Journal of Public Health Research最新文献

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.

Background: Physical activity holds multiple dimensions of value, including health, social, esthetic, and socio-economic impacts, and influences university students' achievements. This study aimed to determine the level of physical activity among students at the University of Novi Sad (Serbia) and examine its association with anthropometric characteristics and body composition.

Design and methods: A total of 114 first-year students from the Faculty of Technical Sciences, Faculty of Medicine, and Faculty of Sport and Physical Education of the University of Novi Sad (Serbia) participated in the study. The first part involved completing the Global Physical Activity Questionnaire, based on which participants were categorized as physically active or inactive. The second part included anthropometric measurements, calculation of relevant indices, assessment of body composition (body fat), and measurement of arterial blood pressure.

Results: The analysis showed that students of both sexes from the Faculty of Sport and Physical Education had the highest physical activity levels. Statistically significant differences were found between physically active and inactive students in body weight, hip and waist circumference, percentage of body fat, body mass index, waist-to-height ratio, and arterial blood pressure. Higher values were recorded in physically inactive students.

Conclusion: This study found that physically active students had significantly more favorable anthropometric and physiological profiles than their inactive peers. These results highlight the need for universities to promote active lifestyles by reintroducing mandatory Physical Education, offering targeted health education, and creating supportive environments for daily activity.

Background: Physical fitness is a key protective factor against cardiovascular diseases, metabolic disturbances, and cancer, partly due to its influence on antioxidant capacity. However, the relationship between aerobic fitness and specific redox markers remains inadequately explored in young Saudi men.This study investigates the correlation between maximal oxygen uptake (VO₂max) and key antioxidant parameters in healthy Saudi males.

Design and methods: In this cross-sectional study, a group of 88 healthy Saudi men aged 18-25 years with a normal BMI (18.50-24.99) and moderate physical activity levels was recruited. VO₂max was assessed using cardiopulmonary exercise testing on a Bruce treadmill protocol. The resting redox status was evaluated by plasma total antioxidant capacity (TAC), superoxide dismutase (SOD) catalase, and thiobarbituric acid reactive Species (TBARS) using ELISA technique.

Results: The mean VO₂max of the participants was 41.8 ± 7.1 ml/kg/min, with over 50% classified as having "poor" or "very poor" fitness categories. A significant positive correlation was identified between VO₂max and TAC (r = 0.251, p = 0.018). However, no significant associations were detected between VO₂max and SOD, catalase, or TBARS.

Conclusions: These findings indicate that aerobic fitness is positively associated with resting total antioxidant capacity, potentially offering greater protection against oxidative stress-related chronic diseases. The absence of significant correlations between VO₂max, individual antioxidant enzymes and lipid peroxidation markers may be attributed to the relatively low VO₂max levels in this cohort. Further research is warranted to explore this relationship across a broader range of fitness levels and additional oxidative stress biomarkers.

Background: Active leisure events are health interventions promoting physical activity amongst non-traditional sporting participants. Models of physical activity assume that individual and environmental components interact to shape activity levels. The active leisure event organiser, parkrun, recently introduced a new volunteer role, the parkwalker, to manipulate the social environment at their events to encourage more walkers to attend.

Design and methods: This study compares the finishing times of new parkrun participants in Scotland for a year before and after the introduction of the parkwalker initiative. Different parkrun venues in Scotland were separated into those that fully adopted, partially adopted and did not adopt the parkwalker role into their events.

Results: A model of finishing times revealed they have slowed after the introduction of parkwalkers and the level of slowing is associated with the level of adoption of the role by events. The parkwalker initiative was particularly associated with the slowing of finishing times of older new participants and participants at larger events. The initiative was also associated with an increase in the proportion of female new participants and a reverse in the recent decline in the age of new participants.

Conclusions: The findings suggest that parkrun have introduced a successful intervention to their events that has manipulated the social environment to increase both engagement and inclusivity. This has management implications for both parkrun and other active leisure events. Practitioners engaging in social prescription might want to direct patients towards those active leisure events most engaged in welcoming slower new participants.

Contribution to public health: This study investigates how an intervention, the parkwalker Initiative, impacted the demographics of participants at parkrun. The intervention manipulated the social environment at events through using a volunteer walker who encourages other walkers.This study showed that finishing times slowed at parkrun events after the introduction of the initiative suggesting that a barrier to participation for some walkers had been overcome. The level of engagement with the initiative was associated with the level of slowing in finishing times.Active leisure events can successfully manipulate their social environment to increase participation by specific target demographics. It was also notable that the slowing involved increases in the proportion of slower runners as well as walkers. The findings have implications for event organisers and practitioners engaging in social prescription of parkrun who might be best directing patients to events with a regular parkwalker.

Background: Problems assessing migrant patients' pain may cause inadequate treatment. Standardised patient-reported outcome measures (PROMs) are used as basis for tailoring treatment plans. This study investigates patients' experiences of filling in PROMs translated into their home language.

Design and methods: Explorative design with in-depth interviews with 12 patients speaking the target languages Urdu, Somali, Arabic and Polish. The data analysis was inductive, thematic and hermeneutic in character.

Results: Many interviewees found concepts used in the PROMs difficult to understand. Several viewed questions about mental health, suicide and sexual activity as taboo. Some of the PROM questions/answer options did not fit their situation and/or experience. Completing six different PROMs was exhausting.

Discussion: Idiomatic and dialectic variations as well as diverse cultural backgrounds influence how concepts and questions were understood and made completing the PROMs challenging. Translations, although technically correct, must be understandable in the cultural context in which they are to be used. Some questions/response options do not reflect lived experience, and/or are couched in language reflecting biomedical understanding of illness. Culture, religion, traumatic experiences, migration-induced stress etc. shape individuals' understanding and expression of health problems and symptoms. Secrecy and not sharing information is often an adaptive response to avoid shame.

Conclusion: Although the PROMs used were translated by professional translators, cultural, religious and educational backgrounds influence how concepts and questions are comprehended. Questions considered too private/taboo might be ignored. These problems may lead to seriously impaired treatment outcomes.

Background: Anticoagulant therapy is high-risk and requires pharmacists to be highly competent in its management. In Saudi Arabia, the confidence of pharmacists in providing such care is not well-established. This study aimed to assess the self-reported confidence levels of pharmacists in Saudi Arabia regarding the provision of pharmaceutical care for patients on anticoagulants.

Methods: A cross-sectional online survey was distributed to pharmacists across various healthcare settings in Saudi Arabia. The questionnaire assessed confidence across multiple domains of anticoagulant care, including knowledge, adverse event management, and patient counseling. Data were summarized using descriptive statistics. Confidence scores were compared across groups with t-tests, and predictors were analyzed using logistic regression.

Results: Among 194 respondents, overall self-reported confidence was moderate (70.3%). While a strong majority felt confident in foundational tasks, such as discussing indications and benefits (over 79%) and adverse effects (71%), considerably lower confidence was reported in managing critical scenarios, including controlling bleeding events (~60%). This indicates a disparity between theoretical knowledge and confidence in practical application. Hospital pharmacists reported higher confidence levels than community pharmacists. The most frequently referenced resources were Lexicomp (18.6%) and clinical guidelines (17.5%).

Conclusions: While Saudi pharmacists report foundational knowledge of anticoagulants, a significant confidence gap exists in the management of serious complications. These findings suggest that continuing education programs should move beyond theoretical knowledge and focus intensively on practical, case-based training in bleeding management and emergency response. A key limitation of this study is its reliance on self-reported data, which may not reflect objective competence.

Context: Breastfeeding is essential for the health and survival of infants, with WHO and UNICEF recommendations for exclusive breastfeeding for the first 6 months, followed by complementary feeding for up to 2 years. However, breastfeeding rates remain a cause for concern, particularly in Cameroon, where various socio-economic and cultural factors influence mothers' behavior.

Methodology: A cross-sectional, quantitative, and analytical study was conducted in the Bertoua Health District between April and June 2024. A non-probabilistic convenience sampling method was used to recruit 405 consenting participants out of 532 approached (participation rate: 70.68%). Data were collected using a structured questionnaire, designed by the Cameroon Pediatric Association, which assessed target mothers' knowledge, attitudes, and practices regarding continued breastfeeding. Descriptive statistics and multivariate logistic regression analyses were performed, using a significance level of p < 0.05.

Results: The results revealed that 70.21% of women demonstrated poor knowledge of breastfeeding, 60% held negative attitudes, and 50.62% engaged in poor breastfeeding practices. Notably, being single or in a common-law relationship, as well as holding a negative attitude, significantly increased the likelihood of poor knowledge. Furthermore, both unfavorable attitudes and poor practices were more prevalent among women who reported having no religion or identified as Christian. Thus, two key sociodemographic predictors consistently associated with suboptimal outcomes were marital status and religious affiliation. Specifically, single mothers and those without a religious affiliation or those identifying as Christian were more likely to exhibit unfavorable attitudes and lower levels of knowledge regarding continued breastfeeding.

Conclusion: This study highlights the need for targeted interventions to improve mothers' knowledge and attitudes toward breastfeeding. Educational programs adapted to socio-economic realities are essential to promote favorable breastfeeding practices and improve infant health in Bertoua.