Clinical Epidemiology and Global Health最新文献

{"title":"Empowering recovery: A scoping review of post-ICU exercise rehabilitation success factors and challenges","authors":"Sakshi Surve ,&nbsp;G. Arun Maiya ,&nbsp;Vishal Shanbhag ,&nbsp;Mukesh Kumar Sinha","doi":"10.1016/j.cegh.2025.102174","DOIUrl":"10.1016/j.cegh.2025.102174","url":null,"abstract":"<div><h3>Problem considered</h3><div>Post-intensive care syndrome (PICS) frequently results in physical impairments, notably intensive care unit-acquired weakness (ICU-AW), affecting neuromuscular functions such as swallowing, breathing, mobility, and personal autonomy. Despite advancements, achieving comprehensive post-ICU physical recovery presents significant challenges. This necessitates a thorough understanding of physical activity patterns among survivors and the exploration of barriers and facilitators that can enhance recovery outcomes. This review aims to systematically identify and categorize these factors in the context of post-intensive care exercise-based rehabilitation.</div></div><div><h3>Methods</h3><div>Employing Arksey and O'Malley's scoping review framework, we examined three electronic databases: MEDLINE via PubMed, Scopus, and Web of Science. The review focused on qualitative studies published in English that evaluated the barriers and facilitators affecting physical activity among survivors of critical illness.</div></div><div><h3>Results</h3><div>The search resulted in seven qualitative studies meeting the inclusion criteria, all scoring seven to eight out of 10 criteria on the JBI checklist for qualitative research. The identified facilitators and barriers were categorized into three primary themes: patient-related, task-related, and environment-related. Patient-related factors included elements such as motivation, spirituality, concentration difficulties, and sleep disturbances. Task-related aspects were primarily related to communication and managing conflicting priorities. The environmental factors included family and peer support, transport accessibility, and financial management.</div></div><div><h3>Conclusion</h3><div>The review highlights a range of modifiable barriers encountered by ICU survivors in their exercise-based rehabilitation following discharge, encompassing physical, social, psychological, financial, and environmental spheres. Further exploration of these elements is critical to improve patient care outcomes.</div></div><div><h3>Clinical significance</h3><div>Understanding and mitigating barriers to postcritical care rehabilitation is essential for developing targeted, patient-centered rehabilitation strategies, facilitating more effective and rapid recovery for critical illness survivors.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102174"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor and non-poor gaps in antibiotic misuse in Indonesia: A Blinder-Oaxaca decomposition analysis","authors":"Wahyu Pudji Nugraheni,&nbsp;Bunga Astria Paramashanti,&nbsp;Dea Anita Ariani Kurniasih,&nbsp;Asep Kusnali,&nbsp;Syarifah Nuraini,&nbsp;Debri Rizki Faisal","doi":"10.1016/j.cegh.2025.102172","DOIUrl":"10.1016/j.cegh.2025.102172","url":null,"abstract":"<div><h3>Problem considered</h3><div>Antibiotic misuse is a significant public health concern. Moreover, the gap between poor and non-poor groups in Indonesia remains understudied. Identifying the factors contributing to this disparity is key for effective intervention strategies. This study aims to quantify the contributing factors explaining the gap in antibiotic misuse between the poor and the non-poor in Indonesia.</div></div><div><h3>Methods</h3><div>We used data from the 2023 Indonesia Health Survey, which included 446,605 individuals aged 15 years and older in Indonesia. The main effect was antibiotic misuse—buying medications without a prescription from practitioners. Poor and non-poor gaps in antibiotic misuse determinants were examined using Blinder–Oaxaca decomposition, which separates differences between groups into those explained by observed factors and those unexplained by them.</div></div><div><h3>Results</h3><div>The gap of antibiotic misuse between poor and non-poor groups was 6.0 percentage points (p &lt; 0.001). The between-group differences in the predictors of study participants (endowments) contributed 0.051 (85.0 %) to the gap, whereas the between-group differences in effects of the predictors (coefficients) contributed 0.009 (15.0 %) towards the gap. The predictors that contributed most towards the gap due to endowments (explained component) were household economic status, knowledge of antibiotic use, antibiotic procurement source, region, and insurance ownership, and due to coefficients were place of residence, insurance ownership, drug literacy, knowledge of antibiotic use, and region.</div></div><div><h3>Conclusion</h3><div>Endowments like economic status and antibiotic knowledge explain much of the antibiotic usage discrepancy between poor and non-poor groups. Economic, health education, and healthcare interventions may narrow this gap.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102172"},"PeriodicalIF":1.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Knowledge, Attitude, and Screening practices for breast cancer among women in Odisha: A community-based study","authors":"Saumyasree Pradhan ,&nbsp;Srinivas Bishoyi ,&nbsp;Soumalaya Ghosh ,&nbsp;Manjunatha Vk ,&nbsp;Sushil Kumar Rathore ,&nbsp;Mukesh Kumar Sahoo ,&nbsp;Hemeswari Bhuyan ,&nbsp;Amitosh Dandsena ,&nbsp;Jyoti Rath ,&nbsp;Jyoti Ranjan Mohanty ,&nbsp;Paramjot Panda","doi":"10.1016/j.cegh.2025.102171","DOIUrl":"10.1016/j.cegh.2025.102171","url":null,"abstract":"<div><h3>Problem considered</h3><div>Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide. In developing countries such as India, women's knowledge of breast cancer screening remains limited. This study investigated women's knowledge of breast cancer and their screening uptake behaviour in eastern India.</div></div><div><h3>Methods</h3><div>A community-based cross-sectional survey was conducted among 1506 women aged 18 years and above in urban and rural areas of Odisha, India. Data were collected through a structured questionnaire and analysed using SPSS version 23. Descriptive statistics were used to examine socio-demographic characteristics, knowledge, attitudes, and practices. Knowledge scores were generated to assess awareness of breast cancer, breast self-examination (BSE), and mammography.</div></div><div><h3>Results</h3><div>Among the participants, 1158 women demonstrated a medium level of overall cancer knowledge (mean score 1.00, SD 0.01). Higher knowledge scores were observed among married women, those with a graduate degree, and those from smaller families. Dependent women showed comparatively higher knowledge than employed or self-employed participants. Knowledge of BSE and mammography was poorer among women from medium- and low-income households. Most participants reported neither performing BSE nor undergoing mammography. The main reasons for not engaging in screening included lack of awareness, absence of a doctor's referral, perceived youthfulness, limited time during free screening opportunities, and unavailability of facilities.</div></div><div><h3>Conclusion</h3><div>Knowledge and practice of breast cancer screening among women in Odisha remain inadequate. Awareness campaigns and improved accessibility of screening services are urgently required to overcome barriers and promote early detection.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102171"},"PeriodicalIF":1.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between dietary quality and metabolically healthy profile among overweight/obese cameroonian adults: A cross-sectional study","authors":"Maxwell Wandji Nguedjo ,&nbsp;Hippolyte Tene Mouafo ,&nbsp;Guy Roussel Takuissu Nguemto ,&nbsp;Judith Laure Ngondi ,&nbsp;Julius Enyong Oben","doi":"10.1016/j.cegh.2025.102175","DOIUrl":"10.1016/j.cegh.2025.102175","url":null,"abstract":"<div><h3>Problem considered</h3><div>In Cameroon, where food quality indices are widely used to assess cardiometabolic risk, it is necessary to clarify the link between diet quality and metabolically healthy profile in overweight and obese adults.</div></div><div><h3>Methods</h3><div>The study included 324 overweight/obese Cameroonian adults aged 21–65 years. Food quality was assessed using Food Consumption Scores (FCS) and Dietary Diversity Scores (DDS) derived from the different food groups consumed. Anthropometric and clinical measurements were performed. A metabolically unhealthy profile was defined by the presence of at least one disorder (hypertension, hypertriglyceridemia, hypercholesterolemia or hyperglycemia), while the complete absence of these disorders defined the metabolically healthy profile. Bivariate logistic regression analyses were used to estimate odds ratios (OR) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>The proportion of participants with unacceptable FCS was higher in the metabolically healthy group than in the metabolically unhealthy group (44.8 % vs. 27.2 %). The main contributors to dietary diversity in metabolically healthy overweight/obese individuals were vitamin A-rich foods (13.45 % vs 12.06 %), pulses (16.01 % vs 13.13 %), and fruits and vegetables (13.45 % vs 11.33 %), compared to their unhealthy counterparts. Logistic regression indicated that unacceptable FCS (OR = 0.46; 95 % CI: 0.28–0.75) was paradoxically associated with a higher probability of having a metabolically healthy profile. In contrast, DDS was not significantly associated with metabolic health in this overweight/obese population.</div></div><div><h3>Conclusion</h3><div>These results highlight the need for personalized nutritional strategies specific to the Cameroonian context to improve the prevention and management of cardiometabolic risk in overweight and obese individuals.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102175"},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factor identification and classification of diabetic retinopathy among Northeast Indian population using machine learning models","authors":"Bishamber Nath ,&nbsp;Srilekha Anumulapuri ,&nbsp;Amir Ali ,&nbsp;Rupam Das ,&nbsp;Priyank Bhola ,&nbsp;Manabjyoti Barman ,&nbsp;Srinivasa Rao Mutheneni ,&nbsp;Ramu Adela","doi":"10.1016/j.cegh.2025.102170","DOIUrl":"10.1016/j.cegh.2025.102170","url":null,"abstract":"<div><h3>Problem considered</h3><div>Diabetic retinopathy (DR) is the most common cause of blindness among working-age population. With escalating global diabetes prevalence, identifying risk factors is crucial for prioritizing DR diagnosis. This study aimed to determine key risk factors in the Northeast Indian population and classify DR using artificial intelligence models.</div></div><div><h3>Methods</h3><div>In this study, twenty-seven clinical and biochemical characteristics of 188 individuals across four groups, healthy control (HC), type-2 diabetes mellitus (T2DM), non-proliferative DR (NPDR), and proliferative DR (PDR) were analysed to identify the DR risk factors. Data were analysed using four ML models, and Shapley Additive Explanation (SHAP) analysis was applied to the best-performing random forest (RF) model to assess the clinical relevance of features. Additionally, convolutional neural network (CNN) and graph neural network (GNN) models were employed for DR classification using fundus images.</div></div><div><h3>Results</h3><div>Among four classifiers, the RF model achieved 100 % training accuracy and 92 % test accuracy. In the testing dataset, the RF model achieved an area under the ROC curve (AUC) of 1 for HC and PDR. While it achieved an AUC of 0.96 and 0.97 for T2DM and NPDR, respectively. SHAP analysis identified uric acid levels, T2DM duration, glycosylated haemoglobin (HbA1c), fasting blood sugar (FBS), and tobacco/betelnut chewing as significant predictors of DR. The GNN model outperformed CNN in fundus image classification, achieving 82 % test accuracy and an AUC of 0.85.</div></div><div><h3>Conclusion</h3><div>The RF model effectively identified DR risk factors in the Northeast Indian population, while GNN demonstrated robust classification accuracy. Integrating ML and DL enhances early DR risk assessment and diagnosis, improving disease management and patient outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102170"},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical site infection following colorectal surgeries: Incidence, healthcare resource utilisation and risk factors in a major referral hospital in Malaysia","authors":"Kenneth Kwing Chin Lee ,&nbsp;Jing Sheng Lim ,&nbsp;Fitjerald Henry ,&nbsp;Mayurran Panirselvam ,&nbsp;Cindy Sin Yee Ngiam ,&nbsp;Pavithra Malaimany ,&nbsp;Julie Angela Aguilar ,&nbsp;HyeJin Park ,&nbsp;Wei Chern Ang ,&nbsp;Wai Yee Choon ,&nbsp;Subramaniam Thanimalai ,&nbsp;Renukha Sellappans","doi":"10.1016/j.cegh.2025.102167","DOIUrl":"10.1016/j.cegh.2025.102167","url":null,"abstract":"<div><h3>Problem considered</h3><div>Surgical site infections (SSI) remain a significant clinical and economic burden, particularly in colorectal surgeries. Despite the high volume of surgeries performed in Malaysia, there is limited local data on the incidence, risk factors, and cost implications of colorectal SSI. This study aimed to address this gap by evaluating the burden of SSI in a Malaysian public hospital setting.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from a Malaysian colorectal referral centre for central region, between January 1, 2023, and June 30, 2024. Adult patients aged 18–75 years who underwent inpatient colorectal surgery were included, with 30-day postoperative follow-up. Descriptive analysis was performed using clinical and resource utilisation data obtained from electronic medical records.</div></div><div><h3>Results</h3><div>A total of 125 colorectal surgeries were performed during the study period, with 42 patients developing SSI, yielding an incidence rate of 33.6 %. Patients with SSI incurred higher healthcare costs, with mean index hospitalisation costs of RM 8978 (RM 1 = 0.23 USD) compared to RM 6057 for those without SSI. Post-discharge costs were also higher in the SSI group (RM 937 vs RM 341). The total direct cost attributable to SSI was RM 166,286, with key cost drivers being laboratory investigations (46 %) and facility-related costs (30 %).</div></div><div><h3>Conclusion</h3><div>The high incidence and cost burden of SSI in colorectal surgery highlight the need for improved infection prevention. Enhancing adherence to prophylactic guidelines, expanding Enhanced Recovery After Surgery (ERAS) protocol implementation and strengthening surveillance systems are critical to improving outcomes and reducing costs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102167"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Knowledge, attitude and gatekeeper behaviour towards suicide prevention among Pre University college teachers: A cross-sectional descriptive survey” [Clinical Epidemiology and Global Health 35 (2025) 102125]","authors":"Kallabi Borah ,&nbsp;Tessy Treesa Jose ,&nbsp;Anil Kumar M. Nagaraj ,&nbsp;R. Vani Lakshmi ,&nbsp;Lorna Moxham","doi":"10.1016/j.cegh.2025.102153","DOIUrl":"10.1016/j.cegh.2025.102153","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102153"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Epidemiology and associated factors of genital warts among patients in Iran: A cross-sectional study highlighting the impact of education and sexual behavior” [Clinic Epidemiol Glob Health 32 (2025) 101945]","authors":"Hossein Faramarzi ,&nbsp;Hasti Jofreyi ,&nbsp;Nahid Heydari Marandi ,&nbsp;Mehdi Ghahartars ,&nbsp;Nasrin Aliabadi","doi":"10.1016/j.cegh.2025.102146","DOIUrl":"10.1016/j.cegh.2025.102146","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102146"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The effect of a community-based health behaviour intervention on healthcare services use among people with type 2 diabetes in Nepal” [Clin. Epidemiol. Glob. Health 32 (2025) 101954]","authors":"Grish Paudel ,&nbsp;Corneel Vandelanotte ,&nbsp;M. Mamun Huda ,&nbsp;Padam Kanta Dahal ,&nbsp;Lal Rawal","doi":"10.1016/j.cegh.2025.102160","DOIUrl":"10.1016/j.cegh.2025.102160","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102160"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating person-centered care in Cameroonian hospitals: A qualitative exploration","authors":"Emmanuel Aoudi Chance ,&nbsp;Papa Théophile","doi":"10.1016/j.cegh.2025.102166","DOIUrl":"10.1016/j.cegh.2025.102166","url":null,"abstract":"<div><h3>Problem considered</h3><div>Person-centered care (PCC) is vital for high-quality healthcare, but its adoption is inconsistent, especially in low- and middle-income countries (LMICs) like Cameroon. There is a significant gap in the literature regarding the specific barriers and facilitators to implementing PCC in this context.</div></div><div><h3>Methods</h3><div>This qualitative study used semi-structured interviews with 25 participants, including healthcare providers, patients, and hospital administrators in Cameroon. Thematic analysis was employed to explore their experiences and perspectives on PCC implementation.</div></div><div><h3>Results</h3><div>Key barriers to implementing PCC were limited resources, hierarchical healthcare structures, and specific cultural attitudes. Conversely, strong leadership commitment, patient advocacy initiatives, and training programs focused on communication and empathy emerged as significant facilitators.</div></div><div><h3>Conclusion</h3><div>Targeted interventions that address the unique challenges of implementing PCC in Cameroonian hospitals have significant potential. Fostering a more inclusive and empathetic healthcare culture can enhance the quality of care and help reduce healthcare disparities in LMICs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102166"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}