Frontiers in Public Health最新文献

Background: The COVID-19 pandemic exacerbated mental health challenges among adolescents, yet the protective role of regular physical exercise (PE) in enhancing life satisfaction (LS) and quality of life (QOL) remains underexplored in this population. This study aimed to investigate the direct and indirect effects of PE on LS and QOL among Chinese adolescents during the pandemic, with a focus on its mediating pathways through alleviating depressive and anxious symptoms.

Methods: Adolescents aged 12 to 17 seeking for psychological services at Shandong Provincial Hospital were recruited between June 2021 and May 2022. Using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), 6-items QOL questionnaire (QOL-6), and Adolescent Students' Life Satisfaction Scale (ASLSS), we assessed depressive symptoms, anxious symptoms, QOL, and LS.

Results: A total of 392 adolescents (133 regular physical exercisers (PEs) vs. 259 non-regular physical exercisers (NPEs)) were included. Significant differences were observed in educational level, residence, general health status, and regular diet between PE and NPEs. A one-way ANOVA showed that PEs had significantly lower scores on GAD-7 and PHQ-9, higher QOL-6 scores, and greater LS across all six ASLSS dimensions compared to NPEs. The mediation analysis showed regular exercise indirect positive effects on QOL-6 and ASLSS 6 dimensions through the alleviation of anxious and depressive symptoms. Stepwise regression confirmed the significant positive effect of exercise on QOL, as well as LS with friendship, academic performance, and autonomy.

Conclusion: PE alleviates emotional distress and enhances subjective well-being in adolescents through dual pathways, underscoring its value as a low-cost intervention during public health crises. Findings advocate integrating structured physical activity into school-based mental health programs to foster resilience. Longitudinal studies are needed to validate causal mechanisms and optimize exercise protocols for diverse adolescent populations.

Objective: The purpose of this study was to explore the effect of orthopedic nurse burnout on sleep quality.

Methods: The Chinese versions of the Maslach Burnout Inventory-General Survey and the Pittsburgh Sleep Quality Index (PSQI) were administered to 184 orthopedic nurses in five Grade-A tertiary hospitals in Chengdu. Multiple linear regression was used for data analysis.

Results: The total PSQI score of orthopedic nurses was 6.10 ± 2.87, and the detection rate of sleep disorders was 58.7%; the total job burnout score was 43.14 ± 9.76, and emotional exhaustion, depersonalization, and reduced personal accomplishment were all moderately positively correlated with PSQI (r = 0.228-0.376); regression showed that the three dimensions jointly explained 41.7% of the variance in sleep quality, with emotional exhaustion (β = 0.301) having the largest effect; being married, having more than 5 years of work experience, and low income also significantly positively affected sleep quality.

Conclusion: Job burnout significantly affects sleep quality among orthopedic nurses, with emotional exhaustion having the greatest impact; those who are married, have long tenure, and have low income are at higher risk. Reducing burnout and strengthening support and incentives are key to improving sleep quality among orthopedic nurses.

Background: Bipolar disorder (BD) is a severe mental illness characterized by high recurrence rates and notable cognitive deficits. Although sex differences are known to influence the clinical characteristics of BD, their specific impact on cognitive function remains unclear. This study aimed to examine the role of sex in shaping cognitive profiles within a large sample of BD patients.

Methods: The sample included 243 individuals, 168 patients with first-diagnosed bipolar disorder (107 males and 61 females) and 75 healthy controls (44 males and 31females). Cognitive functions were assessed using the Continuous Performance Test (CPT), the Digital Span Test (DST), and the Wisconsin Card Sorting Test (WCST). Cognitive performance was compared between patient groups and healthy control groups.

Results: Compared with female patients, the total scores of PPE and DST in male patients were significantly higher in the BD group. There were significant main effects of group on CPT, DST, and WCST. There were significant main effects of group and sex for total administered (TA) and non-perseverative errors (NPE) (all with p-value of <0.05). The TA and NPE of male patients are significantly higher than female patients. Among male subjects, the TA and NPE scores of BD patients were significantly higher than healthy controls. Among female subjects, the NPE score of BP patients was significantly higher than healthy controls. The hospital admission frequency was significantly and negatively correlated with attention function scores.

Conclusion: Both male and female patients with BD exhibit cognitive impairment. Sex appears to play a crucial role in cognitive function among first-diagnosed patients with bipolar disorder. Male patients may be more vulnerable to deficits in cognitive transferability and attention stability, whereas female patients may be more susceptible to memory impairments.

Background: Gestational Diabetes Mellitus (GDM) is a common complication of pregnancy and that uncontrolled GDM increases the risk of poor maternal and neonatal health outcomes.

Objective: While regular exercise benefits GDM pregnant women, exercise adherence remains suboptimal; thus, this study aimed to identify the factors influencing exercise adherence among pregnant women with gestational diabetes in order to inform the development of tailored intervention to improve physical activity adherence and thereby promote more GDM pregnant women to achieve the recommended physical activity level.

Methods: The descriptive qualitative study was conducted in the obstetric clinic of tertiary hospital in Beijing, China. A total of 16 pregnant women with GDM were recruited as participants via purposive sampling, and face-to-face semi-structured interviews were adopted to collect data. All the interviews were audio-recorded and timely transcribed. The directed content analysis was used to analyze data and the themes generated were mapped onto the Capability, Opportunity, Motivation and Behavior model components.

Results: Sixteen women from a broad spectrum of socio-demographic backgrounds participated in this study. Three main themes and nine sub-themes were identified as shown below: Capability-related factors included: (1) absence of established exercise habits and exercise foundation, (2) physical discomfort with limited coping strategies, and (3) insufficient knowledge and skills regarding exercise during pregnancy. Opportunity-related factors comprised: (1) inadequate informational support and individualized guidance from healthcare professionals, (2) strong family support, and (3) insufficient peer support and community-based support. Motivation-related factors encompassed: (1) heightened risk perception of GDM promoting exercise intention, (2) recognition of exercise-related benefits enhancing motivation, and (3) negative emotions stemming from uncertainty about exercise safety.

Conclusion: Our study found that limited engagement in pre-pregnancy and early pregnancy physical activity, challenges of physical discomfort, insufficient knowledge and skills regarding exercise during pregnancy, insufficient professional guidance, limited peer support and community-based support, and negative emotions related to uncertain exercise safety during pregnancy were notable barriers to compliance with exercise recommendations in women with GDM. This has clinical implications for healthcare professionals to design context-specific interventions to address these barriers, thereby improving exercise compliance and physical activity levels among women with GDM.

Introduction: Influenza A and Mycoplasma pneumoniae (M. pneumoniae) are common respiratory pathogens, causing severe co-infections in clinical diseases. Current vaccines have failed to provide comprehensive protection against both of the pathogens, highlighting the requirement of integrated solution.

Methods: In this study, a novel dual-target multi-epitope vaccine was developed based on the immunoinformatics method. Based on the consistent sequences, we used the HA and NA proteins of influenza A virus, and the p1, p65, HMW1-3 proteins of M. pneumoniae to determine the immunodominant T- and B-cell epitopes.

Results and discussion: The designed vaccine included 21 linear B-cell epitopes, 34 CTL epitopes and 19 HTL epitopes from influenza A virus and M. pneumoniae. The selection was based on antigenicity, immunogenicity, and alignment with previously validated epitopes. Structural and physicochemical assessments indicated that the vaccine had high stability, solubility, and minimal allergy risk. Molecular docking with TLR3 and TLR4 receptors revealed strong binding, suggesting robust immune activation. Population coverage analysis showed the vaccine could cover 97.07% of the global population, with high efficacy across key regions such as North America and East Asia. In this study, we provided an immunoinformatics approach for vaccine design.

Background: The cumulative damage impulses have been proposed as a crucial parameter for analyzing joint kinetics and tissue loading during prolonged running. Although prolonged running may have detrimental effects, research focusing on the bones and soft tissues of the lower extremity remains limited. Therefore, this study aimed to examine how treadmill half-marathons influence biomechanical variables in high-performing endurance runners. We additionally quantified per-step peak load, impulse, cumulative impulse, and cumulative weight impulse of the Achilles tendon (AT) and the patellofemoral joint (PFJ) during half marathon running.

Method: Sixteen high-performing endurance runners (9 males and 7 females) completed a half marathon on a Zebris FDM-T pressure-sensing treadmill in a standardized biomechanics laboratory. The lower extremity kinematic and kinetic parameters were measured at every 10 km (0 km, 10 km, and 20 km) and subsequently processed using Visual3D and simulation musculoskeletal modeling. We used a one-way repeated measures ANOVA to determine the main effect of running distance on the outcome variables.

Results: During the running stance phases, contact time and step frequency significantly increased from 10 km to 20 km (p < 0.005). Conversely, step length and stride length exhibited a significant decrease (p < 0.005). Ankle peak plantarflexion angle, ankle push-off phase range of motion (ROM), and hip braking phase ROM were significantly reduced at 10 km (p < 0.005). The cumulative loading on the ankle, knee, and hip joints was significantly greater at both 10 km and 20 km (p < 0.005). The AT force and cumulative weighted impulse value decreased at 10 km (p < 0.005) but significantly increased at 20 km running (p < 0.005). Simultaneously, the PFJ cumulative loading parameter was increased from 10 km to 20 km running (p < 0.005).

Conclusion: As the running distance increases, the running mechanism is significantly altered. The cumulative loading on the knee and hip significantly increased, indicating a shift in the compensatory mechanism from the proximal to the distal joint. Cumulative loading on the AT and PFJ increased with the accumulated running distance, which directly reflects that prolonged running might cause greater cumulative loading on the lower extremity.

Introduction: The majority of presumptive TB cases report late. Early detection of tuberculosis (TB) cases is crucial for its control. We developed a logic model program involving members of a governmental and community-driven youth club of Nehru Yuva Kendra Sangathan (NYKS) volunteers and explored its feasibility.

Methodology: The study defined the purpose, scope, and program domains. The domains were input, process, output, and outcome. These domains were drafted, refined, and finalized using standard techniques. A qualitative study, including in-depth interviews and focus group discussions, was undertaken with community members, healthcare staff, and NYKS volunteers across diverse settings. Acceptability, feasibility, effectiveness, barriers, and improvement strategies of the developed model were synthesized through thematic analysis.

Results: The developed "Logic Model" aims to actively screen and motivate individuals with TB-suggestive symptoms for early detection of active TB, using various domains and corresponding activities. Information, education, communication (IEC), screening, referral, and case detection activities have been monitored using 36 indicators. Most participants expressed acceptance of the model, owing to its alignment with community values, trust among volunteers, and perceived benefits. Key motivators included the proximity of services, improved awareness, and civic responsibility. Barriers included a lack of financial incentives, logistical challenges, and overlapping stakeholder roles. Suggestions for improvement included enhancing gender diversity, confidentiality, volunteer training, and intersectoral coordination.

Discussion: The developed logic model provides a visual display of the input, process, output, and outcome domains, their activities, and relationships. The model links resources, activities, and outcomes for the screening and referral of diagnosed cases. It was broadly accepted, despite some reported challenges. Addressing barriers is essential for program sustainability. Tailored strategies to improve volunteer support, training, and trust-building can enhance the model's effectiveness and contribute to India's TB elimination program.

Background: Cardiovascular diseases (CVDs) remain the leading cause of global morbidity and mortality, influenced by lifestyle, socioeconomic status, and genetic factors. Emerging innovations, including wearable health technologies, telemedicine, and CRISPR-Cas9 gene editing, provide new possibilities for rapid prevention and personalized management.

Methods: This narrative review collected evidence from Scopus, PubMed, and Google Scholar, using keywords such as cardiovascular (CV) prevention, lifestyle determinants, digital health, telemedicine, CRISPR-Cas9, and public health ethics. Eligible peer-reviewed studies, clinical guidelines, and policy documents were included to assess behavioral, technological, and genomic strategies for CVD care.

Results: Modifications in lifestyle, such as quitting smoking, regular physical activity, following a heart-healthy diet plan, and getting adequate sleep, can significantly reduce the risk of CVD. Additionally, telemedicine and wearable devices facilitate early detection, better self-management, and treatment adherence, especially in underserved communities. CRISPR-Cas9 holds a significant potential for correcting genetic variants related to lipid disorders and inherited cardiomyopathies, but its clinical translation remains in early stages. However, existing evidence is limited by heterogeneity in study design, brief follow-up, particularly for digital health and CRISPR applications. Additional challenges, such as health inequities, digital access, data privacy, and ethical oversight, further influence their real-world implementation.

Conclusion: Effective integration of behavioral, digital and genomic innovations requires policy frameworks that ensure equity, ethical governance, and long-term sustainability. Combining precision medicine with efforts to address social determinants of health will be crucial in reducing the global burden of CVD and shaping the future of CV care.

Background: Child Sexual Abuse (CSA) is a global social and health problem requiring a comprehensive, multi-level prevention approach. School-based education is recognized as one of the most effective prevention strategies.

Objective: This project aims to test the effectiveness of the preventive intervention, "Pinta tu Raya ASI" (Set your Limit LIKE THIS), to prevent CSA. Methods: This is a two-arm matched cluster-randomized controlled trial of an educational intervention to prevent CSA in Mexican elementary school children using Immersive Virtual Reality (IVR). The study will be administered in clusters of public and private schools in urban and rural areas across two Mexican states. The intervention group will receive a learning session with an IVR animation, while the control group will receive the intervention only after the final knowledge acquisition measurement.

Results: The project is expected to enhance elementary students' knowledge of self-esteem, body safety, and rights to help them prevent child violence in Mexico.

Ethics: The study was approved by the National Institute of Public Health's Commissions of Research, Ethics, and Biosafety. Ethical safeguards include obtaining informed consent from guardians and assent from minors, providing trained staff, continuous monitoring during the IVR session, and having a specialized psychology team for case management and referral.

Trial registration: The study was approved by the Commissions of Research, Ethics and Biosafety at the National Institute of Public Health: code CI: 1713 V47.