Public Health Guidelines Research Articles

"Will I survive this?": A qualitative exploration of the wider impacts of the COVID-19 pandemic on the health and well-being of pregnant and parenting youth and their children in Canada.

Pregnant and parenting youth in Canada face multiple challenges in fulfilling their parenting responsibilities while meeting their own unique needs. The COVID-19 pandemic and its associated public health restrictions exacerbated their challenges by reducing access to support networks, limiting opportunities to promote growth and well-being, and destabilizing their financial and economic standing. The impacts of the pandemic on the mental, physical, and emotional health of individuals are well-documented in the literature. However, there is limited research on how the pandemic influenced the lives, health, and well-being of pregnant and parenting youth and their children in Canada. Therefore, we aimed to examine the wider impacts (social and structural determinants that directly or indirectly impact health and well-being) of the pandemic and its implications for this population. We used a constructivist grounded theory approach to explore the experiences of pregnant and parenting youth during the pandemic and how certain social determinants of health intersected to shape health outcomes and influence their ability to access services. We conducted qualitative interviews using a semi-structured interview guide over Zoom. Using grounded theory principles, we inductively analyzed the data and categorized our findings into themes. We recruited a total of 50 participants from different regions in Canada. The findings from the interviews were categorized into the following themes: (1) "They bear the burden alone": Struggles of pregnant and parenting youth, (2) "How will I live the next day?": Concerns and consequences arising from the pandemic, and (3) "Try to keep your mask on": Navigating healthcare services while maintaining public health guidelines. Our findings highlight the various challenges encountered by the youth during the pandemic, particularly those associated with financial and economic constraints, lack of accessible health and social services, and increased stress from parenting responsibilities. Pregnant and parenting youth in Canada encountered various barriers while accessing health and social services, maintaining their well-being, and connecting with reliable sources of support during the pandemic. Our study findings emphasize the urgent need for adaptable and comprehensive support systems explicitly catering to the needs of pregnant and parenting youth during crises, such as the pandemic.

Assessing the Potential Dangers of Cell Phone Use to Human Health: A Review of the Evidence on Cancer Risk

Cell phones have become ubiquitous in modern life, leading to concerns about potential health risks associated with prolonged exposure to radiofrequency electromagnetic fields (RF-EMF) emitted by these devices. This review examines the current scientific evidence on the potential link between cell phone use and cancer risk, focusing on epidemiological studies, experimental research, and mechanistic investigations. Epidemiological studies, including large-scale cohort studies and case-control studies, have produced mixed results, with some indicating possible associations between cell phone use and specific cancers such as glioma and acoustic neuroma, while others find no significant link. Experimental research has explored potential biological mechanisms, such as oxidative stress and DNA damage, but definitive connections to cancer remain elusive. Regulatory perspectives and public health recommendations emphasize cautious use, particularly among vulnerable populations. Despite extensive research, significant gaps remain, including limited long-term data and inadequate exploration of new technologies like 5G. Future research should address these gaps through long-term, interdisciplinary studies and improved exposure assessment methods. This review highlights the complexity of the issue and underscores the need for ongoing research to provide clearer insights and inform public health guidelines. Keywords: Cell phone use, cancer risk, radiofrequency electromagnetic fields (RF-EMF), epidemiological studies.

Enhancing Public Health: training an AI chatbot for complex tasks support

Abstract Background The evolution of Large Language Models (LLMs) such as GPT-4, Gemini, and Copilot has transformed the field of Natural Language Processing, demonstrating human-level capabilities and potential applications in Public Health. Here, we report on the training of a chatbot model based on GPT-4 designed to assist operators with relevant and complex public health tasks. Methods A scoping review of existing studies on the application of LLMs in Public Health settings was conducted to understand the landscape and identify gaps in their current implementations. We then proceeded to analyse the necessary skills and competencies required for public health professionals to adequately instruct the model on required tasks. Finally, we selected the Italian regulations and guidelines with the greatest relevance in the public health field to provide the knowledge base to the model. Results The review revealed no relevant documents on the use of LLMs in areas related to Public Health. Skills and competencies were retrieved from the Guidelines of the Italian Society of Hygiene for Public Health operators and used to instruct the model on how to address public health tasks. As for the knowledge base, we retrieved 25 documents regulating specific areas of the public health field, such as vaccinations, hygiene and safety at work, infection prevention, and school hygiene. Such documents were used to train the model, after formatting them appropriately. Conclusions Despite challenges with non-standardized and technically complex documentation, preliminary testing of our model has shown its versatility and utility in supporting daily public health operations. A validation phase is under definition and will involve a DELPHI process, in which products of the custom GPT model will be evaluated by a panel of public health operators to evaluate its performance in real-world settings, ensuring compliance with national health regulations. Key messages • Training a GPT-4-based chatbot to support complex tasks in Public Health, tailored by relevant national guidelines. • Our custom model, informed by public health guidelines, showed potential in preliminary tests.

“I stayed on the street, as if there was no COVID-19”: enacting practices of care with youth at risk of violence and social exclusion in Portugal

As the COVID-19 pandemic unfolded, a world of carelessness was made visible. Public health guidelines against the spread of COVID-19 (e.g., school closures, staying home, social distancing) have substantially affected youth’s health and well-being and highlighted the need for context-specific understandings of infection, risk, and care. Our research aims to contribute to a deeper understanding of the impacts of COVID-19 on boys and girls serving educational measures and placed in the custody of the juvenile justice system in Portugal during the pandemic. Sustained by the use of ethnographic principles and methods along with participatory techniques, this article uncovers complex entanglements between the public health measures to mitigate contagion and the dynamics that exacerbated socio-spatial dynamics of social exclusion and isolation, educational and (mental) health inequities, and lived and practiced forms of violence by youth-serving tutelary measures in Portugal’s six educational centers. Following Tronto’s feminist ethical–political proposal of care, I argue that COVID-19 became a lens to access youth care needs — self-care, care for others, care as essential work of nurturing affective trajectories and solidarities and promoting positive and non-violent relationships. By caring for youth stories, the engagement of researchers and professionals in this action-oriented research aimed to promote the enactment of practices of care with youth in the Portuguese detention centers as a way to positively affect their inhabited present, promote healthier lives and nurture the construction of caring and non-violent post-pandemic futures.

Toothbrushing habits are associated with self perceived stress

Abstract Background Personal self-care is one of the most important factors in maintaining and improving oral health. Public health guidelines are recommending tooth brushing at least twice daily, once before bed time and at least on one occasion. On the other hand, our regular routines and caring for our own health is influenced by different factors including stress. We wanted to research how much does daily stress influencing tooth brushing habits. Methods We analyzed data from 2020 CINDI nationwide cross-sectional survey in Slovenia. Tooth brushing once a day or less was assessed as inadequate. Stress was assessed with question >>How often in the last 14 days have you felt tense, stressed or under a lot of pressure? << Participants who chose often or always as an answer were assessed as persons under stress. Method of binary logistic regression was used for statistical analysis of association between tooth brushing frequency and self-perceived stress, modified for some socioeconomic factors. Results Prevalence of inadequate frequency of tooth brushing was present in 31,6 % of sample, 31,5% in participants who were not feeling tense and 31,8% in participants who often felt tense or stressed. At first it seemed stress is not associated with tooth brushing habits. We adjusted this association for gender, education level and age and this association became clearer. Participants who felt stress and/or under pressure had higher odds for poor tooth brushing habits, their odds ratio was 1,283 (p < 0,001; 95% CI 1,124; 1,464) when adjusted for aforementioned factors. Conclusions Oral health is integral part of general health. Association between oral and mental health is often overlooked even though psycho-social aspects are part of modern oral health definition. As personal self-care is cornerstone of maintaining and improving oral health, implementation of mental health aspects should be incorporated in public health advises and programmes for promoting oral health. Key messages • Self-perceived stress is associated with toothbrushing habits. • People who are under stress less regularly brush their teeth.

Mental Multimorbidity Among General-Population Adults: Sex-Specific Sociodemographic Profiles of Anxiety, Insomnia, and Eating Disorders.

To determine the prevalence and sociodemographic profiles of mental morbidity and multimorbidity. A descriptive analysis was performed with data from 25,269 women and 8,389 men from the French NutriNet-Santé general-population cohort. Participants were split into 8 groups: 1. No mental morbidity; 2. Pure anxiety; 3. Pure insomnia; 4. Pure eating disorders (ED); 5. Comorbid anxiety and insomnia; 6. Comorbid anxiety and ED; 7. Comorbid insomnia and ED; 8. Multimorbid anxiety, insomnia, and ED. Data were weighted using the 2016 French Census and analyzed with Chi2 tests. 40.6% of the participants had ≥1 mental disorder; 2.3% had all 3 disorders. Most pure and comorbid disorders were more common in women than in men. The multimorbidity group had the largest proportions of men who were overweight (52.1%) and current smokers (23.2%). Men with insomnia and ED were the most likely to have obesity (45.8%) and low physical activity (44.3%). Women with ≥2 disorders were the most likely to be current smokers. The findings could inform research, prevention, and public health guidelines for multimorbidity.

A Study of Sociocultural Adaptation for Practices of Religious Doctrines during the Covid-19 Pandemic and Using the Religious Dimension to Prevent and Mitigate the Covid-19 Pandemic

This article presents the findings of a study on the effects of sociocultural adaptation on religious practices during the COVID-19 pandemic and the utilization of the religious dimension to prevent and mitigate the spread of the virus. The results stem from a mixed-methods research approach involving quantitative and qualitative data collection from 15,505 participants through questionnaires. Statistical analysis comprises numerical summaries such as counts, percentages, means, standard deviations, and qualitative content analysis. Data presentation employed descriptive analytics. Findings revealed: 1) Among Thai followers, a high adherence to religious practices was observed (94.62%). Brahmanism-Hinduism adherents demonstrated the highest adherence (100.00%), followed by Sikhs (94.60%), Muslims (93.60%), Buddhists (92.50%), and Christians (92.43%). 2) Sociocultural adaptation for religious practices during the pandemic aligned with public health guidelines, emphasizing social distancing, mask-wearing, and frequent hand sanitization. 3) Clear directives were established for utilizing religious practices to combat COVID-19, ensuring conformity with the Ministry of Public Health protocols for all religious ceremonies, both auspicious and inauspicious. Additionally, education played a vital role in disseminating these guidelines effectively to religious communities, fostering greater compliance and understanding.

How big is too big? A qualitative study of discretionary food portion size norms among Australian consumers.

The high availability of energy-dense nutrient-poor discretionary foods in large serving and package sizes may have shifted portion size norms (described as a typical perception of how much people choose to eat from a given food at a single eating occasion) towards larger sizes. Few public health recommendations exist around appropriate discretionary food portion sizes. This qualitative study aimed to explore the underlying rationale of portion size norms of discretionary foods among Australian adults 18-65 years. Four focus group sessions were conducted. Collected data were analysed using inductive thematic analysis. Focus groups were held online via Zoom between September and October 2023. Thirty-four participants were recruited in the study (mean age 38 years, 19 females). The key themes raised from inductive analysis were personal factors, eating context factors, and food environment factors relevant to the portion size norms. A framework was established to illustrate the interaction across these themes during the conceptualisation of the norms. For serving size availability, consumers found that there were limited serving size choices when making portion size selections and lacked the knowledge and skills in portion control. These findings highlight the need to make positive changes to the current food environment and develop relevant public health guidelines around appropriate portion sizes to promote healthier portion size norms and enable better portion control.

Developing a High School Mental Health Action Checklist in Thailand: insights on perception and communication.

This study aimed to develop a mental health action checklist for high school students that emphasized the importance of readiness, safety, and good hygiene at work to enhance their mental health and prepare them for the workforce. In total, 949 students from public high schools in Bangkok, Thailand voluntarily participated in this study. The 15-item High School Mental Health Action Checklist was developed based on a literature review and a pilot study. We used the index of item-objective congruence (IOC) to verify the content validity of the Checklist and exploratory factor analysis (EFA) to establish its construct validity. The tool's internal consistency was estimated using Cronbach's alpha coefficient. The High School Mental Health Action Checklist had good content (IOC = 0.867) and construct validity. EFA revealed four factors that accounted for 46.5% of the variance. The overall reliability coefficient for the High School Mental Health Action Checklist was 0.788, and the reliability coefficients of the subdomains were 0.783-0.797. The Checklist will allow schools to develop an annual action plan for student mental health promotion activities, in accordance with public health guidelines. Our results indicate the High School Student Mental Health Action Checklist has good psychometric properties.

Integrating ethics in public health guideline development: a case-study of the NTCA guidelines on respiratory isolation for persons with TB in community settings.

Public health interventions often involve explicit tradeoffs in which the health of the many must be weighed against burdens imposed on individuals. We describe development of public health guidelines for respiratory isolation in community settings for persons with tuberculosis. While stopping the spread of disease is a core moral imperative in public health, the duty to prevent disease transmission does not supersede all other considerations. Community wellbeing must be balanced with individual wellbeing, liberty, and social justice. In response to these challenges, the National TB Coalition of America's (NTCA) 2024 Guidelines for persons with tuberculosis in community settings were developed using a modified GRADE approach supported by a complementary, comprehensive, and context-specific ethical framework. By addressing the distinct roles that evidence (subject to uncertainty), values, justificatory conditions, and procedural legitimacy all play in ethical guideline development, we promote rigor and transparency in the integration of ethics in public health guidelines.

Effect of coastal and island geographic environments on patients with acute ischemic stroke in southeastern China.

To analyze the geographic variation in characteristics and treatment processes of patients with acute ischemic stroke (AIS) in coastal, island, and inland regions. We conducted a retrospective, cross-sectional analysis of data from patients with AIS in southeastern China. We collected demographic and clinical information, including the time from stroke onset to treatment for those receiving reperfusion therapy, using a time-tracking table. Among 8069 patients with AIS, 26.6% received reperfusion therapy, with a higher proportion undergoing endovascular therapy in maritime hospitals than in inland hospitals (14.2% vs. 6.7%). Maritime hospitals had a higher prevalence of atrial fibrillation (15.1% vs. 11.9%) and cardioembolism (17.2% vs. 13.6%) than inland hospitals. Patients in maritime hospitals had shorter in-hospital processing times than those in inland hospitals (39 vs. 46 minutes). Island hospitals showed different patterns, with a shorter time from stroke onset to emergency room arrival (80 vs. 120 minutes) but a longer in-hospital process time (51 vs. 36 minutes), than coastline hospitals. Our study suggests geographic variation in AIS characteristics and treatment processes across southeastern China, emphasizing the need for region-specific strategies. These findings are essential for tailoring public health policies and guidelines to improve stroke outcomes in various regions.

Evaluating the Influence of Role-Playing Prompts on ChatGPT's Misinformation Detection Accuracy: Quantitative Study.

During the COVID-19 pandemic, the rapid spread of misinformation on social media created significant public health challenges. Large language models (LLMs), pretrained on extensive textual data, have shown potential in detecting misinformation, but their performance can be influenced by factors such as prompt engineering (ie, modifying LLM requests to assess changes in output). One form of prompt engineering is role-playing, where, upon request, OpenAI's ChatGPT imitates specific social roles or identities. This research examines how ChatGPT's accuracy in detecting COVID-19-related misinformation is affected when it is assigned social identities in the request prompt. Understanding how LLMs respond to different identity cues can inform messaging campaigns, ensuring effective use in public health communications. This study investigates the impact of role-playing prompts on ChatGPT's accuracy in detecting misinformation. This study also assesses differences in performance when misinformation is explicitly stated versus implied, based on contextual knowledge, and examines the reasoning given by ChatGPT for classification decisions. Overall, 36 real-world tweets about COVID-19 collected in September 2021 were categorized into misinformation, sentiment (opinions aligned vs unaligned with public health guidelines), corrections, and neutral reporting. ChatGPT was tested with prompts incorporating different combinations of multiple social identities (ie, political beliefs, education levels, locality, religiosity, and personality traits), resulting in 51,840 runs. Two control conditions were used to compare results: prompts with no identities and those including only political identity. The findings reveal that including social identities in prompts reduces average detection accuracy, with a notable drop from 68.1% (SD 41.2%; no identities) to 29.3% (SD 31.6%; all identities included). Prompts with only political identity resulted in the lowest accuracy (19.2%, SD 29.2%). ChatGPT was also able to distinguish between sentiments expressing opinions not aligned with public health guidelines from misinformation making declarative statements. There were no consistent differences in performance between explicit and implicit misinformation requiring contextual knowledge. While the findings show that the inclusion of identities decreased detection accuracy, it remains uncertain whether ChatGPT adopts views aligned with social identities: when assigned a conservative identity, ChatGPT identified misinformation with nearly the same accuracy as it did when assigned a liberal identity. While political identity was mentioned most frequently in ChatGPT's explanations for its classification decisions, the rationales for classifications were inconsistent across study conditions, and contradictory explanations were provided in some instances. These results indicate that ChatGPT's ability to classify misinformation is negatively impacted when role-playing social identities, highlighting the complexity of integrating human biases and perspectives in LLMs. This points to the need for human oversight in the use of LLMs for misinformation detection. Further research is needed to understand how LLMs weigh social identities in prompt-based tasks and explore their application in different cultural contexts.

Emerging trends in cannabis administration for women with chronic pain

AbstractCannabis use among women who experience chronic pain is on the rise in the United States. However, little is known about women's motives and preferences for cannabis administration. The purpose of this study was to characterize cannabis use among women with chronic pain. This study examined self‐reported forms of cannabis administration and preferred source of cannabis, frequency and quantity of use, and self‐reported side effects, and type, level, and intensity of chronic pain among adult women in the United States. This study also compared women who use cannabis for chronic pain and those who do not across the level of chronic pain, length of chronic pain, and the number of types of chronic pain experienced. Participants showed a significant preference (60%) for using recreational cannabis to treat chronic pain but reported that medical cannabis was more effective. For participants who preferred medical cannabis 24.3% reported daily use, as compared to only 7.8% of recreational cannabis users. Smoking was the most common form of administration (62.1%), followed by edibles (25.3%), vaporizing in any form (7.4%), tinctures and concentrates (3.2%), and topicals (2.1%). Participants reported using 1–6 different forms of cannabis administration. Those who preferred smoking were significantly likely to use all other forms of administration. However, those who preferred alternatives to smoking were significantly likely to use all forms of administration except for smoking. Medical cannabis users preferred to obtain cannabis from a dispensary, while recreational users preferred to obtain cannabis from unlicensed sources. Additionally, participants who used cannabis for chronic pain reported a 74% reduction in past 30‐day opioid use. Future research is needed to investigate the health effects associated with single and combined forms of cannabis administration for women with chronic pain. Results can inform educational and intervention programs, treatment development, content regulation of products, policy formation, women's health research, and public health guidelines.

Comparing E-Cigarettes and Traditional Cigarettes in Relation to Myocardial Infarction, Arrhythmias, and Sudden Cardiac Death: A Systematic Review and Meta-Analysis.

The use of electronic cigarettes (e-cigarettes) as a perceived safer alternative to traditional cigarettes has grown rapidly. However, the cardiovascular risks associated with e-cigarettes compared to regular cigarettes remain unclear. To systematically review and compare the cardiovascular outcomes of e-cigarette use versus traditional cigarette use, focusing on the risks of myocardial infarction, arrhythmias, and sudden death. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed studies published in English were included if they reported cardiovascular outcomes related to e-cigarette or traditional cigarette use. A total of 20 studies were included, covering observational and interventional studies focusing on heart rate variability, myocardial infarction, arrhythmias, and sudden cardiac events. The quality of the evidence was assessed using the GRADE criteria, and data were extracted and analyzed based on the PICOS (Population, Interventions, Comparisons, Outcomes, and Study designs) framework. The systematic review found that both e-cigarettes and traditional cigarettes pose significant cardiovascular risks, with traditional cigarettes linked to a higher incidence of myocardial infarction, arrhythmias, and sudden cardiac death. E-cigarette users also face increased risks of arrhythmias and myocardial infarction compared to non-smokers, primarily due to the constituents of aerosolized e-liquid, including nicotine and flavorings, which contribute to adverse cardiac effects. Regular e-cigarette use, particularly in combination with traditional cigarette use, was associated with a heightened risk of myocardial infarction. Studies also reported heart function abnormalities, such as systolic and diastolic dysfunction, and reduced ejection fractions. Additionally, changes in heart rate variability, heart rate, and blood pressure were observed, indicating both acute and chronic effects of e-cigarettes on cardiovascular autonomic regulation. While e-cigarettes may present a lower cardiovascular risk compared to traditional cigarettes, they are not without harm. Both products are linked to increased risks of myocardial infarction and arrhythmias, though traditional cigarettes pose a higher overall threat. Given the limitations in the current evidence base, particularly concerning the long-term effects of e-cigarette use, further research is needed to clarify these cardiovascular risks and inform public health guidelines.

Isolation and identification of major cockroaches associated pathogenic bacteria in Bonga town, Ethiopia

Cockroaches are a reservoir of various pathogenic microorganisms that pose a significant risk to public health because of unsanitary living spaces, poor waste management, inappropriate food storage, limitations of public health guidelines, and education on hygiene practices. The aim of this study was to isolate and identify major pathogenic bacteria associated with cockroaches in Bonga Town, Kaffa Zone. A total of 300 cockroaches were collected from Restaurants, Houses, and Hospitals, with 100 specimens from each location. The collected cockroaches were then subjected to microbiological analysis in the laboratory to identify potential bacterial pathogens. The cockroaches were killed using cotton-soaked chloroform, surface-sterilized using 70 % ethanol, and dissected aseptically. The cockroaches were added to 2 mL of sterile normal saline and shaken thoroughly for two minutes. The cockroaches were taken out of the tubes, and the remaining liquid was centrifuged at 2000 rpm for 10 minutes. The supernatants were then removed, and the remaining sediments were used for culture. In each tube, a fixed volume of 1 mL of the sediments was cultured on various culture media separately. Different species of bacteria with similar morphological characteristics were identified on the external and internal surfaces of the cockroaches. These results indicate the morphological characteristics of the colonies grown on each agar plate in different settings (Hospital, Restaurants and Households). The specific characteristics of the colonies can help in identifying different bacterial species. The isolated pathogens were then identified using standard microbiological techniques, including gram staining, morphology, microscopic slides, and biochemical tests. The results revealed the presence of bacterial pathogens, including E. coli, Salmonella, Pseudomonas, Staphylococcus spp., Shigella spp., and Proteus spp. The bacterial species were predominantly found in Households and Hospital areas, while fewer were found in restaurant areas. The presence of these pathogenic bacteria in cockroaches highlights the potential risk of food contamination and subsequent human diseases. Therefore, further analysis and characterization of these pathogenic bacteria should be done at the molecular level, and more clinical evaluation must be undertaken after the final identification and characterization.

A comparative analysis of 24-hour movement behaviors features using different accelerometer metrics in adults: Implications for guideline compliance and associations with cardiometabolic health.

Movement behavior features such as time use estimates, average acceleration and intensity gradient are crucial in understanding associations with cardiometabolic health. The aim of this study was to 1) compare movement behavior features processed by commonly used accelerometer metrics among adults (i.e. Euclidian Norm Minus One (ENMO), Mean Amplitude Deviation (MAD) and counts per minute (CPM)), 2) investigate the impact of accelerometer metrics on compliance with movement behavior guidelines, and 3) explore potential variations in the association between movement behavior features and cardiometabolic variables depending on the chosen metric. This cross-sectional study collected movement behavior features (Actigraph GT3X+) and cardiometabolic variables. Accelerometer data were analyzed by four metrics, i.e. ENMO, MAD, and CPM vertical axis and CPM vector magnitude (GGIR). Intraclass correlations and Bland‒Altman plots identified metric differences for time use in single movement behaviors (physical activity, sedentary behavior), average acceleration and intensity gradient. Regression models across the four metrics were used to explore differences in 24-hour movement behaviors (24h-MBs; compositional variable) as for exploration of associations with cardiometabolic variables. Movement behavior data from 213 Belgian adults (mean age 45.8±10.8 years, 68.5% female) differed according to the metric used, with ENMO representing the most sedentary movement behavior profile and CPM vector magnitude representing the most active profile. Compliance rates for meeting integrated 24h-MBs guidelines varied from 0-25% depending on the metric used. Furthermore, the strength and direction of associations between movement behavior features and cardiometabolic variables (body mass index, waist circumference, fat% and HbA1c) differed by the choice of metric. The metric used during data processing markedly influenced cut-point dependent time use estimates and cut-point independent average acceleration and intensity gradient, impacting guideline compliance and associations with cardiometabolic variables. Consideration is necessary when comparing findings from accelerometry studies to inform public health guidelines.

Physical Activity and Its Effects on Cancer Prevention, Survival Rates, and Recovery

Introduction and Objective: Physical activity is any movement using skeletal muscles. It can be classified into four main categories: occupational, household, transport and recreational. These activities can also vary in intensity. This article aims to describe how physical activity affects cancer prevention, survival rates and recovery. Review and Methods: Review and summary of studies and meta-analysis of studies available in open-source format on Google Scholar and PubMed. State of Knowledge: Extensive research shows that regular physical activity reduces the risk of several cancers, particularly breast, colon, and endometrial cancers. Epidemiological studies consistently find that more active individuals have a lower incidence of certain cancers. Physical activity is also a useful adjunct to treatment, alleviating its negative effects. The protective effect of physical activity is believed to be dose-dependent, with greater benefits from higher frequencies, durations, and intensities. Recent studies suggest that physical activity may also improve survival rates in cancer patients, particularly for prostate, colorectal, and breast cancers. Conclusions: The current data strongly supports the inclusion of regular physical activity as a key component of cancer prevention strategies. It may also be beneficial for cancer patients to enhance their chances of survival. Public health guidelines stress the importance of exercise to lower cancer risk and improve overall health.

Alcohol Consumption and Cardiovascular Disease: A Narrative Review of Evolving Perspectives and Long-Term Implications.

Cardiovascular illnesses remain the primary cause of death, accounting for at least 17.9 million fatalities per year and posing a significant public health problem because of its extensive predominance and effect on healthcare systems. The etiology of cardiovascular disease is complex and involves several environmental and lifestyle factors. Alcohol use is a highly important determinant because of its dual-edged effect on cardiovascular health. Multiple studies indicate that moderate alcohol consumption may have certain advantages, such as slight enhancements in lipid profiles. Conversely, excessive alcohol intake is associated with serious negative consequences, including cardiomyopathy, hypertension, arrhythmias, and even mortality. The aim of this study is to provide a comprehensive analysis of the several effects of alcohol on cardiovascular health and their understanding within the medical field over time. It uses an interpretative narrative review methodology and analyzes studies that focus on genetic risk factors, gender differences, and shifts in paradigms in recent years. This article highlights the need for obtaining a thorough understanding of the effects of alcohol on cardiovascular health to support public health guidelines and clinical practice, and it underscores the significance of including alcohol consumption into the broader context of cardiovascular risk management and identifies important subjects for further study.

"Life as We Knew It": Continued Challenges in Getting Up-to-Date COVID-19 Vaccinations Amongst Black and Latinx Michigan Residents.

Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination. Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted. Findings indicate participants' lack of confidence in the COVID-19 vaccine's efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial. There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.

Facilitators and barriers to implementing successful exclusion among children with shiga toxin-producing Escherichia coli: a qualitative analysis of public health case management records

BackgroundShiga toxin-producing Escherichia coli (STEC) infections are a significant public health concern as they can cause serious illness and outbreaks. In England, STEC incidence is highest among children and guidance recommends that children under six diagnosed with STEC are excluded from childcare until two consecutive stool cultures are negative. We aimed to describe the barriers and facilitators to implementing exclusion and the impact of exclusion policies on young children and their families.MethodsIndividual level data was obtained from a wider study focusing on shedding duration among STEC cases aged < 6 years between March 2018 – March 2022. Data was extracted from England’s public health case management system. The case management system includes notes on telephone conversations, email correspondence and meeting minutes relating to the case. Collected data consisted of free text in three forms: (1) quotes from parents, either direct or indirect, (2) direct quotes from the case record by health protection practitioners or environmental health officers, and (3) summaries by the data collector after reviewing the entire case record. We analysed free text comments linked to 136 cases using thematic analysis with a framework approach.ResultsThe median age of included cases was 3 years (IQR 1.5-5), with males accounting for 49%. Nine key themes were identified. Five themes focused on barriers to managing exclusion, including (i) financial losses, (ii) challenges with communication, engagement and collaboration, (iii) issues with sampling, processing, and results, (iv) adverse impact on children and their families and (v) conflicting exclusion advice. Four themes related to facilitators to exclusion, including (i) good communication with parents and childcare settings, (ii) support with childcare, (iii) improvements to sampling, testing, and reporting of results, and (iv) provision of supervised control measures.ConclusionsQualitative analysis of public health case records can provide evidence-based insights around complex health protection issues to inform public health guidelines. Our analysis highlights the importance of considering wider social and economic consequences of exclusion when developing policies and practices for the management of STEC in children.