BMC Public Health最新文献

Background: A key-population approach to sexually transmitted disease prevention does not fully take into account the multidimensional nature of sexual risk behavior. Visits to sexual health centers for HIV/STI screening provide an opportunity to spread prevention messages and tools, but few data are available on patients' sexual and prevention behaviors. This study aimed to identify the profile of patients consulting for HIV/STI testing in a Parisian sexual health center.

Methods: This observational study included 5,130 patients who attended the center for HIV/STI testing from August 2017 through January 2020 and completed a self-administered electronic questionnaire. Data were obtained from the consultation database and the questionnaire. The data included STI results, sociodemographic characteristics, sexual and prevention behaviors, as well as HIV knowledge. To identify homogeneous groups of patients regarding sexual risky behavior, we conducted a mixed approach including both a priori classification and agglomerative hierarchical clustering (AHC) based on multiple correspondence analysis (MCA). Sexual behaviors and substance use were included in the MCA.

Results: Median age of patients was 26 years [Q1-Q3:23-32]. Seven clusters of patients were identified. Two clusters had a high HIV/STI positivity rate (15-19%) with very different profiles: cluster 1 included socially disadvantaged patients who had no health insurance and cluster 5 included 89% of men who have sex with men. Two clusters had an HIV/STI positivity rate corresponding to that observed in the overall study population (10-11%) but exhibited risky behaviors (cluster 7 with a high frequency of unprotected sexual intercourse, substance use, cannabis use and weekly binge drinking) or lack of knowledge on HIV (cluster 6 including 100% of patients having transactional sex).

Conclusions: The multidimensional approach demonstrated that both key populations and lower-risk populations visit a sexual health center. While several groups could benefit from tailored interventions, knowledge of HIV and its treatment should be enhanced for every patient visiting a sexual health center. To provide a complete offer in sexual health, patients' profiles and expectations need to be taken into account.

Backgrounds: Psychiatric patients have been the focus of social attention, and they may be more susceptible to hepatitis viruses. This study aims to investigate the prevalence and influencing factors of hepatitis virus infection among psychiatric patients in East China.

Methods: A total of 6,5911 newly admitted psychiatric patients at Shandong Daizhuang Hospital from 2017 to 2023 were included in this study. Test results of serum biomarkers for HBV and HCV infection were collected from psychiatric patients. Background information such as sex, age, ethnicity, marital status, occupation, residence, region, and types of psychosis were collected. Results of serum markers for hepatitis B and C were also collected from 23,628 non-psychiatric individuals.

Results: In the study area, the HBV infection rate in psychiatric patients was 3.75% (95% CI: 3.46-3.74%) and showed a decreasing trend by year (p for trend = 0.000). The HCV infection rate in psychiatric patients was 0.23% (95% CI: 0.19-0.27%). The HBV infection rates differed among sex, age, marital status, occupation, residence, region, severity, and psychosis types. The HCV infection rates differed among age, marital status, occupation, and psychosis types. The HBV infection rate in psychiatric patients was positively skewed with age, being lowest in the age group of 5-15 years old and the highest in the age group of 36-40 years old, similar to the distribution of HBV infection in non-psychiatric patients. The HCV infection rate in psychiatric patients increased with age (p for trend = 0.000) and was similar to non-psychiatric patients (p for trend = 0.000). Compared with non-psychiatric patients, the "Mental and behavioural disorders due to use of alcohol", "Schizophrenia", "Mental disorders due to epilepsy", "Behavioural and emotional disorders with onset usually occurring in childhood and adolescence", "Obsessive-compulsive disorder", "Somatoform disorders" and "Depressive episode" become influencing factors for HBV infection. Compared with non-psychiatric patients, the "Dementia in other diseases classified elsewhere", "Depressive episode" become influencing factors for HCV infection. Being male, jobless and living in rural were risk factors for HBV infection, and urban became a risk factor for HCV infection.

Discussion and conclusion: The rate of HBV and HCV infection among psychiatric patients in this region have remained low. Gender, age, occupation, residence, and types of psychosis were identified as potential influencing factors for hepatitis virus infection.

Objective: This study aims to describe the epidemiological features of craniofacial soft tissue injuries in a major plastic emergency department in northwest China.

Methods: A retrospective review of emergency medical records (2019-2023) was conducted for craniofacial soft tissue injury patients. Demographic and clinical data were collected and analyzed, stratified by age and with consideration of the COVID-19 period.

Results: A total of 22,887 patients with 24,050 craniofacial soft tissue injuries were included. The mean age was 13.46±15.52 years, with a male to female ratio of 1.57. Collisions were the primary cause of injury (86.5%), and contusion and laceration were the most common types of wounds (97.4%). The most frequent injury locations were the forehead (24.4%), chin (13.8%), cheeks (13.0%), and supercilium (12.3%). Peak visiting times were in April, May, June, September, and October during the year, on weekends during the week, and in the afternoon and evening during the day. The average time interval between injury and hospital visit was 6.17±5.68 hours, with a median time of 4 hours. Epidemiological characteristics were also described for different age subgroups (underage [0-17 years], working-age [18-65 years], elderly [≥65 years]) and within each underage subgroup (infant-toddler [0-2 years], preschool [3-5 years], primary school [6-11 years], secondary school [12-17 years]). The COVID-19 pandemic led to a decrease in the frequency of facial injuries and a change in hospital visiting pattern, but had no apparent influence on other epidemiological characteristics.

Conclusions: This study provides a detailed epidemiological description of craniofacial soft tissue injuries in a large single-center retrospective cohort. The findings can contribute to optimizing treatment strategies, resource allocation, and the development of public health policies.

Background: Mobile apps can promote different behavioral interventions, thus decreasing preventable health problems. Challenges persist in ensuring the quality and reliability of these applications, as few have undergone rigorous scientific evaluation. Additionally, few scientifically validated questionnaires on well-being, adapted for the general public, are available in the literature. The objective of this study was to test and validate a general health assessment instrument based on questionnaires available in the literature, previously validated for the Brazilian population.

Methods: The tracking tool was tested with healthy women, 18 to 50 years old. The instrument was constructed as a 29-question online form comprising 5 main clusters or "pillars" of individual health: general health, diet and nutrition, movement and activity, sleep, and mental health. The original and adapted versions of two sections (Sleep and Mental Health) were applied in a subsample of participants to compare intra-individual variability. Data from the "Mental Health" and "Sleep" sections were rigorously tested for normality and Pearson's correlation test was performed to compare the results of the original and adapted versions intra-individually. Chi-Square and McNemar tests were employed to pair categorical data and account for correspondence between the answers to the two forms of the questionnaires.

Results: Seventy-one women answered the instrument with the proposed adapted versions of the questionnaires. The average completion time was between 12-20 min. The mean scores of the diet, movement, and general health questionnaires were similar to those of the original questionnaires from which questions were taken. The "Sleep" and "Mental Health" exhibited intra-individual divergences concerning the classification of results. The correlation between the original and adapted versions was improved after revising some of the questions (r = 0.9287; p < 0.0001).

Conclusion: The results of the present study demonstrate that this adapted instrument is valid and reliable for assessing the intended five pillars of health. Studies with larger sample sizes and other populations are encouraged.

Background: COVID-19 has affected many hospitalizations. In this study, we intended to understand the effects of COVID-19 pandemic on heart failure hospitalizations in the state of California.

Method: This study was a retrospective analysis of California State Inpatient Database during March to December of 2019 and 2020. Adult hospitalizations with heart failure were included for the analysis. Main outcome variables were in-hospital mortality, mechanical ventilation, mechanical circulatory support, vasopressor use, and acute respiratory distress syndrome (ARDS).

Results: There were 450,771 (53.7%) heart failure hospitalizations during March to December of 2019, compared to 388,795 (46.3%) during March to December of 2020 (relative decrease, 13.7%). Heart failure hospitalization rates were lower during 2020, compared to 2019. Comparison of adverse hospital outcomes across the two-time frames showed that in-hospital mortality (2.9% versus 2.7%, P = 0.003), mechanical circulatory support (0.7% versus 0.5%. P < 0.001), vasopressor use (1.3% versus 1.0%, P < 0.001), and ARDS (0.1% versus 0.06%, P = 0.007) were significantly higher among hospitalizations in 2020. Regression analysis showed that the odds of in-hospital mortality (OR, 1.09; 95% CI, 1.06-1.11), mechanical ventilation (OR, 1.07; 95% CI, 1.05-1.09), vasopressor use (OR, 1.07; 95% CI, 1.04-1.10), and ARDS (OR, 1.74; 95% CI, 1.58-1.91) were significantly higher among heart failure hospitalizations in 2020.

Conclusions: Our study found that patients with heart failure hospitalized during the COVID-19 pandemic had greater in-hospital adverse events such as greater in-hospital mortality, mechanical ventilation use, vasopressor use, and ARDS. These findings warrant that heart failure required prompt hospitalization and treatment irrespective of restrictive mandates during COVID-19 pandemic.

Introduction: Public health today is challenged by a wide array of hazards that threaten humans, often resulting in high rates of morbidity and mortality when they strike. These events should be detected and responded to as early as possible to save lives and minimize their impact. The Epidemic Intelligence from Open Sources (EIOS) system leverages natural language processing and machine learning techniques for the early detection of public health events from open-source information using an all-hazards approach. In this study, we quantitatively evaluate the performance of the EIOS system for the early detection of outbreaks and health emergencies in the African region.

Methods: We retrospectively searched the EIOS system to determine if a signal was found on the system for each public health event notified to WHO by the 47 countries in the African region from 2018 to 2023. We computed the proportion of public health event detected by the EIOS system, its sensitivity, harmonic mean, and timeliness. We assessed the association between selected predictors (year of report, hazard type, subregion, source type, and language of source) and early detection of public health events on the EIOS system using a multivariable logistic regression model.

Results: We found a detection proportion of 81.0% and a sensitivity of 47.4%, with a harmonic mean of 59.8%. The proportion of events detected steadily increased over the years and sensitivity increased from a baseline of 44.1% in 2018 to 47.3% in 2023. Signals for more than 80.0% of the public health events notified to WHO in 28 countries were detected on the EIOS system. In 22 countries, signals of at least 50% of the public health events were detected early, that is, before official notification from the National Authorities to WHO. The median time between detection on the EIOS system and notification to WHO was zero days. We found that the type of hazard (infectious and zoonotic), the subregion (West and Central Africa), and the type of source (medical and social media) were associated with early detection.

Conclusions: We conclude that the EIOS system performed well in detecting public health events in the African region early. However, some improvements are needed. We recommend increasing social media and local community radio sources on the EIOS system.

Background: COVID-19 caused a significant impact on food security; particularly among low- and middle-income countries. The objective of the current study was to assess both the direct and indirect impact of COVID-19 on individuals' food security in the metropolitan and regional context of Ethiopia.

Methods: This project utilized a retrospective study design with a mixed methods approach. It assessed the food insecurity experience of individuals both before and after the emergence of COVID-19 through the Food Insecurity Experience Scale (FIES). Food sellers were interviewed to identify the factors that increased post-COVID-19 emergence food insecurity. Inferential analysis using ordinal logistic regression was undertaken based on the Polytomous Universal Model (PLUM) procedure.

Results: The size of the family and the type of work for income generation were statistically associated (p < 0.05) with the food security of individuals, both before and after COVID-19 emergence. Location (p = 0.002, odds = 0.37), age (p = 0.002, odds = 2.57) and educational status (p = 0.001, odds = 0.24/) of individuals had a statistically significant effect on the food security of individuals before COVID-19 emergence only. The ordinal value of all FIES indicators increased after COVID-19 emergence compared with pre-pandemic food insecurity. Overall food security of individuals was reduced by 21.5%, with the moderate and severe food insecurity of individuals increasing by 13.1% and 15.9%, respectively. The COVID-19 preventive measures that affected the individuals' food security, in the order of their priority, were: transport bans; food price increment; lockdown measures; job loss; market bans; social distance restrictions; fear of the pandemic; movement restrictions; over-buying; food inaccessibility; and, lack of cash due to bank closure. In addition, pre-existing non-pandemic related natural and man-made disasters played a role in the food security crisis, including drought, war, and desert locust emergence.

Conclusion: The COVID-19 pandemic has directly and indirectly affected individuals' food security. Learning from the experiences of COVID-19 may assist governments in preparing for future pandemics. Suggested improvements include forming impact reduction task forces and establishing disease prevention strategies that will not compromise food security.

Background: Experiences of racial discrimination during adolescence can negatively affect lifelong health. Although many ethnic minority adolescents face discrimination in common worldwide, there are few updated review studies that explored how discrimination affected health status and behavior among ethnic minority adolescents.

Methods: Comprehensive searches of the PubMed, Embase, PsycINFO, and CINAHL were conducted, integrating keywords about adolescent, ethnic groups, discrimination, and health. The search encompassed articles published between January 2016 and March 2021, following Whittemore and Knafl's integrative literature review method. Quality appraisal was evaluated by the Risk of Bias Assessment Tool.

Results: After conducting the initial screening of 167 studies, eleven studies met the inclusion criteria and were included in the review. More than 80% of the studies were conducted African-American/Black adolescents in the United States. There were clear associations between group discrimination and mental health problems. Discrimination was also linked to the low overall health, high substance use, high emotional eating, and high behavioral problems, and low ethnic identity. Of the six studies investigating gender differences, two each reported that discrimination was linked to higher substance use in boys and stronger internalizing symptoms in girls.

Conclusion: This integrative review provides insights into the discrimination experiences of ethnic minority adolescents, with particular implications for mental health, overall health, substance use, and behavioral problems. This review contributes evidence for need of integrative health promotion programs to mitigate racial discrimination against ethnic minority adolescents for health equity.

Background: Physical inactivity in adolescents is a major public health issue. Schools are important settings for physical activity interventions. The WISH Study was a peer-led, school-based walking intervention that aimed to increase physical activity levels of adolescent girls. This study uses the RE-AIM Framework to present the process evaluation of the WISH Study with a focus on factors that affected participation, motivation, and enjoyment of the intervention.

Methods: Pupils (n589 12-14 years) were recruited from 18 schools in the border region of Ireland and Northern Ireland. In intervention schools (n9), older pupils (15-18 years) were trained as walk leaders and led pupils (12-14 years) in brisk walks (10-15 min) during the school day, across the school year (2021-22). Questionnaires to measure self-efficacy for walking and physical activity, health-related quality of life and reasons for engaging in physical activity were administered throughout the intervention. At the end of the intervention focus groups were held with pupils, and interviews conducted with teachers and walk leaders. Attendance at walks was monitored by walk leaders. Quantitative data were analysed descriptively, and qualitative analysis was undertaken using thematic analysis. Themes were reported under RE-AIM indicators (reach, effectiveness, adoption, implementation, and maintenance).

Results: Pupils in the intervention schools (n286) were representative of adolescent girls in Northern Ireland and Ireland, in terms of their activity level. At baseline, 15% of these pupils met the recommended physical activity guidelines of 60 min moderate-vigorous physical activity per day, as measured by accelerometers. The total number of walks reported per school ranged from 2 to 104 across intervention schools. One quarter of pupils (n74, 26%) never attended a walk and 15% (n23) of walk leaders did not lead a walk. Pupils and walk leaders self-reported improvements in their physical health, mental well-being, and social relationships, and walk leaders reported gaining transferrable skills. Implementation was aided by school support in some schools, although barriers such as COVID-19, lack of time, harsh weather, inadequate facilities for indoor walks, and walk leader availability, were identified. Staff engagement was a key driver for the maintenance of walks.

Conclusions: Despite a promising feasibility study and a comprehensive walk leader training programme, the extent to which the intervention was adopted and implemented varied, suggesting future school-based physical activity interventions need to consider individual school contexts to ensure intervention fidelity.

Trial registration: ISRCTN 12847782.

Background: Evidence on psychological outcomes of gaming disorder (GD) is still scarce. This study aimed to investigate the mediating role of sleep hygiene in the relationship between GD and psychological distress (depression and anxiety) among Iranian adolescents.

Methods: This was a cross-sectional study among school students in Qazvin city, Iran. We administered GD, anxiety, and depression questionnaires in a paper-and-pencil format. GD was measured using the GD S4-SF scale, and anxiety and depression were evaluated using the DASS-21. We assessed sleep health as a mediator using the Sleep Hygiene Behaviors scale. Covariance-Based Structural Equation Modeling (CB-SEM) was employed for data analysis, accounting for sex and physical activity as the main confounders. Statistical significance was determined using various fit indices and confidence intervals.

Results: The sample consisted of 600 adolescents (41% female). CB-SEM revealed a positive but not statistically significant association between GD and depression, along with a negative statistically significant association with anxiety. Notably, sleep hygiene was identified as a partial mediator in the relationship between GD and depression, indicating that poor sleep practices may exacerbate depressive symptoms among adolescents with GD. However, no mediating effect was observed for anxiety.

Conclusion: Our data supported a mediating role for sleep hygiene in the association between GD and depression among participants. Our results highlight the critical need for targeted policy interventions to improve sleep hygiene among adolescents with GD.