Frontiers in Public Health最新文献

{"title":"Battery for fall risk assessment in older adult people-BARQ: analysis of reliability and objectivity.","authors":"Andrea Carmen Guimarães, Brisa D'Louar Costa Maia, Karollyni Bastos Andrade Dantas, Gustavo Costa Santos, Letícia Moreira Américo, Nelzy Aparecida Silva Werner, Lucio Flávio Gomes Ribeiro da Costa, César Augusto da Silva Santos, Estélio Henrique Martin Dantas","doi":"10.3389/fpubh.2024.1456564","DOIUrl":"10.3389/fpubh.2024.1456564","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to address significant gaps in fall risk assessment among older adult individuals, using a methodological approach to develop and validate effective instruments.</p><p><strong>Objective: </strong>To establish the objectivity and reliability of the Battery for Fall Risk Assessment in older adult people - BARQ.</p><p><strong>Methodology: </strong>This descriptive, cross-sectional, exploratory study started with a preliminary version of BARQ, based on the Comprehensive Falls Risk Screening Instrument-CFRSI. The following variables were included: Fall History and Adverse Events (FH), Medication Use (MU), Home Safety (HS), Balance (Ba), Mobility (Mo), and Visual Acuity (VA). BARQ was administered to 136 older adult participants (X̅ = 70.3 ± 7.20 years) by two assessment teams (∝ and <i>β</i>), at three different times, to examine instrument reliability and objectivity. Statistical analyses included Pearson's correlation, Cronbach's alpha coefficient, Student's <i>t</i>-test, and Hedges' g.</p><p><strong>Results: </strong>Intra-rater and inter-rater correlations were significant for mobility (<i>r</i> = 0.90 and <i>r</i> = 0.88, respectively; <i>p</i> < 0.01) and visual acuity (<i>r</i> = 0.86 and <i>r</i> = 0.87, respectively; <i>p</i> < 0.01). Cronbach's alpha coefficients indicated nearly perfect reliability for mobility (0.97) and visual acuity (0.96). No statistically significant differences were found in intra-rater assessments (p ranging from 0.11 to 0.55) and inter-rater assessments (p ranging from 0.37 to 0.55). Hedges' g test showed medium effect sizes for the overall fall risk index between S1 and S2 (<i>g</i> = 0.39) and small to medium for other variables.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1456564"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between fluoride exposure and the risk of serum CK and CK-MB elevation in adults: a cross-sectional study in China.","authors":"Junhua Wu, Ming Qin, Yue Gao, Yang Liu, Xiaona Liu, Yuting Jiang, Yanmei Yang, Yanhui Gao","doi":"10.3389/fpubh.2024.1410056","DOIUrl":"10.3389/fpubh.2024.1410056","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the relationship between urinary fluoride concentration and myocardial disease.</p><p><strong>Methods: </strong>This is a cross-sectional study that was conducted in three villages in Wenshui County, Shanxi Province. A total of 737 villagers were included in this analysis. Urinary fluoride was detected using a fluoride-ion selective electrode. Myocardial enzymes were detected using an automatic biochemical analyzer. Myocardial ischemia and arrhythmia were diagnosed using 12-lead electrocardiogram.</p><p><strong>Results: </strong>The median level of urinary fluoride concentration was 1.32 mg/L. Urinary fluoride was associated with serum creatine kinase (CK) elevation (odds ratio [OR] = 1.39 [95% confidence interval (CI)]: 1.09-1.78) and CK isoenzyme (CK-MB) elevation (OR = 1.49 [95% CI: 1.12-1.97]). Stratified analysis revealed that urinary fluoride concentration was associated with CK elevation in villagers under the age of 60 years (OR = 1.80 [95% CI: 1.26-2.59]). This study found that there was a positive association between urinary fluoride concentration and the risk of CK-MB elevation in participants under the age of 60 years(OR = 2.18 [95% CI: 1.39-3.42]), those who were of female gender (OR = 1.53 [95% CI: 1.07-2.19]), those who were overweight/obese (OR = 1.96 [95% CI: 1.28-2.99]), those who had central obesity (OR = 1.59 [95% CI: 1.12-2.25]), consumed alcohol (OR = 1.49 [95% CI: 1.09-2.05]), and smoked (OR = 1.50 [95% CI: 1.10-2.04]).</p><p><strong>Conclusion: </strong>Our study suggests that fluoride exposure is associated with the risk of serum CK and CK-MB elevation; however, it is not associated with myocardial ischemia, arrhythmia, serum lactate dehydrogenase (LDH), serum alpha-hydroxybutyrate dehydrogenase (<i>α</i>-HBD), or serum aspartate aminotransferase (AST). Further investigations are needed to substantiate our findings and explore the potential underlying mechanisms.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1410056"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of telemedicine in chronic patients from diverse socioeconomic contexts: systematic review of qualitative studies.","authors":"Yuzhe Li, Qifang Shi, Jing Yang, Li Ran","doi":"10.3389/fpubh.2024.1510735","DOIUrl":"10.3389/fpubh.2024.1510735","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine has a positive impact on improving health literacy and disease management ability of chronic disease patients and reducing the medical burden. However, telemedicine still has many problems in chronic disease management. We should actively solve the problems and maximize the functions of telemedicine.</p><p><strong>Objective: </strong>To explore the application and improvement of telemedicine in chronic disease self-management to provide important insights from functional module analysis for stakeholders, healthcare professionals, and policymakers to promote the development of telemedicine in chronic disease management.</p><p><strong>Design: </strong>We conducted a systematic review and qualitative synthesis of five English databases including PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and Scopus, as well as three Chinese databases: China National Knowledge Infrastructure (CNKI), WanFang and VIP database. Databases were searched from inception until November 12, 2024.</p><p><strong>Methods: </strong>This review is reported in accordance with guidelines for Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). Two reviewers independently performed study selection, data extraction, and quality assessment using the Joanna Briggs Institute's key assessment tools for qualitative research. Thematic analysis was used for data synthesis.</p><p><strong>Results: </strong>A total of 35 studies were included, and the contents were refined and summarized into 8 new subthemes. Then, four themes were synthesized: Reminder and supervisor, Access to knowledge, Transition in medical treatment mode, and Emotional support platform.</p><p><strong>Conclusion: </strong>By improving information quality, developing diverse functions, and constructing multidisciplinary coordination mechanisms to meet the needs of patients with chronic diseases, improve the medical service system, maximize the function of telemedicine, and enhance the stickiness of patients to use telemedicine.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1510735"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characterization of congenital heart disease at different altitudes in Ecuador: a four-year retrospective study in a pediatric referral hospital.","authors":"Juan S Izquierdo-Condoy, Fabian D Arias-Rodríguez, Walter I Díaz-Chamba, Diego A Mena-Noroña, Lizbeth Cueva Toaquiza, Beanjuly Espín-Sambache, Emilia J Valdivieso-Andrade, Amanda Cangas-Isacaz, Susana García-Cañarte, Mario Rubio-Niera, Esteban Ortiz-Prado","doi":"10.3389/fpubh.2025.1497253","DOIUrl":"10.3389/fpubh.2025.1497253","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease (CHD) is one of the main causes of hospital admissions and infant mortality, especially in developing regions.</p><p><strong>Objectives: </strong>This study aims to describe the epidemiological and clinical features of CHD in pediatric patients, from one of the largest tertiary-level national referral pediatric hospitals in Ecuador.</p><p><strong>Materials and methods: </strong>An epidemiological, retrospective cohort study was conducted among patients with CHD who were hospitalized at \"Hospital Baca Ortiz\" between January 2019 to December 2022 in Quito, Ecuador.</p><p><strong>Results: </strong>A total of 1,000 pediatric patient medical records were reviewed from 2019 to 2022. Among these patients, 56.0% were female, and 65.2% resided at high altitudes (2,500-3,500 m). Most cases (71.4%) were acyanotic CHD, with patent ductus arteriosus being the most prevalent (48.7%). Among cyanotic CHD, Tetralogy of Fallot was predominant (28.1%). Mortality was observed in 5.3% of patients, with a higher rate among acyanotic CHD (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Most cases of CHD were of the acyanotic type, predominantly affecting female patients. Although most cases occurred in children living above 2,500 meters, no clear influence of altitude on specific types of CHD was found. While mortality related to CHD was low, the burden of disability from these conditions was significant among patients with acyanotic CHD.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1497253"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of children and adolescents with acute lymphoblastic leukemia from 1990 to 2021: a systematic analysis for the global burden of disease study 2021.","authors":"Lei Wang, Xue Yao, Linhua Yang","doi":"10.3389/fpubh.2025.1525751","DOIUrl":"10.3389/fpubh.2025.1525751","url":null,"abstract":"<p><strong>Background: </strong>Acute lymphoblastic leukemia (ALL) is a common cancer in children and adolescents, severely affecting their survival and health. With the discovery of new drugs and improved treatment options, the survival rate of ALL in children and adolescents has improved significantly.</p><p><strong>Methods: </strong>We used the GBD (global burden of disease) database to collect patients aged 0-19 years (0-5 years, 5-9 years, 10-14 years, 15-19 years) diagnosed with ALL between 1990 and 2021. Disease status and change were analyzed by learning about the prevalence, death, incidence, DALYs (disability-adjusted life years), percentage change, and the estimated annual percentage change (EAPC).</p><p><strong>Results: </strong>In 2021, there were 53,485 new cases of childhood and adolescent ALL, 23,991 deaths, and an estimated 1960,922 DALYs. Incidence, deaths and DALYs have declined globally, with only a rise in low-SDI regions. In 2021, middle-SDI regions have the highest cases of prevalence, incidence, deaths, and DALYs, accounting for approximately one-third of the global total. High-SDI regions have the lowest deaths and DALYs. East Asia has the highest prevalence and incidence. Australasia has the lowest death and DALYs. From 1990 to 2021, children and adolescent ALL deaths and DALYs show a declining trend in about 72.5% of countries, with only Sub-Saharan Africa showing an increase. The prevalence of ALL in children and adolescents is higher in males, with the highest cases in patients under 5 years of age.</p><p><strong>Conclusion: </strong>Our study highlights the trend of decreasing deaths and DALYs of ALL in children and adolescents. However, there is a need to improve healthcare prevention and timely standardized treatment in developing countries and less developed regions.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1525751"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of mDiabetes intervention in enhancing diabetes awareness and promoting healthy lifestyle changes among the general population in rural India.","authors":"Padmaja Kumari Rani, Jachin David Williams, Nidhi Jaswal, Venkateswaralu Yandluri, Payal Sangani, Kavya Sanagavarapu, Ramya Natarajan, Sandhya Ramalingam, Nalini Saligram, Rohit C Khanna","doi":"10.3389/fpubh.2024.1470615","DOIUrl":"10.3389/fpubh.2024.1470615","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the impact of a mHealth and community health education intervention on diabetes awareness and promoting healthy dietary and lifestyle habits within a rural population in Andhra Pradesh, India.</p><p><strong>Methods: </strong>Using a quasi-experimental design, the mDiabetes program was implemented for 1 year, among 1,03,538 rural individuals. Under this program, 56 diabetes prevention messages (twice a week) in local language) were disseminated among the participants via voice calls for a period of 6 months. Additionally, community health education meetings were facilitated by trained community health workers and educational leaflets were distributed among the community members. Questionnaires were administered at three different time points-baseline (before the intervention), endline (after intervention), and follow-up (3 months after endline) to collect demographic data, diabetes-related knowledge, attitudes, practices, physical activity, and dietary habits. Analysis compared data from 545 subjects who participated in all the three surveys.</p><p><strong>Results: </strong>The cohort comprised 45.5% males and 54.5% females, aged 19-85 years (mean: 55.42; SD 10.3). Post-intervention, diabetes awareness rose to 97.43% at endline and 99.63% at follow-up from 82.75% at baseline. Belief in diabetes preventability increased from 25.5% to 69.5%, and awareness of lifestyle's impact on diabetes management improved from 72.6% to 80.9%. Over 90% recalled prevention messages, with significant lifestyle changes reported by 83% at endline and 73% at follow-up. Improved dietary and activity habits were evident, with fruit consumption and high-fat food avoidance at 78.5% and 67.7% in follow-up. Physical activity levels improved in both endline and follow-up groups compared to baseline. Daily participation in yoga, running, gym, and aerobics increased to 38.7% in endline and follow-up from 7.3% at baseline (<i>p</i> < 0.001). Outdoor sports engagement rose significantly to 15% in endline and follow-up from 0.5% at baseline (<i>p</i> < 0.001). Regular stair usage (59.8%), walking for chores (84.7%), and short walking breaks (93%) increased significantly in follow-up compared to baseline and endline (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The combined mHealth and community health education intervention improved diabetes awareness and healthy habits in rural areas, showing potential for lasting outcomes and guiding future public health efforts in similar settings.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1470615"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital solid waste management strategies to prevent healthcare-associated infections from occupational exposure to bloodborne pathogens and improve occupational safety.","authors":"Augusto Jorge Antonio Ibáñez-Cruz, Alejandra Micaela Elena Vergara-Florián, William C Algoner","doi":"10.3389/fpubh.2025.1499463","DOIUrl":"10.3389/fpubh.2025.1499463","url":null,"abstract":"<p><p>Improving occupational safety and public health is crucial to reducing nosocomial infections in healthcare workers due to the ongoing deficiencies in solid waste management in private clinics. For this reason, it is necessary to implement appropriate solid waste management practices to mitigate risks for clinical staff, patients, and the environment. This research focused on reducing the risk of nosocomial infections in healthcare workers exposed to bloodborne pathogens. It was carried out at the private clinic and concentrated on properly managing hospital solid waste, with special attention to occupational health and safety. 400 health workers were trained online during six sessions, addressing biosafety, conditioning, segregation, storage, collection, and transportation of solid waste. The amount of waste produced in kilograms daily was 232.76 bio-contaminated, 11.23 special, and 218.58 joint. Bio-contaminated waste included patient care, bags with human blood and blood products, surgical and anatomicalpathological waste, sharps and biological objects, pharmaceuticals, and hazardous and radioactive chemicals. Proper solid waste management, supported by adequate training, contributed to a significant decrease in the incidence of nosocomial infections: two cases were reported in August and one in September, and there was no incidence of cases from October to December. The estimation of the method used for solid waste disposal showed an acceptable degree in the stages of conditioning, segregation, primary storage, internal transport within the clinic, and central storage. In addition, the occupational health and safety of the personnel at the private clinic was improved.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1499463"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating retrieval-augmented generation for enhanced personalized physician recommendations in web-based medical services: model development study.","authors":"Yingbin Zheng, Yiwei Yan, Sai Chen, Yunping Cai, Kun Ren, Yishan Liu, Jiaying Zhuang, Min Zhao","doi":"10.3389/fpubh.2025.1501408","DOIUrl":"10.3389/fpubh.2025.1501408","url":null,"abstract":"<p><strong>Background: </strong>Web-based medical services have significantly improved access to healthcare by enabling remote consultations, streamlining scheduling, and improving access to medical information. However, providing personalized physician recommendations remains a challenge, often relying on manual triage by schedulers, which can be limited by scalability and availability.</p><p><strong>Objective: </strong>This study aimed to develop and validate a Retrieval-Augmented Generation-Based Physician Recommendation (RAGPR) model for better triage performance.</p><p><strong>Methods: </strong>This study utilizes a comprehensive dataset consisting of 646,383 consultation records from the Internet Hospital of the First Affiliated Hospital of Xiamen University. The research primarily evaluates the performance of various embedding models, including FastText, SBERT, and OpenAI, for the purposes of clustering and classifying medical condition labels. Additionally, the study assesses the effectiveness of large language models (LLMs) by comparing Mistral, GPT-4o-mini, and GPT-4o. Furthermore, the study includes the participation of three triage staff members who contributed to the evaluation of the efficiency of the RAGPR model through questionnaires.</p><p><strong>Results: </strong>The results of the study highlight the different performance levels of different models in text embedding tasks. FastText has an <i>F</i> ₁-score of 46%, while the SBERT and OpenAI significantly outperform it, achieving <i>F</i> ₁-scores of 95 and 96%, respectively. The analysis highlights the effectiveness of LLMs, with GPT-4o achieving the highest <i>F</i> ₁-score of 95%, followed by Mistral and GPT-4o-mini with <i>F</i> ₁-scores of 94 and 92%, respectively. In addition, the performance ratings for the models are as follows: Mistral with 4.56, GPT-4o-mini with 4.45 and GPT-4o with 4.67. Among these, SBERT and Mistral are identified as the optimal choices due to their balanced performance, cost effectiveness, and ease of implementation.</p><p><strong>Conclusion: </strong>The RAGPR model can significantly improve the accuracy and personalization of web-based medical services, providing a scalable solution for improving patient-physician matching.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1501408"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health belief model of parents' COVID-19 vaccination intentions for children: perceived benefits and barriers in Indonesia.","authors":"Eka Wuri Handayani, Dyah Aryani Perwitasari, Fredrick Dermawan Purba","doi":"10.3389/fpubh.2024.1485416","DOIUrl":"10.3389/fpubh.2024.1485416","url":null,"abstract":"<p><strong>Introduction: </strong>The uptake of vaccines against COVID-19 remains low. Some barriers to childhood vaccination uptake persist, such as parents' assumption that children are at lower risk of severe COVID-19 and tend to be asymptomatic carriers. This study aims to develop guidance for in-depth interviews for a future qualitative study based on a cross-sectional quantitative study of parents with school-age children.</p><p><strong>Methods: </strong>This study adopted a cross-sectional design. The study population comprised parents of 6-11-year-old children in the Centra Java province who had received the COVID-19 vaccine or not. The data were collected from August 2023 by filling in an online questionnaire. The sample size was calculated using formulation in OpenEpi for 95% confidence levels, with a statistical power of 80%.</p><p><strong>Results: </strong>Our study finds that perceived benefit and perceived barriers are the two domains that most significantly influenced the parents' intention to vaccinate their children. In our study, there was no significant association between parent gender and the intention to vaccinate their children. Our study shows that parents' acceptance of vaccinating their children is high. We emphasized questions related to benefits and barriers in the interview. The questions on perceived benefits explored the advantages of COVID-19 vaccination. The content on perceived barriers examined the concerns of parents, the information influencing their decision to vaccinate their child, the procedure vaccination and the effect after vaccination.</p><p><strong>Discussion: </strong>The significant association between parents' intention to vaccinate their children and the perceived benefits and perceived barriers to vaccination generated guidance for in-depth interviews in the qualitative study. The health belief model should be further explored in Indonesia because of the potential external factors that may influence parents' intention to vaccinate their children.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1485416"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries.","authors":"Yaovi Mahuton Gildas Hounmanou, Adonias Houefonde, Tram Thuy Nguyen, Anders Dalsgaard","doi":"10.3389/fpubh.2024.1525873","DOIUrl":"10.3389/fpubh.2024.1525873","url":null,"abstract":"<p><p>Hospital wastewater (HWW) is a significant environmental and public health threat, containing high levels of pollutants such as antibiotic-resistant bacteria (ARB), antibiotic-resistant genes (ARGs), antibiotics, disinfectants, and heavy metals. This threat is of particular concern in low- and middle-income countries (LMICs), where untreated effluents are often used for irrigating vegetables crops, leading to direct and indirect human exposure. Despite being a potential hotspot for the spread of antimicrobial resistance (AMR), existing HWW treatment systems in LMICs primarily target conventional pollutants and lack effective standards for monitoring the removal of ARB and ARGs. Consequently, untreated or inadequately treated HWW continues to disseminate ARB and ARGs, exacerbating the risk of AMR proliferation. Addressing this requires targeted interventions, including cost-effective treatment solutions, robust AMR monitoring protocols, and policy-driven strategies tailored to LMICs. This perspective calls for a paradigm shift in HWW management in LMIC, emphasizing the broader implementation of onsite treatment systems, which are currently rare. Key recommendations include developing affordable and contextually adaptable technologies for eliminating ARB and ARGs and enforcing local regulations for AMR monitoring and control in wastewater. Addressing these challenges is essential for protecting public health, preventing the environmental spread of resistance, and contributing to a global effort to preserve the efficacy of antibiotics. Recommendations include integrating scalable onsite technologies, leveraging local knowledge, and implementing comprehensive AMR-focused regulatory frameworks.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1525873"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}