure with the potential to significantly reduce the incidence of cervical cancer. However, vaccination programs in developing countries encounter challenges in vaccine procurement, distribution, and achieving high coverage rates among the target population. Innovations in vaccine delivery, education campaigns to raise awareness, and partnerships with international health organizations are crucial for overcoming these barriers.This comprehensive review underscores the need for a multifaceted approach to cervical cancer prevention in developing countries, encompassing improvements in screening and vaccination strategies, health system strengthening, community engagement, and international collaboration. By learning from successful models and addressing identified gaps, there is a significant opportunity to reduce the burden of cervical cancer in these regions and move closer to achieving global health equity.

Co-worker unprofessional behaviour and patient safety risks: an analysis of co-worker reports across eight Australian hospitals.

A key component of professional accountability programmes is online reporting tools that allow hospital staff to report co-worker unprofessional behaviour. Few studies have analysed data from these systems to further understand the nature or impact of unprofessional behaviour amongst staff. Ethos is a whole-of-hospital professional accountability programme that includes an online messaging system. Ethos has now been implemented across multiple Australian hospitals. This study examined reported unprofessional behaviour that staff indicated created a risk to patient safety. This study included 1310 Ethos submissions reporting co-worker unprofessional behaviour between 2017 and 2020 across eight Australian hospitals. Submissions that indicated the behaviour increased the risk to patient safety were identified. Descriptive summary statistics were presented for reporters and subjects of submissions about unprofessional behaviour. Logistic regression was applied to examine the association between each unprofessional behaviour (of the six most frequently reported in the Ethos submissions) and patient safety risk reported in the submissions. The descriptions in the reports were reviewed and the patient safety risks were coded using a framework aligned with the World Health Organization's International Classification for Patient Safety. Of 1310 submissions about unprofessional behaviour, 395 (30.2%) indicated that there was a risk to patient safety. Nurses made the highest number of submissions that included a patient safety risk [3.47 submissions per 100 nursing staff, 95% confidence interval (CI): 3.09-3.9] compared to other professional groups. Medical professionals had the highest rate as subjects of submissions for unprofessional behaviour with a patient safety risk (5.19 submissions per 100 medical staff, 95% CI: 4.44-6.05). 'Opinions being ignored' (odds ratio: 1.68; 95% CI: 1.23-2.22; P < .001) and 'someone withholding information which affects work performance' were behaviours strongly associated with patient safety risk in the submissions (odds ratio: 2.50; 95% CI: 1.73-3.62; P < .001) compared to submissions without a patient safety risk. The two main types of risks to patient safety described were related to clinical process/procedure and clinical administration. Commonly reported events included staff not following policy or protocol; doctors refusing to review a patient; and interruptions and inadequate information during handover. Our findings indicate that unprofessional behaviour was associated with risks to patient safety. Co-worker reports about unprofessional behaviour have significant value as they can be used by organizations to better understand how unprofessional behaviour can disrupt work practices and lead to risks to patient safety.

Comparative medical importance of spider bites in Spain over 1997-2020: a retrospective study based on hospital cases coded using ICD.

Envenomation by terrestrial toxic animals is considered a serious risk to human health worldwide. Snakes, hymenopterans, spiders, and scorpions have mainly attracted the attention of medical literature. However, the relative importance of spiders has been studied only in a few countries. Here, we present the first retrospective study on the incidence of spider bites requiring hospital care in Spain, compared to bites or stings from snakes, hymenopterans, and scorpions. Using ICD9MC and ICD10 databases from the World Health Organization's International Classification of Diseases for the period 1997-2020, we quantified the cases of envenomation by spiders, compared to those by other terrestrial toxic animals, the demographic data of envenomation cases, the relative severity of spider bites, and the geographic distribution of envenomation cases. Overall, the incidence of acute intoxication by terrestrial toxic animals in Spain was ca. 1.23 cases per million inhabitants. In decreasing order of importance, cases were due to snakes, hymenopterans, spiders, scorpions, and myriapods. Fatal cases were extremely rare, caused mainly by hymenopterans. No fatalities were caused by spiders, scorpions, and myriapods. A greater incidence of snake bites occurred in northern Spain, but no geographical trends were found for spider bites or scorpion stings. Severe poisoning or life-threatening cases due to bites or stings from toxic terrestrial animals in Spain seems to be very low, especially for spiders, compared to other countries in the world. In general, spiders do not present a risk to human health and should not be considered a major driver of morbidity.

Occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms following traumatic brain injury: a scoping review protocol.

The objective of the review is to identify, categorize, and examine literature describing occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms (PPCS). PPCS are symptoms experienced by adults a minimum of 2 to 4 weeks after a traumatic brain injury (TBI), and include vestibular, neuropsychiatric, visual, and cognitive issues. Enduring PPCS may result in disability, affecting a person's independence and/or participation in daily activities. Despite growing recognition of the role occupational therapy can offer in TBI rehabilitation, evidence is limited regarding the scope of practice occupational therapists have in the rehabilitation of adults experiencing PPCS. Literature that includes adults (aged 18 to 65 years) experiencing PPCS that describes the occupational therapy scope of practice in concussion programs will be considered for inclusion in this review. Sources reporting on participants aged under 18 years, classified with non-persistent symptoms, and receiving care in acute health care settings will be excluded. Non-English publications or gray literature from civil society or disabled persons organizations or other representative bodies in the field of brain injury will also be excluded. The scoping review will follow the JBI methodology for scoping reviews. Five electronic databases will be searched for literature published between 2013 and the present: MEDLINE, Embase, Emcare, PsycINFO, and CINAHL. Two reviewers will independently conduct title and abstract screening of the results and, upon consensus, independently screen full texts to confirm final sources for inclusion. Any disagreements will be resolved by discussion with a third reviewer. Data will be extracted from included sources and we will then map occupational therapy scope of practice (inclusive of assessments and interventions) against the World Health Organization's International Classification of Functioning One-Level Classification. Results will be presented in tabular or narrative format. Open Science Framework osf.io/qxgzj.

A SYSTEMATIC REVIEW ON MALARIA DISEASE AND ITS TREATMENTS FOCUS ON ARTEMETHER DRUG

Malaria is one of the infectious illnesses of the highest scientific significance and importance to international health organizations. Plasmodium falciparum, the parasite responsible for a highly severe form of the disease in Africa, has traditionally received the most attention. However, in the last two decades, the Plasmodium vivax parasite, which is linked to a large number of cases in Latin America, the Middle East, South and Southeast Asia, the Horn of Africa, and Oceania, has sparked enormous interest, owing to published evidence that it can cause severe malaria, among other things. Malaria is a worldwide public health problem, with a saw 247 million cases recorded in 2021. African countries accounted for approximately 94% of all reported cases. So far, over 200 distinct varieties of protozoa have been discovered and identified, with at least 13 of them being pathogenic to humans. The malaria parasite's life cycle is a complex process involving a mosquito with the species Anopheles and a vertebrate host.&#x0D; Artemether is a lipid-soluble artemisinin derivative. It is available in both oral and intramuscular forms. It is also available as a fixed-dose formulation with lumefantrine. Artemether-lumefantrine is one of the ACTs authorized by the WHO and is being used by the majority of countries transitioning from less effective medications to ACTs. However, the emergence of antimalarial medication resistance poses a significant challenge to malaria control. It works by killing the pathogenic organisms responsible for malaria. It is known as an antimalarial medication, and it is more effective than quinine therapies.

Use of the Patient Generated Index to Identify Physical Health Challenges among People Living with HIV: A Cross-sectional Study

Many people living with HIV experience physical health challenges including mobility problems, pain, and fatigue. Purpose: To estimate how many people living with HIV identify physical health challenges as important using the patient generated index (PGI). Secondary Objectives: a. Identify factors associated with reporting physical health challenges; b. Identify relationships between reporting physical health challenges and standardized health-related quality of life (HRQOL) items; and c. Estimate the extent to which reporting a physical health challenge explains downstream HRQOL outcomes. Methods: Cross-sectional data came from a large Canadian cohort. We administered the PGI and three standardized HRQOL measures. PGI text threads were coded according to the World Health Organization's International Classification of Functioning, Disability, and Health. Regression, discriminant analysis, and chi-square tests were used. Results: Of 865 participants, 248 [28.7%; 95% CI (25.7%, 31.8%)] reported a physical health challenge on the PGI. Participants with better pain (OR: 0.81, 95% CI: 0.71, 0.90) and vitality (OR: 0.71, 95%CI: 0.63, 0.80) by 20 points had lower odds of reporting a physical health challenge. Those who reported a physical health challenge had significantly lower HRQOL on some standardized items. Conclusion: The PGI is well-suited to identify the physical challenges of people living with HIV.

Impact of pharmacist-supported transition of care services in the Middle East and North Africa: a systematic review and meta-analysis.

Transition of care (TOC) is associated with an increased risk of medication-related problems. Despite recent advancements in pharmacy practice and research in the Middle East and North Africa (MENA), the characteristics and impact of regional pharmacy-supported TOC interventions remain unclear.This systematic review and meta-analysis aimed to describe pharmacist-supported TOC interventions in the MENA region and evaluate their effectiveness. PubMed, CINAHL, EMBASE, Web of Science, World Health Organization's International Clinical Trials Registry Platform (ICTRP) were searched from their inception to March 9, 2023, for experimental studies published in English, comparing pharmacist-supported TOC interventions with usual care for adults (age ≥18 years) discharged from the hospital. The risk of bias was evaluated using Cochrane's risk-of-bias tool for randomised trials (ROB2) and the risk of bias in non-randomised studies of interventions (ROBINS-I) tool for randomised and non-randomised studies respectively. Narrative syntheses and meta-analysis methods were employed depending on the outcomes evaluated. Twelve studies (n = 2377 subjects), 10 randomised controlled trials and 2 quasi-experimental studies, were included. Most studies had high or serious risk of bias. The included studies were quite heterogeneous in terms of nature and the delivery of intervention, and assessment of outcome measures. Compared to the usual care group, pharmacist-led TOC interventions contributed to a significant reduction in preventable drug-related (N = 2) and cardiac-related healthcare utilisation (N = 1), a significant reduction in preventable adverse drug events (ADEs) (Odds ratio (OR) 0.34, 95% CI: 0.13-0.94) and an improvement in medication adherence. However, all-cause hospitalisation and medication discrepancies were not significantly reduced. Pharmacy-supported TOC interventions may improve patient outcomes in the MENA region. However, considering the limited quality of evidence and the variability in intervention delivery, future well-designed clinical trials are needed.

Assessment of obstetric characteristics and outcomes associated with pregnancy with Turner syndrome

To assess national-level trends, characteristics, and outcomes of pregnancies with Turner syndrome in the United States. Cross-sectional study. The Healthcare Cost and Utilization Project's National Inpatient Sample. 17,865,495 hospital deliveries from 2016-2020. A diagnosis of Turner syndrome, identified according to the World Health Organization's International Classification of Disease 10th revision code of Q96. Obstetrics outcomes related to Turner syndrome, assessed with inverse probability of treatment weighting cohort and multivariable binary logistic regression modeling. Prevalence of pregnant patients with Turner syndrome was 7.0 per 100,000 deliveries (one in 14,235). Number of hospital deliveries with patients who have a diagnosis of Turner syndrome increased from 5.0 to 11.7 per 100,000 deliveries during the study period (adjusted-odds ratio [aOR] for 2020 vs 2016, 2.18, 95% confidence interval [CI] 1.83-2.60). Pregnant patients with Turner syndrome were more likely to have a diagnosis of pregestational hypertension (4.8% vs 2.8%, aOR 1.65, 95%CI 1.26-2.15), uterine anomaly (1.6% vs 0.4%, aOR 3.01 95%CI 1.93-4.69), and prior pregnancy losses (1.6% vs 0.3%, aOR 4.70, 95%CI 3.01-7.32) compared to those without Turner syndrome. For the index obstetric characteristics, Turner syndrome was associated with increased risk of intrauterine fetal demise (10.9% vs 0.7%, aOR 8.40, 95%CI 5.30-13.30), intrauterine growth restriction (8.5% vs 3.5%, aOR 2.11, 95%CI 1.48-2.99), and placenta accreta spectrum (aOR 3.63, 95%CI 1.20-10.97). For delivery outcome, pregnant patients with Turner syndrome were more likely to undergo cesarean delivery (41.6% vs 32.3%, aOR 1.53, 95%CI 1.26-1.87). Moreover, the odds of peri-viable delivery (22-25 weeks: 6.1% vs 0.4%, aOR 5.88, 95%CI 3.47-9.98) and pre-viable delivery (<22 weeks: 3.3% vs 0.3%, aOR 2.87, 95%CI 1.45-5.69) were increased compared to those without Turner syndrome. The results of contemporaneous, nationwide assessment in the United States suggests that although pregnancy with Turner syndrome is uncommon this may represent a high-risk group, particularly for intrauterine fetal demise and peri-viable delivery. Establishing society-based approach for preconception counseling and antenatal follow-up would be clinically compelling.

Outdoor Assessment of Airborne Microorganisms During the COVID-19 Outbreak in Madinah City, KSA

The COVID-19 outbreak was a serious challenge for countries around the globe. With the objective of mitigating the spread of the virus, both national and international health organizations swiftly enacted quarantine measures across numerous cities around the globe. This presented a unique chance to evaluate the consequences of human actions on the quality of the air. This study aimed to investigate airborne microbial levels in different outdoor locations in Al-Madinah City, Kingdom of Saudi Arabia (KSA), during the COVID-19 pandemic by comparing lockdown against non-lockdown conditions. Twelve outdoor locations were investigated in terms of microbial total counts using the open plate method during and after the COVID-19 lockdown. Environmental factors that could affect the airborne microbial load, including humidity, temperature and wind speed, were recorded during the assessment. The means of the total colony-forming units (CFU) for each cubic meter (m3) of air were calculated. Lockdown restrictions caused significant decreases in the biological contaminants in all locations compared with the numbers after the pandemic. Gram-positive bacteria represented most of the samples, with fewer fungal strains detected. The outdoor average total bacterial counts ranged between 0.00±0.00-8337.50±248.98 CFU/m3, compared with 2903.75±407.60-19722.50±475.03 CFU/m3 after the pandemic. The mean concentrations of total fungi were lower than those of bacteria and ranged between 0.00±0.00-143.75±131.75 CFU/m3 during the COVID-19 lockdown and were elevated after the lockdown to reach 28.75±49.80-776.25±298.78 CFU/m3. Based on the available data, there are no studies comparing outdoor microbial counts during and after the COVID-19 pandemic. Therefore, this research offers additional perspectives on the air quality experienced amidst the COVID-19 pandemic and the subsequent implementation of lockdown measures and could serve as a valuable resource for monitoring and implementing measures to control air pollution.

A Brief Review on Foodborne Zoonosis in Pakistan with the Perspective of One Health

Background: Zoonotic diseases pose a significant public health challenge globally, with developing countries like Pakistan facing heightened risks due to various factors such as climate change, environmental degradation, and socio-economic disparities. These diseases, transmitted between animals and humans, have profound implications for healthcare systems, food safety, and public health policies. Objective: This study aims to identify the key risk factors associated with the prevalence of zoonotic diseases in Pakistan and evaluate the effectiveness of the 'One Health' approach in addressing these multifaceted challenges. Methods: A comprehensive review of existing literature was conducted, focusing on zoonotic disease outbreaks in Pakistan, their associated risk factors, and the impact of integrated health strategies. Data from government reports, peer-reviewed articles, and international health organization databases were analyzed to assess the current state of zoonotic diseases in Pakistan. Results: The findings indicate that climate change, environmental issues, lack of public awareness, and socio-economic inequities are the primary drivers of zoonotic disease transmission in Pakistan. Despite some progress in disease surveillance and public health education, gaps in food and water safety practices, vector control, and environmental management persist. The 'One Health' approach has shown potential in improving cross-sectoral collaboration and enhancing disease prevention measures, yet its implementation remains inconsistent. Conclusion: Effective management of zoonotic diseases in Pakistan requires a concerted effort that encompasses improved surveillance, enhanced public awareness, and robust environmental and food safety policies. The 'One Health' approach emerges as a critical framework for fostering collaboration across human, animal, and environmental health sectors to mitigate the risks and impacts of zoonotic diseases. Keywords: Zoonotic Diseases, One Health Approach, Public Health, Pakistan, Climate Change, Environmental Health, Disease Surveillance, Food Safety, Vector Control, Socio-economic Factors.

Interdisciplinary managerial interventions for healthcare workers' mental health - a review with COVID-19 emphasis.

Healthcare workers are representatives of occupations that are most exposed to high levels of stress in the work environment. These characteristics of work increase the probability of suffering from mental disorders. One aspect of mental disorder prevention in the workplace is the role of healthcare managers as those people who are responsible for minimizing the negative impact of work-related stress factors. Their role can be performed by creating effective initiatives supporting workers' mental health. The need to support the implementation of such initiatives has been highlighted by the COVID-19 pandemic. The aim of the review is to summarize available types of managerial interventions in the field of mental health protection of medical staff, considering the assessment of their prevalence, determinants of effectiveness, and limitations from the perspective of healthcare managers. The article was prepared based on the literature review method and covered publications from original research in English and Polish, published until June 2023 in the following databases: PubMed, Google Scholar, and PsycINFO. In addition to the original research, the review also includes documents developed by international health organizations. The determinants of effective managerial interventions that can be used for the needs of managers and decision-makers in the field of mental health management in the workplace have been presented. The greatest widespread of mental health initiatives concerned the pandemic period, but now the key systemic task should be to maintain the frequency of impacts outside the pandemic period, due to the constant nature of stressors. The determinants of their effectiveness include, among others: incorporating elements of psychological knowledge into the process of educating managers, involving healthcare specialists in the development of programs, and examining the needs of the staff each time at the stage preceding interventions. Med Pr Work Health Saf. 2024;75(1):57-67.

Organic food and its health benefits for humans and how it differs from regular food : Review.

As public awareness of organic food products' advantages for health, social convenience, the environment, and sustainable development has grown, so has their knowledge of their benefits. Gaining understanding of consumer views is crucial for the sector as it continues to grow. The current study was methodically created to assess the strength of the data supporting the benefits of feeding organic foods to health. Foods labeled as organic are produced utilizing only natural fertilizers. The regulations around organic animal production are extensive and impact various aspects such as nutrition, reproduction, housing, medical care, and treatment. Additionally, these foods are not produced using genetically modified pesticides or insecticides. Animals raised in organic farms are given more space to live in than those raised in conventional systems, and they are also required to consume organic feed, straw bedding, and roughage. The fatty acid composition of milk, eggs, and meat is significantly influenced by the animal diet. Breed selection is used in connection to animal health and wellbeing; proper diet, husbandry, and management all contribute to illness prevention and improved animal welfare. Antimicrobial durability is a global public health concern these days, and many international health organizations recognize that it poses a threat to the current health care system. Thus, the market's demand for organic products and their simplicity of use has grown over the past several years, contributing significantly to the economy. Because organic food is healthier and less likely to contain chemicals, many people are beginning to choose it over conventional food. As a result, raising consumer knowledge of the value of organic products and supporting their production is crucial for the growth of organic farming and the production of pure water. The market for organic food products is growing quickly because consumers believe that organic food may be healthier than conventional food and has a superior nutritional profile.

Current approaches addressing oral health practitioners' responsiveness to child abuse and neglect: A scoping review protocol.

Child abuse and neglect (CAN) poses significant risks, causing severe and long-lasting effects on a child's well-being, including physical and mental health and learning and socializing capabilities. Oral health practitioners (OHPs) uniquely position themselves to identify signs of maltreatment in the orofacial area, offer appropriate support, and collaborate with a multidisciplinary team. The literature has shown that OHPs under-report child protection concerns to a statutory child protection agency. Responding to CAN is often hindered by various factors, such as the fear of making false accusations and insufficient knowledge to detect and report potential cases. However, the literature lacks a comprehensive understanding of the strategies and interventions that can address the responsiveness of OHPs and other professionals to child protection issues. This scoping review aims to provide a broad overview and map the literature on the existing approaches to enhance the responsiveness of OHPs in child protection. The proposed scoping review will be conducted following the JBI methodology for scoping reviews guideline and reported using the PRISMA-ScR guideline. The first exploratory search is conducted to refine the search strategy and inclusion and exclusion criteria. The second search will include MEDLINE (EBSCO), CINAHL (EBSCO), Dentistry & Oral Science Source (EBSCO), Cochrane Library, and Scopus, with a date range from January 2000 to March 2023. The third search will involve reference list searching and gray literature searching in Google and Google Scholar. Government and international health organizations' websites will be searched for policies and guidelines. The review will consider studies that report the current approaches to address OHPs' responsiveness to CAN in any setting. Two reviewers will independently select sources and extract data. Any disagreements will be resolved by consensus of the research team. The extracted data will be presented in a tabulated chart with a narrative summary.