Archives of Public Health最新文献

Background: Sarcopenia is an age-related syndrome marked by a gradual decline in skeletal muscle mass and function. While various factors influencing sarcopenia have been studied, the link between daily sedentary time and sarcopenia remains underexplored.

Method: This study analyzed the association between daily sitting time and sarcopenia using data from the National Health and Nutrition Examination Survey (NHANES 2011-2018). Daily sitting time was assessed through questionnaires, while sarcopenia was measured using body mass index (BMI) adjusted appendicular skeletal muscle mass (ASM). The relationship was analyzed using weighted logistic regression models and smoothing curves. Stratified analyses and interaction testing were employed to investigate population-specific characteristics of this association. Furthermore, chi-square test and grouped logistic regression were used to further analyze the impact of vigorous activity on the relationship between the two variables.

Result: This study included 9998 participants with complete information. The fully adjusted model showed a significant positive correlation between daily sitting time and the prevalence of sarcopenia (OR = 1.07, 95% CI: 1.03-1.10, P = 0.0026). The group with daily sitting time ≥ 9 h had a 90% higher risk of sarcopenia compared to the < 4 h group (OR = 1.90, 95% CI: 1.22-2.84, P = 0.0040). Smooth curve fitting analysis showed a linear correlation between this relationship. Stratified analysis shows that non-Hispanic white men with a lower BMI (BMI < 25) have a higher risk of sarcopenia. Compared to those who actively participate in vigorous activities, individuals who lack recreational activities have a higher prevalence and risk of sarcopenia.

Conclusion: Our research has found that increased sedentary time significantly increases the risk of sarcopenia, especially among non-Hispanic white men with lower BMI. Additionally, individuals who lack vigorous physical activity also have a higher prevalence and risk of sarcopenia. Therefore, reducing sedentary behavior and increasing moderate exercise may be effective prevention strategies.

Background: In India, approximately 3.5 million children are affected by Developmental Delay (DD), often stemming from preterm births. These delays contribute to neurological and motor development delays, placing a significant financial burden on families. Maternal unemployment rates are also elevated in such cases. Delayed Developmental Milestones identification, often due to a lack of parental awareness, further compounds these challenges. This study introduces a multiphasic approach aimed at educating antenatal women on monitoring neurological maturation, with the overarching objective of assessing the effectiveness of a targeted multi-method parental education intervention in improving parents' knowledge and early detection of developmental disorders in early childhood.

Methods: Antenatal women will be assigned to intervention or control groups. The intervention group will undergo specialized training in a multiphasic study, while the control group will receive routine care. A meticulously developed intervention module for early detection of neurodevelopmental disorders will empower mothers to monitor their newborns for potential deficits. Outcomes will be assessed through questionnaires, analyzing knowledge improvement and early identification of DD using statistical methods such as chi-square tests. The study involves three phases: preparatory, implementation, and evaluation, aiming to empower mothers to detect developmental concerns early and improve maternal awareness of child development. The study was approved by the SRM Institutional Ethical Committee with the reference number 8688/IEC/2023.

Discussion: This study will identify DD and improve parental awareness by providing tools for early detection thereby empowers parents to identify developmental concerns early. The study supports policy goals to reduce the burden of DD, enhance early intervention, and improve long-term outcomes for children. It is anticipated that this intervention will complement existing health policies, contributing to better child health and developmental outcomes in India.

Trial registration: Trail is registered under Clinical Trails Registry - India (CTRI/2024/04/065008) registered on 01 April 2024.

Background: Globally, more than half of the adult population is overweight, including those who are obese, which increases the risk of premature death and reduces quality of life (QoL). Technologies such as digital health applications (DiHA) can potentially improve clinical outcomes (e.g., health status, illness duration, QoL) or patient-related factors (e.g., therapy monitoring, adherence, health literacy). To date, there is no systematic review addressing the effectiveness of DiHA on the QoL in patients with overweight or obesity.

Objective: The objective was to investigate the impact of DiHA on QoL in overweight or obese patients.

Methods: A systematic literature search was conducted in MEDLINE via PubMed, Cochrane Library, and Embase via Ovid in 2023, supplemented by additional manual searches. The eligibility criteria included patients with overweight and/or obesity who used a digital intervention independently and without interaction with a healthcare professional. The outcome of interest was QoL. As potentially eligible trials had to demonstrate effectiveness, only randomized controlled trials (RCT) were included as the minimum evidence standard. The study screening (title-abstract, full-text) was conducted independently by two researchers using pre-specified eligibility criteria. CONSORT-EHEALTH checklist was used for data extraction of qualitative and quantitative data (study characteristics and study results) and the Cochrane Risk of Bias Tool (version 2) for quality assessment independently by two researchers.

Results: Seven RCT conducted in Europe and the United States were included in this systematic review with a total sample size of N = 946. Observation periods were heterogeneous and ranged from 3 to 24 months. The evaluated interventions consisted of websites or apps, all of which included nutrition and physical activity features, and functioned independently with minimal or no involvement of a healthcare professional. All studies showed a high risk of bias, no statistically significant improvement and no effects regarding QoL using different validated questionnaires.

Conclusions: This systematic review provides a comprehensive analysis of DiHA effectiveness on QoL in patients with overweight or obesity. Overall, there is heterogeneity regarding the operationalization of QoL and the examined interventions have no statistically significant impact on QoL. Comparable systematic reviews show that digital interventions have the potential to improve the QoL of these patients, but further RCT and high-quality studies are needed to assess the impact of DiHA on QoL.

Trial registration: PROSPERO CRD42023408994.

Background: Despite its obvious relevance for clinical practice and research, it is surprising that presently no hope measure is available for use among Arabic-speaking populations, especially the most vulnerable ones who have been going through major humanitarian crises. This paper aimed to provide novel insights into psychometric information on the psychometric properties of an Arabic translation of the Perceived Hope Scale (PHS) in Palestinians living in Gaza who have endured several months of suffering since the war began in October 2023.

Method: This study had a cross-sectional design and applied a quantitative research approach. It was carried-out over a one-month period (September 2024) using an anonymous self-report questionnaire that was shared through social networks and the snowball sampling technique. A total of 534 Arabic-speaking Palestinian adults aged over 18 years and currently living in Gaza took part in the study. We conducted a confirmatory factor analysis (CFA) via the SPSS AMOS v.29 software, using the maximum likelihood method to obtain parameters estimates.

Results: The fit indices of the one-factor solution reached the standards of good model fit, with excellent internal consistency (Cronbach's alpha = 0.90). Invariance was established in our sample at the configural, metric and scalar levels in terms of gender groups. PHS scores significantly and positively correlated with religiosity, resilience and post-traumatic growth. In addition, PHS inversely correlated with anxiety and depression.

Conclusion: Overall, our results add to the measurement assessment of the PHS, lending further support to its value as a sound measure to assess perceived hope in a new context and cultural background of Arabic-speaking adults and fragile survivors of several decades of war that dramatically escalated over the past months.

Background: This study aims to assess the global burden and trends in cardiovascular diseases (CVDs) prevalence, stratified by sociodemographic index (SDI) categories and age groups, across 204 countries and territories.

Methods: Utilizing data from the Global Burden of Disease Study 2019, this study analyzed trends in the age-standardized prevalence rate of overall and type-specific CVDs, including rheumatic heart disease, ischemic heart disease, stroke, hypertensive heart disease, non-rheumatic valvular heart disease, cardiomyopathy and myocarditis, atrial fibrillation and flutter, peripheral artery disease, endocarditis, and other cardiovascular and circulatory diseases. Age-standardized prevalence rates were stratified by SDI categories (low, low-middle, middle, high-middle, and high) and age groups (0-14, 15-49, 50-69, and ≥ 70 years). The corresponding average annual percentage change was calculated to assess temporal trends.

Results: From 1990 to 2019, the global age-standardized prevalence rate per 100,000 population for CVD decreased from 6728.04 (95% UI 6394.55 to 7059.66) to 6431.57 (95% UI 6109.95 to 6759.8), with an average annual percent change of -0.15% (95% CI -0.17 to -0.13). When stratified by SDI category, the age-standardized prevalence rate of CVD decreased significantly in high-middle and high SDI countries but increased in middle, low-middle, and low SDI countries. By age group, the age-standardized prevalence rate of CVD declined in the 50-69 and ≥ 70 years groups but increased in the 0-14 and 15-49 years groups. SDI levels were negatively associated with faster increases in the age-standardized prevalence rate of CVD across all ages and age groups. Low SDI countries consistently showed the highest age-standardized prevalence rates of CVD in the younger age groups (0-14 and 15-49 years), while high-middle SDI countries had the highest rates in the older age groups (50-69 and ≥ 70 years). The age-standardized prevalence rate of CVD was negatively associated with SDI levels in the 0-14 and 15-49 years groups and positively associated with SDI levels in the 50-69 and ≥ 70 years groups. Type-specific CVDs such as rheumatic heart disease, other cardiovascular and circulatory diseases, non-rheumatic valvular heart disease, and hypertensive heart disease showed increased age-standardized prevalence rates from 1990 to 2019.

Conclusions: This study highlights significant disparities in CVD prevalence across sociodemographic and age groups. While the global prevalence of CVD has generally decreased, the rise in CVD prevalence in lower SDI countries and younger populations calls for tailored intervention strategies. Addressing these disparities is crucial to mitigating the growing burden of CVD and promoting cardiovascular health on a global scale.

Background: The Covid-19 pandemic has posed unprecedented challenges to healthcare systems worldwide, affecting routine medical services, including for cancer patients. This study investigates the impact of the Covid-19 pandemic on outpatient visits for patients with cancer in Iran.

Methods: We conducted an interrupted time series analysis (ITSA) on data collected from electronic medical records. The ITSA methodology was employed to analyze monthly outpatient visits for patients with cancer data from March 2017 to January 2023 in Lorestan University of Medical Sciences.

Results: Following the announcement of Covid-19 in Iran, outpatient visits for patients with cancer decreased immediately and sharply, with a mean of 247.08 visits per month, which has a 95% confidence interval of [-297; -197]. Subsequent waves in June 2020, September 2020, April 2021, July 2021, and January 2022 further affected outpatient visits. However, the initiation of Covid-19 vaccination, particularly for cancer patients, marked a positive turning point, leading to an increase of 156.39 outpatient visits between January and February 2022.

Conclusion: Our study provides critical insights into the dynamic relationship between the Covid-19 pandemic, patient behavior, and cancer care utilization. The observed decrease in outpatient visits underscores the multifaceted challenges faced by cancer patients during the pandemic, while the positive influence of vaccination signals a pathway towards recovery. The importance of vaccination is highlighted as a key factor in improving outpatient visit rates. As healthcare systems adapt to ongoing challenges, understanding the complex interplay between public health crises and patient behavior is crucial for shaping resilient and patient-centric healthcare systems.

Background: The objective of this paper was to determine whether the medicolegal assessment of injured and disabled persons is based on the biopsychosocial model of disability proposed by the International Classification of Functioning, Disability, and Health.

Methods: We searched for the word disability and other keywords, occurring alone or in combination as well as the meaning given to the word "disability" in two Belgian legal databases (JURA and STRADALEX) for the period from 1960 to 2020.

Results: The use of the term disability has increased over time, more so from 2001 to 2010, in areas of public health law, labor relations, and personal injury law. Cross-referencing keywords revealed that incapacity (personal, domestic, or professional) reflecting the victim's disability from a legal perspective appears to be dominated by the impairment criterion.

Conclusions: Although the biopsychosocial model of disability appears to be widely accepted by courts, medical experts have made few changes to their methodology of assessing personal injuries. We identify four potential factors that could explain the status quo.

Background: It is known that leprosy is a socially determined disease, but most studies using spatial analysis have not considered the vulnerabilities present in these territories.

Objectives: To measure the association between social vulnerability and the burden of leprosy in the urban space of Cuiabá.

Methods: Ecological study, carried out in Cuiabá, Brazil. Diagnosed cases of leprosy were surveyed through the Notifiable Diseases Information System, from 2008 to 2018. The spatial scan statistics technique of leprosy cases per each Human Development Unit was applied. Social vulnerability was measured based on the Municipal Human Development Index (MHDI), education level and average per capita income. For the spatial correlation between vulnerability and leprosy, Global and local bivariate Moran's index was used.

Results: 8389 cases of leprosy were georeferenced, the majority being male (58%), 30% of cases were not evaluated for degree of physical disability. One of the spatial scan clusters had a relative risk (RR) of 6.93 (95% CI 6.49-7.4), and another had 1360 cases with RR 1.71 (95% CI 1.62-1.82). The bivariate global autocorrelation of Moran's index for MHDI was 0.579, observing 1 High-High in the East region and 1 in South, for education the index was 0.429, 2 High-High in the East and 1 in the South, and 0.145 for average per capita income, 1 High-High in the East.

Conclusion: There was a spatial association between leprosy cases and territories with low MHDI, having a percentage of the population without schooling and/or with low income. The study advances knowledge by presenting characteristics of territories most affected by leprosy, verifying the spatial correlation of the disease with the recurrent socioeconomic characteristics in these territories.

Background: This study evaluated the prevalence of sick building syndrome (SBS) in Rasht, Iran, a subtropical climate with wetter cold season city, during the autumn and winter months of 2020, focusing on the effects of noise and ventilation.

Methods: A total of 420 residents completed the indoor air climate questionnaire (MM040EA), and a walk-through survey of 45 randomly selected residential units assessed environmental noise, ventilation rate, and luminous conditions.

Results: Approximately 38.2% reported SBS symptoms in the past three months. Significant associations were found between SBS and dim light (P-value = 0.012, OR = 2.1, CI = 1.09-4), noise (P-value = 0.031, OR = 1.75, CI = 1.1-2.9), passive smoking (P-value < 0.01, OR = 2.6, CI = 1.22-5.4), static electricity (P-value < 0.01, OR = 3.8, CI = 1.15-12.6), bad air (P-value < 0.01, OR = 4.6, CI = 1.6-13), and high room temperature (P-value = 0.039, OR = 2.6, CI = 1.13-5.95) at α = 0.05. The field survey revealed that 75.5% of units exceeded the national noise threshold of 55 dBA. The average ventilation rate was 20 lit/(p.sec), while 32% of the units reported low or moderate lighting during daytime hours. No significant association was found between the type of interior wall finishing or heating systems and SBS. Stronger correlation was observed between noise and SBS in districts with higher traffic-induced noise.

Conclusion: Considering high noise levels in residential areas, local authorities must prioritize noise insulation policies in building design and construction.

Background: As the population ages, hypertension has become the leading risk factor for cardiovascular diseases (CVDs) and premature deaths worldwide. Accurate monitoring of CVD risks and planning community-based public health interventions require reliable estimates of hypertension prevalence and management. While the validity of self-reporting in assessing hypertension prevalence has been debated, the concordance between self-reports and clinical measurements of hypertension control remains underexplored, particularly in large, community-based older populations. This study aims to examine the agreement between self-reported and objectively measured data on both hypertension diagnosis and control, as well as the associated factors, among community-dwelling middle-aged and older Chinese adults.

Methods: Data from the China Health and Retirement Longitudinal Study were utilized, with household survey responses combined with biomedical data. Sensitivity, specificity, and kappa coefficients were used to assess the agreement between self-reported and objectively measured hypertension diagnosis in the general sample, and the agreement on hypertension control among individuals who reported having hypertension. Binary and multinomial logistic regression analyses were conducted to identify individual, household, and community-level factors associated with the agreement.

Results: Self-reports exhibited substantial sensitivity, excellent specificity, and moderate agreement with objective measurements for hypertension diagnosis, while demonstrating fair sensitivity, excellent specificity, but low agreement for hypertension control. The odds of agreement on hypertension diagnosis were negatively associated with older age and heavy drinking, but positively related to marital status, higher education, chronic kidney disease, recent healthcare service utilization, and higher household economic levels. Meanwhile, the likelihood of agreement on hypertension control was negatively associated with older age, comorbid diabetes or cardiovascular disease, heavy drinking, BMI over 25, and antihypertensive medication adherence, but positively associated with recently healthcare service utilization.

Conclusions: Self-reporting underestimated hypertension prevalence but significantly overestimated the hypertension control rates. For middle-aged and older Chinese adults, individual-level factors including age, multimorbidity, behavioural risks, and healthcare-seeking behaviours were identified as significant predictors of agreement between self-reported and objectively measured hypertension data. Recognizing these factors is essential for improving the accuracy of chronic condition estimates and facilitating targeted chronic disease management programs for China's aging population and other developing countries with similar demographic and health challenges.