Longitudinal Study of Avian Pathogenic Escherichia coli (APEC) serogroups associated with disease in Georgia poultry using molecular serology and virulence gene analysis.

Avian pathogenic Escherichia coli (APEC) is a significant cause of morbidity, mortality, and production loss to the poultry industry worldwide. Here, we characterized 569 E. coli isolates from avian-diagnosed colibacillosis cases from the state of Georgia, USA. A total of 339 isolates were assigned into 32 serogroups with the majority classifying as O78, O2, O25, O8, O1, O86, O18, and O15. Serogroup O25 was found to link with broilers, while broiler breeders were more often associated with serogroup O1 and pet/ hobby birds with serogroup O8. In addition, some serogroups (O1) were more prevalent in the Summer and Fall. Analysis for virulence-associated genes (VAGs) found 23.20% of isolates did not harbor any genes linked with the APEC pathotype, while ColV plasmid-associated genes (iroN, ompT, hlyF, iss, and aerJ,) were frequently detected among most isolates (with 80 to 96% prevalence) and some of these genes were linked with serogroup. Phylogenetic analysis, classified isolates into phylogenetic groups B2 (27%), G (21%), F (15%), and A (11%). The phylogenetic group B2 isolates also harbored the highest number of VAGs. This study highlights that the current APEC-causing disease in birds in the State of Georgia has identified several emerging serogroups possessing several VAGs that could potentially lead to challenges in colibacillosis control.

Hepatitis C virus attributable liver cancer in the country of Georgia, 2015-2019: a case-control study.

BACKGROUND: Hepatitis C virus (HCV) infection can lead to a type of primary liver cancer called hepatocellular carcinoma (HCC). Georgia, a high HCV prevalence country, started an HCV elimination program in 2015. In addition to tracking incidence and mortality, surveillance for the HCV-attributable fraction of HCC is an important indicator of the program's impact. This study assesses HCV infection-attributable HCC in the Georgian population. METHODS: This case-control study utilized HCV programmatic and Georgian Cancer Registry data from 2015-2019. Bivariate logistic regression and age- and sex-stratified analyses assessed HCV and liver cancer association. HCV-attributable liver cancer proportions for the HCV-exposed and total population were calculated. A sub-analysis was performed for HCC cases specifically. RESULTS: The total study population was 3874 with 496 liver cancer cases and 3378 controls. The odds for HCV-infected individuals developing liver cancer was 20.1 (95% confidence interval [CI] 15.97-25.37), and the odds of developing HCC was 16.84 (95% CI 12.01-23.83) compared to the HCV-negative group. Odds ratios varied across strata, with HCV-infected older individuals and women having higher odds of developing both liver cancer and HCC. A large proportion of liver cancer and HCC can be attributed to HCV in HCV-infected individuals; however, in the general population, the burden of liver cancer and HCC cannot be explained by HCV alone. CONCLUSION: HCV was significantly associated with a higher risk of developing liver cancer and HCC in the Georgian population. In addition, given Georgia's high HCV burden, increased HCC monitoring in HCV-infected patients is needed.

Descriptive Epidemiology of Gastric Cancer: A Population-Based Study From Georgia.

Background Gastric cancer (GC) remains a significant public health issue in many countries globally due to its high morbidity and mortality rates. In Georgia, the incidence of GC reflects the prevalence patterns of established risk factors. To develop appropriate prevention and treatment strategies, GC requires a comprehensive approach and research. This study aims to review and describe GC epidemiologic characteristics in the country. Methodology We conducted a descriptive analysis utilizing data from the national population-based cancer registry. All patients diagnosed with invasive GC between 2015 and 2022 were eligible for inclusion in the analysis. To calculate age-standardized incidence (ASIR) and mortality (ASMR) rates we used a direct method, standardized to the World (WHO 2000-2025) standard population. Trends in Incidence and mortality were assessed using standardized rate ratios (SRRs). The mortality-to-incidence ratio (MIR) was defined as the ratio of the ASMR to the ASIR for the corresponding year. The Kaplan-Meier method was utilized to construct survival curves with survival comparisons performed using the log-rank test. Results A total of 2,707 GC cases with 62% (n = 1,668) of patients being male were enrolled in this descriptive study. The median age at diagnosis was 65 years, and about 70% (n = 1,893) of cases were detected at advanced (III and IV) stages. Over the study period, the ASIR per 100,000 population for both sexes decreased from 8.4 to 7.3. The SRR and 95% confidence interval indicated no significant change in ASIR for males but it decreased for females in 2022 compared to 2015. In 2022, the ASMR decreased compared to 2015 for males (from 10.5 to 7.3/100,00) and for females (from 5.8 to 3.0/100,000) as well. However, the MIR ​​indicated an unstable reduction in mortality, fluctuating over the observation period. The five-year survival rate was around 22.0%. Conclusions This study provides a comprehensive overview of GC epidemiology in Georgia between 2015 and 2022. GC remains a significant public health challenge, characterized by the high proportion of late-stage diagnoses and high mortality rates. The implementation of prevention and early diagnosis strategies is crucial to reduce the burden of GC in the country.

Motivators and mechanisms for an international rural health collaboration.

Collaborations are critical to address rural health challenges. We evaluated a new international collaboration between institutions in Georgia, the United States (US), and Scotland, United Kingdom (UK), to address rural health issues and to understand the barriers and facilitators to effective international collaboration efforts. A qualitative approach was used through in-depth interviews and focus groups with educators, researchers, and healthcare providers in the US and Scotland who were involved in the CONVERGE international rural health collaboration. Transcriptions were imported into the NVivo qualitative software program. A reflexive thematic analysis was employed to identify key themes from the collected data. Twelve interviews and two focus groups were conducted virtually with 17 participants. Two primary domains were identified from the thematic analysis: (1) motivators that increase engagement in international collaboration, and (2) mechanisms for, and barriers to, the continuity needed to create meaningful change. Six themes emerged related to commonality of issues, prospect of sharing knowledge, need of sustained funding and institutional support, and selection of human resources. Participants of CONVERGE were more likely to engage when they had a space to share ways to address challenging issues and integrate knowledge and practice. They were motivated by their desire for growth and the institutions they serve and emphasized that infrastructure support is vital for sustainable collaborations.

Effects of social determinants on the health outcomes and academic success of international college students in Georgia, United States.

Objective: Although there are many international college students in the state of Georgia, few studies have been conducted on how social determinants affect their health outcomes and academic success. This study examined the effects of social determinants on the health outcomes and academic success of international college students in Georgia. Participants: Participants were international college students (n = 136) in Georgia. Methods: A mixed methods cross-sectional design was used for the study. Results: The lack of access to sufficient funds caused study participants to experience anxiety (39.0%), depression (20.6%), and stress (52.9%). Cultural differences (16.9%), lack of access to health care (15.4%), transportation (14.7%), poor housing (7.4%), and financial insecurity (54.5%) affected study participant health outcomes and academic success. Conclusion: Addressing financial insecurity, the lack of access to health care, poor housing, transportation issues, and cultural differences experienced by international college students in Georgia, is crucial to their health outcomes and academic success.

Work Motivation and Job Satisfaction among Primary Healthcare Workers in Georgia.

Motivation is defined as human effort, striving, stimulation process for successful work, and achievement of organizational goals. The purpose of the research is to study the factors determining the motivation and job satisfaction of primary healthcare personnel in Georgia. The relevance of the issue is indicated by the poorly development of the primary healthcare system in Georgia, which is confirmed by the fact that the number of referrals to outpatient medical institutions is 3.6 per capita per year, while it reaches 7.5 in European countries. A quantitative study was conducted in this research. As a result of the research, it was determined that motivation and job satisfaction are complex constructs. The following main factors that influence the job satisfaction of employees in primary care organizations were identified: individual characteristics, financial and non-financial incentives, organizational structures and processes, including supervision, leadership, fairness, and responsibility for the distribution of resources, staff dynamics, and team cohesion, relationships with colleagues and management, relationships with patients, intellectual stimulation, opportunities for continuing medical education. A family physician's and family nurse practitioner's job satisfaction significantly improves the services and has a positive impact on the patient's well-being. Health policymakers and managers need to critically analyze the importance of providing additional incentives. In order to improve the job satisfaction of primary health care workers, in addition to salary, special emphasis should be placed on supporting family life, creating decent living conditions, adequate free time, educational prospects, and better opportunities for professional development and promotion.

Pregnancy-related maternal mortality in the state of Georgia: Timing and causes of death.

BACKGROUND: The maternal mortality rate in the United States is high and disparities among non-Hispanic White and non-Hispanic Black women remain. In the State of Georgia, the pregnancy-related death rate is among the worst in the nation. OBJECTIVE: To examine current pregnancy-related deaths in the State of Georgia using measures of timing and cause-specific mortality across maternal sociodemographic characteristics. DESIGN: This cross-sectional study of pregnancy-related deaths in Georgia was based on 2016-2019 maternal mortality data obtained from the Georgia Department of Public Health. METHODS: Our study analysis involved complete-case data of maternal deaths identified as pregnancy-related deaths (n = 129). Statistical analyses included two distinct population-level measures: (a) timing (i.e. during pregnancy, 0 to 60 days, 61 to 180 days, and 181 to 365 days postpartum) and (b) cause-specific deaths patterned by sociodemographic groups of women and by rural and urban county of residence. Categorical variables were compared using the Chi square or Fisher's exact test and presented as numbers and percentages. A post hoc power analysis was conducted to inform whether there was sufficient power to detect statistically significant effects given available sample sizes. RESULTS: Among a total of 129 pregnancy-related deaths, 30 (23.3%) deaths occurred during pregnancy and 63 (48.8%) deaths occurred within the first 60 days postpartum. Pregnancy-related deaths were disproportionally common among non-Hispanic Black, 25 to 34 years old, and poorly educated women. Three leading underlying causes, cardiomyopathy (22.7%), hemorrhage (21.6%), and cardiovascular or coronary disease (20.4%), accounted for about 65% of all pregnancy-related deaths. Mental health conditions were common causes of death among non-Hispanic White women during pregnancy and in late postpartum. CONCLUSION: Continued monitoring, collecting and analyzing reliable data will help identify root causes and find ways to eliminate the disproportionate burden of pregnancy-related deaths in the State of Georgia.

Discriminating woody species assemblages from National Forest Inventory data based on phylogeny in Georgia.

Classifications of forest vegetation types and characterization of related species assemblages are important analytical tools for mapping and diversity monitoring of forest communities. The discrimination of forest communities is often based on ß-diversity, which can be quantified via numerous indices to derive compositional dissimilarity between samples. This study aims to evaluate the applicability of unsupervised classification for National Forest Inventory data from Georgia by comparing two cluster hierarchies. We calculated the mean basal area per hectare for each woody species across 1059 plot observations and quantified interspecies distances for all 87 species. Following an unspuervised cluster analysis, we compared the results derived from the species-neutral dissimilarity (Bray-Curtis) with those based on the Discriminating Avalanche dissimilarity, which incorporates interspecies phylogenetic variation. Incorporating genetic variation in the dissimilarity quantification resulted in a more nuanced discrimination of woody species assemblages and increased cluster coherence. Favorable statistics include the total number of clusters (23 vs. 20), mean distance within clusters (0.773 vs. 0.343), and within sum of squares (344.13 vs. 112.92). Clusters derived from dissimilarities that account for genetic variation showed a more robust alignment with biogeographical units, such as elevation and known habitats. We demonstrate that the applicability of unsupervised classification of species assemblages to large-scale forest inventory data strongly depends on the underlying quantification of dissimilarity. Our results indicate that by incorporating phylogenetic variation, a more precise classification aligned with biogeographic units is attained. This supports the concept that the genetic signal of species assemblages reflects biogeographical patterns and facilitates more precise analyses for mapping, monitoring, and management of forest diversity.

Surveillance Metrics and History of the COVID-19 Pandemic in Central Asia: Updated Epidemiological Assessment.

BACKGROUND: This study updates the COVID-19 pandemic surveillance in Central Asia we conducted during the first year of the pandemic by providing 2 additional years of data for the region. The historical context provided through additional data can inform regional preparedness and early responses to infectious outbreaks of either the SARS-CoV-2 virus or future pathogens in Central Asia. OBJECTIVE: First, we aim to measure whether there was an expansion or contraction in the pandemic in Central Asia when the World Health Organization (WHO) declared the end of the public health emergency for the COVID-19 pandemic on May 5, 2023. Second, we use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Third, we aim to provide historical context for the course of the pandemic in Central Asia. METHODS: Traditional surveillance metrics, including counts and rates of COVID-19 transmissions and deaths, and enhanced surveillance indicators, including speed, acceleration, jerk, and persistence, were used to measure shifts in the pandemic. To identify the appearance and duration of variants of concern, we used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID). We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a 1-sided t test to determine whether regional speed was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data across the sample period. RESULTS: Speed for the region had remained below the outbreak threshold for 7 months by the time of the WHO declaration. Acceleration and jerk were also low and stable. Although the 1- and 7-day persistence coefficients remained statistically significant, the coefficients were relatively small in magnitude (0.125 and 0.347, respectively). Furthermore, the shift parameters for either of the 2 most recent weeks around May 5, 2023, were both significant and negative, meaning the clustering effect of new COVID-19 cases became even smaller in the 2 weeks around the WHO declaration. From December 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t test of speed equal to 10 became entirely insignificant for the first time in March 2023. CONCLUSIONS: Although COVID-19 continues to circulate in Central Asia, the rate of transmission remained well below the threshold of an outbreak for 7 months ahead of the WHO declaration. COVID-19 appeared to be endemic in the region and no longer reached the threshold of a pandemic. Both standard and enhanced surveillance metrics suggest the pandemic had ended by the time of the WHO declaration.

Bridging cancer prevention efforts: Georgia's alignment with European code against cancer.

This report provides a concise overview of how Georgia has integrated the principles of the European Code Against Cancer (ECAC) into its national cancer strategies. Through a structured exploration, we highlight Georgia's commitment to cancer prevention, while addressing the challenges and opportunities encountered.

Numerous Asymptomatic Brain Tuberculomas Complicated by Fatal Tuberculous Meningitis.

Tuberculosis (TB) is still one of the most challenging infectious diseases worldwide. Coinfection with HIV increases the likelihood of extrapulmonary involvement, including the tuberculosis of the central nervous system (CNS-TB). CNS-TB often presents as tuberculomas or tuberculous meningitis. Although tuberculomas can be single or multiple, asymptomatic carriage of numerous tuberculomas is seldom reported. We present a case of a 55-year-old man who carried at least 34 tuberculomas of different sizes asymptomatically before developing and succumbing to tuberculous meningitis. Furthermore, we highlight several possible public health challenges that might have complicated his clinical course, suggesting that future studies also focus on these variables alongside more traditional clinical issues.

Validation of the Internet Addiction Test for Adolescents (IAT-A) in the Georgian language.

BACKGROUND: The internet has become an integral part of daily life, impacting various aspects, especially among children and adolescents. Internet overuse has been associated with numerous physical and mental health issues. Despite its significant implications, there is no universally accepted assessment tool for internet addiction. This study focuses on validating the Georgian version of the Internet Addiction Test (IAT) among pediatric patients aged 9 to 17, specifically the Internet Addiction Test - Adolescence (IAT - A). METHODS: The study, conducted in 2022-2023, involved pediatric patients from Givi Zhvania Pediatric Academic Clinic, generally healthy but with parental concerns about screen time. The IAT-A, a self-administered questionnaire, was adapted for cultural relevance. Translation-back-translation was employed for linguistic validation. Data was collected twice, with a 6-month interval. Statistical analyses included the Kappa coefficient, Kendall's tau test, paired t-test, and Bland-Altman plots. RESULTS: The translation process ensured linguistic accuracy and cultural relevance. The study included 100 participants (59 % boys, 41 % girls) with a mean age of 12 years. The mean IAT - A score remained consistently high over both testing periods. Kendall's tau correlation coefficient indicated a strong correlation (0.97), and Bland-Altman plots confirmed repeatability. The cut-off of 40 points identified 84 % as problematic internet users. Individual question analysis showed strong correlation and agreement. CONCLUSION: The Georgian version of the IAT - A demonstrated reliability and consistency in assessing internet addiction among pediatric patients. The prevalence of problematic internet use among children referred to a university hospital because parents were worried about their internet use was indeed high. The study contributes valuable insights into internet addiction research in Georgia and underscores the importance of a standardized assessment tool. The repeatability of the scores of each question was strong among both groups of problematic internet users and non-problematic internet users, confirming that the Georgian version of IAT - A has high level of accuracy and can be used in internet addiction research.

First Report of Watermelon Crinkle Leaf-Associated Virus-2 (WCLaV-2) in Watermelon (Citrullus lanatus) in Georgia, USA.

Watermelon (Citrullus lanatus) is a key horticultural crop in Georgia with farmgate value of 142 million USD (2022 Farm Gate Value Report), yet faces challenges from whitefly-transmitted viruses, especially during periods of elevated whitefly populations in the fall. Foliar symptoms on watermelon plants including yellow mottling and chlorosis, wrinkling, bunching, and upward curling, were observed in experimental fields at UGA Tifton and commercial fields in Colquitt County in the fall of 2023. These were similar to those described for watermelon crinkle leaf-associated viruses (WCLaV-1 and WCLaV-2) from Florida (Hendrick et al, 2021) and Texas (Hernandez et al., 2021). The disease incidence reached 100% in both locations. WCLaV-1 was previously identified in Georgia (Adeleke et al., 2022a); however, WCLaV-2 remained undetected in further surveys (Adeleke et al., 2022b). Total nucleic acid was extracted from symptomatic leaf tissues with the MagMAXTM 96 Viral RNA isolation kit (ThermoFisher Scientific, USA), following the manufacturer's guidelines, with the omission of DNAse treatment. The presence of WCLaV-1 was identified through reverse transcription-polymerase chain reaction (RT-PCR) (Hernandez et al., 2021) in 17 out of 24 samples in Tift County, and 12 out of 15 samples from Colquitt County. Within the same set of samples, WCLaV-2 was identified in three samples from Tift County and four samples from Colquitt County by RT-PCR directed at the RdRp gene (Hernandez et al., 2021). WCLaV-1 was not detected in the three samples from Tift County that had WCLaV-2, while mixed infections of WCLaV-2 and WCLaV-1 were observed in the samples form Colquitt County. Two whitefly transmitted viruses, previously reported in Georgia were also identified as mixed infection in these samples (Table S1). The presence of WCLaV-2 was further confirmed by amplifying the movement protein (MP) gene of WCLaV-2 by RT-PCR assays (Hernandez et al., 2021). The amplicons, with expected sizes of 968bp for the RdRp gene and 562bp for the MP gene of WCLaV-2, located on RNA 1 and RNA 2 segments respectively, were directly sequenced from both directions (Genewiz, USA) from a sample collected in Tift County. The resulting data were analyzed via BLASTn search. The MP gene fragment (PP178543) shared 100% identity with isolates from Brazil (LC636074.1), Texas (MW559086.1), and Florida (MZ325858.1). RdRp gene (PP178542) shared >99.7% identity with isolates from Brazil (LC636073.1), Texas (MW559083.1) and Florida (MZ325855.1). WCLaV-1 and WCLaV-2, initially discovered in Asia (Xin et al., 2017), have been assigned to the genus Coguvirus, in the family Phenuiviridae (Walker et al., 2022). Subsequent reports from the USA (Hendrick et al., 2021; Hernandez et al., 2021), Australia (Mulholland et al., 2023), and Brazil (Maeda et al., 2022) indicate the global spread of these viruses. Watermelon is the primary host of WCLaV-2. Despite these findings, biological information, including vector relations, for both viruses and other members of the genus Coguvirus remains elusive. The impact of these viruses on watermelon production and yield in the identified regions remains largely unknown, underscoring the need for further investigations.

Does Nesting Material Affect Wood Duck (Aix sponsa) Nest Box Selection, Reproduction, and Eggshell Bacteria?

Wood Ducks (Aix sponsa) are secondary cavity nesters that use natural cavities and artificial nest boxes, the latter of which has been attributed to the recovery of populations across the southeastern US. Continual use of these boxes results in a buildup of bacteria, parasites, and other pathogens. To avoid the accumulation of these deleterious organisms, best management practices include the occasional removal of old nesting material (i.e., wood shavings) and replacement with fresh wood shavings. No studies have been performed on the effects of shaving material on nest box selection, nest success, and bacterial growth. We monitored 142 and 111 nest boxes in Florida and Georgia, USA, respectively, and filled a random sample with aspen or cedar shavings. We then swabbed the surface of 144 and 150 eggs during 2020 and 2021, respectively, to screen for culturable bacteria. We detected no effect of shaving type on nest box selection, nest success, or egg surface bacterial growth. We found 3-8 bacterial colony types (1-123 colony-forming units [CFU]/box) and 1-8 bacterial colony types (3-382 CFU/box) among the Georgia and Florida samples, respectively. We detected no effect from shaving type on Wood Duck reproduction or bacterial growth in the sampled nest boxes. We concluded that both shaving types are suitable nesting materials for box-nesting Wood Duck populations and the continued use of either would be a reasonable decision for managers.

Investigating the role of county-level colorectal cancer screening rates on stage at diagnosis of colorectal cancer in rural Georgia.

BACKGROUND: To examine the impact of county-level colorectal cancer (CRC) screening rates on stage at diagnosis of CRC and identify factors associated with stage at diagnosis across different levels of screening rates in rural Georgia. METHODS: We performed a retrospective analysis utilizing data from 2004 to 2010 Surveillance, Epidemiology, and End Results Program. The 2013 United States Department of Agriculture rural-urban continuum codes were used to identify rural Georgia counties. The 2004-2010 National Cancer Institute small area estimates for screening behaviors were applied to link county-level CRC screening rates. Descriptive statistics and multinominal logistic regressions were performed. RESULTS: Among 4,839 CRC patients, most patients diagnosed with localized CRC lived in low screening areas; however, many diagnosed with regionalized and distant CRC lived in high screening areas (p-value = 0.009). In multivariable analysis, rural patients living in high screening areas were 1.2-fold more likely to be diagnosed at a regionalized and distant stage of CRC (both p-value < 0.05). When examining the factors associated with stage at presentation, Black patients who lived in low screening areas were 36% more likely to be diagnosed with distant diseases compared to White patients (95% CI, 1.08-1.71). Among those living in high screening areas, patients with right-sided CRC were 38% more likely to have regionalized disease (95% CI, 1.09-1.74). CONCLUSION: Patients living in high screening areas were more likely to have a later stage of CRC in rural Georgia. IMPACT: Allocating CRC screening/treatment resources and improving CRC risk awareness should be prioritized for rural patients in Georgia.

Correlation of SARS-CoV-2 in Wastewater and Individual Testing Results in a Jail, Atlanta, Georgia, USA.

Institution-level wastewater-based surveillance was implemented during the COVID-19 pandemic, including in carceral facilities. We examined the relationship between COVID-19 diagnostic test results of residents in a jail in Atlanta, Georgia, USA (average population ≈2,700), and quantitative reverse transcription PCR signal for SARS-CoV-2 in weekly wastewater samples collected during October 2021‒May 2022. The jail offered residents rapid antigen testing at entry and periodic mass screenings by reverse transcription PCR of self-collected nasal swab specimens. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between strength of SARS-CoV-2 PCR signal (cycle threshold value) in wastewater and percentage of jail population that tested positive for COVID-19. Of 13,745 nasal specimens collected, 3.9% were COVID-positive (range 0%-29.5% per week). We observed a strong inverse correlation between diagnostic test positivity and cycle threshold value (r = -0.67; p<0.01). Wastewater-based surveillance represents an effective strategy for jailwide surveillance of COVID-19.

Beachgoers' responses to beach health advisories.

Drawing on responses from 238 beachgoers who have visited a Georgia (U.S. state) beach in the past three years, this study asks respondents about their knowledge of beach water quality monitoring, awareness of beach health advisories, perception of water quality, and expected responses upon learning of a beach's water pollution advisory. Binomial logistic regression finds that the only demographic predictor of respondents who would completely stop visiting a beach with an advisory is whether the respondent is a visitor or resident (year-round or part-time). Nearly 40% of visitors would not come to a beach with an advisory compared to 13.4% of residents. Most respondents report they would continue to visit a beach but would stay out of the water and stop harvesting seafood from the beach's waters. More than a third (36.1%), however, are unaware Georgia regularly monitors beach water for water quality, and 41.2% have never read a beach sign warning of contaminated water or seafood. Alarmingly, just over half view aesthetic factors such as no litter, no odor, and clear water as criteria for defining whether beach water is safe.

Energy poverty in the Energy Community region: Interrogating policy formulation and coverage.

The capacity of the state to develop and implement policy at the complex nexus of energy infrastructure, social inequality and housing is indicative of the political priorities of governing structures and, by extension, the nature of statecraft more generally. We compare and contrast the energy poverty amelioration policies of two former Yugoslav and two post-Soviet states located outside the European Union, but seeking to join its regulatory sphere - Serbia, Montenegro, Ukraine and Georgia - against the background of deep and persistent patterns of domestic energy hardship. We are particularly interested in uncovering the time horizons, socio-technical systems and target constituencies of different policy measures, as well as energy sector-specific responses to the COVID-19 pandemic. We find that most states in the region have done little to address some of the more substantive challenges around improving housing quality, energy efficiency and gender inequality. However, energy poverty is present in the policy lexicon of all case study countries, and Ukraine, in particular, has advanced a number of more sophisticated approaches and programmes.

Relationship Between Hepatitis C Infection and Treatment Status and Coronavirus Disease 2019-Related Hospitalizations in Georgia.

BACKGROUND: The aim of this study was to evaluate the impact of hepatitis C virus (HCV) infection and treatment status on coronavirus disease 2019 (COVID-19)-related hospitalizations in Georgia. METHODS: We analyzed 2020-2021 Georgian health registry data for COVID-19-positive individuals and categorized the data by HCV infection and treatment status. Logistic regression was used to assess the strengths of the associations. RESULTS: Treated individuals with HCV had lower odds of COVID-19-related hospitalization compared to anti-HCV-negative individuals, while untreated HCV-viremic and anti-HCV-positive nonviremic individuals had higher odds. CONCLUSIONS: HCV treatment prior to COVID-19 infection was associated with lower odds of COVID-19-related hospitalization, highlighting the benefits of HCV management in the context of the pandemic.

Treatment Disparities in Georgia: Methamphetamine Use Disorder.

BACKGROUND: Methamphetamine use disorder (MUD) is becoming more of a public health issue in Georgia State, with health and social effects affecting both people and communities. This study aimed to investigate attributes that may affect the accessibility of treatment among the methamphetamine-use population in the state of Georgia. METHODS: We utilized the Treatment Episode Data Set - Discharges (TEDS-D) for 2016-2020 in Georgia, comprising participants with MUD (175,270). We utilized descriptive statistics and inferential techniques to ascertain the relationship between variables. Multiple logistic regression was used to control for confounding variables at a 95% confidence interval. RESULTS: This study's findings showed individuals aged 25-49 years had 1.8 times higher odds of getting treatment for methamphetamine use compared to those aged 12-24 years (adjusted odds ratio (AOR) = 1.8; 95% CI: 1.50-2.16). Alaska Native individuals (Aleut, Eskimo, and Indian) had 7.07 times higher odds of receiving treatment than Asian or Pacific Islander individuals (AOR = 7.07; 95% CI: 2.02-24.67). Compared to Asian or Pacific Islander individuals, Black or African American individuals had 12.11 times higher odds of receiving treatment (AOR = 12.11; 95% CI: 9.37-15.66), while White individuals had 6.82 times higher odds of getting treatment (AOR = 1.09; 95% CI: 0.86-1.37). CONCLUSION: MUD treatment disparity challenges are revealed in our study, emphasizing the critical need for focused intervention programs.