International Journal of Public Health最新文献

Objectives: Skin diseases account for 1.79% of the global disease burden, though their impact may be underreported due to limited research. Raising awareness about early detection is essential, but tools to measure this are scarce. This study aimed to develop and validate a questionnaire assessing community awareness and early detection of common skin diseases, including leprosy, in Indonesia.

Methods: The questionnaire was drafted in English, translated into Bahasa Indonesia, and tested for face validity, content validity, and internal consistency. A pilot test with 25 participants and a field test with 680 participants were conducted. Results were analyzed using Cronbach alpha and descriptive methods.

Results: The final questionnaire comprised 17 questions on skin disease: common knowledge, intentions on prevention and health-seeking behavior. Validity and internal consistency were confirmed during pilot testing, and no participants in the field test reported confusion. The Cronbach alpha score exceeded 0.70, confirming strong internal consistency.

Conclusion: This validated questionnaire can assess public awareness of early skin disease detection. It is available for international adaptation and may help improve early detection and prevention in Indonesia's healthcare system.

Objectives: This study examines how different measures of socioeconomic status (SES) across childhood and adulthood relate to frailty in older age.

Methods: Data came from the Lausanne cohort 65+ (Lc65+), a population-based study of approximately 4,500 older adults followed over 20 years. SES measures included education in young adulthood, occupational class in midlife, and specific early old-age factors: perceived income, wealth, financial strain, and receipt of financial subsidies. Frailty trajectories over a 10-year period were assessed using Fried's frailty phenotype and group-based trajectory modeling. Logistic regression models adjusted for sex, age, cohort, living situation, marital status, and number of children.

Results: Lower education, occupational class, financial strain, and financial subsidies in older age were each independently associated with higher frailty risk at ages 65-70. Financial strain and financial subsidies in early old age increased odds of medium- (aOR, 1.48-1.69) and high-frailty (aOR, 2.07-2.28) trajectories.

Conclusion: SES across the life course strongly correlates with frailty in early old age. Early interventions and financial protection policies in older age could help mitigate frailty risk and SES-related frailty inequalities.

Objectives: To describe the prevalence and distribution of perceived need for mental healthcare among adults in Germany and examine its association with more objective indicators of need as well as mental health literacy.

Methods: We used data from 6,558 adults randomly sampled from a health insurance company as well as nationally representative survey data from 10,676 adults. Prevalence estimates were calculated, also by sex, age and education. Bivariate and multivariate associations between perceived need and sociodemographic characteristics, psychopathological symptoms, functional impairment and F-diagnoses as well as mental health literacy were examined.

Results: Approximately one-sixth of adults perceived a need for mental healthcare in the previous 12 months. Perceived need was associated with female sex (bivariate association only), younger age, high educational attainment, psychopathological symptoms, mental health-related functional impairment and mental health literacy. Those with perceived need were also twice as likely to have a documented F-diagnosis than those without.

Conclusion: Perceived need should be monitored within mental health surveillance to inform healthcare planning from a patient perspective and address the mental health treatment gap.

Objectives: This study aims to establish a multicenter database to evaluate Parkinson's disease in the MENASA region in the context of expert care.

Methods: The CGD-PD consortium includes 20 institutes from 9 MENASA countries. The database collects comprehensive data from PD patients.

Results: Initial data from participating sites showed significant heterogeneity in patient demographics, clinical characteristics, and healthcare management within the MENASA area. Descriptive analyses will include patient demographics and treatment methods, while multilevel regression models will explore correlations across care levels, environmental factors, and health outcomes. The results are anticipated to reveal region-specific patterns and gaps in the management of Parkinson's disease.

Conclusion: The CGD-PD database will be instrumental in addressing the gap in PD research in the MENASA region, ultimately improving the quality of life for PD patients.

During the COVID-19 pandemic (2020-2023), governments around the world implemented an unprecedented array of non-pharmaceutical interventions (NPIs) to control the spread of SARS-CoV-2. From early 2021, these were accompanied by major population-wide COVID-19 vaccination programmes-often using novel mRNA/DNA technology, although some countries used traditional vaccines. Both the NPIs and the vaccine programmes were apparently justified by highly concerning model projections of how the pandemic could progress in their absence. Efforts to reduce the spread of misinformation during the pandemic meant that differing scientific opinions on each of these aspects inevitably received unequal weighting. In this perspective review, based on an international multi-disciplinary collaboration, we identify major problems with many aspects of these COVID-19 policies as they were implemented. We show how this resulted in adverse impacts for public health, society, and scientific progress. Therefore, we propose seven recommendations to reduce such adverse consequences in the future.

Objectives: To investigate type 2 diabetes self-management behaviors and glycemic control under the impacts of COVID-19 legacy and Diabetes Prevention and Control Action, and explore the heterogeneous impacts of five self-management activities on glycemic control and how these impacts differ across key groups.

Methods: A cross-sectional survey was conducted between April and September 2023 in hospitals and communities in China. Overall, 1817 adults with type 2 diabetes and normal cognitive and behavioral capacities completed a questionnaire regarding diabetes self-management behaviors and glycemic control. Ordinary least squares regression analyses were conducted.

Results: Mean score of overall self-management behaviors was 5.89. About 26.86% reported good glycemic control. Among five self-management activities, medication adherence was the best (mean = 6.77) but glucose-monitoring adherence was the worst (mean = 5.18). Overall self-management behaviors and the five activities (coefficient = 0.031-0.146, all p < 0.001) all exerted positive impacts on glycemic control, with dietary control showing the greatest impact while medication adherence the least. Younger persons, rural persons, and persons with financial difficulties were key groups benefiting less from self-management.

Conclusion: Diabetes self-management behaviors and glycemic control were suboptimal. Customized health promotions should focus on key groups and addressing the deficiencies in self-management activities especially dietary control.

Objectives: This study aims to examine vulnerable ADL-based subgroups of Chinese older adults, their links to depressive symptoms, and life satisfaction as a mediating factor.

Methods: We screened 8,211 participants aged 60 years and above who met the inclusion criteria from 2018 CHARLS. The different subgroups of ADL were identified by latent profile analysis. Life satisfaction and depressive symptoms were compared among the various ADL subgroups. Mediation analysis helped investigate the mediating role of life satisfaction between the various subgroups of ADL and depressive symptoms.

Results: Two vulnerable subgroups of ADL were identified (Low Damaged class and High Damaged class), along with another subgroup of ADL (Not Damaged class), comprising the majority of Chinese older adults. The vulnerable subgroups of ADL had significantly lower life satisfaction and higher levels of depressive symptoms. The relationship between depressive symptoms and the vulnerable subgroups of ADL was partially mediated by life satisfaction.

Conclusion: The results emphasize the role of life satisfaction in linking ADL with depressive symptoms, indicating potential areas for interventions to reduce depressive symptoms among older adults. This study is limited by its cross-sectional design precluding causal inference, reliance on self-reported data and unexplored moderating factors.

Objective: Few studies on teenage pregnancy in Tanzania have used a nationally representative sample. This study sought to determine the prevalence and factors associated with teenage pregnancy in Tanzania.

Methods: We conducted a secondary data analysis of 3,083 teenagers aged 15-19 years drawn from the 2022 Tanzania Demographic and Health Survey.

Results: After controlling for other covariates, we found that teenagers aged 18-19 years (AOR = 4.5, 95% CI:3.3, 6.1), those who said that getting permission to access healthcare was not a big problem (AOR = 2.7, 95% CI:1.4, 5.3), and those from the Southern zone (AOR = 2.4, 95% CI: 1.5, 3.9), had higher odds of reporting ever having been pregnant. Those with secondary or higher education levels (AOR = 0.3, 95% CI: 0.19, 0.39) and those who married after age 15 (AOR = 0.4, 95% CI: 0.2, 0.8), had lower odds of reporting ever having been pregnant.

Conclusion: This study highlights the significant factors associated with teenage pregnancy among teenagers aged 15-19 years in Tanzania. The education system should facilitate the majority of girls obtaining at least a secondary level of education. Teenager-friendly sexual and reproductive health services need to prioritize older teenagers, with lower education levels and those from poor families.

Objectives: Extreme Weather Events (EWEs) are increasingly frequent in the United Kingdom (UK) and can lead to adverse health outcomes, resulting in additional pressure on the NHS. The aim of this review is to investigate the health impacts of EWEs on the population in the UK, through an economic lens.

Methods: A systematic review of the evidence was conducted. Seven databases were searched for studies related to the public health outcomes of EWEs.

Results: 48 papers met inclusion criteria: 22 flood, 25 extreme temperature, one wind. Three themes emerged: physical health impacts (predominantly temperature extremes); mental health impacts (predominantly flood-related) and socio-economic considerations (EWEs experienced disproportionately by marginalised populations).

Conclusion: Whilst there is a substantial body of research on physical and mental health impacts of EWEs in the UK, there is limited evidence on socio-economic impacts, and little consideration of the economic costs. Building resilience against the health impacts of EWEs is essential. Future studies should consider incorporating cost-benefit analyses (CBA) to investigate the economic costs of EWEs on populations and health systems in the UK, and of potential mitigation efforts.