Subjects -> ENVIRONMENTAL STUDIES (Total: 913 journals)
    - ENVIRONMENTAL STUDIES (810 journals)
    - POLLUTION (31 journals)
    - WASTE MANAGEMENT (18 journals)

ENVIRONMENTAL STUDIES (810 journals)            First | 1 2 3 4 5     

Showing 401 - 378 of 378 Journals sorted alphabetically
International Journal of Environment     Open Access   (Followers: 3)
International Journal of Environment and Climate Change     Open Access   (Followers: 28)
International Journal of Environment and Geoinformatics     Open Access   (Followers: 4)
International Journal of Environment and Health     Hybrid Journal   (Followers: 5)
International Journal of Environment and Pollution     Hybrid Journal   (Followers: 3)
International Journal of Environment and Sustainable Development     Hybrid Journal   (Followers: 17)
International Journal of Environment and Waste Management     Hybrid Journal   (Followers: 4)
International Journal of Environment, Workplace and Employment     Hybrid Journal   (Followers: 7)
International Journal of Environmental Engineering     Hybrid Journal   (Followers: 6)
International Journal of Environmental Health Engineering     Open Access   (Followers: 1)
International Journal of Environmental Health Research     Hybrid Journal   (Followers: 2)
International Journal of Environmental Policy and Decision Making     Hybrid Journal   (Followers: 3)
International Journal of Environmental Research     Hybrid Journal  
International Journal of Environmental Research and Public Health     Open Access   (Followers: 27)
International Journal of Environmental Science and Technology     Hybrid Journal   (Followers: 6)
International Journal of Environmental Studies     Hybrid Journal   (Followers: 4)
International Journal of Exergy     Hybrid Journal   (Followers: 2)
International Journal of Global Environmental Issues     Hybrid Journal   (Followers: 4)
International Journal of Global Sustainability     Open Access   (Followers: 2)
International Journal of Global Warming     Hybrid Journal  
International Journal of Greenhouse Gas Control     Partially Free   (Followers: 5)
International Journal of Hygiene and Environmental Health     Hybrid Journal   (Followers: 7)
International Journal of Logistics Research and Applications : A Leading Journal of Supply Chain Management     Hybrid Journal   (Followers: 16)
International Journal of Mining and Geo-Engineering     Open Access   (Followers: 1)
International Journal of Phytoremediation     Hybrid Journal   (Followers: 1)
International Journal of Process Systems Engineering     Hybrid Journal   (Followers: 1)
International Journal of Recycling of Organic Waste in Agriculture     Open Access   (Followers: 1)
International Journal of Reliability and Safety     Hybrid Journal   (Followers: 11)
International Journal of Renewable Energy Development     Open Access   (Followers: 6)
International Journal of Social Sciences and Management     Open Access   (Followers: 2)
International Journal of Soil, Sediment and Water     Open Access   (Followers: 4)
International Journal of Stress Management     Full-text available via subscription   (Followers: 6)
International Journal of Sustainable Construction Engineering and Technology     Open Access   (Followers: 8)
International Journal of Sustainable Engineering     Hybrid Journal   (Followers: 4)
International Journal of Sustainable Materials and Structural Systems     Hybrid Journal   (Followers: 1)
International Journal of Sustainable Society     Hybrid Journal   (Followers: 2)
International Journal of the Commons     Open Access   (Followers: 2)
International Journal of Toxicology     Hybrid Journal   (Followers: 17)
International Journal of Water Resources and Environmental Engineering     Open Access   (Followers: 12)
International Review of Environmental and Resource Economics     Full-text available via subscription   (Followers: 3)
Iranian Journal of Health and Environment     Open Access  
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 5)
Isotopes in Environmental and Health Studies     Hybrid Journal  
JACEE (Journal of Advanced Civil and Environmental Engineering)     Open Access  
Jahangirnagar University Environmental Bulletin     Open Access  
Journal for the History of Environment and Society     Open Access   (Followers: 3)
Journal of Bioremediation & Biodegradation     Open Access   (Followers: 1)
Journal of Earth Science & Climatic Change     Open Access   (Followers: 14)
Journal of Petroleum & Environmental Biotechnology     Open Access   (Followers: 1)
Journal of Advances in Environmental Health Research     Open Access   (Followers: 2)
Journal Of Advances In Natural Sciences     Open Access   (Followers: 1)
Journal of Aging and Environment     Hybrid Journal   (Followers: 4)
Journal of Agricultural and Environmental Ethics     Hybrid Journal   (Followers: 8)
Journal of Agricultural Chemistry and Environment     Open Access   (Followers: 3)
Journal of Agriculture and Ecology Research International     Open Access  
Journal of Air Pollution and Health (رتبه علمی- پژوهشی)     Open Access  
Journal of Anatolian Environmental and Animal Sciences     Open Access  
Journal of Applied Ecology     Hybrid Journal   (Followers: 249)
Journal of Applied Meteorology and Climatology     Hybrid Journal   (Followers: 42)
Journal of Applied Sciences and Environmental Management     Open Access   (Followers: 1)
Journal of Applied Toxicology     Hybrid Journal   (Followers: 19)
Journal of Applied Volcanology     Open Access   (Followers: 7)
Journal of Applied Water Engineering and Research     Hybrid Journal  
Journal of Arid Environments     Hybrid Journal   (Followers: 12)
Journal of Biochemical and Molecular Toxicology     Hybrid Journal   (Followers: 4)
Journal of Biosystems Engineering     Full-text available via subscription  
Journal of Chemical Ecology     Hybrid Journal   (Followers: 4)
Journal of Civil Engineering and Environmental Sciences     Open Access  
Journal of Climate     Hybrid Journal   (Followers: 60)
Journal of Climate Change     Full-text available via subscription   (Followers: 29)
Journal of Climate Change and Health     Open Access   (Followers: 7)
Journal of Coastal Research     Hybrid Journal   (Followers: 31)
Journal of Contaminant Hydrology     Hybrid Journal   (Followers: 23)
Journal of Earth, Environment and Health Sciences     Open Access   (Followers: 2)
Journal of East African Natural History     Full-text available via subscription   (Followers: 7)
Journal of Ecology     Hybrid Journal   (Followers: 165)
Journal of Ecology and Environment     Open Access   (Followers: 3)
Journal of Economic Development, Environment and People     Open Access   (Followers: 11)
Journal of Energy & Natural Resources Law     Hybrid Journal   (Followers: 5)
Journal of Energy and Environment Technology of Graduate School Siam Technology College     Open Access  
Journal of Environment and Earth Science     Open Access   (Followers: 12)
Journal of Environment and Ecology     Open Access   (Followers: 10)
Journal of Environment Pollution and Human Health     Open Access   (Followers: 3)
Journal of Environmental Analysis and Progress     Open Access  
Journal of Environmental and Agricultural Studies     Open Access   (Followers: 1)
Journal of Environmental and Public Health     Open Access   (Followers: 16)
Journal of Environmental Assessment Policy and Management     Hybrid Journal   (Followers: 5)
Journal of Environmental Chemical Engineering     Hybrid Journal   (Followers: 5)
Journal of Environmental Economics and Policy     Partially Free   (Followers: 5)
Journal of Environmental Education     Hybrid Journal   (Followers: 7)
Journal of Environmental Engineering and Landscape Management     Open Access   (Followers: 8)
Journal of Environmental Engineering and Science     Hybrid Journal   (Followers: 3)
Journal of Environmental Extension     Full-text available via subscription  
Journal of Environmental Geography     Open Access   (Followers: 8)
Journal of Environmental Law     Hybrid Journal   (Followers: 23)
Journal of Environmental Management     Hybrid Journal   (Followers: 45)
Journal of Environmental Management     Open Access   (Followers: 1)
Journal of Environmental Management and Tourism     Open Access   (Followers: 15)
Journal of Environmental Media     Hybrid Journal  
Journal of Environmental Planning and Management     Hybrid Journal   (Followers: 28)
Journal of Environmental Policy & Planning     Hybrid Journal   (Followers: 16)
Journal of Environmental Professionals Sri Lanka     Open Access  
Journal of Environmental Protection     Open Access   (Followers: 1)
Journal of Environmental Science and Health, Part A: Toxic/Hazardous Substances and Environmental Engineering     Hybrid Journal   (Followers: 5)
Journal of Environmental Science and Health, Part B: Pesticides, Food Contaminants, and Agricultural Wastes     Hybrid Journal   (Followers: 5)
Journal of Environmental Science and Technology     Open Access   (Followers: 7)
Journal of Environmental Sciences     Full-text available via subscription   (Followers: 8)
Journal of Environmental Statistics     Open Access   (Followers: 4)
Journal of Environmental Studies and Sciences     Partially Free   (Followers: 2)
Journal of Environmental Sustainability     Open Access   (Followers: 7)
Journal of Environments     Open Access  
Journal of Exposure Science and Environmental Epidemiology     Hybrid Journal   (Followers: 6)
Journal of Fisheries and Environment     Open Access  
Journal of Forest and Natural Resource Management     Open Access  
Journal of Freshwater Ecology     Hybrid Journal   (Followers: 14)
Journal of Geography, Environment and Earth Science International     Open Access   (Followers: 1)
Journal of Geoscience and Environment Protection     Open Access   (Followers: 1)
Journal of Great Lakes Research     Hybrid Journal   (Followers: 5)
Journal of Green Building     Full-text available via subscription   (Followers: 10)
Journal of Hazardous Materials     Hybrid Journal   (Followers: 13)
Journal of Hazardous Materials Advances     Open Access  
Journal of Health Management     Hybrid Journal   (Followers: 11)
Journal of Health Organisation and Management     Hybrid Journal   (Followers: 30)
Journal of Housing and the Built Environment     Hybrid Journal   (Followers: 10)
Journal of Human Behavior in the Social Environment     Hybrid Journal   (Followers: 8)
Journal of Hydrology X     Open Access   (Followers: 6)
Journal of Industrial Ecology     Hybrid Journal   (Followers: 21)
Journal of Integrative Environmental Sciences     Hybrid Journal   (Followers: 4)
Journal of International Maritime Safety, Environmental Affairs, and Shipping     Open Access   (Followers: 1)
Journal of Iron and Steel Research International     Hybrid Journal   (Followers: 8)
Journal of Korean Society of Environmental Engineers     Open Access  
Journal of Land Use Science     Hybrid Journal   (Followers: 4)
Journal of Management and Sustainability     Open Access   (Followers: 7)
Journal of Mega Infrastructure & Sustainable Development     Hybrid Journal  
Journal of Natural Resources and Development     Open Access   (Followers: 2)
Journal of Natural Sciences Research     Open Access   (Followers: 2)
Journal of Occupational and Environmental Hygiene     Hybrid Journal   (Followers: 6)
Journal of Operational Oceanography     Hybrid Journal   (Followers: 5)
Journal of Organizational Behavior     Hybrid Journal   (Followers: 63)
Journal of Outdoor and Environmental Education     Hybrid Journal   (Followers: 2)
Journal of Pharmacological and Toxicological Methods     Hybrid Journal   (Followers: 7)
Journal of Plant Science and Phytopathology     Open Access  
Journal of Policy Analysis and Management     Hybrid Journal   (Followers: 29)
Journal of Population and Sustainability     Open Access  
Journal of Reliable Intelligent Environments     Hybrid Journal  
Journal of Renewable and Sustainable Energy     Hybrid Journal   (Followers: 14)
Journal of Research in Forestry, Wildlife and Environment     Open Access   (Followers: 8)
Journal of Rural and Community Development     Open Access   (Followers: 5)
Journal of Safety Engineering     Open Access   (Followers: 37)
Journal of Safety Research     Hybrid Journal   (Followers: 76)
Journal of School Violence     Hybrid Journal   (Followers: 6)
Journal of Sustainability and Environmental Management     Open Access   (Followers: 6)
Journal of Sustainable Development     Open Access   (Followers: 25)
Journal of Sustainable Development Studies     Open Access   (Followers: 15)
Journal of Sustainable Society     Open Access   (Followers: 2)
Journal of the American Planning Association     Hybrid Journal   (Followers: 20)
Journal of the Atmospheric Sciences     Hybrid Journal   (Followers: 85)
Journal of Tropical Ecology     Hybrid Journal   (Followers: 15)
Journal of Urban and Environmental Engineering     Open Access   (Followers: 5)
Journal of Urban Ecology     Open Access   (Followers: 7)
Journal of Vietnamese Environment     Open Access   (Followers: 1)
Journal of Water and Environmental Nanotechnology     Open Access   (Followers: 2)
Journal of Water Security     Open Access   (Followers: 6)
Julius-Kühn-Archiv     Open Access  
Jurnal Kesehatan Lingkungan     Open Access  
Jurnal Manusia dan Lingkungan     Open Access  
Jurnal Pengendalian Pencemaran Lingkungan     Open Access   (Followers: 2)
Jurnal Presipitasi     Open Access   (Followers: 1)
Jurnal Rekayasa Kimia & Lingkungan     Open Access  
Jurnal Sains & Teknologi Lingkungan     Open Access  
Jurnal Wilayah dan Lingkungan     Open Access  
Knowledge Management Research & Practice     Hybrid Journal   (Followers: 16)
Koedoe : African Protected Area Conservation and Science     Open Access   (Followers: 3)
Lake and Reservoir Management     Hybrid Journal   (Followers: 7)
Landscape Ecology     Hybrid Journal   (Followers: 61)
Landscapes     Hybrid Journal   (Followers: 18)
Latin American Journal of Management for Sustainable Development     Hybrid Journal  
Letras Verdes. Revista Latinoamericana de Estudios Socioambientales     Open Access  
Limnological Review     Open Access   (Followers: 3)
Living Reviews in Landscape Research     Open Access  
Local Environment: The International Journal of Justice and Sustainability     Hybrid Journal   (Followers: 11)
Low Carbon Economy     Open Access   (Followers: 4)
Luna Azul     Open Access  
M+A. Revista Electrónica de Medioambiente     Open Access  
Macquarie Journal of International and Comparative Environmental Law     Full-text available via subscription   (Followers: 9)
Madagascar Conservation & Development     Open Access   (Followers: 2)
Management International Review     Hybrid Journal   (Followers: 7)
Management of Environmental Quality: An International Journal     Hybrid Journal   (Followers: 2)
Management of Sustainable Development     Open Access   (Followers: 4)
Marine Ecology     Hybrid Journal   (Followers: 28)
Marine Ecology Progress Series MEPS     Hybrid Journal   (Followers: 39)
Marine Environmental Research     Hybrid Journal   (Followers: 32)
Marine Pollution Bulletin     Hybrid Journal   (Followers: 37)
Materials for Renewable and Sustainable Energy     Open Access   (Followers: 6)
Medio Ambiente y Urbanizacion     Full-text available via subscription  
Mediterranean Geoscience Reviews     Hybrid Journal  
Membranes     Open Access   (Followers: 3)
Metabarcoding and Metagenomics     Open Access  
Michigan Journal of Sustainability     Open Access   (Followers: 1)
Microbial Risk Analysis     Full-text available via subscription  

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Similar Journals
Journal Cover
International Journal of Environmental Research and Public Health
Journal Prestige (SJR): 0.735
Citation Impact (citeScore): 2
Number of Followers: 27  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1660-4601 - ISSN (Online) 1661-7827
Published by MDPI Homepage  [258 journals]
  • IJERPH, Vol. 20, Pages 6802: Enhancing Driving Ability in Older Adults
           through Health Exercises and Physical Activity: A Randomized Controlled

    • Authors: Akihiko Katayama, Ayako Hase, Nobuyuki Miyatake
      First page: 6802
      Abstract: The global rise in the aging driving population has heightened concerns about traffic incidents involving this demographic. Beyond transportation, automobiles represent a vital lifeline for older adults, fostering social activities and influencing their health-related quality of life. This study explores improving and sustaining driving ability among older adults with anticipated declines through health-conscious exercises. Sixty-eight participants were randomly allocated into two groups. The exercise-oriented group (E-group) engaged in twelve 90 min health and exercise sessions over twelve weeks, while the control group (C-group) maintained their regular daily routines and did not receive any specific interventions during this period. The focal point of assessment was driving ability, as evaluated by a person using a real car on public roads without using a simulator. Driving ability and physical fitness were assessed before the intervention in both groups. Post-intervention measurements occurred twelve weeks after the initial gauging, encompassing both cohorts. Comparative analysis of pre- and post-intervention changes was executed between the two groups. The E-group demonstrated improved overall driving ability compared to the C-group. The results suggest that healthy exercise and physical activity may maintain and enhance driving ability for older adults.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196802
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6803: Demographic and Clinical Characteristics of
           Mpox Patients Attending an STD Clinic in Lisbon

    • Authors: Margarida Brito Caldeira, José Miguel Neves, Mafalda Pestana, Rita Corte-Real, Maria José Borrego, Rita Cordeiro, Jorge Machado, Ana Pelerito, Isabel Lopes De Carvalho, Maria Sofia Núncio, Cândida Fernandes
      First page: 6803
      Abstract: Mpox is a viral disease caused by the monkeypox virus, which marked the year of 2022 with a global outbreak. While previously considered to be a zoonosis of almost exclusive animal-to-human transmission, the current outbreak has been attributed to human-to-human transmission, particularly sexual transmission. As a new sexually transmissible disease, we studied the epidemiological and clinical features, as well as the concomitant occurrence of other sexually transmissible diseases, treatment approach, and outcome of our 291 patients, in the current outbreak. We found a total of 169 concomitant sexually transmissible infections of bacterial and viral origins, corresponding to 107 patients. Neisseria gonorrhoeae was the most common agent, particularly in the anal location. With this work, we emphasize the need for a thorough epidemiological and medical history, as well as a concomitant complete laboratorial screening for other STIs in patients with confirmed or suspected mpox.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196803
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6804: Seeking Health in a Digital World: Exploring
           Immigrant Parents’ Quest for Child Health Information—A
           Scoping Review

    • Authors: Annina E. Zysset, Patricia Schwärzler, Julia Dratva
      First page: 6804
      Abstract: During pregnancy and early parenthood, parents’ strong interest in pediatric health information presents a valuable opportunity to positively impact long-term health-seeking behavior and overall child health. In line with the increasing prevalence of digital transformation, a scoping review was conducted to explore two key aspects: (1) information seeking and use of digital health information among immigrant parents, and (2) associated reasons and factors. The literature search covered the period until July 2022, using Web of Science, MEDLINE, and CINAHL Complete databases. Out of 625 articles, 12 were included, comprising six qualitative, five quantitative studies, and one review. The majority of studies focused on immigrants in North America, primarily from Latin America and Asia. The studies varied in topics and methodologies, making it challenging to draw general conclusions. Nevertheless, while most immigrant parents rely on digital information on child health, they often prefer human sources such as family, friends, or healthcare providers. Trustworthiness and accessibility emerged as critical criteria for health resources. Two focus group discussions, derived from the results of the review, confirmed these findings for migrant mothers in Switzerland.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196804
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6805: Disabled People or Their Support
           Persons’ Perceptions of a Community Based Multi-Sensory Environment
           (MSE): A Mixed-Method Study

    • Authors: Amanda Wilkinson, Allyson Calder, Beth Elliott, Ryan Rodger, Hilda Mulligan, Leigh Hale, Meredith Perry
      First page: 6805
      Abstract: Multi-sensory environments (MSEs) are specialised spaces purposely designed to stimulate the senses, whilst providing a calming and relaxing environment for leisure and enjoyment, predominantly intended for disabled people. Most MSEs are in institutions, hospitals, or educational settings, with a few in community-based settings. We explored disabled users’ experiences of a community based MSE in a large metropolitan area in New Zealand, with a view to expanding access to MSE-type environments within the area. We used a convergent mixed method design with a web-based electronic survey (e-survey; n = 105), as well as semi-structured interviews (n = 14) with disabled MSE users (adults and children), who were supported, where necessary, by their support person/s. We collected the MSE users’ demographics, frequency of use with respect to age, disability, and ethnicity, and experiences of the room, equipment, and accessibility. The participants and their support persons’ perspectives about their experiences of using the MSE were represented by four themes: (i) Self-determination; (ii) Enhancing wellbeing opportunities; (iii) the MSE itself; (iv) Accessibility. While the MSE was considered positively, the MSE experience could be enhanced by addressing access challenges and broadening the scope of equipment to improve the usability and make it a more inclusive environment for all.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196805
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6806: A COVID-19 Outbreak in a Large
           Meat-Processing Plant in England: Transmission Risk Factors and Controls

    • Authors: Yiqun Chen, Helen Beattie, Andrew Simpson, Gillian Nicholls, Vince Sandys, Chris Keen, Andrew D. Curran
      First page: 6806
      Abstract: The meat-processing industry had frequent COVID-19 outbreaks reported worldwide. In May 2021, a large meat-processing plant in the UK had an outbreak affecting 4.1% (63/1541) of workers. A rapid on-site investigation was conducted to understand the virus transmission risk factors and control measures. This included observational assessments of work activities, control measures, real-time environmental measurements and surface microbial sampling. The production night-shift attack rate (11.6%, 44/380) was nearly five times higher than the production day-shift (2.4%, 9/380). Shared work transport was provided to 150 staff per dayshift and 104 per nightshift. Production areas were noisy (≥80 dB(A)) and physical distancing was difficult to maintain. Face visors were mandatory, additional face coverings were required for some activities but not always worn. The refrigeration system continuously recirculated chilled air. In some areas, the mean temperature was as low as 4.5 °C and mean relative humidity (RH) was as high as 96%. The adequacy of ventilation in the production areas could not be assessed reliably using CO2, due to the use of CO2 in the packaging process. While there were challenges in the production areas, the observed COVID-19 control measures were generally implemented well in the non-production areas. Sixty surface samples from all areas were tested for SARS-CoV-2 RNA and 11.7% were positive. Multi-layered measures, informed by a workplace specific risk assessment, are required to prevent and control workplace outbreaks of COVID-19 or other similar respiratory infectious diseases.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196806
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6807: Teledentistry and Forensic Odontology:
           Qualitative Study on the Capacity of Implementation

    • Authors: Céline Sabourin, Nicolas Giraudeau, Eric Baccino, Frédéric Camarasa, Laurent Martrille, Camille Inquimbert
      First page: 6807
      Abstract: The postmortem identification of people without an identity is performed either by using DNA, dental charts, or fingerprints (until advanced decomposition prevents their study). The lack of forensic dentists who can conduct identifications lead us to reflect on the use of digital technology in this area. The aim of this study was to validate the organizational capacity of using teledentistry for the identification of bodies in a forensic medicine department. A mixed observational study was conducted on 55 cases between July 2020 and February 2021 in the Forensic Medicine and Thanatology Department of Montpellier University Hospital. The protocol was structured in five steps: an initial interview with the agent (a forensic autopsy technician/caregiver specialized in forensic medicine), regarding the idea they had in terms of using telemedicine in their daily practice; agent training in the telemedicine system; realization of a clinical examination using an intra-oral camera by the agent; data analysis by a dental surgeon; final interview with the agent. The study was conducted on 55 subjects. The average age was 54 years old, with more than two-thirds of the patients being male (69%). The videos had an average duration of 29 min. There was an increase in visit duration when rigidity was high; this was also the case when there were many dental specificities in the oral cavity. The quality of the videos was either good or excellent. This study showed that remote identification could be considered as a new non-invasive identification tool. Many features were analyzed to create a training guide for forensic institutes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196807
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6808: Electronic Cigarette Harms: Aggregate
           Evidence Shows Damage to Biological Systems

    • Authors: Stephen L. Hamann, Nipapun Kungskulniti, Naowarut Charoenca, Vijj Kasemsup, Suwanna Ruangkanchanasetr, Passara Jongkhajornpong
      First page: 6808
      Abstract: Evidence of the harms of e-cigarettes has been unfolding slowly and has been documented in many reviews and reports worldwide. A narrative review of new evidence is presented since, as research has continued, newly aggregated evidence of the dangers of electronic cigarettes on the brain, heart, and lungs is vital to inform decisions on restricting the use of e-cigarettes. Several biomedical research databases were searched for electronic cigarette health effects, emphasizing reviews, systematic reviews, and meta-analyses. Over 50 review studies, primarily in 2022 and 2023, illustrate some of the latest information on e-cigarette harms. Results show studies of respiratory, neurological, and cardiovascular effects. Researchers call for expanding studies through new methods to elaborate on initial findings of multiple harms emerging in clinical investigations. Since the use of electronic cigarettes for adult cessation is not sanctioned in most countries, it is clear that health authorities see significant costs to the health of the general population if the promotion and use of electronic cigarettes occur worldwide. Regulatory action to control electronic cigarettes should consider the substantial evidence of electronic cigarette harm.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196808
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6809: Nurses’ Roles, Responsibilities and
           Actions in the Hospital Discharge Process of Older Adults with Health and
           Social Care Needs in Three Nordic Cities: A Vignette Study

    • Authors: Ann E. M. Liljas, Natasja K. Jensen, Jutta Pulkki, Janne Agerholm
      First page: 6809
      Abstract: The hospital discharge process of older adults in need of both medical and social care post hospitalisation requires the involvement of nurses at multiple levels across the different phases. This study aims to examine and compare what roles, responsibilities and actions nurses take in the hospital discharge process of older adults with complex care needs in three Nordic cities: Copenhagen (Denmark), Stockholm (Sweden) and Tampere (Finland). A vignette-based interview study consisting of three cases was conducted face-to-face with nurses in Copenhagen (n = 11), Stockholm (n = 16) and Tampere (n = 8). The vignettes represented older patients with medical conditions, cognitive loss and various home situations. The interviews were conducted in the local language, recorded, transcribed and analysed thematically. The findings show that nurses exchanged information with both healthcare (all cities) and social care services (Copenhagen, Tampere). Nurses in all cities, particularly Stockholm, reported to inform, and also convince patients to make use of home care. Nurses in Stockholm and Tampere reported that some patients refuse care due to co-payment. Nurses in these two cities were more likely to involve close relatives, possibly due to such costs. Not accepting care, due to costs, poses inequity in later life. Additionally, organisational changes towards a shift in location of care, i.e., from hospital to home, and from professional to informal caregivers, might be reflected in the work of the nurses through their initiatives to convince older patients to accept home care and to involve close relatives.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-22
      DOI: 10.3390/ijerph20196809
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6810: School Memories about Homophobic Bullying: A
           Study Based on Cultural-Historical Psychology

    • Authors: Rômulo Lopes da Silva, Vera Lucia Trevisan de Souza
      First page: 6810
      Abstract: The expression of homophobic violence in schools reveals the urgency of an analytical approach to debate the impact of this phenomenon on students’ mental health. This article seeks to debate and better comprehend school memories from young gays, lesbians, and bisexuals, as well as to discuss how homophobic bullying affected their school trajectories. This study is based on cultural-historical psychology in intersection with gender and sexuality studies. In-depth online interviews were conducted with three young subjects who identified themselves as non-heterosexual. The interviews were recorded, transcribed, and analyzed through the analytical discourse tool defined as Nuclei of Meanings. The results were organized in two topics of discussion: (a) the problems associated with non-heterosexual identity in schools; (b) the search for other ways of experiencing sexual identity in school. Throughout the article, reflections were held about the challenges participants had to deal with in order to regularly attend school and be educated, as well as the obstacles they faced in building their own ways of recognizing their sexual identity. The unique ways in which these young subjects took a stand in the face of homophobic situations show new methods to create educational interventions in order to include sexual diversity and openness to different possibilities of being and acting.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196810
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6811: Preventing Perinatal Depression: Cultural
           Adaptation of the Mothers and Babies Course in Kenya and Tanzania

    • Authors: Huynh-Nhu Le, Elena McEwan, Maureen Kapiyo, Fidelis Muthoni, Tobias Opiyo, Kantoniony M. Rabemananjara, Shannon Senefeld, John Hembling
      First page: 6811
      Abstract: Pregnant women and mothers in sub-Saharan Africa are at high risk for perinatal depression, warranting a need to develop culturally tailored interventions to prevent perinatal depression. This paper documents the process of adapting an evidence-based preventive intervention developed in the United States, the Mothers and Babies Course (MBC), to fit the contexts of rural pregnant women and mothers of young children in Kenya and Tanzania using the updated Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Data from informant interviews and field observations from the planning and implementation phases were used to make adaptations and modifications of the MBC for perinatal women through the eight aspects of FRAME. Follow-up field visits and reflection meetings with case managers and intervention participants indicated that the adapted version of the MBC was well accepted, but fidelity was limited due to various implementation barriers. The FRAME provided an optimal structure to outline the key adaptations and modifications of a preventive intervention intended to maximize engagement, delivery, and outcomes for high-risk perinatal women in rural settings.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196811
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6812: Coping, Supports and Moral Injury: Spiritual
           Well-Being and Organizational Support Are Associated with Reduced Moral
           Injury in Canadian Healthcare Providers during the COVID-19 Pandemic

    • Authors: Andrea M. D’Alessandro-Lowe, Mauda Karram, Kim Ritchie, Andrea Brown, Heather Millman, Emily Sullo, Yuanxin Xue, Mina Pichtikova, Hugo Schielke, Ann Malain, Charlene O’Connor, Ruth Lanius, Randi E. McCabe, Margaret C. McKinnon
      First page: 6812
      Abstract: Healthcare providers (HCPs) have described the onset of shame- and trust-violation-related moral injuries (MI) throughout the COVID-19 pandemic. Previous research suggests that HCPs may turn to various coping methods and supports, such as spirituality/religiosity, substance use, friends/family or organizational support, to manage workplace stress. It remains unknown, however, if similar coping methods and supports are associated with MI among this population. We explored associations between MI (including the shame and trust-violation presentations individually) and coping methods and supports. Canadian HCPs completed an online survey about their mental health and experiences during the COVID-19 pandemic, including demographic indices (e.g., sex, age, mental health history) and measures of MI, organizational support, social support, spiritual well-being, self-compassion, alcohol use, cannabis use and childhood adversity. Three hierarchical multiple linear regressions were conducted to assess the associations between coping methods/supports and (i) MI, (ii) shame-related MI and (iii) trust-violation-related MI, when controlling for age, mental health history and childhood adversity. One hundred and seventy-six (N = 176) HCPs were included in the data analysis. Spiritual well-being and organizational support were each significantly associated with reduced total MI (p’s < 0.001), shame-related MI (p = 0.03 and p = 0.02, respectively) and trust-violation-related MI (p’s < 0.001). Notably, comparison of the standardized beta coefficients suggests that the association between trust-violation-related MI and both spiritual well-being and organizational support was more than twice as great as the associations between these variables and shame-related MI, emphasizing the importance of these supports and the trust-violation outcomes particularly. Mental health history (p = 0.02) and self-compassion (p = 0.01) were additionally related to shame-related MI only. Our findings indicate that heightened levels of spiritual well-being and organizational support were associated with reduced MI among HCPs during the COVID-19 pandemic. Rather than placing sole responsibility for mental health outcomes on HCPs individually, organizations can instead play a significant role in mitigating MI among staff by implementing evidence-informed organizational policies and interventions and by considering how supports for spiritual well-being may be implemented into existing models of care where relevant for employees.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196812
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6813: Exercise Effects on Health-Related Quality of
           Life (HRQOL), Muscular Function, Cardiorespiratory Function, and Body
           Composition in Smokers: A Narrative Review

    • Authors: Nduduzo Msizi Shandu, Musa Lewis Mathunjwa, Ina Shaw, Brandon Stuwart Shaw
      First page: 6813
      Abstract: Smoking is amongst the leading global threats with high incidences of preventable premature mortality, morbidity, and various chronic diseases. The World Health Organization (WHO) proclaims a decrease in the prevalence of daily smoking in both males and females from 1980 to 2012, however, the number of regular smokers since then has exponentially increased. The low socio-income status individuals contribute greatly towards tobacco-attributable diseases due to limited access to healthcare systems, mostly in developing countries as compared to developed countries. Smoking affects the optimal functioning of the human body, which results in altered body system processes. Although a high intake of nicotine can lead to prolonged adherence and dependence on smoking, other factors, such as an individual’s level of health-related quality of life (HRQOL), stress, depression, and anxiety, can produce similar effects. Smoking has a wide impact on lifestyle factors, which explains the increase in the number of sedentary smokers with decreased health fitness levels and poor lifestyle conditions. Therefore, this study seeks to investigate the exercise effects on health-related quality of life (HRQOL), muscular function, cardiorespiratory function, and body composition in smokers. Concurrently, exercise as an intervention has been sourced as a rehabilitation strategy during smoking cessation programmes to restore the diminishing health components, however, a high rate of relapse occurs due to intolerable withdrawal symptoms.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196813
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6814: The Prevalence of Metabolic Syndrome and Its
           Components in Firefighters: A Systematic Review and Meta-Analysis

    • Authors: Ashley Beckett, Jake Riley Scott, Angel Marie Chater, Louise Ferrandino, Jeffrey William Frederick Aldous
      First page: 6814
      Abstract: Previous studies consistently report a high prevalence of cardiovascular disease (CVD) risk factors among firefighters. However, the clustering of CVD risk factors, defined as metabolic syndrome (MetSyn), has received little attention by comparison. Therefore, the aim of this study was to estimate the pooled prevalence of MetSyn among firefighters. Using combinations of free text for ‘firefighter’ and ‘metabolic syndrome’, databases were searched for eligible studies. Meta-analyses calculated weighted pooled prevalence estimates with 95% confidence intervals (CI) for MetSyn, its components and overweight/obesity. Univariate meta-regression was performed to explore sources of heterogeneity. Of 1440 articles screened, 25 studies were included in the final analysis. The pooled prevalence of MetSyn in 31,309 firefighters was 22.3% (95% CI: 17.7–27.0%). The prevalences of MetSyn components were hypertension: 39.1%; abdominal obesity: 37.9%; hypertriglyceridemia: 30.2%; dyslipidemia: 30.1%; and hyperglycemia: 21.1%. Overweight and obesity prevalence rates in firefighters were 44.1% and 35.6%, respectively. Meta-regression revealed that decreased risk of bias (RoB) score and increased body mass index (BMI) were positively associated with an increase in MetSyn prevalence. Since one in five firefighters may meet the criteria for MetSyn, novel interventions should be explored to both prevent MetSyn and reduce the onset of CVD risk factors.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196814
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6815: Recognizing Relational Interactions with
           Social Institutions in Refugee Children’s Experiences of
           Intertwining Vulnerability and Agency

    • Authors: Jeanette A. Lawrence, Agnes E. Dodds, Ida Kaplan, Maria M. Tucci
      First page: 6815
      Abstract: In this paper, we examine relational interactions between refugee children and social institutions, building the case for the recognition of the co-occurrence and intertwining of vulnerability and agency in children’s experiences in diverse refugee situations. This developmental relational approach offers refinement of a general relational worldview by specifying how vulnerable and agentic experiences are co-constructed by children and adult individuals and institutions. We analyze the conceptual roots of vulnerable and agentic experiences, and use the concept of co-construction to specify the processes and outcomes of interactive relational experiences. Evidence from example studies of the intertwining of vulnerability and agency in specific refugee situations demonstrates how refugee children contribute to power-oriented experiences. Due recognition of the relational co-construction of intertwining vulnerable and agentic experiences provides a basis for refining generalized relational observations, and a fine-grained basis for developing policies and procedures to dispel ambivalence to refugee children and to change inequitable policies and practices.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196815
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6816: Comprehensive Knowledge of HIV and AIDS and
           Related Factors in Angolans Aged between 15 and 49 Years

    • Authors: Neida Neto Vicente Ramos, Inês Fronteira, Maria do Rosário O. Martins
      First page: 6816
      Abstract: A comprehensive knowledge of HIV and AIDS among men and women in Africa is reportedly low. To the best of our knowledge, no studies using any definition of comprehensive knowledge of HIV and AIDS have been conducted in Angola. To address this gap, we aimed to describe the comprehensive knowledge held by individuals aged between 15 and 49 years regarding HIV and AIDS and some associated factors, using the most recent Angolan demographic and health survey (DHS). Using an observational, cross-sectional design, we analyzed data collected from 19,785 individuals aged between 15 and 49 years for the 2016 DHS in Angola. We conducted a logistic regression analysis of descriptive and complex samples to examine the data and to unravel possible factors associated with having a comprehensive knowledge of HIV and AIDS. Almost half of the respondents (47.7%) had a general comprehensive knowledge of HIV and AIDS. Individuals who watched television (adjusted odds ratio [aOR]: 2.40; 95% CI: 2.11, 2.72) or read newspapers and magazines (aOR: 1.99; 95% CI: 1.72, 2.30) more than once a week had higher odds of having a comprehensive knowledge of HIV and AIDS compared to those who did not. Similarly, having completed primary education and above (aOR: 1.83; 95% CI: 1.67, 2.00) or living in urban areas (aOR: 1.51; 95% CI: 1.34, 1.71) increased the likelihood of individuals having a comprehensive knowledge of HIV and AIDS compared to their counterparts. These results reflect inequalities that require further attention at either a research or a political level. Nevertheless, we consider that these results can assist decision-makers in advocating for continuous investment in HIV health literacy and in adapting global solutions to local Angolan contexts.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-23
      DOI: 10.3390/ijerph20196816
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6817: Predicting Unmet Healthcare Needs in
           Post-Disaster: A Machine Learning Approach

    • Authors: Hyun Jin Han, Hae Sun Suh
      First page: 6817
      Abstract: Unmet healthcare needs in the aftermath of disasters can significantly impede recovery efforts and exacerbate health disparities among the affected communities. This study aims to assess and predict such needs, develop an accurate predictive model, and identify the key influencing factors. Data from the 2017 Long-term Survey on the Change of Life of Disaster Victims in South Korea were analyzed using machine learning techniques, including logistic regression, C5.0 tree-based model, and random forest. The features were selected based on Andersen’s health behavior model and disaster-related factors. Among 1659 participants, 31.5% experienced unmet healthcare needs after a disaster. The random forest algorithm exhibited the best performance in terms of precision, accuracy, Under the Receiver Operating Characteristic (AUC-ROC), and F-1 scores. Subjective health status, disaster-related diseases or injuries, and residential area have emerged as crucial factors predicting unmet healthcare needs. These findings emphasize the vulnerability of disaster-affected populations and highlight the value of machine learning in post-disaster management policies for decision-making.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-24
      DOI: 10.3390/ijerph20196817
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6818: Impact of the TEI Peer Tutoring Program on
           Coexistence, Bullying and Cyberbullying in Spanish Schools

    • Authors: Vanesa Sainz, O’Hara Soto-García, Juan Calmaestra, Antonio Maldonado
      First page: 6818
      Abstract: The TEI peer tutoring program (in Spanish, Tutoría entre Iguales, hereinafter TEI ) is Spain’s most important coexistence program for the prevention of violence and bullying in secondary schools and one of the first worldwide. So that we may better appreciate the effectiveness and benefits of this program, a comparative study has been developed between four schools that are presently following this preventive strategy (TEI centres) and four other schools that do not carry out the TEI program (non-TEI centres). Controlling the other sociodemographic variables, students’ perception of coexistence, bullying and cyberbullying has been evaluated. In total, 1015 secondary school students belonging to eight schools from four autonomous communities in Spain participated. The results reveal that the students of TEI centres have a more favourable perception of educational coexistence and indicate lower rates of bullying and cyberbullying than those studying at non-TEI centres. These results highlight the benefits of the TEI program and the need to continue promoting and expanding these preventing bullying strategies in schools.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-24
      DOI: 10.3390/ijerph20196818
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6819: Therapeutic Lifestyle Intervention Targeting
           Enhanced Cardiometabolic Health and Function for Persons with Chronic
           Spinal Cord Injury in Caregiver/Care-Receiver Co-Treatment: A Study
           Protocol of a Multisite Randomized Controlled Trial

    • Authors: Gregory E. Bigford, Luisa F. Betancourt, Susan Charlifue, Mark S. Nash
      First page: 6819
      Abstract: Background: Chronic spinal cord injury (SCI) significantly accelerates morbidity and mortality, partly due to the increased risk of cardiometabolic diseases (CMD), including neurogenic obesity, dyslipidemia, and impaired glucose metabolism. While exercise and dietary interventions have shown some transient benefits in reducing CMD risk, they often fail to improve clinically relevant disease markers and cardiovascular events. Moreover, SCI also places caregiving demands on their caregivers, who themselves experience health and functional decline. This underscores the need for more substantial interventions that incorporate appropriate physical activity, heart-healthy nutrition, and behavioral support tailored to the SCI population. Objectives: This randomized clinical trial (RCT) protocol will (1) assess the health and functional effects, user acceptance, and satisfaction of a 6-month comprehensive therapeutic lifestyle intervention (TLI) adapted from the National Diabetes Prevention Program (DPP) for individuals with chronic SCI and (2) examine the impact of a complementary caregiver program on the health and function of SCI caregivers and evaluate user acceptance and satisfaction. Caregivers (linked with their partners) will be randomized to ‘behavioral support’ or ‘control condition’. Methods: Dyadic couples comprise individuals with SCI (18–65 years, >1-year post-injury, ASIA Impairment Scale A-C, injury levels C5-L1) and non-disabled SCI caregivers (18–65 years). Both groups undergo lock-step circuit resistance training, a calorie-restricted Mediterranean-style diet, and 16 educational sessions focused on diet/exercise goals, self-monitoring, psychological and social challenges, cognitive behavioral therapy, and motivational interviewing. The outcome measures encompass the cardiometabolic risks, cardiorespiratory fitness, inflammatory stress, multidimensional function, pain, life quality, independence, self-efficacy, program acceptance, and life satisfaction for SCI participants. The caregiver outcomes include multidimensional function, pain, quality of life, independence, and perceived caregiver burden. Discussion/Conclusions: This study evaluates the effects and durability of a structured, multi-modal intervention on health and function. The results and intervention material will be disseminated to professionals and consumers for broader implementation. Trial Registration:, ID: NCT02853149 Registered 2 August 2016.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196819
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6820: Impact of an Educational Intervention for
           Healthy Eating in Older Adults: A Quasi-Experimental Study

    • Authors: José Ortiz Segarra, Ulises Freire Argudo, Dayanara Delgado López, Stalin Ortiz Mejía
      First page: 6820
      Abstract: The elderly population in Ecuador is increasing rapidly, with an increasing incidence of diet-related diseases. The elderly living in the community seek alternative and complementary methods to improve their diet and quality of life. This study aimed to investigate the impact of an educational intervention on knowledge related to healthy eating among older adults. This intervention is rooted in the principles of meaningful learning and incorporates culturally adapted materials. A quasi-experimental study design was employed using a pre-test–post-test control group. Study participants were a total of 109 elderly (intervention: n = 51, control: n = 58) people in Cuenca, Ecuador. The educational intervention based on Ausubel’s theory of significant learning and Vygotsky’s sociocultural theory was programmed to be carried out for one session per week, over 24 weeks, with a duration of 120 min per session. The measures were the general characteristics of the study participants and knowledge about necessary amounts, food sources and the consequences of deficits or excesses in the consumption of macro- and micronutrients. Data were collected from August 2018 to February 2019. Statistically significant differences were observed between the intervention group (IG) and the control group (CG) in terms of knowledge about healthy eating for older adults following the educational intervention. The outcomes of this study strongly suggest the efficacy of the program in improving knowledge related to healthy eating among older adults. Healthcare providers should prioritize food education based on meaningful learning, utilizing culturally adapted materials for the elderly individuals residing within the community.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196820
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6821: Workplace Bullying Seen from the Perspective
           of Bystanders: Effects on Engagement and Burnout, Mediating Role of
           Positive and Negative Affects

    • Authors: Joséphine Pascale Ada Manga, Pascale Desrumaux, Willys N’dong Nguema
      First page: 6821
      Abstract: The first and original aim of this study was to measure the impact of workplace bullying (WB) seen from the perspective of the witnesses (bystanders) on the work engagement and the burnout of these bystanders. The second aim was to test the mediating roles of affects between WB seen from the perspective of bystanders and two resulting variables, bystanders’ work engagement and bystanders’ burnout. This study was conducted using self-administered questionnaires with WB bystanders (n = 222) from the Cameroonian health sector. The results indicated that positive and negative affects played mediating roles between WB as seen by witnesses and the two resulting variables, burnout and work engagement. This study offers new avenues for intervention on the issue of WB bystanders. In addition to prevention for victims, witnesses experiencing bullying as bystanders in Cameroon must be supported and accompanied by occupational health services, occupational and psychosocial risk prevention workers, psychologists, as well as human resources.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196821
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6822: Emergency Department Syndromic Surveillance
           to Monitor Tick-Borne Diseases: A 6-Year Small-Area Analysis in
           Northeastern Italy

    • Authors: Massimiliano Colucci, Marco Fonzo, Liana Miccolis, Irene Amoruso, Sara Mondino, Andrea Trevisan, Romina Cazzaro, Tatjana Baldovin, Chiara Bertoncello
      First page: 6822
      Abstract: Tick-borne diseases (TBD) are endemic in Europe. However, surveillance is currently incomplete. Alternative strategies need to be considered. The aim of this study was to test an Emergency Department Syndromic Surveillance (EDSyS) system as a complementary data source to describe the impact of tick bites and TBD using a small-area analysis approach and to monitor the risk of TBD to target prevention. ED databases in the Local Health Authority 8 District (Veneto, Italy) were queried for tick-bite and TBD-related visits between January 2017 and December 2022. Hospitalisations were also collected. Events involving the resident population were used to calculate incidence rates. A total of 4187 ED visits for tick-bite and 143 for TBD were recorded; in addition, 62 TBD-related hospitalisations (of which 72.6% in over 50 s and 22.6% in over 65 s). ED visits peaked in spring and in autumn, followed by a 4-week lag in the increase in hospital admissions. The small-area analysis identified two areas at higher risk of bites and TBD. The use of a EDSyS system allowed two natural foci to be identified. This approach proved useful in predicting temporal and geographic risk of TBD and in identifying local endemic areas, thus enabling an effective multidisciplinary prevention strategy.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196822
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6823: Real-Time Measurements of
           Indoor–Outdoor Exchange of Gaseous and Particulate Atmospheric
           Pollutants in an Urban Area

    • Authors: Elisabeth Alonso-Blanco, Francisco Javier Gómez-Moreno, Elías Díaz-Ramiro, Javier Fernández, Esther Coz, Carlos Yagüe, Carlos Román-Cascón, Adolfo Narros, Rafael Borge, Begoña Artíñano
      First page: 6823
      Abstract: Air pollution is one of the greatest environmental risks to health, causing millions of deaths and deleterious health effects worldwide, especially in urban areas where citizens are exposed to high ambient levels of pollutants, also influencing indoor air quality (IAQ). Many sources of indoor air are fairly obvious and well known, but the contribution of outside sources to indoor air still leads to significant uncertainties, in particular the influence that environmental variables have on outdoor/indoor pollutant exchange mechanisms. This is a critical aspect to consider in IAQ studies. In this respect, an experimental study was performed at a public site such as a university classroom during a non-academic period in Madrid city. This includes two field campaigns, in summer (2021) and winter (2020), where instruments for measuring gases and particle air pollutants simultaneously measured outdoor and indoor real-time concentrations. This study aimed to investigate the dynamic variations in the indoor/outdoor (I/O) ratios in terms of ambient outdoor conditions (meteorology, turbulence and air quality) and indoor features (human presence or natural ventilation). The results show that the I/O ratio is pollutant-dependent. In this sense, the infiltration capacity is higher for gaseous compounds, and in the case of particles, it depends on the particle size, with a higher infiltration capacity for smaller particles (<PM2.5). Additionally, under specific situations of high atmospheric stability, the concentrations of gases derived from traffic tend to accumulate in the room, keeping the background concentrations. These concentrations decreased when room ventilation was produced simultaneously with well-ventilated (high wind speed) external conditions. This suggests that the meteorology and turbulence parameters played a key role in influencing indoor ambient pollution conditions by enhancing the dispersion or accumulation of pollutants. The obtained results highlight the high number of variables involved in the outdoor/indoor exchange of air pollutants and, consequently, how complex its study is. Thus, the knowledge of these factors is critical for understanding the behavior of indoor pollutants and controlling human exposure in indoor environments.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196823
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6824: Differences in the Effects of Work
           Environment on Health Problems and Satisfaction of Working Condition by
           Gender: The 6th Korean Working Conditions Survey

    • Authors: Ko Myungsun, Chae Hyeseon, Park Sooin, Kim Insoo
      First page: 6824
      Abstract: This study investigated gender differences in exposure to hazardous factors, health problems, and work environment satisfaction and identified the effects of such differences on farmworkers in Korea. Through the 6th Korean Working Conditions Survey (KWCS) conducted by the Occupational Safety and Health Research Institute (OSHRI), the raw data on 2347 farmworkers were analyzed to present descriptive statistics for demographic characteristics, exposure to hazardous factors, health problems, and work environment satisfaction. We compared genders using chi-squared tests and investigated the effects of gender-specific working conditions on work-related health problems and work environment satisfaction using multivariate logistic analysis. The results were presented as an odds ratio (OR) with 95% confidence interval. Job position predicted work-related health problems in male farmworkers and work environment satisfaction in female farmworkers. Furthermore, female farmworkers perceived themselves to have more health problems than male farmworkers. Nevertheless, female farmworkers received less health and safety information and had lower work environment satisfaction compared to male farmworkers. The findings may improve the occupational welfare of farmworkers through continuous enhancement of the agricultural labor environment.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196824
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6825: BioChainReward: A Secure and Incentivised
           Blockchain Framework for Biomedical Data Sharing

    • Authors: Mahmoud Elkhodr, Ergun Gide, Omar Darwish, Shorouq Al-Eidi
      First page: 6825
      Abstract: In the era of digital healthcare, biomedical data sharing is of paramount importance for the advancement of research and personalised healthcare. However, sharing such data while preserving user privacy and ensuring data security poses significant challenges. This paper introduces BioChainReward (BCR), a blockchain-based framework designed to address these concerns. BCR offers enhanced security, privacy, and incentivisation for data sharing in biomedical applications. Its architecture consists of four distinct layers: data, blockchain, smart contract, and application. The data layer handles the encryption and decryption of data, while the blockchain layer manages data hashing and retrieval. The smart contract layer includes an AI-enabled privacy-preservation sublayer that dynamically selects an appropriate privacy technique, tailored to the nature and purpose of each data request. This layer also features a feedback and incentive mechanism that incentivises patients to share their data by offering rewards. Lastly, the application layer serves as an interface for diverse applications, such as AI-enabled apps and data analysis tools, to access and utilise the shared data. Hence, BCR presents a robust, comprehensive approach to secure, privacy-aware, and incentivised data sharing in the biomedical domain.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196825
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6826: Development of the Refugees and Asylum
           Seekers Occupational Satisfaction (RASOS) Assessment Tool

    • Authors: Pavlina Psychouli, Ioulia Louta, Constantina Christodoulou
      First page: 6826
      Abstract: The objective of this study was to develop an occupation-centered and client-centered assessment tool for refugees and asylum seekers. A preliminary tool outline was produced based on a literature review, while considering previous published tools’ strengths and limitations. A qualitative study was undertaken via focus groups to improve on the tool’s design and adequacy for its purpose, resulting in the creation of a pilot version of the tool. Convenience sampling included 8 Greek and Cypriot professional and student occupational therapists with experience in the field, 8 international expert occupational therapists, 4 laypeople, 4 humanitarian professionals, and 5 refugees and asylum seekers. Basic qualitative content and thematic analysis led to topics regarding tool modifications that concerned categorization, formation/structure, wording, administration, and assessment scale. Corresponding tool revisions ensued. This study led to the development of the pilot version of the Refugees and Asylum Seekers Occupational Satisfaction (RASOS), which can also be used to identify underlying personal and environmental factors that contribute to self-perceived low satisfaction. A future quantitative study is required to establish the psychometric properties of the tool.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196826
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6827: The Influence of Short-Term Weather
           Parameters and Air Pollution on Adolescent Airway Inflammation

    • Authors: Ashtyn Tracey Areal, Nidhi Singh, Qi Zhao, Dietrich Berdel, Sibylle Koletzko, Andrea von Berg, Monika Gappa, Joachim Heinrich, Marie Standl, Michael J. Abramson, Tamara Schikowski
      First page: 6827
      Abstract: Fraction of exhaled Nitric Oxide (FeNO) is a marker of airway inflammation. We examined the main effects and interactions of relative humidity (RH) and air pollution on adolescents’ FeNO. Two thousand and forty-two participants from the 15-year follow-up of the German GINIplus and LISA birth cohorts were included. Daily meteorological (maximum [Tmax], minimum [Tmin] and mean [Tmean] temperatures and RH) and air pollution [Ozone (O3), nitrogen dioxide (NO2) and particulate matter < 2.5 µm (PM2.5)] were assessed. Linear models were fitted with Ln(FeNO) as the outcome. Increases in FeNO indicate an increase in lung inflammation. Increased FeNO was associated with an increase in temperature, PM2.5, O3 and NO2. A 5% increase in RH was associated with a decrease in FeNO. Interactions between RH and high (p = 0.007) and medium (p = 0.050) NO2 were associated with increases in FeNO; while interactions between RH and high (p = 0.042) and medium (p = 0.040) O3 were associated with decreases in FeNO. Adverse effects were present for male participants, participants with low SES, participants with chronic respiratory disease, and participants from Wesel. Short-term weather and air pollution have an effect on lung inflammation in German adolescents. Future research should focus on further assessing the short-term effect of multiple exposures on lung inflammation in adolescents.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196827
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6828: The Feasibility of Make My Day—A
           Randomized Controlled Pilot Trial of a Stroke Prevention Program in
           Primary Healthcare

    • Authors: Emelie Mälstam, Eric Asaba, Elisabet Åkesson, Susanne Guidetti, Ann-Helen Patomella
      First page: 6828
      Abstract: Incorporating and sustaining engaging everyday activities (EEAs) in everyday life holds potential for improving health and wellbeing; thus, there is reason to explore EEAs as a behavioral change technique in stroke prevention. The aim of this study was to evaluate the feasibility of the stroke prevention program Make My Day (MMD) for people with moderate-to-high risk for stroke in a primary healthcare setting, where EEAs are utilized to promote healthy activity patterns. A randomized controlled pilot trial was designed to evaluate the feasibility of MMD. Twenty-nine persons at risk for stroke were recruited and randomized into either an intervention group (n = 14) receiving MMD or a control group (n = 15) receiving brief health advice and support with goal setting. The results suggest that MMD is feasible, with timely recruitment, overall high response rates and study completion, and sensitivity to change in key outcome measures. Moreover, the results demonstrate that the application of EEAs can be useful for promoting behavioral change in stroke prevention. Recommendations for improvements for a full-scale trial include recruiting a relevant sample, using reliability- and validity-tested outcome measures, and implementing strategies to limit missing data.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-25
      DOI: 10.3390/ijerph20196828
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6829: Current Trends in Balance Rehabilitation for
           Stroke Survivors: A Scoping Review of Experimental Studies

    • Authors: Júlia Saraiva, Gonçalo Rosa, Sónia Fernandes, Júlio Belo Fernandes
      First page: 6829
      Abstract: Balance impairment is a common consequence of a stroke, which can significantly hinder individuals’ participation in daily activities, social interactions, and leisure pursuits and their ability to return to work. Rehabilitation is vital for minimizing post-stroke sequelae and facilitating the recovery of patients. This review aims to identify current trends in balance rehabilitation of stroke survivors. This Scoping review followed Arksey and O’Malley’s methodological framework. The literature search was conducted in electronic databases, including CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection. The search was performed in March 2023, and the inclusion criteria were articles published in English or Portuguese between 2013 and 2023. A total of 446 articles were identified. After selecting and analyzing the reports, fourteen publications were included in this review. Seven distinct categories of balance rehabilitation interventions were identified, covering various approaches. These categories included conventional rehabilitation exercises, gym-based interventions, vibration therapy, rhythmic auditory stimulation training, boxing therapy, dual-task training, and technology-based rehabilitation interventions. Each of these methods presents unique benefits and can significantly impact the recovery of balance in stroke survivors, enhancing their overall well-being and functional capacity.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196829
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6830: Housing Instability Associated with Return to
           Stimulant Use among Previously Abstaining Women

    • Authors: Nicky J. Mehtani, Chika C. Chuku, Meredith C. Meacham, Eric Vittinghoff, Samantha E. Dilworth, Elise D. Riley
      First page: 6830
      Abstract: Stimulant use among unstably housed individuals is associated with increased risks of psychiatric co-morbidity, violence, HIV transmission, and overdose. Due to a lack of highly effective treatments, evidence-based policies targeting the prevention of stimulant use disorder are of critical importance. However, little empirical evidence exists on risks associated with initiating or returning to stimulant use among at-risk populations. In a longitudinal cohort of unstably housed women in San Francisco (2016–2019), self-reported data on stimulant use, housing status, and mental health were collected monthly for up to 6 months, and factors associated with initiating stimulants after a period of non-use were identified through logistic regression. Among 245 participants, 42 (17.1%) started using cocaine and 46 (18.8%) started using methamphetamine. In analyses adjusting for demographics and socio-structural exposures over the preceding month, experiencing street homelessness was associated with initiating cocaine use (AOR: 2.10; 95% CI: 1.04, 4.25) and sheltered homelessness with initiating methamphetamine use (AOR: 2.57; 95% CI: 1.37, 4.79). Other factors—including race, income, unmet subsistence needs, mental health, and treatment adherence—did not reach levels of significance, suggesting the paramount importance of policies directed toward improving access to permanent supportive housing to prevent stimulant use among unstably housed women.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196830
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6831: Validation and Psychometric Properties of the
           German Operational and Organizational Police Stress Questionnaires

    • Authors: Lauriane Willemin-Petignat, Royce Anders, Sabrina Ogi, Benjamin Putois
      First page: 6831
      Abstract: Context: Working in the police force is an operationally and organizationally stressful job. Suitable psychometric tools are needed to detect and study the psychosocial risks of these professionals. The original version contains 40 items, which may be too long for clinical use or as a research control measure. The main aim of this study is to validate the Police Stress Questionnaire (PSQ) in German. The secondary objective is to validate a shorter version. Method: After translation and counter translation of the PSQ-G by a committee of experts, 10 participants pre-tested the comprehension of an intermediate version, allowing the development of a final version that was submitted to a psychometric validation plan with 2314 German-speaking officers. Structure, reliability, and convergent, divergent, and discriminant validities were tested for each sample. Results: The German version of the PSQ performed well psychometrically. We have created a short version of 14 items with good psychometric properties, 7 items for each subscale: operational stressors and organizational stressors. Conclusion: This study validated a German version of the PSQ and provides a reliable measure of stress processes in the police force. A short version is now available.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196831
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6832: Types of Offers of Combustible Cigarettes,
           E-Cigarettes, and Betel Nut Experienced by Guam Youths

    • Authors: Francis Dalisay, Scott K. Okamoto, Jane Teneza, Christina Dalton, Kayli Lizama, Pallav Pokhrel, Yoshito Kawabata
      First page: 6832
      Abstract: The present study examined types of scenarios in which Guam youths are offered tobacco—namely, combustible cigarettes and e-cigarettes—and betel (areca) nut. We conducted 10 focus groups with public middle school students (n = 34) from Guam. Results suggested that the types of offer scenarios of combustible cigarettes, e-cigarettes, and betel nut referenced by the students fall into two categories—direct-relational offers and indirect-contextual offers. The results also suggested that both categories of offer scenarios were more likely to occur in school rather than in other locations such as the home. Family members were more likely to make offers than other types of people. Indirect-contextual offers were more easily avoidable depending on the substance offered, the location where the offer took place, and the person making the offer. Based on the findings, we provide brief suggestions on developing a school-based prevention curriculum focused on training young adolescents from Guam on ways to resist offers of cigarettes, e-cigarettes, and betel nut.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196832
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6833: Informing ASR Treatment Practices in a
           Florida Aquifer through a Human Health Risk Approach

    • Authors: Anna Gitter, Kristina D. Mena, John T. Lisle
      First page: 6833
      Abstract: Aquifer storage and recovery (ASR) can augment water supplies and hydrologic flows under varying climatic conditions. However, imposing drinking water regulations on ASR practices, including pre-treatment before injection into the aquifer, remains arguable. Microbial inactivation data—Escherichia coli, Pseudomonas aeruginosa, poliovirus type 1 and Cryptosporidium parvum—were used in a human health risk assessment to identify how the storage time of recharged water in the Floridan Aquifer enhances pathogen inactivation, thereby mitigating the human health risks associated with ingestion. We used a quantitative microbial risk assessment to evaluate the risks for a gastrointestinal infection (GI) and the associated disability-adjusted life years (DALYs) per person per year. The risk of developing a GI infection for drinking water no longer exceeded the suggested annual risk threshold (1 × 10−4) by days 31, 1, 52 and 80 for each pathogen, respectively. DALYs per person per year no longer exceeded the World Health Organization threshold (1 × 10−6) by days 27, <1, 43 and 72. In summary, storage time in the aquifer yields a significant reduction in health risk. The findings emphasize that considering microbial inactivation, caused by storage time and geochemical conditions within ASR storage zones, is critical for recharge water treatment processes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196833
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6834: Substance Use among Emerging Adults during
           the COVID-19 Pandemic: A Review through the Lens of Sustainable
           Development Goals

    • Authors: Ajith K. Remesan, Varalakshmi Chandra Sekaran, Teddy Andrews Jaihind Jothikaran, Lena Ashok
      First page: 6834
      Abstract: Public health initiatives, including lockdowns to reduce the spread of COVID-19, have resulted in societal stressors like loneliness, job loss, and economic collapse linked to worsening mental health outcomes, such as depression, anxiety, and coping-related substance use. The various psychosocial stressors caused by the pandemic have potentially led to the increased use of substances across the globe, particularly among emerging adults. The current study summarises the literature on substance use among emerging adults during the COVID-19 pandemic. The terms “coronavirus”, “COVID-19”, “substance use”, “substance abuse”, “drug use”, drug abuse”, “emerging adults”, and “young adults” were all used in different combinations throughout the search, using the Scopus, PubMed, and JSTOR databases. Using this method, a total of 28 English-language citations published between 2020 and 2023 were obtained. Following a study of the articles mentioned above, 16 papers were removed. The remaining 12 papers were included in this review. Even though substance use dropped when COVID-19 lockdowns began, it rose when restrictions were removed, particularly among those with prior substance use. Studies related to mental health need to assess substance use, as many emerging adults use substances to cope with distress, including isolation and loneliness, which are part of the current mental health crisis among emerging adults.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196834
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6835: Results from a Nationwide Evaluation Study of
           Labor Market-Integrative Health Promotion for the Unemployed: Impact of
           the JOBS Program Germany

    • Authors: Alfons Hollederer, Heiko J. Jahn
      First page: 6835
      Abstract: Compared to the employed, the unemployed suffer from poorer health, especially in terms of mental health. At the same time, health promotion rarely reaches unemployed people. The “JOBS Program” is an intervention to promote health and labor market integration and has shown positive effects in the USA and Finland. In this confirmatory study, we investigated whether the JOBS Program achieves similar effects in Germany. We applied a randomized controlled trial to compare an intervention group (IVG) with a waiting control group (WCG) before (T0; N = 94) and shortly after (T1; n = 65) the intervention. Concerning our primary outcomes, the JOBS Program Germany was beneficial: Compared to the WCG, the regression estimated that the IVG had (1) a 2.736 scale point higher level of life satisfaction (p = 0.049), (2) a 0.337 scale point higher level of general health (p = 0.025), and (3) a 14.524 scale point higher level of mental well-being (p = 0.004). Although not statistically significant, job search-specific self-efficacy also appeared to be positively associated with the intervention. This study provides evidence of the effectiveness of JOBS Program on the abovementioned outcomes, including for older and long-term unemployed people, supporting the benefits of regular implementation of this program for a wide range of unemployed people in Germany.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196835
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6836: Advancing the Management of Long COVID by
           Integrating into Health Informatics Domain: Current and Future

    • Authors: Radha Ambalavanan, R. Sterling Snead, Julia Marczika, Karina Kozinsky, Edris Aman
      First page: 6836
      Abstract: The ongoing COVID-19 pandemic has profoundly affected millions of lives globally, with some individuals experiencing persistent symptoms even after recovering. Understanding and managing the long-term sequelae of COVID-19 is crucial for research, prevention, and control. To effectively monitor the health of those affected, maintaining up-to-date health records is essential, and digital health informatics apps for surveillance play a pivotal role. In this review, we overview the existing literature on identifying and characterizing long COVID manifestations through hierarchical classification based on Human Phenotype Ontology (HPO). We outline the aspects of the National COVID Cohort Collaborative (N3C) and Researching COVID to Enhance Recovery (RECOVER) initiative in artificial intelligence (AI) to identify long COVID. Through knowledge exploration, we present a concept map of clinical pathways for long COVID, which offers insights into the data required and explores innovative frameworks for health informatics apps for tackling the long-term effects of COVID-19. This study achieves two main objectives by comprehensively reviewing long COVID identification and characterization techniques, making it the first paper to explore incorporating long COVID as a variable risk factor within a digital health informatics application. By achieving these objectives, it provides valuable insights on long COVID’s challenges and impact on public health.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-26
      DOI: 10.3390/ijerph20196836
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6837: Bridging Inequity Gaps in Healthcare Systems
           While Educating Future Healthcare Professionals—The Social Health
           Bridge-Building Programme

    • Authors: Gitte Valentin, Claus Vinther Nielsen, Anne-Sofie Meldgaard Nielsen, Merete Tonnesen, Kristina Louise Bliksted, Katrine Tranberg Jensen, Karen Ingerslev, Thomas Maribo, Lisa Gregersen Oestergaard
      First page: 6837
      Abstract: Social inequity in healthcare persists even in countries with universal healthcare. The Social Health Bridge-Building Programme aims to reduce healthcare inequities. This paper provides a detailed description of the programme. The Template for Intervention Description and Replication (TIDieR) was used to structure the description. The programme theory was outlined using elements from the British Medical Research Council’s framework, including identifying barriers to healthcare, synthesising evidence, describing the theoretical framework, creating a logic model, and engaging stakeholders. In the Social Health Bridge-Building Programme, student volunteers accompany individuals to healthcare appointments and provide social support before, during, and after the visit. The programme is rooted in a recovery-oriented approach, emphasising personal resources and hope. The programme finds support in constructs within the health literacy framework. Student volunteers serve as health literacy mediators, supporting individuals in navigating the healthcare system while gaining knowledge and skills. This equips students for their forthcoming roles as healthcare professionals, and potentially empowers them to develop and implement egalitarian initiatives within the healthcare system, including initiatives that promote organisational health literacy responsiveness. The Social Health Bridge-Building Programme is a promising initiative that aims to improve equity in healthcare by addressing individual, social, and systemic barriers to healthcare. The programme’s description will guide forthcoming evaluations of its impact.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196837
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6838: Contrary Perceptions of Environmental Health
           and the Governance of the Bucaramanga Metropolitan Area, Colombia

    • Authors: Alexander Rojas, Douglas Molina-Orjuela, Laura Peña-Rodríguez, Andrea Hernández-Quirama, Mauricio Rojas-Betancur, Claudia Amaya-Castellanos, Laura A. Rodríguez-Villamizar, Alvaro J. Idrovo
      First page: 6838
      Abstract: The participation of civil society is essential for environmental health policies to be accepted. The objective of this study was to know the perceptions of government officials, members of civil society, and academics about environmental health problems and its governance in the Bucaramanga Metropolitan Area, Colombia. In the region, there is a strong citizens movement that defends the moorland ecosystem (páramo) as a source of drinking water for large-scale mining projects. A multi-method study was conducted, including the review of newspaper and scientific articles, a citizens survey, and interviews and focus groups with identified key stakeholders. The findings indicate that government officials prioritize their actions on issues related to air and water pollution and environmental education. In contrast, citizens prioritize water availability from the moorland ecosystem. There are some advances in the management of environmental health, mainly related to greater citizen awareness. Contrary perceptions among government officials, academics, and civil society prevent adequate prioritization of environmental health problems. Participation of civil society is absent in activities related to environmental governance. An ongoing citizens science experience engaging high school students and the academy can be the first meeting point with government officials in the pathway to improve the environmental governance in the territory. The participation of civil society in the environmental health governance must be enforced to broaden the issues of interest and prioritize the activities in short- and long-term policy planning.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196838
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6839: Active Lifestyle and Mobility of Adults with
           Vision Impairment: A Multiphase Mixed-Methods Study

    • Authors: Deborah Barasche-Berdah, Ora Paltiel, Raanan Raz
      First page: 6839
      Abstract: Individuals with vision impairment (VI) are less physically active than their sighted peers, heightening their risk of chronic illness. This study aimed to explore real and perceived barriers and promoters of an active lifestyle among adults with VI. We used mixed-methods, including a quantitative analysis of spatial data and a qualitative analysis of input from focus groups. The data were analyzed using descriptive statistics, graphical and thematic analysis. The spatial analysis highlighted frequent impediments, including high proportions of inaccessible crosswalks and stairs, a high density of obstacles (12/km) and almost inexistent guidance markings (0.1/km). Factors influencing active lifestyle of individuals with VI reported in the focus groups included: VI severity and self-confidence; accessibility of the physical environment as well as support and consideration of the society; use of behavioral strategies, striving for good health and willpower. Combined psychosocial, behavioral and infrastructural modifications could enhance active lifestyles among adults with VI. Consideration of the needs of individuals with VI is critical among environmental planners. Sustainable solutions for improving accessibility and mobility in the city for individuals with VI will influence not only their social integration but will enable them to adopt an active lifestyle and reduce their risk of chronic illness.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196839
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6840: Predictors of Unmet Healthcare Needs during
           Economic and Health Crisis in Greece

    • Authors: George Pierrakos, Aspasia Goula, Dimitra Latsou
      First page: 6840
      Abstract: (1) Background: The aim of this study was to identify predictors of the unmet healthcare needs during the financial and recent health crisis in Greece. (2) Methods: Time series analysis was performed for the years 2008 through 2022 using the Eurostat database. The dependent variable was the percentage of people who reported unmet need for medical care. Demographic, socioeconomic, and health data, as well as health expenditures, were used as independent variables. Correlation analysis and simple linear regression models were conducted to analyze the results. (3) Results: Unmet health needs in Greece increased from the start of the crisis until 2016, as a gradual de-escalation of the crisis was observed. However, in 2019 the country recorded the second highest level of unmet needs for medical care before the health crisis. Limitations in usual activities, reporting bad/very bad health status, being unemployed, and having low income increased the likelihood of unmet needs. Health expenditures (public or private) were also significant determinants of unmet healthcare needs. (4) Conclusions: The increased unmet health needs widen inequalities in health and healthcare access. Therefore, health policies should eliminate barriers which restrict the access to health and enhance healthcare services, developing conditions for citizens’ well-being.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196840
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6841: Misjudgement of One’s Own Performance'
           Exploring Attention Deficit (Hyperactivity) Disorder (ADHD) and Individual
           Difference in Complex Music and Foreign Language Perception

    • Authors: Christine Groß, Valdis Bernhofs, Eva Möhler, Markus Christiner
      First page: 6841
      Abstract: In previous research, we detected that children and adolescents who were diagnosed with ADHD showed deficits in both complex auditory processing of musical stimuli and in musical performance when compared to controls. In this study, we were interested in whether we could detect similar or distinct findings when we use foreign speech perception tasks. Therefore, we recruited musically naïve participants (n = 25), music-educated participants (n = 25) and participants diagnosed with ADHD (n = 25) who were assessed for their short-term memory (STM) capacity and the ability to discriminate music and speech stimuli and we collected self-ratings of the participants’ music and language performances. As expected, we found that young adults with ADHD show deficits in the perception of complex music and difficult speech perception stimuli. We also found that STM capacity was not impaired in young adults with ADHD and may not persist into young adulthood. In addition, subjective self-estimation about the participants’ language and music performances revealed that the ADHD group overestimated their performance competence relatively compared to both control groups. As a result, the findings of our study suggest that individuals diagnosed with ADHD require a special training program that not only focuses on improving performance in perceptual skills of music and language but also requires metacognitive training to develop realistic self-assessment skills.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196841
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6842: Healthcare Policies to Eliminate Neglected
           Tropical Diseases (NTDs) in India: A Roadmap

    • Authors: Ajay Chandra, S. D. Sreeganga, Nibedita Rath, Arkalgud Ramaprasad
      First page: 6842
      Abstract: The need for systemic healthcare policies to systematically eliminate NTDs globally and in India has been stressed for more than two decades. Yet, the present policies and the research on them do not meet the need. We present an ontological framework, a research roadmap, and a policy brief to address the gap. The ontology clearly, concisely, and comprehensively represents the combinations of diseases, the objectives regarding the diseases, the entities to address them, the outcomes sought, and the potential policy instruments to invoke. The paper explicates the state of the-policies and state of the research on policies to eliminate NTDs in India. It highlights the significant gaps in the diseases covered, balance in the objectives, comprehensiveness of policies, portfolio of outcomes, and involvement of entities. Last, it presents a set of systemic policies congruent with the ontology to systematically address the gaps. The recommendations are aligned with the present research, policies, practices, and recommendations in India and of the WHO, UN agencies, and other similar bodies. The approach can be generalized to provide roadmaps for other countries facing a similar challenge and for other diseases of similar complexity. The roadmaps, with continuous feedback and learning, can help navigate the challenge efficiently and effectively.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196842
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6843: The Cost of Universal Suicide Risk Screening
           for Adolescents in Emergency Departments

    • Authors: Kyle L. Grazier, Jacqueline Grupp-Phelan, David Brent, Adam Horwitz, Taylor C. McGuire, T. Charles Casper, Michael W. Webb, Cheryl A. King
      First page: 6843
      Abstract: Suicide is the second leading cause of death among adolescents. As nearly 20% of adolescents visit emergency departments (EDs) each year, EDs have an opportunity to identify previously unrecognized suicide risk. A novel Computerized Adaptive Screen for Suicidal Youth (CASSY) was shown in a multisite study to be predictive for suicide attempts within 3 months. This study uses site-specific data to estimate the cost of CASSY implementation with adolescents in general EDs. When used universally with all adolescents who are present and able to participate in the screening, the average cost was USD 5.77 per adolescent. For adolescents presenting with non-behavioral complaints, the average cost was USD 2.60 per adolescent. Costs were driven primarily by time and personnel required for the further evaluation of suicide risk for those screening positive. Thus, universal screening using the CASSY, at very low costs relative to the cost of an ED visit, can facilitate services needed for at-risk adolescents.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196843
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6844: The Roles of Depression, Life Control and
           Affective Distress on Treatment Attendance and Perceived Disability in
           Chronic Back Pain Sufferers throughout the Duration of the Condition

    • Authors: Humberto M. Oraison, Daniel Loton, Gerard A. Kennedy
      First page: 6844
      Abstract: The aims of this study were to examine psychological factors that predict treatment seeking and disability over the total duration of experiencing back pain. A sample of 201 adults experiencing chronic back pain was recruited through health professionals and completed the Depression, Anxiety and Stress Scale (DASS), the Oswestry Back Pain Disability Questionnaire (ODQ), the McGill Pain Questionnaire (MPQ) and the life control and affective distress variables of the West Haven–Yale Multidimensional Pain Inventory (WHYMP), and participants disclosed the number of treatment sessions attended over the course of the illness. Depression, life control and affective distress were tested as indirect predictors of disability severity that were mediated by treatment attendance. Each unit increase in life control predicted attending nearly 30 more treatment sessions, each unit increase in affective distress predicted attending 16 fewer treatments and each unit increase in depression predicted 4 fewer treatments, together explaining 44% of variance in treatment seeking. The effects of life control and affective distress on disability were explained by treatment attendance, whereas depression retained a direct effect on disability. Treatment attendance had an effect on disability. The findings show that participants with lower life control and higher affective distress and depression had higher levels of pain and disability, in part due to due to their treatment-seeking behaviour.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196844
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6845: Bridge Healing: A Pilot Project of a New
           Model to Prevent Repeat “Social Admit” Visits to the Emergency
           Department and Help Break the Cycle of Homelessness in Canada

    • Authors: Matthew Robrigado, Igor Zorić, David A. Sleet, Louis Hugo Francescutti
      First page: 6845
      Abstract: Homelessness continues to be a pervasive public health problem throughout Canada. Hospital Emergency Departments (EDs) and inpatient wards have become a source of temporary care and shelter for homeless patients. Upon leaving the hospital, homeless patients are not more equipped than before to find permanent housing. The Bridge Healing program in Edmonton, Alberta, has emerged as a novel approach to addressing homelessness by providing transitional housing for those relying on repeated visits to the ED. This paper describes the three essential components to the Bridge Healing model: partnership between the ED and a Housing First community organization; facility design based on The Eden Alternative™ principles; and grassroots community funding. This paper, in conjunction with the current pilot project of the Bridge Healing facilities, serves as a proof of concept for the model and can inform transitional housing approaches in other communities.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196845
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6846: Treating Older Children with Clubfoot:
           Results of a Cross-Sectional Survey of Expert Practitioners

    • Authors: Grace Drury, Timothy R. Nunn, Firaol Dandena, Tracey Smythe, Christopher B. D. Lavy
      First page: 6846
      Abstract: Treating clubfoot in walking-age children is debated, despite studies showing that using the Ponseti casting principles can correct the midfoot effectively. We aimed to explore techniques and approaches for the management of older children with clubfoot and identify consensus areas. A mixed-methods cross-sectional electronic survey on delayed-presenting clubfoot (DPC) was sent to 88 clubfoot practitioners (response rate 56.8%). We collected data on decision-making, casting, imaging, orthotics, surgery, recurrence, rehabilitation, multidisciplinary care, and contextual factors. The quantitative data were analysed using descriptive statistics. The qualitative data were analysed using conventional content analysis. Many respondents reported using the Pirani score and some used the PAVER score to aid deformity severity assessment and correctability. Respondents consistently applied the Ponseti casting principles with a stepwise approach. Respondents reported economic, social, and other contextual factors that influenced the timing of the treatment, the decision to treat a bilateral deformity simultaneously, and casting intervals. Differences were seen around orthotic usage and surgical approaches, such as the use of tibialis anterior tendon transfer following full correction. In summary, the survey identified consensus areas in the overall principles of management for older children with clubfoot and the implementation of the Ponseti principles. The results indicate these principles are well recognised as a multidisciplinary approach for older children with clubfoot and can be adapted well for different geographical and healthcare contexts.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196846
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6847: Digital Assessment of the Knowledge,
           Attitudes and Preparedness of Dentists towards Providing Dental Treatment
           to People Living with HIV in Northern Brazil

    • Authors: Ricardo Roberto de Souza Fonseca, Rogério Valois Laurentino, Silvio Augusto Fernandes de Menezes, Aldemir Branco Oliveira-Filho, Paula Cristina Rodrigues Frade, Roberta Pimentel de Oliveira, Luiz Fernando Almeida Machado
      First page: 6847
      Abstract: People living with HIV (PLWH) continue to face stigma and discrimination during dental treatment in Brazil. This study aimed to describe the sociodemographic, educational and professional characteristics of dentists working in the Northern Brazilian region and to identify the level of knowledge of these health professionals in relation to the care and management of PLWH using a digital form. Methods: This cross-sectional study was population-based among dentists and was conducted between July and December 2021. A total of 396 dentists were invited using the “snowball” sampling technique and received an anonymous digital form (Google® Forms platform) composed of four blocks of dichotomous and multiple-choice questions. After signing the informed consent form, dentists were divided into seven groups according to the amount of time that had passed (in years) since they had completed their bachelor’s degree in dentistry. A total of 25 questions referring to sociodemographic, educational and professional factors and knowledge about the dental care of PLWH were asked, and all data were presented as descriptive percentages and then analyzed using the Kappa test. Results: The average age was 31.9 years, and the states of Pará and Amazonas presented better knowledge about the dental care of PLWH. Dental prostheses (62/381-16.3%), orthodontics (57/381-15%) and periodontics (56/381-14.7%) were the most cited dental specialties, and demographic, professional and epidemiological characteristics showed a statistically significant difference regarding knowledge (<0.0001). Conclusions: The knowledge of dentists in Northern Brazil is partially high, although there is some lack of knowledge about the dental care of PLWH.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196847
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6848: An Integrated Patient-Centred Medical Home
           (PCMH) Care Model Reduces Prospective Healthcare Utilisation for
           Community-Dwelling Older Adults with Complex Needs: A Matched
           Observational Study in Singapore

    • Authors: Grace Sum, Silvia Yu Hui Sim, Junxing Chay, Soon Hoe Ho, Mimaika Luluina Ginting, Zoe Zon Be Lim, Joanne Yoong, Chek Hooi Wong
      First page: 6848
      Abstract: The global ageing population is associated with increased health service use. The PCMH care model integrates primary care and home-based care management to deliver comprehensive and personalised healthcare to community-dwelling older adults with bio-psycho-social needs. We examined if an integrated PCMH reduced healthcare utilisation burden of older persons in Singapore. We compared the healthcare utilisation between the intervention group and coarsened exact matched controls for a follow-up of 15 months. Baseline matching covariates included socio-demographics, health status, and past healthcare use. We accounted for COVID-19 social distancing effects on health-seeking behaviour. The intervention group consisted of 165 older adults with complex needs. We analysed national administrative healthcare utilisation data from 2017 to 2020. We applied multivariable zero-inflated regression modelling and presented findings stratified by high (CCI ≥ 5) and low disease burden (CCI < 5). Compared to controls, there were significant reductions in emergency department (β = −0.85; 95%CI = −1.55 to −0.14) and primary care visits (β = −1.70; 95%CI = −2.17 to −1.22) and a decrease in specialist outpatient visits (β = −0.29; 95%CI = −0.64 to 0.07) in the 3-month period immediately after one-year enrolment. The number of acute hospitalisations remained stable. Compared to controls, the intervention group with high and low comorbidity burden had significant decreases in primary care use, while only those with lower comorbidity burden had significant reductions in utilisation of other service types. An integrated PCMH appears beneficial in reducing healthcare utilisation for older persons with complex needs after 1 year in the programme. Future research can explore longer-term utilisation and scalability of the care model.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196848
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6849: Exploring the Mediating Role of Parental
           Anxiety in the Link between Children’s Mental Health and Glycemic
           Control in Type 1 Diabetes

    • Authors: Evija Silina Silina, Maris Taube, Maksims Zolovs
      First page: 6849
      Abstract: Pediatric diabetes type 1 diabetes mellitus (T1D), as a chronic, incurable disease, is associated with psychoemotional and socioeconomic burden for the whole family. Disease outcomes are determined by the metabolic compensation of diabetes, characterized by the level of glycated hemoglobin (HbA1c). The caregivers play a critical role in the metabolic control of children with T1D. The aim of this study was to investigate which environmental factors may explain the relationship between diabetes compensation and anxiety and depression of a child. The cross-sectional interdisciplinary study recruited dyads from adolescents and their parents (N = 251). Adolescent and parent groups were screened for anxiety and depression. General linear model (GLM) mediation analysis was performed to determine the potential mediating effect of surrounding factors on the relationship between dependent variables (glycated hemoglobin) and independent variables (the child’s anxiety and depression symptoms). The study revealed that the relationship between HbA1c and the child’s anxiety and depression is fully mediated (B = 0.366, z = 4.31, p < 0.001) by parental anxiety. Diabetes metabolic control in adolescents with T1D is related to adolescents’ mental health via parents’ anxiety. This means that parents’ anxiety plays a more significant role in the level of HbA1c than the anxiety and depression of the adolescent.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-27
      DOI: 10.3390/ijerph20196849
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6850: Mixing Meds and Milk: Evaluation of a
           Performance Gap Intervention for Provider Education in Breastfeeding and
           Maternal Medication Use

    • Authors: Kaci Bohn, Alejandra Fernandez, Stephanie Stroever, Dara O’Neil, Joan Enderle, Kaytlin Krutsch
      First page: 6850
      Abstract: The need for maternal medications is a known barrier to breastfeeding. Though most medications are compatible with lactation, healthcare providers use abundant caution, often viewing medications and breastfeeding as mutually exclusive. A dual intervention of an educational webinar and access to a mobile app for lactation pharmacology was used to enhance provider familiarity, confidence, and access to knowledge in medication use during breastfeeding. Surveys were administered before, one week after, and three months after the webinar to evaluate performance gap improvement. Usage data of the mobile app was collected over twelve months to monitor topic engagement. Results suggested the interventions temporarily increased provider confidence in maternal medication use during lactation; however, the increase was not sustained at three months. Even with one-time training and lactation-specific mobile app access, simply providing an informational resource is insufficient to support evidence-informed care for lactating patients. Longitudinal training on evidence-based medication safety is critical to care for the lactating dyad.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196850
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6851: “Women Friendly”: A Childbirth
           Preparation Intervention in Israel for Women with Symptoms of
           Post-Traumatic Stress Disorder

    • Authors: Rachel Bachner-Melman, Racheli Haim-Dahan, Ada H. Zohar
      First page: 6851
      Abstract: Pregnant women with symptoms of post-traumatic stress disorder (PTSD), who have experienced traumatic events such as sexual abuse and traumatic births, are particularly vulnerable to experiencing extreme fear of childbirth complications during labor and traumatic deliveries. In this commentary, we review the literature on this group of women and their specific needs during pregnancy and childbirth. We present a childbirth preparation intervention for pregnant women with PTSD symptoms, “Women Friendly”, designed in Israel and gradually becoming available in the community and Israeli hospitals. This intervention is intended for women with high levels of fear of childbirth who are unmotivated or unable to undergo traditional psychotherapy that focuses on exposure to and processing of past traumatic event(s). It is based on birth-oriented thinking, principles of positive psychology, and trauma-informed care. In addition to the five sessions offered to pregnant women, medical staff are provided with 19 training sessions on the “Women Friendly” approach. Qualitative and quantitative research should examine the effectiveness of this intervention. Should results be encouraging, this intervention could be more widely implemented in Israel and abroad and applied in broader contexts, such as gynecological check-ups and medical examinations, interventions, and surgery.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196851
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6852: What Can One Minute of the Day Tell about
           Physical Activity'

    • Authors: Henri Vähä-Ypyä, Pauliina Husu, Harri Sievänen, Tommi Vasankari
      First page: 6852
      Abstract: High cardiorespiratory fitness (CRF) allows individuals to perform daily activities and operate at a higher intensity level. This study investigates the connection between the CRF and peak intensity of physical activity (PA) in absolute and relative terms. A total of 3587 participants (1447 men, 51.9 ± 13.0 years; 2140 women, 50.0 ± 13.0 years) provided substantial accelerometer wear time, and their CRF was estimated via the 6 min walking test. Participants were divided into CRF thirds by age group and sex. Daily one-minute peak intensities were captured in both absolute terms and relative to individual CRF levels. In absolute terms, the highest CRF third had the highest intensity value for men (6.4 ± 1.7 MET; 5.9 ± 1.4 MET; 5.3 ± 1.0 MET) and for women (6.4 ± 1.6 MET; 5.9 ± 1.3 MET; 5.4 ± 1.1 MET). In relative terms, the highest CRF third utilized the least aerobic capacity for men (49 ± 14%; 51 ± 13%; 56 ± 14%) and for women (52 ± 13%; 54 ± 12%; 62 ± 15%). One minute of daily activity offers valuable insights into an individual’s CRF and the effort demanded during PA. Fitter individuals can sustain higher PA intensity levels in absolute terms, whereas individuals with lower CRF utilize a greater fraction of their aerobic capacity. Consequently, heightened CRF not only allows for enhanced intensity levels but also safeguards against strenuous PA during daily routines.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196852
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6853: Hourly Associations between Heat Index and
           Heat-Related Emergency Medical Service (EMS) Calls in Austin-Travis
           County, Texas

    • Authors: Kijin Seong, Junfeng Jiao, Akhil Mandalapu
      First page: 6853
      Abstract: This paper aims to investigate the following research questions: (1) what are the hourly patterns of heat index and heat-related emergency medical service (EMS) incidents during summertime'; and (2) how do the lagged effects of heat intensity and hourly excess heat (HEH) vary by heat-related symptoms' Using the hourly weather and heat-related EMS call data in Austin-Travis County, Texas, this paper reveals the relationship between heat index patterns on an hourly basis and heat-related health issues and evaluates the immediate health effects of extreme heat events by utilizing a distributed lag non-linear model (DLNM). Delving into the heat index intensity and HEH, our findings suggest that higher heat intensity has immediate, short-term lagged effects on all causes of heat-related EMS incidents, including in cardiovascular, respiratory, neurological, and non-severe cases, while its relative risk (RR) varies by time. HEH also shows a short-term cumulative lagged effect within 5 h in all-cause, cardiovascular, and non-severe symptoms, while there are no statistically significant RRs found for respiratory and neurological cases in the short term. Our findings could be a reference for policymakers when devoting resources, developing extreme heat warning standards, and optimizing local EMS services, providing data-driven evidence for the effective deployment of ambulances.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196853
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6854: Digital Health Interventions to Improve
           Access to and Quality of Primary Health Care Services: A Scoping Review

    • Authors: Daniel Erku, Resham Khatri, Aklilu Endalamaw, Eskinder Wolka, Frehiwot Nigatu, Anteneh Zewdie, Yibeltal Assefa
      First page: 6854
      Abstract: Global digital technology advances offer the potential to enhance primary health care (PHC) quality, reach, and efficiency, driving toward universal health coverage (UHC). This scoping review explored how digital health solutions aid PHC delivery and UHC realization by examining the context, mechanisms, and outcomes of eHealth interventions. A comprehensive literature search was conducted, capturing qualitative and quantitative studies, process evaluations, and systematic or scoping reviews. Our analysis of 65 articles revealed that a well-functioning digital ecosystem—featuring adaptable, interoperable digital tools, robust Information and Communications Technology foundations, and enabling environments—is pivotal for eHealth interventions’ success. Facilities with better digital literacy, motivated staff, and adequate funding demonstrated a higher adoption of eHealth technologies, leading to improved, coordinated service delivery and higher patient satisfaction. However, eHealth’s potential is often restricted by existing socio-cultural norms, geographical inequities in technology access, and digital literacy disparities. Our review underscores the importance of considering the digital ecosystem’s readiness, user behavior, broader health system requirements, and PHC capacity for adopting digital solutions while assessing digital health interventions’ impact.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196854
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6855: Gaming in Pandemic Times: An International
           Survey Assessing the Effects of COVID-19 Lockdowns on Young Video
           Gamers’ Health

    • Authors: Joanne DiFrancisco-Donoghue, Bernat De las Heras, Orville Li, Jake Middleton, Min-Kyung Jung
      First page: 6855
      Abstract: The onset of COVID-19 coincided with the peak growth of video game usage, with 2.7 billion gamers in 2020. During the pandemic, gaming and streaming platforms offered an entertaining, social, and safe alternative to recreation during severe lockdowns and social isolations. This study aimed to examine the impact of the COVID-19 pandemic on health-related outcomes in self-proclaimed video gamers based on the type of lockdown experienced and to discuss the potential role of video games during times of preventive lockdown measures. This was a cross-sectional international survey constructed by two academic institutions, NYIT (NY, USA) and McGill University (Montreal, Canada), and Adamas Esports (BC, Canada). The survey consisted of questions including demographics, multiple choice, ratings, and Likert scales relating to the periods prior to and during the COVID-19 lockdowns. There were 897 respondents from North America (72.7%), Europe (10.9%), Asia (4.9%), and other countries (11.5%), with a mean age of 22 years. Significant increases in game time were reported in casual and competitive gamers during the first months of the pandemic. The level of gaming, type of lockdown, and physical activity level prior to the pandemic were examined as potential moderating factors. Significant increases in sedentary behaviors (video game time and sitting time) were observed, while physical activity levels remained unchanged in most participants, regardless of the type of lockdown. Sleep time, but not sleep quality, increased, while mental health exhibited opposing effects, influenced by the type of lockdown and gaming competition levels. Video games, when played moderately, could offer a cost-effective, safe strategy to promote socialization and mental health and improve the overall well-being of the non-gaming and gaming population during pandemic times when strict lockdowns are in place.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196855
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6856: The Integration of Social Science for
           Community Engagement in the Humanitarian Fields of Conflicts and
           Disasters: A Scoping Review

    • Authors: Luisa Toro-Alzate, Paola Maffi, Anu Puri, Rania Elessawi, Maria Falero Cusano, Jozefien Groenendijk, Daniel H. de Vries
      First page: 6856
      Abstract: Community engagement (CE) is essential to humanitarian assistance, and the social sciences have been credited in recent epidemics and disease outbreaks as having played a crucial, supportive role. Broadening this attention to other humanitarian fields, this scoping review asks what lessons learned can be found in grey and peer-reviewed literature on the integration of the social sciences in CE for conflicts and disasters. Using an analytical framework developed through a UNICEF-led project called Social Science for Community Engagement (SS4CE) in Humanitarian Action, we identified 1093 peer reviewed publications and 315 grey literature reports of possible relevance. The results show that only a small minority—18 publications and 4 reports—tangibly comment on the relevance of social sciences, mostly only in passing and implicitly. While social science techniques are used and the importance of understanding a community’s cultural, linguistic, and religious context is emphasized, further discussion on the integration of transdisciplinary and multidisciplinary social sciences is absent. Furthermore, CE is mostly seen as an instrumental (‘means to an end’) involvement, for example to collect data in emergency situations and receive feedback on interventions, but not as a critical and transformative intervention. We conclude that unlike the attention given to social sciences in disease outbreaks, there is a knowledge gap and an accordingly proper planning and implementation gap regarding the potentiality of social science to improve CE across all humanitarian contexts of disasters and conflicts.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196856
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6857: Social Capital and Mental Wellbeing of Older
           People Migrating along with Adult Children in Shenzhen, China

    • Authors: Julia Juan Wang, Daniel W. L. Lai, Wenqing Yu
      First page: 6857
      Abstract: The phenomenon of ‘older people migrating along’ (OPMA) with adult children is a unique outcome of social changes that have occurred in China. These individuals generally experience different challenges and needs associated with mental wellbeing. However, there is limited research on the relationship between the social capital and mental health of OPMA in China. This study aims to examine the mental health status of OPMA and the effects of bonding social capital and bridging social capital on their mental wellbeing in China by conducting a quantitative research survey among 399 OPMA participants. We found that bonding social capital correlated to only one indicator of mental wellbeing, subjective happiness. Bridging social capital had significant relationships with four mental health indicators, namely, the 12-item General Health Questionnaire (GHQ-12), Geriatric Depression Scale (GDS), subjective happiness, and life satisfaction. Through strengthening bridging social capital, these older adults can benefit from more opportunities for participation in formal or informal organizations in their communities and improve their mental wellbeing.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196857
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6858: Effect of Different Frequencies of Dental
           Visits on Dental Caries and Periodontal Disease: A Scoping Review

    • Authors: Najith Amarasena, Liana Luzzi, David Brennan
      First page: 6858
      Abstract: Recommending dental visits every six months is commonplace among dental practitioners worldwide. A scoping review was conducted by electronically searching PubMed, Scopus and Embase to identify and map the nature of evidence for the effect of different frequencies of dental visits on dental caries and periodontal disease. Studies were written in English on the frequency of dental visits and published between January 2008 and April 2023. Three systematic reviews that evaluated the risk of bias, strength of studies and certainty of evidence were included from the 4537 articles yielded through the search strategy. The available evidence was weak and of low quality for the currently recommended frequencies of dental visits, whether these are fixed or universal. For adults, there was little to no effect of making biannual, biennial or risk-based dental visits on dental caries and periodontal disease, which was supported by moderate- to high-certainty evidence. Accordingly, it is suggested that dental professionals and dental insurance providers make individually tailored, customised and risk-based recommendations for dental visits, rather than encouraging fixed or universal frequencies of dental visits. For children and adolescents, further research on this issue warrants well-designed randomised controlled trials (RCTs) and cohort studies of sufficient duration with an adequate number of participants.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196858
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6859: An Exploration of Black Men’s Attitudes
           and Experiences Communicating with Dentists about Oral and Pharyngeal

    • Authors: Patrick D. Smith, Darien J. Weatherspoon, Tiosha Bailey, Caryn E. Peterson, Marcus Murray, Osei Bekoe, Anuoluwapo Shadamoro, Nosayaba Osazuwa-Peters, Kimberly Nu-Tall
      First page: 6859
      Abstract: Background: Poor oral and pharyngeal cancer (OPC) survival among Black men is partially due to their limited knowledge about OPCs, which is exacerbated by dentists’ limited training and discomfort in discussing OPC risk factors. The purpose of this study was to assess the attitudes and experiences that Black men have communicating with dentists about OPCs. Methods: To qualitatively assess these attitudes and experiences, a focus group guide and recruitment strategy were developed using a community engagement approach. Data were analyzed using grounded theory. Results: Twenty-three self-identified Black men participated in three focus groups through the Zoom platform (mean age of 46.1 years). Four main themes emerged, which identified that participants: (1) had little knowledge of OPCs; (2) felt that addressing OPC risk among Black men was not a priority for dentists; (3) stressed the importance of dentists acknowledging the complexity of how race and gender affects Black men’s healthcare experiences; and (4) expressed a benefit to receiving information from multiple social networks. Conclusion: The focus groups provided context for how dentists might engage with Black men in discussions about OPC prevention and treatment.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-28
      DOI: 10.3390/ijerph20196859
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6860: Health Disparities in the Use of Primary
           Cesarean Delivery among Asian American Women

    • Authors: Yuqing Zhang, Lisa Heelan-Fancher, Suzanne Leveille, Ling Shi
      First page: 6860
      Abstract: This study examined the health disparities in primary cesarean delivery (PCD) use among Asian American (AA) women and within AA subgroups. We examined 22 years of birth registry data from one diverse northeastern state in the United States, including singleton vertex live births between 24 and 44 weeks of gestation without congenital abnormalities. Multivariate logistic regression was used to test the association between PCD and race and ethnicity groups adjusting for maternal demographic and health behaviors, infant gender and birth weight, gestational age, initiation of prenatal care, and other risk factors. Among the eligible sample, 8.3% were AA. AAs had the highest rate of PCD (18%) among all racial and ethnic groups. However, extensive heterogeneity was found among the AA subgroups. After controlling for confounding variables, compared to non-Hispanic White women, Filipino, Asian Indian, and Other Asian subgroups had a higher risk for PCD (Adj OR = 1.40, 1.37, and 1.21, p < 0.001), while Japanese, Chinese, and Korean had a lower risk (Adj OR = 0.57, 0.83, and 0.90, p < 0.001), and Vietnamese had no significant difference in PCD use. Although AA as a single racial and ethnic group had higher prevalence of PCD, more studies are warrantied to address the disproportional distribution of health disparities in PCD use within AA subgroups.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-29
      DOI: 10.3390/ijerph20196860
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6861: Trajectories of Adjustment Disorder and
           Well-Being in Austria and Croatia during 20 Months of the COVID-19

    • Authors: Irina Zrnić Novaković, Alina Streicher, Dean Ajduković, Marina Ajduković, Jana Kiralj Lacković, Annett Lotzin, Brigitte Lueger-Schuster
      First page: 6861
      Abstract: The present study aimed to investigate the trajectories of adjustment disorder (AD) symptoms and well-being over 20 months of the COVID-19 pandemic in Austria and Croatia. Further objectives of this study were to examine whether sociodemographic characteristics and the symptoms of anxiety and depression could predict these trajectories. As part of the pan-European ESTSS ADJUST study, N = 1144 individuals were recruited using convenience sampling and assessed four times between June 2020 and January 2022 through an online survey. Latent growth curve modelling was applied to estimate the trajectories of AD symptoms and well-being. Over time, the prevalence of probable AD varied between 9.8% and 15.1%. The symptoms of AD tended to increase, whereas well-being tended to decrease. According to the majority of the models tested, women, participants from Austria and those with lower income had higher initial AD symptoms, whereas older participants and those from Croatia had higher initial well-being. In all models and at all timepoints, anxiety and depression significantly predicted AD and well-being scores. Overall, our study points to several predictors of AD and well-being and indicates high variability in people’s reactions to the pandemic. Psychosocial support for the general population is needed during pandemics and similar crises, with a special focus on vulnerable groups.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-29
      DOI: 10.3390/ijerph20196861
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6862: Contraceptive Behavior in Appalachia:
           Exploring Use, Nonuse, and Contraceptive Attitudes

    • Authors: Samantha Auerbach, Kafuli Agbemenu, Rebecca Lorenz, Amy Hequembourg, Gretchen E. Ely
      First page: 6862
      Abstract: Very little is known about contraceptive behavior in Appalachia, a large geographic region in the eastern United States where even basic prevalence estimates of contraceptive use/nonuse are lacking. This study characterizes contraceptive behavior among Appalachians, including contraceptive use, reasons for use, and methods used; contraceptive nonuse and reasons for nonuse; and attitudes about contraception, including acceptability. This is a secondary analysis of a subsample of survey data collected on sexual and reproductive health attitudes, behaviors, and needs among reproductive-age women (18–49 years) living in the Appalachian region (n = 332). Results identify rates of contraceptive use (66.6%) and nonuse (33.1%) among Appalachian residents. Methods used most frequently included those that did not require prescription (i.e., external condoms and natural family planning methods) though many reported the use of intrauterine devices (IUDs). Among nonusers, fear of side effects from contraception and ambivalence towards pregnancy were most commonly selected as the most important reason for not using contraception. Contraception was considered acceptable by this sample overall, and these acceptability attitudes were significantly associated with contraceptive behavior.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-29
      DOI: 10.3390/ijerph20196862
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6863: Caring for People with Rare Diseases: A
           Systematic Review of the Challenges of, and Strategies for Dealing with,

    • Authors: Elena Faccio, Matteo Bottecchia, Michele Rocelli
      First page: 6863
      Abstract: The COVID-19 pandemic took a toll on everyone’s lives, and patients with rare diseases (RDs) had to pay an even higher price. In this systematic review, we explored the impact of the COVID-19 pandemic on individuals with RDs from a psychological perspective. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we retrieved articles from the Google Scholar, Scopus, and PubMed databases focusing on ‘COVID-19,’ ‘psychology,’ and ‘rare diseases.’ Seventeen primary articles were identified (mainly from continental Europe). The results revealed the psychological effects of the pandemic on rare disease patients, including increased anxiety, stress, and depressive moods. This review also highlighted the increased vulnerability and reduced quality of life of rare disease patients during the pandemic, as well as the importance of telecare and psychological support as critical interventions for improving their well-being. There is an urgent need for multidisciplinary research and stronger healthcare systems to meet the unique challenges of rare disease patients, who represent 3.5–5.9% of the global population.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-29
      DOI: 10.3390/ijerph20196863
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6864: Acute Effect of Night Shift Work on
           Endothelial Function with and without Naps: A Scoping Review

    • Authors: Paul D. Patterson, Jacob C. Friedman, Samuel Ding, Rebekah S. Miller, Christian Martin-Gill, David Hostler, Thomas E. Platt
      First page: 6864
      Abstract: We examined the breadth and depth of the current evidence investigating napping/sleeping during night shift work and its impact on non-invasive measures of endothelial function. We used a scoping review study design and searched five databases: Ovid Medline, EMBASE, Ovid APA PsycInfo, Web of Science Core Collection, and EBSCO CINAHL. We limited our search to English language and publications from January 1980 to September 2022. Our reporting adhered to the PRISMA-ScR guidance for scoping reviews. Our search strategy yielded 1949 records (titles and abstracts) after deduplication, of which 36 were retained for full-text review. Five articles were retained, describing three observational and two experimental research studies with a total sample of 110 individuals, which examined the non-invasive indicators of endothelial function in relation to the exposure to night shift work. While there is some evidence of an effect of night shift work on the non-invasive indicators of endothelial function, this evidence is incomplete, limited to a small samples of shift workers, and is mostly restricted to one measurement technique for assessing endothelial function with diverse protocols. In addition, there is no identifiable research investigating the potential benefits of napping during night shift work on non-invasive measures of endothelial function.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-29
      DOI: 10.3390/ijerph20196864
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6865: Emotion Regulation Strategies in Educational,
           Work and Sport Contexts: An Approach in Five Countries

    • Authors: Silvia Cristina Da Costa Dutra, Xavier Oriol Granado, Darío Paéz-Rovira, Virginia Díaz, Claudia Carrasco-Dajer, Alicia Izquierdo
      First page: 6865
      Abstract: One of the greatest challenges in the domain of emotional regulation is comprehending the functionality of strategies and their utilization in various social contexts. In this sense, this study analyzes differences in the use and efficacy of regulation strategies, particularly of interpersonal strategies like altruism, social support, negotiation, mediation, regulation, and rituals, in samples of workers (N = 687) and students (N = 959) from Brazil, Chile, Cuba, Spain, and Uruguay, and athletes (N =144) from Spain. Participants answered questions pertaining to measures of affect or emotional regulation (MARS and ERQ self-regulation scales and EROS heteroregulation), as well as questions of a wellbeing scale (PHI) and questions related to emotional creativity (ECI), humor styles (HSQ), and adjustment to stress. Athletes reported less emotional discharge, use of humor, and affection, and greater confrontation and use of rituals than students and workers. A congruent relationship was found between the use of functional strategies (like direct coping, distraction, reevaluation, and active physiological regulation) and adjustment to stress, well-being, and creativity. Seeking social support, negotiation, and, to an extent, altruism, confirmed their predicted adaptive character. Mediation and delegation did not confirm their predicted adaptive character. Rumination, social comparison, rituals, confrontation, and suppression were maladaptive for workers and students, but the first four strategies were functional for athletes, who display a higher self-control and a more team-oriented and competitive emotional culture. Finally, the results show that adaptive regulation strategies mediate the relationship between well-being and adjustment to stress.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-29
      DOI: 10.3390/ijerph20196865
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6866: Dramatic Reductions in Cigarette Smoking
           Prevalence among High School Youth from 1991 to 2022 Unlikely to Have Been
           Undermined by E-Cigarettes

    • Authors: Cristine D. Delnevo, Andrea C. Villanti
      First page: 6866
      Abstract: There is concern that youth e-cigarette use could lead youth to initiate cigarette smoking. This study identifies epochs of cigarette smoking among U.S. high school students in three commonly utilized national school-based surveys over three decades without a priori assumptions. We examined trends in ever and current cigarette smoking among high school youth from 1991 to 2022 in three datasets: Monitoring the Future (MTF), the National Youth Risk Behavior Survey (NYRBS) and the National Youth Tobacco Survey (NYTS) via Joinpoint regression. High stable rates of ever smoking were noted from 1991 to 1999 (NYRBS and MTF) and then significantly declined from 1999 to 2013; declines accelerated through to 2022. In the NYTS, ever cigarette smoking significantly declined from 1999 to 2018 and then declines accelerated to 2022. Current cigarette smoking reached its peak in 1997, and then significantly declined from 1997 to 2013 in the NYRBS and MTF and similarly in the NYTS from 1999 to 2018. Declines in current smoking then accelerated in all surveys through to 2022. These findings suggest dramatic successes in reducing youth smoking since the late 1990s, with more rapid declines in prevalence in the past decade.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-30
      DOI: 10.3390/ijerph20196866
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6867: Infrared Imaging of the Brain-Eyelid Thermal
           Tunnel: A Promising Method for Measuring Body Temperature in Afebrile

    • Authors: Franciele De Meneck, Vinicius Santana, Gabriel Carneiro Brioschi, Denise Sabbagh Haddad, Eduardo Borba Neves, Maria do Carmo Franco, Marcos Leal Brioschi
      First page: 6867
      Abstract: (1) Infrared thermography of the inner canthus of the eye has emerged as a promising tool for temperature screening and fever diagnosis. Its non-invasive nature lends itself well to mass screening in diverse settings such as schools, public transport, and healthcare facilities. Swift and accurate temperature assessment plays a pivotal role in the early identification of potential fever cases, facilitating timely isolation, testing, and treatment, thereby mitigating the risk of disease transmission. Nonetheless, the reliability of this approach in the pediatric population, especially when compared to conventional thermometry methods, remains unexplored. This preliminary study aimed to evaluate the concordance between the temperature of the inner canthus of the eye (Tic,eye), referred to as the brain-eyelid thermal tunnel (BTT°), with axillary and tympanic methods in afebrile children. (2) Methods: A cohort of 36 children, matched in a 1:1 ratio for gender and age, underwent comprehensive assessments encompassing anthropometric data, blood pressure evaluations, axillary (Tax) and tympanic (Tty) temperature measurements, as well as BTT° infrared thermography. (3) Results: The findings revealed a high level of concordance among the tympanic, axillary, and BTT° measurement methods. Bland–Altman plots showed that the bias was minimal, and no statistically significant differences were observed when comparing BTT° with axillary (p = 0.136) and tympanic (p = 0.268) measurements. Passing–Bablok regression scatter plots further confirmed the agreement, aligning the fitted regression line closely with the identity line for both axillary versus BTT° and tympanic (Tty) versus BTT° comparisons. (4) Conclusions: This study holds significant implications for public health, especially in the context of infectious disease outbreaks such as COVID-19. BTT° infrared thermography of the inner canthus of the eye (Tic,eye) reliably measures body temperature in afebrile children in controlled settings; nevertheless, its practical application necessitates the adaptation of biothermodynamic parameters to accommodate diverse environmental conditions.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-30
      DOI: 10.3390/ijerph20196867
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6868: Evaluation of the Effect of Perfluorohexane
           Sulfonate on the Proliferation of Human Liver Cells

    • Authors: Kyeong Hwa Sim, Hyeon Seo Oh, Chuhee Lee, Heesoo Eun, Youn Ju Lee
      First page: 6868
      Abstract: Perfluorohexane sulfonate (PFHxS) is a widely detected replacement for legacy long-chain perfluoroalkyl substances (PFAS) in the environment and human blood samples. Its potential toxicity led to its recent classification as a globally regulated persistent organic pollutant. Although animal studies have shown a positive association between PFHxS levels and hepatic steatosis and hepatocellular hypertrophy, the link with liver toxicity, including end-stage liver cancer, remains inconclusive. In this study, we examined the effects of PFHxS on the proliferation of Hep3B (human hepatocellular carcinoma) and SK-Hep1 (human liver sinusoidal endothelial cells). Cells were exposed to different PFHxS concentrations for 24–48 h to assess viability and 12–14 days to measure colony formation. The viability of both cell lines increased at PFHxS concentrations <200 μM, decreased at >400 μM, and was highest at 50 μM. Colony formation increased at <300 μM and decreased at 500 μM PFHxS. Consistent with the effect on cell proliferation, PFHxS increased the expression of proliferating cell nuclear antigen (PCNA) and cell-cycle molecules (CDK2, CDK4, cyclin E, and cyclin D1). In summary, PFHxS exhibited a biphasic effect on liver cell proliferation, promoting survival and proliferation at lower concentrations and being cytotoxic at higher concentrations. This suggests that PFHxS, especially at lower concentrations, might be associated with HCC development and progression.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-30
      DOI: 10.3390/ijerph20196868
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6869: Validation of a Harmonised, Three-Item
           Cognitive Screening Instrument for the Survey of Health, Ageing and
           Retirement in Europe (SHARE-Cog)

    • Authors: Mark R. O’Donovan, Nicola Cornally, Rónán O’Caoimh
      First page: 6869
      Abstract: More accurate and standardised screening and assessment instruments are needed for studies to better understand the epidemiology of mild cognitive impairment (MCI) and dementia in Europe. The Survey of Health, Ageing and Retirement in Europe (SHARE) does not have a harmonised multi-domain cognitive test available. The current study proposes and validates a new instrument, the SHARE cognitive instrument (SHARE-Cog), for this large European longitudinal cohort. Three cognitive domains/sub-tests were available across all main waves of the SHARE and incorporated into SHARE-Cog; these included 10-word registration, verbal fluency (animal naming) and 10-word recall. Subtests were weighted using regression analysis. Diagnostic accuracy was assessed from the area under the curve (AUC) of receiver operating characteristic curves. Diagnostic categories included normal cognition (NC), subjective memory complaints (SMC), MCI and dementia. A total of 20,752 participants were included from wave 8, with a mean age of 75 years; 55% were female. A 45-point SHARE-Cog was developed and validated and had excellent diagnostic accuracy for identifying dementia (AUC = 0.91); very good diagnostic accuracy for cognitive impairment (MCI + dementia), (AUC = 0.81); and good diagnostic accuracy for distinguishing MCI from dementia (AUC = 0.76) and MCI from SMC + NC (AUC = 0.77). SHARE-Cog is a new, short cognitive screening instrument developed and validated to assess cognition in the SHARE. In this cross-sectional analysis, it has good–excellent diagnostic accuracy for identifying cognitive impairment in this wave of SHARE, but further study is required to confirm this in previous waves and over time.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-30
      DOI: 10.3390/ijerph20196869
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6870: Breast and Colorectal Cancer Screening
           Utilization after Hurricane María and the COVID-19 Pandemic in
           Puerto Rico

    • Authors: Vivian Colón-López, Héctor M. Contreras-Mora, Cynthia M. Pérez, Hérmilis Berríos-Ortiz, Carola T. Sánchez-Díaz, Orville M. Disdier, Nilda Ríos-Morales, Erick L. Suárez-Pérez
      First page: 6870
      Abstract: Puerto Rico (PR) has faced environmental and public health challenges that could have significantly affected cancer screening access. Using administrative claims data from PR’s Medicaid population, this study assessed trends in colorectal and breast cancer screening from 2016 to 2021, the impact of disasters in screening, and the absolute deficit in screening due to the pandemic. The monthly rates of claims were analyzed using Poisson regression. Significant reductions in breast and colorectal cancer screening utilization were observed. The colorectal cancer screening rate in 2017 was 77% lower a month after Hurricanes Irma and María [RRadj: 0.23; 95% CI: 0.20, 0.25] compared to the same time period in 2016. Breast cancer screening dropped 50% in November 2017 compared to November 2016 [RRadj: 0.50; 95% CI: 0.47, 0.54]. Prospectively, a recovery in utilization has been observed only for breast cancer screening. The results revealed that cancer screening utilization substantially declined after environmental disasters and the pandemic. These findings have potentially severe long-term implications for cancer health disparities and mortality in PR.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-01
      DOI: 10.3390/ijerph20196870
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6871: Factors Influencing Progressive Utilization
           of Palliative Care Services among Cancer Patients in Kenya: The Case of
           Nairobi Hospice

    • Authors: Caroline Wambui Kimani, Urbanus Mutuku Kioko, Catherine Ndinda, Pauline Wambui Adebayo
      First page: 6871
      Abstract: The rising cases of non-communicable diseases, specifically cancer, have led to the integration of palliative care in their management. However, only 10% of cancer patients have access to palliative care. Healthcare utilization is an important step in disease management as it aids individuals in accessing opportunities for the prevention and treatment of diseases. The study applied the binary probit model to estimate the progressive utilization of palliative care services by cancer patients. The aim of the study was to determine factors influencing the progressive utilization of palliative care by cancer patients. A cross-sectional data survey was conducted for 169 cancer patients seeking palliative care at the Nairobi Hospice in 2013. For each patient, the predisposing, enabling, and need (PEN) factors were analyzed as key criteria for applying progressive utilization of palliative care at the Nairobi Hospice as compared to those residing in other counties in the study. Descriptive statistics showed that 27% of patients studied resided in Nairobi County, where 61% were female, 62% were married, 35% had primary education, 44% were self-employed, and 59% had medical insurance. Probit regression and marginal effects showed that employment and religion were significant in determining the progressive utilization of palliative care. Employment status and religion are consequently the main factors that both governments and health-focused non-governmental organizations need to consider increasing the probability of progressively utilizing palliative care to improve the quality of life of cancer patients.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196871
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6872: Time Spent Jogging/Running and Biological
           Aging in 4458 U.S. Adults: An NHANES Investigation

    • Authors: Christina M. Blackmon, Larry A. Tucker, Bruce W. Bailey, Lance E. Davidson
      First page: 6872
      Abstract: Telomere length is a good index of cellular aging. Longer telomeres are predictive of longer life, and healthy lifestyles are associated with longer telomeres. This study explored the relationship between time spent jogging or running each week and leukocyte telomere length (LTL) in 4458 randomly selected U.S. adults. The association was studied using data collected by the National Health and Nutrition Examination Survey (NHANES), and a cross-sectional design. Total weekly jog/run time was calculated from survey responses. From the minute totals, three categories were formed: <10 min/week, 10–74 min/week, and ≥75 min/week. Adults in the third category met the U.S. guidelines. Data were analyzed using one-way ANOVA. Partial correlation was used to adjust for differences in potential mediating factors, including demographic and lifestyle/medical factors. In the total sample, after adjusting for all the potential covariates, mean LTL significantly differed across the three jog/run categories (F = 4.1, p = 0.0272). Specifically, adults who met the guidelines via jogging and/or running had significantly longer telomeres than adults who performed no jogging/running. Adults in the middle category did not differ from the other two categories. A minimum of 75 min of jogging/running weekly is predictive of longer telomeres when compared to adults who do not jog or run regularly.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196872
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6873: Integrating Social Care into Healthcare: A

    • Authors: M. Lelinneth B. Novilla, Michael C. Goates, Tyler Leffler, Nathan Kenneth B. Novilla, Chung-Yuan Wu, Alexa Dall, Cole Hansen
      First page: 6873
      Abstract: Despite the substantial health and economic burdens posed by the social determinants of health (SDH), these have yet to be efficiently, sufficiently, and sustainably addressed in clinical settings—medical offices, hospitals, and healthcare systems. Our study contextualized SDH application strategies in U.S. clinical settings by exploring the reasons for integration and identifying target patients/conditions, barriers, and recommendations for clinical translation. The foremost reason for integrating SDH in clinical settings was to identify unmet social needs and link patients to community resources, particularly for vulnerable and complex care populations. This was mainly carried out through SDH screening during patient intake to collect individual-level SDH data within the context of chronic medical, mental health, or behavioral conditions. Challenges and opportunities for integration occurred at the educational, practice, and administrative/institutional levels. Gaps remain in incorporating SDH in patient workflows and EHRs for making clinical decisions and predicting health outcomes. Current strategies are largely directed at moderating individual-level social needs versus addressing community-level root causes of health inequities. Obtaining policy, funding, administrative and staff support for integration, applying a systems approach through interprofessional/intersectoral partnerships, and delivering SDH-centered medical school curricula and training are vital in helping individuals and communities achieve their best possible health.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196873
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6874: Depressed Mood as a Significant Risk Factor
           for Gynecological Cancer Aggravation

    • Authors: Seon-Mi Lee, Jae-Yun Song, Aeran Seol, Sanghoon Lee, Hyun-Woong Cho, Kyung-Jin Min, Jin-Hwa Hong, Jae-Kwan Lee, Nak-Woo Lee
      First page: 6874
      Abstract: Background: The aim of this study was to evaluate the relationship between depressed mood and gynecological cancer outcomes, identifying risk factors for cancer aggravation. Methods: This study was a retrospective analysis of gynecological cancer patients (January 2020–August 2022) at Korea University Anam Hospital using Patient Health Questionnaire-9 (PHQ-9). Patients were classified into non-depressed mood (NDM)- and depressed mood (DM)-based scores. Statistical analysis was performed using Student’s t-test, chi-square test, Fisher’s exact test, Kaplan–Meier analysis, and Cox regression analyzing using SPSS. Results: Of the 217 participants, the NDM group comprised 129 patients, and the DM group comprised 88. The two-year disease-free survival (DFS) rates showed significant differences (NDM, 93.6%; DM 86.4%; p = 0.006), but overall survival (OS) did not (p = 0.128). Patients with stage 3 or higher cancer, undergoing five or more chemotherapies, experiencing post-chemotherapy side effects, and depressed mood had an increased risk of cancer aggravation. Conclusions: Appropriate treatment of depressed mood, as well as adequate treatment for advanced gynecological cancer patients, those with numerous CTx., and those with post-CTx. side effects, may contribute to reducing the risk of cancer aggravation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196874
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6875: Editorial to the Special Issue: “Recent
           Advances in the Management of Chronic Pain”

    • Authors: Cascella
      First page: 6875
      Abstract: Chronic pain is a complex biopsychosocial phenomenon with far-reaching implications, not only in terms of clinical care but also in the realms of social and economic impact [1,2]. [...]
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196875
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6876: A Focus on Aging, HIV/AIDS, and
           Neurocognitive Challenges: Examining Southern Nevada HIV Sector
           Providers’ Awareness and Prospective Roles

    • Authors: Brandon Ranuschio, Sherry Bell, Jason D. Flatt, Lianne Barnes, Trinity Puno, Alexander Ribeiro, Nadia Sheik-Yosef, Esmeralda Villalobos, Janelle Wackens, Renato M. Liboro
      First page: 6876
      Abstract: Although abundant research has been carried out to investigate the underlying mechanisms that may cause neurocognitive challenges among middle-aged and older people living with HIV/AIDS (PLWH), to monitor the prevalence rates of HIV-related neurocognitive deficits, and to identify factors related to the improvement of diagnostic screening tools, classification and nosology, and clinical and rehabilitative treatment of HIV-Associated Neurocognitive Disorder (HAND); to date, there have been only a few studies that have explored and examined the awareness and work experiences HIV sector healthcare and service providers have related to HAND. To address this research gap, we conducted a qualitative, community-based participatory research study and interviewed 12 HIV sector providers in Southern Nevada, USA, from January to April 2022. After performing a thematic analysis of our interviews, we were able to identify two major themes and several sub-themes. Under our first major theme, provider awareness and knowledge, we identified four sub-themes: (1) prior knowledge and current awareness; (2) lived experiences of patients and clients with neurocognitive challenges; (3) lack of knowledge as a barrier to providing needed care; and (4) continuing education and professional development. Under our second major theme, prospective provider roles, we identified three sub-themes: (1) early detection; (2) direct and practical support; and (3) appropriate and timely referrals. In this article, we discuss our findings and lessons learned from our study, as well as their implications for the future work of researchers and providers in the HIV sector related to improving care and support for people aging with HIV/AIDS and experiencing neurocognitive challenges.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196876
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6877: Condom Use among HIV-Positive Postnatal Women
           in Primary Health Care Facilities in Tshwane Sub-District 1, Gauteng
           Province, South Africa

    • Authors: Mpho Kgoele, Modikwe Rammopo, Oluwafemi O. Oguntibeju
      First page: 6877
      Abstract: Condoms have been and are still an important part of HIV preventative measures worldwide, and many countries have designed programmes that encourage their use. Consistent and correct condom use among HIV-positive individuals is important in preventing multiple infections. Hence, the uptake and determining factors associated with condom use were investigated in this study. This study was aimed at determining the level of, and factors associated with, condom use among HIV-positive postnatal women in primary health care facilities in Tshwane sub-district 1, Gauteng Province, South Africa. A descriptive cross-sectional study was conducted among 326 HIV-positive postnatal women aged between 15 and 50 years who were conveniently selected and voluntarily participated in the study. A self-developed pretested questionnaire was used to collect data on level of condom use and factors associated with its use from the selected participants. Statistical tests of correlation were then used to determine the association between frequency of condom use during sexual encounter and condom use at last sexual encounter with the independent variables. Regular condom use during sexual encounters was reported by 63.2% of the participants while 83% of the participants reported using a condom at their last sexual encounter. Frequency of condom use during sexual encounter was found to be associated with employment status (p < 0.05), residence (p < 0.001), number of children (p < 0.05), first HIV diagnosis (p < 0.05) and disclosure of HIV status to partner (p < 0.05). Condom use at last sexual encounter was also found to have a significant statistical association with level of education (p < 0.05) and the ability to negotiate condom use (p < 0.001). A good proportion of the participants used condoms regularly. Interventions to improve condom use among this population should focus on female empowerment by investing in their education, and economic empowerment to improve their economic status, which, in turn, would help the women to better negotiate condom use. The other factors mentioned above should also be considered when developing health education policies and programmes about condom use amongst HIV-positive postnatal women.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-02
      DOI: 10.3390/ijerph20196877
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6878: Knowledge and Attitudes towards HIV and HCV
           among the Population Attending the Fast-Track Cities Mobile Unit in
           Brescia, Italy

    • Authors: Francesca Viola, Beatrice Formenti, Stefania Arsuffi, Itala Polesini, Emanuele Focà, Francesco Castelli, Eugenia Quiros-Roldan
      First page: 6878
      Abstract: The Infectious and Tropical Diseases Department of the University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast-Track City commitment. A cross-sectional study was conducted, consisting of an anonymous multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18–40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Overall, only 107 (32%) of respondents knew how HIV is transmitted. Major differences were shown between different age groups, where people under the age of 40 had a significantly higher correct response rate than people over 40 (n = 101; 39% versus n = 6; 7.8%, p < 0.00001). Similarly, almost half of LGBTQI+ people (n = 28; 44.4%) gave the correct answer, versus 30% (n = 79) of heterosexuals (p = 0.0359). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. Our study highlights that misconceptions about HIV and HCV should be addressed in prevention and education programs, whose target should also be specific populations.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-03
      DOI: 10.3390/ijerph20196878
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6879: Nutritional Considerations for Bladder
           Storage Conditions in Adult Females

    • Authors: Barbara Gordon
      First page: 6879
      Abstract: Background: Clinical guidelines developed by urologic, urogynecologic, and gynecologic associations around the globe include recommendations on nutrition-related lifestyle and behavioral change for bladder storage conditions. This study identified and compared clinical guidelines on three urological conditions (interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder, and stress urinary incontinence) affecting adult women. Methods: A three-step process was employed to identify the guidelines. Next, a quality assessment of the guidelines was conducted employing the Appraisal of Guidelines Research and Evaluation (AGREE II) International tool. (3) Results: Twenty-two clinical guidelines, prepared by seventeen groups spanning four continents, met the inclusion criteria. The AGREE II analyses revealed that most of the guideline development processes complied with best practices. The most extensive nutrition recommendations were for women with IC/BPS. Dietary manipulation for the other two storage LUTS primarily focused on the restriction or limitation of specific beverages and/or optimal fluid intake. (4) Conclusion: Clinical guidelines for IC/BPS, overactive bladder, and stress urinary incontinence include nutrition recommendations; however, the extent of dietary manipulation varied by condition. The need to ensure that clinicians are informing patients of the limitations of the evidence supporting those recommendations emerged. Furthermore, given the need to treat nutrition-related comorbid conditions as a strategy to help mitigate these three urological disorders, the value of referral to a dietitian for medical nutrition therapy is apparent.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-03
      DOI: 10.3390/ijerph20196879
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6880: Health Access, Health Promotion, and Health
           Self-Management: Barriers When Building Comprehensive Ageing Communities

    • Authors: Leticia Pérez-Saiz, Mireia Ferri Sanz, Maite Ferrando, Mirian Fernández Salido, Tamara Alhambra-Borrás, Jorge Garcés Ferrer, Rachael Dix
      First page: 6880
      Abstract: A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalized care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of workshops in different locations of the city to encourage a sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighborhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their health and understand their values and preferences. In the present manuscript, we focus on the qualitative results, which show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered among the reasons to visit health professionals. Some of the conclusions revealed that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognized the benefits of this new approach but required more time and incentives to dedicate the effort needed. The main aim of this study was to present these barriers related to health access, health promotion, and health self-management, as well as the actions developed to face them.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-03
      DOI: 10.3390/ijerph20196880
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6881: Community Champions: The Crucial Contribution
           of an Independent Pharmacy in COVID-19 Vaccination Efforts in an
           Underserved Community

    • Authors: Chardaé Whitner, Stacey D. Curtis, John M. Allen, Kevin J. Duane
      First page: 6881
      Abstract: Historically, pharmacists in independent community pharmacies have been pivotal in promoting community health. During the COVID-19 pandemic, they demonstrated their commitment by advocating for vaccination and providing accessible care, particularly in underserved communities. By addressing disparities, implementing strategies like mobile clinics and community outreach, and fostering trust and engagement, independent community pharmacists played a crucial role in bridging gaps in healthcare access for vulnerable populations and mitigating the impact of the COVID-19 pandemic.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-10-03
      DOI: 10.3390/ijerph20196881
      Issue No: Vol. 20, No. 19 (2023)
  • IJERPH, Vol. 20, Pages 6782: Exploration of the Relationships between
           Men’s Healthy Life Expectancy in Japan and Regional Variables by
           Integrating Statistical Learning Methods

    • Authors: Fumiya Sato, Keiko Nakamura
      First page: 6782
      Abstract: A quantitative understanding of the relationship between comprehensive health levels, such as healthy life expectancy and their related factors, through a highly explanatory model is important in both health research and health policy making. In this study, we developed a regression model that combines multiple linear regression and a random forest model, exploring the relationship between men’s healthy life expectancy in Japan and regional variables from open sources at the city level as an illustrative case. Optimization of node-splitting in each decision tree was based on the total mean-squared error of multiple regression models in binary-split child nodes. Variations of standardized partial regression coefficients for each city were obtained as the ensemble of multiple trees and visualized on scatter plots. By considering them, interaction terms with piecewise linear functions were exploratorily introduced into a final multiple regression model. The plots showed that the relationship between the healthy life expectancy and the explanatory variables could differ depending on the cities’ characteristics. The procedure implemented here was suggested as a useful exploratory method for flexibly implementing interactions in multiple regression models while maintaining interpretability.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-19
      DOI: 10.3390/ijerph20186782
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6783: Reaching the Frail Elderly for the Diagnosis
           and Management of Atrial Fibrillation—REAFEL

    • Authors: Carsten Bamberg, Caroline Thorup Ladegaard, Mathias Aalling, Dorthea Marie Jensen, Christoffer Læssøe Madsen, Sadaf Kamil, Henrik Gudbergsen, Thomas Saxild, Michaela Louise Schiøtz, Julie Grew, Luana Sandoval Castillo, Iben Tousgaard, Rie Laurine Rosenthal Johansen, Jakob Eyvind Bardram, Anne Frølich, Helena Domínguez
      First page: 6783
      Abstract: BACKGROUND: Frail elderly patients are exposed to suffering strokes if they do not receive timely anticoagulation to prevent stroke associated to atrial fibrillation (AF). Evaluation in the cardiological ambulatory can be cumbersome as it often requires repeated visits. AIM: To develop and implement CardioShare, a shared-care model where primary care leads patient management, using a compact Holter monitor device with asynchronous remote support from cardiologists. METHODS: CardioShare was developed in a feasibility phase, tested in a pragmatic cluster randomization trial (primary care clinics as clusters), and its implementation potential was evaluated with an escalation test. Mixed methods were used to evaluate the impact of this complex intervention, comprising quantitative observations, semi-structured interviews, and workshops. RESULTS: Between February 2020 and December 2021, 314 patients (30% frail) were included, of whom 75% had AF diagnosed/not found within 13 days; 80% in both groups avoided referral to cardiologists. Patients felt safe and primary care clinicians satisfied. In an escalation test, 58 primary-care doctors evaluated 93 patients over three months, with remote support from four hospitals in the Capital Region of Denmark. CONCLUSIONS: CardioShare was successfully implemented for AF evaluation in primary care.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-19
      DOI: 10.3390/ijerph20186783
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6784: The Effect of Mindset and Breathing Exercises
           on Physical and Mental Health in Persons with Spinal Cord Injury—A
           Pilot Feasibility Study

    • Authors: Sonja de Groot, Frank W. L. Ettema, Christel M. C. van Leeuwen, Wendy J. Achterberg, Thomas W. J. Janssen, Sven P. Hoekstra
      First page: 6784
      Abstract: This study investigated the feasibility and efficacy of mindset and breathing exercises (Wim Hof Method (WHM)) on physical and mental health in persons with spinal cord injury (SCI). Ten individuals with SCI participated in this pilot study. These ten participants followed a 4-week WHM intervention, with one weekly group session in the rehabilitation center and daily practice at home using the WHM app. An in-person exit-interview was conducted post-intervention to collect qualitative information on participants’ experiences, regarding the feasibility and effects of the intervention. Furthermore, tests and questionnaires were administered pre- and post-intervention to assess physical and mental health outcomes. Adherence to the weekly in-person meetings was excellent and no adverse events occurred. Physical and mental health outcomes in this small sample size showed some pre–post differences. This pilot feasibility study provides preliminary evidence supporting the feasibility and efficacy of the WHM, including mindset and breathing exercises, on physical and mental health of people with SCI. These results warrant a randomized-controlled trial, including cold exposure, of this novel intervention in people with SCI.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-20
      DOI: 10.3390/ijerph20186784
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6785: Knowledge, Attitude, Behavior Practices and

    • Authors: Mwaba Sifanu, Thomas K. Taylor, Kennedy K. Kalebaila, Patrick Hayumbu, Lubinda Nabiwa, Stephanus J. L. Linde
      First page: 6785
      Abstract: Work in the copper mining industry is often associated with exposure to respirable dust and respirable crystalline silica. This exposure has the potential to cause silicosis, an incurable occupational respiratory lung disease. This study aimed at establishing the relationship between knowledge, attitudes, work behavioral practices and compliance with safety standards and workers’ exposure to respirable dust. A cross-sectional descriptive survey was conducted on 528 mine workers. The Statistical Package for Social Sciences (SPSS) was used for the descriptives. Structural equation modeling (SEM) with latent variables and partial least squares (LVPLS) analysis were employed to determine the relationship among these variables. The results indicated that of the four hypotheses, two were supported, and two were rejected, showing that there is a significant relationship between exposure to respirable dust and work behavioral practices, as well as compliance with safety standards. Knowledge and attitudes toward respirable dust exposure did not significantly influence exposure. According to the results from the survey, positive work behavioral practices as well as compliance with safety standards were significantly associated with exposure to respirable dust. It is recommended that mines should focus on the miners’ work behavioral practices and compliance with safety standards.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-20
      DOI: 10.3390/ijerph20186785
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6786: Callous and Unemotional Traits as Precursors
           to the Development of Female Psychopathy

    • Authors: Ana Raquel Cardoso, Maria João Costa, Ana Isabel Sani, Diana Moreira
      First page: 6786
      Abstract: Objective: Conduct a systematic review concerning the literature that reflects whether the callous and unemotional traits present in childhood and/or adolescence are precursors in the development of female psychopathy in adulthood. Materials and Methods: A systematic review involved consulting three databases—EBSCO, the Web of Science, and PubMed—for peer-reviewed and quantitative studies within the period 2000–2023. Nine articles with quality of three and above were included. Results: The presence of callous and unemotional traits designates a group of youth that show characteristics associated with psychopathy, specifically when predicting a more severe and chronic pattern of antisocial behaviour. Children with high rates of callous and unemotional traits, who show symptoms of attention deficit hyperactivity disorder in combination with severe conduct problems, are most likely to show features associated with psychopathy. The multidimensional psychopathy construct is considered a better predictor of future and stable antisocial behaviour than the callous and unemotional traits alone model. Conclusions: According to the studies selected, the callous and unemotional traits in childhood seem to be precursors of female psychopathy in adulthood, but only because of the way they seem to enhance conduct problems, disruptive behaviour disorders, and, as a possible outcome, delinquency and antisocial traits, which may be precursors of future psychopathy.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-20
      DOI: 10.3390/ijerph20186786
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6787: Mental Health Clinician Attitudes about
           Service User and Family Agency and Involvement in Recovery-Oriented

    • Authors: Janice Chisholm, Judy Hope, Ellie Fossey, Melissa Petrakis
      First page: 6787
      Abstract: Background: Recovery-oriented practice (ROP) is a framework focusing on recovery through hope, choice, and meaning, to live with or without enduring symptoms and challenges. Aims: To examine clinicians’ attitudes about the involvement of service users and family or supporters in ROP. Methods: A bespoke Qualtrics survey obtained views of mental health clinicians working in an Australian public mental health service about service user and family involvement in ROP, using a five-point Likert scale of agreement and free-text responses. Data were analysed with descriptive statistics and content analysis methods. Results: Two hundred and three clinicians completed the survey. Most (79%) clinicians agreed with the statement that service users want clinicians to use ROP principles, and the majority (63%) also ‘strongly believed’ that ROP made a difference to service users’ mental health outcomes. Only 15% ‘strongly agreed’ and 57% somewhat agreed with the statement that service users know what treatment is best for them, and only 20% of clinicians ‘strongly agreed’ that supporters of service users believed in and wanted ROP for their family member or friend. Future directions: This study adds to the literature on clinicians’ views about ROP and shows that although clinicians are supportive of ROP, they also express substantial ambivalence about whether service users and families know what treatment is best. For ROP implementation to be successful, workforce training needs to support clinicians to reflect on these views with service users and families, and to encourage supported decision making. Future studies should focus on changes in clinicians’ views and practice post ROP training.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-20
      DOI: 10.3390/ijerph20186787
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6788: Determining Medication Errors in an Adult
           Intensive Care Unit

    • Authors: Renata da Nóbrega Souza de Castro, Lucas Barbosa de Aguiar, Cris Renata Grou Volpe, Calliandra Maria de Souza Silva, Izabel Cristina Rodrigues da Silva, Marina Morato Stival, Everton Nunes da Silva, Micheline Marie Milward de Azevedo Meiners, Silvana Schwerz Funghetto
      First page: 6788
      Abstract: Introduction: Research addressing the costs of Medication errors (MEs) is still scarce despite issues related to patient safety having significant economic and health impacts, making it imperative to analyze the costs and adverse events related to MEs for a better patient, professional, and institutional safety. Aim: To identify the number of medication errors and verify whether this number was associated with increased hospitalization costs for patients in an Intensive Care Unit (ICU). Method: This retrospective cross-sectional cohort study evaluated secondary data from patients’ electronic medical records to compile variables, create a model, and survey hospitalization costs. The statistical analysis included calculating medication error rates, descriptive analysis, and simple and multivariate regression. Results: The omission error rate showed the highest number of errors per drug dose (59.8%) and total errors observed in the sample (55.31%), followed by the time error rate (26.97%; 24.95%). The omission error had the highest average when analyzing the entire hospitalization (170.40) and day of hospitalization (13.79). Hospitalization costs were significantly and positively correlated with scheduling errors, with an increase of BRL 121.92 (about USD $25.00) (95% CI 43.09; 200.74), and to prescription errors, with an increase of BRL 63.51 (about USD $3.00) (95% CI 29.93; 97.09). Conclusion: We observed an association between two types of medication errors and increased hospitalization costs in an adult ICU (scheduling and prescription errors).
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-20
      DOI: 10.3390/ijerph20186788
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6789: Metabolic Diseases—A Challenge for
           Public Health in the 21st Century

    • Authors: Anna Garus-Pakowska
      First page: 6789
      Abstract: Metabolic diseases refer to a broad term that includes all diseases that result from disturbances in the body’s biochemical metabolism [...]
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-20
      DOI: 10.3390/ijerph20186789
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6790: Changes in Residential Greenspace and Birth
           Outcomes among Siblings: Differences by Maternal Race

    • Authors: Samantha Gailey
      First page: 6790
      Abstract: Growing research investigates the perinatal health benefits of greenspace in a mother’s prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = −0.51, 95% CI: −22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186790
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6791: Association between Sleep Timing, Being
           Overweight and Meal and Snack Consumption in Children and Adolescents in
           Southern Brazil

    • Authors: Denise Miguel Teixeira Roberto, Luciana Jeremias Pereira, Francilene Gracieli Kunradi Vieira, Patricia Faria Di Pietro, Maria Alice Altenburg Assis, Patrícia de Fragas Hinnig
      First page: 6791
      Abstract: Sleep timing is one of the dimensions of sleep that refers to the time of day when sleep occurs. It has been included in sleep-related research because of the potential associations between being overweight and the consumption of meals and snacks. This cross-sectional study aimed to investigate associations between sleep timing, meal and snack consumption and weight status in 1333 schoolchildren aged 7–14 years. The midpoint of sleep was used as a sleep timing measure obtained by the midpoint between bedtime and wake-up time, classified as Early, Intermediate, and Late. Schoolchildren in the Early group were less likely to be overweight (OR: 0.83, 95% CI 0.69; 0.99), and had higher odds of mid-morning snack consumption (OR: 1.95, 95% CI 1.56; 2.44) and lower probability to consume an evening snack (OR: 0.75, 95% CI 0.59; 0.94) compared with the Intermediate group. The Late group had lower odds of mid-morning snack consumption (OR: 0.67, 95% CI 0.55, 0.80) than the Intermediate group. The consumption of mid-morning and evening snacks was associated with the Early and Late midpoints of sleep. These results suggest that bedtime and wake-up time are relevant to consuming meals and snacks and may also be related to a greater probability of being overweight in children and adolescents.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186791
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6792: Usability and Feasibility Testing of an
           Atrial Fibrillation Educational Website with Patients Referred to an
           Atrial Fibrillation Specialty Clinic

    • Authors: Kathy L. Rush, Lindsay Burton, Cherisse L. Seaton, Peter Loewen, Brian P. O’Connor, Kendra Corman, Robyn Phillips, Lana Moroz, Jason G. Andrade
      First page: 6792
      Abstract: Background: The purpose of this study was to design, usability test, and explore the feasibility of a web-based educational platform/intervention for patients with atrial fibrillation (AF) as part of their virtual AF care. Methods: Participants were patients attending a specialized AF clinic. The multiple mixed-methods design included website design, think-aloud usability test, 1-month unstructured pre-testing analysis using Google Analytics, follow-up interviews, and a non-randomized one-group feasibility test using pre/post online surveys and Google Analytics. Results: Usability testing participants (n = 2) guided adjustments for improving navigation. Pre-testing participants’ (n = 9) website activity averaged four sessions (SD = 2.6) at 10 (SD 8) minutes per session during a 1-month study period. In the feasibility test, 30 patients referred to AF specialty clinic care completed the baseline survey, and 20 of these completed the 6-month follow-up survey. A total of 19 patients accessed the website over the 6 months, and all 30 participants were sent email prompts containing information from the website. Health-related quality of life, treatment satisfaction, household activity, and AF knowledge scores were higher at follow-up than baseline. There was an overall downward trend in self-reported healthcare utilization at follow-up. Conclusions: Access to a credible education website for patients with AF has great potential to complement virtual and hybrid models of care.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186792
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6793: Assessment of Electrical Brain Activity of
           Healthy Volunteers Exposed to 3.5 GHz of 5G Signals within Environmental
           Levels: A Controlled–Randomised Study

    • Authors: Layla Jamal, Lydia Yahia-Cherif, Laurent Hugueville, Paul Mazet, Philippe Lévêque, Brahim Selmaoui
      First page: 6793
      Abstract: Following the recent deployment of fifth-generation (5G) radio frequencies, several questions about their health impacts have been raised. Due to the lack of experimental research on this subject, the current study aimed to investigate the bio-physiological effects of a generated 3.5 GHz frequency. For this purpose, the wake electroencephalograms (EEG) of 34 healthy volunteers were explored during two “real” and “sham” exposure sessions. The electromagnetic fields were antenna-emitted in an electrically shielded room and had an electrical field root-mean-square intensity of 2 V/m, corresponding to the current outdoor exposure levels. The sessions were a maximum of one week apart, and both contained an exposure period of approximately 26 min and were followed by a post-exposure period of 17 min. The power spectral densities (PSDs) of the beta, alpha, theta, and delta bands were then computed and corrected based on an EEG baseline period. This was acquired for 17 min before the subsequent phases were recorded under two separate conditions: eyes open (EO) and eyes closed (EC). A statistical analysis showed an overall non-significant change in the studied brain waves, except for a few electrodes in the alpha, theta, and delta spectra. This change was translated into an increase or decrease in the PSDs, in response to the EO and EC conditions. In conclusion, this studhy showed that 3.5 GHz exposure, within the regulatory levels and exposure parameters used in this protocol, did not affect brain activity in healthy young adults. Moreover, to our knowledge, this was the first laboratory-controlled human EEG study on 5G effects. It attempted to address society’s current concern about the impact of 5G exposure on human health at environmental levels.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186793
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6794: Enhancing Food Literacy and Food Security
           through School Gardening in Rural and Regional Communities

    • Authors: Timothy P. Holloway, Sisitha Jayasinghe, Lisa Dalton, Michelle L. Kilpatrick, Roger Hughes, Kira A. E. Patterson, Robert Soward, Kylie Burgess, Nuala M. Byrne, Andrew P. Hills, Kiran D. K. Ahuja
      First page: 6794
      Abstract: A qualitative case study approach with in-depth, semi-structured interviews of key school staff, and student feedback was used to assess a school kitchen and garden program in the regional area of North-West Tasmania, Australia. A detailed program description was produced to conduct a realist evaluation with a Context-Mechanism-Outcome configuration, followed by a program theory evaluation through the construction of a retrospective program logic model. Dedicated kitchen and garden spaces, knowledgeable teachers committed to the program, provision of sufficient materials and consumables, and support from the school and community were found to be the basic requirements to establish a program. Additionally, it is essential to integrate both the kitchen and garden teaching components into the school curriculum. The positive outcomes (e.g., engagement, participation, knowledge, skills, behavioral change) of the program were dependent on the underlying factors, including dedicated support of school leadership, teaching staff, and the parent body for effective student engagement in the teaching spaces and for wider engagement from families and the community. The students’ feedback provided supporting evidence of increased food literacy with improvements in their understanding, abilities, and attitudes towards gardening, producing healthy food, and preparing food. This may further lead to enhanced food security for students’ families and the broader community.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186794
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6795: Dental Pain Medication Prescriptions in Minas
           Gerais, Brazil (2011–2021): A Time-Series Analysis

    • Authors: Alex Junio Silva Cruz, Maria Auxiliadora Parreiras Martins, Victor Santos Batista, Henrique Pereira de Aguilar Penido, Jacqueline Silva Santos, Thiago Rezende dos Santos, Woosung Sohn, Lia Silva de Castilho, Mauro Henrique Nogueira Guimarães Abreu
      First page: 6795
      Abstract: To describe trends of dentist-prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, from January 2011 to December 2021, as well as to examine the relationship between these trends and characteristics of public oral health services in Minas Gerais, Brazil. In this time-series analysis, all drugs were classified according to the Anatomical Therapeutic Chemical classification system. Drugs categorized as NSAIDs (M01A), and other analgesics and antipyretics (N02B) were included for analysis. The outcome was the number of Defined Daily Doses (DDDs)/1000 inhabitants/year for NSAIDs and analgesics in each town. Covariates referred to characteristics of public oral health services, such as coverage, estimates of dental procedures, and frequency of toothache. Linear time-series regression models were used to determine the influence of covariates on the outcome. Overall, there were 58,482 prescriptions of NSAIDs recorded in thirty-eight towns, while 47,499 prescriptions of analgesics in forty-three towns. For each year, there was a 0.38 (p < 0.001), and 0.28 (p < 0.001) increase in the average log of DDD/1000 inhabitants/year for NSAIDs and analgesics, respectively. A positive association was detected between toothache (p < 0.001) and the prescription of NSAIDs. Over the eleven years, there was a general rising trend in the prescriptions. Toothache was the only characteristic of public oral health services associated with the prescription rates of NSAIDs, implying that as the frequency of toothaches increase, so do the prescriptions of NSAIDs in the studied towns.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186795
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6796: Changes in Food Consumption, BMI, and Body
           Composition in Youth in the US during the COVID-19 Pandemic

    • Authors: Nasreen Moursi, Marian Tanofsky-Kraff, Megan Parker, Lucy Loch, Bess Bloomer, Jennifer Te-Vazquez, Ejike Nwosu, Julia Lazareva, Shanna B. Yang, Sara Turner, Sheila Brady, Jack Yanovski
      First page: 6796
      Abstract: Rates of childhood overweight/obesity have risen for decades; however, data show the prevalence increased at a faster rate during the COVID-19 pandemic. Pandemic-associated increases in youth’s body mass index (BMI; kg/m2) have been attributed to decreases in reported physical activity; few studies have examined changes in food intake. We therefore examined changes in total energy, nutrient consumption, BMI, BMIz, and adiposity longitudinally over 3 years, comparing healthy youth aged 8–17 years assessed twice prior to the pandemic, to youth seen once before and once during the pandemic. The total energy intake and percent macronutrient consumption were assessed using a standardized, laboratory-based, buffet-style meal. Height and weight were measured and adiposity was collected via dual energy X-ray absorptiometry. Generalized linear model univariate analyses investigated differences between groups. One-hundred-fifteen youth (15.6 + 2.8 years 47.8% female; 54.8% White) from the Washington D.C., Maryland, and Virginia greater metropolitan area participated. In this secondary analysis, neither changes in total energy intake (p = 0.52) nor changes in nutrient consumption were significantly different between the two groups (ps = 0.23–0.83). Likewise, changes in BMI, BMIz, and adiposity (ps = 0.95–0.25) did not differ by group. Further research should investigate food intake and body composition, comparing youth with and without overweight/obesity to better identify those at greatest risk of excess weight gain during the pandemic.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186796
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6797: Measuring Māori Health, Wellbeing, and
           Disability in Aotearoa Using a Web-Based Survey Methodology

    • Authors: Tristram R. Ingham, Bernadette Jones, Meredith Perry, Martin von Randow, Barry Milne, Paula T. King, Linda W. Nikora, Andrew Sporle, Te Ao Mārama Study Group Te Ao Mārama Study Group
      First page: 6797
      Abstract: High-quality evidence on the prevalence and impact of health, wellbeing, and disability among Māori, and other Indigenous peoples, is crucial for mitigating health inequities. Current surveys are predominantly centred within a biomedical paradigm, with the constructs mismatched with Indigenous worldviews. We aimed to develop and deploy an accessible and culturally grounded survey exploring Māori health, wellbeing, and disability using a Kaupapa Māori Research methodology. An extensive codesign process with Māori community partners interrogated all aspects of the design to ensure the process and outcomes met the needs of Māori. A large-scale, nationally representative survey of people of Māori descent was conducted. We used a multi-modal deployment approach that included online and alternate methods of completion. Our analysis included a novel dual-weighting system to ensure generalisability of results to the national Māori population. This achieved a survey of 7230 participants, a sample size comparable with government-administered surveys. The response rate was 11.1%, with 7.3% opting for alternate methods. A high completion rate of 93.4% was observed. This approach demonstrated a high level of engagement, resulting in an unprecedented collection of Māori health, wellbeing, and disability data. This highlights the importance of Indigenous codesign for ensuring accessible and culturally appropriate survey methods.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186797
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6798: Trees, Climate Change, and Health: An Urban
           Planning, Greening and Implementation Perspective

    • Authors: Alistair Woodward, Andrea Hinwood, Daniel Bennett, Brenton Grear, Sotiris Vardoulakis, Neha Lalchandani, Katrina Lyne, Carmel Williams
      First page: 6798
      Abstract: The In Conversation: Boundary, Spanners, Thinkers and Policy Actors Round Table Series provides a platform for researchers, policy actors, and implementation experts to elevate discussion on emerging issues, present new and upcoming research, and facilitate conversations around impacts and possible solutions. This brief report, on trees, climate change, and health, reflects a conversation between the authors of this paper, along with supporting literature. It explores the potential of green spaces and trees as a viable strategy to address climate change challenges and simultaneously improve population health, well-being, and health equity. In particular, it highlights the public health benefits of trees and green space, the challenges faced in urban areas, and opportunities for the protection, maintenance and regeneration of urban green space.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186798
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6799: A Single Center Observational Study on
           Clinical Manifestations and Associated Factors of Pediatric Long COVID

    • Authors: Enrica Mancino, Raffaella Nenna, Luigi Matera, Domenico Paolo La Regina, Laura Petrarca, Elio Iovine, Greta Di Mattia, Antonella Frassanito, Maria Giulia Conti, Enea Bonci, Mattia Spatuzzo, Sara Ialongo, Anna Maria Zicari, Alberto Spalice, Fabio Midulla, on behalf of the Long COVID Research Group on behalf of the Long COVID Research Group
      First page: 6799
      Abstract: Children with SARS-CoV-2 are mostly mild symptomatic, but they may develop conditions, such as persisting symptoms, that may put them at greater risk of complications. Our aim was to evaluate the frequency and the presence of risk factors for persisting COVID-19 symptoms in children. We carried out a prospective observational study of the clinical manifestation of Long COVID at the Department of Maternal Infantile Science of a tertiary University hospital in Rome. We included 697 children (0–18 years), with previous SARS-CoV-2 infection. Children and parents were asked questions regarding persistent symptoms of COVID-19. Children with symptoms 30 days after initial diagnosis were 185/697 (26.4%). Moreover, 81/697 (11.6%) patients presented symptoms 90 days after the diagnosis. Thirty-day-persisting symptoms were mostly present in children with anosmia, atopy, asthenia, and cough in the acute phase compared with the asymptomatic children 30 days after infection. After 90 days, symptoms described were mainly neurological (47/697 children, 6.7%), and headache (19/697; 2.7%) was the most frequent manifestation. In conclusion, a relatively large proportion of the patients reported persisting symptoms that seem to be related to the symptom burden and to the atopy. Ninety days after the infection, most of the children had recovered, showing that long-term effects are not frequent. Limitations of the study include the single-center design and the lack of a control group.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186799
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6800: Commonalities and Differences in the
           Experiences of Visible Minority Transnational Carer–Employees: A
           Qualitative Study

    • Authors: Reemal Shahbaz, Allison Williams, Bharati Sethi, Olive Wahoush
      First page: 6800
      Abstract: This qualitative study explored the commonalities and differences among the experiences of visible minority Transnational Carer–Employees (TCEs) before and after COVID-19. TCEs are immigrants who live and work in the country of settlement while providing caregiving across international borders. Purposive and snowball sampling resulted in the participation of 29 TCEs of Pakistani, Syrian, African, and South American origin living in London, Ontario. Thematic analysis of the dataset using the ATLAS.ti software, Version 23.2.1., generated three themes: (1) feelings associated with transnational care; (2) employment experiences of TCEs; and (3) coping strategies for well-being. The results of the secondary analysis conducted herein suggested that there are more similarities than differences across the four cohorts. Many participants felt a sense of satisfaction at being able to fulfill their care obligations; however, a different outlook was observed among some Syrian and African origin respondents, who disclosed that managing care and work is overwhelming. Most TCEs also reported facing limited job options because of language barriers. While various interviewees experienced a lack of paid work and reduced income after COVID-19, a distinct perspective was noted from African descent TCEs as they expressed facing increased work demands after the pandemic. Participants additionally revealed four common coping strategies such as keeping busy, praying, family support, and staying active. Study implications include the promotion of Carer-Friendly Workplace Policies (CFWPs) that can facilitate the welfare of unpaid caregivers. This research is important as it may inform policymakers to create opportunities that may not only foster economic stability of TCEs and the Canadian economy, but also contribute towards a more equitable society.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186800
      Issue No: Vol. 20, No. 18 (2023)
  • IJERPH, Vol. 20, Pages 6801: Elucidating and Expanding the Restorative
           Theory Framework to Comprehend Influential Factors Supporting
           Ageing-in-Place: A Scoping Review

    • Authors: Anne Johanna Jacoba Grave, Louis Neven, Masi Mohammadi
      First page: 6801
      Abstract: Exposure to stress and attention fatigue resulting from changes in capabilities and residing in environments that do not align with individual needs can adversely impact older adults’ mental health and complicate ageing-in-place. Research into the psychological restoration process can help assist in alleviating these issues. Existing research on restoration perspectives has predominantly centred on university students and lacks comprehensive insights into older adults. Consequently, this study seeks to acquire a deeper understanding of the restorative theory framework within the context of ageing populations. We identified and analysed thirty-nine papers on the restoration process of older adults employing the scoping review method. Our findings indicate that adjustments to the general restorative theory framework are imperative for ageing populations. By incorporating additional features—such as being with and familiarity—the framework can more effectively support the development of age-inclusive neighbourhoods that enhance the mental health of the older population and facilitate healthy ageing-in-place. While more in-depth research is required on the restoration process of older adults, this research marks the initial in adapting the general framework to ageing populations. Furthermore, insight is given into how the adapted framework can contribute to help address the challenges of global ageing and support ageing-in-place.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2023-09-21
      DOI: 10.3390/ijerph20186801
      Issue No: Vol. 20, No. 18 (2023)
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