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Review Special Issue Series: Recent Advances in Epidemiology & Public Health

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 18298

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Special Issue Editors

Prof. Dr. Francisco Guillen-Grima

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Guest Editor

1. Department of Preventive Medicine, Clinica Universidad de Navarra, University of Navarra, 31008 Pamplona, Spain
2. Navarra Medical Research Institute (IdiSNA), 31008 Pamplona, Spain
3. Center for Biomedical Research Network Epidemiology and Public Health, (CIBERESP), 28029 Madrid, Spain
4. Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain
Interests: epidemiology; preventive medicine; public health; methodology
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. María M. Morales Suárez-Varela

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Guest Editor

1. Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, Valencia, Spain
2. Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Spain
Interests: environmental epidemiology; human health; environmental pollution; epidemiological studies; biostatistics
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Agustín Llopis-González

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Guest Editor

1. Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Universitat de Valencia, 46100 Burjassot, Spain
2. Center for Biomedical Research Network Epidemiology and Public Health, (CIBERESP), 28029 Madrid, Spain
Interests: epidemiology; public health; preventive medicine; cancer; nutrition; maternal and fetal health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In a time where Clinical Epidemiology & Public Health are seeing critical developments, our understanding of diseases, prevention, and clinical care is expanding. This Review Special Issue Series: "Recent Advances in Clinical Epidemiology & Public Health" is committed to presenting an exclusive collection of comprehensive reviews. This Special Issue will primarily focus on clinical aspects, accepting only submissions pertaining to clinical Epidemiology and Public Health.

The Special Issue will concentrate on important advancements in infectious and chronic disease epidemiology that directly pertain to clinical practice. It will explore new methodologies, surveillance techniques, and preventive strategies that have clinical applications. Specific areas of interest include:

- Disease Prevention: Understanding and implementing measures for the prevention of various diseases.

- Epidemiology of Chronic or Acute Diseases: Exploration of the occurrence, distribution, and control of chronic and acute diseases in clinical settings.

- Hospital Infection Control: Examination of strategies and best practices to prevent and control infections within hospital environments.

- Etiology and Risk Factors of Diseases: Analysis of the cause and factors contributing to diseases to inform clinical intervention and prevention.

- Hospital Mortality: Investigation of mortality rates and related factors within hospital settings.

- Application of Artificial Intelligence to Clinical Epidemiology and Public Health: Utilization of AI technologies in enhancing clinical epidemiology research and public health initiatives.

- Clinical Aspects of Aging: Exploration of aging processes, age-related diseases, and preventive interventions within clinical contexts.

- Clinical Insights into Women's Health: Specific examination of health concerns related to women, including reproductive epidemiology, maternal health, and gender-specific clinical care.

- Clinical Nutrition Insights: Examination of dietary patterns and the impact of nutrition on clinical health and well-being.

- Physical Activity in Clinical Practice: Investigation of the role of physical activity in disease prevention, mental health, and well-being within clinical settings.

By focusing exclusively on clinical aspects, this Special Issue aims to provide a nuanced insight into the complexities and dynamics of Clinical Epidemiology & Public Health. We aim to promote dialogue, collaboration, and innovation among clinicians, researchers, and policymakers through critical examination and thoughtful synthesis.

Prof. Dr. Francisco Guillen-Grima
Prof. Dr. María M. Morales Suárez-Varela
Prof. Dr. Agustín Llopis-González
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

clinical epidemiology
public health
infectious diseases
chronic diseases
disease prevention
hospital infection control
etiology and risk factors of diseases
hospital mortality
application of artificial intelligence
clinical aspects of aging
women's health
clinical nutrition
physical activity in clinical practice

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Published Papers (11 papers)

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Research

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14 pages, 256 KiB

Open AccessArticle

The Effects of General Mental Health Symptomatology, COVID Anxiety, and Sociodemographic Factors on Pandemic-Induced Negative and Positive Trauma Effects: A Polish Survey from the Late Stages of the Pandemic

by Jakub F. Juranek, Maja Wojtkiewicz, Judyta K. Juranek, Jarosław Szuszkiewicz, Marcin Jóźwik and Joanna Wojtkiewicz

J. Clin. Med. 2025, 14(10), 3343; https://doi.org/10.3390/jcm14103343 - 12 May 2025

Viewed by 228

Abstract

Background/Objectives: COVID-19, caused by the SARS-CoV-2 virus, emerged in late 2019 and rapidly became a global pandemic, affecting over 200 countries. The pandemic has had profound impacts on global health, the economy, and mental health, leading to increased anxiety and more cases of posttraumatic stress disorder in the general population. This study aimed to evaluate the factors influencing the long-term psychological effects, both positive and negative, seen in the late stages of the COVID-19 pandemic in Poland (starting in the second half of 2021). It combined specific COVID-19 anxiety factors with a broader general mental health assessment to identify significant associations. Methods: Data were collected from 416 participants through paper-based and online questionnaires, with 235 valid responses gathered in total. This study utilized the Coronavirus Anxiety Scale; General Health Questionnaire (GHQ-28); and, to study Positive Trauma Effects (PTEs) and Negative Trauma Effects (NTEs), the Changes in Outlook Questionnaire. Data analysis was performed using the R language and a Generalized Additive Model analysis was also performed. Results: The study found generally low levels of COVID-19 anxiety and mental distress among participants. Significant predictors of NTEs included COVID-19 anxiety and general mental health status, which explained 47% of the variance. PTEs were significantly associated with gender, with women experiencing higher PTE levels relative to men. Conclusions: The findings indicate that combining specific ailment anxiety measurements with general mental health assessments enhances our ability to predict Negative Trauma Effects. Addressing mental health symptomatology and well-being during mass health crises is crucial to mitigate long-lasting psychological damage. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

21 pages, 277 KiB

Open AccessArticle

Assessment of the Quality of Life of Patients with Diabetes and Prediabetes in Poland: A Cross-Sectional Study

by Mariola Mroz, Dorota Sadowska, Mateusz Zarychta, Grazyna Iwanowicz-Palus, Adam Kretowski and Mateusz Cybulski

J. Clin. Med. 2025, 14(6), 1883; https://doi.org/10.3390/jcm14061883 - 11 Mar 2025

Viewed by 590

Abstract

Background: Diabetes mellitus is one of the greatest public health challenges worldwide and one of the major conditions contributing to a poorer quality of life. The main factors that may deteriorate quality of life among patients with diabetes include age, financial status, educational background, quality of healthcare services and presence of disease complications. This study aimed to assess the quality of life among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province, taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among participants of the “Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolReD” (“Stop Diabetes! Polish Diabetes Registry (PolRed)”) project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the 36-Item Short Form Survey (SF-36). Results: The overall study group had the highest level of quality of life assessment in the domains of social functioning (M = 69.48; SD ± 28.07), physical functioning (M = 64.54; SD ± 31.57) and role limitations due to emotional problems (M = 62.40; SD ± 45.21), and the lowest level of quality of life in the domain of general health perceptions (M = 42.21; SD ± 12.77). Age was found to be negatively correlated in all quality of life domains analysed (r = −0.438; p < 0.001)—quality of life decreased with age in all investigated domains. Men had a statistically significantly (p < 0.05) higher quality of life in each analysed domain (M = 43.52–74.08; SD ± 12.68–44.09) compared to women (M = 41.18–65.88; SD ± 12.76–46.08). Place of residence also exhibited a statistically significant (p < 0.05) differentiated quality of life in terms of physical functioning. Conclusions: The assessment of quality of life among patients with type 1 and type 2 diabetes and those diagnosed with prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The assessment of quality of life among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. Respondents with type 1 diabetes have a higher quality of life in terms of role limitations due to physical health, role limitations due to emotional problems, pain (bodily pain) and general health compared to respondents with type 2 diabetes. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

11 pages, 1666 KiB

Open AccessArticle

Occurrence and Phenotypic Characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) in Emergency Medical Service Ambulances as a Potential Threat to Medical Staff and Patients

by Piotr Konrad Leszczyński, Aleksandra Olędzka, Kamila Wierzchowska, Aneta Frankowska-Maciejewska, Krzysztof Marek Mitura and Daniel Celinski

J. Clin. Med. 2024, 13(23), 7160; https://doi.org/10.3390/jcm13237160 - 26 Nov 2024

Cited by 1 | Viewed by 1060

Abstract

Introduction: An ambulance used by an emergency medical service team is the workplace of specialised medical personnel, providing daily transportation for patients in life-threatening conditions, from all walks of life, with numerous diseases and injuries. MRSA (methicillin-resistant Staphylococcus aureus) strains are classified as Gram-positive cocci, characterised primarily by their multidrug resistance. Infections caused by S. aureus have a low treatment success rate and are associated with persistent carrier state. This study aimed to isolate MRSA and MSSA (methicillin-sensitive Staphylococcus aureus) in the emergency vehicle and determine drug resistance of these isolates. Materials and Methods: This study involved an ambulance vehicle operated in central Poland. A total of 39 swabs were taken and evaluated from inside the ambulance on permanent duty. The isolates were analysed using catalase and coagulase assays, Gram staining, culturing on Chapman medium, growth evaluation on agar with 5% sheep blood, and assessing the strains’ sensitivities to selected antibiotics. Material was collected from 13 designated points located in the medical compartment and driver’s cabin. Results: S. aureus bacteria were detected in 51.28% of the samples, 40% of which were MRSA strains. Despite the application of high disinfection standards for the interior of the ambulance, it was not possible to kill all S. aureus strains, which may be because the pathogens in question produce a biofilm that effectively allows them to survive on various surfaces, including those disinfected. Almost 100% of the MRSA isolates were resistant to antibiotics from the β-lactam group (penicillin, ticarcillin, cefotaxime, and cefoxitin), the macrolide group (erythromycin) and the lincosamide group (clindamycin). However, only a few MRSA strains proved resistant to streptomycin (12.5%) and ciprofloxacin (37.5%). β-lactam antibiotics, such as cefotaxime (100% resistant strains) and penicillin (58% resistant strains), were also ineffective against MSSA. Although MSSA isolates showed slight resistance to ticarcillin and erythromycin (33.3%) and clindamycin (25%), the remaining antibiotics proved effective (no resistant strains). Conclusions: Among the isolated strains, the greatest resistance to β-lactam antibiotics and erythromycin was observed. Multidrug-resistant strains of S. aureus were found in the emergency medical system. Even the MSSA strains detected in the studied ambulance showed resistance to some of the antibiotics used. The prevalence of S. aureus strains within ambulances indicates the need for a high hygiene level in daily prehospital work with patients. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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8 pages, 1623 KiB

Open AccessArticle

Leading Causes of US Deaths in the 2022

by Camilla Mattiuzzi and Giuseppe Lippi

J. Clin. Med. 2024, 13(23), 7088; https://doi.org/10.3390/jcm13237088 - 23 Nov 2024

Cited by 1 | Viewed by 1713

Abstract

Background and Objective: Obtaining reliable and up-to-date information on mortality causes is essential for the planning and implementation of effective preventive interventions. We present here an analysis of the leading causes of death in the US in 2022. Material and Methods: We conducted an electronic search of the US Centers for Control and Prevention (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS) and Wide-Ranging, Online Data for Epidemiologic Research (WONDER) to obtain information on the leading causes of death in the US for the most recent searchable year with definitive data (i.e., 2022), stratified by age and sex. Results: Overall, heart disease was the leading cause of death (26.2% of all deaths), followed by malignant neoplasms (22.7%), unintentional injuries (8.5%) and coronavirus disease 2019 (COVID-19; 6.9%). Although heart disease and malignant neoplasms remained the leading causes of death in both sexes, unintentional injuries were the third cause for men (10.5%), while strokes were the third cause in women (7.5%). COVID-19 remained the fourth most common cause of death in both sexes (7.1% in men and 6.8% in women). The ten most common causes of death showed an increasing mortality tendency in parallel with the aging of population, with similar trends for both sexes. The only exception was unintentional injury, which was the most common cause of death in both sexes between the ages of 15-44 years, then reached a plateau, before increasing again in people aged 65 years or older. Conclusions: Greater efforts should be put into prevention and education, as heart disease, cancer, and even unintentional injuries are preventable diseases. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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22 pages, 1714 KiB

Open AccessArticle

Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-Revised

by Amira Mohammed Ali, Saeed A. Al-Dossary, Carlos Laranjeira, Maha Atout, Haitham Khatatbeh, Abeer Selim, Abdulmajeed A. Alkhamees, Musheer A. Aljaberi, Annamária Pakai and Tariq Al-Dwaikat

J. Clin. Med. 2024, 13(20), 6045; https://doi.org/10.3390/jcm13206045 - 10 Oct 2024

Cited by 3 | Viewed by 1850

Abstract

Background: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69–0.88), high convergent validity (item total correlations r range = 0.39–0.81, and correlations with the IES-R’s total score r range = 0.62–0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42–0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12–0.39) and the diagnosis of hypertension (r range = 0.12–0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction). Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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12 pages, 1552 KiB

Open AccessArticle

Italian National Surveillance of Alcohol-Based Hand Rub Consumption in a Healthcare Setting—A Three-Year Analysis: 2020–2022

by Alessandra Caramia, Daniele Petrone, Claudia Isonne, Francesco Battistelli, Sauro Sisi, Stefano Boros, Giulia Fadda, Maria Fenicia Vescio, Adriano Grossi, Martina Barchitta, Valentina Baccolini, Patrizio Pezzotti and Fortunato D’Ancona

J. Clin. Med. 2024, 13(12), 3371; https://doi.org/10.3390/jcm13123371 - 7 Jun 2024

Cited by 2 | Viewed by 1644

Abstract

Background/Objectives: Hand hygiene (HH) is pivotal in mitigating infectious disease transmission and enhancing public health outcomes. This study focuses on detailing the national surveillance system for alcohol-based hand rub (ABHR) consumption in healthcare facilities across Italy, presenting results from a comprehensive three-year evaluation period, from 2020 to 2022. It aims to delineate this surveillance system and report on ABHR consumption trends in various Regions/Autonomous Provinces (Rs/APs). Methods: ABHR consumption data, collected through the ABHR Italian national surveillance system, coordinated by the Istituto Superiore di Sanità (ISS), were analyzed. Statistical methods, e.g., the Mann–Whitney test, were used to assess trends in ABHR consumption, expressed in liters per 1000 patient days (L/1000PD). Results: The results show significant variation in ABHR consumption across Rs/APs and over the years studied. National median ABHR consumption decreased from 2020 to 2022, with a significant reduction from a median of 24.5 L/1000PD in 2020 to 20.4 L/1000PD in 2021 and 15.6 L/1000PD in 2022. Conclusions: The decline in ABHR consumption raises concerns about the ongoing adherence to HH practices in Italian healthcare settings. This underscores the essential role that systematic ABHR monitoring and improved surveillance play in enhancing HH compliance, suggesting that sustained and strategic efforts are fundamental to uphold high standards of hygiene and to effectively respond to fluctuating ABHR usage trends over time. Further research is needed to explore barriers to effective ABHR use and to develop targeted strategies to improve HH practices. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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11 pages, 271 KiB

Open AccessArticle

COVID-19 Posttraumatic Stress Disorder and Mental Health among Spanish Adolescents: SESSAMO Project

by Nora Yárnoz-Goñi, Adriana Goñi-Sarriés, Azucena Díez-Suárez, Guillermo Pírez, Leticia Morata-Sampaio and Almudena Sánchez-Villegas

J. Clin. Med. 2024, 13(11), 3114; https://doi.org/10.3390/jcm13113114 - 26 May 2024

Cited by 2 | Viewed by 1337

Abstract

Background: Child and adolescent mental health problems have increased after the COVID-19 pandemic. The objective of this study was to establish the association of the presence and intensity of posttraumatic stress due to COVID-19 with the presence of (1) self-harm and suicide risk, (2) depressive and anxious symptoms, (3) eating disorders and (4) problematic Internet and video game use. Methods: A cross-sectional analysis was performed on a sample of second–fourth grade secondary school students (14 to 16 years old) from Navarra and the Canary Islands recruited at the SESSAMO project. Validated questionnaires were used to assess the intensity of posttraumatic stress due to COVID-19, risk of suicide and presence of self-harm, symptoms of mental disorder and problematic use of the Internet and video games. Results: Out of 1423 participants analyzed, those with the highest level of posttraumatic stress showed a significant increase in the risk of suicide (OR = 5.18; 95% CI = 2.96–9.05) and in the presence of eating disorder symptoms (OR = 3.93; 95% CI = 2.21–7.00), and higher anxiety and depression scores (b coefficient for anxiety = 11.1; CI = 9.7–12.5; for depression = 13.0; CI = 11.5–14.5) as compared to those with the lowest level. Participants with a high level of posttraumatic stress were almost 10 times more likely to present problematic video game use (OR = 9.49; 95% CI = 3.13–28.82). Conclusions: Years after the pandemic, posttraumatic stress derived from it continues to impact the mental health of adolescents. Further long-term research is needed, as well as close follow-up and intervention in this population. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

11 pages, 876 KiB

Open AccessArticle

Musculoskeletal Diseases as the Most Prevalent Component of Multimorbidity: A Population-Based Study

by Nina Rajovic, Slavisa Zagorac, Andja Cirkovic, Bojana Matejic, Danilo Jeremic, Radica Tasic, Jelena Cumic, Srdjan Masic, Jovana Grupkovic, Vekoslav Mitrovic, Natasa Milic and Boris Gluscevic

J. Clin. Med. 2024, 13(11), 3089; https://doi.org/10.3390/jcm13113089 - 24 May 2024

Viewed by 1823

Abstract

Background/Objectives: Due to their high frequency, common risk factors, and similar pathogenic mechanisms, musculoskeletal disorders (MSDs) are more likely to occur with other chronic illnesses, making them a “component disorder“ of multimorbidity. Our objective was to assess the prevalence of multimorbidity and to identify the most common clusters of diagnosis within multimorbidity states, with the primary hypothesis that the most common clusters of multimorbidity are MSDs. Methods: The current study employed data from a population-based 2019 European Health Interview Survey (EHIS). Multimorbidity was defined as a ≥2 diagnosis from the list of 17 chronic non-communicable diseases, and to define clusters, the statistical method of hierarchical cluster analysis (HCA) was performed. Results: Out of 13,178 respondents, multimorbidity was present among 4398 (33.4%). The HCA method yielded six multimorbidity clusters representing the most common diagnoses. The primary multimorbidity cluster, which was prevalent among both genders, age groups, incomes per capita, and statistical regions, consisted of three diagnoses: (1) lower spine deformity or other chronic back problem (back pain), (2) cervical deformity or other chronic problem with the cervical spine, and (3) osteoarthritis. Conclusions: Given the influence of musculoskeletal disorders on multimorbidity, it is imperative to implement appropriate measures to assist patients in relieving the physical discomfort and pain they endure. Public health information, programs, and campaigns should be utilized to promote a healthy lifestyle. Policymakers should prioritize the prevention of MSDs by encouraging increased physical activity and a healthy diet, as well as focusing on improving functional abilities. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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29 pages, 3745 KiB

Open AccessArticle

Infodemiology of Influenza-like Illness: Utilizing Google Trends’ Big Data for Epidemic Surveillance

by Dong-Her Shih, Yi-Huei Wu, Ting-Wei Wu, Shu-Chi Chang and Ming-Hung Shih

J. Clin. Med. 2024, 13(7), 1946; https://doi.org/10.3390/jcm13071946 - 27 Mar 2024

Cited by 1 | Viewed by 2387

Abstract

Background: Influenza-like illness (ILI) encompasses symptoms similar to influenza, affecting population health. Surveillance, including Google Trends (GT), offers insights into epidemic patterns. Methods: This study used multiple regression models to analyze the correlation between ILI incidents, GT keyword searches, and climate variables during influenza outbreaks. It compared the predictive capabilities of time-series and deep learning models against ILI emergency incidents. Results: The GT searches for “fever” and “cough” were significantly associated with ILI cases (p < 0.05). Temperature had a more substantial impact on ILI incidence than humidity. Among the tested models, ARIMA provided the best predictive power. Conclusions: GT and climate data can forecast ILI trends, aiding governmental decision making. Temperature is a crucial predictor, and ARIMA models excel in forecasting ILI incidences. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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Review

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24 pages, 824 KiB

Open AccessReview

Probiotics and Prebiotics for the Treatment of Irritable Bowel Syndrome—A Narrative Review

by Carolina Marques Lopes, Cristina Sofia de Jesus Monteiro, Ana Paula Duarte and Jorge Luiz dos Santos

J. Clin. Med. 2024, 13(21), 6337; https://doi.org/10.3390/jcm13216337 - 23 Oct 2024

Viewed by 3383

Abstract

Background/Objectives: Gastrointestinal functional disorders (GFDs), including irritable bowel syndrome (IBS), are imbalances in the gut–brain axis characterized by persistence of symptoms in the abdominal area. Probiotics are live microorganisms that provide benefits to the health of their hosts when administered in adequate amounts, while prebiotics are a substrate that is selectively used by host microorganisms. This narrative review aimed to evaluate the effectiveness of prebiotics and probiotics mostly in irritable bowel syndrome, particularly on issues such as the interaction between these products and the gut microbiota, the duration of supplementation and long-term effects, the definition of ideal dosages, and the regulation and quality control of these products. Methods: A bibliographic search was carried out in indexed databases and articles published within 10 years before the beginning of the study and publications in English language, which investigated the specific theme of the study were considered. Papers dealing with topics not covered by the research questions, or presenting errors related with the wrong population or the wrong methods, as well as experimental studies and case reviews were excluded. Fifty-five articles were selected, initially in isolation by the authors and, afterward, under consensus. Results: It was possible to observe the effectiveness mainly of probiotics, in improving specific symptoms of the respective disorder; however, the available data remain unclear due to limitations concerning samples and methods of the studies evaluated. Conclusions: Despite evidence suggestive of therapeutic efficacy, additional multicenter randomized controlled trials (RCTs) with better defined protocols are still necessary to fill in the gaps in this subject, define measures to ensure the safe administration of these products, and confirm their therapeutic potential. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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Other

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15 pages, 262 KiB

Open AccessSystematic Review

Predictors of Antenatal Care Service Utilization Among Women of Reproductive Age in Ethiopia: A Systematic Review and Meta-Analysis

by Amanuel Yoseph, G. Mutwiri and Francisco Guillen-Grima

J. Clin. Med. 2025, 14(7), 2517; https://doi.org/10.3390/jcm14072517 - 7 Apr 2025

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Abstract

Objective: This study aimed to provide pooled predictors of ANC (antenatal care) service use among women of reproductive age in Ethiopia. Methods: Studies were systematically searched using PubMed, Medline, CINAHL, EMBASE, and Google Scholar. The Newcastle–Ottawa scale (NOS) tool was utilized for quality assessment (risk of bias). All data analyses were conducted by utilizing Stata version 17. A random-effects model was used to obtain the pooled predictors of ANC use. The publication bias was checked using a funnel plot and Egger’s regression test. Results: Twenty-two studies with a sample size of 25,671 were included in this review. The identified predictors of ANC service use were highest wealth rank (AOR 1.92 [95% CI: 1.53–2.31]), formal women education (AOR 2.40 [95% CI: 1.75–3.06]), formal husband education (AOR 1.49 [95% CI: 1.36–1.66]), women age ≥ 20 (AOR 1.75 [95% CI: 1.47–2.17]), mass media exposure (AOR 1.44 [95% CI: 1.21–1.66]), good maternal knowledge about the pregnancy complication (AOR 1.49 [95% CI: 1.11–1.88]), planned pregnancy (AOR 1.59 [95% CI: 1.28–1.91]), women autonomy (AOR 1.42 [95% CI: 1.23–1.62]), and positive husband attitude about the ANC service use (AOR 2.63 [95% CI: 1.47–3.79]). Conclusions: Several predictors have increased the ANC service utilization, like wealth status, women’s and their husbands’ education, older/increasing women’s age, media exposure, maternal knowledge about pregnancy complications, planned pregnancy, women’s autonomy to decide on household health care, and positive husband attitude about the ANC service utilization. Full article

(This article belongs to the Special Issue Review Special Issue Series: Recent Advances in Epidemiology & Public Health)

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