BMC Public Health最新文献

Background: The purpose of this study was to develop a digital self-harm scale suitable for Chinese adolescents, and to test its reliability and validity.

Methods: Through semi-structured interview, literature analysis and expert evaluation, the initial questionnaire was developed, and 1651 students from three middle schools in Jilin Province were selected for questionnaire survey. Item analysis and exploratory factor analysis were carried out, and 843 students were selected for confirmatory factor analysis, convergent validity, discrimination validity, criterion validity, content consistency reliability and retest reliability.

Results: The results showed that the digital self-harm scale consisted of eight items divided into two factors, namely External self image harm and Inner self emotional harm. And 73.47% of the total variance was explained. The two-factor structure model fitted well (²χ/df = 4.2, CFI = 0.994, TLI = 0.989, SRMR = 0.01, RMSEA = 0.062). The total score and each factor score of the digital self-harm scale were negatively correlated with sleep duration, and positively correlated with other criteria. The Cronbach α coefficient of the total scale and each factor was 0.938-0.965, and the retest reliability was 0.983-0.991.

Limitations: The Inner self emotional harm dimension has few questions, the relationship and mechanism between digital self-harm and non-suicidal self-injury is not deep enough.

Conclusions: The digital self-harm scale developed in this study has good validity and reliability, and can be used as a measurement tool to assess the digital self-harm of Chinese adolescents.

The 2023 Kahramanmaraş earthquakes, with magnitudes of 7.7 and 7.6, caused extensive destruction and psychological distress across southeastern Turkey. This study explores the psychological impact on non-victims, particularly Istanbul residents, focusing on mental health outcomes and coping mechanisms. A cross-sectional survey was conducted from March to May 2024 with 721 participants from various Turkish cities, including a significant portion from Istanbul. Validated psychological scales such as the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and PTSD Checklist for DSM-5 (PCL-5) measured depression, anxiety, well-being, and PTSD symptoms. Sociodemographic factors like age, gender, occupation, income, education level, and previous earthquake experience were also analyzed.Results showed significant psychological distress among non-victims: 51.9% reported high levels of distress, with 24% meeting PTSD criteria, 30% exhibiting moderate to severe depression, and 28% experiencing significant anxiety. Higher income and education levels correlated with better mental health outcomes. Higher education levels were linked to lower PTSD risk (β = -0.20, p < 0.01) and fewer depression symptoms (β = -0.15, p < 0.05). Higher income was associated with lower depression scores (β = -0.20, p < 0.01) and fewer PTSD symptoms (β = -0.15, p < 0.05). Age positively correlated with well-being (r = 0.68, p < 0.001) and negatively with PTSD symptoms (r = -0.15, p < 0.05).Comparisons with victim studies of major earthquakes, such as the 1995 Great Hanshin-Awaji earthquake, the 1999 Marmara earthquake, the 2008 Wenchuan earthquake, and the 2000 Iceland earthquakes, revealed similar profound psychological impacts. This highlights the need for comprehensive mental health interventions for both direct and indirect exposures. This study underscores the necessity for inclusive mental health strategies to enhance resilience and well-being, ensuring robust recovery after catastrophic events.

Background: Anxiety is a severe global health problem. The long-established urban-rural dichotomy in China has led to unequal development in rural and urban areas, which may result in significant differences in the anxiety of rural and urban China. However, a comprehensive nationwide study exploring such disparities among Chinese adults remains lacking.

Methods: The study extracted 27875 Chinese adults from the Psychology and Behaviour Investigation of Chinese Residents in 2022. The study utilized generalized linear regression analysis to explore the factors associated with Chinese adults' anxiety in urban and rural areas. Further, we used the Blinder-Oaxaca decomposition to analyze the role of explanatory factors in urban-rural disparities in anxiety among Chinese adults.

Results: The median anxiety score among rural adults was 5.00 (P₂₅: 1.00, P₇₅: 7.00), surpassing that among urban adults, which was 4.00 (P₂₅: 0.00, P₇₅: 7.00) (P < 0.001). The generalized linear model showed that the differences in anxiety between rural and urban Chinese adults were reflected in intermittent fasting and marital status, career status, family per capita monthly income, age, and gender. The Blinder-Oaxaca decomposition revealed that 83.49% of the urban-rural disparities in anxiety among Chinese adults could be explained, and interpersonal network level was the most significant explanatory factor.

Conclusion: The prevalence of anxiety was higher in rural than in urban Chinese adults. The government should identify urban-rural disparities' explanatory factors to target precise intervention strategies, thereby narrowing the mental health differences between rural and urban.

Background: During the early part of the COVID-19 pandemic, travel restrictions were implemented in Greenland to contain SARS-CoV-2 transmission. Despite their widespread use, empirical evidence supporting the effectiveness of travel restrictions is scarce. Greenland was in a unique position to maintain pre-departure testing among travellers, and we aimed to describe the effectiveness of pre-departure testing to inform the implementation of travel restrictions in future outbreaks.

Methods: Our analysis included SARS-Cov-2 PCR test results from travellers, including children, arriving in Greenland from Denmark between June 15, 2020, and January 26, 2022. Additionally, we identified positive tests performed within 14 days post-arrival to Greenland in this population. We estimated the sensitivity of pre-departure screening by dividing the number of positive cases identified pre-departure by the sum of cases identified pre-departure and within 14 days post-arrival in Greenland.

Results: Our analysis covered around 43% of all travellers who underwent pre-departure screening. Out of 26,406 SARS-CoV-2 PCR tests, the proportion of positive tests was 0.6%, which varied over time according to the incidence in Denmark. Overall sensitivity of pre-departure screening was 59% and decreased over time, reaching a minimum of 36% in January 2022. The overall proportion of positive PCR post-arrival tests among all travellers was 0.4%.

Conclusions: Implementing pre-departure PCR testing for SARS-CoV-2 among travellers can be effective in the early stages of outbreaks, particularly in geographical regions like Greenland where community transmission had not yet occurred. Our findings suggest that pre-departure screening of travellers contributed to delaying community transmission in Greenland compared to most other countries, thereby reducing the COVID-19 disease burden.

Introduction: Undernutrition, particularly stunting, and deficiency of micronutrients are prevalent nutrition-related problems in adolescent girls residing in low- and middle-income countries. The coexistence of both kinds of malnutrition typically impacts the most vulnerable people, such as women of reproductive age, and it has a detrimental impact on maternal and child health. Besides, malnutrition and inequality form a vicious cycle that is hard to break without all-encompassing solutions that address every stage of the life cycle. Therefore, this study aimed to assess the presence of socioeconomic inequality in the co-occurrence of anemia and stunting and its contributors in sub-Saharan African countries.

Methods: A total of 39,712 weighted adolescent girl samples from DHS data SSA countries were included in the study. Erreygers normalized concentration index and its concentration curve were used to assess socioeconomic-related inequality in the co-occurrence of anemia and stunting. Decomposition analysis was performed to identify factors contributing to socioeconomic-related inequality.

Results: The weighted Erreygers normalized concentration index for co-occurrence of anemia and stunting was - 0.046 with Standard error = 0.0043 (P value < 0.0001); indicating that co-occurrence of anemia and stunting was disproportionately concentrated among the poor. The decomposition analysis revealed that wealth index, place of residency, adolescent educational level, and unimproved source of water were the major contributors to the pro-poor socioeconomic inequalities in the co-occurrence of anemia and stunting.

Conclusion and recommendation: In this study, there is a pro-poor inequality in the co-occurrence of anemia and stunting. Therefore, it's vital to step up initiatives that improve access to education for adolescent girls, supply of safe water, and boost the economic standing of their country to enhance the level of living status of the population.

Background: During the COVID-19 pandemic, Florida reported some of the highest numbers of cases and deaths in the US; however, county-level variation in COVID-19 outcomes has yet to be comprehensively investigated. The present ecological study aimed to assess correlates of COVID-19 outcomes among Florida counties that explain variation in case rate, mortality rate, and case fatality rate (CFR) across pandemic waves.

Method: We obtained county-level administrative data and COVID-19 case reports from public repositories. We tested spatial autocorrelation to assess geographic clustering in COVID-19 case rate, mortality rate, and CFR. Stepwise linear regression was employed to investigate the association between COVID-19 outcomes and 17 demographic, socioeconomic, and health-related county-level predictors.

Results: We found mortality rate and CFR were significantly higher in rural counties compared to urban counties, among which significant differences in vaccination coverage were also observed. Multivariate analysis found that the percentage of the population aged over 65 years, the percentage of obese people, and the percentage of the rural population were significant predictors of COVID-19 case rate. Median age, vaccination coverage, percentage of people who smoke, and percentage of the population with diabetes were significant influencing factors for CFR. Importantly, higher vaccination coverage was significantly associated with a reduction in case rate (R = -0.26, p = 0.03) and mortality (R = -0.51, p < 0.001). Last, we found that spatial dependencies play a role in explaining variations in COVID-19 CFR among Florida counties.

Conclusion: Our findings emphasize the need for targeted, equitable public health strategies to reduce disparities and enhance population resilience during public health crises.

Objective: This study was conducted to explore the human immunodeficiency virus (HIV) status of and compare HIV knowledge, HIV testing, and other healthy behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO), to provide a scientific basis for targeted HIV interventions for this population.

Methods: A cross-sectional survey was conducted to collect demographic and behavioral information using questionnaires for statistical analysis.

Results: Among 1,993 participants, 772 (38.7%) reported having sexual intercourse with women. The results of the multivariate logistic regression model analysis indicated that MSMW had a lower probability than MSMO of reporting HIV knowledge 1 (adjusted odds ratio [aOR]:0.556, 95% CI: 0.409-0.756), knowledge 2 (aOR:0.626; 95% CI, 0.515-0.761), knowledge 3 (aOR:0.569; 95% CI: 0.447-0.724), informing their HIV status to the last casual sex partners offline (aOR: 0.515, 95% CI: 0.358-0.743), HIV testing more than once in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931), and HIV testing in a hospital in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931). In contrast, MSMW had a higher probability of post-exposure prophylaxis (PEP) intake in the past 6 months (aOR: 2.252, 95% CI: 1.570-3.229), pre-exposure prophylaxis (PrEP) intake in the past 6 months (aOR: 1.630, 95% CI: 1.091-2.434), and cumulative HIV testing more than twice (aOR: 1.917, 95% CI: 1.434-2.563).

Conclusion: MSMW showed significant differences with MSMO in HIV knowledge and HIV related risky reduction behaviors. It is necessary to enhance awareness and skills on HIV self-testing, PEP, and PrEP among MSM. Encouraging HIV knowledge education and HIV testing service are important for MSMW. PEP and PrEP might be enhanced among MSMO for reducing the risk of HIV transmission.

Background: The heightened HIV prevalence in Nigeria is partly associated with challenges in accessing people living with HIV in geographically isolated and unidentified regions. Spatial Data Infrastructure (SDI) is an innovation that has shown promise for HIV case-finding in unidentified settlements. This study reports the use of SDI to improve HIV case identification in Anambra North Senatorial District, Nigeria.

Methods: This study utilised a pre-post intervention study design to analyse data from the implementation of HIV testing services (HTS). Settlements for HTS were identified in the district using SDIs, such as microplans and hotspot maps. Community teams captured areas' names and geolocations using a custom application. Geographical Information Systems technology was overlayed on coordinates to generate microplans and hotspot maps, which were used for targeted tests and new case identification.

Results: Our study showed varying trends across the periods when SDIs were utilised and when they were not. The use of SDI greatly enhanced HIV case identification and provided a strategic framework for HTS implementation. Overall, the period when SDI was used recorded relatively higher new cases than before. Local Government Areas with more rural settlements that leveraged SDI significantly upscaled their case identification.

Conclusions: SDI can facilitate HIV case identification. Our study revealed twice as many cases identified across the periods compared. Our pioneering use of SDI for HIV case finding in Nigeria offers promise for efficient HTS implementation in high-burden and yet-to-be-identified locations.

Background: Breast cancer is the most common type of cancer and the leading cause of cancer death among women worldwide. In 2020, approximately 2.3 million women were newly diagnosed with breast cancer, resulting in around 685,000 deaths globally. The high incidence and prevalence of breast cancer have made it a major public health problem in both developed and developing nations, leading to overburdened health systems and increased direct medical expenditure. This research was conducted to assess the impact of breast cancer awareness programs on breast screening utilization among women in the United Arab Emirates.

Methods: A cross-sectional study using a content-validated interviewer-administered questionnaire was conducted among 959 women aged ≥ 20 years from 31st May 2023 to 31st October 2024, in the United Arab Emirates. Data on sociodemographics, awareness program participation, screening utilization, and barriers were analyzed using descriptive statistics and chi-square tests.

Results: Among the study participants,304 (31.7%) had attended awareness programs. Attendance was associated with younger age, higher education, and being single (p < 0.001). Among those who have ever attended any breast cancer awareness programs who had utilized the screening were 38.5% compared to 13.3% non-attendees (p < 0.001). The study concluded that age, education level, and marital status were significantly associated with participation in breast cancer awareness programs (p-value < 0.05). Key barriers included a lack of physician recommendations (24.3%), knowledge gaps (23%), and cost concerns (22.6%).

Conclusions: The study shows that participation in the awareness programs varied based on age, education and marital status, additionally, those with lower educational levels had a higher attendance at the awareness programs, emphasizing the significance of educational initiatives. The study showed a link between attending breast cancer awareness programs and the use of screening services, furthermore, notable gap in screening utilization such as emotional and perceived barriers were noted. Thus, its necessary to overcome these challenges for enchaning early detection and treatment outcomes. Interventions such as targeted educational campaigns, improved screening facility and better communication between physicians and patients can aid in addressing these challenges.