Articles

<b>Background:</b> Tobacco endgame, defined as elimination of commercial tobacco sales The U.S. tobacco control landscape is a complex, adaptive system shaped by diverse stakeholders, evolving products and regulations, shifting social norms, and the strategic countermeasures of a powerful industry. Managing such complexity requires more than isolated interventions—it demands a coordinated, enterprise-wide approach that accounts for dynamic interactions, feedback loops, and emergent risks. <b>Objective:</b> Drawing on complex systems thinking, Zachman enterprise architecture model, and public health best practices, we conceptualize tobacco control as an evolving enterprise progressing through six interconnected phases: (1) Conception &#x26; Initiation, (2) Policy &#x26; System Design, (3) Implementation &#x26; Operation, (4) Evaluation &#x26; Adaptation, (5) Consolidation &#x26; Endgame Transition, and (6) Sustainment or Sunset. Each phase incorporates governance structures, performance benchmarks, and transition criteria designed to manage interdependence and reduce systemic vulnerabilities. <b>Results:</b> The lifecycle framing emphasizes how tobacco control in the U.S. can evolve as a complex, adaptive enterprise—integrating public health objectives with legal, operational, and cultural change processes. This model supports strategic sequencing, cross-sector alignment, and risk mitigation against emergent industry tactics, enabling a resilient and measurable pathway to the endgame. <b>Conclusions:</b> Seeing tobacco control as a complex enterprise that operates under a lifecycle model may offer a roadmap for achieving and sustaining the tobacco endgame. Using this approach may enhance policy coherence, resource efficiency, and adaptability, ensuring tobacco endgame is achieved.

The rapid spread of COVID 19 outbreak has put a heavy burden on human society and is a great challenge for health care workers. The present study aims to assess the perceptions of nursing personnel regarding challenges in usage of PPE during COVID 19 pandemic and to find out the association between severity of physical symptoms and selected personal variables of nursing personnel. A quantitative approach with descriptive survey research design was used for the study. Web based self-administered questionnaire, rating scale and checklist were developed and distributed among study participants in the “Google forms”. A total of 134 participants were included in the study. Out of the 134 participants, 85(63.4%) nursing personnel were working in the government sector and 49(36.6%) of nursing personnel were working in the private sector. The top five challenges in the usage of PPE ranked based on self-reported data were; 1. difficulty to meet the basic needs such as food and fluids, 2. difficulty to meet elimination needs, 3. Unable to relax, 4. difficulty to meet hygienic needs and 5. disconnected with friends and family during working hours. Analysis of physical symptoms experienced by the nursing personnel showed that 41(30.6%) had mild symptoms, 54(40.3%) had moderate symptoms and 39(29.1%) had severe symptoms experienced owing to PPE usage. The most common physical symptoms reported by nurses were heat stress 124(92.5%), head ache 120(89.6%), exhaustion 117(87.3%) and dryness in throat (86.6%). There were no significant association between physical symptoms of nursing personnel and selected personal variables at 0.05 level of significance.

<b>Background:</b> Onchocerciasis is a vector-borne neglected tropical disease (NTD) caused by the filarial worm <i>Onchocerca</i><i> volvulus</i>. Given the high morbidity and mortality, onchocerciasis control gained great attention from many stakeholders both nationally and internationally. However, there are still the need for further solidified commitments and compelling initiatives across concerned stakeholders including regional bodies in the fight toward controlling its burden and risks. Thus, this review briefly appraised the current understanding and dynamics in the control and eradication efforts of Onchocerciasis in Africa. <b>Methods:</b> A rapid scoping review was used for this paper. Key databases used for this study include Web of Science, Scopus, Science Direct, PubMed and Google Scholar to identify a series of relevant peer-reviewed publications. The search contained just English-language articles. In addition, African government websites and specialized organizations such as WHO, UNAIDS, CDC, etc. were accessed and reviewed to gather important data on national and international control programs, related documentation and consultative expert reports. <b>Results:</b> In Africa, long-standing strides toward the control and elimination measures for onchocerciasis were conducted for several decades. Between 1974 to 2002, OCP had actively led the control and containment efforts for onchocerciasis in the context of 11 West Africa. However, endemic regions and states have switched their policies from controlling to eradication, with the ultimate objective of preventing their territories from parasite spread. Some key challenges are the insufficient identification of all endemic areas, high prevalence of both onchocerciasis and loiasis, potential development of resistance to ivermectin, inconsistent initiatives to address cross-border problems, disagreements and social disturbance. Various challenges, however, impede current efforts to eradicate African onchocerciasis. <b>Conclusion</b>: In the last decades, extensive measures have been taken with specialized state programs, largely efficient in high endemic nations, to manage and control onchocerciasis in African regions. The implications of these and other difficulties at country level control programs must therefore be identified and country-specific contextual remedies used to expedite the elimination of onchocerciasis.