International Journal of Environmental Research and Public Health

16 pages, 284 KiB

Open AccessArticle

Resilience amid Adversity: A Qualitative Narrative Study of Childhood Sexual Abuse Among Bangladeshi Transgender Individuals

by Sanzida Yeasmin and Jennifer J. Infanti

Int. J. Environ. Res. Public Health 2025, 22(4), 615; https://doi.org/10.3390/ijerph22040615 - 15 Apr 2025

Cited by 1 | Viewed by 5342

Abstract

Childhood sexual abuse (CSA) is a prevalent form of violence against children, associated with profound negative impacts on survivors’ health and well-being. In Bangladesh, sociocultural and economic barriers hinder CSA prevention and intervention, particularly for vulnerable populations such as transgender individuals. This study [...] Read more.

Childhood sexual abuse (CSA) is a prevalent form of violence against children, associated with profound negative impacts on survivors’ health and well-being. In Bangladesh, sociocultural and economic barriers hinder CSA prevention and intervention, particularly for vulnerable populations such as transgender individuals. This study explores the experiences of CSA among Bangladeshi transgender individuals, focusing on their coping mechanisms and resilience-building strategies. A qualitative narrative approach was employed, using life story-telling interviews with four transgender CSA survivors, and data were analyzed thematically. The findings reveal significant challenges, including social exclusion, humiliation, and lack of family support. Participants reported experiencing physical injuries, mental trauma, and loss of trust due to CSA, while the conservative nature of Bangladeshi society often prevented them from disclosing their abuse or seeking healthcare. These barriers exacerbate health inequalities among gender-minority children. Despite these adversities, participants described engaging in resilience-building strategies such as self-care, personal development, advocacy, and efforts to derive meaning from their experiences, while highlighting the perceived importance of family support. This study provides insights into the unique experiences of transgender CSA survivors in Bangladesh and calls for efforts towards gender-inclusive education, mental health support, and further research to address CSA-related adversity, encourage disclosure, and promote health equity for gender-minority groups. Full article

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

16 pages, 3084 KiB

Open AccessArticle

A Global Index to Quantify Discrimination Resulting from COVID-19 Pandemic Response Policies

by Claus Rinner, Mariko Uda and Laurie Manwell

Int. J. Environ. Res. Public Health 2025, 22(4), 467; https://doi.org/10.3390/ijerph22040467 - 21 Mar 2025

Viewed by 4769

Abstract

Immediately following the emergency use authorizations of COVID-19 vaccines, governments around the world made these products available to their populations and later started implementing differential rules for vaccinated and unvaccinated citizens regarding mobility and access to venues and services. The Oxford COVID-19 Government [...] Read more.

Immediately following the emergency use authorizations of COVID-19 vaccines, governments around the world made these products available to their populations and later started implementing differential rules for vaccinated and unvaccinated citizens regarding mobility and access to venues and services. The Oxford COVID-19 Government Response Tracker (OxCGRT) is a time series database that reflects the extent of public health measures in each country. On the basis of the OxCGRT Containment and Health Index, we calculated a corresponding discrimination index by subtracting the daily index values for vaccinated and unvaccinated individuals. The resulting metric provides a cursory quantification of the discrimination experienced by unvaccinated individuals throughout 2021 and 2022. Patterns in the index data show a high degree of discrimination with great numeric and temporal differences between jurisdictions. Around 90% of countries in Europe and North and South America discriminated against their unvaccinated citizens at some point during the pandemic. The least amount of discrimination was found for countries in Central America and Africa. In order to move towards sustainable post-pandemic recovery and prevent discriminatory public health policies in the future, we recommend that human rights protections be expanded and the prohibition of discrimination be extended beyond a limited list of grounds. Full article

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35 pages, 4777 KiB

Open AccessReview

The Global Burden of Periodontal Disease: A Narrative Review on Unveiling Socioeconomic and Health Challenges

by Nada Tawfig Hashim, Rasha Babiker, Vivek Padmanabhan, Azza Tagelsir Ahmed, Nallan C. S. K. Chaitanya, Riham Mohammed, Sivan Padma Priya, Ayman Ahmed, Shadi El Bahra, Md Sofiqul Islam, Bakri Gobara Gismalla and Muhammed Mustahsen Rahman

Int. J. Environ. Res. Public Health 2025, 22(4), 624; https://doi.org/10.3390/ijerph22040624 - 16 Apr 2025

Cited by 4 | Viewed by 3932

Abstract

Periodontal disease is a prevalent chronic inflammatory condition that impacts over a billion people worldwide, leading to substantial tooth loss, reduced quality of life, and heightened systemic health risks. This narrative review synthesizes current evidence regarding the global burden of periodontal disease, its [...] Read more.

Periodontal disease is a prevalent chronic inflammatory condition that impacts over a billion people worldwide, leading to substantial tooth loss, reduced quality of life, and heightened systemic health risks. This narrative review synthesizes current evidence regarding the global burden of periodontal disease, its established associations with systemic conditions including cardiovascular disease, diabetes, adverse pregnancy outcomes, respiratory infections, and neurodegenerative disorders, and its significant socioeconomic implications. The review focused on the following research question: What is the global burden of periodontal disease, and how do its systemic and socioeconomic implications necessitate integrated public health strategies? A structured search of the PubMed, Scopus, and WHO databases from 2000 to 2024 was conducted to identify relevant literature using key terms, including “periodontal disease”, “global burden”, “systemic inflammation”, and “public health strategies”. Out of 312 initially identified articles, 175 satisfied the inclusion criteria for the final synthesis. The findings underscore the significance of periodontal disease as a modifiable risk factor for various noncommunicable diseases, the influence of healthcare disparities on disease progression, and the critical necessity for integrated public health strategies to mitigate the global burden of periodontal disease and its consequences. The review concludes that coordinated policy reform, health system integration, and enhanced research efforts are crucial for mitigating the global burden of periodontal disease and advancing health equity. Full article

(This article belongs to the Special Issue 2nd Edition of Epidemiology and Global Health)

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17 pages, 1825 KiB

Open AccessArticle

School-Based Mental Health Education: Program Effectiveness and Trends in Help-Seeking

by Jean Kirnan, Gianna Fotinos, Kelsey Pitt and Gavin Lloyd

Int. J. Environ. Res. Public Health 2025, 22(4), 523; https://doi.org/10.3390/ijerph22040523 - 29 Mar 2025

Cited by 1 | Viewed by 3499

Abstract

One of the strategies to address the persistent youth mental health crisis is school-based educational programming. This paper reports on two distinct studies regarding Coming Up for AIR, a school-based mental health education program: (1) program effectiveness, measured as gains in student [...] Read more.

One of the strategies to address the persistent youth mental health crisis is school-based educational programming. This paper reports on two distinct studies regarding Coming Up for AIR, a school-based mental health education program: (1) program effectiveness, measured as gains in student mental health literacy; and (2) trends in help-seeking behavior before, during, and after the pandemic. A survey on program content was administered to assess program effectiveness. Data collected between 2020 and 2023 from four schools yielded 473 responses. A comparison of pre- and post-scores demonstrated statistically significant gains in program content. Mental health literacy improved across gender and grade level (8th, 9th, and 10th), as well as for students with prior exposure to a mental health curriculum. In the second study, help-seeking behavior was evaluated before, during, and after the pandemic. While other programs measure intention, Coming Up for AIR measures actual behavior as students can ask for help for themselves or a friend. Data did not reflect individual student responses, but rather were aggregated and provided the number of students per presentation who requested help. Archived declaration card data from January 2019 through February 2024 was accessed, representing 28 different schools and 16,289 middle and high school student responses. School-level data were analyzed by grade level (middle school or high school) and date (pre-, intra-, or post-COVID-19). Significant differences in self-referral were found for both grade level and presentation date. Self-referrals were significantly higher post-COVID-19 compared to pre-COVID-19 with middle schoolers increasing 90% and high school students increasing 36%. Analysis of friend referrals showed a significant difference for grade level, but not presentation date. Again, middle school students were more likely to make a referral than high schoolers. The data suggest that the mental health crisis in middle school students persists at an alarming rate. Schools are at the forefront of addressing mental health issues for youth. External educational programming can bring awareness to mental health concerns and promote help-seeking in youth. Full article

(This article belongs to the Special Issue Mental Health and Health Promotion in Young People)

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16 pages, 3370 KiB

Open AccessSystematic Review

Prevalence of CVD Among Indian Adult Population: Systematic Review and Meta-Analysis

by Mohd Shannawaz, Isha Rathi, Nikita Shah, Shazina Saeed, Amrish Chandra and Harpreet Singh

Int. J. Environ. Res. Public Health 2025, 22(4), 539; https://doi.org/10.3390/ijerph22040539 - 1 Apr 2025

Cited by 1 | Viewed by 3485

Abstract

Cardiovascular disease is among the leading causes of mortality and morbidity globally. Over three-quarters of CVD-related deaths now occur in low- and middle-income countries (LMICs); India accounts for one-fifth of global CVD-related deaths, especially among the younger population. The objective of this study [...] Read more.

Cardiovascular disease is among the leading causes of mortality and morbidity globally. Over three-quarters of CVD-related deaths now occur in low- and middle-income countries (LMICs); India accounts for one-fifth of global CVD-related deaths, especially among the younger population. The objective of this study was to evaluate the prevalence of CVD among the Indian adult population. We systematically searched Scopus and PubMed from January 2000 to December 2024 to identify relevant articles and pooled the prevalence of CVD using random-effects meta-analysis. Among the 14,647 records screened, 501 full-text articles were assessed for eligibility and 15 studies were included in the final analysis. The pooled prevalence of CVD was 11% (95% CI: 0.09–0.17). Subgroup analysis showed prevalence rates of 12% among males and 14% among females. Urban areas had a higher prevalence (12%) compared to rural areas (6%), with a significant difference. Our study shows the significant prevalence of cardiovascular disease (CVD) in India, particularly in urban areas, with slightly higher rates among females. Focused public health strategies are required to mitigate the growing burden of CVD, along with preventive measures, to reduce further increases in disease prevalence and related fatalities. Full article

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17 pages, 311 KiB

Open AccessArticle

Changes in Bullying Experiences and Mental Health Problems Among Adolescents Before and After the COVID-19 Pandemic in Greece

by Georgios Giannakopoulos, Foivos Zaravinos-Tsakos, Maria Mastrogiannakou, Andre Sourander and Gerasimos Kolaitis

Int. J. Environ. Res. Public Health 2025, 22(4), 497; https://doi.org/10.3390/ijerph22040497 - 26 Mar 2025

Viewed by 2965

Abstract

Bullying poses significant challenges to adolescent health and well-being. This time-trend study examined the impact of the COVID-19 pandemic on bullying behaviors and associated emotional and behavioral difficulties among Greek adolescents. Data were collected from two cross-sectional surveys in 2016 (n = [...] Read more.

Bullying poses significant challenges to adolescent health and well-being. This time-trend study examined the impact of the COVID-19 pandemic on bullying behaviors and associated emotional and behavioral difficulties among Greek adolescents. Data were collected from two cross-sectional surveys in 2016 (n = 1574) and 2023 (n = 5753) conducted in Greece. Both samples comprised students aged 12–16 years, with near-equal gender distribution (2016, 53.4% girls; 2023, 54.5% girls) and a predominance of urban residents (approximately 73% in both samples). Traditional and cyberbullying experiences were assessed via structured questionnaires, while mental health outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ). Post-pandemic findings revealed substantial increases in bullying involvement; traditional bullying victimization rose from 12.4% to 21.7%, and cyberbullying victimization increased from 4.0% to 11.6%. Correspondingly, mean SDQ total scores increased significantly from 8.59 to 14.16, reflecting heightened emotional and behavioral problems. Logistic regression analyses identified male gender, urban residence, and non-traditional family structures as significant predictors of bullying involvement. These results underscore the amplified burden of bullying and mental health difficulties in the post-pandemic era, highlighting the urgent need for targeted prevention and intervention strategies to address both traditional and cyberbullying within diverse sociodemographic contexts. Full article

(This article belongs to the Special Issue Lifestyle Aspects of Students in the Era of the COVID-19 Pandemic, Armed Conflict and Economic Crisis and Other Social Events)

12 pages, 425 KiB

Open AccessArticle

Parenting Style and Child Internet Addiction in China: Mediation Effect of Parental Active Meditation

by Shu-Wen Liu, Sheng Chen, Chienchung Huang and Julia Vallario

Int. J. Environ. Res. Public Health 2025, 22(4), 461; https://doi.org/10.3390/ijerph22040461 - 21 Mar 2025

Cited by 1 | Viewed by 2855

Abstract

With the rapid advancement of technology, internet addiction among children has become a growing concern, particularly in China. This study examines the impact of different parenting styles on internet addiction and the role of parental mediation on the relationship among Chinese children. A [...] Read more.

With the rapid advancement of technology, internet addiction among children has become a growing concern, particularly in China. This study examines the impact of different parenting styles on internet addiction and the role of parental mediation on the relationship among Chinese children. A survey of 600 Chinese families with children aged 6 to 17 was conducted in 2024. Using structural equation modeling (SEM), the results reveal that authoritative parenting is linked to lower levels of internet addiction, while authoritarian and permissive parenting are associated with higher levels. Parental mediation partly mediates this relationship, with authoritative parents who are actively involved with their children’s internet activities showing a reduced risk of addiction. The findings highlight that both parenting style and parental intervention are key factors in addressing internet addiction among Chinese children. Encouraging authoritative parenting alongside active mediation may help children mitigate internet addiction. Full article

(This article belongs to the Special Issue Problematic Internet and Smartphone Use as a Public Health Concern)

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12 pages, 732 KiB

Open AccessArticle

Immediate Effects of Light Mode and Dark Mode Features on Visual Fatigue in Tablet Users

by Praphatson Sengsoon and Roongnapa Intaruk

Int. J. Environ. Res. Public Health 2025, 22(4), 609; https://doi.org/10.3390/ijerph22040609 - 12 Apr 2025

Viewed by 2769

Abstract

Background: Prolonged tablet use can cause visual fatigue, dry eye, and changes in critical flicker frequency, affecting visual comfort and performance. While the light and dark mode features aim to reduce eye strain, their immediate effects on these issues remain unclear. Objective: To [...] Read more.

Background: Prolonged tablet use can cause visual fatigue, dry eye, and changes in critical flicker frequency, affecting visual comfort and performance. While the light and dark mode features aim to reduce eye strain, their immediate effects on these issues remain unclear. Objective: To compare the immediate effects of light and dark mode features on visual fatigue in tablet users. Methods: This experimental study involved 30 female tablet users. The participants were randomly assigned using a block randomization method to use both light and dark mode features. Visual fatigue, critical flicker frequency, and dry eye symptoms were measured before and after exposure to each mode. Results: No statistically significant difference in visual fatigue was observed between the two modes (p > 0.05). However, a statistically significant difference was found in critical flicker frequency (p < 0.05) and dry eye symptoms (p < 0.05) between the two modes. Furthermore, visual fatigue, critical flicker frequency, and dry eye symptoms significantly increased after tablet use in both modes (p < 0.05). Conclusions: Both light and dark mode features impact visual fatigue, critical flicker frequency, and dry eye symptoms. However, the dark mode may help reduce the risk of eye fatigue compared to the light mode. Further studies are recommended to explore the long-term effects and optimize screen settings for visual comfort. Full article

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17 pages, 669 KiB

Open AccessArticle

Trauma, Mental Health Workforce Shortages, and Health Equity: A Crisis in Public Health

by Suha Ballout

Int. J. Environ. Res. Public Health 2025, 22(4), 620; https://doi.org/10.3390/ijerph22040620 - 16 Apr 2025

Viewed by 2730

Abstract

The global mental health workforce is facing a severe crisis marked by burnout, secondary trauma, compassion fatigue, and workforce shortages, with disproportionate effects on marginalized communities. This paper introduces the Integrated Workforce Trauma and Resilience (IWTR) Model, a comprehensive framework to understand and [...] Read more.

The global mental health workforce is facing a severe crisis marked by burnout, secondary trauma, compassion fatigue, and workforce shortages, with disproportionate effects on marginalized communities. This paper introduces the Integrated Workforce Trauma and Resilience (IWTR) Model, a comprehensive framework to understand and address these interconnected challenges. This study employs a conceptual, documentary analysis approach to examine the challenges faced by mental health workers, particularly trauma, burnout, and workforce shortages. By synthesizing existing qualitative and quantitative studies, the research identifies recurring themes and provides recommendations for policy reform to improve workforce sustainability and equity. Using a thematic synthesis of 75 peer-reviewed articles, conceptual papers, and policy reports published between 2020 and 2025, alongside foundational theoretical works, the IWTR Model integrates five theoretical perspectives: trauma-informed care, Conservation of Resources Theory, Intersectionality Theory, the Job Demands–Resources Model, and Organizational Justice Theory. The analysis identifies three dimensions: the impact of trauma on mental health professionals, organizational and systemic factors influencing workforce retention, and strategies to build resilience through policy and education. The findings reveal how secondary trauma, burnout, and systemic inequities interact to undermine workforce stability and access to care. The IWTR Model emphasizes that individual-level interventions will be insufficient without addressing structural issues, such as workload inequities, lack of leadership diversity, and underfunding. This model offers a roadmap for systemic reforms to strengthen workforce resilience, improve retention, and advance global equity in mental health care systems. Full article

(This article belongs to the Special Issue Multidimensional Trauma and Its Impact on Public Mental Health)

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15 pages, 551 KiB

Open AccessReview

Cannabis Hyperemesis Syndrome in Youth: Clinical Insights and Public Health Implications

by Jamie A. Seabrook, Morgan Seabrook and Jason A. Gilliland

Int. J. Environ. Res. Public Health 2025, 22(4), 633; https://doi.org/10.3390/ijerph22040633 - 17 Apr 2025

Viewed by 2398

Abstract

This review focuses on Cannabis Hyperemesis Syndrome (CHS) in youth, a condition linked to chronic cannabis use and characterized by cyclic vomiting, abdominal pain, and dehydration. The objectives were to explore CHS progression in youth and its impact on health, and to assess [...] Read more.

This review focuses on Cannabis Hyperemesis Syndrome (CHS) in youth, a condition linked to chronic cannabis use and characterized by cyclic vomiting, abdominal pain, and dehydration. The objectives were to explore CHS progression in youth and its impact on health, and to assess current treatment strategies. There are the three distinct phases of CHS: prodromal, hyperemetic, and recovery. During the prodromal phase, individuals experience early morning nausea and discomfort, often mistakenly alleviated by continued cannabis use. The hyperemetic phase is marked by severe vomiting, dehydration, and complications like electrolyte imbalances, leading to potentially serious health risks. Temporary relief may be experienced through hot showers or baths. In the recovery phase, symptoms gradually resolve, and normal eating and bathing habits return. The review emphasizes the physical and psychological impacts of CHS on youth, highlighting the potential for misdiagnosis and the importance of early intervention. It stresses the need for targeted educational efforts in schools, healthcare settings, and public health campaigns to prevent delayed diagnosis and improve outcomes. Findings underscore the importance of increasing healthcare provider awareness and promoting preventive education. The review also advocates for further research into CHS pathophysiology to improve diagnostic and treatment protocols for young populations. Full article

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

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36 pages, 673 KiB

Open AccessReview

Barriers to and Facilitators of Technology Adoption in Emergency Departments: A Comprehensive Review

by Ann Thong Lee, R Kanesaraj Ramasamy and Anusuyah Subbarao

Int. J. Environ. Res. Public Health 2025, 22(4), 479; https://doi.org/10.3390/ijerph22040479 - 23 Mar 2025

Cited by 1 | Viewed by 2303

Abstract

Background: Even while technology is advancing quickly in many areas, the healthcare industry, particularly emergency departments, is slow to incorporate new technologies. The majority of research is on healthcare in general, with few studies examining medical officers’ adoption of technology in emergency departments. [...] Read more.

Background: Even while technology is advancing quickly in many areas, the healthcare industry, particularly emergency departments, is slow to incorporate new technologies. The majority of research is on healthcare in general, with few studies examining medical officers’ adoption of technology in emergency departments. Methods: This study used a comprehensive review design and examined a total of 30 peer-reviewed articles that were published between 2019 and 2024. The articles were reviewed by using keywords such as “technology adoption”, “influence factors”, “medical technology”, “barriers”, “healthcare”, “emergency departments”, “ED”, and so on. This review aimed to identify barriers and facilitators to provide insights to improve technology adoption in emergency departments. Results: The studies were conducted using different techniques, including surveys, interviews, and systematic reviews, to examine technology adoption in emergency departments across different geographic locations. The technologies studied include clinical decision support systems, telemedicine, electronic health records, and AI-based innovations. Several barriers were discovered in this study, including high employee turnover, accessibility issues, insufficient technology availability, resistance to change, and excessive workload. Key enabling facilitators were also identified, namely, good collaboration and communication, a supportive and engaged management team, and rigorous education and training. Conclusions: This study highlights that tailored strategies and collaboration are essential to overcoming barriers in emergency departments, which will lead to faster adoption of technologies that improve patient outcomes and efficiency. Further research will involve performing a deeper study of these findings and investigating more creative techniques to improve technology integration and further establish higher standards of care inside emergency departments. Full article

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20 pages, 603 KiB

Open AccessPerspective

The Intersection of Sarcopenia and Musculoskeletal Pain: Addressing Interconnected Challenges in Aging Care

by Yacov Grosman and Leonid Kalichman

Int. J. Environ. Res. Public Health 2025, 22(4), 547; https://doi.org/10.3390/ijerph22040547 - 2 Apr 2025

Viewed by 2287

Abstract

The global aging population faces a growing prevalence of sarcopenia and musculoskeletal (MSK) pain, two interrelated conditions that diminish physical function, quality of life, and independence in older adults. Sarcopenia, characterized by the loss of muscle strength, mass, and function, often coexists with [...] Read more.

The global aging population faces a growing prevalence of sarcopenia and musculoskeletal (MSK) pain, two interrelated conditions that diminish physical function, quality of life, and independence in older adults. Sarcopenia, characterized by the loss of muscle strength, mass, and function, often coexists with MSK pain, with emerging evidence suggesting that each condition may contribute to the progression of the other. This perspective explores the bidirectional relationship between sarcopenia and MSK pain, highlighting shared mechanisms, including inactivity, cellular aging, chronic inflammation, gender-related hormonal changes, and psychosocial factors such as depression and social isolation, which underlie the mutual exacerbation between conditions. Through a multidisciplinary framework, the article emphasizes integrating care across specialties to address these interconnected conditions. Practical approaches, including comprehensive screening protocols, tailored resistance exercise, and nutritional support, are discussed alongside innovative hybrid care models combining in-person and telemedicine systems to enhance accessibility and continuity of care. A call to action is presented for clinicians, policymakers, and researchers to adopt collaborative strategies, prioritize investment in integrated healthcare, and bridge critical knowledge gaps. By reframing care delivery and advancing multidisciplinary efforts, this perspective aims to effectively address the complex challenges posed by the intersection of sarcopenia and MSK pain in older adults. Full article

(This article belongs to the Special Issue Perspectives in Health Care Sciences)

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20 pages, 871 KiB

Open AccessSystematic Review

The Effectiveness of Debriefing on the Mental Health of Rescue Teams: A Systematic Review

by Francesca Ancarani, Pedro Garijo Añaños, Bain Gutiérrez, Juan Pérez-Nievas, Germán Vicente-Rodríguez and Fernando Gimeno Marco

Int. J. Environ. Res. Public Health 2025, 22(4), 590; https://doi.org/10.3390/ijerph22040590 - 9 Apr 2025

Viewed by 2224

Abstract

Background: Rescue teams and emergency services face high levels of mental health problems due to their frequent exposure to traumatic situations. Critical incident stress debriefing (CISD) is widely used as a psychological intervention for emergency responders and military personnel exposed to traumatic [...] Read more.

Background: Rescue teams and emergency services face high levels of mental health problems due to their frequent exposure to traumatic situations. Critical incident stress debriefing (CISD) is widely used as a psychological intervention for emergency responders and military personnel exposed to traumatic events. However, its effectiveness remains controversial, with systematic reviews yielding mixed results and some evidence of negative and harmful outcomes. This systematic review, conducted according to PRISMA guidelines, evaluates the evidence on the efficacy of CISD in mitigating psychological distress and preventing post-traumatic stress disorder (PTSD). Methods: A systematic search was conducted in PubMed and PsycINFO from inception to November 2024. Eligibility criteria included randomized controlled trials (RCTs) and cohort studies assessing the impact of CISD on PTSD, anxiety, depression, and psychological distress. Two independent reviewers screened studies, extracted data, and assessed the risk of bias using the PEDro scale. Data narrative synthesis was applicable. Results: A total of 6 out of 371 studies were included, comprising 4751 participants. The PEDro scale showed that one study was of high methodological quality, four were of acceptable quality, and two had deficiencies. The findings revealed mixed outcomes: while some studies reported a reduction in PTSD symptoms, others found no significant effect or even potential harm. Heterogeneity in intervention implementation, population characteristics, and study quality influenced the results. Risk of bias was moderate to high in several studies, with limitations in sample size and follow-up duration. No specific effects have been studied in mountain rescue teams. Conclusions: Current evidence does not unequivocally support the efficacy of CISD in preventing PTSD and psychological distress. Given methodological concerns and potential adverse effects, alternative debriefing methods, such as Battlemind debriefing, warrant further exploration. Future research should focus on well-powered RCTs with standardized intervention protocols to enhance reliability. Full article

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

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26 pages, 1691 KiB

Open AccessReview

Second-Hand Smoke Exposure and Risk of Lung Cancer Among Nonsmokers in the United States: A Systematic Review and Meta-Analysis

by Safa Elkefi, Gabriel Zeinoun, Achraf Tounsi, Jean-Marie Bruzzese, Corina Lelutiu-Weinberger and Alicia K. Matthews

Int. J. Environ. Res. Public Health 2025, 22(4), 595; https://doi.org/10.3390/ijerph22040595 - 10 Apr 2025

Viewed by 2212

Abstract

This study aims to explore the link between exposure to tobacco smoke among nonsmokers and the risk of lung cancer in the United States. We searched six databases for studies on second-hand smoke (SHS) and lung cancer following PRISMA guidelines. Following the random [...] Read more.

This study aims to explore the link between exposure to tobacco smoke among nonsmokers and the risk of lung cancer in the United States. We searched six databases for studies on second-hand smoke (SHS) and lung cancer following PRISMA guidelines. Following the random effects model and specific statistical methods, our meta-analysis analyzed studies based on SHS exposure type. A total of 19 eligible studies were included in the review and 15 in the meta-analysis. We covered exposure from parents (childhood), spouses and partners (household), and work-related exposure (colleagues), with higher risk among non-smoking children and domestic partners. Findings reveal a consistent link between SHS exposure and increased lung cancer risk for this population (exposure effect sizes: 1.05–3.11). Analysis of childhood SHS exposure reveals a distinct increased risk associated with parental exposure. For nonsmokers living with smoking spouses, there is a marked 41% increase in risk. Higher risk was associated with more and more prolonged SHS exposure. Exposure to SHS in the workplace shows a correlation with lung cancer risk. Our findings highlight increased SHS-related lung cancer risk, particularly among non-smoking children and domestic partners, intensifying with the amount and duration of exposure, indicating the significant impact of SHS within domestic environments. Full article

(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)

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14 pages, 640 KiB

Open AccessReview

Exploring the Association Between Problematic Internet Use, Internet Gaming Disorder in Adolescents with ADHD: A Scoping Review

by Roberto Ghiaccio, Anna Passaro, Fabrizio Stasolla, Elvira Martini, Angelo Maria De Fortuna and Raffaele De Luca Picione

Int. J. Environ. Res. Public Health 2025, 22(4), 496; https://doi.org/10.3390/ijerph22040496 - 26 Mar 2025

Viewed by 2086

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Adolescents with ADHD have an elevated risk of developing Internet Gaming Disorder (IGD), a condition involving excessive gaming that disrupts daily life. IGD is linked to traits such as [...] Read more.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Adolescents with ADHD have an elevated risk of developing Internet Gaming Disorder (IGD), a condition involving excessive gaming that disrupts daily life. IGD is linked to traits such as low frustration tolerance and sensation-seeking, with comorbid conditions like anxiety and depression further increasing vulnerability. Gaming frequently serves as a coping strategy due to emotional regulation difficulties. The dynamics within family units and peer relationships play a pivotal role, with dysfunctional environments heightening the risks and positive interactions serving as protective factors. Methods: This scoping review analyzed empirical studies published in the last decade exploring the association between ADHD, Problematic Internet Use (PIU), or IGD, focusing on neurobiological, psychological, and environmental factors. Results: The findings highlight that impulsivity and emotional dysregulation in ADHD contribute to IGD. Gaming is frequently used as a maladaptive coping strategy, with social and family influences modulating risk. Diagnostic complexities arise in distinguishing ADHD-related behaviors from IGD symptoms. Conclusions: Addressing these comorbid conditions requires interdisciplinary collaboration and evidence-based interventions. Future research should focus on understanding ADHD, PIU, or IGD interactions and developing targeted interventions. Longitudinal studies are necessary to establish causal links and assess effective treatment strategies. Full article

(This article belongs to the Special Issue Psychological Wellbeing, Mental Health and Problematic Internet Use Among Adolescents)

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22 pages, 1081 KiB

Open AccessArticle

The Impact of Morning Meditation and Sleep Quality on Affective and Health Outcomes in Healthcare Workers

by Ana Junça-Silva, Marisa Kulyk and António Caetano

Int. J. Environ. Res. Public Health 2025, 22(4), 592; https://doi.org/10.3390/ijerph22040592 - 9 Apr 2025

Viewed by 1989

Abstract

Background: Health is a critical factor influencing key workplace outcomes, including job attitudes, behaviors, and performance. This study investigated the role of daily micro-breaks, specifically morning meditation practices, and positive affective experiences (i.e., positive affect) at work in predicting health-related outcomes, namely vitality [...] Read more.

Background: Health is a critical factor influencing key workplace outcomes, including job attitudes, behaviors, and performance. This study investigated the role of daily micro-breaks, specifically morning meditation practices, and positive affective experiences (i.e., positive affect) at work in predicting health-related outcomes, namely vitality and mental health. Using a non-experimental design, this study tested a moderated mediation model in which sleep quality moderates the relationship between morning meditation and positive affect, which, in turn, predicts end-of-the-day health-related outcomes. Methodology: Data were collected twice a day from 44 healthcare employees over five consecutive workdays using a daily survey approach. Key Results: Multilevel modeling analyses revealed that morning meditation was significantly associated with increased positive affect and improved health indicators at the end of the workday. Moreover, sleep quality moderated the relationship between morning meditation and positive affect, such that the conditional indirect effect of meditation on end-of-day mental health and vitality via positive affect was significant when sleep quality from the preceding night was poor. Conclusions: These findings underscore the interactive effect of prior-night sleep quality and morning meditation on affective and health-related outcomes by the end of the day. By identifying sleep quality as a key boundary condition, we contribute to a more nuanced understanding of when meditation is most beneficial. Our findings have significant implications for both research and practice, particularly in high-stress environments such as healthcare, where optimizing employee well-being is crucial for both individual and organizational performance. Full article

(This article belongs to the Special Issue Exploring the Link—Better Sleep Equals Better Health)

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35 pages, 1530 KiB

Open AccessArticle

Integrating Australian Native Foods for a More Sustainable Food System: A Qualitative Co-Design Study with Aboriginal Communities

by Carla Vanessa Alves Lopes, John Hunter, Renee Cawthorne, Shirley Gilbert, Ayoola Shogunle, Cassandra Ebsworth, Mike Bartlett, Rimante Ronto and Seema Mihrshahi

Int. J. Environ. Res. Public Health 2025, 22(4), 646; https://doi.org/10.3390/ijerph22040646 - 19 Apr 2025

Viewed by 1952

Abstract

(1) Background: Integrating native foods into food systems has shown promising benefits for health, the environment, and the revitalisation of Aboriginal culture. This study aims to explore the benefits, facilitators, and barriers of integrating Australian native foods into the current food system and [...] Read more.

(1) Background: Integrating native foods into food systems has shown promising benefits for health, the environment, and the revitalisation of Aboriginal culture. This study aims to explore the benefits, facilitators, and barriers of integrating Australian native foods into the current food system and how traditional knowledge around these foods can be revitalised in a culturally safe way. (2) Methods: This qualitative co-design study involved the following four phases: (I) Relationship building with the communities and cultural training for the research team; (II) Establishment of the Aboriginal Reference Group (ARG) for community involvement and governance; (III) Data collection through interviews and focus groups with participants from two urban Aboriginal communities in Sydney and experts in native foods; and (IV) Collaborative data analysis using both deductive and inductive thematic analysis. (3) Results: We interviewed 22 participants who acknowledged the nutritional, health, cultural, environmental, and economic benefits of Australian native foods. They strongly identified the impact of colonisation and imposed Western culture as root barriers impacting other barriers at the structural, socioeconomic, social, and environmental levels. Participants aspire to achieve food security and sovereignty in a more sustainable food system including native foods. To achieve their aspirations, a framework based on Aboriginal values and principles was developed to guide multicomponent initiatives using native foods. (4) Conclusions: A compassionate food model based on emancipatory community-based and land-based education is essential, connecting ancient and contemporary knowledge to transform the food system. Future research should focus on implementing and evaluating the multicomponent interventions suggested by the participants. Full article

(This article belongs to the Special Issue Sustainable Nutrition: Bridging Food Systems, Climate Change, and Human Health)

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39 pages, 2838 KiB

Open AccessReview

The Interplay Between Sleep and Safety Outcomes in the Workplace: A Scoping Review and Bibliographic Analysis of the Literature

by Janet Mayowa Nwaogu, Albert P. C. Chan, John A. Naslund and Shahnawaz Anwer

Int. J. Environ. Res. Public Health 2025, 22(4), 533; https://doi.org/10.3390/ijerph22040533 - 31 Mar 2025

Viewed by 1693

Abstract

Occupational incidents comprising injuries and accidents remain a serious concern globally. With sleep deprivation and fatigue representing key drivers of many workplace incidents, one strategy to reduce occupational incidents is implementing effective sleep management systems. Yet, to date, there are complaints about the [...] Read more.

Occupational incidents comprising injuries and accidents remain a serious concern globally. With sleep deprivation and fatigue representing key drivers of many workplace incidents, one strategy to reduce occupational incidents is implementing effective sleep management systems. Yet, to date, there are complaints about the methodological approach in sleep–safety studies. The extent of work carried out with respect to the impact of sleep on safety outcomes needs to be reviewed to highlight the state of the art in the face of increasing technological advancement and changing lifestyle attitudes. A systematic search of the Scopus and PubMed databases retrieved 63 journal articles published up to 2023. The units of analysis included article performance and thematic analysis. It was deduced that workers in healthcare and construction have been the focus of most studies, pointing to the prevalence of safety issues in both these sectors. Most of the studies adopted a quantitative methodology employing validated sleep questionnaires, especially the Pittsburgh Sleep Quality Index. Using thematic analysis, the research focus was mapped into six areas, including sleep disorders, cognition and performance, and injury and accident prevention in the construction sector. In objective studies, alertness and cognitive performance were considered a proxy for sleep deprivation and safety performance. Harmonising sleep questionnaires is necessary to prevent excessive paperwork and ineffective safety systems. This study has the potential to provide occupational health and safety researchers outside of the medicine and psychology disciplines with knowledge on baseline information that could advance efforts to address sleep deprivation and the resulting safety concerns in the workplace. Full article

(This article belongs to the Special Issue Promoting Health and Safety in the Workplace)

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39 pages, 428 KiB

Open AccessSystematic Review

Why Do Emergency Medical Service Employees (Not) Seek Organizational Help for Mental Health Support?: A Systematic Review

by Sasha Johnston, Polly Waite, Jasmine Laing, Layla Rashid, Abbie Wilkins, Chloe Hooper, Elizabeth Hindhaugh and Jennifer Wild

Int. J. Environ. Res. Public Health 2025, 22(4), 629; https://doi.org/10.3390/ijerph22040629 - 17 Apr 2025

Viewed by 1581

Abstract

Emergency medical service (EMS) ambulance employees play a critical role in emergency healthcare delivery. However, work-related experiences can compromise their mental health and job satisfaction. Despite available supportive services offered by EMS organizations, employee uptake remains low, while mental ill health and suicide [...] Read more.

Emergency medical service (EMS) ambulance employees play a critical role in emergency healthcare delivery. However, work-related experiences can compromise their mental health and job satisfaction. Despite available supportive services offered by EMS organizations, employee uptake remains low, while mental ill health and suicide rates remain higher than those of the general population. Understanding barriers to and enablers of such support is crucial for addressing factors that connect employees with the services designed to help. This systematic review identified 34 relevant articles and utilized an innovative process of integrating quantitative and qualitative aspects of the primary and gray literature to provide a qualitative synthesis of barriers and facilitators as perceived by EMS employees. Themes of employee (in)ability to ask for help, tailored person-centered support, and education and training about mental health were overarched by organizational culture. Barriers included perceived organizational obligation rather than genuine care, alongside machismo and stigma. Enablers included valuing and acknowledging employee risk by providing time and normalizing support utilization at work. Reframing machismo from dominance, competition, and toughness to respect, perseverance, and courage; promoting adaptive coping; and providing time and training were essential. Future research should aim to understand the factors influencing employee utilization of supportive interventions based on these themes. Full article

22 pages, 3491 KiB

Open AccessSystematic Review

Molecular Effects of Physical Activity and Body Composition: A Systematic Review and Meta-Analysis

by Jenni Chambers, Clare M. P. Roscoe, Corinna Chidley, Agnieszka Wisniewska and Aparna Duggirala

Int. J. Environ. Res. Public Health 2025, 22(4), 637; https://doi.org/10.3390/ijerph22040637 - 18 Apr 2025

Viewed by 1424

Abstract

Physical activity (PA) and body composition are important lifestyle factors that influence public health. Research suggests that DNA regions (CpG site locations) are differentially methylated in a physically active population. This meta-analysis aimed to identify CpG sites associated with various levels of PA [...] Read more.

Physical activity (PA) and body composition are important lifestyle factors that influence public health. Research suggests that DNA regions (CpG site locations) are differentially methylated in a physically active population. This meta-analysis aimed to identify CpG sites associated with various levels of PA and associated metabolic pathways. The meta-analysis followed PRISMA guidelines using PubMed, SportDISCUS, Embase, Scopus, Cochrane and Web of Science. Epigenomic analyses performed on DNA of participants with no underlying health conditions were included. Articles were screened using Rayyan AI and extracted CpG sites, and their location were confirmed using the EWAS catalogue. Six studies comprising 770 subjects were included in this meta-analysis. The meta-analysis was performed on clinical metrics extracted from the six studies and showed that BMI, blood pressure, insulin and glucose testing are significantly improved upon PA intervention. Amongst the included studies, a total of 257 CpG sites were differentially methylated in physically active participants, with 134 CpGs located in 92 genes associated with obesity-related pathways. The identified differentially methylated genes either belonged to the lipid metabolism or insulin signalling pathway. The genes which were differentially regulated in multiple tissue types and studies are JAZF1 (insulin signalling, and lipid and carbohydrate metabolism pathways) and NAV1 (mTOR signalling pathway). In conclusion, the current epigenomic meta-analysis showed that PA levels induce differential DNA methylation signatures on genes that affect metabolism. To understand the positive molecular effects of PA, further research on the above candidate genes needs to be conducted amongst various levels of a physically active population. Full article

(This article belongs to the Special Issue Physical Activity and Health: Strategies and Action Plans to Prevent Public Health Risks)

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24 pages, 345 KiB

Open AccessArticle

Australian Women Veterans’ Experiences of Gendered Disempowerment and Abuse Within Military Service and Transition

by Sharon Lawn, Elaine Waddell, Louise Roberts, Pilar Rioseco, Tiffany Beks, Liz McNeill, David Everitt, Tiffany Sharp, Dylan Mordaunt, Amanda Tarrant, Miranda Van Hooff, Jon Lane and Ben Wadham

Int. J. Environ. Res. Public Health 2025, 22(4), 584; https://doi.org/10.3390/ijerph22040584 - 8 Apr 2025

Viewed by 1290

Abstract

Disempowering experiences of military service and transition for women veterans exist within an established, dominant, masculinised culture, in which their presence is highly visible, challenged, and often subject to institutional prejudice. Sexual abuse of women in the military, in particular, is a persistent [...] Read more.

Disempowering experiences of military service and transition for women veterans exist within an established, dominant, masculinised culture, in which their presence is highly visible, challenged, and often subject to institutional prejudice. Sexual abuse of women in the military, in particular, is a persistent finding in contemporary international research and national inquiries into military culture in countries such as Australia, the United Kingdom (UK), the United States (US), and Canada. This study sought to understand military service, transition to civilian life, and post-military experiences of Australian women veterans, specifically their experiences of discrimination, military sexual harassment and assault, and consequent military sexual trauma (MST). In-depth qualitative interviews were undertaken with 22 Australian women veterans that examined how women veterans manage their identity as women in the military. Issues included gender-based challenges in conforming to a masculinised culture, experiences of misogyny, sexual harassment and assault, systemic failures to recognize women’s specific health needs, and experiences of separation from the military and transition, including help-seeking and engagement with services to address their experiences of MST. Women veterans’ adverse experiences largely stemmed from an entrenched masculinised military culture, in which military sexual assault was enabled, ignored, and condoned. Military and veteran support services have been slow to recognize, acknowledge, and address this significant issue. Full article

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

30 pages, 6863 KiB

Open AccessReview

Global Trends in Diabetic Foot Research (2004–2023): A Bibliometric Study Based on the Scopus Database

by Yolanda Fuentes-Peñaranda, Alma Labarta-González-Vallarino, Elena Arroyo-Bello and Marina Gómez de Quero Córdoba

Int. J. Environ. Res. Public Health 2025, 22(4), 463; https://doi.org/10.3390/ijerph22040463 - 21 Mar 2025

Viewed by 1248

Abstract

Diabetic foot is one of the leading complications of diabetes mellitus that affects millions of people around the world and involves the presence of ulcers, infections, tissue destruction, and loss of sensation and can even lead to limb amputation. This research explores trends [...] Read more.

Diabetic foot is one of the leading complications of diabetes mellitus that affects millions of people around the world and involves the presence of ulcers, infections, tissue destruction, and loss of sensation and can even lead to limb amputation. This research explores trends in diabetic foot global research through a bibliometric analysis of publications indexed in Scopus in the period 2004–2023. A total of 7136 documents were analysed using Excel, Python, Biblioshiny, and VOSviewer. Scientific production has multiplied by a factor of 6.6 from the first to the last year analysed. Armstrong D.G. is the most productive and cited author. China is the most productive country, and the United States is the most cited. The most productive journal is the International Journal of Lower Extremity Wounds, and the most cited journal is Diabetes Care. Research on diabetic foot is mainly focused on the complications of diabetes mellitus; the treatment and healing of wounds; infections; and epidemiology and patient care. Infections and antibiotic treatment are emerging topics, while deep learning and machine learning are among the niche topics in this area of knowledge. The present study allows us to identify current trends and future directions of research in diabetic foot. Full article

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

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16 pages, 523 KiB

Open AccessArticle

Adolescents’ Knowledge on Climate Change: A Nationwide Study in Indonesia

by Evi Martha, Besral, Ulfi Hida Zainita, Naurah Assyifa Rilfi and Syifa Aulia Aminudin

Int. J. Environ. Res. Public Health 2025, 22(4), 571; https://doi.org/10.3390/ijerph22040571 - 5 Apr 2025

Viewed by 1234

Abstract

Adolescents’ knowledge about climate change is key to protecting the well-being of all generations and to promoting individuals’ rights and resilience. This study assesses the climate change literacy of Indonesian adolescents and its determinants. This nationwide study was conducted in 2023 in Sumatra, [...] Read more.

Adolescents’ knowledge about climate change is key to protecting the well-being of all generations and to promoting individuals’ rights and resilience. This study assesses the climate change literacy of Indonesian adolescents and its determinants. This nationwide study was conducted in 2023 in Sumatra, Java, Kalimantan, Sulawesi, and Eastern Indonesia. A total of 1126 adolescents aged 13–19 years were selected through multi-stage sampling. The data were analyzed using the chi-square test and multinomial logistic regression. This study found that 49.7% of adolescents had poor climate change literacy. In the multivariate analysis, the significantly related factors had an odds ratio of 1.66–4.75. Climate change literacy was higher in adolescents from the West and Central Regions, from public or religious schools, and those with educated parents, than in adolescents from the Eastern Region, from private or vocational schools, and those whose parents had low education, respectively. This study suggests the need to promote equality in climate change literacy among Indonesian adolescents through formal and informal education. High-quality formal education would necessitate well-trained teachers with expertise in climate change, as well as a structured, age-appropriate curriculum. Meanwhile, informal education through another information dissemination and social media-based movements can help broaden outreach among adolescents. Full article

(This article belongs to the Special Issue The Intersection of Nursing Education, Public Health and Climate Change)

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24 pages, 4089 KiB

Open AccessArticle

Study of the Trace Element Composition of Drinking Water in Almaty City and Human Health Risk Assessment

by Marina Krasnopyorova, Igor Gorlachev, Pavel Kharkin, Mariya Severinenko and Dmitriy Zheltov

Int. J. Environ. Res. Public Health 2025, 22(4), 560; https://doi.org/10.3390/ijerph22040560 - 3 Apr 2025

Cited by 2 | Viewed by 1208

Abstract

This research investigates the elemental composition of 78 drinking water samples collected during the summer, autumn, and winter of 2023 in different districts of Almaty city. Seasonal average concentrations and standard deviations were calculated for a range of chemical elements, including arsenic (As), [...] Read more.

This research investigates the elemental composition of 78 drinking water samples collected during the summer, autumn, and winter of 2023 in different districts of Almaty city. Seasonal average concentrations and standard deviations were calculated for a range of chemical elements, including arsenic (As), beryllium (Be), cobalt (Co), cadmium (Cd), copper (Cu), lithium (Li), molybdenum (Mo), nickel (Ni), lead (Pb), selenium (Se), uranium (U), mercury (Hg), aluminum (Al), barium (Ba), chromium (Cr), iron (Fe), manganese (Mn), strontium (Sr), vanadium (V), zinc (Zn), calcium (Ca), potassium (K), magnesium (Mg), and sodium (Na), across three distinct datasets. The sites of sampling represent various categories of drinking water sources. The quality of drinking water was assessed by comparing the obtained data with current national, international, and World Health Organization (WHO) standards. Drinking water contaminant indices for the heavy metal groups were calculated and the water quality compliance with the hygienic criteria adopted in the Republic of Kazakhstan was determined. With the exception of two sampling points, the levels of non-carcinogenic risk remained below the acceptable threshold. The predominant pathway for exposure for both adults and children was identified as the oral ingestion of hazardous elements. Carcinogenic risks linked to Ni, Pb, and Cr presence in the drinking water of Almaty were identified, with risk values at the majority of sampling sites categorically classified within the “high risk” designation. No substantial differences in carcinogenic risk levels were detected between adults and children. These results underscore the necessity for enhanced water purification methodologies and ongoing surveillance to protect public health. Full article

(This article belongs to the Section Environmental Sciences)

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21 pages, 1195 KiB

Open AccessReview

Barriers and Facilitators for Implementing Digital Interventions for Anxiety and Depression in Latin America: A Scoping Review

by Bárbara Battistotti Vieira, Léa Savoy, Kathya Acuña Luna, Antoine Flahault and Jennifer Hasselgard-Rowe

Int. J. Environ. Res. Public Health 2025, 22(4), 628; https://doi.org/10.3390/ijerph22040628 - 17 Apr 2025

Viewed by 1192

Abstract

Mental health disorders have a high prevalence in Latin America (LATAM), with an estimated 6.7% of the population suffering from anxiety and 4% from depression. Digital mental health interventions (DMHIs) have been implemented to address these issues. However, there has yet to be [...] Read more.

Mental health disorders have a high prevalence in Latin America (LATAM), with an estimated 6.7% of the population suffering from anxiety and 4% from depression. Digital mental health interventions (DMHIs) have been implemented to address these issues. However, there has yet to be a clear picture of these interventions in the region. This scoping review aims to analyze DMHIs’ characteristics and the barriers and facilitators for their implementation in five LATAM countries (Brazil, Chile, Colombia, Mexico, and Peru). To achieve this goal, four databases (PubMed, APA PsycNet, Scielo, and LILACS) were searched using relevant search terms in English, Spanish, and Portuguese. A total of 484 references were identified and narrowed down to 15 articles included in the final analysis. The studies mostly consisted of RCTs and mixed-methods studies. Most of the DMHIs were designed for individuals, with a focus on targeted communication and personal health tracking. Interventions targeting healthcare professionals were less common, primarily focusing on decisional support. The most prominent barriers to the successful implementation of DMHIs included insufficient healthcare professional training (40%) and resistance from clinicians and organizational culture (40%), while common facilitators included easy access to the interventions (46.7%) and increased training and support for clinical teams (46.7%). Positive outcomes were reported in terms of both effectiveness (33.3%), with many interventions showing results equal to or better than traditional methods (33.3%), and patient satisfaction (33.3%). Full article

(This article belongs to the Special Issue Risk Reduction for Health Prevention)

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16 pages, 292 KiB

Open AccessReview

Contributions of Health Psychology to Climate Change: A Review

by Elisa Kern de Castro and Marta Reis

Int. J. Environ. Res. Public Health 2025, 22(4), 634; https://doi.org/10.3390/ijerph22040634 - 17 Apr 2025

Viewed by 1191

Abstract

Climate change poses a significant threat to human health, necessitating interdisciplinary approaches to mitigate its effects. Health psychology, with its focus on behavior change and well-being, is uniquely positioned to contribute to climate action. This review examines how health psychology can address climate-related [...] Read more.

Climate change poses a significant threat to human health, necessitating interdisciplinary approaches to mitigate its effects. Health psychology, with its focus on behavior change and well-being, is uniquely positioned to contribute to climate action. This review examines how health psychology can address climate-related challenges, emphasizing psychological responses to environmental stressors, behavior modification strategies, and public health interventions. The findings indicate that climate change functions as a psychological stressor, contributing to anxiety, depression, and eco-distress. Additionally, behavioral science insights are underutilized in climate governance, despite their potential to drive sustainable actions. Health psychology can enhance climate adaptation by promoting pro-environmental behaviors, fostering resilience, and integrating psychological well-being into policy frameworks. However, barriers such as limited interdisciplinary collaboration and insufficient emphasis on systemic change hinder progress. To maximize impact, health psychologists must engage in climate governance, advocate for policy integration, and address both individual and collective behavior change. Future research should explore the intersection of mental health, climate resilience, and behavior adaptation to develop comprehensive strategies for tackling climate change. This review underscores the urgent need for health psychology to play a more active role in shaping climate policy and fostering sustainable, health-promoting behaviors. Full article

(This article belongs to the Special Issue The 20th Anniversary of IJERPH)

14 pages, 1624 KiB

Open AccessArticle

Integrating AAA Care Coordinators in Primary Care for Dementia Support: Implementation Challenges and Lessons Learned

by Mary C. Ehlman, Suzanne Leahy, Reagan Lawrence and Della Evans

Int. J. Environ. Res. Public Health 2025, 22(4), 506; https://doi.org/10.3390/ijerph22040506 - 26 Mar 2025

Viewed by 1185

Abstract

Patient, provider, and community barriers challenge dementia diagnosis and management in primary care. Interventions emphasizing EHR-based workflows with minimal provider training are insufficient to address these challenges. To improve early detection, dementia care, and the global health of caregivers and patients living with [...] Read more.

Patient, provider, and community barriers challenge dementia diagnosis and management in primary care. Interventions emphasizing EHR-based workflows with minimal provider training are insufficient to address these challenges. To improve early detection, dementia care, and the global health of caregivers and patients living with dementia, interventions must take a more comprehensive approach, addressing provider education and helping families be aware of the community supports available. Methods: Through a retrospective evaluation utilizing secondary data sources, researchers examine the results of a dementia care intervention that involved a clinical workflow, semiannual dementia training, and the integration of a care coordinator from an Area Agency on Aging (AAA) into the primary care team. Results: Seventeen caregivers received education and referrals to support during the intervention year and again in the final year. This represented 5.3% of the 322 patients diagnosed with dementia and with medical visits at the three clinics in 2023 During the last two grant years, there also was a large increase in provider referrals; thus, dementia care referrals decreased in proportion to patient referrals overall. Conclusions: Utilizing AAA care coordinators is a promising model for addressing health-related social needs in primary care. Yet, findings point to the complexities that remain in managing dementia in this setting. Full article

(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)

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25 pages, 11430 KiB

Open AccessSystematic Review

by Julien Jacquier-Bret and Philippe Gorce

Int. J. Environ. Res. Public Health 2025, 22(4), 652; https://doi.org/10.3390/ijerph22040652 - 21 Apr 2025

Viewed by 1172

Abstract

Nurses are highly exposed to work-related musculoskeletal disorders (WMSDs). Several studies on this have been carried out in different Asian countries, but no synthesis was conducted. The aim of this study was to map the evidence of WMSDs among nurses in Asia. A [...] Read more.

Nurses are highly exposed to work-related musculoskeletal disorders (WMSDs). Several studies on this have been carried out in different Asian countries, but no synthesis was conducted. The aim of this study was to map the evidence of WMSDs among nurses in Asia. A systematic review and a meta-analysis with subgroups were performed during October 2024. Five open databases were scanned without a date limit. The article selection and data extraction processes were performed independently by two reviewers. The results report was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among the 15,751 unique identified records, 40 studies were included, covering a total of 19,903 Asian nurses. A high heterogeneity (Cochran’s Q test and I² statistic) was evidenced between the studies. The meta-analysis polled an overall prevalence of 84.3% (95% CI: 81.1–87.4%). The lower back (58.4%, 95% CI: 52.9–63.8%), neck (45.7%, 95% CI: 38.1–53.2%) and shoulder (43.0%, 95% CI: 36.2–49.9%) were the three most exposed areas. Subgroup analyses have shown that the presence of WMSD is steadily increasing, and that years of practice reduce the exposure of the neck and shoulder, while the lower back becomes more exposed. Further efforts are needed to prevent WMSDs among Asian nurses, in order to improve their quality of life at work. Full article

(This article belongs to the Special Issue New Trends in Work-Related Musculoskeletal Disorders and Health-Related Quality of Life)

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21 pages, 601 KiB

Open AccessReview

Period Poverty and Barriers to Menstrual Health Equity in U.S. Menstruating College Students: A Scoping Review

by Lea Sacca, Diana Lobaina, Sara Burgoa, Vama Jhumkhawala, Meera Rao, Goodness Okwaraji, Yasmine Zerrouki, Joshua Sohmer, Michelle Knecht, Maria C. Mejia and Panagiota Kitsantas

Int. J. Environ. Res. Public Health 2025, 22(4), 619; https://doi.org/10.3390/ijerph22040619 - 16 Apr 2025

Viewed by 1143

Abstract

Objectives: This scoping review aims to fill research gaps by exploring four guiding research questions. First, we aim to understand the major barriers encountered by U.S. menstruating college students in accessing menstrual health products at their educational institutions, households, and community. Second, we [...] Read more.

Objectives: This scoping review aims to fill research gaps by exploring four guiding research questions. First, we aim to understand the major barriers encountered by U.S. menstruating college students in accessing menstrual health products at their educational institutions, households, and community. Second, we aim to identify social determinants of health (SDoH) that significantly influence and contribute to menstrual health inequities experienced by U.S. college students. Third, we aim to explore the measurement tools that have been used to assess menstrual health inequities experienced by U.S. menstruating college students. Lastly, we aim to determine the lessons learned and recommendations to improve overall menstrual health outcomes in U.S. menstruating college students. Study Design: This scoping review followed the Arksey and O’Malley framework (2005) and incorporated recommendations from the Joanna Briggs Institute (JBI) for the extraction, analysis, and presentation of results. Methods: The four databases searched were PubMed, Embase (Ovid), Web of Science, and Cochrane Library (Medline). Included articles were (1) published between 2000 and 2023, (2) focused on menstruating college students in the United States, (3) addressed menstrual health, menstrual equity, and period poverty in college campuses in the U.S., and/or (4) explored challenges encountered by menstruating college students in accessing menstrual health products. Results: A total of seven studies were retained for assessment. The most frequently cited Healthy People 2030 categories were economic stability (n = 5) and social and community context (n = 5). The most-cited barriers were sorted into the “Financial Constraints and Accessibility” (n = 13) theme category. Conclusions: Our study highlights practical applications and several recommendations for the future design, adoption, implementation, and evaluation of effective evidence-based interventions to address period poverty and subsequent barriers imposed by menstruating college students specific SDoH. More research is needed to further explore the health implications of menstrual health on mental, physical, and socioeconomic outcomes of menstruating individuals, particularly young adults experiencing different challenges as they venture into college and build their careers. Full article

(This article belongs to the Special Issue Creating the Future We Expect: Enhancing Women’s Health, Well-Being, and Gender Equality)

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20 pages, 707 KiB

Open AccessArticle

The Influence of Distributed Leadership on Chinese Teachers’ Job Satisfaction: The Chain Mediation of Teacher Collaboration and Teacher Self-Efficacy

by Xiaodong Fan and Zuwang Chu

Int. J. Environ. Res. Public Health 2025, 22(4), 507; https://doi.org/10.3390/ijerph22040507 - 26 Mar 2025

Viewed by 1141

Abstract

The leadership structure within educational institutions has a significant bearing on teacher job satisfaction (TJS). This study employs data from the OECD’s Teaching and Learning International Survey (TALIS 2018) specific to Shanghai to construct a structural equation model that investigates how distributed leadership [...] Read more.

The leadership structure within educational institutions has a significant bearing on teacher job satisfaction (TJS). This study employs data from the OECD’s Teaching and Learning International Survey (TALIS 2018) specific to Shanghai to construct a structural equation model that investigates how distributed leadership (DL) impacts TJS in China. Findings reveal that DL has a markedly positive effect on the job satisfaction of teachers in China. Teacher self-efficacy (TSE) serves as an independent mediator in this relationship, while teacher collaboration (TC) does not mediate independently; nonetheless, both collaborate sequentially in a mediation pathway. These findings affirm the relevance of DL in the Chinese educational setting, offering empirical evidence to inform policymakers. Furthermore, it underscores that enhancing TC and TSE can lead to increased job satisfaction under DL. The results highlight the practical implications of this study for the advancement of educational governance and the optimization of school management models in China. Full article

(This article belongs to the Topic Leadership and Employee Well-Being: Fostering a Healthy Work Environment)

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Int. J. Environ. Res. Public Health, Volume 22, Issue 4 (April 2025) – 194 articles

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