Public Health Goals Research Articles

Enhancing vitamin D levels in care homes: the role of healthy building design in preventing respiratory infections.

The recent article by Willcox etal. in the Journal of Public Health highlights the effectiveness of antiviral prophylaxis and high-dose vitamin D supplementation in reducing acute respiratory infections (ARIs) in care homes. This correspondence extends the discussion by emphasizing the critical role of healthy building design in enhancing vitamin D levels, which is vital for immune function and ARI prevention. Many care home residents suffer from vitamin D deficiency due to limited sunlight exposure. Incorporating architectural elements such as large windows, skylights, and outdoor spaces can significantly increase natural light exposure, thereby boosting vitamin D levels and potentially reducing ARI susceptibility. Despite the benefits of supplementation, addressing environmental factors through healthy building design offers a sustainable, long-term strategy that aligns with public health goals of preventive care and environmental sustainability. Prioritizing such design principles in care home planning and renovation can enhance residents' health and resilience against infections like influenza and COVID-19.

Distribution and drivers of co−hosts of antibiotic and metal(loid) resistance genes in the fresh−brackish−saline groundwater

Groundwater is an essential source of drinking water and agricultural irrigation water, and its protection has become a global goal for public health. However, knowledge about heavy metal(loid) resistance genes (MRGs) in groundwater and the potential co−selection of antibiotic resistance genes (ARGs) have seldom been developed. Here, during the wet and dry seasons, we collected 66 groundwater samples (total dissolved solids = 93.9−9530 mg/L) adjacent to Baiyangdian Lake in Northern China, which presented the few metal(loid) and antibiotic contamination. We identified 160 MRGs whose composition exhibited significant seasonal variation, and dissolved metal(loid)s (particularly Ba) played a determinative role in promoting the MRGs proliferation though with relatively low concentrations, suggesting the relatively vulnerable groundwater ecosystems. Moreover, 27.4% of MRG−carrying metagenome−assembled genomes (MAGs) simultaneously carried ARGs, with the most frequently detected MRG types of Cu, Hg, and As, and ARG types of multidrug and bacitracin. Physicochemical variables, variables related to total dissolved solids, metal(loid)s, and antibiotics synthetically shaped the variation of MRG−ARG hosts in groundwater. We found that the increase of MRG−ARG hosts was critically responsible for the spread of MRGs and ARGs in groundwater. Our findings revealed the widespread co−occurrence of MRGs and ARGs in few−contaminated groundwater and highlighted the crucial roles of salinity in their propagation and transmission.

Multiomics: Functional Molecular Biomarkers of Micronutrients for Public Health Application.

Adequate micronutrient intake and status are global public health goals. Vitamin and mineral deficiencies are widespread and known to impair health and survival across the life stages. However, knowledge of molecular effects, metabolic pathways, biological responses to variation in micronutrient nutriture, and abilities to assess populations for micronutrient deficiencies and their pathology remain lacking. Rapidly evolving methodological capabilities in genomics, epigenomics, proteomics, and metabolomics offer unparalleled opportunities for the nutrition research community to link micronutrient exposure to cellular health; discover new, arguably essential micronutrients of microbial origin; and integrate methods of molecular biology, epidemiology, and intervention trials to develop novel approaches to assess and prevent micronutrient deficiencies in populations. In this review article, we offer new terminology to specify nutritional application of multiomic approaches and encourage collaboration across the basic to public health sciences to advance micronutrient deficiency prevention.

Five years of discourse related to Indonesia tobacco control reform: a content analysis of online media coverage

BackgroundIn 2017, Indonesia initiated the amendment of its 11-year-old tobacco control regulation (PP 109/2012) to reduce smoking among youth, but the process was stalled. The proposed changes in the regulation...

Integrating Sexual and Reproductive Health Equity Into Public Health Goals and Metrics: Comparative Analysis of Healthy People 2030's Approach and a Person-Centered Approach to Contraceptive Access Using Population-Based Data.

The Healthy People initiative is a national effort to lay out public health goals in the United States every decade. In its latest iteration, Healthy People 2030, key goals related to contraception focus on increasing the use of effective birth control (contraceptive methods classified as most or moderately effective for pregnancy prevention) among women at risk of unintended pregnancy. This narrow focus is misaligned with sexual and reproductive health equity, which recognizes that individuals' self-defined contraceptive needs are critical for monitoring contraceptive access and designing policy and programmatic strategies to increase access. We aimed to compare 2 population-level metrics of contraceptive access: a conventional metric, use of contraceptive methods considered most or moderately effective for pregnancy prevention among those considered at risk of unintended pregnancy (approximating the Healthy People 2030 approach), and a person-centered metric, use of preferred contraceptive method among current and prospective contraceptive users. We used nationally representative data collected in 2022 to construct the 2 metrics of contraceptive access; the overall sample included individuals assigned female at birth not using female sterilization or otherwise infecund and who were not pregnant or trying to become pregnant (unweighted N=2760; population estimate: 43.9 million). We conducted a comparative analysis to examine the convergence and divergence of the metrics by examining whether individuals met the inclusion criteria for the denominators of both metrics, neither metric, only the conventional metric, or only the person-centered metric. Comparing the 2 approaches to measuring contraceptive access, we found that 79% of respondents were either included in or excluded from both metrics (reflecting that the metrics converged when individuals were treated the same by both). The remaining 21% represented divergence in the metrics, with an estimated 5.7 million individuals who did not want to use contraception included only in the conventional metric denominator and an estimated 3.5 million individuals who were using or wanted to use contraception but had never had penile-vaginal sex included only in the person-centered metric denominator. Among those included only in the conventional metric, 100% were content nonusers-individuals who were not using contraception, nor did they want to. Among those included only in the person-centered metric, 68% were currently using contraception. Despite their current or desired contraceptive use, these individuals were excluded from the conventional metric because they had never had penile-vaginal sex. Our analysis highlights that a frequently used metric of contraceptive access misses the needs of millions of people by simultaneously including content nonusers and excluding those who are using or want to use contraception who have never had sex. Documenting and quantifying the gap between current approaches to assessing contraceptive access and more person-centered ones helps clearly identify where programmatic and policy efforts should focus going forward.

Challenges in the Treatment of Coinfection of Visceral Leishmaniosis and Hepatitis B/C Viruses

There is a significant research gap in India due to incomplete investigation of seroprevalence of co-infection with visceral leishmaniasis (VL), hepatitis B (HBV) and hepatitis C (HCV). This study attempts to fill this gap by providing an in-depth analysis of the prevalence and consequences of these co-infections. The study of 32 VL patients revealed that 28 (8.88%) tested positive for HBV, 1 (0.317%) for HCV and 3 (0.95%) for both HBV and HCV. These results highlight how difficult it is to treat people with two diseases at the same time. An example of how co-infection makes treatment much more difficult is the fact that a patient with both VL and HBV required six courses of anti-leishmaniasis medication. The study shows how important it is for VL patients to be tested regularly for HBV and HCV to improve treatment response and support India's plan to get rid of kala-azar. Accurate identification of co-infections is necessary to reduce the overall burden of the disease and develop effective treatment regimens. Systematic testing of VL patients for HBV and HCV not only helps in controlling and perhaps even eliminating kala-azar, but also makes it easier to treat each patient as an individual, improving their health. In areas where viral hepatitis is prevalent, this strategy is particularly important as these diseases represent a double burden on public health. Implementing integrated treatment regimens and routine screening can reduce the impact of co-infection and advance the public health goal of kala-azar elimination. To improve patient outcomes and advance public health goals, the results of this study strongly support the integration of comprehensive screening programs into existing healthcare systems to improve the treatment of VL patients.

Double-duty actions addressing the double burden of malnutrition among adolescents aged 10-19: protocol for a scoping review.

The global adolescent population faces the challenge of the double burden of malnutrition (DBM), characterized by the coexistence of undernutrition and overweight/obesity, including diet-related non-communicable diseases (NCDs). This dual challenge, prevalent across various socio-economic backgrounds, necessitates double-duty actions, i.e., integrated interventions designed to concurrently address both sets of conditions. These actions are critical for fostering the overall health and well-being of adolescents. The objective of this review is to describe the content, setting, and delivery mechanisms of double-duty actions, synthesize their impacts on adolescents' nutritional status, and offer policy and program implications for future interventions. As part of this scoping review, we will conduct a comprehensive search across multiple databases, including MEDLINE, Embase, CENTRAL, CINAHL, and Google Scholar, to identify relevant interventions, programs, policies, guidelines, evaluation studies, and strategies targeting DBM among adolescents aged 10-19 years. Inclusion criteria encompass a range of evidence sources with methodologically sound and well-described study designs. All full-text articles and abstracts will be independently screened by two reviewers to ensure a comprehensive inclusion of papers that align with the established criteria. The final protocol is available on Open Science Forum (https://osf.io/kxapb). Addressing DBM through integrated double-duty actions is crucial for achieving global nutrition and public health goals. However, challenges persist in the form of uncoordinated efforts, lack of comprehensive evidence for what interventions work among adolescents, and the need for context-specific strategies to effectively address the heterogeneity of DBM. The results of this scoping review may provide evidence for future policies and interventions, emphasizing integrated, multi-sectoral strategies tailored to the unique needs of the adolescent population.

Health and non-health benefits and equity impacts of individual-level economic relief programs during epidemics/pandemics in high income settings: a scoping review

BackgroundEconomic relief programs are strategies designed to sustain societal welfare and population health during a regional or global scale infectious disease outbreak. While economic relief programmes are considered essential during a regional or global health crisis, there is no clear consensus in the literature about their health and non-health benefits and their impact on promoting equity.MethodsWe conducted a scoping review, searching eight electronic databases from January 01, 2001, to April 3, 2023, using text words and subject headings for recent pathogens (coronavirus (COVID-19), Ebola, Influenza, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), HIV, West Nile, and Zika), and economic relief programs; but restricted eligibility to high-income countries and selected diseases due to volume. Title and abstract screening were conducted by trained reviewers and Distiller AI software. Data were extracted in duplicates by two trained reviewers using a pretested form, and key findings were charted using a narrative approach.ResultsWe identified 27,263 de-duplicated records, of which 50 were eligible. Included studies were on COVID-19 and Influenza, published between 2014 and 2023. Zero eligible studies were on MERS, SARS, Zika, Ebola, or West Nile Virus. We identified seven program types of which cash transfer (n = 12) and vaccination or testing incentive (n = 9) were most common. Individual-level economic relief programs were reported to have varying degrees of impact on public health measures, and sometimes affected population health outcomes. Expanding paid sick leave programs had the highest number of studies reporting health-related outcomes and positively impacted public health measures (isolation, vaccination uptake) and health outcomes (case counts and the utilization of healthcare services). Equity impact was most often reported for cash transfer programs and incentive for vaccination programs. Positive effects on general well-being and non-health outcomes included improved mental well-being and quality of life, food security, financial resilience, and job security.ConclusionsOur findings suggest that individual-level economic relief programs can have significant impacts on public health measures, population health outcomes and equity. As countries prepare for future pandemics, our findings provide evidence to stakeholders to recognize health equity as a fundamental public health goal when designing pandemic preparedness policies.

Communication Public Health: An Integration of Audiology, Speech-Language Pathology, and Public Health.

Health care is advancing toward a collaborative and integrative approach that promotes general health and wellness while addressing health inequities through the consideration of broader social and economic factors that influence the well-being of the entire population. Recently, there has been growing evidence of public health concept applications in fields related to speech, language, and hearing. However, there is an outstanding need to explicitly define the intersection of public health, including prevention and health promotion, and the discipline of communication sciences and disorders (CSD) across the areas of education, clinical practice, research, and policy. The authors propose a definition for this intersection using the new term communication public health. This tutorial provides guidance on how to conceptualize communication public health and invites refinement and expansion of the intersection between public health and CSD. Because readers are experts in CSD, this tutorial aims to supplement existing knowledge with information on public health to achieve three main objectives: (a) increase knowledge of the application of public health concepts among speech, language, hearing, and related professionals (SLHP+); (b) introduce the concept of communication public health; and (c) discuss the relevance of communication public health across domains within CSD. The authors utilize the socioecological model to provide examples of applications. The concept of communication public health is proposed as the collaborative area of CSD and public health, which encompasses prevention and promotion of equity in communication health through individual-, community-, and population-level efforts. The goals of communication public health are achieved through applications of public health principles in CSD education, clinical practice, research, and policy. Communication public health defines an area of collaboration between public health and CSD in which SLHP+ can apply public health concepts to both advance communication health and address health disparities.

Trust in Physicians and Hospitals During the COVID-19 Pandemic in a 50-State Survey of US Adults

Trust in physicians and hospitals has been associated with achieving public health goals, but the increasing politicization of public health policies during the COVID-19 pandemic may have adversely affected such trust. To characterize changes in US adults' trust in physicians and hospitals over the course of the COVID-19 pandemic and the association between this trust and health-related behaviors. This survey study uses data from 24 waves of a nonprobability internet survey conducted between April 1, 2020, and January 31, 2024, among 443 455 unique respondents aged 18 years or older residing in the US, with state-level representative quotas for race and ethnicity, age, and gender. Self-report of trust in physicians and hospitals; self-report of SARS-CoV-2 and influenza vaccination and booster status. Survey-weighted regression models were applied to examine associations between sociodemographic features and trust and between trust and health behaviors. The combined data included 582 634 responses across 24 survey waves, reflecting 443 455 unique respondents. The unweighted mean (SD) age was 43.3 (16.6) years; 288 186 respondents (65.0%) reported female gender; 21 957 (5.0%) identified as Asian American, 49 428 (11.1%) as Black, 38 423 (8.7%) as Hispanic, 3138 (0.7%) as Native American, 5598 (1.3%) as Pacific Islander, 315 278 (71.1%) as White, and 9633 (2.2%) as other race and ethnicity (those who selected "Other" from a checklist). Overall, the proportion of adults reporting a lot of trust for physicians and hospitals decreased from 71.5% (95% CI, 70.7%-72.2%) in April 2020 to 40.1% (95% CI, 39.4%-40.7%) in January 2024. In regression models, features associated with lower trust as of spring and summer 2023 included being 25 to 64 years of age, female gender, lower educational level, lower income, Black race, and living in a rural setting. These associations persisted even after controlling for partisanship. In turn, greater trust was associated with greater likelihood of vaccination for SARS-CoV-2 (adjusted odds ratio [OR], 4.94; 95 CI, 4.21-5.80) or influenza (adjusted OR, 5.09; 95 CI, 3.93-6.59) and receiving a SARS-CoV-2 booster (adjusted OR, 3.62; 95 CI, 2.99-4.38). This survey study of US adults suggests that trust in physicians and hospitals decreased during the COVID-19 pandemic. As lower levels of trust were associated with lesser likelihood of pursuing vaccination, restoring trust may represent a public health imperative.

The role of metaphor in the corporate political strategies of health harming industries: Comparing the concept of balance in the gambling and opioid industry discourses

Scholars have identified notable similarities between the political strategies employed by health-harming industries. This includes similarities in the narratives employed by industry actors seeking to oppose public health regulations that threaten their commercial interests. This study seeks to examine the use of a specific concept – the balance metaphor – in the policy discourses of two health-harming industries. Namely, the pharmaceutical industry implicated in the prescription opioid crisis in the US, and the UK gambling industry, whose products and practices are associated with a serious, but largely neglected, series of harms. We first review research on metaphors, demonstrating how this provides additional theoretically-informed concepts with which to understand how industry discourse circumscribes the terrain of policy debates in ways amenable to commercial interests. Building from these insights, we conducted a rhetorical analysis, examining how the concept of balance is employed by different actors in distinct contexts to shape understandings of the social and policy problems associated with gambling and opioid products and to promote industry-favourable regulatory responses to these. This brings a micro-level of analysis to supplement previous meso- and macro-level scholarship in this space. We use our findings to argue that the depoliticization of the policy process and objectivization of the policy space – in ways that obscure its contingent and political nature – through discourses of balance is itself an arch political act. Examining the metaphors used in policy debates and their functions provides important insights that can be used to inform the construction of counter-narratives to industry-favourable discourses, including the creative use of novel metaphors in the service of public health goals.

Recent deep learning-based brain tumor segmentation models using multi-modality magnetic resonance imaging: a prospective survey.

Radiologists encounter significant challenges when segmenting and determining brain tumors in patients because this information assists in treatment planning. The utilization of artificial intelligence (AI), especially deep learning (DL), has emerged as a useful tool in healthcare, aiding radiologists in their diagnostic processes. This empowers radiologists to understand the biology of tumors better and provide personalized care to patients with brain tumors. The segmentation of brain tumors using multi-modal magnetic resonance imaging (MRI) images has received considerable attention. In this survey, we first discuss multi-modal and available magnetic resonance imaging modalities and their properties. Subsequently, we discuss the most recent DL-based models for brain tumor segmentation using multi-modal MRI. We divide this section into three parts based on the architecture: the first is for models that use the backbone of convolutional neural networks (CNN), the second is for vision transformer-based models, and the third is for hybrid models that use both convolutional neural networks and transformer in the architecture. In addition, in-depth statistical analysis is performed of the recent publication, frequently used datasets, and evaluation metrics for segmentation tasks. Finally, open research challenges are identified and suggested promising future directions for brain tumor segmentation to improve diagnostic accuracy and treatment outcomes for patients with brain tumors. This aligns with public health goals to use health technologies for better healthcare delivery and population health management.

Optimal approaches for COVID-19 control: the use of vaccines and lockdowns across societal groups.

By March 2023, the COVID-19 illness had caused over 6.8 million deaths globally. Countries restricted disease spread through non-pharmaceutical interventions (NPIs; e.g. social distancing). More severe "lockdowns" were also required to manage disease spread. Although lockdowns effectively reduce virus transmission, they substantially disrupt economies and individual well-being. Fortunately, the availability of vaccines provides alternative approaches to manage disease spread. Yet, vaccination programs take several months to implement fully, require further time for individuals to develop immunity following inoculation, may not have complete coverage and/or may be imperfectly efficacious against the virus. Given these aspects of a vaccination programme, it is important to understand how NPIs (such as lockdowns) can be used in conjunction with vaccination to achieve public health goals. We use mathematical methods to, investigate optimal approaches for vaccination under varying lockdown lengths and/or severities to prevent COVID-19-related deaths exceeding critical thresholds. We find that increases in vaccination rate cause a disproportionate decrease in the length and severity lockdowns to keep mortality levels below a critical threshold. With vaccination, severe lockdowns can further reduce infections by up to 89%. Notably, we include simple demographics, modelling three groups: vulnerable, front-line workers, and non-vulnerable. We investigate the sequence of vaccination. One counter-intuitive finding is that even though the vulnerable group is high risk, demographically, this is a small group and critically, per person, vaccination therefore occurs more slowly. Hence vaccinating this group first achieves limited gains in overall disease control. Importantly, we conclude that improved disease control may be best achieved by vaccinating the non-vulnerable group coupled with longer and/or more severe NPIs.

Dietary Diversity and Nutritional Status Among Rwandan Women Engaged in Agriculture: A Cross‐Sectional Study

ABSTRACTBackgroundDietary diversity is crucial for nutritional adequacy, particularly among women of reproductive age who have increased nutritional needs due to menstruation, pregnancy, and lactation. This is especially important in addressing anemia in Rwanda, which poses significant health risks for both mothers and children. This study assessed the dietary diversity, nutritional status, and related factors among Rwandan women engaged in agriculture.MethodsIn 2022, a cross‐sectional study in Nyamagabe, Karongi, and Nyabihu districts, Rwanda, focused on high malnutrition rates. Agriculture households with children under 5 were sampled using a multistage method. Data, including nutritional status via MUAC and dietary diversity via 24‐h recall, were collected digitally through Kobo Collect.ResultsThe study included 439 respondents, with a mean age of 33 years. Among participants, 359 (81.8%) had low dietary diversity, with Nyamagabe having the highest proportion at 39%. Anemia prevalence was 22.1%, with Karongi having the highest at 10.7%. Factors associated with higher odds of high dietary diversity included the education of the household head (adjusted OR = 6.4, 95% CI: 1.05–39.7), age of women (adjusted OR = 3.03, 95% CI: 1.1–7.8), and wealth status (adjusted OR = 1.66, 95% CI: 0.51–5.4). Conversely, the occupation of women (adjusted OR = 0.13, 95% CI: 0.001–0.19), reading skills (adjusted OR = 0.27, 95% CI: 0.1–0.72), and family size (adjusted OR = 0.63, 95% CI: 0.35–1.1) were associated with lower odds of lower dietary diversity.ConclusionThe findings highlight a significant nutritional challenge among Rwandan women, with low dietary diversity, significant rates of anemia, and food insecurity. The study calls for an urgent need for targeted nutritional interventions to improve dietary diversity and address micronutrient deficiencies among women in agriculture to enhance maternal health and child development, thereby contributing to broader public health goals.

Accelerating Global Measles and Rubella Eradication-Saving Millions of Lives, Preventing Disability, and Averting the Next Pandemic.

No vaccine has been more effective in reducing disease burden, especially in preventing child deaths, than measles-containing vaccine. The return on investment makes measles-containing vaccine one of the most cost-effective public health measures available. Exhaustive reviews of biological, technical, economic and programmatic evidence have concluded that measles can and should be eradicated, and by including rubella antigen in measles-containing vaccine, congenital rubella syndrome will also be eradicated. All World Health Organisation Regions have pledged to achieve measles elimination. Unfortunately, not all countries and global partners have demonstrated an appropriate commitment to these laudable public health goals, and the negative impact of the COVID-19 pandemic on coverage rates has been profound. Unsurprisingly, large disruptive outbreaks are already occurring in many countries with a global epidemic curve ominously similar to that of 2018/2019 emerging. The Immunization Agenda 2030 will fail dismally unless measles and rubella eradication efforts are accelerated. Over half of all member states have been verified to have eliminated rubella and endemic rubella transmission has not been re-established in any country to date. In 2023, 84 countries and areas were verified to have sustained elimination of measles. However, without a global target, this success will be difficult to sustain. Now is the time for a global eradication goal and commitment by the World Health Assembly. Having a galvanising goal, with a shared call for action, will demand adequate resourcing from every country government and global partners. Greater coordination across countries and regions will be necessary. Measles, rubella and congenital rubella syndrome eradication should not remain just a technically feasible possibility but rather be completed to ensure that future generations of children do not live under the shadow of preventable childhood death and lifelong disability.

Dietary supplementation with a wild green oat extract (Avena sativa L.) to improve wellness and wellbeing during smoking reduction or cessation: a randomized double-blind controlled study.

Smoking reduction or cessation are critical public health goals, given the well-documented risks of tobacco use to health. Reducing smoking frequency and cessation entirely are challenging due to nicotine addiction and withdrawal symptoms, which can significantly affect mental wellness and overall wellbeing. Previous research has suggested that certain dietary supplements may support smoking cessation and reduction efforts by mitigating these adverse effects. The objective of this study was to assess the effect of supplementation with 900 mg/day of Neuravena®, a green oat extract (GOE) of Avena sativa L., in enhancing wellness and wellbeing during a smoking reduction or cessation experience. This was an 8-week randomized, double-blind, placebo-controlled study, ClinicalTrials Identifier: NCT04749017 (https://classic.clinicaltrials.gov/ct2/show/NCT04749017). Participants were assigned to one of the study groups, 72 participants were assigned to GOE and 73 to placebo. The subjects were followed for 8-weeks intervention period as well as an additional 4-week follow-up period. At subsequent visits, they underwent clinical assessments including assessments of quality of life, perceived stress, depression, nicotine dependence, anxiety, cognitive performance, and specific assessments of craving intensity. GOE was associated with greater improvements in elements of the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire as compared with placebo. Similar results were obtained from the SF-36 questionnaire and a visual QoL analogue scale (VAS). Perceived stress levels showed greater decline from baseline among the GOE supplemented participants as compared to placebo. Sleep quality parameters improved with GOE supplementation and worsened in the placebo group. At the end of the intervention period, the percentage of successful reducers (defined as >20% reduction in daily cigarettes) was higher in the GOE group as compared to placebo (66.7% vs. 49.3%, p = 0.034). The improvements from baseline in QoL measures in the GOE group persisted at 4 weeks after termination of the intervention. GOE supplementation demonstrated greater improvements in quality of life measures, stress and sleep related parameters during a smoking reduction or cessation experience and the product was shown to be safe and well tolerated.

Price elasticity of cigarette smoking in Bangladesh: evidence from the Global Adult Tobacco Surveys (GATS)

IntroductionThe overall prevalence of cigarette smoking has not changed significantly for over a decade in Bangladesh. Raising the price of cigarettes through taxation is an important policy instrument for reducing...

Transforming Public Health Practice With Generative Artificial Intelligence.

Public health practice appears poised to undergo a transformative shift as a result of the latest advancements in artificial intelligence (AI). These changes will usher in a new era of public health, charged with responding to deficiencies identified during the COVID-19 pandemic and managing investments required to meet the health needs of the twenty-first century. In this Commentary, we explore how AI is being used in public health, and we describe the advanced capabilities of generative AI models capable of producing synthetic content such as images, videos, audio, text, and other digital content. Viewing the use of AI from the perspective of health departments in the United States, we examine how this new technology can support core public health functions with a focus on near-term opportunities to improve communication, optimize organizational performance, and generate novel insights to drive decision making. Finally, we review the challenges and risks associated with these technologies, offering suggestions for health officials to harness the new tools to accomplish public health goals.

A chimeric haemagglutinin-based universal influenza virus vaccine boosts human cellular immune responses directed towards the conserved haemagglutinin stalk domain and the viral nucleoprotein

The development of a universal influenza virus vaccine, to protect against both seasonal and pandemic influenza A viruses, is a long-standing public health goal. The conserved stalk domain of haemagglutinin (HA) is a promising vaccine target. However, the stalk is immunosubdominant. As such, innovative approaches are required to elicit robust immunity against this domain. In a previously reported observer-blind, randomised placebo-controlled phase I trial (NCT03300050), immunisation regimens using chimeric HA (cHA)-based immunogens formulated as inactivated influenza vaccines (IIV)-/+ AS03 adjuvant, or live attenuated influenza vaccines (LAIV), elicited durable HA stalk-specific antibodies with broad reactivity. In this study, we sought to determine if these vaccines could also boost T cell responses against HA stalk, and nucleoprotein (NP). We measured interferon-γ (IFN-γ) responses by Enzyme-Linked ImmunoSpot (ELISpot) assay at baseline, seven days post-prime, pre-boost and seven days post-boost following heterologous prime:boost regimens of LAIV and/or adjuvanted/unadjuvanted IIV-cHA vaccines. Our findings demonstrate that immunisation with adjuvanted cHA-based IIVs boost HA stalk-specific and NP-specific T cell responses in humans. To date, it has been unclear if HA stalk-specific T cells can be boosted in humans by HA-stalk focused universal vaccines. Therefore, our study will provide valuable insights for the design of future studies to determine the precise role of HA stalk-specific T cells in broad protection. Considering that cHA-based vaccines also elicit stalk-specific antibodies, these data support the further clinical advancement of cHA-based universal influenza vaccine candidates. This study was funded in part by the Bill and Melinda Gates Foundation (BMGF).

Urgent actions needed by digital services platforms to help achieve conservation and public health goals

Urgent actions needed by digital services platforms to help achieve conservation and public health goals