Neighborhood-level racialized socioeconomic deprivation and contraceptive use in the United States, 2011-2019.

INTRODUCTION: The social and structural environments where people live are understudied in contraceptive research. We assessed if neighborhood measures of racialized socioeconomic deprivation are associated with contraceptive use in the United States. METHODS: We used restricted geographic data from four waves of the National Survey of Family Growth (2011-2019) limited to non-pregnant women ages 15-44 who had sex in the last 12 months. We characterized respondent neighborhoods (census tracts) with the Index of Concentration at the Extremes (ICE), a measure of spatial social polarization, into areas of concentrated privilege (predominantly white residents living on high incomes) and deprivation (predominantly people of color living on low incomes). We used multivariable binary and multinomial logistic regression with year fixed effects to estimate adjusted associations between ICE tertile and contraceptive use and method type. We also assessed for an interactive effect of ICE and health insurance type. RESULTS: Of the 14,396 respondents, 88.4% in neighborhoods of concentrated deprivation used any contraception, compared to 92.7% in the most privileged neighborhoods. In adjusted models, the predicted probability of using any contraception in neighborhoods of concentrated deprivation was 2.8 percentage points lower than in neighborhoods of concentrated privilege, 5.0 percentage points higher for barrier/coital dependent methods, and 4.3 percentage points lower for short-acting methods. Those with Medicaid were less likely to use any contraception than those with private insurance irrespective of neighborhood classification. CONCLUSIONS: This study highlights the salience of structural factors for contraceptive use and the need for continued examination of structural oppressions to inform health policy.

Exploring genetic counselors' practice of discussing clinical trials with patients.

Despite concerted and accelerated efforts to increase the knowledge of medicine and disease via clinical studies, clinical trials continue to face low enrollment for all patient groups. The dissemination of the availability of clinical trials to individuals with or at risk for hereditary disorders is critical. This study acts as a foundation in determining an unexplored role of clinical trial discussion in genetic counseling practice. Board-certified, patient-facing genetic counselors in the United States were invited to participate in an anonymous survey via the National Society of Genetic Counselors. Between February and April 2022, 157 participants (N = 157) completed the survey on clinical trial discussion with patients, barriers, and facilitators to discussing clinical trials with patients, research experience, and demographics. Survey results identified that most respondents have discussed the availability of clinical trials with a patient (85%). Almost one-third have previous research experience working for a clinical trial (30%). Most agreed that discussions of clinical trials are within the scope of genetic counseling (82%); however, one-third were not comfortable discussing them with patients (34%). Respondents who know how to find specific clinical trials (p < 0.001) were reportedly more likely to be comfortable discussing clinical trials with their patients. In addition to clinical research exposure, this study suggests that further education and training is necessary for genetic counselors to learn how to find and identify specific clinical trials for their patients. In turn, we hope for this to increase genetic counselors' comfort of clinical trial discussion.

T(r)icky Environments: Higher Prevalence of Tick-Borne Zoonotic Pathogens in Rodents from Natural Areas Compared with Urban Areas.

Background: Urban areas are unique ecosystems with stark differences in species abundance and composition compared with natural ecosystems. These differences can affect pathogen transmission dynamics, thereby altering zoonotic pathogen prevalence and diversity. In this study, we screened small mammals from natural and urban areas in the Netherlands for up to 19 zoonotic pathogens, including viruses, bacteria, and protozoan parasites. Materials and Methods: In total, 578 small mammals were captured, including wood mice (Apodemus sylvaticus), bank voles (Myodes glareolus), yellow-necked mice (Apodemus flavicollis), house mice (Mus musculus), common voles (Microtus arvalis), and greater white-toothed shrews (Crocidura russula). We detected a wide variety of zoonotic pathogens in small mammals from both urban and natural areas. For a subset of these pathogens, in wood mice and bank voles, we then tested whether pathogen prevalence and diversity were associated with habitat type (i.e., natural versus urban), degree of greenness, and various host characteristics. Results: The prevalence of tick-borne zoonotic pathogens (Borrelia spp. and Neoehrlichia mikurensis) was significantly higher in wood mice from natural areas. In contrast, the prevalence of Bartonella spp. was higher in wood mice from urban areas, but this difference was not statistically significant. Pathogen diversity was higher in bank voles from natural habitats and increased with body weight for both rodent species, although this relationship depended on sex for bank voles. In addition, we detected methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase/AmpC-producing Escherichia coli, and lymphocytic choriomeningitis virus for the first time in rodents in the Netherlands. Discussion: The differences between natural and urban areas are likely related to differences in the abundance and diversity of arthropod vectors and vertebrate community composition. With increasing environmental encroachment and changes in urban land use (e.g., urban greening), it is important to better understand transmission dynamics of zoonotic pathogens in urban environments to reduce potential disease risks for public health.

Molecular characterization of Cryptosporidium in wild rodents from the Inner Mongolian Autonomous Region and Liaoning Province, China: assessing host specificity and the potential for zoonotic transmission.

Introduction: Wild rodents are key hosts for Cryptosporidium transmission, yet there is a dearth of information regarding their infection status in the Inner Mongolian Autonomous Region and Liaoning Province of China. Therefore, the present study was conducted to determine the prevalence and genetic characteristics of Cryptosporidium among wild rodents residing in these two provinces. Methods: A total of 486 rodents were captured, and fresh feces were collected from each rodent's intestine for DNA extraction. Species identification of rodents was performed through PCR amplification of the vertebrate cytochrome b (cytb) gene. To detect the presence of Cryptosporidium in all fecal samples, PCR analysis and sequencing of the partial small subunit of the ribosomal RNA (rRNA) gene were performed. Results: Four species of rodents were identified: Rattus norvegicus, Mus musculus, Apodemus agrarius, and Cricetulus barabensis. Positive results for Cryptosporidium were obtained for 9.2% (18/195), 6.6% (7/106), 5.6% (5/89), and 6.3% (6/96) of these rodents, respectively, with an average infection rate of 7.4% (36/486). The identification revealed the presence of five Cryptosporidium species, C. ubiquitum (n = 8), C. occultus (n = 5), C. muris (n = 2), C. viatorum (n = 1), and C. ratti (n = 1), along with two Cryptosporidium genotypes: Rat genotype III (n = 10) and Rat genotype IV (n = 9). Discussion: Based on the molecular evidence presented, the wild rodents investigated were concurrently infected with zoonotic (C. muris, C. occultus, C. ubiquitum and C. viatorum) as well as rodent-adapted (C. ratti and Rat genotype III and IV) species/genotypes, actively participating in the transmission of cryptosporidiosis.

Epidemiology of alcohol use disorder in the general population of Togo and Benin: the ALCOTRANS study.

INTRODUCTION: Access to data concerning mental health, particularly alcohol use disorders (AUD), in sub-Saharan Africa is very limited. This study aimed to estimate AUD prevalence and identify the associated factors in Togo and Benin. METHODS: A cross-sectional study was conducted between April and May 2022, targeting individuals aged 18 years and above in the Yoto commune of Togo and the Lalo commune of Benin. Subjects were recruited using a multi-stage random sampling technique. AUD diagnoses were made using the MINI adapted to DSM-5 criteria. Our study collected sociodemographic information, data on psychiatric comorbidities, stigmatization, and assessed cravings, using a series of scales. The association between AUD and various factors was analyzed using multivariable logistic regression. RESULTS: In Togo, 55 of the 445 people investigated had AUD (12.4%; [95% CI: 9.5-15.7%]). Among them, 39 (70.9%) had severe AUD and the main associated comorbidities were suicidal risk (36.4%), and major depressive disorder (16.4%). Associated factors with AUD were male gender (aOR: 11.3; [95% CI: 4.8-26.7]), a higher Hamilton Depression Rating Scale (HDRS) score (aOR: 1.2; [95% CI: 1.1-1.3]) and a lower Stigma score measured by the Explanatory Model Interview Catalogue (EMIC) (aOR: 0.9; [95% CI: 0.8-0.9). The stigma scores reflect perceived societal stigma towards individuals with AUD. In Benin, 38 of the 435 people investigated had AUD (8.7%; [95% CI: 6.4-11.7]), and the main associated comorbidities were suicidal risk (18.4%), tobacco use disorder (13.2%) and major depressive episode (16.4%). Associated factors with AUD were male gender (aOR: 6.4; [95% CI: 2.4-17.0]), major depressive disorder (aOR: 21.0; [95% CI: 1.5-289.8]), suicidal risk (aOR: 3.7; [95% CI: 1.2-11.3]), a lower Frontal Assessment Battery (FAB) score (aOR:0.8; [95% CI: 0.8-0.9]) and a lower perceived stigma score (by EMIC )(aOR: 0.9; [95% CI: 0.8-0.9]). CONCLUSION: In these communes of Togo and Benin, AUD prevalence is notably high. A deeper understanding of the disease and its local determinants, paired with effective prevention campaigns, could mitigate its impact on both countries.

Promoting healthy eating without plastics: An ethical practice in primary care

Effective clinical interventions to engage in new habits remain a challenge despite intense research. One such strategy is to include the environmental issue of plastic packaging from ultra-processed food in nutrition recommendations. It expands the notion of health, contributing to engaging in healthy eating behaviors, in addition to being an ethical practice for health professionals. It brings co-benefits for both the environment and individual health through motivational incentives of less individual pollution, contributing to healthier food systems. Primary health professionals should be prepared to deal with risks of plastics and waste reduction strategies in their practice.

FAIR reporting of clinical trials for public health practice.

The number of clinical trials is rapidly growing, and automation of literature processing is becoming desirable but unresolved. Our purpose was to assess and increase the readiness of clinical trial reports for supporting automated retrieval and implementation in public health practice. We searched the Medline database for a random sample of clinical trials of HIV/AIDS management with likely relevance to public health in Africa. Five authors assessed trial reports for inclusion, extracted data, and assessed quality based on the FAIR principles of scientific data management (findable, accessible, interoperable, and reusable). Subsequently, we categorized reported results in terms of outcomes and essentials of implementation. A sample of 96 trial reports was selected. Information about the tested intervention that is essential for practical implementation was largely missing, including personnel resources needed 32·3% (.95 CI: 22·9-41·6); material/supplies needed 33·3% (.95 CI: 23·9-42·8); major equipment/building investment 42·8% (CI: 33·8-53·7); methods of educating providers 53·1% (CI: 43·1-63·4); and methods of educating the community 27·1% (CI: 18·2-36·0). Overall, 65% of studies measured health/biologic outcomes, among them, only a fraction showed any positive effects. Several specific design elements were identified that frequently make clinical trials unreal and their results unusable. To sort and interpret clinical trial results easier and faster, a new reporting structure, a practice- and retrieval-oriented trial outline with numeric outcomes (PROTON) table was developed and illustrated. Many clinical trials are either inconsequential by design or report incomprehensible results. According to the latest expectations of FAIR scientific data management, all clinical trial reports should include a consistent and practical impact-oriented table of clinical trial results.

[What do we need to work with community orientation in Primary Health Care? Twenty-five measures for management and teams]. / ¿Qué necesitamos para «hacer comunitaria¼? Veinticinco medidas prácticas para gerencias y equipos de atención primaria.

OBJECTIVE: Identify and clarify what practical organizational measures would promote the development of level 2 (community-oriented group health education) and level 3 (community action) community activities in Primary Health Care (PHC) from the perspective of medical professionals with training and experience in this area. METHOD: Exploratory, descriptive and cross-sectional study carried out using qualitative methodology using two techniques: 3 focus groups (24 participants) and 12 open questionnaires (12 participants). RESULTS: 25 measures are defined to promote the development of these activities that are the responsibility of management and Primary Care Teams (PCT). The most notable proposals are: enhance training in community health, incorporate community activity into the work agendas of professionals, political prioritization and support from management, ensure the job stability of the teams, strengthen the recognition of activities community, resize the patient population of professionals, strengthen multidisciplinary work, cohesion and an autonomous and flexible organization in the PCT, and have the support of the coordinations-directions of the PCT. CONCLUSIONS: Three proposals have been considered fundamental to promote the development of level 2 and level 3 community activities in PHC: 1) promote training in community health; 2) incorporate community activity into the work agendas of professionals; 3) political prioritization and support from management for the development of these two levels of work in PHC. Six other proposals have been recognized as being of special importance.

Breathing in danger: Understanding the multifaceted impact of air pollution on health impacts.

Air pollution, a pervasive environmental threat that spans urban and rural landscapes alike, poses significant risks to human health, exacerbating respiratory conditions, triggering cardiovascular problems, and contributing to a myriad of other health complications across diverse populations worldwide. This article delves into the multifarious impacts of air pollution, utilizing cutting-edge research methodologies and big data analytics to offer a comprehensive overview. It highlights the emergence of new pollutants, their sources, and characteristics, thereby broadening our understanding of contemporary air quality challenges. The detrimental health effects of air pollution are examined thoroughly, emphasizing both short-term and long-term impacts. Particularly vulnerable populations are identified, underscoring the need for targeted health risk assessments and interventions. The article presents an in-depth analysis of the global disease burden attributable to air pollution, offering a comparative perspective that illuminates the varying impacts across different regions. Furthermore, it addresses the economic ramifications of air pollution, quantifying health and economic losses, and discusses the implications for public policy and health care systems. Innovative air pollution intervention measures are explored, including case studies demonstrating their effectiveness. The paper also brings to light recent discoveries and insights in the field, setting the stage for future research directions. It calls for international cooperation in tackling air pollution and underscores the crucial role of public awareness and education in mitigating its impacts. This comprehensive exploration serves not only as a scientific discourse but also as a clarion call for action against the invisible but insidious threat of air pollution, making it a vital read for researchers, policymakers, and the general public.

Advancements of CRISPR technology in public health-related analysis.

Pathogens and contaminants in food and the environment present significant challenges to human health, necessitating highly sensitive and specific diagnostic methods. Traditional approaches often struggle to meet these requirements. However, the emergence of the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) system has revolutionized nucleic acid diagnostics. The present review provides a comprehensive overview of the biological sensing technology based on the CRISPR/Cas system and its potential applications in public health-related analysis. Additionally, it explores the enzymatic cleavage capabilities mediated by Cas proteins, highlighting the promising prospects of CRISPR technology in addressing bioanalysis challenges. We discuss commonly used CRISPR-Cas proteins and elaborate on their application in detecting foodborne bacteria, viruses, toxins, other chemical pollution, and drug-resistant bacteria. Furthermore, we highlight the advantages of CRISPR-based sensors in the field of public health-related analysis and propose that integrating CRISPR-Cas biosensing technology with other technologies could facilitate the development of more diverse detection platforms, thereby indicating promising prospects in this field.

Gender differences in COVID-19 preventative measures and vaccination rates in the United States: A longitudinal survey analysis.

BACKGROUND: Pandemics present challenges for individuals as they face uncertainties, risks, and decisions which influence their attitudes towards public health interventions. This study investigates gender differences in attitudes towards COVID-19 preventive measures and vaccination intentions in the United States, focusing on the link between risk perception and attitudes towards public health guidelines. METHODS: We utilised data from the Understanding America Study, a nationally representative longitudinal survey of U.S. adults from March 2020 to March 2022 to assess how gender differences in health risk perception were associated with attitudes, behaviours, and vaccination intentions, while also evaluating how these gender effects changed over time. We used multilevel logistic regression models to adjust for age, level of education, employment status and income. RESULTS: Women had a higher risk perception of COVID-19 and exhibited greater compliance with preventive measures compared to men. Women also showed higher agreement with COVID-19 restraining public policy measures. However, this contrasted with attitudes towards the COVID-19 vaccine, where men displayed more positive views and a higher intention to receive the vaccine. This gender effect was persistent over time. CONCLUSIONS: This seemingly paradoxical outcome suggests that while women's heightened risk perception relative to men's leads to greater adherence to non-pharmaceutical COVID-19 preventative public health interventions, it may also result in more negative views towards the novel COVID-19 vaccine. Understanding the complex interactions between risk perception, behaviour, and gender can inform policymakers and health authorities to tailor interventions that address the diverse needs of the population.

SIR+ models: accounting for interaction-dependent disease susceptibility in the planning of public health interventions.

Avoiding physical contact is regarded as one of the safest and most advisable strategies to follow to reduce pathogen spread. The flip side of this approach is that a lack of social interactions may negatively affect other dimensions of health, like induction of immunosuppressive anxiety and depression or preventing interactions of importance with a diversity of microbes, which may be necessary to train our immune system or to maintain its normal levels of activity. These may in turn negatively affect a population's susceptibility to infection and the incidence of severe disease. We suggest that future pandemic modelling may benefit from relying on 'SIR+ models': epidemiological models extended to account for the benefits of social interactions that affect immune resilience. We develop an SIR+ model and discuss which specific interventions may be more effective in balancing the trade-off between minimizing pathogen spread and maximizing other interaction-dependent health benefits. Our SIR+ model reflects the idea that health is not just the mere absence of disease, but rather a state of physical, mental and social well-being that can also be dependent on the same social connections that allow pathogen spread, and the modelling of public health interventions for future pandemics should account for this multidimensionality.

Assessment of the pathogen genomics landscape highlights disparities and challenges for effective AMR Surveillance and outbreak response in the East African community.

The East African Community (EAC) grapples with many challenges in tackling infectious disease threats and antimicrobial resistance (AMR), underscoring the importance of regional and robust pathogen genomics capacities. However, a significant disparity exists among EAC Partner States in harnessing bacterial pathogen sequencing and data analysis capabilities for effective AMR surveillance and outbreak response. This study assesses the current landscape and challenges associated with pathogen next-generation sequencing (NGS) within EAC, explicitly focusing on World Health Organization (WHO) AMR-priority pathogens. The assessment adopts a comprehensive approach, integrating a questionnaire-based survey amongst National Public Health Laboratories (NPHLs) with an analysis of publicly available metadata on bacterial pathogens isolated in the EAC countries. In addition to the heavy reliance on third-party organizations for bacterial NGS, the findings reveal a significant disparity among EAC member States in leveraging bacterial pathogen sequencing and data analysis. Approximately 97% (n = 4,462) of publicly available high-quality bacterial genome assemblies of samples collected in the EAC were processed and analyzed by external organizations, mainly in Europe and North America. Tanzania led in-country sequencing efforts, followed by Kenya and Uganda. The other EAC countries had no publicly available samples or had all their samples sequenced and analyzed outside the region. Insufficient local NGS sequencing facilities, limited bioinformatics expertise, lack of adequate computing resources, and inadequate data-sharing mechanisms are among the most pressing challenges that hinder the EAC's NPHLs from effectively leveraging pathogen genomics data. These insights emphasized the need to strengthen microbial pathogen sequencing and data analysis capabilities within the EAC to empower these laboratories to conduct pathogen sequencing and data analysis independently. Substantial investments in equipment, technology, and capacity-building initiatives are crucial for supporting regional preparedness against infectious disease outbreaks and mitigating the impact of AMR burden. In addition, collaborative efforts should be developed to narrow the gap, remedy regional imbalances, and harmonize NGS data standards. Supporting regional collaboration, strengthening in-country genomics capabilities, and investing in long-term training programs will ultimately improve pathogen data generation and foster a robust NGS-driven AMR surveillance and outbreak response in the EAC, thereby supporting global health initiatives.

Knowledge mobilization between the food industry and public health nutrition scientists: findings from a case study.

BACKGROUND: Improving the nutritional quality of the food supply increases access to nutritious foods, which improves dietary habits and population health. Yet, knowledge mobilization initiatives between public health nutrition researchers and food industries are often not adequately considered and understood. This study explored what elements related to this specific context need to be recognized so that researchers can better mobilize nutrition science knowledge with the food industry to promote the nutritional improvement of food products. METHOD: A case study qualitative approach was selected to answer the research question, using semi-structured interviews as the data collection technique. Québec baking industry actors were shown a mock-up of an online mobilization platform sharing the results of the Food Quality Observatory that describes the nutritional quality of breads offered in Québec, Canada. They were asked to think aloud as they explored the web platform and were interviewed. Two coders analyzed the data using an inductive approach and thematic content analysis, starting with individual open coding, and then put forward their analyses and drafted the final themes. RESULTS: The final data consisted of 10 semi-structured interviews conducted between October 2019 and August 2020. Four main themes were identified: the industry's context, the knowledge mobilization initiative, the product-related matters stemming from the information shared and the motivation within the industry. Within each theme, sub-themes were highlighted and related to the industries' motivation to improve their products' nutritional quality. This study also specified key considerations for changes to the sodium and fiber content in bread. CONCLUSION: Other steps beyond using simple language and a website format could be taken to better mobilize scientific knowledge with food industries, such as providing more consumer information, using an integrated knowledge mobilization approach that includes a consideration of ethics, working with communication professionals, collaborating with food science experts, and providing resources to act on shared information. Legislation such as the front-of-pack regulations could accelerate the pace of collaboration between researchers and industry. Overall, establishing a prior relationship with industries could help gain a better understanding of the themes highlighted in this study. Future research could build on this case study to provide more insights and solidify these findings. CLASSIFICATION CODES: Public Health, Public Private, Policy Making, Research Institutions, Use of Knowledge.

Assessment of Arabic Web-Based Knowledge About Root Canal Treatment: An Infodemiologic Study.

BACKGROUND: Root canal treatment (RCT) is a vital dental procedure aimed at preserving tooth function and minimizing infection. Access to accurate and comprehensive information about RCT is crucial for informed decision-making. With the increasing reliance on the Internet for health-related information, it is essential to evaluate the quality and readability of web-based RCT content, particularly in Arabic-speaking regions. METHODS: This study conducted an extensive web search using three major search engines (Google, Yahoo, and Bing) to identify Arabic-language websites providing information on RCT. Inclusion criteria required websites in Arabic with comprehensive RCT content. Quality assessment employed the DISCERN instrument, JAMA benchmarks, and Health on the Net (HON) assessment tools, while readability was assessed using Flesch Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) metrics. RESULTS: Out of 152 websites included, the majority were affiliated with university/medical centers (56.58%) and non-profit organizations (28.29%). Quality assessment revealed that the mean DISCERN score was 2.82, indicating moderate quality. Only one website achieved a high DISCERN score. JAMA benchmarks showed limited compliance, with only two websites meeting all criteria. The HON code was found on only five websites. Readability analysis indicated that most websites were reasonably easy to read by the general population. CONCLUSION: This study highlights the significant gap in the quality and reliability of web-based health information related to RCT in Arabic. While the majority of websites examined in this study did not meet established quality standards, there is a clear need for improvements in the accuracy and comprehensiveness of online resources. Patients seeking information on RCT should exercise caution and consider consulting healthcare professionals for trustworthy guidance. Further research should explore strategies to enhance the quality of web-based health information and expand the scope of evaluation to ensure that individuals have access to reliable resources for making informed decisions about their dental health.

Iatrogenic Right-Sided Diaphragmatic Hernia After Colonoscopy.

Congenital diaphragmatic hernias (CDH) occur as a result of genetic and environmental factors that occur during the early stages of fetal development. Overall, CDH are considered to be quite rare and are often discovered when patients are neonates. The patient in this case underwent a routine colonoscopy for high-risk polyps but then developed the sudden onset of cramping abdominal pain and PO (per os) intolerance. She was found to have a right-sided diaphragmatic hernia which ultimately required operative intervention. Retrospectively, a close review of prior imaging revealed a potential diaphragm defect. Post-colonoscopy diaphragmatic hernias are very rare and right-sided ones are rarer, making this case report an important addition to the literature.

Epidemiological Characterization of Dengue Fever - Yunnan Province, China, 2010-2021.

Objective: The goal of this study is to analyze the epidemiological patterns of dengue fever across different districts and counties in Yunnan Province from 2010 to 2021. Methods: In this study, we employed joinpoint regression analysis, spatial autocorrelation analysis, and space-time scan analysis to illustrate the spatio-temporal propagation and demographic influence of dengue fever, using both graphical and tabular presentations to clearly demonstrate the findings. Results: Yunnan Province reported 14,098 cases of dengue fever during the period from 2010 to 2021. Of these, 11,513 cases were caused by local transmission, 2,566 were imported internationally, and 19 were inter-provincial imports. Seasonal trends emerged, revealing a surge in incidences during the summer and autumn months. The sex ratio of male to female cases was 1:0.88, with a significant majority of 82.00% of cases involving individuals belonging to the age group of 15-60. Commercial service workers constituted the most impacted occupational group, forming 20.96% of total cases. A spatio-temporal scan identified significant clustering of dengue fever cases across space and time, with the most pronounced cluster observed in southern Yunnan, primarily between 2015 and 2019. Conclusions: Dengue fever in Yunnan Province manifests as biennial outbreaks, underscoring the necessity for increased surveillance, particularly in counties bordering other regions.

Mobile Technologies for Monitoring Sleep Time: A Systematic Search of App Stores in Brazil.

Introduction Decreased sleep time is detrimental to physical and mental health, exerting negative impacts on daily functioning and quality of life. Mobile health (mHealth) applications can be useful for improving sleep quality. Objective To perform a systematic search of mHealth applications for monitoring sleep time at Brazilian online stores and evaluate the selected applications in terms of engagement, functionality, aesthetics, and quality of information. Methods A systematic search was performed at the Google Play Store and the App Store developed or updated between 2020 and 2022. The mobile app rating scale (MARS) was used to assess their quality. The characteristics and information of these applications were presented. Data were analyzed descriptively. Results Among the 2,264 relevant mHealth apps identified, 11 were eligible for inclusion. There was one app that offered only sleep time recordings, three offered sleep recordings and educational content, three monitored sleep time with audiovisual resources, two offered sleep time recordings with a focus on monitoring snoring, and two offered sleep time monitoring with individual content customizations. The apps scored fair on MARS, with a mean of 3.5 points (standard deviation: 0.8) on a scale of 1 to 5. Most apps scored low due to poor evidence-based information, aesthetics, and engagement. Conclusion Although the use of mHealth technologies for monitoring sleep time has considerable potential for investigation, it is a relatively new, underexplored topic. Collaboration between researchers, clinical professionals, patients, and application developers is necessary for the creation of new evidence-based mHealth applications focused on Brazilian users.

A one health-focused literature review on bovine and zoonotic tuberculosis in Pakistan from the past two decades: challenges and way forward for control.

Bovine tuberculosis (bTB), caused by Mycobacterium bovis (M. bovis), is a globally prevalent zoonotic infectious disease. World Organization for Animal Health (WOAH) estimates indicate that up to 10% of the total human TB cases in developing countries are attributed to M. bovis. Pakistan ranks 4th in global milk production with a livestock population of over 212 million animals. Over 8 million families are involved in raising these animals as a means of livelihood. To date, there is an absence of national-level data on the prevalence of bTB and an effective control program is still lacking. The multifaceted impacts and substantial economic losses render addressing bTB a daunting, but highly important challenge. In this review, we summarise all the freely available literature on M. bovis infection from Pakistan using Google scholar and PubMed databases. A total of 40 animal studies were identified using search terms: "bovine tuberculosis in Pakistan, bTB, Pakistan, Mycobacterium bovis in Pakistan, M. bovis in Pakistan"; while seven human studies were identified using the terms: zoonotic tuberculosis in Pakistan', 'M. bovis in humans Pakistan', 'zTB in TB patients in Pakistan". We have summarized all these studies to identify critical risk factors involved in transmission of bTB among animals and humans. Despite lack of comprehensive and geographically representative studies, the literature suggests a varying prevalence of bTB in animals, ranging from as low as 2% to as high as 19%. Regarding zTB prevalence in humans, estimates range from 1.5% to 13% in high-risk group of farm and abattoir workers, with notably higher percentages in extra-pulmonary TB cases. The review also addresses the challenges that Pakistan faces in formulating an effective policy for the control and eradication of bTB. We conclude with one-health based recommendations as a way forward for controlling TB caused by M. bovis in cattle and humans.