اپیدمیولوژی
مقالهها، منابع و پژوهشهای تازه حوزه اپیدمیولوژی
ورود به زیرشاخهنقشه موضوعی
جستوجوی دقیقبهداشت و سلامت عمومی
سلامت جمعیت، پیشگیری، سیاستگذاری و عدالت سلامت
زیرشاخهها
برای رسیدن به فهرست متمرکزتر، یک مسیر تخصصی را انتخاب کنید.
آمار زیستی
مقالهها، منابع و پژوهشهای تازه حوزه آمار زیستی
ورود به زیرشاخهبهداشت محیط
مقالهها، منابع و پژوهشهای تازه حوزه بهداشت محیط
ورود به زیرشاخهبهداشت حرفهای
مقالهها، منابع و پژوهشهای تازه حوزه بهداشت حرفهای
ورود به زیرشاخهسیاستگذاری سلامت
مقالهها، منابع و پژوهشهای تازه حوزه سیاستگذاری سلامت
ورود به زیرشاخهاقتصاد سلامت
مقالهها، منابع و پژوهشهای تازه حوزه اقتصاد سلامت
ورود به زیرشاخهآموزش و ارتقای سلامت
مقالهها، منابع و پژوهشهای تازه حوزه آموزش و ارتقای سلامت
ورود به زیرشاخهسلامت جهانی
مقالهها، منابع و پژوهشهای تازه حوزه سلامت جهانی
ورود به زیرشاخهتعیینکنندههای اجتماعی سلامت
مقالهها، منابع و پژوهشهای تازه حوزه تعیینکنندههای اجتماعی سلامت
ورود به زیرشاخهکنترل بیماریهای واگیر
مقالهها، منابع و پژوهشهای تازه حوزه کنترل بیماریهای واگیر
ورود به زیرشاخهبیماریهای غیرواگیر
مقالهها، منابع و پژوهشهای تازه حوزه بیماریهای غیرواگیر
ورود به زیرشاخهتازهترین رکوردها
شواهد بهداشت و سلامت عمومی
PubMed2027
Global Genomic Surveillance.
Global genomic surveillance has emerged as a foundational pillar of public health in the twenty-first century, enabling real-time tracking of pathogen evolution and informing outbreak response. This chapter examines the strategic architecture of global genomic surveillance, focusing on its application to arboviruses such as chikungunya virus (CHIKV). It explores the integration of genomic data with epidemiological, clinical, and environmental information within a One Health framework, while addressing critical challenges in governance, equity, and interoperability. The discussion covers the entire genomic surveillance workflow, from sample collection and sequencing to bioinformatic analysis and phylogenetic inference, and highlights the transformative role of artificial intelligence (AI) in predictive surveillance. By analyzing global initiatives, operational barriers, and emerging technologies, this chapter underscores the necessity of sustainable, equitable, and interoperable genomic systems to proactively address current and future infectious disease threats.
PubMed2026
[THE HEALTH PRESERVATION OF FEMALE SAILORS CONCERNING ISSUES OF GENDER-CONDITIONED VIOLENCE. PART II. THE ROLE OF INTERNATIONAL ORGANIZATIONS].
The article summarizes results of analysis of the normative and institutional architecture of counteracting gender-conditioned violence in maritime industry. It is demonstrated that the Convention of International Labor Organization №190 and the Recommendation №206 shape ecosystemic standard of protection standard that extends to ship as workplace and covers wide range of situations and employment statuses. The mutual attachment with regimen of the International Maritime Organization and systems of security management enhances integration of psycho-social risks into corporate compliance and risk management. At the industry level, the principles of the International Chamber of Shipping (2024) codify zero-tolerance approach, mandatory training, secure communication channels and access to medical and psychological support. The support ecosystem (trade unions, charitable foundations and professional networks) decreases barriers of appealability and increases trust to procedures. The empirical data confirms high prevalence of undesirable behavior on ships with mixed-gender crew and demonstrates efficiency of combination of normative, organizational, technological and educational interventions. The conclusion is made that concordance with international standards, maturity of corporate systems and access to specialized care shift prevention from area of declarations to sustainable business practice, decreasing latency of violations, strengthening reliability of operations and improving staff retention.
PubMed2026
Comparative Barriers and Enablers in ASEAN Long-Term Care Systems: Insights From the 2025 Regional Policy Dialogue and Policy Recommendations for Equitable Active Ageing.
OBJECTIVE: To examine barriers and enablers to equitable long-term care (LTC) across ASEAN-Plus Three (APT) economies and to propose a framework for equitable active ageing, contributing to Sustainable Development Goals 3 and 10. METHODS: A qualitative participatory-observation study was conducted during the 2025 Regional Policy Dialogue on Inclusive and Equitable Care Systems. Reflexive thematic analysis, read through a life-course lens, was applied to three deliberation sessions involving 107 stakeholders from policy, academic, civil-society and provider sectors across diverse welfare regimes. RESULTS: Three themes were generated: institutional fragmentation converts earlier disadvantage into unequal access; communities absorb shortfalls in formal care without displacing public responsibility; and equity depends on redistributing voice and coordinating responsibility across levels. Costs fall heaviest on women and on rural and low-income older people. CONCLUSIONS: A critical participatory life-course framework can guide LTC redesign through inclusive governance; national coordination hubs are advanced as an author-generated proposal extending participants' calls for coordination.
PubMed2026
The Impact of Infectious Disease Severity on Stigma Associated With Affected Regions: A Facial Representation Perspective.
Individuals from regions affected by infectious disease outbreaks may be stigmatized because others hold negative mental images-or mental representations-of them. This study investigated whether such outbreaks lead to the formation of negative mental representations of residents in affected areas and explored the role of disease severity in this process. Study 1 revealed that during the early stages of the COVID-19 epidemic, the public's mental representations of residents from Wuhan were perceived as less attractive than those of Chengdu residents and associated with disgust and behavioural avoidance. However, differences disappeared after the restrictions of the epidemic were lifted. The results indicate that the COVID-19 outbreak triggered stigmatization of residents in Wuhan. In Study 2, disease severity and perceived threat were manipulated, and results show that participants formed less attractive face representations of residents from areas where severe infectious diseases broke out than those from areas affected by mild infectious diseases. This proved that the severity of infectious diseases affected the extent of stigmatization towards residents in outbreak areas. These results further our understanding of the mechanisms and factors underlying stigmatization associated with affected regions and may inform effective public health strategies to mitigate stigma and support disease control efforts.
PubMed2026
Community Stakeholder Perspectives on Children With Cerebral Palsy and Their Caregivers: A Qualitative Study From Rural Malawi.
BACKGROUND: Cerebral palsy (CP) disproportionately affects children in low- and middle-income countries, where stigma and discrimination lead to marginalization and reduced participation. To design culturally appropriate community-based health promotion strategies that can address these challenges, the role of community stakeholders is crucial, yet unstudied in rural sub-Saharan Africa. This study aimed to explore stakeholders' perceptions, beliefs and attitudes towards children with CP and their caregivers in rural Malawi. METHODS: A qualitative study using semistructured focus group discussions was conducted with 68 stakeholders across five villages in Mangochi District, Malawi, from November 2022 to January 2023. Participants included traditional leaders, religious leaders, teachers, health surveillance assistants, traditional healers and community volunteers. Thematic analysis identified key themes regarding knowledge, perceptions, community participation and future needs. RESULTS: The following four major themes emerged: (1) limited knowledge about CP causes and treatment, with CP often attributed to infectious diseases, witchcraft or pregnancy complications; (2) perception of difficulties and their impact on the children and their caregivers; with financial constraints being named most and problems accessing education; (3) community participation and response; were stigma was identified as primary barrier to health promotion and community participation; and (4) future facilitators to improve quality of life including strong stakeholder willingness to support integrated care approaches. CONCLUSIONS: Community stakeholders demonstrated positive attitudes towards children with CP and willingness to support inclusive care programmes, despite limited disease-specific knowledge. Findings suggest that community-based health promotion interventions addressing knowledge gaps, reducing stigma and strengthening referral pathways could significantly improve outcomes for children with CP and their families in low-resource settings.
PubMed2026
Global, Regional and National Burden of Viral Hepatitis From 1990 to 2021 With Forecasts to 2046: Findings From the Global Burden of Disease Study 2021.
Viral hepatitis constitutes a primary cause of liver cirrhosis and carcinoma and ranks as the second leading cause of mortality worldwide due to challenges in early detection and limited preventive measures, thereby posing a significant threat to public health. This study analyses the burden and risk factors associated with viral hepatitis at global, regional, and national levels from 1990 to 2021, and projects the disease burden from 2022 to 2046. From 1990 to 2021, the global burden of viral hepatitis increased, despite a decline in age-standardized rates. Population growth emerged as the primary driver influencing this trend, with the highest disease burden observed in the African region. A high body-mass index (BMI) demonstrated a distinct and significant association with the sustained increase in disease burden. Excessive alcohol consumption was identified as the leading cause of hepatitis B, while drug abuse was predominantly linked to hepatitis C. Notably, males exhibited a markedly higher susceptibility to these risk factors compared to females. Over the next 25 years, the disease burden of hepatitis A, B, C and E is projected to remain stable or decline. Viral hepatitis remains a significant global public health challenge. It is imperative to strengthen efforts to prevent alcohol and drug abuse, consistently advance disease detection and treatment methods, and enable low- and middle-income countries to improve healthcare infrastructure and expand vaccination coverage. These measures are essential to promptly reduce the disease burden and achieve the goal of eliminating viral hepatitis by 2030.
PubMed2026
Impact of Community Factors on Mental and Physical Health During Successive Waves of COVID-19 Pandemic in China.
This study examined how community factors impacted well-being during the COVID-19 pandemic in China. Data were collected at two time points: Time 1 (T1) in September 2021 (N = 992) when COVID-19 cases stabilized, and Time 2 (T2) in January 2023 (N = 497) during a sudden outbreak of new infected cases. At T1, perceived community safety and sense of community directly affected depression, anxiety, and physical health symptoms, with sense of community partially mediating these effects. At T2, community factors at T1 continued to impact depression, anxiety, and physical health symptoms. Sense of community at T1 partially mediated the link between community safety at T1 and mental health at T2. Higher income and older age were associated with a stronger sense of community, better perceived community safety, and improved health. Policymakers should consider the impact of community factors on well-being during health crises.
PubMed2026
Implementation of a Multidisciplinary Non-Pharmacological Program to Improve Urinary Incontinence in an Intermediate Care Hospital.
INTRODUCTION: Urinary incontinence (UI) is a prevalent geriatric syndrome that significantly affects the physical, psychological, and social well-being of older adults. Non-pharmacological interventions are recommended as the first-line approach, especially in frail older adults. DESIGN: This was a prospective pre-post observational study. METHODS: The study included sixty-one patients with rehabilitable UI who were admitted to an intermediate care hospital. The nurse-led multidisciplinary program integrated education, hygiene-dietary measures, pelvic floor physiotherapy, behavioral strategies, and transcutaneous electrical nerve stimulation (TENS). The primary outcomes were UI severity (International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)), voiding awareness, diurnal and nocturnal voids, disposable absorbent product use, functional status (Barthel Index), cognitive status (Pfeiffer test), and quality of life (EQ-5D). Data were collected at baseline and discharge. RESULTS: Data from 61 participants were analyzed. Significant improvements were observed in the ICIQ-SF scores (16.72 ± 3.39 vs. 9.10 ± 5.86; p < 0.001), daytime voiding awareness (83.6% vs. 100%; p = 0.002), nocturnal voiding awareness (66.7% vs. 88.5%; p = 0.002), nocturnal voids (3.46 ± 2.22 vs. 2.35 ± 1.68; p < 0.001), Barthel Index (49.83 ± 23.84 vs. 70.33 ± 19.59; p < 0.001), and EQ-5D scores (0.39 ± 0.28 vs. 0.56 ± 0.26; p < 0.001). The use of disposable absorbent products decreased from 98.36% to 62.30% (p = 0.065). The patient's cognitive status remained stable. The mean satisfaction with the program was 8.53/10. CONCLUSIONS: A nurse-led, multidisciplinary, non-pharmacological intervention effectively reduced UI severity, increased voiding awareness, enhanced functional autonomy, and improved the quality of life in older adults. These findings support the implementation of individualized, evidence-based programs in intermediate care settings. CLINICAL RELEVANCE: Non-pharmacological interventions led by advanced practice nurses provide effective, patient-centered management of urinary incontinence, improving autonomy and quality of life while potentially reducing healthcare costs.
PubMed2026
Narrative Numbing and the Politics of Public Health Emergencies.
We examine how political polarization and prolonged crisis governance contribute to narrative numbing in public health emergencies and explore how these dynamics reshape executive emergency powers in the United States. Using Google Trends data, we assess changes in public attention to the opioid epidemic. We follow this with an explanatory case study of Pennsylvania's opioid state of emergency and a comparative review of national legislative reforms to state emergency powers. Prolonged emergency governance during COVID-19 coincided with narrative numbing, weakening the agenda-setting power of emergency declarations. In Pennsylvania, this shift was associated with legislative reforms that constrained executive authority with downstream effects on the opioid emergency. Nationally, state legislatures adopted time-limit, legislative termination, and scope constraints that reallocated authority from executives to legislatures. Narrative numbing is reflected in legislative reforms and has reshaped public health governance by limiting states' capacity to sustain emergency responses to prolonged or recurring public health crises. These changes carry implications for regional health equity and population health outcomes, demonstrating the need to maintain political legitimacy for sustained public health action. (Am J Public Health. 2026;116(11):1719-1726. https://doi.org/10.2105/AJPH.2026.308730).
PubMed2026
Psychoeducational Challenges of Dyslexic Children During the COVID-19 Pandemic: A Systematic Review.
Dyslexic students faced psychological and educational challenges during the COVID-19 pandemic and online learning, including increased anxiety, low self-esteem, reduced reading interest, limited access to educational technologies, insufficient teacher support, and difficulties with reading fluency and concentration. Examining these challenges is crucial for implementing effective measures and enhancing post-pandemic learning. This study investigates the psycho-educational challenges of dyslexic children during the pandemic, highlighting the need for targeted interventions to support them in current and future contexts. This systematic review identified relevant articles through electronic searches of PubMed, Wiley, Scopus, Web of Science, Google Scholar, and ScienceDirect, supplemented by the snowballing technique, which involved examining the bibliographies of retrieved references. The study identified two main categories of challenges for dyslexic children: psychological (mental health, emotional well-being, behavioural issues, parental stress) and educational (socioeconomic status, technology access, special educational needs, teacher support, remote learning difficulties) affecting children with learning disabilities. The research results show that dyslexic children faced various psychological and educational difficulties identified in this review during the COVID-19 pandemic. Therefore, targeted, evidence-based strategies-such as teacher training, family-school collaboration, adaptive learning technologies, and psychological support-are needed to mitigate these challenges in the post-pandemic period.
PubMed2026
Regional and Temporal Dynamics of Dengue in Mexico (2020-2024): A Comprehensive Epidemiological Analysis.
Dengue remains a major public health concern in Mexico, with incidence and clinical burden increasing substantially in recent years. Using national surveillance data from 2020 to 2024, this study provides a comprehensive overview of the changing epidemiological landscape, with an emphasis on geographic distribution, temporal trends, serotype dynamics, and disease severity. Over this period, Mexico saw an almost fivefold increase in dengue cases, reaching over 123,000 confirmed infections and 426 deaths in 2024, the highest annual number recorded. Seasonal patterns shifted, with sustained transmission extending into unusual winter months from late 2023. Serotyping data revealed a shift in predominant virus serotypes, with DENV2 predominating until 2022, DENV1 peaking in 2021, and DENV3 rising sharply from 2022 onward, becoming dominant in 2023 and almost exclusive by 2024. This shift coincided with a sustained rise in dengue with warning signs (from 16.9% in 2020 to > 42% in 2023-2024) and higher hospitalisation rates, while severe dengue remained below 5%. Although DENV3 dominated nationally, DENV1 and DENV2 persisted in specific states, and DENV4 circulated sporadically, particularly in southern and northern regions. Several traditionally low-prevalence states experienced atypical outbreaks, underscoring the potential for sudden epidemic expansion. Climatic analysis showed a consistent positive association between temperature and DENV3 prevalence, with precipitation effects varying by year. Odds ratio analysis suggested serotype-specific differences in severity across years. These findings underscore the heterogeneous and dynamic nature of dengue transmission in Mexico and highlight the need for regional surveillance, prevention, and clinical preparedness strategies.
PubMed2026
Secondary Use of Health Data in Canada and the European Union: Expectations, Frictions and the Politics of Scale.
In this article, we trace expectations associated with efforts to promote secondary use of health data in Canada and the European Union. In Canada, we focus on initiatives enabling cross-jurisdictional data access in a highly devolved federal system with parallel commitments to Indigenous data sovereignty. In the EU, we focus on the European Health Data Space, a new regulatory regime intended to facilitate access to health data for clinical care, research, policymaking and innovation across 27 member states. Drawing on a comparative analysis of policy documents and semi-structured interviews across nine EU member states and four Canadian provinces and one territory, we find that despite institutional differences, secondary use in both jurisdictions is characterised by strikingly similar promissory vocabularies. We argue that these expectations are fundamentally ones of scale: They seek to render health data interoperable, comparable and usable to different ends. At the same time, we document shared frictions: between sovereignty and integration; between access and control; and between private assets and public goods. We understand these as spaces where competing valuations of health data are negotiated. We suggest that secondary use logics are progressively reorienting health systems, with implications for public value, equity and political collectives.
PubMed2026
Turning Structures Into Attributes: The Marginalisation of Critical Theory in Research on Social Determinants of Health.
Critical theory has provided important resources for understanding the social determinants of health (SDOH). Yet less is known about what happens to these explanatory resources as SDOH becomes increasingly institutionalised in research and policy. We examine this question through a scoping review of 298 peer-reviewed SDOH reviews published between 2005 and 2025, together with a close analysis of the 15 reviews with the highest annualised Web of Science citation rates. The findings show a pronounced and widening discursive asymmetry: mainstream, technically oriented reviews dominate the literature and have expanded substantially over time, whereas explicitly critical approaches have remained rare. At the same time, critical concepts such as class, exploitation and social reproduction have not disappeared. Instead, they are often retained in attenuated form, reframed as indicators of risk, vulnerability or group difference rather than as concepts for explaining how health inequalities are produced. This process is described here as explanatory marginalisation. Greater engagement with critical theory can therefore strengthen the capacity of SDOH research to explain, rather than merely describe, the structural production of health inequality.
PubMed2026
A tale of two realities: how do policymakers and general practitioners perceive the performance of primary health networks in Australia.
BACKGROUND: As the major regional primary health care (PHC) organisations in Australia, Primary Health Networks (PHNs) are expected to coordinate health care for patients and respond to local health needs. To evaluate their success, it is important to examine both policy practitioners' and GPs' perceptions of PHNs' role, structure and performance. METHODS: Thirty-six semi-structured interviews were conducted, including 15 interviews with policy practitioners and 21 interviews with GPs. The interviews were audio-recorded, transcribed and thematically analysed to gain a comprehensive understanding of key stakeholders' perceptions of the performance of PHNs. RESULTS: The interviews with policy practitioners gave rise to three main themes: (1) PHNs enabled federal and state collaboration in PHC; (2) PHNs played an intermediary role in system integration; and (3) further actions were needed to improve the performance of PHNs. Three further main themes were derived from interviews with GPs: (4) PHNs did not engage enough with general practice; (5) GPs preferred the former divisions of General Practice and distrusted PHNs; and (6) PHNs were viewed as a means for the federal health department to recentralise, rather than decentralise, the health system. CONCLUSION: The different sets of themes reflected different perspectives on PHNs' role, structure and performance. Although policy practitioners generally held a positive view over PHNs' role and performance, GPs complained about the lack of engagement from PHNs and demonstrated distrust of PHNs. Given GPs' critical role in the delivery of PHC, their distrust of PHNs limits the success of PHNs in terms of supporting better PHC and improving care coordination. The Australian Federal Government should find ways to mitigate GPs' distrust of Commonwealth-funded regional PHC organisations, including by encouraging improved engagement by PHNs with general practice.
PubMed2026
Clinical outcomes and management of syphilis during pregnancy amidst the Northern Territory syphilis outbreak: a 10-year retrospective cohort study.
BACKGROUND: This retrospective study describes the clinical outcomes and management of people diagnosed with syphilis during pregnancy and their newborns at risk of congenital syphilis in the Northern Territory (NT), Australia between 2013 and 2023. METHODS: Demographic, clinical, and contact tracing information on all pregnancies with syphilis diagnosed prior to or during pregnancy, and clinical information of neonates, were sourced from spreadsheets and the NT Syphilis Register Information System. RESULTS: A total of 380 pregnancies were monitored, of which 186 pregnancies were identified as at risk of mother-to-child transmission of syphilis. Reinfection accounted for 13.8% of the 181 new syphilis infections. Of the 188 neonates, there were 11 cases of congenital syphilis, including 1 case of stillbirth. All congenital syphilis cases occurred when maternal syphilis was diagnosed in the third trimester or at the time of childbirth. While maternal treatment was completed in all pregnancies, 22 (11.8%) received treatment less than 30 days prior to childbirth or were untreated at the time of childbirth. Initial treatment was inadequate in 10 pregnancies (5.4%). A lack of four-fold reduction in rapid plasma reagin (RPR) titres by the time of childbirth due to delayed diagnosis and treatment was significantly associated with neonatal congenital syphilis (P < 0.001), with a median RPR of 1:8. Among identified contact/s, 54 (43.2%) tested positive for syphilis. CONCLUSION: Early detection, treatment, and follow-up of maternal syphilis before and during pregnancy are key measures to prevent congenital syphilis. Universal syphilis screening with repeat testing should be incorporated into antenatal care to minimise stigma.
PubMed2026
Describing an integrated partnership approach to improving sexual health literacy and service navigation for international students in Sydney, Australia.
BACKGROUND: The population of international students (IS) in New South Wales (NSW) continues to grow post-COVID-19, with IS a key priority within NSW Health HIV and sexually transmissible infection (STI) strategies and efforts. Evidence shows gaps in sexual and reproductive health knowledge (SRH), and barriers to accessing services, including stigma, unfamiliarity with the Australian healthcare system and service cost concerns. Although the existing NSW International Student Health Hub website provides tailored information, awareness and utilisation of statewide and local sexual health preventive services remains limited. METHODS: A partnership between Sydney Local Health District and the NSW Multicultural HIV and Hepatitis Service implemented a localised, culturally responsive health promotion program. Consultations with IS and student services informed strategies to improve SRH literacy, strengthen service navigation, and enhance supportive environments. Key strategies included developing a local International Student Health Directory, peer and service capacity building, dissemination of SRH information through culturally responsive health stalls, and a mobile STI screening clinic on a university campus. RESULTS: This review describes the program delivery between January 2024 and March 2026. More than 5000 international students engaged with 28 health promotion stalls, with >2500 health directories distributed. The peer capacity-building program trained 106 student leaders, with participant sexual health knowledge increasing from 75 to 91% in pre- and post-training assessments. Campus-based STI screening tested 22 students, and identified one undiagnosed case of syphilis. CONCLUSION: A health promotion program delivering localised, multifaceted and partnership-driven activities can strengthen IS SRH literacy, service navigation and engagement with demonstrated transferability across NSW.
PubMed2026
Moving beyond sexual and reproductive health knowledge: an evaluation of a co-designed digital engagement tool to promote sexual and reproductive health among international students in New South Wales, Australia.
BACKGROUND: This study evaluates the perceived impact and needed enhancement of a co-designed digital sexual and reproductive health (SRH) tool ('the Hub') developed to address SRH literacy gaps among international students (IS) in New South Wales, Australia. Despite Australia's large IS population and recognition of SRH as a fundamental human right, many report limited exposure to SRH information and face barriers to navigating health systems and accessing SRH services in host countries. METHODS: A mixed-methods evaluation was conducted comprising an online survey (August-October 2024; N = 129) and a focus group discussion (FGD) with professionals working with IS (N = 11). RESULTS: Survey findings indicate high acceptability and perceived usefulness of the Hub, with over 80% of participants rating content, including on the Australian health system, as high quality and most endorsing its design, tone, and usability. Although IS knowledge of HIV prevention and STI treatment was generally strong, gaps persisted regarding asymptomatic STIs, contraceptive limitations, and health system navigation. Notably, despite high awareness and favourable peer norms toward condom use and STI testing, testing uptake remained low: fewer than one in five sexually active IS reported STI (17.8%) or HIV (19.4%) testing in the previous 12 months. Qualitative FGD findings highlighted support for broader promotion strategies, including pre-arrival and campus-based dissemination, alongside needed enhancements to service navigation and cost transparency for SRH services. CONCLUSION: Overall, the Hub demonstrates feasibility and relevance as a digital intervention, though improved promotion and stronger linkage between knowledge and service uptake are essential to maximise public health impact.
PubMed2026
Perspectives on primary care management of chronic hepatitis B in refugees: findings from qualitative interviews with healthcare providers in Melbourne, Victoria.
BACKGROUND: In Australia, healthcare providers face significant challenges in meeting the niche health needs of refugees. Social determinants of health, including limited health literacy and finances, complicate refugees' access to treatment for conditions, such as chronic hepatitis B (CHB). Understanding the strategies utilised by a specialised general practice for refugees can offer guidance for treating this population. The aim of this study was to explore how primary care is currently managing CHB care tailored to refugees and to identify areas for potential improvements. METHODS: Between August and December 2024, we conducted 15 semi-structured interviews with nine general practitioners, four nurses, one pharmacist and one infectious disease specialist. We used a convenience sample and snowballing; most participants worked at a refugee-focused general practice in the west of Melbourne, Victoria, Australia. All interviews were recorded and transcribed; data were analysed descriptively. RESULTS: Primary healthcare providers in our study recognised the challenges of treating refugees with CHB, including low health literacy, and the cost of providing and seeking care. However, when compared with hospital services, the benefits of primary care include community integration and location, rapport development, and the availability of interpreter services. Subsidising primary care provider training and other costs were recommended. CONCLUSIONS: Primary care may be better positioned than hospital services to treat refugees with CHB. These findings support funding and improving CHB management in primary care to meet the needs of refugees, which will lead to better health outcomes for this disadvantaged population.
PubMed2026
[Clinical risk factors and molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae infection].
Objective: To investigate the molecular epidemiological characteristics, antimicrobial resistance mechanisms, and clinical risk factors for infection with carbapenem-resistant Klebsiella pneumoniae (CRKP), and to examine the relationship between antimicrobial resistance and virulence. Methods: A total of 528 Klebsiella pneumoniae (KP) isolates and corresponding clinical data were collected from hospitalized patients at Qingdao Municipal Hospital between November 2016 and October 2023. Based on antimicrobial susceptibility testing results, 80 patients with CRKP infection were assigned to the CRKP group. Patients with carbapenem-susceptible K. pneumoniae (CSKP) isolates recovered within 7 days before or after the CRKP isolation date were selected as matched controls for each patient in the CRKP group. If insufficient eligible controls were available, the matching window was expanded to 30 days before or after the isolation date. Ultimately, 160 matched patients were included in the CSKP group. Whole-genome sequencing was performed on all included isolates to systematically characterize their molecular epidemiological features and resistance and virulence gene profiles. A multivariable logistic regression model was used to identify independent risk factors for CRKP infection. Spearman rank correlation analysis was performed to assess the correlation between resistance and virulence gene scores. Results: Multivariable logistic regression analysis showed that a history of antimicrobial agent use in the 30 days before infection (OR=4.411, 95%CI: 1.749-11.128; Wald χ²=9.882; P<0.01) and invasive abdominal procedures in 30 days before infection (OR=6.846, 95%CI: 3.141-14.922; Wald χ²=23.411; P<0.01) were independent risk factors for CRKP infection. ST11 was the predominant sequence type among CRKP isolates (80.0%), and the blaKPC-2 gene was the predominant resistance determinant (88.8%). The predominant CRKP clone, ST11, underwent a serotype transition from ST11-K25/O5 to ST11-K64/O2a. At the overall population level, the antimicrobial resistance gene score was negatively correlated with the virulence gene score (Spearman ρ=-0.321, P<0.001). However, subgroup analysis showed no significant correlation between the two scores within the same ST11 clone (Spearman ρ=0.020, P=0.872). These findings suggest that the overall negative correlation was a population-level artifact caused by inherent phenotypic differences among distinct clonal groups, rather than an evolutionary trade-off in which the acquisition of antimicrobial resistance within the same clone resulted in reduced virulence. The intensive care unit (ICU) was the central hub for nosocomial clonal transmission of CRKP. The predominant clone may have disseminated from the ICU to general wards through patient transfers, healthcare workers, or medical equipment, thereby forming interdepartmental transmission chains. Conclusions: A history of antimicrobial agent use and invasive abdominal procedures in the 30 days before CRKP infection were independent risk factors for CRKP infection. CRKP isolates frequently carried plasmids coharboring multiple antimicrobial resistance determinants and exhibited extensive antimicrobial resistance.
PubMed2026
An overview of international reference values for vitamin E intake - similarities and differences in derivation.
PURPOSE: The scientific knowledge for the essential fat-soluble vitamin E (VitE) remains inconclusive. There is still a lack of valid status parameters and deficiency symptoms for insufficient intake. Therefore, the derivation of a dietary reference value (DRV) for VitE is challenging and differs between the different organizations and countries. The aim of the current paper is to provide an overview of selected international DRVs and discuss the different derivation procedures. METHODS: DRVs from sixteen countries and international organizations were retrieved, compared and evaluated. RESULTS: The DRVs are inconsistent in the absolute value as well as the employed concept of derivation. Due to the uncertainty of the available data some organizations did not specify a DRV. Others used plasma cut off levels or the required amount for the protection of polyunsaturated fatty acids against oxidation. Many DRVs are based on population intake data and given as adequate intake. But this approach may overestimate the VitE needs. CONCLUSION: In conclusion, due to missing symptoms and markers of insufficient supply, the compensation of daily losses with the consideration of the bioavailability appears to be a good basis for deriving a DRV for VitE intake. A balanced and plant-based diet (without supplements) appears to be sufficient for an adequate VitE supply.
PubMed2026
Clinical Nurse Specialists' Contribution to Safe Jackson-Pratt Drain Removal.
PURPOSE/OBJECTIVE: This project aimed to educate nurses on teaching patients about the safe management and removal of Jackson-Pratt (JP) drains at home. Using a multimodal learning approach allowed staff and patients to practice the procedure and build confidence to independently perform a JP drain removal. The project objective was to ensure that patients safely remove their own JP drain at home without complications. DESCRIPTION: After 2 extensive literature searches on the adverse effects of a delayed drain removal and the benefits of an at-home drain removal, a teaching plan was developed, which included a handout for the nurses with key teaching points, a patient education handout, and face-to-face education with staff for hands-on practice. OUTCOMES: This is an ongoing project that was initiated in February 2025. Although this is a new project, close to 100 drains have been successfully removed at home with no complications reported. CONCLUSIONS: By teaching nurses to educate their patients on JP drain management and removal at home, our staff was able to ensure patient safety and comfort. By educating patients on proper care and removal of their JP drains, bedside nurses improved patient satisfaction, reduced the risk of complications, decreased resource utilization, while not compromise patient outcomes.
PubMed2026
Codevelopment, Implementation, and Evaluation of an AI-powered Conversational Interface for Tobacco Cessation: Protocol for a Single-Group Pre-Post Study.
BACKGROUND: Despite several efforts to expand tobacco cessation services through tobacco cessation centers (TCCs) and quit lines, key operational challenges still persist. Recently, AI-based digital interventions have shown promise globally for smoking cessation; however, they remain underused in tobacco cessation strategy in the Indian context. OBJECTIVE: This study aimed to (1) codevelop the conversational interface with beneficiaries and cessation providers; (2) assess its feasibility, acceptability, usability, and user engagement; and (3) evaluate its effectiveness in promoting attempts and intention to quit tobacco. METHODS: The study consists of three phases: (1) codeveloping the comprehensive AI-powered Conversational Interface to Quit Tobacco (CARE) conversational interface through in-depth interviews with tobacco users, counselors, and health care professionals; (2) feasibility testing with tobacco users to assess engagement, usability, and acceptability; and (3) 6-month effectiveness testing using pre-post surveys. The CARE conversational interface will be developed using a retrieval-augmented generation-based large language model by the Indian Institute of Technology (Bombay, Maharashtra, India), delivering personalized, multilingual cessation support via a chatbot integrated into a mobile app. Key evaluation measures will use validated tools such as the Fagerström Test for Nicotine Dependence, Smoking Self-Efficacy Questionnaire, Decisional Balance Scale, and a Knowledge Score Questionnaire. Data will be analyzed using mixed methods, including thematic analysis for qualitative data and descriptive statistics and a multivariate logistic regression for quantitative data. RESULTS: The CARE study was funded in March 2025 and is being implemented across 3 TCCs. Preparatory activities, including tool development, site engagement, ethics approval, and trial registration (CTRI/2024/11/076916), were completed in 2025. Phase 1 (codevelopment) is scheduled from February to August 2026, followed by phase 2 (feasibility testing) from September 2026 to August 2027, and phase 3 (effectiveness assessment) from September to November 2027. Data analyses are expected to be completed by late 2027, with key findings on feasibility, acceptability, usability, user engagement, and preliminary cessation outcomes targeted for peer-reviewed publication from 2027 onward. CONCLUSIONS: The CARE study will attempt to introduce a novel, culturally tailored conversational interface targeting both smokers and smokeless tobacco users in India by integrating AI-based solutions as an adjunct to conventional counseling at the TCCs. Given the single-group pre-post design without a control arm, feasibility and effectiveness findings will be interpreted as preliminary and hypothesis-generating rather than causal evidence of intervention impact. The intervention approach of codevelopment, strengthening capacity in evidence-based content, and enabling a multilingual conversation interface is expected to enhance tobacco user engagement and improve cessation outcomes. Findings from this pilot will inform a future randomized controlled trial and provide evidence for the potential integration of the CARE interface into India's tobacco cessation platforms, offering a low-cost, high-impact solution for India and other low- and middle-income countries that face similar challenges. TRIAL REGISTRATION: Clinical Trials Registry-India CTRI/2024/11/076916; https://tinyurl.com/3vfs5d8s. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/82264.
PubMed2026
Detection of Acute Hepatitis C Outbreaks in California Using SaTScan: Statewide Spatiotemporal Analysis.
BACKGROUND: Acute hepatitis C virus outbreaks in California are identified by local health jurisdictions through the investigation of cases reported by laboratories and health care providers to the state's public health surveillance system. However, acute hepatitis C cases are widely underreported, limiting timely outbreak detection and early intervention. SaTScan (Space and Time Scan Statistics) has been proposed as a valuable tool to better detect disease clusters that may be missed by traditional surveillance, even when the disease is underreported, but it is not routinely used for acute hepatitis C surveillance. Timely outbreak detection enables prompt investigation, interruption of transmission networks, and expeditious access to treatment that prevents chronic hepatitis C progression. OBJECTIVE: We assessed the feasibility of using SaTScan to identify verified acute hepatitis C outbreaks using public health surveillance data by conducting a retrospective cluster analysis followed by a prospective, proof-of-concept (POC) analysis that simulated routine surveillance at a single time point using the preceding 2 years of available data. METHODS: We geocoded acute hepatitis C cases with an episode date between January 2022 and December 2023 that were reported to the California Department of Public Health (CDPH). Cases among people experiencing homelessness were included using proxy locations corresponding to their reporting jurisdiction. First, we applied a retrospective space-time permutation scan to determine if any detected significant clusters corresponded to a verified acute hepatitis C outbreak reported in California. We then performed a single prospective POC scan using surveillance data from August 2020 through August 2022 to simulate routine surveillance on August 28, 2022. Detection performance was evaluated based on whether the scan generated a signal corresponding to the known acute hepatitis C outbreak, measured using recurrence intervals. RESULTS: Of the 236 acute hepatitis C cases reported in California with an episode date between January 2022 and December 2023, 97.9% (n=231) were successfully geocoded. The retrospective scan identified 1 significant cluster that corresponded to a verified outbreak in Los Angeles County. The prospective POC scan detected the same outbreak 1 day after the second outbreak-related case was reported, based on symptom onset. The cluster exceeded the recurrence interval threshold (1.7 y), and 2 of 3 outbreak-related cases were identified. CONCLUSIONS: SaTScan successfully identified a verified acute hepatitis C outbreak using both retrospective and prospective space-time permutation scans, demonstrating its potential to enhance real-time surveillance. However, detection performance depends on the timeliness and completeness of case reporting. Future research should explore the prospective use of SaTScan with real-time surveillance data to fine-tune signaling thresholds and scan statistic parameters and assess its broader applicability for acute hepatitis C outbreak detection.
PubMed2026
Developing a youth sustainability healthy active living intervention for chronic disease prevention and environmental sustainability through community engagement and codesign: protocol for a multimethod community-based participatory research study in Canada and Jamaica.
BACKGROUND: Most non-communicable diseases (NCDs) develop through multiple complex pathways that involve non-modifiable and modifiable risk factors. Prevention efforts optimally involve a life course approach that promotes healthy eating and physical activity because behaviours adopted early in adolescence and young adulthood are likely to be sustained and can prevent NCDs in later life. This research protocol describes a community-based co-designed study taking place in Canada and Jamaica that positions youth aged 15-25 as agents-of-change in their communities to increase knowledge and develop tools to adopt and promote sustainable practices and healthy active living. METHODS: The SCORE! Youth Sustainability Healthy Active Living (SCORE! Youth-SHAL)-Community Engagement and Co-design is a multimethod community-based participatory research (CBPR) study to be conducted in two sequential stages. Stage 1 involves community contextual mapping, a maximum of two community engagement workshops along with key informant interviews with both youth and stakeholders. Stage 2 includes a co-design workshop with local youth to develop customised healthy active living activities. Participants will be recruited using convenience and purposive sampling. Workshops and interviews will be audio-recorded and transcribed. Data will be collected to understand the SHAL intervention's feasibility, fidelity and contextual fit across diverse settings. Content and thematic analysis will occur concurrently and iteratively with data collection. ETHICS AND DISSEMINATION: This study has approval from Hamilton Integrated Research Ethics Board in Health Sciences, Brock University Research Ethics Board, The University of the West Indies-Mona Campus Research Ethics Committee, and Ministry of Health and Wellness, Jamaica-Advisory Panel on Ethics and Medico-Legal Affairs. Findings assist in finalising a SHAL intervention for youth in equity-deserving populations. We will also publish the study results in an academic journal and present at conferences, webinars and workshops.
PubMed2026
Fatal haemophagocytic lymphohistiocytosis and atypical haemolytic uraemic syndrome following coronavirus disease 2019 infection.
A previously healthy woman in her early 30s developed rash, fever and arthralgia 3 weeks after SARS-CoV-2 infection, rapidly progressing to multiorgan failure. Laboratory studies revealed severe thrombocytopenia (23×109/L), microangiopathic haemolytic anaemia, acute kidney injury and ferritin >100 000 ng/mL. Kidney biopsy demonstrated thrombotic microangiopathy with negative antinuclear antibody, supporting atypical haemolytic uraemic syndrome (aHUS). Concurrently, low haptoglobin, elevated lactate dehydrogenase (2500 U/L), interleukin-2 receptor (18 644), triglycerides (425 mg/dL) and splenomegaly supported haemophagocytic lymphohistiocytosis (HLH). Despite plasmapheresis, corticosteroids, etoposide, eculizumab and continuous renal replacement therapy, she died 7 weeks after SARS-CoV-2 infection. Autopsy confirmed aHUS with extensive thrombotic microangiopathy and HLH with bone marrow haemophagocytosis. This case underscores the importance of recognising concurrent aHUS and HLH after COVID-19, as complement-mediated injury and hyperinflammation may produce catastrophic outcomes.
PubMed2026
How personality traits shape susceptibility to mental distress in times of crisis: Evidence from the COVID-19 pandemic.
Empirical evidence indicates that societal crises and adverse conditions can negatively impact population mental health. The Big Five personality traits - neuroticism, extraversion, openness, agreeableness, and conscientiousness -significantly influence stress responses. In this article, we examine how personality traits were associated with mental distress during and in the aftermath of the COVID-19 pandemic. Based on data from the Understanding America Study, we find that, since the pandemic began, individuals with high levels of neuroticism were more likely to experience mental distress. By contrast, the remaining personality traits exhibited weaker, inconsistent, or statistically insignificant associations with mental health trajectories. Further analyses indicate that the heightened vulnerability among individuals high in neuroticism was accompanied by elevated risk perceptions, differential adoption of protective behaviors, and less adaptive coping patterns. Taken together, these findings suggest that personality-linked differences, particularly driven by the level of neuroticism, help explain heterogeneity in mental health responses to large-scale societal stressors. Our findings point to the relevance of personality traits (particularly neuroticism) for identifying individuals who may benefit from targeted mental health support during future crises.
PubMed2026
Modelling plant disease spread via high-resolution human mobility networks.
Human mobility plays a crucial role in the spread of human diseases but is rarely quantified in plant disease epidemics. To address this gap, we integrate a unique, high-resolution network of human movements in New Zealand with a metapopulation model to mechanistically simulate pathogen transmission. We calibrate the model on the nationwide 2010 kiwifruit vine disease (Psa-V) outbreak and show that it reproduces the observed spatio-temporal spread, confirming that the human mobility network is a strong foundation for modelling human-mediated transmission dynamics. By analysing spatial infection trends, we find that most dispersal occurs locally, as often illustrated in the plant-outbreak literature. However, sporadic long-range connections are necessary to model a nationwide outbreak. Using the model as an in silico laboratory, we demonstrate that the severity of human-mediated pathogen transmission is highly sensitive to the timing and location of initial importation. We observe a potential causal link between seasonal labour patterns and epidemic risk in high-traffic seasons. This study showcases a novel data-driven framework for modelling the spatio-temporal spread of agricultural pathogens when human-mediated dispersal is epidemiologically relevant, underscoring the importance of leveraging human mobility networks for building better biosecurity systems.
PubMed2026
Molecular epidemiology, seroprevalence and genetic characterization of bovine rotavirus in Qinghai yaks: first identification of G6P[5] genotype.
Bovine Rotavirus (BRV) is the main pathogen responsible for viral diarrhea in calves, which has a serious impact on the cattle industry and leads to economic losses. Therefore, this study aimed to fill the gap in the epidemiological research of yak-sourced rotavirus in Qinghai Province by investigating the infection rate and antibody positive rate of BRVA from yaks in Qinghai Province. We collected a total of 1,195 yak anal swab samples, 95 diarrheal fecal samples, and 834 serum samples from various cities and prefectures in Qinghai Province. The TaqMan probe method and indirect ELISA assay were used to detect and comprehensively analyze the infection rate of BRVA and the positive rate of serum antibodies in different cities and prefectures of Qinghai Province. Additionally, the key factors influencing virus transmission were explored in combination with epidemiological characteristics. The results showed that BRVA infections occurred to varying degrees in Xining City, Haidong City, Haibei Tibetan Autonomous Prefecture, Huangnan Tibetan Autonomous Prefecture, and Haixi Mongolian and Tibetan Autonomous Prefecture. The dominant genotype G6P[5] of the BRVA strains was first identified from yak populations in Qinghai Province. A total of 766 positive sera were detected by indirect ELISA, with an overall antibody positive rate of 91.85%. This study not only provided the latest epidemiological data of bovine rotavirus from yak populations in Qinghai Province, but more importantly, offered crucial data support for formulating targeted prevention and control strategies against BRVA in this region.
PubMed2026
Multimodal Online Recruitment and Engagement of Black Breast Cancer Survivors for Mixed Methods Social Determinants of Health Research: Feasibility Study.
This pilot study provides evidence that multimodal online recruitment and engagement are feasible for mixed methods social determinants of health research with sociodemographically diverse Black breast cancer survivors.
PubMed2026
Persistence of cardiovascular risk factor changes after the great recession: fixed effects analysis of prospective cohort data from the multi-ethnic study of atherosclerosis.
OBJECTIVE: Multiple prospective cohort studies, including the multi-ethnic study of atherosclerosis (MESA), have documented elevations in cardiovascular risk factors after the Great Recession (GR) of 2008, despite other studies that report mortality declines after the GR. It is possible that the deleterious effects of the GR on cardiovascular risk profiles are short-lived and reversed. We examine whether risk factor elevations seen in MESA in the 2010-2011 wave persist into the 2016-2018 wave of data collection. DESIGN: Individual fixed effects (IFE) analysis of prospective cohort data from MESA, with rate of change in the risk factor (from wave 2 to later waves) as the dependent variable, effectively controlling for individual-specific linear trends in ageing and all time-invariant characteristics. Models included controls for time-varying characteristics. SETTING: Communities centred around Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York City, New York; and St. Paul, Minnesota. PARTICIPANTS: All MESA participants who participated in at least two pre-GR waves and both post-GR waves; n=3101 (47% men, 25% African American, 21% Hispanic, 13% Asian). OUTCOMES: Primary: Systolic blood pressure (SBP), pulse pressure (PP), fasting blood glucose, serum C-reactive protein (CRP). Secondary: Serum low density lipoprotein cholesterol (LDL-C) and Body Mass Index (BMI) RESULTS: Mean SBP and PP in 2016-2018 were greater by 8.6 (95% CI 5.9 to 11.4) and 8.0 (95% CI 6.0 to 9.9) mm Hg, respectively, than predicted by individual-specific pre-GR linear ageing trends, and fasting blood glucose was 6.3% higher (95% CI 4.6 to 8.1). In comparison, corresponding increases in 2010-2011 were 2.5 and 3.0 mm Hg and 3.3%. CRP increased by 29.7% (95% CI 21.8 to 38.2) in 2010-2011 and 45.1% (95% CI 28.3 to 64.2) in 2016-2018. Mean BMI did not change in 2010-2011 but decreased by 0.5 kg/m2 (95% CI -0.7 to -0.2) in 2016-2018. LDL-C decreased by 4.4 (95% CI -6.5 to -2.2) and 5.2 (95% CI -9.5 to -0.9) mg/dL in the two post-GR waves. CONCLUSIONS AND RELEVANCE: Post-GR increases in blood pressure, blood glucose and CRP in the USA not only persisted for 8-10 years after the GR but also grew in magnitude. In contrast, mean BMI and mean LDL-C reduced post-GR. Further studies are needed to uncover mechanisms (behavioural or otherwise) underlying the BMI and LDL-C reductions seen here, and the mortality consequences of these risk factor changes.