BMC Public Health最新文献

Background: To investigate the sociodemographic, anthropometric, biochemical, lifestyle and cardiometabolic risk factors associated with type 2 diabetes (T2D) among First Nations Australians.

Methods: A systematic review of prospective cohorts and cross-sectional studies was conducted. Electronic data sources (MEDLINE/PubMed, Embase, CINHAL, and PsycINFO) were searched for peer-reviewed articles until August 2023. We reviewed observational and interventional studies on T2D that reported sociodemographic, anthropometric, lifestyle, and biochemical risk factors for Australian First Nations people. Narrative synthesis was applied without meta-analysis. We highlighted the major risk factors for T2D by reporting the most significant findings from individual studies in the results. The review followed PRISMA guidelines.

Results: The review included 20 eligible studies: 12 cross-sectional studies and 8 prospective cohort studies. The findings from these studies showed that First Nations people who resided in very remote areas (Modified Monash Category 7; MM7) (OR = 1.61; 95% CI: 1.03, 2.52), living adjacent to food store stocking "Western" food items (OR = 2.92; 95% CI: 1.51, 5.63), rented their home (OR = 2.07; 95% CI: 1.30, 3.30) and part-time employment (OR = 2.47; 95% CI: 1.54, 3.95) were associated with a statistically higher risk of developing T2D. First Nations people who had obesity class 1 (BMI > 30 kg/m²), central obesity (WC > 88 cm in women; >102 cm in men), and higher waist-to-hip ratio (WHR) (≥ 1.0 in men and 0.85 in women) were more likely to have T2D. First Nations people with elevated triglycerides (≥ 1.7 mmol/L) (OR = 4.9; 95% CI: 2.7, 8.8), one standard deviation (SD) increase in C-reactive protein (CRP) value (AHR = 1.23; 95% CI: 1.05, 1.45) and lower levels of vitamin D (< 53 nmol/L) (AOR = 2.15; 95% CI: 1.10, 2.18) were significantly associated with a higher risk of T2D. However, no significant association was found with either daily smoking or daily alcohol.

Conclusion: To address the First Nations Health Gap attributed to T2D in Australia, interventions should prioritise remote areas, socioeconomic disadvantage, central obesity, elevated triglycerides, and vitamin D deficiency. This was the first comprehensive systematic review examining sociodemographic, anthropometric, biochemical, lifestyle, and cardiometabolic risk factors associated with T2D among First Nations Australians.

Introduction: Early detection and treatment of HIV and sexually transmitted infections (STIs) are crucial for effective control. We previously developed MySTIRisk, an artificial intelligence-based risk tool that predicts the risk of HIV and STIs. We examined the attributes that encourage potential users to use it.

Methods: Between January and March 2024, we sent text message invitations to the Melbourne Sexual Health Centre (MSHC) attendees to participate in an online survey. We also advertised the survey on social media, the clinic's website, and posters in affiliated general practice clinics. This anonymous survey used a discrete choice experiment (DCE) to examine which MySTIRisk attributes would encourage potential users. We analysed the data using random parameters logit (RPL) and latent class analysis (LCA) models.

Results: The median age of 415 participants was 31 years (interquartile range, 26-38 years), with a minority of participants identifying as straight or heterosexual (31.8%, n = 132). The choice to use MySTIRisk was most influenced by two attributes: cost and accuracy, followed by the availability of a pathology request form, level of anonymity, speed of receiving results, and whether the tool was a web or mobile application. LCA revealed two classes: "The Precisionists" (66.0% of respondents), who demanded high accuracy and "The Economists" (34.0% of respondents), who prioritised low cost. Simulations predicted a high uptake (97.7%) for a tool designed with the most preferred attribute levels, contrasting with lower uptake (22.3%) for the least preferred design.

Conclusions: Participants were more likely to use MySTIRisk if it was free, highly accurate, and could send pathology request forms. Tailoring the tool to distinct user segments could enhance its uptake and effectiveness in promoting early detection and prevention of HIV and STIs.

Background: Alcohol consumption is a significant public health concern among young people worldwide. While alcohol use is culturally embedded in many Nepalese communities, evidence regarding the prevalence of problematic drinking and its associated factors remains scarce among youths. This study aims to assess the prevalence of alcohol consumption and problematic drinking and their associated factors among management undergraduate students of Bhaktapur, Nepal.

Method: A cross-sectional study was conducted among 304 undergraduate students in Bhaktapur, Nepal. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess problematic drinking. Pearson's chi-square test and multivariable logistic regression analysis were performed to determine factors associated with alcohol consumption and problematic drinking, at the 5% level of significance.

Results: The prevalence of alcohol consumption was 58.2% (95% CI:52.0-63.6%), with 26.6% (95% CI: 19.2-33.1%) exhibiting problematic drinking. Being male (aOR: 2.05, 95% CI:1.11-3.76), dissatisfaction with academic performance (aOR: 2.43, 95% CI:1.35-4.38), and alcohol preparation at home (aOR: 2.54, 95% CI: 1.20-5.40) were associated with alcohol consumption. Problematic drinking was linked to male gender (aOR: 4.03, 95% CI: 1.71-9.46), living in a joint family (aOR: 2.40, 95% CI: 1.09-5.29), poor perceived emotional support from family (aOR: 4.94, 95% CI: 1.50-16.26), and traumatic experience (aOR: 2.68, 95% CI: 1.19-6.02).

Conclusion: This study revealed the concerning prevalence of alcohol consumption and dependency among Nepali undergraduate students. These findings highlight the need for comprehensive interventions targeting gender, the family environment, and academic factors to address alcohol misuse among Nepali youth.

Environmental awareness serves as an intrinsic motivator for individuals' engagement in environmental protection behaviors, and social media platforms can foster such awareness. Drawing on the 2018 China General Social Survey data (CGSS 2018), this study employs non-parametric and semi-parametric approaches within the framework of marginal treatment effect (MTE) to examine the influence of WeChat usage on the environmental awareness of Chinese residents. The findings unveil significant heterogeneity in the impact of frequent WeChat usage on individuals' levels of environmental awareness. Through estimation of the average treatment effect, treatment group average treatment effect, and non-treatment group average treatment effect, the study reveals that WeChat exerts a stronger positive influence on the environmental awareness of residents with a high propensity for using the platform, while it has no discernible effect on the environmental awareness of residents with a low inclination to engage with WeChat. The growth of environmental knowledge facilitated by WeChat plays a crucial role in shaping environmental awareness. Furthermore, this research underscores the influence of real-life social network structures on information exchange within the WeChat platform in China. This observation suggests that WeChat transcends its role as a mere information transmission tool and becomes intricately woven into the social network fabric of its users, thus mirroring certain characteristics of information dissemination within offline social networks. These insights imply that targeted strategies can be devised to bolster residents' environmental awareness by capitalizing on the interconnectedness of real-life social networks and leveraging the information exchange potential of WeChat. By doing so, it is possible to enhance environmental protection endeavors and encourage more sustainable behaviors among individuals.

Background: Stressful large-scale events, such as the COVID-19 pandemic and natural disasters, impact birthing individuals' postpartum experiences and their mental health. Resultant changes in government assistance, housing, and employment may further exacerbate these impacts, with differences experienced by varying income levels and races. This study aimed to examine maternal depression and anxiety in postpartum individuals by income and race during a stressful large-scale event, and the mediating role of government assistance, housing, and employment.

Methods: An explanatory sequential mixed methods study was conducted (QUANT + QUAL). For aim 1 (quantitative), birthing individuals who delivered during peak pandemic (June 2020 - September 2021) completed questionnaires related to their perinatal experiences and mental health. Macrosystem factors (government assistance, housing, and employment changes) were assessed using the Psychosocial Recommended Measures. The Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD7) assessed depression and anxiety, respectively. Serial linear regression models assessed the relationship between race and income with mental health and macrosystem factors. For aim 2 (qualitative), 40 individuals from the quantitative study balanced by income (low vs. high income) and race (Black vs. White) completed one-on-one semi-structured interviews which were analyzed using thematic analysis.

Results: Amongst 1582 birthing individuals, Black individuals had a significantly higher EPDS score compared to White counterparts. Not receiving government assistance, unstable housing, and experiencing various employment changes were all related to worse mental health during stressful large-scale events. In semi-structured interviews, low-income individuals discussed that government assistance helped alleviate a financial and mental burden. Low- and high-income individuals reported varying job changes that impacted their mental health (low-income: job loss, high-income: increased hours).

Conclusions: This research spotlights the negative impact of large-scale events most affected both Black and low-income individuals' postpartum mental health, and the role of government assistance, stable housing, and secure employment in helping to alleviate these disparities between income levels.

Background: The COVID-19 pandemic and the associated measures have had a significant impact on millions of individuals and families worldwide. Although cross-sectional studies have demonstrated the considerable burden placed on families during the pandemic, trends over different phases of the pandemic including later stages and using population-based samples is scarce.

Objective: In this study, we aimed to assess trends in family functioning across four population-based surveys between December 2020 and March 2023 using a repeated cross-sectional design. The surveys were conducted using a similar sampling strategy and measures. We included individuals residing in a household with at least one minor below the age of 16.

Results: The most notable changes across surveys over time were related to quality of life. While 54.3% of respondents reported a decline in quality of life during the winter of 20/21 compared to pre-pandemic levels, this was observed in only 22.6% of participants during the spring of 23. The proportion of respondents who indicated a deterioration in their relations with their children also decreased during the pandemic. While 9.9% of respondents reported a deterioration in their relationship with their children during the winter of 20/21 in comparison to the initial phase of the pandemic, this was reported by only 5.2% in the spring 23. The relationship with one's partner and health status exhibited minimal fluctuations. Mental health problems were associated with a decline in quality of life, health status and relationships with children and partners compared to pre-pandemic levels at all time points. Moreover, lower income levels were associated with poorer relationship quality with the partner in the most recent wave.

Conclusions: Our findings demonstrate significant improvements in family functioning since the onset of the pandemic, indicating that individuals and families in our sample were generally adapting well. However, a subgroup of the population still reports suboptimal family functioning compared to before the pandemic. Psychosocial care and social policy support for families are needed.

Background: In contemporary society, physical appearance significantly influences individuals' social interactions and career achievements. Although some studies suggest that physical exercise may positively impact physical appearance, most rely on subjective self-assessment data. In contrast, third-party evaluations are widely regarded as more objective and reliable. Thus, this study aims to explore the effects of physical exercise on physical appearance, as assessed by third-party evaluations, and to examine its heterogeneity.

Methods: This study utilized third-party physical appearance evaluation data from 25,460 respondents in the 2018 China Family Panel Studies (CFPS) and assessed the impact of physical exercise on physical appearance using multiple linear regression and instrumental variable analysis. Furthermore, the heterogeneity in the effects of physical exercise was investigated using subgroup regression and quantile regression analyses.

Results: The findings indicate that physical exercise substantially enhances physical appearance, with its effects varying significantly across different populations. Specifically, women, urban residents, and those with lower appearance scores experience more pronounced enhancement from physical exercise compared to men, rural residents, and those with higher scores. Additionally, the effect of age on the impact of physical exercise on appearance exhibits an inverted U-shaped relationship. Middle-aged adults (40-59 years) experience the most significant improvements, while benefits are lower for adolescents (10-20 years), young adults (20-39 years), and older adults (60-80 years).

Conclusions: This study systematically reveals the positive impact of physical exercise on physical appearance, demonstrating that regular exercise can significantly enhance individual appearance scores. This finding contributes to a broader understanding of the multifaceted benefits of physical exercise.

Background: 24-hour movement behaviors integrating physical activity (PA), sedentary behavior (SB), and sleep are important components influencing adults' health. Canadian 24-hour movement guidelines for adults were launched in 2020. However, there is little evidence on the prevalence and correlates of guideline compliance and its associations with health outcomes among Chinese adults. The purposes of this study were to investigate the prevalence and correlates of meeting 24-hour movement guidelines and examine its association with physical fitness and depressive symptoms among Chinese adults.

Methods: A total of 7059 adults (45.73 ± 14.56 years, age range: 20-79 years, 52% female) were recruited by stratified cluster random sampling from health surveillance of Hubei, China, between 25-Jul and 19-Nov 2020 during the COVID-19 pandemic. Participants completed a self-reported questionnaire including movement behaviors (PA, SB, and sleep), depressive symptoms, and demographic information. In addition, eight objectively measured physical fitness tests (body mass index, waist-hip ratio, body fat percentage, vital capacity, handgrip strength, flexibility, balance, and choice reaction time) were conducted. SPSS 28.0 was used to perform Generalized Linear Mixed Models analysis to examine the correlates of movement guidelines and its association with fitness and depressive symptoms.

Results: 25.54% of participants met all three movement guidelines, while 48.62% met only two, 23.10% met one, and 2.75% met none. Participants who were older adults (OR = 2.24; P = .017), unmarried (OR = 0.21; P < .001), and living near PA facilities (OR = 1.58; P = .017) were more likely to meet all three movement guidelines. Meeting more movement recommendations was associated with less likelihood of depressive symptoms (OR = 0.41; P < .001), while no significant associations were observed between meeting 24-hour movement guidelines and physical fitness indicators (P > .05).

Conclusions: The findings of this study indicate the need to promote adherence to all movement guidelines among Chinese adults. Future promoting strategies to meet movement guidelines should emphasize the demographic differences of the targeting population, especially age, marital status, and accessibility of PA facilities. Future interventions should be applied to affirm the effects of compliance with overall 24-hour movement guidelines to mitigate depressive symptoms among adults.