Development Of Public Health Policies Research Articles

Exploring oral health challenges and integration strategies in opioid treatment programs: perspectives from clinicians and clients.

Background Despite the paramount importance of oral health, individuals undergoing treatment for opioid use disorder face unique challenges beyond traditional addiction care. This qualitative study explores the challenges Opioid Treatment Program (OTP) clients in Australia encounter when accessing oral health care, aiming to understand the underlying factors and identify effective strategies for integrating oral health into an OTP. Methods Semi-structured interviews were conducted with OTP clients, OTP clinicians and oral health clinicians using tested interview guides. Thematic analysis identified patterns and themes across participants' responses. Results Client behaviour and traits such as inadequate health prioritisation, crisis-driven care and lack of motivation, shaped by a complex social environment, contribute significantly to inconsistent care and neglected oral health. Addiction exacerbates oral health issues as clients prioritise drug use over oral care and financial constraints, resulting in poor oral hygiene and a higher prevalence of dental problems. Psychological barriers such as dental anxiety deter clients from seeking care, while access issues including administrative burdens and system barriers, lost phones and unstable living conditions hinder consistent management of oral health. Stakeholders recommend actionable steps to address OTP clients' challenges, including integrating holistic care, establishing collaborative support systems, improving awareness and education and enhancing accessibility and flexible scheduling. Conclusion This study established a framework for improving OTP clients' oral health through integrated, holistic strategies. By addressing gaps in existing research, it supports the development of public health policies integrating oral health care into OTPs, aiming to foster collaboration, improve access and advance client education for better health outcomes.

Depression among people living in rural and urban areas of Thailand: A cross-sectional study.

Depression has a growing trend in the population worldwide. In this cross-sectional study, we investigated the prevalence and associated factors of depression among individuals residing in rural (Ban Luang district, Nan Province) and urban (Lak Si, Bangkok) areas of Thailand. Understanding the differences in depression between these two settings can provide insights for specific targeted interventions and mental health policies. The multistage stratified random sampling was applied to select the study participants. We recruited participants from rural and urban communities in Thailand using a structured survey questionnaire through either face-to-face interviews or in paper or electronic form. We collected data on depression using the Patient Health Questionnaire-9 (PHQ-9) tool and sociodemographic characteristics and conducted descriptive statistics and logistic regression analysis. Of 867 survey participants, 420 were from rural areas (Nan) and 447 were from urban areas (Bangkok). Participants' mean age was 55.9±9.5 years in rural areas and 56.0±12.0 years in urban areas. Most participants in urban areas were women, married, and had lower education levels (71.1%, 50.3%, 58.8%, respectively). The overall prevalence of depression across both settings was 18.6%. We found a higher prevalence of depression in the urban (31.8%) than the rural (4.5%) setting. In multiple logistic regression analysis, urban residence was significantly associated with higher rates of depression compared with rural residence (adjusted odds ratio [AOR] 9.43, 95% confidence interval [CI] 5.08-17.52). Nuclear family and using social media were associated with lower levels of depression in urban areas (AOR 0.50 and 0.43, 95% CI 0.27-0.93 and 0.22-0.84, respectively). Higher education level was significantly associated with higher levels of depression in rural areas (AOR 3.84, 95% CI 1.19-12.42). This study emphasized the difference in depression and related factors between rural and urban areas of Thailand, highlighting a greater prevalence in urban areas. To help prevent depression, it is important to address specific challenges in each setting, such as those faced by highly educated individuals living in rural areas with high depression rates, exploring social media use patterns in urban populations, and understanding dynamics of the nuclear family. Our findings can inform the development of public health policies aimed at effectively mitigating the burden of depression and improving overall mental well-being in specific settings.

Socioeconomic, health, and social connectedness factors associated with self-rated health of octogenarians and nonagenarians in South Korea: urban and rural comparison

BackgroundThe aging population, including octogenarians (aged 80–89) and nonagenarians (aged 90–99), is rapidly increasing. Understanding their self-rated health in urban and rural settings is vital for public health policy development. This study examined factors associated with self-rated health among octogenarians and nonagenarians across urban and rural areas of South Korea.MethodsWe analyzed data from 21,896 older adults (aged 80–99) from the 2023 Korea Community Health Survey. Self-rated health was assessed on a 5-point scale and categorized as “good” or “poor.” Variables included age, residence area (urban/rural), sociodemographic characteristics, health behaviors, healthcare utilization, morbidity, and social interactions. Descriptive statistics were used to examine variable distributions, and logistic regression models identified factors associated with self-rated health in each age group and residential area.ResultsAmong octogenarians, 18.7% in urban areas reported good self-rated health, compared to 15.0% in rural areas. Conversely, a smaller proportion of nonagenarians in urban areas (13.6%) reported good self-rated health than those in rural areas (14.7%). Among octogenarians, having a high school education or higher was associated with better self-rated health compared to those with no formal education (urban OR = 1.67, 95% CI = 1.39–2.00; rural OR = 1.67, 95% CI = 1.30–2.14). Furthermore, a monthly household income of 3 million Korean Won (KRW) or more, compared to an income of less than 1 million KRW, was associated with better self-rated health among octogenarians (urban OR = 1.35, 95% CI = 1.09–1.66; rural OR = 1.54, 95% CI = 1.19–2.00). The associations between educational level and self-rated health were less pronounced among nonagenarians. Consistently across both age groups and settings, regular walking (OR range: 1.39 [95% CI = 1.21–1.60] for rural octogenarians to 2.17 [95% CI = 1.78–2.64] for urban nonagenarians), good self-rated oral health (OR range: 2.51 [95% CI = 1.96–3.22] for urban nonagenarians to 3.51 [95% CI = 3.01–4.09] for rural octogenarians), and participation in social activities (OR range: 1.23 [95% CI = 1.09–1.41] for urban octogenarians to 1.58 [95% CI = 1.20–2.07] for rural octogenarians) were positively associated with good self-rated health.ConclusionsCharacteristics associated with self-rated health differed significantly between octogenarians and nonagenarians in rural and urban areas. Public health strategies must support health-promoting behaviors such as regular walking, enhance oral health services, improve healthcare accessibility, reduce environmental stressors, and strengthen social support networks to promote health among octogenarians and nonagenarians.

Trends in the growing impact of group A Streptococcus infection on public health after COVID-19 pandemic: a multicentral observational study in Okayama, Japan.

Following the COVID-19 pandemic, group A Streptococcus (GAS) infection has been surging worldwide. We aimed to compare the disease burden between notified cases of streptococcal toxic shock syndrome (STSS) and unreported GAS infections. This is a multicentral observational study, retrospectively performed at seven hospitals in Okayama prefecture in Japan from January 2022, to June 2024. Clinical and microbiological data of patients with positive cultures of GAS were collected from the medical records. Primary outcomes were defined as rates of surgical procedures, intensive care unit (ICU) admission, and in-hospital mortality, which were compared among patients with locally-defined STSS, invasive GAS (iGAS), and non-iGAS infection. GAS was detected in 181 patients, with 154 active cases of GAS infection. The number of patients with GAS infection surged in late 2023. The most common source of infection was skin and soft tissue infections, accounting for 83 cases, including 15 cases of necrotizing fasciitis, and 12 cases (7.8%) were notified to public health authorities as STSS. Among the 25 unreported iGAS cases, 9 (36.0%) underwent surgical intervention, and 4 patients (16.0%) required ICU admission. The mortality rates in the unreported iGAS cases were comparable to those observed in the notified STSS. We highlighted that the number of iGAS infections was twofold higher than that of notified STSS, with comparable mortality rate between these groups, indicating substantial underestimation of the true burden of iGAS. This epidemiological investigation has significant implications for enhancing infectious disease surveillance frameworks and public health policy development.

Global, regional and national temporal trends in Parkinson's disease incidence, disability-adjusted life year rates in middle-aged and older adults: a cross-national inequality analysis and Bayesian age-period-cohort analysis based on the global burden of disease 2021.

Parkinson's disease (PD) ranks as the second most prevalent neurodegenerative disorder; however, its epidemiological characteristics among middle-aged and older adults at global, regional, and national levels remain inadequately documented. This study assessed temporal trends in PD among middle-aged and older adults by extracting incidence rates, disability-adjusted life year (DALY) rates, and corresponding age-specific rates (ASRs) from the Global Burden of Disease (GBD) database spanning 1990 to 2021. Estimated annual percentage change (EAPC) was employed to analyze trends over the past 30 years. The slope index of inequality (SII) and concentration index (CI) were utilized to evaluate disparities in the burden of PD across various countries. Additionally, Bayesian age-period-cohort (BAPC) modeling was applied to project DALY figures for the next 15 years. In 2021, the global incidence and DALY rates for middle-aged and older adults with PD stood at 79.68 and 477.50 cases per 100,000 population, respectively. Both incidence and DALY rates have exhibited an upward trajectory over the past 32 years, with EAPCs of 1.2 (95% UI: 1.1-1.3) and 0.6 (95% UI: 0.5-0.7), respectively. Among the five sociodemographic index (SDI) regions, the high-middle SDI region reported the highest incidence and DALY rates for PD in 2021, at 93.93 and 512.29 cases per 100,000 population, respectively. A positive correlation was observed between the SDI and age-specific incidence rate (ASIR) as well as age-specific DALY rate (ASDR). Disparities in the burden of PD among middle-aged and older adults, associated with SDI, are on the rise and are primarily concentrated in high SDI countries. It is projected that the global incidence and DALY rates for middle-aged and older adults with PD will experience significant increases over the next 15 years. The global burden of PD among middle-aged and older adults has markedly escalated over the past 32 years, particularly in high-middle SDI regions. These findings underscore the necessity for the development of effective interventions and public health policies, contributing to the attainment of the sustainable development goals established by the World Health Organization (WHO).

Global esophageal cancer epidemiology in 2022 and predictions for 2050: A comprehensive analysis and projections based on GLOBOCAN data.

The burden of esophageal cancer varies across different regions of the world. The aim of this study is to analyze the current burden of esophageal cancer in 185 countries in 2022 and to project the trends up to the year 2050. We extracted data on primary esophageal cancer cases and deaths from the GLOBOCAN 2022database, which includes data from 185 countries. Age-standardized incidence rates (ASIR) and mortality rates (ASMR) per 100,000 person-years were calculated by stratifying by Human Development Index (HDI) levels and regions. Considering changes in population size and age structure, we assumed that the risks of incidence and mortality remain constant at the levels of 2022 to forecast the number of new cases and deaths from esophageal cancer globally by 2050. In 2022, an estimated 511,054 people were diagnosed with esophageal cancer globally, and 445,391died from the disease. The global ASIR and ASMR for esophageal cancer were 5.00 and 4.30 per 100,000, respectively. The highest rates were observed in East Africa (7.60 for incidence, 7.20 for mortality per 100,000), East Asia (7.60 for incidence, 5.90 for mortality per 100,000), Southern Africa (6.30 for incidence, 5.90 for mortality per 100,000), and South Central Asia (5.80 for incidence, 5.50 for mortality per 100,000). Among the 185 countries worldwide, esophageal cancer was among the top five causes of cancer incidence in 18 countries and among the top five causes of cancer mortality in 25 countries. In 2022, China had 224,012 new cases and 187,467deaths from esophageal cancer, accounting for approximately 43.8% and 42.1% of the global total, respectively, which is higher than the proportion of China's population to the global population (17.9%). ASIR was 8.30 per 100,000, and ASMR was 6.70 per 100,000. The highest burden of esophageal cancer was in high HDI countries, with new cases and deaths accounting for 51.3% and 50.0% of the global total, respectively. The ASIR and ASMR were highest in the high HDI group (6.10 and 5.10 per 100,000, respectively), also exceeding the global averages. There was a trend of decreasing mortality to incidence ratio (M:I) with increasing HDI, but no correlation was observed between HDI and ASIR or ASMR. In all regions worldwide, the incidence and mortality rates were higher in males than in females (with a male-to-female ASR ratio ranging from 1.10 to 28.7). Compared to 2022, it is projected that by 2050, the number of new esophageal cancer cases will increase by approximately 80.5%, and deaths will increase by 85.4% due to population growth and aging. The burden of esophageal cancer remains heavy. Adopting a healthy lifestyle, including reducing tobacco and alcohol intake, avoiding moldy foods, and increasing intake of fresh fruits and vegetables, can help reduce the risk of stomach and esophageal cancer. In addition, the development and implementation of evidence-based and effective public health policies are critical to reducing the global disease burden of esophageal cancer.

Utilizing Wastewater Surveillance to Model Behavioral Responses and Prevent Healthcare Overload During ‘Disease X’ Outbreaks

During the COVID-19 pandemic, healthcare systems worldwide faced severe strain. This study, utilizing wastewater virus surveillance, identified that periodic spontaneous avoidance behaviors significantly impacted infectious disease transmission during rapid and intense outbreaks. To incorporate these behaviors into disease transmission analysis, we introduced the Su-SEIQR model and validated it using COVID-19 wastewater data from Beijing and Hong Kong. The results demonstrated that the Su-SEIQR model accurately reflected trends in susceptible populations and confirmed cases during the COVID-19 pandemic, highlighting the role of spontaneous collective avoidance behaviors in generating periodic fluctuations. These fluctuations helped reduce infection peaks, thereby alleviating pressure on healthcare systems. However, the effect of these spontaneous behaviors on mitigating healthcare overload was limited. Consequently, we incorporated healthcare capacity constraints into the model, adjusting parameters to further guide population behaviors during the pandemic, aiming to keep the outbreak within manageable limits and reduce strain on healthcare resources. This study provides robust support for the development of environmental and public health policies during pandemics by constructing an innovative transmission model, which effectively prevents healthcare overload. Additionally, this approach can be applied to managing future outbreaks of unknown viruses or ‘Disease X’.

Prevalence of Preterm Birth in Saudi Arabia: A Systematic Review and Meta-Analysis.

Preterm birth, defined as delivery before 37 weeks of gestation, is a significant contributor to neonatal morbidity and mortality worldwide. Understanding the prevalence of preterm birth is critical to improving neonatal care, informing public health strategies, and supporting health care planning. The objective of this study was to explore the problem of preterm birth in Saudi Arabia by estimating the prevalence of preterm birth over a defined period of time. CINAHL, Cochrane Pregnancy and Childbirth Database, Embase, and Medline were searched, limiting the search to the human Saudi population, with no date or language restriction. Titles, abstracts, and full texts were screened to determine eligibility for inclusion. Included studies were assessed for risk of bias utilizing the Let Evidence Guide Every New Decision (LEGEND) tool. Then, data were extracted in a customized data collection form. Among the 14 full texts reviewed, 10 studies met the eligibility criteria and were included in the final review, with a total of 50,514 participants for singletons and 336 sets of twins or/and high-order gestation in different regions of Saudi Arabia. Six studies have been entered into the meta-analysis and resulted in a pooled prevalence of preterm birth of 7.89 per 100 live births (95% confidence interval: 6.94 to 8.97). For multiple pregnancies, the average prevalence of preterm birth was 91.3 per 100 live births (95% confidence interval: 88.3 to 94.3). The overall preterm birth rate in Saudi Arabia can be utilized in national health planning and public health policy development. By knowing the prevalence of preterm birth, healthcare practitioners and policymakers can effectively plan for capacity building and healthcare services to provide efficient and proactive care for preterm infants, ultimately improving patient outcomes by reducing neonatal morbidity and mortality.

Industry influence on public health policy formulation in the UK: a complex systems approach.

Unhealthy commodity industries (UCIs) such as tobacco, alcohol, gambling, ultra-processed food and beverage producers are known to influence policy-making to advance their interests, often to the detriment of public health goals. This study mapped the complex system underpinning UCI's influence on public health policy formulation in the UK and identified potential interventions to shift the system towards being able to better attain public health goals. We conducted a participatory systems mapping workshop with ten experts to build a causal loop diagram (CLD) and identify potential interventions to address UCI's influence on public health policy development. The resulting CLD depicts a highly interconnected and reinforcing system driving UCI's involvement in public health policy formulation across five thematic areas. Among the most connected elements were the 'dominance of market mechanisms', 'perception of partnership as good governance principle', 'industry involvement lending perceived legitimacy to the policy formulation process', 'industry is seen as part of the solution' and 'industry ties to policy-makers'. Participants identified a total of 22 interventions within this system. Analysis of the CLD and interventions identified the potential for two key paradigmatic changes in this complex system: de-normalizing the perception of unhealthy commodity industry actors as legitimate stakeholders in policy formulation; and prioritizing public health and wellbeing objectives over profit and economic gain. In order to shift the system towards better attaining public health goals, interventions should reinforce each other and be supportive of these two key paradigmatic shifts.

Abstract 4122008: Bayesian modeling to forecast mortality due to Ischemic Heart Disease, Stroke, and Peripheral Artery Disease in Brazil until 2040

Introduction: Atherosclerotic cardiovascular disease, specifically ischemic heart disease (IHD), stroke, and peripheral artery disease (PAD) together are among the leading causes of cardiovascular mortality in Brazil. As the obesity, hypertension, and diabetes rates in the Brazil continue to increase, projecting mortality rates related to these conditions are important for guiding health policy. Hypothesis: We hypothesized that there are differences in the future trends of IHD, stroke and PAD in Brazil. Aims: We sought to forecast the trends in IHD, stroke, and PAD in Brazil until 2040 to fill in this important knowledge gap and inform public health policy development. Methods: We collected the annual death counts for IHD, stroke, and PAD and the mid-year population estimates in 5-year age brackets (40 – 79 years) between 1990 and 2019 from the Global Burden of Disease. We calculated the annual crude and age-standardized mortality rates (per 100 000 residents) for IHD, stroke and PAD between 1990 and 2019. Using this observed data, we estimated the projected mortality rates for these conditions till 2040 using Bayesian age-period-cohort (BAPC) models. Results: Brazil`s population (aged 40-79 years) will increase by 237.5% between 1990 and 2040. Nationally, compared to 2019, the age standardized IHD mortality is projected to reduce by 31.66 % [2019: 131.13, 2040:89.6 (IQR: 65.83, 113.37)] and stroke rates are estimated to reduce by 16.75% [2019: 91.09, 2040: 75.83 (IQR: 51.68, 99.98)]. However, PAD rates are projected to increase by 1.2% in the same period [2019: 1.58, 2040: 1.66 (IQR: 1.24, 2.07)]. The age standardized IHD and stroke mortality rates will reduce in males and females. However, the age standardized PAD rates will increase in females [2019: 1.33, 2040: 1.48 (IQR: 1.06, 1.89), 11.28% difference] and remain reasonably constant among males. Conclusion: In Brazil, the age standardized rates for IHD and stroke mortality are projected to decline till 2040. However, PAD related mortality is likely to be an important issue among females. Our findings highlight the need for early and targeted interventions to address these potential cardiovascular health disparities.

THE RELATIONSHIP BETWEEN ELDERLY PEOPLE AND NATURE: IMPACTS OF TRADITIONAL KNOWLEDGE ON PROMOTING WELL-BEING AND QUALITY OF LIFE

This study aimed to explore the relationship between older adults and nature and the impacts of this interaction on promoting well-being and quality of life. To this end, a systematic literature review was conducted to identify recent studies that analyzed older adults’ perceptions of natural environments and the consequences of outdoor activities on the physical, mental, and emotional health of this population group. The results demonstrated that contact with nature significantly contributes to reducing feelings of loneliness and depression, in addition to favoring the strengthening of social bonds and promoting a renewed sense of belonging and identity. In addition, studies indicate that older adults who maintain a connection with nature tend to have higher levels of subjective happiness and a greater willingness to participate in sustainable practices and environmental conservation. Based on these findings, it is concluded that nature plays a crucial role in promoting active and healthy aging, and that initiatives aimed at facilitating older adults’ access to natural environments are fundamental to the development of public health and well-being policies.

Knowledge, attitudes and practices of meat hygiene among slaughterhouse workers and retail meat sellers in Bangladesh

Inadequate handling of raw meat leading to cross-contamination, often stemming from insufficient knowledge and practices among meat handlers, poses a significant global health challenge, especially in developing nations where food-borne diseases are prevalent. Effective understanding and implementation of preventive measures by meat handlers are essential in reducing the incidence of food-borne illnesses and the contamination of raw meat. This study aimed to assess the knowledge, attitudes, and practices regarding meat hygiene among retail meat sellers and slaughterhouse personnel in the Bogura district of Bangladesh. A descriptive, cross-sectional survey was conducted, encompassing 408 meat handlers selected through a multistage sampling approach. Data on their knowledge, attitudes, and practices of meat hygiene were collected using a structured questionnaire, and then analyzed. The participants had a mean age of 34.63 years with a standard deviation of 13.44. The majority of participants demonstrated good knowledge (70.70 %) and positive attitudes (53 %). However, no significant differences were observed in good (49.80 %) or poor (50.20 %) practices regarding meat hygiene. Interestingly, significant associations were observed between knowledge and age (p = 0.022), location (p < 0.001), and borderline significance in training (p = 0.051). Similarly, a statistically significant association was found between the practice of meat hygiene and age (p = 0.041), level of education (p = 0.008), and training (p = 0.004). Furthermore, a significant association existed between knowledge and practices of meat hygiene (p < 0.001). Older meat handlers with training exhibited better knowledge and practices of meat hygiene compared to their younger counterparts. This study underscores the importance of public health education, policy development, and regular training and retraining programs for meat handlers to ensure safe meat handling practices and overall hygiene.

Association between frailty and fear of falling among the elderly in Latvia

Abstract Background Frailty and fear of falling in the ageing population represent notable public health challenges. Fear of falling among the elderly population is a significant concern, as it can lead to decreased mobility, loss of independence, and increased risk of injury. Frailty intensifies this fear, as frail individuals often have reduced strength, balance, and coordination, making them more susceptible to falls. Methods Data from the population-based survey SHARE with respondents aged 50+ in Latvia of Wave 9 (collected 2022) was analysed. Frailty was assessed using the SHARE-Frailty Instrument. Fatigue, appetite, walking difficulties, and physical activity were self-reported and grip strength was measured using a hand grip dynamometer. Fear of falling was evaluated using visual material. Financed by the project RSU internal and RSU with LSPA external consolidation No.5.2.1.1.i.0/2/24/I/CFLA/005, Postdoctoral Grant Associated factors of frailty and fall-related mortality in the older population in Latvia No.RSU-PG-2024/1-0005. Results The sample comprised 1439 older adults from Latvia (60.4 % female) with a mean age of 67.9 (95% CI 67.5 - 68.4). Based on SHARE-FI, frailty and pre-frailty prevalence were 7.2% and 44.5% respectively. In the study, 11.3% of females and 6.5% of males interviewed reported experiencing fear of falling. Frailty was correlated with fear of falling in 43.7% of frail individuals and 11.5% of pre-frail individuals. After adjusting for age and gender, those with pre-frailty and frailty had greater odds of fear of falling. Conclusions Understanding the interaction between the fear of falling and frailty in older adults can guide the development of public health policies and initiatives that aim to mitigate the fear of falling and, consequently, reduce the prevalence of frailty. Promoting healthy ageing behaviours, such as regular exercise, balanced nutrition, and social engagement, can help prevent frailty and its associated risks. Key messages • Fear of falling results in limitation of activities, intensification of physical decline, and increased susceptibility to frailty. • Encouraging healthy ageing underscores the significance of early recognition of frailty symptoms and accessing suitable support.

Boosting influenza vaccination rates through policy gamification: the ‘Let’s Control Flu’ project

Abstract Background Influenza remains a public health challenge globally, leading to substantial morbidity and mortality, particularly among vulnerable groups. Despite the benefits of vaccination, achieving the desired vaccination coverage rates (VCR) proves challenging across Europe. The ‘Let’s Control Flu’ (LCF) tool emerges as a new contribution, merging gamification with epidemiological data and public health policies to help increase influenza VCR. Methods The LCF tool, developed from an extensive literature review and validated by a National Advisory Board, initially showcased its capabilities in Sweden. Offering an interactive simulation, it allows stakeholders to explore the outcomes of implementing 13 targeted public health policies (PHP) on influenza VCR and health outcomes such as infection rates, hospitalizations, and mortality. This approach simplifies epidemiological complexities, paving the way for informed decision-making. Results Following its success in Sweden, the LCF tool was extended to Germany and Czechia, underlining the value of gamified tools in public health decision-making. The application across these new countries not only resulted in paths to improve VCR but also provided insights into the tool’s scalability and adaptability different landscapes. Conclusions The LCF project underscores the efficacy of integrating gamification into health policy decision-making, offering a replicable model for enhancing influenza vaccination uptake across Europe. With the tool now successfully applied in multiple countries, its potential for broader European and global application is evident. This initiative aligns with WHO’s objectives, spotlighting gamification as a relevant component in improving vaccination strategies and readiness for influenza and other preventable diseases, thereby reinforcing the importance of innovative approaches in public health policy development. Key messages • The LCF tool integrates gamification with public health strategies to help effectively raise influenza vaccination coverage. • By merging gamification and epidemiological insights, the LCF tool also serves as a scalable model for Europe, supporting WHO’s goals to improve vaccine strategies and preparedness.

Numerical simulation on exhaled aerosol transmission based on realistic oral-nasal structures and temperature distribution

ABSTRACT Respiratory infections are currently understood to be caused by pathogens released through the nose or mouth of an infected individual, and subsequently transmitted to susceptible hosts. These pathogens are enclosed in liquid particles that are aerosolized from the respiratory tract during activities such as breathing, speaking, sneezing, and coughing. These particles vary widely in size, ranging from submicron to several microns. While past research has largely overlooked the human respiratory system, recent analysis has revealed that the actual structure of the nasal cavity significantly influences the prediction of aerosol transmission during exhalation. In this study, computational fluid dynamics (CFD) simulations were conducted to analyze the aerosol transmission generated during exhalation from the nasal and oral cavities. Realistic nasal and oral cavity structures were taken into account, and authentic temperature distributions were applied to the surfaces. Additionally, inhalation conditions for susceptible individuals were established to evaluate the risk of inhalation-generated exposure. Through various simulation scenarios, we separately discussed the impact of environmental wind speed, separation distance, and exhalation flow rate. The simulation results indicate that environmental wind amplifies the complexity of the flow field and the transmission and deposition of particles between two individuals. Under ambient wind velocities of 0.5 m/s and 1 m/s, it was observed that over 80% of the particles with a diameter of 1 µm inhaled through the nasal cavity accounted for the total deposition on the infected individual. Furthermore, high exhalation flow rates exhibited higher deposition ratios at close distances, in line with our expectations. Therefore, it is advisable to minimize close contact as much as possible during periods of frequent respiratory infections, and to wear masks in order to reduce the risk of inhalation exposure. Implications: During the activities such as breathing, speaking, sneezing, and coughing, liquid particles containing pathogens are aerosolized from the respiratory tract and are released from nose or mouth through the nebulization. In this study, we investigated the transmission of aerosols from human exhalation in the outdoor environment, innovatively taking the real oral-nasal structure and the active inhalation of vulnerable people into consideration, and explored the human-to-human transmission of respiratory viruses. The results are beneficial for public health assessment and policy development.

Mechanisms of young professional engagement in health policy development: a cultural domain approach.

Engagement in public health policy development is critical to forward-thinking public health policy. There is a robust empirical case to support the prospect of the engagement of young adults in civic and research efforts. However, the literature is limited in conceptualizing the mechanisms of engagement in health policy development from the perspective of young adults. This study applied the concepts and methods of cognitive anthropology to identify the mechanisms of engagement in health policy development from the perspective of young people. Online elicitation and cognitive domain analysis were applied to collect and analyze the data. Students enrolled in a public health leadership class at a large United States southeastern university were invited to participate in an online discussion. Saturation was achieved after the eighth submission. Data were analyzed qualitatively for repetition and recurrence and quantitatively to assess their cultural saliency. Thirty-two students submitted 147 individual engagement ideas. The analysis resulted in 24 unique mechanisms organized into 10 clusters. The most prominent engagement mechanisms included education, peer activities, advocacy, direct involvement, and activism. In the dynamic landscape of public health, active involvement in health policy development presents a crucial pathway for leadership among young professionals. The application of cognitive anthropology methods contributes to the emerging science of engagement and allows to identify and measure consensus around the pathways for engagement in health policy development among young professionals.

High Adherence to COVID-19 Public Health Preventive Measures in Indigenous Communities in the Canadian Northwest Territories.

The aim of this project is to explore perceptions towards and adherence to COVID-19 public health preventive measures in Indigenous communities within Northwest Territories, Canada. Utilizing a cross-sectional study design the project took place within ten Northwest Territories communities between 1st April and 30th November 2021. Convenience sampling methods were utilized and adhered to public health restrictions. Self-identifying Indigenous adults (≥ 18 years old) were invited to complete a semi-structured interviewer-administered questionnaire. Participants (n = 287; 33.1% men, 66.6% women) had a mean age of 41.6 years (SD ± 13.5). Preventive measures were practiced by 98.6% of participants. Most participants reported often or always practicing three measures: avoiding gatherings (67.2%), avoiding usual greetings (63.3%), and limiting contact with high-risk individuals (71.4%). Most participants reported rarely/never practicing self-isolation (67.5%) and self-quarantining (76.5%) measures. Significant associations existed between the August 2021 COVID-19 outbreak and self-quarantining (p = 0.0023), self-isolating (p = 0.0023), and going onto the land (p = 0.0001). Participants found masking and travel restrictions challenging. Sadness and loneliness resulted from limited access to Elders. Kinship and community safety were important to Indigenous community members and influenced COVID-19 preventive measure utilization. The findings can inform culturally specific COVID-19 public health policy development.

Mapping new psychoactive substances: Leveraging GIS technology for advanced global surveillance and policy support

The escalating challenge of New Psychoactive Substances (NPS) necessitates enhanced global monitoring and analysis capabilities. This study introduces an advanced interactive visualization tool that employs Geographic Information System (GIS) technologies to improve the functionality of the UNODC's Early Warning Advisory. The tool enables dynamic observation and analysis of NPS's geographical and temporal distribution, thereby facilitating a comprehensive understanding of their public health impacts. By incorporating detailed choropleth maps and annual and cumulative bar charts, the tool allows policymakers and researchers to visually track and analyze trends in NPS usage and control efforts across different regions. The results demonstrate the tool's effectiveness in providing actionable insights, which support the strategic development of public health policies and interventions to curb the global rise in NPS usage. This initiative illustrates the essential role of digital tools in enhancing public health strategies and responses to emerging drug trends. This rising challenge underscores the urgent need for innovative solutions in monitoring drug trends, a theme explored in this paper. The web tool is available at https://nps-vis.cmdm.tw, and the code is available at https://github.com/CMDM-Lab/nps-vis.

The influence of adult urine lead exposure on bone mineral densit: NHANES 2015-2018.

Previous studies have indicated that exposure to heavy metals related to bone health is primarily limited to some common harmful metals, and the impact of lead has not been fully understood. This study aims to explore the relationship between urine lead exposure and bone density. 1,310 adults were included from the NHANES database (2015-2018), and through generalized linear regression analysis and constrained cubic spline models, the association between lead levels and total bone density as well as lumbar spine bone density was explored. The study also examined the impact of combined exposure to lead and cadmium on bone density. Urinary lead levels were significantly negatively correlated with total bone mineral density (β: -0.015; 95%CI: -0.024, -0.007) and lumbar spine bone mineral density (β: -0.019; 95%CI: -0.031, -0.006). Compared to the lowest three quartiles of lead levels, the adjusted odds ratios for T3 changes in total bone mineral density and lumbar spine bone mineral density were 0.974 (95%CI: 0.959, 0.990) and 0.967 (95%CI: 0.943, 0.991), indicating a significant negative trend. Further analysis with constrained cubic spline models revealed a non-linear decreasing relationship between urinary lead and total bone mineral density as well as lumbar spine bone mineral density. Stratified analyses suggested that the relationship between urinary lead levels and bone mineral density might be significantly influenced by age, while gender showed no significant impact on the relationship. Moreover, combined exposure to lead and cadmium was found to be associated with decreased bone mineral density, emphasizing the potential synergistic effects between lead and cadmium on bone health. However, the specific mechanisms of lead and its effects on different populations require further comprehensive research. This study provides valuable insights for further exploration and development of relevant public health policies.

The Impact of Wildfire Smoke on Asthma Control in California: A Microsimulation Approach.

Wildfire smoke exposure leads to poorer health among those with pre-existing conditions such as asthma. Particulate matter in wildfire smoke can worsen asthma control, cause acute exacerbations, and increase health resource utilization (HRU) and costs. Research to date has been retrospective with few opportunities to project changes in underlying asthma control and HRU given exposure to wildfire smoke. Using a microsimulation of 5,000 Californians with asthma, we calculated changes in asthma control distribution, risk of exacerbation, and HRU and cost outcomes in the 16weeks during and after a wildfire. The model was calibrated against empirical values on asthma control distribution and increased HRU after exposure to wildfire smoke. Without smoke exposure, 48% of the cohort exhibited complete or well control of asthma, and 8% required acute healthcare per cycle. Following two consecutive weeks of wildfire smoke, complete or well control of asthma fell to 27%, with an additional 4% HRU. This corresponds to total additional $601,250 in all-cause medical costs and eight fewer quality-adjusted life years over 16weeks of model time. Our model found increased asthma health and cost burden due to wildfire smoke that were aligned with empirical evidence from a historic wildfire event. This study establishes a framework for a more nuanced understanding of asthma impacts from wildfire smoke that can help inform the development of public health policies to mitigate harm and promote resilience among asthma patients in the face of climate change.