Frontiers in Public Health最新文献

{"title":"Prevalence and associated factors of screening-defined myopia among schoolchildren in Urumqi: a comparison of two cross-sectional surveys conducted in 2012 and 2019.","authors":"Jin Luo, Xuemei Li, Haonan Shi, Jia Zhu, Jin Wang, Xuan Yao, Tingting Wang","doi":"10.3389/fpubh.2026.1875125","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1875125","url":null,"abstract":"<p><strong>Background: </strong>Myopia is an important public health concern among schoolchildren. This study described the prevalence of screening-defined myopia and its associated factors among schoolchildren in Urumqi using data from two independently sampled cross-sectional surveys conducted in 2012 and 2019.</p><p><strong>Methods: </strong>The 2012 survey included 1,938 students from Xinshi and Shayibake districts, whereas the 2019 survey included 9,503 students from Xinshi, Shayibake, Tianshan, and Shuimogou districts. Information on visual status and individual and environmental factors was collected. Crude and internally standardised prevalence estimates were calculated. Because the two surveys differed in geographic coverage and sample composition, comparisons between survey years were interpreted descriptively.</p><p><strong>Results: </strong>The crude prevalence of myopia was 39.7% in the 2012 survey and 37.1% in the 2019 survey. After equal-weight standardisation by school stage, the corresponding estimates were 45.9 and 43.7%, respectively. Descriptive prevalence patterns differed across school stages; however, because the two surveys did not have identical geographic coverage or sampling frames, these differences should not be interpreted as evidence of a population-level temporal trend. Myopia was higher in females than males and lower in Han than other ethnic groups (all <i>p</i> < 0.05). Multivariable logistic regression for 2012: risk factors - reading <30 cm from books (<i>OR</i> = 1.51, 95%<i>CI</i> = 1.28-1.78), poor reading/writing habits (<i>OR</i> = 1.55, 95%<i>CI</i> = 1.26-1.91), daily computer use (<i>OR</i> = 1.21, 95%<i>CI</i> = 1.00-1.46), parental myopia (<i>OR</i> = 2.11, 95%<i>CI</i> = 1.65-2.71); protective factors - eye exercises (<i>OR</i> = 0.66, 95%<i>CI</i> = 0.53-0.81), daily outdoor time (<i>OR</i> = 0.84, 95%<i>CI</i> = 0.71-1.00), daily sleep time (<i>OR</i> = 0.75, 95%<i>CI</i> = 0.60-0.95). For 2019: risk factors - reading <30 cm (<i>OR</i> = 1.69, 95%<i>CI</i> = 1.56-1.82), poor habits (<i>OR</i> = 1.22, 95%<i>CI</i> = 1.09-1.36), parental myopia (OR = 2.22, 95%CI = 2.03-2.43); protective factors-resting eyes after 1 h reading/writing (<i>OR</i> = 0.79, 95%<i>CI</i> = 0.74-0.84), eye exercises (<i>OR</i> = 0.87, 95%<i>CI</i> = 0.79-0.95), daily TV hours (<i>OR</i> = 0.85, 95%<i>CI</i> = 0.79-0.92), frequent distance viewing (<i>OR</i> = 0.85, 95%<i>CI</i> = 0.74-0.98), daily outdoor time (<i>OR</i> = 0.90, 95%<i>CI</i> = 0.83-0.98), daily sleep time (<i>OR</i> = 0.84, 95%<i>CI</i> = 0.75-0.94), weekly frequency of eating zhuafan (<i>OR</i> = 0.85, 95%<i>CI</i> = 0.77-0.95).</p><p><strong>Conclusion: </strong>Myopia represented a substantial public health burden among schoolchildren in both surveys. Several behavioural and familial characteristics were associated with myopia, although the cross-sectional design precluded causal inference. Because the two surveys used different sampling frames, the obse","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1875125"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897135","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":"Models for identifying cognitive frailty in hospitalized older adults with chronic heart failure in China: a systematic review.","authors":"Yue Mou, Longyun Li, Qian Geng, Yao Li, Tingjia Zhang, Fang Cao, Yuanyuan Li, Ting Zhang","doi":"10.3389/fpubh.2026.1904724","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1904724","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate models for identifying cognitive frailty (CF) among hospitalized older adults with chronic heart failure (CHF) in China and assess their intended use, performance, and methodological quality.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Web of Science Core Collection, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and the Chinese Biomedical Literature Database from inception to March 31, 2026. Two reviewers independently screened the records according to the predefined eligibility criteria and extracted data using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies. For each included study, the operational definition of CF, the reported approach to dementia exclusion, and the timing of predictor and outcome assessment were rechecked. Models in which predictors and CF were assessed during the same hospitalization were classified as diagnostic or screening models for prevalent CF rather than prognostic models for future CF onset. Risk of bias and applicability were independently assessed using the Prediction Model Risk of Bias Assessment Tool.</p><p><strong>Results: </strong>Eight cross-sectional studies reporting 20 models were included. All were conducted among hospitalized older adults with CHF in China, and none predicted incident CF during follow-up. Development sample sizes ranged from 246 to 645, and CF prevalence ranged from 17.8% to 50.5%. Six studies performed internal validation, four performed external validation, and one reported no validation; three studies performed both internal and external validation. The area under the receiver operating characteristic curve in external validation ranged from 0.770 to 0.852. One study did not report calibration. The most frequently retained predictors were age, New York Heart Association functional classification, depression, nutritional status, and sleep-related factors. All studies had a high overall risk of bias, whereas applicability concerns were generally low.</p><p><strong>Conclusion: </strong>Existing evidence concerns concurrent identification of prevalent CF rather than prediction of future onset. Current models are not ready for routine clinical decision-making because of high risk of bias, incomplete reporting, limited external validation, and lack of clinical-impact evidence. Longitudinal model development, multicenter external validation, comprehensive calibration and clinical-utility assessment, and prospective impact evaluation are required before implementation.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261413101, CRD420261413101.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1904724"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897065","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":"Disability and dignity: a qualitative systematic review of WASH-related barriers, facilitators and interventions for adults with musculoskeletal disabilities.","authors":"Soumyaranjan Sahu, Manisha Jnyanajyoti, Jaya Singh Kshatri, Subrata Kumar Palo, Sanghamitra Pati","doi":"10.3389/fpubh.2026.1799013","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1799013","url":null,"abstract":"<p><strong>Background: </strong>Adults with musculoskeletal disabilities (MSDs) including arthritis, spinal cord injuries, amputations, and congenital deformities face significant barriers in accessing water, sanitation, and hygiene (WASH) services. These barriers compromise health, dignity, and independence, particularly in low- and middle-income countries. This systematic review aimed to identify WASH-related barriers and facilitators for adults with MSDs and synthesize existing interventions to promote inclusive WASH access.</p><p><strong>Methods: </strong>This systematic review was conducted following PRISMA 2020 guidelines. We searched MEDLINE, Embase, and CENTRAL databases up to March 1, 2025, using MeSH and free-text terms. Inclusion criteria were primary research studies involving adults (≥18 years) with MSDs, reporting on WASH barriers, facilitators, or interventions. Only qualitative or mixed-methods studies published in English were included. Studies involving children, lacking primary data, or behind paywalls were excluded. Two independent reviewers conducted screening and full-text appraisal using Covidence. Data were extracted using a standardized template, and findings were thematically synthesized. Study quality was assessed using the NIH Quality Assessment Tool.</p><p><strong>Results: </strong>From 5,301 initial records, 19 studies met the inclusion criteria, representing diverse geographical settings. Key barriers included inaccessible infrastructure (e.g., lack of ramps or handrails), stigma, poverty, exclusion from planning, and inadequate menstrual hygiene management. Facilitators included home modifications, affordable technology (e.g., biosand filters), caregiver and community support, gender-sensitive WASH education, and inclusive policies. Interventions ranged from inclusive Community-Led Total Sanitation (CLTS) programs to disability-aware infrastructure designs. Despite progress, participation of adults with MSDs in WASH planning and services remained limited.</p><p><strong>Conclusion: </strong>This review highlights persistent exclusion of adults with MSDs from WASH access. Inclusive design, community engagement, and policy-level integration are essential for achieving equitable WASH services. Future research should evaluate the scalability and effectiveness of low-cost interventions, particularly in resource-constrained settings. However, the findings should be interpreted considering the absence of meta-analysis and formal risk-of-bias assessment.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1799013"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897107","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":"Willingness to receive cross-border human papillomavirus vaccination among Chinese male university students: a cross-sectional study with statistical indirect-association analysis.","authors":"Yunyu Zhang, Wenming Cao, Hongyi Jiang, Jianyu Wan, Ya Liu, Yang Zhang, Huiyan Liao, Mei Wang, Weiwei Sun, Yiran Fu, Lu Cui, Ting Mao, Yutao Gao","doi":"10.3389/fpubh.2026.1937514","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1937514","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) vaccination is an important strategy for preventing HPV-related disease among males. Access to male HPV vaccination may involve cross-border health seeking for some university students in mainland China. This study estimated willingness to receive cross-border HPV vaccination among Chinese male university students and examined associations of HPV-related disease recognition, awareness of cross-border vaccination availability, and demographic and informational characteristics with willingness.</p><p><strong>Methods: </strong>A cross-sectional anonymous online survey was conducted between September 2025 and March 2026 among 4,260 male university students in mainland China, Hong Kong, Macao, and overseas. The primary outcome was willingness to travel at personal expense to Hong Kong or Macao for HPV vaccination. HPV-related disease recognition was assessed using four conditions with established HPV associations: anogenital warts, penile cancer, anal cancer, and oropharyngeal cancer. Multivariable logistic regression estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of 4,260 participants, 3,182 (74.69%) reported willingness to receive cross-border HPV vaccination. Participants with a disease-recognition gap had substantially lower adjusted odds of willingness than those identifying at least one condition (aOR = 0.041, 95% CI: 0.017-0.095; <i>p</i> < 0.001). Awareness of cross-border HPV vaccination availability was positively associated with willingness (aOR = 1.233, 95% CI: 1.056-1.441; <i>p</i> = 0.008). Students studying in Guangdong province had higher adjusted odds of willingness than students in other mainland provinces (aOR = 1.213, 95% CI: 1.045-1.409; <i>p</i> = 0.011). Higher academic grade (aOR per level = 1.111, 95% CI: 1.023-1.206; <i>p</i> = 0.012) and exposure to school-based HPV information (aOR = 1.203, 95% CI: 1.005-1.440; <i>p</i> = 0.044) were also independently associated with willingness. The estimated indirect association through cross-border service awareness was statistically significant but small (<i>B</i> = -0.022, bootstrap 95% CI: -0.040 to -0.006).</p><p><strong>Conclusion: </strong>Willingness to receive cross-border HPV vaccination was reported by approximately three-quarters of participants. Recognition of established HPV-related male diseases and awareness of cross-border vaccination availability were associated with willingness. The cross-sectional design precludes causal inference. Longitudinal and intervention studies are needed to determine whether male-focused HPV education and service-navigation strategies increase actual vaccine uptake.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1937514"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897170","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":"Artificial intelligence anxiety and its association with willingness to receive AI-related training among maternal and child health nurses: a multicenter network analysis.","authors":"Cheng Huang, Qin Zeng, Jun Zhu, Yuji Wang, Xi Huang","doi":"10.3389/fpubh.2026.1889617","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1889617","url":null,"abstract":"<p><strong>Background: </strong>Rapid integration of artificial intelligence (AI) into maternal and child healthcare introduces unique psychological challenges for nursing staff. This study aimed to explore the network structure of AI anxiety among Chinese maternal and child health nurses and examine its associations with willingness to receive AI-related training, thereby generating preliminary implications for organizational support strategies.</p><p><strong>Methods: </strong>A multicenter cross-sectional survey was conducted between May and August 2025, enrolling 848 nurses from 46 maternal and child healthcare institutions across 26 Chinese provinces. AI anxiety was assessed using the Artificial Intelligence Anxiety Scale (AIAS), and willingness to receive AI-related training was assessed using a single 10-point item. Network analysis using the Least Absolute Shrinkage and Selection Operator (LASSO) and the Extended Bayesian Information Criterion (EBIC) was performed to estimate statistically central nodes, cross-dimensional bridge connectivity, and node predictability.</p><p><strong>Results: </strong>The highest strength centrality values were observed for a humanoid-AI-fear item and a learning-anxiety item. AI misuse concerns and job replacement fears showed the highest bridge-strength values, indicating relatively strong cross-dimensional connectivity among the anxiety dimensions. Notably, learning-anxiety items showed the strongest positive associations with willingness to receive AI-related training, with edge weights ranging from 0.22 to 0.24. The estimated strength and bridge-strength rankings showed acceptable stability, with correlation-stability coefficients of 0.594 and 0.750, respectively, while node predictability ranged from 69.3 to 92.1%.</p><p><strong>Conclusion: </strong>AI anxiety among maternal and child health nurses showed a multifaceted network structure in which learning-related stress and fear of anthropomorphic AI were statistically prominent. These data generate preliminary hypotheses about organizational support but do not identify effective intervention targets. Because willingness to receive AI-related training was assessed using a single global item, the study does not identify nurses' multidimensional educational needs, preferred content or delivery modalities, competency priorities, or perceived barriers. Literature-informed options such as phased or simulation-based training should therefore undergo needs assessment and longitudinal or interventional evaluation before implementation.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1889617"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897095","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":"Latent profile analysis and determinants of social isolation among older adults in China.","authors":"Xiaoxing Lai, Zhiyuan Zhang, Yonghua Cai, Yang Li, Rui Sun, Shuai Zhang, Kexin Zhang, Hongdi Du, Shuxian Li, Jingwei Hao, Xiaopeng Huo","doi":"10.3389/fpubh.2026.1845790","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1845790","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify social isolation profiles among older adults in China using latent profile analysis and to explore their associations with demographic and health factors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between July and December 2023 in the Chaoyang and Dongcheng districts of Beijing, China. Participants aged 60 years or older were recruited through convenience sampling from six communities. Latent profile analysis was used to classify social isolation patterns, and multivariate logistic regression models to assess associated factors.</p><p><strong>Results: </strong>529 participants were included. Three social isolation profiles were identified: the mild social isolation subgroup (<i>n</i> = 239, 45.2%), the moderate social isolation subgroup (<i>n</i> = 213, 40.3%), and the severe social isolation subgroup (<i>n</i> = 77, 14.5%). Comparing mild to severe social isolation, multivariate analysis revealed that older adults living alone without caregiver had significantly higher odds of severe social isolation compared to those living with children (OR = 0.099, 95% CI: 0.034-0.377, <i>P</i> < 0.001). Frailty (OR = 0.141, 95% CI: 0.039-0.588, <i>P</i> = 0.033), severe ADL dependence (OR = 0.249, 95% CI: 0.145-0.454, <i>P</i> = 0.048), and moderate to severe IADL dependence (OR = 0.448 to 0.307, <i>P</i> = 0.046, <i>P</i> = 0.017) were also significantly associated with severe social isolation. Similarly, in the comparison between the moderate and severe subgroups, compared to those living with children, older adults living alone without caregiver were more likely to experience severe social isolation (OR = 0.199, 95% CI: 0.078-0.328, <i>P</i> = 0.001). In terms of functional status, severe ADL dependence (OR = 0.152, 95% CI: 0.061-0.505, <i>P</i> = 0.015) and moderate to severe IADL dependence (OR = 0.231 to 0.128, <i>P</i> = 0.045, <i>P</i> = 0.033) were significantly associated with severe social isolation.</p><p><strong>Conclusion: </strong>Older adults living alone without caregiver, with frailty, and with functional dependence are at significantly higher risk of severe social isolation. Family network integrity emerged as the primary dimension differentiating severe social isolation from mild-to-moderate isolation, which may be linked to a quantitative gradient of overall network restriction. Understanding the specific factors contributing to different profiles could inform tailored support strategies to enhance social engagement and quality of life in this population.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1845790"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897057","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":"Knowledge, attitudes, and practices of healthcare professionals regarding palliative care family meetings: a multicenter cross-sectional study.","authors":"Chunjin Lin, Xiaona Zheng, Fang Zhu, Chengying Li, Yifang Guo, Fan Lin, Pengli Zhu","doi":"10.3389/fpubh.2026.1902540","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1902540","url":null,"abstract":"<p><strong>Background: </strong>To assess the knowledge, attitudes, and practices (KAP) of healthcare professionals (HP) regarding palliative care family meetings and to identify factors independently associated with practice level.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted among 401 healthcare professionals across four institutions in Fujian Province between January and February 2026. Data were collected using a validated self-designed questionnaire encompassing demographic characteristics and KAP scores. Multivariable logistic regression identified factors independently associated with practice level, and structural equation modeling (SEM) examined whether attitude mediated the knowledge-practice relationship.</p><p><strong>Results: </strong>The mean scores were 14.35 ± 5.95 for perceived knowledge (55.2% of maximum), 42.63 ± 5.92 for attitude (85.3%), and 24.96 ± 8.93 for practice (71.3%). Multivariable analysis identified knowledge score (OR = 1.088, 95%CI: 1.046-1.132, <i>p</i> < 0.001), attitude score (OR = 1.063, 95%CI: 1.023-1.104, <i>p</i> = 0.002), and monthly income <5,000 RMB versus >10,000 RMB (OR = 0.448, 95%CI: 0.217-0.923, <i>p</i> = 0.029) as independent associates of proactive practice. SEM indicated that attitude partially mediated the perceived knowledge-practice relationship (indirect effect <i>β</i> = 0.052, <i>p</i> = 0.003), with knowledge also showing a significant direct association with practice (<i>β</i> = 0.277, <i>p</i> = 0.010).</p><p><strong>Conclusion: </strong>Healthcare professionals in Fujian Province demonstrated limited perceived knowledge but positive attitudes and proactive practices toward palliative care family meetings. Both perceived knowledge and attitude were independently associated with practice, with attitude serving as a partial mediator. Targeted training programs and institutional support are needed to translate positive attitudinal endorsement into consistent, high-quality practice.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1902540"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897079","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":"Heavy spenders in digital games: expenditure disparities and associations between microtransactions, gaming disorder and gambling disorder among adolescents.","authors":"Markus Meschik, Elena Hammer, Doris Malischnig, Natalia Wächter, Mark D Griffiths","doi":"10.3389/fpubh.2026.1867460","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1867460","url":null,"abstract":"<p><p>Free-to-play games have transformed the economics of digital play, shifting revenue from upfront sales to continuous microtransactions. Research on the free-to-play model has largely focused on specific mechanics such as loot boxes or pay-to-win systems. However, little is known about how adolescents' spending behaviour relates to problematic engagement. Drawing on survey data from 2,308 Austrian students aged 10-19 years (48.8% male; M = 14.3 years, SD = 2.1), the present study examined the distribution of in-game expenditure and its association with gaming disorder, gambling disorder, and socioeconomic status. Expenditure was highly unequal: 10% of players accounted for 61.4% of all spending, and heavy spenders showed higher prevalences of gaming disorder and gambling disorder than casual spenders. Expenditures were not significantly associated with socioeconomic status, suggesting that high spending is not limited to adolescents with greater family affluence. The concentration of spending resembles patterns observed in other highly unequal expenditure markets, including gambling, suggesting potential structural similarities between the two industries. These findings raise questions about the assumption that microtransactions are harmless optional features and suggest that policy efforts targeting only loot boxes may not fully address potential risks associated with broader monetization practices among adolescent gamers.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1867460"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896956","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":"Influencing factors of low-dose computed tomography screening behavior among first-degree relatives of lung cancer patients based on the theory of planned behavior: a qualitative study.","authors":"Si Lin, Yaming He, Weixuan Ye, Xiaokun Wu, Lixue Liang, Yinsong Chen","doi":"10.3389/fpubh.2026.1896783","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1896783","url":null,"abstract":"<p><strong>Objective: </strong>To explore the factors influencing the screening behavior of first-degree relatives of lung cancer patients toward low-dose computed tomography (LDCT) screening based on the Theory of Planned Behavior (TPB), gain deeper insights into their subjective experiences and core demands, and provide a theoretical basis and improvement measures for enhancing screening participation rates among this high-risk population.</p><p><strong>Methods: </strong>Employing a descriptive phenomenological approach, semi-structured interviews were conducted with 14 first-degree relatives of lung cancer patients at a hospital from May to July 2025. Thematic analysis was performed using directed content analysis.</p><p><strong>Results: </strong>Guided by the TPB, 11 themes across 3 dimensions were identified: Behavioral Attitudes (affirming screening value, family environment influence, cognitive biases hindering screening), Subjective Norms (influence of others' behavior, healthcare professional recommendations, rural cognitive limitations), and Perceived Behavioral Control (financial constraints, work-time conflicts, cumbersome screening procedures, negative psychological perceptions, policy reference effects).</p><p><strong>Conclusion: </strong>Screening behaviors among first-degree relatives of lung cancer patients are influenced by multidimensional factors. Healthcare providers should integrate the TPB framework and implement multi-level improvement measures-including enhanced health education, optimized screening services, and improved policy support-to increase screening adherence.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1896783"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897060","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":"Effects of dust exposure on IGF1 and autophagy related to coal workers' pneumoconiosis.","authors":"Yi Hu, Chunchao Zheng, Lei Chu, Xinyao Wang, Hailan He, Heliang Liu","doi":"10.3389/fpubh.2026.1899729","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1899729","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the correlated factors of pneumoconiosis in coal miners, and explore the potential regulatory mechanism of insulin-like growth factor 1 (IGF1) in pneumoconiosis progression, so as to provide scientific evidence for the prevention and clinical treatment of coal workers' pneumoconiosis.</p><p><strong>Methods: </strong>Clinical data of 2028 employees from a coal mining enterprise in Tangshan City, Hebei Province during 2023-2024 were retrospectively analyzed to screen the risk indicators of coal workers' pneumoconiosis. A SiO₂-induced macrophage injury cell model was established to simulate pneumoconiosis-related pathological changes. The expression levels of inflammatory cytokines (IL-6, IL-1β), polypeptide growth factor (IGF1), autophagy marker proteins (LC3, P62) and intracellular signaling kinases (PI3K, AKT, mTOR) were detected. Logistic regression analysis was applied to identify pneumoconiosis correlated factors, and bioinformatics analysis was performed to clarify the regulatory relationship between dust exposure, IGF1 expression and cellular autophagy activity.</p><p><strong>Results: </strong>Early initial working age, long dust exposure duration, smoking, elevated white blood cell count and increased AST/ALT ratio were key correlated factors for pneumoconiosis. The coal worker pneumoconiosis group presented enhanced inflammatory response, upregulated IGF1 expression and altered autophagy-related protein expression activity. Consistent with the observational trends observed in human subjects, <i>in vitro</i> cellular assays demonstrated that SiO₂ stimulation was accompanied by elevated inflammatory response and IGF1 abundance, altered autophagy-related protein expression, and a rise in activity of the PI3K/AKT/mTOR kinase signaling cascade.</p><p><strong>Conclusion: </strong>Age, early initial working age, prolonged dust exposure, smoking, elevated white blood cell count and increased AST/ALT ratio are correlated factors for coal workers' pneumoconiosis. Synchronous alterations in IGF1 upregulation, elevated phosphorylation levels of PI3K and AKT, and abnormal expression of autophagy-related markers were observed in pneumoconiosis patients and silica-stimulated macrophages, revealing correlative molecular links among these molecules in pneumoconiosis progression.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1899729"},"PeriodicalIF":4.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897084","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}