Int. J. Environ. Res. Public Health, Volume 20, Issue 9 (May-1 2023) – 145 articles

The risks of developing cancer are significantly affected by our lifestyle and environment. While there are several uncontrollable risk factors, we can modify our lifestyle and our environment to reduce the increased threat of cancer. This systematic review aims to evaluate the methodological assessment used to evaluate attitudes about cancer risk factors among the general population. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Programme (CASP) checklists were used to assess the methodology of the included studies. Thirty-one manuscripts met the inclusion criteria with a majority of them focusing on attitudes to several cancer risk factors and six on specific cancer location risk factors. This systematic review highlights the diversity of notions used around attitudes and methods used in the method of administering the survey, as well as the format of the questions and the response scales. It is thus difficult to compare data between different countries. However, cancer is a global problem. Harmonizing methods could allow a comparison of data between countries. Recommendations to this effect are suggested. Full article

A wider range of social protection services, including social insurance and social assistance, are gaining global attention as a key driver of improved health service coverage and financial protection among vulnerable populations. However, only a few studies have investigated the associations between social protection and universal health coverage (UHC). Therefore, we conducted a literature review on relevant international organizations with respect to this topic. We found that many international organizations consider the wide range of social protection services, including social insurance and social assistance, essential for achieving UHC in 2030. In specific health programs, social protection is considered an important service to promote health service access and financial protection, especially among vulnerable populations. However, discussions about social protection for achieving UHC are not given high priority in the World Health Organization. Currently, the coverage of social protection services is low among vulnerable populations in low- and middle-income countries. To address this issue, we employed the metrics recommended by the migrant integration policy index (MIPEX). Based on our findings, a conceptual framework was developed. We expect this framework to lead synergy between social protection and health systems around the globe, resulting in healthy ageing. Full article

COVID-19 is a respiratory infectious disease that first reported in Wuhan, China, in December 2019. With COVID-19 spreading to patients worldwide, the WHO declared it a pandemic on 11 March 2020. This study collected 1,746,347 tweets from the Korean-language version of Twitter between February and May 2020 to explore future signals of COVID-19 and present response strategies for information diffusion. To explore future signals, we analyzed the term frequency and document frequency of key factors occurring in the tweets, analyzing the degree of visibility and degree of diffusion. Depression, digestive symptoms, inspection, diagnosis kits, and stay home obesity had high frequencies. The increase in the degree of visibility was higher than the median value, indicating that the signal became stronger with time. The degree of visibility of the mean word frequency was high for disinfectant, healthcare, and mask. However, the increase in the degree of visibility was lower than the median value, indicating that the signal grew weaker with time. Infodemic had a higher degree of diffusion mean word frequency. However, the mean degree of diffusion increase rate was lower than the median value, indicating that the signal grew weaker over time. As the general flow of signal progression is latent signal → weak signal → strong signal → strong signal with lower increase rate, it is necessary to obtain active response strategies for stay home, inspection, obesity, digestive symptoms, online shopping, and asymptomatic. Full article

The article presents a study into the impact that the COVID-19 pandemic had on the daily mobility of those over 60 residing in small towns in the Lodz Province. The study determines the impact on the trip destination, trip frequency, preferred means of transport, distance and duration of trips, and length of the target activity. To achieve these objectives, a survey was conducted using the CATI technique (Computer Assisted Telephone Interviewing), which comprised 500 residents of small towns in the Lodz Province aged 60+, who were divided into three classes of small towns (by population size). In order to determine the impact of the COVID-19 pandemic on the daily mobility of those over 60, the tools the authors decided to use descriptive statistics and hypothesis testing. Overall, the pandemic was found to have had only a minor impact on the changes in transport behavior of those over 60 in small towns. Only 9% of respondents declared any effect on their daily mobility. The impact mainly involved a reduction in travel time and frequency, primarily among the oldest residents. Since a low level of daily mobility leads to low social activity, especially for the elderly—with a consequent sense of loneliness or even depression-towns should take measures to improve the already poor situation, one that has been further exacerbated by the pandemic. Full article

We characterized the physical and physiological profiles of high-level female Portuguese handball players and examined the relationships between their anthropometric characteristics, general motor performance and cardiopulmonary fitness. Twenty-four high-level female handball players with an average age of 23.6 ± 5.5 years, height of 173.6 ± 5.1 cm and body mass of 72.6 ± 9.1 kg volunteered to participate. A Pearson correlation test was used to assess the relationship between variables. Direct relationships were observed between the players’ height and arm span (r = 0.741), as well as between their squat jump and countermovement jump performances with regard to body mass (r = 0.448 and 0.496, respectively). The 9 m jump shot has a large relationship with the 7 m standing throw (r = 0.786) and between left hand dynamometry and body mass index (r = 0.595). The 30 m sprint has a relationship with the 7 m standing throw (r = −0.526) and the 9 m jump throw (r = −0.551). Oxygen uptake has a relationship with the players’ height (r = −0.482) and time limit (r = 0.513), while the fitness index has a relation to the players’ height (r = −0.488) and arm span (r = −0.422). Our results should be considered when using physical testing to plan optimal physical training regimens in elite team handball. Full article

In this study, a valuable adsorbent was functionalized using commercial ZnO and a mango seed extract (MS-Ext) as a green approach for synthesis. Fourier-transform infrared spectroscopy, transmission electron microscopy, scanning electron microscopy, and energy-dispersive X-ray analysis spectraconfirmed the presence of bioactive phenolic compounds and ${\mathrm{Cu}}^{2+}$ ions on the surface of ZnO. Functionalized Cu-doped ZnO/MS-Ext exhibits high efficacy in acidic, neutral, and alkaline medium, as indicated by 98.3% and 93.7% removal of methylene blue (MB) and crystal violet (CV) dyes, respectively. Cu-doped ZnO/MS-Ext has a zeta potential significantly lower than pristine zinc oxide (p-ZnO), which results in enhanced adsorption of cationic MB and CV dyes. In binary systems, both MB and CV were significantly removed in acidic and alkaline media, with 92% and 87% being removed for CV in acidic and alkaline media, respectively. In contrast, the removal efficiency of methyl orange dye (MO) was 16.4%, 6.6% and 11.2% for p-ZnO, ZnO/Ext and Cu-doped ZnO/Ext, respectively. In general, the adsorption kinetics of MB on Cu-doped ZnO/MS-Ext follow this order: linear pseudo-second-order (PSO) > nonlinear pseudo-second-order (PSO) > nonlinear Elovich model > linear Elovich model. The Langmuir isotherm represents the adsorption process and indicates that MB, CV, and MO are chemisorbed onto the surface of the adsorbent at localized active centers of the MS-extract functional groups. In a binary system consisting of MB and CV, the maximum adsorption capacity (q_m) was 72.49 mg/g and 46.61 mg/g, respectively. The adsorption mechanism is governed by electrostatic attraction and repulsion, coordination bonds, and π–π interactions between cationic and anionic dyes upon Cu-doped ZnO/Ext surfaces. Full article

The aim of this study was to identify (i) emotions experienced by healthcare professionals (HCPs) after adverse or traumatic events and (ii) needs for support after adverse or traumatic events. Data for this qualitative, descriptive study were collected at 27 seminars for 198 HCPs introducing a peer-support programme after adverse or traumatic events (The Buddy Study). Through interactive exercises, participants shared their experiences, and this study reports on the responses of an exercise identifying emotions and needs after an adverse or traumatic event. The top five emotions were anger, guilt, impotence, grief, and frustration and anxiety, and the top five needs were to be met with understanding, recognition, listening, care, and respect. Ten categories of emotions experienced by HCPs after adverse or traumatic events were constructed, and the five categories with the highest number of mentions were anger and impotence, fear and insecurity, negative self-evaluation, guilt and shame, and alone and overloaded. Nine categories relating to needs for support after adverse or traumatic events were constructed, and the five categories with the highest number of mentions were: being seen and understood, compassion, being respected, time to recover, and organisational support. The emotional disclosure promoted at the peer seminars of the Buddy Study revealed that all participants share the same emotional distress, being either second victims or potential second victims. Moreover, the support needed was of a human-to-human nature that all participants felt capable of providing as a “buddy” for a colleague. Both the identified emotions and needs for support identified in this study may contribute to qualifying the development of the content of support programmes for HCPs after traumatic or adverse events. Full article

This scoping review presents the extent and nature of the body of literature on illicit online pharmacies (IOPs) and identifies research gaps. Using the five-step framework developed by Arksey and O’Malley, we searched PubMed, Web of Science, EMBASE, CINAHL, Science Direct and PsycInfo to retrieve relevant studies published in English in peer-reviewed journals. The search strategy identified forty-three articles that met the inclusion criteria. Ten themes were identified and categorized into five clusters: patient risk, healthcare providers, marketing and supply chain, public health and society, and policy and regulation. Research into these clusters has evolved over time and has focused increasingly on issues related to specific drugs rather than the overall phenomenon. Data collection has been dominated by convenience sampling, online searches, content analysis and surveys. Data analysis remains primarily descriptive. Gaps within the extant literature suggest an agenda for future research into regulation and enforcement; public health awareness and education; healthcare services; risks to patients and public health; patient-, price- and product-related issues; website design; social media promotion; and supply chains and logistics. We conclude that IOPs are vastly understudied and suggest an urgent need for further empirical and conclusive research. Full article

Centralized intake [CI] or single-entry models are utilized in health systems to facilitate service access by reducing waiting times. This scoping review aims to consolidate the Literature on CI service models to identify their characteristics and rationales for their use, as well as contexts in which they are used and challenges and benefits in implementing them. The review also aims to offer some lessons learned from the Literature and to make recommendations for its implementation in non-acute mental health services. The findings show that CI is mostly considered when there is increased demand for services and clients are required to navigate multiple services that operate individually. Successful models have meaningfully engaged all stakeholders from the outset and the telephone is the most common mode of intake. Recommendations are made for planning and preparation, for elements of the model, and for setting up the service network. When successfully implemented, CI has been shown to improve access and increase demand for services. However, if CI is not supported by a network of service providers who offer care that is acceptable to clients, the purpose of its implementation could be lost. Full article

This study aimed to clarify the longitudinal goal negotiation and collaboration process of achieving activity- and participation-level goals. We conducted a qualitative study using the trajectory equifinality model. Nine occupational therapists with experience in setting and achieving activity- and participation-level goals were recruited and interviewed about their clients. We identified two phases and four pathways in the setting and attainment process for activity- and participation-level goals. Throughout the longitudinal goal-setting process, when the occupational therapist and client had difficulty discussing activity- and participation-level goals, the therapist respected the client’s expectations, explained the purpose of occupational therapy in detail, and conducted individual face-to-face interviews. When it was difficult to provide work-based interventions, the occupational therapist made flexible use of functional training, elemental movement training, occupation-based practice, and environmental modifications. The results of this study may assist in supporting clients to improve their activity and participation in home rehabilitation. Full article

Horyzons is a digital health intervention designed to support recovery in young people receiving specialized early intervention services for first-episode psychosis (FEP). Horyzons was developed in Australia and adapted for implementation in Canada based on input from clinicians and patients (Horyzons–Canada Phase 1) and subsequently pilot-tested with 20 young people with FEP (Horyzons–Canada Phase 2). Objective: To understand the experiences of young adults with FEP who participated in the pilot study based on focus group data. Methods: Among the twenty individuals that accessed the intervention, nine participated across four focus groups. Three team members were involved in data management and analysis, informed by a thematic analysis approach. A coding framework was created by adapting the Phase 1 framework to current study objectives, then revised iteratively by applying it to the current data. Once the coding framework was finalized, it was systematically applied to the entire dataset. Results: Four themes were identified: (1) Perceiving Horyzons-Canada as helpful for recovery; (2) Appreciating core intervention components (i.e., peer networking; therapeutic content; moderation) and ease of use; (3) Being unaware of its features; and (4) Expressing concerns, suggestions, and future directions. Conclusions: Horyzons-Canada was well received, with participants wanting it to grow in scale, accessibility, and functionality. Full article

Piercing insertion is a common practice among people of all ages for different reasons (e.g., esthetics, culture, religion). In the oral cavity, the jewel can be placed in the lips, cheeks, tongue, and frenulum. The presence of an oral piercing could cause local and systemic complications in the short term. In the long term, irreversible damage may occur to the hard and soft tissues of the oral cavity. Different authors in the past have produced publications focusing on this issue. This study analyzes 10 published articles sourced from online databases according to the PRISMA flowchart. These articles were chosen from the 501 suitable papers initially found. PubMed, Web of Science, and Scopus were used as the online databases for searching for papers that matched the topic, using the keywords “complication” and “oral piercing”. The purpose of this review is to describe and analyze all possible complications related to the presence of a piercing in the mouth. Local and systemic complications are related to the presence of plaque and localized pathogenic micro-organisms that can spread via the bloodstream, although they rarely occur in patients without predisposing conditions. Maintaining proper oral hygiene and frequent check-ups are essential to avoid the onset of complications. Full article

Background: Acute Coronary Syndrome (ACS) causes the most deaths in the United States and accounts for the highest amount of healthcare spending. Cardiovascular Health (CVH) metrics have been widely used in primary prevention, but their benefits in secondary prevention on total healthcare expenditures related to ACS are largely unknown. This study aims to quantify the potential significance of ideal CVH scores as a tool in secondary cardiovascular disease prevention. Methods: In a cross-sectional analytical study, ten years of Medical Expenditure Panel Survey (MEPS) data from 2008 to 2018 were pooled, comparing ACS to non-ACS subgroups, utilizing a Two-part model with log link and gamma distribution, since our sample had both positive and zero costs. Conditional on positive expenditure, healthcare expenditure amounts were measured as a function of ACS status, socio-demographics, and CVH while controlling for relevant covariates. Finally, interactions of ACS with CVH metrics and other key variables were included to allow for variations in the effect of these variables on the two subgroups. Results: Improvements in CVH scores tended to reduce annual expenditures to a greater degree percentage-wise among ACS subjects compared to non-ACS groups, even though subjects with an ACS diagnosis tended to have approximately twice as big expenditures as similar subjects without an ACS diagnosis. Meanwhile, the financial impact of an ACS event on total expenditure would be approximately $88,500 ([95% CI, $70,200–106,900; p < 0.001]), and a unit improvement in CVH management score would generate savings of approximately $4160 ([95% CI, $5390–2950; p < 0.001]) in total health expenditures. Conclusions: Effective secondary preventive measures through targeted behavioral endeavors and improved health factors, especially the normalization of hypertension, diabetes mellitus, body mass index, and smoking cessation, have the potential to reduce medical spending for ACS subgroups. Full article

The management of nutrition, food, and health for disaster relief personnel is one of the crucial aspects for carrying out effective rescue activities during large-scale natural disasters, such as a big earthquake, flooding, and landslide following heavy rainfall or man-made disasters, such as widespread fire in industrial areas. Rescue workers, such as fire fighters and rescue teams who work on the disaster relief operations, have to work long, hard, and irregular hours that require energy (both intake and expenditure), with especially altered eating patterns. Reliable estimates of the energy expenditure (TEE) for such disaster relief operations have not been fully established. Here, we propose to clarify the energy expenditure for each type of large-scale disaster activity conducted by fire fighters. Thirty fire fighters (survey participants in this research) who participated in the simulation training of large-scale disaster activities wore tri-axial accelerometers and heart rate monitors during training; and, post-training, 28 fire fighters submitted complete activity record tables. An estimation formula combining tri-axial accelerometer and heart rate monitor data was used. Additionally, energy expenditure per hour (excluding resting energy expenditure: REE) (per average body weight of participants) was calculated for 10 types of large-scale disaster response activities. We propose utilization of these data as a reference value for examining the TEE of firefighting and rescue operations in future large-scale disasters. Full article

The Georgia Community Engagement Alliance (CEAL) Against COVID-19 Disparities Project conducts community-engaged research and outreach to address misinformation and mistrust, to promote inclusion of diverse racial and ethnic populations in clinical trials and increase testing and vaccination uptake. Guided by its Community Coalition Board, The GEORGIA CEAL Survey was administered among Black and Latinx Georgia 18 years and older to learn about community knowledge, perceptions, understandings, and behaviors regarding COVID-19 testing and vaccines. Survey dissemination occurred using survey links generated through Qualtrics and disseminated among board members and other statewide networks. Characteristics of focus counties were (a) highest proportion of 18 years and older Black and Latinx residents; (b) lowest COVID-19 testing rates; and (c) highest SVI values. The final sample included 2082 surveyed respondents. The majority of participants were men (57.1%) and Latinx (62.8%). Approximately half of the sample was aged 18–30 (49.2%); the mean age of the sample was 33.2 years (SD = 9.0), ranging from 18 to 82 years of age. Trusted sources of COVID-19 information that significantly predicted the likelihood of vaccination included their doctor/health care provider (p-value: 0.0054), a clinic (p-value: 0.006), and university hospitals (p-value: 0.0024). Latinx/non-Latinx, Blacks vs. Latinx, Whites were significantly less likely to get tested and/or vaccinated. Non-Latinx, Blacks had higher mean knowledge scores than Latinx, Whites (12.1 vs. 10.9, p < 0.001) and Latinx, Blacks (12.1 vs. 9.6, respectively, p < 0.001). The mean knowledge score was significantly lower in men compared to women (10.3 vs. 11.0, p = 0.001), in those who had been previously tested for COVID-19 compared to those who had never been tested (10.5 vs. 11.5, respectively, p = 0.005), and in those who did not receive any dose of vaccination compared to those who were fully vaccinated (10.0 vs. 11.0, respectively, p < 0.001). These data provide a benchmark for future comparisons of the trajectory of public attitudes and practices related to the COVID-19 pandemic. They also point to the importance of tailoring communication strategies to specific cultural, racial, and ethnic groups to ensure that community-specific barriers to and determinants of health-seeking behaviors are appropriately addressed. Full article

The cancer incidence among adolescents and young adults (AYAs) has significantly increased in recent years, but there is limited information about the factors that influence the perceived cancer risk among AYAs. A cross-sectional, web-based survey of 281 physically active Black and White AYA women was administered to assess the influences of demographic characteristics, family history of cancer, cancer risk factor knowledge, and lifestyle-related risk and protective behaviors on perceived cancer risk. Linear regression analyses were performed in SAS version 9.4. Self-reported Black race (β = −0.62, 95% CI: −1.07, −0.17) and routine doctor visits (β = −0.62, 95% CI: −1.18, −0.07) were related to a lower perceived cancer risk. Family history of cancer (β = 0.56, 95% CI: 0.13, 0.99), cancer risk factor knowledge (β = 0.11, 95% CI: 0.03, 0.19), and current smoking status (β = 0.80, 95% CI: 0.20, 1.40) were related to a higher perceived cancer risk. Perceptions of cancer risk varied among this sample of physically active, AYA women. Lower perceptions of cancer risk among Black AYA women demonstrate a need for culturally tailored cancer educational information that presents objective data on lifetime cancer risk. Reportedly higher perceptions of cancer risk among AYA smokers presents an ideal opportunity to promote smoking cessation interventions. Future interventions to address cancer risk perception profiles among physically active, AYA women should tailor approaches that are inclusive of these unique characteristics. Full article

Sleep problems are common among United States (U.S.) veterans and are associated with poor health, mental health, and functioning. Yet, little is known about insufficient sleep and factors contributing to sleep disparities among veterans experiencing homelessness. We conducted semi-structured interviews to better understand the clinical, environmental, and structural factors contributing to insufficient sleep among veterans and to improve care for this population. Interviews were conducted with 13 providers caring for veterans experiencing homelessness, including physicians, psychologists, nurses, social workers, and peer support specialists. Providers worked at a West Coast VA institution serving a large population of veterans experiencing homelessness. Interviews were analyzed for themes pertaining to sleep using the social-ecological model as a framework. On an individual level, factors influencing sleep included psychiatric disorders and use of substances. On an interpersonal level, factors included safety concerns while sleeping. On an environmental level, factors included noise and proximity to others as barriers to sleep. On the organizational level, logistical issues scheduling sleep clinic appointments and lack of transportation to attend sleep clinic appointments were identified as treatment barriers. These findings can inform future research studying the impact of sleep on health and housing outcomes and interventions addressing sleep among veterans experiencing homelessness. Full article

The National Research Mentoring Network (NRMN) Strategic Empowerment Tailored for Health Equity Investigators (SETH) study evaluates the value of adding Developmental Network to Coaching in the career advancement of diverse Early-Stage Investigators (ESIs). Focused NIH-formatted Mock Reviewing Sessions (MRS) prior to the submission of grants can significantly enhance the scientific merits of an ESI’s grant application. We evaluated the most prevalent design, analysis-related factors, and the likelihood of grant submissions and awards associated with going through MRS, using descriptive statistics, Chi-square, and logistic regression methods. A total of 62 out of 234 applications went through the MRS. There were 69.4% that pursued R grants, 22.6% career development (K) awards, and 8.0% other grant mechanisms. Comparing applications that underwent MRS versus those that did not (N = 172), 67.7% vs. 38.4% were submitted for funding (i.e., unadjusted difference of 29.3%; OR = 4.8, 95% CI = (2.4, 9.8), p-value < 0.0001). This indicates that, relative to those who did not undergo MRS, ESIs who did, were 4.8 times as likely to submit an application for funding. Also, ESIs in earlier cohorts (1–2) (a period that coincided with the pre COVID-19 era) as compared to those who were recruited at later cohorts (3–4) (i.e., during the peak of COVID-19 period) were 3.8 times as likely to submit grants (p-value < 0.0001). The most prevalent issues that were identified included insufficient statistical design considerations and plans (75%), conceptual framework (28.3%), specific aims (11.7%), evidence of significance (3.3%), and innovation (3.3%). MRS potentially enhances grant submissions for extramural funding and offers constructive feedback allowing for modifications that enhance the scientific merits of research grants. Full article

The 24-Hour Movement Guidelines provide specific recommendations on movement behaviors for children and adolescents. The objective of this study was to verify the adequacy of children and adolescents to the guidelines for moderate to vigorous physical activity, recreational screen time, and sleep duration, and the overall adequacy to the guidelines, before and during the COVID-19 pandemic. A cross-sectional study was conducted with parents or guardians of children or adolescents from different regions of Brazil using a digital interview form including sociodemographic characteristics of families, moderate to vigorous physical activity, recreational screen time, and sleep duration before and during the pandemic. Statistically significant variation was observed in both groups in relation to moderate to vigorous physical activity and recreational screen time between the two periods evaluated. Overall adequacy to the guidelines before the pandemic was 19.28% for children from Group 1 (0–5 years old) and 39.50% for those from Group 2 (6 to 17 years old). During the pandemic, it corresponded to 3.58% in Group 1 and 4.94% in Group 2 (p-value between periods ≤0.001). This study showed the significant impact of pandemic restrictions on reducing overall compliance and physical activity, and increasing screen time among Brazilian children and adolescents. Full article

With structural changes in work arrangements, employee retention becomes more important for organizational success. Guided by the Ability, Motivation, Opportunity (AMO) framework, this study investigated the factors affecting remote workers’ job satisfaction and personal wellbeing in Utah. From a sample of n = 143 remote workers, the study used a correlational design to identify the significant predictors of job satisfaction and personal wellbeing. It mapped the relationships between significant predictors of job satisfaction and personal wellbeing and explored the role of human resources (HR) policies and organizational culture in a remote work environment. Results showed intrinsic motivation, affective commitment, opportunity, and amotivation affected employee job satisfaction, while self-efficacy, amotivation, and job satisfaction affected personal wellbeing. A structural equation model (SEM) showed that remote workers with higher levels of self-efficacy, lower amotivation, and higher job satisfaction were likely to have greater personal wellbeing compared to others. When exploring the role of HR, findings showed that HR bundles and organizational culture indirectly affected job satisfaction but had a direct effect on the most important predictors of job satisfaction and personal wellbeing. Overall, results demonstrated the interconnectivity of HR practices, AMO factors, job satisfaction, and personal wellbeing. Full article

Work-related stress presents a significant impact on work performance and physical health. It has been associated with the onset of a multitude of symptoms that can lead to occupational stress diseases, namely Adjustment Disorder and Post-Traumatic Stress Disorder. The literature has evidenced that “exposure therapy” of cognitive-behavioral training (CBT-E) seems to be the most effective technique to manage stress symptoms, including work stress diseases, and several studies have considered Virtual Reality (VR) as an adjuvant tool to exposure-based psychotherapy (CBT-VR) for the treatment of multiple psychiatric disorders. The aim of this study is to evaluate the effectiveness of CBT with exposure to stressful work scenarios in imaginative (CBT-E) and in immersive virtual reality (CBT-VR) scenarios in a group of workers affected by work-related stress disorders and compare the clinical and physiological outcomes between the two exposure techniques. A long-term goal would be to develop an evidence-based rehabilitation program as a treatment for the reintegration into work of patients affected by these psychiatric disorders. Full article

One in three people globally suffers from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all its forms. This narrative literature review aims to understand the impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We used PubMed as our primary research database, complemented by Google Scholar, to identify systematic reviews, meta-analyses, and randomised controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualised counselling and worksite environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on the impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps. Full article

Past work has extensively documented that job insecurity predicts various work- and health-related outcomes. However, limited research has focused on the potential consequences of perceived job insecurity climate. Our objective was to investigate how the psychological climate about losing a job and valuable job features (quantitative and qualitative job insecurity climate, respectively) relate to employees’ exit, voice, loyalty, and neglect behaviors, and whether such climate perceptions explain additional variance in these behaviors over individual job insecurity. Data were collected through an online survey using a convenience sample of employees working in different organizations in Türkiye (N = 245). Hierarchical multiple regression analyses showed that quantitative job insecurity climate was associated with higher levels of loyalty and neglect, while qualitative job insecurity climate was related to higher levels of exit and lower levels of loyalty. Importantly, job insecurity climate explained additional variance over individual job insecurity in exit and loyalty. Our findings underscore the importance of addressing job insecurity in a broader context regarding one’s situation and the psychological collective climate. This study contributes to addressing the knowledge gap concerning job insecurity climate, an emerging construct in the organizational behavior literature, and its incremental impact beyond individual job insecurity. The foremost implication is that organizations need to pay attention to the evolving climate perceptions about the future of jobs in the work environment, because such perceptions are related to critical employee behaviors. Full article

The National Guard (NG) served as a critical component of the US COVID-19 response while concurrently managing personal COVID-19 responses. Understanding pandemic-related concerns, sleep difficulties, increased substance use, and stress management strategies can promote readiness for subsequent disasters. We surveyed 3221 NG service members (75% Army; 79% enlisted; 52% 30–49 years; 81% male) during COVID-19 (August-November 2020). Almost half were activated in response to COVID-19 (mean = 18.6 weeks) and completed the survey 2–3 months post-activation. Service members indicated great concern about family health (39%), the indefinite nature of the pandemic (35%), and their financial situation (23%). Over one-third reported changes in usual sleep amount, 33% described poor sleep quality, and 21% had trouble falling/staying asleep. Increased substance use was reported by 30%, including increased alcohol (13.5%), tobacco (9%), and caffeine/energy drinks (20.1%) consumption. Chi-square analyses and analyses of variance found those who activated reported more increased tobacco and caffeine/energy drink use versus non-activated, with no sleep difficulties nor alcohol use differences. Helpful stress management strategies included spending time outdoors (53%), exercising (48%), talking to family/friends (38%), and having a daily routine (38%). Specific health-, financial-, and job-related stressors were associated with COVID-19. Incorporating stress management in planning/preventive efforts promotes resilience during disasters. Full article

Background: With the aging population comes greater risks associated with polypharmacy, a significant public health problem. Objective: This study aimed to identify the prevalence of polypharmacy and its associated factors through Comprehensive Geriatric Assessment (CGA) among older adults treated in primary health care (PHC) in a large Brazilian urban center. Methods: We conducted a cross-sectional study with a random sampling of 400 older adults using primary health care. Polypharmacy was defined as the cumulative use of five or more daily medications. An assessment of a sociodemographic and health survey, fear of falling, and physical disabilities affecting activities of daily living and instrumental activities of daily living was conducted. Results: The mean age was 75.23 (SD: 8.53) years. The prevalence of polypharmacy and hyperpolypharmacy was 37% (n = 148) and 1% (n = 4), respectively. The adjusted logistic regression showed that participants with chronic non-communicable diseases (CNCDs) (OR = 9.24; p = 0.003), diabetes (OR = 1.93; p = 0.003), and obesity (OR = 2.15; p = 0.005) were associated with a greater propensity to use polypharmacy. Conclusion: Our results show that older adults with CNCDs, diabetes, and obesity were more likely to use polypharmacy. The results reinforce the importance of using CGA in clinical practice in PHC. Full article

National data suggest that non-Hispanic, White youth engage in electronic cigarette (e-cigarette) use at the highest rates. These results are not likely to be mirrored across regional contexts. State-representative data from Utah in 2019 (N = 58,689) were used to estimate the odds of lifetime and past 30-day vaping across seven racial/ethnic categories. Youth in grades 8, 10, and 12 (mean age 15.2; 52% female) self-reported race/ethnicity and vaping product use history, including e-cigarettes, vape pens, or mods. A Cox proportional hazards model estimated the cumulative probabilities for initiating vaping product use. The results indicated that American Indian or Alaskan Native, Black or African American, Hispanic/Latino, Multiracial, and Native Hawaiian or other Pacific Islander youth had significantly higher odds of both lifetime and past 30-day vaping compared to non-Hispanic White youth. The results showed significant variation in the cumulative probability of initiation by race/ethnicity, with Hispanic/Latino youth reporting the highest odds of initiation at each age. The regional patterns of vaping across racial/ethnic groups may not mirror national trends. State- and community-level data should be used to inform efforts to reduce e-cigarette use and promote health equity among youth. Full article

(1) Background: Stroke is one of the leading causes of disability. To identify the best treatment strategies for people with stroke (PwS), the aim of the current study was to compare the effects of training on a treadmill with functional electrical stimulation (TT-FES) with training on a treadmill (TT), and to analyze the effects of sequence of training on mobility and the parameters of walking ability. (2) Methods: Prospective, longitudinal, randomized and crossover study, in which 28 PwS were distributed into groups, namely the A-B Group (TT-FES followed by TT) and B-A Group (TT followed by TT-FES), using the foot drop stimulator, and were measured with functional tests. (3) Results: We found improved mobility, balance, non-paretic limb coordination, and endurance only in the group that started with TT-FES. However, sensorimotor function improved regardless of the order of training, and paretic limb coordination only improved in the B-A Group, but after TT-FES. These data indicate that the order of the protocols changed the results. (4) Conclusions: Although biomechanical evaluation methods were not used, which can be considered a limitation, our results showed that TT-FES was superior to isolated training on a treadmill with regard to balance, endurance capacity, and coordination of the non-paretic limb. Full article

Child sexual abuse (CSA) is a severe and concerning public-health problem globally, but some children are at higher risk of experiencing it. The harms caused by colonization and particularly the inter-generational legacy of residential schools would presumably increase the vulnerability of Indigenous children in former British colonies. Among 282 Indigenous participants in Canada recruited from Prime Panels, CSA was reported by 35% of boys, 50% of girls, and 57% of trans and gender non-conforming participants. These rates are substantially higher than global meta-analytic estimates (7.6% of boys and 18.0% of girls). There was evidence of intersectionality based on socioeconomic status. CSA was associated with a variety of other indicators of negative childhood experiences and significantly predicted numerous negative outcomes in adulthood, including mental-health issues (e.g., PTSD), unemployment, and criminal legal-system involvement. Sexual abuse of Indigenous Canadian children is a public-health crisis, and layers of marginalization (e.g., gender, social class) exacerbate this risk. Trauma-informed services to address the harms of colonization are severely needed, in line with recommendations from Canada’s Truth and Reconciliation Commission. Full article

One of the aims of our paper “The Paradox of Suicide Prevention” is to promote greater discourse on suicide prevention, with a particular focus on the mental health models used for the identification of, and interventions with, individuals who come into contact with tertiary mental health services [...] Full article