Leadership,communication,and science:three pillars essential to public health emergency response and closing the gap in the HIV response among key populations

Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.While their arguments promoting autonomy and consent might be superficially appealing,their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits.Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies,as well as risk-benefit analyses,have found that the medical benefits of infant NTMC greatly exceed the risks,and there is no reduction in sexual function and pleasure.The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom.The consequence is higher prevalence of preventable infections,adverse medical conditions,suffering and net costs to the UK’s National Health Service for treatment of these.Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based.Indeed,that document called for a review by others of the medical issues surrounding NTMC.While societal factors apply,ultimately,NTMC can only be justified rationally on scientific,evidence-based grounds.Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision.Their decision either for or against NTMC should then be respected.

Demand for and Accessibility to Reproductive Health Service of Urban Floating Population

Summary： The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.

Aging in China: perspectives on public health

In line with the worldwide trend in population aging,China has stepped into an aging society since 2000.The outstanding features of aging,including a large proportion of the older population,rapid growth,dramatic expansion of the oldest-old,and uneven aging distribution,have put China in a unique position.Besides,older population is expanding in parallel with the escalating burden of disease,high prevalence of disability,and low social involvement.However,China is not prepared to solve these problems in terms of the economy,awareness,geriatric care system,geriatric team,social security,or age-friendly environment.From the perspective of public health,we summarized the major challenges and proposed the following policy recommendations:(1)strengthening the top-level design and building a"government-leading,multi-sectoral-cooperating,and society-participating"pattern;(2)enhancing health services by implementing the"comprehensive health"strategy;(3)developing home and community care,coordinately enhance institutional care,promote integration of medical and care systems,and establish a multidimensional tailored care system;(4)optimizing geriatric the supporting system,included the construction of geriatric team and the long-term care insurance system;and(5)establishing a physical and socially age-friendly environment.

The Challenges of Water Pollution, Threat to Public Health, Flaws of Water Laws and Policies in Pakistan

In an era of unprecedented urbanization, population and industrial growth pressure is serious threat for the water management in Pakistan in present days. Water pollution from raw sewage, industrial wastes, and agricultural runoff limited natural fresh water resources in the country. Human health is facing serious problems due to deteriorating drinking water quality. Current review paper provides an insight to the water quality problems in Pakistan with an attempt to emphasize the challenges of water laws enforcement. Although Pakistan has developed many water laws the state of implementation is dominant, intermediate pollution crises are still remaining. We could come to the conclusion that strictly enforcement is compulsory for water environment regulations in Pakistan. Moreover, it is necessary to establish a reliable risk assessment system for water quality, human health and ecological safety.

The Internet of Things and Next-generation Public Health Information Systems

The Internet of things has particularly novel implications in the area of public health. This is due to (1) The rapid and widespread adoption of powerful contemporary Smartphone’s;(2) The increasing availability and use of health and fitness sensors, wearable sensor patches, smart watches, wireless-enabled digital tattoos and ambient sensors;and (3) The nature of public health to implicitly involve connectivity with and the acquisition of data in relation to large numbers of individuals up to population scale. Of particular relevance in relation to the Internet of Things (IoT) and public health is the need for privacy and anonymity of users. It should be noted that IoT capabilities are not inconsistent with maintaining privacy, due to the focus of public health on aggregate data not individual data and broad public health interventions. In addition, public health information systems utilizing IoT capabilities can be constructed to specifically ensure privacy, security and anonymity, as has been developed and evaluated in this work. In this paper we describe the particular characteristics of the IoT that can play a role in enabling emerging public health capabilities;we describe a privacy-preserving IoT-based public health information system architecture;and provide a privacy evaluation.

Influenza prevention can help meet wider public health objectives

Influenza burden: Influenza imposes a major burden on people and public health systems, causing millions of severe cases and up to one million deaths annually. Much of this burden is borne by those aged 65 or over, children under 2 years of age and people with non-communicable chronic diseases, such as heart and lung conditions and diabetes. In the elderly, influenza can have longer-term effects beyond acute infection, with some facing increased disability and care requirements. Prevention: Taking into account the growing elderly population worldwide and their susceptibility to non-communicable conditions as well as rising healthcare costs, public health policies are increasingly focusing on disease prevention strategies and promotion of healthy ageing initiatives. Influenza vaccination has an important role to play in these approaches. Immunization of high-risk groups is recommended by public health organizations, both internationally and locally within many countries. However, although vaccines are considered the most effective method for preventing influenza, many high-risk people remain unvaccinated. Improving vaccination rates: In recent years, research has focused on increasing vaccine coverage. The results demonstrate the key role healthcare professionals play in encouraging immunization, alongside factors such as communication, education and financial support for vaccination. Paradoxically, although vaccination recommendations often include healthcare professionals and studies demonstrate the potential protection offered to workers and patients, many remain unvaccinated. As a result, a growing number of organizations, particularly in North America, are implementing policies requiring vaccination of healthcare pro fessionals as a patient safety measure. In summary: Influenza vaccination has a key role to play in helping to protect the health of the growing elderly population, reduce the burden associated with non-communicable diseases and decrease the annual toll on public health. Improving vaccination levels relies on the support of healthcare professionals, and increasingly healthcare professional immunization is considered an integral part of patient care.

Evaluating the Effectiveness of Targeted Public Health Control Strategies for Chlamydia Transmission in Omaha, Nebraska: A Mathematical Modeling Approach

Objectives: Sexually Transmitted Infections (STIs) have a great public health impact globally. STIs are one of the most critical health problems in the United States of America (USA). Here, we present a mathematical model for testing several interventions that are designed for various communities in order to control the Chlamydia epidemic. Study Design: Based on a community sexual behavior survey, we constructed and parameterized a mathematical disease transmission model to estimate the spread dynamics of Chlamydia in young adults in the northern part of Omaha, Nebraska. Methods: A differential equations based continuous time simulation model is run for various scenarios. The model considers only one age group i.e., 19 - 25 ages, which is considered as the highest risk group for this sexually transmitted disease. Our model assumes homogeneous mixing within this age group and use published estimates to model mixing rates between individuals. Results: The presented model quantified the potential value of screening and treatment programs for Chlamydia in reducing the burden of disease in this specific community. By increasing the screening and treatment rates from 35% to 85%, great public health benefit can be achieved in two years, i.e., total cases reduction around 9% just in this considered age group. Conclusions: Computational results show that behavioral change based interventions on prevention have some effect on reducing the prevalence in the targeted age group;however, more benefit can be obtained with frequent screening and treatment programs.

Prioritizing Strategies for Building the Resilience of Public Health Systems to Disasters Across Multiple Communities and Countries

The COVID-19 pandemic highlighted the urgent need to strengthen public health systems.In response,the United Nations Disaster Risk Reduction(UNDRR) Public Health System Resilience Scorecard(Scorecard) was applied in workshops across multiple countries.The aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system resilience.We conducted a workshop from 14 to 16 March 2023,at the UNDRR Global Education and Training Institute in Incheon,Republic of Korea.A sequential modified Delphi method was utilized to develop a set of prioritized resilience strategies.These were drawn from 70 strategies identified from 13 distinct workshops in eight countries.After two surveys,23 strategies were finalized.Ten received ratings of "High" or Very High" from89% of participants.These related to the inclusion of public health risks in emergency plans,integrating multidisciplinary teams into public health,enabling local transport mechanisms,and improving the ability to manage an influx of patients.The Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system resilience.By leveraging this methodology,our study demonstrated how resilience strategies could inform disaster risk reduction funding,policies,and actions.

Climate change,ambient air pollution,and students'mental health

The impact of global climate change and air pollution on mental health has become a crucial public health issue.Increased public awareness of health,advancements in medical diagnosis and treatment,the way media outlets report environmental changes and the variation in social resources affect psychological responses and adaptation methods to climate change and air pollution.In the context of climate change,extreme weather events seriously disrupt people's living environments,and unstable educational environments lead to an increase in mental health issues for students.Air pollution affects students'mental health by increasing the incidence of diseases while decreasing contact with nature,leading to problems such as anxiety,depression,and decreased cognitive function.We call for joint efforts to reduce pollutant emissions at the source,improve energy structures,strengthen environmental monitoring and governance,increase attention to the mental health issues of students,and help student groups build resilience;by establishing public policies,enhancing social support and adjusting lifestyles and habits,we can help students cope with the constantly changing environment and maintain a good level of mental health.Through these comprehensive measures,we can more effectively address the challenges of global climate change and air pollution and promote the achievement of the United Nations Sustainable Development Goals.

Impact of Plastic Waste on the Human Health in Low-Income Countries: A Systematic Review

Background: Plastic pollution is the accumulation of waste composed of plastic and its derivatives all over the environment. Whether in the form of visible garbage or microparticles, as it slowly degrades, plastic pollution poses significant threats to terrestrial and aquatic habitats and the wildlife that call them home, whether through ingestion, entanglement or exposure to the chemicals contained in the material. Unfortunately, there is a lack of documentation on the impact of plastic waste on human health in low- and middle-income countries (LMICs). Methods: We searched five electronic databases (PubMed, Embase, Global Health, CINAHL and Web of Science) and gray literature, following the preferred reporting elements for systematic reviews and meta-analyses (PRISMA), for the impact of plastic waste on human health in developing countries. We included quantitative and qualitative studies written in English and French. We assessed the quality of the included articles using the Mixed Methods Appraisal tool (MMAT). Results: A total of 3779 articles were initially identified by searching electronic databases. After eliminating duplicates, 3167 articles were reviewed based on title and abstract, and 26 were selected for full-text review. Only three articles were retained. The three articles dealt with practices likely to lead to oral exposure to plastic chemicals in human health, as well as the level of awareness of participants concerning the possible impact of plastic on human health, namely, the use of plastic baby bottles, the use of microwaves to cook food and reheat precooked food, the use of plastic bottles to store water in the refrigerator, water purifier containers with plastic bodies and plastic lunch boxes, the reuse of plastic bags and the inadequacy of treatment facilities. Conclusion: Plastic waste poses different risks to human health at every stage of its life cycle. Hence, strategies must be adopted to raise public awareness of the dangers of plastic waste to their health. Trial registration: The review protocol is registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42023409087).

Dialectic Approaches and Public Policy Interactions for Social, Environmental and Health Problems: Challenges for Health Promotion across Territorial Scales

A constant reproduction of environmental injustices and health iniquities has demanded the employment of participatory/dialectic approaches to research and to intervene in the reality making possible the involvement of social actors in healthy public policies. On this framework, the aim of this paper is to analyse scientific production with dialectic approaches associated with public policies in the context of social, environmental and health problems, considering territorial scales of intervention and the correspondence with some relevant strategies of health promotion. A systematic bibliographic review was applied on a wide pan-disciplinary scientific data base and 36 papers were analysed and classified by their territorial scales of approach. The amount of papers found and their spread through a variety of journals showed a modest, but increasing production which has been dispersed in terms of knowledge areas. Within the classification of territorial approaches, 14 papers were classified as local, 5 as expanded and 17 as a multi-level. Although the papers classified as local approaches were in a good structure of stakeholders’ participation, they are limited to dealing with the global driving forces that reproduce the environmental injustices. Regarding this limitation, the multilevel approaches were identified as more opportune to jointly deal with social, environmental and health problems by means of allowing interaction through multiple territorial scales, fomenting the strengthening of community action, creating supportive environments, and building healthy public policies.

Health Impacts and Mechanisms of Per- and Polyfluoroalkyl Substances (PFAS) from Epidemiological to Toxicological

This research provides a comprehensive analysis of the health impacts of Per- and Polyfluoroalkyl Substances (PFAS) through an integration of epidemiological and toxicological studies. The study identifies significant correlations between PFAS exposure and adverse health outcomes, including thyroid dysfunction, elevated cholesterol levels, and increased risk of specific cancers. Utilizing a mixed-methods approach, the research combines a systematic review and meta-analysis of recent literature with in vitro and in vivo toxicological experiments. The epidemiological analysis reveals increased risks of thyroid dysfunction, cholesterol elevation, and certain cancers among PFAS-exposed individuals. Toxicological findings further corroborate these results, showing dose-dependent cytotoxic effects in human cell lines and endocrine disruption in rodent models. The study emphasizes the importance of regulatory measures to mitigate PFAS exposure and the urgent need for more comprehensive research into their long-term effects. The integration of epidemiological and toxicological data underscores the significant health risks posed by PFAS, highlighting the necessity of immediate action to limit exposure and develop safer alternatives.

Public Health Insurance and Farm Labor Supply:Evidence from China's Rural Health Insurance Reform

This study examines the impact of China’s public health insurance program on the farm employment decisions of the rural population.Using a difference-in-differences(DID)model,this study indicates that the public health insurance reform led to reallocation of the rural labor force out of the farm sector by reducing the farm employment and increasing the likelihood of rural residents working in both the farm and nonfarm sectors.This research finds that rural female residents who are of a younger age and in better health were more likely to leave farm employment when covered by public health insurance.Suggestive evidence also finds that such public health insurance reform increased the individual income of the farm population.

COVID-19,mental health and Indigenous populations in Brazil:The epidemic beyond the pandemic

The aim of this paper was to report on factors contributing to the deterioration of the mental health of Indigenous populations(IP)in Brazil.Five factors seem to have a direct impact on the mental health of IP in Brazil:(1)The absence of public policies;(2)Intellectual production;(3)Psychiatric medical care for remote areas(e.g.,telemedicine)aimed at promoting the mental health of Brazil’s IP,which causes a huge gap in the process of assistance and social,psychological,economic and cultural valorization of native peoples;(4)The dissemination of fake news,which exposed,above all,older IP to risk behaviors in the pandemic,such as refusal of vaccination;and(5)The violence carried out on IP lands due to economic interests with mining/agribusiness.

Civic and Social Applications to Support Public Policies on Health

The discussion with emphasis on social control is expressed in new guidelines for its effectiveness through normative instruments and the legal creation of institutional spaces that guarantee the participation of organized civil society in the direct supervision of the executive in the three spheres of government.Social participation for the strengthening of public health in Brazil has undergone complex processes of change,which have resulted in an increasingly qualified,deliberative,independent,and representative social control system.However,policy makers need to identify new technologies and carefully analyze their potential before they begin to exert their breaking power in the economy and society.Mobility and unlimited connectivity deserve special attention from the public power for the ability to achieve the digital inclusion of the citizen through smartphones.This requires a transformation of the governance structure into a platform that is based on the tripod transparency,participation,and collaboration,which relies on the Internet,social networks and connectivity.

Universal health coverage and public-private participation: towards a new balance?

This commentary discusses the emergence of a new paradigm to address the health policy issues through Public-Private Participation (PPP).The discussion provides a detailed literature review of PPPs by presenting an initial overview of the ideological shift from state to market intervention,then identifying arguments in support of or against public-private approaches and finally exploring the emergence of this new paradigm of PPP or its hybrid forms.It then discusses the contextual realities of Public-Private Participation in health care,and whether an optimal balance is possible with better government stewardship and private provision.Conceptually,the premise of stewardship in governance is that it is possible to create not only efficient but also effective systems.These ideas may find a receptive audience in many countries,especially in the emerging economies with improving standards.In East Asian societies,the concept of stewardship bears a strong resemblance to Confucian ideals of morality in government,with social expectations of those who govern to be principled and virtuous.Increasingly,a pragmatic theory of development seems to apply in public-private,similarly,through it is expected,that public-private participation in the healthcare system should also achieve the goal of Universal Health Coverage through good governance.

Tell health stories comprehensively and accurately: A case study of health edition of People's Daily

Objectives:People increasingly search for health information through the media and make decisions about their health based on these health stories.The mainstream media,including newspapers,are often the first source for the public to obtain health information.This study aims to assess the health stories reported in the health edition of People's Daily in 2019 with four tools of the Media Doctor Toolkit(MDT),which can be an effective tool to evaluate the quality of public health stories.Based on the results,we attempt to address the gap in media coverage in terms of reporting on public health issues,and promote media to display the image of medical staff objectively,both of which can improve relationship of doctors,nurses and patients.Methods:A prospective quantitative analysis of the quality of health stories reported in the health edition of People's Daily from 1 February to September 31,2019 was conducted.Forty-eight articles were collected and divided into four groups according to the MDT standards.Four rating tools were adapted from the MDT to assess the quality of the groups with corresponding criteria.Results:Forty-eight unique health stories were assessed with four MDT rating tools.The mean total satisfactory score was 80%.Health advice had the highest average satisfactory score,84%,compared with health policy group and public health problems and their solutions,at 80%and 77%,respectively.Health news group had the lowest score at 73%.Conclusion:This study provides a description of the quality of health stories on People's Daily.The overall quality of People's Daily was fairly good,although there was a wide range of quality between groups.The health edition of People's Daily covers a wide range of health topics such as new medical methods,doctorpatient relationship,advanced nursing practice,lifestyle change of health promotion etc.which promote excellence in providing the latest health information,representing medical staff image,resolve the disharmonious factors in the relationship between doctors and patients,and creating a good medical environment for the public.The findings of this study also provide insight into problems in health reporting of People's Daily.

Perinatal mental health in China:views of health system professionals in Shanghai

Background:Mental health has recently been receiving a growing amount of attention in China's Mainland,with mental disorders increasingly being recognized as a major public health concern.However,the treatment gap for mental health care is markedly high in China.Previous research and clinical practice have focused on high-risk physical disorders but overlooked psychosocial factors,especially during the perinatal period.Aims:To explore Chinese professionals'perception and attributions of perinatal mental health in China.Method:The study was conducted in Shanghai,China,in 2018,drawing on interviews with 15 key informants including health professionals,government officials,and policymakers recruited through snowball sampling.Content analysis of the semi-structured interviews was performed.Results:The study yielded insights into the perceptions of perinatal mental health among health professionals in Shanghai.Three themes emerged from the informants'reports:(1)mental health influenced by tradition—describing traditions affecting the perception of mental health at both the societal and individual level;(2)societal changed contributing perinatal mental health problems—referring to a rapidly changing cultural and economic backdrop as a source of stress leading to mental health problems;and(3)existing and required resources—demonstrating a lack of professional training,staff shortages,and inadequacy of resources to provide the required mental health care.Conclusion:Our results provide new insights into key health professionals'perceptions of mental health problems in Shanghai.Hesitation to seek care owing to a lack of knowledge,and resource shortages in health care systems are obstacles to improve mental health among women in urban China.