Public health challenges最新文献

Objective: Insufficient physical activity (PA) is a well-known risk factor for many non-communicable diseases. This study aimed to develop a screening tool, the Helsinki Physical Activity Questionnaire (HPAQ), to identify physically inactive people at the population level and to help social and health care professionals promote PA among people at risk.

Methods: Eighty-five healthy adults wore a hip-worn accelerometer for 7 days, after which they completed several PA questionnaires. These included some novel and several validated questions on PA. The reliability of individual questions to identify physically inactive people was assessed by correlation analysis. Logistic regression analysis was used to find the combination of questions that best identified physically inactive people.

Results: The highest correlation of the screening questionnaire with the accelerometer was 0.46 (p < 0.001) for sedentary behavior (SB) and 0.42 (p < 0.001) for the total amount of moderate-to-vigorous physical activity (MVPA), respectively. The best pair of questions on total PA identified 64% of all inactive subjects (MVPA < 150 min/week) based on accelerometer data.

Conclusions: The questionnaires developed for screening PA have a poor correlation with the accelerometer data. The screening questionnaires roughly describe PA level among middle-aged participants, but if a more sensitive or specific method is needed, device-based measurements are recommended.

Background and objectives: Among the multitude of health effects on children associated with the COVID-19 pandemic, there have been significant interruptions in the provision of routine pediatric primary care, including blood lead level (BLL) screening. We aimed to investigate trends in BLL screening before and during the pandemic era using patient-level electronic health record data extracted from CurrentCare, Rhode Island's statewide health information exchange (HIE).

Methods: De-identified data were analyzed from CurrentCare for the study period January 2018 to December 2021. We utilized ATLAS, a web-based analytics platform from the Observational Health Data Sciences and Informatics (OHDSI) community, to extract and stratify BLL by variables of interest from the CurrentCare data, standardized to OHDSI's Observational Medical Outcomes Partnership common data model.

Results: A decrease in BLL screening occurred in the spring of 2020, aligning with initial periods of shelter-in-place in response to the novel coronavirus outbreak; there was a 48% decrease comparing quarter 2 (April to June) of 2019 and 2020. BLL screening rebounded in the summer of 2020, however, it remained 16% lower overall in 2020 than in 2019. In 2021, BLL screening fell again to 23% lower than in 2019. Although overall numbers of BLL screenings were reduced, the proportion of abnormal BLLs was higher, particularly in the range of 3.5-5.0 µg/dL.

Conclusions: Leveraging statewide HIE data, we found that significant deficiencies in BLL screening remain unresolved since the beginning of the COVID-19 pandemic. The disruption of children's lives by the COVID-19 pandemic appears to have greatly affected lead screening and exposure in Rhode Island.

Introduction: Maternal exposure to mass media has been linked to various health outcomes, but its influence on childhood morbidity and mortality in Benin remains unexplored. This study examines the relationship between maternal mass media exposure and two critical child health indicators: morbidity and mortality.

Methods: This secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) included 13,851 women. Childhood morbidity (fever, cough, and diarrhea) and mortality were analyzed as outcomes. Bivariable and multivariable logistic regression and Cox regression models were applied, and results were expressed as odds ratios (OR), hazard ratios (HR), and their adjusted counterparts (aOR/aHR) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05.

Results: Fever was the most common morbidity (22.1%, 95%CI: 20.9-22.6), followed by cough (18.6%, 95%CI: 17.3-19.0) and diarrhea (13.1%, 95%CI: 12.6-14.1). At least one morbidity was reported for 35.7% (95%CI: 34.4-36.5) of children, whereas child mortality was observed in 5.6% (95%CI: 5.1-5.9). After adjustment, maternal exposure to radio and television was significantly associated with an increased likelihood of childhood cough and overall morbidity. Mothers with no exposure to radio (aOR = 0.76, 95%CI: 0.67-0.86) or television (aOR = 0.86, 95%CI: 0.75-0.99) had lower odds of their children experiencing cough compared to those exposed.

Conclusion: Maternal exposure to mass media, particularly radio and television, was associated with increased childhood morbidity. This association could reflect heightened maternal health awareness, leading to increased reporting of symptoms or exposure to misleading health information through media content. These findings highlight the dual role of media as a tool for health education and a potential source of risk-promoting influences. Policymakers and health practitioners should leverage mass media for targeted interventions while addressing its adverse impacts to improve child health outcomes.

Aim and objectives: To investigate the level of stigma, medication adherence and resilience among recently diagnosed people living with HIV/AIDS (PLWHA) and explore the relationship between medication adherence, stigmatization and resilience.

Design/method: This is a convergent-parallel mixed-method design involving both qualitative and quantitative research methodologies. The quantitative aspect utilized a cross-sectional design among 200 PLWHA at the anti-retroviral therapy clinic of the Lagos University Teaching Hospital, Lagos, Nigeria, whereas the qualitative part entailed semi-structured, in-depth interviews of 26 PLWHA. Spearman's rho correlation was used to explore the relationship between medication adherence, stigmatization and resilience, and qualitative data were analysed using thematic analysis.

Result: Four themes emerged from the qualitative analysis, including building resilience, experiences relating to diagnosis, experiences related to treatment and factors facilitating medication adherence. Overall, 113 (57%) experienced a high level of stigma, 149 (76%) reported high medication adherence, and above average 115 (57.2%) demonstrated high resilience.

Conclusion: In this study, PLWHA in Nigeria who recently received their diagnosis experienced a high level of stigma, resilience and medication adherence. However, nearly one-third of the participants were non-adherent to medication due to several reasons. This noteworthy proportion of non-adherence needs to be addressed while improving resilience and reducing stigmatization.

Background: Toxoplasmosis has public health importance, particularly in immunocompromised individuals such as pregnant women leading to congenital abnormalities and fetal losses. In this study, we aimed to determine the seroprevalence of toxoplasmosis in sheep at Mandeeq Slaughter House in Hargeisa and pregnant women attending antenatal care at Hargeisa Group Hospital.

Methods: Cross-sectional study design with systematic random sampling method and Questionnaire surveys were used for the collection of data from sheep and pregnant women. Sera were collected and examined for anti-Toxoplasma gondii antibodies using latex agglutination test.

Results: The overall prevalences of toxoplasmosis were 25.5% and 28% in sheep and human, respectively. Multivariable logistic regression analysis indicated that female (AOR = 2.18; 95% CI: 1.38-3.47; p = 0.001) and young age groups of sheep (AOR = 3.04; 95% CI: 1.04-8.86; p = 0.041) were significantly associated with T. gondii seropositivity. In pregnant women, age groups between 25 and 34 (AOR = 2.76; 95% CI: 1.07-7.14; p = 0.037), pregnant women who have cats in their home (AOR = 6.45; 95% CI: 2.37-17.52; p = 0.000), women who have close contact with garden soil (AOR = 6.74; 95% CI: 2.55-17.81; p = 0.000), poor hand washing practices before food eating (AOR = 29.5; 95% CI: 5.41-161.11; p = 0.000), and drinking tap water (AOR = 8.4; 95% CI: 2.54-28.08; p = 0.000) were significantly associated with T. gondii seropositivity.

Conclusion: Toxoplasmosis is prevalent in sheep and pregnant women in Hargeisa. We recommend that pregnant women should avoid eating uncooked mutton, reduce gardening activities, keep personal and environmental hygiene, and drink boiled water to reduce the risk of the toxoplasmosis.

The coronavirus disease 2019 (COVID-19) placed an unprecedented burden on the global healthcare system, severely affecting the physical and mental health of healthcare workers, particularly nurses. Nurses faced immense workloads, increased infection risks, uncertainty, and public scrutiny. Despite these challenges, nurses were lauded for their dedication and resilience in confronting the pandemic. Many experienced mortality, morbidity, and post-COVID sequelae. This review integrates psychological resilience literature from 2020 to 2022, utilizing Whittemore and Knafl's integrative review method. A total of 22 studies met the inclusion criteria, focusing on how nurses demonstrated resilience during the COVID-19 crisis. Most studies reported a moderate level of resilience, with a mean score of 62.54. Factors such as positive acceptance of change, trust in personal judgment, perceived competence, and spiritual influences were positively associated with resilience, whereas burnout, anxiety, and depressive thoughts negatively impacted it. Resilience was found to mediate the relationships between variables like perceived stress, emotional exhaustion, and quality of life. The literature suggests that healthcare administrations should foster a healthy work environment, maintain an optimistic outlook, and establish strong connections with frontline staff to mitigate the pandemic's impact. Providing supportive environments, resilience training, and mental health interventions will be crucial in enhancing resilience for future crises.

Background: Chagas disease (CD) is a neglected zoonosis that requires study through the One Health approach, as it involves various aspects of animal, environmental, and human health in its transmission cycle. This disease affects 7 million people in 20 countries in Latin America, resulting in approximately seven thousand deaths annually worldwide. Local knowledge is crucial for developing educational strategies to mitigate the risks of disease transmission, particularly in endemic areas.

Aims: In this study, we present the experience of integrating five stands with complementary subjects on CD, focusing on environmental, biological, and human life factors, as well as its invertebrate and vertebrate hosts.

Methods: This research was conducted as part of the Chagas Express XXI initiative, a social-educational technology conceived as an imaginary train consisting of six thematic "wagons" (education stations) related to CD. The current study took place in the northern region of the state of Minas Gerais, Brazil, focusing on the activities of wagon 4, which involved 649 participants in two municipalities: Espinosa and Montes Claros, both endemic rural and urban areas for CD.

Results: Participants' prior knowledge was assessed through a series of questions, and educational mediators engaged in dialog during voluntary sessions. We found that crucial aspects related to the prevention and control of vector-borne transmissions, such as host and vector diversity, as well as household risks, were neglected in local education activities or unknown to the populations of both municipalities.

Conclusions: This study demonstrates that zoonosis, particularly CD, should be included in basic education and health professional training courses, employing strategies that consider the different socio-environmental interfaces and aim to improve human, animal, and environmental living conditions.

Despite the availability of effective biologics, rabies continues to impact several low- and middle-income countries. More than 50,000 people succumb to rabies every year due to the lack of timely and appropriate post-bite care. Biologics used in post-exposure prophylaxis, such as rabies vaccine, rabies immune globulins, and rabies monoclonal antibodies, are not readily available and often in short supply in the developing world, especially in Asia and Africa, where rabies is endemic in domestic dog populations and poorly controlled. Moreover, many healthcare professionals in these settings have less than ideal knowledge of current post-exposure prophylaxis guidelines. To combat this, we have integrated current post-bite prophylaxis guidelines and accurate information about the availability of rabies biologics into an interactive, user-friendly web application, ZeroRabiesApp (ZRA). Designed as a point-of-care tool for treating dog bite cases, ZRA generates a customized post-exposure prophylaxis schedule using the user-provided date of exposure. The schedule is based on the latest guidelines developed by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). The ZRA also provides access to the rabies biologics database that can be used to find the nearest locations where rabies biologics needed for post-exposure prophylaxis are currently available. The freely available app can offer a simple, real-time, and local solution to prevent human rabies deaths following potentially rabid exposures like dog bites.

Approximately one in five children in the United States has a special health care need. Mothers of children with special health care needs have worse mental and physical health compared to other mothers. Physical activity (PA) can improve depressive symptoms (DS) and overall health; however, little is known about the acceptability of PA interventions in these mothers. Therefore, the primary aim of this cross-sectional study was to understand the use of PA in mothers of a child with a special health care need to cope with DS. Specifically, this study examined PA norms, interests, and rationale for participation PA in 348 mothers (age = 39.3 ± 7.3 years; White = 92%; Midwest = 80.1%; employed = 59.2%; prenatal or at birth diagnosis = 51.7%). Most mothers reported meeting PA guidelines before pregnancy but not during pregnancy, postpartum, and currently, and a majority reported elevated DS. Most mothers (85%) of expressed interest in using PA and yoga to cope with DS. The majority of mothers' viewed PA as a means to increase health and fitness to meet the needs of their children, though they failed to meet the levels of PA associated with DS reduction. Future initiatives should consider population-specific PA norms, interests, and rationales to increase the salience of meeting PA recommendations in this population.

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in Kyrgyzstan. The study aimed to explore the CVD prevalence depending on various risk factors across diverse ethnic groups in Kyrgyzstan.

Materials and methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used a questionnaire with 47 questions to explore the health status, behavior and lifestyle determinants, and prevalence of CVD. We used the chi-square test to investigate differences between groups, and ANCOVA to determine differences between mean scores on analyzed variables. Logistic regression was used to analyze the relationship between independent and dependent variables. Confounding variables were only included if they correlated with both the independent and dependent variables. Interaction analyses were conducted with logistic regression to investigate if there were any differences between the nationalities in the relationships between the independent and dependent variables.

Results: Our study confirmed that the CVD prevalence across diverse ethnic groups can be significantly different: In Kyrgyzstan, the most disadvantaged groups in this context were East European and the least-Western Asian. There was no difference between studied groups found in the ethnicity-stratified prevalence of such CVD risk factors as low fruit and vegetable consumption, alcohol intake, smoking, and body mass index (BMI). There was no statistically significant association between educational attainment and CVD risk markers within the studied ethnic groups. The analysis of ethnicity-stratified prevalence of CVD risk markers resulted in a significant difference in physical activity across ethnicity groups.

Conclusion: The study results provided an understanding of the ethnicity-stratified prevalence of CVD risk markers in the population in Kyrgyzstan. They could serve as instrumental in tailoring targeted public health interventions to address the burden of CVDs in specific subpopulations.