Frontiers in Public Health最新文献

Introduction: Sociodemographic factors such as parental education level (ED) influence the physical activity (PA) and sedentary behavior (SED) of primary school-aged children. In this context, family factors, such as the physical activity-related Family Health Climate (FHC_PA), are relevant. However, the effect of FHC_PA on the interaction between ED and children's activity behavior has not yet been investigated. Therefore, this study aimed to analyze the mediating effect of FHC_PA on the relation between parental ED and children's device-based measured PA and SED.

Methods: A total of 94 children and their parents participated in the study. Questionnaires were used to assess parental ED and FHCPA. Children's moderate to vigorous physical activity (MVPA) and SED were measured using accelerometers. Bivariate correlations were conducted to investigate associations between parental ED and MVPA/SED/FHC_PA. Mediation analyses were used to investigate the role of FHCPA in the association between maternal and paternal ED and children's MVPA/SED. Results indicate a small correlation between maternal ED and FHC_PA for the total sample (ρ = 0.318, p < 0.001) and a medium correlation for girls only (ρ = 0.570, p < 0.001). Mediation analyses showed no significant mediation effect. However, there was a significant direct association when considering FHC_PA in the relation between higher maternal ED and SED in girls compared to lower ED.

Discussion: Future research should examine more complex models to further develop and refine to facilitate the derivation of more effective recommendations for health prevention programs, particularly for mothers and girls.

Background: Childhood obesity is a significant public health issue with far-reaching implications. The World Health Organization reported that in 2020, around 38 million children under five were overweight or obese globally, and in 2016, 340 million children and adolescents aged 5-19 were affected. In Pakistan, the situation is alarming; 66.9% of school-going children in Punjab were overweight, and 5.8% were obese in 2022. This study explores mothers' knowledge, attitudes, and practices regarding childhood obesity in Pakistan and identifies factors contributing to this epidemic. Maternal perspectives are crucial as they significantly influence children's dietary habits, physical activity, and attitudes toward food and body image.

Methods: A cross-sectional study was conducted from November 2023 to January 2024 at four medical centers: Fazaia Ruth Pfau Medical College Hospitals Karachi, Baqai Medical University Karachi, and Nishtar Medical University Multan. The study included 191 mothers with children aged 5 to 15 years. Data were collected using a structured questionnaire on sociodemographic characteristics, knowledge, attitudes, practices, and perceptions of childhood obesity. IBM-SPSS version 26.0 was used for data analysis, employing statistical tests like Kruskal-Wallis, Mann-Whitney U, Spearman, or Kendall Tau correlation to examine associations.

Results: Among the 191 mothers, 48.7% had education beyond intermediate, and 86.9% were housewives. The children's BMI distribution showed that 27.7% were obese and 21.5% overweight. Mothers had moderate knowledge (60.5%) about childhood obesity; 75.4% recognized its long-term health risks, and 62.8% associated it with diabetes. Attitudes were generally positive, with a 78.5% average score. Most mothers (73.8%) believed obesity could be controlled and had healthy practices (70.1% average score). However, 96.9% reported witnessing stigmatization of obese children, and 79.6% felt pressured by relatives about their child's weight.

Conclusion: The findings indicate that while Pakistani mothers have moderate knowledge and positive attitudes toward childhood obesity, their practices are influenced by educational and socioeconomic factors. Addressing these disparities, enhancing public health initiatives, and mitigating stigmatization could improve childhood obesity management in Pakistan.

Background: There is persistent pressure on countries with a high burden of HIV infection to reach desired targets for HIV treatment outcomes. This has led to moving from the "one-size-fits-all" model to differentiated service delivery (DSD) models, which are meant to be more patient-centered and efficient but without compromising on the quality of patient care. However, for DSD models to be efficient, facilities should have indicators of HIV services available and ready to provide the DSD models. We aimed to assess the availability of HIV service indicators and the readiness of facilities to provide DSD models for HIV treatment in selected public health facilities in Zambia.

Methods: We conducted a nationwide cross-sectional survey among public health facilities in Zambia that provide antiretroviral therapy (ART) services. We used an interviewer-administered questionnaire based on a World Health Organization (WHO) Service Availability Readiness Assessment (SARA) tool to assess the availability of HIV service indicators and the readiness of facilities to implement DSD models for HIV treatment. Availability and readiness were considered latent constructs, and therefore, we used structural equation modeling (SEM) to determine the correlations between them and their respective indicators.

Results: Of 60 public health ART facilities, the overall availability of HIV service indicators was 80.0% (48/60), and readiness to provide the DSD models was 81.7% (48/60). However, only 48 and 39% of the facilities had all indicators of availability and readiness, respectively. Retention in care for HIV multidisciplinary teams was more likely to occur in urban areas than in rural areas. SEM showed that the standardized estimate between availability and readiness was significantly and positively correlated (r = 0.73, p < 0.0001). In addition, both availability and readiness were significantly and positively correlated with most of their respective indicators.

Conclusion: Although most facilities had available HIV service indicators and were ready to provide DSD models, most facilities did not have all indicators of availability and readiness. In addition, there were differences between rural and urban facilities in some indicators. There is a need for persistent and heightened efforts meant to implement DSD in HIV treatment, especially in rural areas to accelerate reaching the desired HIV treatment outcomes.

In the world today, there are many unknowns especially with rising environmental concerns. However, one of the most important is an irreplaceable and shared resource, water or as the Diné (Navajo) refer to as, Tó. Throughout the world many Indigenous communities are facing water challenges, from lack of and access to adequate infrastructure, water rights, climate change and water contamination issues due to a variety of sources including anthropogenic sources like mining, especially, on the Navajo (Diné) reservation. This article aims to bring forth awareness of the long-standing water contamination issues in Diné communities and to shed light on innovative solutions being developed through current research efforts. Specifically, Dr. Tsosie's research aims to optimize a handheld point of use filter unit with a filter casing design that is customizable to a community and/or household through an easily removable and exchangeable cartridge system. Despite all the challenges and legacies of mining faced by not only Diné communities but many Indigenous communities, We Remain and We Are Still Here.

The benefits of breastfeeding are widely established and therefore the World Health Organization recommends that every child be exclusively breastfed for the first 6 months of life and continue breastfeeding up to 2 years of age or beyond. However, the rate of exclusive breastfeeding is low globally and has declined in Bangladesh in recent years. In this review, Bangladesh is used as an example to demonstrate the complex individual- and system-level determinants of breastfeeding in a low-resource setting. Mothers face barriers to breastfeeding within the context of marketing by commercial milk formula companies, limited safe alternatives to breastfeeding directly from the breast, and insufficient resources to support breastfeeding in the hospital, community, and workplace setting. Future research and implementation science is required to investigate the overlapping effects between breastfeeding and the high antibiotic use and Caesarean section rates in Bangladesh, along with public health efforts to promote breastfeeding based on robust evidence.

Background: Within China's healthcare landscape, the sharing of medical data has emerged as a pivotal force propelling advancements in the insurance sector and enhancing patient engagement with healthcare services. However, medical institutions often exhibit reluctance toward data sharing due to apprehensions regarding data security and privacy safeguards. To navigate this conundrum, our research introduces and empirically validates a model grounded in evolutionary game theory, offering a robust theoretical framework and actionable strategies for facilitating healthcare data sharing while harmonizing the dual imperatives of data utility and privacy preservation.

Methods: In this paper, we construct an evolutionary game model involving medical institutions, big data innovation platforms, and insurance companies within the context of digital platforms. The model integrates exogenous causes of data breaches, endogenous causes of data breaches, compensation payments, government penalties, subsidies, unreasonable fees, claims efficiency, and insurance fraud.

Results: The stability analysis of the evolutionary game identifies eight equilibrium points among medical institutions, platforms, and insurance companies. Numerical simulations demonstrate convergence toward strategy E ₇ = (0, 0, 1), suggesting a trend for medical institutions to adopt a fully anonymous information-sharing strategy, platforms to implement strict regulation, and insurance companies to opt for an auditing approach. Sensitivity analysis reveals that the parameters selected in this study significantly influence the players' behavioral choices and the game's equilibria.

Conclusions: When breaches occur, medical institutions tend to seek co-sharing between platforms and insurance companies. This promotes enhanced regulation by platforms and incentivizes insurance companies to perform audits. If the responsibility for the breach is attributed to the platform or the insurance company, the liability sharing system will push healthcare organizations to choose a fully anonymous information sharing strategy. Otherwise, medical institutions will choose partially anonymous information sharing for more benefits. In case of widespread data leakage, the amount of compensation shall augment, and the role of compensation shall replace the role of government supervision. Then, the government shall penalize them, which shall reduce the motivation of each subject.

Introduction: Aggressive behaviors in the online gaming world are frequent and have far-reaching negative effects.

Method: To explore the factors and mechanisms of aggressive in games, we surveyed 945 university students using a framework of social dominance orientation, online disinhibition, moral disengagement, and aggression in gaming, and examined the moderating role of gender traits.

Results: We found no direct relationship between online disinhibition and aggression in gaming; however, through the mediating role of moral disengagement, online disinhibition indirectly affected aggression in gaming behavior and enhanced social dominance orientation. Social dominance orientation predicted both moral disengagement and aggression in gaming behaviors, and the mediating effect of moral disengagement was confirmed through the indirect influence of moral disengagement on aggression in gaming behavior. Moreover, the moral disengagement mechanism significantly predicted aggression in gaming behavior. Furthermore, femininity and androgyny moderated both social dominance orientation toward moral disengagement and aggression in gaming, while masculinity and androgyny moderated the path from online disinhibition to social dominance orientation. Regarding the path from moral disengagement to aggression, all gender trait moderations were significant.

Discussion: This study reveals the role of the moral disengagement mechanism in the process of game-related aggression, providing theoretical support for the explanation of aggressive behavior, which applies to players of any gender. Moreover, this study confirms the moderating role of gender. Unlike biological sex, gender traits are malleable; androgynous traits offer greater adaptability in various environments. Thus, prevention and intervention efforts against online aggression should include strengthening moral education and properly guiding and fostering androgynous gender traits.

Background: Persons with physical disabilities are more likely to suffer from psychological symptoms and inferiority feelings, and social support plays an important role in improving those symptoms. However, the interaction between psychological symptoms, inferiority feelings and social support is yet to be understood.

Methods: A cross-sectional study was conducted to investigate anxiety, depression, and inferiority feelings among individuals with physical disabilities in a Chinese sample. The questionnaire included the Generalized Anxiety Disorder 7, Patient Health Questionnaire 9, Self-designed Disability Questionnaire, and Social Support Rating Scale including three dimensions: subjective social support, objective social support and utilization of social support.

Results: Out of the 1,453 respondents with physical disabilities, 49.7, 60.4, and 62.5% reported experiencing anxiety, depression, and inferiority feelings, respectively. Factors such as time since identification of physical disabilities, comorbidities, daily travel, social interaction, internet use, subjective social support, and inferiority feelings were found to be associated with anxiety or depression symptoms among physically disabled individuals. Subjective social support was found to be associated with inferiority feelings, which partly mediated the effect of subjective social support on anxiety symptoms by 37.4% and depression symptoms by 28.7%.

Conclusion: This study highlights the importance of addressing the psychological well-being of physically disabled individuals in addition to their physical rehabilitation. Psychological intervention strategies should focus on improving subjective social support and reducing inferiority feelings, particularly among vulnerable groups.

The recommendation to apply external heat to patients with anorexia nervosa (AN) was first documented by William Gull in 1874. Gull encountered this practice during his tenure as a consultant physician, responsible for issuing medical certifications for wealthy clients seeking admission to Ticehurst Asylum, one of the most successful and reputable private asylums in England. Gull attributed the origins of this practice to the studies by Charles Chossat (1796-1875), a physiologist, physician, and politician from Geneva, who discovered the therapeutic effects of heat on starved animals by chance. In the 20th century, further evidence of the beneficial effects of heat on starved animals emerged serendipitously when anomalies were observed following a malfunction in laboratory thermostats controlling animal temperatures. Moving into the 21st century, experimental research has empirically substantiated the crucial role of ambient temperature (AT) in the animal model of activity-based anorexia (ABA). Recent translational studies have shown that a warmed environment significantly reduces anxiety around mealtime in AN patients, a method shown to be more effective than exposure-based procedures. Despite the overwhelming evidence from both animal and patient studies, it is difficult to comprehend how the impact of providing a warm environment to AN patients, particularly around mealtimes, continues to be a neglected area of research.

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.