Frontiers in Public Health最新文献

{"title":"A predictive model to explore risk factors for Henoch-Schönlein purpura nephritis in children: a retrospective cross-sectional study.","authors":"Qianwen Yang, Maoyang Zhang, Zilong Dong, Fang Deng","doi":"10.3389/fpubh.2025.1507408","DOIUrl":"10.3389/fpubh.2025.1507408","url":null,"abstract":"<p><strong>Objective: </strong>The risk factors for Henoch-Schönlein purpura nephritis (HSPN) remain largely unclear, particularly in family environment and vaccination. This study aimed to develop a predictive framework to quantify the risk of HSPN by examining family environmental factors and COVID-19 vaccination outcomes in children with Henoch-Schönlein purpura (HSP) in Anhui, China.</p><p><strong>Methods: </strong>This study retrospectively analyzed 362 children diagnosed with HSP at Anhui Children's Hospital between January 2020 and February 2024. A questionnaire was designed to collect information from enrolled children. For patients with incomplete medical records, parents were contacted via phone or the questionnaire was sent to them to complete the survey. After data collection, the patients were split randomly into a training group and a validation group at a 7:3 ratio, univariate and multivariate logistic regression analyses were performed to identify risk factors for nephritis, and a nomogram was constructed from these factors to provide a visual prediction of the likelihood of nephritis in HSP. The nomogram's performance was evaluated in both the training and validation groups using the area under the receiver operating characteristic (AUC) curve, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The study identified family income/month, age of onset, BMI, number of recurrences, and COVID-19 vaccination status as independent risk factors for HSPN. A nomogram was subsequently developed afterward using these factors. In the training group, the nomogram achieved an area under the curve (AUC) of 0.83 (95% CI: 0.78-0.88), while in the validation group, the AUC was 0.90 (95% CI: 0.84-0.96), demonstrating strong predictive performance. The calibration curve showed that the nomogram's predictions were well-aligned with the actual outcomes. Additionally, DCA indicated that the nomogram provided considerable clinical net benefit.</p><p><strong>Conclusion: </strong>The nomogram offers accurate risk prediction for nephritis in children with HSP, helping healthcare professionals identify high-risk patients early and make informed clinical decisions.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1507408"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772156","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":"Lifestyle factors associated with being overweight and obesity in children and adolescents: a cross-sectional study in Zhejiang, China.","authors":"Xiaoting Pan, Chaoyi Jiang, Wenqing Wang, Jianfeng Lin","doi":"10.3389/fpubh.2025.1551099","DOIUrl":"10.3389/fpubh.2025.1551099","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of overweight and obesity among children and adolescents aged 7 to 17 in China is increasingly concerning. Additionally, there is a notable phenomenon where height does not correspond with weight. This study aimed to investigate the prevalence of overweight and obesity in this demographic, explore associations with lifestyle factors, and propose strategies for health promotion.</p><p><strong>Methods: </strong>This study combines a questionnaire survey with field interviews. Using stratified cluster random sampling, we selected 2,243 primary and middle school students from 49 counties in Zhejiang, China, for the questionnaire survey. Furthermore, we conducted semi-structured interviews with 52 parents.</p><p><strong>Results: </strong>Among the 2,243 participants surveyed, 523 were classified as either overweight or obese, resulting in a detection rate of 23.32%. The prevalence of overweight and obesity was higher in boys compared to girls (25.6% vs. 21.1%, <i>p</i> = 0.01). Additionally, the rates among adolescents and children in urban areas were greater than those in rural areas (25.8% vs. 20.5%, <i>p</i> = 0.003). Logistic regression analysis identified several risk factors for overweight and obesity: male gender (OR = 1.846; CI = 1.287 ~ 2.649; <i>p</i> = 0.001), 7 days/week the highest frequency of fried food consumption per week (OR = 88.293; CI = 49.369 ~ 157.905; <i>p</i> < 0.001), 7 days/week the highest frequency of night snacking (OR = 13.24; CI = 7.176 ~ 24.429; <i>p</i> < 0.001), and diets prefer sweetness (OR = 26.299; CI = 15.073 ~ 45.885; <i>p</i> < 0.001), saltiness (OR = 14.672; CI = 8.972 ~ 23.992; p < 0.001), and spiciness (OR = 1.967; CI = 1.125 ~ 3.438; <i>p</i> = 0.018). Conversely, 7 days/week the highest frequency of moderate-to- vigorous physical activities per week was associated with a lower risk of overweight and obesity (OR = 0.137; CI = 0.057 ~ 0.328; <i>p</i> < 0.001). Notably, 84% of parents reported that their children rarely shared interesting stories during school breaks, highlighting the common occurrence of \"quiet ten minutes\" between classes.</p><p><strong>Conclusion: </strong>The issue of overweight and obesity among children and adolescents in China is significant, particularly among boys in primary schools. An obesogenic environment contributes to this problem, influenced by changes in dietary habits, exercise patterns, and sociocultural factors. Preventing and controlling overweight and obesity among adolescents and children requires the collective efforts from all sectors of society, including government departments, educational institutions, communities and families. Preventative measures should include lifestyle modifications including exercise and dietary adjustments.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1551099"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772193","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":"Association of acrylamide exposure with markers of systemic inflammation and serum alpha-klotho concentrations in middle-late adulthood.","authors":"Lin Gan, Jiaoyang Wang, Kang Qu, Wei Jiang, Yuhong Lei, Ming Dong","doi":"10.3389/fpubh.2025.1457630","DOIUrl":"10.3389/fpubh.2025.1457630","url":null,"abstract":"<p><strong>Background: </strong>Acrylamide (AA) is a ubiquitous environmental contaminant linked to systemic inflammation and oxidative stress in animal studies; however, the epidemiological evidence is still lacking. This study aimed to evaluate the association of AA exposure with markers of systemic inflammation and serum concentrations of an anti-aging protein, <i>α</i>-klotho.</p><p><strong>Methods: </strong>The study used data of 1,545 adults aged 40-79 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Internal AA exposure was assessed using hemoglobin adducts of acrylamide and glycidamide (HbAA and HbGA, respectively), the sum of HbAA and HbGA (HbAA + HbGA), and the ratio of HbGA and HbAA (HbGA/HbAA). Two novel indicators, systemic immune-inflammation index (SII) and system inflammation response index (SIRI), were calculated using the lymphocyte, platelet, neutrophil, and monocyte counts. The serum concentration of soluble <i>α</i>-klotho was measured using enzyme-linked immunosorbent assay. Multivariable linear regression models were used to estimate the associations of AA hemoglobin biomarkers with systemic inflammation indicators and serum concentration of <i>α</i>-klotho.</p><p><strong>Results: </strong>Each one-unit increase in ln-transformed HbAA, HbGA, and HbAA+HbGA was associated with an increase in SII in models adjusted for age, sex, and race/ethnicity [regression coefficient (<i>β</i>) = 32.16, 95% confidence interval (CI): 3.59, 60.73; β =36.37, 95% CI: 5.59, 67.15; and β = 37.17, 95% CI: 6.79, 67.55, respectively]. However, the associations were no longer significant after additional adjustment for lifestyle factors. Higher HbAA and HbAA+HbGA predicted lower serum <i>α</i>-klotho concentrations (<i>β</i> = -35.76 pg./mL, 95% CI: -63.27, -8.25; β = -33.82 pg./mL, 95% CI: -62.68, -4.96, respectively).</p><p><strong>Conclusion: </strong>The hemoglobin adducts of AA parameters, as biomarkers of internal AA exposure, were associated with reduced serum concentrations of <i>α</i>-klotho among the United States population in their middle-late adulthood. The findings indicated that exposure to AA may have impacts on the molecular pathways of aging and related diseases by influencing <i>α</i>-klotho concentrations.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1457630"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772166","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":"Sedentary behavior is associated with systemic immune-inflammation index and systemic inflammation response index levels: a cross-sectional analysis of the NHANES 2011-2018.","authors":"Xian Wu, Lin Zhong, Yuehong Hu, Lingying Ruan, Kaiyu Zhou, Hanmin Liu, Lina Chen","doi":"10.3389/fpubh.2025.1431065","DOIUrl":"10.3389/fpubh.2025.1431065","url":null,"abstract":"<p><strong>Background: </strong>Sedentary behavior (SB), has been closely linked to numerous detrimental health effects. While the individual and combined impacts of such behaviors on immune-inflammatory responses remain ambiguous, innovative indices like the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI) are considered as comprehensive tools to assess inflammation. This study endeavors to elucidate the potential correlations between SB, SII, and SIRI, thereby contributing to a deeper understanding of how lifestyle choices influence systemic inflammation profiles.</p><p><strong>Methods: </strong>This research entailed a retrospective, cross-sectional examination of 39,156 adult participants sourced from 2011 to 2018 of the National Health and Nutrition Examination Survey (NHANES). SASB was used as the independent variable and SII and SIRI as dependent variables. Weighted linear regression was used to assess the correlation between the independent and dependent variables. Smoothed curve fitting and threshold effect analyses were also performed to determine to identify if there was a non-linear relationship between SII and SIRI and SASB. Subgroup analyses were then performed to identify sensitive populations.</p><p><strong>Results: </strong>A total of 15,789 individuals ≥18 years old were included. Elevated SB levels were correlated with a rise in SII levels in three models (<i>p</i> < 0.05). There was a positive correlation of SB and SII (as a continuous variable). At the same, higher SB was associated with increased SIRI level in three models (<i>p</i> < 0.05). However, there was a non-linear correlation between SB and SIRI with 485 min (min) being the inflection point.</p><p><strong>Conclusion: </strong>Among US adults, SII and SIRI exhibited a positive correlation with heightened SB, underscoring the need for more extensive, prospective studies to further elucidate SB's impact on these inflammation indices.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1431065"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771992","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":"Analyzing the perception of happiness among Korean medical students using a concept mapping methodology: a cross-sectional study.","authors":"Jaemu Lee, Kyung Hye Park, Sangmi Teresa Lee","doi":"10.3389/fpubh.2025.1476022","DOIUrl":"10.3389/fpubh.2025.1476022","url":null,"abstract":"<p><strong>Introduction: </strong>Happiness differs according to population groups and cultures. For medical students, more studies have focused on negative emotions than on happiness. This study explored the overall perceptions and standards of medical students to analyze the concept of happiness from various perspectives in the Korean context.</p><p><strong>Methods: </strong>A concept mapping analysis comprising five stages was conducted with medical students at Yonsei University's Wonju College of Medicine in South Korea. Focus questions were generated in Phase 1, and 23 students participated in individual brainstorming in Phase 2. Fifty statements were confirmed in Phase 3. Sixteen students assigned an importance score to each statement and participated in the individual sorting of statements and naming of categories in Phase 4. Finally, the concept maps were interpreted using multidimensional scaling and hierarchical cluster analysis.</p><p><strong>Results: </strong>The medical students' perception of happiness was divided into two dimensions, \"Study-Life\" on the X-axis and \"Self-Relationship\" on the Y-axis, and was expressed in three categories and five sub-categories. The subcategories of \"Self-management\" and \"Quality of life\" were grouped under \"Personal development,\" \"Social support\" was named as a single category, and \"Guaranteed future\" and \"Academic achievement\" were grouped as \"Professional fulfillment.\" The most important sub-category for medical students was \"Social support.\" Among the statements generated in these categories, the most important was \"When I have a healthy body and stamina,\" which belonged to \"Quality of life.\"</p><p><strong>Discussion: </strong>This study showed that to enhance the happiness of medical students, a system that supports their social relationships, careers, learning, and individual efforts is required. The results of this study can provide information for the development of student support programs that allow medical educators and institutions to promote medical students' happiness.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1476022"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772161","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":"Socioeconomic determinants of low birth weight and its association with peripubertal obesity in Brazil.","authors":"Fernanda Lima-Soares, Renato Simões Gaspar, Silas Alves-Costa, Cecilia C Costa Ribeiro, Antonio Marcus de Andrade Paes","doi":"10.3389/fpubh.2025.1424342","DOIUrl":"10.3389/fpubh.2025.1424342","url":null,"abstract":"<p><strong>Introduction: </strong>Low birth weight (LBW) is an early life adversity associated with various risk factors and metabolic dysfunction throughout life. However, the role of socioeconomic factors in the association between LBW and peripubertal health in low- and middle-income countries (LMICs) remains unclear. This ecological study investigated the factors contributing to LBW and its impacts in Brazil.</p><p><strong>Methods: </strong>Data were collected from the Global Health Data Exchange as summary exposure values (SEVs), which serve as a proxy for population prevalence weighted by the relative risk. Additionally, information was sourced from official Brazilian government resources covering the years 1995 to 2017, resulting in a total of 338 state-year observations applied for temporal lagged analyses. First, we tested the SEV of 1-year lagged reproductive-age population (15-49 years) risk factors as exposures and the SEV of LBW as an outcome. In the second temporal lagged analysis, we tested the association between the SEV of LBW as the primary exposure and the SEV of high body mass index (HBMI) in peripubertal population 10 years later as the outcome. Fixed-effects multivariable linear regression models with lags were constructed, adjusting for socioeconomic covariates.</p><p><strong>Results: </strong>The exposure of the reproductive-age population to smoking, alcohol, high systolic blood pressure, and HBMI was positively associated with the SEV of LBW. A diet high in sugar-sweetened beverages (SSB diet) was also positively associated, but the association disappeared when GDP per capita and access to primary care were added to the model. Regarding the repercussions of LBW, a 1-point increase in the SEV of LBW was associated with a 1.6-point increase in HBMI in the peripubertal population (95% CI: 0.66 to 2.55). However, this association disappeared after adjusting for GDP per capita and access to primary care, indicating their confounding roles.</p><p><strong>Discussion: </strong>Our study highlights several risk factors in the adult population associated with LBW and its relationship with peripubertal HBMI. Interestingly, GDP per capita and access to primary care were found to be the socioeconomic determinants for birth outcomes as a result of exposure to the risk factors tested and the mid-term effects of LBW. These findings enhance our understanding of the role of socioeconomic factors contributing to LBW in LMICs and the need for public policies addressing healthcare and welfare to reduce the burden of LBW in LMICs.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1424342"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772025","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":"The epidemiology and burden of respiratory syncytial virus and influenza infections in hospitalized children under 5 years old in Zhejiang, China (2018-2023).","authors":"Wanwan Sun, Qiuyao Duan, Lei Guo, An Zhu, An Tang, Ziping Miao, Yu Zhang, Fen Yuan, Xiaofei Fu, Suyan Shi, Lan Wang, Shijian Li, XiaoZhi Xu, Chunlei Zhu, Lefei Zhou, Li Rui, Pang Yue, Zhao Yu, Jinren Pan, Chaorong Ni, Shelan Liu","doi":"10.3389/fpubh.2025.1470770","DOIUrl":"10.3389/fpubh.2025.1470770","url":null,"abstract":"<p><strong>Objective: </strong>Estimate changes in hospital-based respiratory syncytial virus (RSV) disease burden before and after the COVID-19 pandemic and compare this burden with influenza among children younger than 5 years old in China's Zhejiang Province.</p><p><strong>Methods: </strong>We enrolled hospitalized children under 5 years old from eight hospitals in Zhejiang Province. Multiple testing methods were used to compare epidemiological characteristics, and multivariate logistic regression analyses were used to estimate the odds ratio (OR) and 95% confidence interval (CI) between the two groups.</p><p><strong>Results: </strong>In this study, of the 7,857 RSV and 2,571 influenza patients, the median age of the children was significantly lower for RSV infection than for influenza. Inpatients with RSV had longer hospitalization durations (mean: 5.66 days vs. 5.04 days; <i>p</i> < 0.001) and hospitalization costs (mean: 5,616.12 RMB vs. 5,352.99 RMB; <i>p</i> = 0.023) than those with influenza. RSV inpatients increased from 1,081 before the COVID-19 pandemic to 6,776 after the pandemic (<i>p</i> < 0.001), with 526.8% more hospitalizations than before the pandemic (<i>p</i> < 0.001). During 2020-2023, hospitalized children were older (16.86 months vs. 10.09 months; <i>p</i> < 0.001) and had a higher proportion of pneumonia (82% vs. 75% of hospitalized patients; <i>p</i> < 0.001) than during pre-pandemic seasons for children admitted due to RSV infection. However, the average RSV hospitalization cost was much lower after the pandemic (4,299.29 RMB vs. 5,697.51 RMB; <i>p</i> < 0.001). Compared with the prepandemic years (2018-2019), the influenza groups showed a similar trend; the number of inpatients increased during the 2020-2023 season (1,949 vs. 622, <i>p</i> < 0.001), with older ages (33.13 months vs. 27.42 months, <i>p</i> < 0.001), a lower proportion of pneumonia (38% vs. 45%, <i>p</i> < 0.001), and lower costs (3,631.03 RMB vs. 3,742.59 RMB, <i>p</i> < 0.001). RSV infection was related to a higher risk of hospitalization in all age groups, and the greatest risk was observed in the 6-12 month age group (OR = 23.1; 95% CI, 18.0-29.6), followed by the 5 months and younger group (OR = 22.4; 95% CI, 17.3-28.9), compared with influenza infection.</p><p><strong>Conclusion: </strong>RSV is a significant contributor to disease burden in hospitalized children under 5 years old, outweighing influenza. The COVID-19 pandemic impacted the epidemiological characteristics and disease burden of hospitalization for RSV and influenza infections. A more effective prevention strategy for both infections in young children, especially vaccinations against RSV and influenza, is urged.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1470770"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779906","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":"Curvilinear association between cardiometabolic index and depressive symptoms in individuals aged 45 and older: a cross-sectional study of CHARLS.","authors":"Sibo Han, Yingqi Zhang, Bingxin Wu, Qingyun Chen, Zhengyuan Han, Jingmin Chen, Peishan Li, Meimei Xu","doi":"10.3389/fpubh.2025.1534302","DOIUrl":"10.3389/fpubh.2025.1534302","url":null,"abstract":"<p><strong>Objective: </strong>This research is aimed at investigating the association between the cardiometabolic index (CMI) and depressive symptoms in Chinese population of middle and older age, using data derived from the CHARLS study.</p><p><strong>Methods: </strong>Using data from 7,800 participants in the 2011-2012 wave of the CHARLS cohort, this cross-sectional analysis concentrated on examining the association between CMI and depressive symptoms, assessed through CESD-10 scores. The study utilized multivariate logistic regression, multiple linear regression, and restricted cubic spline (RCS) models to investigate the link between CMI and depression, with subgroup analyses offering further insights. Sensitivity analyses included propensity score matching and data from 8,457 participants in the 2015-2016 CHARLS wave.</p><p><strong>Results: </strong>In fully adjusted models, higher CMI was significantly associated with an elevated risk of depression, with participants having a CMI ≥ 0.594 showing a 162% higher risk compared to those with lower CMI. The RCS analysis identified a threshold at CMI = 0.594, where participants with CMI ≥ 0.594 had a 162% elevated possibility of depression in comparison to those with CMI < 0.594 [OR = 2.62, 95% CI: 2.36-2.91]. Sensitivity analyses, including propensity score matching and data from the 2015-2016 CHARLS wave, confirmed the robustness of the findings.</p><p><strong>Conclusion: </strong>Our analysis demonstrates that elevated CMI levels are independently correlated with a heightened likelihood of experiencing depressive symptoms, highlighting the significance of metabolic interventions in mitigating depressive tendencies in middle-aged and older individuals.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1534302"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772170","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":"Nutritional knowledge, insulin resistance, and the risk of orthorexia nervosa: a comparative cross-sectional study among polish women.","authors":"Wiktoria Staśkiewicz-Bartecka, Karolina Masłoń, Aleksandra Kołodziejczyk, Agnieszka Białek-Dratwa, Agata Kiciak, Sylwia Jaruga-Sękowska, Daria Dobkowska-Szefer, Mateusz Grajek, Oskar Kowalski, Marek Kardas","doi":"10.3389/fpubh.2025.1562866","DOIUrl":"10.3389/fpubh.2025.1562866","url":null,"abstract":"<p><strong>Background: </strong>The global rise in insulin resistance has led to an increased emphasis on dietary modifications as a primary strategy for its management. While such interventions are essential for improving metabolic health, they can also contribute to heightened nutritional knowledge. However, this increased focus on diet may inadvertently lead to the development of disordered eating patterns, including orthorexia nervosa. This study aimed to determine the level of nutritional knowledge regarding proper eating habits among women with insulin resistance and to assess the relationship between this knowledge and the risk of developing orthorexia nervosa.</p><p><strong>Methods: </strong>The study was using the Computer-Assisted Web Interview method, involving 133 female participants from a primary care clinic in Katowice, Poland. Of these, 101 women had a medically confirmed diagnosis of insulin resistance, and 32 were healthy controls. Data were collected using an online survey, which included a demographic section, a 15-item questionnaire to assess nutritional knowledge, and the ORTO-15 tool to evaluate orthorexia nervosa risk.</p><p><strong>Results: </strong>Women with insulin resistance had significantly higher Body Mass Index values and demonstrated greater nutritional knowledge than their healthy counterparts. However, 56.44% of women with insulin resistance were at risk of orthorexia nervosa, compared to 15.63% of the control group. Increased dietary knowledge in women with insulin resistance was also associated with a higher risk of developing orthorexic behavior.</p><p><strong>Conclusion: </strong>The findings indicate that while women with insulin resistance benefit from improved nutritional knowledge in managing their condition, this knowledge may simultaneously increase their risk of developing orthorexia nervosa. Balancing the promotion of healthy eating habits with strategies that prevent the emergence of distorted eating behaviors is crucial. Future interventions should emphasize flexibility, psychological support, and individualized guidance to ensure both metabolic and mental well-being.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1562866"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771712","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":"Toward better prevention of physician burnout: insights from individual participant data using the MD-specific Occupational Stressor Index and organizational interventions.","authors":"Karen Belkić","doi":"10.3389/fpubh.2025.1514706","DOIUrl":"10.3389/fpubh.2025.1514706","url":null,"abstract":"<p><strong>Background: </strong>Physician burnout has become a public-health crisis. The need is dire for robust organizational solutions, focusing on reduction of specific stressors. The physician-specific Occupational Stressor Index (OSI) based on cognitive ergonomics can help. Individual-participant data (IPD) from different studies addressing physician burnout are lacking.</p><p><strong>Aims: </strong>To perform IPD analysis regarding job stressors and their relation to physician burnout and to utilize the IPD results to inform a systematic review of the stressors that show an association with physician burnout, focusing on intervention studies.</p><p><strong>Methods: </strong>PRISMA guidelines are followed for the IPD analysis and systematic review of intervention studies on the implicated stressors, taking the COVID-19 pandemic into consideration. The IPD analysis is performed on studies using the physician-specific OSI vis-à-vis burnout assessed by the Copenhagen Burnout Inventory (CBI). Odds ratios (OR) ± 95% confidence-intervals (CI) are reported, adjusting for age, gender and caring for patients with suspected COVID-19 infection.</p><p><strong>Results: </strong>Three studies fulfilled the inclusion criteria, providing complete IPD data for 95 physicians. Thirty-two (33.7%) physicians had total OSI scores >88, for which intervention is urgently needed. Unit-change in the total stressor burden assessed via OSI yielded OR = 1.11 (95%CI: 1.03-1.18) (<i>p</i> = 0.003) for personal burnout, OR = 1.17 (95%CI: 1.08-1.26) (<i>p</i> = 0.0001) for work-related burnout and OR = 1.07 (95%CI: 1.01-1.15) (<i>p</i> = 0.03) for patient-related burnout. Caring for patients with suspected COVID-19 infection showed significant multivariable results (<i>p</i> = 0.04) only for personal burnout. Twenty distinct work stressors revealed multivariable associations with CBI. Systematic examination via PUBMED, CINAHL and OVID Medline yielded 33 publications mitigating those stressors among physicians. Adequate staffing was pivotal. Clerical staff off-loaded administrative burden. Information-technology staff helped diminish interruptions, enhancing workflow. Cross-coverage reduced time constraints, ensured separate periods for non-clinical tasks, and ≥1 work-free day/week. Several interventions impacted physician burnout, as did recognition of physicians' efforts/achievements. Other OSI-identified stressors were insufficiently examined in intervention studies: e.g. vacation; appropriately-timed, cross-covered restbreaks; and counter-measures for emotionally-disturbing aspects of MD's work, particularly during the pandemic.</p><p><strong>Conclusions: </strong>Further participatory-action research is needed in well-controlled intervention trials to alleviate physician burnout.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1514706"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771987","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}