Health Strategy Research Articles

How individuals apply and perceive sunscreen: Empirical evidence from Germany.

This study explores how individuals in Germany use and perceive sunscreen, aiming to identify the factors that influence their sunscreen choices. The research focuses on key elements such as convenience, environmental awareness, openness to new technologies, and preferences for different sunscreen products. The findings reveal that the majority of participants prioritize convenience when selecting sunscreen, often choosing products that are easy to apply and carry. Detailed information about the sunscreen's ingredients or health benefits tends to be less important in their decision-making process. Notably, many participants did not consider important factors such as the environmental impact of sunscreen or its effectiveness after reapplication, suggesting a gap in awareness regarding these issues. Additionally, the study investigates the relationship between demographic factors, including age and gender, and sunscreen usage patterns. It was found that these demographic variables do play a role in shaping individuals' attitudes and behaviors regarding sunscreen. For instance, younger participants showed more openness to new technologies and innovative products, while older individuals tended to rely on traditional options. Overall, this research provides valuable insights into how people perceive and use sunscreen in Germany, highlighting the need for further studies to delve deeper into these factors. Understanding these perceptions is crucial for developing effective public health strategies and enhancing product design to better meet the needs and preferences of consumers.

A IMPORTÂNCIA DO PRÉ-NATAL NA ATENÇÃO PRIMÁRIA PARA A REDUÇÃO DE COMPLICAÇÕES OBSTÉTRICAS PARA GESTANTES: REVISÃO INTEGRATIVA

INTRODUCTION: Prenatal care is the complete health monitoring of pregnant women health through consultations. High maternal mortality hates in Brazil underscore the importance of prenatal care in primary health services to reduce pregnancy-related complications. Qualified monitoring is essential for early detection of problems, ensuring the health of both mother and baby, with nurses playing a central role in consultations and preventive strategies for pregnant women. OBJECTIVE: To explore the importance of prenatal care in primary health, highlighting its fundamental role in preventing obstetric complications in pregnant women. METHODOLOGY: This study is an integrative review guided by six steps of the review process. Articles were selected from databases, including Medical Literature Analysis and Retrieval System Online (MEDLINE), LILACS, Scientific Electronic Library (SciELO), and PubMed, following the established inclusion and exclusion criteria. RESULTS: Initially, 108 articles were identified, of which three were duplicates, 84 were excluded, and 14 were included in the study. DISCUSSION: The central role of primary care in gestational follow-up is discussed, emphasizing that the quality of care directly has a direct impact on both, maternal and fetal health. Failures in basic healthcare units that compromise the effectiveness of care are highlighted. Challenges in conducting essential diagnostic tests, such as rapid tests, are mentioned, alongside the need for preventive strategies to manage common obstetric complications. CONCLUSION: Effective prenatal follow-up enable early detection of adverse conditions, preventing negative outcomes for both mother and baby. This underscores the importance of nursing professionals and the Family Health Strategy (ESF) in providing comprehensive care, ensuring quality in prenatal services and ongoing education.

Preventive Practices among Young Adults toward COVID-19 during the Pandemic in a Selected Town of Bangladesh

This study assessed COVID-19 preventive practices among 200 young adults in Tangail town, Bangladesh, focusing on the influence of socio- demographic factors such as sex and education level. Data collected through a pre-tested, semi-structured questionnaire revealed that 79% visited crowded places, 89% wore masks, 94.5% disinfected hands with soap, and 92% obeyed government restrictions. Significant gender differences were observed, with females showing higher compliance in mask-wearing and hand hygiene practices. Education level was also linked to better adherence, with those having higher education showing greater adherence to preventive practices. These findings highlight the need for targeted public health strategies and improved communication to address gaps in preventive behaviors and enhance preparedness for future pandemics.

The Intersection of Demographics and Immunization Beliefs among Nursing Mothers

Background: This research aims to elucidate the influence of demographic factors on nursing mothers' beliefs regarding childhood immunization in Ondo State, Nigeria. By identifying key variables, the study seeks to inform public health strategies that could enhance vaccination rates and improve child health outcomes. Methodology: A cross-sectional survey design was employed, utilizing a structured questionnaire to collect data from 400 mothers attending postnatal clinics in selected health facilities across Ondo East and West Local Government Areas (LGAs). The sample size was determined using Cochran’s formula, ensuring a representative sample. Multistage sampling techniques were applied, with health facilities grouped into clusters for systematic random sampling. The questionnaire, validated for face and content, consisted of four sections addressing study variables. Pre-testing was conducted with a Cronbach alpha reliability score of 0.69 for beliefs respectively. Data were analyzed using SPSS version 22.0, employing descriptive and inferential statistics. Results: Among respondents aged 21-30 years, 36.3% exhibited positive beliefs about immunization, though no significant correlation with age was found (r=0.103; p>0.05). Conversely, education significantly influenced beliefs; 23.9% of those with tertiary education demonstrated higher positive beliefs (r=0.163; p<0.05). Religious affiliation did not significantly correlate with immunization beliefs (Chi-square=0.104; p>0.05). A significant portion of nursing mothers expressed skepticism regarding vaccination safety, with 41.7% strongly disagreeing that vaccines cause more harm than diseases they prevent. Conclusion: The findings underscore the urgent need to address nursing mothers' beliefs about childhood immunization in Ondo State. Education emerged as a critical factor influencing acceptance, while age and religion were less significant. Targeted educational interventions are essential to combat misconceptions about vaccine safety and efficacy, leveraging insights from the Health Belief Model and the Theory of Reasoned Action to enhance health literacy and vaccination coverage in the region.

Do Health Literate Older People Have Fewer Depressive Symptoms? Evidence from the Urban Areas of Western China

Background: Previous research has indicated that health literacy has a good influence on the mental health among older adults. The current study aims to determine whether health literacy is linked to depressive symptoms in older adults in west China, and tries to detect the mechanisms underlying the linkage between health literacy and depressive symptoms in the Chinese context. Methods: Study data were obtained from a cross-sectional ageing health literacy survey conducted in 2017 in Western China, and 812 urban individuals aged 60 and older were selected. Results: Health literacy was associated with fewer symptoms of depression; additionally, older adults who reported harmonious family and filial piety, those with greater self-rated health, and those with a higher level of life satisfaction tended to have fewer depressive symptoms, whereas older individuals who reported a poor financial status and those with functional impairment had more depressive symptoms. Conclusions: The findings indicate the protective role of health literacy against depressive symptoms among urban older adults. In addition, the findings also indicate the potential impact of financial strain and functional impairment on the development of depressive symptoms and show that other factors including a harmonious family, filial piety, self-rated health and life satisfaction are generally protective against depressive symptoms. Specific evidence is presented for the national action plans and public health strategies needed to reinforce and promote health literacy in the Chinese context. The current results also suggest that health education and promotion programs designed to strengthen financial assistance, functional improvement, family relationships, life satisfaction and self-rated health should gain a growing importance on the health agenda. Future longitudinal studies, mediation or moderator models, and structural equation modeling would be needed to identify a causal relationship, the moderating or mediating effect, and the possible pathways underlying the linkage between health literacy and depressive symptoms, respectively.

Social Infrastructure During the COVID-19 Pandemic: Evaluating the Impact of Outdoor Recreation on Pandemic Dynamics in Europe

The COVID-19 pandemic has drastically affected mental and physical well-being, leading to significant changes in daily habits and preferences. Given that pandemics require the tear down of most social ties and interactions to limit their inevitable spread, this study delved into the extent to which social infrastructures have been affected, focusing on behavioral shifts in essential services such as retail, recreation, groceries, pharmacies, public transport, parks and open spaces, workplaces, and residential areas. Notably, while most social infrastructures saw a decline in public usage, parks and open spaces experienced increased visitation despite public health measures aimed at minimizing social interactions. This striking increase in park and open space visitations has captured the interest of this study to observe the impact it had on the trajectory of the COVID-19 pandemic, as well as the underlying causes behind this trend. Since Europe was heavily affected by the pandemic, this study focused specifically on European countries over a two-year period (March 2020 to March 2022), covering the severe period of the pandemic. While parks and open spaces initially showed no direct influence on the pandemic trajectory, when closely observing visitation trends, both increases and declines, opposing insights were revealed. This study found that attempts to reduce park and open space visitation were significantly unsuccessful, leading to substantial increases in both the magnitude and duration of visits once restrictions were eased. This surge in park and open space attendance corresponded to notable spikes in new infections during periods of peak visitation. Therefore, urban planning and public health authorities must prioritize safely accommodating the increased park and open space demand while effectively minimizing virus transmission. This involves considering park sizes and proximity, along with implementing a balanced set of crucial public health strategies to support community well-being and resilience.

Impact of COVID-19 vaccination on preventive behavior: The importance of confounder adjustment in observational studies.

The COVID-19 pandemic has underscored the critical role of observational studies in evaluating the effectiveness of public health strategies. However, although many studies have explored the true impact of vaccination on preventive behavior, their results may be skewed by potential biases and confounding variables. This study examines the application of covariate adjustment and propensity score (PS) estimation, particularly through inverse probability treatment weighting (IPTW), to assess their performance in reducing bias in a framework featuring ordinal outcomes and cumulative logistic regression models, as commonly used in observational studies related to social sciences and psychology. Before applying these methods to the case study, we conducted a simulation study that accounted for the presence or absence of model misspecification in an observational scenario with ordinal outcomes, binary treatment, and a continuous confounder. Our findings demonstrate the effectiveness of combining covariate adjustment with PS methods in reducing bias and improving causal inference. These methods were subsequently applied to an Italian observational study on COVID-19 vaccine hesitancy conducted during the initial phase of the vaccination campaign (April-May 2021). Our analysis revealed that vaccination status had a limited short-term impact on the adoption of preventive measures. This study highlights the importance of employing appropriate adjustment techniques in observational research, particularly when evaluating complex behavioral outcomes. The results support the combined use of covariate adjustment and PS methods to enhance the reliability of findings, ultimately contributing to more informed public health decision-making.

Association between nighttime and daytime ambient temperature and insomnia using national emergency department database in the capital city of South Korea.

Insomnia is a growing health concern globally, with significant implications for public health. Most studies have primarily focused on the effects of nighttime temperatures on sleep problems. However, there is a lack of studies comparing nighttime temperatures with daytime temperatures, which are more closely related to daily life activities. This study aimed to explore a short-term association of nighttime and daytime ambient temperature with emergency department (ED) visits for insomnia in the capital city of South Korea. A time-stratified case-crossover design was employed using a conditional logistic regression model. A distributed lag non-linear model was utilized to explore potential non-linear and lag effects of ambient temperature on ED visits for insomnia. Odds ratio (OR) for temperature with maximum ED visits for insomnia (MaxIT) and that for temperature with minimum ED visits for insomnia (MinIT) were calculated and compared. We observed significant associations at high temperatures for both nighttime and daytime (nighttime: 25.0℃ (94.1%) [OR: 1.82, 95% CIs: 1.31-2.55], daytime: 30.6℃ (99.0%) [OR: 2.13, 95% CIs: 1.49-3.06]) compared to MinIT (-8.5℃ (2.7%) and - 8.4℃ (1.0%), respectively). Subgroup analyses found significant associations at high temperatures in females, individuals aged 35-49, and those without comorbidities, and during spring, fall, and winter, for both daytime and nighttime. Our findings provide insights for proactive public health strategies for managing insomnia during global temperature rise.

THE CRITICAL CONNECTION BETWEEN ORAL HEALTH AND CARDIOVASCULAR WELL-BEING

The relationship between oral health and cardiovascular health has gained significant attention, particularly regarding the prevention of periodontal diseases to mitigate cardiovascular complications, especially in hypertensive patients. Periodontal diseases, including gingivitis and periodontitis, are chronic infections affecting the gums and supporting structures of teeth, potentially leading to systemic inflammation and the release of inflammatory mediators into the bloodstream. This chronic inflammation is associated with cardiovascular diseases, as it can contribute to plaque formation in arteries, increasing the risk of adverse cardiac events. Hypertension is a notable risk factor for cardiovascular diseases, and studies suggest that individuals with periodontal diseases are more likely to develop hypertension and related conditions. Therefore, proper prevention and treatment of periodontal diseases play a crucial role in the cardiovascular health of hypertensive patients. Early detection and intervention through periodontal screening programs can help reduce systemic inflammation and healthcare costs related to cardiovascular complications. Various studies support the positive effects of periodontal therapy on cardiovascular risk factors, indicating significant reductions in blood pressure and inflammatory markers following periodontal treatment. Furthermore, the alarming prevalence of hypertension, affecting approximately 45% of the global population, necessitates increased awareness of its links to periodontal health. Collaborative approaches between dentists and primary care physicians are essential to improve early detection and management of both periodontal and systemic health issues. Investing in preventive dental care not only enhances oral health but can also lead to substantial savings in healthcare costs by alleviating the financial burden associated with treating cardiovascular diseases. Ultimately, integrating oral health into broader health strategies is vital for promoting overall health and preventing chronic diseases.

Community-Based Nursing and Public Health: A Synergistic Approach to Health Promotion

Community-based nursing and public health are pivotal in addressing the complex health needs of populations, particularly in underserved and vulnerable communities. This article examines the synergistic relationship between these fields and their collective impact on health promotion. Employing a mixed-methods approach, the study combines qualitative insights from community-based nurses with quantitative analysis of health outcomes in three diverse communities. Results indicate that collaboration between community-based nursing and public health improves health literacy, enhances access to care, and reduces preventable health disparities. Key challenges, such as resource constraints and workforce shortages, are discussed alongside opportunities for leveraging technology and policy support to strengthen these partnerships. The findings underscore the transformative potential of integrating nursing expertise with public health strategies to achieve sustainable health outcomes.

Perspectives of Digital Health Innovations in Low- and Middle-Income Health Care Systems From South and Southeast Asia.

Digital health innovations have emerged globally as a transformative force for addressing health system challenges, particularly in resource-constrained settings. The COVID-19 pandemic underscored the critical importance of these innovations for enhancing public health. In South and Southeast Asia, a region known for its cultural diversity and complex health care landscape, digital health innovations present a dynamic interplay of challenges and opportunities. We advocate for ongoing research built into system development and an evidence-based strategy focusing on designing and scaling national digital health infrastructures combined with a vibrant ecosystem or "marketplace" of local experiments generating shared experience about what works in which settings. As the global digital health revolution unfolds, the perspectives drawn from South and Southeast Asia-including the importance of local partnerships-may provide valuable insights for shaping future strategies and informing similar initiatives in low- and middle-income countries, contributing to effective digital health strategies across diverse global health contexts.

Exploring Community Workshops on Health and Arts

This review examines the intersection of health and the arts within community workshops, highlighting how these programs foster individual and community well-being, expand professional health training, and offer new frameworks for understanding health holistically. By using creative expression as a pathway to enhance mental, social, and emotional health, these participant-centered workshops promote adaptive capacities, social bonds, and cultural inclusion. This paper examines relevant research agendas, particularly those that study health outcomes related to arts-based engagement, and advocates for the integration of arts into public health strategies. Attention is given to designing inclusive, trauma-informed practices that respond to community needs, with case studies illustrating both successful implementation and areas for improvement. A future-focused section encourages the creation of policy-driven frameworks and resource hubs that prioritize sustainable community arts initiatives in public health. Keywords: Community health, arts integration, well-being, mental health, social engagement, public health.

Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020

Background: The integration of maternal and child health services (MCH) with routine immunization is an important global health strategy, particularly in low- and middle-income countries (LMICs). However, evidence is lacking regarding the best practices for service integration and the effect of integration on immunization and linked health service outcomes. Methods: We searched publication databases and gray literature for articles published between 2011 and 2020 that include approaches to integrating MCH services with immunizations during the first two years of life in LMICs. Abstracts and full-text articles were screened for eligibility. For the included articles, data extraction and analysis examined the descriptive characteristics of studies, outcomes, and implementation considerations. Results: Among the 16,578 articles screened, 44 met the criteria for inclusion, representing 34 studies, of which 29 were from Africa. The commonly linked MCH services were family planning (24%), human immunodeficiency virus (HIV) diagnosis or care (21%), and malaria prevention or control (21%). Multiple integration strategies were typically used; the co-location of linked services (65%), the provision of extra services by immunization staff (41%), and/or the provision of extra information by immunization staff (41%) were the most common. In general, integration improved MCH service outcomes (76%) and was either beneficial (55%) or neutral for immunization (35%), with some examples in family planning, malaria, and HIV where integrated services were not beneficial. Important implementation considerations included the careful matching of target populations in service re-design, ensuring support from policy, logistics, and information systems, the provision of adequate training and support of staff to avoid overload, clear client communication regarding service integration, and the need to address community concerns. Conclusions: Integrating MCH services with routine immunization can expand linked services and improve immunization coverage. This study has identified key implementation considerations relevant to both childhood and adult vaccination programs. More research is needed regarding costs and client preferences.

DIGITAL HEALTH AND PUBLIC POLICIES: EVOLUTION AND CHALLENGES FOR BRAZIL

Digital health is a field that involves the use of information and communication technologies to improve the quality, efficiency, and equity of health services. In Brazil, digital health has gained prominence especially after the COVID-19 pandemic, which required the adoption of social distancing measures and the expansion of access to telemedicine, telehealth, and electronic medical records. However, the country faces several challenges in creating public policies that can guide and regulate the creation, implementation, and use of the benefits of digital health. Among these challenges, we can highlight the territorial dimension and regional inequalities, which hinder the universalization and integration of health information systems and the availability of adequate technological infrastructure in all areas of the country. This paper presents a review of public initiatives and policies in Brazil, analyzing scientific publications, standards, resolutions, and laws that address this topic and proposes, as a result, the challenges that need to be overcome in the development or improvement of existing policies in the field of digital health. The challenges facing the development of these policies include the large population and socioeconomic diversity, which require personalized solutions adapted to the different realities and needs of users, as well as ensuring digital inclusion and health literacy; the unequal distribution of medical professionals and other health professionals, which imposes limits on the supply and quality of health services, especially in the most remote and vulnerable areas, and which requires ongoing training of digital health workers; the General Data Protection Law (LGPD) and the adoption of new technologies, which bring new ethical, legal and technical challenges for the protection of the privacy and security of personal health data, as well as for the evaluation of the efficacy, effectiveness and security of digital health solutions. In view of these challenges, it is essential that Brazil develop a national digital health strategy that can define the objectives, guidelines, responsibilities and actions to promote the appropriate and sustainable use of information and communication technologies in health, for the benefit of the Brazilian population.

Enhancing multilabel classification for unbalanced COVID-19 vaccination hesitancy tweets using ensemble learning

Purpose:Vaccination plays a crucial role in public health strategies, particularly in combating contagious diseases like COVID-19. Despite developing and authorizing numerous vaccines, achieving widespread immunity remains a challenge. Understanding individuals’ willingness to receive vaccines is essential, and recent studies have explored acceptance rates across various regions. However, vaccine hesitancy is still considered a significant global health concern, even after the pandemic’s peak. Methods:This article explores the topic of classification in social media networks, specifically in tweets, focusing on the challenges of class imbalance and multilabel multiclass tweet classification. It investigates the effectiveness of oversampling in addressing unbalanced datasets and proposes an ensemble-based framework comprising various BERT models fine-tuned on diverse text corpora. Results:The proposed model was applied to a benchmark dataset containing 12 classes with a highly imbalanced distribution. Compared to recent literature, the model achieved significant improvements in performance metrics. We observed a 2% increase in micro, macro, and weighted average F1 scores, a 4% increase in accuracy, and a 3% increase in average Jaccard index when using the proposed framework on this unbalanced multi-labeled benchmark. Conclusion:The study investigated fine-tuning BERT models for improved classification in tweets on unbalanced datasets related to public health. The proposed ensemble approach with oversampling techniques yielded significant improvements in multiple metrics compared to existing methods. This suggests a promising approach to analyzing vaccine discourse on social media and potentially aiding public health efforts.

My ‘normal’ isn't your normal...What is maternal wellbeing? A scoping review

ProblemMany global health strategies are developed to optimise ‘maternal wellbeing’. However, what is meant by this term and therefore how it is interpreted and understood by different groups of people is currently poorly understood. BackgroundFor midwives to provide woman-centred care they must recognise the diverse understandings of what is considered ‘maternal wellbeing’ and be able to identify factors underpinning this. AimTo identify and synthesise the literature related to the meaning and understanding of the term ‘maternal wellbeing.’ MethodsA search of PubMed, CINAHL Ultimate, OVID and Emcare databases was conducted between 2015 and 2024 for studies related to maternal wellbeing. Data from fourteen studies were charted and thematically analysed. FindingsTwo overarching but interrelated themes were identified. One refers to the inner self, and the second to the woman's place in her social world. Theme 1, sense of self, comprises two sub-themes: finding a sense of self and sustaining a sense of self. Theme 2, the sense of place, comprises two sub-themes: sustaining place and making space in place. DiscussionDisconnects between the practice-oriented concept of wellbeing and wellbeing as perceived by women exist. Current maternal wellbeing assessment methods only measure the woman's sense of identity, and sense of self in their changed worlds. ConclusionClear articulation of maternal wellbeing is needed to operationalise health strategies, institutional policies, procedures and standards of care that support positive maternal and infant outcomes. Midwives are pivotal to promoting maternal wellbeing during transitions across the pregnancy, birth, and motherhood continuum.

Additive effect of high transportation noise exposure and socioeconomic deprivation on stress-associated neural activity, atherosclerotic inflammation, and cardiovascular disease events.

Noise exposure and lower socioeconomic status (SES) are both independently linked to increased cardiovascular disease (CVD) risk. Although these factors frequently coexist, their combined impact and the underlying pathophysiological mechanisms remain poorly understood. This study aimed to evaluate the joint effects of high transportation noise exposure and lower SES on major adverse cardiovascular events (MACE) and the role of the neural-arterial axis in mediating this relationship. We retrospectively analyzed data from 507 individuals who underwent clinical 18F-FDG-PET/CT imaging at a single center. SES was evaluated using local median income (as a primary measure) and area deprivation index (ADI, as a secondary measure). Participants were classified into three groups based on transportation noise exposure and income/ADI: low noise/higher SES, high noise or lower SES, and high noise/lower SES. Cox models assessed MACE risks. Linear regression models evaluated associations with stress-related neural activity (SNA) and arterial inflammation (ArtI). The combination of high noise exposure and low income (vs. neither exposure) associated with increased MACE risk (HR [95% CI]: 5.597 [2.201-14.233], p < 0.001). SNA (standardized β [95% CI]: 0.389 [0.192-0.586], p < 0.001) and ArtI (0.151 [0.005-0.298], p = 0.043) were greater in this group. Mediation analysis showed that the neural-arterial axis contributes to increased exposure-related MACE risk and accounts for 8% of the overall effect. Similar results were found with ADI. Our study uniquely demonstrates how combined high transportation noise and lower socioeconomic status additively increases cardiovascular disease risk through specific biological pathways, particularly via effects on stress-associated neural activity and arterial inflammation. As such, the research offers novel insights into the interplay between environmental and socioeconomic factors in cardiovascular health. This underscores an urgent need for integrated public health strategies that address both noise pollution and socioeconomic disparities and provides a foundation for targeted interventions aimed at reducing the burden of cardiovascular disease in vulnerable populations. Central illustration of hypothesized mechanistic pathways linking transportation noise/SES exposure groups and MACE. SNA stress related neural activity (as AmygAc-ratio of amygdala to background cortical activity), MACE major adverse cardiovascular events, ArtI arterial inflammation, ADI Area Deprivation Index, SES socioeconomic status.

Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT): Global and Risk-Group Stratified Course of Well-Being and Mental Health During the COVID-19 Pandemic in Adolescents

To identify the COVID-19 impact on well-being/mental health, coping strategies and risk factors in adolescent worldwide. Anonymous online multi-national/language survey in the general population (representative/weighted non-representative samples, 14-17years), measuring change in well-being (WHO-5/range=0-100) and psychopathology (validated composite P-score/range=0-100), WHO-5 <50 and <29, pre- versus during COVID-19 pandemic (26/04/2020-26/06/2022). Coping strategies, nine a-priori defined individual/cumulative risk factors were measured. χ2, penalized cubic splines, linear regression, and correlation analyses were conducted. Analyzing 8,115 of 8,762 initiated surveys (representative=75.1%), the pre-pandemic WHO-5 and P-score remained stable during the study (excluding relevant recall bias/drift), but worsened intra-pandemic by 5.55±17.13 (standard deviation) and 6.74±16.06 points, respectively (effect size d=0.27 and d=0.28). The proportion of adolescents with WHO-5 scores suggesting depression screening (<50) and major depression (<29) increased from 9% to 17% and 2% to 6%. WHO-5 worsened (descending magnitude, with cumulative effect) in adolescents with a mental or physical disorder, female gender, and with school closure. Results were similar for P-score, with the exception of school closure (not significant) and living in a low-income country, as well as not living in a large city (significant). Changes were significantly but minimally related to COVID-19 deaths/restrictions, returning to near-pre-pandemic values after >2 years. The three most subjectively effective coping strategies were internet use, exercise/walking, and social contacts. Overall, well-being/mental health worsened (small effect sizes) during early stages of COVID-19, especially in vulnerable subpopulations. Identified at-risk groups, association with pandemic-related measures, and coping strategies can inform individual behaviours and global public health strategies.

Recent advances in applying metabolomics to uncover dietary impact on cardiometabolic health.

Cardiometabolic diseases are a major global health concern, with diet playing a crucial role in their prevention and management. Recent advancements in the identification of metabolic signatures related to dietary patterns offer a more objective assessment of individualized dietary exposure and provide deeper insights into diet-disease associations. Recent studies have shown that distinct metabolic signatures are associated with the adherence to various dietary patterns. These signatures show even stronger associations with cardiometabolic disease incidence, independent of traditional risk factors and self-reported adherence to such dietary patterns. Emerging dietary approaches, such as sustainable diets, health outcome-focused diets, and population data-driven dietary patterns, also hold promise for improving cardiometabolic health. Additionally, metabolic signatures could offer insights into diet-disease associations in underrepresented populations, addressing genetic and lifestyle differences. Application of metabolomics provides a more precise understanding of how dietary patterns influence cardiometabolic health. Although the number of studies remains limited, and current evidence is inconsistent, the approach has significant potential for improving clinical and public health strategies. Future research should prioritize prospective studies and address population- and outcome-specific dietary needs to enable targeted interventions that optimize cardiometabolic health.

Government Digital Transformation and the utilization of Basic Public Health Services by China’s migrant population

BackgroundThis research delves into the ramifications of Government Digital Transformation (GDT) on Basic Public Health Services (BPHS) utilization among China’s migrant populace. Within the framework of escalating digital incorporation into public services, it becomes imperative to assess how GDT initiatives could ameliorate healthcare access for migrants, a group habitually confronted with systemic obstacles. Such scrutiny is crucial for the formulation of evidence-based policies that harness digital innovations to mitigate healthcare disparities.MethodsThe analysis employs data from the 2018 China Migrants Dynamic Survey, matched with details on the National Pilot Cities for Information Benefit to the Public policy at the prefecture city level, yielding a dataset comprising 113,905 observations. To gauge BPHS utilization among migrants, two indicators were developed: the establishment of health records and registration with family doctors. The influence of GDT on BPHS access was estimated utilizing Ordinary Least Squares regression for the initial analysis, incorporating a comprehensive array of individual and household attributes, alongside province fixed effects, to ensure a thorough evaluation.ResultsBaseline regression analyses revealed that GDT is significantly correlated with an enhanced probability of migrants establishing health records and registering with family doctors, with increases of 7.53% and 2.75%, respectively. Subsequent robustness checks, including sensitivity analyses with alternate dependent variables, the Propensity Score Matching method, Double/Debiased Machine Learning method, and placebo tests, further substantiated these findings. Additionally, the analysis explored mechanisms through which GDT facilitates BPHS access, identifying health information accessibility as a significant mediator in promoting healthcare engagement among migrants. Notably, both individual and regional heterogeneity were observed in GDT’s impact: female migrants, those with lower educational levels, older individuals, and rural hukou holders experienced more pronounced benefits, while the effects of GDT were also stronger in cities with lower GDP and smaller populations. These findings suggest that GDT is particularly effective in bridging healthcare access gaps in economically or demographically constrained areas.ConclusionsThe outcomes underscore that GDT significantly enhances BPHS utilization among migrants, positioning digital governance as an instrumental mechanism in bridging healthcare access gaps. The observed differential impacts across various subgroups and regions emphasize the importance of customized digital health strategies that cater to the diverse needs of migrant communities. For instance, targeted interventions in lower-GDP or smaller cities could maximize the benefits of GDT in under-resourced areas. Contributing to the body of empirical evidence on digital governance and public health, this research advocates for the expanded deployment of GDT initiatives to foster more equitable health service provision for migrant demographics, promoting inclusivity within a rapidly urbanizing society.