Frontiers in Public Health最新文献

Poisoning caused by pesticides is widely recognized as a major public health problem among smallholder farmers and rural communities, including in the Caribbean. However, a lack of quality data impedes understanding of the problem and hampers the development of effective strategies for its management. To better understand the prevalence of unintentional acute pesticide poisoning (UAPP) in Trinidad and Tobago and Jamaica and the pesticides and practices involved, we conducted a cross-sectional survey of 197 and 330 vegetable farmers in Trinidad and Jamaica, respectively. The findings from this study revealed a high incidence of self-reported health effects from occupational pesticide exposure, with 48 and 16% of respondents, respectively, experiencing symptoms of UAPP within the previous 12 months. Furthermore, the substantial proportion of UAPP incidents were associated with a few highly hazardous pesticides (HHPs), particularly lambda-cyhalothrin, acetamiprid, and profenofos in Jamaica, and alpha-cypermethrin, paraquat and lambda-cyhalothrin in Trinidad. Given the well-documented adverse effects of these chemicals on human health, the results of this study should be of significant concern to health authorities in Jamaica and Trinidad. This clearly indicates an urgent need for improved regulation and safer alternatives to the use of HHPs, as well as the promotion of alternatives. We provide policy recommendations and identify alternatives to HHPs for tropical vegetable production.

Background: Mental health professionals require exceptional communication skills and the ability to maintain an empathetic and authentic attitude within the therapeutic relationship. It is crucial that they achieve an optimal balance of physical, mental, and social wellbeing to enhance their performance in this context. This necessity has sparked a growing interest in promoting mental health among these professionals by focusing on the evaluation of both Positive Mental Health and the Sense of Humor.

Objective: To assess the level of sense of humor and positive mental health, and to analyse the relationships between the sense of humor construct, the positive mental health construct, and the sociodemographic, occupational, and educational characteristics of mental health professionals who care for patients in hospital and community settings.

Methods: An observational, descriptive, and cross-sectional with a non-experimental quantitative approach study has been carried out. The study was conducted involving 130 mental health care professionals. Levels of sense of humor and positive mental health were evaluated using authenticated questionnaires, while the relationship between these two constructs and the sociodemographic, occupational, and training characteristics of health workers were analyzed following STROBE guidelines.

Results: The study involved 130 professionals, predominantly women (71.5%), with an average age of 41.4 years. The majority were nurses (45.4%) with varied work experience and educational levels. Regarding the PMHQ questionnaire, an average score of 102.6 was achieved in the general evaluation, showing an insignificant relationship with sociodemographic and occupational variables. However, a significant trend regarding age and autonomy was noted. On the other hand, the Multidimensional Sense of Humor Questionnaire produced an average score of 67.3, also without significant correlations with the variables under scrutiny. Although no positive relationships were found between the general scores of Positive Mental Health Questionnaire and Multidimensional Sense of Humor Questionnaire, a positive correlation emerged between the use of humor and situational control. In summary, the findings suggest that the level of autonomy and the use of humor may be associated with specific sociodemographic and occupational characteristics, although the precise relationship remains complex and requires further research.

Background: Low back pain (LBP) is an increasing concern amongst medical students. There is a dearth of publications regarding how the occurrence of LBP impact medical trainees' career decisions.

Objective: To determine: (i) the point and annual prevalence of LBP amongst Ugandan medical students, (ii) its associated factors, and (iii) whether the experience of LBP during clinical rotations influence medical students' career choices regarding medical practice.

Methods: A multi-center cross-sectional study of 387 randomly selected clinical-phase students was conducted in three Ugandan medical schools, during 17th January to 10th March 2023. Proportions of participants with current and 12-months history of LBP were computed as well as odds for career prospects. We performed binary logistic regression models to determine factors associated with LBP at 95% confidence interval regarding p < 0.05 as statistically significant.

Results: The response rate was 100%. Participants' mean age was 24.7 ± 3.2 years of which 66.2% (256/387) were males. The point and annual prevalence of LBP was 52.5% (203/387) and 66.1% (256/387) respectively. Age [OR 1.23, 95% CI (1.03-1.47), p = 0.02], time spent sitting per day [OR 1.08, 95% CI (1.06-1.3), p < 0.01], perceived influence of LBP on future medical career [OR 4.75, 95% CI (1.87-12.06), p < 0.01] were the significant predictors of LBP. LBP interrupted the students' learning for at least 6.8 ± 12.8 h in 42.4% of participants. Nearly half of participants affirmed that their LBP experience would influence their career prospects. Based on their LBP experiences, trainees ruled out surgery 51.5% (172/334), obstetrics/gynecology 29.6% (99/334), paediatrics 18.3% (61/334), and internal medicine 17.7% (59/334) as their future career specialties. The proportion of trainees that would not consider surgical as opposed to medical disciplines were 81.1% vs. 36.0%, respectively, (p < 0.001).

Conclusion: The high prevalence of low back pain among medical students impacts their choices of future medical career with an aversion towards specialization in surgical disciplines. This has far-reaching implications on the disparities in specialist physician health workforce in Low-middle-income countries.

Aim: To explore the relationship of selected socio-demographic and occupational characteristics of nurses and their level of professional values, hospital ethical climate and job satisfaction.

Methods: Cross-sectional study was conducted among 388 Polish nurses from the spring of 2021 to winter of 2023, in the eastern part of Poland; and followed by Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Four research tools were used to collect data together with questionnaire for socio-demographic and occupational characteristics.

Results: Professional values such as activism correlate negatively with religious beliefs (Z = -1.789; p = 0.044), this means that nurses who are more involved in professional change activities are likely to be less associated with religious beliefs. A positive correlation was observed between the Ethical Hospital Climate Survey subscale-peer relations and nurses' education level (H = 5.638; p = 0.048), indicating that a higher education level was associated with better relationships with colleagues at work. A negative relationship was identified between nurses' external job satisfaction and their marital status (Z = -1.958; p = 0.040), that is, married nurses feel less satisfaction with the external aspects of their jobs than their single colleagues.

Discussion: These findings underscore that medical staff management should take into account both sociodemographic factors [e.g., age, education, place of residence, marital status, religious beliefs, as well as professional factors (working hours, qualification course, etc.)] that affect nurses' professional values, job satisfaction and the ethical climate of the hospital. These underscore the need to adapt management strategies to the individual needs of employees, which can contribute to improving working conditions in healthcare facilities.

Data collection tool: The data collection tool consists of four sections.

Demographics: Collected background and demographic information.

Nurses’ professional values scale npvs-3: Assessed professional values among nurses.

Hospital ethical climate survey hecs: Assessed hospital ethical climate among nurses.

Minnesota satisfaction questionnaire-short form msq-sf: Assessed job satisfaction levels among nurses.

[This retracts the article DOI: 10.3389/fpubh.2022.952901.].

Objective: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence and mortality, and self-management is a key component for better outcomes of COPD. Recently, nudging has shown promising potential in COPD management. In the present study, we conducted a systematic review to collate the list of nudges and identified the variables that influence nudging.

Methods: We undertook a systematic review. We employed database searches and snowballing. Data from selected studies were extracted. The risk of bias was assessed using the Cochrane Effective Practice and Organization of Care risk of bias tool. The study is registered with PROSPERO, CRD42023427051.

Results: We retrieved 4,022 studies from database searches and 38 studies were included. By snowballing, 5 additional studies were obtained. Nudges were classified into four types: social influence, gamification, reminder, and feedback. Medication adherence, inhalation technique, physical activity, smoking cessation, vaccination administration, exercise capacity, self-efficacy, pulmonary function, clinical symptoms, and quality of life were analyzed as targeted health behaviors and outcomes. We found medication adherence was significantly improved by reminders via mobile applications or text materials, as well as feedback based on devices. Additionally, reminders through text materials greatly enhance inhalation techniques and vaccination in patients.

Conclusion: This review demonstrates nudging can improve the health behaviors of patients with COPD and shows great potential for certain outcomes, particularly medication adherence, inhalation techniques, and vaccination. Additionally, the delivery modes, the patient characteristics, and the durations and seasons of interventions may influence the successful nudge-based intervention.

Clinical trial registration: This review has been registered in the international Prospective Registry of Systematic Evaluation (PROSPERO) database (identifier number CRD42023427051).

Objective: The results of epidemiological studies on the association between nickel exposure and diabetes remain controversial. Therefore, an update meta-analysis was conducted to examine the association between urinary nickel levels and diabetes risk, and to focus on whether there is an association between blood nickel levels and diabetes risk.

Methods: Relevant studies were comprehensively searched from PubMed, Web of Science, and Wanfang databases from their inception to July 2024. The random-effects model was utilized to determine pooled Standard Mean Difference (SMD) and 95% confidence intervals (CIs), with stratified and sensitivity analyses also performed. Heterogeneity between studies was assessed using I ² statistic, while publication bias was evaluated using Egger's and Begg's tests. The quality of the included studies was assessed using the Newcastle-Ottawa Scale.

Results: A total of 19 studies involving 46,071 participants were included in this meta-analysis. The random-effects model indicated that the pooled SMD for nickel exposure levels in diabetic patients and non-diabetic controls were 0.16 (95% CI 0.07-0.2) for urine and 0.03 (95% CI -0.20 to 0.27) for blood, respectively.

Conclusion: It was discovered that diabetes risk was positively correlated with urinary nickel levels, whereas there was no significant correlation with blood nickel levels. Furthermore, it appeared that the association between nickel exposure and diabetes risk differ in individuals with diabetes compared to those with pre-diabetes, and that the direction of the correlation may even be reversed. In conclusion, more high-quality prospective studies are needed in order to validate these findings in future research endeavors.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, registration number: CRD42024534139.

[This corrects the article DOI: 10.3389/fpubh.2024.1414631.].

Background: This scoping review aims to examine the extant literature and summarize findings related to barriers to accessing health care faced by older Chinese immigrants in Canada.

Methods: We conducted a search of electronic databases for peer-reviewed articles using a comprehensive set of keywords without limiting the search to a specific time period. To be included in our review, articles had to meet the following criteria: (a) published in a peer-reviewed journal, (b) written in English, (c) provide a clear description of the methods used, and (d) respond to our research question, which focuses on identifying barriers to accessing healthcare for older Chinese immigrants living in Canada.

Results: Fifteen papers were selected based on the criteria, and five main barriers were identified, which are ranked in descending order according to the number of times they were mentioned: culture and health beliefs (N = 13), language and communication (N = 7), structural and circumstances (N = 2), health literacy and information (N = 2), and demographic, social, and economic factors (N = 2).

Conclusions: The issue of accessing healthcare for older Chinese immigrants in Canada is complex, as it involves multiple aspects that are relevant to both patients and healthcare providers. Our research findings suggest that the culturally and linguistically sensitive education programs, inter-sectoral coordination, and social support should be improved for older Chinese immigrants and those of other ethnic backgrounds.

Introduction: Medication adherence contributes to poor HIV outcomes, especially among people with HIV and Substance use disorder (SUD). Mobile health applications have been leveraged to improve behavioral health outcomes among this population. Our cross-sectional study examined the relationship between medication adherence with factors such as treatment self-regulation, isolation, and internalized stigma, among people with HIV and SUD using the Addiction Comprehensive Health Enhancement Support System (A-CHESS) mobile app.

Methods: A sample of 208 participants using A-CHESS to improve treatment adherence completed a survey. Adherence was measured using the Four-item Morisky Medication Adherence Scale and dichotomized (maximum score of 20 points considered as adherent). Positive and negative affect was measured separately using Positive Affect Negative Affect Schedule and loneliness was measured using UCLA three-item Loneliness Scale. Internalized stigma was measured using Internalized AIDS-Related Stigma Scale. Competence/Treatment self-regulation was measured using Treatment Self-regulation Questionnaire. Multivariable logistic regression was used to assess the associations of affect, treatment self-regulation, isolation, and internalized stigma, with adherence to antiretroviral therapy adjusting for age, education, and gender.

Results: Among 208 participants in this study, most were Black (n = 137; 66%), male (n = 156; 75%) and had a mean age of 46 (standard deviation = 11.3). The most reported substances associated with missing HIV medication were alcohol (27%) and cocaine/crack (20%). Logistic regression analysis revealed that internalized stigma was significantly associated with HIV medication adherence (OR = 0.82; 95% CI: 0.70-0.99; p = 0.034).

Conclusion: Internalized stigma was significantly associated with HIV medication adherence. Further research is needed to better understand this relationship and develop interventions addressing stigma in people with HIV and SUD.