Frontiers in Public Health最新文献

{"title":"Autonomy support in telehealth: an evolutionary concept analysis.","authors":"Yi Hou, Manyao Sun, Xueying Huang, Jiang Nan, Jing Gao, Nan Zhu, Yuyu Jiang","doi":"10.3389/fpubh.2025.1544840","DOIUrl":"10.3389/fpubh.2025.1544840","url":null,"abstract":"<p><strong>Aims: </strong>Autonomy support plays a critical role in safeguarding patients' fundamental rights and promoting health behaviors. The context of autonomy support is transitioning from traditional face-to-face healthcare settings to telehealth, leading to an evolution in the connotation of autonomy support. This study aimed to clarify the connotation of autonomy support in telehealth and to develop a conceptual framework to guide innovations in clinical practice and the advancement of related theories.</p><p><strong>Methods: </strong>Rodgers' evolutionary method was used to clarified attributes, antecedents, and consequences of autonomy support in telehealth. The integrative review strategy of Whittemore and Knafl was used as the methodology for searching relevant literature.</p><p><strong>Results: </strong>Twenty-five articles were included. The attributes were identified as: (i) technical feedback; (ii) virtual agent; (iii) choice; (iv) rationale; (v) empathy; (vi) collaboration; and (vii) strengths. The antecedents were: (i) telehealth service system; (ii) change in awareness toward autonomy support; and (iii) patient preference of needs for autonomy. The consequences were: (i) multidimensional perception; (ii) emotional experience; (iii) health behavior; (iv) social relation; and (v) technological dependence.</p><p><strong>Conclusion: </strong>This study clarified the attributes, antecedents, and consequences of autonomy support in telehealth, developing and improving a conceptual framework for autonomy support. These findings will provide a theoretical foundation for developing technology-enabled autonomy support strategies in telehealth practice, better adapting to the emerging needs of patients in the context of the digital age.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1544840"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752170","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 capsule network-based public health prediction system for chronic diseases: clinical and community implications.","authors":"Haiyan Xie","doi":"10.3389/fpubh.2025.1526360","DOIUrl":"10.3389/fpubh.2025.1526360","url":null,"abstract":"<p><strong>Objective: </strong>To observe the role of a public health chronic disease prediction method based on capsule network and information system in clinical treatment and public health management.</p><p><strong>Methods: </strong>Patients with hypertension, diabetes, and asthma admitted from May 2022 to October 2023 were incorporated into the research. They were grouped into hypertension group (<i>n</i> = 341), diabetes group (<i>n</i> = 341), and asthma group (<i>n</i> = 341). The established chronic disease prediction method was used to diagnose these types of public health chronic diseases. The key influencing factors obtained by the prediction method were compared with the regression analysis results. In addition, its diagnostic accuracy and specificity were analyzed, and the clinical diagnostic value of this method was explored. This method was applied to public health management and the management approach was improved based on the distribution and prevalence of chronic diseases. The effectiveness and residents' acceptance of public health management before and after improvement were compared, and the application value of this method in public health management was explored.</p><p><strong>Results: </strong>The key factors affecting the three diseases obtained by the application of prediction methods were found to be significantly correlated with disease occurrence after regression analysis (<i>p</i> < 0.05). Compared with before application, the diagnostic accuracy, specificity and sensitivity values of the method were 88.6, 89 and 92%, respectively, which were higher than the empirical diagnostic methods of doctors (<i>p</i> < 0.05). Compared with other existing AI-based chronic disease prediction methods, the AUC value of the proposed method was significantly higher than theirs (<i>p</i> < 0.05). This indicates that the diagnostic method proposed in this study has higher accuracy. After applying this method to public health management, the wellbeing of individuals with chronic conditions in the community was notably improved, and the incidence rate was notably reduced (<i>p</i> < 0.05). The acceptance level of residents toward the management work of public health management departments was also notably raised (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The public health chronic disease prediction method based on information systems and capsule network has high clinical value in diagnosis and can help physicians accurately diagnose patients' conditions. In addition, this method has high application value in public health management. Management departments can adjust management strategies in a timely manner through predictive analysis results and propose targeted management measures based on the characteristics of residents in the management community.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1526360"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752143","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":"Effectiveness of OH card-based group mental health education in improving mood and behavior in breast cancer patients.","authors":"Zhaojun Wang, Xiaoqing Hu, Jiangang Xu, Jieyu Zhou, Xiaojing Ou, Meihua Chen","doi":"10.3389/fpubh.2025.1533073","DOIUrl":"10.3389/fpubh.2025.1533073","url":null,"abstract":"<p><strong>Purpose: </strong>Psychological disorders and different coping styles often occur after breast cancer (BC) diagnosis. The purpose of this study was to explore the effect of OH card on psychological status and coping styles of individuals with breast cancer.</p><p><strong>Methods: </strong>This was a non-randomized trial in which 54 outpatients or inpatients with BC who were willing to be assessed using psychological scales, allocated to either the OH card intervention group (OHG) or the usual care group (CG). The OHG received 1 session of OH card therapy over 2 h. Participants completed assessments of anxiety and depressive symptoms and coping styles using the Hospital Anxiety and Depression Scale (HADS) and Simplified Coping Style Questionnaire (SCSQ) scales at baseline, month 1, 3 and 6 post-intervention. Data were analyzed using descriptive statistics, chi-squared test and repeated measures ANOVA.</p><p><strong>Results: </strong>The HADS score in the intervention group was lower than that of the control group by 2.296 (<i>p</i><0.05) at 1 month post-intervention. The SCSQ-positive coping aspect of usual care group scores showed a downward trend, while the OH card intervention group scores showed an upward trend, with a significant difference between the two groups (<i>p</i> = 0.040), and the difference between the two groups was significant at 1, 3 and 6 months after the intervention (all <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The results of our study suggest that OH card intervention may improve symptomatology of anxiety and depression among people with BC at month1, and promote positive behavior within 6 months. The OH card intervention has a potential role in the psychological rehabilitation of individuals with breast cancer and warrants further research.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1533073"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751702","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":"Healthcare providers' intention to discriminate against people with HIV.","authors":"Almutaz M Idris, Rik Crutzen, Hubertus W van den Borne, Sarah E Stutterheim","doi":"10.3389/fpubh.2025.1464250","DOIUrl":"10.3389/fpubh.2025.1464250","url":null,"abstract":"<p><strong>Background: </strong>Healthcare providers' discrimination practices against people with HIV is a real challenge for control and prevention efforts. The study aims to explore the association between healthcare providers' intention to discriminate against people with HIV and HIV stigma-related constructs, their sociodemographic, and occupation characteristics in Sudan.</p><p><strong>Methods: </strong>A cross-sectional survey of healthcare providers was carried out in governmental hospitals in Kassala State, Sudan. Respondents completed measures assessing their intentions to discriminate against people with HIV, HIV-related stigma constructs, sociodemographic, and occupational characteristics. Bivariate and multiple linear regression analysis were used to assess the associations between discriminatory intentions against people with HIV and the studied variables.</p><p><strong>Results: </strong>A total of 387 participants (223 physicians and 164 nurses) completed the survey. Participants had relatively high intentions to discriminate against people with HIV (M = 5.19, SD = 1.34-on a scale from 1 to 7), prejudiced attitudes (M = 4.70, SD = 1.29), internalized shame about HIV (M = 5.19, SD = 1.34), fear of HIV (M = 4.65, SD = 1.39), and the belief that patients with HIV do not deserve good care (M = 4.90, SD = 1.35). Healthcare providers' intention to discriminate against people with HIV was associated with prejudiced attitudes, internalized shame about HIV, fear of HIV, and the belief that people with HIV do not deserve good care. Female health care providers, nurses, and those with postgraduate degrees and fewer years of work experience were more likely to have a high intention to discriminate against people with HIV.</p><p><strong>Conclusions: </strong>Intention to discriminate against people with HIV was high among healthcare providers. Addressing HIV-related stigma constructs and understanding the differential effects of healthcare providers' sociodemographic and occupational characteristics on their discriminatory intentions are imperative to developing effective intervention to reduce intention to discriminate against people with HIV among healthcare providers.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1464250"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752115","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":"Mediating effects of insulin resistance on lipid metabolism with elevated paraben exposure in the general Taiwan population.","authors":"Po-Chin Huang, Hsin-Chang Chen, Han-Bin Huang, Yu-Lung Lin, Wan-Ting Chang, Shih-Hao Leung, Hsi Chen, Jung-Wei Chang","doi":"10.3389/fpubh.2025.1416264","DOIUrl":"10.3389/fpubh.2025.1416264","url":null,"abstract":"<p><strong>Introduction: </strong>Parabens are commonly used to prevent bacteria from growing in cosmetics and foodstuffs. Parabens have been reported to influence hormone regulation, potentially leading to metabolic anomalies, including insulin resistance and obesity. However, there is a paucity of knowledge regarding the relationship between urinary paraben levels and lipid metabolism in the general Taiwanese population. Therefore, the objective of this study was to determine whether the mediating role of insulin resistance exists between paraben exposure and lipid metabolism.</p><p><strong>Methods: </strong>We selected the data of 264 adult participants from a representative survey in five major Taiwan area in 2013. UPLC tandem mass spectrometry was used to examine four urine parabens: methyl- (MeP), ethyl- (EtP), propyl- (PrP) and butyl- (BuP). Blood samples were analyzed for concentrations of glucose and lipid metabolic indices using the DxI 800 immunoassay analyzer and immunoradiometric assay kit. The relationship between urinary paraben levels and metabolism indices were evaluated through a multiple linear regression analysis. Finally, a mediation analysis was employed to understand the underlying mechanism by which paraben exposure influences lipid metabolism through insulin resistance.</p><p><strong>Results: </strong>The significant positive association between MeP exposure and Castelli risk index I (CRI-I; β = 0.05, <i>p</i> = 0.049) was found, and also exhibited the similar associations between EtP exposure and low-density lipoprotein cholesterol (β = 0.10, <i>p</i> = 0.001), total cholesterol (β = 0.06, <i>p</i> = 0.003), and non-HDL cholesterol (NHC; β = 0.08, <i>p</i> = 0.005). EtP exhibited a significant positive association with triglyceride BMI (TyG-BMI; β = 0.02, <i>p</i> = 0.040). Additionally, TyG-BMI was positively associated with CRI-I (β = 0.98, <i>p</i> < 0.001), CRI-II (β = 1.03, <i>p</i> < 0.001) and NHC (β = 0.63, <i>p</i> < 0.001). Moreover, insulin resistance served as mediators for the effects of EtP exposure on lipid metabolism indices.</p><p><strong>Discussion: </strong>The results indicate that changes in insulin resistance mediated the relationship between urinary paraben and lipid metabolism. Large-scale epidemiological and animal studies are warranted to identify biological mechanisms underlying validate these relationships.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1416264"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752125","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":"Adolescent physical activity during school days: a comparative study before and after COVID-19 pandemic restrictions.","authors":"Karel Frömel, Gregory Welk, Dorota Groffik, Lukáš Jakubec, Jan Dygrýn, Josef Mitáš","doi":"10.3389/fpubh.2025.1488153","DOIUrl":"10.3389/fpubh.2025.1488153","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) during the school day is crucial for the health and well-being of adolescents. This study examines the impact of the COVID-19 pandemic on youth PA patterns to better understand these changes and to provide guidelines for school programming.</p><p><strong>Methods: </strong>Differences in PA within specific segments of the school day were examined before and after the pandemic using the Youth Activity Profile questionnaire. Participants included 956 boys and 1,317 girls from 21 high schools. The study involved 12 Czech and 9 Polish high schools before the pandemic and 9 Czech and 8 Polish high schools after the pandemic.</p><p><strong>Results: </strong>Both Czech and Polish boys and girls exhibited significantly less transportation PA to and from school and reduced PA during the school day after the pandemic compared to before. Additionally, Czech and Polish boys were significantly less physically active during school breaks, and Czech boys and girls had notably less PA during physical education lessons. The pandemic disrupted the habit of regular PA on school days, particularly evident in the decline of PA to and from school.</p><p><strong>Conclusion: </strong>The study confirms a significant difference in PA of Czech and Polish adolescents in various segments of the school day after students return to school following pandemic restrictions. Promoting achievement of the recommendations in the segments of the school day and in comprehensive school PA programs should be an important part of school health and education policy and public health promotion for adolescents.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1488153"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752168","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":"Exploring predictors of insomnia severity in shift workers using machine learning model.","authors":"Hyewon Yeo, Hyeyeon Jang, Nambeom Kim, Sehyun Jeon, Yunjee Hwang, Chang-Ki Kang, Seog Ju Kim","doi":"10.3389/fpubh.2025.1494583","DOIUrl":"10.3389/fpubh.2025.1494583","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia in shift workers has distinctive features due to circadian rhythm disruption caused by reversed or unstable sleep-wake cycle work schedules. While previous studies have primarily focused on a limited number of predictors for insomnia severity in shift workers, there is a need to further explore key predictors, and develop a data-driven prediction model for insomnia in shift workers. This study aims to identify potential predictors of insomnia severity in shift workers using a machine learning (ML) approach and evaluate the accuracy of the resulting prediction model.</p><p><strong>Methods: </strong>We assessed the predictors of insomnia severity in large samples of individuals (4,572 shift workers and 2,093 non-shift workers). The general linear model with the least absolute shrinkage and selection operator (LASSO) was used to determine an ML-based prediction model. Additional analyses were conducted to assess the interaction effects depending on the shift work schedule.</p><p><strong>Results: </strong>The ML algorithms identified 41 key predictors from 281 variables: 1 demographic, 7 physical health, 13 job characteristics, and 20 mental health factors. Compared to the non-shift workers, the shift workers showed a stronger association between insomnia severity and five predicting variables: passiveness at work, authoritarian work atmosphere, easiness to wake up, family and interpersonal stress, and medication. The prediction model demonstrated good performance with high accuracy and specificity overall despite a limited F1 score (classification effectiveness) and recall (sensitivity). Specifically, a prediction model for shift workers showed better balance in F1 scores and recall compared to that for non-shift workers.</p><p><strong>Discussion: </strong>This ML algorithm provides an effective method for identifying key factors that predict insomnia severity in shift workers. Our findings align with the traditional insomnia model while also reflecting the distinctive features of shift work such as workplace conditions. Although the potential for immediate clinical application is limited, this study can serve as guidance for future research in improving a prediction model for shift workers. Constructing comprehensive ML-based prediction models that include our key predictors could be a crucial approach for clinical purposes.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1494583"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752062","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 research protocol for a prospective, multicenter, cohort study on interferon therapy for chronic hepatitis B combined with metabolism-associated fatty liver disease to achieve clinical cure.","authors":"Daqiong Zhou, Chao Zhang, Lu Zhang, Jianru Jia, Junliang Fu, Zhenhuan Cao","doi":"10.3389/fpubh.2025.1546182","DOIUrl":"10.3389/fpubh.2025.1546182","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of chronic hepatitis B (CHB) combined with metabolism-associated fatty liver disease (MAFLD) is increasing annually, and the presence of MAFLD may influence the clinical assessment of viral activity and transaminase levels. However, it remains unclear whether MAFLD impacts the achievement of clinical cure in CHB patients treated with polyethylene glycol interferon (Peg-IFN).</p><p><strong>Methods: </strong>A prospective cohort study was conducted to enroll patients with dominant CHB (on NA treatment, HBsAg <1,500 IU/mL, HBeAg negative, HBV DNA <10 IU/mL) and patients with dominant CHB combined with MAFLD, all of whom were treated with Peg-IFN. The study aimed to assess the efficacy and safety of Peg-IFN treatment and to elucidate the effect of MAFLD on achieving HBsAg clearance in these patients. Additionally, the study explored the T-lymphocyte characteristics of patients with CHB combined with MAFLD, analyzed the role of T-lymphocytes expressing inhibitory receptors in HBsAg clearance, and investigated the immunological mechanisms of HBsAg clearance through single-cell transcriptome sequencing technology.</p><p><strong>Ethics and dissemination: </strong>Patients will be recruited at four medical centers in Beijing and Hebei, and written informed consent will be obtained to inform participants of the purpose of the study, potential risks, and benefits. Ethical approval has been granted for the study, which will focus on 48-week HBsAg clearance, and a detailed follow-up and adverse event monitoring plan has been developed.</p><p><strong>Strengths and limitations of this study: </strong>Strengths are that this study fills the gap in treatment strategies for patients with CHB combined with MAFLD and provides important treatment guidance to clinicians; the multicenter design may increase the diversity of the sample size, reduce the bias of single-center studies, and improve the external validity of the results. Limitations are that interferon therapy is often associated with side effects, which may lead to lower patient adherence and affect long-term follow-up and outcome monitoring of the study; the heterogeneity of the MAFLD population may have different effects on the efficacy of interferon therapy.</p><p><strong>Clinical trial registration: </strong>http://www.chictr.org.cn/bin/project/edit?pid=231498, identifier ChiCTR2400084913.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1546182"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752166","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":"ENERGY expenditure of COmmuting to school (ENERGYCO): protocol for a cluster randomized controlled trial.","authors":"Pablo Campos-Garzón, Víctor Manuel Valle-Muñoz, José Manuel Segura-Díaz, Manuel Ávila-García, Romina Gisele Saucedo-Araujo, Ana Ruiz-Alarcón, Francisco David López-Centeno, Unai A Pérez De Arrilucea Le Floc'h, Juan M A Alcantara, Luis Miguel Medel-Carbonell, David Rodriguez-Sanchez, Ana Ramírez-Osuna, Marina Castillo-Barragán, Estela Águila-Lara, Francisco Javier Huertas-Delgado, Manuel Herrador-Colmenero, Sandra Mandic, Palma Chillón, Yaira Barranco-Ruiz, Emilio Villa-González","doi":"10.3389/fpubh.2025.1467227","DOIUrl":"10.3389/fpubh.2025.1467227","url":null,"abstract":"<p><strong>Introduction: </strong>This article outlines the rationale and methodology of the ENERGY expenditure of COmmuting to school study (the ENERGYCO study), a cluster-randomized controlled trial. The ENERGYCO study is divided into two phases: Phase I will aim; to assess the physical activity energy expenditure (PAEE) of different modes of commuting to school (i.e., walking, cycling, and motorized-vehicle) using indirect calorimetry in Spanish adolescents; and Phase II will aim to assess the effect of a school-based cycling intervention on resting metabolic rate and PAEE, as well as on other physiological, physical, and psychosocial outcomes on Spanish adolescents.</p><p><strong>Method: </strong>For Phase I, a convenience sample of ~50 adolescents will be recruited. These participants will have their PAEE assessed in three different modes of commuting. Regarding phase II, a total of 300 adolescents from different schools in three Spanish cities will participate in this cluster randomized controlled trial. As many schools as necessary to meet the target sample will be included. In addition, each school will be randomized as either an intervention or control group. Participants from intervention schools will be asked to complete a school-based cycling intervention, while participants from control schools will be asked to continue their same habits for 8 weeks. The school-based cycling intervention will last for 8 weeks and will include <i>Bikeability</i> sessions, along with encouragement strategies to increase adherence to cycling to and from school.</p><p><strong>Conclusion: </strong>The ENERGYCO study will provide novel insights into the PAEE associated with different modes of commuting to school using indirect calorimetry, as well as a comprehensive overview of how an 8-week school-based cycling intervention impacts resting energy expenditure, daily energy expenditure, and the physical and psychosocial health of adolescents.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1467227"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751847","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":"Comparative study on government subsidy models for competitive drug supply chains under centralized procurement policy.","authors":"Yan Wen, Yan Wei, Lu Liu","doi":"10.3389/fpubh.2025.1542858","DOIUrl":"10.3389/fpubh.2025.1542858","url":null,"abstract":"<p><p>As the generic drug market tends to be saturated, the structural transformation of generic drug companies is imminent, while the high investment and high-risk attributes of innovative drug research and development aggravate the transformation difficulties. Against the backdrop of drug centralized procurement policy, considering the effect of health insurance reimbursement and market competition ferocity, this study constructs a differential game model of a secondary drug supply chain comprising two competing drug companies and a single healthcare institution. In addition, this study comparatively analyzes the optimal equilibrium strategies and supply chain profit levels of drug research and development investment and healthcare service efforts under four government subsidy modes, further discussing them along with arithmetic examples. It is found that the government's subsidy behavior markedly influenced drug companies' investment in drug research and development and healthcare institution' service cost investment. Besides, different incentives for supply chain members' decision-making and profits were noted in different markets with different competition intensities. In the low-intensity competition market, the government's subsidies to innovative drug companies generate much higher social welfare than other modes. In the high-intensity competition market, the government subsidized healthcare institution can minimize the mutually exclusive effects of subsidies on the development of innovative and generic drug companies, and eventually drive the reform and development of the entire drug industry.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1542858"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752173","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}