BMC Public Health最新文献

{"title":"Environmental and occupational risk factors associated with multiple myeloma: a multicenter, hospital-based, matched case-control study.","authors":"Mohammad Alnees, Nizar Abu Hamdeh, Ibraheem AbuAlrub, Anwar Zahran, Sari Zraiq, Basem Bali, Fadi Hadya, Osama Ewidat, Duha Najajra, Abdalaziz Darwish, Ruzan Jamaleddin, Mohammed M H Qabaha, Moaath Sawalha, Abed Alawna, Saad Allaham, Loay Shaheen, Ezz Aldeen Obaid, Ahmad Khaleel, Faridah Ihmoud, Nuha Riyad, Malak M Ahmad, Amid Barq, Sara Atallah, Hamza A Abdul-Hafez, Mohammad Masu'd, Oswatalrasoul Anan Abdulaziz Dweikat, Mohammad F Nu'man, Osama Ikhdour, Yahya Z Fraitekh, Oday Badawi, Moataz Basim Ejao, Maram Qanam, Yaman N Qunaibi, Haitham Abu Khadija","doi":"10.1186/s12889-025-24366-9","DOIUrl":"https://doi.org/10.1186/s12889-025-24366-9","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple myeloma (MM), a hematologic malignancy driven by neoplastic plasma cell proliferation, remains insufficiently characterized with respect to occupational and environmental risk factors and their impact on patients' quality of life (QoL). This study explores modifiable exposures in the West Bank, Palestine, and evaluates their associations with MM risk and disease-specific QoL outcomes.</p><p><strong>Methods: </strong>A multicenter, hospital-based case-control study was conducted between 2018 and 2025, including 227 MM patients and 176 matched controls. Matching was based on age, sex, hospital setting, and admission type. Occupational/environmental exposures including ionizing radiation, cosmetics-related agents, pesticides, organic solvents, and farming were assessed via structured interviews and chart reviews. MM diagnosis adhered to International Myeloma Working Group criteria. QoL was evaluated using the validated EORTC QLQ-MY20 instrument. Multivariable logistic and linear regression analyses were performed, adjusting for clinical confounders using LASSO selection.</p><p><strong>Results: </strong>Cosmetics-related chemical exposure was independently associated with higher odds of MM (OR = 2.85; 95% CI: 1.56-5.21) and a mixed QoL profile. Specifically, it predicted increased disease symptoms (Coeff = 11.55; 95% CI: 2.82-20.28; p = 0.010), lower treatment side-effects scores (Coeff = -2.17; 95% CI: -8.57 to -0.23; p = 0.049), and a marked decline in future perspective (Coeff = -13.73; 95% CI: -22.88 to -4.58; p = 0.003). Pesticide exposure was significantly linked to lower disease symptom burden (Coeff = -3.77; 95% CI: -12.61 to -2.06; p = 0.041) and better future outlook (Coeff = 10.05; 95% CI: 0.77-19.34; p = 0.034). Meanwhile, organic solvent exposure (carcinogenic-organic compounds) was associated with a decline in future perspective (Coeff = -3.96; 95% CI: -5.70 to -2.62; p = 0.042).</p><p><strong>Conclusion: </strong>This study highlights cosmetics-related agents, pesticides, and organic solvents as key modifiable risk factors for both MM development and QoL deterioration. Their significant physical and psychological impacts underscore the urgency of integrating preventive occupational health strategies with holistic myeloma care that addresses symptom burden and future outlook.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3308"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211548","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":"Associations between family functioning, psychological resilience, and emotional competence among primary and secondary school students in Chengdu, Sichuan Province: an exploratory study using structural equation modeling.","authors":"Xi Huang, Xiujuan Zhang, Qiong Chen, Yanling Hu, Xiufang Zhao, Li Zhao","doi":"10.1186/s12889-025-24539-6","DOIUrl":"10.1186/s12889-025-24539-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In recent years, with rapid societal changes and increasing educational pressures, the mental health of primary and secondary school students has garnered significant attention. Psychological resilience, as a core capacity for coping with adversity, and emotional competence, as a foundation for emotional regulation in social adaptation, are crucial for student development, with family functioning being a primary environmental factor closely associated with them. Research suggests that healthy family functioning may be associated with higher psychological resilience and emotional competence, while family dysfunction may be linked to increased psychological distress. However, the interconnected mechanisms among family functioning, psychological resilience, and emotional competence, as well as the roles of factors such as gender, urban-rural differences, and grade level, still require further exploration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To explore the associations between family functioning, psychological resilience, and emotional competence among primary and secondary school students in Chengdu, Sichuan Province, and their underlying mechanisms. The study aims to provide a scientific basis for educators and parents to develop targeted mental health interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Multicenter cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cluster sampling method was employed to survey 7,937 students from grades 1 to 9 across five schools in Chengdu. Data were collected using the Chinese Family Assessment Instrument (C-FAI, assessing family mutual support, communication, and conflict harmony), the Resilience Subscale and Emotional Competence Subscale of the Chinese Positive Youth Development Scale (CPYDS, measuring adaptation and recovery under stress, and the ability to perceive, understand, and manage emotions, respectively). Data were double-entered and verified using Epidata 3.1. SPSS 26.0 was used for descriptive statistics, correlation analysis, and difference tests (independent samples t-test, Welch t-test, one-way ANOVA, or Welch ANOVA based on data distribution, with Games-Howell post-hoc tests). Partial correlation analysis controlled for gender, urban/rural residence, and grade. Structural equation modeling was conducted using AMOS 26.0 to analyze the associations and mediating effects among family functioning, psychological resilience, and emotional competence, and to evaluate model fit. Harman' s single-factor test was applied to detect common method bias. The significance level was set at α=0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Family functioning showed significant differences across gender, urban/rural location, and grade level (P&lt;0.05): male students (1.97±0.74), rural students (1.97±0.73), and students in grades 7-9 reported more severe family dysfunction. Psychological resilience was significantly positively correlated with emotional competence (r=0.646,P&lt;0.001), and both we","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3278"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study protocol for a randomized controlled trial evaluating the impact of adding community health worker coaching calls and healthy grocery bag deliveries to a Meals on Wheels home-delivered meal program for homebound older adults in Rhode Island.","authors":"Isabelli L Costa da Silva, Kim M Gans, Kali S Thomas, Roee Gutman, Brie Tyler, Snehaa Ray, Meghan Grady, Shana DeFelice, Maya Hussein, Amelia Lusi, Caitlin E Caspi","doi":"10.1186/s12889-025-24080-6","DOIUrl":"10.1186/s12889-025-24080-6","url":null,"abstract":"<p><strong>Background: </strong>Home-delivered meal programs (HDMP), such as Meals on Wheels, offer nutritious meals for homebound older adults experiencing nutritional risk. Despite receiving meals, participants may still have difficulty achieving nutritional goals, overcoming social isolation, and addressing other health issues. We aim to evaluate the impact of adding enhancements to traditional HDMP on improving diet quality, food and nutrition security, loneliness, and health-related quality of life among older adults in a randomized controlled trial.</p><p><strong>Methods: </strong>Homebound older adults at nutritional risk and participating in the Meals on Wheels of Rhode Island, Inc. (MOWRI) HDMP are randomized to receive either a usual care control group of the traditional HDMP (5 meals delivered per week) or the enhanced program (Meals+), which includes four Community Health Worker (CHW) coaching calls using motivational interviewing, and delivery of three healthful grocery bags during 12 weeks, in addition to the traditional HDMP. The primary outcome is diet quality measured by the validated Dietary Screening Tool (DST). Food and nutrition security, loneliness, and health-related quality of life are secondary outcomes assessed by validated measures. In the 12-week follow-up call, CHWs also ask participants about utilization and satisfaction with the intervention. The usual care group receives coaching from CHWs to connect them to community resources in this follow-up call. Study procedures were tested in a pilot randomized controlled trial (n = 12), resulting in modifications to the study protocol.</p><p><strong>Discussion: </strong>Enhancements such as CHW calls and grocery bags can help HDMP target food access, social and health interventions for older adults. These enhanced HDMP have the potential to be sustained and replicated nationwide.</p><p><strong>Trial registration: </strong>Number NCT06401694; Start date: 2024-06-20.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3285"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting physical activity during recess in small sized elementary school: a pilot study.","authors":"Yiping Yan, Danqing Zhang, Yang Liu","doi":"10.1186/s12889-025-24451-z","DOIUrl":"10.1186/s12889-025-24451-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of this pilot study was to examine the effect of structured and unstructured recess intervention based on spatial analysis technology on physical activity (PA) levels among children attending a small-sized elementary school.</p><p><strong>Methods: </strong>A small-sized elementary school (4.82 m² per child) was used as a pilot with 1162 students from grades 3 to 6. The effect of the intervention was assessed by a self-controlled experiment. Structured and unstructured recess intervention is the change of activity type and the addition of game markings based on spatial analysis. Duration and number of PA behaviors were measured with accelerometer and direction observation respectively.</p><p><strong>Results: </strong>During structured recess, post-tests demonstrated a significant increase in the duration of moderate to vigorous physical activity (MVPA) for both boys and girls (p < 0.05), as well as significant improvement in vigorous physical activity (VPA) for them (p < 0.05). Significant increases (p < 0.05) in the duration of VPA were shown among boys during unstructured recess; The number of students observed in the added markings spaces increased from 182 to 344; Significant increases (p < 0.05) in the proportion of MVPA were shown in the added markings spaces of the gate and playground.</p><p><strong>Conclusions: </strong>Activity type change to Tabata exercise improved PA during the structured recess of all students. Adding game markings based on spatial analysis technology increased participation number in PA during unstructured recess. This low-cost pilot intervention is expected to be used in the program of recess activities in small-sized elementary schools.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3249"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between muscle-strengthening exercise and depressive and anxiety symptoms in children and adolescents.","authors":"Lubo Zhai, Zhengyang Yang, Xingyi Yang, Sitong Chen","doi":"10.1186/s12889-025-23663-7","DOIUrl":"10.1186/s12889-025-23663-7","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3284"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating silence: cultural, familial, and immigration influences on the sexual violence experiences of Asian female college students in the university of California system.","authors":"Jianchao Lai, Eunhee Park, Jenny Lee, Rhea Gandhi, Jennifer Wagman","doi":"10.1186/s12889-025-24487-1","DOIUrl":"10.1186/s12889-025-24487-1","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3242"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, country, and regional cancer burden attributable to dietary risk: Results from the global burden of disease study 2021.","authors":"Xingyuan Li, Hui Li","doi":"10.1186/s12889-025-24570-7","DOIUrl":"10.1186/s12889-025-24570-7","url":null,"abstract":"<p><strong>Background: </strong>The distribution of diet-attributable cancer burden has not been systematically analyzed globally. This study aimed to analyze the diet-attributable cancer burden using the Global Burden of Disease (GBD) database to provide insights into reducing the dietary risk-related cancer burden across regions with different development levels.</p><p><strong>Methods: </strong>Data on cancer deaths and disability-adjusted life years (DALYs) attributable to diet were downloaded from the GBD database (1990-2021). The cancer burden attributable to nine dietary factors and total dietary factors was sorted, and Joinpoint regression analysis was performed according to the Socio-Demographic Index (SDI) regions. Then, using the DALYs data, a health inequality analysis was conducted, and the Slope Index of Inequality (SII) and concentration indices (CI) for 1990 and 2021 were calculated.</p><p><strong>Results: </strong>From 1990 to 2021, the global cancer burden attributed to diet decreased continuously, with an average annual percentage change (AAPC) of -1.40 (-1.48, -1.32) for mortality (P < 0.01) and an AAPC of -1.49 (-1.57, -1.42) for DALYs (P < 0.01). Colon and rectal cancers were the most influenced by dietary factors, with diet-attributable deaths comprising 71.70% and 68.14% of total deaths in 1990 and 2021, respectively, followed by breast and stomach cancers, which both exceeded 40% in both years. The diet-related cancer burden decreased rapidly in the high and high-middle SDI regions with AAPCs for both mortality and DALYs being less than 0 (P < 0.01). In contrast, there was Little improvement in the low- and low-middle SDI regions. In 2021, the absolute values of the SII (296.72) and CI (-0.17) attributed to global dietary risks were higher than those in 1990 with the SII of 267.61 and CI of -0.17.</p><p><strong>Conclusion: </strong>Dietary factors continued to be a significant risk factor for cancer in 2021. High red meat consumption, low intake of whole grains, and low milk intake were the three primary dietary risks.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3244"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of former participants' experiences of the Green Prescription program in Aotearoa New Zealand.","authors":"Kobus Du Plooy, Beth Wishart, Damian Scarf","doi":"10.1186/s12889-025-24524-z","DOIUrl":"10.1186/s12889-025-24524-z","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3251"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of physical activity and sedentary behavior with mental health among university students: the mediating role of cardiorespiratory fitness and moderating role of gender.","authors":"Liya Xu, Yutian Ji, Xu Wen","doi":"10.1186/s12889-025-24528-9","DOIUrl":"10.1186/s12889-025-24528-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the associations between physical activity (PA), sedentary behavior, and mental health among university students, with a focus on the mediating role of cardiorespiratory fitness (CRF) and the potential moderating effect of gender.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 233 university students from Zhejiang University. PA and sedentary behavior were assessed using the Global Physical Activity Questionnaire, mental health was measured by the Depression Anxiety Stress Scale (DASS-42), and CRF was evaluated via a treadmill-based VO₂max test. Harman's single-factor test was used to assess common method bias. Partial correlation, mediation, and moderation analyses were performed using SPSS 27.0 and the PROCESS 3.5 macro.</p><p><strong>Results: </strong>PA was positively associated with CRF (β = 0.0016, P < 0.001) and negatively associated with depression (β = -0.0010, P < 0.001), anxiety (β = -0.0004, P = 0.004), and stress (β = -0.0014, P < 0.001). Sedentary behavior was negatively associated with CRF (β = -0.0096, P = 0.002) but not significantly associated with mental health outcomes directly (P > 0.05). CRF was negatively associated with depression (β = -0.0721, P = 0.040), anxiety (β = -0.0806, P = 0.040), and stress (β = -0.2502, P = 0.007), and partially mediated the associations of PA and sedentary behavior with mental health. Gender significantly influenced depression (F = 1.191, P = 0.276) and anxiety (F = 3.552, P = 0.061), but did not significantly moderate the associations among PA, sedentary behavior, and CRF (interaction P-values > 0.05).</p><p><strong>Conclusion: </strong>CRF partially mediates the association between PA and mental health, suggesting that improved CRF may be one pathway through which PA supports psychological well-being. While sedentary behavior did not directly predict mental health outcomes, its negative impact on CRF may indirectly contribute to psychological distress. Gender differences in mental health were observed, but gender did not significantly alter the relationships between the key study variables.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3260"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between perceived air pollution and myopia: an exploration of the mediating effects of healthy lifestyle factors.","authors":"Ziyun Zhang, Changkun Tang, Peng Shi, Xiaosu Feng","doi":"10.1186/s12889-025-24583-2","DOIUrl":"10.1186/s12889-025-24583-2","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between air pollution and myopia in Chinese adult population, as well as the mechanism of physical exercise, sedentary behavior and sleep quality in the association between them, so as to provide a basis for formulating comprehensive myopia prevention and control policies.</p><p><strong>Methods: </strong>The data of 2,717 participants from CGSS 2021 were Analyzed. This database used subjective assessment methods to evaluate the perceived air pollution level, myopia prevalence, frequency of physical exercise, sedentary time And sleep quality. Based on SPSS 21.0 software, independent samples t-test, binary logistic regression analysis, and the three-step method for mediating effect test were applied to conduct data statistics and analysis.</p><p><strong>Results: </strong>The average age of the subjects was (52.04 ± 17.64) years old, And the proportion of females was 54.8%. After controlling for relevant variables, there was a significant positive correlation between perceived air pollution and myopia (OR = 1.132, 95%CI = 1.003 ~ 1.278, P < 0.05); there was still a significant positive correlation between sedentary time and myopia (OR = 1.032, 95%CI = 1.005 ~ 1.060, P < 0.05); there was still a significant negative correlation between sleep quality and myopia (OR = 0.798, 95%CI = 0.707 ~ 0.901, P < 0.01); while the correlation between frequency of physical exercise and myopia was not significant (OR = 1.029, 95%CI = 0.967 ~ 1.094, P > 0.05). In addition, sleep quality plays a mediating role in the correlation between perceived air pollution and myopia (P < 0.01), with the mediating effect accounting for 12.06%, while the mediating effects of physical exercise and sedentary behavior are not significant (P > 0.05).</p><p><strong>Conclusion: </strong>There is a significant positive correlation between perceived air pollution and myopia, and sleep quality plays a mediating role in the above correlation.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3281"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}