Public Health Initiatives Research Articles

Effectiveness of recommendations in promoting the use of Mobile health applications in health guidance: a randomized controlled trial.

Use of commercially available mobile health (mHealth) applications in supporting lifestyle improvements has become popular in recent years. However, the effectiveness of advice promoting the use of such applications based on individual behavioral goals in a health guidance setting remains unclear. This study explored how guiding participants of the Specific Health Guidance (SHG) program, a Japanese public health initiative to prevent cardiovascular disease, to use commercially available mHealth applications impacted their application usage, lifestyle habits, and cardiovascular risk factors. In this multicenter, randomized, open-label, parallel-group comparison study, 156 individuals with a history of SHG participation and were engaged in the Motivational Health Guidance program (a type of SHG) in 2021 were assigned to intervention (n = 76) or control (n = 80) groups. While both groups received standard guidance, the intervention group also received recommendations for mHealth applications based on their individual behavioral goals. The participants' application usage, behavioral changes, and body weight were assessed after 3 months, with health checkup data evaluated after 1 year. The proportion of mHealth application users after 3 months was significantly higher in the intervention group (68.4%) than in the control group (40.0%). The intervention group also reported a significantly greater weekly frequency of mHealth application usage. Moreover, the intervention group reported a significantly decreased change in triglyceride levels after 1 year compared with the control group. Recommending commercially available mHealth applications in a health guidance setting significantly increased the number of mHealth application users and their frequency of use. Japanese University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR: UMIN000042986).

The Impact of Air Quality on Patient Mortality: A National Study

Introduction: Air pollution is a risk factor for a variety of cardiopulmonary diseases and is a contributing factor to cancer, diabetes, and cognitive impairment. The impact on mortality is not clearly elucidated. Objectives: The goal of this study is to determine the impact (if any) of air pollution on the 5-year mortality of patients in the American Family Cohort (AFC) dataset. Methods: The AFC dataset is derived from the American Board of Family Medicine PRIME Registry electronic health record data. It includes longitudinal information from 6.6 million unique patients from an estimated 800 primary care practices across 47 states, with 40% coming from rural areas. The Environmental Protection Agency’s Air Quality Index (AQI) measures were downloaded for the study period (2016–2022). Using the Python library pandas, the AFC and EPA datasets were merged with respect to date, time, and location. Cox Regression Models were performed on the merged dataset to determine the impact (if any) of air quality on patients’ five-year survival. In the model, AQI was handled as a time-independent (time-fixed) covariate. Results: The group with AQI > 50 had an adjusted hazard of death that was 4.02 times higher than the hazard of death in the group with AQI ≤ 50 (95% CI: 3.36, 4.82, p < 0.05). The hazard of death was 6.73 times higher in persons older than 80 years of age (95% CI: 5.47, 8.28; p < 0.05) compared to those younger than 80 years of age. Black/African American patients had a 4.27 times higher hazard of death (95%CI: 3.47, 5.26; p < 0.05) compared to other races. We also found that regional effects played a role in survival. Conclusions: Poor air quality was associated with a higher hazard of mortality, and this phenomenon was particularly pronounced in Black/African American patients and patients older than 80 years of age. Air pollution is an important social determinant of health. Public health initiatives that improve air quality are necessary to improve health outcomes.

Prevalence of Common Dental Problems and Oral Hygiene Behaviors Among Adults in Bangladesh- A Cross-Sectional Study

Background: Oral health is a key component of general well-being, yet it remains a neglected area of public health in many developing countries, including Bangladesh. Understanding the prevalence of common dental problems and oral hygiene behaviors is essential for planning effective preventive and educational interventions. Therefore, this study aimed to assess the prevalence of common dental problems and oral hygiene practices among adults in Bangladesh. Methods: This cross-sectional study was conducted at the Department of Dentistry, Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, and Sadar Hospital, Sunamganj, Bangladesh. A total of 300 adult participants with dental problems from various age groups, ranging from under 20 to over 60 years, were included. Results: The most common age group among participants was 30–39 years (27.67%), and the majority were female (62.0%), with a female-to-male ratio of 1.63:1. Gingivitis (41.0%) and dental caries (27.0%) were the most frequently reported dental problems. While 65.4% used toothbrushes for cleaning teeth, a considerable portion relied on fingers, neem sticks, or meshwak. Among toothbrush users (n=196), 81.6% brushed once daily, and 51.0% used a mixed brushing technique. Only 40.7% reported rinsing their mouth after meals, and a significant proportion did not engage in flossing (62.0%) or tongue cleaning (85.3%). Regarding dental visits, only 21.3% had sought routine dental checkups, and most (68.8%) of them visited only when experiencing a problem. Conclusion: The findings indicate a high prevalence of dental problems and inadequate oral hygiene practices among adults in Bangladesh. Public health initiatives focusing on oral health education and promotion of regular dental checkups are urgently needed to address these gaps.

Global national and rational burdens of female fertility via exposure to different alcohols

Alcohol intake is a key lifestyle component and a major public health concern that affects reproductive health around the world. According to the World Health Organization (WHO), alcohol causes infertility by altering hormonal balance, ovulation, and implantation. The prevalence of alcohol-related infertility varies by region, with higher rates found in nations with significant alcohol consumption, such as Europe and the Americas. Previous research has revealed that both chronic and acute alcohol consumption can disrupt reproductive hormones, decrease ovulatory function, and deplete ovarian reserve, resulting in diminished fertility potential. Alcohol causes infertility through changes in the hypothalamic-pituitary-ovarian axis, oxidative stress, and DNA damage in oocytes. Furthermore, heavy alcohol use has been related to an increased risk of monthly abnormalities, miscarriage, and ART failure. Moderate alcohol consumption is still debatable. Evidence suggests that even low to moderate consumption may have a deleterious impact on reproductive outcomes. Addressing challenges of female infertility caused by alcohol consumption necessitates targeted legislation, public health initiatives, and enhanced knowledge in order to lessen the impact on reproductive health and overall societal well-being. We believe that more study is needed to establish better dose-response correlations and to investigate the potential reversibility of alcohol-induced reproductive abnormalities Keywords: Alcohol, female infertility, global burden, oxidative stress miscarriage, menstrual irregularities

Writing Beyond the Academic Context: Exploring Writing Among Public Health Practitioners.

Public health work involves diverse types of writing to communicate health messages to various audiences. Clear, concise, audience-oriented writing is essential, yet public health practitioners often receive little training in effective writing. This study explores the writing public health practitioners do in their everyday work. We emailed a web-based questionnaire in April 2024 to a sample of public health practitioners working in municipalities, regional health departments, governmental agencies, and nongovernmental organizations in 5 regions in Sweden. The questionnaire asked about writing, support, professional development, and writing self-efficacy. We analyzed data using descriptive statistics and content analysis. Seventy-two public health practitioners responded to our questionnaire. The most common types of writing that respondents reported engaging in were presentations (88.9%), reports (59.7%), and decision-making documents (47.2%). Scientific articles (75.0%), blog posts (69.4%), and opinion pieces (56.9%) were the least common. The most common target audiences were politicians, followed by managers and citizens. Colleagues provided the most common source of writing support, followed by communication officers and managers. Most practitioners reported a desire to develop their professional writing skills and achieve high self-efficacy in public health writing. Public health practitioners in Sweden write more for politicians and managers than for the public. Expanding practitioners' writing skills beyond operational and technical document writing to include public-facing writing will benefit the public health profession by opening communication channels to diverse audiences. Communicating more clearly with public audiences can improve health literacy, promote health for all, and strengthen the effectiveness of public health initiatives.

Peace in mind: responding to mental ill health associated with the climate crisis through personally meaningful change.

To explore the principles of the Wellness Recovery Action Plan (WRAP) framework in relation to climate change as a global threat to mental health. To introduce WRAP to public health practitioners involved in improving the mental health of diverse populations in response to climate change. To critically review how privileging the principles of WRAP can inform public and healthcare practitioner approaches to tackling rising distress resulting from climate change. A selective, iterative, purposive review of theoretical and empirical studies, within a critical realist epistemology, was undertaken. Analysis was undertaken deductively. The WRAP principles of personal responsibility, self-advocacy, hope, support, and education are considered in turn. While exploring the principles of WRAP, additional frameworks and concepts in mental health are explored in relation to climate change. Each of the principles explored has a link to the work already being undertaken informally by those involved in climate activism. Principles of recovery from distress draw our attention to 'active hope' and 'citizenship' through reconnection with people and planet, and sharing common experiences. Experiences of those experiencing distress and those involved in climate activism can provide new ways to re-formulate theory and practice for public health initiatives. By meeting the concerns of citizens in relation to their health in the context of a changing climate, health practitioners have the opportunity to improve psychological and material circumstances by using accessible, personally meaningful, and community-connecting frameworks such as WRAP. By encouraging hope-full re-orientation and action, healthcare workers and the citizens they aim to serve can improve their mutual health and inform future individual or collective action in relation to climate change.

Agreement between parental reports and accelerometer measures of sleep duration in primary school children

Abstract Sleep plays a critical role in children’s health and development, with sleep duration being one of the most commonly analyzed measures by researchers. Accurate assessment of sleep duration in school-aged children is crucial for understanding its impact on cognitive development, behavior, and overall health. However, discrepancies between parent-reported sleep duration and objective measurements, such as accelerometry, pose challenges in assessing sleep patterns in children. This study examines the agreement between accelerometer-measured and parent-reported sleep duration in school-aged children from socially vulnerable contexts. A total of 735 children from primary schools wore accelerometers for seven consecutive days, while parents reported their children’s sleep duration. The results revealed significant discrepancies, with parents generally overestimating sleep duration and demonstrating poor predictive accuracy. These findings underscore the need for more reliable methods in assessing sleep duration in children from socially vulnerable backgrounds. By highlighting the discrepancy between accelerometer data and parent reports, the study emphasizes the importance of objective measurements in sleep research. The study’s implications are particularly relevant for public health initiatives aimed at promoting healthy sleep habits among children in socioeconomically disadvantaged communities.

Prevalence and associated factors of waterpipe tobacco smoking in Japan

INTRODUCTIONDespite the global increase in waterpipe tobacco use (hookah tobacco, shisha), its prevalence and characteristics are understudied in Japan. We aimed to investigate the prevalence and associated factors of waterpipe tobacco use in the Japanese population.METHODSData were obtained from the Japan ‘Society and New Tobacco’ Internet Survey, conducted in February 2023. Of the 34000 surveyed participants, a total of 31037 respondents (91.3%) aged 15–82 years were included. Current waterpipe tobacco smokers were defined as those reporting use ‘occasionally’ or ‘almost every day’ in the past 30 days. Inverse probability weighting was used to calculate waterpipe tobacco use, which approximated the Japanese national population. Logistic regression analyses were conducted to estimate the effect of waterpipe tobacco use, adjusted for sociodemographic variables.RESULTSThe prevalence of current and former waterpipe tobacco use in Japan was 1.4% and 3.9%, respectively, both with higher prevalence among men. Use was notably higher among individuals in their 20s, with prevalence rates of 4.4% among those aged 20–29 years. Waterpipe tobacco use among current tobacco product users was 2.5% for cigarette users, 4.7% for heated tobacco product users, and 32.5% for electronic cigarette users. Waterpipe tobacco use was more strongly associated with current e-cigarette (AOR=4.06; 95 % CI: 2.7–6.0) and heated tobacco product (HTP) use (AOR=2.44; 95 % CI: 1.9–3.2), while individuals with former combustible tobacco (AOR=3.12; 95 % CI: 2.4–4.1) or cannabis use (AOR=14.8; 95 % CI: 9.5–23.2) reported higher prevalence of current waterpipe use.CONCLUSIONSWe found a high prevalence of waterpipe tobacco smoking among young adults and other tobacco product users in Japan. Public health initiatives should focus on educating the population about the risks associated with waterpipe tobacco use and developing policies to regulate its availability and marketing.

Demographic criteria of diabetes mellitus burden in the periphery of the Sultanate of Oman: Realizing where we stand is the first step in deciding where to go

Objectives: Diabetes mellitus (DM) poses a significant global health challenge, with a particularly high prevalence in the Gulf countries. Understanding the specific demographic criteria and burden of DM in local communities is crucial for targeted interventions and resource allocation. This study aimed to delineate the demographic profile, risk factors, complications, and glycemic control status of diabetic patients in the South AlSharqiyah governorate, Sultanate of Oman, a region with previously scarce data. Material and Methods: A single-center, cross-sectional study was conducted, analyzing data from all 3306 adult patients with DM attending the Sur Specialized Diabetic Center between January 2019 and December 2021. Data on demographics, DM type, risk factors, associated comorbidities, diabetic complications, and initial and latest glycated hemoglobin (HbA1c) levels were extracted from the Al Shifaa 3+ health data system and analyzed using the Statistical Package for the Social Sciences. Results: The study cohort comprised 57% females and 43% males, with approximately half (47.5%) aged between 40 and 59 years. Type 2 DM was predominant (94.7%). Obesity was the most prevalent risk factor, with 53% of patients classified as obese (body mass index >30 kg/m2) and an additional 32% as overweight. Hypertension was the most common comorbidity, affecting 55% of patients. Diabetic retinopathy was the leading complication (22%), followed by diabetic nephropathy (13%). At registration, over 60% of patients had an HbA1c >9%, indicating poor initial glycemic control. However, at the end of the study period, 41% of patients achieved an HbA1c <7%, demonstrating significant improvement in glycemic management. Conclusion: This study provides the first comprehensive overview of the DM burden in the South AlSharqiyah governorate of Oman, highlighting a high prevalence of type 2 DM, obesity, and associated complications. While improvements in glycemic control were observed, the initial poor control and high rates of complications underscore the need for enhanced preventive strategies, early detection, and optimized management protocols tailored to this specific population. These findings serve as a vital baseline for future public health initiatives and research in the region.

Cost-Effectiveness of Increasing Outdoor Activity in Preventing Myopia in Children and Adolescents - China.

Myopia has emerged as a significant public health concern in China, particularly among children and adolescents. While evidence demonstrates the effectiveness of outdoor activity in preventing myopia, comprehensive economic analyses evaluating its role in reducing myopia-related diseases remain limited. This study evaluates the cost-effectiveness of increasing outdoor activity across different educational stages in preventing myopia-related diseases among Chinese children and adolescents. The findings indicate that interventions implemented at all educational stages, with the exception of high school, are cost-effective strategies for reducing the myopia burden. This research demonstrates the cost-effectiveness of increasing outdoor activity as a myopia prevention strategy among children and adolescents in China. It provides valuable insights for policymakers and healthcare planners to optimize resource allocation and develop targeted public health initiatives aimed at reducing the burden of myopia.

Epidemiological analysis of self-harm and suicide attempts in Iran: a cross-sectional study in Kurdistan’s emergency hospitals

BackgroundSelf-harm and suicide are major global public health issues, especially in low- and middle-income nations. Finding trends and risk factors is essential to creating successful solutions. The purpose of this study was to look into the risk factors and epidemiological characteristics of self-harm and suicide attempts among patients who were hospitalized to the emergency rooms at Kurdistan hospitals in 2021–2022.MethodsA cross-sectional study was conducted on 604 cases of self-harm and suicide attempts. Data were extracted from medical records, including demographic, clinical, and social variables. Statistical analysis was performed using SPSS (version 24), employing chi-square tests to determine associations between variables and outcomes.ResultsThe majority of patients (48.8%) were male, and the most affected age group was 17–40 years. Recovery or fatality outcomes were significantly associated with gender (p < 0.05), age group (p < 0.01), and method of self-harm (p < 0.001). Drug overdose (71%) was the most common method, with a recovery rate of 88% (p < 0.01), while hanging had the highest fatality rate at 40% (p < 0.001). Among the cases, 83.6% were discharged after treatment, while 16.4% resulted in death due to suicide attempts.ConclusionThe study identifies important clinical and demographic trends linked to suicide attempts and self-harm. Young adults, people with long-term medical or mental health issues, and those who are struggling financially should all be the focus of preventive programs. To lower the suicide rate, public health initiatives must give mental health services and community awareness campaigns first priority.

Nutritional impact symptoms and dietary changes among women in a cancer support network: a qualitative analysis

ObjectiveTo examine nutritional impact symptoms and dietary changes experienced by cancer patients in Trinidad, as well as the nutritional support and guidance they received during treatment.MethodA qualitative study was conducted of 12 adult cancer patients who were diagnosed within the last five years, undergoing treatment and recruited from a non-profit organisation. Participants’ experiences with dietary changes and nutritional needs were examined through face-to-face interviews guided by 21 semi-structured questions. Interviews were recorded, transcribed and analysed thematically using Dedoose© software.ResultsTwelve participants were interviewed, from which three major themes emerged: Nutrition Impact Symptoms (NIS), Dietary Changes, and Lack of Information. Participants experienced a combination of symptoms during treatment: nausea, metallic taste, constipation, fatigue, and loss of appetite, taste and smell. Dietary changes included the introduction of new foods and the decrease or eliminations of others, portion sizes and meal frequency. Intake restrictions were also noted for flour, sugar, processed foods, artificially flavoured foods/beverages, and meats (chicken, beef and pork). Limited information and dietary guidance were received from healthcare professionals; participants relied on personal research, information from other cancer patients and support groups.ConclusionThere is a need for capacity-building initiatives that train healthcare professionals to deliver appropriate nutritional guidance. Efforts are needed to integrate dietary education into public health initiatives which could empower patients and caregivers to make informed decisions about nutrition during treatment.

Do Physical Fitness and Emotional Well-being Shape Consumer Preferences for Fruit Salad? A Discrete Choice Experiment in Urban Indonesia

Psychological factors influencing healthy food choices remain understudied. This research investigates how physical fitness awareness and emotional well-being shape urban Indonesian consumers’ preferences for fruit salad attributes. Using validated psychological scales within a discrete choice experiment (n = 298), preferences for packaging, promotion, ordering channels, and pricing were analyzed. Health-conscious consumers significantly preferred glass packaging and value-oriented promotions but favored traditional purchasing over digital channels. Conversely, emotionally balanced consumers showed stronger preferences for digital ordering methods and immediate discount promotions. These findings offer practical implications, suggesting differentiated marketing strategies aligned with consumer health profiles, benefiting targeted marketing and urban public health initiatives.

Role and Controversies in the Management of Colorectal Cancer

Colorectal cancer (CRC) is the third most prevalent malignancy globally, with marked disparities in incidence and management between high-income countries (HICs) and low- and middle-income countries (LMICs). Incidence rates in LMICs are rising due to lifestyle factors and limited healthcare access. Key risk factors include high-fat diets and obesity. While high-income countries (HICs) benefit from advancements in treatment, such innovations remain largely inaccessible in low- and middle-income countries (LMICs), further complicated by challenges such as late-stage presentations and inadequate health literacy. Nevertheless, HICs continue to encounter issues related to the accuracy of these treatment procedures. This review highlights the need for integrated strategies, combining dietary interventions, innovative treatments, and public health initiatives, in order to improve CRC outcomes worldwide. Colorectal cancer (CRC) exhibits significant disparities in incidence and management globally, influenced by racial, ethnic, and socioeconomic factors. Key modifiable risk factors include obesity, physical inactivity, and diet, while non-modifiable factors encompass genetic predispositions and age. Enhanced screening, access to innovative treatments, and public health initiatives are essential to address these disparities, particularly for underserved populations. A multidisciplinary approach and tailored interventions are crucial for improving CRC outcomes worldwide.

Educational attainment and employment status in lung cancer patients: a nationwide study.

Lung cancer remains the leading cause of cancer-related deaths globally, with low-dose computed tomography (LDCT) screening widely implemented in several countries. However, current screening eligibility, based largely on the National Lung Cancer Screening Trial and NELSON trial outcomes, does not account for socioeconomic risk factors such as education and employment status, which may impact lung cancer incidence and outcomes. This study used data from the Danish National Patient Register to examine educational attainment and employment status among 109,940 lung cancer patients diagnosed between 1994 and 2018, compared to a randomly selected matched general population cohort. Patients were less likely to hold higher education degrees and more likely to be on disability pension compared to controls, underscoring a significant socioeconomic disparity. Lung cancer patients frequently had only primary school education, with this educational gap widening over time. Employment disparities were also noted, with lung cancer patients twice as likely to be on disability benefits. These findings suggest that socioeconomic vulnerabilities, including educational level and employment, may exacerbate lung cancer risk, possibly linked to higher smoking prevalence and occupational carcinogen exposure in lower socioeconomic groups. Targeted public health initiatives focusing on smoking cessation and LDCT access for socioeconomically disadvantaged individuals are crucial for addressing these disparities and improving lung cancer outcomes. National wealth alone appears insufficient in bridging these socioeconomic gaps, emphasizing the need for strategic, targeted interventions in lung cancer prevention and early detection.

An Ounce of Prevention: The Growing Need for Preventive Neurologists.

The global burden of neurologic disorders is rising, driven by aging populations and improved survival following acute neurologic events. As a result, more individuals are living with long-term disabilities from conditions such as stroke, dementia, and other neurodegenerative diseases. Despite significant advances in neurology, there remains an urgent need for a preventive approach to mitigate these trends. Growing evidence highlights the effectiveness of preventive strategies, including lifestyle modifications and risk factor management, in preserving brain health and reducing the risk of stroke, neurodegenerative conditions, and cognitive decline. Preventive neurology operates within a multilevel framework, ranging from direct patient-centered interventions to systemic policy actions requiring organizational and societal support. Neurologists are uniquely positioned as advocates for brain health, promoting preventive strategies in line with the American Academy of Neurology's Brain Health Initiative. This article explores how neurologists can drive change across individual, family, community, and policy levels by leveraging their clinical expertise, community engagement, and health policy influence. Sustainable progress in brain health will also require system-level changes that integrate preventive goals into the fabric of health care delivery, public health infrastructure, and policy frameworks. Special attention is given to underserved populations, who bear a disproportionate burden of neurologic diseases. Through targeted interventions, public health initiatives, and collaborative care models, preventive neurologists can shape brain health outcomes across the lifespan. Training neurologists with a preventive focus will integrate brain health promotion into standard neurology practice, complementing disease management. By addressing the root causes and risk factors of neurologic conditions, preventive neurology provides a pathway to improving quality of life while reducing the global health care burden.

Diferentele de gen in insecuritatile legate de imaginea corporala si interventiile cosmetice

CONTEXT: Body dysmorphic disorder (BDD) is a mental health conditioncharacterized by excessive concern about perceived physical flaws. This studyexamines gender differences in the symptoms of the disorder, psychologicaldistress, and attitudes toward cosmetic interventions.METHODS: A cross-sectional study was conducted on a sample of 370Romanian respondents through an anonymous online questionnaire. Thecollected data included awareness of BDD, body image concerns, andconsideration of cosmetic enhancements.RESULTS: Women showed greater awareness of BDD (71% compared to49%) and higher levels of emotional distress (39% compared to 28%). Their mainconcerns were related to weight, skin, and body proportions, while men focusedon muscle definition, weight, and height. More women (48%) considered cosmeticinterventions compared to men (20%).CONCLUSION: Gender differences in BDD are influenced by social beautystandards. Addressing these disparities through public health initiatives canimprove body image perception and mental well-being.

Most vulnerable diet and health profiles: identifying countries at risk through a three-theme clustering

BackgroundGlobal disparities in dietary habits, healthcare services, and life expectancy continue to affect vulnerable populations, particularly in low-and middle-income countries. Malnutrition, inadequate healthcare infrastructure, and diet-related chronic diseases contribute significantly to these disparities, necessitating targeted public health interventions.ObjectivesThis study aims to identify the most vulnerable countries in terms of diet, health, and life expectancy using a three-theme clustering approach. The study categorizes countries based on nutrition and diet, health and disease burden, and healthcare access and life expectancy to determine those at the highest risk.MethodsA cross-sectional analysis was conducted using 2019 data from 168 countries. A k-means clustering algorithm was applied to classify countries into three risk-based clusters for each theme. The Jaccard similarity coefficient was used to evaluate cluster overlap, and statistical significance was assessed through robust regression models and the Kruskal–Wallis H test. Data processing and visualization were performed using RStudio.ResultsThe analysis identified Cluster 3 as the most vulnerable group, comprising 45 countries with high similarity across all three themes. These countries, predominantly in Africa and Asia, exhibited low daily animal protein intake (&amp;lt;20 g/day), high rates of diet-related diseases, and limited access to healthcare. The healthcare coverage index in these countries ranged from 45.33 to 84.48, with life expectancy as low as 63.39 years. The findings highlight critical inequalities in global health, emphasizing the need for targeted interventions.ConclusionThis study underscores the urgent need for improved nutrition policies and healthcare investments in high-risk regions. Addressing malnutrition, enhancing healthcare services, and implementing targeted public health initiatives are crucial for reducing global health disparities and improving outcomes in vulnerable populations.

Human papillomavirus vaccines in obstetrics and pediatrics: a comprehensive review

Human papillomavirus (HPV) is a highly prevalent infection with significant implications for global public health, particularly in obstetric and pediatric populations. Persistent infection with high-risk HPV genotypes, such as HPV-16 and HPV-18, is a leading cause of cervical cancer, a major contributor to cancer-related mortality worldwide. Beyond cervical malignancies, HPV is etiologically linked to anal, vulvar, vaginal, penile, and oropharyngeal carcinomas. Additionally, it is responsible for benign but distressing conditions such as genital warts, imposing substantial psychosocial and economic burdens. Prophylactic HPV vaccines have significantly improved the prevention of HPV-associated diseases. The currently available bivalent, quadrivalent, and nonavalent vaccines target high-risk oncogenic HPV types and provide near-complete protection against vaccine-included genotypes. These vaccines function by eliciting a robust immune response, effectively neutralizing HPV before it establishes an infection. However, despite their well-documented benefits, challenges such as vaccine hesitancy, misinformation, economic barriers, and global disparities in vaccine access persist. This review provides a comprehensive analysis of HPV vaccination within obstetrics and pediatrics, emphasizing its epidemiological impact, immunological mechanisms, efficacy, safety, and implementation strategies. Furthermore, we explore existing barriers to vaccine uptake, disparities in global access, and potential future advancements, including next-generation vaccines and therapeutic interventions. Addressing these challenges through targeted public health initiatives, healthcare provider education, and equitable vaccine distribution strategies is essential to maximizing the public health impact of HPV vaccination and reducing the global burden of HPV-related diseases.

Experiences in Nature and Benefits on Emerging Adult Wellbeing: A Qualitative Systematic Review

Research demonstrates that wellbeing can benefit from contact with natural environments. How nature benefits emerging adults isn’t well understood. This review sought to systematically synthesise and analyse emerging adults’ experiences in nature for wellbeing. We aimed to achieve greater conceptual understanding of nature as a tool for wellbeing, and the barriers inhibiting engagement. A systematic search and inclusion criteria meant 11 studies were included for quality assessment and data analysis. Four analytical themes were generated following Thomas and Harden’s thematic synthesis framework. Findings revealed that nature provides a safe and calming space for self-reflection, social bonding, and emotional regulation through connection to the present moment. Barriers, including time constraints and unappealing green space, highlight interpersonal and intrapersonal reasons for not engaging with nature. Implications for behaviour change approaches, green space provision, and public health initiatives are given. This review highlights the potential nature has in supporting this stage of life.