Journal of Public Health Research最新文献

Objective: This study aimed to cross-culturally adapt and validate the Self-Regulation Questionnaire for Dental Home Care (SRQDHC) for use among Vietnamese children and to examine the relationship between motivation for oral hygiene and dental caries status.

Methods: The SRQDHC was translated and culturally adapted for Vietnamese children aged 9-10 years using cross-sectional study. A total of 200 students were randomly selected from a primary school in Hanoi. Clinical dental examinations were conducted to assess caries experience using the dmft and DMFT indices. Subsequently, participants completed the Vietnamese version of the SRQDHC to evaluate their oral hygiene motivation. Internal consistency and factor loadings were analyzed to assess the questionnaire's reliability.

Results: Dental caries was observed in 84.5% of participants. The mean dmft and DMFT scores were 3.20 ± 3.18 and 2.15 ± 2.37, respectively. The SRQDHC demonstrated acceptable internal consistency (Cronbach's alpha = 0.7021) and strong factor loadings (>0.3). A statistically significant correlation was found between motivation scores and caries status.

Conclusion: The Vietnamese version of the SRQDHC is a reliable tool for assessing dental home care motivation in children. Given the high prevalence of caries in this population, motivation-based oral health interventions are warranted. Further refinement of selected questionnaire items is recommended to enhance its utility in clinical and research settings.

Not-for-profit healthcare systems have a mission-driven obligation and federal mandate to address significant community health concerns through the Community Health Improvement Planning process. In this county, four hospitals, the county public health department and several community-based organizations collaborate to review data, prioritize needs, and identify evidence-based interventions every 3 years. Recently the partnership initiated a mini-grant process to fund community-based organizations that propose evidence-informed projects to address improvement goals. The mini-grant process funded three community-based projects in high-risk areas to address disparities in maternal and child health outcomes, including mental health. Results showed increased contraception education to adolescents, 45 new Mental Health First Aid providers for children and new families, and 176 refugee children screened for behavioral health concerns. By supporting community-based agencies to design, conduct and evaluate evidence-informed interventions, hospitals can build strong partnerships and trust among their patient community while improving health outcomes for those at greatest risk.

The accelerating exodus of physicians from Nepal threatens to dismantle its public health system, creating a profound crisis in health equity. Annually, the number of physicians seeking to emigrate now rivals the number of new graduates, neutralizing national investment in medical education. This trend has resulted in extreme disparities, with physician-to-population ratios ranging from 1:850 in urban Kathmandu to a catastrophic 1:150,000 in remote districts, and vacancy rates for general practitioners exceeding 62% nationwide. Applying a structured policy-analysis approach based on the 'context-content-actors-process' framework, this perspective connects these outcomes to failures in recruitment cycles, postings and transfers, workplace safety, and financing within Nepal's existing Human Resources for Health policy, including remote-area allowances and service requirements under the Health Service Act, bonded service linked to Nepal Medical Council registration, the Human Resources for Health Strategy 2021-2030, and the 2022 ordinance on the safety and security of health workers. Conventional retention measures are necessary but insufficient. Two complementary pillars are proposed. First, operationalize 'brain circulation' by transforming the Brain Gain Center from a registry into a delivery platform that enables credentialed tele-consultations integrated into referral networks, virtual residency and mentorship with competency credit, and targeted continuing professional development aligned to documented service gaps. Second, establish shared-responsibility financing through bilateral tax-sharing agreements that remit a negotiated portion of income tax paid by Nepali physicians in high-income countries to a ring-fenced 'Health Workforce Sustainability Fund', with disbursements tied to reductions in rural vacancies and safer working conditions and aligned with the World Health Organization Global Code of Practice.

The variety of ways that cultural competency has been used to improve health care for historically marginalized groups, including the lesbian, gay, bisexual, transgender, and queer community, has been documented in the literature. As clinicians seek to deliver competent care, we encourage consideration of how the intersectionality of patient lives, including institutional racism, impacts clinical care, and assert the need for the immediate application of an antiracist framework to center and achieve the goal of restorative and holistic clinical care.

Background: Health-related Quality of Life (HRQoL) is a concept covering social, physical, psychological, and environmental factors. This study aimed to evaluate the HRQoL of medical students in Mogadishu, Somalia, using the WHOQOL-BREF instrument.

Methods: This is a cross-sectional study design to assess QOL among medical students in Mogadishu, Somalia, between August and November, 2024 at selected public and private universities offering undergraduate medical programs. Data were collected using a structured self-administered questionnaire comprising socio-demographic variables (Gender, Age, Residence, Marital Status, Academic Year, and GPA). The WHOQOL-BREF instrument consists of 26 items grouped into 4 domains: physical, psychological, social, and environmental. Data were analyzed using descriptive statistics, ANOVA, and Regression with p < 0.05 were statistically significant.

Results: The majority of students (57%) reported their overall QOL as "good," while 22% reported it as "very good." A significant association was found between age and psychological health (p = 0.011), with students above 25 scoring highest (76.82 ± 13.88) compared to those aged 21-24 (69.41 ± 15.27) and 18-20 (71.51 ± 15.90). Academic year showed a significant association with social health (p = 0.026), highest in years 3-4 (73.48 ± 20.72), followed by years 1-2 (71.46 ± 21.06), and lowest in years 5-6 (65.85 ± 27.29). In multivariate Age 21-24 years had association with the Psychological domain (β = -0.858, 95% CI: -1.672, -0.045).

Conclusions: The study demonstrates that medical students in Mogadishu generally report a good QOL; however, it underscores the necessity for interventions aimed at improving psychological resilience and social support systems.

Objective: Financial difficulties are associated with poor mental health. This paper aimed to systematically review the impact of COVID-19 related financial difficulties on mental health in adults.

Methods: A systematic search was conducted across Web of Science, Medline, and PsycINFO, from March 2020 to March 2023 to identify studies examining the mental health impact of COVID-19 related financial disruption in adults. We performed two meta-analyses to quantify the effect of income loss due to the pandemic on anxiety and depression. Studies were rated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Heart, Lung and Blood Institute was used.

Results: A total of 2659 papers were identified of which 76 (59 cross-sectional and 17 longitudinal) met inclusion criteria. The results show that COVID-19 related financial disruption (income loss and financial stress) negatively impact mental health across a range of adult populations globally, including the general population, students, and other specific groups. The meta-analyses examined data from 278,854 participants from 15 studies indicated that those who lost income reported greater anxiety levels than those who did not experience income loss. Similarly for 268,128 participants across 16 studies, a meta-analysis showed greater depression symptoms for those experiencing income loss.

Conclusion: COVID-related financial constraints, both objective and subjective, are associated with poor mental health outcomes (particularly anxiety and depression) in various populations around the world. The results highlight the need for targeted clinical interventions for those experiencing mental health problems linked to financial problems during global crises.

Background: Stunting is a global health challenge with high prevalence in Asia and Africa. Although many studies have discussed its determinants, fragmented evidence and regional differences still hinder the formulation of effective policies.

Objective: This study aims to identify and map predictors of stunting in children under 5 years of age, focusing on socio-demographic, prenatal, natal, and postnatal factors, as well as distinguishing universal and contextual determinants across regions.

Design and methods: This systematic review followed the PROSPERO protocol (CRD42025633321) and the PRISMA 2020 guidelines. Literature searches were conducted in databases (Scopus, Web of Science, PubMed, ProQuest, ScienceDirect, Taylor & Francis, and Emerald). Included articles were original English-language studies published between 2015 and 2024 that examined predictors of stunting in children aged 0-59 months. Methodological quality was assessed by two independent reviewers using the JBI Critical Appraisal Tools. Data were then extracted, narratively synthesized, and mapped according to UNICEF regional classifications.

Results: Of the 5094 initial records, 92 studies met the inclusion criteria. Maternal education, socioeconomic status, sanitation, maternal age, maternal height, birth weight, and exclusive breastfeeding and complementary feeding practices emerged as the most consistent and universal predictors. Other factors were more contextual, depending on the region. Cross-regional analysis confirmed the existence of universal determinants as well as specific regional risk factors.

Conclusion: Stunting is a multifactorial problem across life phases. Regional mapping enriches theoretical understanding and provides a scientific basis for context-based policies. These findings emphasize the need for multi-level interventions and cross-regional longitudinal research with uniform measurement standards.

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Background: Virological failure in second-line antiretroviral therapy (ART) occurs when HIV patients have a viral load exceeding 1000 copies/ml, presenting significant public health challenges, including increased risk of transmission of HIV, heightened morbidity and mortality rates, and the risk of developing drug resistance. The extent of virological failure among second-line ART patients in the Harari region and Dire Dawa city of Eastern Ethiopia has not been thoroughly investigated. This study aimed to determine the prevalence of virological failure and its influencing factors from January 1 to December 31, 2023.

Design and methods: A cross-sectional study was conducted among 478 adult second-line antiretroviral therapy users at an institution-based setting. A census was employed to recruit the study participants. Data was collected using a semi-structured data extraction checklist entered into EpiData version 4.6 and exported to SPSS version 26 for analysis. Descriptive statistics, along with bivariable and multivariable logistic regression analyses, were performed to determine the associations between virological failure and independent variables, using adjusted odds ratios with 95% confidence intervals. A p-value less than 0.05 was used to declare the statistical significance.

Results: The overall prevalence of virological failure among adult second-line ART users was 12.76% (95% CI = 10.05-16.07). Smoking (AOR = 2.81), BMI status (AOR = 6.97), TB-HIV co-infection (AOR = 0.20), history of INH prophylaxis (AOR = 4.25), and enhanced ART adherence counseling (AOR = 7.02) were found to be significantly associated with virological failure among second-line ART users.

Conclusion: Nearly 1 in 10 adults on second-line ART experienced virological failure. Factors such as smoking, nutritional status, TB-HIV co-infection, and adherence counseling significantly influenced outcomes. Continuous monitoring and clinical interventions are crucial to reduce virological failures in this population.

Objectives: This study explores the dynamics of vaccine rumors during the COVID-19 pandemic, particularly those surrounding messenger RNA vaccines. By employing and developing Hallin's communication model of credibility spheres, we analyze how controversial ideas regarding vaccine safety gained public attention and challenged established vaccine narratives.

Methods: The focal point of the investigation is the viral spread of a biomedical article from Lund University, which intensified existing vaccine rumors shared on Twitter, that, in turn, the authorities had tried to refute. Through a mixed methods analysis of Swedish-language tweets, reflecting a limited segment of the population's opinions, we highlight persistent skepticism toward mRNA vaccines, characterized by fears of side effects, rushed development, and distrust in pharmaceutical companies.

Results: The findings suggest that vaccine skeptics on Twitter leveraged the Lund medical article to legitimize their concerns, aiming to move their arguments from the Sphere of Deviant Vaccine Propositions into the Sphere of Legitimate Public Vaccine Debate, where they could be debated alongside mainstream views.

Conclusion: We interpret the possible impact of the mRNA rumors shared on Twitter as an expression of an increasingly populistic society with a decreasing trust in democratic institutions and authorities, in which the constant flow of content via the internet reinforces the credibility of conspiracy theories.