International Journal of Public Health最新文献

Objectives: This study analyzes the perceptions of master's nursing and midwifery students regarding ethical and legal dilemmas related to the declaration of brain death.

Methods: An anonymized, self-administered web-based survey was conducted among 269 master's students in nursing and midwifery at Poznan University of Medical Sciences.

Results: The most controversial ethical and legal dilemmas concerned the lack of legal consequences for patients' declarations of will, family objections to organ donation, and sustaining vital functions in pregnant brain-dead patients. While 82.5% accepted the medical definition of brain death, only 53.6% prioritized quality of life over life preservation. Students identified medical knowledge (96.3%) as the most influential factor shaping their attitudes, followed by ethical (66.2%) and religious (45.4%) views. Regression analysis showed that religiosity and age were associated with support for sustaining life functions, while liberal views and a nursing background correlated with greater support for overriding family objections and discontinuing futile therapy.

Conclusion: Education in up-to-date medical knowledge should place greater emphasis on professional ethics, legal frameworks, and real-life bioethical dilemmas to better prepare students for clinical challenges.

Objectives: This paper examines a stakeholder engagement initiative to develop public health recommendations for addressing mental health gaps after the COVID-19 pandemic in southern Switzerland. It explores local healthcare professionals' experiences with the pandemic's impact on mental health and service use.

Methods: We used a stakeholder dialogue methodology based on participatory research. After mapping, we selected participants based on their power and interest on the subject. Data were gathered through two structured dialogues. We conducted thematic content analysis to identify and interpret patterns within dialogues. We used multi-step coding to assign codes to text segments, grouping similar patterns into themes and subthemes while ensuring consistency and exclusivity.

Results: Thirty-two healthcare stakeholders from diverse sectors across urban and rural southern Switzerland participated in the dialogues. They emphasized flexible mental health service restructuring to address evolving patient needs and advocated for stronger prevention and promotion efforts, especially for vulnerable groups.

Conclusion: Engaging local healthcare stakeholders turned up as an effective strategy to derive public health recommendations to improve mental health prevention and promotion along with the access and use of related services.

Objectives: To explore the relationship between forced displacement and variables associated with mental health in an indigenous Colombian pediatric population.

Methods: A mixed methods design was applied with 69 children aged six to 16 years belonging to 45 families of the Embera Dobidá People: 25 displaced families and 20 non-displaced families. The qualitative phase involved focus groups, while the quantitative phase used a cross-sectional correlational design.

Results: Quantitative findings revealed statistically significant correlations (p < 0.001) between displacement and multiple mental health indicators, particularly emotional and behavioral problems. Food insecurity showed a moderate but meaningful effect, highlighting the impact of nutritional vulnerability on the emotional wellbeing of displaced children and adolescents. In the qualitative phase distinct themes emerged in each community: A territory that cannot be returned to, in Caldas, and The angry and dying territory, in Chocó.

Conclusion: For Indigenous communities in Colombia, mental health is closely tied nutritional sufficiency and a meaningful relationship with ancestral territory. These elements are disrupted by forced displacement, contributing to elevated suicidal risk and emotional distress among children and adolescents.

Objectives: This study aimed to examine trends in relative and absolute social inequality in overweight/obesity among Danish infants born between 2002 and 2022.

Methods: The study applied yearly cross-sectional data on infants' weight and length at age 6-10 months, n = 63,100. Data was linked with parental education from population registers. Social inequality was measured by OR, relative index of inequality (RII), and slope index of inequality (SII). Trend tests measured changes over time.

Results: No difference in odds for overweight/obesity by parental education was observed between 2002 and 2004, but from 2005 social inequality in overweight/obesity was revealed. The OR for overweight/obesity ranged from 1.20 (95% CI: 0.76-1.89) to 2.31 (95% CI: 1.64-3.25) for infants of parents with lowest educational attainment. RII ranged from 0.78 to 0.41 (test for trend, p = 0.179) and SII ranged from -0.92 to -4.54 (test for trend, p = 0.026) indicating a persistent relative social inequality and an increase in absolute social inequality in overweight/obesity from 2002 to 2022, respectively.

Conclusion: The study revealed persistent relative social inequality and increased absolute social inequality in overweight/obesity among Danish infants from 2002 to 2022.

Objectives: In this protocol, we describe a planned intervention to adapt the Mother Mentor (MoMent) peer support program for women living with HIV (WLWH). WLWH face a six-fold higher risk of cervical cancer, yet screening and treatment rates remain low in Nigeria.

Methods: Using an implementation science approach, we will engage key stakeholders-including ministries of health, NACA, professional bodies, WLWH, Mentor Mothers, healthcare providers, and development partners (e.g., WHO, US CDC, USAID)-through deliberative democracy to adapt and expand MoMent for home-based HPV screening and follow-up treatment. We will pilot the adapted MoMent HIV+HCC program with 1,500 women in 15 health facilities across Nigeria's five geopolitical zones. The RE-AIM framework will guide evaluation of reach, adoption, fidelity, effectiveness, and sustainability.

Results: This study is designed to contribute to WHO's global strategy to eliminate cervical cancer by improving access to home-based screening and care in low-resource settings.

Conclusion: Findings will inform national HPV prevention efforts and may drive broader integration into Nigeria's cervical cancer program.

Clinical trial registration: Clinicaltrials.gov, identifier NCT06751030.

Objectives: This study aims to assess the knowledge and attitude of medical students in Lebanon towards disaster medicine.

Methods: An exploratory online cross-sectional survey was conducted on 388 medical students from different educational levels and universities in Lebanon. The data was analyzed using the Statistical Package for Social Sciences (SPSS), considering a p-value of <0.05 as significant.

Results: The participants had a mean knowledge score of 12.19 ± 4.04 out of 25 questions. Those who received a disaster medicine educational course (19.1%) had a higher knowledge score (p-value <0.001). There was a significant association between the knowledge score on one hand, and the confidence level of respondents (p-value of 0.003) and their willingness to enroll in a disaster medicine course on the other hand (p-values <0.001).

Conclusion: It is evident that medical students in Lebanon possess a fair level of knowledge and a high attitude towards disaster medicine.

Objectives: The COVID-19 pandemic significantly affected global psychological well-being. We explored long-term trajectories of adults' well-being from before the pandemic through its progression and identified risk factors for compromised well-being.

Methods: Psychological well-being of a diverse group of 481 adults (18-74 years) was assessed prior to (T0) and during the pandemic (T1-T5: 04-05/2020, 10-11/2020, 04-05/2021, 10-11/2021, 04-05/2022). Latent variable mixture modelling identified subgroups with distinct trajectories of well-being. Ordinal regression analysis investigated risk factors for low well-being during the pandemic.

Results: Three subgroups with different trajectories were identified: 73% reported consistently good well-being; 21% experienced decreasing well-being; and 5% exhibited consistently low well-being. Decreasing or consistently low well-being was significantly associated with younger age, limited social support, caregiving responsibilities, concerns about COVID-19 infection, and stress due to pandemic-related changes.

Conclusion: While many individuals remained resilient, a vulnerable subgroup experienced mental health challenges over 2 years of the pandemic. Given the global scale, even a small affected proportion represents millions of people. Public health measures are essential to identify and support those at highest risk for impaired psychological well-being.