Frontiers in Public Health最新文献

{"title":"Latent profile analysis of adolescent quality of life and its associations with lifestyle behaviors.","authors":"Xiaomin Song, Zhiwen Yang","doi":"10.3389/fpubh.2026.1910401","DOIUrl":"10.3389/fpubh.2026.1910401","url":null,"abstract":"<p><strong>Background: </strong>Adolescent quality of life (QoL) is critical for development, yet its heterogeneity is underexplored. We aimed to identify latent QoL profiles and examine associations with lifestyle behaviors.</p><p><strong>Methods: </strong>Latent profile analysis (LPA) was performed on 7,244 Chinese adolescents (49.3% boys) using the Quality of Life Scale for Children and Adolescents. Multinomial logistic regression tested links between QoL profiles and sleep duration, physical activity, screen time, ultra-processed foods (UPF), and minimally processed foods (MPF), adjusting for demographics.</p><p><strong>Results: </strong>Five profiles emerged: Low QoL (C1), Health-advantaged (C2), Moderate QoL (C3), Low Physical and Psychological Health (C4), and High QoL (C5). Relative to C3, longer sleep duration was associated with lower odds of C1 (OR = 0.83) and C2 (OR = 0.74), but higher odds of C4 (OR = 1.26) and C5 (OR = 1.27). Higher physical activity was associated with lower odds of C2 (OR = 0.71) and higher odds of C4 (OR = 1.41) and C5 (OR = 1.62). Screen time was associated with lower odds of C2 and higher odds of C4. Greater MPF intake was associated with lower odds of C1 (OR = 0.70) and C2 (OR = 0.61), and higher odds of C4 (OR = 1.78) and C5 (OR = 1.35). Higher UPF intake was associated with lower odds of C1 (OR = 0.25), C2 (OR = 0.54), and C5 (OR = 0.56), and higher odds of C4 (OR = 1.45).</p><p><strong>Conclusion: </strong>Relative to the Moderate QoL class, lifestyle behaviors showed distinct associations with QoL profiles. Sleep duration, physical activity, and MPF intake were associated with lower odds of the Health-advantaged class and higher odds of the Low Physical and Psychological Health and High QoL classes. UPF intake was inversely associated with Low QoL, Health-advantaged, and High QoL classes, and positively associated with the Low Physical and Psychological Health class. These findings highlight the heterogeneity of adolescent QoL and suggest that interventions should be tailored to specific QoL profiles.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1910401"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention among nurses: a structural equation modeling study.","authors":"Mengyun Peng, Jiqin Ma, Wenyu Shi, Suyan Chen, Zixuan Zhang, Xiaoling Zhu","doi":"10.3389/fpubh.2026.1962028","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1962028","url":null,"abstract":"<p><strong>Background: </strong>The interrelationships between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention remain insufficiently understood in nursing populations.</p><p><strong>Objective: </strong>This study examined the associations between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted involving 511 nurses. Composite scores from the Work Productivity and Activity Impairment (WPAI) questionnaire, the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), the Quality of Nursing Care Tool, and the Nurse Retention Intention Scale were analyzed using an observed-composite path structural equation modeling (SEM) approach. Indirect effects were estimated using 5,000 bootstrap resamples with percentile-based 95% confidence intervals.</p><p><strong>Results: </strong>Presenteeism was positively associated with burnout (β = 0.262, <i>p</i> < 0.001) and negatively associated with the quality of nursing care (β = -0.250, <i>p</i> < 0.001) and retention intention (β = -0.334, <i>p</i> < 0.001). Burnout was negatively associated with the quality of nursing care (β = -0.177, <i>p</i> < 0.001) and retention intention (β = -0.179, <i>p</i> < 0.001). Bootstrap analyses indicated indirect associations between presenteeism and productivity loss and both outcomes through burnout. The model showed an acceptable but imperfect fit: χ² (4) = 13.151, CFI = 0.959, TLI = 0.877, RMSEA = 0.067, and SRMR = 0.043.</p><p><strong>Conclusion: </strong>Higher presenteeism was statistically associated with lower retention intention and poorer nursing care quality, both directly and indirectly, through burnout. Health-related productivity loss showed indirect associations with both outcomes through burnout.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1962028"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticipating El Niño-related health risks in Latin America and the Caribbean: from climate information to public health preparedness.","authors":"Esteban Ortiz-Prado, Jorge Vasconez-Gonzalez, Rasa Zalakeviciute, Juan S Izquierdo-Condoy","doi":"10.3389/fpubh.2026.1959622","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1959622","url":null,"abstract":"<p><p>El Niño is a recurrent mode of tropical Pacific climate variability with major public health implications for Latin America and the Caribbean. Its development is partly driven by the Bjerknes feedback, a coupled ocean-atmosphere process in which weakened equatorial trade winds reduce coastal upwelling and allow warm surface waters to shift eastward. Warming of the central and eastern tropical Pacific can reshape regional rainfall and temperature patterns, increasing the likelihood of floods, droughts, wildfires, food-system disruption, and health-service interruption in locations with established ENSO teleconnections. This narrative review synthesizes evidence on the environmental and health pathways through which El Niño may affect populations in Latin America and the Caribbean. We distinguish evidence directly linking health outcomes to ENSO or Coastal El Niño from evidence derived from floods, droughts, wildfires, and other hydrometeorological disasters without formal attribution to ENSO. The latter is used to characterize plausible health pathways and preparedness needs rather than ENSO-specific causal effects. Potential consequences include immediate mortality and injury, waterborne and vector-borne infections, disruption of chronic disease care, food insecurity, undernutrition, toxic exposures, psychological distress, and prolonged health-system burden. The timing and persistence of these effects are context-dependent; preparedness and response priorities are therefore organized by operational needs rather than fixed post-event intervals. As of August 2026, authoritative forecasts indicated that El Niño was present and strengthening, providing a current illustration of why anticipatory preparedness is necessary while not guaranteeing any specific regional impact. Early warning, flood-risk mapping, water, sanitation, and hygiene interventions, epidemiological and entomological surveillance, continuity of health services, and community-centered risk communication should therefore be adapted to local forecasts, vulnerabilities, and surveillance data.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1959622"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary diversity and healthy life expectancy among Chinese older adults: a multistate analysis of CLHLS, 2008-2018.","authors":"Jiaqi Shi, Shimin Su, Yumeng Zhang, Tingting Xu, Huiling Dong, Bingyi Wu, Zhenhua Feng","doi":"10.3389/fpubh.2026.1922052","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1922052","url":null,"abstract":"<p><strong>Objective: </strong>This study estimated healthy life expectancy (HLE) among Chinese older adults across varying levels of dietary diversity, and examined sex and urban-rural differences.</p><p><strong>Methods: </strong>Drawing on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, data on 9,953 older adults aged 65 years and older were included. Transition probabilities among health statuses were estimated. Further, a microsimulation model was used to calculate life expectancy (LE), HLE, and HLE/LE for older adults with varying levels of dietary diversity. Sex and urban-rural differences were also examined descriptively. <i>Z</i>-tests were applied to determine whether differences in HLE within subgroups were statistically significant (<i>p</i> < 0.05).</p><p><strong>Results: </strong>Compared with older adults with low dietary diversity, those with high dietary diversity exhibited a higher probability of transitioning from health to disability. However, they also exhibited a greater likelihood of recovering from disability and returning to health. Additionally, older adults with high dietary diversity exhibited lower transition probabilities to death from both health and disability. Across all age groups, older adults with high dietary diversity had higher LE and HLE values, albeit with lower HLE/LE ratios. At age 65, the difference in LE between the low- and high-dietary-diversity groups was 1.26 years [14.54 years (95% CI: 14.42-15.34) versus 15.80 years (95% CI: 15.55-16.17)]. Meanwhile, the corresponding difference in HLE was 0.90 years [13.32 years (95% CI: 13.25-13.95) versus 14.22 years (95% CI: 13.91-14.58)]. Stratified analyses further indicated that differences in HLE between dietary diversity groups were consistently observed across sex and urban-rural residence groups. Descriptively, the differences appeared larger among men and urban residents.</p><p><strong>Conclusion: </strong>Higher dietary diversity was associated with a higher probability of transition from disability to health, lower probabilities of transition from either health or disability to death, and higher LE and HLE. These associations were observed across sex and urban-rural residence groups. Descriptively, larger differences in HLE between dietary diversity groups were observed among males and urban residents.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1922052"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural intentions to limit social media use among nursing students in Saudi Arabia: a cross-sectional theory of planned behaviour and structural equation modelling study.","authors":"Asrar S Almutairi, Rayhanah R Almutairi, Abdulaziz M Alodhailah, Hend N Almutairi, Waleed M Alshehri, Mohammed Almutairi","doi":"10.3389/fpubh.2026.1958042","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1958042","url":null,"abstract":"<p><strong>Background: </strong>Social media addiction (SMA) carries professional risks for nursing students, yet determinants of their intention to limit social media use are poorly characterised. Using the Theory of Planned Behaviour (TPB), this study examined how attitudes, subjective norms, and perceived behavioural control relate to this intention in Saudi nursing students.</p><p><strong>Methods: </strong>A cross-sectional survey of 258 nursing students (response rate 91.5%), recruited by stratified random sampling from nursing colleges in Riyadh, Saudi Arabia, was conducted in April-May 2026. Participants completed the Bergen Social Media Addiction Scale (BSMAS) and a 17-item TPB questionnaire. Analyses comprised confirmatory factor analysis (CFA), hierarchical regression, and structural equation modelling (SEM).</p><p><strong>Results: </strong>In total, 48.4% scored at or above the BSMAS threshold for probable SMA, and perceived behavioural control scored lowest (2.62/5). The four-factor CFA fitted well (CFI = 0.984; RMSEA = 0.029). The final regression model explained 41.2% of variance in intention, with perceived behavioural control the largest standardised predictor (<i>β</i> = 0.43), followed by attitudes (<i>β</i> = 0.22) and subjective norms (<i>β</i> = 0.13). In SEM, perceived behavioural control (<i>β</i> = 0.57) and attitudes (<i>β</i> = 0.28) were associated with intention; subjective norms were associated with attitudes (<i>β</i> = 0.57) but not directly with intention.</p><p><strong>Conclusion: </strong>Perceived behavioural control was the least strongly held TPB antecedent but the most strongly associated with intention. As the design was cross-sectional and measured only intention, these associations identify candidate targets for nursing education interventions, not causes of behaviour change. Longitudinal studies measuring actual use are needed.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1958042"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment decisions, not patient demographics, predict a positive pregnancy test after autologous IVF: a retrospective cohort study from northern India.","authors":"Rajesh Kamath, Gwendolen Rodrigues, Saurabh Singh, Nahima Akthar, Rakshitha R Shenoy, Sandesh Kini","doi":"10.3389/fpubh.2026.1922605","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1922605","url":null,"abstract":"<p><strong>Background: </strong>Infertility affects about one in six people worldwide over a lifetime, and <i>in vitro</i> fertilisation (IVF) is the mainstay of treatment for many of them. In India most IVF is delivered in private clinics and paid for out of pocket. The question is which factors determine whether an IVF cycle produces a pregnancy: the characteristics a patient arrives with, or the treatment decisions made once she is there.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 288 women who underwent IVF at a private fertility centre in Faridabad, Haryana, between April 2023 and October 2024. One record was analysed per woman, taken from her most recent cycle. The outcome was a positive serum beta-human chorionic gonadotropin (beta-hCG) test, the last outcome routinely documented at the centre. Donor-oocyte (recipient) cycles were analysed separately from autologous cycles, because success in a donor cycle depends on the donor rather than on the patient. Categorical associations were tested using Fisher's exact test. Independent predictors were identified using multivariable binomial logistic regression.</p><p><strong>Results: </strong>Seventy-seven cycles (26.7%) used donor oocytes and 211 (73.3%) were autologous. The positive beta-hCG rate was 70.6% in autologous cycles and 54.5% in donor cycles (<i>p</i> = 0.016). Within autologous cycles, two treatment decisions were associated with the outcome: intracytoplasmic sperm injection (ICSI) versus conventional IVF (76.0% versus 46.2%, <i>p</i> < 0.001) and frozen versus fresh embryo transfer (74.9% versus 51.3%, <i>p</i> = 0.006). No demographic characteristic was associated with the outcome. After adjustment (<i>N</i> = 210), conventional IVF carried lower odds than ICSI (adjusted odds ratio 0.16, 95% CI 0.06-0.42, <i>p</i> < 0.001) and frozen transfer higher odds than fresh (adjusted odds ratio 2.80, 95% CI 1.30-6.04, <i>p</i> = 0.009). Oocyte yield was marginally associated (adjusted odds ratio 1.11 per oocyte, 95% CI 1.00-1.22, <i>p</i> = 0.041). In absolute terms, ICSI corresponded to 32.5 percentage points and frozen transfer to 18.5 percentage points. Age was not associated with the outcome, although autologous cycles spanned only 22-42 years and the study was underpowered to detect age effects.</p><p><strong>Conclusion: </strong>In autologous cycles at this centre, treatment decisions rather than patient demographics predicted a positive pregnancy test. The cohort was socioeconomically narrow and drawn from a single private centre. The absence of demographic effects should therefore not be read as evidence that social position does not matter. Social position might operate earlier, in determining who reaches a fertility centre at all.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1922605"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-stratified association between systemic immune-inflammation index and gallstone risk: a cross-sectional study in a Chinese adult population.","authors":"Yajie Teng, Daiyi Zhang, Yingxue Yang, Lijuan Qian, Qinghua Wang","doi":"10.3389/fpubh.2026.1923451","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1923451","url":null,"abstract":"<p><strong>Introduction: </strong>Gallstone disease is a prevalent biliary condition with rising incidence in China, driven by changes in lifestyle, metabolism, and inflammation. The systemic immune-inflammation index (SII), a composite marker reflecting immune and inflammatory status, has been linked to various chronic diseases. However, its association with gallstone in the general Chinese population remains unclear. This study aimed to investigate the relationship between SII and gallstone risk in a large adult cohort.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted among 55,241 adults undergoing health screening. Gallstone was diagnosed via abdominal ultrasonography. SII was log-transformed (Ln-SII) to correct for skewness. Logistic regression models assessed the association between Ln-SII and gallstone risk with progressive adjustments. Smooth curve fitting and two-piece wise linear regression were used to explore potential nonlinear associations. Subgroup analyses were performed by sex.</p><p><strong>Results: </strong>Gallstone was identified in2,606 participants (4.72%). After full adjustment, higher Ln SII was significantly associated with increased gallstone risk (OR = 1.10, 95% CI: 1.01-1.21, <i>p</i> = 0.0372). In sex-stratified analyses, a significant linear association was found in females (OR = 1.21, 95% CI: 1.06-1.39, <i>p</i> = 0.0059), whereas a nonlinear association emerged in males, with increased risk only above an Ln-SII threshold of 6.52. Despite these sex-specific patterns, no statistically significant interaction between sex and SII was observed.</p><p><strong>Conclusion: </strong>Higher Ln SII was associated with increased gallstone risk, and sex-stratified analyses revealed distinct association patterns. However, no significant interaction between sex and SII was observed, suggesting that these differences may not represent effect modification. Further studies are needed to clarify the underlying mechanisms.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1923451"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous trajectories of oral frailty and their determinants in older patients receiving dental implants: a longitudinal study.","authors":"Ying Zhang, Nan Lu, Mengyao Liang, Qiufeng Zhu","doi":"10.3389/fpubh.2026.1891290","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1891290","url":null,"abstract":"<p><strong>Objective: </strong>To describe distinct trajectory patterns of oral frailty after implant-supported prosthesis delivery in older patients and to identify associated factors.</p><p><strong>Methods: </strong>This prospective longitudinal cohort study consecutively enrolled 211 older patients who completed implant-supported prosthesis delivery at Nantong Stomatological Hospital and Haoting Dental Clinic between January 1 and April 30, 2025. Oral frailty was assessed using the adapted seven-item version of the Oral Frailty Index-8 (OFI-8, 7-item version; score range 0-9) at baseline (T0, prosthesis delivery) and at 3, 6, 9, and 12 months post-delivery (T1-T4). Distinct trajectories were identified using latent class growth modeling (LCGM). Multivariable multinomial logistic regression was used to analyze factors associated with trajectory membership.</p><p><strong>Results: </strong>Three distinct oral frailty trajectories were identified: (1) Rapid Improvement-Stable Pattern (Class 1, <i>n</i> = 90, 42.7%), characterized by a sharp decline in OFI-8 scores immediately after prosthesis delivery followed by sustained low levels; (2) Gradual Improvement-Plateau Pattern (Class 2, <i>n</i> = 74, 35.1%), showing a gradual decline followed by a plateau; and (3) Persistent High-Risk Pattern (Class 3, <i>n</i> = 47, 22.2%), with scores remaining elevated throughout the 12-month observation period. Multivariable multinomial logistic regression analysis revealed that age (aOR = 1.12, 95% CI: 1.04-1.21), number of medications (aOR = 1.25, 95% CI: 1.05-1.49), and number of missing teeth (aOR = 1.09, 95% CI: 1.02-1.16) were independently associated with membership in Class 3. Bootstrap validation supported the robustness of the model. None of these variables showed statistical significance in distinguishing Class 2 from Class 1.</p><p><strong>Conclusion: </strong>Oral frailty trajectories in older patients with dental implants are heterogeneous. Older age, polypharmacy, and a greater number of missing teeth were independently associated with membership in the persistent high-risk trajectory, suggesting that these factors may help identify patients requiring prioritized follow-up.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1891290"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A copula-based geo-additive approach to childhood health outcomes in five West African nations.","authors":"Reshav Beni, Shaun Ramroop, Faustin Habyarimana","doi":"10.3389/fpubh.2026.1871312","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1871312","url":null,"abstract":"<p><strong>Background: </strong>Anemia and malnutrition are major contributors to child morbidity and mortality in Sub-Saharan Africa, particularly in West Africa where their prevalence remains high due to multifaceted socio-economic and environmental factors. Malnutrition, as defined by WHO, includes both undernutrition and overnutrition and is linked to increased risk of non-communicable diseases. Anemia, characterized by low hemoglobin levels, impairs oxygen transport and is associated with developmental delays and increased mortality in children. Given their interrelated nature, a joint modeling approach is essential to understand shared risk factors and inform targeted interventions.</p><p><strong>Methods: </strong>This study analyses pooled DHS data from Gabon, Gambia, Liberia, Mauritania, and Nigeria to identify determinants of anemia and malnutrition. Malnutrition is measured using the Composite Index of Anthropometric Failure (CIAF), which integrates stunting, underweight, and wasting for a comprehensive assessment. A copula-based geo-additive joint model is employed to simultaneously examine both conditions, accounting for spatial variation and interdependence. This approach offers a novel framework for informing policy and improving child health outcomes in West Africa.</p><p><strong>Results: </strong>Key predictors of malnutrition and anemia were identified across five West African countries. Malnutrition risk was significantly associated with maternal education, water source, household wealth, child age, gender, and feeding practices. Notably, children from households using non-bottled water sources and those given milk were at higher risk. Several water-source categories were positively associated with malnutrition relative to bottled/sachet water; however, these associations may reflect socioeconomic and residential differences in the reference group and warrant cautious, non-causal interpretation. Anemia risk was significantly lower among urban children and those whose mothers had higher education. Fortified food and egg consumption were protective against anemia, while poverty and poor water sources increased risk. These findings highlight distinct and overlapping determinants of both conditions.</p><p><strong>Conclusion: </strong>This study highlights the complex interplay of socioeconomic, environmental, and dietary factors influencing malnutrition and anemia among children in West Africa. Key predictors include maternal education, household wealth, water source, and feeding practices, with notable geographic variation. Addressing these challenges requires integrated, multisectoral strategies focused on improving maternal education, access to safe water, dietary diversity, and poverty reduction. Geographically targeted interventions and strengthened health systems are essential.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1871312"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived academic demands and psychological distress among Chinese university students: structural associations involving chronic time pressure and leisure-time physical activity.","authors":"Zhikai Gong, Gang Shen, Zhuang Zhou","doi":"10.3389/fpubh.2026.1984531","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1984531","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the direct and specific indirect associations among perceived academic demands, chronic time pressure, leisure-time physical activity, and psychological distress in Chinese university students.</p><p><strong>Methods: </strong>A cross-sectional online survey included 1,390 undergraduates from 10 higher-education institutions in Jiangsu Province, China. Perceived academic demands, chronic time pressure, and psychological distress were modeled as latent variables, whereas log-transformed leisure-time physical activity was modeled as an observed variable. Confirmatory factor analysis and covariate-adjusted structural equation modeling were conducted. Specific indirect associations were estimated using 5,000 bootstrap resamples with bias-corrected 95% confidence intervals.</p><p><strong>Results: </strong>The adjusted structural model showed good fit (CFI = 0.966, TLI = 0.959, RMSEA = 0.034, SRMR = 0.024). Perceived academic demands were positively associated with chronic time pressure (β = 0.539) and psychological distress (β = 0.382). Chronic time pressure was positively associated with psychological distress (β = 0.334) and negatively associated with leisure-time physical activity (β = -0.179), whereas leisure-time physical activity was negatively associated with distress (β = -0.097; all <i>p</i> < 0.001). The specific indirect association through chronic time pressure was <i>B</i> = 0.182 (95% bias-corrected CI [0.134, 0.236]), whereas the serial specific indirect association additionally involving leisure-time physical activity was considerably smaller (<i>B</i> = 0.010, 95% bias-corrected CI [0.005, 0.018]).</p><p><strong>Conclusions: </strong>The indirect association through chronic time pressure was substantially larger than the serial indirect association additionally involving leisure-time physical activity, indicating that leisure-time physical activity made only a minimal additional contribution within the concurrent structural model. These findings highlight chronic time pressure as a relevant correlate of student psychological distress and support further investigation of academic time organization alongside opportunities for physical activity. Because the data were cross-sectional, temporal mediation and causal direction cannot be established.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1984531"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}