Exploring the Prevalence and Contributing Factors of Depression among Sickle Cell Anemia Patients in Saudi Arabia’s Jazan Region

Sickle Cell Anemia(SCA)is a prevalent genetic condition in Saudi Arabia,particularly in the Jazan region.The study’s purpose was to assess the prevalence of de-pression among individuals with SCA in this area and to identify the factors associated with this condition.The study involved 391 adult participants,all patients in the hematology center of Prince Mohammed bin Nasser Hospital(PMNH).Data was collected through an anonymous interview questionnaire–the Arabic version of the Patient Health Questionnaire-9(PHQ-9)–between March–May 2022.The questionnaire covered socio-demographic information and variables related to the participant’s SCA history,such as pain levels,frequency of pain,hospitalization duration,and frequency of blood transfusions.These variables underwent Chi-square and One-way ANOVA testing,followed by multivariate regression.The study found a 42%prevalence of depression among the SCA patients.Factors significantly linked with heightened depression levels included being widowed or divorced,experiencing frequent and severe pain,and longer duration of hospital stays.An educational level of at least a bachelor’s degree was also a significant factor.The study reveals a high prevalence of depression among SCA patients in the Jazan region.It underscores the need for policymakers to educate both physicians and patients about the importance of mental health in SCA management.The study also highlights the need for more research into the specific causes and effects of depressive symptoms in SCA patients to inform the creation of effective management plans.

Does knowledge of physical activity recommendations increase physical activity among Chinese college students？ Empirical investigations based on the transtheoretical model

Background: Based on the transtheoretical model, the current study investigated whether awareness of physical activity(PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students.Methods: In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations,PA stage distribution, and self-reported PA level were surveyed. Pearson's χ2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups,students' PA stages and PA level were examined before the test and then 4 months post-test. Mc Nemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention.Results: Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior(χ~2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations(t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test(χ~2(1) = 112.06, p < 0.001; χ~2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed(t(139) < 1, p = 0.89).Conclusion: The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population.

Prevention and control measures to further optimize COVID-19 response

On November 11,2022,the Chinese government released the Scientific and Targeted Prevention and Control Measures to Optimize COVID-19 Response.Since that time,adjusted measures have been implemented throughout China,leading to major shifts in implementation of the national prevention and control strategy.On the basis of the current situation of the epidemic and the evolving SARS-Cov-2 variants,an additional 10 specifications(referred to as“the 10-point measures”)were officially released on December 7,2022,in an effort to further optimize the prevention and control measures.The latest adjustments pertain to the specification of:precise delineation of high-risk areas,nucleic acid testing scheme,isolation and health monitoring,restriction and lifting of high-risk areas,medicine supply,vaccination rollout among older people,health status of key populations,social functioning,and campus response.

Scientific and targeted prevention and control measures to optimize COVID-19 response

Since the outbreak of the COVID-19 pandemic,under the strong leadership of the Central Committee of the Communist Party of China and President Xi Jinping,China has made firm decisions to prioritize people's lives and health.Efforts have been made to avoid foreign imported infection and domestic rebound of COVID-19 cases;the“dynamic zero COVID”policy has been executed without wavering;and the prevention and control measures have been optimized and improved in response to changing circumstances,actively responding to the impact caused by multiple waves of COVID-19 surge globally.China has made extraordinary efforts to safeguard people's lives and health.Meanwhile,prevention and control measures were timely updated to coordinate with economic and social development.On November 10,the Standing Committee of the Central Political Bureau held a meeting to discuss the latest situation of the COVID-19 pandemic in China.Twenty measures(referred to as“the 20-point measures”)were officially announced to further optimize the COVID-19 response.The latest prevention and control measures involve the requirements and guidance for isolation at home,high-risk area delineation,nucleic acid testing,international inbound flights and travelers,vaccination rollout,medical resource preparedness,and protection for special places and vulnerable population.

The military as a neglected pathogen transmitter,from the nineteenth century to COVID-19:a systematic review

Background:The risk of outbreaks escalating into pandemics has soared with globalization.Therefore,understanding transmission mechanisms of infectious diseases has become critical to formulating global public health policy.This systematic review assessed evidence in the medical and public health literature for the military as a disease vector.Methods:We searched 3 electronic databases without temporal restrictions.Two researchers independently extracted study data using a standardized form.Through team discussions,studies were grouped according to their type of transmission mechanism and direct quotes were extracted to generate themes and sub-themes.A content analysis was later performed and frequency distributions for each theme were generated.Results:Of 6477 studies,210 met our inclusion criteria and provided evidence,spanning over two centuries(1810–2020),for the military as a pathogen transmitter,within itself or between it and civilians.Biological mechanisms driving transmission included person-to-person transmission,contaminated food and water,vector-borne,and airborne routes.Contaminated food and/or water were the most common biological transmission route.Social mechanisms facilitating transmission included crowded living spaces,unhygienic conditions,strenuous working,training conditions,absent or inadequate vaccination programs,pressure from military leadership,poor compliance with public health advice,contractor mismanagement,high-risk behaviours,and occupation-specific freedom of movement.Living conditions were the most common social transmission mechanism,with young,low ranking military personnel repeatedly reported as the most affected group.Selected social mechanisms,such as employment-related freedom of movement,were unique to the military as a social institution.While few studies explicitly studied civilian populations,considerably more contained information that implied that civilians were likely impacted by outbreaks described in the military.Conclusions:This study identified features of the military that pose a significant threat to global health,especially to civilian health in countries with substantial military presence or underdeveloped health systems.While biological transmission mechanisms are shared by other social groups,selected social transmission mechanisms are unique to the military.As an increasingly interconnected world faces the challenges of COVID-19 and future infectious diseases,the identified features of the military may exacerbate current and similar challenges and impair attempts to implement successful and equitable global public health policies.

Evaluation of the effectiveness of surveillance policies to control the COVID-19 pandemic in São Paulo,Brazil

Background:Surveillance efforts are essential to pandemic control,especially where the state is the primary health provider,such as Brazil.When public health testing guidelines limit molecular tests,there are reductions in detection efforts aimed at early recognition,isolation,and treatment of those infected with the virus.This study evaluates the effectiveness of surveillance policies to control the COVID-19 pandemic in São Paulo.Methods:We conducted an interrupted time series analysis with a segmented regression model to analyze if changes in the state’s guidelines improved RT-PCR testing outcomes in Brazil’s most affluent and largest state,São Paulo.Anonymized daily data on the RT-PCR tests conducted in public laboratories belonging to the state-wide network from March 1,2020 to June 5,2021 were extracted from the Sao Paulo State open-source database,while the data on the genomic sequences were obtained from GISAID.We then aggregated these data for the 17 regional health departments in the state to evaluate regional-level outcomes.Results:The public health system restricted RT-PCR testing to hospitalized cases in the first months.Testing was expanded to permit symptomatic testing of non-hospitalized persons only in July 2020,but a statistically significant increase in surveillance efforts was not observed.Case definition was expanded to allow case confirmation based on clinical,laboratory and image data criteria other than an RT-PCR test without increasing the testing effort for asymptomatic suspicious cases in September 2020.There was an increase in the mean volume of testing in each RHD,but the test positivity rate increased due to insufficient testing expansion.Results also show an uneven improvement in testing outcomes following these changes across the state’s regional health departments.Conclusions:Evidence suggests that lower RT-PCR testing and genomic surveillance efforts are associated with areas characterized by a higher population concentration and a greater population reliance on the public health system.Our results highlight the need to structure health surveillance and information systems for disease control and prevention in emergency settings considering local demographics and vulnerabilities.In high prevalence settings,efforts at identifying and including vulnerable populations in routine and enhanced surveillance programs during COVID-19 must be significantly improved.

The Global Leprosy Assessment Index(GLAI):A new approach for measuring the severity of disease in Brazil

Background:In Brazil,the Ministry of Health(MH)monitors leprosy using 15 indicators,with the aim of imple-menting and evaluating evidence-based public policies.However,an excessive number of variables can compli-cate the definition of objectives and verification of epidemiological goals.Methods:In this paper,we develop the Global Leprosy Assessment Index(GLAI),a composite measure that integrates two key dimensions for the control the disease:epidemiological and operational.Using a confirmatory factor analysis model to examine 2020 state-level data,we have standardized GLAI to a range of 0 to 1.Results:Higher values within this range indicate a greater severity of the disease.The mean value of the GLAI was 0.67,with a standard deviation of 0.22.Roraima has the highest value,followed by Paraíba with 0.88 while Tocantins records the lowest value of the indicator,followed by Mato Grosso with 0.14.The epidemiological and operational indicators have a positive but statistically insignificant correlation(r=0.25;p-value=0.20).Conclusions:The development of evidence-based public policies depends on the availability of valid and reliable indicators.The GLAI presented in this paper is easily reproducible and can be used to monitor the disease with disaggregated information.Furthermore,the GLAI has the potential to serve as a more robust parameter for evaluating the impact of actions designed to eradicate leprosy in Brazil.