Frontiers in Public Health最新文献

Background: Catheter-associated urinary tract infection (CAUTI) is a leading cause of hospital-acquired infections globally, with a high prevalence in China, especially in high-risk settings like intensive care and post-operative environments. These infections are influenced by factors such as patient volume, healthcare worker training, and adherence to infection control protocols. Shanghai, as a major healthcare hub, faces unique challenges in CAUTI prevention. Healthcare workers' knowledge, attitudes, and practices (KAP) play a crucial role in infection control, yet research on factors affecting KAP in obstetrics and gynecology remains limited. The unique patient population and specialized care protocols in these departments present specific challenges, emphasizing the need for deeper insights to enhance prevention strategies.

Objective: The objective was to investigate the KAP scores of healthcare workers in an OB/GYN hospital regarding CAUTI prevention and to identify the factors influencing the scores. The ultimate aim is to provide evidence for improving targeted training programs and infection control measures.

Methods and participants: A cross-sectional study was conducted in an OB/GYN hospital in Shanghai, China. A total of 327 healthcare workers from various departments completed a self-administered questionnaire assessing the KAP scores related to CAUTI prevention. The questionnaire also gathered data on demographic and professional characteristics, CAUTI training frequency, leadership emphasis on infection control, and other relevant factors. Data were analyzed using univariate and multivariate analyses to identify factors significantly influencing KAP scores.

Results: Doctors scored higher than nurses in the knowledge dimension (p < 0.001), and increased training frequency was significantly associated with higher knowledge scores (p for trend < 0.001). In terms of attitudes, a longer duration of service, more frequent training, and stronger leadership emphasis were all significantly associated with more positive attitudes toward CAUTI prevention (p for trend < 0.001). Strong leadership emphasis on CAUTI prevention was also linked to improved practices (p for trend < 0.001). The multivariate analysis confirmed that factors such as professional role (doctor vs. nurse), years of service, the role of a clinical instructor, the degree of leadership emphasis, training frequency significantly influenced the scores across various KAP dimensions.

Conclusion: Healthcare workers' KAP scores toward CAUTI prevention are influenced by factors such as professional role, experience, clinical instruction, leadership emphasis, and training frequency. Tailored, role-specific training and active leadership involvement are essential to improving infection control and reducing CAUTI incidence.

Introduction: Innovation is crucial to realize the modernization and industrialization of traditional Chinese medicine (TCM), so its incentive methods and influence mechanisms are worth exploring. Based on externality theory and imprinting theory, this paper demonstrates the significance of external support and internal resources in the innovation of TCM enterprises.

Methods: This study adopts a sample of listed TCM enterprises in China during 2007-2023 to examine the impacts and differences between innovation subsidies and tax incentives on TCM enterprise innovation. Innovation in TCM enterprises is deconstructed into five dimensions, including innovation quantity (InNum), innovation quality (InQua), substantive innovation (SubIn), strategic innovation (StrIn), and inheritance innovation (InhIn).

Results: It is found that the incentive effect of innovation subsidies on other dimensions of innovation in TCM firms is generally stronger than that of tax incentives, except for strategic innovation. Heterogeneity analysis indicates that the promoting effect of tax incentives is more significant in the southern TCM production region. Moreover, R&D investment mediates the relationship between innovation subsidies and innovation of TCM enterprises. Furthermore, executives with pharmaceutical backgrounds (EPB) strengthen the impact of innovation subsidies on innovation in various dimensions of TCM enterprises, while EPB only strengthens the impact of tax incentives on innovation quality and substantive innovation.

Discussion: The findings provide new insights for government and TCM enterprises to promote innovation.

Introduction: Migrant workers constitute a significant portion of China's workforce, and their health directly affects labor supply and economic stability. Health vulnerability plays a crucial role in shaping the well-being of migrant workers, yet its determinants, particularly the impact of temperature change, remain underexplored. This study, based on the socio-ecological model, investigates how temperature variations influence the health vulnerability of migrant workers in China.

Methods: Using data from 2020, this study quantifies health vulnerability and examines the impact of temperature fluctuations across different seasons. Robustness checks, including dependent variable substitutions and model modifications, ensure the reliability of the findings. Furthermore, a mechanism analysis is conducted to explore the underlying pathways through which temperature change affects health vulnerability.

Results: The findings reveal that rising temperatures in spring, summer, and winter significantly exacerbate the health vulnerability of migrant workers, while increasing autumn temperatures mitigate it. Mechanism analysis identifies heightened psychological burden as a key channel through which temperature change worsens health vulnerability. Additionally, generational differences emerge: older migrant workers are more adversely affected by elevated spring temperatures, whereas younger workers exhibit greater sensitivity to rising summer temperatures.

Discussion: These results underscore the necessity of targeted health interventions and adaptive labor protection policies. By highlighting the seasonal and generational disparities in the effects of temperature change, this study offers theoretical and empirical support for enhancing the resilience of migrant workers to climate variations. The findings provide valuable insights for policymakers in designing strategies to safeguard the health and stability of the migrant workforce.

This study provides a comprehensive review of the research surrounding the Chernobyl nuclear incident, focusing on its far-reaching impacts on human health, and environmental contamination. Based on the Scopus database, 258 relevant papers were identified using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. These papers were metal-analyzed and quantitatively analyzed using a similarity map generated through VOSViewer in order to visualize key themes and their interconnections. The research highlights critical areas such as radiation-induced health effects, ecological damage, and the implications for sustainable energy practices. Additionally, this review explores the alignment of these findings with several United Nations Sustainable Development Goals (UNSDGs), particularly UNSDG 3 (Good Health and Wellbeing), UNSDG 6 (Clean Water and Sanitation), UNSDG 7 (Affordable and Clean Energy), UNSDG 13 (Climate Action), and UNSDG 15 (Life on Land). By synthesizing existing research, this study emphasizes the importance of integrating safety protocols, environmental rehabilitation, and sustainable energy policies to prevent and to mitigate the impacts of future nuclear incidents.

Low-income families in dry regions, including in the Southwestern United States, frequently cool their homes with evaporative ("swamp") coolers (ECs). While inexpensive and energy efficient compared to central air conditioners, ECs pull unfiltered outdoor air into the home, creating a health hazard to occupants when wildfire smoke and heat events coincide. A community-engaged research project to reduce wildfire smoke in homes was conducted in California's San Joaquin Valley in homes of Spanish-speaking agricultural workers. A total of 88 study participants with ECs were asked about their level of satisfaction with their EC and their willingness to pay for air filtration. About 47% of participants reported dissatisfaction with their EC, with the most frequently reported reason being that it brings in dust and air pollution. Participants were highly satisfied with air cleaners and air filters that were offered to them free-of-charge. However, a willingness to pay analysis showed that air filtration solutions would not be adopted without significant subsidies; furthermore, air filtration would be an ongoing cost to participants due to the need to regularly replace filters. Short-term filtration solutions for EC users are feasible to implement and may reduce smoke exposure during wildfire events. Such solutions would need to be offered at low-or no-cost to reduce barriers to adoption. Longer term solutions include prioritizing homes with ECs in wildfire smoke exposed regions for replacement with air cooling technologies that provide clean air. Because ECs are disproportionately in low-income homes, addressing smoke intrusion through these devices is an environmental justice issue.

Background: Understanding health system delay (HSD) in pulmonary tuberculosis (PTB) diagnosis aids in tailoring interventions for case detection and curbing transmission. However, recent nationwide studies on HSD in PTB diagnosis have been scarce. This study assesses HSD and its risk factors in China, taking into account the impact of the COVID-19 epidemic.

Methods: Patients diagnosed with PTB between 2019 and 2022 were selected using a multistage stratified clustering method. A semi-structured questionnaire was employed to assess HSD, which was defined as the interval between the patient's initial visit to a health facility and the definitive PTB diagnosis. The HSD was then compared between 2019 (before the epidemic) and 2020-2022 (during the epidemic). Factors associated with long health system delay (LHSD, defined as HSD > 14 days) were examined using both univariate and multivariate analyses with chi-square tests and binary logistic regression, respectively.

Results: In total, 958 patients with PTB were analyzed: 478 before and 480 during the epidemic. The HSD was 14 (interquartile range, 7-30) days for all patients, and the HSD before and during the epidemic also shared this value. A total of 199 patients (20.8%) had LHSD. LHSD was more prevalent in patients presenting solely with cough and expectoration (Odds ratio [OR]: 1.482, 95% confidence interval [CI]: 1.015-2.162) and those visiting ≥2 health facilities before definitive diagnosis (2 health facilities: OR = 2.469, 95%CI: 1.239-4.920; ≥3 health facilities: OR = 8.306, 95%CI: 4.032-17.111). Additionally, patients with negative bacteriological results were independently associated with higher LHSD risk (OR = 1.485, 95%CI: 1.060-2.080).

Conclusion: In China, HSD in PTB diagnosis remains relatively low and is primarily mediated by factors associated with health providers. No significant impact on HSD from the COVID-19 epidemic has been found. Implementing targeted training programs to enhance health providers' awareness of chronic respiratory symptoms and maintain vigilance for PTB; strengthening presumptive PTB identification capabilities at grassroots health facilities, and promoting the use of Mycobacterium tuberculosis (MTB) bacteriological technologies are recommended to shorten the HSD.

Introduction: Addiction recovery can be conceptualized as multidimensional changes to health and wellness including changes in substance use, physical and mental health, and social relationships. These outcomes are often measured through recovery capital which recognizes the various resources, both internal and external, that one may use to enhance their recovery. Internal and external resources can also be accumulated by engaging in an activity an individual is passionate about, explained by the dualistic model of passion (DMP) as enhancing mental and spiritual well-being, health, and personal growth, thereby fostering positive emotions, community involvement, deeper relationships, and heightened performance across various life domains. Evidence indicates that both RC and the DMP contribute to improved health outcomes including life satisfaction and well-being; however, the DMP has not yet been applied to addiction recovery science. The current study aimed to contribute to the growing body of research on addiction recovery by exploring the way passion may influence recovery outcomes. Further, the study investigated how the differences in passion type [e.g., harmonious (HP) and obsessive (OP)] impacted RC.

Methods: Participants for the study (N = 346; M _age = 42.1; 53.2% Male) included individuals who self-reported being in recovery from alcohol and/or drugs and completed an online survey through Amazon's Mechanical Turk platform.

Results: A significant bivariate correlation was found between HP and RC (r = 0.42, p < 0.001), and mean comparisons showed significant differences for individuals endorsing HP as they scored higher on a measure of RC (M = 4.69) than did their peers endorsing OP (M = 4.26). Finally, a regression analysis found that HP predicted RC (B = 0.19, p < 0.001), even when time in recovery and mental health variables such as depression and anxiety were included in the model.

Discussion: This study offers novel evidence for an association between the DMP and recovery outcomes warranting future research.

Background: Decubitus ulcers, also known as pressure ulcers, pose a significant public health challenge due to their substantial impact on morbidity, mortality, and healthcare expenditures.

Methods: The number and age-standardized rates (ASRs) of prevalence, death, disability adjusted life-year (DALY), years of life lost (YLL), and years lived with disability (YLD) at the global, regional, and national levels were acquired from the GBD 2021 database. Trends were evaluated based on the estimated average percentage change (EAPC) of ASRs. Additionally, data were stratified by socio-demographic index (SDI) quantiles, regions, countries, territories, and age groups.

Results: The total number of decubitus ulcer cases increased from 300,442 in 1990 to 645,588 in 2021. The global ASR of prevalence decreased slightly from 8.25 to 7.92 per 100,000 persons, with most cases occurring in individuals aged 60 and older. Deaths due to decubitus ulcers rose from 16,622 in 1990 to 37,033 in 2021, while the global ASR of death declined from 0.53 to 0.46 per 100,000 persons. DALY due to decubitus ulcers increased, exhibiting significant variation across regions and age groups. A higher SDI was correlated with increased ASRs of prevalence (R = 0.488, p < 0.001) and YLD (R = 0.495, p < 0.001). Conversely, a higher SDI was correlated with lower ASRs of death (R = -0.329, p < 0.001), DALY (R = -0.398, p < 0.001), and YLL (R = -0.445, p < 0.001).

Conclusion: The global burden of decubitus ulcers has risen, with notable regional and age-related disparities. This study offers valuable insights for policymakers to optimize healthcare strategies and mitigate the public health impact of decubitus ulcers.

Introduction: The physical and mental health of adolescents is a crucial cornerstone for social development. Therefore, this study aimed to examine whether family socioeconomic status made a difference in Chinese teenage mental and physical health and to disentangle the mediating role of parental involvement in youth sports in the process in which family socioeconomic status influenced adolescent health.

Methods: A quantitative analysis used a sample of approximately 11,000 adolescents from Chinese middle schools. The research employed structural equation modelling (SEM) to explore the relationships among family socioeconomic status, parental involvement in youth sports, and adolescent mental and physical health.

Results: The findings indicated that both family socioeconomic status and parental involvement in youth sports significantly positively predict levels of adolescents' physical health and mental health. Further analysis revealed that parental involvement in youth sports mediated the relationship between family socioeconomic status and adolescent health.

Discussion: It is evident that parental involvement in youth sports plays a crucial role in adolescent mental and physical health. Regardless of family socioeconomic status, parents should actively engage in sports activities with their children, which is not only an important way to promote adolescents' health but also a manifestation of realizing health equity.

Objectives: Accessibility is a critical factor in ensuring equitable public services. In urban older adult care systems, resource allocation and service disparities present unique challenges. The classical "5A" theory-availability, accessibility, affordability, adaptability, and acceptability-provides a robust framework for evaluating service delivery. However, its application in urban older adult care, especially in rapidly aging societies like China, remains limited. This study aims to develop and validate a framework to address affordability, resource allocation, and service mismatches in urban older adult care systems.

Methods: A web-based cross-sectional study was performed in 2023. A multi-phase methodology was adopted to construct the framework, grounded in the "5A" theory. Indicators were refined through expert consultations using the Delphi method, involving 20 experts, while the entropy weight method ensured objective indicator weighting. The framework was empirically validated in Xi'an, China, using survey data collected from 438 older adult residents across urban strata. A fuzzy comprehensive evaluation (FCE) method was employed to assess accessibility and identify key service gaps.

Results: This study constructs a comprehensive evaluation framework for basic older adult care services (BECS), structured around 5 primary dimensions, 14 sary indicators, and 37 tertiary indicators. Empirical validation in Xi'an further demonstrates the framework's scientific rigor and practical applicability. While the framework identifies strong spatial accessibility (3.8815), it also reveals critical gaps in affordability (3.1347) and psychological care (3.0862), confirming its effectiveness in diagnosing systemic disparities and guiding policy interventions.

Conclusion: This study introduces a novel accessibility evaluation framework tailored for basic older adult care services, addressing critical gaps in affordability, psychological care, and service responsiveness. Empirical results validate the framework's practicality and its alignment with the real-world conditions of urban aging societies. Furthermore, an innovative "Matching-Realization-Satisfaction" improvement pathway is proposed, offering actionable strategies to enhance accessibility and optimize service delivery. This framework serves as a replicable model for advancing equitable older adult care in rapidly aging urban communities.