Public Health Assessment Research Articles

Evaluating a Public Health Assessment and Response Framework: SARS-CoV-2 Spread Under the Controlled Distancing Model of Rio Grande do Sul, Brazil.

In early 2020, to halt the spread of SARS-CoV-2, the state government of Rio Grande do Sul in Brazil established a public health assessment and response framework known as a "controlled distancing model." Using this framework, the government divided the state into 21 regions and evaluated them against a composite index of disease transmission and health service capacity. Regions were assessed using a color-coded scale of flags that was updated on a weekly basis and used to guide the adoption of nonpharmaceutical interventions. In this study, we aimed to evaluate the extent to which the controlled distancing model accurately assessed transmission and the effectiveness of its responses throughout 2020. We estimated the weekly effective reproduction number (Rt) of SARS-CoV-2 for each region using a renewal equation-based statistical model of notified COVID-19 deaths. Using Rt estimates, we explored whether flag colors assigned by the controlled distancing model either reflected or affected SARS-CoV-2 transmission. Results showed that flag assignments did reflect variations in Rt to a limited extent, but we found no evidence that they affected Rt in the short term. Medium-term effects were apparent in only 4 regions after 8 or more weeks of red flag assignment. Analysis of Google movement metrics showed no evidence that people moved differently under different flags. The dissociation between flag colors and the propagation of SARS-CoV-2 does not call into question the effectiveness of nonpharmaceutical interventions. Our results show, however, that decisions made under the controlled distancing model framework were ineffective both at influencing the movement of people and halting the spread of the virus.

Quantitative assessment of Public Health and Social Measures implementation and relaxation on influenza transmission during COVID-19 in China: SEIABR and GBDT models.

Since 2019, China has implemented Public Health and Social Measures (PHSMs) to manage the coronavirus disease 2019 (COVID-19) outbreak. As the threat from SARS-CoV-2 diminished, these measures were relaxed, leading to increased respiratory infections and strained health care resources by mid-2023. The study utilised WHO's FluNet and Oxford's COVID-19 Government Response Tracker to assess how policy shifts have affected influenza. It examined changes in influenza incidence, subtype prevalence, and epidemic cycles over three periods: pre-COVID-19 and pre-PHSMs, during COVID-19 and PHSMs, and post-COVID-19 and post-PHSMs. The SEIABR model estimated the transmission probability () and real-time reproduction number () across these periods, while a gradient boosting decision tree (GBDT) analysed the effects of PHSM indicators on influenza transmission. Results indicate that before PHSMs, the average incidence was 4.87 per 100 000, with a β-value of (7.95 ± 1.27) × 10-10 and Rt-value of 1.21 ± 0.16. During PHSMs, incidence dropped to 2.55 per 100 000, and β decreased to (3.17 ± 0.75) × 10-10 (Rt-value of 0.86 ± 0.20). Post-PHSMs, the incidence surged to 17.00 per 100 000, with β rising to 8.36 × 10-10 (Rt-value of 2.25). The GBDT model identified testing policies, public information campaigns, and workplace closures as the most impactful PHSM indicators. PHSMs effectively mitigated the spread of influenza, providing a foundation for future policy development to prevent respiratory diseases.

Environmental public health research at the U.S. Environmental Protection Agency: A blueprint for exposure science in a connected world.

Exposure science plays an essential role in the U.S. Environmental Protection Agency's (U.S. EPA) mission to protect human health and the environment. The U.S. EPA's Center for Public Health and Environmental Assessment (CPHEA) within the Office of Research and Development (ORD) provides the exposure science needed to characterize the multifaceted relationships between people and their surroundings in support of national, regional, local and individual-level actions. Furthermore, exposure science research must position its enterprise to tackle the most pressing public health challenges in an ever-changing environment. These challenges include understanding and confronting complex human disease etiologies, disparities in the social environment, and system-level changes in the physical environment. Solutions will sustainably balance and optimize the health of people, animals, and ecosystems. Our objectives for this paper are to review the role of CPHEA exposure science research in various recent decision-making contexts, to present current challenges facing U.S. EPA and the larger exposure science field, and to provide illustrative case examples where CPHEA exposure science is demonstrating the latest methodologies at the intersection of these two motivations. This blueprint provides a foundation for applying exposomic tools and approaches to holistically understand real-world exposures so optimal environmental public health protective actions can be realized within the broader context of a One Health framework. IMPACT STATEMENT: The U.S. EPA's Center for Public Health and Environmental Assessment exposure research priorities reside at the intersection of environmental decision contexts and broad public health challenges. The blueprint provides a foundation for advancing the tools and approaches to holistically understand real-world exposures so optimal environmental protection actions can be realized. A One Health lens can help shape exposure research for maximum impact to support solutions that are transdisciplinary and must engage multiple sectors.

HiCorr: an influenza surveillance model using over-the-counter sales from community pharmacies

Abstract Background In large-scale community transmission, such as seasonal influenza, monitoring geographic trends and estimating the transmission intensity are critical to support public health decision-making. Previous studies have successfully used sales data from over-the-counter (OTC) products in community pharmacies to detect and monitor different epidemiological outbreaks, developing surveillance systems that are able to anticipate the load on primary care services and hospitals by up to 3 weeks. Methods The subset of OTC products sold in Portuguese community pharmacies was selected by correlating sales data to primary care attendance in previous flu seasons. This data pertained to daily coded episodes of influenza-like-illness (International Classification of Primary Care, 2nd Edition, code R80) in the Portuguese health cluster Oeste Sul. By fitting a moving epidemic method to historical sales data and then applying it to daily collected sales data, the developed index was used to anticipate the relative load to the primary care system as well as the start and the peak of epidemic activity for the current flu season. Results were compared to the public health data available on respiratory infections in Portugal. Results The model pinpointed the onset of the 2023-2024 flu epidemic in week 47 and its peak in week 52. The index curve showed a high correlation with the data published by the Portuguese national health service, with no time lag. However, the availability of consolidated public data was delayed, on average, by approximately two weeks. Discussion and conclusions Data from community pharmacies significantly enhance the early detection of seasonal flu trends, while reflecting population distribution. This underscores their invaluable contribution to public health assessments and the potential for improving the timeliness and accuracy of seasonal flu surveillance. Key messages • Community pharmacy data significantly enhance the early detection of seasonal flu trends. • Real world sales data maybe useful to support epidemic surveillance in public health.

Numerical simulation on exhaled aerosol transmission based on realistic oral-nasal structures and temperature distribution

ABSTRACT Respiratory infections are currently understood to be caused by pathogens released through the nose or mouth of an infected individual, and subsequently transmitted to susceptible hosts. These pathogens are enclosed in liquid particles that are aerosolized from the respiratory tract during activities such as breathing, speaking, sneezing, and coughing. These particles vary widely in size, ranging from submicron to several microns. While past research has largely overlooked the human respiratory system, recent analysis has revealed that the actual structure of the nasal cavity significantly influences the prediction of aerosol transmission during exhalation. In this study, computational fluid dynamics (CFD) simulations were conducted to analyze the aerosol transmission generated during exhalation from the nasal and oral cavities. Realistic nasal and oral cavity structures were taken into account, and authentic temperature distributions were applied to the surfaces. Additionally, inhalation conditions for susceptible individuals were established to evaluate the risk of inhalation-generated exposure. Through various simulation scenarios, we separately discussed the impact of environmental wind speed, separation distance, and exhalation flow rate. The simulation results indicate that environmental wind amplifies the complexity of the flow field and the transmission and deposition of particles between two individuals. Under ambient wind velocities of 0.5 m/s and 1 m/s, it was observed that over 80% of the particles with a diameter of 1 µm inhaled through the nasal cavity accounted for the total deposition on the infected individual. Furthermore, high exhalation flow rates exhibited higher deposition ratios at close distances, in line with our expectations. Therefore, it is advisable to minimize close contact as much as possible during periods of frequent respiratory infections, and to wear masks in order to reduce the risk of inhalation exposure. Implications: During the activities such as breathing, speaking, sneezing, and coughing, liquid particles containing pathogens are aerosolized from the respiratory tract and are released from nose or mouth through the nebulization. In this study, we investigated the transmission of aerosols from human exhalation in the outdoor environment, innovatively taking the real oral-nasal structure and the active inhalation of vulnerable people into consideration, and explored the human-to-human transmission of respiratory viruses. The results are beneficial for public health assessment and policy development.

Protecting whose welfare? A document analysis of competition regulatory decisions in four jurisdictions across three harmful consumer product industries

Background and methodsCompetition regulation has a strong influence on the relative market power of firms. As such, competition regulation can complement industry-specific measures designed to address harms associated with excessive market power in harmful consumer product industries. This study aimed to examine, through a public health lens, assessments and decisions made by competition authorities in four jurisdictions (Australia, South Africa, the United States (US), and the European Union (EU)) involving three harmful consumer product industries (alcoholic beverages, soft drinks, tobacco). We analysed legal case documents, sourced from online public registers and dating back as far as the online records extended, using a narrative approach. Regulatory decisions and harms described by the authorities were inductively coded, focusing on the affected group(s) (e.g., consumers) and the nature of the harms (e.g., price increases) identified.ResultsWe identified 359 cases published by competition authorities in Australia (n = 202), South Africa (n = 44), the US (n = 27), and the EU (n = 86). Most cases (n = 239) related to mergers and acquisitions (M&As). Competition authorities in Australia, the US, and the EU were found to make many decisions oriented towards increasing the affordability and accessibility of alcohol beverages, soft drinks, and tobacco products. Such decisions were very often made despite the presence of consumption-reduction public health policies. In comparison, South Africa’s competition authorities routinely considered broader issues, including ‘Black Economic Empowerment’ and potential harms to workers.ConclusionMany of the competition regulatory decisions assessed likely facilitated the concentration of market power in the industries we explored. Nevertheless, there appears to be potential for competition regulatory frameworks to play a more prominent role in promoting and protecting the public’s health through tighter regulation of excessive market power in harmful consumer product industries.

The Impact of Public Health on Health Assessment

Policy formulation, health promotion, and disease prevention are all important aspects of public health that shape population health. This study investigates the numerous ways in which public health influences health evaluation, namely data gathering, epidemiology, and health surveillance. The historical achievements of public health professionals are explored alongside constraints such as limited resources and technological barriers. Furthermore, innovations such as telemedicine, mobile health technologies, and data analytics are being investigated as potential directions for improving public health assessment. The study concludes by emphasising the importance of ongoing investment in public health technology, collaborations, and policy innovations to address future health concerns and increase community well-being. Keywords: Public health, health assessment, epidemiology, disease surveillance, health promotion, disease prevention.

Modern Approaches to Integrated Assessment of Public Health in Russian Federation and the Republic of Kazakhstan

Public health management plays an important role in Russian healthcare system. However, the task is impossible without an integrated assessment. In order to understand modern approaches to integral assessment of public health as well as to develop effective methods for its determination, it is necessary to systematize the existing research data. Countries of vast geographical extent, such as Kazakhstan, are of particular interest, as their regional peculiarities do not allow to elaborate a unified approach aimed at improving public health. The purpose was to analyze the scientific research findings on integrated assessment of public health in the Russian Federation and the Republic of Kazakhstan. Material and methods. A keyword search of scientific data available in eLibrary.RU, PubMed, Google Scholar scientometric databases, subsequent study and analysis were carried out. As a result, 35 articles were included in the review for further analysis. Results. In the scientific literature, there is ambiguity in the choice of criteria for an integrated assessment of public health. The use of different approaches and public health indicators reveals the complexity and multilevel nature of the phenomenon. The revealed weight contributions of various public health indicators, as well as the change in their role in different regions, age groups and other cohort groups indicate the need to adapt unified and standardized approaches using correction factors taking into account the above factors. The existing scientific groundwork on integrated assessment of public health in Russian Federation and the Republic of Kazakhstan allows us to predict an upcoming appearance of scientific research that will contain the results of the most accurate and adequate integrated assessment of public health. Conclusion. A comprehensive assessment of public health is a complex multi-level system that should be measured by integral indicators. In this regard, in order to improve these indicators, it is necessary to clarify the criteria characterizing the high indicative value and coverage of various aspects that determine the level of public health.

Effective Public Health Assessment: Research on Alzheimer Disease Diagnosis Model With Communication Technology

Rapid identification and appropriate management of Alzheimer's pose important challenges, particularly within public health contexts. This research introduces a unique framework for diagnosing Alzheimer's disease using communication technologies (such as wearable sensors). Novel chimp search-driven ReLu recurrent network (CS-RRN) strategy is introduced in this study for effectively detecting Alzheimer's disease. The ReLu function is employed in long/short-term memory (LSTM) to learn nonlinear dependencies, and then the chimp optimization strategy is applied to enhance the detection performance of the LSTM network. The gait signal data is collected from various wearable sensor devices to analyze the effectiveness of the suggested CS-RRN m technique. The performance of the proposed method is analyzed through a Python-driven implementation platform in terms of various metrics. The CS-RRN approach effectively achieved the maximum performance in detecting Alzheimer's disease when compared with other existing approaches. Based on the findings of this research, communication technology may substantially boost public health by providing a low-cost and high-performing method for Alzheimer disease identification.

Unraveling the Influence of Satellite-Observed Land Surface Temperature on High-Resolution Mapping of Ground-Level Ozone Using Interpretable Machine Learning.

Accurately mapping ground-level ozone concentrations at high spatiotemporal resolution (daily, 1 km) is essential for evaluating human exposure and conducting public health assessments. This requires identifying and understanding a proxy that is well-correlated with ground-level ozone variation and available with spatiotemporal high-resolution data. This study introduces a high-resolution ozone modeling method utilizing the XGBoost algorithm with satellite-derived land surface temperature (LST) as the primary predictor. Focusing on China in 2019, our model achieved a cross-validation R2 of 0.91 and a root-mean-square error (RMSE) of 13.51 μg/m3. We provide detailed maps highlighting ground-level ozone concentrations in urban areas, uncovering spatial variations previously unresolved, along with time series aligning with established understandings of ozone dynamics. Our local interpretation of the machine learning model underscores the significant contribution of LST to spatiotemporal ozone variations, surpassing other meteorological, pollutant, and geographical predictors in its influence. Validation results indicate that model performance decreases as spatial resolution becomes coarser, with R2 decreasing from 0.91 for the 1 km model to 0.85 for the 25 km model. The methodology and data sets generated by this study offer new insights into ground-level ozone variability and mapping and can significantly aid in exposure assessment and epidemiological research related to this critical environmental challenge.

Development of a tool for rapid assessment of the evidence of human observational epidemiological studies with focus on risk of bias in the context of public health and risk assessment

Development of a tool for rapid assessment of the evidence of human observational epidemiological studies with focus on risk of bias in the context of public health and risk assessment

Методические подходы к измерению общественного и индивидуального здоровья как медико-социального ресурса и потенциала общества.

One of the main indicators in healthcare is public and individual health. However, despite a comprehensive, in-depth and long-term study of the theoretical component of «health», there is still a need to define its universal and effective criteria, methodological approaches to measuring public and individual health as a medical and social resource and the potential of society. The purpose to analyze the published data in the scientific literature on methodological approaches to measuring public and individual health as a medical and social resource and the potential of society. Research methods. The collection, study and analysis of available information sources in the scientometric databases WoS, Scopus included in the list approved by the Higher Attestation Commission under the Ministry of Education and Science of the Russian Federation. The search for scientific articles was carried out in the electronic databases PubMed, Google Scholar, eLibrary.RU by keywords. 47 articles were included in the review for analysis. The results of the study. The analysis of the literature data has shown the need to systematize and adapt existing methods of assessing public and individual health into a single multi-level assessment system. Indicators of public and population health should reflect all aspects of the well-being of the population. This is evidenced by the published data on measuring instruments, which have shown their effectiveness, but have a disadvantage – the lack of complexity, or the complexity claimed in the research is not complete. Conclusion. Currently, there is a whole arsenal of methodological approaches to measuring public and individual health. To assess it as a medical and social resource and the potential of society, the use of individual indicators does not allow a comprehensive assessment of public health, in addition, the lack of monitoring of an integrated assessment of public health makes it difficult to apply operational management decisions in the field of healthcare.

Lethal injuries in single stabs to the trunk – A study on homicides and suicides in Sweden

IntroductionHomicides using knives or other sharp objects are the most common type of homicide in Europe, and the second most common type of homicide worldwide. In contrast, suicides using sharp objects are rarer, constituting only a few per cent of all suicides in western countries. We investigated single stab injuries to the trunk in both homicides and suicides to assess differences in extent of injuries and in medical care, which could be of value for trauma management, public health and forensic assessment. MethodsWe identified all cases in Sweden between 2010 and 2021 that died of a single stab to the trunk, in either a homicide (n = 94) or a suicide (n = 45), and that were the subject of a forensic autopsy. We obtained data on demographics, hospital care and injured structures. To assess the severity of injuries, we applied AIS (Abbreviated Injury Score) and NISS (New Injury Severity Score). The inter-rater reliability of NISS between two raters was evaluated with intra-class correlation (ICC), with 95 % confidence intervals (CI). The data was analysed using Fisher's exact test, Mann-Whitney U test and logistic regression models. ResultsThe inter-rater reliability between the two NISS raters showed an ICC of 0.87 (95 % CI 0.68−0.95). We observed a larger variation of injuries in suicides, with a higher proportion of both unsurvivable (NISS 75) and minor injuries (NISS ≤ 8) (66.7 % and 8.9 % respectively) compared to in homicides (46.8 % and 0 % respectively). We observed a larger proportion of injuries to the heart in suicides (68.9% vs. 46.8 %, p = 0.018). In homicides, injuries involving vessels (52.1% vs. 13.3 %, p < 0.001) and hospital care (56.4 % vs. 8.9 %, p < 0.001) were significantly more common compared to suicides. Discussion and conclusionCausation (self-inflicted or assaults) seems to be associated with characteristics of injury and the likelihood of receiving hospital care. These findings could potentially be valuable for trauma management and forensic assessment of manner of death, however, determining the mortality of the injuries would require a comparison group comprising injured survivors.

On alert for Ebola: public health risk assessment of travellers from Uganda to the USA during the 2022 outbreak.

On 20 September 2022, the Ugandan Ministry of Health declared an outbreak of Ebola disease caused by Sudan ebolavirus. From 6 October 2022 to 10 January 2023, Centers for Disease Control and Prevention (CDC) staff conducted public health assessments at five US ports of entry for travellers identified as having been in Uganda in the past 21days. CDC also recommended that state, local and territorial health departments ('health departments') conduct post-arrival monitoring of these travellers. CDC provided traveller contact information, daily to 58 health departments, and collected health department data regarding monitoring outcomes. Among 11 583 travellers screened, 132 (1%) required additional assessment due to potential exposures or symptoms of concern. Fifty-three (91%) health departments reported receiving traveller data from CDC for 10 114 (87%) travellers, of whom 8499 (84%) were contacted for monitoring, 1547 (15%) could not be contacted and 68 (1%) had no reported outcomes. No travellers with high-risk exposures or Ebola disease were identified. Entry risk assessment and post-arrival monitoring of travellers are resource-intensive activities that had low demonstrated yield during this and previous outbreaks. The efficiency of future responses could be improved by incorporating an assessment of risk of importation of disease, accounting for individual travellers' potential for exposure, and expanded use of methods that reduce burden to federal agencies, health departments, and travellers.

Estimating Disease-Free Life Expectancy Based on Clinical Data from the French Hospital Discharge Database

The development of health indicators to measure healthy life expectancy (HLE) is an active field of research aimed at summarizing the health of a population. Although many health indicators have emerged in the literature as critical metrics in public health assessments, the methods and data to conduct this evaluation vary considerably in nature and quality. Traditionally, health data collection relies on population surveys. However, these studies, typically of limited size, encompass only a small yet representative segment of the population. This limitation can necessitate the separate estimation of incidence and mortality rates, significantly restricting the available analysis methods. In this article, we leverage an extract from the French National Hospital Discharge database to define health indicators. Our analysis focuses on the resulting Disease-Free Life Expectancy (Dis-FLE) indicator, which provides insights based on the hospital trajectory of each patient admitted to hospital in France during 2008–2013. Through this research, we illustrate the advantages and disadvantages of employing large clinical datasets as the foundation for more robust health indicators. We shed light on the opportunities that such data offer for a more comprehensive understanding of the health status of a population. In particular, we estimate age-dependent hazard rates associated with sex, alcohol abuse, tobacco consumption, and obesity, as well as geographic location. Simultaneously, we delve into the challenges and limitations that arise when adopting such a data-driven approach.

Role of the "High Institute of Public Health" during the COVID-19 Pandemic: A Case from Egypt.

The High Institute of Public Health (HIPH), as a post-graduate academic institute, was affected by the COVID-19 pandemic in several aspects. This paper describes the effect of COVID-19 on the three main domains of HIPH: research, education, and community services. Documenting the activities and practices of the HIPH during the pandemic reflects the degree of resilience and preparedness against possible future global emergencies. Despite its importance for policymakers, such data is lacking from similar institutes in the Middle East, including Egypt. An extensive search in four popular scientific databases (Google Scholar, PubMed, Scopus, and Scival) was conducted to extract publications by authors affiliated with the HIPH using relevant keywords. Records were reviewed to collect data on the educational process as well as data on community services (convoys, campaigns, seminars, and workshops held by HIPH staff). All the mentioned activities were described, analyzed and compared before and during the pandemic to study the impact of the pandemic on the HIPH, as an example of a postgraduate institute. The total numbers of COVID-19-related publications in Scopus by authors affiliated with the HIPH were 115 publications, the majority of which were research articles in the 'Medicine' and 'Immunology and Microbiology' domains. Most of them focused on assessing the relationship between the pandemic and quality of life, and prevention and treatment of COVID-19 (22.2% each). Publications on COVID-19 by HIPH researchers during the pandemic constituted 33.1% (115 publications) of the total publications by Alexandria University. Among the top ten authors on COVID-19 at Alexandria University, four were HIPH affiliated. The year 2022 witnessed the most frequent publications on COVID-19 by HIPH (51/115 publications, 44.3% of all COVID-19 publications by the HIPH on Scopus). All program courses were taught online during the year 2019-2020 (343 courses). HIPH provided several community services during the pandemic, which included 16 convoys in the poorer areas of Alexandria that served more than 1250 beneficiaries. Their goals were raising health awareness on COVID-19 vaccination, health education, and environmental assessment. This paper is the first of its kind by members of the High Institute of Public Health, Alexandria University. It provides baseline data for future similar work and is a documentation of the compilation of efforts during the COVID-19 pandemic that gives baseline data for public health assessment and planning by policy makers.

Understanding the transition to viable but non-culturable state in Escherichia coli W3110: a comprehensive analysis of potential spectrochemical biomarkers

The viable but non-culturable (VBNC) state is considered a survival strategy employed by bacteria to endure stressful conditions, allowing them to stay alive. Bacteria in this state remain unnoticed in live cell counts as they cannot proliferate in standard culture media. VBNC cells pose a significant health risk because they retain their virulence and can revive when conditions normalize. Hence, it is crucial to develop fast, reliable, and cost-effective methods to detect bacteria in the VBNC state, particularly in the context of public health, food safety, and microbial control assessments. This research examined the biomolecular changes in Escherichia coli W3110 induced into the VBNC state in artificial seawater under three different stress conditions (temperature, metal, and antibiotic). Initially, confirmation of VBNC cells under various stresses was done using fluorescence microscopy and plate counts. Subsequently, lipid peroxidation was assessed through the TBARS assay, revealing a notable increase in peroxidation end-products in VBNC cells compared to controls. ATR-FTIR spectroscopy and chemomometrics were employed to analyze biomolecular changes, uncovering significant spectral differences in RNA, protein, and nucleic acid concentrations in VBNC cells compared to controls. Notably, RNA levels increased, while protein and nucleic acid amounts decreased. ROC analyses identified the 995 cm− 1 RNA band as a consistent marker across all studied stress conditions, suggesting its potential as a robust biomarker for detecting cells induced into the VBNC state under various stressors.

Using Photovoice to Improve Engagement in Community Health Assessments Addressing Behavioral Health.

Behavioral health disorders are well-known to have close links with the social determinants of health, yet little is known about how impacted communities perceive these links. Qualitative participatory methods can not only provide insight into how communities conceptualize these relationships but also empower those with lived experience to contextualize their perspectives and formulate calls to action. This study used Photovoice as a participatory method to supplement the Clark County Health Department Community Health Assessment and determine priority facilitators and barriers contributing to the behavioral health of Clark County, KY, residents. A secondary aim was to gain a greater understanding of how the Photovoice methodology impacts community engagement efforts in Community Health Assessments. Twenty-three Clark County residents participated in four Photovoice groups involving five weekly sessions, which included photograph "show and tell," critical group dialogue, participatory analysis, and planning for dissemination. Secondary analysis of Photovoice focus group discussions revealed behavioral health facilitators and barriers were most influenced by (1) public sector unresponsiveness, (2) strong partnerships formed between community and grassroots organizations, and (3) the siloed division of responsibility between agencies and across sectors. The authors also found the Photovoice method successfully enhanced engagement and empowered those with lived experience to frame their perspectives of the behavioral health landscape. This project has implications for enhancing community engagement and empowerment in behavioral health-focused public health assessments and shaping policy to promote multi-sector collaboration.

Prevalence and associated factors of burnout among working adults in Southeast Asia: results from a public health assessment.

The COVID-19 pandemic has spotlighted the mental health crisis among employees worldwide. However, burnout research is often industry- or occupation-specific, and limited knowledge currently exists on the prevalence of burnout in the general working population of Southeast Asia. This study aims to examine the prevalence of employee burnout and its associated factors among working adults in Southeast Asia using secondary data. 4,338 full-time employees aged 18-65 years old living in Malaysia, Singapore, Philippines, and Indonesia were assessed for burnout, depression, anxiety, stress, and sociodemographic characteristics as part of an online public health assessment in October 2022. The prevalence of burnout in the region was 62.91%. Burnout was highest among employees in the Philippines (70.71%) and lowest in Malaysia (58.13%). Experiencing burnout was associated with severe or extremely severe depression (AOR = 6.48 [95% CI = 5.06-8.33]), anxiety (AOR = 2.22 [1.74-2.85]), and stress (AOR = 5.51 [4.13-7.39]). Working more than 50 hours a week (AOR = 1.38 [1.04-1.82]) and being very dissatisfied with the job led to higher odds of burnout (AOR = 16.46 [8.99-30.53]). Alarmingly, more than half of working adults in the region are reporting increased levels of burnout, and improving employee mental health and work conditions may be key to improving employee burnout in the region. Findings contribute to existing research on burnout prevalence in the region and provide more comprehensive insights into understanding the factors driving employee burnout in the working population of Southeast Asia 2 years after the onset of the pandemic.

A city-level dataset of heavy metal emissions into the atmosphere across China from 2015–2020

The absence of nationwide distribution data regarding heavy metal emissions into the atmosphere poses a significant constraint in environmental research and public health assessment. In response to the critical data deficiency, we have established a dataset covering Cr, Cd, As, and Pb emissions into the atmosphere (HMEAs, unit: ton) across 367 municipalities in China. Initially, we collected HMEAs data and covariates such as industrial emissions, vehicle emissions, meteorological variables, among other ten indicators. Following this, nine machine learning models, including Linear Regression (LR), Ridge, Bayesian Ridge (Bayesian), K-Neighbors Regressor (KNN), MLP Regressor (MLP), Random Forest Regressor (RF), LGBM Regressor (LGBM), Lasso, and ElasticNet, were assessed using coefficient of determination (R2), root-mean-square error (RMSE) and Mean Absolute Error (MAE) on the testing dataset. RF and LGBM models were chosen, due to their favorable predictive performance (R2: 0.58–0.84, lower RMSE/MAE), confirming their robustness in modelling. This dataset serves as a valuable resource for informing environmental policies, monitoring air quality, conducting environmental assessments, and facilitating academic research.