BMC Public Health最新文献

Background: Hypertensive heart disease (HHD) is a significant public health concern in China. We intend to provide an updated estimate of the burden of HHD in China between 1990 and 2030.

Methods: HHD prevalence, mortality, and disability-adjusted life years (DALYs) data were obtained from Global Burden of Disease (GBD) 2019 databases. Temporal trends of HHD from 1990 to 2019 were analyzed using Joinpoint regression models, and projections through 2030 were estimated by Bayesian age-period-cohort model.

Results: In 2020, an estimated 334,695 newly prevalent cases and 13,196 deaths due to HHD occurred in China. From 1990 to 2019, age-standardized rate of prevalence (ASPR), mortality (ASMR) and DALYs (ASDR) showed a decreasing trend. The behavior-related risk, diet risk and excessive BMI were the most common reasons of death in HHD. According to our prediction, ASMRs and ASDRs will continue to decrease from 2020 to 2030. However, ASPRs will have a moderate rise.

Conclusion: HHD continues to pose a significant threat to public health in China. To achieve the Healthy China 2030 objective, a tailored approach involving comprehensive strategies is essential. These strategies should include, but are not limited to, enhancing public awareness about hypertension through educational campaigns, improving access to healthcare services for early diagnosis and treatment, implementing policies to promote healthy lifestyles, such as regular physical activity and a balanced diet, and strengthening the surveillance and monitoring systems to track the prevalence and impact of HHD over time.

Background: The issue of school adaptation among urban adolescents has received increasing attention. Previous research has primarily focused on Chinese rural and mobile adolescents, exploring the impact of factors such as teacher support, resilience, and left-behind status on their academic achievement. However, there has been relatively limited research on urban adolescents in this regard.

Methods: In line with the study's objectives, this study selected parent and student questionnaires from the CEPS (2013-2014) and CEPS (2014-2015) datasets for a matched analysis. This process resulted in a final sample of 2502 urban adolescents aged 13 to 15. The key variables examined included teacher academic support, teacher emotional support, teacher relationship support, resilience, school adaptation, and left-behind status. To investigate these relationships, we employed structural equation modeling to explore how resilience mediates the impact of teacher support on school adaptation among urban adolescents. Additionally, we examined whether left-behind status moderates this mediation process.

Results: The findings reveal that teacher support directly affects the school adaptation of urban adolescents and also indirectly influences it through the mediating role of resilience. Additionally, the left-behind status significantly moderates the direct effect of teacher relationship support on school adaptation among urban adolescents, but it does not similarly affect the direct impact of teacher academic support and emotional support.

Conclusions: Enhancing teacher support can effectively enhance the resilience of urban adolescents, leading to improved school adaptation. For left-behind adolescents, strengthening the quality of teacher-student relationships is particularly crucial for their school adaptation. Moreover, providing all students with consistent emotional support is essential, as it positively influences school adaptation regardless of their left-behind status.

The purpose of this study was to conduct a meta-analysis of the effects of high-intensity functional training on the physical fitness of healthy individuals. This system review followed the PRISMA guidelines and has been registered in PROSPERO with the registration number CRD42023475055. As of January 2024, we did a thorough search across five databases: PubMed, Scopus, Web of Science, EBSCOhost, and Cochrane Library. We evaluated the methodological quality of the included study by TEST EX tool and ROB 2 tool. GRADE framework determines the level of certainty of evidence. Meta-analysis of random effects model calculations. 19 high-quality studies were included in this review, involving 911 healthy individuals. Positive effects were observed in improving strength (ES = 1.380; p < 0.001), power (ES = 1.320; p < 0.001), speed (ES = 3.093; p < 0.001), endurance (ES = 1.802; p < 0.001), and agility (ES = 2.086; p < 0.001). However, flexibility performance had no significant effect (ES = 0.640; p = 0.092), which may be attributed to limited articles. Therefore, it is necessary to expand high-quality research to explore the impact of HIFT on the physical fitness in healthy individuals.

Background: The prevalence of childhood overweight and obesity in China has been rapidly increasing in recent years. The purposes of this study were to investigate the prevalence of infant overweight in Beijing and to explore the influencing factors using a generalized estimating equation (GEE) model.

Methods: This is a birth cohort study from January 2022 to December 2022 in Beijing, involving 2,008 newborns from local residents. Four times of follow-up visits were conducted at 2, 5, 8, and 12 months of age for physical measurements and health information collection. Multiple exposures were considered, including demographic characteristics of infants, maternal pregnancy information, feeding pattern and outdoor activities of infants. The GEE model was utilized to identify influencing factors for infant overweight while adjusting for potential confounders.

Results: The prevalence of overweight for 2-, 5-, 8-, and 12-month-old infants were 14.4%, 21.6%, 24.4%, and 24.2%, respectively. Among the influencing factors, irregular exercise during pregnancy (OR = 1.190, P = 0.045), mixed feeding or artificial feeding (non-exclusive breastfeeding) (OR = 1.233, P = 0.025), high birth weight (OR = 1.468, P < 0.001), and high pre-pregnancy body mass index (BMI) (OR = 2.113, P = 0.005) were positively correlated with infant overweight. Conversely, weight gain ≤ 15.0 kg during pregnancy (OR = 0.778, P = 0.016), high birth length (OR = 0.990, P = 0.003), and longer duration of outdoor activity for infants (OR = 0.764, P < 0.001) were negatively correlated with infant overweight.

Conclusions: Our findings suggest certain factors are associated with infant overweight risk. Further research is required before making causal inferences and formulating preventive strategies for infant overweight.

Background: Malaria is a significant health challenge in Sierra Leone, particularly affecting pregnant women and children under five years of age. Despite efforts to reduce malaria cases, its prevalence remains high. The Sierra Leone National Malaria Elimination Strategic Plan (NMESP) 2021-2025 aims to reduce the malaria burden significantly through universal access to Insecticide Treated Nets (ITNs).

Objective: This study evaluates the knowledge and utilization of ITNs for malaria control in the Moyamba and Bo districts of Sierra Leone (at the Njala University's Main Campus in Moyamba District and Towama Location on Bo Campus in Bo District). It assesses awareness levels, factors associated with ITN use, and the effectiveness of current campaign strategies.

Methods: A cross-sectional survey was conducted from July to September 2023, involving 742 participants from the Moyamba and Bo districts. Data were collected using a pretested interview guide covering ITN ownership, usage, and challenges. Descriptive statistics and Pearson's Chi-squared test were used for data analysis.

Results: Of the respondents, 84.8% received training on ITN usage, primarily from health workers (46.1%). Most participants (94.7%) understood that ITNs provide protection against mosquitoes, and 84.5% believed in their effectiveness in preventing malaria. Sociodemographic factors like age, sex, education, marital status, and sources of information were significantly associated with ITN knowledge and utilization. Moreover, health workers' campaigns and interpersonal networks (community leaders, plus family and friends) play crucial roles in promoting ITN utilization, while mass media campaigns alone may not suffice. However, 48.2% of the participants found current ITN campaign strategies effective.

Conclusion: While awareness and ownership of ITNs are high in the Moyamba and Bo districts, utilization is hindered by various factors, including availability and alternative uses. Enhanced campaign strategies and increased ITN distribution are necessary to improve usage and reduce malaria incidence.

Background: The high costs associated with diabetes management, coupled with the increasing prevalence of comorbidities, present a significant challenge to China's healthcare system, with cardiovascular complications being particularly prominent. The purpose of this study was to evaluate the comorbidities of diabetic patients with stroke in Beijing from 2016 to 2018 and the impact on treatment options and associated costs.

Methods: This retrospective cohort study included diabetic patients enrolled in Beijing's medical insurance with outpatient medical records. We compared comorbidities, medications, and related treatment costs between stroke and non-stroke patients.

Results: A representative sample of 2,853,036 patients with diabetes was identified from the data collected from 2016 to 2018, of which an average of 21.18% of patients reported stroke. A higher percentage of diabetic patients with stroke reported other comorbidities including hypertension, coronary artery disease, dyslipidemia, chronic respiratory disease, and osteoporosis as compared to those without stroke(all p's < 0.0001). The costs increased dramatically if diabetic patients developed comorbidities, including hypertension, CAD, dyslipidemia, CRD, and osteoporosis. Annual costs of medications were higher for diabetic patients with stroke and any types of comorbidity compared to diabetic patients without stroke (p <.0001, respectively). More types of drugs were used for diabetic patients with stroke and any types of comorbidity.

Conclusions: The needs of individuals with diabetes and stroke, including their comorbidity patterns and medical burdens, must be carefully taken into account. Health systems will need to address the increasing demand for diagnosing and managing comorbidities in individuals with diabetes and stroke.

Purpose: To test the effects of a physical activity intervention program on symptoms of mental disorders among adolescents.

Methods: This study is a 12-week cluster randomized controlled trial. The sample consisted of 306 adolescents (45,8% male, age: 13,6 [0,72] years; 54.2% female, age: 13.5 [0.69] years), randomized into an intervention group (N = 165) and a control group (N = 141). The physical activity program involved sessions including muscle strengthening and cardiorespiratory exercises and lifestyle guidance. The mental health indicators analyzed were: anxiety, depression, sleep, and psychological well-being. Intervention effects were analyzed by generalized estimating equations.

Results: After 12 weeks, no significant improvements were observed in the intervention group for sleep; anxiety; depression, and psychological well-being. In the subgroup analysis, significant group×time interactions were observed for adolescents who were classified with moderate symptoms of depression (mean difference: -0.97, p = 0.002) and anxiety (mean difference: -3.03, p = 0.01) with favorable effects for intervention group.

Conclusion: After the 12-week intervention period, it can be concluded that 12 weeks of school-based physical activity intervention significantly reduced symptoms of anxiety and depression in adolescents with moderate/severe symptoms. Furthermore, the intervention contributed to the maintenance of psychological well-being, since the control group showed a significant reduction in this mental health indicator.

Background: The role of antithrombotic therapy in prognosticating patients with coronary heart disease (CHD) is crucial. This study evaluated the Knowledge, Attitude, and Practice (KAP) of CHD patients regarding antithrombotic therapy.

Methods: This cross-sectional study distributed questionnaires to collect data. Participants' demographic information was recorded, and their KAP scores were assessed. The Self-Efficacy for Appropriate Medication Use Scale (SEAMS) measured self-efficacy.

Results: The study comprised 639 individuals. The median scores were as follows: knowledge score 8 (IQR 6-10), attitude score 25 (IQR 23-27), and practice score 22 (IQR 20-24). Notably, up to 70% of patients incorrectly responded to questions about dosage and administration of antithrombotic agents, and approximately 40% lacked awareness of the treatment's importance and side effects. Low practice scores were independently linked to rural residence, low attitude scores, and poor self-efficacy. Furthermore, Predictive factors for low self-efficacy included being underweight, having a high family income, a short medical history, and low attitude scores.

Conclusions: The surveyed patients with CHD exhibited good attitudes, practices, and self-efficacy but demonstrated only median knowledge levels toward antithrombotic therapy, especially about the importance and precautions associated with antithrombotic treatment. Therefore, initiatives aimed at improving adherence to antithrombotic therapy among CHD patients should focus on the knowledge gaps, especially for patients in rural areas. Improving the patient KAP could help improve the physician-patient interaction.

Background: The COVID-19 pandemic brought with it several changes, both regarding infection with COVID-19 itself as well as measures to combat the spread of infection, that might have affected sickness absence (SA) patterns. The aim was to explore whether incidence and length of SA changed between 2019, 2020, and 2021, as well as to determine factors associated with SA due to COVID-19 or COVID-like diagnoses among privately employed white-collar workers.

Methods: A cohort of all privately employed white-collar workers in 2018 in Sweden (n = 1 347 778; 47% women) was followed prospectively during 2019, 2020, and 2021 using linked nationwide register data. We calculated numbers and proportions of people with incident SA (in SA spells > 14 days) due to COVID-19, COVID-like diagnoses (certain respiratory, infectious, and symptom-based diagnoses used in the beginning of the pandemic for suspected COVID-19), and all other SA, respectively, and mean number of SA days with somatic and mental diagnoses. Logistic regression was used to determine odds ratios (OR) and 95% confidence intervals for associations between prior diagnosis-specific SA, sociodemographic and work-related factors and incident SA due to COVID-19 or COVID-like diagnoses.

Results: In 2020, 0.6% of the women and 0.3% of the men had incident SA due to COVID-19. For SA with COVID-like diagnoses, the corresponding proportions were 1.2% and 0.5%. The proportion of people with all other SA was stable across the years, at 8.1-8.4% for women and 3.7-3.9% for men. The mean number of SA days per person increased each year for somatic diagnoses but for mental diagnoses it decreased from 2019 to 2020 and increased to 2021 among women and men. Factors associated most strongly with incident SA due to COVID-19 or COVID-like diagnoses were low income (adjusted OR-range 1.36-5.67 compared to the highest income group) and prior SA due to COVID-like diagnoses (OR-range 4.67-5.31 compared to those with no such prior SA).

Conclusions: A small proportion of privately-employed white-collar workers had incident SA spells > 14 days due to COVID-19 or COVID-like diagnoses. The factors associated with SA due to COVID-19 were similar to factors associated with SA due to other diagnoses in previous studies.

Background: Condom use has long been recommended as an effective method for preventing HIV/AIDS. However, a large proportion of older adults in China reported not using condoms, leading to an alarming increase in HIV prevalence among this population. Negative attitudes, especially condom-related stigma, have been identified as the main barrier. However, no condom-related stigma scale has been developed or validated for older adults in the Chinese cultural context. This study aimed to adapt and validate a condom-related stigma scale for older adults (CRSS-OA) in China, based on a scale previously developed for men who have sex with men (CRSS).

Methods: Based on qualitative interviews, we adapted and revised the CRSS to better address the ageism and unique stigma faced by older adults in the Chinese cultural context. The reliability and validity of the adapted CRSS-OA were examined using a random sample of 498 older adults in Hunan Province, south-central China. Reliability was assessed by calculating Cronbach's alpha. Construct validity was assessed through exploratory and confirmatory factor analyses. Concurrent validity was assessed by examining the correlation between each factor of the CRSS-OA and two criterion scales (the HIV/AIDS Stigma Scale and the Aging Sexual Attitudes Scale). Predictive validity was evaluated by analyzing the association between condom-related stigma and engagement in condomless sexual behavior.

Results: The adapted scale included 16 items, loading on three factors, and collectively explaining 70.646% of the variance. These factors were named "labeling condom use," "shaming condom purchase," and "violating traditional sex beliefs," demonstrating strong internal consistency with Cronbach's alpha coefficients of 0.942, 0.850, and 0.852, respectively. Concurrent validity was established by evaluating the correlation between each factor of the CRSS-OA and two criterion scales, with Pearson correlation coefficients ranging from 0.227 to 0.508 (p < 0.05). Predictive validity was assessed by measuring the scale's ability to correctly predict condomless sexual behavior, with an average predictability of 0.77.

Conclusions: The adapted CRSS-OA has proven to be a valid and cultural-adaptive tool for assessing condom-related stigma among older adults in China. Further studies are needed to explore the external validity of this scale in the future.