Public Health Improvement Research Articles

Epidemiological shifts in chronic kidney disease: a 30-year global and regional assessment

BackgroundChronic kidney disease (CKD) presents a growing global health challenge, with significant variability in disease burden across different regions and countries. This study aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for CKD from 1990 to 2019, utilizing data from the Global Burden of Disease Study.MethodsWe conducted an in-depth study on the global and age-standardized incidence, prevalence, mortality, and DALYs of CKD, and assessed trends over a 30-year period. Additionally, we explored the associations between healthcare access and quality (HAQ), the Socio-Demographic Index (SDI), and CKD. Furthermore, we conducted a detailed analysis of six risk factors closely related to CKD, and based on these findings, provided strong evidence for enhancing the management of CKD.ResultsIn 2019, there were 18,986,903 cases of CKD, with an average annual percent change (AAPC) of 1.82 (95% CI = 1.8 to 1.82) in incidence since 1990. The age-standardized incidence rate increased from 192.45 per 100,000 in 1990 to 233.65 per 100,000 in 2019. Prevalence also rose, with a total of 69,729,430 cases in 2019 and an AAPC of 1.19 (95% CI = 1.19 to 1.2). Mortality and DALYs have increased correspondingly, with the mortality rate reaching 18.29 per 100,000 and total DALYs at 41,538,592 in 2019. The analysis showed that higher HAQ levels are associated with better outcomes in terms of lower mortality and DALY rates, whereas lower HAQ levels correlate with poorer outcomes. In addition, high fasting plasma glucose and high systolic blood pressure are the main contributors to CKD-related deaths, with their population attributable fraction (PAF) significantly decreasing as the SDI decreases.ConclusionThe burden of CKD has significantly increased over the past three decades, influenced by demographic changes and variations in healthcare quality and access. Effective public health strategies and improvements in healthcare delivery are needed to address the disparities in CKD outcomes globally.

Projected health benefits of air pollution reductions in a Swedish population.

A large part of the Swedish population is exposed to higher levels of air pollution than the health-centered air quality guidelines recommended by the World Health Organization (WHO). The aim of the study was to illustrate the potential health benefits of cleaner air in Sweden by conducting a comprehensive health impact assessment, using a population sample of 100,000 individuals representing the country's demographics. Exposure-response functions for various health outcomes were derived from epidemiological literature, mainly from systematic reviews and low-exposure settings. Two hypothetical scenarios were studied: a 1 µg/m3 decrease in particulate matter with an aerodynamic diameter <2.5µm (PM2.5) and nitrogen dioxide (NO2), and a reduction in PM2.5 or NO2 from average exposure corresponding to Sweden's Clean Air objectives to WHO's air quality guidelines. The findings demonstrated that even a modest decrease in air pollution concentrations can yield significant health benefits. For example, reducing PM2.5 by 1 µg/m3 was projected to correspond to a 1% to 2% decrease in mortality, a 2% reduction in myocardial infarction cases, a 4% decrease in stroke incidence, a 2% decline in chronic obstructive pulmonary disease, and a 1% decreases in lung cancer and type 2 diabetes annually. Moreover, this reduction is estimated to lower childhood asthma cases, incidences of hypertension during pregnancy, and premature births by 3%, 3% and 2%, respectively, each year. The results highlighted that even minor enhancements in air quality would lead to substantial improvements in public health.

Innovative development of territories based on the integrated use of social, resource and environmental potential

This article investigates the interrelationships and interdependencies inherent in the integrated use of the territory’s social, resource, and environmental potential to achieve its sustainable development. The basic hypotheses formulated during this study were as follows: Sustainable development of the territory’s resource and ecological potential cannot be achieved if its social potential is reduced; Sustainable development of the territory’s ecological and social potential can be achieved only if it is economically feasible, that is if it contributes to the sustainable development of the territory’s resource potential; Sustainable development of the territory’s resource and social potential cannot be achieved while its ecological potential deteriorates; Ensured sustainable development of territories in today’s world is only possible with simultaneous integrated use of the territory’s social, resource, and environmental potential. The aim of this research is to investigate the interrelationships among these three components and to determine their impact on the overall development of the regions. A comprehensive multi-stage research project based on the analysis of statistical information and survey results was designed and applied to meet the research objective. Methodologically, the study was based on a quantitative approach, which led to the integrated use of economic-statistical and econometric data processing methods. All these hypotheses were tested and found to be true in the Kizilsu Kyrgyz Autonomous Prefecture of the People’s Republic of China. The results indicate a direct and stable relationship between the development of resource potential, ecological potential, and social potential of the territories. Specifically, regions with high resource potential exhibit better social indicators, while ecological investments contribute to the improvement of public health and quality of life. The originality of this study lies in its comprehensive approach to examining the interconnections among resources, social aspects, and ecological sustainability, thereby contributing to the international literature in the field of sustainable development. These results can be of use to state and municipal government experts when planning territorial development, as well as to academic researchers, including to identify promising avenues for later research.

Eco-friendly synthesis and high-efficiency adsorption of potassium permanganate using a magnetic hydrochar composite derived from Calotropis procera

Water pollution poses significant health and environmental risks, impacting ecosystems and human health. This study investigates the removal of potassium permanganate (KMnO4) from water using a magnetic hydrochar composite (HTCNP) synthesized from Calotropis procera (CP) leaves through a single-step hydrothermal carbonization process. This eco-friendly and efficient synthesis method provides an advantageous alternative to traditional multi-step processes. Structural analysis confirmed the composite’s porous structure and functional groups that contribute to effective adsorption. Under optimal conditions (pH 7, adsorbent dose of 1 g/L, contact time of 60 minutes, and temperature of 298 K), HTCNP achieved a maximum adsorption capacity of 388.09 mg/g. Adsorption kinetics followed a pseudo-second-order model, and the adsorption behavior aligned with the Freundlich isotherm, indicating multilayer adsorption on a heterogeneous surface. Furthermore, the HTCNP composite demonstrated good reusability over five cycles, maintaining high removal efficiency, and effectively removed KMnO4 from real wastewater samples. These findings highlight the potential of HTCNP as an efficient, sustainable, and practical adsorbent for water purification applications, contributing to environmental protection and public health improvement.

Genomic Surveillance of Foodborne Pathogens: Advances and Obstacles

Context: The genomic surveillance of foodborne pathogens in the United States has grown exponentially in the past decade, grounded in a powerful combination of novel sequencing technologies, bioinformatic approaches, data-sharing networks, and metadata harmonization efforts. This practice report examines recent advances in genomic epidemiology as applied to food safety programs and delineates State, Tribal, Local, and Territorial infrastructure necessary for continued life-saving improvements in public health. Program: National databases of foodborne pathogen genomes, along with data sharing and evaluation networks such as GenomeTrakr and PulseNet, have transformed how connections are made among isolates and how root causes of outbreaks are determined, allowing much more timely interventions to protect public health. Freely available bioinformatics tools such as GalaxyTrakr and the National Center for Biotechnology Information Pathogen Detection database have allowed laboratories with limited local computing resources to participate in surveillance efforts and contribute to traceback investigations. Implementation: In this report, we describe advances in genomic epidemiology that have occurred over the past decade and examine obstacles to fully implementing this technology within State, Tribal, Local, and Territorial public health systems. Evaluation: Despite a clear return on investment from governmental expenditures on genomic surveillance of foodborne pathogens, we identify significant obstacles to further sustained progress. These obstacles include workforce gaps, ineffective data sharing, and lack of constitutive and sustained funding. Discussion: Many public health laboratories face major obstacles to widespread and routine adoption of genomic surveillance technologies. While whole genome sequencing has become an integral part of routine public health microbiology, the seamless integration of these protocols into the existing practices, laboratory workflows, and information systems remains challenging. Centralized efforts to address these issues include (1) support through the Food and Drug Administration Laboratory Flexible Funding Model, (2) training and proficiency assessments, (3) open-source, standardized protocols for collecting high-quality genomic data, and (4) open access informatics software.

Data Security and Privacy Protection in Health Information Management: Challenges and Solutions

This study provides a comprehensive review of the current trends and future challenges in the field of Health Information Management (HIM). With advancements in technologies such as big data, cloud computing, and artificial intelligence, the global health information management market is projected to experience rapid growth. Research indicates that HIM not only enhances the efficiency and quality of healthcare services but also contributes to improvements in public health and medical services worldwide. However, despite these significant advancements, the field continues to face numerous challenges, including patient data privacy and security, optimization of user interface design, and the demand for personalized information services. Therefore, this study focuses on these core issues and reviews related research in the field of health information management. It analyzes the advantages and limitations of various methods and technologies and predicts future development trends. Consequently, interdisciplinary collaboration, technological innovation, and personalized services are expected to be key directions for future development. This study not only reviews current trends and challenges in health information management but also provides strategic insights and innovative approaches that contribute to advancing the field, setting the stage for future research and practical improvements in data security and privacy.

Navigating the Global Dietary Transition and Its Impact on Planetary and Human Health: The Role of Middle-Income Countries

Abstract This case study examines global dietary transitions and their impact on environmental sustainability, nutritional well-being, and socio-economic inequalities, focusing on middle-income countries (MICs) like China, India, Brazil, Turkey, and Mexico. As economic expansion, urbanization, and cultural shifts drive changes in eating habits, MICs encounter both advantages and disadvantages. The study explores how socio-economic transformation influences dietary preferences, resulting in increased consumption of processed foods and animal-based products, linked to rising non-communicable diseases and environmental impacts such as greenhouse gas emissions and resource depletion. It delves into the influence of cultural heritage and social norms on dietary practices, alongside the impact of Western dietary patterns and media. Additionally, the case study underscores the role of governmental strategies in fostering sustainable and nutritious diets through policies that support local agriculture and public health. It also investigates contributions from the private sector and emphasizes the significance of community-driven and grassroots movements in promoting sustainable dietary habits and reinforcing food security. This study aims to provide insights into the interconnection between dietary transitions, their environmental and nutritional impacts, and the socio-economic drivers and disparities within and across MICs, offering guidance for sustainable development and public health improvement. Information © The Author 2024

Multidisciplinary management of gastroesophageal reflux disease: an italian retrospective study

Abstract Background Millions of individuals are affected by gastroesophageal reflux disease (GERD) that causes significant discomfort negatively affecting patients’ overall quality of life. For a collaborative approach of continuous improvement in public health we wanted to know the real-world perspectives in the multidisciplinary and multimodal management pathway. Methods We aimed to interview a sample of gastroenterologists (GE), primary care physicians (GP), and otolaryngologists (ENT) to investigate the management of the intake and treatment of patients reporting symptoms of GERD. Symptoms were divided into typical and extraesophageal, and their severity and impact on quality of life was explored with the GERD Impact Scale (GSI) and Reflux Symptom Index (RSI). Results A total of 6211 patients were analyzed of whom with typical symptoms were 53.5%, while those with extraesophageal symptoms were 46.5%. The latter were more frequently reported by ENT patients (53.6%, p &amp;lt; 0.0001). GSI was highest in patients followed by GE (9 points) and GP (9 points) than ENT specialists (8 points), while the RSI was higher in the ENT group (14.3 ± 6.93) than in the groups of GP and GE, respectively (10.36 ± 6.36 and 10.81 ± 7.30, p &amp;lt; 0.0001). Chest pain had the greatest negative impact on quality of life (p &amp;lt; 0.0001). Of the 3,025 patients who used (proton pump inhibitors) PPIs, non-responders had a lower GSI when treated with a combination of adjunctive drug treatments and bioadhesive compounds, compared with single-component drugs. Conclusions The multidisciplinary and multimodal approach to the management pathway of GERD patients reveals variations in patient profiles by physician specialty, directing toward more appropriate and targeted treatments. In addition, the combination of adjunctive drug treatments and bioadhesive compounds appears to be effective in the management of patients refractory to PPIs. Key messages • The presentation of GERD symptoms is different in accordance with the physician’s speciality: the patients with GERD referred to a gastroenterologist had more severe disease and poorer quality of life. • The combination of adjunctive pharmacological treatments and bioadhesive compounds seems to be effective in the management of PPI refractory patients.

The Relationship Between Mental Health Status and Daily Step Count in Adults: A Cross-Sectional Study

Abstract Aim This study was conducted to determine the relationship between the mental health status and daily step count of adult individuals. Methods The research was conducted between November 2023 and April 2024 with a descriptive cross-sectional design. The research population consisted of 386 individuals over the age of 18 who voluntarily filled out public electronic forums on online platforms. Data were collected with the socio-demographic characteristics diagnostic form consisting of 21 questions, the average number of steps in the last week, and the General Health Survey-28 (GHQ-28). Data were evaluated using descriptive statistics, normality statistics, analysis of variance (ANOVA), t test, Kruskal Wallis variance analysis, Mann-Whitney U test. Statistical significance level was accepted as p &amp;lt; 0.05 Results GHQ-28 total score average was found to be 5.59 ± 6.52. 42.0% of the participants received a score of 5 or above on the GHQ-28 and were considered at risk for mental health. The individuals’ average weekly step count was mean=5269±3065 steps and 43% were basal-limited active. According to GHQ-28, the average weekly step count of individuals in the mental health risk group (4528.62 ±2892.31) was lower than those who were not at risk (5804.63 ±3081.67) (p &amp;lt; 0.05). According to step count categories, individuals who were basal-limited active (51.2%) and low active (39.4%) were found to be at higher risk for mental health than those who were slightly active (36.0%) and active-highly active (18.4%) (p &amp;lt; 0.05). A weak negative correlation was found between the average number of steps and the scores obtained from the GHQ-28 (r = -.187; p = 0.000). Conclusions It was determined that more than half (51.2%) of the individuals (42.0%) in the risk group in terms of mental health were sedentary, that is, basal-limited active (less than 2500-4999 steps). Key messages • Increasing awareness about the positive effects of individuals’ daily step counts on mental health can contribute positively to the promotion of health. • As part of policies aimed at enhancing mental health within society, implementations directed towards increasing daily step counts can contribute positively to the improvement of public health.

The relationship between health literacy and healthy lifestyle behaviors: A meta-analysis.

Health literacy and healthy lifestyle behaviors are both pivotal elements for public health improvement. This meta-analysis aims to scrutinize studies investigating the nexus between health literacy and healthy lifestyle behaviors and to examine the correlation between health literacy and such behaviors. Studies conducted from 2013 to 2023 exploring the association between health literacy and healthy lifestyle behaviors, as well as the impact of gender and chronic disease status on health literacy, were included. The selection criteria for the meta-analysis involved a literature search utilizing databases such as PubMed, Google Academic, Web of Science, and the National Thesis Center. The keywords "health literacy" and "healthy lifestyle behaviors" were employed, identifying 206 studies. Subsequently, 53 studies meeting predetermined criteria were deemed suitable for inclusion in the meta-analysis. The analysis of the relationship between health literacy and healthy lifestyle behaviors revealed no publication bias. Despite heterogeneity among the studies, the correlation effect size was determined to be 0.278 using the random effect model. In the meta-analysis examining the effect of gender on health literacy, no publication bias was detected. Since there was heterogeneity among the studies, the average effect size was calculated as 0.078 according to the random effect model. Regarding the meta-analysis on the effect of chronic disease status on health literacy, no publication bias was observed, and due to homogeneity between the studies, the average effect size was determined to be -0.098 using the fixed effect model. A positive yet weak relationship was identified between health literacy and healthy lifestyle behaviors. Notably, gender was a significant sociodemographic factor affecting health literacy, with higher levels observed in women. Moreover, individuals without chronic diseases exhibited higher mean health literacy scores than those with chronic diseases.

Dr. Kiyoshi Shiga (1871-1957): Outstanding Bacteriologist Who Discovered Dysentery Bacillus and Contributed Immensely to Public Health in Japan.

Kiyoshi Shiga (1871-1957) was a renowned Japanese bacteriologist best known for discovering the dysentery bacillus. Born in Sendai during the Meiji Restoration, Shiga graduated from Tokyo Imperial University's School (later University of Tokyo) of Medicine and began microbiological research under Shibasaburo Kitasato. In 1897, during a dysentery (sekiri) epidemic, he isolated and identified the causative organism (later named Shigella dysenteriae) using Koch's postulates, laying the foundation for enteric disease research. Shiga later worked with Paul Ehrlich in Germany, pioneering chemotherapy research for trypanosomiasis. Upon returning to Japan, he continued studying infectious diseases such as tuberculosis and beriberi, significantly contributing to public health improvements. As a professor at Keio University School of Medicine, Shiga advanced medical education in Japan and abroad. In his later years, he returned to his hometown near Sendai, living in harmony with nature. His gentle demeanor and scientific achievements earned him deep respect and affection from the local community. Shiga's funeral was marked by a long line of mourners, a testament to the impact he had on those around him. His life embodied the balance between scientific inquiry and humanitarian spirit, profoundly influencing the development of bacteriology and public health globally.

Estimates of Air Pollutant Emissions by Vehicle Fleet in the State of Pará, Brazil: Impacts and Trends

Objective: aims to estimate emissions of the main atmospheric pollutants from vehicular sources in the state of Pará, to continue the environmental agenda of monitoring air quality. Theoretical Framework: The growing global concern about air quality in urban areas is driven by the environmental and public health impacts caused by air pollution. The concentration of pollutants from vehicle sources represents one of the main challenges, especially in densely populated regions such as the capital and other major cities in the state of Pará, where the automotive fleet has increased significantly. Method: The methodology used combined "bottom-up" and "top-down" methods to calculate emissions of carbon monoxide (CO), nitrogen oxides (NO) and total hydrocarbons (HC) for different vehicle categories and fuel types. Data on licensed vehicle fleets and fuel consumption obtained from DETRAN-PA and ANP were used. Results and Discussion: The results revealed that gasoline-powered vehicles are responsible for the majority of CO and HC emissions, while diesel vehicles emit the largest amounts of NO into the atmosphere. Motorcycles were identified as the largest source of emissions due to their larger number in the circulating fleet. Our results also highlight the importance of assessing and monitoring vehicle emissions to develop effective air pollution control strategies. Research Implications: The information obtained in this study is unprecedented for the study area, and can therefore support the formulation of environmental policies aimed at reducing emissions of atmospheric pollutants in the state of Pará, thus promoting an improvement in air quality and public health. Originality/Value: This paper makes an unprecedented contribution to national and international literature on environmental pollution in large urban centers. On the eve of the largest climate and environment conference on the planet (COP30) to be held in Pará, Amazonas, this research joins efforts in relation to the monitoring, forecasting and mitigation of air pollution, considered one of the main environmental problems of today.

IMPROVING HEALTH BEHAVIOR IN THE COMMUNITY THROUGH EMPOWERING HEALTH-AWARE COMMUNITIES

This article reports on a community service program conducted in Nglajur Hamlet, Tugusumberejo Village, Peterongan District, Jombang Regency, from April 29 to May 25, 2024. The program aimed to improve public health behavior by empowering a health-aware community. The initiative involved a series of activities, including health education on waste management, community service efforts, education on common health issues such as hypertension and stroke, health screenings, and providing home care for the elderly. Led by three lecturers and 23 students from the Bachelor of Nursing Science Study Program at the College of Health Sciences of Husada Jombang, the program successfully engaged the local community in each activity. The active participation of community members reflected the program's effectiveness in fostering collective responsibility and promoting sustainable health behaviors. The results underscore the importance of community empowerment in achieving long-term improvements in public health.

Yogurt as a fermented food for healthy and sustainable daily consumption. Recommendations to the population

Yogurt has been valued very positively for centuries, but the concern for food sustainability and the fact that it is a food of animal origin has raised doubts about the consumption that may be convenient. The objective of this work is to deepen the topic and establish recommendations for the population. From the nutritional point of view, yogurt is a valuable food, for its high content, quality and bioavailability of its nutrients, in a low energy content, its components together with probiotic microorganisms are provided in a matrix that helps achieve greater nutritional and health benefit. Regular consumption of yogurt has been linked to cardiovascular protection, against diabetes, excess weight, cancer, bone health. Thinking about environmental sustainability, yogurt production is not particularly dangerous, as the kg of CO2 eq (greenhouse gases) associated with their production are the lowest obtained compared to other animal foods and even lower than those associated with the production of some plant foods and the supply of nutrients per 1000 kcal, per 100 g, or per euro is one of the highest available. There is the possibility to further improve sustainability with improvements in animal feed, packaging, transport, etc. Considering this evidence, the daily consumption of yogurt / fermented milk should be included in the food guidelines, not only as one more milk option, but specifying a specific consumption such as a ration / day, this pattern can be useful from the nutritional point of view and for the improvement of public health.

Socioeconomic inequalities in adverse pregnancy outcomes in India: 2004-2019.

Although India has made substantial improvements in public health, it accounted for one-fifth of global maternal and neonatal deaths in 2015. Stillbirth, abortion, and miscarriage contribute to maternal and infant morbidity and mortality. There are known socioeconomic inequalities in adverse pregnancy outcomes. This study estimated changes in socioeconomic inequalities in rates of stillbirth, abortion, and miscarriage in India across 15 years. We combined data from three nationally representative health surveys. Absolute inequalities were estimated using the slope index of inequality and risk differences, and relative inequalities were estimated using the relative index of inequalities and risk ratios. We used household wealth, maternal education, and Scheduled Caste and Scheduled Tribe membership as socioeconomic indicators. We observed persistent socioeconomic inequalities in abortion and stillbirth from rates of 2004-2019. Women at the top of the wealth distribution reported between 2 and 5 fewer stillbirths per 1,000 pregnancies over the study time period compared to women at the bottom of the wealth distribution. Women who completed primary school, and those at the top of the household wealth distribution, had, over the study period, 5 and 20 additional abortions per 1,000 pregnancies respectively compared to women who did not complete primary school and those at the bottom of the wealth distribution. Women belonging to a Scheduled Caste or Scheduled Tribe had 5 fewer abortions per 1,000 pregnancies compared to other women, although these inequalities diminished by the end of the study period. There was less consistent evidence for socioeconomic inequalities in miscarriage, which increased for all groups over the study period. Despite targeted investments by the Government of India to improve access to health services for socioeconomically disadvantaged groups, disparities in pregnancy outcomes persist.

Educational Technologies in Support of Pedagogical Activity and Public Health Improvement Amidst the Implementation of State Policies on Humanistic-Legal Values in Education

Educational Technologies in Support of Pedagogical Activity and Public Health Improvement Amidst the Implementation of State Policies on Humanistic-Legal Values in Education

The impact of economic agglomeration on China's urban public health.

This study aims to explore the impact of economic agglomeration on the urban prosperity through economies of scale and agglomeration, it may also affect the public health of the agglomeration area. This paper takes 280 cities in China as the research object, and explores the impact of economic agglomeration on public health through a two-way fixed effects model, instrumental variable method, and generalized moment estimation. The results indicate that: (1) the improvement of China's economic agglomeration can significantly promote urban public health, and economic agglomeration is a prerequisite for the improvement of urban public health, but there is no reverse causal relationship. (2) The enhancement of economic agglomeration in Northeast China has the greatest promotion effect on public health, followed by the eastern, western, and central regions; The economic agglomeration enhancement of the pilot medical group in closely connected cities has a greater promoting effect on public health than the pilot medical group in non-closely connected cities. (3) Empirical results based on micro sample data show that the improvement of economic agglomeration will also promote the increase of the number of public hospitals in cities. This study emphasizes the important role of economic accumulation in the improvement of urban public health and provides empirical support for future economic development policies and practices.

Analysis of Indirect Costs of Absence Associated with Mental Disorders on the Basis of Social Security Data (2012-2023).

Mental and behavioral disorders significantly impair psychophysical functioning, leading to challenges in daily activities. The increasing recognition of the importance of mental health in global development goals has resulted in its inclusion in the United Nations' Sustainable Development Goals. The burden of mental disorders has grown worldwide due to demographic changes, with substantial economic and social impacts. This study aimed to examine the indirect costs of mental disorders in Poland by analyzing the expenditures by the Social Insurance Institution (ZUS) on work incapacity benefits and disability pensions from 2012 to 2023. The goal was to identify trends, dependencies, and the economic impact of policy changes. Data were collected from ZUS reports on annual expenditures for work incapacity benefits and disability pensions. Advanced statistical methods, including linear regression and Pearson correlation, were employed to analyze trends and relationships. Student's t-tests assessed the statistical significance of the observed trends. The expenditures on benefits for work incapacity due to mental disorders increased significantly over the past decade, particularly from 2020 to 2023, partly due to the COVID-19 pandemic. Short-term absenteeism due to mental disorders accounted for 10.5% of the total sick leave days. A strong positive correlation was found between years and benefit expenditures. Conversely, the disability pension expenditures exhibited a downward trend, potentially reflecting improvements in public health or policy changes. The significant increase in expenditures on benefits related to mental disorders may reflect greater awareness, improved diagnostics, and the impact of the COVID-19 pandemic. In contrast, the decline in disability pension expenditures could suggest improved mental health or effective policy measures. However, it is important to emphasize that the presented data are not the only factor influencing this situation. Multiple variables, including societal, economic, and healthcare system changes, contribute to these trends. Therefore, further research is necessary to fully understand the underlying causes and to guide effective policy development. Regular monitoring and continued investment in mental health are essential to managing indirect costs such as absenteeism and presenteeism efficiently.

Biohazards Signatures of Cough Syrup Isolates from Patent Medicine Shops, Akungba-Akoko Metropolis

The aim of this study is, to isolate, identify and characterize microbial analysis &amp; biohazards signatures of cough syrup isolates from patent medicine shop in Akungba-Akoko metropolis and determined the antibiotics pattern of the isolates from cough syrup. Microbial bioharzard of cough syrup can occur at various stages of the manufacturing process, including raw material handling, storage, and packaging. Microorganisms such as bacteria, fungi, and viruses can survive and multiply in the cough syrup, leading its contamination. For this reason, this study was conducted to investigate the quality and safety of cough syrup from patent medicine shops using a combination of conventional method and molecular techniques. Different brands of eigth (8) cough syrups were collected from different patent medicine shop in Akungba-Akoko and the pour plate technique was performed to enumerate the microbial contaminant from the collected samples. Bacterial isolates were identified using Bergeys Manual of Determinative Bacteriology based on the results obtained from microscopic examination, cultural and morphological examination and biochemical tests. The antibiotics susceptibility patterns of the isolates were determined. Using an Ultraviolet spectrophotometer the growth dynamics and killing time of the cough syrup isolates were also determined. The 16s molecular sequencing was used to validate the bacteria isolates after the conventional method of analysis. The result showed that 75% of organisms isolated were Gram-negative, while the remaining 25% were Gram-positive which includes Staphylococcus aureus (2), Bacillus spp (2), Proteus spp (4), Citrobacter freundii (1), Enterobacter spp (3)., Klebsiella spp.(1) and Salmonella spp.(3), Streptococcus spp.(2). The results of this study showed that the majority of the cough syrup isolates were resistant to different antibiotics; 62% of the Gram-negative microorganisms identified were resistance to the antibiotics used, while 20% of the Gram-positive microorganisms were resistant to the antibiotics used. The findings of this study highlight the need for improved regulation and oversight of patent medicine shops in Nigeria, to ensure the quality and safety of healthcare products and services for consumers. By using a combination of advanced techniques, this study provides valuable insights into the quality and safety of cough syrup products sold in patent medicine shops in Akungba-Akoko metropolis. These findings can inform policy and practice in the healthcare sector, contributing to the improvement of public health and safety in Nigeria.

What’s in a landscape? Nature, memory, and tourism in Bitterfeld-Wolfen’s post-mining landscape, East Germany

This paper addresses the transformation of the region around the twin-town Bitterfeld-Wolfen in Eastern Germany from a highly polluted industrial hub into a lakeland idyll and destination for recreation and nature-based tourism. From the perspective of local residents of age, the significance of this transformation was fundamentally shaped by German reunification, in particular by the experience of stigmatisation related to high levels of pollution in Bitterfeld-Wolfen in the context of general bias that devalued East German subjectivities in the course of German reunification. As I detail through both historical and ethnographic research, I show how mine restoration and the clean-up of contaminated sites have subsequently acquired meaning beyond ecological recovery and the improvement of public health. Tied up with the uncertainties and ambivalences of the transformation of East Germany and its integration into a West German entity, I demonstrate how the (im)possibility of restoring a destroyed landscape became inseparable from the postulated need of fundamental recovery of an East German region and its inhabitants from, so-perceived, socialist ruination. Consequently, I argue, the clean-up of contaminated sites and the remediation of a large open-cast mine in (former) East Germany produced not only an idyllic post-mining landscape, but a post-socialist one. Furthermore, as an archive of local history, the restored landscape became a way for elderly people to re-appropriate their past through its transformation into a remarkable present. In tracing this contested history, this paper contributes to landscape-centred analyses of post-socialist transformations in Europe.