Category: Statistics

Front Public Health. 2024 Aug 7;12:1443844. doi: 10.3389/fpubh.2024.1443844. eCollection 2024.

ABSTRACT

BACKGROUND: Landscaping studies related to public health education in India do not exclusively focus on the most common Masters of Public Health (MPH) program. The field of public health faces challenges due to the absence of a professional council, resulting in fragmented documentation of these programs. This study was undertaken to map all MPH programs offered across various institutes in India in terms of their geographic distribution, accreditation status, and administration patterns.

METHODOLOGY: An exhaustive internet search using various keywords was conducted to identify all MPH programs offered in India. Websites were explored for their details. A data extraction tool was developed for recording demographic and other data. Information was extracted from these websites as per the tool and collated in a matrix. Geographic coordinates obtained from Google Maps, and QGIS software facilitated map generation.

RESULTS: The search identified 116 general and 13 MPH programs with specializations offered by different universities and institutes across India. India is divided into six zones, and the distribution of MPH programs in these zones is as follows, central zone has 20 programs; the east zone has 11; the north zone has 35; the north-east zone has 07; the south zone has 26; and the west zone has 17 MPH programs. While 107 are university grants commission (UGC) approved universities and institutes, only 46 MPH programs are conducted by both UGC approved and National Assessment and Accreditation Council (NAAC) accredited universities and institutes. Five universities are categorized as central universities; 22 are deemed universities; 51 are private universities; and 29 are state universities. Nine are considered institutions of national importance by the UGC, and four institutions are recognized as institutions of eminence. All general MPH programs span 2 years and are administered under various faculties, with only 27 programs being conducted within dedicated schools or centers of public health.

CONCLUSION: The MPH programs in India show considerable diversity in their geographic distribution, accreditation status, and administration pattern.

PMID:39171312 | PMC:PMC11335718 | DOI:10.3389/fpubh.2024.1443844

Front Public Health. 2024 Aug 7;12:1368360. doi: 10.3389/fpubh.2024.1368360. eCollection 2024.

ABSTRACT

BACKGROUND: Using data from a nationwide survey among high school students in Denmark, the aim of the current study is to measure the prevalence of online bullying and online sexual harassment and assess gender and age differences in exposure.

METHODS: We used data from the Danish National Youth Study 2019, which is a nationwide web survey among high school students, including general, commercial, preparatory and technical high schools. Data were collected from January to April 2019 through a self-administered questionnaire in the classroom. A total of 29,086 students participated (response rate: 66%). The survey included questions about online sexual harassment (victimization and perpetration) and online bullying.

RESULTS: Approximately 11% of students reported receiving sexually offensive inquiries online, and about 10% received a sexual image/video of others without the subjects’ consent. Additionally, 4% experienced that other people shared a sexual image/video of them without their consent within the last 12 months. The most common type of online bullying was feeling ignored by others online (25%), followed by someone spreading rumors or writing nasty things about them (13%), and receiving threats/unpleasant messages (12%). Gender results were mixed.

PMID:39171309 | PMC:PMC11335486 | DOI:10.3389/fpubh.2024.1368360

Front Public Health. 2024 Aug 7;12:1386441. doi: 10.3389/fpubh.2024.1386441. eCollection 2024.

ABSTRACT

INTRODUCTION: Metal carpentry includes a wide range of work activities such as welding and cutting metallic components, use of solvents and paints. Therefore, the employees in these types of activities are mainly exposed to welding fumes and volatile organic solvents. Here, we present an NMR-based metabolomic approach for assessing urinary profiles of workers in the same company that are exposed to two different risk factors.

METHODS: The study enrolled 40 male subjects exposed to welding fumes, 13 male subjects exposed to volatile organic compounds of a metal carpentry company, and 24 healthy volunteers. All samples were collected, in the middle of the working week at fast. Thirty-five urinary metabolites belonging to different chemical classes such as amino acids, organic acids and amines were identified and quantified. Results were processed by multivariate statistical analysis for identifying significant metabolites for each working group examined, compared to controls.

RESULTS: Workers exposed to welding fumes displayed urinary increase in glutamine, tyrosine, taurine, creatine, methylguanidine and pseudouridine associated to oxidative impairment, while workers exposed to volatile organic compounds showed higher urinary levels of branched chain aminoacids.

CONCLUSION: Our work identified specific urinary profile related to each occupational exposure, even if it is below the threshold limit values.

PMID:39171307 | PMC:PMC11335539 | DOI:10.3389/fpubh.2024.1386441

Front Public Health. 2024 Aug 7;12:1413772. doi: 10.3389/fpubh.2024.1413772. eCollection 2024.

ABSTRACT

BACKGROUND: The older adult migrant population in China is on the rise, which presents challenges for the national public health service system. However, the heterogeneity of public health service utilization and its relationship with social integration among the older adult migrant population remains unclear. This study aims to explore the heterogeneity the public health service utilization and how it relates to their social integration.

METHODS: A total of 6,178 older adult migrants from the China Migrants Dynamic Survey (CMDS) in 2017 were included in this study. Exploratory factor analysis was used to categorize social integration into four dimensions. Latent class analysis (LCA) was used to identify different sub-groups of public health service utilization. ANOVA and multivariate logistic regression were used to determine the characteristics of different sub-groups.

RESULTS: Three potential classes of public health service utilization were identified: low utilization of basic public health services class (N = 3,264,52.756%), medium utilization of basic public health services class (N = 1,743,28.172%), and high utilization of basic public health services class (N = 1,180,19.072%). Gender, education, extent of mobility, and move alone or not, flow time were all predictors of the class of public health service utilization. There were significant differences in social integration across potential categories (p<0.0001).

CONCLUSION: The utilization of public health services of the older adult migrants is affected by many aspects. Social integration deserves attention as a significant influencing factor in the utilization of public health services. The government should pay attention to the characteristics of the older adult migrants and formulate relevant policies in a targeted manner in order to improve the utilization of public health services of the older adult migrants.

PMID:39171305 | PMC:PMC11335552 | DOI:10.3389/fpubh.2024.1413772

Front Public Health. 2024 Aug 7;12:1412496. doi: 10.3389/fpubh.2024.1412496. eCollection 2024.

ABSTRACT

INTRODUCTION: Anaemia remains a primary concern of public health in developing countries. Indigenous populations are a significant and frequently underreported group at risk for anaemia. This study aimed to assess the prevalence of anaemia and identify its determinants in the Temiar sub-ethnic indigenous Orang Asli (OA) community in Peninsular Malaysia.

METHODOLOGY: A community-based cross-sectional study was conducted among 640 indigenous Temiar OA participants from a remote settlement in Gua Musang, Kelantan, Malaysia. Data was collected using face-to-face interviews with a standardised pretested questionnaire and through blood samples collected for haemoglobin (Hb) testing. Anaemia status was determined using the Hb level cut-off established by the World Health Organization (WHO). Descriptive analysis was used to determine the prevalence of anaemia, while multiple logistic regression was used to determine factors associated with anaemia.

RESULTS: The overall anaemia prevalence was 44.7% (286/640), and the prevalence rates of mild, moderate and severe anaemia were 42.7, 50.7 and 6.6%, respectively. Anaemia-specific prevalence varied significantly by age group (p < 0.001) and was highest in the ≤5 group for both moderate anaemia (43.4%) and severe (42.1%), followed by the 6-17 age group for mild anaemia (39.3%). The prevalence of anaemia was also highest among students (53.9%), with a significant difference observed between the three anaemia severity classifications (p = 0.002). In the multivariate logistic regression, only age groups of 6-17 (adjusted odds ratio [aOR] 0.38, p < 0.001), 18-40 (aOR 0.18, p < 0.001) and > 40 (aOR 0.25, p < 0.001) were significantly associated with the lower odds of anaemia in the population.

CONCLUSION: This study has highlighted the high prevalence of anaemia among indigenous OA in Peninsular Malaysia and revealed that younger children were positively associated with childhood anaemia. Effective interventions and special attention to this indigenous population need to be implemented to reduce the risk of anaemia.

PMID:39171304 | PMC:PMC11336250 | DOI:10.3389/fpubh.2024.1412496

Front Public Health. 2024 Aug 7;12:1403196. doi: 10.3389/fpubh.2024.1403196. eCollection 2024.

ABSTRACT

BACKGROUND: Multimorbidity has become a major public health problem among Chinese middle-aged and older adults, and the most costly to the health care system. However, most previous population-based studies of multimorbidity have focused on a limited number of chronic diseases, and diagnosis was based on participants’ self-report, which may oversimplify the problem. At the same time, there were few reports on the relationship between multimorbidity patterns and health care costs. This study analyzed the multimorbidity patterns and changes among middle-aged and older people in China over the past decade, and their association with medical costs, based on representative hospital electronic medical record data.

METHODS: Two cross-sectional surveys based on representative hospital data were used to obtain adults aged 45 years and older in Xiangyang in 2013 (n = 20,218) and 2023 (n = 63,517). Latent Class Analysis was used to analyze changes in the patterns of multimorbidity, gray correlation analysis and ordered logistics model were used to assess the association of multimorbidity patterns with medical expenses. The diagnosis and classification of chronic diseases were based on the International Classification of Diseases, Tenth Revision codes (ICD-10).

RESULTS: The detection rate of chronic disease multimorbidity has increased (70.74 vs. 76.63%, p < 0.001), and multimorbidity patterns have increased from 6 to 9 (2013: Malignant tumors pattern, non-specific multimorbidity pattern, ischemic heart disease + hypertension pattern, cerebral infarction + hypertension pattern, kidney disease + hypertension pattern, lens disease + hypertension pattern; new in 2023: Nutritional metabolism disorders + hypertension pattern, chronic lower respiratory diseases + malignant tumors pattern, and gastrointestinal diseases pattern) in China. The medical cost of all multimorbidity patients have been reduced between 2013 and 2023 (RMB: 8216.74 vs. 7247.96, IQR: 5802.28-15,737 vs. 5014.63-15434.06). The top three specific multimorbidity patterns in both surveys were malignancy tumor pattern, ischemic heart disease + hypertension pattern, and cerebral infarction + hypertension pattern. Hypertension and type 2 diabetes are important components of multimorbidity patterns. Compared with patients with a single disease, only lens disorders + hypertension pattern were at risk of higher medical costs in 2013 (aOR:1.23, 95% CI: 1.03, 1.47), whereas all multimorbidity patterns were significantly associated with increased medical costs in 2023, except for lens disorders + hypertension (aOR:0.35, 95% CI: 0.32, 0.39). Moreover, the odds of higher medical costs were not consistent across multimorbidity patterns. Among them, ischemic heart disease + hypertension pattern [adjusted odds ratio (aOR):4.66, 95%CI: 4.31, 5.05] and cerebral infarction + hypertension pattern (aOR: 3.63, 95% CI: 3.35, 3.92) were the two patterns with the highest risk. Meanwhile, men (aOR:1.12, 95CI:1.09, 1.16), no spouse (aOR:1.09, 95CI: 1.03, 1.16) had a positive effect on medical costs, while patients with total self-pay (aOR: 0.45, 95CI: 0.29, 0.70), no surgery (aOR: 0.05, 95CI: 0.05, 0.05), rural residence (aOR: 0.92, 95CI: 0.89, 0.95), hospitalization days 1-5 (aOR: 0.04, 95CI: 0.04, 0.04), and hospitalization days 6-9 (aOR: 0.15, 95CI: 0.15, 0.16) had a negative impact on medical costs.

CONCLUSION: Multimorbidity patterns among middle-aged and older adults in China have diversified over the past decade and are associated with rising health care costs in China. Smart, decisive and comprehensive policy and care interventions are needed to effectively manage NCDS and their risk factors and to reduce the economic burden of multimorbidity on patients and the country.

PMID:39171301 | PMC:PMC11335498 | DOI:10.3389/fpubh.2024.1403196

Front Public Health. 2024 Aug 7;12:1420943. doi: 10.3389/fpubh.2024.1420943. eCollection 2024.

ABSTRACT

OBJECTIVE: Few comparisons have been implemented between different prenatal care utilization indices and their effects on adverse outcomes. This study investigated the appropriateness of Chinese antenatal care (ANC) regulations and compared Chinese and American adequacy of prenatal care utilization (APNCU) scores.

METHODS: From 2010 to 2022, the medical records of 60,114 pregnant women were collected from the electronic medical record system (EMRS) in Zhoushan, China. ANC utilization was measured using the APNCU score and five times antenatal care (ANC5). Birth weight outcomes, including small for gestational age (SGA) and large for gestational age (LGA), low birth weight (LBW), macrosomia, birth weight, and preterm birth (PTB), were utilized as outcomes. Multinomial, linear, and logistic regression were used to analyze the association of ANC5 and APNCU with outcomes, respectively. Crossover analysis was implemented to compare the interaction between ANC5 and APNCU on the outcomes.

RESULTS: Women who received inadequate prenatal care had increased odds for PTB (ANC5: odds ratio (OR) = 1.12, 95% confidence interval (95%CI) = 1.03-1.21; APNCU: OR = 1.18, 95%CI: 1.07-1.29), delivering SGA infants (ANC5: OR = 1.13, 95%CI = 1.07-1.21; APNCU: OR = 1.11, 95%CI = 1.03-1.20). Crossover analysis revealed that inadequate prenatal care in APNCU only was significantly associated with an increased risk of PTB (OR = 1.48, 95%CI: 1.26-1.73).

CONCLUSION: Women with inadequate prenatal care in ANC5 or APNCU were more likely to suffer from adverse birth outcomes, including PTB, birth weight loss, SGA, and LBW. It indicated that adequate prenatal care is necessary for pregnant women. However, there were interactions between ANC5 and APNCU on PTB, with inadequate prenatal care use by APNCU showing the highest risk of PTB. This indicates that APNCU would be a better tool for evaluating prenatal care use.

PMID:39171300 | PMC:PMC11335484 | DOI:10.3389/fpubh.2024.1420943

Front Public Health. 2024 Aug 7;12:1421509. doi: 10.3389/fpubh.2024.1421509. eCollection 2024.

ABSTRACT

INTRODUCTION: Socio-economic background is often an important determinant for health with low income households having higher exposure to risk factors and diminished access to healthcare and prevention, in a way that is specific to each country.

METHODS: Here, we perform a comparative analysis of the relations between health and income inequality in two developed countries, USA and Italy, using longitudinal and cross-sectional data from surveys.

RESULTS AND DISCUSSION: We show that the income class determines the incidence of chronic pathologies, associated risk-factors and psychiatric conditions, but find striking differences in health inequality between the two countries. We then focus our attention on a fraction of very disadvantaged households in the USA whose income in persistently at the bottom of the distribution over a span of 20 years and which is shown to display particularly dire health conditions. Low income people in the USA also display comorbidity patterns that are not found in higher income people, while in Italy income appears to be less relevant for comorbidity. Taken together our findings illustrate how differences in lifestyle and the healthcare systems affect health inequality.

PMID:39171297 | PMC:PMC11335724 | DOI:10.3389/fpubh.2024.1421509

Huan Jing Ke Xue. 2024 Aug 8;45(8):4577-4588. doi: 10.13227/j.hjkx.202308211.

ABSTRACT

Groundwater is one of the major water sources for production, living, and agricultural irrigation in the Yinchuan Plain. Owing to the influence of the regional environmental background and long-term effects of human activities, groundwater quality is generally inferior. To deeply analyze the formation mechanism and source of hydrochemical components in groundwater in the Yinchuan Plain, the traditional hydrochemical graphic method and mathematical statistics and principal component analysis-multivariate linear statistical model were used. Based on inorganic component contents of 100 phreatic water samples and 46 confined groundwater samples, the hydrochemical characteristics and quality status, spatial distribution of over-limit toxicological components, and contribution rate of hydrochemical components were analyzed. The results showed that the chemical components of groundwater were controlled by rock weathering and evaporation concentration. Dissolution-enrichment （F1）, original geological environment （F2）, and human activities（F3） were the principal factors that influenced groundwater hydrochemistry with the contribution rates of 73.67%, 14.45%, and 11.88%, respectively. The major over-limit toxicity indices in groundwater were NO₃^–-N and F^–. High NO₃^–-N phreatic water was mainly influenced by agriculture activities, followed by the discharge of domestic sewage. Enrichment of groundwater F^– was mainly caused by leaching of F-bearing minerals and cation exchange adsorption.

PMID:39168677 | DOI:10.13227/j.hjkx.202308211

Huan Jing Ke Xue. 2024 Aug 8;45(8):4565-4576. doi: 10.13227/j.hjkx.202307248.

ABSTRACT

To understand the karst groundwater hydrochemical characteristics and ion sources of the Jinan Baotu Spring area, this study focused on the three functional zones as an indirect recharge area, direct recharge area, and discharge area. Through water sample collection and testing, the spatial variability of groundwater chemical characteristics in different functional zones and the formation mechanism were analyzed using hydrochemistry parameter statistics, multivariate statistics, self-organizing map, hydrochemistry graphical analysis, ion ratios, and other methods, guided by the theory of groundwater flow system and combined with regional physical geography and hydrogeological conditions. The results showed that： the groundwater of each functional zone was alkaline as is typical in the dissolution of carbonate minerals. Owing to the different groundwater runoff pathways, the variability of water chemistry parameters in different functional areas was obvious. The groundwater of the discharge area was recharged by both the direct recharge area and the indirect recharge area. The hydrochemistry type changed from HCO₃-Ca type to HCO₃·SO₄-Ca type through the indirect recharge area to the discharge area. The presence of a small amount of gypsum dissolution within the aquifer generated Ca²⁺ and SO₄^2-. The ions in groundwater mainly came from the dissolution and filtration of aquifer rock minerals, and at the same time, they were affected by cation exchange, mineral dissolution equilibrium, and the combined effects of human activities. The groundwater in the Baotu Spring area was greatly influenced by human activities, which to some extent affected the evolution of groundwater hydrochemistry in the spring area.

PMID:39168676 | DOI:10.13227/j.hjkx.202307248