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 25.8 days after submission; acceptance to publication is undertaken in 3.3 days (median values for papers published in this journal in the second 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
Effect of Ballroom Dancing on the Physical, Psychological, and Mental Well-Being of Oncological Patients: A Pilot Study
Int. J. Environ. Res. Public Health 2025, 22(4), 470; https://doi.org/10.3390/ijerph22040470 (registering DOI) - 21 Mar 2025
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Purpose: Previous studies have shown that dancing can improve well-being, but few studies have looked at ballroom dancing. The present pilot study focuses on ballroom dancing and aims to investigate its effect on the physical, psychological, and mental well-being of cancer patients. Owing
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Purpose: Previous studies have shown that dancing can improve well-being, but few studies have looked at ballroom dancing. The present pilot study focuses on ballroom dancing and aims to investigate its effect on the physical, psychological, and mental well-being of cancer patients. Owing to COVID-19, face-to-face courses had to be replaced by online courses to continue the intervention and maintain learning progress; after the end of the pandemic, the courses could occur on site again when possible. Methods: For this cohort study, a total of 51 participants (38 patients and 12 healthy partners, no data for 1; 34 women and 9 men, no data for 8) participated. There were no limitations regarding the type of cancer, treatment, or comorbidities. It was an open access offering; participants were recruited through the newspaper and support groups. Using an anonymous standardized questionnaire and a numeric rating scale (NRS) ranging from 1 to 10, the participants were asked to rate their mental, physical, and psychological well-being at defined time points over one week. No side effects were registered and the teaching methods appeared to be practicable for the patients. Results: The pilot study showed an improvement in well-being after ballroom dancing. The results for physical, psychological, and mental well-being were significant (p < 0.0001). On average, men reported better scores, and all improvements were significant for both men and women. Overall, the healthy partners rated their well-being slightly better on average than the patients. A mixed-model analysis with repeated measurements in SAS was used to evaluate significant results (p < 0.05). Conclusion: Our data show that ballroom dancing for cancer patients has a positive effect on their well-being, even though their well-being returns to baseline levels within the following days. Positive effects were also demonstrated for participating healthy partners.
Full article
Open AccessBrief Report
Advancing One Health Principles in Bulgaria: A Mixed-Methods Approach to Transdisciplinary Research and Practice
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Desislava Vankova, Petya Boncheva, Silviya Mihaylova, Zhaneta Radkova and Ilina Micheva
Int. J. Environ. Res. Public Health 2025, 22(4), 469; https://doi.org/10.3390/ijerph22040469 - 21 Mar 2025
Abstract
The One Health (OH) concept emphasizes public health collaboration and transdisciplinary research. Following the COVID-19 crisis, Bulgaria’s first OH scientific initiative was launched at the Medical University of Varna to raise national awareness and promote OH principles. Expanding on WHO’s holistic OH definition,
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The One Health (OH) concept emphasizes public health collaboration and transdisciplinary research. Following the COVID-19 crisis, Bulgaria’s first OH scientific initiative was launched at the Medical University of Varna to raise national awareness and promote OH principles. Expanding on WHO’s holistic OH definition, the project explores “One Health—Integrated Social and Scientometric Approaches for Better Quality of Life”, involving researchers, students, and the University Publishing Department. This report aims to outline the project’s parallel mixed-methods design (PMMD) and initial findings. Using the nominal group technique and horizon scanning, the project was structured into three thematic research areas: (1) OH and antimicrobial resistance (AMR)—assessing knowledge, attitudes, and practices (KAP) among medical and veterinary professionals, and investigating the potential of integrative approaches to manage AMR; (2) OH and wellbeing—examining the wellbeing levels among students and among chronically ill patients; and (3) OH education and dissemination—integrating OH into education and public awareness campaigns. Preliminary findings show policy gaps, particularly the lack of a national OH Action Plan. A KAP survey was conducted (sample size—228, 2023–2024) and wellbeing studies are ongoing (193 students participated, Feb. 2025), while OH topics are being integrated into the curricula. Despite low awareness in Bulgaria, this project seeks to attract national attention to the EU OH strategies.
Full article
(This article belongs to the Special Issue Advancing One Health Approaches for Health Promotion and Disease Prevention: Transdisciplinary Perspectives)
Open AccessArticle
TRAINERWALL: An Innovative, Cost-Effective Removable Anteroom for Pathogen Containment in Healthcare Settings
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Giorgio Ramorino, Anna Gobetti, Elena Roca and Giovanna Cornacchia
Int. J. Environ. Res. Public Health 2025, 22(4), 468; https://doi.org/10.3390/ijerph22040468 - 21 Mar 2025
Abstract
The COVID-19 pandemic exposed critical gaps in healthcare infrastructure, particularly the lack of effective isolation anterooms for managing infectious diseases. This study presents TrainerWall, a cost-effective, portable anteroom designed for rapid deployment in both high-resource and resource-limited settings. TrainerWall features a modular, self-supporting
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The COVID-19 pandemic exposed critical gaps in healthcare infrastructure, particularly the lack of effective isolation anterooms for managing infectious diseases. This study presents TrainerWall, a cost-effective, portable anteroom designed for rapid deployment in both high-resource and resource-limited settings. TrainerWall features a modular, self-supporting structure with antimicrobial materials, integrated sanitization, and adaptable dimensions, ensuring seamless integration into healthcare environments without disrupting operations. Its dual function as an infection control measure and a training platform makes it particularly valuable for non-specialized healthcare workers. Pre-clinical evaluations conducted in simulated hospital environments have demonstrated their ease of deployment, procedural efficiency, and positive impact on infection control practices, particularly in non-specialized departments. Designed for quick assembly, disassembly, and transport, TrainerWall enhances healthcare readiness during outbreaks, offering a scalable solution where permanent infrastructure is lacking. Future integration of augmented reality and interactive guidance could further improve training and compliance. This innovation provides an accessible, adaptable approach to infection control, particularly in underserved regions and emergency response scenarios.
Full article
(This article belongs to the Special Issue New Advances in Infection Control Research)
Open AccessArticle
A Global Index to Quantify Discrimination Resulting from COVID-19 Pandemic Response Policies
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Claus Rinner, Mariko Uda and Laurie Manwell
Int. J. Environ. Res. Public Health 2025, 22(4), 467; https://doi.org/10.3390/ijerph22040467 - 21 Mar 2025
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Immediately following the emergency use authorizations of COVID-19 vaccines, governments around the world made these products available to their populations and later started implementing differential rules for vaccinated and unvaccinated citizens regarding mobility and access to venues and services. The Oxford COVID-19 Government
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Immediately following the emergency use authorizations of COVID-19 vaccines, governments around the world made these products available to their populations and later started implementing differential rules for vaccinated and unvaccinated citizens regarding mobility and access to venues and services. The Oxford COVID-19 Government Response Tracker (OxCGRT) is a time series database that reflects the extent of public health measures in each country. On the basis of the OxCGRT Containment and Health Index, we calculated a corresponding discrimination index by subtracting the daily index values for vaccinated and unvaccinated individuals. The resulting metric provides a cursory quantification of the discrimination experienced by unvaccinated individuals throughout 2021 and 2022. Patterns in the index data show a high degree of discrimination with great numeric and temporal differences between jurisdictions. Around 90% of countries in Europe and North and South America discriminated against their unvaccinated citizens at some point during the pandemic. The least amount of discrimination was found for countries in Central America and Africa. In order to move towards sustainable post-pandemic recovery and prevent discriminatory public health policies in the future, we recommend that human rights protections be expanded and the prohibition of discrimination be extended beyond a limited list of grounds.
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Open AccessArticle
Vaccine-Preventable Conditions: Disparities in Hospitalizations Affecting Rural Communities in the Southeast United States
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Etienne Pracht, Christina Eldredge, Divyani Tangudu, Richa Phuel and Athanasios Tsalatsanis
Int. J. Environ. Res. Public Health 2025, 22(4), 466; https://doi.org/10.3390/ijerph22040466 - 21 Mar 2025
Abstract
Vaccinations are among the most effective means of preventing hospitalizations related to infections. Despite this, high hospitalization rates for vaccine-preventable diseases strain available healthcare resources and imply deficiencies in primary care. Barriers to vaccinations exist, such as the recent pandemic, vaccine hesitancy, misinformation,
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Vaccinations are among the most effective means of preventing hospitalizations related to infections. Despite this, high hospitalization rates for vaccine-preventable diseases strain available healthcare resources and imply deficiencies in primary care. Barriers to vaccinations exist, such as the recent pandemic, vaccine hesitancy, misinformation, and access to care. This study analyzes hospitalization rates due to vaccine-preventable conditions and identifies factors contributing to an increase in these rates in the southeast United States. This study used data from four different data sources. The data covers four pre-pandemic years (2016 to 2019) and the pandemic period (2020 to 2022). The analysis categorized the numbers and rates of hospitalizations for conditions with an available preventative vaccine across three age groups: pre-school aged children, school-aged children, and adults. Comparisons between school- versus non-school-mandated vaccines and a focus on differences between rural versus urban communities, as well as demographic characteristics (i.e., gender, race, and ethnicity), are included. Chi-squared tests were used to assess differences in this descriptive part of the analysis. Linear multiple regression was used to examine the independent influence of geographic location while accounting for potential longitudinal trends and the dimensions of the SVI, including socioeconomic status, household composition, disability, minority status and language, and household type and transportation. The dataset included data from 22,797,826 inpatient episodes, including 32,358 for which the principal reason for hospitalization was a vaccine-preventable condition, not including COVID-19. The analysis shows a consistent pattern characterized by higher rates of hospitalization for counties classified as rural. The pattern holds for preschool age (p < 0.001), school age (p = 0.004), and adults (p = 0.009). The differences are statistically significant in the white population (p = 0.008); in pre-school children, school-age children, and adults (p < 0.001); in females (p = 0.08 in pre-school, and p = 0.013 in adults); and black adults (p = 0.02). The regression results confirmed the findings of the descriptive analysis, indicating significantly higher rates in rural communities. Finally, the regression analysis also showed significantly higher rates associated with greater social vulnerability. This study highlights gaps in vaccination opportunities. These gaps can be seen geographically and in terms of social vulnerability, affected by factors such as poverty, language barriers, household composition, and access to care. Hospitalizations due to immunizable diseases were found to be higher in rural areas, particularly among adults. Communities with a high SVI show a significant increase in hospitalization rates. Community-engaged vaccination outreach programs and state policies could improve vaccination rates, and therefore, public health in rural areas, reducing hospitalizations, and lowering infectious disease risks in these areas.
Full article
(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
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Open AccessSystematic Review
The Effects of Thirdhand Vape Residue from Nicotine and Non-Nicotine Vapes on Cells: A Systematic Review
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Jazzlin Marie Adele Stracci, Alyssa Priyanka Ganesan, Prescious Grace Pitogo and Sheree Margaret Smith
Int. J. Environ. Res. Public Health 2025, 22(4), 465; https://doi.org/10.3390/ijerph22040465 - 21 Mar 2025
Abstract
Rationale: Vapes are increasingly popular, however, their clouds leave a residue on surfaces, referred to as thirdhand smoke. Recent studies have reported the detrimental cellular impacts of thirdhand smoke. However, research on thirdhand vape residue exposure is relatively new and understudied. Objectives: This
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Rationale: Vapes are increasingly popular, however, their clouds leave a residue on surfaces, referred to as thirdhand smoke. Recent studies have reported the detrimental cellular impacts of thirdhand smoke. However, research on thirdhand vape residue exposure is relatively new and understudied. Objectives: This review aims to evaluate the current literature associated with the impact of thirdhand vape residue from nicotine and non-nicotine vapes on cells, compared to unexposed controls. Methods: A systematic search was performed in PubMed (Medline), Embase, Web of Science, Scopus, and Google databases to identify relevant studies. Two independent reviewers screened articles using the inclusion criteria of controlled experimental studies on human and animal in vitro and in vivo models which investigate thirdhand vape residue as the exposure variable and cell concepts. Studies were assessed for bias through tools specialised for animal studies. Data were extracted and synthesised in accordance with PRISMA guidelines. Results: Of 139 articles retrieved, three are included in this review, focusing on mice cell models only, one of which investigates non-nicotine vapes. No studies on human cell models that fit the criteria were found. Mice were directly exposed to vape-infused materials from which their cells were extracted and evaluated, finding that exposure to thirdhand nicotine vape residue damages mice cells. The effects of non-nicotine vapes are inconclusive. Conclusions: Thirdhand nicotine vape residue contributes to changes in some cells in mouse models but not others. Data available to date provide no convincing evidence of likely significant harm to humans. Further investigation is warranted to confirm or deny this impression.
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(This article belongs to the Section Environmental Health)
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Open AccessArticle
Wrangling Real-World Data: Optimizing Clinical Research Through Factor Selection with LASSO Regression
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Kerry A. Howard, Wes Anderson, Jagdeep T. Podichetty, Ruth Gould, Danielle Boyce, Pam Dasher, Laura Evans, Cindy Kao, Vishakha K. Kumar, Chase Hamilton, Ewy Mathé, Philippe J. Guerin, Kenneth Dodd, Aneesh K. Mehta, Chris Ortman, Namrata Patil, Jeselyn Rhodes, Matthew Robinson, Heather Stone and Smith F. Heavner
Int. J. Environ. Res. Public Health 2025, 22(4), 464; https://doi.org/10.3390/ijerph22040464 - 21 Mar 2025
Abstract
Data-driven approaches to clinical research are necessary for understanding and effectively treating infectious diseases. However, challenges such as issues with data validity, lack of collaboration, and difficult-to-treat infectious diseases (e.g., those that are rare or newly emerging) hinder research. Prioritizing innovative methods to
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Data-driven approaches to clinical research are necessary for understanding and effectively treating infectious diseases. However, challenges such as issues with data validity, lack of collaboration, and difficult-to-treat infectious diseases (e.g., those that are rare or newly emerging) hinder research. Prioritizing innovative methods to facilitate the continued use of data generated during routine clinical care for research, but in an organized, accelerated, and shared manner, is crucial. This study investigates the potential of CURE ID, an open-source platform to accelerate drug-repurposing research for difficult-to-treat diseases, with COVID-19 as a use case. Data from eight US health systems were analyzed using least absolute shrinkage and selection operator (LASSO) regression to identify key predictors of 28-day all-cause mortality in COVID-19 patients, including demographics, comorbidities, treatments, and laboratory measurements captured during the first two days of hospitalization. Key findings indicate that age, laboratory measures, severity of illness indicators, oxygen support administration, and comorbidities significantly influenced all-cause 28-day mortality, aligning with previous studies. This work underscores the value of collaborative repositories like CURE ID in providing robust datasets for prognostic research and the importance of factor selection in identifying key variables, helping to streamline future research and drug-repurposing efforts.
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(This article belongs to the Special Issue Big Data in Public Health: Challenges and Opportunities)
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Open AccessReview
Global Trends in Diabetic Foot Research (2004–2023): A Bibliometric Study Based on the Scopus Database
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Yolanda Fuentes-Peñaranda, Alma Labarta-González-Vallarino, Elena Arroyo-Bello and Marina Gómez de Quero Córdoba
Int. J. Environ. Res. Public Health 2025, 22(4), 463; https://doi.org/10.3390/ijerph22040463 - 21 Mar 2025
Abstract
Diabetic foot is one of the leading complications of diabetes mellitus that affects millions of people around the world and involves the presence of ulcers, infections, tissue destruction, and loss of sensation and can even lead to limb amputation. This research explores trends
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Diabetic foot is one of the leading complications of diabetes mellitus that affects millions of people around the world and involves the presence of ulcers, infections, tissue destruction, and loss of sensation and can even lead to limb amputation. This research explores trends in diabetic foot global research through a bibliometric analysis of publications indexed in Scopus in the period 2004–2023. A total of 7136 documents were analysed using Excel, Python, Biblioshiny, and VOSviewer. Scientific production has multiplied by a factor of 6.6 from the first to the last year analysed. Armstrong D.G. is the most productive and cited author. China is the most productive country, and the United States is the most cited. The most productive journal is the International Journal of Lower Extremity Wounds, and the most cited journal is Diabetes Care. Research on diabetic foot is mainly focused on the complications of diabetes mellitus; the treatment and healing of wounds; infections; and epidemiology and patient care. Infections and antibiotic treatment are emerging topics, while deep learning and machine learning are among the niche topics in this area of knowledge. The present study allows us to identify current trends and future directions of research in diabetic foot.
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(This article belongs to the Special Issue New Advances in Diabetes)
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Open AccessArticle
Advancing Health Equity Through Substance Use Medical Record Data Sharing: Insights from Healthcare Providers
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Mengyi Wei, Anita Murcko, Sai Prathyusha Nookala, Dharma Teja Bhattu, Sai Jahnavi Vemula, Darwyn Chern, Eric Lott, Mary Jo Whitfield, Nick Stavros, Deborah Ariosto and Maria Adela Grando
Int. J. Environ. Res. Public Health 2025, 22(4), 462; https://doi.org/10.3390/ijerph22040462 - 21 Mar 2025
Abstract
Background: Better care is delivered when patients and providers share health information. Unfortunately, critical health data are often unavailable due to fragmentation within healthcare systems. Sensitive health information, like substance use disorder, is often sequestered in ways that do not meet patient data
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Background: Better care is delivered when patients and providers share health information. Unfortunately, critical health data are often unavailable due to fragmentation within healthcare systems. Sensitive health information, like substance use disorder, is often sequestered in ways that do not meet patient data privacy choices and provider data access needs. This study explored healthcare providers’ perspectives on barriers and facilitators to substance use data sharing and its impact on care. Methods: Focus groups were conducted with 31 healthcare providers from four treatment facilities. Discussions focused on privacy concerns, data-sharing workflows, and scenarios involving four Healthcare Effectiveness Data and Information Set (HEDIS) substance use disorder specific metrics. Open coding identified key concepts, and thematic analysis was employed to identify barriers and facilitators influencing data sharing and care outcomes. Results: Providers identified five main barriers: patient reluctance to share (48%), data access challenges (42%), poor provider coordination (29%), incomplete health information (26%), and complexity of privacy regulations (23%). Key facilitators included patient understanding (26%), patient–provider relationship (16%), and reliability of health information systems (16%). Discussion: This study sets the stage for understanding and addressing sensitive healthcare data access and privacy concerns through improved care coordination, systems interoperability, education, and policy reform.
Full article
(This article belongs to the Special Issue Substance Use Research Methods: Ethics, Culture, and Health Equity)
Open AccessArticle
Parenting Style and Child Internet Addiction in China: Mediation Effect of Parental Active Meditation
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Shu-Wen Liu, Sheng Chen, Chienchung Huang and Julia Vallario
Int. J. Environ. Res. Public Health 2025, 22(4), 461; https://doi.org/10.3390/ijerph22040461 - 21 Mar 2025
Abstract
With the rapid advancement of technology, internet addiction among children has become a growing concern, particularly in China. This study examines the impact of different parenting styles on internet addiction and the role of parental mediation on the relationship among Chinese children. A
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With the rapid advancement of technology, internet addiction among children has become a growing concern, particularly in China. This study examines the impact of different parenting styles on internet addiction and the role of parental mediation on the relationship among Chinese children. A survey of 600 Chinese families with children aged 6 to 17 was conducted in 2024. Using structural equation modeling (SEM), the results reveal that authoritative parenting is linked to lower levels of internet addiction, while authoritarian and permissive parenting are associated with higher levels. Parental mediation partly mediates this relationship, with authoritative parents who are actively involved with their children’s internet activities showing a reduced risk of addiction. The findings highlight that both parenting style and parental intervention are key factors in addressing internet addiction among Chinese children. Encouraging authoritative parenting alongside active mediation may help children mitigate internet addiction.
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(This article belongs to the Special Issue Problematic Internet and Smartphone Use as a Public Health Concern)
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Open AccessArticle
Barriers and Facilitators Concerning Involuntary Oral Care for Individuals with Dementia: A Qualitative Study
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Maud Jonker, Coos Engelsma, David J. Manton and Anita Visser
Int. J. Environ. Res. Public Health 2025, 22(3), 460; https://doi.org/10.3390/ijerph22030460 - 20 Mar 2025
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Many individuals with dementia show care-resistant behavior toward oral care, while care providers are often reluctant to provide it involuntarily, risking negative health outcomes. This study aims to identify the barriers and facilitators of providing involuntary oral care for individuals with dementia who
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Many individuals with dementia show care-resistant behavior toward oral care, while care providers are often reluctant to provide it involuntarily, risking negative health outcomes. This study aims to identify the barriers and facilitators of providing involuntary oral care for individuals with dementia who show care-resistant behavior. In total, 32 semi-structured one-on-one interviews with healthcare providers were conducted. Through the interviews, multiple barriers and facilitators were identified and divided into four main themes, each containing multiple sub-themes: (1) communication (between dental and non-dental care providers, and amongst non-dental care providers themselves), (2) logistics (materials, transportation, and staff and time), (3) knowledge (training, awareness of oral health problems, and assessment of severity of oral health problems), and (4) oral care provision (psychology care providers, attitude concerning involuntary oral care, ethical and legal considerations, and sedation). Our study shed more light on the barriers and facilitators regarding involuntary oral care provision to older individuals with dementia. Multiple recommendations were provided, including designating nurses to help monitor oral health, involving dental professionals in multidisciplinary team meetings, discussing a shift in attitude concerning oral care, providing clear guidelines and protocols for sedation and daily oral care provision, and performing more research into involuntary oral care.
Full article
Open AccessArticle
How Social Support and Parent–Child Relationships Related to LGBTQ+ College Students’ Academic Challenges During COVID-19
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Yuan Zhang, Miranda R. Garcia and Eva. S. Lefkowitz
Int. J. Environ. Res. Public Health 2025, 22(3), 459; https://doi.org/10.3390/ijerph22030459 - 20 Mar 2025
Abstract
The COVID-19 pandemic disrupted the living arrangements of many college students in the United States, potentially impacting their academic development, which plays a critical role in their mental health. At the start of the pandemic, university closures led to an abrupt transition from
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The COVID-19 pandemic disrupted the living arrangements of many college students in the United States, potentially impacting their academic development, which plays a critical role in their mental health. At the start of the pandemic, university closures led to an abrupt transition from face-to-face instruction to online instruction, which may have caused significant challenges for college students, particularly lesbian, gay, bisexual, transgender, queer, and others who identify as having a minority sexual orientation and/or gender identity (LGBTQ+). To identify academic challenges and associated protective factors, we examined LGBTQ+ college students’ social support from family and friends, the parent–child relationship quality, and their associations with academic challenges during the first months of the pandemic. The results of online surveys indicated that LGBTQ+ college students (N = 408; Mean Age = 20.4 yrs) who reported less family support and worse relationship quality with their parents perceived that academics had become relatively harder than before the pandemic. In contrast, friend support was unrelated to perceived academic challenges. These findings underscore the potentially protective role of supportive and high-quality relationships with family. The findings also provide insight into how universities could support students’ academic success during other temporary academic breaks and sudden, unplanned disruptions, such as hurricanes or other weather-related events, which is essential in promoting LGBTQ+ college students’ mental health and academic success.
Full article
(This article belongs to the Special Issue Mental Health Challenges Affecting LGBTQ+ Individuals and Communities)
Open AccessReview
Individuals 45 Years and Older in Opioid Agonist Treatment: A Scoping Review
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Zhanna Gaulen, Linn-Heidi Lunde, Silvia Eiken Alpers and Siv-Elin Leirvaag Carlsen
Int. J. Environ. Res. Public Health 2025, 22(3), 458; https://doi.org/10.3390/ijerph22030458 - 20 Mar 2025
Abstract
This scoping review explores the unique challenges and needs faced by ageing individuals, aged 45 and above, in opioid agonist treatment (OAT), noting the earlier onset of age-related impairments among this population. The literature search was conducted in PsycINFO, EMBASE, MEDLINE, CINAHL, and
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This scoping review explores the unique challenges and needs faced by ageing individuals, aged 45 and above, in opioid agonist treatment (OAT), noting the earlier onset of age-related impairments among this population. The literature search was conducted in PsycINFO, EMBASE, MEDLINE, CINAHL, and Web of Science. A total of 28 observational studies were included. Five topics were identified: health, treatment, substance use, demographic, and social aspects. Findings reveal that, while health and age-related concerns are often discussed in the literature, limited attention has been given to gender differences, social factors such as financial issues, and psychological factors, which are also critical aspects of the lives of ageing individuals undergoing OAT. This review emphasizes the importance of expanding research to address these gaps, ultimately aiming to improve their overall well-being.
Full article
(This article belongs to the Special Issue Substance Use Research Methods: Ethics, Culture, and Health Equity)
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Open AccessArticle
Integrating Mental Health Services into Primary Care Settings: A Multiple Case Study of Congolese Experiences Testing the Feasibility of the WHO’s Mental Health Gap Action Programme
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Erick Mukala Mayoyo, Bart Criel, Aline Labat, Yves Coppieters and Faustin Chenge
Int. J. Environ. Res. Public Health 2025, 22(3), 457; https://doi.org/10.3390/ijerph22030457 - 20 Mar 2025
Abstract
Some experiences of integrating mental health into primary care settings, testing the feasibility of the World Health Organization’s mental health Gap Action Programme, have been launched in the Democratic Republic of the Congo to address treatment gaps. However, they have not yet been
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Some experiences of integrating mental health into primary care settings, testing the feasibility of the World Health Organization’s mental health Gap Action Programme, have been launched in the Democratic Republic of the Congo to address treatment gaps. However, they have not yet been documented to look at scaling up. This study described the health outcomes and lessons learned from two of these experiences. A multiple case study was conducted on two integration programmes in the urban Tshamilemba district in the Haut-Katanga province, ongoing since 2021, and in the rural Mangembo district in the Kongo Central province, ongoing since 2022. Data were collected between July and August 2024 from focus group discussions, interviews, document reviews, including routine health information systems. We carried out descriptive statistical analyses to measure indicators of accessibility and the use of services, and content analysis to explore the lessons learned. A total of 1708 individuals with mental disorders were treated in primary care settings between 2021/22 and 2024 under both programmes. From 2021 to 2024, the curative consultations rate for mental disorders, which was unknown at the start of both programmes, reached 14.4 new cases/1000 inhabitants/year in the Tshamilemba district and 14.2 new cases/1000 inhabitants/year in the Mangembo district. Several lessons were learned, related to each phase of mental health Gap Action Programme. The findings confirm the feasibility and effectiveness of the mental health Gap Action Programme in the Congolese context and highlight the need for concerted action to address the identified challenges.
Full article
(This article belongs to the Special Issue Mental Health Services in Primary Care Settings: Challenges, Opportunities and Best Practices)
Open AccessArticle
Assessing Neighborhood Characteristics and Their Association with Prenatal Maternal Stress, Depressive Symptoms, and Well-Being in Eight Culturally Diverse Cities: A Cross-Sectional Study
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Laura Campo-Tena, Gabriela Diana Roman, Aja Louise Murray, Bao Yen Luong-Thanh, Marguerite Marlow, Yasmeen Anwer, Awurabena Dadzie, Sarah Foley, Sandra Stuart Hernandez, Carene Lindsay, Shobhavi Randeny, Joanne A. Smith, Diana Taut and Manuel P. Eisner
Int. J. Environ. Res. Public Health 2025, 22(3), 456; https://doi.org/10.3390/ijerph22030456 - 20 Mar 2025
Abstract
Despite growing evidence on the influence of neighborhood characteristics on maternal well-being, there is a critical gap in the availability of validated instruments for measuring these constructs across different cultural settings. Existing neighborhood-related scales often lack cross-cultural validation, limiting their applicability in low-
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Despite growing evidence on the influence of neighborhood characteristics on maternal well-being, there is a critical gap in the availability of validated instruments for measuring these constructs across different cultural settings. Existing neighborhood-related scales often lack cross-cultural validation, limiting their applicability in low- and middle-income countries. Understanding the impact of neighborhood characteristics is crucial given its multigenerational impact. We used data from the Evidence for Better Lives dataset to assess the conceptual and measurement equivalence of the community scales of neighborhood cohesion, intergenerational closure, and neighborhood and social disorder, testing for measurement invariance across eight low- and middle-income countries. Secondly, we examined patterns of associations with prenatal maternal stress, well-being, and depressive symptoms through the use of nomological networks. We found that the conceptual and measurement equivalence of the neighborhood domains were comparable across the eight studied countries. Additionally, our results suggest that higher levels of neighborhood and social disorder and lower levels of cohesion and intergenerational closure in the community are associated with adverse maternal outcomes across the included sites. The results of this study stress the importance of exploring the community context when assessing maternal well-being and supports the need to advocate for community-based interventions that promote safer physical and social environments within maternal programs and urban planning.
Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle
A Geospatial Analysis of the Lung Cancer Burden in Philadelphia, Using Pennsylvania Cancer Registry Data from 2008–2017
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Russell K. McIntire, Katherine Senter, Christine Shusted, Rickisa Yearwood, Julie Barta, Scott W. Keith and Charnita Zeigler-Johnson
Int. J. Environ. Res. Public Health 2025, 22(3), 455; https://doi.org/10.3390/ijerph22030455 - 20 Mar 2025
Abstract
(1) Background: Lung cancer is the deadliest and second most prevalent cancer in Pennsylvania (PA), and African American patients are disproportionately affected. Lung cancer morbidity and mortality in Philadelphia County are among the highest in PA. Geographic information systems (GIS) are useful to
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(1) Background: Lung cancer is the deadliest and second most prevalent cancer in Pennsylvania (PA), and African American patients are disproportionately affected. Lung cancer morbidity and mortality in Philadelphia County are among the highest in PA. Geographic information systems (GIS) are useful to explore geospatial variations in the cancer burden and risk factors. Therefore, we used GIS to analyze the lung cancer burden in Philadelphia to assess which areas of the city have the highest morbidity and mortality, identify potential clusters, and determine which census tract-level characteristics were associated with higher tract-level cancer burden. (2) Methods: Using secondary data from the Pennsylvania Cancer Registry, age-adjusted standardized incidence and mortality ratios (SIR and SMR) were calculated by census tract, and choropleth maps were created to visualize geographic variations in the disease burden. Two geostatistical methods were used to determine the presence of lung cancer clusters. Multivariable regression analyses were performed to identify which census-tract level characteristics correlated with a higher lung cancer burden. (3) Results: Three distinct geographical lung cancer clusters were identified. After controlling for demographics and other covariates, adult smoking prevalence, prevalence of chronic obstructive pulmonary disease, and percentage of residential addresses vacant were positively associated with higher lung cancer SIR and SMR. (4) Conclusions: Our findings may inform cancer control efforts within the region and guide future municipal-level GIS analyses of the lung cancer burden.
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(This article belongs to the Special Issue Cancer Causes and Control)
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Open AccessArticle
Evaluation of the Reversibility of Cadmium-Induced Testicular Toxicity Following Recovery Alone or with Zinc Supplementation
by
Jihane Ait Benbella, Samy Housbane, Youness Kadil, Fatimaezzahra Kabbali, Ikram Ghicha, Hasnaa Bazhar, Fatiha Bousselham, Afaf Banid, Othmane Hammani, Noureddine Louanjli, Mehdi Karkouri, Abderrahmane Mellouki, Houda Filali and Rachid Aboutaieb
Int. J. Environ. Res. Public Health 2025, 22(3), 454; https://doi.org/10.3390/ijerph22030454 - 20 Mar 2025
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Cadmium (Cd) is a toxic heavy metal that disrupts spermatogenesis and steroidogenesis due to its long half-life. This study evaluated the impact of recovery alone or with zinc (Zn) supplementation on Cd-induced testicular toxicity. A total of 42 pubertal male Wistar rats were
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Cadmium (Cd) is a toxic heavy metal that disrupts spermatogenesis and steroidogenesis due to its long half-life. This study evaluated the impact of recovery alone or with zinc (Zn) supplementation on Cd-induced testicular toxicity. A total of 42 pubertal male Wistar rats were divided into seven groups of six rats each. The control group (1) received NaCl (0.9%). Groups 2, 3, and 4 were treated with Cd 10 μg/kg/d by intraperitoneal injection for 1, 2, and 3 months respectively. Group 5 received Cd for 3 months with a recovery period of 1 month; Group 6 was exposed to Cd for 3 months, followed by a 1-month recovery period combined with Zn supplementation. (0.5 mg/kg/d). The last group was treated with zinc at a dose of 0.5 mg/kg/day for one month. The results showed decreased body weight, testicular and epididymal weight, testicular dimensions, and sperm parameters, along with Cd accumulation in the testes. Cd caused testicular damage and reduced serum testosterone levels, with more pronounced effects in the 3-month treatment group. Recovery alone did not significantly reverse Cd’s toxic effects, whereas Zn supplementation mitigated most of the damage. Recovery combined with Zn supplementation was more effective in correcting Cd-induced testicular toxicity than recovery alone.
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Open AccessArticle
Social Fragility: Impact of Early Fertility and Domestic Violence in Colombia During the Pandemic
by
Fabian Dávila and Favio Cala-Vitery
Int. J. Environ. Res. Public Health 2025, 22(3), 453; https://doi.org/10.3390/ijerph22030453 - 20 Mar 2025
Abstract
Social fragility, defined as the inability of a society to manage risks and resolve conflicts without violence or external aid, is closely linked to early fertility and domestic violence, particularly among vulnerable populations. These challenges were exacerbated by the COVID-19 pandemic, which exposed
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Social fragility, defined as the inability of a society to manage risks and resolve conflicts without violence or external aid, is closely linked to early fertility and domestic violence, particularly among vulnerable populations. These challenges were exacerbated by the COVID-19 pandemic, which exposed regional disparities across Colombia, particularly in areas with weak social infrastructure and high dependence on public policies. This study integrates data from all Colombian departments on annual births, deaths by cause, domestic violence by perpetrator, and other demographic factors to construct key indicators of early fertility and structural inequalities. To measure fragility, we developed the Early Fertility Fragility Index (EFFI) and refined it using a Generalized Linear Model (GLM) to identify the most critical predictors of early fertility risk. The findings reveal marked regional disparities, with departments exhibiting high Indigenous and migrant populations, high domestic violence rates, and weak social protection systems experiencing the greatest fragility and the most pronounced increases in early fertility. However, these results reflect correlational relationships rather than causal effects. Further research using longitudinal or experimental designs is needed to establish causality.. In contrast, urbanized regions with stronger social and economic infrastructures showed greater resilience. These results highlight how structural inequalities intensify the effects of crises on vulnerable populations. The refined EFFI model provides a robust framework for assessing regional fragility and guiding evidence-based policy interventions. Addressing these disparities requires regionally tailored strategies that prioritize investment in social infrastructure, reproductive health services, and protective policies to mitigate the long-term consequences of early fertility and social fragility in Colombia.
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(This article belongs to the Section Behavioral and Mental Health)
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Open AccessArticle
Impact of COVID-19 on the HIV Treatment Outcomes Among Men Who Have Sex with Men in South Africa After the Implementation of a Differentiated Service Delivery Model: An Interrupted Time Series Analysis
by
Betty Sebati, Edith Phalane, Yegnanew A. Shiferaw, Jacqueline Pienaar, Stanford Furamera and Refilwe Nancy Phaswana-Mafuya
Int. J. Environ. Res. Public Health 2025, 22(3), 452; https://doi.org/10.3390/ijerph22030452 - 19 Mar 2025
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The impacts of COVID-19 among men who have sex with men (MSM), who face limited access to HIV services due to stigma, discrimination, and violence, need to be assessed and quantified in terms of HIV treatment outcomes for future pandemic preparedness. This study
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The impacts of COVID-19 among men who have sex with men (MSM), who face limited access to HIV services due to stigma, discrimination, and violence, need to be assessed and quantified in terms of HIV treatment outcomes for future pandemic preparedness. This study aimed to evaluate the effects of the COVID-19 lockdown on the HIV treatment cascade among MSM in selected provinces of South Africa using routine programme data after the implementation of differentiated service delivery (DSD) models. An interrupted time series analysis was employed to observe the trends and patterns of HIV treatment outcomes among MSM in Gauteng, Mpumalanga, and KwaZulu-Natal from 1 January 2018 to 31 December 2022. Interrupted time series analysis was applied to quantify changes in the accessibility and utilisation of HIV treatment services using the R software version 4.4.1. The segmented regression models showed a decrease followed by an upward trend in all HIV treatment outcomes. After the implementation of the DSD model, significant increases in positive HIV tests (estimate = 0.001572; p < 0.001), linkage to HIV care (estimate = 0.001486; p < 0.001), ART initiations (estimate = 0.001003; p = 0.004), ART collection (estimate = 0.001748; p < 0.001), and taking viral load tests (estimate = 0.001109; p = 0.001) were observed. There was an overall increase in all HIV treatment outcomes during the COVID-19 lockdown in light of the DSD model.
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Open AccessArticle
Factors Influencing Mental Health Outcomes Amongst Senescent County Residents
by
Jack Golder, Evan Lagerberg, William Flanagan, Jennifer Blouin, Corey Horn, Sabrina Avanzato, Ryan Scagliarini and Alexis M. Stoner
Int. J. Environ. Res. Public Health 2025, 22(3), 451; https://doi.org/10.3390/ijerph22030451 - 18 Mar 2025
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Background: Despite increased mental health awareness and expanded healthcare services in recent years, older adults face significant gaps in mental health support. The purpose of this study was to examine factors affecting mental health among elderly residents in Greenville County, South Carolina, using
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Background: Despite increased mental health awareness and expanded healthcare services in recent years, older adults face significant gaps in mental health support. The purpose of this study was to examine factors affecting mental health among elderly residents in Greenville County, South Carolina, using the ecological model of health. Methods: The ecological model of health was used as a conceptual base for a convenience survey of older adults participating in a community involvement program. These results were analyzed using structural equation modeling. Results: The findings revealed that outlooks on aging significantly influence mental health, particularly through personal and relational factors. This study also found that there is a relationship between the concept of healthy aging and overall mental health. Conclusions: This study underscores the need for targeted interventions that enhance social engagement, strengthen community support, and address societal gaps to improve mental health outcomes and create a supportive environment for elderly populations.
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