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One limitation of research that assesses the effectiveness of physical activity interventions for people with dementia is that most do not describe the intervention in sufficient detail to ascertain a theoretical basis or mechanism of action that determines the effective components. This paper aims to identify studies which evaluate the mechanisms of action of physical activity interventions for people with dementia, to further inform effective intervention development.

Papers were screened for evidence of evaluation of specific forms of physical activity, using pre-defined inclusion criteria. Analysis was conducted to ascertain if mechanisms of action were corroborated by data within and between studies.

The authors identified 26 studies with a measured mechanism of action; these related to the effects of physical activity on either neurological structure or endocrinal markers, including hormones. Physical activity had potential to reduce hippocampal atrophy, increase neural recruitment, activate the noradrenergic system and improve anti-inflammatory responses. While individual studies were hampered by small sample sizes, the body of evidence indicated that physical activity may have potential to delay cognitive decline.

Mechanisms of action in relation to dementia and physical activity are likely to be multifaceted, and physical activity may be protective against progression in the early stages of cognitive decline. Physical activity may be of greatest benefit if incorporated into on-going lifestyle, rather than engaged in for short periods, and combined with social interaction.

This paper is unique in its focus on the mechanisms of action of physical activity interventions for people with dementia.

This was a cross-sectional study to assess the psychological response to quarantine during COVID-19 pandemic and knowledge level about the disease among inmates of a Custodial Center in Enugu, Nigeria. A total of 66 new prison inmates were assessed for psychological distress using the Kessler Psychological Distress Scale (K10); and inmates’ knowledge about COVID-19 using a COVID-19 Knowledge Questionnaire developed by the researchers.

Participants had a mean age of 28.39±8.71 years; 63 (95.5%) were male inmates and 3 (4.5%) were female inmates. Sixty-one (92.4%) were awaiting-trial inmates, 43 (65.1%) had psychological distress, and 35 (53%) had completed at least secondary school. COVID-19 questionnaire mean score was 3.82±3.33. Thirty-one (21.8%) had adequate knowledge of COVID-19 (7-10 score), while 35 (53%) and 10 (15.2%) had poor (0-3) and average (4-6) knowledge, respectively. Adequate COVID-19 knowledge level was significantly higher among those that completed at least secondary school (48.6%) than those who did not (12.9%). Though not statistically significant, adequate COVID-19 knowledge level was commoner among those without psychological distress (43.5%) than those with psychological distress (25.6%).

Considering responses to specific questions contained in the questionnaire, knowledge about some questions was relatively high. For example, a majority of the participants 45 (68.2%) correctly responded that death can be a complication of COVID-19; whereas half of them 33 (50%) correctly responded that regular hand washing with soap and water can help prevent the spread of the disease. Nevertheless, responses to some questions showed poor knowledge about the disease as 18 (27.3%) correctly answered that COVID-19 can affect the lungs, while 20 (30.3%) correctly responded that COVID-19 is caused by a virus.

Our study highlighted the need to have all quarantined persons educated about the disease for which they are being quarantined. It also provided the opportunity to raise awareness of COVD-19 among the inmates.

This study aimed to estimate the economic benefits of PM2.5 emission abatement by Red Pine, Pinus Koraiensis and Quercus, using a metering model analyzing the amount of PM2.5 absorption in Korea.

To estimate the economic effects of PM2.5 adsorptions by trees, the frequency of hospital visits resulting from respiratory and circulatory diseases was estimated using a Probit model based on the data from National Health and Nutrition Survey.

The results show that Quercus and Pinus Koraiensis absorb and eliminate the largest amount of PM2.5. Reducing 1 ton of PM2.5 emission through the planting of trees leads to lower incidences of respiratory and circulatory diseases equivalent to the amount of 95 million won. When the trees planted are 2-year-old Red Pine, Pinus Koraiensis and Quercus, the resulting economic benefits of the PM2.5 abatement would amount to 481 million won, 173 million won and 1,027 million won, respectively. If the trees are 80 years old, the economic benefits are estimated to be 73 billion won for Red Pine, 103 billion won for Pinus Koraiensis and 38 billion won for Quercus.

One limitation of this study is that the weight of PM2.5 adsorbed by each leaf area entirely depended on the experimental results from a prior study and the values are likely to be different from those actually absorbed in natural surroundings. In addition, because of the lack of data from a domestic survey on the surface of leaf area or the reload flow rate of PM2.5, this study referred to data from foreign research. Unfortunately, this specific data may not reflect climatic and terrain characteristics specific to the target country. We used the annual wind speed to calculate the reload flow rate and elimination volume; however, the figures could be more accurate with hourly or daily climate variations. When estimating the health benefits of changes in PM2.5 emissions on respiratory and circulatory diseases, more segmented access to patients' hospital visits and hospital admissions are desirable. Finally, the study focused on the three major tree species of Korea, however, a more detailed study of PM2.5 reduction by various tree types is needed in the future.

This paper quantitatively assessed the amount of PM2.5 adsorption by each of the three tree species. Then, the economic benefits were calculated in terms of how much money would be saved on hospital visits thanks to the reduced PM2.5 levels and lower incidences of respiratory and circulatory system diseases. The net contribution of this study was to prove the trees' function of reducing PM2.5 as it relates to human health. We focused on the most common trees in Korea and compared them to provide new information on the species.

COVID-19 remains a public health emergency of international concern. Efforts at the global and national levels are being made to control its spread. The Nigerian Correctional Service is also proactive in the fight against the disease by organizing COVID-19 awareness training for correctional officers. We conducted a pre- and post-test assessment of COVID-19 knowledge among correctional officers in Enugu State Command to determine the impact of awareness training on their knowledge level. The study also assessed correctional officers’ attitude and preventive practices towards the disease.

The mean knowledge score was 19.34 out of 25, and the awareness training significantly improved the participants’ COVID-19 knowledge. We found a significant moderate, positive correlation between knowledge and attitude/practice, and a significantly higher knowledge level among those with higher educational qualifications.

Regular hand washing with soap and water (87.9%), wearing face masks (84.4%), and social distancing (83%) were practiced by the majority of the participants. The majority of the participants (53.2%) received COVID-19 information from multiple sources including the Nigeria Centre for Disease Control and the World Health Organization.

Front-of-pack nutritional labels have been extensively studied to support consumers in making healthier and more informed food choices. However, existing research has gathered conflicting evidence about which category of label, nutrient-specific or summary labels, is more effective. As a result, the European Union has postponed its decision on selecting a unified label to collect additional information. This study specifically focusses on individuals with noncommunicable diseases, an overlooked yet relevant segment of consumers who can significantly benefit from the proper use of nutritional labels in their self-care.

In a sequence of three studies grounded in the front-of-pack acceptance model and focussing on customers with specific noncommunicable diseases, the authors examined the different effects of the NutrInform Battery and Nutri-Score on food acceptance and portion selection. This research involved the use of structural equation modelling and ANOVA and was conducted with a cumulative sample of 2,942 EU adults, residing in countries with or without previous exposure to nutritional labels.

The results suggest that among individuals with noncommunicable diseases, nutrient-specific labels are perceived as more useful and easier to use. They also generate a better attitude towards the usage of nutritional labels and are more effective in nudging those consumers towards a proper selection of portions.

The results provide valuable insights into how front-of-pack nutritional labels can impact the food choices of individuals with noncommunicable diseases and have implications for public health policies.

Investigation of the effects of NutrInform Battery and Nutri-Score on consumers with noncommunicable diseases, an area currently under-researched.

A global trend of type 2 diabetes prevalence is rising. Preventing and managing of systemic and dental complications is crucial to decrease negative effects on glycemic control. The purpose of this paper is to estimate the efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs to decrease glycemic level and improve periodontal status in patients with type 2 diabetes.

Health Center 54 conducted randomized controlled trial among 192 patients (96 intervention and 96 control) from February to August 2018. Group education for lifestyle modification, individual oral hygiene instruction and lifestyle counseling by motivational interviewing was provided to the intervention group at baseline. Motivation of lifestyle modification every month by multimedia was also provided to the intervention group. The usual program was provided to the control group. At baseline and a six-month follow-up, glycemic level and periodontal status were assessed from participants. Data were analyzed by descriptive statistic, t-test, χ² test, Fisher’s exact test, Repeated measure ANOVA and multiple linear regression.

Glycemic level and periodontal status were lower in the intervention group than the control group at the sixth-month followed up with statistical significances. Glycemic level and periodontal status had negatively correlated to intervention group with statistically significant.

Brief-LCDC Program which incorporated lifestyle modification and oral health care had efficacious to decrease glycemic level and improve periodontal status in patients with type 2 diabetes. Early prevention program by Brief-LCDC Program is crucial to prevent dental complications.

The purpose of this paper is to investigate epidemiology and control strategies of the four priority vector-borne diseases (VBDs) in Nepal, i.e. malaria, Kala-azar (visceral leishmaniasis), lymphatic filariasis (LF) and dengue fever/dengue hemorrhagic fever.

The study was a retrospective design to collect data during 1998–2016 from VBDs endemic districts of Nepal. All data were reviewed and epidemiological information of the four VBDs were analyzed.

The number of malaria cases during 1998–2016 of the 13 affected districts was declined from 8,498 to 991 cases with no record of deaths since 2012. The number of cases and deaths in the 12 kala-azar (visceral leishmaniasis) affected districts in 1998 was 1,409 and 42 cases, respectively, but was dramatically decreased in 2016 to 213 and 2 cases, respectively. LF cases of the 61 affected districts in 2011, 2014 and 2016 were 28,855, 30,000 and 33,517 cases, respectively. In total, 25 districts achieved elimination target and the remaining are expected to complete the needful cycles by 2018. Dengue incidence of the 31 affected districts during 2006–2015 was under controlled with reported cases of 642, 356 and 136 cases in 2013, 2014 and 2015, respectively, and only one death in 2015. Implementation of control strategies particularly disease management and community peoples’ awareness significantly reduced the cases and deaths of the target VBDs.

The results of this study clearly suggest that the current control strategies have been worked effectively. However, in particular of the VBDs, health education in communities in the endemic areas should be adopted for better community participation in the context of the primary health care approach and increase the effectiveness of disease control.

VBDs, i.e., malaria, kala-azar (visceral leishmaniasis), LF and dengue fever/dengue hemorrhagic fever, are major causes of morbidity and mortality in the least developed countries which include Nepal. Globalization of travel and trading, unplanned urbanization, environmental and climate change are having a significant impact on disease transmission. Therefore, the Ministry of Health of Nepal had brought some changes in strategies based on activities for disease control, vector control, preventive and preparedness for outbreak response. Consequently, the cases and deaths due to malaria, kala-azar (visceral leishmaniasis), lymphatic filaiasis and dengue fever/dengue hemorrhagic fever have been brought down markedly.

Chronic kidney disease (CKD) is a worldwide public health problem which imposes a significant financial burden not only on patients but also on the healthcare systems, especially under the pressure of the rapid growth of the elderly population in China. The purpose of this paper is to examine the hospitalization costs of patients with CKD between two urban health insurance schemes and investigate the factors that were associated with their inpatient costs in Guangzhou, China.

This was a prevalence-based, observational study using data derived from two insurance claims databases during the period from January 2010 to December 2012 in the largest city, Guangzhou in Southern China. The authors identified 5,803 hospitalizations under two urban health insurance schemes. An extension of generalized linear model – the extended estimating equations approach – was performed to identify the main drivers of total inpatient costs.

Among 5,803 inpatients with CKD, the mean age was 60.6. The average length of stay (LOS) was 14.4 days. The average hospitalization costs per inpatient were CNY15,517.7. The mean inpatient costs for patients with Urban Employee-based Basic Medical Insurance (UEBMI) scheme (CNY15,582.0) were higher than those under Urban Resident-based Basic Medical Insurance (URBMI) scheme (CNY14,917.0). However, the percentage of out-of-pocket expenses for the UEBMI patients (19.8 percent) was only half of that for the URBMI patients (44.5 percent). Insurance type, age, comorbidities, dialysis therapies, severity of disease, LOS and hospital levels were significantly associated with hospitalization costs.

The costs of hospitalization for CKD were high and differed by types of insurance schemes. This was the first study to compare the differences in hospitalization costs of patients with CKD under two different urban insurance schemes in China. The findings of this study could provide economic evidence for understanding the burden of CKD and evaluating different treatment of CKD (dialysis therapy) in China. Such useful information could also be used by policy makers in health insurance program evaluation and health resources allocation.

Health for all is an ideal goal that all governments aspire to reach. The purpose of this paper is to assess the definitions of the key terms used to better appreciate the role of the WHO member states in their efforts to achieve improved healthcare systems that suit each nation’s particular needs.

Definitions of the terms disease, illness and health are discussed against health concepts as a means of assessing the most effective approach toward achieving an effective universal healthcare system.

Universal health and treatment of sickness and disease have improved globally, but the target of achieving total wellness still remains as a goal for the future and may be impeded by diseases that have not yet evolved. The implementation of a universal health coverage system is a positive step toward achieving the goals of health and wellness for the present times.

This is a commentary piece.

This study aims to explore the link between mortality and climate change. The focus is in particular on individuals’ adaptation to temperature changes. The authors analyze the relationship between climatic change (measured by temperature rate) and mortality in 23 Organisation for Economic Co-operation and Development countries during 1970-2010.

This study performs the adaptation regression model in the level form as a dynamic panel fixed effects model. The authors use a non-linear threshold estimation approach to examine the extreme temperature changes effect on the temperature–mortality relation. More specifically, the study explores whether the large increases/decreases in temperature rates affect mortality rates more than the modest changes.

This study indicates that the temperature–mortality relation is significant in early part of the sample period (before 1990) but insignificant during the second part (after 1990). After including controlling factors, as well as nation and year fixed effects, the authors provide evidence that people do adapt to the most of the temperature-related mortalities. Also, this study provides evidence of the non-linear relationship between national temperatures and mortality rates. It is observed that only after 5 per cent increase in the annual temperature, the relation between temperature and overall mortality is significant.

Most studies cover only one specific country, hence making it difficult to generalize across countries. Therefore, the authors argue that the best estimation of the health effects of temperature change can be found by modeling the past relationships between temperature and mortality across countries for a relatively long period. To the authors’ knowledge, previous studies have not systemically tested the adaptation effect across countries.