Robust Public Health Research Articles

Advancing immunisation information systems: a proposal for the “unvaccinated registry”

Abstract Through a systematic review of 253 studies, we identified significant advancements in IIS functionalities including real-time data access, interoperability, and life-course vaccination records, crucial for robust public health responses. Our review reveals that vaccinations are vital for public health and societal welfare; however, vaccine hesitancy is a significant barrier, driven by complex factors. Most IIS implementations predominantly utilise web-based platforms focused on children’s vaccinations with features that enhance data interoperability and public health surveillance. Despite these advancements, gaps in vaccine coverage and hesitancy mapping persist due to suboptimal data integration and system interoperability. Parallelly, we propose a comprehensive registry that includes unvaccinated individuals, aiming to address vaccine hesitancy by integrating demographic and socio-economic data. This initiative promises to enhance health equity by providing actionable insights into vaccination gaps and facilitating targeted interventions. Ethical considerations, particularly data privacy, are paramount, as well as adhering to regulations such as GDPR to ensure the protection of personal health information. The integration of IIS with a registry that includes unvaccinated populations represents a transformative approach to public health, potentially increasing vaccine coverage and effectively informing policy decisions. This dual strategy leverages not only technological advancements but also incorporates essential behavioural insights, offering a path forward in the ongoing battle against vaccine-preventable diseases. This model aligns with the Italian National Vaccination Prevention Plan and underscores proactive, evidence-based strategies to enhance vaccination uptake, serving as a cornerstone for broader application in other national contexts.

Distribution of the Culex pipiens mosquito in mainland Portugal: a geospatial modelling study

Abstract Background The mosquito Culex pipiens is a vector for several pathogens, such as the West Nile virus. As the most abundant mosquito in Portugal, understanding its spatial distribution can support vector-borne diseases control and robust public health planning, given the mainland’s favourable climate for this vector. Information on its spatial distribution at a national level is limited, especially its association with climate variables. Thus we aimed to predict the suitability of Culex pipiens distribution in mainland Portugal, considering climate factors. Methods We used presence records for adult and larvae of Culex pipiens mosquitoes sampled across mainland Portugal from January 2017 to October 2023, as part of the Portuguese Vector Surveillance Network program (REVIVE). Between May-October, in random locations and throughout the year in point-of-entry sites, adult mosquito collection used CDC light traps and BG-Sentinel traps, and larvae collection used dippers in breeding sites. Sampling bias was corrected by filtering presence sites, retaining one record per each cell grid of 1 km2. Climatic data (including temperature, precipitation and elevation) were used as predictors in a maximum entropy (MaxEnt) model of the Culex pipiens geographical distribution. Results From the dataset of 6859 records, 1416 unique sites were obtained after filtering. Suitable habitats seem to be mainly distributed on the coast, particularly in Minho, Porto and Lisbon metropolitan areas, and Tagus Valley, with precipitation as the most important predictor. Conclusions Most West Nile Virus case reports come from the south of Portugal, but the potential distribution of Culex pipiens covers the whole mainland territory, with seemingly higher distribution on the north coast. However, bias due to convenience sampling could be present. West Nile vector surveillance should be a priority across all regions to accurately assess transmission risk and implement effective control measures. Key messages • The suitability of Culex pipiens distribution covers the entire mainland of Portugal, with higher presence in the north. • The distribution of Culex pipiens in the country points towards a need for developing region-specific strategies regarding West Nile Virus prevention and control.

Examining Cycle Threshold values in Repeat SARS-CoV-2 Cases: A Retrospective Analysis in Ireland

Abstract Background Effective public health management during the COVID-19 pandemic requires accurate differentiation between re-infections and residual viral RNA detections in repeat positive cases. This study investigates cycle threshold (CT) trends in repeat SARS-CoV-2 cases to discern between persistent viral remnants and active infections. Collaboration between contact tracing and laboratories is essential for shaping robust public health strategies. Methods A retrospective analysis was conducted on 427 individuals with repeat positive PCR tests. Data was collected at a contact tracing centre from March to August 2021. Key variables including age, gender, and biomedical markers (test intervals, CT values) were examined. Regression and correlation techniques assessed CT trends and their implications. Results Younger individuals (<60 years) occasionally exhibited significantly lower CT values in subsequent tests, suggesting potential re-infections, while older adults generally displayed higher CT values indicative of residual RNA. These age-specific CT trends were statistically significant and instrumental in refining testing protocols and isolation guidelines. Further analysis is expected to strengthen these findings Conclusions Collaborative approaches between contact tracing and laboratories are vital in shaping robust public health strategies for distinguishing between types of repeat infections. Revision of health policies is imperative to prevent unnecessary isolation and optimise healthcare workforce allocation during ongoing transmission periods. Key messages • Decisive decision-making skills are crucial in managing repeat SARS-CoV-2 infections. • Revised health policies align testing and isolation practices with empirical CT data, enhancing public health efficacy.

Principal Component Analysis (PCA) of MALDI-TOF for the Identification of Waterborne Pathogenic Bacteria

The study focuses on the application of Principal Component Analysis (PCA) combined with MALDI-TOF MS (Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry) for the identification of waterborne pathogenic bacteria in urban water networks. In this comprehensive research, 168 bacterial strains were meticulously isolated from the water networks of Abidjan, Côte d'Ivoire, a region known for its inadequate wastewater treatment infrastructure. The analysis aimed to rapidly and precisely identify these bacterial pathogens, leveraging the power of MALDI-TOF MS and the sophisticated data reduction capabilities of PCA. This approach not only accelerates the identification process but also enhances the accuracy of detecting various pathogens. The study identified a diverse range of pathogens, including Pseudomonas aeruginosa, Escherichia coli, Salmonella, Shigella, Vibrio cholerae, Morganella morganii, Proteus mirabilis, Acinetobacter baumannii, Klebsiella pneumoniae, Providencia rettgeri, Providencia stuartii, Aeromonas hydrophila, Bacillus cereus, Lysinibacillus fusiformis, Lysinibacillus sphaericus, and Staphylococcus aureus. These findings underscore the critical public health risks posed by microbial contamination in water networks, particularly in areas with deficient waste management systems. This study highlights the necessity for improved wastewater management practices, robust public health strategies, and regular monitoring to mitigate the risks associated with waterborne pathogens. Moreover, the integration of PCA with MALDI-TOF MS proves to be a powerful tool for enhancing the efficiency and accuracy of pathogen identification in environmental water samples, offering a promising solution for better public health protection and water quality management in urban settings.

A critical review of public health policies for radiation protection and safety

The increasing use of radiation in various sectors, including medicine, industry, and research, underscores the need for robust public health policies to ensure radiation protection and safety. This critical review examines the effectiveness of current public health policies aimed at mitigating the risks associated with radiation exposure. The review synthesizes findings from peer-reviewed literature and official reports to evaluate the strengths and weaknesses of existing frameworks. Public health policies for radiation protection are designed to safeguard individuals and communities from the potential hazards of radiation exposure. These policies include regulatory standards for radiation use, safety protocols in medical and industrial settings, and public education programs. The review explores the evolution of these policies over time, highlighting significant regulatory milestones and their impact on radiation safety. Key areas of focus include the effectiveness of international guidelines and national regulations, such as those established by the International Atomic Energy Agency (IAEA) and national bodies like the U.S. Environmental Protection Agency (EPA) and the European Commission. The review assesses how well these guidelines are implemented and adhered to in practice, identifying gaps in enforcement and areas where policies may fall short. The review also examines the role of risk communication and public awareness in shaping effective radiation protection policies. It discusses how well current policies address the needs of vulnerable populations and how they balance the benefits of radiation use with potential health risks. Challenges such as emerging technologies, changes in radiation exposure patterns, and the need for ongoing policy adaptation are also considered. The review concludes with recommendations for strengthening public health policies, including enhancing regulatory oversight, improving risk communication strategies, and investing in research to address new and evolving radiation safety issues. Overall, this review underscores the importance of continuous evaluation and adaptation of public health policies to ensure effective radiation protection and safety in an ever-changing technological landscape.

Bridging Gaps in Wearable Technology for Exercise and Health Professionals: A Brief Review.

The proliferation of wearable devices, especially over the past decade, has been remarkable. Wearable technology is used not only by competitive and recreational athletes but is also becoming an integral part of healthcare and public health settings. However, despite the technological advancements and improved algorithms offering rich opportunities, wearables also face several obstacles. This review aims to highlight these obstacles, including the prerequisites for harnessing wearables to improve performance and health, the need for data accuracy and reproducibility, user engagement and adherence, ethical considerations in data harvesting, and potential future research directions. Researchers, healthcare professionals, coaches, and users should be cognizant of these challenges to unlock the full potential of wearables for public health research, disease surveillance, outbreak prediction, and other important applications. By addressing these challenges, the impact of wearable technology can be significantly enhanced, leading to more precise and personalized health interventions, improved athletic performance, and more robust public health strategies. This paper underscores the transformative potential of wearables and their role in advancing the future of exercise prescription, sports medicine and health.

THE IMPACT OF HAIR LOSS IN CAMBODIA: CAUSES, PREVENTION METHODS, AND TREATMENT SOLUTIONS

Hair loss is a significant global problem, affecting individuals' quality of life physically and psychologically. In Cambodia, this issue remains understudied despite genetic, environmental, and lifestyle factors contributing to its prevalence. This research investigates hair loss prevention and treatment in Cambodia aiming to develop a comprehensive strategy tailored to the local population. The study evaluates pharmaceutical interventions, such as Minoxidil and Finasteride, surgical options, including Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE), along with natural remedies and lifestyle modifications. Methodology involves an extensive literature review, surveys, and clinical trials with a diverse sample from across Cambodia. Advanced data analysis assesses the effectiveness and side effects of different treatments, while qualitative methods, including interviews and focus groups, explore the psychological impact of hair loss and support systems available. Results indicate that a combined approach—integrating medical treatments, natural remedies, dietary guidance, and stress management—achieves the best outcomes in hair regrowth and patient satisfaction. The research highlights the need for accessible public health initiatives, such as educational campaigns and financial aid, to ensure broad community benefits. In conclusion, a multifaceted strategy combining medical interventions, lifestyle changes, and robust public health policies is advocated. This holistic approach effectively addresses both physical and psychological aspects of hair loss, providing a tailored solution for the Cambodian population.

Unbiased care, unequal outcomes: a nursing telehealth intervention reveals systematic inequities in COVID-19 care delivery

BackgroundThe Covid Connected Care Center (C4), a low-barrier telephone nurse hotline, was developed at an academic medical center to increase access to healthcare information and services across the state of Oregon, including to those without a usual source of care. Other studies have demonstrated that telephone triage services can positively influence health behaviors, but it is not known how this effect is maintained across racial/ethnic groups. The objective of this study was to show that the C4 reached throughout the state of Oregon, was valuable to callers, and that recommendations given affected callers’ subsequent health-related behaviors.MethodsThis mixed-methods study, informed by the RE-AIM (Reach, Effectiveness, Addoption, Implementation and Maintenance) framework, assessed caller demographics and clinical care from March 30 2020 until September 8, 2021. Descriptive statistics, multivariable risk models and Zou’s modified Poisson modeling were applied to electronic health record and call system data; An inductive approach was used for patient and staff experience surveys and semi-structured interviews. Approval was obtained from the OHSU Institutional Review Board (Study 00021413).Results145,537 telephone calls and 92,100 text-based contacts (61% and 39%, respectively) were included. Callers tended to not have a usual source of primary care and utilized recommended services. Emergency department utilization was minimal (1.5%). Racial or ethnic disparities were not detected in the recommendations, but Black (RR 0.92, CI 0.86–0.98) and Multiracial (RR 0.90 CI 0.81–0.99) callers were less likely than non-Hispanic white callers to receive a COVID-19 test. Participants in the post-call survey (n = 50) would recommend this service to friends or family. Interviews with callers (n = 9) revealed this was because they valued assistance translating general recommendations into a personalized care plan. C4 staff interviewed (n = 9) valued the opportunity to serve the public. The C4 was a trusted resource to the public and reached the intended audiences. However, disparities in access to COVID-19 testing persisted.ConclusionsNursing triage hotlines can guide caller behavior and be an effective part of a robust public health information infrastructure.

Respond to Public Health Emergencies and The Law Preparedness Challenges and Solutions

Laws are a very powerful tool for defending human rights. These could be parliamentary enactments, local panchayat regulations, international conventions, or constitutions. Every facet of the emergency and public health response is based on law and policy. Laws made it possible to establish lockdowns, declare states of emergency, and, more recently, speed the clearance process for vaccines. The removal of antiquated laws, regulations, and backup plans frequently revealed them to be insufficient or out-of-date, necessitating the quick creation of new legislation. Never before have so many laws concerning one incident been passed in so many nations in such a short period of time. Communities are kept safe and lives are saved by domestic legal preparedness for catastrophes, which includes public health emergencies. The cornerstones of disaster risk management are law and policy, which establish guidelines for the who, what, and when of emergency response operations. When preparedness and response efforts lack a solid legal foundation, they may be disorganised and ineffectual, which frequently causes the most vulnerable individuals to wait longer for critical assistance. This essay suggests that there is a general deficiency of robust public health emergency legislation as well as a lack of legal readiness for such situations.

Parliamentarily speaking: A thematic analysis of Kerala Legislative Assembly questions relating to health from 2016 to 2021.

Legislative assemblies often provide a platform for legislators to question the government during question hours, which are crucial for governance However, question hours remain understudied, especially when addressing health policy and systems related issues in lower- and middle-income countries. This study assesses the 14th Kerala Legislative Assembly questions, focusing on health-related areas to provide insights for health policy formulation and decision-making processes. We sourced and transcribed all starred questions (346) related to health that were answered by the health minister in the 14th Legislative Assembly between 2016 and 2021 from the archives of the assembly website. We conducted a thematic analysis of these questions and mapped them into various themes, guided by the World Health Organization building blocks framework. About 7.8% of all questions (N = 4404) were related to health (N = 346). Of these questions, the majority were directly related to service delivery (43.4%), followed by health information (16.5%). Health financing, food safety, and human resources were the least discussed topics throughout the assessed period within the state. The legislators primarily focussed on health services and health information, with less attention given to health financing, food safety, and human resources regardless of constituency or political affiliation. This study underscores the need for a balanced approach to public health issues, highlighting the importance of legislators to priortizing health services and information, while also addressing health financing, food safety, and human resources. This would enable a robust and resilient public health system to effectively address diverse health concerns.

A model of academic-practice collaboration for facilitating informatics capacity and building a learning health system framework in public health.

The data modernization initiative (DMI) is a multi-year, multi-billion-dollar endeavor toward a robust public health information infrastructure. The various DMI projects (interoperability, analytics, workforce, governance) present an opportunity for a learning health system (LHS) framework in public health. The objective is to share an academic-practice partnership model between the University of Minnesota (UMN) and the Minnesota Department of Health (MDH) in advancing public health informatics (PHI) and its relationship to an LHS model. The UMN-MDH partnership was conceptualized in 2018 as a 1-year pilot with annual renewals through a time/cost-sharing faculty position with PHI expertise. The partnership focus was decided based on MDH's needs and mutual interests, with the core collaborating faculty (SR) being an embedded researcher at MDH. Responsibilities included supporting electronic case reporting (eCR), interoperability projects, and assisting MDH staff with PHI presentations/publications. The partnership has expanded to PHI workforce development through a national grant and now includes an interest in applying the LHS framework to MDH-DMI work. The MDH-DMI team has embarked upon 13 projects for assessment through an LHS approach: systems interoperability projects between MDH and healthcare/local public health (n = 6); systems modernization for MDH programs (n = 5); informatics workforce development (n = 1); and program governance (n = 1). Each project has been evaluated and/or has current/future assessment plans to synthesize learnings and create a feedback loop for iterative improvement. The partnership has been mutually beneficial as it met agreed upon metrics across both institutions. The program's productivity is showcased with shared authorship in 10 peer-reviewed proceedings/publications, 22 presentations and 16 posters across local/national conferences. The current case report of the UMN-MDH partnership is a relatively recent exemplar to support tangible LHS demonstration in public health. Building LHS momentum at MDH and other public health entities will require LHS champion(s) and continued academic collaboration.

Comparing healthcare systems between the Netherlands and Australia in management for children with acute gastroenteritis.

Acute gastroenteritis is a highly contagious disease demanding effective public health and clinical care systems for prevention and early intervention to avoid outbreaks and symptom deterioration. The Netherlands and Australia are both top-performing, high-income countries where general practitioners (GPs) act as healthcare gatekeepers. However, there is a lower annual incidence and per-case costs for childhood gastroenteritis in Australia. Understanding the systems and policies in different countries can lead to improvements in processes and care. Therefore, we aimed to compare public health systems and clinical care for children with acute gastroenteritis in both countries. A cross-country expert study was conducted for the Netherlands and Australia. Using the Health System Performance Assessment framework and discussions within the research group, two questionnaires (public health and clinical care) were developed. Questionnaires were delivered to local experts in the Netherlands and the state of Victoria, Australia. Data synthesis employed a narrative approach with constant comparison. In Australia, rotavirus vaccination is implemented in a national program with immunisation requirements and legislation for prevention, which is not the case in the Netherlands. Access to care differs, as Dutch children must visit their regular GP before the hospital, while in Australia, children have multiple options and can go directly to hospital. Funding varies, with the Netherlands providing fully funded healthcare for children, whilst in Australia it depends on which GP (co-payment required or not) and hospital (public or private) they visit. Additionally, the guideline-recommended dosage of the antiemetic ondansetron is lower in the Netherlands. Healthcare approaches for managing childhood gastroenteritis differ between the Netherlands and Australia. The lower annual incidence and per-case costs for childhood gastroenteritis in Australia cannot solely be explained by the differences in healthcare system functions. Nevertheless, Australia's robust public health system, characterized by legislation for vaccinations and quarantine, and the Netherland's well-established clinical care system, featuring fully funded continuity of care and lower ondansetron dosages, offer opportunities for enhancing healthcare in both countries.

Neonatal sepsis-a peek into our findings in Northwest Nigeria: a prospective study

BackgroundNeonatal sepsis is still a global health concern as it contributes to a high burden of neonatal morbidity and mortality especially in developing countries. The aim of the study is to give an insight into neonatal sepsis: risk factors, sepsis types, clinical features, pathogen burden with their antibiotic sensitivities, and outcome of admission in our facility. The study was a prospective hospital-based study conducted over 10 months, October 2018–July 2019.ResultOf the 248 term neonates with features of sepsis enrolled in the study 94 (37.9%) were confirmed to have sepsis. Late-onset sepsis LOS (68%) was found to be the most common, and most of the neonates were delivered elsewhere. Clinical features were non-specific for both early-onset (EOS) and LOS and include fever, jaundice, poor suck, and depressed primitive reflexes. Infections were mostly caused by gram-negative bacteria, and while Staphylococcus aureus was the single most common isolate for both EOS and LOS. Antibiotic sensitivity was highest with ciprofloxacin for both EOS and LOS. Mortality was high at 14.9% and was mostly contributed to by Staphylococcus aureus infection.ConclusionNeonatal sepsis is still a burden with mostly non-specific clinical features. The local prevalent organisms were Staphylococcus aureus, Enterobacter agglomerans and Klebsiella pneumonia with good antibiotic susceptibility to ciprofloxacin. Most presented with late-onset sepsis and therefore infection is likely to be community-acquired which to a great extent can be prevented with robust public health interventions.

Detection of Multiple Human Viruses, including Mpox, Using a Wastewater Surveillance Approach in Brazil.

Sewage surveillance can be used as an effective complementary tool for detecting pathogens in local communities, providing insights into emerging threats and aiding in the monitoring of outbreaks. In this study using qPCR and whole genomic sewage surveillance, we detected the Mpox virus along with other viruses, in municipal and hospital wastewaters in Belo Horizonte, Brazil over a 9-month period (from July 2022 until March 2023). MPXV DNA detection rates varied in our study, with 19.6% (11 out of 56 samples) detected through the hybrid capture method of whole-genome sequencing and 20% (12 out of 60 samples) through qPCR. In hospital wastewaters, the detection rate was higher, at 40% (12 out of 30 samples) compared to 13.3% (4 out of 30 samples) in municipal wastewaters. This variation could be attributed to the relatively low number of MPXV cases reported in the city, which ranged from 106 to 341 cases during the study period, and the dilution effects, given that each of the two wastewater treatment plants (WWTP) investigated serves approximately 1.1 million inhabitants. Additionally, nine other virus families were identified in both hospitals and municipal wastewaters, including Adenoviridade, Astroviridae, Caliciviridae, Picornaviridade, Polyomaviridae, Coronaviridae (which includes SARS-CoV-2), Herspesviridae, Papillomaviridae and Flaviviridae (notably including Dengue). These findings underscore the potential of genomic sewage surveillance as a robust public health tool for monitoring a wide range of viruses circulating in both community and hospitals environments, including MPXV.

Association of Problematic Internet Use With Psychotic Experiences and Depression in Adolescents: A Cohort Study.

Problematic internet use (PIU) is prevalent among adolescents. Past research suggested cross-sectional associations between PIU and psychotic experiences, but little information is available on the longitudinal association. We hypothesized that PIU in adolescence may be longitudinally associated with psychotic experiences, adjusting for confounders. We analyzed a random sample of adolescents in the Tokyo Teen Cohort to examine how PIU at ages 10 (2012-2015), 12 (2014-2017), and 16 (2019-2021) was associated with mental health issues at age 16. PIU was evaluated by the modified Compulsive Internet Use Scale, psychotic experiences by the Adolescent Psychotic-like Symptom Screener, and depression by the Short Mood and Feelings Questionnaire. We also examined the mediating role of social withdrawal. We analyzed 3171 adolescents; 151 reported psychotic experiences and 327 reported depression at age 16. Compared with the lowest tertile PIU group, the highest tertile PIU group at age 12 showed an increased adjusted risk of psychotic experiences (RD 3.3%, 95% CI 2.9%-3.7%; RR 1.65, 95% CI 1.55-1.73) and depression (RD 5.9%, 95% CI 5.5%-6.3%; RR 1.61, 95% CI 1.55-1.68) at age 16. PIU at age 16 showed analogous results, while PIU at age 10 suggested a smaller impact. Social withdrawal mediated 9.4%-29.0% of the association between PIU and psychotic experiences. PIU is longitudinally associated with psychotic experiences and depression in adolescents. Further longitudinal and intervention studies are warranted to provide robust public health implications and foster a safer digital future.

Impact of Climate Change on Global Health: A Comprehensive Review

Climate change poses significant challenges to global health, with far-reaching implications for human health and well-being. This comprehensive review synthesizes evidence from diverse disciplines to elucidate the complex relationship between climate change and health. Key areas of focus include the direct impacts of extreme weather events, alterations in infectious disease transmission, air quality changes, food security issues, and mental health effects. Vulnerable populations, including low-income communities and indigenous peoples, are disproportionately affected, emphasizing the need for targeted interventions and equitable adaptation strategies. Methodologically, a search of peer-reviewed literature was conducted, covering studies published up to 2024. Both quantitative and qualitative studies were included, and thematic analysis was employed to identify patterns and trends. The review highlights gaps in current policy frameworks and international cooperation efforts, calling for enhanced collaboration and knowledge sharing to address the multifaceted challenges posed by climate change on health. Furthermore, proactive adaptation measures, robust public health infrastructure, and inclusive strategies are essential to mitigate adverse health impacts and foster resilience. By prioritizing collective action and interdisciplinary collaboration, we can work towards a healthier and more resilient future in the face of climate change.

National Public Health Dashboards: Protocol for a Scoping Review.

The COVID-19 pandemic highlighted the importance of robust public health data systems and the potential utility of data dashboards for ensuring access to critical public health data for diverse groups of stakeholders and decision makers. As dashboards are becoming ubiquitous, it is imperative to consider how they may be best integrated with public health data systems and the decision-making routines of diverse audiences. However, additional progress on the continued development, improvement, and sustainability of these tools requires the integration and synthesis of a largely fragmented scholarship regarding the purpose, design principles and features, successful implementation, and decision-making supports provided by effective public health data dashboards across diverse users and applications. This scoping review aims to provide a descriptive and thematic overview of national public health data dashboards including their purpose, intended audiences, health topics, design elements, impact, and underlying mechanisms of use and usefulness of these tools in decision-making processes. It seeks to identify gaps in the current literature on the topic and provide the first-of-its-kind systematic treatment of actionability as a critical design element of public health data dashboards. The scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The review considers English-language, peer-reviewed journal papers, conference proceedings, book chapters, and reports that describe the design, implementation, and evaluation of a public health dashboard published between 2000 and 2023. The search strategy covers scholarly databases (CINAHL, PubMed, Medline, and Web of Science) and gray literature sources and uses snowballing techniques. An iterative process of testing for and improving intercoder reliability was implemented to ensure that coders are properly trained to screen documents according to the inclusion criteria prior to beginning the full review of relevant papers. The search process initially identified 2544 documents, including papers located via databases, gray literature searching, and snowballing. Following the removal of duplicate documents (n=1416), nonrelevant items (n=839), and items classified as literature reviews and background information (n=73), 216 documents met the inclusion criteria: US case studies (n=90) and non-US case studies (n=126). Data extraction will focus on key variables, including public health data characteristics; dashboard design elements and functionalities; intended users, usability, logistics, and operation; and indicators of usefulness and impact reported. The scoping review will analyze the goals, design, use, usefulness, and impact of public health data dashboards. The review will also inform the continued development and improvement of these tools by analyzing and synthesizing current practices and lessons emerging from the literature on the topic and proposing a theory-grounded and evidence-informed framework for designing, implementing, and evaluating public health data dashboards. DERR1-10.2196/52843.

Analysis of The Feasibility of Hydrogen Injection in Pipeline Gas Challenges in The Management of Acute Myocardial Infarction in Patients With Associated Comorbidities: A Review of The Literature

Objective: The objective of this study is to investigate the challenges in the management of Acute Myocardial Infarction in patients with associated comorbidities, with the aim of identifying gaps in treatment and proposing strategies to improve care. Theoretical Framework: Modifiable risk factors play a significant role in the incidence of myocardial infarction, as evidenced by a relevant international study. Understanding the epidemiology of heart attack, including its prevalence, incidence and geographic distribution, is essential to develop effective prevention and control strategies. Identifying and managing traditional risk factors, such as smoking, hypertension, hyperlipidemia and obesity, is crucial in the preventive approach to this condition. Method: Through an integrative literature review, recent studies are explored that cover everything from epidemiology and risk factors to prevention and treatment strategies. An initial selection of 153 articles was refined to 10 studies that met all criteria. Results and Discussion: The results highlight an increasing trend in the prevalence of Coronary Artery Disease (CAD), with a stabilization in the age-standardized prevalence rate, suggesting advances in prevention and treatment. The analysis emphasizes the importance of robust and inclusive public health strategies, focused on educating the population about the risks, ensuring rapid access to treatment, and reducing inequalities in access to healthcare. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how results can influence healthcare management, public policy formation, and clinical practice in cardiology. These implications may include the need for continuing education programs for healthcare professionals, the implementation of integrated care models, and the adaptation of healthcare systems to meet the specific needs of patients with comorbidities associated with AMI. Originality/Value: This study contributes to the literature by highlighting the specific challenges faced in the management of AMI in patients with comorbidities, providing valuable insights to improve the quality of AMI care and reduce disparities in treatment. The relevance and value of this research are evidenced by its contribution to a more comprehensive understanding of the factors that influence the prognosis and quality of life of these patients.

Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation.

Respiratory pathogens inflict a substantial burden on public health and the economy. Although the severity of symptoms caused by these pathogens can vary from asymptomatic to fatal, the factors that determine symptom severity are not fully understood. Correlations in symptoms between infector-infectee pairs, for which evidence is accumulating, can generate large-scale clusters of severe infections that could be devastating to those most at risk, whilst also conceivably leading to chains of mild or asymptomatic infections that generate widespread immunity with minimal cost to public health. Although this effect could be harnessed to amplify the impact of interventions that reduce symptom severity, the mechanistic representation of symptom propagation within mathematical and health economic modelling of respiratory diseases is understudied. We propose a novel framework for incorporating different levels of symptom propagation into models of infectious disease transmission via a single parameter, α. Varying α tunes the model from having no symptom propagation (α = 0, as typically assumed) to one where symptoms always propagate (α = 1). For parameters corresponding to three respiratory pathogens-seasonal influenza, pandemic influenza and SARS-CoV-2-we explored how symptom propagation impacted the relative epidemiological and health-economic performance of three interventions, conceptualised as vaccines with different actions: symptom-attenuating (labelled SA), infection-blocking (IB) and infection-blocking admitting only mild breakthrough infections (IB_MB). In the absence of interventions, with fixed underlying epidemiological parameters, stronger symptom propagation increased the proportion of cases that were severe. For SA and IB_MB, interventions were more effective at reducing prevalence (all infections and severe cases) for higher strengths of symptom propagation. For IB, symptom propagation had no impact on effectiveness, and for seasonal influenza this intervention type was more effective than SA at reducing severe infections for all strengths of symptom propagation. For pandemic influenza and SARS-CoV-2, at low intervention uptake, SA was more effective than IB for all levels of symptom propagation; for high uptake, SA only became more effective under strong symptom propagation. Health economic assessments found that, for SA-type interventions, the amount one could spend on control whilst maintaining a cost-effective intervention (termed threshold unit intervention cost) was very sensitive to the strength of symptom propagation. Overall, the preferred intervention type depended on the combination of the strength of symptom propagation and uptake. Given the importance of determining robust public health responses, we highlight the need to gather further data on symptom propagation, with our modelling framework acting as a template for future analysis.

医疗器械行业发展战略的比较分析 －江苏省和广东省头部企业案例研究－

This research delineates the expansion of the medical device sector, pivotal for the enhancement of medical technologies, the protection of public health, and the establishment of a robust public health infrastructure. The medical device industry, both globally and within China, has exhibited continual positive growth, underscored by the pronounced market dominance of leading firms, thereby highlighting a market trend where the strong become stronger. Focusing on the medical device industries within Jiangsu and Guangdong Provinces as case studies, this paper evaluates the industry’s development trends concerning agglomeration and innovation by comparing metrics such as output value, industry scale, the number of listed companies, and product registration status between the two regions. Concurrently, it identifies Jiangsu Province’s shortcomings in terms of industrial scaling and the nurturing of leading local enterprises. Anchored in the growth trajectory of China’s medical device industry during the “14th Five-Year Plan,” this study endeavors to explore and delineate strategies for fostering leading medical device enterprises in Jiangsu Province from a governmental macro perspective. It aims to offer strategic insights and recommendations to expedite the development of principal local enterprises within the province.