公共卫生研究摘要 (2025-07-20)
共收录 60 篇研究文章
1. Gabapentinoids for Neuropathic Pain After Spinal Cord Injury: An Updated Meta-Analysis of Randomized Controlled Trials.
期刊: Pain practice : the official journal of World Institute of Pain 发表日期: 2025-Sep 链接: PubMed
摘要
Spinal cord injury (SCI) is a debilitating condition frequently associated with chronic symptoms such as central neuropathic pain (CNP) and its related complications. Gabapentinoids are often used in the treatment of post-SCICNP; however, the optimal management of this condition is still unclear. This study aimed to assess the efficacy and safety of gabapentinoids compared with placebo in post-SCI patients affected by CNP. We systematically searched PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) comparing gabapentinoids (gabapentin, pregabalin, or mirogabalin) with placebo in post-SCI patients experiencing CNP.We calculated mean differences (MD) and risk ratios (RR) for continuous and dichotomous outcomes, respectively, with 95% confidence intervals (CI). Pain was measured on a 0 to 10 numerical rating scale. We included 5 RCTs comprising 682 patients. The mean age was 50.2 years, and 83.8% were male. When compared with placebo, patients treated with gabapentinoids experienced a significant decrease in average daily pain (MD -1.75; 95% CI: -3.23 to -0.28; p = 0.02) and pain-related sleep interference (MD -0.99; 95% CI: -1.38 to -0.60; p < 0.001). Additionally, there were higher proportions of individuals with pain intensity relief ≥ 50% (RR 2.19; 95% CI: 1.47 to 3.25; p < 0.001) and with at least some perceived improvement on the clinical global impression scale (RR 1.71; 95% CI: 1.34 to 2.18, p < 0.001) in the gabapentinoids group compared to the placebo group. However, treatment with gabapentinoids was associated with a significantly increased risk of blurred vision (RR 8.55; 95% CI: 1.53 to 47.7; p = 0.02), somnolence (RR 3.77; 95% CI: 2.44 to 5.84; p < 0.001), peripheral edema (RR 2.86; 95% CI: 1.37 to 5.99; p < 0.01), and dizziness (RR 2.83; 95% CI: 1.67 to 4.78; p < 0.001). In this meta-analysis of RCTs evaluating patients with CNP following SCI, gabapentinoids were associated with significant improvements in pain and pain-related sleep interference compared with placebo. Nonetheless, gabapentinoids significantly increased the risk of adverse events.
2. Investing in the Advanced Practice Nursing Workforce to Improve Health System Responses to Armed Conflict.
期刊: International nursing review 发表日期: 2025-Sep 链接: PubMed
摘要
To pose an argument for health systems to improve responses to armed conflict by investing in developing the advanced practice nursing workforce. Armed conflict catalyzes infectious disease, noncommunicable disease, and physical and psychological trauma. Health systems in countries at war face challenges in meeting the health service needs for affected populations while providing sufficient care for the rest of the public. Integrating advanced practice nurses into the workforce is one solution to address the demand for health services during war. Importantly, policies facilitating a quick, efficacious advanced practice nurse response during war must be in place before armed conflict arises. A critical narrative review of peer-reviewed articles was conducted. The review focused on the benefits of advanced practice nurses during crises and systemic policy setbacks preventing advanced practice nurse workforce development. A case study from the Israel-Hamas War is presented. Holistic, patient-centered care positions advanced practice nurses to care for the physical and psychological needs of the population arising from war. Evidence from other public health crises, such as the COVID-19 and H1N1 pandemics, reinforces this notion. However, common policy setbacks, such as an ill-defined scope of practice and a lack of interprofessional awareness of the role, prevent advanced practice nurses from providing care when conflict arises. Israel’s policy efforts before and during the Israel-Hamas War exemplify advanced practice nursing workforce policy development that facilitated an effective response to crisis. Addressing expanded advanced practice nurse authorities before conflict starts will facilitate an improved health system response. Research examining the effectiveness of advanced practice nursing care quality during armed conflict will facilitate national-level investment in advanced practice nursing workforce development.
3. Response: Methodological Considerations for Assessing the Long-Term Impact of Maternal MASLD on Offspring Health.
期刊: Liver international : official journal of the International Association for the Study of the Liver 发表日期: 2025-Aug 链接: PubMed
摘要
4. Pathogenesis, Non-Invasive Assessments and Treatment of Hepatic Fibrosis in Autoimmune Liver Diseases.
期刊: Liver international : official journal of the International Association for the Study of the Liver 发表日期: 2025-Aug 链接: PubMed
摘要
Autoimmune liver diseases (AILD), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), can lead to progressive liver fibrosis, development of cirrhosis, decompensation, hepatocellular carcinoma (HCC), and need for liver transplantation (LT). This review aims to provide a comprehensive overview of the mechanisms of liver fibrogenesis, non-invasive methods to assess hepatic fibrosis and potential anti-fibrotic interventions in AILD. Current management for AILD should incorporate non-invasive methods to evaluate changes in hepatic fibrosis and consider potential interventions aiming at controlling the progression of the disease, interruption and, potentially, reversal of liver fibrosis. Several laboratory tests can help distinguish patients with advanced fibrosis or cirrhosis but their utility in discriminating earlier histological stages of fibrosis is unclear. A current shift toward non-invasive radiological methods, such as vibration-controlled transient elastography, shear wave elastography, acoustic radiation force impulse imaging and magnetic resonance elastography, opens promising avenues for their wide application; however, their performances may be compromised by hepatic inflammation, ascites, biliary obstruction, or concomitant obesity and metabolic dysfunction-associated steatotic liver disease. Corticosteroids and immunomodulators have been shown to regress fibrosis in AIH patients. In PBC, treatment with either synthetic bile acids, farnesoid X receptor agonists or peroxisome proliferator-activated receptor agonist leads to the improvement or stabilization in the fibrosis stage. There is an urgent need for effective medical treatment in PSC, and available evidence of antifibrotic treatment is particularly limited. Promising anti-fibrotic interventions in AILD encompass conventional pharmacological agents as well as potential new treatments, such as fibrates, monoclonal antibodies, and site- and organelle-specific agents.
5. Trauma, complex PTSD, and somatoform dissociation among disadvantaged parents in a community center: Prevalence and relationships with parenting and children's behavioral problems.
期刊: The International journal of social psychiatry 发表日期: 2025-Jul-19 链接: PubMed
摘要
Although the health effects of trauma have been increasingly recognized, much less is known about the intergenerational effects of trauma and its outcomes. This study examined trauma and trauma-related mental health problems among socio-economically disadvantaged parents. We recruited parents in disadvantaged housing and living conditions from a community development center in Hong Kong (response rate = 74.09%). Participants completed standardized self-report measures. In this sample of 203 parents, 40.39% and 43.84%, respectively, reported at least one childhood and adulthood traumatic event; 6.90% suffered from probable ICD-11 PTSD/Complex PTSD and/or somatoform dissociation. Parents’ disturbances in self-organization (DSO) symptoms were associated with problematic parenting styles. Parents’ childhood trauma and DSO symptoms were also associated with children’s behavioral problems. Although trauma is not particularly prevalent in this sample, trauma and trauma-related symptoms are strongly linked to problematic parenting styles (such as over-reacting) and children’s behavioral issues. More attention to the intergenerational effects of trauma is necessary from a public mental health perspective.
6. Women's participation in mobile phone surveys in Mozambique: Findings from a qualitative study.
期刊: Tropical medicine & international health : TM & IH 发表日期: 2025-Jul-19 链接: PubMed
摘要
The use of mobile phone surveys in low- and middle-income countries is increasing as a low-cost and rapid alternative to in-person interviews. However, ensuring they are representative of women and, when women are included reducing potential response bias and harm are important considerations. To improve women’s participation in phone surveys, we conducted a qualitative study in Mozambique to better understand women’s experiences of participating in mobile phone surveys. This study was part of the Rapid Mortality Mobile Phone Survey (RaMMPS) project implemented in Mozambique to test the use of mobile phone interviews for childhood mortality measurement at the national level. We conducted a qualitative study with 32 women who had previously participated in the RAMMPS mobile phone survey. Interviews were conducted both in-person and over the phone. Thematic analysis was done manually using the Framework approach. Gender-related considerations that emerged from the data regarding women’s participation included women’s access to mobile phones, the reduced time burden and convenience of participating in mobile phone interviews compared to in-person interviews, difficulties ensuring privacy in mobile phone surveys, the effect of the interviewer’s gender on participant responses, and women’s safety concerns. Important considerations for including women in mobile phone surveys relate to efforts to reduce response bias and mitigate harm, such as ensuring privacy and considering the gender of the data collector. Addressing these issues is crucial to improving women’s participation and experience in mobile phone surveys.
7. Association of CRP levels and clinical and radiological outcomes in patients with large-vessel occlusion stroke: A MR CLEAN Registry study.
期刊: European stroke journal 发表日期: 2025-Jul-19 链接: PubMed
摘要
Inflammation is important in the pathogenesis of acute ischemic stroke (AIS). The association between CRP and outcomes in patients with large vessel occlusion (LVO) stroke receiving endovascular therapy (EVT) has not been fully elucidated. We used data from the MR CLEAN Registry (2014-2017), including LVO-AIS patients with intracranial carotid atherosclerotic disease (ICAD), extracranial carotid atherosclerotic disease (ECAD) or atrial fibrillation (AF). The primary outcome was modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included mRS ⩾3 at 90 days, all-cause mortality, successful recanalization, and symptomatic intracranial hemorrhages. CRP was analyzed both dichotomously (>3.0 vs ⩽3.0 mg/L) and continuously, using multivariable regression adjusted for potential confounders. Among 865 included patients (ICAD: 286; ECAD: 154; AF: 425), median CRP level was 3.4 mg/L (IQR: 2.0-6.1) and 446 patients had elevated CRP (>3.0 mg/L). AF patients had higher CRP than ICAD and ECAD patients (4.0-3.0-3.2 mg/L, p = 0.002). CRP >3.0 mg/L was not associated with mRS in the full cohort (acOR 0.983, 95% CI (0.767, 1.260)) or in any etiological subgroups (ICAD: acOR = 0.968, 95% CI (0.626, 1.496), ECAD: acOR = 1.114, 95% CI (0.617, 2.012), AF: acOR = 0.937, 95% CI (0.653, 1.344)). There was also no association between CRP and any of the other outcomes. When analyzed as a continuous variable, CRP was also not associated with any other outcomes. We did not observe an association between CRP levels and clinical and radiological outcomes after LVO stroke.
8. Prenatal multiple micronutrient supplementation is associated with improved maternal gestational weight gain: A prospective longitudinal study in Parepare, Indonesia.
期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 发表日期: 2025-Jul-19 链接: PubMed
摘要
The aim of the present study was to assess the association between prenatal multiple micronutrient supplementation (MMS) intake levels and gestational weight gain (GWG) recommendations in pregnant women in Indonesia. We performed a population-based prospective cohort data collection during the rollout of MMS supplementation in Parepare, Indonesia. A total of 1216 pregnant women were enrolled and followed up until after delivery. Data on pre-pregnancy weight, height, and maternal parity were collected, as well as the starting trimester of MMS consumption and total number of tablets consumed. Weight measurements were performed at enrollment and in the late third trimester. The threshold applied for MMS adherence was ≥90 tablets. The Institute of Medicine 2009 guideline was used to determine GWG adequacy. Associations between total MMS consumption and GWG were assessed by binary logistic regression. Women with underweight, normal weight and overweight/obesity accounted for 11.4%, 58.1%, and 30.5% of the cohort, respectively; overall, 63.2% had inadequate, 26.3% had adequate, and 10.5% had excessive GWG; 53.9% consumed ≥90 MMS tablets. Crude analysis showed that women who consumed ≥90 MMS tablets had higher odds of achieving adequate GWG (OR = 1.34, 95% CI: 1.05-1.69). Several potential confounders were examined but did not materially affect the association. Our findings indicate that many women in Indonesia do not achieve adequate GWG. Ensuring the recommended MMS dose during pregnancy may improve nutrition status and increase the likelihood of adequate GWG. Thus, advice on the provision of MMS consumption and appropriate GWG should be part of antenatal care services for all pregnant women.
9. Medicaid expansion and overall mortality among women with cervical cancer.
期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 发表日期: 2025-Jul-19 链接: PubMed
摘要
To assess the association between Medicaid expansion under the Affordable Care Act (ACA) and overall mortality among women with cervical cancer, specifically evaluating changes in stage at diagnosis and treatment utilization and emphasizing differences in survival between early expansion states (implemented by 2014) and non-expansion states. Researchers conducted a retrospective cohort study using data from the National Cancer Database for the period 2006-2021, involving individuals aged 18-64 years. Medicaid expansion served as the primary explanatory variable, classifying states that implemented Medicaid expansion before January 2014 as early expansion states and states that did not expand as non-expansion states. The Difference-in-Differences (DID) analytical method assessed the effects of Medicaid expansion on survival, cancer stage at diagnosis, and treatment utilization, adjusting for demographics, cancer stage, treatment modalities, and incorporating state and year fixed effects. Robust standard errors were clustered at the state level. The analysis included 77 774 women aged 18-64 years diagnosed with cervical cancer, with 37 901 (48.7%) diagnosed pre-ACA and 39 873 (51.3%) diagnosed post-ACA. In early expansion states, Medicaid expansion correlated with a 3.12% increase in early-stage cervical cancer diagnoses (95% confidence interval [CI] 1.74%-4.53%) and a 1.44 percentage point reduction in distant metastatic disease at presentation (95% CI -2.52% to -0.30%). Additionally, there was a 3.24% increase in surgical treatment utilization (95% CI 1.83%-4.62%) compared with non-expansion states. Furthermore, early expansion states demonstrated a 29.12% reduction in overall mortality hazard (95% CI -56.41% to -1.63%), with these survival improvements consistent across racial groups and disease stages. Medicaid expansion was associated with earlier diagnosis, increased surgical treatment utilization, and significantly reduced overall mortality among women with cervical cancer.
10. A Smartphone Application for People Who are Not Ready to Quit Smoking: A Post-intervention Qualitative Assessment of the Phoenix Project.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Jul-19 链接: PubMed
摘要
PurposeTo assess the acceptability and feasibility of the Phoenix smoking cessation smartphone app in people who smoke and are not yet ready to quit.Approach/DesignPost-intervention telephone interview.SettingOklahoma and Texas.ParticipantsAdults who were not ready to quit smoking at baseline (71% female, 76% White, mean age 52.6 years).InterventionThis 26-week 3-arm randomized controlled trial examined the utility of the Phoenix app which encouraged and provided support for smoking cessation attempts through twice-daily messages and weekly surveys.MethodsParticipants (100/152) completed an audio-recorded interview that assessed app engagement including benefits, barriers, most useful features, and suggested app modifications. Transcribed interviews were coded and analyzed for themes.ResultsAdults who were not ready to quit smoking experienced few barriers to using Phoenix app content, and reported increased self-reflection, awareness of smoking behaviors, and motivation to quit smoking in response to the tailored messages and weekly assessments. Participants with less control over daily schedules wanted more access to missed messages and surveys. Messages and surveys were helpful, but participants suggested increasing the variety of message and survey content.ConclusionAdults not yet ready to quit smoking are receptive to using mHealth smoking cessation apps to reduce/quit smoking. mHealth applications can increase access to evidence-based smoking cessation interventions and may be an effective tool for reducing smoking disparities.
11. Associations Between US High School Student and Parental Job Loss During the COVID-19 Pandemic and Adverse Mental Health Outcomes, Short Sleep, and Abuse by a Household Adult.
期刊: American journal of industrial medicine 发表日期: 2025-Jul-19 链接: PubMed
摘要
Parental job loss has been associated with adverse mental health outcomes and child abuse. This study examines associations between student and parental/household adult (referred to as “parent” for brevity) job loss and these outcomes among US high school students during a period of high job loss-early in the COVID-19 pandemic. Adolescent Behaviors and Experiences Survey (ABES) data from January to June 2021 were analyzed to obtain prevalence and adjusted prevalence ratios for select adverse mental health outcomes, short sleep, and emotional and physical abuse by a parent associated with student and parental employment status before and during the pandemic. The sample was composed of 7705 US high school students. Over half of students (55.1%, 95% CI: 52.4%-57.8%) reported emotional abuse by a parent. Parental and student job loss were associated with adverse mental health outcomes and emotional abuse by a parent. However, only parental job loss was associated with physical abuse by a parent, which was reported by 15.3% of students (95% CI: 13.3-17.3). Students who lost a job during the pandemic reported a high prevalence of persistent feelings of sadness and hopelessness (54.9%; 95% CI: 48.5-61.3) and poor mental health during the past 30 days (43.7%; 95% CI: 37.6-49.8). The high levels of adverse mental health outcomes and child abuse associated with parental and student job loss highlight the need for better supports in this area. Identification of the causes and potential interventions related to child maltreatment in the context of household economic stress could help reduce the burden of negative outcomes.
12. Clinical features of medication-related osteonecrosis of the jaw in prostate cancer management.
期刊: BJU international 发表日期: 2025-Jul-19 链接: PubMed
摘要
To evaluate the cumulative incidence of medication-related osteonecrosis of the jaw (MRONJ) in patients with prostate cancer and bone metastases receiving long-term denosumab treatment, and also the occurrence of severe MRONJ and risk factors associated with the development of both MRONJ and severe MRONJ. This retrospective study included 624 patients with prostate cancer and bone metastases treated with denosumab between January 2015 and December 2024. Patients without bone metastasis or with insufficient clinical data were excluded. The study assessed the cumulative incidence of MRONJ, as well as risk factors associated with MRONJ of any stage and severe MRONJ (Stage ≥2). Cox regression analysis was used to identify independent risk factors. The cumulative incidence of MRONJ at 1, 2, 3, and 6 years was 4.6%, 9.6%, 20.3%, and 51.9%, respectively. For severe MRONJ, the corresponding rates were 2.4%, 6.7%, 13.1%, and 27.9%, respectively. Multivariate analysis identified the following independent risk factors for MRONJ: extent of disease grade ≥3 (hazard ratio [HR] 2.00, P = 0.009), use of anticoagulants and/or antiplatelets (HR 2.08, P = 0.026), and a history of dental treatment within the past 6 months (HR 2.29, P = 0.003). Denosumab administration at intervals >1 month was associated with a reduced risk (HR 0.46, P = 0.041). This study demonstrates that long-term denosumab treatment in patients with prostate cancer and bone metastases is associated with a substantial cumulative incidence of MRONJ. Key risk factors were identified, along with a modifiable factor that may reduce risk. These findings suggest that adjusting denosumab dosing schedules could help mitigate MRONJ risk, underscoring the need for personalised treatment plans and early preventive strategies.
13. Impact of first-line antiretroviral therapy choice on adverse drug reactions in children with HIV infection: a retrospective cohort study in southwest China.
期刊: AIDS care 发表日期: 2025-Jul-19 链接: PubMed
摘要
Antiretroviral therapy (ART) is essential in managing children with human immunodeficiency virus (HIV) infection, but is often complicated by adverse drug reactions (ADRs), which can significantly impact therapeutic outcomes. This study investigates ADRs in 375 children with HIV receiving zidovudine (AZT)- or abacavir (ABC)-based ART regimens, using Kaplan-Meier, Cox regression analyses to evaluate ADR incidences, and propensity score matching (PSM) to address confounders. We found ADRs occurred in 21.9% of the cohort. Incidence was significantly higher with the ABC-based regimen (31.2%) versus the AZT-based regimen (17.2%). Most ADRs-primarily gastrointestinal-emerged within the first month of ART. Cox regression analysis confirmed ABC-based regimen nearly tripled the ADR risk (adjusted hazard ratio [aHR] = 2.987, P < 0.001). Notably, children at advanced WHO clinical stages (III-IV) on the ABC-based regimen faced even greater risk (aHR = 3.190, P = 0.005) compared to earlier stages (I-II). These results underscore the need for regimen customization based on disease severity to improve safety and efficacy in pediatric HIV treatment, informing optimized ART protocols and personalized strategies.
14. Mapping of volatile organic compounds in children's saliva using headspace sorbent extraction coupled to TD-GC-MS.
期刊: Expert review of proteomics 发表日期: 2025-Jul-19 链接: PubMed
摘要
Saliva, an easily accessible biofluid, has emerged as a promising source of biomarkers for noninvasive disease diagnostics. Human saliva comprises a complex mixture of volatile organic compounds (VOCs) originating from various sources, including exhaled breath, diet, environmental factors, and the body’s metabolic activity. Their presence in saliva can be influenced by several factors, including age, gender, diet, lifestyle, health status, and the oral microbiome. Qualitative analysis of salivary VOCs as potential indicators of specific lifestyles and early environmental exposure in children was performed. Saliva samples from 40 children were analyzed using a headspace high-capacity sorptive extraction (HS-HiSorb) technique coupled with thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS). The method was developed and conditions such as the choice of sorbent material and sample preparation steps were optimized. A range of VOCs in the saliva samples, including alcohols, aldehydes, ketones, nitrogen and sulfur containing compounds, organic acids, esters and hydrocarbons were identified and a selection of them were quantified. The influence of the HiSorb coating composition and the extraction parameters on the observed chromatographic areas of each analyte were also evaluated. A green sample preparation method for the qualitative analysis of VOCs in the saliva of children was developed.
15. A Novel Questionnaire and Algorithm for Work-Related Asthma Screening and Surveillance: An EAACI Task Force Report.
期刊: Allergy 发表日期: 2025-Jul-19 链接: PubMed
摘要
Work-related exposures contribute to one in six new-onset adult asthma cases and exacerbation of one in five existing cases, which together are termed ‘work-related asthma’ (WRA). A valid and standardized WRA questionnaire is needed for workplace surveillance and epidemiological studies. This project aimed to review evidence on WRA questionnaires and algorithms to propose a standardized instrument. A scoping review was conducted using PubMed, Embase, and Cochrane databases up to March 2021. Search terms focused on asthma, occupational diseases, questionnaires, surveys, and algorithms. High-quality studies were identified and data extracted on instrument construction, validation, and performance. Common questions were used to develop a questionnaire and algorithm for detecting suspected WRA. Six studies were included. The final WRA questionnaire consists of eight questions on general asthma symptoms, diagnosis, and medication; four on WRA symptoms; and two on work-related ocular-nasal symptoms. The algorithm calculates a WRA total score (WRATS) based on the general asthma and work-related symptoms. A score of ≥ 1 triggers a referral for further evaluation. This is the first WRA questionnaire based on validated questionnaires. Evaluation of its performance and validation in diverse geographic and occupational settings are needed for further refinement and translation for broader applications.
16. The 2024 Declaration of Helsinki Revision: Relevance to Nursing Research.
期刊: Journal of advanced nursing 发表日期: 2025-Jul-19 链接: PubMed
摘要
The 2024 revision of the Declaration of Helsinki (DoH) marks a pivotal shift in biomedical research ethics, with significant implications for nursing research. This paper critically evaluates the Declaration’s relevance to nursing practice, with particular attention to challenges in low-resource settings. Key updates emphasising global health equity, environmental sustainability, participant-centred consent and artificial intelligence (AI) governance are examined through nursing’s ethical lenses of justice, beneficence and patient advocacy. Using a multidimensional ethical framework grounded in Virtue Ethics, utilitarianism and phenomenology, the manuscript explores how nurses can ethically engage vulnerable populations, safeguard data privacy and advance inclusive, community-based research. It highlights gaps in the Declaration, particularly regarding algorithmic bias and digital consent and proposes practical strategies for nurse researchers, such as AI governance tools, dynamic consent models and context-sensitive sustainability practices. Rather than treating ethics as an abstract principle, the paper grounds theory in real-world practice, offering case examples that reflect the lived constraints of nursing researchers in underfunded and culturally diverse environments. By aligning ethical ideals with operational realities, this work reinforces nursing’s critical role in shaping equitable and ethically resilient research practices under the revised Declaration.
17. "Healthcare professionals' attitudes towards euthanasia in the Balearic Islands.".
期刊: BMC medical ethics 发表日期: 2025-Jul-19 链接: PubMed
摘要
Euthanasia is a topic of ethical, legal, and medical debate, particularly among healthcare professionals, who play a key role in its implementation. Their attitudes toward euthanasia are essential for shaping healthcare policies and training programs, as these professionals must navigate complex moral and practical considerations in their daily practice. Understanding these perspectives is key to ensuring appropriate policy development and providing effective education for healthcare providers. This study aims to analyze the sociodemographic factors influencing attitudes toward euthanasia among healthcare professionals in the Balearic Islands and examine the correlation between two scales measuring these attitudes. A cross-sectional study was conducted with a sample of 746 healthcare professionals from the Balearic Health Service. Participants completed a validated questionnaire assessing their attitudes toward euthanasia with the Euthanasia Attitude Scale and the Attitude Toward Euthanasia, along with a socio-demographic questionnaire. The findings reveal that attitudes toward euthanasia are significantly influenced by variables such as age, gender, religious beliefs, and professional experience. Younger professionals, males, and those with fewer religious convictions tend to express more favorable attitudes toward euthanasia. Differences were also observed across professional categories, with nurses generally showing greater acceptance compared to physicians and other healthcare workers. Sociodemographic factors play a crucial role in shaping healthcare professionals’ attitudes toward euthanasia. These findings underscore the importance of tailored educational strategies and policy considerations to address diverse perspectives within the healthcare sector.
18. Nursing and midwifery students' perceptions of sign language training in Ghana: relevance, instructional methods, and assessment practices.
期刊: BMC nursing 发表日期: 2025-Jul-18 链接: PubMed
摘要
Effective communication between healthcare practitioners and patients is essential in ensuring quality healthcare delivery and the attainment of positive health outcomes. However, many healthcare providers lack adequate training to communicate appropriately with patients with hearing loss or hard-of-hearing patients, resulting in avoidable barriers to quality care. Despite the recent integration of sign language training into the curriculum of nursing and midwifery, research examining its application and effectiveness remains limited. This study examines the perceived relevance, teaching methods, and assessment practices of sign language training in Ghana. A cross-sectional survey design was employed using a standardised questionnaire to collect data from a convenience sample of 468 s and final-year nursing and midwifery students who had completed a sign language course. Data were analysed using descriptive statistics in IBM SPSS (version 23). Students recognised the importance of sign language training in providing care for people with hearing loss and the hard-of-hearing community (mean = 3.85, standard deviation = 1.067) and promoting diversity in healthcare (mean = 3.81, standard deviation = 1.045). However, they expressed limited confidence in applying these skills in practical settings (mean = 2.93, standard deviation = 1.207). While students appreciated the engaging instructional methods (mean = 3.70, standard deviation = 1.126) and the validity of assessment practices (mean = 3.77, standard deviation = 1.010), they emphasised the need for more practical training, timely feedback, and continuous skill development to enhance communication with deaf and hard-of-hearing patients. The findings highlight the value of sign language training but reveal gaps in students’ confidence and practical application. Recommendations include increasing practical training opportunities, standardising assessment and feedback mechanisms, and integrating professional interpreters where necessary. Future research should explore the long-term impact of sign language training, evaluate teaching methods, and assess deaf and hard-of-hearing patients’ perspectives on interactions with healthcare professionals. Not applicable.
19. A global living systematic review and meta-analysis hub of emerging vaccines in pregnancy and childhood.
期刊: Reproductive health 发表日期: 2025-Jul-18 链接: PubMed
摘要
The COVID-19 pandemic accelerated vaccine development and generated a rapidly evolving body of evidence before and after the vaccine rollout. We developed a robust online platform to efficiently synthesize this emerging information for current and future challenges. Expanding upon our interactive living systematic review-initially focused on COVID-19- we now include chikungunya and Lassa fever (with protocols presented in this issue), Mpox, and Disease X ( https://www.safeinpregnancy.org ). We aim to continuously monitor and periodically update and disseminate high-quality data on vaccine safety, efficacy, effectiveness, and immunogenicity in pregnancy and childhood. This platform computes real-time meta-analyses and features a visualization tool to present findings in a clear and accessible manner, supporting decision-making, vaccine development pipelines, and implementation strategies worldwide. It is also designed to integrate data on a hub of emerging vaccines in pregnancy and childhood and reflects a collaborative effort among multiple organizations.
20. Developing a cross-organisational physiotherapy-specific critical care competency framework to enable collaborative working: an overview of the integration journey across an academic health science centre.
期刊: BMC health services research 发表日期: 2025-Jul-18 链接: PubMed
摘要
Competency frameworks are commonly used to define expectations, aid acquisition of appropriate skills and ensure safe delivery of care to patients. The Intensive Care Society’s Allied Health Professionals Critical Care Professional Development Framework (CCPDF) provides broad descriptors of levels of practice ranging from novice to expert. Prior to May 2021, no standardised clinical competency frameworks governed physiotherapy practice or development in the critical care setting in the UK. The aim was to develop and evaluate the value of a cross-organisational, physiotherapy-specific, critical care competency framework to enable collaborative working in a partnership comprising of three previously independent NHS foundation trusts across six sites within an academic health science centre. Between May and November 2021, a pragmatic approach following the first three stages of Whiddett and Hollyforde’s process for developing a tailored competency framework was used: 1) preparation, 2) information collection and 3) compiling the framework and validation. Following analysis of key documents and through comprehensive engagement, a proposed competency framework was agreed upon, reflecting levels from Foundation to Expert. Competencies were categorised into eight areas: Anatomy and Physiology, Assessment, Laboratory and Pharmacy, Respiratory Support, Airway Clearance Techniques, Tracheostomy, Rehabilitation, and Communication, Documentation, and Teamwork. A survey was sent to 112 staff with a 39% response rate. Most respondents said the framework would support improvement in patient care and staff development, with time and staffing being barriers to use. An online format was preferred. The final document was called Kings Health Partners Physiotherapy Critical Care PROSPECTS (PROfession SPecific Excpectations, CompeTencies and Skills) Framework. It was valued by users as a self-assessment document and tool for career development and learning opportunities. Future work will focus on piloting the framework and developing associated learning resources.
21. "I think that that really could benefit a lonely user:" perceptions of overdose response hotlines among people who use opioids.
期刊: Harm reduction journal 发表日期: 2025-Jul-18 链接: PubMed
摘要
Overdose response hotlines, such as the SafeSpot and Never Use Alone phone hotlines and Brave smartphone application, are promising tools to reduce fatal overdose risk among people who use drugs (PWUD). These free and confidential services connect callers to a trained operator who monitors them for adverse reactions during and after drug use. We explored PWUD’s perceptions of overdose response hotlines. PWUD receiving substance use treatment in a facility in a Midwestern US city were screened for eligibility using the NIDA-Modified ASSIST questionnaire and invited to enroll if they had a moderate or severe substance involvement score for use of street or prescription opioids. Ten participants completed a 30-45-minute in-depth interview focused on overdose prevention, including perceptions and use of overdose response hotlines, in February 2022. Inductive content analysis was used to describe perspectives on overdose response hotlines. Only 1 of the 10 participants had heard of overdose response hotlines, but most were optimistic about their potential benefits for PWUD. One participant said, “I believe that if word was out there, people would use it.” Another stated, “I would trust it today. I know that there is [sic] people trying to change what’s going on in our culture with opiates.” Participants described several potential barriers to utilization, including distrust, especially in the context of drug-induced paranoia and concerns about being arrested, and the cost of an emergency medical response if an overdose occurred. One participant stated, “people get paranoid when they’re using drugs. And to be like, ‘I’m using!’ over the phone, that’s not too easy.” Another said, “If you call 911, the police are coming and if you’re using, you’re going to jail.” Overdose response hotlines are acceptable and trustworthy fatal overdose prevention tools. However, several barriers may limit their utilization, including distrust, drug-induced paranoia, and the cost and potential consequences should an overdose occur, including arrest or cost of emergency response. Further study of utilization, acceptability, and policy and practical solutions addressing perceived barriers to utilizing these services are needed.
22. HOME protocol for a national online survey of people who inject drugs.
期刊: Harm reduction journal 发表日期: 2025-Jul-18 链接: PubMed
摘要
Most surveys of people who inject drugs (PWID) fail to represent the full population of PWID, because usual recruitment methods do not achieve geographic and sociodemographic diversity. People of color, people residing in rural and/or harm reduction-deprived areas, and people who rarely connect with social services are the least surveyed and understood PWID populations. Online-based recruitment and surveys may better reach these hidden PWID populations than standard venue-based recruitment. As technology use and internet access become more ubiquitous, even for unstably housed populations, research using online-based recruitment and survey techniques are growing in the substance use field. These methods hold promise for obtaining larger and more diverse PWID samples, but there are no standards for using online recruitment and survey administration methods to reach large populations of PWID vulnerable to overdose and other threats. Best practices are needed to maximize data quality, prevent fraudulent responses, and minimize selection biases. The HOME (Harm reduction services Offered through Mail-delivery Expansion) study recruits and enrolls a national, online-recruited, longitudinal cohort of 1233 PWID and follows them for 18 months. Key objectives are to assess prior harm reduction utilization and future uptake of mail-based harm reduction services and retention in these services. We describe our online data collection protocol, including recruitment approaches, detecting fraud, maximizing data quality, and participant retention throughout follow-up. These strategies can inform subsequent large-scale, nationwide efforts that recruit PWID through the internet.
23. Characterizing changes to harm reduction site operations in British Columbia following the implementation of the decriminalization of drugs: Findings from a provincial survey.
期刊: Harm reduction journal 发表日期: 2025-Jul-18 链接: PubMed
摘要
In January 2023, British Columbia (BC), Canada, piloted a three-year decriminalization policy to address the escalating overdose crisis. The policy seeks to reduce stigma and the fear of criminal prosecution, and foster a safer and more supportive environment, encouraging greater utilization of treatment and harm reduction (HR) services among people who use drugs. There are limited data on the operational characteristics of HR sites in BC, which are essential for monitoring how decriminalization may influence service operations and utilization. This study aimed to characterize HR site operations in BC and assess any operational changes following decriminalization. A cross-sectional, online self-report survey was distributed to HR sites across BC between March and April 2024. The survey was completed by a site representative, and survey questions focused on client demographics and drug use patterns, service uptake and capacity, resource and staffing demands, police activity near sites, and the availability of HR services. Changes pre-and post-decriminalization were analyzed descriptively to identify trends. A total of 33 HR sites completed the survey. Almost a third (30%) of sites reported an increase in client’s post-decriminalization, and 18% indicated plans to expand or modify services to meet the increasing demand. However, challenges related to staffing and resources were highlighted, with 45% of sites reporting increased staffing demands post-decriminalization, and 33% noting changes to resource needs, most of which increased. Five sites reported an increase in annual operating budgets. Nearly half (43%) of sites that experienced police activity around their site reported increased police activity post-decriminalization. Moreover, approximately one-fifth (21%) of sites received formal decriminalization training. HR sites have experienced an increase in client engagement post-decriminalization, reporting challenges related to site capacity and funding, and emphasizing the need for additional investments to support and expand HR services. Consideration should be given to needs-based planning and providing decriminalization training to HR staff. Moreover, steps are necessary to address the continued police presence near sites, which may hinder service uptake and perpetuate stigma. Addressing these gaps is critical for improving health system engagement for people who use drugs and achieving the goals of decriminalization.
24. English- and Spanish-speaking U.S. adults' perceptions of the most common reasons for abortion: a study of open-ended data before and after Dobbs v. Jackson.
期刊: Reproductive health 发表日期: 2025-Jul-18 链接: PubMed
摘要
The 2022 Dobbs v. Jackson decision, which overturned Roe v. Wade, has given individual states more capacity to legislate abortion. State legislators have and continue to design and pass laws that restrict or ban abortion, often naming exceptions based on specific reasons (i.e., fetal health, woman’s health, rape). Given that these reasons often do not align with those reported by abortion-seekers, it is crucial to assess whether the U.S. public accurately understands why people seek abortions. This study explored a sample of U.S. adults’ perceptions of the three most common reasons why someone might get an abortion. We analyzed open-ended data from two waves of a 2022 longitudinal survey (n = 681 participants; n = 2,043 responses per wave; n = 4,086 total responses) collected before and after the Dobbs decision in English and Spanish via Ipsos’s KnowledgePanel®. We explored three main research questions: (1) What does the U.S. public perceive to be the most common reasons for someone to seek abortion? (2) Are there differences in perceived reasons before and after the Dobbs v. Jackson decision? (3) Are there differences in perceived reasons across languages? Findings indicated that people perceive the three most common reasons to seek abortion to be: unwanted/unplanned pregnancy reasons, violence-related reasons, and health reasons. After the Dobbs decision, there was an increase in respondents mentioning that people have abortions for health reasons and financial reasons, and a decrease in responses related to unwanted/unplanned pregnancy reasons, not ready/unprepared reasons, and partner-related reasons. Additionally, we found significant differences in perceptions between languages (i.e., English and Spanish). We also note discrepancies between perceived reasons among our sample and reasons reported by abortion patients in national studies. This study underscores the public’s misconceptions of reasons for seeking abortion and the importance of correcting such misunderstandings to ensure alignment of public sentiment and legislative and judicial policy post-Dobbs.
25. Effect of behavioural modification for small portions size consumption on BMI in college students of North India: a quasi experimental study.
期刊: Journal of health, population, and nutrition 发表日期: 2025-Jul-18 链接: PubMed
摘要
Large meal portions contribute to the rise in Body Mass Index (BMI) leading to higher burden of Non-Communicable Diseases (NCDs), especially among the youths. College students frequently exhibit poor dietary habits; thus, it is important to pay attention to their eating habits in order to lower their risk for NCD. Therefore, we conducted this study with objective to measure the effect of health promotion intervention for small portion size consumption behaviour on body mass index (BMI) among college students in Chandigarh, India. We conducted this quasi-experimental research among college students aged 18-21 years from two colleges with co-education, having same streams considered as intervention and control from 2019 to 2020. Motivating group therapy, individual counselling, classroom training including power point presentations, lectures, and messaging via WhatsApp were implemented to the intervention group. No intervention was applied to the control group. Overall, the mean BMI decreased in the both the intervention (n = 149) and control groups (n = 142) between the baseline and 6 months post intervention follow up period. The difference in difference (DID) of mean using paired t-test analysis showed that the estimated difference between the two groups was statistically significant for BMI (0.21; 95% CI 0.117-0.244; p-value < 0.001) and for waist hip ratio (0.02; 95% CI 0.001-0.005; p-value 007). There was reduction of 8.1% (from 28.9 to 20.8%) in obese, while 2.7% (from 44.3 to 47.0%) increase in participants with normal BMI in intervention. On the contrary there was almost no change in the proportion of obese and overweight participants in control group after 6 months. Considering the higher surge of obesity especially among the Indian youths, this study provided significant contribution in the field of public health in view of effective health promotion intervention to reduce BMI levels, by which get hold of the rising trend of this alarming problem. We recommend pragmatic community level large scale randomised control trials with frequent and controlled follow up to generate further evidence.
26. Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision.
期刊: Malaria journal 发表日期: 2025-Jul-18 链接: PubMed
摘要
Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related problems. Hence, this study aimed to determine the level of adherence to malaria diagnosis and treatment guidelines among healthcare providers working in the public health facilities in Southwest Ethiopian Peoples Regional State (SWEPRS). A facility-based cross-sectional study triangulated with qualitative inquiry was applied from March 2024 and July 2024. A multi-stage stratified and purposive sampling technique was used for the quantitative and qualitative study, respectively. Data were collected by the records review, Focus Group Discussions (FGDs), and In-depth Interviews (IDIs). The adherence of healthcare providers was evaluated according to recommendations of the current malaria diagnosis and treatment guidelines. The findings in the qualitative analysis were presented in the thematic analysis and triangulated with the quantitative findings. 1,684 patient cards were reviewed. The mean age of patients was 20.99 (± 15.61) years. 1,616 (95.96%) patients were screened through microscopy and/or multispecies rapid diagnostic tests (RDT). The overall adherence of healthcare providers to the updated malaria treatment standards was 36.99% (95%CI: 33.93-38.52%) and the majority, 982 (58.31%) were diagnosed with Plasmodium falciparum followed by Plasmodium vivax, and mixed infections. Shortage of anti-malarial drugs was reported as the foremost barrier followed by lack of training on the updated malaria case management guideline, shortage of health professionals, and lack of laboratory materials. In addition, shortage of electric supply, shortage of computers, shortage of outpatient department (OPD) rooms, lack of transport, distance from a health facility, community resistance, improper use of prescribed anti-malarial drugs, perceived inefficacy of drugs, inability to afford the anti-malarial drugs, lack of new malaria case management guideline, lack of private pharmacy, language barriers, and poor quality of Giemsa, were identified barriers. The adherence level of healthcare providers was found to be low. Hence, ensuring the availability of all nationally recommended anti-malarial drugs and supplies, qualified health professionals, providing continuous training, strengthening continuous follow-up and supervision in the public health facilities are recommended to improve the adherence level of health professionals to national malaria treatment guideline.
27. Acute splenic torsion in an adolescent with polysplenia syndrome: case report.
期刊: Italian journal of pediatrics 发表日期: 2025-Jul-18 链接: PubMed
摘要
Splenic torsion is a rare but potentially serious event. It can occur in association with various anatomical anomalies, such as polysplenia. The presence of multiple small spleens is often associated with other abdominal and chest abnormalities, defining a condition known as Polysplenia Syndrome (PSS). We report on a 14-year-old girl who presented with a 3-day history of left lower abdominal pain and vomiting, with a known history of congenital heart disease associated with Situs Viscerum Inversus and polysplenia. She was found to have normal vital signs but elevated C-reactive protein, and leukocytosis with neutrophilia. In light of the clinical and laboratory data, in addition to the suggestive imaging findings revealed on US and contrast-enhanced abdominal CT, a splenic torsion was suspected. The patient underwent a laparotomy, which confirmed a pedunculated mass in the left flank and iliac fossa, consistent with torsion of one of the spleens, and allowing complete resection of the lesion. The postoperative course was uneventful, and she was discharged after 10 days. Splenic torsion in PSS is an extremely rare condition that may present in a time-critical manner, with nonspecific clinical manifestations and abnormal laboratory results, representing a real diagnostic challenge.
28. Using time use diaries to assess physical activity and sedentary behavior in jail populations.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
People incarcerated have limited access to physical activity and there are challenges to accurately measure their physical activity in jail settings. We aimed to (1) determine the feasibility of time use diaries to measure physical activity and sedentary time among people incarcerated in jail and (2) estimate time spent in physical activity and sedentary behaviors, overall and by gender and job assignment. In July 2023, we recruited women and men from two housing units at Yavapai County Detention Facility, a county jail in Camp Verde, Arizona. Participants were asked to complete a four-day time use diary, documenting activities in 10-minute increments. Participants provided feedback about the diary during listening sessions after the four-day period. Feasibility was measured as the proportion of people recruited who participated and the proportion of completed and returned diaries. Activities documented in the diaries were linked to the Compendium of Physical Activities to determine intensity and duration of physical activity and sedentary behavior. Average daily time spent in physical activity and sedentary behavior was calculated for each participant. Of the 24 women and 41 men recruited, 24 (100%) women and 40 (97.5%) men agreed to participate in the study. All diaries were returned. Most (82.8%) participants completed all four days in the diary. Participants were enthusiastic about filling out the diaries because they helped pass the time and felt the work would further knowledge and wellbeing in jails. Participants made concrete recommendations including altering the diary format to allow for additional detail about their time in jail. Participants spent on average 571 minutes sedentary, 79 minutes in light activity, and 60 minutes in moderate activity per day. Women spent 66 more minutes per day engaged in light activities compared to men. Women with job assignments spent 179 less minutes in sedentary behavior and 245 more minutes in moderate activity compared to women who did not have a job assignment. Time use diaries are a feasible and appropriate way to measure physical activity and sedentary behavior among people incarcerated in jail.
29. Decomposing socioeconomic inequalities in contraceptive use among Kurdish women: a cross-sectional analysis of the ravansar cohort study.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
Access to contraception methods is essential for reproductive health and family planning; however, socioeconomic disparities influence their utilization. This study aimed to examine socioeconomic inequalities in contraceptive use (CU) among Kurdish women in western Iran, using data from the Ravansar Non-Communicable Disease (RaNCD) cohort study. Data from 4,823 married women aged 35 years and older were analyzed, categoriezed by their history of CU. The Wagstaff normalized concentration index was employed to assess income-related inequalities. Two separate models were developed to analyze the contributing factors for the use of temporary contraceptive methods and tubectomy. Decomposition analysis was conducted to identify the contributions of various factors, including age, marital status, age at first pregnancy, number of live births, place of residence, and socioeconomic status (SES). The findings revealed that 83.79% of participants had a history of CU. Decomposition analysis indicated that marital status and age were the primary contributors to inequality in the use of temporary contraceptive methods, accounting for 38.93% and 18.55% of the inequality, respectively. In contrast, for tubectomy, marital status and age contributed -81.37% and -38.76% to the reduction in inequality, while the number of live births had a positive contribution of 10.79%. Moreover, women in higher socioeconomic quintiles reported greater use of temporary methods, whereas tubectomy was more prevalent among those in lower socioeconomic groups. This study highlights significant socioeconomic inequalities in CU among Kurdish women in western Iran. Higher-income women tend to use temporary methods, while lower-income women more often undergo tubectomy. These disparities underscore the need for targeted interventions. Policymakers should focus on improving access to a variety of contraceptive options and enhancing educational initiatives to promote equity in reproductive health.
30. Designing context-specific physical activity interventions for English primary schools: key learning from a four-month rapid ethnography.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
Physical activity is essential for children’s health. Primary schools offer an opportunity to equitably promote physical activity. However, school-based interventions have been shown to have little to no effect, potentially due to a lack of consideration of school heterogeneity. This study reports on a rapid ethnography study that was used to capture insights into English primary schools physical activity. The data are intended to inform the design of a context-specific intervention to improve pupil physical activity. Three researchers conducted a four-month rapid ethnography study within three primary schools in Bristol, UK, between March and July 2024. Several methods were used: observations (n = 80), interviews (n = 26), photo elicitation with pupils (n = 4 activities, total 22 pupils), collection of documentary data (i.e. pupil demographics, school policies, etc.), informal conversations, and field notes. Reflexive thematic analysis was used to analyse the data. Each school measured success in physical activity differently, such as increased opportunities, personal development, or broader curriculum attainment. Across all schools levels of pupil physical activity varied across physical activity opportunities in the school day, with breaktimes most active, PE lessons focused on fundamental skills, and active clubs providing quality but not fully inclusive opportunities. Furthermore, across all schools different school communities consistently had different goals and needs for physical activity: senior leaders were focused on how physical activity can support broader school-level strategies (e.g. academic achievement and student wellbeing); teachers were concerned with how physical activity can fit in and around curriculum pressures; and pupils wanted fun and engaging activities. Not all physical activities were feasible across settings, emphasising the need for tailored strategies. And differences in Parent Teacher Association (PTA) funding impacted resources and opportunities for pupil physical activity. These various areas of convergence and difference across the schools suggest strategies for intervention development. This study underscores the importance of context-specific approaches to promoting physical activity in primary schools. Context-specific intervention design should closely consider school context to ensure strategies are appropriate. Intervention designs should also include steps to understand different stakeholder goals, PTA funding disparities, and the appropriate areas of physical activity to target.
31. Digital public health interventions for the promotion of mental well-being and health behaviors among university students: a rapid review.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
Student life offers many opportunities for personal development; however, this transitional phase often also poses challenges to mental health. Various factors associated with university life, such as academic stress and financial burdens, have been found to exacerbate psychological distress and contribute to increased alcohol and substance use among students. Our aim is to closely examine (i) components of available digital public health interventions (DPHIs), (ii) to evaluate their effectiveness for promoting well-being, health behaviors, and reducing symptoms of mental disorders among university students and (iii) to rate the quality of the evidence identified in this rapid review. We conducted a rapid review to capture the evidence on DPHIs for university students. We adhered to the methodological criteria recommended by the Cochrane Rapid Reviews Methods Group and PRISMA. The literature search was performed in Ovid MEDLINE to look for articles related to university students, mental well-being, mental health, and DPHIs published between June 2018 - June 2023. The selection was carried out in two steps: Screening of titles and abstracts and screening of full texts. One thousand one hundred thirty-two articles were screened, of which 24 met the inclusion criteria for data extraction. (i) Of the intervention components in the included studies, 18 used web-based platforms, while six used smartphone applications. The interventions were aimed at improving mental health (68%), reducing substance use (28%), promoting physical activity (PA) (36%) and changing eating habits (16%). (ii) 42% of the included studies were able to demonstrate significant effects in the intended direction for mental health, 4% for substance use, 25% for PA and 8% for eating behavior. (iii) The quality assessment revealed that 58% of the studies were classified with ‘some concerns’, indicating moderate bias, while 29% were classified as ‘high risk’, suggesting considerable bias affecting the validity of the results. This rapid review comprehensively summarized intervention components of DPHIs. Further, the findings of this review provide significant insights into the effectiveness of DPHIs targeting mental well-being and health behaviors among university students. The studies included in the analysis demonstrate varying degrees of success across different domains, highlighting both the potential and limitations of DPHIs.
32. Critical Evaluation of Methods for the Identification of Aneugens.
期刊: Environmental and molecular mutagenesis 发表日期: 2025-Jul-18 链接: PubMed
摘要
The genotoxic potential of chemicals must be evaluated in regulatory safety assessment settings, including but not limited to, the development of new pharmaceuticals, industrial chemicals, food and cosmetic ingredients, and agrochemicals. Initial assessment of the chromosome-damaging potential of chemicals is often conducted in mammalian cells using the micronucleus (MN) assay, a method capable of detecting both aneugenicity and clastogenicity. When differentiation between these modes of action (MOAs) is necessary, microscopy-based analyses using fluorescent In Situ Hybridization (FISH) or CREST staining have traditionally been employed. More recently, semi-automated in vitro new approach methods (NAMs), which leverage technologies like flow cytometry and high-content imaging, have increasingly been used across sectors due to their higher throughput and faster turnaround times. A SWOT (strengths, weaknesses, opportunities, and threats) analysis was conducted to systematically evaluate the merits and limitations of widely used NAMs in industry, with a focus on the pharmaceutical sector. Data from cultured mammalian cells exposed to reference aneugens (colchicine, taxol, and AMG900) and DNA-reactive clastogens (mitomycin C and methyl methanesulfonate) across methodologies are presented to illustrate the process of distinguishing aneugens from clastogens for the different techniques described herein. Collectively, these analyses highlight the capabilities of NAMs to distinguish aneugens from clastogens. The newer, high information content, semi-automated approaches were considered preferable to traditional microscopy-based FISH and CREST techniques as they provide insight into molecular mechanisms of aneugenicity and help optimize the design of future in vivo genotoxicity studies to facilitate deriving points of departure which may contribute to margin of exposure estimates.
33. Potential of ethyl acetate and ethanol extracts of Bintaro (Cerbera manghas L.) seeds as bioinsecticides against Aedes aegypti (Diptera: Culicidae).
期刊: BMC research notes 发表日期: 2025-Jul-18 链接: PubMed
摘要
Research on vector control with bioinsecticides is still being done to reduce the negative impacts of employing pesticides. Reduced insecticide use should prevent mosquitoes from harming the environment and from developing resistance to the active components in insecticides. Botanical insecticides are derived from plants that have bioactive compounds (toxic to insects) that readily break down in the environment, do not pollute the ecosystem, and are more selective and safer than conventional pesticides. The point of this study is to find out what happens to Ae. aegypti when ethyl acetate and ethanol are mixed with a 96% solution of Bintaro fruit seeds. Samples of adult mosquitoes aged 3-5 days were 1120 with three replicates. The research design is experimental, with the post-test only being a controlled group design. Recording Mosquito mortality was recorded after 24 h of observation, while the effects of adult mosquito toxicity sprays were observed for 20 min. Giving mosquitoes ethyl acetate and 96% ethanol extract solutions of C. manghas fruit seeds killed a lot of them. It was found that the ethyl acetate solutions had LC50 values of 22,594 (225,940 ppm) and LC90 values of 92,242 (922,420 ppm). The values for the 96% ethanol extract solutions were 5,207 (52,070 ppm) and 10,436 (104,360 ppm) in 100 ml of distilled water. A one-way ANOVA test was done on the n-hexane and 96% ethanol extracts of C. manghas seeds and found that the two solutions were quite different. There was a 0.001 (p < 0.05) difference between the yields of the maceration method with 96% ethanol and the yields of ethyl acetate for each concentration of Bintaro seed extract.
34. Understanding the child feeding decisions among urban parents: a qualitative study in addis ababa, Ethiopia.
期刊: BMC nutrition 发表日期: 2025-Jul-18 链接: PubMed
摘要
Food choice decisions are complex processes influenced by various factors that affect the family’s diet and, thus, their health and nutrition. In low- and middle-income countries like Ethiopia, these factors are shaped by the ongoing nutrition transition, urbanization, and socio-economic challenges. Despite growing concerns about the double burden of malnutrition, the factors influencing food choices among parents of children under five in Addis Ababa, Ethiopia, remain poorly understood. This study explores these factors. Five focus groups with fathers and mothers (30 participants total, 5-7 per group) were conducted, along with 11 in-depth interviews with mothers of children under the age of five, for a total of 41 participants. Participants were permanent residents of Addis Ababa, having lived in the city for at least six months. Using health extension workers and community guides, participants were purposively sampled from two districts in Addis Ababa. Data were collected from November 2023 to April 2024, with interviews conducted in Amharic, audio-recorded, transcribed, and translated into English. Thematic analysis, both inductive and deductive, was performed using Bronfenbrenner’s socio-ecological model as a lens. Factors influencing parental food choice were identified at three levels: individual, community, and environmental. Health concerns, affordability, child food preferences, and convenience were most frequently mentioned at an individual level. At the community level, family norms and social pressure played key roles. Food safety concerns and marketing influences were identified as important influences at the environmental level. Parents reported that while food availability was not typically a concern, changes in the food environment and economic constraints significantly impacted their food choices. They also emphasized that food safety and the reliability of food markets were essential issues. This study underscores the complex, multi-level factors shaping food choices among parents of children under five in Addis Ababa. Health concerns, affordability, food safety, and market reliability were identified as key influences on food choices. These multi-level factors can guide interventions to improve children’s diets by addressing individual motivations and the broader environmental contexts influencing food choices. Not applicable.
35. A power analysis framework to aid the design of robust semi-field vector control experiments.
期刊: Malaria journal 发表日期: 2025-Jul-18 链接: PubMed
摘要
Semi-field experiments are an efficient way of assessing the impacts of potential new vector control tools (VCTs) before field trials. However, their design is critically important to ensure their results are unbiased and informative. An essential element of the design of semi-field experiments is power analysis, which empowers researchers to ensure that only designs with adequate statistical power are adopted. In this study, a methodology was developed, and its use was demonstrated in a tutorial, to determine the required number of semi-field chambers, sampling frequency and the number of mosquitoes required to achieve sufficient power for evaluating the impact of a single VCT or two in combination. By analysing data simulated from a generalized linear mixed-effects model, power was estimated for various experimental designs, including short- (24 h) vs. long-term (3 months) experiments and single vs. combined application of interventions (e.g., insecticide-treated nets combined with pyriproxyfen autodissemination). Although power increased with increasing number of chambers, sampling frequency and the number of mosquitoes, the number of chambers and variance between chambers were the dominant factors determining power relative to all other design choices. High variance between chambers decreased power, highlighting the importance of making conditions similar among chambers, by reducing variation if possible and by rotating variables if not. As compared to a single intervention, an additional intervention required an increase in the number of chambers, while short and long experiments were similar in terms of key aspects such as the number of chambers per treatment. Determining the most efficient experimental design for a semi-field experiment will depend on a balance of design choices and resource constraints. The power analysis framework and tutorial provided here can aid in the robust design of these widely used experiments and ultimately facilitate the development of new vector control tools (VCTs).
36. Association between high polygenic risk scores and long-term exposure to air pollution in asthma development: a hospital-based case-control study.
期刊: Environmental health : a global access science source 发表日期: 2025-Jul-18 链接: PubMed
摘要
Air pollution is widely associated with allergic diseases, including asthma. Although previous studies have suggested an epidemiological link between air pollution and asthma, the combined effects of air pollutants and polygenic risk scores (PRSs) on asthma risk remain incompletely understood. This study aimed to examine the impact of air pollutants and PRS on asthma risk among patients in a Taiwan medical institution. This retrospective matched case-control study utilized data from the Taiwan Precision Medicine Initiative (TPMI) project to compare asthma patients with a non-asthmatic control group. Participants were stratified into quartiles based on their asthma PRS, while air pollutant exposure was assessed by both duration and concentration. Conducted at Taichung Veterans General Hospital, the study followed participants from January 1, 2000, to December 31, 2021. Logistic regression was used to analyze the relationships between air pollution exposure, genetic risk, and asthma incidence. A total of 9,756 participants were included (3,252 asthma patients and 6,504 controls). Individuals in the highest PRS quartile demonstrated a significantly increased asthma risk (odds ratio = 1.532, 95% CI = 1.333-1.762, p < 0.0001). Long-term exposure to low levels of PM2.5, PM10, NO2, Mn, and O3 further elevated asthma risk, with the association becoming more pronounced under conditions of high air pollution. Long-term exposure to low concentrations of air pollutants significantly increases asthma risk, especially among individuals with high genetic susceptibility. These findings emphasize the importance of personalized health management for individuals with elevated PRS. Not applicable.
37. Organisational and social work environment factors and occupational balance as predictors of work and life satisfaction among Swedish principals who are also parents to small children.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
In Sweden, managers, individuals working within education, and parents with small children are three groups at high risk for sick leave due to stress-related mental health problems. However, the combined risk of being a parent and manager working within education, i.e., as a principal, on individual work and life satisfaction is not well understood or well-described in the scientific literature. Accordingly, the present study aimed to examine to what extent indicators for occupational balance and organisational and social work environment factors are predictors of work and life satisfaction among Swedish school principals who are also parents to small children. A prospective longitudinal study design was used, and data were collected with a one-year interval (T1 and T2) using a web survey. The participants (n = 149) had at least one child under 8 years old and answered the survey at T1 and T2. Logistic regression analyses were used to estimate how predictors at T1 determined the reporting of work and life satisfaction at T2. Supportive organisational structures and few role conflicts at T1 predicted work satisfaction at T2, and supportive organisational structures and a perception of occupational balance at T1 predicted life satisfaction at T2. Adjusted for outcomes at T1, supportive organisational structures and occupational balance still remained predictors. Supportive organisational structures that clearly define authority and areas of responsibility, and few role conflicts appear to be important for reporting higher work satisfaction among Swedish principals with small children. In addition, high occupational balance and supportive organisational structures that clearly define authority and areas of responsibility also appear to be important for reporting higher life satisfaction. These results suggest that employers of principals with small children may help them by taking action in the above-mentioned areas. The principals themselves could also benefit from being attentive to these issues. Both are important for strengthening public health and preventing sick leave.
38. Associations of serum and bronchoalveolar immunoglobulins with lung microbiota diversity, B-cell memory phenotypes, and COPD morbidity and exacerbations.
期刊: Respiratory research 发表日期: 2025-Jul-18 链接: PubMed
摘要
Immunoglobulins (Ig) protect against pathogens frequently implicated in COPD exacerbations. We previously demonstrated an association of low-normal serum IgA and IgG concentrations with prospective exacerbation risk, but responsible mechanisms are undefined. Here, we examined associations of lower respiratory tract bacterial diversity to Ig levels in serum and bronchoalveolar lavage (BAL) and to the memory phenotypes of blood and BAL B cells. We analyzed data from phase I of SPIROMICS, an observational cohort study of smoking-related COPD. A subset of participants completed comprehensive research bronchoscopies, including analysis of BAL bacterial microbiota by 16 S rRNA gene (V4 region) sequencing and of blood and BAL B-cells by 12-color flow cytometry. In some participants, we also analyzed serum and BAL Ig levels by ELISA. We constructed linear regression models including either serum or BAL (albumin-corrected) Ig measurements as the independent variable and separate dependent variables, including B-cell subsets, BAL bacterial diversity metrics (Faith phylogenetic diversity, inverse Simpson, and richness indices), and clinical measures (FEV1% predicted, risk of prospective exacerbations), adjusted by age, sex, race, educational attainment, smoking status, and use of inhaled corticosteroids. Serum IgG and IgA (n = 66 participants) were 1,486.1 ± 510.6 mg/dL [mean ± standard deviation (SD)] and 237.7 ± 131.6 mg/dL, respectively. Albumin-corrected BAL IgG and IgA (n = 117) were 0.03 ± 0.02 mg/dL and 0.01 ± 0.01 mg/dL, respectively. B-cells (n = 82) comprised 3.5 ± 3.0% of blood leukocytes. Serum IgA was associated with higher blood switched memory (IgD- CD27+) B-cell percentages (β 6.06, p = 0.01) and inversely associated with blood double-negative (IgD-CD27-) B-cell percentages (β - 9.96, p = 0.02). Available BAL microbiome data (n = 107) showed that reduced lung bacterial diversity associated with lower serum IgG, but not with serum IgA, BAL IgA, or BAL IgG concentrations. Neither BAL IgG nor IgA were associated with lung function or exacerbations. These results demonstrate an association of low serum IgG with reduced lung bacterial diversity, a feature of dysbiosis that may predispose to exacerbation. Defining the role of Ig in specific anatomic compartments is relevant to designing vaccine strategies.
39. Prospective associations between occupational physical activity level and sleep disturbances: a five-year follow-up study.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
Sleep disturbances are commonly reported in working populations. While research has identified various work-related risk factors for poor sleep, the relationship between prior occupational physical activity (OPA) and future sleep disturbances remains unclear. The study aimed to examine the prospective associations between OPA levels and sleep disturbances in adults. We utilized longitudinal data from the MJ cohort study (1998 to 2022). The sample (N = 62528) consisted of adults aged 18 years or above. The mean age (in years) was 35.9 (SD = 9.5), and they were working full-time and reported no sleep disturbances at baseline. We examined the prospective associations between self-reported OPA levels (light, moderate, moderately heavy, and heavy) at baseline, and the presence of sleep disturbances at a mean follow-up time of 5.6 years (SD = 4.5). Cox proportional hazard models were conducted, adjusting for potential confounding variables. Using light OPA level as the reference group, individuals with moderately heavy OPA (HR: 1.13, 95% CI: 1.07, 1.19, p < 0.001) and heavy OPA (HR: 1.22, 95% CI: 1.11, 1.34, p < 0.001) at baseline had a higher risk of sleep disturbances at follow-up. Stratified analyses showed that the association between higher levels of OPA and sleep disturbances remained across different subgroups. Notably, these associations were more pronounced among females (pinteraction = 0.008), for moderately heavy OPA (HR: 1.23, 95% CI: 1.12, 1.35, p < 0.001) and heavy OPA (HR: 1.45, 95% CI: 1.10, 1.91, p = 0.009). These associations were also more pronounced in certain occupational groups (pinteraction = 0.003), where only heavy OPA was significantly associated with an elevated risk of sleep disturbances among civil servants (HR: 1.66, 95% CI: 1.08, 2.55, p = 0.020) and office workers, professionals and technicians (HR: 1.49, 95% CI: 1.09, 2.05, p = 0.010). Higher OPA levels were associated with an increased risk of sleep disturbances. Workplace support or interventions are in need to improve sleep patterns.
40. Epidemiology of age-related macular degeneration among elderly in geriatric homes, East Cairo, Egypt.
期刊: BMC public health 发表日期: 2025-Jul-18 链接: PubMed
摘要
41. Improved cookstoves enhance household air quality and respiratory health in rural Rwanda.
期刊: Scientific reports 发表日期: 2025-Jul-18 链接: PubMed
摘要
Household air pollution (HAP) from biomass combustion in traditional cooking methods poses significant health risks, particularly in rural communities of low- and middle-income countries. Improved cookstoves (ICS), designed to enhance combustion efficiency and reduce emissions, have been promoted as a transitional alternative towards cleaner cooking. However, evidence of their benefits remains mixed and context-specific. A randomized controlled trial was conducted to evaluate the impact of introducing the Save80 ICS on the respiratory health of adults in rural settlements in Rwanda. The study comprised two assessment rounds, and participants (n = 1001) were divided into two groups: one using traditional cooking methods and one using improved cookstoves. Baseline and follow-up data were collected through structured questionnaires and lung function tests. Furthermore, HAP was measured in a field campaign at households cooking with the ICS or traditional methods. The primary outcomes included respiratory symptoms, spirometry (FVC, FEV1, and PEF), and exposure to particulate matter (PM0.3-2.5) and its components (EC, OC, BC, BrC, and PAH). We found that households using the ICS spent, on average, 34% less time cooking and had 77% lower indoor PM0.3-2.5 levels. BC and BrC exposure decreased by 50% and 78%, respectively; OC and TC concentrations were 58% and 45% lower. PAH concentrations showed inconsistent patterns, with most species presenting non-statistically significant changes, constraining objective conclusions. Over the study period (3 years), ICS users reported lower prevalence of cough (-11%) and mucus production (-9%), and showed better forced vital capacity than users of traditional methods. A comparison of lung function decline over time showed that the ICS users had lower deterioration of FVC over three years. This study documents the effects and benefits of introducing ICS. While limitations such as the lack of baseline HAP data during the first health assessment and inconclusive PAH concentrations constrain interpretations and quantified causality, the results contribute to the evidence on the health and indoor air pollution impacts of ICS adoption in rural East African areas.
42. Genetics First Approach: Expanding the Utility of Genetic Testing by Non-Geneticist Physicians.
期刊: Genetics in medicine : official journal of the American College of Medical Genetics 发表日期: 2025-Jul-15 链接: PubMed
摘要
The increasing demand for genetic testing and a global shortage of geneticists has significantly strained healthcare systems worldwide. This highlighted the need for new strategies aiming to increase testing accessibility, reduce wait times, and enhance patient care quality. We implemented a four-step program, “Genetics First,” to empower non-geneticist physicians (NGPs) to play an active role in the process of genetic consultation and testing. The steps included (1) establishing criteria to identify suitable clinical domains, (2) selecting clinical indications within the domain through expert panel review, (3) designing tailored education and workflows for NGPs across indications, and (4) monitoring test outcomes and providing further support for complex cases. Test outcomes were compared between NGPs and clinical geneticists (CGs). Endocrinology was selected as the first domain, with 114 endocrinologists who completed the program. During the study, 260 gene panels were performed for monogenic diabetes (MD), with NGPs initiating 68% of tests, leading to a 107% increase in referrals. The diagnostic yield was 30%, with no significant difference between NGP- and CG-initiated tests. This study demonstrates the feasibility and impact of involving NGPs in genetic testing, offering a paradigm shift that could expand access to genetic testing and improve patients’ care and clinical outcomes.
43. Pancreatic duct calculi: pathophysiology and management.
期刊: Current opinion in gastroenterology 发表日期: 2025-Jul-15 链接: PubMed
摘要
Pancreatic ductal calculi (PDC) are a defining feature of chronic pancreatitis and contribute significantly to morbidity through pain and ductal obstruction. This review provides a timely update on the evolving understanding of PDC pathogenesis and highlights current and emerging strategies for their management. Stone formation in chronic pancreatitis is multifactorial, involving altered pancreatic juice composition, reduced lithostatic proteins, genetic predispositions, and environmental risk factors such as alcohol and smoking. Advances in endoscopic techniques, particularly the combination of extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP), have improved ductal clearance and symptom control. Pancreatoscopy-guided lithotripsy is gaining traction in complex cases. Surgical options such as longitudinal pancreatojejunostomy and head resection remain vital in patients with extensive disease or failed endoscopic therapy, with evidence supporting superior long-term pain relief when performed early. Management of PDC requires a multidisciplinary, personalized approach. Endoscopic therapy is the first-line intervention in most cases, while surgery offers durable benefits in select patients. Future directions include identifying biomarkers for early intervention, refining patient selection, and exploring pharmacological strategies to prevent stone formation and recurrence.
44. Idiopathic recurrent acute pancreatitis: current and future approaches to management.
期刊: Current opinion in gastroenterology 发表日期: 2025-Jul-14 链接: PubMed
摘要
Idiopathic recurrent acute pancreatitis (IRAP) is a clinically relevant condition with a high likelihood of progression to chronic pancreatitis (CP) in 20-50% of patients. This review outlines the importance of early diagnosis of IRAP and potential upcoming therapies to halt disease progression. It highlights a potential therapeutic window in the natural history of IRAP. Despite advancements in diagnostic modalities, identifying a definitive aetiology remains challenging in a significant proportion of cases. Current approaches emphasize structured, stepwise evaluation including metabolic, genetic, and structural factors. Emerging therapies aim to target inflammation, trypsin activation, and pancreatic fibrosis. While diagnostic tools have improved, therapeutic options remain limited in IRAP. Early identification of modifiable risk factors, use of advanced imaging, and application of evolving treatment strategies may offer an opportunity to prevent the transition from IRAP to CP. Future research must focus on validating disease-modifying treatments and optimizing individualized management strategies.
45. Current Periodic Health Evaluation for athletes exclude pelvic floor health: Are we neglecting an essential domain?
期刊: Journal of science and medicine in sport 发表日期: 2025-Jul-07 链接: PubMed
摘要
46. Gender/Sex Entanglement, Structural Sexism, and Injury: The Case of Australian Rules Football.
期刊: American journal of human biology : the official journal of the Human Biology Council 发表日期: 2025-Jul 链接: PubMed
摘要
This article considers how to approach sporting injury from the perspective of gender/sex entanglement. Taking the case of anterior cruciate ligament (ACL) injuries, I explore how the gender differences and inequalities that fundamentally shape many sporting environments may contribute to injury in women athletes. I look to Australian Rules football (Aussie Rules)-a male-dominated, high-contact, highly skilled running game and Australia’s largest commercial sport-where, following the launch of a women’s professional league in 2017, a marked gender disparity in ACL injury has been reported. Rather than attribute this reported disparity to essential biological differences between women and men, I consider how gendered practices and disparities may accumulate across the life course of athletes with consequences for the embodied experiences of women and girls. Building on the concept of structural sexism as a key determinant of health, I document gender-related differences and inequalities at the early childhood, youth, and elite levels of Aussie Rules football. Via this case, I contribute to calls for a dynamic, developmental, and fundamentally gendered approach to studies of injury both in and beyond sport.
47. Letter to the editor: Use of integrated genomic surveillance by local public health authorities: recommendations based on a mixed-methods study of current adoption, applications and success factors, Germany, 2023.
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
48. Spread of the FAR-MRSA clone, a fusidic acid- and meticillin-resistant Staphylococcus aureus ST121, Europe, 2014 to 2024.
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
We describe the genetic characteristics of a fusidic acid- and meticillin-resistant Staphylococcus aureus (MRSA) clone widespread in Europe, based on whole genome sequences from 317 isolates. The clone is causing impetigo and other skin and soft tissue infections, primarily in young children. Comparison with publicly available S. aureus ST121 sequences showed that the clone is clearly distinct from previously described ST121 clones. European and other international readers should be aware of the emergence of this community-acquired MRSA clone.
49. Detection of West Nile virus via retrospective mosquito arbovirus surveillance, United Kingdom, 2025.
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
In March 2025, as part of ongoing enhanced surveillance for mosquito-borne Orthoflaviviruses, West Nile virus (WNV) RNA was detected in two pools of female Aedes vexans collected in July 2023 in Nottinghamshire, England. Sequencing and phylogenetic analysis of a 402 bp fragment indicate clustering with WNV lineage 1a. The exact origin of this virus remains unclear, but this finding indicates a historic WNV presence in the United Kingdom. Surveillance has not provided evidence of further WNV transmission to date.
50. Socioeconomic position and urban environments as drivers of antimicrobial resistance? An ecological study in Germany, 2010 to 2019.
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
BACKGROUNDGermany lacks comprehensive studies on the relationship between socioeconomic position (SEP) and antimicrobial resistance (AMR).AIMWe assessed the association between area-level SEP and AMR infection and colonisation in Germany.METHODSIn an ecological study design, we analysed statutory notifications of invasive meticillin-resistant Staphylococcus aureus (MRSA, n = 34,440) in 2010-2019, and colonisations and infections with carbapenem-resistant Acinetobacter spp. (CRA, n = 1,979) and Enterobacterales (CRE, n = 10,825) in 2017-2019. Area-level SEP was measured by the German index of socioeconomic deprivation (GISD), incorporating education, employment and income data. A multilevel Poisson regression analysis estimated the association between AMR incidence and GISD at district level, adjusting for age, sex, notification year and urbanisation degree.RESULTSMedian ages of patients with carbapenem-resistant bacteria were between 66 (CRA colonisation) and 69 years (CRE infection). For MRSA infections, the median age was 74 years. Across each pathogen, approximately two thirds of patients were male. Estimated MRSA incidence was almost five times higher in districts with lowest vs highest area-level SEP (incidence rate ratio, IRR: 4.8; 95% CI: 2.8-8.2). This association was strongest in large cities (IRR: 9.1; 95% CI: 2.7-30.9), and sparsely populated rural districts (IRR: 6.5; 95% CI: 2.8-15.0). Associations of CRA (IRR: 0.6; 95% CI: 0.3-1.2) and CRE (IRR: 0.9; 95% CI: 0.6-1.4) infections with SEP were not statistically significant.CONCLUSIONLower area-level SEP and degree of urbanisation were associated with MRSA incidence, however, no associations were uncovered between SEP and CRA or CRE infections. Further individual-level research could explore if health behaviours, living/working conditions or healthcare access explain the findings. Socioeconomic conditions should be considered for AMR prevention and control.
51. High-risk human papillomavirus cervical infection prevalence: a nationwide retrospective study comparing opportunistic and organised screening, France, 2020 to 2023.
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
BACKGROUNDIn France, cervical cancer screening for females aged 30–65 years primarily tests for high-risk (HR) human papillomavirus (HPV) infections.AIMWe aimed to map the prevalence of cervical infections caused by HPV16 and/or 18, or by any of 12 other carcinogenic HPV genotypes and compare prevalence estimates from tests from spontaneous medical visits (opportunistic screening) or the national screening programme (organised screening).METHODSWe extracted data from a large network of biology laboratories, containing all available results from HR HPV tests performed between 1 January 2020 and 30 November 2023 in metropolitan France. A full hierarchical Bayesian model was used to compute spatially resolved expected prevalence maps at the postcode level.RESULTSThe analytic sample contained results of 362,963 HR HPV tests. Among samples positive for HPV16 and/or 18, 2.9% and 3.8% were from organised and opportunistic screening, respectively. Samples positive for other genotypes were 6.9% and 9.4%, respectively.During the last week of the study (week 48 2023), among females aged 30 years, opportunistic screening was associated with a greater expected prevalence of HPV16 and/or 18 and other genotypes in 97.2% and 99.9% of postcodes, respectively. The probability this percentage was lower among females aged 66 years was below 95% for both genotype groups.For organised screening, a pronounced north-west/south-east gradient in infection prevalence was found across France for both genotype groups, with hotspots located at the border with Italy, Spain and Switzerland.CONCLUSIONOpportunistic screening is associated with systematic inflation of HR HPV infection prevalence.
52. Quadriceps Morphology 6- to 60-Months After Anterior Cruciate Ligament Tear.
期刊: Scandinavian journal of medicine & science in sports 发表日期: 2025-Jul 链接: PubMed
摘要
The purpose of this study was to compare quadriceps morphology between legs and individuals with a first-time anterior cruciate ligament (ACL) tear and uninjured controls. This was an exploratory cross-sectional study. We enrolled participants who were aged 19-35 years, and 6-60 months after a first-time ACL tear as well as uninjured controls. Participants attended two sessions separated by a minimum of 7 days. Bilateral knee extensor concentric and eccentric strength and rate of torque development (RTD) were assessed at the first session, and bilateral vastus lateralis muscle biopsies were obtained at the second. Muscle fiber-type specific cross-sectional area (fCSA), fiber-type proportions, and extracellular matrix area were calculated. Between-limb and between-group differences were estimated using mixed-effects regression. 41 of 47 (87%) participants completed the study (n = 21 ACL, n = 20 control). ACL group participants were a median (range) of 23 months from injury, and 78% had undergone an ACL reconstruction. Uninjured group participants had greater knee extensor concentric strength (-39.3 Nm; 95% CI: -54.2, -20.5), eccentric strength (-30.2 Nm; 95% CI: -53.4, -11.6), and RTD (-0.16 Nm/ms; 95% CI: -0.33, -0.04). No between-group or between-limb differences in muscle fiber-type specific fCSA, fiber-type proportions, or extracellular matrix area were observed. Despite deficits in knee extensor muscle performance, no difference in vastus lateralis fiber-type specific CSA, fiber-type proportion, or extracellular matrix area was detected between individuals 6-60 months after an ACL tear and uninjured controls.
53. Psychosocial and NF-κB Activity Effects of the Stress Management and Resiliency Training: Relaxation Response Resiliency Program (SMART-3RP) on Patients With MGUS and Smoldering Multiple Myeloma: A Randomized Waitlist Control Trial.
期刊: Psycho-oncology 发表日期: 2025-Jul 链接: PubMed
摘要
Patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM), precursors to multiple myeloma, need supports for the psychological sequelae of medical uncertainty. This secondary and exploratory analysis of psychosocial outcomes from a randomized controlled trial evaluated a mind-body intervention, the Stress Management and Resiliency Training: Relaxation Response Resiliency Program (SMART-3RP) for perceived stress, global distress and secondary distress (depression, anxiety, NF-κB DNA-binding activity) and well-being (coping ability, mindfulness, optimism, gratitude) indices for individuals with MGUS and SMM. Participants were randomized to immediate treatment (n = 45) or waitlist control (n = 48), providing data at baseline (T1), 3 months (T2), and 6 months (T3). Compared to waitlist control, the immediate treatment group experienced greater T1-T2 reductions in global distress (Mdiff = -1.04, p = 0.04), but not perceived stress (Mdiff = -1.67, p = 0.12). Participants receiving immediate treatment also experienced greater reductions in depression (Mdiff = -4.22, p < 0.001) and improvements in coping abilities (Mdiff = 0.36, p < 0.001) and optimism (Mdiff = 1.39, p = 0.02), with no significantly different changes in mindfulness (Mdiff = 4.36, p = 0.14), anxiety (Mdiff = -1.23, p = 0.26), gratitude (Mdiff = 0.59, p = 0.47), or NF-κB activity (Mdiff = -0.16, p = 0.23). The SMART-3RP demonstrated efficacy for global distress and other important outcomes for individuals with MGUS and SMM. Stress reduction did not significantly differ from waitlist control. ClinicalTrials.gov Registration #: NCT01955395.
54. Job vacancy at the European Centre for Disease Prevention and Control (ECDC).
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
55. Author's correction for Euro Surveill. 2025;30(25).
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
56. Response: Use of integrated genomic surveillance by local public health authorities: Recommendations based on a mixed-methods study of current adoption, applications and success factors, Germany, 2023.
期刊: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 发表日期: 2025-Jul 链接: PubMed
摘要
57. Key Determinants of a Healthy Shipping Company: A Pilot Study of Seafarers' and Management Perspectives.
期刊: Inquiry : a journal of medical care organization, provision and financing 发表日期: 2025 链接: PubMed
摘要
The concept of a healthy organisation promotes environments that enhance employee well-being, motivation, and productivity. Despite its benefits, it remains underexplored in the shipping sector. To address this gap, a pilot study was conducted to examine how seafarers and management perceive a healthy shipping company, with a focus on identifying the key determinants. This approach underlines the importance of active employee involvement, which is consistent with the principles of a healthy organisation. An exploratory, convergent, mixed-methods pilot study combined qualitative and quantitative data collection. The questionnaire included demographic and work-related characteristics, an open-ended question on the definition of a healthy shipping company from a personal perspective, and scaled ratings of key determinants of healthy shipping companies identified through a literature review. The sample consisted of 309 participants from the international shipping sector, including 238 seafarers and 71 shipping company managers. The study identified key factors that contribute to a healthy shipping company, with both seafarers and managers recognising the importance of employee well-being, safety, work-life balance, and a supportive organisational culture. These findings were consistently reflected in both the quantitative and qualitative data. The qualitative results also revealed group-specific perspectives: managers highlighted the importance of financial management, strategic innovation, and corporate governance, while seafarers placed greater emphasis on immediate working conditions and mutual respect. Overall, the findings underscore the importance of a collaborative approach, where both seafarers and managers are actively engaged in shaping a healthy organisational environment.
58. Embedding Two of the 4Ms Into the Electronic Health Record: One Health System's Journey Towards Systemwide Spread of Age-Friendly Care.
期刊: Inquiry : a journal of medical care organization, provision and financing 发表日期: 2025 链接: PubMed
摘要
The purpose of this article is to describe 2 quality improvement projects aimed at embedding 2 of the 4Ms into the electronic health record for system-wide spread of Age-Friendly care. The 2 projects described in this case study serve as exemplars for the future implementation and sustainability of 4Ms care. Rapid-cycle quality improvement projects, via the Plan, Do, Study Act model, focused on the 4Ms were conducted by interprofessional teams to integrate clinical decision support for clinicians within the electronic health record. Project Senior Care Review for Evaluating and Eliminating Non-essential and potentially inappropriate medications (SCREEN) embedded a geriatric medication screen into the ordering panels of the top medications identified as being prescribed to older patients potentially inappropriately. Project Predictive Real-time Evaluation of Delirium in Clinical Therapy (PREDICT) embedded a delirium prediction rule in the electronic health records to guide clinicians to implement delirium mitigation interventions on patients at risk of developing or experiencing delirium. Outcomes were evaluated descriptively utilizing data and reports generated by the electronic health record. Embedding non-interruptive and actionable clinical decision support in the electronic health record supported the rapid spread of Age-Friendly care across a 7-hospital system. The 4Ms can be embedded into existing workflows through novel implementation of best practices by leveraging the electronic health record. By embedding 2 of the 4Ms into existing workflows and creating non-disruptive, actionable clinical decision support within the electronic health record, clinicians have the tools to implement Age-Friendly care within the 4Ms framework. Additional projects aimed at embedding the other Ms are underway, and long-term outcomes are being evaluated.
59. Impact of reduced institutional delivery coverage on neonatal survival during the peak of coronavirus disease 2019 pandemic in Nepal: Estimates using Lives Saved Tool model.
期刊: Women’s health (London, England) 发表日期: 2025 链接: PubMed
摘要
An alarming observation from high-volume obstetric facilities in Nepal indicating a decreased institutional delivery rate and increased institutional neonatal mortality rate after the initial nationwide lockdown signaled the adverse population-level impact of the pandemic on the national trajectory of neonatal survival. We aimed to estimate the impact of change in institutional delivery coverage on cause-specific neonatal mortality during the coronavirus disease 2019 pandemic in Nepal. Modeling-based study. We used the open-access Lives Saved Tool, based on a linear deterministic mathematical model validated for estimating cause-specific neonatal mortality in low- and middle-income countries, to estimate the number of additional neonatal lives saved and neonatal mortality rates. Using coverage change in institutional delivery rates as a proxy for interventions during childbirth, we compared the estimates using ‘reported’ coverage change during the pandemic with the ‘targets’ per Nepal Every Newborn Action Plan. The projected number of additional neonatal lives saved when the pandemic hit the hardest (Nepalese fiscal year 2020-2021) when national annual institutional delivery rate reportedly decreased was lower (104; 95% confidence interval: 69-148) compared to the target scenario (222; 95% confidence interval: 152-313). However, in the next year 2021-2022 when the institutional delivery rate increased, the number was higher (926; 95% confidence interval: 643-1295) compared to target scenario (329; 95% confidence interval: 226-466). The trajectory of the projected neonatal mortality rate per 1000 live births reversed (increased to 20.18) in 2020-2021 compared to 20.11 in 2019-2020 and then tracked down to 18.75 in 2021-2022. Most newborn lives would be saved from asphyxia, sepsis, and prematurity-related complications. Neonatal resuscitation, thermal protection, and cord care are the top three lifesaving interventions during childbirth. Neonatal survival in Nepal was adversely impacted during the peak of the coronavirus disease 2019 pandemic, with a favorable bounce back next year, based on the Lives Saved Tool projection per change in institutional delivery coverage. Projections From the Lives Saved Tool Model Based on the Change in Coverage of Institutional Childbirth Suggest an Adverse Impact on Neonatal Survival During the Peak of the Coronavirus Disease 2019 Pandemic in NepalThe utilization of routine maternal, newborn, and child health services in low- and middle-income countries including Nepal was adversely but variably affected by the coronavirus disease 2019 pandemic. An alarming observation reported from an increase in the deaths of newborn babies with a decrease in the number of deliveries occurring in maternity hospitals in the beginning of the pandemic in Nepal signaled concern with uncertainty in the extent of negative impact on neonatal survival at the level of the population through the course of the pandemic. The researchers utilized the validated and open-access Lives Saved Tool to estimate the number of additional newborn lives that could be potentially saved from routine and basic interventions during childbirth when the coverage rates of institutional delivery changed during the pandemic in Nepal. Compared to the projection based on the scenario of meeting target coverage rates, the projected number of additional newborn lives saved was lower in the Nepalese fiscal year 2020–2021 based on the scenario of reported decrease in the annual rate of institutional delivery, which recovered favorably in the next year. The projected neonatal mortality rate also increased in that year (2020–2021) worst hit by the pandemic, instead of following the decremental trend before and after. These findings noted in the face of a global public health emergency call for a resilient and sustainable national and global health policy and programming for maternal and newborn health.
60. Current lifestyle and risk for asthma: Sedentary lifestyle, obesity, and ETS.
期刊: Allergologia et immunopathologia 发表日期: 2025 链接: PubMed
摘要
The increasing prevalence of asthma necessitates consideration of modifiable asthma risk factors, such as sedentary lifestyle, overweight/obesity, and environmental tobacco smoke (ETS) exposure. The aim of this study was to analyze the relationship between asthma symptoms and the risk factors in young adolescents. This cross-sectional study, as part of the Global Asthma Network (GAN) Phase I project, used standardized questionnaires based on ISAAC (International Study of Asthma and Allergies in Childhood) Phase I and Phase III questionnaires. In Gjilan, Kosovo, self-reported data from 1200 school children aged 13-14 years were collected. Overweight (BMI [body mass index] > 25 kg/m2) had a statistically significant association with asthma symptoms (p < 0.05), particularly with disturbed sleep due to wheezing (OR [odds ratio] = 3.93 [95% CI [confidence interval]: 1.27-12.12]) and the reported wheezing by females during or after exercise. Sedentary lifestyle (≥ 3 hours/day on a computer/television) was found to be associated with wheezing (OR = 1.89 [95% CI: 1.34-2.66]) and the diagnosis of asthma. ETS exposure was significantly associated with wheezing during or after exercise (OR = 1.67 [95% CI: 1.15-2.42]) and coughing at night (OR = 1.67 [95% CI: 1.19-2.33]). The findings support the importance of sedentary lifestyle, obesity, and ETS exposure as asthma risk factors in young adolescents experiencing asthma symptoms. Future public health interventions should take these modifiable risk factors into account, especially in urban locations, in order to alleviate asthma morbidity.