Archives of Public Health最新文献

Background: Information regarding children's exposure to tobacco smoke, posing significant risks, is usually reliant on parental reports. We aimed to adopt the scale of parental perception of children's tobacco smoke exposure (PPE) into Turkish, and investigate its correlation with sociodemographic factors.

Methods: The language and cultural adaptation of the original scale was carried out according to the international guidelines. The participants consisted of 250 females and 250 males living in Samsun province who are over the age of 18, have children younger than 18 years old, without any visual impairment or communication barrier. The survey forms were administered through face-to-face interviews between November 2022 and April 2023.

Results: Mean age of the parents was 36.7 ± 6.9 years. A total of 179 (35.5%) parents were current smokers, and 44% of the households had at least one parent who reported smoking indoors. The mean score of PPE scale was 4.9 ± 1.2. Female sex, parents with higher education, with healthcare profession and with no history of smoking had better awareness about children exposure to smoke. A positive correlation was found between educational level and PPE scale score (r = 0.13; p = 0.004). Parents not allowing smoking indoors or in the car, and those not bringing children to restaurants where smoking was allowed, had higher PPE scores.

Conclusions: There is a need for multidisciplinary and community-based interventions, with more effective enforcement and monitoring of smoking bans in enclosed spaces and children's play areas.

Background: Traditional healers play a significant role in Sub-Saharan Africa's healthcare system, but little is known about their role across the cancer care continuum in this context. Given the prevalence of patients consulting healers, we aimed to elucidate their role and impact on cancer care delivery in Sub-Saharan Africa.

Methods: Following the PRISMA reporting standards, all research focused on the role of traditional healers in the cancer care continuum in sub-Saharan Africa was included in this scoping review. Data sources assessed include PubMed, Cochrane Library, Embase, and CINAHL Plus with Full Text, Scopus, Sociological Abstracts, African Journals Online, African Index Medicus, and Google Scholar. Studies that lacked perspectives on the healers' role, focused solely on the actual herbal medicines, were written in non-English language, were not primary research, or the full-text was unavailable were excluded. Two reviewers performed screening and data extraction for each article, confirmed by a third reviewer.

Results: One thousand four hundred seventy-one studies were identified, with 1437 screened and 191 full-texts reviewed. Of those, 158 were excluded, and 33 (comprising of 1564 healers) were included for final data extraction and analysis. Five studies (64 healers) showed their role in prevention, eleven (454 healers) in diagnosis, twenty-seven (1524 healers) in treatment, and two (25 healers) in palliative care in Sub-Saharan Africa. While some desired increased collaboration with the biomedical system and referred patients, others lacked trust and remained hesitant to provide referrals.

Conclusion: Results showed that traditional healers play an important role in cancer treatment. This provides an opportunity to leverage the skills of traditional healers to improve cancer outcomes, in a way that recognizes and respects local culture. Future research focused on improving the collaboration between traditional healers and the biomedical healthcare system may lead to strengthening the referral system and early detection and treatment of cancer.

Registration:  This study was registered on PROSPERO, CRD42022293055.

Background: Globally, alarmingly high rates of maternal and infant mortality and morbidity persist. A constellation of health system and social factors contribute to this, including poor quality and barriers to accessing health care, including preventive services. As such, there have been calls for a redesign of maternal and child health (MCH) services. Although group care has primarily been tested in antenatal settings, it offers a promising redesign that optimizes maternal and child health care, survival, and well-being. The purpose of this study was to produce a blueprint of an adapted group care model that integrates postnatal maternal care, well-child care, and family engagement to be adapted to realities of different settings.

Methods: Using a human-centered design approach and the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME), we employed qualitative methods to adapt CenteringParenting^® (retaining its three core pillars of health assessment, interactive learning, and community building), and co-create the blueprint for group care beyond birth that can be used across settings. We initiated the process through face-to-face workshops during a global meeting on group care, followed by six online incubator sessions with key stakeholders from 13 countries during which we used qualitative methods of free listing, pile sorting, and ranking. We conducted a rapid qualitative analysis to produce a blueprint.

Results: Participants collaboratively modified the content, format, and evaluation of CenteringParenting^® with the goal of creating a blueprint that integrates postnatal and pediatric care into group care that can be further adapted and implemented across diverse settings and contexts. The blueprint consists of suggested timing of visits over two years after birth, suggested visit content, and evaluation metrics for research and practice.

Conclusions: The resulting group care beyond birth blueprint offers a strategy to redesign maternal and infant/child health services that can positively transform postnatal care and provide essential services to postpartum people. Adaptation of the blueprint to local realities is expected. Future research is recommended to test the model's acceptability, feasibility, and effectiveness across settings. Using this blueprint, we can build the evidence base to support this model aiming to improve maternal and infant/child health outcomes.

Background: Previous studies have proven the relationship between frailty and major adverse cardiovascular and cerebrovascular events (MACCE). However, the potential mechanisms need to be further explored. This study aimed to investigate the mediating effect of lipid accumulation products (LAP) in the relationship between frailty and MACCE.

Methods: This study recruited 7901 participants aged 45 and above from wave 2011 and 2018 of the China Longitudinal Study of Health and Retirement (CHARLS). Logistic regression models were employed to examine the relationship between frailty and MACCE and the mediating effects of LAP, using the bootstrap method to confirm path effects.

Results: Frailty group presented the highest risk of MACCE (OR 1.07, 95% CI 1.03-1.10). Frailty directly impacted MACCE (β = 0.045, P = 0.007). Frailty had a significant effect on LAP (β = 12.21, P < 0.01), while LAP had a significant impact on MACCE (β = 11.14, p = 0.014). The mediation effect of LAP accounted for 1.7% of the total effect regarding the frailty with MACCE.

Conclusion: LAP mediate the relationship between frailty and MACCE. Our findings suggest that instructing frailty patients to have a reasonable diet and exercise to control LAP at a low level may be an effective measure to reduce MACCE.

Background: Cervical cancer (CC) is the fourth most common cancer globally in females, caused by oncogenic infections with high-risk human papillomavirus (hrHPV) strains. Successful CC screening programs strongly depend on the participation rate of the target population. Nevertheless, it remains challenging to reach under screened populations. The CASUS study aimed to develop a complete CC screening solution based on first-void urine (FVU) self-sampling. Here we report on the usability perceptions and preferences from females that participated in the CASUS study by collecting FVU as a liquid biopsy.

Methods: Females self-collected FVU samples at home the day before colposcopy using the Colli-Pee^® UCM FV-5010, a FVU collection device prefilled with 3 mL of UCM preservative, collecting a total volume of 10mL. Afterwards, they completed a questionnaire expressing their usability perceptions and preferences regarding the device.

Results: A total of 332 females (26-70y) were enrolled in the CASUS study of which 210 completed the questionnaire. Overall, 66.6% of females preferred FVU self-sampling over a physician taken cervical sample (PTS) (32.9%) for their next CC screening. Out of 159 women who reported prior experience with a urine cup, 79.2% expressed a preference for using the Colli-Pee^® UCM FV-5010, while 20.8% favored the traditional urine cup. Additionally, 96.6% of females found Colli-Pee^® UCM FV-5010 easy to use and 97.1% would use the device again. A total of 208 valid System Usability Score (SUS) scores were received with an average of 86.17 ± 1.03 Standard Error of Mean (SEM).

Conclusion: The results of this study show that the majority of females in this referral cohort would prefer to self-collect a FVU sample at-home over a PTS for their next CC screening. Moreover, Colli-Pee^® UCM FV-5010 was considered an easy-to-use and well-accepted self-sampling device for CC screening in a Belgian colposcopy referral population. From a future perspective, these results highlight the possibility of home-based FVU self-sampling as a liquid biopsy in CC screening where under screened populations could be approached more easily.

Trial registration: The CASUS study was registered in http://www.

Clinicaltrials: gov (identifier: NCT04530201).

Background: High prevalence of poppers use was observed among men who have sex with men (MSM) and the use of poppers was associated with risky sexual behaviors and increased risk for human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) infection. To assess the risks for HIV/STDs transmission following poppers use, this study described the prevalence of poppers use and its associations with adherence to antiretroviral therapy (ART) and risky sexual behaviors among HIV-positive MSM.

Methods: Between June 2022 to June 2023, 1501 HIV-positive MSM enrolled in the study and data on sociodemographic characteristics, substances use, depressive and anxiety symptoms, perceived HIV-related stigma, adherence to ART and sexual behaviors were collected using an online questionnaire. Multivariate logistic regression models were constructed to identify factors associated with poppers use, as well as its relationship with adherence to ART and risky sexual behaviors.

Results: Among the 1501 participants, 32.4% reported poppers use in the past 6 months, of whom 99.6% reported that poppers were used before or during anal intercourse. Multivariate logistic analysis indicated that MSM who used poppers were more likely to report ART non-adherence (aOR = 3.92, 95% CI: 2.36-6.53), have multiple sex partners (aOR = 7.70, 95% CI: 5.61-10.57), participate in group sex (aOR = 18.30, 95% CI: 9.72-34.43), practice condomless anal intercourse with regular sex partners (aOR = 5.49, 95% CI: 3.93-7.68) and non-regular sex partners (aOR = 2.95, 95% CI: 1.97-4.43) and engage in condomless insertive anal intercourse (aOR = 5.32, 95% CI: 3.72-7.60) and condomless receptive anal intercourse (aOR = 3.72, 95% CI: 2.62-5.29).

Conclusions: This study indicated that HIV-positive MSM commonly used poppers in the context of anal intercourse and participants who used poppers were at increased odds of reporting ART non-adherence and risky sexual behaviors. Further research is needed to explore the mechanisms through which poppers use may influence these outcomes. Tailored harm reduction programs and counseling should be implemented to mitigate the use of poppers and address their potential risks.

Introduction: Breast cancer remains the most common cancer and a leading cause of cancer-related deaths among women worldwide. In Ethiopia, the survival rate of breast cancer patients is influenced by various socio-demographic, clinical, and health system factors. This systematic review and meta-analysis aimed to identify and synthesize the predictors of survival rates among breast cancer patients in Ethiopia.

Methods: We conducted a systematic review of observational cohort studies. The literature search was performed between August 1 and 30, 2024, using PubMed, Hinari, EMBASE, Google, Google Scholar, and Web of Science. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11.

Results: A total of 15 articles with 6,375 study participants from six regions were included. We found that significant predictors of decreased survival rate among breast cancer patients were age (aHR 1.05, 95% CI 1.02-1.08), illiteracy (aHR 7.34, 95% CI 4.38-10.3), married (aHR 1.21, 95% CI 1.03-1.40), rural residence (aHR 1.71, 95% CI 1.06-2.36), two or more lymph node involvement (aHR 3.57, 95% CI 1.02-6.13), histological grade two or more (aHR 1.44, 95% CI 1.12-2.77), overweight (aHR 0.56, 95% CI 0.24-0.87), and having comorbidity (aHR 1.86, 95% CI 1.04-2.68).

Conclusion: This systematic review and meta-analysis identified several key predictors of reduced survival rates among breast cancer patients in Ethiopia, including older age, illiteracy, rural residence, involvement of two or more lymph nodes, higher histological grade, marital status, and the presence of comorbidities. Interestingly, being overweight was associated with improved survival. Health stakeholders and policymakers emphasizing public health education, managing comorbidities, and expanding access to early detection and treatment, especially in rural areas, are critical.

Background: There is limited evidence of the relationship between cognitive changes and all-cause mortality. And it has no report of population-attributable fraction (PAF) of mortality due to cognitive impairment in Chinese elderly. In light of this, we comprehensively examined the relationship between cognitive impairment and all-cause mortality after 20-year follow-up among the elderly Chinese.

Methods: This is an epidemiological survey with a 20-year prospective cohort study design. A total of 9093 participants came from the Chinese Longitudinal Healthy Longevity Survey 1998-2018 waves. Cox proportional hazards regressions were performed to analyze the relationship between baseline cognitive impairment status, the rate of change in the MMSE scores over two years and subsequent all-cause mortality.

Results: We observed a dose-response relationship between cognition and mortality. Compared to those with no impairment, elderly with mild (AHR = 1.11, 95% CI 1.05-1.18), moderate (AHR = 1.22, 95% CI 1.13-1.33) and severe (AHR = 1.30, 95% CI 1.19-1.42) cognitive impairment showed increased mortality risk. Elderly with rapid cognitive decline had 24% higher mortality risk than those with stable cognitive (AHR = 1.24, 95%CI 1.10-1.39). The PAF of mortality due to severe cognitive impairment was 3.69% (95%CI:2.36-5.25%). Impairment in the subdomain of naming foods (AHR = 1.12, 95% CI 1.04-1.21), registration (AHR = 1.18, 95% CI 1.11-1.26), attention and calculation (AHR = 1.13, 95% CI 1.07-1.21), copy figure (AHR = 1.13, 95% CI 1.06-1.20), delayed recall (AHR = 1.14, 95% CI 1.07-1.20) and language (AHR = 1.14, 95% CI 1.05-1.24) were independently associated with increased mortality risk among participants.

Conclusion: Baseline cognitive impairment was inversely associated with longevity among the elderly Chinese. The rapid cognitive decline increased all-cause mortality, and this risk would continue for 20 years. These findings underscore the crucial role of early detection and management of cognitive impairment in the elderly.

Background: Asthma is a significant public health issue that cannot be ignored in China and around the world, bringing a huge social burden.

Objectives: To evaluate the disease burden of asthma in China, including health loss and cost of illness, and identify its influencing factors.

Methods: A systematic literature review and qualitative descriptive analysis were conducted, Literature was accessed through PubMed, EMBASE, Web of Science, CNKI, Wangfang Data, and VIP databases, with a cutoff date of April 3, 2024. The analysis focused on two main aspects: health loss burden, measured by disability-adjusted life years (DALYs), including years of life lost (YLLs) and years lived with disability (YLDs); and economic burden, assessed through direct and indirect costs. The risk of bias in economic studies was assessed using an 11-item methodological checklist for cost of illness, while cross-sectional studies were evaluated using the Agency for Healthcare Research and Quality's recommendation rating tool.

Results: The analysis included 50 studies, with eight focused on health loss and 42 on economic burden. The health loss studies showed a 51% decrease in asthma's age-standardized DALYs rate over 30 years, from 209.24 to 102.81 per 100,000 person-years. The health loss burden is influenced by factors such as high BMI, smoking, and occupational exposure. Economic burden studies reported annual direct costs from $348 to $1187 per capita, indirect costs from $7 to $1195, and hospitalization costs from $177 to $1547, influenced by frequency and severity of acute exacerbation, comorbidities, and treatment adherence. Quality assessment revealed moderate overall quality, with gaps in sensitivity analyses and cost data transparency.

Conclusion: The health loss burden of asthma in China has significantly decreased from 1990 to 2019, with males experiencing a higher burden. However, regional disparities in the economic burden persist, highlighting the need for improved management and adherence to standardized treatment protocols to address these disparities.