Search Results (1,510)

Background: Thallium is a metal that is ubiquitous in our natural environment. Despite its potential for high toxicity, thallium is understudied and not regulated in food. The California Department of Public Health was alerted to a household cluster of elevated urine thallium levels noted among a mother (peak 5.6 µg/g creatinine; adult reference: ≤0.4 µg/g creatinine) and her three young children (peak 10.5 µg/g creatinine; child reference: ≤0.8 µg/g creatinine). Objectives: This case report identifies questions raised after a public health investigation linked a household’s thallium exposure to a commercially available food product. We provide an overview of the public health investigation. We then explore concerns, such as gaps in toxicological data and limited surveillance of thallium in the food supply, which make management of individual and population exposure risks challenging. Methods: We highlight findings from a cross-agency investigation, including a household exposure survey, sampling of possible environmental and dietary exposures (ICP-MS analysis measured thallium in kale chips at 1.98 mg/kg and 2.15 mg/kg), and monitoring of symptoms and urine thallium levels after the source was removed. We use regulatory and research findings to describe the challenges and opportunities in characterizing the scale of thallium in our food supply and effects of dietary exposures on health. Discussion: Thallium can bioaccumulate in our food system, particularly in brassica vegetables like kale. Thallium concentration in foods can also be affected by manufacturing processes, such as dehydration. We have limited surveillance data nationally regarding this metal in our food supply. Dietary reviews internationally show increased thallium intake in toddlers. Limited information is available about low-dose or chronic exposures, particularly among children, although emerging evidence shows that there might be risks associated at lower levels than previously thought. Improved toxicological studies are needed to guide reference doses and food safety standards. Promising action towards enhanced monitoring of thallium is being pursued by food safety agencies internationally, and research is underway to deepen our understanding of thallium toxicity. Full article

This study evaluates the 2022 rollout of the Clean School Bus Rebate Program (CSBRP) to understand how eligibility rules and data practices shape funding distribution across communities with varying needs. We ask whether more accurate maps can improve environmental funding outcomes or whether challenges stem from how agencies define and apply eligibility criteria. Using logistic regression and dasymetric mapping, we find that prioritization criteria helped direct funds to underserved areas, but reliance on school district boundaries introduced inconsistencies that affected program reach. Including charter schools as independent applicants increased competition and sometimes diverted funds from larger public systems serving more. Our geospatial analysis shows that while refined mapping approaches improve resource targeting and reduce goal-outcome mismatches, agency discretion and administrative rules remain key factors in ensuring equitable outcomes. Full article

The sharing economy is considered to be a potentially efficacious approach for promoting sustainable production and consumption (SPC). This study utilizes dockless bike sharing (DBS) in Beijing as a case study to examine how sharing economy policies and business practices advance SPC. It also dynamically quantifies the environmental and economic performance of DBS practices from a life cycle perspective. The findings indicate that effective SPC practices can be achieved through the collaborative efforts of multiple stakeholders, including the government, operators, manufacturers, consumers, recycling agencies, and other business partners, supported by regulatory systems and advanced technologies. The SPC practices markedly improved the sustainability of DBS promotion in Beijing. This is evidenced by the increase in greenhouse gas (GHG) emission reduction benefits, which have risen from approximately 35.81 g CO₂-eq to 124.40 g CO₂-eq per kilometer of DBS travel. Considering changes in private bicycle ownership, this value could reach approximately 150.60 g CO₂-eq. Although the economic performance of DBS operators has also improved, it remains challenging to achieve profitability, even when considering the economic value of the emission reduction benefits. In certain scenarios, DBS can maximize profits by optimizing fleet size and efficiency, without compromising the benefits of emission reductions. The framework of stakeholder interaction proposed in this study and the results of empirical analysis not only assist regulators, businesses, and the public in better understanding and promoting sustainable production and consumption practices in the sharing economy but also provide valuable insights for achieving a win-win situation of platform profitability and environmental benefits in the SPC practice process. Full article

(1) The beach areas of Galveston, Texas, USA are heavily used for recreational activities and often experience elevated fecal indicator bacteria levels, representing a potential threat to ecosystem services, human health, and tourism-based economies that rely on suitable water quality. (2) During the span of 15 months (March 2022–May 2023), water samples that exceeded the U.S. Environmental Protection Agency-accepted alternative Beach Action Value (BAV) for enterococci of 104 MPN/100 mL were analyzed via microbial source tracking (MST) through quantitative polymerase chain reaction (qPCR) assays. The Bacteroides HF183 and DogBact as well as the Catellicoccus LeeSeaGull markers were used to detect human, dog, and gull fecal sources, respectively. The qPCR MST data were then utilized in a quantitative microbial risk assessment (QMRA) to assess human health risks. Additionally, samples collected in July and August 2022 were sequenced for 16S rRNA and matched with fecal sources through the Bayesian SourceTracker2 program. (3) Overall, 26% of the 110 samples with enterococci exceedances were positive for at least one of the MST markers. Gull was revealed to be the primary source of identified fecal contamination through qPCR and SourceTracker2. Human contamination was detected at very low levels (<1%), whereas dog contamination was found to co-occur with human contamination through qPCR. QMRA identified Campylobacter from canine sources as being the primary driver for human health risks for contact recreation for both adults and children. (4) These MST results coupled with QMRA provide important insight into water quality in Galveston that can inform future water quality and beach management decisions that prioritize public health risks. Full article

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. Full article

Background: The quality of decision-making processes is increasingly recognized as critical to public trust and policy sustainability. Objectives: This narrative review aims to identify and describe process-focused decision support models (DSMs) applied in pharmaceutical policy, and to examine their potential contributions to improving procedural quality in decisions related to pricing, reimbursement, and access to medicines. Methods: Relevant peer-reviewed and gray literature published between 2000 and 2025 was considered, drawing from key databases (e.g., PubMed and Scopus) and international policy reports (e.g., WHO, ISPOR, and HTA agencies). Studies were included if they provided insights into DSMs addressing at least one dimension of decision process quality. Results: Findings are synthesized narratively and organized by tool type, application context, and key quality dimensions. Frequently referenced tools included the Quality of Decision-Making Orientation Scheme (QoDoS), WHO-INTEGRATE, and AGREE II. QoDoS emerged as the only tool applied across regulatory, HTA, and industry settings, evaluating both individual- and organizational-level practices. WHO-INTEGRATE highlighted equity and legitimacy considerations but lacked a structured format. Overall, most tools demonstrated benefits in promoting internal consistency, transparency, and stakeholder engagement; however, their adoption remains limited, especially in low- and middle-income countries. Conclusions: Process-focused DSMs offer promising avenues for enhancing transparency, consistency, and legitimacy in pharmaceutical policy. Further exploration is needed to standardize evaluation approaches and expand the use of DSMs in diverse health systems. Full article

The COVID-19 pandemic fundamentally disrupted assumptions about entrepreneurship, career planning, and professional development. This study explored how the pandemic influenced the entrepreneurial intentions of undergraduate business students in the United States. Using a qualitative methodology based on in-depth interviews with 31 students at a public Midwestern university, the research interpreted student narratives through the lenses of effectuation theory, resilience theory, and the theory of planned behavior. Findings revealed that many participants reframed entrepreneurship as a strategy for navigating economic uncertainty and enhancing personal agency. Students reported valuing adaptability, resourcefulness, and opportunity recognition, often experimenting with side hustles during the pandemic as a means of resilience. Their entrepreneurial thinking shifted from purely economic motivations toward aspirations for flexibility, self-fulfillment, and purposeful work. The study highlights the formative role of crisis contexts in shaping entrepreneurial identity among emerging professionals. It suggests that entrepreneurship education should move beyond traditional models, fostering skills for navigating complexity and building resilience. In doing so, the findings contribute to broader conversations about youth entrepreneurship, post-pandemic career development, and the evolving demands of the labor market in times of disruption. Full article

Food safety regulations and their implementations are becoming increasingly complex due to various reasons such as diverse food sources, supply chain, processing technologies, distribution systems and environmental concerns. Additionally, it is crucial to address diversified consumers and their preferences. To address these multifaceted challenges, adopting an integrated unified management system is essential. This review provides a comprehensive overview of the progressive food safety governance in the Sultanate of Oman. The country is transitioning from a multi-agency to an integrated food control management system. This integrated approach can enhance the coordination between different government agencies and other stakeholders, avoid duplication, identify required resources and ensure optimum use of the resources. The progress can enhance efficiency and effectiveness in managing food safety in Oman. It addresses the issues of the food safety management system, explores the legislative frameworks, risk-based assessment and their enforcement, and creates public awareness and required research for continuous improvement in food safety. This integration approach is expected to continue strengthening food safety governance in the country. Finally, future challenges in achieving food safety are envisioned, including new food sources and technologies, applications of artificial intelligence, and new sensors for quick identification of risks in foods. Full article

Introduction: Respiratory Syncytial Virus (RSV) is the leading cause of lower respiratory tract infections in infants and children, as well as hospitalizations for respiratory infections in the pediatric population, representing a significant public health concern. Nirsevimab, a long-acting anti-RSV monoclonal antibody, has recently been approved by the European Medicines Agency (EMA). The aim of this study is to assess the utility of certain parameters, such as the Number Needed to Immunize (NNI), in supporting decision-makers regarding the introduction of nirsevimab as a universal prophylactic measure. Methods: A literature review was conducted to identify the definition and application of the NNI in the context of infectious disease prevention. The following online databases were consulted: Scopus, MEDLINE, Google Scholar, Web of Science, and Cochrane Library. The search was restricted to English-language texts published between 1 January 2000 and 30 January 2025. Results: The NNI represents the number of individuals who need to be immunized to prevent clinical outcomes such as medical visits and hospitalizations caused by infectious diseases. Six studies were identified that utilized this parameter to outline the benefits of immunization and describe the advantages of using monoclonal antibodies for RSV disease. Finelli and colleagues report that to prevent one RSV-related hospitalization, 37–85 infants aged 0–5 months and 107–280 infants aged 6–11 months would need to be immunized with long-acting anti-RSV antibodies. A recent study by Mallah et al. on the efficacy of nirsevimab estimates that the NNI required to prevent one RSV-related hospitalization is 25 infants. Studies by Francisco and O’Leary report NNI values of 82 and 128 infants, respectively, to prevent one RSV-related hospitalization with nirsevimab. Mallah et al. describe NNI as a metric useful to quantify the immunization effort needed to prevent a single RSV hospitalization. A recent Italian study reports that 35 infants need to be immunized to prevent one hospitalization due to RSV-LRTI and 3 infants need to be immunized to prevent one primary care visit due to RSV-LRTI. The studies indicate that the NNI for anti-RSV monoclonal antibodies is lower than the corresponding Number Needed to Vaccinate (NNV) for vaccines already included in national immunization programs. The main limitations of using this parameter include the absence of a shared threshold for interpreting results and the lack of consideration for the indirect effects of immunization on the population. Conclusions: The NNI is an easily understandable tool that can be used to convey the value of an immunization intervention to a variety of stakeholders, thereby supporting public health decision-making processes when considered in association with the uptake of the preventative strategy. At the current status, the estimated NNI of monoclonal antibodies against RSV results favourable and confirms the use in the first year of life for the prevention of RSV disease. Full article

Procedural physician-scientists have made significant contributions to medicine and science, with twelve proceduralists receiving a Nobel Prize. Unfortunately, several systemic challenges have jeopardized the existence, let alone the flourishing, of procedural physician-scientists: the widening gap in the National Institutes of Health salary cap, decreasing funding from nonfederal public and private agencies, and shifting priorities among U.S. hospitals, payers, and policymakers toward relative value unit productivity-based compensation and fee-for-service models. Additional pressures include prolonged training pathways and the need to maintain clinical continuity. Adopting a team science approach may offer a powerful strategy to mitigate these competing demands, support rigorous scientific inquiry, and address the growing complexity of biomedical research. Concerted efforts by the federal government, policymakers, corporations, institutions, and procedural departments will also be crucial to restoring the vitality of this diminishing workforce. Full article

Unmanned Aerial Vehicle Remote Sensing (UAV-RS) has emerged as a transformative technology in high-resolution Earth observation, with widespread applications in precision agriculture, ecological monitoring, and disaster response. However, a systematic understanding of its scientific evolution and structural bottlenecks remains lacking. This study collected 4985 peer-reviewed articles from the Web of Science Core Collection and conducted a comprehensive scientometric analysis using CiteSpace v.6.2.R4, Origin 2022, and Excel. We examined publication trends, country/institutional collaboration networks, keyword co-occurrence clusters, and emerging research fronts. Results reveal an exponential growth in UAV-RS research since 2015, dominated by application-driven studies. Hotspots include vegetation indices, structure from motion modeling, and deep learning integration. However, foundational challenges—such as platform endurance, sensor coordination, and data standardization—remain underexplored. The global collaboration network exhibits a “strong hubs, weak bridges” pattern, limiting transnational knowledge integration. This review highlights the imbalance between surface-level innovation and deep technological maturity and calls for a paradigm shift from fragmented application responses to integrated systems development. Our findings provide strategic insights for researchers, policymakers, and funding agencies to guide the next stage of UAV-RS evolution. Full article

According to the World Health Organization (WHO), indoor air quality (IAQ) is becoming a serious global concern due to its significant impact on human health. However, not all relevant health parameters are currently regulated. For example, particle number concentration (PNC) and its associated carbonaceous species, such as black carbon (BC), which are classified as carcinogenic by the International Agency for Research on Cancer (IARC), are not currently regulated. Compared with IAQ studies in other types of buildings, studies focusing on IAQ in hospitals or other healthcare facilities are scarce. Therefore, this study aims to evaluate the impact of these outdoor pollutants, among others, on the indoor environment of a hospital under different atmospheric conditions. To identify the seasonal influence, two different periods of two consecutive seasons (summer 2020 and winter 2021) were selected for the measurements. Regulated pollutants (NO, NO₂, O₃, PM₁₀, and PM_2.5) and nonregulated pollutants (PM₁, PNC, and equivalent BC (eBC)) in outdoor air were simultaneously measured indoor and outdoor. This study also investigated the impact of indoor activities on indoor air quality. In the absence of indoor activities, outdoor sources significantly contribute to indoor traffic-related pollutants. Indoor and outdoor (I-O) measurements showed similar behavior, but indoor concentrations were lower, with peak levels delayed by up to two hours. Seasonal variations in indoor/outdoor ($\mathrm{I}/\mathrm{O}$) ratios were lower for particles than for associated gaseous pollutants. Particle infiltration depended on particle size, with it being higher the smaller the particle size. Indoor activities also significantly affected indoor pollutants. PM_x (especially PM₁₀ and PM_2.5) concentrations were mainly modulated by walking-induced particle resuspension. Vertical eBC profiles indicated a relatively well-mixed environment. Ventilation through open windows rapidly altered indoor air quality. Outdoor-dominant pollutants (PNC, eBC, and NO_X) had $\mathrm{I}/\mathrm{O}$ ratios ≥ 1. Staying in the room with an open window had a synergistic effect, increasing the $\mathrm{I}/\mathrm{O}$ ratios for all pollutants. Higher I/O ratios were associated with turbulent outdoor conditions in both unoccupied and occupied conditions. Statistically significant differences were observed between stable (TKE ≤ 1 m² s⁻²) and unstable (TKE > 1 m² s⁻²) conditions, except for NO₂ in summer. This finding was particularly significant when the wind direction was westerly or easterly during unstable conditions. The results of this study highlight the importance of understanding the behavior of indoor particulate matter and related pollutants. These pollutants are highly variable, and knowledge about them is crucial for determining their health effects, particularly in public buildings such as hospitals, where information on IAQ is often limited. More measurement data is particularly important for further research into I-O transport mechanisms, which are essential for developing preventive measures and improving IAQ. Full article

The implementation of Building Information Modelling (BIM) in public design processes enhances efficiency, transparency, and sustainability. However, public agencies often encounter significant barriers, particularly regarding organisational and managerial readiness. This study develops a BIM implementation framework tailored to the specific needs of an Italian public agency. The research adopts a qualitative approach, combining 15 semi-structured interviews with process mapping Using (Business Process Modeling Notation) BPMN. The current as-is workflows were analysed and validated by internal stakeholders. Based on this analysis, strategic objectives were defined, relevant (Building Information Modelling) BIM uses were selected, and revised to-be processes were proposed, integrating new roles and responsibilities according to the standards. The framework addresses both technical and organisational dimensions of BIM adoption, highlighting the need for training, coordination, and stakeholder engagement. The main outcomes include a structured process model, a priority-based selection of BIM uses, and a role matrix supporting organisational transformation. The added value for researchers lies in the replicable methodology that combines empirical process mapping with implementation planning. For practitioners, especially consultants in sustainable design, the study offers a practical roadmap for aligning BIM adoption with project goals, regulatory compliance, and environmental performance targets in complex public sector contexts. Full article

Food-borne botulism is a rare but serious disease caused by ingestion of botulinum neurotoxin pre-formed in food by Clostridium botulinum. Between 2006 and 2009, no foodborne botulism cases were reported in the UK. However, the period from 2010 to 2024 saw 13 cases, encompassing seven separate incidents and two outbreaks, with no reported fatalities. Cases were predominantly linked to imported, home-made, and artisanal foods, occasionally to commercial products. Diagnostic and public health challenges include delayed clinical diagnosis, delayed sample collection, inadequate specimen volumes, and the frequent unavailability of suspected food sources, hampering epidemiological investigations. The UK has an extremely low incidence of foodborne botulism with an estimated rate of 0.001 cases per 100,000 people per year, but despite this low occurrence, food botulism remains a public health emergency as it requires timely treatment and rapid reactive intervention to be undertaken by multiple regulatory agencies. Continuous professional training of medical staff, up-to-date clinical guidance, rapid diagnostic, and food investigations are essential for optimising patient outcomes and prevention. Full article

Introduction: Efficient communication and collaboration among local health departments (LHDs), healthcare organizations, governmental entities, and other community stakeholders are critical for public health preparedness and response. This study evaluates (1) the impact of informatics on LHDs’ frequency and collaboration in creating consistent COVID-19 messaging; (2) the influence of informatics on targeted messaging for vulnerable populations; and (3) LHD characteristics linked to their consistent and/or targeted messaging engagement. Methods: This study analyzed the 2020 National Association of County and City Health Officials (NACCHO) Forces of Change (FOC) survey, the COVID-19 Edition. Of the 2390 LHDs invited to complete the core questionnaire, 905 were asked to fill out the module questionnaire as well. The response rate for the core was 24% with 587 responses, while the module received 237 responses, achieving a 26% response rate. Descriptive analyses and six logistic regression models were utilized. Results: Over 80% (183) of LHDs collaborated regularly with public health partners, and 95% (222) used information management applications for COVID-19. Most interacted with local and state agencies, but only half with federal ones. LHDs that exchanged data with local non-health agencies, engaged with local non-health agencies, and communicated weekly to daily with the public about long-term/assisted care had higher odds of creating consistent messages for the public, and about the use and reuse of masks had lower odds of collaborating with public health partners to develop consistent messages for the public. Conclusion: Our findings underscore the centrality of informatics infrastructure and collaboration in ensuring equitable public health messaging. Strengthening public health agencies and investing in targeted training are crucial for effective communication across the communities served by these agencies. Full article