Frontiers in Public Health最新文献

Background: Drowning is a leading cause of death among young children. The United Nations Resolution on global drowning prevention (2021) and World Health Assembly Resolution in 2023 have drawn attention to the issue. This scoping review synthesizes the current evidence on the effectiveness of child drowning prevention interventions since the 2008 World Report on Child Injury Prevention and implications for their implementation.

Methods: Quantitative studies published between 2008 and 2023 focusing on interventions targeting unintentional injuries, including drowning, among children and adolescents under age 20 years were searched on Cochrane Database of Systematic Reviews, Epistemonikos, PubMed, and Embase. Relevant data on interventions were extracted using a pre-defined template on Microsoft Excel. This scoping review focuses on the interventions addressing drowning.

Results: Overall, 12 studies fulfilled the inclusion criteria. Evidence generated between 2008 and 2023 support the effectiveness of introducing barriers around water bodies, immediate resuscitation and first-responder training, and use of personal floatation devices (PFDs). Basic swimming and water safety skills training for children ages 6 years and older, and enacting and enforcing regulations on pool fencing and PFD use were found to be promising based on new evidence published since 2008. This scoping review also found evidence on new interventions studied since 2008, such as close adult supervision, inspections of safety standards of pools, and the use of door barriers and playpens, all of which demand further research to ensure context-specific implementation in LMICs.

Conclusion: While there is evidence to support both existing and new interventions, most of the available interventions are still classified as promising and emerging, underlining the need for further evaluation of those interventions in diverse settings (including low and middle- income) through effectiveness studies and implementation research. In addition, it is important to highlight the nexus between drowning prevention and the Sustainable Development Goals to advocate multisectoral and interdisciplinary collaboration, to influence the broader child health agenda.

Research typically promotes two types of outcomes (inventions and discoveries), which induce a virtuous cycle: something suspected or desired (not previously demonstrated) may become known or feasible once a new tool or procedure is invented and, later, the use of this invention may discover new knowledge. Research also promotes the opposite sequence-from new knowledge to new inventions. This bidirectional process is observed in geo-referenced epidemiology-a field that relates to but may also differ from spatial epidemiology. Geo-epidemiology encompasses several theories and technologies that promote inter/transdisciplinary knowledge integration, education, and research in population health. Based on visual examples derived from geo-referenced studies on epidemics and epizootics, this report demonstrates that this field may extract more (geographically related) information than simple spatial analyses, which then supports more effective and/or less costly interventions. Actual (not simulated) bio-geo-temporal interactions (never captured before the emergence of technologies that analyze geo-referenced data, such as geographical information systems) can now address research questions that relate to several fields, such as Network Theory. Thus, a new opportunity arises before us, which exceeds research: it also demands knowledge integration across disciplines as well as novel educational programs which, to be biomedically and socially justified, should demonstrate cost-effectiveness. Grounded on many bio-temporal-georeferenced examples, this report reviews the literature that supports this hypothesis: novel educational programs that focus on geo-referenced epidemic data may help generate cost-effective policies that prevent or control disease dissemination.

[This corrects the article DOI: 10.3389/fpubh.2023.1231550.].

Introduction: Environmental pollution and health issues are hot topics of discussion in modern society. However, there is a lack of research from the perspective of subjective factors such as environmental protection to study the impact of environmental literacy on health, especially in rural areas.

Methods: First, through field research in the mountainous rural areas of Sichuan Province, 396 data points were collected. Based on the KAP model, we constructed an interactive impact mechanism model for the health of rural residents. We used chi-square tests and t-tests to examine the relationship between the background characteristics of rural residents and environmental protection. All environmental literacy variables were classified into strong and weak observational variables, and a multiple linear regression model was employed to explore the impact mechanism of environmental literacy (divided into environmental protection awareness, attitudes, behaviors, and perceptions of environmental pollution) on the health of rural residents.

Results and discussion: (1) Young village officials with higher education levels are more likely to have stronger environmental literacy. (2) The health status of rural residents is positively affected by their positive attitude towards environmental protection and negatively affected by their environmental protection behaviors. (3) Age, gender, marital status, and party membership have a significant impact on the health of rural residents. The results of this study can enhance the attention to the living environment and health in rural areas, and provide a scientific basis for improving the environmental literacy and health level of rural residents.

Background: Periviable infants are a highly vulnerable neonatal group, and their survival rates are considerably affected by patient-, caregiver-, and institution-level factors, exhibiting wide variability across different income countries and time periods. This study aims to systematically review the literature on the survival rates of periviable infants and compare rates among countries with varied income levels and across different time periods.

Methods: Comprehensive searches were conducted across MEDLINE, Embase, CENTRAL, and Web of Science. Cohort studies reporting survival outcomes by gestational age (GA) for periviable infants born between 22 + 0 and 25 + 6 weeks of gestation were considered. Paired reviewers independently extracted data and assessed the risk of bias and quality of evidence. Data pooling was achieved using random-effects meta-analyses.

Results: Sixty-nine studies from 25 countries were included, covering 56,526 live births and 59,104 neonatal intensive care unit (NICU) admissions. Survival rates for infants born between 22 and 25 weeks of GA ranged from 7% (95% CI 5-10; 22 studies, n = 5,658; low certainty) to 68% (95% CI 63-72; 35 studies, n = 21,897; low certainty) when calculated using live births as the denominator, and from 30% (95% CI 25-36; 31 studies, n = 3,991; very low certainty) to 74% (95% CI 70-77; 48 studies, n = 17,664, very low certainty) for those admitted to NICUs. The survival rates improved over the two decades studied; however, stark contrasts were evident across countries with varying income levels.

Conclusion: Although the survival rates for periviable infants have improved over the past two decades, substantial disparities persist across different economic settings, highlighting global inequalities in perinatal health. Continued research and collaborative efforts are imperative to further improve the global survival and long-term outcomes of periviable infants, especially those in Low- and Middle-Income Countries.

Systematic review registration: PROSPERO, CRD42022376367, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022376367.

Background: Cognitive impairment is a major public health concern in aging societies. This study aimed to investigate the prevalence of cognitive impairment and its associated factors among Chinese adults aged 60 years and older using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS).

Methods: Utilizing data from the 2018 wave of CHARLS, we assessed participants' cognitive status using the Mini-Mental State Examination (MMSE), and the influencing factors related to cognitive impairment were analyzed by using the chi-square test and multifactor logistic regression. The prevalence of cognitive impairment was stratified by gender, education level, residence, marital status, daytime napping, and nighttime sleep duration, and the trend of cognitive impairment prevalence with age was observed.

Results: 9,804 participants were finally included in the study and the overall prevalence of cognitive impairment was 44.04% (95%CI, 43.02-45.06%). The prevalence was significantly higher in females (50.8%) than males (37.1%), and increased with age, from 41.5% in those aged 60-64 years to 57.7% in those aged ≥75 years. Lower educational level, rural residence, and being divorced/ widowed/unmarried were associated with a higher prevalence of cognitive impairment (all p < 0.001). Multifactor logistic regression indicated that older age (OR = 1.51, 95%CI, 1.33-1.73 for ≥75 vs. 60-64 years), female gender (OR = 1.54, 95%CI, 1.35-1.77), higher education (OR = 0.46, 95%CI, 0.42-0.51 for primary school and below vs. illiteracy), rural areas (OR = 2.35, 95%CI, 2.07-2.65 for village vs. the center of city/town), divorced/ widowed/unmarried status (OR = 1.40, 95%CI, 1.25-1.57) and participation in physical activity (OR = 0.80, 95%CI, 0.73-0.87) were significantly associated with cognitive impairment.

Conclusion: Cognitive impairment is highly prevalent among older adults in China with substantial demographic disparities. Targeted interventions and public health strategies are needed to promote cognitive health in this rapidly aging population.

Background: The increase in the dual burden of HIV and cardiovascular diseases (CVD), calls for the provision of integrated HIV/CVD care. This study aimed to explore barriers and facilitators to the integration of HIV/CVD care within HIV care and treatment clinics (CTCs) in urban, Tanzania.

Methods: Between March and April 2023, we conducted 12 key informant interviews with healthcare providers at six HIV CTCs in urban, Tanzania. Guided by the Consolidated Framework for Implementation Research (CFIR 1.0), we designed the interview guide and conducted a thematic analysis.

Results: Out of the 11 CFIR constructs explored, three were barriers (cost, availability of resources, and access to information and knowledge), six were facilitators (complexity, relative advantage, patient needs, external policies and incentives, relative priority, and knowledge and belief about the intervention), and two (compatibility and self-efficacy) were both barriers and facilitators. Barriers to integration included a lack of equipment, such as BP machines, lack of space, unavailability of an electronic data-capturing tool at the HIV CTCs for monitoring CVD outcomes, and a shortage of trained healthcare workers, particularly in managing CVD comorbidities according to current recommendations. Providers acknowledged the increasing demand for CVD care among ALHIV and regarded integration as not a complex task. Providers reported that both services could be delivered simultaneously without disrupting client workflow and were determined to offer integrated care within HIV CTCs. Providers expressed concerns about medication costs and recommended that medications should be provided for free as part of the integrated care.

Conclusion: Effective and sustainable HIV/CVD integrated care requires an understating of the existing barriers and facilitators within the HIV CTCs. This study identifies key barriers at HIV CTCs that must be addressed and facilitators to be leveraged before CVD care is integrated into HIV CTCs to ensure that CVD care is delivered effectively within an integrated system.

Introduction: Research-practice-policy partnerships are shifting the academic research paradigm toward collaboration and research-informed action at community and policy levels. In this case study, researchers partnered with philanthropic foundations to actualize data findings from a rigorous, longitudinal study.

Context: In 2016, a survey of post-9/11 military veterans began assessing veterans' well-being in key domains: health, vocation (education and employment), finances, and social relationships. Data were collected from 9,566 veterans with three study aims: document factors affecting well-being, describe the use of transition-assistance programs and distill them into common components, and identify components associated with positive changes in veterans' well-being.

Partnership formation and priorities: The study evolved into a partnership among an academic applied research center and philanthropic funders to disseminate survey findings, investigate additional research questions of practical application, and help ensure public and private funds are invested in evidence-informed programs and services that support veterans' well-being. Four RPP partnership goals were identified.

Mechanisms and actions: Goal 1 included survey expansion to capture data on emerging concerns (e.g., COVID-19 impacts, educational experiences, burn pit exposure, civic engagement, social-media use). This resulted in eight waves of data collection over 6.5 years. Goal 2 involved co-interpretation of data to define successful military-to-civilian transition (MCT) and strategic communications to engage national leaders in policy change for veterans. Goal 3 focused on evaluation support of partners' organizational portfolios and programs, which resulted in new tools such as an online screener that veteran-serving providers could use to identify veterans' MCT risks and respond with tailored, research-informed resources and program components. Goal 4 allowed for the application of research findings with an innovative model for using longitudinal study variables within robust comparison analyses to assess partners' program components; propensity matching demonstrated that effective component use leads to better outcomes for veterans (e.g., higher salaries).

Discussion: Partnerships can equip funders and service organizations with credible data, clear messaging, and tools to advocate for and champion the well-being of populations. This partnership, galvanized by using data for co-learning and collaborative action, has augmented the nation's understanding of veterans' reintegration and has led to veterans receiving data-driven support for successful transitions and enhanced well-being.

Introduction: The COVID-19 (COronaVIrus Disease-2019) pandemic highlighted the importance of assessing the rationales behind vaccine hesitancy for the containment of pandemics. In this nationwide study, representative of the Luxembourgish population, we identified hesitant groups from adolescence to late adulthood and explored motivations both for and against vaccination.

Methods: We combined data collected via online surveys for the CON-VINCE (COvid-19 National survey for assessing VIral spread by Non-affected CarriErs) study, 1865 respondents aged 18-84, and for the YAC (Young people And Covid-19) study, 3740 respondents aged 12-29. Data from both studies were harmonized and weighted to ensure a sample representative of Luxembourg's resident population. The surveys included information on demographic and socio-economic factors as well as vaccination hesitancy.

Results: At the time of the survey, 67.0% of respondents had been vaccinated against SARS-CoV-2 (Severe Acute Respiratory Syndrome COronaVirus-2), while 33.0% of the respondents had not yet been vaccinated. Of those not yet vaccinated, 41.8% of respondents were vaccine hesitant. The most important concerns against vaccination were that the vaccine had not been tested sufficiently (59.4%) and the fear of side effects (52.4%). The most frequent reasons for vaccination were to help society overcome the pandemic (74.8%), and to protect oneself from the consequences of infection with the virus (69.3%). The proportion of unvaccinated respondents unwilling or undecided to get vaccinated was higher in the younger age groups compared to the higher age groups.

Conclusion: Our findings contribute to improving public health policy communications, not only for future pandemics but also for routine vaccination campaigns. This will help reach those who are unwilling (26.7%) or undecided (15.1%) about vaccination and reinforce strategies that have successfully increased vaccination willingness.