Journal of public health (Oxford, England)最新文献

Background: Co-design is increasingly used in residential aged care research. However, there is limited literature on how these co-design processes are evaluated, particularly in the absence of co-design evaluation frameworks developed specifically for this setting. We examined how co-design processes used with residents and informal carers to develop healthcare interventions in residential aged care are evaluated.

Methods: Six electronic databases were searched, and 4594 studies reporting co-design of healthcare interventions with older adults and/or informal carers in residential aged care were screened. Data extraction included study characteristics and co-design evaluation practices.

Results: Of 22 included studies, six evaluated their co-design process. Narrative reflection was the most common approach (n = 4). Evaluation was predominantly retrospective and based on researchers' reflections, drawing on data collected during the process. No studies used pre-defined evaluation criteria to measure the impact or effectiveness of the co-design process, or if the process meaningfully involved residents or their informal carers.

Conclusion: Co-design is increasingly used in residential aged care research, although evaluation of these processes is uncommon. As a result, little is known about how effectively co-design is being applied in this setting, or whether it is achieving its core aim of meaningfully involving end-users in research.

Introduction: Accumulating evidence suggests that early-onset and late-onset cancers may be etiologically heterogeneous. Thus, we examined the global distribution of incidence rates of early-onset and late-onset cancers by sex.

Methods: The GLOBOCAN database provides age-standardized incidence rates (ASIRs) of cancers by age and sex across countries worldwide. By defining early-onset and late-onset cancers using the age cut-off of 50 years, we examined global trends in ASIRs of early-onset and late-onset cancers by visualizing data with various graphs.

Results: The top five countries with the highest ASIRs of early-onset and late-onset cancers were concentrated in Europe in men, whereas the rates were scattered across the continents in women. While ASIRs of early-onset cancers had increased steadily over time, the rates were considerably lower than ASIRs of late-onset cancers in both men and women. By cancer type, thyroid cancer and lung cancer ranked first in ASIRs of early-onset and late-onset cancers, respectively, in men. In women, breast cancer ranked first for both early-onset and late-onset cancers. Colorectal cancer appeared among the top five for both early-onset and late-onset cancers across all sexes.

Conclusions: Global ASIRs trends of early-onset and late-onset cancers were heterogeneous with respect to sex, geographic distribution, time-trend, and cancer types.

Background: The World Health Organization's convention, agreement or other international instrument on pandemic prevention, preparedness, and response, often referred to as the 'pandemic treaty', was established with principles to guide implementation. The treaty's underlying ethic was cosmopolitan in intent, emphasizing equal value of all people with obligations stemming from shared humanity.

Methods: The principles of the working draft of 13 July 2022 and the proposed agreement of 22 April 2024 were compared by textual analysis for content and sequence. Changes were analysed using the ethical framework of cosmopolitanism and associated public health implications identified.

Results: Compared with the working draft, the proposed agreement consolidated principles such as solidarity and reduced specific obligations, weakening ethical demands. Sovereignty was elevated to the cardinal principle, while obligations tied to equity and human rights were less specific, reflecting a shift from cosmopolitan intentions and a reduced emphasis on cooperation for shared public health goals.

Conclusions: Changes made through the pandemic treaty negotiation process suggest ethical amnesia, undermining global equity, justice, and solidarity with consequences for public health and pandemic preparedness. Strengthening obligations in the treaty text is essential to embed a collective motivation for cooperation necessary for effective public health before the next pandemic.

Objective: We compared non-laboratory models' efficacy with standard laboratory-based model in identifying high-risk populations for cardiovascular disease (CVD) in resource-limited settings.

Methods: A national sample of 121 672 individuals aged 40-70 from the PERSIAN cohort was analyzed. Non-laboratory models, including the World Health Organization (WHO) and Iranian pooled-cohort CVD mortality models, were compared with the WHO laboratory-based model. Intra-class correlation coefficient (ICC) and concordance correlation coefficient (CCC) were utilized. Sensitivity and specificity of non-laboratory models were evaluated against the laboratory-based one at various risk thresholds. The number of reduced tests in the stepwise approach was calculated considering the Iranian census.

Results: Both non-laboratory and laboratory-based models showed similar trends in predicting CVD risks across age groups. Strong correlations and concordance were observed in both men (ICC: 94.4%, CCC:0.893) and women (ICC: 93.8%, CCC:0.883). Utilizing a 5% risk threshold for WHO non-laboratory and 2% for the Iranian pooled-cohort CVD mortality model as the initial step achieved high sensitivity (99.6%) and moderate specificity (52%) for identifying candidates for the second-step laboratory test. This approach effectively reduced the number of tests by 16 807 982.

Conclusion: Non-laboratory models, in a stepwise approach, offer a promising strategy to alleviate strain on financial resources and enhance healthcare system efficiency in resource-limited countries.

Background: Tobacco smoke exposure was associated with inflammation and adverse health outcomes. However, the impact of early-life tobacco exposure on rheumatic diseases, including rheumatoid arthritis, osteoarthritis, gout, and spondyloarthritis, and the potential modifying role of inflammation are unclear.

Methods: A prospective analysis of over 200 000 participants without rheumatic diseases at baseline in the UK Biobank was conducted. Cox proportional hazards regression models were employed to assess the associations between early-life tobacco exposure with rheumatic diseases. Furthermore, we evaluated whether inflammation status modified these associations.

Results: Among participants, 77,825 (29.0%) experienced in utero tobacco exposure, and 14,216 (5.4%) initiated smoking during childhood. In utero tobacco exposure was associated with increased rheumatic disease incidence, with hazard ratios of 1.18 (1.08, 1.28) for rheumatoid arthritis, 1.10 (1.08, 1.13) for osteoarthritis, 1.12 (1.05, 1.19) for gout, and 1.24 (1.13, 1.35) for spondyloarthritis. Earlier smoking initiation significantly increased the incidence of rheumatic diseases (P < .001), with remarkable trends (Ptrend < .001). Combined associations and interactions were observed between in utero tobacco exposure, smoking initiation age, and inflammation. Participants with high inflammation, in utero tobacco exposure, and earlier smoking initiation had the highest rheumatic disease risk.

Conclusions: In utero tobacco exposure and earlier smoking initiation were associated with an increased risk of rheumatic diseases, especially in those with high inflammation status.

Background: Social prescribing (SP) connects individuals with community resources to address practical, social and emotional needs affecting health. While predominantly located in primary care, SP models have been introduced in some Emergency Departments (EDs). This study evaluated the feasibility, reach and acceptability of an ED-based SP pilot in the United Kingdom.

Methods: Feasibility and reach were assessed through a retrospective review of anonymised patient trackers and clinical records. Acceptability was evaluated via a staff survey exploring knowledge, attitudes and referral practices.

Results: Over 14 months Social Prescribers supported 1,057 ED patients, with mental wellbeing being the most common referral reason. Patients were signposted or referred to over 200 different community organisations. The programme was valued by ED staff, who recognised its potential to improve patient health and wellbeing. Reported barriers included limited awareness of the out-of-hours referral pathway.

Discussion: This is the first published evaluation of an ED-based SP programme, building upon existing conceptual models and qualitative studies that have explored its potential. The findings demonstrate that the model is both feasible and acceptable to staff, while effectively reaching patients with a broad range of health and social needs. Further research is needed to explore long-term impacts on patient outcomes and broader system-wide benefits.

The aim of this study is to examine the impact of comprehensive group interventions on the psychological health of university students after the Türkiye earthquake centered in Kahramanmaras on 6 February 2023. In this research two different studies were conducted. In Study-1, group guidance was organized for all university students (N = 239) studying at the university where researchers work. In Study-II, group counseling was organized for volunteer students were assigned to the intervention group (N = 9). No intervention was applied to the control group (N = 9). The survey and experimental research model were used. Data collection tools consisted of the Personal Information Form, the Post-traumatic Stress Diagnostic Scale, Patient Health Questionnaire, Positive and Negative Affect Scale, Group Guidance and Counseling Questionnaire. Descriptive analyses and two-factor ANOVA for mixed measures were used. As a result, comprehensive group interventions after the Kahramanmaras-centered earthquake have positive effects on the psychological health of university students.

Background: Parental vaccine hesitancy (VH) remains a public health concern in Georgia, where misinformation and distrust continue to hinder routine childhood immunization. VH is shaped by psychological, sociocultural, and informational factors, including trust in science, public authorities, and religious institutions. This study examined whether trust-related variables were stronger predictors of VH than traditional sociodemographic characteristics.

Materials and methods: A cross-sectional study was conducted between 15 May and 13 June 2025, using a structured questionnaire distributed at two pediatric clinics in Tbilisi and online. A total of 1086 parents participated. Vaccine hesitancy was measured using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Data were analyzed using SPSS 26, applying correlation, chi-square, ANOVA, linear regression, and General Linear Models.

Results: The mean PACV score was 10.01, indicating low to moderate hesitancy. Trust in science (mean = 8.16) showed a strong negative association with VH. Trust in public authorities was also inversely related to VH, while higher trust in the Georgian Orthodox Church predicted greater hesitancy.

Conclusion: Trust in science and institutions was more predictive of VH than demographics. Public health strategies should promote scientific literacy and culturally sensitive communication, especially in religious and less-educated communities.

Background: In Nepal, frequent dengue outbreaks have been reported in the past decades leading abrupt and substantial burden to healthcare system. Thus, this study aimed to assess dengue service readiness and factors influencing readiness at health facilities level.

Methods: A convergent parallel mixed method study was conducted in 131 primary healthcare facilities of the Bagmati Province. Key informant interviews were carried out for exploring facilitators and barriers for dengue service readiness.

Results: The majority of primary healthcare facilities were found with sub-optimal readiness for dengue i.e. 63.4% of facilities and readiness was found varied by health facility type, settings, ecological region, and districts. In the study, health facility type [Primary healthcare centers Adjusted Odds Ratio (AOR): 6.1, CI: 1.5-23.9], review and trend analysis practice [AOR: 3.6, CI: 1.1-11.6], and facilities meetings [AOR: 5.8, CI: 1.2-26.7] were identified as key predictors for service readiness. External supervision, quality assurance practice and stakeholder sensitization were explored as facilitators for the readiness.

Conclusions: Improving and expanding dengue services in all primary healthcare facilities, and ecological regions, having regular facilities meeting, review and trend analysis practice and stakeholder sensitization can enhance dengue service readiness at facility level.

Background: The Clalit Active Cohort Study (CACS) assess the impact of lifestyle factors, particularly physical activity, on short- and long-term health outcomes using real-world data. Launched in January 2021, CACS focuses on Clalit Health Services members with supplemental health insurance who use the Clalit Active smartphone app.

Methods: The study integrates data from the Clalit Active app with electronic health records from CHS, covering primary and secondary care, hospitalizations, medications, laboratory results, and imaging. The cohort currently includes 622 584 participants and continues to grow.

Results: The app monitors various health-related behaviors, including physical activity and sleep. Preliminary findings show significant variations in daily step counts based on sociodemographic and clinical factors. Substantial differences were found between app users and non-users app users and non-users. On average, males recorded higher daily step counts compared to females, and individuals under the age of 40 demonstrated greater activity levels than older participants. Participants with pre-existing comorbidities demonstrated lower activity levels.

Conclusions: CACS is a powerful resource for researchers and policymakers, providing insights into the relationship between lifestyle factors and health outcomes within a diverse population. Findings can inform public health policies and guide the lifestyle interventions, highlighting the potential of integrating smartphone data with electronic health records to improve health outcomes.