公共卫生研究摘要 (2026-01-14)
共收录 58 篇研究文章
1. Hearing Loss as a Neurological Manifestation of Diabetes.
期刊: The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses 发表日期: 2026-Jan-13 链接: PubMed
摘要
Diabetes mellitus affects millions of people and is a significant public health concern. Neurologically, hearing occurs with intact outer, middle, and inner ear functioning, with brain recognition and decoding. Hearing impairments are underrecognized and contribute to safety issues and poor quality of life. CONTENT: This article identifies how diabetes contributes to neurological changes that manifest as impaired hearing and balance. A pathophysiological review of the auditory pathway and ongoing theories of diabetes-related changes in the auditory nerves and blood vessels results in impaired hearing and balance. SUMMARY: Neuroscience nurses benefit from understanding how uncontrolled diabetes and nerve destruction impact communication, quality of life, and safety. Diabetic neuropathy does not exist in isolation and hearing loss often goes unappreciated.
2. Explainable AI for Predicting Mortality Risk in Metastatic Cancer: Retrospective Cohort Study Using the Memorial Sloan Kettering-Metastatic Dataset.
期刊: JMIR cancer 发表日期: 2026-Jan-13 链接: PubMed
摘要
Metastatic cancer remains one of the leading causes of cancer-related mortality worldwide. Yet, the prediction of survivability in this population remains limited by heterogeneous clinical presentations and high-dimensional molecular features. Advances in machine learning (ML) provide an opportunity to integrate diverse patient- and tumor-level factors into explainable predictive ML models. Leveraging large real-world datasets and modern ML techniques can enable improved risk stratification and precision oncology. This study aimed to develop and interpret ML models for predicting overall survival in patients with metastatic cancer using the Memorial Sloan Kettering-Metastatic (MSK-MET) dataset and to identify key prognostic biomarkers through explainable artificial intelligence techniques. We performed a retrospective analysis of the MSK-MET cohort, comprising 25,775 patients across 27 tumor types. After data cleaning and balancing, 20,338 patients were included. Overall survival was defined as deceased versus living at last follow-up. Five classifiers (extreme gradient boosting [XGBoost], logistic regression, random forest, decision tree, and naive Bayes) were trained using an 80/20 stratified split and optimized via grid search with 5-fold cross-validation. Model performance was assessed using accuracy, area under the curve (AUC), precision, recall, and F1-score. Model explainability was achieved using Shapley additive explanations (SHAP). Survival analyses included Kaplan-Meier estimates, Cox proportional hazards models, and an XGBoost-Cox model for time-to-event prediction. The positive predictive value and negative predictive value were calculated at the Youden index-optimal threshold. XGBoost achieved the highest performance (accuracy=0.74; AUC=0.82), outperforming other classifiers. In survival analyses, the XGBoost-Cox model with a concordance index (C-index) of 0.70 exceeded the traditional Cox model (C-index=0.66). SHAP analysis and Cox models consistently identified metastatic site count, tumor mutational burden, fraction of genome altered, and the presence of distant liver and bone metastases as among the strongest prognostic factors, a pattern that held at both the pan-cancer level and recurrently across cancer-specific models. At the cancer-specific level, performance varied; prostate cancer achieved the highest predictive accuracy (AUC=0.88), while pancreatic cancer was notably more challenging (AUC=0.68). Kaplan-Meier analyses demonstrated marked survival separation between patients with and without metastases (80-month survival: approximately 0.80 vs 0.30). At the Youden-optimal threshold, positive predictive value and negative predictive value were approximately 70% and 80%, respectively, supporting clinical use for risk stratification. Explainable ML models, particularly XGBoost combined with SHAP, can strongly predict survivability in metastatic cancers while highlighting clinically meaningful features. These findings support the use of ML-based tools for patient counseling, treatment planning, and integration into precision oncology workflows. Future work should include external validation on independent cohorts, integration with electronic health records via Fast Healthcare Interoperability Resources-based dashboards, and prospective clinician-in-the-loop evaluation to assess real-world use.
3. Cluster Randomized Controlled Trial to Promote Physical Activity Among Low-Resourced Mothers in New York City: Protocol for the Free Time for Wellness Effectiveness Trial.
期刊: JMIR research protocols 发表日期: 2026-Jan-13 链接: PubMed
摘要
Physical inactivity is pervasive and prevalent in the United States, particularly among women of low socioeconomic position and women with children. Structural and social barriers make active leisure time a rare commodity, creating a pressing health issue because physical inactivity increases the risk of chronic diseases and poor health. The broad objective of this study is to test the effectiveness of Free Time for Wellness, a multilevel intervention to increase physical activity among low-resourced mothers. This study comprises a 3-arm parallel cluster randomized controlled trial (RCT) with low-resourced mothers living in New York City. We will randomize fitness class sites (clusters) into arm A (contact control), receipt of free weekly fitness classes; arm B, receipt of free childcare combined with free weekly fitness classes; and arm C, receipt of free childcare combined with free weekly fitness classes and peer support activities. Over 2 years, we will recruit a pilot wave followed by 7 additional waves, totaling 720 participants into 24 fitness classes. Physical activity is the primary outcome, measured using accelerometers, but secondary outcomes also include physical activity assessed using a self-reported questionnaire and attendance data. We will assess additional secondary outcomes (eg, health status, depression, and anxiety) and mediators or moderators (eg, social support and cohesion) with a baseline and follow-up questionnaire. The intention-to-treat analysis will use linear mixed-effects models to assess the main intervention effects on physical activity outcomes and other secondary outcomes. Ethnographic methods will examine how intersecting forms of social identity shape women’s experiences of physical activity and understand how real-world conditions shape the intervention implementation. The study received funding from the US National Institute of Health, covering the period of time from April 1, 2023, through March 31, 2028. We received initial institutional review board approval in August 2023. The study is active and recruiting participants. As of the day of manuscript submission, we have enrolled 471 participants. Data collection is anticipated to occur until September 2026 for primary completion. The estimated study completion date is December 2026. Dissemination of the results will take place with participants, community members, partners, and researchers through methods such as reports, websites, events, and academic publications and conferences. This cluster RCT tests whether access to childcare (an understudied structural barrier) and social support can increase physical activity. The study design and outcomes integrate ethnographic methods with a cluster RCT to better understand mechanisms and the impact of intersecting factors such as race or ethnicity, culture, gender, and socioeconomic position. The study leverages widely accessible, existing resources to promote physical activity and foster social support with the ultimate goal of assessing the effect of childcare access on parental health. ClinicalTrials.gov NCT06654843; https://clinicaltrials.gov/study/NCT06654843. DERR1-10.2196/71381.
4. The energy burden of care: Insights from a regional survey in Italian hospitals.
期刊: Health services management research 发表日期: 2026-Jan-13 链接: PubMed
摘要
IntroductionHospitals are among the most energy-intensive public infrastructures due to their continuous operations and complex systems. Despite the strategic importance of energy management in healthcare, detailed benchmarks for hospital energy costs remain limited in Italy.MethodsThis study analyzes energy-related facility management expenditures in 27 public hospitals in Lombardy between 2019 and 2022. Data were collected via a structured survey, focusing on electricity and heating expenditures. Parametric values were calculated in €/sqm and hospitals were classified by complexity (Basic, DEA I, DEA II).ResultsThe results reveal that energy costs represent approximately 48% of total facility management expenses. Over the 4-year period, total energy expenditures rose by 51.22%, with the most significant increases in 2021-2022. Parametric values varied by hospital type: from €71.64/sqm in Basic Hospitals to €101.65/sqm in DEA II. Though newer buildings generally showed lower energy costs, building age alone did not fully explain cost variability.ConclusionsThe study provides a first benchmarking effort on hospital energy costs in the Italian context. The findings highlight the need for energy monitoring, retrofitting, and the adoption of efficiency-oriented management strategies, providing actionable insights for infrastructure planning and healthcare policy.
5. Association Between Sociodemographic Marginalization and Combination Therapy for Metastatic Hormone-Sensitive Prostate Cancer: Population-Based Cohort Study in Ontario, Canada.
期刊: JCO oncology practice 发表日期: 2026-Jan-13 链接: PubMed
摘要
Combination therapy, which adds docetaxel or androgen receptor pathway inhibitors (ARPIs) to androgen deprivation therapy, improves overall survival in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Despite strong clinical evidence and guideline support, real-world use of these therapies remains suboptimal. The extent to which sociodemographic marginalization contributes to this gap in care is poorly understood. We conducted a population-based cohort study in Ontario, Canada, including patients 66 years or older diagnosed with de novo mHSPC between 2014 and 2022. The primary exposure was marginalization, measured using the Ontario Marginalization Index (ON-MARG), which captures area-level socioeconomic disadvantage across four domains: residential instability, material deprivation, age and labor force participation, and racialized and newcomer populations. We used hierarchical logistic regression models to assess the association between ON-MARG and receipt of combination therapy, adjusting for demographic, clinical, and physician-level factors. A secondary exposure examined socioeconomic status using a hybrid measure combining rurality and urban income quintile. We included data from 6,051 men. Higher overall ON-MARG scores were associated with lower odds of receiving combination therapy (odds ratio [OR], 0.91 [95% CI, 0.83 to 0.99]). The most pronounced disparity was observed in the domain capturing racialized and newcomer populations (OR, 0.89 [95% CI, 0.81 to 0.97). Patients residing in higher median household income urban areas had greater odds of combination therapy compared with rural residents (OR, 1.39 [95% CI, 1.08 to 1.79]). Despite universal health care, access to combination therapy for mHSPC remains inequitable, particularly among patients living in marginalized, rural, and/or low-income communities. These disparities underscore the need for equity-driven policy interventions to ensure that all patients with mHSPC benefit from life-prolonging treatment advances.
6. Patient Engagement With Clinicians and Family Members About Genetic Test Results Across Risk Groups in Women With Hereditary Cancer Susceptibility.
期刊: JCO oncology practice 发表日期: 2026-Jan-13 链接: PubMed
摘要
To examine patient report of engagement with clinicians and relatives about their germline genetic test results across risk groups in women diagnosed with cancer. We surveyed women age 20-79 years diagnosed with breast, ovarian, or uterine cancer in 2018-19 in Georgia or California, in whom a germline genetic testing yielded a pathogenic variant (PV) in a breast, ovarian, or uterine cancer susceptibility gene (grouped by high v moderate risk) or a variant of unknown significance (VUS) about 4 years after diagnosis (N = 1,767, 52.4% response rate). Most patients with PVs (84.5%) had a genetic counseling visit to discuss test results, and a majority (70.6%) were encouraged to share results with relatives with no difference across PV risk groups. Half of the patients with PV reported that a genetic counselor gave them advice about how to talk to relatives and one third reported that a counselor talked directly with a relative. Physician engagement with patients about family communication of test results was low: one third of patients with high-risk PV reported that their oncologist encouraged them to share results with relatives. Patients with PV shared test results with 80% of first-degree relatives and one third of second-degree relatives. Compared with patients with PVs, those with VUS had less engagement with clinicians about sharing test results with relatives; were less likely to believe that they had a responsibility to share results with family; and were less likely to share results with relatives. Patients with PVs share results with many family members but clinician support is insufficient, especially among cancer doctors. A substantial proportion of patients with VUS-only engage relatives about results but more research is needed about the nature of the discussions regarding these indeterminate findings.
7. Estimation of lifetime benefits from the optimisation of secondary prevention in patients with established atherosclerotic cardiovascular disease.
期刊: European journal of preventive cardiology 发表日期: 2026-Jan-13 链接: PubMed
摘要
Cardiovascular disease causes almost four million deaths in Europe, costing the EU €282billion/annum. Future mortality rate improvements will be gained through improving secondary prevention of atherosclerotic cardiovascular disease (ASCVD) events. Wide gaps exist between ASCVD prevention/treatment guidelines and their implementation across Europe. We aim to estimate lifetime benefits available via optimised secondary prevention in patients with ASCVD in Denmark, France, Germany, Italy, Poland, Spain and the UK. A literature review identified ASCVD risk factor prevalence in ASCVD populations in seven countries. The simulation used an analytical framework and the SMART-REACH survival model to derive event probabilities over 1-year, associated with being ‘at-risk’ and ‘risk free’. The effect of modifying four risk-factors in the SMART-REACH model - hypertension, hypercholesterolaemia, diabetes and tobacco smoking - was examined. The impact of improving treatment coverage and smoking cessation from (estimated) 43% to 70% (i.e. 70% of patients reach treatment targets/cease smoking) was analysed. Over 94,359 cardiovascular-event-free life years could be gained/year across seven countries by improving secondary ASCVD prevention: 25,333 years in Germany, 21,144 in Italy, 14,584 in France, 13,324 in the UK, 9,393 in Spain, 9,369 in Poland and 1,212 in Denmark. This is a step in better quantifying the impact of improved secondary ASCVD prevention, giving an indication of the potential of EU and national Cardiovascular Health Plans in cardiovascular survival gains. Countries should incentivise proactive identification of patients at risk and ensure subsequent, timely treatment according to guidelines. Future work should utilise updated data and modelling integrating additional cardiometabolic risk factors. This study estimates the potential health benefits of improving treatment for people with atherosclerotic cardiovascular disease (ASCVD) in seven European countries.Improving treatment for hypertension, hypercholesterolemia, diabetes mellitus and smoking cessation rates to 70% could save over 94,000 cardiovascular-event-free life years annually across Denmark, France, Germany, Italy, Poland, Spain, and the UK.The findings highlight the importance of closing the gap between clinical guidelines and real-world care to reduce deaths and improve cardiovascular health outcomes.
8. An App-Based Behavioral Support Intervention Promoting Physical Activity (APPROACH) in Patients Diagnosed With Breast, Prostate, or Colorectal Cancer: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2026-Jan-13 链接: PubMed
摘要
Strong evidence highlights that sufficient physical activity (PA) has multiple benefits for people living with and beyond cancer. However, many are not meeting PA recommendations. APPROACH is a trial of a theory-driven, app-based behavioral support intervention to promote brisk walking after breast, prostate, or colorectal cancer. The aim of this trial is to evaluate the efficacy and cost-effectiveness of the intervention. APPROACH is a multicenter, phase III, 2-armed, individually randomized controlled trial (N=472). We will recruit patients with localized breast, prostate, or colorectal cancer from hospitals in Yorkshire and surrounding areas in the North of England, United Kingdom, and randomize them 1:1 between the intervention and control arm (usual care). The intervention consists of an app designed for the general population to encourage brisk walking (NHS Active 10), supplemented with habit-based behavioral support, including 2 brief telephone or video calls, a leaflet, website, and walking planners. The primary endpoint is the difference between trial arms in the changes from baseline in activPAL-assessed average minutes of brisk walking (≥100 steps per minute) after 3 months. Demographic and medical characteristics will be collected through self-report and hospital records. Secondary outcomes (assessed at 0, 3, and 6 months) will be the other activPAL-assessed outcomes (brisk walking at 6 months, total steps, light PA, standing time, and sitting times, weekly metabolic equivalent of task), self-reported PA, and self-reported BMI and waist circumference. Patient-reported outcome measures of quality of life, fatigue, sleep, anxiety, depression, self-efficacy, habit strength for walking, and social support will also be collected. Interviews will explore experiences of receiving the intervention. We will use health economic modeling to estimate the cost-effectiveness of the intervention over a lifetime horizon. The study was funded in June 2019. Trial recruitment commenced in November 2023 and is planned to be completed in 2025. As of December 2025, a total of 473 participants have been randomized. The publication of the main results is expected in autumn 2027 after all follow-up data collection and analysis are complete. Overall findings will determine the clinical and cost-effectiveness of the intervention for patients diagnosed with breast, prostate, or colorectal cancer. If successful, APPROACH provides a potential model of supportive care to increase PA among people living with and beyond cancer. ISRCTN Registry ISRCTN14149329; https://www.isrctn.com/ISRCTN14149329. DERR1-10.2196/77096.
9. Correlates and Trends in Glucose Testing at Postpartum Checkups Among Women Diagnosed With Gestational Diabetes: Pregnancy Risk Assessment Monitoring System, 2016-2022.
期刊: Diabetes care 发表日期: 2026-Jan-13 链接: PubMed
摘要
10. Military training efficacy on physical fitness and mental health in college students.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-13 链接: PubMed
摘要
BackgroundUniversity military training enhances national defense awareness and cultivates strategic talent. Its effects on students’ physical fitness and psychological resilience remain underexplored.ObjectiveTo evaluate the impact of a 14-day military training program on physical performance and psychological resilience in first-year university students.MethodsSeventy-six students completed a 14-day military training program, while 33 students served as a physical fitness control group. Assessments included the Functional Movement Screen (FMS), Lower Quarter Y Balance Test (YBT-LQ), handgrip strength, core endurance, Sense of Coherence (SOC-13) scale, and weekly physical activity (IPAQ).ResultsMilitary training significantly improved FMS (males +6.9%, females +13.8%, p < 0.01), YBT scores (left limb both sexes, right limb females +5.1%, p = 0.009), and SOC-13 scores (+5.1%, p = 0.011). Female participants also showed increased dominant-hand grip strength (+6.3%, p = 0.047). Core endurance exhibited minor, non-significant sex-specific trends, with a slight decrease in males and a modest increase in females (12-35%). The physical fitness control group showed smaller FMS and grip strength improvements, no significant YBT gains, and no significant SOC-13 change. Correlation analyses revealed positive associations between physical performance, psychological resilience, and training duration, suggesting mutual reinforcement of physical and mental capacities.ConclusionsA 14-day military training program enhances lower-limb balance, functional movement, female grip strength, and psychological resilience. These findings support the effectiveness of short-term military training in improving both physical and mental readiness among university students, with potential sex-specific effects on both grip strength and core endurance.
11. Initial Low and Moderate Dose of Hydroxyurea Has a Durable Impact on Primary Stroke Prevention in Low-Income Settings.
期刊: Blood advances 发表日期: 2026-Jan-13 链接: PubMed
摘要
12. The role of physical activity in an obesogenic environment for cardiovascular risk reduction across the lifespan. A Scientific Statement of the European Association of Preventive Cardiology of the ESC.
期刊: European journal of preventive cardiology 发表日期: 2026-Jan-13 链接: PubMed
摘要
The rising prevalence of obesity poses an increasing burden on individuals, health care systems, and society. Obesity is the main risk factor for several cardiovascular diseases (CVD). Physical activity (PA) may help to reduce the risk for CVD across the lifespan independent of obesity. The obesogenic and built environment can influence obesity and PA. The primary objective of this scientific statement is to underscore the role of obesity as a risk factor for CVD and to explore how PA can be leveraged to mitigate CVD risk. A novel aspect is the examination of how environmental factors influence the feasibility and implementation of current PA guidelines. Rather than focusing exclusively on a specific age group, this scientific statement investigates how environmental determinants may affect the implementation of increasing PA throughout the lifespan by focusing on three age groups: children and adolescents (<18 years), adults (18-64 years), and older adults (≥65 years). Furthermore, this scientific statement analyses the association of the built environment on PA behaviour by conducting a scoping literature review to identify age-specific evidence regarding the relation of the built environment on PA across the lifespan. This review highlights potentially effective strategies to reduce CVD risk within the context of the built environment and provides practical implications for healthcare professionals and policymakers to increase PA behaviour on an individual and societal level. Altogether, the present work raises awareness of the broader challenges posed by obesity and advocates for PA as a key strategy to improve public health outcomes.
13. High Fasting Plasma Glucose in Early Pregnancy and Postpartum Diabetes in Chinese Women With Gestational Diabetes.
期刊: Diabetes care 发表日期: 2026-Jan-13 链接: PubMed
摘要
14. Trapeziometacarpal joint arthroplasty: avoiding imbalance and optimizing outcomes.
期刊: The Journal of hand surgery, European volume 发表日期: 2026-Jan-13 链接: PubMed
摘要
Trapeziometacarpal joint osteoarthritis is common and can lead to pain, loss of pinch strength, and progressive deformity, including the classic Z-deformity. Understanding the pathomechanics of the disease progression can help surgeons effectively balance trapeziometacarpal joint arthroplasty.Biomechanics:The disease process begins with resorption of the anterior beak of the thumb metacarpal, weakening the anterior oblique ligament. This alters joint contact mechanics, leading to thumb metacarpal flexion and dorsoradial subluxation. As deformity progresses, the effective excursion of the thenar muscles shortens, reducing grip efficiency. Compensation by the flexor pollicis longus produces distal phalanx flexion, which shifts load dorsally across the metacarpophalangeal joint and promotes hyperextension, culminating in the classic Z-deformity.Arthroplasty:Trapeziometacarpal joint arthroplasty aims to restore thumb column balance by correcting basal joint deformity. Correct component selection and alignment are critical to stability and function. Cup orientation within the trapezium should approximate the flexion-extension axis to reduce dislocation risk. Dual-mobility designs have lowered dislocation rates compared with single-mobility implants. Careful resection of osteophytes, particularly between the thumb and index metacarpals, is essential to prevent bony impingement. Metacarpophalangeal joint hyperextension often improves following TMC arthroplasty through secondary soft-tissue stabilization, reducing the need for adjunctive metacarpophalangeal procedures. Arthrodesis remains an option in selected cases with significant instability or degenerative change. Modern arthroplasty, particularly with dual-mobility prostheses, provides reliable correction of deformity, improved stability, and durable outcomes in patients with advanced TMC osteoarthritis. V.
15. A multiphase national study on patient glaucoma care priorities from the perspectives of patients and clinicians in Croatia.
期刊: European journal of ophthalmology 发表日期: 2026-Jan-13 链接: PubMed
摘要
Background/AimsThe goal of glaucoma care is to preserve vision and quality of life This study aimed to develop, and rank patient-centered priorities for glaucoma care in Croatia and compare them with the perspectives of ophthalmologists.MethodsA five-phase, Delphi-based national study was conducted involving patients of the Croatian National Glaucoma Referral Center and Croatian ophthalmologists. An initial 20-item questionnaire was completed by 75 patients to identify patient priorities in glaucoma care. The most frequent responses were synthesized into a final 12 patient-centered priority statements, which patients and clinicians ranked independently. Rankings were compared overall and across prespecified patient and clinician subgroups.ResultsThe 20-item questionnaire informed a final 12-item survey completed by 130 patients and 97 ophthalmologists. Highest-ranking items across stakeholders were impaired quality of life and fear of losing sight or independence; patient associations ranked lowest. Clinicians emphasized reducing topical therapy burden and side-effects, whereas patients prioritized innovative and curative treatments (including vision restoration), faster, simpler diagnostics, and better communication with clinicians. Subgroup analyses showed stable patterns across clinician groups; among patients, later disease stage shifted focus toward disease control, longer treatment duration increased preference for innovation, and urban-rural differences were minimal.ConclusionThis study provides a ranked, stakeholder-informed set of glaucoma-care priorities for Croatia. Patient perspectives centered on preventing sight loss, preserving independence, and reducing treatment burden, while highlighting unmet needs in innovation, diagnostics, and communication. These findings complement ongoing European Glaucoma Society initiatives and may inform future Europe-wide strategies in patient-centered glaucoma care.
16. Comparison of pain, depression, quality of life, grip strength, and balance according to physical activity levels in office workers.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-13 链接: PubMed
摘要
BackgroundMusculoskeletal problems are commonly observed among office workers.ObjectiveThis study aims to examine whether levels of physical activity are associated with differences in pain, depressive symptoms, quality of life, grip strength, and balance in office workers.Methods61 office workers (29 men and 32 women) who regularly used computers were included in the study. The Centers for Disease Control and Prevention Health-Related Quality of Life-4 for measuring the Quality of Life, the Visual Analog Scale for measuring pain, the Beck Depression Inventory for measuring mental health, the International Physical Activity Questionnaire-Short Form for measuring physical activity, the Biodex Balance System for measuring balance, and two distinct methods for measuring grip strength-the Jamar and Handgrip dynamometers-were all used in the assessments.ResultsA significant difference in pain during activity was found among the physical activity levels (inactive, minimally active, highly active) (p < 0.05). There was no difference in depression scores between the groups (p > 0.05). General quality of life scores were higher in the highly active group compared to both the inactive (p = 0.016) and minimally active (p = 0.020) groups. Right and left hand grip strength assessed with Jamar (p = 0.004, p = 0.044; respectively) and right hand grip strength assessed with handgrip (p = 0.04) were statistically significantly higher in the highly active group than in the inactive group. For balance with eyes open, anterior-posterior stabilization scores were significantly better in the highly active group compared to the inactive group (p = 0.004).ConclusionsPhysically active office workers exhibited superior outcomes in activity pain, quality of life, grip strength and balance compared to their less active counterparts.
17. Exploring Perceived Changes to Mental Health When Restricting and Resuming Specific Adaptive Daily Actions: Longitudinal Qualitative Substudy Within a Randomized Controlled Trial.
期刊: JMIR formative research 发表日期: 2026-Jan-13 链接: PubMed
摘要
Anxiety and depressive disorders are common and burdensome, yet many people prefer to self-manage and do not access treatment or fail to achieve meaningful improvement. Prior research indicates that the frequency of performing simple, everyday actions, namely “The Things You Do” (TYD; ie, healthy thinking, meaningful activities, having goals and plans, healthy routines, and social connection), is strongly associated with support mental health and well-being. This research has been primarily quantitative in nature, and so less is known about how people perceive and interpret changes in their mental health when engaging in or limiting these actions. This study aims to explore participants’ perceptions of mental health changes and associated insights into what most impacts their mental health, during a randomized controlled trial involving the systematic restriction and followed by the resumption of the TYD actions. This longitudinal qualitative substudy analyzed weekly free-text comments from 70 healthy Australian adults (intervention group [IG] n=36; control group [CG] n=34). IG participants completed an 8-week randomized controlled trial comprising 3 phases: a 2-week baseline phase (Phase A), a 2-week behavior restriction phase during which they reduced the frequency of the TYD actions (Phase B), and a 4-week recovery or resumption phase during which they increased the frequency of the TYD actions back to usual levels (Phase C). CG participants were instructed to maintain usual habits and activities. The weekly free-text comments were related to what participants had noticed and learned about their mental health. These were thematically analyzed using framework methods to identify patterns in perceived changes, considering trial phase, group allocation, and participant characteristics. Analyses identified five interrelated themes around what participants reportedly learned and what most impacted their mental health: (1) rhythms of daily life and routine, (2) harnessing internal psychological resources, (3) social support and interpersonal stressors, (4) staying active and enjoying yourself, and (5) environmental and external influences. In the IG, participants reported that behavioral restriction led to subjective disruptions across all 5 themes, precipitating declines in mood, energy, and stability; resumption fostered recovery, along with increased insights into oneself and mental health, coping strategies, and a sense of agency. Compared to the IG, the CG more often emphasized environmental and external influences. The findings reinforce the centrality of specific daily actions, namely the TYD, to people’s subjective well-being and suggest an additional “macro-level” comprising environmental and external influences. Exposure to behavioral restriction and resumption/recovery served to highlight the importance of certain factors for mental health and appeared to improve people’s sense of agency and locus of control regarding their mental health.
18. The new reality of occupational health in the face of climate change.
期刊: Hispanic health care international : the official journal of the National Association of Hispanic Nurses 发表日期: 2026-Jan-13 链接: PubMed
摘要
IntroductionClimate change has intensified extreme weather events, creating growing challenges for occupational health. Rising temperatures, air pollution, and climatic instability increase the burden of respiratory, cardiovascular, and mental health conditions among workers, particularly those exposed to adverse environmental conditions. Outdoor workers and individuals with pre-existing chronic diseases are especially vulnerable, while informal workers face compounded health and social risks. Addressing these challenges requires climate-adaptive workplaces, supportive occupational health policies, and coordinated action among governments, employers, and the scientific community to protect workers’ health in a changing climate.
19. Investigating the relationship between narcissism and procrastination and unsafe behavior among workers of one of the steel industries.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-13 链接: PubMed
摘要
BackgroundUnsafe behavior is a leading cause of occupational accidents, influenced by various background conditions, including personality traits. While past studies have qualitatively identified some of these traits, research on the impact of narcissism and procrastination on unsafe behavior is limited.ObjectiveThis study aimed to explore the relationship between narcissism, procrastination, and the tendency to engage in unsafe behavior among workers in a steel industry.MethodsThis cross-sectional study involved 199 workers from the one of the steel industry complex in Qom, Iran in 2024. Data were collected using questionnaires on demographic characteristics, unsafe behavior, narcissism, and procrastination. The unsafe behavior questionnaire consisted of 40 questions across 8 areas on a 4-option Likert scale. The narcissism and the procrastination questionnaires included 40, and 16 items, respectively. Statistical analysis was performed using SPSS 22.ResultsThe mean (SD) age and work experience of participants was 40.05 (9.55) and 12.29 (5.16) years, respectively. The mean (SD) scores for the questionnaires on unsafe behavior, narcissism, and procrastination were 103.06 (9.14), 61.12 (8.34), and 47.61 (9.14), respectively. Significant relationships were found between demographic variables and unsafe behavior, as well as between narcissism and the use of personal protective equipment. A direct and significant relationship was also observed between unsafe behavior and both narcissism and procrastination (p < 0.001).ConclusionThe personality traits of narcissism and procrastination influence unsafe behavior. Industry managers and decision-makers should consider these factors, along with other worker characteristics, to prevent unsafe behavior and occupational accidents.
20. Employee-nature interactions: A scoping review on employees' green exercise behaviors.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-13 链接: PubMed
摘要
BackgroundGreen exercise is emerging as a promising approach to improve employee well-being.ObjectiveThis scoping review aimed to map the existing literature on employees’ green exercise behaviors.MethodsFollowing the methodological framework suggested by Arksey and O’Malley, relevant studies were identified in the Web of Science and Scopus databases on March 10, 2025. Various study types, including quantitative, qualitative, mixed-methods, and intervention studies published in peer-reviewed English journals, were screened. 13 studies were selected for detailed review, focusing on employed adults engaging in intentional physical activity within natural or semi-natural outdoor environments, such as parks and forests. Exclusions were applied to studies involving non-working populations, those that focused on non-exercise behaviors, as well as studies conducted in indoor or virtual environments. Editorials, opinion articles, theses/dissertations, conference papers, and non-English publications were also excluded.ResultsAmong the included studies, nature walking was the most prevalent form of green exercise. Psychological outcomes were the most frequently reported, while occupational outcomes were the least commonly addressed. The findings suggest that there is a growing body of research supporting the benefits of green exercise for employees. However, there remains a significant gap in understanding the facilitators and barriers that influence employees’ participation in green exercise.ConclusionsFuture research should examine underlying mediating and moderating mechanisms. Integrating theoretical frameworks from occupational health psychology and behavioral sciences will be essential to develop a more comprehensive understanding of how and why green exercise is adopted or avoided by employees.
21. Validation of the Stroke Drivers' Screening Assessment in people with stroke in the Spanish context.
期刊: Clinical rehabilitation 发表日期: 2026-Jan-13 链接: PubMed
摘要
ObjectiveTo culturally adapt the Stroke Drivers’ Screening Assessment (SDSA) and evaluate its construct and predictive validity in a Spanish stroke population.DesignCultural adaptation and validation study.SettingHospitals and neurorehabilitation clinics in Spain.ParticipantsForty-five stroke patients completed the SDSA-Spain, a neuropsychological battery, and a road test.Adaptation processA panel of experts (two occupational therapists, a psychologist specializing in driving, and a driving instructor) adapted the SDSA to the Spanish context.Main measuresThe correlations of the SDSA-Spain with attention and memory tests, its ability to discriminate between fit and unfit drivers according to the instructor’s judgment, and its predictive validity for the road test were analyzed.ResultsThe SDSA-Spain correlated significantly with the Useful Field of View subtests 2 and 3, and with the Trail Making Test-part B time. No significant differences were observed in discriminative ability alone between pass and fail participants. A logistic regression was performed selecting Dot Cancellation-time, Dot Cancellation-errors, Road Sign Recognition from the Spanish SDSA, and Useful Field of View-subtest 2. The model achieved an area under the curve of 0.81, accuracy of 0.73, specificity of 0.75, and sensitivity of 0.714.ConclusionsThe SDSA-Spain is an off-road tool that can be useful for assessing fitness to drive in stroke patients, especially when combined with other tests.
22. The impact of compassion fatigue and work-life balance on life satisfaction: A study of healthcare professionals in Türkiye.
期刊: Work (Reading, Mass.) 发表日期: 2026-Jan-13 链接: PubMed
摘要
BackgroundHealthcare professionals are frequently exposed to intense emotional demands that may lead to compassion fatigue. Challenges in maintaining work-life balance also play a significant role in shaping life satisfaction. Yet, studies examining their combined effects on healthcare professionals’ life satisfaction remain limited.ObjectiveThis study aims to examine the impact of compassion fatigue and work-life balance on the life satisfaction of healthcare professionals.MethodsThis cross-sectional quantitative study collected data from 301 healthcare workers at Kahramanmaraş Sütçü İmam University Hospital in Türkiye, using validated psychometric scales. Analyses included reliability testing, normality assessment, confirmatory factor analysis, and structural equation modeling.ResultsChanges in life satisfaction were 11% attributable to compassion fatigue (R2 = 0.115). The occupational burnout subdimension negatively affected life satisfaction (ß = -0.363; t = -4.060; p < 0.001), with each unit increase resulting in a 0.175-point decrease in life satisfaction. Nine percent of the variation in life satisfaction (R2 = 0.099) was explained by the positive impact of work on life (ß = 0.190; t = 2.739; p = 0.007) and the positive impact of life on work (ß = 0.155; t = 2.377; p = 0.018). However, the negative impact of work on life caused a 0.132-point reduction in life satisfaction (ß = -0.151; t = -2.385; p = 0.018). Overall, compassion fatigue and work-life balance together explained 12% of the variation in life satisfaction (R2 = 0.125; F = 21.332; p < 0.001).ConclusionFindings underscore the importance of alleviating emotional burden and implementing institutional policies that support work-life balance to enhance healthcare professionals’ life satisfaction. However, because this study was conducted in a single hospital and employed a convenience sampling method, generalizability of the results is limited.
23. Occupational radiation exposure indicated by increased chromosomal damage in lymphocytes of orthopaedic surgeons in Japan.
期刊: Journal of radiation research 发表日期: 2026-Jan-13 链接: PubMed
摘要
This study aims to assess chromosome aberrations in peripheral blood lymphocytes of orthopaedic surgeons in Japan, specifically focusing on potential occupational dose overexposure and its correlation with adverse health reactions. The main objective is to investigate the extent of chromosomal damage and evaluate the accuracy of estimating radiation dose with cytogenetic biodosimetry where no physical dosimetry exists. This study involved 18 male orthopaedic surgeons, with occupational experience spanning 15 to 33 years. Chromosome aberrations were analyzed in 32 573 and 45 674 cells with dicentric chromosome and translocation assays, respectively. Statistical tests were used to retrospectively estimate whole-body doses with chromosome damage and compare observed aberration frequencies with work experience, while considering factors such as adverse health effects and skin cancer history. Materials and methods included information on study design, participant criteria and the procedures performed, using a retrospective approach. Participants had a mean age of 46 ± 6.6 years. Analysis revealed an increase in dicentric abnormalities compared to background levels, and translocations were observed above spontaneous levels in all surgeons but one. Surgeons reporting adverse health effects or skin cancer exhibited the highest chromosome aberrations frequencies. The estimated average whole-body doses were 75 ± 24 and 321 ± 103 mGy for dicentrics and translocations, respectively. Some Japanese orthopaedic surgeons demonstrated increased chromosome aberrations, especially in those reporting adverse health effects. Estimating radiation dose solely based on chromosomal damage is challenging, emphasizing the complexities of biological dosimetry for prior, partial and repeated exposures.
24. Waste anesthetic gas control: From discovery to source control scavenging in the postanesthesia care unit.
期刊: Journal of occupational and environmental hygiene 发表日期: 2026-Jan-13 链接: PubMed
摘要
The National Institute for Occupational Safety and Health (NIOSH) recently highlighted the presence of waste anesthetic gases (WAGs) in Postanesthesia Care Units (PACUs), raising significant concerns about occupational exposures in these environments. Exposure to WAGs is associated with a range of adverse health effects, from symptoms such as headaches and0 fatigue to more severe outcomes, including cancer, genetic mutations, reduced fertility, miscarriages, and congenital anomalies. The primary source of WAGs in PACUs is patient exhalation, as individuals leave the operating rooms (ORs) with lungs containing approximately 95% unmetabolized anesthetic gases, which are subsequently released into the ambient air. While NIOSH has emphasized the need for exposure controls in ORs, and the Occupational Safety and Health Administration (OSHA) has issued general (5a1) duty citations regarding WAG exposure in ORs, the risks within PACUs remain poorly recognized. As a result, PACU workers, particularly nurses, are left vulnerable due to the lack of effective source control measures. Furthermore, many PACU nurses and healthcare leaders are unaware of the occupational hazards posed by WAG exposure. This paper provides a brief overview, from WAG discovery to source control in the PACU. This paper highlights health risks associated with exposure to waste anesthetic gases (WAGs), with a focus on contamination levels in PACUs as reported by NIOSH. Evidence indicates that general ventilation and standard air exchange rates are insufficient to mitigate exposure within the patient breathing zone in PACUs. Source control technologies offer a promising solution to this underrecognized hazard. The role of the industrial hygienist is emphasized as critical in implementing protective strategies and advancing occupational health and safety for PACU personnel.
25. Coastal eutrophication and freshwater inputs drive acidification in the Indian River Lagoon, Florida.
期刊: Marine pollution bulletin 发表日期: 2026-Jan-12 链接: PubMed
摘要
The additive effects of eutrophication and acidification in coastal environments have a wide range of implications for the health of organisms and ecosystems. In the eutrophic waters of the Indian River Lagoon (IRL), FL, USA, decreases in overall shellfish size have been reported, which may be related to coastal acidification. To better understand the relationship between acidification and eutrophication in the IRL, environmental parameters, dissolved nutrients, and aragonite saturation state (Ωarag) were monitored along the entire IRL in the 2016-2017 wet and dry seasons. Additionally, three sites in the central IRL were sampled approximately weekly from June 2016-June 2017 to observe temporal variability. For the IRL-wide survey, northern sites with higher dissolved nutrient concentrations had lower Ωarag due to nutrient pollution and harmful algal blooms, while southern sites with lower salinity had lower Ωarag related to freshwater inputs (i.e., discharges and rainfall). In the time series sampling, there was a positive correlation between Ωarag with salinity and negative correlations with dissolved nutrient concentrations. This work suggests that freshwater inputs and associated dissolved nutrients and organics have implications for acidification in the IRL, which will be important considerations for restoration efforts in the IRL and beyond.
26. Rats, residues and rodenticide resistance: Hepatic concentration of anticoagulant rodenticides in genetically susceptible wild brown and black rats.
期刊: The Science of the total environment 发表日期: 2026-Jan-12 链接: PubMed
摘要
Invasive rats are major pests worldwide, posing economic and public health risks. Since the 1950s, efforts have been made to control or eradicate these animals by using anticoagulant rodenticides (ARs). Initially effective, ARs quickly lost efficacy due to the emergence of resistance-associated mutations in the Vkorc1 gene. When consumed in (sub-)lethal doses, these biocides bioaccumulate in the liver, becoming a risk for non-target predators. First, this study aims to assess genetic resistance to ARs in two synanthropic rat species, Rattus rattus and Rattus norvegicus, from port urban areas in Lisbon (mainland Portugal) and Ponta Delgada (São Miguel Island, Azores, Portugal). Secondly, we aim to detect and quantify the hepatic concentration of first- (FGARs) and second-generation anticoagulants (SGARs). We analysed 203 sequences of exon 3 of the Vkorc1 gene and found no known resistance-conferring mutations in either species or locations. A subsample of 177 liver tissues from genotyped rats was examined for AR residues via Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). No FGARs were detected, but five SGARs were identified with 80.4% of individuals accumulating at least one of them. The absence of genetically mediated resistance via exon 3 of Vkorc1 mutations does not necessarily mean that the risk of AR exposure to rat predators is low, as 16.0% of the live-trapped rats bioaccumulated high levels of ARs, above the 100 ng/g toxicosis threshold. This finding underscores significant ecological risks, particularly for non-target wildlife apex-predators, that are more susceptible to AR exposure and may bioaccumulate lethal concentrations through repeated consumption of contaminated prey.
27. Adverse childhood experiences and violence in adulthood: Exploring gendered patterns of victimization and perpetration.
期刊: Child abuse & neglect 发表日期: 2026-Jan-12 链接: PubMed
摘要
Adverse childhood experiences (ACEs) are well-established predictors of health and socioeconomic disadvantage across the life course, yet their implications for adult violence involvement-both victimization and perpetration-remain less understood. Clarifying these links is critical to understanding the broader social consequences of early adversity. This study investigated the relationship between ACEs and violence outcomes in adulthood, distinguishing between victimization and perpetration, and examined potential gender differences in these associations. Data were drawn from the National Longitudinal Study of Adolescent to Adult Health (N = 14,277). Ten ACE indicators were used to construct a cumulative ACE index as well as individual adversity measures. Violence outcomes in the past year were assessed separately for victimization and perpetration. Negative binomial regression models estimated associations, adjusting for a comprehensive set of individual and family covariates. Gender differences were assessed using gender-specific average marginal effects (AMEs) and AME contrasts. ACEs were strongly and positively associated with both victimization and perpetration. Several specific adversities, including physical abuse and community violence, showed the strongest independent associations. Gender analyses demonstrated that ACEs predicted higher violence involvement for both men and women, but the magnitude of the association was significantly greater for men. Childhood adversity has lasting consequences for adult violence involvement, and the strength of these effects differs by gender. Differentiating victimization from perpetration, modeling dose-response patterns, and probing gender heterogeneity deepen understanding of how early adversity shapes behavioral trajectories across the life course.
28. [Strategy for improving patient and users service for a public health system].
期刊: Journal of healthcare quality research 发表日期: 2026-Jan-12 链接: PubMed
摘要
The current health situation necessitates a paradigm shift in Patient Care Services to meet societal needs. The general objective wasto improve the quality and effectiveness of the Patient Care Service and users of a public health system. A systematic bibliographic review of aspects related to the Patient/User/Citizen Care Service was conducted, and a survey was developed on general and organizational aspects and the strategies followed by different hospitals in various Autonomous Communities. Significant differences in User Care Services exist between the Autonomous Communities in Spain due to the decentralization of the health system and outdated regulations. These differences include nomenclature, hierarchical dependence, organization and management, services offered, responsibilities, professional training, accessibility, implementation of user rights and duties, and citizen participation in health centers. The results highlight the need for a comprehensive model that combines personalization, technology, and citizen participation. This approach enhances the efficiency of User Care Services, strengthens equity, and reinforces institutional trust. In the face of the sociodemographic and structural challenges of the healthcare system, it is essential to move towards person-centered models, where the patient’s voice is integrated as a driver of quality and transformation.
29. Heatwaves, ageing, and dementia: assessing mortality risks and adaptation strategies in a warming China.
期刊: EBioMedicine 发表日期: 2026-Jan-12 链接: PubMed
摘要
30. Nursing leadership in Housing First implementation: A comparative analysis of care coordination approaches across four U.S. states.
期刊: Nursing outlook 发表日期: 2026-Jan-12 链接: PubMed
摘要
Homelessness affects over 650,000 Americans annually, with 25% to 30% experiencing co-occurring mental health and substance use disorders. Despite evidence supporting Housing First approaches, implementation remains inconsistent across states, leading to fragmented care delivery and persistent housing instability for vulnerable populations. To analyze Housing First implementation across four U.S. states and identify nursing practice and policy implications using the Minnesota Public Health Intervention Wheel framework. Comparative case study analysis of Housing First policies across California, Utah, Oregon, and Minnesota (2014-2025) using integrated Multiple Streams Framework and Health Policy Triangle approaches. Analysis examined policy adoption dynamics, implementation structures, and nursing contributions through case management, outreach, consultation, and systems-level advocacy. Four generalizable implementation pathways emerged: High-Mandate/Variable Practice (California), Transitional/Evolving (Utah), Emergent-Practice/Collaborative (Oregon), and Mature/Sustainable (Minnesota). Governance capacity and cross-sector coordination proved more critical than legislative mandate strength. States with integrated Medicaid financing and stable interagency coordination demonstrated superior outcomes, with nursing coordination improving medication adherence (45%-50% to 70%-85%), reducing psychiatric readmissions (25%-40%), and decreasing emergency department utilization. Nursing leadership significantly enhances Housing First implementation effectiveness. Medicaid-funded care coordination, operationalized through public health nursing interventions, demonstrates pathways toward comprehensive care improving housing stability and health outcomes for vulnerable populations.
31. Risk Score Development to Predict Postpartum Cardiovascular Disease Incorporating Pregnancy and Nonpregnancy Factors: A Canada-Wide Study.
期刊: JACC. Advances 发表日期: 2026-Jan-12 链接: PubMed
摘要
Pregnancy events including severe maternal morbidity are associated with future cardiovascular disease (CVD), yet no models exist to identify at-risk individuals postpartum. The purpose of this study was to develop a risk score with likelihood ratios (LRs) predicting postpartum CVD based on pregnancy and nonpregnancy CVD risk factors. Using national administrative hospitalization data from Canada 2008-2021, the authors randomly selected 1 delivery per individual aged 18-55 years without pre-existing CVD. Cox proportional hazards models were used to predict CVD hospitalization, following individuals from 43 days after delivery discharge until CVD, censoring at in-hospital noncardiovascular death, subsequent pregnancy, or end of study. Risk scores and LRs for CVD hospitalization were generated using model coefficients. Model performance was characterized using C-statistics with 95% CIs. In this cohort of 1,992,972 individuals (median follow-up 3.7 years [Q1-Q3: 1.6-7.9 years]), the LRs for CVD within 1 year of delivery were 0.55 (95% CI: 0.49-0.61), 1.42 (95% CI: 1.28-1.57), and 7.81 (95% CI: 6.69-9.11) for standardized risk scores of <0, 0 to <3, and ≥3, respectively, which was similar at 5 and 10 years postpartum. Most individuals (59.3%) had a risk score of <0, 39.1% had a risk score between 0 and 3, and 1.5% had a risk score ≥3. The C-statistic for the multivariable Cox model was 0.669 (95% CI: 0.668-0.670). The lack of sociodemographic, clinical, and health behavior information may have contributed to the low predictive performance of this score for postpartum CVD hospitalizations. However, this score derived from a national administrative database, provides an initial framework for estimating future cardiac risk, which may provide guidance regarding the need and intensity of postpartum CVD surveillance.
32. Navigating the Zhongkao: How perceived parental expectations shape adolescents' transition choices in China.
期刊: Acta psychologica 发表日期: 2026-Jan-12 链接: PubMed
摘要
Accelerating and universalizing senior-high-school education is critical for advancing educational equity, particularly in Asia where senior-high-school entrance examination policies (e.g., China’s zhongkao) shape adolescent trajectories. Grounded in Human Capital Theory, this study employs unordered multinomial logistic regression to examine how adolescents’ perceived parental expectations across five dimensions-academic performance, physical/mental health, future achievement, behavioral conduct, and interpersonal relationships-influence their post-junior-highschool pathway intentions in Western China (N = 1077). Key findings reveal: (1) Adolescents identified parental expectations as the primary determinant (78.3 % of respondents) of their tracking decisions; (2) each 1-point increase in perceived parental academic expectations significantly reduced dropout intention odds by 75.1 % (OR = 0.249, p* < .01), while lower parental expectations predicted stronger inclinations toward vocational pathways or workforce entry; (3) systemic gaps persist: 88% of adolescents lacked professional career guidance, with 92 % relying solely on teachers for zhongkao policy information. This research yields three primary contributions: An empirical framework for facilitating parent-adolescent expectation alignment, potentially mitigating transitional conflicts; robust empirical evidence supporting the enhancement of professional career guidance services; a cross-culturally adaptable methodology for adolescent development studies. Implications for educational equity initiatives and counseling practices in Asian contexts are discussed.
33. Current situation and emerging foot-and-mouth disease virus lineages in Egypt: Historicment SAT1 Introduction, and Vaccine Policy Implications.
期刊: Veterinary immunology and immunopathology 发表日期: 2026-Jan-12 链接: PubMed
摘要
Foot-and-mouth disease (FMD) continues to impose significant constraints on livestock health and productivity in Egypt due to the persistent circulation, evolution, and transboundary introduction of antigenically diverse foot-and-mouth disease virus (FMDV) serotypes and lineages. Since the 1950s, Egypt has experienced recurrent incursions of serotypes O, A, and SAT2, accompanied by progressive antigenic shifts, including the emergence of O/EA-3, A/Africa G-IV, and SAT2 Lib-12. Recent developments have further reshaped the national epidemiological landscape. In 2022, the detection of FMDV-A-Egy-AHRI-RL385-Ven-2022, phylogenetically linked to the EURO-SA lineage, provided the first evidence of intercontinental viral introduction into Egypt. This was followed in 2025 by the first confirmed incursion of serotype SAT1 (topotype I), previously absent from Egypt and its vaccine formulations. The introduction of SAT1 into a fully naïve livestock population triggered rapid viral spread and revealed a critical immunological gap associated with longstanding trivalent vaccination strategies. Vaccine-matching analyses conducted at the Central Laboratory for Evaluation of Veterinary Biologics revealed that ongoing antigenic drift, particularly within serotypes A and SAT2, had diminished the protective capacity of traditional vaccines. In response, vaccine formulations were updated to incorporate A EURO-SA, A Africa G-IV, and SAT2 Lib-12, and a monovalent SAT1 vaccine was developed for emergency deployment. This review integrates historical, molecular, antigenic, and epidemiological evidence to assess recent FMDV evolution in Egypt and its implications for vaccination policy. The findings highlight the urgent need for adaptive FMD control strategies that combine continuous genomic surveillance, systematic vaccine matching, and dynamic antigen updating to protect Egypt’s livestock sector against an increasingly complex and evolving viral threat.
34. Shape-driven toxicity of polystyrene microplastics: Impacts on physiology and gut microbiota in Daphnia magna.
期刊: Marine pollution bulletin 发表日期: 2026-Jan-12 链接: PubMed
摘要
Microplastic pollution has emerged as a global issue that poses serious risks to aquatic ecosystems. Although Daphnia spp. are widely used as model organisms to study the effects of microplastics on their fitness, their microbiome response remains largely unexplored. This study investigated the effects of ground polystyrene microplastics (G-PS; fragments below the EC10 value) and commercial polystyrene microplastics (C-PS; beads below the EC10 value) on the physio-biochemical responses and gut microbiota of Daphnia magna. The toxicity of polystyrene microplastics to D. magna was shape-dependent, with G-PS being more toxic than C-PS. Exposure to G-PS and C-PS triggered Reactive oxygen species (ROS) production in D. magna. Although G-PS increased the abundance of both harmful (Fusobacterium) and beneficial bacteria (Blautia and Subdoligranulum) in the gut microbiota of Daphnia, C-PS only increased the abundance of beneficial bacteria (Lactobacillus, Ligilactobacillus, and Aerococcus), which may mitigate the toxicity of microplastics. Functional predictions based on amplicon sequencing suggested that altered microbiota may support the growth of D. magna by modulating associated metabolic pathways. D. magna exposed to G-PS exhibited a significantly higher abundance of gut microbiota pathways and enzymes associated with the detoxification of harmful compounds than those exposed to C-PS. This suggests that the higher toxicity of G-PS requires a stronger adaptive response from the gut microbiota. Overall, these findings highlight microplastic shape as a key factor influencing toxicity in D. magna and its associated microbiota.
35. Soil microbial diversity, stability, and function are enhanced by cover cropping: A machine learning-based pooled analysis of Mississippi agroecosystems.
期刊: The Science of the total environment 发表日期: 2026-Jan-12 链接: PubMed
摘要
Cover cropping has emerged as a pivotal strategy to enhance soil health and microbiome functionality across diverse agroecosystems. However, the extent to which cover crops reshape microbial diversity, composition, functional capacity, and ecological stability remains insufficiently understood, particularly within heterogenous environments like Mississippi. In this study, we conducted a comprehensive pooled analysis of 473 soil samples collected from multiple independent cover crop trials (2020-2024) across diverse cropping systems and edaphic contexts in Mississippi. Amplicon sequencing (16S rRNA and ITS2) coupled with machine learning, co-occurrence network modeling, and functional prediction tools were employed to evaluate microbial community responses to cover cropping. Results revealed that cover crops significantly elevated bacterial and fungal α-diversity, altered community composition, and enriched taxa associated with nitrogen fixation, organic matter turnover, and pathogen suppression. Notably, Proteobacteria, Acidobacteriota, and Chloroflexi were more abundant under cover cropping, whereas Firmicutes and Actinobacteriota dominated control plots. Fungal communities under cover cropping exhibited higher relative abundance of Rozellomycota and Chytridiomycota, indicating enhanced saprotrophic and decomposition potential. Functional predictions showed increased cellular and environmental processing functions in cover-cropped soils, alongside a marked reduction in KEGG pathways linked to human diseases and pathotroph dominance. Co-occurrence network analysis indicated increased connectivity, modularity, and robustness under cover cropping, suggested enhanced microbial interaction strength and ecological stability. Sloan’s neutral model fitting and increased migration rates further revealed that stochastic processes played a greater role in microbial assembly under cover cropping. Random Forest model identified Bradyrhizobium, Bryobacter, and Solirubrobacter as top bacterial biomarkers enriched in cover-cropped soils, while Talaromyces, Purpureocillium, and Clonostachys were the most predictive fungal genera, known for their biocontrol and nutrient cycling roles. These findings underscore the ecological potential of cover crops to enhance soil microbial networks and sustainability within Mississippi production systems, while insights may inform similar humid, subtropical agroecosystems elsewhere.
36. Geogenic Se and organic- and inorganic-Hg in fungi in the alpine, the Sino-Tibetan Mountains, China - benefit or risk?
期刊: The Science of the total environment 发表日期: 2026-Jan-12 链接: PubMed
摘要
Dietary selenium (Se) is an essential component of selenoproteins, enzymes that are vital for health but crucially, the element is also involved in countering toxicity from organic- and inorganic‑mercury (o-Hg/i-Hg). This aspect is increasingly being explored in seafood but barely any studies consider wild mushrooms which readily uptake both elements. The information may prove useful in regions, such as parts of the Yunnan province where diseases caused by Se deficiency are endemic somewhere in China but which are also the habitat of a huge range of edible wild fungi. Selenium and Hg contents were determined in raw and cooked (traditionally, on site) specimens of Boletus shiyong, B. viscidicipes, Retiboletus griseus, Leccinum versipelle, Suillus placidus and Lactarius deliciosus, collected in the high Lanping county. Dry weight Se concentrations in whole fruiting bodies of B. shiyong, B. viscidiceps, R. griseus and S. placidus, were 15 ± 6, 12 ± 0.6, 12 ± 1 and 16 ± 0.8 mg·kg-1 respectively, with lower levels of 1.3 ± 0.1 and 2.2 ± 1.0 mg·kg-1 in L. versipelle and L. deliciosus. Corresponding concentrations of total Hg (THg) were elevated in B. shiyong and B. viscidiceps at 7.3 ± 0.1 and 7.0 ± 0.3 mg·kg-1 but were much lower (≤ 1.2 mg·kg-1) in the other species. Organic-Hg was a very minor contributor to THg (< 2%) in most studied species but was significantly higher (15-16%) in S. placidus. Prepared mushroom dishes were characterised by very favourable excesses of Se, high Se health benefit (HBVSe) indices and relatively low levels of o-Hg, a finding that potentially indicates significant health benefits for millions of regional consumers.
37. A series of diagnostic contamination events from seasonal influenza vaccines.
期刊: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 发表日期: 2026-Jan-10 链接: PubMed
摘要
Polymerase chain reaction (PCR) is preferred for diagnosing influenza, allowing differentiation between influenza A and B viruses and their subtypes/lineages. However, PCR’s high sensitivity can lead to false positives from contamination. During the 2022-2023 influenza season in Norway, a pattern of diagnostic samples testing positive for both influenza A and B or the presumably extinct B/Yamagata lineage suggested external contamination. We conducted PCR testing for these samples, environmental samples from vaccination sites, and vaccines, alongside a retrospective review of test data. This review revealed an increased frequency of unusual detection patterns, particularly during weeks 42-46 of 2022, aligning with the peak of the vaccination campaign. During this period, suspected vaccine-contaminated samples comprised 3.45 % of all influenza-positive samples. Environmental sampling at vaccination sites confirmed the presence of influenza A and B RNA, supporting suspicion of vaccine-derived contamination. Detection in suspect diagnostic specimens of multiple influenza types/subtypes/lineages, including the extinct B/Yamagata lineage, corroborated the seasonal influenza vaccine’s contamination source. These findings highlight the risk of diagnostic sample contamination with RNA from influenza virion-derived vaccines, impacting diagnostic accuracy and public health surveillance.
38. Building research evidence for advancing prevention and translation: reflecting on a 20-year organizational approach of applied chronic disease preventive health research.
期刊: Translational behavioral medicine 发表日期: 2026-Jan-07 链接: PubMed
摘要
Translating public health research into practice remains challenging despite ongoing focus on evidence-based approaches. This study profiles the scope of research undertaken by the Prevention Research Collaboration (PRC), a university based applied public health research organization, with funding from both traditional academic sources and from policy agencies, and examines how it contributed to a translational, evidence-building approach in chronic disease prevention. We analyzed PRC’s research output using two complementary approaches: (i) a review of journal articles published from 2018 to 2024 where PRC researchers were lead or senior authors; and (ii) an examination of annual reports and workplans from 2013 to 2023 to identify major research programs. Research was classified according to public health evidence-building typology and whether it was investigator-initiated or policy-initiated. Overall, investigator-initiated research was dominant amongst journal publications, and particularly showcased problem definition studies. Intervention evaluation, as identified in journal publications and internal documents, was more likely to be policy-initiated. PRC demonstrated a high degree of collaboration with policy and practice professionals (42.5% of investigator-initiated and 50% of policy-initiated publications included policy co-authors). Key research areas across chronic disease prevention included physical activity (40.4% of publications), obesity prevention (14.2%), and tobacco control (12.8%). This case study demonstrates that a small public health research group can successfully navigate the research-policy interface over a sustained period. PRC’s continuity of management, staffing and funding arrangements, plus shared agenda and strong partnership with government, are considered to be key enabling factors for this collaborative evidence-building public health approach. Turning public health research into effective policies remains challenging. This study examines the Prevention Research Collaboration (PRC) at the University of Sydney, which has maintained a research-policy partnership for over 20 years. By analyzing PRC’s body of work, we explored insights into how research organizations can practically contribute to public health. The findings show that PRC produced both researcher-initiated and policy-initiated research. Researcher-initiated studies primarily appearing in academic journals and focused on defining health problems, while policy-initiated projects were more often documented in reports and concentrated on evaluating intervention programs. Both types of research contributed to comprehensive evidence building for chronic disease prevention. PRC’s key strength was its sustained, collaborative approach, with policymakers involved in both policy-initiated and investigator-initiated research and publications. Success factors included knowledge brokerage activities, mixed funding sources, alignment of policy priorities, diverse research methods and active engagement and collaboration with practitioners and policy makers. This demonstrates how a small research group can maintain academic excellence while achieving practical relevance to public health policy through collaborative partnerships and commitment to evidence-building across different stages of research.
39. The changing context of Health in All Policies in Finland since the 8th Global Conference on Health Promotion in Finland.
期刊: Health promotion international 发表日期: 2026-Jan-07 链接: PubMed
摘要
40. Health-promoting housing policy in a changing climate: integrating affordability, security, and resilience.
期刊: Health promotion international 发表日期: 2026-Jan-07 链接: PubMed
摘要
Housing is a fundamental determinant of health, yet many housing systems fail to promote well-being or address growing challenges such as climate change, inequality, and urbanization. It is increasingly treated as an investment vehicle and as a commercial product supporting the construction industry, with substantial interactions with climate change, rather than its fundamental role providing shelter. This perspective addresses this gap by proposing an integrated framework for health-promoting housing policy that combines affordability, security, and quality, paying particular attention to their interdependence and the growing influence of climate, adopting a systems-thinking approach. The framework was developed through an iterative literature synthesis and interdisciplinary dialogue, designed to overcome the disciplinary fragmentation of existing evidence. We conducted structured searches in PubMed, Scopus, and Web of Science, supplemented by grey literature, concentrating on materials published since 2010, reflecting the increasing relevance of climate resilience and equity. Inclusion criteria focused on sources examining housing-health interactions, policy interventions, and systemic challenges; purely technical engineering studies were excluded. Themes were mapped against four policy levers, legal, financial, planning, and community-based measures. The resulting framework offers policymakers a flexible menu of options to strengthen housing systems and advance health equity. By integrating climate resilience and social inclusion into housing policy, this approach provides a foundation for coordinated action across sectors. Aligning housing policy with public health goals is essential for building equitable, sustainable, and resilient communities.
41. Patient perspectives and barriers to effective home-based care in lymphatic filariasis: A mixed methods study from Puducherry, India.
期刊: PLoS neglected tropical diseases 发表日期: 2026-Jan 链接: PubMed
摘要
Morbidity Management and Disability Prevention (MMDP) remain an under-addressed component of lymphatic filariasis elimination. Despite the simplicity of the hygiene-based regimen, adherence to these practices remains low due to multiple barriers, exacerbating chronic suffering. As the primary role remains vested in the patients, this study explores their perspectives and barriers to home-based care to inform strategies to improve outcomes. This study employed a mixed-methods approach using an explanatory sequential design. The quantitative phase involved a cross-sectional survey of 321 adult patients from Puducherry and adjacent areas of Tamil Nadu, utilising a validated questionnaire informed by the Self-Management Assessment Scale (SeMaS) framework. The qualitative phase comprised 12 in-depth interviews (IDIs) and four focus group discussions (FGDs), with participants evenly distributed based on gender and health-seeking behaviours, and the data were analyzed using deductive thematic analysis. Only 46.4% of participants regularly practised home-based limb care. Morbidity management scores were significantly higher among patients with an income (p = 0.005) and regular healthcare visits (p < 0.001), and lower among those with grade 4 lymphedema (p < 0.001). Participants under 60 years (p < 0.001), women (p = 0.015), and those with higher grades of lymphedema (p < 0.001) perceived a higher disease burden. Key barriers pertaining to home-based care were identified in social support (84.7%), perceived disease burden (33.0%), and mental health issues (15%). Qualitative findings highlighted the interactions of socioeconomic, structural, and cultural factors, indicating the key role of structural factors alongside individual-level determinants like locus of control, self-efficacy, and emotional well-being. The findings underscore the need for a multifaceted approach that transcends individual-level interventions to include systemic reforms, such as policy integration, capacity building, and community-driven support mechanisms. Addressing the barriers holistically and tailoring the solutions addressing diverse disadvantaged groups can enhance adherence to morbidity management practices.
42. Lived experiences of Type 1 diabetes patients visiting a tertiary care hospital of Nepal: A descriptive phenomenological study.
期刊: PLOS global public health 发表日期: 2026 链接: PubMed
摘要
Type 1 diabetes is a non-preventable chronic disease that predominantly affects young people, accounting for 10-15% of all diabetes cases. The condition is multidimensional, affecting various aspects of life, and daily living requires consistent effort, lifestyle modification, and close monitoring. This study aimed to explore the lived experiences of patients with Type 1 diabetes attending the outpatient department of Patan Hospital, focusing on their perspectives on living with the disease condition. A descriptive phenomenological research design was used for the study. Data were collected from 22 purposively selected patients who attended the Medicine and Pediatrics Outpatient Department (OPD) of Patan Hospital. Patients aged 15 years and above, with at least one year since initial diagnosis, were included in the study. Colaizzi’s descriptive phenomenological method was used for data analysis. Ten themes emerged from the analysis: (1) Initial hospitalization (2) Solidarity in illness and support systems (3) Learning process and acceptance (4) Changes and adjustments (5) Diabetes management challenges (6) Concerns and worries (7) Socioeconomic and structural challenges (8) Healthcare experiences (9) Type 1 diabetes-related stigma (10) Experiences of living with Type 1 diabetes during the COVID-19 pandemic. The study highlights a lack of awareness in the community on Type 1 diabetes, experiences of stigma were also reported by the participants. It also emphasizes the need for regular parental counseling to prevent overprotection. Financial burden appeared as a significant challenge in the study. The study further suggests that authorities ensure access to insulin and other essential medical supplies during lockdowns, as participants reported difficulties in obtaining them. School-related difficulties point towards the importance of effective implementation of the “School Health Nurse” program. These findings indicate the need for greater awareness, psychological support, and healthcare preparedness to improve the quality of life of individuals living with Type 1 diabetes.
43. Custom GPTs to aid in compliance checking for reporting standards in academic publishing.
期刊: ALTEX 发表日期: 2026 链接: PubMed
摘要
Reporting standards have proliferated across biomedicine, yet incomplete methods reporting remains routine - less because the community doubts the value of transparency, but rather because compliance checking is tedious, inconsistently enforced, and poorly integrated into everyday writing and review. As a sequel to the Good In Vitro Reporting Standards (GIVReSt) argument that better reporting is essential infrastructure, this article explores a pragmatic next step: translating standards from static checklists into interactive, always-on guidance. We describe the development of three specialized “compliance copilots” built as custom GPT-based assistants - one aligned with the emerging GIVReSt, one reflecting the established ToxRTool reliability framework, and one mapped to ARRIVE for animal studies. The tools are designed to point to specific text evidence, flag missing essential information, and provide actionable suggestions while the manuscript is being written. Early benchmarking against expert assessments suggests that this approach can approx-imate human judgments for many checklist items in a fraction of the time and with high consistency. We also highlight why “strict” versus “lenient” interpretations matter, and why these systems should be framed as decision-support, not decision-makers. The central claim is cultural, not technical: arti-ficial intelligence (AI) will matter most when it makes rigorous reporting the path of least resistance, turning standards into routine practice rather than aspirational add-ons. Many laboratory papers are hard to reproduce because important details are missing. Reporting checklists exist but their use is tedious and inconsistent. We built “AI compliance checkers” that read a manuscript and flag whether key information has been reported, pointing to the exact text as evidence. One checker targets the draft Good In Vitro Reporting Standards (GIVReSt), one applies the ToxRTool/Klimisch approach to judge the reliability of toxicology studies, and the third assesses animal study reporting against the ARRIVE guidelines. When we compared AI outputs with expert human assessments on benchmark papers, the tools agreed with humans most of the time. The main risk was the AI giving authors “the benefit of the doubt” unless run in a strict mode. Used appropriately, these tools can help authors avoid omissions and help journals screen papers more consistently while still requiring human oversight and further validation before regulatory use.
44. Type 2 diabetes and age-related cognitive decline over 40 years in Danish men-A cohort study based on the Danish Aging and Cognition (DanACo) cohort.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
The extant literature on type 2 diabetes and cognitive decline is based on short cognitive follow-ups and assessments of baseline cognitive ability after diagnosis. The objective was to investigate the influence of type 2 diabetes on cognitive decline over a period of on average 44 years. This cohort study included 5,147 men from the Danish Aging and Cognition cohort consisting of a late mid-life (mean age 64.2 years) follow-up of men with intelligence test scores (IQ) available from statutory conscription board examinations in young adulthood (mean age 20.4 years). Follow-up included re-administration of the conscription board intelligence test and a comprehensive questionnaire. Exposure was self-reported but register-based type 2 diabetes and duration of disease were also calculated. Cognitive decline was defined as both IQ change (baseline-follow-up) and significant IQ decline based on the reliable change index (cut-off: 13.2 IQ-points). Associations were analyzed in linear and logistic regression models. Men having type 2 diabetes had a 1.81 IQ points (95%CI:1.14,2.49) larger decline compared to men without diabetes when adjusting for baseline IQ, years of education, follow-up age, retest interval, depression, and smoking status. Moreover, type 2 diabetes was associated with 1.42 times higher odds of a significant IQ decline and longer duration was associated with a larger, though not statistically significant, decline. The participation rate was 13.4%, and the participants were healthier and more well-educated than non-participants. To account for potential selection bias, inverse probability weights (IPW) were calculated based on baseline characteristics. The analyses applying these weights yielded similar estimates. Type 2 diabetes was associated with modestly greater cognitive decline and higher odds of a statistically significant (>13.2 IQ points) and clinically relevant decline. Finally, the alignment between main and IPW results indicates the findings are robust and likely generalizable.
45. Barriers and facilitators to establishing Early Psychosis Intervention (EPI) services in remote and rural communities across Canada.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
There is a paucity of data on how Early Psychosis Intervention (EPI) services adapt to the challenges of rural practice, including geographical isolation and provider shortages. This qualitative study seeks to fill this gap by exploring the experiences of EPI programs in rural and remote communities in Canada. An introductory email was sent to 117 EPI contacts, inviting them to first complete a survey and then participate in a semi-structured interview if their program contained a rural component. The interviews were conducted between June 2023-January 2024 via Zoom or phone by a member of our research team, while another member took detailed notes. Qualitative data was analyzed using thematic analysis. Twenty-five representatives from seventeen distinct EPI programs with a rural and remote component across seven Canadian provinces and one Canadian territory participated in the interviews. Several barriers to establishing EPI programs in rural and remote areas were identified, including limited access to care, challenges in referral processes, geographical and technological constraints, and funding limitations. Facilitators of successful program delivery included the use of virtual care, standardized care models, strong leadership and teamwork, and adaptive resourcefulness in addressing local needs. Identifying and addressing these barriers and leveraging facilitators can enhance the accessibility and effectiveness of EPI service delivery in rural and remote areas.
46. The mediation effect of attitude on the association between knowledge and practices toward air pollution among commercial drivers and traders in South-Western Ghana: A cross-sectional study.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
There are extant studies on the knowledge, attitudes and practices of air pollution in sub-Saharan Africa and Ghana, however, studies among commercial drivers and traders in transport stations in Ghana are sparse. This study examined the mediation effect of attitude on the association between knowledge and practice toward air pollution among two high-risk workers in the Greater Accra Metropolitan Area, Ghana. A population-based cross-sectional study was conducted among commercial drivers and traders between November 2023 and June 2024. A consecutive sampling technique was used to select 1011 participants (drivers [n = 619, 61.2%] and traders [n = 392, 38.8%]). A structured questionnaire was used, including questions on knowledge (9 items), attitude (7 items) and practices (5 items) toward air pollution. Statistical analysis (descriptive, hierarchical linear regression and partial least squares structural equation modelling) was performed using Stata 17/MP. The primary sources of air pollution information for drivers and traders were social media and radio. The PLS-SEM revealed a significant direct effect of knowledge for both drivers/traders (β = 0.23/0.26, p < 0.001). Moreover, attitude partially mediated the relationship between knowledge and practices, with a direct significant effect observed for drivers/traders (β = 0.10/0.02, p < 0.001). HLR further confirmed that knowledge strongly predicted protective practices for both drivers (β = 0.23, p < 0.001) and traders (β = 0.26, p < .001. Higher educational level consistently predicted better knowledge and protective practices but old age had an inverse relationship with protective behaviour toward air pollution. Although a cross-sectional design precludes causality, attitude partially mediated the association between knowledge and practices, but the effect was more substantial among drivers than traders. The findings have implications for social and traditional media education and attitudinal change campaigns to effectively reduce air pollution exposure risk among these high-risk occupational groups.
47. Etiology of Infantile Epileptic Spasms Syndrome and Clinical Response With Vigabatrin as the First Treatment.
期刊: Pediatric neurology 发表日期: 2025-Dec-31 链接: PubMed
摘要
Etiology is an important predictor for treatment outcomes of infantile epileptic spasms syndrome (IESS). In Thailand, vigabatrin (VGB) is the first-line treatment for all patients due to the unavailability of adrenocorticotropic hormone. We aimed to determine the etiology of IESS using the 2017 International League Against Epilepsy classification and evaluate the clinical response of VGB as a first-line treatment. A retrospective cohort study was conducted on IESS-diagnosed patients between January 2013 and December 2022. Etiology was categorized per the 2017 International League Against Epilepsy classification. Clinical outcomes were assessed at days 14-42 and one year after treatment. We included 191 IESS patients (57.6% males). Etiology was identified in 75.4% (structural 61.2%: 48.1% with nontuberous sclerosis complex [non-TSC] and 13.1% with TSC; genetic, 6.3%; infectious, 6.3%; and metabolic, 1.6%). Among the 163 patients who received VGB as first-line treatment, 50 (30.7%) achieved clinical cessation of epileptic spasms at days 14-42, and 44 patients (27.0%) had sustained freedom of epileptic spasms at one year. Patients with TSC etiology were more likely to achieve cessation of epileptic spasms at day 14-42 after treatment (adjusted OR 3.548, 95% confidence interval 1.193, 10.550, P = 0.023). Definite developmental delay at spasm diagnosis decreased the odds of sustained clinical freedom from epileptic spasms at one year (adjusted OR 0.26, 95% confidence interval 0.09, 0.74, P = 0.012). The etiology of IESS was identified in 75%. VGB was most effective as first-line, short-term treatment in TSC patients, and one-year treatment in children with normal development at diagnosis of IESS.
48. Inhibition of CYP2A6-mediated nicotine metabolism: A potential strategy for smoking cessation therapy.
期刊: The Journal of pharmacology and experimental therapeutics 发表日期: 2025-Dec-09 链接: PubMed
摘要
Despite the availability of US Food and Drug Administration-approved pharmacotherapies, smoking continues to be a significant public health problem, with long-term cessation rates often falling below 20%. The cytochrome P450 2A6 (CYP2A6) enzyme plays a critical role in nicotine metabolism, and individuals with genetically reduced CYP2A6 activity exhibit slower nicotine clearance, lower cigarette consumption, and greater cessation success. This observation has led researchers to explore pharmacological inhibition of CYP2A6 as a strategy to aid in smoking cessation. In this review, we discuss 4 CYP2A6 inhibitors, methoxsalen, tranylcypromine, 5-(4-ethylpyridin-3-yl)thiophen-2-yl)methanamine, and cannabidiol, describing their potency, translational potential, and safety considerations. Methoxsalen, a mechanism-based inactivator, inhibits nicotine metabolism in both animals and humans, but there are concerns about its phototoxicity and off-target effects. Tranylcypromine, although a competitive inhibitor of CYP2A6, may also increase nicotine consumption via monoaminergic effects, thereby limiting its practical use in cessation therapies. 5-(4-ethylpyridin-3-yl)thiophen-2-yl)methanamine is a novel synthetic inhibitor with unprecedented potency and specificity in vitro, but lacks clinical validation to support this claim. Cannabidiol is a promising dual-action candidate because it inhibits CYP2A6 in vitro and reduces nicotine intake in rodents, as well as reduces cigarette use and cue reactivity in early human trials. Although these findings emphasize the therapeutic potential of targeting CYP2A6 in smoking cessation efforts, additional validation is required for clinical translation. These include the need for robust human pharmacokinetic studies, long-term safety evaluations, and assessment across genetically diverse populations. With additional research, CYP2A6 inhibition could become a practical and personalized way to improve smoking cessation outcomes. SIGNIFICANCE STATEMENT: This study highlights the clinical significance of inhibiting CYP2A6-mediated nicotine metabolism as a novel smoking cessation strategy by reviewing in vitro, preclinical, and clinical data of agents that mimic the slow CYP2A6 metabolizer phenotype and improve smoking cessation outcomes.
49. Assessment of the first 5 years of pharmacist-administered vaccinations in Australia: learnings to inform expansion of services.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
Pharmacist-administered vaccination has expanded in Australia but has not been comprehensively assessed. We aimed to assess the pharmacists’ role in vaccination in Australia before and during the first year of the COVID-19 pandemic, as well as the completeness of data on pharmacist-administered immunisations. Cross-sectional study. We analysed data on pharmacist-administered vaccinations that were reported to the Australian Immunisation Register (AIR) between 2016 and 2019, categorised by gender, jurisdiction, age group and vaccine type. We conducted a national survey of community pharmacists providing vaccination services during June and July 2020 to understand how pharmacists record and report vaccinations to the AIR. We assessed data completeness by comparing the number of vaccinations reported by surveyed pharmacists to the number recorded on the AIR. 576 780 pharmacist-administered vaccinations were recorded on the AIR between 2016 and 2019, of which 94.7% were influenza vaccines. The proportion of vaccinations given by pharmacists increased each year, from <0.001% in 2016 to 2.7% in 2019. Between 2017 and 2019, rates of pharmacist-administered vaccinations were highest among people aged 60-64 years (2046 per 100 000 people) and those living in regional areas (1074 per 100 000 people). Among 243 survey respondents, 57.8% (126/223) reported vaccinations to the AIR automatically via software, 27.8% (62/223) manually entered data and 13.5% (30/223) used both methods. Of the 87 665 vaccination encounters recorded by 121 respondents, 82.2% (72 045/87 665) were recorded on the AIR. There were more AIR-recorded encounters from those who reported automatically via software (84.8% [49 309/58 134]) than from those who manually entered data (68.3% [12 127/17 746]). Pharmacists have an increasing role in providing vaccination services in Australia, with great potential to improve coverage among adults and populations in regional locations. Measures introduced during the COVID-19 pandemic may have increased the uptake of electronic methods of recording and reporting data, which can improve data completeness. Our results provide an assessment of the first 5 years of pharmacist vaccination services in Australia, against which future evaluations of the impacts of policy changes during the COVID-19 pandemic can be compared.
50. Co-creation in public health research: an introduction to basic principles.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
Co-creation is a participatory design approach that leverages the experiential knowledge of non-academic actors. It is increasingly adopted in public health research to enhance the relevance, acceptability, and impact of interventions. This perspective article provides a practical introduction to co-creation, its application, and benefits and considerations for public health researchers. Based on the authors’ experiences with co-creation in public health, four key considerations for co-creation are outlined: 1) the selection of collaborators (those participating in the co-creation process) and their power dynamics and interests; 2) frameworks and guidelines for the co-creation process; 3) capacities needed to successfully apply a co-creation approach, such as emotional intelligence and adaptability; and 4) practical matters, such as resources and ethics approval. These insights serve as a practical introduction for public health researchers considering the application of co-creation in their projects to facilitate more effective and impactful, user-centered research designs and interventions.
51. Travel-associated illness in children in pre-pandemic Western Sydney, 2018-2020.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
Australian children frequently travel overseas, but little is known about their travel-related morbidity. We aimed to describe the spectrum of illness and injury in returned travellers presenting to the largest paediatric referral centre in NSW, the Children’s Hospital at Westmead (CHW). Observational cohort study. In the 18 months immediately before the COVID-19 pandemic (2018-2020), we prospectively collected demographic, travel and clinical data from children with travel-acquired illness or injury identified by active surveillance of CHW Emergency Department attendees and referrals to the infectious diseases service. We identified 587 returned child travellers with an illness or injury associated with overseas travel. Most were aged younger than 5 (62.8%) and had travelled within the Asia-Pacific region (84.6%). The main reason for travel, where recorded (50.3%), was visiting friends and relatives (VFR)(65.4%). Most travellers (90.1%) had a common childhood infection, illness or injury coincidentally acquired during travel, including respiratory infection (37.5%), acute diarrhoea (15.7%) and nonspecific febrile illness (13.1%). Exotic/nonendemic infections were uncommon (9.9%, including potential rabies exposure) but were associated with much higher admission rates than ‘cosmopolitan’ (globally distributed) diseases (74.2% vs 21.9%). Most of these occurred in VFR travellers (86.3%); enteric fever, largely acquired in South Asia, predominated (51.7%). One in five admitted patients had a disease for which specific pretravel vaccination is available. Receipt of pretravel vaccines was infrequently recorded. Returned child travellers in Western Sydney frequently presented with respiratory infections and may be a key population for surveillance of imported respiratory viruses. The burden of exotic disease was small and borne by VFR travellers. Travel-related illness in Western Sydney could be reduced by health education of travellers and targeted pretravel vaccination, especially typhoid vaccination for VFR travellers to South Asia. Universal, systematic screening of emergency department attendees for recent overseas travel would improve surveillance of travel-related illness.
52. Economic benefits of reducing childhood and adolescent overweight and obesity in Australia.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
The Australian Government, through the National Obesity Strategy 2022-2032, has set an aspirational goal of reducing the prevalence of childhood and adolescent overweight and obesity by 5% by 2030 (from 25% to 20%). Our objective was to quantify the long-term economic benefits of achieving this goal. Using a microsimulation model and a synthetic cohort of Australian children and adolescents aged 4-17 years, we estimated the excess per capita lifetime costs of overweight and obesity. Using these results and population projections for 2030, we estimated the potential lifetime cost savings that could be achieved through attaining the National Obesity Strategy goal. Compared with their peers of a healthy weight, children and adolescents with overweight and obesity were estimated to incur, per capita, excess lifetime costs (discounted) of approximately $19 700 and $46 700, respectively (in 2030 Australian dollars). Achieving the National Obesity Strategy’s goal was estimated to save approximately $7.44 billion, predominantly through reductions in lifetime obesity-related healthcare costs and premature mortality. Our results demonstrate the considerable economic benefits that could be achieved by reducing the current prevalence of childhood and adolescent overweight and obesity in Australia; they provide justification for investment in prevention and treatment for this demographic.
53. Impact of COVID-19 on lung cancer care in New South Wales, Australia: real-world data from the EnRICH Program.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems worldwide, causing substantial changes to routine healthcare delivery. National and international modelling studies have predicted adverse impacts of this disruption. This study aimed to assess the real-world impact of the COVID-19 pandemic on quality of care and outcomes for patients with lung cancer in New South Wales (NSW). Pre-post observational cohort study using data prospectively collected for the Embedding Research (and Evidence) in Cancer Healthcare (EnRICH) Program. The study population comprised 2000 patients with lung cancer from six specialist cancer centres in metropolitan and regional NSW. We split this population into two cohorts: the pre-COVID-19 cohort (1143 patients diagnosed from 8 September 2016 to 10 March 2020) and the post-COVID-19 cohort (857 patients diagnosed from 11 March 2020 to 28 October 2021). The main outcome measures were lung cancer clinical quality indicators, 1-year and 2-year overall survival, and patient-reported health-related quality of life and psychological distress. Patient and disease characteristics (e.g. age, gender, cancer stage) were similar for the pre-and post-COVID-19 cohorts, except for histology (non-small cell lung cancer (NSCLC) 88% in the pre-COVID-19 cohort and 84% in the post-COVID-19 cohort; p = 0.008) and region of residence (62% and 55%, respectively, lived in metropolitan areas; p = 0.002). Compared to the pre-COVID-19 cohort, fewer patients in the post-COVID-19 cohort received a diagnosis within 28 days of the first investigation of symptoms (clinical diagnosis: 77% compared with 72%; p = 0.017, pathological diagnosis: 60% compared with 53%; p = 0.005). However, the median time from the first investigation of symptoms to treatment initiation did not differ. One- and 2-year overall survival, quality of life and psychological distress did not differ between cohorts. This analysis found that the COVID-19 pandemic did not significantly adversely affect quality of care and outcomes for patients with lung cancer in NSW. Reassuringly, these results suggest that prioritising urgent health services, such as cancer care and implementing protective mitigation measures were effective in avoiding the predicted adverse outcomes of healthcare service disruption.
54. Acceptability of an asymptomatic COVID-19 screening program for schools in Victoria, Australia: a qualitative study with caregivers from priority populations.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
An asymptomatic COVID-19 rapid antigen testing (RAT) screening program was implemented in Victorian schools in January 2022, to support keeping schools open throughout the pandemic. This study explored compliance with the program among caregivers from priority populations in Victorian mainstream and specialist schools. We conducted semi-structured interviews between 7-31 March 2022 with caregivers of school-aged children participating in the RAT program in Victoria. Participants were asked about awareness, acceptability, compliance, frequency, and barriers to testing. Recordings were transcribed and deductively analysed using a framework approach. Fifty caregivers participated. They expressed confusion about the ‘recommended’ program, assuming it was mandatory. Caregivers wanted notification from schools of positive cases to increase motivation for compliance. Culturally and linguistically diverse (CALD) families were compliant; however, in-language resources were limited. Aboriginal or Torres Strait Islander (Koori) families tested less regularly and received information from their community rather than school. Caregivers of children living with disabilities reported behavioural challenges to testing, resulting in distress or non-compliance, and received non-specific information for their children. To increase engagement with future surveillance programs, caregivers need clarity about optionality, conducting tests, reporting results, and timely notification of cases. Requirements unique to each priority population include: accurate in-language information for CALD caregivers, community-led communication for Koori caregivers, tailored information, less testing, and flexibility for caregivers of children living with a disability. Keeping schools open and having tailored strategies to ensure equitable access for priority populations are essential for future pandemic management.
55. Aboriginal and Torres Strait Islander peoples' Quitline use and the Tackling Indigenous Smoking program.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
The Australian Government Tackling Indigenous Smoking (TIS) program aims to reduce tobacco use among Aboriginal and Torres Strait Islander peoples, delivering locally tailored health promotion messages, including promoting the Quitline. We aimed to analyse data on use of the Quitline by Aboriginal and Torres Strait Islander peoples nationally, specifically in TIS and non-TIS areas. We analysed usage of the Quitline in seven jurisdictions across Australia in areas with and without TIS teams (TIS areas and non-TIS areas respectively) between 2016-2020. Demographic and usage characteristics were quantified. Clients and referrals as a proportion of the current smoking population were calculated for each year, 2016-2020. From 2016-2020, 12 274 Aboriginal and Torres Strait Islander people were clients of the Quitline in included jurisdictions. Most (69%) clients were living in a TIS area. Two-thirds (66.4%) of referrals were from third‑party referrers rather than self-referrals. Overall, between 1.25% and 1.62% of Aboriginal and Torres Strait Islander peoples who currently smoked were clients of Quitline (between 1.15-1.57% in TIS areas and 0.82-0.97% in non-TIS areas). The Quitline provided smoking cessation support to approximately 2500-3000 Aboriginal and Torres Strait Islander clients annually between 2016-2020. Referrals from third parties including Aboriginal and Torres Strait Islander services are an important pathway connecting community members to an evidenced-based cessation support service.
56. Co-designing policy with Aboriginal and Torres Strait Islander peoples: a protocol.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
In the public service context, co-design is novel and ever-expanding. Co-design brings together decision-makers and people impacted by a problem to unpack the problem and design solutions together. Government agencies are increasingly adopting co-design to understand and meet the unique needs of priority populations. While the literature illustrates a progressive uptake of co-design in service delivery, there is little evidence of co-design in policy development. We propose a qualitative study protocol to explore and synthesise the evidence (literary, experiential and theoretical) of co-design in public policy. This can inform a framework to guide policymakers who co-design health policy with Aboriginal and Torres Strait Islander people. The study design is informed by a critical qualitative approach that comprises five successive stages. The study commences with the set-up of a co-design brains trust (CBT), comprising people with lived experience of being Aboriginal and Torres Strait Islander who have either co-designed with public agencies and/or have health policymaking expertise (stage 1) The brains trust will play a key role in guiding the protocol’s methodology, data collection, reporting and co-designing a ‘Version 1’ framework to guide policymakers in co-designing health policy with Aboriginal and Torres Strait Islander people (the framework). Two realist evaluations will explore co-design in health policy settings to understand how co-design works for whom, under what circumstances, and how (stages 2 and 3) The findings of the realist evaluations will guide the CBT in developing the framework (stage 4). A process evaluation of the CBT setup and framework development will assess the degree to which the CBT achieved its intended objectives (stage 5). The proposed study will produce much-needed evidence to guide policymakers to share decision-making power and privilege the voices of Aboriginal and Torres Strait Islander people when co-designing health policy. Learnings from this translational research will be shared via the CBT, academic papers, conference presentations and policy briefings.
57. Effectiveness of the Go4Fun program: a comparison of face-to-face and digital delivery.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
Despite an increasing trend in digitally delivered health promotion programs, evidence of their effectiveness compared to face-to-face approaches is limited. Go4Fun is a 10-week, scaled-up healthy lifestyle program in New South Wales (NSW) for children 7-13 years who are above a healthy weight and their families, delivered either face-to-face or digitally. We compared the impact of Standard Go4Fun (face-to-face) and Go4Fun Online (digital) on children’s weight and health behaviour outcomes and whether attendance levels influenced outcomes. Pre-post study. We conducted a secondary analysis of Go4Fun cohort data from 1893 face-to-face and 1283 digital participants (January 2018 to May 2022). Outcomes of interest were body mass index z-score (zBMI), physical activity, sedentary behaviour, and fruit, vegetable, sugary drink and takeaway food consumption. A higher proportion of Standard Go4Fun children lived in major cities, in areas of greatest disadvantage and spoke a language other than English at home than in Go4Fun Online. Children in both Standard Go4Fun and Go4Fun Online demonstrated improvements in all outcomes; however, children in Go4Fun Online showed significantly larger improvements. On average, digital participants had a reduction in zBMI of 0.11 more than the reduction seen in face-to-face participants (95% Confidence Interval [CI] -0.12, -0.09), increased the days/week of moderate-to-vigorous-physical-activity by 30% more (95% CI 24%, 36%), were more likely to eat ≥ 2 serves of fruit/day (compared to < 2, Odds Ratio [OR] 1.85; 95% CI: 1.36, 2.52) or eat ≥ 3 serves of vegetables/day (compared to < 3, OR 1.96; CI: 1.58, 2.42). Across both modes, with each additional session attended, the odds of eating ≥ 3 serves of vegetables/day increased by 10% (95% CI 1.02, 1.19). There were no significant differences for other health outcomes. Our evaluation demonstrated that both face-to-face and digital program delivery helped children above a healthy weight to improve their weight and health behaviour outcomes. Go4Fun Online achieved significantly greater improvements in outcomes, which is encouraging for the future of digital interventions. Participation in Standard Go4Fun by more children with obesity from disadvantaged areas and non-English speaking backgrounds suggests that ongoing delivery of both modes of Go4Fun could facilitate program reach among all children above a healthy weight.
58. UV arrows descend from above: lessons from a mass media campaign to improve sun protection behaviours among young adults.
期刊: Public health research & practice 发表日期: 2024-Oct-23 链接: PubMed
摘要
More than 95% of melanomas in Australia are caused by UV radiation from the sun. Young adults are particularly at risk, with 18-24-year-olds spending more time in the sun and protecting their skin less than older adults. A new mass media campaign was delivered in New South Wales, Australia, to motivate this hard-to-reach group to protect their skin from harmful UV radiation. This paper shares learnings from this campaign for public health educators working across diverse fields. Guided by audience research and testing, the campaign combined fear-based and self-efficacy messaging. UV radiation was portrayed as arrows descending from the sky, transforming it into a visible and ever-present threat. High-reach channels such as cinema, outdoor advertising, online videos, audio apps and social media were used to reach the audience. The campaign was evaluated through an online tracking survey (n = 750, 18-24-year-olds) measuring prompted recognition, message take-out, key diagnostics, and self-reported sun protection intentions and behaviours. The evaluation found that 57% of survey participants recognised the campaign when prompted. Among those that recognised the campaign, 76% said they had used sun protection when outdoors over the summer campaign period (vs 64% of non-recognisers, p < 0.05), and 45% said they had adopted at least three of the five sun protection behaviours (Slip, Slop, Slap, Seek and Slide) ‘always’ or ‘often’ (vs. 36% of non-recognisers, p < 0.05). A mass-media campaign that aimed to elicit emotional (fear) and cognitive (perceived efficacy) responses and which drew upon social and heuristic cues was associated with greater self-reported sun protection among the target audience. Delivering a combination of message strategies simultaneously within a campaign tailored to young adults may be more effective than adopting a more singular focus.