Asia-Pacific Journal of Public Health最新文献

Occupational stress among public transport workers, particularly bus conductors, remains underexplored in literature. This cross-sectional study included 524 Sri Lanka Transport Board bus conductors in the Colombo District of Sri Lanka. A culturally adapted effort-reward imbalance (ERI) questionnaire was used to assess stress. Cluster sampling was employed, and Cronbach α was used to indicate reliability. Chi-square tests were used to analyze depot-level variations, and multivariate regression was used to identify stress determinants. The prevalence of occupational stress was 48.3% (95% CI [44.02, 52.57]), with significant depot-level differences (P < 0.05). Older workers (>40 years) and nonsmokers had significantly lower stress levels, whereas irregular meal patterns (adjusted odds ratio [aOR] = 2.24; 95% CI [1.38, 3.65]), increased awareness of duty responsibilities (aOR = 4.59; 95% CI [1.52, 13.87]), and external challenges (threats) (aOR = 3.49; 95% CI [1.30, 9.38]) were significantly associated with increased stress. Systemic ERIs, exacerbated by psychosocial strain and hazardous conditions, emphasize vulnerabilities in conductor roles. Policy interventions should prioritize workplace health promotion programs that integrate stress management and ergonomic enhancement. In the medium term, automated ticketing and passenger conduct regulations can be implemented. In the long term, fair salary revisions and public recognition should be established to sustain the workforce's motivation.

The prevalence of overweight/obesity (OW/OB-defined by body mass index) in low- and middle-income countries is rising, and the sociodemographic characteristics of the most affected populations are changing. The relationship between education, widely recognized as a gender-related variable, and OW/OB in high-income countries is well understood; however, the impact in South Asian (SA) countries is less clear. This systematic review interrogated the relationship between educational attainment and OW/OB, by searching Ovid MEDLINE, CINAHL, EMBASE, and Web of Science for studies published after 2013, reporting the prevalence of OW/OB by educational attainment in eight SA countries. Data were extracted and the association between education and OW/OB was coded as direct, indirect, null, or U-shaped. A total of 32 studies were included in the review. The mean age was 38.5 years. The prevalence of OW/OB ranged between 4.6% and 64.4%. Females were reported to be at higher risk of OW/OB compared with males. Most of the studies reported women with higher education at greater risk of being OW/OB. SA countries are undergoing substantial transformations in their economic and social frameworks that influence how sex and gender mediate cardiovascular risk factors like OW/OB. Preventive strategies must be tailored to the unique characteristics of the SA population.

The purpose of this study was to investigate the effects of the COVID-19 pandemic on the mortality of traumatic brain injury (TBI) patients transported by emergency medical services (EMS). Adult TBI patients who were assessed and transported by EMS between January 2018 and December 2021 were analyzed. The main exposure was during the COVID-19 pandemic period at the time of the event. The primary outcome was in-hospital mortality. A total of 18 988 patients were analyzed. The in-hospital mortality in the COVID-19 era group was 1812 (20.9%), and that in the non-COVID-19 era group was 2040 (19.8%). Multivariate logistic regression analysis revealed a significantly greater probability of in-hospital mortality in the COVID-19-era group; adjusted odds ratio [95% confidence interval] of 1.16 [1.07, 1.25]. Compared with non-COVID-19 era patients, TBI patients who were assessed and transported during the COVID-19 era were more likely to have higher in-hospital mortality.

In Indonesia, weaknesses in the neonatal emergency referral and transport system have been identified as important factors in preventable neonatal deaths. To address this, a bottleneck analysis study was conducted in Surabaya using the modified Tanahashi model to identify bottlenecks in four key domains: supply, demand, quality, and the enabling environment. A mixed-method approach was employed. Qualitative data from interviews and focus groups identified gaps and underlying causes. Tracer indicators were used for targeted quantitative data collection through Health Facility Assessments and secondary data review to measure the gap extent. Primary health care facilities lacked trained staff, and bed shortages delayed transfers. Nonstandardized processes hindered transfer efficiency and affected neonatal care at specialized hospitals. Systemic weaknesses were found in data collection, monitoring, interagency coordination, and policy implementation. The bottleneck analysis framework effectively identified critical gaps and guided strategic prioritization for system improvement. Findings highlight the need for reviewing facility standards, modifying staff training, streamlining referral processes, establishing clear oversight roles for referral and prioritizing systematic monitoring and evaluation. The selected tracer indicators offer a framework for assessing neonatal emergency referral systems in other resource-limited settings, supporting efforts to improve neonatal survival through more effective referral and transport mechanisms.

Japan launched a municipal financial incentive program in 2018 to promote higher-quality long-term care (LTC). We quantified the association between municipal incentive performance and subsequent incident LTC certification and all-cause mortality among community-dwelling older people. Baseline 2016 data from the Japan Gerontological Evaluation Study (N = 90 896 adults aged ≥65 years in 23 municipalities) were linked to 2018-2020 administrative records. Each municipality received a composite incentive score (0-612). Using multivariable logistic regression with fixed effects, we estimated odds ratios (ORs) per 1 SD score increase, adjusting for demographics, socioeconomic status, and health. Over three years, 10.7% newly required LTC certification and 5.1% died. A 1 SD higher incentive score was associated with lower odds of incident LTC (OR: 0.91, 95% CI [0.90, 0.92]) and all-cause mortality (OR: 0.66, 95% CI [0.54, 0.81]). These benefits were driven by the "Support Functional Independence/Prevent Progression" domain in less-urban areas, while plan-do-check-act-style activities predominated in cities. Overall, better municipal performance under Japan's financial incentive policy correlated with short-term reductions in LTC utilization and mortality among older residents, supporting continued monitoring and policy refinement.

The Council of Indigenous Peoples in Taiwan has established tribal-based Cultural Health Stations offering basic health services and social activities for Indigenous communities. However, little is known about the factors influencing participation. This pilot study examined the reasons for attendance among older adults from five Paiwan communities in eastern Taiwan. A structured questionnaire, informed by Andersen's Behavioral Model of Health Services Use and shaped through community consensus, was administered to 211 elders, 77 of whom were attending Cultural Health Stations. Participants who attended were generally older, female, living alone, not engaged in paid work or farming, and reported positive perceptions of the activities. Common reasons for non-attendance included time constraints, preference for alternative social settings, and dissatisfaction with the programs. Multivariable logistic regression analysis revealed that being aged 75 or older, living alone, and reporting a higher self-rated ability to manage health issues were positively associated with attendance. In contrast, having paid employment was negatively associated. Findings from the open-ended questions suggested attendees appreciated services and activities but requested more cultural content. Non-attendees expressed that activities should be inclusive of different age groups and ability levels, culturally connected to local communities, and mindful that many elders still need to work. These findings highlight the importance of incorporating elders' perspectives in the planning and evaluation of community-based services and may inform policy improvements for Indigenous elder care in Taiwan. However, it is also necessary to consider the economic circumstances of elders, design culturally centered activities, and respond to their interest in courses related to cultural transmission to ensure services are both accessible and meaningful.

Informal carers are essential to post-stroke recovery in Malaysia but often encounter significant challenges with minimal support. This qualitative study examined the lived experiences of 10 carers of stroke survivors with moderate to severe dependency in Klang Valley. Guided by Schlossberg's transition theory, in-depth interviews were analyzed using inductive thematic analysis. Five main themes emerged: (1) focus shifted toward the stroke survivors, (2) caregiving repercussions, (3) lack of resources, (4) ways of surviving hardships, and (5) beauty emerging from hardships. Findings highlight the public health importance of integrating carer support into post-stroke services, particularly in aging societies. Policy measures should include structured carer training, expanded community rehabilitation, workplace flexibility, and stronger linkages between health care, social services, and non-governmental organizations. Addressing these needs can enhance carer wellbeing, improve survivor outcomes and reduce long-term health system burdens.

Evidence on modern contraceptive use among Orang Asli women is limited. This study aimed to assess the prevalence and factors influencing modern contraceptive use among married or cohabiting Orang Asli women of reproductive age (15-49 years). Data from 3249 Orang Asli women in the 2022 Orang Asli Health Survey (OAHS), a cross-sectional study employing a two-stage stratified random sampling design, were analyzed. Complex sample analysis with logistic regression was applied. The study found that 53.3% of Orang Asli women used modern contraceptives. Key factors significantly associated with contraceptive use included residence in remote areas (aOR=1.88; 95% CI = 1.08, 3.27), age 20-34 years (aOR = 2.43; 95% CI = 1.91, 3.09), and having three or more children (aOR = 2.17; 95% CI = 1.75, 2.70). The prevalence of modern contraceptive use among Orang Asli women exceeded Malaysia's national average and Indigenous populations globally. Improving accessibility and affordability remains critical, particularly for Orang Asli women in urban areas, to reduce disparities.