REDISSE in Benin and Lessons Learned for the Management of Public Health Emergencies after Five Years of Implementation

Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.

Association of preschool children behavior and emotional problems with the parenting behavior of both parents

BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.

Brain region-specific roles of brain-derived neurotrophic factor in social stress-induced depressive-like behavior

Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.

Health Risk Assessment of Employees Exposed to Chlorination By-products of Recreational Water in Large Amusement Parks in Shanghai

Objective Chlorination is often used to disinfect recreational water in large amusement parks;however,the health hazards of chlorination disinfection by-products(DBPs)to occupational populations are unknown.This study aimed to assess the exposure status of chlorinated DBPs in recreational water and the health risks to employees of large amusement parks.Methods Exposure parameters of employees of three large amusement parks in Shanghai were investigated using a questionnaire.Seven typical chlorinated DBPs in recreational water and spray samples were quantified by gas chromatography,and the health risks to amusement park employees exposed to chlorinated DBPs were evaluated according to the WHO's risk assessment framework.Results Trichloroacetic acid,dibromochloromethane,bromodichloromethane,and dichloroacetic acid were detected predominantly in recreational water.The carcinogenic and non-carcinogenic risks of the five DBPs did not exceed the risk thresholds.In addition,the carcinogenic and non-carcinogenic risks of mixed exposure to DBPs were within the acceptable risk limits.Conclusion Typical DBPs were widely detected in recreational water collected from three large amusement parks in Shanghai;however,the health risks of DBPs and their mixtures were within acceptable limits.

Is it possible to run after positive affective experiences instead of health benefits without tackling social inequalities?

We recently read the opinion piece titled“Why people should run after positive affective experiences instead of health benefits”,which was carried out by Maltagliati et al.^(1)and published in the Journal of Sport and Health Science.The article started an important discussion about a physical activity(PA)promotion approach that encourages the use of affective experience to PA activity.Although we agree with the authors’point of view and believe that its message can generate an important insight for PA promotion,the authors presented a scenario where behavior change seems to be exclusively dependent on the individual.Recognizing the existence of other barriers to an active lifestyle(e.g.,social inequalities)could enhance the authors’suggested approach because many people live in conditions that reduce their opportunities to engage in affective experiences related to PA;furthermore,affective experiences can vary depending on individual context.

Health system interventions for the cost containment of drugs used for cardiovascular diseases: a systematic review and exploration of how the results could be adapted to the Sri Lankan context

Objectives:Cardiovascular disease(CVD)in low and middle-income countries(LMICs),accounts for over 80%of global CVD-related deaths.The high cost of drugs is a major concern in not of managing CVD.This study aimed to conduct a comprehensive review to identify interventions for cost containment of cvD drugs and use the inter-vention scalability assessment tool(ISAT)to examine the acceptability and application of relevant interventions in the Sri Lankan context,that can also be adaptable to other LMICs.Methods:A systematic search across three databases(Medline,Web of Science and Embase)was completed to identify relevant health system interventions.The ISAT assessed the feasibility of adapting the identified interven-tions to Sri Lanka,using structured interviews with 25 Sri Lankan stakeholders representing five groups:health managers,cardiologists,pharmacists,nursing officers,and patients.Results:The search yielded nine publications.Five were conducted on a national scale,while others were con-ducted at the regional levels.Seven were published in developed countries.The identified interventions were categorised into six intervention themes:Imposing a ceiling price or reference price;introduction of the polypill;introduction of volume price contract initiatives;prescribing generic and essential drugs;one intervention pack-age including generics,essential medicine,90-day drugs,and free delivery;and a second intervention package including discounts,rebates,cost-free medicine,and bundling.Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular,while other interventions were least popular..Conclusions:The study provides a roadmap for future interventions based on successful scaling,emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy.The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka,but also adaptable to other LMICs.These outcomes can contribute to policy decisions,aimed at reducing the significant global burden of CVD.

Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Epidemiology for public health practice:The application of spatial epidemiology

Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors,morbidity and mortality with respect to their distributions associated with demographic,socioeconomic,environmental,health behavior,and genetic risk factors,and time-varying changes.In the Letter to Editor,we had a brief description of the practice for the mortality and the spacetime patterns of John Snow's map of cholera epidemic in London,United Kingdom in 1854.This map is one of the earliest public heath practices of developing and applying spatial epidemiology.In the early history,spatial epidemiology was predominantly applied in infectious disease and risk factor studies.However,since the recent decades,noncommunicable diseases have become the leading cause of death in both developing and developed countries,spatial epidemiology has been used in the study of noncommunicable disease.In the Letter,we addressed two examples that applied spatial epidemiology to cluster and identify stroke belt and diabetes belt across the states and counties in the United States.Similar to any other epidemiological study design and analysis approaches,spatial epidemiology has its limitations.We should keep in mind when applying spatial epidemiology in research and in public health practice.

Shaping global health promotion:a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences(1986-2021)

Objective This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion,effectively addressing diverse health challenges that evolved over different periods.Methods The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986-2021.We summarized the themes and key achievements,and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.Results The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale.The primary purpose and goal are to promote health from regional to global.Significantly,our findings highlight a transition in the primary actors driving health promotion.It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization,governments,and international bodies,to a more inclusive approach involving non-governmental organizations and the general public.This development implies that health promotion has evolved into a collective global endeavor,demanding the proactive involvement of various stakeholders,and forging new alliances in public health.Meanwhile,the coronavirus disease 2019(COVID-19)pandemic has further shaped the landscape of health promotion,underscoring the need for intensified focus on areas including disease prevention,health education,and the integration of digital health technologies,and emphasizing the importance of a multidimensional,responsive approach in public health initiatives.Conclusions Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally.Countries,together with public and private entities,should intensify cooperation.Multisectoral collaboration among partners such as healthcare,education,social security,and the industry is vital for health promotion and achieving global health goals.

The Risk Role of Defeat on the Mental Health of College Students:A Moderated Mediation Effect of Academic Stress and Interpersonal Relationships

Background:College students face significant academic and physiological changes,making them more susceptible to psychological issues such as depression,self-injury,and suicidal ideation.Feelings of defeat can exacerbate these risks by increasing academic stress.However,interpersonal relationships can moderate the impact of academic stress on students’mental health.Utilizing the presage–process–product model,this study aims to empirically investigate how feelings of defeat influence depression,self-injury,and suicidal ideation among college students.Additionally,it explores the mediating role of academic stress and the moderating role of various types of interpersonal relationships.Methods:A total of 1612 college students(750 females,862 males,mean age=19.64±0.62 years)were recruited through cluster sampling.Data were collected via offline questionnaires administered by a trained psychology teacher and a postgraduate student,ensuring high reliability with two examiners per class.Latent profile analysis(LPA)was used to examine the impact of defeat on mental health outcomes,while mediation analysis was conducted to assess the roles of academic stress and interpersonal relationships.Results:1.Defeat is identified as a significant risk factor for mental health issues among college students;2.Four distinct patterns of interpersonal relationships were identified:the interpersonal-relationship risk group,the father–child-relationship high-risk group,the general interpersonal-relationship group,and the superior interpersonal-relationship group;3.Academic stress partially mediates the relationship between defeat and mental health issues such as depression,self-injury,and suicidal ideation;4.Different interpersonal relationship models moderate the impact of academic stress on depression and suicidal ideation.Conclusion:Defeat is a significant risk factor for mental health problems in college students.Academic stress partially mediates the negative impact of defeat on mental health,while patterns of interpersonal relationships moderate this impact.Effective early prevention and intervention should focus on monitoring students’stress levels and fostering warm,positive parent–child relationships.

Global health education in Chinese universities and potential for collaboration with schools of nursing: A qualitative study

Background: The Chinese Consortium of Universities for Global Health (CCUGH) was established within schools of public health in 2013 with the goal of enhancing global health in China.Expanding nursing students' exposure to global health curricula is important as nurses are essential actors in the health care system.However,information related to existing global health education within CCUGH-affiliated universities and the current engagement of Chinese schools of nursing in global health remains extremely limited.Objective: To identify and describe the current definitions and conceptualizations of global health education in Chinese universities,with a focus on schools of nursing,in order to explore potential opportunities for strengthened collaboration between global health initiative and schools of nursing in China.Methods: Purposive sampling with snowballing was used to recruit 19 key informants who were critical stakeholders in global health and nursing in China.Key informant interviews were conducted from July 2014 to February 2015,and data were updated in June 2016.Content analysis was used to analyze data via Atlas.ti 7.Results: There was a rapid growth in global health education within and beyond CCUGH-affiliated universities with nine universities establishing global health institutes.Translation and definition of global health lacked consistency in Chinese language.Though no course directly related to global health was offered,schools of nursing were gradually participating in global health education and research.Nursing was a critical component of global health,and global health and nursing mutually advanced each other.Nursing education should include global health contents,but at present independent global health curriculum in schools of nursing was not appropriate.Conclusion: Increasingly Chinese universities are promoting global health education through the platform of CCUGH.It is an ideal moment to promote and expand work across the fields of global health and nursing,specifically to highlight opportunities for collaboration across education,research and practice.

J-shaped association between dietary thiamine intake and the risk of cognitive decline in cognitively healthy,older Chinese individuals

Background The prospective association of dietary thiamine intake with the risk of cognitive decline among the general older adults remains uncertain.Aims To investigate the association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals.Methods The study included a total of 3106 participants capable of completing repeated cognitive function tests.Dietary nutrient intake information was collected through 3-day dietary recalls and using a 3-day food-weighed method to assess cooking oil and condiment consumption.Cognitive decline was defined as the 5-year decline rate in global or composite cognitive scores based on a subset of items from the Telephone Interview for Cognitive Status-modified.Results The median follow-up duration was 5.9 years.There was a J-shaped relationship between dietary thiamine intake and the 5-year decline rate in global and composite cognitive scores,with an inflection point of 0.68 mg/day(95%confidence interval(Cl):0.56 to 0.80)and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.Before the inflection point,thiamine intake was not significantly associated with cognitive decline.Beyond the inflection point,each unit increase in thiamine intake(mg/day)was associated with a significant decrease of 4.24(95%Cl:2.22 to 6.27)points in the global score and 0.49(95%Cl:0.23 to 0.76)standard units in the composite score within 5 years.A stronger positive association between thiamine intake and cognitive decline was observed in those with hypertension,obesity and those who were non-smokers(all p<0.05).Conclusions This study revealed a J-shaped association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals,with an inflection point at 0.68 mg/day and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.

Kafubu River Fish, Real Poisons for the Consumer Population in the South East of the Democratic Republic of Congo

In the Democratic Republic of Congo,the Kafubu River has received,for several decades,mining waste from GECAMINE Kipushi and Lubumbashi as well as those from the CHEMAF plant.Given this situation,we wanted to verify the degree of contamination of fish in the Kafubu River with TME(Trace Metal Elements).In doing so,fish samples from this river,downstream of mining activities,as well as samples of reference fish from upstream of any mining activity from the sources of the Panda and Kasungwe rivers and that of the Congo River were analyzed with Inductively Couple Plasma Mass Spectrometry(ICP-MS)and Inductively Couple Plasma Optical Emission Spectroscopy(ICP-OES).Statistical analysis,using the Wilcoxon test,of the results obtained as well as the comparison of these with the thresholds of the WHO(World Health Organization),FAO(Food and Agriculture Organization)and the EU(European Union)revealed that the fish of the Kafubu River are contaminated with As,Cd,Co,Cu,Mn,Ni,Pb,Se and Zn.Thus,it was concluded that the fish of the Kafubu River were not fit for human consumption.In addition,because of the very high level of bioaccumulation of these TMEs in the fish of the Kafubu River,the latter have been described as poisonous for the consuming population.The main principle that emerges from this study is that fish from an ecosystem polluted by mining waste are not fit for human consumption.The results of this study will be brought to the attention of Decision-makers in the Haut-Katanga Province so that rigorous measures can be taken to prohibit metallurgical plants from dumping their mining waste into aquatic ecosystems.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers:a systematic review and meta-analysis

Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthcare workers’psychological well-being.Methods A systematic literature search was conducted on Medline,Embase,Cumulative Index for Nursing and Allied Health Literature,PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords‘healthcare worker’,‘doctor’,‘nurse’,‘allied health’,‘mindfulness’,‘wellness’,‘workshop’and‘program’.Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion.R V.4.0.3 was used for data analysis,with the standardised mean difference as the primary outcome,employing DerSimonian and Laird’s random effects model.Grading of Recommendations,Assessment,Development and Evaluation framework was used to evaluate the quality of evidence.Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias in the included studies.Results A total of 27 studies with 2506 participants were included,mostly from the USA,involving various healthcare professions.MBIs such as stress reduction programmes,apps,meditation and training showed small to large effects on anxiety,burnout,stress,depression,psychological distress and job strain outcomes of the participants.Positive effects were also seen in self-compassion,empathy,mindfulness and well-being.However,long-term outcomes(1 month or longer postintervention)varied,and the effects were not consistently sustained.Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers.The review also highlights limitations such as intervention heterogeneity,reduced power in specific subgroup analyses and variable study quality.

Factors Associated with HIV/Tuberculosis Coinfection among People Living with HIV after Initiation of Antiretroviral Treatment in Lingwala Health Zone from 2021 to 2023

Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV. The DRC is one of the 30 countries in the world bearing the brunt of co-infection. Despite the efforts made by countries to improve access to antiretroviral traitement (ART), TB remains a major problem among people living with HIV. The Lingwala Health Zone in the provincial city of Kinshasa recorded a large number of cases of HIV/TB co-infection during the study period. The aim of this study was to determine the factors associated with HIV/TB co-infection among PLHIV on ART in the Lingwala health zone (HZ) in Kinshasa. Methods: This was a case-control study conducted in the state-run HIV care facilities in the Lingwala health district among PLHIV who had visited the health facilities during the period 2021-2023. Cases were coinfected patients and controls were PLHIV who had not developed tuberculosis during the study period. Results: A total of 281 PLHIV were enrolled in the study, with 70 cases and 211 controls. Factors associated with HIV/TB co-infection after multivariate analysis were viral load (OR = 5.34;95% CI;1.8-15.8, p = 0.005). History of tuberculosis (OR = 20.84;95% CI;8.6-50.3, p -85.0, p = 0.005) and BMI Conclusion: The results of this study indicate that the detection of these enumerated factors should prompt providers to actively search for tuberculosis with a view to organising early management.

Demographic and socioeconomic determinants of urinary arsenic concentration for elementary school children in Bangladesh

Background:Arsenic(As)is a toxic element that can lead to various health issues in humans.The primary exposure to As is through the consumption of water contaminated with high As levels,particularly in Bangladesh.Previous studies have shown that urinary arsenic(UAs)concentration can reflect As exposure and metabolism in individuals.However,little is known about how other factors,such as age,sex,and socioeconomic status,may affect UAs concentrations in children.Objective:This study aimed to investigate the influence of factors such as age,sex,and socioeconomic status on UAs concentrations in children,in addition to the impact of drinking water arsenic(WAs)levels.Methods:We conducted our study on elementary school-going children aged 8-11 years from rural Araihazar in Bangladesh.We measured UAs(available for a subset of 391 children)and WAs levels and collected information on demographic and socioeconomic characteristics.We employed regression analysis and t-tests to analyze the data.Results:Our findings revealed that younger children(β=197.95,95%confidence interval[CI]:111.97 to 283.94),female children(β=93.95,95%CI:8.49 to 179.40),and children with less educated fathers(β=138.03,95%CI:26.47 to 249.58)had higher UAs levels,particularly when they consumed water with high As content.Conclusion:The study concludes that children's As exposure and UAs concentration may vary depending on their age,sex,and socioeconomic status.Therefore,these factors should be considered when assessing the health risks associated with As.

Survey on Attitude of Middle School Educators for Sex and Reproductive Health Education

Objective To get a general picture of the attitudes of middle school educators on sex and reproductive health education. Methods A cross-sectional survey was carried out among 144 middle school educators in three districts of Shanghai from September to October 2005 using anonymous self-administered questionnaire. Results The majority of the educators thought that it was necessary to launch the sex and reproductive health education in all of the middle schools in Shanghai （97. 02%）. They were aware that the age of the students＇puberty were earlier now than before （94.41%）, but the reproductive health knowledge of students was neither sufficient nor correct （78.34%）. The sex and reproductive health education had been involved in the curriculum of many middle schools （66.11%）. Lacking of qualified education staffs contributed most （90. 71%） in the schools which had not launched the sex and reproductive health education. Lacking of qualified education staffs （90.91%） challenged most in the schools which had carried the education. Conclusion The middle school educators thought it was necessary to carry the sex and reproductive health education in all of the middle schools in Shanghai while the major challenges were lacking of qualified education staffs and sufficient teaching time.

Social Determinants of Health Behaviors in Primary School Children：A Cross-sectional Study of both Migrant and Resident Children in Beijing,China

Childhood risky behaviors always result in adverse health outcomes. These behaviors are greatly affected by social environment and individual factors. However, few studies explored the social determinants of schoolchildren＇s health behaviors. In this cross-sectional study, the social determinants of health behaviors were examined among both migrant and resident students in Beijing, China. Data of 967 children from six urban and suburban primary schools were analyzed using multiple linear regression analysis. The results showed that less than 60% of children performed some healthy behaviors, although their health knowledge was generally good. Children＇s health behavior scores were greatly determined by school characteristics, health knowledge, demographic characteristics, and family context. Therefore, improving health education and conditions in primary schools is the priority to promote children＇s healthy behaviors, especially for disadvantaged children.

Injury-Related Profiles among School-Aged Children in Cameroon: Analysis Based on the “First Survey—Health Young People”

Aims: Establish profiles of young “at risk” of injuries, first, on an overall point of view and, secondly, for some types of injuries (sport, home, road traffic, school and work injuries). Methods: We have taken nearly 50 variables into consideration: 17 variables for construction of the socioeconomic status, 9 variables for the investigation of symptoms, 11 concerning drugs, 5 for healthy habits, 3 for investigating the violence behavior, 4 concerning the school, 3 for subjective health and finally 3 for social network. We have used the principal component analysis, the multiple correspondence analysis and the weighted-frequency score for reducing the number of them. After these reductions, 15 variables were available for analyses. The relationship between injuries and investigated factors was assessed using the Pearson’s chi-square test. We also calculated odds ratio (OR) with their 95% confidence intervals (95%CI) to estimate the strengths of the associations. To further assess these relationships but also for taking into account the potentials confounding effects of some variables, logistic regression model and multinomial logistic regression model were applied. Results: The whole injury prevalence was equal to 45.6% and among the injured, the proportion of the several types was equal to 33.8% for sport injuries, 32.2% for home injuries, 16.6% for traffic injuries, 11.6% for school injuries and 5.7% for work injuries. We can say that, in light of the variables studied, the “at risk” profile for having reported an injury is being a boy, being younger, having drug experiences, with the violent profile, and declaring several symptoms. There are no consistent and marked deviations in this study from the findings obtained in previous studies. Conclusion: Analyzing injuries in general is interesting but for preventing them it is important to know in which activities children and students are engaged when they are injured.

Latent Categories of Mental Health Literacy in Patients with Coronary Artery Disease and Their Relationship with Quality of Life

Objectives: This study aims to explore the latent categories of mental health literacy among patients with coronary artery disease and examine their associations with quality of life. Design: A cross-sectional quantitative design was used. Methods: The study sample consisted of 208 patients with coronary artery disease from five wards in the Department of Cardiology at a tertiary hospital. Data were collected using a general information questionnaire, the Chinese version of the Multiple Mental Health Literacy Scale and the Chinese Cardiovascular Patient Quality of Life Assessment Questionnaire. The data were analysed with Mplus (v.8.3) and SPSS (v.25.0). Results: The mental health literacy of the 208 patients was categorised into four latent categories: low literacy (n = 28, 13.5%), high knowledge-low resources (n = 53, 25.5%), low knowledge-high resources (n = 63, 30.2%) and high literacy (n = 64, 30.8%). A significant difference in quality of life was observed according to mental health literacy category (P Conclusion: The quality of life of patients with coronary artery disease is significantly influenced by their levels of mental health literacy. Targeted interventions addressing the various profiles of mental health literacy should be implemented to improve the quality of life for patients with coronary artery disease.