AIMS Public Health最新文献

{"title":"Mesoamerican nephropathy: A silent epidemic at the nexus of climate, labor, and health.","authors":"J Luis Espinoza, Leyla Abdalah-Perez","doi":"10.3934/publichealth.2026035","DOIUrl":"10.3934/publichealth.2026035","url":null,"abstract":"<p><p>Mesoamerican nephropathy (MeN) has emerged as a critical yet often overlooked occupational and environmental health crisis. Primarily affecting young, otherwise healthy agricultural workers in Central America, this disease leads to rapid progression to kidney failure without traditional causes like diabetes or hypertension. While the central drivers are recurrent heat stress and chronic dehydration, emerging research reveals a multifactorial pathogenesis. This includes synergistic nephrotoxic insults from agrochemicals, heavy metals, chronic endotoxin exposure, and mycotoxins (e.g., ochratoxin A). Morphologic studies point to shared pathways of tubular injury, characterized by mitochondrial dysfunction and lysosomal abnormalities. Furthermore, gut-kidney crosstalk and genetic susceptibility, particularly among individuals with Native American ancestry, may amplify renal inflammation and injury. Although targeted interventions, such as enhanced hydration, rest, and access to shade, show promise, their efficacy in halting disease progression remains limited. As global temperatures rise, similar disease patterns are now being reported among outdoor laborers in other hot regions, signaling a broader climate-linked public health threat. Addressing MeN demands a concerted, multidisciplinary effort encompassing rigorous pathogenesis research, enforceable occupational protections, and global recognition of heat-associated kidney disease as a growing epidemic. This perspective synthesizes recent insights into MeN and calls for urgent, actionable measures to confront this silent crisis.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"659-670"},"PeriodicalIF":4.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of floss band-augmented perceptual balance training on balance, proprioception, and lower limb function in women with chronic ankle instability: Implications for injury prevention and rehabilitation in public health.","authors":"Melika Hamzehzadeh, Seyed Kazem Mosavi Sadati, Abdulrasol Daneshjoo, Hadi Mohammadi Nia Samakosh, Sameer Badri Al-Mhanna, Georgian Badicu","doi":"10.3934/publichealth.2026034","DOIUrl":"10.3934/publichealth.2026034","url":null,"abstract":"<p><p>In this study, an assessor-blinded randomized trial with concealed allocation was conducted. Thirty women aged 25-35 years with chronic ankle instability (CAIT score ≤ 24 on the affected ankle) were randomly assigned (1:1) to perceptual balance (PB) training with floss bands (FB group, n = 15) or PB training alone (n = 15). Both groups completed a 6-week program (3 sessions/week), progressing from static to dynamic and plyometric tasks. FBs were applied at perceived occlusion pressure of 5-7/10 (0-10 scale); no adverse events occurred. Outcomes (assessed on the affected limb only) included static balance (single-leg stance time), dynamic balance (Y-balance test-normalized reaches in anterior, posteromedial, and posterolateral directions and composite score), ankle proprioception [joint position sense (JPS) error at 20° plantarflexion], and functional performance (single-leg hop and triple-hop for distance). A 2 × 2 mixed ANOVA (time × group) was used, with Bonferroni post hoc tests. Effect sizes were partial η² (ANOVA interactions) and Cohen's d_z (repeated-measures within-group changes with 95% CI). Both groups improved significantly (p < 0.01). The FB group showed greater improvements in static balance (25.7 ± 2.9 s vs. 22.3 ± 2.8 s, p = 0.015), dynamic balance (composite and all directions, p < 0.015), JPS (4.2 ± 1.1° vs. 6.1 ± 1.3°, p = 0.022), single-leg hop (1.80 ± 0.15 m vs. 1.65 ± 0.18 m, p = 0.032), and triple-hop (5.10 ± 0.30 m vs. 4.70 ± 0.35 m, p = 0.039). Interaction effect sizes (dz) ranged from 0.143 to 0.234 (large). These findings suggest that floss band augmentation may provide additional short-term benefit to PB training in women with CAI, although mechanisms remain speculative, and larger, longitudinal trials are needed.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"640-658"},"PeriodicalIF":4.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding antibiotic use and antimicrobial resistance: A cross-sectional study among outpatients in Greek primary health care.","authors":"Aikaterini Toska, Dimitra Kourneta, Dimos Mastrogiannis, Evangelos Fradelos, Pavlos Sarafis, Eustratia Mourtou, Marianna Mantzorou, Maria Saridi","doi":"10.3934/publichealth.2026033","DOIUrl":"10.3934/publichealth.2026033","url":null,"abstract":"<p><strong>Background: </strong>Antibiotics are crucial for treating bacterial illnesses; however, overuse and abuse of these drugs, together with improper consumption, have led to selection pressure and the rise of resistant bacteria.</p><p><strong>Aim: </strong>To investigate the knowledge and attitudes of outpatients in a healthcare setting regarding antibiotic consumption and antimicrobial resistance.</p><p><strong>Methods: </strong>This exploratory survey was conducted among 120 outpatients visiting a public primary healthcare setting in Greece, from February to March 2024. Data were collected via a 38-item self-administered questionnaire covering three domains: antimicrobial resistance (AMR) knowledge, antibiotic knowledge, and consumption practices. Statistical analysis was performed using SPSS (ver.29), employing Mann-Whitney and Kruskal-Wallis tests to identify demographic correlates (p < 0.05).</p><p><strong>Results: </strong>A total of 120 individuals participated in the study, 72 of whom were women (60.0%); 37.5% resided in an urban center, and 30.8% were lyceum graduates. Most of the sample knew that AMR signifies resistance of microbes to antibiotics (75.0%), that it constitutes a significant public health problem in the country (70.0%), and that it is due to the inappropriate use of antibiotics in humans (67.5%). 74.2% disagreed with stopping antibiotic treatment earlier, while 40.0% of respondents stated that taking antibiotics is only useful for fighting bacterial infections. 27.5% thought antibiotics were necessary for viral illnesses with fever, and 35.8% thought they speed up recovery from a cold. Remarkably, 52.5% of respondents acknowledged keeping antibiotics for later use, and 56.7% reported using non-prescription antibiotics in the past. Antibiotic knowledge scores were statistically significantly higher for women and people living in urban and semi-urban areas (p < 0.05). People with less education knew less about antibiotics, antimicrobial resistance, and antibiotic consumption practices (p < 0.005).</p><p><strong>Conclusions: </strong>Although primary health care recipients demonstrate a generally satisfactory awareness of antimicrobial resistance, significant knowledge gaps and misconceptions about antibiotics persist, leading to inappropriate antibiotic use practices.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"622-639"},"PeriodicalIF":4.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet healthcare in Chinese public hospitals: Towards high-quality development (1986-present).","authors":"Dan Du, Guodong Sun, Lili Yuan, Yiyun Yao, Tong Yang, Junliang Gao, Lei Zhang","doi":"10.3934/publichealth.2026032","DOIUrl":"10.3934/publichealth.2026032","url":null,"abstract":"<p><strong>Background: </strong>Internet healthcare has become a key part of China's hospital-centered health system. Driven by \"Internet Plus Healthcare\", Healthy China 2030, and public-hospital high-quality development policies, it has evolved from remote consultation experiments into regulated online-offline care pathways. This review traces its development from the first documented remote medical practice in 1986 to the present, focusing on policy, institutional models, clinical evidence, governance challenges, and reform.</p><p><strong>Methods: </strong>We conducted a structured narrative review of English- and Chinese-language sources on internet healthcare in Chinese public hospitals. PubMed/MEDLINE, Web of Science Core Collection, China National Knowledge Infrastructure (CNKI), and official policy sources were searched. Eligible sources addressed internet hospitals, telemedicine, online follow-ups, remote monitoring, e-prescriptions, insurance payments, digital governance, clinical outcomes, patient safety, equity, or implementation barriers in mainland China.</p><p><strong>Results: </strong>Internet healthcare progressed through early telemedicine, institutional network expansion, internet-hospital development, and pandemic-driven normalization. The 2018 regulatory framework positioned internet hospitals as extensions of licensed physical medical institutions, thereby permitting online follow-ups for common and chronic diseases while preserving offline accountability. During COVID-19, online consultation, e-prescriptions, drug delivery, and insurance payments rapidly expanded. Evidence suggests benefits for chronic disease management, medication adherence, cardiovascular secondary prevention, and reduced travel burden. However, evidence remains limited for diagnostic accuracy, adverse events, emergency escalation, and long-term outcomes. Persistent barriers include quality variation, workload, cybersecurity, data fragmentation, artificial intelligence (AI) accountability, reimbursement design, regional inequity, and digital exclusion among older adults.</p><p><strong>Conclusion: </strong>China's model may be understood as a hospital-centered extension of public-hospital functions rather than a stand-alone virtual-care system. Future development should prioritize outcome-based evaluations, safety governance, equitable access, data interoperability, and accountability for internet-based and AI-assisted care.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"598-621"},"PeriodicalIF":4.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing public health surveillance: A statistical validation of potential sampling bias in large retrospective vaccine cohorts.","authors":"Marco Roccetti","doi":"10.3934/publichealth.2026031","DOIUrl":"10.3934/publichealth.2026031","url":null,"abstract":"<p><p>In the context of Global Health, massive administrative datasets have become indispensable tools for health surveillance. However, the sheer scale of Big Data can mask systemic selection biases that standard mathematical adjustments may not fully mitigate. In this study, I propose a methodological audit of a recent large-scale cohort (N = 2,975,035) concerning COVID-19 vaccination and oncological outcomes. By benchmarking the cohort's architecture against national demographic and epidemiological gold standards through single-proportion Z-tests, we identified notable structural divergences. The first inferential test yielded a Z-score of -260.39 (p < 10⁻⁵⁰), suggesting a structural under-sampling of the elderly population (32.2% deficit) relative to the reference population. The second test identified a statistically inconsistent cancer incidence deficit in the non-vaccinated control group (Z = -15.23, p < 10⁻⁵⁰). These findings indicate that the reported statistical signals may emerge as a computational consequence of structural selection bias, where an artificially deflated baseline in the control group potentially inflates Hazard Ratios. Within a One Health approach, ensuring the structural integrity of data is crucial for effective prevention and control measures. We conclude that large-scale surveillance studies could be inferentially validated against demographic benchmarks to ensure that public health conclusions are grounded in baseline equivalence, thereby safeguarding the reliability of global health monitoring.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"589-597"},"PeriodicalIF":4.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between workplace gaslighting, mental health and work life in nurses: a cross-sectional study in Greece.","authors":"Aglaia Katsiroumpa, Ioannis Moisoglou, Olympia Konstantakopoulou, Parisis Gallos, Maria Rekleiti, Petros Galanis","doi":"10.3934/publichealth.2026030","DOIUrl":"10.3934/publichealth.2026030","url":null,"abstract":"<p><strong>Background: </strong>Workplace gaslighting is an alarming issue. However, the negative consequences of workplace gaslighting in nurses are unknown. In this context, our aim was to examine the association between workplace gaslighting and nurses' mental health and work life.</p><p><strong>Methods: </strong>We conducted an online cross-sectional study in Greece during December 2024. We employed a convenience sample of nurses. We used the Gaslighting at Work Scale (GWS) to measure levels of workplace gaslighting among our nurses. We used the Patient Health Questionnaire-4, the Quiet Quitting Scale, and the Utrecht Work Engagement Scale-3 to measure anxiety-like symptoms, depressive-like symptoms, quiet quitting, and work engagement, respectively.</p><p><strong>Results: </strong>The study population included 369 nurses with a mean age of 37.86 years. We found a positive association between workplace gaslighting, anxiety-like symptoms, and depressive-like symptoms in our nurses. After adjustment for confounders, we found a positive association between GWS scores and anxiety-like symptoms (adjusted b = 0.758, 95% CI = 0.606 to 0.909, p < 0.001), and depressive-like symptoms (adjusted b = 0.720, 95% CI = 0.555 to 0.885, p < 0.001). Moreover, our multivariable models showed a positive association between GWS scores and quiet quitting (adjusted b = 0.258, 95% CI = 0.186 to 0.330, p < 0.001). Also, we found a negative association between GWS scores and work engagement (adjusted b = -0.353, 95% CI = -0.512 to -0.195, p < 0.001).</p><p><strong>Conclusions: </strong>Our findings suggest that nurses who experience higher levels of gaslighting from their supervisors have more anxiety-like symptoms and depressive-like symptoms. Moreover, workplace gaslighting is associated with quiet quitting and work engagement. However, considering the cross-sectional nature of our study and the study limitations, further research should be conducted to extract more valid results.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"573-588"},"PeriodicalIF":4.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From early risk to preventive action: Empowerment based digital triage and intervention for burnout, anxiety, and depression in Scandinavian healthcare workers.","authors":"Clive Michelsen","doi":"10.3934/publichealth.2026029","DOIUrl":"10.3934/publichealth.2026029","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Burnout, anxiety, and depression among healthcare workers are associated with long-term sickness absence, reduced quality of care, and impaired patient safety. In Sweden and other Scandinavian countries, common mental disorders account for a substantial share of sickness absence, with costs borne by employers and national insurance systems (the \"payee side\"). Early identification of workers at elevated risk, followed by proportionate preventive support, is therefore central to sustainable hospital management and occupational health. The Empowerment for Participation (EFP) assessment is a 110-item web-based system that maps everyday participation, demands, and self-expectations and derives validated risk indices for burnout, anxiety, and depression, together with constructs such as motivation, stress, and defence routines. The EFP battery has been used as a triage tool and an outcome framework in web-based psychotherapy trials targeting burnout risk and as a component in AI-driven digital triage concepts within the My-E-Health ecosystem. Prior Swedish evidence also links burnout and stress symptoms in healthcare workers to subsequent long-term sickness absence, supporting the relevance of risk indices for occupational prevention. Empowerment-related constructs have further been shown to be responsive to interventions such as mindfulness-based treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To integrate empirical data from a cohort of healthcare personnel assessed with the EFP battery into a broader preventive model linking early risk identification, digital and therapist-delivered support, and the Scandinavian sick-pay context, while clarifying the methodological limits of non-randomised, real-world data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;I analysed EFP data from 325 healthcare workers with baseline (T1) and follow-up (T2) assessments who, in routine practice, either (1) received no structured treatment or AI support (no structured support/control), (2) engaged in human-delivered psychotherapy (human therapy), or (3) used an AI-supported, web-based intervention grounded in the EFP architecture (AI-only support). Outcomes included the EFP Empowerment index and EFP-derived risk indices for burnout, anxiety, and depression, plus stress burden, motivation, and defence routines. Change over time was examined within groups (paired t-tests; Cohen's d_z) and explored between groups using change-score ANOVAs (η²). Because groups were not randomised and differed at baseline, between-group comparisons were interpreted cautiously as descriptive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At baseline, participants who went on to use human therapy or AI-only support showed higher EFP-derived risk for burnout, anxiety, and depression and lower empowerment than those who did not engage in structured support, consistent with risk-driven help-seeking. Under naturalistic conditions, human therapy and AI-only support were associated with large within-","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"561-572"},"PeriodicalIF":4.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation and identification of microorganisms from public and semi-public multi-user video gamepads with respect to hygiene and disinfection measures.","authors":"Abdullah Alfarhan, Muhammad Poyil, Saad Alshahrani, Elmutasim Ibnouf, Maged Abdel-Kader","doi":"10.3934/publichealth.2026028","DOIUrl":"10.3934/publichealth.2026028","url":null,"abstract":"<p><p>The purpose of the current study was to evaluate the possible role of multi-user video gamepads in spreading microbial populations among users and understand how to reduce this risk. The study design involved 10 public locations in Al-Kharj city and 10 semi-public locations inside the campus of Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia. Air samples were collected from all selected places once during the study using a passive air sampling technique. Semi-public places with a good aeration system and a regular cleaning routine showed much less airborne organisms than public places with less care. Samples from the multi-user video gamepads were taken from each gamepad three times during a period of two weeks. Each time, one sample was taken before any intervention, and another sample was collected after disinfection with commercial alcohol swab pads containing 70% isopropyl alcohol. All samples were examined for the number of viable organisms. The mean microbial count ranged from 98 to 270 CFU in public locations and from 18 to 34 CFU in semi-public locations. Samples collected from semi-public places showed 3 bacterial genera and were free from fungi, while samples from public places showed 9 bacterial and 4 fungal genera. After disinfection of the multi-user video gamepads in the public places, the number of colonies reached a maximum of 8 CFU (approximately 97% reduction), while the semi-public places expressed a 91% reduction in the number of organisms. The results obtained demonstrate the importance of following hygiene measures in multi-user objects to reduce the risk of infection transmission.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"546-560"},"PeriodicalIF":4.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observing children's outdoor loose parts play, fundamental movement skills, and physical activity in after-school programs through a behavioral mapping approach.","authors":"Nila Joshi, Son Truong, Janet Loebach, Daniel Rainham, Becky Feicht, Michelle Stone","doi":"10.3934/publichealth.2026027","DOIUrl":"10.3934/publichealth.2026027","url":null,"abstract":"<p><strong>Background: </strong>Outdoor Loose Parts Play (OLPP) has been recognized for its potential to support children's fundamental movement skills (FMS) and physical activity (PA). However, few researchers have explored its association in after-school settings or observed how different outdoor spaces may influence these outcomes.</p><p><strong>Purpose: </strong>We observed patterns of children's FMS and PA across two after-school programs with varied outdoor spaces in Nova Scotia, Canada, following an OLPP intervention. We also explored how types of loose parts and fixed features were associated with specific FMS and PA intensities.</p><p><strong>Methods: </strong>Using a multi-site case study approach, behavioral mapping was conducted with children aged 4-12 years pre/post a six-week OLPP intervention. Movements (FMS) were recorded using the Movement Observations during Play (MOP) measure, and PA intensities were recorded using the Children's Activity Rating Scale (CARS). Proportions of FMS, PA intensities, and environmental interactions (LP and fixed features) pre-post were explored using descriptive analyses and McNemar's test (p < 0.05). Logistic regression examined how interaction with LP and fixed features was associated with the likelihood of observing different movements and PA intensities.</p><p><strong>Results: </strong>Pre-post patterns differed by site. At Site A (larger, suburban, natural outdoor space, pre-existing OLPP), a higher proportion of stability skills were observed, while PA intensity remained unchanged. At Site B (smaller, urban, manufactured outdoor space, limited prior OLPP), a higher proportion of object control skills and moderate-intensity PA were observed. Across both sites, loose manufactured and loose natural materials were more likely to include object control skills, while fixed natural features were more likely to include stability skills.</p><p><strong>Conclusion: </strong>OLPP was associated with site-specific patterns. Findings suggest that LP types and fixed feature affordances may shape opportunities for different movements and PA intensities. These findings can inform educators and policymakers in designing outdoor play spaces that optimize children's movement opportunities.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"513-545"},"PeriodicalIF":4.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting nurses' professional quality of life in Europe - A systematic review.","authors":"Efrosini Vera, Petros Galanis, Polyxeni Mangoulia, Theodoros Pesiridis","doi":"10.3934/publichealth.2026026","DOIUrl":"10.3934/publichealth.2026026","url":null,"abstract":"<p><strong>Background: </strong>Nursing care involves both cognitive and emotional aspects, significantly impacting nurses' professional quality of life (ProQOL). This systematic review investigated the factors affecting nurses' professional quality of life in Europe.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting framework and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD420251133948). Searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and EBSCOhost from inception to August 2025. Eligible peer-reviewed quantitative studies from European Union countries utilized the ProQOL instrument, reporting on all three dimensions: compassion satisfaction, burnout, and secondary traumatic stress. Two reviewers independently screened records, extracted data, and appraised methodological quality using the Joanna Briggs Institute critical appraisal tool.</p><p><strong>Results: </strong>A total of 3407 records were initially identified, and 35 studies were ultimately included, comprising 8580 nursing staff across diverse clinical settings, predominantly hospitals, with 13 studies conducted during the coronavirus disease period in 2019. Most studies reported moderate levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. Higher compassion satisfaction was generally associated with greater age and professional experience, relevant education and training, work engagement, supportive work environments, better perceived control over workload, and stronger psychosocial resources, including resilience, psychological flexibility, self-compassion, mindfulness, and social support. Higher burnout and secondary traumatic stress related to indirect exposure were consistently linked to a high workload, overtime, rotating schedules, job stress, workplace violence, employment in high-intensity clinical areas, and adverse psychological states, including persistent stress, fear related to the coronavirus disease, and moral distress.</p><p><strong>Conclusions: </strong>Professional quality of life among European nursing staff is influenced by a combination of demographic, occupational, and psychosocial factors. Multilevel strategies addressing organizational stressors while strengthening individual and team-based resources are warranted to improve compassion satisfaction and reduce burnout and secondary traumatic stress.</p>","PeriodicalId":45684,"journal":{"name":"AIMS Public Health","volume":"13 2","pages":"485-512"},"PeriodicalIF":4.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}