International Journal of Environmental Research and Public Health

28 pages, 5314 KiB

Open AccessArticle

Environmental Cyanide Pollution from Artisanal Gold Mining in Burkina Faso: Human Exposure Risk Analysis Based on a Conceptual Site Model

by Edmond N’Bagassi Kohio, Seyram Kossi Sossou, Hela Karoui and Hamma Yacouba

Int. J. Environ. Res. Public Health 2025, 22(7), 1125; https://doi.org/10.3390/ijerph22071125 (registering DOI) - 16 Jul 2025

Abstract

Artisanal and small-scale gold mining (ASGM) in Burkina Faso increasingly relies on cyanide, intensifying concerns about environmental contamination and human exposure. This study assessed free cyanide levels in water and soil across three ASGM sites—Zougnazagmiline, Guido, and Galgouli. Water samples (surface and groundwater) [...] Read more.

Artisanal and small-scale gold mining (ASGM) in Burkina Faso increasingly relies on cyanide, intensifying concerns about environmental contamination and human exposure. This study assessed free cyanide levels in water and soil across three ASGM sites—Zougnazagmiline, Guido, and Galgouli. Water samples (surface and groundwater) and topsoil (0–20 cm) were analyzed using the pyridine–pyrazolone method. Data were statistically and spatially processed using SPSS version 29.0 and the Google Earth Engine in conjunction with QGIS version 3.34, respectively. A site conceptual model (SCM) was also developed, based on the literature review, field observations, and validation by multidisciplinary experts in public health, toxicology, ecotoxicology, environmental engineering, and the mining sector, through a semi-structured survey. The results showed that 9.26% of the water samples exceeded the WHO guideline (0.07 mg/L), with peaks of 1.084 mg/L in Guido and 2.42 mg/L in Galgouli. At Zougnazagmiline, the water type differences were significant (F = 64.13; p < 0.001), unlike the other sites. In the soil, 29.36% of the samples exceeded 0.5 mg/kg, with concentrations reaching 9.79 mg/kg in Galgouli. A spatial analysis revealed pollution concentrated near the mining areas but spreading to residential and agricultural zones. The validated SCM integrates pollution sources, transport mechanisms, exposure routes, and vulnerable populations, offering a structured tool for environmental monitoring and health risk assessment in cyanide-impacted mining regions. Full article

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15 pages, 1238 KiB

Open AccessArticle

Assessing Heat–Health Vulnerability Through Temporal, Demographic, and Spatial Lenses: A Time-Stratified Case-Crossover Analysis in New York State

by Heather Aydin-Ghormoz, Temilayo Adeyeye, Wanhsiang Hsu and Neil Muscatiello

Int. J. Environ. Res. Public Health 2025, 22(7), 1124; https://doi.org/10.3390/ijerph22071124 (registering DOI) - 16 Jul 2025

Abstract

New York State (NYS) has experienced warming outpacing the national average, and heat events are increasing. This case-crossover study uses conditional logistic regression to estimate how maximum heat index affects heat-related illness across temporal, demographic, and spatial groups in NYS, from May to [...] Read more.

New York State (NYS) has experienced warming outpacing the national average, and heat events are increasing. This case-crossover study uses conditional logistic regression to estimate how maximum heat index affects heat-related illness across temporal, demographic, and spatial groups in NYS, from May to September, 2008–2019. The highest risks were in May (Relative Risk (RR) = 1.81, CI: 1.72, 1.90) and August (RR = 1.86, CI: 1.79, 1.94). Older adults, especially those aged 85 and above, are at greatest risk (RR = 1.83, CI: 1.71, 1.96). The Southern Tier climate region had a higher risk (RR = 1.93, CI: 1.80, 2.07) than several other regions. Overall, similar risk between rural and urban NYS was observed. Rural non-Hispanic Black (RR = 2.38, CI: 1.78, 3.19) populations had a higher risk than their urban counterparts. This study was innovative for NYS, providing a deeper understanding of heat–health risks to vulnerable sub-groups. This can assist with facilitating targeted interventions and public health messaging during the periods of highest risk, such as promoting awareness of cooling centers and air-conditioning benefits. Full article

(This article belongs to the Section Environmental Health)

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13 pages, 898 KiB

Open AccessArticle

The Impact of Air Quality on Patient Mortality: A National Study

by Divya Periyakoil, Isabella Chu, Ndola Prata and Marie Diener-West

Int. J. Environ. Res. Public Health 2025, 22(7), 1123; https://doi.org/10.3390/ijerph22071123 (registering DOI) - 16 Jul 2025

Abstract

Introduction: Air pollution is a risk factor for a variety of cardiopulmonary diseases and is a contributing factor to cancer, diabetes, and cognitive impairment. The impact on mortality is not clearly elucidated. Objectives: The goal of this study is to determine the impact [...] Read more.

Introduction: Air pollution is a risk factor for a variety of cardiopulmonary diseases and is a contributing factor to cancer, diabetes, and cognitive impairment. The impact on mortality is not clearly elucidated. Objectives: The goal of this study is to determine the impact (if any) of air pollution on the 5-year mortality of patients in the American Family Cohort (AFC) dataset. Methods: The AFC dataset is derived from the American Board of Family Medicine PRIME Registry electronic health record data. It includes longitudinal information from 6.6 million unique patients from an estimated 800 primary care practices across 47 states, with 40% coming from rural areas. The Environmental Protection Agency’s Air Quality Index (AQI) measures were downloaded for the study period (2016–2022). Using the Python library pandas, the AFC and EPA datasets were merged with respect to date, time, and location. Cox Regression Models were performed on the merged dataset to determine the impact (if any) of air quality on patients’ five-year survival. In the model, AQI was handled as a time-independent (time-fixed) covariate. Results: The group with AQI > 50 had an adjusted hazard of death that was 4.02 times higher than the hazard of death in the group with AQI ≤ 50 (95% CI: 3.36, 4.82, p < 0.05). The hazard of death was 6.73 times higher in persons older than 80 years of age (95% CI: 5.47, 8.28; p < 0.05) compared to those younger than 80 years of age. Black/African American patients had a 4.27 times higher hazard of death (95%CI: 3.47, 5.26; p < 0.05) compared to other races. We also found that regional effects played a role in survival. Conclusions: Poor air quality was associated with a higher hazard of mortality, and this phenomenon was particularly pronounced in Black/African American patients and patients older than 80 years of age. Air pollution is an important social determinant of health. Public health initiatives that improve air quality are necessary to improve health outcomes. Full article

(This article belongs to the Special Issue Air Pollution Exposure and Its Impact on Human Health)

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18 pages, 549 KiB

Open AccessArticle

Rethinking Smoking and Quitting in Low-Income Contexts: A Qualitative Analysis with Implications for Practice and Policy

by Monique T. Cano, Oscar F. Rojas Perez, Sara Reyes, Blanca Pineda and Ricardo F. Muñoz

Int. J. Environ. Res. Public Health 2025, 22(7), 1122; https://doi.org/10.3390/ijerph22071122 (registering DOI) - 16 Jul 2025

Abstract

Despite a general decline in smoking rates among the U.S. population, smoking among low-income populations remains disproportionately high, likely due to the social determinants of health. To inform tailored approaches and responsive public health policies, the aim of this study was to qualitatively [...] Read more.

Despite a general decline in smoking rates among the U.S. population, smoking among low-income populations remains disproportionately high, likely due to the social determinants of health. To inform tailored approaches and responsive public health policies, the aim of this study was to qualitatively explore the sociocultural contexts, attitudes, and behaviors regarding smoking and quitting in a sample of low-income adults who smoke. In-depth, semi-structured qualitative interviews were conducted with 20 adults. Participants were recruited through local safety-net primary care clinics and community sites. A thematic analytic approach was utilized to analyze transcribed interviews. In exploring smoking and quitting within the context of low-income individuals, the following six themes were identified: caught between health and tobacco use; the nuances of context; roadblocks to quitting; motivation without movement; a temporary escape; and one size does not fit all. Insights into sociocultural and environmental contexts that shape smoking and quitting among low-income individuals revealed a complex interplay of factors that perpetuate smoking behavior and make it difficult to achieve sustained cessation. The study findings point to the importance of patient-centered and collaborative approaches that tailor smoking cessation efforts to the unique needs and lived experiences of low-income people who smoke. Full article

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22 pages, 592 KiB

Open AccessReview

Reproductive Health Literacy and Knowledge Among Female Refugees: A Scoping Review of Measurement Methodologies and Effect on Health Behavior

by Kimberly W. Tseng, Henna Mohabbat, Anne Adachi, Angela Calaguas, Amardeep Kaur, Nabeala Salem and Zahra Goliaei

Int. J. Environ. Res. Public Health 2025, 22(7), 1121; https://doi.org/10.3390/ijerph22071121 (registering DOI) - 16 Jul 2025

Abstract

Reproductive health literacy (RHL) is essential to women’s ability to make informed reproductive health (RH) decisions and is a key determinant of RH outcomes. Resettled refugee women often experience poorer RH outcomes, yet there is limited research on their RHL and its influence [...] Read more.

Reproductive health literacy (RHL) is essential to women’s ability to make informed reproductive health (RH) decisions and is a key determinant of RH outcomes. Resettled refugee women often experience poorer RH outcomes, yet there is limited research on their RHL and its influence on RH decision-making. This scoping review aims to (1) to evaluate existing methods for measuring RHL among resettled refugee women and (2) to characterize the relationship between RHL, RH decision-making, behavior, and outcomes among refugee women residing in high-income countries. A search of peer-reviewed literature published in English found limited direct measurement of RHL. Measurement methods were primarily qualitative or based on unvalidated survey instruments, limiting comparability and generalizability. The current methodologies do not adequately capture RH knowledge or RHL proficiency. A range of additional factors were found to influence RH decision-making and behavior, supporting the need for a means to accurately measure RHL. Further quantitative research is needed to clarify the extent to which RHL and knowledge influence RH behavior and outcomes. The development of a culturally relevant, validated RHL instrument that integrates knowledge and contextual influences would support healthcare providers and public health agents in serving and designing effective interventions for refugee women post-resettlement. Full article

(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)

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19 pages, 336 KiB

Open AccessArticle

The Unique Experience of Intersectional Stigma and Racism for Aboriginal and Torres Strait Islander People Who Inject Drugs, and Its Effect on Healthcare and Harm Reduction Service Access

by Emily Pegler, Gail Garvey, Lisa Fitzgerald, Amanda Kvassay, Nik Alexander, Geoff Davey, Diane Rowling and Andrew Smirnov

Int. J. Environ. Res. Public Health 2025, 22(7), 1120; https://doi.org/10.3390/ijerph22071120 (registering DOI) - 16 Jul 2025

Abstract

Aboriginal and Torres Strait Islander people who inject drugs face persistent health inequities, highlighting the need for programs that meet the needs of these groups. This study explored how intersectional stigma and discrimination affect Aboriginal and Torres Strait Islander people’s access to quality [...] Read more.

Aboriginal and Torres Strait Islander people who inject drugs face persistent health inequities, highlighting the need for programs that meet the needs of these groups. This study explored how intersectional stigma and discrimination affect Aboriginal and Torres Strait Islander people’s access to quality healthcare. Aboriginal and Torres Strait Islander participants aged ≥18 years who had injected drugs within the past 12 months were recruited from two regional needle and syringe programs (NSPs) and a major city NSP in Queensland, Australia. Participants completed a structured survey and yarned with an Aboriginal researcher and non-Indigenous research assistant about their healthcare experiences. Through a process of reflexive and thematic analysis, three major qualitative themes emerged: participants’ social circumstances and mental health challenges made help-seeking difficult and complex; enacted stigma and racism diminished access to health services and the quality of care received; and injecting drug use was associated with disconnection from culture and community. Privileging the expertise and voices of those with lived/living experience is essential for the creation of culturally safe, inclusive, and destigmatising healthcare services for Aboriginal and Torres Strait Islander people who inject drugs. Full article

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

12 pages, 307 KiB

Open AccessArticle

Quality and Satisfaction in Health Care: A Case Study of Two Public Hospitals in Trujillo, Peru

by Ariane Morales-Garrido, Brigitte Valderrama-Pazos, Jeremy García-Carranza, Alexis Horna-Velásquez, Willy Reyes-Anticona, Anlli Estela-Vargas and Walter Rojas-Villacorta

Int. J. Environ. Res. Public Health 2025, 22(7), 1119; https://doi.org/10.3390/ijerph22071119 - 16 Jul 2025

Abstract

(1) Background: The Peruvian healthcare system is widely regarded as deficient, with ongoing improvements identified as a key area of need. This study sought to assess user satisfaction and the quality of care in two public hospitals in Trujillo. (2) Methods: A non-experimental, [...] Read more.

(1) Background: The Peruvian healthcare system is widely regarded as deficient, with ongoing improvements identified as a key area of need. This study sought to assess user satisfaction and the quality of care in two public hospitals in Trujillo. (2) Methods: A non-experimental, cross-sectional, and correlational study was carried out. A group of 384 people who used two public hospitals in the city of Trujillo was studied. The people in the study were chosen based on the researchers’ convenience sampling. Information was collected using a survey based on the SERVQUAL model. This survey was used to evaluate the quality of service. Descriptive and inferential analyses were performed, including Spearman’s correlation and multinomial logistic regression to assess associations and identify key predictors of perceived service quality. (3) Results: The results indicated that 97.66% of the users perceived a low quality of care and 100% expressed dissatisfaction with the services. The most critical dimensions were reliability and responsiveness, while tangible items obtained better results. A positive correlation (rho = 0.723) was identified between quality of care and user satisfaction, with empathy (rho = 0.559) and safety (rho = 0.543) emerging as the most influential dimensions. (4) Conclusions: Responsiveness and Security were identified as key predictors of the perceived service quality in two public hospitals in Trujillo, Peru. Despite high empathy correlations, only timely care and safety significantly influenced satisfaction. The findings align with SDG 3, calling for improved efficiency and humanized care in public health services. Full article

11 pages, 317 KiB

Open AccessArticle

Strength Training and Nutrition Help Prevent Sarcopenia in Older Adults

by Milton Pereira, Ana Carolina Silva, Vinícius Mapa, Lilian Peixoto, Ingrid Lacerda, João Batista Ferreira-Júnior, Izinara Rosse, Emerson Cruz de Oliveira, Lenice Kappes Becker, Gabriela Venturini and Daniel Barbosa Coelho

Int. J. Environ. Res. Public Health 2025, 22(7), 1118; https://doi.org/10.3390/ijerph22071118 (registering DOI) - 16 Jul 2025

Abstract

Sarcopenia is a musculoskeletal, progressive, and generalized disease characterized by decreased muscle strength and mass, leading to reduced quality of life. Sarcopenia is directly related to age, a sedentary lifestyle, and poor nutrition. The objective of this study was to evaluate the effect [...] Read more.

Sarcopenia is a musculoskeletal, progressive, and generalized disease characterized by decreased muscle strength and mass, leading to reduced quality of life. Sarcopenia is directly related to age, a sedentary lifestyle, and poor nutrition. The objective of this study was to evaluate the effect of 12-week progressive intensity Resistance Training (RT) associated with nutritional advice on the frequency of sarcopenia in older adults. A total of 74 older adults (37 in the intervention group and 37 in the control group), with a mean age of 69.1 ± 6.85 years, were included in the study. The sarcopenia status of the participants was assessed at baseline and after a 12-week intervention. In the intervention group, resistance training combined with nutritional counseling reduced the prevalence of sarcopenia from 100% to 59.5% (p = 0.000). Additionally, participants in the intervention group showed significant improvements in handgrip strength (from 27.70 ± 10.71 to 30.24 ± 10.38 kg), chair stand test performance (from 14.04 ± 3.46 to 11.67 ± 1.80 s), and time up and go test (from 7.49 ± 1.20 to 6.74 ± 0.95 s) (p < 0.05). On the other hand, the control group increased the incidence of sarcopenia (p = 0.000). After 12 weeks, progressive intensity RT associated with nutritional advice proved to be an effective treatment to reverse sarcopenia and help participants remain non-sarcopenic. In addition, the results of this study provide information about efficient and non-pharmacological sarcopenia treatment. Full article

(This article belongs to the Special Issue Association of Physical Activity and Sedentary Behavior with Older Adults’ Health)

18 pages, 580 KiB

Open AccessArticle

Instructors’ Views on and Experiences with Last Aid Courses as a Means for Public Palliative Care Education—A Longitudinal Mixed-Methods Study

by Georg Bollig, Sindy Müller-Koch and Erika Zelko

Int. J. Environ. Res. Public Health 2025, 22(7), 1117; https://doi.org/10.3390/ijerph22071117 - 15 Jul 2025

Abstract

Background and aims: The Last Aid Course (LAC) has been established to enhance the discussion about dying, death and grief and to raise the public’s awareness of palliative care. The aim of this study was to explore the views and experiences of German [...] Read more.

Background and aims: The Last Aid Course (LAC) has been established to enhance the discussion about dying, death and grief and to raise the public’s awareness of palliative care. The aim of this study was to explore the views and experiences of German Last Aid Course instructors with the LAC as means for Public Palliative Care Education (PPCE), including their opinion about the course content and format and practical aspects of teaching in different settings. Methods: A longitudinal mixed-methods approach was used to explore the views and experiences of the Last Aid Course instructors over a period of five years. Social space orientation was used as the framework for the data analysis. Results: The LAC participants felt empowered after the LACs. Continuing development was a characteristic of the LAC project. The positive effects of the LACs included empowerment and positive interactions between the instructors and participants. In addition, the LACs had a positive impact on all five principles of social space orientation. Conclusion: LACs can contribute to raising public awareness about dying, death, grief and palliative care and empower people to participate in caring for those who are serious ill, dying and grieving. Full article

(This article belongs to the Special Issue End-of-Life Care and Nursing)

33 pages, 2115 KiB

Open AccessReview

PFAS Exposure, Mental Health, and Environmental Justice in the United States: Impacts on Marginalized Communities

by Shiryn D. Sukhram, Ji Kim, Sabrina Musovic, Ayotunde Anidugbe, Emiliano Corte, Tasneem Ahsan, Selvia Rofail, Nicolli Mesquita and Miguel Padilla

Int. J. Environ. Res. Public Health 2025, 22(7), 1116; https://doi.org/10.3390/ijerph22071116 - 15 Jul 2025

Abstract

Per- and polyfluoroalkyl substances (PFASs), commonly known as “forever chemicals”, are synthetic compounds with highly stable carbon–fluorine bonds, making them resistant to environmental degradation. These chemicals accumulate in ecosystems and water supplies, posing significant risks to human health, including cancer, immune system dysfunction, [...] Read more.

Per- and polyfluoroalkyl substances (PFASs), commonly known as “forever chemicals”, are synthetic compounds with highly stable carbon–fluorine bonds, making them resistant to environmental degradation. These chemicals accumulate in ecosystems and water supplies, posing significant risks to human health, including cancer, immune system dysfunction, and neurological disorders. However, the mental health impacts of PFAS exposure remain underexplored, particularly in marginalized communities. This review examines the emerging evidence linking PFAS exposure to mental health issues such as anxiety, depression, and cognitive decline, with a focus on communities of color who face heightened vulnerability due to environmental and social health disparities. The review highlights the persistence of PFASs in the environment, common exposure pathways, and the disproportionate effects on populations living near contaminated sites. Despite some regulatory progress, U.S. regulations on PFASs are limited, especially compared to international standards. The review calls for stronger policy frameworks and emphasizes the need for environmental justice, health equity, and public awareness. By connecting environmental health, social justice, and mental well-being, the review aims to guide future research and policy reforms to mitigate the mental health consequences of PFAS exposure in vulnerable populations. Full article

(This article belongs to the Special Issue Feature Papers in Environmental Exposure and Toxicology)

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14 pages, 565 KiB

Open AccessArticle

GerenciaVida: Validity Evidence of a Mobile Application for Suicide Behavior Management

by Daniel de Macêdo Rocha, Aline Costa de Oliveira, Sandra Marina Gonçalves Bezerra, Laelson Rochelle Milanês Sousa, Rafael Saraiva Alves, Breno da Silva Oliveira, Iara Barbosa Ramos, Muriel Fernanda de Lima, Renata Karina Reis and Lídya Tolstenko Nogueira

Int. J. Environ. Res. Public Health 2025, 22(7), 1115; https://doi.org/10.3390/ijerph22071115 - 15 Jul 2025

Abstract

Technology-based strategies for the prevention and management of suicidal behavior are widely referenced for identifying vulnerable groups and for supporting clinical reasoning, decision-making, and appropriate referrals. In this study, we estimated the interface and content validity evidence of an interactive mobile application developed [...] Read more.

Technology-based strategies for the prevention and management of suicidal behavior are widely referenced for identifying vulnerable groups and for supporting clinical reasoning, decision-making, and appropriate referrals. In this study, we estimated the interface and content validity evidence of an interactive mobile application developed for managing suicidal behavior. This methodological study employed psychometric parameters to evaluate the content and interface of the mobile application, following five action phases: analysis, design, development, implementation, and evaluation. A total of 27 healthcare professionals participated, selected by convenience sampling, all working within the Psychosocial Care Network across different regions of Brazil. Data were collected using an electronic form, the Delphi technique for evaluation rounds, and a Likert scale to achieve consensus. The validity analysis was based on a Content Validity Index (CVI) equal to or greater than 0.80. The results showed that GerenciaVida, a technology developed for healthcare workers—regardless of their level of care or professional category—can be used to screen for suicide risk in the general population and indicate preventive alternatives. The app demonstrated satisfactory indicators of content validity (0.974) and interface validity (0.963), reflecting clarity (0.925), objectivity (1.00), adequacy (0.925), coherence (0.962), accuracy (0.962), and clinical relevance (1.00). The development path of this mobile application provided scientific, technological, and operational support, establishing it as an innovative care tool. It consolidates valid evidence that supports the identification, risk classification, and prevention of suicidal behavior in various healthcare contexts. Full article

(This article belongs to the Special Issue Media Psychology and Health Communication)

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14 pages, 342 KiB

Open AccessArticle

Association Between Body Image and Quality of Life of Women Who Underwent Breast Cancer Surgery

by Camila Zanella Battistello, Eduardo Remor, Ícaro Moreira Costa, Mônica Echeverria de Oliveira and Andréa Pires Souto Damin

Int. J. Environ. Res. Public Health 2025, 22(7), 1114; https://doi.org/10.3390/ijerph22071114 - 15 Jul 2025

Abstract

Breast cancer is a condition characterized by the uncontrolled growth of breast cancer cells. The treatment for the disease, such as surgery, chemotherapy, radiotherapy, and systemic therapy, can significantly impact patients’ body image and overall quality of life. This study aimed to evaluate [...] Read more.

Breast cancer is a condition characterized by the uncontrolled growth of breast cancer cells. The treatment for the disease, such as surgery, chemotherapy, radiotherapy, and systemic therapy, can significantly impact patients’ body image and overall quality of life. This study aimed to evaluate body image perceptions and cancer-related quality of life in women who underwent surgical treatment for breast cancer at a reference hospital in southern Brazil. One hundred six women with breast cancer, aged 21 to 93 years (M = 55.3; SD = 12.9), participated in this cross-sectional study. They responded to the Body Image and Relationships Scale (BIRS), Functional Assessment of Cancer Therapy for Breast Cancer scale (FACT-B), and a questionnaire on clinical and sociodemographic variables. Multiple linear regression analyses revealed that general perceived body image, as measured by BIRS, was significantly predicted by younger age and chemotherapy (F(2, 99) = 7.376, p = 0.003). These predictors accounted for 11.2% of the variance in BIRS (adjusted R² = 0.112). Hierarchical multiple regression analysis indicated that cancer-related quality of life was significantly predicted by younger age, use of psychiatric medication, and body image domains, including strength and health, social barriers, and appearance and sexuality. The complete model, encompassing all predictors, was significant (F(5, 96) = 15.970, p < 0.001) and explained 42.6% of the variance in FACT-B (adjusted R² = 0.426). Clinicians should be aware that younger patients who have undergone chemotherapy for breast cancer may experience changes in body image perception following surgery. Contributing factors such as younger age, use of psychiatric medications, and negative postoperative body image may be associated with a diminished quality of life related to cancer. Full article

(This article belongs to the Special Issue Mental Health Across the Breast Cancer Survivorship Continuum: Risk Factors and Outcomes in Diverse and Understudied Populations)

2 pages, 174 KiB

Open AccessComment

Methodological Considerations for a Risk Model Adopted into the Chronic Disease Prevention Policy of Taiwan. Comment on Chang et al. Developing and Validating Risk Scores for Predicting Major Cardiovascular Events Using Population Surveys Linked with Electronic Health Insurance Records. Int. J. Environ. Res. Public Health 2022, 19, 1319

by Che-Jui Chang

Int. J. Environ. Res. Public Health 2025, 22(7), 1113; https://doi.org/10.3390/ijerph22071113 - 15 Jul 2025

Abstract

Chang, H.-Y. et al. (2022) developed a risk prediction model for major adverse cardiovascular events (MACEs), coronary heart disease (CHD), and stroke using nationwide claims data retrieved from the Taiwan National Health Insurance (NHI) records [...] Full article

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

21 pages, 1877 KiB

Open AccessArticle

Touching Emotions: How Touch Shapes Facial Emotional Processing Among Adolescents and Young Adults

by Letizia Della Longa and Teresa Farroni

Int. J. Environ. Res. Public Health 2025, 22(7), 1112; https://doi.org/10.3390/ijerph22071112 - 15 Jul 2025

Abstract

Emotion recognition is an essential social ability that continues to develop across adolescence, a period of critical socio-emotional changes. In the present study, we examine how signals from different sensory modalities, specifically touch and facial expressions, are integrated into a holistic understanding of [...] Read more.

Emotion recognition is an essential social ability that continues to develop across adolescence, a period of critical socio-emotional changes. In the present study, we examine how signals from different sensory modalities, specifically touch and facial expressions, are integrated into a holistic understanding of another’s feelings. Adolescents (n = 30) and young adults (n = 30) were presented with dynamic faces displaying either a positive (happy) or a negative (sad) expression. Crucially, facial expressions were anticipated by a tactile stimulation, either positive or negative. Across two experiments, we use different tactile primes, both in first-person experience (experiment 1) and in the vicarious experience of touch (experiment 2). We measured accuracy and reaction times to investigate whether tactile stimuli affect facial emotional processing. In both experiments, results indicate that adolescents were more sensitive than adults to the influence of tactile primes, suggesting that sensory cues modulate adolescents’ accuracy and velocity in evaluating emotion facial expression. The present findings offer valuable insights into how tactile experiences might shape and support emotional development and interpersonal social interactions. Full article

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

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15 pages, 631 KiB

Open AccessArticle

Competences Enabling Young Germans to Engage in Activities for Climate Protection and Global Health

by Volker Gehrau, Iris Morgenstern, Carola Grunschel, Judith Könemann, Marcus Nührenbörger, Angela Schwering and Christian Fischer

Int. J. Environ. Res. Public Health 2025, 22(7), 1111; https://doi.org/10.3390/ijerph22071111 - 15 Jul 2025

Abstract

The study examines how individual skills influence adolescents’ and young adults’ commitment to climate protection and global health. Based on 21st-century skills and transformative education, it focuses on competences in science, geography, mathematics, religion, ethics, and media. A representative online survey of 783 [...] Read more.

The study examines how individual skills influence adolescents’ and young adults’ commitment to climate protection and global health. Based on 21st-century skills and transformative education, it focuses on competences in science, geography, mathematics, religion, ethics, and media. A representative online survey of 783 participants in Germany assessed topic relevance, information-seeking behavior, and active engagement. The results show that subject-specific skills significantly affect engagement, especially when closely related to the topics. Scientific, mathematical, and geographical competences enhance all three engagement dimensions. Media competence primarily increases perceived importance, while religious and ethical competences positively influence all areas. Structural equation modeling reveals a process: perceived relevance leads to information search, which then drives engagement. Thus, competences have both direct and indirect effects on active involvement. The findings highlight that long-term engagement is not only driven by campaigns but also by education that equips young people with the skills to recognize important issues, seek information, and take action independently. Full article

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8 pages, 242 KiB

Open AccessArticle

A Worldwide Study of the Relationship Between Gini Coefficients and Suicide Rates

by Juncheng Lyu, Jie Zhang and Dorian A. Lamis

Int. J. Environ. Res. Public Health 2025, 22(7), 1110; https://doi.org/10.3390/ijerph22071110 - 15 Jul 2025

Abstract

Background: The Gini coefficient measures how much the distribution of income or consumption within an economy deviates from an equal distribution. However, there has been a paucity of research examining the association between Gini coefficients and suicide rates in the countries of the [...] Read more.

Background: The Gini coefficient measures how much the distribution of income or consumption within an economy deviates from an equal distribution. However, there has been a paucity of research examining the association between Gini coefficients and suicide rates in the countries of the world. Objective: To prove the hypothesis that the higher the Gini coefficient, the larger the relative deprivation and the higher the suicide rate, and further to verify the effect of relative deprivation on suicidality. Methods: Suicide rates for different countries were obtained from the World Health Organization (WHO) website. The Gini coefficients for the countries were taken from the World Bank website. Correlations were performed between the suicide rates and the Gini coefficients. SPSS 21.0 was used to analyze the data. Results: Overall the suicide rates and Gini coefficients decreased slightly from 2017 to 2019. There was an overall negative association between Gini coefficients and suicide rates in the countries studied. However, a different trend was observed in lower-income countries, where higher Gini coefficients were associated with higher suicide rates. The correlation between Gini coefficients and the suicide rates of females was larger than males in low- and high-income countries. However, the correlation for males was larger than females in lower-middle- and upper-middle-income countries. Conclusions: Current data show that Gini coefficients are negatively associated with suicide rates, but there is a different trend for lower-income countries. Economic development and the strain theory of suicide can be applied to explain the effects of relative deprivation on suicidality. Full article

(This article belongs to the Special Issue Research on Suicide Assessment, Prevention and Management)

16 pages, 1762 KiB

Open AccessArticle

Barriers and Promoters of Healthy Eating from the Perspective of Food Environment Perception: From Epidemiology to the Talking Map

by Bruna Aparecida Avelar, Anabele Pires Santos, Renata Adrielle Lima Vieira, Raquel De Deus Mendonça and Mariana Carvalho de Menezes

Int. J. Environ. Res. Public Health 2025, 22(7), 1109; https://doi.org/10.3390/ijerph22071109 - 15 Jul 2025

Abstract

Background: Food environments can determine food choices, acting as barriers to or promoters of healthy eating. It is necessary to investigate individuals’ perceptions of those barriers and promoters of healthy eating in the food environment. Methods: This is a qualitative and quantitative study [...] Read more.

Background: Food environments can determine food choices, acting as barriers to or promoters of healthy eating. It is necessary to investigate individuals’ perceptions of those barriers and promoters of healthy eating in the food environment. Methods: This is a qualitative and quantitative study involving patients diagnosed with arterial hypertension. In the quantitative approach, a validated questionnaire for the Brazilian population, the Perceived Nutrition Environment Measures Survey, was used. For the qualitative approach, a talking map was applied in a focus group with guiding questions. Quantitative data were analyzed through simple relative frequency, and qualitative data through reports; subsequently, both were grouped into perceived barriers and facilitators. Results: Participants found high access to ultra-processed foods, strongly influenced by advertising in commercial establishments, as a barrier, as well as barriers related to changes in commensality habits and transformations in food systems. As promoting factors, access to fruits and vegetables was highlighted as favoring healthier food choices. The qualitative findings emphasized the importance of home gardens and foods sourced from family farming. Conclusions: This study found that individuals perceive high access to ultra-processed foods in their food environment, both in financial terms and availability, while reporting low access to fresh foods. Full article

(This article belongs to the Special Issue Bridging the Gap in Studies on the Food Environment: The State-of-the-Art in Low- and Middle-Income Countries (LMICs))

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26 pages, 659 KiB

Open AccessArticle

Predictors of Health-Workforce Job Satisfaction in Primary Care Settings: Insights from a Cross-Sectional Multi-Country Study in Eight African Countries

by Samuel Muhula, Yvonne Opanga, Saida Kassim, Lazarus Odeny, Richard Zule Mbewe, Beverlyne Akoth, Mable Jerop, Lizah Nyawira, Ibrahima Gueye, Richard Kiplimo, Thom Salamba, Jackline Kiarie and George Kimathi

Int. J. Environ. Res. Public Health 2025, 22(7), 1108; https://doi.org/10.3390/ijerph22071108 - 15 Jul 2025

Abstract

Job satisfaction in sub-Saharan Africa is crucial as it directly impacts employee productivity, retention, and overall economic growth, fostering a motivated workforce that drives regional development. In sub–Saharan Africa, poor remuneration, limited professional development opportunities, and inadequate working conditions impact satisfaction. This study [...] Read more.

Job satisfaction in sub-Saharan Africa is crucial as it directly impacts employee productivity, retention, and overall economic growth, fostering a motivated workforce that drives regional development. In sub–Saharan Africa, poor remuneration, limited professional development opportunities, and inadequate working conditions impact satisfaction. This study examined job-satisfaction predictors among health workers in primary healthcare settings across eight countries: Ethiopia, Kenya, Malawi, Senegal, South Sudan, Tanzania, Uganda, and Zambia. A cross-sectional study surveyed 1711 health workers, assessing five dimensions: employer–2employee relationships, remuneration and recognition, professional development, physical work environment, and supportive supervision. The study was conducted from October 2023 to March 2024. The job-satisfaction assessment tool was adopted from a validated tool originally developed for use in low-income healthcare settings. The tool was reviewed by staff from all the country offices to ensure contextual relevance and organization alignment. The responses were measured on a five-point Likert scale: 0: Not applicable, 1: Very dissatisfied, 2: Dissatisfied, 3: Neutral, 4: Satisfied, and 5: Very satisfied. The analysis employed descriptive and multivariable regression methods. Job satisfaction varied significantly by country. Satisfaction with the employer–employee relationship was highest in Zambia (80%) and lowest in Tanzania (16%). Remuneration satisfaction was highest in Senegal (63%) and Zambia (49%), while it was very low in Malawi (9.8%) and Ethiopia (2.3%). Overall, 44% of respondents were satisfied with their professional development, with Uganda leading (62%) and Ethiopia having the lowest satisfaction level (29%). Satisfaction with the physical environment was at 27%, with Uganda at 40% and Kenya at 12%. Satisfaction with supervisory support stood at 62%, with Zambia at 73% and Ethiopia at 30%. Key predictors of job satisfaction included a strong employer–employee relationships (OR = 2.20, p < 0.001), fair remuneration (OR = 1.59, p = 0.002), conducive work environments (OR = 1.71, p < 0.001), and supervisory support (OR = 3.58, p < 0.001. Improving the job satisfaction, retention, and performance of health workers in sub-Saharan Africa requires targeted interventions in employer–employee relationships, fair compensation, supportive supervision, and working conditions. Strategies must be tailored to each country’s unique challenges, as one-size-fits-all solutions may not be effective. Policymakers should prioritize these factors to build a motivated, resilient workforce, with ongoing research and monitoring essential to ensure sustained progress and improved healthcare delivery. Full article

(This article belongs to the Special Issue Access to Public Health Services and Challenges to Healthcare Management)

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12 pages, 275 KiB

Open AccessArticle

Associations of Butyrylcholinesterase Activity and Lipid-Related Indices with Obesity in Thai Children

by Kanjana Suriyaprom, Sujinda Songtrai, Nittiya Chowchaikong and Chutima Sirikulchayanonta

Int. J. Environ. Res. Public Health 2025, 22(7), 1107; https://doi.org/10.3390/ijerph22071107 - 14 Jul 2025

Abstract

Background: Childhood obesity is a significant global health concern. Butyrylcholinesterase (BChE) has been shown to play a role in lipid metabolism. This study aimed to assess BChE activity, obesity-related and lipid-related indices, and dyslipidemia in obese and non-obese children, and to investigate the [...] Read more.

Background: Childhood obesity is a significant global health concern. Butyrylcholinesterase (BChE) has been shown to play a role in lipid metabolism. This study aimed to assess BChE activity, obesity-related and lipid-related indices, and dyslipidemia in obese and non-obese children, and to investigate the associations of these parameters with obesity among Thai children. Methods: The study included 661 Thai children, consisting of 338 with obesity and 323 with a normal weight. Anthropometric measurements, metabolic parameters, obesity- and lipid-related indices, and BChE activity were evaluated. Results: The obese group exhibited significantly higher BChE activity and obesity-related and lipid-related indices compared to the non-obese group (p < 0.01). Additionally, metabolic parameters—including glucose levels, triglyceride-glucose (TyG) index, and TyG-related indices—as well as the lipid profile, which included triglycerides (TG), non-high-density lipoprotein cholesterol (non-HDL-C), and very-low-density lipoprotein cholesterol (VLDL-C), were all significantly elevated in the obese group (p < 0.01). Obesity was associated with dyslipidemia (p < 0.01). Moreover, BChE activity showed a positive correlation with obesity-related and lipid-related indices, along with several metabolic parameters (p < 0.002). The upper stratum of BChE activity (OR = 5.356), the non-HDL-C/HDL-C ratio (OR = 2.185), and the TG/HDL-C ratio (OR = 1.703) were found to be effective in evaluating and predicting the risk of obesity, even after adjusting for potential covariates (p < 0.01). Conclusions: These findings indicate a significant relationship between obesity and increased BChE activity, lipid-related indices, and dyslipidemia in Thai children. Therefore, changes in BChE activity may be considered a factor associated with obesity, enhancing its potential as a marker for obesity assessment. Full article

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