Epidemiologic Trends, Social Determinants, and Brain Health: The Role of Life Course Inequalities

Brain health as expressed in our mental health and occurrence of specific disorders such as dementia and stroke is vitally important to quality of life, functional independence, and risk of institutionalization. Maintaining brain health is, therefore, a societal imperative, and public health challenge, from prevention of acquisition of brain disorders, through protection and risk reduction to supporting those with such disorders through effective societal and system approaches. To identify possible mechanisms that explain the differential effect of potentially modifiable risk factors, and factors that may mitigate risk, a life course approach is needed. This is key to understanding how poor health can accumulate from the earliest life stages. It also allows us to integrate and investigate key material, behavioral, and psychological factors that generate health inequalities within and across communities and societies. This review provides a narrative on how brain health is intimately linked to wider health determinants, thus importance for clinicians and societies alike. There is compelling evidence accumulated from research over decades that socioeconomic status, higher education, and healthy lifestyle extend life and compress major morbidities into later life. Brain health is part of this, but collective action has been limited, partly because of the separation of disciplines and focus on highly reductionist approaches in that clinicians and associated research have focused more on mitigation and early detection of specific diseases. However, clinicians could be part of the drive for better brain health for all society to support life courses that have more protection and less risk. There is evidence of change in such risks for conditions such as stroke and dementia across generations. The evidence points to the importance of starting with parental health and life course inequalities as a central focus.

A Multilevel Analysis of Trends and Predictors Associated with Teenage Pregnancy and Early Motherhood in Zambia (2001 - 2018)

IntroductionTeenage pregnancy remains a major social and public health challenge in developing countries especially sub-Saharan Africa (SSA) where prevalence rates are still increasing. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. Furthermore, no known study has focussed on both individual and contextual factors influencing teenage pregnancy in Zambia. This study, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy and early motherhood as well as its individual and contextual determining factors. MethodsA total pooled weighted sample of 10,010 teenagers (in the age group 15 to 19) from four waves of the Zambia Demographic and Health Surveys (ZDHS) were extracted. Using bivariate analysis, we investigated the trends of teenage pregnancy between 2001 and 2018. Separate multilevel logistic regression models were fitted on pooled teenage pregnancy data in relation to several individual and contextual level factors. Both fixed and random effects were produced. Parameter estimates were produced using Bayesian Markov chain Monte Carlo (MCMC) Methods in BRMS.ResultsResults show that the trends of teenage pregnancy in Zambia have shown an overall decrease of 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy (p < 0.001) in a bivariate analysis across the four ZDHS waves. In multilevel analysis, the odds of being pregnant were higher for teenagers who were aged between 18 and 19 years (AOR = 2.57, 95% CI: 2.20-2.98), employed (AOR= 1.24, 95% CI: 1.06-1.46) married (AOR =8.33, 95% CI: 6.84-10.26) and those with knowledge of fertile period (AOR=1.69, 95% CI: 1.43-2.00). On the other hand, being in higher wealth quintile, 15-17 years of age, exposure to family planning messages and delayed sexual debut were associated with decreased odds of early teenage pregnancy. ConclusionThe study shows that early pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Factors associated with teenage pregnancy and early motherhood include age, marital status, and employment, knowledge of fertility period, wealth quintile, sexual debut and exposure to mass-media family planning messaging. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.

Enhanced Spontaneous Antibacterial Activity of δ-MnO2 by Alkali Metals Doping

Recently, the widespread use of antibiotics is becoming a serious worldwide public health challenge, which causes antimicrobial resistance and the occurrence of superbugs. In this context, MnO2 has been proposed as an alternative approach to achieve target antibacterial properties on Streptococcus mutans (S. mutans). This requires a further understanding on how to control and optimize antibacterial properties in these systems. We address this challenge by synthesizing δ-MnO2 nanoflowers doped by magnesium (Mg), sodium (Na), and potassium (K) ions, thus displaying different bandgaps, to evaluate the effect of doping on the bacterial viability of S. mutans. All these samples demonstrated antibacterial activity from the spontaneous generation of reactive oxygen species (ROS) without external illumination, where doped MnO2 can provide free electrons to induce the production of ROS, resulting in the antibacterial activity. Furthermore, it was observed that δ-MnO2 with narrower bandgap displayed a superior ability to inhibit bacteria. The enhancement is mainly attributed to the higher doping levels, which provided more free electrons to generate ROS for antibacterial effects. Moreover, we found that δ-MnO2 was attractive for in vivo applications, because it could nearly be degraded into Mn ions completely following the gradual addition of vitamin C. We believe that our results may provide meaningful insights for the design of inorganic antibacterial nanomaterials.

Prevalent of Staphylococcus aureus from Sachet Waters Sold in Different Areas of Jos Terminus Market, Nigeria

Staphylococcus aureus is an important human pathogen that causes wide range of infectious diseases both in nosocomial and community settings. The Gram-positive pathogen possess virulence factors that facilitate it to establish infections in the hosts. When a “water for life” is contaminated with infectious bacteria such as Staphylococcus aureus then, there may be public health challenge in the area. In this study Samples of Sachet water of different companies ware purchased, marked E, T, C and R and examined for the presence of staphylococcus aureus. Total of 80 sachet waters were examined and a prevalence rate of Staphylococcus aureus 5(25.00%) was recorded. The study revealed that sachet water (E) has the highest prevalence of 15.00%, followed by T (5%) and C (5%) and R had the least prevalence with 0.00%. It was discovered that a Prevalence rate of Abuja market terminus recorded 1(5.00%) while that of Ahmadu Bello way has the highest prevalence of 2(10.00%), Yan Taya market 1(5.00%) and railway 1(5.00%). This shows that S. aureus can be isolated from sachet waters. Though the sachet eaters had NAFDAC numbers, it is advisable to review and quality control such sachet water companies regularly because of Staphylococcus aureus and other public health infectious agants. The populace should equally be careful with the type of waters they drink.

Drivers to Obesity—A Study of the Association between Time Spent Commuting Daily and Obesity in the Nepean Blue Mountains Area

Obesity has become a public health challenge in every country on this planet, with a substantial contribution to global mortality and morbidity. Studies of the built environment have shown some promise in understanding the drivers of this obesity pandemic. This paper contributes to this knowledge, by focusing on one aspect of the urban environment and asking whether there is an association between commuting and obesity in residents of the Nepean Blue Mountains area on the fringes of Sydney. This is a cross-sectional study with obesity being the dependent variable, and commuting the independent variable, where 45 min or less was defined as local and distant commute was more than 45 min. In the sample of 158 respondents, the risk of obesity was twice as likely in the distant commuters than in the local commuters (OR 2.04, 95% CI 1.051 to 3.962, p = 0.034). Investigation of possible mediators of this association was limited by sample size; however, mode of transport was found to be a significant mediator. The results support the design of cities to provide health supporting environments for all residents, including equitable access to employment at a reasonable distance and effective public transport.

Perspectives of patients and consumers on the use of generic medicines

INTRODUCTION Access to medicines constitutes a public health challenge worldwide. Promoting utilization of generic medicines is one of the strategies that has been proposed to optimize pharmaceutical spending and thus allow greater coverage. However, its use is not yet widespread enough. This study seeks to explore the perspectives and acceptability to the use of generic medicines from patients and consumers. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a evidence synthesis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified four systematic reviews that together include 47 primary studies, of which one corresponds to a randomized trial. A low rate of patients or consumers has a negative perception regarding generic medicines, including dimensions such as risk, quality, safety, risk of adverse effects, among others.

Postmortem Liver Pathology Findings in Patients With COVID-19: A Systematic Review

Background: The Coronavirus Disease 2019 (COVID-19) pandemic promptly became a significant public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving patient management. This study summarized the current knowledge of the postmortem liver pathology of patients with COVID-19. Methods: This review was conducted on studies evaluating the postmortem macroscopic and microscopic findings of the liver in patients with COVID-19. Accordingly, we searched 4 electronic databases (PubMed, Scopus, Google Scholar, & Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died due to COVID-19 were selected. Results: The significant findings of the liver were moderate macro and microvesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space, and multifocal hepatic necrosis. Additionally, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection has various manifestations in patients who have expired due to COVID-19. Conclusion: Therefore, monitoring liver function during the course and treatment of this disease is necessary for better patient management and to decrease the COVID-19-induced mortality rate COVID.

Frailty levels in non-institutionalized older adults and sociodemographic characteristics

Introduction: Frailty in older adults is a public health challenge and a priority, given its effects on the functional decline of individuals. Several factors account for its occurrence, including individual aspects. Purpose: To determine frailty levels and their association with sociodemographic characteristics in non-institutionalized older adults.

Unveiling the Membrane and Cell Wall Action of Antimicrobial Cyclic Lipopeptides: Modulation of the Spectrum of Activity

Antibiotic resistance is a major public health challenge, and Gram-negative multidrug-resistant bacteria are particularly dangerous. The threat of running out of active molecules is accelerated by the extensive use of antibiotics in the context of the COVID-19 pandemic, and new antibiotics are urgently needed. Colistin and polymyxin B are natural antibiotics considered as last resort drugs for multi-resistant infections, but their use is limited because of neuro- and nephrotoxicity. We previously reported a series of synthetic analogues inspired in natural polymyxins with a flexible scaffold that allows multiple modifications to improve activity and reduce toxicity. In this work, we focus on modifications in the hydrophobic domains, describing analogues that broaden or narrow the spectrum of activity including both Gram-positive and Gram-negative bacteria, with MICs in the low µM range and low hemolytic activity. Using biophysical methods, we explore the interaction of the new molecules with model membranes that mimic the bacterial inner and outer membranes, finding a selective effect on anionic membranes and a mechanism of action based on the alteration of membrane function. Transmission electron microscopy observation confirms that polymyxin analogues kill microbial cells primarily by damaging membrane integrity. Redistribution of the hydrophobicity within the polymyxin molecule seems a plausible approach for the design and development of safer and more selective antibiotics.