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International Journal of Environmental Research and Public Health
Journal Prestige (SJR): 0.735  Citation Impact (citeScore): 2 Number of Followers: 27  Open Access journalISSN (Print) 1660-4601 - ISSN (Online) 1661-7827 Published by MDPI  [258 journals]
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- IJERPH, Vol. 21, Pages 960: Prevalence and Determinants of Changes in
Physical Activity and Sedentary Behavior during and after the COVID-19
Pandemic: A Swedish Repeated Cross-Sectional Study
Authors: Birgitta Kerstis, Maria Elvén, Kent W. Nilsson, Petra von Heideken Wågert, Jonas Stier, Micael Dahlen, Daniel Lindberg
First page: 960
Abstract: Physical activity (PA) and sedentary behavior (SB) changed during the COVID-19 pandemic; hence, this study examined PA and SB at four time points between December 2019 and December 2022. The participants’ PA decreased during the pandemic and did not recover afterwards. Among women, PA increased slightly in 2022 but not at all in men. From 2019 to 2020, SB increased and then decreased to near the pre-pandemic level in both sexes. Regarding age, PA decreased in the oldest age group (65–79 years) across all time points, while SB increased in all age groups during 2019–2020 and then returned close to pre-pandemic levels among the two middle age groups (30–64 years), but not among the youngest and oldest groups. Considering occupation, PA decreased from 2020 to December 2022 among retired and “other” participants, while SB decreased among nonmanual workers and retired participants. The regression models associated better self-reported health, male sex, and those born overseas with higher PA. Higher age, better self-reported health, poor education, and later survey time points were associated with lower SB. These findings highlight the need to return PA and SB to at least pre-pandemic levels and that subgroups may need different interventions.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-23
DOI: 10.3390/ijerph21080960
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 961: Characteristics of Sexual Health Programs for
Migrants, Refugees, and Asylum Seekers: A Scoping Review
Authors: Angelina Bolyta Inthavong, Davoud Pourmarzi
First page: 961
Abstract: Background: Social, cultural, and structural determinants of health for migrants, refugees, and asylum seekers can contribute towards poorer sexual health outcomes. People from migrant, refugee, and asylum seeker backgrounds usually use less mainstream sexual healthcare services and have lower levels of sexual health literacy compared with the destination countries’ general population. However, there is little collated knowledge about sexual health programs that have been implemented to improve sexual health among these groups. This study aimed to describe the characteristics of programs for improving sexual health among migrants, refugees, and asylum seekers. Methods: This study was a scoping review in which Scopus and PubMed were searched for peer-reviewed articles published in English since 2010 from countries similar to and including Australia such as New Zealand, the United States of America, Canada, the United Kingdom, and European Union countries). The final search of databases was performed on 26 June 2023, and resultant studies were inputted into Endnote and Covidence systematic review software to remove duplicates before screening. The study utilised a qualitative approach using inductive thematic analysis of the content of the studies to extract and categorise the characteristics of the program. Results: A total of 3044 articles were screened and 20 were included for data extraction. The included studies were conducted in six countries (the United States of America, Australia, France, Italy, Denmark, and Belgium). The key characteristics of sexual health programs identified included consumer consultation and engagement, cultural appropriateness, language support, peer education, self-directed learning, group learning, financial support, and outreach services. the programs had a combination of these characteristics to ensure that they can improve target population engagement with educational materials and decrease barriers to accessing sexual healthcare. Conclusion: Consideration of migrants, refugees, and asylum seekers’ culture, language, socioeconomic characteristics, and access to information and services in the design of the sexual health programs may improve sexual health outcomes among these groups. However, further research is needed to assess the importance and implementation feasibility of the identified characteristics for sexual health programs in specific context.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-23
DOI: 10.3390/ijerph21080961
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 962: Ecotoxicological and Microbiological Risk
Assessment of Groundwater from Dimba Cave, Democratic Republic of the
Congo
Authors: Daniel M. Mudinga, Archal M. Ngandote, John M. Kayembe, Séraphin N. Lusamba, Emmanuel K. Atibu, Fernando P. Carvalho, John Poté
First page: 962
Abstract: Dimba Cave is a large array of natural galleries in limestone mountains of the Democratic Republic of the Congo that contains highly valued pre-historic archaeological artifacts. The cave attracts a high number of tourists every year and is used by local populations as a water supply source. The main objective of the research undertaken in Dimba Cave consisted of assessing the quality of water and sediments from Dimba Cave ponds through evaluating contamination by heavy metals (15 elements analyzed, including As, Cd, Pb, and Hg) and by microbial populations (including Escherichia coli and total coliforms) in order to estimate the ecotoxicological risk to humans and to non-human biota. All water samples collected in the cave ponds showed very high metal concentrations exceeding the internationally recommended limits for drinking water, particularly for Cr, Mn, As, Pb, and Hg. Most sediment samples from cave ponds also displayed high heavy metal concentrations. The calculated pollution parameters, such as the enrichment factor (EF), and ecological risk parameters, such as the ecological risk index (Eri), indicated that the sediment may be toxic to aquatic biota. Furthermore, the microbiological analysis of pond waters indicated a widespread contamination with bacteria such as Escherichia coli, Enterococcus spp., total coliforms, and Pseudomonas spp., probably from anthropogenic and/or animal sources. Therefore, the consumption of Dimba Cave water as a drinking water represents a threat to public health. Urgent management measures should be enforced to protect public health and the cave ecosystem.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-23
DOI: 10.3390/ijerph21080962
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 963: Psychological Distress and Associated Factors
among Technical Intern Trainees in Japan: A Cross-Sectional Study
Authors: Ei Thinzar Khin, Yuko Takeda, Kazunari Iwata, Shuhei Nishimoto
First page: 963
Abstract: Japan is experiencing significant demographic shifts due to an aging and declining population. In 1993, the Japanese Government introduced the Technical Intern Training Program (TITP) to accept foreign national workers. While the number of technical intern trainees under this program has constantly increased, many of them face challenges in their daily lives, such as stress, health insecurities and limited access to healthcare. Therefore, we conducted a cross-sectional study to assess the mental well-being of technical intern trainees, focusing on psychological distress and its related factors. This study included 304 technical intern trainees from 12 prefectures in Japan, and was conducted from August 2021 to October 2021. We used self-administered questionnaires in the participants’ native languages to assess their sociodemographic conditions, health-related conditions such as health insecurities and healthcare-seeking behaviors, and psychological distress. The K6 Kessler Psychological Distress Scale was applied to evaluate the levels of psychological distress. Among the participants, 26.3% had moderate psychological distress and 2.3% had severe psychological distress. In addition, about 15% of the participants reported health insecurities and did not see a doctor despite wanting to. The multivariate model of logistic regression revealed significant associations between psychological distress and female gender (AOR 2.62, 95% CI 1.12–6.12), nationality other than Vietnamese (AOR 4.85, 95% CI 2.60–9.07), tough financial conditions (AOR 2.23, 95% CI 1.18–4.19), experiencing health insecurity (AOR 2.21, 95% CI 1.04–4.66) and the health behavior of refraining from seeking medical care (AOR 3.06, 95% CI 1.49–6.30). The top reasons for refraining from seeking medical care were the participants’ limited knowledge about the healthcare system in Japan and their worries about medical bills. These findings highlight the necessity to extend mental health support services, including counseling services, and share information about Japan’s healthcare system to supply medical services to the targeted technical intern trainee population.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-23
DOI: 10.3390/ijerph21080963
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 964: PON1 Status in Relation to Gulf War Illness:
Evidence of Gene–Exposure Interactions from a Multisite
Case–Control Study of 1990–1991 Gulf War Veterans
Authors: Lea Steele, Clement E. Furlong, Rebecca J. Richter, Judit Marsillach, Patricia A. Janulewicz, Maxine H. Krengel, Nancy G. Klimas, Kimberly Sullivan, Linda L. Chao
First page: 964
Abstract: Background: Deployment-related neurotoxicant exposures are implicated in the etiology of Gulf War illness (GWI), the multisymptom condition associated with military service in the 1990–1991 Gulf War (GW). A Q/R polymorphism at position 192 of the paraoxonase (PON)-1 enzyme produce PON1192 variants with different capacities for neutralizing specific chemicals, including certain acetylcholinesterase inhibitors. Methods: We evaluated PON1192 status and GW exposures in 295 GWI cases and 103 GW veteran controls. Multivariable logistic regression determined independent associations of GWI with GW exposures overall and in PON1192 subgroups. Exact logistic regression explored effects of exposure combinations in PON1192 subgroups. Results: Hearing chemical alarms (proxy for possible nerve agent exposure) was associated with GWI only among RR status veterans (OR = 8.60, p = 0.014). Deployment-related skin pesticide use was associated with GWI only among QQ (OR = 3.30, p = 0.010) and QR (OR = 4.22, p < 0.001) status veterans. Exploratory assessments indicated that chemical alarms were associated with GWI in the subgroup of RR status veterans who took pyridostigmine bromide (PB) (exact OR = 19.02, p = 0.009) but not RR veterans who did not take PB (exact OR = 0.97, p = 1.00). Similarly, skin pesticide use was associated with GWI among QQ status veterans who took PB (exact OR = 6.34, p = 0.001) but not QQ veterans who did not take PB (exact OR = 0.59, p = 0.782). Conclusion: Study results suggest a complex pattern of PON1192 exposures and exposure–exposure interactions in the development of GWI.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-24
DOI: 10.3390/ijerph21080964
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 965: Non-Fungible Tokens (NFTs) in Healthcare: A
Systematic Review
Authors: Tiago Nunes, Paulo Rupino da Cunha, João Mendes de Abreu, Joana Duarte, Ana Corte-Real
First page: 965
Abstract: Amid global health challenges, resilient health systems require continuous innovation and progress. Stakeholders highlight the critical role of digital technologies in accelerating this progress. However, the digital health field faces significant challenges, including the sensitivity of health data, the absence of evidence-based standards, data governance issues, and a lack of evidence on the impact of digital health strategies. Overcoming these challenges is crucial to unlocking the full potential of digital health innovations in enhancing healthcare delivery and outcomes. Prioritizing security and privacy is essential in developing digital health solutions that are transparent, accessible, and effective. Non-fungible tokens (NFTs) have gained widespread attention, including in healthcare, offering innovative solutions and addressing challenges through blockchain technology. This paper addresses the gap in systematic-level studies on NFT applications in healthcare, aiming to comprehensively analyze use cases and associated research challenges. The search included primary studies published between 2014 and November 2023, searching in a balanced set of databases compiling articles from different fields. A review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and strictly focusing on research articles related to NFT applications in the healthcare sector. The electronic search retrieved 1902 articles, ultimately resulting in 15 articles for data extraction. These articles span applications of NFTs in medical devices, pathology exams, diagnosis, pharmaceuticals, and other healthcare domains, highlighting their potential to eliminate centralized trust sources in health informatics. The review emphasizes the adaptability and versatility of NFT-based solutions, indicating their broader applicability across various healthcare stages and expansion into diverse industries. Given their role in addressing challenges associated with enhancing data integrity, availability, non-repudiation, and authentication, NFTs remain a promising avenue for future research within digital health solutions.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-24
DOI: 10.3390/ijerph21080965
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 966: Impacts of a Prescribed Physical Activity
Program for People with Chronic Diseases Living in Community Settings in
France
Authors: Christophe Martinez, Aurélie Goncalves, Olivier Coste, Sarah Pabion, Elodie Charbonnier
First page: 966
Abstract: Background: Sedentary behavior and physical inactivity are modifiable risk factors at the forefront of prevention and health promotion strategies. The health benefits of physical activity (PA) have been widely demonstrated in chronic diseases and have led to the prescription of adapted PA. To date, French scientific data are insufficient to evaluate the effectiveness of prescribing adapted PA. This study aimed (1) to evaluate the effectiveness of a community-based program and (2) to identify patient characteristics at inclusion that could be associated with improved post-program anthropometric data. Methods: Our sample was composed of 113 participants with a chronic disease (83.18% women) with a mean age of 55.4 ± 13.9 years. Participants benefited from an 8-week adapted PA program. All participants were evaluated at the beginning and end of the program by anthropometric measurements, a subjective measure of the level of PA and a measure of physical condition. Results: Almost 86% of the participants were overweight and two-thirds were obese. Statistical analyses showed a significant improvement in physical condition, expressed by a better cardiorespiratory endurance (up to +14% for a 2 min walk test; MT0 = 78.1 m vs. MT1 = 89 m; p < 0.001 with a 2 min walk test), improved flexibility (+12.5%; MT0 = 2.4 vs. MT1 = 2.7; p < 0.001), and increased muscle strength in the lower limbs (+22.7%; MT0 = 11.9 vs. MT1 = 14.6; p < 0.001). The level of physical activity increased significantly for all participants (57.52% of inactive individuals at T0 vs. 5.31% at T1; p = 0.004). Correlational analyses revealed that the decrease in BMI and weight throughout the program correlated positively with age (r = 0.252 and p = 0.007, and r = 0.247 and p = 0.008, respectively) and negatively with BMI from baseline (r = −0.271; p = 0.004). Conclusions: The key points of this community-based PA program are the following: (1) It improves participants’ physical condition. (2) It improves anthropometric parameters. (3) It modifies physical activity behavior. Furthermore, in the context of the program set up specifically for this purpose, it would appear that elderly and overweight people are more likely to exhibit beneficial effects on anthropometric parameters than younger participants or those with a high level of obesity. However, these results need to be confirmed by a long-term evaluation of the effectiveness of such devices.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-24
DOI: 10.3390/ijerph21080966
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 967: The Knowledge Acquired by Parents in Pregnancy
Monitoring Consultations
Authors: Raquel Cerdeira, Otília Zangão
First page: 967
Abstract: (1) Pregnancy surveillance nursing consultations in the pandemic context have undergone some changes, namely the restriction of accompanying persons. In this sense, assessing the knowledge acquired by parents in pregnancy surveillance is of great importance. Since there are no studies on the subject in the period before the pandemic, we will only assess the knowledge acquired by parents in pregnancy monitoring. (2) For this reason, the aim of our study is to evaluate the knowledge acquired by parents in pregnancy surveillance. (3) This study is descriptive, cross-sectional and quantitative in nature, with a sample of 196 couples. A questionnaire was administered about the knowledge acquired by parents in pregnancy surveillance nursing consultations. (4) Pregnant mothers and their partners reported having some knowledge. The classification was assessed using a questionnaire with quantifiable response options from 1 to 5 points. Items with a score of 1 indicate a low level of knowledge and 5 indicates a higher level of knowledge. (5) We can verify that the level of knowledge acquired by the pregnant mother during the pregnancy surveillance nursing consultation is higher than the level of knowledge acquired by the father during the same consultation. Most parents consider it important to receive information through the pregnancy surveillance nursing consultations carried out by Maternal and Obstetric Health Nurse Specialists (midwives).
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-24
DOI: 10.3390/ijerph21080967
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 968: The Integration of Information Technology in
the Management and Organization of Nursing Care in a Hospital Environment:
A Scoping Review
Authors: Dulce Cachata, Mónica Costa, Teresa Magalhães, Filomena Gaspar
First page: 968
Abstract: The adoption of health technologies is occurring on an unprecedented scale, with enormous potential to improve the health of populations. In this context, information technology (IT) in nursing has emerged with a focus on quality and safety of care for the benefit of the patient. There is insufficient reliable evidence demonstrating how the integration of IT in nursing care influences methodologies for managing and organizing care in terms of structure and care practice, justifying a scoping review that synthesizes the knowledge produced so far. Online databases were used to identify papers published in 2012–2023, from which we selected nine publications that used information technology in the nursing care processes. The participants were hospital nurses and nurse managers. The results show that the integration of IT in healthcare organizations impacts the management and organization of nursing care, and changes in structure, process reorganization, management, training, and the development of nurses’ skills. To minimize this impact, the organizational structure must be prepared for a cultural change, with well-defined and communicated policies and procedures, and strong leadership. Within the teams, the importance of process reorganization, continuous training, and skill development emerges, thus enhancing the integration of IT into practice environments in conjunction with care.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-24
DOI: 10.3390/ijerph21080968
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 969: Health, Performance Ratings and
Approachability of 50–60-Year-Old Sedentary Adults (ActIv-Study):
Key Insights for Health Economy and Exercise Promotion
Authors: Dieter Leyk, Nadine Hartmann, Emanuel Vits, Thomas Rüther, Stefanie Klatt, Ralf Lämmel, Herbert Löllgen
First page: 969
Abstract: Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2888 study participants aged 50–60 years, 668 persons were categorised into the subgroups “never-athletes”, “sports-dropouts”, “always-athletes” and “sports-beginners”. Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. In total, 42.5% of “never-athletes” and 32.5% of “sports-dropouts” did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between “sports-dropouts” and “sports-beginners”, whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated for by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-24
DOI: 10.3390/ijerph21080969
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 970: Parenting Stress Following a Neonatal
Intensive Care Unit Hospitalization: A Longitudinal Study of Mothers and
Fathers
Authors: Corinna C. Klein, Nicole M. McDonald
First page: 970
Abstract: A neonatal intensive care unit (NICU) hospitalization can add significant stress to the postpartum period. Parents experience isolation and uncertainty, which can affect their capacity to bond with their new baby. Understanding how stress is shaped by and changes following a NICU experience will help in developing supports for these families. We examined patterns of parenting stress over the first year of life following a NICU stay to better understand changes in stress, differences in maternal and paternal stress, and how medical and developmental variables impact parent stress. Parents of infants (n = 51) who had experienced a NICU hospitalization and met criteria for California’s High-Risk Infant Follow-Up program completed assessments at 6, 9, and 12 months. A comparison group (n = 38) from a historic dataset included parents of infants born full term without medical complications. NICU parents reported higher levels of parenting stress at 6 months, but not 12 months, with mothers and fathers reporting similar stress levels. Parenting-related stress was found to be relatively stable and consistent over this period. Among NICU parents, lower developmental level at 12 months was associated with more distress in interacting with their child. These findings highlight the importance of monitoring parenting stress following discharge from the NICU and developing interventions for supporting parents of NICU graduates showing developmental delays.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-25
DOI: 10.3390/ijerph21080970
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 971: Sociocultural Implications in the Development
of Early Maladaptive Schemas in Adolescents Belonging to Sexual and Gender
Minorities
Authors: Bruno Luiz Avelino Cardoso, Ana Flávia Azevedo Lima, Fabiana Rachel Martins Costa, Christof Loose, Xi Liu, Matteo Angelo Fabris
First page: 971
Abstract: Culture is a central theme across various theories and disciplines, influencing behavior and self-perception through interactions within social groups, families, and legal systems. This influence extends to the general population and particularly impacts sexual and gender minorities (SGMs), resulting in minority stress that contributes to mental health issues and the development of Early Maladaptive Schemas (EMSs). Adolescents within these groups face typical developmental stressors—such as hormonal changes and societal pressures—compounded by prejudice, increasing their vulnerability to depression, anxiety, stress, substance abuse, and eating disorders. Despite these challenges, Schema Therapy (ST) lacks comprehensive studies on the sociocultural aspects influencing EMS acquisition in SGM adolescents. This theoretical review aims to fill this gap by exploring the impact of society and culture on EMS development within SGM adolescents. We recognize the broad spectrum of cultural influences and emphasize the importance of cultural sensitivity and diversity. This review specifically addresses how societal and cultural dynamics impact SGM individuals, acknowledging that while ethnic or other cultural factors are not the focus of this paper, they merit future research. This manuscript will discuss central topics and their impact on LGBTQIA+ youth, including (1) the background (definition of culture, lack of studies on ST focusing on culture, and studies on adverse psychological outcomes), (2) minority stress theory and prejudice against sexual and gender diversity (distal and proximal stressors and sociocultural aspects), (3) EMSs and unmet emotional needs, (4) ST affirmative strategies (working with schema modes, imagery rescripting, chair work, and photo techniques), and (5) final considerations (limitations and research agenda).
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-25
DOI: 10.3390/ijerph21080971
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 972: Creating and Reliving the Moment: Using
Musical Improvisation and Care Aesthetics as a Lens of Connection and
Self-Expression for Younger People Living with Dementia
Authors: Robyn Dowlen, Dougal Henry James McPherson, Caroline Swarbrick, Lizzie Hoskin, James Thompson, John Keady
First page: 972
Abstract: Musical improvisation is a generative process of spontaneously creating music ‘in the moment’. For people with young onset dementia, musical improvisation provides an extended opportunity for creative self-expression and connection to one’s own body and life story. Using visual research methods, including video elicitation interviews, this paper explores the ‘in the moment’ musical experiences of five people living with young onset dementia who took part in a 15-week improvised music-making programme (Music in Mind). We frame the exploration of the group’s musical experiences through the emerging lens of ‘care aesthetics’—a concept that identifies the sensory relations and embodied practices between two (or more) people in a caring relationship. In the context of this analysis, we look to the caring practices by, with, and between people living with dementia, their family members, and the musicians who lead the programme and the relationship of these practices to feelings of self-expression and meaningful connection. Musical improvisation has the potential to support the psychological, social, and spiritual wellbeing of people living with young onset dementia. In applying a lens of care aesthetics, it is possible to observe the micro-level experiences of people living with dementia and their family carers.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-25
DOI: 10.3390/ijerph21080972
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 973: Variation in Psychiatric Hospitalisations: A
Multiple-Membership Multiple-Classification Analysis
Authors: Emely Ek Blæhr, Beatriz Gallo Cordoba, Niels Skipper, Rikke Søgaard
First page: 973
Abstract: The complexity of variation in healthcare, particularly in mental health, remains poorly understood. However, addressing this issue presents a significant opportunity to optimise the allocation of scarce healthcare resources. To explore this, we aim to investigate the variation in psychiatric care as measured by the number of psychiatric hospitalisations. We estimated multiple-membership multiple-classification models utilising Danish register data for 64,694 individuals and their healthcare providers, including 2101 general practitioners, 146 community-based care institutions, 46 hospital departments, and 98 municipalities. This approach recognises that data are not strictly hierarchical. We find that, among individuals attending a single healthcare provider, 67.4% of the total variance in psychiatric hospitalisations can be attributed to individual differences, 25.6% to differences in practice context, and 7.95% to differences in medical practice. Adding characteristics to the model explains 68.5% of the variance at the healthcare provider municipality level, but almost no explanation of the variation was found on the three other levels despite the numerous characteristics considered. This suggests that medical practice may vary unwarrantedly between healthcare providers, indicating potential for optimisation. Streamlining medical practices, such as adhering to clinical guidelines, could lead to more efficient consumption of mental health resources. In conclusion, understanding and addressing variation in psychiatric care can have a profound impact on resource allocation and patient outcomes, ultimately leading to a more effective healthcare system.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-25
DOI: 10.3390/ijerph21080973
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 974: Psychiatrists’ Insights on Integrating
Occupational Therapy in Mental Health Care: A Multisite Middle Eastern
Study
Authors: Naser Alotaibi, Hamad Alhamad, Haitham Jahrami, Muhammad O. Al-Heizan, Lujane Albaghli, Hasan Ashkanouni, Hashem Abu Tariah, Hamad Abouelhassan, Moh Alkhamis
First page: 974
Abstract: Objective: The purpose of this study was to explore the knowledge, perception, attitude, and self-efficacy of psychiatrists regarding the role of occupational therapy in mental health practice. Materials and Methods: This study utilized a cross-sectional design to examine the perspectives of psychiatrists from various Middle Eastern countries on occupational therapy practice. A self-developed tool was mainly used to assess occupational therapy knowledge, autonomy, attitude, and self-efficacy. STATA version 16.0 was employed for all subsequent statistical analyses. The data were analyzed using the Kruskal–Wallis and chi-square tests. Results: A total of 117 participants (psychiatrists) from various Middle Eastern countries, including Kuwait, Bahrain, Saudi Arabia, and Jordan, took part in this study. Overall, no significant differences were found between the sites in terms of knowledge and self-perception of occupational therapy autonomy, indicating a lack of understanding about the unique nature of occupational therapy as a distinct health care profession (p-values > 0.05). However, this study’s participants demonstrated a positive attitude and self-efficacy towards occupational therapy. Conclusions: In order to promote the desired therapeutic outcomes, a referral form for occupational therapy, encompassing the main areas of intervention, was proposed. Such a referral form can help inform psychiatrists about the key components of occupational therapy services in mental health practice, thus facilitating the desired interprofessional collaboration and patient outcomes. This study’s implications and future directions are also discussed.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080974
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 975: Post-Traumatic Stress Disorder 4 Years after
the COVID-19 Pandemic in Adolescents with Different Levels of Physical
Activity Engagement: A Repeated Cross-Sectional Study
Authors: Giulia Di Martino, Marco Centorbi, Andrea Buonsenso, Giovanni Fiorilli, Carlo della Valle, Giuseppe Calcagno, Enzo Iuliano, Alessandra di Cagno
First page: 975
Abstract: The aim of this study was to assess whether the psychological impact of the COVID-19 pandemic on children and adolescents had decreased four years after the initial assessment. This study aimed to determine if children with an active lifestyle and participation in sports activities were protected against this traumatic stress. This study included a total of 284 Italian participants assessed at two different time points: the first assessment was conducted in 2020 when the children were aged 9–12 years, and a second assessment was carried out four years later when the participants were aged 13–16. Participants completed the Impact of Event Scale–Revised questionnaire (IES-R), with the IES-8 and IES-15 versions used accordingly based on age group. In the 2020 assessment, 146 (51.4%) reported a score higher than the cut-off for significant traumatic stress, while in 2024, only 49 participants (17.2%). The chi-square analysis indicated that this decrement was statistically significant (p < 0.001). RM-ANOVA showed a significant reduction for both Intrusion Score and Avoidance Score (p < 0.001). A statistical interaction between gender and time was observed. There were weak correlations between the level of children’s sport practice, and no differences between those who engage in individual or team sports. Despite this study showing that young people are overcoming the pandemic crisis and its consequences, identifying potential modifiable risk factors and empowering protective factors remains crucial, especially for those who continue to experience psychological issues. The restrictions particularly impacted active children by disrupting their routine, which may have compromised the universally recognized protective value of sports.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080975
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 976: Temporal Trends in Air Pollution Exposure
across Socioeconomic Groups in The Netherlands
Authors: Niklas Hlubek, Yvonne Koop, Alfred Wagtendonk, Ilonca Vaartjes
First page: 976
Abstract: Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the Netherlands from 2014 to 2019. Our dataset includes over 12.5 million individuals, aged 18 years and above, who resided in the Netherlands between 2014 and 2019, using Statistics Netherlands data. The address-level air pollution concentrations were estimated by dispersion models of the National Institute of Public Health and the Environment. We linked the exposure estimations of particulate matter < 10 or <2.5 μm (PM10, PM2.5) and nitrogen dioxide (NO2) to household-level socioeconomic data. In highly urbanized areas, individuals from both the lowest and highest socioeconomic groups were exposed to higher air pollution concentrations. Individuals from the lowest socioeconomic group were disproportionally located in highly urbanized and more polluted areas. The air pollution concentrations of PM10, PM2.5, and NO2 decreased between 2014 and 2019 for all the socioeconomic groups. The decrease in the annual average air pollution concentrations was the strongest for the lowest socioeconomic group, although differences in exposure between the socioeconomic groups remain. Further research is needed to define the health and equity implications.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080976
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 977: The Role of Functional Deficits, Depression,
and Cognitive Symptoms in the Perceived Loneliness of Older Adults in
Mexico City
Authors: Ana Belén Ramírez López, Yaneth Rodríguez-Agudelo, Francisco Paz-Rodríguez, Silvia Aracely Tafoya, Benjamín Guerrero López, Claudia Diaz Olavarrieta
First page: 977
Abstract: The world is aging and experiencing loneliness. Functional impairment in instrumental activities of daily living (IADL) in older people (OP) with mild neurocognitive disorder (MNCD) predicts loneliness. After the pandemic, there was an increase in perceived loneliness. We explored the association between loneliness, depression, deficits in IADL, and cognitive symptoms among OP. From February to December 2023, using a cross-sectional design, we interviewed probable cases with mild cognitive impairment and caregivers in two public facilities. We administered the UCLA Loneliness Scale v3, Lawton IADL Scale, Mini-Mental State Examination (MMSE), and Yesavage’s Geriatric Depression Scale. Samples were matched: 85 per group, 82.4% were women, married (52.95%), and mean age of 69.17 (±6.93) years. In our study, 30% displayed moderate to high levels of perceived loneliness. Multivariate analysis showed loneliness was associated with depression, low levels of IADL, and older age, but not with cognitive symptoms, which explained 22% of the total variance (F 165) = 16.99, (p < 0.001). Targeting symptoms and behaviors that could be modified (i.e., depression and functionality) can improve feelings of perceived loneliness and have an impact on morbidity and mortality with which it is associated.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080977
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 978: Raising Awareness about Sex Trafficking among
School Personnel
Authors: Elena Savoia, Amy Liu, Amy Leffler, Léa Kay Nadril Churchill, Maxwell Su
First page: 978
Abstract: Background: We aimed to (1) understand the level of knowledge about sex trafficking of minors among school personnel and the determinants of such knowledge and (2) test the efficacy of short educational videos in increasing knowledge (awareness level) about sex trafficking of minors among school personnel. Methods: We employed an online survey to gather responses from 741 school personnel living in the US. The McNemar test was used to test for differences in knowledge before and after exposure to the videos. Logistic regression was used to identify predictors of knowledge based on the respondents’ characteristics. Results: Predictors of knowledge about sex trafficking were years of experience in working with youth, level of education, and being a female. Exposure to the educational videos improved school personnel’s basic knowledge about this crime and interest in seeking additional educational material. Conclusion: School personnel have a high level of awareness of risk factors for sex trafficking but less awareness of the definition of sex trafficking in children. Exposure to short educational videos can increase awareness in the short term. There is a need to develop more comprehensive training initiatives for school personnel on sex trafficking. However, training alone is not sufficient, and there is also a need for developing school protocols and programs to provide adequate support to victims of this crime.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080978
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 979: Maximal Oxygen Consumption Is Negatively
Associated with Fat Mass in Facioscapulohumeral Dystrophy
Authors: Oscar Crisafulli, Luca Grattarola, Giorgio Bottoni, Jessica Lacetera, Emanuela Lavaselli, Matteo Beretta-Piccoli, Rossella Tupler, Emiliano Soldini, Giuseppe D’Antona
First page: 979
Abstract: Facioscapulohumeral dystrophy (FSHD) leads to progressive changes in body composition such as loss of muscle mass and increase in adiposity. In healthy subjects, anthropometric parameters are associated with the maximum volume of oxygen consumed per minute (VO2max), which is a health and function indicator in several populations of subjects, both healthy and pathological. Since VO2max can be difficult to test in patients with FSHD due to exercise intolerance, the identification of associated anthropometric parameters could provide new easily obtainable elements for the patients’ clinical stratification. The aim of this study was to evaluate whether anthropometric and body composition parameters are associated with VO2max in patients with FSHD. A total of 22 subjects with a molecular genetics-based diagnosis of FSHD (6 females, 16 males, mean age of 35.18 years) were recruited for the study. VO2max was measured by cardiopulmonary exercise tests (CPETs) on a cycle ergometer, utilizing a step incremental technique (15 Watts (W) every 30 s). Weight (Kg) and height (m) were obtained and utilized to calculate body mass index (BMI). Body composition parameters (fat mass (FM), fat free mass (FFM), and body cell mass (BCM)) were obtained by bioelectrical impedance analysis (BIA). Significant negative associations were found between VO2max and FM (Spearman correlation coefficient (SCC) −0.712), BMI (SCC −0.673), age (SCC −0.480), and weight (SCC −0.634), unlike FFM and BCM. Our results indicate that FM, BMI, age, and body weight are negatively associated with VO2max in patients with FSHD. This evidence may help practitioners to better stratify patients with FSHD.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080979
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 980: Biological Sex Disparities in the Economic
Burden of Tobacco Use: A Comparative Analysis between Men and Women in
China
Authors: Rong Zheng, Lingyun Meng, Aduqinfu He
First page: 980
Abstract: To examine the impact of tobacco use on the economic costs between biological sex differences, we utilized propensity score matching and human capital methods to analyze the economic costs associated with smoking. Our findings reveal a nuanced pattern in the economic burden: although men who smoke bear a higher overall economic cost, the individual impact on women who smoke is significantly more profound. As a result, there exists a distinct disparity in the distribution of economic consequences stemming from tobacco use between men and women.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-26
DOI: 10.3390/ijerph21080980
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 981: Leukemia Incidence by Occupation and Industry:
A Cohort Study of 2.3 Million Workers from Ontario, Canada
Authors: Konrad Samsel, Tanya Navaneelan, Nathan DeBono, Louis Everest, Paul A. Demers, Jeavana Sritharan
First page: 981
Abstract: Although a significant body of evidence has attributed certain occupational exposures with leukemia, such as benzene, formaldehyde, 1,3-butadiene and ionizing radiation, more research is needed to identify work environments at increased risk for this disease. Our study aimed to identify occupational and industry groups associated with an elevated incidence of leukemia using a diverse cohort of workers’ compensation claimants from Ontario, Canada. A total of 2,363,818 workers in the Occupational Disease Surveillance System (ODSS) cohort, with claims between 1983–2019, were followed for malignant leukemia diagnoses up to 31 December 2019. We used a Cox proportional-hazards model to estimate the relative incidence of leukemia in specific occupation and industry groups. After adjusting for age and birth year, males in protective services (HR = 1.17, 95% CI = 1.02–1.35), metal machining (HR = 1.23, 95% CI = 1.07–1.41), transport (HR = 1.15, 95% CI = 1.06–1.25), and mining occupations (HR = 1.28, 95% CI = 1.02–1.60) had elevated risks of leukemia compared to other workers in the ODSS, with comparable findings by industry. Among female workers, slight risk elevations were observed among product fabricating, assembling, and repairing occupations, with other increased risks seen in furniture and fixture manufacturing, storage, and retail industries. These findings underscore the need for exposure-based studies to better understand occupational hazards in these settings.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080981
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 982: HIV Stigma in Awi Zone, Northwest Ethiopia,
and a Unique Community Association as a Potential Partner
Authors: Muluken Azage Yenesew, Gizachew Yismaw, Dabere Nigatu, Yibeltal Alemu, Addisu Gaseneit, Taye Zeru, Belay Bezabih, Getahun Abate
First page: 982
Abstract: Indigenous institutions play a vital role in fighting HIV stigma by leveraging their cultural knowledge, leadership, and community connections. Understanding HIV/AIDS attitudes, information gaps, and stigma among members of indigenous institutions is critical for devising culturally relevant and successful interventions and preventative strategies. This study was conducted with the objective of assessing the levels of knowledge about HIV/AIDS and the various HIV/AIDS discriminatory attitudes and practices among members of the Awi Equestrian Association, an indigenous association in Awi Zone, Northwest Ethiopia, that plays major roles in the social, cultural, political, and economic activities of the community. The study is a cross-sectional study conducted from June through July 2022. Eight hundred and forty-six people in the study area were interviewed using a pilot-tested questionnaire. Multiple linear regression analysis was used to identify factors associated with the score level of HIV-related stigma. Forty-five percent of study participants did not have adequate knowledge of HIV/AIDS, and 67.4% had moderate to high discriminatory attitudes towards people living with HIV. HIV-stigmatizing practices were high, with 36% admitting to speaking badly about people living with HIV and 23% wanting their relative with HIV to seek treatment in another zone. In our study, low level of knowledge about HIV/AIDS (p < 0.001), older age (p < 0.05), and male sex (p < 0.05) were factors associated with higher levels of stigmatizing practices. In conclusion, HIV-related stigma is common in Awi Zone. The Awi Equestrian Association has become a unique potential partner for HIV control in the area in an effort to achieve United Nation AIDS target of 95–95–95.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080982
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 983: Aerosol-Mediated Spread of Antibiotic
Resistance Genes: Biomonitoring Indoor and Outdoor Environments
Authors: Nazima Habibi, Saif Uddin, Montaha Behbehani, Abu Salim Mustafa, Wadha Al-Fouzan, Hanan A. Al-Sarawi, Hussain Safar, Fatemah Alatar, Rima M. Z. Al Sawan
First page: 983
Abstract: Antimicrobial resistance (AMR) has emerged as a conspicuous global public health threat. The World Health Organization (WHO) has launched the “One-Health” approach, which encourages the assessment of antibiotic resistance genes (ARGs) within an environment to constrain and alleviate the development of AMR. The prolonged use and overuse of antibiotics in treating human and veterinary illnesses, and the inability of wastewater treatment plants to remove them have resulted in elevated concentrations of these metabolites in the surroundings. Microbes residing within these settings acquire resistance under selective pressure and circulate between the air–land interface. Initial evidence on the indoor environments of wastewater treatment plants, hospitals, and livestock-rearing facilities as channels of AMR has been documented. Long- and short-range transport in a downwind direction disseminate aerosols within urban communities. Inhalation of such aerosols poses a considerable occupational and public health risk. The horizontal gene transfer (HGT) is another plausible route of AMR spread. The characterization of ARGs in the atmosphere therefore calls for cutting-edge research. In the present review, we provide a succinct summary of the studies that demonstrated aerosols as a media of AMR transport in the atmosphere, strengthening the need to biomonitor these pernicious pollutants. This review will be a useful resource for environmental researchers, healthcare practitioners, and policymakers to issue related health advisories.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080983
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 984: Persons Experiencing Homelessness during
Extreme Temperatures: Lessons for Promoting Socially Inclusive Adaptive
Capacity
Authors: Courtney Cronley, Amanda Fackler, Jennifer M. First, Sangwon Lee, Iris Tsouris
First page: 984
Abstract: Climate change and increasing extreme temperatures present unique challenges to persons experiencing homelessness (PEH), including heightened physical and psychological harm. While green and urban infrastructure has emerged as one possible mitigation strategy, homeless populations are rarely included in municipal disaster planning or infrastructure research. This study used in-depth interviews with PEH (N = 42) during the summers of 2022 and 2023. Questions were designed around phenomenological methods to explore the individuals’ firsthand descriptions of the lived experience of coping during extreme temperatures within a mid-size city in the Southeastern United States. Our findings highlight how social exclusion within the built environment reduces PEH’s adaptive capacity and increases the physical and psychological risks of extreme temperatures, namely through limiting and policing scarce resources and restricting the mobility of PEH. In contrast, public transit provided relief from extreme temperatures. Implications from our findings include the need for attention on inclusive green urban infrastructure, including increased placement and access to shade, public water, mixed-use daytime sheltering models, and the installation of lockers to increase capacity to maintain supplies and gear necessary for enduring extreme temperatures. Findings also highlight the challenges of designing inclusive green infrastructure and the importance of de-stigmatizing homelessness and building more housing and income support to increase adaptive capacity for an entire community in the context of a rapidly warming climate.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080984
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 985: Roma Women’s Role in the Health
Preservation of Their Communities during the COVID-19 Pandemic
Authors: Paula Abella, Adriana Aubert, María Virginia Matulič, Ariadna Munté-Pascual
First page: 985
Abstract: The scientific literature has evidenced the stereotypes that affect the Roma people, which are detrimental to their access to the health systems in various countries. With the COVID-19 pandemic, this situation has been aggravated by falsely blaming, on many occasions, the Roma people as spreaders of the virus for supposedly not complying with the norms established by the health authorities. However, it has not been explored in depth what actions have been carried out by the Roma people during the pandemic to cope with this aspect. The aim of this article is to learn about the leadership of Roma women in relation to maintaining the health of their community during the pandemic. The research has been conducted through focus groups and life stories with a total of 47 Roma women and 24 Roma men participants, as well as interviews with 40 professionals from education, social services, health services, and civic organizations. The results show how the reality of the studied contexts was different to those stereotypes, that the Roma women in the contexts studied have led actions that preserved the health of their communities, that the established measures were strictly followed, breaking with the extended stereotype about the Roma people.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080985
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 986: Associations between Cannabis Consumption
Methods and Cannabis Risk Perception
Authors: Namkee G. Choi, C. Nathan Marti, Bryan Y. Choi
First page: 986
Abstract: Given diversified cannabis products, we examined associations between cannabis consumption methods and cannabis risk perception of smoking cannabis 1–2 times a week. Using the 2022 U.S. National Survey on Drug Use and Health data (N = 12,796 past-year adult cannabis users; M = 6127 and F = 6669), we used multinomial and binary logistic regression models. Smoking was the most prevalent method, followed by eating/drinking, vaping, and dabbing. One-half of cannabis users reported no perceived risk of smoking cannabis 1–2 times a week, 37.5% perceived slight risk, 9.2% moderate risk, and 2.9% great risk. Those with moderate or great risk perception had a lower likelihood of using 4+ methods of consumption (e.g., RRR = 0.40, 95% CI = 0.20, 0.77 for great risk perception). Any perceived risk was associated with higher odds of edibles/drinks only (e.g., aOR = 2.81, 95% CI = 1.43, 5.54 for great risk perception). Along with medical use and CUD, sociodemographic factors, mental illness, and other substance use were also significant correlates of cannabis consumption methods. Understanding the varying risk perceptions associated with different consumption methods is needed for harm reduction initiatives. More research is needed on cannabis products, particularly edibles/drinks and dabs/concentrates, to better understand the potential risks associated with them.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080986
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 987: Adolescent Health and Dark Personalities: The
Role of Socioeconomic Status, Sports, and Cyber Experiences
Authors: Ilrang Lee, Yonghwan Chang, Ye Lei, Taewoong Yoo
First page: 987
Abstract: By investigating the impact of dark personality traits on adolescent health, this study explores the interplay among economic disadvantage, spectator sports involvement, and cyber victimization. We analyzed data from 1844 students aged 13–17 in a school district in the USA, and our findings reveal positive associations between economic disadvantage and both Machiavellianism and psychopathy, influencing negative emotions-driven eating. Spectator sports engagement exhibits links with Machiavellianism and narcissism, suggesting potential drawbacks to competitive behaviors. Cyber victimization shows associations with psychopathy and negative emotions-driven eating. The results illuminate the dynamic associations between emotional eating and health outcomes, including BMI and perceived quality of life. These findings deepen our understanding of how dark personality is shaped and subsequently influences adolescents’ well-being, offering insights for targeted interventions.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-27
DOI: 10.3390/ijerph21080987
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 988: The Long-Term Physical–Psychiatric
Comorbidities Related to Childhood Exposure to 9/11 Trauma
Authors: Lawrence Amsel, Yael M. Cycowicz, Diana V. Rodriguez-Moreno, Keely Cheslack-Postava, Larkin S. McReynolds, George J. Musa, Christina W. Hoven
First page: 988
Abstract: Extensive research has explored the enduring effects of childhood trauma on health, revealing its potential to produce chronic health problems. Despite findings that adults exposed to 9/11 suffer from enduring concurrent psychiatric and physical illnesses, investigations into the long-term physical–psychiatric comorbidities experienced by children and adolescents affected by the 9/11 trauma remain limited. In our study, we examined individuals directly exposed to 9/11 as children (N = 844 high exposure and N = 104 low exposed) and compared them to a matched unexposed, control group (N = 491). Fourteen years after their 9/11 exposure, we evaluated their physical and mental health conditions using parent- or youth self-reported health questionnaires, including psychiatric assessments. Those individuals with high 9/11 exposure were significantly more likely to have experienced a psychiatric disorder in the past year and a lifetime physical health condition compared to unexposed individuals. Moreover, the prevalence of physical–psychiatric comorbidities was higher among the 9/11-exposed group, with a 3.5-fold increased prevalence compared to the unexposed group. This underscores how exposure to traumatic events during childhood heightens the risk of long-term concurrent mental and physical health issues. Our findings also highlight the importance of early and ongoing interventions to prevent future comorbidities and promote better quality of life throughout the lifespan.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-28
DOI: 10.3390/ijerph21080988
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 989: Manager–Team (Dis)agreement on
Stress-Preventive Behaviours: Relationship with Psychosocial Work
Environment and Employees’ Well-Being
Authors: Stefano Toderi, Glauco Cioffi, Joanna Yarker, Rachel Lewis, Jonathan Houdmont, Cristian Balducci
First page: 989
Abstract: The “Management Competencies to Prevent and Reduce Stress at Work” (MCPARS) approach focuses on identifying the stress-preventive managers’ competencies able to optimise the employees’ well-being through the management of the psychosocial work environment. Considering leadership as contextualised in complex social dynamics, the self–other agreement (SOA) investigation of the MCPARS may enhance previous findings, as it allows for exploring the manager–team perceptions’ (dis)agreement and its potential implications. However, no studies have tested the MCPARS using the SOA and multisource data. Grounded in Yammarino and Atwater’s SOA reference theory, we conducted an in-depth investigation on the MCPARS’s theoretical framework by examining the implications of manager–team (dis)agreement, regarding managers’ competencies, on employees’ psychosocial environment (H1–H2) and affective well-being (H3). Data from 36 managers and 475 employees were analysed by performing several polynomial regressions, response surface, and mediation analyses. The results reveal a significant relationship between SOA on MCPARS and employees’ perceptions of the psychosocial environment (H1). Employees report better perceptions when supervised by in-agreement good or under-estimator managers, while lower ratings occur under over-estimator or in-agreement poor managers (H2). Moreover, the psychosocial environment significantly mediated the relationship between SOA on MCPARS and employees’ well-being (H3). The MCPARS theoretical model’s soundness is supported, and its implications are discussed.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-28
DOI: 10.3390/ijerph21080989
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 990: Gamification for Mental Health and Health
Psychology: Insights at the First Quarter Mark of the 21st Century
Authors: Carmina Castellano-Tejedor, Andrés Cencerrado
First page: 990
Abstract: The concept of gamification, originally rooted in digital media and game design, has increasingly emerged as a pivotal element in psychology and engagement strategies. Its application spans diverse domains within healthcare, offering innovative solutions to transform patient care through behavior modification and heightened engagement. This contemporary perspective explores theoretical frameworks and provides a critical interdisciplinary examination of current advancements in gamification for mental health and health psychology, identifying existing knowledge gaps and projecting future trends and research directions within these contexts. Based on this, concise criteria for designing, implementing, and evaluating gamification in healthcare, aligned with acknowledged best practices to promote ethical, fair, and trustworthy systems, are outlined, establishing a robust theoretical framework to design gamified interventions and scientifically evaluate their impact.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-28
DOI: 10.3390/ijerph21080990
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 991: The Perception and Roles of School Mental
Health Professionals Regarding School Bullying (Suluk Audwani) in Oman: A
Qualitative Study in an Urban Setting
Authors: Muna Al Saadoon, Rawaa Abubakr Abuelgassim Eltayib, Amjad Hassan Alhaj, Moon Fai Chan, Said Aldhafri, Samir Al-Adawi
First page: 991
Abstract: With increasing mental health risks among school populations and prevalent bullying, school mental health professionals (SMHP) are crucial globally. This study explores the perspectives of SMHP on bullying in Omani schools, focussing on definitions, types, current practices, and future strategies. Involving 50 Omani SMHP from Muscat Governorate with at least three years of experience, data was collected through structured interviews and analyzed using Braun and Clarke’s six-step thematic analysis. Six key themes emerged: The definition of bullying, its components, common types, current anti-bullying practices, challenges, and future suggestions. Bullying, termed “سلوكعدواني” (Suluk Audwani), meaning aggressive behavior, includes five components: perpetrators, victims, harmful behavior, spectators, and psychosocial factors. Verbal bullying, physical bullying, and cyberbullying are common and vary by age. SMHP frequently employ awareness-raising and psychological first aid. Challenges include resistance from students and parents and institutional barriers. In the future, SMHP will emphasize greater awareness to effectively address Suluk Audwani. Oman has adopted international best practices to recruit SMHP. SMHP’s perspectives on Suluk Audwani reflect both their training and Omani cultural influences. Future research should explore various social strata to improve evidence-based understanding and prevention of Suluk Audwani.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-28
DOI: 10.3390/ijerph21080991
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 992: Exploring Maternal Socio-Demographic Factors
Shaping Children’s Dietary Patterns in Brazil: Results from the 2019
National Health Survey
Authors: Flávia dos Santos Barbosa Brito, Emanuela Santos da Costa, Ariane Cristina Thoaldo Romeiro, Debora Martins dos Santos, Alexandre dos Santos Brito, Alessandra Silva Dias de Oliveira, Amanda Rodrigues Amorim Adegboye
First page: 992
Abstract: This study aimed to identify the dietary patterns of Brazilian children aged 6–23 months and to investigate their association with maternal socio-demographic factors. Data from the 2019 Brazilian National Health Survey were used in this cross-sectional study. Mothers of 1616 children aged 6–23 months reported on their children’s dietary intake. Dietary patterns were identified using principal component analysis, and their associations with maternal socio-demographic characteristics were assessed using linear regression models. The first consisted of healthy patterns and the second, unhealthy ones. Linear regression showed that adherence to a healthy dietary pattern was higher among children of mothers who were older (β = 0.02, p = 0.01), had more years of education (β = 0.49, p = 0.04), reported living with a partner (β = 0.29, p = 0.01), and resided in an urban area (β = 0.35, p = 0.01). Conversely, adherence to the unhealthy pattern was positively associated with mothers who declared themselves as black or brown (β = 0.25, p = 0.03). Our results show that older mothers with higher levels of education and paid work and who live with a partner are more likely to contribute to their children’s healthy eating patterns. We conclude that socio-demographic factors may influence the quality of the food offered to children. Nevertheless, advocating for public policies promoting nutritious complementary diets emphasising fresh and minimally processed foods remains crucial for children whose mothers do not possess these favourable socio-demographic characteristics.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-29
DOI: 10.3390/ijerph21080992
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 993: Associations between Cardiovascular Risk
Factors and Timed Up and Go Test for Elderly Participants in Public
Physical Activity Programs
Authors: Marília Salete Tavares, Sara Lucia Silveira de Menezes, Emanuel Davi Farias Ribeiro, Marco Orsini, Fábio Augusto d’Alegria Tuza, Paulo Henrique de Moura, Dinah Vasconcelos Terra, Adalgiza Mafra Moreno
First page: 993
Abstract: Variables such as body mass index (BMI), waist circumference (WC), and waist/height ratio (WHtR) are used to assess cardiovascular risks associated with abdominal obesity. The Timed Up and Go (TTUG) test assesses mobility and the risk of falls, especially in the elderly and individuals with physical limitations. The objective was to correlate anthropometric indicators of cardiovascular risk (BMI, WC, WHtR) with performance on the TTUG test in elderly people who practice physical activity. Methods: Observational, cross-sectional study, CAAE: 27116319.1.0000.8044. Active elderly participants in a public physical exercise program “Project 60 Up”, promoted by the Municipal Secretariat for the Elderly of the City of Niterói, RJ, Brazil, were evaluated. Elderly people of both sexes, with independent locomotion and preserved cognitive status, were included and those with visual, hearing, severe mobility difficulties or neurological sequelae and imbalances were excluded. Anthropometric data were collected: BMI, WC, WHtR, and the TTUG test was performed. Results: In the sample composed of 55 elderly people of both sexes, with an average age of 68 years, the means of the variables were: body weight (67.8 ± 12.7 kg), height (157.2 ± 8.4 cm), TTUG (10.3 ± 2 s), WC (93.3 ± 10.9 cm), WHtR (0.59), and BMI (27.4 ± 4.4). The correlations were between TTUG and age (r = −0.24, p = 0.69), TTUG and BMI (r = 0.111, p = 0.426), and WC and WHtR (r = 0.885, p < 0.000). Weak correlations were observed between TTUG and BMI and WC and WHtR, indicating that factors other than BMI and abdominal fat accumulation may have a greater influence on performance on the TTUG test. In this specific context of elderly people participating in a physical activity program, the results found may have been shaped by the very nature of the interventions carried out in the program, with factors such as muscular strength, flexibility and balance preserved and acquired through the practice of regular physical exercise. Despite the benefits of physical activity, managing weight and abdominal fat remains challenging for elderly individuals with high anthropometric measurements. Conclusion: Although many elderly people have anthropometric measurements above average levels, the results indicate that no negative influence on their performance on the TTUG was observed. However, the limitation of the sample size and the underrepresentation of elderly people ≥ 80 years and of men highlight the need for future studies with larger and more balanced samples to confirm these results.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-29
DOI: 10.3390/ijerph21080993
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 994: Empowering and Building the Capabilities of
Mid-Level Health Service Managers to Lead and Support the Health
Workforce—A Study Protocol
Authors: Zhanming Liang, Jemma C. King, Cate Nagle, Tilley Pain, Andrew J. Mallett
First page: 994
Abstract: (1) Background: Mid-level managers in healthcare are central to improving safety and quality of care. Their ability in demonstrating leadership and management competency in their roles and supporting frontline managers and frontline staff has a direct effect on staff retention and turn-over. Yet, investment in their professional development and support for mid-level managers is often neither adequate nor effective, and high rates of staff turnover are evident. This study, set in northern Queensland, Australia, takes a strength-based approach to explore the role and strengths of mid-level managers and organisations’ existing mechanisms in supporting managers. With broad involvement and contribution from managers at different management level and frontline staff, the project will identify strategies to address the challenges mid-level managers face while building on their capabilities. (2) Methods: Using co-design principles, a situation analysis approach will guide a mixed-methods, multiphase design. Qualitative data will be collected using transcripts of focus groups and quantitative data will be collected by surveys that include validated scales. (3) Results: Thematic analysis of the transcripts will be guided by the framework of Braun and Clarke. Quantitative data will employ descriptive and inferential analysis, including chi-squared, t-tests, and univariate analyses of variance. (4) Conclusions: This study will generate evidence to guide two partner organisations, and other similar organisations, to develop strategies to improve support for mid-level managers and build their capabilities to support and lead frontline managers and staff. Competent mid-level managers are critical to high-quality patient care and improve the outcomes of the population they serve.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-29
DOI: 10.3390/ijerph21080994
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 995: A Comparison of Oral Function in Older In- and
Outpatients: An Observational Study
Authors: Anna K. Eggimann, Leo Badura, Rahel Zehnder, Miriam Koemeda, Ramona Buser, Martin Schimmel
First page: 995
Abstract: (1) Background: Insufficient data exist regarding oral function among older adults in Europe. Therefore, we aimed to assess and compare oral function between older in- and outpatients and identify predictors of low masticatory performance. (2) Methods: Patients were consecutively recruited from the outpatient center (n = 31) and the inpatient geriatric department (n = 31) at a tertiary University Hospital in Switzerland in 2023. Assessments on oral function included the total number of intraoral eruptive teeth, number of supporting zones with dentures, maximal bite force (Dental Prescale II, Fuji Film Corp., Tokyo, Japan), and masticatory performance (Hue-Check Gum©, University of Bern, Bern, Switzerland) using a visual (SA1–SA5) and a digital (SD_Hue) scale. The visual and digital assessment of masticatory performance showed a strong correlation (Kendall tau = 0.83). Low masticatory performance was defined as SA-Grade 1–2 (vs. SA3–SA5 as reference). In a multivariate model adjusting for age, sex, and clinical setting, we investigated associations of maximal bite force, few eruptive teeth, and few supporting zones with low masticatory performance. (3) Results: Mean age was 81.9 (standard deviation (sd) 5.2) years, and 62.9% were female. Overall, maximal bite force was 247 N (sd 261). A total of 39 patients (63.9%) had a low masticatory performance, 62.9% a low maximal bite force, and 50% a low number of eruptive teeth (<10). Masticatory performance, number of eruptive teeth, and maximal bite force did not significantly differ between in- and outpatients. The number of supporting zones was significantly higher in outpatients compared to inpatients (median 4, interquartile range (IQR) 4–4; vs. 4, IQR 2–4; p = 0.03). In the multivariate model, maximal bite force and a low number of eruptive teeth were independently associated with low masticatory performance (adjusted odds ratio 7.4 (95% CI, 1.8–30.4; p < 0.01), and OR 7.8 (95% CI, 1.7–36.4; p < 0.01), respectively). (4) Conclusions: Impaired oral function is highly prevalent in both European older in- and outpatients to a similar degree. The association of low masticatory performance with maximal bite force and with a low number of eruptive teeth may indicate that a basic screening should include either of these parameters to identify impaired oral function.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-29
DOI: 10.3390/ijerph21080995
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 996: Exploring Musculoskeletal Complaints in a
Needle Manufacturing Industry: A Cross-Sectional Study
Authors: Paulo C. Anacleto Filho, Ana Cristina Braga, Paula Carneiro
First page: 996
Abstract: Musculoskeletal disorders (MSD) encompass a variety of conditions affecting muscles, joints, and nerves. In Portugal, MSDs are the most prevalent occupational health problem in companies. Based on the relevance of work-related MSD (WMSD), this study aims to assess the prevalence of MSD complaints in a needle manufacturing industry in Northern Portugal, following a cross-sectional approach. Thus, 526 workers from five departments (i.e., operator, tuning, maintenance, administration, and logistics) answered a sociodemographic questionnaire and the Nordic Musculoskeletal Questionnaire (NMQ). Within the last 12 months, females exhibited a higher frequency of complaints than males across all body parts except for ankles/feet. The body parts eliciting the most percentage of complaints for both genders include the lower back (54.2%), neck (42.2%), shoulders (39.0%), ankles/feet (38.2%), and wrists/hands (35.7%). No significant association was found between Body Mass Index (BMI) and body part complaints. Tuners reported the highest complaint rate, with occupations as substantial predictors of complaints in certain body parts. Likewise, complaints tend to increase with age. The findings advocate for ergonomic interventions that are gender-, age-, and job-sensitive.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-29
DOI: 10.3390/ijerph21080996
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 997: Start of the Season in a Seasonal Work
Context: A Better Understanding of the Difficulties Experienced by
Seasonal Workers in the Food Processing Industry for the Prevention of
Work-Related Musculoskeletal Disorders
Authors: Audrey Goupil, Marie-Eve Major
First page: 997
Abstract: The specific period of the start of a new working season and a return to work after the off-season seems to be a critical moment for the musculoskeletal health of seasonal workers. This study aims to identify the difficulties and working conditions encountered by seasonal workers in this particular period of the working season which may increase the risk of work-related musculoskeletal disorders (WMSDs). An in-depth ergonomic work activity study, combined with a multiple case study of eight seasonal workers from a meat processing facility, was conducted. Various interviews (n = 24) and observations of work activity, organization, and production (n = 96 h) were held at different moments (off-season, return to work at the start of the season, and during the season). Critical work situations exposing workers to WMSD risks emerged and highlighted a diversity of difficulties, such as accomplishing work activity involving strong physical strain and a significant and underestimated mental load, and having to rapidly develop new skills or re-learn working strategies after a long off-period. The study findings have implications for developing actions to prevent WMSDs that target working conditions and support a return to work for returning seasonal workers and a start of work for new seasonal workers, and to address work disability in this context.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21080997
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 998: Gambling Harm-Minimisation Tools and Their
Impact on Gambling Behaviour: A Review of the Empirical Evidence
Authors: Ben J. Riley, Jane Oakes, Sharon Lawn
First page: 998
Abstract: The harms accompanying disordered gambling are well documented. Additionally, there is growing attention to the harms that arise from people who gamble heavily but do not meet the criteria for a gambling disorder. Accordingly, there has been an increasing interest in the effectiveness of consumer protection tools for consumers of gambling products. Subsequently, there is a need to properly evaluate the evidence for their effectiveness. This review aimed to conduct a narrative synthesis of empirical studies to identify gaps, weaknesses, and strengths in the existing evidence for the effectiveness of harm minimisation tools available to people who gamble. This review includes studies published between January 2015 to July 2022 and comprises 55 peer-reviewed studies for final synthesis. Findings reveal that while more research is needed to examine the effectiveness of active and passive consumer protection tools, uptake of tools is low in part because users view them as tools for individuals already experiencing gambling harm as opposed to protective tools for all users. Research is needed to determine effective ways of communicating the value of consumer protection tools for gambling.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21080998
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 999: Empowering Personal Trainers to Work with
Individuals with Disabilities to Improve Their Fitness
Authors: Cassandra Beattie, Aspen E. Streetman, Katie M. Heinrich
First page: 999
Abstract: The benefits of regular physical activity for individuals with disabilities (IWDs) are well recognized. Nonetheless, IWDs report several barriers to physical activity participation, including limited access to qualified and experienced personal trainers. Limited research exists from personal trainers’ perspective. This qualitative study aimed to examine the experiences of personal trainers who successfully improve the fitness of IWDs. Individual interviews were conducted with ten personal trainers, focusing on educational and occupational background, experiences training IWDs, and experiences training IWDs within gyms. Thematic analysis produced five themes: (1) personal trainers working with IWDs need specialized education and extensive, often multidisciplinary, experience; (2) personal trainers are most successful when they have the opportunity to work with IWDs who have a diverse range of disabilities and differing expressions of each; (3) a robust network between personal trainers and allied healthcare providers is necessary to support IWDs; (4) access to physical activity is enhanced when trainers manage resources appropriately; and (5) personal trainers can empower IWDs to be advocates for their physical activity needs. Future research could examine the effects of an adaptive hands-on educational intervention among personal trainers to enhance IWDs’ health and fitness.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21080999
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1000: Burnout and Attention Failure in STEM: The
Role of Self-Control and the Buffer of Mindfulness
Authors: Mahima Saxena
First page: 1000
Abstract: Drawing on self-regulatory strength models of self-control, this research examined the relationship between burnout and attentional processes for STEM (science, technology, engineering, and mathematics) students. Using data from participants in STEM, burnout was found to be associated with higher levels of off-task thinking, also known as mind-wandering. Further, self-control acted as a mediator in the relationship between burnout and mind-wandering such that higher levels of burnout predicted poor self-control that subsequently increased the mind’s tendency to wander. Additionally, mindfulness buffered the relationship between burnout and mind-wandering such that burnout had the most detrimental impact on attention for those students who were low in mindfulness. Using the Johnson-Neyman approach, results reveal the upper limits for the moderating impact of mindfulness. Results and implications for science and practice are discussed with a special grounding for students in the STEM context.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21081000
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1001: Sexual Violence, Disclosure Pattern, and
Abortion and Post-Abortion Care Services in Displaced People’s Camps
in Africa: A Scoping Review
Authors: Paul O. Adekola, Sunday A. Adedini
First page: 1001
Abstract: Violent social and political conflicts have caused several challenges to internally displaced persons (IDPs), especially girls and young women, among which is sexual violence (SV). Despite extensive records on SV in humanitarian contexts, studies to assess the level, examine the disclosure pattern (DP) and evaluate the availability of abortion care in these settings have received inadequate attention. This scoping review sought to synthesise the current African-based research on SV, DP, and abortion and post-abortion care (APAC) in humanitarian contexts. We conducted a systematic search of five databases: MEDLINE, PubMed, Scopus, Embase and Google Scholar, where the articles retrieved met the criteria for inclusion. The review adhered to PRISMA guidelines and the Critical Appraisal Skills Programme (CASP), containing ten questions to help confirm the validity of the research design and the originality of the results in comparison with similar studies. A series of inclusion and exclusion criteria were applied after the search, and 35 eligible articles from ten African countries with evidence of sexual violence, disclosure patterns, and APAC in camp settings were included in the study. Results described situations of SV in humanitarian settings in Africa as “terrible”, “bad”, “an epidemic”, and “severe” as girls were used as sex objects, for profile enhancement and as a weapon of war. We also found that the illegality of APAC in Africa is causing a high occurrence of clandestine abortions in conflict contexts. Disclosing SV among IDPs in Africa did not follow a clear-cut pattern but was generally determined by socio-demographic characteristics. Sexual health is a fundamental right of all, as enshrined in SDG 3, which makes this topic a major public health issue. We therefore conclude that although disclosure may aggravate stigmatisation in some instances due to adverse reactions, it is still crucial to the healing processes.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21081001
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1002: Assessment of Heavy Metal Contamination and
Health Risks in “Snow Cover–Soil Cover–Vegetation
System” of Urban and Rural Gardens of an Industrial City in
Kazakhstan
Authors: Alina Faurat, Galymbek Azhayev, Kazbek Shupshibayev, Kairat Akhmetov, Elmira Boribay, Talgat Abylkhassanov
First page: 1002
Abstract: This article investigates the extent of heavy metal pollution in both urban and rural gardens in Pavlodar, which cultivate potatoes and tomatoes. As a city of industrialization, Pavlodar is exposed to emissions from industrial enterprises, transport and stove heating. The city also has the highest incidence of environmental diseases among the population. This study examines the accumulation of heavy metals and metalloid in the snow, their migration into the soil and their accumulation in plants, and assesses the non-cancer and cancer health risks of consuming these vegetables. The results show that the concentrations of trace elements in the solid phase of snow decrease in the following order: Fe (26,000) > Mn (592.5) > Cr (371.3) > Zn (338.8) > Pb (161.9) > Cu (142.5) > Ni (30.9) > As (15.1) > Co (12.1) > Cd (2.6). In soils, the concentrations of elements decrease in the following order: Mn (22,125) > Fe (20,375) > Zn (246.9) > Cr (109.5) > Cu (39.3) > Pb (25.6) > Ni (22.4) > As (9) > Co (6.6) > Cd (0.2). In urban gardens, the snow pollution coefficient was the highest. In rural gardens, the contamination index varied from 0.3 (Cr) to 5.3 (Cd). Magnesium in the soil exceeds the maximum allowable concentration (MPC) by 28.6–35.7 times, and zinc by 1.6–10.9 times. Only zinc and copper exceed the MPC for vegetables. Nickel in potatoes exceeds MPC by a factor of 6 and in tomatoes by a factor of 4.4. The cobalt content in tomatoes exceeds the background value by 2.2 times, with a maximum value of 5.3 times. The risk assessment showed that the non-carcinogenic and carcinogenic risks associated with potato and tomato consumption were low. However, these risks are higher in urban areas than in rural areas.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21081002
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1003: Workplace Health Promotion in Italian
University Employees: Effects on Body Composition and Mediterranean Diet
Adherence
Authors: Alessia Moroni, Margherita Micheletti Cremasco, Giorgio Gilli, Raffaella Degan
First page: 1003
Abstract: As Workplace Health Promotion is spreading among several working environments, the university context seems to be one of the best to apply primary prevention activities. Working in this direction, the University of Torino led the Wellness@Work for UniTo Project (W@W), with the aim of promoting employees’ health. Internal university professionals assessed body composition and adherence to the Mediterranean diet (MD), giving on-target advice for improving lifestyle. The aim of this paper is to evaluate the effectiveness of the W@W Project after a 4-month intervention period. This project was addressed to university employees, who could participate on a voluntary basis. Researchers assessed (T1) socio-demographic information and collected anthropometric variables. Body composition was evaluated through Classic and Specific Bioelectrical impedance Vector Analysis (BIVA). Adherence to the MD was assessed through the Medi-Lite questionnaire. After the assessments, participants were given 5-min counselling from internal professionals. After about 4 months, participants were supposed to undergo same assessments (T2). Overall, 479 workers joined the project, and of those, 246 came back for the T2 assessment. Globally, either anthropometric, body composition, or MD variables improved significantly after 4 months, both for male and female samples, suggesting how an easy-to-apply WHP intervention could help to improve workers’ health.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21081003
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1004: Breast Cancer Screening among African
Immigrants in the United States: An Integrative Review of Barriers,
Facilitators, and Interventions
Authors: Julian I. Rauch, Joseph Daniels, Alyssa Robillard, Rodney P. Joseph
First page: 1004
Abstract: The purpose of this review was to synthesize the available literature on breast cancer-screening barriers, facilitators, and interventions among U.S. African immigrants. Following the integrative review framework and PRISMA guidelines for reporting systemic reviews, five electronic databases were searched: PubMed, CINAHL, PsycINFO, Medline, and Google Scholar. Studies were included if they were published in English language journals after 1 January 2000 and reported data on breast cancer-screening barriers, facilitators, or interventions among U.S. African immigrants. Barriers and facilitators reported by studies were descriptively examined and synthesized by two authors and classified as aligning with one of the three levels of influences based on the social–ecological model (intrapersonal, interpersonal, and community). Interventions promoting breast cancer screening were narratively summarized. Search procedures retrieved 1011 articles, with 12 meeting the criteria for inclusion in the review (6 qualitative and 6 quantitative). Intrapersonal barriers included limited awareness, fear of pain, language barriers, health concerns, transportation issues, costs, and negative past experiences. Interpersonal barriers involved modesty, spiritual beliefs, and lack of support, while community-level barriers included provider and healthcare-system challenges. Regarding facilitators, past screening experiences and health insurance were the most commonly reported intrapersonal facilitators. The only interpersonal facilitator identified was observing other women experience a breast cancer diagnosis and undergo treatment. Community-level facilitators included appointment reminders, scheduling assistance, culturally congruent interpreters, transportation to screening facilities, and patient navigators. Three articles reported outcomes of breast cancer-screening interventions. All three were pilot studies and reported increased knowledge and attitudes regarding breast cancer screening following the respective interventions. One study examined the uptake of breast cancer screening following the intervention, with results indicating an increase in screening. Findings provide a comprehensive synthesis of factors influencing breast cancer screening among African immigrants and highlight the need for future research on the topic. This review was registered with Prospero (CRD42024502826) before the initiation of search procedures.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21081004
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1005: Comprehensive Criteria for Reporting
Qualitative Research (CCQR): Reporting Guideline for Global Health
Qualitative Research Methods
Authors: Priyanka Sinha, Binita Paudel, Tamara Mosimann, Hanan Ahmed, Gaotswake Patience Kovane, Miriam Moagi, Angel Phuti
First page: 1005
Abstract: Globally, the demand for qualitative research has risen, driven by the health sector’s need for in-depth investigation of complex issues behind any phenomenon that may be inadequately comprehended and that other research methods cannot explore, uncover, or describe. The authors aimed to improve the accessibility and comprehensiveness of reporting guidelines for qualitative research. A comprehensive review of scientific articles was conducted on PubMed, Medline, CINAHL, and Embase, and it retrieved 1989 articles plus 13 more articles through the snowball method. After screening, 17 key articles were identified, which led to the development of Comprehensive Criteria for Reporting Qualitative Research that comprises 14 categories, offering key elements in an organized table. This novel guideline complements the two widely used guidelines, Consolidated Criteria for Reporting Qualitative Research and Standards for Reporting Qualitative Research, by including additional aspects like objectives, existing knowledge, rationale behind methodologies, conclusions, recommendations, and reference citations. The study responds to the rising need for improved qualitative research reporting guidelines in global health.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-30
DOI: 10.3390/ijerph21081005
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1006: Relationship between Screening, Diagnostic
Mammograms, Hospital Admissions, and Mortality Rates from Breast Cancer
Authors: Kely Paviani Stevanato, Helena Fiats Ribeiro, Lander dos Santos, Fernando Castilho Pelloso, Pedro Beraldo Borba, Deise Helena Pelloso Borghesan, Maria Dalva de Barros Carvalho, Raíssa Bocchi Pedroso, Constanza Pujals, Sandra Marisa Pelloso
First page: 1006
Abstract: Background: Breast cancer is the most common type of cancer worldwide. If diagnosed and treated early, it has a high chance of cure, and for this, screening tests are necessary, namely mammograms, which are the most commonly used. The objective of this study was to analyze the association between the number of screening and diagnostic mammograms and the number of hospitalizations and deaths from breast cancer. Methods: This is a cross-sectional, analytical, retrospective study with secondary data made available by the Ministry of Health. Pearson correlation analysis was employed to assess whether the number of mammograms is associated with the number of deaths and hospitalizations, Poisson regression was used to assess whether an increase in the number of mammograms and hospitalizations is related to the number of deaths, and the Cox–Stuart test was used to analyze the temporal trend of the variables under study and the projection of time series. Results: There was a strong positive correlation for all age groups when relating the variables hospitalizations and deaths, a moderate-to-strong correlation for the variables mammography and hospitalization, and a weak correlation for the variables mammography and death. There was no statistical significance in the relationship between the number of mammograms and deaths, whereas the hospitalization variable had a significant impact in relation to death, increasing the chance by 0.015%. There has also been a significant growth trend in the variables deaths and hospitalizations in Brazil over the years. Conclusions: A growing trend was identified from 2013 to 2021, both in hospitalizations and deaths, thus suggesting that strategies aimed at reformulating public health policies are necessary for earlier diagnosis in order to improve the treatment of breast cancer and the prognosis of the disease.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-31
DOI: 10.3390/ijerph21081006
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1007: A Mixed Methods Exploration of Young
Women’s Agency and Mental Health during COVID-19 in Low-Income
Communities in Mumbai, India
Authors: Marie A. Brault, Melissa F. Peskin, Anastasia N. Jones, Amrita Saikia, Rinchen O. Bhutia, Sai Sammitha Cheruvu, Vaishali M. Jagtap, Rajendra Singh, Poornima Nair, Rajesh Vedanthan, Sten H. Vermund, Shubhada Maitra
First page: 1007
Abstract: Introduction: Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai. Methods: We conducted semi-structured interviews with AGYW (aged 15–25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS. Results: Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety. Discussion: Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-31
DOI: 10.3390/ijerph21081007
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1008: From Wasteland to Bloom: Exploring the
Organizational Profiles of Occupational Health and Well-Being Strategies
and Their Effects on Employees’ Health and Well-Being
Authors: Marie-Ève Beauchamp Legault, Denis Chênevert
First page: 1008
Abstract: Based on the signaling and conservation of resources theories, this study aims to identify different strategic organizational profiles related to occupational health and well-being (OHWB). Additionally, this study explores how these various organizational profiles impact employees’ well-being, specifically in relation to absenteeism, emotional exhaustion, work overload, intention to quit, and job satisfaction. Data were collected from 59 organizations and 2828 employees. The first phase of this study presents the latent profile analysis carried out to identify OHWB organizational profiles. This analysis reveals four organizational profiles that are metaphorically named according to the growth stages of plants (i.e., wasteland, sprouting, budding, and blooming OHWB profiles). The second phase of this study investigates the associations between the latent profiles assigned to the organizations with absenteeism, intention to quit, emotional exhaustion, feelings of work overload, and job satisfaction among their employees using MANOVA. The results show that organizational profiles influence employees’ health and well-being. Employees working in organizations with a low OHWB profile, known as the “wasteland profile”, tend to report more days of absenteeism, higher levels of emotional exhaustion, greater work overload, and lower job satisfaction. Employees are also more likely to express a greater intention to quit their jobs than those working in organizations with a higher OHWB profile (a “blooming profile”). This study is useful for organizations and practitioners seeking to understand how investing in a health and well-being strategy can benefit their employees.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-31
DOI: 10.3390/ijerph21081008
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1009: Vision-Specific Tools for the Assessment of
Health-Related Quality of Life (HR-QoL) in Children and Adolescents with
Visual Impairment: A Scoping Review
Authors: Tshubelela Sello Simon Magakwe, Rekha Hansraj, Zamadonda Nokuthula Xulu-Kasaba
First page: 1009
Abstract: Vision-related quality-of-life (QoL) measures offer a comprehensive evaluation of the impact of eye conditions and the effectiveness of treatment on important aspects of QoL. A substantial number of tools for assessing health-related quality of life (HR-QoL) in adults have been reviewed. However, despite the high prevalence of uncorrected refractive errors causing visual impairment (VI) in children, there is a notable lack of similar tools for this vulnerable population. This review aimed to systemically map evidence on the availability and use of vision-specific instruments for assessing HR-QoL in children and adolescents with VI. This review follows the Joanna Briggs Institute (JBI) guidelines (2020) and the framework by Arksey and O’Malley and Levac et al. (2010). We conducted systematic searches through databases PubMed, Science Direct, and Scopus and search platforms Web of Science and EBSCOhost to source reviews published in English from the date of their inception to December 2023. The findings are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). We reviewed twenty tools, nine of which were developed for children in the United States and three of which were developed for children in developing countries; no tools specifically developed for children in Africa were found. In the reviewed papers, the tools were presented to children, parents, or proxies in an interview or questionnaire format. For most of the tools, reliability was assessed using internal consistency (n = 12) and test–retest reliability (n = 12). The most dominant measures of validity were construct (n = 16), content (n = 8), internal (n = 4), and criterion (n = 4). There appears to be a need for more tools developed for children in middle–low-income countries, especially for African children.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-31
DOI: 10.3390/ijerph21081009
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1010: Examining Relationships between Perceptions
of Air Quality—Objectively Assessed Particulate Matter—And
Health-Related Attributions among Midlife and Older Adults from the San
Francisco Bay Area, California, USA
Authors: Astrid N. Zamora, Maria I. Campero, Dulce M. Garcia, Abby C. King
First page: 1010
Abstract: This investigation explored (1) correlations between midlife and older adults’ air quality perceptions with objective particulate matter 2.5 (PM2.5) and diesel PM, and (2) correlations between air quality perceptions with health-related attributions among a sample of midlife and older adults (n = 66) living in or around senior affordable public housing sites in California’s San Francisco Bay Area. The adapted air quality perception scale was used to measure perceptions of air quality, while health-related attributions were obtained from the vitality plus scale (VPS), with higher values indicating worse perceptions of air quality and poorer responses to health-related attributions, respectively. Self-reported data were linked to zip code level PM2.5 and diesel PM obtained from the CalEnviroScreen 4.0. All correlations were evaluated using Spearman’s rank correlations. The mean (SD) age was 70.6 (9.1) years, and 75.7% were female. We observed moderate, positive correlations between both PM2.5 and diesel PM with three domains: perceptions related to protection measures against air quality, emotional/mental perceptions, and sensorial perceptions. We also found evidence of moderate, positive correlations between the domains of physical symptoms, perceptions related to protection measures against air quality, and emotional/mental perceptions with health-related attributions, such as sleep-related items and feelings of restlessness or agitation. Results from this exploratory study suggest that midlife and older adults’ perceptions of air quality may be moderately related to both objective air quality data and certain health behaviors and symptoms. Findings underscore the importance of considering individual perceptions as an additional area in public health strategies aimed at protecting midlife and older adults from the impacts of air pollution.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-31
DOI: 10.3390/ijerph21081010
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1011: Second-Hand Tobacco Smoke Exposure: Results
of Particulate Matter (PM2.5) Measurements at Hospitality Venues in Addis
Ababa, Ethiopia
Authors: Selamawit Hirpa, Noreen Dadirai Mdege, Terefe Gelibo Argefa, Yifokire Tefera, Selam Abraham Kassa, Winnie Awuor, Wakgari Deressa
First page: 1011
Abstract: Introduction: In Ethiopia, a comprehensive smoke-free law that bans smoking in all publ3532ic areas has been implemented since 2019. This study aimed to evaluate compliance with these laws by measuring the air quality and conducting covert observations at 154 hospitality venues (HVs) in Addis Ababa. Methods: Indoor air quality was measured using Dylos air quality monitors during the peak hours of the venues, with concentrations of particulate matter <2.5 microns in diameter (PM2.5) used as a marker of second-hand tobacco smoke. A standardized checklist was used to assess compliance with smoke-free laws during the same peak hours. The average PM2.5 concentrations were classified as good, moderate, unhealthy for sensitive groups, unhealthy for all, or hazardous using the World Health Organization’s (WHO) standard air quality index breakpoints. Results: Only 23.6% of the venues complied with all smoke-free laws indicators. Additionally, cigarette and shisha smoking were observed at the HVs. Overall, 63.9% (95% confidence interval: 56–72%) of the HVs had PM2.5 concentrations greater than 15 µg/m3. The presence of more than one cigarette smoker in the venue, observing shisha equipment in the indoor space, and the sale of tobacco products in the indoor space were significantly associated with higher median PM2.5 concentration levels (p < 0.005). Hazardous level of PM2.5 concentrations—100 times greater than the WHO standard—were recorded at HVs where several people were smoking shisha and cigarettes. Conclusions: Most HVs had PM2.5 concentrations that exceeded the WHO average air quality standard. Stricter enforcement of smoke-free laws is necessary, particularly for bars and nightclubs/lounges.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-31
DOI: 10.3390/ijerph21081011
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1012: Adapting the Baseline Resilience Indicators
for Communities (BRIC) Framework for England: Development of a Community
Resilience Index
Authors: Christine Camacho, Roger T. Webb, Peter Bower, Luke Munford
First page: 1012
Abstract: Community resilience results from complex interactions between people, places, and environments. Measuring community resilience aligns with policy objectives to enhance resilience to adverse events and address spatial disparities. The Baseline Resilience Indicators for Communities (BRIC) is a composite index used to measure resilience. This study adapts the BRIC approach to develop a Community Resilience Index (CRI) for England. A systematic review informed indicator selection, and principal components analysis was used to define sub-indices and allocate weightings. The resulting CRI comprised 44 indicators across five domains, quantifying the resilience of English local authorities. Geographical comparisons were made using t-tests and ANOVA, and the CRI was validated against the Index of Multiple Deprivation (IMD). The mean CRI score for local authorities in England was 83.1, ranging from 53.3 to 108.9. Resilience scores showed spatial patterning, with London and the South East scoring highest. The North had lower CRI scores than the Midlands and South (p = 0.022). Coastal and rural areas also showed lower resilience (p < 0.001). CRI and IMD were inversely correlated (r = −0.564, p < 0.0001). This study contributes to the literature by providing the first detailed assessment of community resilience in England using an adapted BRIC framework. The CRI provides a framework for measuring community resilience in England and could be used to explore associations with health outcomes and guide funding allocation.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-01
DOI: 10.3390/ijerph21081012
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1013: Overrepresentation of New Workers in Jobs
with Multiple Carcinogen Exposures in Canada
Authors: Disann Katende, Elizabeth Rydz, Emma K. Quinn, Emily Heer, Raissa Shrestha, Sajjad S. Fazel, Cheryl E. Peters
First page: 1013
Abstract: Background. In Canada, understanding the demographic and job-related factors influencing the prevalence of new workers and their exposure to potential carcinogens is crucial for improving workplace safety and guiding policy interventions. Methods. Logistic regression was performed on the 2017 Labour Force Survey (LFS), to estimate the likelihood of being a new worker based on age, industry, occupation, season, and immigration status. Participants were categorized by sector and occupation using the North American Industry Classification System (NAICS) 2017 Version 1.0 and National Occupational Classification (NOC) system 2016 Version 1.0. Finally, an exposures-per-worker metric was used to highlight the hazardous exposures new workers encounter in their jobs and industries. Results. Individuals younger than 25 years had 3.24 times the odds of being new workers compared to those in the 25–39 age group (adjusted odds ratios (OR) = 3.24, 95% confidence interval (95% CI) = 3.18, 3.31). Recent immigrants (less than 10 years in the country) were more likely to be new workers than those with Canadian citizenship (OR 1.36, 95% CI: 1.32, 1.41). The total workforce exposures-per-worker metric using CAREX Canada data was 0.56. By occupation, new workers were the most overrepresented in jobs in natural resources and agriculture (20.5% new workers), where they also experienced a high exposures-per-worker metric (1.57). Conclusions. Younger workers (under 25 years) and recent immigrants who had arrived 10 or fewer years prior were more likely to be new workers, and were overrepresented in jobs with more frequent hazardous exposures (Construction, Agriculture, and Trades).
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-01
DOI: 10.3390/ijerph21081013
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1014: Impact of Nutrition Interventions on Vitamin
and Mineral Intake among Native American Children and Parents: Insights
from Food Resource Equity for Sustainable Health (FRESH) Study
Authors: Wenjie Sun, Tori Taniguchi, Kaylee R. Clyma, Tvli S. Jacob, Valarie Blue Bird Jernigan
First page: 1014
Abstract: The Food Resource Equity for Sustainable Health (FRESH) study started as a tribe community-based nutrition education program in 2018, implemented with children and parents in Osage Nation. The purpose of the FRESH study is to examine the effects of a farm-to-school family intervention on diet. The FRESH study did not directly intervene on adult caregiver participants’ diet, and, as far as we know, it is the first of its kind to implement a farm-to-school intervention in rural/tribally owned Early Childhood Education. Two communities received intervention and two served as wait-list controls. Outcomes included diet and other secondary health outcomes including vitamin and mineral intake. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Among adult caregiver participants, carbohydrate, cholesterol, and caffeine intake significantly decreased after the intervention (p < 0.05). There is a hidden hunger issue among caregivers in Native American populations. The family-based nutritional intervention, which includes educational components for caregivers, might have some effect on improving micronutrient status. Future studies focusing on key micronutrients through efficient methods are warranted.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-01
DOI: 10.3390/ijerph21081014
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1015: The Effects of Functional Training on the
Ambulatory Blood Pressure and Physical Fitness of Resistant Hypertensive
Elderly People: A Randomized Clinical Rehearsal with Preliminary Results
Authors: Jenifer Kelly Pinheiro, Marcos Antonio Araújo Bezerra, Bárbara Raquel Souza Santos, Antônio Gomes de Resende-Neto, Rogério Brandão Wichi
First page: 1015
Abstract: Objective: This study evaluated the impact of functional training (FT) on the ambulatory blood pressure and physical fitness of resistant hypertensive older adults. Method: This randomized clinical and controlled rehearsal involved 15 participants from Juazeiro do Norte-CE divided into two groups: a control group (CG), n = 7, without physical training, and an experimental group (EG), n = 8, subjected to 24 sessions of FT. The comparative analysis included ambulatory blood pressure (24 h mapping) and physical fitness (Senior Fitness Test), using an ANOVA of two factors, an alpha of 0.05, and a post hoc by Bonferroni where necessary. The dimension of the intervention effect was verified using Eta Squared. Results: The results show that FT promoted a significant reduction in systolic blood pressure (SAP) during the day and at night, as well as improving physical fitness, including the force/resistance of the lower and upper limbs, physical mobility, and aerobic resistance. The flexibility of the upper and lower limbs was not affected. Conclusion: It is concluded that FT is effective in reducing SAP and improving physical fitness in resistant older adults. However, this type of training may positively influence general physical fitness of older adults with resistant hypertension.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-01
DOI: 10.3390/ijerph21081015
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1016: Dual Use of Cannabis with Tobacco Is
Associated with Increased Sugary Food and Drink Intake in Young People
Authors: Niamh Malhotra, Nikita Kasaraneni, Zoya Ahadian, Howard Chang, Ira Advani, Jade McDermott, Caitlyn Truong, Samvel Gaboyan, Ankita Mittal, Alexia Perryman, Jorge A. Masso-Silva, Christine M. Steeger, Russell P. Bowler, Peter J. Castaldi, Sunita Sharma, Laura E. Crotty Alexander
First page: 1016
Abstract: Rates of cannabis initiation among teenagers and young adults are increasing. Further, the use of various forms of cannabis (smoked or vaped) with nicotine (dual use) is increasingly common among young people. The health effects of dual use are lesser known, particularly in the context of high-potency cannabis products and across different routes of administration, which is ominous in terms of predicting future health outcomes. There is a long history of cannabis use being associated with decreased activity and increased snacking, both of which could portend an increased risk of metabolic and cardiovascular disease, particularly when these habits begin during formative years. However, modern forms of cannabis may not have these same effects. Here, we assess whether cannabis use alone and dual use of cannabis with nicotine impact dietary and exercise habits in young people. An anonymous, social media-based survey was designed based on the UC San Diego Inhalant Questionnaire and published diet and exercise questionnaires. A total of 457 surveys were completed. Young sole cannabis users represented 29% of responders, 16% were dual users of cannabis and nicotine, and 55% were non-users of either drug. Although the sole use of cannabis was not associated with dietary or activity differences relative to non-users, dual users of cannabis and nicotine reported higher consumption of unhealthy sugars. This novel finding of dual use being associated with increased sugar intake in young people raises concerns for an increased risk of metabolic syndrome and cardiovascular disease in this population.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081016
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1017: Exploring Community Perspectives on
Functional Paediatric Habitual Constipation
Authors: Nawaf Al Khashram, Ahmad A. Al Abdulqader, Haytham Mohammed Alarfaj, Mohammed Saad Bu Bshait, Ahmed Hassan Kamal, Ossama M. Zakaria, Mohammed Nasser Albarqi, Mohannad Adnan Almulhim, Mazin Abdulwahab Almousa, Abdullah Almaqhawi
First page: 1017
Abstract: (1) Background: Functional habitual constipation (FC) in children is a common gastrointestinal problem. This study aimed to explore the local community’s view on this problem, emphasising the challenges that parents face in managing the condition and its impact on the child’s quality of life. (2) Methods: A prospective, cross-sectional, community-based study was conducted between March and July 2023. The survey received 933 responses. The target population was adults over 18 years of age living in the Eastern Province of Saudi Arabia. An electronically distributed questionnaire was designed in the Arabic language. (3) Results: The mean knowledge scores were significantly higher in females than males, with t (931) = −2.701 and p = 0.007. The Bonferroni post hoc test results indicated that participants between 20 and 29 years exhibited significantly higher levels of knowledge scores compared to those between 30 and 39 years. Furthermore, the results revealed that those with three or more children had significantly higher knowledge scores compared to those with only one child. (4) Conclusions: This study demonstrated that parents in the local community have a good perceived knowledge of FC, but it needs to be linked with practice. They tended to report high levels of perception and demonstrated better practices. These results emphasise the importance of exploring the local community’s view on constipation among children.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081017
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1018: Music Therapy with Preterm Infants and Their
Families after Hospital Discharge: An Integrative Review
Authors: Verena Clemencic-Jones, Suza Trajkovski, Allison Fuller, Karen Mattock, Virginia Stulz
First page: 1018
Abstract: After discharge from a neonatal unit, families of preterm infants may require therapeutic support to address challenges related to their infant/s’ development, changed family circumstances, and/or parent wellbeing. This integrative review (IR) sought to examine the impact of music therapy on preterm infants and their families post-hospital discharge. A systematic search encompassing seven databases resulted in 83 citations, with six studies initially meeting the inclusion criteria. A further six studies were evaluated and selected upon their publication during the review process. Each study was assessed using the Mixed Methods Appraisal Tool (MMAT), followed by the identification of major themes and sub-themes. Our results suggest that music therapy contributed to creating supportive physical and metaphorical environments for preterm infants and their families, in which they could acquire essential skills, tools, and resources for fostering communication and connection with one another. Preterm infants and toddlers may have also enhanced their developmental skills through music therapy sessions post-discharge. Further investigation into the impact of music therapy on preterm infants and their caregivers at different timepoints after hospital discharge is recommended, as well as a comparison of individual and group music therapy outcomes on infant development and parent health. Future research should include a broader spectrum of family members, along with caregivers from diverse family structures and gender identities, reflecting practices already established in some clinical settings.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081018
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1019: The Genetic Profile of Combat Sport Athletes:
A Systematic Review of Physiological, Psychological and Injury Risk
Determinants
Authors: Konstantinos Anastasiou, Mhairi Morris, Liz Akam, Sarabjit Mastana
First page: 1019
Abstract: This systematic review aims to assess the genetic determinants influencing combat sports performance and address potential gaps in previous reviews. Twenty-four selected studies were analysed, investigating genetic influences on physiological performance, psychological traits, psychophysiological factors like pain perception, and injury susceptibility in combat sport athletes. The systematic literature search, using keywords, encompassed PubMed, Scopus, SportDiscus, Medline, and Google Scholar. The Covidence systematic review management software facilitated the screening process and the creation of the PRISMA flow diagram. The quality assessment complied with the PRISMA guidelines, featuring a custom 10-point scale and the STREGA criteria for more reliable study inclusion. Collectively, the 24 studies incorporated 18,989 participants, of which 3323 were combat athletes of majority European ancestry (71.7%) from various combat sports disciplines. Twenty-five unique genetic variants were significantly associated with combat sports performance across diverse domains. These included physiological performance (nine genetic variants), psychological traits (ten genetic variants), psychophysiological factors (one genetic variant), and injury susceptibility (four genetic variants). In conclusion, this systematic review lays the foundation for a more comprehensive exploration of the association between genetics and athletic performance in the demanding arena of combat sports, offering valuable insights for talent identification, training optimisation, and injury prevention.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081019
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1020: A Systematic Review on the In Vivo Studies on
Radiofrequency (100 kHz–300 GHz) Electromagnetic Field Exposure and
Co-Carcinogenesis
Authors: Rosanna Pinto, Lucia Ardoino, Paola Giardullo, Paola Villani, Carmela Marino
First page: 1020
Abstract: In this systematic review, the potential role of in vivo RF–EMF exposure combined with the administration of well-known carcinogens in tumor promotion/progression is assessed. A total of 25 papers were included in the review. Each paper was assessed for Risk of Bias and for the attribution of the quality category. A meta-analysis was conducted on 18 studies, analyzing data for nine different organs/tumors to assess the potential increased risk for the onset of tumors as well as the effects on survival. A descriptive review was performed for the remaining seven eligible papers. In most cases, the results of the meta-analysis did not reveal a statistically significant difference in tumor onset between the sham and co-exposed samples. There was a numerically small increase in the risk of malignant tumors observed in the kidney and liver, as well as benign lung tumors. The level of evidence for health effects indicated “inadequate” evidence for an association between in vivo co-exposure to RF–EMF and known carcinogens and the onset of malignant or benign tumors in most of the analyzed tissues. Nevertheless, the limited number of eligible papers/studies for most of the analyzed tissues suggests that these results cannot be considered definitively conclusive.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081020
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1021: Abortion Incidence among Young Women in Urban
Slums and Non-Slums in Kinshasa, DR Congo
Authors: Glory B. Nkombondo, Francis K. Kabasubabo, Pierre Z. Akilimali
First page: 1021
Abstract: Background: Worldwide, around 73 million induced abortions take place every year. Of these, 45% are unsafe and can lead to complications. The evolution of the legal and practical landscape of abortion in the Democratic Republic of the Congo (DRC) over the last few years necessitates a re-examination of the experience of induced abortion, leading this study to measure the incidence of abortion among young women (15 to 29 years of age), as well as the heterogeneity of this problem according to the residence of these young women (slum vs. non-slum areas). Methodology: We used representative survey data on women aged 15–49 in Kinshasa, collected from December 2021 to April 2022. The survey included questions about the respondents’ and their closest confidants’ experience of induced abortion, including the methods and sources used. We estimated abortion incidence and heterogeneity over one year based on residence in the city of Kinshasa according to sociodemographic characteristics. Results: The fully adjusted one-year friend abortion rate in 2021 was 131.5 per 1000 (95% CI: IQR 99.4–163.6). These rates were significantly higher than the corresponding estimates of respondents. The incidence of induced abortion for respondents was 24.4 per 1000 (95% CI: 15.8–32.9) abortions per 1000 women. The incidence rates of induced abortion were much higher among the respondents residing in slums than among those residing in non-slums (29.2 vs. 13.0 per 1000; p < 0.001). Slum respondents indicated higher use of non-recommended methods than non-slum respondents. Conclusions: More precise estimates of the incidence of abortion indicate that the incidence rate of abortion was higher among young women residing in slums who were unmarried and had no children. These incidences were higher among confidants than among respondents. There is still a lot of work to be done to fulfill the obligations outlined in the Maputo Protocol. The aim is to decrease the occurrence of unsafe abortions and their associated effects.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081021
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1022: Obesity and Associated Factors in Brazilian
Adults: Systematic Review and Meta-Analysis of Representative Studies
Authors: Cecilia Alcantara Braga Garcia, Karina Cardoso Meira, Alessandra Hubner Souza, Ana Laura de Grossi Oliveira, Nathalia Sernizon Guimarães
First page: 1022
Abstract: To review the literature and select population-based studies that are representative of Brazilian capitals or Brazil as a whole to estimate the prevalence of obesity among Brazilian adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used. The search was conducted in six databases and reference lists of included studies. We included observational studies but excluded interventional studies, reviews, in vitro studies, and editorials. The study population consisted of young adults and adults (18 to 59 years old). Adolescents, infants, children, the elderly, and pregnant women were excluded. The primary outcomes were the prevalence of obesity among Brazilian adults, both men and women. The secondary outcomes were factors associated with obesity. The meta-analysis was performed using Rstudio software, version 4.1.0, by using the ‘Meta’ package, version 5.0-0. The search strategy identified 5634 references, of which 19 studies and 21 national surveys were included in the meta-analysis. The pooled prevalence of obesity in Brazilian adults was 20.0% (95% CI: 14.0–25.0%) while in the capitals it was 17.0% (95% CI: 16.0–19.0%). Across the regions of Brazil, the prevalence ranged from 11.0% to 17.0%, with the highest frequency in the south. Increases in obesity prevalence were observed for both sexes in almost all periods, with consistently higher rates among women in most cases. The prevalence of obesity among Brazilian adults is high, with no statistically significant differences found in the subgroup analysis.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081022
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1023: Using an Empathetic Approach to Explore
Technology Readiness and Needs for Digital Services to Assist People with
Dementia
Authors: Mille Aagaard Engblad, Emilie Pind Herstal, Emilie Kauffeldt Wegener, Lars Kayser
First page: 1023
Abstract: This qualitative study investigates technology readiness, i.e., self-management, social support, and digital health literacy, in people with dementia (PwD). PwD are difficult to recruit; therefore, we used an empathic approach to recruit and conduct interviews. The interviews with seven participants with dementia and two informal caregivers, guided by the READHY framework, reveal nuanced insights into their experiences. Participants demonstrate varying degrees of self-management, with informal caregivers playing pivotal roles in facilitating activities and supporting overall well-being. Cognitive challenges, such as concentration and communication difficulties, are prevalent, highlighting the importance of robust support systems. Internal and external support networks significantly influence social integration, yet societal misconceptions impede inclusion, exacerbating feelings of isolation for both participants and caregivers. Limited interaction with technology is observed, primarily reliant on caregivers for assistance. Technology may hold potential for enhancing independence and alleviating caregiver burden. As an empathetic approach eased recruitment and communication with PwD, we recommend using this approach for future studies to include participants who otherwise would not be recruited. Given that the number of participants in this study is limited to only seven PwD with moderate to severe cognitive impairment, further investigation using mixed methods, including the READHY framework, and a larger number of participants is needed to examine the generalizability of the findings.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-02
DOI: 10.3390/ijerph21081023
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1024: Brain, Metabolic, and RPE Responses during a
Free-Pace Marathon: A Preliminary Study
Authors: Florent Palacin, Luc Poinsard, Julien Mattei, Christian Berthomier, Véronique Billat
First page: 1024
Abstract: The concept of the “central governor” in exercise physiology suggests the brain plays a key role in regulating exercise performance by continuously monitoring physiological and psychological factors. In this case report, we monitored, for the first time, a marathon runner using a metabolic portable system and an EEG wireless device during an entire marathon to understand the influence of brain activity on performance, particularly the phenomenon known as “hitting the wall”. The results showed significant early modification in brain activity between the 10th and 15th kilometers, while the RPE remained low and cardiorespiratory responses were in a steady state. Thereafter, EEG responses decreased after kilometer 15, increased briefly between kilometers 20 and 25, then continued at a slower pace. After kilometer 30, both speed and respiration values dropped, along with the respiratory exchange ratio, indicating a shift from carbohydrate to fat metabolism, reflecting glycogen depletion. The runner concluded the race with a lower speed, higher RPE (above 15/20 on the Borg RPE scale), and reduced brain activity, suggesting mental exhaustion. The findings suggest that training strategies focused on recognizing and responding to brain signals could allow runners to optimize performance and pacing strategies, preventing premature exhaustion and improving overall race outcomes.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-03
DOI: 10.3390/ijerph21081024
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1025: Knowledge, Acceptance, and Uptake of Family
Planning: A Cluster Randomized Controlled Trial of Group Antenatal Care in
Ghana
Authors: Ruth Zielinski, Samia Abdelnabi, Georgina Amankwah, Vida A. Kukula, Veronica Apetorgbor, Elizabeth Awini, John Williams, Cheryl Moyer, Bidisha Ghosh, Jody R. Lori
First page: 1025
Abstract: The use of family planning (FP) methods significantly contributes to improved outcomes for mothers and their offspring. However, the use of FP remains low, particularly in low- and middle-income countries. A cluster randomized controlled clinical trial was implemented in Ghana, comparing group antenatal care (ANC) with routine care. The group ANC intervention included eight meetings where the seventh group meeting incorporated information and discussion regarding methods of FP. Data collection occurred at five time points: baseline (T0), 34 weeks’ gestation (T1), 6–12 weeks post birth (T2), 5–8 months post birth, and 11–14 months post birth (T4). At T1, there was a significantly greater increase in the knowledge of FP methods as well as the intention to use FP after the birth among the intervention group. The uptake of FP was significantly higher in the intervention group for all post-birth timepoints except for T4 where the control group had significantly higher rates. The reasons for the diminishing effect are unclear. An increasing uptake of FP methods requires a multifaceted approach that includes increasing accessibility, knowledge, and acceptability as well as addressing societal and cultural norms.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-03
DOI: 10.3390/ijerph21081025
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1026: Cultural Adaptation and Validation of the
Ambulatory Self-Confidence Questionnaire (ASCQ), Portuguese (European)
Version
Authors: Maria Teixeira, Mónica Luís, Magda Reis, Carlota Carvão, Anabela Correia Martins
First page: 1026
Abstract: In a world where physical activity and social participation are fundamental pillars of a full and healthy life, confidence in walking has emerged as a fundamental aspect to assess, especially for older adults. Therefore, the purpose of this study was to develop a Portuguese (European) version of the Ambulatory Self-Confidence Questionnaire (ASCQ) that was both linguistically and psychometrically adapted. To do so, a translation method was used, followed by an assessment of its validity and reliability. The Portuguese version was completed by 173 older adults. To assess reliability, Cronbach’s alpha and intraclass correlation coefficients (ICCs) were used. For sociodemographic and clinical characterization, as well as questionnaire scoring, descriptive statistical analysis was used. Pearson’s correlation (r), Student’s t-test, and one-way ANOVA were used to analyze criterion and construction validity. The Portuguese interactions with ASCQ were effectively translated and adjusted, revealing exceptional internal consistency and test–retest reliability, as reflected in Cronbach’s alpha and ICC values of 0.95. No floor effect was observed; however, a ceiling effect was identified (3.5%). The criterion and construct validity were verified as all the correlations established were statistically significant. The adaptation of the ASCQ to Portuguese culture is adequate, making it valid for use within the Portuguese population.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-04
DOI: 10.3390/ijerph21081026
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1027: Correlational Insights into
Attention-Deficit/Hyperactivity Disorder in Lebanon
Authors: Melyssa Assaf, Melissa Rouphael, Sarah Bou Sader Nehme, Michel Soufia, Abbas Alameddine, Souheil Hallit, Marc Landry, Tania Bitar, Walid Hleihel
First page: 1027
Abstract: Attention-Deficit/Hyperactivity Disorder (ADHD), a prevalent childhood neurodevelopmental disorder with complex etiology involving genetic and environmental factors, causes impairments across various life domains and substantial social and economic burden. Identifying correlates to prevent its onset and decrease its incidence is crucial. To our knowledge, our study represents the first case–control investigation of Lebanese ADHD patients to explore potential correlations between familial, maternal, and child health variables and ADHD to enhance understanding of its etiology and aid in prevention efforts. We recruited 61 Lebanese ADHD patients and 58 matched controls aged 6–24 years from all districts of Lebanon. The data to analyze were collected using a questionnaire. We employed statistical tests, including the independent samples t-test and the Chi-square test or Fisher’s exact test. We conducted a multivariate logistic regression analysis to identify the statistically significant factors explaining ADHD likelihood. We observed male predominance (68.9%) among patients. Maternal anemia during pregnancy (OR = 3.654; 95% CI [1.158–11.529]), maternal self-reported stress during pregnancy (OR = 3.268; 95% CI [1.263–8.456]), neonatal jaundice (OR = 5.020; 95% CI [1.438–17.532]), and familial history of ADHD (OR = 12.033; 95% CI [2.950–49.072]) were significantly associated with increased odds of the disorder. On the other hand, breastfeeding (OR = 0.263; 95% CI [0.092–0.757]) was identified as a protective factor against ADHD. This pilot study shed light on risk and protective factors associated with ADHD in the Lebanese population. The results are relevant, as some identified correlates could be avoidable. Further rigorous investigation is required to expand upon the observed correlations and to assist in early detection, prevention, and intervention strategies targeting ADHD.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-05
DOI: 10.3390/ijerph21081027
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1028: Correction: Reco, M.d.O.N.; Soares-Marangoni,
D.A. Randomized Controlled Trial Protocol on the Effects of a Sensory
Motor Intervention Associated with Kangaroo Skin-to-Skin Contact in
Preterm Newborns. Int. J. Environ. Res. Public Health 2024, 21, 538
Authors: Mariane de Oliveira Nunes Reco, Daniele Almeida Soares-Marangoni
First page: 1028
Abstract: In the original publication [...]
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-05
DOI: 10.3390/ijerph21081028
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1029: What Interventions Work to Reduce Cost
Barriers to Primary Healthcare in High-Income Countries' A Systematic
Review
Authors: Bailey Yee, Nisa Mohan, Fiona McKenzie, Mona Jeffreys
First page: 1029
Abstract: High-income countries like Aotearoa New Zealand are grappling with inequitable access to healthcare services. Out-of-pocket payments can lead to the reduced use of appropriate healthcare services, poorer health outcomes, and catastrophic health expenses. To advance our knowledge, this systematic review asks, “What interventions aim to reduce cost barriers for health users when accessing primary healthcare in high-income countries'” The search strategy comprised three bibliographic databases (Dimensions, Embase, and Medline Web of Science). Two authors selected studies for inclusion; discrepancies were resolved by a third reviewer. All articles published in English from 2000 to May 2022 and that reported on outcomes of interventions that aimed to reduce cost barriers for health users to access primary healthcare in high-income countries were eligible for inclusion. Two blinded authors independently assessed article quality using the Critical Appraisal Skills Program. Relevant data were extracted and analyzed in a narrative synthesis. Forty-three publications involving 18,861,890 participants and 6831 practices (or physicians) met the inclusion criteria. Interventions reported in the literature included removing out-of-pocket costs, implementing nonprofit organizations and community programs, additional workforce, and alternative payment methods. Interventions that involved eliminating or reducing out-of-pocket costs substantially increased healthcare utilization. Where reported, initiatives generally found financial savings at the system level. Health system initiatives generally, but not consistently, were associated with improved access to healthcare services.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-05
DOI: 10.3390/ijerph21081029
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1030: Bi-Directional and Time-Lagged Associations
between Engagement and Mental Health Symptoms in a Group Mindfulness-Based
Mental Health Intervention
Authors: Brock A. Rigsby, Reagan L. Miller, Megan J. Moran, Addie J. Rzonca, Jonathan I. Najman, Melanie S. Adams, Mark A. Prince, Rachel G. Lucas-Thompson
First page: 1030
Abstract: There is a high need for accessible avenues for improving mental health among emerging adults, particularly on college campuses. Mindfulness-based intervention (MBI) is a promising avenue for reducing mental health symptoms, but initial discomforts associated with MBI may cause symptoms to fluctuate before decreasing, which presents a barrier to engagement with mindfulness on a daily basis. Consistent mindfulness practice is key for forming habits related to MBI, and engagement with mindfulness at home, including between intervention sessions, is an important predictor of mental health outcomes. Research suggests that mental health symptoms may serve as barriers to their own treatment. Thus, it is important to understand how mental health symptom levels impact adherence to treatment protocols. To improve understanding of symptom-specific barriers to treatment and engagement with mindfulness, the present study collected daily diary surveys about engagement with mindfulness and mental health symptoms from a sample of 62 adults recruited to participate in a six-week mindfulness intervention. We explored mental health symptoms as a predictor of engagement with MBI at the mean level and whether within-person variability in symptoms predicted same-day or time-lagged changes in engagement via mixed-effects associations. Using heterogeneous location scale models, we further explored whether erraticism in either mental health symptoms or engagement with mindfulness predicted the other and if outcomes of the mindfulness intervention were homogeneous among subjects. Results showed that bi-directional and time-lagged associations exist between symptoms and engagement, indicating that there is a nuanced temporal and reciprocal relationship between engagement with mindfulness and mental health symptoms. Daily within-person elevations in engagement with mindfulness were associated with concurrent improvements in mental health but prospective increases in mental health symptoms. We also found that higher engagement (over personal averages) was not consistently associated with improvements in mental health across the sample but was instead associated with greater heterogeneity in outcomes. We also found that increases in mental health symptoms (over personal averages), as well as higher average levels of mental health symptoms, were both associated with lower levels of engagement in the mindfulness treatment protocol.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-05
DOI: 10.3390/ijerph21081030
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1031: Effect of Moringa oleifera Seeds Powder on
Metallic Trace Elements Concentrations in a Wastewater Treatment Plant in
Senegal
Authors: Nini Sané, Malick Mbengue, Seyni Ndoye, Serge Stoll, John Poté, Philippe Le Coustumer
First page: 1031
Abstract: A wastewater treatment plant (WWTP) prototype coupled with Moringa oleifera seeds (MOSs) was developed to evaluate its effectiveness to reduce metallic trace elements (MTEs) in domestic wastewater. The WWTP is composed of a septic tank (F0) where wastewater is treated by biological processes under anaerobic conditions, followed by a bacterial filter (F1) where wastewater is filtered under aerobic conditions, followed by an infiltration well (F2), which provides additional filtration of wastewater before discharge into the soil. MTEs present in waters can bind with humic substances contained in colloid particles and then be eliminated by coagulation–flocculation with a cationic polyelectrolyte. MOSs contain positively charged cationic polymers that can neutralize the colloids contained in waters, which are negatively charged. Based on this observation, 300 mg·L−1 of MOS was added into F0, 50 mg·L−1 into F1, and 50 mg·L−1 into F2 mg·L−1. MOS activation in samples was performed by stirring rapidly for 1.5 min, followed by 5 min of gentle stirring and 3 h of settling. The data analysis shows that wastewater samples had significant concentrations of MTEs, particularly for Cu, Ni, Sr, and Ti, and sediment samples had high amounts of Cr, Cu, Ni, Sr, Ti, and V. The addition of MOS to F0, F1, and F2 samples resulted in reductions in MTE concentration of up to 36%, 71%, 71%, 29%, 93%, 81%, 13%, 52%, and 67% for Co, Cr, Cu, Ni, Pb, Se, Sr, Ti, and V, respectively. The quantified MTEs (As, Co, Cr, Cu, Ni, Pb, Se and V) in treated samples were reported to be lower than UN-EP standards for a safe reuse for irrigation and MOS proved to be as effective as chemical coagulants such as lime and ferric iron for the removal of MTEs contained in wastewater. These results highlight the potential of MOSs as natural coagulants for reducing MTE content in domestic wastewater. This study could be the first to evaluate the effectiveness of MOS in reducing 10 MTEs, including As, Co, Se, Sr, Ti, and V, which are currently understudied. It could also provide a better understanding of the origin of MTEs found in domestic wastewaters and how an effective treatment process can result in high-quality treated wastewaters that can be reused for irrigation without posing health or environmental risks. However, more research on MOSs is needed to determine the type and composition of the coagulant substance found in the seeds, as well as the many mechanisms involved in the decrease in MTEs by MOSs, which is currently understudied. A better understanding of MOS structure is required to determine the optimum alternative for ensuring the optimal effect of MOS paired with WWTP in removing MTEs from domestic wastewaters.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-05
DOI: 10.3390/ijerph21081031
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1032: The Feasibility of the Diabetes
Self-Management Coaching Program in Primary Care: A Mixed-Methods
Randomized Controlled Feasibility Trial
Authors: Fikadu Ambaw Yehualashet, Dorothy Kessler, Segenet M. Bizuneh, Catherine Donnelly
First page: 1032
Abstract: Background: Diabetes mellitus, a chronic metabolic disorder associated with elevated blood sugar levels, is a significant cause of morbidity, mortality, and disability globally. The rampant rise in the prevalence of diabetes presents a public health burden and a challenge to the primary care setting. Diabetes self-management coaching is an emergent, client-centered, solution-focused approach to enhance self-efficacy and self-care behavior, control glycemia, and prevent acute and chronic complications. Currently, there is no diabetes self-management support strategy in the primary care setting in Ethiopia. Therefore, this study assessed the feasibility, acceptability, and fidelity of implementing the Diabetes Self-Management Coaching Program in primary care in Ethiopia. Method: A single-center, single-blinded, parallel group mixed-methods feasibility randomized control design was applied to assess the feasibility, acceptability, and fidelity of the Diabetes Self-Management Coaching Program in primary care. Adult patients with type 2 diabetes with HbA1c ≥ 7%, taking diabetic medication, and living in Gondar town were included in the study. A block randomization technique with a block size of four was used to allocate participants into the treatment and control groups. The treatment group attended a 12-week Diabetes Self-Management Coaching Program in addition to undergoing usual care, while the control group received the usual care for the same period. Data were collected at baseline, at the end of the intervention, and after the follow-up period. Descriptive statistics such as the frequency, mean, median, and standard deviations were computed. Based on the normality assessment, the baseline group difference was examined using the independent sample Student’s t-test, the Mann–Whitney U test, and the chi-square test. Result: This study’s eligibility, recruitment, retention, and adherence rates were 23%, 70%, 90%, and 85%, respectively. Both the qualitative and quantitative findings show that the program was feasible to implement in primary care and acceptable to the participants. The fidelity assessment of the Diabetes Self-Management Coaching Program indicates an appropriate intervention implementation. Conclusions: This study demonstrated remarkable recruitment, retention, and adherence rates. The Diabetes Self-Management Coaching Program was feasible, acceptable, and implementable in primary care in Ethiopia. As a result, we recommend that a large-scale multi-center cluster randomized controlled trial with an adequate sample can be designed to evaluate the effect of the DSM Coaching Program on clinical and behavioral outcomes.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-06
DOI: 10.3390/ijerph21081032
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1033: Health Status and COVID-19 Epidemiology in an
Inland Region of Portugal: A Retrospective Study
Authors: Jorge Lindo, Patrícia Coelho, Catarina Gavinhos, Manuel Martins, Joana Liberal, António Jorge Ferreira, Teresa Gonçalves, Francisco Rodrigues
First page: 1033
Abstract: Multiple factors, from socioeconomic development to genetic background, can affect the regional impact of some diseases, and this has also been seen during the COVID-19 pandemic. The objective of this retrospective study was to characterize a population in the interior of Portugal regarding health status and COVID-19 epidemiology. Between October 2021 and January 2023, 1553 subjects residing in Beira Baixa, Portugal, were included. Using a self-report approach, demographic and clinical data were obtained. Blood group, blood pressure, peripheral oxygen saturation and anti-spike protein immunoglobulin concentration were also analyzed. Statistical analysis was performed using IBM SPSS Statistics. The average age of the participants was 48.95 (±14.43) years, with 64% being male and 36% being female. The most prevalent comorbidities were hypertension (19.2%), dyslipidemia (12.6%) and diabetes mellitus (6.6%). Half of the population was overweight, and more than half of the subjects had no history of tobacco consumption. Among the participants, 33% were infected with SARS-CoV-2: 70.1% had mild disease, 14.1% moderate disease and 1.4% severe disease. There was a very significant adherence to vaccination (97%). Previously infected or vaccinated people had higher anti-spike protein immunoglobulin values; this value depended on the vaccine administered (p < 0.001). Patients with autoimmune diseases and smokers had lower levels of anti-S IgG antibodies (p = 0.030 and p = 0.024, respectively). The severity of COVID-19 did not affect the concentration of anti-S IgG (p = 0.430). This study highlights the general health statuses and the impact of COVID-19 on a population in the Portuguese interior. Knowledge of the circulation and impact of the virus in this specific population can alert and assist in better interventions being conducted by health authorities.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-06
DOI: 10.3390/ijerph21081033
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1034: Disaster Preparedness among Healthcare
Professionals in Lebanon
Authors: Yara Skaff, Mohammad Jarrah, Rabih Nasrallah, Reina Habib, Rania Sakr
First page: 1034
Abstract: Background: Disaster disrupts the normal functioning of a community, causing significant damages and losses. In recent years, Lebanon faced multiple disasters, including one of the largest explosions ever recorded, the Beirut Blast, in August 2020. Limited studies in the literature have examined disaster medicine preparedness among healthcare professionals (HCPs). Objective: To examine the knowledge (K), attitude (A), readiness to practice (rP), and KArP associated with disaster medicine preparedness among HCPs in Lebanon. Methods: A cross-sectional observational study was conducted in Lebanon using data from participants answering an online survey. Participants enrolled in this study were HCPs (residents and faculty), medical students, and postdoctoral research scholars. Levels of knowledge, attitude, and readiness to practice were assessed and used to examine their association with participants’ socio-demographic characteristics. Results: A total of 195 participants (average age 30.6 ± 11.4 years) were included in this study. Participants reported moderate scores of knowledge, attitude, and readiness to practice. Older participants reported better readiness to practice and a KArP score. A significant difference was observed in all categories according to gender, with men having higher scores than women. No significant difference was observed between the level of education and knowledge, attitude, and total KArP scores. Conclusions: Our study’s findings showed that age and the level of education were positively correlated with readiness to practice. Men, compared to women, had significantly higher scores in all categories. Barriers to the KArP should be identified and targeted in future studies, as disaster preparedness at the institutional level may improve outcomes in future disaster encounters.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-06
DOI: 10.3390/ijerph21081034
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1035: A New Approach for Understanding
International Hospital Bed Numbers and Application to Local Area Bed
Demand and Capacity Planning
Authors: Rodney P. Jones
First page: 1035
Abstract: Three models/methods are given to understand the extreme international variation in available and occupied hospital bed numbers. These models/methods all rely on readily available data. In the first, occupied beds (rather than available beds) are used to measure the expressed demand for hospital beds. The expressed occupied bed demand for three countries was in the order Australia > England > USA. Next, the age-standardized mortality rate (ASMR) has dual functions. Less developed countries/regions have low access to healthcare, which results in high ASMR, or a negative slope between ASMR versus available/occupied beds. In the more developed countries, high ASMR can also be used to measure the ‘need’ for healthcare (including occupied beds), a positive slope among various social (wealth/lifestyle) groups, which will include Indigenous peoples. In England, a 100-unit increase in ASMR (European Standard population) leads to a 15.3–30.7 (feasible range) unit increase in occupied beds per 1000 deaths. Higher ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand. The USA has a high relative ASMR (for a developed/wealthy country) because healthcare is not universal in the widest sense. Lastly, a method for benchmarking the whole hospital’s average bed occupancy which enables them to run at optimum efficiency and safety. English hospitals operate at highly disruptive and unsafe levels of bed occupancy, manifesting as high ‘turn-away’. Turn-away implies bed unavailability for the next arriving patient. In the case of occupied beds, the slope of the relationship between occupied beds per 1000 deaths and deaths per 1000 population shows a power law function. Scatter around the trend line arising from year-to-year fluctuations in occupied beds per 1000 deaths, ASMR, deaths per 1000 population, changes in the number of persons hidden in the elective, outpatient and diagnostic waiting lists, and local area variation in births affecting maternity, neonatal, and pediatric bed demand. Additional variation will arise from differences in the level of local funding for social care, especially elderly care. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-06
DOI: 10.3390/ijerph21081035
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1036: Analysis of Hospital Safety and Risk of Falls
in the Elderly: A Cross-Sectional Study in Brazil
Authors: Leane Macêdo de Carvalho, Letície Batista Lira, Lairton Batista de Oliveira, Annarelly Morais Mendes, Francisco Gilberto Fernandes Pereira, Francisca Tereza de Galiza, Lívia Carvalho Pereira, Ana Larissa Gomes Machado
First page: 1036
Abstract: This study analyzed hospital safety and the risk of falls in elderly people in a university hospital in Brazil. The Morse Falls Scale was used to stratify the risk of falls in 45 hospitalized elderly individuals, and two checklists were used to analyze the hospital environment. The analysis was based on the Chi-square test and multiple regression. The moderate risk of falls was predominant (51.1%). The variable age group (p-value = 0.024) showed statistical evidence of association with the risk of falls. However, the multiple regression analysis showed no difference between the age groups and the risk situation for falls. The hospital wards showed an adequate arrangement of furniture, but some aspects had inadequacies, such as objects in the corridors, non-functional bells in some beds, inadequacy of the toilet bowls in terms of the recommended height, and an absence of non-slip flooring and the support bar in some bathrooms. In conclusion, the moderate risk of falls among the elderly and the adequacy of the hospital environment to technical standards were evident with the exception of failures in the emergency communication system and sanitary installation.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-06
DOI: 10.3390/ijerph21081036
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1037: Psychological Well-Being and Self-Efficacy
for Self-Regulated Learning
Authors: Maria Luisa Pedditzi, Laura Francesca Scalas
First page: 1037
Abstract: This study explores psychological well-being in adolescence through a multidimensional perspective using the Adolescent Students’ Basic Psychological Needs at School Scale, derived from the Self-Determination Theory. The ASBPNSS focuses on three basic psychological needs (Competence, Autonomy, and Relatedness) in adolescence and has not yet been used within the school context in Italy. This study’s main objectives are: (1) to validate a preliminary Italian version of the ASBPNSS; (2) to analyze the association between well-being at school and self-efficacy for self-regulated learning; and (3) to verify whether there are differences by gender. A sample of 395 students (mean age = 17.5; SD = 0.75) completed the ASBPNSS and the Self-Efficacy for Self-Regulated Learning Scale. The factorial structure, composite reliability, and gender invariance of the ASBPNSS were examined. Associations between well-being at school and self-efficacy were tested with structural equation models (CFI = 0.935, TLI = 0.925; RMSEA = 0.054). Measures of well-being were associated with school self-efficacy for self-regulated learning, which predicted Competence (beta = 0.639), Relatedness (beta = 0.350), and Autonomy (beta = 0.309). These relationships were invariant over gender, although girls reported lower latent means in the Relatedness factor. This study highlights the importance of promoting school self-efficacy and well-being in adolescence.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-07
DOI: 10.3390/ijerph21081037
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1038: Energy-Dense and Low-Fiber Dietary Pattern
May Be a Key Contributor to the Rising Obesity Rates in Brazil
Authors: Iuna Arruda Alves, Mahsa Jessri, Luana Silva Monteiro, Luiz Eduardo da Silva Gomes, Taís de Souza Lopes, Edna Massae Yokoo, Rosely Sichieri, Rosangela Alves Pereira
First page: 1038
Abstract: Hybrid methods are a suitable option for extracting dietary patterns associated with health outcomes. This study aimed to identify the dietary patterns of Brazilian adults (20–59 years old; n = 28,153) related to dietary components associated with the risk of obesity. Data from the 2017–2018 Brazilian National Dietary Survey were analyzed. Food consumption was obtained through 24 h recall. Dietary patterns were extracted using partial least squares regression, using energy density (ED), percentage of total fat (%TF), and fiber density (FD) as response variables. In addition, 32 food groups were established as predictor variables in the model. The first dietary pattern, named as energy-dense and low-fiber (ED-LF), included with the positive factor loadings solid fats, breads, added-sugar beverages, fast foods, sauces, pasta, and cheeses, and negative factor loadings rice, beans, vegetables, water, and fruits (≥ 0.15 ). Higher adherence to the ED-LF dietary pattern was observed for individuals >40 years old from urban areas, in the highest income level, who were not on a diet, reported away-from-home food consumption, and having ≥1 snack/day. The dietary pattern characterized by a low intake of fruits, vegetables, and staple foods and a high intake of fast foods and sugar-sweetened beverages may contribute to the obesity scenario in Brazil.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-07
DOI: 10.3390/ijerph21081038
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1039: Neural Correlates of Mobility in Children
with Cerebral Palsy: A Systematic Review
Authors: Isabella Pessóta Sudati, Diane Damiano, Gabriela Rovai, Ana Carolina de Campos
First page: 1039
Abstract: Recent advances in brain mapping tools have enabled the study of brain activity during functional tasks, revealing neuroplasticity after early brain injuries and resulting from rehabilitation. Understanding the neural correlates of mobility limitations is crucial for treating individuals with cerebral palsy (CP). The aim is to summarize the neural correlates of mobility in children with CP and to describe the brain mapping methods that have been utilized in the existing literature. This systematic review was conducted based on PRISMA guidelines and was registered on PROSPERO (n° CRD42021240296). The literature search was conducted in the PubMed and Embase databases. Observational studies involving participants with CP, with a mean age of up to 18 years, that utilized brain mapping techniques and correlated these with mobility outcomes were included. The results were analyzed in terms of sample characteristics, brain mapping methods, mobility measures, and main results. The risk of bias was evaluated using a checklist previously created by our research group, based on STROBE guidelines, the Cochrane Handbook, and the Critical Appraisal Skills Programme (CASP). A total of 15 studies comprising 313 children with CP and 229 with typical development using both static and mobile techniques met the inclusion criteria. The studies indicate that children”with’CP have increased cerebral activity and higher variability in brain reorganization during mobility activities, such as gait, quiet standing, cycling, and gross motor tasks when compared with children with typical development. Altered brain activity and reorganization underline the importance of conducting more studies to investigate the neural correlates during mobility activities in children with CP. Such information could guide neurorehabilitation strategies targeting brain neuroplasticity for functional gains.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-07
DOI: 10.3390/ijerph21081039
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1040: The Association between Psychological and
Behavioral Economic Factors and the Rapid Assessment Disuse Index (RADI)
during the COVID-19 Pandemic
Authors: Clare Meernik, Qing Li, Jeffrey Drope, Ce Shang, Tammy Leonard, Bob M. Fennis, Mahmoud Qadan, Carolyn E. Barlow, Laura F. DeFina, Reid Oetjen, Loretta DiPietro, Kerem Shuval
First page: 1040
Abstract: The deleterious health effects of prolonged sitting and physical inactivity are well-established, yet these behaviors are pervasive in modern culture. To inform interventions aimed at reducing sedentary behavior and increasing lifestyle activity, this study examined psychological and behavioral economic factors that may be associated with these behaviors. This cross-sectional study was conducted among 4072 adults in Israel. Participants completed a survey pertaining to lifestyle behaviors and economic preferences using an online platform in September 2020. The psychological and behavioral economic factors of interest were patience, self-control, risk-taking, grit, and general self-efficacy. Sedentary behavior and lifestyle activity (e.g., time spent moving about) was assessed using the Rapid Assessment Disuse Index (RADI) tool (higher score indicative of more sitting and less activity). Multivariable linear and logistic regression analyses examined the association between psychological and behavioral economic factors and RADI score. Among 4072 participants, those who were impatient (vs. patient, β: −1.13; 95% CI: −1.89, −0.38) had higher grit (β: −1.25, 95% CI: −1.73, −0.77), and those who were more risk-seeking (β: −0.23; 95% CI: −0.33, −0.13) had lower RADI scores (i.e., less sedentary, more active). Significant associations for grit and risk-taking were also observed when the RADI score was dichotomized, such that individuals who had higher grit or were more risk-seeking were more likely to be non-sedentary/active. No significant associations were observed for self-control or general self-efficacy. Higher grit and more risk-seeking were associated with a decreased propensity for sedentary behaviors and inactivity; these factors may provide targets for interventions aimed at reducing sedentary behavior and increasing lifestyle activity.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-07
DOI: 10.3390/ijerph21081040
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1041: Ecosystem Barriers and Facilitators Linked to
the Fear of Cancer Recurrence: An Umbrella Review
Authors: Benjamin Caumeil, Nicolas Bazine, Axel Maugendre, Sarah Calvin
First page: 1041
Abstract: The fear of cancer recurrence is an important topic in the healthcare field. In general, approximately 40% of survivors experience high levels of fear of recurrence. This study aims to fill this gap by synthesizing the findings of systematic reviews studies investigating ecosystems, correlates or predictors, and barriers and facilitators of fear of cancer recurrence among cancer survivors. An umbrella meta-synthesis was conducted using the following databases: MEDLINE, PsycINFO, PsycARTICLES, CINAHL, Business source premier, and SOCindex, ending in April 2024 with PRISMA methods. A total of 24 systematic reviews, representing 729 articles, were included in the study. In total, six ecosystems were identified, including family, work, friends, the healthcare system, caregivers, and religion. As part of this umbrella review, 55 specific ecosystemic factors were identified that may contribute to fear of cancer recurrence. Furthermore, the umbrella review identified 12 facilitators and 12 barriers related to fear of cancer recurrence. This umbrella meta-synthesis contributed significantly to our review’s strength in synthesizing the main ecosystem and its influence on fears of cancer recurrence. Understanding the interdependence of ecosystems should enable future research on intervention effectiveness or the development of interventions that could reduce the fear of cancer recurrence.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-07
DOI: 10.3390/ijerph21081041
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1042: Development and Content Validation of a
Nursing Clinical Simulation Scenario on Transfusion Reaction Management
Authors: Francisco Mayron Morais Soares, Samia Valéria Ozorio Dutra, Gleiciane Kélen Lima, Ana Beatriz Frota Lima Rodrigues, Davi Santos Magalhães, Elaine Cristina Negri, Igor Cordeiro Mendes, Luciana Mara Monti Fonseca, Lucas Ribeiro Araujo, Maria Ivaneide Teixeira dos Santos, Ana Clara Negri, Ana Valeska Siebra e Silva, Tatyane Oliveira Rebouças, Carmen Heidi Linhares, Francisco Arnoldo Nunes de Miranda
First page: 1042
Abstract: Blood transfusion is a life-saving procedure widely used in healthcare. However, complications such as transfusion reactions may occur. Knowledge of these reactions is essential for patient safety. Nurses play a crucial role in this process by identifying complications and adverse reactions early on. A lack of professional competence in blood transfusion can lead to errors and serious complications, such as death. The aim of this study was to present evidence of the content validity of a simulated clinical scenario on transfusion reactions for teaching and learning for nursing students. This methodological study was carried out in three phases: (1) development of the simulated scenario of a transfusion reaction; (2) analysis of evidence of content validity by experts (n = 11); and (3) determination of satisfaction and self-confidence in the use of the simulated scenario by the nursing students (n = 45). The Content Validity Index was 94%. After the scenario had been developed, the content was validated and approved by 100% of the experts. All the items in the simulated scenario obtained agreement scores above 0.90. The simulated scenario was validated in terms of content and can be used to teach the management of transfusion reactions.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-08
DOI: 10.3390/ijerph21081042
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1043: Stakeholders’ Experiences and
Preferences Regarding Comprehensive Sexuality Education in Zambia:
Implications for Determining Programme Priorities and Strategies
Authors: Bright Mukanga, Siyabonga Blessing Dlamini, Myra Taylor
First page: 1043
Abstract: Background: Understanding and exploring stakeholders’ perceptions and preferences regarding comprehensive sexuality education (CSE) is critical in enhancing programme acceptability. We conducted this qualitative study to explore stakeholders’ experiences and preferences of CSE in Kitwe district, Zambia. Methods: We employed a qualitative descriptive design within the interpretive paradigm at nine purposefully selected secondary schools. Data were collected through classroom observation, in-depth interviews, and focus group discussions. In depth interviews were undertaken among 21 pupils, 17 teachers, 4 policymakers, 4 parents, and 4 religious leaders. Two focus group discussions were conducted among 14 pupils with each group having seven pupils. Data were analysed using inductive thematic analysis. Interviews continued until data saturation. Results: Our analysis yielded themes on stakeholder experiences of CSE which included: a lack of pupil-centred pedagogy; a lack of stakeholder engagement; a lack of CSE competency and skills; holding back culturally sensitive topics; a lack of guidance from the comprehensive sexuality curriculum; and a lack of CSE prioritisation in schools. Themes on preferences included: the formation of community advisory boards; the need to enhance teachers’ professional competencies, linking CSE with community SRH services, pupils SRH needs assessment. Conclusions: A community participatory approach to the design and implementation of a CSE programme is critical in enhancing programme acceptability in schools. While understanding the experiences and preferences of pupils regarding CSE can help determine programme content and priority, improving teachers’ competency and skills through appropriate CSE training can help to reconcile teachers’ personal beliefs and the content of CSE.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-08
DOI: 10.3390/ijerph21081043
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1044: Somebody to Lean on: Understanding
Self-Stigma and Willingness to Disclose in the Context of Addiction
Authors: Qing Ma, Christopher R. Whipple, Övgü Kaynak, Erica Saylor, Weston S. Kensinger
First page: 1044
Abstract: Substance use self-stigma is a barrier to treatment and can negatively impact individuals’ well-being and treatment engagement. Given the mixed findings in previous research and the limited specific investigation into the concept of self-stigma within the context of opioid misuse, examining factors associated with self-stigma in the context of opioid use disorder (OUD) is warranted. The current study examines the influence of individual-level factors (race, sex, urban/rural status, support group attendance) on self-stigma and willingness to disclose opioid use. Data for this study were from a larger study of OUD-related stigma among adults in Pennsylvania, U.S. The current study included participants who indicated a personal past or current history with OUD were included (n = 84). Exploratory factor analysis and multiple indicators, multiple causes (MIMIC) model were used to explore the associations between demographic factors (i.e., sex, age, race/ethnicity, urban/rural status), attendance at mutual support groups, and self-stigma factors. Results indicated that sex and attendance at mutual support groups significantly predicted levels of self-stigma. Women and individuals with no previous experience attending mutual support groups endorsed lower levels of self-stigma. Additionally, attendance at mutual support groups predicted willingness to self-disclose past and present opioid use. Individuals who reported no history of attending mutual support groups demonstrated less willingness to disclose past and present OUD use compared to participants who were support group attendees. The current research findings enhance the understanding of OUD-related self-stigma by examining its relationship with individual-level factors, disclosure, and attendance to mutual support groups. The results offer insights into the influence of sex and support group attendance on self-stigma and disclosure. These findings have significant clinical implications for developing future interventions and promoting health policy changes.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-08
DOI: 10.3390/ijerph21081044
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1045: Changes in Spousal Intimacy in Women
Suffering Trauma Symptoms from Domestic Abuse: A Culturally Embedded
Intervention Study in Pakistan
Authors: David L. Rowland, Kamran Ehsan, Stewart E. Cooper
First page: 1045
Abstract: While emerging research is highlighting the significant effects of culture on marital and family relationships, studies investigating relationship intimacy and abuse in non-Western cultures are non-existent. This investigation assessed relationship intimacy in Pakistani women experiencing trauma symptoms (PTSD) from domestic abuse (DA) who received a culturally informed trauma intervention in a context that differs greatly in values and assumptions about marital relationships relative to Western traditions. Forty women meeting inclusion criteria were assessed on domestic violence type and characteristics (both victim and perpetrator characteristics), PTSD symptomology, and three aspects of relationship intimacy: engagement, communication, and shared friendships. PTSD symptomology and relationship intimacy were reassessed post-intervention. Results indicated significant changes in engagement and communication intimacy following the intervention, with engagement decreasing and communication increasing. The third aspect of intimacy, namely, shared friendships, showed no change. Engagement and overall intimacy showed significant negative correlations with physical abuse, though not with sexual or psychological/emotional abuse. These findings are interpreted within a cultural context where women have few options for leaving an abusive relationship. As such, the results highlight the importance of culture when studying facets of intimate relationships and the need to use culturally informed assessments to better understand the experience of intimacy within abusive relationships.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-08
DOI: 10.3390/ijerph21081045
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1046: Sexual and Reproductive Healthcare Needs of
Refugee Women Exposed to Gender-Based Violence: The Case for
Trauma-Informed Care in Resettlement Contexts
Authors: Cherra M. Mathis, Jordan J. Steiner, Andrea Kappas Mazzio, Meredith Bagwell-Gray, Karin Wachter, Crista Johnson-Agbakwu, Jill Messing, Jeanne Nizigiyimana
First page: 1046
Abstract: This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women’s experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women’s Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-08
DOI: 10.3390/ijerph21081046
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1047: The Design of Health Promoting Outdoor
Environments for People with Young-Onset Dementia—A Study from a
Rehabilitation Garden
Authors: Nina Oher, Jonna Tingberg, Anna Bengtsson
First page: 1047
Abstract: Health-promoting outdoor environments designed for people living with dementia (PLwD) has proved to be an effective non-pharmacological intervention for treatment of symptoms and improved well-being. However, for individuals with Young-Onset Dementia (YOD), who have particular symptoms and needs, the content and design of these environments are underexplored. This study aimed to explore the needs of individuals with YOD in a garden setting, to generate design-related knowledge for ‘dementia-friendly’ outdoor environments, while contributing to the field of Evidence-Based Design (EBD). An 8-week long nature-based program was carried out in Alnarp’s rehabilitation garden, a specifically developed garden based on research from e.g., landscape architecture, environmental psychology and medical science. The study used a triangulation of qualitative methods including six participants with YOD and a multidisciplinary team of five staff members. Content analysis was used for all gathered data, including 17 semi-structured interviews with participants with YOD and with staff. Data collection and analysis was performed based on the evidence-based Quality Evaluation Tool (QET). The study led to a target group adapted version of the QET for people with YOD containing 20 developed environmental qualities for designers to pursue in therapeutic gardens, including the additional quality of Calmness. A progression was noted, as a result of perceived positive effects during the intervention, indicating possible change and development of the group’s needs and preferences in the outdoors.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-09
DOI: 10.3390/ijerph21081047
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1048: Nursing Students’ Health Literacy and
Strategies to Foster Patients’ Health Literacy
Authors: Veronika Anselmann, Simone Halder, Sophie Sauer
First page: 1048
Abstract: Health literacy can be defined as an individual’s competence to use knowledge and information to maintain and improve health. Research has shown the crucial importance of health literacy in everyday life. Nurses play an important role in fostering patients’ health literacy. But there is a lack in research on nurses’ health literacy and how it influences their work. Therefore, this study aims to determine nursing students’ health literacy and find out whether this group assessed that there was a change in their health literacy before and after the COVID-19 pandemic. In addition, this study aims to find out whether there is a relation between nursing students’ assessments of their health literacy and their assessments of whether and how they use strategies to foster their patients’ health literary in everyday work. We conducted a longitudinal study with two points of measurement, before the COVID-19 pandemic (N = 112) and after (N = 304). Nursing students filled out an online questionnaire using validated scales. To analyze the data, we used descriptive statistics, correlation analysis, and Welch’s t-test. The results show that before the COVID-19 pandemic, the nursing students assessed their health literacy as quite high, and after the COVID-19 pandemic, they found it difficult to access (t = 17.881; p < 0.001; Cohen’s d = 0.46), understand (t = 16.404; p < 0.001; Cohen’s d = 0.56), appraise (t = 15.429; p < 0.00; Cohen’s d = 0.47), and apply health-related information (t = 13.761; p < 0.001; Cohen’s d = 0.54). Implications of our study concern nurses’ vocational education and training in which nurses must learn about health literacy and strategies to foster their patients’ health literacy.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-09
DOI: 10.3390/ijerph21081048
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1049: Quantitative Definition of
Low-Health-Interest Populations by Using Regression Trees: A Nationwide
Internet Survey in Japan
Authors: Yoko Nishizawa, Takuya Yamada, Kumi Sugimoto, Chie Ozawa, Takahiro Tabuchi, Hirono Ishikawa, Yoshiharu Fukuda
First page: 1049
Abstract: Background: Reducing health disparities is a public health issue. Identification of low-health-interest populations is important, but a definition of people with low health interest has not yet been established. We aimed to quantitatively define low-health-interest populations. Methods: A nationwide cross-sectional internet survey was conducted in 2022. We compiled regression tree (RT) analyses with/without adjustment for age, sex, and socioeconomic status with the 12-item Interest in Health Scale (IHS, score range 12–48) as an explanatory variable and the 10 composite health behaviors as a dependent variable. We defined the first IHS branching condition from the root node as a lower-health-interest group and the terminal node with the lowest health behaviors as the lowest-health-interest group. Results: The mean IHS value of 22,263 analyzed participants was 32.1 ± 5.6; it was higher in females and in those who were aged over 45 years, had a high education, a high income, or a spouse. The first branching condition was IHS 31.5, and the terminal node branched at 24.5, before/after adjustment for covariates. Conclusions: We determined the cutoff values of the IHS as <32 for a lower-health-interest group and <25 for the lowest-health-interest group. Using these cutoffs might enable us to reveal the characteristics of low-health-interest populations.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-09
DOI: 10.3390/ijerph21081049
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1050: Olive Mill Wastewater Extract: In Vitro
Genotoxicity/Antigenotoxicity Assessment on HepaRG Cells
Authors: Tommaso Rondini, Raffaella Branciari, Edoardo Franceschini, Mattia Acito, Cristina Fatigoni, Rossana Roila, David Ranucci, Milena Villarini, Roberta Galarini, Massimo Moretti
First page: 1050
Abstract: Olive mill wastewater (OMWW), with its high level of phenolic compounds, simultaneously represents a serious environmental challenge and a great resource with potential nutraceutical activities. To increase the knowledge of OMWW’s biological effects, with an aim to developing a food supplement, we performed a chemical characterisation of the extract using the Liquid Chromatography–Quadrupole Time-of-flight spectrometry (LC–QTOF) and an in vitro genotoxicity/antigenotoxicity assessment on HepaRG ™ cells. Chemical analysis revealed that the most abundant phenolic compound was hydroxytyrosol. Biological tests showed that the extract was not cytotoxic at the lowest tested concentrations (from 0.25 to 2.5 mg/mL), unlike the highest concentrations (from 5 to 20 mg/mL). Regarding genotoxic activity, when tested at non-cytotoxic concentrations, the extract did not display any effect. Additionally, the lowest tested OMWW concentrations showed antigenotoxic activity (J-shaped dose–response effect) against a known mutagenic substance, reducing the extent of DNA damage in the co-exposure treatment. The antigenotoxic effect was also obtained in the post-exposure procedure, although only at the extract concentrations of 0.015625 and 0.03125 mg/mL. This behaviour was not confirmed in the pre-exposure protocol. In conclusion, the present study established a maximum non-toxic OMWW extract dose for the HepaRG cell model, smoothing the path for future research.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-09
DOI: 10.3390/ijerph21081050
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 1051: Using the Reach Effectiveness Adoption
Implementation Maintenance (RE-AIM) Framework to Evaluate a Tailored
Education Program to Reduce Obesity-Related Cancers in El Paso, Texas
Authors: Jennifer J. Salinas, Roy Valenzuela
First page: 1051
Abstract: Background: Pasos Para Prevenir Cancer is a tailored lifestyle program that focuses on behavioral modification through knowledge and behavioral strategy education, which was delivered in El Paso, Texas, on the U.S.–Mexico border. Methods: Using the RE-AIM framework, we assessed Pasos Para Prevenir Cancer for efficacy and potential for sustainability. Survey, administrative, and observational data were collected between 2018 and 2022. The program was evaluated to determine reach, effectiveness, adoption, implementation, and maintenance. Results: Tailoring and adapting to the U.S.–Mexico border context is feasible and necessary to deliver evidence-based healthy eating and active living education content. Pasos Para Prevenir Cancer was well received and delivered in diverse settings with varying linguistic needs. Components of the program were adopted by other organizations and integrated into existing programming. Conclusions: Adapting and tailoring evidence-based programs to improve healthy eating and active living is required to meet the needs of Latino subgroup populations, like those on the U.S.–Mexico border.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-08-09
DOI: 10.3390/ijerph21081051
Issue No: Vol. 21, No. 8 (2024)
- IJERPH, Vol. 21, Pages 952: Enhancing Self-Esteem, Well-Being, and
Relaxation in the Elderly through Nature-Based Interventions
Authors: Anna Heród, Bożena Szewczyk-Taranek, Bożena Pawłowska
First page: 952
Abstract: As the populations of many countries are aging, institutions providing support for the elderly increasingly often use nature-based interventions (NBIs) as part of their therapeutic activities. This study aimed to show the impact of 8-week active and passive NBI programs on self-esteem, well-being, and relaxation in the elderly. The NBI programs were conducted in two groups of elderly citizens of Poland: independent senior students and seniors requiring 24 h care. The Rosenberg’s Self-Esteem Scale and the World Health Organization Well-Being Index were used to assess self-esteem and well-being before and after the programs. To assess relaxation, pre–post session measurements of pulse rate (PR) and blood oxygen saturation (SpO2) were used. Our study showed an improvement in the self-esteem, well-being, and relaxation of the participants of both active and passive NBI programs. In all study groups, self-esteem and well-being improved after the programs, regardless of the type of intervention, and after each NBI session, the elderly showed a decrease in PR and an increase in SpO2, which indicated a deeper state of relaxation. Our research showed a greater improvement in the tested parameters in the seniors participating in the passive programs in a garden. This confirms a key role of green spaces in residential areas for the elderly and in nursing homes.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-20
DOI: 10.3390/ijerph21070952
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 953: An Ethnographic Study Concerning the
Implementation of Education on Ageing for Older Adults with Mild
Intellectual Disability: The Perspective of the Educators
Authors: Marianne Holmgren, Gerd Ahlström
First page: 953
Abstract: Despite the fact that longevity in people with intellectual disability has increased at least as much as in the general population, there is a dearth of interventions related to ageing for these older people. Therefore, this study investigated educators’ implementation strategies in a new tailor-designed educational intervention with the goal of supporting the process of ageing for people with mild intellectual disability. An ethnographic research design was employed, including participant observations, field notes, and 15 ad hoc interviews with educators, spread over two years in four towns. The strategies used for facilitating learning about ageing were expressed in the two themes promoting social togetherness through everyone’s participation and learning together and from each other through recognition and consolidation. These strategies were applied to create a learning environment characterised by a good atmosphere and respectful interaction. Learning together involved consolidation through repetition, group discussions, the use of visual learning materials, and study visits. This new educational intervention about ageing is promising, but less resource-intensive interventions should also be developed and preferably integrated into the disability service. Before concluding whether this education supports the ageing process, it needs to be evaluated from the perspective of people with intellectual disability.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-21
DOI: 10.3390/ijerph21070953
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 954: Risk Factors Associated with Urothelial
Bladder Cancer
Authors: Souhail Alouini
First page: 954
Abstract: Background: Urothelial bladder carcinoma (UBC) is the most frequent histologic form of bladder cancer, constituting 90% of the cases. It is important to know the risk factors of UBC to avoid them and to decrease its recurrence after treatment. The aim of this review was to provide an overview of the risk factors associated with UBC incidence. Methods: A comprehensive literature search from 2012 to 2024 was carried out in databases such as PubMed, Google Scholar, and Medline with potential keywords such as “bladder cancer”, “urothelial bladder cancer”, “incidence of urothelial bladder cancer worldwide”, “mortality rate of bladder cancer”, “incidence according to gender”, “treatment for bladder cancer”, and “risk factors of bladder cancer”. Smoking tobacco was comprehended to be the major risk factor for UBC. Smoke from tobacco products contains polycyclic aromatic hydrocarbons (PAHs) and aromatic amines such as 4-aminobiphenyl, which are known to cause UBC. Smoking-related bladder cancer mortality ranks just second to smoking-related lung cancer mortality. For non-smokers, pollution became a major risk factor associated with UBC. Polycyclic aromatic hydrocarbons (PAHs) are linked to many cancers, especially to UBC. Indoor and outdoor pollution generates VOCs (volatile organic compounds) and PAHs. Small-particle matter < 2.5 is linked to UBC and lung cancers. Drinking chlorinated water is linked to UBC. Also, swimming in chlorinated pools that produce trihalomethanes increases the risk of many cancers, and especially of bladder cancer. Occupational exposure to carcinogens, specifically aromatic amines, is a significant UBC risk factor. It has been estimated that approximately 20% of all UBCs may be linked to this type of exposure, primarily in industrial settings that treat dye, paint, petroleum chemicals, and metal. The other risk factors included genetics, diet, and medical conditions. Alcohol, consumption of processed meat and whole milk, and higher intakes of selenium and vitamins A and E also contribute to the development of UBC. Further, chemotherapeutic agents, oral hypoglycemic drugs, and radiation therapy are positively associated with UBC. Conclusions: The significance of the initial prevention of UBC must be emphasized, and especially programs for quitting cigarettes should be encouraged and supported. However, smoking is not the only risk factor for UBC. For non-smokers, other risk factors should be investigated. Air and water pollution are linked to UBC. Indoor and outdoor pollution should be more controlled. Patients and people should be informed of the risk of drinking chlorinated water and swimming in chlorinated pools.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-22
DOI: 10.3390/ijerph21070954
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 955: Climate Change and Health Risk Perceptions of
Authors: Rachel B. Hale, Keneshia Bryant-Moore, Anna Eichenberger
First page: 955
Abstract: Climate change poses health risks to Arkansas small farmers. Farmers face an increased risk of heat-related illnesses (e.g., heat exhaustion, cerebral vascular accidents, and cardiovascular issues) and work-related injuries, death, and mental health conditions due to climate change. This cross-sectional survey employed the health belief model (HBM) as its theoretical framework. This study aimed to assess the health status of small farmers, climate change beliefs, adaptive agricultural practices, and the perceived effects of climate change on health. Study data were collected using non-probability sampling methods from small farmers (n = 72) with a gross farm income of < USD 250,000. The study findings show that 93% of participants reported good–excellent health, 69% believe the climate is changing and getting warmer, 58.3% believe people are responsible for the changes in our climate, and 75% believe the changing climate impacts farmers. Among the HBM predictive variables, participants reported self-efficacy (50%), perceived susceptibility (48.6%), and perceived severity (43%). Only 16.7% of farmers reported believing they have all the information needed to prepare for climate-related health impacts. This study suggests small farmers have protective factors and adaptive capacity, including health status, income, and education levels, but believe they lack the information necessary to protect their health from climate change.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-22
DOI: 10.3390/ijerph21070955
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 956: A Systematic Review and Meta-Analysis of Noise
Annoyance as a Determinant of Physiological Changes Linked to Disease
Promotion
Authors: Emily Senerth, Tejanth Pasumarthi, Neha Tangri, Bhavya Abbi, Skye Bickett, James P. McNamee, David S. Michaud, Rebecca L. Morgan
First page: 956
Abstract: This systematic review investigates the certainty of evidence (CoE) regarding noise annoyance as a determinant of biological changes known to contribute to disease development. We searched PubMed MEDLINE, EMBASE, Cochrane Central, and CINAHL for English-language comparative studies conducted on humans of any age from 1 January 1940, to 28 August 2023. Further, studies that provided quantitative data on the relationship between noise annoyance and biomarkers of interest were included. Where possible, random-effects meta-analyses were used to calculate the odds ratios of noise annoyance on biomarkers and biological conditions considered to be risk factors for developing health effects. The risk of bias of individual studies was assessed using the Risk of Bias of Non-randomized Studies of Exposures (ROBINS-E) instrument. The CoE for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The search identified 23 primary studies reporting on relevant biomarkers. Although some studies and pooled estimates suggest a possible association between noise annoyance and biological measures, the CoE overall is very low due to concerns with the risk of bias, inconsistency, and imprecision in the estimates of effects. In the context of environmental impact assessment, where guidelines aim to mitigate the prevalence of populations experiencing a high level of noise annoyance, our results suggest that such practices should be grounded in the understanding that annoyance is health-relevant because it reflects an undesirable reaction to noise, rather than a precursor to chronic physical health conditions.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-22
DOI: 10.3390/ijerph21070956
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 957: Successful Elimination of Endemic Rubella in
the WHO European Region. Is It Proper to Remove the Recommendation for
Preconceptional Immunization'
Authors: Anna Franca Cavaliere, Marco Parasiliti, Rita Franco, Vitalba Gallitelli, Federica Perelli, Amelia Spanò, Barbara Pallone, Maria Grazia Serafini, Fabrizio Signore, Georgios Eleftheriou, Giovanni Scambia, Antonio Lanzone, Annalisa Vidiri
First page: 957
Abstract: Background: Rubella is a contagious viral infection that has garnered significant attention in the field of public health due to its potential consequences, especially during pregnancy. In recent decades, it has been recommended that non-immune women receive immunization during the preconceptional and/or postpartum periods. The goal of this strategy is to prevent primary rubella infection in order to protect pregnant women against congenital rubella syndrome. In November 2022, the WHO’s Regional Verification Commission declared the elimination of rubella infection in Italy. In recent years, the main migration flows to Italy have originated from regions where rubella has not yet been eliminated and where no program is in place to achieve this goal. Objective: The aim of this study was to retrospectively assess rubella immunity in pregnant women who have attended three delivery centers in Rome over the past three years, from January 2021 to May 2023. Methods: Data about the rubella serological status of 7937 non-consecutive pregnant women were collected. Univariate analysis was performed to verify any difference between the study groups in terms of age distribution. Results: Anti-rubella IgG antibodies were found in 7224 (91%) women while 713 (9%) were susceptible to rubella (IgG negative), without differences in terms of immunity rate between Italian and non-Italian women. Age analysis showed a statistically significant older age of immune women than receptive women and of Italian immune women than non-Italian immune women. Conclusions: The National Plan for the Elimination of Measles and Congenital Rubella aimed to achieve a percentage of susceptible women of childbearing age below 5%. These data indicate the relevance of maintaining the recommendation for preconceptional rubella vaccination in Italy.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-22
DOI: 10.3390/ijerph21070957
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 958: Recovering from COVID-19 (ReCOV): Feasibility
of an Allied-Health-Led Multidisciplinary Outpatient Rehabilitation
Service for People with Long COVID
Authors: Aruska N. D’Souza, Myvanwy Merrett, Hilda Griffin, An Tran-Duy, Carly Struck, Timothy N. Fazio, Genevieve Juj, Catherine L. Granger, Casey L. Peiris
First page: 958
Abstract: Background: A multidisciplinary approach is required for the management of long COVID. The aim of this study was to determine the feasibility (demand, implementation, practicality, acceptability, and limited efficacy) of an allied-health-led multidisciplinary symptom management service (ReCOV) for long COVID. Methods: A single-group observational cohort feasibility study was conducted to determine demand (referrals), acceptability (survey), implementation (waitlist times, health professions seen), practicality (adverse events), and limited efficacy (admission and discharge scores from the World Health Organization Disability Assessment Scale, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire, and EuroQol 5D-5L). Data are presented as median [interquartile range] or count (percentage). Results: During the study, 143 participants (aged 42.00 [32.00–51.00] years, 68% women) participated in ReCOV. Participants were waitlisted for 3.86 [2.14–9.86] weeks and engaged with 5.00 [3.00–6.00] different health professionals. No adverse events occurred. The thematic analysis revealed that ReCOV was helpful but did not fully meet the needs of all participants. Limited efficacy testing indicated that participants had improved understanding and control (p < 0.001) of symptoms (BIPQ) and a small improvement in EQ VAS score (median difference 5.50 points [0.00–25.00], p = 0.004]). Conclusions: A multidisciplinary service was safe and mostly acceptable to participants for the management of long COVID. Further research should investigate the clinical and cost effectiveness of such a service, including optimal service duration and patient outcomes.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-22
DOI: 10.3390/ijerph21070958
Issue No: Vol. 21, No. 7 (2024)
- IJERPH, Vol. 21, Pages 959: Distribution of Private Dental Healthcare
Facilities in Riyadh City: A GIS-Based Approach
Authors: Najla S. Alrejaye, Faisal H. Alonazi, Zaid M. Alonazi, Rahf S. Alobaidi, Asma B. Alsaleh, Alanoud A. Alshami, Sultan A. Alshamrani, Seena T. Kaithathara
First page: 959
Abstract: Background: The dental healthcare private sector in Riyadh city has been growing rapidly over the past few years; however, there is a lack of information on the accessibility and spatial distribution of private dental healthcare facilities (PDHFs) in the area. This study aimed to evaluate the spatial distribution of PDHFs in Riyadh city in relation to population density in each sub-municipality. Methods: The current information regarding the number, location, and operability of PDHFs in Riyadh city was obtained from the Ministry of Health. A total of 632 operating PDHFs were included with the precise location plotted on Quantum Geographic Information System software (version 3.32.1, Essen, Germany) using Google Earth. Four levels of buffer zones—1 km, 3 km, 5 km, and >5 km—were determined. The population statistics and mean monthly individual income per district were gathered from Zadd.910ths. Microsoft Excel (version 16.0, Microsoft, Redmond, WA, USA) and RStudio software (version 4.1.3, Posit Software, PBC, Boston, MA, USA) were used for additional data analysis. Results: There was an overall ratio of one PDHF per 9958 residents in Riyadh city. Olaya and Maather sub-municipalities had the largest PDHF-to-population ratios: (1:4566) and (1:4828), respectively. Only 36.3% of the city’s total area was within a 1 km buffer zone from a PDHF. There was an overall weak positive correlation between the number of PDHFs and the total area in each sub-municipality (r = 0.29), and the distribution of PDHFs was uneven corresponding to the area (G* = 0.357). Conclusions: There was an uneven distribution of PDHFs in Riyadh city. Some areas were underserved while others were overserved in several sub-municipalities. Policy-makers and investors are encouraged to target underserved areas rather than areas with significant clustering to improve access to care.
Citation: International Journal of Environmental Research and Public Health
PubDate: 2024-07-22
DOI: 10.3390/ijerph21070959
Issue No: Vol. 21, No. 7 (2024)
