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Cyprus College
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The college was founded in 1961 with the purpose to provide a well rounded education of high calibre where students can acquire the necessary academic knowledge.
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Wroclaw University
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Founded in 1702 by Leopold I Habsburg. Since the beginning of 20th century the university has produced 9 Nobel Prize winners.
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Volyn University
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The history dates back to 1940. At present, the university includes 4 institutes, 14 faculties and 73 departments.
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Berkeley College
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Through the power of internet, Berkeley college online brings the classroom to you anywhere in the world with the same high level of support as On-Campus classes.
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AIS
ais.ac.nz
New Zealand's largest international degree provider. The programmes are focused on the global marketplace.
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WORLD UNIVERSITY DIRECTORY
Medical Education Journal of Public Health - current issue
<span class="paragraphSection"><span style="font-style:italic;">‘Long as I remember the rain been comin’ down</span><span style="font-style:italic;">Clouds of mystery pourin’ confusion on the ground</span><span style="font-style:italic;">Good men through the ages tryin’ to find the sun</span><span style="font-style:italic;">And I wonder, still I wonder, who’ll stop the rain?’</span><a href="#ref1" class="reflinks"><sup>1</sup></a></span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>This study aimed to explore the Italian population’s knowledge and perceptions regarding health data storage and sharing for treatment and research and to identify factors associated with citizens’ attitudes toward data storage and sharing.<div class="boxTitle">Methods</div>A cross-sectional questionnaire, distributed to 1389 participants, collected sociodemographic information, assessed knowledge and gauged attitudes toward sharing data for treatment and research. Descriptive analyses and logistic regressions were performed to examine the associations between sociodemographic factors and knowledge/attitudes about data storage and sharing.<div class="boxTitle">Results</div>Most respondents wrongly believed that healthcare providers could access personal health–related data across the entire national territory, while 94% expressed willingness to share personal health data nationwide. A substantial percentage of respondents (73%) fully agreed that storing and sharing personal health–related data could improve research and quality of care.Males and younger individuals (<41 years) were likelier to have higher data-sharing knowledge. Lower educational-level respondents exhibited lower positive attitudes towards sharing health data for treatment and research purposes.<div class="boxTitle">Conclusions</div>The results provide valuable insights for policymakers, healthcare professionals and researchers seeking to improve data management, promote collaboration and leverage the full potential of health data for personalized care and scientific advancements.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Participation in paid work after childbirth may have important health and socioeconomic impacts on women and their families. We investigated women's employment patterns at six months postpartum and the factors that influence them.<div class="boxTitle">Methods</div>Using data from a 2018 population-based national maternity survey in England, employment status at six months postpartum was assessed. Logistic regression was used to explore sociodemographic and pregnancy- and birth-related factors associated with being in paid work by six months postpartum. Descriptive analysis was used to explore employment characteristics and motivations of women in paid work.<div class="boxTitle">Results</div>Of the 4313 participants included, 7.7% were in paid work by six months postpartum. Factors associated with being in paid work were age ≥35 years [(adjusted odd ratios (aOR):1.37, 95% confidence interval (CI):1.02–1.84], not living with a partner (aOR:0.50, 95%CI:0.28–0.90), and pre-term birth (aOR:0.38, 95%CI:0.20–0.69). The most frequently reported motivation was financial need (76%), followed by wanting to work (41%). Financial need was associated with younger age, living in a more socioeconomically disadvantaged area, not living with a partner, and lower education level.<div class="boxTitle">Conclusion</div>Postpartum employment patterns and motivations for working vary according to sociodemographic characteristics. These findings have important implications for parental leave and childcare policies, which should be equitable across different groups.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The Covid-19 pandemic showed higher infection, severity and death rates among those living in poorer socioeconomic conditions. We use syndemic theory to guide the analyses to investigate the impact of social adversity and multiple long-term conditions (MLTC) on Covid-19 mortality.<div class="boxTitle">Methods</div>The study sample comprised 154 725 UK Biobank participants. Structural equation modeling was used to investigate pathways between traumatic events, economic deprivation, unhealthy behaviors, MLTC, for Covid-19 mortality. Cox regression analysis was used to investigate MLTC and Covid-19 mortality. We also tested effect modification by traumatic events, economic deprivation and unhealthy behaviors.<div class="boxTitle">Results</div>Covid-19 mortality (<span style="font-style:italic;">n</span> = 186) was directly explained by overall level of MLTC. Economic deprivation and unhealthy behaviors contributed to Covid-19 death indirectly via their negative impact on MLTC. The risk for Covid-19 mortality grew exponentially for every quintile of predicted scores of MLTC. The presence of traumatic events, economic deprivation or unhealthy behaviors did not modify the impact of MLTC on Covid-19 mortality.<div class="boxTitle">Conclusions</div>Results suggest a serially causal pathway between economic deprivation and unhealthy behaviors leading to MLTC, which increased the risk of Covid-19 mortality. Policies to tackle the social determinants of health and to mitigate the negative impact of multimorbidity are needed.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Nutrient deficiencies during pregnancy may affect offspring development. We aim to examine the association between prenatal vitamin B<sub>12</sub> intake and children’s cognitive development.<div class="boxTitle">Methods</div>A total of 5151 mother–child pairs from the Czech part of ELSPAC study were included in the analysis. Dietary information was obtained during pregnancy using food frequency questionnaire. Parents reported on their child’s speech and language development at 18 months, 3, 5 and 7 years. Intelligence quotient (IQ) was measured at 8 years in subcohort of 854 children.<div class="boxTitle">Results</div>Children of mothers with higher vitamin B<sub>12</sub> intake demonstrated higher scores in language (<span style="font-style:italic;">B</span> = 0.20, 95% CI 0.06, 0.34) and talking and understanding (<span style="font-style:italic;">B</span> = 2.39, 95% CI 0.97, 3.80) in a fully adjusted model at 18 months. Additionally, they were more likely to get maximum points in the intelligibility test at age 3 (OR = 1.05, 95% CI 1.01, 1.09) in unadjusted model, however, not in fully adjusted model. We found a positive effect of higher vitamin B<sub>12</sub> intake on verbal IQ (<span style="font-style:italic;">B</span> = 1.08, 95% CI 0.09, 2.08).<div class="boxTitle">Conclusions</div>We identified consistent associations between prenatal vitamin B<sub>12</sub> intake and children’s cognitive development. The results suggest that inadequate vitamin B<sub>12</sub> during pregnancy may negatively affect children’s cognitive development, particularly in speech and language.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Healthcare demand procrastination is a public health concern in Türkiye, with limited research available. This study examines the prevalence of healthcare procrastination and identifies associated factors among patients at Pamukkale University Hospital.<div class="boxTitle">Methods</div>This cross-sectional study was conducted from 2 to 13 February 2023 in Denizli and involved 503 patients from 15 outpatient clinics. Data on sociodemographic characteristics, healthcare utilization and procrastination behaviors were collected via a structured questionnaire, including the Healthcare Demand Procrastination Scale (HDPS). Descriptive statistics and linear regression were used for analysis.<div class="boxTitle">Results</div>The participants had a mean age of 41.46 years (±15.34), with 52.9% being female. A significant 77.3% reported delaying healthcare despite needing it. The primary reasons for delays were difficulty in getting appointments (51.5%), long waiting times (21.9%) and COVID-19 concerns (19.9%). The mean HDPS score was 2.29 ± 0.65, indicating moderate procrastination. Regression analysis revealed that younger age (≤35 years) and rural residence significantly predicted higher HDPS scores, whereas receiving health information from professionals was linked to lower procrastination.<div class="boxTitle">Conclusions</div>Healthcare procrastination is common among patients in Türkiye, particularly among younger individuals and rural residents. Improving healthcare accessibility, reducing wait times and implementing targeted interventions are essential to mitigate this issue and enhance health outcomes.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Understanding of the factors influencing oesophageal cancer trends is crucial. Therefore, this cross-sectional cohort study sought to disentangle the age, period and cohort effects on the trends of oesophageal cancer in Kuwait.<div class="boxTitle">Methods</div>The data on incident oesophageal carcinoma cases diagnosed between January 1, 1980, through December 31, 2019, and reference population were obtained. Age-period-cohort (APC) analysis was conducted using a loglinear Poisson regression model.<div class="boxTitle">Results</div>A total of 496 oesophageal carcinoma cases in 12.8 million person-years (i.e. squamous-cell carcinoma, 269, 54.23%), adenocarcinoma,147, 29.64% and unspecified cases, 80,16.13%) were diagnosed. The overall age-standardized incidence rate (per 10<sup>5</sup> person-years) of oesophageal carcinoma during the study period was 10.51 (95% CI: 6.62–14.41). The APC analysis results showed that the age and birth cohort effects were the significant determinants of declining, and subsequently steadying the oesophageal carcinoma incidence rates.<div class="boxTitle">Conclusions</div>A substantial decline in oesophageal carcinoma incidence rates was recorded, which significantly varied in all three temporal dimensions. The observed birth cohort patterns suggest changing lifestyle and dietary patterns seem to be responsible for decreasing oesophageal carcinoma risk in Kuwait. Future studies may look for the component causes maintaining the endemicity of oesophageal carcinoma risk in this and similar countries in the region.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>We aimed to conduct an updated and comprehensive summary of the sensitivity and specificity of three human papillomavirus (HPV) point-of-care (POC) tests (careHPV™, oncoE6™ cervical test, Xpert® HPV) to guide resource-constrained countries for their implementation in cervical cancer screening.<div class="boxTitle">Methods</div>Databases including Medline, Embase, Web of Science and cumulated index in nursing and allied health literature (CINAHL) were searched between January 2004 and October 2024. Observational studies analyzing the three tests for cervical cancer screening were included. Pooled estimates for the performance characteristics were calculated using random-effect models.<div class="boxTitle">Findings</div>Of the 3976 records, 33 studies were included. The sensitivity and specificity of careHPV™ for detection of CIN2+ lesions in self-collected samples were 75.6% and 85.6% compared to 86.4% and 80.4% for physician-collected samples. The sensitivity and specificity of OncoE6™ cervical test were 54.5% and 98.4%, respectively, for physician-collected samples. Xpert® HPV had a sensitivity and specificity of 91.5% and 56.5% in self-collected vaginal samples (SCSs), 92.3% and 53.3%, respectively, in physician-collected cervical samples.<div class="boxTitle">Interpretation</div>Both careHPV™ and Xpert® HPV have a good sensitivity and specificity as a POC cervical cancer screening method. These methods also hold potential for use on SCSs.<div class="boxTitle">Funding</div>None.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Public health research and prevention policies often use the small area Index of Multiple Deprivation (IMD) at neighbourhood level to proxy individual socio-economic status because it is readily available. We investigated what household income adds to IMD in early childhood for predicting adverse health in adolescence.<div class="boxTitle">Methods</div>Using data from the Millennium Cohort Study, we analysed IMD and self-reported equivalised household income (ages 0–5) to predict outcomes at age 17: poor academic achievement, psychological distress, poor health, smoking, and obesity. Predictions were compared using IMD quintile groups alone, household income quintile groups alone, and both together.<div class="boxTitle">Results</div>Household income was a stronger and more consistent predictor of age 17 outcomes than IMD and revealed inequalities within neighbourhoods. Decreasing household income showed steep gradients in educational attainment and smoking across all IMD quintiles, and moderate gradients in obesity, psychological distress and poor health in most quintiles. IMD did not predict smoking or psychological distress within any income group, or educational attainment within the poorest income group.<div class="boxTitle">Conclusions</div>Household income is associated with inequality gradients within all quintiles of neighbourhood IMD. Early childhood public health strategies should consider household income in combination with neighbourhood deprivation.</span>
<span class="paragraphSection"><div class="boxTitle">ABSTRACT</div><div class="boxTitle">Background</div>Saint Louis encephalitis virus (SLEV) re-emergence and its geographical expansion, evidenced by its emergence in previously unaffected areas, have raised significant public health concerns. We aimed to show the usefulness of haemovigilance as an effective tool to fill arboviruses surveillance gaps to track trends and identify hotspots.<div class="boxTitle">Methods</div>Within the framework of a blood bank haemovigilance program, we performed a survey to evaluate the potential threat of circulating mosquito-borne infections for transfusion safety. SLEV was detected by a PCR targeting the conserved NS5-gene region, and the PCR-product was subjected to direct nucleotide sequencing reaction.<div class="boxTitle">Results</div>The SLEV-strain detected in the blood donor (OR236721) clustered with previously reported CbaAr-4005, 79 V-2533, and MN413675 isolated in Córdoba (2005, epidemic), Santa Fe (1979, non-epidemic) and Buenos Aires (2013, non-epidemic), with 97% identity.<div class="boxTitle">Conclusions</div>Herein, we show the usefulness of haemovigilance in uncovering the silent circulation of arboviral infections. Implementing this systematic surveillance approach would allow for monitoring the distribution and incidence of vector-borne diseases, providing information that could prevent the spread of the virus and its introduction into novel biomes. Ultimately, leveraging haemovigilance enables timely identification of potential outbreaks and empowers policymakers to make well-informed decisions to safeguard public health.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The investigation of prevalence trends of metabolic cardiovascular risk factors is important for appropriate planning of future health programs aiming to prevent cardiovascular morbidity and mortality. In a previous study, we demonstrated an increase in the prevalence of type 2 diabetes (T2D) between 2000 and 2010 in Northeast Germany. The purpose of this study is to investigate prevalence trends of T2D treatment, dyslipidemia and hepatic steatosis in Northeast Germany.<div class="boxTitle">Methods</div>The baseline examinations of the first Study of Health in Pomerania (SHIP) project were carried out from 1997 to 2001 (SHIP-START-0, 4308 subjects). A second, independent random sample of the same region was enrolled between 2008 and 2012 (SHIP-TREND-0, 4420 subjects). All data were standardized with post-stratification weighting derived from the adult population of the German federal state of Mecklenburg-West Pomerania.<div class="boxTitle">Results</div>The prevalence of metformin intake increased from 2.1% to 4.1% and insulin use from 2.0% to 2.8%. While the prevalence of statin intake increased from 6.8% to 12.2%, the prevalence of dyslipidemia decreased slightly from 49.0% in SHIP-START-0 to 45.5% in SHIP-TREND-0. The prevalence of hepatic steatosis increased from 29.7% to 37.3%. This increase was most prominently observed in women and younger age groups.<div class="boxTitle">Conclusions</div>T2D, dyslipidemia and hepatic steatosis are common and increasing health problems among adults in Northeast Germany. Reassuring healthy diet and controlling obesity may result in prevention of above-mentioned health problems.</span>
<span class="paragraphSection">This is a correction to: Rosalia Dewi Nawantara, Laelatul Arofah, Dwi Sri Rahayu, Nila Zaimatus Septiana, Riza Amalia, M Akbar Husein Allsabah, When love hurts: emotional labor and hidden strains of intimate partner violence in toxic relationships, <span style="font-style:italic;">Journal of Public Health</span>, 2024, fdae280, <a href="https://doi.org/10.1093/pubmed/fdae280">10.1093/pubmed/fdae280</a></span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>This study examined the temporal relations between a decline in health and changes in life purpose to better understand the causal direction between life purpose and morbidity.<div class="boxTitle">Methods</div>Over a 16-year period, 7598 individuals completed up to four quadrennial surveys, which included information on 14 health metrics (lung function, grip strength, walking speed, balance and diagnoses of hypertension, diabetes, cancer, lung disease, heart condition, stroke, psychiatric problem, arthritis, dementia and Alzheimer’s) and life purpose. Ordinary and logistic regressions were used to examine the temporal relations between changes in purpose and changes in health over both the same 4-year period and over the subsequent 8 years.<div class="boxTitle">Results</div>A decline in health was associated with a 5% standard deviation decline (95% confidence interval −0.08, −0.02) in purpose over the same 4-year period. In contrast, there was no evidence that a decline in purpose was associated with a subsequent decline in health.<div class="boxTitle">Conclusions</div>The results fail to support the hypothesis that life purpose causes subsequent morbidity but support the hypothesis that a decline in health causes a decline in purpose. There is little evidence that life-purpose intervention policies will meaningfully impact subsequent morbidity.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Reusable menstrual pads (RMPs) offer a sustainable alternative, but the effectiveness and properties of novel eco-friendly materials for RMPs remain unclear. The objective of this scoping review is to identify novel eco-friendly materials used for RMPs.<div class="boxTitle">Methods</div>This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A comprehensive three-step search strategy was employed to locate both published and unpublished studies. Two reviewers independently screened titles and abstracts using the software Covidence. Data were extracted and charted using a standardized form. This search was conducted in February, 2024.<div class="boxTitle">Results</div>The search yielded 479 studies, 37 studies were assessed for full-text review, which led to inclusion of 16 studies. A diverse array of eco-friendly materials were identified for RMPs. The top layer includes bamboo, banana, organic cotton and other natural fibers. The core layer, focused on absorbency, features materials like cotton terry cloth, hemp, bamboo wadding and bamboo kun. The bottom layer uses water-repellent materials, such as polyester, polyurethane laminate, nylon and bio-plastic sheets.<div class="boxTitle">Conclusion</div>This review highlights the potential of plant-based fibers as eco-friendly materials for RMPs.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults.<div class="boxTitle">Methods</div>Cross-sectional data on 147 465 participants of the ‘All of Us’ Research Program (6 May 2018–1 July 2022), ≥50 years of age at enrollment, were analyzed. Self-reported housing instability over the past 6 months was examined in relation to diagnosed conditions at age ≥50 years based on electronic health records. Multivariable logistic regression models sequentially adjusting for demographic and socioeconomic characteristics were constructed to estimate odds ratios (OR) with their 95% confidence intervals (CI).<div class="boxTitle">Results</div>After adjusting for confounders, past 6 months housing instability was associated with lower odds of diagnosed cardiovascular disease (OR = 0.89, 95% CI: 0.87, 0.93) and cancer (OR = 0.82, 95% CI: 0.78, 0.86), higher odds of diagnosed psychiatric (OR = 1.35, 95% CI: 1.30, 1.40) conditions, but was unrelated to diagnosed diabetes (OR = 0.98, 95% CI: 0.94, 1.01).<div class="boxTitle">Conclusions</div>Recent housing instability among aging adults is positively associated with psychiatric diagnoses, but negatively associated with cardiovascular and cancer diagnoses, with implications for chronic disease prevention.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Data on the birth prevalence of congenital anomalies in low- and middle-income countries report wide variations in prevalence estimates. We conducted a scoping review to identify the sources of bias in studies reporting birth prevalence of congenital anomalies in World Health Organization South-East Asia region (SEAR) countries.<div class="boxTitle">Methods</div>PubMed and Google Scholar databases were screened for relevant literature. Data on study characteristics and sources of bias was extracted. A narrative synthesis of the data is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A checklist for reporting studies on birth prevalence of congenital anomalies (CD-Checklist) was developed.<div class="boxTitle">Results</div>The literature search retrieved 47 articles. Birth prevalence varied from 0.21% to 9.68%. Sampling bias was evident as studies were single hospital studies, lacked relevant description of sample, did not justify sample size or describe the process of sampling. Information bias was identified as studies did not mention classification system used, and failed to clearly distinguish between number of malformations and babies with malformations. Observer and reporting bias were noted.<div class="boxTitle">Conclusions</div>Several sources of bias introduce variations in birth prevalence reports of congenital anomalies in SEAR countries. A checklist (CD-Checklist) has been suggested which can guide investigators to minimize the risk of bias in studies.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>In 2018, Scotland pioneered national legislation which set a Minimum Unit Price (MUP) of 50 pence (∼US$0.64, €0.59) per unit of UK alcohol sold (8 g/10 ml). To inform policy development, we examine the policy effect using the Alcohol Use Disorders Identification Test (AUDIT-C), employing longitudinal data for over 17 200 individuals.<div class="boxTitle">Methods</div>The effect of MUP on AUDIT-C scores is inferred by employing difference-in-difference regression. Pre- and post-intervention alcohol behaviours of individuals from Scotland are compared to a matched ‘control’ from England. Drinking at hazardous and harmful levels could be identified, as well as the frequency of alcohol consumption, number of drinks and heavy episodic drinking. Estimates adjust for demographic, socioeconomic and health characteristics. Potential inequalities by gender, age and household income are examined.<div class="boxTitle">Results</div>MUP led to an estimated 5.3% reduction in the number of drinks consumed on drinking occasions, though a statistically significant effect on overall reported AUDIT-C scores or drinking at hazardous levels was not detected, with few differential effects for subgroups.<div class="boxTitle">Conclusions</div>Differences in the findings of this research compared to other studies may be explained by differences in population coverage collected in the survey data, compared to more comprehensive, population-wide administrative data, as well as sample attrition.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>During the first year of the covid-19 pandemic the adoption of non-pharmacological interventions (NPI), resulted in a significant fall in the incidence of respiratory tract infections. However, after the relaxation of these restrictions some of these infections have returned. This study evaluates the incidence and severity of community acquired pneumonias (CAPs) in children before and after the onset of pandemic.<div class="boxTitle">Methods</div>Characteristics of CAPs admitted to Archbishop Makarios Hospital, between March 2016 and February 2023 were reviewed. Comparison was made between the first, second and third pandemic year, and the four pre-pandemic years.<div class="boxTitle">Results</div>The mean annual number of admissions in the pre-pandemic years was 32 and dropped to 11 during the first pandemic year. However, admissions increased again in the second year of the pandemic to 41 (increase by 28%), and this increase was sustained into the third year. The proportion of complicated pneumonias, approximately doubled, from 20% in the pre-pandemic years to 35% and 33% in the second and third pandemic year, respectively.<div class="boxTitle">Conclusions</div>During the first year the use of NPIs appeared to have decreased the incidence of pneumonias. However, during the second and third pandemic years, an increase in the numbers and severity of pneumonias was noted.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Although there is evidence that sitting time (ST) and insufficient physical activity (PA) are associated with premature mortality, the burden of cardiovascular disease (CVD) and all-cause mortality (ACM) attributable to the combined effects of ST and PA in counterfactual scenarios is limited.<div class="boxTitle">Methods</div>Potential impact fractions (PIFs) were used to calculate premature deaths (PDs) and disability-adjusted life years (DALYs). Cause-eliminated life tables were utilized to estimate health-adjusted life expectancy (HALE) gains. Monte Carlo simulations were performed for uncertainty analysis.<div class="boxTitle">Results</div>The theoretical minimum risk exposure level (ST < 4 $\mathrm{h} \cdot{\mathrm{d}}^{-1}$, PA > 65 $\mathrm{min} \cdot{\mathrm{d}}^{-1}$) could prevent 16.7% of CVD deaths and 12.3% of all-cause deaths annually. This would save 669 to 2,630 DALYs per 100,000 and increase healthy life years by 0.57 to 2.94. Increasing PA to > 65 $\mathrm{min} \cdot{\mathrm{d}}^{-1}$ while maintaining ST could yield gains in HALE from 0.49 (CVD) to 2.60 (ACM) years. Reducing ST to < 4 $\mathrm{h}\cdot{\mathrm{d}}^{-1}$ while keeping PA constant could lead to gains in HALE from 0.07 (CVD) to 0.34 (ACM) years. A 50% reduction in suboptimal ST (≥ 4 $\mathrm{h}\cdot{\mathrm{d}}^{-1}$) doubled HALE gains, ranging from 0.11 to 0.63 years.<div class="boxTitle">Conclusions</div>Public health decision-makers should prioritize vulnerable populations, including older adults and individuals with inadequate PA levels.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Adolescent problematic social media use (PSMU) has been increasing. Digital engagement has been associated with substance use, but little is known about the potential protective role of parents. We investigated whether screen and substance-related parental rules moderated the associations between (problematic) SMU and intake of tobacco, alcohol, hashish/marijuana, and laughing gas.<div class="boxTitle">Methods</div>We used data from the Amsterdam Born Children and Development study (<span style="font-style:italic;">N</span> = 1787; <span style="font-style:italic;">M</span>age = 15.86 years; <span style="font-style:italic;">SD</span> = 0.36). Both frequent and problematic SMU in relation to tobacco, alcohol, hashish/marijuana, and laughing gas intake levels; and moderation by perceived parental rules (screen/substances), was tested with ordinal logistic regression models.<div class="boxTitle">Results</div>PSMU was associated with higher chances of higher substance use levels. Hashish/marijuana use and heavy drinking were less prevalent in adolescents reporting the presence of parental rules on alcohol/drugs, compared to adolescents reporting no rules. Although parental rules on alcohol/drugs, but not screen time, moderated the relationship between PSMU and both hashish/marijuana use and heavy drinking, the moderation effect was modest, especially in mitigating substance use at higher PSMU-scores.<div class="boxTitle">Conclusion</div>PSMU was positively associated with a wide range of substance use behaviours. The potential significant role of parental rules (alcohol/drugs) mitigating these associations are highlighted.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Latch On’s objective was to achieve improved breastfeeding rates in women with raised body mass indices using a multicomponent breastfeeding support intervention.<div class="boxTitle">Methods</div>A hybrid type 1 implementation-effectiveness trial with mixed-methods process and health economics analyses were conducted. Data collection included stakeholder questionnaires, interviews, focus groups, fidelity data, participant and health system costs.<div class="boxTitle">Results</div>The intervention was delivered with fidelity but the high breastfeeding rates at 3 months were not different between intervention and usual care. Participants receiving the minimum intervention dose were more likely to initiate breastfeeding (<span style="font-style:italic;">P</span> = 0.045) and be breastfeeding at hospital discharge (<span style="font-style:italic;">P</span> = 0.01) compared with participants below the threshold. Participant exit interview themes highlighted the importance of improving breastfeeding support to women, the effect of COVID-19 on the breastfeeding experience, and found that the intervention improved the experience of establishing breastfeeding. The intervention cost €157 per participant, with no other cost difference between groups. Process analysis found that follow-up breastfeeding services continued in half of sites after study completion.<div class="boxTitle">Conclusions</div>This low-cost intervention resulted in a more enjoyable breastfeeding experience for participants and changed practice in some study sites. The intervention dose received may impact effectiveness, but further research is needed to provide definitive evidence of clinical and cost effectiveness.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>We examined changes in diabetes care and management practices before and during the COVID-19 pandemic.<div class="boxTitle">Methods</div>Population-based data regarding four diabetes-related healthcare engagement and four self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups in 2019 (before the pandemic) and 2021 (during the pandemic).<div class="boxTitle">Results</div>Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp; 95% confidence interval: −4.8, −0.4), from 75.4% to 73.1%, and prevalence of annual eye exams fell by 4.0 pp (−6.2, −2.8), from 72.2% to 68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (−5.9, −1.1), from 44.9% to 41.9%. Of self-management behaviors, avoidance of smoking increased by 2.0 pp (0.4, 3.6) from 84.7% to 87.1%.<div class="boxTitle">Conclusions</div>The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The Chief Medical Officer (CMO), one of the UK’s most senior public health leadership roles, was crucial in supporting policymakers in responding to COVID-19. Yet, there exist only a handful of (largely historical) accounts of the role in England. This article is the first to empirically examine how the scope, focus and boundaries of the CMO role vary over time across the four UK nations, including during public health emergencies.<div class="boxTitle">Methods</div>We undertook semi-structured interviews with 10 current and former CMOs/Deputy CMOs in the four UK nations and analysed relevant documents.<div class="boxTitle">Findings</div>The CMO role is not clearly defined in contemporary UK legislation and is instead shaped by iterative policies, incumbent preferences, and organizational needs, leading to variation over time and between nations. Nonetheless, most participants framed the role as primarily providing ‘independent’ advice to government despite being senior civil servants who, in communicating with the public, sometimes speak ‘on behalf’ of government.<div class="boxTitle">Conclusions</div>The flexibility of UK CMO roles allows for responsive adaption but poses risks for how well these roles are understood. A potential tension between providing ‘independent’ policy advice and a need to publicly communicate government policies and guidelines may be exacerbated in emergency contexts.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The 21st century has seen a decline in employment rates in the US at the same time that it has experienced a historically unprecedented rise in the numbers of adults under criminal justice system control. Both low employment and high incarceration have posed serious challenges for public health.<div class="boxTitle">Methods</div>Using data from the National Survey on Drug Use and Health from 2002–2021, we estimated employment rates by community supervision status. Variations by sociodemographic subgroups were explored as well as correlations between employment and a range of mental and behavioural health variables.<div class="boxTitle">Results</div>Those on probation were twice as likely as those not to live in poverty. They experienced higher rates of poor mental and behavioural health, including three times the rate of substance use. Employment rates varied little by community supervision status. Health risk factors were associated with more risk and protective factors did less to mitigate risk for those under community supervision.<div class="boxTitle">Conclusions</div>Despite the range of adversities faced by individuals under criminal justice system control, their employment rates are remarkably close to those not. Despite near equivalent involvement in the labour force, this population has substantially poorer health and substantially reduced likelihood of escaping poverty.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The present study aimed to investigate the association between the duration of anti-coronavirus disease 2019 (COVID-19) public health measures and the quality of life (QOL) and mental health of the Japanese public.<div class="boxTitle">Methods</div>The present, nationwide, questionnaire-based, cross-sectional study was conducted in September 2021. The cumulative duration in days of anti-COVID-19 public health measures was calculated for each prefecture in the year prior to the survey, and multilevel linear regression analysis was used to determine the association between the duration of these measures and any impairment of QOL or mental health as assessed by the EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the Kessler scale (K6).<div class="boxTitle">Results</div>The study included 28 118 participants from all 47 prefectures. The median duration of public health measures of all prefectures was 179 days. Long-term duration of the measures (181–365 days) was not independently associated with low EQ-5D-5L (<span style="font-style:italic;">P</span> = 0.128) or high K6 (<span style="font-style:italic;">P</span> = 0.179) scores after adjusting for potential confounders (Graphical Abstract).<div class="boxTitle">Conclusions</div>Prolongation of the measures may not be associated with a deterioration in the QOL or mental health of the Japanese public. Nevertheless, it may be necessary to reconsider long-term public health measures given the potential they may have to cause collateral damage, such as socioeconomic one.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The broader implications of the Coronavirus disease 2019 pandemic on cardiovascular hospitalizations remain unclear. We aimed to assess trends in cardiovascular presentations during the Coronavirus disease 2019 pandemic.<div class="boxTitle">Methods</div>This multicentre study examined cardiovascular presentations from March 2018 to February 2023. Patients with cardiovascular presentations were identified through administrative health records using ICD-10-AM diagnosis codes. Four key study periods were analysed: T0—pre-pandemic, T1—first lockdown, T2—easing of restrictions and T3—release of restrictions and widespread vaccination. Interrupted time series analysis was used to predict weekly cardiovascular presentations, with the mean difference between actual and predicted numbers assessed for significance.<div class="boxTitle">Results</div>Overall, 116 518 patients were included across three major public hospitals in Australia. Cardiovascular presentations were significantly lower in T1 than predicted, with a mean decline of 13.1% (SD 16.2%; <span style="font-style:italic;">P</span> = 0.004). There was a significant difference between the expected and actual number of most cardiovascular presentations in T2 and T3, apart from a significant reduction in cardiomyopathy and heart failure presentations during T3 (4.5% [SD 23.7%]; <span style="font-style:italic;">P</span> = 0.007).<div class="boxTitle">Conclusions</div>Cardiovascular presentations were significantly lower during the initial lockdown phase of the COVID-19 pandemic; this attenuated with easing of social restrictions and widespread vaccination, except for persistent reduction in cardiomyopathy and heart failure presentations.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Crime has been described as a public health issue in Trinidad and Tobago, a small developing nation. COVID-19 restrictions, aimed at maintaining public health safety by limiting disease spread, may have negatively impacted crime rates due to an alteration of social and economic conditions. This study evaluates the implications of these restrictions on crime dynamics and hence their impacts on overall public health.<div class="boxTitle">Methods</div>Employing interrupted time series analysis with seasonal autoregressive integrated moving average with exogenous factor (Seasonal Autoregressive Integrated Moving Average with Exogenous Variables) models, monthly data on murders, sexual offences, and motor vehicle larcenies from January 2013 to June 2023 were analysed.<div class="boxTitle">Results</div>The study found a decrease in murders and motor vehicle larcenies with the onset of restrictions, followed by an inverse trend correlating with the easing of measures. Sexual offences showed no significant change in response to the restrictions.<div class="boxTitle">Conclusions</div>While COVID-19 restrictions initially influenced certain crime rates, the effect varied across crime types. Policy interventions based on lessons learned from the COVID-19 pandemic must be done to strategically reduce and prevent crime without having the negative side effects of the pandemic.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The health visiting service in UK promotes the health and wellbeing of families with young children and comprises a universal offer (three mandated contacts between birth and 12 months) and additional contacts based on need. We aimed to understand how the level of health visiting support received varies by family characteristics.<div class="boxTitle">Methods</div>Using the Community Services Data Set linked to Hospital Episode Statistics, we identified 52 555 children in 10 local authorities with complete health visiting data for 12 months between April 2016 and March 2020. We analysed variation in health visiting contacts by deprivation, child ethnicity, maternal age, adversity and previous live births.<div class="boxTitle">Results</div>41 340/52 555 children (79%) received the universal service; 63% received ≥1 additional contact and 25% received ≥3 additional contacts. The likelihood of receiving ≥3 additional contacts was greatest for children whose mothers had a history of hospital admissions relating to mental health, violence, self-harm or substance misuse (adjusted relative risk = 1.55, 95% confidence interval 1.26–1.92).<div class="boxTitle">Conclusions</div>Most families received health visiting support in addition to the universal service. Policymakers and commissioners should consider how health visiting services can be expanded or targeted more effectively to ensure all families receive the support they need.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div>The global COVID-19 pandemic has significantly impacted inadequate physical activity, which has an impact on public health. Government policies are critical in supporting public health and encouraging physical activity during COVID-19. In addition, collaboration between public and health authorities, influencers, and governments is essential in implementing public education campaigns to promote physical activity and healthy behaviors. In Indonesia, strategies to encourage physical activity among children can include home-based physical activity programs, online physical education classes, and outdoor activities that adhere to social distancing guidelines.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div>This article highlights local Indonesian wisdom in the psychosocial treatment of female earthquake survivors, including interaction with nature, God and fellow humans, which helps reduce the psychological impact through activities such as reading the Koran, praying and cooking together in the refugee camp’s public kitchen.</span>
<span class="paragraphSection">In a correspondence to the journal, the authors reasoned that ‘climate change is not taken as seriously as other prominent public health risks, thereby affecting resource allocation for the same’.<a href="#ref1" class="reflinks"><sup>1</sup></a> The waning effects of climate change and, by extension, global warming bring a hazard to sentient and endangered animals whose welfare within the climate change framework is treated as minor or of secondary importance—a clear retrogress in the One Health approach that acknowledges the interconnectedness of human, animal and environmental health. The conservation and protection of endangered animal species are crucial for biodiversity preservation, ecosystem resilience and the mitigation of climate change impacts. In this paper, we postulate the central role of genetic engineering concerning the complex conservation challenges confronting endangered species under the effects of a changing climate and a warming planet.</span>
<span class="paragraphSection">Youth mental health is an urgent and global issue, mainly due to the impact of health and economic crises that tend to affect this group disproportionately. The article by Saputra <span style="font-style:italic;">et al.</span>, entitled ‘Food Insecurity Risk and Suicidal Ideation among Young Adults in Indonesia’, illustrates the complex relationship between food insecurity and mental health.<a href="#ref1" class="reflinks"><sup>1</sup></a> However, there is little discussion on how food security’s ability to access sufficient, safe and nutritious food explicitly improves youth’s mental health. Building food security is crucial to reducing malnutrition and related physical health problems and psychological stress due to uncertainty in access to healthy food.</span>
<span class="paragraphSection">Lembaga Pengelola Dana Pendidikan10.13039/501100014538Balai Pembiayaan Pendidikan TinggiKementerian Pendidikan10.13039/501100004565KebudayaanRiset dan Teknologi202209092414</span>
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