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Clostridium perfringens, as a foodborne pathogen, can cause various intestinal diseases in both humans and animals according to its repertoire of toxins. In recent years, a multitude of studies have highlighted its threat to infants and young children. C. perfringens carries numerous toxins, with the newly identified BEC toxin confirmed as the second toxin to cause diarrheal illness, after CPE. However, the global dissemination of C. perfringens strains carrying becAB genes, which encode BEC toxins, has not been extensively studied. Following epidemiological surveillance of the prevalence of C. perfringens from different sources in various provinces of China, we identified two becAB-carrying strains and one strain carrying a sequence similar to becAB from distinct provinces and sources. When combined with genomic analysis of other becAB-carrying C. perfringens strains from public databases, we found that becAB was present in strains from different lineages. Our analysis of the plasmid and genetic environment corroborates previous findings on becAB-carrying strains, confirming that it currently achieves horizontal transmission through one type of evolutionarily conserved Pcp plasmid. This study provides a comprehensive analysis of the prevalence and transmission patterns of the newly emerged toxin gene locus, becAB, in C. perfringens. Despite the relatively low identification rate of becAB-carrying strains, their potential impact requires ongoing surveillance and investigation of their features, particularly their antimicrobial resistance.
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Toxinas Bacterianas , Infecções por Clostridium , Clostridium perfringens , Clostridium perfringens/genética , Clostridium perfringens/classificação , Clostridium perfringens/isolamento & purificação , Infecções por Clostridium/microbiologia , Infecções por Clostridium/epidemiologia , Infecções por Clostridium/veterinária , China/epidemiologia , Prevalência , Humanos , Toxinas Bacterianas/genética , Animais , Genoma Bacteriano , Plasmídeos/genética , Genômica , FilogeniaRESUMO
Resumen Introducción: El concepto de salud pública aparece con frecuencia en las prácticas disciplinares de las ciencias de la salud, sociales y humanas. Sin embargo, la salud pública es objeto de debate debido a su naturaleza multifacética e interdisciplinaria. Esta variabilidad se atribuye a las diferencias en cómo cada disciplina interpreta y aplica el concepto, basándose en su propia comprensión de las problemáticas que buscan intervenir. Objetivo: Analizar críticamente el concepto de salud pública y su objeto de estudio a partir de su relación y diferenciación con distintos enfoques en psicología y medicina. Método: Se trató de un estudio de reflexión y análisis crítico de las diferentes conceptualizaciones y aplicaciones de la salud pública. Reflexión: Se abordaron tres debates relevantes: los vínculos de la salud pública con la psicología y la medicina (1), el objeto de estudio de la salud pública (2) y los retos para abordar problemas sociales y de salud actuales (3). Se discute la evolución histórica del concepto de salud pública, su carácter interdisciplinar y su adaptabilidad a los contextos sociopolíticos y a las emergentes problemáticas sociales contemporáneas. Conclusión: Se destaca la interdisciplinariedad para atender los retos emergentes, centrando esfuerzos en mitigar factores multidimensionales asociados con la salud y el bienestar global, así como la relevancia de fortalecer las estructuras organizativas, desarrollar políticas adecuadas y contar con sistemas epidemiológicos robustos para enfrentar desafíos actuales y futuros.
Abstract Introduction: The concept of public health appears frequently in the disciplinary practices of health, social, and human sciences. However, the concept of public health is controversial because of its multifaceted and interdisciplinary nature. This happens because its meaning, theorization, and application vary according to how each discipline understands the issues it seeks to address. Objective: To critically analyze the concept of public health and its object of study, based on its relationship and differentiation with different approaches in psychology and medicine. Methodology: This was a study of reflection and critical analysis of the different conceptualizations and applications of public health. Reflection: Three relevant debates have been addressed: the links of public health with psychology and medicine (1), the object of study of public health (2), and the challenges to address current social and health problems (3). The historical evolution of the concept of public health, its interdisciplinary nature, and its adaptability to sociopolitical contexts and emerging contemporary social issues are discussed. Conclusion: Interdisciplinarity is emphasized to address emerging challenges, focusing efforts on mitigating multidimensional factors associated with global health and well-being, as well as the importance of strengthening organizational structures, developing appropriate policies, and having robust epidemiological systems to face current and future challenges.
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Introducción: En inicios del año 2015 se implementa el convenio de complementación público-privado entre los dos principales prestadores del Departamento de San José - Uruguay: AMSJ y ASSE San José, conformándose así la Unidad Departamental de Medicina Paliativa de San José (UDMP). El convenio tiene como principal objetivo asegurar la asistencia paliativa a todos los usuarios de los prestadores involucrados con los principios fundamentales de calidad, equidad y accesibilidad, siguiendo los lineamientos del Plan Nacional de Cuidados Paliativos del Ministerio de Salud Pública de Uruguay. El objetivo es describir y analizar la experiencia de la implementación del primer modelo de complementación público-privado del país en Cuidados Paliativos (CP). Metodología: Estudio descriptivo analítico, retrospectivo que incluye datos de los primeros siete años de funcionamiento del convenio. Resultados: El convenio de complementación público-privado en el Departamento de San José, permitió la creación de un equipo interdisciplinario que asistió en forma continua a 1422 pacientes provenientes de zonas urbanas y rurales, portadores de diversas patologías. La cobertura departamental de CP aumentó de forma significativa, pasando de 24 % en 2014 a 57% en 2021. Estos resultados se lograron implementando un modelo de asistencia paliativa que asegura la continuidad asistencial en internación, consultorio y domicilio, que permitió respetar la autonomía del paciente, logrando el fallecimiento de 67% de los pacientes en su hogar. La satisfacción de usuarios y familiares de la asistencia brindada fue evaluada como muy buena. Conclusiones: El convenio de complementación resultó ser una herramienta eficiente para favorecer el acceso a CP, evitando la superposición de equipos en la asistencia domiciliaria en todo el departamento de San José.
Introduction: At the beginning of 2015, the public-private complementarity agreement was implemented between the two main providers of the Department of San José Uruguay: AMSJ and ASSE San José, thus forming the Departmental Unit of Palliative Medicine of San José (UDMP). The main objective of the agreement is to ensure palliative care to all users of the providers involved, with the fundamental principles of quality, equity and accessibility, following the guidelines of the National Palliative Care Plan of the Ministry of Public Health of Uruguay. The objective is describe and analyze the experience of implementing the country's first public-private complementation model in Palliative Care (PC). Methodology: Descriptive, analytical, retrospective study that includes data from the first seven years of operation of the agreement. Results: The public-private complementation agreement in the Department of San José allowed the creation of an interdisciplinary team that continuously assisted 1,422 patients from urban and rural areas, with various pathologies. Departmental CP coverage increased significantly, from 24% in 2014 to 57% in 2021. These results were achieved by implementing a palliative care model that ensures continuity of care in hospitalization, office and home, which allowed the patient's autonomy to be respected, achieving the death of 67% of patients at home. The satisfaction of users and family members with the assistance provided was evaluated as very good. Conclusions: The complementation agreement turned out to be an efficient tool to promote access to CP, avoiding the overlap of teams in home care throughout the department of San José.
Introdução: No início de 2015, foi implementado o acordo de complementaridade público-privado entre os dois principais prestadores do Departamento de San José Uruguai: AMSJ e ASSE San José, formando assim a Unidade Departamental de Medicina Paliativa de San José (UDMP). O principal objetivo do acordo é garantir cuidados paliativos a todos os usuários dos prestadores envolvidos, com os princípios fundamentais de qualidade, equidade e acessibilidade, seguindo as diretrizes do Plano Nacional de Cuidados Paliativos do Ministério de Saúde Pública do Uruguai. El objetivo es descrever e analisar a experiência de implementação do primeiro modelo de complementação público-privada em Cuidados Paliativos (CP) do país. Metodologia: Estudo descritivo, analítico, retrospectivo que inclui dados dos primeiros sete anos de vigência do convênio. Resultados: O acordo de complementação público-privada no Departamento de San José permitiu a criação de uma equipe interdisciplinar que atendeu continuamente 1.422 pacientes de áreas urbanas e rurais, com diversas patologias. A cobertura departamental do CP aumentou significativamente, de 24% em 2014 para 57% em 2021. Estes resultados foram alcançados através da implementação de um modelo de cuidados paliativos que garante a continuidade dos cuidados no internamento, no consultório e no domicílio, o que permitiu respeitar a autonomia do doente, atingindo a morte de 67% dos doentes no domicílio. A satisfação dos usuários e familiares com a assistência prestada foi avaliada como muito boa. Conclusões: O convênio de complementação revelou-se uma ferramenta eficiente para promover o acesso à CP, evitando a sobreposição de equipes na atenção domiciliar em todo o departamento de San José.
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Enteroparasitosis are diseases caused by parasitic agents present in the environment and in the gastrointestinal tract of living beings. In addition, they are still considered neglected diseases, but of great importance for public health, especially when they are related to secondary infections and currently their co-infection profile with COVID-19. The interaction of protozoa and/or helminths with the SARS-CoV-2 virus is timely and its signs and symptoms are confused with other pathogen relationships. In this way, this study aims to correlate the incidence of enteroparasitosis and COVID-19, in the pandemic period from 2020 to April 2022. This is a documentary and exploratory study of secondary data from laboratory tests of patients who were treated and diagnosed with COVID-19 and enteroparasitosis at Hospital Doutor Cloves Bezerra Cavalcante, Municipal Hospital of Bananeiras, Paraíba, Brazil. In the analysis of the database, a significant increase of approximately 48.85% in the incidence of COVID-19 cases from 2020 to 2021 stands out, remaining high until 2022. In contrast, cases of enteroparasites peaked at 48.74% in 2021, followed by an average reduction of 23.12%, with a deviation of 1.49%, in relation to the years 2020 and 2022. It was concluded that COVID-19 is predominantly associated with an increase in secondary infections, highlighting the crucial need to promote health education, improve basic sanitation and guarantee access to health services as essential components in combating the increase in parasitic infections, especially those related to viral pathologies.
As enteroparasitoses são enfermidades originadas por agentes parasitários presentes no meio ambiente e no trato gastrointestinal dos seres vivos. Ademais, ainda são consideradas doenças negligenciadas, porém de grande importância para a saúde pública, em especial, quando estão relacionadas com infecções secundárias e atualmente seu perfil de coinfecção com a COVID-19. A interação de protozoários e/ou helmintos com o vírus SARS-CoV-2 é oportuna e seus sinais e sintomas são confundidos com outras relações de patógenos. Desta maneira, este estudo visa correlacionar a incidência de enteroparasitoses e COVID-19, no período pandêmico de 2020 a abril de 2022. Trata--se de uma pesquisa documental e exploratória, de dados secundários dos exames laboratoriais de pacientes que foram atendidos e diagnosticados com COVID-19 e enteroparasitoses no Hospital Doutor Cloves Bezerra Cavalcante, Hospital Municipal de Bananeiras, Paraíba, Brasil. Na análise da base de dados, destaca-se um aumento significativo de aproximadamente 48,85% na incidência de casos de COVID-19 de 2020 a 2021, mantendo-se elevado até 2022. Em contraste, os casos de enteroparasitas atingiram um pico de 48,74% em 2021, seguido por uma redução média de 23,12%, com um desvio de 1,49%, em relação aos anos de 2020 e 2022. Conclui-se que a COVID-19 está predominantemente associada ao aumento de infecções secundárias, destacando a necessidade crucial de promover a educação em saúde, melhorar o saneamento básico e garantir o acesso aos serviços de saúde como componentes essenciais no combate ao aumento de infecções parasitárias, especialmente aquelas relacionadas a patologias virais.
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Humanos , Masculino , FemininoRESUMO
Objectives: The phenomenon of self-medication is a noteworthy public health concern that is increasingly prevalent on a global level, particularly in developing nations. This study aims to explore the prevalence of self-medication of over-the-counter (OTC) medications among the general public in Jordan. Materials and methods: This cross-sectional online survey study was conducted in Jordan between November and December 2022. An online questionnaire link was distributed to the study participants through social media platforms (Facebook, WhatsApp, and Instagram). The questionnaire tool for this study was adapted from a previously developed questionnaire by Tesfamariam et al. The questionnaire tool comprised four sections that examined participants' demographic characteristics, knowledge of OTC self-medication, attitudes toward OTC self-medication, and associated practices. Binary logistic regression analysis was used to identify predictors of OTC self-medication practice. Results: A total of 1,218 individuals participated in this study. More than half of the study participants (56.9%) confirmed that they were currently using or had in the past year used medication(s) not prescribed by a healthcare specialist. Participants' agreement level on statements that reflected a positive attitude toward self-medication practice ranged between 13.1 and 33.0%. The statement most commonly agreed with was that 'OTC medications are safe but I would seek a physician's advice before using them' (57.7%). Individuals aged 36-40 years and 51 years and over, those who were married or divorced, those who were employed, and those who had chronic diseases were more likely to practice self-medication compared to others (p < 0.05). Conclusion: The current study findings suggest a significant lack of awareness among the general population in Jordan regarding the expected efficacy of OTC medications. A restricted level of agreement was observed among the participants concerning the behavior of self-medication.
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Medicamentos sem Prescrição , Automedicação , Humanos , Jordânia , Estudos Transversais , Automedicação/estatística & dados numéricos , Masculino , Feminino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Medicamentos sem Prescrição/uso terapêutico , Adulto Jovem , Adolescente , Conhecimentos, Atitudes e Prática em Saúde , IdosoRESUMO
To investigate the relationship between Leisure time physical activity (LTPA) patterns and PhenoAgeAccel in patients with Type 2 diabetes (T2D), emphasizing the role of regular LTPA in mitigating biological aging. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, including 4,134 adults with T2D. Multivariable linear regression models and restricted cubic spline (RCS) methods were employed to assess the relationship between LTPA and Phenotypic age acceleration (PhenoAgeAccel), with segmented likelihood ratio tests to detect nonlinear thresholds. Stratified regression and interaction tests were conducted for robust analysis. Compared to individuals with no LTPA patterns, those with regular LTPA patterns had significantly lower PhenoAgeAccel scores (ß = -1.164, 95% CI: -1.651 to -0.677, P < 0.0001), while the "Weekend Warrior" and "Inactive-LTPA" patterns showed no significant effects. A nonlinear threshold effect was identified; below 594.57 min of weekly LTPA, there was a significant negative correlation (ß = -0.002, 95% CI: -0.003 to -0.001, P = 0.000), with gender-specific effects present. Regular LTPA significantly reduces phenotypic age acceleration in T2D patients, with a nonlinear threshold effect indicating that moderate physical activity is most beneficial. These findings highlight the necessity of personalized physical activity recommendations and provide evidence for public health strategies to promote healthy aging in T2D patients.
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Envelhecimento , Diabetes Mellitus Tipo 2 , Exercício Físico , Atividades de Lazer , Humanos , Diabetes Mellitus Tipo 2/fisiopatologia , Masculino , Feminino , Exercício Físico/fisiologia , Pessoa de Meia-Idade , Estudos Transversais , Envelhecimento/fisiologia , Idoso , Adulto , Inquéritos NutricionaisRESUMO
PURPOSE: Population mobility significantly contributes to the spread and prevalence of infectious diseases, posing a serious threat to public health safety and sustainable development across the globe. Understanding the impact of population mobility on the prevention and control of infectious diseases holds profound significance. METHODS: In this study, we collected the data on the incidence of notifiable infectious diseases in mainland China from 2013 to 2019, and analyzed the characteristics of notifiable infectious diseases, as well as their correlation with transportation passenger traffic. RESULTS: Among 29 common notifiable infectious diseases, the incidence rate of intestinal diseases per 100,000 people was the highest (256.35 cases), while the mortality rate was the lowest (0.017 cases). The mortality rate per 100,000 people due to sexually transmitted and bloodborne diseases was the highest (1.154 cases). A significant linear correlation was noted between commercial passenger traffic and the number of cases of tuberculosis (r = 0.83, P = 0.022), hepatitis A (r = 0.87, P = 0.012), bacillary and amebic dysentery (r = 0.90, P = 0.006), typhoid/paratyphoid (r = 0.94, P = 0.002), leptospirosis (r = 0.90, P = 0.005), AIDS(r=-0.90, P = 0.006), gonorrhea (r=-0.79, P = 0.035) and scarlet fever (r=-0.85, P = 0.016). A significant linear correlation was noted between public transportation passenger traffic and the number of cases of measles (r = 0.94, P = 0.002), hepatitis A (r = 0.96, P = 0.001), parasitic and vector-borne diseases (r = 0.96, P = 0.001), brucellosis (r = 0.95, P = 0.001), leptospirosis (r = 0.88, P = 0.008), other infectious diarrhea (r = 0.86, P = 0.013) and gonorrhea (r = 0.84, P = 0.018). CONCLUSION: The results of this study indicated that transportation passenger traffic significantly affected the incidence of infectious diseases, and reasonable management of passenger traffic was a potentially important means of prevention and control of infectious diseases.
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Doenças Transmissíveis , Meios de Transporte , Humanos , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Meios de Transporte/estatística & dados numéricos , Incidência , Notificação de Doenças/estatística & dados numéricosRESUMO
BACKGROUND: Human Papillomavirus (HPV) infection has garnered significant attention due to its high prevalence and association with various cancers and other health conditions. Composite lifestyle factors may influence the risk of HPV infection, yet their cumulative impact remains insufficiently explored. This study aims to explore the association between the Life's Essential 8 (LE8) Score and HPV infection status, highlighting the potential role of lifestyle and health behaviors in HPV infection prevention. METHODS: Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2016, we analyzed the health and nutritional statuses of 6,773 participants after excluding those with missing HPV infection status, inability to calculate the LE8 Score, and missing covariate data. The LE8 Score was computed based on eight cardiovascular health metrics, encompassing both health factors (BMI, non-HDL cholesterol, blood pressure, and blood glucose) and health behaviors (physical activity, diet, sleep duration, and nicotine exposure). HPV infection status was determined through vaginal swab specimens analyzed using various Roche assays. Multivariate logistic regression, the restricted cubic splines (RCS) analysis and weighted quantile sum (WQS) regression were employed to assess the association between LE8 Score and HPV infection risk. RESULTS: Our findings indicate a significant inverse association between the LE8 Score and HPV infection risk. Participants with medium and high LE8 Scores exhibited a 21% and 31% lower risk of HPV infection, respectively, compared to those with low LE8 Scores in multivariate logistic regression models. The analysis also revealed that lifestyle factors, particularly nicotine exposure and blood pressure, significantly contributed to the observed association. CONCLUSION: The study underscores the importance of healthy lifestyle behaviors in reducing the risk of HPV infection. Public health strategies promoting such behaviors could complement existing HPV prevention measures, potentially lowering the burden of HPV-related diseases. Future research should further investigate the mechanisms underlying this association and the effectiveness of lifestyle interventions in diverse populations.
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Estilo de Vida , Inquéritos Nutricionais , Infecções por Papillomavirus , Humanos , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Estados Unidos/epidemiologia , Comportamentos Relacionados com a Saúde , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Working alongside patients and the public to shape and engage with research, Patient and Public Involvement and Engagement (PPIE), facilitates more impactful research outcomes. The UK Standards for Public Involvement provides a framework for conducting PPIE; however, they do not refer directly to ethical conduct. Research ethics involve the moral principles that govern researchers' actions, and securing ethical approval from a research ethics committee is necessary before starting a study. Nonetheless, in the UK, ethical approval is not needed for PPIE activities. MAIN TEXT: By its very nature, PPIE requires interaction with patients and public about their lived/living experience of often sensitive and emotional topics. We need to consider ethical principles of PPIE, and potential for harm to those involved. The authors call for ethics guidance to be included in the UK Standards for Public Involvement and discuss this with regards to (a) emotional risk (b) physical risk (c) confidentiality and personal data (d) support versus paternalism (e) marginalisation and (f) building and maintaining healthy relationships. CONCLUSION: The argument presented here has been informed by the authors' own experiences in topic areas ranging from transplantation, respiratory disease and health inequalities to women living with domestic abuse, and suggests that although requiring ethical approval for PPIE would be a step too far, and stifle research progress, PPIE needs to be conducted with an 'ethical anchor' to facilitate ethical practice and mitigate risk.
Patient and Public Involvement and Engagement (PPIE) is key to achieving more meaningful and effective research results. While the UK Standards for Public Involvement offer valuable direction for PPIE activities, they currently lack specific guidance on ethical conduct. Research ethics are fundamental moral principles that researchers follow to ensure the safety and well-being of individuals involved in their studies. These principles are overseen by research ethics committees (REC). In the UK, obtaining REC approval is not mandatory for PPIE activities. However, given that PPIE often involves sensitive and emotional discussions with patients and the public, ethical considerations are paramount. While REC oversight could ensure ethical practices, it might also introduce delays, consume resources, and deter researchers from engaging with the public. Instead, the authors propose enhancing the UK Standards for Public Involvement by incorporating ethics guidance tailored to emotional and physical risks, confidentiality, maintaining a balance between support and control, preventing marginalisation, and building and maintaining healthy relationships.
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BACKGROUND: Temporomandibular disorders (TMD) are multifactorial musculoskeletal pain and dysfunctions in temporomandibular joints (TMJs) and masticatory muscles. Genetic factors play a role in TMD-related pain, but only a few genome-wide association studies (GWAS) have been conducted. OBJECTIVE: The aim of this GWAS was to explore genetic factors associated with painful TMD in Finnish populations. METHODS: Data from two epidemiological surveys, the Northern Finland Birth Cohort 1966 (NFBC1966) and the Health 2000 Survey in Finland, including altogether 468 cases and 6833 controls, were used. Case definition was based on pain on palpation of masticatory muscles and/or TMJs. GWASs of the whole data and stratified by sex were conducted from both cohorts using additive models, followed by meta-analysis of the two cohorts. Replications of the previously reported TMD risk loci (rs73460075, DMD; rs4794106, SGCA; rs73271865, SP4; rs60249166, RXP2; rs1531554, BAHCCI; rs5862730, OTUD4/SMAD1; rs10092633, SFRP1; rs34612513, SOX14/CLDN18; rs878962, TSPAN9) were also investigated. RESULTS: Four genome-wide significant loci were found in sex-stratified analysis of NFBC1966, including associations at three loci in males (rs1023114, PRIM2, p = 5 × 10-9; rs4244867, ALG10, p = 3 × 10-8; rs79841648, ADCYAP1, p = 4 × 10-9) and one locus in females (rs148476652, DNER, p = 4 × 10-9). However, the results could not be replicated in the Health 2000 Survey or in the meta-analysis of these two cohorts. The previous TMD GWAS associations did not replicate in our data either. CONCLUSION: Several TMD pain-associated variants were found in sex-stratified analysis of NFBC1966, suggesting the role of neuroendocrine stress responses and central nervous system. These findings need to be confirmed in future studies.
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Mathematical modeling plays a crucial role in understanding and combating infectious diseases, offering predictive insights into disease spread and the impact of vaccination strategies. This paper explored the significance of mathematical modeling in epidemic control efforts, focusing on the interplay between vaccination strategies, disease transmission rates, and population immunity. To facilitate meaningful comparisons of vaccination strategies, we maintained a consistent framework by fixing the vaccination capacity to vary from 10 to 100% of the total population. As an example, at a 50% vaccination capacity, the pulse strategy averted approximately 45.61% of deaths, while continuous and hybrid strategies averted around 45.18 and 45.69%, respectively. Sensitivity analysis further indicated that continuous vaccination has a more direct impact on reducing the basic reproduction number $ R_0 $ compared to pulse vaccination. By analyzing key parameters such as $ R_0 $, pulse vaccination coefficients, and continuous vaccination parameters, the study underscores the value of mathematical modeling in shaping public health policies and guiding decision-making during disease outbreaks.
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Número Básico de Reprodução , Doenças Transmissíveis , Surtos de Doenças , Modelos Teóricos , Vacinação , Humanos , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/transmissão , Número Básico de Reprodução/estatística & dados numéricos , Surtos de Doenças/prevenção & controle , Simulação por Computador , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde Pública , Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Vacinas/administração & dosagemRESUMO
The opioid crisis has emerged as a significant public health concern globally, with India facing unique challenges in preventing and managing substance abuse. This systematic review aims to analyze the current state of the opioid crisis in India, evaluate existing prevention and management strategies, and propose evidence-based recommendations for addressing this complex issue. A comprehensive literature search was conducted across multiple databases, resulting in the inclusion of 30 studies meeting the predefined criteria. The review highlights the multifaceted nature of the opioid crisis in India, influenced by factors such as socioeconomic conditions, cultural norms, and healthcare accessibility. Key findings include the need for comprehensive prevention programs, improved access to evidence-based treatments, and integration of harm reduction strategies. The review also emphasizes the importance of addressing co-occurring mental health disorders and the potential of community-based interventions in managing substance abuse. Challenges identified include stigma, limited access to treatment, inadequate healthcare infrastructure, regulatory barriers, and lack of comprehensive policies. Recommendations for future directions include developing culturally appropriate prevention programs, assessing the long-term effectiveness of treatment modalities, exploring innovative approaches to reduce stigma, and investigating the role of technology in improving access to care. By implementing a multifaceted approach that considers the unique sociocultural context of India (including factors such as family structures, religious beliefs, economic disparities, and regional variations in drug use patterns), there is potential to significantly reduce the burden of opioid abuse and improve outcomes for affected individuals and communities.
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The world could witness another pandemic on the scale of COVID-19 in the future, prompting calls for research into how social and behavioral science can better contribute to pandemic response, especially regarding public engagement and communication. Here, we conduct a cost-effectiveness analysis of a familiar tool from social and behavioral science that could potentially increase the impact of public communication: survey experiments. Specifically, we analyze whether a public health campaign that pays for a survey experiment to pretest and choose between different messages for its public outreach has greater impact in expectation than an otherwise-identical campaign that does not. The main results of our analysis are 3-fold. First, we show that the benefit of such pretesting depends heavily on the values of several key parameters. Second, via simulations and an evidence review, we find that a campaign that allocates some of its budget to pretesting could plausibly increase its expected impact; that is, we estimate that pretesting is cost-effective. Third, we find pretesting has potentially powerful returns to scale; for well-resourced campaigns, we estimate pretesting is robustly cost-effective, a finding that emphasizes the benefit of public health campaigns sharing resources and findings. Our results suggest survey experiment pretesting could cost-effectively increase the impact of public health campaigns in a pandemic, have implications for practice, and establish a research agenda to advance knowledge in this space.
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Objective: This study aimed to assess the undergraduates' and lecturers' perspectives on the implementation of online learning and to compare perspectives between private and public universities. Materials and methods: The study followed a mixed-method design and involved dental undergraduates and lecturers from two study settings in Malaysia: International Medical University (IMU), a private university, and Universiti Teknologi MARA (UiTM), a public university. All undergraduates and lecturers were invited to complete an online questionnaire with evaluative statements regarding three domains: handling, didactic benefit, motivation, and an overall assessment. The comparison of perception between the private and public universities was analyzed using Mann-Whitney test. Focus group discussions (FGDs) were carried out for undergraduates and lecturers. Each FGD consisted of six people. The audio-recorded conversations were transcribed verbatim. Results: Mean scores of perceptions regarding the domains, handling, and motivation were higher among undergraduates from public universities (p < 0.05), while there were no differences for the didactic domain. There was no difference in perception of any of the three domains between private and public university lecturers. Mean scores for perceptions on the optimal amount of online learning in the future domains were higher among undergraduates from a public university (p < 0.05), while lecturers' perceptions showed no difference. Thematic analysis of FGDs revealed that both groups from private and public universities felt that flexibility and a student-centered approach are the advantages of online learning. The inadequacy to cover the entire curriculum and lack of student engagement and interaction were highlighted as limitations. Conclusion: Regardless of the university background, the undergraduates and lecturers were able to adjust to the online learning environment, which mainly reflected a positive perspective on the implementation of online learning. There were modest differences in the perceptions of dental undergraduates between private and public universities, while the perception of the lecturers did not show any difference.
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The rapid advancement of artificial intelligence (AI) in medical imaging has generated significant interest and debate among healthcare professionals, researchers, and the general public. This study aims to explore trends and public perception of AI in medical imaging by analyzing social media discussions. Using a retrospective content analysis approach, social media posts from X (formerly known as Twitter) and Reddit were collected, covering discussions from 2019 to 2024. A total of 1,022 posts were analyzed after data cleaning, employing both qualitative and quantitative methods to examine sentiment, themes, and keyword frequencies. The sentiment analysis revealed that 55% of the comments expressed positive sentiments towards AI in medical imaging, emphasizing its potential to enhance diagnostic accuracy and efficiency. Neutral sentiments accounted for 35% of the posts, while 10% expressed negative sentiments, primarily focusing on concerns related to job displacement, ethical issues, and data privacy. Thematic analysis identified four primary themes: ethical and privacy concerns, job displacement, trust and reliability, and workflow efficiency. Keyword frequency analysis highlighted significant discussions around AI, imaging, and radiology. The results underscore both the optimism and concerns associated with AI in medical imaging, emphasizing the need for ongoing dialogue among technology developers, healthcare providers, and the public. Addressing ethical and privacy concerns, and integrating AI responsibly into clinical workflows, is crucial for maximizing its benefits and minimizing potential risks. These findings provide valuable insights into public perceptions and inform strategies for the effective and ethical implementation of AI technologies in healthcare.
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Focusing on the design of a public space, we propose a methodological contribution to integrate possible future users to studies in prospective ergonomics. Our objective is to establish a rigorous protocol for comparing two methods of projecting potential usage. First, a projection interview based on a virtual environment movie and second, a Guided Imaginary Projection interview. We sought to determine to what extent these two methods provide participants with the ability to live a 'quasi-experience' of the space. This 'quasi-experience' is measured by a questionnaire inspired by the concepts of presence and absorption and by the analysis of the embodiment level of the discourse produced during the interviews, from embodied to general discourse. The results show that while the two methods produce similar results in terms of the level of projection experience, the virtual environment movie projection produces significantly more general discourse.
The aim of this study is to compare, on similar samples, the ability of a non-immersive virtual environment movie and an imagined visit to project the probable future users of a space. The comparison is based on a questionnaire inspired by the concept of presence and an analysis of the rate of embodied speech produced.
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For over a decade, the non-publication of negative results from preclinical studies has been identified as a significant concern in biomedical research. Such underreporting is considered a contributor to the reproducibility crisis in the field and has been recognized by significant journals such as Science and Nature. In response to the consistently high non-publication rates of preclinical animal research in Europe, a survey was conducted among the biomedical research community to gather their views on publishing negative results. Using the EUSurvey platform, over 200 researchers directly working with animals were surveyed. The study aimed to understand the frequency of negative results, the reasons behind their non-publication, and the perceived pros and cons of making such results public. Insights from the survey could guide steps toward promoting transparency in science, refining research methodologies, reducing animal usage in experiments and minimizing research waste.
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OBJECTIVE: In this paper, we examined whether there are inequalities in access to food retail (by type and healthiness) across local government areas (LGA) in Greater Melbourne and by LGA grouped based on their distance from the central business district and Growth Area designation. We also examined whether these inequalities persisted over time. DESIGN: This is a secondary analysis of a repeated cross-sectional census of food outlets collected at four time points (2008, 2012, 2014 and 2016) across 31 LGA. Using Geographical Information Systems, we present a spatial analysis of food retail environments in Melbourne, Australia, at these four times over eight years. SETTING: Greater Melbourne, Australia. PARTICIPANTS: 31 LGA in Greater Melbourne. RESULTS: Findings show significant inequalities in access to healthy food retail persisting over time at the LGA level. Residents in lower density urban growth areas had the least access to healthy food retail. Unhealthy food retail was comparatively more accessible, with a temporal trend indicating increased accessibility over time in urban growth areas only. CONCLUSION: Accessibility to food outlets, particularly healthy food outlets and supermarkets, in Greater Melbourne is not equal. To identify and address health inequalities associated with rapid urban growth, further understanding of how people interact with the food environment needs to be explored.