International Journal of Environmental Research and Public Health

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 (registering DOI) - 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, 285 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

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)

21 pages, 404 KiB

Open AccessPerspective

Genomics and Bioinformatics in One Health: Transdisciplinary Approaches for Health Promotion and Disease Prevention

by Fabio Scarpa and Marco Casu

Int. J. Environ. Res. Public Health 2024, 21(10), 1337; https://doi.org/10.3390/ijerph21101337 - 9 Oct 2024

Abstract

The One Health concept underscores the interconnectedness of human, animal, and environmental health, necessitating an integrated, transdisciplinary approach to tackle contemporary health challenges. This perspective paper explores the pivotal role of genomics and bioinformatics in advancing One Health initiatives. By leveraging genomic technologies [...] Read more.

The One Health concept underscores the interconnectedness of human, animal, and environmental health, necessitating an integrated, transdisciplinary approach to tackle contemporary health challenges. This perspective paper explores the pivotal role of genomics and bioinformatics in advancing One Health initiatives. By leveraging genomic technologies and bioinformatics tools, researchers can decode complex biological data, enabling comprehensive insights into pathogen evolution, transmission dynamics, and host-pathogen interactions across species and environments (or ecosystems). These insights are crucial for predicting and mitigating zoonotic disease outbreaks, understanding antimicrobial resistance patterns, and developing targeted interventions for health promotion and disease prevention. Furthermore, integrating genomic data with environmental and epidemiological information enhances the precision of public health responses. Here we discuss case studies demonstrating successful applications of genomics and bioinformatics in One Health contexts, such as including data integration, standardization, and ethical considerations in genomic research. By fostering collaboration among geneticists, bioinformaticians, epidemiologists, zoologists, and data scientists, the One Health approach can harness the full potential of genomics and bioinformatics to safeguard global health. This perspective underscores the necessity of continued investment in interdisciplinary education, research infrastructure, and policy frameworks to effectively employ these technologies in the service of a healthier planet. Full article

(This article belongs to the Special Issue Advancing One Health Approaches for Health Promotion and Disease Prevention: Transdisciplinary Perspectives)

24 pages, 9445 KiB

Open AccessArticle

Relationship between COVID-19 Cases and Environmental Contaminants in Quito, Ecuador

by Andrea Damaris Hernández-Allauca, Carlos Gabriel Pérez Castillo, Juan Federico Villacis Uvidia, Paula Abdo-Peralta, Catherine Frey, Guicela Margoth Ati-Cutiupala, Juan Ureña-Moreno and Theofilos Toulkeridis

Int. J. Environ. Res. Public Health 2024, 21(10), 1336; https://doi.org/10.3390/ijerph21101336 - 9 Oct 2024

Abstract

The relationship between COVID-19 infections and environmental contaminants provides insight into how environmental factors can influence the spread of infectious diseases. By integrating epidemiological and environmental variables into a mathematical framework, the interaction between virus spread and the environment can be determined. The [...] Read more.

The relationship between COVID-19 infections and environmental contaminants provides insight into how environmental factors can influence the spread of infectious diseases. By integrating epidemiological and environmental variables into a mathematical framework, the interaction between virus spread and the environment can be determined. The aim of this study was to evaluate the impact of atmospheric contaminants on the increase in COVID-19 infections in the city of Quito through the application of statistical tests. The data on infections and deaths allowed to identify the periods of greatest contagion and their relationship with the contaminants O₃, SO₂, CO, PM_2.5, and PM₁₀. A validated database was used, and statistical analysis was applied through five models based on simple linear regression. The models showed a significant relationship between SO₂ and the increase in infections. In addition, a moderate correlation was shown with PM_2.5, O₃, and CO, and a low relationship was shown for PM₁₀. These findings highlight the importance of having policies that guarantee air quality as a key factor in maintaining people’s health and preventing the proliferation of viral and infectious diseases. Full article

(This article belongs to the Special Issue 2nd Edition: Public Health during and after the COVID-19 Pandemic)

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17 pages, 366 KiB

Open AccessArticle

Using the Social–Ecological Model to Assess Vaccine Hesitancy and Refusal in a Highly Religious Lower–Middle-Income Country

by Rachael M. Chait, Anindrya Nastiti, Delfi Adlina Chintana, Putri Nilam Sari, Nabila Marasabessy, Muhamad Iqbal Firdaus, Mila Dirgawati, Dwi Agustian, Heidi West, Herto Dwi Ariesyady and Tomoyuki Shibata

Int. J. Environ. Res. Public Health 2024, 21(10), 1335; https://doi.org/10.3390/ijerph21101335 - 9 Oct 2024

Abstract

(1) Background: The aim of this study was to understand the factors associated with vaccine hesitancy and refusal in Indonesia using the Social–Ecological Model (SEM). (2) Methods: Data on demographics, religiosity, family dynamics, and perceptions of public health efforts were collected through an [...] Read more.

(1) Background: The aim of this study was to understand the factors associated with vaccine hesitancy and refusal in Indonesia using the Social–Ecological Model (SEM). (2) Methods: Data on demographics, religiosity, family dynamics, and perceptions of public health efforts were collected through an online survey and compared to the rates of vaccine hesitancy and refusal. (3) Results: Income and sex were significantly associated with vaccine hesitancy. Based on a vaccine passport policy to enter public spaces, people who felt inhibited to enter public spaces or perceived privacy threats were twice as likely to exhibit vaccine hesitancy. Participants who believed that religious groups had a difficult time getting vaccinated were nearly twice as likely to exhibit vaccine hesitancy and three times more likely to exhibit vaccine refusal. However, participants who believed in a higher religious power were 58% less likely to exhibit vaccine hesitancy. Religious leaders significantly influenced participants to make the decision regarding vaccination. Individuals with vaccine refusal were more than twice as likely to share information with others without fact-checking. Notably, structural barriers such as distance and transportation were most strongly associated with vaccine hesitancy and refusal. (4) Conclusion: Cultural factors play a significant role in vaccine hesitancy and refusal. The SEM can be used to propose multi-level interventions with collaboration and communication among stakeholders to improve community health. Full article

(This article belongs to the Special Issue Preventive Medicine and Community Health)

13 pages, 870 KiB

Open AccessArticle

Cancer Treatment Disruption by Residence Region in the Aftermath of Hurricanes Irma and María in Puerto Rico

by Francisco Muñoz-Torres, Marievelisse Soto-Salgado, Karen J. Ortiz-Ortiz, Xavier S. López-León, Yara Sánchez-Cabrera and Vivian Colón-López

Int. J. Environ. Res. Public Health 2024, 21(10), 1334; https://doi.org/10.3390/ijerph21101334 - 8 Oct 2024

Abstract

Since 2017, Puerto Rico has faced environmental, economic, and political crises, leading to the emigration of healthcare workers and weakening the healthcare system. These challenges have affected cancer treatment continuity, exacerbating healthcare access challenges island-wide. In this study, we estimate the effect of [...] Read more.

Since 2017, Puerto Rico has faced environmental, economic, and political crises, leading to the emigration of healthcare workers and weakening the healthcare system. These challenges have affected cancer treatment continuity, exacerbating healthcare access challenges island-wide. In this study, we estimate the effect of the residence region on cancer treatment disruption following Hurricanes Irma and María (2017). Telephone surveys were conducted with 241 breast and colorectal cancer patients aged 40 and older who were diagnosed within six months before the hurricanes and were receiving treatment at the time of the hurricanes. Treatment disruption was defined as any pause in surgery, chemotherapy, radiotherapy, or oral treatment due to the hurricanes. Prevalence ratios (PRs) of treatment disruption by residence region were estimated using the San Juan Metropolitan Area (SJMA) as the reference. Fifty-nine percent of respondents reported treatment disruption; among them, half experienced disruptions lasting more than 30 days, with 14% of these enduring disruptions longer than 90 days. Adjusted models showed a 48% higher prevalence of disruption outside the SJMA (PR = 1.48, 95% CI: 1.06–2.07). Specific geographic regions (Arecibo, Bayamón, Caguas, and Mayagüez) exhibited higher disruption prevalence. These findings emphasize the need for disaster preparedness strategies that ensure equitable healthcare access for all cancer patients following environmental calamities. Full article

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

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12 pages, 1281 KiB

Open AccessArticle

A Population-Based Analysis of the Cancer Incidence in Individuals under 50 in a Northern Italian Province: Focusing on Regional Disparities and Public Health Implications

by Lucia Mangone, Francesco Marinelli, Isabella Bisceglia, Francesca Roncaglia, Fortunato Morabito, Cinzia Testa, Carmine Pinto and Antonino Neri

Int. J. Environ. Res. Public Health 2024, 21(10), 1333; https://doi.org/10.3390/ijerph21101333 - 8 Oct 2024

Abstract

International studies have shown an increase in cancer incidence among young adults, raising public concern. This study aims examines trends in the cancer incidence among individuals aged 15–49 years in a province of Northern Italy, covering diagnoses from 1996 to 2021, and compares [...] Read more.

International studies have shown an increase in cancer incidence among young adults, raising public concern. This study aims examines trends in the cancer incidence among individuals aged 15–49 years in a province of Northern Italy, covering diagnoses from 1996 to 2021, and compares the annual percentage change (APC) with national and international data. In males, the overall cancer incidence showed a modest increase between 1996 and 2013 (APC 1.6), followed by a decline in the subsequent years (APC −2.5). In females, there was a modest increase over the entire period (APC 1.0). The lung cancer incidence decreased in both sexes (APC −3.9 in males and APC −3.3 in females), while a decrease was observed for colorectal cancers in women (APC −2.4). Since 2015, the thyroid cancer incidence declined significantly in females (APC −10.2), while an increase was noted in males (APC 2.5). The testicular cancer incidence rose in males (APC 1.5), and the melanoma incidence increased in both sexes (APC 3.4 in males and APC 3.9 in females). The breast cancer incidence remained stable (APC 0.3). These results underline the importance of promoting healthy lifestyles even among younger generations to address emerging cancer trends and support cancer prevention efforts. Full article

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15 pages, 340 KiB

Open AccessReview

Crafting the Future of Community-Based Medical Rehabilitation: Exploring Optimal Models for Non-Inpatient Rehabilitation Services through a Narrative Review

by Iuly Treger, Amit Kosto, Dor Vadas, Alan Friedman, Lena Lutsky and Leonid Kalichman

Int. J. Environ. Res. Public Health 2024, 21(10), 1332; https://doi.org/10.3390/ijerph21101332 - 8 Oct 2024

Abstract

Community-based medical rehabilitation encompasses diverse programs that cater to patients outside of inpatient settings, such as home rehabilitation, day rehabilitation centers, and ambulatory clinics. While inpatient rehabilitation principles are widely standardized, outpatient programs display significant variability influenced by healthcare models, local environments, economic [...] Read more.

Community-based medical rehabilitation encompasses diverse programs that cater to patients outside of inpatient settings, such as home rehabilitation, day rehabilitation centers, and ambulatory clinics. While inpatient rehabilitation principles are widely standardized, outpatient programs display significant variability influenced by healthcare models, local environments, economic constraints, and available resources. This narrative review aims to explore and synthesize the various models of non-inpatient rehabilitation services, evaluating their effectiveness, cost-efficiency, and patient satisfaction. The review also seeks to identify optimal practices and strategies to enhance community-based rehabilitation, alleviate the burden on inpatient facilities, and improve patient outcomes through multidisciplinary and patient-centered approaches. Additionally, the study examines the critical role of a professional program coordinator and the importance of effective clinical communication in outpatient rehabilitation. A comprehensive search of peer-reviewed literature was conducted across multiple databases, focusing on studies that examined community-based rehabilitation models. The findings suggest that community-based rehabilitation programs are generally more cost-effective than inpatient programs, with their success being heavily dependent on the intensity and timing of interventions. Multidisciplinary approaches and high-intensity rehabilitation have shown promise in improving patient quality of life, though their effectiveness varies by condition. Despite limited research, the involvement of a Physical and Rehabilitation Medicine (PRM) physician as a program coordinator appears vital for ensuring continuity of care. Moreover, effective clinical communication is essential, impacting all aspects of patient care and interprofessional collaboration, with continuous adaptation required to meet the evolving needs of diverse patient populations. Full article

(This article belongs to the Special Issue Clinical Communication in Rehabilitation)

10 pages, 306 KiB

Open AccessArticle

Respiratory Symptoms and Paper Dust Exposure among Workers in the Paper Industry in Ethiopia: A Comparative Cross-Sectional Study

by Ararso Tafese, Abera Kumie, Bente E. Moen, Teferi Abegaz, Wakgari Deressa, Samson Wakuma Abaya and Magne Bråtveit

Int. J. Environ. Res. Public Health 2024, 21(10), 1331; https://doi.org/10.3390/ijerph21101331 - 8 Oct 2024

Abstract

Chronic respiratory symptoms are a health concern in the paper industry. This study evaluates the association between personal inhalable paper dust exposure and chronic respiratory symptoms among workers in this industry. In total, 270 workers from the paper industry and 267 from a [...] Read more.

Chronic respiratory symptoms are a health concern in the paper industry. This study evaluates the association between personal inhalable paper dust exposure and chronic respiratory symptoms among workers in this industry. In total, 270 workers from the paper industry and 267 from a water bottling factory participated. Chronic respiratory symptoms were assessed using a standardized questionnaire, modified from the American Thoracic Society. A job exposure matrix, based on cross-sectional personal measurements of inhalable paper dust, was used to estimate the exposure–response relationship between cumulative dust exposure and chronic respiratory symptoms. There was a higher prevalence of chronic coughs (27.4% vs. 7.5%), breathlessness (25.6% vs. 11%), coughs with sputum (21.1% vs. 1.1%), and wheezing (25.6% vs. 5%) among paper workers compared to those in the water bottling industry. A Poisson regression analysis revealed that the prevalence ratios for chronic coughs (APR = 3.3 and 95% CI: 2.0–5.4), breathlessness (APR = 2.2 and 95% CI: 1.4–3.4), and wheezing (APR = 4.3 and 95% CI: 2.3–7.7) were significantly higher in paper workers than in water bottling workers. Among paper workers, a significant exposure–response relationship was observed between cumulative dust exposure and chronic coughs after adjusting for age, sex, history of respiratory illnesses, work in other dusty industries, and use of biofuels. As there were only four ever-smokers, smoking was not included in the regression analysis. The results show a significant association between dust exposure and coughing, highlighting the need for control measures to prevent the development of respiratory symptoms among workers. Full article

(This article belongs to the Section Environmental Health)

18 pages, 359 KiB

Open AccessArticle

Stakeholder Perspectives on the Acceptability, Design, and Integration of Produce Prescriptions for People with Type 2 Diabetes in Australia: A Formative Study

by Kristy K. Law, Kathy Trieu, Jennifer Madz, Daisy H. Coyle, Kimberly Glover, Maoyi Tian, Yuze Xin, David Simmons, Jencia Wong and Jason H. Y. Wu

Int. J. Environ. Res. Public Health 2024, 21(10), 1330; https://doi.org/10.3390/ijerph21101330 - 8 Oct 2024

Abstract

Produce prescription programs can benefit both individuals and health systems; however, best practices for integrating such programs into the Australian health system are yet unknown. This study explored stakeholders’ perspectives on the acceptability, potential design and integration of produce prescription programs for adults [...] Read more.

Produce prescription programs can benefit both individuals and health systems; however, best practices for integrating such programs into the Australian health system are yet unknown. This study explored stakeholders’ perspectives on the acceptability, potential design and integration of produce prescription programs for adults with type 2 diabetes in Australia. Purposive sampling was used to recruit 22 participants for an online workshop, representing six stakeholder groups (government, healthcare service, clinician, food retailer, consumer, non-government organisation). Participant responses were gathered through workshop discussions and a virtual collaboration tool (Mural). The workshop was video-recorded and transcribed verbatim, and thematic analysis was conducted using a deductive–inductive approach. Stakeholders recognised produce prescription as an acceptable intervention; however, they identified challenges to implementation related to contextuality, accessibility, and sustainability. Stakeholders were vocal about the approach (e.g., community-led) and infrastructure (e.g., screening tools) needed to support program design and implementation but expressed diverse views about potential funding models, indicating a need for further investigation. Aligning evaluation outcomes with existing measures in local, State and Federal initiatives was recommended, and entry points for integration were identified within and outside of the Australian health sector. Our findings provide clear considerations for future produce prescription interventions for people with type 2 diabetes. Full article

(This article belongs to the Special Issue Advancing Health Services and Systems for Vulnerable Populations including People with Chronic Conditions)

16 pages, 320 KiB

Open AccessArticle

Living and Researching the COVID-19 Pandemic: Autoethnographic Reflections from a Co-Research Team of Older People and Academics

by Louise McCabe, Tamara Brown, Roy Anderson, Liz Chrystall, David Curry, Margot Fairclough, Christine Ritchie, Pat Scrutton, Ann Smith and Elaine Douglas

Int. J. Environ. Res. Public Health 2024, 21(10), 1329; https://doi.org/10.3390/ijerph21101329 - 8 Oct 2024

Abstract

This article describes and reflects upon the work of a co-research team on the Healthy Ageing in Scotland (HAGIS) ‘COVID-19 Impact and Recovery’ study (January 2021 to November 2022). The co-research team (seven older adults and three academics) was constituted near the start [...] Read more.

This article describes and reflects upon the work of a co-research team on the Healthy Ageing in Scotland (HAGIS) ‘COVID-19 Impact and Recovery’ study (January 2021 to November 2022). The co-research team (seven older adults and three academics) was constituted near the start of this project; the team contributed to the development of recruitment materials and research tools and undertook qualitative research and analysis with older adults living across Scotland. This article provides a collaborative autoethnography about the activities undertaken by the team, the impact of the co-research process on the individuals involved, and the research findings and reflects the realities of co-research during the COVID-19 pandemic. Team members describe benefits, including increased confidence, new skills, and social connections, and reflect on the increased validity of the findings through their close involvement in the co-creation of knowledge. The process of team building and the adoption of an ‘ethics of care’ in our practice underpinned the success of this project and the sustainability of the group during and after the challenging circumstances of the pandemic. Full article

(This article belongs to the Special Issue Rising to the Healthy Ageing Challenge: Co-production with Older People and Business)

14 pages, 335 KiB

Open AccessArticle

Problematic and Harmful Social Media Use among Adolescents Receiving Intensive Psychiatric Care

by Sarah E. Domoff, Stacey B. Armstrong, Heide Rollings, Amy Mancuso, Mary B. Pacheco, Russell Fridson and Carol A. Janney

Int. J. Environ. Res. Public Health 2024, 21(10), 1328; https://doi.org/10.3390/ijerph21101328 - 8 Oct 2024

Abstract

Although research has shown both positive and negative mental health correlates of social media use, few studies focus on adolescents who are receiving intensive psychiatric care. The purpose of this study was to describe problematic media use, experiences of cybervictimization and sextortion, and [...] Read more.

Although research has shown both positive and negative mental health correlates of social media use, few studies focus on adolescents who are receiving intensive psychiatric care. The purpose of this study was to describe problematic media use, experiences of cybervictimization and sextortion, and correlates with adolescents’ health in a sample of adolescents (N = 97; 53.6% female) in a partial psychiatric hospitalization program. Approximately one-quarter of participants reported being cybervictimized at least once over the past month and 17.5% of participants reported ever experiencing sextortion. Greater problematic media use was associated with lower physical activity and greater feelings of loneliness. In a subsample of 51 participants, questions were asked regarding who they had gone to for support regarding experiences of online harm, and barriers to disclosing such experiences. The majority of youth who experienced cybervictimization indicated going to a friend for support but rarely endorsed telling a mental health clinician about it. Even fewer disclosed their experience of sextortion, with nearly half reporting not telling anyone (44.4%). Given the rates of online harm experienced by youth in acute psychiatric treatment, screening for and conducting brief interventions on problematic or risky social media use is recommended. Full article

(This article belongs to the Special Issue The Effect of Social Media on Adolescent Health Behaviors and Health-Related Outcomes)

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