Frontiers in Public Health最新文献

{"title":"The relationship between multimorbidity and cognitive function in older Chinese adults: based on propensity score matching","authors":"Yumeng Zhang, Xiaoli Yuan, Zhixia Jiang, Rujun Hu, Heting Liang, Qingyun Mao, Yan Xiong, Jiabi Zhang, Mi Liu","doi":"10.3389/fpubh.2024.1422000","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1422000","url":null,"abstract":"ObjectiveThe goal of this study was to further validate the effect of multimorbidity on cognitive performance in older adults after controlling for confounders using propensity score matching (PSM).MethodsA cross-sectional survey of older adult people aged 60 years or older selected by convenience sampling was conducted in seven medical institutions, three communities, and five nursing homes in Zunyi City, Guizhou Province. The data collected included general information, health-related information, and Mini-Mental State Examination (MMSE) scores. Variables were controlled for confounders by PSM to analyze differences in cognitive ability between multimorbidity and nonmultimorbidity older adults. Logistic regression and multivariate-adjusted restricted cubic spline (RCS) curves for matched samples were used to assess the relationship between multimorbidity and cognitive decline.ResultsA total of 14,175 respondents were enrolled, and the mean age of the participants included in this study was 71.26 ± 7.1 years, including 7,170 (50. 58%) of the participants were males, 7,005 (49.42%) were females, and 5,482 participants (38.67%) were screened for cognitive decline. After PSM, logistic regression analysis revealed that multimorbidity was a risk factor for cognitive decline (OR = 1.392, 95% CI = 1.271–1.525, <jats:italic>p</jats:italic> &amp;lt; 0.001). The RCS show that the risk of cognitive decline is always greater in older adults with multimorbidity than in older adults without multimorbidity at the same age. Age, sex, marital status, educational level, monthly income, drinking status, participation in social activities, and exercise were influential factors for cognitive decline in older adults (<jats:italic>p</jats:italic> &amp;lt; 0.05). The incidence of cognitive decline in older adults with multimorbidity was also greater than that in older adults with one chronic disease (<jats:italic>p</jats:italic> &amp;lt; 0.001).ConclusionThe risk of cognitive decline in older adults with multimorbidity is greater than that in older adults without multimorbidity; therefore, the government should strengthen the prevention and treatment of multimorbidity in older adults to further protect their cognitive abilities.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of statistical methods for the identification of buildings and areas with high radon levels","authors":"Joan F. Rey, Sara Antignani, Sebastian Baumann, Christian Di Carlo, Niccolò Loret, Claire Gréau, Valeria Gruber, Joëlle Goyette Pernot, Francesco Bochicchio","doi":"10.3389/fpubh.2024.1460295","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1460295","url":null,"abstract":"Radon is a natural and radioactive noble gas, which may accumulate indoors and cause lung cancers after long term-exposure. Being a decay product of Uranium 238, it originates from the ground and is spatially variable. Many environmental (i.e., geology, tectonic, soils) and architectural factors (i.e., building age, floor) influence its presence indoors, which make it difficult to predict. However, different methods have been developed and applied to identify radon prone areas and buildings. This paper presents the results of a systematic literature review of suitable statistical methods willing to identify buildings and areas where high indoor radon concentrations might be found. The application of these methods is particularly useful to improve the knowledge of the factors most likely to be connected to high radon concentrations. These types of methods are not so commonly used, since generally statistical methods that study factors predictive of radon concentration are focused on the average concentration and aim to identify factors that influence the average radon level. In this paper, an attempt has been made to classify the methods found, to make their description clearer. Four main classes of methods have been identified: descriptive methods, regression methods, geostatistical methods, and machine learning methods. For each presented method, advantages and disadvantages are presented while some applications examples are given. The ultimate purpose of this overview is to provide researchers with a synthesis paper to optimize the selection of the method to identify radon prone areas and buildings.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic determinants of health inequities in low back pain: a narrative review","authors":"Janny Mathieu, Kamille Roy, Marie-Ève Robert, Meriem Akeblersane, Martin Descarreaux, Andrée-Anne Marchand","doi":"10.3389/fpubh.2024.1392074","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1392074","url":null,"abstract":"BackgroundHealth equity is defined as the absence of unjust and avoidable disparities in access to healthcare, quality of care, or health outcomes. The World Health Organization (WHO) has developed a conceptual framework that outlines the main causes of health inequalities and how these contribute to health inequities within a population. Despite the WHO implementing health equity policies to ensure accessibility and quality of healthcare services, disparities persist in the management of patients suffering from low back pain (LBP). The objective of this study was to review the existing evidence on the impact of health inequities on the care trajectories and treatments provided to individuals with LBP.MethodsA narrative review was performed, which included a literature search without language and study design restrictions in MEDLINE Ovid database, from January 1, 2000, to May 15, 2023. Search terms included free-text words for the key concepts of “low back pain,” “health inequities,” “care pathways,” and “sociodemographic factors.”ResultsStudies have revealed a statistically significant association between the prevalence of consultations for LBP and increasing age. Additionally, a significant association between healthcare utilization and gender was found, revealing that women were more likely to seek medical attention for LBP compared to men. Furthermore, notable disparities related to race and ethnicity were identified, more specifically in opioid prescriptions, spinal surgery recommendations, and access to complementary and alternative medical approaches for LBP. A cross-sectional analysis found that non-Hispanic White individuals with chronic LBP were more likely to be prescribed one or more pharmacological treatments. Lower socioeconomic status and level of education, as well as living in lower-income areas were also found to be associated with greater risks of receiving non-guideline concordant care, including opioid and MRI prescriptions, before undergoing any conservative treatments.ConclusionPersistent inequalities related to sociodemographic determinants significantly influence access to care and care pathways of patients suffering from LBP, underscoring the need for additional measures to achieve equitable health outcomes. Efforts are needed to better understand the needs and expectations of patients suffering from LBP and how their individual characteristics may affect their utilization of healthcare services.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formalized peer referral to HIV pre-exposure prophylaxis supported with self-testing: a mixed-methods pilot study among young Kenyan women","authors":"Maureen McGowan, Njeri Wairimu, Adriana M. Reedy, Peter Mogere, Carlos Culquichicon, Irene Njeru, Rachel C. Malen, Albrecht Jahn, Till Bärnighausen, Stephanie D. Roche, Kenneth Ngure, Katrina F. Ortblad","doi":"10.3389/fpubh.2024.1428609","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1428609","url":null,"abstract":"BackgroundThe uptake of daily oral HIV pre-exposure prophylaxis (PrEP)—a highly effective intervention—remains low among African adolescent girls and young women (AGYW) who could benefit. AGYW who initiate PrEP often do so through informal peer referral, which may be enhanced with formalized peer referral and peer-delivered HIV self-testing (HIVST). To understand the feasibility of this PrEP referral model among AGYW, we conducted a pilot study in Kenya.MethodFrom March to May 2022, we recruited AGYW (≥16–24 years) using PrEP (i.e., “peer providers”) from public healthcare clinics in Kiambu County and trained them on HIV prevention, HIVST use, and peer-supported linkage to clinic-based HIV services. Following training, peer providers received eight HIVST kits and were encouraged to refer four peers (i.e., “peer clients”) to PrEP. We completed surveys with peer providers and clients one month following intervention delivery to assess PrEP initiation among peer clients. Later, we conducted focus group discussions (FGDs) with peer providers and clients to identify factors that facilitated or challenged intervention outcomes.ResultsWe trained 16 peer providers (median age: 23 years, IQR 21–24) who reported delivering the intervention to 56 peer clients; 30 peer clients (median age: 21 years, IQR 19–22) contacted the study team and were enrolled. Most of the enrolled peer clients reported behaviors associated with HIV risk (e.g., condomless sex; 80%, 24/30) and were PrEP-naïve (87%, 26/30). At one-month, PrEP initiation among eligible PrEP-naïve peer clients was high, as reported by providers (78%, 43/55) and clients (85%, 22/26); recent HIVST use was also high among peer clients (provider report: 95%, 53/56; client report: 97%, 29/30). In the FGDs, participants reported that intervention outcomes were facilitated by close preexisting relationships, HIVST assistance, and being escorted to clinic-based HIV services by peer providers; intervention barriers included conflicting priorities and limited HIVST experience.ConclusionA formalized model of peer referral with HIVST delivery supported PrEP initiation among Kenyan AGYW. These findings demonstrate the potential for peer-delivered interventions to engage AGYW in HIV prevention services; however, more research is needed on the effectiveness and sustainability of this approach at scale.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modernizing undergraduate medical education by bringing public health into focus","authors":"Eleanor J. Hothersall","doi":"10.3389/fpubh.2024.1451155","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1451155","url":null,"abstract":"Healthcare and healthcare education are changing rapidly, being pulled in a number of directions by political, economic, environmental and technological imperatives. At the University of Dundee Medical School a curriculum review during the Covid-19 pandemic has allowed opportunities to reframe aspects of the program to emphasize themes linking public health and social determinants of health to the wider curriculum, while also bringing a shared understanding of the core outcomes of the program. This brings some adaptability into the structure and content of the course, helping graduates and staff to be “future proof.”","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life assessed by EQ-5D-5L and its determinants among Chinese adults","authors":"Gengliang Bai, Jiawen Zhang, Yijun Chen, Lejing Cao, Yong Yang, Chao Jiang","doi":"10.3389/fpubh.2024.1383781","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1383781","url":null,"abstract":"BackgroundDue to the rising standard of living and advances in public health and medical care in recent years in China, the health-related quality of life (HRQoL) has been increasingly acknowledged as an important part of health management of adults. This study aimed to analyze the HRQoL of Chinese adults and identify the influencing factors, proposing specific recommendations for improvement.MethodsA cross-sectional study was conducted among 1,291 selected adults from four provinces spanning different regions in China aged ≥18 years from July 2021 and January 2022. The EuroQol-5D-5L (EQ-5D-5L) was used to conduct the HRQoL survey, and a general questionnaire was administered to collect demographic characteristics, general information, and health behaviors of participants. The health utility value was measured, and one-way analysis of variance was performed. The Tobit regression model was employed to analyze the factors influencing the HRQoL of Chinese adults.ResultsThe mean health utility values and visual analog scale scores for adults were 0.9400 ± 0.1197 and 84.09 ± 14.392, respectively. Notably, 60.3% of respondents reported no difficulties in any of the five dimensions of EQ-5D. However, a substantial proportion faced challenges in anxiety/depression (27%) and pain/discomfort (26.2%). Tobit regression model revealed that age, marital status, educational level, diet, sleep, mental state, mood, and chronic diseases significantly impact the HRQoL of Chinese adults.ConclusionThe HRQoL among Chinese adults is generally satisfactory, but pay particular attention on areas such as pain, psychological anxiety, chronic diseases, and negative emotions is needed. The factors such as stress associated with marriage and the demands of high-skilled occupations might influence the overall health of the population. According to our findings, public health strategies to improve HRQoL should be developed to promote relatively healthy environments and lifestyles for older adults. Moreover, proactive measures are crucial for mitigating the potential health impacts associated with marital stress and high-skilled employment.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health equity in COVID-19 testing among patients of a large national pharmacy chain","authors":"Tanya Singh, Renae L. Smith-Ray, Elijah Ogunkoya, Amy Shah, Daniel A. Harris, Kaleen N. Hayes, Vincent Mor","doi":"10.3389/fpubh.2024.1422914","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1422914","url":null,"abstract":"BackgroundSeveral social determinants of health and other structural factors drive racial and ethnic disparities in COVID-19 risk, morbidity, and mortality. Public-private collaborations with community pharmacies have been successful in expanding access to COVID-19 testing and reaching historically underserved communities. The objectives of this study were to describe individuals who sought testing for COVID-19 at a national community pharmacy chain and to understand potential racial and ethnic inequities in testing access, positivity, and infection with emerging variants of concern.MethodsWe conducted a cross-sectional study of individuals aged ≥18 who were tested for COVID-19 (SARS-CoV-2) at a Walgreens pharmacy or Walgreen-affiliated mass testing site between May 1, 2021 and February 28, 2022. Positivity was defined as the proportion of positive tests among all administered tests. A geographically balanced random subset of positive tests underwent whole genome sequencing to identify specific viral variants (alpha, delta, and omicron). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) to compare the likelihood of testing positive and testing positive with an emerging variant of concern across race and ethnicity groups.ResultsA total of 18,576,360 tests were analyzed (16.0% tests were positive for COVID-19; 59.5% of tests were from White individuals and 13.1% were from Black individuals). American Indian or Alaska Native (OR = 1.12; 95%CI = 1.10–1.13), Hispanic or Latino (1.20; 95%CI = 1.120, 1.21), and Black (1.12; 95%CI = 1.12, 1.13) individuals were more likely to test positive for COVID-19 compared to White individuals. Non-White individuals were also more likely to test positive for emerging variants of concern (e.g., Black individuals were 3.34 (95%CI = 3.14–3.56) times more likely to test positive for omicron compared to White individuals during the transition period from delta to omicron).DiscussionUsing a national database of testing data, we found racial and ethnic differences in the likelihood of testing positive for COVID-19 and testing positive for emerging viral strains. These results demonstrate the feasibility of public-private collaborations with local pharmacies and pharmacy chains to support pandemic response and reach harder to reach populations with important health services.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National trends in loneliness and social isolation in older adults: an examination of subgroup trends over three decades in Sweden","authors":"Lena Dahlberg, Isabelle von Saenger, Mahwish Naseer, Carin Lennartsson, Neda Agahi","doi":"10.3389/fpubh.2024.1444990","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1444990","url":null,"abstract":"IntroductionLoneliness and social isolation are public health concerns. This study aimed to examine levels and trends in loneliness and social isolation among older adults (77+ years) in Sweden, assess subgroup variations, and determine associations between loneliness and social isolation.MethodsThe 1992, 2002, 2004, 2011, 2014 and 2021 waves of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were analysed through ordered logistic and linear regressions.ResultsOn average, 12.5 percent of the participants experienced loneliness often/nearly always, while 6 percent were categorised as severely isolated. Loneliness and social isolation were more common in women, those aged 85+, and persons with basic education, in psychological distress or with mobility limitations. Loneliness was also associated with living alone. No increases in loneliness or isolation were identified; instead, loneliness tended to decrease in groups already experiencing lower levels of loneliness. Loneliness and social isolation were moderately associated each survey year.DiscussionThis study challenges perceptions of high and increasing levels of loneliness and social isolation. Given the impact on health and wellbeing and the ageing of populations, policy and practice should still address these issues and target vulnerable groups. Subgroup analyses in trends are scarce and should be explored further in future research.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared challenges to the control of complex intracellular neglected pathogens","authors":"Rebecca Lynn Perez, Jemima Chase, Rachel Tanner","doi":"10.3389/fpubh.2024.1423420","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1423420","url":null,"abstract":"The complex intracellular pathogens <jats:italic>Mycobacterium tuberculosis</jats:italic>, <jats:italic>Mycobacterium leprae</jats:italic>, <jats:italic>Leishmania</jats:italic> spp., and <jats:italic>Burkholderia pseudomallei</jats:italic>, which cause tuberculosis, leprosy, leishmaniasis, and melioidosis respectively, represent major health threats with a significant global burden concentrated in low- and middle-income countries. While these diseases vary in their aetiology, pathology and epidemiology, they share key similarities in the biological and sociodemographic factors influencing their incidence and impact worldwide. In particular, their occurrence in resource-limited settings has important implications for research and development, disease prevalence and associated risk factors, as well as access to diagnostics and therapeutics. In accordance with the vision of the VALIDATE (VAccine deveLopment for complex Intracellular neglecteD pAThogeEns) Network, we consider shared challenges to the effective prevention, diagnosis and treatment of these diseases as shaped by both biological and social factors, illustrating the importance of taking an interdisciplinary approach. We further highlight how a cross-pathogen perspective may provide valuable insights for understanding and addressing challenges to the control of all four pathogens.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National survey questionnaire on the diagnosis and treatment status of Helicobacter pylori in peptic ulcer bleeding disease","authors":"Zongdan Jiang, Yaokun Ding, Chao Li, Zhenyu Zhang","doi":"10.3389/fpubh.2024.1433139","DOIUrl":"https://doi.org/10.3389/fpubh.2024.1433139","url":null,"abstract":"Background and objectiveThe Maastricht VI/Florence Consensus and Chinese National Consensus Report provide comprehensive guidelines for treating <jats:italic>Helicobacter pylori</jats:italic> infection. This study aimed to assess physicians' understanding of and adherence to this consensus in different hospitals.MethodsChinese medical staff attending gastrointestinal conferences across various regions were selected for this study. The questionnaire included: 1. the number of patients with peptic ulcer bleeding in hospitals of different levels annually and the diagnostic methods used for <jats:italic>H. pylori</jats:italic>; 2. whether routine <jats:italic>H. pylori</jats:italic> examination was conducted and the specific methods employed; and 3. Treatment plans for <jats:italic>H. pylori</jats:italic> eradication; 4. The mean follow-up duration after treatment 5. Plans for re-eradication in cases of <jats:italic>H. pylori</jats:italic> treatment failure.ResultsAcross all levels of Chinese hospitals, the urea breath test was the most commonly used method for detecting <jats:italic>H. pylori</jats:italic> infection. Most primary (81.53%), secondary (89.49%), and tertiary (91.42%) centers opted for a 14-day quadruple regimen. The preferred antibiotic regimen at all hospital levels was amoxicillin+clarithromycin, with rates of 63.69, 58.08, and 59.27% in the primary, secondary, and tertiary hospitals, respectively. The rates of <jats:italic>H. pylori</jats:italic> re-examination were 68.15, 87.07, and 87.46% in the primary, secondary, and tertiary hospitals. If <jats:italic>H. pylori</jats:italic> eradication failed, hospitals at different levels choose to replace the initial plan.ConclusionThere is a need for an enhanced understanding of and adherence to guidelines for <jats:italic>H. pylori</jats:italic> among physicians in hospitals at all levels.","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}