International Journal of Environmental Research and Public Health

13 pages, 340 KiB

Open AccessArticle

Differences in COVID-19 Vaccination and Experiences among Patients with Hypertension in Colombia and Jamaica during the COVID-19 Pandemic

by Jacqueline P. Duncan, Siyi Geng, Carene Lindsay, Trevor S. Ferguson, Katherine T. Mills, Jose Patricio Lopez-Lopez, Hua He, Paola Lanza, Allison N. Marshall, Makeda J. Williams, Veronica Tonwe, Mabel Reyes, Alfonso Campo, Patricio Lopez-Jaramillo and Marshall K. Tulloch-Reid

Int. J. Environ. Res. Public Health 2024, 21(10), 1356; https://doi.org/10.3390/ijerph21101356 (registering DOI) - 15 Oct 2024

Abstract

During the COVID-19 pandemic, hypertensive patients had increased infection and healthcare disruption in many low- and middle-income countries (LMICs) with limited vaccine access. The objective of this report is to describe COVID-19 experiences and vaccination uptake among hypertensive patients in Colombia and Jamaica. [...] Read more.

During the COVID-19 pandemic, hypertensive patients had increased infection and healthcare disruption in many low- and middle-income countries (LMICs) with limited vaccine access. The objective of this report is to describe COVID-19 experiences and vaccination uptake among hypertensive patients in Colombia and Jamaica. A cross-sectional study of patients with hypertension was conducted in primary care clinics in both countries between 2021 and 2022. Trained interviewers used a telephone-administered questionnaire to assess COVID-19 experiences (infection, vaccination, and healthcare access). A total of 576 patients (68.5% female, mean age: 67.5 years) participated. Health service disruption affecting access to care was low (<10%). Compared to Jamaica, more participants from Colombia reported testing positive for COVID-19, having family members or friends testing positive, losing family members or friends due to COVID-19, and being vaccinated. In logistic regression models, adjusted for age, sex, education, and rural/urban clinic status, fear of COVID-19 (OR 2.7, 95% CI: 1.2–6.1) and residence in Colombia (OR 5.9, 95% CI: 2.4–14.6) were associated with higher vaccination uptake. Disparities in access to COVID-19 testing and diagnosis may have influenced these country differences including fear of COVID-19 and vaccine uptake. Other factors need to be better understood to prepare for future pandemic responses. Full article

(This article belongs to the Special Issue Advances in the Challenges and Opportunities of Global Public Health)

16 pages, 641 KiB

Open AccessReview

Lesbian and Gay Population, Work Experience, and Well-Being: A Ten-Year Systematic Review

by Marina Lacatena, Ferdinando Ramaglia, Federica Vallone, Maria Clelia Zurlo and Massimiliano Sommantico

Int. J. Environ. Res. Public Health 2024, 21(10), 1355; https://doi.org/10.3390/ijerph21101355 - 14 Oct 2024

Abstract

Despite an increase in the promotion of equal opportunities at work, there is still persistent discrimination against lesbian and gay (LG) workers. In this vein, this study aimed to systematically review the research investigating the peculiarities of the work experience of LG people, [...] Read more.

Despite an increase in the promotion of equal opportunities at work, there is still persistent discrimination against lesbian and gay (LG) workers. In this vein, this study aimed to systematically review the research investigating the peculiarities of the work experience of LG people, particularly considering the theoretical frameworks in the approach to sexual minorities’ work-related issues, as well as individual and contextual variables influencing the work experience and the impact they may have on health and well-being. We explored the PsycArticles, EMBASE, Scopus, and Web of Science electronic databases and the EBSCOHost (PsycInfo, Psychology and Behavioral Sciences Collection) scholarly search engine, between 01/01/2013 to 01/03/2023, with regards to the search terms “lgb*”, “gay*”, “lesbian*”, “homosexual*”, and “sexual minorit*”, associated with “employee*”, ”personnel”, “worker*”, and “staff”, and with “workplace”, “work”, “job”, “occupation”, “employment”, and “career”. Data were narratively synthesized and critically discussed. Of the 1584 potentially eligible articles, 140 papers contributed to this systematic review. Five main theoretical frameworks were identified: (a) minority stress, (b) sexual prejudice and stigma, (c) queer and Foucauldian paradigms, (d) social identity theories, and (e) intersectionality. Furthermore, significant individual (e.g., outness, disclosure, and work–family conflict) and contextual (e.g., heterosexist and heteronormative workplace climate and culture) variables influencing LG people’s work experience were identified. This review highlights the need to develop a unified theoretical model for the construction of specific measurement tools to assess the work experience of LG people and for the implementation of interventions aimed at minimizing the effects of stigma in work contexts. Full article

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15 pages, 1036 KiB

Open AccessArticle

Efficacy of a Telephone-Intervention on Caregiving Burden and Mental Health among Family Caregivers of Persons with Dementia in Malaysia: A Randomized Controlled Trial

by Syarifah Amirah Binti Syed Ahmad, Zarina Nahar Kabir, Marie Tyrrell, Åsa Craftman and Hashima E. Nasreen

Int. J. Environ. Res. Public Health 2024, 21(10), 1354; https://doi.org/10.3390/ijerph21101354 - 13 Oct 2024

Abstract

Identifying effective and accessible interventions for family caregivers of persons with dementia (PWD) is crucial as the prevalence of dementia increases in Asia. This study investigated the efficacy of a telephone-intervention on the reduction in caregiver burden, as well as depressive and anxiety [...] Read more.

Identifying effective and accessible interventions for family caregivers of persons with dementia (PWD) is crucial as the prevalence of dementia increases in Asia. This study investigated the efficacy of a telephone-intervention on the reduction in caregiver burden, as well as depressive and anxiety symptoms among family caregivers (FCs) of PWD in Malaysia. A single-blinded randomized controlled trial was carried out with 121 FCs of PWD selected from memory or psychiatry clinics in three tertiary hospitals in Malaysia, who were randomly allocated into the intervention or control group. The intervention group received the psychoeducational intervention delivered by healthcare staff via telephone for 10 sessions over 12 weeks. The outcome of the intervention was measured by the Malay version of the Zarit Burden Interview and the Hospital Anxiety and Depression Scale at baseline and post-intervention. An intention to treat analysis shows that caregiver burden, anxiety symptoms, and psychological distress among FCs in the intervention group decreased by 7.57 units (p < 0.001), 2.46 units (p < 0.001), and 2.98 units (p = 0.011), respectively, at post-intervention, compared to the differences from baseline to post-intervention in the control group. Policies aimed at integrating the telephone-intervention into memory/psychiatry clinics in Malaysia may help FCs of PWD to reduce their caregiver burden and stress while caring for a family member with dementia. Full article

(This article belongs to the Special Issue Family Caregiving of Older Adults)

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15 pages, 947 KiB

Open AccessArticle

Early Socioemotional Difficulty as a Childhood Barrier to the Expected Benefits of Active Play: Associated Risks with School Engagement in Adolescence

by Laurie-Anne Kosak, Kianoush Harandian, Simon L. Bacon, Isabelle Archambault, Luca Correale and Linda S. Pagani

Int. J. Environ. Res. Public Health 2024, 21(10), 1353; https://doi.org/10.3390/ijerph21101353 - 13 Oct 2024

Abstract

Active play allows children to develop social and cognitive skills, which could lead to higher school engagement. Little is known about the role of child socioemotional difficulty in these associations. This study aims to examine the interaction between active play and socioemotional difficulty [...] Read more.

Active play allows children to develop social and cognitive skills, which could lead to higher school engagement. Little is known about the role of child socioemotional difficulty in these associations. This study aims to examine the interaction between active play and socioemotional difficulty in childhood and their prospective association with academic engagement in adolescence. The participants were 4537 children (51.1% boys) who were longitudinally followed, between ages 6 and 14 years, from the National Longitudinal Study on Children and Youth (NLSCY), Canada. Active play (weekly organized sport and unstructured physical activity outside of school hours) and child behavior (hyperactivity, anxiety, and relational difficulties) were reported by mothers for their children at age 6 years. Academic engagement was self-reported at age 14 years. Unstructured physical activity predicted lower subsequent school engagement for boys (β = −0.057, p < 0.05). Boys with high anxiety symptoms and high relational aggression who participated in more unstructured physical activity in childhood were subsequently less engaged in school (respectively, β = −0.066, p < 0.05 and β = −0.062, p < 0.05). Girls who partook in more organized sports showed lower school engagement in adolescence when they had high anxiety symptoms (β = −0.067, p < 0.05). Although past studies have highlighted the contribution of active play to school engagement, certain socioemotional difficulties could impede the child’s ability to reap its benefits. Full article

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

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8 pages, 294 KiB

Open AccessArticle

Analyzing Social Support from Facebook on Viral Suppression among Young Black Men Who Have Sex with Men Living with HIV: A Pilot Study

by Eleanor E. Friedman, Natascha Del Vecchio, Joseph A. Mason, Samantha A. Devlin, Jessica P. Ridgway and John A. Schneider

Int. J. Environ. Res. Public Health 2024, 21(10), 1352; https://doi.org/10.3390/ijerph21101352 - 12 Oct 2024

Abstract

Social support has been associated with viral suppression among persons living with HIV (PWH). We examined cross-sectional data from young Black men who have sex with men to see if sociodemographic factors, medical history, and egocentric Facebook social support measures are related to [...] Read more.

Social support has been associated with viral suppression among persons living with HIV (PWH). We examined cross-sectional data from young Black men who have sex with men to see if sociodemographic factors, medical history, and egocentric Facebook social support measures are related to viral suppression. Differences between participants were examined using Chi-square, Fisher’s exact, or Wilcoxon Rank Sum Tests, with significance set at p = 0.10. Degree centrality (p = 0.074) and Eigenvector centrality (p = 0.087) were significant, indicating that PWH with unsuppressed viral loads had more social connections. These results contrast prior studies in the literature. Further research on online social support for PWH is needed. Full article

19 pages, 1954 KiB

Open AccessArticle

Spatial–Temporal Patterns in the Enteric Pathogen Contamination of Soil in the Public Environments of Low- and Middle-Income Neighborhoods in Nairobi, Kenya

by Fanta D. Gutema, Bonphace Okoth, John Agira, Christine S. Amondi, Phylis J. Busienei, Sheillah Simiyu, Blessing Mberu, Daniel Sewell and Kelly K. Baker

Int. J. Environ. Res. Public Health 2024, 21(10), 1351; https://doi.org/10.3390/ijerph21101351 - 12 Oct 2024

Abstract

Public spaces in countries with limited societal development can be contaminated with feces containing pathogenic microbes from animals and people. Data on contamination levels, spatial distribution, and the diversity of enteric pathogens in the public settings of low- and middle-income neighborhoods are crucial [...] Read more.

Public spaces in countries with limited societal development can be contaminated with feces containing pathogenic microbes from animals and people. Data on contamination levels, spatial distribution, and the diversity of enteric pathogens in the public settings of low- and middle-income neighborhoods are crucial for devising strategies that minimize the enteric infection burden. The objective of this study was to compare spatial–temporal differences in the detection rate and diversity of enteric pathogens in the public spaces of low- and middle-income neighborhoods of Nairobi, Kenya. TaqMan array card (TAC) molecular assays were employed to analyze soil samples for 19 enteropathogens, along with a selective bacterial culture for pathogenic Enterobacteriaceae. An observational assessment was conducted during every site visit to document the hygienic infrastructure and sanitation conditions at the sites. We detected at least one pathogen in 79% (127/160) and ≥2 pathogens in 67.5% (108/160) of the soil samples tested. The four most frequently detected pathogens were EAEC (67.5%), ETEC (59%), EPEC (57.5%), and STEC (31%). The detection rate (91% vs. 66%) and mean number of enteric pathogens (5 vs. 4.7) were higher in low-income Kibera than in middle-income Jericho. The more extensive spatial distribution of pathogens in Kibera resulted in increases in the detection of different enteric pathogens from within-site (area < 50 m²) and across-site (across-neighborhood) movements compared to Jericho. The pathogen detection rates fluctuated seasonally in Jericho but remained at sustained high levels in Kibera. While better neighborhood conditions were linked with lower pathogen detection rates, pathogenic E. coli remained prevalent in the public environment across both neighborhoods. Future studies should focus on identifying how the sources of pathogen contamination are modified by improved environmental sanitation and hygiene and the role of these contaminated public environments in enteric infections in children. Full article

(This article belongs to the Section Environmental Health)

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19 pages, 20820 KiB

Open AccessArticle

Massive Education in Prison Health in Brazil: A Look Beyond the Walls

by Janaina L. R. da S. Valentim, Sara Dias-Trindade, Aline de P. Dias, Alexandre R. Caitano, Laysa G. de S. Nunes, Manoel H. Romão, Felipe Fernandes, Nícolas V. R. Veras, Kelson C. Medeiros, Ronaldo S. Melo, Edneide da C. Bezerra, Antonio Quintas-Mendes, Marilyn A. A. Bonfim, Alcindo A. Ferla, Ricardo B. Ceccim and Ricardo A. M. Valentim

Int. J. Environ. Res. Public Health 2024, 21(10), 1350; https://doi.org/10.3390/ijerph21101350 - 11 Oct 2024

Abstract

Equal access to health initiatives and services under the principles of universal and comprehensive care remains a challenge in Brazil. The realization of public health policies is further intricate when one examines the health situation of people deprived of liberty. This study showcases [...] Read more.

Equal access to health initiatives and services under the principles of universal and comprehensive care remains a challenge in Brazil. The realization of public health policies is further intricate when one examines the health situation of people deprived of liberty. This study showcases the “Prison System: Beyond the Walls” educational pathway, available on the Virtual Learning Environment of the Brazilian National Health System (AVASUS). The action research methodological strategy guided the pathway development, emphasizing dialogic learning. The goal was to address the need for massive training on the topic of prison health, with the model focusing on engagement through spontaneous, non-mandatory participation in the pathway courses. The pathway comprised four modules, whose educational offerings were based on the self-learning model. Students were free to choose which courses to take and in what order, as there was no prerequisite for participating in modules. Hence, students could either take all the courses or only those with which they identify their learning needs, regardless of work demands or personal interests. Structuring the pathway through action research facilitated a massive, cohesive, and continuous training process. This approach expanded knowledge and established meaningful relationships among the related topics and the key players involved: health professionals, prison officers, and people deprived of liberty. Notably, the pathway courses have surpassed the 50,000-enrollment mark, spanning all five regions of Brazil. In this context, this article presents and discusses the development of the “Prison System: Beyond the Walls” pathway, emphasizing the massive improvement of health within Brazil’s prison system and highlighting the results achieved. Full article

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10 pages, 628 KiB

Open AccessArticle

The Relationship between Components of Postural Control and Locomotive Syndrome in Older Adults

by Charupa Lektip, Chadapa Rungruangbaiyok, Jiraphat Nawarat, Eiji Miyake, Keiichiro Aoki, Hiroyuki Ohtsuka, Yasuko Inaba, Yoshinori Kagaya and Sirawee Chaovalit

Int. J. Environ. Res. Public Health 2024, 21(10), 1349; https://doi.org/10.3390/ijerph21101349 - 11 Oct 2024

Abstract

Locomotive Syndrome (LS), a condition related to impaired mobility, is influenced by balance control, which comprises six components. Deficiencies in these components can lead to reduced mobility and decreased quality of life. This study aimed to evaluate the relationship between the components of [...] Read more.

Locomotive Syndrome (LS), a condition related to impaired mobility, is influenced by balance control, which comprises six components. Deficiencies in these components can lead to reduced mobility and decreased quality of life. This study aimed to evaluate the relationship between the components of postural control and LS in older adults using the Brief-BESTest. Therefore, this cross-sectional study involved 122 elderly participants from Tha Sala District, Nakhon Si Thammarat Province, both with and without LS. Participants underwent assessments using the Instrumental Activities of Daily Living (IADL) assessment, the Thai Mental State Examination (TMSE), the Two-Step Test, and the Brief-BESTest. The Brief-BESTest covers six balance components: Biomechanical Constraints, Stability Limits, Anticipatory Postural Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait. Descriptive statistics were used to summarize participant characteristics, and Chi-square tests were conducted to examine the relationship between each balance component and LS. Cramer’s V was used to assess the strength of the relationships. The results showed the average age of the sample was 67.67 ± 6.01 years with 85.20 percent female and 14.80 percent male. There were significant relationships between LS and three balance components: Biomechanical Constraints (Chi-square = 5.35, p = 0.021, Cramer’s V = 0.209), Stability Limits (Chi-square = 5.00, p = 0.025, Cramer’s V = 0.204), and Anticipatory Postural Adjustments (left: Chi-square = 4.12, p = 0.042, Cramer’s V = 0.213; right: Chi-square = 5.50, p = 0.019, Cramer’s V = 0.213). No significant associations were found for Reactive Postural Response, Sensory Orientation, and Stability in Gait. These findings suggest that targeted interventions focusing on specific balance components consist of Biomechanical Constraints, Stability Limits, and Anticipatory Postural Adjustments could help reduce the risk of LS in older adults. Full article

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17 pages, 373 KiB

Open AccessArticle

Perceived Importance of Types and Characteristics of Support to Informal Caregivers among Spouse Caregivers of Persons with Dementia in Sweden: A Cross-Sectional Questionnaire-Based Study

by Marcus F. Johansson, Kevin J. McKee, Lena Dahlberg, Christine L. Williams and Lena Marmstål Hammar

Int. J. Environ. Res. Public Health 2024, 21(10), 1348; https://doi.org/10.3390/ijerph21101348 - 11 Oct 2024

Abstract

Informal caregivers play a crucial role in the care of individuals with dementia, and their caregiving may significantly impact their own health and well-being. This cross-sectional survey study focuses on the perceived importance of various types and characteristics of formal support in a [...] Read more.

Informal caregivers play a crucial role in the care of individuals with dementia, and their caregiving may significantly impact their own health and well-being. This cross-sectional survey study focuses on the perceived importance of various types and characteristics of formal support in a convenience sample of caregivers aged 65 years or older (N = 175) caring for a spouse with dementia. Participants completed a questionnaire containing 17 items describing different types of support and 12 items describing different characteristics of support, rating their importance. The questionnaire also contained questions on various caregiving-related factors. Principle components analysis (PCA) was carried out on the importance ratings, separately, on the types of support items and the characteristics of support items. Each PCA produced three components. For types of support, they were Proficiency and Opportunity, Supportive Structures, Flexible Counselling. For characteristics of support, they included Respectful and Competent, Timely Support, and Accessible and Acceptable. The three characteristics of the support components all had higher mean importance ratings than the three types of support components. The content of some components indicated that while spouse caregivers rate support for their caregiving needs as important, they may not always differentiate their own needs from those of their partner with dementia. The negative impact of caregiving was the factor most strongly and consistently associated with the components’ importance ratings. This study emphasizes the need for health and social care providers to address the unique needs of spouse caregivers while simultaneously ensuring the delivery of quality care for individuals with dementia. Full article

(This article belongs to the Special Issue Family Caregiving of Older Adults)

14 pages, 890 KiB

Open AccessReview

Resilience Mechanisms and Coping Strategies for Forcibly Displaced Youth: An Exploratory Rapid Review

by Akm Alamgir, Christopher Kyriakides, Andrew Johnson, Gemechu Abeshu, Bay Bahri and Miles Abssy

Int. J. Environ. Res. Public Health 2024, 21(10), 1347; https://doi.org/10.3390/ijerph21101347 - 11 Oct 2024

Abstract

Context: The global escalation of conflict, violence, and human rights violations sets a pressing backdrop for examining the resilience of forcibly displaced youth (FDY) in Canada. This study aims to unpack the multifaceted challenges and resilience mechanisms of FDY, focusing on their health, [...] Read more.

Context: The global escalation of conflict, violence, and human rights violations sets a pressing backdrop for examining the resilience of forcibly displaced youth (FDY) in Canada. This study aims to unpack the multifaceted challenges and resilience mechanisms of FDY, focusing on their health, well-being, and integration into host communities. It seeks to identify current models of resilience, understand the factors within each model, and highlight gaps and limitations. Methodology: Using a university librarian-supported structured search strategy, this exploratory rapid review searched literature from Ovid Medline and open-source databases, published in English between January 2019 and January 2024, that fit specific inclusion criteria. The eligible articles (N = 12 out of 4096) were charted and analyzed by two student researchers with the Principal Investigator (PI). Charted data were analyzed thematically. Results: The selected studies captured diverse geographical perspectives, resilience models (such as Ungar’s ecological perspective and Masten’s resilience developmental models), as well as protective and promotive frameworks. Key findings indicate the complexity of resilience influenced by individual, familial, societal, and cultural factors. Each model offers insights into the dynamic interplay of these influences on FDY’s resilience. However, these models often fall short of addressing the nuances of cultural specificity, the impact of trauma, and the intersectionality of FDY’s identities. Conclusions: Recognizing the diverse and evolving nature of FDY’s coping mechanisms, this study advocates for a culturally appropriate approach to resilience that integrates an intersectionality framework of individual attributes and culturally sensitive models. Full article

(This article belongs to the Special Issue Migrant Health and Newly Emerging Public Health Issues)

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19 pages, 751 KiB

Open AccessArticle

Developing Self-Compassion in Healthcare Professionals Utilising a Brief Online Intervention: A Randomised Waitlist Control Trial

by Amanda Super, Joanna Yarker, Rachel Lewis, Samuel Keightley, Denvar Summers and Fehmidah Munir

Int. J. Environ. Res. Public Health 2024, 21(10), 1346; https://doi.org/10.3390/ijerph21101346 - 11 Oct 2024

Abstract

(1) Background: The level of stress experienced by staff in the healthcare sector is highly prevalent and well documented. Self-compassion may support the health and wellbeing of individuals and enable them to stay well at work. This study aimed to understand whether a [...] Read more.

(1) Background: The level of stress experienced by staff in the healthcare sector is highly prevalent and well documented. Self-compassion may support the health and wellbeing of individuals and enable them to stay well at work. This study aimed to understand whether a brief, online, self-guided, novel intervention improved the health and wellbeing of healthcare professionals. (2) Methods: In a parallel randomised controlled trial, a volunteer sample of healthcare professionals were assigned to an intervention group (n = 110) or a waitlist control group (n = 80). Measures of self-compassion, mental wellbeing, stress and burnout were collected by an online questionnaire at baseline, post-programme and, for the intervention group, at follow-up. (3) Results: This intervention appeared to be effective in increasing self-compassion and mental health and decreasing stress and burnout. Significant group effects and significant time × group interactions for overall self-compassion [F (2, 183) = 32.72, p < 0.001; effect size η_p² = 0.226], mental wellbeing [F (2, 212) = 17.46, p < 0.001; effect size η_p² = 0.135], perceived stress [F (2, 205) = 5.42, p = 0.006; effect size η_p² = 0.46], personal burnout [F (2, 224) = 7.57, p = 0.001; effect size η_p² = 0.063] and work burnout [F (2, 208) = 7.39, p = 0.001; effect size η_p² = 0.062] were found. (4) Conclusions: This study shows promise that an affordable and scalable intervention can be effective for busy healthcare professionals operating in a significantly challenging environment. Full article

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13 pages, 331 KiB

Open AccessArticle

The Association between Post-Traumatic Stress Disorder and Problematic Alcohol and Cannabis Use in a Multi-Ethnic Cohort in The Netherlands: The HELIUS Study

by Christin Kühner, Joanne P. Will, Sera A. Lortye, Henrike Galenkamp, Anja Lok, Mirjam van Zuiden, Arnoud R. Arntz, Kathleen Thomaes, Anna E. Goudriaan and Marleen M. de Waal

Int. J. Environ. Res. Public Health 2024, 21(10), 1345; https://doi.org/10.3390/ijerph21101345 - 11 Oct 2024

Abstract

(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been [...] Read more.

(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been investigated. (2) Methods: Self-report data on problematic alcohol/cannabis use (AUDIT/CUDIT) and presence of severe PTSD symptoms (PSS-SR) of N = 22,841 participants of Dutch (n = 4610), South-Asian Surinamese (n = 3306), African Surinamese (n = 4349), Ghanaian (n = 2389), Turkish (n = 3947), and Moroccan (n = 4240) origin were available from the HELIUS study. (3) Results: We found a positive association between the presence of severe PTSD symptoms and problematic alcohol and cannabis use. Ethnicity did not moderate the association between the presence of severe PTSD symptoms and problematic alcohol/cannabis use. (4) Conclusions: We demonstrated the relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use in a multi-ethnic sample. The relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use was similar between ethnic groups. We recommend screening for PTSD symptoms in those exhibiting problematic substance use and vice versa, regardless of ethnic background. Full article

(This article belongs to the Special Issue Substance Use Research Methods: Ethics, Culture, and Health Equity)

14 pages, 287 KiB

Open AccessArticle

Cultural Practices of Mothers and Babies during the Postnatal Period: A Qualitative Study in Rural Bangladesh

by Nusrat Jahan and Md Shahidul Islam

Int. J. Environ. Res. Public Health 2024, 21(10), 1344; https://doi.org/10.3390/ijerph21101344 - 11 Oct 2024

Abstract

This study describes the experiences of women in rural Bangladesh, and the cultural practices related to how they take care of themselves and their babies, in the early postnatal period. Data were gathered through immersion in the field for six months, participant observation, [...] Read more.

This study describes the experiences of women in rural Bangladesh, and the cultural practices related to how they take care of themselves and their babies, in the early postnatal period. Data were gathered through immersion in the field for six months, participant observation, document collection and in-depth interview techniques to gain a deep understanding of women’s everyday lives and practices during the postnatal period. In-depth interviews were undertaken with 28 mothers who had had at least one live child within the five years before the date of data collection, in Purba Sharifabad village of the Barisal Division in Bangladesh. The key findings of this study highlight the role of culture in the experiences of women during the postnatal period, and reveal that cultural practices, beliefs and traditions are deeply embedded in the lives of rural women. This study focuses on cultural practices which have an effect on the choices of women regarding care and support from healthcare facilities. Culture, together with poverty and low levels of education, leads them to resist healthcare from a skilled birth attendant and encourages them to believe in and trust traditional care practices during the postnatal period. Therefore, the findings of this study may contribute to future policies, planning, programs and research in Bangladesh by providing an understanding of the importance of culturally and socially rooted traditional beliefs and cultural practices. These need to be addressed for maternal and newborn healthcare initiatives to be effective, particularly in rural Bangladesh. Full article

14 pages, 1364 KiB

Open AccessArticle

Food Insecurity and Women’s Choice of Reversible Contraceptives: Differential Effects by Maternal Age

by Otobo I. Ujah, Pelumi Olaore and Russell S. Kirby

Int. J. Environ. Res. Public Health 2024, 21(10), 1343; https://doi.org/10.3390/ijerph21101343 - 10 Oct 2024

Abstract

We investigated the relationships between food insecurity (FI) and women’s choice of reversible contraceptives, overall and according to the level of method effectiveness, among partnered women of reproductive age in Nigeria. This population-based cross-sectional analysis used nationally representative data from Round 6 of [...] Read more.

We investigated the relationships between food insecurity (FI) and women’s choice of reversible contraceptives, overall and according to the level of method effectiveness, among partnered women of reproductive age in Nigeria. This population-based cross-sectional analysis used nationally representative data from Round 6 of the UNICEF-supported Multiple Indicator Cluster Survey (MICS) conducted in Nigeria. The sample included married or in-union women aged 15–49 years who reported a live birth in the last 2 years preceding the survey (unweighted N = 8496). Survey-weighted multivariable binomial and multinomial logistic regression analyses were performed to generate estimates of the association between FI (none, moderate, and severe) and reversible contraceptive use (overall and by method effectiveness). A Bonferroni correction was used to account for multiple testing. We stratified the models by maternal age to describe the experiences of women aged 15–24 years, 25–34 years, and 35–49 years. Overall, 6438 (74.1%) of the women in the sample experienced food insecurity (moderate, n = 2559, 30.7%; severe, n = 3879, 43.4%). In the adjusted model, we observed no statistically significant association between experiencing MFI and SFI and the use of reversible contraceptives (overall and specific) after adjustment for multiple testing. The stratified analyses showed that among women aged 25–34 years in the sample, those experiencing SFI in the past 12 months, compared to their food-secure counterparts, had significantly lower odds of reporting the use of a least effective contraceptive method (OR, 0.53; 95% CI, 0.34–0.83; p = 0.0052). However, this failed to reach the significance threshold upon adjustment for multiple testing. We found no significant association between the FI levels and use of reversible contraceptives (overall and specific) among partnered women (15–49 years) in Nigeria who were 2 years postpartum following a live birth and who were at risk of pregnancy. Full article

(This article belongs to the Section Global Health)

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20 pages, 1000 KiB

Open AccessArticle

The Geographical Conditioning of Regional Differentiation Characterising the COVID-19 Pandemic in European Countries

by Marcin Mazur, Jerzy Bański and Wioletta Kamińska

Int. J. Environ. Res. Public Health 2024, 21(10), 1342; https://doi.org/10.3390/ijerph21101342 - 10 Oct 2024

Abstract

The aim of this paper is to assess the influence of selected geographical factors on the diversity of the development of the COVID-19 pandemic in Europe’s regions, and on its dynamics across the continent. The work took into account 250 of NUTS-2 regions. [...] Read more.

The aim of this paper is to assess the influence of selected geographical factors on the diversity of the development of the COVID-19 pandemic in Europe’s regions, and on its dynamics across the continent. The work took into account 250 of NUTS-2 regions. The datasets included the course of the COVID-19 pandemic (two dependent variables), intervening actions (four variables of the research background), and potential environmental and socio-economic conditioning (twelve independent variables). The dependent variables’ set was composed of two indexes: morbidity and temporal inertia. The temporal scope of the research was 23 March 2020–15 May 2022, with weekly resolution. By means of multiple linear regression model, the influence of the administrative actions and of the selected natural and socio-economic factors was assessed. Finally, a synthetic Regional Epidemic Vulnerability Index (REVI) for each individual region was calculated. It allowed us to classify the regions into three categories: resistant, neutral, or sensitive. REVI’s spatial distribution indicates that the zone of above-average vulnerability occurred in the western part of Europe and around the Alps. Therefore, focus ought to extend beyond regional statistics, towards spatial relationships, like contiguous or transit position. This research also validated the strong impact of national borders. Full article

(This article belongs to the Special Issue Health Geography’s Contribution to Environmental Health Research)

15 pages, 368 KiB

Open AccessArticle

Shaping Public Servant Well-Being: Lessons from Brazil’s SIASS Program

by Marcos Massaki Imamura, Gabrielly de Queiroz Pereira, José Roberto Herrera Cantorani and Luiz Alberto Pilatti

Int. J. Environ. Res. Public Health 2024, 21(10), 1341; https://doi.org/10.3390/ijerph21101341 - 10 Oct 2024

Abstract

This study aims to identify how the health and well-being of public servants are promoted and managed at the Federal University of Technology—Paraná (UTFPR). The Integrated Subsystem for Attention to the Health of Public Servants (SIASS), established by the federal government in 2009, [...] Read more.

This study aims to identify how the health and well-being of public servants are promoted and managed at the Federal University of Technology—Paraná (UTFPR). The Integrated Subsystem for Attention to the Health of Public Servants (SIASS), established by the federal government in 2009, is an initiative that integrates health actions, work safety, and social assistance. This qualitative study utilized the analysis of institutional documents and semi-structured interviews with managers involved in SIASS implementation at the UTFPR. The analysis reveals that, despite the creation of the SIASS, the UTFPR faces challenges such as resource scarcity, reliance on procurement processes, and a reactive rather than preventive approach to occupational health issues. The structural diversity across campuses and the lack of systematic evaluation of working conditions further limit the effectiveness of policies. It is recommended that the UTFPR adopt a more integrated, data-driven, and proactive approach to occupational health management. Strengthening interinstitutional partnerships, optimizing resource allocation, and developing continuous evaluation systems are essential steps to ensure a work environment that effectively promotes the health and well-being of its employees. Full article

(This article belongs to the Special Issue Workplace Health and Wellbeing Research and Evaluation)

12 pages, 514 KiB

Open AccessArticle

Impact of Weight Status on Hemodynamic Parameters and Aerobic Fitness in School-Aged Children: A Study in a Rural School Community

by Ncomi Primrose Lukhele, Lourens Millard and Gerrit Jan Breukelman

Int. J. Environ. Res. Public Health 2024, 21(10), 1340; https://doi.org/10.3390/ijerph21101340 - 10 Oct 2024

Abstract

Maintaining a high level of physical activity provides significant health benefits for children, particularly in enhancing cardiorespiratory fitness and maintaining a healthy weight. This study aimed to investigate the impact of weight status on children’s hemodynamic parameters and aerobic fitness levels. This cross-sectional [...] Read more.

Maintaining a high level of physical activity provides significant health benefits for children, particularly in enhancing cardiorespiratory fitness and maintaining a healthy weight. This study aimed to investigate the impact of weight status on children’s hemodynamic parameters and aerobic fitness levels. This cross-sectional study included 350 rural primary school children (146 boys and 204 girls) aged 11–13 years, randomly selected from two schools in the King Cetshwayo District, KwaDlangezwa area of KwaZulu-Natal. The anthropometric measurements recorded included height, weight, waist circumference, and hip circumference, with percentiles calculated using Cole’s Lambda, Mu, and Sigma method. Additionally, skinfold measurements were obtained at four sites (biceps, triceps, subscapular, and suprailiac). Hemodynamic measurements included systolic blood pressure, diastolic blood pressure, and heart rate. Aerobic fitness was assessed using the 20 m shuttle run test, which evaluated speed, level, and age. The healthy group demonstrated significantly lower ratios in several measurements compared to those of the overweight group, i.e., the VO₂max was 6% higher (<0.001), the waist-to-hip ratio was 6% lower (<0.001), the body fat percentage was 16% lower (<0.001), the waist circumference was 12% lower (<0.001), and the resting heart rate was 3% lower (p ≤ 0.055). Differences in systolic and diastolic blood pressure were also observed, with the systolic pressure 2% lower (p ≤ 0.116) and the diastolic pressure 3% lower (p ≤ 0.086) in the healthy group. The study revealed a significant association between body weight status, aerobic fitness, and blood pressure parameters. Conducted in rural primary schools in KwaDlangezwa, KwaZulu-Natal, the research highlights notable correlations among weight status, aerobic competence, and blood pressure (BP) in children aged 11 to 13 years. The findings indicate that children with a healthy body weight showed higher VO₂max levels and a reduced risk of developing childhood obesity and hypertension, unlike their overweight or obese peers, who displayed lower aerobic fitness and higher blood pressure. Full article

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14 pages, 319 KiB

Open AccessReview

Autoimmune Health Crisis: An Inclusive Approach to Addressing Disparities in Women in the United States

by Syreen Goulmamine, Sarah Chew and Irene O. Aninye

Int. J. Environ. Res. Public Health 2024, 21(10), 1339; https://doi.org/10.3390/ijerph21101339 - 10 Oct 2024

Abstract

Autoimmune diseases are identified by the chronic inflammation and tissue damage resulting from unregulated immune responses throughout the body. Systemic lupus erythematosus, type 1 diabetes mellitus, and Hashimoto’s thyroiditis are among the 80+ characterized conditions, 80% of which are diagnosed in women. The [...] Read more.

Autoimmune diseases are identified by the chronic inflammation and tissue damage resulting from unregulated immune responses throughout the body. Systemic lupus erythematosus, type 1 diabetes mellitus, and Hashimoto’s thyroiditis are among the 80+ characterized conditions, 80% of which are diagnosed in women. The compounded effects of biological sex and hormones; social identities, such as age, race, and gender; and other determinants on health highlight a pressing need for an inclusive approach to address disparities for women living with autoimmune diseases. Such an approach must recognize and incorporate intersectional experiences of diverse populations of women into biomedical research, clinical practice, and policy solutions. Research must prioritize inclusive designs, data collection, and representation of women in clinical studies. Clinical care must focus on developing guidelines and promoting patient–provider interactions that meet a range of demographic needs. Health care policies must support financial investments in research and equitable access to care. This review provides an overview of the impacts of autoimmune diseases on women’s health through an intersectional lens, identifies persistent gaps in addressing the unique needs of women, and proposes recommendations for a comprehensive, equity-focused approach to mitigate disparities and better serve all women at risk for or living with autoimmune diseases. Full article

(This article belongs to the Special Issue Challenging Health Disparities through the Promotion of Health Equity)

21 pages, 336 KiB

Open AccessArticle

British South Asian and Muslim Community’s Perceptions and Experiences of Addiction and Traditional Drug and Alcohol Treatment Services

by Zeibeda Sattar, Lydia Lochhead, Hayley Alderson, Monique Lhussier, Ruth McGovern and William McGovern

Int. J. Environ. Res. Public Health 2024, 21(10), 1338; https://doi.org/10.3390/ijerph21101338 - 10 Oct 2024

Abstract

Within traditional drug and alcohol (D&A) treatment services, the majority of those accessing support are of white ethnicity, with only a small percentage of people from the British South Asian (BSA) and Muslim community engaging in treatment services. This paper aims to explore [...] Read more.

Within traditional drug and alcohol (D&A) treatment services, the majority of those accessing support are of white ethnicity, with only a small percentage of people from the British South Asian (BSA) and Muslim community engaging in treatment services. This paper aims to explore perceived barriers to accessing traditional D&A services within the British South Asian and Muslim communities, based on qualitative data from interviews with family members and a practitioner. Qualitative data were obtained via 11 semi-structured interviews involving a practitioner (n = 1), and family and friends (n = 10) of those with historic and current D&A use in the community. Reflexive thematic analysis revealed four themes: (1) awareness of drug and alcohol use in the community, (2) drug and alcohol use as a taboo topic and the impact of admitting use, (3) knowledge of services for treatment, (4) how to increase awareness and accessibility of treatment. There was an increasing awareness of D&A use in the BSA and Muslim community. Despite this, limited conversations and misconceptions around D&A use and recovery led to those using D&A and their family members feeling stigmatised within their community and unable to seek support. This paper concludes by recommending increased communication between the BSA and Muslim communities and D&A treatment services to ensure accessibility of treatment by improving cultural competency. Full article

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

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