Search Results (44)

Background/Objectives: Cardiovascular disease (CVD) is the leading cause of death in China. While obesity and dietary patterns are well-established factors, the independent association between overall dietary quality and CVD prevalence—specifically whether this link persists regardless of Body Mass Index (BMI)—requires further clarification. Furthermore, the behavioral and cognitive correlates that drive dietary quality, such as health literacy, remain insufficiently explored. This study evaluated the association of dietary quality with self-reported CVD among Chinese adults, independent of BMI, and identified the key behavioral and cognitive factors associated with dietary adherence in this population. Methods: This cross-sectional study surveyed 975 Chinese adults through anonymous questionnaires and collected self-reported data on CVD, BMI, dietary quality, and health literacy. One-way analysis of variance (ANOVA) and the chi-square test were used to compare the characteristics between groups, and multivariate Logistic regression was used to analyze the association between dietary quality and the odds of CVD, sequentially adjusting for variables such as BMI, physical activity. Results: Higher dietary quality was independently associated with lower odds of CVD (Model 3: OR = 0.879, 95% CI: 0.845–0.915, p < 0.001). Notably, this inverse association remained significant after adjusting for BMI, which itself showed no significant association with CVD prevalence in the multivariable model. Regarding population profiling, poor dietary quality was significantly related to regular smoking (p < 0.05), whereas age, gender, residence, employment status, and BMI showed no significant associations with dietary quality categories. Furthermore, health literacy (p < 0.05) and physical activity (p < 0.05) showed positive associations with superior dietary quality. Conclusions: Dietary quality is a significant independent factor inversely associated with CVD prevalence, regardless of obesity status. Suboptimal dietary habits cluster among smokers and individuals with lower health literacy and physical activity levels, showing a stronger association with cognitive and behavioral factors than with demographic or occupational characteristics. Interventions should prioritize enhancing health literacy and addressing the clustering of unhealthy behaviors to effectively address the cardiovascular burden in the Chinese population. Full article

Background: Last Aid Courses (LACs) for the public aim to enhance the public discussion about dying, death and grief and to increase the awareness for palliative care throughout the whole society. Based on the wishes and needs of professionals from health and social care and results from previous studies on LACs, a longer Last Aid Course Professional (LACP) was developed. The aim of the present study was to evaluate the experiences and views of course participants and instructors on the Last Aid Course Professional (LACP) with ten teaching hours including the foundations of palliative care based on the storyline method. Methods: A mixed-methods approach was used including qualitative and quantitative data from a questionnaire for LACP participants and focus group interviews of LACP instructors. Results: A total of 394 of the 422 participants participated in the study by returning a questionnaire (response rate 93%). The age ranged from 21 to 81 years (median 45 years). In addition, 14 instructors participated in two focus group interviews. The results from the questionnaires showed that 84% of all participants assess the course as useful for all professionals working in health and social care. The qualitative data show that the LACP was well accepted by different organizations and participants from different professions. The participants welcome the opportunity for interprofessional exchange and the possibility for a change in perspective, as well as getting insight from different perspectives, reflecting on ethical challenges, and working on different options for action in palliative care. Lack of staff was the main barrier for participation in the LACP. Conclusions: The LACP is very well accepted by the participants and is a good option for palliative care education for professionals from health and social care. Full article

Considering the high prevalence of adolescent depression and anxiety, the profound functional consequences of untreated early psychosis and suicide being the number one cause of death in Australia among 15–19-year-olds, ensuring that teachers are literate about these disorders should be a high priority. Teachers’ disorder-specific literacy is a pragmatic response to healthcare system constraints. This scoping review aimed to map the evidence of teacher mental health literacy training programs, specifically for depression, anxiety, early psychosis and suicide risk. PRISMA-ScR guidelines were followed. Included studies were published in English between 2000 and 2024, focused on teachers working with students in Year 7–12 and measured teachers’ knowledge of depression, anxiety, psychosis or suicide risk. Studies were appraised for quality. Eighteen studies met the inclusion criteria. Nine evaluated knowledge of student depression, five evaluated knowledge of anxiety and five evaluated knowledge of psychosis, while nine studies focused on suicide risk. Providing disorder-specific training and evaluation, rather than general mental health literacy training, is recommended for future research. When healthcare systems lack the capacity to provide care for ill adolescents, schools often function as frontline sites for recognition and triage. Disorder-specific literacy is recommended for teachers so they can manage their real-world, health-system compensation role. Full article

The cut-off low that struck Valencia (Spain) on 29 October 2024, causing 229 deaths, underscored the pressing need to promote awareness and strengthen education on natural hazards, particularly among school-aged students. In this scenario, revising the school curriculum becomes essential to ensure that future generations are prepared to confront the challenges posed by climate change. This study examines how knowledge related to natural hazards is incorporated into the official curricula of Secondary (ages 12 to 16) and Baccalaureate education (ages 16 to 19), based on the Royal Decrees enacted since 2022. The study aims to determine which contents are included, the Specific Competencies addressed, and the pedagogical approaches employed (descriptive, preventive, or critical), while also evaluating the coherence of these elements across subjects and educational levels. Findings reveal a scarce and often fragmented presence of such contents, with a predominance of descriptive approaches and limited emphasis on prevention or critical reflection. The study concludes that risk education should be transversal, contextually grounded, and transformative. Current curricular gaps and that current gaps and overlaps represent an opportunity to reinforce territorial literacy and enhance students’ resilience. Full article

Objective: To provide a narrative overview of the scientific knowledge on Last Aid Courses and experiences from different countries. Background: The levels of death literacy, grief literacy, and knowledge about palliative care are low in many countries around the world. For many people, dying, death, and grief are still a taboo. Public Palliative Care Education (PPCE), the public knowledge approach, and the Last Aid Course (LAC) aim to increase death literacy, grief literacy, and public knowledge about palliative care. Methods: A literature search in the databases PubMed/Medline, CINAHL, and PsycInfo was undertaken. Other additional sources were found by hand searching, books, reference lists, and the internet. A narrative overview of the existing literature on LAC and Public Palliative Care Education (PPCE) is provided. Experiences with PPCE and LAC from different countries are presented. Based on the findings, a future agenda for research on PPCE and LAC is presented. Results and Discussion: PPCE and LAC have been introduced in 23 countries. A total of 17 articles and reviews on Last Aid were included. Research on the effects of LAC in different countries and cultural issues connected to LAC are ongoing. Conclusions: Since 2015, LACs have been introduced in 23 different countries. The LAC, the LAC-KT, and PPCE may enhance the public debate on dying, death, grief, and palliative care and may empower people to contribute to end-of-life care in the community. Future research on PPCE, the LAC, and the LAC-KT should focus on retention over time and the long-term effects of the courses. Full article

Cancer is the second leading cause of death in the U.S., with 612,000 deaths estimated in 2023. Cancer screening (CS) reduces mortality through early detection, but the impact of chronic conditions like adult asthma (AA) on screening is less understood. This study explores the association between AA and uptake of prostate, breast, cervical, and colorectal CS using BRFSS 2016, 2018, 2020 and 2022 data. Weighted and adjusted multivariable logistic regression assessed the association between AA and CS across sex and age-based subgroups with significant effect modification testing and subsequent subgroup analyses. Results showed significantly higher CS adherence among individuals with AA across all four CS sites compared to counterparts without asthma (CCWA). Males (55–69 years old (YO)) with AA had 15% significantly higher weighted and adjusted odds (WAO) of prostate CS (95% CI: 1.04–1.27). Women (50–74 YO) with AA had 16% significantly higher WAO of breast CS (95% CI: 1.01–1.32), with non-depressed, heavy-drinking women showing 300% significantly higher WAO (95% CI: 2.20–7.22) of breast CS. Women (21–65 YO) with AA had 9% significantly higher WAO of cervical CS (95% CI: 1.02–1.17), with education significantly modifying the association (WAOR for college-educated women = 1.23, 95% CI: 1.11–1.36). When CCWA, colorectal CS showed significantly higher odds of 36% for men aged 50–75 (95% CI: 1.24–1.49) and 24% for women aged 50–75 (95% CI: 1.15–1.33). This is the first national study to examine the association between AA and uptake of prostate, female breast, cervical, and colorectal CS over four years. Individuals with AA had significantly greater odds of CS adherence than CCWA. Effect modification by heavy drinking and education suggests the need for targeted outreach and low-literacy interventions. Full article

This study investigates the public health consequences of media exposure to terrorism by examining individuals’ emotional responses to photographs from the October 7th terror attack, assessing how such imagery interacts with personality traits to influence emotional states. The research aims to explore how these reactions are moderated by personality traits—specifically the Big Five. A diverse sample comprising Israeli Jews (final sample N = 826) viewed media-sourced images categorized as explicit negative (n = 279; e.g., photos of bodies or deceased individuals), implicit negative (n = 269; images depicting destruction and devastation without explicit death symbols), and positive (n = 278; images of reconstruction and renewal). Participants’ affective states and specific emotions were assessed both before and after exposure to capture potential shifts. Results revealed a significant increase in negative emotions and a corresponding decrease in positive emotions following exposure to negative images. Personality traits moderated these emotional responses in nuanced ways. Neuroticism exacerbated negative emotional reactions, particularly among men exposed to implicit negative imagery, likely reflecting heightened sensitivity to ambiguous threats. Similarly, agreeableness was associated with heightened anger responses—specifically among men exposed to implicit negative imagery and women exposed to explicit negative images—although this effect was limited to anger and did not extend to other negative emotions. In contrast, openness was linked to decreased anger but only for men exposed to implicit negative imagery. Together, these findings underscore the complex interplay between media exposure, personality traits, and emotional responses to terror-related content. From a public health perspective, the results highlight the need for the following: (a) targeted mental health interventions that account for personality-based vulnerabilities, (b) responsible media reporting practices that minimize unnecessary harm, and (c) media literacy initiatives that empower individuals to manage exposure to distressing content. By linking personality, media imagery, and emotional outcomes, this study provides actionable insights for strengthening resilience, guiding ethical media practices, and promoting psychological well-being in communities affected by terrorism. Full article

Background/Objectives: In Angola, malnutrition contributes each year to the deaths of an estimated 42,000 to 76,000 children under the age of 5. Addressing this issue must stand as a priority and requires providing local residents with access not only to nutritious food but also to adequate and accurate information in order to facilitate informed dietary choices. As part of the “Seigungo—Health, Education and Quality of Maternal and Child Life in Gungo project”, a nutrition-focused study was conducted in Gungo, Angola to evaluate the effectiveness of a training model designed to enhance food literacy among residents. Methods: Data were collected using a 14-item questionnaire developed to assess various key domains of food literacy: information seeking and access; comprehension and thematic knowledge; critical evaluation of information and behaviour; practical application and sound decision-making. Results: Thirty trainees took part in the study, of which 60% were men, with a mean age of 45.6 years. The majority were single (53.3%) and had completed six years of formal education (26.7%). Before attending the training program, 86.7% of the participants demonstrated inadequate or problematic food literacy. Following the intervention, the proportion of participants with adequate food literacy increased significantly from 13.3% to 73.3% (p < 0.001). Conclusions: The training program had a statistically significant impact on improving food literacy. Full article

Suicide is a leading cause of death among construction workers, particularly younger and lower-skilled employees. Barriers such as stigma, low mental health literacy, and traditional masculine norms hinder help-seeking in this male-dominated sector. Few mental health interventions are tailored to this context. This study developed a co-designed, theory-informed training to improve mental health literacy, reduce stigma, and increase help-seeking among construction workers in Ireland. Using the Medical Research Council’s framework, the training was developed with the Theory of Planned Behavior (TPB), Behavior Change Techniques, and extensive stakeholder co-design. Two systematic reviews, a broad literature review, and focus groups with industry managers informed the content and structure. The training will be pilot-tested using validated measures: the Literacy of Suicide Scale (LOSS), the Stigma of Suicide Scale (SOSS), and the General Help-Seeking Questionnaire (GHSQ), the results of which will be the subject of a separate study. CAIRDE is a promising, evidence-based training that addresses key mental health barriers in Irish construction. Embedding the TPB within a co-design methodology has resulted in the development of a training program that is underpinned by theoretical fidelity and cultural relevance and provides a framework for other male-dominated industries to draw upon. Future work should address remaining challenges related to stigma and help-seeking, and explore broader implementation through integration into mandatory safety training. Full article

Background and aims: The Last Aid Course (LAC) has been established to enhance the discussion about dying, death and grief and to raise the public’s awareness of palliative care. The aim of this study was to explore the views and experiences of German Last Aid Course instructors with the LAC as means for Public Palliative Care Education (PPCE), including their opinion about the course content and format and practical aspects of teaching in different settings. Methods: A longitudinal mixed-methods approach was used to explore the views and experiences of the Last Aid Course instructors over a period of five years. Social space orientation was used as the framework for the data analysis. Results: The LAC participants felt empowered after the LACs. Continuing development was a characteristic of the LAC project. The positive effects of the LACs included empowerment and positive interactions between the instructors and participants. In addition, the LACs had a positive impact on all five principles of social space orientation. Conclusions: LACs can contribute to raising public awareness about dying, death, grief and palliative care and empower people to participate in caring for those who are serious ill, dying and grieving. Full article

Neonatal mortality, particularly due to early-onset sepsis (EOS), remains a pressing issue in Eastern Europe, with Romania experiencing one of the highest neonatal mortality rates in the European Union. EOS, caused by bacterial infections within the first 72 h of life, significantly contributes to neonatal deaths, particularly in rural and underserved areas where healthcare resources are limited. Disparities in prenatal care access, maternal demographics, and systemic healthcare gaps worsen this issue, highlighting the need for comprehensive interventions. Objectives: This review aims to examine the prevalence of neonatal mortality due to EOS in Romania and the broader Eastern European context, focusing on current prenatal care monitoring protocols and maternal demographics, and comparing the available literature with new data. By evaluating disparities in healthcare access, costs, and outcomes, this study identifies systemic barriers to maternal and neonatal care. Methods: A systematic review of 100 articles was conducted using PRISMA guidelines. Key sources included PubMed, Google Scholar, and open-access journals, with 25 articles meeting the inclusion criteria. The analysis encompassed maternal age, parity, literacy levels, marital status, and their impact on neonatal outcomes, alongside the financial burden of prenatal care. Results: The findings underscore stark inequalities in healthcare delivery between rural and urban regions, where limited prenatal visits, out-of-pocket costs, and cultural barriers hinder prompt EOS prevention and management. Advanced maternal age, low literacy, and socioeconomic disparities were identified as critical risk factors. Conclusions: To reduce neonatal mortality due to EOS, targeted efforts must address healthcare accessibility, improve prenatal care protocols, and integrate culturally sensitive practices. These interventions can bridge systemic gaps and promote equitable health outcomes for mothers and newborns across Eastern Europe. Full article

Human rabies is preventable but almost always fatal once symptoms appear, causing 59,000 global deaths each year. Limited awareness and inconsistent access to post-exposure prophylaxis hinder prevention efforts. To identify gaps and opportunities for improvement in online rabies information, we assessed the readability, understandability, actionability, and completeness of online public rabies resources from government and health agencies in Australia and similar countries, with the aim of identifying gaps and opportunities for improvement. We identified materials via Google and public health agency websites, assessing readability using the Simple Measure of Gobbledygook (SMOG) index and understandability and actionability with the Patient Education Materials Tool for Print materials (PEMAT-P). Completeness was assessed using a framework focused on general and vaccine-specific rabies information. An analysis of 22 resources found a median readability of grade 13 (range: 10–15), with a mean understandability of 66% and mean actionability of 60%; both below recommended thresholds. Mean completeness was 79% for general rabies information and 36% for vaccine-specific information. Visual aids were under-utilised, and critical vaccine-specific information was often lacking. These findings highlight significant barriers in rabies information for the public, with most resources requiring a high literacy level and lacking adequate understandability and actionability. Improving readability, adding visual aids, and enhancing vaccine-related content could improve accessibility and support wider prevention efforts. Full article

HIV-1, Hepatitis B and HTLV-1 have similar risk factors and shared routes of transmission and MSM are disproportionately affected by HIV. The aim of the study was to determine the prevalence of HTLV-1 and HBsAg positivity at initial enrolment among MSM attending a large HIV Clinic in Trinidad. Chart reviews were conducted between 2 and 15 January 2024, among self-identified MSM and a comparative group of randomly selected self-identified heterosexual males where sociodemographic, clinical and laboratory data were collected and analysed using SPSS Version 25. During the period April 2002–31 October 2023, in total there were 10,424 patients registered at the clinic, of whom 1255 (12.0%) were self-identified MSM, with an age range of 19–85 years and a median age of 40 years. There were 1822 randomly selected heterosexual males, with an age range of 18–94 years old and a median age of 52 years. Among the MSM, there were 21 (1.67%) patients who were HIV-1/HTLV-1-coinfected, 64 (5.10%) who were HIV-1/HBsAg-coinfected and two (0.16%) who were coinfected with all three viruses (HIV-1/HTLV-1/HBsAg) as compared to 47 ((2.58%) HIV-1/HTLV-1-coinfected (p = 0.12), 69 (3.79%) HIV-1/HBsAg-coinfected (p = 0.10) and three (0.16%) patients coinfected with all three viruses among the heterosexual males. There were no patients with HTLV-1-related diseases among the HIV-1/HTLV-1-coinfected patients and there were no deaths from chronic liver disease in patients coinfected with HIV-1/HBsAg. Despite the availability of an efficacious vaccine, there is a prevalence of hepatitis B of 5.1% among MSM attending the HIV Clinic in Trinidad; therefore, programmes to increase health literacy, screening and immunization are urgently needed. Full article

Cervical cancer is the leading cause of cancer deaths among Sub-Saharan African women. This systematic review aimed to identify information sources and their relation to cervical cancer knowledge, literacy, screening, and attitudes. Peer-reviewed literature was searched on 2 March 2022, and updated on 24 January 2023, in four databases—CINAHL Plus, Embase, PubMed, and Web of Science. Eligible studies included those that were empirical, published after 2002, included rural women, and reported on information sources and preferences. The quality of the selected articles was assessed using the Mixed Methods Appraisal Tool. Data extraction was conducted on an Excel spreadsheet, and a narrative synthesis was used to summarize findings from 33 studies. Healthcare workers were the most cited information sources, followed by mass media, social networks, print media, churches, community leaders, the Internet, and teachers. Community leaders were preferred, while healthcare workers were the most credible sources among rural women. There was generally low cervical cancer knowledge, literacy, and screening uptake, yet high prevalence of negative attitudes toward cervical cancer and its screening; these outcomes were worse in rural areas. A content analysis revealed a positive association of health information sources with cervical cancer literacy, knowledge, screening, and positive screening attitudes. Disparities in cervical cancer prevention exist between rural and urban Sub-Saharan African women. Full article

Injury is the leading cause of death and disability amongst those between 0 and 16 years of age. Routinely associated with a social gradient of health, childhood injury is reportedly higher in rural and regional areas. A retrospective cross-sectional study collected deidentified emergency injury presentation data from nine health services in regional Victoria for children aged 0–14 years between 2017 and 2022. Emergency injury presentation incidence rates and predictor variables were analysed using hierarchical multiple regression. Significance was determined at p < 0.05. Amongst the 15,884 emergency injury presentations, 35.2% (n = 5597) occurred at health services that did not routinely report data to government datasets. Although some findings are consistent with current research, this study highlights specific factors that are predictive of injury amongst 0–4-year-old children who require deeper investigation, including general practitioner access and health literacy-related elements such as preschool health assessment attendance rates, parent education levels, and overseas birth. These findings provide more comprehensive insights for healthcare workers and policymakers as they seek to support people with injuries and accurately address health inequities. Full article