Frequent consumption of aflatoxins-contaminated spices has been linked to serious adverse health effects among consumers. The likelihood of exposure to these toxins is influenced by the level of public awareness. Controlling aflatoxins contamination throughout the food chain is critical for public health. This study aimed to assess the handling practices and awareness of aflatoxin contamination among micro- and small-scale spice processors. A total of 60 processors from 4 districts of two regions of Tanzania were interviewed. The results showed that while 56.7% of interviewed processors were aware of aflatoxin contamination in spices primarily through training (38.3%) and mass media (30%). However, there were still misconceptions regarding the causes and effects of aflatoxins to human health. It was observed that, poor drying and storage practices, inadequate monitoring of processors aggravated the situation. Nonetheless, all interviewed processors expressed willingness to participate in training programs to ensure quality and safety along the chain. The study findings underscore the necessity for targeted interventions to reduce aflatoxin risks in the spice value chain. These should include strengthened food safety inspections and enforcement, as well as tailored training and support for micro and small-scale spice processors. Enhancing their knowledge and ability to adopt proper handling, drying and storage practices is critical for enhancing food safety and safeguarding public health.

Objective: To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature. Methodology: A structured review was conducted following PRISMA 2020 guidelines. Thirty-one peer-reviewed studies were selected through a targeted manual search based on predefined eligibility criteria. Included studies evaluated functional recovery following TKA using validated outcome measures such as the WOMAC, KSS, KOOS, IKDC, SF-36, and SANE. Data extraction focused on the instruments used, patient population characteristics, and reported outcomes. A descriptive synthesis was compiled in Table 1. Additionally, 15 studies with quantitative data were analyzed using a forest plot to illustrate risk ratios (RR) and 95% confidence intervals (CI) for functional improvement. Risk of bias was assessed qualitatively based on methodological rigor, clarity of reporting, and validation of the outcome tools. Results: All included studies reported improvements in functional status following TKA. Most risk ratios ranged from 0.66 to 0.85, indicating a consistent reduction in the risk of postoperative functional limitation. High-quality studies demonstrated more precise effect estimates and greater internal validity. The SANE scale emerged as a valid and practical tool with high responsiveness, including in its culturally adapted Brazilian version. Despite heterogeneity in study design, the direction of effect remained consistent across all included studies. Conclusion: Validated functional assessment tools are essential for monitoring recovery after total knee arthroplasty. Instruments such as WOMAC and SANE demonstrate strong clinical utility and psychometric validity. Their systematic use enhances outcome comparability, supports individualized rehabilitation planning, and improves decision-making in orthopedic care.

Background: Adolescent girls living in disaster-prone coastal regions of Bangladesh face heightened nutritional vulnerability due to limited food access, poor dietary diversity, and environmental stressors. Despite growing concerns about adolescent malnutrition, few studies have examined the combined influence of food security, dietary diversity, and age on nutritional outcomes in these settings. Objectives: This study aimed to assess the association between dietary diversity, food security, and age with the nutritional status of adolescent girls in coastal Bangladesh. Methods: A cross-sectional survey was conducted among 345 adolescent girls aged 10–19 in Chattogram and Cox’s Bazar. Data on dietary intake were collected using a 24-hour dietary recall and a food frequency questionnaire. Household food security was assessed using a validated scale. Nutritional status was determined using BMI-for-age classifications. Bivariate and multivariate analyses explored associations between dietary diversity, food security, age, and nutritional status. Results: Among participants, 10.14% were underweight, and 29.85% were either overweight or obese. While 17.39% demonstrated high dietary diversity (≥7 food groups), the majority had moderate diversity (5 or 6 food groups) (59.42%). Food-insecure households were significantly more likely to have overweight or obese adolescents (p < 0.05). Although dietary diversity was associated with BMI in bivariate analysis, it was not a significant predictor in the multivariate model. Age showed a significant relationship with both dietary diversity and nutritional status. Conclusion: The findings emphasize the importance of addressing household food security and age-related nutritional vulnerabilities in coastal areas. Interventions should prioritize age-sensitive, culturally appropriate strategies to improve dietary quality and prevent the double burden of malnutrition among adolescent girls.

Background: Scapulohumeral periarthritis commonly afflicts individuals in their middle age. Its etiology is multifaceted, and treatment presents a challenge with a high risk of recurrence. The main symptoms include shoulder pain and limited joint mobility, seriously affect the quality of life of the patients. Recent research indicate that acupuncture combined with bloodletting cupping can significantly improve the function of activity of shoulder joint and the pain in individuals with scapulohumeral periarthritis. However, these studies have typically been limited in scope, therefore additional research to substantiate the efficacy and safety of these intervention. Methods: To evaluate the efficacy of acupuncture combined with bloodletting cupping for treating patients with scapulohumeral periarthritis. We conducted an online search of databases in both Chinese and English, including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wangfang Data, China Science and Technology Journal Database (VIP) and Chinese BioMedical Literature Database (CBM), to collect randomized controlled trials (RCTs) concerning the use of acupuncture combined with bloodletting cupping in scapulohumeral periarthritis patients. We also examined the references within the identified literature. Search utilised subject headings and free-text terms in both languages, without racial restrictions, for records up to April 3, 2024. Two researchers independently screened the literature, extracted data, and evaluated their qualities. RevMan 5.3 software was used for meta-analysis of the included studies. The protocol of this review was recorded in the International Platform of Registered Systematic Review and Meta-analysis Protocols (PROSPERO). Its registration number is CRD42023454614. Results: This review incorporated 22 RCTs involving a total of 1,774 patients. The results of meta-analysis showed that the clinical effective rate (RR=1.25, 95%CI [1.20, 1.30], P＜0.00001) of treating scapulohumeral periarthritis with acupuncture combined with bloodletting cupping was higher in the experimental group than in the control group. The all of Visual Analogue Scale (VAS) score (MD=-1.70, 95% CI [-2.17, -1.22], P＜0.00001). Melle score (SMD=-2.45, 95% CI [-2.55, -2.34], P=0.007]) and recurrence rate (RR=0.23, 95% CI [0.07, 0.77], P=0.02) were lower in the experimental group than in the control group with statistical significance (P<0.05). Conclusion: The acupuncture combined with bloodletting cupping for the treatment of shoulder impingement syndrome demonstrates definite efficacy and safety, with superior clinical effectiveness, pain relief, improvement in shoulder joint mobility, and reduction in recurrence compared to acupuncture alone. Therefore, it is worthy of being promoted and applied clinically.

Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ Diminished Returns (MDRs) posits that structural racism, segregation, and labor market discrimination limit the benefits of socioeconomic resources, such as education, for Black and Latino individuals. This suggests that the effects of education on maternity leave may not be uniform across racial and ethnic groups. Objective: This study aimed to examine the MDRs of education on access to unpaid and paid maternity leave among Black and Latino mothers compared to White mothers giving birth while living in poverty. Methods: We utilized baseline data from the Baby’s First Years Study (BFY), a longitudinal investigation of the effects of poverty on child development. The sample consisted of 1,050 mothers living in poverty who had recently given birth. Maternity leave (paid and unpaid) was assessed via self-report, and educational attainment was measured in years of schooling. Structural equation modeling (SEM) and interaction terms were employed to analyze racial and ethnic differences in the relationship between education and access to maternity leave. Results: Educational attainment was positively associated with access to unpaid maternity leave for the overall sample of mothers giving birth in poverty, but this association was weaker for Black and Latino mothers compared to non-Latino White mothers. Education did not significantly increase the likelihood of paid maternity leave, and there were no group differences for this association. Conclusion: This study highlights the urgent needs to address structural racism, labor market discrimination, and residential segregation that diminish the impact of education on living conditions for Black and Latino mothers, compared to non-Latino White mothers, even for those living under poverty. Policymakers and practitioners should develop targeted interventions to reduce racial and ethnic disparities in access to paid and unpaid maternity leave and other critical resources, particularly for new mothers living in poverty. Addressing these inequities is essential for improving maternal and newborn health outcomes and promoting social justice.

Silver nanoparticles (Ag⁺NPs) contamination in the environment is a serious concern. This study investigated selected heavy metal (Ag⁺, Cd^2+, Cr²⁺ and Pb²⁺) concentrations at different sampling points to assess the risk to human health (infants, children, and adults). To do this, an enclosed area (laboratory) of 12.6 m X 8.5 m (107.1 m²) was clearly marked at different coded distances of S1, S2, S3, and S4 representing 2, 4, 6, and 8 m, while unpolluted atmosphere at 50 m away without Ag⁺NPs served as the control (S5). The silver fireworks were allowed to burn for an approximate 00h03m30s at each sampling points using a high-volume air sampler mounted at the Environmental Engineering Departmental Laboratory, Rivers State University, with windows and doors closed to simulate indoor conditions. Samples were digested using a mixture of analytical-grade nitric acid, analytical-grade hydrochloric acid and analyzed to evaluate the levels of heavy metals by atomic absorption spectrophotometry. The Ag⁺ result at S1 shows 30,000 µg/cm³, S2 was 29,000 µg/cm³, while S3 was 28000 µg/cm³ and then S4 was 13,000 µg/cm³. These results exceeded the permissible values of the United States National Ambient Air Concentration for rural, urban and industrial areas (0.0005, 0.004 and 0.6 µg/cm³, respectively). The result for the control (S5) (0.037 µg/cm³) was within the maximum allowable value. Results from other heavy metals such as Cd were 1000, 743, 401, 153, 0.001 µg/cm³, Cr was 5000, 4000, 3729, 2960, 0.002 µg/cm³, Pb was 0.048, 0.041, 0.035, 0.034 and 0.01, µg/cm³, respectively. However, higher values of Ag⁺, Cd, and Cr indicated a higher propensity for the metals to be toxic (bioavailable). In addition, the assessment of the potential health risk posed by these metals proved contaminated and harmful. Visitors recorded high values in exposure concentration (EC) and low values in average daily dose (ADD).

Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. Results and Discussion: Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. Conclusion: The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. Implications: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.

Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, and nativity groups. The theory of Minorities’ Diminished Returns (MDRs) suggests that the positive effects of education on outcomes such as income and financial security are weaker for marginalized groups, including Black individuals, Latinos, and immigrants. Objective: This study examines the diminished returns of education on financial well-being among Black, Latino, and immigrant populations in the United States. We aim to investigate how structural inequalities contribute to weaker financial returns on education for these groups compared to their White and native-born counterparts. Methods: We utilized data from the Understanding America Study (UAS 2014) to conduct a cross-sectional analysis of adult respondents. The study assessed financial well-being outcomes (e.g., income, savings, and financial security) and their association with educational attainment across racial, ethnic, and nativity groups. Regression models were employed to test for interaction effects between education and race/ethnicity/nativity, adjusting for sociodemographic factors such as age, gender, employment, and family structure. Results: Our analysis included 8,121 individuals. The mean age of the respondents was 48 years (SD = 16). High education was associated with higher financial well-being (B = 1.284, 95% CI: 1.157, 1.410). The interaction terms between education and immigrant status (B = -0.507, 95% CI: -0.930, -0.084), race (Black) (B = -0.770, 95% CI: -1.208, -0.331), and ethnicity (Hispanic) (B = -0.589, 95% CI: -0.969, -0.210) were all significant, suggesting that immigrant, Black, and Hispanic individuals experience diminished returns on education in terms of financial well-being, relative to US-born non-Hispanic White individuals. The significant negative interactions between education and minority statuses (Black, Hispanic, and immigrant) indicate that while education generally improves financial well-being, the magnitude of this improvement is substantially smaller for these marginalized groups. Conclusion: Understanding how education translates to financial well-being across different racial, ethnic, and nativity groups is critical for addressing persistent financial disparities.

This article focuses on primary liver cancer and tries to present a possible CBT-Cognitive Behavioral Therapy group intervention of 6 sessions and a follow up based on a scientific review. We present an international national data analyze of the problem and characterize it in terms of symptoms, diagnosis and treatment. From the psychological point of view our goal is to show and reflect on the connection between theory and practice in research mental health and the quality of life of people suffering from liver cancer. CBT interventions programme have shown efficacy and effectiveness on improving quality of life of patients. The expected outcomes of CBT intervention are mainly a better adaptation to cancer and a better perception on quality of live.

1) Background: Culture shock is a common experience by internationally educated nurses (IENs) working in foreign countries, characterized by disorientation and discomfort due to distinct norms, values, and rituals. 2) Aim: this study explores culture shock in IENs and explores mitigation techniques to enhance understanding of challenges faced in foreign cultural contexts. 3) Method: Using Concept Analysis by Walker and Avant (2019). 4) Results: A total of 20 articles were reviewed. Four major attributes were identified: psychological and emotional impact, communication barriers, acculturation and quality of life, and organizational challenges. 5) Conclusion: This paper explores the challenges faced by nurses from foreign countries due to cultural adjustment and proposes solutions to minimize its effects. It is beneficial for nurses, healthcare organizations, and policymakers, aiming to improve patient care and health outcomes. 6) Implication for Practice: Addressing culture shock can promote a smooth transition, enhance nurses' experience, and improve their cultural competence. Providing tailored orientation and mentorship programs can help IENs feel supported and empowered, leading to increased job satisfaction, retention rates, and better patient outcomes.

Breast cancer is the most prevalent cancer in women worldwide, with approximately two million new cases every year. The number of cases increases despite the high survival rate. The aim of this study is, therefore, to understand this cancer by finding out what has been studied in this area using scientific evidence published between 2003 and 2023. A search was therefore carried out for scientific articles and other relevant sources on the subject with free access, and 48 documents were then analyzed. According to the analysis, many studies have been conducted in the area, particularly on quality of life and body image. However, little has been done in terms of environmental sustainability and breast cancer.

The banana (Musa spp.) is a tropical fruit with excellent sensory characteristics in terms of aroma, flavor and texture, consumed worldwide and exploited in most tropical countries. Green banana flour is rich in flavonoids, which protect the gastric mucosa, has a high content of resistant starch, which acts in the body as a dietary fiber and thus has health benefits, and is an alternative option for bakery products, reducing waste of both the peel and the pulp. The aim of this study was to develop bread formulations with partial substitution of wheat flour with green banana flour (FBV), thus increasing the nutritional, technological and sensory value. 4 formulations, (A), standard sample; (B), bread with 10% FBV; (C), bread with 15% FBV and (D), bread with 20% FBV. Physico-chemical quality was assessed in terms of moisture content by drying at 105ºC, ash by incineration, fat by the Soxhlet method, protein by the biuret method, carbohydrates by difference calculation and calorific value by sum calculation and sensory analysis by affective methods. The data was evaluated using the RStudio 4.2.1 DCC statistical package. There were no significant differences in moisture content, lipids and calorific value. Differences were evident in the ash and protein content. Sensory acceptance of the standard formulation was 82.22%. The results obtained show that green banana flour can be used as a partial substitute for wheat flour to produce breads with functional properties.

The quality of communication between healthcare providers and pregnant women is a topic of paramount importance within the realm of maternal healthcare. It is not merely an aspect of medical interaction; rather, it is the prerequisite that influences various critical dimensions of maternal care, including maternal satisfaction, health outcomes, and shared decision-making. Effective communication between healthcare providers and pregnant women is essential for optimal maternal care during pregnancy and childbirth. Maternal satisfaction is a fundamental metric of patient-centered care, and improved communication, characterized by empathy, information sharing, and active listening, cultivates trust and enhances women's contentment with their care experiences. Positive provider-patient interactions are associated with improved emotional well-being, reduced stress levels, and increased adherence to prenatal recommendations, contributing to positive health outcomes for both mother and fetus. Shared decision-making is impacted by open and transparent dialogue between healthcare providers and pregnant women. Inclusive discussions about available interventions, risks, and benefits empower women to make informed choices aligned with their preferences and values. This shared decision-making promotes autonomy, self-efficacy, and a collaborative care partnership, potentially influencing the birthing experience and postpartum adaptation. However, challenges persist in communication quality, such as variability in healthcare provider communication styles, cultural considerations, and system-level factors. Addressing these challenges through targeted interventions, training, and policy implementation can further enhance the overall maternal care experience. Further research is needed to explore innovative strategies that optimize communication and promote positive outcomes throughout the continuum of maternal care.

The accurate estimation of Individual Wave Components (IWC) is crucial for automated diagnosis of the human digestive system in a clinical setting. However, this process can be challenging due to signal contamination by other signal sources in the body, such as the lungs and heart, as well as environmental noise. To address this issue, various denoising techniques are commonly employed in bowel sound signal processing. While denoising is important, it can increase computational complexity, making it challenging for portable devices. Therefore, signal processing algorithms often require a trade-off between fidelity and computational complexity. This study aims to evaluate an IWC parameter extraction algorithm that was previously developed and reconstruct the IWC without denoising using synthetic and clinical data. To that end, the role of a reliable model in creating synthetic data is paramount. The rigorous testing of the algorithm is limited by the availability of quality and quantity recorded data. To overcome this challenge, a mathematical model has been proposed to generate synthetic bowel sound data that can be used to test new algorithms. The proposed algorithm’s robust performance is evaluated using both synthetic and clinically recorded data. We perform time-frequency analysis of original and reconstructed bowel sound signals in various digestive system states and characterize the performance using Monte Carlo simulation when denoising is not applied. Overall, our study presents a promising algorithm for accurate IWC estimation that can be useful for predicting anomalies in the digestive system.

Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A cross-sectional study was conducted in the University Hospital, where a total of 52 health record officers were purposively sampled. Relevant data were collected using the Short Form survey (SF-36v2) questionnaire. One-way ANOVA was used to determine mean group differences across the nine and the two QoL (physical and mental) summary domains based on respondents’ socio-demographics, while level of significance was set at 0.05. Results: All the QoL sections of the instrument used yielded an α-Cronbach’s score of > 0.70. Analysis of some QoL physical component dimensions showed that; Bodily pain (BP) was found to be significantly (P=0.032) associated with marital status, Physical functioning (PF) with gender (P=0.023), and general health (GH) with age group (P=00.025) and highest level of education (P=0.023). On the other hand, mental health component analysis revealed that Social Functioning (SF) was associated with age group (P=014), Role limitation (RE) with marital status (P=0.048), highest level of education (P=0.048) and years of service (P=0.015) etc. Conclusion: The QoL among HROs studied was generally above average, and demographic characteristics such as age, gender and marital status significantly influence QoL. Health managers and stakeholders should consider some of the factors identified in managing HROs.

Background: The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care during the pandemic is needed but lacking. Methods: We systematically searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL for studies on telehealth for osteoporosis published between January 2021 and March 2023. Five studies met the inclusion criteria of: osteoporosis population, telehealth intervention, and COVID-19 pandemic timeframe. Data was extracted on study characteristics, COVID-19 outcomes, osteoporosis status, telehealth purpose, patient satisfaction, and clinical outcomes. Result: The five studies showed telehealth was used for monitoring data, delivering test results, adjusting medications, and assessments. Osteoporosis prevalence among telehealth users ranged 30-100%. High patient satisfaction was reported with telehealth versus in-person care. No major differences occurred in medication delays or fractures between telehealth and in-person groups. Conclusion: This review found telehealth enables effective osteoporosis care and monitoring during the pandemic, with high patient and provider satisfaction. However, more robust randomized controlled trials are needed to establish stronger evidence around telehealth's impacts on clinical osteoporosis outcomes. Implications: Though promising, further high-quality studies will help clarify telehealth's role in improving osteoporosis care and outcomes. Findings inform guidelines on integrating telehealth into routine management. Evidence on user perspectives optimizes telehealth implementation policies.

Background: Oncology nurse navigators (ONNs) are becoming even more vital as healthcare continues to develop into a more complicated, confusing maze for patients. When many specialists on the treatment team have divergent points of view due to the nature of their respective professions or other factors, the patient may experience feelings of confusion. In the end, this can cause delays in treatment, pose a threat to the established standard of care, and lead to a decrease in patient satisfaction. Aim: To enumerate various ways in which ONNs may help improve the quality of life of cancer patients. Design: An integrative review. Results: A total of 19 studies related to the topic are evaluated. Four main themes namely: provider of psychological support, facilitator of timely care, oncology nurse navigators perception of their role and patient’s perception of oncology nurse navigators and 3 sub themes which are: information giver, source of emotional support and coordinator, were identified to be the roles of the ONNs. The findings showed that oncology nurse navigators help reduce patients anxiety and distress, increase patient satisfaction, shorten the time from diagnosis to treatment, provide necessary information, support them emotionally and coordinate their care with the different members of the healthcare team and resources. Conclusion: The main function of the ONNs is to address any barrier that may hinder the patient’s cancer treatment, survivorship and even palliative care. ONNs make sure that each patient has individualized nursing care according to the patients and their families' needs. Implications for Practice: ONNs have the potential to significantly contribute not only to the quality of life of cancer patients but also to the process of achieving better service integration. The result of this integrative review contributes to the growth of the healthcare system by improving accessibility, fairness, efficiency, effectiveness, and the ability to maintain health services throughout time brought about by ONNs.

The government of Mexico City carried out the introduction of palm trees in the 50s to increase the visual appearance of the main avenues. As a result of introduction of these exotic species, phytosanitary problems appeared. Currently there is scarce information on how to evaluate the health of these majestic monocots, in this sense, it is necessary to implement assessment scales to determine the health condition of the most frequently found species to advance on their care and management. The present study had the following objectives: 1) To determine the current state of health of palm trees by means of a scale of visual evaluation of the crown; 2) To know the diversity and structural characteristics of palm trees and 3) To determine the influence of composite variables on the ecosystem services such as the amount of shade provided. Health of palm trees were evaluated two times (dry and rainy seasons in 2022) on 35 transects of 200 m length. An imaginary circle divided into twelfths was overlapped on palm tree “crowns”, and through it, two absolute variables, Live Crown Ratio (LCR) and Crown Quality (CQ) were evaluated. Composite variables were also calculated. The 12/12 health scale adapted in the present study was useful. Four health categories were obtained for the Live crown ratio (LCR): 7.62% of the palm trees were in critical condition, 7.80% were in intermediate condition, 80.36% were in normal condition, and 4.20% were in excellent condition. Meanwhile, for crown quality (CQ), the percentages were 13.50%, 20.00%, 56.96% and 0.43%, respectively. The total height and “crown” diameter showed a positive correlation with the volume composite variables. The shadow area projected as an important ecosystem service increased as the health of the palm trees improved. This is the first study on palm trees health assessment in Mexico City.

Along with the increasing quality of human life, people pay more attention to healthcare. Public health and one's health have become daily issues. As a branch of communication, more and more scholars pay attention to health communication studies. Supported by the Healthy China Initiative, health communication study has ushered in a new development opportunity. This paper elaborates on the specific practices of health communication in a provincial hospital from three dimensions: (1) how to empower communication with the Healthy China Initiative; (2) the effects of health communication; (3) health communication strategy analysis.