Overweight and obesity are major public health challenges, requiring preventive efforts targeting diet, physical activity (PA), sedentary behaviour (SB) and sleep. Current research often treats these behaviours in isolation, ignores daily fluctuations and focuses on between-person differences. Studies examining the temporal covariance of these behaviours, assessing within-day and day-to-day variations in determinants and exploring how these time-varying determinants predict within-person variability in behaviours are needed. This paper aims to evaluate the feasibility of a measurement burst design with repeated intensive longitudinal assessments and to present patterns of behaviours and determinants. A 12-month observational study with a measurement burst design was conducted (January–December 2025). In total, 130 participants aged 55–75 years enrolled in the study, which consisted of four 7-day measurement bursts. Data collection included monitoring of diet, PA, SB, sleep and time-based ecological momentary assessment (EMA). Compliance rates, descriptive statistics per burst and across bursts were computed. 116 participants completed all bursts (retention rate = 89·2 %). Compliance rates ranged from 83·5 % for time-based EMA to 91·8 % for SB, supporting feasibility of the protocol. Mean values of 1692 kcal/day (sd = 565) for energy intake, 9·4 h/day (sd = 2·4) for sedentary time and 10 610 steps/day (sd = 6302) were observed. Mean daily light, moderate and vigorous PA-levels were 102·9 (sd = 37·4), 65·5 (sd = 43·4) and 11·5 (sd = 17·0) minutes, respectively. Mean sleep duration was 6·4 h/night (sd = 1·3), with a mean sleep efficiency of 79·2 % (sd = 10·2). This paper demonstrated the feasibility of integrating multiple assessment methods within a measurement burst design for studying health behaviours in adults aged 55–75 years and highlighted the value of analyses at more fine-grained temporal and individual levels.

How did health governance get internationalised, and with what effects? In the early nineteenth century, a range of transregional sanitary councils were responsible for mitigating the pandemic spread of diseases such as cholera. The International Sanitary Conferences, first convened in 1851, centralised this arrangement but also discriminated against non-European public health expertise. This article argues that this was a case neither of imperial power politics alone nor simply of functional problem-solving, but of the appropriation of pre-existing governance structures. The article singles out epistemic and institutional appropriation as crucial twin dynamics that shaped nineteenth-century health governance. Analysis of the 1866 and 1892 sanitary conferences shows how Europeans systematically disqualified non-European expertise: they constructed and prioritised cholera as an ‘Oriental’ threat to Europe, and repeatedly claimed the superiority of French and German over Ottoman, Persian, and Egyptian experts. Inversely, expert-based resistance to European policy proposals was nominally welcomed, but in practice sidelined whenever expert-based objections did not reproduce the dominant Eurocentric interpretation of public health. By showing how imperial and racial hierarchies actively obscured the transregional origins of health governance, the article innovates International Relations’ understanding of what internationalisation empirically looks like and contributes a novel account of appropriation as a key means by which hierarchical relations get built into international organisations.

Excessive sodium consumption is a major public health concern worldwide. In response, a few countries worldwide have implemented mandatory policies to reduce the sodium content of processed and ultra-processed foods. However, evidence on their potential impact on sodium intake remains limited, particularly among children. The aim of this study was to estimate the potential impact of mandatory maximum sodium content policies, varying in scope, on sodium intake among young children, with a specific focus on sodium derived from processed and ultra-processed foods. A two-step modelling approach was applied using dietary data from the 2018 National Survey on Child Development and Health. First, alternative policy scenarios were defined based on the Pan American Health Organization (PAHO) regional sodium targets, varying in their scope. Second, the potential impact of these scenarios on sodium intake was simulated among children aged 6–59 months. Baseline sodium intake from processed and ultra-processed products included in the PAHO targets averaged 673 mg/d and increased with age. Implementation of a comprehensive policy aligned with PAHO targets resulted in a statistically significant reduction in population-level sodium intake (–166 mg/d). Less stringent policies, prioritising subcategories that contributed the most to sodium intake, also led to statistically significant reductions (–148 mg/d and −137 mg/d for policies including subcategories contributing at least 1 and 3 % of children’s sodium intake, respectively). However, statistically significant reductions across all age subgroups were observed only when all PAHO subcategories were included. These findings highlight the potential of mandatory maximum sodium content policies to reduce sodium intake among children and underscore the importance of designing interventions that are closely aligned with population dietary patterns.

Between 1938 and 1941, nearly 20,000 Jewish refugees fleeing Nazi persecution arrived in wartime Shanghai, a city already destabilized by the Sino-Japanese War (1937-1945), mass displacement, and fragmented governance. Their arrival exposed the limits of Shanghai’s overstretched public health system while also generating new forms of medical organisation, refugee self-governance, and intercultural collaboration. Drawing on archival records, refugee memoirs, wartime newspapers, and medical journals, this article reconstructs the development of an improvised yet integrated refugee healthcare infrastructure between 1939 and 1945. The article argues that refugee medicine in Shanghai evolved beyond emergency relief into a broader regime of care comprising hospitals, nutrition programmes, sanitation campaigns, disease surveillance, and work-relief initiatives. Far from being passive recipients of humanitarian aid, refugee physicians became central actors in constructing and administering this system. In conditions of institutional fragmentation and material scarcity, they adapted European medical knowledge to unfamiliar climatic and epidemiological environments, collaborated with Chinese practitioners and local institutions, and contributed to new forms of medical knowledge production. The Shanghai case complicates conventional narratives of humanitarian governance and colonial medicine. Rather than operating under a centralised state or colonial authority, refugee healthcare emerged through negotiations among municipal authorities, international aid organisations, occupying military force, and Jewish communities. Wartime Shanghai thus became not merely a ‘port of last resort,’ but a significant site of transnational medical production in which displacement reshaped both medical practice and the meaning of care.

COVID-19 was the most recent pandemic to highlight profound ethnic inequities. However, most mathematical epidemiological models do not adequately represent these inequities, limiting the potential for such models to inform equitable public health responses and interventions. This systematic review identifies mathematical models of infectious respiratory disease transmission that report results by ethnic group and surveys the different mathematical modelling approaches used to attempt to capture ethnicity-related outcomes. Only 28 studies met the inclusion criteria, which is rare relative to the volume of infectious disease modelling literature. The most common model frameworks were compartmental models (11 studies), individual-based models (12 studies), and metapopulation models (5 studies). Across these studies, ethnic heterogeneities were represented directly by incorporating some combination of ethnic group population demographics, ethnicity-specific interaction patterns, and ethnicity-specific disease parameters, or indirectly through spatial differences in interaction patterns or disease transmission. Consideration of ethnicity in mathematical models of disease transmission is in its infancy, with only three of the studies published before 2020, but it has the potential to provide improved evidence for public health action that reduces the epidemic burden and inequities across ethnic groups.

Like tobacco, gambling is a risky, urge-driven lifestyle choice with serious health, social and economic consequences, while simultaneously representing a lucrative global industry shaped by powerful commercial interests. In 2024, the Lancet Public Health Commission on Gambling called for public health-motivated interventions in gambling activity, including prohibitions or restrictions on “ … access, promotion, marketing, and sponsorship.” As the first set of universal norms to govern a lifestyle risk, the Framework Convention on Tobacco Control (‘FCTC’) has set a benchmark for universal population-led public health norms that address the sale and supply of tobacco products. To investigate the potential for transposition of the FCTC’s model to gambling, this paper examines the critical strategies of tobacco control norms. It evaluates them against the features of gambling regulation, taking a first step towards examining the “fit” of the FCTC as a normative model for common, internationally agreed public health-motivated measures of gambling control. It finds that while some normative elements may be transferable from tobacco control, fundamental differences between the highly targeted interventions of tobacco law and the broader regulatory objectives of gambling control frameworks make a direct transposition of norms problematic.

Conflicts in the Middle East have intensified public health emergencies through progressive failure of water, sanitation, and hygiene (WASH) systems. This policy-oriented narrative review synthesizes peer-reviewed and humanitarian evidence published between January 2020 and March 2026 on WASH system failure and related public health consequences in Gaza and the occupied Palestinian territory, Yemen, Syria, Lebanon, and Iraq. Across these settings, four recurring mechanisms emerged: physical damage; loss of electricity, fuel, chemicals, and spare parts; restrictions on access and workforce safety; and governance, financing, and coordination failures. These mechanisms impaired water treatment and distribution, wastewater and waste management, and hygiene in health care facilities. The evidence documented plausible pathways connecting these failures to diarrheal illness, cholera, hepatitis A, environmental exposure, and weakened infection prevention and control, although disrupted surveillance limited causal attribution. The settings also showed distinct patterns, ranging from acute infrastructure damage in Gaza to protracted institutional attrition in Yemen and Syria, conflict spillover and economic stress in Lebanon, and episodic vulnerability in Iraq. The review advances a cross-setting failure-to-harm pathway and a phased preparedness framework. Immediate priorities are protecting WASH workers and assets, sustaining energy and critical inputs, and linking WASH indicators with health surveillance; medium-term recovery requires service restoration, workforce capacity, and coordinated financing; and long-term resilience requires decentralized, redundant, conflict-resilient systems.

The purpose of this qualitative study was to explore farmers’ attitudes and beliefs as members of local public health systems, using the socio-ecological model (SEM) as a guide for framing their identities. In-person, semi-structured interviews were conducted with 24 farmers between May and September of 2019. The interviews were recorded and averaged 40 min. The farms were located within a 100-mile radius of Dayton, Ohio. The interviews were completed on the farmers’ properties. Purposive and snowball sampling were used to select 24 farm owners and/or operators in Indiana and Ohio. The sample included eight farmers from each farming method: conventional, certified organic, and non-certified organic. Key themes discovered using the SEM included: farming and nutrition policy; community outreach and education; institutional healthcare partners; farmers’ knowledge, attitudes, and beliefs. Farmers shared how intrapersonal factors, including their own knowledge and attitudes, framed their perceptions of their ability to influence community food systems and nutrition education. Farmers defined their influence based on interactions in their community organizations and outreach programming. They also discussed how policies can affect their farming decisions. Farmers have innovative ideas about health, nutrition, and the future of community/public health. Healthcare professionals should consider farmers as part of the healthcare and food systems network. The ideas and suggestions gathered from farmers in the current study could be the beginning of partnerships and programs to help promote health in communities, especially rural locations.

This article examines public toilets in late Ottoman İstanbul as liminal spaces where urban governance, public health, and everyday life intersected. It argues that these sites functioned as arenas through which modern notions of hygiene, order, and civilization were articulated and contested. Drawing on archival documents, municipal records, and contemporary accounts, the study shows that while purpose-built public toilets began to emerge in limited numbers in the early twentieth century, urban sanitation largely relied on mosque latrines and other semi-public spaces, blurring the boundary between public and private. At the same time, sanitary interventions in bureaucratic buildings reveal how the modern toilet was imagined as a controlled, technical environment, even as persistent problems exposed the limits of this ideal. Taken together, these sites demonstrate that sanitation did not follow a linear trajectory of modernization but unfolded through technological experimentation, institutional frictions, and everyday practices shaped by concerns over smell, gender, and property value. By tracing how waste, infrastructure, and urban space were continuously negotiated, the article positions public toilets as critical nodes in the making of late Ottoman urban modernity.