Frontiers in Public Health最新文献

Background: This study aimed to examine the causal effect between perceived social support and self-management in rural patients with hypertension and to provide a basis for improving self-management.

Methods: A cross-sectional study of 1,091 rural hypertensive patients in Shanxi Province was conducted from March through June 2022 to analyze the factors influencing social support as well as the causal effects of social support and self-management using generalized propensity score matching.

Results: Rural hypertensive patients had a low level of social support (social support score = 0.632 ± 0.178). Social support had a significant and inverted U-shaped relationship with self-management; with increasing social support levels, the levels of self-management first rose and then declined, with an inflexion point of 0.774. Social support had significant negative correlations with sex, age, number of child, living status (i.e., living alone or living with others), disease duration, family economic status, and decision-making power, and positive correlations with having a spouse and having medical insurance.

Conclusion: Greater emphasis should be placed on the older adult, individuals living alone, those without spouses, only children, economically disadvantaged populations, and uninsured individuals to enhance the social support they received and ultimately improve their self-management of hypertension. Furthermore, establishing social support systems that are congruent with rural relational networks is crucial for promoting effective hypertension self-management.

Religious beliefs can shape how people process fear. Yet the psychophysiological mechanisms underlying this phenomenon remain poorly understood. We investigated fear learning and extinction processes in a group of individuals who professed a belief in God, compared to non-believers. Using a virtual reality Pavlovian fear conditioning/extinction task, we measured neurovegetative activity associated with these forms of associative learning. Our finding shows reduced fear extinction among God believers, compared to non-believers. This suggests that the general mechanism of fear extinction learning is suppressed in these individuals. Importantly, this effect was not explained by state or trait anxiety scores. These findings align with previous evidence linking religiosity and spirituality with the neural circuit of fear and suggest that religiosity may be associated with weaker inhibitory learning processes related to fear.

Background: With the accelerated increase in the population of seniors aged 60 years or older in Saudi Arabia, understanding the utilization of senior residential care homes is crucial for improving service delivery and policy planning to meet the care transformation objectives of Vision 2030.

Objective: To assess the distribution and determinants of senior residential care home utilization across Saudi Arabia's 13 administrative regions, focusing on predictors of functional dependency among different socio-demographic groups.

Methods: This study analyzed data from 283 Saudi individuals aged ≥65 admitted to social residential care homes in 2021. Variables included age, sex, education level, marital status, region, and reasons for service use. Statistical analyses comprised descriptive statistics, chi-square tests, independent t-tests, and multivariable logistic regression.

Results: The Makkah region had the highest number of senior residential care home users (56.8%; p < 0.0001). Most participants were men (67.8%), while women constituted 32.2%. The mean age was 78.9 years (SD = 10.6), with women being significantly older than men (p = 0.014). Illiteracy was prevalent (73.5%), particularly among women (82.4% vs. 69.3% for men; p = 0.006). Most participants were divorced (68.2%), with higher rates among men (84.9% vs. 33% for women; p < 0.0001). The primary reasons for utilizing residential care home services were old age and functional dependency (88.5% of men and 83.4% of women). Multivariable logistic regression indicated that being in the age group 75-84 years (odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.02-1.81, p < 0.001), 85 years and above (OR = 2.63, 95% CI = 1.28-3.11, p < 0.001), and being single (OR = 2.43, 95% CI = 1.14-5.13, p = 0.019) were significant predictors of old age and functional dependency.

Conclusion: The study highlights regional and socio-demographic variations in senior residential care home service utilization in Saudi Arabia, emphasizing the need for targeted interventions and policies aligned with Saudi Arabia's Vision 2030 to enhance service accessibility and effectiveness for the aging population.

Background: Bronchial asthma is a global health problem in particular a respiratory condition characterized by broncho spasms that negatively affect the quality of life (QOL) of children. However, there is a paucity of data regarding the health-related quality of life of asthma in children in Ethiopia, and the study area.

Objective: The objective of this study was to assess the health-related quality of life among asthmatic children aged 7-17 in selected hospitals in Addis Ababa, Ethiopia.

Methods: An institutional-based analytical cross-sectional study involving 136 asthmatic children aged 7-17 years was conducted in the selected hospital in Addis Ababa, from February to April 2024. Respondents were chosen using a systematic random sampling method. Structured, interviewer-administered, and pretested questionnaires, were used to collect data. The data were coded and entered into Epi-Data 3.1 before being exported to SPSS version 25 for analysis. Logistic regression was employed to identify factors influencing health-related quality of life Statistical significance was set at p < 0.05 with a 95% confidence interval.

Results: The study found that 46% [95% CI: 37.6-54.4%] of the study participants had a poor quality of life. Factors associated with an increased likelihood of poor quality of life included caregivers' lack of formal education (Adjusted Odds Ratio [AOR]: 1.39 [1.80-10.69]), a family history of asthma (AOR: 2.51 [1.46-4.299]), longer asthma duration (AOR: 3.47 [1.89-6.39]), uncontrolled asthma (AOR: 3.47 [1.89-6.39]), moderate persistent asthma (AOR: 2.4 [1.40-4.20]), and comorbidities (AOR: 2.4 [1.40-4.20]).

Conclusion: The study highlights almost half of asthmatic children had a poor quality of life in Addis Ababa. Factors such as caregivers' lack of formal education, a family history of asthma, longer duration and increased severity of asthma, uncontrolled asthma, and comorbidities were significantly associated with poor quality of life. Therefore, implementing targeted education programs, encouraging family history assessments, and strengthening comorbidity screening and management for children and their families in Addis Ababa are recommended.

Background: Norovirus remains a significant viral cause of waterborne and foodborne gastroenteritis outbreaks and epidemics worldwide. The burden of norovirus extends across different income settings.

Methods: Leveraging secondary data from the 2021 Global Burden of Diseases Study, our analysis spanned the period from 1990 to 2021 to assess the burden of norovirus-associated diseases (NADs). We utilized descriptive statistics to examine global mortality rates and disability-adjusted life years (DALYs). For trend analysis, we employed annual percentage change (EAPC) through linear regression and applied Joinpoint analysis to identify significant changes over time. A comprehensive age-period-cohort model evaluated the key mortality risk factors. Furthermore, a Bayesian age-period-cohort analysis was conducted to forecast trends up to 2035, providing valuable insights for policy formulation and resource allocation.

Results: In 2021, the global age-standardized mortality rate (ASMR) for NADs was 1.62 per 100,000 population (95% UI: 0.35 to 2.91), while the age-standardized DALY rates (ASDR) was 79.02 years per 100,000 population (95% UI: 26.61 to 132.26). A downward trend was observed in most regions and countries, with EAPC of -4.29% (95% UI: -4.53 to -4.05) for ASMR and -4.40% (95% UI: -4.62 to -4.19) for ASDR from 1990 to 2021. Notably, children under 5 years old had considerably higher ASDR: 475.52 years (95% UI: 160.73 to 893.72) per 100,000 for males and 335.44 years (95% UI: 112.29 to 623.48) per 100,000 for females. Mortality risk from NADs escalated with age, with a peak of 69.27 (95% CI: 64.04 to 74.92) per 100,000 for the under-five age group, and 11.38 (95% CI: 10.59 to 12.22) per 100,000 for individuals over 95 years. Bayesian Age-Period Cohort projections indicate a continued decline in ASMR and ASDR through 2035.

Discussion: Between 1990 and 2021, ASMR and ASDR for NADs significantly declined due to public health interventions, vaccination, and improved sanitation. However, norovirus remains highly contagious, especially among children and the older adult. Projections suggest a continued decrease in the burden of such diseases by 2035. To further reduce this burden, preventive measures like vaccination and infection control strategies are essential for high-risk populations, alongside ongoing research into norovirus epidemiology and transmission dynamics.

Introduction: Newborn Screening (NBS) is a public health program designed to identify and provide early interventions for infants with genetic disorders such as Sickle Cell Disease (SCD). Lack of awareness and unwillingness to participate in the NBS by caregivers and some healthcare workers are major contributing factors impeding NBS for SCD.

Objective: To evaluate the level of awareness and acceptance of NBS for SCD and the determinant factors influencing caregivers in Gwagwalada Area Council of the Federal Capital Territory, Abuja, Nigeria.

Methods: The study employed a descriptive, quantitative design using questionnaires administered to healthcare workers and caregivers at immunization and antenatal clinics of 10 selected Primary Healthcare Centers (PHC) in Gwagwalada Area Council of the Federal Capital Territory, Abuja, Nigeria.

Result: A total of 357 participants, comprising 301 caregivers and 56 health care workers responded to the questionnaires. Among the caregivers, 171 (57.2%) were not aware of NBS for SCD. Two hundred and ninety (97%) expressed willingness to participate in the NBS. However, 32 (10.6%) indicated reluctance to accept positive results of SCD. The majority, 175 (59.1%) of the caregivers strongly agreed that NBS for SCD helps in the early detection and management of SCD, while 7 (2.4%) disagreed. Notably 272 (90.4%) of the caregivers had secondary and tertiary education. Among the healthcare workers, 39 (73.6%) were aware of NBS for SCD and 30 (73.2%) have recommended it to caregivers.

Conclusion: This study revealed a low level of awareness of NBS for SCD among caregivers. However, there was a high level of acceptance among them. The level of awareness is high among healthcare workers. Education emerged as the major factor determining the knowledge and attitude of caregivers toward NBS for SCD.

Background: Tuberculosis (TB) is one of the oldest infectious diseases and continues to be a major killer of human beings. This paper was designed to provide insights into the disease burden of TB.

Methods: The data was retrieved and downloaded from the latest GBD database. Joinpoint regression was done for the temporal trend analysis. The age-period-cohort model was introduced to get further insights into the independent effects of age, period, and cohort. The BAPC model was utilized to predict ASIR and ASMR from 2022 to 2036.

Results: From 1990 to 2021, the ASPR dropped from 31,446 (95% UI: 27,902 to 35,142) to 30,557 (95% UI: 27,693 to 33,531) per 100,000 people, and ASDALYR dropped from 719 (95% UI: 611, 837) to 76 (95% UI: 63, 94) per 100,000 people with an AAPC of -7.009 (95% CI: -7.219, -6.799). ASIR and ASMR decreased from 109 (95% UI: 95, 125) to 36 (95% UI: 33, 40) and from 20 (95% UI: 17, 24) to 2 (95% UI: 2, 3) per 100,000 people, respectively. Men had a higher TB burden than women. The age-period-cohort analysis showed the age effect represented significant fluctuations with a valley at age 5 for incidence rate, and a similar but relatively simple pattern for death rate. Period effect and cohort effect showed both incidence and mortality rates significantly decreased with advancing time points and more recent birth cohorts. At the current decline rate, the ASIR and ASMR would be 26.12 (95%CI: 15.75, 36.48) per 100,000 people and 1.13 (95%CI: 0.45, 1.81) per 100,000 people in 2030, respectively. And the ASIR would be 21.96 (95%CI: 6.14, 37.79) per 100,000 people in 2035.

Conclusion: TB burden in China has decreased significantly overall in the past years. However, it is still hard to achieve the national goal of "End TB" by 2035, which means more effective strategies for TB prevention and control are urgently needed. Effective strategies aimed at men should include increasing awareness of tuberculosis among both the general population and healthcare workers, promoting smoking cessation and alcohol reduction, enhancing disease screening and treatment access, and providing psychological support and care.

Urban public health resilience has become a critical focus in the transition to high-quality development, especially in addressing increasing public health challenges. This study explores the role of artificial intelligence (AI) technology in enhancing urban public health resilience across 284 Chinese cities from 2011 to 2021. Using a comprehensive index based on resistance, recovery, and innovation dimensions, the study quantifies AI technology levels through patent applications and authorizations, further disaggregating these into invention, utility model, and design patents. A two-way fixed effects regression model and spatial econometric models are employed to analyze the direct and spillover effects of AI on urban public health systems. The results demonstrate that AI technology significantly enhances resilience by improving resource allocation and response efficiency, with stronger impacts observed in eastern and central regions compared to western regions, where economic and technological capacities are weaker. Spatial analysis reveals significant positive spillover effects, particularly from patent authorizations, which enhance public health resilience in neighboring cities through cross-regional collaboration and resource sharing. Despite these advancements, regional disparities in economic development and technological infrastructure limit AI's broader impact, underscoring the need for targeted policies, enhanced funding, and interdisciplinary training to bridge the digital divide. The findings highlight AI's transformative potential in fostering urban public health resilience and call for sustained investment and collaboration to maximize its benefits.

Adolescents worldwide are increasingly affected by mental health disorders, with anxiety disorders, including Generalized Anxiety Disorder (GAD), being particularly prevalent. Despite its significant impact, GAD in adolescents often remains underdiagnosed due to vague symptoms and delayed medical attention, highlighting the need for early diagnosis and prevention strategies. This study utilized data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) from 2020 to 2023 to analyze factors influencing GAD in adolescents. Using machine learning techniques such as Lasso Regression, SelectKBest, and XGBoost, we identified key variables, including health behaviors such as sleep, smoking, and fast-food intake, as significant factors associated with GAD. Predictive models using Random Forest and Artificial Neural Networks demonstrated that the XGBoost feature selection method effectively identified key factors and showed strong performance. These findings emphasize the need for educational programs focusing on sleep management, smoking prevention, and balanced nutrition to reduce the risk of GAD in adolescents, providing crucial insights for early diagnosis and intervention efforts.

Introduction: The mental health of medical students is a key factor for academic performance and the delivery of high-quality medical care in the future. Globally, medical students face numerous challenges that can affect their education. Living and studying facing the war has a crucial influence on medical students' education and daily life. The study aimed to determine the psychological well-being and academic achievements of Ukrainian medical students who lived in the rear areas after the 18 months of the Russian-Ukrainian war.

Methods: The cross-sectional study was conducted at I.Ya. Horbachevsky Ternopil National Medical University. We analyzed the psychological well-being and educational achievements of medical students from the second to fifth year of Medical Faculty using the self-report scales DASS-21 and IES-R. A total of 776 students filled out the DASS-21 scale and 491 IES-R scale, respectively.

Results: Following the first 18 months of the war, 62.5, 59.6, and 58.8% of Ukrainian medical students self-reported signs of stress, anxiety, and depression, respectively. Severe and extremely severe depressive symptoms were observed in 25.6% of students, anxiety in 31.9%, and stress in 29.7%, with a higher prevalence among female students. Additionally, 44.2% of responders had significant symptoms of post-traumatic stress disorder, with the highest scores on the hyperarousal subscale (>37). Academic performance in 2023 was significantly lower compared to the pre-war period in 2019 (p < 0.001) (p = 0.000). The multiple linear regression analysis showed that academic performance was positively associated with depression (p = 0.003), hyperarousal (p < 0.001), anxiety (p = 0.03), and negatively associated with stress (p = 0.002).

Conclusion: Ukrainian medical students in rear areas are facing various challenges, with war-related stressors having a profound impact on their mental health. Our findings have shown an increasing prevalence of anxiety, stress, depression, and symptoms of post-traumatic stress disorder, all of which may negatively affect academic performance. The educational process during wartime is important for facilitating qualified medical personnel and quality healthcare. Understanding the burden of war allows for the development of wellness programs that support student mental health in conflict zones.