BMC Public Health最新文献

Background: Overweight and obesity among children is a serious public health challenge worldwide which may lead to a range of negative physical, mental, and social consequences in childhood and later in life. There is a strong need for developing new innovative, integrated approaches and programs which can prevent overweight in children effectively and can be embedded into everyday practices. The Generation Healthy Kids intervention is a multi-component, multi-setting intervention aiming to promote healthy weight and well-being in children aged 6-11 years in Denmark. The present study investigates the feasibility and acceptability of 10 selected school-based intervention components and barriers and facilitators for implementation.

Methods: A seven-week feasibility study was conducted in January to March 2023 among children in 1st and 2nd grade at a Danish public school, testing the multi-component intervention targeting children's meal-, physical activity-, sleep- and screen habits. Process evaluation data were collected using multiple methods (surveys, logbooks, evaluation sheets, registrations, counts, interviews, and observations) and data sources (parents, school staff, and school leader).

Results: Most intervention components were feasible to deliver at the school, but only four components were fully delivered as intended, while the remaining components to some or low degree were delivered as intended. Some components were found acceptable by all/nearly all children (e.g., 40 min of high intensity training three times a week), and others by some or few children (e.g., reusable water bottles and midmorning snack). Intervention activities for the parents and families were found acceptable by all/nearly all participating parents. Parents' acceptability of the intervention activities delivered to their children at school could not be assessed, as only few parents participated in surveys and none in interviews. School staff's acceptability of the intervention tasks they were asked to deliver varied but was overall relatively high. Facilitators and barriers for implementation of intervention components were identified at both individual-, school class-, and school level.

Conclusions: The study underlines the importance of conducting feasibility studies as preparation for large trials. The findings will be used to refine intervention components, implementation strategies and data collection procedures before the Generation Healthy Kids main trial.

Objective: We evaluated the interaction of urinary protein-to-creatinine ratio (UPCR) with diabetes on the risk of cardiovascular events in a cohort study.

Methods: The study population consisted of 639 participants with chronic kidney disease (CKD) stages 2-5, enrolled between 2010 and 2011 in Japan. Cox proportional hazards models were used to evaluate the independent and combined effects of the UPCR and diabetes on cardiovascular events.

Results: During a median follow-up of 3 years, 59 participants developed cardiovascular events during follow-up. A notably higher risk of cardiovascular events was found in participants with proteinuria [hazards ratio (HR): 2.16, 95% confidence interval (95% CI): 1.17-3.97] compared to those without proteinuria at UPCR levels. In addition, the participants with diabetes had a higher risk of cardiovascular events (HR: 2.53, 95% CI: 1.49-4.30) than those without diabetes. Moreover, an interaction was found between UPCR and diabetes on cardiovascular events (P for interaction = 0.04). Participants with both proteinuria (UPCR ≥ 0.5 g/gCr) and diabetes had a 4.09 times higher risk of cardiovascular events (HR: 4.09, 95% CI: 1.97-8.47) compared with those without proteinuria (UPCR < 0.5 g/gCr) and diabetes.

Conclusions: In summary, among participants with CKD stages 2-5, proteinuria and diabetes were found to independently and jointly affect the risk of cardiovascular events. Participants with proteinuria and diabetes had the highest risk of cardiovascular events compared with other groups.

Background: As e-cigarettes gain popularity as potential tobacco cessation aids, concerns arise about their dual use with traditional cigarettes, especially among pregnant women, potentially subjecting both women and fetuses to heightened risks. This systematic review and meta-analysis aimed to determine the overall prevalence of dual use of tobacco smoking and e-cigarette use in pregnant women.

Methods: A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane on October 20, 2023. The included studies reported the number of pregnant women and the count of those who were dual users. Quality assessment was undertaken using the JBI tool. The pooled prevalence of dual use was determined via a random-effects model. All statistical analyses were executed using R software, version 4.3.

Prospero: CRD42023486020.

Results: Eighteen studies were analyzed, encompassing 5,983,363 pregnant women. The meta-analysis indicated an overall prevalence of 4.6% (95% CI: 2.0-10.3) for dual users with significant heterogeneity (I² = 100%). Subgroup analysis based on the country showed a prevalence of 4.9% (95% CI: 2.0 to 11.6) for USA and 8.1% (95% CI: 0.00 to 1.00) for UK. Meta-regression revealed reduction of prevalence of dual use from 2019 to 2023. A potential publication bias was indicated by the LFK index and the Doi plot.

Conclusion: The dual consumption of e-cigarettes and traditional tobacco in pregnant women is a significant health concern, with a notable prevalence. Given the established risks of tobacco smoking during pregnancy and the uncertainties surrounding e-cigarettes, more comprehensive research and public health interventions are urgently needed to address this issue.

Background: This study aimed to understand the vision health status of adolescents in the Western Pacific Region (WPR) using Global Burden of Disease (GBD) data from 1990 to 2019.

Methods: We conducted a comprehensive analysis of blindness and vision loss using GBD data from 1990 to 2019, analyzed trends in the prevalence and burden of blindness and vision loss over time using joinpoint regression, and analyzed their independent effects on blindness and vision loss in three dimensions using age-period-cohort (APC) modeling.

Results: The prevalence of blindness and vision loss among adolescents in the WPR showed an increasing trend between 1990 and 2019 (AAPC: 0.56%) and a slight increase in YLD (AAPC: 0.11%). The joinpoint regression showed a decreasing trend after 2017 (AAPC: -2.45%). The prevalence and burden trended downward in most Western Pacific countries, with only China rising significantly (AAPC prevalence: 0.57%). Refractive disorders had the highest prevalence among the subgroups. The risk of blindness and vision loss in adolescents reduced with age but grew later in time and at later birth. In addition, prevalence and burden were generally higher in females than males.

Conclusions: In the context of a declining global trend in the prevalence and burden of blindness and vision loss among adolescents, there is an increasing trend among adolescents in WPR, with the most pronounced rise in China. This finding has important implications for WPR, suggesting that more attention should be given to adolescent eye health in the region.

Introduction: Tuberculosis(TB), currently has limited treatment options, and faces worldwide threat of drug-resistance(DR). In 2022, the DR-TB prevalence in Cameroon was 1.4% among new-cases and 8.3% among retreatment-cases. We analyzed the DR-TB database to descript the trends and DR-TB profile, treatment-outcome and associated risk-factors so-as-to propose measures to enhance program performance in Cameroon.

Materials and methods: We conducted a retrospective cohort study, analysed the DR-TB database of the Littoral region from 2013 to 2022. We appreciated the data-quality using zero-reporting, completeness, consistency, and validity indicators. We categorized DR-TB into Rifampicin-resistant-TB(RR-TB), multi-drug-resistant-TB(MDR-TB), pre-extensive-drug-resistant-TB(pre-XDR-TB), and XDR-TB and performed descriptive statistics. We assessed DR-TB treatment outcome targeting > 80% cure and/or completed treatment. Multiple logistic regression was used to determine risk factors related to poor treatment outcomes, and adjusted relative risk(RR) was considered significant at p < 0.05.

Results: Overall database quality was 93.7% with uniqueness 100%, data-completeness 82.5%, consistency 97% and validity 95.1%. A total of 567 DR-TB cases were reported, with median age of 34 (1-80) years, male-to-female sex ratio (3:2). Cases were classified as 19(3.4%) RR-TB, 536(94.6%) MDR-TB, 7(1.3%) pre-XDR-TB, and 4(0.7%) XDR-TB. Case-reporting increased from 2013, reaching their peak in 2018. The overall treatment refusal rate was 123(11.9%) and treatment outcomes of 270(60.8%) cured, 116(26.4%) completed, 32(7.2%) deaths, 19(4.3%) lost-to-follow-up, and 6(1.4%) failure were recorded. We identified 84 dead (CFR:14.8%) amongst whom 52(62%) refused treatment, 17(20%) occurred during the first month of therapy and 13(15.5%) HIV-TB co-infected. Male gender [p = 0.006, RR = 2.5 (95% CI: 1.3-4.7)], HIV positive status [p = 0.012, RR = 2.1 (95% CI: 1.2-3.7)], and previous DR-TB status [p = 0.02, RR = 3.9 (95% CI: 1.3-12.0)] were statistically associated to poor treatment outcomes.

Conclusion: In the Littoral Region-Cameroon, cases of DR-TB increased from 2013, reaching their peak in 2018 befor dropping right up to 2022. RR-TB, MDR-TB, Pre-XDR-TB and XDR-TB represented 3.4%, 94.6%, 1.3% and 0.7% of all reported DR-TB cases. Overall, DR-TB treatment success rate was 87.2%. Male-gender, HIV-positive status, and previous DR-TB are associated with poor TB treatment outcomes. We recommend universal drug susceptibility testing to ensure early/maximum DR-TB case-detection and proper pre-treatment counselling to limit the high death rates and anti-TB treatment refusal rates which are setbacks from achieving end-TB strategies.

Background: The misuse of novel psychoactive substances (NPSs) is highly prevalent among university students, leading to significant public health and social safety concerns. To improve our drug education efforts related to NPSs, we developed a knowledge, attitudes and practices (KAP)-based questionnaire for university students.

Methods: We developed a KAP-based questionnaire after performing a comprehensive literature review and consulting experts. The questionnaire was then administered to randomly selected college students in Fujian Province. The items were evaluated using the critical ratio, correlation analysis, and Cronbach's α coefficient. Furthermore, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the construct validity of the questionnaire. Subsequently, the convergent validity, discriminant validity, and reliability of the questionnaire were evaluated.

Results: A total of 587 college students were enrolled, including 280 (47.7%) males and 550 (93.7%) students who had received anti-drug education. Item analysis revealed that 3 items did not meet the t value (t < 4) or correlation coefficient thresholds (r < 3) or that Cronbach's α coefficient increased after removing these items. After conducting EFA, 7 items with multiple loading factors above 0.4 or loading factors below 0.4 were removed, and 5 subdimensions were observed. CFA indicated that the questionnaire model exhibited a strong fit and acceptable convergent validity. However, there were some limitations in discriminant validity. The Cronbach's α coefficients for the overall questionnaire and each dimension exceeded 0.9, indicating excellent internal consistency. Additionally, the questionnaire exhibited excellent split-half reliability (Cronbach's α coefficients > 0.8, Spearman-Brown value = 0.982).

Conclusion: The questionnaire developed herein exhibited high levels of reliability and validity, making it a suitable KAP-based tool for evaluating NPS-related addiction and harm among university students. These findings can guide the development of drug education and behavioral interventions.

Introduction and objective: Modern and intelligent triage systems are used today due to the growing trend of disasters and emergencies worldwide and the increase in the number of injured people facing the challenge of using traditional triage methods. The main objective of this study is to investigate the application of artificial intelligence and Technology in the triage of patients injured by disasters and emergencies and the challenges of the implementation of intelligent triage systems.

Method: The present study is a systematic review and follows PRISMA guidelines. The protocol of this study was registered in PROSPERO with the code CRD42023471415. To find relevant studies, the databases PubMed, Scopus and Web of Science (ISI) were searched without a time limit until September 2024. The scientific search engine Google Scholar and the references of the final articles were read manually for the final review.

Results: The search identified 2,630 articles, narrowing down to 19 high-quality studies on AI in triage, which improved patient care through optimized resource management and real-time data transmission. AI algorithms like OpenPose and YOLO enhanced efficiency in mass casualty incidents, while e-triage systems allowed for continuous vital sign monitoring and faster triaging. AI tools demonstrated high accuracy in diagnosing COVID-19 (94.57%). Implementing intelligent triage systems faced challenges such as trust issues, training needs, equipment shortages, and data privacy concerns.

Conclusion: Developing assessment systems using artificial intelligence enables timely treatment and better resuscitation services for people injured in disasters. For future studies, we recommend designing intelligent triage systems to remove the obstacles in triaging children and disabled people in disasters.

Background: Antimicrobial resistance is a significant global health threat. Therefore, robust surveillance systems for antimicrobial consumption (AMC) are essential to develop public health strategies. However, Latin American countries, including Costa Rica, face challenges in regularly reporting AMC data. This study aims to estimate and analyse the overall AMC in Costa Rica for 2019.

Methods: This study is a national-level, retrospective, observational, and descriptive analysis of AMC in Costa Rica from 1 January to 31 December 2019. The study followed the World Health Organization (WHO) guidelines for the Surveillance of National AMC. The Anatomical Therapeutic Chemical (ATC) / Defined Daily Doses (DDD) system was used to analyse types of antimicrobials and DDD per 1000 inhabitants per day (DID). Antimicrobial dispensation data from the Costa Rican Social Security Fund (CCSS) represented the public sector, while the private sector data was sourced from IQVIA. The analysis included data from both inpatient and outpatient sectors.

Results: A total AMC of 14.32 DID, of which 12.75 DID was within the public sector and 4.12 DID was within the private sector. Penicillins had the highest consumption nationally and in the public sector, while macrolides and lincosamides predominate in the private sector. According to the WHO-AWaRe (Access-Watch-Reserve) classification, antibiotics predominantly consumed nationally (74.7%) and in the public (83.0%) sectors are categorized under Access, whereas the private (61.0%) sector predominates the Watch category.

Conclusion: This study illustrates the importance of enhancing AMC surveillance by integrating data from both the public and private sectors. The findings indicate an excessive use of "Watch" antimicrobials in the private sector. To address this issue, all sectors and regulatory authorities must play an active and supportive role, in the development of effective, multisectoral policies. The methodology employed in this study is applicable to other Latin American countries, and therefore should be utilized for future analysis AMC in this region.

Purpose: This study was aimed to build a prediction model to identify high-risk groups for overweight or obesity among Korean men in their 30s and 40s.

Methods: This study analyzed data from 28,388 men aged 30-40 years, gathered in the 2022 Community Health Survey. Participants were categorized into two groups based on BMI: underweight/normal weight group and overweight/obese group. This study used chi-squared tests and independent t-tests to compare general and health-related characteristics. Moreover, a prediction model was developed using decision tree analysis, and its validity was verified through a split-sample test.

Results: The proportions of participants in the underweight /normal and overweight/obese groups were 50.4% and 49.6%, respectively. The group with the highest overweight/obesity rate at 60.6% had the characteristics of drinking more than 7 cups at a time, being married, and lacking sleep. On the other hand, the group with the lowest overweight or obesity rate (38.7%) had the characteristics of drinking less than 6 cups of alcohol at a time, getting enough sleep, and smoking less than 15 cigarettes.

Conclusions: The rate of overweight and obesity among Korean males in their 30s and 40s is significantly high. This study found that individuals who consume more than seven glasses of alcohol at a time, are married, and do not get enough sleep are at high risk of being overweight or obese. Therefore, it is essential to develop and implement targeted intervention programs for this high-risk group of Korean men in their 30s and 40s.