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Int. J. Environ. Res. Public Health, Volume 21, Issue 6 (June 2024) – 112 articles

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18 pages, 1259 KiB  
Article
Investigating the Interplay of Toxic Metals and Essential Elements in Liver Disease
by Aderonke Gbemi Adetunji and Emmanuel Obeng-Gyasi
Int. J. Environ. Res. Public Health 2024, 21(6), 762; https://doi.org/10.3390/ijerph21060762 - 12 Jun 2024
Viewed by 139
Abstract
Liver diseases, including non-alcoholic fatty liver disease (NAFLD), are a growing global health issue. Environmental exposure to toxic metals can harm the liver, increasing the risk of NAFLD. Essential elements are vital for liver health, but imbalances or deficiencies can contribute to the [...] Read more.
Liver diseases, including non-alcoholic fatty liver disease (NAFLD), are a growing global health issue. Environmental exposure to toxic metals can harm the liver, increasing the risk of NAFLD. Essential elements are vital for liver health, but imbalances or deficiencies can contribute to the development of NAFLD. Therefore, understanding the interplay between toxic metals and essential elements in liver disease is important. This study aims to assess the individual and combined effects of toxic metals (lead(Pb), cadmium (Cd), mercury (Hg)), and essential elements (manganese and selenium) on the risk of liver disease. Methods: We assessed the individual and combined effects of Pb, Cd, Hg, manganese (Mn), and selenium (Se) on liver disease risk using data from the National Health and Nutrition Examination Survey between 2017 and 2018. We performed descriptive statistics and linear regression analysis and then utilized Bayesian Kernel Machine Regression (BKMR) techniques such as univariate, bivariate, and overall effect analysis. BKMR enabled the assessment of non-linear exposure–response functions and interactions between metals and essential elements. Posterior Inclusion Probabilities (PIPs) were calculated to determine the importance of each metal and essential element in contributing to liver disease. Regarding our study results, the regression analysis of liver injury biomarkers ALT, AST, ALP, GGT, total bilirubin, and the FLI—an indicator of NAFLD—with toxic metals and essential elements, adjusting for covariates such as age, sex, BMI, alcohol consumption, ethnicity, income, and smoking status, demonstrated the differential effects of these contaminants on the markers of interest. Our BKMR analysis provided further insights. For instance, the PIP results underscored Pb’s consistent importance in contributing to liver disease (PIP = 1.000), followed by Hg (PIP = 0.9512), Cd (PIP = 0.5796), Se (PIP = 0.5572), and Mn (PIP = 0.4248). Our univariate analysis showed a positive trend with Pb, while other exposures were relatively flat. Our analysis of the single-variable effects of toxic metals and essential elements on NAFLD also revealed that Pb significantly affected the risk of NAFLD. Our bivariate analysis found a positive (toxic) trend when Pb was combined with other metals and essential elements. For the overall exposure effect of exposure to all the contaminants together, the estimated risk of NAFLD showed a steady increase from the 60th to the 75th percentile. In conclusion, our study indicates that Pb exposure, when combined with other toxic metals and essential elements, plays a significant role in bringing about adverse liver disease outcomes. Full article
(This article belongs to the Section Environmental Health)
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12 pages, 326 KiB  
Article
The Influence of Kindergarten Environment on the Development of Preschool Children’s Physical Fitness
by Alice Haav, Leila Oja and Jaanika Piksööt
Int. J. Environ. Res. Public Health 2024, 21(6), 761; https://doi.org/10.3390/ijerph21060761 - 12 Jun 2024
Viewed by 99
Abstract
The aim of this research is to find out to what extent the special qualifications of physical education teachers and the physical environment of kindergartens influence the physical development of preschoolers. Forty-four kindergartens across Estonia participated in the study, half of which had [...] Read more.
The aim of this research is to find out to what extent the special qualifications of physical education teachers and the physical environment of kindergartens influence the physical development of preschoolers. Forty-four kindergartens across Estonia participated in the study, half of which had a physical education teacher (PEt), whereas the remaining 22 kindergartens were taught by non-qualified kindergarten teachers (NoPEt). Six Eurofit fitness tests were used to assess the physical development of children (n = 704; aged 6–7 years old, with an average age of 6.55 ± 0.5 years). An analysis of variance was used to compare the mean values of the fitness test results of the two groups. Linear regression analysis was applied to clarify the influence of individual and environmental factors on children’s fitness scores. In kindergartens where the position of a PEt had been created, the results of children’s physical fitness were statistically significantly better, more specifically in handgrip strength (m = 12.0, 95% CI = 11.8–12.3 vs. m = 11.5, 95% CI = 11.2–11.7) and in speed tests (m = 23.0, 95% CI = 22.8–23.2 vs. m = 23.6, 95% CI = 23.3–23.8). According to the teacher interviews, these kindergartens also had more rooms and areas specially created for physical exercises. The study revealed that the physical development of children is, when controlling for other individual and environmental factors, influenced by the professional qualification of the PE teacher (95% CI = 0.06–0.56) as well as children’s participation in sports training (95% CI = 0.29–0.83). These findings are important for preschool institutions and municipalities in designing the optimal physical environment for facilitating children’s physical fitness. Full article
(This article belongs to the Special Issue Exercise and Physical Activity in Health Promotion)
13 pages, 1089 KiB  
Review
The Role of Street Medicine and Mobile Clinics for Persons Experiencing Homelessness: A Scoping Review
by Rebekah A. Kaufman, Mahwish Mallick, Jarvis Thanex Louis, Mollie Williams and Nancy Oriol
Int. J. Environ. Res. Public Health 2024, 21(6), 760; https://doi.org/10.3390/ijerph21060760 - 12 Jun 2024
Viewed by 181
Abstract
Introduction: An estimated 5800 to 46,500 lives are lost due to homelessness each year. Experiencing homelessness and poor health are cyclically related, with one reinforcing the other. Mobile programs, which include vehicles that travel to deliver care, and street medicine, the act of [...] Read more.
Introduction: An estimated 5800 to 46,500 lives are lost due to homelessness each year. Experiencing homelessness and poor health are cyclically related, with one reinforcing the other. Mobile programs, which include vehicles that travel to deliver care, and street medicine, the act of bringing care to spaces where PEH live, may play a role in alleviating this burden by providing trusted, affordable, and accessible care to this community. Methods: We conducted a scoping review of peer-reviewed literature on the role of mobile clinics and street medicine in providing care for PEH by searching PubMed, Embase, and Web of Science on 10 August 2023. Articles from 2013 to 2023 specific to programs in the United States were included. The protocol was developed following the PRISMA-ScR guidelines. The primary outcome was the role of mobile programs for persons experiencing homelessness. Results: A total of 15 articles were included in this review. The descriptive findings emphasized that street medicine and mobile clinics provide primary care, behavioral health, and social services. The utilization findings indicate that street medicine programs positively impact the health system through their ability to defer emergency department and hospital visits, providing financial benefits. The comparative findings between mobile programs and office-based programs indicate current successes and areas for improvement. Discussion: Mobile clinics and street medicine programs that serve PEH provide a wide range of services. While more significant structural change is needed to address healthcare costs and housing policies in the United States, mobile clinics and street medicine teams can improve healthcare access and the healthcare system. Full article
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12 pages, 950 KiB  
Article
Temporal Recall Strategies in Rheumatoid Arthritis Patients’ Emotionally Intense Life Events
by Fanni Balikó, Krisztina Csókási, Melinda Pohárnok, Orsolya Vincze, Gábor Kumánovics, Marcell Deme, Preston Alexander Long and Tanja Stamm
Int. J. Environ. Res. Public Health 2024, 21(6), 759; https://doi.org/10.3390/ijerph21060759 - 11 Jun 2024
Viewed by 310
Abstract
Background: Rheumatoid arthritis (RA) patients often encounter psychological challenges due to chronic pain, fatigue, side effects of medications, and disability. This study examines the relationship between autobiographical narratives and recollection patterns in RA patients. We investigated how different recall strategies for positive life [...] Read more.
Background: Rheumatoid arthritis (RA) patients often encounter psychological challenges due to chronic pain, fatigue, side effects of medications, and disability. This study examines the relationship between autobiographical narratives and recollection patterns in RA patients. We investigated how different recall strategies for positive life events affect the emotional processing of negative episodes. We hypothesized that vividly recalling positive life events provides psychological resources that support a more intense emotional elaboration of stressful memories, allowing individuals to delve deeper into negative life experiences. Additionally, we explored the impact of these perspectives on self-reported well-being and physical health, proposing that re-living positive events improves overall well-being. Methods: We collected and analyzed high-point and low-point life-story episodes from 60 RA patients (85% female; age mean 61 ± 11 years; range 37–79) using episodic narrative interviews and the Narrative Categorical Content Analysis algorithm (NarrCat). Participants were categorized into 2 clusters based on their temporal perspective during high-point episodes: 25 used a Retrospective viewpoint, while 35 employed a Re-experiencing strategy. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS), and functioning was measured using the Health Assessment Questionnaire (HAQ). Results: The Re-experiencing group, which was more likely to articulate their high-point episode in vivid and real-time narrative, used more psychological perspectives (U(58) = 223, p < 0.01) and showed heightened emotional frequency (U(58) = 280, p < 0.05; positive: U(58) = 328, p < 0.05; negative: U(58) = 278, p < 0.05) in low-point episodes. No significant difference emerged between the two groups regarding psychological state (anxiety, depressive symptoms) and physical impairment. Conclusions: Vividly recalling positive events may facilitate a deeper exploration of negative memories. The Re-experiencing group showed increased positive emotions during low points, suggesting better emotion regulation. However, no significant association was found between recalling strategies, psychological state, and physical impairment. This indicates that further research is needed to determine whether re-experiencing positive life events is adaptive or maladaptive. Full article
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10 pages, 306 KiB  
Article
Arithmetic vs. Weighted Means in Fish Fillets Mercury Analyses
by Helvi Heinonen-Tanski
Int. J. Environ. Res. Public Health 2024, 21(6), 758; https://doi.org/10.3390/ijerph21060758 - 10 Jun 2024
Viewed by 324
Abstract
Mercury (Hg) analyses in species of fish are performed for two reasons: (1) to safeguard human health; and (2) to assess environmental quality, since different environmental changes may increase the Hg concentrations in fish. These analyses are important since both natural and human [...] Read more.
Mercury (Hg) analyses in species of fish are performed for two reasons: (1) to safeguard human health; and (2) to assess environmental quality, since different environmental changes may increase the Hg concentrations in fish. These analyses are important since both natural and human activities can increase these Hg concentrations, which can vary extensively, depending on the species, age and catching location. Hg-contaminated fish or other marine foodstuffs can be only detected by chemical analysis. If the aim of Hg analysis is to protect the health of marine food consumers, researcher workers must consider the location where the fish were caught and interpret the results accordingly. Health and environmental officials must appreciate that in specific places, local people may have a daily diet consisting entirely of fish or other marine foods, and these individuals should not be exposed to high concentrations of Hg. Regional and national health and environmental officials should follow the recent guidance of international organizations when drawing their final conclusions about whether the products are safe or unsafe to eat. Correct statistical calculations are not always carried out; so, too high Hg amounts could be presented, and fish eaters could be protected. This work has been conducted to show the differences in Hg concentrations between weighted (weighted with fish weights) and arithmetic means. Thus, the mean that is only weighted also includes the Hg content in fishes; so, the exposure to Hg can be evaluated. Full article
12 pages, 337 KiB  
Review
Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity
by Yilun Wu, Dan Li and Sten H. Vermund
Int. J. Environ. Res. Public Health 2024, 21(6), 757; https://doi.org/10.3390/ijerph21060757 - 10 Jun 2024
Viewed by 507
Abstract
Obesity reflects excessive fat deposits. At-risk individuals are guided by healthcare professionals to eat fewer calories and exercise more, often using body mass index (BMI; weight/height2) thresholds for screening and to guide progress and prognosis. By conducting a mini-narrative review of [...] Read more.
Obesity reflects excessive fat deposits. At-risk individuals are guided by healthcare professionals to eat fewer calories and exercise more, often using body mass index (BMI; weight/height2) thresholds for screening and to guide progress and prognosis. By conducting a mini-narrative review of original articles, websites, editorials, commentaries, and guidelines, we sought to place BMI in the context of its appropriate use in population health, clinical screening, and monitoring in clinical care. The review covers studies and publications through 2023, encompassing consensus reviews and relevant literature. Recent consensus reviews suggest that BMI is a valuable tool for population surveys and primary healthcare screening but has limitations in predicting the risk of chronic diseases and assessing excess fat. BMI can guide nutritional and exercise counseling, even if it is inadequate for reliable individual risk prediction. BMI cut-offs must be reconsidered in populations of varying body build, age, and/or ethnicity. Since BMI-diagnosed overweight persons are sometimes physically and physiologically fit by other indicators, persons who are overweight on BMI should be more fully evaluated, diagnosed, and monitored with combined anthropometric and performance metrics to better clarify risks. The use of combined anthropometric and performance metrics involves integrating measurements of body composition with assessments of physical function and fitness to provide a more comprehensive evaluation of an individual’s health and fitness status. Eligibility for bariatric surgery or semaglutide satiety/appetite-reduction medications should not be determined by BMI alone. Awareness of the advantages and limitations of using BMI as a tool to assess adult obesity can maximize its appropriate use in the context of population health and in rapid clinical screening and evaluation. Full article
16 pages, 1823 KiB  
Article
Adolescents’ Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies
by Thulitha Wickrama, Michael J. Merten, K. A. S. Wickrama and Amanda Terrell
Int. J. Environ. Res. Public Health 2024, 21(6), 756; https://doi.org/10.3390/ijerph21060756 - 9 Jun 2024
Viewed by 440
Abstract
There is a knowledge gap regarding the link between disaster exposure and adolescent mental health problems in developing countries. This study examines the case of Sri Lanka to investigate (a) the immediate and long-term mental health impact of the 2004 tsunami disaster on [...] Read more.
There is a knowledge gap regarding the link between disaster exposure and adolescent mental health problems in developing countries. This study examines the case of Sri Lanka to investigate (a) the immediate and long-term mental health impact of the 2004 tsunami disaster on adolescents and (b) the potential moderating effects of unique cultural and family practices that prevail in Sri Lanka. This study used a random sample of 160 adolescents (ages 12–19) and their mothers who were exposed to the tsunami disaster while living in a southern Sri Lankan village and provided prospective data immediately after the disaster (2005) and three years later (2008). A cross-culturally validated instrument assessed adolescent–mother dyads’ tsunami exposure, stressful loss, family cultural rituals and familism, and adolescent mental health. Structural equation modeling analysis showed that exposure and perceptions of tsunami-induced stressful experiences were associated with early and later mental health problems in adolescents. In addition, this study found that unique cultural practices and familism moderated the link between adolescent tsunami exposure, stressful experiences, and levels of PTSD and depressive symptoms. The findings of this study could be utilized to develop prevention and intervention programs that are contextually and culturally valid and empirically supported, which would be more effective for trauma-exposed adolescents in developing countries. Full article
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18 pages, 351 KiB  
Article
Breastfeeding Intention and Breastfeeding Postpartum Outcomes between High-Risk and Low-Risk Pregnant Women: A Greek Prospective Cohort Study
by Panagiota Brani, Irina Mrvoljak-Theodoropoulou, Fani Pechlivani, Maria Iliadou, Evangelia Antoniou, Georgios Daskalakis, Peter Drakakis and Maria Dagla
Int. J. Environ. Res. Public Health 2024, 21(6), 755; https://doi.org/10.3390/ijerph21060755 - 9 Jun 2024
Viewed by 307
Abstract
Background: This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group. Methods: The study was [...] Read more.
Background: This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group. Methods: The study was conducted in one of the largest public hospitals in Attica that provides care to pregnant women, enrolling 380 participants divided into high-risk (n = 200) and low-risk (n = 180) cohorts. Data were collected over 20 months (starting from the end of May 2020 until January 2022), spanning from pregnancy to six months postpartum, via comprehensive questionnaires. Results: Statistical analysis revealed a pronounced correlation between prenatal breastfeeding intentions and actual breastfeeding behaviors across both groups. Specifically, 81.1% of women in the high-risk group and 82.5% in the low-risk group expressed intentions of exclusively breastfeeding during pregnancy. By six months postpartum, 54.9% of the high-risk and 64.3% of the low-risk pregnancy group managed to sustain breastfeeding. Extended antenatal hospitalization emerged as a statistically significant factor (p = 0.045) negatively impacting exclusive breastfeeding intentions among high-risk pregnancies. Conclusion: The findings illuminate the critical influence of antenatal intentions on breastfeeding outcomes, particularly among high-risk pregnancies. Moreover, the study identifies the detrimental effect of prolonged hospital stays on breastfeeding aspirations. These insights underscore the necessity for nuanced, supportive interventions aimed at bolstering breastfeeding rates, thereby advancing maternal and neonatal health objectives aligned with World Health Organization recommendations. Full article
(This article belongs to the Section Health Care Sciences)
14 pages, 939 KiB  
Article
Assessment of a Community-Based Nutrition Program for Women and Children in Nepal Using Demographic and Health Survey
by Gauri Joshi, Masaru Ichihashi and Chalise Binaya
Int. J. Environ. Res. Public Health 2024, 21(6), 754; https://doi.org/10.3390/ijerph21060754 - 9 Jun 2024
Viewed by 405
Abstract
Undernutrition is a particularly acute problem in middle- and low-income countries. The “Suaahara” program is a 5-year community-focused program in Nepal, aimed at improving the health and nutrition of pregnant and lactating women and their children under the age of 2 years. This [...] Read more.
Undernutrition is a particularly acute problem in middle- and low-income countries. The “Suaahara” program is a 5-year community-focused program in Nepal, aimed at improving the health and nutrition of pregnant and lactating women and their children under the age of 2 years. This research contributes to evidence on the impact of the “Suaahara” program in 41 treated districts compared to 34 control districts. Using the difference-in-differences method, we found that the weight-for-height z-score and body mass index z-score of children under the age of 2 in the treated districts significantly increased by 0.223 standard deviations (SDs) and 0.236 SDs, respectively, compared with the control districts 5 years before and after the program. The number of antenatal care visits (at least four visits) and safe deliveries significantly increased for pregnant women by 10.4% and 9.1%, respectively, in the treated districts compared with the control districts. The prevalence of fever in children under 2 years of age was significantly reduced by 6.2% in the treated districts. The results show the significance of a policy evaluation with transparent indicators on public health, which is necessary for policymakers so that they can propose evidence-based policy. Full article
(This article belongs to the Section Exercise and Health-Related Quality of Life)
19 pages, 686 KiB  
Systematic Review
Psychological Therapies Used for the Reduction of Habitual Cigarette Smoking Cigarette Consumption: A Systematic Review
by Sandra-Milena Carrillo-Sierra, Lorena Cárdenas-Cáceres, John Anderson Cadrazco-Urquijo, Angie Natalia Salazar-Gómez, Diego Rivera-Porras and Valmore Bermúdez
Int. J. Environ. Res. Public Health 2024, 21(6), 753; https://doi.org/10.3390/ijerph21060753 - 9 Jun 2024
Viewed by 520
Abstract
Globally, there are around 1.3 billion cigarette consumers, indicating it to be the second highest risk factor for early death and morbidity. Meanwhile, psychological therapy offers tools based on its different models and techniques, which can contribute to smoking cessation. In this context, [...] Read more.
Globally, there are around 1.3 billion cigarette consumers, indicating it to be the second highest risk factor for early death and morbidity. Meanwhile, psychological therapy offers tools based on its different models and techniques, which can contribute to smoking cessation. In this context, this study gathers scientific evidence to identify psychological therapies that can be used to reduce cigarette consumption. A systematic review of controlled clinical studies was conducted, implementing the PRISMA methodology. Search queries were performed with terms extracted from MESH (Medical Subject Headings) and DECS (Descriptors in Health Sciences). Subsequently, the search was queried in the scientific databases of Medline/PubMed, Cochrane, Scopus, Science Direct, ProQuest, and PsycNet, with subsequent verification of methodological quality using the Joanna Briggs Institute checklists. The selected documents revealed that cognitive behavioral therapy prevails due to its use and effectiveness in seven publications (25%). The cognitive approach with mindfulness therapy is found in 4 publications (14%), the transtheoretical model with motivational therapy in 4 publications (14%), brief psychological therapy in 3 publications (10%), and the remaining 10 documents (37%) correspond with others. Intervention studies refer to cognitive behavioral therapy as the most used in reducing cigarette consumption; in terms of the duration of abstinence, scientific evidence shows beneficial effects with short-term reduction. Full article
(This article belongs to the Section Behavioral and Mental Health)
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14 pages, 1010 KiB  
Article
Advancing Cancer Workforce Capacity for American Indians and Alaska Natives: The Development of a Validated System to Optimize Trainee Participation and Outcome Tracking
by Kelly A. Laurila, Laurie D. Rogers, Celina I. Valencia, Naomi Lee, Hendrik de Heer, Jennifer W. Bea, Jani C. Ingram and Francine C. Gachupin
Int. J. Environ. Res. Public Health 2024, 21(6), 752; https://doi.org/10.3390/ijerph21060752 - 8 Jun 2024
Viewed by 448
Abstract
Although American Indian and Alaska Native (AIAN) students are the most underrepresented group in the U.S. in biomedical and health sciences relative to population size, little is known about long-term research education programs and outcome tracking. For over 20 years, the Partnership for [...] Read more.
Although American Indian and Alaska Native (AIAN) students are the most underrepresented group in the U.S. in biomedical and health sciences relative to population size, little is known about long-term research education programs and outcome tracking. For over 20 years, the Partnership for Native American Cancer Prevention (NACP) has been supported under the National Cancer Institute’s (NCI)-funded Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) program. Programming included hands-on mentored research and an array of development opportunities. A validated tracking system combining participation records, institutional records, and enrollment/degree attainment from the National Student Clearinghouse documents outcomes. Collectively (2002–2022) NACP engaged 367 AIAN trainees, of whom 237 individuals earned 220 bachelors, 87 masters, and 34 doctoral/professional degrees. Approximately 45% of AIAN doctoral recipients are currently engaged in academic or clinical work, and 10% in industry or tribal leadership. A total of 238 AIAN students participated in mentored research, with 85% demonstrating strong outcomes; 51% attained a degree, and 34% are currently enrolled. Implementation of a robust tracking system documented acceleration in degree attainment over time. Next steps will evaluate the most impactful training activities on student outcomes. Full article
(This article belongs to the Special Issue Second Edition: Cancer Health Disparities and Public Health)
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15 pages, 467 KiB  
Article
The Impact of Workplace Bullying on Turnover Intention and Psychological Distress: The Indirect Role of Support from Supervisors
by Pascal Malola, Pascale Desrumaux, Eric Dose and Christine Jeoffrion
Int. J. Environ. Res. Public Health 2024, 21(6), 751; https://doi.org/10.3390/ijerph21060751 - 8 Jun 2024
Viewed by 329
Abstract
Workplace bullying is characterized by negative, repetitive, and frequent behaviors towards a person, affecting his/her physical and mental health The present study aimed to assess the relationship between bullying, turnover intention, and psychological distress, considering the potential mediating effect of perceived supervisor support. [...] Read more.
Workplace bullying is characterized by negative, repetitive, and frequent behaviors towards a person, affecting his/her physical and mental health The present study aimed to assess the relationship between bullying, turnover intention, and psychological distress, considering the potential mediating effect of perceived supervisor support. A questionnaire was completed by 252 women and 172 men (n = 424) from 70 French companies and institutions. They were working in private (70%), public (28%), and parapublic (2%) sectors. Finally, 33 trades are represented in this study: commercial (21%), educational (12%), medical (8.3%), and industry (8.3%) were the most prominently represented. Regression analyses showed that bullying was significantly linked to turnover intention (ß = 0.52, p < 0.05) and psychological distress (ß = 0.78, p < 0.001). Moreover, supervisor support played a mediating role between workplace bullying and turnover intention, as well as between workplace bullying and psychological distress. The implications and perspectives of the present research were subsequently discussed. Full article
14 pages, 959 KiB  
Article
Healthcare Provider-Based Contraceptive Coercion: Understanding U.S. Patient Experiences and Describing Implications for Measurement
by Laura E. T. Swan and Lindsay M. Cannon
Int. J. Environ. Res. Public Health 2024, 21(6), 750; https://doi.org/10.3390/ijerph21060750 - 8 Jun 2024
Viewed by 321
Abstract
Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a [...] Read more.
Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample (N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant (p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t[1194] = 7.54, p < 0.001; upward coercion: t[1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t[1160] = −14.77, p < 0.001; upward coercion: t[1160] = −18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist’s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement. Full article
(This article belongs to the Special Issue Innovations in Women’s Health Promotion and Healthcare)
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16 pages, 877 KiB  
Article
Predicting Post-Disaster Post-Traumatic Stress Disorder Symptom Trajectories: The Role of Pre-Disaster Traumatic Experiences
by Sydney T. Johnson, Susan M. Mason, Darin Erickson, Jaime C. Slaughter-Acey and Mary C. Waters
Int. J. Environ. Res. Public Health 2024, 21(6), 749; https://doi.org/10.3390/ijerph21060749 - 8 Jun 2024
Viewed by 421
Abstract
The mental health impact of disasters is substantial, with 30–40% of direct disaster victims developing post-traumatic stress disorder (PTSD). It is not yet clear why some people cope well with disaster-related trauma while others experience chronic dysfunction. Prior research on non-disaster trauma suggests [...] Read more.
The mental health impact of disasters is substantial, with 30–40% of direct disaster victims developing post-traumatic stress disorder (PTSD). It is not yet clear why some people cope well with disaster-related trauma while others experience chronic dysfunction. Prior research on non-disaster trauma suggests that an individual’s history of traumatic experiences earlier in the life course, prior to the disaster, may be a key factor in explaining variability in psychological responses to disasters. This study evaluated the extent to which pre-disaster trauma predicts PTSD trajectories in a sample of Hurricane Katrina survivors followed for 12 years after the storm. Four PTSD trajectories were identified using latent class growth analysis: Resistant (49.0%), Recovery (29.3%), Delayed-Onset (8.0%), and Chronic–High (13.7%). After adjusting for covariates, pre-Katrina trauma had only a small, positive impact on the probability of long-term, chronic Katrina-specific PTSD, and little effect on the probability of the Resistant and Delayed-Onset trajectories. Higher pre-Katrina trauma exposure moderately decreased the probability of being in the Recovery trajectory, in which Katrina-specific PTSD symptoms are initially high before declining over time. When covariates were added to the model one at a time, the association between pre-Katrina trauma and Chronic–High PTSD was attenuated most by the addition of Katrina-related trauma. Our findings suggest that while pre-disaster trauma exposure does not have a strong direct effect on chronic Katrina-specific PTSD, pre-Katrina trauma may impact PTSD through other factors that affect Katrina-related PTSD, such as by increasing the severity of Katrina-related trauma. These findings have important implications for the development of disaster preparedness strategies to diminish the long-term burden of disaster-related PTSD. Full article
(This article belongs to the Special Issue The Lifelong Impact of Adverse Childhood Experiences on Health)
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12 pages, 368 KiB  
Article
Physical Activity and Associated Factors among Brazilian Adult Inmates: A Cross-Sectional Study
by Wanessa Cristina Baccon, Carlos Laranjeira, Priscila Garcia Marques, Carla Franciele Höring, Adriana Martins Gallo, Juliane Pagliari Araujo, Francielle Renata Danielli Martins Marques, Lígia Carreira and Maria Aparecida Salci
Int. J. Environ. Res. Public Health 2024, 21(6), 748; https://doi.org/10.3390/ijerph21060748 - 7 Jun 2024
Viewed by 397
Abstract
Previous studies on health in prison facilities have determined that imprisonment has adverse effects on both physical and emotional well-being. Therefore, the introduction of public health measures is encouraged. This study aimed to (a) evaluate the levels of physical activity and the health [...] Read more.
Previous studies on health in prison facilities have determined that imprisonment has adverse effects on both physical and emotional well-being. Therefore, the introduction of public health measures is encouraged. This study aimed to (a) evaluate the levels of physical activity and the health condition of a sample of Brazilian prisoners and (b) determine the predictors of low physical activity. An observational and cross-sectional study was developed following the STROBE checklist. Data collection took place between June and November 2019 in a maximum-security Brazilian prison institution. This study’s final sample included 220 people selected through convenience sampling, of which 115 (53.2%) were aged 18 to 29 years, followed by 79 (36.6%) aged 30 to 44 years and 22 (10.2%) aged 45 to 59 years old. Overall, 64.3% of participants failed to meet the World Health Organization (WHO) recommendation for physical activity [at least 150–300 min of moderate-intensity or 75 min of vigorous-intensity aerobic physical activity per week]. The majority reported unhealthy food consumption (116; 53.7%). Regarding body mass index (BMI), 50.2% of individuals were classified as eutrophic, 38.1% were overweight and 11.6% were obese. Older age (AOR: 0.95; CI95%: 0.92–0.99; p = 0.01) and sitting time (AOR: 0.74; CI95%: 0.65–0.85; p < 0.01) were associated with low adherence to physical activity. Our results highlight the importance of practicing physical activity within the prison context and the need for institutional programs that promote regular physical activity. Full article
11 pages, 421 KiB  
Brief Report
Understanding the Role of Extension Professionals in Public Health and One Health in Kansas
by Heather Poole, Antoinette Lona, Toni Rose M. Barroga, McKenzie Ghrist and Ellyn R. Mulcahy
Int. J. Environ. Res. Public Health 2024, 21(6), 747; https://doi.org/10.3390/ijerph21060747 - 7 Jun 2024
Viewed by 454
Abstract
This study aims to understand the roles of selected extension professionals (EPs) in the field of public health and One Health and the challenges involved in performing these duties to their communities in the state of Kansas. To evaluate the role of EPs [...] Read more.
This study aims to understand the roles of selected extension professionals (EPs) in the field of public health and One Health and the challenges involved in performing these duties to their communities in the state of Kansas. To evaluate the role of EPs in public health and One Health, researchers interviewed nine (9) EPs following a set of structured questions. Emerging themes were extrapolated from the responses of the EPs. Researchers assigned codes for qualitative analysis and assigned themes related to public health, One Health, and effective delivery of services. Researchers identified the following themes related to the role of EPs in public health (youth development, physical activity, personal health care, proper nutrition, access to transportation), One Health (food safety and food security, environmental health, disease control and prevention) and effective delivery of services (community engagement, collaboration, challenges in implementation). The study provided an overview of the diverse roles that EPs play in public health and One Health, keys on how to engage the community effectively, and challenges in extending services to the community. Full article
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14 pages, 336 KiB  
Article
The Use of Podcasts as Patient Preparation for Hospital Visits—An Interview Study Exploring Patients’ Experiences
by Jannie Christina Frølund, Anders Løkke, Hanne Irene Jensen and Ingeborg Farver-Vestergaard
Int. J. Environ. Res. Public Health 2024, 21(6), 746; https://doi.org/10.3390/ijerph21060746 - 6 Jun 2024
Viewed by 481
Abstract
Introduction: Podcasts have emerged as a promising tool in patient preparation for hospital visits. However, the nuanced experiences of patients who engage with this medium remain underexplored. Objectives: This study explored patients’ experiences of receiving information by way of podcasts prior to their [...] Read more.
Introduction: Podcasts have emerged as a promising tool in patient preparation for hospital visits. However, the nuanced experiences of patients who engage with this medium remain underexplored. Objectives: This study explored patients’ experiences of receiving information by way of podcasts prior to their hospital visits. Methods: Semi-structured interviews were conducted with patients with suspected chronic obstructive pulmonary disease (COPD), lung cancer, or sleep apnea. The method of data analysis chosen was thematic analysis. Results: Based on data from 24 interviews, five key themes were identified: technical challenges in utilization of podcasts; individual preferences for information prior to hospital visits; building trust and reducing anxiety through podcasts; the role of podcasts as an accessible and convenient source of information; and enhancement of engagement and empowerment through podcasts. Additionally, the study highlighted the critical importance of tailoring podcasts’ content to individual preferences to optimize the delivery of healthcare information. Conclusions: Podcasts can serve as a meaningful supplement to traditional information sources for patients. However, it is important to recognize that not all patients may be able to engage with this medium effectively due to technical challenges or personal preferences. Full article
13 pages, 346 KiB  
Article
Influence of Environmental Risk Exposure on the Determinants of COVID-19 Booster Vaccination in an Urban Thai Population
by Weerawat Ounsaneha, Orapin Laosee and Cheerawit Rattanapan
Int. J. Environ. Res. Public Health 2024, 21(6), 745; https://doi.org/10.3390/ijerph21060745 - 6 Jun 2024
Viewed by 436
Abstract
This study aimed to identify the influence of environmental risk exposure levels on the predictive factors of COVID-19 booster dose vaccination in an urban Thai population in the post-pandemic era. Six study locations, including the three provinces with the highest environmental risk levels [...] Read more.
This study aimed to identify the influence of environmental risk exposure levels on the predictive factors of COVID-19 booster dose vaccination in an urban Thai population in the post-pandemic era. Six study locations, including the three provinces with the highest environmental risk levels and the three provinces with the lowest environmental risk levels, were selected by calculating the environmental risk exposure indexes. Participants from the capital district of each province were chosen via the simple random sampling technique and interviewed using a structured questionnaire. A total of 1315 individuals were included in a sample in this study, and the best predictors of booster dose vaccination were determined using multiple regression analysis. The results showed that a high level of environmental risk exposure occurred in the provinces with a high number of total days exceeding the limits set for PM10 and high rates of mortality for lung cancer. The number of COVID-19 booster vaccinations given amount to 43.4% of the population during the post-COVID-19 pandemic period. Our multivariate analysis indicated that individuals in the working age group (≥25 years old); those with higher education (diploma degree and above); full-time employment (government and private sectors); those with high monthly incomes (≥USD144.1); and those in areas with the lowest risk level of environmental exposure significantly contributed to the number of booster dose vaccinations given during the post-pandemic period. To summarize, the rate of COVID-19 booster dose vaccination acceptance in Thailand was influenced by socio-economic factors with environmental concerns. These findings improve our understating of both the global pandemic and how environmental exposure affects behavioral change patterns and could improve the effectiveness of post-pandemic management. Full article
(This article belongs to the Special Issue Pandemic Preparedness: Lessons Learned from COVID-19)
16 pages, 491 KiB  
Article
Comparison of Estonian Schoolchildren’s Physical Activity and Fitness Indicators before and after the COVID-19 Pandemic’s Period of Restricted Mobility
by Saima Kuu, Joe Noormets, Triin Rääsk, Kirsti Pedak, Viktor Saaron, Karin Baskin and Kristjan Port
Int. J. Environ. Res. Public Health 2024, 21(6), 744; https://doi.org/10.3390/ijerph21060744 - 6 Jun 2024
Viewed by 360
Abstract
It is recognized that the time adolescents spend on physical activity, and the corresponding physical fitness indicators, have diminished over time. However, the exact impact of the COVID-19 pandemic restriction period on physical activity and health-related physical fitness indicators remains unclear. This study [...] Read more.
It is recognized that the time adolescents spend on physical activity, and the corresponding physical fitness indicators, have diminished over time. However, the exact impact of the COVID-19 pandemic restriction period on physical activity and health-related physical fitness indicators remains unclear. This study sought to determine if and to what degree the primary indicators of physical activity (exercise frequency, exercise intensity, and outdoor physical activity) and health-related physical fitness (strength and endurance) among schoolchildren have shifted, by comparing data from before and after the coronavirus pandemic period. Students aged 12–17 years took part in the study. The physical activity questionnaire and fitness tests were conducted in the autumn of 2017 and spring of 2022. The main results show that moderate- and vigorous-intensity physical activity time and time spent actively outdoors have decreased among adolescents (p < 0.05). There were no significant changes in exercise frequency (p > 0.05). However, there was a statistically significant decline in strength (standing broad jump, bent arm hang) (p < 0.05) and endurance (20 m shuttle run, curl-up) (p < 0.01) when comparing results from before and after the COVID-19 pandemic restriction period. In conclusion, restricted mobility had the greatest impact on the time spent outdoors and, in turn, on physical fitness. Full article
(This article belongs to the Special Issue Exercise and Physical Activity in Health Promotion)
15 pages, 569 KiB  
Article
Experience of Discrimination and Oral Health Self-Perception: A Cross-Sectional Study among Brazilian Adults
by Renato Vitor Vieira, Carlos Antonio Gomes da Cruz, Gizelton Pereira Alencar, Viviane Elisângela Gomes, Loliza Luiz Figueiredo Houri Chalub, Anna Rachel dos Santos Soares, Maria Luiza Viana Fonseca, Ichiro Kawachi and Raquel Conceição Ferreira
Int. J. Environ. Res. Public Health 2024, 21(6), 743; https://doi.org/10.3390/ijerph21060743 - 6 Jun 2024
Viewed by 323
Abstract
This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; [...] Read more.
This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; poor + very poor). Reported experiences of discrimination included attributions based on the respondent’s race/skin color, social class, income, occupation, illness, sexual orientation, religion, sex, and age. Covariates included sociodemographic data, oral health conditions, access to healthcare services, health habits, mental health, and participation in social and/or religious activities. Data were analyzed using ordinal logistic regression for non-proportional odds, considering sample weights and complex samples. Among 60,202 adults, 5.84% perceived their oral health as poor + very poor, with a significantly higher proportion among those experiencing discrimination (9.98%). Adults who experienced discrimination were 1.39 times more likely to report a “poor/very poor/fair” oral health self-perception compared to those who did not experience discrimination. Those who suffered discrimination were 1.28 times more likely to have a “very poor/poor” oral health self-perception than their counterparts who were not affected by discrimination. These findings underscore the importance of considering discrimination experiences as part of the social determinants influencing oral health. Full article
12 pages, 2405 KiB  
Project Report
Methodological and Practical Challenges in Synthesizing Occupational Cancer Studies
by Soyeon Ahn, Laura A. McClure, Paulo S. Pinheiro, Diana Hernandez, Devina J. Boga, Henna Ukani, Jennifer V. Chavez, Jorge A. Quintela Fernandez, Alberto J. Caban-Martinez, Erin Kobetz and David J. Lee
Int. J. Environ. Res. Public Health 2024, 21(6), 742; https://doi.org/10.3390/ijerph21060742 - 6 Jun 2024
Viewed by 424
Abstract
Studies examining occupational exposures and cancer risk frequently report mixed findings; it is thus imperative for researchers to synthesize study results and identify any potential sources that explain such variabilities in study findings. However, when synthesizing study results using meta-analytic techniques, researchers often [...] Read more.
Studies examining occupational exposures and cancer risk frequently report mixed findings; it is thus imperative for researchers to synthesize study results and identify any potential sources that explain such variabilities in study findings. However, when synthesizing study results using meta-analytic techniques, researchers often encounter a number of practical and methodological challenges. These challenges include (1) an incomparability of effect size measures due to large variations in research methodology; (2) a violation of the independence assumption for meta-analysis; (3) a violation of the normality assumption of effect size measures; and (4) a variation in cancer definitions across studies and changes in coding standards over time. In this paper, we first demonstrate these challenges by providing examples from a real dataset collected for a large meta-analysis project that synthesizes cancer mortality and incidence rates among firefighters. We summarize how each of these challenges has been handled in our meta-analysis. We conclude this paper by providing practical guidelines for handling challenges when synthesizing study findings from occupational cancer literature. Full article
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18 pages, 1772 KiB  
Article
Wastewater-Based Epidemiology for SARS-CoV-2 in Northern Italy: A Spatiotemporal Model
by Matilde Fondriest, Lorenzo Vaccari, Federico Aldrovandi, Laura De Lellis, Filippo Ferretti, Carmine Fiorentino, Erica Mari, Maria Grazia Mascolo, Laura Minelli, Vincenza Perlangeli, Giuseppe Bortone, Paolo Pandolfi, Annamaria Colacci and Andrea Ranzi
Int. J. Environ. Res. Public Health 2024, 21(6), 741; https://doi.org/10.3390/ijerph21060741 - 6 Jun 2024
Viewed by 375
Abstract
The study investigated the application of Wastewater-Based Epidemiology (WBE) as a tool for monitoring the SARS-CoV-2 prevalence in a city in northern Italy from October 2021 to May 2023. Based on a previously used deterministic model, this study proposed a variation to account [...] Read more.
The study investigated the application of Wastewater-Based Epidemiology (WBE) as a tool for monitoring the SARS-CoV-2 prevalence in a city in northern Italy from October 2021 to May 2023. Based on a previously used deterministic model, this study proposed a variation to account for the population characteristics and virus biodegradation in the sewer network. The model calculated virus loads and corresponding COVID-19 cases over time in different areas of the city and was validated using healthcare data while considering viral mutations, vaccinations, and testing variability. The correlation between the predicted and reported cases was high across the three waves that occurred during the period considered, demonstrating the ability of the model to predict the relevant fluctuations in the number of cases. The population characteristics did not substantially influence the predicted and reported infection rates. Conversely, biodegradation significantly reduced the virus load reaching the wastewater treatment plant, resulting in a 30% reduction in the total virus load produced in the study area. This approach can be applied to compare the virus load values across cities with different population demographics and sewer network structures, improving the comparability of the WBE data for effective surveillance and intervention strategies. Full article
(This article belongs to the Topic Spatial Epidemiology and GeoInformatics)
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9 pages, 583 KiB  
Article
Impact of Pregestational Obesity on the Oral Health-Related Quality of Life in Brazilian Pregnant Women: A Cohort Study
by Ana Carolina da Silva Pinto, Gabriela de Figueiredo Meira, Francisco Carlos Groppo, Fernanda Ruffo Ortiz, Gerson Foratori, Jr., Eduardo Bernabé and Silvia Helena de Carvalho Sales-Peres
Int. J. Environ. Res. Public Health 2024, 21(6), 740; https://doi.org/10.3390/ijerph21060740 - 6 Jun 2024
Viewed by 415
Abstract
The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life [...] Read more.
The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life (OHRQoL) in pregnant women. A prospective cohort study was carried out with 93 pregnant women who were evaluated in the 2nd trimester of pregnancy (T1) and after delivery (T2). The following were analyzed: dental caries (DMFT), OHRQoL (OHIP-14), anthropometric data (BMI), socioeconomic, demographic, oral hygiene behavioral habits and the use of dental services. Unadjusted and adjusted Poisson regression analyses were performed to determine the impact of predictors on OHRQoL. The results of the adjusted analysis showed lower education relative risk (RR) (1.37; 95%CI 1.02–1.83; <0.00), low income (RR 2.19; 95%CI 1.63–2.93; <0.00) and higher BMI pre-pregnancy (RR 1.03; 95% CI 1.01–1.04; <0.00) were associated with worse OHRQoL in postpartum pregnant women. Flossing was a predictor of better OHRQoL at T2 (RR 0.73; 95%CI 0.57–0.93; <0.01). Higher BMI, low education, low income and inadequate oral hygiene habits were predictors of worse OHRQOL of pregnant women after the birth of the baby. Full article
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11 pages, 537 KiB  
Article
MMP-8 in Periodontal Sites of Postpartum and without-Any-Pregnancy Women
by Karyne Martins Lima, Keiko Aramaki Abreu Calado, Adriana de Fátima Vasconcelos Pereira, Mayara Cristina Pinto da Silva and Fernanda Ferreira Lopes
Int. J. Environ. Res. Public Health 2024, 21(6), 739; https://doi.org/10.3390/ijerph21060739 - 6 Jun 2024
Viewed by 381
Abstract
The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and [...] Read more.
The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and women without a history of pregnancy, comparing health parameters and periodontal disease. This is a case–control study with 40 participants, 20 cases (women in the postpartum period) and 20 controls (women without any pregnancy), who underwent clinical periodontal examination and the collection of crevicular gingival fluid. The ELISA test was used to detect MMP-8 levels. Postpartum women had worse periodontal parameters, such as bleeding index on probing, number of sites with CAL ≥ 3, and fewer teeth present. In the group of women without a history of pregnancy, a significantly lower MMP-8 level was observed in healthy sites and a higher one was observed in periodontal pockets (p < 0.01). In contrast, in postpartum women, MMP-8 levels were elevated in both healthy sites and periodontal pockets (p > 0.01). The MMP-8 levels in gingival fluid appear to be related to periodontal clinical parameters and may be a possible marker of enzymatic changes involved in periodontal tissue destruction in postpartum women. Full article
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13 pages, 452 KiB  
Article
Enhancing Emotion Regulation Skills in High-Risk Adolescents Due to the Existence of Psychopathology in the Family: Feasibility and Uncontrolled Pilot Study of a Group Intervention in a Naturalistic School Setting
by Christiana Theodorou, Maria Karekla and Georgia Panayiotou
Int. J. Environ. Res. Public Health 2024, 21(6), 738; https://doi.org/10.3390/ijerph21060738 - 5 Jun 2024
Viewed by 816
Abstract
Background: Emotion regulation skills form part of many interventions for youth with internalizing and externalizing difficulties. This pilot study examines a prevention program delivered at school to improve adolescents’ emotion regulation skills, focusing on those at risk for mental health problems. Methods: Adolescents [...] Read more.
Background: Emotion regulation skills form part of many interventions for youth with internalizing and externalizing difficulties. This pilot study examines a prevention program delivered at school to improve adolescents’ emotion regulation skills, focusing on those at risk for mental health problems. Methods: Adolescents 12–18 years old were referred to a six-session group program by their school counselors, based on inclusion criteria related to family sociodemographic and mental health characteristics. Group sessions took place during school hours to facilitate participation and reduce dropout. The intervention targeted emotion regulation skills, drawing from central components of different cognitive behavioral approaches. To assess clinical outcomes, participants answered questionnaires before and after the program, which covered emotion regulation strategies, addictive behaviors, and internalizing and externalizing symptoms. The acceptability of the program was also assessed. Results: Emotion regulation skills improved after the program, and there was a significant reduction in internalizing and externalizing problems. The program was evaluated as useful by participants. Counsellors reported satisfaction with the program. Conclusions: Targeted emotion regulation skills training is a potentially useful transdiagnostic intervention to prevent mental health problems in youth. Bringing the intervention to the school setting and involving counsellors in referring at-risk students can facilitate uptake and reduce dropout. Full article
(This article belongs to the Special Issue Research on Emotional and Cognitive Development in Children)
17 pages, 455 KiB  
Article
Heat Risk Perceptions and Coping Strategies of the Unhoused
by Brett W. Robertson, Kirstin Dow, Julie Salinas and Susan L. Cutter
Int. J. Environ. Res. Public Health 2024, 21(6), 737; https://doi.org/10.3390/ijerph21060737 - 5 Jun 2024
Viewed by 332
Abstract
The escalating awareness of heat-related risks and the associated imperative to enhance preparedness strategies at various levels has spurred a growing emphasis on disseminating knowledge about heat vulnerability. These efforts aim to equip diverse stakeholders with practical heat planning and forecasting tools. The [...] Read more.
The escalating awareness of heat-related risks and the associated imperative to enhance preparedness strategies at various levels has spurred a growing emphasis on disseminating knowledge about heat vulnerability. These efforts aim to equip diverse stakeholders with practical heat planning and forecasting tools. The success of these communication initiatives hinges on understanding the nuanced perceptions of risk and the priority assigned to addressing heat as a health risk. This paper delves explicitly into the unhoused population’s risk perceptions and coping strategies. Acknowledged as one of the most underserved and vulnerable groups to extreme heat, unhoused individuals face prolonged exposure, a heightened frequency of mental and physical health issues, and limited coping resources during extreme heat events. Despite widespread acknowledgment of their vulnerability, little attention has been directed towards researching health behavior within this demographic about excessive heat. We developed a survey instrument using the theory of planned behavior (TPB) to bridge this gap. We collected quantitative survey data from unhoused populations in Columbia, South Carolina, an area of the United States that experiences extreme heat events and has a sizeable unhoused population. Using a series of hierarchical multiple regression models, our findings indicate that TPB variables predict the intention to avoid the heat while considering additional coping strategies common among unhoused individuals. These findings offer valuable insights for public health researchers, practitioners, and community officials engaged in direct interactions with unhoused populations, informing how this underserved group manages excessive heat exposure. Full article
12 pages, 676 KiB  
Systematic Review
Could Nature Contribute to the Management of ADHD in Children? A Systematic Review
by Maddison Hood and Oliver Baumann
Int. J. Environ. Res. Public Health 2024, 21(6), 736; https://doi.org/10.3390/ijerph21060736 - 5 Jun 2024
Viewed by 531
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of [...] Read more.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of the symptomatology of individuals with ADHD, this provides a rationale to investigate the potential benefits of exposure to nature for this population. Four electronic databases (PubMED, PsycINFO, Embase, and Web of Science) were searched for empirical studies investigating the effects of nature on ADHD prevalence and/or symptom severity in populations of school-aged children. Key characteristics, methodologies, and outcomes of included studies were extracted and evaluated. Out of the 458 studies identified, 7 met the inclusion criteria. Despite the large heterogeneity in methodological approaches, the included articles consistently reported that exposure to nature is associated with reduced ADHD diagnoses and symptom severity. Furthermore, when several covariates, such as age, gender, annual household income, parental income, and education level, as well as several pre-natal factors, were controlled for, the relationship between nature and ADHD remained significant. The reviewed literature provides strong support for the benefits of exposure to nature on ADHD in school-aged children. Full article
(This article belongs to the Section Behavioral and Mental Health)
10 pages, 313 KiB  
Article
Oral Health Literacy and Determinants among an Elderly Community in Portugal
by Helder Costa, Pedro Lopes, Maria José Correia, Patrícia Couto, Ana Margarida Silva, Joaquin Francisco López-Marcos and Nélio Veiga
Int. J. Environ. Res. Public Health 2024, 21(6), 735; https://doi.org/10.3390/ijerph21060735 (registering DOI) - 5 Jun 2024
Viewed by 358
Abstract
High average life expectancy has caused an increase in the elderly population and with it arises the need to characterize this population regarding their health and, in particular, their oral health. The purpose of this study was to assess and characterize oral health, [...] Read more.
High average life expectancy has caused an increase in the elderly population and with it arises the need to characterize this population regarding their health and, in particular, their oral health. The purpose of this study was to assess and characterize oral health, oral rehabilitation, oral health literacy, oral health perception and quality of life in a sample of elderly participants of a physical activity program in Portugal. An observational cross-sectional study was designed with a group of 206 individuals. All the individuals were clinically assessed, DMFT, PSR and the plaque index were registered, and a questionnaire was applied in the form of a “face-to-face” interview with questions related to the quality of life related to oral health (GOHAI index and the REALD-30 scale). Of the 206 study participants, 90.3% admit brushing their teeth daily, 6.3% practice daily flossing, and 5.8% had a dental appointment in the last 12 months. Applying the REALD-30 scale, 22.7% have a low level (score 0–14), 43.7% a moderate level (score 15–22) and 33.6% a high level (score 23–29) of oral health literacy. The GOHAI scale reveals that 37.4% have a high self-perception of their oral health. A considerable proportion of the sample studied present a moderate level of oral health literacy. Therefore, educating each person about their oral health when participating in a specific health program and developing proposals for oral health promotion activities should be widely considered as a strategy towards primary prevention. Future oral health literacy sessions should be held in order to improve oral health and quality of life among the community. Full article
(This article belongs to the Section Health Care Sciences)
12 pages, 491 KiB  
Article
Use of Dietary Supplements and Influencing Factors in Children
by Orkut Koç, Merve Tosyalı, Şule Gökçe and Feyza Koç
Int. J. Environ. Res. Public Health 2024, 21(6), 734; https://doi.org/10.3390/ijerph21060734 - 5 Jun 2024
Viewed by 270
Abstract
Introduction: In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this [...] Read more.
Introduction: In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this use, and the attitudes of parents about these products. Methods: A total of 1038 children aged 2–18 years without any chronic disease who presented to the pediatric outpatient clinics of Ege University Children’s Hospital were included in this study. Parents (n = 1000) who agreed to participate in the study were interviewed face-to-face, and a comprehensive questionnaire including questions about children’s use of dietary supplements, sociodemographic characteristics, and parents’ attitudes towards dietary supplements was administered. Analyses were performed with SPSS 25.0. Results: The mean age of the children included in our study was 8.6 ± 4.8 years, and 51% (n = 510) were male. It was found that 32.5% of the children used nutritional supplements, and vitamin–mineral preparations (23.2%) were the most frequently used. Omega-3 (19.3%) and immune support products (9.4%) were the second and third most frequently used supplements, respectively. A significant relationship was found between the use of dietary supplements and the child’s age, body weight, body mass index, parents’ educational level, being health worker, and economic status (p < 0.05). It was found that most of the families thought that vitamin–mineral and omega-3 products were beneficial for growth and development and that they received information from doctors most frequently before taking these products. However, it was found that families followed the media as the second most frequent source of information for these products. Conclusions: Approximately one-third of the children in our study use dietary supplements. It is very important to raise awareness among families about the use of these products when necessary and with the recommendation of a physician. To prevent families from using dietary supplements that are not necessary for their children, especially due to misinformation in the media, pediatricians should provide correct information to parents about these products at every clinic visit. A concerted effort is needed from policy makers, media organizations, and health care providers to guide the safe use of DS. The results obtained from this study will shed light on future randomized controlled prospective studies. Full article
20 pages, 8391 KiB  
Article
Assessment of Human Health Risk Indices Due to Metal Contamination in the Surface Water of the Negro River Sub-Basin, Áncash
by Walter Bravo-Zevallos, Yadira Fernández-Jerí, Juan C. Torres-Lázaro and Karol Zuñiga-Bardales
Int. J. Environ. Res. Public Health 2024, 21(6), 733; https://doi.org/10.3390/ijerph21060733 - 5 Jun 2024
Viewed by 460
Abstract
The accelerated loss of glacial cover in the Cordillera Blanca in Áncash, Peru, exposes the underlying rocks with high concentrations of sulfides from the Chicama Formation to oxidation and leaching processes, generating acid rock drainage (ARD) in glacial and periglacial areas. These are [...] Read more.
The accelerated loss of glacial cover in the Cordillera Blanca in Áncash, Peru, exposes the underlying rocks with high concentrations of sulfides from the Chicama Formation to oxidation and leaching processes, generating acid rock drainage (ARD) in glacial and periglacial areas. These are transported by surface runoff, contaminating the surface water with high concentrations of metals and sulfates, as well as increasing the acidity, which poses a risk to human health and the ecosystem. Therefore, the risk indices for human health due to metal contamination were evaluated at 19 surface water sampling points distributed in the Río Negro sub-basin. Hydrochemical analyses revealed average metal concentrations in the following order: Fe (28.597 mg/L), Al (3.832 mg/L), Mn (1.085 mg/L), Zn (0.234 mg/L), Ni (0.085 mg/L), Co (0.053 mg/L), Li (0.036 mg/L), Cu (0.005 mg/L), and Pb (0.002 mg/L). The risk was determined by calculating the Heavy Metal Pollution Index (HPI) and the Hazard Index (HI). The average HPI value was 360.959, indicating a high level of contamination (HPI ≥ 150). The human health risk assessment indicated that adverse effects caused by iron, lithium, and cobalt in children and adults should be considered. Through the use of Pearson correlation analysis, principal component analysis, and cluster analysis, it was identified that SO42−, Fe, S, Al, Co, Mn, Ni, Zn, and Li originate from natural sources, associated with the generation of ARD in glacial and periglacial areas. Full article
(This article belongs to the Collection Environmental Risk Assessment)
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