Public Health Recommendations Research Articles

Longitudinal study of vitamin D status among Thai individuals in a sun-abundant country

BackgroundVitamin D deficiency is a major public health problem worldwide, even in countries with abundant sunshine. Understanding the risk factors for vitamin D deficiency is important to inform public health recommendations. We conducted a longitudinal analysis of vitamin D status in Thai individuals to assess changes in vitamin D status over time and identify potential determinants. Study designThis study is a long term prospective cohort study. MethodsOf the 1239 participants who were employees of the Electricity Generating Authority of Thailand, serum 25-hydroxyvitamin D (25(OH)D) levels were measured by liquid chromatography/tandem mass spectrometry from samples collected in 2009 and 2019. ResultsThere was a significant 14.8% increase in serum total 25(OH)D (P < 0.001) from 2009 to 2019, which resulted from significant increases in both 25(OH)D3 and 25(OH)D2. The epimeric form of 25(OH)D2 also increased significantly, while there was no increase in the epimeric form of 25(OH)D3. A univariate analysis showed significant associations between increased total 25(OH)D and increasing age, male sex, and lower body mass index. After controlling for baseline vitamin D status, multivariate regression analyses found that the direction of association and significance from univariate analyses persisted for total 25(OH)D and 25(OH)D3. However, a univariate association found between female sex and an increase in 25(OH)D2 was not significant in multivariate regression analysis. ConclusionsA long-term trend of improved vitamin D status was found among Thai adult individuals over a 10-year period; however, improvements were less noticeable in women.

Assessing the quality and completeness of reporting in health systems guidance for pandemics using the AGREE-HS tool.

During health emergencies, leading healthcare organisations, such as the World Health Organization (WHO), the European Centre for Disease Control and Prevention (ECDC), and the United States Centers for Disease Control and Prevention (CDC), provide guidance for public health response. Previous studies have evaluated clinical practice guidelines (CPGs) produced in response to epidemics or pandemics, yet few have focused on public health guidelines and recommendations. To address this gap, we assessed health systems guidance (HSG) produced by the WHO, the ECDC, and the CDC for the 2009 H1N1 and COVID-19 pandemics. We extracted HSG for the H1N1 and COVID-19 pandemics from the organisations' dedicated repositories and websites. After screening the retrieved documents for eligibility, five assessors evaluated them using the Appraisal of Guidelines Research & Evaluation - Health Systems (AGREE-HS) tool to assess the completeness and transparency of reporting according to the five AGREE-HS domains: "Topic", "Participants", "Methods", "Recommendations", and "Implementability". Following the screening process, we included 108 HSG in the analysis. We observed statistically significant differences between the H1N1 and COVID-19 pandemics, with HSG issued during COVID-19 receiving higher AGREE-HS scores. The HSG produced by the CDC had significantly lower overall scores and single-domain scores compared to the WHO and ECDC. However, all HSG scored relatively low, under the median of 40 total points (range = 10-70), indicating incomplete reporting. The HSG produced by all three organisations received a median score <4 (range = 1-7) for the "Participants", "Methods", and "Implementability" domains. There is still significant progress to be made in the quality and completeness of reporting in HSG issued during pandemics, especially regarding methodological approaches and the composition of the guidance development team. Due to their significant impact and importance for healthcare systems globally, HSG issued during future healthcare crises should adhere to best reporting practices to increase uptake by stakeholders and ensure public trust in healthcare organisations.

Dilemma, an innovative public health scientific animation for the youth, France, 2022

Abstract Background The spread of disinformation and institutions distrust increases individuals difficulty to adhere to public health recommendations. How citizens can critically appraise health information is a major public health matter and a need to favor health democracy. In this field, to both enhance curiosity and critical thinking, young people represent a population with specific needs for innovative approaches. Objectives To provide 15-24y people a space for experimentation and discussion on public health concepts, a multidisciplinary experts team created the “Dilemma” scientific animation that uses a playful approach. Trained young facilitators guide participants through four games (on proportions, risk/protective factors, scientific estimation, benefit/risk ratio). We assessed the program using mixed method (self-questionnaires; focus groups) to answer the following questions: can the approach generate curiosity and participation among young people? Is it effective in improving health literacy and confidence in control over one's own well-being? Results Dilemma was launched in a French region in Nov 2022 targeting high-school students; preliminary results are presented for 67 participants from a Bordeaux technical high school (extended results are awaiting). Of these, 76% were satisfied, 82% felt they improved their critical thinking skills and 79% their curiosity. Facilitators’ fun and friendly nature was an important aspect in participants’ satisfaction. However, they reported difficulties in remembering the messages behind the games and asked for more calm and shorter texts. No effect was found on health literacy or internal locus of control. Conclusions Dilemma shown promising results on how science animations on public health could interest young people. It should develop more games and closer collaboration with school teachers to improve its effectiveness. Fun aspects and peer support needs to be considered for future actions. Key messages • The scientific public health animation Dilemma shows promising results in increasing curiosity and critical thinking of the youth. • Using playful scenarios could contribute to favor health democracy.

Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood

Abstract Loneliness and a sense of belonging refer to social connectedness and are associated with young people's health; however, the relationship between these constructs and their impact on health is still being discussed. The dual continuum model has been suggested (Lim et al., 2021) where these two constructs are regarded as independent but related. Four groups of individuals are defined in the model depending on the level of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially searching (high loneliness, high belonging), socially distressed (high loneliness, low belonging), and socially indifferent (low loneliness, low belonging). Swedish cohort data collected among late adolescents (age 17-18 at baseline in 2019) who were followed up in young adulthood (age 20-21 in 2022) (n = 2684) was used to examine the association between these distinct groups of individuals and psychosomatic complaints. Three psychosomatic complaints were measured: stomach aches, headaches, and sleeping difficulties, and a summary index (range 3-15) was calculated. Linear regression analyses showed that loneliness and a sense of belonging were cross-sectionally associated with psychosomatic complaints (additional adjustment for sociodemographic characteristics barely affected the estimates). The socially fulfilled group reported fewer psychosomatic complaints compared with the other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Furthermore, the socially indifferent group reported fewer psychosomatic complaints than the socially searching group. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, only the socially distressed group showed a significant positive association with subsequent psychosomatic complaints. These findings confirm that the dual continuum model reflects the complexity of social needs and their association with health complaints. Key messages • The categorisation of the conjoint relationship of loneliness and belonging helps to reveal more nuanced links between these two constructs and psychosomatic complaints in young people. • Knowledge of the more nuanced links between loneliness, belonging, and health complaints can be beneficial for developing specific, targeted public health recommendations and interventions for youth.

Cancer risk factors and access to cancer screening for people experiencing homelessness

Abstract Background People experiencing homelessness (PEH) are significantly more likely to develop and die from cancer than the housed population. Major factors influencing outcome are timely detection and treatment, which especially populations with complex needs lack access to. This scoping review outlines cancer risk factors among PEH and their facilitators and barriers to access cancer prevention. Methods Databases were searched in Embase, Global Index Medicus, PubMed, Scopus, and Web of Science in February 2023. OpenGrey and Google were searched for grey literature. Peer-reviewed and grey literature on cancer risk factors among PEH and factors facilitating or hampering access to cancer prevention services were eligible and synthesized narratively. Results We included 40 articles published between 1998 and 2023. Most eligible studies were conducted in the US (n = 34; 85%), indicating a paucity of data from other regions. More than one-third of the studies were published between 2018 and 2023, suggesting a recent increase in research interest. Access to cancer screening was associated with factors on the individual level (e.g., psychological and physical factors), interpersonal level (e.g., practical support), system level (e.g., continuous care), policy level (e.g., interventions to facilitate access). Most eligible studies reported high tobacco use among PEH. Overall, cancer risk factors among PEH have been less studied and require further research. Conclusions Mapping the evidence on cancer risk factors as well as barriers to accessing preventive services in this underserved population is a necessary step to create evidence-based public health recommendations: (a) Due to higher cancer risk factors among PEH, preventive strategies tailored to this population are necessary; (b) innovative strategies such as patient navigation may be viable to increase participation in screening programs; (c) investment in research within the European context is necessary. Key messages • Findings suggest that a system-wide approach is needed to address the increased risks and facilitate timely uptake of cancer screening to ensure sustainable use of cancer prevention services in PEH. • Evidence suggests policymakers need to be aware of inequity in access to cancer preventive services among PEH.

Net effects explains the benefits to children from maternal fish consumption despite methylmercury in fish

In 2001 the U.S. Food and Drug Administration (FDA) issued precautionary advice to pregnant women to limit fish consumption over concern that the methylmercury content might harm their children’s neurodevelopment. This concern was based largely on results from an epidemiological study of mothers primarily exposed to methylmercury from consuming pilot whale. Subsequently, FDA and the World Health Organization/Food and Agriculture Organization (WHO/FAO) undertook independent assessments of fish consumption that considered net effects from both fish nutrients, primarily omega-3 fatty acids, as beneficial and methylmercury as harmful. Both assessments estimated that when mothers regularly consume fish during pregnancy, their children are likely to have improved neurodevelopment compared to children of non-fish eaters despite their exposure to methylmercury. These estimated improvements included gains of two to over five full scale IQ points from levels of maternal consumption that are achievable in most of the world. Consistent with those estimates, human research on fish consumption and child neurodevelopment from more than 200,000 mother-child pairs now collectively reports 51 beneficial associations with neurodevelopmental outcomes and three adverse associations, the latter with no discernable pattern. These associations include full scale IQ gains similar to, or somewhat higher than, those estimated by FDA and FAO/WHO. Also consistent with the FDA and FAO/WHO estimates, research has reported beneficial associations with fish consumption when pregnant women are exposed to methylmercury from fish in excess of the U.S. Environmental Protection Agency’s (EPA) Reference Dose (RfD). Our analysis evaluates how the net effects approach as utilized by FDA and FAO/WHO provides a holistic explanation for these results with implications for public health policy. This concordance of net effects modeling and empirical scientific evidence supports a clarification of current public health recommendations to focus on greater fish consumption by pregnant women for their children’s neurodevelopment.

The Shift: COVID-19-Associated Deaths are Now Trending Lower Among Blacks and Hispanics Compared to Whites.

Throughout the coronavirus (COVID-19) pandemic, research revealed people of color were more likely to be infected, have severe illness, and die due to the virus. However, some areas in the USA are now reporting a new shift; lower Black and Hispanic COVID-19 mortality rates compared to their White counterparts. Research indicates that this shift is the result of COVID-19's impact on disparities by race. In this paper, we analyze death data to determine if the new shift has occurred locally. Specifically, we examined COVID-19 prevalence and related death data in Connecticut by comparing race/ethnicity through two periods of time: one before and one after the first case of the Omicron variant of COVID-19. This cross-sectional epidemiological analysis to examine cases and deaths by racial/ethnic status utilizes Connecticut data from March 2020 to February 2022. The following assumption is applied: expected pre-Omicron cases and deaths from March 5, 2020 to November 27, 2021 are equal to the number of cases and deaths during Omicron cases and deaths from November 28, 2021 to February 17, 2022. Race/ethnicity are operationalized as non-Hispanic White, non-Hispanic Black, and Hispanic. Pre-Omicron (March 5, 2020 to November 27, 2021) compared to the monthly aged adjusted COVID-19 case rate for Whites (394/10,000 populations), Blacks had a higher rate (501/10,000 populations), and Hispanics had the highest (585/10,000 populations). During the Omicron period (November 28 to February 17, 2022), significant changes in COVID-19 case rates were observed in all three ethnic groups, but the biggest changes were observed in Hispanics, followed by Blacks, and then Whites. The rate ratios further showed a remarkable reduction of 47% in case rates (from 1.0 pre-Omicron and from 1.47 during Omicron, p < 0.0001) for Hispanics, when compared to that of Whites. While Blacks showed a significant, smaller reduction of 5% in case rates (from 1.27 pre-Omicron and from 1.22 during the Omicron, p < 0.001) when compared to Whites. Regarding COVID-19-related mortality, the racial differences were similar. By examining Connecticut's COVID-19 death and case data, this study identified the new shift that occurred locally. The current shift may be anchored in the evolution of the COVID-19 virus, public health guidelines/policies, and the degree to which populations have complied with public health recommendations.

The Costs of Polarizing a Pandemic: Antecedents, Consequences, and Lessons

Polarization has been rising in the United States of America for the past few decades and now poses a significant—and growing—public-health risk. One of the signature features of the American response to the COVID-19 pandemic has been the degree to which perceptions of risk and willingness to follow public-health recommendations have been politically polarized. Although COVID-19 has proven more lethal than any war or public-health crisis in American history, the deadly consequences of the pandemic were exacerbated by polarization. We review research detailing how every phase of the COVID-19 pandemic has been polarized, including judgments of risk, spatial distancing, mask wearing, and vaccination. We describe the role of political ideology, partisan identity, leadership, misinformation, and mass communication in this public-health crisis. We then assess the overall impact of polarization on infections, illness, and mortality during the pandemic; offer a psychological analysis of key policy questions; and identify a set of future research questions for scholars and policy experts. Our analysis suggests that the catastrophic death toll in the United States was largely preventable and due, in large part, to the polarization of the pandemic. Finally, we discuss implications for public policy to help avoid the same deadly mistakes in future public-health crises.

Effectiveness of piperonyl butoxide and pyrethroid-treated long-lasting insecticidal nets (LLINs) versus pyrethroid-only LLINs with and without indoor residual spray against malaria infection: third year results of a cluster, randomised controlled, two-by-two factorial design trial in Tanzania

BackgroundAfter decades of success in reducing malaria through the scale-up of pyrethroid long-lasting insecticidal nets (LLINs), the decline in the malaria burden has stalled, coinciding with the rapid spread of pyrethroid resistance. In a previously reported study, nets treated with a pyrethroid and a synergist, piperonyl butoxide (PBO), demonstrated superior efficacy compared to standard pyrethroid LLINs (std-LLINs) against malaria. Evidence was used to support the public health recommendation of PBO-Pyrethroid-LLIN by the World Health Organization in 2018. This study looks at the third year of rollout of these nets in Muleba district, Tanzania to inform whether policy guidelines need to be updated.MethodsA four-group cluster randomized trial (CRT) using a two-by-two factorial design was carried out between January 2014 and December 2017. A total of 48 clusters, were randomized in a 1:1:1:1 ratio to the following treatment groups, each intervention being provided once in 2015: 1/std-LLIN; 2/PBO-pyrethroid LLIN; 3/std-LLIN + Indoor Residual Spraying (IRS) and 4/PBO-Pyrethroid-LLIN + IRS. During the third year follow-up, malaria infection prevalence in 80 children per cluster, aged 6 months to 14 years, was measured at 28- and 33-months post-intervention and analysed as intention-to-treat (ITT) and per protocol (PP). Mosquito collections were performed monthly in all clusters, using CDC light traps in 7 randomly selected houses per cluster.ResultsAt 28 and 33 months, study net usage among household participants was only 47% and 31%, respectively. In ITT analysis, after 28 months malaria infection prevalence among 7471 children was 80.9% in the two std-LLIN groups compared to 69.3% in the two PBO-Pyrethroid-LLIN (Odds Ratio: 0.45, 95% Confidence Interval: 0.21–0.95, p-value: 0.0364). After 33 months the effect was weaker in the ITT analysis (prevalence 59.6% versus 49.9%, OR: 0.60, 95%CI:0.32–1.13, p-value: 0.1131) but still evident in the PP analysis (57.2% versus 44.2%, OR: 0.34, 95%CI: 0.16–0.71, p-value: 0.0051). Mean number of Anopheles per night collected per house was similar between PBO-Pyrethroid-LLIN groups (5.48) and std-LLIN groups (5.24) during the third year.ConclusionsDespite low usage of PBO- Pyrethroid LLIN, a small impact of those nets on malaria infection prevalence was still observed in the 3rd year with the most protection offered to children still using them. To maximize impact, it is essential that net re-distribution cycles are aligned with this LLIN lifespan to maintain maximum coverage.Trial registration: The trial was registered with ClinicalTrials.gov (registration number NCT02288637).

Evolution of humoral immune response to SARS-CoV-2 mRNA vaccine in liver transplant recipients - a longitudinal study.

Liver transplant recipients show suboptimal vaccine-elicited immune responses to severe acute respiratory coronavirus 2 (SARS-CoV-2) vaccination. This study aimed to assess real-world data on SARS-CoV-2 antibodies after the second and third SARS-CoV-2 vaccination in liver transplant recipients in Switzerland. We enrolled liver transplant recipients who attended regular follow-up visits between 01/07/2021 and 30/04/2022 at the outpatient clinic of the Department of Visceral Surgery and Medicine at Bern University Hospital, Switzerland. Following the Swiss Federal Office of Public Health recommendations, we measured SARS-CoV-2 anti-spike IgG antibodies in 117 liver transplant recipients ≥4 weeks after the second SARS-CoV-2 mRNA vaccination from 07/2021-04/2022. In case of antibody levels of <100 AU/ml, patients received a third vaccination and antibodies were re-measured. Patients with antibody levels of >100 AU/ml were defined as "responders", those with 12-100 AU/ml as "partial responders" and those with <12 AU/ml as "non-responders". After two vaccinations, 36/117 (31%) were responders, 42/117 (36%) were partial responders and 39/117 (33%) were non-responders. The humoral immune response improved significantly after the third vaccination, resulting in 31/55 (56%) responders among the previous partial or non-responders. A total of 26 patients developed COVID-19, of whom two had a moderate or severe course (both non-responders after three doses). One third of liver transplant recipients showed an optimal response following two vaccinations; a third dose achieved a complete antibody response in more than half of partial and non-responders. We observed only one severe course of COVID-19 and no deaths from COVID-19 in the vaccinated liver transplant recipients.

Air Pollution and Cardiac Diseases: A Review of Experimental Studies.

Air pollution is associated with around 6.5 million premature deaths annually, which are directly related to cardiovascular diseases, and the most dangerous atmospheric pollutants to health are as follows: NO2, SO2, CO, and PM. The mechanisms underlying the observed effects have not yet been clearly defined. This work aims to conduct a narrative review of experimental studies to provide a more comprehensive and multiperspective assessment of how the effect of atmospheric pollutants on cardiac activity can result in the development of cardiac diseases. For this purpose, a review was carried out in databases of experimental studies, excluding clinical trials, and epidemiological and simulation studies. After analyzing the available information, the existence of pathophysiological effects of the different pollutants on cardiac activity from exposure during both short-term and long-term is evident. This narrative review based on experimental studies is a basis for the development of recommendations for public health.

Cost-effectiveness of screening and valacyclovir-based treatment strategies for first-trimester cytomegalovirus primary infection in pregnant women in France.

To assess the effectiveness, cost and cost-effectiveness of four screening strategies for first-trimester (T1) cytomegalovirus (CMV) primary infection (PI) in pregnant women in France. In a simulated pregnant population of 800 000 (approximate number of pregnancies each year in France), using costs based on the year 2022, we compared four CMV maternal screening strategies: Strategy S1, no systematic screening (current public health recommendations in France); Strategy S2, screening of 25-50% of the pregnant population (current screening practice in France); Strategy S3, universal screening (current medical recommendations in France); Strategy S4, universal screening (as in Strategy S3) in conjunction with valacyclovir in case of T1 PI. Outcomes were total cost, effectiveness (number of congenital infections, number of diagnosed infections) and incremental cost-effectiveness ratio (ICER). Two ICERs were calculated, comparing Strategies S1, S2 and S3 in terms of euros (€) per additional diagnosis, and comparing Strategies S1 and S4 in € per avoided congenital infection. Compared with Strategy S1, Strategy S3 enabled diagnosis of 536 more infected fetuses and Strategy S4 prevented 375 congenital infections. Strategy S1 was the least expensive strategy (€98.3m total lifetime cost), followed by Strategy S4 (€98.6m), Strategy S2 (€106.0m) and Strategy S3 (€118.9m). In the first analysis, Strategy S2 was dominated and Strategy S3 led to an additional €38 552 per additional in-utero diagnosis, compared with Strategy S1. In the second analysis, Strategy S4 led to an additional €893 per avoided congenital infection compared with Strategy S1, and was cost-saving compared with Strategy S2. In France, current screening practice for CMV PI during pregnancy is no longer acceptable in terms of cost-effectiveness because this strategy was dominated by universal screening. Moreover, universal screening in conjunction with valacyclovir treatment would be cost-effective compared with current recommendations and is cost-saving compared with current practice. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Relationship Between Dietary Patterns and Cognitive Function in Older Adults in USA

Purpose: The aim of the study was to investigate relationship between dietary patterns and cognitive function in older adults.&#x0D; Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.&#x0D; Findings: Dietary patterns significantly influence cognitive function in older adults. Adherence to the Mediterranean diet is associated with reduced cognitive decline risk. Nutritional components like walnuts can enhance memory and executive function. The ketogenic diet shows promise for improving cognitive function, particularly in mild cognitive impairment cases. Cultural diets impact cognitive outcomes, with traditional diets often linked to better cognitive performance. These findings highlight the crucial role of diet in preserving cognitive health in older populations and underscore the need for tailored dietary recommendations across diverse contexts.&#x0D; Unique Contribution to Theory, Practice and Policy: Mediterranean diet theory, the micronutrient-related dietary pattern theory, the dietary pattern index theory may be used to anchor future studies on relationship between dietary patterns and cognitive function in older adults. Promote community-based interventions that provide older adults with access to affordable, nutritious foods and opportunities for social engagement. Policy makers should recognize the importance of a balanced diet for cognitive health and reflect this in public health recommendations.

Association Between Pandemic Fatigue and Disease Knowledge, Attitudes, Concerns, and Vaccination Intention at Two Key Moments of the COVID-19 Pandemic.

Objective: This study aimed to describe the change in knowledge, attitudes, concerns, perceptions, preventive practices, and vaccination intention at two key time points of the COVID-19 pandemic and to assess whether these changes varied by level of pandemic fatigue. Methods: Data included in this study came from the third and the ninth round of the COSMO-Spain cross-sectional study. A general linear model was used to investigate the interaction terms between rounds and levels of pandemic fatigue. Results: Changes between rounds were observed in knowledge, attitudes, concerns, perceptions, behaviours, and vaccination intention. Significant interactions between rounds indicated that those with low levels of pandemic fatigue had a greater increase in knowledge, lower decrease in concerns, greater decrease in agreement with the decisions made, and lower increase in vaccination intention compared with those with high pandemic fatigue. Conclusion: As a pandemic evolves, it becomes necessary to consider the level of pandemic fatigue of the population and how this affects knowledge, concerns, and agreement with the measures adopted, as they influence the population's adherence to public health recommendations aimed at controlling infections and protecting the most vulnerable.

96 Foreign Body Aspiration in Children: A Review of the Public Health Prevention Guidelines by Analyzing the Circumstances of Choking Episodes in a Canadian Tertiary Centre from 2006 to 2020

Abstract Background Choking and foreign body aspiration are major causes of morbidity and mortality in infants and young children. To prevent choking episodes and their complications, many associations, from the Canadian Paediatric Society to National Public Health Institutes, have suggested prevention guidelines for parents and health professionals. They specify what types of food should be restricted in young children, such as nuts and raw hard vegetables, and give advice on surveillance. Yet, every year, children are admitted to our centre following a choking episode that requires a bronchoscopy under general anesthesia. Objectives Our objective was to identify the risks factors associated with choking episodes in children and compare them with actual prevention guidelines to determine if public health recommendations are still adequate. Design/Methods This retrospective study included all patients, from 0 to 17 years old, who presented to our tertiary centre between April 2006 and December 2020 and underwent a bronchoscopy under general anesthesia for a suspicion of foreign body aspiration. Data on demographic characteristics of the patients, the circumstances of the episodes and on severity criteria were collected from the patients’ electronic files and compared to the prevention guidelines. Results One-hundred and ninety-one patients with a history of suspected foreign body aspiration were included. Among them, 101 had a positive bronchoscopy. Close to 65% of patients were boys. The mean age at presentation was 31,5 months. Food was the most common type of foreign body, causing 73,3% of all choking episodes. Close to 70% of those choking episodes involved nuts, seeds or raw hard vegetables. 84,5% of those events happened at home, and 79,4% of choking episodes happened under the surveillance of one or both parents. Thirty patients ended in the paediatric intensive care unit where they spent an average of 6,47 days. Conclusion Our results show that most choking episodes in children result from a non-respect of actual recommendations. They involve types of food and circumstances that are already restricted by the prevention guidelines. It highlights the need for better parent education and should inspire clinicians to make some time to address choking hazards with families.

Compliance with public health recommendations of cancer-free female research volunteers: the French Seintinelles study.

Acting on modifiable risk factors can prevent approximately 40% of cancers. Knowing the factors that lead people to adopt healthy behaviors is crucial for designing effective primary prevention campaigns. Our study attempts to provide knowledge in this direction. This cross-sectional study was conducted via the Seintinelles collaborative research platform in a community of women without a personal cancer history, and volunteering to take online questionnaires. We collected data on sociodemographic and health factors, knowledge of cancer risk factors, behaviors, and possible behavior changes (tobacco/alcohol use, diet, body weight, and physical activity) in the last 10years. The study involved 1465 women aged between 18 and 84years. Factors such as young age, living alone, and obesity were associated with some positive or negative behavior changes. Being professionally active and having comorbidities favored certain positive behavior changes, while having dependent children, living in a rural area, and being hospitalized were associated with negative or no change in behaviors. Lack of knowledge about modifiable risk factors for cancer was associated with the non-adoption of various healthy behaviors (consumptions of fruit and vegetables, processed and red meat; physical activity). Only 5.5% of participants currently reported to be compliant with seven public health recommendations (smoking; alcohol, fruit/vegetables, and red/processed meat intakes; body mass index; and physical activity). This study allowed to identify the need to increase the level of knowledge on modifiable risk factors for cancer among the general population and to better clarify the content of prevention messages.

Recent Outbreak of Monkeypox: Implications for Public Health Recommendations and Crisis Management in India.

Monkeypox is a rare and self-limiting disease that was eradicated globally through vaccination approximately forty years ago, following the eradication of smallpox. The purpose of this article is to explore the implications of the recent monkeypox outbreak on public health recommendations and crisis management in India. An overview of the consequences of the current monkeypox epidemic on public health, epidemiology, clinical findings, management, challenges, and existing strategies for this disease, along with recommendations are discussed. It is crucial to develop evidence-based recommendations for the diagnosis and treatment of monkeypox, as well as early case identification and contact tracing. To prevent the spread of infection, travelers from affected countries should be subjected to health testing and quarantine. In order to successfully control the outbreak, a multidisciplinary team should be established to manage the monkeypox virus at tertiary care facilities, and health workers with occupational exposure to the virus should be assessed and given management plans.

Are We Getting the Full Picture? A Systematic Review of the Assessment of Resistance Training Behavior

ABSTRACT The measurement of resistance training (RT) is often based on adaptations of aerobic physical activity measures which may not contain the elements necessary to assess RT. The purpose of this systematic review was to examine what measures are used to assess RT and appraise their composition. Specifically, the inclusion of frequency, duration, intensity, the use of major muscle groups, reps, and sets. Search terms included “resistance training,” “strength training,” OR “weight training” AND “behavior” OR “participation.” Studies were evaluated based on whether RT measures assessed the key components of participation. In the 92 included studies, only one of the six components of the RT recommendations was assessed on average. This was almost exclusively frequency. Many assessments of RT were adapted from aerobic measures without rigorous validity evidence. Construct validity in RT measurement may lead to improved public health recommendations, surveillance of behavior, and precision in determining effective interventions and correlates.

E-Mental Health Program to Prevent Psychological Distress Among French-Speaking International Students in a Linguistic-Cultural Minority Context (Ottawa, Alberta, and Quebec): Protocol for the Implementation and Evaluation of Psy-Web.

Based on experiences with the COVID-19 pandemic, postsecondary institutions were most affected by the restrictions. Students, especially international students, have borne the brunt associated with in-person learning restrictions imposed by public health recommendations. Canada is among the top 3 countries hosting international students (ISs), including Francophone students in provinces such as Quebec and other anglophone regions. Academic restrictions were accompanied by other measures such as quarantine, self-isolation, social distancing, and travel ban, to cite some. This has had a wide-ranging impact on these ISs. The resulting psychological distress and burden may have a much greater impact on Francophone ISs in anglophone settings, many of whom had ordinarily limited access to active offers of care in French in addition to cultural barriers and low literacy of the health care system. In order to take advantage of the effectiveness of eHealth as a pertinent and promising avenue, our project intends to build a web-based application that is cost-effective, user-friendly, anonymous, and capable to prompt interactive interventions as a first-line resource for psychological distress. In fact, internet applications have been increasingly used for the management of psychological distresses, and internet-based cognitive behavioral therapy is one of the preferred methods to prevent or control them. The aims of this study are to (1) design, implement, and maintain Psy-Web for the psychological support of ISs and (2) analyze the results of the implementation of the Psy-Web platform, the additional resources solicited, and the results obtained. This interventional project will use a sequential mixed design in the exploratory phase (phase 1) including the construction of the Psy-Web platform. A quantitative prospective component (phase 2) will include the intervention content of the Psy-Web platform. In total, 105 ISs participants (study group) and 52 ISs (control group), based on a ratio of 1:2, will be considered. The control group participants include those who did not use the web platform. The project is at the data collection stage (phase 1). Psy-Web will be built in accordance with the DMAIC (Define, Measure, Analyze, Improve and Control) model with the perspective of boosting its robustness. As a first-line resource to prevent psychological distress and ultimately improve their academic performance, Psy-Web is an innovative opportunity for high education managers. The project involves a multisectoral and a multidisciplinary partnership. The project will develop a promising web-based solution to prevent psychological distress. Ultimately, Psy-Web will be operable in multiple languages including French. PRR1-10.2196/47059.

COVID-19 public health lessons in science class boost knowledge and efficacy beliefs

Background: Integrating public health into science courses helps students grasp the links between health recommendations and scientific principles. During COVID-19, a team of 19 educators, scientists and clinicians designed 25 science inquiry lessons to enhance disease knowledge and prevention strategies among school-aged children. The efficacy of two lessons was evaluated. Design: Pre-/post-evaluation; both quantitative and qualitative data were collected. Setting: Teachers (24 elementary and 26 high school) and their students (562 elementary, 8–9 years old; 1,271 high school, 14–15 years old) participated from schools in Houston, TX, USA. Method: Lessons were delivered in Spring 2021. Teachers completed evaluation surveys using Likert-type and open-ended items. Students completed pre- and post-assessments of COVID-19 knowledge, attitudes towards science and confidence in their knowledge of COVID-19 and vaccine science. Results: Over 80% of teachers agreed that they would use the lessons again and felt more confident in their abilities to teach about COVID-19 after using the lessons. Teachers reported students’ heightened interest in health professions and discussing the presented topics. High school students gained basic recall knowledge, but there was little change on items related to in-depth science concepts or attitudes. Elementary students demonstrated gains on items related to the scientific rationale underlying public health recommendations and confidence in their abilities to protect themselves from COVID-19. Conclusion: The integration of health information into science teaching helps learners understand the science behind public health recommendations and increases teachers’ preparedness and comfort levels with these topics. Even short-term supplementary lessons can have a positive impact on knowledge and attitudes. Effects were particularly positive with elementary students, who should be included in future public health education efforts. Partnerships between schools and health organisations are vital for the rapid development and integration of lessons that are accurate and informative. The lessons evaluated in this paper are freely available online.