Archives of Public Health最新文献

Background: Amid high youth out-migration, India's older parents face severe social, economic, psychological, and health crises due to their children's separation. However, remittances from their migrant children alleviate economic hardships, improve healthcare access, and partially compensate for their absence. So, this study examines how adult-child migration affects older parents' physical and mental health and how remittance support helps mitigate these challenges.

Methodology: This study used the 2011 Building a Knowledge Base on Population Ageing in India (BKPAI) dataset, the current study (n = 5122) employs bivariate statistics, logistic regression, and mediation analysis to address the objectives. Logistic regression determines the factors of self-rated health and depression, while mediation analysis is implied to understand the intermediate effect of financial support i.e. remittance on left-behind older adult health.

Results: The findings indicate that approximately 43% of the study populations were left behind, meaning they have at least one migrant child. Notably, 20% of these left-behind older adults report poor health conditions, and 17% exhibit depressive symptoms, while the poor health and having depressive symptoms were lower among the non-left-behind older adults i.e., 13% and 12% respectively. The mediation analysis indicates that the likelihood of good self-rated health increased 1.35 times through the effect of remittance, which compensates for around 55% of the total adverse effect of migration.

Conclusion: The consistent inflow of remittances serves to alleviate the impact on household finances, ensure food security, and address medical expenses. However, it is crucial to recognize that while remittances contribute significantly to economic stability, they cannot fully replace the physical presence of adult children, especially in terms of caregiving.

Background: The global health crisis of obesity has prompted a need for better indicators of abdominal obesity than body mass index, with sagittal abdominal diameter emerging as a potential candidate. Nonetheless, the association between sagittal abdominal diameter-to-height ratio (SADHtR) and mortality remains inadequately established. Our objective was to contribute novel evidence to this association.

Methods: This study encompassed 12,572 participants aged 18-80 years from the National Health and Nutrition Examination Survey 2011-2016. Mortality data were tracked until December 31, 2019. Weighted multivariable Cox proportional hazard models were employed to evaluate the association between SADHtR and all-cause mortality, with subgroup analyses conducted for result robustness.

Results: Following a median follow-up period of 69 months, each standard deviation (SD) increase in SADHtR was consistently associated with a higher risk of all-cause mortality across three models, yielding a hazard ratio (HR) and 95% confidence interval (CI) of 1.51(1.29,1.76) in model 3. Additionally, compared to the first tertile of SADHtR, the third tertile exhibited a higher risk for all-cause mortality, with HRs(95%CIs) of 1.58(1.25,2.01) in model 1, 2.01(1.33,3.02) in model 2, and 1.74(1.19,2.57) in model 3. Notably, subgroup analysis revealed persistent positive associations between SADHtR and all-cause mortality among subgroups based on age-at-risk (< 65, ≥ 65 years), sex, diabetes, hypertension, and hyperlipidemia.

Conclusions: Elevated SADHtR was consistently associated with a higher risk of all-cause mortality in American adults. Regular SADHtR measurement should be considered to be integrated into clinical practice and healthcare examinations.

Introduction: The Irish Prostate Cancer Outcomes Research (IPCOR) Study collected longitudinal data on men newly diagnosed with Prostate Cancer (PC). Understanding the nuances of disease presentation is essential, considering the high incidence of PC in Ireland. This study aims to characterise disease presentation features, identify factors related to socio demographic disparities in presentation following opportunistic screening, and shed light on potential inequality challenges within Ireland's healthcare structure.

Methods: Data were collected on demographics, diagnosis, and treatment of 6,816 men newly diagnosed with PC across 16 hospitals in the Republic of Ireland from February 2016 to January 2020. A complete case analysis was carried out, complemented by a sensitivity analysis for addressing sites with high rates of missing values. Multivariable logistic regression was conducted to examine the association between various predictor variables and the initial presentation to the urology clinic subsequent to opportunistic screening.

Results: A multivariable logistic regression model revealed that the type of hospital was a key determinant in post-opportunistic screening presentation, with patients in public hospitals 45.7% more likely to be presented following screening compared to those in private hospitals. Urban residents were 34% more likely to present following screening than rural ones. Age negatively influenced presentation following screening likelihood, decreasing by 3.4% yearly.

Discussion: Our research has highlighted the key features of PC presentation in Ireland, revealing potential inequalities affecting mainly urban populations, middle socioeconomic groups, and individuals with inadequate healthcare coverage. While the differences we observed in various groups may appear subtle and may indicate the success of the Rapid Access Prostate Clinics, they are still significant in pinpointing specific populations that require special attention.

Conclusions: By addressing these nuanced differences in access to healthcare, socioeconomic status, and urban versus rural residence and implementing tailored strategies, we can work towards closing disparity gaps in PC, ultimately leading to improved health outcomes and equity across all population segments.

Background: Functional disability significantly burdens healthcare services, negatively affecting older adults' social interaction and quality of life. This study aims to identify the association between functional disability and mental health, and examine the moderating effects of social participation and physical exercise on the association.

Methods: The data were drawn from 2018 wave of Chinese Longitudinal Healthy Longevity Survey, and ordinary least squares regression model was exploited to explore the association between functional disability and mental health.

Results: Activity of daily living (ADL) disability negatively predicted mini-mental state examination (MMSE) score. Furthermore, social participation and physical exercise moderated the association between ADL disability and MMSE score.

Conclusion: The results highlight the importance of social participation and physical exercise for the older adults with ADL disability.

Background: The COVID-19 pandemic led to significant excess mortality in 2020 in Belgium. By using microlevel cause-specific mortality data for the total adult population in Belgium in 2020, three outcomes were considered in this study aiming at predicting sociodemographic (SD) and socioeconomic (SE) patterns of (1) COVID-19 specific death compared to survival; (2) all other causes of death (OCOD) compared to survival; and (3) COVID-19 specific death compared to all OCOD.

Methods: Two complementary statistical methods were used. First, multivariable logistic regression models providing odds ratios and 95% confidence intervals were fitted for the three study outcomes. In addition, we computed conditional inference tree (CIT) algorithms, a non-parametric class of classification trees, to identify and rank by significance level the strongest predictors of the three study outcomes.

Results: Older individuals, males, individuals living in collectivities, first-generation migrants, and deprived SE groups experienced higher odds of dying from COVID-19 compared to survival; living in collectivities was identified by the CIT as the strongest predictor followed by age and sex. Education emerged as one of the strongest predictors for individuals not living in collectivities. Overall, similar patterns were observed for all OCOD except for first- and second-generation migrants having lower odds of all OCOD compared to survival; age group was identified by the CIT as the strongest predictor. Older individuals, males, individuals living in collectivities, first- and second-generation migrants, and individuals with lower levels of education had higher odds of COVID-19 death compared to all OCOD; living in collectivities was identified by the CIT as the strongest predictor followed by age, sex, and migration background. Education and income emerged as among the strongest predictors among individuals not living in collectivities.

Conclusions: This study identified important SD and SE disparities in COVID-19 mortality, with living in collectivities highlighted as the strongest predictor. This underlines the importance of implementing preventive measures, particularly within the most vulnerable populations, in infectious disease pandemic preparedness to reduce virus circulation and the resulting lethality.

Background: This study protocol outlines the phased construction of a questionnaire, data collection, and a strategy for analysis within the framework of the ATTAS project. This study has two primary objectives. First, it allows us to map the duration of the various phases of the abortion trajectory for women presenting for abortion in Flanders, Belgium. Second, it identifies barriers that cause delays within these phases.

Methods: The questionnaire was distributed to all women seeking abortion care at one of the five Flemish abortion centers; specifically, the LUNA centers, which are located in Ostend, Ghent, Antwerp, and Hasselt, as is the VUB-Dilemma center in Brussels during the fall and winter of 2023-2024. Ethical clearance for the described research was obtained from the University of Antwerp's Ethics Committee for the Social Sciences and Humanities (reference numbers: SHW_2023_48_1 and SHW_2023_48_2).

Discussion: The collected data provide a dataset on the abortion trajectories of Flanders women who presented for abortion. This study protocol outlines the ATTAS project's rationale, phased development, and implementation of the questionnaire, as well as the upcoming data analyses. To our knowledge, this is the first study within the Flemish context to investigate abortion trajectories, timing, and access. Furthermore, this study protocol provides a phased and systematic approach to adapt validated research instruments to fit within diverse legal and cultural contexts. Building on this protocol, future research will seek to advance reproductive justice for all women in Belgium.

Background: Assessing maternal health care utilisation is imperative for the health of both mother and her child. Maternal education is an important determinant in subsequent maternal health care usage, according to research. There is a dearth of research on the causal relationship between maternal education and maternal health services as well as examining the performance of different propensity score methods for estimating absolute effects. Therefore, this study aims to estimate the effect of maternal education on usage of maternal health services minimising the confounding effect and to compare different propensity score approaches to estimate absolute effects of maternal education on usage of maternal health services.

Methods: We used data from a cross-sectional study conducted by icddr,b in Bangladesh. A total of 1300 recently delivered mothers were included in this study. We used different propensity score (PS) methods to estimate the causal effect of maternal education on receiving maternal health services, including PS matching, PS weighting, covariate adjustment using PS, as well as used modified log-Poisson regression with and without multiple covariates.

Results: The study revealed highly imbalanced possible confounding factors for mother's educational level, which might lead to erroneous estimates. All methods indicated a significant effect of higher maternal education, whether measured as a continuous scale or a binary variable (secondary or higher vs. below secondary) on maternal health services, significantly increased the likelihood of receiving four or more ANC, delivered at facility, PNC within 42 days and receiving all maternal health services compared to the mothers with lower level of education. The PS weighting provided precise estimates with a low range of confidence interval.

Conclusions: The results provided important insights on how well these techniques worked to reduce effect of confounding variables and achieve precise estimates. Propensity score weighting method performed better in terms of providing more precise estimates with a narrower range of confidence intervals, indicating that this method may be a reliable approach for estimating the causal effect of maternal education on maternal health service utilisation. However, careful consideration should be given to selecting the most appropriate method.

Background: The association between chronotype and leisure-time physical activity (LTPA) remains unclear. We investigated the difference in regular LTPA and for a sufficient duration between those with evening-type (ET) and morning-type chronotypes (MT).

Methods: We conducted a cross-sectional analysis using the data of the Aichi Workers' Cohort Study. It included 3,221 men (mean [standard deviation] age: 45.0 [11.6] years) and 1,294 women (39.8 [11.2] years). Chronotypes were determined with the reduced version of the Morningness-Eveningness Questionnaire. We calculated the metabolic equivalents (METs) consumed per week based on the four types of LTPA: strolling, brisk walking, light- and moderate-intensity PA, and vigorous-intensity PA. Regular LTPA and for a sufficient duration was defined as doing once or more per week and for 30 min or longer per session, respectively. Logistic regression analysis was conducted separately by sex to calculate odds ratios of ET for regular LTPA and for a sufficient duration, adjusted for age and other factors, for each type of LTPA.

Results: ET men consumed fewer total METs per week than MT men (p < .001), although this pattern is not found in women. Compared to MT men, ET men were less likely to be engaged in regular LTPA in all types of LTPA (prevalence and adjusted odds ratio [95% confidence interval]: strolling: 39.1% vs. 28.7%, 0.685 [0.524-0.895]; brisk walking: 23.9% vs. 14.4%, 0.639 [0.454-0.899]; light- and moderate-intensity PA: 15.4% vs. 8.4%, 0.613 [0.404-0.929]; vigorous-intensity PA: 21.4% vs. 16.8%, 0.715 [0.518-0.989]). They were less likely to spend a sufficient duration in brisk walking (25.9% vs. 16.5%, 0.635 [0.461-0.875]), light- and moderate-intensity PA (37.1% vs. 26.8%, 0.684 [0.521-0.899]), and vigorous-intensity PA (35.3% vs. 35.8%, 0.741 [0.568-0.968]). Compared with MT women, ET women were less likely to be engaged in strolling (30.5% vs. 22.2%, 0.629 [0.398-0.995]), and less likely to spend a sufficient duration in light- and moderate-intensity PA (27.3% vs. 15.3%, 0.561 [0.335-0.937]).

Conclusions: ET was inversely associated with LTPA in men and partly in women.

Background: This study attempts to analyse physical fitness and basic anthropometric parameters of children and adolescents participating in the nationwide physical activity promotion programme "Athletics for All!" (AFA). The programme aims to establish a national system for diagnosing, selecting, recruiting, and identifying talents in youth training. It also aims to build a career development path for athletics, forming the basis of a new structure for youth training in Poland. The primary goal of this study was to assess physical fitness of AFA participants over the years of its implementation (2015-2022) and to identify the leading motor ability with consideration for age, gender, and body build parameters determined with Body Mass Index and Ponderal Index.

Methods: Nationwide measurements of basic anthropometric parameters as well as physical fitness tests were conducted among 31,790 girls (F) and 22,260 boys (M) participating in the AFA programme. Physical fitness assessments were performed using the OSF test (3 × 10 m shuttle run, standing broad jump, 1 kg medicine ball throw, 4-minute run). Comparative analysis of OSF test results, considering gender, was conducted using the independent samples T-test. The strength and direction of correlations between variables were calculated using the rho-Spearman coefficient.

Results: OSF test results were converted into points, considering age and gender. Gender was found to be a significantly differentiating factor in physical fitness of AFA participants. Among twelve- and fifteen-year-olds, statistically significant differences were observed in all analysed variables, i.e. in each of the four tests and the overall score. It was noted that the examined girls aged 11 to 17 exhibited higher levels of strength compared to their male counterparts. Statistical analysis revealed significant correlations between OSF test results and the age and body build indicators, with the strength of the correlations being negligible in most cases.

Conclusions: Participants of the nationwide programme "Athletics for All!" demonstrate a high level of physical fitness, with endurance being a fundamental motor ability. Physical fitness levels show significant correlations with the anthropometric parameters of children and adolescents. The study results confirm the need and justification for implementing physical activity promotion programmes for the younger generation.