Public Health [JOURNAL]
Sun
200 papers
The association between parents' marital status, problematic internet use, and negative emotions among Chinese adolescents: a cross-lagged panel network analysis.
Fang T, Song J, Hu Z … +4 more , Jiang L, Zhuo F, Yang Y, Kong L
BMC Public Health · 2026 Jun · PMID 42380831 · Full text
BACKGROUND: Prior studies have established a link between problematic internet use (PIU) and negative emotional states, highlighting how familial factors are associated with this relationship. However, most existing stud...
BACKGROUND: Prior studies have established a link between problematic internet use (PIU) and negative emotional states, highlighting how familial factors are associated with this relationship. However, most existing studies have employed cross-sectional designs, with few utilizing cross-lagged panel network analysis to explore the dynamic symptom-level relationships among parental marital status, PIU, and negative emotions. This study aimed to investigate the dynamic network interactions among them in Chinese adolescents. METHODS: The sample comprised 10,394 adolescents who completed the Internet Addiction Test (IAT), the Children's Depression Inventory (CDI), and the Multidimensional Anxiety Scale for Children (MASC) twice over a six-month period. A total of four symptom networks and two cross-lagged panel networks were developed. RESULTS: The findings revealed that adolescents from divorced families exhibited significantly higher rates of PIU (PIU: T1 = 21.6%, T2 = 25.6%), depressive symptoms, and anxiety symptoms compared to their peers from non-divorced families (PIU: T1 = 15.3%, T2 = 16.5%). "Social anxiety" emerged as the key node of the networks across time. "Negative self-esteem" emerged as the most influential node in both the married and divorced family groups (married: OEI = 0.896; divorced: OEI = 0.888). It also functioned as a bridge symptom in the divorced group, whereas "anhedonia" served as the bridge symptom in the married group. CONCLUSIONS: This study underscores that PIU and negative emotions differ across parental marital status groups. Key and bridge symptoms may serve as priority targets for preventing and addressing PIU and negative emotions among Chinese adolescents.
Early exposure to aggressive and prosocial television content and children's social and behavioral development from ages 2 to 8.
Swit CS, Gath M, Gawn J … +3 more , Smith J, McLean MA, Wang Y
BMC Public Health · 2026 Jun · PMID 42380830 · Full text
BACKGROUND: Early childhood is a sensitive developmental period during which television exposure is widespread which may include portrayals of aggressive and prosocial behavior. Although prior research suggests modest as...
BACKGROUND: Early childhood is a sensitive developmental period during which television exposure is widespread which may include portrayals of aggressive and prosocial behavior. Although prior research suggests modest associations between media content and child behavior, most studies focus on screen time rather than content quality and typically examine aggressive and prosocial content in isolation. From a public health perspective, there is limited longitudinal evidence on how early exposure to aggressive and prosocial television content, and their co-occurrence, relates to children's social and behavioral development over time. METHODS: Data were drawn from the Growing Up in New Zealand longitudinal cohort. Children's exposure to aggressive and prosocial television content at age 2 was assessed using fine-grained content coding of children's most frequently watched television programmes. Children's conduct problems, peer relationship problems, and prosocial behavior were assessed at ages 2, 4.5, and 8 using the Strengths and Difficulties Questionnaire (N = 5,338). A series of latent growth curve models were estimated to examine associations between aggressive content exposure, prosocial content exposure, their interaction, and overall television viewing time, with children's initial levels and developmental trajectories of social and behavioral outcomes. RESULTS: Children's television exposure frequently included both aggressive and prosocial behaviors, highlighting the heterogeneity of content viewed by young children. Higher exposure to aggressive television content was associated with higher levels of conduct and peer relationship problems at age 2, though these associations were attenuated after accounting for overall television viewing time, which predicted a steeper decline in conduct problems across childhood. Exposure to prosocial television content, the co-occurrence of aggressive and prosocial content, and all interaction terms with overall television viewing time were not associated with any outcome at age 2 or over time. CONCLUSIONS: Overall, the findings suggest that early television content exposure is associated with behavioral differences early in development, though associations with developmental change across childhood did not contribute beyond the contribution of total television viewing time. From a public health perspective, these findings highlight the importance of considering television content quality alongside viewing quantity, recognizing that both are embedded within broader family and developmental contexts that warrant further investigation.
Pharmaceuticals and Personal Care Products (PPCPs) disposal practices in Tokha, Nepal: a health belief model study.
Bhandari G, Magar UG
BMC Public Health · 2026 Jun · PMID 42380815 · Full text
BACKGROUND: Unused and expired Pharmaceuticals and Personal Care Products (PPCPs) are emerging environmental contaminants that may pose serious risks to human health and the environment. In Nepal, household and pharmacy...
BACKGROUND: Unused and expired Pharmaceuticals and Personal Care Products (PPCPs) are emerging environmental contaminants that may pose serious risks to human health and the environment. In Nepal, household and pharmacy level waste disposal behaviors remain poorly documented. METHODS: A cross-sectional survey was conducted in Tokha municipality among 298 households and 53 pharmacy retailers. Structured questionnaires included data on: (i) demographic features, (ii) usage and storage patterns of PPCPs, and (iii) their disposal practices. This study was based on the Health Belief Model (HBM) constructs. Data were analyzed using descriptive statistics, chi-square tests, Spearman's correlation analysis, and partial least squares structural equation modeling (PLS-SEM). RESULTS: Unsafe storage and improper disposal practices being common among households and pharmacy retailers. About 41.6% of the households stored unused or expired pharmaceuticals, primarily analgesics and skincare products that accounted 63.1% and 77.5%, respectively. Expired PPCPs were mostly disposed of in household garbage containers (88.9%) or burned (12.8%), while only 4.7% were returned to pharmacies. Of the HBM constructs, self-efficacy was the strongest predictor of response to cues for safe disposal behaviors (β = 0.184). Of all pharmacy retailers, only 17% were aware of disposal regulations and facilities. Major challenges included the lack of take-back systems (37.8%) and limited disposal facilities (24.5%). The study highlighted significant challenges in the management of unused and expired PPCPs among households and pharmacy retailers in Tokha municipality. CONCLUSIONS: Households and pharmacy retailers reported unsatisfactory waste disposal practices. Community-based awareness drives and pharmaceutical waste management modules boost self-efficacy by giving people the knowledge and confidence to safely handle and manage unused and expired PPCPs. In a case there are accessible municipal collection systems, pharmacy- or municipal-level take-back points, and clear regulatory mechanisms in the country, it becomes easier for individuals to accelerate that confidence into safety practices to reduce environmental deterioration and protect public health in Nepal.
Beyond knowledge deficits: social visibility, family dynamics, and delayed initiation among people living with HIV in Southwestern China-a descriptive phenomenological study.
Zhou Y, He Q, He X … +4 more , Li M, Yang H, Suen LKP, Chen L
BMC Public Health · 2026 Jun · PMID 42380811 · Full text
BACKGROUND: Despite global recommendations for early antiretroviral therapy (ART) initiation and the well-established benefits of timely treatment, delayed ART initiation remains a concern in some settings. Previous stud...
BACKGROUND: Despite global recommendations for early antiretroviral therapy (ART) initiation and the well-established benefits of timely treatment, delayed ART initiation remains a concern in some settings. Previous studies have identified multiple barriers to ART initiation, including limited treatment knowledge, stigma, disclosure concerns, side-effect fears, and service-related barriers. Less is known, however, about how these factors become organized in everyday life into a sustained process of delay after diagnosis. This study explored how people living with HIV in southwestern China experienced delayed ART initiation, with attention to social visibility, family relationships, informal information, and changing perceptions of treatment urgency. METHODS: A descriptive phenomenological design was used. Semi-structured, in-depth interviews were conducted with 23 people living with HIV who had delayed ART initiation and were recruited from two HIV-designated hospitals in Yunnan Province, China. Interviews were audio-recorded, transcribed, and analyzed using Colaizzi's seven-step method. The analysis was primarily inductive, while an HIV-related stigma framework informed the research question, interview domains, and later interpretation. RESULTS: Four themes were identified. First, delayed ART initiation often began when treatment entry was experienced as a risk of being recognized, leading to concealment, stigma-related shame, and avoidance. Second, delay was sustained through family negotiation, informal information, symptom-free periods, concerns about side effects, and the normalization of waiting. Third, treatment initiation became more likely when family or significant-other support, continued healthcare-provider contact, symptoms, or complications changed participants' perceptions of risk. Fourth, cross-theme patterns showed that delayed ART initiation was experienced as unfolding from concealment and waiting toward treatment entry when support, symptoms, or changing perceptions of risk made continued delay less acceptable. The local context functioned primarily as a contextual condition shaping social visibility, mobility-related experience, informal information, and treatment urgency, rather than as a standalone mechanism. CONCLUSIONS: Delayed ART initiation in this study was not solely attributable to insufficient knowledge or poor treatment awareness. Participants described delay as an experience shaped by social visibility concerns, stigma-related shame, family negotiation, informal information, symptom experiences, and changing perceptions of risk. Efforts to promote timely ART initiation may need to address not only treatment knowledge, but also confidentiality concerns, stigma-sensitive support, family context, and the social conditions in which treatment decisions are made.
Hungry for equity in the Green Mountain State: food insecurity among college students in Vermont.
Bhurosy T, Danzy J, Scott L … +6 more , Abraham FO, Cromis M, Mbaya PY, Lyras S, Reilly N, Chung T
BMC Public Health · 2026 Jun · PMID 42380808 · Full text
BACKGROUND: There are limited data on food insecurity among college students from different marginalized backgrounds, both in Vermont and other predominantly White spaces, and what their institutions could do to improve...
BACKGROUND: There are limited data on food insecurity among college students from different marginalized backgrounds, both in Vermont and other predominantly White spaces, and what their institutions could do to improve food security and other basic needs. Thus, the aims of this study were to 1) examine food insecurity prevalence and its correlates among underrepresented college students, 2) assess their reasons for using campus food pantries and strategies for improving access to culturally appropriate foods on campus, and 3) determine their perspectives regarding how their institutions can address their basic needs. METHODS: Using a mixed methods cross-sectional research design, a convenience sample of full-time students or trainees ages 18 and older enrolled at four institutions of higher education in Vermont, United States, were recruited through flyers, course announcements, newsletters, listservs, and social media posts. An online survey provided estimates of food insecurity, on-campus food pantry use, and participant perspectives on institutional strategies to address basic needs through open-ended questions. Food insecurity was assessed by the 10-item United States Department of Agriculture food security survey module. Descriptive statistics assessed frequencies and percentages along with means and standard deviations. Binary logistic regression was conducted to estimate the odds of food insecurity. Inductive coding was used to analyze qualitative data and identify emergent themes. RESULTS: Around 40% of all participants experienced food insecurity in the past year, with higher odds observed in students aged ≥ 30, Pell Grant recipients, first-generation students, Black students, and those who used a food pantry. The most cited reason for using a campus food pantry was ease of getting to the pantry while lack of awareness was the most reported barrier. Over 50% of participants recommended gathering feedback from students about their preferences to improve access to culturally appropriate foods. Common themes from qualitative analyses included: food access support, safe and affordable housing access, mental health and healthcare access, financial aid access, reliable and affordable transportation access, non-financial academic support, and general support services. CONCLUSIONS: Institutions should prioritize food assistance programs targeting college students and incorporate mental health care, housing support, and financial aid for comprehensive safety nets.
Does the obesity paradox truly exist? A study on the relationship between different degrees of obesity and stroke incidence and mortality based on the UK Biobank.
Shi L, Zhai S, Shi J … +7 more , Zhang F, Zhang Z, Pan Z, Tian M, Zhang Z, Dong Z, Li Y
BMC Public Health · 2026 Jun · PMID 42380798 · Full text
BACKGROUND: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors, as well as an elevated risk of stroke. However, the evidence of its effect on outcomes in stroke patie...
BACKGROUND: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors, as well as an elevated risk of stroke. However, the evidence of its effect on outcomes in stroke patients has been equivocal. Previous studies have documented the obesity paradox in stroke, characterized by a negative correlation between BMI and stroke mortality. To address the limitations of relying solely on BMI in previous investigations, notably the documented obesity paradox linking BMI to stroke mortality, our study incorporates additional obesity metrics beyond BMI. We aimed to comprehensively evaluate the relationship between obesity and stroke outcomes, thereby providing a more holistic understanding of their association. METHODS: The present study included 502,128 participants from the UK Biobank database. Cox proportional hazard models were performed to determine the associations of indicators, including BMI, WC, WHR, WHtR and BFP with the incidence and mortality of stroke. RESULTS: Increased BMI was associated with elevated stroke incidence and mortality, with the lowest risk observed in the BMI range of 18-24 kg/m². Both lower BMI (17≤BMI<18.5 kg/m²) and higher BMI (BMI≥25 kg/m²) were linked to higher incidence and mortality of stroke. In contrast, other obesity-related indicators (WC, WHR, WHtR and BFP) exhibited more pronounced linear relationships with the incidence of stroke, all-cause mortality in the total population, stroke mortality in the total population and all-cause mortality in stroke patients. However, no significant differences were found in stroke-specific mortality among underweight, normal weight, overweight and obese groups in stroke patients across various obesity indicators, suggesting no obvious association between obesity and stroke-specific mortality in stroke patients under the current definitions and adjustments in this study. Notably, stroke severity, acute care, and complications were not available in the analysis, and residual confounding from these unmeasured factors cannot be ruled out. Furthermore, our analyses on the relationships between several obesity subtypes with different metabolic health statuses and stroke incidence and mortality revealed that, regardless of normal weight or not, individuals with metabolic abnormalities had significantly higher incidence and mortality of stroke compared to those with normal metabolism. This highlights the importance of metabolic status in the onset and prognosis of stroke. CONCLUSIONS: Our findings demonstrate that stroke-specific mortality in stroke patients was not associated with obesity severity when assessed using multiple obesity indicators including BMI, WC, WHR, WHtR and BFP. This is inconsistent with previous observations of the obesity paradox. Meanwhile, the observation that individuals with metabolic abnormalities exhibit significantly higher stroke incidence and mortality compared to those with normal metabolism further confirms the adverse impact of metabolic disturbances on stroke risk and prognosis, underscoring the pivotal role of metabolic health in stroke management.
Comment on 'Global inequities in hepatitis B and C genomic surveillance revealed through an interactive data integration dashboard'.
Rahmanto AA, Santoso B, Priyono EA
Public Health · 2026 Jun · PMID 42378786 · Publisher ↗
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A global systematic review and meta-analysis on preterm birth and air pollution exposure.
Kermani M, Kashani H, Nakhjirgan P
Public Health · 2026 Jun · PMID 42378785 · Publisher ↗
OBJECTIVE: Evidence on the association between ambient air pollutants and preterm birth (PTB) is increasing, yet findings remain inconsistent. This study aims to systematically review and synthesize evidence on the assoc...
OBJECTIVE: Evidence on the association between ambient air pollutants and preterm birth (PTB) is increasing, yet findings remain inconsistent. This study aims to systematically review and synthesize evidence on the association between maternal exposure to ambient pollutants (PM, PM, NO, SO, and O) and the risk of PTB. STUDY DESIGN: A systematic review and meta-analysis. METHODS: A comprehensive search of PubMed, Web of Science, and Scopus (2014-2024) identified 69 eligible studies. Of these, 66 studies (n = 66) were included in the meta-analysis. Using random-effects models, the study evaluated the impact of air pollutants on PTB risk. RESULTS: Based on cohort studies, which provide the highest level of evidence, an increase of 1 μg/m in air pollutants (PM, PM, NO, and O) was significantly associated with an increased risk of PTB. The results are presented as follows: (PM: pooled RR = 1.016, 95% CI: 1.010-1.021, PM: (pooled RR = 1.004, 95% CI: 1.002-1.007), NO (pooled RR = 1.007, 95% CI: 1.00-1.013), O (pooled RR = 1.004, 95% CI: 1.001-1.006). Additionally, this study examined the association between air pollutants and PTB across the three trimesters of pregnancy. Based on cohort studies, a significant association was observed between NO and particulate matter exposure during the third trimester and PTB. CONCLUSION: Although the number of observational studies in this field is limited and further research is needed, current evidence suggests that air pollutants, particularly particulate matter, may increase the risk of PTB. Therefore, effective health policies are essential to mitigate these harmful effects.
Comment on 'Multidomain expert evaluation of leading large language models as providers of vaccination and preventive medicine information'.
Long Z
Public Health · 2026 Jun · PMID 42378784 · Publisher ↗
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Impact of the Italian antimicrobial resistance National Action Plan on antibiotic consumption in primary care: An interrupted time series analysis from 1999 to 2024.
Bonacquisti M, Nurchis MC, Mao S … +7 more , Panariello F, Laurenti P, Parente P, Agodi A, Solipaca A, Villani L, Ricciardi W
Public Health · 2026 Jun · PMID 42378783 · Publisher ↗
OBJECTIVES: Antimicrobial resistance (AMR) is a major global health threat, largely driven by inappropriate and excessive antibiotic use. Italy has historically reported antibiotic consumption rates above the European av...
OBJECTIVES: Antimicrobial resistance (AMR) is a major global health threat, largely driven by inappropriate and excessive antibiotic use. Italy has historically reported antibiotic consumption rates above the European average, especially in primary care. In 2017, Italy implemented the National Action Plan on Antimicrobial Resistance (NAP-AMR), including targets for reducing overall community antibiotic and fluoroquinolone use. This study evaluated the impact of NAP-AMR on antibiotic consumption trends in Italian primary care from 1999 to 2024. STUDY DESIGN: Quasi-experimental interrupted time series study. METHODS: Annual ECDC data were expressed as defined daily doses (DDD) per 1000 inhabitants per day. Total antibiotic consumption was analyzed for 1999-2024 and fluoroquinolone consumption for 2005-2024. Segmented linear regression with Newey-West standard errors estimated post-2017 changes in level and trend. Total systemic antibiotic consumption was the primary outcome, and fluoroquinolone consumption was the secondary outcome. RESULTS: Total antibiotic consumption showed a significant pre-intervention upward trend, increasing annually by 0.10 DDD per 1000 inhabitants per day (annual change = 0.096; p = 0.032; 95% CI: 0.014 to 0.178). NAP-AMR implementation was associated with a significant immediate reduction in total antibiotic use (mean level difference = -4.940; p = 0.003; 95% CI: -7.864 to -2.016), while the post-intervention slope change was not significant (annual change = 0.126; p = 0.606; 95% CI: -0.346 to 0.599). Fluoroquinolone consumption showed a significant pre-intervention upward trend (annual change = 0.039; p = 0.016; 95% CI: 0.011 to 0.066) and a significant immediate reduction (mean level difference = -1.079; p = 0.023; 95% CI: -1.910 to -0.248). The post-intervention trend was negative but not significant (annual change = -0.219; p = 0.096; 95% CI: -0.459 to 0.021). CONCLUSIONS: NAP-AMR was associated with immediate reductions in total antibiotic and fluoroquinolone consumption, but sustained trend changes were not statistically significant. No significant long-term trend change was observed, underscoring ongoing surveillance and future evaluation.
A Case-Case Study of Sporadic and Outbreak-Associated Listeriosis Exposures: Initiative Food History Data, 2016-2022.
Namwase AS, Taylor EV, Conrad A … +4 more , Richardson L, Rose EB, Bruce BB, Weller DL
Public Health Rep · 2026 Jun · PMID 42377015 · Full text
OBJECTIVES: Little is known about foods associated with sporadic listeriosis, a foodborne bacterial infection. We compared self-reported foods consumed by people with sporadic versus outbreak-associated listeriosis, over...
OBJECTIVES: Little is known about foods associated with sporadic listeriosis, a foodborne bacterial infection. We compared self-reported foods consumed by people with sporadic versus outbreak-associated listeriosis, overall and for certain populations. METHODS: We analyzed data on cases with ≥1 reported food exposure reported during 2016-2022 in the United States to the Initiative. We used counterfactual random forests to identify foods associated with sporadic and outbreak-associated listeriosis in certain populations (eg, pregnant women). RESULTS: Of 3413 listeriosis cases reported during 2016-2022, 83.5% (n = 2849) were sporadic. Many foods showed no differential association between sporadic and outbreak-associated illness, indicating similar associations or lack thereof with both illness types. While a subset of foods were associated with sporadic versus outbreak-associated listeriosis, these associations varied by population. For example, strawberries (odds ratio [OR] = 2.48; 95% CI, 1.11-5.52) were the only foods associated with sporadic illness among nonpregnant females aged 15 to 49 years. Among adults aged ≥65 years, 10 foods, including deli-counter sliced cheese (OR = 1.78; 95% CI, 1.28-2.47), were associated with sporadic listeriosis. CONCLUSIONS: Foods associated with sporadic listeriosis differed from foods associated with outbreak-associated illness, with differences observed across population groups and by pregnancy status. These findings highlight variation in exposure patterns and underscore the need for further attribution studies focused on sporadic illness across demographic groups, to inform population-specific prevention messaging.
Developing a Prioritization Method for Imported Infectious Diseases Using National Notifiable Surveillance Data: The Tokyo 2020 Olympic and Paralympic Games Experience.
Ikenoue C, Griffith MM, Fukusumi M … +9 more , Kanou K, Nishiki S, Arima Y, Takahashi T, Saito T, Matsui T, Shimada T, Oishi K, Sunagawa T
Public Health Rep · 2026 Jun · PMID 42377014 · Full text
An increase in imported infectious diseases that are unfamiliar to health professionals was expected during the Tokyo 2020 Olympic and Paralympic Games. The National Institute of Infectious Diseases, Japan, therefore dev...
An increase in imported infectious diseases that are unfamiliar to health professionals was expected during the Tokyo 2020 Olympic and Paralympic Games. The National Institute of Infectious Diseases, Japan, therefore developed a pragmatic quantitative methodology to prioritize imported infectious diseases with the greatest implications for medical and public health workers. This approach selected acute-onset infectious diseases recorded in the national surveillance system and defined 2 indicators: absolute caseload and the relative contribution from importations, reflecting potential workload in diagnosis and acute public health responses, and relative importation impact. We prioritized diseases exceeding predefined thresholds for both indicators. The prioritization results, based on simple calculations, identified 15 prioritized diseases and facilitated transparent nationwide public health planning. With increasing global mobility, this method can serve as a useful tool to improve preparedness for mass gatherings and routine public health planning.
Reduction in Hepatitis C Virus RNA Positivity Among Clients in an Inpatient Substance Use Treatment Program in New York City.
Weiss JJ, Riazi F, Herrera J … +1 more , Diaz Munoz D
Public Health Rep · 2026 Jun · PMID 42376802 · Full text
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Physical activity among active-duty US military servicemembers with overweight and obesity.
Yarish NM, Morse JL, Wooldridge JS … +2 more , Dooley EE, Afari N
BMC Public Health · 2026 Jun · PMID 42374412 · Full text
BACKGROUND: To examine physical activity (PA) among US military servicemembers (SM) with overweight and obesity (OW/OB) and if they meet Physical Activity Guidelines (PAG). To assess differences in PA by sex and associat...
BACKGROUND: To examine physical activity (PA) among US military servicemembers (SM) with overweight and obesity (OW/OB) and if they meet Physical Activity Guidelines (PAG). To assess differences in PA by sex and associations between PA and body composition. METHODS: PA duration and intensity were objectively collected via accelerometers and self-reported daily average via self-report International Physical Activity Questionnaire (IPAQ) among US active-duty SM (n=113, 58% female, Mean BMI = 33.3 ± 3.9 kg/m2). Sex, body mass index (BMI), and body fat % (BF% via circumference and an equation) were measured. Accelerometer PA and sedentary time were computed for IPAQ categories who met PAG. PA sex differences were assessed with t-tests and chi-square. Pearson correlations examined associations between PA, BMI, and BF%. RESULTS: Accelerometry showed SM engaged in a daily average of 93 minutes of moderate to vigorous PA (MVPA), 145.2 minutes of light, and 307 minutes of sedentary activity. The IPAQ showed SM engaged in 91 minutes of MVPA, 121.1 minutes of walking, and 423 minutes sitting. Males engaged in more accelerometer-derived MVPA (p = 0.04) than females. Accelerometry showed 100% of SM met the PAG while the IPAQ showed 90% met the PAG. The IPAQ and accelerometer MVPA metrics were correlated (r = 0.26; p < 0.01). Sedentary time was correlated with BMI (r = 0.25; p < 0.01). Sitting was correlated with BF % (r = -0.26; p = 0.02). CONCLUSIONS: Overall, SM with OW/OB meet PAG. PA levels among SM are related to sex, BMI, and BF%.
Post-disaster psychosocial and physical determinants of perceived chewing difficulty among fukushima residents: the Fukushima Health Management Survey.
Funakubo N, Ohira T, Sato S … +7 more , Nagao M, Hayashi F, Eguchi E, Maeda M, Miura I, Yabe H, Yasumura S
BMC Public Health · 2026 Jun · PMID 42374378 · Full text
BACKGROUND: Oral functions, including chewing and occlusal function, are associated with nutritional intake, cognitive function, muscle strength, and balance. Therefore, maintaining oral functions is crucial for extendin...
BACKGROUND: Oral functions, including chewing and occlusal function, are associated with nutritional intake, cognitive function, muscle strength, and balance. Therefore, maintaining oral functions is crucial for extending healthy life expectancy. This study aimed to identify factors associated with perceived chewing difficulty as a functional oral outcome and its worsening following the Great East Japan Earthquake, with a particular focus on disaster-related psychosocial factors. METHODS: This cross-sectional study investigated self-reported chewing difficulty, psychological factors (e.g., traumatic reactions and psychological distress), disaster-related experiences (e.g., evacuation and experiences related to the nuclear accident, job loss, loss of a close person), medical history, and lifestyle factors among 64,188 residents aged 16-101 years who experienced the earthquake on March 11, 2011. Multinomial logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each factor associated with prevalent and exacerbated chewing difficulty. RESULTS: The proportions of participants with prevalent and exacerbated chewing difficulty were 2.8% and 0.31%, respectively. Multivariate-adjusted ORs (95% CIs) for factors associated with exacerbated chewing difficulty were as follows: post-traumatic stress disorder symptoms, 3.23 (2.35-4.43); psychological distress, 3.71 (2.71-5.09); experience of the nuclear accident, 1.57 (1.14-2.17); job loss, 1.47 (1.08-2.02); history of mental illness, 2.94 (2.00-4.32); dyslipidemia, 1.47 (1.06-2.05); and current exercise habit, 0.60 (0.44-0.83). CONCLUSIONS: These findings suggest that previously underexplored post-disaster psychosocial factors, including PTSD symptoms, experience of the nuclear accident, and job loss, as well as physical factors such as a history of mental illness and dyslipidemia, are associated with perceived chewing difficulty. In contrast, regular exercise habits were negatively associated with perceived chewing difficulty and may have a preventive role.
Predicting high perceived stress in late adolescence: development and validation of a prognostic model.
Steen PB, Dalgaard VL, Andersen JH … +2 more , Willert MV, Biering K
BMC Public Health · 2026 Jun · PMID 42374368 · Full text
AIM: Stress levels have increased among adolescents, yet tools for identifying those at high risk remain limited. This study aimed to develop and internally validate a prognostic model estimating the probability of high...
AIM: Stress levels have increased among adolescents, yet tools for identifying those at high risk remain limited. This study aimed to develop and internally validate a prognostic model estimating the probability of high perceived stress in young adulthood using data collected at age 15. METHODS: Data were from the West Jutland Cohort Study including 2,108 Danish adolescents with complete information on the 4-item Perceived Stress Scale at ages 15 and 18. High stress at age 18 was defined as a total score of 9 or higher. Twenty-three candidate predictors were examined using Least Absolute Shrinkage and Selection Operator (LASSO) regression across 100 imputed datasets. Predictors selected in ≥ 80% of imputations were entered into a pooled logistic regression model. Model performance was evaluated using 10-fold cross-validation under multiple imputation. Discrimination was assessed with the area under the receiver operating characteristic (ROC) curve (AUC), and calibration with calibration-in-the-large (CITL) and slope. RESULTS: Three predictors at age 15 were retained: perceived stress, depressive symptoms, and self-esteem. The model showed good calibration (CITL = 0.003; slope = 1.008; expected-to-observed ratio = 0.998) and acceptable discrimination with an AUC = 0.72 (0.68;0.76). The Brier score was 0.081, indicating satisfactory overall predictive accuracy. The model showed high negative predictive values but modest positive predictive values. CONCLUSIONS: A simple model based on self-reported psychosocial measures in mid-adolescence predicted later high stress with good calibration and moderate discrimination. External validation is needed to assess generalisability and inform potential use as a low-burden decision-support tool in school health settings.
Perceived barriers to maternal healthcare utilization: insights from skilled birth attendants in six high-burden states of northern Nigeria.
Ebinim H, Akpiroroh E, Ajayi M … +12 more , Sabbath UO, Jibril J, Ehize P, Isiaka S, Kolawole D, Nto S, Unogu C, Rauf R, Atobatele S, Sampson S, Eugene E, Okagbue H
BMC Public Health · 2026 Jun · PMID 42374354 · Full text
BACKGROUND: Maternal mortality remains a major public health concern globally despite significant progress over the past two decades. Nigeria is among the countries with the highest maternal mortality rates. Within the c...
BACKGROUND: Maternal mortality remains a major public health concern globally despite significant progress over the past two decades. Nigeria is among the countries with the highest maternal mortality rates. Within the country, marked regional disparities persist, with northern Nigeria experiencing a significantly higher burden. These disparities are shaped by a complex interaction of sociocultural norms, household power relations, geographic constraints, and health system limitations that influence women's access to skilled birth attendance and facility-based delivery. The study explored skilled birth attendants' perceived barriers to the provision of maternal healthcare services that prevent pregnant women from seeking appropriate care in government-based facilities. METHODS: This study employed a qualitative research design to explore skilled birth attendants' perspectives on barriers preventing women from accessing maternal healthcare services. Twenty-four skilled birth attendants were purposively selected from primary healthcare facilities across six high-burden northern Nigerian states: Bauchi, Kaduna, Katsina, Kano, Jigawa, and Niger. Data were collected through in-depth interviews using a semi-structured and pretested interview guide. The Three Delay Model guided the study to examine factors affecting women's decisions to seek care, their ability to reach healthcare facilities, and their experiences receiving care within facilities. RESULTS: The findings revealed multiple barriers across the three phases of delay. At the household level, cultural expectations, generational beliefs, and patriarchal decision-making structures limited women's autonomy to seek skilled care. Mothers-in-law and husbands often influenced or determined childbirth decisions, sometimes discouraging facility delivery. Structural barriers also affected women's ability to reach health facilities, including long travel distances, poor road infrastructure, and limited transportation options. Even when women arrived at health facilities, systemic challenges such as shortages of skilled health workers, inadequate medical supplies, insufficient delivery beds, financial constraints, and weak referral systems contributed to delays in receiving appropriate care. CONCLUSION: In conclusion, maternal healthcare service utilization in northern Nigeria is shaped by interconnected sociocultural, economic, and health system factors that contribute to delays in seeking, reaching, and receiving care. Therefore, addressing maternal mortality in this context requires comprehensive strategies that strengthen health system capacity, improve transportation and referral systems, reduce financial barriers, and promote gender-equitable decision-making within households and communities. Such integrated efforts are essential for improving access to skilled birth attendance and advancing progress toward global maternal health targets.
Physical exercise and problematic smartphone use among adolescents in Western China: a multi-center cross-sectional study on the serial mediation of self-control and meaning in life.
He X, Liu M, Mo P … +2 more , Luo W, Luo J
BMC Public Health · 2026 Jun · PMID 42374353 · Full text
OBJECTIVE: Problematic smartphone use has become a prominent public health issue in the information era. Although research has shown that exercise is beneficial in alleviating problematic smartphone use among adolescents...
OBJECTIVE: Problematic smartphone use has become a prominent public health issue in the information era. Although research has shown that exercise is beneficial in alleviating problematic smartphone use among adolescents, the specific underlying mechanisms have not been fully elucidated. This study aims to explore the internal mechanisms between self-control and the meaning in life in adolescents' problematic smartphone use (PSU) through physical exercise. METHODS: A multi-center, large-sample cross-sectional study was conducted among students from 34 primary and secondary schools in western China. Assessments were conducted using the Physical Activity Rating Scale (PARS-3), the Brief Self-Control Scale (BSCS), Meaning in Life Questionnaire (MLQ), and the Smartphone Addiction Scale-Short Version (SAS-SV). Data were analyzed using the Mann-Whitney U test, correlation analysis, and mediation analysis based on structural equation modeling. RESULTS: A total of 8,245 participants were included. The rates of PSU in males and females were found to be 23.97% and 19.47%, respectively. After adjusting for relevant demographic covariates, structural equation modeling analysis indicated that exercise was negatively associated with PSU (β = -0.056, p < 0.001). Both self-control (β = -0.034, p < 0.001) and meaning in life (β = -0.019, p < 0.001) played potential partial mediating roles in the relationship between physical exercise and PSU. Furthermore, self-control and meaning in life served as potential partial chain mediators between physical exercise and adolescent PSU (β = -0.011, p < 0.001), accounting for 9.17% of the total association. CONCLUSION: Maintaining regular physical exercise can enhance adolescents' self-control ability and meaning in life thereby helping to prevent or alleviate PSU behaviors.
The burden and risk factors of NCDs in Zimbabwe: evidence from the Zimbabwe population based HIV impact assessment 2020 survey.
Mapingure MP, Dzinamarira T, Chingombe I … +6 more , Moyo E, Mpofu A, Mugurungi O, Herrera H, Madziva R, Musuka GN
BMC Public Health · 2026 Jun · PMID 42374351 · Full text
BACKGROUND: The burden of non-communicable diseases (NCDs) has emerged as a critical public health challenge in Zimbabwe, exacerbated by a complex interplay of socioeconomic factors, demographic shifts, and urbanization....
BACKGROUND: The burden of non-communicable diseases (NCDs) has emerged as a critical public health challenge in Zimbabwe, exacerbated by a complex interplay of socioeconomic factors, demographic shifts, and urbanization. This study leverages data from the Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2020 survey to provide further insights and understanding of the prevalence and risk factors associated with NCDs in the country. METHODS: Utilizing a two-stage, stratified cluster sample design, we analyzed data from 19,535 participants. We conducted univariate and multivariate logistic regression analyses to evaluate the relationship between self-reported NCDs and demographic factors, including age, gender, urban versus rural residency, HIV status, and socioeconomic status. RESULTS: Findings revealed that approximately 14.3% of the population reported being diagnosed with at least one NCD, with hypertension and diabetes presenting prevalences of 10.8% and 2.2%, respectively. Age was a significant predictor of NCD burden, and we also noted disparities, particularly among women and individuals in higher wealth quintiles. CONCLUSION: Approximately one in seven Zimbabwean adults had been diagnosed with at least one non-communicable disease before 2020, with hypertension and diabetes the most common conditions. Older age increases NCD risk, and women and people in higher wealth quintiles carry a higher burden. These patterns suggest the need to keep prioritizing NCD prevention, screening, and management.
Knowledge, practices, perceived challenges, and factors associated with menstrual hygiene among adolescent school girls in southern Sri Lanka.
Dissanayaka DMYWK, Balapitiya WMPAF, Sundarapperuma SMTD … +1 more , Kariyawasam PN
BMC Public Health · 2026 Jun · PMID 42374340 · Full text
BACKGROUND: Menstrual hygiene is essential for adolescent girls, as it greatly affects their capacity to engage in academic and extracurricular activities. Adolescent girls often encounter various challenges in maintaini...
BACKGROUND: Menstrual hygiene is essential for adolescent girls, as it greatly affects their capacity to engage in academic and extracurricular activities. Adolescent girls often encounter various challenges in maintaining proper menstrual hygiene, making it essential to explore these challenges to design effective future interventions. Therefore, this study was conducted to assess the knowledge, practices, perceived challenges, and factors associated with menstrual hygiene among adolescent school girls in Galle Educational Zone in southern Sri Lanka. METHODS: This study employed a mixed-methods design, utilizing a sequential explanatory strategy, comprising a quantitative descriptive component followed by an exploratory descriptive qualitative component. The study was conducted with the participation of 389 girls in the Galle educational division using the multi-stage cluster sampling method in 2024. A validated, modified, self-administered questionnaire was used to collect data. Descriptive statistics, Chi-square test, independent sample t-test, one-way ANOVA, and multiple linear regression were used based on the type of variable. For the qualitative component, in-depth interviews were conducted with 15 purposively selected school girls. The interviews were transcribed verbatim, and the data were coded systematically to identify recurring patterns and themes. The ethical approval was obtained from the ethics review committee Faculty of Allied Health Sciences, University of Ruhuna. RESULTS: Among the participants, only 32.7% (n = 125) had satisfactory knowledge, and only 17.3% (n = 66) had a satisfactory level of practice on menstrual hygiene. Knowledge on menstruation was associated with menstrual hygiene practices (p = 0.015), information received from the media (p = 0.010), experience on menstruation (p = 0.025), mother's level of education (p < 0.001) and father's level of education (p < 0.001). Hygiene practices on menstruation were associated with the type of family (p = 0.023). In the qualitative component, under the perceived challenges, four sub-themes emerged: comfort and dignity, socio-cultural taboos, physical constraints, and insufficient resources. CONCLUSION: The participants' overall knowledge on menstruation and menstrual hygiene was inadequate. Key factors influencing menstrual hygiene included parents' level of education, family structure, and prior experience with menstruation.
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