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Frontiers in Medicine 2024Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients... (Review)
Review
Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.
PubMed: 38933107
DOI: 10.3389/fmed.2024.1395698 -
North Carolina Medical Journal 2024Tobacco use remains a leading cause of preventable morbidity and premature mortality. In December 2019, the federal age of sale for tobacco products increased from 18 to...
BACKGROUND
Tobacco use remains a leading cause of preventable morbidity and premature mortality. In December 2019, the federal age of sale for tobacco products increased from 18 to 21 years of age. This study aimed to evaluate the implementation of federal tobacco 21 policies in Pitt County, North Carolina (NC), by conducting multiple purchase attempts for cigarettes.
METHOD
Stores in Pitt County that sold cigarettes were randomly sampled and visited by up to six different underage (18-20) buyers who attempted to buy cigarettes from January-March 2022. Buyers made a total of 217 cigarette purchase attempts from 49 Pitt County retailers. Analyses were conducted using SPSS Complex Samples (v.28/Macintosh) and estimate retailer prevalence of requesting identification (ID) and selling to underage buyers across multiple purchase attempts.
RESULTS
On average, retailers failed to request ID in 15.4% of purchase attempts (95% CI: 9.4%-21.3%) and sold to an underage buyer 34.2% of the time (95% CI: 27.0-41.4%). Additionally, 75.5% (95% CI: 63.4%-84.6%) of retailers sold to an underage buyer at least once.
LIMITATIONS
This study is limited to a single county in NC and to underage buyers aged 18 to 20.
CONCLUSION
There is widespread non-compliance with federal age of sale policies for tobacco products in Pitt County, NC. State enforcement is warranted, and NC's youth access law should be amended to match the federal age of sale. Changes to the law should allow research involving underage purchases.
Topics: North Carolina; Humans; Tobacco Products; Commerce; Adolescent; Young Adult
PubMed: 38932935
DOI: 10.18043/001c.117074 -
Frontiers in Public Health 2024This case study on the Children, Youth, and Families At-Risk (CYFAR) Professional Development and Technical Assistance (PDTA) Center highlights a government-funded...
This case study on the Children, Youth, and Families At-Risk (CYFAR) Professional Development and Technical Assistance (PDTA) Center highlights a government-funded entity's efforts to provide technical assistance to federal grantees of the CYFAR Sustainable Community Projects (SCP) grant program. The PDTA Center aligns with and supports components of an evidence-based system for innovation support. Through these components, the system provides targeted tools, training for CYFAR SCP grantees, dedicated technical assistance in the form of coaching, and quality improvement support through the evaluation of available program data.
Topics: Humans; United States; Health Policy; Child; Financing, Government
PubMed: 38932789
DOI: 10.3389/fpubh.2024.1347632 -
Frontiers in Public Health 2024In the contemporary context marked by globalization and the growing prominence of sustainable development, assessing urban tourism competitiveness has emerged as a...
In the contemporary context marked by globalization and the growing prominence of sustainable development, assessing urban tourism competitiveness has emerged as a crucial research domain. This paper aims to develop a comprehensive model for evaluating city tourism competitiveness, grounded in the principles of sustainable development. The model incorporates factors such as city tourism resources, environmental considerations, economic aspects, and societal factors. This holistic approach seeks to offer valuable insights for the city tourism industry. The study conducts a thorough analysis of current research both domestically and internationally, highlighting gaps and articulating the objectives and significance of the research. Employing a machine learning-based empowerment method, the paper determines the significance of evaluation indices and utilizes the Topsis method for assessing urban tourism competitiveness. Distinguishing itself from traditional evaluation methods, this model integrates the principles of sustainable development throughout the evaluation process, with environmental, social, and economic sustainability serving as pivotal evaluation indicators. Empirical analysis involves the evaluation of tourism competitiveness for select cities, facilitating inter-city comparisons. Results from empirical studies demonstrate the model's effectiveness in evaluating urban tourism competitiveness, providing targeted developmental recommendations for urban tourism.
Topics: Humans; Sustainable Development; Cities; Tourism; Models, Theoretical
PubMed: 38932779
DOI: 10.3389/fpubh.2024.1396134 -
Frontiers in Public Health 2024Climate change affects the transmission of vector-borne diseases like dengue, posing a substantial public health threat. Bangladesh, with its favorable conditions for...
BACKGROUND
Climate change affects the transmission of vector-borne diseases like dengue, posing a substantial public health threat. Bangladesh, with its favorable conditions for Dengue transmission, has experienced periodic outbreaks. This study explores the relationship between climate change knowledge, perceptions of the Dengue-climate link, and the associated factors among Bangladeshi youth.
METHODS
In the Dhaka district of Bangladesh, a cross-sectional study was conducted between September and October 2023, involving face-to-face interviews with 1,358 participants. Convenient (non-probability) sampling was utilized for participant selection. Data collection involved the administration of a semi-structured questionnaire encompassing informed consent, socio-demographic information, and inquiries pertaining to climate change-related knowledge (13 items) and perception (11 items). Data analysis utilized STATA (Version 15.0) and SPSS (Version 26.0).
RESULTS
The mean scores for knowledge and perceptions were determined to be 7.10 ± 3.20 (out of 13) and 26.60 ± 4.12 (out of 33) respectively. Participants had a mean age of 22.02 ± 1.58 years. The study revealed that unmarried status, living in a nuclear family, being a non-smoker, good self-perception of physical health, regular sleep patterns, moderate social media usage, older age, unemployment, and daily media consumption are factors associated with higher knowledge and perception regarding the Dengue-climate change link. Moreover, a positive association was observed between knowledge of climate change and favorable attitudes toward the Dengue-climate connection.
CONCLUSION
This study underscores the importance of tailored climate change education for youth in Bangladesh and highlights key variables influencing their knowledge and perceptions. Notably, there exists a positive association between climate change knowledge and favorable attitudes toward the Dengue-climate connection. These insights underscore the importance of targeted educational campaigns and policy interventions aimed at enhancing climate consciousness among the youth population, thereby fostering proactive measures to mitigate the impact of Dengue fever in the context of climate change.
Topics: Humans; Bangladesh; Dengue; Climate Change; Male; Female; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Young Adult; Surveys and Questionnaires; Adolescent; Adult
PubMed: 38932778
DOI: 10.3389/fpubh.2024.1346692 -
Frontiers in Public Health 2024The issue of low consumption among rural households in China has a longstanding history, and the experience of infectious diseases may exacerbate the existing challenges...
OBJECTIVE
The issue of low consumption among rural households in China has a longstanding history, and the experience of infectious diseases may exacerbate the existing challenges in fostering consumption growth. However, studies that characterize the impact of infectious diseases on household consumption are limited in China. This study aims to explore rural household consumption responses to infectious diseases post-assessment, and identify the underlying mechanisms.
METHODS
A total of 1,539 rural households from China Family Panel Studies (CFPS) datasets of 2014, 2016, 2018, and 2020 were recruited as the study sample. The presence of infectious disease experience was employed as the independent variable and household consumption as the dependent variable. A panel fixed effects (FE) regression model was initially employed to identify the influence of infectious disease experiences on rural household consumption. The instrumental variable (IV) method was used to address potential endogeneity between independent and dependent variables. Robustness checks such as Propensity Score Matching (PSM) test were employed to ensure the reliability of the findings.
RESULTS
The results reveal a statistically significant negative impact of infectious disease experiences on consumption over time, becoming no more significant at around 7-9 years post-disaster. This effect leads to more pronounced consumption deprivation for households with limited health insurance coverage and heightened healthcare resource constraints. The mechanism test indicates that infectious disease experiences affect the consumption levels of rural households through channels that include income constraints, the crowding-out of healthcare expenditure, and risk perception, with the precautionary savings motive acting as a moderator. Furthermore, the diminishing effect of infectious diseases on individual consumption surpasses that of natural disasters. Temporal discrepancy is observed in the impacts of infectious and chronic disease shocks on household consumption. The accumulation of liquid assets emerges as an effective strategy for households to mitigate the impact of infectious disease shocks.
CONCLUSION
The findings underscore the importance of integrating short- and long-term policies to bolster consumption capacity, strategically allocate inter-regional medical resources, and fortify the resilience of rural households against economic risks.
Topics: Humans; China; Rural Population; Family Characteristics; Communicable Diseases; Female; Male; Adult; Middle Aged
PubMed: 38932772
DOI: 10.3389/fpubh.2024.1390432 -
Frontiers in Public Health 2024To investigate the status quo of empathic fatigue, professional identity, and sleep quality of nursing staff in nursing institutions. To analyze the correlation between...
OBJECTIVE
To investigate the status quo of empathic fatigue, professional identity, and sleep quality of nursing staff in nursing institutions. To analyze the correlation between empathic fatigue, professional identity and sleep quality of nursing staff.
METHODS
This is a cross-sectional study. The method of convenient sampling was used to select 224 nursing workers from the older adult's institutions in the Panjin area as the investigation objects. The nurses' general data questionnaire, the Chinese version of the compassion fatigue short scale, the nurses' professional identity Scale, and the Pittsburgh Sleep Quality Index were used as evaluation tools. SPSS26.0 statistical software was used to sort out and analyze the data.
RESULTS
There was a positive correlation between empathic fatigue and sleep quality; there was a negative correlation between empathy fatigue and professional identity. Occupational identity and sleep quality were negatively correlated.
CONCLUSION
There is a correlation between empathic fatigue, professional identity, and sleep quality of nursing workers. Empathy fatigue is positively correlated with sleep quality. Empathy fatigue was negatively correlated with professional identity. Occupational identity was negatively correlated with sleep quality. To provide a theoretical basis for the management of older adult's nursing staff and the formulation of corresponding management systems and policies, promote the mental health of older adult's nursing staff, improve sleep quality, and provide a theoretical basis and reference for future intervention research.
Topics: Humans; Cross-Sectional Studies; Male; Female; Adult; Surveys and Questionnaires; Sleep Quality; Middle Aged; Compassion Fatigue; China; Empathy; Nursing Staff; Nursing Staff, Hospital
PubMed: 38932768
DOI: 10.3389/fpubh.2024.1401044 -
Frontiers in Public Health 2024This article deals with combat experiences and their consequences and could be potentially disturbing.
TRIGGER WARNING
This article deals with combat experiences and their consequences and could be potentially disturbing.
INTRODUCTION
Moral injury (MI) is a severe form of combat trauma that shatters soldiers' moral bearings as the result of killing in war. Among the myriad ways that moral injury affects veterans' reintegration into civilian life, its impact on political and societal reintegration remains largely unstudied but crucial for personal, community, and national health.
METHODS
13 in-depth interviews examine combat soldiers' exposure to potentially morally injurious events (PMIEs) that include killing enemy combatants, harming civilians, and betrayal by commanders, the military system, and society. Interviewees also described their political activities (e.g., voting, fundraising, advocacy, protest) and social activism (e.g., volunteering, teaching, charitable work). Interviewees also completed the Moral Injury Symptom Scale.
RESULTS
Two distinct narratives process PMIEs. In a narrative, soldiers hold themselves or their in-group morally responsible for perpetrating, witnessing, or failing to prevent a morally transgressive act such as killing or injuring civilians or placing others at unnecessary risk. In contrast, a perspective blames an out-group for leaving soldiers with no choice but to act in ways that trigger moral distress. Associated with shame and guilt, the humanitarian perspective triggered amends-making and activism after discharge. In contrast, a national security perspective associated with anger and frustration fostered protest and intense activism.
DISCUSSION
Despite its harmful health effects, moral trauma and injury can drive intense political and social activism, depending upon the narrative veterans adopt to interpret PMIEs. Aside from moral injury's personal, familial, and social effects, moral injury drives veterans' return to the political arena of civil society. As such, veterans play a central role in politics and dramatically affect post-war policy in democratic nations following conflict.
Topics: Humans; Veterans; Male; Adult; Israel; Political Activism; Morals; Military Personnel; Female; Middle Aged; Interviews as Topic; Qualitative Research
PubMed: 38932767
DOI: 10.3389/fpubh.2024.1336406 -
Frontiers in Public Health 2024Public transportation is an important mode of transportation in developing countries like Pakistan since it is accessible and convenient. But there are also serious...
Public transportation is an important mode of transportation in developing countries like Pakistan since it is accessible and convenient. But there are also serious health hazards associated with it, especially when it comes to the transmission of infectious diseases including COVID-19, TB, and . Worldwide transportation systems are vulnerable, as the COVID-19 pandemic has shown, underscoring the necessity for study and mitigating measures. The danger of disease transmission is increased in Pakistan by crowded metropolitan areas, inadequate sanitation, and low health awareness. In addition, congested public transportation and inadequate ventilation lead to reduced air quality and elevated stress levels among commuters. Comprehensive actions are needed to address these health hazards, such as promoting physical distance, improving cleanliness, enforcing traffic safety laws, and implementing policy changes that support sustainable transportation. Community involvement and advocacy are critical in campaigning for safer and more sustainable transportation networks. Pakistan can enhance public health outcomes and reduce the health hazards linked to public transportation by giving priority to these measures.
Topics: Pakistan; Humans; COVID-19; Public Health; Transportation; SARS-CoV-2
PubMed: 38932765
DOI: 10.3389/fpubh.2024.1325193 -
Vaccines Jun 2024The reported study compared the impact of four influence strategies (agency assignment, enhanced active choice, deviance regulation marking, and temporal framing) on...
The reported study compared the impact of four influence strategies (agency assignment, enhanced active choice, deviance regulation marking, and temporal framing) on English- and Spanish-speaking parents' reported intention to vaccinate their children for HPV. An online experiment was conducted to examine the impact of the strategies. In a fractional factorial design, participating parents (N = 1663) were exposed to combinations of influence strategies in text messages presented as reminders they might receive from a healthcare provider about their child's eligibility for the vaccine series. The results indicated small but significant impacts of agency assignment, enhanced active choice, and deviance regulation marking on parents' reported vaccination intentions. The study adds to the research literature on HPV vaccination communication in two important respects. First, it demonstrated how incorporating evidence-based influence strategies into reminder messages can increase parents' vaccination intentions, an important precursor and predictor of actual vaccine uptake. Second, it sets an important precedent by examining the effects of influence strategies on vaccination intentions across different languages.
PubMed: 38932379
DOI: 10.3390/vaccines12060650