Journal of Biosocial Science最新文献

Loneliness and social isolation represent persisent global public health concerns, particurarly for people in later life, with extensive mental, social, and biological consequences. Both have been associated with increased risk of depression, anxiety, dementia, cardiovascular disease, premature mortality, and greater demand for health and social care services. A growing body of evidence indicates that nature-based interventions are effective in reducing loneliness, enhancing mood, and promoting overall well being, yet they still remain underutilised within health and social care strategies; particularly for older adults and those with limited mobility. One such initiative, Cycling Without Age, a grassroots programme, demonstrates the potential of nature-based interventions. Evidence across multiple contexts indicates improvements in mood, life satisfaction, and social connectedness, alongside benefits for families and care staff. Cycling Without Age illustrates a type of scalable, person-centred intervention that could be integrated into healthy ageing strategies. However, rigourous large-scale research remains scarce, which highlights the need for further evaluation to guide policy adoption and sustainable implementation. Effective responses to loneliness and social isolation require integrated support programmes that foster social connectedness and healthy ageing, delivered through coordinated efforts spanning public health, urban design, and community services.

Mortality trends among Indigenous peoples in Brazil remain poorly characterised. An ecological time-series study (2010-2022) was conducted, comparing Indigenous and non-Indigenous populations using nationwide open-access demographic and mortality data. Mortality was stratified by sex, age, and ICD-10 groups, populations were compared using Pearson's chi-square test (p < 0.05), and trends were evaluated with joinpoint regression (JR) to estimate Average Annual Percentage Changes (AAPCs). Between 2010 and 2022, mortality among Indigenous peoples increased by 82.5% (from 2,927 to 5,343), compared with a 42.3% increase in the non-Indigenous population. Over 40% of deaths among Indigenous peoples occurred outside health facilities in both years, versus fewer than 30% among non-Indigenous populations. Crude mortality rates remained lower in Indigenous peoples (2010: 35.8 versus 55.9; 2022: 43.5 versus 74.8 per 10,000 population). However, age-specific differences were marked: mortality among Indigenous children and adolescents (0-19 years) was 3.3 times higher in 2010 and 3.8 times higher in 2022, while mortality among adults aged ≥40 years was approximately 2.5 times lower in both years compared with non-Indigenous populations (all p < 0.05). Mortality rates among Indigenous peoples were consistently higher for maternal, perinatal, and congenital conditions in both 2010 and 2022. JR revealed heterogeneous proportional mortality trends: significant increases in perinatal, congenital, and external causes (AAPC approximately 5.0-6.4%), as well as neoplasms, circulatory, haematological, digestive, respiratory, and endocrine/metabolic diseases (AAPC approximately 1.6-4.4%); a significant decline in infectious and parasitic diseases (AAPC -6.6%); and stability in other groups. Indigenous peoples in Brazil continued to face unfavourable mortality, particularly among children, adolescents, and maternal conditions. Many leading causes of death are preventable. Strengthening primary healthcare, expanding prenatal and perinatal services, improving vaccination and mental-health support, and adopting culturally safe, community-driven strategies to address chronic diseases are critical to reducing inequities and preventable deaths.

Hypertension (HTN) is the primary cause of preventable cardiovascular-related deaths globally, representing the most important modifiable risk factor for preventing such deaths. Nearly 700 million of the 1.3 billion adults with HTN worldwide remain untreated, most of whom live in low-and middle-income countries, including East Africa. Barriers to the diagnosis of HTN also impact treatment adherence after diagnosis and the initiation of treatment. This scoping review used a qualitative synthesis method to describe studies examining the cultural and contextual factors influencing HTN treatment adherence in East Africa and the lived experiences of patients with HTN to gain a better understanding of these factors in the region. A total of 34 studies, 25 qualitative and 9 mixed-methods designs from five East African nations were included in the final review. Reported influencing factors are classified into individual, structural, and social factors. Lack of HTN literacy and limited risk perception were often cited as individual barriers to adherence, along with mental health challenges, including fear of stigma, while trust and HTN literacy enhanced adherence. Inconsistent healthcare delivery, lack of access, and financial constraints were the most reported structural factors. Social norms surrounding health behaviours and attitudes towards HTN treatment were identified as key determinants of adherence at the social level. The findings underscore the complex interplay of individual, structural, and social factors associated with HTN treatment adherence in East Africa, offering practical ways to enhance adherence in the region at all three levels.

Given the surging economic and health costs associated with childhood stunting, identifying its associated factors is crucial. This study therefore explores a key determinant of long-term nutritional status, women's participation in household decision-making in the context of Pakistan. To empirically estimate this association, three-level modelling was employed by pooling the data from two recent nationally representative survey rounds PDHS 2012-13 and PDHS 2017-18. Multilevel analysis was better suited compared to traditional methods for robust estimates because of the hierarchical nature of the data. Women's decision-making power was measured by formulating an index through factor analysis from the direct questions about women's participation in household decisions. This study found a positive association between women's decision-making power and children's nutritional growth at the national level, with no significant changes across the survey years. However, this relationship was moderated by regional variations, which was more pronounced in Sindh and relatively modest in other regions. The sensitivity analysis showed that among the different decision-making domains, only women's participation in large household purchases was significantly and positively associated with child linear growth. The insights of this research suggest that nutrition-oriented policies should also consider non-nutritional factors, like women's decision-making power when designing projects for target population. Meanwhile, it is also crucial to recognize that decision-making power is a contextual factor and its effect on child nutritional growth may vary across regions.

Family planning programmes in sub-Saharan Africa (SSA) often disseminate the proposition that birth spacing improves child survival. Yet, there are few examinations of this hypothesis that benefit from longitudinal data. This paper addresses this gap using 15 years of prospective data from three rural districts of Tanzania. The effect of birth interval durations on the risk of childhood mortality was estimated by fitting Weibull parametric hazard regression models with shared frailties to a dataset that comprised records of reproductive events and their succeeding survival trajectories of 25,762 mother-child dyads that lived in the sentinel areas of the Ifakara and Rufiji Health and Demographic Surveillance Systems from 2000 to 2015. The analysis was motivated by two hypotheses: First, that relatively short subsequent and preceding birth intervals would be associated with heightened risks of child mortality; however, that the effects of short subsequent birth intervals would be most pronounced among children between 12 and 59 months of age; and second, that the effects of short preceding birth intervals would be most acute during the neonatal and post-neonatal period. Results, which were adjusted for confounder effects at the individual, household, and contextual levels, demonstrated significant associations between subsequent and preceding birth interval durations and childhood mortality risk. Regarding subsequent birth intervals, relative to birth spacing of less than 18 months, durations 24-35 and ≥36 months were associated with 1-5-year-old mortality risks that were 0.29 and 0.21 times lower. Relative to preceding birth intervals of less than 18 months, those of 24-35 months were associated with a neonatal mortality risk that was 0.48 lower. Compared to the same referent group, preceding birth intervals of 18-23, 24-35, and ≥36 months were significantly associated with 12-23-month-old mortality risks that were 0.20, 0.39, and 0.33 times lower. The findings are compared with those from similar studies held in SSA, and the potential for family planning programmes to contribute to improved child survival in settings, such as Tanzania, is discussed.

The objective of this study is to assess the effects of the configuration, size, and density of family and personal networks on women's current fertility in Ouagadougou. The association between women's reproductive histories and their social networks was evaluated using Poisson regression models and fairly original data on these networks. The study is based on three family configurations: 'Restricted' (children and friends), 'Kinship' (blood or marital relatives), and 'Sibling' (brothers and sisters). Results show that the type of family configuration has a significant effect on current fertility. 'Kinship' and 'Sibling' configurations are associated with higher current fertility, while the 'Restricted' configuration is associated with lower fertility. Regarding the size and density of the network, the findings indicate that network size and density are negatively associated with current fertility. These results highlight the need to take social networks into account in strategies aimed at controlling fertility in the city of Ouagadougou.

Gestational diabetes mellitus (GDM) is a common medical condition during pregnancy and is linked to short- and long-term complications for both mothers and offspring. However, there is limited information regarding poor glycaemic control in Malaysia. This study aims to determine the predictors of poor glycaemic control among women with GDM and to explore women's perceptions and experiences in self-managing glycaemic control. An explanatory sequential mixed methods study was conducted among women with GDM in Northern Terengganu. A proportional-to-size stratified sampling method was used in quantitative research to obtain 238 samples. Logistic regression was applied to determine associations between factors and poor glycaemic control. Then, purposive sampling was done in qualitative inquiry to obtain 12 samples. Thematic analysis was applied to identify recurring themes. The data from both quantitative and qualitative inquiry were then combined to answer research questions. Dietetic counselling (AOR = 2.95; 95% CI: 1.41, 6.17; p-value=0.004) and diet self-efficacy (AOR = 0.78; 95% CI: 0.61, 0.98; p-value=0.040) were associated with poor glycaemic control. Six themes that emerged from the interviews were: fear and worry; knowledge and motivation; dietary preferences and beliefs; family factors; occupational factors; and availability and affordability. The findings provide useful evidence for healthcare providers in delivering comprehensive health education and providing care for women with GDM.

This study presents a revised estimation of the prevalence of female genital mutilation/cutting (FGM/C) among migrant women and second-generation girls in Italy as of 1 January 2023. The study is based on an enhanced indirect estimation of the prevalence among migrants and data on first- and second-generation women legally residing in Italy as of 1 January 2023. The study estimates that approximately 88,600 women aged 15 and over have undergone FGM/C in Italy, representing 46% of migrant women from practising countries. Notably, around one-third of these women are over 50 years old, indicating that FGM/C remains a significant health concern beyond childbearing age. Among foreign-born women, 46.5% are estimated to be affected, compared to 22.5% of Italian-born women. The research also identifies approximately 16,000 girls under 15 at potential risk, with the highest numbers among those of Egyptian, Nigerian, and Senegalese descent. Methodologically, the study underscores the importance of refining indirect estimation techniques to account for the socio-demographic selectivity of migration. While the overall prevalence of FGM/C is decreasing, the persistence of the practice among specific communities calls for targeted interventions. The findings emphasise the need for culturally sensitive awareness campaigns, strengthened legal frameworks, and accessible healthcare services. Furthermore, this research contributes to the European discourse on FGM/C by providing a replicable estimation model adaptable to other non-practising countries receiving migrants from FGM/C-prevalent regions. Periodic replication of such estimates can provide valuable insights into evolving FGM/C trends, aiding policymakers in resource allocation and intervention strategies to eradicate the practice.

Social isolation and loneliness have been linked to adverse health outcomes such as depression in old age. However, limited data exist on the association of loneliness and social isolation with probable depression (PD) in low- and middle-income countries (LMICs), while psychosocial mediators are largely unknown. This study investigates the individual and joint associations of social isolation and loneliness with PD among older adults in Ghana. It quantifies the extent to which psychosocial factors mediate the associations. Cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behaviour Study were analyzed. PD was defined as moderate to severe depressive symptoms with the Center for Epidemiologic Studies Depression (CES-D-9) scale. Loneliness and social isolation were assessed with the University of California, Los Angeles 3-item loneliness scale and the Berkman-Syme Social Network Index, respectively. Multivariable logistic models and PROCESS macro bootstrapping mediation analyses were performed. Among the 1,201 adults aged ≥50 years (M_age = 66.1 ± 11.9 years, 63.3% women), 29.5% PD cases were found. The prevalence of social isolation and loneliness was 27.3% and 17.7%, respectively. Loneliness (OR = 3.15, 95% CI = 3.26-5.28) and social isolation (OR = 1.24, 95% CI = 1.10-1.41) were independently associated with higher odds of PD. The loneliness and PD association was modified by spatial location (P_interaction = 0.021); thus, the association was more pronounced in rural areas (OR = 7.06) than in urban areas (OR = 3.43). Psychosocial factors (e.g. sleep problems) mediated the loneliness/social isolation and PD association. Loneliness and social isolation were independently associated with a higher likelihood of PD, and psychosocial factors mediated the associations. Interventions to reduce PD in later life should also consider addressing loneliness and social isolation, as well as sleep problems.

The deliberations for the Pandemic Accord have opened an important moment of reflection on future approaches to pandemic preparedness. The concept had been increasingly prominent in global health discourse for several years before the pandemic and had concretised into a set of standardised mainstream approaches to the prediction of threats. Since 2019, the authors and the wider research team have led a research project on the meanings and practices of preparedness. At its close, the authors undertook 25 interviews to capture reflections of regional and global health actors' ideas about preparedness, and how and to what extent these were influenced by Covid-19. Here, an analysis of interview responses is presented, with attention to (dis)connections between the views of those occupying positions in regional and global institutions. The interviews revealed that preparedness means different things to different people and institutions. Analysis revealed several domains of preparedness with distinct conceptualisations of what preparedness is, its purposes, and scope. Overall, there appear to be some changes in thinking due to Covid-19, but also strong continuities, especially with respect to a technical focus and an underplaying of the inequities that became evident (in terms of biosocial vulnerabilities but also global-regional disparities) and, related to this, the importance of power and politics. Here, the analysis has revealed three elements, cutting across the domains but particularly strong within the dominant framing of preparedness, which act to sideline direct engagement with power and politics in the meanings and practices of preparedness. These are an emphasis on urgent action, a focus on universal or standardised approaches, and a resort to technical interventions as solutions. A rethinking of pandemic preparedness needs to enable better interconnections across scales and attention to financing that enables more equitable partnerships between states and regions. Such transformation in established hierarchies will require explicit attention to power dynamics and the political nature of preparedness.