International Journal of Environmental Research and Public Health

18 pages, 1421 KB

Open AccessArticle

Exploring Emerging Trends in Climate Change’s Impacts on the Cardiopulmonary Health of Adults Living in the Canton of Valais, Switzerland: Preliminary Autumn and Winter Results from a Pilot Study

by Omar Portela Dos Santos, Florence Selz Amaudruz, Paulo Jorge Pereira Alves and Henk Verloo

Int. J. Environ. Res. Public Health 2026, 23(2), 274; https://doi.org/10.3390/ijerph23020274 - 23 Feb 2026

Viewed by 878

Abstract

Background: Climate change and air pollution are major threats to cardiopulmonary health, yet their population-level impacts in alpine regions remain insufficiently documented. Methods: This pilot study aimed to generate preliminary evidence and assess the feasibility of a larger investigation by examining associations between [...] Read more.

Background: Climate change and air pollution are major threats to cardiopulmonary health, yet their population-level impacts in alpine regions remain insufficiently documented. Methods: This pilot study aimed to generate preliminary evidence and assess the feasibility of a larger investigation by examining associations between meteorological and air pollution variables and adult cardiopulmonary emergency department admissions in the canton of Valais, Switzerland. Results: Weekly admissions averaged 4.2 cases (range: 1–14), with peaks in late January and early February. Mean weekly temperature was inversely associated with admissions (IRR = 0.92), indicating higher demand during colder weeks. Ozone exposure showed a positive but non-statistically significant association with weekly cardiopulmonary admissions (IRR = 1.014), suggesting a potential signal that warrants confirmation in larger studies. A demographic–clinical risk index (age, sex, diabetes) was the strongest predictor of care demand (IRR = 1.52), exceeding the influence of individual environmental variables. Place of residence, municipality, and altitude were not significant predictors. Recruitment feasibility was high, with three refusals among 204 screened patients. Conclusions: These preliminary findings highlight the need for longitudinal, high-resolution studies and support integrating climate resilience into healthcare preparedness, early-warning systems, and sustainable health planning. Full article

(This article belongs to the Special Issue Climate Change and Medical Responses)

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33 pages, 898 KB

Open AccessReview

Peer-Led Models Focussed on Emotional Distress and Suicide Prevention: A Scoping Review

by Dianna G. Smith, Mel Giugni, Amelia Gulliver, Scott J. Fitzpatrick, Heather Lamb, Louise A. Ellis, Erin Oldman, Helen T. Oni, Caroline Allen and Michelle Banfield

Int. J. Environ. Res. Public Health 2026, 23(2), 273; https://doi.org/10.3390/ijerph23020273 - 23 Feb 2026

Viewed by 1437

Abstract

Suicidality is a significant and persistent public health concern, and people who are suicidal report negative experiences with clinical services. Peer-based interventions are a rapidly growing component of mental health care and suicide prevention. This scoping review’s aim is to identify, summarise and [...] Read more.

Suicidality is a significant and persistent public health concern, and people who are suicidal report negative experiences with clinical services. Peer-based interventions are a rapidly growing component of mental health care and suicide prevention. This scoping review’s aim is to identify, summarise and synthesise the design, features and evidence for peer-led models and interventions for people experiencing emotional distress or suicidal crisis. This study followed the Joanna Briggs Institute scoping review guidelines. Online databases were searched in May 2022 and in October 2024. A total of 59 papers were identified. The scoping review provides an overview of key components of service models and interventions. In general, peer-led programs were widely accepted, with participants reporting positive improvements to mood, social connectedness, communication and coping skills. Despite the importance of training and supervision, a review of training content revealed a discordance between training and peer work principles in some cases. A concentration on facilitation of the service model or intervention rather than on the peer model itself meant there was limited information on the empirical and ethical arguments that supported the model of care. Future research is needed on peer-led models and how involvement and engagement of peers, consumers and carers can positively influence the planning, design, implementation and evaluation of new service models and interventions. Full article

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

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13 pages, 286 KB

Open AccessArticle

Occupational Hazards, Social Support, and Quality of Working Life in Sub-District Health Promoting Hospitals in Southern Thailand: A Cross-Sectional Study

by Sasithorn Thanapop, Sintira Lucksila, Nattachalisa Saritdisuk, Warangkana Chankong, Linxiong Wu and Chamnong Thanapop

Int. J. Environ. Res. Public Health 2026, 23(2), 272; https://doi.org/10.3390/ijerph23020272 - 23 Feb 2026

Viewed by 673

Abstract

Healthcare personnel working in sub-district health promoting hospitals (SHPHs) are vital to Thailand’s primary healthcare system but often face occupational, psychosocial, and organizational challenges that may affect their quality of working life (QWL). This study aimed to assess QWL and identify its key [...] Read more.

Healthcare personnel working in sub-district health promoting hospitals (SHPHs) are vital to Thailand’s primary healthcare system but often face occupational, psychosocial, and organizational challenges that may affect their quality of working life (QWL). This study aimed to assess QWL and identify its key predictors among SHPH healthcare personnel in southern Thailand. A cross-sectional survey was conducted among 340 healthcare personnel in Nakhon Si Thammarat Province using stratified random sampling. Data were collected through a structured questionnaire covering socio-demographic characteristics, working conditions, occupational hazard exposures, social support, and QWL measured by the 36-item Thai version of the QWL scale. Descriptive statistics and stepwise multiple linear regression analyses were performed. Participants were predominantly female (80.9%) with a mean age of 34.0 years (SD = 9.2), and one-third (33.2%) worked more than eight hours per day. Most participants (75.6%) had moderate hazard exposure, while 73.2% reported high social support. Overall, 51.2% of respondents had good QWL, with safe and healthy working conditions and social relevance of work life rated highest. Regression analysis identified social support (β = 0.790, p < 0.001) and working hours per day (β = 0.109, p = 0.001) as positive predictors, while work experience (β = −0.064, p = 0.049) was a negative predictor (R² = 0.655). These findings emphasize the need for organizational strategies that strengthen social support and effectively manage working conditions, including the organization of working hours, to promote sustainable quality of working life among healthcare personnel in Thailand’s primary healthcare system. Full article

(This article belongs to the Special Issue Community-Engaged Approaches to Occupational Health and Safety)

20 pages, 839 KB

Open AccessArticle

Prolonged Effects on Frontline Caregivers: Occupational Stress and Mental Well-Being in Transformed Healthcare Environments Post-COVID-19

by Rauer Ferreira Franco, Jefferson Martinelli, Amanda Oliva Spaziani, Luis Carlos Spaziani, João Daniel de Souza Menezes, Matheus Querino da Silva, Emerson Roberto dos Santos, Rita de Cássia Helú Mendonça Ribeiro, Josimerci Ittavo Lamana Faria, Janaína Aparecida de Sales Floriano, Fernando Nestor Facio Júnior, Nádia Antônia Aparecida Poletti, Flávia Cristina Custódio, Clarissa Albuquerque Vaz Nunes, Franciane Michele da Silva, Maysa Alahmar Bianchin, Luís Cesar Fava Spessoto, Ana Paula Bernardes da Rosa, Maria Helena Pinto, Cíntia Canato Martins, Marli de Carvalho Jerico, Fabiana de Souza Orlandi, Lais Fernanda de Amorin, Paula Buck de Oliveira Ruiz, Fabricio Sidnei da Silva, Luan Souza do Nascimento, Catia Canova Fraccari, Gerardo Maria de Araújo Filho, Marcia Regina Furlani, Stela Regina Pedroso Vilela Torres de Carvalho, Ana Maria Rita Pedroso Vilela Torres de Carvalho Engel, Thiago Sivieri, Bruna Santos de Oliveira Martins, Daniela Gonçalves Faustino, Maicon José de Jesus Vijarva and Júlio César André Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2026, 23(2), 271; https://doi.org/10.3390/ijerph23020271 - 22 Feb 2026

Cited by 1 | Viewed by 678

Abstract

Objectives: This study evaluated Quality of Life (QoL) and mental health among nursing technicians in Brazilian Unified Health System (SUS) emergency units, specifically exploring occupational safety and well-being in the post-COVID-19 era. Design: A quantitative, descriptive, exploratory, cross-sectional design was employed. Methods: Data [...] Read more.

Objectives: This study evaluated Quality of Life (QoL) and mental health among nursing technicians in Brazilian Unified Health System (SUS) emergency units, specifically exploring occupational safety and well-being in the post-COVID-19 era. Design: A quantitative, descriptive, exploratory, cross-sectional design was employed. Methods: Data from 146 nursing professionals in Brazilian SUS emergency units were collected remotely during the post-acute pandemic phase (July–Nov 2024). QoL (WHOQOL-BREF) and mental health (HADS) were assessed, followed by descriptive and correlational statistics. Results: The predominantly female, experienced sample showed heterogeneous general QoL but pervasive anxiety, reflecting a sustained psychological burden. Sociodemographic/professional factors had a negligible impact; the emergency environment’s overwhelming influence, intensified by post-pandemic challenges, was key. Psychological distress was strongly negatively correlated with overall QoL and depression in the social domain. Conclusions: The intrinsic nature of emergency work, amplified by persistent psychosocial effects of the global health crisis, drives anxiety and impairs QoL/social relationships. Interventions strengthening QoL, enhancing coping, and adapting work environments to new realities (e.g., loneliness, prolonged mental health impacts) are vital for professional well-being and patient care in this post-pandemic era. Full article

(This article belongs to the Special Issue Work Psychology and Occupational Health: 2nd Edition)

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11 pages, 329 KB

Open AccessArticle

Evaluation of the Effectiveness of a School-Based Smoking Prevention Program Among Young Adolescents in Central Greece: An Analytical, Non-Randomized Interventional Study

by Sofia Maria Panagiotidou, Maria Tziastoudi, Marios Politis, Chrissi Hatzoglou, Ioannis Stefanidis, Panagiotis Behrakis, Christos Hadjichristodoulou and Georgios Rachiotis

Int. J. Environ. Res. Public Health 2026, 23(2), 270; https://doi.org/10.3390/ijerph23020270 - 22 Feb 2026

Viewed by 775

Abstract

Background: Smoking remains a major global public health challenge. As smoking often begins in early adolescence, early preventive programs are essential, yet research focusing exclusively on elementary school students is limited. This study measured smoking prevalence, smoking-related knowledge and attitudes, and the impact [...] Read more.

Background: Smoking remains a major global public health challenge. As smoking often begins in early adolescence, early preventive programs are essential, yet research focusing exclusively on elementary school students is limited. This study measured smoking prevalence, smoking-related knowledge and attitudes, and the impact of a school-based intervention on these outcomes among 12–13-year-old students in Larissa, Greece. Methods: A total of 769 students participated (response rate: 75%). Knowledge, attitudes, and smoking prevalence were assessed at baseline. The intervention group (n = 316) was exposed to audiovisual and printed materials, and both groups were followed up at three- and twelve months post-intervention. Multivariable linear mixed-effects models and generalized estimating equations were used to evaluate intervention effects. Results: Baseline characteristics were balanced between groups. A statistically significant stage × group interaction was observed, indicating improvements in smoking-related knowledge and attitudes (p < 0.001) and a reduced likelihood of smoking initiation (p = 0.011) in the intervention group. Conclusions: This school-based intervention demonstrated significant improvements in knowledge and attitudes toward smoking and reduced the likelihood of smoking initiation. These findings support integrating early prevention programs into school curricula as a potentially effective approach to improving smoking-related outcomes. Full article

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18 pages, 364 KB

Open AccessReview

Diagnosis and Management of Parkinson Disease in Individuals with Pre-Existing Mood Disorders

by Laura Buyan Dent

Int. J. Environ. Res. Public Health 2026, 23(2), 269; https://doi.org/10.3390/ijerph23020269 - 21 Feb 2026

Viewed by 1095

Abstract

Parkinson disease (PD) and mood disorders represent two substantial global health burdens that increasingly co-occur as both conditions rise in prevalence worldwide. Diagnosing Parkinson disease in patients with pre-existing mood disorders is clinically challenging due to overlapping symptoms, medication effects, and shared neurobiological [...] Read more.

Parkinson disease (PD) and mood disorders represent two substantial global health burdens that increasingly co-occur as both conditions rise in prevalence worldwide. Diagnosing Parkinson disease in patients with pre-existing mood disorders is clinically challenging due to overlapping symptoms, medication effects, and shared neurobiological mechanisms. Apathy, psychomotor slowing, and fatigue may mimic depressive symptoms, leading to delayed recognition of early parkinsonism. Development of an underlying neurodegenerative disorder could account for some treatment-resistant symptoms or treatment failures if not recognized. Therefore, the identification of PD will change the treatment and management plan significantly. Accurate diagnosis of PD requires a detailed neurologic examination focusing on bradykinesia, rigidity, and resting tremor, supported when appropriate by dopamine transporter imaging (DaT scan) or other emerging biomarkers. Understanding the temporal relationship between psychiatric and motor features helps differentiate prodromal PD from primary mood disorders. Management of patients with both mood disorders and PD integrates dopaminergic replacement therapy for motor symptoms with individualized treatment of psychiatric comorbidities. Levodopa remains the cornerstone for motor control, while dopamine agonists, MAO-B inhibitors, and COMT inhibitors can be added as needed. For depression and anxiety, SSRIs and SNRIs are first-line choices; quetiapine or clozapine are preferred when treatment for psychosis is necessary. Intentional, thoughtful polypharmacy is frequently required. Non-pharmacologic interventions—including cognitive behavioral therapy, structured exercise, and patient–caregiver education—enhance mood, function, and quality of life. Multidisciplinary collaboration between neurology, psychiatry, and allied health professionals is essential for optimal outcomes. This review offers guidance to healthcare providers as well as other interested parties involved in patients with mood disorders who may also be developing or have PD, especially to those who may have limited access to neurologic resources. Full article

(This article belongs to the Special Issue Managing and Promoting the Mental Health of People with Psychiatric Comorbidities)

28 pages, 1491 KB

Open AccessSystematic Review

Towards a Quality Care Climate Perspective: A Systematic Review of Associations Among Patient Experience, Patient Outcomes, and Organisational Climate Factors in Hospitals

by Seth Ayisi Addo, Reidar Johan Mykletun and Espen Olsen

Int. J. Environ. Res. Public Health 2026, 23(2), 268; https://doi.org/10.3390/ijerph23020268 - 20 Feb 2026

Viewed by 1026

Abstract

Objective (study question): The main purpose of this systematic review was to conduct a qualitative synthesis of quantitative studies among patient experience, patient outcomes, and organisational climate factors. The review sought to answer the following research questions: (i) What are the main directions, [...] Read more.

Objective (study question): The main purpose of this systematic review was to conduct a qualitative synthesis of quantitative studies among patient experience, patient outcomes, and organisational climate factors. The review sought to answer the following research questions: (i) What are the main directions, dominant methods, and theories on the associations among these concepts? (ii) What theoretical propositions can be made? Data sources/study setting (w/hospital/institution setting anonymised): The study involved a search for literature in PubMed, PsychINFO, Medline, CINAHL, Academic Search Premier, Scopus, and Web of Science between 2007 and 2022 with the guidance of a librarian. The search was limited to English language and to human adult inpatients. Study design: This study primarily employed a systematic review method, following the guidelines in the PRISMA statement. Data collection/extraction methods: Articles were screened and excluded first on title and abstract, and then on fulltexts. Quality assessments were done on remaining articles using the National Institutes of Health (NIH) quality assessment tool for observational, cohort and cross-sectional studies. Data was extracted from articles that met the inclusion criteria and passed the checks. Principal findings: The search identified 11,571 records that were checked for duplications. After removing duplicates and applying the eligibility criteria, a final list of 220 articles were included for the qualitative synthesis. Results showed that the relationships among the concepts were more conclusive and generally positive rather than negative, especially between patient experience and patient outcomes. The review, however, showed areas that required more attention such as an encompassing quality-oriented care climate theory, validation of patient-reported instruments, and longitudinal studies linking subjective patient outcomes to objective patient outcomes. Conclusions: The review shows that conclusions can be drawn on the relationships among the variables, indicating that favourable factors in the hospitals, as perceived by patients, have positive implications for patient experiences and their outcomes. Based on this, an argument for an encompassing framework on quality care climate from the patients’ perspectives was made to enhance understanding of these relationships. Limitations: Among others, this review is limited by the search restriction to quantitative studies or studies that employed mainly quantitative tools to assess associations or changes. Funding: This study received no external funding. Registration: PROSPERO ID- CRD42021291787. Full article

(This article belongs to the Special Issue The Patient Experience: Antecedents, Structural Models and Links to Hospital Quality)

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11 pages, 274 KB

Open AccessArticle

Why People Share (Or Don’t): Race/Ethnicity and Contextual Correlates of Willingness to Disclose Contact Information During the COVID-19 Pandemic in Rural North Carolina

by Leah J. Floyd, Irene Doherty, Tanisha Burford and Deepak Kumar

Int. J. Environ. Res. Public Health 2026, 23(2), 267; https://doi.org/10.3390/ijerph23020267 - 20 Feb 2026

Viewed by 671

Abstract

For historically marginalized groups and residents of low-resource rural communities, contact tracing is a critical tool for controlling the spread of communicable diseases. To improve its effectiveness, more research on identifying factors that influence an individual’s willingness to comply with contact tracers is [...] Read more.

For historically marginalized groups and residents of low-resource rural communities, contact tracing is a critical tool for controlling the spread of communicable diseases. To improve its effectiveness, more research on identifying factors that influence an individual’s willingness to comply with contact tracers is needed. Therefore, we examined the association of race/ethnicity, contextual factors, and willingness to engage in contact tracing during the COVID-19 pandemic. The sample included 337 adults (56% Black/African American and 66% female). Approximately 80% of the participants indicated they would disclose the names of contacts. The results from the multivariate logistic regression analyses indicated lack of access to COVID-19 testing sites (aOR = 2.20; 95% CI = 1.08–4.48) and trust in health care providers (aOR = 7.57; 95% CI = 3.82–14.88) were significantly associated with willingness to share information with contact tracers. Race did not moderate the relationship between trust and engaging with contact tracers. The results suggest contact tracing is a viable strategy for mitigating disease transmission in rural communities, particularly when trust in health care providers is high and access to testing is limited, regardless of race. Public health officials should invest in maintaining contact tracing teams that include medical providers and prioritize building trusting relationships with all community members. Full article

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

21 pages, 367 KB

Open AccessArticle

Developing a Strong Sense of Coherence as a Pathway Beyond Intergenerational Trauma: Narratives of Adult Children of Vietnamese Boat Refugees

by Yen Pham and Marguerite Daniel

Int. J. Environ. Res. Public Health 2026, 23(2), 266; https://doi.org/10.3390/ijerph23020266 - 20 Feb 2026

Viewed by 823

Abstract

Maladaptive family interaction is one of the mechanisms through which trauma is transmitted across generations. The current intervention approach for trauma-affected families focuses on traumatized parents and child–parent dyads during childhood. This leaves a gap in how adult children, who might no longer [...] Read more.

Maladaptive family interaction is one of the mechanisms through which trauma is transmitted across generations. The current intervention approach for trauma-affected families focuses on traumatized parents and child–parent dyads during childhood. This leaves a gap in how adult children, who might no longer live with their parents, can overcome the negative impacts of maladaptive childhood interactions with parents as a legacy of parental trauma history. This study focuses on the children of Vietnamese boat refugees in their 30s and 40s in two cities in Norway, applying narrative interviews to elicit long narratives about their lifespan experiences. A hybrid analytic approach utilizes Thematic Network Analysis, informed by a conceptual framework integrating salutogenesis theory and Bowen family systems theory. The findings reveal that maladaptive parent–child interactions in Vietnamese boat refugee families include parents’ high expectations, harsh parenting, children’s obligation to please parents, and adultification, which are trauma-shaped and mediated by Vietnamese culture. Developing a strong sense of coherence (SOC), characterized by enhancing one’s understanding of the self in relation to family, making meaning regarding the past, and playing an active role in reframing relationships with one’s parents, serves as a pathway to outgrow the impacts of maladaptive patterns in one’s family of origin. Overall, this paper contributes a salutogenic, lifespan-oriented framework for understanding recovery beyond childhood impacts of intergenerational trauma. Full article

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

14 pages, 585 KB

Open AccessArticle

Research Considerations for the Use of Publicly Available Documentary Films to Study Refugee Family Therapy

by Charity Mokgaetji Somo

Int. J. Environ. Res. Public Health 2026, 23(2), 265; https://doi.org/10.3390/ijerph23020265 - 20 Feb 2026

Viewed by 627

Abstract

Scholars in family therapy are increasingly calling for family-centered interventions for trauma-affected refugees, as many trauma-informed therapies favor individual models of treatment. Research contributes to the study and implementation of family-centered care models. However, for methodological reasons, research on family therapy with displaced [...] Read more.

Scholars in family therapy are increasingly calling for family-centered interventions for trauma-affected refugees, as many trauma-informed therapies favor individual models of treatment. Research contributes to the study and implementation of family-centered care models. However, for methodological reasons, research on family therapy with displaced populations is limited. In response to scholars’ call, this paper argues for the use of documentary film as qualitative research data in refugee family therapy research. Documentary films have historically been used in the social sciences to examine people’s lived experiences and to address data gaps in hard-to-reach populations. This paper outlines key methodological considerations inherent in research with refugee populations, including challenges related to recruitment and retention, language and cultural barriers, insecure and unstable living conditions affecting participants, research design constraints, and ethical complexities. It then discusses how the use of documentary film can help mitigate these challenges through careful epistemological positioning, research design, data selection and analysis strategies, and attention to ethical and research trustworthiness considerations. By doing so, the paper contributes to the development of qualitative research skills necessary for studying refugee family well-being and supporting the growth of family-centered therapeutic approaches. Full article

(This article belongs to the Special Issue Immigrant and Refugee Mental Health Promotion)

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8 pages, 249 KB

Open AccessPerspective

Emotional Regulation as Relational Infrastructure: A Living Systems Perspective on the Capacity to Be Alone and Collective Care

by Luca Cerniglia and Silvia Cimino

Int. J. Environ. Res. Public Health 2026, 23(2), 264; https://doi.org/10.3390/ijerph23020264 - 20 Feb 2026

Viewed by 550

Abstract

In response to escalating global crises and widespread emotional distress, this paper advances a novel integrative framework that reconceptualizes emotional regulation as a relational public infrastructure essential for societal resilience. While traditional models treat emotional regulation as an individual psychological trait, we challenge [...] Read more.

In response to escalating global crises and widespread emotional distress, this paper advances a novel integrative framework that reconceptualizes emotional regulation as a relational public infrastructure essential for societal resilience. While traditional models treat emotional regulation as an individual psychological trait, we challenge this paradigm by repositioning it as a systemic capacity grounded in a psychodynamic living systems model. We argue that early caregiving experiences do not merely influence private development but form a foundational “affective infrastructure” that determines long-term social stability. Through this lens, the capacity to be alone is redefined from a solitary milestone to a relationally enabled skill that facilitates collective autonomy and prevents social polarization. We posit that when these relational fields are destabilized by inequality, the resulting dysregulation is a systemic failure rather than an individual deficit. The paper concludes by advocating for a normative shift in public health, treating emotional well-being as a public good cultivated through institutional systems of attunement. This perspective offers a timely and urgent vision for fostering inclusive, cooperative, and emotionally robust futures. Full article

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

18 pages, 333 KB

Open AccessArticle

Participant Perceptions of a University Continuing Education Intervention Addressing Job Burnout and Self-Care Strategies

by Brandon Workman, Laura Nabors and Samuel Adabla

Int. J. Environ. Res. Public Health 2026, 23(2), 263; https://doi.org/10.3390/ijerph23020263 - 20 Feb 2026

Viewed by 753

Abstract

Objective: The current study assessed outcomes of a continuing professional education program aimed at managing job-related stress to assist employees with recognizing and managing burnout and enhancing both productivity and overall well-being. Study Design: This study outlines the implementation of a [...] Read more.

Objective: The current study assessed outcomes of a continuing professional education program aimed at managing job-related stress to assist employees with recognizing and managing burnout and enhancing both productivity and overall well-being. Study Design: This study outlines the implementation of a needs assessment survey and the development of a non-credit training course for working professionals that addressed risks of burnout, suicidality, and self-care strategies to support mental health in the workplace. Methods: The sample for the current study consisted of 398 predominantly mid- to senior-level professionals. Participants were divided into two cohorts. The first cohort completed a structured needs assessment survey between June 2023 and July 2023 and provided ideas for curriculum development. The second cohort participated in synchronous, instructor-led virtual training sessions and completed pre- and post-training questionnaires between January 2024 and June 2024. A mixed-method content analysis was conducted to identify recurring themes and their frequency in course questionnaires. Results: Findings suggest that the training successfully expanded participants’ understanding of signs of burnout and of new approaches to improve well-being in the workplace including forming friendships, engaging in mindfulness activities, and taking time off for a mental health day. Conclusions: Future research should explore the long-term impacts of such interventions and compare delivery methods, including virtual and in-person formats, to determine the most effective approaches for promoting mental well-being at work. Full article

(This article belongs to the Special Issue Psychological Well‑Being and Psychosocial Risks in Evolving Workplaces and Communities)

18 pages, 567 KB

Open AccessArticle

Impact of Occupational Noise Exposure on Physical and Mental Health of Water Pumping Station Operators in Lebanon

by Rola Sammoura and Akram El Tannir

Int. J. Environ. Res. Public Health 2026, 23(2), 262; https://doi.org/10.3390/ijerph23020262 - 19 Feb 2026

Viewed by 686

Abstract

This study investigates the impact of occupational noise on the physical and mental health of 50 water pumping station operators in Lebanon. The research aimed to quantify noise exposure, assess its effects on hearing and psychological well-being, and identify contributing factors. To achieve [...] Read more.

This study investigates the impact of occupational noise on the physical and mental health of 50 water pumping station operators in Lebanon. The research aimed to quantify noise exposure, assess its effects on hearing and psychological well-being, and identify contributing factors. To achieve this, this study employed several evaluation methods. Noise exposure was measured using a calibrated sound level meter to determine the average A-weighted sound pressure levels (dBA) at 52 stations, which were then compared to the 85 dBA recommended limit from the National Institute for Occupational Safety and Health (NIOSH). Physical health, specifically hearing ability, was assessed using a validated smartphone-based pure-tone audiometry application to measure hearing thresholds across multiple frequencies. The resulting data were used to calculate the pure-tone average (PTA) and classify hearing impairment according to the World Health Organization (WHO) standards. Psychological health was evaluated through a structured 14-item questionnaire developed for this study, covering self-reported impacts on stress, anxiety, sleep quality, concentration, communication, and emotional state. The results indicated a hazardous work environment, with the mean noise level across stations (86.67 dBA) significantly exceeding the NIOSH safety threshold. A high prevalence of hearing impairment was observed among operators, with 88% exhibiting impairment in the worse ear. A multiple linear regression analysis revealed that noise level, age, and duration of exposure were all statistically significant predictors, collectively explaining 62.3% of the variance in hearing impairment (F(3, 46) = 25.32, p < 0.001). The analysis further identified age as a key effect modifier; the duration of exposure was the dominant risk factor for younger workers, while the intensity of the noise level was more critical for older workers. Psychologically, workers reported a high prevalence of adverse effects, with sleep disturbances being the most common issue (reported by 75%), followed by emotional distress (67%) and anxiety (60%). This study also found a complete lack of hearing protection use and no formal training on noise hazards, highlighting significant gaps in occupational safety practices. Full article

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10 pages, 1007 KB

Open AccessPerspective

Is There Sufficient Local Evidence to Inform Biofortification Policies Against Micronutrient Deficiencies? A Global Concern for Food Security and Human Health

by Johan Camilo Vergara-Rios, Ivan David Lozada-Martinez, Juan David Reyes-Duque and Maria Trinidad Plaza Gómez

Int. J. Environ. Res. Public Health 2026, 23(2), 261; https://doi.org/10.3390/ijerph23020261 - 19 Feb 2026

Cited by 1 | Viewed by 665

Abstract

Micronutrient deficiencies remain a persistent challenge to global health and food security, particularly in low- and middle-income countries where evidence-based strategies are urgently needed. Biofortification of staple crops has been promoted as a complementary intervention to supplementation and food fortification, but its effective [...] Read more.

Micronutrient deficiencies remain a persistent challenge to global health and food security, particularly in low- and middle-income countries where evidence-based strategies are urgently needed. Biofortification of staple crops has been promoted as a complementary intervention to supplementation and food fortification, but its effective implementation requires locally relevant studies. Such evidence is essential because the performance and adoption of biofortified crops depend on context-specific factors, including crop varieties, soil micronutrient dynamics, dietary patterns, cultural acceptability, and bioavailability, which limit the transferability of findings across settings. This perspective examines whether countries with the highest micronutrient burdens generate sufficient local research to inform biofortification policy decisions. We conducted a bibliometric mapping of peer-reviewed literature indexed in Scopus and compared country-level publication counts with indicators of iodized salt coverage, zinc deficiency, and childhood anemia, which were selected because they are prioritized metrics in global health and food security. From 776 eligible articles, most publications originated from a small group of high- and middle-income countries, whereas regions facing the greatest nutritional burdens, including parts of Sub-Saharan Africa and South Asia, contributed little to the scientific output. Countries with low iodized-salt coverage, high zinc deficiency, or childhood anemia above 40% frequently showed zero or minimal publications. This misalignment suggests that countries facing the greatest nutritional vulnerabilities may be underrepresented in the indexed scientific literature. These findings highlight the value of further strengthening research participation and visibility in high-burden settings to ensure that the evidence base more accurately reflects global needs. Full article

(This article belongs to the Special Issue Beyond Hunger: Food Insecurity, Unhealthy Diets, and the Public Health Challenge of Malnutrition)

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12 pages, 275 KB

Open AccessArticle

The Influence of Elementary School Personnel’s Achievement Goal Orientation on CPR Education Immersion and Self-Management

by Tae-Young Moon, Hyeon-Ji Lee and Mi-Young Choi

Int. J. Environ. Res. Public Health 2026, 23(2), 260; https://doi.org/10.3390/ijerph23020260 - 19 Feb 2026

Viewed by 611

Abstract

Despite mandatory cardiopulmonary resuscitation (CPR) training for elementary school personnel in South Korea, current programs are often delivered as uniform, compliance-oriented sessions that prioritize procedural completion over sustained engagement and self-regulated practice. However, little empirical evidence explains why some participants remain actively engaged [...] Read more.

Despite mandatory cardiopulmonary resuscitation (CPR) training for elementary school personnel in South Korea, current programs are often delivered as uniform, compliance-oriented sessions that prioritize procedural completion over sustained engagement and self-regulated practice. However, little empirical evidence explains why some participants remain actively engaged and capable of self-managing CPR skills after mandatory training, while others do not. In this study, immersion in CPR education refers to learners’ cognitive and behavioral engagement during training, reflecting their concentration and active participation in learning activities. Accordingly, this study aimed to examine how achievement goal orientation influences CPR education immersion and self-management among elementary school educational officials. A survey was conducted from March to June 2024 with 150 teachers and administrative staff in Gangwon Province, South Korea. Data were analyzed using correlation and multiple regression analyses. The results showed significant positive correlations among achievement goal orientation, CPR education immersion, and self-management. Both self-goal and task goal orientations significantly increased CPR education immersion, whereas only task goal orientation positively influenced self-management. In addition, both cognitive and behavioral immersion significantly predicted self-management These findings suggest that mastery-oriented motivation is associated with deeper engagement during CPR training and stronger self-management, supporting motivationally informed instructional design rather than compliance-focused delivery. Full article

13 pages, 683 KB

Open AccessSystematic Review

Cost and Length of Hospitalization Associated with Dental Infections: A Systematic Review

by Somayeh Parvizi, Albert Yaacoub, Stephen Cox, Carlos Marcelo da Silva Figueredo and Mafaz Ullah

Int. J. Environ. Res. Public Health 2026, 23(2), 259; https://doi.org/10.3390/ijerph23020259 - 18 Feb 2026

Viewed by 733

Abstract

Objectives: This study aimed to investigate the cost of hospitalization and length of stay (LOS) associated with dental infections and their impact on healthcare resources. Materials and Methods: Web of Science, Medline via Ovid, and Google Scholar were searched for articles published from [...] Read more.

Objectives: This study aimed to investigate the cost of hospitalization and length of stay (LOS) associated with dental infections and their impact on healthcare resources. Materials and Methods: Web of Science, Medline via Ovid, and Google Scholar were searched for articles published from 2013 to 2023 using relevant MeSH terms. A descriptive summary was produced to describe study characteristics, and selected studies were analyzed to evaluate financial implications and hospitalization outcomes. Results: After removing duplicates, 125 articles were screened, with 25 read in full and 9 excluded. Sixteen retrospective studies were included, encompassing 156,487 patients. Hospital length of stay ranged from 1.15 to 10 days, and hospitalization costs ranged from AUD 2402 to USD 47,836.60. Variability in outcomes appeared to be influenced by infection severity, healthcare infrastructure, and geographic setting. Conclusions: Dental infections impose a substantial and variable burden on healthcare systems. These findings emphasize the need for timely intervention, preventive strategies, and standardized management protocols to reduce clinical complications and financial strain on healthcare services. Full article

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

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12 pages, 312 KB

Open AccessArticle

Content Validation and Perceived Value of Text Messages to Promote Physical Activity Among U.S. Older Adults and Care Partners

by Oluwaseun Adeyemi, Tracy Chippendale, Gbenga Ogedegbe, Dowin Boatright and Joshua Chodosh

Int. J. Environ. Res. Public Health 2026, 23(2), 258; https://doi.org/10.3390/ijerph23020258 - 18 Feb 2026

Viewed by 563

Abstract

Background: Motivational text messages can encourage increased physical activity. This study aimed to validate motivational text messages among older adults and care partners and to assess differences in perceived motivational value between the two groups. Methods: We designed nine motivational text messages to [...] Read more.

Background: Motivational text messages can encourage increased physical activity. This study aimed to validate motivational text messages among older adults and care partners and to assess differences in perceived motivational value between the two groups. Methods: We designed nine motivational text messages to capture nine distinct physical activity scenarios. For this cross-sectional observational study, we enrolled 14 content experts, 310 older adults, and 305 care partners. Content experts assessed the relevance, while the older adults and care partners assessed the perceived motivational value of each text message on a 5-point Likert scale. We computed the item content validity index and assessed differences in perceived motivational value among older adults and care partners using quantile regression while adjusting for sociodemographic and health characteristics. Results: The item content validity index ranged from 0.86 to 1.00. The median (interquartile range) perceived motivational value for each text message was 4.0 (3.0–5.0), and there were no statistically significant differences in reported motivational values between older adults and care partners. Conclusion: We present nine content-validated text messages with high motivational value for older adults and care partners that can be integrated into technology-based intervention studies and may improve physical activity behavior in both groups. Full article

(This article belongs to the Special Issue Public Health Perspectives on Physical Exercise for Adults and Older People)

12 pages, 1562 KB

Open AccessArticle

Strengthening Civil Registration Through Grassroots Health Institutions in India

by Sheetal Verma, Somnath Jana, Ritul Kamal, Laxmi Kant Dwivedi and Shiva S. Halli

Int. J. Environ. Res. Public Health 2026, 23(2), 257; https://doi.org/10.3390/ijerph23020257 - 18 Feb 2026

Viewed by 716

Abstract

Civil registration of births and deaths underpins people’s legal identity, access to essential services, and evidence-based policy. Over the last two decades, the expansion of the National Health Mission (NHM) and the dramatic increase in institutional deliveries have created new opportunities to link [...] Read more.

Civil registration of births and deaths underpins people’s legal identity, access to essential services, and evidence-based policy. Over the last two decades, the expansion of the National Health Mission (NHM) and the dramatic increase in institutional deliveries have created new opportunities to link maternal healthcare with critical event documentation. Primary health centres (PHCs) and community health centres (CHCs), which are frequently the initial point of contact for rural households, are emerging as important places for birthing and registration. Despite their expanding importance, the particular role of these grassroots facilities in birth registration results has not been thoroughly investigated. This study addresses that gap by assessing their role in increasing registration coverage among children under the age of five. We analyzed nationally representative data from the National Family Health Survey rounds 4 (2015–2016) and 5 (2019–2021). This study focused on children under five, examining the association between place of delivery and registration status. Descriptive analysis and multivariable logistic regression estimated the odds of registration across delivery settings. Pooled data from both survey rounds captured temporal shifts, and predicted probabilities were calculated for institutional deliveries, adjusting for socio-demographic covariates. The proportion of institutional births occurring in PHCs and CHCs rose from 30.5% to 34.7% between the two survey rounds. Registration among children delivered in these facilities increased from 80.8% to 90.2%, the highest gain among all delivery settings. Regression analysis showed that births in PHCs/CHCs were associated with 38% higher odds of being registered compared to private facilities. States designating PHCs and CHCs as official registrars, such as Delhi, Rajasthan, and Uttar Pradesh, reported the greatest improvements. Lower-level government health facilities are not only advancing safe delivery but also acting as pivotal nodes for civil registration. Their dual function creates a scalable model for integrating healthcare with legal identity creation, supporting equity and accelerating progress toward Sustainable Development Goal 16.9. Full article

(This article belongs to the Section Health Care Sciences)

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21 pages, 895 KB

Open AccessArticle

Clinicogenomic Insights for Progression-Free Survival in Prostate Cancer

by Kelvin Ofori-Minta, Bofei Wang, Jonathon E. Mohl, Abhijit Mandal and Ming-Ying Leung

Int. J. Environ. Res. Public Health 2026, 23(2), 256; https://doi.org/10.3390/ijerph23020256 - 18 Feb 2026

Viewed by 777

Abstract

Prostate cancer (PrCa), the second most common cancer diagnosed in men globally, remains a critical challenge in precision oncology. While PrCa can be deadly, it is highly treatable if detected early. Identifying associative factors influencing disease progression risks can help inform preliminary steps [...] Read more.

Prostate cancer (PrCa), the second most common cancer diagnosed in men globally, remains a critical challenge in precision oncology. While PrCa can be deadly, it is highly treatable if detected early. Identifying associative factors influencing disease progression risks can help inform preliminary steps that will further the expedition of clinical therapeutic intervention decisions, which will improve treatment outcomes. While conventional PrCa progression assessment tools rely heavily on a few clinical parameters, the importance of genomic information is increasingly recognized. In this study, we evaluate the prognostic value of patients’ clinicogenomic profiles in modeling progression-free survival (PFS) of PrCa. Three survival models, namely the penalized Cox model, random survival forest, and a deep learning survival neural network, were deployed with extensive tuning applied to a dataset for a cohort of 494 patients with PrCa. This dataset, compiled from public data in The Cancer Genome Atlas (TCGA) accessed via cBioPortal, consists of relevant clinical features and single-nucleotide variant information on likely PrCa-related genes. The survival models demonstrated satisfactory discriminatory performance, with Harrell’s concordance index ranging from approximately 0.80 to 0.87 on held-out test data, indicating their ability to rank patients according to their relative progression risk among patients, while exhibiting distinct dynamics, all three models consistently identified clinical variables that indicated neoadjuvant treatment history, neoplasm cancer status, and tumor recurrence as well as the gene MYH6 as important predictor variables for PrCa PFS. Our findings suggest the incorporation of genomic data into the survival modeling workflow, thereby allowing the use of integrated clinicogenomics information to gain insights into progression risks for patients with PrCa. 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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17 pages, 337 KB

Open AccessArticle

Cannabis and Psychedelics Among U.S. Young Adults: Use, Messaging Exposure, Perceptions, and Legalization Support

by Carla J. Berg, Cassidy R. LoParco, Darcey M. McCready, Laura C. Schubel, Patricia A. Cavazos-Rehg, Erin Kasson, Shriya Thakkar, Diane M. Ndisebuye and Y. Tony Yang

Int. J. Environ. Res. Public Health 2026, 23(2), 255; https://doi.org/10.3390/ijerph23020255 - 17 Feb 2026

Cited by 1 | Viewed by 983

Abstract

This study assessed the correlates of cannabis and psychedelic use and legalization support among young adults in the United States (US). Using 2025 data among adults ages 18–34 (n = 3227), we assessed cannabis and psychedelic message exposure and perceptions, mental health [...] Read more.

This study assessed the correlates of cannabis and psychedelic use and legalization support among young adults in the United States (US). Using 2025 data among adults ages 18–34 (n = 3227), we assessed cannabis and psychedelic message exposure and perceptions, mental health symptoms (Patient Health Questionnaire-4 [PHQ-4]), and adverse childhood experiences (ACEs) in relation to past-6-month cannabis use (40.5%), past-year psychedelic use (11.9%), and legalization support. Relative to cannabis, psychedelics showed less legalization support, promotional and risk-message exposure, and social acceptability and higher perceived addictiveness and harm (p’s < 0.001). Factors associated with cannabis use and greater legalization support included: lower perceived addictiveness (aOR = 0.88, CI = 0.83–0.93; B = −0.04, SE = 0.01) and harm (aOR = 0.75, CI = 0.71–0.80; B = −0.16, SE = 0.01), higher social acceptability (aOR = 1.25, CI = 1.19–1.33; B = 0.19, SE = 0.01), and higher PHQ-4 (aOR = 1.04, CI = 1.01–1.07); more ACEs (aOR = 1.10, CI = 1.06–1.14) and more promotional (aOR = 1.08, CI = 1.01–1.17) and risk-message exposure (aOR = 1.27, CI = 1.17–1.39) were associated with use. Factors associated with psychedelic use and greater legalization support included: more promotional-message exposure (aOR = 1.61, CI = 1.36–1.91; B = 0.09, SE = 0.04), lower addictiveness (aOR = 0.87, CI = 0.78–0.97; B = −0.03, SE = 0.02) and harm (aOR = 0.74, CI = 0.66–0.82; B = −0.19, SE = 0.02), higher acceptability (aOR = 1.59, CI = 1.47–1.73; B = 0.15, SE = 0.01), and higher PHQ-4 (aOR = 1.06, CI = 1.02–1.11; B = 0.02, SE = 0.01); more risk-message exposure (aOR = 1.29, CI = 1.08–1.54) and ACEs (aOR = 1.15, CI = 1.09–1.21) were associated with use. Perceptions and mental health may influence cannabis and psychedelic use and legalization support, and message exposure may be particularly relevant in shaping psychedelic use and legalization support. Thus, information is crucial to ensure population understanding of the risks, benefits, and overall population impacts of cannabis and psychedelic use and legalization. Full article

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

14 pages, 307 KB

Open AccessArticle

“I Just Glove up and Do What Has to Be Done”: A Mixed-Methods Exploration of Dementia Care Challenges and Care Management Strategies

by Amanda N. Leggett, Natasha Nemmers, Sophia Tsuker, Laura N. Gitlin and Helen C. Kales

Int. J. Environ. Res. Public Health 2026, 23(2), 254; https://doi.org/10.3390/ijerph23020254 - 17 Feb 2026

Viewed by 864

Abstract

Family care partners for persons living with dementia (PLwD) adopt a variety of care management strategies to navigate care. We utilize a convergent parallel mixed-methods design to integrate family care partners’ descriptions of care challenges and associated management approaches. Primary family care partners [...] Read more.

Family care partners for persons living with dementia (PLwD) adopt a variety of care management strategies to navigate care. We utilize a convergent parallel mixed-methods design to integrate family care partners’ descriptions of care challenges and associated management approaches. Primary family care partners for PLwD (n = 100) were interviewed about their management of a care challenge (qualitative), the PLwD’s function, behavior and cognition (quantitative), and their management strategies (qualitative/quantitative). Care challenges and strategies were compared across qualitative content analysis and t-tests. Care partners providing more functional (r = 0.34, p < 0.01) and cognitive (r = 0.30, p < 0.01) care used more active management strategies, whereas care partners providing greater behavioral care (r = 0.34, p < 0.001) reported more criticism, with similar themes seen qualitatively. Active management may be required when dementia severity increases, yet criticism may emerge with greater behavioral severity. Because criticism is associated with more negative outcomes, future interventions should help care partners practice more adaptive behavioral management. Full article

(This article belongs to the Special Issue Family Caregiving of Older Adults: 2nd Edition)

29 pages, 480 KB

Open AccessArticle

A Theory-Based Approach to Predict Stress Relaxation Behavior Among South Asian Americans: A Cross-Sectional Study

by Manoj Sharma, Asma Awan, Vikash Patel, Badrunnisa Hanif, Aastha Poudel, Tooba Laeeq and Sandhya Wahi-Gururaj

Int. J. Environ. Res. Public Health 2026, 23(2), 253; https://doi.org/10.3390/ijerph23020253 - 17 Feb 2026

Viewed by 824

Abstract

South Asian Americans experience multifaceted sociocultural and acculturative stressors that influence mental well-being, yet few studies have applied contemporary behavioral theories to understand relaxation behaviors in this population. This cross-sectional study examined predictors of initiating and sustaining relaxation behaviors using the Multi-Theory Model [...] Read more.

South Asian Americans experience multifaceted sociocultural and acculturative stressors that influence mental well-being, yet few studies have applied contemporary behavioral theories to understand relaxation behaviors in this population. This cross-sectional study examined predictors of initiating and sustaining relaxation behaviors using the Multi-Theory Model (MTM) of health behavior change. A web-based survey of 271 South Asian adults incorporated the Perceived Stress Scale (PSS-10), MTM constructs, and sociodemographic characteristics. Reliability was high across MTM subscales (Cronbach’s α = 0.81–0.93). Structural equation modeling demonstrated acceptable fit (CFI > 0.90, TLI > 0.90, RMSEA < 0.08, SRMR < 0.08). Hierarchical regressions revealed that among participants practicing relaxation (n = 202), behavioral confidence significantly predicted initiation (β = 0.481, p < 0.001), followed by participatory dialogue (β = 0.194, p < 0.05) and changes in the physical environment (β = 0.242, p < 0.01). Emotional transformation strongly predicted sustenance (β = 0.395, p < 0.001), along with practice for change (β = 0.307, p < 0.05) and changes in the social environment (β = 0.210, p < 0.05). MTM constructs explained 69.8% of initiation variance and 70.4% of sustenance variance. Among non-practitioners, participatory dialogue predicted initiation (β ≈ 0.18–0.34, p < 0.05), and emotional transformation predicted sustenance (β = 0.570, p < 0.001). These findings underscore MTM’s strong predictive utility and support culturally tailored interventions enhancing confidence, emotional regulation, and social/environmental supports to promote relaxation behaviors in South Asian communities in the United States. Full article

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

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24 pages, 2307 KB

Open AccessArticle

Operationalizing Co-Design in Exercise Interventions with Indigenous Peoples in Australia: Development and Cultural Adaptation of the PrIDE Tools

by Morwenna Kirwan, Connie Henson, Blade Bancroft-Duroux, Kerri Colegate, Cheryl Taylor, David Meharg, Neale Cohen and Kylie Gwynne

Int. J. Environ. Res. Public Health 2026, 23(2), 252; https://doi.org/10.3390/ijerph23020252 - 17 Feb 2026

Viewed by 953

Abstract

Indigenous Australians experience a disproportionate burden of type 2 diabetes mellitus and cardiovascular disease. While clinician-led, community-based exercise programs are effective in general populations, limited peer-reviewed evidence is available describing culturally adapted exercise interventions with Indigenous Australians that transparently reports governance, cultural adaptation, [...] Read more.

Indigenous Australians experience a disproportionate burden of type 2 diabetes mellitus and cardiovascular disease. While clinician-led, community-based exercise programs are effective in general populations, limited peer-reviewed evidence is available describing culturally adapted exercise interventions with Indigenous Australians that transparently reports governance, cultural adaptation, and theoretical design. This paper reports the co-design and development of tools for the Preventing Indigenous Cardiovascular Disease and Diabetes through Exercise (PrIDE) study, an adaptation of the Beat It program that incorporates wearable technology. Using the Co-design Health Research and Innovation Model, four tools were developed with Indigenous governance through a Consumer Advisory Group and a project-specific Consumer User Panel. Three tools were culturally adapted—the PrIDE Exercise Program, the Strong Spirit Strong Self self-efficacy assessment, and Keep Your Heart Strong educational materials—and a newly developed tool, the Success Plan. Cultural adaptations were prospectively documented using the Model for Adaptation Design and Impact, and all tools were assessed using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. Behavior change mechanisms were mapped using the COM-B model. This paper provides transparent documentation of culturally adapted theory-informed tool development to support reproducibility and knowledge translation. The evaluation of effectiveness, acceptability, and psychometric properties will be reported following PrIDE implementation. Full article

(This article belongs to the Special Issue Scaling Up Physical Activity Interventions in the Prevention of Chronic Diseases)

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11 pages, 428 KB

Open AccessArticle

Higher Rates of Emergency Oral Health Care Presentations Among Indigenous Australians: A Comparative Public Health Study

by Neeraj Vyas, Simranjit Cheema, Rachel Scobie, Barbie Fusitu’a, Gary Low, Albert Yaacoub, Muhammad Irshad, Stephen Cox and Mafaz Ullah

Int. J. Environ. Res. Public Health 2026, 23(2), 251; https://doi.org/10.3390/ijerph23020251 - 17 Feb 2026

Viewed by 783

Abstract

Background: This study compared the reasons for dental presentations between Indigenous and non-Indigenous Australian adults at the Nepean Centre for Oral Health, NSW, Australia. Methods: A retrospective cohort study was conducted on adult patients presenting between 1 July and 31 December 2019. Clinical [...] Read more.

Background: This study compared the reasons for dental presentations between Indigenous and non-Indigenous Australian adults at the Nepean Centre for Oral Health, NSW, Australia. Methods: A retrospective cohort study was conducted on adult patients presenting between 1 July and 31 December 2019. Clinical notes were audited and categorized as either ‘emergency’ (pain, dental infection, dental trauma, loose teeth or dental implants, bleeding) or ‘conservative’ (dental check-ups, examinations, prosthodontic, restorative, periodontal, or non-emergency endodontic therapy). Results: A total of 4663 patients met the inclusion criteria; 61.6% were female, and 6.4% were identified as Indigenous Australians. Overall, 41.3% of presentations were for emergency dental care. Indigenous Australians were significantly more likely to present for dental emergencies compared with non-Indigenous (58.2% vs. 40.2%; χ²(1, N = 4663) = 53.4, p < 0.00001; OR = 2.07, 95% CI: 1.64–2.63), and were also more likely to undergo emergency tooth extractions (p < 0.05). Conclusions: Indigenous Australians demonstrated a higher proportion of emergency and oral surgery-related presentations and underwent tooth extractions as the primary treatment compared to their non-Indigenous counterparts. These findings suggest a higher burden of oral disease and delayed access to general dental services among Indigenous Australians, highlighting the need for targeted and culturally appropriate public health interventions. Full article

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9 pages, 395 KB

Open AccessReview

Mental Health, Trauma, and Cardiovascular Risk Within South Asian Diaspora

by Jyoti Sinha

Int. J. Environ. Res. Public Health 2026, 23(2), 250; https://doi.org/10.3390/ijerph23020250 - 17 Feb 2026

Viewed by 708

Abstract

South Asian immigrants in the United States face disproportionate cardiovascular disease (CVD) risks, rooted in multidimensional trauma stemming from immigration stress, sociocultural stigma, and systemic discrimination. This paper situates these health disparities within a broader public mental health crisis, examining the intricate relationship [...] Read more.

South Asian immigrants in the United States face disproportionate cardiovascular disease (CVD) risks, rooted in multidimensional trauma stemming from immigration stress, sociocultural stigma, and systemic discrimination. This paper situates these health disparities within a broader public mental health crisis, examining the intricate relationship between chronic psychological stress, intergenerational trauma, and CVD outcomes. Applying theoretical frameworks such as intersectionality and allostatic load, we explore how cumulative biopsychosocial consequences contribute to the co-morbidity of CVD and mental health disorders in South Asian communities. The study highlights SAWC-Boston’s community-based public mental health intervention, which employs culturally grounded, trauma-informed strategies to address these complex health challenges. This intervention serves as a model for addressing health disparities through community-centered approaches. Full article

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

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20 pages, 654 KB

Open AccessArticle

Using Sport to Build Inclusion Between Mainstream and Special Schools for Students with Intellectual Disabilities in Eastern Europe

by Roy McConkey, Sabine Menke, Eva Gazova, Emilia Ispas and Joanna Styczeń-Lasocka

Int. J. Environ. Res. Public Health 2026, 23(2), 249; https://doi.org/10.3390/ijerph23020249 - 17 Feb 2026

Viewed by 558

Abstract

Children with intellectual disabilities experience social exclusion in all countries of the world. This is compounded too by their attendance at special schools in more affluent countries, especially those with a history of segregation. The article describes how sport was used to bring [...] Read more.

Children with intellectual disabilities experience social exclusion in all countries of the world. This is compounded too by their attendance at special schools in more affluent countries, especially those with a history of segregation. The article describes how sport was used to bring together students from special schools with their non-disabled peers in neighboring mainstream schools based around the Special Olympics Unified Champion Schools^® program. A process evaluation was undertaken by the first author using interviews and questionnaires with 21 Special Olympics personnel and teachers from both mainstream and special schools. Based on their direct experiences, a process model was developed that could assist other sports organizations and schools to implement similar initiatives to advance the social inclusion of students with intellectual disabilities. Moreover the health outcomes from sports could be further enhanced if people with intellectual disabilities had greater access and inclusion in public health and primary care services. The process model outlined here might well be adapted to promote equity of access to healthcare which remains sadly lacking internationally. Full article

(This article belongs to the Section Global Health)

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20 pages, 4841 KB

Open AccessEssay

Walking for Health: Franz Tappeiner (1816–1902), Meran, and the Origins of Public Health-Oriented Physical Activity

by Christian J. Wiedermann, Patrick Rina, Ulrike Kindl and Doris Hager von Strobele Prainsack

Int. J. Environ. Res. Public Health 2026, 23(2), 248; https://doi.org/10.3390/ijerph23020248 - 16 Feb 2026

Viewed by 883

Abstract

Background/Objectives: Franz Tappeiner (1816–1902) is often celebrated as a pioneer of alpine medicine and the founder of Tappeiner Promenade in Meran (South Tyrol, Italy). However, his legacy extends far beyond the scenic infrastructure, encompassing a comprehensive vision of physical activity as a public [...] Read more.

Background/Objectives: Franz Tappeiner (1816–1902) is often celebrated as a pioneer of alpine medicine and the founder of Tappeiner Promenade in Meran (South Tyrol, Italy). However, his legacy extends far beyond the scenic infrastructure, encompassing a comprehensive vision of physical activity as a public health intervention. His multidisciplinary practice anticipated the principles of contemporary rehabilitation, preventive medicine, and climate-sensitive public health. Methods: This historical public health analysis, combining biographical, contextual, and material–spatial approaches, reinterprets Tappeiner’s writings, institutional engagements, and civic projects through the lens of modern public health frameworks. Drawing on primary materials (e.g., published articles, autobiographical fragments, and commemorative texts) and recent evidence from rehabilitation and environmental health research, these contributions were contextualized. Results: Tappeiner’s early focus on infectious disease prevention (e.g., cholera and tuberculosis) transitioned into a strategic emphasis on recovery and behavioral therapy through environmental design. The walking therapy model of Max Joseph Oertel, locally realized in the Tappeiner Promenade, prefigured modern concepts such as structured green rehabilitation, walkability, and urban-health citizenship. His systematic integration of graded walking into civic infrastructure represents one of the earliest documented examples of embedding physical activity promotion at the population level. He contributed substantial personal funds to the path’s construction, embedding therapeutic gradients, curating vegetation, and promoting inclusive design to support convalescence. Contemporary research supports the intuition that green, low- to moderate-intensity walking improves cardiometabolic health, psychological well-being, and functional capacity. Moreover, his integrative ethos, merging clinical medicine, civic ethics, and spatial intervention, parallels contemporary eco-social models of public health. Conclusions: Franz Tappeiner’s career exemplifies a still-relevant model of physician leadership that is empirically grounded, socially accountable, and ecologically attuned, with physical activity promotion embedded as a central element of his public health vision. His work invites reflection on how medical professionals can shape not only individual care but also urban environments and collective health futures. Full article

(This article belongs to the Special Issue Physical Activity, Body–Mind Training and Well-Being in Community Settings)

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19 pages, 1414 KB

Open AccessArticle

Impacts of Social Environments on Neighborhood Depression Incidence: Fully Accounting for Spatial Effects

by Peter Congdon and Esmail Abdul-Fattah

Int. J. Environ. Res. Public Health 2026, 23(2), 247; https://doi.org/10.3390/ijerph23020247 - 16 Feb 2026

Viewed by 602

Abstract

Neighborhood variations in depression, an important aspect of the overall mental health burden, have been linked both to environmental context (e.g., area crime, neighborhood cohesion), and to area socio-demographic composition. Previous models seeking to explain such spatial variations in mental health, such as [...] Read more.

Neighborhood variations in depression, an important aspect of the overall mental health burden, have been linked both to environmental context (e.g., area crime, neighborhood cohesion), and to area socio-demographic composition. Previous models seeking to explain such spatial variations in mental health, such as those based on Bayesian disease mapping, follow a standard approach defined by: spatially stationary effects of area predictors; predictor effects neglecting potential spatial spillover; and a spatially structured residual to account for unmodelled spatial dependencies. In a study of depression incidence in England neighborhoods, we consider the gains from an alternative strategy, allowing nonstationary environmental impacts; spillover effects of environmental factors, and a non-stationary spatial intensity. We focus particularly on impacts of socio-behavioral environments, namely neighborhood cohesion and crime. We find these to be major influences on neighborhood depression incidence, and also find major gains in model performance by explicitly considering non-stationarity and spillovers. Allowing context heterogeneity, varying spatial intensity and spillover are shown to enhance the impacts of socio-behavioral environments on depression incidence, and such findings have broader relevance to disease mapping regression. Public health policy framing may therefore need to be tailored to locally specific environmental impacts, and to inter-agency collaboration across arbitrary boundaries. Full article

(This article belongs to the Special Issue How and Why Do Neighbourhood Environments Affect Population Mental Health?)

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11 pages, 346 KB

Open AccessArticle

Feasibility of Using College Students to Increase Cancer Screening Behaviors Among Their Parents

by Caitlin C. Abar, Logan Robert Kayser, Amanda Lewis, Hannah Randolph and Beau Abar

Int. J. Environ. Res. Public Health 2026, 23(2), 246; https://doi.org/10.3390/ijerph23020246 - 16 Feb 2026

Viewed by 438

Abstract

This study evaluated the feasibility of using college students to encourage cancer screening among their parents or other close adults. Methods: A sample of college students were surveyed on their willingness to discuss cancer screening with their parents and their perceived importance of [...] Read more.

This study evaluated the feasibility of using college students to encourage cancer screening among their parents or other close adults. Methods: A sample of college students were surveyed on their willingness to discuss cancer screening with their parents and their perceived importance of cancer screening. Individuals reporting high levels (≥7/10) on each were offered a brief intervention (i.e., basic cancer screening information) and a follow-up survey. Results: A total of 189 students completed the baseline survey. A subset of 92 students met intervention criteria (49%), with 54 of 92 accepting (59%). Of those who accepted, 19 of 54 were reached at follow-up (35%). Roughly half of those reached engaged in cancer screening discussions with a parent, most speaking with their mother. Open-ended feedback was positive and commonly focused on the desire for additional knowledge. Conclusions: Results demonstrate that college students are a promising target for future intergenerational intervention work. Full article

(This article belongs to the Collection Health Behaviors, Risk Factors, NCDs and Health Promotion)

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15 pages, 595 KB

Open AccessArticle

Physical Activity During Pregnancy: Associations Between Levels and Types of Physical Activity and Low Back Pain–Related Disability in Portuguese Pregnant Women

by Isabel Teixeira, Paula Clara Santos, Clarinda Festas and Diana Bernardo

Int. J. Environ. Res. Public Health 2026, 23(2), 245; https://doi.org/10.3390/ijerph23020245 - 15 Feb 2026

Viewed by 1010

Abstract

Low back pain (LBP) is one of the most prevalent musculoskeletal conditions during pregnancy and frequently impairs daily living activities and quality of life. The association between different levels and types of physical activity (PA) and LBP-related functional disability remains insufficiently explored. This [...] Read more.

Low back pain (LBP) is one of the most prevalent musculoskeletal conditions during pregnancy and frequently impairs daily living activities and quality of life. The association between different levels and types of physical activity (PA) and LBP-related functional disability remains insufficiently explored. This study aimed to examine the association between PA levels and types and functional disability among pregnant women with LBP. A cross-sectional analytical study was conducted involving 192 Portuguese pregnant women. Data were collected through an online questionnaire comprising the Pregnancy Physical Activity Questionnaire and the Oswestry Disability Index (ODI). Most participants engaged predominantly in light-intensity or sedentary activity (69.1%), with minimal participation in vigorous activity (0.8%). Functional disability was generally mild (mean ODI = 11.5 ± 7.35); however, 42.2% of participants reported moderate disability and 11.0% severe disability. Advancing gestational age showed weak associations with increased domestic activity (r = 0.146, p = 0.044), decreased occupational activity (r = −0.295, p = 0.001), and higher functional disability scores (r = 0.142, p = 0.049). Parity was associated with differences in total PA levels (p = 0.005) and domestic activity (p = 0.001). Higher ODI scores were weakly associated with light-intensity and sedentary activity (r = 0.144, p = 0.047), whereas severe disability demonstrated a moderate association with sedentary behavior (r = 0.529, p = 0.014). Overall, lower levels of PA, particularly sedentary behavior, were weakly associated with higher LBP-related disability; however, the observed associations were generally weak and should be interpreted with caution considering the cross-sectional design. Full article

(This article belongs to the Special Issue Advances in Women’s Health and Pelvic Health: Lifelong Care)

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Int. J. Environ. Res. Public Health, Volume 23, Issue 2 (February 2026) – 135 articles

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