BACKGROUND: In 2021, there were 4 million tuberculosis (TB) cases that were not detected by health systems, globally. Many of those cases are among hard-to-reach populations or key population groups. An Optimized Case Finding (OCF) strategy was introduced in Ukraine to enhance case detection and identify those \"missing\" cases. OCF included screening of up to eight referred household and social network contacts of an index TB case. Following the OCF project implementation, TB detection and characteristics of index cases and contacts were assessed.
METHODS: A cohort study using project data (July 2018 - April 2022) was conducted.
RESULTS: In total 7,976 close contacts were engaged in the project from 1,028 index TB cases. Among the contacts, 507 were diagnosed with TB. The TB case detection was 6,356/100,000 and the number needed to investigate was 16. Multiple factors were identified as associated with TB detection including smoking, HIV, poverty, etc. About 90% of cases were identified at the initial screening of the contacts. OCF was proven to be 5.8 times more effective than the standard active case finding using household surveys and 106 times more effective than passive case finding in the general public.
CONCLUSIONS: Our study demonstrated the effectiveness of OCF in detecting cases among key population groups and their social networks. We encourage adaptation and use of OCF by civil society organizations that already work with key vulnerable populations around the globe.

BACKGROUND: It is well documented that Canadian healthcare does not fully meet the health needs of First Nations, Inuit or Métis peoples. In 1996, the Royal Commission on Aboriginal Peoples concluded that Indigenous peoples\' healthcare needs had to be met by strategies and systems that emerged from Indigenous worldviews and cultures. In 2015, the Truth and Reconciliation Commission also called on health organizations to learn from Indigenous \"knowledges\" and integrate Indigenous worldviews alongside biomedicine and other western ways of knowing. These calls have not yet been met. Meanwhile, the dynamic of organizational learning from knowledges and evidence within communities is poorly understood-particularly when learning is from communities whose ways of knowing differ from those of the organization. Through an exploration of organizational and health system learning, this study will explore how organizations learn from the Indigenous communities they serve and contribute to (re-)conceptualizing the learning organization and learning health system in a way that privileges Indigenous knowledges and ways of knowing.
METHODS: This study will employ a two-eyed seeing literature review and embedded multiple case study. The review, based on Indigenous and western approaches to reviewing and synthesizing knowledges, will inform understanding of health system learning from different ways of knowing. The multiple case study will examine learning by three distinct government organizations in Northwest Territories, a jurisdiction in northern Canada, that have roles to support community health and wellness: Tłı̨chǫ Government, Gwich\'in Tribal Council, and Government of Northwest Territories. Case study data will be collected via interviews, talking circles, and document analysis. A steering group, comprising Tłı̨chǫ and Gwich\'in Elders and representatives from each of the three partner organizations, will guide all aspects of the project.
CONCLUSIONS: Examining systems that create health disparities is an imperative for Canadian healthcare. In response, this study will help to identify and understand ways for organizations to learn from and respectfully apply knowledges and evidence held within Indigenous communities so that their health and wellness are supported. In this way, this study will help to guide health organizations in the listening and learning that is required to contribute to reconciliation in healthcare.

Air pollution levels rise as a result of industrial and vehicular emissions, epidemiological issues such as asthma become more prevalent in Lahore, Punjab, Pakistan and cause adverse public health effects. Many studies explored the association between air pollutants and frequency of asthma hospital visits, although their effects are unclear. This study examined the link between air pollution, asthma, and socioeconomic and demographic factors. A questionnaire survey was administered among four age groups (15-25, 25-45, 45-60, and over 60 years old) in public and private hospitals of Lahore city. Daily average concentrations of five air pollutants including carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter (PM2.5 and PM10) were recorded at ten fixed air monitoring sites in Lahore city. There were favorable connections between outpatient department (OPD) asthma visits (64%) and levels of outdoor air quality during winter season throughout the study period. The correlation between 1, 29, and 370 asthma patients and average daily air pollution levels found that the condition was more prevalent in females (53%) than males (47%). There was a significant correlation between PM10 exposure and asthma OPD visits in the city (p 0.001), as well as the elevated PM10 levels were substantially linked with OPD asthma visits over the winter season in the city. The hazard index (HI) for all adult population was estimated 0.001132. The study\'s findings indicate that exposure to ambient air pollution is a significant predictor of asthma hospital visits, particularly among the elderly. Strategies can be developed by policymakers in response to the worrying situation of allergic disease asthma in industrial cities due to air pollution.

Almost 200,000 deaths from COVID-19 were reported in Brazil in 2020. The case fatality rate of a new infectious disease can vary by different risk factors and over time. We analysed the trends and associated factors of COVID-19 case fatality rates in Brazilian public hospital admissions during the first wave of the pandemic.
A retrospective cohort of all COVID-19-related admissions between epidemiological weeks 10-40 in the Brazilian Public Health System (SUS) was delimited from available reimbursement records. Smoothing time series and survival analyses were conducted to evaluate the trends of hospital case fatality rates (CFR) and the probability of death according to factors such as sex, age, ethnicity, comorbidities, length of stay and ICU use.
With 398,063 admissions and 86,452 (21.7%) deaths, the overall age-standardized hospital CFR trend decreased throughout the period, varying from 31.8% (95%CI: 31.2 to 32.5%) in week 10 to 18.2% (95%CI: 17.6 to 18.8%) in week 40. This decreasing trend was observed in all sex, age, ethnic groups, length of stay and ICU admissions. Consistently, later admission (from July to September) was an independent protective factor. Patients 80+ year old had a hazard ratio of 8.18 (95% CI: 7.51 to 8.91). Ethnicity, comorbidities, and ICU need were also associated with the death risk. Although also decreasing, the CFR was always around 40-50% in people who needed an ICU admission.
The overall hospital CFR of COVID-19 has decreased in Brazilian public hospitals during the first wave of the pandemic in 2020. Nevertheless, during the entire period, the CFR was still very high, suggesting the need for improving COVID-19 hospital care in Brazil.

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How to improve access and quality of social services to respond to cultural diversity is receiving increased attention. Yet no approach to cultural responsiveness has been widely accepted. Coproduction has been championed in many service fields for better service outcomes and has the potential to inform practices for cultural responsiveness. This study explored how coproduction can be used to deliver culturally responsive social services. We conducted a qualitative case study and examined how an Australian disability service organisation operated a programme to improve cultural responsiveness with Australian Chinese people with disability and their families. The findings suggested that coproduction enabled the organisation to identify that the people with disability and their families considered services were culturally responsive when the staff were competent and committed to person-centred services. The coproduction contributed to continuous improvement of the services and revealed the qualities that were valued by the Australian Chinese service users. This study enriches the knowledge on coproduction by demonstrating the influence of the process of coproduction on outcomes for service users and providers. The study also contributes to the knowledge on cultural responsiveness by highlighting the elements of culturally responsive services valued by the service users. Coproduction could be more widely used for service development given its capacity to identify and respond to service needs. Practical implications for culturally responsive social services are that workforce training could focus on the principles of person-centred services and skills for working effectively with people from culturally diverse backgrounds.

Predicting PM2.5 concentrations at a fine spatial and temporal resolution (i.e., neighborhood, hourly) is challenging. Recent growth in low cost sensor networks is providing increased spatial coverage of air quality data that can be used to supplement data provided by monitors of regulatory agencies. We developed an hourly, 500 × 500 m gridded PM2.5 model that integrates PurpleAir low-cost air sensor network data for Los Angeles County. We developed a quality control scheme for PurpleAir data. We included spatially and temporally varying predictors in a random forest model with random oversampling of high concentrations to predict PM2.5. The model achieved high prediction accuracy (10-fold cross-validation (CV) R2 = 0.93, root mean squared error (RMSE) = 3.23 μg/m3; spatial CV R2 = 0.88, spatial RMSE = 4.33 μg/m3; temporal CV R2 = 0.90, temporal RMSE = 3.85 μg/m3). Our model was able to predict spatial and diurnal patterns in PM2.5 on typical weekdays and weekends, as well as non-typical days, such as holidays and wildfire days. The model allows for far more precise estimates of PM2.5 than existing methods based on few sensors. Taking advantage of low-cost PM2.5 sensors, our hourly random forest model predictions can be combined with time-activity diaries in future studies, enabling geographically and temporally fine exposure estimation for specific population groups in studies of acute air pollution health effects and studies of environmental justice issues.

BACKGROUND: Research carried out in partnership with Indigenous youth at The Native Youth Sexual Health Network (NYSHN) demonstrates that Indigenous youth can (and do) develop and implement public health interventions amongst their peers and within their communities, when supported by non-youth allies and mentors.
METHODS: Together, NYSHN and Well Living House researchers co-designed a qualitative case study to demonstrate and document how Indigenous youth can and do practice their own form of public health implementation research (PHIR) in the realm of mental health promotion for 2SLGBTTQQIA and Gender Non-Conforming Indigenous youth. Academic and Indigenous youth researchers were: participant observers; conducted a focus group; and designed and implemented an online survey with Indigenous youth project participants. Governance, intellectual property, financial terms and respective academic and NYSHN roles and responsibilities were negotiated using a customized community research agreement. The data were thematically analyzed using a critical decolonizing lens that recognizes the historic and ongoing marginalization of Indigenous peoples while also highlighting the unique and diverse strengths of Indigenous communities\' knowledge and practice in maintaining their health and wellbeing.
RESULTS: Analysis revealed how colonialism and intergenerational trauma have impacted Indigenous youth identity and the value of self-determination as it relates to their identity, their relationships, health and wellbeing. We also learned how knowing and doing about and for Indigenous youth needs to be youth determined - \'nothing about us, without us\' -- yet also supported by allies. Finally, our analysis shares some promising practices in knowing and doing for and with Indigenous youth.
CONCLUSIONS: This study provides a reminder of the need to centre Indigenous youth throughout PHIR in order to realize sustainable benefit from research, services and programming. It emphasizes the need to recognize Indigenous youth as leaders and partners in these initiatives, support their efforts to self-determine, compensate them as partners, and prioritize Indigenous youth-determined frameworks and accountability mechanisms.

OBJECTIVE: to map and synthesize the strategies implemented for case management in transitional care for patients with complex needs in emergency services.
METHODS: a scoping review conducted under the Joanna Briggs Institute guidance. Twenty-three studies were analyzed, with different methodological designs, on the strategies used in case management involving adult and elderly populations in emergency services.
RESULTS: the main strategies employed were patient risk stratification screening/identification, care management plan, coordination of care through multidisciplinary activities, support for the transition process, continuous patient monitoring, and follow-up.
UNASSIGNED: these strategies used structured approaches to care in emergency services to promote support for self-management and effective transitional care for people with complex needs, ensuring comprehensiveness, coordination, and continuity of care.

Ethnobotanical research provides ample justification for comparing diverse biological nomenclatures and exploring ways that retain alternative naming practices. However, how (and whether) comparison of nomenclatures is possible remains a subject of discussion. The comparison of diverse nomenclatural practices introduces a suite of epistemic and ontological difficulties and considerations. Different nomenclatures may depend on whether the communities using them rely on formalized naming conventions; cultural or spiritual valuations; or worldviews. Because of this, some argue that the different naming practices may not be comparable if the ontological commitments employed differ. Comparisons between different nomenclatures cannot assume that either the naming practices or the object to which these names are intended to apply identifies some universally agreed upon object of interest. Investigating this suite of philosophical problems, I explore the role grey nomenclatures play in classification. \'Grey nomenclatures\' are defined as those that employ names that are either intentionally or accidently non-Linnaean. The classification of the lichen thallus (a symbiont) has been classified outside the Linnaean system by botanists relying on the International Code of Nomenclature for algae, fungi, and plants (ICN). But, I argue, the use of grey names is not isolated and does not occur exclusively within institutionalized naming practices. I suggest, \'grey names\' also aptly describe nomenclatures employed by indigenous communities such as the Samí of Northern Finmark, the Sherpa of Nepal, and the Okanagan First Nations. I pay particular attention to how naming practices are employed in these communities; what ontological commitments they hold; for what purposes are these names used; and what anchors the community\'s nomenclatural practices. Exploring the history of lichen naming and early ethnolichenological research, I then investigate the stakes that must be considered for any attempt to preserve, retain, integrate, or compare the knowledge contained in both academically formalized grey names and indigenous nomenclatures in a way that preserves their source-specific informational content.