AIMS Public Health最新文献

Background: Air pollution is a leading cause of premature deaths in developing countries compared to developed countries. We aimed to analyze and compare the economic loss due to premature deaths caused by air pollution in the USA and India.

Methods: Data on household and ambient air pollution, mortality, population, and GDP were collected from the WHO Global Health Observatory, the 2019 Global Burden of Disease Study, and World Development Indicators. The economic loss of premature deaths caused by air pollution were assessed for 2019 in India and the USA by calculating the adjusted labor output per worker, factoring in the likelihood of a person being employed. However, reported mortality cases of air pollution can be less than the actual cases, so the actual loss can be greater than that calculated in this study.

Results: The findings showed that in 2019, the total economic loss due to premature deaths caused by air pollution was $34.85 billion and $24.76 billion in India and the USA, respectively. In 2019, India and the USA lost around 1.67 million and 100,000 lives because of air pollution, respectively. However, the per capita loss amounted to $20,868 for India and $247,600 for the USA, highlighting the stark disparity in the per capita income. Despite significant socioeconomic variations, ambient air pollution is the leading cause of total premature deaths from air pollution, accounting for 58% and 80% in India and the USA, respectively.

Conclusions: Air pollution is rising in India and decreasing in the USA. The United States has implemented stringent laws and regulations, such as the Clean Air Act, to control air pollution, and India should benefit from this example. Moreover, monitoring the ground-level situation is important to reduce air pollution and associated fatalities.

Background: Hypertension is a critical modifiable risk factor for mortality in the elderly, yet optimal systolic blood pressure (SBP) targets for older adults remain unclear. This study examined the association between SBP trajectories and all-cause mortality in Chinese elderly individuals, aiming to identify age-adjusted SBP ranges for survival benefits.

Methods: A population-based prospective cohort study was conducted in Luzhou, China (2017-2023). A total of 390,100 participants aged ≥65 years were followed for 1,994,050 person-years, with 48,013 deaths analyzed. Cox proportional hazards and restricted cubic spline (RCS) Cox regression models were used to evaluate baseline SBP categories, 7-year mean SBP, and longitudinal trajectories (Class 1: ideal to elevated; Class 2: normal-high to elevated; Class 3: mild hypertension to elevated).

Results: Baseline SBP: Lowest mortality risk at 100-139 mmHg (HR < 1). 7-year mean SBP: Optimal range at 120-159 mmHg. Trajectories: Class 2 (normal-high to elevated) had the lowest all-cause mortality (HR: 0.90, 95% CI: 0.88-0.92). Class 1 showed the lowest cardiovascular mortality. Class 3 exhibited the lowest non-cardiovascular/cancer mortality.

Conclusions: Gradual SBP increases from normal (≤160 mmHg) with age are associated with reduced mortality in the elderly. These findings challenge strict hypertension control guidelines, advocating for age-adjusted SBP targets to optimize survival outcomes. Further validation across different ethnic groups and regions will be needed in the future.

Alexithymia is a personality trait with significant clinical impact worldwide. It is a relevant transdiagnostic risk factor for a wide range of psychopathologies, including depression, anxiety, eating and substance use disorders, and other psychosomatic conditions. This underscores the importance of having validated instruments to measure alexithymia, particularly brief scales suitable for quick and practical applications. The Perth Alexithymia Questionnaire (PAQ-S) has shown promising results in this context. However, few cross-cultural studies have validated its use, which is the aim of the present study. To this end, a sample of 2535 university students was recruited (mean age = 20.59 years; SD = 2.04; 26.75% males and 73.25% females) from Spain (n = 388), Italy (n = 376), Lebanon (n = 487), Nigeria (n = 561), Türkiye (n = 410), and Ukraine (n = 313). The PAQ-S and the Type D Personality Scale (DS-14) - designed to assess Negative Affectivity (NA) and Social Inhibition (SI) - were administered. The Classical Test Theory (CTT) and Network Analysis (NwA) were applied. The confirmatory factor analysis yielded satisfactory results in all cases, with an adequate internal consistency. Metric invariance was obtained between genders and cultures. Additionally, several of the analysed countries presented strict invariance. Therefore, the data obtained in these countries can be compared and their results extrapolated between them. The NwA supports the data obtained through the CTT, as well as the independence of alexithymia, NA, and SI constructs. Hence, the scale proved to be useful for its intended aim and may be useful to monitor alexithymia in large-scale health campaigns.

This study presents an Electroencephalography (EEG) emotion recognition using a long short-term memory (LSTM)-based method. Our proposed method selects window sizes and overlaps to divide the EEG data into segments, which optimally captures subtle signal changes. A Bidirectional LSTM (BiLSTM) layer is added to standard LSTM layers to better detect forward and backward patterns in the data. By using this dual-layer setup, we aim to improve both the feature extraction and the classification accuracy. The model was tested on the Database for Emotion Analysis using Physiological signals (DEAP) dataset and showed acceptable accuracy across emotional dimensions: arousal (94.0%), liking (98.9%), dominance (95.3%), and valence (99.6%). Our results suggest that the model better supports emotion recognition and has potential for mental health monitoring and adaptive therapy.

Background: Functioning, recognized as the third health indicator and a key metric for rehabilitation, can be assessed by measuring capacity and performance.

Objective: To quantify the prevalence of disability and cognitive impairment in individuals aged 50+ and evaluate the reliability and clinical relevance of capacity and performance qualifiers in the activity and participation domains of the international classification of functioning checklist (ICF checklist).

Methods: A cross-sectional study was conducted in a population from rural and urban areas of Aragón (Spain), including 1707 participants. Disability and cognitive impairment were assessed using the WHO Disability Assessment Schedule 12-item version (WHODAS 12) and mini-mental state examination. A randomly selected subsample (n = 129) underwent a detailed functional evaluation. The ICF checklist was used to compare capacity and performance, analyzing their agreement and differences.

Results: Disability was present in 50.6% of participants. Severe or total disability was most prevalent in general tasks/demands (10.1%) and domestic life (7.1%), reflecting significant daily functioning limitations. The largest capacity-performance discrepancies were in domestic life, self-care, and learning, indicating key intervention areas. Notably, 40.5% of participants had lower performance in domestic life, followed by learning/knowledge (28%) and mobility (17%). Conversely, performance exceeded capacity in community living (13.3%) and personal relationships (5.5%), highlighting the influence of environmental factors.

Conclusions: Disability is highly prevalent in adults aged 50+, notably affecting daily functioning. Gaps between ability and performance indicate environmental barriers, especially at home and in learning contexts. Improved outcomes in social domains suggest enabling conditions. Findings support the ICF checklist's clinical value and advocate for integrating environmental factors into disability care.

Current disaster medicine programs and simulation exercises often fail to adequately incorporate crucial elements such as situational awareness and a disaster mindset. This gap in training can significantly impact the effectiveness of healthcare professionals' responses during real-world disasters and public health emergencies. In this review, we examined the literature to explore the critical role of situational awareness and a disaster mindset in enhancing healthcare provider preparedness for disaster events, proposing the integration of innovative technologies, such as virtual and augmented reality, to create immersive simulations that foster situational awareness and a resilient disaster mindset. Addressing this educational gap will improve healthcare professionals' confidence and optimize patient outcomes during crises.

Background: Cholera remains a persistent and deadly global public health threat, with recent years witnessing a resurgence of large-scale outbreaks, particularly in conflict-affected and resource-limited regions. The disease disproportionately affects vulnerable populations lacking access to clean water, sanitation, and essential healthcare services.

Objective: This systematic review aimed to synthesize evidence published between 2019 and 2024 to examine the evolving public health implications, economic burden, and prevention strategies associated with cholera outbreaks globally.

Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted across the major databases. Eligible studies were screened and assessed for quality and relevance using predefined inclusion criteria and standardized appraisal tools.

Results: The review reveals an integrated perspective on cholera by analyzing the intersection of epidemiological trends, health system readiness, and socioeconomic vulnerabilities. Emerging factors such as climate change, population displacement, and political instability were identified as key contributors to cholera outbreaks. Innovative tools, including predictive modeling and artificial intelligence, demonstrate promise for early detection and response. The review also highlights the benefits and challenges of oral cholera vaccines (OCVs), the critical need for sustainable water and sanitation infrastructure, and the importance of community-based interventions.

Conclusion: This review reinforces the urgency of adopting a multisectoral, systems-based approach to cholera prevention. Applying the "One Health" framework and aligning public health strategies with economic and policy insights can significantly enhance global efforts to reduce cholera's incidence and mortality. The findings inform key research and policy priorities to strengthen preparedness and resilience in high-burden settings.

Background: The term "Phubbing" has been defined as a behavior in which a person snubs another in a social setting by focusing on their phone instead of having a conversation. Phubbing is a common phenomenon and reduces the quality of social interactions in people, particularly those in adolescence.

Objective: We aimed to validate in Italian, the Generic Scale of Phubbing (GSP), and Generic Scale of Being Phubbed (GSPB), in order to measure the experiences of phubbing, and being phubbed, through confirmatory factor analysis (CFA).

Methods: We investigated whether the factor structure of GSP and GSBP may be replicated for the Italian sample, through confirmatory factor analysis (CFA). For the assessment, we used the Generic Scale of Being Phubbed, the Generic Scale of Phubbing, the Internet Addiction Test, and Brief COPE.

Results: We found that four important factors of phubbing are nomophobia, interpersonal conflict, self-isolation, and acknowledgement of problems, and phubbing behavior is predictive of social disconnectedness.

Conclusion: The GSP and GSBP instruments can be useful in the clinical setting to identify specific psychological dimensions associated with phubbing, such as nomophobia and social isolation.

Background: This study presents a novel mathematical framework to quantify the societal and economic impacts of delays in the reimbursement and distribution of innovative medicines.

Methods: Utilizing the concept of years of life lost (YLL) as a measure of premature mortality, the framework calculated the impact of delay on YLL, years of potential productive life lost (YPPLL), and cost of productivity loss (CPL). The proposed model incorporated mortality probabilities through the Heligman-Pollard (HP) model, examining how delays influence health outcomes, particularly for patients awaiting treatments like Icosapent ethyl.

Results: The findings reveal that extended delays significantly increase mortality and economic losses, emphasizing the need for timely access to high-value therapies. This mathematical framework not only emphasizes the adverse effects of delayed reimbursement on populations but also highlights the importance of high-quality data in accurately assessing these effects. By ensuring completeness, consistency, and reliability in healthcare data, the framework advocates for evidence-based policy decisions that promote equitable healthcare access and minimize disparities.

Conclusions: The present study underscores the importance of efficient pharmaceutical policymaking in maximizing the societal benefits of innovative treatments, ensuring that both health outcomes and economic sustainability are prioritized in healthcare systems.

Background: In 2024, North Carolina (NC) had a smoking rate of 17.2% and a higher-than-average rate of binge and heavy drinking. These behaviors often cluster with other health risks such as hypertension, hypercholesterolemia, and diabetes, thus leading to significant disparities in cardiovascular, physical, and mental health outcomes across the state. However, limited research has examined these clustering patterns within North Carolina.

Objective: This study seeks to investigate the associations between latent class membership, defined by clustering of behavioral and chronic health risk factors, and cardiovascular disease, self-reported health status, physical health status, and mental health status.

Methods: We conducted a cross-sectional analysis using the 2017, 2019, and 2021 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) data. A latent class analysis (LCA) was used to identify distinct health risk profiles among adults based on smoking, alcohol use, physical activity, fruit and vegetable intake, hypertension, elevated cholesterol, and diabetes status. Multivariable logistic regression models were used to examine associations between latent class membership and four outcomes: cardiovascular disease (CVD), self-reported general health, physical health status, and mental health status. Analyses were adjusted for sociodemographic variables, and age-stratified analyses were conducted.

Results: The LCA identified two distinct classes: "Moderate drinking overweight non-smokers" (Class 1) and "High behavioral and chronic risk profile" (Class 2). Class 1 was characterized by moderate alcohol consumption, overweight status, and low smoking prevalence, while Class 2 reflected a higher prevalence of smoking, binge drinking, hypertension, diabetes, and elevated cholesterol. Membership in Class 2 was significantly associated with increased odds of CVD (OR = 1.93; 95% CI: 1.60-2.34), poor self-reported health (OR = 1.69; 95% CI: 1.46-1.96), ≥14 days of poor physical health (OR = 1.82; 95% CI: 1.55-2.15), and ≥14 days of poor mental health (OR = 1.68; 95% CI: 1.43-1.97). In age-stratified analyses, the strongest associations were observed among young adults (18-39 years), with significantly higher odds of CVD (OR = 6.84; 95% CI: 2.79-16.72), poor physical health (OR = 2.32; 95% CI: 1.58-3.40), and poor mental health (OR = 2.12; 95% CI: 1.60-2.81). Similar but attenuated associations were observed among adults aged 40-59 and ≥60 years.

Conclusion: These findings support the importance of targeted public health efforts in North Carolina that address the co-occurrence of behavioral and chronic health risk factors, especially among younger populations. Syndemic-informed interventions which focus on behavioral and proximal chronic disease risk factors may help reduce CVD burden and improve the population health.