International Journal of Environmental Research and Public Health

15 pages, 396 KiB

Open AccessReview

Anxiety and Depression Disorders in Undergraduate Medical Students During the COVID-19 Pandemic: An Integrative Literature Review

by Ana Luisa Varrone Sartorao and Carlos Izaias Sartorao-Filho

Int. J. Environ. Res. Public Health 2024, 21(12), 1620; https://doi.org/10.3390/ijerph21121620 - 3 Dec 2024

Abstract

Introduction: The COVID-19 pandemic has triggered several challenges on the front of mental health. Undergraduate medical students face considerable stress in their academic routines. Thus, there is a need to explore the implications for the mental health of undergraduate medical students during the [...] Read more.

Introduction: The COVID-19 pandemic has triggered several challenges on the front of mental health. Undergraduate medical students face considerable stress in their academic routines. Thus, there is a need to explore the implications for the mental health of undergraduate medical students during the COVID-19 pandemic. Objective: To review the global literature about anxiety and depressive disorders in undergraduate medical students during the COVID-19 pandemic. Method: We developed an integrative literature review on the occurrence of anxiety and depressive symptoms in undergraduate medical students during the COVID-19 pandemic. We included the manuscripts that used the PHQ-9 and/or GAD-7 questionnaires. We excluded systematic reviews, narrative reviews, integrative reviews, meta-analyses, and qualitative analytical studies. We assessed the results on the occurrence of anxiety and depression and the severity of symptoms in medical students during the COVID-19 pandemic using quantitative studies applying the GAD-7 questionnaire for anxiety or the PHQ-9 for depression. Results: We reviewed 85 selected studies, and the results showed a significant prevalence of moderate and severe symptoms of anxiety and depression, with 28.2% of participants presenting scores of ≥ 10 on the GAD-7 and 38.9% on the PHQ-9. Statistical analyses using simple and multiple regression tests revealed associations between higher rates of anxiety symptoms among students from developing countries and data collected after the lockdown period in 2020 during the pandemic lockdown. In addition, female students were at risk of depressive disorders. We emphasize as a limitation that the diagnosis of depression and anxiety requires a detailed clinical evaluation, which is not focused on in this actual study. Conclusions: Our findings highlight the need for specific interventions to support the mental health of undergraduate medical students, especially female students from developing countries, during a pandemic crisis. Full article

(This article belongs to the Special Issue Advances in Mental Health and Well-Being at the Workplace)

15 pages, 590 KiB

Open AccessArticle

Gender, Mental Health Stigma, and Help-Seeking in Arabic- and Swahili-Speaking Communities in Australia

by Shameran Slewa-Younan, Renu Narchal, Ruth Das, Klimentina Krstanoska-Blazeska, Ilse Blignault, Bingqin Li, Nicola Reavley and Andre Renzaho

Int. J. Environ. Res. Public Health 2024, 21(12), 1619; https://doi.org/10.3390/ijerph21121619 - 3 Dec 2024

Abstract

Australia is an ethnically diverse nation with large numbers of migrants and refugees entering the country yearly. Despite research demonstrating that individuals from culturally and linguistically diverse (CaLD) communities experience an elevated risk of developing a mental illness, mental health services uptake is [...] Read more.

Australia is an ethnically diverse nation with large numbers of migrants and refugees entering the country yearly. Despite research demonstrating that individuals from culturally and linguistically diverse (CaLD) communities experience an elevated risk of developing a mental illness, mental health services uptake is consistently low. To improve the mental health outcomes of these CaLD individuals in Australia, there is an urgent need to understand barriers to treatment, such as stigma. Research has noted that gender may play a role in mental health stigma and help-seeking. Using a qualitative approach as part of the Embrace Multicultural Mental Health Project, the aim of this study was to explore gender perspectives in mental health stigma and help-seeking among Arabic-speaking and Swahili-speaking individuals in Sydney. A total of five focus group discussions and 18 interviews were undertaken online using Zoom, digitally recorded, transcribed, and thematically analysed. Three major themes were identified. The first theme related to stigma and the fears regarding mental illness being discovered by others. The second theme related to the different approaches to confronting stigma. The last theme related to the various issues considered when identifying sources of help. Our findings suggest that a nuanced approach using the ‘what matters most’ framework can explain how men and women within each community may experience stigma and emphasise different aspects of help-seeking. These findings can help to guide clinical practitioners in delivering gender-specific and culturally sensitive and effective treatment sessions with these CaLD individuals, in addition to offering directions for stigma-reduction initiatives. Full article

9 pages, 255 KiB

Open AccessBrief Report

Perceptions of the Harm of Cigarettes, Mental Health, and Quality of Life Among Transgender Adults Who Smoke Menthol Cigarettes: Results from Wave 5 of the Population Assessment for Tobacco and Health (PATH) Study

by Nichelle Brown, Heesung Shin and Sabrina L. Smiley

Int. J. Environ. Res. Public Health 2024, 21(12), 1618; https://doi.org/10.3390/ijerph21121618 - 3 Dec 2024

Abstract

Sexual and gender minority (SGM) individuals in the United States are at greater risk for combustible tobacco use and mental health problems compared to heterosexual and cisgender individuals. National data comparing associations of menthol cigarette use and mental health among transgender and cisgender [...] Read more.

Sexual and gender minority (SGM) individuals in the United States are at greater risk for combustible tobacco use and mental health problems compared to heterosexual and cisgender individuals. National data comparing associations of menthol cigarette use and mental health among transgender and cisgender individuals in the United States are lacking. The goals of the current study were to (1) characterize transgender and cisgender individuals who smoke menthol cigarettes, and (2) investigate cross-sectional associations between gender identity, harm perceptions of cigarettes, mental health experiences, and quality of life. Data were drawn from Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study (2018–2019). A total of 3989 cisgender (mean [SD] age, 40.47 [0.32] years) and transgender (mean [SD] age, 38.36 [0.09] years) participants who reported current (past 30-day) menthol cigarette use were included in the analysis. Comparing transgender to cisgender groups, significant differences were found in associations between harm perceptions of cigarettes (adjusted odds ratio [AOR] 0.07; 95% CI: 0.02–0.28) and reported depression (AOR 4.57; 95% CI: 1.36–15.33). Collectively, these findings provide evidence that transgender adults who smoke menthol cigarettes are less likely than cisgender adults who smoke menthol cigarettes to perceive smoking as harmful to health and more likely to report recent experiences of depression. Full article

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

22 pages, 415 KiB

Open AccessReview

Temporal Stages of Burnout: How to Design Prevention?

by Céline Leclercq and Isabelle Hansez

Int. J. Environ. Res. Public Health 2024, 21(12), 1617; https://doi.org/10.3390/ijerph21121617 - 3 Dec 2024

Abstract

Burnout, a major concern defined most commonly in the literature with a symptoms-based classification, can also be described as a temporal process with various stages experienced by workers, each composed of unique characteristics and challenges. This intricate process of burnout emphasizes pivotal moments, [...] Read more.

Burnout, a major concern defined most commonly in the literature with a symptoms-based classification, can also be described as a temporal process with various stages experienced by workers, each composed of unique characteristics and challenges. This intricate process of burnout emphasizes pivotal moments, such as engagement and enthusiasm with a high job ideal (Stage 0), weakening of the ideal (Stage 1), protective withdrawal (Stage 2) and confirmed burnout (Stage 3). Through an opinion review, the objective of this article is to examine which prevention level, and more specifically which prevention actions, can be developed at each stage of this temporal process of burnout. The review criteria allow for the integration of both individual- and organization-focused interventions, ranging from early organizational-level strategies (primary prevention) to clinical consultations addressing the erosion of professional ideals (secondary prevention), as well as psychoeducational sessions aimed at promoting worker well-being. In conclusion, the article underscores the need for a holistic approach, combining organization-focused interventions with individual-focused interventions. Through a comprehensive review, this research provides insights into evidence-based practices, identifies gaps in current research, and offers guidance for future interventions for better support of workers facing burnout. Full article

(This article belongs to the Special Issue Promoting Health and Safety in the Workplace)

12 pages, 474 KiB

Open AccessArticle

Facilitators and Barriers to Implementing a Community Suicide Database and Prevention Program in Diverse Tribal Communities

by Meredith Stifter, Novalene Goklish, Charity Watchman, Kristin Mitchell, Jennifer Duncan, Michelle Miller, Mary HorseChief, Christopher G. Kemp, Mary Cwik and Emily E. Haroz

Int. J. Environ. Res. Public Health 2024, 21(12), 1616; https://doi.org/10.3390/ijerph21121616 - 3 Dec 2024

Abstract

Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes [...] Read more.

Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes a community-led database and case management follow-ups. Due to the success of the program in preventing suicides, the White Mountain Apache team has worked with other tribal communities to adapt the program. We wanted to understand the factors that are most important to implementing and sustaining this model and how these factors compare with existing implementation science frameworks. We employed an adapted nominal group technique to compile facilitators and barriers to implementation of the suicide prevention model across settings with five partner teams. Two researchers independently coded the resulting list of facilitators and barriers using the Consolidated Framework for Implementation Research (version 1.0) codebook. The final list of cross-site prioritized facilitators and barriers included 41 factors. Some factors did not match easily with the framework’s constructs. The White Mountain Apache suicide prevention team noted that seven of the top prioritized factors are considerations they most try to emphasize to new communities working in suicide prevention. The factors fall into two key themes: staffing and tribal engagement. This finding affirms their focus when they conduct suicide prevention trainings with new communities and provides an opportunity for more structure and in-depth training in those two areas. Several factors could not be easily coded to the framework, especially around the sociocultural characteristics of suicide prevention work in Native communities. This contributes to the larger discussion in implementation science concerning the ways in which Indigenous approaches to public health differ from Western models. Full article

(This article belongs to the Special Issue First Nation, Indigenous and Aboriginal Perspectives of Health Promotion and Wellbeing)

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42 pages, 3923 KiB

Open AccessReview

Environmental Exposure to Per- and Polyfluorylalkyl Substances (PFASs) and Reproductive Outcomes in the General Population: A Systematic Review of Epidemiological Studies

by Alex Haimbaugh, Danielle N. Meyer, Mackenzie L. Connell, Jessica Blount-Pacheco, Dienye Tolofari, Gabrielle Gonzalez, Dayita Banerjee, John Norton, Carol J. Miller and Tracie R. Baker

Int. J. Environ. Res. Public Health 2024, 21(12), 1615; https://doi.org/10.3390/ijerph21121615 - 2 Dec 2024

Abstract

This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review synthesized effects of background levels of per- and polyfluorylalkyl substance (PFAS) levels on reproductive health outcomes in the general public: fertility, preterm birth, miscarriage, ovarian health, menstruation, menopause, sperm health, and [...] Read more.

This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review synthesized effects of background levels of per- and polyfluorylalkyl substance (PFAS) levels on reproductive health outcomes in the general public: fertility, preterm birth, miscarriage, ovarian health, menstruation, menopause, sperm health, and in utero fetal growth. The inclusion criteria included original research (or primary) studies, human subjects, and investigation of outcomes of interest following non-occupational exposures. It drew from four databases (Web of Science, PubMed, Embase and Health and Environmental Research Online (HERO)) using a standardized search string for all studies published between 1 January 2017 and 13 April 2022. Risk of bias was assessed by two independent reviewers. Data were extracted and reviewed by multiple reviewers. Each study was summarized under its outcome in terms of methodology and results and placed in context, with recommendations for future research. Of 1712 records identified, 30 were eligible, with a total of 27,901 participants (33 datasets, as three studies included multiple outcomes). There was no effect of background levels of PFAS on fertility. There were weakly to moderately increased odds of preterm birth with higher perfluorooctane sulfonic acid (PFOS) levels; the same for miscarriage with perfluorooctanoic acid (PFOA) levels. There was limited yet suggestive evidence for a link between PFAS and early menopause and primary ovarian insufficiency; menstrual cycle characteristics were inconsistent. PFAS moderately increased odds of PCOS- and endometriosis-related infertility, respectively. Sperm motility and DNA health were moderately impaired by multiple PFAS. Fetal growth findings were inconsistent. This review may be used to inform forthcoming drinking water standards and policy initiatives regarding PFAS compounds and drinking water. Future reviews would benefit from more recent studies. Larger studies in these areas are warranted. Future studies should plan large cohorts and open access data availability to capture small effects and serve the public. Funding: Great Lakes Water Authority (Detroit, MI), the Erb Family Foundation through Healthy Urban Waters at Wayne State University (Detroit, MI), and Wayne State University CLEAR Superfund Research (NIH P42ES030991). Full article

(This article belongs to the Section Environmental Health)

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14 pages, 486 KiB

Open AccessReview

Women’s Empowerment and Health: A Narrative Review

by Marina Couva, Michael A. Talias, Miranda Christou and Elpidoforos S. Soteriades

Int. J. Environ. Res. Public Health 2024, 21(12), 1614; https://doi.org/10.3390/ijerph21121614 - 2 Dec 2024

Abstract

Empowerment, the process by which a person is enabled to increase control over decisions concerning their life, is a multidimensional construct that has been extensively discussed by various disciplines for more than four decades. Several empowerment models have been presented, based on different [...] Read more.

Empowerment, the process by which a person is enabled to increase control over decisions concerning their life, is a multidimensional construct that has been extensively discussed by various disciplines for more than four decades. Several empowerment models have been presented, based on different approaches. This paper proposes a four-step model, based on individual and contextual awareness and advancement. Disparate factors may positively or negatively affect empowerment, including gender, race, culture, education, financial autonomy, socioeconomic status, family, neighborhood, religion, social cohesion, civic society, and political context. Empowerment has been extensively discussed in parallel with health promotion, since it is expected to positively affect health, both on the level of the individual and community, as well as in the context of the patient–healthcare professional relationship. Considering the position of women in patriarchal societies, where women may experience feelings of powerlessness, their social position and more importantly health may be adversely affected. Gender biases that were developed due to the marginalized position of women in different societies, coupled with paternalistic approaches of healthcare professionals, may significantly contribute to higher comorbidity, albeit longer life expectancy for women. Empowerment can therefore be a powerful tool for achieving equity in health and improving women’s well-being. Full article

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13 pages, 2400 KiB

Open AccessArticle

Development of an eHealth Intervention Prototype to Prevent Health Risk Behaviors Among Hispanic Adolescents: A User-Centered Formative Study

by Yannine Estrada, Alyssa Lozano, Padideh Lovan, Devina J. Boga, Lara Martinuzzi, Jennifer Chavez, Maria I. Tapia, Guillermo Prado and Victoria Behar-Zusman

Int. J. Environ. Res. Public Health 2024, 21(12), 1613; https://doi.org/10.3390/ijerph21121613 - 1 Dec 2024

Abstract

Health risk behaviors continue to disproportionately affect Hispanic youth. Despite the existence of successful family and school-based interventions, there is a need for developing and testing individually-based preventive interventions that are easily accessed and widely disseminated. Therefore, this study aimed to develop a [...] Read more.

Health risk behaviors continue to disproportionately affect Hispanic youth. Despite the existence of successful family and school-based interventions, there is a need for developing and testing individually-based preventive interventions that are easily accessed and widely disseminated. Therefore, this study aimed to develop a prototype (proof of concept) for an individual-level mobile application (app), informed by Hispanic parents and adolescents, to prevent/reduce drug use and sexual risk behaviors among Hispanic youth. An iterative user-centered approach was used to inform the development of the app prototype via focus groups with 66 participants (n = 46 adolescents, n = 20 parents). A coding team analyzed data from the focus groups and identified major themes. The coding team summarized interview data into sub-categories that yielded five intervention modules for Hispanic adolescents, three more than originally proposed (i.e., drug use and sexual risk behaviors): (1) effective communication, (2) depression, (3) sexual health, (4) drug use, and (5) mindfulness. A mobile application for health risk behaviors can be used as an additional preventive tool to decrease the existing behavioral health disparities among Hispanic youth. Incorporating a user-centered approach to inform development is important for including the needs and voices of this population. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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15 pages, 619 KiB

Open AccessArticle

Sargassum Inundations and the Risk of Hypertension Disorders Among Pregnant Women Living in the French Caribbean Island of Martinique

by Rishika Banydeen, Mickael Rejaudry Lacavalerie, Loic Savoyen, Alice Monthieux, Mehdi Jean-Laurent, Jonathan Florentin, Fatima Radouani, Hossein Mehdaoui, Dabor Resiere and Remi Neviere

Int. J. Environ. Res. Public Health 2024, 21(12), 1612; https://doi.org/10.3390/ijerph21121612 - 1 Dec 2024

Abstract

Since 2011, Caribbean territories have experienced massive and repeated sargassum seaweed inundations. Once on shore, sargassum degradation through anaerobic metabolism elicits the release of many noxious molecules, including hydrogen sulfide (H₂S) and ammonia (NH₃). H₂S has been [...] Read more.

Since 2011, Caribbean territories have experienced massive and repeated sargassum seaweed inundations. Once on shore, sargassum degradation through anaerobic metabolism elicits the release of many noxious molecules, including hydrogen sulfide (H₂S) and ammonia (NH₃). H₂S has been long recognized as a malodorous and highly toxic gas, while chronic exposure has not been extensively explored. Our objective was to assess whether pregnant women exposed to sargassum emissions would be more prone to developing hypertensive disorders compared to unexposed women. We conducted a retrospective study including 3020 pregnant women at the Obstetrics Department of the University Hospital of Martinique between 25 January 2016 and 31 July 2020. Exposure was defined as a distance of less than 2 km between the residence/workplace of the women and the sargassum strandings. Multivariate regression retained age, body mass index, sickle cell disease, primipaternity, gestational diabetes and sargassum emissions exposure as independent predictors of hypertensive events in pregnant women. Jointly with previous studies from our group, this study highlights the deleterious effects of sargassum emissions on human health in individuals chronically exposed to low to moderate H₂S concentrations. Full article

(This article belongs to the Section Environmental Health)

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16 pages, 596 KiB

Open AccessArticle

Mental and Physical Wellbeing of Carer–Employees in Canada

by Ito Peng

Int. J. Environ. Res. Public Health 2024, 21(12), 1611; https://doi.org/10.3390/ijerph21121611 - 30 Nov 2024

Abstract

Today, an increasing number of Canadian adults are providing unpaid care to their family members and friends while working full or part-time. We conducted a national survey of unpaid caregiving for older people in 2022 to learn who these people are, why they [...] Read more.

Today, an increasing number of Canadian adults are providing unpaid care to their family members and friends while working full or part-time. We conducted a national survey of unpaid caregiving for older people in 2022 to learn who these people are, why they care, and to identify the social, economic, and health impacts of unpaid caregiving. Our findings show that many of these caregivers are also employees. While most research shows that women caregivers and carer-employees experience work-care tension that results in negative mental and physical health outcomes, our results are more mixed. This paper provides descriptive findings of carer-employee’s health and well-being, and compares them to previous research in Canada and abroad. I conclude with policy options for governments and employers to support the health and well-being of carer-employees. Full article

(This article belongs to the Special Issue Work–Life Policies, Employee Health and Well-Being)

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14 pages, 1695 KiB

Open AccessReview

Clinical Readiness for Practice of Nursing Students: A Concept Analysis

by Kennedy Diema Konlan, Dulamsuren Damiran and Tae Wha Lee

Int. J. Environ. Res. Public Health 2024, 21(12), 1610; https://doi.org/10.3390/ijerph21121610 - 30 Nov 2024

Abstract

Introduction: The concept of clinical readiness for practice among nursing students is yet to be analyzed, and there is a lack of empirical evidence on its usage among academics and clinicians. Methods: This concept analysis is anchored on a systematic literature review that [...] Read more.

Introduction: The concept of clinical readiness for practice among nursing students is yet to be analyzed, and there is a lack of empirical evidence on its usage among academics and clinicians. Methods: This concept analysis is anchored on a systematic literature review that adhered to the PRISMA guidelines and incorporated the eight iterative steps of Walker and Avant’s concept analysis method. This concept analysis method involved: (1) choosing a concept; (2) determining the objectives of the analysis; (3) identifying usages of the concept; (4) determining the defining attributes; (5) identifying a model case; (6) identifying other cases, including borderline, contrary, and related cases; (7) identifying antecedents and consequences; and (8) defining empirical references. The integrative thematic data synthesis method was adopted. Results: The concept of nursing students’ clinical readiness for practice is said to have four interrelated attributes. These attributes included (1) professional skills, (2) communication skills, (3) self-management skills, and (4) self-confidence. The two antecedents for nursing students’ clinical readiness to practice are (1) personal factors, including demographic characteristics, prior healthcare experience, income, and emotional intelligence; and (2) educational factors, including the clinical learning environment, clinical internship program, learning resource, and learning strategy. The consequence of clinical readiness for the practice of nursing students includes obtaining practice skills that can lead to more personal and job-related satisfactory outcomes. Conclusions: clinical readiness for practice in nursing encompasses the acquisition and integration of professional knowledge, skills, effective communication abilities, and self-management capabilities and the application of these competencies with confidence toward the provision of high-quality care to patients. Clinical Relevance: Understanding the components of clinical readiness is crucial for nursing educators, preceptors, and healthcare institutions to ensure that nursing students are adequately prepared for the challenges they will face in clinical practice. By recognizing the importance of professional knowledge, skills, communication, and self-management in clinical readiness, educators and training institutions can tailor their curricula, programs, and support systems to better prepare nursing students for the demands of real-world healthcare settings. This focus on clinical readiness ultimately delivers safe, effective, and compassionate patient care. Full article

(This article belongs to the Special Issue Nursing Care: Nurses’ Knowledge, Attitudes and Behaviors)

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15 pages, 836 KiB

Open AccessArticle

Determinants of Neonatal Mortality at a Referral Paediatric Hospital in Angola: A Case–Control Study Using Theoretical Frameworks

by Israel C. Avelino, Joaquim Van-Dúnem and Luís Varandas

Int. J. Environ. Res. Public Health 2024, 21(12), 1609; https://doi.org/10.3390/ijerph21121609 - 30 Nov 2024

Abstract

Neonatal mortality rates in developing countries are influenced by a complex array of factors. Despite advancements in healthcare, Angola has one of the highest neonatal mortality rates in sub-Saharan Africa, with significant contributors including premature birth, intrapartum events, tetanus, and sepsis. This study, [...] Read more.

Neonatal mortality rates in developing countries are influenced by a complex array of factors. Despite advancements in healthcare, Angola has one of the highest neonatal mortality rates in sub-Saharan Africa, with significant contributors including premature birth, intrapartum events, tetanus, and sepsis. This study, utilizing key theoretical frameworks such as intersectionality, social determinants of health (SDOH), and ecosocial theory, aimed to identify the primary causes and contributing factors of neonatal mortality among infants admitted to the Neonatology Service at DBPH in Luanda from May 2022 to June 2023. A retrospective matched case–control design was employed, pairing each neonatal death with two surviving neonates based on age and sex. The analysis included 318 newborns, of whom 106 experienced hospital deaths. A stepwise binary logistic regression model was used to examine associations between variables and neonatal mortality. Variables with p < 0.25 in bivariate analysis were included in the multivariate model. Significant factors associated with neonatal mortality included the following: a low Apgar score at 1 min (<7) (OR 2.172; 95% CI: 1.436–4.731); maternal age under 20 years (OR 3.746; 95% CI: 2.172–6.459); home delivery (OR 1.769; 95% CI: 1.034–3.027); and duration of illness before admission ≥ 3 days (OR 2.600; 95% CI: 1.317–5.200). Addressing these issues requires urgent interventions, including improving Apgar score management through enhanced training for healthcare professionals, supporting young mothers with intensified maternal education, ensuring deliveries occur in appropriate healthcare settings, and improving universal health coverage and referral systems. These measures could be crucial for enhancing neonatal care and reducing mortality. Full article

(This article belongs to the Special Issue Child Health and Effective Health Care in Low- and Middle-Income Countries)

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9 pages, 251 KiB

Open AccessArticle

Political Affiliation, Policy Measures, and Intention to Receive COVID-19 and Influenza Vaccines

by Isabel J. Ricke, Alicen B. Spaulding, Nickolas N. Rajtar, Lauren Lundberg and Ruby H. N. Nguyen

Int. J. Environ. Res. Public Health 2024, 21(12), 1608; https://doi.org/10.3390/ijerph21121608 - 30 Nov 2024

Abstract

Our study aimed to assess the impact of political affiliation, personal beliefs, and policy measures on the intention to receive routine COVID-19 and influenza vaccines in the coming year. A cross-sectional study of 1256 individuals at Minnesota State and County Fairs was conducted [...] Read more.

Our study aimed to assess the impact of political affiliation, personal beliefs, and policy measures on the intention to receive routine COVID-19 and influenza vaccines in the coming year. A cross-sectional study of 1256 individuals at Minnesota State and County Fairs was conducted to assess their intention to receive COVID-19 booster and influenza vaccines in the coming year. The association between vaccine intention and political affiliation, belief in collective responsibility, and workplace/school vaccine requirements were analyzed using multinomial logistic regression. Vaccine intention in the coming year was high among our participants; 65% intended to receive both vaccines, 11% intended to receive only the influenza vaccine, 7% intended to receive only the COVID-19 vaccine, and 17% planned to receive neither. Political affiliation was strongly associated with the intention to receive both vaccines. Republicans were far more likely than Democrats to report plans to receive neither vaccine (aOR: 12.8; 95% CI: 6.2–26.6), or only the influenza vaccine in the coming year (aOR: 8.7; 95% CI: 4.2–17.9). Additionally, those who planned to receive both vaccines were significantly more likely to view vaccines as a collective responsibility. This study highlights the significant influence of political affiliation and beliefs in collective responsibility on vaccine intentions. Full article

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

18 pages, 1542 KiB

Open AccessArticle

The Impact of Disease X on Potential Travelers’ Travel Decision

by Robertico Croes, Jeong-Yeol Park, Kenneth Alexander, Chaithanya Renduchintala and Frank Badu-Baiden

Int. J. Environ. Res. Public Health 2024, 21(12), 1607; https://doi.org/10.3390/ijerph21121607 - 30 Nov 2024

Abstract

This study used ANCOVA models to investigate how pandemic characteristics—spreading speed, severity, and vaccination requirements—affect travel intentions. The results reveal that these factors explain 31.7% of the variance in travel decisions, with disease-spreading speed and severity being the most significant determinants. While vaccination [...] Read more.

This study used ANCOVA models to investigate how pandemic characteristics—spreading speed, severity, and vaccination requirements—affect travel intentions. The results reveal that these factors explain 31.7% of the variance in travel decisions, with disease-spreading speed and severity being the most significant determinants. While vaccination requirements are relevant, they play a secondary role compared to the immediate threat of disease characteristics. The interaction effects between these factors further demonstrate their combined impact on travel reluctance. Demographic variables, such as gender and the presence of children, also influence decisions in specific contexts. These findings contribute to the understanding of risk perception during health crises, reinforcing the role of perceived severity in shaping cautious travel behavior. Practical implications for the tourism industry include the need for transparent communication, tailored health protocols, and demographic-specific marketing strategies. Future research should explore broader factors and adopt longitudinal approaches to capture evolving travel intentions during pandemics. Full article

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16 pages, 477 KiB

Open AccessArticle

“I Prefer High-Intensity Exercise”—A Qualitative Study of Men’s Experiences with a Nature-Based Exercise Program for People with Arthritis

by Signe Andersson, Jonas Risum Ahler, Lars Hermann Tang, Thomas Vedste Aagaard, Søren T. Skou and Charlotte Simonÿ

Int. J. Environ. Res. Public Health 2024, 21(12), 1606; https://doi.org/10.3390/ijerph21121606 - 30 Nov 2024

Abstract

Arthritis significantly reduces health-related quality of life, causing pain, fatigue, and decreased physical activity. To address this, exercise is highly recommended. However, men are less likely to participate in rehabilitation compared to women. We detected the same tendency in a nationwide nature-based exercise [...] Read more.

Arthritis significantly reduces health-related quality of life, causing pain, fatigue, and decreased physical activity. To address this, exercise is highly recommended. However, men are less likely to participate in rehabilitation compared to women. We detected the same tendency in a nationwide nature-based exercise program in Denmark, with only 8% male participants. Therefore, this qualitative study investigated what engaged and restrained men with arthritis from participating in a nature-based exercise program. We employed interviews as the primary method for data collection. Data were analyzed using Braun and Clarke’s thematic analysis, revealing key patterns in participants’ experiences. This study finds that the fourteen participants’ experiences revealed two themes: (1) meeting with the nature-based exercise program was confusing, motivating, and disappointing, and (2) the social aspect is less important. To better engage men, future programs should include a clear description of the concept of the exercise, high-intensity exercise, a reduced emphasis on social activities, and consistency in the instructors’ roles and guidance. Incorporating these findings can better address the needs and preferences of men, helping them feel more like individuals than patients. Full article

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18 pages, 302 KiB

Open AccessArticle

Giving Up the Guidelines: A Qualitative Evaluation of Disrupted Prescribing of Opioid Substitution Therapy in a Rural UK County During and Following the COVID-19 Pandemic

by Tim Lewington, Deanne Burch and Georges Petitjean

Int. J. Environ. Res. Public Health 2024, 21(12), 1605; https://doi.org/10.3390/ijerph21121605 - 30 Nov 2024

Abstract

The COVID-19 pandemic had wide impacts and repercussions for the NHS in the UK beyond the acute medical sector. This qualitative study evaluates the experience of medical (4) and non-medical prescribers (7) plus other staff (2 recovery workers; 2 community pharmacists) involved in [...] Read more.

The COVID-19 pandemic had wide impacts and repercussions for the NHS in the UK beyond the acute medical sector. This qualitative study evaluates the experience of medical (4) and non-medical prescribers (7) plus other staff (2 recovery workers; 2 community pharmacists) involved in opioid substitution therapy (OST) in a southern English county during and following the COVID-19 pandemic. Remote contact and a shift to predominantly weekly OST pick-up were anxiety-producing for clinicians, especially during the first lockdown. Widespread negative consequences were anticipated, such as a rise in fatal overdoses, which largely failed to materialise. Some diversion of medication was noted as were negative mental health consequences of enforced social isolation. Following a hiatus, psychosocial therapies transitioned to fully digital and subsequently hybrid delivery before returning to in-person group work towards the close of the pandemic. Changing power dynamics between clinicians and those accessing OST services were reported particularly around the re-introduction of daily supervised consumption and associated surveillance. Implications for future OST service delivery and national clinical guidance are suggested by way of conclusions. Full article

13 pages, 1861 KiB

Open AccessArticle

An Ecological Study Relating the SARS-CoV-2 Epidemiology with Health-Related, Socio-Demographic, and Geographical Characteristics in South Tyrol (Italy)

by Antonio Lorenzon, Lucia Palandri, Francesco Uguzzoni, Catalina Doina Cristofor, Filippo Lozza, Cristiana Rizzi, Riccardo Poluzzi, Pierpaolo Bertoli, Florian Zerzer and Elena Righi

Int. J. Environ. Res. Public Health 2024, 21(12), 1604; https://doi.org/10.3390/ijerph21121604 - 30 Nov 2024

Abstract

The literature associating the spread of SARS-CoV-2 with the healthcare-related, geographical, and demographic characteristics of the territory is inconclusive and contrasting. We studied these relationships during winter 2021/2022 in South Tyrol, a multicultural Italian alpine province, performing an ecological study based on the [...] Read more.

The literature associating the spread of SARS-CoV-2 with the healthcare-related, geographical, and demographic characteristics of the territory is inconclusive and contrasting. We studied these relationships during winter 2021/2022 in South Tyrol, a multicultural Italian alpine province, performing an ecological study based on the 20 districts of the area. Data about incidence, hospitalization, and death between November 2021 and February 2022 were collected and associated to territorial variables via bivariate analyses and multivariate regressions. Both exposure variables and outcomes varied widely among districts. Incidence was found to be mainly predicted by vaccination coverage (negative correlation). Mortality and ICU admission rates partially followed this distribution, while the case fatality rate was inversely correlated to average salary, and hospital admission rates increased where hospitals capacity was higher, and from the southern to the northern border of the province. These findings, besides confirming the efficacy of vaccination in preventing both new and severe SARS-CoV-2 cases, highlight that several geographical and socio-demographic variables can be related to disease epidemiology. Remote areas with wage gaps and lower access to care suffered most from the pandemic. Our findings, therefore, underly the existence of health inequity issues that need to be targeted by implementing specifically tailored public health interventions. Full article

(This article belongs to the Special Issue Pandemic Preparedness: Lessons Learned from COVID-19)

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12 pages, 539 KiB

Open AccessArticle

Risk Factors for Falls in Community-Dwelling Older Adults During the Novel Coronavirus Pandemic in Japan: A Prospective Cohort Study

by Akihiko Murayama, Daisuke Higuchi, Kosuke Saida, Shigeya Tanaka and Tomoyuki Shinohara

Int. J. Environ. Res. Public Health 2024, 21(12), 1603; https://doi.org/10.3390/ijerph21121603 - 30 Nov 2024

Abstract

This study aimed to test the hypothesis that knowledge derived from indirect assessments can be used to identify fall risk factors during a period of social distancing. A baseline survey of 1953 community-dwelling older adults was conducted in May 2020, with a follow-up [...] Read more.

This study aimed to test the hypothesis that knowledge derived from indirect assessments can be used to identify fall risk factors during a period of social distancing. A baseline survey of 1953 community-dwelling older adults was conducted in May 2020, with a follow-up survey performed in May 2023 to assess the situation 3 years later. In total, 339 individuals were followed from baseline to follow-up. Baseline age, sex, Questionnaire for Change of Life, Frailty Screening Index, and Questionnaire for Medical Checkup of Old-Old (QMCOO) scores and subscales were used to determine fall predictors. In addition, history of falls in the past year was assessed at follow-up (outcome). The participants were categorized into fall (n = 78) and non-fall (n = 261) groups. Using binary logistic regression analysis, items that showed significant differences in a between-group comparison were analyzed, and age and history of falls, which were sub-items of the QMCOO, were identified as predictors of falls. Although special assessments may be required during periods of social distancing, we believe that it is important for these assessments to continue being performed as they are performed during normal times. Full article

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15 pages, 1686 KiB

Open AccessArticle

Awareness and Knowledge of Developmental Coordination Disorder Among Healthcare Professionals in the Eastern Province of Saudi Arabia: A Cross-Sectional Study

by Abdulaziz A. Al-Ahmari, Abdullah A. Alshabaan, Ali A. Almeer, Mohammed N. AlKhater, Mohammed A. Al-Ibrahim, Hassan H. Altuwal, Alaeddin A. Al-Dajani, Saleh A. Alqahtani, Mohammed A. Al-Omari, Abdullah K. Almutairi and Faisal O. AlQurashi

Int. J. Environ. Res. Public Health 2024, 21(12), 1602; https://doi.org/10.3390/ijerph21121602 - 30 Nov 2024

Abstract

Developmental coordination disorder (DCD) is a lifelong neurological disorder impairing the coordination and planning of motor and sensory tasks. Its functional manifestation includes difficulties in various aspects of daily living, making early diagnosis and management essential. This cross-sectional, questionnaire-based study targeted healthcare providers [...] Read more.

Developmental coordination disorder (DCD) is a lifelong neurological disorder impairing the coordination and planning of motor and sensory tasks. Its functional manifestation includes difficulties in various aspects of daily living, making early diagnosis and management essential. This cross-sectional, questionnaire-based study targeted healthcare providers in Saudi Arabia’s Eastern Province who work with children under the age of 18. The questionnaire was completed through field visit interviews and electronically via social platforms from October 2023 to March 2024, collecting data on demographics, professional experience, familiarity with related disorders, and awareness of dyspraxia symptoms. Of the participants, 21.2% had previously diagnosed at least one child with dyspraxia, with family physicians comprising 30% of those diagnoses. The overall mean knowledge score was 17%, ranging from 8.3% to 23.1%. The most recognized symptom was motor learning difficulties (22.7%), followed by gross and fine motor skill delays (22.3%). Notably, 65.15% of respondents were unsure about the gender distribution of dyspraxia. The findings align with international studies, showing significant knowledge gaps among healthcare providers in the Eastern Province. These findings also emphasize the need for targeted health promotion programs, promotional activities, and media involvement for enhancing public health outcomes, early identification, and better management of DCD. Full article

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International Journal of Environmental Research and Public Health

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