Frontiers in Public Health最新文献

Introduction: Food pantry managers play a key role in determining the food environment of the pantry, which can influence their clients' dietary composition. However, their impact on pantry food environments remains understudied. We sought to understand food pantry managers' nutrition knowledge, beliefs, and behaviors (KBBs) in this study.

Methods: We surveyed 47 Alabama food pantry managers' nutrition KBBs from November 2022 to November 2023. Validated and previously published tools used include the Consumer Nutrition Knowledge Scale, a diet beliefs scale, and a dietary-related consumer behavior questionnaire.

Results: The majority of managers were college-educated (54%), white (74%), and female (74%), with a mean age of 60 ± 13 years and an average of 7 ± 5.5 years of experience in managing food pantries. Managers reported positive nutrition beliefs and behaviors but scored lower on objective nutrition knowledge. Exploratory analyses indicated moderate to very strong associations between KBBs, pantry characteristics, and neighborhood characteristics.

Conclusion: Nutrition education for pantry managers, along with improved pantry infrastructural support, could play a key role in improving the healthfulness of the food provided.

Objective: This study aims to explore the association between mobile phone involvement, body mass index (BMI) levels, and the sleep quality of Chinese university students.

Methods: Using a cluster sampling method, we selected 17,085 university students from three universities in eastern, central, and western China as the study subjects. Demographic information such as age and sex were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Mobile Phone Involvement Questionnaire (MPIQ) were utilized to measure their sleep quality scores and mobile phone involvement scores, respectively. Pearson correlation analysis, two-way ANOVA, and multiple linear regression were employed to examine the relationship between BMI levels, mobile phone involvement, and sleep quality.

Results: The results show that 15.87% (2,712 participants) are classified as overweight, and 18.45% (3,151 participants) are classified as obese. Additionally, 35.87% (6,125 participants) exhibit mobile phone involvement, while 57.94% (9,899 participants) reported poor sleep quality. Pearson correlation analysis indicates a significant negative correlation (p < 0.01) between sleep quality and both BMI levels and mobile phone involvement. Two-way ANOVA shows the significant effect of BMI levels (p < 0.001) and mobile phone involvement (p < 0.001) on sleep quality, and there is no interaction effect between the two. Additionally, the sleep quality of overweight and obese individuals is significantly poorer than that of those with normal weight (p < 0.05), while the sleep quality of overweight individuals is significantly lower than that of obese individuals (p < 0.05). Multiple linear regression analysis indicates that, after controlling for age and gender, both BMI (β = -2.69) levels and mobile phone involvement (β = -1.34) are significantly negatively associated with sleep quality (p < 0.001), accounting for 19% of the variance in poor sleep quality.

Conclusion: This study found that BMI levels and mobile phone involvement are both independently associated with sleep quality among Chinese university students. However, among individuals with excess BMI, although their sleep quality is worse than individuals with normal weight, overweight individuals may have poorer sleep quality than obese individuals. This study also revealed high rates of overweight and obesity, with over half of participants reporting poor sleep quality, highlighting the need for targeted interventions to address weight management and mobile phone usage to improve sleep health in this population.

Background: It is well-known that sex and age play critical roles in smoking-related diseases and mortality. However, quantification of the extent of smoking requires self-reports in these studies, which may yield only partially accurate results. This study investigated sex-and age-related differences in the association between smoking and all-cause, cardiovascular disease, and cancer mortality by measuring serum cotinine levels.

Methods: Participants aged 20-85 years from the US National Health and Nutrition Examination Survey (1999-2018) were included. All-cause and disease-specific mortality data were obtained from publicly available user-linked mortality files. Multivariate Cox regression was performed to identify serum cotinine as an independent risk factor of mortality. Subgroup and interaction analyses were performed to investigate these sex and age differences. Smooth curve fitting was conducted to discover potential nonlinear relationships and threshold saturation effects.

Results: Sex was significantly associated with all-cause and cancer mortality. Threshold saturation effects were observed in all-cause mortality among both males and females, cancer mortality among females, and cardiovascular disease mortality among males. Age markedly associated with all-cause and cardiovascular disease mortality. Threshold saturation effects were found in cardiovascular disease mortality among younger adults and cancer mortality among the all-age population.

Conclusion: These findings suggest that there are threshold saturation effects between smoking and mortality, and sex and age differences in smoking-related mortality are inconsistent in different diseases.

Background: Suicide is a major behavioral issue among children and adolescents, and family functioning potentially influencing its occurrence. Furthermore, positive behavior recognition, as a key component of positive youth development, may act as a mediating factor in the relationship between family functioning and suicide. Non-suicidal self-injury (NSSI) often co-occurs with suicide and may also mediate the impact of family functioning on suicide. Therefore, the aim of this study is to examine the role of family functioning in child and adolescent suicide, with positive behavior recognition and NSSI serving as sequential mediating factors.

Methods: The participants in this study were recruited from the Chengdu Positive Child Development (CPCD) cohort study. The analysis was based on the second round of cross-sectional data from the CPCD cohort. They were required to complete questionnaires that included measures of family functioning, suicide, positive behavior recognition, and NSSI. SPSS 26.0 and Mplus 8.3 were used for descriptive statistical analysis, correlation analysis and mediation effect analysis.

Results: A total of 8,124 participants completed the questionnaires, with an average age of 11.00 ± 2.18 years. The sample comprised 4,195 male and 3,929 female participants. The findings indicate that 17.93% of children and adolescents reported suicide thoughts, 10.06% had formulated suicide plans, and 8.64% had attempted suicide. Poor family functioning shows a significant positive correlation with suicide (r = 0.322, p < 0.01). The multiple mediation effect of positive behavior recognition and NSSI in the association between family functioning and suicide was statistically significant (β = 0.034, 95% CI = 0.027, 0.042).

Conclusion: This study found that poor family functioning is a risk factor for suicide in children and adolescents, with positive behavior recognition and non-suicidal self-injury acting as sequential mediating factors.

Although public health programs among undergraduate students have been increasing and gaining popularity worldwide, few studies have focused on the needs and structure of public health courses for non-medical students. This study aimed to design a public health course as a general education elective for non-medical undergraduates at Nankai University, one of China's leading multidisciplinary and research-oriented universities. Students' feedback on the course was collected and analyzed after the completion of the elective course. We designed and developed the course under the general education elective course at Nankai University. The course includes four segments: (a) Public Health Fundamentals and Population Research Methods; (b) Chemical Safety and Health, (c) Diet, Nutrition, and Health, (d) Immunology, Microbiology, and Infectious Diseases, spanning 34 class hours (with 6 class hours designated for a flipped classroom format). The teaching content was divided into five parts: (1) Health and Medicine Knowledge, (2) Public Health Knowledge, (3) Public Health Methodology and Philosophy, (4) Proper View of Health Issues, and (5) Values Education. Students' feedback after the course indicated that Diet, Nutrition, and Health was the most interesting segment, and the students considered basic biological or medical knowledge to be more important than other public health knowledge. A problem-based learning model was implemented for flipped classrooms, and we found that the problem-based learning questions were not only helpful for students' knowledge construction but also for educators in understanding and managing the learning expectations of non-medical students. We believe that the lesson may guide other institutions in designing similar curricula.

Objective: To develop and evaluate the effectiveness of multimodal machine learning approach for the differentiation of NTM from MTB.

Methods: The clinical data and CT images of 175 patients were retrospectively obtained. We established clinical data-based model, radiomics-based model, and multimodal (clinical plus radiomics) model gradually using 5 machine learning algorithms (Logistic, XGBoost, AdaBoost, RandomForest, and LightGBM). Optimal algorithm in each model was selected after evaluating the differentiation performance both in training and validation sets. The model performance was further verified using external new MTB and NTM patient data. Performance was also compared with the existing approaches and model.

Results: The clinical data-based model contained age, gender, and IL-6, and the RandomForest algorithm achieved the optimal learning model. Two key radiomics features of CT images were identified and then used to establish the radiomics model, finding that model from Logistic algorithm was the optimal. The multimodal model contained age, IL-6, and the 2 radiomics features, and the optimal model was from LightGBM algorithm. The optimal multimodal model had the highest AUC value, accuracy, sensitivity, and negative predictive value compared with the optimal clinical or radiomics models, and its' favorable performance was also verified in the external test dataset (accuracy = 0.745, sensitivity = 0.900). Additionally, the performance of multimodal model was better than that of the radiologist, NGS detection, and existing machine learning model, with an increased accuracy of 26, 4, and 6%, respectively.

Conclusion: This is the first study to establish multimodal model to distinguish NTM from MTB and it performs well in differentiating them, which has the potential to aid clinical decision-making for experienced radiologists.

Introduction: Stress is an increasing public health issue among the student population. This stress affects their academic performance, mental health, and overall well-being. As a result, we conducted a systematic review and meta-analysis to determine the pooled prevalence and associated factors of stress among students in Ethiopia.

Methods: An extensive search of electronic databases such as PubMed, Google Scholar, Semantic Scholar, HINARI, and Science Direct, cross-referencing, and Google manual search was conducted to identify cross-sectional studies published from 1998 to 2024. The preferred PRISMA guideline was used to report items for this systematic review and meta-analysis. To extract data, Microsoft Excel 16 and to analyze STATA 17 software were used. The JBI quality assessment tool was used for the included studies with medium to high-quality scores. To estimate the pooled prevalence of stress and its associated factors, a random effects model was used. The funnel plot and Egger's regression test were used to assess publication bias, and I² test statistics were used to determine heterogeneity of the included studies. The protocol for this review has been registered with PROSPERO (ID: CRD42024578490).

Results: A total of 23 studies with 8,946 study participants met the inclusion criteria. The pooled prevalence of stress among students in Ethiopia was 37.64% (95% CI: 29.61-45.66; I² = 98.8%). Female gender (OR = 1.82, 95% CI: 1.57-2.12), rural resident (OR = 1.51, 95% CI: 1.22-1.87), living outside university dormitory (OR = 2.02, 95% CI: 1.34-3.05), the habit of alcohol consumption (OR = 1.46, 95% CI: 1.12-1.91), being a cigarette smoker (OR = 2.36, 95% CI: 1.49-3.74), being a khat chewer (OR = 1.35, 95% CI: 1.02-1.80), working in an unfavorable environment (OR = 1.80, 95% CI: 1.20-2.71), and having poor social support (OR = 1.93, 95% CI: 1.39-2.68), were significantly associated with an increased risk of stress.

Conclusion: The findings of this systematic review and meta-analysis indicated a high prevalence of stress among students. The study identified female gender, being a rural residence, living outside a university dormitory, khat chewing, having the habit of alcohol consumption, working in an unfavorable environment, poor social support, and cigarette smoking as significant risk factors for stress. To develop coping skills and resilience, integrating mental health education into the curriculum could help students to prevent stress. Furthermore, strategies such as academic support programs, substance use reduction programs, counseling services, and stress management workshops could be beneficial.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024578490, CRD42024578490.

Background: In the context of multiple global crises, including the COVID-19 pandemic, climate change, and global conflicts, children and adolescents worldwide are experiencing heightened psychological stress. As the foundation for lifelong mental health is established during childhood and adolescence, early prevention and treatment of mental health problems, such as through psychotherapy, are crucial. In Germany, current outpatient psychotherapeutic care capacities appear inadequate, while systematic evaluations of the care situation are lacking. This study investigates the state of statutory health insurance-funded outpatient psychotherapeutic care for children and adolescents in Germany and evaluates various methodological approaches for its assessment.

Methods: We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Publications from January 2018 to December 2023 were sourced from PubPsych, PubMed, APA PsycInfo, Google Scholar, and ProQuest. Included studies report quantitative primary data on the mental health of community samples of children and adolescents in Germany or their outpatient psychotherapeutic care.

Results: We included 41 publications comprising epidemiological studies, administrative data, and psychotherapist and patient reports. A lack of systematic and standardised research approaches resulted in significant variance in data. Nonetheless, qualitative analysis revealed that approximately one four children and adolescents in Germany is affected by mental health problems, while one in six to seven children and adolescents requires psychotherapeutic treatment. Yet, only up to one in 50 receives guideline-based psychotherapy. Most requests for initial psychotherapeutic consultations are unmet, with waiting times for guideline-based psychotherapy exceeding 6 months for at least half of the patients.

Conclusion: Overall, our findings suggest that outpatient psychotherapeutic care for children and adolescents in Germany is still insufficient. They advocate for a systematic, multimodal, and longitudinal assessment of statutory health insurance-funded outpatient psychotherapeutic care, along with an expansion of treatment capacities to enhance access for children and adolescents in Germany.

Introduction: Nurses' professionalism is linked to the profession's principles and plays a crucial role in the quality and safety of care in the current context of complexity in healthcare systems. In the Portuguese context, no instrument allows evaluation of the nurses' professionalism, which led to the objective of cross-culturally adapting and validating the content of the Nurses' Professionalism Inventory for the Portuguese context.

Methods: A methodological study was carried out and comprised six stages: translation, synthesis, back-translation, committee of experts, pre-test, and approval of the process by the original author developer of the instrument.

Results: The first three stages were completed without difficulty. Nine experts were part of the committee to validate the instrument content. They evaluated items' semantic, idiomatic, cultural, and conceptual equivalences, clarity, and relevance. Modified Kappa and Content Validity Index were calculated for all assessments. Seven items were submitted in two rounds to achieve consensus in the assessments. The usability of the instrument was tested in the fifth stage. Forty nurses performed the pre-test and agreed that the instructions, items, and response options of the Portuguese version of the Nurses' Professionalism Inventory were easy to understand at 95.00, 97.50, and 92.50%, respectively. The author who developed the original instrument analyzed and approved the entire process carried out.

Discussion: The cross-cultural adaptation of the Nurses' Professionalism Inventory to the Portuguese context was carried out according to international recommendations, and the conclusion of this study will provide an instrument to assess the nurses' professionalism in Portugal.