BMC Public Health最新文献

Background: Seeking refuge in another country is a significant life event associated with health burdens and unmet health needs. However, the diversity within the migrant population necessitates a multidimensional framework acknowledging intersectional perspectives, and there is a notable lack of studies about the health and support of sexual minority forced migrant women. The aim of this study was to explore psychosocial health and wellbeing among lesbian forced migrants in Sweden.

Methods: Exploratory qualitative study consisting of semi-structured interviews with lesbian forced migrants recruited via purposeful, convenience, and snowball sampling. All participants originated from Africa. Data were analyzed with systematic text condensation through a collaborative approach involving researchers, experts by lived experience, and a clinical psychologist.

Results: Participants experienced a challenging journey involving intersectional disadvantages and an unsafe living situation. They struggled to meet basic needs, experienced painful memories during asylum interviews, feared potential deportation, and faced loneliness in a new and unfamiliar society. A newfound freedom and social support empowered them to keep pursuing happiness in the face of struggles. They found strength in welcoming spaces, found belonging and comfort among peers, and were aided through informational and instrumental support. When trying to access health services, participants suffered in silence because of barriers hindering their access. While the importance of sensitivity and respect in clinical settings was emphasized, non-affirming behaviors were sometimes encountered when interacting with health professionals. Interpreters' discretion and safety were considered essential aspects when they are utilized in health services.

Conclusions: Lesbian forced migrants face a range of challenges impacting their health and wellbeing. Loneliness is a pressing concern, while social support among peers is highly desired and appreciated. Lesbian forced migrants emphasize the importance of accessible and affirming health services, including respectful behaviors and appropriate utilization of interpreters promoting client safety. Peer support has the potential to offer comfort and belonging, but more research is needed.

Background: With population ageing, multimorbidity has become a major public health concern. Although healthy lifestyles are associated with reduced risks of single chronic diseases and mortality, their relationship with multimorbidity patterns among older Chinese remains insufficiently explored.

Methods: Data from 16,820 participants aged 60 and older, from the 2008-2018 waves of the China Longitudinal Healthy Longevity Survey (CLHLS), were analyzed. Participants were categorized into three lifestyle groups (favorable, average, and unfavorable) based on five modifiable lifestyle factors: social engagement, physical activity, smoking, drinking, and diet. Disease progression was assessed using multimorbidity networks, and all-cause mortality was analyzed with Cox proportional hazards models.

Results: Compared to an unfavorable lifestyle, a favorable lifestyle was associated with a lower risk of all-cause mortality (HR = 1.63, 95% CI: 1.50-1.77). Among the five lifestyle factors, social engagement showed the strongest association with mortality (HR for inactive vs. active engagement = 1.36, 95% CI: 1.29-1.43). Multimorbidity networks revealed that individuals with favorable lifestyles exhibited denser, more interconnected disease networks, while those with unfavorable lifestyles showed more streamlined, linear disease progressions, primarily driven by hypertension, cardiovascular disease, and dementia.

Conclusions: A favorable lifestyle was linked to lower mortality and more complex multimorbidity networks, likely due to longer survival and the accumulation of chronic conditions. These findings underscore the need for interventions to reduce premature mortality and manage multimorbidity in aging populations.

Background: Farmers are at risk of excessive exposure to solar radiation. Knowledge and practices in photoprotection were evaluated and barriers to sun protection were explored among insured farmers in Bagua Grande.

Materials and methods: A mixed methodology with a sequential explanatory design with quantitative dominance was used. A questionnaire in Spanish, "CHACES," was administered to 203 farmers selected by simple random sampling, and seven people were interviewed in depth to achieve data saturation. The survey data were synthesized using Stata statistical software, and the interviews were analyzed thematically.

Results: 83% of respondents had low knowledge of photoprotection. Farmers are exposed to the sun during midday hours (62%), do not use sunscreen (53%) or sunglasses (88%), although they do wear long sleeves and pants (42%). Significant differences in knowledge levels were found with age (p < 0.001), natural skin color (p < 0.001), and use of sunscreen (p = 0.002). The most common barriers were lack of information about sun protection measures, discomfort from wearing protective clothing, the high cost of sunscreen, and access to health services.

Conclusion: Farmers' knowledge of sun protection was low and practices were inadequate, and the barriers identified prevent the practice of sun protection. Therefore, interventions aimed at modifying behavior and practices in photoprotection according to the characteristics of the population are required, using behavioral measures and barrier methods to safeguard both their health and safety.

Background: This study examines the associations between multiple dimensions of media use, including screen time, parental joint media engagement, rule-setting and preschool children's prosocial behavior in Singapore.

Methods: Data were drawn from two waves of a nationally representative study- Singapore Longitudinal Early Development Study, with children's time diaries being used to enhance the accuracy of media exposure measurement. We employed Structural Equation Modeling and applied propensity weighting to adjust for the selection bias related to screen time and parental joint media engagement at the baseline.

Results: We found that a sizable preschool children spent long hours on screens, often without parental engagement. We observed a direct positive association between parental joint media engagement and children's prosocial behavior in Wave 1, which further correlates with the children's prosocial behavior in Wave 2. No direct associations were found between screen time or rule-setting and young children's prosocial behavior at either wave, suggesting that active parental mediation through direct parental joint media engagement in preschool children's media use is more important than the duration of screen use and restrictive rule-setting in supporting children's prosocial behavior.

Conclusions: Parental joint media engagement plays a more important role than screen time and rule-setting in affecting children's prosocial behaviour in early childhood. Our study reveals the need for policies to go beyond focusing solely on quantity of screen time as intervention to emphasize the multidimensional context of media use, especially parental engagement, in order to effectively benefit children's development.

Background: The global prevalence of type 2 diabetes mellitus (T2DM) is rising, significantly increasing the risk of cognitive impairment and dementia. Although exercise improves cognitive function in T2DM, few studies have compared different exercise modalities. This network meta-analysis assessed their effects on global cognitive function in patients with T2DM.

Methods: This study systematically searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases from their inception to October 10, 2025, and included randomized controlled trials (RCTs) evaluating the effects of exercise interventions on global cognitive function in patients with T2DM. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were pooled using a random-effects model, and treatment rankings were estimated using surface under the cumulative ranking curve (SUCRA) values. Subgroup analyses were performed according to cognitive assessment tools, intervention duration, and training frequency.

Results: Twenty-one RCTs involving 2,118 participants were included. Compared with usual care, multimodal exercise (ME, 7 trials, n = 423, SMD = 1.04, 95% CI: 0.49-1.59), aerobic exercise (AE, 9 trials, n = 399, SMD = 0.85, 95% CI༚0.38-1.33), and mind-body exercise (MBE, 4 trials, n = 202, SMD = 0.93, 95% CI༚0.25-1.62) significantly improved global cognitive function, while resistance exercise (RE, 2 trials, n = 77, SMD = 0.46, 95% CI༚-0.57-1.48) showed no significant effect. SUCRA rankings indicated the highest efficacy for ME (78.1%), followed by MBE (69.0%), AE (61.5%), and RE (36.6%). Subgroup analyses showed that ME was most effective when cognition was assessed with MoCA and in long-term interventions (> 3 months), whereas MBE and AE were more effective with MMSE and in short-term interventions (≤ 3 months). At exercise frequencies ≤ 3 sessions per week, ME, AE, and MBE were effective, while at higher frequencies only ME remained effective.

Conclusion: This study indicates that ME is the most effective intervention for improving global cognitive function in patients with T2DM, while MBE and AE also provide benefits. In clinical practice, exercise interventions should be tailored to individual patient characteristics to optimize cognitive outcomes.

Background: Resilience research increasingly recognises the influence of cultural context and community perspective on adaptive responses to adversity. However, many resilience indices embody theoretical underpinnings that are not necessarily congruent with lived experiences, especially in relation to culturally diverse groups. This study explores resilience factors through community narratives of diversity in Aotearoa New Zealand.

Methods: We conducted nine focus groups (N = 92) across urban and rural contexts with 48% of participants identifying as Māori or Pacific Peoples. The twelve resilience indicators were explored through the participant narratives promoted by vignettes and semi-structured discussions using a thematic analysis approach. Culturally grounded protocols were embedded throughout, including Māori-led facilitation using the Hui Process and Talanoa-informed engagement for Pacific participants, guided by Māori, Pacific and lived-experience advisors.

Findings: Five themes emerged: (1) Personal resilience factors; (2) health and wellbeing; (3) social connection and reciprocity; (4) systemic and structural factors; and (5) cultural and environmental resources. Participants contested Western individualised models of resilience by demonstrating that agency emerges through complex assemblages of relationships across human, more-than-human, ancestral, and environmental domains, rather than from individual capacity alone.

Conclusion: In this study, resilience did not emerge as an individual capacity, but as something grounded in relational networks situated within cultural, spiritual and ecological contexts. These findings suggest a need for transformational approaches to resilience assessment and intervention by policymakers and clinicians, which attend to structural determinants as well as individual coping capacity. Effective interventions are likely to be more acceptable and meaningful when they are community-grounded, culturally embedded and recognise resilience as a collective resource, rather than only individualised adaptation to inequitable conditions.

Background: The wellbeing of university students has become a significant concern globally. This scoping review aimed to explore key social determinants of health, such as food insecurity, housing issues, social isolation, and psychological distress and how it affects the overall experiences and wellbeing of university students. The review included studies comparing the experiences of international and domestic students to highlight unique challenges faced by each group.

Methods: This scoping review followed the first five stages of Arksey and O'Malley's framework and used Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A comprehensive search was conducted across Medline, Scopus, and Web of Science databases, focusing on studies published between 2014 and 2024. The inclusion criteria targeted research on international students in comparison to domestic students addressing food insecurity, housing issues, social support, psychological distress and wellbeing. A total of 23 studies met the inclusion criteria and were assessed for quality using the Joanna Briggs Institute (JBI) critical appraisal tool. Data were extracted and synthesised using a narrative approach.

Results: The review identified that international students are particularly vulnerable to psychological distress due to combined influence of other key social determinants of health. Social isolation was identified as a critical factor, with international students reporting higher levels of loneliness and lack of social support compared to domestic counterparts. Food insecurity significantly impacts both domestic and international students, with international students experiencing higher levels of anxiety and depression due to limited access to affordable food and support networks. Housing issue affect stress and mental health, particularly among international students who face additional barriers such as cultural adjustments and unfamiliarity with local housing markets. The interconnectedness of these factors intensifies their impact, resulting in poorer wellbeing among international students compared to domestic students.

Conclusions: This review highlights the critical need for targeted interventions to address food insecurity, housing issues, social isolation and psychological distress among university students, particularly international students. Comprehensive support systems and tailored policies are recommended, and future research is needed to develop and evaluate solutions for these challenges to improve student wellbeing.

Background: Thalassemia is a significant public health issue in many high-prevalence countries. Despite progress in thalassemia management, limited public awareness and engagement continue to hinder early detection and prevention efforts. This study aimed to assess public awareness, knowledge, and attitudes toward thalassemia and its screening in five high-prevalence countries: Azerbaijan, Indonesia, Kuwait, Saudi Arabia, and Thailand.

Methods: A cross-sectional online survey was conducted among females aged 18-50 residing in the selected countries. The study required each country to include at least 300 participants, with sample size estimated via a simplified normal approximation method. The 31-item questionnaire covered personal information, knowledge and attitude scales, and factors influencing thalassemia screening. Statistical analyses used chi-square test, student t-test, and logistic regression to assess associations, with results expressed as odds-ratios and 95% confidence intervals, complemented by concentration curves to evaluate knowledge distribution across educational levels.

Results: A total of 1,539 participants were included in the analysis. Awareness of thalassemia was relatively high (85.06%), though Saudi Arabia showed significantly lower awareness compared to other countries (P < 0.05). The survey revealed significant gaps in public understanding of thalassemia: only 20.08% of respondents correctly identified it as a genetic disorder, and an even smaller proportion-merely 5.39%-were aware that thalassemia is a curable condition. Disparities in knowledge were evident, with higher education levels correlating with better understanding, particularly in Azerbaijan (concentration index: 0.092, P < 0.001). Older participants, those with higher education, and individuals who were married or had children demonstrated greater knowledge. Positive attitudes were associated with higher education, personal familiarity with thalassemia, and better knowledge.

Conclusion: While public awareness of thalassemia is relatively high, knowledge levels remain poor, highlighting the need for targeted educational interventions and awareness campaigns to address knowledge gaps and improve attitudes toward thalassemia screening in diverse populations.