ENDSs have become widely popular, inadvertently increasing the risk of pediatric liquid nicotine exposures. Even small amounts of concentrated nicotine can result in severe toxicity in young children. This study aimed to quantify emergency department visits for liquid nicotine poisoning among children aged <5 years from 2019 to 2024. Data from the National Electronic Injury Surveillance System from 2019 to 2024 were analyzed using a cross-sectional approach. Cases were identified by extracting records with poisoning diagnoses and filtering narratives using keywords associated with ENDS poisonings. Two independent reviewers confirmed each case involving exposure to ENDS liquid nicotine. National Electronic Injury Surveillance System sample weights were applied to produce national estimates with 95% CIs. An estimated 3,952 emergency department visits nationally (95% CI=2,600; 5,305) were attributed to liquid nicotine poisoning among children aged <5 years from 2019 to 2024. Children aged <2 years accounted for 2,921 cases (73.9%). Males represented 2,345 cases (59.3%), and females represented 1,607 cases (40.7%). White children comprised 2,345 cases (59.3%). Most children (88.3%) were treated and released, whereas 165 cases (4.2%) required hospital admission. No fatalities were reported. Liquid nicotine poisoning remains a significant pediatric health concern, with over 3,900 emergency department visits nationally during 2019-2024. Children aged <2 years are at highest risk owing to developmental factors and exploratory behaviors. Although most cases did not require hospitalization, the potential for serious outcomes underscores the need for enhanced prevention strategies, including improved product packaging and public education about safe storage practices.

Perinatal depression policies in China: A three-dimensional analysis with implications for low- and middle-income countries health systems.

Despite the critical role of advocacy in health promotion and public health practice, there is limited inclusion of this competency in public health curricula. This may leave graduates underprepared for advocacy work and contribute to a workforce ill-equipped to engage in advocacy efforts. This research explores reasons for the limited inclusion of advocacy education within Australian tertiary public health curricula and examines educators' perspectives on public health advocacy. This study used a semi-structured exploratory approach. Fourteen individuals participated in two focus groups. The participants were attendees of a national public health educators teaching and learning forum. Data analysis involved reflexive thematic analysis. The majority of participants were female (91%) and employed at universities in various academic roles across diverse fields of public health. Two primary themes were identified: perceptions of public health advocacy and teaching public health advocacy. Participants attributed the inconsistent inclusion of advocacy curricula to ambiguities in definition, conceptualisation, scope and interpretation and emphasised the need for explicit integration of advocacy within curricula. They reported lacking self-efficacy and discipline-specific knowledge in teaching this material and expressed uncertainty regarding effective pedagogical approaches for teaching advocacy. Participants proposed a comprehensive framework for advocacy practice could facilitate its understanding and instruction. Findings highlight the need for consensus on public health advocacy core competencies and a structured framework to guide its definition and instruction. Additionally, there is a need for professional development, evidence of effective advocacy pedagogy, and the explicit integration of advocacy within public health curricula. SO WHAT?: Addressing these challenges is crucial for developing a public health workforce capable of skilled advocacy in order to effectively influence policy and improve population health outcomes. This study demonstrates the imperative to strengthen both the conceptual understanding of public health advocacy and the provision of advocacy training within tertiary public health education.

In England and Wales, drug use and related harms among young adults aged 18-25 remain high. They are neglected in existing service provision. Drawing on evaluation findings of a multi-component drug outreach service in England and informed by the concept of 'emerging adulthood', this paper explores the possibilities for the development of bespoke interventions for young adults. This paper draws on semi-structured interviews (n=19) conducted with managers and practitioners within the outreach service, regional leads for young people's services, and strategic stakeholders in public health, police and education. The co-produced outreach model was found to be agile, innovative and responsive to local drug trends. It was able to reach groups vulnerable to drug-related harms, by employing a different conceptualisation of 'harm reduction' centered on safety. Outreach interactions were limited in scope at some transition points to adulthood, with contact often lost when individuals reached age 18. Onward referral for those who need more intensive interventions was often difficult from ad hoc interactions, and existing adult treatment services were deemed unsuitable for young adult needs. Emerging adults aged 18-25 are a diverse group with distinct substance use profiles. Outreach activities are effective for education, harm reduction messaging, and signposting for further support. However, there is a need for the development of bespoke young adult service provision with skilled, specialist staff who can help young adults navigate these transitions without harm.

Gender Differences in Correlates of Cannabis Consumers Among Youth: Results From the 2023 Canadian Health Survey on Children and Youth.

Despite strong evidence supporting screening in reducing lung cancer mortality, uptake remains low globally. This study aimed to assess the public perceptions of the acceptability and feasibility of lung cancer screening among potentially high-risk adults in Hong Kong, and to identify associated factors. A cross-sectional survey was conducted among adults in Hong Kong identified as potentially high-risk for lung cancer. Perceptions of screening acceptability, and feasibility were measured alongside sociodemographic characteristics, health status, and psychosocial beliefs based on Health Belief Model(HBM) constructs. Multivariable logistic regressions were used to examine associations between participant characteristics and implementation outcomes. Among the 1,100 participants, 90.1% found lung cancer screening acceptable and 88.4% found it feasible. Financial factors, including health insurance coverage and household income≥HKD 50,000, were positively associated with perceived screening acceptability. Responsibility for household cooking was also associated with both acceptability and feasibility. Regarding HBM constructs, higher perceived benefits and self-efficacy were the strongest predictors of both acceptability and feasibility. Perceived higher threat of lung cancer were significantly more likely to perceive lung cancer screening as feasible compared to their counterparts. Perceived barriers were negatively associated with both outcomes (p<0.05). Acceptability and feasibility toward lung cancer screening in Hong Kong are influenced by psychosocial readiness and financial capacity. Enhancing public education, addressing affordability, and embedding screening in primary care with public-private partnerships may support future program success. Findings offer actionable insights for policymakers designing equitable and sustainable lung cancer screening strategies in Hong Kong and similar contexts.

Purpose:This study explores the role of service learning in achieving educational goals among Doctor of Public Health (DrPH) students at Universiti Kebangsaan Malaysia (UKM) and its impact on sustaining community empowerment and engagement initiatives. Methodology:A community health intervention project was implemented over 4 years in Semenyih and Cheras, involving four cohorts of DrPH students. Enrolment in the elderly health module was an elective course under the family health discipline, with one of the learning outcomes requiring students to design and implement a community-based intervention informed by a situational analysis and needs assessment. A total of 76 students took part in the elderly health promotion projects. All students were required to submit a reflective report. All reports were analysed through qualitative document review. Findings: Analysis revealed two major themes underpinning the integration of service learning with community engagement: (1) participatory action research and (2) capacity development. These themes were further explained through the application of social learning theory, the theory of planned behaviour, and self-determination theory, offering insights into student and community behavioural dynamics. Conclusion:Embedding service learning within doctoral public health education fosters meaningful community engagement and strengthens capacitybuilding initiatives. This approach demonstrates potential for sustaining health promotion participation while simultaneously enhancing higher education outcomes.

Waiting in the Shadows: Diagnostic Delays and Illness Perceptions in Colorectal Cancer Patients.

ABSTRACT No information is available on the validation of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration in Spanish (JeffSATIC-S). Few studies have examined attitudes toward collaborative work among medical residents, and research focusing specifically on medical residents in Mexico is currently absent. We evaluated the validity and reliability of the JeffSATIC-S. We then examined attitudes toward interprofessional collaboration among medical residents and their associations with empathy, personality traits – including covert narcissism – and affective – cognitive dysregulation. All medical residents at a public tertiary care teaching hospital were invited to participate in the survey; 213 completed the anonymous online questionnaire (77% response rate). Exploratory factor and reliability analyses were performed. Partial Spearman’s correlation coefficients (rs) were calculated, adjusting for sex, age, specialty, and year of residence. The factor structure resembled the original instrument. Cronbach’s alpha was 0.90 for working relationships and 0.73 for accountability. Empathy was significantly and positively correlated with the two domains (working relationships: rs = 0.557; accountability: rs = 0.495; p < .001). In contrast, aggression – hostility (rs = −0.212 and −0.241, respectively; p < .001) and affective – cognitive dysregulation (rs=−0.328 and −0.347, respectively; p <0.001) were significantly negatively correlated. Covert narcissism, impulsive sensation seeking, and neuroticism-anxiety were significantly and negatively linked to accountability, but not to working relationships. The JeffSATIC-S is valid and reliable. Individual factors influence teamwork attitudes in different ways: some affect both working relationships and accountability, whereas others affect only the latter. Medical educators should anticipate interpersonal variability when designing training to enhance attitudes toward interprofessional collaboration. At the organizational level, teamwork-supportive cultures and learning environments should benefit all learners while accommodating additional support when needed.

ABSTRACT Domestic, sexual and gender-based violence (DSGBV) encompasses physical, sexual and psychological violence. The pervasive nature and severe consequences of DSGBV, spanning physical injury, emotional trauma and psychological harm, have established it as a significant public health concern. In Ireland, DSGBV continues to represent a significant societal challenge. Ireland ratified the Istanbul Convention in 2019, incorporating its four pillars of prevention, protection, prosecution and coordinated policies into its third national strategy called Zero Tolerance. This qualitative study examines Ireland’s progress in aligning with the Convention, drawing on the perspectives of stakeholders across the DSGBV sector. Data were collected through four focus groups and analysed using reflective thematic analysis, with findings mapped against the Convention’s four pillars. While the study highlights notable advances, including legislative reform, expanded refuge spaces and enhanced victim services, substantial gaps remain. Challenges persist in public education, judicial processes, resource allocation, professional training, data integration and inter-agency coordination. Addressing these deficits is crucial to strengthening Ireland’s systemic response and ensuring the effective translation of policy into practice. The findings offer valuable sectoral insights, highlighting both the progress made and the critical areas that require further development to meet the Convention’s standards.

Abstract Purpose This study explores the impact of health capital on economic growth, employing an ARDL model with data from 2000 to 2022. The aim is to assess the contribution of health capital, alongside other key macroeconomic variables, to the economic performance of the country. Findings The results show that health capital plays a significant positive role in economic growth, with improvements in health contributing to higher productivity and overall economic development. Education expenditure, however, exhibits a negative long-term impact, suggesting inefficiencies in public spending. Gross fixed capital formation and trade openness emerge as key drivers of economic growth, reinforcing the importance of investment in infrastructure and global integration. The findings also highlight the importance of maintaining macroeconomic stability to ensure sustained growth. Implications Policymakers should prioritize investments in health capital while improving the efficiency of public education spending. The results further emphasize the role of physical capital accumulation and trade openness in supporting economic growth, alongside the need for sound fiscal and monetary policies to maintain macroeconomic stability. Originality/value This study provides country-specific evidence on the role of health capital in long-term economic growth by integrating health, education, and key macroeconomic variables within a unified ARDL framework. The findings offer valuable insights for policymakers in Bangladesh and other emerging economies seeking to balance growth acceleration with economic stability.

ABSTRACT The French liberal tradition is often characterised by its strong emphasis on political unity and its suspicion toward pluralism. Nineteenth-century historian and politician François Guizot (1787-1874) is presented as a paradigmatic figure of this tradition and is usually credited with having contributed to forge France’s enduring ‘political culture of generality’. This article revisits that interpretation by emphasising a lesser-known aspect of Guizot’s work: the central importance he attributed to decentralisation. By focusing on his theory of civilisation and looking at his education reforms, this study argues that, although Guizot undeniably assigned a central role to the executive power, his main preoccupation throughout the July Monarchy was to prevent any single principle–including the state–from dominating the political order. Guizot sought to institutionalise the permanent tension between unity and diversity that he regarded as the historical condition of European liberty. Public education was a key area in which this tension was organised and maintained. In this light, France’s monist political culture may appear less as the product of a liberal ‘apology for centralisation’ than as the outcome of a theoretically ambitious, yet practically fragile, endeavour to sustain liberty through the continuous preservation of the tension between unity and plurality.

Youth and adolescent substance use remains a persistent public health challenge in the United States; the delivery of evidence-based interventions (EBIs) is critical to improving related negative consequences. The Substance Abuse and Mental Health Services Administration funds a large portion of the implemented substance use prevention interventions in the United States by supporting a funding infrastructure that plays an important role in the adoption and scaling of interventions. Prevention intervention developers and researchers need to understand this infrastructure and its influence on local practitioners to increase the adoption of their EBIs. This study sought to identify which agencies in each state and jurisdiction are involved in funding allocation, how they prioritize and distribute funding to intervention implementers, and, subsequently, how they guide the selection of EBIs. This study used a mixed-methods, cross-sectional design to understand the infrastructure of prevention funding that underlies EBI decision-making. In 2023, we conducted surveys with 40 National Prevention Network representatives (NPNs) and 222 community-level practitioners; in early 2024, we conducted qualitative interviews with a subset of 16 NPNs. NPNs' priorities were shaped by the agencies in which they were housed and the partners with whom they collaborated. Most were located within their state's or jurisdiction's department of health or behavioral health, and many engaged in partnerships with departments of public health or education. Most NPNs reported that they prioritized school and health settings and youth populations for prevention intervention delivery. Almost all NPNs directly distributed funding to intervention implementers (community, regional, or state entities); about half distributed some funds through an intermediary that then subcontracted another entity to implement interventions. More NPNs required or recommended that funded recipients select EBIs from lists or registries (75%) than required or recommended a specific strategy for at least some of their programs (53%). Many practitioners (47%) reported that they selected a recent strategy from a list of interventions provided by their funder, but 27% received no funder guidance on intervention selection. Prevention developers and researchers could increase the adoption of EBIs by focusing them on the priority areas for NPNs, including the health, behavioral health, and education sectors. Developers need to get their EBIs onto registries or intervention lists and increase the EBIs' wide-scale dissemination. Audiences for information about specific EBIs should include NPNs, regional entities, and their funded community practitioner recipients.

To analyse the landscape of active US National Institutes of Health (NIH) artificial intelligence (AI) health research grants, with emphasis on studies conducted in low- and middle-income countries (LMICs), to characterise use cases, health challenges addressed and gaps relevant to the ethical and responsible application of AI-enabled health science. Descriptive portfolio analysis of NIH-funded AI health research grants. NIH research portfolio analysis, with a focus on global health studies in LMICs. None. Data are derived from active NIH-funded grants involving AI applications in health research, as of 31 January 2025. Not applicable (portfolio analysis). Primary measures included the proportion and funding of AI health research grants focused on LMICs and their thematic use cases. Secondary measures compared LMIC-focused and high-income country (HIC)-focused grants by research focus and health area and identified gaps relevant to ethical and responsible AI use in global health. Of 1850 active NIH AI health research grants, 97 (5.2%) focused on LMICs, representing US$40.2 million (2.4%) of the total US$1.66 billion portfolio. compared with HICs, LMIC-based studies emphasised diagnostics and treatment (72.2% vs 66.8%), health system optimisation (18.6% vs 15.6%), disease surveillance and outbreak response (14.4% vs 8.8%), and telemedicine and remote care (7.2% vs 4.4%). HIC-based grants more frequently addressed public health education (10.4% vs 8.2%) and ethics and data governance (12.8% vs 7.2%). All settings emphasised data science training and capacity strengthening, as well as basic research and early-stage AI-augmented tools. LMIC-based studies most often targeted non-communicable diseases (39%), communicable diseases (30%) and health system strengthening (24%). 31 awards were made directly to LMIC-based principal investigators (1.7% of the portfolio), most commonly in South Africa, Kenya and Uganda. NIH investment in peer-reviewed AI-enabled health research is expanding globally. LMIC-focused studies prioritise areas aligned with pressing global health needs, including outbreak detection, disease surveillance, diagnostics and treatment, health system optimisation and remote care. Greater attention to ethics, data governance and public health communication, alongside support for digital infrastructure and meaningful collaboration, may help strengthen the relevance and sustainability of AI-enabled research for population health.

ABSTRACT This study examines disability education policy implementation across Indonesia's dual education system through a comparative case study in East Java Province, comparing two provincial-level institutions: the Regional Office of the Ministry of Religious Affairs East Java (Kanwil Kemenag Jatim), overseeing Islamic education (madrasah), and the East Java Provincial Education Department (Dindik Jatim), overseeing public schools. Using Anderson's policy framework, this research analyzes four policy stages: problem mapping, formulation, implementation, and evaluation. Data were collected through participant observation, interviews with seven key informants, and document analysis across two institutional contexts. Findings reveal significant differences: Kanwil Kemenag follows a three-stage reactive proposal process (receiving, classifying, verifying madrasah proposals) focusing on access provision, while Dindik Jatim emphasizes comprehensive educational services. The study identifies a critical gap in Islamic education where evaluation results are not systematically integrated into policy improvement cycles, contrasting with the public system's integrated approach. These findings contribute to understanding inclusive education policy implementation in diverse institutional contexts and highlight the need for systematic approaches moving beyond access provision to comprehensive service delivery.

Paedophilic disorder remains a profoundly stigmatised mental health condition, posing significant challenges to effective treatment, both internationally and in South Africa. Ethical and pragmatic considerations necessitate providing stigma-free support and treatment for individuals with this disorder. Despite the critical need, there is a notable scarcity of local and international research on effective management and treatment strategies for those diagnosed with paedophilic disorder. The study explored South African psychologists’ experience of psychotherapeutic approaches and models to counsel and treat individuals diagnosed with paedophilic disorder. Data were collected through semi-structured interviews with six Health Professions Council of South Africa-registered psychologists who responded to a targeted recruitment advert on social media platforms. Thematic analysis was systematically applied to the interview data, revealing participants’ use and experiences of psychotherapeutic approaches and models, further distinguished by their clinical experiences, perceptions of training adequacy, and reliance on the international Risk-Need-Responsivity Model and Good Lives approach, in the absence of local guidance. Findings highlight the urgent need for specialised professional training, locally relevant treatment protocols, and public education to reduce stigma and enhance access to care. The study contributes a foundational understanding of the therapeutic landscape of paedophilic disorder in South Africa and offers directions for future research and training.

To assess the clinical patient exposure of residents over 20 years following the statutory introduction of a maximum working week of 50 hours in 2005. Retrospective analysis of longitudinal cohorts of residents who worked on the medical wards between 2001 and 2023 or the emergency department (ED) between 2007 and 2023. Cantonal Hospital of Baden, a representative, large Swiss teaching hospital affiliated with the University Hospital of Zurich. Residents in training working on the internal medical wards and the ED. Annual Patient Exposure (APEX) of residents, which is the ratio of annual patients to residents and describes the annual number of patients treated per resident. We assessed time trends of the APEX in annual cohorts of residents in training on the internal medicine wards (2001-2023) and the ED (2007-2023). We analysed the annual case severity (Case Mix Index and Emergency Severity Index (ESI)), patient age and the length of hospital stay (LOS) as a proxy for changes in the patient population over time and the readmission rate as a quality indicator. The medical ward APEX even increased by 5.2% from 325 patients to 342, despite the workhour restrictions and the increased number of residents (+90%). Inpatients increased by 100% (from 3250 to 6507). Their LOS decreased from 12.4 to 7.5 days and the readmission rate decreased from 4.2% to 3.3%.In the ED, the APEX decreased by 21% (from 3261 to 2576), but the case complexity (ESI) and the LOS increased substantially. In contrast to the general belief, work hour restrictions and the increased number of residents did not reduce the inpatient APEX over 20 years. The reduced APEX in the ED may be compensated by the increase in case complexity and the LOS.

Abstract Psychedelic drug use is experiencing a global resurgence, both in clinical research and community settings. This paper presents a comprehensive public health analysis of the naturalistic use of psychedelics—defined as use outside clinical or research environments. Drawing on a review of 104 peer-reviewed articles, this analysis evaluates the mental, physical, and social outcomes associated with substances such as psilocybin, LSD, MDMA, mescaline, and 5-MeO-DMT. Findings indicate that naturalistic psychedelic use is associated with reductions in depression, anxiety, PTSD, substance use disorders, interpersonal violence, and suicidality, while enhancing emotional well-being, social connectedness, spirituality, nature relatedness, psychological flexibility and physical health. These benefits are observed across diverse populations in many countries, including individuals with trauma, addictions, and chronic pain, as well as in older adults and marginalized groups. Importantly, while adverse effects can occur, they are typically short-lived and often associated with identifiable risk factors such as youth, high doses, psychological vulnerability, and poor set and setting. Drawing on harm reduction principles and Indigenous cultural models, the paper outlines how public education and safe use guidelines—emphasizing mindset, environment, and dosage—can mitigate risks. The data suggest that current prohibitionist drug policies are both outdated and harmful and that a shift toward legalization, regulated access, and evidence-informed education is not only justified but urgently needed. A public health approach to psychedelics, one grounded in safety, inclusion, and scientific evidence, offers the most rational path forward.

Kenya faces significant seismic and landslide risks due to its location along the East African Rift System. Historical earthquakes, such as the 1928 Subukia event (magnitude 6.9), have caused widespread damage, and recent deadly landslides, including the 2019 West Pokot disaster, have resulted in over 70 fatalities and the displacement of thousands. The study employs a comprehensive analytical framework encompassing vulnerability assessment, risk assessment, preparedness measures, mitigation strategies, response mechanisms, and rehabilitation protocols. A vulnerability matrix identifies residential buildings, informal settlements, rural hill communities, and vulnerable populations (children, elderly, persons with disabilities) as high-risk elements, while a risk assessment matrix reveals that landslides present more frequent and immediate threats compared to earthquakes, which though less frequent, carry potential for devastating impacts. The findings indicate that effective preparedness requires integrating early warning systems, public education, emergency drills, stockpiling of relief supplies, and evacuation planning. Mitigation strategies include hazard mapping, enforcement of building codes, slope stabilization, reforestation, and land-use planning regulations. The study highlights the stark implementation divide between developed nations with institutionalized preparedness and developing countries like Kenya facing challenges of limited resources, weak enforcement, fragmented coordination, and systemic vulnerabilities. The paper concludes that multi-faceted, collaborative, and continuous preparedness planning, incorporating scientific data with community-based approaches, is essential for reducing disaster impacts, saving lives, and minimizing economic losses. Recommendations include strengthening institutional capacity, enforcing building regulations, investing in early warning technologies, promoting community awareness, and mainstreaming disaster risk reduction into national and county development plans.

Food in educational institutions for early childhood currently takes on different meanings. Based on observations made, an analysis of feeding practices is outlined that allows us to problematize the education of the body as well as the centrality that it acquires for what we know today as “early childhood.” In this way, it became necessary to reconstruct certain conditions of possibility regarding education, care and feeding in early childhood in Uruguay, to then outline a certain distinction between two traditions: one that focuses on socioeconomic vulnerability in its relationship with early childhood and the family, where food is related to a concern that is mainly oriented towards guaranteeing food security; and another that is oriented towards the expansion and redistribution of early childhood care where the arms of the state seek to extend beyond nutritional risk. The unit of analysis for the work was: a CAIF (early childhood care center) and a full-time public kindergarten (Council of Initial and Primary Education, National Public Education Administration). The observations made in these institutions during feeding practices allowed us to recognize the tensions inherent in body education in educational institutions. Food is understood within these institutions as a social benefit, allowing us to reflect on the neoliberal advance in body education as well as the political resistance that arises from it.