Where should "Humans" be in "One Health"? Lessons from COVID-19 for One Health.

The culling of animals that are infected, or suspected to be infected, with COVID-19 has fuelled outcry. What might have contributed to the ongoing debates and discussions about animal rights protection amid global health crises is the lack of a unified understanding and internationally agreed-upon definition of "One Health". The term One Health is often utilised to describe the imperative to protect the health of humans, animals, and plants, along with the overarching ecosystem in an increasingly connected and globalized world. However, to date, there is a dearth of research on how to balance public health decisions that could impact all key stakeholders under the umbrella of One Health, particularly in contexts where human suffering has been immense. To shed light on the issue, this paper discusses whether One Health means "human-centred connected health" in a largely human-dominated planet, particularly amid crises like COVID-19. The insights of this study could help policymakers make more informed decisions that could effectively and efficiently protect human health while balancing the health and well-being of the rest of the inhabitants of our shared planet Earth.

Drunk in China? The Imperative for Effective Interventions Against Alcohol Abuse.

BACKGROUND: Alcohol use and abuse remain prevalent in China, though mounting evidence shows that even drinking in moderation is detrimental to health. While many countries' intake is on the decline, China's alcohol consumption is rising fast and is on the path to overtaking countries like the United States, even on a per capita level. OBJECTIVES: This paper aims to analyze the danger of lax enforcement of laws and regulations against alcohol use and abuse and underscores the imperative for effective health interventions to curb problematic alcohol consumption in China. RESULTS: Different from their Western counterparts, Chinese drinkers often consume more spirit with a high percentage of alcohol in social settings that encourage the "ganbei culture"-making toasts with alcohol filled to the brim and downed in one go to show respect-which perpetuates excessive drinking at a fast pace. Though the country has various laws and regulations in place to curb problematic alcohol consumption, like workplace drinking, their impacts are dismal. Considering that China has 1.4 billion people, the country's uncurbed alcohol consumption trend could have a detrimental effect on national strategic objectives like "Healthy China 2030" and international ones like the Sustainable Development Goals. To further compound the situation, prevalent campaigns promoted by liquor companies-like alcohol-infused coffee, chocolate, and ice cream-may groom young people to develop alcohol consumption habits, if not addictions, for generations to come. CONCLUSIONS: We developed the Framework of 5Vs of China's "Ganbei Culture to shed light on the issue, with the hope that it, along with the overarching insights of this paper, can assist health professionals and policymakers in better guarding and improving public health against the harms of alcohol use and abuse in China and beyond.

Post-pandemic policy imperatives to stem violence against women in China.

Violence against women is rampant in China. Even though meaningful strides have been made in the country, it remains disturbingly common for men to assault women-verbally or physically, who may or may not be their partners-in broad daylight in China. To make the situation worse, COVID-19, along with its restrictions, has both undermined women's ability to escape from abuse or violence and society's ability to provide timely help to victims. In light of the rising violence against women post-COVID, in this paper, we discuss the policy imperatives for countries like China to establish effective guardrails and support systems to protect women from the dehumanizing and destabilizing crime that is violence against women-a social malaise that not only harms and undermines the safety of society's daughters, mothers, and grandmothers, but also the integrity of local communities and social contract, let along shared humanity and global solidarity at large.

Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil.

BACKGROUND: A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil. METHODS: This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups. RESULTS: Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE. CONCLUSION: This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.

Psychoneuroimmunology concerns of the Olympic boycotts.

Just weeks away from the Opening Ceremony of the Beijing 2022 Winter Olympics, the United States, followed by Australia, the United Kingdom, and Canada, has declared a diplomatic boycott of the Games. A diplomatic boycott stipulates that while government officials of these countries will not attend the event, the athletes' scheduled attendance will largely remain intact. An unintended consequence of the boycotts is that they force the attending athletes to cope with the stress and distress associated with the 2022 Winter Olympics in an unfamiliar environment on their own. It is important to underscore that many of the challenges the athletes could face amid the Games are either deep-rooted or unprecedented, ranging from stressors fuelled by the nonstop media reports, the competitions, to the Omicron scares. These insights combined, in turn, underscore the imperative for effective and preemptive mental health support for Olympic athletes. To shed light on the issue, this paper highlights the reasons why timely solutions are needed to adequately safeguard Olympic athletes' mental health and overall wellbeing, and underlines promising technology-based solutions that can be cost-effectively designed and developed for the athletes.

Facial recognition law in China.

Although the prevalence of facial recognition-based COVID-19 surveillance tools and techniques, China does not have a facial recognition law to protect its residents' facial data. Oftentimes, neither the public nor the government knows where people's facial images are stored, how they have been used, who might use or misuse them, and to what extent. This reality is alarming, particularly factoring in the wide range of unintended consequences already caused by good-intentioned measures and mandates amid the pandemic. Biometric data are matters of personal rights and national security. In light of worrisome technologies such as deep-fake pornography, the protection of biometric data is also central to the protection of the dignity of the citizens and the government, if not the industry as well. This paper discusses the urgent need for the Chinese government to establish rigorous and timely facial recognition laws to protect the public's privacy, security, and dignity amid COVID-19 and beyond.

6G and Artificial Intelligence Technologies for Dementia Care: Literature Review and Practical Analysis.

BACKGROUND: The dementia epidemic is progressing fast. As the world's older population keeps skyrocketing, the traditional incompetent, time-consuming, and laborious interventions are becoming increasingly insufficient to address dementia patients' health care needs. This is particularly true amid COVID-19. Instead, efficient, cost-effective, and technology-based strategies, such as sixth-generation communication solutions (6G) and artificial intelligence (AI)-empowered health solutions, might be the key to successfully managing the dementia epidemic until a cure becomes available. However, while 6G and AI technologies hold great promise, no research has examined how 6G and AI applications can effectively and efficiently address dementia patients' health care needs and improve their quality of life. OBJECTIVE: This study aims to investigate ways in which 6G and AI technologies could elevate dementia care to address this study gap. METHODS: A literature review was conducted in databases such as PubMed, Scopus, and PsycINFO. The search focused on three themes: dementia, 6G, and AI technologies. The initial search was conducted on April 25, 2021, complemented by relevant articles identified via a follow-up search on November 11, 2021, and Google Scholar alerts. RESULTS: The findings of the study were analyzed in terms of the interplay between people with dementia's unique health challenges and the promising capabilities of health technologies, with in-depth and comprehensive analyses of advanced technology-based solutions that could address key dementia care needs, ranging from impairments in memory (eg, Egocentric Live 4D Perception), speech (eg, Project Relate), motor (eg, Avatar Robot Café), cognitive (eg, Affectiva), to social interactions (eg, social robots). CONCLUSIONS: To live is to grow old. Yet dementia is neither a proper way to live nor a natural aging process. By identifying advanced health solutions powered by 6G and AI opportunities, our study sheds light on the imperative of leveraging the potential of advanced technologies to elevate dementia patients' will to live, enrich their daily activities, and help them engage in societies across shapes and forms.

Cutaneous melanoma: cost of illness under Brazilian health system perspectives.

BACKGROUND: The landscape of cutaneous melanoma (CM) diagnosis, staging, prognosis, and treatment has undergone fundamental changes in the past decade. While the benefits of new health resources are recognized, there is a distinct lack of accurate cost-of-illness information to aid healthcare decision makers. METHODS: The cost-of-illness study for CM was conducted from the perspective of two health systems in Brazil: the public health system (Unified Health System, SUS) and the private health system (Health Management Organization, HMO). The study considered the direct medical cost in a bottom-up analysis, using melanoma incidence, knowledge of the disease's progression, and the overall survival rates. The executional costs for the complete healthcare delivery cycle were investigated considering different disease stages and possible clinical course variations. The structural cost was assessed qualitatively considering the health value chain in Brazil. RESULTS: CM represents a critical financial burden in Brazil, and the cost of illness varied according to the health system and by stage at diagnosis. HMO patient costs are approximately 10-fold and 90-fold more than a SUS patient in the early-stage and advanced disease, respectively. Overall, spending on advanced disease patients can be up to 34-fold (SUS) or 270-fold (HMO) higher than that required for the early-stage disease. Given the massive amount of resources spent by the SUS and HMO, significant efforts must be made to improve the health value chain to deliver the right mix of medical care goods and services using available resources. CONCLUSION: The cost-of-illness study for CM has the potential to inform policymakers and decision-makers regarding the economic burden that melanoma impose on a society in terms of the use of health care services, assisting them in making projections of future health care costs and resource allocation decisions. We believe that cost-of-illness analysis from a strategic perspective could be of help in assessing executional costs and be used to support the change in structural costs required for long-term strategies related to the health value chain.

Advancing nursing education in Brazil: A systematic literature review of curricular evolution and emerging challenges.

OBJECTIVE: This study assesses changes and challenges within the nursing curriculum in the Brazilian context, focusing on addressing contemporary professional and societal demands. DESIGN: A systematic literature review (SLR) was conducted to identify and analyze the changes in Brazil's nursing curricula over time. DATA SOURCES: Articles published between 1987 and 2023 were selected from Scopus and Web of Science databases for the systematic review. REVIEW METHODS: A hybrid review approach was employed, integrating Systematic Literature Review (SLR), Bibliometrics, and metanarrative. The study adhered to the SPAR-4-SLR (Scientific Procedures and Rationale for Systematic Literature Reviews) protocol, involving three main stages: (i) aggregation, (ii) organization, and (iii) evaluation. The analysis primarily focused on identifying emerging trends and evaluating curricular changes over the specified timeframe. RESULTS: Analysis of the selected literature identified four principal thematic groups that emerged during the review period: (i) longitudinal curriculum assessment, (ii) biological and health sciences, (iii) human and social sciences, and (iv) nursing sciences. Noteworthy trends included the integration of emerging topics like mental health and care for victims of violence, coupled with a notable increase in emphasis on transformative and competency-based education. Nevertheless, significant gaps were observed in the existing literature, particularly concerning the absence of perspectives from students and recent graduates and limited research on vulnerabilities within the curriculum structure. CONCLUSIONS: This study underscores the imperative for flexible and adaptable nursing curricula that effectively address Brazil's diverse regional and social realities. It emphasizes the significance of adopting a holistic and inclusive approach to nursing education, preparing professionals to confront contemporary health challenges in a nation characterized by extensive cultural diversity and vast geographical dimensions. Further research and input from students and recent graduates are indispensable to rectify the gaps and ensure the continuous evolution of nursing education in Brazil.

The dangers of having only one pandemic exit strategy.

BACKGROUND: When it comes to pandemic response, preparation can be the key. Between 2020 and 2024, the fast-paced development of COVID-19-often compounded by pubic policies' failures to reflect the latest reality and the public's divergent reactions to the pandemic and the policies-means that society should prepare for exit strategies that can reflect the reality of the pandemic and the interests of the people. Yet oftentimes societies only have one exit strategy with limited scope. This paper investigates the dangers of having only one pandemic exit strategy for pandemics like COVID-19. METHODS: Analyses were based on a review of the literature on COVID-19 exit strategies and our own research. The PubMed literature search focused on two concepts-"COVID-19″ and "exit strategy"-and was limited to peer-reviewed papers published between 2020 and 2024 in English. RESULTS: A total of 31 articles were included in the final review. Analyses showed that existing studies on COVID-19 exit strategies often focused on using the modelling method to gauge one exit strategy. Exit strategies were often discussed in the context of implementing, easing, or lifting specific pharmaceutical or non-pharmaceutical interventions. Staged and country-wide coordinated exit strategies were also discussed in the literature, both of which were often deemed as comparatively rigorous options compared to single or stand-alone exit strategies. Drawing on the overall development of COVID-19 and our own research, we presented and discussed the importance of having multiple exit strategies that are considerate of all possible pandemic trajectories, diverse interests of the public, and the communication challenges officials might face in introducing or implementing pandemic policies. CONCLUSION: This paper underscored the importance of having multiple exit strategies for societies to prepare for pandemics. The insights of this study can help inform health policies so that they can more comprehensively and compassionately protect the needs and wants of the "public" in public health, particularly in grave times like COVID-19.

Immune checkpoint inhibitors for the treatment of non-small cell lung cancer: The regulatory journey in Brazil.

BACKGROUND: Recent therapeutic advances such as immune checkpoint inhibitors (ICIs) have impact on the care of non-small cell lung cancer (NSCLC) patients, however, they bring new setbacks for regulatory agencies. OBJECTIVE: To evaluate the regulatory journey of ICIs registered for NSCLC treatment in Brazil and to establish comparisons of Brazilian regulatory agency with the US regulatory agency. METHODS AND DATA SOURCE: Information for each ICI prescribing as well as the date of regulatory approval of the therapeutic indications of interest were collected from the Anvisa and the FDA websites. The search took place on October 2022. KEY FINDINGS: There are only 20 % disagreements on regulatory approvals between Anvisa and FDA. The prioritization review at Anvisa in 2008 has made the regulatory assessment faster. CONCLUSIONS: The results of this study identified a potential improvement in Anvisa's time performance to connect the target established by the legal framework of the sector.

Media-Induced War Trauma Amid Conflicts in Ukraine.

War could be traumatic. War trauma could often lead to severe and sustained health consequences on people's physical and psychological health. War trauma is often prevalent in people who either participated in the war or lived near conflict zones, such as military professionals, refugees, and health workers. Advances in information and communication technologies, such as the speed, scale, and scope at which people worldwide could be exposed to the near-time happenings of the war, mean that an unprecedented number of people could face media-induced war trauma. Different from war experienced in person, which could be limited in scope and intensity, media-induced war trauma can be substantially more extensive and comprehensive-news reports on the war often cover all aspects and angles possible, possibly paired with disturbing, if not demoralizing, images, repeatedly 24/7. Although media-induced war trauma could have a profound influence on people's mental health, particularly factoring in the compounding challenges caused by the pandemic, there is a dearth of research in the literature. To shed light on this issue, in this article, we aim to examine the implications of media-induced war trauma on people's health and well-being. Furthermore, we discuss the duties and responsibilities of the media industry amid and beyond the current conflicts in Ukraine.

Reviewing the relationship between organizational performance, dynamic capabilities and strategic behavior.

Current business challenges mean that understanding elements that can affect organizational performance represents a differential factor in maintaining competitiveness. In this context, the objective of this article is to conduct a Systematic Literature Review (SLR) of the relationship between dynamic capabilities, strategic behavior, and organizational performance. For this, A three-stage SLR protocol was used: (i) planning, (ii) conduct, and (iii) knowledge development. A total of 118 articles covering the publication period of 2006-2021 were included, which evidenced: (i) the grouping of words into three classes: "Knowledge Management," "Measurement Instrument," and "Organizational Environment"; (ii) the methodological framework; (iii) directions for future research. The findings reinforce the importance of the theoretical, methodological, and empirical relationship between the three constructs. Furthermore, the results indicate the relationship between the set of terms selected in each class, highlighting the strong connection between dynamic capabilities and competitive intensity. The main findings of the research show that organizations can expand or modify their processes by building and using dynamic capabilities as institutional factors, shaping strategic behavior to advance better performance.

Nannies Go Rogue? A Call for Research into Nanny-Induced Elderly Abuse in China.

Older people often face varied and vicious abuse from care workers. Situations are often more pronounced for older people who live with additional cognitive or physical difficulties, such as dementia and disabilities, the prevalence of which has been on the rise in China and elsewhere. Recent discoveries of elderly abuse in China, which span from alarming levels of verbal, physical, psychological, financial, to sexual abuse, are all caused by nannies or "bao mu". Different from Western countries, the word nanny is often used to refer to people who offer caregiving help in residential settings at large, regardless of the age of the care recipients. What is also different is the lack of regulations or even rigorous training and evaluation processes for nannies in China: almost anyone could become a nanny-even though a background check is often required for nannies, this process is often highly variable and dependent on the specific labour agencies that nannies are registered with. Yet without structured studies and systematic data, little is known about the extent and severity of nanny-induced elderly abuse in China. To this end, this paper aims to discuss the unique elderly care environment-such as the "721 Rule"-in China, particularly in the post-COVID era, and highlight the critical need for timely and rigorous studies on the potential prevalence and severity of nannies' abuse and neglect of older people.

Technology-Based Mental Health Interventions for Domestic Violence Victims Amid COVID-19.

INTRODUCTION: Domestic violence is a threat to human dignity and public health. Mounting evidence shows that domestic violence erodes personal and public health, spawning issues such as lifelong mental health challenges. To further compound the situation, COVID-19 and societies' poor response to the pandemic have not only worsened the domestic violence crisis but also disrupted mental health services for domestic violence victims. While technology-based health solutions can overcome physical constraints posed by the pandemic and offer timely support to address domestic violence victims' mental health issues, there is a dearth of research in the literature. To bridge the research gap, in this study, we aim to examine technology-based mental health solutions for domestic violence victims amid COVID-19. METHODS: A literature review was conducted to examine solutions that domestic violence victims can utilize to safeguard and improve their mental health amid COVID-19. Databases including PubMed, PsycINFO, and Scopus were utilized for the literature search. The search was focused on four themes: domestic violence, mental health, technology-based interventions, and COVID-19. A reverse search of pertinent references was conducted in Google Scholar. The social ecological model was utilized to systematically structure the review findings. RESULTS: The findings show that a wide array of technology-based solutions has been proposed to address mental health challenges faced by domestic violence victims amid COVID-19. However, none of these proposals is based on empirical evidence amid COVID-19. In terms of social and ecological levels of influence, most of the interventions were developed on the individual level, as opposed to the community level or social level, effectively placing the healthcare responsibility on the victims rather than government and health officials. Furthermore, most of the articles failed to address risks associated with utilizing technology-based interventions (e.g., privacy issues) or navigating the online environment (e.g., cyberstalking). CONCLUSION: Overall, our findings highlight the need for greater research endeavors on the research topic. Although technology-based interventions have great potential in resolving domestic violence victims' mental health issues, risks associated with these health solutions should be comprehensively acknowledged and addressed.

Mind the "Vaccine Fatigue".

Background: Omicron scares and speculations are gaining momentum. Amid the nonstop debates and discussions about COVID-19 vaccines, the "vaccine fatigue" phenomenon may become more prevalent. However, to date, no research has systematically examined factors that shape people's vaccine fatigue. To bridge the research gap, this study aims to investigate the antecedents that cause or catalyze people's vaccine fatigue. Methods: A narrative literature review was conducted in PubMed, Scopus, and PsycINFO to identify factors that shape people's vaccine fatigue. The search was completed on December 6, 2021, with a focus on scholarly literature published in English. Results: A total of 37 articles were reviewed and analyzed. Vaccine fatigue was most frequently discussed in the context of infectious diseases in general at the pre-vaccination stage. Vaccine fatigue has been identified in the general public, the parents, and the doctors. Overall, a wide range of antecedents to vaccine fatigue has been identified, ranging from the frequency of immunization demands, vaccine side effects, misconceptions about the severity of the diseases and the need for vaccination, to lack of trust in the government and the media. Conclusion: Vaccine fatigue is people's inertia or inaction towards vaccine information or instruction due to perceived burden and burnout. Our study found that while some contributors to vaccine fatigue are rooted in limitations of vaccine sciences and therefore can hardly be avoided, effective and empathetic vaccine communications hold great promise in eliminating preventable vaccine fatigue across sectors in society.

A call to ban the sale of tobacco products.

Tobacco is both toxic and addictive. Mounting evidence shows that tobacco use has a detrimental impact on almost every aspect of human health, causing or worsening deadly public health crises from the cancer epidemic to the COVID-19 pandemic. However, while tobacco use is a threat to both personal and public health, it continues to surge across the world, especially in China and other low- and middle-income countries. To this end, this article argues in favor of using a ban on the sale of all tobacco products as a practical solution to the global tobacco use epidemic. It is our hope that insights provided by our work will inspire swift policy actions in countries such as China and beyond to curb the tide of rising tobacco consumption, so that populations around the world could be better shielded from the pervasive and long-lasting damage that tobacco products cause or compound.

Corrigendum: Mind the "vaccine fatigue".

[This corrects the article DOI: 10.3389/fimmu.2022.839433.].

Factors That Shape Women's Physical Activity: Development of the Reasons to Participate in Physical Activity Scale (RPPAS).

(1) Background: Obesity could deepen women's susceptibility to COVID-19 infections and deaths. While physical activity has the potential to improve women's physical and psychological resilience to the pandemic, there is a dearth of research on factors that motivate women's participation in physical activity. Thus, to bridge the research gap, this study aims to identify factors that motivate women's participation in physical activity. (2) Methods: An online survey on motivations for physical activity was developed and distributed to the participants. A total of 108 women offered complete answers (N = 108, 18-33 years old, Mage = 20.34 ± 2.42 years). Participants selected factors that promote their physical activity from a list of 34 factors from the Reasons to Participate in Physical Activity Scale (RPPAS) developed in this study. (3) Results: Exploratory factor analysis revealed that factors that motivate women's participation in physical activity are: enjoyment and gratification, consideration for other activities (i.e., exergaming), health benefits, networking opportunities, and appearance and performance. Multiple linear regression analyses indicate that only consideration for appearance and performance was significantly associated with participants' physical activity levels after controlling for compounding factors. (4) Conclusions: The findings of this study underscore the importance of appearance and performance in shaping women's participation in physical activity. Furthermore, the results also emphasize the need for a nuanced understanding of factors that influence women's physical activity levels. Future research could investigate how to leverage these motivators in tailored health interventions that aim to improve women's physical activity.