Search Results (47)

Intimate partner violence (IPV) continues to be a serious public health issue, particularly in Ghana. It is crucial to create evidence-based, preventative measures to stop IVP. This study empirically investigated the factors related to married women’s perceptions of male IPV against women. The United Nations Sustainable Development Goals (SDGs) (Goal 5.2) advocate for the elimination of male violence against women by governments, hence this study contributes to monitoring the progress being made. This study employed cross-sectional secondary data from Ghana Multiple Indicator Cluster Surveys (MICS) conducted in 2018 with a sample of 14,237 women aged 15–49. Data were analyzed using descriptive statistics and bivariate and multivariate logistic regressions, and the results were presented as odds ratios (ORs) with a confidence interval (CI) of 95%. Women’s justification of male IPV against women was correlated with socio-demographic factors such as education level, marital status, age of the woman, area of residence (rural or urban), ethnic background, and economic disadvantage (wealth status). Higher educated women (OR 0.248 [95% CI 0.185–0.332, p < 0.001]) were less likely to justify male IPV against women than women with no/less formal education. Women who were in the richest quintile (OR 0.766 [95% CI 0.634–0.926, p = 0.006]) were less likely than those in the poorest/lowest quintile to rationalize/justify intimate partner violence. In terms of ethnicity of the household head, the Ga/Dangme (OR 0.86 [95% CI 0.714–1.036, p = 0.112]) had lower odds of justifying male IPV against women compared to the Akan. The government, through the Ministry of Gender and Child Protection and women’s advocacy groups, should devise strategies, programs, and policies to empower women through formal education and economically through job training and employment support for women and victims to help them achieve financial independence and reduce negative attitudes toward women and the prevalence of male IPV against women. Full article

Background: Acute diarrheal disease remains a leading cause of childhood morbidity and mortality, particularly among children under five. Despite being preventable and treatable, cultural, socioeconomic, and familial factors influence home management. This study examined how these factors shape childhood diarrhea care in Ecuador. Objective: To analyze maternal, child, and household characteristics associated with diarrhea management in children under five years of age using data from the 2018 Ecuadorian National Health and Nutrition Survey (ENSANUT). Methods: This cross-sectional study applied logistic regression models to assess the influence of various factors on diarrhea management practices. Results: Maternal education, ethnicity, child’s age, household size, and urban or rural residence significantly influenced diarrhea management. Households with 4–6 persons (OR = 1.584, p < 0.05) and 7–9 persons (OR = 2.006, p < 0.05) had higher odds of receiving medical care. However, the child’s sex, birth order, maternal marital status, and socioeconomic status were not significant predictors. Conclusions: Although most children received some form of healthcare, disparities persisted, particularly in education level, ethnicity, and rural residence. These findings highlight the need for targeted maternal health literacy programs, culturally tailored interventions, and improved water-security initiatives to enhance diarrhea management and reduce inequities in care. Full article

Background/Objectives: The preschool period plays an essential role in shaping a child’s overall development, which influences physical, emotional, social, and cognitive growth. At this stage, establishing proper postural habits is essential, as it can have lasting effects on health, well-being, helps to prevent future issues, and supports overall development. Therefore, the present work aims to determine the differences in postural status between boys and girls of preschool age. Methods: The sample of participants consisted of 92 children (n = 46 boys and n = 46 girls); the average age for girls was 5.41 ± 0.30 years and for boys it was 5.53 ± 0.31 years. Data were collected using licensed state-of-the-art diagnostic equipment, Contemplas 3D Posture Compact, using 16 variables to assess postural status with a Mann–Whitney U test. Results: The results of this study indicate that boys have more pronounced deformities in the following variables: shoulder displacement (p = 0.047), pelvic obliquity (p = 0.000), sag. distance cervical spine–sacrum (p = 0.029), sag. distance thoracic spine–sacrum (SDTS) (p = 0.016), and sag. distance lumbar spine–sacrum (SDLS) (p = 0.005). Conclusions: This study confirmed gender differences in postural characteristics in preschool children. Boys showed a greater tendency towards postural deviations, indicating the necessity for specific interventions and programs to improve their posture. On the basis of the results of this research, it is recommended to carry out cross-cultural research that would enable the comparison of results among children from different environments and cultural contexts in order to determine possible differences and particularities in the development of postural characteristics. Future research should include larger and more diverse samples of participants, including children from rural and urban areas, in order to ensure the representativeness and generalizability of the results. In addition, conducting a longitudinal study that would monitor the postural characteristics of children through different developmental stages is suggested, aiming to identify critical periods for intervention and to determine, more precisely, development trends within the context of gender differences. Full article

Vaccinations are among the most effective means of preventing hospitalizations related to infections. Despite this, high hospitalization rates for vaccine-preventable diseases strain available healthcare resources and imply deficiencies in primary care. Barriers to vaccinations exist, such as the recent pandemic, vaccine hesitancy, misinformation, and access to care. This study analyzes hospitalization rates due to vaccine-preventable conditions and identifies factors contributing to an increase in these rates in the southeast United States. This study used data from four different data sources. The data covers four pre-pandemic years (2016 to 2019) and the pandemic period (2020 to 2022). The analysis categorized the numbers and rates of hospitalizations for conditions with an available preventative vaccine across three age groups: pre-school aged children, school-aged children, and adults. Comparisons between school- versus non-school-mandated vaccines and a focus on differences between rural versus urban communities, as well as demographic characteristics (i.e., gender, race, and ethnicity), are included. Chi-squared tests were used to assess differences in this descriptive part of the analysis. Linear multiple regression was used to examine the independent influence of geographic location while accounting for potential longitudinal trends and the dimensions of the SVI, including socioeconomic status, household composition, disability, minority status and language, and household type and transportation. The dataset included data from 22,797,826 inpatient episodes, including 32,358 for which the principal reason for hospitalization was a vaccine-preventable condition, not including COVID-19. The analysis shows a consistent pattern characterized by higher rates of hospitalization for counties classified as rural. The pattern holds for preschool age (p < 0.001), school age (p = 0.004), and adults (p = 0.009). The differences are statistically significant in the white population (p = 0.008); in pre-school children, school-age children, and adults (p < 0.001); in females (p = 0.08 in pre-school, and p = 0.013 in adults); and black adults (p = 0.02). The regression results confirmed the findings of the descriptive analysis, indicating significantly higher rates in rural communities. Finally, the regression analysis also showed significantly higher rates associated with greater social vulnerability. This study highlights gaps in vaccination opportunities. These gaps can be seen geographically and in terms of social vulnerability, affected by factors such as poverty, language barriers, household composition, and access to care. Hospitalizations due to immunizable diseases were found to be higher in rural areas, particularly among adults. Communities with a high SVI show a significant increase in hospitalization rates. Community-engaged vaccination outreach programs and state policies could improve vaccination rates, and therefore, public health in rural areas, reducing hospitalizations, and lowering infectious disease risks in these areas. Full article

Suicide in Italy represents a serious public health problem, with significant data highlighting the urgency for prevention interventions. According to the epidemiological data, in the two-year period 2020–2021, 7422 suicides were recorded, representing an increase compared to previous years. Suicide is the most extreme self-harm. The contributing factors that surround this event are multiple, typically in conditions of serious distress or psychological distress, in particular in people suffering from serious psychiatric and/or mental disorders, such as depression. The role of the forensic pathologist in the context of suicide is crucial for ascertaining the contributing factors of death and for understanding the circumstances that lead to the suicidal act. Forensic medicine plays a crucial role in the analysis and understanding of suicides, addressing both the legal and medical implications. The aim of this study was to accurately describe the phenomenon of suicide in Italy. The accuracy of the review was very important in paying attention to the large difference in how the phenomenon manifests itself in the male population compared to the female population. The different ages at which suicide is committed were highlighted. The geographical difference between the North and the South and between the more urbanized areas compared to the rural areas where suicide is committed was analyzed. This scientific work also aimed to explore how forensic pathologists contribute to the resolution of complex forensic investigations. Psychological autopsy is an investigative method used primarily in cases of violent or questionable death, with the aim of understanding the psychological and social circumstances that led to an individual’s death. This practice is distinct from forensic autopsy, which focuses on the physical analysis of the body to determine the cause of death. The role of forensic pathologists in investigating suicide cases is crucial, as they not only determine the cause of death but also analyze the psychological implications that may have led to the extreme act. The main objective of a forensic pathologist in these cases is to gather and interpret evidence that can help understand the psychological and social context that influenced the decision to commit suicide, identifying any warning signs and underlying motivations and factors that may have contributed to the suicide. This approach provides valuable information for prevention, enhancing the understanding of the psychological mechanisms behind suicide and supporting targeted interventions in the future. The manuscripts also have an explanatory purpose and may have a therapeutic role in helping surviving relatives understand suicide. Knowledge of the messages contained in suicide notes could be useful for suicide prevention programs. Full article

Background: Non-communicable diseases (NCDs) are the leading cause of global mortality. The WHO projects a rise in NCD-related deaths from 36 million in 2018 to 55 million by 2030, with developing countries being the most affected. Effective community-based primary health care (PHC) can reduce the burden of chronic diseases of lifestyle (CDLs). This study aimed to develop a risk assessment and health promotion framework to strengthen CDL prevention and control in Free State (FS) communities in South Africa. Methods: A convergent mixed-method design was used. Quantitative analysis identified CDL risk factors in rural and urban FS settings, while qualitative focus group discussions explored participants’ knowledge of CDLs and their experiences with program implementation. Results: Key findings highlighted differences in risk profiles, CDL training needs for PHC teams, patient education gaps, and curriculum development. Step 1 of the framework development identified differences and similarities in the CDL risk profiles of the study populations. Step 2 identified CDL training needs for PHC teams, patient educational needs, and CDL curriculum development needs. Step 3 revealed three main barriers: resource constraints, patient non-compliance, and the lack of supporting healthcare services. In Step 4, the six focus areas identified (steps 1–3) were used to develop strategies for implementing a tailored, community-based, patient-centred approach. Conclusions: The results provide valuable insights for improving PHC responses in resource-limited settings. Full article

Background: Childhood obesity is a significant public health issue. This study aimed to evaluate the prevalence of overweight and obesity among 8- and 9-year-old children in Szczecin, Poland, and unlike other studies to assess differences in nutritional status within a single urban agglomeration of nearly 500,000 residents, it was influenced by place of residence and socioeconomic status. Methods: The study included 4705 children (2327 boys and 2378 girls) aged 8 and 9 years, attending 50 primary schools in Szczecin (45 public, 5 private) across four districts: North, Right Bank, City Center, and West. Anthropometric measurements were used to calculate BMI. Overweight was diagnosed when BMI was ≥85th percentile but lower than the 95th percentile for age and sex, while obesity was when the BMI was ≥95th percentile. Data on parental BMI, education, and place of residence were also collected. Results: The prevalence of overweight was 16.6%, and obesity was 6.2%. Overweight was more common in girls, while obesity was more frequent in boys. Children attending special education schools and living in the Right-Bank district had the highest rates of overweight and obesity. Parental obesity and low parental education, particularly the father’s, were the strongest risk factors for excess body weight. Conclusions: Differences in childhood nutritional status exist even within the same city, influenced by residence and socioeconomic factors. Parental obesity, low education, living in the city’s rural districts, and attending special education schools are key risk factors. Enhanced prevention programs tailored to these factors are crucial to combat childhood obesity effectively. Full article

Background: Influenza poses a substantial health burden, especially among older adults in China. While vaccination is one of the most effective preventions, influenza vaccine uptake rates among Chinese older adults remain low. This study examines the individual and combined effects of behavioral interventions based on the Information–Motivation–Behavioral Skills (IMB) model and economic incentives in promoting influenza vaccine uptake among older adults living in China. Methods: The study will recruit 640 older adults living in eight communities that have not been covered by the free influenza vaccination policy. These eight communities (as clusters), stratified by urban and rural, will be randomized to four parallel arms, including a usual care arm, an IMB-based behavioral intervention arm, a conditional economic incentive arm, and a combined behavioral-economic arm. The interventions will start from the beginning of the flu season and last for about one month. Specifically, the IMB-based behavioral intervention encompasses health education brochures, healthcare provider-led lectures, interactive quizzes, and personalized consultations. The exact number of economic incentives is conditional on the timing of vaccination (a higher amount for early immunization) and the number of people within a household to be vaccinated at the same appointment (a higher amount for more people). The primary outcome is the influenza vaccination rate. Data will be gathered through vaccination records and questionnaires covering IMB-based vaccination cognitions. Mixed-effects models will be used to analyze the outcome of vaccination rate, reporting difference-in-differences estimates with 95% confidence intervals. Conclusions: The results of this study have the potential to inform influenza vaccination program scaleup among older adults who are not yet covered by the free influenza vaccination policy. Ethics and dissemination: Ethics approval has been granted by the ethics commission of Peking University Health Science Centre (IRB00001052-24090). Participants will be required to sign a written consent form. Findings will be reported in conferences and peer-reviewed publications in accordance with the recommendations of the Consolidated Standards of Reporting Trials. Registration number: This study was registered at the Chinese Clinical Trial Registry (ChiCTR2400090229). Full article

eHealth literacy (eHL) is directly linked to disease prevention, health promotion, and improved healthcare outcomes. The objectives of this study are to assess undergraduate university students’ knowledge and perceived skills of finding, appraising, and applying electronic health information to health-related problems, as well as to assess the association of eHL with physical, psychological, and emotional self-care. Methods: The measurement model, comprising four correlated factors based on the 28 valid items from two reliable and valid tests, the ‘eHealth literacy scale (eHEALS)’ and ‘the self-care assessment tool (SCAT)’, was estimated using confirmatory factor analysis (CFA) among a sample of 1557 undergraduate university students in Pakistan. Results: The mean value of the eHEALS ranges between 2.90 and 3.33, indicating that the majority of the respondents had moderate levels of eHL skills. Female respondents and respondents from urban areas have greater levels of perceived eHL skills compared with their male and rural counterparts. The CFA model fit indices show that the goodness of fit values are acceptable: x² = 7.727, p = 0.000; RMSEA = 0.065; TLI = 0.930, CFI = 0.936, IFI = 0.936, GFI = 0.890, NFI = 0.928, RFI = 0.920, PGFI = 0.754. Conclusion: Electronic health (eHealth) literacy has a strong positive association with physical, psychological, and emotional self-care. However, perceived eHL skills among undergraduate university students are moderate, making them potentially susceptible to health risks. Implications: Our study has several practical implications. Its findings can be used to devise eHealth literacy programs for developing relevant skills among undergraduate university students based on their identified needs. Full article

Cardiovascular diseases, which are the leading cause of death in Croatia, are linked to the high prevalence of hypertension. Both are associated with high salt intake, which was determined almost two decades ago when Croatian Action on Salt and Health (CRASH) was launched. The main objective of the present study was to evaluate salt, potassium, and iodine intake using a single 24 h urine sample in a random sample of the adult Croatian population and to analyse trends in salt consumption after the CRASH was intensively started. Methods: In this study, we analysed data on 1067 adult participants (mean age 57.12 (SD 13.9), men 35%). Results: Mean salt and potassium intakes were 8.6 g/day (IQR 6.2–11.2) and 2.8 g/day (IQR 2.1–3.5), respectively, with a sodium-to-potassium ratio of 2.6 (IQR 1.8–3.3). We detected a decrease of 17.6% (2 g/day less) in salt consumption compared with our previous salt-mapping study. However, only 13.7% and 8.9% met the WHO salt and potassium recommended targets of 5 g/day and 3.5 g/day, respectively. Salt intake was higher, and potassium ingestion was lower, in rural vs. urban regions and in continental vs. Mediterranean parts of Croatia. Moderate to severe iodine insufficiency was determined in only 3% of the adult participants. Conclusion: In the last fifteen years, salt consumption has been significantly reduced in the Croatian adult population because of the intensive and broad CRASH program. However, salt intake is still too high, and potassium ingestion is too low. Salt reduction programs are the most cost-effective methods of cardiovascular disease prevention and merit greater consideration by the government and health policy makers. Full article

Background: Brazil has a high prevalence of toxoplasmosis. However, there is a gap in comparing seroprevalence for Toxoplasma gondii across different environments, particularly among pregnant residents of rural and urban areas. Methods: The prevalence of IgG and IgM for T. gondii was compared among pregnant residents of the urban, peri-urban, and rural settlement areas in a municipality in southeastern Brazil. Information regarding age and area of residence was compiled from January 2015 to December 2022. Logistic regression analysis was used to assess the age and area of residence as risk factors. Results: A total of 1614 examinations were recorded, revealing 54.0% seropositivity, which was highest in the rural settlement (61.1%), followed by the peri-urban area (55.9%), and lowest in the urban area (49.2%). Conclusions: The high prevalence of IgG and presence of IgM in pregnant residents of rural, peri-urban, and urban areas highlights the significance of the results obtained for strengthening maternal health programs aimed at preventing toxoplasmosis, regardless of their residence. Full article

Background: Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based “PETICA—Play for Health” obesity prevention program in urban and rural areas in Croatia. Methods: This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. “PETICA” multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student’s t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman’s correlation, and heatmaps were used. Results: The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents’ and children’s physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. Conclusion: The study shows that “PETICA” is an efficient school-based educational model that contributes to positive changes in children’s knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention. Full article

Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title and abstract review, potentially relevant citations were further examined by assessing the full text. Each stage of review was conducted by two independent reviewers. Twelve studies met the inclusionary criteria and are included in this review. Most of the studies focused on elementary school participants (n = 7) and improving both diet and PA (n = 9). Out of the twelve studies, only five included the target audience in intervention development or implementation. The most popular type of community engagement was community participation (n = 4). This review revealed that community-engaged research is under-utilized in obesity prevention interventions tested with school-aged children in rural US communities. Full article

Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban–rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013–2016 with three age groups of children (2–5, 6–11, and 12–17 years old), the associations of weight status and child and household food security status by urban–rural residence were examined using Rao–Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6–11 years. The associations between children’s weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs. Full article

This narrative review explores the multifaceted barriers hindering access to quality cancer care in Jordan. A literature-based narrative review was undertaken to explore the current identified barriers to cancer care in Jordan. Four databases were searched using relevant keywords to identify key insights on barriers and proposed solutions. Key challenges and potential solutions were identified based on evidence from studies, reports, and initiatives. Medical services and infrastructure exhibit centralized disparities, impacting rural and underserved areas. Human resources shortages, geopolitical instability, and quality management issues pose significant challenges. Public awareness campaigns face hurdles in addressing the tobacco epidemic and late-stage diagnosis. Socioeconomic disparities, particularly in health insurance and urban–rural divides, further compound barriers. Refugees encounter distinct challenges, including late-stage diagnosis, financial barriers, and psychological distress. Despite multiple challenges, Jordan presents a model for regional development and health equity. This study not only contributes to improving cancer care in Jordan but also offers a roadmap for policymakers, healthcare practitioners, and researchers in similar contexts globally. Government initiatives, financial aspects, and proposed policy measures are examined as potential solutions. Recommendations include coordinated prevention strategies, enhanced screening uptake, training programs, the equitable distribution of facilities, and policy directives aligned with global commitments. The role of digital technologies, telemedicine, and community engagement models is emphasized. Full article