Journal of Health, Population, and Nutrition最新文献

Background: Childhood obesity is a growing global health issue. The World Health Organization identifies obesity as a significant risk factor for Non-Communicable Diseases and considers it a pandemic. This study aimed to investigate headteachers' perspectives and practices concerning childhood obesity prevention interventions in primary schools highlighting the barriers and facilitators for those interventions.

Methods: This qualitative study used a phenomenological approach and semi-structured interviews with headteachers of primary schools in the West Yorkshire area, UK. The collected data was transcribed and analysed using inductive thematic analysis.

Results: A total of 32 interviews with headteachers were conducted. The data indicated that interventions meant to prevent childhood obesity in schools are influenced by a range of barriers and facilitators that are organized under the following seven key themes: (1) staff perception of obesity prevention at school; (2) school policies on eating at schools; (3) School curriculum on healthy diets and physical activities; (4) role models at school; (5) partnership with parents; (6) extra-curricular activities on healthy diets and physical activities; (7) School capacity and resources.

Conclusions: Childhood obesity prevention interventions vary across UK schools depending on staff and head teachers' beliefs, awareness, commitments, school resources, parents' involvement and parents' awareness, income, and culture. The study suggests raising awareness of childhood obesity among parents and staff, involving external partners like school nurses for training, making all primary pupils eligible for free meals, and providing schools with guidance on securing government funding. It provides a foundation for improving school-based strategies that indirectly contribute to better health outcomes for children.

Background: Pakistan is a multi-cultural country with different ethnic groups living in both rural and urban communities. There is a significant occurrence of congenital and hereditary neurodevelopmental disorder (NDD) contributing to mortality and morbidity rates.

Objectives: This study aims to explore the prevalence, patterns, and phenotypic spectrum of NDD in district Lakki Marwat population of Khyber Pakhtunkhwa, Pakistan.

Methodology: From 2022 to 2023, a cross-sectional study was conducted and subjects or families with NDD were recruited from district hospitals, rural and urban areas. Door to door survey was also carried out to collect appropriate data. The study gathered phenotypic and descriptive data, clinical information including age, gender, family history, consanguinity and bio-demographic features were recorded.

Results: A total of 276 independent cases/families with NDD were ascertained. The malformations were grouped into major and minor categories. Most of the case/families (58.69%) were sporadic, and 38.04% of the population was classified as having a low-income status. The most frequent family type was a single spouse with children (27.89%), while extended families made up 21.37% of all cases. Demographic variables such as parental consanguinity, syndromic/non-syndromic, familial/sporadic nature, economics status, age of disease onset and pedigree structures showed conspicuous heterogeneity among the major and minor categories of NDD.

Conclusion: The high incidence of NDD indicates that nongenetic factors may play a vital role in their etiology which could be diminished by improving the healthcare system.

Background: Hypertension and muscle strength are known to be associated; however, identifying simple clinical indicators of this relationship is challenging. Relative muscle strength (RMS), defined as strength per unit muscle mass, has been proposed as a potential indicator, but its association with hypertension is unclear. This study aimed to estimate the prevalence of hypertension and determine its association with RMS in an adult Indian population attending a tertiary care center in Gujarat.

Methods: This hospital-based cross-sectional study included 430 adults aged 18 years and older who were admitted to outpatient medicine clinics between January and October 2023. Grip strength and appendicular lean muscle mass (ALM), estimated using a validated formula, were measured. The RMS was calculated as grip strength/ALM. Hypertension was defined using standard criteria. Logistic regression was used to analyze the association between RMS (analyzed continuously and categorically in tertiles) and hypertension, adjusting for confounders. A p value of < 0.05 was considered significant.

Results: The prevalence of prehypertension and hypertension was 187 (43%) and 96 (23%), respectively. Compared to participants in the low RMS tertile (0.00-2.45 kg/kg ALM), those in the high tertile (3.79-6.12 kg/kg ALM) had 26% lower odds of hypertension (OR 0.74, 95% CI 0.59-0.89) and 33% lower odds of prehypertension (OR 0.67, 95% CI 0.49-0.91) after adjusting for confounders. The RMS also showed strong negative correlations with systolic and diastolic blood pressure (r = - 0.559 and - 0.418, respectively; p < 0.001).

Conclusion: Increased RMS was significantly protective against prehypertension and hypertension. These findings highlight the potential importance of muscle quality, beyond muscle mass, in blood pressure regulation.

Background: Approximately 1 in 8 children under the age of 6 in Tamil Nadu are diagnosed with neurodevelopmental disorders (NDD), yet only a fraction of these children receives proper medical care. The unequal distribution of healthcare services is mainly due to the lack of accessibility, especially in rural areas, leading to a significant burden on caregivers. This research aims to alleviate caregiver burden and reduce disability in preschool children by establishing model clinics or specialized outreach centers in rural villages, supported by SRM Institute of Science and Technology under the Unnat Bharat Abhiyan Scheme.(UBA-SRMIST).

Methods: The study will commence with screening all preschool children registered in Anganwadi in the designated villages. Tailored model clinics will be set up in these villages based on the prevalence of NDD. Once established, children diagnosed with NDD will undergo rehabilitation for a year. Baseline and endline assessments will be conducted to evaluate the effectiveness of the model center on both the child's disability and the caregiver burden.

Discussion: This research will demonstrate the effectiveness of a model outreach center in rural villages in reducing disability levels in children and alleviating caregiver burden by eliminating the need for long travels to access rehabilitation services. The findings of this study will not only contribute to the objectives of UBA-SRMIST in uplifting villages but also facilitate the creation of registries and provision of data to the government for the implementation of policies that address the current disparities in healthcare access. Trial registration Trail has been registered under Clinical Trials Registry-India (CTRI/2024/06/069196).

Despite years of a national deworming campaign, the incidence of intestinal parasitic infections (IPIs) remains relatively high among certain ethnic groups, with lifestyle factors distinct from those of the general population. Despite existing studies on the prevalence of IPIs, there is limited research exploring the contextual associated factors within the Badi Indigenous community. Our objective in this study was to assess the prevalence of IPIs in the indigenous Badi community of Gurbhakot Municipality, Surkhet, Nepal, considering socioeconomic, lifestyle, and behavioral factors. A total of 205 stool samples were obtained from individuals aged 18-70 years through purposive sampling and preserved in a 2.5% potassium dichromate solution. A structured questionnaire was administered to the selected participants. Three diagnostic methods were used: direct wet mount, saturated salt flotation, and formal ether sedimentation. The study revealed an overall parasite prevalence of 27% (n = 55) in the indigenous Badi communities. Protozoan infections were found in 19% (n = 39) of the studied community, whereas helminthic infections were present in only 7.8% (n = 16). The highest prevalence was observed for Giardia lamblia at 16.1% (n = 33), followed by Ascaris lumbricoides at 5.9% (n = 12), Entamoeba histolytica at 2.9% (n = 6), and both Enterobius vermicularis and Hymenolepis nana at 1% (n = 2). The female population had a higher exposure to E. histolytica (5.8%, n = 6) than did the male population (0%, n = 0). The multivariate logistic regression analysis revealed increased odds of IPIs among participants involved in agriculture [aOR: 5.37, 95% CI: (2.31 to 12.47)], those who kept free-ranging pigs and poultry [aOR: 5.22, 95% CI: (1.87 to 14.53)], those who did not use soap before eating [aOR: 9.96, 95% CI: (2.11 to 46.99)], and those who consumed raw or undercooked meat [aOR: 2.76, 95% CI: (1.08 to 7.05)] compared with others. Therefore, health education, particularly regarding hygiene practices and lifestyle changes, is crucial for reducing the burden of intestinal parasitic infections (IPIs) in indigenous Badi communities.

Background: Middle-aged adults, defined as individuals between the ages of 45 and 64, represent a significant yet under researched group of healthcare service users. This scoping review aimed to provide a comprehensive overview of the patterns of healthcare utilisation and the factors contributing to them within this demographic.

Methods: Following PRISMA-ScR guidelines and the framework proposed by Arksey and O'Malley, a systematic literature search was conducted across PubMed, EMBASE, and the Cochrane Library databases from their inception until July 2023. Key search terms such as "healthcare utilisation" and "middle-aged" were used to identify relevant studies. Articles were included if they were original cohort, case-control, or cross-sectional studies published in English. The findings were then synthesised narratively, by identifying recurring concepts and grouping them into broader themes. The themes were categorised according to the Andersen healthcare utilisation model's three factors: predisposing factors, enabling factors, and need-related factors.

Results: After screening 4,810 records, a total of 25 articles were selected for final analysis, comprising 15 from developed countries and 10 from developing countries. Consistent factors influencing healthcare utilisation included multimorbidity, socioeconomic status, and poor health behaviours. Differences emerged across contexts: in developed countries, healthcare utilisation was influenced by lifestyle behaviours and access to private care, while in developing countries, socioeconomic inequalities and limited insurance coverage played more dominant roles. Healthcare system structures likely shaped utilisation patterns.

Conclusion: Healthcare utilisation among middle-aged adults is driven by an interplay of medical, social, and economic factors that vary across contexts. Common contributors, such as multimorbidity and poor health behaviours, highlight the need for targeted interventions and policies focusing on primary and preventive care to address the long-term burden of healthcare utilisation. This demographic faces unique challenges in managing healthcare decisions amidst varying systemic and individual-level challenges, which should be further studied.

Objective: To analyze the differences in life satisfaction and the factors that influence it among elderly people in urban and rural locations in China and to provide a reference for narrowing these differences.

Methods: Binary logistic regression was used to analyze 2018 data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to understand the status of life satisfaction and urban-rural differences among the elderly.

Results: Among 4,910 elderly participants, the overall life satisfaction rate was 72.5% (3,560/4,910). The life satisfaction rate was higher in urban areas (75.5%) compared to rural areas (68.0%), with a statistically significant difference (χ²=33.817, P < 0.001). Multivariate analysis revealed that residence was an independent factor influencing life satisfaction among urban elderly (P < 0.05), while marital status and smoking status were independent factors among rural elderly (P < 0.05).

Conclusion: The study found significant urban-rural differences in life satisfaction among the elderly, with higher satisfaction in urban areas. Key factors influencing life satisfaction varied between urban and rural settings. These findings highlight the need for targeted interventions to address these disparities and improve the well-being of China's elderly population.

Background: Serum glucose, cholesterol, triglycerides and high-density lipoproteins (HDL) are established cardiovascular disease (CVD) markers, however accessibility to these markers is less in individuals from low-middle income countries. The non-invasive CVD risk marker especially skinfold measured fat percentages are less explored for its relevance with established serum biochemistry markers.

Methods: A cross-sectional study was conducted in 70 sedentary office workers (aged 30-40 years) who were healthy. Peripheral fat percentages were estimated from four skinfold thickness measurements and biochemistry markers were measured and analysed using standard laboratory measurements. Blood pressure was also measured. Multivariate linear regression models were drawn to establish the association between the non-invasive and invasive CVD risk markers.

Results: The skinfold measured fat percentage was negatively associated with the HDL (coefficient β = -0.15, standard error SE = 0.07, p < 0.05). No significant relation between the other biochemistry parameters with the skinfold thickness. Age and BMI were found to be mediating the above relationship.

Conclusions: Skinfold thickness derived fat percentage is associated with the few of the CVD markers (especially HDL). Age and BMI are crucial mediating factors for the fat measurement. Skinfold measurements could be included as part of routine primary care screening for CVD risk, alongside invasive biochemistry parameters.

Background: An estimated 40% of the world's population lives in malaria-prone areas, there are 300-500 million malaria episodes worldwide, and at least one million malaria fatalities occur each year which makes malaria is a major public health concern [1]. In sub-Saharan Africa, malaria claims the lives of about 90% of all people worldwide. Today, there is a growing interest in using ITNs as one of the leading strategies for the prevention and control of malaria. Many studies on ITN use and associated factors have shown that factors influencing ITN use differ from place to place, with very few similarities; specifically, there are no studies conducted in the study area on ITN ownership, utilization, or associated factors.

Methods: A community-based cross-sectional study was conducted from April 2023 to June 2023. A multistage sampling technique was employed to recruit the study participants. From twenty Malaria kebeles, six kebeles were selected by the lottery method, and study households were selected by the systematic random sample technique. A total of 770 planned sample sizes were calculated by using a single population formula. A trained data collector was used to collect the data, and the data entry and analysis were performed with SPSS 27.0. Simple frequency distribution and descriptive analyses were performed to describe participants' sociodemographic, ownership, and utilization. Bivariate and multivariate analyses were performed to determine associations between dependent and independent variables, with a p-value < 0.05 indicating statistical significance.

Results: Data were collected from a total of 766 study participants, for a response rate of 99.5%. The majority (89%) of the respondents had at least one ITN, and 83.5% of the households reported sleeping under the ITN the night preceding the survey. Knowledge about ITN as a preventive agent for malaria [AOR 2.028, 95% CI: 1.010, 4.070], the presence of pregnant mothers in the household [AOR 4.373, 95% CI: 1.70, 11.203], willingness to buy ITN [AOR 2.106, 95% CI: 1.330, 3.335] and home visited by health extension workers [AOR 2.002, 95% CI: 1.228, 4.540] were identified as factors associated with ITN utilization by households.

Conclusion: ITN ownership and utilization were 89% and 83.5%, respectively. Knowledge about the use of the ITN for preventing malaria, the presence of pregnant mothers in the household, willingness to buy the ITN, and home visits by HEW were identified as factors associated with ITN utilization. The ITN distribution for malaria cases and the mechanism for accessing the ITN in the market need to be considered by health authorities. Continuing to apply IEC/BCC interventions to increase the knowledge of the community on the ITN and of home visits and support the proper utilization of the ITN is highly important.

Background: Inflammation and nutrition are strongly linked to respiratory diseases, but the link between inflammation and nutrition-based indicators and chronic obstructive pulmonary disease (COPD) and its mortality has not been reported.

Methods: We recruited adults no younger than 20 years old from the NHANES 1999-2018. Inflammation and nutrition-based indicators included NAR, PNI, MAR, RAR, HALP, and ALI. COPD were assessed through a self-report questionnaire. Participants' mortality rates were determined by association with the National Death Index.

Results: A total of 46,572 individuals were collected in this study, including 1,549 COPD patients. NAR, MAR, and RAR were positively linked with the prevalence of COPD. However, PNI and HALP were negatively linked with the prevalence of COPD. In participants with COPD, the highest quartile of NAR (HR = 1.43 [1.04-1.97]), MAR (HR = 1.66 [1.23-2.26]), and RAR (HR = 2.45 [1.90-3.17]) were linked with an increased risk of all-cause mortality compared to the lowest quartile. However, the highest quartile of PNI (HR = 0.48 [0.38-0.61]) and HALP (HR = 0.56 [0.44-0.71]) were linked with a decreased risk of all-cause mortality compared to the lowest quartile. Randomized survival forests (RSF) showed that RAR had the strongest predictive power for all-cause mortality in COPD individuals among all indicators.

Conclusion: We found that inflammation and nutrition-based indicators were linked to prognosis in COPD patients, with RAR having the highest predictive value.