Comparative analysis of the incidence of enteroparasitosis andthe COVID-19 pandemic profile in the city of Bananeiras - PB / Análise comparativa da incidência de enteroparasitoses e doperfil pandêmico da COVID-19 na cidade de Bananeiras - PB

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.

The Instrumentalization of Public Health Issues for Propaganda by the Far-Right.

Political opportunism of the far-right threatens the efficacy of public health policies and political stability in general. In this commentary, we outline some of the ways that the European far-right has misused public health concerns as propaganda tools. This is a significant threat to the goals of making health and science more inclusive, and we recommend some policies for mitigating the racist effect of the far-right. Notably, we recommend (a) transparency in health policies and robust implementation of the rule of law, (b) the use of operative public values and human rights in health policy making, and (c) investment in decolonizing mindsets which may be corrosive of health policies.

EPIDEMIOLOGIC AND THERAPEUTIC APPROACHES TO SEVERE BURN INJURY IN KOSOVO: A COMPREHENSIVE REVIEW.

The aim of this study is to provide a comprehensive review of the current therapeutic approaches to severe burn injuries. The study will cover the epidemiology of burn injuries, treatment options and adjunctive therapies. It will also emphasize the importance of a multidisciplinary approach in treatment options and discuss current challenges and future directions for research in the treatment of burns. This study aims to provide updated, evidence-based information and guidelines for medical professionals involved in the management of severe burn injuries, and to improve care and outcome for patients affected by these injuries. The WHO states that burn injuries are a major public health concern worldwide, with an estimated 180,000 deaths annually, with the majority of these deaths occurring in low- and middle-income countries.

Le but de cette étude est de présenter une revue exhaustive de la prise en charge des brûlés sévèrement atteints. Ceci comprend l'épidémiologie, la stratégie thérapeutique et les traitements adjuvants. Elle met en avant l'importance d'une approche multidisciplinaire, les difficultés actuelles et les directions prises par la recherche. Elle veut améliorer les soins et le devenir des patients au moyen de la mise à disposition des professionnels des dernières données factuelles et des recommandations actuelles. L'OMS indique que les brûlures représentent un problème de santé publique à l'échelle mondiale, responsables annuellement de 180 000 décès, survenant en majorité dans les pays à niveau de développement bas ou moyen.

Mediterranean diet adherence in 9-years old children: a cross-sectional study in the part of the Split-Dalmatia County, Croatia.

OBJECTIVES: Childhood obesity is a growing global problem that can be prevented by improving diet quality. Mediterranean diet (MedDiet), historically present in Mediterranean countries, is considered one of the healthiest dietary patterns. This cross-sectional study aimed to determine the MedDiet adherence and anthropometric parameters in 9-year-old children from the central geographic locations of Split-Dalmatia County, Croatia. METHODS: The study analysed data obtained from 158 children aged nine years from central parts of Dalmatia: Split and Hvar. To assess the MedDiet adherence, the parents of the children filled out the Mediterranean Diet Index (KIDMED) questionnaire. Appointed school medicine specialists collected anthropometric data of the children and categorized them into body mass index (BMI) categories according to the Center for Disease Control and Prevention (CDC) criteria. Additionally, we assessed the influence of parents' education degree on children's MedDiet adherence and anthropometric measures. RESULTS: Results showed that more than a quarter of nine-year-olds included in this study were overweight or obese (BMI ≥ 85th percentile for age and sex). One of the main findings was that 72% of children had suboptimal (poor or average) MedDiet adherence. Moreover, children with suboptimal KIDMED results (KI < 8) had significantly higher body weight, waist circumference, hip circumference, and waist-to-height ratio. Also, results showed that mothers' education notably influences children's anthropometry. CONCLUSION: Our study found that childhood obesity is a significant concern among 9-year-olds, with a high prevalence of overweight and obesity. Additionally, our results showed that MedDiet adherence is suboptimal among this age group. These results indicate that children of the Mediterranean are not spared of modern life challenges. This problem should be prioritized in the future to prevent the development of a metabolically compromised adult population.

Support for Siblings of Children With Complex Care Needs: Public Health Nurses' Perceptions of Their Role in Primary Schools.

AIM: To explore the role of public health nurses (PHNs) in Norwegian primary school health services in supporting siblings who have a brother or a sister with complex care needs. DESIGN: A qualitative, exploratory design using focus groups combined with visual methods. METHODS: Nineteen Norwegian PHNs participated in three focus group discussions between May and September 2022. The nurses were asked to draw themselves as PHNs working in primary schools. Braun and Clarke's reflexive thematic approach was used to analyse the transcribed interviews. The drawings were analysed using critical visual analysis methodology. RESULTS: The findings revealed that PHNs in primary schools focused on establishing good relationships and found it important to be flexible and creative. However, a challenge to successful service provision in supporting siblings and their families was that the nurses lacked support for the implementation of health promotion interventions and often felt alone. The analysis elicited three main themes: 'the importance of relationships and flexibility in meeting siblings' needs', 'feeling alone with responsibility for supporting siblings' and 'the forgotten children: a need for coordinated services'. CONCLUSION: PHNs in school health services are in a unique position to provide support to improve siblings' mental health and well-being. To fully benefit from PHNs' potential to support siblings, there is a need to clarify guidelines and develop evidence-based interventions. IMPACT: This study provides valuable insights for health authorities, educators and practitioners on what inhibits sibling support in Norway. The study highlights the potential for PHNs to play a significant role in delivering timely health-promoting interventions for these siblings in school settings independent of context. REPORTING METHOD: This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The Rhetoric of Healthcare and the Moral Debate About Theatre-Funded Hospitals in Early Modern Spain.

While early modern Spain may seem a world away, it is an extremely rich and relevant context for gaining a better understanding of the Rhetoric of Health, specifically the power of metaphor, in the related spheres of policy-making and public debate. It was a time and place in which the urban populace's physical well-being depended upon the fortunes of theatrical performances due to a system of alms for hospitals driven by ticket receipts. Anti-theatricalists argued that the immoral nature of theatrical performances made them spiritually and medically detrimental to society. Pro-theatricalists argued that plays were always a public good on balance because they raised much-needed funds for hospitals. Instead of producing a conflict between morality and public health, each side reinforced their connection until the two topics became nearly inseparable in the sphere of public debate. While pro-theatricalists mainly stayed with their arguments about funding hospitals, anti-theatricalists developed a new strategy of literalising the metaphor of theatre as a "plague of the republic" and arguing that immoral entertainment brought literal disease to the populace as a punishment from God. This exemplifies Stephen Pender's observation of how, in an early modern medical context, "Rhetoric as a way of perceiving probabilities and adjusting one's argument to the audience and circumstance offers a model of ethical action and interaction". This article is organised chronologically to track specific adjustments to a specific public-health debate that rely upon moral metaphors of medicine. Each side wrangled over these metaphors in an effort to break a deadlock in a public-health policy debate with entertainment, finance, and morality at its centre. By the end of the seventeenth century, anti-theatricalists finally found their best rhetorical weapon in the literalisation of the "plague of the republic" metaphor, but it only offered a short-term solution to banning theatre contingent upon the ebb and flow of epidemics. Simultaneously, the finance structure of funding hospitals began to erase the role of hospitals from the longstanding debate about the morality of public theatre. The case of early modern Spain provides valuable lessons about the power of metaphor in the Rhetoric of Healthcare that are still applicable today.

Understanding excess mortality in 2022: The dual impact of COVID-19 and heatwaves on the Italian elderly population.

In this study, we employ a comprehensive approach to model the concurrent effects of the COVID-19 epidemic and heatwaves on all-cause excess mortality. Our investigation uncovers distinct peaks in excess mortality, notably among individuals aged 80 years and older, revealing a strong positive correlation with excess temperatures (ET) during the summer of 2022 in Italy. Furthermore, we identify a notable role played by COVID-19 hospitalizations, exhibiting regional disparities, particularly during the winter months. Leveraging functional data regression, we offer robust and coherent insights into the excess mortality trends observed in Italy throughout 2022.

Signaling pathways in HPV-induced cervical cancer: Exploring the therapeutic promise of RNA modulation.

Cervical cancer, originating from the epithelial tissue of the uterine cervix, constitutes the most commonly diagnosed malignancy among women worldwide. The predominant etiological factor underpinning cervical carcinogenesis is persistent infection with high-risk human papillomavirus (HPV) genotypes, notably HPV-16 and HPV-18. Oncoproteins encoded by high-risk HPV interfere with multiple essential cellular signaling cascades. Specifically, E5, E6, and E7 proteins disrupt the signaling pathways like p53, retinoblastoma tumor suppressor protein (pRB), The phosphoinositide 3 kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR), epidermal growth factor receptor (EGFR), mitogen-activated protein kinases (MAPK)/extracellular signal-regulated kinases (ERK), and Wnt/ß-catenin, promoting HPV-mediated carcinogenesis. This dysregulation disrupts cell cycle control, apoptosis, and metastasis through modulation of microRNAs (miRNA) and key cellular processes. The novel therapeutic interventions for HPV prevention and detection are fundamental to patient management. RNA-based treatment modalities offer the potential for manipulating critical pathways involved in cervical carcinogenesis. RNA therapeutics offer novel approaches to drug development by targeting intracellular genetic elements inaccessible to conventional modalities. Additional advantages include rapid design, synthesis, and a reduced genotoxic profile compared to DNA-based therapies. Despite beneficial attributes, system stability and efficient delivery remain critical parameters. This study assessed the intricate relationship between HPV, cervical cancer, and various signaling pathways. The study explores miRNAs' diagnostic and therapeutic potential, mall interfering RNAs (siRNAs), and long non-coding RNAs (lncRNAs)in cervical cancer management. The review highlights the prospect of RNA-targeted therapies to modulate specific cancer signaling pathways. This approach offers a novel strategy for cervical cancer treatment through precise regulation of cancer signaling. Future research should concentrate on developing RNA-targeted interventions to improve cervical cancer treatment outcomes through increased therapeutic efficacy and specificity.

Overall and race-specific associations between state-level minimum wage policy and food insecurity in the United States.

BACKGROUND: In the USA, states can set higher minimum wages than the federal government. We investigated the association between state minimum wages and racial/ethnic inequities in food insecurity. METHODS: Household-level food insecurity and sociodemographic data were obtained from the cross-sectional Current Population Survey 2015-2019 (n=189 665 households) and merged by state and year with minimum wage and cost-of-living data obtained from the US Department of Labor and US Bureau of Economic Analysis, respectively. We fitted Poisson regression models with robust standard errors with 12-month or 30-day household food insecurity as the outcome, and minimum wage or inflation-adjusted minimum wage (ie, real wage) as the predictor, adjusting for cost of living, sociodemographic covariates and state fixed-effects. We tested interactions between minimum wage and race/ethnicity and ran race/ethnicity-stratified models. RESULTS: In adjusted models, the real wage was not associated with 12-month or 30-day food insecurity. Minimum wage was associated with 5% lower prevalence rate of 12-month food insecurity (PR 0.95, 95% CI=0.93 to 0.98) and 7% lower prevalence rate of 30-day food insecurity (PR 0.93, 95% CI 0.91 to 0.96) for all households. The interaction p values for race/ethnicity with real wage and minimum wage were p<0.001. In stratified models, results were statistically significant for minimum wage and 12-month food insecurity among non-Hispanic (NH) white households (PR 0.93, 95% CI 0.89 to 0.96) and Hispanic households (PR 0.95, 95% CI 0.92 to 0.98), and minimum wage and 30-day food insecurity among NH white (PR 0.92, 95% CI 0.88 to 0.96), NH black (PR 0.94, 95% CI 0.89 to 0.99) and Hispanic (PR 0.90, 95% CI 0.85 to 0.95) households. CONCLUSIONS: Higher state-level minimum wages, but not real wages, were associated with lower food insecurity prevalence overall and for racial/ethnic subgroups.

Gun violence exposure and population health inequality: a conceptual framework.

This essay establishes a conceptual framework to understand how direct, secondar and community exposures to gun violence converge to influence population health. Our framework asserts that persistent gun violence in structurally disadvantaged communities enacts broad consequences for mental, physical and behavioural health, operating as a key driver of racial and socioeconomic health disparities. We discuss the applications of this framework for research and improved data collection with a focus on establishing timely and accurate measures of gun violence alongside individual and community health measures. We then address the policy implications of the framework, emphasising the need for long-term, institutional investment in gun violence prevention and intervention, survivor service provision and evidence-based policies at all levels of government.

Seven insights from Albert Camus's Plague about epidemics, public health and morality.

For Albert Camus, plague was both a fact of life and a powerful metaphor for the human condition. Camus engaged most explicitly and extensively with the subject of plague in his 1947 novel, The Plague (La peste), which chronicles an outbreak of what is presumably cholera in the French-Algerian city of Oran. I often thought of this novel-and what it might teach us-during the recent COVID-19 pandemic. In this article, I discuss seven important insights from The Plague about epidemics, public health and morality.

Youth's internet dependence forming factors as a global public health problem.

OBJECTIVE: Aim: The aim is to study the main factors of youth's Internet dependence formation. PATIENTS AND METHODS: Materials and Methods: We conducted psychodiagnostic examination of students in the National Academy of Internal Affairs. The research involved 154 students: full-time students aged 18-25 (n = 78) and part-time students aged 26-35 (n = 76). RESULTS: Results: The degree of prevalence of various types of Internet dependence among young people was determined. It was determined that the problem of Internet dependence requires consideration of socio-demographic, socio-psychological, individual, and psychological, as well as organizational factors. CONCLUSION: Conclusions: It was found that the number of Internet-dependent people among youth is currently growing rapidly. The most favorable individual-typological properties of a personality for the development of Internet dependence are introversion, anxiety, sensitivity, and aggressiveness. Internet dependence is a type of social dependence. An Internet-dependent individual suffers from the inability to maintain harmonious interpersonal contacts and resolve personal issues that are distorted by the virtual environment. Deviations from normal behavior in society change the peaceful way of life and affect public health.

Navigating Uncertainty: Adapting Guidance for Mental Health During the COVID-19 Public Health Emergency & the Crucial Role of Bi-directional Feedback.

In response to the COVID-19 public health emergency, state and local mental health authorities rapidly developed and disseminated guidance to community mental health agencies. While tailored communication is effective to reach target audiences under usual circumstances, strategies to facilitate the implementation of guidance amidst a rapidly evolving public health emergency are not well understood. This project sought to understand factors informing decision-making about adaptations to guidance, and strategies used to disseminate and facilitate guidance implementation among system-level community partners in OnTrackNY Coordinated Specialty Care (CSC) programs for early psychosis. Semi-structured interviews were conducted with New York State Office of Mental Health (NYS OMH) state and local mental health authorities including state leaders (n = 3) and NYS OMH field office directors (n = 4), OnTrackNY program directors (n = 4), and leadership and trainers of an intermediary organization, OnTrack Central (n = 12). Interviews were analyzed using content analysis. Code reports relevant to guidance decision-making and dissemination were reviewed to identify emerging themes. For state and local mental health authorities, decision-making was influenced by changing COVID-19 risk levels, need for alignment between federal and local guidance, and balancing support for workforce capacity and mental health service continuity. For OnTrackNY program directors, decision-making was influenced by internal infrastructure and processes (e.g., program autonomy), availability of resources (e.g., technology), and perspective on managing risk and uncertainty (e.g., COVID-19, regulatory waiver expiration). For OnTrack Central, decision-making focused on balancing CSC model fidelity with OnTrackNY team capacity and resources. Dissemination of guidance consisted of mass and targeted strategies. Information flow was bidirectional such that top-down dissemination of guidance (e.g., from state mental health authorities to providers) was informed and refined with bottom-up feedback (e.g., from providers to state leadership) through surveys and professional forums (e.g., COVID-19 town halls, provider learning collaboratives). Unlike a planned approach to disseminate new policies, public health emergencies create variable landscapes that may warrant a deeper understanding of how guidance may be adapted to fit rapidly evolving community partner needs. Findings may inform efforts to identify processes that contribute to adaptation and dissemination of guidance for mental health during future public health emergencies.

Smoking & autonomy: the generational tobacco endgame.

New Zealand and Malaysia have abandoned plans to introduce a generational smoking ban because of concerns that such a policy is incompatible with liberal democracy as it undermines autonomy. This paper challenges this claim by showing that smoking is not an autonomous act. Autonomy requires a deliberation of preferences, wills and inclinations. This does not occur in smokers because of three related factors: nicotine addiction, cognitive biases and psychosocial development in addiction. Nicotine addiction results in strong physical and psychological desires to seek pleasure and to avoid withdrawal. This is further potentiated by conditioned behaviour. Cognitive biases explain why smokers act in ways that are detrimental to their health. Psychosocial development explains how the brains of smokers are unable to make rational decisions. This combination renders smokers unable to reflect on their actions and thus act autonomously. This stance is compatible with Mill's view that actions that devalue autonomy cannot be considered autonomous. Defenders of liberalism should not be quick to dismiss a smoking ban and can instead foster autonomy by supporting it.

Public health, pluralism, and the telos of political virtue.

In the ethics of public health, questions of virtue, that is, of what it means for public health to act excellently, have received little attention. This omission needs remedy first because achieving improvements in population-wide health can be in tension with goals like respect for the liberty, self-determination, or non-oppression of various individuals or groups. A virtue-ethics approach is flexible and well-suited for the kind of deliberation required to resolve or mitigate such tension. Public health requires practically wise and careful thinking, which virtue ethics brings with it. Furthermore, too tight a focus on delivering outcomes in determining how public health should act has, in some cases, actually undermined its ability to achieve those consequences. However, the main concern about incorporating virtue into public health in a pluralistic society is likely to be that virtue is generally teleological, and we would surely need some widely agreed upon idea of something like flourishing or the common good for this to work. In this paper, I propose that for public health to express virtue in its work, it must express a commitment to justice as it goes about its business promoting and protecting the health of the population. Justice is both a contributor toward better health for groups in society, and a worthwhile goal in its own right. I will sketch an argument that justice as non-oppression - not merely health equity - is the right telos toward which excellent public health should aim in a pluralist society.

Psychological distress and trajectories of sleep duration among Australian adolescents: a prospective cohort study.

OBJECTIVES: This study investigated the association between indicators of psychological distress and well-being and trajectories of sleep duration among a cohort of Australian adolescents. DESIGN: A prospective cohort of adolescents was followed over 27 weeks (8 November 2019-14 May 2020). Data on sleep duration and psychological distress were collected via smartphones, based on ecological momentary assessments. SETTING: Sydney population catchment, Australia. PARTICIPANTS: Young people aged 13-19 years were recruited via social media (Instagram or Facebook). PRIMARY OUTCOME MEASURE: Self-reported sleep duration in the past 24 hours. Sleep duration was dichotomised into 'less than 8 hours' and 'at least 8 hours', to represent those participants not meeting the recommended minimum amount of daily sleep. RESULTS: Participants with high psychological distress had higher odds of sleeping less than 8 hours (OR 1.51 (95% CI 1.17 to 1.96)), compared with those with low psychological distress. Social media use (OR 1.34 (95% CI 1.01 to 1.79)) and longer periods spent on homework (OR 1.37, (95% CI 1.07 to 1.75)) were also associated with a sleep duration of less than 8 hours. Also, decreasing sleep trajectories were associated with increased psychological distress (ß=0.069, (95% CI -0.010 to 0.149)) and increased homework hours (ß=0.078 (95% CI 0.036 to 0.120)). CONCLUSION: Findings highlight the adverse impact of psychological distress and high levels of social media use on sleep duration among adolescents. Longitudinal studies with longer follow-up periods are warranted to further explore the temporal associations between sleep duration and different health outcomes among varying populations.

Misinformation and perception of COVID-19 and risk assessment among people in Pakistan: A pilot study.

BACKGROUND: During the coronavirus pandemic, misinformation was circulated through technology and social media on a large scale. Since people rely on media to keep connected and informed, misinformation can prevent them from staying safe. OBJECTIVES: To examine the quality of information reaching Pakistanis, the effect of information/misinformation on people's perception, and its relationship with risky health behaviours in different demographical groups. METHODS: A community sample of N= 103 Pakistanis was assessed using a mixed-method cross-sectional survey research design to investigate their sources of knowledge/information, perceptions of coronavirus-related facts, and risky health behaviours. RESULTS: Content analysis of the material that participants read/watched indicated the possible effect of media on people's perception of COVID-19. Specific demography (e.g., increasing age) and people's tendency to believe misinformation/information may indicate risky health behaviours pertaining to coronavirus infection. DISCUSSION: Findings showed how the models considered (social cognitive theory, biological warfare conspiracy theory, theory of planned behaviour, protection motivation theory, the health belief model, and biopsychosocial model) may be relevant to examination of the effects of misinformation on different demographic groups. CONCLUSION: The findings and models need to be verified on larger, more representative samples of Pakistanis using a large-scale survey based on the insights obtained from this pilot study.

Dynamics of Feline Sporotrichosis in Espírito Santo, Brazil: Impact of Urbanisation.

INTRODUCTION: Sporotrichosis is a chronic infectious mycosis caused by traumatic implantation of Sporothrix spp., which poses a significant challenge to public health because of its zoonotic nature. It affects humans and other animals, particularly cats. This study investigated epidemiological trends and spatial distribution of feline sporotrichosis in Espírito Santo between 2017 and 2022. METHODS: This study collected diagnostic data on sporotrichosis from the Veterinary Pathology Laboratory and Center for Infectious Diseases in Espírito Santo from 2017 to 2022. Statistical analyses were performed using STATA and spatial analyses were performed using ArcGIS software to create maps and identify hotspots. Kernel density estimation and directional mean statistics were applied to visualise the disease concentration and transmission trends. RESULTS: The results showed a significant increase in feline sporotrichosis cases in Espírito Santo from 2017 to 2022, with hotspots identified in urban and densely populated areas. Anchieta, Aracruz and Vila Velha reported the highest numbers of cases. Spatial analysis indicated a spread towards the central and northern coastal regions. CONCLUSION: This study highlights the growing threat of feline sporotrichosis in Espírito Santo, Brazil, particularly in densely populated urban areas. This underscores the urgent need for comprehensive public health strategies that address urbanisation, human-animal interactions and managing stray cat populations. Effective control measures and enhanced surveillance are crucial to mitigate the spread of this zoonotic disease. Importantly, this study provides valuable insights into the epidemiology of sporotrichosis in Brazil and offers a framework for other regions identified as emerging hotspots that face similar challenges.

Measuring the Collective Community Capacity of a Network to Address Health Inequities during a Public Health Emergency: Findings from the National COVID-19 Resiliency Network.

OBJECTIVE: This study assesses the collective community capacity of the National COVID-19 Resiliency Network (NCRN), a multisectoral network mitigating the disproportionate impact of COVID-19 on minoritized populations. METHODS: From January to April 2022, we used two concurrent data collection methods: a Collective Community Capacity (C3) survey (n=65) and key informant interviews (KIIs) (n=26). The C3 assessed capacity for creation of a shared vision, engagement in community change, and distributive leadership. KIIs assessed perspectives on network formation and implementation. We used a convergent design and triangulation for interpretation. RESULTS: NCRN has growing collective community capacity. The C3 survey found high capacity for establishing a shared mission and evidence of mutual commitment, trust, and accountability. About three-quarters of respondents strongly agreed that partners addressed social, economic, and cultural barriers related to COVID-19. Interviewees valued NCRN leaders' openness, availability, and willingness to listen. Partners learned from one another, increased their health communication capacity, and supported sustainability. They sought greater opportunities to partner and support decision-making. CONCLUSIONS: NCRN developed a collaborative network with a shared vision of improving health equity during and beyond the COVID-19 pandemic, while identifying areas for improvement in distributive leadership. Findings can support other organizations seeking to build collective community capacity to address equity in public health emergencies.

Impact of COVID-19 on referrals to paediatric liaison psychiatry at Children's Health Ireland at Crumlin as the pandemic moved to endemic status.

BACKGROUND: Rates of acute mental health presentations in youth were increasing pre-pandemic internationally. Longitudinal studies following COVID-19 attest to ongoing deterioration in youth mental health, recognising adverse unintended consequences following public health restrictions. AIMS: To examine whether the initial post-COVID-19 increase in mental health presentations persisted following the reclassification of COVID-19 to endemic status, accompanied by the removal of most restrictions. METHOD: All referrals to paediatric liaison psychiatry (PLP) between January 2018 and December 2022 in a Dublin tertiary children's hospital were included in the study. An interrupted time series analysis with autoregressive integrated moving average models was conducted, examining referrals with respect to different phases of COVID-19 and application of public health restrictions. RESULTS: Some 1385 referrals to PLP were received over the 5-year study. There was a significant decrease in PLP referrals immediately post-COVID-19, followed by a significant and sustained increase as the pandemic progressed and moved to endemic status. Public health restriction phases had a unique effect on those presenting with suicidal ideation, with a significant increase in the number of referrals. There was no effect of restrictions on other clinical profiles. CONCLUSIONS: Increased referrals for youth with mental health difficulties, reported during the COVID-19 pandemic, persisted into the early endemic stage, after COVID-19 public health restrictions ceased. Specific impacts of restrictions on suicidal ideation referrals require further study. Investment in child and adolescent mental health services remains a priority, and future pandemic response strategies need to examine unintended consequences of any enforced public health measure.