Authors:Zhuo Jiang, Aixiang Yang, Hao Chen, Yiqiu Shi, Xiaojing Li Abstract: PurposeThe purpose of this study is to develop an intelligent diagnosis model based on the LASSO method to predict the severity of COVID-19 patients.MethodsThe study uses the clinical data of 500 COVID-19 patients from a designated hospital in Guangzhou, China, and selects eight features, including age, sex, dyspnea, comorbidity, complication, lymphocytes (LYM), CRP, and lung injury score, as the most important predictors of COVID-19 severity. The study applies the LASSO method to perform feature selection and regularization, and compares the LASSO method with other machine learning methods, such as ridge regression, support vector machine, and random forest.ResultsThe study finds that the ridge regression model has the best performance among the four models, with an AUROC of 0.92 in the internal validation and 0.91 in the external validation.ConclusionThe study provides a simple, robust, and interpretable model for the intelligent diagnosis of COVID-19 severity, and a convenient and practical tool for the public and the health care workers to assess COVID-19 severity. However, the study also has some limitations and directions for future research, such as the need for more data from different sources and settings, and from prospective, longitudinal, multi-class classification models. The study hopes to contribute to the prevention and control of COVID-19, and to the improvement of the diagnosis and treatment of COVID-19 patients. PubDate: 2024-03-28T00:00:00Z
Authors:Xuebin Zhang, Jing Shi, Meng Chao, Junfeng Yin Abstract: An aging population is one of the main features of China's current population structure, and it is a key area that needs attention to achieve high-quality population development. Because of its unique geographical environment, economic conditions, and sociocultural background, the study of population aging in the karst region of southwest China is particularly important. However, there is a lack of research exploring the regional differentiation of population aging and its influencing factors in the karst regions of southwest China. In light of this, we chose Anshun City, located in Guizhou Province's southwest area, as the case study area. We used the Lorenz curve and spatial autocorrelation to study the differences in the spatial distribution pattern of population aging and introduced multi-scale geographical weighted regression to explore its influencing factors. The results show that Anshun City's older people population proportion (OPP) is generally high with more than 7% of the older people there, making it part of an aging society. The OPP appeared high in the east and low in the west in spatial distribution; the older people population density (OPD) revealed a gradually increasing trend from south to north. At the township scale, both the OPP and the OPD showed significant spatial positive correlation, and the spatial agglomeration characteristics were obvious. OPD and OPP have a positive spatial correlation at the global level, and townships with similar OPP or OPD were spatially adjacent. The spatial distribution characteristics of population aging are the consequence of complex contributions such as natural, social, economic, and karst factors. Further, the spatial distribution pattern of aging is determined by a variety of influencing factors, which have different directions and intensities. Therefore, it is necessary to formulate and implement corresponding policies and strategies to deal with the aging problem in the future. PubDate: 2024-03-28T00:00:00Z
Authors:Xuetao Pu, Rong Jiang, Zhiming Song, Zhihong Liang, Liang Yang Abstract: The rapid development of the Hospital Information System has significantly enhanced the convenience of medical research and the management of medical information. However, the internal misuse and privacy leakage of medical big data are critical issues that need to be addressed in the process of medical research and information management. Access control serves as a method to prevent data misuse and privacy leakage. Nevertheless, traditional access control methods, limited by their single usage scenario and susceptibility to single point failures, fail to adapt to the polymorphic, real-time, and sensitive characteristics of medical big data scenarios. This paper proposes a smart contracts and risk-based access control model (SCR-BAC). This model integrates smart contracts with traditional risk-based access control and deploys risk-based access control policies in the form of smart contracts into the blockchain, thereby ensuring the protection of medical data. The model categorizes risk into historical and current risk, quantifies the historical risk based on the time decay factor and the doctor’s historical behavior, and updates the doctor’s composite risk value in real time. The access control policy, based on the comprehensive risk, is deployed into the blockchain in the form of a smart contract. The distributed nature of the blockchain is utilized to automatically enforce access control, thereby resolving the issue of single point failures. Simulation experiments demonstrate that the access control model proposed in this paper effectively curbs the access behavior of malicious doctors to a certain extent and imposes a limiting effect on the internal abuse and privacy leakage of medical big data. PubDate: 2024-03-28T00:00:00Z
Authors:Jie Deng, Hong Wang, Tingting Fu, Chong Xu, Qiqi Zhu, Liya Guo, Yu Zhu Abstract: ObjectiveOur network meta-analysis aimed to ascertain the effect of physical activity on the visual–spatial working memory of individuals with mild cognitive impairment and Alzheimer’s disease as well as to propose tailored exercise interventions for each group.MethodsEmploying a frequentist approach, we performed a network meta-analysis to compare the effectiveness of different exercise interventions in improving the visual–spatial working memory of individuals with mild cognitive impairment and Alzheimer’s disease. Subsequently, we explored the moderating variables influencing the effectiveness of the exercise interventions through a subgroup analysis.ResultsWe included 34 articles involving 3,074 participants in the meta-analysis, comprised of 1,537 participants from studies on mild cognitive impairment and 1,537 participants from studies on Alzheimer’s disease. The articles included exhibited an average quality score of 6.6 (score studies) and 6.75 (reaction time [RT] studies), all passing the inconsistency test (p > 0.05). In the mild cognitive impairment literature, mind–body exercise emerged as the most effective exercise intervention (SMD = 0.61, 95% CI: 0.07–1.14). In Alzheimer’s disease research, aerobic exercise was identified as the optimal exercise intervention (SMD = 0.39, 95% CI: 0.06–0.71).ConclusionThe results of the subgroup analysis suggest that the most effective approach to enhancing the visual–spatial working memory of individuals with mild cognitive impairment entails exercising at a frequency of three or more times per week for over 60 min each time and at a moderate intensity for more than 3 months. Suitable exercise options include mind–body exercise, multicomponent exercise, resistance exercise, and aerobic exercise. For individuals with Alzheimer’s disease, we recommend moderately intense exercise twice per week for over 90 min per session and for a duration of 3 months or longer, with exercise options encompassing aerobic exercise and resistance exercise. PubDate: 2024-03-28T00:00:00Z
Authors:Forsad Al Hossain, M. Tanjid Hasan Tonmoy, Sri Nuvvula, Brittany P. Chapman, Rajesh K. Gupta, Andrew A. Lover, Rhoel R. Dinglasan, Stephanie Carreiro, Tauhidur Rahman Abstract: Syndromic surveillance is an effective tool for enabling the timely detection of infectious disease outbreaks and facilitating the implementation of effective mitigation strategies by public health authorities. While various information sources are currently utilized to collect syndromic signal data for analysis, the aggregated measurement of cough, an important symptom for many illnesses, is not widely employed as a syndromic signal. With recent advancements in ubiquitous sensing technologies, it becomes feasible to continuously measure population-level cough incidence in a contactless, unobtrusive, and automated manner. In this work, we demonstrate the utility of monitoring aggregated cough count as a syndromic indicator to estimate COVID-19 cases. In our study, we deployed a sensor-based platform (Syndromic Logger) in the emergency room of a large hospital. The platform captured syndromic signals from audio, thermal imaging, and radar, while the ground truth data were collected from the hospital's electronic health record. Our analysis revealed a significant correlation between the aggregated cough count and positive COVID-19 cases in the hospital (Pearson correlation of 0.40, p-value < 0.001). Notably, this correlation was higher than that observed with the number of individuals presenting with fever (ρ = 0.22, p = 0.04), a widely used syndromic signal and screening tool for such diseases. Furthermore, we demonstrate how the data obtained from our Syndromic Logger platform could be leveraged to estimate various COVID-19-related statistics using multiple modeling approaches. Aggregated cough counts and other data, such as people density collected from our platform, can be utilized to predict COVID-19 patient visits related metrics in a hospital waiting room, and SHAP and Gini feature importance-based metrics showed cough count as the important feature for these prediction models. Furthermore, we have shown that predictions based on cough counting outperform models based on fever detection (e.g., temperatures over 39°C), which require more intrusive engagement with the population. Our findings highlight that incorporating cough-counting based signals into syndromic surveillance systems can significantly enhance overall resilience against future public health challenges, such as emerging disease outbreaks or pandemics. PubDate: 2024-03-28T00:00:00Z
Authors:Qiang Li, Yiwen Chen, Yongmei Zhang, Xue Liu Abstract: IntroductionIn response to the increasing demand for long-term care services for older people, the Chinese government has launched a pilot program for long-term care insurance (LTCI) since 2016. The objective of this study is to evaluate the performance and effectiveness of this program in China and provide recommendations for the future development and expansion of the LTCI system.MethodsWe developed a comprehensive evaluation framework to assess these LTCI policies implemented in all 49 pilot cities in China.ResultsBased on our evaluation, the average assessment score for the LTCI program across all pilot cities was 71.8 points, with scores ranging from 57.5 to 92.5 points in these cities. Furthermore, most of the pilot cities achieved higher scores in the fact-based assessment compared to the value-based assessment.DiscussionThe results suggested that the overall pilot effect regarding LTCI was favorable, but there were significant regional disparities. Moreover, in most of pilot cities, current LTCI policies were designed to alleviate both the financial burden and the burden of caring for people with disabilities that families faced. However, some challenges still remained, such as the lack of community and home-based care services, the need to expand the coverage of insurance, and the importance of diversifying funding sources. PubDate: 2024-03-28T00:00:00Z
Authors:Bo Liu, Jie Gu, Chao Wang Abstract: IntroductionWith the increase of urban population density, urban sanitation becomes more severe; urban sanitation has important influence on public health. Therefore, in order to realize the detection of public health in smart cities, the research will use cutting-edge scientific and technological methods to improve urban environmental health, so as to promote the realization of public health achievements. This study introduces public health detection and optimizationtechnologies for smart cities.MethodsFirstly, a data detection system for urban public health environment was established using sensors and intelligent multi-objective technology to evaluate the water quality, air quality, and noise level of the city. Then, an intelligent garbage management system based on Tensor-flow was constructed to achieve efficient garbage collection and treatment. Finally, an intelligent traffic management system was developed to monitor and regulate urban traffic flow.ResultsThe results of the simulation experiment demonstrated that the life data detection system was operationally stable, with a high success rate of 98%. Furthermore, its accuracy in detecting residents’ living environment data was above 95%, the maximum relative error was only 0.0465, making it a reliable and efficient tool. The waste recycling system achieved a minimum accuracy of 83.6%, the highest accuracy rate was 95.3%, making it capable of sorting and recycling urban waste effectively. Additionally, the smart traffic management system led to a 20% reduction in traffic congestion rates, 20 tonnes less tailpipe emissions and an improvement in public health and well-being.DiscussionIn summary, the plan proposed in this study aims to create a more comfortable, safe, and healthy urban public health environment, while providing theoretical support for environmental health management in smart cities. PubDate: 2024-03-28T00:00:00Z
Authors:Mackenzie Fong, Ryan Patrick William Kenny, Katie Thomson, Amrita Jesurasa, Amber Lavans, Maddey Patterson, Letitia Sermin-Reed, Giang Nguyen, Maria Raisa Jessica Aquino, Emer Cullen, Hannah O'Keefe, Malcolm Moffat, Nicola Heslehurst Abstract: Lower-intensity interventions delivered in primary and community care contacts could provide more equitable and scalable weight management support for postnatal women. This mixed-methods systematic review aimed to explore the effectiveness, implementation, and experiences of lower-intensity weight management support delivered by the non-specialist workforce. We included quantitative and qualitative studies of any design that evaluated a lower-intensity weight management intervention delivered by non-specialist workforce in women up to 5 years post-natal, and where intervention effectiveness (weight-related and/or behavioural outcomes), implementation and/or acceptability were reported. PRISMA guidelines were followed, and the review was prospectively registered on PROSPERO (CRD42022371828). Nine electronic databases were searched to identify literature published between database inception to January 2023. This was supplemented with grey literature searches and citation chaining for all included studies and related reviews (completed June 2023). Screening, data extraction and risk of bias assessments were performed in duplicate. Risk of bias was assessed using the Joanna Briggs Institute appraisal tools. Narrative methods were used to synthesise outcomes. Seven unique studies described in 11 reports were included from the Netherlands (n = 2), and the United Kingdom, Germany, Taiwan, Finland, and the United States (n = 1 each). All studies reported weight-related outcomes; four reported diet; four reported physical activity; four reported intervention implementation and process outcomes; and two reported intervention acceptability and experiences. The longest follow-up was 13-months postnatal. Interventions had mixed effects on weight-related outcomes: three studies reported greater weight reduction and/or lower postnatal weight retention in the intervention group, whereas four found no difference or mixed effects. Most studies reporting physical activity or diet outcomes showed no intervention effect, or mixed effects. Interventions were generally perceived as acceptable by women and care providers, although providers had concerns about translation into routine practice. The main limitations of the review were the limited volume of evidence available, and significant heterogeneity in interventions and outcome reporting which limited meaningful comparisons across studies. There is a need for more intervention studies, including process evaluations, with longer follow-up in the postnatal period to understand the role of primary and community care in supporting women’s weight management. Public Health Wales was the primary funder of this review. PubDate: 2024-03-28T00:00:00Z
Authors:Yi Fu, Xiaohan Li Abstract: ObjectiveChina’s middle-aged and older population is a rich source of human capital. Therefore, considering the health of this group is important when creating and using human resources.MethodsUsing data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 baseline survey of 19,000 adults ages 45 years and older, this study was an objective investigation of the effects of work on the physical and mental health of middle-aged and older adults. We conducted several types of analyses using details of participants’ lifestyles and demographic characteristics (living environment, education, financial level, and access to medical services) with work (i.e., employment or volunteer work) as a primary input component of health production to examine their effects on the health status of middle-aged and older individuals.ResultsSix primary outcomes were identified: (1) Employment positively affects both the physical and mental health of middle-aged and older people; (2) Employment can influence the physical and mental health of middle-aged and older people through income, cognitive level, and social support networks; (3) Compared to non-self-employment, self-employment dramatically worsens physical health but has no apparent detrimental effects on mental health. Compared to non-agricultural employment, agricultural labor affects both physical and mental health. (4) Employment has more positive physical and mental health effects in Individuals with higher rather than lower levels of education. (5) Employment opportunities in the eastern region are more likely to promote better physical health than those in the central and western regions of China, although the effects on mental health are negative. (6) When considering groups at different ages of the lifespan, the 60–65-year-old group, who are just entering retirement probably benefit more from continuing work.ConclusionWe provide some recommendations to encourage middle-aged and older people to work and utilize their experience, which will enhance their physical and mental well-being and help them in realize their own value and social integration. PubDate: 2024-03-28T00:00:00Z
Authors:Sirirat Aud-in, Yotin Juprasong, Bannapuch Pinkaew, Kanokporn Talek, Pongsakorn Tantilipikorn, Wisuwat Songnuan Abstract: BackgroundAllergic rhinitis (AR) is a prevalent public health concern globally, significantly impacting quality of life. In Thailand, the prevalence of AR is rising, with grass and weed pollen identified as primary outdoor triggers.ObjectivesThis study aimed to (1) assess patterns of pollen sensitization in Thai AR patients and (2) investigate correlations between demographics/clinical data and SPT results.MethodsA total of 121 individuals aged ≥18 years with clinically diagnosed AR were recruited. Skin prick testing (SPT) was performed using a panel of commonly encountered tropical grass and weed pollen extracts. SPT wheal sizes and clinical symptom scores were recorded. Correlations between SPT outcomes and symptom scores were analyzed.ResultsAmong the participants, 104 (85.95%) exhibited positive SPT reactions to at least one pollen type. Nutsedge (76/121), para grass (57/121), and Bermuda grass (48/121) were the most frequently identified allergens. Hurricane grass elicited the strongest reaction, evidenced by the highest average wheal size (6.2 mm). Poly-sensitization was observed in 77 (63.6%) of the SPT-positive individuals, with most cases involving two different pollen extracts (35/77). Notably, AR severity positively correlated with both average wheal size and the number of positive SPT tests.ConclusionThis study highlights nutsedge, para grass, and Bermuda grass as major allergenic pollen sources for Thai AR patients. Including nutsedge, hurricane grass, and careless weed in clinical SPT panels is recommended for improved diagnostic accuracy. Additionally, the positive correlation between AR severity and pollen reaction strength emphasizes the importance of implementing patient education and avoidance strategies. PubDate: 2024-03-28T00:00:00Z
Authors:Nathanael Sirili, Manase Kilonzi, George Kiwango, Edward Lengai, Ramla Nandala, Dorkasi L. Mwakawanga, Erick G. Philipo, Joseph Matobo Thobias, Gasto Frumence Abstract: BackgroundThe COVID-19 pandemic significantly affected access to healthcare services, particularly among individuals living with Non-Communicable Diseases (NCDs) who require regular healthcare visits. Studies suggest that knowledge about a specific disease is closely linked to the ability to access services for that condition. In preparation for the future, we conducted the study to assess knowledge of NCDs and access to healthcare services among adults residing in rural areas before and during the COVID-19 pandemic.MethodsWe conducted a community-based cross-sectional study in rural Tanzania in October 2022, a few months after the end of the third wave of the COVID-19 pandemic. A total of 689 community residents participated in the study. The level of knowledge of NCDs was assessed using an 11-item Likert questionnaire, which was later dichotomized into adequate and inadequate levels of knowledge. In addition, access to healthcare was assessed before and during the pandemic. We summarized the results using descriptive statistics and logistic regression was applied to determine factors associated with adequate levels of knowledge of NCDs. All statistical tests were two-sided; a p-value PubDate: 2024-03-28T00:00:00Z
Authors:Haiping Hu, Xinxin Yang, Qingquan Chen, Xinfeng Huang, Xiangyu Cao, Xiaoyang Zhang, Youqiong Xu Abstract: BackgroundIn recent years, an increasing number of observational studies have reported the impact of air pollution on autoimmune diseases (ADs). However, no Mendelian randomization (MR) studies have been conducted to investigate the causal relationships. To enhance our understanding of causality, we examined the causal relationships between particulate matter (PM) and nitrogen oxides (NOx) and ADs.MethodsWe utilized genome-wide association study (GWAS) data on PM and NOx from the UK Biobank in European and East Asian populations. We also extracted integrated GWAS data from the Finnish consortium and the Japanese Biobank for two-sample MR analysis. We employed inverse variance weighted (IVW) analysis to assess the causal relationship between PM and NOx exposure and ADs. Additionally, we conducted supplementary analyses using four methods, including IVW (fixed effects), weighted median, weighted mode, and simple mode, to further investigate this relationship.ResultsIn the European population, the results of MR analysis suggested a statistically significant association between PM2.5 and psoriasis only (OR = 3.86; 95% CI: 1.89–7.88; PIVW PubDate: 2024-03-28T00:00:00Z
Authors:Emilie Mosnier, Maxime Hoyer, Fernanda Artigas, Hippolyte Regnault, Elodie Richard, David Michels, Marine Mosnier, Grâce Inegbeze, Manuela Salcedo Robledo, Bruno Spire, Stéphanie Vandentorren, Marc Lescaudron, Carole Eldin, Perrine Roux Abstract: IntroductionGiven the high infection rate of sexually transmitted infections (STI) among migrant women sex workers (WSWs), it is necessary to understand how to improve prevention, information and care for this vulnerable population. Community health workers (CHWs), by linking community to health services, are positioned to improve health outcomes in migrant communities. This article aims to describe a pilot innovative intervention performed by CHWs to improve sexual health in migrant WSWs.MethodsThis one-year intervention study used a respondent-driven sampling (RDS) to recruit a representative cohort of migrant WSWs in Marseille, France. Four CHWs were recruited from different communities and participated in all stages of the research. They performed individual and group interventions of prevention, support in care and empowerment. Data on participant characteristics, type of intervention and adherence to the intervention were reported via questionnaires given to participants. Simultaneously, semi-structured interviews and informal interviews of migrant WSW, CHWs and care providers were carried out.ResultsA total of 132 migrant WSWs were included in the cohort. Very few of them knew about PrEP (12%) or already used HIV post-exposure treatment (9%). Migrant WSWs were often victims of rape or racism, 15 and 21%, respectively. In two-thirds of cases the level of health literacy was low. Participants suffered from a combination of vulnerability factors: difficulties with access to social rights, food or housing. Only 13% reported having benefited from medical follow-up or assistance by an NGO in the 3 months prior to the program. By 3 months, more than one third of the participants had been tested for HIV (35%) and 63% knew about PrEP. A total retention rate of 70% was reported in the cohort after 6 months.ConclusionCHWs enabled to improve care access for migrant WSWs by improving the collaboration between care and social actors at a local level. Through these “bring-back-to” interventions for this hard-to-reach population, CHWs enabled an optimization of the care pathway. Our results also highlight the importance of a population-based approach for individual and group support of empowerment interventions in order to strengthen their capacity for action. PubDate: 2024-03-27T00:00:00Z
Authors:Hongying Hao, Yemin Yuan, Jie Li, Dan Zhao, Peilong Li, Jingjie Sun, Chengchao Zhou Abstract: ObjectiveThe aim of the study was to examine the association between physical activity (PA) and health-related quality of life (HRQOL) among adults and explore the role of age in the association between PA and HRQOL in Shandong, China.MethodsWe investigated the relationship between PA and HRQOL and examined the moderated role of age in this association among adults with different age groups and physical activity levels. Data were obtained from the sixth China National Health Services Survey conducted in Shandong province in 2018. The multi-stage-stratified cluster random sampling method was used to selected respondents, with individuals aged 18 and above included in the present study. The tool of assessing HRQOL was the three-level EuroQol Five Dimensions Questionnaire (EQ-5D-3L).ResultsThe study found PA was significantly related to HRQOL (P < 0.05). The interaction analysis indicated that the relationship between PA and HRQOL was significantly different across young, middle-aged, and older adults (P < 0.05). Older adults with the sufficient PA (coefficient = 0.090, 95%CI: [0.081, 0.100]) and active PA (coefficient = 0.057, 95%CI: [0.043, 0.072]) had significantly higher HRQOL compared with young and middle-aged groups.ConclusionPA was positively associated with HRQOL among the adults. Age played a moderate role between the association between PA and HRQOL. Guidelines for PA should be specifically tailored to adults of different age groups in order to enhance their HRQoL. PubDate: 2024-03-27T00:00:00Z
Authors:Kaiqi Tang, Junfeng Yuan, Lin Luo Abstract: ObjectiveThis study aims to explore the association between health information preferences and specific health behaviors and outcomes, such as preventive measures and chronic disease management among college students. It assesses how different levels of health information preference influence individuals’ utilization, perception, and self-efficacy within healthcare and health information contexts. Given the rising prevalence of non-communicable chronic diseases among younger populations in China, this research seeks to understand how tailored health information preferences can support effective health education and behavioral interventions. The development of the Health Information Preference Questionnaire (HIPQ) aims to bridge the existing gap in tools for assessing health information preferences among Chinese college students, with a focus on collecting validity evidence to confirm the HIPQ’s applicability in this group.MethodsThe study employed a mixed-methods approach, beginning with an initial item pool derived from a comprehensive review of existing research tools, literature, and expert inputs. An expert review panel conducted item evaluations, leading to item reduction for clarity and relevance. The validation process utilized two independent samples of college students, detailing the sample size (n = 446 for preliminary testing, n = 1,593 for validation) and characteristics (age, major, urban vs. rural background) to enhance the understanding of the study’s generalizability.ResultsThe HIPQ, comprising 25 items across five dimensions—prevention-oriented approaches, relationship with healthcare providers, self-efficacy in obtaining health information, perception of the importance of health information, and health information behavior—demonstrated excellent content validity (ICVI ranged from 0.72 to 0.86). Factor analysis confirmed significant loadings for each item across the anticipated factors, with fit indices (RMSEA = 0.065, CFI = 0.942) supporting good model fit. The HIPQ’s reliability was underscored by Cronbach’s alpha coefficients (>0.8) for each subscale, with significant correlations across all subscales, indicating strong internal consistency and construct validity.ConclusionThe HIPQ proves to be a reliable and valid instrument for assessing health information preferences among Chinese college students, highlighting its potential for broader application in health education and intervention strategies. Recognizing the study’s focus on a specific demographic, future research should investigate the HIPQ’s adaptability and utility in broader populations and different cultural settings. The study’s limitations, including its concentrated demographic and context, invite further exploration into the HIPQ’s applicability across diverse groups. Additionally, potential future research directions could include longitudinal studies to assess the impact of tailored health information on actual health outcomes and behaviors. PubDate: 2024-03-27T00:00:00Z
Authors:Anusha Ban, Ashish Shrestha, Carissa Van den Berk-Clark, Janice Ballard, Richard Logan, Tripp Logan, Anne Francioni, Megan Murray, Elizabeth A. Baker Abstract: Public health emergencies, such as the COVID-19 pandemic, elucidate the strengths, weaknesses, and significant gaps in infrastructure, compatibility and consistency in communication systems, as well as the quality of collaborative relationships, and provider and workforce capacity. They also expose longstanding patterns of mistrust in the government and healthcare systems, and inadequacy in socio-economic infrastructures. These issues resulted in higher COVID-19 infection and mortality rates, and lower vaccination rates in many rural counties across the nation, including Missouri. In response to these challenges, the COVID-19 Response Network was formed in the Southeast corner of the state. The Network was a community-academic partnership that brought together community and faith-based leaders, academicians, healthcare providers and administrators, public health practitioners, and pharmacists to facilitate collaboration on education and outreach efforts aimed at reducing vaccine inequity in the 16-county project area. Importantly, the Network also included Community Health Workers (CHWs) who worked with these different agencies and organizations and were at the heart of implementing Network activities. The intent of this study was to assess their perspectives on the factors that influenced community engagement and communication strategies, and increased vaccine uptake in rural Missouri. Qualitative methods, including in-depth interviews, were used to explore the professional and personal experiences of CHWs working at the grassroots level during an ongoing pandemic. Narrative analysis revealed effective communication and engagement strategies for increasing vaccine uptake in rural communities. For instance, fear-based messaging was perceived as coercive and met with resistance. In contrast, messages that shared personal experiences and catered to the human need to protect their loved ones were more effective. Trust in the source of information was critical. This study highlights the significance of exploring and leveraging the capacities of trusted community members like CHWs to increase the effectiveness of public health interventions in rural communities. PubDate: 2024-03-27T00:00:00Z
Authors:Thi Thu Le Pham, Kerry S. O'Brien, Sara Liu, Katharine Gibson, Janneke Berecki-Gisolf Abstract: BackgroundWhile cultural backgrounds are well-documented to be relevant to intentional self-harm, little is known about how cultural and linguistically diverse (CALD) backgrounds affect mortality outcomes following self-harm.AimThis study aimed to compare the risk of all-cause mortality and suicide after intentional hospital admissions for self-harm among people from CALD (vs. non-CALD) backgrounds.MethodLinked hospital and mortality data in Victoria, Australia, was used to assess suicide and all-cause death after hospital admissions for self-harm among patients aged 15+ years. All-cause death was identified by following up on 42,122 self-harm patients (hospitalized between 01 July 2007 and 30 June 2019) until death or 15 February 2021. Suicide death was evaluated in 16,928 self-harm inpatients (01 January 2013 and 31 December 2017) until death or 28 March 2018. Cox regression models were fitted to compare mortality outcomes in self-harm patients from CALD vs. non-CALD backgrounds.OutcomesDuring the follow-up periods, 3,716 of 42,122 (8.8%) participants died by any cause (by 15 February 2021), and 304 of 16,928 (1.8%) people died by suicide (by 28 March 2018). Compared to the non-CALD group, CALD intentional self-harm inpatients had a 20% lower risk of all-cause mortality (HR: 0.8, 95% CI: 0.7–0.9) and a 30% lower risk of suicide (HR: 0.7, 95% CI: 049–0.97). Specifically, being from North Africa/Middle East and Asian backgrounds lowered the all-cause mortality risk; however, the suicide risk in Asians was as high as in non-CALD people.ConclusionOverall, people from CALD backgrounds exhibited lower risks of all-cause mortality and suicide following hospital admission for self-harm compared to the non-CALD group. However, when comparing risks based on regions of birth, significant variations were observed. These findings underscore the importance of implementing culturally tailored background-specific suicide preventive actions. The study focussed on outcomes following hospital admission for self-harm and did not capture outcomes for cases of self-harm that did not result in hospital admission. This limits generalisability, as some CALD people might avoid accessing healthcare after self-harm due to cultural factors. Future research that not limited to hospital data is suggested to build on the results. PubDate: 2024-03-27T00:00:00Z
Authors:Sihyun Song, Jihwan Park, Mi Jung Rho Abstract: IntroductionNumerous COVID-19-related apps were widely used during the COVID-19 pandemic. Among them, those supporting epidemiological investigations were particularly useful. This study explored the effectiveness of apps that support epidemiological investigations, factors influencing users’ intention to use them, and ways to encourage their use.MethodsWe developed and evaluated the KODARI app to demonstrate its importance in epidemiological investigations. After adapting a questionnaire based on an existing evaluation framework for COVID-19–related apps, we collected data from 276 participants through an online survey conducted between April 28 and May 25, 2023. We conducted two independent sample t-tests to determine the differences between each variable according to demographic characteristics and a multiple regression analysis to identify factors affecting intention to use.ResultsUsers were generally satisfied with the KODARI. We observed differences in sex, age, marital status, occupational characteristics, and experience with epidemiological investigation. Females rated the app’s information accuracy higher than males. Males had a higher intention to use than females. Participants aged under 35 years rated information accuracy and transparency highly, whereas single participants rated information accuracy higher than married participants. Occupational groups with frequent interactions with others evaluated their self-determination regarding the application. The app’s self-determination was highly valued among participants with experience in epidemiological investigations. By investigating the factors affecting the intention to use the app, we confirmed that effectiveness, self-determination, and usability significantly affected the intention to use.DiscussionThis study demonstrated the effectiveness of app supporting epidemiological investigations, identified meaningful factors that influence intention to use, and confirmed the applicability of our new framework by considering the specificity of infectious disease situations such as COVID-19. This study provides a new basis for future epidemiological studies. PubDate: 2024-03-27T00:00:00Z
Authors:Zhang Dan-ni, Zheng Guang-min, Du Yu-hua, Lin Ying, Wang Ting, Chen Yuan-yuan, Xie Yu-hong, Xiao Xin-cai Abstract: BackgroundMental health disorders in patients with multi-drug or rifampicin-resistant tuberculosis (MDR/RR-TB) receive consistent attention. Anxiety and depression can manifest and may impact disease progression in patients with MDR/RR-TB. Given the heightened stressors resulting from the COVID-19 pandemic, this scenario is even more concerning.ObjectiveTo evaluate the prevalence of and risk factors associated with anxiety and depression among patients with MDR/RR-TB in southern China.MethodsA facility-based cross-sectional study was undertaken at Guangzhou Chest Hospital in southern China, encompassing a cohort of 219 patients undergoing outpatient and inpatient treatment for MDR/RR-TB. Anxiety and depressive symptoms were assessed using the 7-Item Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire-9 (PHQ-9). The ramifications of anxiety and depression were examined using univariate and multivariate logistic regression analyses, with odds ratios (ORs) and age- and sex-adjusted ORs (AORs) employed to quantify their influence. All data underwent statistical analysis using SPSS 25.0, with statistical significance established at P < 0.05.ResultsTwo hundred and nineteen individuals with MDR/RR-TB were included in the study. The prevalence of anxiety and depression was 57.53% (n = 126) and 65.75% (n = 144), respectively, with 33.3% (n = 73) of the participants experiencing both conditions simultaneously. Multivariate logistic regression analysis revealed that an age of 20–40 years [anxiety AOR = 3.021, 95% confidence interval (CI): 1.240–7.360; depression AOR = 3.538, 95% CI: 1.219–10.268], disease stigma (anxiety AOR = 10.613, 95% CI: 2.966–37.975; depression AOR = 4.514, 95% CI: 2.051–10.108) and poor physical health (anxiety AOR = 7.636, 95% CI: 2.938–19.844; depression AOR = 6.190, 95% CI: 2.468–15.529) were significant risk factors for moderate levels of anxiety and depression.ConclusionsWe found that individuals with MDR/RR-TB had an elevated risk of anxiety and depression. To decrease the likelihood of unfavorable treatment outcomes, it is imperative to carefully monitor the psychological wellbeing of patients with MDR/RR-TB and promptly address any detrimental psychiatric conditions. PubDate: 2024-03-27T00:00:00Z
Open Access journal
