Life expectancy is a key determinant of a nation’s health and well-being. However, West African countries face several challenges in improving life expectancy, such as inadequate healthcare infrastructure, corruption, poor sanitation, and environmental quality due to environmental degradation. In addition, energy accessibility is an important determinant of health outcomes and environmental quality. The United Nations’ Sustainable Development Goals 7, 12, 13, 14, and 15 are directly linked with energy access; achieving these goals will lead to an improvement in energy access. Therefore, in this study, using data obtained from the World Bank and the Central Bank of Nigeria Statistical Bulletin, we investigated the impact of energy consumption and corruption on life expectancy in lower-middle-income West African countries from 1990 to 2021. The results of the cross-sectional auto-regressive distributed lag technique showed that renewable energy has a positive and significant impact on life expectancy in lower-middle-income West African countries in both the short and long run. However, non-renewable energy was found to have a significant and negative impact on life expectancy in the long run and a negative but non-significant impact in the short run. Corruption had a debilitating effect on life expectancy in both the short and long run. We recommend that policymakers should make a conscious and deliberate push toward transitioning to renewable energy through public-private partnerships to provide affordable and clean energy while tackling corruption.

Most diseases acquired from sporting activities are accidental and often influenced by environmental factors. Neglecting the environment in disease prevention is counterproductive. This was evident during the peak of the COVID-19 pandemic when many sporting activities were halted. Medical laboratory diagnostics, particularly microbiological techniques, detect infectious agents and help contain diseases, thereby fostering a healthy environment for entrepreneurship. Using a One Health approach, this review highlights the dual role of sporting activities in promoting healthy living and facilitating the spread of pathogens. Although sports are widely recognized for enhancing health, the link between microbiology and sports, and their combined roles in promoting global peace, quality health, and entrepreneurship, is not well understood. To address this knowledge gap, the main objective of this review is to examine the relationship between sports-accidental infections and their impact on global peace, health, and entrepreneurship. This review employs a combination of life experiences, observations, and literature analysis, drawing on both qualitative and quantitative data. The findings reveal various types of sports-accidental infections, including gastrointestinal, respiratory, skin, blood-borne, cardiovascular, and neurodegenerative infections. The results indicate that microbial infections significantly impair athletic performance, often necessitating a “return-to-sport” strategy, where athletes must fully recover before resuming sports activities. Sports-accidental infections are also associated with sudden deaths among athletes on the field, negatively affecting health, peace, and entrepreneurship. Microbiology plays a significant role in diagnosing, treating, and managing sports-accidental infections. Through medical laboratory diagnostics, such as microbiological investigations, many pandemics, including COVID-19, have been contained. Identifying infectious agents enables effective preventive measures, helping restore peace and health, and supporting economic activities. The review offers eight recommendations that aim to foster a safer, healthier, and more resilient sports environment, benefitting individual athletes and promoting broader societal goals of health, peace, and economic growth.

The coronavirus disease 2019 (COVID-19) pandemic profoundly reshaped political, religious, economic, social, and financial institutions across the globe. More than 80 countries imposed border closures, shut down business activities, and advised citizens to self-quarantine. The pandemic also caused schools to close indefinitely, affecting approximately 1.5 billion children worldwide. This study sought to integrate the diverse effects of COVID-19 on varied human interests and offer a comprehensive overview of the effects of the pandemic. A systematic literature review encompassing the period between February 2019 and December 2022 was conducted using Web of Science, PubMed, and Google Scholar. The search included keywords related to the impact of COVID-19 on health, education, economics, and the environment, and articles were selected based on pre-defined inclusion criteria. The literature review was limited by its specific time frame, potential publication bias, and language restrictions. Nevertheless, the study findings highlight critical areas for prospective policy interventions and recommend that future research endeavors should address the diverse effects of the pandemic across varied sectors. This literature review revealed that COVID-19 exerted far-reaching consequences beyond health, impacting mental and emotional well-being, education, financial and economic stability, social dynamics, business operations, travel and tourism, and the environment. The pandemic introduced a profoundly challenging period of human history, revealing itself as more than just a health crisis: it signified a significant threat to multiple facets of global life. Despite the successful rollout of the severe acute respiratory syndrome coronavirus-2 vaccine, an ongoing public debate persists regarding whether COVID-19 will reemerge or eventually wane.

Population health management is a sustainable, strategic, and interprofessional collaboration that focuses on the health needs of individuals diagnosed with and living with chronic diseases. A chronic disease is defined as a longstanding health condition that persists for more than a year and requires ongoing medical care, such as heart disease, cancer, and diabetes. Since many chronic diseases are incurable, the management and financial burden of chronic diseases remain significant concerns for individuals, clinicians, and health-care systems. Preventing and managing chronic diseases through health promotion and education continues to be a fundamental cost-effective strategy. Educational seminars and participatory learning for individuals with chronic diseases play an important role in improving health outcomes and reducing health-care costs. This perspective aims to highlight objective insights into how health education contributes to cost-effectiveness and strategic population health management.

Addictive behavior treatment networks comprise harm-reduction services and recovery programs. Recovery is an approach toward interventions for addictive behavior that focuses on the individual’s empowerment, abilities, and life skills. Rehabilitation-oriented programs have evolved from traditional therapeutic communities to comprehensive services that are integrated into social and health networks and delivered by multidisciplinary professionals. This paper aims to analyze the development of recovery programs, drawing from quantitative and qualitative data from an action research approach. It also presents theoretical models and best practices for recovery. In summary, recovery-oriented programs must be integrated with harm-reduction networks, social and employment services, and health systems. Furthermore, as recovery is based on empowerment and peer social support, there is an urgent need to develop structured programs to address these issues. Moreover, there is a need to design and implement specific interventions for a broad range of populations and develop evaluation systems to assess the effectiveness and relevance of recovery-oriented programs.

In recent decades, maternal mortality has significantly reduced on a global scale. However, persistent inequities have undermined these advances in middle- and low-income countries. Therefore, there has been a shift toward more inclusive approaches, such as human capital formation. This perspective article analyzes maternal mortality, fertility, and family planning outcomes in Pakistan, comparing them with educational attainment, socioeconomic status, and demographics. Pakistan’s maternal mortality rate among those with a rural background is 21% higher than those with an urban background in the country. Historically, the country’s total fertility rate (TFR) has been gradually declining, from 4.9 in 1990 - 1991 to 4.1 in 2006 - 2007, to 3.8 in 2012 - 2013, and to 3.6 in 2017 - 2018. However, there are stark disparities in TFR based on demographic background, education, and poverty. Meanwhile, the contraceptive prevalence rate (CPR) has remained stagnant for the past two decades, largely due to inadequate initiatives in poverty reduction, education, and rural development. Pakistan has committed to reducing maternal mortality and fertility and increasing CPR under the International Conference on Population Development, Family Planning 2030, and the recommendations of Pakistan’s Council of Common Interest. Along with these goals, infrastructure development, in (interprovincial roads connecting rural and urban areas and alternative energy initiatives) presents promising prospects for economic growth, poverty reduction, and increased employment opportunities. The paper concludes that health service delivery measures cannot sustain improvements in maternal health, fertility, and family planning indicators alone. Rather, a multipronged strategy focused on poverty reduction, education, and reductions in rural-urban disparities is essential for sustained progress.

Myanmar continues to face the burden of maternal mortality, with most maternal deaths occurring during or immediately after childbirth. Many women, particularly those in rural areas, do not deliver in health institutions offering comprehensive obstetric care. Despite the importance of institutional delivery, few studies have examined its determinants among rural women in Myanmar. This community-based cross-sectional study was conducted in selected villages in the Magway region, located in central Myanmar, and exhibited a maternal mortality ratio higher than the national average. A total of 500 married women who had delivered in the two years before the survey were selected using multistage sampling and interviewed with a semi-structured questionnaire. Independent determinants were identified using a generalized linear mixed model under a logistic regression framework. Approximately one-third (35.6%; 95% confidence interval [CI]: 31.5 - 39.9%) of the respondents delivered their last child at a health institution. The “pull in” factors of institutional delivery included being aged 25 - 35 years (adjusted odds ratio [AOR] = 2.96; 95% CI: 1.21 - 7.22), having a secondary or higher education (AOR = 2.83; 95% CI: 1.50 - 5.32), receiving information from health-care providers (AOR = 2.01; 95% CI: 1.11 - 3.83), recognizing high-risk pregnancies (AOR = 5.47; 95% CI: 1.42 - 21.11), and completely taking up antenatal care (AOR = 3.04; 95% CI: 1.42 - 6.49). The “push out” factors that deterred institutional delivery included a lack of women’s autonomy (AOR = 0.26; 95% CI: 0.14 - 0.50) and inadequate birth preparedness (AOR = 0.37; 95% CI: 0.19 - 0.72). The institutional delivery rate among rural women was considerably low. To improve it, it is crucial to provide information about high-risk pregnancies and the importance of institutional delivery during antenatal visits, empower women, and encourage birth preparedness in rural Myanmar.

Maternal health-care service (MHCS) utilization is a crucial indicator of a country’s progress in protecting the health and well-being of its women and children. This paper examines trends, patterns, determinants, and disparities in MHCS utilization between the poorest and richest women in India’s Empowered Action Group. The study used data from the second (1998 - 1999), third (2005 - 2006), fourth (2015 - 2016), and fifth (2019 - 2021) rounds of the National Family Health Survey. A logistic regression model was applied to assess MHCS utilization, and the Blinder-Oaxaca decomposition method (BODM) was used to explain inequalities in utilization between the poorest and richest women. The findings indicate that MHCS utilization has increased over the years among both groups. However, the utilization rate is higher among the poorest women. Furthermore, rural women are less likely to utilize MHCS compared to urban women. Key determinants include women’s education, their partners’ education, mass media exposure (MME), and women’s empowerment. The BODM results show that although MHCS utilization has increased among both groups, inequalities persist, largely explained by coefficient effects. A trend analysis reveals a reduction in discrimination between the poorest and richest women over time. Women’s education, MME, and autonomy are the key factors driving the reduction of inequalities. There is a need for comprehensive strategies to enhance education among disadvantaged women, increase MME, and promote health awareness. The government should empower women through incentives, such as cash benefits, to ensure higher MHCS utilization among poorer women.

This study aims to explore the perceptions of service providers in Portugal, specifically regarding (i) how victims of human trafficking are aided; (ii) the victims’ needs and their understanding of the “condition of special vulnerability”; and (iii) the opinions of service providers on the obstacles victims face in seeking and receiving assistance. According to our research, most organizations offered assistance, ranging from legal aid to food and lodging, to victims of all ages, genders, and forms of exploitation. Participants recognized that the needs of human trafficking victims differ from those of victims of other crimes, such as domestic abuse survivors, particularly in terms of the unique challenges they face in rebuilding trust. They also identified challenges in delivering assistance, including insufficient financial resources, inadequate interinstitutional cooperation, and the victims’ lack of cooperation. Fear of traffickers along with feelings of humiliation, embarrassment, and fear of reprisal against themselves or their families were cited as major reasons why victims refuse assistance.

Antiretroviral therapy (ART), essential for halting the progression of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) infection and restoring immunity, should be taken regularly to be effective. This study aimed to assess the factors that may affect adherence to ART among people living with HIV (PLHIV) aged between 15 and 60 years at the Cité des Palmiers District Hospital. Thus, we conducted a descriptive and analytical cross-sectional study using a non-probabilistic, convenience survey. Data were collected using a questionnaire administered to PLHIV aged between 15 and 65 years (n=309). These factors affecting adherence were established by determining relative and absolute frequencies, and associations were estimated by calculating the odds ratios, confidence intervals, and P-values. Subsequently, 48.5% of participants were found to comply with ART and 51.5% were not. The independent predictors of poor adherence to ART were missed appointments at the HIV unit, occasional use of excitants/cigarettes, fear of disclosing HIV status, perceived limited opening hours of HIV-related services, discomfort with medication, recent initiation of treatment, and use of therapy reminders. Our study results are essential to orient public health policies and measures toward PLHIV non-adherents to ART treatment and mitigate the social, economic, and health impact of HIV threats on developing countries by focusing on good adherence.

Psychosis is a severe mental health condition that is highly stigmatized, significantly increasing the costs of mental healthcare and reducing the productivity of those affected. Due to public stigma, individuals with psychosis often delay seeking professional help, exacerbating the socioeconomic burden of their ill-health. Psychoeducation, delivered in a structured and systematic manner, has been a key part of evidence-based psychological treatments and has been gradually adopted in stigma reduction efforts. This study evaluated the effectiveness of a digital single-session cognitive behavioral psychoeducation intervention in reducing public stigma toward people with psychosis in a collectivist society through a randomized controlled trial. Stigma was assessed using standardized self-report tools at pre-intervention, post-intervention, and 1-month follow-up. A significant reduction was observed in stereotyping, prejudice, and discrimination on seven out of 10 public stigma components post-intervention. However, the desired effects were maintained for only two components at the 1-month follow-up. No significant changes were found in negative emotions, tolerance, and support from pre-intervention to post-intervention. Attribution of responsibility significantly increased after the intervention, contrary to predictions. The findings of this study provide empirical support for the short-term effectiveness of a brief cognitive behavioral psychoeducation intervention in reducing public stigma toward individuals with psychosis while highlighting the potential benefits of delivering this intervention digitally. At the same time, the limitations of individual-level interventions in sustaining long-term effects are discussed from a sociocultural perspective. This study also examined the relevance of these findings in the context of health economics.

Significant changes are observed during adolescence with respect to health-related habits and risky behaviors. Among the behavioral changes, the consumption of substances such as alcoholic beverages, cigarettes, and illicit drugs, and social interactions are relevant factors for the intake of such substances. This study aims to analyze the relationship between the joint decisions of substance use by adolescents and their peers from the perspective of the affect heuristics. To this end, a multivariate probit model was estimated, based on microdata from the 2019 National School Health Survey. The results showed that substance use by adolescents was positively related to substance use by their peers; therefore, having friends who consume alcohol, illicit drugs, and cigarettes or having parents who consume alcohol or cigarettes increases the likelihood of an adolescent consuming these substances. The study also identified that the substance consumption decision was governed by an unobserved common factor compatible with the affect heuristic.

This study employs bibliometric techniques to construct a comprehensive knowledge map encompassing medical, health, therapy, and wellness (MHTW) tourism for sustainable development. It also aims to detail collaborations between authors, institutions, and countries; analyze keywords; and identify research trends. The study is based on the Web of Science database and utilizes the Citespace software to analyze 318 relevant publications from 2014 to 2024, constructing author coauthorship networks, institutional coauthorship networks, and keyword co-occurrence networks, as well as performing prominence and cluster analyses of keywords. Findings reveal a significant growth trend since 2014 in publications on the integration of MHTW tourism and the advancement of sustainable tourism. Prominent researchers include Lin, Hsiao-Hsien, Hsu, Chin-Hsien, Ariza-Montes, Antonic, Han, and Heesup, along with several closely collaborating research teams. The United States, China, and Spain lead the research output. The National Chin-Yi University of Technology and the Australian National University are preeminently positioned in sustainable research, and new contributors such as Qingdao University are emerging and facilitating wider research efforts. Furthermore, the research agenda highlights the health concept in tourism and promotes MHTW tourism for the sustainable development of societies, economies, and the environment. Future research should emphasize international collaborations and promote knowledge sharing and resource integration to collectively address global health challenges. Moreover, scholarly attention on the application of emerging technologies in MHTW tourism can enhance service quality and sustainability to achieve a harmonious balance of economic, social, and environmental benefits.

Last-mile delivery of health commodities is a critical component of efficient supply chains, and third-party logistics (3PL) providers are pivotal in ensuring cost-effective and reliable product distribution. This study explores the implementation of last-mile delivery outsourcing by government-operated warehouses and drug management agencies (DMAs). This research focuses on the relationship between 3PL utilization and key performance metrics, such as cost reduction, timely delivery, and end-user satisfaction. This study combines a literature review, surveys, and interviews conducted with employees of the DMAs in Minna, Niger State, to establish significant correlations. The findings show that using 3PLs significantly reduced operational costs, improved the frequency of timely deliveries, and enhanced end-user satisfaction. These findings underscore the need for continued engagement with 3PL providers to optimize supply chain performance and improve service delivery outcomes. Managers are recommended to maintain and expand such collaborations to sustain these benefits.

This study aimed to assess the factors associated with cervical cancer screening at the Maroua Regional Hospital. A cross-sectional study was conducted among 376 women aged ≥25 years attending gynecological consultations at the Maroua Regional Hospital between February and May 2023. Data were collected through a structured questionnaire survey. These factors were evaluated through multiple logistic regression analyses, and associations were established by calculating the odds ratios, confidence intervals, and p-values. A total of 376 women were interviewed. Their mean age was 39.21 ± 10.45 years. Of the 376 women, 9.3% had already been screened for cervical cancer. Results of multivariate analyses indicated that age ≥45 years, belief that every woman should be screened at age 25 years, perceived need for frequent screening, use of screening as a preventive measure, and having had first intercourse before age 15 years or between ages 15 and 20 years significantly increased the likelihood of having been screened. Strategies need to be developed to improve access to cervical cancer screening services in Cameroon by strengthening existing screening programs and effectively implementing campaigns to improve access to screening services.

Healthcare professionals often experience fatigue and a diminished quality of life due to demanding hours and challenges in balancing work and personal life. Social support plays a critical role in influencing these factors. This study focused on nurses and healthcare workers in the artificial kidney unit, a specialized area requiring significant expertise to operate complex machinery for seriously ill patients. We assessed levels of fatigue, social support, and quality of life among 159 doctors and nurses in public and private facilities across Greece using the Fatigue Assessment Scale, Multidimensional Scale of Perceived Social Support, and General Health Questionnaire-28. Participants reported moderate fatigue (mean = 2.63, standard deviation [SD] = 0.57 for doctors; mean = 2.42, SD = 0.49 for nurses) and moderate-to-high levels of social support (mean = 5.66, SD = 1.35). Factors negatively impacting quality of life, such as physical symptoms, anxiety, social dysfunction, and severe depression, yielded low scores. Notably, fatigue and quality of life differed significantly between public and private sectors (p < 0.05), with public sector professionals reporting higher fatigue levels and lower quality of life. These findings highlight the need for healthcare authorities to address the unique challenges faced by staff in artificial kidney units, particularly in public hospitals, to improve working conditions and overall well-being.

Fertility pattern analysis and modeling to smooth age-specific fertility rates (ASFRs) form a well-established research field that holds particular importance for Asian countries. In developed nations, ASFRs typically display a bimodal skewed fertility curve, whereas, in developing countries, they usually exhibit a unimodal skewed fertility curve that diverges from the normal one. For decades, demographic experts worldwide have been interested in creating models using deterministic and stochastic approaches to represent these fertility curves. In this regard, parametric and non-parametric models have been created, with the latter providing a better fit for ASFR data. This research investigates the evolution of fertility models aimed at smoothing ASFRs. It explores suitable alternative models for countries with fast-declining, unimodal, and skewed fertility curves of ASFRs, such as Nepal and Malaysia. Nepal’s fertility rate is transitioning from a high level toward the replacement rate (2.1) at the year 2021; meanwhile, Malaysia’s fertility rate (1.7) in the year 2021 has dropped below the replacement rate. Given the lack of a universally applicable model for ASFR pattern variation, this study proposes the Kumaraswamy log-logistic distribution as a promising model to represent the ASFRs of Nepal and Malaysia accurately. Various approaches, including the Akaike information criterion, and Bayesian information criterion, are employed to validate the fitting of the proposed model.

Heart failure (HF) is a complex clinical syndrome, and its prevalence has been increasing in recent years. Despite advancements in pharmacological therapy, symptoms such as fatigue, dyspnea, and exercise intolerance are still likely to persist over time. Therefore, functional evaluation is crucial for treating patients with HF and improving their prognosis. This cross-sectional study aimed to identify the functional profile of patients with HF who were followed up at a referral ambulatory clinic in southern Brazil. In total, 51 patients with HF were treated in an outpatient setting. Functional capacity was assessed using the 6-min walk test, dynamometry, 30s sit-and-stand test, and manovacuometry (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]). The Minnesota Living with HF Questionnaire was used to assess the quality of life (QOL). The sample mostly comprised men (72.5%), with an average age of 48.2 ± 12.4 years. Cardiomyopathy (62.7%) was the most predominant etiology. A reduced left ventricular ejection fraction was prevalent in 94.1% of individuals and New York Heart Association functional class II and III HF in 62.8%. The most predominant risk factors were systemic arterial hypertension (60.8%), sedentary lifestyle (80.4%), obesity (41.2%), and smoking (41.2%). The most used medications were beta-blockers (94.1%), antihypertensives (52.9%), diuretics (100%), antiarrhythmics (64.7%), and angiotensin II blockers (68.6%). The average distance covered in 6MWT (Six Minute Walk Test) was 429.8 ± 96.7 m. The MIP and MEP reduced to 79.6% and 92.6% of the predicted distance, respectively. The right-hand grip strength (39 ± 11 kg) and left-hand grip strength (36 ± 10 kg) and the sit-and-stand test in 30s (30CST) (9.8 ± 2.3 repetitions) also decreased. HF had a moderate impact on QOL (46.6 ± 24.6 points). Individuals with HF have a reduced functional capacity in terms of respiratory and peripheral muscle strength, which moderately impacts QOL.

India’s concerted efforts to achieve sustainable development goal (SDG)-3 targets, which focus on ensuring universal health coverage and promoting well-being across all age groups, form the focal point of rigorous public health actions. This study aims to assess India’s progress toward SDG-3 targets, identify areas needing improvement, and propose measures for future advancements by analyzing the common review mission (CRM) reports of India. Utilizing secondary data collected from public domains, this study employs descriptive data analysis to examine data from 2015 to 2022 and the envisioned 2030 targets across four pivotal domains: maternal health, newborn and child health; communicable diseases; non-communicable diseases and injuries; and overarching health systems strengthening. The qualitative data were obtained from the CRM reports, which are annual reviews conducted by the Government of India. The analysis underscores the average annual rate of change (AARC) calculation for all states and the national average in India, revealing substantive disparities and areas needing enhanced progress. Findings indicate that with the prevailing AARCs (AARC: 6.90%), India will not be able to achieve the maternal mortality ratio (MMR) targets. To achieve the SDGs, the AARC for MMR, neonatal mortality rate, and under-five mortality rate must improve from 6.90% to 7.80%, 3.40% to 5.40%, and 1.30% to 2.11%, respectively. This study highlights that achieving SDG-3 targets requires state-specific, data-driven planning integrated within the Block Health Action Plan, which feeds into district and state health action plans. Effective alignment with SDG-3 imperatives necessitates meticulous planning informed by disease burdens and mortality rates, prioritizing non-communicable diseases, road traffic injuries, and suicides.

This study evaluates the performance of five large language model chatbots - ChatGPT, Copilot, Gemini, Claude, and Cohere - on topics related to cybersecurity, healthcare, and the environment. The chatbots were evaluated by asking five specific questions, and their responses were analyzed to determine how well they aligned with the cybersecurity principles outlined in the Paris Call. To assess the semantic similarity of their responses, 384-dimensional sentence embeddings from Hugging Face (HuggingFace.com) were used to calculate cosine distances, offering a quantitative measure of their alignment with the Paris Call principles. Repeated measures of analysis of variance (ANOVA) revealed no significant differences in how frequently the chatbots applied the nine Paris Call principles to individual questions, with similar application rates across the chatbots. However, a separate ANOVA across all five questions identified significant differences (p = 0.011) in the average use of these principles, suggesting that the chatbots likely rely on different datasets and did not consistently apply the principles across all questions. The study also found errors of omission, where certain key principles were left out of some responses. For example, several chatbots failed to mention critical elements, e.g. protecting the integrity of supply chains or ensuring accountability in technology use, highlighting gaps in their cybersecurity coverage. As a result, users may need to query multiple chatbots to gain comprehensive insights on these topics.