Sound Public Health Research Articles

Possible relationship between respiratory diseases and urinary concentrations of polycyclic aromatic hydrocarbon metabolites - a pilot study.

This study investigates the potential relationship between exposure to polycyclic aromatic hydrocarbons (PAHs), specifically monohydroxylated metabolites (OH-PAHs), in urine, and the prevalence of respiratory diseases in 2-year-old children residing in two locations within the Czech Republic - České Budějovice (control location) and the historically contaminated mining district of Most. Despite current air quality and lifestyle similarities between the two cities, our research aims to uncover potential long-term health effects, building upon previous data indicating distinctive patterns in the Most population. A total of 248 urine samples were analysed for the presence of 11 OH-PAHs. Employing liquid-liquid extraction with ethyl acetate and clean-up through dispersive solid-phase extraction, instrumental analysis was conducted using ultra-high performance liquid chromatography coupled with tandem mass spectrometry. The incidence of respiratory diseases was assessed through questionnaires administered by paediatricians. The concentrations of OH-PAHs were elevated in urine samples from 2-year-olds in Most compared to those from České Budějovice. The incidence of respiratory diseases showed statistically significant higher levels of OH-PAHs in children from Most, together with a higher incidence of influenza. This association underlines the impact of environmental PAH exposure on children's respiratory health. It suggests that elevated urinary OH-PAH levels indicate an increased risk of developing respiratory diseases in the affected population. Further studies are needed to clarify the possible long-term health effects and to contribute to sound public health strategies.

Cost-effectiveness of Improved WIC Food Package for Preventing Childhood Obesity.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prevents food insecurity and supports nutrition for more than 3 million low-income young children. Our objectives were to determine the cost-effectiveness of changes to WIC's nutrition standards in 2009 for preventing obesity and to estimate impacts on socioeconomic and racial/ethnic inequities. We conducted a cost-effectiveness analysis to estimate impacts from 2010 through 2019 of the 2009 WIC food package change on obesity risk for children aged 2 to 4 years participating in WIC. Microsimulation models estimated the cases of obesity prevented in 2019 and costs per quality-adjusted-life year gained. An estimated 14.0 million 2- to 4-year old US children (95% uncertainty interval (UI), 13.7-14.2 million) were reached by the updated WIC nutrition standards from 2010 through 2019. In 2019, an estimated 62 700 (95% UI, 53 900-71 100) cases of childhood obesity were prevented, entirely among children from households with low incomes, leading to improved health equity. The update was estimated to cost $10 600 per quality-adjusted-life year gained (95% UI, $9760-$11 700). If WIC had reached all eligible children, more than twice as many cases of childhood obesity would have been prevented. Updates to WIC's nutrition standards for young children in 2009 were estimated to be highly cost-effective for preventing childhood obesity and contributed to reducing socioeconomic and racial/ethnic inequities in obesity prevalence. Improving nutrition policies for young children can be a sound public health investment; future research should explore how to improve access to them.

공공의료기관 체계에 참여하는 주체들의 역할과 참여 방법에 관한 행정법적 연구

In Korea, it is urgent to establish a sound public health care system, because total number of public hospitals is not sufficient & facilities are aging. In particular, with the COVID-19 pandemic, national & local government's limitation in providing public health care only through public hospitals had been revealed. Therefore, national & local government & various actors in society to participate in establishing a sound public health care system is necessary. In administrative law, Network Theory(Netzwerktheorie in German) is a theory that has attempted to discuss the participation of not only states(includes local governments) and private enterprises, but also more diverse social subjects such as residents in administration. Network theory(Netzwerktheorie in German) means a theory that includes “building a long-term relationship while interacting with a number of independent subjects in society for important resource exchange.
 To establish public health care system, the writer suggests the roles and methods of participation performed by each subject based on Network Theory. For this discussion, the subjects participating in establishing system of public hospitals are divided into ① states and local governments, ② private enterprises, ③ residents and general public, and ④ non-profit private organization. The roles of each subject are below: First, states and local governments plays roles in providing public health care service through public hospitals as before, and provides and maintains a place for cooperation for various subjects to participate in cooperation with the system of public hospitals that are converted to network relations. The method of participation of states and local government focuses on legislation to improve the legal system of public hospitals. Second, private enterprises are in charge of commissioning work related to facilities of public hospitals from the states and local governments. The method of participation of private enterprises focuses on the Private Finance Initiative(PFI) to ease the financial burden administered to facilities of public hospitals and to ensure that public hospitals can properly provide public health care services. Third, residents and the general public play a role in deciding jointly with the states and local governments on the establishment or operation of public hospitals. The method of participation of residents and the general public shall be discussed focusing on the residents-participation in the planning stage. Fourth, non-profit private organizations play a role in monitoring whether the establishment and operation of public hospitals are properly carried out. The method of participation of non-profit private organizations will be discussed focusing on class action.
 By clarifying the roles and methods of the subjects participating in establishing the system of public hospitals, it is expected to be able to effectively respond to the pandemic that may occur again in the future. In addition, it is expected that public hospitals can provide high-quality public health care service to the public and protect the lives and bodies of the people.

7.H. Round table: Legal determinants of health - what do (global) public health professionals need to know?

Abstract Public health and legal systems have different objectives and operate under different frameworks, which can create challenges for public health professionals who need to implement policies and interventions that are legally sound. While public health seeks to promote and protect the health of the population, the legal system focuses on protecting individual rights and ensuring justice is served. One major challenge is that public health interventions can sometimes conflict with individual rights, such as privacy or freedom of movement. Another challenge is the complexity of the legal system. Public health professionals may not have the legal expertise or resources to navigate the legal system. To address these challenges, it is important for public health professionals to collaborate with legal experts and policymakers. As recognised in the 2019 Lancet-O'Neill Institute Commission on Global Health and Law, such collaboration helps to develop effective and legally sound public health policies and interventions to address the legal determinants of health and promote global health and sustainable development. Moreover, there is a growing recognition of the importance of interdisciplinary training for professionals in both law and public health. Law and public health schools are increasingly offering joint degree programs or courses that address the intersection of law and public health. This can help to build a workforce with the necessary skills and knowledge to effectively address public health issues within the legal framework. The WHO-ASPHER Competency Framework for the Public Health Workforce in the European Region was published in 2020 encompassing competencies in law and regulations. This Round Table aims to raise awareness of the importance of legal policies and practices to promote public health outcomes, and collaboration and interdisciplinary approaches, to address health-related legal issues. The three short presentations will be followed by a discussion between the panellists and participation of the audience. First, the legal determinants of health will be addressed, including the human rights dimensions, and examine the impact legislative and regulatory frameworks and jurisprudence have on the enjoyment of the right of health. Second, legal epidemiology will be discussed as an important and innovative approach to understand the complex relationships between legal policies, social determinants of health, and health outcomes, and how it works to guide policy development, advocacy, implementation and accountability for impact. Third, the importance of incorporating legal education into public health training programs is highlighted. Examples of practical measures to incorporate this information and build these skills in the training of public health professionals will be discussed. Key messages • Understanding legal determinants of health is crucial for (global) health professionals in addressing health inequities and improving health outcomes for individuals and populations. • Interdisciplinary structures are needed in which law and health work together and schools of public health are an excellent vehicle for bridging the gap. Speakers/Panelists Brigit Toebes University of Groningen, Groningen, Netherlands Scott Burris Temple University Beasley School of Law, Philadelphia, USA Kasia Czabanowska Maastricht University, Maastricht, Netherlands Monica Brînzac EUPHAnxt

Strategies to Operationalize Health Equity in Island Area Health Departments.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Molecular Identification of Prevalent Streptococcus Pyogenes Serogroup Associated with Respiratory Tract Infections in Children

The current study intends to characterize the respiratory tract infections that have an association with gram positive bacterial pathogens, emm typing, the pattern of antibacterial resistance in isolated pathogens, phenotyping of virulence factor and molecular detection of Macrolide resistance gene. Various samples from patients with respiratory tract infections were collected and identification and antimicrobial susceptibility of clinical isolates was performed as per standard laboratory procedure. Macrolides (Eruthromycin, Clindamycin)-resistant isolates were again subjected to MIC method. Macrolide-inducible resistance to clindamycin (D test) was conducted upon Erythromycin and Clindamycin discs. Multiplex PCR was used to detect the resistance genes in all the three types of macrolide resistance strains. Serum Opacity Factor (SOF) was detected for all the isolates of GAS. Every isolate was checked to produce biofilm through micro titre plate method. Bacterial growth got registered in 156 (36.28%) samples. The most common isolate from URI samples was GAS i.e., 64 (14.9%), only to be followed by GGS 38(8.8%), GCS 29 (6.7%) and Staphylococcus aureus 18 (4.2%). Among GAS, only one isolate was recorded from blood, whereas 8.50% from sputum and the rest. All 71 GAS isolates were found to exhibit sensitivity towards Penicillin and Ceftriazone. GAS exhibited 55% Mtype of resistance whereas 40% were resistant to cMLS and 5% to iMLS. GCS showcased an equal number of cMLS and M type too. GGS portrayed 54.54% resistance to cMLS followed by 36.36% to Mtype and 9.09% to iMLS. The current study found iMLS type with least resistance. The current study identified that Streptococcus pyogenes is the most common bacteria that cause and recur the infection. The prevalence of resistance tends to change geographically and periodically. For this purpose and to achieve a sound public health outcome, periodical screening of antibiotic-resistance pattern becomes inevitable.

BLACK GREEK LETTER ORGANIZATIONS: FACILITATING HEALTH PROMOTION FOR AFRICAN AMERICANS ACROSS THE LIFECOURSE

Abstract African Americans remain underrepresented in accessing and utilizing evidenced-based health promotion interventions (EBIs). Challenges with dissemination and implementation of EBIs further corroborate existing racial/ethnic health/healthcare disparities. Therefore, there is a need to identify effective ways to increase the widespread adoption of health promotion behaviors among African Americans across the life course. It is plausible that engaging in non-traditional partnerships (i.e., community groups or organizations valued in the community with the capacity and infrastructure) could result in greater adoption and improved utilization of EBIs among African Americans. Although frequently overlooked as a study variable in empirically sound public health research, Black Greek Letter Organizations (BGLO) could be an innovative and practical approach to advancing health in the African American community. It is necessary to gain preliminary evidence of feasibility (e.g., motivation, target population reach, acceptability, ). Therefore, the purpose of this study was to conduct a content analysis to identify the intentions and communication trends of BGLOs as it pertains to public health and the African American community and assess population reach and perceptions by evaluating responses to communication specific to health promotion.We assessed health promotion patterns of four BGLOs in a ten-county metropolitan area. Coded content included communication via the organization’s webpage, Facebook, Twitter, YouTube, Instagram, and LinkedIn from a five-year time period. Findings confirm that BLGOs are invested in the health and well-being of the community, place emphasis on mitigating health inequities, and are uniquely positioned to serve as stakeholders for the translation of EBIs to end-users.

BLACK GREEK LETTER ORGANIZATIONS: FACILITATING HEALTH PROMOTION FOR AFRICAN AMERICANS ACROSS THE LIFECOURSE

Abstract African Americans remain underrepresented in accessing and utilizing evidenced-based health promotion interventions (EBIs). Challenges with dissemination and implementation of EBIs further corroborate existing racial/ethnic health/healthcare disparities. Therefore, there is a need to identify effective ways to increase the widespread adoption of health promotion behaviors among African Americans across the life course. It is plausible that engaging in non-traditional partnerships (i.e., community groups or organizations valued in the community with the capacity and infrastructure) could result in greater adoption and improved utilization of EBIs among African Americans. Although frequently overlooked as a study variable in empirically sound public health research, Black Greek Letter Organizations (BGLO) could be an innovative and practical approach to advancing health in the African American community. It is necessary to gain preliminary evidence of feasibility (e.g., motivation, target population reach, acceptability, ). Therefore, the purpose of this study was to conduct a content analysis to identify the intentions and communication trends of BGLOs as it pertains to public health and the African American community and assess population reach and perceptions by evaluating responses to communication specific to health promotion.We assessed health promotion patterns of four BGLOs in a ten-county metropolitan area. Coded content included communication via the organization’s webpage, Facebook, Twitter, YouTube, Instagram, and LinkedIn from a five-year time period. Findings confirm that BLGOs are invested in the health and well-being of the community, place emphasis on mitigating health inequities, and are uniquely positioned to serve as stakeholders for the translation of EBIs to end-users.

Racial and Ethnic Disparities in Housing Instability During the COVID-19 Pandemic: the Role of Assets and Income Shocks.

Stable and adequate housing is critical to sound public health responses in the midst of a pandemic. This study explores the disproportionate impact of the COVID-19 pandemic on housing-related hardships across racial/ethnic groups in the USA as well as the extent to which these disparities are mediated by households' broader economic circumstances, which we operationalized in terms of prepandemic liquid assets and pandemic-related income losses. Using a longitudinal national survey with more than 23,000 responses, we found that Black and Hispanic respondents were more vulnerable to housing-related hardships during the pandemic than white respondents. These impacts were particularly pronounced in low- and moderate-income households. We found that liquid assets acted as a strong mediator of the housing hardship disparities between white and Black/Hispanic households. Our findings imply that housing became less stable for minority groups as a result of the pandemic, particularly those households with limited liquid assets. Such housing-related disparities demonstrate the need for policies and practices that target support to economically marginalized groups and families of color in particular.

S10-1 Developing and monitoring physical activity policy: 1990 to today

BackgroundPhysical inactivity accounts for as many as 5 million deaths per year globally but has yet to be addressed effectively by most governments or the World Health Organization (WHO).Description of the problemReasonable evidence for effective strategies exist, and several countries have implemented consistent public health policies and programs that have increased population prevalence of regular physical activity. In 2018 WHO launched a Global Action Plan for Physical Activity (GAPPA). However, most countries do not have effective public health policies in place for physical activity. Evaluating the history of national and global policies to understand how some countries have developed sound public health programs for physical activity while most have not requires monitoring and evaluating policy, programmatic, and perhaps even research indicators for physical activity. Only recently have there been systematic efforts to do so.ResultsSeveral key questions about physical activity policy, starting with an examination of the evolution of public health physical activity policy and policy research from when it was first explicitly identified in the 1990s to the present will be addressed. Key recommendations, global statements, research reviews and action plans will be summarized to provide a clear picture of the evolution of this important aspect of public health. Evidence on the implementation of policy at national and global levels will also be reviewed. We will examine whether it feasible to track physical activity policy at the global and country levels, if the existence of ?good? physical activity policy is associated with less physical inactivity, how policy indicators may be used for advocacy and guidance.LessonsPhysical activity policy for public health is a relatively new concept that has evolved significantly in the last three decades with formal national and global policy statements, research, and evaluation efforts all increasing markedly since 1990.Main MessageDespite notable growth in policy research and the development of sophisticated national and global policies and action plans, implementation of effective national and global policies and programs for physical activity remains limited.

What effects of COVID-19 on regional economic resilience? Evidence from 31 provinces in China.

After the 2008 global financial crisis, more and more scholars began to focus on economic resilience. In 2020, the outbreak of COVID-19 made the public aware of the importance of regional economies to resist and adapt to external shocks. Based on cross-sectional data from 2020 and 2021, this paper uses causal inference counterfactual to assess the regional economic resilience of various Chinese provinces under the COVID-19 pandemic, and analyzes the determinants of regional economic resilience through geographic detector models. It is found that (1) from the regional perspective, the eastern and central regions are the first to be affected by the epidemic, and their economic resistance is lower than the national average, but the eastern and central regions can stabilize the development trend of the epidemic earlier; (2) from the perspective of provinces, developed provinces are more vulnerable to the epidemic in the early stages than backward provinces; (3) government forces and social environment play an important role in regional economic resistance and adaptation in the initial stage of epidemic impact. Therefore, at the critical moment of China's post-epidemic economic recovery, it should be noted that the regional response to the epidemic depends on the path of action and the specific environment, and cannot be “one-size-fits-all.” Pay close attention to the key role of government and the management of risk prevention. The region has established sound public health policies, systems and mechanisms.

Prevalence of noncommunicable diseases risk factors and their determinants in Malawi

Introduction: By 2030, the noncommunicable diseases (NCDs) are expected to overtake communicable, maternal, neonatal, and nutritional diseases combined as the leading cause of mortality in sub-Saharan Africa. With the increasing trend in NCDs, the NCD risk factors (NCDRF) need to be understood at local level to guide NCD risk mitigation efforts. Therefore, we provide a detailed analysis of some modifiable NCDRF and their determinants in Malawi using the 2017 Stepwise survey (STEPS). Methods: This is a secondary analysis of the Malawi 2017 STEPS. Data were analyzed using frequencies, proportions, odds ratios, and their associated 95% confidence intervals (95%CI). We fitted multiple logistic regression of the NCDRF on the explanatory variables using the likelihood ratio test. The level of statistical significance was set at P < 0.05. Results: Of the 4187 persons, 9% were current smokers, 1% were taking alcohol, 16% had a high salt intake, 64% had insufficient fruit intake, 21% had low physical activity, 25% had high blood sugar, and 11% had high blood pressure. Smoking odds increased with age but decreased with the level of education. Females had lower odds of engaging in harmful alcohol use than males (adjusted odds ratio [AOR] = 0.04, 95%CI: 0.01–0.17, P < 0.001). Females had lower odds of high salt uptake than the males (AOR = 0.70, 95%CI: 0.58–0.84, P = 0.0001). Persons in nonpaid jobs had higher odds of salt uptake than those employed (AOR = 1.70, 95%CI: 1.03–2.79, P = 0.04). Females were 22% more likely to have insufficient fruit uptake compared to males (AOR = 1.22, 95%CI: 1.06–1.41, P = 0.007). Conclusion: The high prevalence of physical inactivity, high salt consumption, insufficient fruit intake, raised blood glucose and high relative blood pressure calls for a sound public health approach. The Malawi Ministry of Health should devise multisectoral approaches that minimize exposure to modifiable NCDRF at population and individual levels.

Emergency department visits among people with predementia highly predicts conversion to dementia.

Emergency department visits (EDV) are common among older adults with and without dementia. The risk factors and demands of EDVs for people with dementia have been well studied; however, the association between EDVs and conversion to dementia among people with predementia has not been thoroughly explored. To study the predictive value of EDVs in predementia’s progression to dementia. The baseline predementia cohort registered from September 2015 to August 2017, with longitudinal follow-up in the History-based Artificial Intelligent Clinical Dementia Diagnostic System database, was retrospectively analyzed. The rates of conversion among the different EDVs were compared. Multivariate logistic regression and Cox proportional hazards analyses were applied to study the influence of EDVs on progression. Age, education, sex, neuropsychological tests, activities of daily living, neuropsychiatric symptoms, parkinsonism, and multiple vascular risk factors were adjusted for. A total of 512 participants were analyzed, including 339 (66.2%) non-converters and 173 (33.8%) converters with a mean follow-up of 3.3 (range 0.4–6.1) and 2.8 (range 0.5–5.9) years, respectively. Compared to people without EDV (EDV 0), the hazard ratios for conversion to dementia were 3.6, 5.9, and 6.9 in those with EDV once (EDV 1), twice (EDV 2), and more than twice (EDV >2), respectively. In addition, older age, lower education, poorer cognition, poorer ADL performance, and longer follow-up periods also increased the conversion rates. EDVs in the predementia stages highly predict progression to dementia. Therefore, a sound public health as well as primary healthcare system that provide strategies for better management of mental and physical condition might help prevention of EDVs among older people in the predementia stages.

Implementation and challenges to preventing the re-establishment of malaria in China in the COVID-19 era

BackgroundThe rapid emergence and global spread of COVID-19 have caused substantial global disruptions that have impacted malaria programs worldwide. Innovative strategies to enable countries aiming to eliminate malaria as well as those that are already certified as malaria-free, are needed to address malaria importation in the context of the COVID-19 pandemic. China was certified as malaria-free in 2021 and now aims to prevent the malaria re-establishment. Nonpharmaceutical interventions such as entry screening, quarantining, and health education for individuals returning from international travel during the COVID-19 pandemic present both opportunities and challenges to the management of imported malaria. This study aimed to describe and analyze the operational challenges associated with an integrated surveillance and case management program in which malaria re-establishment prevention measures were incorporated into the COVID-19 program in China.MethodsAfter the integration of malaria re-establishment prevention activities into the COVID-19 program for 10 months in Jiangsu Province, China, a focus-group discussion of public health workers working on preventing malaria re-establishment and controlling COVID-19 was held in June 2021, aiming to explore the operational challenges and lessons learned from the integrated approach.ResultsFrom 01 August 2020 to 31 May 2021, 8,947 overseas travelers with Yangzhou as the final destination underwent 14-day managed quarantine and 14-day home isolation. Of these travelers, 5,562 were from malaria-endemic regions. A total of 26,026 education booklets and materials were distributed to expand malaria-related knowledge. Twenty-two patients with unknown fever were screened for malaria with rapid diagnostic tests, and one patient was confirmed to have imported malaria. The challenges associated with the implementation of the integrated malaria surveillance and case management program include neglect of malaria due to COVID-19, lack of a standard operating procedure for malaria screening, mobility of public health providers, and difficulties in respecting the timeline of the “1–3-7” surveillance strategy.ConclusionsChina’s experience highlights the feasibility of integrated case surveillance and management of existing infectious diseases and new emerging infections. It also demonstrates the importance of a sound public health infrastructure with adequate, trained field staff for screening, testing, contact tracing, and providing health education, all of which are crucial for the success of both malaria re-establishment prevention program and the effective control of COVID-19.

Investigation of Prescription Data to Define the Disease Demography of Bangladesh

The prosperity of a country is highly dependent on its public health. Bangladesh is very keen to achieve a sustainable public health sector as a developing country. Bangladesh reached the goal of MDG (Millennium Development Goals) and pursued the goal of SDG (Sustainable Development Goals). Without sound public health, it is impossible to achieve SDG. So, Bangladesh is investing a good amount of money in the public health sector. As a part of this grand vision, this research has been conducted on the disease demography of Bangladesh. An interested pharmaceutical company collected prescription data from all administrative districts of Bangladesh, and weather and population data have been collected as a part of this work. An in-depth analysis of these data has been performed to discover insights into Bangladesh’s disease demography. Finally, a set of recommendations has been presented to assist the public health sector of Bangladesh.

Healthcare Financing in West Bengal

The article analyses patterns and trends of healthcare financing in West Bengal. The aim is to understand the direction to which the public health system of the state heads. Real per capita expenditure on health remains almost stagnant in West Bengal during most of the 14th Finance Commission period. The state has shifted its focus from primary and preventive care and has been promoting insurance-based healthcare model, Swasthya Sathi, which might put the population of the state at the risk of being exposed to high medical expenses in absence of a sound public health system. Going by the past experience of healthcare financing in West Bengal, allocation of resources for Swasthya Sathi was contingent on the union government’s allocation of resources for Rashtriya Swasthya Bima Yojana, and later for Pradhan Mantri Jan Arogya Yojana. This means that if allocation for Prandhan Mantri Jan Arogya Yojana is reduced by the centre, allocation for Swasthya Sathi might also fall. For a sound public health system, it is important to allocate resources adequately on public health so that it benefits the poor and socially deprived population.

Out of the trenches; prevalence of Australian veterans among the homeless population and the implications for public health

ObjectivesTo examine the prevalence of Australian Defence Force veterans among people sleeping rough and explore their health and social needs relative to non‐veteran rough sleepers. MethodAnalysis of responses to the Vulnerability Index – Service Prioritisation Decision Assistance Tool (VI‐SPDAT) collected from 8,027 rough sleepers across five Australian States from 2010‐2017. ResultsVeterans were found to comprise 5.6% of people sleeping rough in Australia, with veterans reporting having spent an average of 6.3 years on the street or in emergency accommodation (compared with an average of five years for their non‐veterans counterparts). Veterans had a higher prevalence of self‐reported physical health, mental health and social issues compared with non‐veteran rough sleepers. ConclusionsThis is the first study of its kind to elucidate the presence of Australian veterans among people sleeping rough. That they are likely to have spent more years on the street, and have a higher prevalence of health and social issues, highlights the imperative for earlier intervention and prevention of veteran homelessness itself, and its health impacts. Implications for public healthVeteran homelessness has been comparatively hidden in Australia compared to other countries, and consequently the myriad of health, psychosocial and adjustment issues faced by homeless veterans has also been hidden. With heightened attention on veteran suicide and self‐harm, earlier intervention to prevent veterans becoming homeless constitutes sound public health prevention and mental health policy.

Illusion of Truth: Analysing and Classifying COVID-19 Fake News in Brazilian Portuguese Language

Public health interventions to counter the COVID-19 pandemic have accelerated and increased digital adoption and use of the Internet for sourcing health information. Unfortunately, there is evidence to suggest that it has also accelerated and increased the spread of false information relating to COVID-19. The consequences of misinformation, disinformation and misinterpretation of health information can interfere with attempts to curb the virus, delay or result in failure to seek or continue legitimate medical treatment and adherence to vaccination, as well as interfere with sound public health policy and attempts to disseminate public health messages. While there is a significant body of literature, datasets and tools to support countermeasures against the spread of false information online in resource-rich languages such as English and Chinese, there are few such resources to support Portuguese, and Brazilian Portuguese specifically. In this study, we explore the use of machine learning and deep learning techniques to identify fake news in online communications in the Brazilian Portuguese language relating to the COVID-19 pandemic. We build a dataset of 11,382 items comprising data from January 2020 to February 2021. Exploratory data analysis suggests that fake news about the COVID-19 vaccine was prevalent in Brazil, much of it related to government communications. To mitigate the adverse impact of fake news, we analyse the impact of machine learning to detect fake news based on stop words in communications. The results suggest that stop words improve the performance of the models when keeping them within the message. Random Forest was the machine learning model with the best results, achieving 97.91% of precision, while Bi-GRU was the best deep learning model with an F1 score of 94.03%.

Along the Fold

Along the Fold Jennifer Wenzel (bio) One of the indelible images of Manhattan in late March 2020 was the archive of horror accreting daily on my neighbor’s doormat. Above the fold, the New York Times reported on so many thousand lives lost one day, so many million jobs lost the next. No one who was in New York City in spring 2020 will forget the ambulances wailing nearly nonstop—an awful, inescapable sound that could shatter any numbed state of abstraction in relation to the daily numbers. Yet, after the sheer terror of the first weeks, it became clear that the true horror recorded in the Times lay along the fold: that is, in the stark divide between those most at risk, as reported above the fold, and those able to shelter at home, whose needs were tended to, below. The Times created a robust new “At Home” section, full of tips for what to listen to, watch, cook, make, or otherwise do to pass the endless time, chez vous. “At Home” was (and is) pitched at readers like me: those fortunate and privileged enough to be able to retreat to our cocoons, order in our groceries, and tend our own gardens (or sourdough starters). Those gardens weren’t even entirely metaphorical: my partner started growing lettuce and arugula from seed on the windowsill, while others regrew their scallions in little jars. Although I’ve certainly picked up some helpful tips, I’ve never been able to read “At Home” without a sense of nausea. Fully cognizant that no one, not even me, needs another “My Pandemic Year” narrative, I nonetheless want to think about the pandemic-era newspaper fold and the social relations limned by it. Specifically, how does the fold intersect with the slash in in/habitable, and with the echoes and contradictions and traces of meaning between English and French, as outlined by Thangam Ravindranathan in her evocative meditation on Georges Perec in this issue? If we have learned anything in these months, it is perhaps that this one-word, two-language oxymoron might name the pandemic accommodation to inhabiting a new normal, a mode of living which, in the “old world” or the “before times,” would have seemed (un) inhabitable.1 [End Page 136] This particular notion of in/habitable is a below-the-fold structure of feeling. Although I cannot not grieve all that has been lost in this tough-yet-tattered city and beyond, I also cannot speak for those who must grieve all of theirs who have not lived. Even before the murder of George Floyd in May 2020 and the awakenings that followed, one could look to the coronavirus maps of New York City—where racial and class marginalization and COVID-19 positivity rates overlapped to a shocking-yet-not-surprising degree—to see how very little had changed, even as so much had changed, so quickly. In my household, the sheer terror of the first weeks—the fears that we might fall very ill, that the hospitals might be full, that we might die—receded as it was replaced by what I describe above as the along-the-fold horror: the awful knowledge that we’d probably be just fine, our Zoomable jobs still intact, and therefore able to afford to pay others to expose themselves on our behalf. We tipped everyone, all the time, scattering twenties like talismans. And there was even a public health rationale for this outsourcing of risk: we could do our part to flatten the coronavirus curve by staying home, and to flatten the economic catastrophe curve by spending and donating as much money as possible. And yet, how vast is the gulf between sound public health advice and the project of social justice. The capacity of the affluent to stay home and order in was dependent precisely on the continuing itineration of “essential workers,” the very people whom the real estate market had long pushed to margins of the city, those outer-borough neighborhoods now ravaged by the virus. In this, the pandemic only laid bare and exacerbated the untenable inequalities of the old world, the before times. ________ For several years, I found...

UK food policy: implications for nutritionists.

Implications of the 'changing world' for nutrition and nutritionists are considered, using the UK within a global context as an illustration. The first section summarises the slow recognition by policy makers of the significance of the changing world of food and nutrition. The second section 'Food system stress is now at a critical level' considers the present scale of global food system stress and the failure so far sufficiently to narrow the gap between evidence and policy change. The year 2021 was earmarked when three major UN conferences had the opportunity to chart food changes ahead. The third section 'Multi-criteria analysis helps frame 21st century nutrition science' proposes that multi-criteria analysis is an essential methodology for nutrition within this more complex policy world; nutrition studies can no long exclude social and environmental criteria. The penultimate section 'Nutrition science can reconnect its life science, social and environmental nutrition traditions to contribute to new paradigm formation' suggests that nutrition science can now recombine three traditions within its own history to address this complexity: social nutrition, environmental nutrition and life sciences. The final section 'Priorities ahead' concludes that this multi-criteria approach to nutrition offers new routes for science and policy influence. Five priorities are identified: (1) clarification of the features of a good food system; (2) new sustainable dietary guidelines which integrate different determinants of sustainability; (3) helping consumer engagement with change; (4) developing improved policy frameworks and (5) contributing to professional channels in these processes. In the UK, while the challenge of narrowing the gap between evidence, policy and change remains daunting, the risks of not attempting to improve the transition to an ecologically sound public health nutrition are even greater.