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Abstract: Objectives The purpose of this study is to investigate the factors influencing the occurrence of medical insurance opportunistic behavior among the public in Northeast China and its importance ranking. Methods Data are from a self-administered anonymous questionnaire survey of participants in Northeast China conducted from January to December 2019. Using a stratified sampling method, a sample of 895 residents aged 18 years or older was selected for the study and analysis. We used a stepwise logistic regression model to analyze the factors influencing the opportunistic behavior of the public within the medical insurance domain and standardized the coefficients of the independent variables in the model to further determine the degree of importance of the relevant influencing factors. Results Opportunistic behavior was found in 34.2% of the participants. The order of importance of the factors influencing participants’ opportunistic behavior were the frequency of occurrence of overmedication by medical practitioners, age, participants’ evaluation of the harm of opportunistic behavior in medical insurance, marital status, participants’ evaluation of the nature of opportunistic behavior in medical insurance, and participants’ evaluation of the prevalence of opportunistic behavior in medical insurance. Conclusion One-third of the participants in northeastern China engage in medical insurance opportunistic behavior. Among them, the frequency of occurrence of overmedication by medical practitioners is the most important factor influencing whether opportunistic behavior occurs. PubDate: 2024-08-01
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Abstract: Aim The accessibility of social media data has allowed researchers to measure official–public interactions during COVID-19. However, previous work analyzing official posts or public comments has failed to explore the link between the two. Therefore, this study investigates the relationship between the communication strategies of public health agencies (PHAs) on TikTok and public emotional/sentiment tendencies in COVID-19 normalization. Subject and methods This study uses the 2022 Shanghai city closure event as a public health communication case study in the context of COVID-19 normalization, using TikTok as a data source. We first analyze the communication strategies adopted by the PHA based on the Crisis and Emergency Risk Communication (CERC) model. Then, we classify the sentiment of public comments using the Large-Scale Knowledge Enhanced Pre-Training for Language Understanding and Generation (ERNIE) pre-training model. Finally, we explore the connection between PHA communication strategies and public sentiment tendencies. Results First, the public’s sentiment tendencies differ at different stages. Therefore, appropriate communication strategies should be developed stage-by-stage. Second, the public’s emotional disposition to different communication strategies varies: government statements, vaccines, and prevention and control programs are more likely to produce a friendly comment environment, while policy and new cases per day are more likely to produce unfavorable comment content. However, this does not mean that policy and new cases per day should be avoided; the judicious use of these two strategies can help PHAs understand the current issues causing public dissatisfaction. Third, videos with celebrity appearances can significantly increase positive public sentiment and, thereby, public participation. Conclusion We propose an improved CERC guideline for China based on the Shanghai lockdown case. PubDate: 2024-08-01
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Abstract: Aim Coronavirus is an airborne and infectious disease and it is crucial to check the impact of climatic risk factors on the transmission of COVID-19. The main objective of this study is to determine the effect of climate risk factors using Bayesian regression analysis. Methods Coronavirus disease 2019, due to the effect of the SARS-CoV-2 virus, has become a serious global public health issue. This disease was identified in Bangladesh on March 8, 2020, though it was initially identified in Wuhan, China. This disease is rapidly transmitted in Bangladesh due to the high population density and complex health policy setting. To meet our goal, The MCMC with Gibbs sampling is used to draw Bayesian inference, which is implemented in WinBUGS software. Results The study revealed that high temperatures reduce confirmed cases and deaths from COVID-19, but low temperatures increase confirmed cases and deaths. High temperatures have decreased the proliferation of COVID-19, reducing the virus’s survival and transmission. Conclusions Considering only the existing scientific evidence, warm and wet climates seem to reduce the spread of COVID-19. However, more climate variables could account for explaining most of the variability in infectious disease transmission. PubDate: 2024-08-01
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Abstract: Aim In Germany, the CTC-EFF (Effectiveness of the Community Prevention System Communities That Care) study, a replication study of the US Community Youth Development Study (CYDS), was rolled out in 2021. This article aims to examine the validity of a translated and adapted version of an instrument that measures five constructs of community capacity for prevention. Subject and methods Twenty-two a priori-matched intervention and comparison communities participated in the study. Two to ten community key informants (n = 182) were interviewed for each community. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted to assess structural validity. Reliability was assessed at the individual level using McDonald’s omega and at the community level using a generalizability coefficient (GC). Inter-rater agreement was measured using an intraclass correlation coefficient (ICC). Concurrent construct validity was assessed using bivariate correlations and mean comparisons. Results CFA showed good model fit (CFI = 0.964) for the hypothesized five constructs model. Reliability analyses showed good internal consistency at the individual level (omega = 0.86–0.87) and insufficient to moderate reliability at the community level (CG = 0.00–0.62). Inter-rater agreement ranged from insufficient to substantial (ICC = 0.02–0.32). Consistent with theory, three constructs correlated positively at the individual and community level (r = 0.24–0.42). There are no associations between these constructs and interviewer ratings about the respondents’ cooperativeness, trustworthiness, and understanding. Conclusion Three of the five constructs were measured with good validity. Two constructs show insufficient reliability. These will be revised until the next CTC-EFF data collection wave. Further validation is indicated. Trial registration This study was registered with the German Clinical Trial Register, no. DRKS00022819, on August 18, 2021. PubDate: 2024-08-01
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Abstract: Objectives To explore the influencing factors of family doctors agreement performance rate in Dongguan City, Guangdong Province. Methods The multi-stage sampling method was used to randomly select family doctors in Dongguan City, Guangdong Province, to investigate the status quo of family doctors performance. Logistic regression analysis was used to investigate the influencing factors of family doctors performance, and decision trees and associations were used to further identify the influencing factors. Results 389 family doctors participated in the survey, and 75.07% of them were generally able to perform their duties. Logistic regression analysis shows that whether a family doctor contracted residents is the influencing factor of family doctor performance behavior. The results of decision tree analysis showed that the biggest influence factor of family doctors performance behavior is whether the family doctors contracted residents or not. The most influential factor in decreasing the average Gini index of random forest also proved this result. Conclusions The performance rate of family doctors in Dongguan City is relatively high. Whether family doctors sign contracts with residents is the influencing factor of family doctors performance. Improving the contract rate of family doctors is the key to improve the performance rate of family doctors. PubDate: 2024-08-01
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Abstract: Aim The Health Gym Program is the main health promotion strategy in the Brazilian public health system. This paper aims to measure the impact of the Health Gym Program on hospital admission expenses for stroke in the state of Pernambuco, Brazil. Subject and methods This public health impact evaluation used a panel of socioeconomic, demographic, and epidemiological data from 2007 to 2019 for all 185 municipalities in the state of Pernambuco. The empirical strategy used pre-tests, ordinary least-squares econometric modeling, and quantile regression as a robustness test. Results The municipalities that implemented the Health Gym Program spent an average of 21.04% less on hospitalizations for stroke than the municipalities that did not, and this result was statistically significant at the 1% level. Further, the density of program coverage within the municipality also impacts the reduction of expenses. This saving is directly proportional to the number of hubs of the program in the municipalities. An increase of one program hub for every 10,000 inhabitants results in a 4.57% reduction in expenditure on stroke hospitalizations in the municipalities. Conclusion The presence of the Health Gym Program led to a reduction in expenses related to hospital admissions for stroke, which may indicate that this program effectively expands the scope of health promotion actions in primary healthcare. The evidence generated from this study can be used to implement evidence-based policies aimed at preventing and controlling chronic diseases in Brazil. PubDate: 2024-08-01
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Abstract: Aim The COVID-19 epidemic has caused risk and uncertainty. This study answers whether and how psychological distress and digital sports influence willingness to take the vaccine and precautionary savings. Subject and methods We conducted a cross-sectional study with an online survey sample of 1016 Shanghai residents who live and work there and are aged between 16–60. All of them experienced the COVID-19 lockdown in Shanghai. We used logistic regressions to examine the relationships between the variables of interest. Results Three findings were demonstrated. First, psychologically distressed individuals are less inclined to take the vaccine. Second, those engaged in fitness activities via digital media platforms are more willing to get vaccinated. Third, psychologically distressed individuals and digital video-based physical exercisers are more likely to precautionary save. Conclusions This study contributes to the literature by documenting how people changed their life from the perspective of finance and health during the lockdown and providing practical implications. PubDate: 2024-08-01
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Abstract: Purpose This study examined the impact, trends, and impact levels of factors affecting Pediculus capitis infestation in primary school students. Subject and methods Among the papers reviewed, 226 were selected, as they contained information that suited the study objectives. Results The factors whose trends have higher gradients have a higher impact on the infestation level. In order of impact, the gradients of hair washing frequency, health instructor involvement, bathing frequency, mother's and father's education, existence of bathing facility, family size, hairstyle, and family income trends are higher than hair length, and age and education trends. As a result, the factor impacts are diminished from the beginning to the end. The importance of the family size, father's and mother's education, bathing facility existence, health instructor involvement, and bathing and hair washing frequency factors, whose trends increased over time, is higher than family income, hairstyle and length, and age and education, whose trends remained constant or decreased. Based on the gradient of the factor level impact trends, it seems that hair washing frequency, father's and mother's education, and health instructor involvement are the factors with the greatest effects on infestation level, in that order. These are followed by the influence of family income and size, and hairstyle factors. The existence of bathing facilities, bathing frequency, hair length, and education factors have weaker effects. Conclusion This work provides the importance and impact levels of factors affecting Pediculus capitis infestation levels in primary school students, which will help meet the needs of policymakers. PubDate: 2024-08-01
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Abstract: Aims This study examines the impact of COVID-19 lockdown on postpartum mothers in England, with the aim of identifying opportunities to improve maternal experience and wellbeing. The postpartum/postnatal period is widely acknowledged as a time when mothers require greater levels of support from multiple sources. However, stay-at-home orders, commonly known as “lockdown,” deployed in some countries to limit COVID-19 transmission reduced access to support. In England, many postpartum mothers navigated household isolation within an intensive mothering and expert parenting culture. Examining the impact of lockdown may reveal strengths and weaknesses in current policy and practice. Subject and methods We conducted online focus groups involving 20 mothers living in London, England, with “lockdown babies,” following up on our earlier online survey on social support and maternal wellbeing. We thematically analysed focus group transcripts, and identified key themes around Lockdown Experience and Determinants of Lockdown Experience. Results Participants raised some positives of lockdown, including fostering connections and protection from external expectations, but also raised many negatives, including social isolation, institutional abandonment, and intense relationships within the household. Potential reasons behind variations in lockdown experience include physical environments, timing of birth, and number of children. Our findings reflect how current systems may be “trapping” some families into the male-breadwinner/female-caregiver family model, while intensive mothering and expert parenting culture may be increasing maternal stress and undermining responsive mothering. Conclusions Facilitating partners to stay at home during the postpartum period (e.g., increasing paternity leave and flexible working) and establishing peer/community support to decentre reliance on professional parenting experts may promote positive postpartum maternal experience and wellbeing. PubDate: 2024-08-01
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Abstract: Aim Covid-19 pandemic and its relative containment measures have affected populations' quality of life and psychological well-being worldwide. The fear related to the pandemic and the imposed containment measures has acted as a trigger causing a global increase in negative mental health states. Thus, we aimed to explore the relationship between fear of covid-19 and mental health via QoL (the first and the second lockdown in Italy, 2020). Subject and methods Through a quantitative cross-lagged path model research design, the study investigates people’s fear of Covid-19, quality of life, and negative mental states in a population of 444 Italian adults (Mean=40.7; Standard Deviation=16.9; 80% women), in the period between the first and the second waves of the pandemic. Results Results show that participants’ Covid-19 fear decreased between waves, contributing to a decrease in negative mental states (stress, anxiety and depression), thus improving the perceived quality of life. Furthermore, quality of life emerged as able to buffer the impact of fear of Covid on people’s psychological distress in short and medium terms, confirming its central role in regulating mental distress. Conclusion The study suggests important guidelines for developing interventions to support the populations’ well-being and mental health. PubDate: 2024-08-01
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Abstract: Introduction Quality of work life and perception affects the productivity of healthcare professionals. The study aimed to determine the quality of work life (QWL) and job satisfaction (JS) of military healthcare professionals in Nigeria. Methods A cross-sectional study was conducted at three military hospitals, one each for the Army, Navy, and Air Force. The 35-item QWL and five-item JS Index questionnaires were used to record responses from consenting professionals between January–March 2022. Appropriate descriptive and inferential statistical analyses were conducted, with p < 0.05 considered significant. Results The overall average QWL score for the population was 86.88 ± 23.04, while overall JS had a mean score of 23.2 ± 7.102. Years of experience (β = –0.292, p = 0.018), and previous posting to war areas (β = –0.285, p = 0.022) were significant predictors of QWL, just as years of experience (β=–0281, p = 0.024) and age (β = 0.235, p = 0.097) were for JS. Conclusion Healthcare professionals serving in the Nigerian Armed Forces have a fair perception of their QWL and JS. PubDate: 2024-08-01
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Abstract: Aim The aim of this study was to assess the prevalence of leftover medicatio10ns and the disposal practices of unused medications among patients visiting public health facilities in northwestern Ethiopia. Subject and methods A multi-center cross-sectional study was conducted among 354 participants in the public health facilities of the south Gondar zone, Amhara region, Ethiopia, from June 1 to 30, 2021. Face-to-face interviews using structured questionnaires were conducted to collect data. The data were analyzed using the statistical package for social sciences (SPSS) version 25 software. Results Of the 354 respondents, 267 (75.4%) had taken medication prior to this study. Of the 267 respondents who had taken medication before, 88 (32.9%) of them had leftover medications. The most common reason for having leftover medications was an improvement in disease condition 37 (42.0%). Even though most of the participants (43.8%) were informed about the negative effects of improper disposal of unneeded medicine, 34 (38.6%) of them threw it into the trash. The majority of participants (53.4%) selected the approved disposal technique suggested by the Food and Drug Administration. Conclusion According to the current study, it is very common to keep drugs at home, and the majority of disposal techniques are not recommended. Additionally, the majority of respondents stated that they did not receive any advice from medical professionals regarding how to dispose of leftover medications. Therefore, it is critical to properly inform and direct patients on how to dispose of unused prescriptions. PubDate: 2024-08-01
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Abstract: Aim To identify predictors of transportation-related barriers to healthcare access in a North American suburb. Subject and methods Data from the 2022 Scarborough Survey were used, comprising n = 528 adults living in Scarborough, which is a subu<rb of Toronto, Canada, recruited through iterative sampling. Log binomial regression models identified demographic, socioeconomic, health and transportation predictors of a composite of: (1) delaying a primary care appointment, (2) missing a primary care appointment or (3) postponing or declining a vaccination due to transportation issues. Results Of the sampled individuals, 34.5% experienced the outcome. In the multivariable model, younger age (RR = 3.03), disability (RR = 2.60), poor mental health (RR = 1.70) and reliance on public transit (RR = 2.09) were associated with greater risk of experiencing the outcome. Full-time employment, reliance on active travel and reliance on others for transportation were specifically associated with greater risk of experiencing a transportation-related barrier to vaccination. Conclusion In suburban areas such as Scarborough, transportation-related barriers to healthcare access have a disproportionate impact on groups defined by important demographic, health and transportation-related characteristics. These results corroborate that transportation is an important determinant of health in suburban areas, the absence of which may exacerbate existing inequities among the most vulnerable individuals in a given population. PubDate: 2024-08-01
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Abstract: Aim The currently recommended exercise methods for patients with diabetes require strict physical fitness and are not suitable for all diabetic patients. This study aims to explore the best exercise combination for diabetic patients and to provide scientific and practical personalized exercise guidance for diabetic patients. Subject and methods Basic information about participants was obtained through questionnaires, physical measurements were performed, and fasting blood samples were collected. Polar area diagrams were used to analyze the relationship between different exercise habits and each index. The polar area graph showed the exercise duration with the best expected effect under a particular frequency and intensity. Two-sample Mendelian randomization (MR) was used to test whether there was a direct causal relationship between exercise and diabetes. Results Polar area diagrams showed that diabetes patients who engaged in moderate- to vigorous-intensity exercise > 60 minutes five times per week had better health indicators. The polar area graph showed that low-intensity exercise once or twice a week required more than 30 minutes to achieve the desired effect. There was no significant difference in any indicators among elderly diabetic patients with different exercise intensities. Conclusion Moderate- to vigorous-intensity exercise for more than 30 minutes five times a week was the most beneficial combination of exercise for diabetes. Low frequency needs to be matched with longer exercise time to achieve the desired effect at low intensity. The relationship between low frequency and long duration weakened when the exercise intensity increased. The levels of all indicators in elderly diabetic patients were unrelated to exercise intensity. PubDate: 2024-08-01
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Abstract: Aim University students are sexually active, and the sexual risk behavior of this group is higher than that of the general population. The prevention of sexually transmitted infections (STIs) emphasizes the need for comprehensive knowledge about behaviors for STI protection and the actual realization of these behaviors. Subject and methods First, an online questionnaire was developed to record the knowledge and realization of STI-protective behaviors among students at Hamburg University of Applied Sciences (HUAS) to conduct quantitative cross-sectional interviews. The sample included 1532 students. Specific aspects of the interview are based on lower response rates. The correlations were then tested by Spearman’s rank correlation coefficient and Pearson’s chi-squared test. Results Significant positive correlations were identified between the self-efficacy (SE) and the use of condoms, STI vaccinations, STI tests, and HIV pre-exposure prophylaxis (PrEP). Significant negative correlations were suggested between substance use and the use of condoms and the use of PrEP and the intake of antiretroviral therapy (ART). Significant positive correlations were identified between the knowledge about STI-protective behaviors and the usage of STI-protective vaccinations, STI tests, and ART. Significant positive correlations were identified between the experiences in terms of STIs and the knowledge about STI-protective vaccinations, use of PrEP, and use of ART. Conclusion Moreover, the results indicate that students with a divergent sexual identity have a higher level of knowledge about STI-protective behaviors. The sexual health of university students should be improved by preventive measures to improve the sexual health of individual students and their social environments. PubDate: 2024-08-01
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Abstract: Aim This paper investigates the effect of a religious holiday (Eid-ul-Fitr in Pakistan) on compliance behaviour instituted during the COVID-19 pandemic. Longstanding religion-based norms of behaviour during the Eid holidays (traveling to meet family members, praying in large gatherings, hugging) may counteract newly established (and weaker) norms of health-preserving behaviours. Method We study the impact of Eid-ul-Fitr on compliance with COVID guidelines for a sample of university students. Our effects are identified by unprompted delays in fielding a survey measuring compliance with prescribed behaviours. Results We find that compliance with guidelines declines immediately after the religious holiday in our sample of students, with no observable decline in other well documented predictors of compliance behaviour (risk perceptions, trust in the authorities). We find that this decline in compliance is largely attributable to male participants, with one important exception. We further confirm our results by conducting robustness checks incorporating matching techniques and a smaller follow-up study where we randomize invitations to the survey. Conclusion We conclude that amid the pandemic, newly formed norms pertaining to healthcare guidelines (focusing on social-distancing) emerged, and were subsequently undercut by longstanding norms of behaviour following a religious celebration: Eid-ul-Fitr. This paper underscores the fragility of these newly emerged norms, especially when challenged by a more well-entrenched, traditional norm. PubDate: 2024-08-01
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Abstract: Aim The present study has designed, implemented, and evaluated a machine learning model that can predict fall risk and fall occurrence in community-dwelling elderly based on their home care usage. Subjects and methods A dataset consisting of 2542 weekly home care records for 1499 citizens (59% female, 41% male) with a mean age of 77 years (SD 10 years) was collected from a large municipality in Denmark. The data were recorded between January 1, 2021, and December 31, 2021. The dataset was divided into two cohorts. Subsequently, five machine learning-based survival analysis models were trained and evaluated using cross-validation. Results The CoxBoost model showed the best discriminative performance with a mean 0.64 (95% CI 0.57–0.72) Harrell’s concordance index, indicating better ranking than chance-level by 14% on average. However, the model could not accurately predict when the next fall would take place. Conclusions The proposed method enables professionals to assess individual fall risk by using home care records from an Electronic Health Record (EHR) system. This facilitates the initiation of targeted fall-prevention programs for those at highest risk. Additionally, it is expected that a risk-based approach can lead to a lower number needed to treat (NNT), indicating greater effectiveness of health interventions. PubDate: 2024-07-30
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Abstract: Aim The world’s population suffers greatly from sedentary lifestyles, which are becoming more common as a result of factors such as a lack of easily accessible places to exercise, a rise in sedentary work practices such as office work, and the pervasive use of television and video devices. Consequently, associated health problems are escalating. The primary goal of this study was to examine the state and features of current trends in international publications regarding the effects of sedentary behavior on the elderly. Subject and methods A bibliometric analysis spanning the years 1994–2022, identifying a total of 311 documents, was carried out using the Web of Science Core Collection. Results The findings showed an exponential increase of 79% from 1997 to the present. The most productive journal categories, authors, and countries were Geriatrics & Gerontology and Public, Environmental & Occupational Health; authors S. Amagasa, N. Fukushima, S. Inoue, and H. Kikuchi; and the United States, respectively. Considerable variation was found in the keywords; “aging” and “sedentary lifestyle” were the most frequent terms, with 97 and 37 instances, respectively. Conclusion Maximum investment in programs promoting physical activity is necessary to improve quality of life as people age. Participants’ mental health will improve as a result of these programs, and their risk of illness will decrease. PubDate: 2024-07-30
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