Frontiers in Public Health最新文献

Introduction: This study investigates how park morphology and built environments are associated with residents' physical activity in a suburban context, focusing on Seongnam City, South Korea. It further examines how these relationships differ between master-planned new towns and incrementally developed old towns, which reflect contrasting planning legacies and spatial structures.

Methods: Using high-resolution spatial data and geocoded survey responses from 577 residents, the analysis incorporates morphological indicators-including edge complexity and pedestrian connectivity-alongside physical activity data from the International Physical Activity Questionnaire. Binary logistic regression models were applied separately for old and new towns to examine associations between park morphology and physical activity, controlling for sociodemographic, health, and perceptual variables.

Results: The findings reveal marked spatial and behavioral inequities. Although old towns contain a larger total area of neighborhood parks, their location on steep slopes or at the urban fringe, combined with fragmented distribution of other park types, limits accessibility and routine use. Residents in old towns visit parks less frequently, rely more on vehicles for access, and report lower satisfaction with neighborhood and park environments. In contrast, new towns feature an interwoven green network with centrally located waterfront parks and evenly distributed small parks within residential superblocks, supporting higher accessibility, stronger user preference, and more frequent daily park use. In new towns, higher edge density and greater neighborhood park area were significantly associated with physical activity, corresponding to a 7% increase and tenfold higher odds of participation, respectively-associations not observed in old towns.

Discussion: These results underscore that green space equity extends beyond mere provision to include spatial integration and usability. Promoting health through urban green space requires context-sensitive planning strategies that ensure equitable access and functional design across different neighborhood contexts.

Background: Despite advanced healthcare infrastructure and supportive policy, low donor availability remains the major barrier to organ transplantation in the Kingdom of Saudi Arabia (KSA). Multiple interlinked and complex factors, including psychosocial, cultural, and religious factors, are believed to influence organ donation behavior. The current study explored public knowledge, attitudes, and behavioral intentions toward organ donation in KSA to inform targeted interventions.

Methods: A cross-sectional online survey grounded in the Theory of Planned Behavior was administered nationwide between June and December 2022. Eligible participants were KSA residents aged ≥16 years who could read Arabic and provided consent. A convenience sampling method was used to recruit participants; incomplete responses (<80% of items) were excluded. The instrument assessed knowledge, attitudes, subjective norms, perceived behavioral control, and willingness to register as an organ donor.

Results: Indecision about registering as an organ donor predominated across sociodemographic groups. Females reported higher willingness to register than males (10.4% vs. 8.7%) and lower refusal (10.2% vs. 13.6%), with a significant association (χ ² = 10.3, p = 0.006). Nationality was associated with willingness, with Saudi nationals showing higher willingness (χ ² = 13.8, p < 0.001). Occupation (χ ² = 20.3, p = 0.009) and income (χ ² = 17.3, p = 0.008) were also significantly associated with willingness, with non-working and some higher-income groups more often undecided. Overall, a favorable normative climate and substantial religious endorsement coexisted with gaps in specific knowledge and persistent ambivalence.

Conclusion: In KSA, supportive norms and religious approval are necessary but insufficient to translate positive attitudes into registration behavior. Reducing indecision will likely require sustained, targeted education that addresses misconceptions, clarifies the donation process, and leverages trusted religious and community channels.

Objective: To combat the harmful impacts of cardiovascular diseases (CVDs) on public health, it is crucial to understand the epidemiologic features and disease burden. The study aims to identify the trends of CVDs burden in youths aged 0-19 years from 1990 to 2021 across the global, Asian, and Chinese contexts to inform more effective strategies and actions.

Methods: The data from the Global Burden of Diseases and Risk Factors Study (GBD) 2021 were analyzed, stratified by sex, age, the socio-demographic index (SDI) regions, disease subtypes, respectively. We also employed the Auto-Regressive Integrated Moving Average (ARIMA) to predict the future burden of CVDs up to 2036.

Results: In 2021, DALY rate of CVDs among children and adolescents were 303.140 (268.480-343.800) globally, 268.730 (242.730-298.350) in Asia and 148.800 (126.510-173.620) in China. It exhibited significant declined trends from 1990 to 2021, with average annual percentage changes (AAPCs) of -2.447, -2.665, and -4.379, respectively (all p < 0.001). Compared with males, females had relatively higher prevalence of CVDs globally (797.060 vs. 791.140 per 100,000). Rheumatic heart disease served as the most prominent subtype across the world. Non-optimal temperatures emerged as the primary risk factor for CVDs-related disability-adjusted life years (DALYs). The CVDs incidence rate is predicted to rise to 108.861 per 100,000 globally, while the rate in Asia remains steady and decreases in China in 2036.

Conclusion: A substantial global burden of CVDs in youths aged 0-19 years remains the pressing public health issue in 2021. The burden of overall and type-specific CVDs varies by age, sex, SDI, regions and countries. Current and future challenges in CVDs prevention for youngsters implied by the epidemiologic features are highlighted in this study.

Background: Every child has the fundamental human right to life-saving healthcare, including vaccination. Yet in India, this right is less accessible to girls in households shaped by son preference, a deep-rooted cultural bias that devalues girl children. While immunization prevents millions of deaths each year, girls are less likely to be fully vaccinated-not due to biological need, but because of gender-based discrimination in the allocation of time and care within the home.

Materials and methods: Using nationally representative data from the National Family Health Survey-5 (NFHS-5; 2019-21), we analyzed a sample of 20,899 girls aged12-23 months. Full vaccination (BCG, three doses of DPT, three doses of polio, measles) was the outcome. Maternal son preference was the key exposure. We employed a four-stage generalized linear model (GLM) with a log link to estimate adjusted relative risks, progressively controlling for child, maternal, and household variables. Fairlie decomposition analysis was conducted to quantify the extent to which these characteristics explain the observed vaccination gap between girls and boys.

Results: Girls in son-preferring households had significantly lower vaccination rates (70.8% vs. 76.9%). The GLM showed a consistent negative association between son preference and vaccination across all models; however, it became non-significant (ARR: 0.99, 95% CI: 0.97-1.02) after full adjustment. Fairlie decomposition analysis revealed that 84% of this gap was statistically explained by factors such as birth order (21%), antenatal care (ANC) visits (29%), and household wealth (21%), which were the largest contributors. The remaining 16% was unexplained by unmeasured cultural norms.

Conclusion: Interventions should target girls of higher birth order, those in the poorest households, and those born to mothers with low education. Strategies could include leveraging antenatal care visits to deliver gender-sensitive health messaging and expanding the role of community health workers (CHWs) and Anganwadi teams for door-to-door monitoring. Closing the remaining 16% of the unexplained gap demands confronting cultural norms, ensuring that every child-regardless of birth order or family wealth-has an equal right to protection.

Background: Disaster coverage informs the public yet may expose victims at moments of extreme vulnerability. This study examined how televised rescue-moment broadcasting after the 6 February 2023 Turkey earthquake intersected with bioethical principles relevant to public health.

Methods: Using reflexive thematic analysis, we analyzed 60 rescue-moment videos from two national broadcasters (public and private). Focusing strictly on presented content, we coded ethically salient visuals and discourses (identity disclosure, medical interventions, and emotional framing) and developed themes through iterative reflection among researchers.

Results: Two overarching categories characterized coverage: (1) normalized discursive presentation-open identity disclosure, emotional dramatization, and routinized live "rescue shows"; and (2) privacy-insensitive visual content-unblurred faces, filming of medical interventions, and overt displays of trauma amid crowd convergence.

Conclusions: These practices often conflicted with privacy, dignity, and non-maleficence, underscoring the need for trauma-informed disaster communication.

Limitations: We analyzed content only, not journalists intentions or newsroom processes.

Implications: Findings inform ethical guidelines for disaster reporting and training programs integrating bioethics and journalism ethics.

Introduction: Individuals with lived experience of mental health conditions provide a unique perspective to mental health services. In this systematic review, a broad definition of 'involvement in mental health services' was used, which included peer support, peer mentors, and peer specialists. This review aimed to explore the barriers and facilitators reported to peer involvement in mental health services, to develop an understanding of the impact on the 'peer' and mental health care.

Method: Five bibliographic databases were systematically searched (inception to May 2024) for qualitative studies, to identify the barriers and facilitators of peer involvement in mental health services. Data were analysed using the COM-B (capabilities, opportunities, motivation, and behaviour) model and Theoretical Domains Framework (TDF) to provide a theoretical framework for understanding the behaviour of being involved in mental health services.

Results: The thirty-three studies included in this review provided data across all components of the COM-B model and eleven of the TDF domains. Barriers included the wider staff teams' lack of knowledge about the peer role, which impacted the peers' capability to be involved. The conflict between the professional peer role and identity impacted peers' motivation, positively and negatively, to remain involved. A lack of social support led to peers feeling stigmatised and excluded from the wider team. When peers felt supported, they could use their skills and lived experience knowledge to drive change in the system.

Discussion/conclusion: This review provides insight into the barriers and facilitating factors experienced by individuals in peer involvement roles within mental health services. The wider implications challenge the notion that peer involvement reduces stigma and discrimination. This review highlights that peer involvement can sometimes increase peers' experience of stigmatisation, specifically when involved in mental health services.

Background: Workers in physically demanding industries, such as the marble sector, are highly susceptible to low back pain. This study was conducted to determine the effect of the training given to the workers in a marble factory using different methods on knowledge and behavior for protecting low back health and low back pain level of the workers.

Methods: This non-randomized experimental study with a pre-test, post-test, follow-up, and control group design was conducted with 135 workers. The data were collected with the Low Back Health Protection Information Form, Manual Handling Observation Form, Visual Analog Scale (VAS). P < 0.05 was considered statistically significant in the study.

Results: Knowledge scores increased significantly in both intervention groups, with the highest effect observed in the interactive training + printed materials group (p < 0.001, η² = 0.66). Manual handling behavior scores improved more than doubled in this group (p < 0.001, η² = 0.92). Low back pain (VAS) scores decreased significantly in both intervention groups, with a larger reduction in the interactive training group (p < 0.001, η² = 0.60).

Conclusion: Interactive education is more effective in protecting the back health of workers, increasing the level of knowledge and behavior, and reducing low back pain compared to the use of printed materials alone. However, the use of printed materials also had a significant effect. Proper manual handling training for workers who lift heavy loads can reduce low back pain and increase knowledge and behaviors related to low back health.

Introduction: University students are at risk of experiencing health and mental challenges, including loneliness, insomnia, and poor physical health, which can negatively impact their life satisfaction. Understanding the mechanisms underlying these factors' association is essential for promoting students' well-being.

Methods: This is a cross-sectional survey-based study (from April to September 2024), involving 511 undergraduate students from several Saudi universities. We used validated measures of the General Health Scale, Satisfaction With Life Scale (SWLS), UCLA Loneliness Scale (ULS-8), and Athens Insomnia Scale (AIS). Sex differences were examined, and associations between loneliness, insomnia, physical health, and life satisfaction were analyzed using Pearson's correlation and mediation models.

Results: Our findings indicated that females reported significantly higher insomnia symptoms than males (p < 0.05). Life satisfaction was negatively correlated with loneliness, insomnia, and poor health (p < 0.001), while loneliness was positively associated with insomnia and poor health. Mediation analysis revealed that loneliness negatively contributes to life satisfaction both directly (β = -0.41) and indirectly through increased insomnia and poor physical health. Loneliness significantly reduces life satisfaction among university students, with insomnia and poor physical health partially mediating this relationship.

Discussion: Addressing sleep disturbances and promoting physical health may help attenuate the adverse effects of loneliness and improve student well-being. Additionally, the results underscore the significance of social support in mitigating loneliness. Implementing future interventions, such as regular face-to-face interactions with friends and family, would help reduce loneliness and enhance life satisfaction.

Background: Deep brain stimulation (DBS) is a viable treatment option for Parkinson's disease (PD) based on modulation of brain networks by electrical stimulation powered by implantable pulse generators (IPGs). Commercially available IPGs are either rechargeable (R) or non-rechargeable (NR). A budget impact analysis was developed to compare costs of the two options in PD-DBS patients, focusing on avoided battery replacements, associated complications, hospitalization rates.

Methods: The study was conducted in two phases: an observational, single-center, retrospective analysis from 2005 to 2023 of 94 PD-DBS patients, followed by a second phase in which the economic data obtained were used to build a budget impact analysis (BIA) comparing the two different options.

Results: Data from 47 PD-DBS patients with NR and 47 with R-IPGs were examined. BIA was calculated on a single patient with a 15-year and 25-year R-IPG. The higher initial cost of R devices compared with NR devices is offset by the absence of device replacements. This results in an estimated savings of €38,333 per patient with a 15-year R-IPG and €71,584 with a 25-year IPG.

Conclusions: BIA predicts that the cost savings with a long-lasting R-IPG up to 25 years is cost effective compared with NR, regardless of age and life expectancy.