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Int. J. Environ. Res. Public Health, Volume 20, Issue 11 (June-1 2023) – 141 articles

Cover Story (view full-size image): Volatile organic compounds (VOCs) emitted from personal care products (PCPs) contribute to poor air quality and pose health risks to users via the inhalation exposure pathway. Sunscreens are one of the few PCPs regularly used by people of a wide cross-section of ages, with some being specifically formulated for infants.
Despite being formulated for the same purpose, the VOC emissions observed from a range of sunscreen products are highly variable and have been found to contain contaminant species and fragrance compounds not labelled on their ingredients list.
This paper details VOC speciation from 26 commercially available sunscreens and the likely exposure to applicants via inhalation following recommended sunscreen use. View this paper
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12 pages, 365 KiB  
Article
Health System’s Role in Facilitating Health Service Access among Persons with Spinal Cord Injury across 22 Countries
by Olena Bychkovska, Vegard Strøm, Piotr Tederko, Julia Patrick Engkasan, Alvydas Juocevičius, Linamara Rizzo Battistella, Mohit Arora, Christoph Egen and Armin Gemperli
Int. J. Environ. Res. Public Health 2023, 20(11), 6056; https://doi.org/10.3390/ijerph20116056 - 5 Jun 2023
Cited by 1 | Viewed by 1597
Abstract
(1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular multidisciplinary follow-up care yet experience more access barriers than the [...] Read more.
(1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular multidisciplinary follow-up care yet experience more access barriers than the general population. This study examines health system characteristics associated with access among persons with SCI across 22 countries. (2) Methods: Study data are from the International Spinal Cord Injury Survey with 12,588 participants with SCI across 22 countries. Cluster analysis was used to identify service access clusters based on reported access restrictions. The association between service access and health system characteristics (health workforce, infrastructure density, health expenditure) was determined by means of classification and regression trees. (3) Results: Unmet needs were reported by 17% of participants: lowest (10%) in Japan, Spain, and Switzerland (cluster 1) and highest (62%) in Morocco (cluster 8). The country of residence was the most important factor in facilitating access. Those reporting access restrictions were more likely to live in Morocco, to be in the lowest income decile, with multiple comorbidities (Secondary Conditions Scale (SCI-SCS) score > 29) and low functioning status (Spinal Cord Independence Measure score < 53). Those less likely to report access restriction tended to reside in all other countries except Brazil, China, Malaysia, Morocco, Poland, South Africa, and South Korea and have fewer comorbidities (SCI-SCS < 23). (4) Conclusions: The country of residence was the most important factor in facilitating health service access. Following the country of residence, higher income and better health were the most important facilitators of service access. Health service availability and affordability were reported as the most frequent health access barriers. Full article
13 pages, 662 KiB  
Review
The Conceptual Analysis of Collaboration in the Occupational Therapy by Combining the Scoping Review Methodology
by Tatsunori Sawada, Kyongmi Oh, Mutsumi Namiki, Kounosuke Tomori, Kanta Ohno and Yuho Okita
Int. J. Environ. Res. Public Health 2023, 20(11), 6055; https://doi.org/10.3390/ijerph20116055 - 5 Jun 2023
Viewed by 2354
Abstract
Background: Collaboration is an important concept in goal-setting in occupational therapy. However, this concept is not stable due to various definitions. The purpose of this study was to clarify the concept of collaboration in occupational therapy. Method: A scoping review was used to [...] Read more.
Background: Collaboration is an important concept in goal-setting in occupational therapy. However, this concept is not stable due to various definitions. The purpose of this study was to clarify the concept of collaboration in occupational therapy. Method: A scoping review was used to search for all articles related to occupational therapy and collaboration. PubMed, Web of Science, CINAHL, and OT Seeker searches were conducted using predetermined keywords. Three examiners independently reviewed and assessed the quality of each study using Walker and Avant’s concept analysis method. Results: Results of the database searches yielded 1873 studies, 585 of which were deemed eligible to include in this review. Results showed five attributes (“active participation for the common objective”, “existence of something to share”, “matured communication and interaction”, “relationship founded on the respect and trust” and “complementing each other”) and two antecedents and several consequences. Conclusions: Our findings may contribute to collaborative goal-setting and occupational therapy. Full article
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13 pages, 346 KiB  
Article
Characteristics Associated with Young Adults’ Intentions to Engage with Anti-Vaping Instagram Posts
by Jessica Liu, Donghee N. Lee and Elise M. Stevens
Int. J. Environ. Res. Public Health 2023, 20(11), 6054; https://doi.org/10.3390/ijerph20116054 - 5 Jun 2023
Cited by 1 | Viewed by 2160
Abstract
The purpose of this study was to identify behavioral and sociodemographic factors associated with intentions to engage with anti-vaping Instagram posts among a young adult population. This study proposes the following research questions: (1) Does e-cigarette use status influence intentions to engage with [...] Read more.
The purpose of this study was to identify behavioral and sociodemographic factors associated with intentions to engage with anti-vaping Instagram posts among a young adult population. This study proposes the following research questions: (1) Does e-cigarette use status influence intentions to engage with anti-vaping Instagram posts?, and (2) How are e-cigarette use and social media use associated? We recruited a convenience sample of young adults (N = 459; aged 18–30 years) in July of 2022 into an online experimental study from Prolific. Participants saw five image-based Instagram posts about the health harms of using e-cigarettes. Participants were then asked about their intentions to engage (“Comment on”, “Reshare”, “DM/Send this to a friend”, “Like”, and/or “Take a screenshot of”) with the posts. We used logistic regression to run adjusted models for each engagement outcome, which included fixed effects for sociodemographics, tobacco use, and social media/internet use. For the sum of the engagement outcome, we used Poisson regression. Total number of social media sites used was associated with intentions to “Like” the posts (p = 0.025) and the overall engagement score (p = 0.019), respectively. Daily internet use was associated with intentions to “Comment on” (p = 0.016) and “Like” (p = 0.019) the posts. Young adults who reported past 30-day e-cigarette use had higher odds of using Twitter (p = 0.013) and TikTok (p < 0.001), and a higher total number of social media sites used (p = 0.046), compared to young adults who reported never use e-cigarettes. The initial evidence from our exploratory research using a convenience sample suggests that social media campaigns about the harms of e-cigarette use may be an effective way to engage younger audiences, a generation that frequents social media. Efforts to disseminate social media campaigns should consider launching on multiple platforms, such as Twitter and TikTok, and consider e-cigarette use status when posting. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
16 pages, 3464 KiB  
Systematic Review
Effects of Transitional Care after Hospital Discharge in Patients with Chronic Obstructive Pulmonary Disease: An Updated Systematic Review and Meta-Analysis
by Yukyung Park, Jiwon Kim, Sukyoung Kim, Dahae Moon and Heuisug Jo
Int. J. Environ. Res. Public Health 2023, 20(11), 6053; https://doi.org/10.3390/ijerph20116053 - 5 Jun 2023
Cited by 2 | Viewed by 1951
Abstract
This study aimed to systematically review the effects of transitional care programs on healthcare use and quality of life in patients with chronic obstructive pulmonary disease (COPD). Several databases were searched for randomized controlled trials conducted over the past five years, and their [...] Read more.
This study aimed to systematically review the effects of transitional care programs on healthcare use and quality of life in patients with chronic obstructive pulmonary disease (COPD). Several databases were searched for randomized controlled trials conducted over the past five years, and their quality was evaluated using the Cochrane Risk of Bias 2.0 tool. For indicators with available statistical information, a meta-analysis was performed using RevMan 5.4, and a narrative review was performed for the rest of the results. In the meta-analysis, no statistically significant difference was observed between the intervention and control groups in the number of readmissions and emergency room visits due to COPD. The relative risk (RR) of readmission for COPD was lower in the intervention group. Respiratory-related quality of life tended to be better in the intervention group, though not significantly. Physical capacity was improved in the intervention group. Considering the characteristics of the complex intervention, the context and factors of cases where the expected results could be obtained and cases where the expected results could not be obtained were reviewed and discussed. Based on the results of the analysis, implications for the development of better protocols were presented. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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11 pages, 1490 KiB  
Article
Determining the Appropriate Support for Older Adults with Different Levels of Vitality and Health-Related Quality of Life: An Explanatory Study
by Damien S. E. Broekharst, Sjaak Bloem, Marije Blok, Mariët Raatgever, Nathascha Hanzen and Jasmien J. E. de Vette
Int. J. Environ. Res. Public Health 2023, 20(11), 6052; https://doi.org/10.3390/ijerph20116052 - 5 Jun 2023
Viewed by 1461
Abstract
Vitality and health-related quality of life are often assessed in older adults. However, these assessments do not provide guidance on support for older adults with different levels of vitality and health-related quality of life. This guidance can be established through segmentation. The Subjective [...] Read more.
Vitality and health-related quality of life are often assessed in older adults. However, these assessments do not provide guidance on support for older adults with different levels of vitality and health-related quality of life. This guidance can be established through segmentation. The Subjective Health Experience model segments individuals and indicates support for each segment. By examining how older adults with different levels of vitality and health-related quality of life correspond with each segment and by specifying the indicated support to older adults, guidance can be established. This was examined by administering a questionnaire to 904 older adults and interviewing 8. Analysis was performed using one-way ANOVA and the matrix method. In segment 1, older adults sustained higher levels of vitality and health-related quality of life relative to other segments. They need information and certainty. In segment 2, older adults sustained lower levels of vitality and health-related quality of life relative to segment 1, and higher levels relative to segment 3 or 4. They need planning and structure. In segment 3, older adults sustained lower levels of vitality and health-related quality of life relative to segment 1 or 2, and higher levels relative to segment 4. They need emotive assistance. In segment 4, older adults sustained lower levels of vitality and health-related quality of life relative to other segments. They need personal coaching. As levels of vitality and health-related quality of life correspond with the segments, deploying vitality and health-related quality of life measures together with the model might be beneficial. Full article
(This article belongs to the Section Aging)
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11 pages, 333 KiB  
Article
How the COVID-19 Pandemic Influenced HIV Care: Are We Prepared Enough for Future Pandemics? An Assessment of Factors Influencing Access, Utilization, Affordability, and Motivation to Engage with HIV Services amongst African, Caribbean, and Black Women
by Emily McKay, Emmanuela Ojukwu, Saima Hirani, Tatiana Sotindjo, Ijeoma Okedo-Alex and Patience Magagula
Int. J. Environ. Res. Public Health 2023, 20(11), 6051; https://doi.org/10.3390/ijerph20116051 - 5 Jun 2023
Cited by 1 | Viewed by 1622
Abstract
The COVID-19 pandemic resulted in disruption in healthcare delivery for people living with human immunodeficiency virus (HIV). African, Caribbean, and Black women living with HIV (ACB WLWH) in British Columbia (BC) faced barriers to engage with HIV care services prior to the COVID-19 [...] Read more.
The COVID-19 pandemic resulted in disruption in healthcare delivery for people living with human immunodeficiency virus (HIV). African, Caribbean, and Black women living with HIV (ACB WLWH) in British Columbia (BC) faced barriers to engage with HIV care services prior to the COVID-19 pandemic that were intensified by the transition to virtual care during the pandemic. This paper aims to assess which factors influenced ACB WLWH’s access to, utilization and affordability of, and motivation to engage with HIV care services. This study utilized a qualitative descriptive approach using in-depth interviews. Eighteen participants were recruited from relevant women’s health, HIV, and ACB organizations in BC. Participants felt dismissed by healthcare providers delivering services only in virtual formats and suggested that services be performed in a hybrid model to increase access and utilization. Mental health supports, such as support groups, dissolved during the pandemic and overall utilization decreased for many participants. The affordability of services pertained primarily to expenses not covered by the provincial healthcare plan. Resources should be directed to covering supplements, healthy food, and extended health services. The primary factor decreasing motivation to engage with HIV services was fear, which emerged due to the unknown impact of the COVID-19 virus on immunocompromised participants. Full article
(This article belongs to the Special Issue Women Living with HIV)
19 pages, 355 KiB  
Article
Parent Experiences in the NICU and Transition to Home
by Christine M. Spence, Corri L. Stuyvenberg, Audrey E. Kane, Jennifer Burnsed and Stacey C. Dusing
Int. J. Environ. Res. Public Health 2023, 20(11), 6050; https://doi.org/10.3390/ijerph20116050 - 4 Jun 2023
Cited by 2 | Viewed by 3330
Abstract
Families (n = 12) with infants born at <29 weeks gestation shared their experiences while in the NICU and transitioning home. Parents were interviewed 6–8 weeks after NICU discharge, including some during the acute phase of the COVID-19 pandemic. Findings regarding the [...] Read more.
Families (n = 12) with infants born at <29 weeks gestation shared their experiences while in the NICU and transitioning home. Parents were interviewed 6–8 weeks after NICU discharge, including some during the acute phase of the COVID-19 pandemic. Findings regarding the parent experience in the NICU were focused around challenges navigating parent-infant separation, social isolation, communication difficulties, limited knowledge of preterm infants, mental health challenges. Parents also discussed supports that were present and supports they wished were present, as well as the impact of COVID-19 on their experiences. In the transition to home, primary experiences included the sudden nature of the transition, anxiety around discharge preparation, and the loss of the support from nursing staff. During the first few weeks at home, parents expressed joy and anxiety, particularly around feeding. The COVID-19 pandemic limited emotional, informational, and physical support to parents and resulted in limited mutual support from other parents of infants in the NICU. Parents of preterm infants in the NICU present with multiple stressors, rendering attending to parental mental health crucial. NICU staff need to address logistical barriers and familial priorities impacting communication and parent-infant bonding. Providing multiple opportunities for communication, participating in caretaking activities, and meeting other families can be important sources of support and knowledge for parents of very preterm infants. Full article
(This article belongs to the Special Issue Patient and Family Experience in Health Care)
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16 pages, 826 KiB  
Review
Treponema denticola Has the Potential to Cause Neurodegeneration in the Midbrain via the Periodontal Route of Infection—Narrative Review
by Flavio Pisani, Valerio Pisani, Francesca Arcangeli, Alice Harding and Simarjit Kaur Singhrao
Int. J. Environ. Res. Public Health 2023, 20(11), 6049; https://doi.org/10.3390/ijerph20116049 - 4 Jun 2023
Cited by 2 | Viewed by 2329
Abstract
Alzheimer’s disease (AD) is a neurodegenerative disease and the most common example of dementia. The neuropathological features of AD are the abnormal deposition of extracellular amyloid-β (Aβ) and intraneuronal neurofibrillary tangles with hyperphosphorylated tau protein. It is recognized that AD starts in the [...] Read more.
Alzheimer’s disease (AD) is a neurodegenerative disease and the most common example of dementia. The neuropathological features of AD are the abnormal deposition of extracellular amyloid-β (Aβ) and intraneuronal neurofibrillary tangles with hyperphosphorylated tau protein. It is recognized that AD starts in the frontal cerebral cortex, and then it progresses to the entorhinal cortex, the hippocampus, and the rest of the brain. However, some studies on animals suggest that AD could also progress in the reverse order starting from the midbrain and then spreading to the frontal cortex. Spirochetes are neurotrophic: From a peripheral route of infection, they can reach the brain via the midbrain. Their direct and indirect effect via the interaction of their virulence factors and the microglia potentially leads to the host peripheral nerve, the midbrain (especially the locus coeruleus), and cortical damage. On this basis, this review aims to discuss the hypothesis of the ability of Treponema denticola to damage the peripheral axons in the periodontal ligament, to evade the complemental pathway and microglial immune response, to determine the cytoskeletal impairment and therefore causing the axonal transport disruption, an altered mitochondrial migration and the consequent neuronal apoptosis. Further insights about the central neurodegeneration mechanism and Treponema denticola’s resistance to the immune response when aggregated in biofilm and its quorum sensing are suggested as a pathogenetic model for the advanced stages of AD. Full article
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17 pages, 808 KiB  
Article
Past Traumatic Life Events, Postpartum PTSD, and the Role of Labor Support
by Anna Suarez and Vera Yakupova
Int. J. Environ. Res. Public Health 2023, 20(11), 6048; https://doi.org/10.3390/ijerph20116048 - 4 Jun 2023
Cited by 4 | Viewed by 2922
Abstract
The aim of this study was to investigate the association of postpartum post-traumatic stress disorder (PP-PTSD) symptoms and subjective rates of traumatic birth experience with past traumatic life events (physical and sexual assault, child abuse, perinatal loss, previous traumatic birth experience, and the [...] Read more.
The aim of this study was to investigate the association of postpartum post-traumatic stress disorder (PP-PTSD) symptoms and subjective rates of traumatic birth experience with past traumatic life events (physical and sexual assault, child abuse, perinatal loss, previous traumatic birth experience, and the cumulative traumatic experience). A sample of Russian women (n = 2579) who gave birth within the previous 12 months, filled in a web-based survey, where they reported demographic and obstetric characteristics and past traumatic experiences, evaluated their birth experience (0 = not traumatic, 10 = extremely traumatic), and completed the City Birth Trauma Scale (CBiTS). We found that PP-PTSD symptoms were higher among women who previously experienced physical (F = 22.02, p < 0.001) and sexual (F = 15.98, p < 0.001) assault and child abuse (F = 69.25, p < 0.001), with only associations with child abuse (F = 21.14, p < 0.001) remaining significant for subjective rates of traumatic birth experience. Perinatal loss and previous traumatic birth showed moderate but inconsistent effects. Support during labor did not have a buffering effect for participants with past traumatic experiences but showed a universally protective effect against PP-PTSD. Trauma-informed practices and allowing women to have a supportive birth team of choice during childbirth are promising avenues to minimize the incidence of PP-PTSD and improve the childbirth experience for all women. Full article
(This article belongs to the Section Mental Health)
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12 pages, 348 KiB  
Article
Applying the Socioecological Model to Map Factors Associated with Military Physical Activity Adherence
by Golan Benisti and Orna Baron-Epel
Int. J. Environ. Res. Public Health 2023, 20(11), 6047; https://doi.org/10.3390/ijerph20116047 - 4 Jun 2023
Cited by 1 | Viewed by 1384
Abstract
Physical activity (PA) within the military can have large effects on the soldier’s health, productivity, and ability to meet tasks. This study aims to identify the factors associated with PA adherence during military service, applying the socioecological model, which classifies the factors influencing [...] Read more.
Physical activity (PA) within the military can have large effects on the soldier’s health, productivity, and ability to meet tasks. This study aims to identify the factors associated with PA adherence during military service, applying the socioecological model, which classifies the factors influencing health behaviors into individual, social, and environmental levels. This cross-sectional survey was carried out among 500 soldiers aged 18 to 49 years in the Israeli Defense Forces. Statistical analysis to assess associations between PA and individual, social, and environmental factors included correlations, variance analyses, and multivariable linear regression. PA rates were higher among men soldiers in combat positions. Individual level factors, such as intention to perform PA (β = 0.42, p < 0.001), and self-efficacy regarding PA (β = 0.20, p < 0.001) were associated with PA among men and women. However, social norms were associated with PA only among men (β = 0.24, p < 0.001). The physical environment was not associated with PA adherence (β = −0.04, p = 0.210). Conclusions: Developing interventions on the individual level for all military personnel and interventions on the social level, mainly for men, could help increase levels of PA in the military. Full article
17 pages, 2235 KiB  
Article
Violence across the Life Course and Implications for Intervention Design: Findings from the Maisha Fiti Study with Female Sex Workers in Nairobi, Kenya
by Tara S. Beattie, Rhoda Kabuti, Alicja Beksinska, Hellen Babu, Mary Kung’u, The Maisha Fiti Study Champions, Pooja Shah, Emily Nyariki, Chrispo Nyamweya, Monica Okumu, Anne Mahero, Pauline Ngurukiri, Zaina Jama, Erastus Irungu, Wendy Adhiambo, Peter Muthoga, Rupert Kaul, Janet Seeley, Helen A. Weiss and Joshua Kimani
Int. J. Environ. Res. Public Health 2023, 20(11), 6046; https://doi.org/10.3390/ijerph20116046 - 3 Jun 2023
Cited by 1 | Viewed by 2105
Abstract
We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural–biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the [...] Read more.
We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural–biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for associations of life course factors with reported experience of physical or sexual violence in the past 6 months. We found substantial overlap between violence in childhood, and recent intimate and non-intimate partner violence in adulthood, with 86.9% reporting one or more types of violence and 18.7% reporting all three. Recent physical or sexual violence (64.9%) was independently associated with life course factors, including a high WHO Adverse Childhood Experiences (ACE) score (AOR = 7.92; 95% CI:4.93–12.74) and forced sexual debut (AOR = 1.97; 95% CI:1.18–3.29), as well as having an intimate partner (AOR = 1.67; 95% CI:1.25–2.23), not having an additional income to sex work (AOR = 1.54; 95% CI:1.15–2.05), having four or more dependents (AOR = 1.52; 95% CI:0.98–2.34), recent hunger (AOR = 1.39; 95% CI:1.01–1.92), police arrest in the past 6 months (AOR = 2.40; 95% CI:1.71–3.39), condomless last sex (AOR = 1.46; 95% CI:1.02–2.09), and harmful alcohol use (AOR = 3.34; 95% CI:1.74–6.42). Interventions that focus on violence prevention during childhood and adolescence should help prevent future adverse trajectories, including violence experience and HIV acquisition. Full article
(This article belongs to the Section Global Health)
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11 pages, 1376 KiB  
Case Report
Pollen Sensitization Can Increase the Allergic Reaction to Non-Cross-Reactive Allergens in a Soy-Allergic Patient
by Daniela Briceno Noriega, Huub F. J. Savelkoul, Ad Jansen, Malgorzata Teodorowicz and Janneke Ruinemans-Koerts
Int. J. Environ. Res. Public Health 2023, 20(11), 6045; https://doi.org/10.3390/ijerph20116045 - 3 Jun 2023
Viewed by 1933
Abstract
During and after the pollen season, an increase in food-triggered allergic symptoms has been observed in pollen-food syndrome patients, possibly due to seasonal boosting of pollen-IgE levels. It has been suggested that consumption of birch-pollen-related foods plays a role in seasonal allergenic inflammation. [...] Read more.
During and after the pollen season, an increase in food-triggered allergic symptoms has been observed in pollen-food syndrome patients, possibly due to seasonal boosting of pollen-IgE levels. It has been suggested that consumption of birch-pollen-related foods plays a role in seasonal allergenic inflammation. However, whether this increased pollen sensitization during the pollen season can also affect the allergenicity of allergens that are non-cross-reactive with birch pollen remains in question. This study presents the case of a patient with soy allergy and pollinosis, who experiences worsening of gastrointestinal (GI) symptoms during the birch pollen season even though the eliciting food factor does not cross-react with birch pollen allergens and their homologs (e.g., Bet v 1 and Gly m 4). The results showed a notable increase in sIgE for Gly m 4 (3.3 fold) and Bet v 1 (2.6 fold) during the birch pollen season compared to outside the birch pollen season, while Gly m 5 and Gly m 6 showed only a slight increase (1.5 fold). The basophil activation test (BAT) showed that in this patient Gly m 5 and Gly m 6 are clinically relevant soy allergens, which correlates with the reported clinical symptoms to processed soy. Moreover, the BAT against raw soy shows an increase in basophil activation during the birch pollen season and a negative basophil activation result outside the birch pollen season. Thus, the worsening of GI symptoms could possibly be due to an increase in IgE receptors, an over-reactive immune system, and/or significant intestinal allergic inflammation. This case highlights the importance of including allergens that do not cross-react with birch pollen and using a functional assay such as the BAT to evaluate clinical relevance when assessing birch pollen seasonal influence on soy allergenicity. Full article
(This article belongs to the Special Issue Allergic Diseases in Adulthood: Burden, Mechanisms and Risk Factors)
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12 pages, 334 KiB  
Article
Assessing Condom Use and Views on HIV Counselling and Testing among TVET College Students in Limpopo Province, South Africa
by Mimi Eve Teffo and Mathildah Mpata Mokgatle
Int. J. Environ. Res. Public Health 2023, 20(11), 6044; https://doi.org/10.3390/ijerph20116044 - 3 Jun 2023
Cited by 1 | Viewed by 1765
Abstract
South Africa’s population is predominantly young, presenting a powerful resource for the country. Despite this, adolescents and young people remain at the epicentre of the HIV epidemic, particularly adolescent girls and young women (AGYW). There are limited studies that investigate the views on [...] Read more.
South Africa’s population is predominantly young, presenting a powerful resource for the country. Despite this, adolescents and young people remain at the epicentre of the HIV epidemic, particularly adolescent girls and young women (AGYW). There are limited studies that investigate the views on HIV Counselling and Testing (HCT) and condom use among adolescents and young people, and college students in particular, in South Africa. This cross-sectional study assessed condom use among college students and their views and opinions on HCT. Utilising an adapted questionnaire from the Australian Secondary students and the South African Sexual Health survey, the data from 396 students were analysed using univariate and multiple logistic regression performed using Stata IC version 16. The majority of the students (n = 339, 85.8%) had a sexual partner at the time of the study. Our findings reveal a relatively high occurrence of condom use in the last sexual encounter (n = 225, 60%) and high HCT uptake (n = 50, 88.4%). Females were generally more comfortable regarding HIV services compared to their male counterparts. More than half, 54.6% vs. 36.0% were comfortable about testing, 34.0% vs. 48.3% felt very scared about testing for HIV, 3.6% vs. 10.1% reported that they were not ready to take an HIV test, 7.6% vs. 5.6% intended getting tested soon (p = 0.0002). Condom use was significantly associated with the use of a condom during the first sexual encounter (aOR = 4.71, 95% CI: 2.14, 10.37) and knowing their partner’s HIV status (aOR = 2.08, 95% CI: 1.19–3.65). The HCT and condom promotion strategies implemented by Higher Health in TVET colleges is showing success and colleges in other parts of the region could emulate these best practices. Program developers should consider tailor-made combinations of prevention interventions that would appeal to both female and male college students to improve condom use and uptake of HIV testing services. Full article
22 pages, 1677 KiB  
Article
Sports Utility Vehicles: A Public Health Model of Their Climate and Air Pollution Impacts in the United Kingdom
by Charles Dearman, James Milner, Glenn Stewart, Giovanni S. Leonardi, John Thornes and Paul Wilkinson
Int. J. Environ. Res. Public Health 2023, 20(11), 6043; https://doi.org/10.3390/ijerph20116043 - 2 Jun 2023
Cited by 2 | Viewed by 3227
Abstract
The emission benefits of shifting towards battery electric vehicles have so far been hampered by a trend towards sports utility vehicles (SUVs). This study assesses the current and future emissions from SUVs and their potential impact on public health and climate targets. We [...] Read more.
The emission benefits of shifting towards battery electric vehicles have so far been hampered by a trend towards sports utility vehicles (SUVs). This study assesses the current and future emissions from SUVs and their potential impact on public health and climate targets. We modelled five scenarios of varying SUV sales and electrification rates, and projected associated carbon dioxide (CO2) and nitrogen oxide (NOx) emissions. Multiple linear regression was used to determine the relationship between vehicle characteristics and emissions. Cumulative CO2 emissions were valued using the social cost of carbon approach. Life table analyses were used to project and value life years saved from NOx emission reductions. Larger SUVs were disproportionately high emitters of CO2 and NOx. Replacing these with small SUVs achieved significant benefits, saving 702 MtCO2e by 2050 and 1.8 million life years from NO2 reductions. The largest benefits were achieved when combined with electrification, saving 1181 MtCO2e and gaining 3.7 million life years, with a societal value in the range of GBP 10–100s billion(s). Downsizing SUVs could be associated with major public health benefits from reduced CO2 and NOx emissions, in addition to the benefits of electrification. This could be achieved by demand-side mass-based vehicle taxation and supply-side changes to regulations, by tying emission limits to a vehicle’s footprint rather than its mass. Full article
(This article belongs to the Section Environmental Science and Engineering)
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12 pages, 337 KiB  
Article
Updated Decision Aid Enabling Women to Choose between with or without Epidural Analgesia during Childbirth, and Confirmation of Validity
by Eri Shishido, Yumiko Arabiki and Shigeko Horiuchi
Int. J. Environ. Res. Public Health 2023, 20(11), 6042; https://doi.org/10.3390/ijerph20116042 - 2 Jun 2023
Viewed by 1310
Abstract
Background: The use of a decision aid for choosing whether to have or not have anesthesia during childbirth has been shown to increase both knowledge about birth and the proportion of women who made their own decisions compared with women who did not [...] Read more.
Background: The use of a decision aid for choosing whether to have or not have anesthesia during childbirth has been shown to increase both knowledge about birth and the proportion of women who made their own decisions compared with women who did not use a decision aid. Herein, we updated the first version of our decision aid into a second version and evaluated this updated decision aid. We evaluated the face validity and content appropriateness of the updated decision aid developed to enhance the ability of women to choose between childbirth with or without epidural analgesia. Methods: This was a descriptive study based on a literature review of updated information for addition to the first version. PubMed and Cochrane Library were searched from 2003 to May 2021. Thereafter, obstetricians, anesthesiologists, and midwives were asked to respond to a questionnaire regarding the face validity and content appropriateness of the updated decision aid regarding whether it meets the IPDASi (Version 4.0) quality standards. Results: One obstetrician, one anesthesiologist, and three midwives who had performed epidural anesthesia for at least three years responded to the questionnaire. The responses to the evaluation items of face validity (i.e., style and clarity) were positive. There were 38 specific comments regarding content appropriateness classified into seven categories: “addition or revision of text”, “unification of expressions”, “need for explanation/information”, “lack of evidence”, “potential to mislead”, “questionable”, and “structure”. Conclusion: The face validity and content appropriateness of the updated decision aid was confirmed. The next step is evaluation of the updated decision aid by pregnant women who give birth. Full article
(This article belongs to the Section Women's Health)
15 pages, 1395 KiB  
Article
Parents’ Perceptions of Changes in Sleep Duration, Physical Activity, and Sedentary Behavior in Arab Israeli Children during the COVID-19 Outbreak
by Rafat Ghanamah, Hazar Eghbaria-Ghanamah, Nabil Abu-Saleh and Sujood Kitany
Int. J. Environ. Res. Public Health 2023, 20(11), 6041; https://doi.org/10.3390/ijerph20116041 - 2 Jun 2023
Cited by 4 | Viewed by 1524
Abstract
The COVID-19 pandemic led many countries to apply lockdown measures that could prevent children from achieving the physical activity, sedentary behavior, and sleep levels suggested for their psychophysical health. The current study tested changes in physical activity, sedentary behavior, and sleep length of [...] Read more.
The COVID-19 pandemic led many countries to apply lockdown measures that could prevent children from achieving the physical activity, sedentary behavior, and sleep levels suggested for their psychophysical health. The current study tested changes in physical activity, sedentary behavior, and sleep length of children and the incidence of achieving the 24 h movement standards through the limitations of COVID-19. A total of 490 Arab Israeli parents were surveyed. An electronic cross-sectional survey was performed, including questions addressing engagement in physical activities, use of screens, and sleep duration. Throughout the COVID-19 outbreak, time spent participating in physical activity was reduced, sedentary behavior and sleep duration were increased, and the percentage of the sample who met the physical activity and sedentary behavior suggestions lessened. The percentage of participants who attained the overall 24 h movement recommendations was very low during the pandemic; school children met the guideline recommendations for physical activity and sleep duration more than preschool children, and girls spent more time in physical activity. These findings highlight the need for strategies to enhance physical activity and decrease sedentary behavior in children to prevent long-term effects of limitations imposed by COVID-19. Efforts to perceive and encourage healthy routines in Arab Israeli children in the case of pandemic limitations are expected to serve as a precedence. Full article
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11 pages, 937 KiB  
Article
Risk Factors for Falls and Fall-Related Fractures in Community-Living Older People with Pain: A Prospective Cohort Study
by Tatsuya Hirase, Yoshiro Okubo, Kim Delbaere, Jasmine C. Menant, Stephen R. Lord and Daina L. Sturnieks
Int. J. Environ. Res. Public Health 2023, 20(11), 6040; https://doi.org/10.3390/ijerph20116040 - 2 Jun 2023
Viewed by 2000
Abstract
(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. [...] Read more.
(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Falls were monitored with monthly falls calendars for 12 months. Logistic regression analyses were performed to identify predictors of falls and fall-related fractures during a 12-month follow-up; (3) Results: Of the 389 participants, 175 (45.0%) and 20 (5.1%) reported falls and fall-related fractures during the 12-month follow-up, respectively. Greater postural sway on foam, more depressive symptoms and lower physical activity levels at baseline were associated with falls during the 12-month follow-up. Slower walking speed at baseline was associated with fall-related fractures during the 12-month follow-up. These associations remained significant after adjusting for age, sex, body mass index, comorbidities and medication use; (4) Conclusions: This study suggests poor balance, low mood and a less active lifestyle are predictors of falls, and slower walking speed predicts fall-related fractures among community-dwelling older people with pain. Full article
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13 pages, 626 KiB  
Article
Analysis and Report of the Physical and Rehabilitation Medicine Evaluation Activity in Patients Admitted to Acute Care Setting: An Observational Retrospective Study
by Andrea Bernetti, Marco Ruggiero, Pierangela Ruiu, Martina Napoli, Rossella D’Urzo, Annalisa Mancuso, Flavio Mariani, Luigi Tota, Francesco Agostini, Massimiliano Mangone and Marco Paoloni
Int. J. Environ. Res. Public Health 2023, 20(11), 6039; https://doi.org/10.3390/ijerph20116039 - 2 Jun 2023
Viewed by 1440
Abstract
Background. Disability (both temporary and transitory, or definitive) might occur for the first time in a given patient after an acute clinical event. It is essential, whenever indicated, to undergo a Physical Medicine and Rehabilitation assessment to detect disability and any need for [...] Read more.
Background. Disability (both temporary and transitory, or definitive) might occur for the first time in a given patient after an acute clinical event. It is essential, whenever indicated, to undergo a Physical Medicine and Rehabilitation assessment to detect disability and any need for rehabilitation early. Although access to rehabilitation services varies from country to country, it should always be governed by a PRM prescription. Objective. The aim of the present observational retrospective study is to describe consultancy activity performed by PRM specialists in a university hospital in terms of requests’ typology, clinical questions, and rehabilitation setting assignment. Methods. Multiple parameters were analyzed (clinical condition, patient’s socio-family background, and rehabilitation assessment scale scores) and a correlation analysis was performed between the analyzed characteristics and both the different clinical conditions and the assigned rehabilitation setting. Results. PRM evaluations of 583 patients from 1 May 2021 to 30 June 2022 were examined. Almost half of the total sample (47%) presented disability due to musculoskeletal conditions with a mean age of 76 years. The most frequently prescribed settings were home rehabilitation care, followed by intensive rehabilitation and long-term care rehabilitation. Conclusions. Our results suggest the high public health impact of musculoskeletal disorders, followed by neurological disorders. This is, however, without forgetting the importance of early rehabilitation to prevent other types of clinical conditions such as cardiovascular, respiratory, or internal diseases from leading to motor disability and increasing costs. Full article
(This article belongs to the Special Issue Musculoskeletal Injuries, Rehabilitation and Impact on Public Health)
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11 pages, 666 KiB  
Case Report
Development, Implementation and Evaluation of an Acute Care Physical Therapy ‘Float’ Placement during the COVID-19 Pandemic: A Case Report
by Jasdeep Dhir, Amy Connell, Magda McCaughan, Diana Hatzoglou, Daana Ajami, Andrea Fursman, Sarah Wojkowski and Michelle E. Kho
Int. J. Environ. Res. Public Health 2023, 20(11), 6038; https://doi.org/10.3390/ijerph20116038 - 2 Jun 2023
Viewed by 1545
Abstract
Clinical education is a mandatory component of physical therapy curricula globally. COVID-19 disrupted clinical education, jeopardizing students’ abilities to meet graduation requirements. The objective of this case report is to outline the development, implementation and evaluation of a multiple clinical instructor (CI), multiple [...] Read more.
Clinical education is a mandatory component of physical therapy curricula globally. COVID-19 disrupted clinical education, jeopardizing students’ abilities to meet graduation requirements. The objective of this case report is to outline the development, implementation and evaluation of a multiple clinical instructor (CI), multiple unit, acute care float clinical placement for a final year, entry-level physical therapy student and offer implementation recommendations. This placement included an eight-week, multiple CI (one primary, four supporting), multiple (five) unit clinical placement which was developed between St. Joseph’s Healthcare and the McMaster University Masters of Science (Physiotherapy) Program between 10 August and 2 October 2020. Student evaluations and reflections by the student and CIs were collected and analyzed using interpretive description. Analysis from the reflections revealed six themes: (1) CI and student attributes; (2) increased feasibility; (3) varied exposure; (4) central communication and resources; (5) organization; and (6) managing expectations. An acute care clinical experience is required for students in Canadian entry-to-practice physical therapy programs. Due to COVID-19, placement opportunities were limited. The float placement allowed clinicians to offer supervision despite staff re-deployment and increased organizational and work–life pressures during the pandemic. This model provides an approach to extenuating circumstances and may also increase acute care placements during non-pandemic times for physical therapy and other similarly structured healthcare professions. Full article
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17 pages, 1148 KiB  
Article
How Do We Keep our Heads above Water? An Embedded Mixed-Methods Study Exploring Implementation of a Workplace Reintegration Program for Nurses Affected by Operational Stress Injury
by Chelsea Jones, Elly O’Greysik, Brenda Juby, Shaylee Spencer, Michelle Vincent, Lorraine Smith-MacDonald, Colleen Mooney and Suzette Brémault-Phillips
Int. J. Environ. Res. Public Health 2023, 20(11), 6037; https://doi.org/10.3390/ijerph20116037 - 2 Jun 2023
Cited by 2 | Viewed by 1642
Abstract
Background: Nurses are exposed to potentially psychologically traumatic events which can lead to operational stress injuries (OSI). Workplace reintegration after an OSI can be challenging, especially with repeated exposure to potentially traumatic scenarios and workplace demands. A workplace reintegration program (RP) originally developed [...] Read more.
Background: Nurses are exposed to potentially psychologically traumatic events which can lead to operational stress injuries (OSI). Workplace reintegration after an OSI can be challenging, especially with repeated exposure to potentially traumatic scenarios and workplace demands. A workplace reintegration program (RP) originally developed for police officers may be of benefit for nurses returning to work after an OSI. The purpose of this study is to investigate the perceived need for an RP for nurses, and its potential contextualization and implementation in the nursing context using an implementation science approach. Methods: This mixed-methods study collected data via questionnaires and focus groups from acute care nurses in Canada (N = 19). Data analysis was conducted using descriptive statistics, thematic analysis, and an organizational readiness assessment. Results: Study participants indicated that formalized processes were rarely used to support nurses returning to work after time off due to mental health challenges. Themes included (1) “The Perfect Storm”: the current state of return-to-work, (2) Integral Needs, and (3) A Break in the Clouds: hope for health. Conclusions: Exploration of innovative programs such as the RP may provide additional support to nurses affected by OSIs. Further research is needed regarding workplace reintegration for nurses, and contextualization and evaluation of the RP. Full article
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17 pages, 382 KiB  
Article
Unemployment and Job Search Behavior among People with Disabilities during the First Year of the COVID-19 Pandemic in Germany
by Karsten Ingmar Paul and Alfons Hollederer
Int. J. Environ. Res. Public Health 2023, 20(11), 6036; https://doi.org/10.3390/ijerph20116036 - 2 Jun 2023
Cited by 1 | Viewed by 1836
Abstract
Not much is known about how the COVID-19 pandemic affected the labor market experiences of people with disabilities. Since they constitute a generally disadvantaged group in the labor market, it is important to scrutinize whether their position has worsened during these difficult times [...] Read more.
Not much is known about how the COVID-19 pandemic affected the labor market experiences of people with disabilities. Since they constitute a generally disadvantaged group in the labor market, it is important to scrutinize whether their position has worsened during these difficult times and how they reacted with regard to their job search behavior. We therefore used data for the year 2020 from a large German panel (Panel Arbeitsmarkt und Soziale Sicherung, PASS), in order to scrutinize the prevalence of unemployment among people with disabilities (N = 739) during the first year of the COVID-19 pandemic. The factors that affected their unemployment status were also analyzed. The study found that people with legally recognized disabilities were more often unemployed than non-disabled people, even when controlling for possible confounding factors such as age, gender, or education. This effect was significant for severe disabilities and marginally significant for minor disabilities. Additionally, the type of disability affected the probability of being unemployed, with cardiovascular diseases, mental illnesses, and musculoskeletal disorders carrying a higher risk. In terms of job-seeking behavior, unemployed people with disabilities reported using some job search methods more frequently than their non-disabled counterparts. However, the intensity of the job search did not differ significantly between the two groups. Further differences were found when analyzing the reasons for abstinence from searching for a job, with unemployed people with disabilities primarily citing health-related factors (with a frequency of over 90%). In summary, health played a pivotal role in determining disabled people’s labor market experiences during the COVID-19 pandemic. Full article
(This article belongs to the Section Occupational Safety and Health)
19 pages, 1124 KiB  
Article
The Impact of a Psychoeducational Group Program on the Mental Well-Being of Unit-Based Nurse Leaders: A Randomized Controlled Trial
by Amanda T. Sawyer, Hong Tao and Amanda K. Bailey
Int. J. Environ. Res. Public Health 2023, 20(11), 6035; https://doi.org/10.3390/ijerph20116035 - 2 Jun 2023
Cited by 2 | Viewed by 2607
Abstract
This randomized controlled trial examined the impact of a psychoeducational group program on the mental well-being of unit-based nurse leaders, specifically nurse managers and assistant nurse managers. The program was developed around the themes of resilience, insight, self-compassion, and empowerment to fight burnout [...] Read more.
This randomized controlled trial examined the impact of a psychoeducational group program on the mental well-being of unit-based nurse leaders, specifically nurse managers and assistant nurse managers. The program was developed around the themes of resilience, insight, self-compassion, and empowerment to fight burnout and enhance purposeful adaptive coping to reduce distress and improve mental wellbeing. The sample included 77 unit-based nurse leaders. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout, and job satisfaction. Paired samples t-tests and repeated measures ANOVA tests were conducted to compare outcomes at baseline to the follow-up timepoints of endpoint, one-month follow-up, three-month follow-up, and six-month follow-up. The intervention group participants showed significant improvement in post-traumatic growth between baseline and all follow-up timepoints compared to the waitlist control group. Among intervention group participants, there were also significant improvements in self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction, as well as significant reductions in perceived stress, burnout, and secondary traumatic stress. This study extends existing evidence that this psychoeducational group program can be an effective intervention for improving and protecting mental wellbeing. Among nurse leaders, it can reduce stress and burnout and improve post-traumatic growth, self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction. Full article
(This article belongs to the Special Issue Burnout in Healthcare Workers: A Public Health Issue in 21st Century)
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12 pages, 506 KiB  
Article
Health Disparities and Comparison of Psychiatric Medication Use before and after the COVID-19 Pandemic Lockdown among General Practitioner Practices in the North East of England
by Ge Yu, Eugene Y. H. Tang and Yu Fu
Int. J. Environ. Res. Public Health 2023, 20(11), 6034; https://doi.org/10.3390/ijerph20116034 - 2 Jun 2023
Viewed by 1424
Abstract
Background: Psychiatric medications play a vital role in the management of mental health disorders. However, the COVID-19 pandemic and subsequent lockdown limited access to primary care services, leading to an increase in remote assessment and treatment options to maintain social distancing. This study [...] Read more.
Background: Psychiatric medications play a vital role in the management of mental health disorders. However, the COVID-19 pandemic and subsequent lockdown limited access to primary care services, leading to an increase in remote assessment and treatment options to maintain social distancing. This study aimed to investigate the impact of the COVID-19 pandemic lockdown on the use of psychiatric medication in primary care settings. Methods: We conducted a retrospective claims-based analysis of anonymized monthly aggregate practice-level data on anxiolytics and hypnotics use from 322 general practitioner (GP) practices in the North East of England, where health disparities are known to be higher. Participants were all residents who took anxiolytics and hypnotics from primary care facilities for two financial years, from 2019/20 to 2020/21. The primary outcome was the volume of Anxiolytics and Hypnotics used as the standardized, average daily quantities (ADQs) per 1000 patients. Based on the OpenPrescribing database, a random-effect model was applied to quantify the change in the level and trend of anxiolytics and hypnotics use after the UK national lockdown in March 2020. Practice characteristics extracted from the Fingertips data were assessed for their association with a reduction in medication use following the lockdown. Results: This study in the North East of England found that GP practices in higher health disparate regions had a lower workload than those in less health disparate areas, potentially due to disparities in healthcare utilization and socioeconomic status. Patients in the region reported higher levels of satisfaction with healthcare services compared to the England average, but there were differences between patients living in higher versus less health disparate areas. The study highlights the need for targeted interventions to address health disparities, particularly in higher health disparate areas. The study also found that psychiatric medication use was significantly more common in residents living in higher health disparate areas. Daily anxiolytics and hypnotics use decreased by 14 items per 1000 patients between the financial years 2019/20 and 2020/21. A further nine items per 1000 decreased for higher health disparate areas during the UK national lockdown. Conclusions: People during the COVID-19 lockdown were associated with an increased risk of unmet psychiatric medication demand, especially for higher health disparate areas that had low-socioeconomic status. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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12 pages, 325 KiB  
Opinion
Physical Education: At the Centre of Physical Activity Promotion in Schools
by Lorraine Cale
Int. J. Environ. Res. Public Health 2023, 20(11), 6033; https://doi.org/10.3390/ijerph20116033 - 2 Jun 2023
Viewed by 2565
Abstract
Whilst recognising and advocating for the role and importance of schools and whole school approaches to the promotion of physical activity in schools, this paper argues that physical education (PE) should be at the centre of and driving schools’ efforts to promote physical [...] Read more.
Whilst recognising and advocating for the role and importance of schools and whole school approaches to the promotion of physical activity in schools, this paper argues that physical education (PE) should be at the centre of and driving schools’ efforts to promote physical activity. Various reasons are given for this, with these broadly centring on the unique goal, nature, and responsibilities of the subject with respect to promoting physically active lifestyles and health-related learning. Furthermore, there have been positive strides in recent years to support this endeavour and that serve to highlight, strengthen, and reinforce the focus and responsibility of PE in the promotion of physical activity. In light of these, it is suggested that it is a pivotal time for PE. Equally, it is accepted that PE faces some longstanding challenges that are hindering and raise questions concerning the subject’s physical activity promotion efforts. Despite this, it is contended that these should not be unsurmountable, and more recent developments should also help the subject to realise its physical activity promoting potential moving forwards. In particular, the critical importance of high-quality PE that has young people at the core is highlighted. It is concluded that it is both time and timely for the PE profession to be bold, have confidence, and grasp these opportunities and ensure that high-quality PE is central to the explicit planning and co-ordination of meaningful, coherent, relevant, and sustainable physical activity opportunities for young people in schools. Full article
(This article belongs to the Special Issue Promoting Physical Activity in and through Schools)
17 pages, 364 KiB  
Article
Studying Scripts of Women, Men and Suicide: Qualitative-Method Development and Findings from Nepal
by Silvia Sara Canetto, Andrew D. Menger-Ogle and Usha Kiran Subba
Int. J. Environ. Res. Public Health 2023, 20(11), 6032; https://doi.org/10.3390/ijerph20116032 - 1 Jun 2023
Cited by 1 | Viewed by 2441
Abstract
Information about suicidal behavior in Nepal is limited. According to official records, suicide rates were high until the year 2000 and declined thereafter. Official records are considered unreliable and a gross undercounting of suicide cases, particularly female cases. Suicide research in Nepal has [...] Read more.
Information about suicidal behavior in Nepal is limited. According to official records, suicide rates were high until the year 2000 and declined thereafter. Official records are considered unreliable and a gross undercounting of suicide cases, particularly female cases. Suicide research in Nepal has been mostly epidemiologic and hospital-based. Little is known about how suicide is understood by Nepali people in general—including dominant suicide attitudes and beliefs in Nepal. Suicide attitudes and beliefs, which are elements of a culture’s suicide scripts, predict actual suicidality. Drawing on suicide-script theory, we developed and used a semi-structured survey to explore Nepali beliefs about female and male suicide. The informants were adult (Mage = 28.4) university students (59% male). Female suicide was believed to be a response to the society-sanctioned oppression and abuse that women are subjected to, in their family and community. The prevention of female suicide was viewed as requiring dismantling ideologies, institutions, and customs (e.g., child marriage, dowry) that are oppressive to women, and ensuring that women are protected from violence and have equal social and economic rights and opportunities. Male suicide was believed to be a symptom of societal problems (e.g., unemployment) and of men’s psychological problems (e.g., their difficulties in managing emotions). The prevention of male suicide was viewed as requiring both societal (e.g., employment opportunities) and individual remedies (e.g., psychological counseling). This study’s findings suggest that a semi-structured survey can be a fruitful method to access the suicide scripts of cultures about which there is limited research. Full article
(This article belongs to the Special Issue Suicide in Asia and the Pacific)
15 pages, 1315 KiB  
Article
Social Correlates of HIV-Risky Behaviours among African Canadian Adolescents Living in British Columbia, Canada: A Secondary Data Analysis
by Emmanuela Nneamaka Ojukwu, Helen Uche Okoye and Elizabeth Saewyc
Int. J. Environ. Res. Public Health 2023, 20(11), 6031; https://doi.org/10.3390/ijerph20116031 - 1 Jun 2023
Cited by 2 | Viewed by 1694
Abstract
Studies have linked HIV-risky behaviours among young people to several socio-contextual factors. However, the social factors that might increase African Canadian adolescents’ exposure to HIV-risky behaviours, including unprotected sex and forced or multiple-sexual partnerships, have received little or no attention in the literature. [...] Read more.
Studies have linked HIV-risky behaviours among young people to several socio-contextual factors. However, the social factors that might increase African Canadian adolescents’ exposure to HIV-risky behaviours, including unprotected sex and forced or multiple-sexual partnerships, have received little or no attention in the literature. Using data from the British Columbia Adolescent Health Surveys (2003–2018) and guided by intersectionality and socio-ecological frameworks, we examined the social determinants of HIV-risky behaviours (HRB) among African Canadian adolescents in British Columbia. We observed a general decline in HRB from 2008 to 2018. However, more than half (54.5%) of the 1042 who were sexually experienced in 2018 reported having 2 or more sexual partners, and nearly half reported condom-less sex. Our results demonstrate an important need to evaluate the impacts of several social factors on health outcomes for a unique, marginalized population. Full article
(This article belongs to the Special Issue Health and Risk Behaviors in Adolescents and Youths)
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17 pages, 1208 KiB  
Article
Ecogeographic Drivers of the Spatial Spread of Highly Pathogenic Avian Influenza Outbreaks in Europe and the United States, 2016–Early 2022
by Jonathon D. Gass, Jr., Nichola J. Hill, Lambodhar Damodaran, Elena N. Naumova, Felicia B. Nutter and Jonathan A. Runstadler
Int. J. Environ. Res. Public Health 2023, 20(11), 6030; https://doi.org/10.3390/ijerph20116030 - 1 Jun 2023
Cited by 2 | Viewed by 2746
Abstract
H5Nx highly pathogenic avian influenza (HPAI) viruses of clade 2.3.4.4 have caused outbreaks in Europe among wild and domestic birds since 2016 and were introduced to North America via wild migratory birds in December 2021. We examined the spatiotemporal extent of HPAI viruses [...] Read more.
H5Nx highly pathogenic avian influenza (HPAI) viruses of clade 2.3.4.4 have caused outbreaks in Europe among wild and domestic birds since 2016 and were introduced to North America via wild migratory birds in December 2021. We examined the spatiotemporal extent of HPAI viruses across continents and characterized ecological and environmental predictors of virus spread between geographic regions by constructing a Bayesian phylodynamic generalized linear model (phylodynamic-GLM). The findings demonstrate localized epidemics of H5Nx throughout Europe in the first several years of the epizootic, followed by a singular branching point where H5N1 viruses were introduced to North America, likely via stopover locations throughout the North Atlantic. Once in the United States (US), H5Nx viruses spread at a greater rate between US-based regions as compared to prior spread in Europe. We established that geographic proximity is a predictor of virus spread between regions, implying that intercontinental transport across the Atlantic Ocean is relatively rare. An increase in mean ambient temperature over time was predictive of reduced H5Nx virus spread, which may reflect the effect of climate change on declines in host species abundance, decreased persistence of the virus in the environment, or changes in migratory patterns due to ecological alterations. Our data provide new knowledge about the spread and directionality of H5Nx virus dispersal in Europe and the US during an actively evolving intercontinental outbreak, including predictors of virus movement between regions, which will contribute to surveillance and mitigation strategies as the outbreak unfolds, and in future instances of uncontained avian spread of HPAI viruses. Full article
(This article belongs to the Special Issue 2nd Edition: Infectious Disease Modeling in the Era of Complex Data)
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19 pages, 428 KiB  
Article
Burnout and Brownout in Intensive Care Physicians in the Era of COVID-19: A Qualitative Study
by Léa Baillat, Emilie Vayre, Marie Préau and Claude Guérin
Int. J. Environ. Res. Public Health 2023, 20(11), 6029; https://doi.org/10.3390/ijerph20116029 - 1 Jun 2023
Cited by 1 | Viewed by 1404
Abstract
The health crisis has had a strong impact on intensive care units. The objective of this study was to investigate the experience of resuscitation physicians during the COVID-19 health crisis to understand the associated determinants of quality of life, burnout, and brownout. This [...] Read more.
The health crisis has had a strong impact on intensive care units. The objective of this study was to investigate the experience of resuscitation physicians during the COVID-19 health crisis to understand the associated determinants of quality of life, burnout, and brownout. This qualitative, longitudinal study covered two periods (T1, February 2021, and T2, May 2021). The data were collected in individual semi-directed interviews with 17 intensive care physicians (ICPs) (T1). Nine of the latter also participated in a second interview (T2). The data were examined using grounded theory analysis. We identified a multiplication of burnout and brownout indicators and factors already known in intensive care. In addition, burnout and brownout indicators and factors specific to the COVID-19 crisis were added. The evolution of professional practices has disrupted the professional identity, the meaning of work, and the boundaries between private and professional life, leading to a brownout and blur-out syndrome. The added value of our study lies in identifying the positive effects of the crisis in the professional domain. Our study revealed indicators and factors of burnout and brownout associated with the crisis among ICPs. Finally, it highlights the beneficial effects of the COVID-19 crisis on work. Full article
(This article belongs to the Special Issue Occupational Health Psychology: From Burnout to Well-Being)
19 pages, 549 KiB  
Systematic Review
The Effectiveness of Health-Oriented Interventions and Health Promotion for Unemployed People—A Meta-Analysis
by Karsten Ingmar Paul and Alfons Hollederer
Int. J. Environ. Res. Public Health 2023, 20(11), 6028; https://doi.org/10.3390/ijerph20116028 - 1 Jun 2023
Cited by 3 | Viewed by 2140
Abstract
Background: Unemployment is known to have negative effects on mental and physical health. Yet, the effectiveness of interventions aimed at improving the health of unemployed people is unclear. Methods: We conducted a random-effects meta-analysis of extant intervention studies with at least two measurement [...] Read more.
Background: Unemployment is known to have negative effects on mental and physical health. Yet, the effectiveness of interventions aimed at improving the health of unemployed people is unclear. Methods: We conducted a random-effects meta-analysis of extant intervention studies with at least two measurement points and a control group. A literature search in PubMed, Scopus, and PsycINFO in December 2021 identified 34 eligible primary studies with 36 independent samples. Results: For mental health, the average meta-analytic effect sizes for the comparison of the intervention group and the control group were significant and of small size after the intervention, d = 0.22; 95% CI [0.08, 0.36], as well as at follow-up, d = 0.11; 95% CI [0.07, 0.16]. Effects on self-assessed physical health status were small and marginally significant (p = 0.10) after the intervention: d = 0.09; 95% CI [−0.02, 0.20], and insignificant at follow-up. However, when job search training was not part of the intervention program (i.e., all available resources were used solely for health promotion), the average effect size for physical health was significant after the intervention, d = 0.17; 95% CI [0.07, 0.27]. Furthermore, the effects of physical activity promotion were significant and of small-to-medium size after the intervention, leading to increased levels of activity, d = 0.30; 95% CI [0.13, 0.47]. Conclusions: Population-based health promotion programs are recommended because even measures with small effect sizes can actually improve the health of a large group of unemployed people. Full article
(This article belongs to the Special Issue Health Risks and Health Promotion among Unemployed People)
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10 pages, 347 KiB  
Opinion
Physical Activity Intensity Measurement and Health: State of the Art and Future Directions for Scientific Research
by Juan Pablo Rey-López, Dong Hoon Lee, Gerson Ferrari, Edward Giovannucci and Leandro F. M. Rezende
Int. J. Environ. Res. Public Health 2023, 20(11), 6027; https://doi.org/10.3390/ijerph20116027 - 1 Jun 2023
Viewed by 2016
Abstract
Physical activity guidelines for health recommend any type of unstructured physical activity for health promotion. Adults should perform at least 150–300 min per week of moderate intensity or 75–150 min per week of vigorous intensity activities, or an equivalent combination of the two [...] Read more.
Physical activity guidelines for health recommend any type of unstructured physical activity for health promotion. Adults should perform at least 150–300 min per week of moderate intensity or 75–150 min per week of vigorous intensity activities, or an equivalent combination of the two intensities. However, the relationship between physical activity intensity and longevity remains a debated topic, with conflicting perspectives offered by epidemiologists, clinical exercise physiologists or anthropologists. This paper addresses the current known role of physical activity intensity (in particular vigorous versus moderate intensity) on mortality and the existing problems of measurement. Given the diversity of existing proposals to categorize physical activity intensity, we call for a common methodology. Device-based physical activity measurements (e.g., wrist accelerometers) have been proposed as a valid method to measure physical activity intensity. An appraisal of the results reported in the literature, however, highlights that wrist accelerometers have not yet demonstrated sufficient criterion validity when they are compared to indirect calorimetry. Novel biosensors and wrist accelerometers will help us understand how different metrics of physical activity relates to human health, however, all these technologies are not enough mature to provide personalized applications for healthcare or sports performance. Full article
(This article belongs to the Section Exercise and Health)
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