Journal of Public Health Research最新文献

Background: Neurodevelopmental disorders (NDDs) are chronic disorders considered an emerging public health problem. This condition can markedly impair the Health-related Quality of Life (HRQoL). This study aimed to examine the HRQoL among children with NDDs.

Design and methods: A cross-sectional study was conducted among 73 parents/caregivers of children with NDDs aged 2-12 years. Pediatric Quality of Life Inventory 4.0 Generic Core Scale was used to assess the HRQoL. A multiple linear regression model was performed to assess the association.

Results: Among the 73 parents/caregivers, majority of their children fell into 2-4 year age group, with 70% being male. In contrast to other NDDs, this study highlights that the mean HRQoL scores for Cerebral palsy (CP), Down syndrome, Intellectual disability (ID), Motor disorders, and Neurogenetic disorders were below 50 on the 0-100 scale. The analysis of variance revealed a significant effect of NDD categories on the physical domain of QoL. Findings from regression analysis highlight that the physical functioning domain of QoL was significantly influenced by factors including age [ß: 2.44; 95%CI: (0.07, 4.81)], various NDDs, such as Attention-deficit hyperactivity disorder [ß: -25.54, 95%CI: (-43.12, -7.96)], Autism [ß: -25.44, 95%CI: (-41.51, -9.37)], CP [ß: -46.52, 95%CI: (-65.41, -17.62)], Down syndrome [ß: -42.33, 95%CI: (-63.28, -21.37)], ID [ß: -46.14, 95%CI: (-82.61, -9.67)] and motor disorder [ß: -77.07, 95%CI: (-103.32, -50.82)] and stable family income [ß: 16.37; 95%CI: (3.44, 29.29)]. This study also underscores that emotional functioning was significantly influenced by sex [ß: 18.27; 95%CI: (4.57, 31.97)], motor disorders [ß: -36.15, 95%CI: (-67.14, -5.16)], and social functioning was influenced by birth order 3rd/more [ß: 32.24;95%CI: (7.43, 57.04)].

Conclusions: This exploratory study highlights that multiple factors may influence various domains of HRQoL, including physical, emotional, social, and school functioning in children, providing a foundation for future studies.

Background: Respiratory-related mortality in Bangladesh exhibits pronounced seasonal trends, yet systematic forecasting to guide public health interventions remains limited. This study analyzes temporal patterns and projects future mortality using nationally certified cause-of-death data.

Methods: We applied a Seasonal Autoregressive Integrated Moving Average (SARIMA) model to monthly respiratory mortality records (January 2018-December 2024, 84 data points). Model selection was guided by AIC/BIC criteria, with performance evaluated via fivefold time-series cross-validation (training/test splits: Fold 1: 24/12, Fold 2: 36/12, Fold 3: 48/12, Fold 4: 60/12, Fold 5: 72/12). Seasonality was quantified through decomposition, and 18-month forecasts were generated with 95% prediction intervals.

Results: Mortality demonstrated strong seasonal peaks in July, August (79.5% of death counts in July), and January (66.2% of death counts in July), aligning with monsoon and winter periods. The optimal SARIMA(1,2,3)(0,1,1)[12] model achieved robust accuracy: mean absolute scaled error (MASE) = 0.41, MAE = 259.123, and RMSE = 337.238 (cross-validation mean: MASE = 0.58, MAE = 520.13). Forecasts projected stable monthly averages of 1724 (95% CI: 782-2667) deaths in 2025 and 1711 (593-2830) in 2026, with highest occurrence in July, August then January. Residual diagnostics confirmed model adequacy (Ljung-Box p = 0.971), though non-normality (Shapiro-Wilk p < 0.001) was present, it was negligible.

Conclusion: Respiratory mortality in Bangladesh follows predictable seasonal patterns, with monsoon and winter peaks demanding targeted interventions. The SARIMA model provides actionable forecasts for preemptive public health measures, such as pre-monsoon vaccination campaigns and pollution control. Future research should explore environmental covariates to enhance precision.

Background: In Ethiopia, most family planning users rely on short-acting contraceptives, despite the greater effectiveness of long-acting and permanent methods (LAPCMs). Previous studies on users' intention to adopt LAPCMs have reported inconsistent findings. This study aimed to determine the pooled prevalence of intention to use LAPCMs and identify associated factors among Ethiopian family planning users.

Methods: A systematic search was conducted in PubMed, Scopus, the Cochrane Library, and Google Scholar. Data were extracted using Microsoft Excel and analyzed with STATA version 11. A random-effects model was applied to estimate pooled prevalence, while heterogeneity was assessed using the Cochrane Q test and I ² statistic.

Results: Six studies involving 2773 participants were included. The pooled prevalence of intention to use LAPCMs was 50.98% (95% CI: 43.57-58.40). Significant factors associated with intention included good knowledge (POR = 4.81, 95% CI: 2.01-11.52), positive attitude (POR = 3.15, 95% CI: 2.21-4.50), higher educational attainment (POR = 6.23, 95% CI: 2.71-14.35), and the absence of myths and misconceptions (POR = 2.19, 95% CI: 1.10-4.38).

Conclusion: Intention to use LAPCMs among Ethiopian family planning users is moderate, indicating suboptimal uptake. Knowledge, education, attitudes, and misconceptions strongly influence this intention. Interventions that improve awareness, dispel misconceptions, and foster supportive attitudes are critical for enhancing adoption. Policymakers and health organizations should prioritize targeted education and behavior change strategies to strengthen family planning outcomes.

Background: Drug and alcohol support workers play a vital role in addressing the growing burden of substance-related harm and mortality. The COVID-19 pandemic led to an abrupt and significant shift towards home working for many in this workforce. This study explores these workers' home working experiences, addressing a research gap and providing valuable insights for staff, organisations delivering public health services, and service users.

Design and methods: This qualitative study explores home working experiences of 30 drug and alcohol support workers in northern England during the COVID-19 pandemic. Data collection included innovative digital methods: (1) digital timelines (n = 16); (2) in-depth interviews (n = 17); (3) five focus groups (n = 12). Timeline text was treated as qualitative text data. Interviews and focus groups were recorded, transcribed, and coded. Data were subject to Framework Analysis.

Results: Seven themes were identified: (1) Difficulty balancing and separating work and home life; (2) Importance of setup, infrastructure and conducive work environment; (3) The move to remote/home working - a process; (4) Convenience and efficiency benefits; (5) Loss of the social: - reductions in social connectedness and feelings of isolation; (6) The importance of the 'office' for connection, communication, socialising, and information sharing; (7) Managing remotely - the development and implementation of strategies and ways of coping.

Conclusions: While home working offers some benefits for substance use support workers, providers, and service users, it also introduces significant challenges. Understanding these is critical for service optimisation. A hybrid (in-person/remote) deliver model, combining home and co-located, office-based working may be optimal.

Background: Communication is central to effective public health practice, with all roles and functions requiring proficiency in communication. A competency-based approach to public health enhances workforce development and helps ensure adaptability and collaboration by equipping professionals with the practical skills needed to address complex and evolving public health challenges, including through communication.

Methods: Semi-structured interviews and reflexive thematic analysis were conducted to explore the perspectives of public health communication experts (researchers and practitioners) regarding the importance of public health communication, the challenges and opportunities faced by the field of practice, and the specialized competencies required for strengthened communication in modernized public health practice.

Results: Twelve key informants were interviewed, and seven interrelated themes were generated from the data. The themes were organized in three main areas: the importance of public health communication, the various levels of influence on effective communication, and the support needed for strengthened communication capacity. Participants stressed the importance of partnerships and collaboration, dedicated resources, ongoing professional development, and tools to facilitate the implementation of the specialized competencies.

Conclusions: A competency-based approach, including specialized roles and education and training programs aligned with updated communication competencies, will empower public health to tackle modern challenges. This research contributes to a multi-step research project to develop a Canadian public health communication competency framework and supports ongoing efforts to strengthen the public health workforce in Canada.

Introduction: South Africa's National School Nutrition Programme (NSNP) was created in 1994 to reduce poverty and unemployment and improve children's learning. It aims to aid disadvantaged children and strengthen poor communities, especially in rural areas.

Objectives: The study examined challenges in implementing Total Quality Management (TQM) in the South African National School Nutrition Programme.

Methods: A qualitative case study design was used based on document analysis extracted through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The documents were analysed using thematic analysis.

Results: Key TQM challenges affecting the implementation of the NSNP include Customer focus-lack of funding from the Department of Basic Education to accommodate increased enrolment; Employee involvement-role ambiguity due to lack of communication, and at times, the roles of the NSNP players are not clearly defined; Process-centric approaches-lack of school-level infrastructure to store and cook for students, Continuous improvement and training-lack of education curriculum on nutrition education and Relationship management-lack of coordination of the stakeholders on funding, political landscape, nutrition policies, community involvement, programme adaptability.

Conclusion: Effective monitoring systems should be established to guarantee that students receive the necessary quality and quantity of food. These systems should also oversee food supply, storage, preparation, and hygiene. Additionally, the current targeting system, the quintile system, requires evaluation. This should involve assessing the school's location, available resources, and individual students' social context.

Background: HPV vaccination coverage is important to prevent cervical cancer and other HPV-related diseases. This study estimated the vaccination coverage rate among adolescent schoolgirls aged 12-18 in Greece and identified factors affecting parental vaccination decisions.

Design and methods: A cross-sectional study was conducted from September 2021 to March 2022. A nationwide representative sample of 3205 parents/guardians of schoolgirls from 48 schools was selected through a probabilistic multistage sampling. Besides descriptive statistics, estimation, exploration and inferential methods were used, including 95% CI to estimate the vaccine rate, exploratory factor analysis to emerge the factors of HPV knowledge and multiple logistic regression analysis to identify the crucial parameters associated with vaccination, after adjusting for mutual confounding.

Results: About 62.5% [95% CI: 61.1-63.9] of the girls were fully vaccinated. Mother's HPV vaccination (OR [95% CI] = 2.90 [1.77, 4.73]), parental education level (OR [95% CI] = 2.50 [1.65, 3.79]), child's attendance at the Upper secondary school (OR [95% CI] = 2.36 [1.83, 3.03]) and the level of HPV vaccine knowledge (OR [95% CI] = 1.59 [1.37, 1.84]) influenced parents' decision to vaccinate their daughters.

Conclusions: A significant increase in HPV vaccination coverage was recorded in Greece, compared to previous estimations. The identified determinants of parents' vaccination decisions, especially HPV vaccine knowledge, can feed into targeted public health policies, to achieve the WHO's goal to vaccinate 90% of adolescent girls by 2030. Policies may include the implementation of school-based awareness programmes for students and parents, state incentives for parents and expert recommendations for vaccination.

Background: Community-based health insurance (CBHI) plays a crucial role in achieving universal health coverage. This study investigates the determinants, challenges, and opportunities related to CBHI in Tigray, Ethiopia.

Design and methods: A mixed-methods approach was employed. In 2020, a cross-sectional survey was conducted involving 800 rural households in Tigray, combined with semi-structured key informant and in-depth interviews. Multistage random sampling and logistic regression analyses were also applied.

Results: Enrollment was strongly associated with having a chronic illness (AOR = 64.5, p ≤ 0.01), primarily due to a policy that permits indigents with chronic conditions to enroll without payment. Other factors included membership in a political party (AOR = 3.76, p ≤ 0.01), holding formal positions (AOR = 1.55, p = 0.03), receiving aid (AOR = 1.62, p ≤ 0.01), and membership in Edir (AOR = 1.66, p ≤ 0.01). Conversely, enrollment was negatively impacted by low trust (AOR = 0.66, p = 0.04), limited awareness (AOR = 0.4, p ≤ 0.01), poor healthcare quality (AOR = 0.51, p ≤ 0.01), bureaucracy (AOR = 0.02, p ≤ 0.01), being widowed (AOR = 0.34, p ≤ 0.01), and working as a daily laborer (AOR = 0.23, p ≤ 0.01). Key barriers included structural inefficiencies, substandard healthcare service quality, and inadequate awareness.

Conclusion: To facilitate equitable expansion of CBHI, it is essential to address administrative obstacles, enhance trust and awareness, and provide support to vulnerable groups, in addition to leveraging traditional risk-pooling mechanisms.

Background: Oral health significantly affects the overall well-being of the elderly, influencing nutrition, communication, and quality of life. Poor oral hygiene can cause infections and dental issues. In Thailand, promoting oral hygiene among the aging population remains a pressing and ongoing public health challenge.

Design and methods: This study explores the factors influencing oral health care behaviors among elderly individuals at the Phitsanulok Health Center (Buddhachinaraj Hospital) as a case study of lower Northern Thailand. A total of 365 elderly participants were surveyed using a structured questionnaire.

Results: Multiple regression analysis showed that general employment (β = -0.227, p < 0.001), business (β = -0.300, p < 0.001), and government service (β = -0.205, p < 0.001) were negative predictors of oral health care behaviors. In contrast, enabling factors (β = 0.204, p < 0.001), average monthly income (β = 0.200, p < 0.001), and supporting factors (β = 0.142, p = 0.005) had positive effects. These factors together explained 20.02% of the variation in behaviors (p < 0.001), with enabling factors having the strongest influence.

Conclusions: This study emphasizes the importance of financial security, access to dental care, and social support in maintaining oral health among the elderly. Enhancing affordable dental services is crucial for low-income seniors. The findings suggest further research into factors influencing elderly oral health and strategies to improve care access. Recommendations include reducing dental costs, creating family-centered health initiatives, involving families in oral hygiene, and enacting policies to support low-income elderly individuals.

Background: The decriminalization of cannabis in South Africa has sparked growing concern within the medical community, particularly among medical students. As future healthcare providers, they must navigate evolving legal and professional landscapes while forming beliefs about the health effects of cannabis use. This legal shift has intensified debates surrounding the benefits, risks, and health consequences of cannabis, especially in relation to mental well-being, academic performance, and professional identity.

Objective: This systematic qualitative review aimed to synthesize existing literature on South African medical students' perceptions of cannabis decriminalization and their views on its health-related impacts. The review seeks to clarify how medical students interpret the effects of cannabis use on mental and physical health and how these beliefs shape their professional attitudes and behaviors.

Design and methods: A systematic search and thematic synthesis were conducted across databases including PubMed, Scopus, PsycINFO, and ScienceDirect for literature published between 2010 and 2024. Studies were eligible if they focused on cannabis or marijuana use, included South African medical students, and discussed perspectives or health impacts in the context of decriminalization. Data were extracted, coded line-by-line, and synthesized to generate descriptive and analytical themes.

Results: Four studies met inclusion criteria. Thematic analysis identified four key themes: (1) Health impacts (Mental and Physical); (2) perceptions and attitudes toward decriminalization; (3) educational influences and awareness; and (4) access to support services.

Conclusion: This study emphasized the need for more focused research on the impact of cannabis decriminalization on medical students in South Africa. Current literature suggests that while there are diverse opinions on the subject, the decriminalization of cannabis may influence both attitudes and behaviors.