Int. J. Environ. Res. Public Health, Volume 20, Issue 13 (July-1 2023) – 130 articles

Coparenting competence (CC) is a concept that describes the sense of collective efficacy that parents experience in raising children. An advantage of CC is that it bridges a gap between family systems thinking and efficacy theory, where extant research and theory have focused on the self-efficacy of one or both parents. This study aimed to develop a self-reported measure of CC. Methodology: Participants (n = 302), including cohabiting mothers (n = 240) and fathers (n = 62), completed an online survey (112 items) comprising demographic questions, the Coparenting Relationship Scale (CRS), the Parenting Sense of Competence Scale (PSOC), the Strengths and Difficulties Questionnaire (SDQ), and 36 items designed to explore perceptions of CC. Results: Factor analyses on 36-CC items identified 10 items that reliably formed a brief Coparenting Competence Scale (CCS; Alpha = 0.89). Analysis of convergent and divergent validity demonstrated that the CCS measures a unique construct that is linked to parenting self-efficacy, measured by PSOC (r = 0.47), and coparenting quality, assessed by the CRS (r = 0.63). There was a significant association between CCS and SDQ across age groups and an association stronger than that found for the CRS and SDQ in the current cohort. Conclusions and Implications: The study found support for the reliability and validity of the CCS. Coparenting competence, assessed by the CCS, was found to be distinct from factors previously used to represent coparenting quality in multivariate scales. The strength of associations between the CCS and SDQ suggests this new measure may have an important role in coparenting research. Full article

There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live. Full article

Maternal mortality in Ethiopia was estimated to be 267 per 100,000 live births in 2020. A significant number of maternal deaths occur in the emerging regions of the country: Afar, Somali, Gambela, and Benishangul-Gumuz. Achieving the Sustainable Development Goal (SDG) target requires a dramatic increase in maternal healthcare utilisation during pregnancy, childbirth, and the postpartum period. Yet, there is a paucity of evidence on the continuum of maternity care utilisation in Ethiopia, particularly in the emerging regions. Therefore, this study aimed to assess completion and factors associated with the continuum of maternity care in the emerging regions of Ethiopia. This study used the 2019 Ethiopian Demographic and Health Survey data (n = 1431). Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with the completion of the continuum of maternity care. An adjustment was made to the survey design (weight, stratification, and clustering). 9.5% (95% Confidence Interval (CI): 7.0–13.0) of women completed the continuum of maternity care (four or more antenatal care, institutional delivery, and postnatal care within 24 h). Living in Somali (adjusted Odds Ratio (aOR): 0.23, 95%CI: 0.07–0.78) and Benishangul-Gumuz (aOR 3.41, 95%CI: 1.65–7.04) regions, having a secondary and higher educational level (aOR 2.12, 95%CI: 1.13–4.00), and being in the richest wealth quintile (aOR 4.55, 95%CI: 2.04–10.15) were factors associated with completion of the continuum of maternity care. Although nearly half of the women had one antenatal care, fewer than 10% completed the continuum of maternity care. This indicates that women in these regions are not getting the maximum health benefits from maternal healthcare services, and this might contribute to the high maternal death in the regions. Moreover, the completion of the continuum of maternity care was skewed toward women who are more educated (secondary or higher education) and in the richest quintile. Full article

Coronavirus disease 2019 (COVID-19) has been associated with a variety of psychiatric symptoms. However, COVID-19’s association with psychiatric symptoms after the acute illness phase is not fully understood. Thus, this study sought to examine symptoms of depression and generalized anxiety and associated factors in the period following COVID-19 infection. A cross-sectional study design was conducted in three governorates of the Iraqi Kurdistan region. Face-to-face interviews were held between the period of 15 September and 20 December 2021 with both those who had been infected with COVID-19 and those who had not. Depression symptomology was assessed using the 9-item Patient Health Questionnaire and levels of anxiety were measured using the 7-item Generalized Anxiety Disorder scale. A total of 727 participants were recruited. The bulk of the respondents (n = 454) reported having a past COVID-19 infection, of whom a considerable proportion (82%) had mild–moderate symptoms. More than half of the infected respondents (53.3%) stated they were treated at home. The mean score of generalized anxiety was higher among the infected group compared to the non-infected group t(725) = 2.538, p = 0.011. Factors such as older age, female gender, unemployment, previous psychological problems, and diabetes mellitus were strongly associated with symptoms of depression and anxiety post-COVID-19 infection. Additionally, anxiety was associated with a longer duration of post-COVID symptoms. The majority of the study population had mild to moderate levels of post-COVID-19 depression and anxiety. Psychological education and interventions are required to reduce the psychological burden of post-COVID-19 symptoms among the general population. Full article

Owing to the COVID-19 pandemic, organizations worldwide have implemented remote working arrangements that have blurred the work–family boundaries and brought to the forefront employees’ sense of disconnectedness from their workplace (i.e., organizational disconnectedness) as a concern for multiple organizational outcomes. Cynicism, a job burnout subdimension, refers to a negative and excessively detached response to relational overload at work. While both workplace disconnectedness and cynicism involve a toxic sense of detachment, they refer to different psychological mechanisms. The present study aims to examine how employee workplace disconnectedness differs from their cynicism, and how both constructs differentially exert their detrimental effects on employee performance, work–family interface, and wellbeing. Using anonymous survey data collected online in 2021 and 2022 from a sample of in-person and flexible workers nested within organizations, conceptual distinctiveness between workplace disconnectedness and cynicism was supported. Measurement invariance across the two groups was supported, and subsequent structural invariance analyses suggested a similar pattern of results for flexible and in-person workers. Specifically, compared to disconnectedness, cynicism exerted higher negative effects on mental health and higher positive effects on cognitive failures and family-to-work conflict. Conversely, compared to cynicism, disconnectedness exerted higher negative effects on performance and work-to-family conflict. That is, feeling indifferent toward others particularly affects mental health and errors, while feeling excluded especially hampers productivity and family life. Theoretical and practical (e.g., inclusive leadership, support groups) implications of these results are discussed in light of the globally rising rates of hybrid work arrangements and related costs for employee wellbeing and productivity. Full article

It is essential to equip midwives and nurses working in the perinatal period with comprehensive knowledge and awareness regarding child abuse prevention. However, most midwives and nurses in Japan do not have the opportunity to learn about abuse prevention during their basic education. We aimed to develop an e-learning program to assist obstetric midwives and nurses in acquiring the knowledge needed to provide support and handle cases with a high risk of abuse, as well as to assess the program’s usefulness. This study employed a single-group pre–post design; e-learning served as the intervention. Seventy-one obstetric midwives and nurses were recruited. The program’s usefulness was the difference between the participants’ pretest and post-test knowledge and efficacy scores. The score data were analyzed using the t-test. A paired t-test revealed that the post-test scores of knowledge and efficacy were significantly higher than those of the pretest, with a large effect size (d = 1.71). Platforms where basic knowledge on how to respond to high-risk abuse cases are lacking in nursing education; thus, this e-learning program is recommended for nurses working in the perinatal field throughout Japan. This educational opportunity for perinatal midwives and nurses will increase awareness and contribute to abuse prevention. Full article

Although rotator cuff injures are often associated with a limited range of motion and muscle weakness, being able to conduct pain-free and efficient performances of the activities as part of daily living seems to be more important for patients. The aim of this study was to investigate the correlation between two questionnaires—the disease-specific, subjective questionnaire termed the Western Ontario Rotator Cuff Index (WORC), and the shoulder-specific, subjective-objective questionnaire Constant–Murley score (CMS), with the objective assessment of external rotator muscle strength, and the subjective assessment of pain according to the visual analog scale (VAS) in patients after arthroscopic rotator cuff repair. The study was carried out among 47 patients twice—6 and 12 months after surgery, respectively. All patients completed the WORC, the CMS, and the VAS. Isokinetic evaluation of the external rotators was performed using the Biodex 4 ProSystem. The correlations of all assessed muscle strength parameters with both the CMS and the WORC were found to be statistically significant, being mostly average during the 1st examination and mostly strong during the 2nd examination. There was a significant improvement in all assessed tools as a result of the undertaken rehabilitation. There were weak correlations present between changes in the WORC and changes in the external rotator muscle strength, with correlations between WORC-Sport and EXT90⁰-AVERAGE-POWER and PEAK-TORQUE also being found statistically significant. Correlations of changes in the CMS scale with changes in the external rotator muscle strength were weak and statistically insignificant. It seems that the WORC questionnaire can be recommended more for the population after rotator cuff repair, which allows for a reliable assessment of patients’ ability to function and its changes in various areas of life, and at the same time does not require a direct assessment by a clinician or researcher. Full article

The main goal of the current study was to examine the direct and moderating effects of civic discussions with parents and environmental sensitivity using both the total score and its specific dimensions (i.e., Aesthetic Sensitivity, AES; Ease of Excitation, EOE; Low Sensitivity Threshold, LST) on youth civic engagement (attitudes and behaviours). The empirical analysis relied on a questionnaire-based survey conducted on a sample of 438 adolescents (30% males), aged between 14 and 18 years (M = 16.50, SD = 1.36). We used a structural equation model (SEM) with latent variables and the latent moderated structural equation (LMS) method to test our hypotheses. Our results showed that civic discussions with parents were positively and significantly associated with general environmental sensitivity and with AES and predicted both civic attitudes and civic behaviours; EOE was negatively and significantly related to civic behaviours; AES was positively and significantly related to civic attitudes; and LST was not significantly related to either civic attitudes or behaviours. Contrary to our expectations, environmental sensitivity did not moderate the relationship between civic discussions with parents and civic engagement. Our study further highlights the relevance that parents have in shaping their children’s civic engagement and makes a novel contribution regarding how differences in perceiving and processing environmental stimuli can affect beliefs and behaviours toward community issues among young individuals. Full article

Background: In this study, the annual leukemia mortality rate is estimated by occupational groups potentially exposed to benzene in Brazil and compared to non-exposed workers by sex. Methods: Data were extracted from the Mortality Information System and the National Institute of Geography and Statistics from 2006 to 2011. Occupational groups exposed to benzene were defined by using the Finnish Job-Exposure Matrix, FINJEM. Results: We found 21,049 leukemia deaths in 1917 in occupational groups potentially exposed to benzene, corresponding to an annual average mortality rate of 4.5/100,000, higher than the estimate for non-exposed workers: 2.6/100,000, corresponding to a Mortality rate ratio MRR = 1.7. Each benzene-exposed occupational group had increased leukemia mortality, and printers and occupations in graphics presented the highest MRR (2.7), followed by laboratory assistants (MRR = 2.6), laundry workers, chemists, and upholsterers, each of these occupational groups presenting MRR = 2.3. Conclusions: Benzene shows the need for better enforcement of protective norms against this known carcinogen. Our results support the need for better enforcement of protective norms to reduce benzene exposure. Full article

The extant literature on the U.S. SARS-CoV-2 virus indicates that the vaccination campaign was lagging, insufficient, and uncoordinated. This study uses the spatial model to identify the drivers of vaccine hesitancy (in the middle of the pandemic), one of the critical steps in creating impactful and effective interventions to influence behavioral changes now and in the future. The applied technique accounted for observed and unobserved homogeneity and heterogeneity among counties. The results indicated that political and religious beliefs, quantified by Cook’s political bipartisan index and the percentage of the population affiliated with the main Christian groups, were the main drivers of the SARS-CoV-2 vaccine hesitancy. The past vaccination experience and other variables determining the demand and supply of vaccines were also crucial in influencing hesitancy. The results imply that vaccination campaigns require engaging community leaders at all levels rather than depending on politicians alone and eliminating barriers to the supply and demand of vaccines at all levels. Coordination among religious and community leaders would build a practical institutional arrangement to facilitate (rather than frustrate) the vaccination drives. Full article

The coronavirus disease 2019, or COVID-19, has impacted countless aspects of everyday life since it was declared a global pandemic by the World Health Organization in March of 2020. From societal to economic impacts, COVID-19 and its variants will leave a lasting impact on our society and the world. During the height of the pandemic, it became increasingly evident that indices, such as the Center for Disease Control’s (CDC) Social Vulnerability Index (SVI), were instrumental in predicting vulnerabilities within a community. The CDC’s SVI provides important estimates on which communities will be more susceptible to ‘hazard events’ by compiling a variety of data from the U.S. Census and the American Community Survey. The CDC’s SVI does not directly consider the susceptibility of a community to a global pandemic, such as the COVID-19 pandemic, due to the four themes and 15 factors that contribute to the index. Thus, the objective of this research is to develop a COVID-19 Vulnerability Index, or CVI, to evaluate a community’s susceptibility to future pandemics. With 15 factors considered for CDC’s SVI, 26 other factors were also considered for the development of the CVI that covered themes such as socioeconomic status, environmental factors, healthcare capacity, epidemiological factors, and disability. All factors were equally weighted to calculate the CVI based on New Jersey. The CVI was validated by comparing index results to real-world COVID-19 data from New Jersey’s 21 counties and CDC’s SVI. The results present a stronger positive linear relationship between the CVI and the New Jersey COVID-19 mortality/population and infection/population than there is with the SVI. The results of this study indicate that Essex County has the highest CVI, and Hunterdon County has the lowest CVI. This is due to factors such as disparity in wealth, population density, minority status, and housing conditions, as well as other factors that were used to compose the CVI. The implications of this research will provide a critical tool for decision makers to utilize in allocating resources should another global pandemic occur. This CVI, developed through this research, can be used at the county, state, and global levels to help measure the vulnerability to future pandemics. Full article

Robust social resources that lead to a healthy sense of belonging are imperative during emerging adulthood. However, young adults with alternative care experience, such as residential or foster care, often lack the social resources necessary to transition to adulthood successfully. Though some research has examined the importance of social resources in this population, less is known about a sense of belonging, which is associated with these social resources. The current study examined the association between care experience, belonging, and well-being outcomes among emerging adults (n = 703) who were separated from their biological parents during care and received alternative care in 16 nations. The presence of belonging was associated with type of alternative care, age at separation, and reason for separation. There was also an association between belonging and well-being outcomes, including homelessness and suicidal ideation. Adults lacking a sense of belonging reported higher rates of homelessness and suicidal ideation, lower life satisfaction, and lower resilience. The study has global implications for enhancing social support for emerging adults with care experience in order to facilitate a sense of belonging as a social resource. Full article

Since the outbreak of COVID-19, researchers and clinicians have published scientific articles on the SARS-CoV-2 virus and its medical, organizational, financial, and psychological implications. However, many effects have been observed in the post-lockdown scenario. In this study, we adopted a scientometric–bibliometric approach to drawing the state of the art regarding the emotional and psychological effects of the pandemic after the lockdown. In Scopus, we found 791 papers that were subsequently analyzed using CiteSpace. The document co-citation analysis (DCA) computation generated a network of eight major clusters, each representing a central area of investigation. Specifically, one major cluster—cluster no. 1—focuses on the long-term effects of the COVID-19 pandemic and individuals’ ability to develop adaptive coping mechanisms and resilience. The results allow us to frame the fields covered by researchers more precisely and the areas that still need more investigation. Full article

Malaria is the most widespread endemic disease in Cameroon, and asymptomatic Plasmodium (gametocyte) carriers (APCs) constitute more than 95% of infectious human reservoirs in malaria endemic settings. This study assesses the knowledge of asymptomatic malaria (ASM) among health care workers (HCWs) in health facilities (HFs) in the Centre Region of Cameroon and the acceptability of using Artemisia afra tea to treat APCs. A cross-sectional descriptive survey was conducted among 100 HCWs, in four randomly selected HFs in the Centre Region, in the period of 1–20 April 2022, using semi-structured self-administered questionnaires. Logistic regression analyses were performed to determine factors associated with knowledge. More than seven in eight (88%) respondents were aware of the existence of ASM, 83% defined ASM correctly, 75% knew how it was diagnosed, 70% prescribe ACTs for APCs, and 51.1% were informed about ASM transmission. The professional category of HCWs was significantly associated with their knowledge of the existence and transmission of ASM, and longevity of service was associated with knowledge of transmission (p < 0.05). Two-thirds (67%) of respondents knew about Artemisia afra tea, 53.7% believed that it was effective in treating ASM, and 79% were willing to prescribe it if authorized. There was a fair level of knowledge of ASM among HCWs in the study settings. Full article

Introduction: Athletes have demonstrated a significant increase in anxiety and stress connected to the COVID-19 pandemic. Drawing on the theory of salutogenesis, this study examined the relationship between the sense of coherence and social support and competitive elite-level athletes’ perception of the COVID-19 pandemic situation. Materials and Methods: The perceived secondary gains associated with the pandemic were analysed with a quasi-qualitative research methodology. The sample consisted of 204 competitive elite-level female football players aged 14–36 (M = 17.61, SD = 4.42) who completed the Sense of Coherence Questionnaire (SOC-29), the Berlin Social Support Scales (BSSS), and the researchers’ own questionnaire to assess the perception of the COVID-19 situation. Results: The results confirmed a relationship between a sense of coherence and coping better with the difficult situation caused by the coronavirus pandemic. No protective role of social support in the adaptive perception of the pandemic situation was identified. Conclusions: The data from the quasi-qualitative study testify to the use of the adversity of the pandemic to grow in many areas of female football players’ lives. The sense of coherence was a protective factor in mitigating the negative consequences of the COVID-19 pandemic situation. Full article

Little is known about occupational SARS-CoV-2 exposures and COVID-19 outcomes. We established a Doctor’s First Reports of Occupational Injury or Illness (DFR)-based surveillance system to study cases of work-related COVID-19 exposures and disease. The surveillance data included demographics, occupation, industry, exposure, and illness, details including hospitalization and lost work. We classified workers into ‘healthcare’, non-healthcare ‘public-facing’, or ‘other’ worker groups, and rural–urban commuting areas (RUCAs). We describe worker exposures and outcomes overall by worker group and RUCA. We analyzed 2848 COVID-19 DFRs representing workers in 22 detailed occupation groups and 19 industry groups. Most DFRs were for workers in metropolitan RUCAs (89%) and those in healthcare (42%) and public-facing (24%) worker groups. While DFRs were from 382 unique worksites, 52% were from four hospitals and one prison. Among 1063 DFRs with a suspected exposure, 73% suspected exposure to a patient or client. Few DFRs indicated hospitalization (3.9%); however, the proportion hospitalized was higher among nonmetropolitan (7.4%) and public-facing (6.7%) workers. While 56% of DFRs indicated some lost work time, the proportion was highest among public-facing (80%) workers. Healthcare and prison workers were the majority of reported occupational COVID-19 exposures and illnesses. The risk of COVID-19 hospitalization and lost work may be highest among nonmetropolitan and public-facing workers. Full article

Skin cancer is the most common cancer in Canada, and rates continue to rise. While sunscreen and protective clothing remain critical strategies to reduce skin cancer risk, shade is generally the most effective way to control exposure. There remains a lack of data, particularly in British Columbia (BC), demonstrating the extent to which shade availability reduces ultraviolet radiation (UVR) exposure in a real-world setting and the potential impacts of shade provision on physical activity. We evaluated the impact of shade structures on UVR exposure and physical activity at a Vancouver-area childcare center with an outdoor play area with limited existing shade. 22 children, aged 3–5 years, participated in the study. Three removable shade sails were installed in the outdoor play space, and UVR and physical activity measurements were collected during the spring, summer, and fall months. Ultraviolet B (UVB) radiation data was measured using UVB dosimeters, and physical activity data was measured using accelerometers. Data were collected during each season over a total of four days—two days with shade sails installed and two days with shade sails removed. Overall, with shade installation, UVR exposures and physical activity levels among children were reduced by 50% and 20%, respectively. This study supports the use of shade sails to significantly reduce UVR exposures among preschool-aged children in BC; however, the potential for decreased physical activity from shade sails should be further explored in future research. Full article

It is an assumption that physically active adults lead an overall healthy lifestyle. To examine this assumption, we administered a cross-sectional, web-based survey to a sample of young-to-middle-aged US adults between 18 and 49 who self-reported participation in at least one recreational sporting event in the past month. Logistic regressions were conducted to examine demographic characteristics associated with cancer risk and protective behaviors. Gender was represented equally (N = 938), and the average age was 32 years (SD: 8.4). Most participants reported >three days of moderate- to high-intensity physical activity (79%), but not meeting fruit and vegetable consumption guidelines (78%). Many reported current tobacco use (32%), binge drinking at least once in the past 30 days (62%), and suboptimal sun protection use (67%). Participation in lifestyle-related cancer risk and protective behaviors varied based on age, sex, education, routine doctor visits, perceived overall health, health-information-seeking behavior (how participants obtained health information), or team-based sport participation in regression models. Future interventions should be tailored to address varied cancer risk profiles among even physically active adults to encourage multiple healthy behavior changes. Full article

The assessment of disability-related costs among children remains a largely under-researched subject with related questions rarely included in surveys. This paper addresses this issue through a unique mixed methods study conducted in the Philippines combining a nationally representative survey and in-depth interviews with families and health professionals. To quantify the extra costs associated with disabilities, the research used the standard of living approach, whereby expenditure levels of families with children with and without disabilities were compared in relation to different measures of living standards. The results find consistent evidence of high extra costs among households that have children with disabilities and point to health expenses as the leading source. Using an asset index as the indicator of living standards, a child with a disability is estimated to require between 40% and 80% extra expenditure to reach the same living standard of other children. However, the size of extra costs is substantially higher when the measure of the standard of living relies on a broader set of deprivations. In such cases, higher estimates of extra costs are likely to be the result of the lack of an inclusive environment. Critically, this points to the need to provide not only financial support but also inclusive services, especially in health and education. Full article

Affecting millions of individuals yearly, malaria is one of the most dangerous and deadly tropical diseases. It is a major global public health problem, with an alarming spread of parasite transmitted by mosquito (Anophele). Various studies have emerged that construct a mathematical and statistical model for malaria incidence forecasting. In this study, we formulate a generalized linear model based on Poisson and negative binomial regression models for forecasting malaria incidence, taking into account climatic variables (such as the monthly rainfall, average temperature, relative humidity), other predictor variables (the insecticide-treated bed-nets (ITNs) distribution and Artemisinin-based combination therapy (ACT)) and the history of malaria incidence in Dakar, Fatick and Kedougou, three different endemic regions of Senegal. A forecasting algorithm is developed by taking the meteorological explanatory variable $X_j$ at time $t-{𝓁}_j$, where t is the observation time and ${𝓁}_j$ is the lag in $X_j$ that maximizes its correlation with the malaria incidence. We saturated the rainfall in order to reduce over-forecasting. The results of this study show that the Poisson regression model is more adequate than the negative binomial regression model to forecast accurately the malaria incidence taking into account some explanatory variables. The application of the saturation where the over-forecasting was observed noticeably increases the quality of the forecasts. Full article

Pacific Islanders residing in the U.S. Affiliated Pacific Islands have had among the highest COVID-19-associated morbidity and mortality rates in the U.S. To reduce this disparity, we conducted a study to increase the reach and uptake of COVID-19 testing in Guam. Participants, who completed a pre-survey on demographics, health status, history of COVID-19 testing and vaccination, access to COVID-19 testing, sources of COVID-19 information, and knowledge and attitudes towards COVID-19 test results and transmission, were invited to attend an online educational session about COVID-19 testing and transmission and to complete a post-survey. There were significant positive changes between pre- and post-survey in knowledge and perceptions about COVID-19 testing and transmission, but changes were not necessarily due to exposure to the educational session. Compared to CHamoru participants (n = 380), Other Micronesians (n = 90) were significantly less knowledgeable about COVID-19 transmission and testing, were significantly more likely to not want to know if they had COVID-19, were more likely to believe if they did have COVID-19 there was not much that could be done for them, and that they would have difficulty in getting the needed healthcare. This study is another example of disparities in health knowledge and perceptions of certain Pacific Islander groups. Full article

The aim of this observational study was to investigate the level and association of physical activity and selected chronic diseases in functionally independent LTC residents after prolonged physical and social isolation during COVID-19 in Croatia. Adhering to the inclusion criteria, 180 functionally independent residents were included in the study. Assessment of physical activity was carried out by 7-day motor monitoring. Prolonged physical and social isolation negatively affected the achieved level of physical activity of LTC residents ($\overline{\mathrm{x}}$ = 5058.74). Major depressive disorder resulted in significantly lower residents’ physical activity scores, demonstrating a shrinking effect ranging from 0.42 to 0.45. A significant negative impact on the residents’ physical activity was also found in the presence of osteoarthritis and iron deficiency anemia, where a downward effect was present in the range from 0.66–0.72 and 0.64 to 0.66. The presence of comorbidities has a significant negative impact on the residents’ physical activity, where a downward effect is present in the range from 0.91–0.92. Full article

Research focused on elucidating moral injury amongst healthcare workers (HCWs) is essential due to the deep connection with morality and individuals’ overall wellbeing. Examining moral injury provides an avenue through which researchers can connect individual experiences with systemic level causes (i.e., structural power imbalances between clinicians and health systems) to better study workplace wellbeing. The omnipresence of the COVID-19 pandemic has amplified the need to study moral injury. This paper describes a systematic review conducted using PRISMA-P guidelines to answer the question, “what is the association between moral injury and professional wellbeing and mental health amongst healthcare workers.” Twelve databases were searched to identify specified studies. This study’s criteria included: (1) articles published through December 2022; (2) qualitative and quantitative empirical studies; (3) articles written in English; (4) articles including moral injury; and (5) articles including at minimum one other measure of professional or personal wellbeing. The initial search produced 248 articles, and 18 articles were ultimately included in the final review. To confirm that no articles were left out of this study, the first author of each included article was contacted to inquire about any additional works that met the inclusion criteria of this study. The elements of the 18 included articles described in this review are discussed. The results indicate that moral injury is associated with both professional wellbeing factors and mental health outcomes. Further theoretical development, including (professional- and identity-based) exploratory research on moral injury, and evidenced-based interventions for moral injury are needed. Full article

This study examines the impact of interventions aimed at improving psychosocial health on students’ perception of a caring school climate, their feelings of loneliness, and school completion in Norwegian upper secondary education. Two intervention conditions were tested: a universal single-tier intervention focused on improving the psychosocial school climate: the Dream School Program, and a multi-tier intervention combining the Dream School Program with a targeted measure, the Mental Health Support Team. The direct and indirect effects of these interventions on school completion were analyzed using structural equation models (SEM), with data from 1508 students (mean age at Time 1: 17.02 (SD = 0.92); 60.7% girls; 72.1% Norwegian-born). The results indicated that loneliness levels did not differ significantly between the intervention conditions. However, students in the multi-tier intervention group reported a significantly higher perception of a caring school climate compared to those in the single-tier intervention group. The multi-tier intervention group had a lower rate of school completion compared to the control group and the single-tier intervention group. The SEM analysis revealed that the multi-tier intervention reduced loneliness in the second year of upper secondary school by promoting a caring school climate in the first school year. In contrast, the single-tier intervention was associated with increased loneliness due to a decrease in the perception of a caring school climate. The implications of these findings are discussed. Full article

While gestational physical activity (PA) has demonstrated health benefits for both birthing parent and fetus, the mechanisms still need to be fully understood. Placental macrophages, or Hofbauer cells (HBCs), comprise a heterogenous population containing inflammatory (CD206-) and anti-inflammatory (CD206+) phenotypes. Similar to other tissue-resident macrophages (TRMs), HBCs are potential mediators of angiogenesis due to their secretion of both pro- and anti-angiogenic factors, including FGF2, VEGF, and SPRY2. While PA is associated with an increase in the proportion of VEGF- and FGF2-producing CD206+ macrophages in other tissues, the phenotypes producing FGF2, VEGF, and SPRY2 in the placenta and the associated relationships with gestational PA have not been studied. Using accelerometry, pregnant participants were classified as physically active or inactive in mid- and late-gestation. Term placenta tissue was collected at delivery and used for Western blotting and immunofluorescence to examine the protein expression of FGF2 and SPRY2, and to localize FGF2 in histological samples, respectively. Primary cultures of HBCs were used to examine the phenotypic differences in FGF2, SPRY2, and VEGF production. While no differences in the placental expression of SPRY2, total FGF2, or high-molecular-weight FGF2 were observed based on PA status, active individuals had significantly reduced levels of low-molecular-weight FGF2. Additionally, HBCs of all polarizations produce VEGF, FGF2, and SPRY2, and can form intercellular junctions and multinucleated giant cells. These findings suggest a possible relationship between PA and HBC-driven angiogenesis, providing an avenue for future exploration. Full article

Early onset Non-Communicable Diseases (NCDs), including obesity, allergies, and mental ill-health in childhood, present a serious and increasing threat to lifelong health and longevity. The ORGINS Project (ORIGINS) addresses the urgent need for multidisciplinary efforts to understand the detrimental multisystem impacts of modern environments using well-curated large-scale longitudinal biological sample collections. ORGINS is a prospective community birth cohort aiming to enrol 10,000 pregnant people and follow each family until the children reach 5 years of age. A key objective is to generate a comprehensive biorepository on a sub-group of 4000 families invited to contribute blood, saliva, buccal cells, urine, stool, hair, house dust, cord blood, placenta, amniotic fluid, meconium, breastmilk, and colostrum over eight timepoints spanning the antenatal period and early childhood. Uniquely, ORIGINS includes a series of nested sub-projects, including interventions and clinical trials addressing different aspects of health. While this adds complexity as the project expands, it provides the opportunity for comparative studies. This research design promotes a multidisciplinary, multisystem approach to biological sample collection, analysis, and data sharing to ensure more integrated perspectives and solutions. This paper details the evolving protocol of our collaborative biobanking concept. Further, we outline our future visions for local, national, and ultimately international, comparative, and collaborative opportunities to advance our understanding of early onset NCDs and the opportunities to improve health outcomes for future generations. Full article

Background: The positive role of dispositional awe has been seen in personality and in health. However, its impact on self-worth and internal mechanisms have been unclear. Purposes: This study explored the relationship between dispositional awe and self-worth and the roles of self-concept clarity and the small self in this association. Methods: With a cluster sampling, a cross-sectional sample of 1888 Chinese undergraduates were recruited from Fuzhou, a southeast coastal city in the P.R.C. All the data were analyzed with Pearson’s correlations and the structural equation model (SEM) based on SPSS 25.0 and Mplus 8.1. Results: Dispositional awe was positively correlated with both personal-oriented and social-oriented self-worth (r_s = 0.12, 0.27) and was also positively correlated with small self (r = 0.33) but negatively correlated with self-concept clarity (r = −0.18); in the full model, the direct effect of dispositional awe on society-oriented self-worth was 0.36 (75%); the indirect effects of small self and self-concept clarity were −0.09 (18.8%) and −0.01 (2.1%), respectively; and the chain indirect effect was −0.02 (4.2%). Similarly, the direct effect of dispositional awe on person-oriented self-worth was 0.50 (83.3%); the indirect effects of small self and self-concept clarity were −0.07 (11.7%) and −0.01 (1.7%), respectively; and the chain indirect effect was −0.02 (3.3%); all the indirect effects were suppressing effects, for they were contrary to the direct effects. Conclusion: This study suggested that dispositional awe could help people better understand themselves and enhance their sense of self-worth. Full article

With the increasing life expectancy and ageing population, long-term care has become an urgent policy issue worldwide. The informal care provided by family members, particularly adult children, is a key aspect of long-term care. However, socioeconomic transformations have resulted in changing family and demographic structures and increased geographic mobility, reducing the capacity of families to provide informal care and meet the caregiving needs of older adults. For ageing families, care preparation can be an effective method for coping with eldercare challenges, and care preparation is attracting increasing attention from researchers. This study seeks to conduct a systematic review for studies on caregiving preparation by adult children that were retrieved from six databases, to synthesise the available evidence, and to identify knowledge gaps and opportunities for future investigations. The characteristics and main themes of eighteen reviewed articles were identified and analysed. This study discussed various conceptualisations of caregiving preparation by adult children, the prevalence of caregiving preparation, the factors related to caregiving preparation, and the related consequences. On the basis of the systematic review findings, several limitations of the literature and directions for future research were proposed to promote care preparedness and the well-being of ageing families. Full article

This study aimed to assess the effect of passive prompts on occupational physical behaviours (PBs) and bouts of prolonged sitting among desk-based workers in Ireland who were working from home during the COVID-19 pandemic. Electronic passive prompts were delivered every 45 min, asking participants to walk for five minutes, during working hours. Twenty-eight participants (aged 30–67 years) completed the six-week intervention between October 2020 and April 2021. PBs were measured using an activPAL3^TM accelerometer, following a 24 h wear protocol, worn for the duration of the study. Participants were highly sedentary at both baseline (77.71% of work hours) and during the intervention (75.81% of work hours). However, the number of prolonged occupational sedentary bouts > 90 min was reduced compared to baseline (0.56 ± 0.08 vs. 0.77 ± 0.11, p = 0.009). Similar reductions were observed in the time spent in sustained sitting > 60 and >90 min when compared to baseline sedentary patterns (60 min: −31.27 ± 11.91 min, p = 0.014; 90 min: −27.97 ± 9.39 min, p = 0.006). Light-intensity physical activity (LIPA) significantly increased during the intervention (+14.29%, p = 0.001). This study demonstrates that passive prompts, delivered remotely, can both reduce the number and overall time spent in prolonged bouts of occupational sedentary behaviour and increase occupational LIPA. Full article

Objective: For many years, outcomes such as mortality and morbidity were the standard for evaluating oncological treatment effectiveness. With the introduction of patient-reported outcome measures (PROMs), the focus shifted from a mere extension of a patient’s life or release from disease to the improvement of a multilayered concept of health, decisively affecting life satisfaction. In this study, we deal with the topic of PROMs in liver and gastrointestinal randomized controlled trials. Results: The final database included 43 papers reporting results of randomized controlled trials (RCTs) for liver or gastrointestinal cancer interventions where one of the primary or secondary outcomes was a health-related quality of life measure. The most often used PROM was the European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30) for both liver cancer and gastrointestinal cancer (in 62% of gastrointestinal cancer studies and 57% of liver cancer studies). For the gastrointestinal cancer group, the QLQ-STO22, a cancer-specific extension of the QLQ-C30, was the second most commonly used PROM. In liver cancer, the generic PROM Short Form 36 and the EORTC QLQ-HCC18, a cancer-specific extension of the QLQ-C30, were the second most commonly used PROMs. Conclusion: We found that RCTs often do not include comprehensive quality-of-life measures. When quality of life is part of an RCT, it is often only a secondary outcome. For a holistic view of the patient, a stronger integration and weighting of patient-reported outcomes in RCTs would be desirable. Full article