Journal of Health, Population, and Nutrition最新文献

{"title":"Diversity- and culturally sensitive approaches in nutrition and fluid management in long-term nursing. A scoping review.","authors":"André Heitmann-Möller, Martina Hasseler, Michael Feldhaus, Monika Schlegel, Sandra Hellmers, Andreas Hein, Steffen Busse, Julia Berndt, Mareike Förster, Rebecca Diekmann, Tobias Krahn","doi":"10.1186/s41043-026-01346-2","DOIUrl":"10.1186/s41043-026-01346-2","url":null,"abstract":"<p><strong>Background: </strong>As a result of decades of migration in Germany, the number of persons with migration backgrounds from different cultures in residential long-term care nursing facilities will increase. As a result, cultural diversity may also have an impact on nutritional aspects in long-term care. The project 'Digitally supported diversity and culturally sensitive nursing care on nutritional intake' (NUTRI-SENSE) examines strategies to improve the nutritional and fluid intake of residents with migration backgrounds in long-term care facilities. The interdisciplinary project aims to improve their health and quality of life with a digitally supported nursing process to prevent undernutrition and dehydration. To synthesize the evidence on diversity- and culturally sensitive approaches in nutrition and fluid intake management, a scoping review was conducted. This research led to the question of the extent to which cultural sensitivity with regard to nutrition and fluid intake is addressed in long-term care nursing homes. A literature search of different databases (PubMed, CINAHL, LIVIVO, CareLit^®, manual search: Google Scholar) was conducted in May and June 2025.</p><p><strong>Results: </strong>From the 8.010 findings, 28 publications were screened, and 6 publications were included in the review. The evidence on diversity- and culturally sensitive approaches in institutional long-term care nursing regarding nutrition and fluid intake is limited. The main topics are the relationship of culture-specific and dementia-specific needs; the emotional aspects of belonging, food and memories of residents with dementia; meals as a vital source of well-being in nursing homes; the meaning of mealtime experiences in a multicultural society; and, finally, the involvement of family members in the food supply.</p><p><strong>Conclusion: </strong>The findings from the scoping review revealed that a systematically developed, diverse and culturally sensitive framework for managing residents' nutritional and fluid intake in long-term care facilities has not yet been established. Such a framework is the goal for subsequent research and the development of interventions within the NUTRI-SENSE project. In the context of international population ageing and increasing needs in the long-term care sector, the development and evaluation of culturally and diversity-sensitive nutPrition and hydration strategies are of broad, cross-national relevance.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987784","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":"Investigating the association between the food inflammation scores of individuals and stroke in adults: an extreme gradient boosting machine learning model interpreted with shapley additive explanations.","authors":"Zhiwen Yan, Kang Luo, Qinghuan Yang, Xiaoqing Liu, Huan Zhao, Yuan Gao, Qiang Zhang, Jun Mu","doi":"10.1186/s41043-026-01342-6","DOIUrl":"10.1186/s41043-026-01342-6","url":null,"abstract":"<p><strong>Background: </strong>Chronic systemic inflammation is a pivotal modifiable risk factor for stroke. The food-based Food Inflammation Index (FII) offers a novel approach to assess dietary inflammatory potential, yet the association between its derivative, the Food Inflammation Scores of Individuals (FISI), and stroke prevalence remains to be elucidated.</p><p><strong>Methods: </strong>This study analyzed a cohort of 19,681 adults from the NHANES (2007-2018) database. The FISI-stroke association was assessed using multivariable logistic regression and machine learning models (XGBoost), interpreted via SHAP analysis.</p><p><strong>Results: </strong>Higher FISI scores were positively associated with increased stroke prevalence in a dose-dependent manner. Specifically, a one-unit rise in FISI34, FISI26-USDA, and FISI26-CHINA corresponded to 7%, 18%, and 22% higher stroke odds, respectively. XGBoost modeling identified FISI34 as a key predictor, corroborating regression findings.</p><p><strong>Conclusions: </strong>This study establishes a robust link between higher FISI, derived from the FII, and stroke risk. The FII framework surpasses nutrient-based indices by providing personalized, actionable, food-specific guidance for stroke prevention through anti-inflammatory diets.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973046","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":"Inverse association between dietary antioxidant indices and dietary inflammatory potential in jordanian adults: a cross-sectional study.","authors":"Lana Agraib, Buthaina Alkhatib, Asem Shawabkeh, Ahmad Suleiman Aslaih","doi":"10.1186/s41043-026-01333-7","DOIUrl":"10.1186/s41043-026-01333-7","url":null,"abstract":"<p><strong>Background: </strong>The Dietary Antioxidant Index (DAI) and Dietary Inflammatory Index (DII) measure the antioxidant capacity and inflammatory potential of diets, respectively, and are inversely associated with the risk of chronic disease.</p><p><strong>Aims: </strong>This study examines DAI characteristics and their association with DII in Jordanian adults, adjusting for sex, body mass index (BMI), and waist circumference (WC).</p><p><strong>Methods: </strong>A cross-sectional study was conducted, and 391 adults were randomly included. Sociodemographic, lifestyle, and anthropometric data (BMI and WC) were collected using standardized protocols. Dietary intake was assessed using a validated 157-item FFQ, from which DAI, Dietary Antioxidant Quality Score (DAQS), and DII were calculated using established international methods.</p><p><strong>Results: </strong>Females, individuals with overweight/obesity, and those with central obesity had significantly higher DAI and DAQS scores (p < 0.001). Unexpectedly, participants with overweight/obesity and central obesity were more frequently represented in higher antioxidant score categories, whereas normal-weight and normal-WC individuals clustered in lower antioxidant score categories (p < 0.001). DAI and DAQS decreased progressively across increasing DII quartiles (p < 0.001), showing a moderate, significant inverse correlation with DII (r ≈ - 0.32 to - 0.37). Regression analysis confirmed that higher antioxidant indices were associated with lower DII scores, accounting for 14-16% of the variance after adjustment.</p><p><strong>Conclusion: </strong>Dietary antioxidant indices were inversely and gradually associated with DII, independent of sex and adiposity measures. These findings indicate substantial overlap between antioxidant-rich dietary patterns and lower inflammatory dietary profiles.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973023","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":"Work stress, dietary patterns, and physical activity on metabolic and hepatic biomarkers among healthcare professionals in Ghana.","authors":"Daniel Ayeltigah, Nancy Gyima Wuabu, Mary Amoako, Moses Ofosu Amoako, Collins Afriyie Appiah","doi":"10.1186/s41043-026-01344-4","DOIUrl":"10.1186/s41043-026-01344-4","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between lifestyle exposures (work stress, dietary patterns, and physical activity) and metabolic and hepatic biomarkers among healthcare professionals in Ghana.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 119 participants at the Kibi Government Hospital. The survey included demographic and lifestyle questionnaires, work stress assessments, anthropometric measurements, and biochemical analyses. Metabolic syndrome (MetS) was defined according to the International Diabetes Federation criteria. Binary logistic regression models were applied to determine the associations.</p><p><strong>Results: </strong>The prevalence of MetS was 11.0%, with high blood pressure (29.7%) and abdominal obesity (57.1%) being the most prevalent MetS components. The majority of participants reported high stress levels (60.4%), and 59.7% engaged in moderate physical activity. Approximately 65.3% had AST/ALT greater than 1. Four dietary patterns were identified: Western Pattern, Traditional mixed pattern, Protein-rich pattern, and Fruit and Dairy pattern. Moderate and high adherence to the Western dietary pattern were significantly associated with increased odds of abdominal obesity (Tertile 2: OR 3.244, 95% CI 1.219-8.629, p-value 0.018, Tertile 3: OR 4.231, 95% CI 1.550-11.546, p-value 0.005). A non-significant association was also observed between elevated triglycerides and ALT (OR 1.03, 95% CI 0.998-1.05, p = 0.066).</p><p><strong>Conclusion: </strong>This study highlights a considerable burden of metabolic risk factors among hospital staff in Ghana, with abdominal obesity and elevated blood pressure being the most prevalent components of metabolic syndrome. High work stress levels, moderate physical activity, and elevated AST/ALT ratios (indicating a predominance of hepatocellular injury and suggesting potential liver dysfunction) were also common. Greater adherence to the western dietary pattern was significantly associated with increased odds of abdominal obesity while marginal association was observed between elevated triglycerides and ALT. These findings highlight the need for regular screening for metabolic risk factors and liver function among health professionals. Healthcare institutions should introduce targeted interventions such as nutrition education and improved access to healthy food options to prevent related complications such as liver cirrhosis and diabetes.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973057","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 maternal perceptions of infant growth and feeding and infant growth outcomes in community health clinics: a prospective multicentre longitudinal study.","authors":"Halimah Jalil, Mei-Chan Chong, Muhammad Yazid Jalaludin, Li Ping Wong, Yanjia Liu","doi":"10.1186/s41043-026-01302-0","DOIUrl":"10.1186/s41043-026-01302-0","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding (EBF) during the first six months of life is critical for infant survival, growth, and development. Maternal perceptions of infant growth and feeding, shaped by cultural norms and healthcare support, may influence feeding practices and subsequent growth outcomes. Guided by the Health Belief Model, Social Cognitive Theory, Theory of Planned Behaviour, and Ecological Systems Theory, this study examined the associations between maternal perceptions of infant growth and feeding and infant growth outcomes during early infancy.</p><p><strong>Methods: </strong>A prospective multicentre longitudinal study was conducted from February 2015 to January 2019 across six community health clinics in the Gombak District, Malaysia. A total of 460 full-term mother-infant pairs were followed from 1 to 6 months postpartum. Maternal perceptions of infant growth and feeding were assessed using a culturally adapted questionnaire addressing feeding adequacy, growth concerns, and adherence to recommended feeding practices. Trained nurses measured infant length and weight. Pearson correlation and multiple linear regression analyses were performed to examine associations between maternal perception scores and infant growth indicators, adjusting for ethnicity and maternal education.</p><p><strong>Results: </strong>Maternal perceptions of infant growth and feeding adequacy were positively correlated with length-for-age z-scores (LAZ; r = .18) and weight-for-age z-scores (WAZ; r = .60) at 1 month (p < .001 for both), and with LAZ at 6 months (r = .21; p < .001). Perceptions of feeding recommendations were also correlated with LAZ at both time points and were strongly associated with WAZ at 6 months (r = .90; p < .001). Multiple linear regression analysis indicated that more favourable maternal perceptions at 6 months were independently associated with higher LAZ at 6 months.</p><p><strong>Conclusions: </strong>More positive maternal perceptions of infant growth and feeding are associated with favourable infant growth outcomes during the first six months of life. Theory-informed interventions that strengthen maternal understanding of feeding adequacy and address perceived barriers, particularly through culturally tailored counselling and community-based support, may support optimal feeding practices and healthy early growth trajectories.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973075","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":"The association of triglyceride-glucose index and uric acid-high-density lipoprotein cholesterol ratio with the risk of uterine fibroids: a real-world analysis based on health examination data.","authors":"Weilan Liu, Xiaoyan Duan, Luyang Su, Yan Jiang, Shixia Zhao, Qian Nie","doi":"10.1186/s41043-026-01337-3","DOIUrl":"10.1186/s41043-026-01337-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of triglyceride-glucose index (TyG) and uric acid to high-density lipoprotein cholesterol ratio (UHR) with the prevalence of uterine fibroids (UF), and to evaluate the dose-response relationship and differences in different subgroups.</p><p><strong>Methods: </strong>This cross-sectional study employed real-world data from 40,529 adult female participants who underwent health examinations at Hebei Province Health Examination Center between January 1 and December 31, 2024. This study used multiple logistic regression analysis to determine the independent association between standardized TyG index, UHR, and UF risk. The dose-response relationship was evaluated with restricted cubic spline (RCS), and stratified analysis was conducted according to BMI, diabetes and menopause status.</p><p><strong>Results: </strong>Among 40,529 participants, the prevalence of UF was 29.8% (12,081 cases). The results of the fully adjusted model (Model 3) showed that both the standardized TyG index and UHR were significantly positively correlated with UF risk: for every 1 standard deviation (SD) increase in TyG, UF risk increased by 2.068 times (OR = 3.068); For every 1 SD increase in UHR, the risk increased by 11.7% (OR = 1.117). RCS analysis revealed that both the TyG index and UHR exhibited significant nonlinear associations with the risk of UF (P_overall < 0.001). Hierarchical analysis showed that TyG maintained significant correlation in all subgroups, while the effect of UHR was weakened in people with BMI ≥ 25 kg/m² and diabetes (P > 0.05).</p><p><strong>Conclusion: </strong>Elevated TyG index and UHR are significantly correlated with an increased prevalence risk of UF in women, and exhibit a non-linear dose-response relationship. The TyG index demonstrated a relatively significant association with UF risk, and the findings remained robust, supporting its utility as a simple indicator for capturing the relationship between metabolic abnormalities and UF risk.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963950","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":"Preferences and recommendations from content creators on carnivore diets: a social media analysis.","authors":"Almiera Lietz, Janina Dapprich, Tobias Fischer","doi":"10.1186/s41043-026-01336-4","DOIUrl":"10.1186/s41043-026-01336-4","url":null,"abstract":"<p><strong>Background: </strong>A carnivore diet is characterised by the exclusive consumption of animal foods, particularly red meat. Digital media, particularly TikTok and Instagram, often praise the health-promoting and disease-preventive properties of the carnivore diet. However, the scientific data on this form of nutrition is currently very limited.</p><p><strong>Methods: </strong>After creating a coding guide with an accompanying seven-day pretest and modification, a social media analysis was conducted on the Instagram platform over a period of one month. In addition to content related to nutrition and food, aspects such as lifestyle, advertising measures, and political or social statements were also collected. The survey was conducted quantitatively through categorization, accompanied by qualitative documentation of notable findings.</p><p><strong>Results: </strong>The analysis included 19 content creators (47% male, 53% female; aged 25-64) with an average of 157,758 ± 146,405 (25,200-582,000) followers. A total of 1,169 posts during the survey period showed a notable focus on health- and disease-related statements. With the exception of the strong emphasis on red meat, the nutritional and food recommendations were heterogeneous. This was accompanied by ideology-related themes, politically relevant statements, and critical portrayals of institutions such as science, politics, and industry, some of which could be classified as politically right-wing conservative. However, the data does not allow for a clear political classification. Overall, the carnivore diet was portrayed as positive.</p><p><strong>Conclusions: </strong>The one-sided view of carnivore nutrition, combined with political and social content, should be viewed critically. Nutrition professionals should pay attention to social media and counteract non-evidence-based claims with scientifically sound information.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963988","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":"Economic evaluation of herbal versus antibiotic treatment in treating patients with Helicobacter pylori infection in the South of Iran: an analysis alongside a clinical trial.","authors":"Hossein Faramarzi, Zahra Khajoei, Farhad Lotfi, Mehdi Rezaee, Khosro Keshavarz, Mohammad Mahdi Mojahedian, Seyedeh Azra Shamsdin, Kamran Bagheri Lankrani","doi":"10.1186/s41043-026-01296-9","DOIUrl":"https://doi.org/10.1186/s41043-026-01296-9","url":null,"abstract":"<p><strong>Objectives: </strong>Helicobacter pylori (H. pylori) infection is highly prevalent worldwide and affects more than half of the world's population. Various treatment regimens to eliminate H. pylori have been evaluated; however, selecting the most cost-effective regimen remains a challenge for clinicians. Therefore, the present study aimed at analyzing the cost-effectiveness of using different methods to treat H. pylori in southern Iran.</p><p><strong>Methods: </strong>A cost-effectiveness analysis was conducted alongside a clinical trial that compared antibiotics versus herbal treatment in 132 patients with H. pylori referred to Shahid Motahari Clinic in Shiraz in 2020. A decision-tree model was developed to synthesize clinical and cost data. The patients were randomly divided into two groups, 64 of whom received an antibiotic regimen and 68 patients received a herbal treatment. The success rate of clinical trials in each treatment method was determined as the clinical outcome. This study was conducted from a societal perspective; therefore, direct and indirect costs were included. A data collection form was also used to collect the cost and effectiveness data. In addition, a one-way sensitivity analysis was performed to measure the robustness of the results. The data were analyzed using Tree Age Pro 2011 and Excel 2016 software.</p><p><strong>Results: </strong>The results showed that antibiotic treatment was cheaper and more effective than herbal treatment and was the dominant strategy. The mean costs in the antibiotics and herbal treatment groups were $446.14 and $477.81, respectively, and the effectiveness was 62.5% and 38.2%. In addition, the one-way sensitivity analysis confirmed the robustness of the study results.</p><p><strong>Conclusion: </strong>The results showed that the use of antibiotics was a cost-effective and dominant strategy compared to herbal treatment and could be suggested as a better alternative to a wide range of patients with H. pylori infection. This conclusion is tempered by the short-term perspective, single-center design, and modest sample size of the study, highlighting the need for confirmatory long-term, multicenter research.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963964","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":"Triangulating evidence, expertise, and maternal experience to design a gestational age-specific stimulation protocol for preterm infants in indian neonatal intensive care units.","authors":"Abishek J R, Vadivelan Kanniappan, Manisha Srinivasan, Karthikeyan Saravanan","doi":"10.1186/s41043-026-01339-1","DOIUrl":"10.1186/s41043-026-01339-1","url":null,"abstract":"<p><strong>Background: </strong>Early stimulation is increasingly recognised as essential for optimising neurodevelopmental outcomes in preterm infants admitted to Neonatal Intensive Care Units (NICUs). However, most existing stimulation protocols are derived from controlled research settings and lack guidance in gestational age (GA) -specific timing, caregiver role allocation, and cultural applicability, limiting their translation into routine practice in resource-constrained settings like India.</p><p><strong>Aim: </strong>To develop a GA-specific early stimulation protocol for preterm infants using structured triangulation of trial evidence, therapist-informed practice patterns and maternal experience in Indian NICU settings.</p><p><strong>Methods: </strong>A sequential exploratory mixed-method design was employed. First, a systematic review of randomised controlled trials (2010-2023) mapped stimulation modalities and GA characteristics. Second, a semi-structured interview was conducted with 16 NICU physiotherapists across eight Indian states to capture feasibility-driven clinical expertise. Third, in-depth interviews with 12 mothers of preterm infants explored maternal readiness, emotional acceptance and culturally embedded caregiving practices. Data were integrated using joint display analysis and a fixed decision algorithm.</p><p><strong>Results: </strong>Triangulation classified modalities into four categories: five with strong convergence, five requiring conditional implementation, two restricted to specialist delivery and two excluded from the protocol. These findings were synthesised into a novel, colour-coded week x modality matrix, operationalising developmental sequencing, modality layering and transitions from therapist-led to parent-led delivery across GA.</p><p><strong>Conclusion: </strong>This study presents the foundational development of a contextually grounded GA-specific early stimulation protocol that maps twelve modalities across 26-40 weeks with colour-coded transitions from therapist-led to parent-led care. By integrating evidence, expertise and lived experience, the framework offers a transparent and culturally informed basis for subsequent feasibility testing, validation and implementation.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963376","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 fertility knowledge and attitudes towards parenthood and fertility preservation among tertiary-educated youths in Singapore.","authors":"Kia Hui Lim, See Ling Loy, Chee Wai Ku, Shu Qi Tan, Tat Xin Ee, Sadhana Nadarajah","doi":"10.1186/s41043-026-01322-w","DOIUrl":"10.1186/s41043-026-01322-w","url":null,"abstract":"<p><strong>Background: </strong>Total fertility rates (TFRs) are declining globally, with Singapore among the lowest at 0.87 in 2025. To develop effective strategies that promote informed reproductive choices and improve fertility outcomes, it is essential to understand the evolving perspectives of tertiary-educated youths, who play a pivotal role in shaping the nation's future demographic trends.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among university undergraduates aged 18-25 in Singapore between August 3 and 17, 2023. The 45-item questionnaire assessed attitudes toward childbearing (3 items), fertility knowledge (22 items), and perceptions towards fertility assessment, treatment and preservation (11 items). Internal consistency of the questionnaire was good (Cronbach's alpha 0.87). Categorical variables were compared using chi-square or Fisher's exact tests, and continuous variables using independent t-tests. Multiple linear regression analyses were conducted to examine the association between demographic factors and desire for childbearing and fertility knowledge scores.</p><p><strong>Results: </strong>Among 220 respondents (50.0% female), 62.3% desired biological children, with 52.6% preferring to conceive between ages 26-30. Childbearing considerations varied by age: education (75.0%) was prioritised at ages 21-25, career satisfaction (33.3%) at 26-30, and financial stability (50.0%) at 36-40. Demographic factors were not significantly associated with desire for childbearing. Although 62.7% reported confidence in their fertility knowledge, substantial misconceptions were observed regarding the impact of metabolic health on fertility (94.5%), age of fertility decline (71.8%), conception probabilities (74.5%), and the fertile window (54.1%). Although 74.1% were aware of elective egg freezing (EEF), 73.2% did not know how to access it. Students from healthcare-related faculties had higher fertility knowledge scores than those from non-healthcare faculties (β = 0.17, 95% CI: 0.28, 3.72). While 51.3% considered EEF, only 36.4% were open to in-vitro fertilisation (IVF). In a hypothetical subfertility scenario, 82.7% indicated they would seek help, primarily medical attention (68.6%), although 68.2% would not consider earlier childbearing. Interest in fertility testing (54.5%) and fertility interventions (60.0%) were high.</p><p><strong>Conclusions: </strong>Our study revealed a notable discrepancy between reproductive intentions, fertility knowledge, and prospective behaviours. Enhancing fertility education and access to assessments and preservation methods empowers individuals to make informed reproductive choices aligned with biological realities, thereby supporting long-term fertility outcomes.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930273","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}