International Journal of Public Health最新文献

The development of trustworthy Health Data Spaces (HDS) is currently in the spotlight of digital health policy. Diverse stakeholders agree on the importance of trust for the adoption and legitimacy of HDS. This emphasis on trust has led to the development of conceptual work describing what trust in HDS entails, along with initial suggestions on how trust principles can be operationalized in HDS governance and architecture. In contrast, little research has been conducted on methods to evaluate the performance of trust-building principles and the overall trustworthiness of HDS. In response, we propose two distinct methodologies that share a common focus on assessing trustworthiness: A) Trust Performance Indicators collect routine data related to trust-building principles. B) Trust Stress Tests support the design of resilient HDS architectures by identifying potential future scenarios that could undermine their trustworthiness. Through these methodologies, we aim to contribute to the ongoing development of trustworthy HDS.

Objectives: Healthcare workers (HCWs) face heightened suicide risk due to occupational stressors and other proximal and distal factors. To our knowledge, this study is the first study in Lebanon and among the first globally to examine the association between childhood adversities and suicidality among HCWs within overlapping national crises.

Methods: We conducted a cross-sectional analysis of a cohort study among 390 HCWs in Lebanon. Using an online survey, data included sociodemographics, Beirut port blast, adulthood trauma, economic collapse, COVID-19, network/support, childhood adversities, mental health (PHQ-9/PCL-5), substance use, prior health and suicidality. Analyses in Stata used bivariate and stepwise logistic regressions to determine parsimonious predictors of suicidality in past-two-week and lifetime suicidality.

Results: Childhood emotional neglect and depression emerged significantly predicted suicidality in the past-two-weeks. Younger age, PTSD due to childhood trauma, PTSD related to a loved one's illness and depression were significantly associated with lifetime suicidality. Contrary to previous findings, COVID-19 stressors and financial difficulties were not retained in the final model.

Conclusion: HCWs suicidality is associated with early-life adversities and trauma. Findings highlight the need for targeted interventions.

Objective: To assess the competence of students and academic staff to use generative artificial intelligence (GenAI) as a tool in epidemiological data analyses in a randomised controlled trial (RCT).

Methods: We invited postgraduate students and academic staff at the Swiss Tropical and Public Health Institute to the RCT. Participants were randomized to analyse a simulated cross-sectional dataset using ChatGPT's code interpreter (integrated analysis arm) vs. a statistical software (R/Stata) with ChatGPT as a support tool (distributed analysis arm). The primary outcome was the trial task score (out of 17, using an assessment rubric). Secondary outcome was the time to complete the task.

Results: We invited 338 and randomized 31 participants equally to the two study arms and 30 participants submitted results. Overall, there was no statistically significant difference in mean task scores between the distributed analysis arm (8.5, ±4.6) and the integrated analysis arm (9.4, ±3.8), with a mean difference of 0.93 (p = 0.55). Mean task completion time was significantly shorter in the integrated analysis arm compared to the distributed analysis arm.

Conclusion: While ChatGPT offers advantages, its effective use requires a careful balance of GenAI capabilities and human expertise.

Objectives: This study examines changes in disability, severe disability, and dependence in Spain between 1986 and 2020, highlighting implications for long-term care planning.

Methods: We analyzed microdata from four nationally representative disability surveys (1986, 1999, 2008, 2020) and applied the Sullivan method to estimate disability-free, severe-disability-free, and autonomous life expectancy at ages 6, 45, 65, and 85 years, stratified by sex.

Results: Disability-free life expectancy increased in both sexes, with slightly greater gains in men. However, years lived with severe disability and dependence also rose, especially among older adults. Women consistently lived longer but spent more years with disability and dependence than men. These patterns suggest a partial compression of morbidity, concentrated in milder forms of disability.

Conclusion: Spain has experienced a relative compression of disability over the last four decades, accompanied by a growing burden of severe disability and dependence in old age. These trends raise challenges for care systems in aging societies, particularly where informal caregiving remains central. Our findings provide evidence to support health and social policy reforms aimed at building resilient and equitable long-term care models.

Regular physical activity (PA) is essential for maintaining health and wellbeing across all life stages, particularly in children and adolescents. Despite its benefits, most adolescents fail to meet the World Health Organization's PA recommendations, with global trends indicating alarmingly low participation rates, particularly among girls. This issue is pronounced in Sub-Saharan Africa (SSA), where physical inactivity is a significant public health concern, contributing to rising obesity rates. Environmental, socio-economic, and cultural barriers further exacerbate low PA engagement, including extreme weather conditions, lack of recreational infrastructure, gender norms, and economic constraints. Addressing these challenges requires targeted interventions, including education, improved infrastructure, and policy implementation. Innovative programs such as ARISE-NUTRINT and DASH aim to enhance adolescent health in SSA through nutrition and PA-focused strategies. This commentary paper explores existing barriers to PA, evaluates promising on-going efforts and interventions, and highlights opportunities for promoting PA in SSA through community engagement, digital platforms, and cross-sector collaboration. Implementing sustainable and culturally tailored strategies is crucial to reversing current trends and fostering long-term health benefits for adolescents in SSA.

Objectives: Individual placement and support (IPS) is an evidence-based form of vocational rehabilitation that aims to help people with mental illness obtain and remain in competitive employment. The objective of this study is to quantify the national growth of IPS over an 8-year period in Norway.

Methods: Using a combination of qualitative and registry data, we map how IPS was implemented in Norway between 2012 and 2019, both in terms of geographic availability and intensity of service provision.

Results: In 2012 IPS was available in 4 out of 19 counties, with 14.9% of the population living in an area where IPS was present. By 2019 this had increased to all 19 counties in Norway, and more than 70% of the population lived in an area of Norway where IPS was available. The results are presented in eight heat maps that visually display how the intensity and availability of the service have expanded.

Conclusion: This study has identified when and where IPS became available in Norway, which is key to future effectiveness studies of IPS in the IPSRON project.

Objectives: In the context of introducing pre-referral rectal artesunate for children with severe malaria in Adamawa State, Nigeria, case fatality was 19% among severely sick children visiting primary health centres (PHCs), and 6% among those visiting community health workers (CORPs). To understand this difference, we investigated illness severity, treatment-seeking, and background characteristics of these patients.

Methods: 589 children <5 years of age with fever and danger signs indicative of severe malaria attending CORPs (N = 314) and PHCs (N = 275) were enrolled. After 28 days, caregivers were interviewed about background characteristics, symptom severity, and treatment seeking practices; children attending CORPs and PHCs were compared.

Results: Compared to children attending CORPs, those attending PHCs were more likely to live in urban areas, have ≥4 clinical danger signs (50% vs. 39%, p = 0.02) and signs of central nervous system involvement (90% vs. 74%, p < 0.01), and more often received initial home treatment (42% vs. 33%, p = 0.04).

Conclusion: PHCs may see sicker children due to community assumptions of their professional capacity. Health system strengthening is required to capacitate PHCs to handle severe conditions and save lives in rural communities.

Objectives: Health self-perception (HSP) refers to an individual's subjective evaluation of their overall health, encompassing both physical and psychological dimensions. A number of factors, such as body composition, anxiety levels, and sleep quality, can have an impact on HSP among university students. There is a limited research investigating the combined association between HSP, sleep quality, and anxiety status in this demographic, despite the fact that each of these characteristics has been examined separately in relation to students' health. Furthermore, students' perceptions and reporting of their health may be influenced by contextual and cultural factors, particularly in the United Arab Emirates (UAE). This study aimed to explore the association of HSP with anthropometric measurements, sleep quality, and anxiety status and to compare these associations between female and male university students.

Methods: This cross-sectional study recruited 390 university students (198 males and 192 females), aged 18-25 years. A validated questionnaire was used for determining the sleep quality, anxiety and HSP while body composition was measured by using body analyzer.

Results: Majority (59%) of the students reported positive HSP which was significantly associated with higher sleep quality and lower state anxiety scores compared to negative HSP group. Females were more likely to have negative HSP compared to males (p < 0.001). Moreover, the State-Trait Anxiety Inventory (STAI) score, PBF, FM, and VFR were significantly lower while sleep quality score and FFM were significantly higher among positive HSP group.

Conclusion: This study highlighted that good sleep quality, low anxiety levels, and healthy body composition are correlated with positive HSP and were significantly dependent on sex. A comprehensive health program is essential to improve sleep quality and anxiety status to promote good HSP among university students.

Objectives: In humanitarian settings, poor school hygiene conditions can severely impact children's health and wellbeing. As part of a cluster randomized trial evaluating a multicomponent hand hygiene intervention, this baseline study assessed hand hygiene behaviors, school infrastructure, and wellbeing among schoolchildren in Nigeria.

Methods: Between May and June 2023, cross-sectional data were collected from 26 schools using handwashing observations, questionnaires, infrastructure assessments, and hand rinse sampling. A total of 964 children were observed, 645 interviewed, and 311 provided samples.

Results: Observed handwashing rates were extremely low: 4%-12% before eating and 2%-3% after toilet use. About half of schools lacked designated handwashing stations. General water points, though more available, were often inadequate. Soap was entirely absent. Over half of children's hands rinse samples contained more than 100 colony-forming units (CFU) of Escherichia coli (E: coli) per 100 mL. Misconceptions about hygiene were widespread and gaps existed between reported and observed behavior.

Conclusion: These findings underscore the need for integrated school-based WASH interventions in humanitarian contexts.

Objectives: We conducted this scoping review to describe the factors that influence the risk of spillover of Swine Influenza Virus (SIV) at various human-swine interfaces.

Methods: We used the PubMed and EMBASE databases to identify relevant articles published until February 2024. We included cross-sectional, case-control, cohort, randomized controlled trials (RCTs), and ecological studies. Two authors screened the titles, abstracts, and full texts. The extracted details were presented in tables and figures.

Results: Among the 55 studies, the majority were conducted in the United States (n = 27) and published after 2015 (n = 30). Occupational risk factors were the most commonly reported (n = 14), followed by lack of biosecurity measures (n = 10). We classified the identified risk factors into two broad categories: (1) risk factors that influence the transmission of SIV among swine and from swine to human, and (2) risk factors associated with the type of human-swine interfaces.

Conclusion: Vaccination, biosecurity measures, and surveillance systems at human-swine interfaces effectively reduce swine influenza transmission. These strategies can be tailored to specific risk factors in common interaction settings.