Public Health [JOURNAL]
Sun
200 papers
Epidemiology and factors associated with Talaromyces marneffei detection in the mainland of China, 2022-2024: a cross-sectional study of hospitalized patients.
Lun X, Yuan J, Qiao W … +8 more , Wang M, Li P, Wang X, Jin R, Xu J, Chen C, Song R, Sun Y
BMC Public Health · 2026 Jun · PMID 42343343 · Full text
BACKGROUND: Epidemiological studies of Talaromyces marneffei (T. marneffei) infection are largely confined to HIV-positive populations and specific geographic regions, whereas its population-scale characteristics and env...
BACKGROUND: Epidemiological studies of Talaromyces marneffei (T. marneffei) infection are largely confined to HIV-positive populations and specific geographic regions, whereas its population-scale characteristics and environmental factors associated with infection in China are lacking. This study investigates spatiotemporal patterns, host susceptibility, and environmental correlates of T. marneffei detection in Chinese mainland. METHODS: Targeted next-generation sequencing (tNGS) data from patients hospitalized for acute respiratory tract infections (ARTIs) from 2022 to 2024 were used for epidemiological, spatiotemporal, and co-detection analyses. Geographical detector models with the q-statistic were employed to quantify the associations of meteorological, host distribution, and social factors on detection risk, where the q-statistic measures the proportion of spatial variance explained by each factor. RESULTS: Among 2,316 reported cases, we identified significant spatial clustering, with bimodal seasonal peaks in detection rate. Males and individuals aged 41-50 showed the highest susceptibility. Pneumocystis jirovecii was the predominant co-detected pathogen; 5 pathogens were positively and 16 were negatively correlated with T. marneffei. Univariate analysis using the q-statistic revealed that dew point temperature had the strongest explanatory power for T. marneffei detection at 48.55%. Bivariate interaction analysis demonstrated that paired factor combinations exhibited enhanced explanatory power for disease prevalence compared with single factors. Average air pressure, which alone explained only 1.4% of the spatial variance, showed markedly higher explanatory power when paired with other variables. CONCLUSIONS: This study revealed spatiotemporal heterogeneity, population susceptibility, and environmental factors associated with T. marneffei detection in Chinese mainland, which can guide disease monitoring and control through enhanced surveillance and tailored interventions in epidemic hotspots and among high-risk groups.
Fertility intentions among medical students in war-torn Ukraine: a cross-sectional survey.
Mogilevkina I, Olovsson M, Getsko O … +2 more , Marichereda V, Tyden T
BMC Public Health · 2026 Jun · PMID 42343333 · Full text
BACKGROUND: Ukraine's total fertility rate was 0.9 in 2022, among the lowest in Europe. Amid the ongoing full-scale invasion, understanding reproductive intentions is important for informing future pronatalist policies....
BACKGROUND: Ukraine's total fertility rate was 0.9 in 2022, among the lowest in Europe. Amid the ongoing full-scale invasion, understanding reproductive intentions is important for informing future pronatalist policies. This study assessed fertility intentions and attitudes toward parenthood, with a focus on sex differences, and subjective determinants of reproductive decision-making among undergraduate medical students in wartime Ukraine. METHODS: A cross-sectional, confidential, online survey was conducted among students at Odesa National Medical University in May 2024. The Swedish Fertility Awareness Questionnaire was used, supplemented with a question on contraceptive use. Data were analysed using descriptive statistics, univariable, multivariable and stepwise logistic regression. RESULTS: The mean age was 20 years among the participants: 655 women and 191 men. Overall, 75% intended to have children, with a preferred family size of two children. Women preferred to have their first child at a younger age than men (26.1 vs. 28.1 years; p < 0.001). No sex differences were observed in the perceived importance of having children. Oral and long-acting reversible contraceptive use was relatively low. Furthermore 62% of participants indicated that they would support a hypothetical pregnancy to birth, mainly for moral or religious reasons. Among those opting for abortion, the most commonly cited reasons were financial constraints and war-related concerns. In the case of infertility, more women than men were willing to consider IVF or adoption (p < 0.001). Key prerequisites for parenthood included adequate housing (93%) and financial stability (92%). Women were more likely to anticipate emotional benefits of parenthood (OR 1.66), whereas men were more likely to anticipate negative impacts on personal time (OR 1.91) and finances (OR 1.72). Intention to have children was associated with psychological readiness, emotional fulfilment, life priorities, and perceived housing adequacy (aOR 3.02), as a key independent predictor of overall readiness for parenthood. CONCLUSIONS: Despite the ongoing war, fertility intentions among medical students remain relatively optimistic, equally for women and men. As adequate housing was an important prerequisite for parenthood, post-war pronatalist policies may benefit from integrating housing support into broader family well-being strategies, while also addressing sexuality education and cultural influences on family formation and parenthood decisions.
Unintentional ingestion of recreational drugs among young children, 2000-2024.
Uskovich K, Hays HL, Badeti J … +4 more , Rine NI, Michaels NL, Ding K, Smith GA
BMC Public Health · 2026 Jun · PMID 42343328 · Full text
BACKGROUND: Previous studies of pediatric recreational drug exposures have often been limited in scope. Given the rapidly changing recreational drug supply and the related unintentional ingestion of these drugs by young...
BACKGROUND: Previous studies of pediatric recreational drug exposures have often been limited in scope. Given the rapidly changing recreational drug supply and the related unintentional ingestion of these drugs by young children, a comprehensive study that includes recent data about these exposures is needed. The objective of this study is to investigate the characteristics and trends of unintentional ingestions of recreational drugs by children < 6 years old. METHODS: Using a retrospective cohort study design, National Poison Data System data from 2000 to 2024 were analyzed. United States Census Bureau data were used to calculate population-based ingestion rates. Rate ratios (RRs) with 95% confidence intervals (CIs) were calculated to assess the magnitude of relationships between key characteristics and outcomes, such as highest level of health care received and medical outcome. RESULTS: There were 41,612 unintentional ingestions involving recreational drugs among children < 6 years old reported to United States poison centers from 2000 to 2024. Most were among children < 3 years old (57.6%), involved a single substance (95.9%), and occurred in a residence (96.4%). Although 50.6% of children experienced no or minor effects, 5.0% had a major effect and there were six deaths. Children < 3 years old were more likely to experience a major effect (RR: 1.54; 95% CI:1.39-1.71) or be admitted to a critical care unit (RR: 1.23; 95% CI: 1.16-1.30) than children 3-5 years old. Cannabinoids accounted for 84.7% of ingestions, followed by stimulants (8.4%), psychedelics (3.5%), opioids (2.8%), and dissociative agents (0.6%). Ingestions involving opioids (RR: 2.60; 95% CI: 2.36-2.86), stimulants (RR: 2.16; 95% CI: 2.01-2.31), and dissociative agents (RR: 1.59; 95% CI: 1.23-2.06) were more likely to be admitted to a critical care unit than the other substance categories combined. The recreational drug ingestion rate per 100,000 US children < 6 years old increased 3,307% from 1.05 in 2000 to 35.91 in 2024, with a rapid increase beginning in 2013, especially involving edible marijuana and psilocybin products. CONCLUSIONS: The recreational drug ingestion rate among children < 6 years old reported to United States poison centers increased substantially from 2000 to 2024. Additional efforts are needed to prevent these unintentional ingestions in this vulnerable population.
Study protocol for evaluating integrated urban development plans: impacts on health, social equity, and environmental sustainability in Germany.
Tönnies J, Krumreihn A, Stelzer F … +7 more , Senck E, Bongers-Römer S, Stalling I, Gröne K, Bammann K, Köckler H, Bolte G
BMC Public Health · 2026 Jun · PMID 42343327 · Full text
BACKGROUND: The urban environment plays a significant role in shaping residents' health, wellbeing, and opportunities for social participation. Urban development interventions have been shown to positively influence phys...
BACKGROUND: The urban environment plays a significant role in shaping residents' health, wellbeing, and opportunities for social participation. Urban development interventions have been shown to positively influence physical activity, mental health, quality of life, and self-reported health status. However, most previous studies have focused on single measures or specific environmental aspects. Integrated Urban Development Plans (IUDPs), by contrast, combine interventions from multiple domains, such as housing, infrastructure, green spaces, and social participation, to promote health equity and sustainable urban transformation. The SalusTransform project aims to evaluate IUDPs in three German cities regarding their implementation processes as well as their impacts on health, social equity, and ecological sustainability. METHODS: We will compare three IUDP intervention areas with three control areas in the respective cities using a mixed-methods design. Quantitative and qualitative data will be collected to assess both process and outcome quality of the IUDPs. Primary data collections include resident surveys and focus groups, qualitative interviews with stakeholders, as well as environmental and infrastructural assessments, including air-quality measurements, site visits, and observations related to active mobility and urban green spaces. Secondary data on population structure, aggregated health indicators, and local implementation processes will be provided by the municipalities. Analyses will follow a difference-in-differences approach to identify changes attributable to IUDP implementation while accounting for similar developments in the control areas. DISCUSSION: By building a comprehensive database that links health-related, social, and environmental indicators, SalusTransform will provide valuable evidence on the real-world effects of IUDPs. Findings will inform municipalities, policymakers, and practitioners about the effectiveness and transferability of IUDPs and contribute to the institutionalisation of their systematic evaluation. Close collaboration with local authorities will ensure continuous monitoring of changes and strengthen the practical relevance of the research. Targeted communication strategies will be implemented to engage population groups that are often underrepresented in research and urban planning processes. TRIAL REGISTRATION: This study was prospectively registered with the German Clinical Trials Register (DRKS00036042) on May 28th, 2025.
The effect of fall-prevention education on fall-related behaviors in older adults.
Çevik BE, Tok HH
BMC Public Health · 2026 Jun · PMID 42343326 · Full text
AIM: This study aimed to examine the effect of a structured fall-prevention education program on safe fall-related behaviors among older adults. METHOD: The study was conducted using a pretest-posttest parallel-group ran...
AIM: This study aimed to examine the effect of a structured fall-prevention education program on safe fall-related behaviors among older adults. METHOD: The study was conducted using a pretest-posttest parallel-group randomized controlled design. A total of 66 older adults who attended a family health center in the Central Anatolia region of Türkiye and were classified as high risk according to the Morse Fall Risk Scale were included. The intervention group received an education program consisting of two sessions delivered through interactive presentations and question-answer discussions, while the control group received an informational brochure only. Data were collected using the Personal Information Form, the Morse Fall Risk Scale, and the Fall Behaviors Scale for Older Adults. RESULTS: A statistically significant increase was observed in fall behavior scores in the intervention group between the pretest and posttest assessments. In contrast, no significant difference was found between pretest and posttest scores in the control group. Between-group comparisons revealed that posttest scores of the intervention group were significantly higher than those of the control group. CONCLUSION: The structured and interactive education program was found to be effective in improving safe fall-related behaviors among older adults. Passive information-based approaches were insufficient to produce behavioral change, whereas nursing-based educational interventions that promote active participation were more effective. TRIAL REGISTRATION: NCT07499895- 2026/03/30- Retrospectively registered.
Access to WASH facilities and health implications of period poverty among in-school girls in rural areas of Africa: a scoping review.
Alabi AJ, Fawole OI
BMC Public Health · 2026 Jun · PMID 42343318 · Full text
INTRODUCTION: Menstrual health is essential to adolescent well-being, yet many girls experience period poverty, an inadequate access to sanitary products, water, sanitation facilities, and menstrual education. This scopi...
INTRODUCTION: Menstrual health is essential to adolescent well-being, yet many girls experience period poverty, an inadequate access to sanitary products, water, sanitation facilities, and menstrual education. This scoping review synthesised existing evidence on access to menstrual products, commonly described barriers and reported associations between poor health and period poverty among in-school girls in rural areas of Africa. METHODS: This study was developed in accordance with the Joanna Briggs Institute recommendations and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. PubMed, Web of Science and Google Scholar were searched for literature published in English, between 2015 and 2025. The literature must meet the inclusion criterion of being conducted among in-school girls in rural communities in Africa. Extracted data were summarised in an Excel spreadsheet, and descriptive analyses were conducted. RESULTS: Twenty-one (21) relevant studies were identified, of which 14 were quantitative, four were qualitative, and three were mixed methods studies. The studies were conducted across six countries, with the largest proportion from Kenya (5/21; 23%). Many of the girls were between 10 and 19 years. Period poverty was common among in-school menstruating girls in rural areas of Africa, and it negatively influenced their physical, mental, social and sexual health. Period poverty was linked to body odour, body burns, headaches, fatigue, urogenital symptoms, experience of fear, discomfort, shame, and stress. It can also lead to vulnerability to sexual exploitation, disrupted schooling, poor academic performance and school dropout. CONCLUSIONS: Period poverty was widespread among in-school girls in rural Africa and linked to negative implications on their health. Integrated interventions that reduce girls' vulnerability to stigma and sexual exploitation, such as free or subsidised menstrual products, gender-responsive water, sanitation and hygiene facilities, and menstrual education for boys and girls, are urgently required.
Joint associations between maternal exposure to ambient air pollutants during pregnancy and low Apgar score in newborns: a birth cohort study in China.
Chen Z, Lin B, Ouyang Z … +11 more , Ni W, Jiang L, Wu B, Chen S, Lai L, Chen S, Zheng H, Zhu M, Jing Y, Yu X, Fan J
BMC Public Health · 2026 Jun · PMID 42343309 · Full text
BACKGROUND: Epidemiological evidence on the risk of low Apgar score in newborns associated with ambient air pollutants, their joint associations, and sensitive exposure windows is limited. This study aimed to investigate...
BACKGROUND: Epidemiological evidence on the risk of low Apgar score in newborns associated with ambient air pollutants, their joint associations, and sensitive exposure windows is limited. This study aimed to investigate the independent and joint associations between exposure to ambient air pollutants during different pregnancy trimesters and low Apgar score in newborns. METHODS: Twenty thousand eight hundred ninety-four pregnant women were included in the prospective birth cohort in Shenzhen. Concentrations of PM, PM, NO, O, SO, and CO were assessed based on residential addresses of participants. Generalized additive model (GAM) was used to assess the independent associations of air pollutants exposure with low Apgar score, and restricted cubic spline (RCS) model was used to analyze the dose-response trends. Quantile g-computation (Qgcomp) and weighted quantile sum (WQS) regression models were further used to investigate the joint associations and constituent contributions. RESULTS: Second-trimester exposure to PM, PM, and NO was associated with an increased risk of low 1-minute Apgar score (PM: OR = 1.64, 95% CI: 1.10, 2.44; PM: OR = 1.59, 95% CI: 1.01, 2.50; NO: OR = 1.48, 95% CI: 1.11, 1.98, per interquartile range increase). In the mixed-pollutant models, both Qgcomp and WQS models showed that each one-quartile increase in the air pollutant mixture was significantly associated with low 1-minute Apgar score (Qgcomp: OR = 1.48, 95% CI: 1.06, 2.07; WQS: OR = 1.15, 95% CI: 1.09, 1.21). PM and NO were the primary contributors to the risk (Qgcomp: 48.0%, 34.5%; WQS: 23.6%, 39.4%). CONCLUSIONS: Second-trimester exposure to air pollutants was associated with an increased risk of low 1-minute Apgar score, and PM and NO may be the key relative contributors. These findings support the need for further research and increased public health attention to air pollutant exposure during pregnancy to prevent adverse neonatal health outcomes. TRIAL REGISTRATION: Not applicable.
Prevalence and factors associated with psychological aggression and physical punishment among children aged 12 to 59 months in Malaysia: findings from the National Health and Morbidity Survey 2022.
Rosslan NH, Ganapathy SS, Bakri MH … +1 more , Yoep N
BMC Public Health · 2026 Jun · PMID 42343305 · Full text
INTRODUCTION: Psychological aggression and physical punishment remain common disciplinary practices globally, despite evidence of their adverse effects on child development. This study investigated the prevalence and ass...
INTRODUCTION: Psychological aggression and physical punishment remain common disciplinary practices globally, despite evidence of their adverse effects on child development. This study investigated the prevalence and associated factors of these practices among children aged 12 to 59 months in Malaysia. METHOD: Data were obtained from the National Health and Morbidity Survey (NHMS) 2022, a nationally representative cross-sectional study employing a two-stage stratified random sampling design. The primary respondents were caregivers of children aged 12-59 months. Psychological aggression was defined as being scolded in a harsh tone or using hurtful names, while physical punishment was defined as actions intended to cause pain, such as shaking the child, spanking, or hitting them with a hand or object like a cane. These actions were measured based on occurrences within the past month intended to correct behaviour. Disciplinary practice data were collected through face-to-face interviews using a validated questionnaire adapted from the Multiple Indicator Cluster Survey (MICS). Prevalence estimates with 95% confidence intervals (CI) were generated, and adjusted prevalence ratios (aPR) with 95% CI were obtained using design-adjusted Poisson regression with robust variance. RESULTS: Among the 13,288 respondents, the prevalence of psychological aggression was 58.3% (95% CI: 55.9-60.6) and of physical punishment was 40.7% (95% CI: 38.4-43.0). Older children were significantly more likely to experience both forms of discipline. In adjusted models, compared with children aged 12-23 months, children aged 48-59 months had higher prevalence of psychological aggression (aPR 1.44, 95% CI: 1.33-1.56) and physical punishment (aPR 1.48, 95% CI: 1.31-1.69). Boys had higher adjusted prevalence of physical punishment than girls (aPR 1.13, 95% CI: 1.05-1.21). CONCLUSION: Harsh disciplinary practices remain common. Integration of evidence-based positive parenting programmes into maternal and child health services and community-based support platforms is recommended.
Insufficient mpox knowledge among public health professionals involved in infectious disease prevention and control in China: a large-scale online cross-sectional survey.
Hua M, Zhu W, Chen Z … +7 more , Wu Y, Liang S, Xie Y, Yue X, Li J, Zhang J, Gong X
BMC Public Health · 2026 Jun · PMID 42343300 · Full text
BACKGROUND: The World Health Organization has declared mpox a Public Health Emergency of International Concern twice. In China, public health professionals (PHPs) involved in infectious disease prevention and control are...
BACKGROUND: The World Health Organization has declared mpox a Public Health Emergency of International Concern twice. In China, public health professionals (PHPs) involved in infectious disease prevention and control are responsible for mpox control, case reporting, and health communications during outbreaks. This study aimed to assess mpox knowledge and factors associated with sufficient mpox knowledge among PHPs in China. METHODS: This study analyzed PHPs involved in infectious disease prevention and control from a large-scale online cross-sectional survey of healthcare workers conducted through a nationwide platform. An e-questionnaire was used to collect data on demographic and institutional characteristics, attention to mpox, mpox information sources, training history and 37 mpox knowledge items covering etiology, clinical features, transmission, and prevention. Univariable and multivariable logistic regression analyses were performed to identify factors associated with sufficient mpox knowledge. RESULTS: A total of 1,601 PHPs from 28 of 31 provincial-level regions in China completed the survey, and 1,568 valid responses were included. Among the 1,568 PHPs, 91.3% (1,432/1,568) were aware of mpox, and 61.7% (967/1,568, 95% CI: 59.3%-64.1%) had sufficient mpox knowledge. 44.6% (95% CI: 42.1%-47.0%), 74.2% (95%CI: 72.1%-76.4%) and 47.0% (95% CI: 44.5%-49.5%) PHPs aware of mpox had sufficient knowledge regarding etiology, clinical features and transmission and prevention, respectively. Multivariable logistic regression analysis showed that the associated factors with sufficient mpox knowledge included gender (female: OR = 1.34, 95% CI: 1.03-1.74), professional title (intermediate: OR = 1.85, 95% CI: 1.40-2.45, senior: OR = 2.05, 95% CI: 1.44-2.91), institution (CDC: OR = 2.07, 95% CI: 1.60-2.67), attention toward mpox (occasional: OR = 2.59, 95% CI: 1.72-3.90; daily/frequent: OR = 3.70, 95% CI: 2.39-5.73), mpox information sources (two sources: OR = 1.51, 95% CI: 1.14-2.00; three or more sources: OR = 1.77, 95% CI: 1.31-2.39), and training (OR = 2.44, 95% CI: 1.89-3.15). CONCLUSION: This study found insufficient mpox knowledge among the surveyed PHPs involved in infectious disease prevention and control across multiple regions of China, especially among males, those with junior professional titles, limited information access, low attention to mpox, no prior training, and hospital-based staff. Targeted training, continuing education, and multi-channel information dissemination should be strengthened to support mpox preparedness among frontline PHPs.
Association between road safety awareness and motorcycle riding behaviors with road traffic crashes among Thai university students: a cross-sectional study.
Chautrakarn S, Jaiprom E, Thongduang K … +1 more , Ong-Artborirak P
BMC Public Health · 2026 Jun · PMID 42343290 · Full text
BACKGROUND: Young people, particularly university students, are at significant risk of motorcycle accidents. This study aimed to investigate road safety awareness and motorcycle riding behavior, and their association wit...
BACKGROUND: Young people, particularly university students, are at significant risk of motorcycle accidents. This study aimed to investigate road safety awareness and motorcycle riding behavior, and their association with road traffic crashes among Thai university students. METHODS: In this cross-sectional study, 854 university students who rode motorcycles at least three times per week completed an online self-administered survey. The questionnaire included self-reported road traffic crashes during the past year, basic knowledge of traffic regulations, road safety awareness, and motorcycle riding behavior. RESULTS: The prevalence of road traffic crashes in the past year was 28.7%. The mean scores for road safety awareness and motorcycle riding behavior were 80.44 ± 9.93 and 88.72 ± 8.25 (out of 100), respectively. Multiple logistic regression analysis showed that road traffic crashes were inversely associated with road safety awareness and motorcycle riding behavior scores (per 10-point increase) after adjusting for confounders (AOR = 0.823, 95% CI: 0.705-0.961 and AOR = 0.811, 95% CI: 0.675-0.975, respectively). When the presence of unsafe riding behaviors was categorized by domains, road traffic crashes were significantly associated with traffic law violations (AOR = 1.530, 95% CI: 1.012-2.313) and driving under the influence of alcohol or drugs (AOR = 1.695, 95% CI: 1.244-2.311). CONCLUSIONS: The findings highlight the need for integrated road safety interventions, including education, behavioral change strategies, and traffic law enforcement, to enhance safe riding practices among university students and reduce traffic-related injuries.
Association of combined healthy lifestyle factors with the risk of metabolic dysfunction-associated steatotic liver disease: the Korean National Health and Nutrition Examination Survey 2016-2021.
Jeong NN, Lim HJ, Kim WH … +1 more , Kim MJ
BMC Public Health · 2026 Jun · PMID 42343286 · Full text
BACKGROUND: Lifestyle factors strongly affect the prevention and improvement of liver-related outcomes. However, the relationship between combined lifestyle factors and metabolic dysfunction-associated steatotic liver di...
BACKGROUND: Lifestyle factors strongly affect the prevention and improvement of liver-related outcomes. However, the relationship between combined lifestyle factors and metabolic dysfunction-associated steatotic liver disease (MASLD) has not been comprehensively evaluated. Therefore, this study aimed to investigate the association between a combination of healthy lifestyle factors and MASLD in Korean adults. METHODS: This study analyzed data from 23,111 participants aged 19-80 years who were enrolled in the Korean National Health and Nutrition Examination Survey (2016-2021). A healthy lifestyle was defined based on four factors including diet quality, physical activity, smoking, and sleep duration. Participants were divided into three groups based on healthy lifestyle score ranging from 0 to 4. MASLD was defined as having both hepatic steatosis index ≥ 36 and cardiometabolic risk factor ≥ 1. Multivariate logistic regression analysis was conducted to identify the associations between healthy lifestyles and the risk of MASLD. Additional analyses were conducted based on the combination of lifestyle factors. RESULTS: The weighted prevalence of MASLD was 24.1%, with the highest rates observed in participants with an unfavorable lifestyle. The protective effect against the risk of MASLD increased with the number of lifestyle factors. Compared to individuals in the unfavorable lifestyle group, the multivariate-adjusted odds ratio for MASLD was 0.825 (95% confidence interval [CI], 0.728-0.935) for the intermediate lifestyle group and 0.714 (95% CI, 0.621-0.820) for the favorable lifestyle group. A significant association was found among individuals with combinations of healthy lifestyle factors, and the lowest risk was observed in those with combined diet, physical activity, and smoking, with an odds ratio of 0.680 (95% CI, 0.544-0.848). CONCLUSIONS: In this study, healthy lifestyle factors were inversely associated with MASLD risk. However, due to the cross-sectional design, causal relationships cannot be established, and future longitudinal studies are warranted to confirm these associations. From a public health perspective, our findings support the importance of promoting healthy lifestyle behaviors, particularly smoking cessation and regular physical activity, as potential strategies for MASLD prevention.
Prevalence of myopia among 26,697 school-aged children and adolescents in Taiyuan.
Zhang X, Wang C, Su Q … +3 more , Yan Z, Ma R, Li C
BMC Public Health · 2026 Jun · PMID 42343283 · Full text
PURPOSE: Investigation and analysis of the current status and influencing factors of vision screening-detected myopia among school-aged children and adolescents in primary, junior high, and senior high schools across var...
PURPOSE: Investigation and analysis of the current status and influencing factors of vision screening-detected myopia among school-aged children and adolescents in primary, junior high, and senior high schools across various urban districts of Taiyuan, the capital city of Shanxi Province, to provide directions and recommendations for myopia prevention and control in the region. METHODS: A cross-sectional survey study was conducted in March 2025, involving a total of 26,697 primary, junior high, and senior high school students in Taiyuan. Data were collected through questionnaires and non-cycloplegic autorefraction. RESULTS: The overall screening prevalence of myopia among school-aged children and adolescents in Taiyuan City was 81.8%. The prevalence of myopia was significantly lower in males than in females (χ² = 45.57, P < 0.001).The screening myopia prevalence rates were 71.0% in primary school, 90.4% in junior high school, and 94.4% in senior high school, while the high myopia prevalence rates were 1.7%, 9.6%, and 17.2%, respectively. In primary and junior high schools, the detection rate of myopia was significantly higher in females than in males (χ² = 15.32 and 17.41; P < 0.001). However, in senior high school, the detection rate of myopia was similar between females and males (χ² = 3.57; P > 0.05).At the primary, junior high, and senior high school levels, female students exhibited a significantly higher degree of SER than male students (P < 0.05).The higher prevalence of both myopia and high myopia was significantly associated with the following factors: prolonged near-work duration (≥ 12 h per day, OR = 1.43), insufficient near-work distance, and parental myopia (at least one parent with myopia, OR = 4.02). CONCLUSIONS: In 2025, the screening-detected prevalence of myopia and high myopia among school-aged children and adolescents in Taiyuan City, Shanxi Province, was notably high. This phenomenon was associated with factors such as near work activities and parental myopia. Furthermore, the detection rate of myopia exhibited an increasing trend with advancing educational stages, and the overall prevalence of myopia was higher in females than in males.
Caregivers' knowledge, attitudes, and practices toward pediatric dry eye disease: a cross-sectional study.
Wang W, Zhao H, Zeng Y … +2 more , Shi M, Chen Y
BMC Public Health · 2026 Jun · PMID 42343271 · Full text
BACKGROUND: This study aimed to investigate caregivers' knowledge, attitudes, and practices (KAP) concerning pediatric dry eye disease. METHODS: This cross-sectional study was conducted at the Pediatric Ophthalmology Out...
BACKGROUND: This study aimed to investigate caregivers' knowledge, attitudes, and practices (KAP) concerning pediatric dry eye disease. METHODS: This cross-sectional study was conducted at the Pediatric Ophthalmology Outpatient Department of Yuxi People's Hospital between December 2023 and April 2024. Demographic data and KAP scores were collected through questionnaires. RESULTS: A total of 515 valid questionnaires were collected. Of these, 393 respondents (76.31%) were mothers of the children, and 319 children (61.94%) had suffered from dry eye for less than three months. The participants' mean knowledge, attitude, and practice scores were 7.57 ± 4.14 (possible range: 0-18), 36.76 ± 3.51 (possible range: 9-45), and 40.99 ± 7.13 (possible range: 11-55), respectively. Knowledge, attitude, and practice scores were significantly correlated with each other (all P < 0.001). Mediation analysis showed that knowledge (β = 0.19, P < 0.001), income (β = 0.75, P < 0.001), and marital status (β = 1.63, P = 0.001) were statistically associated with attitude. Meanwhile, knowledge (β = 0.51, P < 0.001), attitude (β = 0.55, P < 0.001), and residence (β = 1.51, P < 0.001) were statistically associated with practice. Further, knowledge (β = 0.10, P < 0.001), income (β = 0.38, P < 0.001), marital status (β = 0.83, P = 0.004) showed statistically modeled indirect associations with practice within the specified mediation framework. CONCLUSIONS: This study revealed that caregivers exhibit inadequate knowledge but generally positive attitudes and moderately adequate yet inconsistent practices towards pediatric dry eye disease. The findings suggest that targeted educational programs may help address caregivers' knowledge gaps and support more appropriate management practices for pediatric dry eye disease.
Heat-related illness symptoms among migrant farmworkers: a systematic literature review and meta-analysis.
van Selm L, Williams S, Elafef E … +5 more , Marti-Soler H, Vecchi S, de'Donato F, De Sario M, Requena-Méndez A
BMC Public Health · 2026 Jun · PMID 42343263 · Full text
BACKGROUND: Farmworkers are at risk for heat-related illnesses (HRI) due to intensifying heat exposure resulting from climate change. Migrant farmworkers might be at further increased risk due to limited control over wor...
BACKGROUND: Farmworkers are at risk for heat-related illnesses (HRI) due to intensifying heat exposure resulting from climate change. Migrant farmworkers might be at further increased risk due to limited control over workplace conditions and language and cultural barriers. This systematic literature review and meta-analysis aims to assess the global prevalence of self-reported heat-related illnesses among migrant farmworkers. METHODS: We searched five databases for peer-reviewed literature and additional sources to capture grey literature in any language up to October 2024. Studies providing self-reported heat-related symptoms among migrant farmworkers were included. A random effects model was used to calculate the pooled proportion of individual and combined heat-related health outcomes. Separate pooled estimates were included for each symptom as well as the number of symptoms. Risk of bias was assessed using the JBI quality assessment tool. RESULTS: Seventeen papers were included, including data from 2966 migrant farmworkers. The pooled proportion for having at least one HRI symptom was 52% (95%CI 39-65) and 21% (95%CI 4-44) reported at least three HRI symptoms. Heterogeneity was high across all pooled estimates (I² ranging from 83% to 99%). The most common symptoms were extreme sweating (46%), weakness (45%), and headache (36%). No differences were found between internal and international migrants nor between studies asking about HRI symptoms experienced in a short-term (e.g., the past week) versus longer periods. DISCUSSION AND CONCLUSION: Migrant farmworkers reported a high proportion of HRI symptoms. Standardized HRI symptom questionnaires and physiological monitoring can aid in early detection to prevent more serious health issues, allow comparison across settings, and support interventions to mitigate heat-related occupational health risks.
Dyslipidemia in Lebanese children and adolescents: parents' knowledge and practices.
Hamadeh K, Boulos M, Atallah B … +4 more , Hamdan MB, Maddah D, Ghorayeb N, Yared MG
BMC Public Health · 2026 Jun · PMID 42343240 · Full text
BACKGROUND: Pediatric dyslipidemia is a common metabolic disorder worldwide, especially in Lebanon, and is an early risk factor for cardiovascular disease. Parents play a crucial role in prevention, screening, and manage...
BACKGROUND: Pediatric dyslipidemia is a common metabolic disorder worldwide, especially in Lebanon, and is an early risk factor for cardiovascular disease. Parents play a crucial role in prevention, screening, and management, but their knowledge and practices remain poorly studied. METHODS: A cross-sectional questionnaire-based study was conducted between March and November 2025 among parents of school-aged children from eight schools in Greater Beirut and Mount Lebanon. An electronic questionnaire was used to collect sociodemographic data and to assess parents' knowledge (using a composite score) and practices regarding dyslipidemia. Factors associated with knowledge levels and their relationship with parental practices were also examined. RESULTS: A total of 946 parents were included (861 women and 85 men) with a mean age of 43.9 ± 6.2 years, 94.1% had a university education, and 11.6% were healthcare professionals. Among them, 42.4% had heard of pediatric dyslipidemia, mainly through the media (25.2%) and healthcare professionals (24.4%). The mean knowledge score was 14.1 ± 4.4 out of 23. Blood test-based lipid screening for dyslipidemia in children had been performed by only 6.7% of parents. The independent determinants of a higher knowledge score were female gender, university education, healthcare professional status, and having heard of pediatric dyslipidemia (p < 0.001, p = 0.007, p < 0.001, p < 0.001, respectively). In addition, higher knowledge scores were significantly associated with favorable preventive practices, including implementation of healthy eating habits (p = 0.02) and lipid screening in children (p < 0.001). CONCLUSION: Parents demonstrated moderate knowledge levels. The association between knowledge level and the adoption of favorable preventive measures suggests that educational campaigns targeting parents and health care professionals could play a role in promoting healthier practices.
Evaluating AI-assisted sign language recognition as a digital health intervention to improve communication access for people who are deaf.
Azizah DF, Handayani AN, Wibawa AP
Public Health · 2026 Jun · PMID 42341733 · Publisher ↗
OBJECTIVES: Communication barriers experienced by people who are deaf remain a persistent public health challenge, particularly in healthcare settings where effective interaction is essential for service quality, patient...
OBJECTIVES: Communication barriers experienced by people who are deaf remain a persistent public health challenge, particularly in healthcare settings where effective interaction is essential for service quality, patient safety, and equity. This study aimed to evaluate an artificial intelligence (AI)-assisted sign language recognition system as a pre-implementation digital health intervention to improve access to health communication for people with hearing loss. STUDY DESIGN: Pre-implementation quantitative system evaluation. METHODS: This study employed a quantitative evaluative design to assess the feasibility of an AI-assisted sign language recognition system using a British Sign Language (BSL) alphabet image dataset. System performance was evaluated across four data partitioning scenarios using multiple model configurations. Performance metrics, including precision, recall, F1-score, mean Average Precision (mAP), and inference time, were interpreted as indicators of feasibility, reliability, and responsiveness relevant to health communication contexts. Descriptive analysis was conducted to examine performance consistency across scenarios. RESULTS: Across all evaluation scenarios, the system demonstrated consistently high performance and stable responsiveness, indicating reliable recognition of sign language gestures under varying data configurations. Performance consistency across scenarios suggests that system feasibility was not dependent on a single data split configuration. All model variants achieved performance levels considered adequate for supporting basic sign language-based communication, with expected trade-offs between recognition accuracy and response time. CONCLUSIONS: From a public health perspective, the findings indicate that AI-assisted sign language recognition systems are feasible as complementary digital health communication tools, particularly in settings with limited access to professional interpreters. While this study does not assess clinical outcomes or real-world implementation, it provides early-stage evidence to inform future implementation-based evaluations and policy considerations aimed at promoting more inclusive and equitable healthcare services for deaf people.
The relationship between occupational balance and physical activity level, physical fitness, and body composition in older adults.
Elmas Ö, Cemali M
BMC Public Health · 2026 Jun · PMID 42337733 · Full text
OBJECTIVES: The aim of this study is to compare occupational balance, physical fitness, and body composition parameters according to physical activity levels in older adults and to examine the relationships between occup...
OBJECTIVES: The aim of this study is to compare occupational balance, physical fitness, and body composition parameters according to physical activity levels in older adults and to examine the relationships between occupational balance and other variables. METHODS: This cross-sectional study included a total of 150 older adults aged 65-75 years. Participants were classified according to their International Physical Activity Questionnaire-Short Form (IPAQ-SF) scores as inactive (n = 51), minimally active (n = 50), and active (n = 49). Occupational balance was assessed using the Occupational Balance Questionnaire-11 Turkish (OBQ11-T). Physical fitness level was assessed using the Timed Up and Go Test (TUG) and hand grip strength measured with a Jamar dynamometer (Sammons Preston, USA). For body composition assessment, skeletal muscle mass and body mass index (BMI) were measured using an InBody 120 device (InBody Co., Ltd., Seoul, Korea). Occupational balance, physical fitness, and body composition parameters were compared among older adults according to their physical activity levels. In addition, the relationships between occupational balance, physical activity, physical fitness, and body composition were examined in all participants. RESULTS: According to IPAQ-SF classification, significant differences were found in occupational balance, physical fitness, and body composition among inactive, minimally active, and active older adults (p < 0.001). Older adults with higher levels of physical activity demonstrated higher occupational balance, greater hand grip strength, greater skeletal muscle mass, shorter TUG durations, and lower BMI values. Regression model results showed that physical activity level, functional mobility, and skeletal muscle mass together explained approximately 52% of the total variation in occupational balance level (Adjusted R² = 0.520). In addition, physical activity level, TUG duration, and skeletal muscle mass were found to be independently associated with OBQ11-T scores (p < 0.05). CONCLUSION: Older adults with higher levels of physical activity were found to have higher occupational balance levels, hand grip strength, functional mobility, and skeletal muscle mass, while their BMI values were lower. Furthermore, physical activity level, functional mobility, and skeletal muscle mass were found to be significantly associated with occupational balance. The findings indicate that occupational balance is an important parameter that should be assessed in older adults along with physical health, physical fitness, and activity participation.
Algorithmic recommendation and adolescent mental health: a grounded theory study of social and commercial determinants.
Winstone L, Parsonage J, Cross L … +5 more , Muir C, Randhawa A, MacArthur G, Garavini E, Asiedu-Addo E
BMC Public Health · 2026 Jun · PMID 42337729 · Full text
BACKGROUND: Existing digital mental health research tends to frame social media in individualistic terms, emphasising screen-time, self-control, or personal vulnerability. Less attention has been given to the role of alg...
BACKGROUND: Existing digital mental health research tends to frame social media in individualistic terms, emphasising screen-time, self-control, or personal vulnerability. Less attention has been given to the role of algorithmic recommendation systems in population mental health. We aimed to develop a grounded theory of how adolescents experience algorithmically curated feeds and how these experiences relate to mental health and wellbeing. METHODS: We conducted semi-structured, photo-elicitation interviews with 27 UK young people aged 14-19 years. Participants shared screenshots from their TikTok 'For You' and Instagram 'Explore' pages to support discussion of algorithmically recommended content. Data were analysed using constructivist grounded theory, with iterative coding, memo-writing, and theoretical sampling. RESULTS: We identify algorithmically structured exposure as a central mechanism through which engagement-driven recommendation systems shape young people's digital mental health. Algorithms organised what content participants encountered, how frequently, and with what emotional intensity, within broader socioecological contexts. Three interlocking processes sustained exposure; algorithmic reinforcement of engagement, emotional feedback loops between mood and recommendations, and a persistent sense of limited control despite high awareness. Although participants developed adaptive strategies and algorithmic literacy, these were unevenly distributed and often insufficient within engagement-driven, profit-oriented systems. CONCLUSIONS: Digital mental health may be produced through interactions between individual capacities, social environments, and commercially driven platform design. Protecting population mental health therefore requires multi-level action, including developmentally appropriate social media and algorithmic literacy education alongside structural reforms to recommendation systems, transparency, and platform governance.
Navigating sexuality information: A comparative study on the actual and preferred sources by young people in Uganda's island communities.
Kirwana VB, Kabagenyi A, Ndugga P … +3 more , Misinde C, Wandera SO, Kakuba C
BMC Public Health · 2026 Jun · PMID 42337715 · Full text
BACKGROUND: Young people's access to sexuality information plays a central role in shaping sexual behaviour. Sexuality information comes from various sources, yet young people often lack access to their preferred and tru...
BACKGROUND: Young people's access to sexuality information plays a central role in shaping sexual behaviour. Sexuality information comes from various sources, yet young people often lack access to their preferred and trusted sources. This paper examined the gap between actual and preferred sources of sexuality information, critical for inclusive and responsive interventions in the underserved, yet high-risk settings. METHODS: A cross-sectional mixed-methods study, guided by the Information-Motivation-Behavioral Skills (IMB) and bioecological models, was conducted among young people aged 10-24 years in Kkoome islands communities. A survey of 569 young people and six focus group discussions were conducted. McNemar tests were used to compare differences between actual and preferred sources of sexuality information by topic, and the rationale for preference was analyzed thematically. RESULTS: Significant differences (p < 0.001) were observed between actual and preferred sources across all sources. Books and recordings were consistently among the most preferred sources (48.2%-49.2%) despite minimal actual use (0.2%-0.4%), while healthcare workers were highly preferred for human body development (46.6% vs. 15.1%) and pregnancy, HIV, and STIs (47.3% vs. 16.2%) topics. Biological parents, teachers, and friends/confidants were also preferred significantly more than they were accessed (all p < 0.001). For higher preference, young people valued privacy, emotional comfort, flexibility, accuracy, and trust in books and recordings; professional expertise and structured guidance from healthcare workers and teachers; and accessibility and emotional support from parents and other close social networks, consistent with the IMB constructs. CONCLUSION: The pronounced mismatch between young people's actual and preferred sources of sexuality information indicates a substantial unmet demand for trusted, structured, and young people-responsive sexuality information and education in Uganda's island communities. Strengthening access to books and recordings, the capacity of healthcare workers, and parents to provide sexuality information, and aligning interventions with IMB components may enhance informed decision-making and improve sexual and reproductive health outcomes among young people in high-risk and underserved settings.
Factors associated with COVID-19 preventive behaviors among patients with hypertension and type 2 diabetes in southern Iran: a structural equation modeling study.
Shamsnia SA, Mobasheri N, Kaveh MH … +2 more , Nazari M, Karimi M
BMC Public Health · 2026 Jun · PMID 42337710 · Full text
BACKGROUND: During the transitional phase of the COVID-19 pandemic-when vaccines were available but coverage remained low-individuals with chronic diseases such as hypertension and type 2 diabetes faced elevated risks, y...
BACKGROUND: During the transitional phase of the COVID-19 pandemic-when vaccines were available but coverage remained low-individuals with chronic diseases such as hypertension and type 2 diabetes faced elevated risks, yet their adherence to nonpharmaceutical preventive behaviors was uneven, and the psychological determinants of this variability remained unclear. This study examined the HBM constructs as correlates of COVID-19 preventive behaviors among this high-risk population in southern Iran. METHODS: A cross-sectional survey was conducted among 338 patients (mean age = 43.83 ± 9.79 years) in Kavar, Iran, using a validated HBM-based questionnaire (CVR > 0.6, CVI > 0.79, Cronbach's α = 0.65-0.92). Structural equation modeling (SEM) was performed using AMOS 24. RESULTS: SEM demonstrated good fit (χ/df = 1.46, CFI = 0.995, RMSEA = 0.037). Perceived barriers exerted the strongest negative association with preventive behaviors (β = -0.311, p < 0.001). Perceived severity (β = 0.206) and cues to action (β = 0.203) were significant positive factors. Perceived benefits (β = 0.150) had a modest positive association, while perceived susceptibility and self-efficacy were nonsignificant. CONCLUSION: Among the studied diabetic and hypertensive patients, practical and psychological barriers- not lack of knowledge or risk awareness-were the primary determinants of behavior. The non-significance of perceived susceptibility and self-efficacy may suggest that due to the prolonged nature of the COVID-19 pandemic, behavior was more heavily influenced by persistent structural barriers than by individual beliefs or confidence. Public health interventions should therefore prioritize reducing access-related, financial, and sociocultural barriers (e.g., mask affordability, misinformation) rather than solely promoting risk perception. These findings may offer actionable insights for epidemic preparedness strategies in similar regional low-resource settings, though validation across diverse contexts remains important.
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