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Heat and its effects on maternal and neonatal health care: Evidence from Burkina Faso 高温及其对孕产妇和新生儿保健的影响：来自布基纳法索的证据

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-17 DOI: 10.1016/j.puhe.2026.106144

Seni Kouanda , Kadidiatou Kadio , Adama Sana , Mariam Congo , Nathalie Roos , Fiona Scorgie , Britt Nakstad , Sari Kovats , Jeremy J. Hess , Véronique Filippi

Objectives

Climate change has a wide range of adverse consequences for human health. The effects of extreme weather on maternal and newborn health, as well as the availability and quality of health services, remain under-researched in the sub-Saharan region. The aim of this study is to examine the effects of heat on pregnant women's use of health services, the health facility working environment and the impact of heat on the quality of care in Burkina Faso, a limited resource country.

Study design

We adopted a qualitative approach to address the research objectives.

Methods

This study was conducted in the primary health care centers of Wemtenga in Ouagadougou and Delga in Kaya, Burkina Faso, from September 30th to October 30th^, 2020. The study included individual interviews and focus group discussions (FGD) with pregnant women, postpartum women, health providers and community leaders, women of reproductive age, as well as relatives and male spouses of women who recently had given birth. The interviews were transcribed into French and coded using NVivo11 software.

Results

Forty pregnant and postpartum women, aged 20–40 years, were interviewed, and 31 women of childbearing age, aged 21–39 years, participated in the FGDs; 29 spouses also participated in the FDGs. Interviews indicated that extreme heat was reported to reduce the attendance and use of health services by pregnant and postpartum women. The women's choice of delivery center depended on the quality of the health centers, notably whether they were equipped with cooling systems, as lack of cooling could adversely affect the care of women and newborns, and the number of managed patients. The conveniences offered by health centers, notably the presence of fans or air conditioners, were important factors influencing women's decisions on where to give birth. All stakeholders agreed that extreme heat affected the relationship between caregivers and patients, especially facilities with inadequate infrastructures, such as the lack of a cooling system and cramped spaces.

Conclusions

Extreme ambient heat negatively impacts the use of maternal and child health services, the performance and quality of care provided by health professionals, and the relationship between carer and patient. This is particularly concerning as worsening heat could undermine the progress made in maternal and child health in Burkina Faso and other similar settings. It is crucial for healthcare systems to adapt to the effects of climate change, particularly to extreme heat and heatwaves, which are becoming increasingly intense, frequent and long-lasting.

气候变化对人类健康具有广泛的不利后果。在撒哈拉以南地区，极端天气对孕产妇和新生儿健康的影响以及保健服务的可得性和质量的研究仍然不足。在资源有限的布基纳法索，本研究的目的是研究高温对孕妇使用保健服务的影响、保健设施的工作环境以及高温对保健质量的影响。研究设计我们采用定性方法来解决研究目标。方法本研究于2020年9月30日至10月30日在布基纳法索瓦加杜古的Wemtenga和卡亚的Delga初级卫生保健中心进行。这项研究包括与孕妇、产后妇女、保健提供者和社区领导人、育龄妇女以及最近分娩妇女的亲属和男性配偶进行个人访谈和焦点小组讨论。采访被转录成法语，并使用NVivo11软件进行编码。结果共调查了40名年龄在20 ~ 40岁的孕妇和产后妇女，31名年龄在21 ~ 39岁的育龄妇女参加了fgd；29名配偶也参加了家庭发展小组。访谈表明，据报告，极端高温减少了孕妇和产后妇女的就诊和使用保健服务。妇女选择分娩中心取决于保健中心的质量，特别是是否配备了冷却系统，因为缺乏冷却会对妇女和新生儿的护理产生不利影响，也会影响被管理病人的数量。卫生中心提供的便利，特别是风扇或空调的存在，是影响妇女决定在哪里分娩的重要因素。所有利益攸关方都认为，极端高温会影响护理人员和患者之间的关系，尤其是基础设施不足的设施，如缺乏冷却系统和狭窄的空间。结论高温环境对妇幼保健服务的使用、卫生专业人员提供的保健服务的绩效和质量以及护理人员与患者之间的关系产生负面影响。这尤其令人担忧，因为日益恶化的高温可能会破坏布基纳法索和其他类似国家在妇幼保健方面取得的进展。至关重要的是，卫生保健系统必须适应气候变化的影响，特别是适应日益强烈、频繁和持久的极端高温和热浪。

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引用次数: 0

Identifying potential post-COVID-19 condition among people experiencing homelessness using longitudinal symptom patterns: A prospective cohort study 利用纵向症状模式确定无家可归者中潜在的covid -19后疾病：一项前瞻性队列研究

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-17 DOI: 10.1016/j.puhe.2026.106148

Lucie Richard , Rosane Nisenbaum , Allison Dyer , Daniela Mergarten , Michael Brown , Suzanne Stewart , Stephen W. Hwang

Objectives

People experiencing homelessness have high SARS-CoV-2 infection and re-infection burden, potentially leading to higher prevalence of post-COVID-19 condition (PCC). However, high baseline symptom rates may make identification of PCC difficult or impossible in this population. This study evaluates symptom patterns over time to assess their ability to identify potential PCC among individuals experiencing homelessness.

Study design

Prospective cohort study

Methods

We prospectively followed a large (n = 736), representative cohort of people experiencing homelessness recruited at random from 62 sites in Toronto, Canada between June and September 2021. Participants were interviewed up to five times over approximately 12 months. Longitudinal patterns of twelve self-reported symptoms were assessed through latent transition analysis, and generalized estimating equations with logit link were applied to determine their association with known risk of potential PCC.

Results

Among 736 participants, three latent statuses were identified: (1) ‘No/Few Symptoms’ (≥70 %), (2) ‘Non-Specific Symptoms’ (15–23 %), and (3) ‘Infection-Related Symptoms’ (≤5 %). Statuses 2 and 3 were associated with being at risk of PCC following symptomatic infection (aOR 3.41 [95 % CI 2.3–5.0] and 3.18 [95 % CI 1.6–6.4]) but not with being at risk of PCC overall. Transition probabilities suggested PCC would mostly occur among individuals with symptoms at baseline. However, the clustered area under the curve was modest (0.70 [95 % CI 0.65–0.75]), indicating symptom-based approaches are suboptimal for identification of potential PCC.

Conclusions

Self-reported symptoms do not reliably identify potential PCC among people experiencing homelessness, due to high rates of underlying symptoms and asymptomatic infections. Alternative, strengths-based approaches are recommended to more equitably identify post-COVID condition in this population.

无家可归者具有较高的SARS-CoV-2感染和再感染负担，可能导致更高的covid -19后病症（PCC）患病率。然而，在这一人群中，高基线症状率可能使PCC的识别变得困难或不可能。本研究评估了一段时间内的症状模式，以评估他们在无家可归者中识别潜在PCC的能力。研究设计前瞻性队列研究方法前瞻性随访了2021年6月至9月期间从加拿大多伦多的62个地点随机招募的大量（n = 736）有代表性的无家可归者队列。参与者在大约12个月的时间里接受了多达5次采访。通过潜在转移分析评估12种自我报告症状的纵向模式，并应用logit链接的广义估计方程来确定其与已知潜在PCC风险的关联。结果在736名参与者中，确定了三种潜在状态：(1)“无症状/很少症状”（≥70%），(2)“非特异性症状”（15 - 23%）和(3)“感染相关症状”（≤5%）。状态2和3与有症状感染后出现PCC的风险相关（aOR为3.41 [95% CI 2.3-5.0]和3.18 [95% CI 1.6-6.4]），但与总体出现PCC的风险无关。过渡概率提示PCC主要发生在基线时有症状的个体中。然而，曲线下的聚集面积适中（0.70 [95% CI 0.65-0.75]），表明基于症状的方法对于识别潜在的PCC不是最理想的。由于潜在症状和无症状感染率很高，自我报告的症状不能可靠地识别无家可归者中潜在的PCC。建议采用基于优势的替代方法，以更公平地确定这一人群的covid后状况。

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引用次数: 0

Predictive modeling and spatiotemporal analysis of TB in Argentina: Advancing control efforts through machine learning 阿根廷结核病的预测建模和时空分析：通过机器学习推进控制工作

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-17 DOI: 10.1016/j.puhe.2026.106151

Iganacio Garcia , Leonardo Giovanini , Leonardo López

Objectives

To improve prediction and understanding of TB dynamics in Argentina, identifying key risk factors and high-incidence areas to inform surveillance and public health control strategies.

Study design

Retrospective observational study.

Methods

We applied (i) machine learning models (Histogram-Based Gradient Boosting, XGBoost, Random Forest, and Logistic Regression) to predict treatment outcomes, (ii) time series models (ARIMA, SARIMAX, and LSTM) to forecast weekly TB case counts, and (iii) spatial analysis tools (LISA, Moran's I) to identify high-incidence clusters.

Results

Weekly TB notifications increased after the onset of the COVID-19 pandemic (t = 4.75, p = 2.10 × 10⁻⁶), with LISA revealing two significant clusters (p < 0.05). HGB predicted treatment outcomes (ROC–AUC = 0.86; top predictors: HIV, treatment duration, age). LSTM outperformed SARIMAX (RMSE 3.50 → 2.88 in Salta–Jujuy; 3.82 → 0.89 in Autonomous City of Buenos Aires (CABA)–Buenos Aires; −18 %/−77 %). A sex-difference test indicated higher infection among men (p < 0.05).

Conclusions

Combining ML and spatial tools enhances TB monitoring by supporting early identification of high-risk areas, improving epidemiological surveillance, and enabling targeted, data-driven public health interventions in Argentina.

目的提高对阿根廷结核病动态的预测和了解，确定关键危险因素和高发地区，为监测和公共卫生控制战略提供信息。研究设计回顾性观察性研究。方法我们应用(i)机器学习模型（Histogram-Based Gradient Boosting、XGBoost、Random Forest和Logistic Regression）预测治疗结果，（ii）时间序列模型（ARIMA、SARIMAX和LSTM）预测每周结核病病例数，（iii）空间分析工具（LISA, Moran’si）识别高发病率集群。结果新冠肺炎大流行发生后，每周结核病通报率增加（t = 4.75, p = 2.10 × 10−6），其中LISA显示两个显著聚集（p < 0.05）。HGB预测治疗结果（ROC-AUC = 0.86；最主要预测因子：HIV、治疗持续时间、年龄）。LSTM在Salta-Jujuy的RMSE为3.50→2.88，在布宜诺斯艾利斯自治市(CABA) -布宜诺斯艾利斯的RMSE为3.82→0.89；−18% /−77%)。性别差异测试显示男性感染率较高（p < 0.05）。结论在阿根廷，将ML和空间工具相结合可以通过支持早期识别高风险地区、改善流行病学监测和实现有针对性的、数据驱动的公共卫生干预来加强结核病监测。

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引用次数: 0

Effects of school-based physical activity interventions on cardiorespiratory fitness and body composition in children and adolescents: A systematic review and meta-analysis using the RE-AIM framework 基于学校的体育活动干预对儿童和青少年心肺健康和身体成分的影响：使用RE-AIM框架的系统回顾和荟萃分析

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-17 DOI: 10.1016/j.puhe.2026.106141

Huihui Wang , Xiaotian Bai , Xiangrong Cheng , Xiaosheng Dong , Xiao Hou

Objectives

This systematic review and meta-analysis aimed to (1) assess the effects of school-based physical activity (PA) interventions on cardiorespiratory fitness (CRF) and body composition in children and adolescents, and (2) evaluate internal validity (i.e., Reach and Effectiveness) and external validity (i.e., Adoption, Implementation, and Maintenance) reported in the included studies using the RE-AIM framework.

Study design

Systematic review and meta-analysis.

Methods

Five databases (PubMed, Embase, Web of Science, EBSCO, and Cochrane Library) were searched for studies published from January 1, 2000, to July 10, 2024. Eligible studies were randomized or non-randomized controlled trials involving healthy children and adolescents aged 5–17 years. Only studies that reported CRF or body composition with PA or exercise as the sole intervention were included.

Results

43 studies with a total of 27,626 participants were included in the meta-analysis. School-based PA interventions had a significant positive effect on CRF (SMD = 0.28, 95 % CI = 0.19 to 0.38; I² = 75 %). However, no significant effect of school-based PA interventions on percentage of body fat (%BF) was observed (SMD = −0.05, 95 % CI = −0.10 to 0.00; I² = 28 %). The total proportion of RE-AIM framework reported was 48.1 %. Among the five dimensions, Effectiveness is the most frequently reported (72.7 %), followed by Reach (53.1 %), Adoption (52.3 %), Implementation (42.4 %), and Maintenance (4.7 %).

Conclusions

School-based PA interventions significantly improve CRF in youth but do not significantly reduce %BF. Moreover, internal validity indicators were reported more often than external validity components in the included studies.

目的：本系统回顾和荟萃分析旨在(1)评估以学校为基础的体育活动（PA）干预对儿童和青少年心肺健康（CRF）和身体成分的影响，以及(2)使用RE-AIM框架评估纳入研究的内部效度（即覆盖范围和有效性）和外部效度（即采用，实施和维持）。研究设计：系统评价和荟萃分析。方法：检索PubMed、Embase、Web of Science、EBSCO和Cochrane Library 5个数据库，检索2000年1月1日至2024年7月10日发表的研究。符合条件的研究是涉及5-17岁健康儿童和青少年的随机或非随机对照试验。仅纳入了报告CRF或体成分与PA或运动作为唯一干预的研究。结果：43项研究共27,626名参与者被纳入meta分析。以学校为基础的PA干预对CRF有显著的正向影响（SMD = 0.28, 95% CI = 0.19 ~ 0.38; I2 = 75%）。然而，没有观察到以学校为基础的PA干预对体脂率（%BF）的显著影响（SMD = -0.05, 95% CI = -0.10至0.00;I2 = 28%）。RE-AIM框架报告的总比例为48.1%。在五个维度中，有效性是最常被报告的（72.7%），其次是Reach（53.1%）、Adoption（52.3%）、Implementation（42.4%）和Maintenance（4.7%）。结论：以学校为基础的PA干预可显著改善青少年的CRF，但不能显著降低BF %。此外，在纳入的研究中，内部效度指标的报告频率高于外部效度成分。

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引用次数: 0

Meteorological associations with out-of-hospital cardiac arrest: A national population-based time-series analysis 气象与院外心脏骤停的关联：一项基于全国人口的时间序列分析

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-16 DOI: 10.1016/j.puhe.2026.106145

Ádám Pál-Jakab , Patrik Pesti , Zsuzsanna Horti-Maricza , Bettina Nagy , Boldizsár Kiss , Botond Biebel , György Pápai , Gábor Csató , Nora Boussoussou , Béla Merkely , András Gelencsér , Péter Sótonyi , Brigitta Szilágyi , Endre Zima

Objectives

Meteorological factors may influence cardiovascular emergency incidence, but comprehensive national evidence for out-of-hospital cardiac arrest (OHCA) associations remains limited. We investigated meteorological associations with OHCA occurrence using complete national population data.

Study design

Population-based time-series retrospective, non-interventional analysis.

Methods

We conducted a population-based time-series analysis using the Hungarian National Ambulance Service registry from November 2018 to December 2023. After excluding COVID-19 disruption period, 114830 OHCA cases across 1584 days were analysed. Meteorological parameters included temperature, wind speed, atmospheric pressure, humidity, and air quality. Associations were assessed using negative binomial regression models with temporal lag structures (0–3 days). We used a rolling 30-day z-score to detect outlier days with high OHCA cases and identified their unique weather conditions. Machine learning validation was performed with XGBoost and SHAP interpretation.

Results

Daily OHCA incidence averaged 60·9 ± 14·3 cases, peaking in winter (17·8 % higher than summer, p < 0·001). Each 1 °C temperature decrease was associated with a 1·4 % increase in daily OHCA incidence (IRR 0·986). Wind speed demonstrated inverse association (7·9 % decrease in OHCA incidence per-IQR effect; IRR 0·928). The highest-incidence days saw 31·9 % more cases, equivalent to 19 additional cases daily, linked to adverse weather.

Conclusion

Meteorological factors demonstrate strong, predictable associations with OHCA incidence, with extreme weather increasing rates by nearly one-third. The 3-day lag patterns enable weather-based early warnings, supporting the integration of meteorological data into emergency response to reduce preventable deaths.

目的气象因素可能影响心血管急症的发生率，但关于院外心脏骤停（OHCA）关联的综合国家证据仍然有限。我们利用完整的国家人口数据调查了与OHCA发生的气象关系。研究设计：基于人群的时间序列、回顾性、非干预性分析。方法：2018年11月至2023年12月，我们使用匈牙利国家救护车服务登记处进行了基于人群的时间序列分析。在排除COVID-19中断期后，分析了1584天内114830例OHCA病例。气象参数包括温度、风速、大气压、湿度和空气质量。使用具有时间滞后结构（0-3天）的负二项回归模型评估相关性。我们使用滚动的30天z分数来检测高OHCA病例的异常天，并确定其独特的天气条件。通过XGBoost和SHAP解释进行机器学习验证。结果OHCA日发病率平均为60·9±14·3例，以冬季最高（比夏季高17.8%,p < 0.001）。温度每降低1°C，每日OHCA发病率增加1.4% （IRR 0.986）。风速与OHCA发病率呈负相关（每iqr效应降低7.9%，IRR为0.928）。在发病率最高的日子里，与恶劣天气有关的病例增加了31.9%，相当于每天增加19例。结论气象因素与OHCA发病率有很强的、可预测的关联，极端天气的发生率增加了近三分之一。3天的滞后模式使基于天气的早期预警成为可能，支持将气象数据纳入应急响应，以减少可预防的死亡。

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引用次数: 0

COVID-19 outcomes among individuals with substance use disorders 物质使用障碍患者的COVID-19结局

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-16 DOI: 10.1016/j.puhe.2026.106156

Chun-Pin Esther Chang , Daniel Knox , Zhe David Yu , Kimberley Shoaf , Sharon L. Talboys , Mia Hashibe

Objectives

Individuals with substance use disorders may be more susceptible to COVID-19 outcomes due to damage in their immune, pulmonary and respiratory systems. The aim of our study is to investigate COVID-19 outcomes among individuals with a history of substance use disorders compared to individuals without substance use disorders.

Study design

This study was a population-based cohort study.

Methods

Using the Utah Population Database, individuals with substance use disorder history (2015–2020; n = 227,277) were individually matched by age and sex to individuals without substance use disorders (n = 227,277). COVID-19 outcomes from 2020 to 2023 were assessed with conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Individuals with substance use disorders had higher odds of hospitalization (OR: 2.90, 95% CI: 2.78–3.02), ICU admission (OR: 2.92, 95% CI: 2.72–3.13), all-cause death (OR: 2.94, 95 % CI: 2.81–3.08), and COVID-19-specific death (OR: 1.34, 95% CI: 1.14–1.57). The ORs for COVID-19 outcomes were similar for individuals with alcohol use disorders and opioid use disorders.

Conclusions

COVID-19 outcomes were strongly associated with substance use disorders, highlighting the need for targeted health strategies for individuals with substance use disorders.

物质使用障碍患者可能更容易受到COVID-19结果的影响，因为他们的免疫、肺和呼吸系统受到了损害。本研究的目的是调查有物质使用障碍史的个体与没有物质使用障碍的个体之间的COVID-19结局。研究设计本研究是一项基于人群的队列研究。方法使用犹他州人口数据库，将有物质使用障碍史的个体（2015-2020;n = 227,277）按年龄和性别与无物质使用障碍的个体（n = 227,277）单独匹配。采用条件逻辑回归评估2020年至2023年COVID-19的结局，以估计优势比（ORs）和95%置信区间（ci）。结果物质使用障碍患者住院（OR: 2.90, 95% CI: 2.78-3.02）、ICU住院（OR: 2.92, 95% CI: 2.72-3.13）、全因死亡（OR: 2.94, 95% CI: 2.81-3.08）和covid -19特异性死亡（OR: 1.34, 95% CI: 1.14-1.57）的几率较高。酒精使用障碍和阿片类药物使用障碍患者的COVID-19结果的or相似。结论2019冠状病毒病结局与物质使用障碍密切相关，强调需要针对物质使用障碍患者制定有针对性的健康策略。

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引用次数: 0

Exploring the factors influencing peer-recommended HIV testing in men who have sex with men (MSM): A qualitative study based on the theory of planned behavior 男男性行为者同伴推荐HIV检测的影响因素探讨：基于计划行为理论的定性研究

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-16 DOI: 10.1016/j.puhe.2026.106136

Mengnan Tan , Jing Ma , Yaoyao Jiang , Mei Chen , Donghang Luo , Yanchao Qiu , Ce Jia , Jie Xu , Fan Lyu , Chu Zhou

Objectives

This study explored the factors influencing peer-recommended HIV testing in men who have sex with men (MSM), using the Theory of Planned Behavior (TPB), to inform strategies that promote peer engagement in HIV testing.

Study design

Qualitative study.

Methods

We recruited MSM participants through the Tongxing Community-based Organization (CBO) in Shijiazhuang City in September 2024. Semi-structured interviews were conducted using a TPB-based guide, and thematic analysis was performed.

Results

Twenty-four MSM were interviewed (median age = 34.5 years; Q1- Q3: 23–43.5). Most were college-educated, unmarried, and employed. Nineteen (79.2 %) expressed willingness to recommend HIV testing to peers. Three key themes emerged: (1) Attitudes – Participants with positive attitudes generally viewed testing recommendation as a beneficial health practice, whereas negative attitudes reflected concerns about creating discomfort or imposing a social burden on peers. (2) Subjective Norms – Influencing factors included supportive peer environments, limited social networks, and the normative role of CBOs. (3) Perceived Behavioral Control – Facilitators included risk awareness, trust in CBOs, prior experience of being recommended for testing, and access to tools such as HIV self-test kits and social media platforms. Barriers included inadequate HIV testing promotion, privacy concerns.

Conclusions

In summary, this study uses the TPB to conceptualize peer-recommended HIV testing among Chinese MSM as a social behavior that combines pathway navigation and transfer of trust in services. The findings suggest that HIV testing promotion programs should more deliberately integrate peer recommendation into existing services by strengthening norms that frame “recommending testing as caring for peers” and by providing simple scripts and clear pathway information to support potential referrers.

目的本研究利用计划行为理论（TPB）探讨影响男男性行为者（MSM）同伴推荐HIV检测的因素，为促进同伴参与HIV检测提供策略。研究设计定性研究。方法我们于2024年9月通过石家庄市同兴社区组织（CBO）招募MSM参与者。采用基于tbb的指南进行半结构化访谈，并进行专题分析。结果共访谈24名男男性行为者（中位年龄34.5岁；第一季至第三季：23-43.5岁）。大多数人受过大学教育，未婚，有工作。19人（79.2%）表示愿意向同龄人推荐HIV检测。出现了三个关键主题：(1)态度——持积极态度的参与者普遍认为检测建议是有益的健康实践，而持消极态度的参与者则担心会造成不适或给同伴带来社会负担。(2)主观规范——影响因素包括支持性同伴环境、有限的社会网络和cbo的规范性角色。(3)感知行为控制-促进因素包括风险意识、对cbo的信任、之前被推荐进行检测的经验以及获得艾滋病毒自检试剂盒和社交媒体平台等工具。障碍包括艾滋病毒检测宣传不足、隐私问题。综上所述，本研究通过TPB将中国男同性恋者中同行推荐的HIV检测概念化为一种结合路径导航和服务信任转移的社会行为。研究结果表明，艾滋病毒检测促进项目应通过加强“将推荐检测视为照顾同伴”的规范，并通过提供简单的脚本和明确的途径信息来支持潜在的转诊者，更有意识地将同行推荐纳入现有服务。

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引用次数: 0

Specific types of screen exposure and adolescent emotional and behavioral problems: Longitudinal associations and moderation by individual, family, and school characteristics 特定类型的屏幕暴露与青少年情绪和行为问题：个体、家庭和学校特征的纵向关联和调节

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-16 DOI: 10.1016/j.puhe.2026.106140

Qianyu Liu , Shuyi Peng , Yuwei Yang , Yannan Guo , Guiyu Jiang , Lan Guo

Objectives

The rise in television and digital media use among adolescents has become a major concern, but the impacts of specific types of screen exposure on mental health remain underexplored. This study examined whether specific types of screen exposure are associated with emotional and behavioral problems (EBPs), and whether individual, family, and school factors moderate these associations.

Study design

Longitudinal study.

Methods

Participants (N = 10,770; mean age 15.89 years, 51.6 % male) completed standardized questionnaires at baseline and follow-up. EBPs were measured using the Strengths and Difficulties Questionnaire, and screen exposure and contextual factors were collected via self-report questionnaires. Generalized linear mixed-effects models, restricted cubic splines, interaction analyses, and sensitivity analyses were conducted.

Results

Specific screen types use, particularly educational apps and shopping/food delivery app exposures, were associated with increased total EBP difficulties. Each additional hour of social networking (OR, 1.04; 95 % CI, 1.01–1.07), short video viewing (OR, 1.05; 95 % CI, 1.01–1.09), or video gaming (OR, 1.06; 95 % CI, 1.01–1.10) was associated with an elevated risk of emotional symptoms. Short videos and video games were also associated with greater hyperactivity/inattention. Moderation analyses showed father's education, academic achievement, health status, and family function significantly modified these associations (e.g., family function × short video use: OR_interaction = 0.89, P_interaction = 0.014).

Conclusions

These findings highlight the differential impacts of screen exposure types on adolescent mental health and underscore the importance of addressing specific screen behaviors while considering individual, family, and school characteristics that may modify these risks, although the study's observational design limits causal inference.

青少年中电视和数字媒体使用的增加已成为一个主要问题，但特定类型的屏幕暴露对心理健康的影响仍未得到充分探讨。本研究调查了特定类型的屏幕暴露是否与情绪和行为问题（ebp）有关，以及个人、家庭和学校因素是否调节了这些关联。研究设计：纵向研究。方法研究对象（N = 10,770人，平均年龄15.89岁，男性51.6%）在基线和随访时完成标准化问卷调查。使用优势和困难问卷测量ebp，通过自我报告问卷收集屏幕暴露和情境因素。进行了广义线性混合效应模型、受限三次样条、相互作用分析和敏感性分析。特定屏幕类型的使用，特别是教育应用程序和购物/外卖应用程序的使用，与EBP总困难增加有关。每增加一个小时的社交网络（OR, 1.04; 95% CI, 1.01-1.07）、短视频观看（OR, 1.05; 95% CI, 1.01-1.09）或视频游戏（OR, 1.06; 95% CI, 1.01-1.10）与情绪症状的风险增加相关。短视频和视频游戏也与更严重的多动症/注意力不集中有关。适度分析显示，父亲的教育程度、学业成绩、健康状况和家庭功能显著地改变了这些关联（例如，家庭功能×短视频使用：or交互作用= 0.89，p交互作用= 0.014）。这些发现强调了屏幕暴露类型对青少年心理健康的不同影响，并强调了在考虑可能改变这些风险的个人、家庭和学校特征的同时处理特定屏幕行为的重要性，尽管该研究的观察设计限制了因果推理。

{"title":"Specific types of screen exposure and adolescent emotional and behavioral problems: Longitudinal associations and moderation by individual, family, and school characteristics","authors":"Qianyu Liu , Shuyi Peng , Yuwei Yang , Yannan Guo , Guiyu Jiang , Lan Guo","doi":"10.1016/j.puhe.2026.106140","DOIUrl":"10.1016/j.puhe.2026.106140","url":null,"abstract":"<div><h3>Objectives</h3><div>The rise in television and digital media use among adolescents has become a major concern, but the impacts of specific types of screen exposure on mental health remain underexplored. This study examined whether specific types of screen exposure are associated with emotional and behavioral problems (EBPs), and whether individual, family, and school factors moderate these associations.</div></div><div><h3>Study design</h3><div>Longitudinal study.</div></div><div><h3>Methods</h3><div>Participants (N = 10,770; mean age 15.89 years, 51.6 % male) completed standardized questionnaires at baseline and follow-up. EBPs were measured using the Strengths and Difficulties Questionnaire, and screen exposure and contextual factors were collected via self-report questionnaires. Generalized linear mixed-effects models, restricted cubic splines, interaction analyses, and sensitivity analyses were conducted.</div></div><div><h3>Results</h3><div>Specific screen types use, particularly educational apps and shopping/food delivery app exposures, were associated with increased total EBP difficulties. Each additional hour of social networking (OR, 1.04; 95 % CI, 1.01–1.07), short video viewing (OR, 1.05; 95 % CI, 1.01–1.09), or video gaming (OR, 1.06; 95 % CI, 1.01–1.10) was associated with an elevated risk of emotional symptoms. Short videos and video games were also associated with greater hyperactivity/inattention. Moderation analyses showed father's education, academic achievement, health status, and family function significantly modified these associations (e.g., family function × short video use: OR<sub>interaction</sub> = 0.89, <em>P</em><sub>interaction</sub> = 0.014).</div></div><div><h3>Conclusions</h3><div>These findings highlight the differential impacts of screen exposure types on adolescent mental health and underscore the importance of addressing specific screen behaviors while considering individual, family, and school characteristics that may modify these risks, although the study's observational design limits causal inference.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106140"},"PeriodicalIF":3.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spatial and spatio-temporal distribution of infant mortality in the state of Sergipe, Brazil: An ecological study, 2019–2023 2019-2023年巴西塞尔希佩州婴儿死亡率时空分布的生态学研究

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-16 DOI: 10.1016/j.puhe.2026.106153

Maria Fernanda de Sá Camarço, Jefferson Felipe Calazans Batista, Sonia Oliveira Lima

Objectives

To analyze the spatial and spatiotemporal distribution of infant mortality in the state of Sergipe from 2019 to 2023.

Study design

Ecological study.

Methods

This ecological study used publicly available data on infant deaths in Sergipe between 2019 and 2023, obtained from the Mortality Information System. Variables related to the child, mother, and healthcare factors were considered. Bayesian mortality rates were calculated and mapped across municipalities. Moran's Index was applied to assess spatial correlation.

Results

Between 2019 and 2023, Sergipe recorded 2547 infant deaths. The leading causes were perinatal conditions (Chapter XVI) and abnormal findings in examinations (Chapter XVIII), predominantly in the northern region. Higher mortality was observed among Black female infants with very low or low birth weight, as well as clusters of deaths among adolescent mothers in the Itabaiana region, and adult or late-age mothers in Propriá, which also showed higher mortality among preterm infants. The municipalities of Propriá and Nossa Senhora do Socorro reported more deaths associated with cesarean deliveries. Aracaju, São Cristóvão, and Nossa Senhora do Socorro formed high-mortality clusters, with a risk 641.77 times greater; conversely, Nossa Senhora da Glória, Lagarto, and Estância exhibited a 66 % lower risk.

Conclusion

Infant mortality in Sergipe is unevenly distributed, concentrated in high-risk clusters, and reflects regional disparities as well as specific maternal and neonatal factors.

目的分析2019 - 2023年塞尔希佩州婴儿死亡率的时空分布特征。研究设计生态研究。方法本生态研究使用了2019年至2023年塞尔希佩州婴儿死亡的公开数据，这些数据来自死亡率信息系统。考虑了与儿童、母亲和保健因素相关的变量。对各个城市的贝叶斯死亡率进行了计算和绘制。采用Moran’s Index评价空间相关性。结果在2019年至2023年期间，Sergipe记录了2547例婴儿死亡。主要原因是围产期条件（第十六章）和检查结果异常（第十八章），主要发生在北部地区。出生体重过低或过低的黑人女婴死亡率较高，在Itabaiana地区的青少年母亲和propriae地区的成年或高龄母亲中也有大量死亡，这也表明早产儿死亡率较高。普罗德市和诺萨·森霍拉·多·索科罗市报告与剖宫产有关的死亡人数更多。Aracaju、s o Cristóvão和Nossa Senhora do Socorro形成了高死亡率集群，风险高出641.77倍；相反，Nossa Senhora da Glória、Lagarto和estncia的风险降低了66%。结论Sergipe地区婴儿死亡率分布不均匀，集中在高危聚集群中，反映了地区差异和特定的母婴因素。

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引用次数: 0

Building climate-resilient primary care: A convergent mixed-methods climate vulnerability and capacity assessment in the Cederberg subdistrict, South Africa 建设气候适应型初级保健：南非Cederberg街道气候脆弱性和能力融合混合方法评估

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-16 DOI: 10.1016/j.puhe.2025.106106

Robert Mash , Stacey Blows , Sa'ad Lahri , Melissa McRae , Christian Lokotola , Kiran Jobanputra , Patricia Nayna Schwerdtle

Objectives

To evaluate the climate resilience of primary care facilities and services in the Cederberg subdistrict of the Western Cape, South Africa.

Study design

We conducted a convergent parallel mixed-methods study to assess the climate vulnerability and adaptive capacity of a primary care network. Quantitative facility audits and qualitative focus groups were undertaken, with subsequent integration to identify risks and generate context-specific adaptation options.

Methods

The study combined a structured audit of primary care facilities with a rapid qualitative assessment involving focus groups with health workers. Quantitative and qualitative datasets were analysed separately and then synthesised to map vulnerabilities and propose feasible adaptation measures. The subdistrict management team later used the integrated findings to prioritise adaptation actions.

Results

Across six primary care facilities, extreme heat was the most significant hazard, particularly where indoor temperatures rose above 40 °C, contributing to staff fatigue, overcrowding as community members sought refuge, and a higher risk of heat-related illness. Heat was also linked to increased drought and wildfire risk. Irregular and excessive rainfall further disrupted service delivery through flooding, road closures, delays in essential supplies, and increased waterborne and respiratory illness. Coastal facilities faced additional exposure to storm surge and sea-level rise. Environmental and operational sustainability challenges, including reliance on carbon-intensive electricity, waste-related emissions, inconsistent water quality, and limited backup water supply, amplified these climate-related risks. The assessment identified a consolidated set of risks across heat, rainfall, flooding, and sustainability domains, and generated 42 feasible adaptation options across infrastructure; governance; service delivery; workforce; energy; and water, sanitation and waste.

Conclusions

This study demonstrated that facility-level VCA assessments can successfully guide climate resilience planning in African primary care settings. The VCA process identified context-specific hazards, risks and feasible adaptation options across key domains of health system function. The approach provides an adaptable framework for other African settings seeking to strengthen primary care resilience to climate impacts. Transitioning from assessment to implementation will require local capacity to conduct VCAs independently and access to sustainable climate finance to support action.

目的评估南非西开普省Cederberg街道初级保健设施和服务的气候适应能力。研究设计我们进行了一项融合并行混合方法研究，以评估初级保健网络的气候脆弱性和适应能力。进行了定量的设施审计和定性的焦点小组，随后进行整合，以确定风险并产生针对具体情况的适应方案。方法本研究结合了对初级保健设施的结构化审计和涉及卫生工作者的焦点小组的快速定性评估。定量和定性数据集分别进行分析，然后进行综合，以绘制脆弱性地图并提出可行的适应措施。街道管理小组后来利用综合调查结果确定适应行动的优先次序。结果在六家初级保健机构中，极端高温是最严重的危害，特别是室内温度超过40°C时，这会导致工作人员疲劳，社区成员寻求庇护时人满为患，以及患热相关疾病的风险更高。高温还与干旱和野火风险增加有关。不规律和过度降雨通过洪水、道路封闭、基本用品延误以及水传播和呼吸系统疾病的增加进一步扰乱了服务的提供。沿海设施面临着风暴潮和海平面上升的额外风险。环境和运营的可持续性挑战，包括对碳密集型电力的依赖、与废物有关的排放、不稳定的水质以及有限的备用供水，放大了这些与气候相关的风险。该评估确定了高温、降雨、洪水和可持续性领域的综合风险，并提出了42个可行的基础设施适应方案；治理;服务交付;劳动力;能源;还有水、卫生设施和废物处理。本研究表明，设施级别的VCA评估可以成功地指导非洲初级保健机构的气候适应能力规划。VCA过程确定了卫生系统功能关键领域的特定环境危害、风险和可行的适应方案。该方法为寻求加强初级保健抵御气候影响能力的其他非洲环境提供了适应性框架。从评估到实施的过渡将需要地方有能力独立开展vca，并获得可持续气候融资来支持行动。

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引用次数: 0