International Journal of Environmental Research and Public Health

12 pages, 1572 KiB

Open AccessArticle

Distribution of Private Dental Healthcare Facilities in Riyadh City: A GIS-Based Approach

by Najla S. Alrejaye, Faisal H. Alonazi, Zaid M. Alonazi, Rahf S. Alobaidi, Asma B. Alsaleh, Alanoud A. Alshami, Sultan A. Alshamrani and Seena T. Kaithathara

Int. J. Environ. Res. Public Health 2024, 21(7), 959; https://doi.org/10.3390/ijerph21070959 - 22 Jul 2024

Viewed by 1203

Abstract

Background: The dental healthcare private sector in Riyadh city has been growing rapidly over the past few years; however, there is a lack of information on the accessibility and spatial distribution of private dental healthcare facilities (PDHFs) in the area. This study aimed [...] Read more.

Background: The dental healthcare private sector in Riyadh city has been growing rapidly over the past few years; however, there is a lack of information on the accessibility and spatial distribution of private dental healthcare facilities (PDHFs) in the area. This study aimed to evaluate the spatial distribution of PDHFs in Riyadh city in relation to population density in each sub-municipality. Methods: The current information regarding the number, location, and operability of PDHFs in Riyadh city was obtained from the Ministry of Health. A total of 632 operating PDHFs were included with the precise location plotted on Quantum Geographic Information System software (version 3.32.1, Essen, Germany) using Google Earth. Four levels of buffer zones—1 km, 3 km, 5 km, and >5 km—were determined. The population statistics and mean monthly individual income per district were gathered from Zadd.910ths. Microsoft Excel (version 16.0, Microsoft, Redmond, WA, USA) and RStudio software (version 4.1.3, Posit Software, PBC, Boston, MA, USA) were used for additional data analysis. Results: There was an overall ratio of one PDHF per 9958 residents in Riyadh city. Olaya and Maather sub-municipalities had the largest PDHF-to-population ratios: (1:4566) and (1:4828), respectively. Only 36.3% of the city’s total area was within a 1 km buffer zone from a PDHF. There was an overall weak positive correlation between the number of PDHFs and the total area in each sub-municipality (r = 0.29), and the distribution of PDHFs was uneven corresponding to the area (G* = 0.357). Conclusions: There was an uneven distribution of PDHFs in Riyadh city. Some areas were underserved while others were overserved in several sub-municipalities. Policy-makers and investors are encouraged to target underserved areas rather than areas with significant clustering to improve access to care. Full article

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14 pages, 705 KiB

Open AccessArticle

Recovering from COVID-19 (ReCOV): Feasibility of an Allied-Health-Led Multidisciplinary Outpatient Rehabilitation Service for People with Long COVID

by Aruska N. D’Souza, Myvanwy Merrett, Hilda Griffin, An Tran-Duy, Carly Struck, Timothy N. Fazio, Genevieve Juj, Catherine L. Granger and Casey L. Peiris

Int. J. Environ. Res. Public Health 2024, 21(7), 958; https://doi.org/10.3390/ijerph21070958 - 22 Jul 2024

Viewed by 1218

Abstract

Background: A multidisciplinary approach is required for the management of long COVID. The aim of this study was to determine the feasibility (demand, implementation, practicality, acceptability, and limited efficacy) of an allied-health-led multidisciplinary symptom management service (ReCOV) for long COVID. Methods: A single-group [...] Read more.

Background: A multidisciplinary approach is required for the management of long COVID. The aim of this study was to determine the feasibility (demand, implementation, practicality, acceptability, and limited efficacy) of an allied-health-led multidisciplinary symptom management service (ReCOV) for long COVID. Methods: A single-group observational cohort feasibility study was conducted to determine demand (referrals), acceptability (survey), implementation (waitlist times, health professions seen), practicality (adverse events), and limited efficacy (admission and discharge scores from the World Health Organization Disability Assessment Scale, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire, and EuroQol 5D-5L). Data are presented as median [interquartile range] or count (percentage). Results: During the study, 143 participants (aged 42.00 [32.00–51.00] years, 68% women) participated in ReCOV. Participants were waitlisted for 3.86 [2.14–9.86] weeks and engaged with 5.00 [3.00–6.00] different health professionals. No adverse events occurred. The thematic analysis revealed that ReCOV was helpful but did not fully meet the needs of all participants. Limited efficacy testing indicated that participants had improved understanding and control (p < 0.001) of symptoms (BIPQ) and a small improvement in EQ VAS score (median difference 5.50 points [0.00–25.00], p = 0.004]). Conclusions: A multidisciplinary service was safe and mostly acceptable to participants for the management of long COVID. Further research should investigate the clinical and cost effectiveness of such a service, including optimal service duration and patient outcomes. Full article

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9 pages, 558 KiB

Open AccessArticle

Successful Elimination of Endemic Rubella in the WHO European Region. Is It Proper to Remove the Recommendation for Preconceptional Immunization?

by Anna Franca Cavaliere, Marco Parasiliti, Rita Franco, Vitalba Gallitelli, Federica Perelli, Amelia Spanò, Barbara Pallone, Maria Grazia Serafini, Fabrizio Signore, Georgios Eleftheriou, Giovanni Scambia, Antonio Lanzone and Annalisa Vidiri

Int. J. Environ. Res. Public Health 2024, 21(7), 957; https://doi.org/10.3390/ijerph21070957 - 22 Jul 2024

Viewed by 949

Abstract

Background: Rubella is a contagious viral infection that has garnered significant attention in the field of public health due to its potential consequences, especially during pregnancy. In recent decades, it has been recommended that non-immune women receive immunization during the preconceptional and/or postpartum [...] Read more.

Background: Rubella is a contagious viral infection that has garnered significant attention in the field of public health due to its potential consequences, especially during pregnancy. In recent decades, it has been recommended that non-immune women receive immunization during the preconceptional and/or postpartum periods. The goal of this strategy is to prevent primary rubella infection in order to protect pregnant women against congenital rubella syndrome. In November 2022, the WHO’s Regional Verification Commission declared the elimination of rubella infection in Italy. In recent years, the main migration flows to Italy have originated from regions where rubella has not yet been eliminated and where no program is in place to achieve this goal. Objective: The aim of this study was to retrospectively assess rubella immunity in pregnant women who have attended three delivery centers in Rome over the past three years, from January 2021 to May 2023. Methods: Data about the rubella serological status of 7937 non-consecutive pregnant women were collected. Univariate analysis was performed to verify any difference between the study groups in terms of age distribution. Results: Anti-rubella IgG antibodies were found in 7224 (91%) women while 713 (9%) were susceptible to rubella (IgG negative), without differences in terms of immunity rate between Italian and non-Italian women. Age analysis showed a statistically significant older age of immune women than receptive women and of Italian immune women than non-Italian immune women. Conclusions: The National Plan for the Elimination of Measles and Congenital Rubella aimed to achieve a percentage of susceptible women of childbearing age below 5%. These data indicate the relevance of maintaining the recommendation for preconceptional rubella vaccination in Italy. Full article

(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)

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31 pages, 2390 KiB

Open AccessReview

A Systematic Review and Meta-Analysis of Noise Annoyance as a Determinant of Physiological Changes Linked to Disease Promotion

by Emily Senerth, Tejanth Pasumarthi, Neha Tangri, Bhavya Abbi, Skye Bickett, James P. McNamee, David S. Michaud and Rebecca L. Morgan

Int. J. Environ. Res. Public Health 2024, 21(7), 956; https://doi.org/10.3390/ijerph21070956 - 22 Jul 2024

Viewed by 956

Abstract

This systematic review investigates the certainty of evidence (CoE) regarding noise annoyance as a determinant of biological changes known to contribute to disease development. We searched PubMed MEDLINE, EMBASE, Cochrane Central, and CINAHL for English-language comparative studies conducted on humans of any age [...] Read more.

This systematic review investigates the certainty of evidence (CoE) regarding noise annoyance as a determinant of biological changes known to contribute to disease development. We searched PubMed MEDLINE, EMBASE, Cochrane Central, and CINAHL for English-language comparative studies conducted on humans of any age from 1 January 1940, to 28 August 2023. Further, studies that provided quantitative data on the relationship between noise annoyance and biomarkers of interest were included. Where possible, random-effects meta-analyses were used to calculate the odds ratios of noise annoyance on biomarkers and biological conditions considered to be risk factors for developing health effects. The risk of bias of individual studies was assessed using the Risk of Bias of Non-randomized Studies of Exposures (ROBINS-E) instrument. The CoE for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The search identified 23 primary studies reporting on relevant biomarkers. Although some studies and pooled estimates suggest a possible association between noise annoyance and biological measures, the CoE overall is very low due to concerns with the risk of bias, inconsistency, and imprecision in the estimates of effects. In the context of environmental impact assessment, where guidelines aim to mitigate the prevalence of populations experiencing a high level of noise annoyance, our results suggest that such practices should be grounded in the understanding that annoyance is health-relevant because it reflects an undesirable reaction to noise, rather than a precursor to chronic physical health conditions. Full article

(This article belongs to the Special Issue Community Response to Environmental Noise)

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24 pages, 4993 KiB

Open AccessArticle

Climate Change and Health Risk Perceptions of Arkansas Small Farmers through the Application of the Health Belief Model

by Rachel B. Hale, Keneshia Bryant-Moore and Anna Eichenberger

Int. J. Environ. Res. Public Health 2024, 21(7), 955; https://doi.org/10.3390/ijerph21070955 - 22 Jul 2024

Viewed by 1223

Abstract

Climate change poses health risks to Arkansas small farmers. Farmers face an increased risk of heat-related illnesses (e.g., heat exhaustion, cerebral vascular accidents, and cardiovascular issues) and work-related injuries, death, and mental health conditions due to climate change. This cross-sectional survey employed the [...] Read more.

Climate change poses health risks to Arkansas small farmers. Farmers face an increased risk of heat-related illnesses (e.g., heat exhaustion, cerebral vascular accidents, and cardiovascular issues) and work-related injuries, death, and mental health conditions due to climate change. This cross-sectional survey employed the health belief model (HBM) as its theoretical framework. This study aimed to assess the health status of small farmers, climate change beliefs, adaptive agricultural practices, and the perceived effects of climate change on health. Study data were collected using non-probability sampling methods from small farmers (n = 72) with a gross farm income of < USD 250,000. The study findings show that 93% of participants reported good–excellent health, 69% believe the climate is changing and getting warmer, 58.3% believe people are responsible for the changes in our climate, and 75% believe the changing climate impacts farmers. Among the HBM predictive variables, participants reported self-efficacy (50%), perceived susceptibility (48.6%), and perceived severity (43%). Only 16.7% of farmers reported believing they have all the information needed to prepare for climate-related health impacts. This study suggests small farmers have protective factors and adaptive capacity, including health status, income, and education levels, but believe they lack the information necessary to protect their health from climate change. Full article

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12 pages, 353 KiB

Open AccessReview

Risk Factors Associated with Urothelial Bladder Cancer

by Souhail Alouini

Int. J. Environ. Res. Public Health 2024, 21(7), 954; https://doi.org/10.3390/ijerph21070954 - 22 Jul 2024

Cited by 1 | Viewed by 1420

Abstract

Background: Urothelial bladder carcinoma (UBC) is the most frequent histologic form of bladder cancer, constituting 90% of the cases. It is important to know the risk factors of UBC to avoid them and to decrease its recurrence after treatment. The aim of this [...] Read more.

Background: Urothelial bladder carcinoma (UBC) is the most frequent histologic form of bladder cancer, constituting 90% of the cases. It is important to know the risk factors of UBC to avoid them and to decrease its recurrence after treatment. The aim of this review was to provide an overview of the risk factors associated with UBC incidence. Methods: A comprehensive literature search from 2012 to 2024 was carried out in databases such as PubMed, Google Scholar, and Medline with potential keywords such as “bladder cancer”, “urothelial bladder cancer”, “incidence of urothelial bladder cancer worldwide”, “mortality rate of bladder cancer”, “incidence according to gender”, “treatment for bladder cancer”, and “risk factors of bladder cancer”. Smoking tobacco was comprehended to be the major risk factor for UBC. Smoke from tobacco products contains polycyclic aromatic hydrocarbons (PAHs) and aromatic amines such as 4-aminobiphenyl, which are known to cause UBC. Smoking-related bladder cancer mortality ranks just second to smoking-related lung cancer mortality. For non-smokers, pollution became a major risk factor associated with UBC. Polycyclic aromatic hydrocarbons (PAHs) are linked to many cancers, especially to UBC. Indoor and outdoor pollution generates VOCs (volatile organic compounds) and PAHs. Small-particle matter < 2.5 is linked to UBC and lung cancers. Drinking chlorinated water is linked to UBC. Also, swimming in chlorinated pools that produce trihalomethanes increases the risk of many cancers, and especially of bladder cancer. Occupational exposure to carcinogens, specifically aromatic amines, is a significant UBC risk factor. It has been estimated that approximately 20% of all UBCs may be linked to this type of exposure, primarily in industrial settings that treat dye, paint, petroleum chemicals, and metal. The other risk factors included genetics, diet, and medical conditions. Alcohol, consumption of processed meat and whole milk, and higher intakes of selenium and vitamins A and E also contribute to the development of UBC. Further, chemotherapeutic agents, oral hypoglycemic drugs, and radiation therapy are positively associated with UBC. Conclusions: The significance of the initial prevention of UBC must be emphasized, and especially programs for quitting cigarettes should be encouraged and supported. However, smoking is not the only risk factor for UBC. For non-smokers, other risk factors should be investigated. Air and water pollution are linked to UBC. Indoor and outdoor pollution should be more controlled. Patients and people should be informed of the risk of drinking chlorinated water and swimming in chlorinated pools. Full article

17 pages, 345 KiB

Open AccessArticle

An Ethnographic Study Concerning the Implementation of Education on Ageing for Older Adults with Mild Intellectual Disability: The Perspective of the Educators

by Marianne Holmgren and Gerd Ahlström

Int. J. Environ. Res. Public Health 2024, 21(7), 953; https://doi.org/10.3390/ijerph21070953 - 21 Jul 2024

Viewed by 857

Abstract

Despite the fact that longevity in people with intellectual disability has increased at least as much as in the general population, there is a dearth of interventions related to ageing for these older people. Therefore, this study investigated educators’ implementation strategies in a [...] Read more.

Despite the fact that longevity in people with intellectual disability has increased at least as much as in the general population, there is a dearth of interventions related to ageing for these older people. Therefore, this study investigated educators’ implementation strategies in a new tailor-designed educational intervention with the goal of supporting the process of ageing for people with mild intellectual disability. An ethnographic research design was employed, including participant observations, field notes, and 15 ad hoc interviews with educators, spread over two years in four towns. The strategies used for facilitating learning about ageing were expressed in the two themes promoting social togetherness through everyone’s participation and learning together and from each other through recognition and consolidation. These strategies were applied to create a learning environment characterised by a good atmosphere and respectful interaction. Learning together involved consolidation through repetition, group discussions, the use of visual learning materials, and study visits. This new educational intervention about ageing is promising, but less resource-intensive interventions should also be developed and preferably integrated into the disability service. Before concluding whether this education supports the ageing process, it needs to be evaluated from the perspective of people with intellectual disability. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

15 pages, 923 KiB

Open AccessArticle

Enhancing Self-Esteem, Well-Being, and Relaxation in the Elderly through Nature-Based Interventions

by Anna Heród, Bożena Szewczyk-Taranek and Bożena Pawłowska

Int. J. Environ. Res. Public Health 2024, 21(7), 952; https://doi.org/10.3390/ijerph21070952 - 20 Jul 2024

Cited by 1 | Viewed by 1105

Abstract

As the populations of many countries are aging, institutions providing support for the elderly increasingly often use nature-based interventions (NBIs) as part of their therapeutic activities. This study aimed to show the impact of 8-week active and passive NBI programs on self-esteem, well-being, [...] Read more.

As the populations of many countries are aging, institutions providing support for the elderly increasingly often use nature-based interventions (NBIs) as part of their therapeutic activities. This study aimed to show the impact of 8-week active and passive NBI programs on self-esteem, well-being, and relaxation in the elderly. The NBI programs were conducted in two groups of elderly citizens of Poland: independent senior students and seniors requiring 24 h care. The Rosenberg’s Self-Esteem Scale and the World Health Organization Well-Being Index were used to assess self-esteem and well-being before and after the programs. To assess relaxation, pre–post session measurements of pulse rate (PR) and blood oxygen saturation (SpO₂) were used. Our study showed an improvement in the self-esteem, well-being, and relaxation of the participants of both active and passive NBI programs. In all study groups, self-esteem and well-being improved after the programs, regardless of the type of intervention, and after each NBI session, the elderly showed a decrease in PR and an increase in SpO₂, which indicated a deeper state of relaxation. Our research showed a greater improvement in the tested parameters in the seniors participating in the passive programs in a garden. This confirms a key role of green spaces in residential areas for the elderly and in nursing homes. Full article

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13 pages, 1610 KiB

Open AccessArticle

Secular Contrasts in Physical Fitness and Athletic Skills in Japanese Elementary School Students (11-Year-Olds)

by Yukitomo Yogi, Yasunari Ishikawa and Shuichi Takahashi

Int. J. Environ. Res. Public Health 2024, 21(7), 951; https://doi.org/10.3390/ijerph21070951 - 20 Jul 2024

Viewed by 1028

Abstract

Since 1964, Japan has been conducting a wide fitness and athletic skills evaluation among 2000–3000 school children. This study used data made public by the Japan Sports Agency from four events that have continuously been evaluated from 1964 to 2021—grip strength, 50 meter [...] Read more.

Since 1964, Japan has been conducting a wide fitness and athletic skills evaluation among 2000–3000 school children. This study used data made public by the Japan Sports Agency from four events that have continuously been evaluated from 1964 to 2021—grip strength, 50 meter dash, repetitive side jumps, and softball throw—to depict a secular trend over the course of 58 years. This is to statistically categorize these into generations, establishing secular contrast by identifying high and low scores for each event within the categorized generations, with the intent to examine the factors embedded within the background. The generations that had the highest average across all four events were the measurements made in 1970–1993 for males and in 1972–1994 for females. Changes made to the curriculum guidelines may have played a role in the differences found within each event. The goal of physical education and its syllabus and assigned hours in the curriculum guidelines are revised approximately every 10 years to meet social demand. Changes in the social and living environments surrounding children may be exhibited in the form of secular contrast in the measured physical fitness and athletic skills. Full article

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19 pages, 1766 KiB

Open AccessArticle

Integrative Care for Challenging Behaviors in People with Intellectual Disabilities to Reduce Challenging Behaviors and Inappropriate Psychotropic Drug Prescribing Compared with Care as Usual: A Cluster-Randomized Trial

by Gerda de Kuijper, Josien Jonker, Karlijn Kouwer, Pieter J. Hoekstra and Annelies de Bildt

Int. J. Environ. Res. Public Health 2024, 21(7), 950; https://doi.org/10.3390/ijerph21070950 - 20 Jul 2024

Viewed by 1026

Abstract

People with intellectual disabilities (IDs) often present with challenging behaviors (CBs) mostly due to inappropriate environments and mental and physical disorders. Integrative care is recommended to address CBs. However, in clinical practice, psychotropic drugs are often prescribed off-label for CBs, although the effectiveness [...] Read more.

People with intellectual disabilities (IDs) often present with challenging behaviors (CBs) mostly due to inappropriate environments and mental and physical disorders. Integrative care is recommended to address CBs. However, in clinical practice, psychotropic drugs are often prescribed off-label for CBs, although the effectiveness is unclear, and side effects frequently occur. We conducted a cluster-randomized controlled study to investigate the effect of integrative care provided by a collaboration of an ID specialized mental healthcare team and participants’ own ID service providers’ care team on reducing CBs and inappropriate off-label psychotropic drug prescriptions compared with care as usual. Participants (N = 33, aged 19–81 years) had a moderate, severe, or profound intellectual disability and used off-label psychotropic drugs. The primary outcome measures were the Aberrant Behavior Checklist and the total dose of psychotropic drug prescriptions. At the study endpoint of 40 weeks, we found no effect of the intervention on the total ABC score and on the total dose of psychotropic drug prescriptions. In the intervention group, however, the psychotropic drug dose decreased significantly, while CBs did not change. The small sample size and not-completed interventions due to organizational problems may have affected our findings. This study illustrates the difficulties in the implementation of integrative care. Full article

(This article belongs to the Section Behavioral and Mental Health)

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21 pages, 650 KiB

Open AccessArticle

Perspectives and Experiences of Public Safety Personnel Engaged in a Peer-Led Workplace Reintegration Program Post Critical Incident or Operational Stress Injury: A Qualitative Thematic Analysis

by Chelsea Jones, Shaylee Spencer, Elly O’Greysik, Lorraine Smith-MacDonald, Katherine S. Bright, Amy J. Beck, R. Nicholas Carleton, Lisa Burback, Andrew Greenshaw, Yanbo Zhang, Phillip R. Sevigny, Jake Hayward, Bo Cao and Suzette Brémault-Phillips

Int. J. Environ. Res. Public Health 2024, 21(7), 949; https://doi.org/10.3390/ijerph21070949 - 19 Jul 2024

Viewed by 1243

Abstract

Introduction: Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process [...] Read more.

Introduction: Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process may contribute to further personal challenges for PSP and their families as well as staffing shortages that adversely affect PSP organizations. The Canadian Workplace Reintegration Program (RP) has seen a global scale and spread in recent years. However, there remains a lack of evidence-based literature on this topic and the RP specifically. The current qualitative study was designed to explore the perspectives of PSP who had engaged in a Workplace RP due to experiencing a potentially psychologically injurious event or OSI. Methods: A qualitative thematic analysis analyzed interview data from 26 PSP who completed the RP. The researchers identified five themes: (1) the impact of stigma on service engagement; (2) the importance of short-term critical incident (STCI) program; (3) strengths of RP; (4) barriers and areas of improvement for the RP; and (5) support outside the RP. Discussion: Preliminary results were favorable, but further research is needed to address the effectiveness, efficacy, and utility of the RP. Conclusion: By addressing workplace reintegration through innovation and research, future initiatives and RP iterations can provide the best possible service and support to PSP and their communities. Full article

(This article belongs to the Special Issue Advances in Ergonomics, Human Factors and Safety for Occupational Health)

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13 pages, 480 KiB

Open AccessArticle

“Empowerment for Us by Us (E4UBU)”: Developing a Model of Empowerment Using Feminist Participatory Methods with LBQT+ Persons Assigned Female at Birth in Western Kenya

by Heather M. Tucker, Rebecca Odhiambo, Laura Jadwin-Cakmak, Anita Mbanda, Ashley Lacombe-Duncan, Caroline Rucah, Ini-Abasi Ubong, Cynthia Akoth Ouko, Wilson Odero and Gary W. Harper

Int. J. Environ. Res. Public Health 2024, 21(7), 948; https://doi.org/10.3390/ijerph21070948 - 19 Jul 2024

Viewed by 1026

Abstract

Lesbian, bisexual, queer, trans and other gender diverse persons assigned female at birth (heretofore referred to as “LBQT+ persons”) in Western Kenya experience intersectional oppression and stigma. This stigma can manifest in acts of sexual and gender-based violence (SGBV) and sexual and gender [...] Read more.

Lesbian, bisexual, queer, trans and other gender diverse persons assigned female at birth (heretofore referred to as “LBQT+ persons”) in Western Kenya experience intersectional oppression and stigma. This stigma can manifest in acts of sexual and gender-based violence (SGBV) and sexual and gender minority (SGM)-based violence, as well as various forms of discrimination—all of which have been linked to disproportionately higher levels of negative health outcomes for this group. Despite these challenges, many LBQT+ persons have been able to gain personal and collective power and thrive in this oppressive environment. The Empowerment for Us by Us (E4UBU) project is a mixed methods feminist participatory research study focused on exploring how LBQT+ persons conceptualize and define empowerment for themselves, and to understand their perspectives on how feelings of power and powerlessness influence their physical and mental health. This paper focuses on data from the first phase of the study, in which qualitative in-depth interviews were conducted with 40 LBQT+ persons (ages 19 to 50) from Kisumu and Homa Bay in Western Kenya. A participatory interpretive phenomenological analysis was conducted to understand the lived experiences of LBQT+ persons as they navigate intersectional oppression and its influence on their experiences of empowerment and subsequent health outcomes. Findings from this analysis were presented to two different focus groups composed of participants who had participated in the in-depth interviews to gather their insights on the interpretations of the interviews as a form of member checking. Findings revealed that “empowerment” was not experienced and viewed by LBQT+ persons as a monolithic construct, but rather a process through which LBQT+ persons are able to transform negative forces of intersectional oppression and powerlessness into experiences of power and subsequent individual and collective action and impact—all leading to improved mental health and well-being. This process is facilitated at several junctures by participatory seeking and attainment of community-appropriate resources at multiple socio-ecological levels that, when accessed with sufficient intensity, frequency, and duration, enhance one’s journey through the process of empowerment. These facilitation junctures are viewed as likely points of focus for public health intervention. Analysis also revealed that the process of empowerment is dependent on the context within which the process is occurring, the specific issues being faced, and the population of focus. Recommendations for how this model can be used for future research and practice to improve the lives of LBQT+ persons in Kenya are discussed. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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11 pages, 507 KiB

Open AccessArticle

Relationship between Tilt Sensation Ability and Lower Limb Injuries in Junior Athletes

by Maki Tanaka, Yuka Inoue, Megumi Gonno, Teruo Nomura, Kyosuke Oku, Tomoyuki Matsui, Machiko Hiramoto, Tetsuya Miyazaki, Hitoshi Koda, Yuya Watanabe, Yoshihiro Kai, Toru Morihara and Noriyuki Kida

Int. J. Environ. Res. Public Health 2024, 21(7), 947; https://doi.org/10.3390/ijerph21070947 - 19 Jul 2024

Viewed by 928

Abstract

The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. [...] Read more.

The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. In this study, a step platform created tilt angles. Participants with eye masks answered “yes” or “no” to sensing a tilt, evaluated over nine or seven trials. Experiment 1 involved 22 university students (20.6 ± 0.9 years). The minimum angle at which a tilt could be sensed while standing on both feet was determined, and measurements were taken again to examine reliability. Experiment 2 involved 40 junior athletes (12.3 ± 2.0 years), where the minimum angle for tilt sensation was obtained, and medical checks were conducted to assess injuries in the knee, lower leg, and foot. Reliability studies showed a moderately significant correlation between the first and second sessions (r = 0.504, p = 0.017), suggesting the reliability of the experimental method. The proportion capable of sensing a tilt of 1.1° and 1.6° was significantly higher in junior high school students than in elementary school students (1.1°; χ² = 8.839, p = 0.003. 1.6°; χ² = 4.038, p = 0.044). The group unable to sense a tilt of 1.6° and 2.1° had a significantly higher positive rate of knee injuries compared to the sensed group among junior high school students (1.6°; χ² = 4.622, p = 0.032. 2.1°; χ² = 4.622, p = 0.032). Our findings suggested that a reduced tilt sensation ability was associated with knee injuries in junior high school students. Utilizing our devised tilt sensation assessment could play a crucial role in preventing and detecting early injuries in junior high school students. Full article

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12 pages, 309 KiB

Open AccessArticle

Exploring the Support Needs of Chinese Family Carers of People Living with Dementia in New Zealand during the COVID-19 Pandemic: A Resilience Resources Framework Perspective

by Fei Li, John Parsons and Gary Cheung

Int. J. Environ. Res. Public Health 2024, 21(7), 946; https://doi.org/10.3390/ijerph21070946 - 19 Jul 2024

Viewed by 767

Abstract

Caring for people living with dementia during the novel coronavirus disease 2019 (COVID-19) pandemic significantly impacted the emotional, physical, and social well-being of carers. However, no study has focused on the well-being of Chinese carers of people living with dementia in New Zealand [...] Read more.

Caring for people living with dementia during the novel coronavirus disease 2019 (COVID-19) pandemic significantly impacted the emotional, physical, and social well-being of carers. However, no study has focused on the well-being of Chinese carers of people living with dementia in New Zealand during the pandemic. This study aimed to explore the support needs of Chinese carers of people living with dementia in New Zealand during the COVID-19 pandemic. Semi-structured interviews were conducted by two bilingual and bicultural researchers. Thematic analysis was used to explore the resilience resources for Chinese carers. Twelve Chinese carers were recruited from four community organizations in New Zealand. Four themes were identified: (1) social isolation, (2) emotional loneliness, (3) ambivalent feelings of being a carer, and (4) a variety of unmet needs. The findings of our study provide new insights into the multiple support needs of Chinese carers of people living with dementia during the COVID-19 pandemic. Implications for practice include the establishment of culturally appropriate care support services and the development of tailored resilience-building interventions to address the unmet needs of Chinese carers of people living with dementia. Full article

16 pages, 1020 KiB

Open AccessArticle

Evaluating Food Procurement against the EAT-Lancet Planetary Health Diet in a Sample of U.S. Universities

by Jaclyn Bertoldo, Abby Fammartino, Sophie Egan, Roni A. Neff, Rebecca Grekin and Julia A. Wolfson

Int. J. Environ. Res. Public Health 2024, 21(7), 945; https://doi.org/10.3390/ijerph21070945 - 19 Jul 2024

Viewed by 1638

Abstract

Aligning institutional food procurement with planetary health targets offers opportunities to improve nutrition and reduce food-related greenhouse gas (GHG) emissions. This study compared foods procured by 19 university dining programs in the U.S. in 2022 with the EAT-Lancet planetary health diet. Each [...] Read more.

Aligning institutional food procurement with planetary health targets offers opportunities to improve nutrition and reduce food-related greenhouse gas (GHG) emissions. This study compared foods procured by 19 university dining programs in the U.S. in 2022 with the EAT-Lancet planetary health diet. Each university’s procurement was then modeled to align with the EAT-Lancet planetary health diet, and changes to Healthy Eating Index (HEI) scores and GHG emissions were evaluated. For a subset of universities that provided cost data, changes in annual total food costs were also estimated. Universities in this study exceeded EAT-Lancet planetary health targets for beef (

\bar{x}

= 657% of target), pork (

\bar{x}

= 587%), poultry (

\bar{x}

= 379%), and eggs (

\bar{x}

= 293%). All universities failed to achieve planetary health targets for legumes and nuts (

\bar{x}

= 39% of the target) and vegetables (

\bar{x}

= 68%). Aligning food procurement with the planetary health diet would result in an estimated average 46.1% reduction in GHG emissions and a 19.7 point increase in HEI scores. Universities that provided cost data saw an average 9.7% reduction in food costs in the EAT-Lancet-aligned scenario. The procurement metrics assessed in this study can help university dining programs and other institutional food service organizations set goals and monitor progress toward planetary health targets. Full article

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12 pages, 631 KiB

Open AccessArticle

Hospital Chaplain Burnout, Depression, and Well-Being during the COVID-19 Pandemic

by Patricia K. Palmer, Zainab Siddiqui, Miranda A. Moore, George H. Grant, Charles L. Raison and Jennifer S. Mascaro

Int. J. Environ. Res. Public Health 2024, 21(7), 944; https://doi.org/10.3390/ijerph21070944 - 19 Jul 2024

Viewed by 1442

Abstract

Healthcare personnel experienced unprecedented stressors and risk factors for burnout, anxiety, and depression during the COVID-19 pandemic. This may have been particularly true for spiritual health clinicians (SHCs), also referred to as healthcare chaplains. We administered a daily pulse survey that allowed SHCs [...] Read more.

Healthcare personnel experienced unprecedented stressors and risk factors for burnout, anxiety, and depression during the COVID-19 pandemic. This may have been particularly true for spiritual health clinicians (SHCs), also referred to as healthcare chaplains. We administered a daily pulse survey that allowed SHCs to self-report burnout, depression, and well-being, administered every weekday for the first year of the pandemic. We used a series of linear regression models to evaluate whether burnout, depression, and well-being were associated with local COVID-19 rates in the chaplains’ hospital system (COVID-19 admissions, hospital deaths from COVID-19, and COVID-19 ICU census). We also compared SHC weekly rates with national averages acquired by the U.S. Census Bureau’s Household Pulse Survey (HPS) data during the same timeframe. Of the 840 daily entries from 32 SHCs, 90.0% indicated no symptoms of burnout and 97.1% were below the cutoff for depression. There was no statistically significant relationship between any of the COVID-19 predictors and burnout, depression, or well-being. Mean national PHQ-2 scores were consistently higher than our sample’s biweekly means. Understanding why SHCs were largely protected against burnout and depression may help in addressing the epidemic of burnout among healthcare providers and for preparedness for future healthcare crises. Full article

(This article belongs to the Special Issue Occupational Health and Wellbeing for Healthcare Providers)

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14 pages, 2150 KiB

Open AccessArticle

Women’s Empowerment and Associated Factors in Kinshasa, Democratic Republic of Congo: A Secondary Data Analysis of the Performance Monitoring Assessment Survey

by Annick Makongote, Branly Mbunga, Pierre Akilimali, Sofia Castro Lopes and Dieudonné Mpunga

Int. J. Environ. Res. Public Health 2024, 21(7), 943; https://doi.org/10.3390/ijerph21070943 - 19 Jul 2024

Viewed by 962

Abstract

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess [...] Read more.

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess women’s empowerment and determine its associated factors in Kinshasa, DRC. We analyzed data from the 2021 Performance Monitoring Assessment (PMA) survey. A sample of 1365 women of childbearing age was retained for this study. Twenty empowerment items related to household decision-making, contraception use, and husband/partner influence were considered. We calculated the average women’s empowerment index (aWEI), identified the women’s empowerment variables using principal component analysis (PCA), and determined the associated factors for the first three principal components through the performance of multivariate binary logistic regression. In Kinshasa, the overall aWEI was estimated at 0.65. It was low for household decision-making (0.34) and high for husband/partner influence domains (0.93). Three principal components were identified and named, including the absence of threats, control of sexuality, and participation in decision-making. The factors associated with these components were having internet access, being in free union with a partner, being aged 40–49 years, and residing in a non-slum area. Increasing access to information would enable women in Kinshasa to make strategic decisions about their lives, benefiting themselves and others. Full article

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10 pages, 2000 KiB

Open AccessArticle

Daylight and Electric Lighting in Primary and Secondary School Classrooms in the UK—An Observational Study

by Luke L. A. Price, Annegret Dahlmann-Noor and Marina Khazova

Int. J. Environ. Res. Public Health 2024, 21(7), 942; https://doi.org/10.3390/ijerph21070942 - 19 Jul 2024

Viewed by 956

Abstract

Only a few recent studies report direct assessment or monitoring of light levels in the indoor learning environment, and no consensus exists on minimum exposures for children’s health. For instance, myopia is a common progressive condition, with genetic and environmental risk factors. Reduced [...] Read more.

Only a few recent studies report direct assessment or monitoring of light levels in the indoor learning environment, and no consensus exists on minimum exposures for children’s health. For instance, myopia is a common progressive condition, with genetic and environmental risk factors. Reduced daylight exposure, electric lighting changes, increased near-work for school children, greater academic focus, and use of display screens and white boards may have important detrimental influences. Published assessment methods had varied limitations, such as incomplete compliance from participants wearing light loggers for extended periods. Climate-Based Daylight Modelling is encouraged in UK school design, but design approaches are impractical for post-occupancy assessments of pre-existing classrooms or ad hoc modifications. In this study, we investigated the potential for direct assessment and monitoring of classroom daylight and lighting measurements. Combined with objective assessments of outdoor exposures and class time use, the classroom data could inform design and light exposure interventions to reduce the various health impacts of inadequate daylight exposure. The relevant environmental measure for myopia depends on the hypothesized mechanism, so the illuminance, spectral distribution, and temporal light modulation from the electric lighting was also assessed. Full article

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23 pages, 2129 KiB

Open AccessArticle

Ergonomics, Health, and Perceptions about Remote Domestic Workposts: Study in Areas of City of João Pessoa, Paraíba, Brazil

by Luiz Bueno Silva, Carmem Julianne Beserra Melo, Adriana Gomes Lisboa de Souza and Lucas Guedes de Oliveira

Int. J. Environ. Res. Public Health 2024, 21(7), 941; https://doi.org/10.3390/ijerph21070941 - 19 Jul 2024

Viewed by 1319

Abstract

Home office (HO) stands out as one of the most promising and popular forms of teleworking, especially after the COVID-19 pandemic. Therefore, many companies want to implement or maintain this working method, given its numerous advantages. However, there are adverse effects that are [...] Read more.

Home office (HO) stands out as one of the most promising and popular forms of teleworking, especially after the COVID-19 pandemic. Therefore, many companies want to implement or maintain this working method, given its numerous advantages. However, there are adverse effects that are mainly related to physical and mental health. This article presents ergonomic analyses of HOs in neighborhoods considered heat islands. Temperature levels, extreme low-frequency non-ionizing radiation (ELF-NIR), illuminance, physical layout characteristics, and physiological parameters of teleworkers were measured. The results reveal that 92% of these professionals work 6 to 8 h daily with an ambient temperature between 25 and 30 °C, illumination levels in the range 11.20–290 Lux, and ELF-NIR > 0.4 µT. The majority of teleworkers are overweight (BMI > 24.9), and some of them have blood pressure higher than average values (129 mmHg for systolic and 84 mmHg for diastolic) in addition to a reduction in the number of red blood cells and hematocrits. Symptoms such as burning sensation, dryness, tired eyes, redness, itching, and photophobia (light sensitivity) show a 68.95% similarity. These HOs do not meet the required ergonomic and health standards. Full article

(This article belongs to the Special Issue Advances in Ergonomics, Human Factors and Safety for Occupational Health)

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13 pages, 1225 KiB

Open AccessSystematic Review

Social Story Intervention for Training Expected Behaviors among Preschool Children: A Systematic Review and Meta-Analysis

by Ni Zhou, Li Zhou, Cheuk Yu Teresa Ho, Colman McGrath and Hai Ming Wong

Int. J. Environ. Res. Public Health 2024, 21(7), 940; https://doi.org/10.3390/ijerph21070940 - 19 Jul 2024

Viewed by 1192

Abstract

Promoting appropriate behaviors in early childhood is crucial for children’s future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. [...] Read more.

Promoting appropriate behaviors in early childhood is crucial for children’s future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. The references were systematically screened in accordance with the PRISMA statements. Randomized or non-randomized controlled studies, as well as single-subject studies, in which SSs served as a behavioral training approach for children aged 2 to 6 years were included. Information related to study design, characteristics of the participants, target behaviors, and implementation of SS intervention was extracted. A meta-analysis was performed using the random-effects model, where similar outcomes were evaluated by similar intervention across multiple studies. Twenty-one studies were identified for qualitative analysis, while two studies formed the basis of the meta-analysis. SS interventions were employed to teach a variety of behaviors among typically developing children as well as those with various disabilities, such as autism, developmental delay, hearing impairments, attention deficit hyperactivity disorder, or other disabilities. The target behaviors included oral health practices, peer interaction, staying on-task, self-regulation, sleep habits, and controlling aggressive behavior during group activities. The SSs were used either alone or combined with other strategies, such as positive reinforcement, music therapy, role play, group discussion, video self-modeling, immediate practices, or additional audio commentary. Most studies reported improvements in appropriate behaviors and/or reductions in unfavorable behaviors. The meta-analysis indicated that children practiced more toothbrushing steps when using SS interventions compared to conventional oral health instruction (Z = 3.60, MD = 0.66, 95%CI 0.30 to 1.02, p < 0.001). SS interventions have the potential to teach target behaviors, particularly toothbrushing behaviors, among preschool children. More well-designed randomized controlled trials are warranted to determine the efficacy of SS interventions among children with various developmental profiles. Full article

(This article belongs to the Section Global Health)

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11 pages, 289 KiB

Open AccessArticle

Factors Associated with Legionella Detection in the Water Systems of National Lodging Organization Facilities with Water Management Programs in the United States

by Rebecca Kahn, Gordana Derado, Elizabeth J. Hannapel, Patrick Vander Kelen, Jasen M. Kunz and Chris Edens

Int. J. Environ. Res. Public Health 2024, 21(7), 939; https://doi.org/10.3390/ijerph21070939 - 18 Jul 2024

Viewed by 1067

Abstract

A better understanding of risk factors and the predictive capability of water management program (WMP) data in detecting Legionella are needed to inform the efforts aimed at reducing Legionella growth and preventing outbreaks of Legionnaires’ disease. Using WMPs and Legionella testing data from [...] Read more.

A better understanding of risk factors and the predictive capability of water management program (WMP) data in detecting Legionella are needed to inform the efforts aimed at reducing Legionella growth and preventing outbreaks of Legionnaires’ disease. Using WMPs and Legionella testing data from a national lodging organization in the United States, we aimed to (1) identify factors associated with Legionella detection and (2) assess the ability of WMP disinfectant and temperature metrics to predict Legionella detection. We conducted a logistic regression analysis to identify WMP metrics associated with Legionella serogroup 1 (SG1) detection. We also estimated the predictive values for each of the WMP metrics and SG1 detection. Of 5435 testing observations from 2018 to 2020, 411 (7.6%) had SG1 detection, and 1606 (29.5%) had either SG1 or non-SG1 detection. We found failures in commonly collected WMP metrics, particularly at the primary test point for total disinfectant levels in hot water, to be associated with SG1 detection. These findings highlight that establishing and regularly monitoring water quality parameters for WMPs may be important for preventing Legionella growth and subsequent disease. However, while unsuitable water quality parameter results are associated with Legionella detection, this study found that they had poor predictive value, due in part to the low prevalence of SG1 detection in this dataset. These findings suggest that Legionella testing provides critical information to validate if a WMP is working, which cannot be obtained through water quality parameter measurements alone. Full article

9 pages, 1229 KiB

Open AccessBrief Report

Aerobic Exercise in the Aquatic Environment Suppresses the Plasma Renin Activity in Individuals with Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial

by Rodrigo Sudatti Delevatti, Larissa dos Santos Leonel, João Gabriel da Silveira Rodrigues, Ana Carolina Kanitz, Cristine Lima Alberton, Gisele Agustini Lovatel, Ionara Rodrigues Siqueira and Luiz Fernando Martins Kruel

Int. J. Environ. Res. Public Health 2024, 21(7), 938; https://doi.org/10.3390/ijerph21070938 - 18 Jul 2024

Viewed by 851

Abstract

To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or [...] Read more.

To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or on an athletics track, respectively. Both sessions comprised seven blocks of 3 min at 85–90% of the heart rate deflection point (HRDP), interspersed with 2 min at <85% HRDP, totaling 35 min, with a 48 h interval between sessions. PRA and blood glucose were assessed before and immediately after the sessions. Generalized estimation equations were used to verify the session effects, with the Bonferroni post hoc test, considering the significance level as 0.05. Twelve individuals (53.2 ± 8.9 years) diagnosed with type 2 diabetes for 6.3 ± 6.34 years participated in the study. A reduction in PRA was found only after the aquatic session (−7.75 ng/mL/h; −69%; p: 0.034), while both aquatic and dry-land sessions similarly reduced the blood glucose levels (aquatic: −38 mg/dL, −21%; dry-land: −26 mg/dL, −14%; time effect, p = 0.007). Despite yielding similar glycemic reductions as dry-land walking/running, aquatic walking/running led to an expressive decrease in PRA among individuals with type 2 diabetes. Full article

(This article belongs to the Special Issue New Advances in Diabetes)

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13 pages, 354 KiB

Open AccessArticle

Is Having Urban Green Space in the Neighborhood Enough to Make a Difference? Insights for Healthier City Design

by Adriano Bressane, Maria Eduarda Guedes Ferreira, Ana Júlia da Silva Garcia and Líliam César de Castro Medeiros

Int. J. Environ. Res. Public Health 2024, 21(7), 937; https://doi.org/10.3390/ijerph21070937 - 18 Jul 2024

Cited by 1 | Viewed by 1249

Abstract

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose [...] Read more.

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose: This study delves into whether merely having green space in the neighborhood is sufficient to impact residents’ mental health in Brazilian metropolitan regions. Method: Utilizing a cross-sectional survey, data were collected from 2136 participants. The analyzed variables included the intensity, duration, and frequency of nature engagement, suitability of UGS for visitation and physical activities, and mental well-being indicators measured by the DASS-21 scale. Multivariate statistical analyses and multiple regression models were employed to verify hypothetical relationships. Results and conclusions: Higher intensity, duration, and frequency of nature engagement in UGS were significantly associated with lower depression, anxiety, and stress scores. Notably, having urban UGS in the neighborhood alone was not enough to reduce mental health issues. Practical implications: The findings point out the need for urban planning policies that prioritize the development of high-quality, accessible green spaces to maximize mental well-being benefits. These insights could inform city designs that foster healthier urban environments. Future directions: Longitudinal studies are needed to establish causality between nature engagement and mental health improvements. Further research should incorporate objective measures of nature engagement and explore more aspects of green space quality, such as biodiversity and amenities. Full article

(This article belongs to the Special Issue Trends in Sustainable and Healthy Cities)

17 pages, 489 KiB

Open AccessArticle

A Randomized Controlled Trial Testing the Effects of a Social Needs Navigation Intervention on Health Outcomes and Healthcare Utilization among Medicaid Members with Type 2 Diabetes

by Amy McQueen, David von Nordheim, Charlene Caburnay, Linda Li, Cynthia Herrick, Lauren Grimes, Darrell Broussard, Rachel E. Smith, Dana Lawson, Yan Yan and Matthew Kreuter

Int. J. Environ. Res. Public Health 2024, 21(7), 936; https://doi.org/10.3390/ijerph21070936 - 18 Jul 2024

Viewed by 942

Abstract

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation [...] Read more.

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation (n = 234) for 6 months and compare HbA1c (primary outcome), quality of life (secondary outcome), and other exploratory outcomes with t-tests and mixed-effects regression. Eligible participants had an HbA1c test in claims in the past 120 days and reported 1+ social needs. Data were collected from November 2019 to July 2023. Surveys were completed at baseline and at 3-, 6-, and 12-month follow-up. Health plan data included care management records and medical and pharmacy claims. The sample was from Louisiana, USA, M = 51.6 (SD = 9.5) years old, 76.1% female, 66.5% Black, 29.4% White, and 3.0% Hispanic. By design, more navigation (91.5%) vs. usual care (6.7%) participants had a care plan. Social needs persisted for both groups. No group differences in HbA1c tests and values were observed, though the large amount of missing HbA1c lab values reduced statistical power. No group differences were observed for other outcomes. Proactively eliciting and attempting to provide referrals and resources for social needs did not demonstrate significant health benefits or decrease healthcare utilization in this sample. Full article

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11 pages, 347 KiB

Open AccessArticle

Food Consumption Inequalities in Primary Care in a Large Metropolis

by Mariana Souza Lopes, Priscila Lenita Candida dos Santos and Aline Cristine Souza Lopes

Int. J. Environ. Res. Public Health 2024, 21(7), 935; https://doi.org/10.3390/ijerph21070935 - 18 Jul 2024

Viewed by 685

Abstract

The aim of this study was to examine the association between health vulnerability and food consumption according to the NOVA classification within primary care in a major Brazilian city. A cross-sectional study was conducted among adults over 20 years old. These participants were [...] Read more.

The aim of this study was to examine the association between health vulnerability and food consumption according to the NOVA classification within primary care in a major Brazilian city. A cross-sectional study was conducted among adults over 20 years old. These participants were part of a representative sample from the Health Academy Program (PAS) in Belo Horizonte, Brazil. We evaluated socio-demographic variables, self-reported illnesses, perceived health and quality of life, and the length of participation in PAS. Health vulnerability was gauged through the Health Vulnerability Index (HVI), which is calculated for each census sector and classified as low, medium, and high/very high. On the other hand, food consumption was determined by evaluating the average consumption described in a 24 h diet recall (24HR) and categorizing it under the NOVA classification: culinary preparations, processed foods, and ultra-processed foods (UPFs). The average calorie intake was 1429.7 kcal, primarily from culinary preparations (61.6%) and UPFs (27.4%). After adjustments, individuals residing in high/very high-HVI areas consumed more culinary preparations (β = 2.7; 95%CI: 4.7; 0.7) and fewer UPFs (β = −2.7; 95%CI: −4.7; −0.7) compared to those from low-vulnerability areas. PAS participants residing in more vulnerable areas reported healthier dietary habits, consuming more homecooked meals and fewer UPFs. These findings underscore the importance of concentrating efforts on promoting and preserving healthy eating habits and emphasizing the value of home cooking in the most vulnerable regions. Full article

(This article belongs to the Section Health Care Sciences)

17 pages, 813 KiB

Open AccessArticle

Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students

by Tamami Suzuki, Yoshiko Bai and Yuko Ohno

Int. J. Environ. Res. Public Health 2024, 21(7), 934; https://doi.org/10.3390/ijerph21070934 - 17 Jul 2024

Viewed by 1068

Abstract

Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted [...] Read more.

Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted on 80 high schools in Gunma Prefecture, Japan. The survey incorporated the Quick Environmental Exposure and Sensitivity Inventory, as well as items related to allergies, the living environment, and lifestyle. Of the 4630 students analyzed, according to Hojo’s cut-off value, 9.0% were classified as high-risk for MCS and 77.9% reported some allergy-like symptoms. Significant factors associated with elevated MCS risk included female sex, having various allergic conditions, having experienced living in a new home or home renovations or extensions, proximity to environmental stressors (freeways, national highway, factories, rubbish dumps, or sources of offensive odors), insufficient physical activity (exercising less than once a week outside of physical education classes), having cold hands and feet, being fatigued, having a bedtime earlier than 11 p.m., and having moderate–frequent subjective stress. Overall, 9.0% of high school students in Japan are at high risk for MCS. Enhancing awareness of MCS-like symptoms and addressing allergies, living environments, and lifestyle habits may mitigate these symptoms. Full article

(This article belongs to the Special Issue Environmental Exposures and Epigenomics in Health and Disease)

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19 pages, 2137 KiB

Open AccessArticle

Parental Mental Health, Gender, and Lifestyle Effects on Post-Pandemic Child and Adolescent Psychosocial Problems: A Cross-Sectional Survey in Northern Italy

by Verena Barbieri, Giuliano Piccoliori, Adolf Engl and Christian J. Wiedermann

Int. J. Environ. Res. Public Health 2024, 21(7), 933; https://doi.org/10.3390/ijerph21070933 - 17 Jul 2024

Viewed by 1121

Abstract

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, [...] Read more.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents’ mental health problems, whereas self-reports tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions. Full article

(This article belongs to the Special Issue Mental Health and Wellbeing of Children and Adolescents)

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19 pages, 1500 KiB

Open AccessArticle

Dietary Minerals and Incident Cardiovascular Outcomes among Never-Smokers in a Danish Case–Cohort Study

by Victoria Fruh, Tesleem Babalola, Clara Sears, Gregory A. Wellenius, Thomas F. Webster, Koren K. Mann, James Harrington, Anne Tjønneland, Ole Raaschou-Nielsen, Birgit Claus Henn and Jaymie R. Meliker

Int. J. Environ. Res. Public Health 2024, 21(7), 932; https://doi.org/10.3390/ijerph21070932 - 17 Jul 2024

Viewed by 1062

Abstract

Background: Diet is known to impact cardiovascular disease (CVD) risk, but evidence for the essential minerals of magnesium (Mg), calcium (Ca), and potassium (K) is inconsistent. Methods: We conducted a case–cohort study within a non-smoking subgroup of the Danish Diet, Cancer and Health [...] Read more.

Background: Diet is known to impact cardiovascular disease (CVD) risk, but evidence for the essential minerals of magnesium (Mg), calcium (Ca), and potassium (K) is inconsistent. Methods: We conducted a case–cohort study within a non-smoking subgroup of the Danish Diet, Cancer and Health cohort, a prospective study of 50–64-year-olds recruited between 1993–1997. We identified incident heart failure (HF), acute myocardial infarction (AMI) and stroke cases through 2015 with an 1135-member subcohort. We measured the dietary intake of minerals, also known as elements, and calculated a combined dietary intake (CDI) score based on joint Ca, Mg and K intakes (mg/d) from Food Frequency Questionnaires. We estimated adjusted hazard ratios (HRs) with Cox proportional hazard models. Results: Most HRs examining associations between CDI score and CVD were null. However, the third quartile of CDI was associated with a lower risk for heart failure (HR: 0.89; 95% CI: 0.67, 1.17), AMI (HR: 0.79; 95% CI: 0.60, 1.04), and stroke (HR: 0.63; 95% CI: 0.44, 0.88). Conclusions: We did not find consistent evidence to suggest that higher levels of essential minerals are associated with incident HF, AMI, and stroke, though results suggest a potential U-shaped relationship between select minerals and CVD outcomes. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 314 KiB

Open AccessArticle

Intensive Care Unit Nurses’ Experiences in Caring for End-of-Life Patients in Saudi Arabia: A Qualitative Study

by Naif H. Alanazi

Int. J. Environ. Res. Public Health 2024, 21(7), 931; https://doi.org/10.3390/ijerph21070931 - 17 Jul 2024

Viewed by 1313

Abstract

Background: Although extensive research on appropriate treatments has been conducted, how nurses provide care to patients at the end-of-life (EOL) is unclear, particularly among intensive care unit (ICU) nurses in Saudi Arabia. Purpose: To explore intensive care unit nurses’ experiences in providing end-of-life [...] Read more.

Background: Although extensive research on appropriate treatments has been conducted, how nurses provide care to patients at the end-of-life (EOL) is unclear, particularly among intensive care unit (ICU) nurses in Saudi Arabia. Purpose: To explore intensive care unit nurses’ experiences in providing end-of-life care in Saudi Arabia. Methods: This study utilized an exploratory, descriptive, qualitative approach. A purposive sampling technique was used to recruit ICU nurses (n = 10) working in ICUs at a tertiary teaching hospital in Riyadh, Saudi Arabia. Using a semi-structured interview guide, ten individual interviews were conducted. Data were analyzed using thematic analysis. The trustworthiness of this study was ensured by following Lincoln and Guba’s (1985) criteria. Findings: Four major themes related to ICU nurses’ experiences of providing EOL care emerged, including: “feeling challenged but driven”, “holistic caring”, “collaborative working ethics”, and “caring for the undying and dying”. Conclusions: This study adds to the body of knowledge about the experience of ICU nurses caring for EOL patients. It offers valuable insights into challenges, coping strategies, holistic caring, collaboration, and the management of critical or dying patients at EOL in the ICUs. Full article

(This article belongs to the Special Issue Palliative Care and End-of-Life Care)

10 pages, 486 KiB

Open AccessArticle

Adherence of Brazilian Minors to the 24-Hour Movement Guidelines after In-Person School Return

by Natália Molleri, Saint Clair Gomes Junior, Daniele Marano and Andrea Zin

Int. J. Environ. Res. Public Health 2024, 21(7), 930; https://doi.org/10.3390/ijerph21070930 - 17 Jul 2024

Viewed by 865

Abstract

The levels of adequacy of movement behaviors after returning to in-person school activities following the COVID-19 pandemic are not yet well understood. This study aimed to assess the adherence of Brazilian minors to the recommendations of the 24-Hour Movement Guidelines (moderate to vigorous [...] Read more.

The levels of adequacy of movement behaviors after returning to in-person school activities following the COVID-19 pandemic are not yet well understood. This study aimed to assess the adherence of Brazilian minors to the recommendations of the 24-Hour Movement Guidelines (moderate to vigorous physical activity, recreational screen time, and sleep duration), as well as overall adherence to these guidelines, after the relaxation of COVID-19 social isolation measures and the resumption of in-person schooling. A cross-sectional study was conducted with parents or guardians (39 ± 7.8) of minors aged up to 18 years of age (3.8 ± 2.5). A total of 172 individuals responded to the questionnaire. Data were compared with those obtained in the Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic. There was an 18.6 percentage decrease (p-value < 0.001) in overall adherence to the 24-Hour Movement Guidelines when comparing the periods before the COVID-19 pandemic (March 2020) and after the return to in-person schooling (March 2021). The largest percentage drop in adherence between these periods was observed for moderate to vigorous physical activity (27.4%; p-value < 0.001) and the lowest for sleep (10.5%; p-value < 0.001). Adherence to the 24-Hour Movement Guidelines did not return to pre-pandemic levels with the resumption of in-person school activities. Full article

(This article belongs to the Special Issue 2nd Edition: Public Health during and after the COVID-19 Pandemic)

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Int. J. Environ. Res. Public Health, Volume 21, Issue 7 (July 2024) – 147 articles

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