BACKGROUND: There have been over 772 million confirmed cases of COVID-19 worldwide. A significant portion of these infections will lead to long COVID (post-COVID-19 condition) and its attendant morbidities and costs. Numerous life-altering complications have already been associated with the development of long COVID, including chronic fatigue, brain fog, and dangerous heart rhythms.
OBJECTIVE: We aim to derive an actionable long COVID case definition consisting of significantly increased signs, symptoms, and diagnoses to support pandemic-related clinical, public health, research, and policy initiatives.
METHODS: This research employs a case-crossover population-based study using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) data generated at Veterans Affairs medical centers nationwide between January 1, 2020, and August 18, 2022. In total, 367,148 individuals with ICD-10-CM data both before and after a positive COVID-19 test were selected for analysis. We compared ICD-10-CM codes assigned 1 to 7 months following each patient\'s positive test with those assigned up to 6 months prior. Further, 350,315 patients had novel codes assigned during this window of time. We defined signs, symptoms, and diagnoses as being associated with long COVID if they had a novel case frequency of ≥1:1000, and they significantly increased in our entire cohort after a positive test. We present odds ratios with CIs for long COVID signs, symptoms, and diagnoses, organized by ICD-10-CM functional groups and medical specialty. We used our definition to assess long COVID risk based on a patient\'s demographics, Elixhauser score, vaccination status, and COVID-19 disease severity.
RESULTS: We developed a long COVID definition consisting of 323 ICD-10-CM diagnosis codes grouped into 143 ICD-10-CM functional groups that were significantly increased in our 367,148 patient post-COVID-19 population. We defined 17 medical-specialty long COVID subtypes such as cardiology long COVID. Patients who were COVID-19-positive developed signs, symptoms, or diagnoses included in our long COVID definition at a proportion of at least 59.7% (268,320/449,450, based on a denominator of all patients who were COVID-19-positive). The long COVID cohort was 8 years older with more comorbidities (2-year Elixhauser score 7.97 in the patients with long COVID vs 4.21 in the patients with non-long COVID). Patients who had a more severe bout of COVID-19, as judged by their minimum oxygen saturation level, were also more likely to develop long COVID.
CONCLUSIONS: An actionable, data-driven definition of long COVID can help clinicians screen for and diagnose long COVID, allowing identified patients to be admitted into appropriate monitoring and treatment programs. This long COVID definition can also support public health, research, and policy initiatives. Patients with COVID-19 who are older or have low oxygen saturation levels during their bout of COVID-19, or those who have multiple comorbidities should be preferentially watched for the development of long COVID.

The intensive global plastic production, use and associated plastic pollution have caused concern for the potential risks to human health and the environment. This has led to the adoption of numerous regulatory initiatives aiming to combat plastic pollution. Despite the considerable regulatory activity in the field of plastic, it appears that there is still debate about the actual risks of plastic to humans and the environment. This raises the question of to what extent the current plastic regulation is evidence-based, a declared ambition in the European Union. Therefore, the aim of this study was to investigate to what extent key policy initiatives targeting plastic pollution are based on scientific evidence. Selection of initiatives was based on expert elicitation accounting for the opinions of persons involved in the development of the policy initiatives, and a thorough assessment of the historical development of plastic pollution regulation, with focus on their importance both with respect to regulation of plastics as well as their historical importance as drivers for societal actions on plastic pollution. We find that scientific evidence appears to be generally present in the scientific foundation for the policy initiatives analysed in this study. All the initiatives are supported by scientific articles and reports about among others plastic sources, ecological impacts of plastic production and consumption patterns. Marine litter monitoring data was found to contribute to the evidence base for 4 out of the 6 policy initiatives and thereby appears to be one of the central scientific drivers behind the societal actions on plastic pollution. Other scientific tools applied when shaping the policy initiatives include risk assessment, impact assessment and life cycle assessment. Despite the prevalent consideration and application of scientific evidence, there seems to be a broad recognition in the preparatory work of the initiatives that there is still a lot of uncertainty related to determining the harm of plastic pollution. In these cases, taking precautionary actions seems however to be justified, recalling not least the precautionary principle. As the issue of plastic pollution is complex and still subject to uncertainty, it seems important both that policy initiatives allow for flexibility and continuing adjustment to the on-going knowledge generation and that the scientific community provides the needed research to continue the science-informed policy development.

This study was conducted to build evidence-based research about the provision of Ethiopian adult education. Therefore, the main purpose of this meta-synthesis study was to upsurge understanding from empirical facts and give evidence-based research regarding the provision of adult education in Ethiopia from the standpoint of policy and practice a wide-ranging spotlight. In doing so, sample qualitative studies were searched and selected from databases using search terms. To find all the relevant primary studies on adult education to this investigation, both electronic and manual search strategies were utilised using the PRISMA (2009) guideline. According to this meta-synthesis result, Ethiopia has had three distinct political systems of government since the 1941, when adult education has been habituated into modern education with erratic emphasis. Each was defined by its approach to education policy. Sometimes adult education in all eras of government is used to spread political ideologies, rather than to directly benefit adult learners, who are the primary audience and effect good change. Although many policies and directives have been implemented to support the provission of adult education programs in the country, the actual effort and outcome are still merely symbolic. To conclude, the adult education policies should be revisited and formulated to reflect the creation of holistic development in all adult learners to be competent citizens and critical thinkers, stand for social justice, peace, and unity in diversity.

Today\'s working population is expected to experience a longer and healthier life than previous generations did. This, combined with a currently shrinking workforce, means the participation of older adults in the labor market is expected to positively contribute to national economic and social development. Policymakers have therefore implemented a series of reforms to motivate and encourage both employers and employees to embrace the prospect of an aging workforce and to respond to the associated challenges of such a demographic change in the workplace. This paper aims to provide an overview of recent policy initiatives in this context and to identify the role of technology in major international initiatives in overcoming the key challenges faced by developed countries. We have conducted a scoping review to obtain large volumes of peer-reviewed and gray literature. Our findings suggest that the stakeholders (researchers, government agencies, employers, and communities) are not only aware of the current issues relating to the aging population but also understand the importance of policies in terms of retaining older people in the workforce. In particular, our results indicate that technology, in both the public and private sectors, can be leveraged as a tool to facilitate older adults\' participation in the workforce.

The global concern over the possible consequences of the downsizing of plastic to microplastics (MPs) and nano plastics (NPs) needs to be addressed with a new conceptual framework. The transformation of plastics to MPs and NPs can be discussed in terms of fundamental physics principles applicable to micro and nanophase matter and colloidal science principles. Further, accurate and reliable detection and characterization of MPs and NPs are crucial for an extensive understanding of their environmental and ecological impacts. The other decisive factor that can classify MPs and NPs as hazardous to existing nanomaterials is discussing the cytotoxicity study on human cell lines. The human health risk assessment that might arise from the ingestion of MPs and NPs can be addressed about contrast agents used for medical imaging. However, the lack of standard analytical techniques for MPs and NPs measurement is an emerging challenge for analytical scientists due to their complex physicochemical properties, especially in environmental samples. This review article navigates readers through the point of origin of MPs and NPs and their interdisciplinary aspects. Biomedical applications of plastics and concerns over the toxicity of MPs and NPs are further analyzed. Moreover, the analytical challenges of MPs and NPs have been discussed with critical inputs. Finally, the worldwide efforts being made for creating a common platform of discussion on a different aspect of plastic pollution were taken into account.

The Health and Aging Policy Fellows (HAPF) Program has, since its inception in 2008, provided health policy training and mentorship for 113 gerontological professionals across a wide range of disciplines and stages of careers. The fellows\' shared passion is the effective engagement of policy levers to improve the lives of older adults. This article briefly describes the HAPF Program and provides a sample of policies with which fellows have been engaged related to dementia and late-life mental health. Approximately 20% of the fellows have specifically addressed one of these areas during their fellowship year. This would be expected, given that 14% of older adults aged 71 and older have a diagnosis of dementia, and although new mental health diagnoses decline as adults age, mental health conditions remain prevalent. Thus, we conclude by describing opportunities for future advocacy and policy efforts in dementia and mental health in the areas of funding, translating science to practice, interprofessional education and innovative models of care for persons with these conditions.

There have been a numerous initiatives in Azerbiajan in recent years to improve antibiotic utilization including educational programmes among patients, pharmacists and physicians. Consequently, this study aimed to analyse the influence of these multiple initiatives on antibiotic utilization as a basis for suggesting future initiatives.
Observational retrospective study of total antibiotic utilization from 2011 to 2015 based on import data. The quality of aggregated antibiotic prescribing was assessed against recognised indicators including those of WHO Europe, as well as compared to neighbouring countries as reference points.
There was a significant reduction in total antibiotic utilization from 17.1 DIDs in 2011 in Azerbaijan to 8.02 DIDs in 2015, the lowest level compared with similar countries. Beta lactam antibiotics were typically the largest group of antibiotics with low overall use of co-amoxiclav (although relative utilisation rising), macrolides, cephalosporins and fluoroquinolones. There are concerns with rising use of tetracyclines in recent years in place of penicillins with changing pricing policies, as well as high relative use of third generation cephalosporins.
Multiple interventions in Azerbaijan in recent years appear to have resulted in low use of antibiotics when compared with similar countries. However, there are some concerns especially with third generation cephalosporins. There needs to be a closer look at indications to further improve antibiotic use.

This article provides an update on advances in both developmental and intervention science that have occurred in the field of early intervention for children with developmental delays in the past decade. From the perspective of developmental science, findings related to multiple and reciprocal pathways of influence on the development of children with delays that can inform early intervention practice are discussed. This is followed by a review of two prominent lines of early intervention research: promoting children\'s developm-ent by enhancing parent-sensitive responsiveness and improving children\'s cognitive and social outcomes in inclusive preschool settings. Merging policy initiati-ves with our knowledge of developmental processes is discussed as the key to accelerating progress in the development of comprehensive early intervention systems.

Despite socio-economic, demographic and epidemiological facts and realities that point to a potential risk for explosion in the prevalence of childhood mental health problems in sub-Saharan Africa, there is still a severe dearth of child and adolescent mental health (CAMH) policy or strategy to respond to the situation in the region. Unfortunately, current attempts at suggesting courses of action in this regard appear to be focused on narrow reactionary approaches. There is a need for theoretical frameworks to capture the full ramification of childhood in sub-Saharan Africa, from which multi-level, context-appropriate and holistic CAMH policy directions can be understood. In this commentary, we propose an amended version of the Bronfenbrenner\'s ecological model of childhood as such framework that captures proximal, intermediate and distal factors that influence the care environment of children. We then used the insights provided by the model to identify and prioritize intervention points and appropriate intervention strategies in charting a tentative course for CAMH policy development in the region. Though the ecological model provides a distinct perspective to the structure and dynamics of the care environment of children, the proposed framework using the model is still largely theoretical and need to be further integrated into future studies on CAMH policy development in the region.

Sustained support of policy initiatives by nursing has resulted in significant legislative victories. One victory, the passage of the 1938 New York State Todd-Feld Act, which underwent legislative debate at a time when the nurse labor market was in disarray, during an economic depression, and before U.S. entry into World War II, reinforces our understanding that nursing must be a strong shepherd for policies beneficial for health care delivery. Designed to correct serious deficiencies in the nursing workforce, the act successfully required licensing for those working as registered and practical nurses. Yet, its provisions failed to stop all unlicensed nurse workers from practicing. Rapid changes occurring in the nurse labor market against the backdrop of growing hospital power over the employment of all nurse workers minimized the act\'s effectiveness. Policy implications include the need to focus on the complex nature of health care policy initiatives, flexibility in the face of changing circumstances, and acceptance of political realities.