Frontiers in Public Health最新文献

{"title":"Preoperative information burden among parents of children with congenital heart disease: a qualitative study of information access, understanding, and decision-making.","authors":"Yuan Hu, Jing Tian, Mei Teng, Yuan Li, Hong Zheng","doi":"10.3389/fpubh.2026.1965200","DOIUrl":"10.3389/fpubh.2026.1965200","url":null,"abstract":"<p><strong>Background: </strong>Parents of children with congenital heart disease must understand complex clinical information, navigate referral and practical barriers, and make treatment decisions on behalf of their child. Information burden may therefore reflect not only information quantity but also whether information is understandable, trustworthy, accessible, and actionable.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted at a tertiary paediatric cardiac centre in China. Twelve parents completed individual face-to-face semi-structured interviews. Purposive sampling sought variation in education, residence, and treatment pathway. Sample adequacy was guided by information power, and recruitment ceased when later interviews no longer altered the main analytic categories or theme boundaries. Data were analysed using the Framework Method, combining within-case timelines with cross-case comparison. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).</p><p><strong>Results: </strong>Four interacting themes were developed: threat before understanding; navigating fragmented information pathways; difficulty translating information into child-specific decisions; and information shaping family adaptation and treatment decisions. Parents described technical language, conflicting recommendations, changing findings, non-comparable digital stories, referral barriers, and cost uncertainty. They valued staged plain-language explanations, visual and written materials, explicit monitoring thresholds, a reliable route for clarification, verified digital information, and practical navigation.</p><p><strong>Conclusion: </strong>Preoperative information burden was driven less by information volume than by difficulty translating fragmented clinical, digital, and practical information into a trusted, child-specific course of action. Public health and paediatric services should treat communication, health-information access, and navigation as connected parts of a family-centred pathway rather than as isolated educational tasks.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1965200"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265710","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 nursing students' experiences of using generative AI for emotional intelligence learning: a qualitative study.","authors":"Xiaohui Fan, Jingjing Sun, Rui Xu, Linghui Zhang, Ruixiao Ou, Ruihua Jin, Hui Yang, Panpan Huai","doi":"10.3389/fpubh.2026.1967799","DOIUrl":"10.3389/fpubh.2026.1967799","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Emotional intelligence is a core competency for nursing students; however, traditional nursing education faces challenges in fostering emotional intelligence, including curricular imbalances, limited teaching methods, and delayed assessment and feedback. The rapid development of generative artificial intelligence (GenAI) offers new possibilities for addressing the above issues; however, existing research has not yet thoroughly explored how nursing students learn emotional intelligence through GenAI or their experiences in this process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Based on the Unified Theory of Acceptance and Use of Technology (UTAUT) and the Teaching Pedagogical Content Knowledge (TPACK) framework, and using Goleman's five-dimensional model of emotional intelligence as a reference, this study explores the experiences of undergraduate nursing students in using generative artificial intelligence for emotional intelligence learning, as well as the factors that facilitate this process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This study employed a qualitative descriptive research design and Reflexive Thematic Analysis (RTA). Using purposive sampling, 19 undergraduate nursing students (from freshman to senior year) were selected for one-on-one semi-structured in-depth interviews. All participants had experience using GenAI tools (such as DeepSeek and Doubao) for communication practice, case discussions, or sentiment analysis. The interview data were analyzed using the RTA six-stage process, with NVivo 12.0 software used to assist with data management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified and synthesized 238 initial codes into three core themes. Theme 1, \"From Efficiency-Driven to Precise Empathy,\" presents the differing descriptions of empathy-related experiences among students in different grade levels: lower-grade students more frequently reported efficiency-driven usage experiences; some middle-grade students described difficulties caused by technical barriers; and upper-grade students more often described the recognition of patients' emotions in conjunction with clinical experience. Theme 2, \"From Mimicking AI to Autonomous Expression,\" focuses on students' reported experiences related to social skills, including direct application, recognition and adjustment, autonomous expression, and the simulation gap that persisted throughout the process. Theme 3, \"From Technical Frustration to Mental Rehearsal,\" integrates experiences related to self-management, self-awareness, and self-motivation. The three themes correspond to different dimensions of emotional intelligence, with students in different grade levels reporting distinct experiential characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Nursing undergraduates in different grades exhibit distinct experiential characteristics when using generative artificial intelligence to learn about emotional intelligence. Students' reports repeatedly highlighted moderate tens","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1967799"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265719","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":"Industrial processing of Ecuadorian household food acquisitions according to NOVA, socioeconomic status and territory.","authors":"Orlando Meneses Quelal","doi":"10.3389/fpubh.2026.1970719","DOIUrl":"10.3389/fpubh.2026.1970719","url":null,"abstract":"<p><strong>Introduction: </strong>Household food-acquisition data can characterise the technological structure of food systems without equating monetary expenditure with individual dietary intake. This study quantified the monetary distribution of Ecuadorian household food acquisitions according to NOVA and examined socioeconomic and territorial patterning.</p><p><strong>Methods: </strong>We analysed 35,398 households from the 2024-2025 Ecuadorian National Survey of Household Income and Expenditure (ENIGHUR), accounting for survey weights, strata and primary sampling units. Of 899 detailed food and non-alcoholic beverage fields, 840 recorded positive expenditure. Products were classified using NOVA through an explicit uncertainty audit, with fourteen categories retained as REVIEW. National and domain estimates, survey-weighted fractional logit models, sensitivity analyses and weighted principal component analysis were performed.</p><p><strong>Results: </strong>Weighted national expenditure shares were 72.91% for NOVA 1, 3.11% for NOVA 2, 11.74% for NOVA 3 and 12.25% for NOVA 4. The NOVA 4 share increased from 9.82% in the first income decile to 15.94% in the tenth. Fractional logit modelling confirmed a positive association with income and a significant income-by-urban-residence interaction, with greater urban divergence at higher income levels. Alternative classification of REVIEW items changed the national NOVA 4 estimate only from 12.21% to 12.53%. Weighted PCA retained three components explaining 54.44% of variance.</p><p><strong>Discussion: </strong>Minimally processed foods remained the dominant component of household monetary acquisitions, while NOVA 4 products were widely present and showed clear socioeconomic and territorial patterning. The small sensitivity range supports the robustness of the classification. These findings provide a reproducible national baseline for monitoring changes in Ecuadorian household food acquisitions by degree of industrial processing.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1970719"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265583","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":"Meropenem as a non-guideline antibiotic: the factor associated with mortality of mortality in <i>Listeria monocytogenes</i> meningitis.","authors":"Qiangsheng Feng, Yuejuan Song, Yuan Xing, Julin Zhan, Tuanjie Che, Xu Heng, Xiliang Bin, Xiaoqin Ha","doi":"10.3389/fpubh.2026.1895883","DOIUrl":"10.3389/fpubh.2026.1895883","url":null,"abstract":"<p><strong>Background: </strong><i>Listeria monocytogenes</i> meningitis has high mortality. Evidence on meropenem's real-world efficacy in Chinese adults is lacking.</p><p><strong>Methods: </strong>This retrospective study of 19 Listeria meningitis cases used CSF/blood culture and ROC analysis for diagnosis, and applied Fisher's exact test to explore the association between meropenem treatment and mortality.</p><p><strong>Results: </strong>In 19 patients with <i>L. monocytogenes</i> meningitis (median age 56 years, male/female 2.16:1), <i>L. monocytogenes</i> was the second most common cause (70.3% of Listeria infections). Underlying diseases were present in 10 patients, and MRI showed periventricular changes (9 cases), bifrontal lesions (2), hydrocephalus (1), and normal findings (4). Of 10 CSF-positive patients, 2 had concurrent positive blood cultures; mean time to blood culture positivity was 19.3 ± 9.3 h. All tested isolates were susceptible to ampicillin, penicillin, TMP-SMX (Trimethoprim-sulfamethoxazole), and meropenem. Serum PCT (AUC = 0.980), CSF WBC (AUC = 1.000), and CSF protein (AUC = 0.959) showed excellent diagnostic performance. In exploratory univariate analysis, Fisher's exact test identified non-guideline antibiotic administration as the factor associated with mortality of mortality (<i>p</i> = 0.035).</p><p><strong>Conclusion: </strong>Non-guideline antibiotic use (meropenem) was the factor associated with mortality of mortality in adult <i>L. monocytogenes</i> meningitis (40% mortality). First-line therapy should remain ampicillin/penicillin; meropenem should be reserved for alternative use only based on existing guidelines, not on the findings of this study alone.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1895883"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265709","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":"Use of quality-of-care and patient-safety policies in the WHO European region: an ecological cross-sectional exploratory analysis of policy adoption and health outcomes.","authors":"Liesbeth Borgermans, Ana Marques Domingues, Anna Crispo, Válter R Fonseca, Lenio Capsaskis, Jennifer Hall, João Breda","doi":"10.3389/fpubh.2026.1904393","DOIUrl":"10.3389/fpubh.2026.1904393","url":null,"abstract":"<p><strong>Objective: </strong>To assess the implementation of quality-of-care and patient-safety policies across the WHO European Region and their association with population health outcomes.</p><p><strong>Methods: </strong>This study used an exploratory, ecological cross-sectional design. We constructed a summary count (0-9) of nine national quality-of-care and patient-safety policies to capture the breadth of policy adoption, and used exploratory multivariable linear regression to examine cross-sectional associations with selected outcomes, adjusting for health-workforce density and public spending on health.</p><p><strong>Results: </strong>Many countries lacked national action plans for quality and patient safety, with only around one-third implementing both. Implementation of a national quality-of-care plan was associated with higher healthy life expectancy (1.68 additional years; <i>p</i> _unadjusted = 0.033, <i>p</i> = 0.144), a lower probability of premature death from cardiovascular disease, cancer, diabetes and chronic respiratory diseases (-3.33 percentage points; <i>p</i> _unadjusted = 0.049, <i>p</i> = 0.144), and reduced under-five mortality (-4.06 deaths per 1,000 live births; <i>p</i> _unadjusted = 0.023, <i>p</i> = 0.144). Implementing a greater number of national policies was associated with small increases in healthy life expectancy (0.29 years per additional policy; <i>p</i> _unadjusted = 0.043, <i>p</i> = 0.167) and lower under-five mortality (-0.72 deaths per 1,000 live births per additional policy; <i>p</i> _unadjusted = 0.018, <i>p</i> = 0.162), while associations with other outcomes were weaker and often non-significant.</p><p><strong>Conclusion: </strong>Given the ecological cross-sectional design, limited adjustment and multiple testing, these findings should be treated as exploratory and non-causal and used as a basis for more detailed longitudinal research.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1904393"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265718","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":"Macroeconomic burden of tracheal, bronchial, and lung cancers in Asia.","authors":"Long Chen, Haoyang Hu, Jiuhe Wang, Jinglian Qu","doi":"10.3389/fpubh.2026.1943102","DOIUrl":"10.3389/fpubh.2026.1943102","url":null,"abstract":"<p><strong>Background: </strong>Although Asia shoulders a considerable burden of tracheal, bronchial, and lung (TBL) cancers, the associated macroeconomic impact has yet to be adequately investigated.</p><p><strong>Methods: </strong>Using 2023 data from the Global Burden of Disease Study and the World Bank, we applied the value of a statistical life year (VSLY) method to estimate the economic welfare losses attributable to TBL cancers in Asian countries. We further analyzed the temporal trends, sex and age-specific disparities, and the drivers of economic inequality and projected the burden trends to 2050.</p><p><strong>Results: </strong>In Asia, the value of lost welfare (VLW) due to these cancers reached USD 3.28 (95% UI, 2.6301-4.0572) trillion, equivalent to 4.18% (95% UI, 3.35-5.17) of the regional GDP. Temporal trend analyses revealed a consistent upward trajectory in both absolute VLW and its GDP share. Sex-stratified analyses showed that the burden was significantly higher in male populations, and age-specific peaks occurred at 70-74 years for both sexes. Health inequality metrics indicated a pronounced widening of relative disparities over time. Projection models forecast a continued increase in absolute VLW, whereas its proportional contribution to GDP is expected to plateau.</p><p><strong>Conclusion: </strong>These findings establish that TBL cancers impose a substantial and inequitably distributed macroeconomic burden across Asia. The pronounced sex and region-specific disparities underscore the urgent need for evidence-based, geographically targeted intervention strategies. Prioritizing the targeted deployment of resources in high-burden zones is critical to mitigating economic losses and improving survival outcomes in the region.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1943102"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265732","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 costs and health-related quality of life associated with oculopharyngeal muscular dystrophy.","authors":"Ian C Smith, Alyssa Grant, Lola E R Lessard, Homira Osman, Fien Oelbrandt, Hanns Lochmüller, Hugh J McMillan, Gerald Pfeffer, Lawrence Korngut, Cynthia Gagnon, Stacey Lintern, Katherine A Selby, Ari Breiner, Kednapa Thavorn, Jodi Warman-Chardon","doi":"10.3389/fpubh.2026.1918801","DOIUrl":"10.3389/fpubh.2026.1918801","url":null,"abstract":"<p><strong>Background: </strong>Oculopharyngeal muscular dystrophy (OPMD) is a progressive genetic neuromuscular disease. OPMD substantially impacts quality of life by limiting swallowing, decreasing mobility and can cause death by choking. We conducted this study to quantify the burden of OPMD from the patient perspective. These data are needed to inform cost-effectiveness studies for treatments in development and to inform public policy.</p><p><strong>Methods: </strong>As part of the national Burden of Inherited and Inflammatory Neuromuscular Disease study survey, Canadians with OPMD were asked about the impact of OPMD on their health-related quality of life (Health Utilities Index Mark 3; HUI3), employment status, household finances, productivity (Work Productivity and Activity Impairment questionnaire), and out-of-pocket costs for assistive equipment and healthcare to help manage OPMD. Sociodemographic and epidemiological data were used to extrapolate participant responses into an estimate of the total patient-borne cost of OPMD for Canada.</p><p><strong>Results: </strong>Health-related quality of life was low in OPMD (<i>n</i> = 139, mean age 66 ± 10 years, 52% female) with HUI3 scores of 0.398 ± 0.323, compared to 0.826 for the normative population. Low HUI3 scores were associated with higher costs for assistive equipment and greater financial hardship. 29% of respondents with OPMD were in paid employment compared to 41% in the normative population. Impairments in total work productivity and non-work activity were 32 ± 27% and 61 ± 29%, respectively. Paid employment was associated with greater access to private insurance (odds ratio 4.2) which was in turn positively associated with the likelihood of visiting allied healthcare providers (odds ratio 2.5). The total patient-borne cost of OPMD for Canada was estimated to be $78.4 million (2026 Canadian dollars). Indirect costs accounted for 84% of the total; 53% for non-work activity impairment, 18% for loss of earning capacity, 12% for presenteeism and 2% for absenteeism. Direct costs comprised 16% of the total; 7% for healthcare visits and 9% for assistive equipment.</p><p><strong>Discussion: </strong>OPMD imposes substantial direct and indirect economic burden, primarily due to impact on work and productivity and less on equipment or health professional costs. The high indirect costs of OPMD should be a consideration in economic evaluations and future health policy decisions for emerging therapeutic interventions.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1918801"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265598","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":"Ebola virus disease and maternal-neonatal health: direct and indirect impacts and health system preparedness gaps.","authors":"Nasro Salad Ahmed, Fatima Abdijabbar Ibrahim, Omar Aweis Ali","doi":"10.3389/fpubh.2026.1952690","DOIUrl":"10.3389/fpubh.2026.1952690","url":null,"abstract":"<p><strong>Background: </strong>Ebola virus disease (EVD) is a severe viral infection that can substantially affect maternal and neonatal health through both direct disease and disruption of essential health services. Pregnant women and neonates may experience serious adverse outcomes during outbreaks, yet pregnancy-specific evidence remains limited and maternal-neonatal health has historically received insufficient attention in Ebola preparedness and research.</p><p><strong>Methods: </strong>This narrative review synthesized evidence on Ebola virus disease and maternal-neonatal health from peer-reviewed literature, international guidance, and outbreak reports. Relevant literature was identified through targeted searches of PubMed, Scopus, and Google Scholar and through reference-list screening of key publications. Findings were synthesized narratively, with attention to study design, methodological limitations, and differences across outbreak settings.</p><p><strong>Findings: </strong>Available evidence indicates that EVD during pregnancy is associated with severe maternal complications and poor fetal and neonatal outcomes, although risk estimates remain uncertain because of small and heterogeneous studies. Placental infection and mother-to-child transmission have been documented. Ebola outbreaks also disrupt antenatal, delivery, immunization, and emergency obstetric services, contributing to additional maternal and neonatal morbidity and mortality. Key preparedness gaps include limited maternity-specific IPC, inadequate pregnancy-disaggregated surveillance, and insufficient evidence on vaccines and therapeutics in pregnancy.</p><p><strong>Conclusion: </strong>EVD poses serious but context-dependent risks to maternal and neonatal health through direct disease and disruption of essential healthcare services. Preparedness should prioritize continuity of essential maternity and newborn care, maternity-specific IPC, pregnancy-disaggregated surveillance, and the responsible inclusion of pregnant and breastfeeding women in vaccine and therapeutic research and access.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1952690"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265627","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":"Antimicrobial resistance of bacteria isolated from blood cultures at a tertiary hospital in Papua New Guinea: implications for antimicrobial stewardship and surveillance.","authors":"Watson Toroi, Victor Musyoki, Becky Max, Donella Omena, Nomvuyo Mothobi, Kudakwashe Chani, Josephine Chanoan, Amrita Ronnachit","doi":"10.3389/fpubh.2026.1914935","DOIUrl":"10.3389/fpubh.2026.1914935","url":null,"abstract":"<p><strong>Introduction: </strong>Bloodstream infection (BSI) is a global healthcare concern, especially in low- and middle-income countries (LMIC) where diagnostic capacity and antimicrobial stewardship programs remain limited. Local data on bacterial causative agents and antimicrobial resistance (AMR) remain scarce in the Pacific Island Countries and Territories, including Papua New Guinea (PNG). This study aimed to determine the prevalence, bacterial spectrum, antimicrobial susceptibility patterns, and distribution of bloodstream pathogens among patients attending Goroka Provincial Hospital in Papua New Guinea.</p><p><strong>Methods: </strong>We conducted a retrospective laboratory surveillance study using routine blood culture data from Goroka Provincial Hospital. Bacterial identification and antimicrobial susceptibility results were retrieved from Senaite Laboratory Information Management System (LIMS) and analysed using WHONET and SPSS.</p><p><strong>Results: </strong>A total of 1,276 blood culture specimens were collected from patients with clinically suspected BSI, of which 141 (11.1%) yielded bacterial pathogens. <i>Salmonella enterica</i> servovar Typhi (<i>S.</i> Typhi) was the predominant isolate (72/141, 51.1%), followed by <i>Staphylococcus aureus</i> (<i>S. aureus</i>) (23/141, 16.3%). Most <i>S.</i> Typhi isolates were susceptible to first line antibiotics tested (98-100%), however, 45% were resistant to chloramphenicol. Methicillin-resistant <i>S. aureus</i> (MRSA) accounted for 60.9% of <i>S. aureus</i> isolates. Extended-spectrumβ-lactamase (ESBL)-positive <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> were susceptible to meropenem, piperacillin-tazobactam, and amikacin.</p><p><strong>Conclusion: </strong><i>Salmonella</i> Typhi was the predominant cause of BSI and showed substantial chloramphenicol resistance, while phenotypically ESBL-positive bacteria were also detected. These findings underscore the need for continued laboratory-based AMR surveillance and locally informed antimicrobial stewardship and infection-prevention strategies in PNG.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1914935"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265681","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 digital health education interventions for chronic disease self-management in community-dwelling older adults: an umbrella review and evidence classification.","authors":"Esra Sezer, Gözde Gür","doi":"10.3389/fpubh.2026.1948010","DOIUrl":"10.3389/fpubh.2026.1948010","url":null,"abstract":"<p><strong>Background: </strong>Digital health education interventions are widely promoted to support chronic disease self-management. However, existing umbrella reviews pool evidence across all ages and have not assessed community-dwelling older adults, who face barriers to digital access. This umbrella review aimed to determine whether current evidence supports the effectiveness of digital health education interventions for chronic disease self-management in community-dwelling adults aged 60 years or older.</p><p><strong>Methods: </strong>We conducted an umbrella review of systematic reviews evaluating digital health education interventions for chronic disease self-management in community-dwelling adults aged 60 years or older. Six databases were searched for systematic reviews published between 2015 and 2026. Meta-analytic outcomes were re-estimated using random-effects models, evidence was graded according to the Ioannidis criteria, methodological quality was assessed with AMSTAR 2, and primary-study overlap was quantified using the corrected covered area (CCA).</p><p><strong>Results: </strong>Of the 1,272 records identified, 11 met the eligibility criteria, and 10 contributed 44 meta-analytic outcomes derived from 199 primary randomized controlled trials (RCTs) across five chronic disease clusters. The evidence base showed minimal overlap among primary studies (overall CCA was 0.76%). None of the outcomes met the criteria for convincing (Class I), highly suggestive (Class II), or suggestive (Class III) evidence. Fifteen outcomes (34.1%) were classified as weak (Class IV), whereas 29 (65.9%) were non-significant. According to AMSTAR 2, only three of the 10 systematic reviews were rated as high confidence, whereas two were rated as low and five as critically low confidence; the 95% prediction interval crossed the null for all 44 outcomes.</p><p><strong>Conclusion: </strong>When the evidence is limited to community-dwelling older adults, no digital health education intervention for chronic disease self-management is supported by high-credibility evidence at the umbrella review level. This finding most likely reflects the immaturity of the current evidence base-characterized by a limited number of trials, short follow-up periods, and substantial heterogeneity-rather than a lack of intervention effectiveness. Well-powered RCTs with longer follow-up and higher-quality systematic reviews specifically focused on older adults are needed to strengthen the evidence base.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1948010"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265711","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}