BMC Public Health最新文献

Background: Previous studies have documented the impact of intergenerational contact on cognitive function in Chinese adults, however, few have focused on the possible mediating pathways. This study aimed to test a hypothetical model in which functional disability and depressive symptoms mediate the association between intergenerational contact and cognitive function.

Methods: This longitudinal study included data of 3666 participants aged 45 years or older (mean age: 60.2 years) from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. Intergenerational contact was measured as the frequency of contact with children and categorized as frequent (≥ 1 time/week) or infrequent (< 1 time/week). Cognitive function was measured in two dimensions: episodic memory and executive function. Depressive symptoms and functional disability were assessed as continuous variables using the 10-item Center for Epidemiological Studies Depression Scale, Activities of Daily Living, and Instrumental Activities of Daily Living Scales. The mediating pathways were quantified using the SPSS PROCESS macro.

Results: Frequent intergenerational contact correlated with a better cognitive function (coefficient: 0.73, 95%CI: 0.39 to 1.06), with plausible mediated pathways via functional disability without depressive symptoms (coefficient: 0.03, 95%CI: 0 to 0.06, proportion mediated: 4.11%), depressive symptoms without functional disability (coefficient: 0.04, 95%CI: 0.01 to 0.08, proportion mediated: 5.48%), and functional disability and depressive symptoms in a chain (coefficient: 0.01, 95%CI: 0 to 0.02, proportion mediated: 1.37%).

Conclusion: Functional disability and depressive symptoms may partly explain the association between intergenerational contact and cognitive function. Further research is needed to explore the mechanisms underlying the association between intergenerational contact and cognitive function.

Background: People living with HIV (PLWH) are more vulnerable to infectious and non-infectious comorbidities due to chronic inflammation and immune dysfunction. Air pollution is a major global health risk, contributing to millions of deaths annually, primarily from cardiovascular and respiratory diseases. However, the link between air pollution and mortality risk in PLWH is underexplored. This systematic review assesses the association between exposure to pollutants such as particulate matter (PM), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), and carbon monoxide (CO) and mortality risk in PLWH.

Methods: A systematic search of PubMed, Web of Science, and Embase was conducted for studies published up to August 2024. Eligibility criteria included cohort, case-control, and cross-sectional studies assessing air pollution exposure and mortality in PLWH. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was applied for quality assessment. A narrative approach and tabular summarization were used for data synthesis and presentation.

Results: Nine studies, mostly from China, demonstrated a significant association between long-term exposure to PM¹, PM^2.5, and PM¹⁰ and increased risks of AIDS-related and all-cause mortality in PLWH. Hazard ratios for mortality increased by 2.38-5.13% per unit increase in PM concentrations, with older adults (> 60), females, and those with lower CD4 counts (< 500 cells/µL) being more vulnerable. Short-term exposure to ozone and sulfur dioxide also increased mortality risks, particularly during the warm season and in older populations. Specific pollutants like ammonium (NH4⁺) and sulfate (SO4²⁻) had the strongest links to elevated mortality.

Conclusion: Air pollution, especially fine particulate matter and ozone, is associated with a higher risk of mortality in PLWH. Targeted interventions to reduce pollution exposure in vulnerable subgroups are crucial. Further research is needed to confirm these findings in diverse regions and develop effective mitigation strategies.

Background: General health literacy (general HL) affects both individual and population health on numerous levels, with low general HL leading to increased morbidity, poor health service utilization, and increased healthcare spending. This study calculated health literacy scores of a population attending specialty consultations in the community of Aragon, Spain. It further produced a sociodemographic profile and examined the relationships between patients' scores and sociodemographic variables.

Methods: A sample of 150 patients from specialty consultations completed the internationally- validated HLS₁₉-Q12 to measure adult general HL. A 4-point-Likert scale gathered information regarding 12 items of health literacy. Final scores were divided into four categorical levels: excellent, sufficient, problematic, or inadequate. Independent sample t-test, one-way ANOVA, and a generalized linear model (GLM) analysis were performed to examine key relationships with respect to sociodemographic variables and health literacy scores.

Results: The survey was completed by 150 subjects aged 18 and over in specialty clinics in Aragon, Spain. 59% of respondents had inadequate or problematic general HL, while 41% had sufficient or excellent general HL. Income level had a significant effect on health literacy scores, F = 2.129, (p < 0.05), as did different work situations, F = 3.762, (p < 0.001). Patients who self-reported as having diabetes had a significantly higher health literacy score, t = 2.356 (p < 0.05) than those reporting other health conditions. According to GLM analysis, education, health status, income, and the number of appointments were the strongest predictors of the heath literacy score.

Conclusions: General HL in this patient population was limited, and lower than in some comparable studies. The sociodemographic profile constructed, and associations with health literacy established, provide policy makers, healthcare administrators, and clinicians with information to consider new policies, processes and strategies to improve general HL in this specific population.

Background: Quitting cigarette smoking can substantially reduce or eliminate the risk of developing numerous chronic diseases. Use of flavored tobacco or nicotine products is commonly cited by adults who smoke cigarettes to be important in helping them reduce or quit smoking. The purpose of this analysis was to understand the association between the levels of use of flavored oral nicotine products and smoking reduction and quitting and how reduction or quitting may differ between predominant users of fruit/other versus mint flavored oral nicotine products after six months of use.

Methods: Participants were provided with their choice of a variety of forms and flavors of Rogue^® nicotine products (Study Products) over a 6-month actual use period and completed online surveys assessing tobacco, nicotine and Study Product use at Baseline and Months 1, 2, 4, and 6 thereafter.

Results: Among the 1393 participants at Month 6, 41.4% and 52.5% used predominantly fruit/other or mint Study Product flavors, respectively. Compared to predominant mint users, predominant fruit/other users had greater cigarette reduction (mean reduction: 50.0% vs. 48.4%) and a higher proportion had quit smoking (proportion quit: 15.4% vs. 11.6%) at Month 6. Additionally, 38.8% of predominant fruit/other users and 39.3% of predominant mint users reduced their cigarette consumption by ≥ 50% from Baseline. Increased use of fruit/other flavors was independently associated with smoking reduction (8.6% greater reduction per 10 pieces/day; p < 0.001) and odds of quitting smoking (OR = 1.29 [95% CI: 1.04-1.59] per 10 pieces/day; p = 0.017). Increased use of mint flavors was independently associated with smoking reduction (7.5% greater reduction per 10 mint pieces/day; p < 0.001) but not with odds of quitting smoking.

Conclusions: Increased use of either fruit/other or mint flavored Study Products at Month 6 was associated with significantly increased smoking reduction, whereas only increased use of fruit/other flavors was associated with greater odds of quitting smoking among participants in the study.

Trial registration: This study was observational. Participants were not prospectively assigned to one or more health-related interventions and could choose to use or not use the commercially available study products provided during the study. Thus, the study was not registered in a trial database by the Sponsor.

Introduction: There exists a gap in the health status of immigrants in comparison to the overall population, and health literacy has been shown to be a mediator for health outcomes and may predict their quality of life (QoL). We aimed to systematically map and synthesize research findings on adult immigrants' health literacy in terms of their health beliefs, understanding, and self-management of Type 2 Diabetes Mellitus.

Methods: A scoping review guided by Arksey and O'Malley's framework was conducted, based on systematic searches in the Embase, Ovid MEDLINE, and APA PsycInfo databases in June 2023. The retrieved articles were screened and assessed by the two authors independently.

Results: Of 568 identified studies, 16 (9 qualitative, 4 cross-sectional, 1 mixed-methods, and 2 experimental) were included in this review. Low/moderate health literacy levels with no sex-related differences were reported. Immigrants' access to health information was limited by language barriers and a lack of culturally adapted information, especially from their physicians. Among women, access to health information was limited by patriarchal norms. Knowledge gaps were primarily related to understanding the necessity of medication and the importance of a healthy lifestyle. Healthcare professionals played an important role in motivating immigrants to adhere to treatment.

Conclusion: Few studies were found on this topic, and additional research is needed to enhance health literacy among immigrants. Limited health information, language barriers, and a shortage of culturally sensitive knowledge appear to hinder immigrants' ability to access, understand, and apply health information. Cultural norms and personal factors further suppress these abilities, ultimately impacting their health outcomes. The findings of this study suggest that health literacy is a crucial component of healthcare professionals' curricula, equipping them with the skills to identify and assist patients with low health literacy.

Background: Access to water, sanitation, and hygiene (WASH) facilities presents a significant global public health challenge. This study aims to investigate the temporal and spatial characteristics of WASH access in mainland China, as well as the socioeconomic equity, using data from national censuses.

Methods: We analyzed households' data from three national censuses spanning 2000 to 2020 to examine the characteristics of safe water, sanitary toilets, and hygiene bathing facilities over time. Spatial clustering of WASH facilities in 2020 was assessed using Moran's I analysis. Socioeconomic disparities in WASH access across provinces were quantified using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII).

Results: Between 2000 and 2020, access to safe water in China increased significantly from 45.7% to 91.3%, access to sanitary toilets rose from 18.7% to 78.5%, and access to hygiene bathing facilities climbed from 26.0% to 88.4%, reflecting continuous improvements in WASH access. Urban areas consistently outperformed rural areas, and the eastern region showed higher access rates compared to the central and western regions. Spatial analysis revealed statistically significant clustering of sanitary toilets and hygiene bathing facilities at the provincial level in 2020. Equity analysis indicated a notable improvement in the fairness of WASH access over the past two decades, with decreases observed in both SII and RII metrics.

Conclusion: Mainland China has made substantial strides in enhancing WASH access over the last 20 years, accompanied by significant improvements in provincial equity. However, persistent regional disparities underscore the need for targeted financial support to rural, central, and western regions to further enhance WASH accessibility.

Introduction: Despite the existence of numerous blood donation centers globally, there remains a significant gap between the demand and supply of blood. In Ethiopia, replacement blood donation is more common than voluntary donation. The National Blood Bank of Ethiopia collects approximately 200,000 units of blood each year, while the daily requirement is 18,000 units. Donors' knowledge and attitudes are vital for ensuring a steady blood supply. This systematic review and meta-analysis sought to evaluate the knowledge and attitudes of Ethiopian residents regarding blood donation and the factors influencing them.

Methods: Relevant research articles were identified through searches of various databases. Data extraction and organization were performed using Microsoft Excel, and the data were then analyzed using STATA/MP 17.0. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Heterogeneity was examined with the Galbraith plot and Cochrane I² statistics. To identify sources of heterogeneity, meta-regression, subgroup analysis, and sensitivity analysis were conducted. Publication bias was assessed using Egger's test and managed with trim and fill analysis. The adjusted odds ratio was calculated to explore the relationship between knowledge and attitudes towards blood donation, with a significance threshold of p < 0.05.

Results: The pooled prevalence of favorable attitudes towards blood donation was 65.95%. Moderators such as study year (p = 0.72), publication year (p = 0.877), and sample size (p = 0.291) were not significant, indicating they did not contribute to heterogeneity. Studies from Northern Ethiopia reported the highest prevalence of favorable attitudes at 69.95%, while research on healthcare workers also indicated a high proportion of favorable attitudes at 69.29%. There was a significant association between knowledge and attitudes towards blood donation (AOR = 2.03).

Conclusion: The pooled prevalence of favorable attitudes towards blood donation was 65.95%, with the highest levels observed in Northern Ethiopia and among healthcare workers. A significant association between knowledge and positive attitudes towards blood donation was found. To enhance attitudes towards blood donation, increasing public awareness and education about the importance and safety of donating blood is crucial.

Background of the study: Along with developments in the clinical domain, medical equipment is becoming more sophisticated, and it needs to function at peak efficiency. In this case, hospitals should priorities the prompt and effective maintenance of life-saving equipment. The purpose of the study was to determine medical equipment maintenance practices, to find out an important factor that influences on-site medical equipment maintenance practices and to suggest possible areas for improvement.

Method: This was a cross-sectional descriptive quantitative research design conducted from November 2022 to February 2023. Data were collected using self-administered structured questionnaires. A sample size of 212 respondents was determined using Slovin's Formula (N/ 1+ Ne²) from a population size of 450. A convenience sample technique was used to select the participants. An exploratory factor analysis was performed to test the inter-relationship between variables, Bartlett's test of sphericity(p = 0,000) indicated a significant correlation, The Kaiser-Meyer- Olkin measure of sample adequacy was 0.800, and this value indicated the appropriateness of the data. A desk review and observational checklist were used.

Results: In this study, a descriptive statistic was performed under three objectives: the overall grand mean value of medical equipment maintenance practice was 2.11, and it showed the practices were uninfluential; the overall grand mean value of factors influencing medical equipment maintenance practices was 3.61, and the identified factors were influential; and lastly, the overall grand mean value of root causes of medical equipment maintenance failures was 3.565, and the identified factors were found to be influential factors.

Conclusions: The findings showed that medical equipment maintenance practice was a weekly practice; factors influencing medical equipment maintenance practice and the root causes of medical equipment maintenance failure were identified as influential factors. Corrective maintenance and outsourcing were the main maintenance practices observed, along with a lack of biomedical personnel, inadequate information aboutdevices, a lack of periodical inspection and prevention, design and implementation, and inappropriate medical equipment.