International Journal of Environmental Research and Public Health

15 pages, 533 KB

Open AccessArticle

Exploring the Role of Genetic Diversity and Cultural Norms in COVID-19 Vulnerability: A Global Analysis

by Andrew Phiri

Int. J. Environ. Res. Public Health 2025, 22(11), 1690; https://doi.org/10.3390/ijerph22111690 (registering DOI) - 8 Nov 2025

Abstract

The COVID-19 disease outbreak is the deadliest viral pandemic our generation has experienced, and much uncertainty remains over the varying vulnerability of different populations to the virus. This study investigates whether long-term evolutionary processes, such as genetic diversity and culturally embedded behavioural norms, [...] Read more.

The COVID-19 disease outbreak is the deadliest viral pandemic our generation has experienced, and much uncertainty remains over the varying vulnerability of different populations to the virus. This study investigates whether long-term evolutionary processes, such as genetic diversity and culturally embedded behavioural norms, can help explain why countries experienced different levels of COVID-19 infections and mortalities. Using a sample of 133 countries, we find that populations with higher expected genetic heterozygosity and greater historical exposure to infectious diseases are associated with lower COVID-19 case and death rates. We reveal two distinct pathways through which these effects manifest. Firstly, populations that migrated further from the evolutionary origins of Homo sapiens in East Africa exhibit lower genetic heterozygosity, which, in turn, is linked to greater susceptibility to COVID-19. Secondly, regions with higher historical disease prevalence tend to develop collectivist cultural norms and behaviours that are shaped to reduce disease transmission, which appear to mitigate the spread of COVID-19. These findings suggest that differences in vulnerability are not random but rather deeply rooted in genetic and cultural evolution. The analysis remains robust after accounting for socioeconomic, geographical, and institutional controls. Our findings offer policymakers fresh perspectives by integrating genetic theory and sociocultural dynamics into contemporary public health strategies. Full article

(This article belongs to the Section Global Health)

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21 pages, 545 KB

Open AccessArticle

Musculoskeletal Health Effects of Manual Sandcrete Block Handling Among Construction Artisans: Implications for Industry Practice and Training

by Kofi Owusu Adjei, Murendeni Liphadzi, Francis Kwesi Bondinuba, Cecilia Modupe Mewomo and Haruna Domanamwin Abudu

Int. J. Environ. Res. Public Health 2025, 22(11), 1689; https://doi.org/10.3390/ijerph22111689 - 7 Nov 2025

Abstract

This study examines the occupational health challenges faced by artisans in Ghana’s Ashanti Region. The study employed a purposive sampling technique to select 425 masons through questionnaires. The data collected included workers’ mass, block weights, and health problems. The analysis identified fourteen health [...] Read more.

This study examines the occupational health challenges faced by artisans in Ghana’s Ashanti Region. The study employed a purposive sampling technique to select 425 masons through questionnaires. The data collected included workers’ mass, block weights, and health problems. The analysis identified fourteen health problems, with headaches, muscle pain, lower back pain, chronic pain, and bruises being most prevalent. Artisan weight negatively correlated with weights of 125 mm blocks (r = −0.202, p < 0.01) and 150 mm blocks (r = −0.248, p < 0.01). Additionally, artisan weight showed a negative correlation with working hours (coefficient = −0.133, p < 0.05), as did body weight with resting hours (coefficient = −0.217, p < 0.05). Higher educational qualifications correlated positively with lifting-related health issues (coefficient = 0.259, p = 0.000) and negatively with weather-related issues (coefficient = −0.154, p = 0.002). Moreover, the number of working days per week was positively correlated with lifting problems (coefficient = 0.270, p < 0.05). The study recommends redesigning block sizes to reduce physical strain. Additionally, policy measures such as reducing machinery import taxes are suggested to encourage mechanisation. The study further emphasises the need for training institutions to incorporate occupational health education into artisan training programs. Full article

(This article belongs to the Special Issue Health, Safety, and Wellbeing in the Engineering and Construction Industry)

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13 pages, 813 KB

Open AccessArticle

A Retrospective Study on Evacuation and Long-Term Displacement Among Home-Visit Psychiatric Nursing Service Users in the Aftermath of the 2024 Noto Peninsula Earthquake

by Hisao Nakai, Masato Oe, Yutaka Nagayama, Shingo Oe, Mayu Tokuoka, Chinatsu Yamaguchi and Koji Tanaka

Int. J. Environ. Res. Public Health 2025, 22(11), 1688; https://doi.org/10.3390/ijerph22111688 - 7 Nov 2025

Abstract

The aim of this retrospective study was to identify the influencing factors of prolonged evacuation among home-visit psychiatric nursing services patients affected by the 2024 Noto Peninsula Earthquake. We examined the associations between demographic factors, mental illness-related factors, living environment factors, and evacuation [...] Read more.

The aim of this retrospective study was to identify the influencing factors of prolonged evacuation among home-visit psychiatric nursing services patients affected by the 2024 Noto Peninsula Earthquake. We examined the associations between demographic factors, mental illness-related factors, living environment factors, and evacuation status. We also visualized evacuation routes using a geographic information system and analyzed their characteristics. We used data from medical records of patients using a single home-visit psychiatric nursing provider in northern Noto, Ishikawa Prefecture, Japan, an area severely affected by the 2024 earthquake. The study population comprised 115 patients with a mean (standard deviation) age of 53.3 (16.8) years; 64 (55.7%) were women and 51 (44.3%) were men. The median (interquartile range) total number of evacuation days was 208 (192–213) days, and the median (interquartile range) length of stay at the initial shelter was 2.0 (2.0–3.0) days. Binomial logistic regression analysis, adjusted for sex and age, showed that factors associated with prolonged evacuation were an initial shelter stay of <23 days (odds ratio: 3.26, 95% confidence interval: 1.15–9.26; p = 0.026) and the initial shelter being a public shelter (odds ratio: 4.56, 95% confidence interval: 1.49–13.95; p = 0.008). Geographic information system spatial analysis showed that for the three participants with the highest number of evacuations, the total distance traveled (minutes) for evacuation was 884.1 km (678.9 min), 159.0 km (158.8 min), and 36.8 km (54.8 min). These findings suggest that initial evacuation behaviors and shelter selection may significantly affect evacuation duration among home-visit psychiatric nursing patients. Full article

(This article belongs to the Special Issue Health Emergencies and Disasters Preparedness)

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24 pages, 1050 KB

Open AccessArticle

Self-Presentation Concerns Among Injured Adolescent Athletes: A Qualitative Investigation

by Noémie Demers, Leslie Podlog, Lucie Forté, Alexis Ruffault, Marie-Lyne Nault and Jeffrey G. Caron

Int. J. Environ. Res. Public Health 2025, 22(11), 1687; https://doi.org/10.3390/ijerph22111687 - 7 Nov 2025

Abstract

Sport psychology research has shown that athletes might experience self-presentation concerns. However, fairly limited work has examined these specific concerns among athletes experiencing an injury, particularly among adolescent populations. Therefore, the purpose of this qualitative study was to explore the nature, precursors, and [...] Read more.

Sport psychology research has shown that athletes might experience self-presentation concerns. However, fairly limited work has examined these specific concerns among athletes experiencing an injury, particularly among adolescent populations. Therefore, the purpose of this qualitative study was to explore the nature, precursors, and implications of injured adolescent athletes’ self-presentation concerns. Semi-structured interviews were conducted with female (n = 12) and male (n = 2) competitive adolescent athletes (Mage = 15.1 years) who experienced a variety of serious injuries (e.g., ACL rupture, labrum tear) as a result of competing in various sports. Braun and Clark’s thematic analysis (2006) was used to develop themes pertaining to the nature, precursors, and implications of injury. Findings highlight a range of specific types of self-presentation concerns (e.g., concerns over “faking” an injury, lacking capability, disappointing others), the impact of the closeness of relationships with significant others, key implications (e.g., future sport apprehensions, negative emotions, motivational enhancements), and coping strategies. Results identify factors for targeted interventions aimed at managing self-presentation concerns among injured adolescents. Full article

(This article belongs to the Special Issue Mental Health in Sport Injury and Rehabilitation: Intersecting Public Health Concerns)

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10 pages, 269 KB

Open AccessProtocol

Guidance for Home Enzyme Replacement Therapy in Children and Adolescents Diagnosed with Mucopolysaccharidoses: A Scoping Review Protocol

by Vinícius Rodrigues de Oliveira, Yarytizza Nycoly Fernandes Martins, Juliana Iscarlaty Freire de Araújo, Eunice Fernandes da Silva, Margarita Baeza Fuentes and Jonas Sâmi Albuquerque de Oliveira

Int. J. Environ. Res. Public Health 2025, 22(11), 1686; https://doi.org/10.3390/ijerph22111686 - 7 Nov 2025

Abstract

Enzyme replacement therapy is one of the main alternatives in the treatment of mucopolysaccharidosis. Conventionally, this therapy is administered in an outpatient setting, but this can be carried out at home, where the patient feels most comfortable. However, there is still a need [...] Read more.

Enzyme replacement therapy is one of the main alternatives in the treatment of mucopolysaccharidosis. Conventionally, this therapy is administered in an outpatient setting, but this can be carried out at home, where the patient feels most comfortable. However, there is still a need for guidance on how to implement the use of this therapy in the home setting. This study aims to present the protocol of a scoping review that aims to identify and map the main existing guidance for the implementation of home-based enzyme replacement therapy in children and adolescents with mucopolysaccharidosis. The review protocol was developed based on the methodological guidance proposed by Peters and the PRISMA-P checklist and was registered on the Open Science Framework platform, available at OSF.IO/QUSB6. The searches will be carried out in the following databases: CINAHL, Cochrane Library, Embase, LILACS, MEDLINE, Science Direct, Scopus, and Web of Science. Gray literature will be searched in the CAPES/Brazilian Theses and Dissertations Catalog, the Brazilian Ministry of Health website, Google Scholar, the National Institute for Health and Care Excellence, and the WHO IRIS. Articles will be selected according to predefined eligibility criteria and extracted using a standardized collection form. The results of this review are expected to provide valuable insights for researchers regarding the main guidance for the implementation of home-based ERT in children and adolescents with mucopolysaccharidosis. Full article

13 pages, 419 KB

Open AccessSystematic Review

Promoting Healthy Aging Through Mindfulness and Yoga: A Systematic Review of Interventions for People Living with HIV Who Use Drugs or Who Have a History of Substance Use

by Chase M. Bryer, Garrett S. Stang, Alexandra B. Collins, Laura N. Haygood, Tria Blu Wakpa and Jeffrey Proulx

Int. J. Environ. Res. Public Health 2025, 22(11), 1685; https://doi.org/10.3390/ijerph22111685 - 6 Nov 2025

Abstract

Advances in HIV care and broader access to antiretroviral therapy (ART) have extended life expectancy for people living with HIV, yet aging-related health concerns, especially among those who use substances, remain under-researched. This systematic review examined the effects of mindfulness and yoga-based interventions [...] Read more.

Advances in HIV care and broader access to antiretroviral therapy (ART) have extended life expectancy for people living with HIV, yet aging-related health concerns, especially among those who use substances, remain under-researched. This systematic review examined the effects of mindfulness and yoga-based interventions on healthy aging outcomes in adults living with HIV who use drugs or who have a history of substance use. We searched Medline, Embase, PsycINFO, and Scopus for randomized controlled trials, cohort studies, quasi-experimental designs, and pre–post intervention studies that assessed healthy aging indicators—broadly defined to include physical, cognitive, and mental health outcomes—along with substance use and HIV-related quality of life measures such as ART adherence. All five studies that met inclusion criteria found mindfulness and yoga interventions to be feasible and acceptable for people living with HIV who use substances, with some evidence suggesting reductions in stress and substance use, as well as improvements in ART adherence. However, most studies were small, short-term pilot trials, none focused specifically on older adults, and few used HIV-specific measures of quality of life or healthy aging. Notably, older adults living with HIV were underrepresented in the studies examined, pointing to the need for increased engagement with older adults living with HIV. These findings suggest promise for mindfulness and yoga for promoting healthy aging among people living with HIV who use substances. Future research should prioritize larger sample sizes and longitudinal designs to better understand clinical efficacy. Existing interventions may be enhanced by incorporating multilevel, community-driven approaches that reflect lived experiences and expand definitions of aging well among people living with HIV who use drugs or who have a history of substance use. Full article

(This article belongs to the Special Issue HIV Care Engagement and Quality of Life Among People Living with HIV)

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10 pages, 3899 KB

Open AccessArticle

Integrating DHIS2 and R for Enhanced Cholera Surveillance in Lebanon: A Case Study on Improving Data Quality

by Abass Toufic Jouny, Hawraa Sweidan, Maryo Baakliny and Nada Ghosn

Int. J. Environ. Res. Public Health 2025, 22(11), 1684; https://doi.org/10.3390/ijerph22111684 - 6 Nov 2025

Abstract

During the 2022–2023 cholera outbreak in Lebanon, cases were reported through the District Health Information System 2 (DHIS2). We developed automated procedures in R computing language to improve completeness of routinely notified variables, apply case definition criteria, improve geographic accuracy and documentation of [...] Read more.

During the 2022–2023 cholera outbreak in Lebanon, cases were reported through the District Health Information System 2 (DHIS2). We developed automated procedures in R computing language to improve completeness of routinely notified variables, apply case definition criteria, improve geographic accuracy and documentation of laboratory results. We developed R scripts for data cleaning, standardization, and reclassification, plotted epidemic curves and produced maps to display cholera incidence rates and rapid diagnostic test (RDT) coverage by district. We shared the R scripts on GitHub platform for open adaptation and use. Prior to cleaning, missingness reached 99.7% for inpatient status and 17–35% for other key variables. After cleaning, all fields were complete. Initially, 92.8% of cases were notified through DHIS2 as suspected and 7.2% as confirmed. Following reclassification, 40% were classified as suspected, 5.8% as confirmed, and 48.6% with unspecified classification. Laboratory data revealed that 5.8% of cases were culture positive, 2.2% RDT positive, and 65.1% had no documented testing. Among facility-entered cases (n = 5953), 11.4% were reported from a different governorate than the patient’s residence. At the time of the outbreak, the daily maps were generated based on place of residence. Integrating R-based analytics with DHIS2 enhanced data completeness, improved case classification, and enabled more better spatial and laboratory analysis. This combined approach provided a clearer epidemiological picture of the cholera outbreak, supporting data-driven public health decision-making and highlighting the value of integrating analytical tools with routine surveillance systems. Full article

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28 pages, 732 KB

Open AccessSystematic Review

Environmental and Human Health Impacts of Agricultural Pesticides on BIPOC Communities in the United States: A Review from an Environmental Justice Perspective

by Belay Tizazu Mengistie, Ram L. Ray and Ayodeji Iyanda

Int. J. Environ. Res. Public Health 2025, 22(11), 1683; https://doi.org/10.3390/ijerph22111683 - 6 Nov 2025

Abstract

In recent years, public discourse on pesticide impacts has increasingly recognized institutional and structural racism as key drivers of health disparities in Black, Indigenous, and People of Color (BIPOC) communities. While pesticides are vital for crop protection from causing yield losses, extensive research [...] Read more.

In recent years, public discourse on pesticide impacts has increasingly recognized institutional and structural racism as key drivers of health disparities in Black, Indigenous, and People of Color (BIPOC) communities. While pesticides are vital for crop protection from causing yield losses, extensive research highlights their adverse effects on environmental quality and human health. These impacts disproportionately burden BIPOC populations, making pesticides a major environmental justice (EJ) concern like many other environmental pollutants. Despite progress in understanding these effects and advancing EJ, significant technical, social, and policy gaps remain. The objective of this review is to systematically examine critical gaps in technical, social, and policy dimensions, as well as the environmental and human health impacts of pesticide exposure on BIPOC communities in the United States, through the lens of environmental justice. This review synthesizes 128 sources peer-reviewed articles, books, reports on pesticides, EJ, and BIPOC communities in the U.S. Key findings reveal uneven distribution of pesticide-related health and environmental burdens along racial, ethnic, and socioeconomic lines. Non-Hispanic Blacks and Mexican Americans exhibit higher pesticide biomarkers and greater exposure risks than non-Hispanic Whites. Structural racism and classism, rooted in historical systems, perpetuate these inequities, compounded by regulatory failures and power imbalances. In addition, the EPA has flagged 31 pesticide manufacturing facilities for “Significant Violations” of key environmental laws, including the Clean Air Act, Clean Water Act, and Resource Conservation and Recovery Act. These systemic issues underscore urgent needs for transparency, accountability, and equitable policy reform. An EJ framework exposes critical knowledge gaps and calls for structural changes to ensure equal protection and responsive policies for the most affected communities. Full article

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19 pages, 596 KB

Open AccessSystematic Review

Addressing Bullying and Cyberbullying in Public Health: A Systematic Review of Interventions for Healthcare and Public Health Professionals

by Stephanie F. Dailey, Rosellen R. Roche and Megan C. Sharkey

Int. J. Environ. Res. Public Health 2025, 22(11), 1682; https://doi.org/10.3390/ijerph22111682 - 6 Nov 2025

Abstract

Bullying and cyberbullying constitute urgent public health challenges, contributing to significant psychological, social, and developmental harms among youth worldwide. While schools have traditionally served as the primary context for prevention, these efforts are often limited in scope, duration, and systemic integration. Healthcare and [...] Read more.

Bullying and cyberbullying constitute urgent public health challenges, contributing to significant psychological, social, and developmental harms among youth worldwide. While schools have traditionally served as the primary context for prevention, these efforts are often limited in scope, duration, and systemic integration. Healthcare and public health professionals are uniquely positioned to contribute to early identification, prevention, and resilience-building, but their roles are not consistently integrated into bullying prevention frameworks. This systematic review, conducted in accordance with PRISMA 2020 guidelines, synthesized 12 empirical studies published between 2013 and 2023 that examined healthcare- and public health–led interventions addressing bullying and cyberbullying among children and adolescents. Using a narrative synthesis mapped onto the SHIELD framework (Strengths, Healing, Interventions, Empowerment, Learning, Development), six themes emerged: (1) screening and early identification protocols, (2) family and community involvement, (3) variable focus on mental health and well-being, (4) multi-component, school-based interventions, (5) cognitive-behavioral and solution-focused interventions, and (6) online and digital interventions. Findings highlight the potential of health professionals to deliver trauma-informed, empowerment-based, and culturally responsive approaches that extend beyond traditional educational settings. Recommendations emphasize cross-sector collaboration, integration of digital tools, and equity-centered practices to strengthen prevention, intervention, and resilience-building. This review underscores the critical role of healthcare and public health professionals in creating safer, more supportive environments for youth. Full article

(This article belongs to the Collection Bullying, Cyberbullying, Dating Violence, and Cyber Dating Violence in Adolescence)

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18 pages, 371 KB

Open AccessArticle

by Tanja Grünberger, Christopher Höhn, Manuel Schabus and Anton-Rupert Laireiter

Int. J. Environ. Res. Public Health 2025, 22(11), 1681; https://doi.org/10.3390/ijerph22111681 - 6 Nov 2025

Abstract

Shift workers face a heightened risk of insomnia. Recent research has yielded promising insights, but further progress is necessary to better treat insomnia in this group. The present pilot study evaluates how different characteristics impact sleep in shift workers to develop an innovative [...] Read more.

Shift workers face a heightened risk of insomnia. Recent research has yielded promising insights, but further progress is necessary to better treat insomnia in this group. The present pilot study evaluates how different characteristics impact sleep in shift workers to develop an innovative therapeutic approach. An online survey was administered to an ad hoc sample of N = 225 (112 shift workers), and correlations were calculated between sleep variables and specific characteristics (e.g., psychological impairment, personality traits, sleep-related behavior, attitudes towards sleep and shift work). Group differences between good/poor sleepers and day/shift work were determined using Mann–Whitney U-tests and Kruskal–Wallis H-tests. Regression was used to identify appropriate predictors. All factors (except perfectionism, chronotype, and importance of sleep) yielded significant results in both correlations and group differences (good/poor sleepers). The two groups of day/shift workers showed only minor differences. Dysfunctional beliefs about sleep, pre-sleep arousal, and depression were identified as predictors of poorer sleep. We conclude that interventions on psychological constraints (anxiety and depression), personality traits (anxiety, concern, emotional instability, and tension), social integration, sleep-related factors (dysfunctional beliefs, especially cognitive pre-sleep-arousal, sleep hygiene) and the attitude toward shiftwork, can replace those on regularity and will build an innovative therapy for shift workers on this basis. Once the newly developed treatment manual is finalized, its efficacy will be assessed through a randomized controlled trial. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

29 pages, 627 KB

Open AccessReview

Evacuation and Transportation Barriers Among Vulnerable Populations in Natural Hazard-Related Disasters: A Scoping Review

by Yuriko Matsuo, Kathryn Kietzman, Ron D. Hays and Yeonsu Song

Int. J. Environ. Res. Public Health 2025, 22(11), 1680; https://doi.org/10.3390/ijerph22111680 - 5 Nov 2025

Viewed by 165

Abstract

Background and Aim: Natural hazard-related disasters such as wildfires, hurricanes, earthquakes, and floods pose significant risks to older adults, individuals with disabilities, and those with chronic health conditions. Transportation-related challenges during and after evacuation can severely impact their safety, mobility, and recovery. This [...] Read more.

Background and Aim: Natural hazard-related disasters such as wildfires, hurricanes, earthquakes, and floods pose significant risks to older adults, individuals with disabilities, and those with chronic health conditions. Transportation-related challenges during and after evacuation can severely impact their safety, mobility, and recovery. This scoping review examines the current evidence to identify research gaps and inform strategies to improve evacuation outcomes and long-term resilience for these at-risk groups. The STEPS framework (Spatial, Temporal, Economic, Physiological, Social) was applied to guide the analysis and interpretation of findings. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and searched five databases, including PubMed, APA PsycINFO, CINAHL Complete, EMBASE, and Web of Science for primary studies on transportation and disaster evacuation among vulnerable populations. Results: Twenty studies were included. Four key areas of concern were identified: (1) immediate transportation barriers during evacuation, (2) prolonged transportation disruptions post-disaster, (3) anticipated logistical challenges in future evacuation planning, and (4) inconsistent and inaccessible communication of transportation-related information during emergencies. These challenges intersected with all five STEPS dimensions. Conclusions: Transportation barriers remain a persistent and under-addressed risk factor in disaster contexts for vulnerable groups. The STEPS framework helped reveal the multidimensional nature of these issues, emphasizing the need for integrated planning, assistive transport options, inclusive communication systems, and stronger public–private coordination. Future research should focus on collecting disaggregated data, evaluating interventions, and supporting inclusive policy reforms tailored to each type of disaster. Full article

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14 pages, 444 KB

Open AccessArticle

Wondering Awe Is the Mediator of the Link Between Experience of Nature and Psychological Wellbeing—Relevance for Public Health

by Arndt Büssing, Julia Wilhelm and Daniela Rodrigues Recchia

Int. J. Environ. Res. Public Health 2025, 22(11), 1679; https://doi.org/10.3390/ijerph22111679 - 5 Nov 2025

Viewed by 171

Abstract

Background: Access to green spaces is crucial for public health. For psychological health, the ability to pause in fascination or wondering awe (as an indicator of mindful resonance with nature) appears particularly relevant. However, it remains unclear whether non-interventional experience of nature is [...] Read more.

Background: Access to green spaces is crucial for public health. For psychological health, the ability to pause in fascination or wondering awe (as an indicator of mindful resonance with nature) appears particularly relevant. However, it remains unclear whether non-interventional experience of nature is directly related to wellbeing or requires a mediator. Methods: A cross-sectional anonymous survey was conducted among 491 participants (74% women; mean age 51 ± 13 years) with standardized instruments (NR-6, ENS, GrAw-7, GQ-6, WHO-5). Results: Experience of Nature (r = 0.56) and Nature-Relatedness (r = 0.55) are strongly associated with Awe/Gratitude, while only Awe/Gratitude is moderately related to Wellbeing (r = 0.42). Mediator analyses revealed that the relationship between Experience of Nature and Wellbeing is significantly mediated by Awe/Gratitude (β = 2.28, p < 0.001). This highlights the central role of this resource through which nature experiences promote wellbeing. Regression analyses confirmed Awe/Gratitude as the best predictor of Wellbeing, followed by Gratitude disposition, and sporting outside (R² = 0.25). Conclusions: Merely being in nature does not substantially affect well-being. Rather, mindful perception of nature as a space where modern public health practices, such as mindful walking, are particularly effective, is essential. From a public health and urban planning perspective, accessible, quiet, and aesthetically engaging green spaces that attract and fascinate people should be prioritized to foster such restorative experiences. Full article

(This article belongs to the Section Environmental Health)

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14 pages, 681 KB

Open AccessArticle

Effects of a 24/48 to 48/96 Shift Schedule Change on Firefighter Sleep and Health: Short-Term Improvements and Six-Month Stability

by Joel M. Billings and Sara A. Jahnke

Int. J. Environ. Res. Public Health 2025, 22(11), 1678; https://doi.org/10.3390/ijerph22111678 - 5 Nov 2025

Viewed by 102

Abstract

This study examined the impact of a shift schedule change on firefighter sleep and health outcomes (n = 24). Firefighters from a U.S. department transitioned from a 24 h on, 48 h off (24/48) schedule to a 48 h on, 96 h [...] Read more.

This study examined the impact of a shift schedule change on firefighter sleep and health outcomes (n = 24). Firefighters from a U.S. department transitioned from a 24 h on, 48 h off (24/48) schedule to a 48 h on, 96 h off (48/96) schedule. Wrist actigraphy and self-reported health outcomes were assessed at three time points: baseline (24/48), 3 months post-transition, and 6 months post-transition. Objective sleep measures included total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO). Self-reported health outcomes included the Insomnia Severity Index (ISI), Beck Depression Inventory–II (BDI-II), Beck Anxiety Inventory (BAI), Multidimensional Assessment of Fatigue (MAF), and the Alcohol Use Disorders Identification Test (AUDIT). Linear mixed-effects models (LMMs) with random intercepts were used to evaluate changes over time, adjusting for age, years of service, and individual night-time call volume. Results showed significant improvements in TST, SE, SOL, and WASO at the 3-month follow-up, which were sustained but did not further increase at 6 months. ISI and BDI-II scores also improved, while BAI, MAF, and AUDIT remained stable. These findings suggest that the 48/96 schedule may provide short-term improvements in sleep and psychological health for firefighters in low call-volume settings. Additional research is needed in higher-volume departments and over longer timeframes. Full article

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7 pages, 238 KB

Open AccessArticle

The Impact of COVID-19 on Racial and Ethnic Disparities in HIV Pre-Exposure Prophylaxis Retention: Data from a Large U.S. Health Care Organization

by Adam C. Sukhija-Cohen, Michael F. Blasingame, Henna Patani, Marie C. D. Stoner, Antón Castellanos-Usigli and Allysha C. Maragh-Bass

Int. J. Environ. Res. Public Health 2025, 22(11), 1677; https://doi.org/10.3390/ijerph22111677 - 5 Nov 2025

Viewed by 78

Abstract

Retention in pre-exposure prophylaxis (PrEP) care—defined as receiving a fourth PrEP prescription within 12 months of initiation—remains a major challenge for young adults and individuals minoritized by race and ethnicity in the United States (U.S.), particularly after disruptions in care from the Coronavirus [...] Read more.

Retention in pre-exposure prophylaxis (PrEP) care—defined as receiving a fourth PrEP prescription within 12 months of initiation—remains a major challenge for young adults and individuals minoritized by race and ethnicity in the United States (U.S.), particularly after disruptions in care from the Coronavirus Disease 2019 (COVID-19) pandemic. This study examined changes in PrEP retention before and after COVID-19 among clients ages 18–29 years at AIDS Healthcare Foundation (AHF) Wellness Center clinics across the U.S. We conducted a retrospective analysis of electronic health record (EHR) data from 6047 clients who initiated PrEP between 1 January 2018 and 15 March 2023. Retention was defined as receiving a fourth PrEP prescription within 12 months of initiation. Overall, PrEP initiation increased threefold post-COVID-19, but retention by the fourth prescription declined from 86.2% pre-COVID-19 to 62.6% post-COVID-19 (p < 0.001). Clients initiating PrEP post-COVID-19 had significantly lower odds of retention (odds ratio [OR] = 0.13; p < 0.001), suggesting these systemic disruptions reduced continuity of care. Additionally, clients who identify as non-White had lower retention odds compared to clients who identify as White post-COVID-19 (OR = 0.80; p = 0.003), indicating that racial/ethnic disparities in PrEP care persist beyond the pandemic’s impact. These findings highlight the need for targeted interventions to strengthen retention in PrEP care post-COVID-19. Full article

(This article belongs to the Special Issue Youth-Focused HIV Prevention Innovations in High-Need Populations)

11 pages, 250 KB

Open AccessArticle

Awareness of the Role of Physiotherapy in Treating Gynecological and Obstetric Issues Among Gynecologists: A Cross-Sectional Study

by Sami Elmahgoub, Adel El Taguri, Aseel Aburub, Mohamed I. Mabrouk, Márta Hock and Viktória Prémusz

Int. J. Environ. Res. Public Health 2025, 22(11), 1676; https://doi.org/10.3390/ijerph22111676 - 4 Nov 2025

Viewed by 178

Abstract

Background: Physiotherapy plays a crucial role in managing women’s health conditions, such as pelvic pain and postpartum recovery. However, its integration into standard care relies heavily on the awareness and referral practices of gynecologists and obstetricians, which may be suboptimal. Objective: To investigate [...] Read more.

Background: Physiotherapy plays a crucial role in managing women’s health conditions, such as pelvic pain and postpartum recovery. However, its integration into standard care relies heavily on the awareness and referral practices of gynecologists and obstetricians, which may be suboptimal. Objective: To investigate the awareness, attitudes, and referral practices of gynecologists and obstetricians in Libya regarding the role of physiotherapy in women’s health. Methods: A cross-sectional study was conducted in public and private hospitals in Tripoli, Libya. A total of 100 practitioners were invited to participate. A self-administered questionnaire assessed demographics, awareness, attitudes, and practices. Results: The response rate was 67% (n = 67/100). The results revealed a key disparity: while the vast majority of respondents (94.1%) acknowledged the importance of physiotherapy in women’s health and 76.1% reported a willingness to refer patients, only 67.1% perceived physiotherapists as competent to manage these conditions. This indicates a significant gap in understanding specific physiotherapy techniques. Awareness percentage was significantly influenced by factors such as the type of hospital and prior exposure to physiotherapy education. Conclusions: A striking disparity was found between high general awareness (94.1%) and significantly lower perceived competence (67.1%) and knowledge of its role in specific conditions. This gap between general approval and specific understanding directly creates the critical barrier to referral. To improve interdisciplinary collaboration and patient access to care, enhanced educational initiatives for physicians, the development of clear clinical guidelines, and the establishment of dedicated women’s health physiotherapy clinics are strongly recommended. Full article

12 pages, 1025 KB

Open AccessArticle

Speciation of Arsenic in Medium Containing Bacterial Strains of Lysinibacillus boronitolerans and Bacillus cereus: Mechanism of Arsenic Removal

by Naidilene Chaves Aguilar, Adriele Santos Van Der Maas, Mayra Soares Santos, Rodrigo de Carvalho Hott, Márcia Cristina da Silva Faria, Bruno Lemos Batista, Cleide Aparecida Bomfeti, João Paulo de Mesquita and Jairo Lisboa Rodrigues

Int. J. Environ. Res. Public Health 2025, 22(11), 1675; https://doi.org/10.3390/ijerph22111675 - 4 Nov 2025

Viewed by 202

Abstract

Environmental issues have become increasingly critical and frequent in recent decades due to excessive population growth and intensified industrial and mining activities. Among the most concerning contaminants is arsenic (As), a toxic element associated with severe environmental and human health risks. This study [...] Read more.

Environmental issues have become increasingly critical and frequent in recent decades due to excessive population growth and intensified industrial and mining activities. Among the most concerning contaminants is arsenic (As), a toxic element associated with severe environmental and human health risks. This study aimed to investigate the bioremediation potential of the bacterial strains Lysinibacillus boronitolerans and Bacillus cereus, elucidating the mechanisms involved in arsenic transformation and removal under controlled conditions. The strains were cultivated in liquid medium containing known concentrations of As(III) and As(V), and the chemical forms of arsenic were analyzed using High-Performance Liquid Chromatography coupled with Inductively Coupled Plasma Mass Spectrometry (LC-ICP-MS). The production of exopolysaccharides (EPSs) and arsenite oxidase activity were also evaluated. Morphological and elemental analyses were performed using scanning electron microscopy with energy-dispersive spectroscopy (SEM-EDS). The bacterial strains exhibited significant 69.38–85.72% reductions in arsenic concentration and approximately 14–15% volatilization rates. No EPS production or arsenite oxidase activity was detected, suggesting alternative detoxification pathways. SEM-EDS analyses revealed intracellular accumulation of arsenic, while LC-ICP-MS speciation confirmed interconversion between As(III) and As(V), indicating the action of methylation-dependent detoxification and membrane transport mechanisms. The findings demonstrate that L. boronitolerans and B. cereus possess efficient arsenic resistance and transformation mechanisms, even without conventional enzymatic pathways. These strains show strong potential for use in sustainable bioremediation of arsenic-contaminated environments, particularly in regions affected by mining activities. Full article

(This article belongs to the Special Issue Environmental Monitoring and Remediation: Evaluating Exposure to Environmental Contaminants and Effects)

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15 pages, 1241 KB

Open AccessArticle

Instability in the Penta-C and Penta-D Loci in Microsatellite-Unstable Endometrial Cancer

by Ahmet Yilmaz, Wendy L. Frankel, Weiqiang Zhao, Adrian A. Suarez, Wei Chen, Joshua F. Coleman, Joseph P. McElroy, Rachel Pearlman, Paul J. Goodfellow and Heather Hampel

Int. J. Environ. Res. Public Health 2025, 22(11), 1674; https://doi.org/10.3390/ijerph22111674 - 4 Nov 2025

Viewed by 149

Abstract

Endometrial cancer (EC) is the most common gynecologic cancer. Early detection is one of the most important predictors of survival. The cancer is curable if detected early but the five-year survival rate in advanced cases can be as low as 22%. Microsatellite instability [...] Read more.

Endometrial cancer (EC) is the most common gynecologic cancer. Early detection is one of the most important predictors of survival. The cancer is curable if detected early but the five-year survival rate in advanced cases can be as low as 22%. Microsatellite instability (MSI) testing is used to screen populations for Lynch Syndrome (LS), the most common cause of inherited EC, and to classify EC into distinct groups with unique histological, prognostic, and molecular features. Accurate sample identification is crucial for successful MSI testing because instability is assessed by comparing amplification patterns in markers in the normal and tumor samples that must be taken from the same individual. Penta-C and Penta-D pentanucleotide markers are used widely for sample identification in not only MSI testing but also parentage verification, forensic science, and population genetics studies. The objective of this study was to test 324 pairs of tumor and matched normal DNAs from EC patients for instability in these markers using the Promega MSI Analysis System^TM considered the “gold standard” in MSI testing. Both markers were unstable, and therefore not reliable for MSI testing, in 8.2% of the EC patients with MSI. Instability in both mono- and pentanucleotide markers suggest that the tumors with MSI likely suffer from a “generalized” form of instability also affecting other short tandem repeats. Results from many studies using these markers for various purposes may not be accurate if samples with MSI are involved. Full article

(This article belongs to the Section Global Health)

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23 pages, 906 KB

Open AccessSystematic Review

Part 1: A Systematic Review to Describe Existing Cultural Adaptations in Lifestyle, Nutrition, and Physical Activity Programs for Native Hawaiian, CHamoru, and Filipino Populations

by Monica K. Esquivel, Kristi Hammond, Bernice C. Delos Reyes, Dareon C. Rios, Niza Mian, Elaine C. de Leon, Samantha M. Torres and Tanisha Franquez Aflague

Int. J. Environ. Res. Public Health 2025, 22(11), 1673; https://doi.org/10.3390/ijerph22111673 - 4 Nov 2025

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Abstract

This research aims to describe existing evidence on the availability of culturally adapted lifestyle, nutrition, and physical activity programs among Native Hawaiian, CHamoru, and Filipino populations who are affected by obesity at rates higher than the general US population, contributing to poorer health [...] Read more.

This research aims to describe existing evidence on the availability of culturally adapted lifestyle, nutrition, and physical activity programs among Native Hawaiian, CHamoru, and Filipino populations who are affected by obesity at rates higher than the general US population, contributing to poorer health outcomes. Addressing this disparity requires programs that are culturally adapted and grounded for these specific populations. A comprehensive description of the availability of lifestyle interventions for Native Hawaiians, Pacific Islanders, and Filipinos is missing in the literature. A systematic literature review was performed in July 2025 to gather articles that included lifestyle (nutrition and/or physical activity) interventions addressing obesity and/or related chronic diseases and that utilized one or more cultural adaptations for Native Hawaiian, CHamoru, and/or Filipino populations. Data were extracted, and methodological quality, social ecological model (SEM) level, and risk for bias was assessed. Twenty-nine articles met inclusion criteria. Interventions addressed pre-diabetes (n = 7), hypertension (n = 7), and/or obesity (n = 5) and included combined nutrition and physical activity (n = 16). Sixteen articles included interventions culturally adapted for Filipino populations only, 7 for Native Hawaiians only, 6 for both Native Hawaiians and Filipinos, and 2 included CHamorus. The most common combination of approaches were interventions that incorporated individual, interpersonal, and community SEM levels (n = 17). Intervention components were reflective of culturally relevant physical activities (n = 16) and nutrition (n = 11). Based on this research, there is a need for additional research to include CHamoru communities and interventions to be tested in geographic locations where these populations have migrated. Full article

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

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35 pages, 499 KB

Open AccessArticle

A Mixed-Methods Evaluation of a Post-COVID-Condition Rehabilitation and Recovery Intervention Delivered in a Football Club Community Trust

by Steven Rimmer, Adam J. Herbert, Adam L. Kelly, Irfan Khawaja, Sam Lee and Lewis A. Gough

Int. J. Environ. Res. Public Health 2025, 22(11), 1672; https://doi.org/10.3390/ijerph22111672 - 4 Nov 2025

Viewed by 204

Abstract

Aim: Post-COVID condition (PCC) is largely considered the biggest public health emergency in recent times. The role of exercise therapy in PCC is currently unknown, and evaluative studies are currently lacking in this area. This study therefore aimed to evaluate the effects of [...] Read more.

Aim: Post-COVID condition (PCC) is largely considered the biggest public health emergency in recent times. The role of exercise therapy in PCC is currently unknown, and evaluative studies are currently lacking in this area. This study therefore aimed to evaluate the effects of a football club community trust exercise rehabilitation programme on physical function and quality of life in individuals with PCC. Method: A mixed-methods retrospective design was employed, utilising a framework to assess the programme’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM). Quantitative data (questionnaires and physiological assessments) were collected at baseline, 6 weeks, and 12 weeks during the programme, and at 6 months post-intervention (n = 7). Qualitative data were gathered through semi-structured focus groups at week 12 (n = 7) and 12 months (n = 5) post-intervention. Quantitative data and qualitative data were analysed using repeated measures ANOVAs and thematic analysis, respectively. Results: The programme led to significant improvements in physical function, including increased six-minute walking distance (6MWT, p < 0.001), one-minute sit-to-stand repetitions (1MSST, p < 0.035), and lung function (spirometry; MIP: p = 0.048, MEP: p = 0.024). Participants also reported enhanced QoL (HRQoL-14, p = 0.004), reduced anxiety (GAD-7, p = 0.008) and depression (PHQ-9, p = 0.008), and increased confidence and self-efficacy. The programme was well-received, with participants valuing the supportive environment and personalised approach. Conclusions: Football community trust exercise rehabilitation programmes can effectively improve physical function and quality of life in individuals with PCC, offering a promising model for community-based rehabilitation. Further studies are needed with larger sample sizes to assess the scalability of similar programmes. Full article

(This article belongs to the Section Exercise and Health-Related Quality of Life)

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18 pages, 599 KB

Open AccessReview

Obesity Interventions for Aboriginal and Torres Strait Islander Children and Adolescents: A Scoping Review of Impact and Outcomes

by Kabita Kharka, Kristina Zafirovski and Fahad Hanna

Int. J. Environ. Res. Public Health 2025, 22(11), 1671; https://doi.org/10.3390/ijerph22111671 - 3 Nov 2025

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Abstract

Background: Childhood Obesity is a significant and growing Public Health threat among Aboriginal and Torres Strait Islander (ATSI) children and adolescents in Australia. Health sectors in Australia have been focusing on health intervention programs across various states to prevent childhood obesity. This [...] Read more.

Background: Childhood Obesity is a significant and growing Public Health threat among Aboriginal and Torres Strait Islander (ATSI) children and adolescents in Australia. Health sectors in Australia have been focusing on health intervention programs across various states to prevent childhood obesity. This review aims to analyse the impact of obesity intervention programs conducted among children and adolescents of ATSI communities across Australia and report on the best practices for conducting future research. Objectives: This scoping review synthesised existing literature on the obesity prevention interventions programs among ATSI Children and Adolescents in Australia and examined their scope, implementation, and outcomes; evaluated their cultural appropriateness; and highlighted critical enablers and barriers. Methods: This scoping review analysed scholarly journal articles that reported on the findings of obesity intervention programs delivered across ATSI children and adolescents. Only Quasi-experimental and Randomized Control Trials (RCTs) were selected for the review. A full search has been carried out in Health databases such as Cochrane Library, Medline, PubMed, and ProQuest Central for the past 15 years. The framework of the Joanna Briggs Institute (JBI) for Scoping reviews was followed throughout this review. Results: Eleven studies met inclusion criteria. Findings were clustered into five themes: (i) community-led, systems-based interventions improved health behaviours and anthropometry; (ii) culturally tailored, community-embedded programs enhanced engagement and health literacy; (iii) early childhood and family-focused approaches showed promise; (iv) community or policy initiatives yielded mixed results; and (v) behavioural interventions were ineffective without addressing social and structural determinants. The most effective programs were community-delivered, multi-stakeholder, and centred on empowerment and capacity building. Conclusions: Obesity prevention efforts targeting Aboriginal and Torres Strait Islander children and adolescents are most successful when community-led, culturally grounded, and supported by multiple stakeholders. These findings underscore the necessity of culturally sensitive, participatory approaches. Further research is needed to strengthen the evidence base and inform sustainable, policy-relevant strategies for childhood obesity. Full article

(This article belongs to the Section Global Health)

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19 pages, 2251 KB

Open AccessArticle

A Bibliometric Analysis of the HCV Drug-Resistant Majority and Minority Variants

by Omega Mathew Immanuel, Olaoluwa Tolulope Fabiyi, Kuat P. Oshakbayev, Gulzhan Abuova, Aliya Konysbekova, Sreenu B. Vattipally, Syed Ali and Syed Hani Abidi

Int. J. Environ. Res. Public Health 2025, 22(11), 1670; https://doi.org/10.3390/ijerph22111670 - 3 Nov 2025

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Abstract

Background: In recent decades, research on Hepatitis C Virus (HCV) drug-resistant variants has expanded; however, critical gaps remain in our understanding of global contributions, emerging trends, and future research directions. Here, we present a bibliometric analysis to understand the research themes and trends [...] Read more.

Background: In recent decades, research on Hepatitis C Virus (HCV) drug-resistant variants has expanded; however, critical gaps remain in our understanding of global contributions, emerging trends, and future research directions. Here, we present a bibliometric analysis to understand the research themes and trends in research related to HCV drug-resistant variants published between 1999 and 2025. Methods: Publications related to HCV drug-resistant variants published between 1999 and 2025 were searched on the Web of Science and Scopus databases. Publication metadata and content-based data were extracted and analyzed using Bibliometrix and VOSviewer for keyword co-occurrence plot and cluster analysis. Results: The analysis of 653 articles revealed a clear paradigm shift, driven by the introduction of direct-acting antivirals (DAAs), which led to a significant surge in annual publications, peaking between 2014 and 2018. This shift in focus led to an emphasis on DAA efficacy, resistance mechanisms, and advanced genotyping. The United States was the most productive country, with the highest number of publications (n = 134) and citations (n = 6458). The University of São Paulo was the most productive institution (n = 40), while Antimicrobial Agents and Chemotherapy published the highest number of articles in this field (n = 40). Susser S. was the most productive researcher. Collaboration networks were found to be predominantly centered in high-income countries. Analysis of studies on minority variants showed that most studies originated from Europe and the United States, identifying low-frequency resistance-associated substitutions (RASs) such as A156V, D168V, Y93H, and S282T, with prevalence ranging from <1% to 35%, which were frequently associated with viral breakthrough and reduced treatment response. Conclusions: The field successfully transitioned to the DAA era, but research output and collaboration networks were primarily driven by high-income countries, leaving a critical gap in data from Low- and Middle-Income Countries (LMICs). Closing this gap by integrating LMIC data is the next essential step to ensure global elimination strategies are effective for all countries from different income strata. Full article

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

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22 pages, 327 KB

Open AccessArticle

A Qualitative Assessment of “Generacion Actual”: An HIV Community Mobilization Intervention Among Gay Men and Transgender Women in Lima, Peru

by Andres Maiorana, Susan Kegeles, Elizabeth Lugo, Wendy Hamasaki, Ximena Salazar and Carlos Cáceres

Int. J. Environ. Res. Public Health 2025, 22(11), 1669; https://doi.org/10.3390/ijerph22111669 - 3 Nov 2025

Viewed by 177

Abstract

The high HIV prevalence among men who have sex with men and transgender women (TW) in Peru calls for innovative HIV prevention strategies to modify social norms, increase social support and promote empowerment and community mobilization. This qualitative article presents the synergistic processes [...] Read more.

The high HIV prevalence among men who have sex with men and transgender women (TW) in Peru calls for innovative HIV prevention strategies to modify social norms, increase social support and promote empowerment and community mobilization. This qualitative article presents the synergistic processes that generated community mobilization throughout Generación Actual (GA, Current Generation in English), an HIV prevention intervention with gay men (GM) and TW in Lima South based on Mpowerment, a U.S.-model intervention program. We conducted 24 interviews with GM and TW participants, informed by observations of GA and the perceptions of its implementing coordinators, and complemented by the number/types of GA activities. Four significant processes occurred throughout GA: (1) high participant engagement, community building and empowerment; (2) an effect on HIV prevention and treatment; (3) the integration of GM and TW and (4) GA’s community center becoming a safe space for socializing, support and information. These processes helped produce positive changes related to self-empowerment, personal agency and the participants’ health, suggesting an impact of GA on HIV prevention, stigma reduction and care engagement. Community mobilization strategies that ensure active community participation and involvement may constitute relevant aspects for an effective approach to HIV prevention for TW and GM in Peru. Full article

(This article belongs to the Topic Social, Structural and Behavioral Interventions for HIV Prevention)

15 pages, 520 KB

Open AccessArticle

Pushing for Structural Reforms: Impacts of Racism and Xenophobia upon the Health of South Asian Communities in Ontario, Canada

by Manvi Bhalla, Ève Dubé, Noni MacDonald, Helana Marie Boutros and Samantha B. Meyer

Int. J. Environ. Res. Public Health 2025, 22(11), 1668; https://doi.org/10.3390/ijerph22111668 - 3 Nov 2025

Viewed by 541

Abstract

South Asian (SA) communities in Ontario, Canada experienced disproportionately higher rates of COVID-19 infection. Moreover, these communities also faced racism fueled by COVID-19-related misinformation and xenophobic sentiments that placed blame on them for virus transmission. The aim of this research was to understand, [...] Read more.

South Asian (SA) communities in Ontario, Canada experienced disproportionately higher rates of COVID-19 infection. Moreover, these communities also faced racism fueled by COVID-19-related misinformation and xenophobic sentiments that placed blame on them for virus transmission. The aim of this research was to understand, from the perspective of local SA communities, the causes behind higher incidences of COVID-19. SA adults (N = 25) participated in a focus group (N = 3) investigating experiences during the early stages of the pandemic. Data, interpreted through the lens of the Public Health Critical Race Praxis, suggest that the structural determinants of health, alongside racism and xenophobia, negatively impacted health outcomes for these communities. By not taking an active anti-racist stance, media, health and government authorities were viewed as perpetuating discriminatory narratives and practices, fueling blame and stigma towards these South Asian communities for COVID-19 transmission. Local public health policies, practices and communications were perceived to be informed by, and best serve, white Anglo-European settlers. This research provides insight into the role that health officials can play in addressing local and regional discrimination and stigma to promote equity-centered disease prevention efforts. Our findings should be integral to current and ongoing research and action related to pandemic preparedness. Full article

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17 pages, 1164 KB

Open AccessArticle

Beyond Communication and Risk in a Post-Pandemic World: A Survey on Radon in Spain

by Jorge Vázquez-Herrero, Berta García-Orosa and Xosé López-García

Int. J. Environ. Res. Public Health 2025, 22(11), 1667; https://doi.org/10.3390/ijerph22111667 - 3 Nov 2025

Viewed by 247

Abstract

This study addresses the construction and perception of risk and the role of the news media through a case study on radon gas, a carcinogenic, persistent hazard with a significant impact on public health, which typically flies under the radar of public opinion. [...] Read more.

This study addresses the construction and perception of risk and the role of the news media through a case study on radon gas, a carcinogenic, persistent hazard with a significant impact on public health, which typically flies under the radar of public opinion. The research is based on a survey (N = 1985) that targeted residents of Spain aged 18 or older. We evaluated cognitive and contextual factors, media consumption, and awareness of radon communication actions and developed a model to explain individual risk perception. The population’s knowledge about the different aspects of the risk of radon gas is moderate and uneven. A key element is the level of radon incidence among Spain’s autonomous communities. The main factors that explain the perception of radon risk are one’s perceived likelihood of being affected by radon, followed by gender and cognitive factors. The results demonstrate a strong correlation between media-disseminated information and public knowledge, but a weaker correlation between such information and protective actions, which are more closely tied to interpersonal and local communication. This study provides insights into addressing new societal risks and will help to create communication tools and analyses that avoid panic and promote responsible actions during crises. Full article

(This article belongs to the Section Global Health)

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13 pages, 1309 KB

Open AccessArticle

by Carlos Manoel Lopes Rodrigues and Lígia Abreu Gomes Cruz

Int. J. Environ. Res. Public Health 2025, 22(11), 1666; https://doi.org/10.3390/ijerph22111666 - 3 Nov 2025

Viewed by 349

Abstract

This study examines whether daily heat exposure worsens psychological well-being among self-employed motorcycle delivery workers in Brasília, Brazil. Using ecological momentary assessment over 15 consecutive days in August 2025, 45 workers were recruited and 30 (66.7%) completed twice-daily mobile prompts (12:00 and 18:00) [...] Read more.

This study examines whether daily heat exposure worsens psychological well-being among self-employed motorcycle delivery workers in Brasília, Brazil. Using ecological momentary assessment over 15 consecutive days in August 2025, 45 workers were recruited and 30 (66.7%) completed twice-daily mobile prompts (12:00 and 18:00) rating stress, fatigue, mood, and perceived heat (1–5 scales) and reporting kilometers traveled. Environmental data (temperature, relative humidity, barometric pressure) were paired from the INMET Brasília station. Linear regressions with cluster-robust standard errors by participant tested associations. Higher temperature was consistently related to greater strain: each +1 °C was associated with higher stress (β = 0.196, 95% CI 0.179–0.213), higher fatigue (β = 0.289, 95% CI 0.284–0.295), and worse mood (β = 0.149, 95% CI 0.130–0.168). Adding relative humidity yielded small but reliable partial effects (lower stress and better mood, yet higher fatigue) amid strong dry-season collinearity between temperature and humidity. The findings indicate that even modest day-to-day warming corresponds to measurable deterioration in psychological outcomes in a precarious, outdoor, platform-mediated workforce. Policies that expand hydration and shaded rest access, integrate heat indices into alerts, and adapt platform scheduling to reduce peak-heat exposure may mitigate risk. Full article

(This article belongs to the Special Issue Sustainable Work Environment and Occupational Well-Being)

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19 pages, 312 KB

Open AccessArticle

Non-Adherence to Treatment Among Patients Attending a Public Primary Healthcare Setting in South Africa: Prevalence and Associated Factors

by Lucky Norah Katende-Kyenda

Int. J. Environ. Res. Public Health 2025, 22(11), 1665; https://doi.org/10.3390/ijerph22111665 - 3 Nov 2025

Viewed by 170

Abstract

In underdeveloped nations, treatment non-adherence continues to be a significant barrier to effective disease management. It has a major impact on patients and healthcare systems in public primary healthcare settings. Patients who do not take their medications as prescribed may be at higher [...] Read more.

In underdeveloped nations, treatment non-adherence continues to be a significant barrier to effective disease management. It has a major impact on patients and healthcare systems in public primary healthcare settings. Patients who do not take their medications as prescribed may be at higher risk for negative health consequences. Polypharmacy, side-effects, and drug-related problems are factors contributing to non-adherence. Additional patient-related issues include multimorbidity, lack of support, chronic-drugs, and health-literacy. The purpose of this study was to ascertain the prevalence and contributing factors of treatment non-adherence among patients presenting to a public primary healthcare setting in South Africa. Between September and October 2014, cross-sectional quantitative research using structured questionnaires was carried out with one hundred patients who were chosen using random sampling. Self-reports from patients were used to assess non-adherence to therapy. A standardized questionnaire administered by the interviewer was used to gather data, and IBM SPSS version 29 was used for analysis. Patients aged 18 years and older who were using prescribed medications were included. The characteristics of the participants were obtained using descriptive statistics, and 95% confidence intervals (CIs) are reported for Odds ratios (ORs). Associations between related factors and treatment non-adherence were obtained using the Pearson Chi-square test; a p-value of less than 0.05 was deemed statistically significant. Of the 100 patients interviewed, 35% were men and 65% women. The majority were in the age-range of 60–80 years with a high school level of education. Demographic characteristics associated with non-adherence to treatment were gender (p = 0.03) and age (p = 0.03). Chronic conditions, alcohol consumption, recreational drug use, use of medication reminders, waiting time to get treatment and support from healthcare providers all were statistically significant with p-values < 0.001, time to get to the clinic (p = 0.02), mode of transport (p = 0.01), alcohol consumption (OR 22.25 [95% CI: 8.539–57.977], p < 0.001) and recreational drug use (OR 8.73 [95% CI: 5.01–15.98], p < 0.001) were also examined. Patient medication non-adherence is a major medical problem globally. Though patient education is the key to improving compliance, use of compliance aids, proper motivation, and support are also shown to increase medication adherence. Full article

(This article belongs to the Special Issue Evidence-Based Nursing in Primary Care: Enhancing Quality and Outcomes)

12 pages, 292 KB

Open AccessArticle

Parenthood and Self-Reported Depression, Anxiety, and Life Satisfaction in the COVID-19 Pandemic in the UK: An Examination of Differences by Age of Children and Level of Social Support

by Hannah Jones, Marie Houghton, Jorge Gato and Fiona Tasker

Int. J. Environ. Res. Public Health 2025, 22(11), 1664; https://doi.org/10.3390/ijerph22111664 - 2 Nov 2025

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Abstract

The COVID-19 pandemic had a marked detrimental effect on the mental health of the UK population. Parents with dependent children were deemed vulnerable but research on parental mental health in this period neglected to examine a child’s age together with the presence of [...] Read more.

The COVID-19 pandemic had a marked detrimental effect on the mental health of the UK population. Parents with dependent children were deemed vulnerable but research on parental mental health in this period neglected to examine a child’s age together with the presence of social support. To inform potential mental health support strategies this study investigated whether the pandemic was associated with different levels of psychological wellbeing for parents with youngest children of varying ages, relative to socio-demographic factors and social support levels. From November 2020 to April 2021 n = 915 UK adults completed an online survey measuring self-reported symptoms of depression, anxiety and stress, satisfaction with life, social support and socio-demographic characteristics. Results provide some evidence of better psychological wellbeing for parents with younger children (aged 0 to 5 years) than older children. Overall, social support was a key factor in mitigating depression, anxiety, and stress scores for parents of dependent-aged children. Findings provide new evidence supporting Pearlin’s Stress Process Model, highlighting the importance of social support to parents under pandemic-related pressures. These findings indicate that one way of safeguarding parents vulnerable to poor mental health could be by increasing social support to parents via formal and informal support services within school communities. Full article

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

13 pages, 617 KB

Open AccessArticle

Agreement Between Consumer and Research-Grade Physical Activity Monitors in a Public Health Intervention for Adolescent Latinas

by Jacob Carson, David Wing, Job G. Godino, Michael Higgins and Britta Larsen

Int. J. Environ. Res. Public Health 2025, 22(11), 1663; https://doi.org/10.3390/ijerph22111663 - 2 Nov 2025

Viewed by 167

Abstract

Consumer wearables are increasingly used in physical activity (PA) interventions, but their validity as a measurement tool among low PA groups, like adolescent girls, is unclear. We assessed the minute- and day-level agreement between PA measures among adolescent Latinas from an intervention. Participants [...] Read more.

Consumer wearables are increasingly used in physical activity (PA) interventions, but their validity as a measurement tool among low PA groups, like adolescent girls, is unclear. We assessed the minute- and day-level agreement between PA measures among adolescent Latinas from an intervention. Participants wore a Fitbit Inspire HR and an ActiGraph GT3X+ for overlapping epochs. ActiGraph data were classified using two different cut points and aligned with Fitbit data to produce 1,149,169 matched minutes of wear across 137 adolescent girls (M = 15.73 yrs). Confusion matrices were calculated for pairwise comparisons to determine minute-level Moderate-Vigorous PA (MVPA) classification. Data were aggregated to 1007 days for Bland–Altman analyses. ActiGraph cut points showed moderate agreement for minute-level MVPA classification (Balanced Accuracy = 0.71, AC1 = 0.98), while Fitbit showed fair agreement (Balanced Accuracy = 0.50, AC1 = 0.95–0.97) largely driven by non-MVPA observations. The Freedson cut point overestimated daily MVPA relative to Treuth by 14.7 min/day and Fitbit by 14.2 min/day in Bland–Altman space. The daily Treuth and Fitbit comparison did not significantly differ. Findings suggest systematic differences between cut points that warrant further consideration. Fitbit showed moderate agreement with ActiGraph, but heteroscedasticity and the epoch of aggregation significantly impacted agreement. Understanding device differences has implications for promoting/researching public health among adolescents. Full article

(This article belongs to the Section Exercise and Health-Related Quality of Life)

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17 pages, 318 KB

Open AccessArticle

Influence of Marital and Parental Status on Public Reactions to Stuttering in Chile: A Socio-Demographic Study

by Yasna Sandoval, Carlos Rojas, Bárbara Farías, Gabriel Lagos, Ángel Roco-Videla, Arnaldo Carocca and Goncalo Leal

Int. J. Environ. Res. Public Health 2025, 22(11), 1662; https://doi.org/10.3390/ijerph22111662 - 2 Nov 2025

Viewed by 248

Abstract

Stuttering is a communication disorder that significantly impacts individuals’ quality of life. This study examines public reactions towards stuttering within the Latin American context, specifically in Chile, using the Public Opinion Survey of Human Attributes-Stuttering. Data were collected from 400 adults, revealing that [...] Read more.

Stuttering is a communication disorder that significantly impacts individuals’ quality of life. This study examines public reactions towards stuttering within the Latin American context, specifically in Chile, using the Public Opinion Survey of Human Attributes-Stuttering. Data were collected from 400 adults, revealing that married individuals and parents exhibit heightened sensitivity and concern towards stuttering, especially regarding close family members. For instance, 56.86% of married respondents expressed worry about a stuttering sibling, contrasting sharply with only 27.18% of single respondents. Moreover, parents were notably anxious about stuttering in their family. This study underscores the significant role of marital status and parental responsibilities in shaping public attitudes towards stuttering. Additionally, it emphasizes the influence of family-centric values, advocating for the need for comprehensive educational initiatives to combat prevailing stigma towards individuals with stuttering. Full article

20 pages, 1422 KB

Open AccessArticle

Engaging Communities and Empowering Research: Lessons from a Network of Community Engagement Cores

by Daniel F. Sarpong, Corrine Yibing Liu, Tandeca King Gordon, Angela Sy, Bibiana Mancera, Mustapha Alhassan and for the RCMI Community Engagement Consortium

Int. J. Environ. Res. Public Health 2025, 22(11), 1661; https://doi.org/10.3390/ijerph22111661 - 1 Nov 2025

Viewed by 434

Abstract

As of the end of 2024, the NIH-funded Research Centers in Minority Institutions (RCMI) Program supported 21 specialized centers at minority-serving institutions. Its goal is to strengthen biomedical research infrastructure and enhance the capacity of investigators focused on health disparities. Since 2017, the [...] Read more.

As of the end of 2024, the NIH-funded Research Centers in Minority Institutions (RCMI) Program supported 21 specialized centers at minority-serving institutions. Its goal is to strengthen biomedical research infrastructure and enhance the capacity of investigators focused on health disparities. Since 2017, the centers have operated under a unified framework that includes four core components, one of which is Community Engagement (CEC). In 2021, the RCMI Coordinating Center established the CEC consortium to unify expertise across minority-serving institutions, which include historically Black colleges and Hispanic-serving institutions. This consortium promotes cross-institutional collaboration and innovation in community-engaged research to advance health equity. This paper examines how RCMI CECs strategically enhance research relevance, advance public health outcomes, and address social determinants of health (SDOH) through inclusive, bidirectional partnerships that position communities as co-leaders in the research process. Drawing on data from NIH RePORTER, the 2024 Community Engagement Consortium Signature Programs Monograph, and RCMI Common Data Elements, we analyze the collective contributions of the Community Engagement Core (CECs) across 21 RCMI centers. Findings underscore the role of tailored strategies, cultural competence, and academic-community partnerships in mitigating health disparities and promoting equity in underserved communities. Full article

(This article belongs to the Special Issue Proceedings of the 2024 and 2025 Research Centers in Minority Institutions (RCMI) Consortium National Conferences)

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Int. J. Environ. Res. Public Health, Volume 22, Issue 11 (November 2025) – 88 articles

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