Public Health最新文献

{"title":"The burden of inequity: Income related disparities in cardiovascular risk factors in Europe","authors":"Ana Margarida Pereira Silva ,&nbsp;Luis Andrés Gimeno-Feliu ,&nbsp;Juan A. Lopez-Rodriguez","doi":"10.1016/j.puhe.2025.105978","DOIUrl":"10.1016/j.puhe.2025.105978","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess intercountry differences in social inequities related to cardiovascular risk factors across European countries in 2020.</div></div><div><h3>Study design</h3><div>Observational, cross-sectional study.</div></div><div><h3>Methods</h3><div>We analyzed data from the European Health Interview Survey (EHIS 3) (2018–2020) across 31 European countries. Focusing on adults over 40, with a sample of 248,420 participants. Socioeconomic position was assessed by net equivalised monthly income, analyzing six cardiovascular risk factors: dyslipidemia, diabetes, high blood pressure, obesity, smoking, and sedentary lifestyle. Descriptive analyses, prevalence estimation along with Poisson regression models and relative inequity indexes (RII) for quantification of health inequity among groups were calculated, considering survey weights.</div></div><div><h3>Results</h3><div>Significant geographical heterogeneity in prevalence and inequity indexes of all cardiovascular risk factors throughout Europe were found. Income presents a linear dose-response relationship with the prevalence of these factors (maximum for Diabetes, High blood pressure and Sedentary lifestyle), revealing some positive and inverse inequities (deviating from expected social gradient). Maximum gender disparity was found for Diabetes in women (RII = 2.265 [95 % CI]: 2.427–2.838) versus Men (RII = 1.785 [95 % CI]: 1.653–1.928) and inverse inequity (RII&lt;1) for smoking habits in Bulgaria, Lithuania, Portugal and Romania.</div></div><div><h3>Conclusions</h3><div>This study highlighted significant income-related inequities in cardiovascular risk factors, with lower-income individuals exhibiting higher prevalence of dyslipidemia, diabetes, high blood pressure, obesity, smoking, and sedentary lifestyle. Country-specific variations were noted, with some countries experiencing a greater inequity, while others showed less pronounced inequity or even inverse inequalities. These findings highlight the need for equity-oriented healthcare services to reduce cardiovascular disease burden and address significant socioeconomic disparities.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105978"},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266627","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":"Targeting health equity through complex health interventions: Which evaluation methods and designs are used? A scoping review","authors":"Iñaki Blanco-Cazeaux ,&nbsp;Thomas Ferté ,&nbsp;Coline Bruzek ,&nbsp;Marie Gaudart ,&nbsp;Karelle Ngabdo ,&nbsp;Jérôme Wittwer ,&nbsp;Florence Francis-Oliviero","doi":"10.1016/j.puhe.2025.105962","DOIUrl":"10.1016/j.puhe.2025.105962","url":null,"abstract":"<div><h3>Objectives</h3><div>Health inequalities (HI) are systematic and avoidable disparities. While many public health interventions target HI reduction, their impact is not always evaluated. We assessed the extent to which economic indicators and methods are used to evaluate HI reduction in complex health interventions.</div></div><div><h3>Study design</h3><div>We performed a scoping review following Arksey and O'Malley's framework.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, CINAHL, EconLit, and PsycINFO for studies evaluating public health interventions aimed at reducing HI.</div></div><div><h3>Results</h3><div>Of 490 screened articles, 19 met inclusion criteria. Most studies (n = 10) used randomised controlled trials. The predominant evaluation method was subgroup analyses based on socioeconomic categories (n = 10), followed by interaction terms (n = 5) and difference-in-differences (n = 4). However, no study directly assessed HI reduction using dedicated economic indicators.</div></div><div><h3>Conclusions</h3><div>Despite the stated goal of reducing HI, evaluations often fail to measure this impact explicitly. This omission poses methodological risks, as some interventions may unintentionally widen disparities. We advocate for systematic inclusion of economic indicators, such as the Gini index or methods, such as Distributional Cost-Effectiveness Analysis, to ensure a more rigorous assessment of HI in public health interventions.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"249 ","pages":"Article 105962"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270603","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":"Changes in the nationwide number of emergency department visits following the junior physicians’ walkout in South Korea: An interrupted time-series analysis","authors":"Changwoo Han","doi":"10.1016/j.puhe.2025.105984","DOIUrl":"10.1016/j.puhe.2025.105984","url":null,"abstract":"<div><h3>Objectives</h3><div>A walkout of junior physicians in South Korea began on February 20, 2024, in response to the government's plan to expand medical school enrollment. Given that junior doctors are the first to assess and manage patients in emergency department (ED) in Korea, their absence may disrupt emergency medical services. This study aimed to evaluate nationwide changes in ED utilization following the walkout.</div></div><div><h3>Study design</h3><div>Descriptive time series study.</div></div><div><h3>Methods</h3><div>Nationwide ED visit data were extracted from the National Health Insurance Database between June 1, 2022, and November 30, 2024. An interrupted time series analysis adjusting for seasonality was used to evaluate changes in disease specific ED visits after the walkout. Additionally, trends in the total number of ED beds and their occupancy rates were analyzed.</div></div><div><h3>Results</h3><div>ED visits sharply declined in the week of the walkout. The estimated step-change was −24,871 visits (95 % CI: −32,542, −17,201) for all-cause and −19,211 visits (95 % CI: −24,922, −13,500) for non-accidental diseases. The greatest step change decreases observed were respiratory diseases, external injuries, infectious diseases, and digestive diseases. The occupancy rate of nationwide general ED beds and pediatric beds sharply declined after walkout and did not return to pre-strike levels, even during the resurgence of COVID-19.</div></div><div><h3>Conclusions</h3><div>The junior physicians’ walkout was associated with a substantial reduction in ED visits and ED capacity. These findings may reflect both a scale-down of emergency medical services and changes in healthcare-seeking behavior. Further research is needed to assess the public health implications of such abrupt service disruptions.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"249 ","pages":"Article 105984"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270601","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":"Association of chemsex and risk of chlamydia, gonorrhoea, and syphilis infections: a systematic review and meta-analysis","authors":"Prakasini Satapathy ,&nbsp;Abhay M. Gaidhane ,&nbsp;Nasir Vadia ,&nbsp;Soumya V. Menon ,&nbsp;Kattela Chennakesavulu ,&nbsp;Rajashree Panigrahi ,&nbsp;Manpreet Kaur ,&nbsp;Ganesh Bushi ,&nbsp;Muhammed Shabil ,&nbsp;Diptismita Jena ,&nbsp;Mayank Goyal ,&nbsp;Harish Kumar ,&nbsp;Anju Rani ,&nbsp;Sanjit Sah ,&nbsp;Mahendra Singh ,&nbsp;Khang Wen Goh","doi":"10.1016/j.puhe.2025.105971","DOIUrl":"10.1016/j.puhe.2025.105971","url":null,"abstract":"<div><h3>Objectives</h3><div>Chemsex, the use of psychoactive substances to enhance sexual experiences, is increasingly recognized as a public health concern, particularly among men who have sex with men (MSM). This behavior is associated with risky sexual practices, including condomless sex, multiple partners, and prolonged sexual sessions, which may elevate the risk of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis. This systematic review and meta-analysis aim to quantify the association between chemsex and these bacterial STIs.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Web of Science was conducted to identify studies reporting associations between chemsex and chlamydia, gonorrhea, or syphilis until November 10, 2024. Eligible studies included observational designs with chemsex participants and STI outcomes. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) with 95 % confidence intervals (CIs). Statistical analysis was performed by using R software version 4.4.</div></div><div><h3>Results</h3><div>A total of 13 studies were included across multiple countries. The meta-analysis revealed a significant association between chemsex and syphilis (pooled OR: 1.741, 95 % CI: 1.337–2.267), gonorrhea (pooled OR: 1.784, 95 % CI: 1.428–2.228), and chlamydia (pooled OR: 1.429, 95 % CI: 1.195–1.710). Two studies reporting hazard ratios for gonorrhea (pooled HR: 1.699, 95 % CI: 1.361–2.121) and chlamydia (pooled HR: 1.202, 95 % CI: 0.972–1.487) showed consistent findings. Heterogeneity across studies was minimal for most outcomes (I² = 0 %), and prediction intervals supported stable effect sizes.</div></div><div><h3>Conclusion</h3><div>This study confirms that chemsex is significantly associated with an increased risk of bacterial STIs, particularly syphilis and gonorrhea. The findings highlight the urgent need for interventions addressing chemsex behaviors, including harm reduction strategies, STI prevention programs, and culturally competent healthcare services. Future research should focus on standardizing definitions of chemsex, expanding investigations to low- and middle-income countries, and addressing publication bias to ensure global relevance and reliability of evidence.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"249 ","pages":"Article 105971"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270602","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":"Co-producing public health advice for people working on premises infected with highly pathogenic avian influenza","authors":"Louise E. Smith ,&nbsp;Alex F. Martin ,&nbsp;Riinu Pae ,&nbsp;Sarah Denford ,&nbsp;Clare Humphreys ,&nbsp;Dale Weston ,&nbsp;Richard Amlôt ,&nbsp;Isabel Oliver ,&nbsp;Lucy Yardley ,&nbsp;G James Rubin","doi":"10.1016/j.puhe.2025.105976","DOIUrl":"10.1016/j.puhe.2025.105976","url":null,"abstract":"<div><h3>Objectives</h3><div>Uptake of protective measures to prevent bird-to-human transmission of avian influenza (AI) (correct use of personal protective equipment [PPE], taking antivirals if recommended) and to increase the timely detection of AI in humans (prompt reporting of symptoms after exposure) is imperfect. The aim of this project was to co-produce public health advice for AI with people who work on infected premises.</div></div><div><h3>Study design</h3><div>Co-production following the Agile Co-production and Evaluation (ACE) framework for developing messaging and guidance.</div></div><div><h3>Methods</h3><div>We co-produced five factsheets in simple English (1. avian influenza, 2. PPE, 3. Tamiflu® (oseltamivir), 4a. Reporting symptoms and active follow-up, 4b. Reporting symptoms and passive follow-up), with accompanying infographics based on theory, previous literature, behavioural science principles, and stakeholder input. Seventeen people who worked on infected premises including two people who did not speak English gave feedback on sheets and shared their lived experience of working on infected premises.</div></div><div><h3>Results</h3><div>Co-producers generally preferred infographics to factsheets and suggested how sheets could be displayed on farms and disseminated within the poultry farming community. Suggested changes included that phrases should be shortened, amendments made to language and images to align with terms and items used on site, and that images in infographics were sometimes ambiguous if accompanying text was not understood. Co-producers also suggested creating videos to accompany the sheets.</div></div><div><h3>Conclusions</h3><div>The co-production process helped to develop good working relationships with people who work on infected premises and gave practical insight into their experiences.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105976"},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259945","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":"Association of weekend warrior physical activity pattern with health outcomes: A systematic review and meta-analysis","authors":"Yun Sung Kim ,&nbsp;Young-Heon Shin ,&nbsp;Minsuk Oh ,&nbsp;Justin Y. Jeon ,&nbsp;Dong Hoon Lee","doi":"10.1016/j.puhe.2025.105977","DOIUrl":"10.1016/j.puhe.2025.105977","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to systematically review and analyze the associations between ‘Weekend Warrior’ patterns (≥150 minutes of moderate-to-vigorous physical activity [MVPA] per week in 1-2 days) and health outcomes compared to regular physical activity patterns (≥150 minutes of MVPA distributed over ≥3 days).</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed and EMBASE databases up to July 2025. Meta-analysis using random-effects models was performed for health outcomes, including mortality (all-cause, cancer, cardiovascular disease), metabolic diseases (metabolic syndrome, hypertension, obesity, type 2 diabetes), and depression.</div></div><div><h3>Results</h3><div>We included 18 publications (8 cohorts and 11 cross-sectional studies). Both weekend warrior and regular physical activity patterns showed similar associations with health outcomes compared to inactivity. Lower risks were observed for all-cause mortality (Weekend warrior: relative risk (RR) 0.76, 95 % confidence interval (CI) 0.66-0.87; Regular physical activity: RR 0.71, 95 % CI 0.63-0.80), cardiovascular disease mortality (Weekend warrior: RR 0.74, 95 % CI 0.60-0.91; Regular physical activity: RR 0.69, 95 % CI 0.56-0.85), and cancer mortality (Weekend warrior: RR 0.81, 95 % CI 0.75-0.88; Regular physical activity: RR 0.86, 95 % CI 0.81-0.93). Both patterns were similarly associated with a lower risk of metabolic syndrome, hypertension, obesity, type 2 diabetes, and depression compared to inactivity.</div></div><div><h3>Conclusion</h3><div>The weekend warrior patterns of physical activity may serve as a practical alternative for time-constrained individuals, showing benefits similar to regular physical activity patterns for diverse health outcomes.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105977"},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259884","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":"Protein-enriched breakfast cereals receive similar Health Star Ratings despite higher sugar and sodium content.","authors":"Mariel Keaney, Alexandra Jones, Damian Maganja, Eden M Barrett","doi":"10.1016/j.puhe.2025.105968","DOIUrl":"https://doi.org/10.1016/j.puhe.2025.105968","url":null,"abstract":"<p><strong>Objectives: </strong>Front-of-pack nutrition labelling (FOPNL) on packaged foods can support consumers to make healthier choices. Australia and New Zealand's voluntary FOPNL, the Health Star Rating (HSR), summarises a product's healthiness from 0.5 (less healthy) to 5.0 (more healthy). Even though the population's protein requirements are largely met, protein content contributes positively to a product's rating, raising concerns that added protein may be used to offset unfavourable nutrients. Our aim was to compare breakfast cereals with and without added protein by examining the prevalence of HSR display, and differences in HSR and nutritional composition.</p><p><strong>Study design: </strong>Cross sectional study of breakfast cereals available for sale in Sydney, Australia, in 2024.</p><p><strong>Methods: </strong>HSRs were calculated using information available on pack. For products with and without added protein, we compared the proportion displaying an HSR on pack, and the median HSR, energy, sodium, total sugars, dietary fibre and protein (per 100g).</p><p><strong>Results: </strong>Breakfast cereals with added protein (n = 49) had a higher prevalence of displaying the HSR compared to those without added protein (n = 436, 91.8 % v 76.1 %, p = 0.012). Both groups reported a median HSR of 4.0 (p = 0.266). Products with added protein contained significantly more sodium (120 [IQR 48-300] v 30 [IQR 10-174] mg/100 g, p < 0.001) and total sugars (15.6 [IQR 9.6-23.9] v 13.7 [IQR 8.1-18.5] g/100 g, p = 0.027).</p><p><strong>Conclusions: </strong>Food manufacturers benefit from adding protein to offset unfavourable nutrients and achieve relatively high HSRs. Consideration of the role and offsetting power of added protein is warranted to ensure that the HSR system, and similar systems used globally, guide consumers towards genuinely healthier products.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":" ","pages":"105968"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245721","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":"Climate change and diagnostic samples - Opening Pandora's (post) box","authors":"Paul Klapper ,&nbsp;Raghavendran Kulasegaran-Shylini ,&nbsp;Andrew Dodgson ,&nbsp;Malur Sudhanva ,&nbsp;Edward Blandford ,&nbsp;Sarah Tunkel ,&nbsp;Sue Hill ,&nbsp;Susan Hopkins ,&nbsp;Tom Fowler","doi":"10.1016/j.puhe.2025.105983","DOIUrl":"10.1016/j.puhe.2025.105983","url":null,"abstract":"<div><h3>Objectives</h3><div>To reflect on how climate change is reshaping the practicalities of diagnostic testing, using the UK's COVID-19 home-based testing programme as a case study, and to call for an urgent review of international standards governing the transport of biological samples.</div></div><div><h3>Study design</h3><div>Narrative-based analysis drawing on operational experience during the UK National Testing Programme's response to COVID-19.</div></div><div><h3>Methods</h3><div>We examine the design and implementation of a large-scale home testing model for COVID-19, which relied on the routine postal service to transport biological samples from homes to laboratories. These samples were transported without temperature control, across widely varying environmental conditions. This approach tested the limits of existing logistical assumptions and exposed critical regulatory gaps.</div></div><div><h3>Results</h3><div>Despite the lack of temperature-controlled logistics, the UK's home testing programme functioned at scale, with internal validation assuring sample stability during both winter and summer extremes. However, this success occurred in the absence of any applicable international standards—such as ISO guidelines—that account for environmental factors in postal transport of biological samples. The experience highlighted a significant blind spot in regulatory frameworks, which currently assume controlled conditions that do not reflect real-world practice in emergency or climate-affected contexts.</div></div><div><h3>Conclusions</h3><div>The changing climate and evolving models of healthcare delivery—particularly the move toward near-patient and home-based diagnostics—require a rethinking of how we assure the quality and reliability of biological samples in transit. Existing international standards are no longer fit for purpose in this regard. There is an urgent need to acknowledge environmental resilience as a core requirement in diagnostic logistics, and to develop new standards that are robust to the realities of climate variability and decentralised healthcare.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"249 ","pages":"Article 105983"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229937","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":"Historic trends and future projections of the prevalence of adult excess weight in Scotland, 2003 to 2040: A modelling study","authors":"Robby De Pauw ,&nbsp;Fatim Lakha ,&nbsp;Eilidh Fletcher ,&nbsp;Diane L. Stockton ,&nbsp;Emma Baird ,&nbsp;Suzanne Connolly ,&nbsp;Brecht Devleesschauwer ,&nbsp;Grant M.A. Wyper","doi":"10.1016/j.puhe.2025.105981","DOIUrl":"10.1016/j.puhe.2025.105981","url":null,"abstract":"<div><h3>Objectives</h3><div>The prevalence of excess weight in Scotland is higher than other UK nations and amongst the highest when compared with European Union countries. We aimed to use historic data to project estimates of the prevalence of excess weight in Scotland using Bayesian age-period-cohort modelling.</div></div><div><h3>Study design</h3><div>A Bayesian age-period-cohort modelling study.</div></div><div><h3>Methods</h3><div>Interviewer-validated height and weight measurements were obtained from the Scottish Health Survey (2003–2019) to calculate body mass index (BMI). Relevant socio-demographic attributes were sourced to contribute to modelling and results stratification. Study outcomes were defined as overweight (BMI ≥25 kg/m²) and obesity (BMI ≥30 kg/m²). We estimated historic trends in study outcomes by sex and age-group, and projected future trends to 2040, using Bayesian hierarchical age-period-cohort modelling.</div></div><div><h3>Results</h3><div>In 2040, we estimate 3.3 million adult cases of overweight, of which 1.6 million are cases of obesity. Projections were more pronounced for obesity, compared to overweight, with an additional 66,000 male cases and 175,000 female cases projected between 2019 and 2040. Between 2003 and 2019, the proportion of male and female cases of both overweight and obesity aged 65 years and above have increased, a trend projected to further intensify as we move towards 2040.</div></div><div><h3>Conclusions</h3><div>Left unaddressed, we estimate a substantial increase in adult excess weight in Scotland by 2040, particularly for females, compounded by increases in obesity and in the proportion of older cases. These findings are a warning signal of future adverse population health impacts and healthcare service sustainability pressures. Projections are not inevitable and underscore the need to accelerate progress on implementing preventative measures to address the food environment, and on further development of weight management and support services, to improve Scotland's population health.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105981"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253012","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":"Is pre-travel advice followed? A study of UK international travellers with gastrointestinal illness and asymptomatic travellers","authors":"Nicola K. Love ,&nbsp;Yanshi ,&nbsp;Parisha Katwa ,&nbsp;Iman Mohamed ,&nbsp;Dipti Patel ,&nbsp;Hilary Kirkbride ,&nbsp;Sooria Balasegaram","doi":"10.1016/j.puhe.2025.105954","DOIUrl":"10.1016/j.puhe.2025.105954","url":null,"abstract":"<div><h3>Objectives</h3><div>Pre-travel advice aims to reduce the risk of gastrointestinal illness, but many travellers don't seek or adhere to advice. We investigated access and adherence to pre-travel advice in returning English travellers with and without gastrointestinal infections.</div></div><div><h3>Study design</h3><div>Unmatched case-control study</div></div><div><h3>Methods</h3><div>Cryptosporidiosis, Giardiasis, non-typhoidal Salmonellosis and Shigellosis cases notified to the UK Health Security Agency (UKHSA) reporting international travel (during incubation period) and market research recruited asymptomatic travellers completed an electronic questionnaire between 01 July and 15 October 2023. All analyses were performed in RStudio. Demographics, pre-travel health advice-seeking and advice awareness were compared by Pearson's Chi-squared test and a multivariable analysis was performed using a forward stepwise approach.</div></div><div><h3>Results</h3><div>53 % of cases (n = 347/653) and 27 % of controls (n = 128/483) sought pre-travel advice. Advice-seeking was higher for destinations with poorer water, hygiene and sanitation (high-risk WASH; p=&lt;0.001). Individuals travelling to high-risk short-haul destinations near to Europe (p = 0.05), visiting friends or relatives (p = 0.09), or travelling for ≤14 days (p = 0.07) were least likely to seek advice, with just over a third stating advice wasn't required for their destination. Individuals without advice were significantly less compliant with advice for the prevention of food and waterborne illness while travelling.</div></div><div><h3>Conclusions</h3><div>A lack of awareness of advice for the prevention of travel associated food and waterborne disease and the perception that some high-risk destinations are low-risk may be putting individuals at increased risk of acquiring potentially serious gastrointestinal infections. Further work is needed to raise awareness of the need for advice prior to travelling, particularly when travelling to higher-risk short-haul destinations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105954"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253043","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}