Public Health Outcomes Research Articles

Good Practices and Initiatives for the Control and Elimination of Hepatitis B in the World: A Scoping Review.

Hepatitis B virus (HBV) infection remains a significant global public health challenge, leading to considerable morbidity and mortality. Implementationof effective strategies and novel initiatives is necessary to control and eliminate HBV. To identify the key approaches and actions used worldwide for HBV control and elimination, we conducted a comprehensive scoping review. We searched various sources, including PubMed, Scopus, Web of Science, Google Scholar, the official websites of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), and relevant articles and reports published in the past decade. Our inclusion criteria focused on studies that reported on strategies for HBV control and elimination, provided evidence of their effectiveness, and assessed their impact on public health outcomes. We included 16 articles in our review, which highlighted a range of strategies, such as universal HBV vaccination, prevention of mother-to-child transmission, mass screening programs, and treatment of chronically infected individuals. These strategies have shown promising results in reducing HBV transmission rate, improving health outcomes, and making progress towardHBV elimination. Moreover, several challenges, including limited access to care, low awareness, stigma, and funding constraints, hinder the effectiveness of elimination programs. The findings underscore the importance of sustained efforts and investment in comprehensive strategies for HBV control and elimination. It is crucial to address barriers to care and enhance public awareness to achieve the goal of eliminating HBV as a public health threat by 2030.

Trust in governments, public health institutions, and other information sources as determinants of COVID-19 vaccine uptake behavior in Japan

ObjectivesTrust in governments and public institutions as a determinant of public health outcomes has gained increased attention since the COVID-19 pandemic. Provided historically low confidence in vaccines in Japan, investigating the role of trust in information sources and actual COVID-19 vaccination uptake behavior will be invaluable for future vaccine promotion policymaking. Therefore, the objective of this study was to elucidate the determinants of COVID-19 vaccination uptake and evaluate the relationship between trust in different information sources and COVID-19 vaccination behavior in Japan. MethodsFor this study, we leveraged a longitudinal series of web-based surveys of 19,174 individuals in Japan conducted between 2021 and 2022 which asked questions regarding a wide range of sociodemographic and psychographic characteristics related to the COVID-19 pandemic. Determinant analysis for vaccination (at least one dose of a COVID-19 vaccine) was conducted via multiple logistic regression, and odds ratios (OR) with 95% confidence intervals (CI) were estimated. ResultsAfter adjustment for sociodemographic determinants of vaccine uptake, aggregate trust in the systems and institutions of vaccine approval (OR: 1.42, 95% CI: 1.30–1.56), and trust in information about the COVID-19 pandemic coming from government sources (OR: 1.27, 95% CI: 1.12–1.44) were found to be consistently powerful predictors of COVID-19 vaccination. Trust in media sources including traditional media (OR: 1.21, 95% CI: 1.07–1.36), and the internet (OR: 0.77, 95% CI: 0.66–0.89) had significant and opposing effects. ConclusionsOur findings support the broader hypothesis that trust in governments and public health institutions remains a powerful determinant for COVID-19 vaccine uptake in Japan. We also found that vaccination decision-making is a multifactorial process that includes the synthesis of trust in public institutions and media, and its interaction with psychosocial determinants such as prosociality and health literacy. We hope to apply this study's findings towards future vaccine programs for contagious diseases.

An Online-Based Survey to Assess Knowledge, Attitudes, and Barriers to Perform First Aid after Road Accidents Conducted among Adult Jordanians.

(1) Background: First aid administered during road accidents can save millions of lives. However, the knowledge and attitudes of the Jordanian population towards first aid are lacking. This study aimed to examine the knowledge, attitudes, and barriers to performing first aid among the Jordanian population during road accidents. (2) Methods: An online questionnaire was developed and distributed using various Jordanian social media platforms. The questionnaire collected the participants' sociodemographic details and assessed their first aid knowledge, attitudes toward first aid, and barriers preventing the participants from performing first aid in emergencies. (3) Results: 732 participants participated in this study. The median knowledge score regarding first aid items was 9 (7-10) out of the maximum possible score of 15. The median first aid attitude score was 24 (22-27) out of a maximum possible score of 30. The most commonly reported barrier to performing first aid among the participants was "lack of first aid training" (76.78%), followed by "lack of knowledge about first aid" (75.81%) and "fear of performing first aid" (57.51%). The participants with lower income levels exhibited more negative attitudes towards first aid (4). Conclusions: This study underscores the urgent need for enhanced first aid training and awareness in Jordan. The participants' first-aid knowledge overall was limited, although positive attitudes toward first-aid delivery were observed. The findings emphasize the need for regular and structured first-aid training courses, addressing barriers such as fear and misinformation and ensuring accessibility across all socioeconomic levels to improve preparedness for road traffic accidents and other emergencies. This comprehensive approach can better equip the Jordanian population to effectively manage emergencies and improve public health outcomes.

Environmental data in epidemic forecasting: Insights from predictive analytics

Epidemic forecasting plays a critical role in public health preparedness and response, enabling proactive measures to mitigate the impact of infectious diseases. Environmental data, encompassing factors such as temperature, humidity, air quality, and geographical features, holds valuable insights for predicting and identifying areas prone to epidemics. This paper explores the integration of predictive analytics with environmental data to enhance epidemic forecasting capabilities. By leveraging predictive analytics techniques, researchers and public health officials can analyze environmental data to identify regions at higher risk of experiencing epidemic outbreaks. Through statistical modeling, machine learning algorithms, and computational simulations, predictive analytics utilize environmental indicators to forecast the likelihood and spread of diseases. For example, areas with high temperatures and humidity may be conducive to mosquito-borne diseases, while regions with poor air quality may experience increased rates of respiratory infections. Case studies highlight the application of predictive analytics in various contexts, including forecasting mosquito-borne diseases in tropical regions and tracking respiratory infections in urban areas with poor air quality. Early warning systems, informed by environmental data, provide timely alerts to potential epidemic threats, enabling proactive interventions and resource allocation. While the integration of environmental data into epidemic forecasting offers significant benefits, challenges remain, including data quality, availability, and ethical considerations. Continued research and collaboration are essential to address these challenges and further enhance the effectiveness of predictive analytics in identifying and mitigating epidemic risks. In conclusion, this paper underscores the importance of leveraging environmental data and predictive analytics for epidemic forecasting, emphasizing their potential to improve public health outcomes and enhance preparedness efforts in the face of emerging infectious diseases and climate change. Keywords: Environmental Data, Epidemic Forecasting, Predictive Analytics.

Conspiracy Theories, Vaccine Hesitancy and Determinants of Vaccination Acceptance in Nigeria: A Conceptual Review

Purpose: This conceptual review aims to dissect the intricate web of conspiracy theories, vaccine hesitancy and determinants of vaccination acceptance within Nigeria's socio-cultural context, shedding light on their genesis, propagation and impact on public health outcomes. Methodology: Employing a multidisciplinary approach, this study synthesizes existing literature and theoretical frameworks from various disciplines, including sociology, anthropology, public health, and communication studies. Methodological rigor is ensured through comprehensive literature review and critical appraisal of relevant studies, enabling a holistic exploration of the subject matter. Findings: Through a systematic analysis, the review identifies and examines socio-cultural, economic and political influences that shape vaccination behavior in Nigeria. It illuminates the multifaceted determinants contributing to vaccine hesitancy, ranging from religious beliefs to historical legacies to socio-economic factors and healthcare accessibility challenges. The review also highlights the genesis and propagation of conspiracy narratives, their impact on public trust in vaccination and consequent implications for immunization uptake. Unique Contribution to Theory, Policy and Practice: This review makes several contributions to theory, policy, and practice in the field of vaccination and public health. Firstly, it advances theoretical understanding by synthesizing existing knowledge and proposing conceptual frameworks that elucidate the socio-cultural, economic, and political determinants of vaccination behavior in Nigeria. Secondly, it informs policy development by identifying key areas for intervention, such as addressing vaccine hesitancy, countering misinformation, and strengthening healthcare infrastructure to enhance vaccine delivery. Finally, it offers practical insights for public health practitioners and policymakers, providing evidence-based recommendations for designing effective vaccination campaigns, communication strategies, and community engagement initiatives tailored to the Nigerian context.

Social Vulnerability and COVID-19 Pandemic Outcomes: Evidence from Spatial Quantile Regression

This paper evaluates the empirical relevance of a prominent social vulnerability measure to local economic and public health outcomes at two distinct stages of the COVID-19 pandemic. In contrast to traditional least-squares regression, conditional quantile regression offers stronger evidence in support of social vulnerability for predicting the pandemic’s uneven economic devastation and death tolls across the United States. An extension of the spatial autoregressive geographically weighted regression model to conditional quantile regression reveals the varying role of social vulnerability within and across broad regions that were exposed to different levels of pandemic impacts.

IS BISPHENOL A (BPA) A PUBLIC HEALTH CONCERN? A CROSS-SECTIONAL STUDY OF PUBLIC KNOWLEDGE, ATTITUDE AND RISK PERCEPTION IN SOUTHWESTERN PART OF NIGERIA

Bisphenol A (BPA) is a chemical produced in large quantities for use primarily in the production of polycarbonate plastics and epoxy resins. Exposure to BPA is a public health concern because studies since the last decade have consistently linked BPA with several physiological disorders such as cardiovascular diseases, neurological, obesity, and some forms of cancers. Hence, this study assessed the level of BPA knowledge and awareness among randomly selected individuals in the Southwestern part of Nigeria. This study employed a mixed-methods approach, utilizing a survey specifically designed to collect data for the research. Different statistical methods were utilized including descriptive and inferential to analyze the data and to assess exploratory variables such as public knowledge, attitude, and risk perception. Findings revealed that though 96.2 % knew chemicals in plastics could cause adverse health effects, the level of knowledge on BPA and its attendant health risks among the sample population was abysmally low (only 35% knew this subject). However, most of our respondents interestingly expressed great attitude in terms of willingness to share information learned about BPA to others in the community. Based on the findings of this study, a massive awareness campaign about BPA and associated health risks would be required through effective scientific communication to improve public health outcomes.

Cross-Cultural Differences in Food Preferences and Consumption Patterns

Purpose: This study sought to explore cross- cultural differences in food preferences and consumption patterns. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to cross- cultural differences in food preferences and consumption patterns. Preliminary empirical review revealed that cultural heritage profoundly influenced individuals' food preferences and consumption habits, with distinct culinary traditions and family influences shaping dietary behaviors within specific cultural contexts. Globalization and urbanization were found to impact food preferences, yet traditional dietary practices remained resilient. Additionally, socio-economic factors significantly influenced dietary behaviors, particularly in low-income communities. These findings emphasized the importance of recognizing cultural diversity and socio-economic disparities in promoting healthy eating behaviors and improving public health outcomes. Unique Contribution to Theory, Practice and Policy: Cultural Anthropology theory, Social Identity theory and Ecological Systems theory may be used to anchor future studies on cross- cultural differences in food preferences and consumption patterns. The study offered valuable recommendations that contributed to theory, practice, and policy in the field of nutrition and public health. By identifying cultural influences on food preferences and consumption patterns, the study enriched theoretical frameworks such as cultural anthropology, social identity theory, and ecological systems theory. Its findings informed the development of culturally sensitive interventions and educational programs, empowering individuals to make healthier food choices while respecting cultural heritage. Additionally, the study's insights guided the formulation of evidence-based policies aimed at addressing diet-related health disparities and promoting food security and nutrition equity on a global scale.

Harnessing nature-based solutions for health in post-COVID era: a narrative review

Harnessing nature-based solutions for health in post-COVID era: a narrative review

Problems and Possible Solutions to Municipal Solid Waste Management in Malawi Urban Areas – An Overview

Municipal solid waste (MSW) management poses significant challenges in urban areas of Malawi, with rapid population growth, poor sanitary conditions, and inadequate waste disposal infrastructure exacerbating the situation. This overview synthesizes existing literature to examine the complexities of MSW management in key Malawian cities, including Mzuzu, Blantyre, Zomba, and Lilongwe. Drawing from diverse sources such as peer-reviewed papers, governmental reports, and policy documents, the study investigates the root causes of MSW problems and explores potential remedies. Key issues identified include poor waste disposal habits, lack of waste classification, insufficient waste removal services, and community perceptions towards waste disposal. Furthermore, the paper analyzes the legal frameworks and environmental regulations governing MSW management in Malawi, highlighting the roles of various stakeholders and policy instruments. To address these challenges, the paper proposes a multi-faceted approach involving enforcement of legal laws, civic education and awareness campaigns, community engagement, involvement of private operators, conversion of waste to energy, promotion of recycling activities, composting, and provision of public bins/trash containers. By implementing these strategies, Malawi can move towards sustainable MSW management, mitigate environmental risks, and improve public health outcomes in urban areas.

Analyzing Burn-Related Content on Social Media Platforms: A Study of Creator Types, Content Focus, and Engagement Metrics.

Social media offers a readily available, cost-effective way for medical experts to disseminate knowledge and shape public health outcomes but also allows for the spread of misinformation. This study aims to analyze burn-related material on social media by creator, content type, and engagement. Facebook, TikTok, and X (formerly Twitter) were queried with the following search terms: "burn," "burn injury," "burn recovery," and "burn treatment." Identified accounts were then manually screened for relevance. Year of creation and engagement metrics were collected. Accounts were categorized by content and creator type. Data was reported using descriptive statistics and visualized graphically to explore trends. Our search yielded 434 profiles, 234 of which met inclusion criteria. TikTok had the most engagement at a median of 43,500 followers per account, with 38.3% of accounts focusing on individual experiences of burn survivors primarily on personal accounts (48.3%). In contrast, content on Facebook was related to promotion of medical services (36.9%), where the most represented creator type was medical centers (33.6%). Nonprofits made up 40.4% of accounts on Twitter/X and more than a third of the content focused on patient advocacy, support, or burn prevention (36.5%). Important topics like burn education, prevention, and social support are lacking on major social media platforms. Engagement from burn care organizations and burn experts on social media is necessary. The findings of this study may guide advocates in the burn community on where and how to disseminate information in social media.

Knowledge, attitudes, and practices related to dietary salt among older adults in Abha, Saudi Arabia

The need to foster successful aging has intensified with the aging of the global population. This study aimed to assess the knowledge, attitudes, and practices (KAP) concerning dietary salt consumption and to investigate the correlations between sociodemographic variables and salt-related KAP. A structured interview was administered to a cohort of 200 older adults in Abha City, Saudi Arabia, recruited through a convenience sampling approach. The evaluation of salt-related KAP revealed widespread low knowledge (91.5%) as participants scored less than 3, negative attitudes (85.5%) scored less than 12, and predominantly unsatisfactory practices (69.5%) with scores less than 26. Noteworthy differences emerged between participants with poor overall KAP (81.5%) and those with good KAP (18.5%). Significantly weak negative correlations were found between age (r=-0.212), marital status (-0.236), and body mass index (-0.243) with overall KAP. Further examination revealed a significantly weak positive correlation between attitude and practice (r = 0.141). KAP scores show a highly significant positive correlation with overall KAP scores (r = 0.169, 0.352, 0.969). The uncovered correlations contribute to a valuable understanding of the complex dynamics surrounding salt-related KAP. This understanding guides the design of targeted interventions, such as health education programs, promoting successful aging and public health outcomes.

Lives or livelihoods: A configurational perspective of COVID-19 policies

In this study, we analyze the complexity of COVID-19 policies that must balance public health and economic outcomes by adopting a configurational perspective. Through a fuzzy-set qualitative comparative analysis (fsQCA), we reveal multiple, nonlinear combinations of the policies leading to the success and failure of health and economic outcomes, using 1543 cases built from a variety of sources. The results provide policymakers with a complementary and substitutive multiple-policy strategy in navigating a complex, unstable environment. Our analysis reveals several noteworthy findings. Each of the four outcomes can be achieved through different pathways. For instance, three configurations lead to Low COVID-19 Deaths, one suggesting an all-in approach with the presence of all causal conditions while an alternative pathway suggesting a combination of present and absent conditions. Further, we note that the causal-effect relation is asymmetric, e.g., school closures can lead to both Low and High COVID-19 Death outcomes, depending on both demand and supply policies undertaken. We provide valuable guidance to policymakers on the need to protect lives with the need to protect livelihoods, an ethical dilemma beyond health crisis settings. Our study framework applies to many policy decisions that involve weighing the protection of human life against economic loss.

Study of Mosquito Borne Deasease Found in Yavatmal Region

Abstract: Mosquito-borne diseases are a significant public health concern in the Yavatmal region of Maharashtra, India. Malaria, dengue fever, and Japanese encephalitis are among the prominent diseases transmitted by mosquitoes in this region. Malaria, caused by the Plasmodium parasite, is endemic in Yavatmal, with transmission occurring mainly during the monsoon and post-monsoon seasons. Dengue fever, caused by the dengue virus and transmitted by Aedes mosquitoes, has seen periodic outbreaks in the region, with increased incidence during the rainy season. Japanese encephalitis, caused by the Japanese encephalitis virus and transmitted by Culex mosquitoes, poses a threat to the population, particularly in rural areas. Several factors contribute to the spread of mosquito-borne diseases in the Yavatmal region, including inadequate sanitation, stagnant water bodies, deforestation, and climate change. Socioeconomic factors such as poverty and limited access to healthcare further exacerbate the problem. Control and prevention efforts in the region primarily focus on vector control measures, including insecticide spraying, larval source management, and the use of bed nets. Community education and awareness campaigns play a crucial role in promoting preventive behaviors such as the use of insect repellents and proper waste disposal. Challenges in addressing mosquito-borne diseases in Yavatmal include inadequate healthcare infrastructure, insufficient funding, and the emergence of insecticide resistance among mosquito populations. Collaborative efforts involving government agencies, healthcare providers, researchers, and community organizations are essential to effectively combat these diseases. Strengthening surveillance systems, improving access to diagnostic and treatment facilities, and implementing integrated vector management strategies are necessary steps towards reducing the burden of mosquito-borne diseases in the Yavatmal region and improving public health outcomes.

Nature as infrastructure to improve health: drawing on gardening and Indigenous health and connection to land research

Abstract The world is currently grappling with several public health issues (like the increase in urbanization, chronic diseases and social isolation). Increased connection with nature has been identified as a possible solution to many of these concerns. This perspective paper draws on recent empirical evidence around the health and wellbeing benefits of nature. To highlight these benefits I will draw on insights from my own research focused on Indigenous people’s connection to land (known as Country in Australia) and gardening as a mechanism for engaging people in nature. This will be applied to support the notion that nature is critical infrastructure that has significant potential to improve public health outcomes. In doing this it must be acknowledged that these are only a few aspects of the relationship between nature and health based on my own expertise and paradigms developed from my research. I will conclude this perspective essay by providing five overarching recommendations to mainstream the evidence substantiating the health and wellbeing benefits of nature into policy and practice.

Developing an Infrastructure Intervention for Solid Waste Exclusion in Pit Latrine Faecal Sludge

Pit latrine emptying is an important maintenance practice meant to increase a toilet's lifespan. However, the presence of solid waste in faecal sludge pose a great challenge during pit emptying, faecal sludge treatment and processing. Recent studies have demonstrated that solid wastes cause pits to fill up at a faster rate, destruct faecal sludge decomposition, and cause damage to emptying devices by blocking machine parts, and in some cases breaking them. When such occurs, emptying devices are usually withdrawn to manually remove the trapped debris, causing a loss of valuable time and reductions in daily revenue. One way of averting the adverse effects of solid wastes in pit latrines is by preventing them from mixing with faecal sludge in the pit. Therefore, the study aimed to design, develop and test an infrastructure intervention that would exclude solid waste from pit latrine faecal sludge. The study used a quantitative approach in which experimental methods were used to collect primary data. The methodology included the design, fabrication, and installation of a solid waste screening unit on a pit latrine. The screening unit was positioned directly below the squat hole to intercept solid waste while allowing excreta to pass through it. The unit was tested on a pit latrine that was used by 20 individuals over a period of 120 days, after which mass measurements of the intercepted solid wastes were done. The data obtained was analysed using Microsoft Excel 2016 version. It was found that the screening unit was capable of intercepting 88.2±0.6 % of the solid waste that entered the toilet through the squat hole. This confirmed that although behavioral, and education interventions have been conducted, there was little change in behavior towards the dumping of solid wastes in pit latrines. The study also showed that installing solid waste screening systems in future pit latrines can be one way of preventing solid wastes from mixing with pit latrine faecal sludge. These findings suggest that incorporating solid waste screening systems into future pit latrines could effectively prevent solid waste from mixing with faecal sludge. This intervention promises to complement existing behavioral and educational interventions prevalent in many developing countries. The study's application and findings promise improvements in faecal sludge management during pit emptying, treatment, and processing, thereby enhancing public health outcomes.

Harnessing the Power of Artificial Intelligence in Climate Change Mitigation: Opportunities and Challenges for Public Health

Artificial intelligence (AI) has emerged as a powerful tool for addressing the challenges posed by climate change and their impact on public health. By leveraging its capacity to analyze and predict climatic patterns, AI offers opportunities to enhance resource management and develop effective strategies for climate change mitigation. Moreover, AI can contribute to generating sustainable solutions that address the complex and interconnected nature of climate change. For example, AI can enable the optimization of energy consumption and facilitate the integration of renewable energy sources into existing systems. It can also support the development of climate models that provide timely and accurate predictions, enabling policymakers to implement proactive measures for disaster preparedness and response. Furthermore, AI-powered disease surveillance and mitigation techniques can improve public health outcomes by identifying patterns and trends in the spread of diseases in relation to climatic factors. However, the widespread adoption of AI-based solutions is not without challenges. Ethical concerns surrounding privacy and data ownership must be addressed, as the use of AI requires access to large datasets, raising potential privacy risks. Technical constraints, such as limited computational power and the need for sophisticated algorithms, also pose obstacles to the implementation of AI in climate change mitigation strategies. Furthermore, issues related to the accessibility and affordability of AI technologies must be resolved to ensure equitable distribution and maximize its potential impact on public health. To fully harness the power of AI in addressing climate change and improving public health outcomes, it is crucial to promote innovation, multidisciplinary collaboration, and open data science. Innovation can drive the development of new AI algorithms and technologies specifically tailored to address climate change challenges. Multidisciplinary approaches that bring together experts from diverse fields, including climate science, public health, and computer science, can foster a holistic understanding of complex systems and enable the design of comprehensive solutions. Finally, open data science practices, such as sharing data and algorithms, can facilitate collaboration and accelerate progress in mitigating climate change and its public health impacts. In conclusion, AI offers promising opportunities for effectively addressing climate change and its impact on public health. However, to fully realize its potential, it is essential to tackle ethical and privacy concerns, overcome technical constraints, and ensure accessibility and affordability. By promoting innovation, multidisciplinary collaboration, and open data science, we can unlock the transformative power of AI in mitigating climate change and improving public health outcomes.

Pericardial Diseases Mortality Trends in Brazil From 2000 to 2022.

Background Pericardial diseases manifest in various clinical forms, including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade, with acute pericarditis being the most prevalent. These conditions significantly contribute to mortality rates. Therefore, this article aimed to analyze mortality trends in the Brazilian population based on age and sex, shedding light on the impact of pericardial diseases on public health outcomes. Methods This is a retrospective time-series analysis of pericardial disease mortality rates in Brazil (2000-2022). Data was obtained from the Department of Informatics of the Unified Health System (DATASUS), and the 10th edition of the International Classification of Diseases (ICD-10) codes: I30, I31, and I32 were included for analysis. We gathered population and demographic data categorized by age range and sex from the Brazilian Institute of Geography and Statistics (IBGE). Subsequently, we computed the age-standardized mortality rate per 100,000 individuals and assessed the annual percentage changes (APCs) and average annual percentage changes (AAPCs) using joinpoint regression, along with their corresponding 95% confidence intervals (CIs). Results In terms of mortality trends based on sex, overall mortality rates remained stable for males and combined sexes over the study period. However, there was a notable increase in mortality rates among females (AAPC=1.18), particularly between 2020 and 2022, with a significant APC of 27.55. Analyzing pericardial diseases across different age groups (20 to 80 years and above), it wasobserved that mortality rates significantly increased in the 70-79 and 80 years and above age groups throughout the study period (AAPC=1.0339 and AAPC=3.4587, respectively). These two age groups experienced the highest significant rise in mortality between 2020 and 2022. Other age groups did not exhibit a significant change in AAPC. Conclusions This comprehensive analysis spanning two decades (2000-2022), examined the mortality trends of pericardial diseases in Brazil and revealed relative stability overall. Males exhibited an overall higher mortality number due to pericardial diseases; however, females showed the most significant increase in mortality trend throughout the whole period. In the first segment (2000-2015), mortality rose across all cohorts, which was attributed to substandard healthcare facilities and infectious diseases like tuberculosis. The second segment (2016-2020) saw a decline in mortality, likely due to improved healthcare, particularly the increased availability of echocardiograms. However, the third segment (2020-2022) witnessed a sharp rise in mortality, coinciding with the COVID-19 pandemic, with post-COVID-19 symptoms, particularly pericarditis. Pericarditis-related death rates declined compared to pericardial effusion, and mortality rates correlated directly with age, with older cohorts experiencing higher mortality due to increased comorbidities, and decline in health and immunocompetency.

Machine learning for public wellness: optimizing hygiene practices and pollution monitoring in smart cities

Introduction. Public health in urban areas is of paramount importance, particularly in the context of smart cities where technology plays a vital role. The integration of sophisticated infrastructure and data-driven systems in smart cities has the potential to significantly enhance public health outcomes. This improvement hinges on optimizing various factors, especially in the realms of hygiene standards and pollution monitoring. The ability to adhere to stringent hygiene procedures and closely monitor pollutants is essential for mitigating health risks in densely populated urban environments. As metropolitan areas become increasingly complex, there is a pressing need to prioritize the optimization of these processes.
 Materials and Methods. To address the challenges associated with public health optimization in smart cities, this study introduces Optimized Public Wellness using Machine Learning (OPWML). OPWML employs advanced machine learning techniques to augment hygiene protocols and pollution surveillance in smart urban areas. The proposed approach incorporates real-time validation, enhanced data-collecting efficiency, intelligent intervention impact, and increased throughput. The methodology aims to streamline processes and overcome the limitations of current approaches, providing more precise and prompt outcomes.
 Results. Simulation findings demonstrate the superior performance of OPWML compared to other methods. The average estimate accuracy achieved by OPWML is 86.76%, showcasing its efficacy in delivering accurate results. Real-time validation latency is notably low at 12.99 ms, indicating the system’s responsiveness. With a data collection efficiency of 22.96 GB/hour, OPWML demonstrates its ability to efficiently gather relevant data. The smart intervention impact of 33.20% underscores the system’s effectiveness in implementing intelligent interventions. Additionally, the throughput of 314.67 kbps signifies the high processing capacity of OPWML.
 Limitations. While OPWML exhibits promising results, it is essential to acknowledge certain limitations in this study. The simulation-based nature of the findings may not fully capture real-world complexities. Additionally, the generalizability of the results to diverse urban contexts requires further investigation. Limitations such as data privacy concerns and potential technological barriers should also be considered when implementing OPWML in practical settings.
 Conclusion. In conclusion, Optimized Public Wellness using Machine Learning (OPWML) emerges as a powerful tool for transforming public health processes in smart cities. The study highlights OPWML’s capacity to significantly enhance hygiene protocols and pollution surveillance, ensuring a healthier and environmentally sustainable urban setting. While acknowledging certain study limitations, the overall outcomes emphasize the potential of OPWML in revolutionizing public health practices and contributing to the well-being of urban populations in the era of smart cities.

Effectiveness of substance use disorder treatment as an alternative to imprisonment

IntroductionDrug courts are criminal justice programs to divert people with substance use disorders from incarceration into treatment. Drug courts have become increasingly popular in the US and other countries. However, their effectiveness in reducing important public health outcomes such as recidivism and substance-related health harms remains ambiguous and contested. We used nationwide register data from Sweden to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism.MethodsIn this prospective cohort study, two quasi-experimental designs were used: difference-in-differences and the within-individual design. In the latter, we compared the risk of outcomes during time on contract treatment to, 1) parole after imprisonment and, 2) probation.ResultsThe cohort included 11,893 individuals (13% women) who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points (95% CI: -.088, -.055) in substance misuse, 5 percentage points (-.064, -.034) in adverse mental health events, 9 percentage points (-.113, -.076) in adverse somatic health events, and 3 fewer charges (-3.16, -2.85) for crime in difference-in-differences analyses. Within-individual associations suggested that the same individual had longer times-to-event for all outcomes during contract treatment than on parole or on probation.ConclusionsContract treatment is an effective intervention from both public health and criminal justice perspective. Our findings suggest that it is a superior alternative to incarceration in its target group. Further, we find that an implementation approach that is less punitive and more inclusive than what is typical in the US can be successful.