Estimation of Dental Caries in Adults coming to a Dental College in Himachal Pradesh (North West India) using CAST Index: a Cross-Sectional Study

Background: Decayed Missing Filled Index is the universal index of choice to record dental caries however, it is unable to estimate the severity of dental caries. The Caries Assessment Spectrum and treatment (CAST) Index is a new index which can be used to distinguish the intensity of caries. Aim: To ascertain dental caries  using CAST index and to compare the association of CAST index with DMF Index values attained using CAST index in adults. Materials and Methods: The cross-sectional survey recorded dental caries using CAST index in adults.30.6% of adults experienced tooth loss and 32.3% recorded caries lesion advancing to dentin. 29.5% of adults had  lesion attacking  pulp but the gender predilection was insignificant. Caries severity in adults worsened with increasing age with significant association (p< 0.00). Scarcely 7.3% had undergone restorative care owing to dental caries.  Conclusion: The CAST index provides all-inclusive knowledge with regard to caries severity and transient shift in oral health in adult

New integrations in patient care: the role of the pharmacist between couselling and medication adherence

The changing scenarios in healthcare in recent years underscore the need to promote diverse, articulated, and complex care approaches capable of paying greater attention to people's vulnerability and responding to multiple care needs. A multidimensional approach to healthcare also suggests a review of the role that pharmacies can assume within the healthcare system, with particular regard to the possibility of creating a relational space with the citizen aimed at strengthening the fiduciary relationship with him or her and promoting greater user empowerment in therapy adherence. The promotion of this ethically relevant service could yield several benefits: greater protection of public health, rationalization of public spending, and shifts in the demand for healthcare services. This paper aims to illustrate some socially and ethically relevant aspects of collaboration between pharmacists, general practitioners, and pediatricians of free choice

The burden of Tuberculosis in a province of a low incidence country: epidemiological differences between Italy-born, regular foreigner and irregular foreigner TB cases.: Tuberculosis and migration in Siracusa LHA, Italy (2014-2023)

Introduction. Tuberculosis (TB) represent a serious public health issue even in most developed countries, where TB cases are mostly concentrated in some risk groups, like immigrants from high-incidence TB countries. Aim of the study was to describe the occurrence of TB in Siracusa Local Health Authority (Italy) and to explore its determinants in three different populations: Italy-born, regular foreigner and irregular foreigner. Methods. Cases were classified per patient origin and legal ground: Italy-born (IB); regular foreigners (REF); irregular foreigners (IRF). All the notifications were evaluated and uploaded to the Notification System of Infectious Diseases (PREMAL) by the Epidemiology Unit of the Prevention Department of Siracusa LHA. Results. During the study period, 183 TB cases were detected: 72 (39.3%) were Italy-born, 26 (14.2%) were regular foreigners and 85 (46.5%) were irregular foreigners. Overall, foreign-born cases (regularly and irregularly residents) accounted for 60.7% of all cases. We demonstrated significative differences in epidemiological, demographic and clinical features among the three different groups. Furthermore, we registered a decrease in TB notifications of 59.5% among Italy-born patients, 46.0% among regular foreigners and 95.5% among irregular foreigners, who, however, remain the population group with the highest incidence of tuberculosis in Siracusa LHA. Conclusions. TB control in migrants is considered key to achieving TB elimination in low TB incidence countries, in accordance with the World Health Organization (WHO)’s End TB Strategy, that set ambitious targets for 2020–2035, including 90% reduction in TB incidence and 95% reduction in TB deaths by 2035, compared with 2015

Identification of Community Vaccine Hesitancy in a Provincial Center: A Descriptive-Cross-Sectional Study: Vaccine Hesitancy

Background: Vaccine hesitancy has become one of the ten global health challenges to be addressed, given its increasing global prevalence Aim: This study aimed to identify community vaccine hesitancy and the factors influencing vaccine hesitancy in a provincial center. Methods: This descriptive cross-sectional research was conducted with 215 adults seeking care at a family health center for any reason. The data collection instruments included the Descriptive Characteristics Questionnaire and the Vaccine Hesitancy Scale. Determinants of vaccine hesitancy were examined through multiple regression analysis (enter model). The STROBE (cross-sectional research model) guidelines were employed for reporting research data. Results: Among participants, 35.3% had a bachelor's degree or higher, 62.3% were employed, and 76.7% had children. 71.2% of the participants had not received education about vaccines, with only 45.6% considering all vaccines necessary and beneficial. Additionally, 16.2% of the participants with children were identified as having under-vaccinated children. Belief in the necessity and benefits of all vaccines (β=-0.245, 95% CI: -4.715 to -1.453), belief in making vaccination mandatory (β=-0.137, 95% CI: -4.873 to -0.083), receiving the COVID-19 vaccine (β=-0.169, 95% CI: -5.925 to -0.947), and receiving the flu vaccine (β=-0.158, 95% CI: -3.828 to -0.429) were determined to be protective against vaccine hesitancy. These variables explained 24.3% of vaccine hesitancy. Conclusion:The assessment revealed that the community exhibited moderate vaccine hesitancy and did not perceive all vaccines as necessary and beneficial. Considering the impact of vaccines on preventing infectious diseases, reducing disabilities, and preventing deaths, it is recommended to provide information on vaccines

Comparing the trend of colorectal cancer before and after the implementation of the Population-Based National Cancer Registry in Iran

Introduction: Colorectal cancer is the third most common malignancy and the second leading cause of cancer deaths worldwide. This disease is the fourth most common malignancy in Iran. Since knowing the trend of this cancer is necessary for planning; this study aimed comparing the trend of colorectal cancer before and after implementing the Population-Based National Cancer Registry. Methods In this time series analysis using secondary data, the autoregressive integrated moving average (ARIMA) was used to predict the future trend. An Interrupted Time Series (ITS) regression model was also used to compare the incidence and mortality of colorectal cancer before and after the setting up the Iranian National Population-Based Cancer Registry (INPCR). Results:  Among Iranian men, an increasing trend in the incidence (from 16.8 in 2019 to 19.5 per 100,000 in 2027) and deaths of colorectal cancer for the coming years was predicted (from 10.2 in 2019 to 11.2 per 100,000 in 2027). A similar pattern also was observed for the incidence of this cancer among females (from 11 in 2019 to 12.3 per 100,000 in 2027), but a reverse pattern was predicted for the trend of deaths among the women (from 2.06 in 2019 to 1.93 per 100,000 in 2027). During the years after the implementation of the INPCR, the trend of cases (β: 0.33 per 100,000, p < 0.001) as well as deaths due to colorectal cancer was significantly increasing (β: 0.08 per 100,000, p < 0.001) among the Iranian population. Conclusion: Implementation of population based cancer registration programs, may improved the cancer registration system and the part of the increase in the incidence and mortality of colorectal cancer could be due to the improvement of the registration and reporting system of new cancer cases

Investigating the Theoretical Possibility of Dengue Fever in Ancient Egypt

Dengue fever, a mosquito-borne viral disease transmitted primarily by the mosquito species Aedes aegypti, has become a significant global health concern, with cases surging in recent years. While no explicit records of dengue exist from ancient Egypt, this study explores the theoretical possibility of its presence during that era. By integrating contemporary epidemiological data, historical medical texts, entomological studies, and palaeoclimatic analyses, the problem of whether ancient Egyptians could have encountered a disease resembling dengue is assessed

Assessment of Knowledge and Practices Related to Children's Physical Fitness and Health Among French PE Teachers.: PE Teachers' Knowledge on Children's Fitness

Objectives: To assess PE teachers' knowledge of physical fitness and its link to children's health and identify barriers and facilitators for its management in schools. Methods: A total of 2,378 PE teachers (56% men) completed an online questionnaire on their knowledge, perceived barriers, and facilitators regarding physical fitness. Results: Most of teachers reported being aware of the associations between cardiorespiratory fitness (CRF) (96%) and muscular strength (MS) (88%) with current health in youth. A smaller proportion of teachers acknowledged knowing the potential associations of these fitness components with future health in adulthood, specifically 40% for CRF and 22% for MS. The majority of teachers (80%) reported being sufficiently trained during their training courses to assess and develop the CRF. Only 50% of teachers reported feeling sufficiently trained to assess MS, while 58% reported being adequately trained to develop this component. Among the teachers, 82% reported that insufficient practice time, large class sizes, and high heterogeneity are key obstacles. Less than 50% identified other prioritized objectives as barriers, while 30% reported a lack of material resources as a significant limitation. Then, 84% of teachers reported being interested in participating in continued professional development focused on the promotion of physical fitness in youth through PE. Conclusions: Barriers such as limited training, structural constraints, and low awareness of MS recommendations hinder effective fitness management. Addressing these through improved curricula, teacher training, and resources is crucial to enhancing youth fitness and health in France

Historical and Social Considerations upon Tuberculosis

The present article offers a concise perspective on tuberculosis (TB) ranging from antiquity to the present day and highlights the dangerousness of the disease in the light of its historical manifestations and current antibiotic resistance. Reflections on the social and economic impact of the TB disease are presented together with notes on TB’s interplay with malnutrition and the social stigma linked to this disease in modern times. Different types of evidence from palaeopathological to artistic ones are offered and the need for a more comprehensive understanding on the disease’s history and evolution is stressed

Policy brief: addressing the shortage of human resources in the Iranian health system

Background: This policy brief addresses the critical shortage of human resources in the Iranian healthcare system, which significantly hampers healthcare access, quality, and patient outcomes. The ongoing mismatch between the supply of healthcare professionals and the growing demand due to population increases and the rising burden of chronic diseases necessitates urgent action. Despite efforts to expand the healthcare workforce, challenges such as geographic maldistribution, migration of healthcare workers abroad, inadequate training opportunities, and limited support systems persist, further exacerbating the crisis. Introduction: The current landscape reveals an uneven distribution of healthcare professionals, with urban areas benefiting disproportionately compared to rural regions. As a result, many communities face difficulties accessing essential healthcare services. Additionally, the migration of skilled professionals seeking better opportunities overseas undermines the existing workforce, leading to further gaps in care delivery. These shortages directly affect healthcare quality, resulting in longer wait times, decreased patient satisfaction, and poorer health outcomes. Furthermore, the strain on remaining healthcare workers contributes to burnout, compromising their well-being and the effectiveness of care provided. Materials and Methods: To address these challenges, this policy brief presents evidence-based recommendations aimed at enhancing the capacity and effectiveness of the healthcare workforce. Key policy options include: Implementing strategies to incentivize the placement of healthcare workers in underserved areas, establishing centralized data systems for workforce management, and developing rural placement programs. Improving salary structures, working conditions, and career development opportunities to retain healthcare workers and reduce migration, along with promoting work-life balance. Increasing investments in medical and nursing education, expanding specialized training opportunities, and establishing continuing education frameworks to ensure ongoing skill development. Exploring innovative models that allow for task-shifting, enabling non-physician health workers to perform essential tasks, thereby optimizing the use of available human resources. Encouraging collaboration with the private sector and NGOs to expand training capacities and provide healthcare services in underserved regions. Promoting digital health tools and telemedicine to extend healthcare access, especially in remote areas. Discussion:  The brief outlines a phased implementation strategy that includes both short-term actions, such as pilot projects and capacity-building initiatives, and long-term structural reforms aimed at sustaining a robust healthcare workforce. Conclusion: Addressing the human resource shortage in Iran's healthcare system is vital for improving healthcare access and outcomes, requiring immediate and comprehensive policy action to foster a resilient healthcare environment for all citizens

The influencing factors of nurses’ well-being in critical care during pandemic era: a systematic review protocol

ABSTRACT Purpose: To review, identify and disclose predictive and protective factors of critical care nurse well-being in the COVID-19 era. Design: Systematic review protocol based on the Joanna Briggs Institute (JBI) guidelines. Review Methods: All quantitative primary studies focused on factors influencing the well-being of critical care nurses and the relationships among these factors will be included. Based on the review question, six databases will be searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, Web on Science, PsycINFO. Time limits will be set according to the COVID-19 pandemic era. To establish the quality of studies JBI tools will be used. Where possible, data will be summarised quantitatively through meta-analysis. Expected Results:  We anticipate that this systematic review will provide an overview of the factors that impacted the professional well-being of critical care nurses during the pandemic period from Covid-19. Conclusions: This study will be the first to reveal which are the factors that play an important role in impacting intensive care nurses in covid-19 pandemic era. Furthermore, it will provide updated and valid evidence of which factors should be considered protective of intensive care nurses' well-being and which are to be considered hindering.  Implication for the profession: Enhancing the professional well-being of nurses is crucial in addressing the growing trend of their intention to leave the profession. Understanding the factors that positively or negatively impact the well-being of critical care nurses during the pandemic is key to developing effective retention strategies within the nursing field. The results of the review will support managers and leaders in direct health policies toward the implementation of interventions to promote the well-being of healthcare workers and to contrast the intention to leave.   KEYWORDS:  intensive care nurses, well-being, systematic review protocol, nursin