Public Health Prevention Research Articles

About Community Health Centers in the Main District of Chongqing Municipality Current Situation and Measures of Infectious Disease Prevention and Control Introduction

With the acceleration of urbanization and the increase of population mobility, the public health and safety situation in the main urban area of Chongqing, as a modern metropolis with rapid economic development and dense population, has become increasingly complex and severe. The outbreak and spread of infectious diseases pose a serious threat to the lives and health of community residents and social stability, so it is crucial to strengthen the research on the prevention and control system of infectious diseases in grassroots community health service centers. Grassroots community health service centers in the main urban areas of Chongqing are the foundation and frontier of the entire public health prevention and control system, which is directly related to the health level of community residents and community public health safety. In the current global context of multiple, new, and frequent outbreaks of infectious diseases, it has become imperative to strengthen the construction of the infectious disease prevention and control system of grassroots community health service centers to improve the effectiveness and level of infectious disease prevention and control. This study will focus on the infectious disease prevention and control system of grassroots community health centers in the main urban areas of Chongqing, aiming to deeply analyze its composition structure, functional positioning, operation mechanism, personnel quality and facilities and equipment. Through the study and analysis of the infectious disease prevention and control system, existing problems and bottlenecks will be identified, and feasible and operable optimization suggestions will be made to promote the improvement and enhancement of the infectious disease prevention and control system. The significance of this study is not only to provide scientific basis and practical guidance for the improvement of the infectious disease prevention and control system in the main urban area of Chongqing, but also to provide reference and experience sharing for similar problems in other cities and regions, so as to jointly promote the modernization and standardization of the infectious disease prevention and control system of China's grassroots community health service centers, in order to ensure the health and safety of the community residents.

A Systematic Review of Evidence-Based Treatments for Adolescent and Adult Sexual Assault Victims.

Sexual assault (SA) is a serious crime that is a prevalent mental and public health problem. Addressing the needs of SA victims and providing appropriate treatment are essential to reduce potential adverse short- and long-term outcomes. Our team undertook an extensive systematic literature review (published between January 2006 and July 2021) to provide evidence-based mental health intervention recommendations for adolescent and adult victims of SA. Where SA-specific research was limited, the literature and clinical practice guidelines on treatments for trauma-induced post-traumatic stress disorder (PTSD) were reviewed to provide additional information to formulate recommendations. Findings strongly support several primary psychotherapy treatments: cognitive behavioral therapy, cognitive processing therapy, eye movement desensitization and reprocessing, narrative exposure therapy, and prolonged exposure therapy. Complementary (aerobic exercise, art, drama, and music therapy) and pharmacological treatments were explored. Mental health nurses who provide services for victims of SA can utilize this overview to guide recommendations for treatment of SA trauma and related PTSD symptoms to mitigate the short- and long-term negative impacts after a traumatic event. When victims of SA receive optimal mental health treatments, our communities benefit as victims heal and recover.

Characteristics of Patients Presenting with Deliberate Self-harm to the Sultan Qaboos University Hospital, Muscat, Oman

Background: Deliberate self-harm (DSH) is an increasingly prevalent public health concern, particularly in adolescents and young adults. There is a dearth of recent studies that focus on DSH in countries in the Arab-Islamic world, such as Oman, which is undergoing rapid urbanization and modernization. Objectives: This study aimed to investigate the demographic and clinical characteristics of patients presenting with DSH at a single tertiary center in Muscat, Oman. Patients and Methods: A retrospective, cross-sectional study was conducted among patients aged ≥ 10 years clinically diagnosed with non-suicidal DSH at the Sultan Qaboos University Hospital between January 2019 and December 2021. Patients' electronic medical records were used to collect information on patients' demographics (gender, age, employment, educational, and marital status) and clinical characteristics (psychological comorbidity, method, frequency, and triggers of DSH). Descriptive and univariate analyses using the Pearson chi-squared test were performed using the statistical package for social sciences (SPSS) software program. Results: A total of 98 patients were diagnosed with DSH during the study period, of whom 17 (17.3%) were male and 81 (82.7%) were female. Most patients were aged 10 - 25 years (61.2%), single (66.3%), and were students either in college (27.6%) or school (24.5%). The majority (62.2%) had mental health comorbidities, with psychotic disorders (27.6%) being the most common, followed by major depressive disorder (24.5%). The majority of DSH acts (88.9%) were impulsive in nature and not premeditated. Social stress was reported to be the most common trigger for DSH (41.8%), with the most common method being drug overdoses (58.2%). Overall, drug overdoses were slightly more common among patients aged < 40 years (60.9%; P = 0.067) and female patients (63.0%; P = 0.067), while self-cutting more frequently occurred among patients aged > 40 years (54.5%; P = 0.070) and male patients (47.1%; P = 0.080); however, these differences were not statistically significant. Conclusions: This study found that DSH was more frequent in young, single female students with comorbid mental disorders. Healthcare providers should be cognizant of the increased likelihood of DSH in this patient group and, therefore, screen and refer at-risk patients and those suspected of DSH for appropriate psychological support and counseling.

Effects of Near-Peer Motivational Interviewing Teaching on Greek Medical Students

BACKGROUND: Obesity presents as a significant and increasingly prevalent public health problem globally. Greece reported an adult obesity rate of 17% in 2016 (OECD) and a more alarming paediatric overweight/obesity rate of 1 in 3 children (WHO). However, weight management can be difficult to negotiate and implement successfully with patients. Previous studies have reported positive results when utilising Motivational Interviewing (MI) techniques in these consultations. To ensure that healthcare systems are well-equipped to deal with increasing obesity rates, it is important to develop MI skills in medical students. Near-peer teaching has been reported as an effective method to improve student learning, and a gap in the literature exists regarding this type of teaching initiative for MI skills. AIM: To introduce and assess the effects of near-peer MI teaching, with the focus on weight management, on the knowledge and skills of medical students with limited previous exposure to the topic. To evaluate and compare how different methods of delivering near-peer teaching material between in-person and online sessions affect teaching efficacy. METHODS: An interactive seminar was delivered in English/Greek, both in-person and online, for Aristotle University of Thessaloniki (AUTh) students in years 3-6 and year 6 respectively. Materials were adapted to the local context from curriculum and literature, and delivered by final year AUTh and KCL medical students based at AUTh. Each seminar consisted of a theoretical section and a practical section. First, a teaching sheet was handed out to the participants that accompanied a PowerPoint presentation. The latter included information on MI for the Overweight/Obese Population, as well as demonstration video clips on certain concepts. Following the presentation, participants were split into small groups to apply MI in a Role-Playing environment. Scenarios were handed out and practiced by two participants in each group, as well as Examiners’ checklists for the observers. This process was repeated three times with different scenarios and participants, and each turn was followed by a short discussion to provide feedback. Anonymous pre- and post-teaching evaluation surveys were also distributed and returned immediately before and after teaching with both cohorts. RESULTS: There were 88 total participants, with 10 in the in-person and 78 in the online cohort. A significant improvement (p<0.001) was seen for both in-person and online cohorts in 5-point Likert confidence ratings for using MI skills whilst consulting both simulated (95%CI, i-p[1.83,3.37];o[1.64,2.05]) and real (95%CI, i–p[1.71,3.09];o[1.56,2.00]) overweight/obese patients. The in-person cohort showed greater positive change across all question domains assessing confidence on session content compared to the online cohort, beginning with skills such as motivational interviewing. CONCLUSION: Near-peer education is an effective method to improve medical student confidence in MI skills, and suggests the potential success of a long-term student-led clinical communication skills course run alongside the core curriculum.

Public health risk and prevention and control of sporotrichosis

Sporotrichosis, a fungal infection caused by Sporothrix species, can greatly lead to chronic inflammation of the skin, mucosa, and lymphatic vessels and disseminate systemically sometimes, even threatening life. It is known that Sporothrix is distributed worldwide, while in China, most of the cases were reported in northeast China and parts of south China. Sporothrix globosa is the main source of infection, and other regions may lack relevant awareness and attention to the disease, making it a public health challenge in China. Thus, it is important to understand its epidemiology and public health risks to prevent and control the disease properly.

Comparison of Paper-and-Pencil Versus Tablet Administration of the 2021 National Youth Risk Behavior Survey (YRBS)

PurposeAs part of efforts to modernize the Youth Risk Behavior Surveillance System, the national Youth Risk Behavior Survey (YRBS) is moving from paper-and-pencil instrument (PAPI) administration to electronic administration using tablets. This study aimed to examine differences in demographic characteristics and the reporting of health behaviors and experiences between the PAPI- and tablet-administered 2021 national YRBS questionnaire. MethodsHigh school students (grades 9–12) in classrooms from 57 schools participating in the 2021 national YRBS were assigned randomly to complete the survey using PAPI (n = 4,684 students) or using tablets (n = 3,645 students). Eighty-nine behavior and experience items were examined to compare the missingness in reporting and the prevalence estimation (i.e., proportions) by administration mode. ResultsDemographic characteristics (sex, race/ethnicity, grade, and sexual identity) did not differ by mode (PAPI vs. tablet). For the majority (93.2%, 83 out of 89) of YRBS behavior and experience items, mode was not significantly associated with the reported proportions, adjusting for sex, race/ethnicity, grade, and sexual identity. However, 30 out of 89 (33.7%) items showed significant variation in missingness by mode; 10 items had higher missingness with PAPI administration while 20 had higher missingness with tablet administration. DiscussionSurvey administration mode was not significantly associated with behavior and experience reporting among high school students. More research is needed to understand differential patterns of missingness by mode. Aligning with Centers for Disease Control and Prevention's Public Health Data Modernization Initiative, findings from this study provide evidence to support electronic survey administration for the national YRBS, particularly using tablet data collection.

Nutritional Status of Short Stature Children under Growth Hormone Therapy

Background: Childhood stunting is one of our community's most prevalent public health nutrition problems. Many factors may lead to the development of stunning. Growth hormones and diet might play a role in the treatment. This study aims to investigate the effect of nutritional status on the growth rate among children with short stature who underwent growth hormone therapy the previous year. Methods: A one-year retrospective, cross-sectional study was carried out among 4-10-year-old children with stunting. Laboratory tests, anthropometric measurements, and dietary intake were measured at the start of the research and one year after the application of growth hormone therapy. Results: A significantly higher growth rate was observed among males than females (P = 0.040). Also, males had significantly higher calorie intake (P). This study found that the patients had a less than 8.5% difference in energy intake vs. total energy requirement. There is a significant association between food consumption from two food groups (milk and meat) (P = 0.04 and 0.021, respectively. Conclusion: Diet plays a significant role in the improvement of growth velocity.

Trust, individualism, and the logics of care in middle America during the first year of the COVID-19 pandemic.

Polarization and turf-wars have characterized the COVID-19 response in the United States. While COVID-19 narratives can be binary and divisive, how people cared for each other throughout the first year of the pandemic is more nuanced. This article describes how and why constructs of fear, individualism, wellbeing, and personal risk-taking became imbued in behaviors that thwarted the risk of the collective. This work is based on informal conversations, public forums, and 86 in-depth interviews during the 2020 summer in a small tourist town in northwest Iowa. Some believed engaging in public health prevention was not their responsibility and instead privileged their personal enjoyment, finances, or mental health over others, de-emphasizing personal risk and stating God will protect them. Others were deeply committed to public health prevention, by staying home, masking, and social distancing. In both cases, people used shame to promote their views (e.g., shame on you for masking/unmasking!) as well as fear (e.g., I do/don't fear coronavirus because I am virtuous). However, most engaged in logics of care, navigating what public health precautions to follow to protect themselves and those they loved most. Yet, such decisions were navigated through a culture of individualism and ideals of personal responsibility that cultivated a mistrust in public health. Understanding how and why such individualism took hold in American publics is a crucial inflection point for policy-making as well as cultural interpretation of why and how people construct risk and responsibility.

The association between periodontitis and hepatitis virus infection: a cross-sectional study utilizing data from the NHANES database (2003–2018)

ObjectivesPeriodontitis and hepatitis virus infection significantly impact individuals' well-being and are prevalent public health concerns globally. Given the current scarcity of large-scale cross-sectional epidemiological studies, this study seeks to enrich the evidence base by examining the link between these two conditions. Study design and methodsA cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2003–2018. A multivariate logistic regression analysis was performed to assess the association between periodontitis and hepatitis virus infection, adjusting for the potential confounding factors. Subsequently, a stratified analysis was conducted to explore the relationship between periodontitis and hepatitis virus infection based on age, gender, race, marital status, alcohol consumption, smoking status, and the presence of chronic diseases. ResultsIn this study, which included 5755 participants, there was a positive association between hepatitis virus infection and periodontitis (odds ratio [OR]: 2.609 [95% confidence interval (CI): 1.513, 4.499]). Furthermore, a significant association was observed between moderate periodontitis and hepatitis virus infection (OR: 2.136 [95% CI: 1.194, 3.822]), and this association was even stronger for severe periodontitis (OR: 3.583 [95% CI: 1.779, 7.217]). Importantly, this positive association between hepatitis virus infection and periodontitis was consistent across different subgroups. ConclusionsThis study presents evidence of a significant association between periodontitis and hepatitis virus infection. These findings highlight the crucial importance of integrating periodontal health and liver health considerations into public health interventions. Further research is necessary to elucidate the underlying mechanisms and develop targeted interventions for effectively managing periodontitis and hepatitis virus infection.

A survey on the current status of Helicobacter pylori infection in households in Hainan Province, China

ObjectiveThis study aims to assess the prevalence of Helicobacter pylori (Hp) infection at the household level in Hainan Province in China and identify the factors that contribute to its spread. The findings of this study have significant implications for public health prevention strategies in the Hainan region.MethodsA total of 421 families, comprising 1355 individuals, were tested for Hp infection across five cities in Hainan Province between July 2021 and April 2022. The study utilized questionnaires that included questions about personal characteristics, household shared lifestyle and dietary habits, and potential pathways of Hp infection in children to identify potential factors linked to household Hp infection and transmission patterns.ResultsThe prevalence of Hp infection on an individual basis was 46.72% (629/1355), with age ≥ 20 years, being married and having junior secondary education and above as risk factors for Hp infection. The prevalence of Hp infection in households was 80.29% (338/421), household size of 5, 6 and above were risk factors for Hp infection with Odds Ratios (ORs) of 4.09 (1.17–14.33) and 15.19 (2.01–114.73), respectively, household income ≥ 100,000 yuan and drinking boiled water from a tap source were protective factors for Hp infection with ORs of 0.52 (0.31–0.89) and 0.51 (0.28–0.95), respectively. The prevalence of Hp infection among minors in the household was 24.89% (58/233), with paternal infection and maternal infection as risk factors for child infection, with ORs of 2.93 (1.29–6.62) and 2.51 (1.07–5.89), respectively.ConclusionHp infection was prevalent among Hainan families, and interaction with infected family members may be the primary cause of transmission.

OP45 HTA And Gender Medicine: Time To Take Action!

IntroductionGender medicine responds to the need for a reassessment of the medical-scientific approach in a gender perspective, to increase knowledge of the different aspects underlying gender differences and the appropriateness/ effectiveness of health interventions.MethodsA policy review of documents prepared by the Italian Ministry of Health on gender medicine was carried out, to investigate the possible areas of intervention of health technology assessment in the development of this interdisciplinary dimension. The areas of highest priority for action have been identified.ResultsIn Italy, the Ministry of Health, with the support of the National Institute of Health, issued a Plan for Application and Dissemination of Gender Medicine in June 2019. Our review shows that for the development of research on the mechanisms of pathogenesis the Italian Plan gives indications on the identification of diagnostic markers, prognostic and predictive response in a gender perspective, but there are no formalized rules that constitute a constraint or an obligation to do so. In Horizon Europe calls, for example, “Pragmatic trials on minimally invasive diagnostics” (HORIZON-MISS-2023-CANCER-01-03) on the other hand, it is required that gender and gender issues should be taken into account in all projects and all data should be disaggregated by gender, socio-economic status and ethnicity. Separating subjects into two groups in the analysis leads to greater complexity. This is even more true when considering the different types of gender. The total number of subjects to be included must likely increase to maintain statistical power in evaluating effects in subgroups. This increase leads to an increase in time and cost, if one needs to provide separate data by sex and even more so by gender. Different statistical tests to be used, according to the type of variables of the primary endpoint, should be considered in the study protocols.ConclusionsIt seems appropriate to suggest reviewing upcoming health technology assessments with an eye to gender medicine. Gender medicine should become a strategic goal of prevention in public health and will strengthen the concept of the patient centrality until the personalization of therapies is achieved.

Social Effects of Prevention Programs and Public Health Projects in the Krasnoyarsk Territory

Introduction. Monitoring and evaluation are an integral part of public health programs. Public health, in turn, is an important element of any society, and prevention programs play an important role in disease prevention and health promotion. In recent years, Krasnoyarsk Territory has shown a steady increase in the number of prevention programs aimed at improving the health and well-being of the population. Although these programs have been implemented to address specific health problems, they have also had a significant social impact. 
 Purpose. This article investigates the social effects of prevention programs and public health projects in the Krasnoyarsk Territory. 
 Materials and methods. The article summarizes the results of sociological research on various aspects of public health in the Krasnoyarsk Territory. The materials of sociological research conducted by the Krasnoyarsk Regional Center for Public Health and Medical Prevention were used. The results of some studies were presented in comparison with the results obtained in other regions of the Russian Federation. 
 Results. According to the data obtained, the study of the health literacy of residents of the Krasnoyarsk Territory allowed us to conclude that a considerable part of the population is insufficiently aware of the main aspects of a healthy lifestyle. In addition, city residents of the Krasnoyarsk Territory are mostly dissatisfied with two aspects of the quality of life: the maintenance and management of the adjacent territories; the work of public utilities; and the availability of high-quality and safe pedestrian areas.

Development of a Video-Delivered Serial Drama Designed to Reduce Community Homophobia and HIV Stigma, Decrease Sexual Risk Behavior, and Increase HIV Testing Among Black Youth.

This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior.

Recent HIV infection and annualized HIV incidence rates among sexual and gender minorities in Brazil and Peru (ImPrEP seroincidence study): a cross-sectional, multicenter study

HIV incidence estimation is critical for monitoring the HIV epidemic dynamics and the effectiveness of public health prevention interventions. We aimed to identify sexual and gender minorities (SGM) with recent HIV infections, factors associated with recent HIV infection, and to estimate annualised HIV incidence rates. Cross-sectional multicentre study in HIV testing services in Brazil and Peru (15 cities). Inclusion criteria: 18+ years, SGM assigned male at birth, not using pre-/post-exposure prophylaxis. We identified recent HIV infection using the Maxim HIV-1 LAg-Avidity EIA assay as part of a recent infection testing algorithm (RITA). Annualized HIV incidence was calculated using the UNAIDS/WHO incidence estimator tool. Multivariable logistic regression models were used to estimate factors associated with recent HIV infection. Trial registration: NCT05674682. From 31-Jan-2021 to 29-May-2022, 6899 individuals participated [Brazil: 4586 (66.5%); Peru: 2313 (33.5%)]; 5946 (86.2%) cisgender men, 751 (10.9%) transgender women and 202 (2.9%) non-binary/gender diverse. Median age was 27 (IQR: 23-34) years. HIV prevalence was 11.4% (N=784/6899); 137 (2.0%) SGM were identified with recent HIV infection. The overall annualized HIV incidence rate was 3.88% (95% CI: 2.86-4.87); Brazil: 2.62% (95% CI: 1.78-3.43); Peru: 6.69% (95% CI: 4.62-8.69). Participants aged 18-24 years had higher odds of recent HIV infection compared to those aged 30+ years in both countries. Our results highlight the significant burden of HIV epidemic among SGM in large urban centres of Brazil and Peru. Public health policies and interventions to increase access to effective HIV prevention methods such as PrEP are urgently needed in Latin America. Unitaid, WHO (Switzerland), Ministry of Health from Brazil and Peru.

Assessing the Health Security Responsiveness of the Caribbean Public Health Agency (CARPHA) and the Government of Trinidad and Tobago: The Zika and COVID-19 Outbreaks

This article examines the response of the Caribbean Public Health Agency and the government of Trinidad and Tobago against the Zika and COVID-19 outbreaks. These contrasting diseases were chosen to examine the surveillance systems and responses and the preventative public health measures that were implemented to protect the population. Health experts were interviewed and the data were analyzed using thematic analysis. The findings revealed that the Caribbean Public Health Agency and the government of Trinidad and Tobago were prepared to respond to the Zika outbreak. However, there is much to be improved in the case of COVID-19. Concrete policy recommendations are discussed.

Association of Hearing Loss and Eating Habits in the Older Population

Background: Age-related hearing loss, also known as hearing loss, is an important and increasingly prevalent public health problem worldwide, as it induces disability and social isolation. Objective: To verify the association between eating habits and hearing loss in the older population. Methods: A cross-sectional study with data analysis of older patients treated in an Outpatient Hearing Health Service accredited to the Unified Health System. Older people aged 60 years and over who attended the Health Service to begin adaptation in the study. The audiological evaluation was performed through Tonal and Vocal Audiometry exams, the auditory rehabilitation process was done using the Individual Sound Amplification Device, and eating habits based on the Dietary Guide for the Brazilian Population. Results: The sample included (n = 654) participants, aged between 60 and 97 years. The type of hearing loss revealed a higher prevalence of sensorineural of moderate degree. Individuals with higher consumption of tea, non-fatty meats, rice, fish, and fruits presented better hearing compared to participants with lower consumption of these types of foods. Conclusion: A higher consumption of foods high in anti-inflammatories and antioxidants may decrease the risk of age-related hearing loss. A higher consumption of foods high in anti-inflammatories and antioxidants may decrease 50% of the risk of age-related hearing loss. The findings also indicate the hypothesis that a pro-inflammatory diet could increase the risk of hearing loss. Antioxidants are believed to counteract the deleterious effects of reactive oxygen species and may be effective in treating diseases related to oxidative stress, including hearing loss.

Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study.

Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans. A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05. Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates. NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans. A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.

Geographical characteristics and influencing factors of the influenza epidemic in Hubei, China, from 2009 to 2019.

Influenza is an acute respiratory infectious disease that commonly affects people and has an important impact on public health. Based on influenza incidence data from 103 counties in Hubei Province from 2009 to 2019, this study used time series analysis and geospatial analysis to analyze the spatial and temporal distribution characteristics of the influenza epidemic and its influencing factors. The results reveal significant spatial-temporal clustering of the influenza epidemic in Hubei Province. Influenza mainly occurs in winter and spring of each year (from December to March of the next year), with the highest incidence rate observed in 2019 and an overall upward trend in recent years. There were significant spatial and urban-rural differences in influenza prevalence in Hubei Province, with the eastern region being more seriously affected than the central and western regions, and the urban regions more seriously affected than the rural region. Hubei's influenza epidemic showed an obvious spatial agglomeration distribution from 2009 to 2019, with the strongest clustering in winter. The hot spot areas of interannual variation in influenza were mainly distributed in eastern and western Hubei, and the cold spot areas were distributed in north-central Hubei. In addition, the cold hot spot areas of influenza epidemics varied from season to season. The seasonal changes in influenza prevalence in Hubei Province are mainly governed by meteorological factors, such as temperature, sunshine, precipitation, humidity, and wind speed. Low temperature, less rain, less sunshine, low wind speed and humid weather will increase the risk of contracting influenza; the interannual changes and spatial differentiation of influenza are mainly influenced by socioeconomic factors, such as road density, number of health technicians per 1,000 population, urbanization rate and population density. The strength of influenza's influencing factors in Hubei Province exhibits significant spatial variation, but in general, the formation of spatial variation of influenza in Hubei Province is still the result of the joint action of socioeconomic factors and natural meteorological factors. Understanding the temporal and spatial distribution characteristics of influenza in Hubei Province and its influencing factors can provide a reasonable decision-making basis for influenza prevention and control and public health development in Hubei Province and can also effectively improve the scientific understanding of the public with respect to influenza and other respiratory infectious diseases to reduce the influenza incidence, which also has reference significance for the prevention and control of influenza and other respiratory infectious diseases in other countries or regions.

Healthcare students’ knowledge, attitudes, and perspectives toward artificial intelligence in the southern Vietnam

The application of new technologies in medical education still lags behind the extraordinary advances of AI. This study examined the understanding, attitudes, and perspectives of Vietnamese medical students toward AI and its consequences, as well as their knowledge of existing AI operations in Vietnam. A cross-sectional online survey was administered to 1142 students enrolled in undergraduate medicine and pharmacy programs. Most of the participants had no understanding of AI in healthcare (1053 or 92.2 %). The majority believed that AI would benefit their careers (890 or 77.9 %) and that such innovation will be used to oversee public health and epidemic prevention on their behalf (882 or 77.2 %). The proportion of students with satisfactory knowledge significantly differed depending on gender (P < 0.001), major (P = 0.003), experience (P < 0.001), and income (P = 0.011). The percentage of respondents with positive attitudes significantly differed by year level (P = 0.008) and income (P = 0.003), and the proportion with favorable perspectives regarding AI varied considerably by age (P = 0.046) and major (P < 0.001). Most of the participants wanted to integrate AI into radiology and digital imaging training (P = 0.283), while the fifth-year students wished to learn about AI in medical genetics and genomics (P < 0.001, 4.0 ± 0.8). The male students had 1.898 times more adequate knowledge of AI than their female counterparts, and those who had attended webinars/lectures/courses on AI in healthcare had 4.864 times more adequate knowledge than those having no such experiences. The majority believed that the barrier to implementing AI in healthcare is the lack of financial resources (83.54 %) and appropriate training (81.00 %). Participants saw AI as a “partner” rather than a “competitor”, but the majority of low knowledge was recorded. Future research should take into account the way to integrate AI into medical training programs for healthcare students.

Temporal, spatial and space-time distribution of infections caused by five major enteric pathogens, Ontario, Canada, 2010-2017.

In Canada, enteric diseases pose substantial health and economic burdens. The distribution of these diseases is uneven across both geography and time and understanding these patterns is therefore important for the prevention of future outbreaks. We evaluated temporal, spatial and space-time clustering of laboratory-confirmed cases of Campylobacter spp. (n = 28,728), non-typhoidal Salmonella spp. (n = 22,640), Shiga toxin-producing Escherichia coli (STEC; n = 1340), Yersinia spp. (n = 1674) and Listeria monocytogenes (n = 471) infections, reported between 2010 and 2017 inclusive in Ontario, the most populous province in Canada (population ~ 13,500,000 in 2016). For each enteric pathogen, we calculated the mean incidence rates (IRs) for Ontario's 35 public health unit (PHU) areas and visualized them using choropleth maps. We identified temporal, spatial and space-time high infection rate clusters using retrospective Poisson scan statistics. Campylobacter and Salmonella infections had the highest IRs, while Listeria infections had the lowest. Campylobacter, Salmonella, STEC and Listeria mostly clustered temporally in the spring/summer and sometimes extended into fall, while Yersinia showed a less clear seasonal pattern. The IR visualizations and spatial and space-time scan statistics showed geographic heterogeneity of infection rates with high infection rate clusters detected mainly in PHUs across the southwestern and central-western regions of Ontario for Campylobacter, Salmonella and STEC infections, and mainly in PHUs located in the central-eastern regions for Yersinia and Listeria. A high proportion of cases in some of the significant Salmonella, STEC and Listeria infection clusters were linked to disease outbreaks. Results from this study will inform heightened public health surveillance, and prevention and control programmes, in populations and regions of high infection rates. Further research is needed to determine the pathogen-specific socioeconomic, environmental and agricultural risk factors that may be related to the temporal and spatial disease patterns we observed in our study.