Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.6 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
Latest Articles
Undesirable Levels of Practice Behaviours and Associated Knowledge amongst Community Health Workers in Rural South India Responsible for Type 2 Diabetes Screening and Management
Int. J. Environ. Res. Public Health 2024, 21(5), 562; https://doi.org/10.3390/ijerph21050562 (registering DOI) - 28 Apr 2024
Abstract
Background: Type 2 diabetes (T2DM) poses an enormous global health care challenge, especially among rural communities. Healthcare in these areas can be inadequate and inaccessible due to socio-demographic barriers. To overcome this situation, many low- and middle-income countries are resorting to task shifting,
[...] Read more.
Background: Type 2 diabetes (T2DM) poses an enormous global health care challenge, especially among rural communities. Healthcare in these areas can be inadequate and inaccessible due to socio-demographic barriers. To overcome this situation, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. Objective: This cross-sectional study aimed to evaluate the proficiency of CHWs involved in diabetes screening and management in rural South India by identifying the existing practice behaviours and knowledge gaps. Methods: Employing a customised questionnaire, developed through inputs from experts and government officials, we assessed practice behaviours and the corresponding knowledge base of 275 CHWs. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results: The study showcased significant deficiencies in both practice behaviours (97%) and knowledge (95%) with current mean levels ranging from 48 to 50%, respectively, among the participants. The identified areas of insufficiency were broadly representative of the core competencies required for effective diabetes management, encompassing diabetes diagnosis and referral, HbA1c testing, diabetes diet, diabetes type and self-management, microvascular complications and their screening, peripheral neuropathy management, and diabetes risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management, and calculation of diabetes risk assessment. Conclusion: This study highlights widespread deficiencies (97% CHWs) in diabetes management practices and knowledge (95% CHWs). To overcome these deficiencies, a thorough needs assessments is vital for effective CHW training. Training of CHWs should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.
Full article
(This article belongs to the Section Health Care Sciences)
Open AccessArticle
Identifying and Responding to Lead in Drinking Water in a University Setting
by
Audrey G. Bousquet, Lauren A. Eaves, Kim Haley, David Catalano, Gregory B. Williams, Hadley J. Hartwell, Catherine Brennan and Rebecca C. Fry
Int. J. Environ. Res. Public Health 2024, 21(5), 561; https://doi.org/10.3390/ijerph21050561 (registering DOI) - 28 Apr 2024
Abstract
Lead is an established neurotoxicant, and it has known associations with adverse neurodevelopmental and reproductive outcomes. Exposure to lead at any level is unsafe, and the United States (US) has enacted various federal and state legislations to regulate lead levels in drinking water
[...] Read more.
Lead is an established neurotoxicant, and it has known associations with adverse neurodevelopmental and reproductive outcomes. Exposure to lead at any level is unsafe, and the United States (US) has enacted various federal and state legislations to regulate lead levels in drinking water in K-12 schools and childcare facilities; however, no regulations exist for higher education settings. Upon the discovery of lead in drinking water fixtures in the University of North Carolina at Chapel Hill (UNC-CH) campus, a cross-campus water testing network and sampling plan was developed and deployed. The campaign was based on the US Environmental Protection Agency’s (EPA) 3Ts (Training, Testing, and Taking Action) guidance. The seven-month campaign involved 5954 tests on 3825 drinking water fixtures across 265 buildings. A total of 502 (8.43%) tests showed lead above the limit of detection (1 part per billion, ppb), which represented 422 (11.03%) fixtures. Fewer than 1.5% of the tests were above the EPA action level for public water systems (15 ppb). In conclusion, systematic testing of all the fixtures across campus was required to identify localized contamination, and each entity in the cross-campus network undertook necessary roles to generate a successful testing campaign. UNC-CH established preventative measures to test drinking water fixtures every three years, which provide a framework for other higher education institutions in responding to lead contamination.
Full article
Open AccessArticle
Utilization of Whey for Eco-Friendly Bio-Preservation of Mexican-Style Fresh Cheeses: Antimicrobial Activity of Lactobacillus casei 21/1 Cell-Free Supernatants (CFS)
by
Victor E. Vera-Santander, Ricardo H. Hernández-Figueroa, Daniela Arrioja-Bretón, María T. Jiménez-Munguía, Emma Mani-López and Aurelio López-Malo
Int. J. Environ. Res. Public Health 2024, 21(5), 560; https://doi.org/10.3390/ijerph21050560 (registering DOI) - 28 Apr 2024
Abstract
Using whey, a by-product of the cheese-making process, is important for maximizing resource efficiency and promoting sustainable practices in the food industry. Reusing whey can help minimize environmental impact and produce bio-preservatives for foods with high bacterial loads, such as Mexican-style fresh cheeses.
[...] Read more.
Using whey, a by-product of the cheese-making process, is important for maximizing resource efficiency and promoting sustainable practices in the food industry. Reusing whey can help minimize environmental impact and produce bio-preservatives for foods with high bacterial loads, such as Mexican-style fresh cheeses. This research aims to evaluate the antimicrobial and physicochemical effect of CFS from Lactobacillus casei 21/1 produced in a conventional culture medium (MRS broth) and another medium using whey (WB medium) when applied in Mexican-style fresh cheese inoculated with several indicator bacteria (Escherichia coli, Salmonella enterica serovar Typhimurium, Staphylococcus aureus, and Listeria monocytogenes). The CFSs (MRS or WB) were characterized for organic acids concentration, pH, and titratable acidity. By surface spreading, CFSs were tested on indicator bacteria inoculated in fresh cheese. Microbial counts were performed on inoculated cheeses during and after seven days of storage at 4 ± 1.0 °C. Moreover, pH and color were determined in cheeses with CFS treatment. Lactic and acetic acid were identified as the primary antimicrobial metabolites produced by the Lb. casei 21/1 fermentation in the food application. A longer storage time (7 days) led to significant reductions (p < 0.05) in the microbial population of the indicator bacteria inoculated in the cheese when it was treated with the CFSs (MRS or WB). S. enterica serovar Typhimurium was the most sensitive bacteria, decreasing 1.60 ± 0.04 log10 CFU/g with MRS-CFS, whereas WB-CFS reduced the microbial population of L. monocytogenes to 1.67 log10 CFU/g. E. coli and S. aureus were the most resistant at the end of storage. The cheese’s pH with CFSs (MRS or WB) showed a significant reduction (p < 0.05) after CFS treatment, while the application of WB-CFS did not show greater differences in color (ΔE) compared with MRS-CFS. This study highlights the potential of CFS from Lb. casei 21/1 in the WB medium as an ecological bio-preservative for Mexican-style fresh cheese, aligning with the objectives of sustainable food production and guaranteeing food safety.
Full article
(This article belongs to the Special Issue Foods and One Health)
►▼
Show Figures
Figure 1
Open AccessArticle
DEXA Body Composition Asymmetry Analysis and Association to Injury Risk and Low Back Pain in University Soccer Players
by
Nicolas Vaillancourt, Chanelle Montpetit, Victoria Carile and Maryse Fortin
Int. J. Environ. Res. Public Health 2024, 21(5), 559; https://doi.org/10.3390/ijerph21050559 (registering DOI) - 28 Apr 2024
Abstract
Soccer is a laterally dominant sport owing to the repetitive nature of unilateral kicking. The relationship between functional and body composition asymmetries related to limb dominance in soccer players has yet to be established. When present, asymmetries can increase the risk of injury
[...] Read more.
Soccer is a laterally dominant sport owing to the repetitive nature of unilateral kicking. The relationship between functional and body composition asymmetries related to limb dominance in soccer players has yet to be established. When present, asymmetries can increase the risk of injury and low back pain. Our study investigated whether lateral dominance is associated with limb asymmetries in a comprehensive body composition assessment among varsity soccer players. Twenty-seven varsity soccer players (age 20.4 ± 1.7 years old; BMI 22.6 ± 4.6 kg/m2) participated in this study. Body composition was assessed through dual-energy X-ray absorptiometry scans. Results showed low lower limb asymmetry indices in both males (3.82%) and females (3.36%) compared to normal ranges. However, upper limb lean mass exhibited high asymmetry, surpassing thresholds in males (7.3%) and females (4.39%). Significant differences were found in total bone mass among males and total lean body mass among females. Male players exhibited higher asymmetry indices in both arm and trunk mass compared to females. Despite these asymmetries, no significant correlations were found between asymmetry indices and occurrences of lower limb injury or low back pain. The study suggests that while evaluating body composition for injury prevention in soccer shows potential, lateral dominance may be influenced by factors extending beyond sport-specific adaptations.
Full article
(This article belongs to the Special Issue Exercise Injury and Rehabilitation)
►▼
Show Figures
Figure 1
Open AccessArticle
The Impact of Climatic Factors on Temporal Mosquito Distribution and Population Dynamics in an Area Targeted for Sterile Insect Technique Pilot Trials
by
Theresa Taona Mazarire, Leanne Lobb, Solomon Wakshom Newete and Givemore Munhenga
Int. J. Environ. Res. Public Health 2024, 21(5), 558; https://doi.org/10.3390/ijerph21050558 (registering DOI) - 28 Apr 2024
Abstract
It is widely accepted that climate affects the mosquito life history traits; however, its precise role in determining mosquito distribution and population dynamics is not fully understood. This study aimed to investigate the influence of various climatic factors on the temporal distribution of
[...] Read more.
It is widely accepted that climate affects the mosquito life history traits; however, its precise role in determining mosquito distribution and population dynamics is not fully understood. This study aimed to investigate the influence of various climatic factors on the temporal distribution of Anopheles arabiensis populations in Mamfene, South Africa between 2014 and 2019. Time series analysis, wavelet analysis, cross-correlation analysis, and regression model combined with the autoregressive integrated moving average (ARIMA) model were utilized to assess the relationship between climatic factors and An. arabiensis population density. In total 3826 adult An. arabiensis collected was used for the analysis. ARIMA (0, 1, 2) (0, 0, 1)12 models closely described the trends observed in An. arabiensis population density and distribution. The wavelet coherence and time-lagged correlation analysis showed positive correlations between An. arabiensis population density and temperature (r = 0.537 ), humidity (r = 0.495) and rainfall (r = 0.298) whilst wind showed negative correlations (r = −0.466). The regression model showed that temperature (p = 0.00119), rainfall (p = 0.0436), and humidity (p = 0.0441) as significant predictors for forecasting An. arabiensis abundance. The extended ARIMA model (AIC = 102.08) was a better fit for predicting An. arabiensis abundance compared to the basic model. Anopheles arabiensis still remains the predominant malaria vector in the study area and climate variables were found to have varying effects on the distribution and abundance of An. arabiensis. This necessitates other complementary vector control strategies such as the Sterile Insect Technique (SIT) which involves releasing sterile males into the environment to reduce mosquito populations. This requires timely mosquito and climate information to precisely target releases and enhance the effectiveness of the program, consequently reducing the malaria risk.
Full article
(This article belongs to the Special Issue Global Climate Change and Public Health)
►▼
Show Figures
Figure 1
Open AccessArticle
Social Support Postpartum: Bengali Women from India on Their Coping Experiences following Childbirth
by
Moumita Gupta, Mahua Patra, Mohammad Hamiduzzaman, Helen McLaren and Emi Patmisari
Int. J. Environ. Res. Public Health 2024, 21(5), 557; https://doi.org/10.3390/ijerph21050557 (registering DOI) - 28 Apr 2024
Abstract
Undertaken in Kolkata, India, our study aimed to explore the experiences of Bengali middle-class women on perceived stressful events, social support, and coping experiences following childbirth. Becoming a mother following childbirth is a shared phenomenon irrespective of culture, social strata, or country, while
[...] Read more.
Undertaken in Kolkata, India, our study aimed to explore the experiences of Bengali middle-class women on perceived stressful events, social support, and coping experiences following childbirth. Becoming a mother following childbirth is a shared phenomenon irrespective of culture, social strata, or country, while stress during the postpartum period or depression is not. Discrete medical intervention does not sufficiently address the complexities of postpartum experiences since influencing factors also include economic, political, cultural, and social backgrounds. Adopting a feminist and phenomenological approach, individual in-person interviews were conducted with twenty women recruited via snowball sampling. Our findings revealed that events experienced as stressful may lead to poor postpartum well-being. Underpinned by gendered discourse and biases, stressful events included familial imperatives for a male child, poor social and emotional support from the family, mostly partners and fathers, and systemic workplace barriers. The women in our study commonly resided with their mothers postpartum. They expressed feeling sheltered from these experiences, cared for, and supported. We discuss the women’s experiences from a feminist pragmatic worldview, which advocates for a flexible feminism recognizant of the unique and nurturing relationship experiences between Bengali middle-class women and their mothers. In conclusion, we advocate for culturally sensitive, women-centered postpartum care practices that may entail the inclusion of intergenerational care during this critical phase of maternal well-being. These insights underscore the necessity of tailoring postpartum support systems to align with the cultural and familial contexts of the individuals they serve.
Full article
Open AccessArticle
The Risk Perception of the Chinese Diaspora during the COVID-19 Pandemic: Targeting Cognitive Dissonance through Storytelling
by
Doris Yuet Lan Leung, Shoilee Khan, Hilary Hwu, Aaida Mamuji, Jack Rozdilsky, Terri Chu and Charlotte Lee
Int. J. Environ. Res. Public Health 2024, 21(5), 556; https://doi.org/10.3390/ijerph21050556 (registering DOI) - 27 Apr 2024
Abstract
The global COVID-19 pandemic in 2020 required risk communications to mitigate the virus’ spread. However, social media not only conveyed health information to minimize the contagion, but also distracted from the threat by linking it to an externalized ‘other’—primarily those appearing to be
[...] Read more.
The global COVID-19 pandemic in 2020 required risk communications to mitigate the virus’ spread. However, social media not only conveyed health information to minimize the contagion, but also distracted from the threat by linking it to an externalized ‘other’—primarily those appearing to be of Chinese descent. This disinformation caused the attribution of blame to Chinese people worldwide. In Canada’s Greater Toronto Area, Chinese individuals reported widespread public stigma that compounded their risk of contagion; to the degree that it was driven by cognitive dissonance, it generated experiences of social and cultural vulnerability. In this paper, we draw on the aforementioned study’s findings to explain how the risk perception and threat appraisal of Chinese diaspora individuals were impacted by different cognitive dissonance pathways. These findings explore how storytelling is a viable intervention with which to target and mitigate cognitive dissonance. Indeed, the mechanisms of cognitive dissonance can modify risk perception and mitigate social and cultural vulnerability, thereby averting potential long-term negative consequences for one’s mental health and well-being. We hope our guidance, training educators to target pathways of cognitive dissonance by drawing on storytelling (with humour), can assist them to better convey information in ways that are more inclusive during public health emergencies.
Full article
(This article belongs to the Special Issue 2nd Edition of COVID-19, Healthcare Quality, Patient Safety and Quality of Life)
►▼
Show Figures
Figure 1
Open AccessArticle
Public Dental Service Access Policies for People with Autism Spectrum Disorder (ASD) in Salvador, Bahia, Brazil: A Pre-Evaluation Study
by
Ednaldo de Jesus-Filho, Sandra Garrido de Barros, Maria Isabel Pereira Vianna and Maria Cristina Teixeira Cangussu
Int. J. Environ. Res. Public Health 2024, 21(5), 555; https://doi.org/10.3390/ijerph21050555 (registering DOI) - 27 Apr 2024
Abstract
This study sought to carry out a systematic and preliminary evaluation of the policies on access to public dental services for people with ASD in a Brazilian city. The study, conducted between November/2019 and February/2020, was developed through document analysis, the design of
[...] Read more.
This study sought to carry out a systematic and preliminary evaluation of the policies on access to public dental services for people with ASD in a Brazilian city. The study, conducted between November/2019 and February/2020, was developed through document analysis, the design of the theoretical logical model of the policies, and seven semi-structured interviews with key informants. The sample was intentionally selected. We also considered the answers to 108 questionnaires from a pilot study on the access of people with ASD to dental services applied to caregivers, dentists, and non-dental professionals. No refusals were recorded. The availability study showed that the policies’ objectives were not being achieved in terms of care network organization: there were no institutional flows, personal contacts were used between professionals to guarantee access to secondary attention, there was no specific training for the dentists about ASD, and the oral health care network was unknown to non-dentist professionals and caregivers. Most people with ASD have visited the dentist at least once in their lives, but a large percentage of those within this study did not do so in the last year. This study identified difficulties in implementing policies and suggested possible strategies for overcoming them as dimensions and subdimensions for evaluation.
Full article
(This article belongs to the Special Issue 2nd Edition: Approach to Promoting Oral Health)
Open AccessReview
The Influence of Social Dynamics on Biological Aging and the Health of Historically Marginalized Populations: A Biopsychosocial Model for Health Disparities
by
Lok Ming Tam, Kristin Hocker, Tamala David and Edith Marie Williams
Int. J. Environ. Res. Public Health 2024, 21(5), 554; https://doi.org/10.3390/ijerph21050554 (registering DOI) - 26 Apr 2024
Abstract
Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the
[...] Read more.
Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one’s wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.
Full article
(This article belongs to the Special Issue Challenging Health Disparities through the Promotion of Health Equity)
Open AccessArticle
The Impact of Air Pollution on Asthma Severity among Residents Living near the Main Industrial Complex in Oman: A Cross-Sectional Study
by
Souad Mahmoud Al Okla, Fatima Al Zahra Khamis Al Rasbi, Hawida Said Al Marhubi, Shima Salim Al Mataani, Yusra Mohammed Al Sawai, Hasa Ibrahim Mohammed, Muna Ali Salim Al Mamari, Salwa Abdullah Abdulrahim Al Balushi and Abdul Qader Abbady
Int. J. Environ. Res. Public Health 2024, 21(5), 553; https://doi.org/10.3390/ijerph21050553 (registering DOI) - 26 Apr 2024
Abstract
Background: Asthma is a widespread chronic respiratory disease that poses a significant public health challenge. The current study investigated the associations between air pollution and asthma severity among individuals residing near the Sohar industrial port (SIP) in Oman. Despite the presence of multiple
[...] Read more.
Background: Asthma is a widespread chronic respiratory disease that poses a significant public health challenge. The current study investigated the associations between air pollution and asthma severity among individuals residing near the Sohar industrial port (SIP) in Oman. Despite the presence of multiple major industrial complexes in Oman, limited knowledge regarding their impact on respiratory health is accredited. Hence, the primary objective of this study is to offer valuable insights into the respiratory health consequences of industrial air pollution in Al Batinah North. Methods: The state health clinics’ records for patient visits related to asthma were collected for the timeframe spanning 2014 to 2022. Exposure was defined as the distance from the SIP, Majan Industerial Area (MIA), and Sohar Industerial Zone (SIZ) to determine high-, intermediate-, and low-exposure zones (<6 km, 6–12 km and >12 km, respectively). Exposure effect modifications by age, gender, and smoking status were also examined. Results: The conducted cross-sectional study of 410 patients (46.1% males and 53.9% females) living in over 17 areas around SIP revealed that 73.2% of asthmatics were under 50 years old, with severity significantly associated with closeness to the port. Risk ratios were estimated to be (RR:2.42; CI95%: 1.01–5.78), (RR:1.91; CI95%: 1.01–3.6), and (RR:1.68; CI95%: 0.92–3.09) for SIP, MIP, and SIZ areas, respectively, compared to the control area. Falaj Al Qabail (6.4 km) and Majees (6 km) had the highest number of asthma patients (N 69 and N 72) and highest percentages of severe asthma cases among these patients (28% and 24%) with significant risk ratios (RR:2.97; CI95%: 1.19–7.45 and RR:2.55; CI95%: 1.00–6.48), correspondingly. Moreover, severe asthma prevalence peaked in the 25–50 age group (RR:2.05; CI95%: 1.26–3.33), and this linkage between asthma and age was much more pronounced in males than females. Smoking and exposure to certain contaminants (dust and smoke) also increased the risk of severe asthma symptoms, but their effects were less important in the high-risk zone, suggesting much more important risk factors. A neural network model accurately predicted asthma risk (94.8% accuracy), with proximity to SIP as the most influential predictor. Conclusions: This study highlights the high asthma burden near SIP, linked to port proximity, smoking, and wind direction as major risk factors. These findings inform vital public health policies to reduce air pollution and improve respiratory health in the region, prompting national policy review.
Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle
Clinical Outcomes from the Alaska Native Tribal Health Consortium Colorectal Cancer Control Program: 2009–2015
by
Sarah H. Nash, Elizabeth Verhage, Christie Flanagan, Donald Haverkamp, Elena Roik, Garrett Zimpelman and Diana Redwood
Int. J. Environ. Res. Public Health 2024, 21(5), 552; https://doi.org/10.3390/ijerph21050552 - 26 Apr 2024
Abstract
The Alaska Native Tribal Health Consortium (ANTHC) participated in the United States Centers for Disease Control and Prevention Colorectal Cancer Control Program (CRCCP) from 2009 to 2015. We conducted a descriptive evaluation of ANTHC CRCCP demographics, quality measures, and clinical outcomes, including screening
[...] Read more.
The Alaska Native Tribal Health Consortium (ANTHC) participated in the United States Centers for Disease Control and Prevention Colorectal Cancer Control Program (CRCCP) from 2009 to 2015. We conducted a descriptive evaluation of ANTHC CRCCP demographics, quality measures, and clinical outcomes, including screening methods employed within the program and screening outcomes. There were 6981 program screenings completed, with the majority (81.3%) of people screened in the 50–75 year age group. Colonoscopy was the primary screening test used, accounting for 6704 (96.9%) of the screening tests. Quality of colonoscopy was high: adequate bowel preparation was reported in 98.2% of colonoscopies, cecal intubation rate was 98.9%, and the adenoma detection rate was 38.9%. A high proportion (58.9%) of colonoscopies had an initial finding of polyps or lesions suspicious for cancer; 41.2% of all colonoscopies had histological confirmation of either adenomatous polyps (40.6%) or cancer (0.5%). The ANTHC CRCCP successfully increased CRC screening among American Indian and Alaska Native peoples living in Alaska; this was achieved primarily through high-quality colonoscopy metrics. These data support a continued focus by the Alaska Native Tribal Health Consortium and its tribal health partners on increasing CRC screening and reducing cancer mortality among Alaska Native peoples.
Full article
(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)
Open AccessReview
Consensus Panel Recommendations for the Pharmacological Management of Breastfeeding Women with Postpartum Depression
by
Georgios Eleftheriou, Riccardo Zandonella Callegher, Raffaella Butera, Marco De Santis, Anna Franca Cavaliere, Sarah Vecchio, Cecilia Lanzi, Riccardo Davanzo, Giovanna Mangili, Emi Bondi, Lorenzo Somaini, Mariapina Gallo, Matteo Balestrieri, Guido Mannaioni, Guglielmo Salvatori and Umberto Albert
Int. J. Environ. Res. Public Health 2024, 21(5), 551; https://doi.org/10.3390/ijerph21050551 - 26 Apr 2024
Abstract
Introduction: Our consensus statement aims to clarify the use of antidepressants and anxiolytics during breastfeeding amidst clinical uncertainty. Despite recent studies, potential harm to breastfed newborns from these medications remains a concern, leading to abrupt discontinuation of necessary treatments or exclusive formula feeding,
[...] Read more.
Introduction: Our consensus statement aims to clarify the use of antidepressants and anxiolytics during breastfeeding amidst clinical uncertainty. Despite recent studies, potential harm to breastfed newborns from these medications remains a concern, leading to abrupt discontinuation of necessary treatments or exclusive formula feeding, depriving newborns of benefits from mother’s milk. Methods: A panel of 16 experts, representing eight scientific societies with a keen interest in postpartum depression, was convened. Utilizing the Nominal Group Technique and following a comprehensive literature review, a consensus statement on the pharmacological treatment of breastfeeding women with depressive disorders was achieved. Results: Four key research areas were delineated: (1) The imperative to address depressive and anxiety disorders during lactation, pinpointing the risks linked to untreated maternal depression during this period. (2) The evaluation of the cumulative risk of unfavorable infant outcomes associated with exposure to antidepressants or anxiolytics. (3) The long-term impact on infants’ cognitive development or behavior due to exposure to these medications during breastfeeding. (4) The assessment of pharmacological interventions for opioid abuse in lactating women diagnosed with depressive disorders. Conclusions: The ensuing recommendations were as follows: Recommendation 1: Depressive and anxiety disorders, as well as their pharmacological treatment, are not contraindications for breastfeeding. Recommendation 2: The Panel advocates for the continuation of medication that has demonstrated efficacy during pregnancy. If initiating an antidepressant during breastfeeding is necessary, drugs with a superior safety profile and substantial epidemiological data, such as SSRIs, should be favored and prescribed at the lowest effective dose. Recommendation 3: For the short-term alleviation of anxiety symptoms and sleep disturbances, the Panel determined that benzodiazepines can be administered during breastfeeding. Recommendation 4: The Panel advises against discontinuing opioid abuse treatment during breastfeeding. Recommendation 5: The Panel endorses collaboration among specialists (e.g., psychiatrists, pediatricians, toxicologists), promoting multidisciplinary care whenever feasible. Coordination with the general practitioner is also recommended.
Full article
(This article belongs to the Section Behavioral and Mental Health)
Open AccessArticle
Orthodontic Status and Association with Oral-Health-Related Quality of Life—A Study of 16-Year-Old Norwegians with a Cleft Lip and Palate
by
Paul K. Saele, Manal Mustafa and Anne N. Åstrøm
Int. J. Environ. Res. Public Health 2024, 21(5), 550; https://doi.org/10.3390/ijerph21050550 - 26 Apr 2024
Abstract
Objective: To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on 16-year-old patients with cleft lip and/or palate (CL/P). Participants: One hundred and twenty-two patients with CL/P, representing cleft-lip (CL), cleft-palate (CP), unilateral/bilateral cleft-lip-palate
[...] Read more.
Objective: To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on 16-year-old patients with cleft lip and/or palate (CL/P). Participants: One hundred and twenty-two patients with CL/P, representing cleft-lip (CL), cleft-palate (CP), unilateral/bilateral cleft-lip-palate (UCLP/BCLP), enrolled in the national CLP-Team, Bergen, Norway. Method: A cross-sectional study by two orthodontists assessing the number of teeth, intermaxillary sagittal relation (ANB-angle), dental arch and occlusion of 16-year-old patients with CL/P. All completed a digital questionnaire including self-reported socio-demographic variables, OHIP-14 questionnaire and dental aesthetics. Cross-tabulations with Pearson’s Chi-square test were used to identify associations between self-reported OHRQoL and socio-demographic and clinical indicators. Multiple variable analyses were conducted with binary logistic regression analysis using the odds ratio (OR) and 95% confidence interval (CI) to assess associations between OHRQoL and clinical indicators adjusted for socio-demographic variables. Ethical approval was granted by the regional ethics committee. Results: Patients with UCLP and BCLP had poorer clinical indicators compared to patients with CL and CP (p < 0.05). A total of 80% of the patients had OHIP-14 > 0. The highest oral impact was reported for psychological domains and articulation and the least for functional domains. Respondents with BCLP and those with poor intermaxillary relationships (ANB < 0°) reported a high impact on OHRQoL (p < 0.05). No statistically significant associations between other clinical indicators and socio-demographic variables such as gender, educational aspiration, and place of residence were reported. Conclusions: The study revealed an association between severe cleft diagnosis, missing teeth, misaligned teeth, negative overjet, and poor OHRQoL, but a statistically significant association was found only between OHRQoL and poor intermaxillary sagittal relations (unfavorable profile). To improve OHRQoL among patients with clefts, there is a need for an individual follow-up and prioritization of oral healthcare.
Full article
(This article belongs to the Special Issue Dental Treatment and Dental Health in Special Care Patients)
Open AccessArticle
Wrist Circumference Cutoff Points for Determining Excess Weight Levels and Predicting Cardiometabolic Risk in Adults
by
Larissa Monteiro Costa Pereira, Márcia Ferreira Cândido de Souza, Felipe J. Aidar, Márcio Getirana-Mota, Alex Menezes dos Santos-Junior, Mario Francisco Dantas de Santana Filho, Marcos Antonio Almeida-Santos, Raysa Manuelle Santos Rocha, Rebeca Rocha de Almeida, Leonardo Baumworcel, Luiz Henrique Sala de Melo Costa, Renata Rebello Mendes and Antônio Carlos Sobral Sousa
Int. J. Environ. Res. Public Health 2024, 21(5), 549; https://doi.org/10.3390/ijerph21050549 - 26 Apr 2024
Abstract
(1) Background: An elevated wrist circumference may indicate excess weight and cardiometabolic risk. The present study aims to identify wrist circumference cutoff points (WrC) to determine excess weight levels and predict cardiometabolic risk in adults. (2) Methods: A cross-sectional study was conducted with
[...] Read more.
(1) Background: An elevated wrist circumference may indicate excess weight and cardiometabolic risk. The present study aims to identify wrist circumference cutoff points (WrC) to determine excess weight levels and predict cardiometabolic risk in adults. (2) Methods: A cross-sectional study was conducted with adults aged 20 to 59 years old, attending the outpatient clinic at University Hospital/Federal University of Sergipe HU/UFS-EBSERH. Demographic, anthropometric, biochemical, and blood pressure (BP) data were collected. Cardiometabolic risk was assessed, according to the global risk score (ERG) and Framingham score criteria. The descriptive analysis included calculating medians and frequencies of anthropometric, demographic, biochemical, and blood pressure variables. The gender and age of adult groups were compared using the Mann–Whitney test. Spearman’s correlation coefficient and multiple regression analysis were used to assess the association between wrist circumference (WrC) and the variables mentioned above. The predictive validity of WrC in identifying excess weight levels and cardiometabolic risk was analyzed using the ROC curve. The sample consisted of 1487 adults aged 20 to 59 years, 55.7% of whom were female; (3) Results: WrC correlated positively with other adiposity indicators such as waist circumference and Body Mass Index. WrC was the anthropometric indicator most significantly associated with cardiometabolic risk factors. WrC cutoff points identified by the study for determining excess weight were categorized by gender and age group. For males aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 17.1 cm and 17.3 cm, and for obesity, 17.9 cm and 17.5 cm. For females aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 15.6 cm and 15.4 cm, and for obesity, 16.1 cm and 16 cm (4). Conclusions: Wrist circumference showed a significant correlation with other adiposity indicators and can be used to identify adults with excess weight and predict cardiometabolic risk.
Full article
(This article belongs to the Special Issue Study on Diet, Nutrition and Health Promotion Strategies to Prevent Chronic Diseases in All Life Stages)
Open AccessArticle
Effects of Childcare Hands-On Gardening on Preschoolers’ (3–5 Years) Physical Activity in Semi-Arid Climate Zone
by
Muntazar Monsur, Tristen Hefner, Jason Van Allen, Nazia Afrin Trina, S. Y. Andalib and Nilda Cosco
Int. J. Environ. Res. Public Health 2024, 21(5), 548; https://doi.org/10.3390/ijerph21050548 - 26 Apr 2024
Abstract
How hands-on gardening impacts behaviors including healthy eating and physical activity during early childhood can be of critical importance for preventing the early onset of obesity. This study investigates how participating in hands-on gardening impacts preschoolers’ (3–5 years old) physical activity (measured by
[...] Read more.
How hands-on gardening impacts behaviors including healthy eating and physical activity during early childhood can be of critical importance for preventing the early onset of obesity. This study investigates how participating in hands-on gardening impacts preschoolers’ (3–5 years old) physical activity (measured by accelerometers) in childcare centers in the semi-arid climate zone. The research was conducted in eight licensed childcare centers located in West Texas with 149 children (n = 149). Four childcare centers in the experimental group received hands-on garden interventions; the other four in the control group did not. In both experimental (intervention) and control (non-intervention) centers, children wore Actigraph GT3X+ accelerometers continuously for 5 days before and for 5 days after intervention (a total of 10 days). Results show that the duration of sedentary behavior of children in the experimental (intervention) group significantly decreased compared to children in the control (non-intervention) group. The finding suggests that the positive effects of childcare hands-on gardening on physical activity extend to semi-arid climate zones where gardening is challenging due to high temperatures and lack of annual rainfall. The research emphasizes the critical need to incorporate hands-on gardening in childcare centers as an obesity prevention strategy nationally in the US and beyond.
Full article
(This article belongs to the Special Issue Exercise in Living Environments: A Healthy Lifestyle)
Open AccessArticle
Clinical and Neuroimaging Predictors of Alzheimer’s Dementia Conversion in Patients with Mild Cognitive Impairment Using Amyloid Positron Emission Tomography by Quantitative Analysis over 2 Years
by
Seonjeong Kim, Daye Yoon, Junho Seong, Young Jin Jeong, Do-Young Kang and Kyung Won Park
Int. J. Environ. Res. Public Health 2024, 21(5), 547; https://doi.org/10.3390/ijerph21050547 - 26 Apr 2024
Abstract
Patients with mild cognitive impairment (MCI) have a relatively high risk of developing Alzheimer’s dementia (AD), so early identification of the risk for AD conversion can lessen the socioeconomic burden. In this study, 18F-Florapronol, newly developed in Korea, was used for qualitative
[...] Read more.
Patients with mild cognitive impairment (MCI) have a relatively high risk of developing Alzheimer’s dementia (AD), so early identification of the risk for AD conversion can lessen the socioeconomic burden. In this study, 18F-Florapronol, newly developed in Korea, was used for qualitative and quantitative analyses to assess amyloid positivity. We also investigated the clinical predictors of the progression from MCI to dementia over 2 years. From December 2019 to December 2022, 50 patients with MCI were recruited at a single center, and 34 patients were included finally. Based on visual analysis, 13 (38.2%) of 34 participants were amyloid-positive, and 12 (35.3%) were positive by quantitative analysis. Moreover, 6 of 34 participants (17.6%) converted to dementia after a 2-year follow-up (p = 0.173). Among the 15 participants who were positive for amyloid in the posterior cingulate region, 5 (33.3%) patients developed dementia (p = 0.066). The Clinical Dementia Rating-Sum of Boxes (CDR-SOB) at baseline was significantly associated with AD conversion in multivariate Cox regression analyses (p = 0.043). In conclusion, these results suggest that amyloid positivity in the posterior cingulate region and higher CDR-SOB scores at baseline can be useful predictors of AD conversion in patients with MCI.
Full article
(This article belongs to the Special Issue Understanding the Aging and Age-Related Neurological Disease)
►▼
Show Figures
Figure 1
Open AccessArticle
Investigating the Barriers and Facilitators to Using Antiretroviral Therapy among Women Living with HIV in Plateau State, Nigeria
by
Emmanuel O. Osayi, Sarah C. Blake, Tolulope Afolaranmi, Oluseye Ajayi, John Onyeji, Atiene S. Sagay, Albert Anderson and Taiwo J. Obindo
Int. J. Environ. Res. Public Health 2024, 21(5), 546; https://doi.org/10.3390/ijerph21050546 - 26 Apr 2024
Abstract
Background: Women and girls account for more than 50% of the global HIV population. In Nigeria, the proportion of women living with HIV on long-term antiretroviral therapy (ART) has been on the rise. Despite this, little research exists on their experiences regarding antiretroviral
[...] Read more.
Background: Women and girls account for more than 50% of the global HIV population. In Nigeria, the proportion of women living with HIV on long-term antiretroviral therapy (ART) has been on the rise. Despite this, little research exists on their experiences regarding antiretroviral therapy use, especially for women living with HIV (WLHIV) in Plateau State, Nigeria. This study investigates the barriers and facilitators influencing antiretroviral therapy use among women living with HIV. Methods: This study employed a qualitative research design, using focus groups, and included women (female sex workers, pregnant and non-pregnant women living with HIV) and the male partners of serodiscordant couples. Eligibility criteria were being 18 years of age or older, on antiretroviral therapy for more than one year/on pre-exposure prophylaxis (PrEP) for more than one month, and speaking English, Hausa, or both. Data coding utilized both inductive and deductive approaches, and standard content analysis was applied to develop emerging themes. Results: Of the 106 participants, 88 were women living with HIV, and 18 were men in serodiscordant couples. The first facilitator shared by the participants was feeling healthier and stronger due to the antiretroviral therapy, which was also expressed by the male participants on PrEP as feeling good while taking the drug. Additional facilitators shared by the participants included weight gain and having a more positive outlook on life. Participants also disproportionately described barriers to using antiretroviral therapy, including experiences with emotional challenges, physical discomfort, and side effects of ART. Such barriers were linked to feelings of past regret, frustration, and disappointment. Conclusion: This study underscores the significance of maintaining a positive perspective on ART use, demonstrated by the connection between a positive outlook and weight gain, and highlights the hurdles that Plateau State’s women living with HIV face in adhering to antiretroviral therapy. Policymakers and healthcare providers can utilize these findings to formulate targeted strategies aimed at minimizing identified barriers and enhancing antiretroviral therapy utilization among this population via peer- support groups, economic empowerment, and psychosocial support.
Full article
(This article belongs to the Special Issue Women Living with HIV)
Open AccessArticle
The Relationship between Anxiety Symptoms and Perceived Quality of Life among Caregivers of Children with Autism Spectrum Disorder in the Amazon
by
Rayanne Vieira da Silva, Manuela Maria de Lima Carvalhal and Daniela Lopes Gomes
Int. J. Environ. Res. Public Health 2024, 21(5), 545; https://doi.org/10.3390/ijerph21050545 - 26 Apr 2024
Abstract
The relationship between anxiety symptoms and perceived quality of life among caregivers of children with autism was verified. To assess perceived quality of life, the Short Form Healthy Survey Item was used; perception of anxiety symptoms was assessed using the Beck Anxiety Inventory.
[...] Read more.
The relationship between anxiety symptoms and perceived quality of life among caregivers of children with autism was verified. To assess perceived quality of life, the Short Form Healthy Survey Item was used; perception of anxiety symptoms was assessed using the Beck Anxiety Inventory. Eighty caregivers of children with autism participated, with 68.7% of caregivers being mothers. Of the total number of caregivers, 68.8% had a severe level of anxiety. Regarding perceived quality of life, they demonstrated greater impairment in limitation due to physical aspects, limitation due to emotional aspects, vitality, and pain. Caregivers with severe anxiety levels had a worse quality of life in the domains of pain (p = 0.012), social aspects (p < 0.001), limitation due to emotional aspects (p = 0.001), and mental health (p < 0.001). However, in the functional capacity domain, caregivers with a moderate level of anxiety had a better physical capacity score (p = 0.001). There was a negative correlation between the general anxiety score and the general physical (p = 0.029) and general emotional components of perceived quality of life (p < 0.001). It was found that caregivers of children with ASD have a high level of anxiety, which is a predictor of the perception of a worse quality of life.
Full article
(This article belongs to the Special Issue The Mental Well-Being of Caregivers: Impacts, Benefits and Advancements)
Open AccessArticle
Pediatric Oral Health Online Education for Rural and Migrant Head Start Programs in the United States
by
Francisco Ramos-Gomez, Stephanie Parkinson, Victor Garcia de Jesus, Jose A. Rios and Janni J. Kinsler
Int. J. Environ. Res. Public Health 2024, 21(5), 544; https://doi.org/10.3390/ijerph21050544 - 25 Apr 2024
Abstract
Children living in rural and migrant areas in the United States disproportionately suffer from poor oral health. Additionally, there continues to be a shortage of pediatric dentists practicing in rural/migrant areas. The purpose of this formative research study was to assess whether staff,
[...] Read more.
Children living in rural and migrant areas in the United States disproportionately suffer from poor oral health. Additionally, there continues to be a shortage of pediatric dentists practicing in rural/migrant areas. The purpose of this formative research study was to assess whether staff, teachers and families from rural/migrant Head Start/Early Head Start (HS/EHS) programs in California were receptive to oral health online education workshops conducted by pediatric dental residents who were assisted by bilingual (English and Spanish) community oral health workers (COHWs). Our findings suggest that partnering pediatric dental residents with bilingual COHWs to educate HS/EHS teachers, staff and parents on oral health care in rural/migrant areas could result in a rewarding experience for pediatric dentists that might lead them to practice in these communities upon graduation from their residency program. Furthermore, the positive feedback received from the teachers, staff and parents who participated in the workshops indicates they were receptive to receiving oral health information related to oral health literacy from the dental providers and COHWs. COHWs can help increase access to oral health care by serving as a bridge between families and providers by relaying information in a cultural, linguistic and sensitive manner.
Full article
(This article belongs to the Special Issue Caries Management)
Open AccessArticle
Relationship between Sleep Bruxism Determined by Non-Instrumental and Instrumental Approaches and Psychometric Variables
by
Nicole Pascale Walentek, Ralf Schäfer, Nora Bergmann, Michael Franken and Michelle Alicia Ommerborn
Int. J. Environ. Res. Public Health 2024, 21(5), 543; https://doi.org/10.3390/ijerph21050543 - 25 Apr 2024
Abstract
Sleep bruxism (SB) can be determined with different diagnostic procedures. The relationship between psychometric variables and SB varies depending on the diagnostic method. The aim of the study was to compare the association between SB and oral health-related quality of life (OHRQoL; measured
[...] Read more.
Sleep bruxism (SB) can be determined with different diagnostic procedures. The relationship between psychometric variables and SB varies depending on the diagnostic method. The aim of the study was to compare the association between SB and oral health-related quality of life (OHRQoL; measured by the Oral Health Impact Profile, OHIP), anxiety (measured by the State-Trait anxiety inventory, STAI), and stress (single scale variable) depending on the diagnostic method in the same sample. N = 45 participants were examined by non-instrumental (possible/probable SB) and instrumental methods (definite SB). The OHIP differed significantly between possible SB (median = 4) and non-SB (median = 0) with W = 115, p = 0.01, and probable SB (median = 6) and non-SB (median = 0) with W = 101, p = 0.01). There was no significant difference in the OHIP score between definite SB and non-SB. For the other psychometric variables, the analyses revealed no significant differences between SB and non-SB in all diagnostic procedures. The results suggest that there is a difference between possible/probable and definite SB with respect to the association with OHRQoL. Certain aspects of possible/probable SB might be responsible for the poor OHRQoL, which are not measured in definite SB.
Full article
Journal Menu
► ▼ Journal Menu-
- IJERPH Home
- Aims & Scope
- Editorial Board
- Reviewer Board
- Topical Advisory Panel
- Instructions for Authors
- Special Issues
- Topics
- Sections & Collections
- Article Processing Charge
- Indexing & Archiving
- Editor’s Choice Articles
- Most Cited & Viewed
- Journal Statistics
- Journal History
- Journal Awards
- Society Collaborations
- Editorial Office
Journal Browser
► ▼ Journal Browser-
arrow_forward_ios
Forthcoming issue
arrow_forward_ios Current issue - Vol. 21 (2024)
- Vol. 20 (2023)
- Vol. 19 (2022)
- Vol. 18 (2021)
- Vol. 17 (2020)
- Vol. 16 (2019)
- Vol. 15 (2018)
- Vol. 14 (2017)
- Vol. 13 (2016)
- Vol. 12 (2015)
- Vol. 11 (2014)
- Vol. 10 (2013)
- Vol. 9 (2012)
- Vol. 8 (2011)
- Vol. 7 (2010)
- Vol. 6 (2009)
- Vol. 5 (2008)
- Vol. 4 (2007)
- Vol. 3 (2006)
- Vol. 2 (2005)
- Vol. 1 (2004)
Highly Accessed Articles
Latest Books
E-Mail Alert
News
26 April 2024
International Journal of Environmental Research and Public Health Exceptional Reviewers List 2024
International Journal of Environmental Research and Public Health Exceptional Reviewers List 2024
24 April 2024
International Journal of Environmental Research and Public Health Papers Cited in the News in Q1 of 2024
International Journal of Environmental Research and Public Health Papers Cited in the News in Q1 of 2024
Topics
Topic in
Energies, IJERPH, Minerals, Mining, Safety
Exploring the Mine Environment, Safety Risk and Occupational Health
Topic Editors: Chengyu Xie, Jian Zhou, Danial Jahed Armaghani, Qingfa Chen, Wei PanDeadline: 30 June 2024
Topic in
Cancers, IJERPH, JCM
Bridging Oral Medicine and Systemic Disease
Topic Editors: Pia Lopez-Jornet, Ivan Alajbeg, Rui Amaral Mendes, Eduardo Pons-FusterDeadline: 7 July 2024
Topic in
Healthcare, IJERPH, Social Sciences
Migration, Health and Equity
Topic Editors: Madhu Sudhan Atteraya, Roman ShersthaDeadline: 31 July 2024
Topic in
IJERPH, Microplastics, Sustainability, Toxics, Water
Microplastics Pollution
Topic Editors: Grigorios L. Kyriakopoulos, Vassilis J. Inglezakis, Antonis A. Zorpas, María Rocío Rodríguez BarrosoDeadline: 31 August 2024
Conferences
Special Issues
Special Issue in
IJERPH
Adipose Tissue and Exercise in Health and Disease
Guest Editor: Kenneth VerbovenDeadline: 30 April 2024
Special Issue in
IJERPH
Applications of Big Data Mining in Healthcare
Guest Editors: Dagang Li, Ying ShenDeadline: 15 May 2024
Special Issue in
IJERPH
Oral Health among the Older Population
Guest Editors: Inger Wårdh, Nivetha GavriilidouDeadline: 31 May 2024
Special Issue in
IJERPH
Using Mobile Technology to Promote Adolescent Sexual and Reproductive Health
Guest Editor: Judith CorneliusDeadline: 15 June 2024
Topical Collections
Topical Collection in
IJERPH
Public Health Surveillance and Infectious Disease Control
Collection Editors: Giovanni Improta, Emma Montella, Giovanni Boccia, Ilaria Loperto
Topical Collection in
IJERPH
A Focus on Healthcare from the Perspective of Gender, Culture, Management, and the Economy
Collection Editors: José Siles Gonzalez, Carmen Solano Ruiz, Paulo Joaquim Pina Queirós, Benito Yañez-Araque
Topical Collection in
IJERPH
Epidemiological Lifestyle Analysis and Infection Prevention in Public Health
Collection Editors: Mariusz Gujski, Mateusz Jankowski