BMC Public Health最新文献

{"title":"Understanding Substance Use in Alaska Native Youth- A Social Network Perspective.","authors":"Madeleine Mason, Katie Schultz, Shuwen Zhang, Jerreed D Ivanich","doi":"10.1186/s12889-026-27557-0","DOIUrl":"https://doi.org/10.1186/s12889-026-27557-0","url":null,"abstract":"<p><strong>Background: </strong>Alaska Native (AN) youth and their communities experience many health inequities, including increased rates of substance use. AN youth have earlier initiation and heavier use of substances compared to other youth, with over half of AN youth having engaged in use by 13. While prior research has examined risk factors, few studies have evaluated how social network structures may protect against substance use in youth. This study used social network analysis to examine associations between peer ties, connections with school staff, cultural connectedness, victimization, and substance use among AN youth.</p><p><strong>Methods: </strong>This cross-sectional study collected social network data from 7th -12th grade students (n = 109) at an urban school in Alaska using Network Canvas, a tablet-based platform. Students nominated peers, school staff, family, and non-family, non-school individuals to whom they are close. They then completed survey items assessing cultural connectedness, substance use, depression, victimization, and suicidal ideation. Multivariate logistic regression models examined associations between demographic, psychosocial, and network characteristics and alcohol, tobacco, and marijuana use in AN youth.</p><p><strong>Results: </strong>The mean age of participants was 14.7 years, with youth nominating an average of 15.4 network members. Victimization was consistently associated with greater odds of alcohol, tobacco, and marijuana use. For alcohol use, contact frequency with staff was protective at higher levels, demonstrated by a negative quadratic effect, while greater emotional closeness to those in one's network had a positive linear effect. Similar patterns were observed for marijuana use, including a significant negative quadratic effect of contact frequency and a positive linear effect of closeness. Neither contact frequency nor closeness was significantly associated with tobacco use. Greater cultural connectedness was associated with greater odds of tobacco use but was not significantly associated with alcohol or marijuana use.</p><p><strong>Conclusion: </strong>Substance use among urban AN youth is influenced by complex social processes involving victimization, peer relationships, and connections with school staff. Frequent contact with school staff appears to play a protective role against alcohol and marijuana use. This study demonstrates how network data can identify both risk and protective factors embedded in youths' social environments and insights can be directly applied to the development of prevention strategies.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An updated pharmacovigilance evidence from U.S. tobacco problem reports following the FDA safety communication on e-cigarettes and seizures.","authors":"Danila Azzolina, Patrizia Bartolotta, Martino Belvederi Murri, Dario Gregori","doi":"10.1186/s12889-026-27386-1","DOIUrl":"https://doi.org/10.1186/s12889-026-27386-1","url":null,"abstract":"<p><strong>Objective: </strong>Following the 2019 FDA safety communication on e-cigarette-related seizures, we conducted an updated pharmacovigilance analysis of FDA Tobacco Problem Reports using multimethod disproportionality approaches.</p><p><strong>Design: </strong>Pharmacovigilance study of spontaneously reported adverse events.</p><p><strong>Setting: </strong>FDA Tobacco Problem Reports database, publicly available online.</p><p><strong>Methods: </strong>Reports in which the affected individual was not the product user were excluded. Cases were classified as e-cigarette exposure if the product description mentioned \"electronic cigarette,\" while all others were grouped as other tobacco products. Reported health problems were harmonized into standardized AE categories. Disproportionality analyses were conducted using four methods: Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and shrinkage-based Observed-to-Expected ratio (O/E). A signal was defined when the lower bound of the 95% confidence or credibility interval exceeded the null.</p><p><strong>Results: </strong>A total of 1,082 reports were analyzed, of which 891 (82.3%) involved electronic cigarettes and 191 (17.7%) involved other tobacco products. Combustible tobacco products accounted for 99 cases (9.15%) of other tobacco products, while other or unknown tobacco products represented 60 cases (5.55%). Smokeless or other nicotine products were least frequently reported, accounting for 32 cases (2.96%). Reports involving electronic cigarettes were significantly more likely to have been submitted before 2020 compared with reports involving other tobacco products (80.8% vs 50.8%; OR = 4.07, 95% CI 2.93-5.67; p < 0.001). Seizures emerged as the strongest and only consistent safety signal across all disproportionality methods. Respiratory outcomes, including shortness of breath, cough, pneumonia, and respiratory failure, were more frequently reported in e-cigarette cases and showed signals in ROR and PRR analyses, but did not remain significant when assessed with Bayesian approaches.</p><p><strong>Conclusions: </strong>Seizures represent a pharmacovigilance signal associated with e-cigarette use. Respiratory events were reported more often among e-cigarette users but did not meet conservative Bayesian thresholds. These findings highlight the need for continued surveillance, studies, and regulatory vigilance regarding the safety of e-cigarettes.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-rated health and mental health before and during the early phase of the COVID-19 pandemic in Germany: the population-based German National Cohort (NAKO) study.","authors":"Yue Xi, Thomas Keil, Lilian Krist, Tobias Pischon, Ilais Moreno Velásquez, Matthias B Schulze, Wolfgang Ahrens, Hajo Zeeb, Oliver Kuß, Tamara Schikowski, Börge Schmidt, Andreas Stang, Alexandra Nieters, Rafael Mikolajczyk, Janka Massag, Volker Harth, Nadia Obi, Anne C Hallet, Carolina J Klett-Tammen, Wolfgang Lieb, Markus Löffler, Rudolf Kaaks, Till Bärnighausen, André Karch, Klaus Berger, Muhammad Nasir Khan Khattak, Claudia Meinke-Franze, Michael Leitzmann, Beate Fischer, Hermann Brenner, Bernd Holleczek, Susanne Rospleszcz, Annette Peters","doi":"10.1186/s12889-026-27633-5","DOIUrl":"https://doi.org/10.1186/s12889-026-27633-5","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic and accompanying social distancing measures might have caused adverse health consequences. We aimed to describe changes in participants' self-rated health and mental health (depression, anxiety, and stress), and investigate factors associated with them.</p><p><strong>Methods: </strong>We collected data from the German National Cohort (NAKO). We first described changes in participants' self-rated health and mental health from the baseline examination (1 to 6 years earlier) to the early phase of the COVID-19 pandemic. We then applied the multinomial logistic regression model (self-rated health) and the quantile regression model (mental health) to investigate the potential factors associated with the health status and changes.</p><p><strong>Results: </strong>After a median of 3.1 [2.1, 4.1] years from baseline to the early pandemic phase (N = 91,809), 39.3% of participants with good health and 69.7% with less good health status at baseline reported better health. However, the percentage of participants with high depression, anxiety, and stress scores (≥ 10) increased from 6.2%, 4.1%, and 4.3% to 8.6%, 5.6%, and 10.1%, respectively. In the multivariable models, we found that being younger, being male, highly educated, being employed, having higher life satisfaction at baseline, being more physically active, drinking heavily, and experiencing improved anxiety symptoms were associated with improved self-rated health. In contrast, smoking and having mental health disorders were all associated with worse self-rated health. Our results showed that being younger, being female, smoking, drinking heavily, and drinking more since baseline were associated with higher depression scores. Having had a coronavirus test was associated with worse self-rated health and more severe anxiety and stress.</p><p><strong>Conclusions: </strong>During the early COVID-19 pandemic, many participants experienced improvements in self-rated health but suffered deterioration in mental health and physical activity engagement. Female participants, those who were physically inactive, and those with pre-existing mental disorders were more likely to report poorer health.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"26 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of couple- or household-targeted interventions for smoking cessation in pregnancy.","authors":"Sadie Mullin, Christy Burden, Kate Grant, Abi Merriel, Anna Davies","doi":"10.1186/s12889-026-27484-0","DOIUrl":"https://doi.org/10.1186/s12889-026-27484-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tobacco smoking is a major modifiable risk for poor pregnancy outcomes. Pregnant women whose partner smokes are six times more likely to continue smoking. Typically, interventions target pregnant mothers or smoking fathers to reduce second-hand smoke exposure. Evidence reviews advocate for couple-targeted smoking cessation interventions, however no recent review has evaluated the effectiveness of interventions targeting both pregnant women and their partner/household member. We aimed to systematically review and evaluate the effectiveness of smoking cessation interventions targeting the couple/household where both parties smoke for antenatal smoking cessation in pregnant women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched 8 databases (MEDLINE, Embase, Emcare, AMED, BNI, CINAHL, PsycINFO, Cochrane Register of Controlled Trials) for randomised controlled trials (RCTs), controlled non-randomised studies and before-and-after studies, meeting PICO criteria: Population: pregnant woman and her partner/household member/s who are tobacco smokers antenatally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Tobacco smoking cessation intervention targeting a couple/household.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Control: &lt;/strong&gt;Intervention targeting woman only, usual care, historical control group. Outcome/s: Objectively assessed or self-reported antenatal maternal smoking cessation. Studies were systematically selected for inclusion and data were extracted by two researchers. Meta-analysis was not undertaken due to clinical and methodological heterogeneity, including differing intervention types, outcome measures, cut-offs used to define cessation and follow-up timepoints. Data were narratively synthesised.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six studies were included: 4 RCTs, 1 non-randomised comparative study and 1 before-and-after study. Interventions were poorly described, variable in content across studies, and differed in content between women and partners/household members within studies. They included behavioural support (n = 6 women, n = 4 partners), written or self-help materials (n = 4 women, n = 6 partners), nicotine replacement therapy (n = 1 women, n = 1 partners), demonstration of smoking effects on the fetal heart (n = 1 women) and incentives (n = 1 women). Three studies directly targeted partners and three targeted them indirectly via the woman. Only one study compared targeting the couple versus the woman only. Varied subjective and objective cessation measures were assessed. Quit definition, measurement timepoint, and whether partner cessation was evaluated varied. Two RCTs, one non-randomised controlled and one before-and-after study reported that their intervention positively impacted smoking cessation for women compared with usual care. One RCT reported increased cessation for intervention versus control for partners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Few up-to-date studies have evaluated smoking cessation interventions targeting couples","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic gambling engagement and psychosocial outcomes among students at the University of Ibadan, Nigeria: a theory of planned behavior perspective.","authors":"Tolani Samuel Fadipe, Chimezie Obinna Odionye","doi":"10.1186/s12889-026-27689-3","DOIUrl":"https://doi.org/10.1186/s12889-026-27689-3","url":null,"abstract":"<p><strong>Background and aims: </strong>The proliferation of electronic gambling in Nigeria presents a significant public health concern among youths facing economic adversity. This study applied the Theory of Planned Behavior (TPB) to investigate the socio-cognitive drivers and self-reported psychosocial consequences of electronic gambling engagement among students at the University of Ibadan. Electronic gambling is defined here as any gambling activity conducted through electronic devices, including mobile phones, laptops, and computers, encompassing mobile sports betting applications, web-based casino platforms, and online poker.</p><p><strong>Methods: </strong>A descriptive cross-sectional survey design was employed. Data were collected from 403 undergraduate and postgraduate students at the University of Ibadan using stratified random sampling and a structured self-administered questionnaire adapted from validated instruments. Analyses included descriptive statistics, scale reliability assessment, and binary logistic regression.</p><p><strong>Results: </strong>The lifetime prevalence of electronic gambling was 49.6%. Positive attitudes toward gambling, subjective norms involving peer approval, and perceived behavioral control were all significant predictors of gambling engagement (p < .001). Economic hardship was the strongest predictor in the model (OR = 3.06). Among participants who reported gambling, 50.9% reported increased stress and anxiety, 48.6% reported financial strain, and 42.6% reported negative academic consequences.</p><p><strong>Practical implications: </strong>University health and counseling services should integrate validated gambling screening tools into routine student health assessments. Interventions should address both the economic motivations and the cognitive distortions sustaining gambling engagement. Prevention campaigns should target the specific TPB constructs validated in this study. Institutional policy must also address the structural driver of economic hardship through expanded work-study programs and student financial support initiatives.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and determinants of pneumococcal vaccine uptake among U.S. adults, 2019-2024: a pooled cross-sectional analysis.","authors":"Mary Isha Koroma, Nirajan Budhathoki, Joseph Inungu, Jayalakshmi Gurrala, Victor Ogbonna Okike, Deborah Testimony Cyprian, Ramaprabha Makireddy, Plamedi Ngankusu Manwana, Hina Kainat","doi":"10.1186/s12889-026-27617-5","DOIUrl":"https://doi.org/10.1186/s12889-026-27617-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pneumococcal disease causes substantial morbidity and mortality among U.S. adults, with an estimated 20,000 deaths and 150,000 hospitalizations annually. Despite effective vaccines, coverage has remained below national targets. Pandemic-related disruptions and the 2022 Advisory Committee on Immunization Practices transition to simplified 15/20 valent Pneumococcal Conjugate Vaccine recommendations may have influenced uptake, but their impact has not been fully assessed. To address this gap, this study examines trends and determinants of pneumococcal vaccine uptake among U.S. adults following the pandemic and 2022 guideline changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a pooled cross-sectional analysis of National Health Interview Survey data from 2019 to 2024, including 166,948 adults aged ≥ 18 years with complete data. Weighted bivariate analyses assessed associations between vaccination uptake and demographic (age, sex, race/ethnicity), socioeconomic (education, income, citizenship), health-related (chronic conditions including Chronic Obstructive Pulmonary Disease, diabetes, asthma, and cancer; smoking; influenza vaccination), and healthcare access factors (insurance, usual source of care, recent provider visit). Multivariable logistic regression identified independent predictors of vaccination. All analyses incorporated National Health Interview Survey complex survey design and sampling weights.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall weighted pneumococcal vaccination coverage remained low, fluctuating between 29.6% and 33.2% across survey years. Coverage was highest among adults aged ≥ 65 years (65.7%) but remained substantially below the Healthy People 2020 goal of 90%. Only 23.0% of adults aged 55-64 years reported vaccination despite risk-based recommendations. Disparities persisted across racial/ethnic groups, with Hispanic adults showing the lowest uptake (13.9%) compared to non-Hispanic White adults (29.1%). In adjusted analyses, age ≥ 65 years (odds ratio [OR] = 9.39; 95% confidence interval [CI]: 8.84-9.96), chronic conditions including Chronic Obstructive Pulmonary Disease (OR = 2.04; 95% CI: 1.90-2.20) and diabetes (OR = 1.84; 95% CI: 1.74-1.95), recent healthcare visits (OR = 1.41; 95% CI: 1.31-1.51), and influenza vaccination were strong independent predictors of uptake. Lack of insurance (OR = 0.89; 95% CI: 0.81-0.98), absence of a usual source of care (OR = 0.81; 95% CI: 0.74-0.88), and non-receipt of influenza vaccine (OR = 0.29; 95% CI: 0.28-0.30) were associated with lower odds of vaccination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Pneumococcal vaccination coverage among U.S. adults remained stagnant from 2019 to 2024, with persistent gaps among younger high-risk adults and racial/ethnic minorities. Healthcare engagement, insurance, provider contact, and influenza vaccination, were strongly associated with uptake. These findings suggest that risk-based screening, provider recommendations, ","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National implementation of a digital Parkinson's disease screening programme in Thailand: reach, adoption, and real-world performance of the CheckPD app.","authors":"Roongroj Bhidayasiri, Saisamorn Phumphid, Jirada Sringean, Chanawat Anan, Teerawat Laosombut, Jeeranun Meesri, Sunaree Wekhinhiran, Natthaphat Leabthong, Onanong Phokaewvarangkul, Decho Surangsrirat, Peerapon Vateekul, Zar Kyi Win, Nurhussneeda Jeh-Voh, Pattamon Panyakaew, Warongporn Phuenpathom, Suppata Maytharakcheep, Priya Jagota, Varis Ratanasirisawad, Surasa Khongprasert, Watchara Rattanachaisit, Tittaya Prasertpan, Ornanong Udomsirithamrong, Appasone Phoumindr, Nontakorn Likhitwitayawuid, Thanachporn Saengmanee, Piyaporn Rattanajun, Kornake Horaruengdecha, Narumol Sukmueng, Punkorn Dornbunlon, Werasit Sittitrai, Sukanda Vorachetbancha, Wittaya Chanchalong, Aekamorn Phonsrithong, Pinit Kullavanijaya, Jintakan Sricholwattana, Vittratorn Chirapravati, Pradhana Chariyavilaskul, Katevisuth Sukpisan, Jadej Thammatacharee, Athaporn Limpanyalers, Jakrawut Juthasong, Wiroj Rattanamornsakul, Tej Bunnag, Grisada Boonrach","doi":"10.1186/s12889-026-27654-0","DOIUrl":"https://doi.org/10.1186/s12889-026-27654-0","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) remains underdiagnosed in Thailand, and its rising prevalence presents a growing challenge for the healthcare system. The previously validated CheckPD digital population screening platform has been implemented nationally in collaboration with the Thai Red Cross Society (TRCS) and the National Health Security Office (NHSO), enabling integration of digital PD risk screening into preventive health frameworks.</p><p><strong>Objective: </strong>To evaluate the early phase of a national rollout of the CheckPD platform, focusing on population reach, adoption, predictive performance, exploratory usability, and implementation factors influencing scalability across diverse real-world settings.</p><p><strong>Methods: </strong>This RE-AIM-guided implementation study in 10 Thai provinces assessed reach, adoption, completion, system performance and positive predictive value among neurologist-evaluated screen-positive participants. Preliminary usability was assessed in 30 post-screening completers using the SUS and UEQ-S. Supplementary implementation feedback was collected from Village Health Volunteers and public health officers.</p><p><strong>Results: </strong>Between January 2024 and October 2025, 13,381 out of 18,520 users completed screening across 10 provinces (completion rate: 72.3%). The mean SUS score was 83, with a 92% first-time task completion rate. Programme reach was achieved through multiple channels, including Village Health Volunteers (6,742 participants), community field campaigns (5,207), facilitated online training initiatives (3,448), and self-initiated app downloads (3,123). When compared with neurologists' diagnoses among 730 screen-positive participants who underwent evaluation, the screening demonstrated a positive predictive value of 81.23% (593/730; 95% CI 78.39%-84.07%). Key facilitators of implementation included TRCS endorsement and network support, community volunteer engagement, and user-centred app design. Exploratory multivariable logistic regression analysis identified educational attainment and geographic context as significant predictors of screening completion, with higher educational attainment and residence outside Bangkok associated with a higher likelihood of completing the screening workflow.</p><p><strong>Conclusions: </strong>The CheckPD programme demonstrates that national-scale digital screening for neurological disorders is feasible in a low-to-middle-income country when embedded within trusted institutions, supported by community networks, and aligned with data protection standards. Thailand's experience provides an early, promising, and potentially scalable model for implementing population-level improvements in brain health by enabling earlier detection and assessment of individuals at risk, in alignment with the World Health Organization's Brain Health framework.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on healthy volunteer motivations: a mixed-methods study of participants in plague vaccine trials in the UK and Uganda.","authors":"Arabella Sv Stuart, Richard Muhumuza, Sylvia Kusemererwa, Maria Teddy Ndagire, Matilda Hill, Peter J O'Reilly, Martin Onyango, Wasswa Solomon, Penelope Akankunda, Sylvia Masawi, Shamim Ssendagire, Denis Murphy, Samantha Vanderslott, Christine S Rollier, Eugene Ruzagira, Andrew J Pollard, Nambusi Kyegombe","doi":"10.1186/s12889-026-27297-1","DOIUrl":"https://doi.org/10.1186/s12889-026-27297-1","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to unprecedented interest and participation in vaccine trials globally, and a concurrent increase in vaccine hesitancy. Whether this impacted recruitment of healthy volunteers to subsequent non-COVID vaccine trials is not well studied. We explored the impact of the COVID-19 pandemic on motivations for participating in two clinical trials of the same novel anti-plague vaccine, conducted in the United Kingdom (UK) and Uganda in 2021 and 2022.</p><p><strong>Methods: </strong>Participants enrolled in PlaVac (UK) and PlaVac Uganda, Phase I trials of ChAdOx1 Plague vaccine, were invited to complete an optional questionnaire and semi-structured interview examining motivations for participating, including questions on the impact of the COVID-19 pandemic on their decision. Questionnaires were self-administered and interviewer-administered for UK and Uganda studies, respectively. Interviews were conducted in local languages, transcribed in English, and analysed using thematic analysis. Results were compared between studies.</p><p><strong>Results: </strong>Thirty-one of the 45 (68.9%; 25.8% female) UK trial participants and all 36 (100.0%; 27.8% female) of the Uganda trial participants completed questionnaires responses, and 19 Uganda questionnaire respondents completed interviews. Responses to questions on the impact of the COVID-19 pandemic on volunteering decisions were divergent between countries, with little effect for UK participants but a strong positive effect for Ugandan participants. Themes relating to this effect were \"contributor, not cause\" in the UK, and in Uganda were preparedness (wanting to contribute to vaccine development to prevent suffering and death from future epidemics), increased awareness (understanding the vaccine development process and seeing rapidly deployed COVID-19 vaccine trials gave them confidence), and personal protection (believing themselves to be protected by the novel plague vaccine). Participants in both studies expressed trust and confidence in the study vaccine which shares the same adenoviral-vectored platform technology used to elicit an immune response (ChAdOx1) with the COVID-19 vaccine ChAdOx1 nCoV-19 (Vaxzevria, AstraZeneca).</p><p><strong>Conclusions: </strong>For Ugandan participants, COVID-19 and mass vaccination increased knowledge about vaccines and trials and encouraged them to participate in research, but had little impact on UK volunteers. There was no evidence of a negative effect of perceptions of the related ChAdOx1 nCoV-19 vaccine on trial participants' confidence in the novel plague vaccine's safety.</p><p><strong>Trial registrations: </strong>Current controlled trial: ISRCTN41077863, prospective registration date: 19/03/2021, and current controlled trial: ISRCTN79243381, prospective registration date 05/08/2022.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of humidex on other infectious diarrhea: a study of seasonal heterogeneity and lagged effects using a distributed lag non-linear model.","authors":"Ruoyu Gui, Wei Zhou, Jinsong Deng, Leiyu Shi, Guangli Hu, Gang Sun, Yingrong Lao","doi":"10.1186/s12889-026-27645-1","DOIUrl":"https://doi.org/10.1186/s12889-026-27645-1","url":null,"abstract":"<p><strong>Objective: </strong>Global climate changehas led to frequent extreme hot and humid events. The Humidex, as a comprehensive temperature and humidity indicator, is closely related to infectious diseases. Other infectious diarrhea is an important public health issue, but the expode-response relationship between it and Humidex, especially the seasonal effect modification and lag effect patterns, still lacks systematic research. This study aims to evaluate the impact of Humidex on the incidence of other infectious diarrhea and explore its seasonal heterogeneity and time lag effect.</p><p><strong>Methods: </strong>Using daily OID case and meteorological data from Guangdong Province (2014-2023), a Distributed Lag Non-linear Model was applied to assess the cumulative effects of Humidex, adjusting for season, day of the week, and holidays. Analyses included establishing the overall exposure-response relationship, stratifying by warm (May-October) and cold (November-April) seasons to examine effect modification, and conducting sensitivity analyses to verify robustness.</p><p><strong>Results: </strong>At the extreme Humidex exposure level (P95, 42.27), the cumulative relative risk (CRR) for OID was 1.183 (95% CI: 1.057-1.323), indicating a significant 18.3% increase in risk, with an attributable fraction (AF) of 15.4%. Conversely, a protective effect was observed at the low Humidex level (P5, 11.3) (RR = 0.832, 95% CI: 0.748-0.926). Lag analysis at high Humidex levels (e.g., P75, P90) showed that the highest risk occurred within 0-2 days after exposure, indicating a short-term lag effect. Seasonal stratification revealed significant effect modification: during the cold season, extreme Humidex showed a protective effect (RR = 0.523, 95% CI: 0.319-0.856), while the effect was non-significant in the warm season (RR = 0.957, 95% CI: 0.880-1.040), with a seasonal effect ratio of 1.83. Sensitivity analyses confirmed the robustness of the findings to variations in lag periods and degrees of freedom for splines.</p><p><strong>Conclusion: </strong>Humidex is significantly associated with OID incidence, showing a non-linear exposure-response relationship and clear seasonal effect modification. While extreme Humidex generally increases OID risk, anomalously high levels during the cold season exhibit a protective effect. These findings support the development of season-specific early warnings and targeted public health interventions based on the Humidex index.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome diagnostic reporting in the 2021-2023 National Health Interview Survey.","authors":"Katherine Fleig, Richard Nahin, Barbara Stussman, Miciah Wilkerson, Elizabeth R Unger, Jin-Mann S Lin, Brian Walitt","doi":"10.1186/s12889-026-27598-5","DOIUrl":"https://doi.org/10.1186/s12889-026-27598-5","url":null,"abstract":"<p><strong>Background: </strong>Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic disabling illness characterized by activity limitations associated with fatigue, post-exertional malaise (PEM), unrefreshing sleep, memory and concentration problems, orthostatic intolerance and painful discomfort. While typically considered to be a chronic condition, some persons who have had ME/CFS report no longer having the disorder. Here, the prevalence and characteristics of adults in the United States who self-report having an ME/CFS diagnosis and those who self-report no longer having ME/CFS are presented.</p><p><strong>Methods: </strong>The current study utilized publicly available data from the 2021-2023 National Health Interview Survey, which interviewed 86,655 United States civilian non-institutionalized adults about their health. For this study, participants were categorized into three groups: Current ME/CFS (individuals currently diagnosed with ME/CFS), Past ME/CFS (individuals who were previously diagnosed but no longer report having the condition), and Never ME/CFS (individuals who have never been diagnosed with ME/CFS). These groups were characterized using descriptive statistics.</p><p><strong>Results: </strong>In the United States adult population, 20.7% of the estimated 1.5% adults who ever received an ME/CFS diagnosis report they no longer have the condition (Past ME/CFS). Overall the Past ME/CFS group reported experiencing symptoms less frequently, less difficulty with daily living, approximately equal prevalence of comorbidities, and better general health status than the Current ME/CFS group but remained significantly impaired compared to the Never ME/CFS group. However, 40-50% of adults with Past ME/CFS report symptoms and function similar to adults with Current ME/CFS and only approximately 25% had substantially less symptoms and better function compared to those with Current ME/CFS. Comorbidities did not differ significantly between the Current and Past ME/CFS groups.</p><p><strong>Conclusion: </strong>Further study to better understand the reasons why those in the Past ME/CFS group report no longer having the disorder is important for understanding the natural history and disease burden of ME/CFS. Studying symptomatic remissions, and the underlying physiology of improvement, could lead to identification of new disease modifying therapeutic approaches.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}