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Exploring Allied Health Models of Care for Children with Developmental Health Concerns, Delays, and Disabilities in Rural and Remote Areas: A Systematic Scoping Review
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Investigation of Underlying Association between Anthropometric and Cardiorespiratory Fitness Markers among Overweight and Obese Adolescents in Canada
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A ‘Cultural Models’ Approach to Psychotherapy for Refugees and Asylum Seekers: A Case Study from the UK
Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.3 days after submission; acceptance to publication is undertaken in 3.3 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
- Companion journal: Air.
Latest Articles
Biological Sex Disparities in the Economic Burden of Tobacco Use: A Comparative Analysis between Men and Women in China
Int. J. Environ. Res. Public Health 2024, 21(8), 980; https://doi.org/10.3390/ijerph21080980 - 26 Jul 2024
Abstract
To examine the impact of tobacco use on the economic costs between biological sex differences, we utilized propensity score matching and human capital methods to analyze the economic costs associated with smoking. Our findings reveal a nuanced pattern in the economic burden: although
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To examine the impact of tobacco use on the economic costs between biological sex differences, we utilized propensity score matching and human capital methods to analyze the economic costs associated with smoking. Our findings reveal a nuanced pattern in the economic burden: although men who smoke bear a higher overall economic cost, the individual impact on women who smoke is significantly more profound. As a result, there exists a distinct disparity in the distribution of economic consequences stemming from tobacco use between men and women.
Full article
(This article belongs to the Section Global Health)
Open AccessArticle
Maximal Oxygen Consumption Is Negatively Associated with Fat Mass in Facioscapulohumeral Dystrophy
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Oscar Crisafulli, Luca Grattarola, Giorgio Bottoni, Jessica Lacetera, Emanuela Lavaselli, Matteo Beretta-Piccoli, Rossella Tupler, Emiliano Soldini and Giuseppe D’Antona
Int. J. Environ. Res. Public Health 2024, 21(8), 979; https://doi.org/10.3390/ijerph21080979 - 26 Jul 2024
Abstract
Facioscapulohumeral dystrophy (FSHD) leads to progressive changes in body composition such as loss of muscle mass and increase in adiposity. In healthy subjects, anthropometric parameters are associated with the maximum volume of oxygen consumed per minute (VO2max), which is a health
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Facioscapulohumeral dystrophy (FSHD) leads to progressive changes in body composition such as loss of muscle mass and increase in adiposity. In healthy subjects, anthropometric parameters are associated with the maximum volume of oxygen consumed per minute (VO2max), which is a health and function indicator in several populations of subjects, both healthy and pathological. Since VO2max can be difficult to test in patients with FSHD due to exercise intolerance, the identification of associated anthropometric parameters could provide new easily obtainable elements for the patients’ clinical stratification. The aim of this study was to evaluate whether anthropometric and body composition parameters are associated with VO2max in patients with FSHD. A total of 22 subjects with a molecular genetics-based diagnosis of FSHD (6 females, 16 males, mean age of 35.18 years) were recruited for the study. VO2max was measured by cardiopulmonary exercise tests (CPETs) on a cycle ergometer, utilizing a step incremental technique (15 Watts (W) every 30 s). Weight (Kg) and height (m) were obtained and utilized to calculate body mass index (BMI). Body composition parameters (fat mass (FM), fat free mass (FFM), and body cell mass (BCM)) were obtained by bioelectrical impedance analysis (BIA). Significant negative associations were found between VO2max and FM (Spearman correlation coefficient (SCC) −0.712), BMI (SCC −0.673), age (SCC −0.480), and weight (SCC −0.634), unlike FFM and BCM. Our results indicate that FM, BMI, age, and body weight are negatively associated with VO2max in patients with FSHD. This evidence may help practitioners to better stratify patients with FSHD.
Full article
(This article belongs to the Section Health Care Sciences)
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Open AccessArticle
Raising Awareness about Sex Trafficking among School Personnel
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Elena Savoia, Amy Liu, Amy Leffler, Léa Kay Nadril Churchill and Maxwell Su
Int. J. Environ. Res. Public Health 2024, 21(8), 978; https://doi.org/10.3390/ijerph21080978 - 26 Jul 2024
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Background: We aimed to (1) understand the level of knowledge about sex trafficking of minors among school personnel and the determinants of such knowledge and (2) test the efficacy of short educational videos in increasing knowledge (awareness level) about sex trafficking of minors
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Background: We aimed to (1) understand the level of knowledge about sex trafficking of minors among school personnel and the determinants of such knowledge and (2) test the efficacy of short educational videos in increasing knowledge (awareness level) about sex trafficking of minors among school personnel. Methods: We employed an online survey to gather responses from 741 school personnel living in the US. The McNemar test was used to test for differences in knowledge before and after exposure to the videos. Logistic regression was used to identify predictors of knowledge based on the respondents’ characteristics. Results: Predictors of knowledge about sex trafficking were years of experience in working with youth, level of education, and being a female. Exposure to the educational videos improved school personnel’s basic knowledge about this crime and interest in seeking additional educational material. Conclusion: School personnel have a high level of awareness of risk factors for sex trafficking but less awareness of the definition of sex trafficking in children. Exposure to short educational videos can increase awareness in the short term. There is a need to develop more comprehensive training initiatives for school personnel on sex trafficking. However, training alone is not sufficient, and there is also a need for developing school protocols and programs to provide adequate support to victims of this crime.
Full article
![](https://pub.mdpi-res.com/ijerph/ijerph-21-00978/article_deploy/html/images/ijerph-21-00978-g001-550.jpg?1721985299)
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Open AccessArticle
The Role of Functional Deficits, Depression, and Cognitive Symptoms in the Perceived Loneliness of Older Adults in Mexico City
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Ana Belén Ramírez López, Yaneth Rodríguez-Agudelo, Francisco Paz-Rodríguez, Silvia Aracely Tafoya, Benjamín Guerrero López and Claudia Diaz Olavarrieta
Int. J. Environ. Res. Public Health 2024, 21(8), 977; https://doi.org/10.3390/ijerph21080977 - 26 Jul 2024
Abstract
The world is aging and experiencing loneliness. Functional impairment in instrumental activities of daily living (IADL) in older people (OP) with mild neurocognitive disorder (MNCD) predicts loneliness. After the pandemic, there was an increase in perceived loneliness. We explored the association between loneliness,
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The world is aging and experiencing loneliness. Functional impairment in instrumental activities of daily living (IADL) in older people (OP) with mild neurocognitive disorder (MNCD) predicts loneliness. After the pandemic, there was an increase in perceived loneliness. We explored the association between loneliness, depression, deficits in IADL, and cognitive symptoms among OP. From February to December 2023, using a cross-sectional design, we interviewed probable cases with mild cognitive impairment and caregivers in two public facilities. We administered the UCLA Loneliness Scale v3, Lawton IADL Scale, Mini-Mental State Examination (MMSE), and Yesavage’s Geriatric Depression Scale. Samples were matched: 85 per group, 82.4% were women, married (52.95%), and mean age of 69.17 (±6.93) years. In our study, 30% displayed moderate to high levels of perceived loneliness. Multivariate analysis showed loneliness was associated with depression, low levels of IADL, and older age, but not with cognitive symptoms, which explained 22% of the total variance (F 165) = 16.99, (p < 0.001). Targeting symptoms and behaviors that could be modified (i.e., depression and functionality) can improve feelings of perceived loneliness and have an impact on morbidity and mortality with which it is associated.
Full article
(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)
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Open AccessArticle
Temporal Trends in Air Pollution Exposure across Socioeconomic Groups in The Netherlands
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Niklas Hlubek, Yvonne Koop, Alfred Wagtendonk and Ilonca Vaartjes
Int. J. Environ. Res. Public Health 2024, 21(8), 976; https://doi.org/10.3390/ijerph21080976 - 26 Jul 2024
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Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the
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Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the Netherlands from 2014 to 2019. Our dataset includes over 12.5 million individuals, aged 18 years and above, who resided in the Netherlands between 2014 and 2019, using Statistics Netherlands data. The address-level air pollution concentrations were estimated by dispersion models of the National Institute of Public Health and the Environment. We linked the exposure estimations of particulate matter < 10 or <2.5 μm (PM10, PM2.5) and nitrogen dioxide (NO2) to household-level socioeconomic data. In highly urbanized areas, individuals from both the lowest and highest socioeconomic groups were exposed to higher air pollution concentrations. Individuals from the lowest socioeconomic group were disproportionally located in highly urbanized and more polluted areas. The air pollution concentrations of PM10, PM2.5, and NO2 decreased between 2014 and 2019 for all the socioeconomic groups. The decrease in the annual average air pollution concentrations was the strongest for the lowest socioeconomic group, although differences in exposure between the socioeconomic groups remain. Further research is needed to define the health and equity implications.
Full article
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Open AccessArticle
Post-Traumatic Stress Disorder 4 Years after the COVID-19 Pandemic in Adolescents with Different Levels of Physical Activity Engagement: A Repeated Cross-Sectional Study
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Giulia Di Martino, Marco Centorbi, Andrea Buonsenso, Giovanni Fiorilli, Carlo della Valle, Giuseppe Calcagno, Enzo Iuliano and Alessandra di Cagno
Int. J. Environ. Res. Public Health 2024, 21(8), 975; https://doi.org/10.3390/ijerph21080975 - 26 Jul 2024
Abstract
The aim of this study was to assess whether the psychological impact of the COVID-19 pandemic on children and adolescents had decreased four years after the initial assessment. This study aimed to determine if children with an active lifestyle and participation in sports
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The aim of this study was to assess whether the psychological impact of the COVID-19 pandemic on children and adolescents had decreased four years after the initial assessment. This study aimed to determine if children with an active lifestyle and participation in sports activities were protected against this traumatic stress. This study included a total of 284 Italian participants assessed at two different time points: the first assessment was conducted in 2020 when the children were aged 9–12 years, and a second assessment was carried out four years later when the participants were aged 13–16. Participants completed the Impact of Event Scale–Revised questionnaire (IES-R), with the IES-8 and IES-15 versions used accordingly based on age group. In the 2020 assessment, 146 (51.4%) reported a score higher than the cut-off for significant traumatic stress, while in 2024, only 49 participants (17.2%). The chi-square analysis indicated that this decrement was statistically significant (p < 0.001). RM-ANOVA showed a significant reduction for both Intrusion Score and Avoidance Score (p < 0.001). A statistical interaction between gender and time was observed. There were weak correlations between the level of children’s sport practice, and no differences between those who engage in individual or team sports. Despite this study showing that young people are overcoming the pandemic crisis and its consequences, identifying potential modifiable risk factors and empowering protective factors remains crucial, especially for those who continue to experience psychological issues. The restrictions particularly impacted active children by disrupting their routine, which may have compromised the universally recognized protective value of sports.
Full article
Open AccessArticle
Psychiatrists’ Insights on Integrating Occupational Therapy in Mental Health Care: A Multisite Middle Eastern Study
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Naser Alotaibi, Hamad Alhamad, Haitham Jahrami, Muhammad O. Al-Heizan, Lujane Albaghli, Hasan Ashkanouni, Hashem Abu Tariah, Hamad Abouelhassan and Moh Alkhamis
Int. J. Environ. Res. Public Health 2024, 21(8), 974; https://doi.org/10.3390/ijerph21080974 - 26 Jul 2024
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Objective: The purpose of this study was to explore the knowledge, perception, attitude, and self-efficacy of psychiatrists regarding the role of occupational therapy in mental health practice. Materials and Methods: This study utilized a cross-sectional design to examine the perspectives of
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Objective: The purpose of this study was to explore the knowledge, perception, attitude, and self-efficacy of psychiatrists regarding the role of occupational therapy in mental health practice. Materials and Methods: This study utilized a cross-sectional design to examine the perspectives of psychiatrists from various Middle Eastern countries on occupational therapy practice. A self-developed tool was mainly used to assess occupational therapy knowledge, autonomy, attitude, and self-efficacy. STATA version 16.0 was employed for all subsequent statistical analyses. The data were analyzed using the Kruskal–Wallis and chi-square tests. Results: A total of 117 participants (psychiatrists) from various Middle Eastern countries, including Kuwait, Bahrain, Saudi Arabia, and Jordan, took part in this study. Overall, no significant differences were found between the sites in terms of knowledge and self-perception of occupational therapy autonomy, indicating a lack of understanding about the unique nature of occupational therapy as a distinct health care profession (p-values > 0.05). However, this study’s participants demonstrated a positive attitude and self-efficacy towards occupational therapy. Conclusions: In order to promote the desired therapeutic outcomes, a referral form for occupational therapy, encompassing the main areas of intervention, was proposed. Such a referral form can help inform psychiatrists about the key components of occupational therapy services in mental health practice, thus facilitating the desired interprofessional collaboration and patient outcomes. This study’s implications and future directions are also discussed.
Full article
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Open AccessArticle
Variation in Psychiatric Hospitalisations: A Multiple-Membership Multiple-Classification Analysis
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Emely Ek Blæhr, Beatriz Gallo Cordoba, Niels Skipper and Rikke Søgaard
Int. J. Environ. Res. Public Health 2024, 21(8), 973; https://doi.org/10.3390/ijerph21080973 - 25 Jul 2024
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The complexity of variation in healthcare, particularly in mental health, remains poorly understood. However, addressing this issue presents a significant opportunity to optimise the allocation of scarce healthcare resources. To explore this, we aim to investigate the variation in psychiatric care as measured
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The complexity of variation in healthcare, particularly in mental health, remains poorly understood. However, addressing this issue presents a significant opportunity to optimise the allocation of scarce healthcare resources. To explore this, we aim to investigate the variation in psychiatric care as measured by the number of psychiatric hospitalisations. We estimated multiple-membership multiple-classification models utilising Danish register data for 64,694 individuals and their healthcare providers, including 2101 general practitioners, 146 community-based care institutions, 46 hospital departments, and 98 municipalities. This approach recognises that data are not strictly hierarchical. We find that, among individuals attending a single healthcare provider, 67.4% of the total variance in psychiatric hospitalisations can be attributed to individual differences, 25.6% to differences in practice context, and 7.95% to differences in medical practice. Adding characteristics to the model explains 68.5% of the variance at the healthcare provider municipality level, but almost no explanation of the variation was found on the three other levels despite the numerous characteristics considered. This suggests that medical practice may vary unwarrantedly between healthcare providers, indicating potential for optimisation. Streamlining medical practices, such as adhering to clinical guidelines, could lead to more efficient consumption of mental health resources. In conclusion, understanding and addressing variation in psychiatric care can have a profound impact on resource allocation and patient outcomes, ultimately leading to a more effective healthcare system.
Full article
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Open AccessArticle
Creating and Reliving the Moment: Using Musical Improvisation and Care Aesthetics as a Lens of Connection and Self-Expression for Younger People Living with Dementia
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Robyn Dowlen, Dougal Henry James McPherson, Caroline Swarbrick, Lizzie Hoskin, James Thompson and John Keady
Int. J. Environ. Res. Public Health 2024, 21(8), 972; https://doi.org/10.3390/ijerph21080972 - 25 Jul 2024
Abstract
Musical improvisation is a generative process of spontaneously creating music ‘in the moment’. For people with young onset dementia, musical improvisation provides an extended opportunity for creative self-expression and connection to one’s own body and life story. Using visual research methods, including video
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Musical improvisation is a generative process of spontaneously creating music ‘in the moment’. For people with young onset dementia, musical improvisation provides an extended opportunity for creative self-expression and connection to one’s own body and life story. Using visual research methods, including video elicitation interviews, this paper explores the ‘in the moment’ musical experiences of five people living with young onset dementia who took part in a 15-week improvised music-making programme (Music in Mind). We frame the exploration of the group’s musical experiences through the emerging lens of ‘care aesthetics’—a concept that identifies the sensory relations and embodied practices between two (or more) people in a caring relationship. In the context of this analysis, we look to the caring practices by, with, and between people living with dementia, their family members, and the musicians who lead the programme and the relationship of these practices to feelings of self-expression and meaningful connection. Musical improvisation has the potential to support the psychological, social, and spiritual wellbeing of people living with young onset dementia. In applying a lens of care aesthetics, it is possible to observe the micro-level experiences of people living with dementia and their family carers.
Full article
(This article belongs to the Special Issue Innovations in Care and Support for People Living with Young Onset or Rarer Forms of Dementia)
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Open AccessReview
Sociocultural Implications in the Development of Early Maladaptive Schemas in Adolescents Belonging to Sexual and Gender Minorities
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Bruno Luiz Avelino Cardoso, Ana Flávia Azevedo Lima, Fabiana Rachel Martins Costa, Christof Loose, Xi Liu and Matteo Angelo Fabris
Int. J. Environ. Res. Public Health 2024, 21(8), 971; https://doi.org/10.3390/ijerph21080971 - 25 Jul 2024
Abstract
Culture is a central theme across various theories and disciplines, influencing behavior and self-perception through interactions within social groups, families, and legal systems. This influence extends to the general population and particularly impacts sexual and gender minorities (SGMs), resulting in minority stress that
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Culture is a central theme across various theories and disciplines, influencing behavior and self-perception through interactions within social groups, families, and legal systems. This influence extends to the general population and particularly impacts sexual and gender minorities (SGMs), resulting in minority stress that contributes to mental health issues and the development of Early Maladaptive Schemas (EMSs). Adolescents within these groups face typical developmental stressors—such as hormonal changes and societal pressures—compounded by prejudice, increasing their vulnerability to depression, anxiety, stress, substance abuse, and eating disorders. Despite these challenges, Schema Therapy (ST) lacks comprehensive studies on the sociocultural aspects influencing EMS acquisition in SGM adolescents. This theoretical review aims to fill this gap by exploring the impact of society and culture on EMS development within SGM adolescents. We recognize the broad spectrum of cultural influences and emphasize the importance of cultural sensitivity and diversity. This review specifically addresses how societal and cultural dynamics impact SGM individuals, acknowledging that while ethnic or other cultural factors are not the focus of this paper, they merit future research. This manuscript will discuss central topics and their impact on LGBTQIA+ youth, including (1) the background (definition of culture, lack of studies on ST focusing on culture, and studies on adverse psychological outcomes), (2) minority stress theory and prejudice against sexual and gender diversity (distal and proximal stressors and sociocultural aspects), (3) EMSs and unmet emotional needs, (4) ST affirmative strategies (working with schema modes, imagery rescripting, chair work, and photo techniques), and (5) final considerations (limitations and research agenda).
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Open AccessArticle
Parenting Stress Following a Neonatal Intensive Care Unit Hospitalization: A Longitudinal Study of Mothers and Fathers
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Corinna C. Klein and Nicole M. McDonald
Int. J. Environ. Res. Public Health 2024, 21(8), 970; https://doi.org/10.3390/ijerph21080970 - 25 Jul 2024
Abstract
A neonatal intensive care unit (NICU) hospitalization can add significant stress to the postpartum period. Parents experience isolation and uncertainty, which can affect their capacity to bond with their new baby. Understanding how stress is shaped by and changes following a NICU experience
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A neonatal intensive care unit (NICU) hospitalization can add significant stress to the postpartum period. Parents experience isolation and uncertainty, which can affect their capacity to bond with their new baby. Understanding how stress is shaped by and changes following a NICU experience will help in developing supports for these families. We examined patterns of parenting stress over the first year of life following a NICU stay to better understand changes in stress, differences in maternal and paternal stress, and how medical and developmental variables impact parent stress. Parents of infants (n = 51) who had experienced a NICU hospitalization and met criteria for California’s High-Risk Infant Follow-Up program completed assessments at 6, 9, and 12 months. A comparison group (n = 38) from a historic dataset included parents of infants born full term without medical complications. NICU parents reported higher levels of parenting stress at 6 months, but not 12 months, with mothers and fathers reporting similar stress levels. Parenting-related stress was found to be relatively stable and consistent over this period. Among NICU parents, lower developmental level at 12 months was associated with more distress in interacting with their child. These findings highlight the importance of monitoring parenting stress following discharge from the NICU and developing interventions for supporting parents of NICU graduates showing developmental delays.
Full article
(This article belongs to the Special Issue Risk and Protective Factors for Maternal and Paternal Mental Health during the Perinatal Period)
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Open AccessArticle
Health, Performance Ratings and Approachability of 50–60-Year-Old Sedentary Adults (ActIv-Study): Key Insights for Health Economy and Exercise Promotion
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Dieter Leyk, Nadine Hartmann, Emanuel Vits, Thomas Rüther, Stefanie Klatt, Ralf Lämmel and Herbert Löllgen
Int. J. Environ. Res. Public Health 2024, 21(8), 969; https://doi.org/10.3390/ijerph21080969 - 24 Jul 2024
Abstract
Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement
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Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2888 study participants aged 50–60 years, 668 persons were categorised into the subgroups “never-athletes”, “sports-dropouts”, “always-athletes” and “sports-beginners”. Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. In total, 42.5% of “never-athletes” and 32.5% of “sports-dropouts” did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between “sports-dropouts” and “sports-beginners”, whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated for by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.
Full article
(This article belongs to the Special Issue Exercise and Physical Activity in Health Promotion)
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Open AccessReview
The Integration of Information Technology in the Management and Organization of Nursing Care in a Hospital Environment: A Scoping Review
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Dulce Cachata, Mónica Costa, Teresa Magalhães and Filomena Gaspar
Int. J. Environ. Res. Public Health 2024, 21(8), 968; https://doi.org/10.3390/ijerph21080968 - 24 Jul 2024
Abstract
The adoption of health technologies is occurring on an unprecedented scale, with enormous potential to improve the health of populations. In this context, information technology (IT) in nursing has emerged with a focus on quality and safety of care for the benefit of
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The adoption of health technologies is occurring on an unprecedented scale, with enormous potential to improve the health of populations. In this context, information technology (IT) in nursing has emerged with a focus on quality and safety of care for the benefit of the patient. There is insufficient reliable evidence demonstrating how the integration of IT in nursing care influences methodologies for managing and organizing care in terms of structure and care practice, justifying a scoping review that synthesizes the knowledge produced so far. Online databases were used to identify papers published in 2012–2023, from which we selected nine publications that used information technology in the nursing care processes. The participants were hospital nurses and nurse managers. The results show that the integration of IT in healthcare organizations impacts the management and organization of nursing care, and changes in structure, process reorganization, management, training, and the development of nurses’ skills. To minimize this impact, the organizational structure must be prepared for a cultural change, with well-defined and communicated policies and procedures, and strong leadership. Within the teams, the importance of process reorganization, continuous training, and skill development emerges, thus enhancing the integration of IT into practice environments in conjunction with care.
Full article
(This article belongs to the Special Issue New Advances in Nursing Care)
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Open AccessArticle
The Knowledge Acquired by Parents in Pregnancy Monitoring Consultations
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Raquel Cerdeira and Otília Zangão
Int. J. Environ. Res. Public Health 2024, 21(8), 967; https://doi.org/10.3390/ijerph21080967 - 24 Jul 2024
Abstract
(1) Pregnancy surveillance nursing consultations in the pandemic context have undergone some changes, namely the restriction of accompanying persons. In this sense, assessing the knowledge acquired by parents in pregnancy surveillance is of great importance. Since there are no studies on the subject
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(1) Pregnancy surveillance nursing consultations in the pandemic context have undergone some changes, namely the restriction of accompanying persons. In this sense, assessing the knowledge acquired by parents in pregnancy surveillance is of great importance. Since there are no studies on the subject in the period before the pandemic, we will only assess the knowledge acquired by parents in pregnancy monitoring. (2) For this reason, the aim of our study is to evaluate the knowledge acquired by parents in pregnancy surveillance. (3) This study is descriptive, cross-sectional and quantitative in nature, with a sample of 196 couples. A questionnaire was administered about the knowledge acquired by parents in pregnancy surveillance nursing consultations. (4) Pregnant mothers and their partners reported having some knowledge. The classification was assessed using a questionnaire with quantifiable response options from 1 to 5 points. Items with a score of 1 indicate a low level of knowledge and 5 indicates a higher level of knowledge. (5) We can verify that the level of knowledge acquired by the pregnant mother during the pregnancy surveillance nursing consultation is higher than the level of knowledge acquired by the father during the same consultation. Most parents consider it important to receive information through the pregnancy surveillance nursing consultations carried out by Maternal and Obstetric Health Nurse Specialists (midwives).
Full article
Open AccessArticle
Impacts of a Prescribed Physical Activity Program for People with Chronic Diseases Living in Community Settings in France
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Christophe Martinez, Aurélie Goncalves, Olivier Coste, Sarah Pabion and Elodie Charbonnier
Int. J. Environ. Res. Public Health 2024, 21(8), 966; https://doi.org/10.3390/ijerph21080966 - 24 Jul 2024
Abstract
Background: Sedentary behavior and physical inactivity are modifiable risk factors at the forefront of prevention and health promotion strategies. The health benefits of physical activity (PA) have been widely demonstrated in chronic diseases and have led to the prescription of adapted PA. To
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Background: Sedentary behavior and physical inactivity are modifiable risk factors at the forefront of prevention and health promotion strategies. The health benefits of physical activity (PA) have been widely demonstrated in chronic diseases and have led to the prescription of adapted PA. To date, French scientific data are insufficient to evaluate the effectiveness of prescribing adapted PA. This study aimed (1) to evaluate the effectiveness of a community-based program and (2) to identify patient characteristics at inclusion that could be associated with improved post-program anthropometric data. Methods: Our sample was composed of 113 participants with a chronic disease (83.18% women) with a mean age of 55.4 ± 13.9 years. Participants benefited from an 8-week adapted PA program. All participants were evaluated at the beginning and end of the program by anthropometric measurements, a subjective measure of the level of PA and a measure of physical condition. Results: Almost 86% of the participants were overweight and two-thirds were obese. Statistical analyses showed a significant improvement in physical condition, expressed by a better cardiorespiratory endurance (up to +14% for a 2 min walk test; MT0 = 78.1 m vs. MT1 = 89 m; p < 0.001 with a 2 min walk test), improved flexibility (+12.5%; MT0 = 2.4 vs. MT1 = 2.7; p < 0.001), and increased muscle strength in the lower limbs (+22.7%; MT0 = 11.9 vs. MT1 = 14.6; p < 0.001). The level of physical activity increased significantly for all participants (57.52% of inactive individuals at T0 vs. 5.31% at T1; p = 0.004). Correlational analyses revealed that the decrease in BMI and weight throughout the program correlated positively with age (r = 0.252 and p = 0.007, and r = 0.247 and p = 0.008, respectively) and negatively with BMI from baseline (r = −0.271; p = 0.004). Conclusions: The key points of this community-based PA program are the following: (1) It improves participants’ physical condition. (2) It improves anthropometric parameters. (3) It modifies physical activity behavior. Furthermore, in the context of the program set up specifically for this purpose, it would appear that elderly and overweight people are more likely to exhibit beneficial effects on anthropometric parameters than younger participants or those with a high level of obesity. However, these results need to be confirmed by a long-term evaluation of the effectiveness of such devices.
Full article
(This article belongs to the Special Issue Effectiveness of Physical Exercise for People with Chronic Diseases)
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Open AccessSystematic Review
Non-Fungible Tokens (NFTs) in Healthcare: A Systematic Review
by
Tiago Nunes, Paulo Rupino da Cunha, João Mendes de Abreu, Joana Duarte and Ana Corte-Real
Int. J. Environ. Res. Public Health 2024, 21(8), 965; https://doi.org/10.3390/ijerph21080965 - 24 Jul 2024
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Amid global health challenges, resilient health systems require continuous innovation and progress. Stakeholders highlight the critical role of digital technologies in accelerating this progress. However, the digital health field faces significant challenges, including the sensitivity of health data, the absence of evidence-based standards,
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Amid global health challenges, resilient health systems require continuous innovation and progress. Stakeholders highlight the critical role of digital technologies in accelerating this progress. However, the digital health field faces significant challenges, including the sensitivity of health data, the absence of evidence-based standards, data governance issues, and a lack of evidence on the impact of digital health strategies. Overcoming these challenges is crucial to unlocking the full potential of digital health innovations in enhancing healthcare delivery and outcomes. Prioritizing security and privacy is essential in developing digital health solutions that are transparent, accessible, and effective. Non-fungible tokens (NFTs) have gained widespread attention, including in healthcare, offering innovative solutions and addressing challenges through blockchain technology. This paper addresses the gap in systematic-level studies on NFT applications in healthcare, aiming to comprehensively analyze use cases and associated research challenges. The search included primary studies published between 2014 and November 2023, searching in a balanced set of databases compiling articles from different fields. A review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and strictly focusing on research articles related to NFT applications in the healthcare sector. The electronic search retrieved 1902 articles, ultimately resulting in 15 articles for data extraction. These articles span applications of NFTs in medical devices, pathology exams, diagnosis, pharmaceuticals, and other healthcare domains, highlighting their potential to eliminate centralized trust sources in health informatics. The review emphasizes the adaptability and versatility of NFT-based solutions, indicating their broader applicability across various healthcare stages and expansion into diverse industries. Given their role in addressing challenges associated with enhancing data integrity, availability, non-repudiation, and authentication, NFTs remain a promising avenue for future research within digital health solutions.
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![](https://pub.mdpi-res.com/ijerph/ijerph-21-00965/article_deploy/html/images/ijerph-21-00965-g001-550.jpg?1721811725)
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Open AccessArticle
PON1 Status in Relation to Gulf War Illness: Evidence of Gene–Exposure Interactions from a Multisite Case–Control Study of 1990–1991 Gulf War Veterans
by
Lea Steele, Clement E. Furlong, Rebecca J. Richter, Judit Marsillach, Patricia A. Janulewicz, Maxine H. Krengel, Nancy G. Klimas, Kimberly Sullivan and Linda L. Chao
Int. J. Environ. Res. Public Health 2024, 21(8), 964; https://doi.org/10.3390/ijerph21080964 - 24 Jul 2024
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Background: Deployment-related neurotoxicant exposures are implicated in the etiology of Gulf War illness (GWI), the multisymptom condition associated with military service in the 1990–1991 Gulf War (GW). A Q/R polymorphism at position 192 of the paraoxonase (PON)-1 enzyme produce PON1192 variants with
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Background: Deployment-related neurotoxicant exposures are implicated in the etiology of Gulf War illness (GWI), the multisymptom condition associated with military service in the 1990–1991 Gulf War (GW). A Q/R polymorphism at position 192 of the paraoxonase (PON)-1 enzyme produce PON1192 variants with different capacities for neutralizing specific chemicals, including certain acetylcholinesterase inhibitors. Methods: We evaluated PON1192 status and GW exposures in 295 GWI cases and 103 GW veteran controls. Multivariable logistic regression determined independent associations of GWI with GW exposures overall and in PON1192 subgroups. Exact logistic regression explored effects of exposure combinations in PON1192 subgroups. Results: Hearing chemical alarms (proxy for possible nerve agent exposure) was associated with GWI only among RR status veterans (OR = 8.60, p = 0.014). Deployment-related skin pesticide use was associated with GWI only among QQ (OR = 3.30, p = 0.010) and QR (OR = 4.22, p < 0.001) status veterans. Exploratory assessments indicated that chemical alarms were associated with GWI in the subgroup of RR status veterans who took pyridostigmine bromide (PB) (exact OR = 19.02, p = 0.009) but not RR veterans who did not take PB (exact OR = 0.97, p = 1.00). Similarly, skin pesticide use was associated with GWI among QQ status veterans who took PB (exact OR = 6.34, p = 0.001) but not QQ veterans who did not take PB (exact OR = 0.59, p = 0.782). Conclusion: Study results suggest a complex pattern of PON1192 exposures and exposure–exposure interactions in the development of GWI.
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Open AccessArticle
Psychological Distress and Associated Factors among Technical Intern Trainees in Japan: A Cross-Sectional Study
by
Ei Thinzar Khin, Yuko Takeda, Kazunari Iwata and Shuhei Nishimoto
Int. J. Environ. Res. Public Health 2024, 21(8), 963; https://doi.org/10.3390/ijerph21080963 - 23 Jul 2024
Abstract
Japan is experiencing significant demographic shifts due to an aging and declining population. In 1993, the Japanese Government introduced the Technical Intern Training Program (TITP) to accept foreign national workers. While the number of technical intern trainees under this program has constantly increased,
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Japan is experiencing significant demographic shifts due to an aging and declining population. In 1993, the Japanese Government introduced the Technical Intern Training Program (TITP) to accept foreign national workers. While the number of technical intern trainees under this program has constantly increased, many of them face challenges in their daily lives, such as stress, health insecurities and limited access to healthcare. Therefore, we conducted a cross-sectional study to assess the mental well-being of technical intern trainees, focusing on psychological distress and its related factors. This study included 304 technical intern trainees from 12 prefectures in Japan, and was conducted from August 2021 to October 2021. We used self-administered questionnaires in the participants’ native languages to assess their sociodemographic conditions, health-related conditions such as health insecurities and healthcare-seeking behaviors, and psychological distress. The K6 Kessler Psychological Distress Scale was applied to evaluate the levels of psychological distress. Among the participants, 26.3% had moderate psychological distress and 2.3% had severe psychological distress. In addition, about 15% of the participants reported health insecurities and did not see a doctor despite wanting to. The multivariate model of logistic regression revealed significant associations between psychological distress and female gender (AOR 2.62, 95% CI 1.12–6.12), nationality other than Vietnamese (AOR 4.85, 95% CI 2.60–9.07), tough financial conditions (AOR 2.23, 95% CI 1.18–4.19), experiencing health insecurity (AOR 2.21, 95% CI 1.04–4.66) and the health behavior of refraining from seeking medical care (AOR 3.06, 95% CI 1.49–6.30). The top reasons for refraining from seeking medical care were the participants’ limited knowledge about the healthcare system in Japan and their worries about medical bills. These findings highlight the necessity to extend mental health support services, including counseling services, and share information about Japan’s healthcare system to supply medical services to the targeted technical intern trainee population.
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(This article belongs to the Special Issue Associations between Mental Health and Intrapersonal, Interpersonal and Cultural Factors)
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Open AccessArticle
Ecotoxicological and Microbiological Risk Assessment of Groundwater from Dimba Cave, Democratic Republic of the Congo
by
Daniel M. Mudinga, Archal M. Ngandote, John M. Kayembe, Séraphin N. Lusamba, Emmanuel K. Atibu, Fernando P. Carvalho and John Poté
Int. J. Environ. Res. Public Health 2024, 21(8), 962; https://doi.org/10.3390/ijerph21080962 - 23 Jul 2024
Abstract
Dimba Cave is a large array of natural galleries in limestone mountains of the Democratic Republic of the Congo that contains highly valued pre-historic archaeological artifacts. The cave attracts a high number of tourists every year and is used by local populations as
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Dimba Cave is a large array of natural galleries in limestone mountains of the Democratic Republic of the Congo that contains highly valued pre-historic archaeological artifacts. The cave attracts a high number of tourists every year and is used by local populations as a water supply source. The main objective of the research undertaken in Dimba Cave consisted of assessing the quality of water and sediments from Dimba Cave ponds through evaluating contamination by heavy metals (15 elements analyzed, including As, Cd, Pb, and Hg) and by microbial populations (including Escherichia coli and total coliforms) in order to estimate the ecotoxicological risk to humans and to non-human biota. All water samples collected in the cave ponds showed very high metal concentrations exceeding the internationally recommended limits for drinking water, particularly for Cr, Mn, As, Pb, and Hg. Most sediment samples from cave ponds also displayed high heavy metal concentrations. The calculated pollution parameters, such as the enrichment factor (EF), and ecological risk parameters, such as the ecological risk index (Eri), indicated that the sediment may be toxic to aquatic biota. Furthermore, the microbiological analysis of pond waters indicated a widespread contamination with bacteria such as Escherichia coli, Enterococcus spp., total coliforms, and Pseudomonas spp., probably from anthropogenic and/or animal sources. Therefore, the consumption of Dimba Cave water as a drinking water represents a threat to public health. Urgent management measures should be enforced to protect public health and the cave ecosystem.
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(This article belongs to the Section Environmental Sciences)
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Open AccessReview
Characteristics of Sexual Health Programs for Migrants, Refugees, and Asylum Seekers: A Scoping Review
by
Angelina Bolyta Inthavong and Davoud Pourmarzi
Int. J. Environ. Res. Public Health 2024, 21(8), 961; https://doi.org/10.3390/ijerph21080961 - 23 Jul 2024
Abstract
Background: Social, cultural, and structural determinants of health for migrants, refugees, and asylum seekers can contribute towards poorer sexual health outcomes. People from migrant, refugee, and asylum seeker backgrounds usually use less mainstream sexual healthcare services and have lower levels of sexual health
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Background: Social, cultural, and structural determinants of health for migrants, refugees, and asylum seekers can contribute towards poorer sexual health outcomes. People from migrant, refugee, and asylum seeker backgrounds usually use less mainstream sexual healthcare services and have lower levels of sexual health literacy compared with the destination countries’ general population. However, there is little collated knowledge about sexual health programs that have been implemented to improve sexual health among these groups. This study aimed to describe the characteristics of programs for improving sexual health among migrants, refugees, and asylum seekers. Methods: This study was a scoping review in which Scopus and PubMed were searched for peer-reviewed articles published in English since 2010 from countries similar to and including Australia such as New Zealand, the United States of America, Canada, the United Kingdom, and European Union countries). The final search of databases was performed on 26 June 2023, and resultant studies were inputted into Endnote and Covidence systematic review software to remove duplicates before screening. The study utilised a qualitative approach using inductive thematic analysis of the content of the studies to extract and categorise the characteristics of the program. Results: A total of 3044 articles were screened and 20 were included for data extraction. The included studies were conducted in six countries (the United States of America, Australia, France, Italy, Denmark, and Belgium). The key characteristics of sexual health programs identified included consumer consultation and engagement, cultural appropriateness, language support, peer education, self-directed learning, group learning, financial support, and outreach services. the programs had a combination of these characteristics to ensure that they can improve target population engagement with educational materials and decrease barriers to accessing sexual healthcare. Conclusion: Consideration of migrants, refugees, and asylum seekers’ culture, language, socioeconomic characteristics, and access to information and services in the design of the sexual health programs may improve sexual health outcomes among these groups. However, further research is needed to assess the importance and implementation feasibility of the identified characteristics for sexual health programs in specific context.
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(This article belongs to the Topic Migration, Health and Equity)
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