Search Results (2,483)

Background/Objectives: The COVID-19 pandemic caused pronounced disorder in healthcare delivery globally, including ophthalmology. Our study explores how ophthalmologists in Puerto Rico (PR) altered their practices during the pandemic, confronting obstacles such as resource shortages, evolving public health mandates, and unique socio-economic and geographic constraints. The study aims to enhance preparedness for future public health crises. Methods: We conducted descriptive analyses on four online surveys distributed at crucial time points of the pandemic (March 2020, May 2020, August 2020, August 2021) to all practicing ophthalmologists in PR (N ≈ 200), capturing data on closures, patient volume, personal protective equipment (PPE) access, telemedicine use, and financial relief. Results: Survey responses ranged from 41% (n = 81) to 56% (n = 111). By March 2020, 22% (24/111) of respondents closed their offices. By May 2020, 20% (19/93) of respondents maintained a closed office, while 89% (64/72) of open offices reported seeing less than 25% of their usual patient volume. Access to PPE was a challenge, with 59% (65/111) reporting difficulty obtaining N95 masks in March 2020. Telemedicine usage increased initially, peaking in May 2020 and declining in July 2020. By August 2021, all respondents were fully vaccinated and most practices returned to pre-pandemic levels. Overall, 86% (70/81) of respondents found the surveys to be useful for navigating practice changes during the pandemic. Conclusions: PR ophthalmologists showed adaptability during the COVID-19 pandemic to maintain care given limited resources. Guidelines from professional organizations and real time surveys play an important role in future crisis preparedness. Full article

Heavy metal pollution represents a pervasive environmental challenge that significantly exacerbates the ever-increasing crisis of antimicrobial resistance and the capacity of microorganisms to endure and proliferate despite antibiotic interventions. This review examines the intricate relationship between heavy metals and AMR, with an emphasis on the underlying molecular mechanisms and ecological ramifications. Common environmental metals, including arsenic, mercury, cadmium, and lead, exert substantial selective pressures on microbial communities. These induce oxidative stress and DNA damage, potentially leading to mutations that enhance antibiotic resistance. Key microbial responses include the overexpression of efflux pumps that expel both metals and antibiotics, production of detoxifying enzymes, and formation of protective biofilms, all of which contribute to the emergence of multidrug-resistant strains. In the soil environment, particularly the rhizosphere, heavy metals disrupt plant–microbe interactions by inhibiting beneficial organisms, such as rhizobacteria, mycorrhizal fungi, and actinomycetes, thereby impairing nutrient cycling and plant health. Nonetheless, certain microbial consortia can tolerate and detoxify heavy metals through sequestration and biotransformation, rendering them valuable for bioremediation. Advances in biotechnology, including gene editing and the development of engineered metal-resistant microbes, offer promising solutions for mitigating the spread of metal-driven AMR and restoring ecological balance. By understanding the interplay between metal pollution and microbial resistance, we can more effectively devise strategies for environmental protection and public health. Full article

Metabolic syndrome is a global health crisis. However, there are no effective therapeutic strategies for metabolic syndrome. Therefore, this study was conducted to find out a novel silkworm-based metabolic syndrome model that bridges microbial ecology and metabolic dysregulation by integrating hemolymph lipids and midgut microbiota. Our results showed that the levels of HDL-C in the hemolymph of the lean silkworm strain were significantly higher than that in the obese silkworm strain. Furthermore, correlation analysis revealed that Lactococcus and Oceanobacillus were positively related to HDL-C levels, while SM1A02 and Pseudonocardia were negatively associated with HDL-C levels. These relationships between the identified bacteria in the midgut and HDL-C, known as the “good” lipid, in the hemolymph could help guide the development of new treatments for obesity and metabolic problems like high cholesterol in humans. Overall, our results not only established a framework for understanding microbiota-driven lipid dysregulation in silkworms but also offered potential probiotic targets and a bacterial biomarker for obesity and metabolic dysfunction intervention in humans. Full article

Background: Amid growing concerns about climate crisis and its psychological toll, understanding how people find meaning through their connection to nature is increasingly important. The first aim of this study is to examine the association between Nature Relatedness (NR) and Meaning in Life (MIL). The second aim is to investigate if gender moderates this association and to explore how Jewish traditions influence gender differences in this relationship. Methods: A multi-methods design was employed. Participants were recruited through purposive sampling of prominent Jewish community figures, followed by snowball sampling via informant referrals. Thirty-five participants completed the Meaning in Life Questionnaire (MLQ) and the NR Scale. Two questions provided qualitative insights into participants’ personal interpretations and culturally grounded meanings of NR and MIL in the context of climate change and Jewish traditions. Results: Hierarchical multiple regression analyses assessed the main effects of NR and gender, as well as their interaction, on MLQ subscales. NR positively correlated with the MLQ Search dimension, indicating that individuals with stronger NR actively seek meaning in life. Gender moderated this relationship: NR did not correlate with MLQ Presence overall, but higher NR was linked to greater MIL presence among female participants. Thematic analysis of qualitative responses revealed gender-based variations and emphasized the role of Jewish teachings in connecting NR to cultural and religious practices. Conclusions: The findings point to the importance of cultural, religious, and gender factors in shaping the relationship between NR and MIL in a time of climate change crisis, offering implications for positive mental health research and culturally sensitive interventions. Full article

This study investigates the foundational causes of unsustainability that obstruct efforts to address global challenges such as climate change, environmental degradation, water crises, and public health deterioration. Using qualitative research with in-depth expert interviews from education, environmental studies, and business, it finds that these global challenges, while visible on the surface, are deeply rooted in worldviews that shape human behavior, societal structures, and policies. Building on this insight, the thematic analysis manifests three interrelated systemic paradigms as the fundamental drivers of unsustainability: a crisis of wholeness, reflected in fragmented identities and collective disorientation; a disconnection from nature, shaped by human-centered perspectives; and the influence of dominant political-economic systems which prioritize growth logics over ecological and social concerns. These paradigms underlie both structural and cognitive barriers to systemic transformation, which influence the design and implementation of education for sustainability. By clarifying a body of knowledge and systemic paradigms regarding unsustainability, this paper calls for transformative education that promotes a holistic, value-based approach, eco-empathy, and critical thinking, aiming to equip future generations with the tools to challenge and transform unsustainable systems. Full article

Per- and polyfluoroalkyl substances (PFAS) are synthetically produced chemicals that are causing a major One Health crisis. These “forever chemicals” are widely distributed globally in air, water, and soil, and because they are highly mobile and extremely difficult to degrade in the environment. They cause additional health concerns in a circular bioeconomy and food system that recycles and reuses by-products and numerous types of waste materials. Uptake of PFAS by plants and food-producing animals ultimately leads to the consumption of PFAS-contaminated food that is associated with numerous adverse health and developmental effects in humans. Contaminated meat, milk, and eggs are some of the main sources of human PFAS exposure. Although there is no safe level of PFAS exposure, maximum tolerable PFAS consumption guidelines have been established for some countries. However, there is no international PFAS monitoring system, and there are no standardized international guidelines and mechanisms to prevent the consumption of PFAS-contaminated foods. Urgent action is needed to stop PFAS production except for critical uses, implementing effective water-purification treatments, preventing spreading sewage sludge on land and pastures used to produce food, and requiring marketers and manufacturers to use packaging that is free of PFAS. Full article

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article

Background: Since the current increase in antimicrobial resistance globally, parasitic infectious diseases have become a greater public health crisis than ever before and an absolute priority. The Egyptian community pharmacist, as a health care provider and advisor, has a potential role to play in deworming. Objective: To evaluate the outcomes of community pharmacist-led deworming-related counseling services. Methods: A prospective randomized controlled study was conducted in Damanhur, Behera, Egypt. The intervention group received community pharmacy counseling, and the control group received the usual care. Both groups were monitored for 12 months for recurrence evaluation. Results: A total of 173 patients were included, of whom 96 (55.5%) received patient counseling. The types of infection included Oxyuris (44.5%), Entamoeba histolytica (28.9%), Ascaris (8.7%), Entamoeba Cyst (8.7%), Giardiasis (4.6%), Schistosomiasis (2.9%), and pinworm (1.7%). A total of 119 participants (68.8%) reported a need for dose repetition. Personal hygiene practices were reported by 71 participants (41%). Recurrence of infection was observed in 101 cases (58.4%). Patient counseling was significantly associated with lower recurrence rates and higher rates of personal hygiene application (p < 0.001). Multivariate logistic regression analysis revealed that patient counseling and personal hygiene measures were the only significant predictors of infection recurrence rate. Conclusions: Community pharmacists’ deworming-related counseling had positive behavioral and clinical outcomes. Full article

Background: Since the election of Hamas in 2006, Gaza has endured eight major military conflicts, culminating in the ongoing 2023–2025 war, now surpassing 520 days. This protracted violence, compounded by a 17-year blockade, has resulted in the near-total collapse of Gaza’s health system. Over 49,000 deaths, widespread displacement, and the destruction of more than 60% of health infrastructure have overwhelmed both local capacity and international humanitarian response. Objectives: This narrative review aims to examine and synthesize the current literature (October 2023–April 2025) on the health crisis in Gaza, with a specific focus on identifying key themes and knowledge gaps relevant to rebuilding a sustainable health system. The review also seeks to outline strategic pathways for recovery in the context of ongoing conflict and systemic deprivation. Methods: Given the urgency and limitations of empirical data from conflict zones, a narrative review approach was adopted. Fifty-two sources—including peer-reviewed articles, editorials, reports, and correspondence—were selected through targeted searches using Medline and Google Scholar. The analysis was framed within a public health and political economy perspective, also taking health system building blocks into consideration. Results: The reviewed literature emphasizes emergency needs: trauma care, infectious disease control, and supply chain restoration. Innovations such as mobile clinics and telemedicine offer interim solutions. Gaps include limited attention to mental health (including that of health workers), local governance, and sustainable planning frameworks. Conclusions: Sustainable reconstruction requires a durable ceasefire; international stewardship aligned with local ownership; and a phased, equity-driven strategy emphasizing primary care, mental health, trauma management, and community engagement. Full article

This study assesses the effects of the COVID-19 pandemic on catastrophic health expenditures and income inequality in Benin. A microsimulation was calibrated to estimate the impact of the pandemic under three different shock scenarios: low, moderate, and severe. The analysis relies on secondary data from household living condition surveys. The results indicate that the COVID-19 crisis would lead to a significant average income loss of up to 20% and income inequality, while the number of households with catastrophic health expenditures would increase by 4%. More importantly, the findings reveal heterogeneous impacts across households, with urban residents, younger individuals, more educated households, and male-headed households experiencing the greatest income decline. These findings underscore the need for targeted health coverage and employment policies to better protect vulnerable populations in Benin in the face of future shocks. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

Since the start of the energy crisis in 2020, the Dutch government has introduced various programmes aimed at alleviating energy poverty among low-income households. This research examines the effects of three specific interventions—energy coaching, home renovations, and white goods schemes—on a range of energy poverty-related aspects, including living comfort, physical and mental health, energy costs, financial concerns, social connection, neighbourhood involvement, and sustainable behaviour. While previous studies have mostly investigated these interventions in isolation, this research offers a comparative analysis to explore how their impacts differ and how they may complement one another. This research, comparing an intervention group and control, shows that energy coaches, renovations, and white goods schemes each have positive effects on various aspects of energy poverty. However, the nature and magnitude of these effects differ by type of support measure. Renovations are the most effective overall, significantly improving living comfort, physical health, and reducing energy costs. White goods schemes primarily reduce moisture and mould in dwellings and have a notable positive impact on mental health. Energy coaches contribute to improved living comfort, lower energy costs, and uniquely enhance community involvement. The complementary nature of these interventions highlights the potential added value of integrated or combined approaches to tackling energy poverty. Full article

Antimicrobial resistance (AMR) has emerged as a global health crisis, with methicillin-resistant Staphylococcus aureus (MRSA) representing one of the most clinically significant multidrug-resistant pathogens. In this study, three structurally unique anthracycline derivatives—keto-ester (1), 4-deoxy-ε-pyrromycinone (2), and misamycin (3)—were first isolated and characterized from the fermentation broth of the marine-derived Streptomyces tauricus NBUD24. These compounds exhibited notable antibacterial efficacy against MRSA, with minimum inhibitory concentrations (MICs) ranging from 16 to 32 µg/mL. Cytotoxicity assays confirmed their safety profile at therapeutic concentrations. The biofilm formation assay demonstrated that 4-deoxy-ε-pyrromycinone inhibited biofilm formation of MRSA ATCC43300, with an inhibition rate of 64.4%. Investigations of antibacterial mechanisms revealed that these compounds exert antibacterial effects primarily through disruption of bacterial cell wall integrity and destruction of DNA structure. These findings underscore the potential of marine-derived microbial metabolites as promising scaffolds for developing next-generation antimicrobial candidates to combat drug-resistant infections. Full article

Background/Objectives: Violence is a significant occupational health issue for paramedics, yet underreporting limits efforts to identify and mitigate risk. Leveraging a novel, point-of-event violence reporting system, we aimed to identify characteristics of 9-1-1 calls associated with an increased risk of violence in a single paramedic service in Ontario, Canada. Methods: We retrospectively analyzed all electronic violence and patient care reports filed by paramedics in Peel Region and used logistic regression to identify call-level predictors of any violence and, more specifically, physical or sexual assault. Results: In total, 374 paramedics filed 974 violence reports, 40% of which documented an assault, corresponding to a rate of 4.18 violent encounters per 1000 9-1-1 calls. In adjusted models, the risk of violence was elevated for calls originating from non-residential locations (e.g., streets, hotels, bars), occurring during afternoon or overnight shifts, and involving young or working-age males. Presenting problems related to intoxication, mental health, or altered mental status were strongly associated with increased risk, with particularly high adjusted odds ratios for assault. Conclusions: These findings support the utility of near-miss and violence surveillance systems and highlight the need for multidisciplinary crisis response to high-risk calls, especially those involving mental health or substance use. Full article