Public Health最新文献

Objectives: This study aimed to develop and validate the eHealth Literacy and Use Scale (eHLUS), a German assessment tool designed to measure health literacy in the context of using medical apps. This scale enhances traditional eHealth literacy tools by focusing on the unique requirements of medical app use, such as integration into everyday life, and self-efficacy.

Study design: This study employed a mixed-method design.

Methods: The development of the eHLUS involved a thorough literature review, expert interviews, and psychometric evaluation in a real-world environment.

Results: The eHLUS, consisting of 14 items across three dimensions, was designed for a nuanced assessment of eHealth literacy in medical apps. Psychometric evaluation data were gathered from 127 participants at two time points (n_t1 = 117; n_t2 = 62). The scale demonstrated excellent internal consistency, with a Cronbach's alpha of 0.913 and a McDonald's omega of 0.911. A mean completion time of 2.2 min underscores its practical applicability. Retest reliability was confirmed in 52 matched cases, affirming the scale's stability. Principal component analysis revealed three dimensions: autonomous use and technical access, eHealth engagement, and eHealth literacy.

Conclusion: The findings demonstrate the suitability of eHLUS for assessing individuals' abilities to effectively use medical apps, highlighting its importance in research and healthcare. The evaluation of the scale, along with expert interviews, underscores both its necessity and feasibility. The eHLUS captures eHealth literacy and its associated determinants within the context of medical app use, contributing to the optimization of patient care.

Objectives: The present study investigated the incidence of mortality by aggression in women who experienced interpersonal violence. The study also aimed identify whether intimate partner violence (IPV) was associated with the risk of death by aggression.

Study design: This was a population-based retrospective cohort study linking data from the National Disease Notification System and the Mortality Information System.

Methods: The study population included women, aged 15-59 years, with notification of interpersonal violence in a 1-year period. Data were also collected on deaths by any cause within 2 years of notification of interpersonal violence in the study population. For survival analysis, this study used the following two approaches: (1) specific risk by aggression; and (2) the subdistribution of risks. In addition, the Cox and Fine-Gray models were used to verify if IPV was associated with the risk of death by aggression.

Results: This study identified 117,743 women, aged 15-59 years, with notification of interpersonal violence. In total, 818 of the study population died within 2 years of notification. The cumulative incidence at the end of 2 years was 0.003; thus, a mortality rate of approximately 300 deaths/100,000 women who had experienced interpersonal violence. In the two survival analysis approaches, IPV showed no significant association with death by aggression. Only the 'Black and Others' ethnic group was associated with death by aggression, with a 33 % increase in the death rate (hazard ratio [HR] 1.33; 95 % confidence interval [CI] 1.08-1.65).

Conclusion: The results of this study highlight the impact of ethnic group on the risk of death among women experiencing interpersonal violence. Intersectoral coordination strategies are required to promote early detection of violence and comprehensive care.

Objectives: The goal of this study was to explore the prevalence of multimorbidity, its geographic variation, and changes from 2022 to 2024 in Portugal.

Study design: Information regarding the chronic health conditions active in the primary healthcare patients' health problems lists on the electronic health records are derived from the digital platform Identity Card of Primary Healthcare (Bilhete de Identidade dos Cuidados de Saúde Primários, BI CSP) data for the period of 2022 and 2024.

Methods: BI CSP nationwide data from May 2024 of the 10,366,861 registered users in Portuguese primary healthcare were used to determine the prevalence of multimorbidity (presence of 2 or more chronic health conditions) and analize differences to 2022.

Results: By May 2024, 73.7 % of the population (7.64 million out of 10.37 million registered users in primary healthcare) were living with multimorbidity, indicating a 4.7 % increase from 2022. The most common chronic conditions in 2024 included lipid disorders, hypertension, obesity, and tobacco abuse. Regionally, multimorbidity exceeded 65 % in all zones, with the North (78.9 %) and Alentejo (78.3 %) regions having the highest rates. The prevalence increased across all regions, with the North region showing the smallest increase from 2022 to 2024.

Conclusions: The prevalence of multimorbidity in Portugal is increasingly high across all the regions considered. Additional studies will be helpful in determining the extent to which the now-reported high prevalence of multimorbidity will impact the healthcare system in Portugal.

Objectives: Urban transport is an important determinant of population health. Ensuringi health is well considered in urban transport planning is important to create healthy cities, healthy populations and sustainable societies. This review aimed to describe how health is considered in urban transport planning.

Study design: A narrative literature review was conducted.

Methods: Eligible literature included research articles, review articles, perspective articles, policy reports and technical reports published in English since 2013. PubMed, the Transport Research Integrated Database and grey literature sources were searched.

Results: Seventy articles were included, predominantly from high-income countries. Findings indicated that while urban transport is well recognised as a determinant of health, health considerations are often underprioritized in urban transport planning. Key issues identified included systemic power imbalances favouring car-orientated planning, insufficient legislative frameworks to promote health, the non-holistic assessment of health impacts in established environmental assessment processes, transport appraisal methodologies which undervalued health and differences between the health and planning professions in their preferred sources of evidence with associated challenges in knowledge translation. A consistent theme in the literature was that a strategic approach needed to be taken to improve how health is considered in urban transport planning and central to this was building relationships to enable collaborative and partnership working.

Conclusion: Health was poorly considered in urban transport planning. Contributing issues related to power, legislation, impact assessment and knowledge translation. A strategic approach is important to address these issues.

Objectives: The COVID-19 pandemic caused unprecedented restrictions, leading to differences in the frequency and patterns of alcohol consumption, especially among young adults. This systematic review aims to investigate the overall evidence concerning changes in alcohol consumption in this period.

Study design: Systematic review.

Methods: Adhering to PRISMA and SWiM guidelines, this study's review protocol is registered in PROSPERO (CRD42023464591). The studies research was carried out in PubMed, Scopus, and Web of Science. Inclusion criteria involved observational studies focusing on participants aged 18 to 35, exploring alcohol consumption during at least the first wave of COVID-19, and publications in English or Spanish.

Results: A total of 28 studies conducted in different countries were included, European (18), North American (9), and Latin American (1). Although in many studies the overall prevalence of alcohol use was reduced, it was mainly among occasional users, in which the main motivation was the lack of social contact. It was exposed that participants with a high risk of problematic use increased their alcohol consumption, showing associated factors such as poor mental health, depressive symptoms, stress, and coping motivations. Males generally exhibited a higher risk of problem use and risky behaviours than females.

Conclusions: During COVID-19, youth alcohol consumption decreased overall, especially among social drinkers, but increased among high-risk users due to factors like distress and loneliness. Similar trends during other disasters emphasize the importance of addressing high-risk drinking in disaster planning. Also, preventing high-risk drinking from adolescence and youth could be helpful in reducing the global burden and impact of alcohol consumption.

Objectives: This study aimed to explore the characteristics, overall anxiety and depression status, and influencing factors of only-child and non-only-child students by examining a medical student population in the post-COVID-19 era.

Study design: This study was a cross-sectional design.

Methods: An online questionnaire survey was administered among medical students. The psychological problems related to depression and anxiety were measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively, which were scored via a Likert-4 scale. Statistical analysis was employed to explore the characteristics and overall differences between only-child and non-only-child students, along with the factors affecting their anxiety and depression.

Results: A total of 1688 participants were enrolled. No significant differences were observed in the prevalence of anxiety (χ² = 1.154, P = 0.283) and depression (χ² = 0.313, P = 0.576) between only-child and non-only-child students. School level, single status, and desire for only child status are associated with anxiety and depression in the two groups. Region and loneliness are merely related to anxiety and depression among only-child students, while gender, willingness to apply for medical school, and equal treatment are associated with anxiety and depression among non-only-child students.

Conclusion: Our study found the factors that are associated with depression or anxiety inthe only-child and non-only-child medical students jointly and separately, which could provide a new theoretical basis for the psychological intervention of medical students, that is, to identify the high risk factors of depression and anxiety from the perspective of only child and non-only child.

Objective: Previous longitudinal studies have investigated the association between baseline loneliness and the risk of developing cardiovascular diseases (CVD). Nevertheless, the cumulative effect of loneliness on CVD remains uncertain. The objective of this study is to assess the relationship between the cumulative duration of loneliness and the risk of CVD in middle-aged and older adults.

Study design: Prospective cohort study.

Methods: The study utilized data from a sample of 8353 adults aged 45 years and older who participated in the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was assessed biennially between 2011 and 2015, and categorized into four groups: never, one time point, two time points, and three time points. The Cox Proportional Hazards Regression Model was employed to estimate hazard ratios (HRs) and corresponding 95 % confidence intervals (CIs).

Results: Following a mean follow-up period of 4.7 years (standard deviation: 0.7 years), a total of 1314 cases of CVD were identified, including 913 cases of heart disease and 504 cases of stroke. After adjusting for potential confounding factors, individuals who experienced loneliness at one time point (HR, 1.21; 95 % CI: 1.06, 1.38), two time points (HR, 1.23; 95 % CI: 1.03, 1.45), and three time points (HR, 1.50; 95 % CI: 1.19, 1.89) had a significantly higher risk of developing CVD compared to those who never experienced loneliness.

Conclusions: Cumulative loneliness was associated with increased risk of CVD in middle-age and older adults. Additional research is warranted to delve into the underlying mechanisms, while it is advisable to contemplate social interventions aimed at addressing loneliness.

Objective: This systematic review aimed to assess the evidence on sexual transmission of HIV in high-income settings between serodiscordant couples where the index partner infected with HIV is on antiretroviral therapy.

Study design: Systematic review and meta-analyses.

Methods: We performed a systematic search in four databases: Embase, MEDLINE, The Cochrane Library, and Web of Science on September 24, 2022. We assessed the risk of bias with ROBINS-I and pooled estimates in meta-analyses using a Poisson regression model with a random effect of the study and population size. The study protocol was pre-registered at PROSPERO. The study involved high-income countries.

Results: The search identified 6886 studies, of which six were included for review. Altogether, studies reported zero linked transmissions among 2383 couples, more than 160,000 acts of intercourse, and 3578 couple years. The risk estimate from overall meta-analyses was 0.000 95%CI (0.000-0.103) per 100 couple-years.

Conclusion: This systematic review and meta-analyses provide epidemiological evidence for a low risk of HIV transmission under antiretroviral therapy in high-income countries and thus cannot reject the theoretical "treatment as prevention" paradigm.

Objectives: To describe the epidemiology of dog-related injuries leading to hospital admission in Scotland and to estimate the direct health care costs.

Study design: A retrospective, longitudinal analysis of Scottish hospital admissions coded under the W54 ICD-10 code 'bitten or struck by dog', 1997-2022.

Methods: Hospital admissions episodes coded under W54 were extracted from the SMR1/01 dataset. Descriptive analyses were performed. Incidence rate ratios (IRR) were calculated using negative binomial distribution. Direct NHS health cost estimates were calculated.

Results: Incidence of dog bite and strike related admissions near tripled between 1997 and 2022, from 5.9 to 17.2 per 100,000 population with an annual IRR of 1.047 (P < 0.001). Incidence has risen most steeply in adults, with all age groups over 15 years having an IRR between 1.040 and 1.065 (P < 0.001). Incidence of overnight admissions doubled, and zero-day admissions increased by five times. Hospital admissions were 2.4 times higher in the most deprived quintile compared to the least deprived. Setting of bite was not consistently recorded, but young age groups were more likely to have the home setting recorded. Admissions related to dog bites or strikes resulted in an estimated £28.6 million of direct health care costs, from the admission alone, over the 25-year period.

Conclusion: Dog bites and strikes can be devastating injuries. Unfortunately, over the last 25 years there has been a steep rise in incidence in Scotland, despite attempts at control through legislation. Further work to better understand the health and wider costs of these injuries, the epidemiology to inform preventative interventions, and improved co-ordination through inter-sectoral collaboration is recommended.

Objective: To assess the substance use disorder (SUD) prevention and response activities that county governments in New York advertise.

Study design: Cross-sectional study.

Methods: We coded websites of county public health, mental health, emergency, and social service departments to identify whether any government agency provided information about ten evidence-based SUD services. We calculated the number and percentage of counties advertising each service, overall and by county size (medium/large and small).

Results: The most common services advertised on county websites were Resource Lists (91.4 %), Naloxone Training, Education, or Distribution (74.1 %), and Addiction/Overdose Education (62.1 %), and the least common were Syringe Exchange (31.0 %) and Anti-Stigma Training or Resources (13.8 %). When counties were assessed by population size, each service was advertised by a higher percentage of medium/large counties than small counties.

Conclusions: Despite public health researchers recommending that government responses to the overdose crisis include the SUD services examined here, many counties do not provide information to their constituents about several important services. Thus, even if these services are available, they may be unknown to residents.