Regional Public Health Research Articles

Age-Specific Seroprevalence of Hepatitis A Virus in Turkey Between 2000 and 2023: Systematic Review and Meta-Analysis

Background: Hepatitis A virus (HAV) is a leading cause of acute viral hepatitis and is primarily transmitted by the fecal–oral route. The clinical presentation and progression of the disease varies according to the age of the patient. Turkey is classified as a moderately endemic country, and HAV infection continues to be an important public health problem worldwide. Methods: In this study, a systematic meta-analysis was conducted to evaluate age-specific HAV seroprevalence rates in Turkey between 2000 and 2023. A comprehensive literature review identified 57 articles that met the inclusion criteria. The studies were assessed for quality, and seroprevalence rates were evaluated across four different age groups. Statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software (CMAVersion 3.0) and SPSS (SPSS Statistics 25.0). Results: HAV seroprevalence rates were found to be 73.18% in the 0 < 5 age group and 90.90% in the >35 age group. The overall seroprevalence estimated using a random effects model was 64.5% (95% CI: 58.3–70). High heterogeneity was observed among the studies, and the prevalence estimates changed when low-quality studies were excluded. Conclusions: This meta-analysis suggests that the increasing trend in HAV IgG seroprevalence in Turkey, especially among young populations, is likely due to the vaccination program initiated in 2012. Furthermore, the heterogeneity observed among regions highlights the importance of regional public health strategies. Future studies should focus on providing more detailed data to evaluate the long-term effects of vaccination and to explain regional differences in HAV seroprevalence.

Air Quality Near Middle East's Large Dried Lake: Heavy Metal Emissions, Machine learning Analysis, and Health Risks

The present study aimed to measure the concentrations and chemical compositions of suspended particulate matters smaller than 10 μm (PM10) in the ambient air of Bakhtegan Lake and to assess the health risks associated with exposure to metal elements through inhalation. Ambient air samples were collected from a rural area close to the lake. The levels of metal elements bonded to PM10 were measured by the Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The mean ambient PM10 concentration around the studied lake (78.12 μg/m3) was higher than the 24 hours guidelines PM10 standards proposed by World Health Organization (WHO) (50 μg/m3). The highest and lowest concentrations were related to Fe and V, respectively. Lifetime Cancer Risk (LCR) was higher for adults than for children. Additionally, the LCR value was higher for As compared to other metals, indicating that the cancer risk in the adults group was mainly due to As. Besides, health risk assessments indicated that adults suffered from higher cancer risks compared to children, while both adults and children did not suffer from non-carcinogenic risks. Through Principal component analysis (PCA) and random forest (RF) analysis, it was determined that metallic concentrations in the air samples are influenced by both natural and anthropogenic sources, with copper and lead identified as pivotal predictors for nickel levels. Therefore, monitoring and addressing such metal-induced pollution is essential for regional public health.

Prevalence of problematic drug use in Martinique in 2006: The NEMO study

ObjectivesSubstance use disorders are of worldwide public health interest. Local estimates of problematic drug use provide useful indicators to regional public health agencies in developing prevention and treatment programs. The purpose of the current study was to estimate the prevalence of problematic drug use in Martinique. MethodsThe capture-recapture method was applied to a multisource data collection (eight specialized drug and two law enforcement sources) to provide an estimate of drug use (opiates, cocaine hydrochloride, crack (cocaine base), stimulants and/or hallucinogens). Data collection was organized over a period of six consecutive months (September 2005 to March 2006) and concerned all persons residing in Martinique longer than three months and who had consumed at least one of the studied drugs in the month prior to the study. ResultsWe identified 287 cases (86% male; mean age 36.1±9.6 years), 98% of whom had used crack. Comorbid use of illicit drugs other than alcohol and cannabis was 4%. Our study showed that patients with problematic drug use in Martinique is estimated to be 1.936 [95% CI: 964,2907] in a total population of 380.863 (INSEE, 1999). Prevalence rates were 5.0 per thousand among the global population and 7.7 per thousand in the adult population aged 15–64 years. ConclusionsOur study is the first to provide relevant data on the extent of problematic drug use in Martinique for health policies and decision-makers.

The Norwegian Counties Public Health Survey (NCPHS)

Abstract Effective public health initiatives should be based upon a thorough understanding of important health-related factors. The purpose of The Norwegian Counties Public Health Survey (NCPHS) is to gain insights from the adult population on topics relevant for planning of public health policy, interventions, and action at the county and municipality levels. The survey includes a core questionnaire on public health-related topics such as health behaviour, subjective quality of life, distress, subjective health, social support, social capital, community contexts, and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register. NCPHS was piloted in three counties in 2015 and in one county in 2018. After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400 000. Expedient data analysis and reporting has enabled the Norwegian Institute of Public Health to present comprehensive reports within six weeks after completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment, and assessment of household economy. Tables are also made available at the municipality level. The NCPHS represent a valuable addition to existing health registries and regional health surveys, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions, and for evaluation of policies and interventions. The value of such a system during times of crises was demonstrated during the COVID-19 pandemic. At the Lisbon 2024 European Public Health conference, a few selected examples of use of data from the NCPHS system will be presented. Key messages • Large-scale community surveys provide important insights for planning of public health policies and action. • Strong involvement and collaboration with regional and local public health personnell as well as with media and local people is a prerequisite for succeeding.

Innovation in border regions: from inequality to equity! Starting with acknowledgment in policy

Abstract Living in a border area can create health inequalities due to limited access to healthcare compared to people in central regions. In centrally located areas, citizens can choose healthcare providers 360 degrees around them, benefiting from full prevention and health promotion coverage. In contrast, border residents have only 180 degrees of access, leading to partial inclusion in health services. National systems typically prioritize health equality but not necessarily equity, especially for those living in border regions. To address this gap, innovative policies that account for cross-border interactions are needed, benefiting over 35% of the EU population living in border areas. A key question is how to ensure health equity in border regions. To explore this, cross-border case studies, like air pollution, food purchases, antibiotic availability and q fever were looked at to identify the situation, the public health challenges it entails and existing solutions. The Essential Public Health Functions (EPHF) framework, developed by the World Health Organization and the International Association of National Public Health Institutes, was used to evaluate public health functions with a focus on achieving greater equity and inclusiveness. Currently in cross-border health key EPHF functions such as health promotion and disease prevention are emphasized, while others like public health governance and community participation need improvement. To better implement health equity in border regions, for use of the EPHF framework an additional and short guideline was developed on how border regions should be considered in national, regional, and local public health policies. This approach offers a pathway to addressing health inequalities in these unique environments: a crucial step towards creating health equity. Key messages • The EPHF framework as an innovative tool to strengthen public health in border regions. • Take the geographical living space of citizens in a border region into account to achieve health equity.

7.X.1. Providing BoD estimates on a regional level – necessity in assessing health inequalities

Abstract Burden of disease indicators, such as Disability-adjusted life years (DALY), Years lost due to disability (YLD) and Years lost due to death (YLL) have become standard indicators in public health reporting systems. Due to the combination of morbidity and mortality, the DALY provides valuable information on the burden due to specific diseases. These tools are employed by policymakers to devise intervention programs with the objective of enhancing the collective health of the population. Studies at the subnational level offer a greater added value to the public health information systems. Identifying variations in health outcomes and disease burden across different regions is a key factor when introducing targeted interventions and allocating resources. Health inequalities persist also in countries with good health systems and well-developed welfare state. There are notable contrasts in the political, economic and social environments across Europe. Moreover, the European countries are at different stages of the epidemiological transition, which encompasses a range of factors influencing health and modifiable risk behaviours. These differences are determined by socioeconomic inequalities at national and sub-national level, such as municipalities, counties and others. It is therefore imperative to provide BoD indicators at the most possible detailed regional-level and to link this information with further indicators such as deprivation indexes or Gini coefficients. Obtaining regional-level data for BoD analysis and health inequalities is not straightforward and can pose many challenges. Data availability is usually scarce and may involve significant resources in collecting it. Data quality and data completeness can also pose challenges in the reporting systems, which can result in under-reporting of certain diseases and overlooking health problems in the population. Also, countries with smaller populations are confronted with the challenge of a limited number of cases, which poses difficulties in obtaining regional estimates. The following workshop presents examples from European BoD studies, that have analysed health inequalities at regional level. The first presentation shows a country comparison study of the overall YLL and their association with socioeconomic and geographical inequalities. The second is from an Estonian study, representing a country with a small population that has developed its own methodology for assessing regional health issues. The third presentation from the German BoD study presents results on 96 spatial planning regions, which have been combined with the German index of socioeconomic deprivation. The final presentation brings example from Norway, where the association between YLL and education and income is examined at municipality level. Key messages • By comparing BoD estimates at the regional level, policymakers and public health officials can identify areas with higher disease burdens, indicating potential health inequalities. • Linking information on BoD indicators with data on regional and socioeconomic inequalities is essential when monitoring developments and tailoring strategies in public health outcomes.

Intergenerational Transmission of Overweight and Obesity among Preschool Children in Sweden

Abstract Background Child overweight including obesity (OWOB) has quadrupled globally, since 1975. It affects a third of European children and even higher rates persist among expectant parents. Parental pre-pregnancy body mass index (BMI) and health behaviours are known to influence offspring health. Thus, this study aimed to investigate the link between parental and children’s OWOB, alongside parental socio-economic and other factors. Methods This is a population-based repeated cross-sectional study utilized data from the Salut Programme in Västerbotten, Sweden, and Swedish national registers, including 5,937 of 3-year-olds and their parents. Logistic regression analyses were used to examine the association of child BMI with prenatal BMI and other factors. Further, the Relative Excess Risk due to Interaction (RERI) arising from the interplay between parent’s OWOB status in relation to their children’s OWOB was calculated. Results OWOB prevalence rates for 3-year-olds, expectant mothers, and their partners were 15.1%, 29.1%, and 53.5%, respectively. Both parent’s OWOB significantly affected children’s BMI (with strongest association for mothers). The Relative Excess Risk due to interaction (RERI) was positive for children’s OWOB if both parents were obese, showing an additive interaction effect of individual parental obesity status. The odds for a child to be OWOB was 2.88 (1.83-4.43) if both parents were obese compared to if none of them were obese. Conclusions OWOB among preschool children remain an important public health concern in Sweden. Based on the study findings, Sweden’s regional and national public health initiatives should prioritize targeting parental overweight and obesity as a key strategy to reduce the burden of OWOB among children. Furthermore, the resemblance of these results with comparable studies across the world, emphasizing the importance of initiating interventions with parents before pregnancy or even earlier. Key messages • Parental combined obesity status significantly increase the odds of childhood overweight and obesity. • The importance of initiating interventions with parents before pregnancy for better health outcomes related to child BMI.

Elective placements for medical students in a regional Public Health Department in Ireland

Abstract Exposure to different specialties during medical school influences the subsequent career choice of students. We describe the development of elective student placements in Public Health in a regional Public Health Department (PHD) in Ireland which serves a population of just over one million. In September 2023, a collaboration to oversee the electives was established between our PHD (HSE Dublin and Midlands) and an academic institution (Trinity College Dublin (TCD)). An Elective Working Group (WG) was formed which developed learning objectives and an elective plan. The electives were scheduled for October and November 2023. The key learning objectives were for students to: • Develop an understanding of the role of Public Health across all domains, in our regional PHD and in Ireland; • Develop an understanding of the career pathway in Public Health Medicine in Ireland; • Contribute to a public health project within the PHD. The elective plan included approximately 15 1:1 tutorials across the public health domains, attendance at PHD meetings and a literature review-based project. Between October and November 2023, two students (one per month) were attached to the PHD. At the end of each elective, students presented project findings to the WG for discussion. Debrief sessions gathered feedback from the students, the WG and the TCD partner. Student feedback was overwhelmingly positive. Feedback suggested taking pairs of students at the same time may increase efficiency and capacity for future electives in our PHD. A collaborative approach to planning and coordinating the electives was crucial to its success. We are building on this experience to expand the electives with an increased number of students being facilitated by our PHD in 2024, providing students with greater opportunity to gain exposure to Public Health Medicine during medical training. Application and evaluation materials were refined which can be shared. Key messages • The success of the Public Health electives in our regional Public Health Department was underpinned by a collaborative academic partnership and a structured, coordinated approach. • Availability of Public Health electives during medical school training can support students to gain exposure to this specialty in a time when they are considering future career choices.

Ban on mobile phones in the classroom: first (positive) effects

Abstract Karin Boode MBA is Strategic Youth Policy Advisor and working at the National Association of Regional Public Health Services Netherlands. Leading on from the presentation on the harms of social media and smartphones, Karin will present examples of policies that have been successful in reducing the health impacts on youngsters. She will focus on the role of schools in addressing this problem, and how public health organisations can effectively disseminate guidance to teachers and parents in limiting screen time and improving self-regulating behaviours of children and adolescents to minimise screen and smartphone addiction. Karin will also explore controversial legislation such as smartphone bans.

Creating good career prospects for professionals in the infectious disease control in the Netherlands

Abstract Background A strong public health system in the Netherlands requires sufficient and motivated professionals. In preparation for new large outbreaks and pandemics, a strong workforce is essential. Providing good career prospects is crucial to attract, engage and retain professionals at the 25 Dutch Regional Public Health Services (RPHSs). However, it is unclear what opportunities and barriers professionals experience concerning their career prospects in the infectious disease control. Methods We aimed to identify these barriers and opportunities using focus groups with infectious disease medical doctors, nurses and assistants. Tangible solutions to address barriers and strengthen facilitating factors were gathered using in-depth interviews with key figures within the board, management, training coordinators and human resources of the RPHSs. Results Forty-six professionals participated in six focus groups. Barriers and opportunities for good career prospects included whether or not professionals experienced: personal development opportunities, achievement appreciation, and opportunities for (financial) growth. Interviews with key figures identified solutions to career prospect barriers, which were grouped into five themes: 1) Engage in conversations about career prospects, 2) Provide sufficient achievement appreciation, 3) Ensure connectivity between RPHSs, 4) Develop a perspective on career prospects, 5) Improve the image of RPHSs. Recommendations A guideline was developed for RPHSs to improve the career prospects of infectious disease control professionals including 17 recommendations. Implementation of these recommendations will contribute to the attractiveness of working in the public healthcare. Key messages • Addressing barriers and encouraging opportunities for good career prospects is essential to captivate, engage and retain public health professionals for pandemic preparedness. • Career prospects can be improved by developing and communicating a perspective on career prospects, increasing appreciation of achievements, and improving the image of working in public health.

Organization of Vaccination Sites in Quebec: Perception of Users, Employees and managers

Abstract Since late 2020, vaccination sites have emerged rapidly in order to protect the population against COVID-19. Health services in Montérégie (Québec) are provided by three organizations. Each adopted a different approach to immunization. The Regional Public Health Department took this opportunity to describe, compare, and explain these three approaches. A mixed methods design through a multiple case study was conducted. Users, employees and managers were interviewed at the end of 2021 on several performance-related topics. Individual interviews with employees and managers in mid-2022 further explored these topics. 38 managers, 360 employees, and 946 users participated in the survey. 9 managers and 10 employees were interviewed. Most participants were satisfied with vaccination organization regardless of the model used, mainly because of high geographic and temporal accessibility of the sites. Further signage to indicate directions could optimize accessibility. High adaptability was essential for managers and employees. Training strategies such as people to refer to and pairing allowed to better deal with frequent changes and staff rotation. The addition of ongoing training could be beneficial. Rapid changes in employee schedules were identified as a challenge. The use of technology-based scheduling tools, accessible to all, brought added flexibility, which was appreciated. Several ideas were used to communicate updates on a daily basis. However, timely implementation of new recommendations remained an ongoing challenge. Dedicated clinics for specific clienteles were successful. Community partnerships were generally beneficial, although establishing more of them could potentially reach other vulnerable communities. To improve accessibility and minimize health social inequities, a greater investment in local partnerships might reach more vulnerable clienteles. Regular communication and innovative employee support are key elements to improve fluidity of operations. Key messages • Reaching out for vulnerable clienteles is essential to minimize health social inequities. • Rapid changes in services needs underlign fluidity communication importance.

Let’s Get Walking: Establishing Workplace Walking Groups in a regional Public Health Department

Abstract Maintaining staff health and wellbeing (HWB) is an ongoing priority for the Department of Public Health HSE Dublin and Midlands (PHD). This is particularly important in the context of an ongoing programme of reform for Public Health in Ireland. To support this priority, in November 2023 a pilot Workplace Walking Groups initiative was established to increase workplace physical activity and build team relationships. The initiative was designed following staff feedback on team HWB initiatives in September 2023. The Model for Improvement (which includes the Plan-Do-Study-Act cycle) was used to take a structured quality improvement approach to the development and evaluation of the 4-week pilot, led by the PHD HWB Committee. Staff joined across 3 sites. Lunchtime walks were arranged for 1-2 days per week. WhatsApp groups and email supported group communication. Quantitative data on registration and attendance were collected via Microsoft Excel. A virtual focus group was arranged to gather participant feedback, which was analysed into themes. Group registration (n = 10, n = 9, n = 5) and weekly attendance varied by site (n = 10, n = 9, n = 5). Key benefits noted by participants included physical activity, building relationships with colleagues, and getting fresh air. The main barrier was the impact of work schedules on attendance. There was broad support for re-establishment of Workplace Walking Groups for 2024. This pilot Workplace Walking Groups initiative achieved its dual aim of increasing physical activity and social connection among staff. Learning from this pilot informed the launch of a 3-month Walking Groups term for Spring 2024. The initiative is now established practice and is a component of the Department’s blended working policy, being a feature of on-site working days. Key messages • Our successful pilot Workplace Walking Groups project has translated into a sustainable health and well-being initiative for staff, during a time of ongoing reform across Public Health in Ireland. • A structured approach to designing and implementing staff health promotion initiatives is crucial to support the cycle of learning and improvement, and to sustain change over time.

Public health rapid response in managing COVID-19 outbreaks in residential aged care facilities: a regional public health unit perspective.

We describe here the impact of managing coronavirus disease 2019 (COVID-19) outbreaks, during January-August 2022, in residential aged care facilities (RACFs) in Central Queensland, Australia, following the deployment of a public health rapid response team (PHRRT, comprising a medical officer, a communicable disease nurse, and an epidemiologist) from a regional public health unit (PHU). Our existing vaccine preventable diseases surveillance framework was used in identifying any symptomatic resident, triggering a PHRRT response. We found that the Hospital in the Home (HiTH) admission and death events were significantly lower after the introduction of the PHRRT than in the outbreaks that occurred before. Based on our experience with a PHRRT-led approach in mitigating the burden of outbreaks, we recommend regular reflection on optimising resources and practices in RACFs. Effective communication from PHUs can improve the RACFs' preparedness and capacity to respond, and can inform the best practice model to protect the highly susceptible elderly residents and their staff.

The Norwegian Counties Public Health Survey (NCPHS): a design study.

Effective public health initiatives should be founded on a comprehensive and robust understanding of health-related factors including societal and community contexts. The Norwegian Counties Public Health Survey (NCPHS) aims for insights into the adult population on topics relevant for planning public health practices at county and municipality levels. The NCPHS includes a core questionnaire on public health-related topics and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register and 'washed' against the Common Contact Register to retrieve digital contact information and exclude those who cannot be contacted electronically. NCPHS was piloted in 2015 and 2018 (four counties). After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400,000. Expedient data analysis has enabled the Norwegian Institute of Public Health to present comprehensive reports within 6 weeks of completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment and self-reported sufficiency of household income. Tables are also made available at the municipality level. The NCPHS represents a valuable addition to existing data sources, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions and for evaluation of policies and interventions. The value of such a system during times of crisis was demonstrated during the COVID-19 pandemic.

The public health challenges of female migration: the Venezuelan diaspora in Andean countries

BackgroundVenezuelan migration has experienced an unprecedented increase in the last decade, with approximately 7.7 million Venezuelan-born individuals residing in other countries as of 2024. Our study aims to identify the potential and actual demand for healthcare services (SRH) in the Venezuelan diaspora’s four primary destinations within the Andean Countries: Colombia, Ecuador, Peru, and Chile.MethodsUsing official data from administrative records, censuses, and sample surveys reported by the host countries and international agencies, we estimate the annual evolution of Venezuelan-born women of reproductive age (WRA) and their offspring. Additionally, we conduct two case studies focusing on Colombia and Chile to analyse the groups most vulnerable to unmet health needs.ResultsThe population of WRA has increased to between 5 and 6.8%, and births have risen to approximately 3–8% in host countries due to Venezuelan migration. Yet, we found a general decrease in health coverage for certain age groups of Venezuelan female migrants in host countries for the period 2017–2022, particularly in Chile. By 2022, an estimated 20% of healthcare needs remained unmet among children, girls, and younger Venezuelan women, contributing to greater health inequalities between Venezuelan-born adolescents and those from other countries of birth.ConclusionsOur findings highlight the escalating demand for and limited access to healthcare services among Venezuelan WRA in their destinations. Unmet healthcare needs are particularly prevalent among younger women by 2022, underscoring the urgency for health system to incorporate gender-responsive, equitable interventions and ensuring health rights for high-risk migrant groups such as infants, children, adolescents, and younger women. Addressing these challenges remains a critical task for the regional public health agenda in Latin America.

Pengaruh Capacity Building dan Motivasi Kerja terhadap Produktivitas Kerja Pegawai Puskesmas Limo

UPTD Puskesmas Limo is a regional public health center for Limo sub-district which is underpinned by the health department and health facilities managed by the local government. The health Dcenter has the responsibility of providing primary health services to the people of Limo city. With these demands and types of work, training or employee self-development is needed to hone employees' abilities and work motivation. To find out how much influence capacity building and work motivation have on the productivity of UPTD Puskesmas Limo employees, this title was raised. This study uses quantitative methods using non-probability sampling techniques, namely saturated sampling techniques. The sample of this study amounted to 50 people. Then tested quantitative statistical analysis, multiple linear regression analysis and coefficient of determination analysis using a data processing program, namely SPSS 25 software. This study found the results using the t test stated that Capacity Building partially has a significant effect on work productivity with a significant level of 0.02 <0.05 and the t test results of 3.021> 2.008. and work motivation partially has a positive and significant effect on work productivity with a significant value of 0.01 <0.05 and a t test value of 3.146> 2.008 Capacity Building d is a positive and significant effect on work productivity.

A Population-Based Analysis of the Cancer Incidence in Individuals under 50 in a Northern Italian Province: Focusing on Regional Disparities and Public Health Implications.

International studies have shown an increase in cancer incidence among young adults, raising public concern. This study aims examines trends in the cancer incidence among individuals aged 15-49 years in a province of Northern Italy, covering diagnoses from 1996 to 2021, and compares the annual percentage change (APC) with national and international data. In males, the overall cancer incidence showed a modest increase between 1996 and 2013 (APC 1.6), followed by a decline in the subsequent years (APC -2.5). In females, there was a modest increase over the entire period (APC 1.0). The lung cancer incidence decreased in both sexes (APC -3.9 in males and APC -3.3 in females), while a decrease was observed for colorectal cancers in women (APC -2.4). Since 2015, the thyroid cancer incidence declined significantly in females (APC -10.2), while an increase was noted in males (APC 2.5). The testicular cancer incidence rose in males (APC 1.5), and the melanoma incidence increased in both sexes (APC 3.4 in males and APC 3.9 in females). The breast cancer incidence remained stable (APC 0.3). These results underline the importance of promoting healthy lifestyles even among younger generations to address emerging cancer trends and support cancer prevention efforts.

Investigation of Microplastic Contamination in the Gastrointestinal Tract of Fish: A Comparative Study of Various Freshwater Species

The aqueous environment has been reported to be seriously threatened by the pollution of microplastics (MPs), which has been confirmed in numerous studies affecting various aquatic habitats. Despite this, few investigations exist on MP contamination in fish of specific regions. Thus, the current study aims to determine MP concentrations in the fish species of the Chhota Nagpur zone of eastern India. From August to September 2023, fish samples were collected from 10 km distance between two locations of Subarnarekha and Kharkai river banks through fishermen. Microplastics were found in the gastrointestinal tract of 45 fish of 8 species out of 48 samples. Of these species, six species were secondary consumers, while the remaining two were primary consumers. The average amount of microplastics consumed by each fish (n = 48) was 3.0 ± 1.8. A total of 144 microplastics were found in collected samples of fish species. Among the analyzed sample of MPs, 69.4% were fibers, films were (22.3%), and (8.3%) were fragments. The least contaminated species was T. ilisha (0.8 ± 0.7 particles/ind.), while L. rohita had the highest microplastic contamination (4.5 ± 1.7 particles/ind.). The present study found a negative correlation of - 0.83 between MP consumption and the mean body weight of fish. Similarly, a negative correlation of - 0.5 was found between the length of fish and MP intake. Polyamide (nylon), polypropylene, polyvinyl chloride, polycarbonate, polyethylene terephthalate, and polyethylene polymers were found. The size of MPs ranged from 45-355 μm and mainly were fibers. They were also predominantly blue and black. Polyamide and polyvinyl chloride were the common MP types in every specimen. The possible sources of MPs were fishing nets, ropes, and packaging material. This investigation points to MP contamination in aquatic ecosystems and particular species. It provides advanced knowledge of MP pollution, sources, and effects on regional ecosystems and public health.

A 2-Day Postpartum CBT-Based Training for Nurses.

Public health nurses (PHNs) are often a first point of contact for postpartum individuals seeking mental health support, but report limited training related to mental health. To determine whether a two-day cognitive behavioral therapy (CBT)-based training program focused on postpartum maternal mental health can improve PHN perceptions of their ability to deliver CBT techniques, their confidence working with distressed clients, and with managing client resistance to treatment recommendations. A convenience sample of 45 PHNs working in the Family Health Division of Niagara Region Public Health in Ontario, Canada were assessed before and after they received a two-day CBT-based training program. Before attending training, PHNs reported their current professional position, years of experience working in public health, and any previous mental health training. Their confidence in delivering CBT techniques, working with distressed clients, and with managing client resistance to treatment recommendations was assessed pre- and post-training. Participants also rated their satisfaction with the training. Statistically significant improvements were seen in confidence using CBT techniques, and in supporting and managing distressed or resistant clients. The two-day training was highly rated overall by participants. Medium to large effect sizes were found for changes in confidence-related questions. Providing PHNs with brief CBT-based mental health-related training can increase their confidence in this aspect of their practice, and could potentially improve the quality of care they provide.

Satisfaction-Behavior Paradox in Lifestyle Choices: A Cross-Sectional Study of Health Behaviors and Satisfaction Levels in Jazan, Saudi Arabia.

Lifestyle choices significantly affect health outcomes in Saudi Arabia, but the relationship between health behaviors and satisfaction is unclear. This study aimed to assess lifestyle choices and associated satisfaction levels among residents in the Jazan region of Saudi Arabia. A cross-sectional study was conducted in Jazan, Saudi Arabia, with 3411 participants. Sociodemographic, lifestyle, and satisfaction data were collected using a questionnaire that was completed during interviews. Logistic regression analyses were implemented to examine the relationships between the study variables and factors related to weight, physical activity, and eating satisfaction. The study found that 38.3% of participants were inactive and 77% rarely ate fruits and vegetables. A total of 47.6% were overweight or obese. Weight (71.12%) and eating (71.59%) satisfaction were high despite these health concerns. The satisfaction-behavior paradox was especially evident in diet. Higher income, physical activity, and healthy eating habits were significantly associated with higher satisfaction (OR = 1.49, 95% CI: 1.15-1.93, p = 0.003 for weight satisfaction, OR = 34.74, 95% CI: 25.42-48.35, p < 0.001 for physical activity satisfaction, and OR = 2.08, 95% CI: 1.67-2.61, p < 0.001 for fruit and vegetable consumption). Lifestyle behaviors and satisfaction in Jazan, Saudi Arabia, are complex. The satisfaction-behavior paradox, especially in diet, reveals a major gap between perceived and actual health. These findings highlight the need for targeted, culturally sensitive interventions that address behavioral change and perception alignment to improve regional public health.