Archives of Public Health最新文献

Background: The Georgian Birth Registry (GBR) is a comprehensive digital birth registry covering 99.8% of births nationwide. By law, registration in the GBR is mandatory, with data primarily transferred from medical records (MRs) by designated personnel at medical facilities. We aimed to assess the correspondence of the registration of selected variables between GBR and MRs.

Methods: We randomly selected 1,044 women who gave birth in 2018. Data were extracted from the GBR on 27 variables related to pregnancy, childbirth, and the newborn and individually linked to the MRs. We specifically compared the agreement of dichotomous, ordinal, and date variables between the GBR and the MRs to assess the consistency of individual registrations.

Results: Of the 27 dichotomous, ordinal, and date variables, 22 displayed more than 95% complete agreement with the information in the MRs. The prevalence of maternal morbidity registered in the MRs was lower than expected, while the proportion of fetuses with transverse lies was higher than expected.

Conclusions: Most antenatal, intrapartum, and newborn information registered in the GBR has satisfactory agreement with the MRs, with error typical for single data entry system. The lower-than-expected prevalence of gestational diabetes, preeclampsia, hypertensive disorders, and postpartum hemorrhage registered in the MRs, as well as the higher-than-expected prevalence of transverse fetal presentation, warrants in-depth investigation to ensure that the quality of care is satisfactory and to further improve registration in both the MRs and GBR. Therefore, our findings indicate that while the agreement between the GBR and MRs is generally high, MRs are sometimes incomplete or incorrect for certain conditions.

Background: Medical doctors and residents are regularly exposed to multiple stressors that may lead to mental health problems. Work-related stressors contribute to elevated levels of psychological distress, anxiety, and depression among health care workers. This is the first investigation evaluating suicidal behaviour and thoughts among Lithuanian medical doctors and residents exposed to various professional stressors at two years after the start of the COVID-19 pandemic. The aim of the study was to evaluate suicidality and factors associated with high suicide risk in a large sample of Lithuanian medical doctors and residents.

Methods: The research included 685 participants who completed an online questionnaire over a two-month period in December 2021 and January 2022. Medical doctors and residents from all specialties were invited to participate in the survey. The most common stressors in their work environment were measured. Mental health was assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21) scale, and suicidality was measured with the Suicidal Behaviors Questionnaire-Revised (SBQ-R).

Results: The lifetime suicide risk was found in 30.4% of the sample. Moreover, 11.4% of medical doctors and residents were identified as having previous or current suicide planning ideation, and 2.5% reported a previous suicide attempt. Univariate analysis showed that younger age, having no long-term relationships, shorter work experience, career change ideation, higher depression and anxiety, poor working conditions, at the direct contact with patients, lack of career perspectives, and exposure to mobbing and exhaustion at work were statistically significant risk factors for higher suicidality. Furthermore, regression analysis supported that having no long-term relationship, high depression, and high anxiety were significant risk factors for suicide risk in the sample.

Conclusion: We found out that almost one-third of medical doctors and residents had lifetime suicide ideations and behaviours at the high suicide risk level. Main suicide risk factors were poor mental health, work-related stressors, and a lack of long-term relationships. The results of the study can help to develop prevention strategies by identifying populations that may be at high risk for mental health problems and provide evidence in implementing specific interventions to address mental health problems in healthcare workers.

Objective: The purpose of this study was to evaluate repeated participation in hospital smoking cessation services and its related factors and to explore the correlation between the frequency of participation and its effectiveness in smoking cessation. This study uniquely follows participants over a seven-year period after the removal of financial barriers, with a maximum charge of TWD 200 (USD 6.4) for cessation medications in Taiwan.

Methods: A secondary analysis of data from a regional teaching hospital in Central Taiwan was conducted, utilizing the database of the Smoking Cessation Therapy Management Center of Health Promotion Administration and the hospital's documentation from 2013 to 2019. Successful smoking cessation was defined as a non-smoking status at the six-month follow-up stages. Repeat participation was identified through the hospital's smoking cessation logs. Logistic and Cox regression analyses were conducted to meet the study objectives, with all statistical procedures performed on SAS version 9.4.

Results: In this study, 19.16% of the smoking cessation service users participated repeatedly over a period of seven years. After adjusting for the observation time, the Cox regression analysis showed that those who experienced the side effects of smoking cessation, long-term smokers, and those with a history of disease were more likely to participate again (HR:1.39;1.17;2.60). However, those who smoked heavily, drank alcohol, and failed to quit smoking after previous participation were significantly less likely to participate again (HR:0.59,0.55,0.70;0.89;0.66). Finally, this study found no significant correlation between the frequency of repeated participation and the effectiveness of the last smoking cessation service.

Conclusion: A certain proportion of smokers repeatedly participate in the same hospital's smoking cessation program, which does not diminish its effectiveness. It is implied that relaxing the limit on the quantity of smoking cessation services subsidies will contribute to overall tobacco harm control efforts.

Background: With the global population aging rapidly, dementia has become a pressing public health challenge, affecting the cognitive functions and daily activities of older adults worldwide. Enhancing literacy about dementia is a proactive prevention strategy, yet the effectiveness of educational programs can vary based on the target population's background. Thus, understanding dementia knowledge levels across different communities and countries is essential for successful educational interventions. Despite the large аmount of studies, there is no common framework for studying dementia knowledge, leading to significant variability in methods and poor data comparability.

Methods: A narrative review is conducted to examine the methodological variability in studies of dementia knowledge and to propose a unified framework for future investigations. We hypothesize that significant differences will be evident in the methodologies employed, particularly regarding knowledge domains, research designs, influencing factors, and assessments of attitudes toward dementia.

Results: A total of 59 research publications published after 2000 were selected, revealing significant variability in approaches to studying dementia knowledge and confirming our hypothesis. We identified eight dementia knowledge domains and various sociodemographic and experiential correlates, along with commonly used complementary assessments. These findings were organized into a unified global framework comprising two core components-dementia knowledge domains and correlates-supplemented by a component addressing affective dispositions towards dementia and an action list to guide future research. The framework aims to provide a foundational basis for enhancing inter-study comparisons and deepening our understanding of dementia knowledge and attitudes across diverse communities.

Conclusion: Aligning methodologies for surveying dementia knowledge through a common framework can empower stakeholders to implement effective educational programs, fostering an informed and supportive environment for individuals affected by dementia.

Background: In Ghana, the government has integrated herbal medicine into the formal healthcare system in response to widespread use of traditional remedies. However, empirical evidence supporting the contribution of integrated healthcare to malaria control remains limited. This study employed a phenomenological qualitative research design to explore the experiences of medical doctors and pharmacists from the coastal, forest and savannah regions of Ghana regarding the integration of modern and herbal medicine in the treatment and control of malaria. Donabedian's framework for evaluating the quality of healthcare served as the foundational theoretical framework for this research.

Methods: Data were collected through individual in-depth interviews involving 26 participants and analysed using a framework analytical approach.

Results: The findings revealed that inadequate political commitment to the practice of integration has led to several challenges, including the high cost of herbal anti-malaria medications, limited promotional activities surrounding integration, a shortage of qualified medical herbalists, inconsistent supply chains for herbal anti-malaria treatments, and a lack of standardisation in herbal medicine practices. Participants had divergent views regarding the impact of integration on malaria control; while medical doctors believed that the intervention has not significantly contributed to reducing malaria prevalence in Ghana, pharmacists viewed the presence of herbal clinics within government hospitals as an effective and sustainable alternative for treating malaria.

Conclusion: Reflecting on these results, it is imperative for policymakers to explore strategies that could enhance the effectiveness of an integrated health system, thereby increasing the contribution of herbal medicine towards achieving a malaria free nation. Future research could benefit from including policymakers, heads of health directorates, and community members, regarding the role of public health interventions in addressing health inequities in Ghana.

Background: Learning communities (LCs) are increasingly used among multidisciplinary public health challenges, such as local healthy weight approaches. LCs aim to stimulate learning, collaboration and actions. Previous research has provided insights into the underlying elements of multidisciplinary LCs, but little is known about the perceived causalities of these elements. Therefore, limited is known about what can be done to leverage LCs. This study aims to gain insights into the perceived dynamics of multidisciplinary LCs during the starting phase, including variables, and interconnectedness between variables.

Methods: To elucidate LC dynamics, all members of two separate LCs participated in a qualitative interview about experiences, perceived learning, and actions during the first six months. Interviews were analyzed thematically. Subsequently, a qualitative causal loop diagram was designed.

Results: The qualitative causal loop diagram showed three intertwined themes. The first theme explains why group dynamics are essential, and how jointly arranging the LC may optimize group dynamics. The second theme explains how insights are obtained through multidisciplinary knowledge exchange. The third theme explains how actions are executed when conditions are met. These LC group dynamics, learning and action influenced one another.

Conclusions: To optimize LCs, it is highly recommended that stakeholders arrange them jointly, involve the appropriate partners, match with LC members' needs, and motivate members to execute action. LC facilitators are recommended to use the causal loop diagram to identify their bottlenecks and how to intervene in those to optimize the LC.

Background: Maternal mortality is among the main indicators of health in nations. Identifying the causes of maternal mortality is crucial in designing preventive interventions. Therefore, this study aimed to evaluate the causes of maternal mortality during 8 years.

Methods: This descriptive-analytical study was conducted on the archived cases of maternal mortality in the Forensic Medicine Department of the Khorasan Razavi Province between March 2013 and March 2022, but as no data was available for the first two years, maternal mortality data for 8 years was evaluated. Demographic characteristics, midwifery data, pregnancy care method, pregnancy care and delivery agent, insurance type, and confirmed cause of death were compared between the first and last five-year periods of the study.

Results: Overall, 250 cases of maternal mortality were identified in the study period. The prevalence of indirect and unrelated causes of maternal mortality was significantly higher in the last four-year period compared to the first four-year period (p < 0.001). The most common direct causes of maternal mortality in both periods were postpartum hemorrhage, eclampsia and gestational hypertension complications; and postpartum infection. Coronavirus disease 2019 (COVID-19) was the most common cause of maternal mortality in the last four-year period but the other common indirect causes of maternal mortality (cardiovascular disease and pulmonary embolism) were similar between the two periods. The most common unrelated cause of maternal mortality was accidents.

Conclusions: Postpartum maternal mortality was higher than intrapartum period. Bleeding was still the main cause of maternal mortality. Despite the progress in prenatal care, it is necessary to improve intrapartum and postpartum quality of care.

Medical consultations depend on a shared linguistic understanding between the patient and physician. When language concordance is not possible, interpretation is required. Prior studies have revealed that professional in-person interpretation (PIPI) results in patients reporting higher satisfaction and a better understanding of things the physician explained. Despite this, language-discordance often results in using family and/or friends for ad hoc interpretation. This systematic review examines the linguistic aspect of medical interpretation by assessing the number of linguistic errors made and their relation to professional in-person interpretation (PIPI) or in-person ad hoc interpretation (IPAHI). PIPI was defined as people employed as interpreters, but with no specific requirements for education or experience. This systematic review examines studies comparing the number of errors when using PIPI and IPAHI. We performed a PICO-criteria-based search in five scientific databases. We screened English and Danish studies published between 1995 and October 2024. Furthermore, we screened references from, and citations of the included articles. We used the appropriate Cochrane Tool for risk of bias assessment. We identified six studies using a PICO search and one additional study by snowballing. The included studies revealed critical methodological differences, and consequently a statistical synthesis of results was not conducted. We found indications that the number of interpreting errors was significantly lower when using PIPI than family members for IPAHI. Interpreting error rates were not significantly lower when comparing PIPI to the use of medical staff without interpretation training for IPAHI. Generally, we found that the difference between PIPI and IPAHI tended to be more prominent when dealing with more severe diagnoses, e.g., incurable cancer. The methodological differences between included studies and the risk of bias within included studies limit the conclusions drawn in this review. Also, no other kinds of interpretation than PIPI and IPAHI were considered, and the recommendations are solely based on accuracy. Considering these limitations and the fact that no other systematic reviews within this highly specific topic exist, this review resulted in the following recommendations: 1) Professional in-person interpretation should be the first choice in language-discordant medical consultations. 2) If professional interpretation is not possible, using medical staff without interpretation training should be chosen before interpretation by family or friends. 3) All consultation participants should keep sentences short and straightforward, as this is related to a lower risk of omissions in interpretation.

Background: In the field of psychiatry, the dissemination of clinical innovations greatly depends on the social capital of clinicians. An instrument specifically aimed at measuring their professional social capital therefore needs to be developed.

Methods: This survey was conducted to develop and validate the Resource Generator for Psychiatrists, an 11-item questionnaire measuring the social capital of psychiatrists. The online questionnaire was administered through a link sent by e-mail to all psychiatrists and residents in psychiatry licensed to work in Belgium, after excluding ineligible psychiatrists. A total of 1618 psychiatrists or residents were reached. An exploratory factor analysis was conducted. Internal consistency was assessed using Pearson's correlation, item-total correlation and Cronbach's alpha. Test-retest reliability was also measured. Multivariable linear regression analysis assessed the association between the total score of the social capital and psychiatrist demographics.

Results: A total of 196 psychiatrists responded to the survey (response rate: 12.1%). The Resource Generator for Psychiatrists showed a normal distribution with a mean of 23.6 (SD = 15.5), good test-retest reliability (ICC = 0.81) and a good total Cronbach's alpha (0.74). Exploratory factor analysis revealed two main subtypes in psychiatrists' social capital: "Resources for the clinician" and "Resources for the professional", with a Cronbach's alpha of 0.62 and 0.7 respectively. Clinicians attending institutional seminars (β = 5.52, SE = 2.2, p = .013) and working in multidisciplinary settings, such as hospitals (β = 4.75, SE = 2.06, p = .023) or a mobile team (β = 8.75, SE = 3.52, p = .014) were more likely to have higher social capital.

Conclusion: Psychiatrists' access to professional resources can be reliably measured by using an 11-item questionnaire.