Public Health最新文献

{"title":"Identifying potential post-COVID-19 condition among people experiencing homelessness using longitudinal symptom patterns: A prospective cohort study","authors":"Lucie Richard ,&nbsp;Rosane Nisenbaum ,&nbsp;Allison Dyer ,&nbsp;Daniela Mergarten ,&nbsp;Michael Brown ,&nbsp;Suzanne Stewart ,&nbsp;Stephen W. Hwang","doi":"10.1016/j.puhe.2026.106148","DOIUrl":"10.1016/j.puhe.2026.106148","url":null,"abstract":"<div><h3>Objectives</h3><div>People experiencing homelessness have high SARS-CoV-2 infection and re-infection burden, potentially leading to higher prevalence of post-COVID-19 condition (PCC). However, high baseline symptom rates may make identification of PCC difficult or impossible in this population. This study evaluates symptom patterns over time to assess their ability to identify potential PCC among individuals experiencing homelessness.</div></div><div><h3>Study design</h3><div>Prospective cohort study</div></div><div><h3>Methods</h3><div>We prospectively followed a large (n = 736), representative cohort of people experiencing homelessness recruited at random from 62 sites in Toronto, Canada between June and September 2021. Participants were interviewed up to five times over approximately 12 months. Longitudinal patterns of twelve self-reported symptoms were assessed through latent transition analysis, and generalized estimating equations with logit link were applied to determine their association with known risk of potential PCC.</div></div><div><h3>Results</h3><div>Among 736 participants, three latent statuses were identified: (1) ‘No/Few Symptoms’ (≥70 %), (2) ‘Non-Specific Symptoms’ (15–23 %), and (3) ‘Infection-Related Symptoms’ (≤5 %). Statuses 2 and 3 were associated with being at risk of PCC following symptomatic infection (aOR 3.41 [95 % CI 2.3–5.0] and 3.18 [95 % CI 1.6–6.4]) but not with being at risk of PCC overall. Transition probabilities suggested PCC would mostly occur among individuals with symptoms at baseline. However, the clustered area under the curve was modest (0.70 [95 % CI 0.65–0.75]), indicating symptom-based approaches are suboptimal for identification of potential PCC.</div></div><div><h3>Conclusions</h3><div>Self-reported symptoms do not reliably identify potential PCC among people experiencing homelessness, due to high rates of underlying symptoms and asymptomatic infections. Alternative, strengths-based approaches are recommended to more equitably identify post-COVID condition in this population.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106148"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980559","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":"Quantifying lifetime productivity loss attributable to cigarette smoking in Taiwan","authors":"Wei-Cheng Lo ,&nbsp;Tsuey-Hwa Hu ,&nbsp;Fuhmei Wang ,&nbsp;Ta-Chien Chan ,&nbsp;Jing-Shiang Hwang","doi":"10.1016/j.puhe.2026.106149","DOIUrl":"10.1016/j.puhe.2026.106149","url":null,"abstract":"<div><h3>Objectives</h3><div>Evaluating long-term health and economic burden of smoking is critical for assessing the effectiveness of tobacco control policies. This study aimed to estimate lifetime productivity loss attributable to smoking among adults in Taiwan.</div></div><div><h3>Study design</h3><div>Longitudinal cohort study.</div></div><div><h3>Methods</h3><div>We analyzed data from the MJ cohort, linking medical and demographic information with National Health Insurance Research Database and Taiwan Death Registry database to estimate participants’ monthly earnings and confirm vital status. Lifetime productivity loss was assessed using survival and earnings functions of comparative groups estimated through a rolling extrapolation algorithm, incorporating inverse probability of treatment weighting to address confounders.</div></div><div><h3>Results</h3><div>Among 215,852 participants aged 30–64 years, those who had smoked had lower baseline employment rates and median monthly incomes. Smoking was associated with reduced life expectancy by 2.0 years (95 % CI: 1.54–2.35) for men and 1.37 years (95 % CI: −0.47 – 2.12) for women, and reduced employment time by 0.70 years (95 % CI: 0.26–1.30) for men and 1.82 years (95 % CI: 0.97–2.44) for women. The estimated average lifetime productivity loss attributable to smoking was US$ 45,572 for men and US$ 61,552 for women. Aggregating across Taiwan's population, this translates to a total lifetime productivity loss of US$ 80,589 million (95 % CI: 56,691 million to 103,743 million). The loss per annum was US$ 4563 million (95 % CI: 3602–5574 million), accounting for 0.6 % of Taiwan's GDP in 2022 (0.49 % from males, 0.11 % from females).</div></div><div><h3>Conclusions</h3><div>This study provides a data-driven analytical framework and demonstrates substantial lifetime and annual productivity losses attributable to smoking in Taiwan. These findings underscore the economic imperative for strengthening tobacco control measures to mitigate the long-term health and financial burden of smoking.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106149"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980462","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":"Specific types of screen exposure and adolescent emotional and behavioral problems: Longitudinal associations and moderation by individual, family, and school characteristics","authors":"Qianyu Liu ,&nbsp;Shuyi Peng ,&nbsp;Yuwei Yang ,&nbsp;Yannan Guo ,&nbsp;Guiyu Jiang ,&nbsp;Lan Guo","doi":"10.1016/j.puhe.2026.106140","DOIUrl":"10.1016/j.puhe.2026.106140","url":null,"abstract":"<div><h3>Objectives</h3><div>The rise in television and digital media use among adolescents has become a major concern, but the impacts of specific types of screen exposure on mental health remain underexplored. This study examined whether specific types of screen exposure are associated with emotional and behavioral problems (EBPs), and whether individual, family, and school factors moderate these associations.</div></div><div><h3>Study design</h3><div>Longitudinal study.</div></div><div><h3>Methods</h3><div>Participants (N = 10,770; mean age 15.89 years, 51.6 % male) completed standardized questionnaires at baseline and follow-up. EBPs were measured using the Strengths and Difficulties Questionnaire, and screen exposure and contextual factors were collected via self-report questionnaires. Generalized linear mixed-effects models, restricted cubic splines, interaction analyses, and sensitivity analyses were conducted.</div></div><div><h3>Results</h3><div>Specific screen types use, particularly educational apps and shopping/food delivery app exposures, were associated with increased total EBP difficulties. Each additional hour of social networking (OR, 1.04; 95 % CI, 1.01–1.07), short video viewing (OR, 1.05; 95 % CI, 1.01–1.09), or video gaming (OR, 1.06; 95 % CI, 1.01–1.10) was associated with an elevated risk of emotional symptoms. Short videos and video games were also associated with greater hyperactivity/inattention. Moderation analyses showed father's education, academic achievement, health status, and family function significantly modified these associations (e.g., family function × short video use: OR_interaction = 0.89, <em>P</em>_interaction = 0.014).</div></div><div><h3>Conclusions</h3><div>These findings highlight the differential impacts of screen exposure types on adolescent mental health and underscore the importance of addressing specific screen behaviors while considering individual, family, and school characteristics that may modify these risks, although the study's observational design limits causal inference.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106140"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980468","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":"Spatial and spatio-temporal distribution of infant mortality in the state of Sergipe, Brazil: An ecological study, 2019–2023","authors":"Maria Fernanda de Sá Camarço,&nbsp;Jefferson Felipe Calazans Batista,&nbsp;Sonia Oliveira Lima","doi":"10.1016/j.puhe.2026.106153","DOIUrl":"10.1016/j.puhe.2026.106153","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the spatial and spatiotemporal distribution of infant mortality in the state of Sergipe from 2019 to 2023.</div></div><div><h3>Study design</h3><div>Ecological study.</div></div><div><h3>Methods</h3><div>This ecological study used publicly available data on infant deaths in Sergipe between 2019 and 2023, obtained from the Mortality Information System. Variables related to the child, mother, and healthcare factors were considered. Bayesian mortality rates were calculated and mapped across municipalities. Moran's Index was applied to assess spatial correlation.</div></div><div><h3>Results</h3><div>Between 2019 and 2023, Sergipe recorded 2547 infant deaths. The leading causes were perinatal conditions (Chapter XVI) and abnormal findings in examinations (Chapter XVIII), predominantly in the northern region. Higher mortality was observed among Black female infants with very low or low birth weight, as well as clusters of deaths among adolescent mothers in the Itabaiana region, and adult or late-age mothers in Propriá, which also showed higher mortality among preterm infants. The municipalities of Propriá and Nossa Senhora do Socorro reported more deaths associated with cesarean deliveries. Aracaju, São Cristóvão, and Nossa Senhora do Socorro formed high-mortality clusters, with a risk 641.77 times greater; conversely, Nossa Senhora da Glória, Lagarto, and Estância exhibited a 66 % lower risk.</div></div><div><h3>Conclusion</h3><div>Infant mortality in Sergipe is unevenly distributed, concentrated in high-risk clusters, and reflects regional disparities as well as specific maternal and neonatal factors.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106153"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980558","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":"Facilitators and barriers to mainstreaming climate change adaptation and mitigation into sub-national health systems: Perspectives from primary health care managers in low-resourced settings of Ghana","authors":"Rudolf Abugnaba-Abanga ,&nbsp;Dzigbodi Adzo Doke ,&nbsp;Maximillian Kolbe Domapielle ,&nbsp;Duncan Alemna Adogboba ,&nbsp;Kei Ostuki","doi":"10.1016/j.puhe.2026.106135","DOIUrl":"10.1016/j.puhe.2026.106135","url":null,"abstract":"<div><h3>Objectives</h3><div>This article explores the perspectives of primary healthcare managers on context-specific facilitators and barriers to mainstreaming climate change adaptation and mitigation into the operations in three primary healthcare (PHC) systems in low-resourced settings of the Upper East Region of Ghana.</div></div><div><h3>Study design</h3><div>A framework approach utilising inductive coding, guided by the Consolidated Framework for Implementation Research Index (CFIR Index) dimensions, to examine the perspectives of PHC managers on facilitators and barriers to mainstreaming climate change adaptation and mitigation in PHC operations.</div></div><div><h3>Methods</h3><div>Between October 31 and November 25, 2022, 18 purposively sampled PHC managers from three PHCs in the Upper East Region of Ghana participated in key informant interviews on facilitators and barriers to mainstreaming the WHO frameworks on building climate resilience and environmentally sustainable health systems. Key-informant interview guides were used to generate the data. Inductive codes were generated along secondary themes of suitability of the framework for PHC, PHC systems and stakeholders, PHC programming attributes and culture, and PHC managers’ identification with the WHO framework.</div></div><div><h3>Results</h3><div>The WHO framework is perceived as suitable because of its alignment with health systems/PHC vision and its potential to enhance staff safety and client satisfaction. PHC programming attributes and culture, such as positive and open learning environments, strong networks, and well-developed systems and structures, were reported as facilitators. Furthermore, high-risk perception, perceived service improvements, and self-efficacy were reported as facilitators. PHC systems and stakeholders are reported as barriers due to the absence of policy frameworks and incentives, inadequate staff and system capacities, and the cost of mainstreaming.</div></div><div><h3>Conclusion</h3><div>Mainstreaming climate action into PHC policies, protocols, and programmes with built-in accountability mechanisms and financing is critical for sustained action.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106135"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967677","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":"STD history predicts persistent condom non-use and partner HIV seroconversion in older Chinese adults with HIV: A retrospective cohort mediation analysis","authors":"Chunxing Tao ,&nbsp;Ting Huang ,&nbsp;Qingyi Liu ,&nbsp;Rongye Huang ,&nbsp;Aidan Nong ,&nbsp;Zhiman Yan ,&nbsp;Lijing Huang ,&nbsp;Bingyu Liang","doi":"10.1016/j.puhe.2026.106155","DOIUrl":"10.1016/j.puhe.2026.106155","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assessed the impact of STD history on condom use and partner HIV seroconversion among older adults with HIV in Southwest China.</div></div><div><h3>Study design</h3><div>We conducted a retrospective cohort study using data from the Chinese HIV/AIDS Comprehensive Response Information Management System (CRIMS) across five cities in Southwest China (2003–2023).</div></div><div><h3>Methods</h3><div>Participants included older adults (aged ≥50 years) newly diagnosed with HIV and with documented baseline STD history. Outcomes were inconsistent condom use and partner HIV seroconversion, assessed using longitudinal follow-up records. Logistic regression examined associations, and mediation analysis estimated the indirect effect of condom use on the STD history-seroconversion relationship. Sensitivity analyses stratified participants by sex, marital status, education, and occupation.</div></div><div><h3>Results</h3><div>Among 30,492 included older adults with HIV (median age: 62.28 years; IQR: 56.26–68.74), 7.3 % had a documented STD history at diagnosis. Most participants were male (72.1 %), farmers (79.8 %), and married/cohabitating (67.8 %). Of the 27,313 participants included in the analysis of condom use, 18.2 % reported inconsistent use, while among the 5025 participants in the partner seroconversion analysis, 6.5 % reported partner HIV seroconversion. STD history was significantly associated with inconsistent condom use post-diagnosis (aOR: 2.18; 95 %CI: 1.96–2.41) and increased partner HIV seroconversion risk (aOR: 1.90; 95 %CI: 1.27–2.84). The mediation analysis indicated that inconsistent condom use explained 11.9 % of the total effect of STD history on partner seroconversion, while the residual effect was unexplained and not captured by the measured mediator.</div></div><div><h3>Conclusions</h3><div>Prior STD exposure was associated with persistent sexual risk and elevated partner HIV transmission among older adults, underscoring the need to integrate STD history into risk assessments and long-term monitoring strategies for serodiscordant partnerships in high-burden settings with aging HIV populations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106155"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041886","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":"Correlates of paternal anxiety during the perinatal period: Systematic review and meta-analysis","authors":"Małgorzata Sobol ,&nbsp;Elisa Mancinelli ,&nbsp;Agata Błachnio ,&nbsp;Silvia Salcuni","doi":"10.1016/j.puhe.2025.106108","DOIUrl":"10.1016/j.puhe.2025.106108","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify and quantify factors associated with paternal perinatal anxiety (PPA) within non-clinical populations.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were performed in line with PRISMA guidelines. Searches were conducted in the PsycARTICLES, PubMed, PsycINFO, MEDLINE, and Scopus databases, supplemented by manual searches and citation-tracking. The risk of bias, the level of evidence, the corresponding score points, and the degree of association with PPA were assessed for each study.</div></div><div><h3>Results</h3><div>37 studies were included, with 16 in the meta-analysis. Results showed that high paternal depressive symptoms, low social support, and high maternal anxiety were associated with higher paternal prenatal anxiety. Higher paternal anxiety postnatally was associated with paternal prenatal anxiety, postpartum depression symptoms, negative birth memories, and maternal anxiety.</div></div><div><h3>Conclusion</h3><div>The positive association between prenatal and postnatal anxiety suggests continuity of anxiety within fathers across the perinatal period, while being closely linked with paternal depression symptoms as well as partner's anxiety, perceived social support, and birth experiences. Findings emphasize the need for family-centered interventions and improved psychosocial support for expectant and new fathers. Addressing these factors may improve paternal mental health outcomes and family well-being during the perinatal period.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106108"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044171","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":"Building climate-resilient primary care: A convergent mixed-methods climate vulnerability and capacity assessment in the Cederberg subdistrict, South Africa","authors":"Robert Mash ,&nbsp;Stacey Blows ,&nbsp;Sa'ad Lahri ,&nbsp;Melissa McRae ,&nbsp;Christian Lokotola ,&nbsp;Kiran Jobanputra ,&nbsp;Patricia Nayna Schwerdtle","doi":"10.1016/j.puhe.2025.106106","DOIUrl":"10.1016/j.puhe.2025.106106","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the climate resilience of primary care facilities and services in the Cederberg subdistrict of the Western Cape, South Africa.</div></div><div><h3>Study design</h3><div>We conducted a convergent parallel mixed-methods study to assess the climate vulnerability and adaptive capacity of a primary care network. Quantitative facility audits and qualitative focus groups were undertaken, with subsequent integration to identify risks and generate context-specific adaptation options.</div></div><div><h3>Methods</h3><div>The study combined a structured audit of primary care facilities with a rapid qualitative assessment involving focus groups with health workers. Quantitative and qualitative datasets were analysed separately and then synthesised to map vulnerabilities and propose feasible adaptation measures. The subdistrict management team later used the integrated findings to prioritise adaptation actions.</div></div><div><h3>Results</h3><div>Across six primary care facilities, extreme heat was the most significant hazard, particularly where indoor temperatures rose above 40 °C, contributing to staff fatigue, overcrowding as community members sought refuge, and a higher risk of heat-related illness. Heat was also linked to increased drought and wildfire risk. Irregular and excessive rainfall further disrupted service delivery through flooding, road closures, delays in essential supplies, and increased waterborne and respiratory illness. Coastal facilities faced additional exposure to storm surge and sea-level rise. Environmental and operational sustainability challenges, including reliance on carbon-intensive electricity, waste-related emissions, inconsistent water quality, and limited backup water supply, amplified these climate-related risks. The assessment identified a consolidated set of risks across heat, rainfall, flooding, and sustainability domains, and generated 42 feasible adaptation options across infrastructure; governance; service delivery; workforce; energy; and water, sanitation and waste.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that facility-level VCA assessments can successfully guide climate resilience planning in African primary care settings. The VCA process identified context-specific hazards, risks and feasible adaptation options across key domains of health system function. The approach provides an adaptable framework for other African settings seeking to strengthen primary care resilience to climate impacts. Transitioning from assessment to implementation will require local capacity to conduct VCAs independently and access to sustainable climate finance to support action.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106106"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980467","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":"Access and engagement with maternity, social care and mental health services for perinatal migrant women with no recourse to public funds and irregular status: A cross-sectional study using the eLIXIR born in South London, UK, maternity-child data linkage","authors":"Hannah Rayment-Jones ,&nbsp;Sam Burton ,&nbsp;Tisha Dasgupta ,&nbsp;Zenab Barry ,&nbsp;Kaat De Backer ,&nbsp;Natasha Baker ,&nbsp;Claire A. Wilson ,&nbsp;Kerrie Stevenson ,&nbsp;Zoë Vowles ,&nbsp;Kirsty Kitchen ,&nbsp;Abigail Easter ,&nbsp;Andrew Jolly ,&nbsp;Judith Rankin ,&nbsp;Cristina Fernandez-Turienzo ,&nbsp;Jane Sandall ,&nbsp;The eLIXIR Born in South London Partnership ,&nbsp;Lucilla Poston ,&nbsp;Laura A. Magee ,&nbsp;Robert Stewart ,&nbsp;David Edwards ,&nbsp;Carolyn Gill","doi":"10.1016/j.puhe.2026.106175","DOIUrl":"10.1016/j.puhe.2026.106175","url":null,"abstract":"<div><h3>Objectives</h3><div>In the UK, an estimated two million migrants are irregular or subject to No Recourse to Public Funds (NRPF) visa conditions, restricting welfare access and often requiring payment for NHS maternity care. The impact on maternity and perinatal service use remains poorly quantified.</div></div><div><h3>Study design</h3><div>Retrospective cross-sectional study.</div></div><div><h3>Methods</h3><div>We used linked electronic health records from maternity, neonatal, and mental health services in South London (eLIXIR-BiSL cohort). The sample included 56,690 women with 67,308 pregnancies (Oct 2018–Oct 2023). Migration status was categorised as UK-born, migrants with recourse to public funds, NRPF, or unknown visa status. Adjusted risk ratios (aRRs) were estimated using generalised linear models, controlling for sociodemographic and clinical characteristics.</div></div><div><h3>Results</h3><div>Compared with UK-born women, migrants, particularly those with NRPF, had lower engagement with services. Women with NRPF were less likely to access early antenatal care (aRR 0.36 [0.33–0.38]), attend maternity triage (0.89 [0.82–0.96]), or birth in midwife-led settings (0.51 [0.36–0.71]). They were more likely to access care late (3.61 [3.33–3.92]), receive inadequate antenatal care (1.41 [1.30–1.53]), transfer providers (1.54 [1.36–1.74]), and experience prolonged postnatal stays (1.38 [1.21–1.57]). Women with NRPF had lower mental health care contact before (0.05 [0.03–0.08]) and during pregnancy (0.51 [0.37–0.69]), and reduced engagement with social care (0.36 [0.17–0.70]) and the criminal justice system (0.30 [0.19–0.44]).</div></div><div><h3>Conclusions</h3><div>Migrants with NRPF or unknown visa status face persistent barriers to maternity and mental health care. Inclusive reforms are needed to address inequity.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106175"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120807","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":"Effects of school-based physical activity interventions on cardiorespiratory fitness and body composition in children and adolescents: A systematic review and meta-analysis using the RE-AIM framework","authors":"Huihui Wang ,&nbsp;Xiaotian Bai ,&nbsp;Xiangrong Cheng ,&nbsp;Xiaosheng Dong ,&nbsp;Xiao Hou","doi":"10.1016/j.puhe.2026.106141","DOIUrl":"10.1016/j.puhe.2026.106141","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review and meta-analysis aimed to (1) assess the effects of school-based physical activity (PA) interventions on cardiorespiratory fitness (CRF) and body composition in children and adolescents, and (2) evaluate internal validity (i.e., Reach and Effectiveness) and external validity (i.e., Adoption, Implementation, and Maintenance) reported in the included studies using the RE-AIM framework.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Five databases (PubMed, Embase, Web of Science, EBSCO, and Cochrane Library) were searched for studies published from January 1, 2000, to July 10, 2024. Eligible studies were randomized or non-randomized controlled trials involving healthy children and adolescents aged 5–17 years. Only studies that reported CRF or body composition with PA or exercise as the sole intervention were included.</div></div><div><h3>Results</h3><div>43 studies with a total of 27,626 participants were included in the meta-analysis. School-based PA interventions had a significant positive effect on CRF (SMD = 0.28, 95 % CI = 0.19 to 0.38; <em>I</em>^<em>2</em> = 75 %). However, no significant effect of school-based PA interventions on percentage of body fat (%BF) was observed (SMD = −0.05, 95 % CI = −0.10 to 0.00; <em>I</em>^<em>2</em> = 28 %). The total proportion of RE-AIM framework reported was 48.1 %. Among the five dimensions, Effectiveness is the most frequently reported (72.7 %), followed by Reach (53.1 %), Adoption (52.3 %), Implementation (42.4 %), and Maintenance (4.7 %).</div></div><div><h3>Conclusions</h3><div>School-based PA interventions significantly improve CRF in youth but do not significantly reduce %BF. Moreover, internal validity indicators were reported more often than external validity components in the included studies.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106141"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999577","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}