Journal of Health, Population, and Nutrition最新文献

{"title":"Nonlinear association between the triglyceride-cholesterol-body weight index and GLIM-defined hospital-acquired malnutrition among Chinese hospitalized adults: a multicenter prospective cohort study.","authors":"Yonghao Li, Xiaoyi Luan, Yilin Li, Liru Chen, Mingwei Zhu","doi":"10.1186/s41043-026-01394-8","DOIUrl":"10.1186/s41043-026-01394-8","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired malnutrition (HAM) is prevalent and harmful. Global Leadership Initiative on Malnutrition (GLIM) criteria lack lipid metabolism information, impeding admission risk identification. TCBI integrates lipids and energy reserve, but its predictive utility for HAM remains unclear.</p><p><strong>Methods: </strong>This multicenter prospective study (June-September 2014, 34 tertiary hospitals in mainland China) consecutively enrolled 3,382 non-critically ill adults without malnutrition at admission and with hospital stays of 7-30 days. TCBI was calculated as triglyceride (mg/dL) × total cholesterol (mg/dL) × body weight (kg) / 1000 and natural log-transformed (TCBI-LN) due to skewness. The primary outcome was HAM diagnosed at discharge by adapted GLIM framework. Multivariable logistic regression, restricted cubic splines, and subgroup analyses with interaction testing were used to assess the independent association and dose‑response relationship between TCBI-LN and HAM.</p><p><strong>Results: </strong>Among 3,382 patients without admission malnutrition, 21.6% developed HAM at discharge. After full adjustment, each one-unit increase in log-transformed TCBI was independently associated with a 14.7% lower HAM risk (OR = 0.853), and restricted cubic spline analysis revealed a significant nonlinear dose-response relationship with two inflection points (TCBI-LN 7.27 and 8.50), suggesting three exploratory RCS-derived strata (HAM incidence: 26.1%, 17.0%, and 18.3%, respectively). The high-TCBI high-risk group had a small sample size and wide confidence intervals; findings are hypothesis‑generating only and require validation in larger cohorts enriched for high TCBI. Subgroup analyses further showed that the protective effect was more pronounced in surgical patients and those without hypertension, with significant effect modifications by hospital department and hypertension history.</p><p><strong>Conclusion: </strong>Admission TCBI is independently associated with the risk of HAM, exhibiting a significant nonlinear dose-response relationship. These findings suggest that TCBI may serve as a complementary metabolic-anthropometric marker for risk stratification for identifying patients at elevated risk for HAM at admission, warranting further prospective validation and interventional studies to confirm its clinical utility.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421696","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":"Gobal, regional, and national burden of hepato-pancreato-biliary cancers in older populations, 1992-2021, and prediction to 2040: analysis of data from the Global Burden of Disease study, 2021.","authors":"Heng Tian, Yipin Yang, Xinyi Wang, Shuxing Chen, Yafen Wang, Siqing Yue, Yuhan Liu, Ran Wei, Congjun Zhang, Fan Wang, Kangsheng Gu","doi":"10.1186/s41043-026-01365-z","DOIUrl":"10.1186/s41043-026-01365-z","url":null,"abstract":"<p><strong>Background: </strong>Hepato-pancreato-biliary (HPB) cancers affect human health and impose a significant burden on older adults. However, a comprehensive assessment of the global HPB disease burden in older adults is lacking.</p><p><strong>Objective: </strong>This research analyzed the trends in the burden of these cancers in older adults (aged 60-89 years) from 1992 to 2021 using data from the Global Burden of Disease Study (GBD) 2021.</p><p><strong>Methods: </strong>We examined the incidence, mortality, and disability-adjusted life years (DALYs) of liver cancer (LC), gallbladder and biliary tract cancer (GBTC), and pancreatic cancer (PC) in 204 countries and territories. Temporal trends were assessed using joinpoint regression and decomposition analysis with a focus on key global, regional, and national patterns.</p><p><strong>Results: </strong>The incidence and mortality rates of LC and PC showed a consistent increase, particularly in regions with a high Socio-Demographic Index (SDI), whereas GBTC rates declined globally. Metabolic risk factors such as high Body Mass Index (BMI) were associated with increased DALYs for LC and PC. Projections indicate that the burden of these cancers will continue to increase.</p><p><strong>Conclusion: </strong>Our findings highlight the significant global disparities in the burden of HPB cancers among older adults, underscoring the need for targeted prevention and treatment strategies, particularly in regions with high SDIs.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421685","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":"Heterogeneous wealth-related differences in modern contraceptive use in Bangladesh: a machine learning-based g-computation analysis of the DHS 2022 cross-sectional survey.","authors":"Sudarshan Saha, Sohel Rana","doi":"10.1186/s41043-026-01371-1","DOIUrl":"10.1186/s41043-026-01371-1","url":null,"abstract":"<p><strong>Background: </strong>Conventional logistic regression estimates a single population-average odds ratio (OR), masking heterogeneity in how social determinants affect health outcomes across population subgroups. We applied machine learning (ML)-based stratified g-computation to estimate individual-specific wealth-associated counterfactual ORs of household wealth on modern contraceptive use among currently married Bangladeshi women in the two extreme wealth quintiles.</p><p><strong>Methods: </strong>We analyzed 11,510 currently married women in the poorest and richest wealth quintiles from the Bangladesh Demographic and Health Survey (BDHS) 2022. Six model classes (Logistic Regression, Random Forest, Gradient Boosting, XGBoost, LightGBM, Stacking Ensemble) were compared with five-fold cross-validated area under the receiver operating characteristic curve (AUC). SHapley Additive exPlanations (SHAP) analysis, primary sampling unit (PSU)-level bootstrap confidence intervals (CIs), doubly-robust augmented inverse probability weighted (AIPW) sensitivity analysis, Benjamini-Hochberg false discovery rate (BH-FDR) correction, and E-value analysis were conducted. Findings apply to the two extreme wealth quintiles and should not be extrapolated to the middle three quintiles.</p><p><strong>Results: </strong>Modern contraceptive prevalence was 37.7% in the poorest quintile versus 32.6% in the richest. The Stacking Ensemble achieved the highest CV-AUC (0.7108). All six AIPW estimates were near-null ([Formula: see text]-0.83), revealing that the aggregate wealth effect is zero because opposing subgroup effects cancel: a [Formula: see text] percentage-point absolute risk difference (ARD) in the 35-49/higher-education subgroup is precisely offset by a [Formula: see text] percentage-point ARD in the 15-24/primary-education subgroup. Individual ORs exhibited a Gini coefficient of 0.4525 (95% bootstrap CI: 0.4475-0.4568); interaction tests confirmed heterogeneity by education ([Formula: see text]) and age ([Formula: see text]). Median ORs ranged 6.4-fold: from 0.552 (15-24/primary; FDR [Formula: see text]) to 3.557 (35-49/higher; E-value = 6.57). Parity was the strongest SHAP predictive contributor, followed by employment and age.</p><p><strong>Conclusions: </strong>Wealth-associated counterfactual OR differences in contraceptive use are patterned within demographic subgroups; population-average estimates are zero because opposing effects cancel, and only individual-level ML-based g-computation reveals this structure. The programmatic targeting framework derived from this approach offers a reproducible prioritisation tool for health equity analyses in any DHS-based survey.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411615","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":"Prevalence, determinants, and perceptions of tobacco use among male college students in Puducherry: a mixed-methods study.","authors":"Vignesh Murugan, Chavada Vijay Kantilal, Johnson Cherian, Sridevi Gnanasekaran, Kavita Vasudevan","doi":"10.1186/s41043-026-01386-8","DOIUrl":"10.1186/s41043-026-01386-8","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco use remains a critical public health concern in India, particularly among young adults. Understanding the interplay of social, familial, and behavioural influences is vital for effective prevention. So, we aimed to estimate the prevalence of tobacco use among male college students in Puducherry and explore factors influencing initiation and maintenance.</p><p><strong>Methods: </strong>A sequential explanatory mixed-methods study was conducted from November 2019 to December 2021, recruiting 750 male undergraduate students through a multistage random sampling technique from ten colleges across five academic streams. Quantitative data were collected using a validated, anonymous questionnaire adapted from the Global Adult Tobacco Survey-2 (GATS-2). Bivariate and Binary logistic regression analyses were performed to identify factors associated with tobacco use. Focus group discussions with users and non-users explored perceptions and experiences, analyzed thematically and integrated for triangulation.</p><p><strong>Results: </strong>The prevalence of ever tobacco use was 10.7% (80/750), with 10.4% (78/750) being current users. Among ever tobacco users, 83.7% (67/80) used smoked forms. Initiation occurred mostly between 15 and 20 years (56/80, 70.0%) and was associated with curiosity and peer pressure. Higher odds of use were associated with older age (AOR 6.54, 95% CI 2.31-18.50), father's tobacco use (AOR 3.94, 95% CI 1.56-9.96), and peer's use (AOR 3.62, 95% CI 1.70-7.73); maternal education was protective (AOR 0.14, 95% CI 0.04-0.52). Qualitative themes highlighted peer/family roles, curiosity and media-related perceptions.</p><p><strong>Conclusion: </strong>The prevalence of tobacco use among college students was 10.7%. Initiation and maintenance of tobacco use were associated with curiosity, peer influence, familial factors and media-related perceptions. Interventions must include family and peer engagement and enforce stricter controls on pro-tobacco media content.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404720","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":"Assessment of the relationship between awareness of popular diets and body image among young women: a cross-sectional study.","authors":"Ayşe Nur Kahve, Ebru Bayrak","doi":"10.1186/s41043-026-01388-6","DOIUrl":"10.1186/s41043-026-01388-6","url":null,"abstract":"<p><strong>Background: </strong>Body image dissatisfaction is common among young women and has been associated with various health-related behaviors. Popular diets, often promoted through media and social platforms, are widely recognized among university students; however, evidence regarding the relationship between body image perception and awareness or use of such diets remains limited.</p><p><strong>Methods: </strong>This cross-sectional study included 580 female university students aged 18-33 years in Türkiye. Data were collected using a sociodemographic questionnaire, a food frequency questionnaire, and the Body Image Scale (BIS). Awareness, perceived healthiness, and practices of popular diets were assessed. Statistical analyses included chi-square tests, analysis of variance, correlation analyses, and effect size measures (Cramér's V and eta-squared).</p><p><strong>Results: </strong>Lower BIS scores were associated with higher BMI, more frequent meal skipping, and lower water intake (p < 0.05). Students with lower body image scores also reported a higher prevalence of chronic diseases. Awareness and practices of most popular diets, including ketogenic, Mediterranean, and gluten-free diets, did not differ significantly according to body image level. However, after Bonferroni correction (p < 0.016), none of the diet-related comparisons remained significant; only nominal differences were observed for detox diet practice (p = 0.029) and awareness of monotrophic diets (p = 0.043), with small effect sizes.</p><p><strong>Conclusions: </strong>Body image perception among young women appears to be related to certain health behaviors but shows limited association with awareness or practices related to most popular diets. These findings suggest that body image alone may not be a primary determinant of dietary trends among university students. Interventions addressing body image should consider broader social, cultural, and behavioral factors to promote healthy eating behaviors among young women.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404770","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":"Mapping, population size estimation, and characteristics of venue-based female sex workers in Iran.","authors":"Maliheh Sadat Bazrafshani, Soheil Mehmandoost, Nima Ghalekhani, Azam Bazrafshani, Parvin Afsar Kazerooni, Mehdi Nejat, Zahra Gholamipour, Fatemeh Davoodi Manesh, Samaneh Abbaszadeh, Ali Mirzazadeh, Hamid Sharifi","doi":"10.1186/s41043-026-01378-8","DOIUrl":"https://doi.org/10.1186/s41043-026-01378-8","url":null,"abstract":"<p><strong>Background: </strong>Female sex workers (FSWs) are one of the key populations affected by HIV. In Iran, the most recent population size estimate of FSWs is nine years old. This study aimed to estimate the number of street- and venue-based FSWs, map the geographical distribution of venues, and identify the characteristics of FSWs in three cities in Iran.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among FSWs in Tehran, Shiraz, and Abadan from June 2019 to March 2020. Women 15 years and older who had a history of sex with more than one man in exchange for money, drugs, services, etc., in the last 12 months were recruited to the study. The number of FSWs in each city was estimated through FSW opinions, secondary key informants' opinions, observations/enumeration of study teams, and the service multiplier method.</p><p><strong>Results: </strong>During the mapping stage, 391 venues were identified in these cities, from where 633 FSWs were interviewed. The median (Interquartile Range) age of sex work initiation among them was 24 (20-30). The lifetime history of HIV testing was 90.3% (n = 558), and the prevalence of self-reported HIV infection was 3.0% (95% CI:1.5-4.4) among those who ever tested for HIV. The number of venue-based FSWs was 317 (95% Uncertainty Levels [UL]: 173-435) in Abadan, 415 (95% UL: 324-687) in Shiraz, and 503 (95% UL: 455-577) in Tehran.</p><p><strong>Conclusion: </strong>This study provides a critical estimate of the population size and characteristics of street- and venue-based FSWs in three major cities in Iran. The findings highlight the need for targeted HIV prevention and intervention strategies, given the substantial number of FSWs engaged in drug use and frequent sex with clients, and the observed prevalence of self-reported HIV infection. Moreover, the findings highlight gaps in service coverage and can guide national HIV programming to better target priority populations and allocate resources more effectively.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptable diet and dietary diversity across countries in infants aged 6-23 months: a multi-country big data analysis from 1999 to 2021.","authors":"Muhammet Ali Aydin, Ayse Camli, Mübin Kiyici, Mürüvvet Emrem, Izzet Ulker, Metin Yildiz","doi":"10.1186/s41043-026-01359-x","DOIUrl":"10.1186/s41043-026-01359-x","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the prevalence of minimum dietary diversity, zero vegetable or fruit consumption, egg and/or food consumption and minimum acceptable diet in 6-23 months children by income status in countries and regions worldwide.</p><p><strong>Method: </strong>This study is a retrospective secondary data analysis. In our study, the prevalences of minimum dietary diversity, zero vegetable or fruit consumption, egg and/or meat and food consumption and minimum acceptable diet were analyzed. Descriptive statistical analyses were performed using Python, and results were visualized using Flourish (a web-based data visualization platform), stratified by WHO and World Bank regional classifications and individual wealth quintiles. In this study, statistics published by the World Health Organization were used as data source. The data were analyzed with Python program and visualized using a web 2.0 tools.</p><p><strong>Results: </strong>Sub-Saharan Africa (SSA) had the lowest rates of minimum dietary diversity (MDD: ~21%) and minimum acceptable diet (MAD: ~14%) across all wealth quintiles, while Latin America and the Caribbean (LAC) had the highest rates (MDD: ~48%; MAD: ~40%). The highest proportions of infants who did not consume any vegetables or fruits were observed in South Asia (~ 51% in the lowest wealth quintile) and SSA (~ 48%), while LAC had the lowest rates (~ 27%). SSA also had the lowest egg and/or meat consumption rates (~ 35% in the lowest wealth quintile), whereas LAC reported the highest (~ 69%). In SSA, nutritional inadequacy was present across all income levels regardless of wealth quintile. In LAC, dietary adequacy was higher than other regions across all income levels.</p><p><strong>Conclusion: </strong>In our study, especially in Sub-Saharan Africa, undernutrition in infants aged 6-23 months was found at all income levels, while in Latin America & Caribbean, the nutritional status at all income levels was higher than in other regions.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396765","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":"Comprehensive and low-cost machine learning models for predicting MASLD prevalence: cross-sectional evidence from the amol cohort study (AmolCS).","authors":"Azam Doustmohammadian, Mohammad Farahmand, Maziar Moradi-Lakeh, Minoo Hasan Rashedi, Bahareh Amirkalali, Nima Motamed, Mansooreh Maadi, Cain Ct Clark, Hossein Ajdarkosh, Fahimeh Safarnezhad Tameshkel, Masoud Reza Sohrabi, Mahmoodreza Khoonsari, Amir Hossein Faraji, Elham Sobhrakhshankhah, Mehran Haghighi, Esmaeel Gholizadeh, Mitra Ameli, Farbod Doustmohammadian, Mohana Eskandari, Farhad Zamani, Mehdi Nikkhah","doi":"10.1186/s41043-026-01372-0","DOIUrl":"https://doi.org/10.1186/s41043-026-01372-0","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a growing global health burden, yet early detection remains difficult, especially in low-resource settings. This study aimed to develop an interpretable machine learning model using both conventional and non-invasive, low-cost predictors to assess the probability of MASLD in the general population. Data from 3120 adults were split into training (n = 2,184) and testing (n = 936) sets. Six ML algorithms, including Random Forest, Gradient Boosting Machine, kernel-based Support Vector Machine, k-Nearest Neighbors, Neural Network, and Recursive Partitioning, were evaluated using standard performance metrics. Model interpretability was examined through SHapley Additive exPlanations. Analyses were also stratified by sex to explore heterogeneity in predictor influence. In the whole-variable model, Random Forest and Gradient Boosting Machine achieved the strongest performance (AUC 0.858 and 0.855, respectively). SHAP consistently identified composite hepatic indices, particularly the Fatty Liver Index and Hepatic Steatosis Index, along with waist circumference and adiposity-related measures, as leading contributors to MASLD probability. Sex-specific patterns were evident, with metabolic traits such as fasting glucose and diastolic blood pressure contributing more strongly in women, while hepatic markers and lipid-related variables were more influential in men. In a reduced model restricted to non-invasive, low-cost predictors, waist circumference remained the dominant determinant across all subgroups, followed by diastolic blood pressure, age, and a healthy lifestyle score. These findings highlight the association of visceral adiposity and metabolic dysfunction with MASLD and demonstrate that models based on widely accessible indicators can distinguish individuals with and without MASLD within this cohort, suggesting the potential feasibility of scalable screening approaches in resource-limited settings.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conflicts of interest as a barrier to the development of health technology assessment in Iran: a qualitative study.","authors":"Meysam Behzadifar, Saeed Shahabi, Ahad Bakhtiari, Mariano Martini, Masoud Behzadifar","doi":"10.1186/s41043-026-01383-x","DOIUrl":"10.1186/s41043-026-01383-x","url":null,"abstract":"<p><strong>Background: </strong>Health Technology Assessment (HTA) is vital for evidence-based decision-making and efficient resource allocation. Although HTA has gained importance in Iran's health policy agenda, its development faces major barriers. Among these, conflicts of interest (COI) remain a critical yet understudied challenge that can undermine the integrity of HTA processes. This study explored how COI manifest within Iran's HTA environment and hinder its development.</p><p><strong>Methods: </strong>A qualitative design was used, employing purposive sampling to select key informants involved in HTA and health policymaking. Twenty-eight semi-structured interviews were conducted with policymakers, academics, healthcare professionals, and representatives from regulatory and insurance bodies. Data were analyzed thematically using an inductive approach to identify the types, sources, and impacts of COI.</p><p><strong>Findings: </strong>Participants described multiple personal, institutional, and systemic COI influencing HTA. Key themes included the lack of formal disclosure and management mechanisms, strong industry influence, overlapping roles of decision-makers, and weak regulatory oversight. These factors distorted priority-setting, delayed the adoption of cost-effective technologies, and eroded public trust. Cultural norms favoring informal relationships and political patronage further reinforced these problems.</p><p><strong>Conclusions: </strong>COI threaten the credibility and transparency of HTA in Iran. Strengthening governance frameworks, ensuring institutional independence, and promoting ethical accountability are essential to enhance HTA integrity. The findings provide insights for other low- and middle-income countries seeking to institutionalize HTA within complex governance systems. This study highlights that managing COI requires not only technical solutions but also interdisciplinary approaches, particularly drawing on legal frameworks and organizational management theories, to address governance failures in Iran's health system.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387605","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 the interplay of maternal anemia and BMI in determining low birth weight among rural Indian children: evidence from NFHS-5.","authors":"Mithun Sarkar, Koyel Majumder, Bikash Barman, Pradip Chouhan","doi":"10.1186/s41043-026-01381-z","DOIUrl":"10.1186/s41043-026-01381-z","url":null,"abstract":"<p><strong>Background: </strong>Low birth weight (LBW) is a serious global health issue that is indicative of an increased risk of newborn illness and mortality. LBW refers to a newborn weighing under 2,500 g (5.5 pounds) at birth, primarily due to either poor fetal growth, premature labor, or both. It is more prevalent in low and middle-income countries than in high-income countries.</p><p><strong>Methods: </strong>The entire study has been completed with the help of secondary data collected from the NFHS-5 of India, a cross-sectional national representative survey conducted from 2019 to 2021. In this study, the low birth weight of children is considered as an outcome variable. Based on previous research, various socio-economic and demographic variables were selected in this study. This study used Pearson's chi-square statistics and multivariable binary logistic regression to identify the association between low birth weight of children and maternal anemia and BMI (Body Mass Index). And descriptive statistics is also performed to analyze the data.</p><p><strong>Results: </strong>The result shows that there is significant association between the maternal anemia and BMI with the occurrence of low birth weight. It is found that the occurrence of low birth weight is higher among severely anemic women and underweight women. Additionally, the prevalence of LBW is high among those women who use cigarettes and tobacco, and those children of multiparity, are female children, and are from central, western, and northern regions.</p><p><strong>Conclusion: </strong>So, it can be said that maternal anaemia and BMI is correlated with the prevalence of low birth weight among children. Hence, implementing appropriate interventions for pregnancy care and ensuring well-planned nutrition can significantly alleviate the challenges associated with LBW in India.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382144","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}