OBJECTIVE

Dengue remains a critical public health concern in the Philippines. Late consultation and delayed presentation of dengue patients to hospitals constantly challenge doctors. This study aimed to identify factors contributing to late consultation of dengue patients.

This analytic, cross-sectional study examined patient, parental, socioeconomic, cultural, and health system factors influencing delayed consultation among parents of patients 0 – 18 years at Batangas Medical Center and Lipa Medix Medical Center. A total of 668 parents were enrolled. Descriptive statistics and frequency tables summarized the key characteristics. Test of proportions assessed differences between groups. Univariate logistic regression screened possible predictors, followed by multiple logistic regression to identify significant factors.

Univariate analysis identified significant predictors of late consultation, including older patient age(p=0.002), residence >50 km from the hospital (p 50 km from the hospital were 2.7 times more likely to consult late (p=0.01).

Delayed consultation was influenced by the patient age, hospital type, geographic distance from the hospital, maternal marital status, and cultural beliefs in home remedies and faith healing. Strategies to improve early consultation should consider these factors.

INTRODUCTION: Social lockdowns and quarantines have been enforced in various populations to mitigate the spread of coronavirus disease 2019 (COVID-19) in the community. This study investigated the impact of COVID-19 lockdown, known as circuit breaker movement restrictions (CBMR), on physical activity (PA) and sedentary time (ST) distribution patterns among Singapore residents aged 21-65 years. METHODS: This was a cross-sectional retrospective study that utilised a 44-item questionnaire that included sections to determine PA and ST distribution patterns before and during CBMR. It also included information on sleep duration, PA preference and routine, awareness of local initiatives and perceptions on barriers towards PA during the CBMR period. RESULTS: There was an overall decrease in PA and a significant increase in physical inactivity and ST during the CBMR period. A greater proportion of participants reported sleeping for longer hours, suggesting positive adaptations in sleep habits during CBMR. Majority were unaware of online exercise initiatives and programmes offered during the CBMR period, and >50% of the respondents never used an online resource for exercise. Singapore residents seemed to prefer outdoor and facility-based venues for exercise and PA, and closure of facilities was the primary barrier for PA during the CBMR period. CONCLUSION Reduced PA and increased ST during CBMR reflect negative lifestyle adaptations and may have adverse public health implications. Increased sleep duration suggests successful coping, which may consequently lead to physical and mental health benefits. While Singapore adult residents may be flexible with certain aspects of being physically active, they seemed less adaptive to changes in type of exercise, facility and environment.
Humans ; COVID-19/epidemiology* ; Singapore/epidemiology* ; Exercise ; Adult ; Sedentary Behavior ; Cross-Sectional Studies ; Middle Aged ; Male ; Female ; Retrospective Studies ; Public Health ; Aged ; Surveys and Questionnaires ; SARS-CoV-2 ; Young Adult ; Quarantine ; Sleep

INTRODUCTION: The rising rate of adolescent suicide, and the burden of self-harm and mental health disorders, pose significant threats to Singapore's future health outcomes and human potential. This study sought to examine the risk profile and healthcare utilisation patterns of Singaporean adolescents who presented to the emergency department (ED) for suicidal or self-harm behaviour. METHOD: A retrospective review of medical records for patients aged 10 to 19 years who visited Singapore's KK Women's and Children's Hospital ED for suicidal or self-harm attempts from January to December 2021 was conducted. RESULTS: A total of 221 patients were identified, with a predominance of female patients (85.5%) over males (14.5%). The mean age was 14.2 ± 1.4 years. Intentional drug overdose (52.0%) was the most commonly used method. Significantly more females presented for intentional paracetamol overdose (46.6% versus [vs] 28.1%, P=0.049), whereas jumping from a height was more common among males (18.8% vs 5.8%, P=0.022). The most frequently observed mental health challenges were stress-related and emotional coping difficulties (50.7%), followed by mood and anxiety symptoms (53.4%). A history of self-harm and suicidal behaviours were the most common psychosocial risk factors. Within the year prior to their ED presentation, 15.4% had accessed healthcare services for mild medical ailments, 19.5% for medically unexplained symptoms, and 17.2% for previous self-harm or suicide attempts. CONCLUSION Most cases involved psychosocial and emotional regulation difficulties, some of which displayed sex-specific patterns, rather than complex psychiatric disorders. The identified predictive factors can help inform Singapore's National Mental Health and Well-being Strategy, to guide targeted and transdiagnostic interventions in schools and community settings.
Humans ; Adolescent ; Singapore/epidemiology* ; Female ; Male ; Suicide, Attempted/psychology* ; Emergency Service, Hospital/statistics & numerical data* ; Self-Injurious Behavior/psychology* ; Retrospective Studies ; Child ; Young Adult ; Drug Overdose/epidemiology* ; Risk Factors ; Acetaminophen/poisoning* ; Patient Acceptance of Health Care/statistics & numerical data* ; Sex Factors

PURPOSE: This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury (SCI). METHODS: This study was based on the methodological framework of scoping reviews, including 3 methodological steps: (1) identifying relevant studies (searching for related studies); (2) selecting related studies; (3) collecting key findings, summarizing, and reporting the results. The electronic databases were searched including Medline (PubMed), Scopus, Web of Science, Embase, and Cochrane Library. Studies were included if they reported data about the related factors of sexual and partnership adjustment in individuals with SCI. No limitations were considered in terms of time or methodology of the search. RESULTS: After the full-text screening, 52 studies were included from the year of 1978 - 2019 with various methodologies. The present review demonstrated that proper sexual health among individuals with SCI is related to several factors including the anatomical factor, level of the injury, completeness of the injury, psycho-social factor, socio-economic status, and type of relationship. CONCLUSION With consideration of factors affecting sexual and partnership adjustment in individuals with SCI, a better estimation of sexual health can be achieved in clinical to improve the relationship and quality of life.
Female ; Humans ; Male ; Quality of Life ; Sexual Behavior ; Sexual Health ; Spinal Cord Injuries/psychology*

BACKGROUND: High temperatures are known to be associated with an increased risk of self-harm, but the influence of demographic changes and country-level indicators on the burden of heat-related self-harm remains unclear. This study examined the key factors driving changes in self-harm mortality linked to high temperatures and explored their impact at the country level. METHODS: This is an ecological study that analyzes data from the 2021 Global Burden of Disease (GBD) study, the World Bank, and the Climate Research Unit (CRU) were analyzed. Decomposition analyses were used to identify key factors driving changes in high temperature-related self-harm mortality between 1990 and 2021. A panel data model assessed the impact of national indicators on heat-related self-harm mortality. RESULTS: In 2021, 14,885 deaths globally were attributed to heat-related self-harm, a 41.94% increase from 1990, with low-middle SDI regions accounting for 47.84% of these deaths. While the global death rate from heat-related self-harm declined slightly over this period, South Asia and low-middle SDI regions contributed most to the decline. However, population aging exacerbated mortality rates. Demographic and meteorological factors were also linked to heat-related self-harm. CONCLUSION The global decline in heat-related self-harm mortality is largely driven by reductions in females, low-middle SDI regions, and South Asia. However, population aging and growth in these regions have added to the mortality burden, slowing the overall decline. Factors such as population density are also associated with heat-related self-harm. Targeted measures are needed to mitigate heat-induced self-harm more effectively in future.
Humans ; Self-Injurious Behavior/etiology* ; Hot Temperature/adverse effects* ; Global Health/statistics & numerical data* ; Female ; Male ; Adult ; Middle Aged ; Aged ; Young Adult ; Adolescent

BACKGROUND: Changes in socioeconomic inequalities in health behaviours following the COVID-19 pandemic remain unknown, particularly among Japanese school-aged adolescents. Therefore, in this study, we examined changes in socioeconomic inequalities in school-aged adolescents' health behaviours, including physical activity (PA), screen time (ST), sleep duration, breakfast consumption, and bowel movement frequency, before and after the pandemic. METHODS: This three-wave repeated cross-sectional study utilised data from the 2019, 2021, and 2023 National Sports-Life Survey of Children and Young People in Japan, analysing data from 766, 725, and 604 participants aged 12-18 years, respectively. Favourable health behaviours were defined as moderate-to-vigorous PA of ≥60 min/day, ST <2 h/day, sleep duration of 8-10 h, daily breakfast consumption, and bowel movements at least every 3 days. Absolute and relative socioeconomic inequalities were quantified using the slope index of inequality (SII) and the relative index of inequality (RII). Temporal changes were analysed using quadratic trend analyses, employing interaction terms between socioeconomic status and survey year. RESULTS: Significant quadratic trends indicated that socioeconomic inequalities in breakfast consumption decreased substantially from 2019 (SII: 20.7%, RII: 5.09) to 2021 (SII: -0.1%, RII: 0.95) but resurged in 2023 (SII: 16.2%, RII: 3.70). This resurgence may have been primarily driven by changes among those in the moderately low-income (poverty level II) and higher-income groups, which had a breakfast consumption rate of 81.0, 87.0, and 76.4% in 2019, 2021, and 2023, and 88.7, 82.1, and 87.5%, respectively. Among low-income households, adherence to PA recommendations significantly declined from 18.6% to 5.3%, and ST adherence worsened over the study period. No significant inequalities or trends were observed for sleep duration or bowel movement frequency across survey years. CONCLUSIONS Socioeconomic disparities in breakfast consumption among Japanese school-aged adolescents resurfaced after initially narrowing during the pandemic, likely driven by changes in moderately low-income and higher-income groups. Among low-income households, adherence to PA and ST guidelines declined over time. However, at the population level, socioeconomic inequalities in PA did not exhibit a consistent trend of widening or narrowing. This study highlights the need for sustained public health initiatives to address these socioeconomic disparities.
Adolescent ; Child ; Female ; Humans ; Male ; Breakfast ; COVID-19/psychology* ; Cross-Sectional Studies ; Exercise ; Health Behavior ; Japan/epidemiology* ; Screen Time ; Sleep ; Socioeconomic Factors ; East Asian People

BACKGROUND: Self-care is increasingly recognized as the foundation of person-centered healthcare and a key driver for simultaneously improving population health outcomes and reducing healthcare expenditures. While the Self-Care Inventory (SCI) has been validated in several languages, Japan lacks a standardized instrument for assessing self-care in the general adult population. Moreover, it remains unclear whether the SCI reflects culturally specific self-care behaviors and retains its psychological measurement properties in non-Western contexts. Addressing both aspects, this study aimed to evaluate the Japanese version of the SCI (JSCI) in terms of its psychometric properties and its association with concrete health behaviors. METHODS: We adapted the JSCI following COSMIN guidelines using forward/backward translation, expert review, and cognitive debriefing. Psychometric evaluation was based on two samples: a nationwide web-based survey (n = 504) and a community-based paper survey (n = 75). Structural validity was examined via CFA; internal consistency via Cronbach's alpha and McDonald's omega; and test-retest reliability via ICCs. Convergent and criterion validity were assessed through correlations with relevant psychological constructs. Measurement invariance and DIF across modes were tested, and associations with five external self-care behaviors were evaluated using AUC. RESULTS: The hypothesized three-factor structure of the JSCI was supported across both administration modes (CFI = 0.926-0.942; SRMR < 0.06), although some subscales had elevated RMSEA. Internal consistency was acceptable to high (α = 0.75-0.85; ω = 0.81-0.92). ICCs indicated moderate to good temporal stability. JSCI scores correlated with self-care efficacy and other related constructs, supporting convergent and criterion validity. Configural invariance was confirmed, and no significant DIF was detected across modes. JSCI scores modestly discriminated individuals engaging in concrete self-care behaviors such as physical activity, strength training, Helicobacter pylori testing, and having a regular primary or dental care provider (AUCs = 0.62-0.80). CONCLUSIONS The JSCI demonstrated satisfactory psychometric properties and structural validity across diverse research settings. Its observed associations with a range of meaningful self-care behaviors support the scale's ecological and practical relevance in the Japanese context. The JSCI may serve as a reliable tool for evaluating and promoting self-care in both research and population health initiatives.
Humans ; Japan ; Self Care/statistics & numerical data* ; Psychometrics ; Male ; Female ; Adult ; Cross-Sectional Studies ; Middle Aged ; Reproducibility of Results ; Surveys and Questionnaires ; Young Adult ; Aged ; Health Behavior ; Translations ; East Asian People

OBJECTIVES: The 24-hour movement behaviors, comprising physical activity, sedentary behavior, and sleep, are crucial factors affecting children's mental health. This study aims to explore the longitudinal association between 24-hour movement behaviors and psychological well-being in overweight and obese children, providing empirical evidence for mental health promotion in this population. METHODS: A total of 445 overweight and obese children were recruited via stratified cluster random sampling from a provincial capital city in China and followed up for one year. Measures included objectively assessed physical activity and sleep duration using triaxial accelerometers (ActiGraph GT3X+), parent-reported sedentary screen-based time (SST), and self-reported psychological well-being. RESULTS: After one year, the proportion of children meeting all 3 movement guidelines increased from 10.11% to 11.68%, while those meeting none increased from 11.24% to 15.06%. After adjusting for relevant covariates, children who met individual guidelines for moderate-to-vigorous physical activity (MVPA) (β=0.377, 95% CI 0.209 to 0.545), sleep (β=0.187, 95% CI 0.042 to 0.332), or guideline combinations of MVPA+SST (β=0.545, 95% CI 0.377 to 0.713) and MVPA+sleep (β=0.602, 95% CI 0.449 to 0.755) showed significant improvements in psychological well-being after one year. Additionally, an increase in the number of guidelines met was significantly associated with improved well-being (β=0.113, 95% CI 0.011 to 0.214). CONCLUSIONS Adherence to any single movement guideline, especially MVPA or sleep, and combinations such as MVPA+SST or MVPA+sleep is significantly associated with enhanced psychological well-being in overweight and obese children. Integrated behaviors may be an effective strategy to improve mental well-being in this population.
Humans ; Child ; Exercise/psychology* ; Sleep ; Sedentary Behavior ; Female ; Male ; Pediatric Obesity/psychology* ; Overweight/psychology* ; Mental Health ; China ; Accelerometry ; Psychological Well-Being

The cardiovascular health index (CVH) is a composite index consisting of 7 CVH metrics (CVHM) to evaluate the cardiovascular health status in the population. CVH has been proven to be closely related to a variety of health outcomes and widely used in the prevention of many diseases and the evaluation of intervention effectiveness. This review summarizes the recent distribution of CVH and CVHM in pregnant women and the relationship between CVH and CVHM with adverse health outcomes, which aims to explore the application of CVH and CVHM in preventing pregnancy-related diseases and improving the long-term health level of perinatal women and their offspring.
Pregnancy ; Humans ; Female ; Risk Factors ; Cardiovascular Diseases/prevention & control* ; Health Behavior ; Health Status

Objective: based on summarizing the simulation and prediction of tobacco control measures across the globe and sorting out the various scenarios of tobacco control measures, the potential short-term effects of seven tobacco control measures in different scenarios were systematically analyzed. Methods: Until April 2022, PubMed, Embase, EconLit, PsychINFO, and CINAHL databases were used to retrieve literature about tobacco control measures simulation and prediction models across the globe. Inclusion and exclusion criteria were strictly followed. Meta-analysis for the potential short-term effects of seven tobacco control measures in different scenarios was performed using the R software. Results: A total of 22 papers covering 16 countries were selected. Five studies were conducted in the United States, three in Mexico, and two in Italy. There were all papers with the measures to tax increases, smoke-free air laws, and mass media campaigns, 21 papers with youth access restrictions, 20 with marketing restrictions, and 19 with cessation treatment programs and health warnings. The tax increases had diverse influences on the price elasticity of different age groups. The price elasticity in the age group 15-17 years was the highest, which was 0.044 (95%CI: 0.038-0.051). The potential short-term effects of smoke-free air laws in workplaces were higher than in restaurants and other indoor public places. The effects of youth access restrictions were greater in the age group <16 years than in the age group 16-17. The stronger the implementation of other measures, the greater the potential short-term effects. A comparison of seven tobacco control measures showed that the cessation treatment programs increase in cessation rate was the highest, 0.404 (95%CI: 0.357-0.456). The reduction in smoking rate and reduction in initiation rate of youth access restrictions strongly enforced and publicized was the highest in the age group <16 years, 0.292 (95%CI: 0.269-0.315), and 0.292 (95%CI: 0.270-0.316). Conclusions: The potential short-term effects of seven tobacco control measures in different scenarios were evaluated more accurately and objectively through Meta-analysis. In the short term, cessation treatment programs will substantially increase smoking cessation rates, and strong youth access enforcement will sharply reduce smoking and initiation rates among adolescents under 16. These results also offer strong data-related support for the simulation and prediction of tobacco control measures in China and other countries.
Adolescent ; Humans ; United States ; Tobacco Control ; Prevalence ; Computer Simulation ; Smoking Cessation ; Health Behavior ; Smoking Prevention