The New Zealand health system is data-rich, information-poor, and intelligence meagre. However, there is widespread confusion about the definitions of these terms, so they are often used synonymously. Like many jurisdictions, we continue to collect and collate vast quantities of data at an increasing rate. Many tools are available to \"analyse\" the data deluge with the false expectation that \"intelligence\" will be produced. Naively, such a data-driven, machine-analysed paradigm is often thought to produce the \"evidence\" for decision-making and policy development. Continuing such a blinded approach poses potential health risks to New Zealanders and remains a major impediment to improving our health statusCreating intelligence from information involves humans (perhaps in concert with AI) utilising their interpretative abilities, asking the \"so what, \"what does it mean\" questions, and employing their communication skills to disseminate the answers. To move from information to intelligence requires agencies to employ, develop and maintain a sufficiently skilled workforce over a long period, rather than the quick and easy investment in more and faster machines and software.Only through a human-driven evaluation of intelligence-based decisions and policies will our knowledge about the environmental health system increase and ultimately yield better health outcomes.Environmental Health Intelligence NZ (EHINZ) provides intelligence as evidence for decision-making and policy development in environmental health. It is based on the interpretation, communication, and dissemination of information from the surveillance more than seventy environmental health indicators (EHIs) across twelve domains (e.g., air and water quality, climate change), exposure to hazardous substances, and social vulnerability indicators to environmental hazards (e.g., flooding, climate change, sea-level rise, wildfires, heat waves).The paper details our approach, with two case studies, in providing the NZ health system with \"intelligence for environmental health decisions.\"

BACKGROUND: Previne Brasil is a new way of financing Primary Health Care (PHC) in Brazil that places users of public health services at the center of the system\'s analysis and attention through the use of seven performance indicators. This study aims to analyze the performance of Primary Health Care in Brazil under the new financing model (Previne Brasil) in the period from the first four months of 2022 to the first four months of 2023.
METHODS: This is a territorial ecological study using secondary data from the Primary Care Health Information System (SISAB). Seven performance indicators were included and analyzed according to Brazil, its regions, states and capitals. A comparative descriptive analysis was carried out between the spatial units.
RESULTS: Of the seven indicators analyzed, only one (Proportion of pregnant women tested for syphilis and HIV) reached the proposed target considering the average of the four-month periods evaluated (target: 60%; Observed: 62.5%). The Northeast was the region with the best performance, surpassing the target in three of the seven indicators (prenatal consultations, tests for syphilis and HIV in pregnant women and dental care for pregnant women). The states and capitals showed progressive improvement in the performance indicators over the four quarters analyzed, although unevenly between the indicators. The indicators related to hypertension and diabetes were the worst. The Final Synthetic Indicator (FSI) showed an increase in the median over the four quarters (4.78; 5.65; 6.02 6.29), which represents an increase of 1.51 in the indicator between the first four months of 2022 and the first four months of 2023.
CONCLUSIONS: Although there have been improvements in the performance of Primary Health Care in Brazil, the achievement of the agreed targets for the indicators seems a long way off. The socio-spatial inequalities in the indicators reflect the country\'s health complexity and reinforce the need for policies that take into account the local-regional context.

[This corrects the article DOI: 10.3389/fpubh.2024.1351972.].

UNASSIGNED: The COVID-19 pandemic had a great impact on several public sectors worldwide, requiring the implementation of public policies in an organized way to contain and control the disease. Thus, this study aimed to analyze public policies to face the COVID-19 pandemic in the State of Paraná, Brazil.
UNASSIGNED: This was a cross-sectional, retrospective, quantitative survey carried out with data from March 2020 to March 2022 in the twenty-two municipalities that host the local health regions. Data collection was documentary, carried out from the municipal Portal da Transparência website, which is dedicated to making public all expenditures, and epidemiological bulletins released by the Health Department of the state of Paraná. The variables analyzed were New Cases and Deaths, Mortality and Lethality Coefficient, Incidence Rate, Vaccination Coverage, Number of Hospital and ICU beds exclusive to COVID-19, Settled Expenses destined for COVID-19 and coping measures, namely, the Declaration of Public Health Emergency, Curfew, Mandatory use of masks, Businesses closure, Teleworking of risk groups, and Suspension of activities with crowds and of classes. After collection, data underwent descriptive analysis, and subsequently, the correlation of variables was analyzed using the Spearman test. Multiple linear regression was applied using the variable selection method called best subset selection (BSS). The dependent variables listed were incidence rate, new cases and new deaths.
UNASSIGNED: The results showed that coping measures, as well as the application of resources for the pandemic, were implemented heterogeneously in the municipalities studied, and the progression of the disease, the distribution of beds and vaccination occurred unevenly and may be a reflection of the limited Brazilian national governance. An important correlation was observed between the incidence rate and new deaths with vaccination coverage. In addition, the regression model showed that measures such as mandatory use of masks, closure of shops, suspension of classes, and curfew showed important correlations with the variables incidence rate, cases, and new deaths.
UNASSIGNED: The study highlighted the importance of carrying out a robust analysis of public policies to face emergencies of global importance so that government entities are prepared for future crises of great repercussions, such as the COVID-19 pandemic.

The attainment of the noble objective of Universal Health Coverage (UHC)- \'leaving no one behind\' necessitates sufficient financial resources, an ample supply of skilled healthcare professionals, and the availability of essential services as part of a basic package This paper presents an analysis of the health system, health seeking behaviours and health service utilization en route to UHC in Pakistan. We have used the UHC 14 tracer indicators of service coverage to see where Pakistan stands, what are the gaps and what needs to be done. Pakistan clearly is lagging behind its neighboring countries. The country\'s health system ought to work on health seeking behaviours and broader determinants of health. The pursuit of UHC demands a shared responsibility and collective action, with stakeholders from different sectors uniting their efforts and expertise. Together, they can establish robust systems, design comprehensive policies, allocate adequate resources, and implement interventions that transcend disciplinary boundaries.

UNASSIGNED: Health indicators are often used for a variety of purposes, including program management, resource allocation, monitoring of country progress, performance-based payment, and global reporting. Real progress in health towards the United Nations Millennium Development Goals and other national health priorities is vitally dependent on stronger health systems. We aimed to analyse the progress of \"birth related indicators\" of selected countries of Balkan and Eastern Europe and to forecast their values in the future.
UNASSIGNED: This research report article represents a descriptive data analysis of selected health indicators, extracted from European Health for All database (HFA-DB) and EuroStat. Indicators of interest were analysed for 17 countries in observational period from 1990 to 2019. The data were analysed using a linear trend estimate and median operation and interquartile range 25th-75th percentile were used for better comparison of each country. Forecasting analysis to year 2025 was performed by combining Excel analysis and SPSS program.
UNASSIGNED: Number of all live births to mothers aged under 20 is decreasing in almost all examined countries, while live births to mother over 35 is mostly increasing. Total fertility rate is also mainly decreasing in almost all countries of interest for our investigation, as well as the crude birth rate. Estimated infant mortality per 1000 live births is decreasing in all observed countries.
UNASSIGNED: Population aging is becoming more pronounced, while current birth-related indicators have negative tendencies; this problem will obviously continue over time.

The exploration of natural alternatives to antibiotics for enhancing productivity and performance in dairy cows is a crucial objective in farm animal management. This is the first study aimed at developing and evaluating the physicochemical properties and effects of Arabic gum-nano montmorillonite (AGNM) compost compared to ionophore monensin as feed additives on rumen fermentation, blood metabolites, and milk production of Holstein dairy cows. In a replicated 4 × 4 Latin square design, four multiparous mid-lactation Holstein dairy cows with an average body weight of 520 ± 15 kg were enrolled. The dietary treatments included a control diet (basal diet without feed additives), monensin diet [a basal diet supplemented with 35 mg/kg dry matter (DM) monensin], and AGNM diets comprising basal diet supplemented with two levels: low (L-AGNM) at 1.5 g/kg DM, and high (H-AGNM) at 3 g/kg DM. AGNM as a feed additive demonstrated promising physiochemical parameters, including containing highly bioactive components (α-amyrin and lupeol), functional groups (OH and Si-O), and essential mineral contents (Mg2+). Supplementations with H-AGNM significantly improved ruminal (p = 0.031) concentrations of total volatile fatty acids (VFAs), acetic (p = 0.05) and butyric (p = 0.05), enhanced (p < 0.05) digestibility of fiber and organic matter, while decreased (p = 0.013) estimated methane production. However, an increase (p = 0.04) in blood high-density lipoprotein levels and decrease (p < 0.05) in concentrations of creatinine (CREA), bilirubin (BILT), cholesterol (CHOL), and sodium (Na) were observed with H-AGNM supplementation. Both monensin and H-AGNM improved (p = 0.008) feed efficiency compared to L-AGNM; however, neither AGNM nor monensin affected the milk composition or energy status indicators of the dairy cows. The findings of this study highlight the potential of AGNM as a natural candidate to replace monensin in enhancing ruminal VFA production, nutrient digestibility, feed efficiency, blood metabolites, and milk yield in dairy cows.

Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one\'s lifespan. Consistent with movement behaviors, several countries have formulated and published 24-h movement guidelines. This review summarized the studies related to 24-h movement guidelines among children and adolescents from six databases (MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, and SPORTDiscus). In a total of 61 studies that discussed compliance with 24-h movement guidelines, the overall adherence rate was very low (7.1%), with boys exceeding girls, children surpassing adolescents, and regional differences. A total of 39 studies examined the associations between 24-h movement guidelines and health indicators. Findings indicated that meeting all three guidelines was favorably associated with adiposity, cardiometabolic health, mental and social health, physical fitness, health-related quality of life, academic achievement, cognitive development, perceived health, dietary patterns, and myopia. Future research should utilize longitudinal and experimental designs to enhance our understanding of the associations between 24-h movement guidelines and health indicators, thereby aiding the formulation and refinement of such guidelines.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, CRD42023481230.

Anthropogenic threats such as water infrastructure, land-use changes, overexploitation of fishes and other biological resources, invasive species and climate change present formidable challenges to freshwater biodiversity. Historically, management of fish and fishery species has largely been based on studies of population- and community-level dynamics; however, the emerging field of conservation physiology promotes the assessment of individual fish health as a key management tool. Fish health is highly sensitive to environmental disturbances and is also a fundamental driver of fitness, with implications for population dynamics such as recruitment and resilience. However, the mechanistic links between particular anthropogenic disturbances and changes in fish health, or impact pathways, are diverse and complex. The diversity of ways in which fish health can be measured also presents a challenge for researchers deciding on methods to employ in studies seeking to understand the impact of these threats. In this review, we aim to provide an understanding of the pathway through which anthropogenic threats in freshwater ecosystems impact fish health and the ways in which fish health components impacted by anthropogenic threats can be assessed. We employ a quantitative systematic approach to a corpus of papers related to fish health in freshwater and utilize a framework that summarizes the impact pathway of anthropogenic threats through environmental alterations and impact mechanisms that cause a response in fish health. We found that land-use changes were the most prolific anthropogenic threat, with a range of different health metrics being suitable for assessing the impact of this threat. Almost all anthropogenic threats impacted fish health through two or more impact pathways. A robust understanding of the impact pathways of anthropogenic threats and the fish health metrics that are sensitive to these threats is crucial for fisheries managers seeking to undertake targeted management of freshwater ecosystems.

The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.