No One Is Leaving This Time: Appraisal of Awareness and Knowledge of Port Health Officers on International Health Regulation IHR (2005)

Background: Historically, ships have played an important role in transmitting infectious diseases around the world. The spread of cholera pandemics in the 19th century was thought to be linked to trade routes and facilitated by merchant shipping. The international maritime traffic of people and goods has often contributed to the spread of pathogens affecting public health. Objectives: To assess level of awareness and knowledge of international Health regulation (IHR 2005) content among port health officer Methods: The study design was descriptive cross-sectional evaluation, questionnaires were used to capture the respondents knowledge, awareness and sanitary condition of ship in accordance with (IHR 2005) Results: On awareness and knowledge, Majority of the respondent (77.1%) demonstrate good awareness of the IHR (2005), while 22.9% had not and some even testified of hearing the said document for the first time. Despite the fact that majority of respondent were aware but only 24.6% of them can actually demonstrate good knowledge of IHR (2005) and its intent to protect and prevent spread of disease along the international route. Conclusion: There is need to improve the knowledge of port health officers by expand training and guidance on application of the IHRs to frontline officer at point of entries. Also ensure more thorough inspection and avoid influence of ship agent during inspection of ship.

Applying Human-Centered Design Principles to Digital Syndromic Surveillance at a Mass Gathering in India: Viewpoint

In the wake of the COVID-19 pandemic, digital health tools have been deployed by governments around the world to advance clinical and population health objectives. Few interventions have been successful or have achieved sustainability or scale. In India, government agencies are proposing sweeping changes to India’s digital health architecture. Underpinning these initiatives is the assumption that mobile health solutions will find near universal acceptance and uptake, though the observed reticence of clinicians to use electronic health records suggests otherwise. In this practice article, we describe our experience with implementing a digital surveillance tool at a large mass gathering, attended by nearly 30 million people. Deployed with limited resources and in a dynamic chaotic setting, the adherence to human-centered design principles resulted in near universal adoption and high end-user satisfaction. Through this use case, we share generalizable lessons in the importance of contextual relevance, stakeholder participation, customizability, and rapid iteration, while designing digital health tools for individuals or populations.

Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative study

This study examined how teachers discuss various factors as impacting their ability to execute with fidelity the Michigan Model for Health (MMH), an evidence-based health universal prevention curriculum widely adopted throughout Michigan. Researchers have found a robust relationship between fidelity and participant outcomes, including in schools. While previous studies have identified barriers that inhibit fidelity, few have focused on identifying key barriers and deepening our understanding of how these factors influence intervention fidelity. We conducted a thematic analysis using the reflexive thematic approach to identify key barriers and facilitators and deepen our understanding of how these factors influence MMH implementation. Guided by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcomes Framework, we conducted semistructured interviews with 23 high school health teachers across Michigan. Teachers identified intervention characteristics (e.g., design quality, packaging, and program adaptability), student needs (e.g., trauma exposure, substances), and the fit between the intervention and the context as factors that contributed to acceptability. They also discussed the curriculum and its alignment with their teaching style and/or experiences as contributing to fidelity. Teachers shared how they would often go “off protocol” to improve intervention-context fit and meet students’ needs. Our results identified acceptability, a perceptual implementation outcome, as demonstrating an important role in shaping the relationship between CFIR factors and fidelity. Results provide guidance for systematically designing implementation strategies that address key barriers to improve acceptability, enhance fidelity, and ultimately achieve desired public health objectives.

Fear and Anxiety Caused by COVID-19 in the Iranian Society and the Influential Factors

Background: Due to the changing nature of the spread of emerging infectious diseases, such crises could cause significant fear, especially when the disease is associated with high mortality. Fear and anxiety adversely affect health. Objectives: The present study aimed to investigate the fear and anxiety caused by COVID-19 in the Iranian society and the influential factors in this regard. Methods: This correlational study was conducted on 458 participants who were recruited for an online survey. Data were collected using a researcher-made questionnaire of COVID-19 fear and Beck's anxiety inventory. Data analysis was performed in SPSS version 23 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics, including t-test and multiple comparisons. Results: The prevalence of fear and anxiety was less than 20%. The correlations between the anxiety scores and fear of COVID-19 with demographic variables indicated that the COVID-19 fear scores had a weak correlation with an appeal to religion and efforts to prevent COVID-19 (P ≤ 0.05), while no correlation was observed with the other variables. In addition, the anxiety scores had weak, inverse correlations with the effort to prevent COVID-19 and satisfaction with the government’s effort (P ≤ 0.05). Conclusions: According to the results, the fear of COVID-19 and the subsequent anxiety is mild in the Iranian society. Low anxiety and fear caused by the disease could lead to negligence and disregarding health standards, which will increase the number of these patients in the community.

Changes in Eating Habits and Lifestyles in a Peruvian Population during Social Isolation for the COVID-19 Pandemic

Background. Peru has one of the highest infection and death rates in the world for the COVID-19 pandemic. The government implemented house confinement measures with probable consequences on lifestyle, particularly affecting eating habits, physical activity, sleep quality, and mental health. Objectives. The aim of this study was to assess the lifestyles, physical activity, and sleep characteristics, as well as changes in eating habits in a Peruvian population during the first wave of the COVID-19 pandemic. Methods. A cross-sectional descriptive study was performed. We analyzed Peruvian adults based on an online self-administered questionnaire divided into sociodemographic, anthropometrics, COVID-19 diagnosis reported, lifestyle habits, and frequency of consumption of foods. Results. During confinement for COVID-19, 1176 participants were studied. Of these, most reported weight gain (1 to 3 kg) and 35.7% were overweight. The lifestyles habits showed that 54.8% reported doing physical activity and 37.2% sleep less. The Peruvian sample presented a main meal pattern of breakfast (95.7%), lunch (97.5%), and dinner (89.1%). Likewise, eating habits before and during COVID-19 pandemic showed that vegetables (OR:1.56, CI95% 1.21–200), fruit (OR: 1.42, CI95% 1.10–1.81), legumes (OR:1.67, CI95% 1.23–2.28), and eggs (OR: 2.00, CI95% 1.52–2.65) presented significant consumption increase during social isolation, while bakery products (OR: 0.74, CI95% 0.56–0.97), meat, snack, refreshment, and fast food decreased in consumption. Other foods showed no significant differences. Conclusion. This study showed an important frequency of overweight and sleep changes. There was a slight increase in physical activity despite the social isolation measures and an increase in healthy eating habits; nevertheless, the majority reported gaining weight.

Public Health Frameworks in Audiology Education: Rationale and Model for Implementation

Purpose: Hearing health care is a public health priority at the national and global levels, yet training in clinical audiology programs lacks formal public health education. The purpose of this review article is to discuss audiology concepts in terms of the public health framework of assessment, policy, and assurance and describe two approaches for implementing public health frameworks into audiology doctoral programs. Method: This review article provides a review of audiology concepts through the framework of public health and discusses the rationale for why public health concepts are critical to achieving population-level objectives in hearing health care. We compare competencies of audiology and public health education and then provide a model for two methods for implementing public health education into audiology doctoral programs: (a) formal integration of public health concepts into existing coursework or curricula and (b) a dual doctor of audiology (AuD) and master's in public health (MPH) degree track. Conclusions: Public health is present in the field of audiology, and the field has many public health objectives; however, audiologists do not receive the training necessary to recognize public health concepts or meet population-level objectives. Educating future audiologists in public health concepts will provide them with the tools needed to work with other hearing professionals to make population-level advances in hearing health care. A subset of students may want to become experts in public health and wish to pursue a dual AuD/MPH track.

What Makes a Commuter Cyclist? A Mixed Methods Study of Behavioural Antecedents and Perceptions of Commuter Cycling in the Wellington Region

<p>Encouraging active transport contributes to both environmental sustainability and public health objectives. However, due to a myriad of physical, societal and personal factors, shifting car trips to the bicycle is notoriously difficult especially in societies where car use is deeply engrained in both the social and urban fabric. It is therefore important to explore novel approaches to promote utilitarian cycling. Past studies have suggested there may be a link between cycling for recreation and cycling for transport. If this is the case, one could hypothesise that policies that promote recreational cycling may also indirectly promote utilitarian cycling. This study begins to explore this important research question by investigating whether recreational cyclists are more amenable to utilitarian cycling than non-cyclists, using a case study of commuting in the Wellington Region of New Zealand. Behaviour theory, based on the Theory of Planned Behaviour, provided the conceptual framework for a mixed methods analysis of Wellington Region commuters. Empirical modelling of commuter cycling behaviour showed that almost all antecedents of the behaviours of recreational cyclists are closer to those of commuter cyclists than to non-cyclists. Qualitative analysis provided further evidence that recreational cyclists are more prepared and willing to cycle their commute than non-cyclists. It is concluded that, for the study sample, recreational cyclists are indeed more amenable to commuting by bicycle than non-cyclists in the Wellington region.</p>

What Makes a Commuter Cyclist? A Mixed Methods Study of Behavioural Antecedents and Perceptions of Commuter Cycling in the Wellington Region

<p>Encouraging active transport contributes to both environmental sustainability and public health objectives. However, due to a myriad of physical, societal and personal factors, shifting car trips to the bicycle is notoriously difficult especially in societies where car use is deeply engrained in both the social and urban fabric. It is therefore important to explore novel approaches to promote utilitarian cycling. Past studies have suggested there may be a link between cycling for recreation and cycling for transport. If this is the case, one could hypothesise that policies that promote recreational cycling may also indirectly promote utilitarian cycling. This study begins to explore this important research question by investigating whether recreational cyclists are more amenable to utilitarian cycling than non-cyclists, using a case study of commuting in the Wellington Region of New Zealand. Behaviour theory, based on the Theory of Planned Behaviour, provided the conceptual framework for a mixed methods analysis of Wellington Region commuters. Empirical modelling of commuter cycling behaviour showed that almost all antecedents of the behaviours of recreational cyclists are closer to those of commuter cyclists than to non-cyclists. Qualitative analysis provided further evidence that recreational cyclists are more prepared and willing to cycle their commute than non-cyclists. It is concluded that, for the study sample, recreational cyclists are indeed more amenable to commuting by bicycle than non-cyclists in the Wellington region.</p>

Age-dependent Effect Imposed by Rotenone Exposure

Background: The increasing awareness that environmental exposure may lead to sporadic neurological disorders has implicated rotenone to the etiology of some neurodegenerative diseases. However, the risk associated with rotenone toxicity remains controversial as a limited amount of research has studied its effects on brain health. Objectives: This work assessed the risk of rotenone exposure to mice of different ages, gender, and duration by examining in vivo effects on brains. Methods: Using a mouse model, the impact of rotenone exposure was determined by analyzing the cellular phenotype in the murine brain. Results: Our results highlight the neurological susceptibility to long-term rotenone exposure in younger ages. For such, younger mice exhibit seizures and convulsions, resulting in shorter lifespan. At the cellular level, rotenone exposure specifically alters the migrating neuroblast populations in the dentate gyrus and causes disorganized pyramidal neurons in the CA3 within the hippocampus. Our findings, albeit the absence of transgenerational inheritance, demonstrated age-related outcomes from rotenone exposure. Discussion: We demonstrated that rotenone exposure specifically influences the population of neuroblasts and pyramidal neurons residing in the hippocampus, a brain region important for learning/memory and associated with convulsive seizure. Our understanding of how exactly rotenone affected region-specific neuronal cells and the molecular mechanism behind exposure risk is still limited. From the perspective of public health, our in vivo study highlights age-related susceptibility to rotenone toxicity. Future investigations in environmental epidemiology should determine whether age and duration of exposure to rotenone in human subjects pertains to the development of seizures or other neurological abnormalities over time.

Evaluation of Visual and Cytology Screening in Preventing Cervical Intraepithelial Neoplasia and Cervical Cancer in Namibia

An estimated 851 340 women in Namibia are at risk of human papilloma viral (HPV) infection that may cause cervical cancer. Visual screening with acetic acid (VIA) and cryotherapy have been proven highly effective. However, data associating with the impact of cervical cancer screening programmes lack. This study evaluated visual and cytology screening in preventing cervical intraepithelial lesions (CIN) and cervical cancer in Namibia. Findings showed that women with HPV, cervicitis, koilocytosis and atypia are at an increased risk of testing positive for VIA. Older women, particularly with HIV are more likely to be diagnosed with squamous cell carcinoma (SCC). VIA procedure seems to be viable in screening, although colposcopy in patient follow-up in the Namibian context should be revised and used with positive HR-HPV results. Screening modalities incorporating HPV testing for different ages and risk populations (e.g. HIV positive, autoimmune disease) is recommended. Screening uptake can further be improved by interventions that adopt a model which uses previous diagnostic outcomes, women’s health objectives, up-to-date knowledge and practice relevant to national context.