Frontiers in Public Health最新文献

{"title":"Self-reported long COVID associated with sleep problems and poor sleep quality among adults in Germany: results of the German Health Update 2023 (GEDA 2023).","authors":"Ann-Kristin Beyer, Dinara Yessimova, Lisa Kümpel, Grit Eckert, Robert Schlack, Hannelore Neuhauser, Giselle Sarganas, Julia Nübel","doi":"10.3389/fpubh.2026.1814427","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1814427","url":null,"abstract":"<p><strong>Introduction: </strong>Long COVID refers to various long-term health impairments following a SARS-CoV-2 infection, including physical, cognitive, and psychological symptoms. Sleep problems are among the most prevalent neuropsychiatric symptoms of long COVID and can negatively affect daily functioning and quality of life. This study aims to investigate sleep onset problems, problems maintaining sleep and poor sleep quality in associations with long COVID among adults in Germany.</p><p><strong>Methods: </strong>Analyses are based on data from the cross-sectional nationwide telephone interview survey \"German Health Update\" (GEDA 2023). Between March 2023 and February 2024, 9,310 adults (50.8% female, median age = 60.8 years) answered questions on any prior SARS-CoV-2 infection and long COVID status, as well as on sleep onset problems, problems maintaining sleep and poor sleep quality over the past 4 weeks. Weighted prevalence estimates for each sleep variable were calculated by self-reported SARS-CoV-2 infection and long COVID status. Multivariable logistic regressions were conducted, adjusted for age, sex, level of education, chronic conditions, depressive symptoms, COVID-19 vaccination status, and multiple SARS-CoV-2 infections.</p><p><strong>Results: </strong>Participants with self-reported current long COVID reported higher proportions of sleep onset problems (32.6%), problems maintaining sleep (47.8%) and poor sleep quality (44.8%) compared to participants without a SARS-CoV-2 infection (20.0%, 30.8 and 24.1%, respectively) or prior infected participants without long COVID (13.8%, 23.8 and 20.0%, respectively). In multivariable logistic regression analyses, participants with self-reported current long COVID had an increased likelihood of experiencing problems maintaining sleep (adjusted odds ratio (aOR) = 1.73; 95% CI = 1.23-2.44) and a higher likelihood of poor sleep quality (aOR = 1.81; 95% CI = 1.29-2.55) compared to non-infected individuals; however, sleep onset problems were not associated with long COVID.</p><p><strong>Discussion: </strong>Our findings from general population data suggest that adults with current long COVID have 1.7- to 1.8-fold higher odds of problems maintaining sleep and poor sleep quality than non-infected individuals. Given the potential impact on quality of life and physical and psychological functioning, sleep-related symptoms may represent an important target for clinical assessment and management in individuals with long COVID.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1814427"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296502","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":"Does climate adaptation policy deliver a health dividend? Exposure, modeled health burden, and defensive capacity in China's climate-adaptive city pilots.","authors":"Cun Wang, Hantao Gong","doi":"10.3389/fpubh.2026.1987084","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1987084","url":null,"abstract":"<p><p>Climate policy is widely expected to yield a health dividend: cleaner air can improve health without a simultaneous expansion of defensive capacity. We distinguish exposure reduction from defensive adaptation in China's 2017 climate-adaptive city pilot, using a 2011-2022 panel of 264 cities, including 21 treated units. A difference-in-differences design examines fine particulate matter (PM2.5) exposure, while the Global Exposure Mortality Model translates exposure into modeled pollution-related health burden. Physicians, hospital beds, and employee-insurance enrolment measure selected defensive inputs. The pilot is associated with a 3.87 μg/m³ lower PM2.5 (95% confidence interval -6.49 to -1.25; wild-bootstrap <i>P</i> = 0.0067). The estimate remains negative after pollution-convergence adjustments but is smaller and imprecise in the matched sample. The central accounting model implies an approximately 8.10% lower burden (conditional 95% confidence interval -11.32 to -4.76%), not an observed mortality reduction. Average capacity estimates are imprecise and cannot establish the absence of defensive adaptation. A physician-based coupling calibration admits positive and negative contributions and cannot bound the total defensive response. Among nine pre-policy capacity interactions, telecommunications intensity is positively associated with bed expansion (+4.40 per 10,000 residents; pointwise 95% confidence interval 2.47-6.32; adjusted <i>P</i> = 0.021), although pre-trend concerns limit causal interpretation. Other interactions remain uncertain. The main estimate is close to an illustrative detection threshold, warranting caution with non-significant findings. The results support an exposure-related health co-benefit under explicit accounting assumptions. Assessment incentives, coordination, and financing are possible explanations for uneven responses, but their roles are not identified by these estimates.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1987084"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13717398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296451","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":"Context and intricacies in the evolution of master of public health programmes in post-apartheid South Africa.","authors":"Thembelihle Dlungwane, Virginia Zweigenthal, Laetitia Rispel","doi":"10.3389/fpubh.2026.1882277","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1882277","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, Master of Public Health (MPH) programmes provide essential skills in epidemiology, health policy, and management and prepare graduates to tackle complex health challenges across the lifespan, and to strengthen health systems. This study is a critical analysis of the evolution of MPH programmes in post-apartheid South Africa and the complex interplay between historical legacies, health system transformation, and shifting national and global public health priorities.</p><p><strong>Methods: </strong>An exploratory, descriptive qualitative study combined in-depth interviews with key informants and a review of relevant documents on the evolution of MPH programmes. The interviews explored stakeholder perspectives on the evolution, development and transformation of MPH programmes, while the document review examined the historical development and evolution of MPH and postgraduate public health training in South Africa. Data were analysed thematically.</p><p><strong>Results: </strong>MPH programmes emerged in the context of profound socio-political change following South Africa's democratic transition in 1994. These programmes were developed to address health workforce gaps, redress apartheid-era inequities, and cultivate a multidisciplinary cadre of health worker equipped to respond to the country's growing burden of disease and determinants of health. However, MPH programmes have been shaped by the tension between global public health standards and local contextual realities, variation in institutional capacity in different universities, and the need to balance academic rigour with practical relevance for a diverse health workforce. Notwithstanding several innovations, insufficient government investment and the lack of career pathways for MPH graduates remain unresolved issues.</p><p><strong>Conclusion: </strong>MPH programmes in South Africa were shaped by contextual drivers and institutional dynamics, with ongoing developments linked to national efforts to address inequities inherited from apartheid and to build a multidisciplinary workforce capable of implementing population-based health strategies. Future research should compare public health curricula across South African institutions.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1882277"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296567","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":"Recentring young people in AI for mental health support: breaking the evidence-design feedback loop.","authors":"Jaspreet Kaur Sangha, Stephanie R Partridge, Rebecca Raeside","doi":"10.3389/fpubh.2026.1954336","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1954336","url":null,"abstract":"<p><p>Young people are largely underrepresented in research underpinning AI-based mental health tools. AI systems are shaped by evidence bases that do not always fully incorporate young people's opinions and perspectives. We propose a conceptual model, an evidence-design feedback loop in which exclusion from research may risk producing interventions that are less likely to be adopted by young people or meet their needs. These risks are amplified for young people from marginalised and underrepresented cultural contexts who face compounded exclusion, as the evidence base and design processes often lack cultural diversity. The relationships in this model are hypothesised from existing literature. This article argues that structural change is required across both research and industry to incorporate co-design with young people. AI developers should demonstrate meaningful involvement of young people from the earliest stages of development, and regulators should enforce higher regulatory standards in this respect. Researchers and AI developers should embed meaningful co-design with young people into the development of AI-based mental health tools which may help these technologies to be more relevant, safe and responsive to young people's lived experiences.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1954336"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296461","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":"Hospital cost structure and resource utilization in unicompartmental knee arthroplasty and hip resurfacing arthroplasty: a single-center comparative cost analysis.","authors":"Ewa Lucka, Przemysław Daroszewski, Mateusz Lucki, Juliusz Huber","doi":"10.3389/fpubh.2026.1881345","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1881345","url":null,"abstract":"<p><strong>Introduction: </strong>Unicompartmental knee arthroplasty (UKA) and hip resurfacing arthroplasty (HRA) are joint-preserving procedures used in different anatomical and clinical settings. Although they are not competing treatment options, both require substantial hospital resources. This study compared institutional cost structure and resource utilization associated with UKA and HRA from the hospital-provider perspective.</p><p><strong>Methods: </strong>This retrospective, single-center study included 68 unique patients undergoing UKA (<i>n</i> = 36) or HRA (<i>n</i> = 32) between January 2023 and July 2024. Each patient contributed one index hospitalization, one surgical procedure, and one independent analytical observation. The primary outcome was total index-hospitalization cost. Secondary outcomes included operating-room personnel costs, costs incurred outside the operating room, medical costs, and non-medical costs. Individual cost components and correlations with length of stay were exploratory. The association between procedure type and total index-hospitalization cost was assessed using a gamma-log generalized linear model adjusted for age, sex, body mass index, Charlson Comorbidity Index, and Kellgren-Lawrence grade 4. Secondary and exploratory comparisons were adjusted using the Benjamini-Hochberg false-discovery-rate procedure.</p><p><strong>Results: </strong>Mean total index-hospitalization cost was €5,561.53 for UKA and €6,631.18 for HRA, an unadjusted difference of €1,069.65 (<i>p</i> < 0.0001). After case-mix adjustment, HRA was associated with a 32% higher expected total index-hospitalization cost than UKA (adjusted cost ratio 1.32, 95% CI 1.07-1.63; <i>p</i> = 0.008). Medical costs were higher for HRA (€2,918.90 vs. €1,985.23; <i>q</i> < 0.0001), whereas operating-room personnel costs were higher for UKA (€371.59 vs. €335.45; <i>q</i> = 0.0035). Costs incurred outside the operating room and non-medical costs did not differ significantly. Implant costs were higher for HRA (€2,544.55 vs. €1,554.55; <i>q</i> < 0.0001). After FDR adjustment, length of stay was associated with laboratory and imaging costs in the UKA group and with laboratory costs in the HRA group.</p><p><strong>Conclusion: </strong>UKA and HRA showed distinct patterns of index-hospitalization costs and resource utilization. Higher implant expenditure was an important component of the observed cost difference. These findings represent a hospital-level comparison of two distinct arthroplasty pathways and should not be interpreted as evidence favoring either procedure. Detailed evaluation of procedure-specific cost structures may support hospital budgeting, resource allocation, implant procurement, and operational planning.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1881345"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296492","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":"Computer vision syndrome among high school students using digital versus printed textbooks: prevalence and associated factors.","authors":"Mar Seguí-Crespo, Mar Sánchez-Brau, José Miguel Martínez, Ana Tauste, Eva Artime-Ríos, Elena Ronda-Pérez","doi":"10.3389/fpubh.2026.1957177","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1957177","url":null,"abstract":"<p><strong>Background: </strong>The increasing implementation of digital textbooks in schools raises concerns regarding their potential impact on the ocular and visual health of adolescents. However, the effect of this educational shift on computer vision syndrome (CVS) has not yet been assessed using validated measurement tools.</p><p><strong>Objective: </strong>This study analyses the prevalence of CVS in adolescent students, comparing the use of printed versus digital textbooks, and considering sociodemographic, visual and digital devices exposure factors.</p><p><strong>Methods: </strong>A longitudinal observational study with repeated assessments of the same participants and estimation of CVS at four time points was conducted during the second academic semester in two high schools in Alicante, Spain (<i>n</i> = 231 students, 15-17 years old). One high school used printed textbooks, whereas the other implemented digital textbooks. An initial visual examination was performed, assessing visual acuity, objective and subjective refraction, eye movements, pupillary reflexes, and the cover test. At each visit, participants completed a questionnaire on digital device exposure and together with the validated CVS-Q© teen questionnaire. Generalized Estimating Equation logistic regression models were used to estimate crude and adjusted odds ratios (aOR) and 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>CVS prevalence was 56.7% among students using printed textbooks and 58.7% among those using digital textbooks to study, with no significant differences between groups (aOR = 1.0; 95% CI, 0.6-1.7). Being female and having an uncorrected refractive error were associated with a higher likelihood of CVS.</p><p><strong>Conclusion: </strong>CVS prevalence was similar among students using digital and printed textbooks, and this pattern remained after adjustment for relevant covariates. However, appropriate optical compensation should be used when necessary to prevent an increase.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1957177"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296559","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":"Associations between latent classes of left-behind experience and non-suicidal self-injury among rural adolescents: the sequential mediating roles of family functioning and shame.","authors":"Wei Mi, Shiying Tan, Zhanqun Gao, Qing Yang, Cuixiao Wang","doi":"10.3389/fpubh.2026.1964648","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1964648","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify latent classes of left-behind experience among rural Chinese adolescents and to examine the sequential mediating roles of family functioning and shame in the relationship between left-behind experience and NSSI.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 1,735 rural middle school students with left-behind experience from two schools in Hunan Province, China, in 2024. Latent class analysis (LCA) was performed to identify subgroups of left-behind experience based on four indicators: age at parental separation, parental migration pattern, duration of parental migration, and frequency of communication with migrant parents. Correlation analysis, multiple linear regression, and a bootstrap-based sequential mediation model with 5,000 resamples were used to examine the relationships among latent class membership, family functioning, shame, and NSSI.</p><p><strong>Results: </strong>LCA identified three distinct latent classes of left-behind experience: a low-risk group, a moderate-risk group, and a high-risk group. Correlation analyses showed that latent class membership was significantly associated with family functioning (<i>ρ</i> = -0.149, <i>p</i> < 0.05), shame (<i>ρ</i> = 0.139, <i>p</i> < 0.001), and NSSI (<i>ρ</i> = 0.142, <i>p</i> < 0.05). Family functioning was negatively associated with shame (<i>r</i> = -0.132, <i>p</i> < 0.001) and NSSI (<i>r</i> = -0.235, <i>p</i> < 0.001), whereas shame was positively associated with NSSI (<i>r</i> = 0.256, <i>p</i> < 0.001). Multiple regression analyses indicated that family functioning was negatively associated with shame (<i>β</i> = -0.126, <i>p</i> < 0.001) and NSSI (<i>β</i> = -0.204, <i>p</i> < 0.001), while shame was positively associated with NSSI (<i>β</i> = 0.229, <i>p</i> < 0.001). Sequential mediation analyses further indicated that, compared with the high-risk group, both the low-risk group (<i>B</i> = -0.107, 95% CI: -0.243 to -0.016) and the moderate-risk group (<i>B</i> = -0.143, 95% CI: -0.306 to -0.027) were associated with lower NSSI levels through the sequential pathway involving family functioning and shame.</p><p><strong>Conclusion: </strong>Left-behind experience among rural adolescents is heterogeneous, and different patterns are associated with varying levels of NSSI risk. Significant indirect associations involving family functioning and shame were observed between left-behind experience and NSSI, including a sequential indirect association through family functioning and shame. These findings suggest that family functioning and shame may represent relevant psychosocial factors to consider in future prevention efforts targeting NSSI among high-risk left-behind adolescents.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1964648"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296611","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-practice decoupling in residential chemical indoor-air pollution: a cross-sectional survey in Lebanon.","authors":"Wissam Ghach, Rina Salhab, Jana K Alwattar, Sara Abou Ibrahim, Nisreen Alwan, Emran Alotaibi","doi":"10.3389/fpubh.2026.1971900","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1971900","url":null,"abstract":"<p><strong>Introduction: </strong>Residential chemical indoor-air pollution arises from combustion, smoking residues, fragranced products, cleaning chemistry, pesticides, building materials and ventilation behavior, yet household-level evidence from Lebanon remains limited. This study assessed knowledge, preventive attitudes, household practices and symptom recognition, with particular attention to whether knowledge translated into exposure-relevant behavior.</p><p><strong>Methods: </strong>This secondary cross-sectional analysis used a non-probability convenience sample of 495 completed self-administered questionnaires collected between 8 November 2025 and 10 April 2026. Evidence-aligned scoring was used for knowledge and preventive attitudes, while practice items were separated into mitigation and source-frequency indices. Descriptive statistics, internal-consistency estimates, Wilson 95% confidence intervals, Spearman correlations, robust linear models and robust logistic models were used.</p><p><strong>Results: </strong>Respondents were predominantly young, female and university educated. Mean knowledge and preventive-attitude scores were 47.3 and 48.8 on 0-100 scales; the mean mitigation index was 66.3 and the mean source-frequency index was 58.4. Knowledge was moderately associated with preventive attitudes but only weakly associated with mitigation behavior. Higher preventive-attitude scores were associated with lower source-frequency, lower odds of regular indoor smoking and a higher mitigation-minus-source difference score. Symptom recognition was stronger for respiratory and neurological than for ocular, irritant and dermatological manifestations.</p><p><strong>Discussion: </strong>The findings indicate knowledge-practice decoupling within this sample: mitigation behaviors coexisted with frequent source-related activities, and knowledge alone did not explain household practice. Because the study used a non-probability, self-reported cross-sectional sample, results are sample-specific and do not establish national prevalence or causal effects. Source-specific risk communication and representative studies incorporating objective exposure measures are warranted.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1971900"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296465","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":"Identity development and the transition to adulthood under polycrisis: a one-year longitudinal study of emerging adults.","authors":"Anna Wendołowska, Katarzyna Sitnik-Warchulska, Weronika Kałwak, Aleksandra Gruszka, Dorota Czyżowska, Bernadetta Izydorczyk","doi":"10.3389/fpubh.2026.1958411","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1958411","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Contemporary emerging adults are navigating the transition to adulthood under conditions of prolonged societal uncertainty associated with multiple concurrent global crises. Although psychological stress has been extensively linked to poorer mental health, considerably less is known about its prospective associations with identity development and adulthood attainment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This longitudinal study examined whether baseline psychological stress burden prospectively predicted identity development, adulthood attainment, and resilience-related resources over 1 year, and whether baseline resilience-related resources prospectively predicted identity and adulthood attainment independently of stress burden.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were drawn from a nationwide longitudinal panel of 831 Polish emerging adults (18-29 years) assessed at two time points separated by 1 year. Psychological stress burden was modelled as a latent factor indicated by perceived stress, adjustment-disorder symptoms, and polycrisis-related adjustment difficulties. Identity development was assessed using the five-dimensional model of identity formation, alongside measures of resilience-related resources and subjective and objective adulthood. Longitudinal hypotheses were examined using autoregressive structural equation models controlling for baseline levels of the respective outcomes and relevant sociodemographic covariates. Subjective adulthood was modelled as a binary outcome using probit structural equation modelling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All developmental outcomes showed significant rank-order stability across the follow-up period, while mean-level changes were generally small. Higher baseline psychological stress burden prospectively predicted greater ruminative exploration, lower commitment making, and lower identification with commitment, but was not significantly associated with exploration in breadth, exploration in depth, resilience-related resources, objective adulthood, or subjective adulthood. Higher baseline resilience-related resources prospectively predicted greater exploration in breadth, commitment making, exploration in depth, and identification with commitment, independently of baseline psychological stress burden, but did not significantly predict ruminative exploration, objective or subjective adulthood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Psychological stress burden and resilience-related resources showed distinct prospective associations with identity development, whereas neither significantly predicted objective or subjective adulthood after accounting for baseline levels and covariates. Higher psychological stress burden was associated with greater ruminative exploration and weaker commitment-related processes, whereas resilience-related resources were associated with both adaptive exploration and commitment processes. These findings suggest that, over the one-year interval ex","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1958411"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296480","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 information needs regarding norovirus infection among parents of primary school students directly affected by outbreaks: a cross-sectional study in Hangzhou, China.","authors":"Xiaojian Duan, Kai Song, Liangliang Huo, Jiayun Wang, Yi Wang, Xiaobin Ren, Jing Wang","doi":"10.3389/fpubh.2026.1896883","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1896883","url":null,"abstract":"<p><strong>Background: </strong>Norovirus outbreaks are prevalent in primary schools; however, few studies have specifically examined the parents directly impacted by these events.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between January 2025 and March 2026. Parents from seven primary schools affected by norovirus outbreaks in Hangzhou, China, were invited to complete a self-administered online questionnaire. Data were collected on sociodemographic characteristics, knowledge of norovirus pathogenesis, attitudes toward prevention and control, and information needs.</p><p><strong>Results: </strong>A total of 322 valid responses were obtained (response rate 82.14%). Among respondents, 83.85% reported awareness of norovirus. The mean knowledge score regarding norovirus pathogenesis was 6.43 ± 1.91 out of 11 (58.45% correct), with only 14.07% attaining a \"good\" knowledge level (≥9 points). Attitude scores were high, with a rate of 88.22% of the maximum. Multivariable logistic regression identified educational attainment (bachelor's degree or higher: OR = 6.27, 95% CI: 1.75-52.28), residence type (detached house: OR = 5.76, 95% CI: 1.48-6.18), and active information-seeking (OR = 24.60, 95% CI: 11.28-53.66) as factors independently associated with good knowledge level.</p><p><strong>Conclusion: </strong>Parents directly affected by norovirus outbreaks demonstrated inadequate knowledge but held positive attitudes. Proactive information-seeking was the strongest predictor of good knowledge. Targeted health education, particularly through WeChat parent groups, is urgently required to bridge knowledge gaps and foster active learning.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1896883"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149296490","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}