BMC Public Health最新文献

{"title":"Disentangling consequences of self-perceived weight from excess adiposity in metabolically healthy overweight/obesity.","authors":"Bobby K Cheon, Julia M P Bittner, Meegan R Smith, Zhen Chen","doi":"10.1186/s12889-025-24254-2","DOIUrl":"https://doi.org/10.1186/s12889-025-24254-2","url":null,"abstract":"<p><strong>Background: </strong>Greater self-perceived weight is detrimental to cardiometabolic health among people with overweight/obesity. However, it is impractical to test and unknown whether weight-related psychosocial factors, like self-perceived weight, independently affect cardiometabolic health apart from physiological dysregulation produced by excess adiposity among people with overweight/obesity. Metabolically healthy overweight/obesity (MHOv/Ob) involves overweight/obesity, but with the absence of metabolic dysfunction. The MHOv/Ob phenotype may be a promising model to examine unique contributions of self-perceived weight to long-term changes in metabolic health. We tested whether self-perceived weight independently contributes to declining metabolic health by comparing people with MHOv/Ob and metabolically healthy normal weight (MHNW). We hypothesized that: (1) those with MHOv/Ob are more likely to become metabolically unhealthy and gain BMI at follow-up (7-11 years later) compared to MHNW, and (2) these transitions in metabolic health and BMI among those with MHOv/Ob will be mediated by higher self-perceived weight.</p><p><strong>Methods: </strong>Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we classified metabolically healthy participants by weight status (normal weight, overweight, obesity) at Wave IV (ages 25-33). We tested whether longitudinal transitions from a metabolically healthy to unhealthy state (n = 788) and changes in BMI (n = 901) among MHOv/Ob (vs. MHNW) participants were mediated by higher self-perceived weight at Wave V (ages 33-43).</p><p><strong>Results: </strong>The MHOv/Ob (vs. MHNW) groups had greater odds of becoming metabolically unhealthy at Wave V (overweight odds ratio [OR]: 3.85 [1.87, 7.94], obesity OR: 9.12 [5.01, 16.61]). However, those with metabolically healthy obesity exhibited decreasing BMI (β: - 0.98 [- 1.75, - 020]). Although self-perceived weight was higher among the MHOv/Ob group, it did not mediate the relationship between Wave IV weight status and Wave V metabolic health (indirect effects-overweight risk difference (RD): 0.0046 [- 0.025, 0.033]; obesity RD: 0.0095 [- 0.050, 0.071]) or change in BMI (indirect effects-overweight β: - 0.30 [- 2.38, 1.75]; obesity β: - 0.51 [- 4.02, 2.84]).</p><p><strong>Conclusions: </strong>Self-perceived weight alone may not contribute to long-term metabolic dysfunction over-and-above physiological strain of excess adiposity among those living with overweight/obesity. However, future research on determinants of MHOv/Ob phenotypes should examine the role of other weight-related psychosocial factors such as weight stigma.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2907"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941965","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":"Wastewater as an early indicator for short-term forecasting COVID-19 hospitalization in Germany.","authors":"Jonas Radermacher, Steffen Thiel, Aimo Kannt, Holger Fröhlich","doi":"10.1186/s12889-025-24149-2","DOIUrl":"https://doi.org/10.1186/s12889-025-24149-2","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has profoundly affected daily life and posed significant challenges for politics, the economy, and the education system. To better prepare for such situations and implement effective measures, it is crucial to accurately assess, monitor, and forecast the progression of a pandemic. This study examines the potential of integrating wastewater surveillance data to enhance an autoregressive COVID-19 forecasting model for Germany and its federal states.</p><p><strong>Methods: </strong>First, we explore the cross-correlations between SARS-CoV-2 viral RNA load measured in wastewater and COVID-19 hospitalization considering different time-lags. Further, the study compares the performance of different models, including Random Forest regressors, XGBoost regressors, ARIMA models, linear regression, and ridge regression models, both with and without the use of wastewater data as predictors. For decision tree-based models, we also analyze the performance of fully cross-modal models that rely solely on viral load measurements to predict COVID-19 hospitalization rates.</p><p><strong>Results: </strong>Our retrospective analysis suggest that wastewater data can potentially serve as an early warning indicator of impending trends in hospitalization at a national level, as it shows a strong correlation with hospitalization figures of up to 86% and tends to lead them by up to 8 days. Despite this, including wastewater data in the prediction models did not statistical significantly enhance the accuracy of COVID-19 hospitalization forecasts. The ARIMA model without the inclusion of wastewater viral load data emerged as the best-performing model, achieving a Mean Absolute Percentage Error of 4.76% forecasting hospitalization 7 days ahead. However, wastewater viral load proved to be a valuable standalone predictor, offering an objective alternative to classical surveillance methods for monitoring pandemic trends.</p><p><strong>Conclusion: </strong>This study reinforces the potential of wastewater surveillance as an early warning tool for COVID-19 hospitalizations in Germany. While strong correlations were observed, the integration of wastewater data into predictive models did not improve their performance. Nevertheless, wastewater viral load serves as a valuable indicator for monitoring pandemic trends, suggesting its utility in public health surveillance and resource allocation. Further research may help to clarify the real-time applicability of wastewater data and expand its use to other pathogens and data sources.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2910"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942189","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":"Perceptions on mental health and depression by adolescents, a systematic review of qualitative studies.","authors":"Elise S Beket, Mariëtte H H Hoogsteder, Arne Popma, Daan H M Creemers, Sanne P A Rasing","doi":"10.1186/s12889-025-23638-8","DOIUrl":"https://doi.org/10.1186/s12889-025-23638-8","url":null,"abstract":"<p><strong>Background: </strong>Mental health issues are on the rise, affecting one in seven adolescents. Depression stands out as the most prevalent mood disorder. Enhancing our understanding of adolescent' perspectives on mental health can improve prevention and promotion efforts. Reviews on mental health of adolescents mainly relied on studies with questionnaires and diagnostic tools. This qualitative systematic review aims to give an overview of the perspectives on mental health expressed by adolescents aged 13-23 in high-income countries on mental health and depression.</p><p><strong>Method: </strong>We searched in Pubmed and Psychinfo databases using terms including synonyms of adolescent, mental health or depression, perspectives and qualitative methods. A total of 34,074 records were screened for eligibility. Included articles were thematically analyzed in three stages: open coding, development of 'descriptive themes' and the generation of 'analytical themes'.</p><p><strong>Results: </strong>We found 74 articles eligible for the synthesis and identified five themes: (1) Importance of maintaining balance for positive mental health, (2) Need for connection with oneself and others to cope with daily stressors, (3) Personal responsibility for their mental health, (4) Mental (un)health is perceived as a continuum, (5) Losing control is key for depression.</p><p><strong>Conclusion: </strong>This review provides a comprehensive exploration of the literature on adolescent' perceptions on mental health and depression. Mental health issues are perceived as personal failure. Adolescents shoulder responsibility for their own mental health, while simultaneously expressing the need for social support. Recognizing adolescents' active role presents opportunities for empowering interventions and support, it also amplifies the perceived burden of responsibility making them susceptible to depression. Our results suggest the need for systemic and collective interventions rather than solely individual-focused interventions. It is necessary to further study adolescents' perceptions of mental health and depression, to promote their mental health, prevent mental health problems and stimulate seeking (professional) help when in need.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2911"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942075","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":"The impact of short-term exposure to black carbon air pollution on asthma exacerbations in Thai children: a time-stratified case-crossover nationwide study from 2015 to 2022.","authors":"Rattapon Uppala, Sirapoom Niamsanit, Leelawadee Techasatian, Suchaorn Saengnipanthkul, Pope Kosalaraksa, Phanthila Sitthikarnkha","doi":"10.1186/s12889-025-24206-w","DOIUrl":"https://doi.org/10.1186/s12889-025-24206-w","url":null,"abstract":"<p><strong>Background: </strong>Black carbon is a critical component of ambient particulate matter and a recognized trigger of respiratory morbidity. Although existing studies have explored the link between black carbon exposure and pediatric asthma, evidence specific to rapidly industrializing middle-income regions remains scarce. In Thailand, increasing industrial activities, agricultural burning, and vehicle emissions have resulted in higher black carbon concentrations; however, comprehensive epidemiological data on the impact of this on children with asthma exacerbations remain limited.</p><p><strong>Methods: </strong>We performed a nationwide retrospective study with time-stratified case-crossover analysis of children (< 18 years) hospitalized for asthma exacerbations under Thailand's Universal Coverage Scheme from 2015 to 2022. Asthma exacerbation admissions were identified using ICD-10 codes (J45.9, J46). Ambient black carbon levels were obtained from NASA's Modern-Era Retrospective Analysis for Research and Application (MERRA-2). Conditional Poisson regression was used to calculate incidence rate ratios (IRRs) for pediatric asthma hospitalizations per 1 µg/m³ increase in black carbon, controlling for intra-week variations.</p><p><strong>Results: </strong>Among 163,825 asthma exacerbation-related hospital admissions (37.3% male, 62.7% female), children aged < 5 years accounted for 49.6% of cases, 5-<10 years for 33.1%, 10-<15 years for 14.1%, and 15-<18 years for 3.2%. The mean black carbon concentration was 1.00 ± 0.46 µg/m³, peaking during summer. On the day of hospitalization (Lag 0), a 1 µg/m³ increase in black carbon was associated with elevated IRR in children aged < 5 (IRR: 1.14; 95%CI: 1.05-1.25; p = 0.002), 5-<10 (IRR: 1.31; 95%CI: 1.18-1.45; p < 0.001), and 10-<15 (IRR: 1.35; 95%CI: 1.16-1.59; p < 0.001). Delayed effects (Lag 1) remained significant for children 5-<10 (IRR: 1.18; 95%CI: 1.06-1.31; p = 0.002) and 10-<15 (IRR: 1.26; 95%CI: 1.07-1.47; p = 0.004) but not for those 15-<18 years.</p><p><strong>Conclusions: </strong>Short-term exposure to black carbon significantly increases the risk of hospitalizations from pediatric asthma exacerbation in Thailand, especially among children under 15 years of age and particularly on the day of exposure. These findings underscore the urgent need for effective air quality interventions, such as cleaner fuel technologies, stricter policies on industrial and agricultural emissions, and enhanced public health measures to mitigate black carbon pollution. Future investigations should integrate personal-level exposures, assess interactions with other pollutants, and evaluate the outcomes of interventions to reduce the respiratory health burden in this vulnerable population.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2909"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941987","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":"Association between perceived exposure to secondhand smoke and depression independent of biomarker-measured exposure.","authors":"Dongkyu Lee, Hyeon Chang Kim, Young-Chul Jung, Sun Jae Jung","doi":"10.1186/s12889-025-23967-8","DOIUrl":"https://doi.org/10.1186/s12889-025-23967-8","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2917"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942060","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":"Time-series analysis of climatic drivers of pediatric rotavirus and adenovirus infections in post-pandemic China.","authors":"Changzhen Li, Lei Xi, Jingjing Rao, Yun Xiang, Feng Tang, Xiaomei Wang","doi":"10.1186/s12889-025-24010-6","DOIUrl":"https://doi.org/10.1186/s12889-025-24010-6","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the epidemiological characteristics and climate-sensitive transmission patterns of rotavirus (RV), adenovirus (AdV), and RV-AdV coinfections among children with acute gastroenteritis in Wuhan, China, during the post-COVID-19 era.</p><p><strong>Methods: </strong>We conducted a retrospective time-series study of 53,088 pediatric patients tested for RV and AdV from April 2020 to August 2024. Age-stratified positivity rates were analyzed alongside temporal trends. Daily meteorological data (temperature, relative humidity, wind speed) and air pollutants were incorporated into a generalized additive model (GAM) framework with distributed lag nonlinear models (DLNMs) to assess delayed and nonlinear associations between weather exposures and virus positivity.</p><p><strong>Results: </strong>RV was the most frequently detected virus (7.74%), peaking in preschool-aged children (3-6 years), while AdV showed broader age distribution with highest positivity in toddlers (1-3 years). Coinfections were most common in children under 2 years. Significant seasonal and interannual fluctuations were observed, particularly a post-pandemic RV surge in 2024. Spearman analysis revealed inverse correlations between RV/AdV positivity and temperature. DLNMs showed that RV risk increased significantly under low wind (RR = 1.79, lag 0), cold (RR = 1.47, lag 21), and dry conditions (RR = 1.23, lag 15). AdV exhibited a U-shaped humidity-risk curve and increased risk with cold and moderately humid conditions. Coinfection risk was primarily driven by cold temperatures. Significant interactions were found between temperature and wind (RV) and between temperature and humidity (AdV). Season-stratified analysis indicated atypical spring and summer RV peaks.</p><p><strong>Conclusion: </strong>This study is the first in China to apply DLNMs in a large pediatric cohort to evaluate climate-driven risk of RV and AdV infections. Findings reveal pathogen-specific, delayed meteorological sensitivities and post-COVID shifts in transmission patterns, providing a foundation for climate-informed surveillance and targeted interventions in pediatric gastroenteritis control.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2915"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942229","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":"The complexity of promoting physical activity in English state primary schools: an in-depth qualitative analysis of the role of social context.","authors":"Robert Walker, Danielle House, Alice Porter, Ruth Salway, Simona Kent-Saisch, Michael Beets, David Revalds Lubans, Frank de Vocht, Russell Jago","doi":"10.1186/s12889-025-23471-z","DOIUrl":"https://doi.org/10.1186/s12889-025-23471-z","url":null,"abstract":"<p><strong>Background: </strong>Primary schools present an opportunity to equitably promote physical activity. To date, school-based interventions have had limited success. Contextual differences between schools could be a key factor that contributes to this lack of impact. However, the elements that constitute a school's social context (i.e. the organisational, political, cultural, and sociodemographic characteristics) and how they might impact on primary school physical activity are unclear. The aims of this study were to conduct an in-depth qualitative analysis of state primary school social context related to physical activity and, using this analysis, provide recommendations for policy and practice.</p><p><strong>Methods: </strong>We conducted one-to-one semi-structured interviews with 33 state primary school staff in Southwest England between November 2023 and January 2024. Staff roles included headteachers/principals (n = 5), deputy headteachers/principals (n = 5), class teachers (n = 7), Physical Education (PE) subject leads (n = 8), dedicated PE teachers (n = 4), teaching assistants (n = 2), and one Parent Teacher Association chair. Staff were recruited from 19 purposively-sampled schools with a range of school sizes and sociodemographic characteristics. We used reflexive thematic analysis.</p><p><strong>Results: </strong>Five themes were generated that highlighted: (1) the impact of regulatory systems and curriculum pressures created an environment where physical activity was difficult to prioritise; (2) schools with high pupil needs experienced increased pressure, which sometimes impacted staff motivation and wellbeing; (3) senior leadership priorities were key to promoting pupil physical activity, influenced by their personal interests/background/values, regulatory inspections, curriculum pressures, and pupil needs; (4) limited PE training during teacher training impacted teacher confidence that, when combined with curriculum pressures, led many schools to outsource PE to external enterprise; and (5) \"passionate\" individual staff members who dedicated their own time were important to drive physical activity in the pressured school environment.</p><p><strong>Conclusion: </strong>Revisions to school regulatory systems and policies are needed to enable schools to prioritise physical activity so it is not dependent on \"passionate\" individuals. Senior leadership plays a key role in prioritising physical activity in the high pressure state primary school environment. It is important that practitioners and researchers consider these diverse and challenging social contextual factors within English state primary schools in intervention design.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2912"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942032","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":"Factors influencing rehabilitation costs for stroke inpatients in Shenzhen: a multicenter retrospective study.","authors":"Mingchao Zhou, Ruixue Ye, Jie Guo, Xiaolong Zhu, Fubing Zha, Jiao Luo, Meiling Huang, Linlin Shan, Dongxia Li, Yulong Wang","doi":"10.1186/s12889-025-24165-2","DOIUrl":"10.1186/s12889-025-24165-2","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of death and disability among Chinese residents, imposing a significant economic burden. This study aimed to analyze the current status and influencing factors of inpatient rehabilitation costs for stroke in Shenzhen, providing evidence to help reduce costs for patients with stroke in rehabilitation centers.</p><p><strong>Methods: </strong>This multicenter retrospective study used data primarily collected from patient's medical records. We included patients admitted to the rehabilitation departments of public and private hospitals in Shenzhen from January 1, 2019, to October 31, 2021, who met the diagnostic criteria for stroke. After data cleaning, we collected information on hospital demographics, diagnoses, functional impairments, length of stay, and hospitalization costs. Multiple linear regression analysis was used to create a path analysis model to assess the direct and indirect effects of various factors on total hospitalization and average daily expenditures.</p><p><strong>Results: </strong>The study included 2638 patients with stroke from 22 hospitals in Shenzhen, with 69.6% males and an average age of 59.2 years. Ischemic and hemorrhagic strokes accounted for 56% and 44% of the cases, respectively. The median total hospitalization costs were 27,306.64 Chinese Yuan (CNY) (4022.79 USD) for ischemic stroke and 32,188.25 CNY (4022.79 USD) for hemorrhagic stroke, while the average daily costs were 848.64 CNY (125.87 USD) and 828.23 CNY (125.87 USD), respectively. The median length of stay (LOS) was 30 days for patients with ischemic stroke and 41 days for patients with hemorrhagic stroke. Rehabilitation accounted for the highest cost category (64% and 68%, respectively). Path analysis revealed that LOS was the primary direct factor influencing total hospitalization costs, while hospital grades, functional impairment levels, disease stage, and age were indirect factors. For average daily costs, the primary direct influencing factor was hospital grades, with functional impairment levels, disease stage, and age as indirect factors.</p><p><strong>Conclusions: </strong>Patients with stroke in Shenzhen face significant financial burden. The government should continuously promote the construction of a three-tiered rehabilitation system and hierarchical LOS management to provide systematic and sustainable medical services. Daily costs should be stratified based on functional impairment levels, disease stage, and age to guide the reform of precision bed-day medical insurance payments for stroke rehabilitation.</p><p><strong>Trial registration: </strong>The study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR-2000034067, Registration date: 22 June 2020, http://www.chictr.org.cn/showproj.aspx?proj=54770 ).</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2908"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941838","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":"COVID-19 and regional inequalities in childhood vaccination uptake in England: a spline regression.","authors":"Amber Sacre, Sarah Sowden, Clare Bambra, Natalie Bennett, Adam Todd","doi":"10.1186/s12889-025-24207-9","DOIUrl":"https://doi.org/10.1186/s12889-025-24207-9","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the uptake of childhood vaccinations before the age of five has declined globally. In England, the decline in measles, mumps, and rubella (MMR) vaccination coverage is concerning and has subsequently been followed by an increase in measles outbreaks. This study analysed the sustained and additional impact of the COVID-19 pandemic on area-level inequalities in childhood vaccination uptake across regions in England.</p><p><strong>Methods: </strong>Spline regressions with three-way interaction terms were used to assess the impact of COVID-19, from the first lockdown, on local authorities across regions and deprivation quartiles. Cover of Vaccination Evaluated Rapidly data was used for the uptake statistics, and the Indices of Multiple Deprivation 2019 for the deprivation quartiles. The lowest coverage vaccines were analysed: the pre-school booster (one dose) and MMR (two doses, cumulative) from July - September 2014 to October - December 2022.</p><p><strong>Results: </strong>The findings suggest the odds of childhood vaccination uptake were declining in England prior to the first lockdown, but there was an additional decrease associated with this event by 12% (OR:0.88, CI:0.79-0.99, p < .05) for the pre-school booster and 13% (OR:0.87, CI:0.77-0.99, p < .05) for the MMR vaccine. For local authorities classified as the most deprived 25% (Quartile 1), there was a 15% (OR: 0.85, CI: (0.72-0.99, p < .05) post-lockdown-associated decline in the odds of MMR uptake, but not the pre-school booster. Post-lockdown and region interaction effects for the pre-school booster were as follows: Yorkshire and the Humber, 39% decreased odds (OR:0.61, CI:0.54-0.68, p < .001); East Midlands, 22% decreased odds (OR:0.77 OR, CI:0.62-0.95, p < .05); and West Midlands, 19% increased odds (OR:1.19, CI:1.00-1.40, p < .05). For the MMR vaccine, these were: Yorkshire and the Humber, 41% decreased odds (OR:0.59, CI:0.52-0.67, p < .001); North West, 30% increased odds (OR:1.3, CI:1.04-1.64, p < .05); West Midlands, 21% increased odds (OR:1.21, CI:1-1.46, p < .05); and South East, 19% decreased odds (OR:0.67, CI:0.98, p < .05). Evidence of three-way post-lockdown interaction effects for deprivation quartile and region was also identified for both vaccines.</p><p><strong>Conclusions: </strong>The results highlight the need for national vaccination uptake analyses to consider regional variation, as similarly deprived local authorities do not necessarily exhibit the same COVID-19-associated effects.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2913"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941931","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":"Impact of urban heat island effect on dengue incidence: a remote sensing approach using thermal and high-resolution optical imagery.","authors":"Swetha Sureshkumar, Sulochana Shekhar","doi":"10.1186/s12889-025-23763-4","DOIUrl":"https://doi.org/10.1186/s12889-025-23763-4","url":null,"abstract":"<p><p>Dengue fever, identified by the World Health Organization as a significant global health threat, is the fastest-spreading mosquito-borne viral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Annually, 100-400 million cases are reported, with over 14 million cases and 10,000 deaths in 2024 alone, highlighting the public health challenge of dengue, especially in tropical and subtropical urban areas. The Urban Heat Island (UHI) effect is a critical factor in dengue transmission, creating favorable conditions for Aedes mosquitoes. This study examines the impact of UHIs on dengue incidence at Thanjavur Municipal Corporation, Tamil Nadu, India, via remote sensing-derived Land Surface Temperature (LST) and epidemiological data from 2017 to 2023. High-resolution thermal and optical imagery was used to assess spatial variations in urban surface temperature, whereas dengue incidence patterns were analysed through hotspot detection and statistical analysis. The study also examines land use and land cover characteristics in modulating dengue risk. The findings revealed strong positive correlations between UHIs, built-up zones, and dengue hotspots. UHI analysis revealed that dengue incidence is highest in areas with moderate heat exposure, not in urban cores with extreme temperatures; only 30.2% of dengue cases occurred within UHI zones, suggesting that extreme temperatures (> 48 °C) may suppress Aedes mosquito survival. The land use analysis revealed that built-up areas (45.85%) were strongly correlated with dengue cases (𝜌 = 0.822, p < 0.01), whereas vegetation (40.98%) and water bodies (2.82%) were negatively correlated, indicating their role in influencing dengue transmission. The findings underscore the critical influence of UHIs on dengue incidence and the need for targeted interventions, including dengue-sensitive urban planning focused on maintaining green spaces, ensuring proper drainage, and minimising water stagnation to balance vegetation benefits with vector control.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2914"},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942120","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}