Linguistic inequity drives systemic disparities in healthcare for non-native English speakers. This study evaluates a project to train and provide qualified medical interpreters (QMI) to assist volunteer and safety-net clinics and community-based organizations in supporting healthcare for immigrants and refugees. We provided scholarships to bilingual community members to take a medical interpreter training course and developed a workforce for those who passed the training course. We focused on lesser-spoken foreign languages such as Arabic, Amharic, Pashto, Dari, and Burmese. Those who passed the course participated in a semi-structured interview to learn about their experiences in the training program, as well as barriers and facilitators to becoming a QMI. To date, 23 people have passed the training and are part of the QMI workforce program that has provided 94 h of interpreter services over four months, serving 66 individual patients. The evaluation showed that community members have interest in becoming QMIs and many have the required language proficiency to enroll and pass training. Finding full-time employment for less spoken languages has proven to be challenging.

Silicon dioxide (SiO), commonly known as silica, is a naturally occurring mineral extracted from the Earth's crust. It is widely used in commercial products such as food, medicine, and dental ceramics. There are few studies on the health effects of pyrogenic and colloidal silica after ingestion. No research has compared the impact of microscale morphologies on mitochondrial activity in colon cells after acute exposure. The results show that crystalline and amorphous silica had a concentration-independent effect on cells, with an initial increase in mitochondrial activity followed by a decrease. Vitreous silica did not affect cells. Diatomaceous earth and pyrogenic silica had a concentration-dependent response, causing a reduction in mitochondrial activity as concentration increased. Diatomaceous earth triggered the highest cellular response, with mitochondrial activity ranging from 78.84% ± 12.34 at the highest concentration (1000 ppm) to 62.54% ± 17.43 at the lowest concentration (0.01 ppm) and an average HO concentration of 1.48 ± 0.15 RLUs. This research advances our understanding of silica's impact on human gastrointestinal cells, highlighting the need for ongoing exploration. These findings can improve risk mitigation strategies in silica-exposed environments.

The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region from 1993 to 2022. The Grossman Health Outcome (H-O) model investigates the theoretical framework. For the existence of the cross-sectional dependency, mixed-order unit root, and cointegration problem, the famous Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) approach is applied. The research also used the Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) to check robustness. The findings illustrated that health expenditure and education lessen the infant mortality rate in Eastern European countries. But ecological footprint, industrialization and unemployment raise the infant mortality rate. According to the CS-ARDL findings, expenditure on healthcare significantly reduces child mortality. Still, the ecological footprint significantly impacts increasing child mortality. However, the AMG and CCEMG models demonstrate that investing in education is the most effective strategy for reducing child mortality. Therefore, the government of Eastern European countries should provide more priorities in the sustainable urbanization, health expenditure, and education sectors. The robustness of the AMG and CCEMG also demonstrated the strength of the CS-ARDL findings. This research paper contributes to SDG 3 by examining the environmental and health factors that influence child mortality in Eastern Europe. Policymakers, public health professionals, and other stakeholders can use the findings to inform the development and implementation of programs that specifically target the identified causes of child mortality.

: There is international agreement that military families (MFs)-active service members, reservists, veterans, and their families-must be resilient to overcome military life adversities. Resilience is defined either as skillsets or as processes implicating multi-systems in a socio-ecological context. While research on resilience-building specific to children and families who face adversity is growing, there is a paucity of evidence on MF-centred resilience-building. : This review describes the evidence on such resilience-building programming and determines if adversity is considered a barrier or facilitator to resilience-building. : This scoping review yielded 4050 peer-reviewed articles from database inception until December 2023, found in 12 databases. Articles were deduplicated, leaving 1317 that were independently screened for eligibility by two reviewers. Disagreements were resolved through discussion with a third reviewer. : Of these articles, 27 were included; 5 additional articles were also included from other sources. The vast majority of included studies (91%) were conducted in the United States. These 32 articles were organised into categories, including demographics, research methodologies used, resilience program descriptors, and outcomes. : Our results reveal that programs on building MF resilience vary widely, often measuring non-resilience health and social outcomes. We provide preliminary insights for MF health and policy. Our review findings will be invaluable for further evidence-based programming that builds resilience in MFs.

(1) Background and Aims: The seasonal factors influencing multiple sclerosis (MS) relapses remain elusive. This study aims to investigate the seasonal variation of MS relapses in Oman and compare it globally. (2) Subject and Methods: This retrospective study was conducted on N = 183 Omani MS patients treated at Sultan Qaboos University Hospital, a tertiary hospital in Muscat, Oman, over sixteen-year period (2007-2022). Demographic and clinical data of all MS patients were juxtaposed with the monthly weather data during this period, using descriptive and inferential statistical techniques. (3) Results: Among the N = 183 MS patients studied, 508 relapses were recorded during the study period. The average number of relapses per patient was 2.8 (range: 1-15). There were significant seasonal variations in MS relapse rate, with the highest prevalence in the winter months of January and February. However, no correlation was found between MS relapses and other climatic parameters (humidity, temperature, and rainfall). (4) Conclusion: The seasonal patterns of MS relapses in Oman differ from other parts of the world, which the local clinicians should take into account while diagnosing and making management decisions. The potential impact of climate change on the anomalous changes in the seasonality of MS relapses warrants further investigation.

Polypharmacy (≥5 drugs) increases the risk of discrepancies between patient- and general practitioner (GP)-reported drugs, leading to adverse outcomes. This explorative analysis assesses the agreement between patient- and GP-reported drugs under the influence of a paper-based patient portfolio in a pilot cluster randomized controlled trial (cRCT). Complete data were available for 68 patients aged 65 or older (26 were female), with multimorbidity, polypharmacy, and at least one hospitalization in the past year. Agreement was assessed for drug name and strength level. Differences between the intervention and control group (IG/CG) and comparisons between two time points (six-month interval) stratified according to gender were analyzed using Wilcoxon and Mann-Whitney U tests (α = 5%). To evaluate the reasons for discrepancies, the agreement of active pharmaceutical ingredients (APIs) and anatomical therapeutic chemical (ATC) groups was analyzed. At baseline, the agreement was 72.1% for the IG and 73.9% for the CG. Inclusion of the reported drug strength reduced the agreement in both groups (IG 66.7%, CG 60.0%). Agreement for the IG decreased statistically significantly after six months (-5.4%). ATC groups B, C, and H had the highest agreement, while N, R, and Z had the lowest. Large discrepancies in the drugs reported, due to the APIs and the corresponding ATC group, were observed.

For most individuals infected with SARS-CoV-2, the acute illness resolves completely. However, for millions of people, symptoms or sequelae from COVID-19 recur or persist for months to years after infection. Post-COVID-19 sequelae are wide-ranging, often affecting the musculoskeletal, pulmonary, and cardiovascular systems. All who experience post-COVID-19 sequelae face significant challenges navigating home and work life. Occupations such as firefighting, however, are of particular concern given the strenuous nature of a job that relies on a healthy musculoskeletal, pulmonary, and cardiovascular system. Research has documented significant musculoskeletal impairment (including muscle weakness, pain, and fatigue), respiratory dysfunction (including reduced lung function, interstitial disease, and diffusion abnormalities), cardiovascular conditions (including cardiac events, ischemic disease, dysrhythmias, and infectious diseases), and diminished cardiorespiratory fitness that continues for months to years in some individuals. These persistent post-COVID-19 conditions may affect a firefighter's ability to return to work, function at full capacity while at work, and potentially compromise firefighter health and public safety. This review, therefore, explores musculoskeletal, pulmonary, and cardiovascular sequelae post-COVID-19 and the impact of these sequelae on firefighter health and occupational readiness.

Viral hepatitis B and C (HBV and HCV) pose significant public health concern in Nigeria, where access to healthcare and treatment affordability are limited. This study investigated sociodemographic and clinical predictors of health insurance coverage and access to care among patients with HBV and HCV in Nasarawa State, Nigeria. A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Participants included patients diagnosed with HBV, HCV, or both who were ≥18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Binary logistic regression was used to analyze the relationship between sociodemographic/clinical factors and health insurance status. Out of 303 participants, 68% had health insurance, which mostly covered hepatitis screening and vaccination. Significant predictors of health insurance coverage included being aged 36-40 years (adjusted odds ratio [aOR]: 11.01, 95% confidence interval [CI]: 2.38-50.89, = 0.002), having post-secondary education (aOR: 25.2, 95% CI: 9.67-65.68, < 0.001), being employed (aOR: 27.83, 95% CI: 8.85-87.58, < 0.001), and being HIV-positive (aOR: 4.06, 95% CI: 1.55-10.61, = 0.004). Nearly all those insured (99%) faced restrictions in insurance coverage for viral hepatitis services. This study reveals that while health insurance coverage is relatively high among viral hepatitis patients in Nasarawa State, significant restrictions hinder access to comprehensive services, especially for vulnerable groups like younger adults, the unemployed, and PLHIV. Key factors influencing coverage include age, education, employment, and HIV status. Expanding benefit packages to include viral hepatitis diagnosis and treatment, raising awareness about viral hepatitis as part of insurance strategy, improving access for underserved populations, and integrating hepatitis services into existing HIV programs with strong policy implementation monitoring frameworks are crucial to advancing universal health coverage and meeting the WHO's 2030 elimination goals.

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing ( < 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity ( < 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure ( > 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities.

The COVID-19 pandemic has led to the adoption of rapid, complex, and changeable measures. These measures allowed effective care planning and implementation of emergency management strategies to meet the needs of the population.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients' views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP, through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: (1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; (2) perceived usefulness and acceptability of PLHP; (3) preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists' competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists, and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context.

South Asians living in the United States are frequently underrepresented in health research. Their lack of participation limits the generalizability of research to them and keeps them from receiving the high-quality care and innovation that some studies may offer. "Research Ready" is a five-panel, community co-created graphic-style story that encourages discussion around the purpose of research, safety/protection while participating, and why diverse participation-including South Asians-improves study results and leads to more effective interventions/treatments. This study leveraged trained young adult "cultural insiders" to invite attendees of a Midwestern South Asian Cultural Festival to read the story aloud together as the characters in English or Hindi and used a decision guide to invite discussion. Post-discussion surveys ( = 104) were analyzed using descriptive statistics. Participants spanned from 10 to 79 years, with 42% < 18 years and more females (61%). Only 18.3% indicated having prior research participation. Adults 40+ years (60%) requested the story/discussion in Hindi, compared to 2.3% of adolescents and 6.7% of younger adults. After the discussion, participants indicated their willingness to consider participation, with most being open to participating in surveys/interviews (95.2%); only 52.9% would consider studies requiring the taking of medicines. Adolescents, females, and adults with higher education were more willing to participate in medication studies. Nearly all (97.1%) said they would feel safe participating in research, and 88.5% shared that the discussion would help them better decide about future participation. In conclusion, "Research Ready" discussions shared by cultural insiders effectively encourage South Asians to consider future research participation.

District hospitals in KwaZulu-Natal Province, South Africa, do not have onsite specialist dermatology services. Doctors at these hospitals use WhatsApp instant messaging to informally seek advice from dermatologists and colleagues before possible referral. They have expressed the need to formalise WhatsApp teledermatology.

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA's partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar's tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, < 0.05) and sweet flavors (x = 22.53, < 0.05) but decrease the number of times of vaping per day (t = -2.18, < 0.05) and the use of menthol flavors (x = 4.57, < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, < 0.05) and secondary (b = 0.2533, < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed.

Environmental surroundings reduce the rate of several diseases, especially those related to stressful events. Ischemic stroke can be affected by such events, either directly or through its risk factors. Therefore, the present study evaluates the effects of green spaces and noise exposure on the risk of ischemic stroke.

Despite guidelines for screening and treating perinatal mood and anxiety disorders (PMADs), systemic issues and clinician biases often result in unmet mental health needs in Black women. This study assessed the feasibility and impact of comprehensive PMAD training on obstetric healthcare providers' attitudes, knowledge, and implicit racial biases. We conducted a feasibility study with two cohorts of healthcare providers who received either in-person or virtual training. The training focused on PMADs, implicit bias, and culturally responsive care. Participants completed pre- and post-training assessments measuring attitudes, knowledge, empathy, and implicit racial biases. Both training modalities showed trends towards improved PMAD screening attitudes and empathy, with significant increases in beliefs about treatment efficacy. Implicit bias scores approached significance, showing a shift toward fewer participants with racial preferences. However, there was an unexplained increase in preference for White over Black post training. The training improved healthcare providers' readiness to screen for PMADs and enhanced their understanding of PMADs. However, the persistence of implicit biases highlights the need for ongoing, sustained interventions to address deeply rooted biases. Future research should incorporate continuous learning strategies and link training to healthcare outcomes for minoritized communities.

People with a spinal cord injury (SCI) report less physical activity than other populations and may engage in more sedentary behaviour (SB), especially sitting time. SB negatively impacts physiological and psychosocial outcomes in the general population, yet minimal research has explored the effects in people with SCI. The goal of this scoping review was to catalogue and describe the effects of acute SB among people with SCI. We searched four databases before February 2024 for studies in which people with any SCI sat, laid, or reclined for more than one hour in a day, and any physiological, psychological, or behavioural (i.e., SB time) outcome was measured. In total, 2021 abstracts were screened, and eight studies were included ( = 172 participants). The studies were characterized by varied definitions, manipulations, and measures of SB. Most measured outcomes were physiological (e.g., metabolic, blood pressure), followed by behavioural (e.g., SB time) and psychological (e.g., well-being, affect). When SB was interrupted, only postprandial glucose and affect improved. Based on two studies, participants engaged in 1.6 to 12.2 h of SB per day. Average uninterrupted wheelchair sitting bouts lasted 2.3 h. Based on the very limited body of research, it is impossible to draw any conclusions regarding the nature, extent, or impact of SB in people with SCI. There is much work to carry out to define SB, test its effects, and determine if and how people with SCI should reduce and interrupt SB.

The current study explored teacher and principal familiarity with school wellness polices in primary schools, including who serves on school wellness committees, and who should implement and enforce wellness policies in the school. An electronic survey guided by the Health Promoting Schools framework was administered from February to May 2020 to teachers and principals from one urban and one suburban school district in the Midwestern United States. There were 450 participants; response rates were 28% (urban), 33% (suburban), and 51% (school principals). Only 41.7% of the aggregate participant pool were familiar with their wellness policy. Participants were more familiar in the suburban compared to the urban district (χ = 68.2, -value ≤ 0.001). Teachers/health teachers, nurses, and principals were most likely to be on wellness committees, and the most preferred wellness champions were teachers, nurses, and food service staff. Teachers and nurses are integral to school wellness and health education as part of multiple systems that can promote school health. The Health Promoting Schools framework is useful for guiding examinations to improve understanding of school wellness within school communities.

To people living with Alzheimer's Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. To evaluate the cost-effectiveness of telehealth visits for people living with ADRD in the state of Nevada, a decision-analytic Markov model was developed from healthcare system perspectives with a 10-year horizon/1-year cycle. To estimate the effects of demographic and geographic parameters on the Markov model, race parameters were divided into non-Hispanic White individuals vs. others and location parameters were divided into urban vs. rural. A 12-item short-version Zarit Burden Interview (ZBI-12) was applied to measure the informal caregiver burdens of non-institutionalized people living with ADRD. The values of mortality rate and healthcare utilization were obtained from healthcare systems' publicly available payor administrative data and Nevada State Inpatient/Emergency Department datasets. Among urban-residing non-Hispanic White individuals, the Incremental Cost-Effectiveness Ratio (ICER) per modified ZBI-12 indicated a cost saving of USD 9.44 with telehealth visits; among urban-residing racial minorities, the ICER per modified ZBI-12 indicated a cost saving of USD 29.26 with in-person visits; and among rural residents, the ICER per modified ZBI-12 indicated a cost-saving of USD 320.93 with telehealth visits. Distributional differences in the cost-saving effects of telehealth primary care were noted in line with racial and geographic parameters. Workforce and caregiver training is necessary for reducing distributional differences, especially among urban-residing racial monitories living with ADRD in the provider shortage area of the state of Nevada.

It is unknown how recurring flooding impacts household diet in Central Java. We aimed to assess how recurrent flooding influenced household food access over 22 years in Central Java by linking the Global Surface Water dataset (GSW) to the Indonesian Family Life Survey. We examined linear and nonlinear relationships and joint effects with indicators of adaptive capacity. We measured recurrent flooding as the fraction of district raster cells with episodic flooding from 1984-2015 using GSW. Food access outcomes were household food expenditure share (FES) and dietary diversity score (DDS). We fit generalized linear mixed models and random forest regression models. We detected joint effects with flooding and adaptive capacity. Wealth and access to credit were associated with improved FES and DDS. The effect of wealth on FES was stronger in households in more flood-affected districts, while access to credit was associated with reduced odds of DDS in more flood-affected districts. Flooding had more predictive importance for FES than for DDS. Access to credit, a factor that ordinarily improves food access, may not be effective in flood-prone areas. Wealthier households may be better able to adapt in terms of food access. Future research should incorporate land use data to understand how different locales are affected and further understand the complexity of these relationships.

There was an error in the original publication [...].