Search Results (3,663)

Vector-borne diseases (VBDs) continue to pose a persistent global health challenge, disproportionately impacting low- and middle-income countries where surveillance and healthcare infrastructure are constrained. Within these countries, residents of remote island communities are particularly vulnerable to emerging VBD threats; however, they remain critically understudied. We conducted a community-based cross-sectional survey of 300 residents from Shahpori Island, Bangladesh, and Gaya Island, Malaysia, to assess knowledge, attitudes, and practices (KAP) related to VBDs. Using a structured questionnaire and mixed-effects Poisson regression modeling, we identified socio-demographic predictors of VBD-related knowledge and compared KAP outcomes across the two islands. Significant disparities were observed between the two settings: the Gaya Island residents demonstrated a higher level of awareness regarding VBDs and preventive practices compared to the Shahpori residents. Education was a strong predictor of VBD knowledge, with individuals possessing secondary education or above exhibiting significantly better knowledge (β = 0.2024, p = 0.0003). Marital status was also a significant factor, with unmarried respondents showing lower levels of knowledge (β = –0.1657, p = 0.0372). Age was positively correlated with VBD knowledge (β = 0.0051, p = 0.0119), indicating a gradual increase with age, while income, gender, occupation, and household size were not significantly associated. Despite basic awareness of VBD symptoms and transmission, detailed understanding of mosquito ecology, disease symptoms, and breeding prevention strategies was remarkably poor, especially among the Shahpori residents. Our findings highlight critical gaps in VBD-related knowledge and prevention behaviors shaped by socio-economic and educational disparities. Community-focused public health strategies including educational campaigns, establishment of health infrastructure, access to trained healthcare providers, and integrated vector control interventions are urgently needed to enhance resilience against emerging VBD threats such as drug-resistant malaria in remote island populations. Full article

Early-onset colorectal cancer (EOCRC) is emerging as a significant global health concern, particularly among individuals under the age of 50. This alarming trend has coincided with an increase in the consumption of processed foods that often rely heavily on synthetic preservatives. At the same time, these additives play a critical role in ensuring food safety and shelf life. Growing evidence suggests that they may contribute to adverse gut health outcomes, which is a known risk factor in colorectal cancer development. At the same time, synthetic preservatives serve essential roles such as preventing microbial spoilage, maintaining color, and prolonging shelf life. Natural preservatives, on the other hand, not only provide antimicrobial protection but also exhibit antioxidant and anti-inflammatory properties. These contrasting functions form the basis of current discussions on their safety and health implications. Despite their widespread use, the long-term health implications of synthetic preservatives remain inadequately understood. This review synthesizes recent clinical, epidemiological, mechanistic, and toxicological data to examine the potential link between synthetic food preservatives and EOCRC. Particular focus is placed on compounds that have been associated with DNA damage, gut microbiota disruption, oxidative stress, and chronic inflammation, which are the mechanisms that collectively increase cancer risk. In contrast, natural preservatives derived from plants and microbes are gaining attention for their antioxidant, antimicrobial, and possible anti-inflammatory effects. While these alternatives show promise, scientific validation and regulatory approval remain limited. This review highlights the urgent need for more rigorous, long-term human studies and advocates for enhanced regulatory oversight. It advocates for a multidisciplinary approach to developing safer preservation strategies and highlights the importance of public education in making informed dietary choices. Natural preservatives, though still under investigation, may offer a safer path forward in mitigating EOCRC risk and shaping future food and health policies. Full article

Colorectal cancer (CRC) is a significant public health issue, representing one of the greatest causes of both cancer diagnosis and mortality globally. While the incidence is highest in high-income countries, it is rising across the world, including in the Middle East and North Africa (MENA) region. Many countries have implemented national screening programmes to reduce the burden of CRC, utilising mostly stool tests and colonoscopy, but this has yet to occur across most MENA countries. Uptake of screening opportunities is generally poor. System-level barriers to establishing screening programmes include cost constraints and limited screening infrastructure. Patient-level barriers include embarrassment, fear of a cancer diagnosis, and limited awareness/education. Screening programmes across the MENA region would likely reduce the CRC incidence. These barriers must be overcome through patient education and government action to ensure appropriate patient uptake. This study aims to examine CRC screening practices across MENA, identify key barriers, and propose solutions for sustainable CRC management in the region, through a narrative review and expert input from the Middle East and North Africa Colorectal Cancer (MENA-CRC) Screening and Prevention collaborators. Full article

Objective: The objective of this retrospective cross-sectional study is to explore how caregiver social determinants of health, appraisal of healthcare provider effectiveness, and insurance coverage influence caregiver ability to have their adolescent child access vision care, including completion of annual vision screening, visiting an ophthalmologist or optometrist, and completion of recommended additional screenings. Study Design: We used National Survey of Children’s Health (NSCH) data for 12–17-year-old adolescents for the years 2022 and 2023 (n = 37,425). Summary statistics for the selected sample were generated and binary logistic regressions were conducted. Outcome variables were the type of vision screening that occurred or not. Covariates were socioeconomic and demographic data of the adolescent’s primary caregiver. Independent variables were insurance coverage and healthcare provider’s skill and effectiveness. Results: Significant associations were reported between visiting an ophthalmologist or optometrist and each of spending enough time with patients; listening carefully to patients; and making patients feel like care is a partnership. Additionally, significant associations were reported between insurance coverage and both successful completion of vision screening and visiting an eye doctor. Conclusions: This study underscores the substantial impact of effectiveness of eye doctors in delivering annual vision exams and insurance adequacy on adolescent vision care engagement. Our results will inform the development of future evidence-based educational interventions to raise awareness on the importance of annual vision screenings in US adolescents and emphasize the need for screening mandates to advocate for this important public health issue. Full article

Background/Objectives: Pulmonary rehabilitation is recognised as one of the most cost-effective interventions. However, patients’ adherence to these programmes remains a challenge. This systematic literature review aimed to describe pulmonary rehabilitation interventions carried out by nurses that promote self-care in elderly people with COPD (at home). Methods: The exploratory literature search was conducted to support the development of the research question and the PICO strategy. The criteria for eligibility were determined for participants, interventions, comparators, and outcomes. Research was conducted in the CINAHL, SCOPUS, and MEDLINE databases and that covered publications up to 31 December 2024 with no temporal limit identified, eight articles that included cohort studies, randomised controlled trials (RCTs), and quasi-experimental studies that met the quality standards established by JBI. Results: The identified interventions include health education, breathing training and physical exercise, the development of tailor-made plans with monitoring and follow-up, psychological support, and oxygen therapy management. Conclusions: The results highlight the importance of tailor-made interventions that can enhance self-care in elderly people with COPD in a home setting, as well as key components of respiratory rehabilitation. Full article

In Tehuacán, Puebla, Mexico, the agricultural sector is primarily dedicated to corn cultivation, which is reflected in the region’s economy, culture, and diet. This sector follows an agro-industrial production model dependent on pesticides and chemical fertilizers, which impacts both soil health and the population’s well-being. The objective of this study was to assess cytotoxic damage using the Buccal Micronucleus Cytome Assay (BMCA) in a population engaged in agricultural activities in San Diego Chalma, Tehuacán, Puebla, Mexico. Sociodemographic parameters were analyzed, along with the buccal micronucleus cytome assay, in a sample of 35 individuals composed of an agricultural group (18) and a control group (17). The agricultural group showed a significantly higher number of total micronucleated cells (Median = 714), which was 19.8 times greater than the non-agricultural group. Age, sex, basic education level, time of residence, and involvement in agricultural activities were key factors contributing to the development of buccal cell micronuclei, in addition to the use of pesticides as lambda-cyhalothrin, spinetoram, ethoprophos, carbofuran, methomyl, and chlorpyrifos ethyl without safety measures. There was an increased risk of developing micronucleated cells in males from the control group (OR = 2.386, 95% CI = 2.123–2.681) and in individuals aged 30–59 years (OR = 16.464, 95% CI = 14.315–18.935). The agricultural population for the 0–29 years presented a risk probability developing micronucleated cells of 99.8% in men and 99.9% in women, with a higher risk observed in women and in individuals who had lived their entire lives in San Diego Chalma, where they are continuously exposed to pesticides. Therefore, it is crucial to provide guidance, training, and improved public policies in the region of Puebla, Mexico. Full article

Background/Objectives: Mental health awareness is rising; thus, neurological and psychiatric side effects also benefit from increased attention from the medical and scientific community. Ibuprofen is a well-known non-steroidal anti-inflammatory drug (NSAID) that is often available over-the counter (OTC) for both adults and children, expressing good efficacy in reducing pain and fever through non-selective cyclooxygenase inhibition. As ibuprofen has already been associated with different neuropsychiatric disorders, the aim of this study was to perform an up-to-date analysis of such signals detected in the cases reported in EudraVigilance (EV). Methods: The disproportionality analysis offered a contextual insight into the real-world situation depicted in the analyzed database. Results: From the total cases reported for ibuprofen (n = 58,911), 13.9% contained nervous system disorders (n = 8214) and 10.7% entailed psychiatric disorders (n = 6295). The cases were distributed between all age groups, with a sensible higher incidence in teenagers and in women in general. Severe cases, including deaths, have been reported. By comparison with ketoprofen, acetylsalicylic acid, and diclofenac, ibuprofen presented a higher probability of reporting psychiatric and behavioral symptoms. Regarding cognitive and attention disorders and disturbances, no disproportionate signal was observed between ibuprofen and all other NSAIDs. Sleep disturbances (hypersomnia, narcolepsy and sleep paralysis) are reported as more probable for ibuprofen than for acetylsalicylic acid, naproxen, and diclofenac. A higher risk of reporting suicidal and self-injurious behaviors was noted for ibuprofen versus all other selected NSAIDs. A limitation of the study can be noted as due to suspected causality, not an established one, and EV reports cannot accurately determine adverse drug reaction frequencies. Conclusions: Considering that ibuprofen is easily accessible as an OTC drug and the higher probability of reporting several neuropsychiatric adverse effects as shown by this study, patient counseling, when possible, and general education for the public are valuable tools in managing these adverse reactions. Full article

This study examines the evolution of willingness to accept the monkeypox (Mpox) vaccine in Romania between 2022 and 2025. It explores key sociodemographic and behavioral predictors of vaccine acceptance and investigates how public perceptions—particularly concerning disease severity and conspiracy beliefs—have shifted across two independent cross-sectional samples. Two nationally distributed surveys were conducted in July 2022 (n = 820) and January–February 2025 (n = 1029), targeting Romanian residents aged 18 and above. Data were analyzed using descriptive statistics, Chi-square tests, Kolmogorov–Smirnov tests, and a Random Forest classification model to assess the relative importance of predictors of vaccine acceptance. Between 2022 and 2025, vaccine acceptance increased modestly, particularly among individuals aged 36–65 and those with prior experience of voluntary or COVID-19 vaccination. Random Forest analysis identified behavioral factors as the strongest predictors of acceptance in both years, while the influence of education and gender varied over time. Belief in conspiracy theories slightly declined and lost predictive relevance by 2025. Perceptions of pandemic potential and fear of infection also decreased, suggesting reduced risk salience and possible pandemic fatigue. Despite a slight upward trend, overall Mpox vaccine acceptance in Romania remains among the lowest in Europe. These findings highlight the need for targeted public health communication, particularly toward skeptical or demographically vulnerable groups. Prior vaccination behavior emerged as a key driver of acceptance, indicating that trust-building strategies should capitalize on existing pro-vaccination habits. Future research should adopt qualitative and longitudinal approaches to better capture the evolving psychosocial dynamics of vaccine hesitancy. Full article

Human toxocariasis is a neglected tropical disease with a potentially major impact on public health. Our aim was to assess the seroprevalence and risk factors associated with Toxocara seroprevalence in blood donors from Romania. Serum samples were obtained from 1347 Romanian blood donors and serologically tested for anti-Toxocara antibodies. An epidemiological questionnaire was used to determine the risk factors associated with Toxocara infection. The overall prevalence of Toxocara antibodies was 29.6%, with a significant age-associated increase (p < 0.001). A higher rate was observed in individuals from rural areas compared to urban areas (p = 0.002) and in males compared to females (p = 0.001). In univariate statistical analysis, seropositivity was significantly associated with household ownership (p < 0.001), contact with soil (p < 0.001), owning dogs (p < 0.001), cats (p = 0.003), and consumption of undercooked poultry (p = 0.002). In a stepwise multivariate logistic regression model, only a lower level of education, age, male gender, consumption of undercooked or raw poultry, and contact with soil were associated with higher Toxocara seroprevalence. Our findings suggest a significant prevalence of Toxocara infection in this region. The identified risk factors highlight the necessity of health education programs that focus on public awareness and promote preventive behaviors, especially among at-risk populations. Full article

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by protozoa of the Leishmania genus. Once confined to endemic regions such as the Middle East, Americas, North Africa, and Central Asia, CL is increasingly emerging in non-endemic areas due to a multitude of drivers, including population displacement, environmental disruption, and political instability. These overlapping drivers contribute to expanding sand fly habitats, degrading living conditions, and weakening health systems, increasing transmission. Rising global temperatures further facilitate vector expansion into new regions, where clinical unfamiliarity often leads to misdiagnosis, delayed treatment, increased morbidity, and greater financial burden. Despite its rising incidence and global spread, CL remains a neglected tropical disease since it is seldom fatal, with scant interest by public health authorities and financial donors, limiting activities that further research and prevent spread of the disease. This review synthesizes current evidence on how geopolitical instability, forced migration, and climate-driven ecological changes collectively reshape CL epidemiology and complicate diagnosis, treatment, and surveillance. As CL extends beyond traditional geographic boundaries, it requires integrated strategies that address its multifaceted drivers through strengthened cross-border surveillance, provider education, and international coordination—focusing on prevention, diagnosis, and equitable access to diagnostics and therapeutics, especially among displaced and underserved populations. Full article

Background/Objectives: E-cigarette use has increased substantially among university students in recent years, coinciding with a broader shift in nicotine consumption patterns globally. Despite initial perceptions of e-cigarettes as harm-reduction tools, growing evidence indicates significant health risks, misinformation, and limited awareness—especially within higher education environments. This structured literature review aims to synthesize peer-reviewed evidence on the health impacts, behavioral determinants, and the role of nursing in addressing e-cigarette use among university students. Methods: A literature search was conducted across five databases (PubMed, CINAHL, Scopus, Embase, Dialnet) between February and March 2025. Eligible studies were published between January 2020 and January 2025 in English or Spanish. A total of 43 studies were included. Data were synthesized narratively, and methodological quality was assessed using Joanna Briggs Institute checklists and The Scale for the Assessment of Narrative Reviews Articles. Results: E-cigarette use among university students showed wide variability in prevalence, with higher rates among males, students in non-health disciplines, and users of disposable devices. Key behavioral and social determinants included peer influence, curiosity, stress management, and social media exposure. Despite documented health risks—such as nicotine dependence, respiratory and cardiovascular impairment, and mental health concerns—misconceptions about safety and cessation efficacy were common, even among health science students. Nursing-led interventions hold great potential for prevention but remain underdeveloped within university settings. Conclusions: The findings underscore the urgent need for evidence-based prevention strategies—particularly those led by nurses—to reduce e-cigarette use, bridge knowledge gaps, and mitigate associated health risks in higher education. Future efforts should prioritize institutional policy reinforcement, improved health communication, and the integration of vaping-related education into nursing curricula and public health campaigns targeting emerging adults. Full article

Background/Objectives: To evaluate the impact of the European–Mediterranean Postgraduate Program on Organ Donation and Transplantation (EMPODaT) on organ donation and transplantation (ODT) at 6 years. Methods: EMPODaT is a Trans-European Mobility Programme for University Studies (TEMPUS) project founded by the European Commission to address ODT professionals’ shortage in Middle East/North Africa (MENA) countries through structured postgraduate education. Leading universities from Spain, Germany, Sweden, and France, and key institutions in Egypt, Lebanon, and Morocco, developed a one-year blended training program incorporating e-learning, in-person courses, and hospital traineeships. The effect of the program at 6 years was analyzed by surveying the 90 healthcare participants. Results: A total of 73.9% of respondents remained actively engaged in the field, and some assumed leadership roles (local directors 14.4%, donor coordinators 13%). Also, 65.2% of participants reported improvements in policies and practices, with notable progress in donor screening (39.1%), brain death diagnosis (30.4%), and hospital policy reforms (69.7%). The study identified barriers, such as legal (34.4%), financial (34.8%), and public/social resistance (39.1%). Training alone, without strong hospital policies, support, and government involvement, was insufficient for introducing meaningful changes in ODT. Conclusions: Key aspects for successful implementation of training programs on ODT in MENA countries should consider hospital leadership engagement, strengthen institutional collaborations, and incorporate national health authorities to enhance sustainability and drive systemic changes. Prioritizing individuals in key decision-making positions could further enhance program effectiveness. Full article

(1) Background: Most studies including health data have relied on reducing all variables to manifest scores, ignoring the latent nature of variables. Moreover, relying only on manifest variables is a limitation of longitudinal studies where identical measures cannot be collected at each time point. (2) Objective: This scoping review aims to identify latent variable statistical methods for longitudinal studies of multi-dimensional health and educational data investigating early health predictors of long-term educational outcomes and developmental trajectories that lead to better or worse than expected outcomes. (3) Eligibility criteria: We included peer-reviewed health and education journal articles, doctoral theses, and book chapters of longitudinal studies of children under 12 years of age that adopted latent variable, multivariate analysis of three or more waves of data. We only included full-text-available, English-written articles, without restriction on date of publication. (4) Sources of evidence: We searched five databases, Scopus, MEDLINE, PsycINFO, ERIC, and Web of Science, and identified 4836 publications for screening. (5) Results: After title, abstract, and full-text screening, nine studies were included in the review, reporting seven statistical methods. These methods were categorised into two groups—variable-oriented modelling and person-oriented modelling. (6) Conclusions: Variable-oriented modelling methods are useful for determining predictors of long-term educational outcomes. Person-oriented modelling methods are effective in detecting trajectories to better or worse than expected outcomes. (7) Registration: Open Science Framework. Full article

Alcohol-associated liver disease (ALD) is a major cause of liver-related mortality worldwide; however, only a subset of heavy drinkers develop progressive disease, suggesting a role for host genetics. In East Asian populations, functional polymorphisms in alcohol-metabolizing enzymes, such as alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2), are common and significantly affect acetaldehyde metabolism. ADH1B accelerates ethanol oxidation, whereas ALDH2 impairs acetaldehyde detoxification and increases oxidative stress, inflammation, and liver injury. Based on genotype combinations, individuals were stratified into five alcohol sensitivity groups with differing risks of cirrhosis and cancer. Although ALDH2 deficiency often suppresses alcohol intake via aversive reactions, paradoxically, continued drinking increases the risk of liver and gastrointestinal cancers. Genetic risk stratification may inform personalized prevention and precision of public health approaches. However, expansion of direct-to-consumer genetic testing has raised ethical and educational challenges. Understanding the interaction between alcohol metabolism and genetic variations is crucial for identifying high-risk individuals and guiding tailored interventions in East Asian populations. Full article

Background: School lunch programs play a crucial role in shaping the nutritional status and academic performance of children, making them a cornerstone of public health initiatives worldwide. Objective: To elucidate emerging trends and propose a comprehensive framework for free school lunch as a nutrition policy through a combined bibliometric approach and critical review. Methods: A bibliometric analysis was performed to identify key thematic areas, influential research, and knowledge gaps from global literature databases, followed by a critical review synthesizing insights on nutritional adequacy, socio-cultural considerations, policy effectiveness, and innovative practices in free school meal programs. Results: The analysis revealed an increasing focus on sustainability, food waste management, and integration of nutrition education within school curricula, alongside notable disparities in implementation and accessibility, particularly in low-income regions. Conclusions: We propose a future-oriented framework emphasizing stakeholder collaboration, culturally adaptive meal designs, and utilization of technology for personalized nutrition strategies, contributing to the optimization of school lunch programs and advancement of sustainable development goals, particularly Zero Hunger and Quality Education. Full article