A country's efforts toward creating an advanced practice nurse in public health.

AIM: The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. BACKGROUND: No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population-based activities such as chronic and acute disease treatment. INTRODUCTION: An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. METHODS: This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). FINDINGS: Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. DISCUSSION: Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population-based model rather than the traditional PHN model. CONCLUSIONS: A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. IMPLICATION FOR NURSING POLICY: Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.

Agrochemical-free genetically modified and genome-edited crops - towards a 'greener' green revolution and achieving the United Nation's Sustainable Development Goals.

Sustainable farming on ever-shrinking agricultural land and declining water resources for the growing human population is one of the greatest environmental and food security challenges of the 21st century. Conventional, age-old organic farming practices alone, and foods based on costly cellular agriculture, do not have the potential to be upscaled to meet the food supply challenges for feeding large populations. Additionally, agricultural practices relying on chemical inputs have a well-documented detrimental impact on human health and the environment. As the available farming methods have reached their productivity limits, new approaches to agriculture, combining friendly, age-old farming practices with modern technologies that exclude chemical interventions, are necessary to address the food production challenges. Growing genetically modified (GM) crops without chemical inputs can allow agricultural intensification with reduced adverse health and environmental impacts. Additionally, integrating high-value pleiotropic genes in their genetic improvement coupled with the use of modern agricultural technologies, like robotics and artificial intelligence (AI), will further improve productivity. Such 'organic-GM' crops will offer consumers healthy, agrochemical-free GM produce. We believe these agricultural practices will lead to the beginning of a potentially new chemical-free GM agricultural revolution in the era of Agriculture 4.0 and help meet the targets of the United Nation's Sustainable Development Goals (SDGs). Furthermore, given the advancement in the genome editing (GE) toolbox, we ought to develop a new category of 'trait-reversible GM crops' to avert the fears of those who believe in ecological damage by GM crops. Thus, in this article, we advocate farming with no or minimal chemical use by combining chemical-free organic farming with the existing biofortified and multiple stress tolerant GM crops, while focusing on the development of novel 'biofertilizer-responsive GE crops' and 'trait-reversible GE crops' for the future.

Female genital mutilation: trends, economic burden of delay and basis for public health interventions.

BACKGROUND: The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. METHODS: Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. RESULTS: For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR - 1.01 and - 10.26) while five, Côte d'Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and < 0). Among these five are the highest FGM prevalence similar distribution regardless the wealth quintiles or residence. There is an economic burden of delay or non-decline of FGM that could be averted. CONCLUSION: Findings indicate that some countries show a declining trend over time while others not. It can be observed that there is heterogeneity and homogeneity in the FGM prevalence within and between countries which may indicate inequality that deserves further investigation. There is considerable economic burden due to delays in the implementation of interventions to reduce or eliminate FGM. These insights can help in the preparation of public health interventions.

Mitigating air pollution benefits multiple sustainable development goals in China.

Achieving the United nations 2030 Sustainable Development Goals (SDGs) remains a significant challenge, necessitating urgent and prioritized strategies. Among the various challenges, air pollution continues to pose one of the most substantial threats to the SDGs due to its widespread adverse effects on human health and ecosystems. However, the connections between air pollution and the SDGs have often been overlooked. This study reveals that out of the 169 SDG targets, 71 are adversely impacted by air pollution, while only 6 show potential positive effects. In China, two major atmospheric nitrogen pollutants, ammonia and nitrogen oxides, resulted in an economic loss of 400 billion United States Dollar (USD) in 2020, which could be reduced by 33% and 34% by 2030, respectively. It would enhance the progress towards SDGs in China by 14%, directly contributing to the achievement of SDGs 1 to 6 and 11 to 15. This improvement is estimated to yield overall benefits totaling 119 billion USD, exceeded the total implementation cost of 82 billion USD with ammonia as the preferential mitigation target. This study underscores the importance of robust scientific evidence in integrated policies aimed at aligning improvements in environmental quality with the priorities of sustainable development.

Transforming pollution into solutions: A bibliometric analysis and sustainable strategies for reducing indoor microplastics while converting to value-added products.

Microplastics (MPs), as emerging indoor contaminants, have garnered attention due to their ubiquity and unresolved implications for human health. These tiny particles have permeated indoor air and water, leading to inevitable human exposure. Preliminary evidence suggests MP exposure could be linked to respiratory, gastrointestinal, and potentially other health issues, yet the full scope of their effects remains unclear. To map the overall landscape of this research field, a bibliometric analysis based on research articles retrieved from the Web of Science database was conducted. The study synthesizes the current state of knowledge and spotlights the innovative mitigation strategies proposed to curb indoor MP pollution. These strategies involve minimizing the MP emission from source, advancements in filtration technology, aimed at reducing the MP exposure. Furthermore, this research sheds light on cutting-edge methods for converting MP waste into value-added products. These innovative approaches not only promise to alleviate environmental burdens but also contribute to a more sustainable and circular economy by transforming waste into resources such as biofuels, construction materials, and batteries. Despite these strides, this study acknowledges the ongoing challenges, including the need for more efficient removal technologies and a deeper understanding of MPs' health impacts. Looking forward, the study underscores the necessity for further research to fill these knowledge gaps, particularly in the areas of long-term health outcomes and the development of standardized, reliable methodologies for MP detection and quantification in indoor settings. This comprehensive approach paves the way for future exploration and the development of robust solutions to the complex issue of microplastic pollution.

Food-Energy-Water Nexus in compliance with Sustainable Development Goals for integrating and managing the core environmental verticals for sustainable energy and circular economy.

Food, energy, and water resources are intricately interconnected, and nexus provides a holistic approach for addressing these complex links to minimize inefficiencies and waste. Nexus approach and circular economy are considered as effective solutions for sustainability. Quantification of these relations is the first step towards incorporating nexus modeling which helps sustainable production and consumption. For achieving the Sustainable Development Goals, understanding and effectively managing the FEW nexus becomes imperative. With an integral performance perspective, there is a need to address the interdependencies and trade-offs among food, energy, and water systems and challenges of economic, social and environmental sustainability. The aim of this study is to provide a comprehensive analysis of the FEW nexus, identify key opportunities and challenges, and propose integrated strategies for managing these core environmental verticals sustainably. The study addresses the accomplishment of these goals through nexus approaches and outlines the need for technological advancements for shared benefits among resources, contributing to conceptual development of nexus and circular economy. The results highlight the critical importance of adopting a nexus approach to advance sustainable development goals, enhance resource efficiency, and promote synergistic solutions across food, energy, and water systems.

A recipe for change: Analyzing the climate and ecosystem impacts of the Brazilian diet shift.

Diet shift is an opportunity to mitigate the impacts of food systems, which are responsible for about a third of greenhouse gas (GHG) emissions globally and exert various environmental pressures on ecosystems. This study evaluates the mitigation potential of both global and local environmental impacts through dietary changes within the Brazilian context. Furthermore, the study aims to identify the potential benefits and trade-offs that may arise from these dietary transitions, thus providing a comprehensive analysis of the overall environmental implications. To this end, a life cycle assessment (LCA) was performed to evaluate the environmental impacts of a conventional diet in Brazil and seven alternatives, namely adjusted-EAT-Lancet, pescatarian, vegetarian, entomophagic (insect-based food), mycoprotein (microbial-based food), and synthetic (cell-based food) diets. Results indicate a substantial mitigation potential for GHG emissions (4-9 kg CO2e/cap/day) (39 % to 86 %) and land use (4-9 m2/cap/day) (38 % to 82 %) through a diet shift from a conventional diet to any of the seven alternative diets. However, certain trade-offs exist. A diet shift demonstrates no mitigation potential of soil acidification, and opportunities to reduce water eutrophication (0.02-0.2 g Pe/cap/day) (2 % to 24 %) and water consumption (0.2-0.5 m3/cap/day) (7 % to 14 %) were only found by completely substituting animal products for insect-based food, microbial-based food, and cell-based food. This study highlights the considerable potential of dietary changes to mitigate global environmental impacts associated with food systems. By revealing opportunities and challenges, this study supports science-based decision-making and guides efforts toward sustainable and environmentally friendly food consumption patterns.

Global health systems strengthening: FIGO's strategic view on reducing maternal and newborn mortality worldwide.

OBJECTIVE: To demonstrate that successful health systems strengthening (HSS) projects have addressed disparities and inequities in maternal and perinatal care in low-income countries. METHODS: A comprehensive literature review covered the period between 1980 and 2022, focusing on successful HSS interventions within health systems' seven core components that improved maternal and perinatal care. RESULTS: The findings highlight the importance of integrating quality interventions into robust health systems, as this has been shown to reduce maternal and newborn mortality. However, several challenges, including service delivery gaps, poor data use, and funding deficits, continue to hinder the delivery of quality care. To improve maternal and newborn health outcomes, a comprehensive HSS strategy is essential, which should include infrastructure enhancement, workforce skill development, access to essential medicines, and active community engagement. CONCLUSION: Effective health systems, leadership, and community engagement are crucial for a comprehensive HSS approach to catalyze progress toward universal health coverage and global improvements in maternal and newborn health.

Sustainable Development Goals' health-related indicators for Brazil and Ecuador: an analysis for the period of 1990-2019.

OBJECTIVE: This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. STUDY DESIGN: Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. METHODS: Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. RESULTS: Both countries have made progress on child stunting (Brazil: PC = -38%; Ecuador: PC = -43%) and child wasting prevalences (Brazil: PC = -42%; Ecuador: PC = -41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = -75%; Ecuador: PC = -60%) and neonatal mortality rates (Brazil: PC = -69%; Ecuador: PC = -51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = -40%; Ecuador: PC = -58%), tuberculosis (Brazil: PC = -27%; Ecuador: PC = -55%) and malaria incidences (Brazil: PC = -97%; Ecuador: PC = -100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = -89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = -37%; Ecuador: PC = -40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = -67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). CONCLUSIONS: Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters.

Ecosystem services potential is declining across European capital metropolitan areas.

Ecosystem services (ES) are essential to sustainable development at multiple spatial scales. Monitoring ES potential (ESP) at the metropolitan level is imperative to sustainable cities. We developed a procedure for long-term monitoring of metropolitan ESP dynamics, utilizing open-source land use land cover (LULC) data and the expert matrix method. We compared the ESP results of 38 European Capital Metropolitan Areas (ECMA) regarding biodiversity integrity, drinking water provision, flood protection, air quality, water purification, and recreation & tourism. Our results show significant declines in ESP across ECMA due to LULC alteration between 2006, 2012, and 2018. We found that ECMA in post-socialist European countries like Poland (Warszawa) have experienced high rates of land use transformation with a remarkable impact on ESP. Surprisingly, we found that Fennoscandinan ECMA, like Helsinki, Stockholm, and Oslo which lead the cumulative ESP ranking, faced the ESP reduction of the highest impact in recent years. The correlation analysis of ESP dynamics to urban expansion and population growth rates suggests that inattentive urbanization processes impact ESP more than population growth. We unveil the implications of our results to the EU and global level agendas like the European Nature Conservation Law and the Sustainable Development Goals.

Knowledge, Attitudes and Practices of Chagas a Neglected Tropical Disease in Rural Communities of the Colombian Caribbean, CHAGCOV Study.

PURPOSE: Chagas disease (CD) a Neglected Tropical Diseases is an important public health issue in countries where is still endemic, included in the Sustainable Development Goals (SDG). Traditionally restricted to rural areas with diverse routes of transmissions from vectorial to oral with acute manifestations but being more common diagnosed in chronic stages. The aim of this investigation was to characterize the Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD) in two rural settlements of the Colombian Caribbean with previous records of the disease and/or the parasite. METHODS: A cross-sectional descriptive study was made in two rural settlements in Colombia and surveillance instrument was developed to measure Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD). RESULTS: In a population with > 60% women and access to social security around 66.5%; 81,6% were homeowners with access to water and electricity > 90% but only 9% of sewerage. The level of knowledge about CD was around 62% but lack of specificity about comprehension of transmission routes (74,6%), and symptoms (85,3%) were found; concluding that 86% of the surveyed sample had very poor level of knowledge about the disease despite preventive campaigns carried out in the two communities studied. CONCLUSIONS: Despite of a low frequency of CD in this Caribbean areas, the presence of vector, risk factors plus poor level of knowledge about the disease justify that public health intervention strategies should be implemented and monitored over time to maintain uninterrupted surveillance of Chagas Disease.

Exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) at Nigeria's petrol stations: a review of current status, challenges and future directions.

Introduction: In Nigeria, because of increasing population, urbanization, industrialization, and auto-mobilization, petrol is the most everyday non-edible commodity, and it is the leading petroleum product traded at the proliferating Nigeria's petrol stations (NPSs). However, because of inadequate occupational health and safety (OHS) regulatory measures, working at NPSs exposes petrol station workers (PSWs) to a large amount of hazardous benzene, toluene, ethylbenzene, and xylene (BTEX) compounds. Methods: Studies on BTEX exposures among Nigerian PSWs are scarce. Thus, constraints in quantifying the health risks of BTEX limit stakeholders' ability to design practical risk assessment and risk control strategies. This paper reviews studies on the OHS of Nigerian PSWs at the NPSs. Results: Although knowledge, attitude, and practices on OHS in NPSs vary from one Nigeria's study setting to another, generally, safety practices, awareness about hazards and personal protective equipment (PPE), and the use of PPE among PSWs fell below expectations. Additionally, air quality at NPSs was poor, with a high content of BTEX and levels of carbon monoxide, hydrogen sulfide, particulate matter, and formaldehyde higher than the World Health Organization guideline limits. Discussion: Currently, regulatory bodies' effectiveness and accountability in safeguarding OHS at NPSs leave much to be desired. Understanding the OHS of NPSs would inform future initiatives, policies, and regulations that would promote the health and safety of workers at NPSs. However, further studies need to be conducted to describe the vulnerability of PSWs and other Nigerians who are occupationally exposed to BTEX pollution. More importantly, controlling air pollution from hazardous air pollutants like BTEX is an essential component of OHS and integral to attaining the Sustainable Development Goals (SDG) 3, 7, and 11.

Risk allocation schemes between public and private sectors in green energy projects.

In this research, we analyse how project risk allocation strategies impact the volume of private investment in renewable energy projects with the participation of both the public and private sectors. To this purpose, we analyse a sample formed by 2215 projects performed in 73 developing countries in the period 1997-2019 involving the following technologies: solar, hydro, wind, waste, biogas, biomass, and geothermal. Our findings reveal that those projects performed through governance schemes in which the private partner takes more project responsibilities attract more private money. Additional drivers for attracting private investment at the project level and institutional level are found. Furthermore, we reveal that the transference of project risks to the private partner emerges as a very relevant project feature that interacts with some of the project and institutional factors, revealing both complementary and substitution effects. The significance of this research extends beyond academia, since there are factors influencing private investment that can be controlled by various stakeholders in projects (such as policymakers, private investors, and project managers). Understanding their impact, significance, and interaction effects-factors that sometimes moderate or accentuate private investment-is crucial. The identified patterns illuminate optimal risk allocation practices, offering practical insights to enhance the effectiveness and sustainability of projects.

Effects of COVID-19 on coastal and marine environments: Aggravated microplastic pollution, improved air quality, and future perspective.

The COVID-19 pandemic during 2020-2023 has wrought adverse impacts on coastal and marine environments. This study conducts a comprehensive review of the collateral effects of COVID-19 on these ecosystems through literature review and bibliometric analysis. According to the output and citation analysis of these publications, researchers from the coastal countries in Asia, Europe, and America payed more attentions to this environmental issue than other continents. Specifically, India, China, and USA were the top three countries in the publications, with the proportion of 19.55%, 18.99%, and 12.01%, respectively. The COVID-19 pandemic significantly aggravated the plastic and microplastic pollution in coastal and marine environments by explosive production and unproper management of personal protective equipment (PPE). During the pandemic, the estimated mismanaged PPE waste ranged from 16.50 t/yr in Sweden to 250,371.39 t/yr in Indonesia. In addition, the PPE density ranged from 1.13 × 10-5 item/m2 to 2.79 item/m2 in the coastal regions worldwide, showing significant geographical variations. Besides, the emerging contaminants released from PPE into the coastal and marine environments cannot be neglected. The positive influence was that the COVID-19 lockdown worldwide reduced the release of air pollutants (e.g., fine particulate matter, NO2, CO, and SO2) and improved the air quality. The study also analyzed the relationships between sustainable development goals (SDGs) and the publications and revealed the dynamic changes of SDGs in different periods the COVID-19 pandemic. In conclusion, the air was cleaner due to the lockdown, but the coastal and marine contamination of plastic, microplastic, and emerging contaminants got worse during the COVID-19 pandemic. Last but not least, the study proposed four strategies to deal with the coastal and marine pollution caused by COVID-19, which were regular marine monitoring, performance of risk assessment, effective regulation of plastic wastes, and close international cooperation.

Challenges of animals shelters in caring for dogs infected with Leishmania and other pathogens.

The incidence of human Visceral Leishmaniasis (VL) has decreased in Brazil; however, the number of areas reporting human and canine cases has increased, with Leishmania infantum usually preceding human infection. This study aimed to analyze the profile of infectious diseases that are endemic for both human and canine VL, in dogs housed in a shelter located in the state of Rio Grande do Norte, Northeast Brazil. Data was obtained between November/2021 to April/2022. All dogs residing at the shelter (98 dogs) were examined and blood was collected for testing for L. infantum, Ehrlichia canis, and Babesia sp. Statistical analyses considered the clinical and laboratory findings. Of the 98 animals, approximately 43% were positive for L. infantum antibodies, 19% were positive for L. infantum kDNA, and 18% were L. infantum positive by culture. Greater levels of anti-leishmania antibodies were observed in dogs with symptoms suggestive of VL. The dogs tested positive for E. canis (19/98) and B. canis (18/98). Lutzomyia longipalpis was captured inside the shelter, representing 74.25% (n = 225) of whole sandflies in the dog shelter. Concomitant infection by L. infantum and E. canis increased the odds of death. Treatment of VL included the use of allopurinol (n = 48) and miltefosine (n = 8). Treated animals showed more signs of Leishmania infection. Tickborn parasites and Leishmania were prevalent in sheltered dogs in a VL-endemic area, which increases the odds of death and poses an additional challenge for caring for abandoned dogs and at the same time setting protocols to manage reservoirs of L. infantum.

Barriers to Adopting a Plant-Based Diet in High-Income Countries: A Systematic Review.

Adopting a plant-based diet (PBD) has been shown to reduce the risk of developing certain diseases and is linked to environmental benefits. This review synthesises the evidence on the barriers adults aged 18 to 65 living in high-income countries (HIC) may experience when adopting a PBD. A systematic literature review was conducted using four search databases: Medline, Embase, Global Health, and Web of Science. Barriers were mapped to behaviour change strategies using the COM-B model. Ten studies were included in the final review, including 1740 participants. Five were qualitative, four were cross-sectional, and one was a pre- and-post-intervention study. In total, 40 barriers were identified and synthesised into 11 themes: financial, lack of knowledge, emotional, health, convenience, social, enjoyment of meat, environmental, accessibility, personal ability, and media. Of the 40 barriers, nutritional intake/requirements (categorised into the "health" theme) had the most evidence. This barrier encompassed concerns around being able to meet nutritional needs if an individual were to adopt a PBD. Habits (in the "personal ability" theme), which included established eating habits and habitual behaviours relating to animal-source foods, had the second most evidence alongside the barrier of not knowing what to eat as part of a PBD (in the "lack of knowledge" theme). Education interventions and communication/marketing policies were the behaviour change mechanisms mapped onto these barriers. Future interventions should focus on informing individuals about what to consume as part of a nutritionally balanced PBD and facilitating habitual dietary change.