International Journal of Environmental Research and Public Health

24 pages, 490 KiB

Open AccessArticle

Workforce Career Development in Public Health, Health Education, and the Health Services: Insights from 30 Years of Cross-Disciplinary National and International Mentoring

by Holly Blake

Int. J. Environ. Res. Public Health 2025, 22(5), 729; https://doi.org/10.3390/ijerph22050729 (registering DOI) - 2 May 2025

Abstract

This paper presents my personal experiences of cross-disciplinary national and international academic mentoring over 30 years in a higher education setting, supporting 605 mentees in public health, health education, and the health services. I supported mentees at diverse career stages through (a) one-to-one [...] Read more.

This paper presents my personal experiences of cross-disciplinary national and international academic mentoring over 30 years in a higher education setting, supporting 605 mentees in public health, health education, and the health services. I supported mentees at diverse career stages through (a) one-to-one mentoring relationships (n = 231 mentees; from the UK, Europe, Middle East, Africa, Asia, and Australasia; academics, industry, and healthcare professionals), (b) a cross-faculty structured mentoring programme (n = 52; junior faculty), (c) a cross-institutional interprofessional internship programme including mentoring and public health placements (n = 302 interns; from five universities), and (d) an interprofessional learning programme in workplace health called WHIRL, which was embedded within Test@Work, a public health innovation bridging health promotion practice, research, and industry and involving peer mentoring and mentor support (n = 20; volunteer healthcare trainees). In this paper, I outline the broader concept of mentoring, together with an overview of mentoring types, uses, and benefits. The diverse contexts in which mentoring occurs are discussed: (i) micro-mentoring, (ii) inducting new staff, (iii) peer mentoring, (iv) career transition moments, (v) career advancement mentoring, (vi) diversity mentoring, (vii) knowledge sharing mentoring, (viii) collaborative learning and support mentoring, and (ix) leadership development mentoring. The challenges of mentoring are presented alongside suggested actions to take. I advocate for mentoring evaluation and provide a worked example of measuring the outcomes of one-to-one mentoring using The Career Support and Psychosocial Support Scales (online survey; n = 103 mentees; from 22 countries). Finally, I reflect upon the diversity of mentoring experiences, with activities and benefits categorised into six key areas: interpersonal relationships; networking opportunities; enhancing knowledge and skills; employment, reward and recognition; support for under-served groups; and convening communities of practice. Full article

20 pages, 845 KiB

Open AccessArticle

The Development and Initial Validation of the Memorial Symptom Assessment Scale-Long COVID (MSAS-LC): A Promising Tool for Measuring Long COVID

by Sadie S. Sommer, Mary S. Dietrich and Julie V. Barroso

Int. J. Environ. Res. Public Health 2025, 22(5), 728; https://doi.org/10.3390/ijerph22050728 (registering DOI) - 2 May 2025

Abstract

Long COVID remains a public health challenge, impacting over 65 million people globally and manifesting as persistent, multisystemic symptoms that complicate both diagnosis and treatment. To address the need for a standardized, patient-centered assessment tool, this study introduces the Memorial Symptom Assessment Scale-Long [...] Read more.

Long COVID remains a public health challenge, impacting over 65 million people globally and manifesting as persistent, multisystemic symptoms that complicate both diagnosis and treatment. To address the need for a standardized, patient-centered assessment tool, this study introduces the Memorial Symptom Assessment Scale-Long COVID (MSAS-LC), which evaluates symptom prevalence, frequency, severity, and distress. The MSAS-LC was developed by modifying the Memorial Symptom Assessment Scale to include 45 prevalent Long COVID symptoms. A cross-sectional survey of 261 U.S. adults (129 with Long COVID and 131 without) assessed validity and group differences. Symptom prevalence was analyzed using logistic regression, while symptom burden (frequency, severity, and distress) was compared using generalized linear models. Participants with Long COVID reported significantly higher symptom prevalence and burden across all systems. Memory problems (73.4% vs. 30.5%; OR = 6.29, p < 0.001) and post-exertional fatigue (OR = 8.55, p < 0.001) were among the most burdensome symptoms. These findings offer preliminary evidence supporting the potential utility of MSAS-LC and underscore the continued public health relevance of individual and collective symptom presentations. The findings suggest the distinct symptom burden, emphasizing the importance of future research to inform diagnostic and treatment strategies. With continued validation, the MSAS-LC may contribute to improved symptom monitoring and care planning in clinical and public health settings. Full article

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25 pages, 778 KiB

Open AccessReview

State-of-the-Art Review on Removal of Naturally Occurring Radioactive Materials in Water

by Zaid Al-Shomali, Alcides Pereira, Ana Clara Marques and Maria de Lurdes Dinis

Int. J. Environ. Res. Public Health 2025, 22(5), 727; https://doi.org/10.3390/ijerph22050727 (registering DOI) - 2 May 2025

Abstract

Radionuclide-contaminated water is carcinogenic and poses numerous severe health risks and environmental dangers. Thus, effective removal techniques are required to ensure the safety of drinking water sources. This article overviews several methods to remove naturally occurring radioactive materials (NORMs) from water, including adsorption, [...] Read more.

Radionuclide-contaminated water is carcinogenic and poses numerous severe health risks and environmental dangers. Thus, effective removal techniques are required to ensure the safety of drinking water sources. This article overviews several methods to remove naturally occurring radioactive materials (NORMs) from water, including adsorption, coagulation, reverse osmosis, ion exchange, electrodialysis, iron manganese filtration, and membrane filtration. A search is conducted in different scientific databases to identify relevant articles, reviews, and studies on removing radionuclides from water. The overarching goal of this article is to deepen the understanding of the techniques available for radionuclide removal from water and to foster the creation of innovative solutions for water contamination concerns. Each technique is examined in terms of its efficiency, cost-effectiveness, and sustainability in removing specific radionuclides from water sources. The advantages and limitations of these techniques are discussed, highlighting the importance of selecting the most appropriate method based on the characteristics of the radionuclides and the water source. Different methods can be combined for the more effective removal of radionuclides from water, such as coagulation and filtration, reverse osmosis, and ion exchange. The treatment of water contaminated with radionuclides requires prior laboratory work and pilot-scale tests to determine the most suitable, cost-effective, and environmentally friendly method. Full article

(This article belongs to the Section Environmental Sciences)

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Graphical abstract

12 pages, 277 KiB

Open AccessArticle

Physical Health Among Adults with Depressive Symptoms in Qatar: Findings from Qatar Biobank Population-Based Study

by Mohammed Aldalaykeh, Ahmad H. Abu Raddaha, Fadwa Alhalaiqa, Waqas Sami and Fadi Khraim

Int. J. Environ. Res. Public Health 2025, 22(5), 726; https://doi.org/10.3390/ijerph22050726 (registering DOI) - 2 May 2025

Abstract

Depression is a mood disorder that is highly prevalent and is characterized by cognitive, emotional, and physical symptoms. This study aimed to describe the physical health status of individuals with depressive symptoms in Qatar and examine the relationships between physical health indicators and [...] Read more.

Depression is a mood disorder that is highly prevalent and is characterized by cognitive, emotional, and physical symptoms. This study aimed to describe the physical health status of individuals with depressive symptoms in Qatar and examine the relationships between physical health indicators and depressive symptoms. A cross-sectional correlational design was used, and data were extracted from the Qatar Biobank. Depression was measured using the Patient Health Questionnaire (PHQ-9). The physical health measurements included heart rate, blood pressure, lung capacity, body mass index (BMI), waist-to-hip ratio, and a self-reported questionnaire. The sample included 687 participants with an average age of 35.39 ± 9.82 years old. The comorbidities reported by participants included diabetes, hypertension, and hypercholesterolemia, and their prevalence ranged from 10 to 26.2%. The BMI data revealed that 38.6% of the participants were either overweight or obese. Approximately 29% of females and 22% of males had an abnormally high waist-to-hip ratio. The percentage of individuals who complained of recurrent chest pain, headache/migraine, or body pain ranged between 12.2 and 43.2%. The mean score of the PHQ-9 was 10.07 ± 4.05, and 43.1% of the sample reported having moderate to severe depression. Several factors were significantly related to depression scores: heart rate, waist-to-hip ratio, headache/migraine, chest pain, body pain, and recent weight change. Healthcare professionals should screen individuals for both depressive symptoms and physical symptoms. This may help in the earlier detection of mental illness and/or physical disease, and thus may ensure better recovery or prognosis and may prevent serious complications. Full article

12 pages, 235 KiB

Open AccessArticle

Evolving Global Migration Trends: Post-Migration Experiences of Iranian Dentists Attempting to Obtain Credential Recognition in Canada

by Sara Hajian and Glen E. Randall

Int. J. Environ. Res. Public Health 2025, 22(5), 725; https://doi.org/10.3390/ijerph22050725 (registering DOI) - 2 May 2025

Abstract

As global migration continues to expand, the diversity of migrant populations increases. This includes a growing number of highly educated individuals from lower-income countries who face significant economic and mental health challenges in attempting to integrate into new communities. Despite extensive education and [...] Read more.

As global migration continues to expand, the diversity of migrant populations increases. This includes a growing number of highly educated individuals from lower-income countries who face significant economic and mental health challenges in attempting to integrate into new communities. Despite extensive education and experience, their expertise is often unrecognized, with many resorting to unskilled labor alternatives. While substantial research exists on the immigration experiences of physicians and nurses, little is known about other professionals, such as dentists. This case study seeks to gain an in-depth understanding of the post-migration experiences of Iranian-trained dentists in Canada, identifying barriers and facilitators to their successful integration. Using a qualitative approach, this study is based on eleven interviews with dentists trained in Iran who recently immigrated to Canada. Semi-structured interviews were conducted via Zoom in English. A thematic analysis was performed using the 2021 Dedoose software program. Barriers to successful integration were categorized into two main themes: “socio-cultural” and “institutional” impediments. The findings show that participants faced significant challenges integrating into Canadian society. Beyond the many socio-cultural obstacles, the negative economic and mental health impacts of attempting to navigate the credential recognition system were substantial, largely due to what appears to be a systematic and institutionalized bias against foreign-trained individuals built into the credentialing system. As a result, their skills often remain underutilized, benefiting neither themselves nor their new country. Findings will inform policy and practice and propose practical recommendations that include reducing institutional barriers for credential assessment, providing mental health support, and offering financial support during assessment of international education. Full article

(This article belongs to the Special Issue Global Migrants and Refugees: Recent Trends, Health Inequities and Aging)

14 pages, 2132 KiB

Open AccessArticle

Subjective Interactions of Wood-Derived Olfactory and Visual Stimuli During Work and Rest

by Takashi Shima, Katsuhiko Sakata and Yuko Tsunetsugu

Int. J. Environ. Res. Public Health 2025, 22(5), 724; https://doi.org/10.3390/ijerph22050724 (registering DOI) - 2 May 2025

Abstract

This study investigated the effects of wood-derived visual and olfactory stimuli on subjective evaluations during work and rest. Twelve participants experienced seven conditions involving walnut panel interiors, Hinoki cypress scents, or their combination, introduced during either work or rest phases. A within-subjects design [...] Read more.

This study investigated the effects of wood-derived visual and olfactory stimuli on subjective evaluations during work and rest. Twelve participants experienced seven conditions involving walnut panel interiors, Hinoki cypress scents, or their combination, introduced during either work or rest phases. A within-subjects design was used to assess spatial impressions, mood states, and fatigue. Visual stimuli significantly improved visual impressions across items such as “settling–unsettling” and “luxurious–simple” (p < 0.05). The Hinoki scent enhanced olfactory impressions and, when introduced during rest, reduced negative mood states including “Anger–Hostility” and “Confusion–Bewilderment” (p < 0.05). Combined stimuli further improved scent impressions (p < 0.1), suggesting cross-modal effects. However, their introduction during work increased “Anger–Hostility” (p < 0.05), highlighting the importance of context. Although the within-subjects design supports internal validity, the small sample size (n = 12) limits generalizability. These findings provide insight into the context-sensitive use of wood-derived sensory elements in workplace design. Full article

(This article belongs to the Section Environmental Health)

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11 pages, 1805 KiB

Open AccessArticle

Radon Concentration Survey in Settlements Located in Uranium Mining Territory in Northern Kazakhstan

by Yerlan Kashkinbayev, Danara Ibrayeva, Moldir Aumalikova, Elena Saifulina, Dinara Bizhanova, Elvira Mussayeva, Aigerim Shokabayeva, Madina Kairullova, Anel Lesbek, Baglan Kazhiyakhmetova and Meirat Bakhtin

Int. J. Environ. Res. Public Health 2025, 22(5), 723; https://doi.org/10.3390/ijerph22050723 (registering DOI) - 2 May 2025

Abstract

Among the Central Asian countries, Kazakhstan is experiencing significant growth in uranium production and plays a key role in the mining industry. The aim of this study was to assess environmental gamma radiation levels and indoor radon concentrations in the settlements of Aqsu, [...] Read more.

Among the Central Asian countries, Kazakhstan is experiencing significant growth in uranium production and plays a key role in the mining industry. The aim of this study was to assess environmental gamma radiation levels and indoor radon concentrations in the settlements of Aqsu, Saumalkol, and Arykbalyk—situated in regions with a history of uranium mining activities—to evaluate potential radiation exposure risks to the local population. Measurements of ambient gamma radiation dose rates indicated that Saumalkol exhibited the highest variability, with recorded values reaching up to 0.56 ± 0.19 µSv/h, suggesting potential influence from abandoned mining areas. The equivalent equilibrium volume activity of radon revealed severe contamination in Aqsu (mean: 303 ± 57 Bq/m³, max: 4974 Bq/m³) and Saumalkol (mean: 658 ± 114 Bq/m³, max: 2470 Bq/m³). These findings underscore the need for immediate intervention measures such as improved ventilation and radon mitigation strategies to reduce exposure risks and protect residents from radiation-induced health hazards. This study presents a screening method to identify areas with potential radon risks. However, radon dose assessment requires long-term measurements for accurate evaluation of exposure levels and health risks, with extended monitoring needed for comprehensive assessment. Full article

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40 pages, 1073 KiB

Open AccessArticle

Navigating Body Perception, Affectivity, Intimacy, Gender Identity, and Sexuality: An Exploratory Qualitative Study in Young Adults with SMI, IDs, and ASD in a Community Setting

by Miriam Belluzzo, Veronica Giaquinto, Daniela Volpe, Camilla Esposito, Erica De Alfieri and Anna Lisa Amodeo

Int. J. Environ. Res. Public Health 2025, 22(5), 722; https://doi.org/10.3390/ijerph22050722 (registering DOI) - 1 May 2025

Abstract

This exploratory qualitative study investigates the challenges faced by young adults (aged 18–40) with severe mental illness (SMI), intellectual disabilities (IDs), and autism spectrum disorder (ASD) in navigating body perception, affectivity, intimacy, gender identity, and sexuality. Through semi-structured interviews with 13 participants recruited [...] Read more.

This exploratory qualitative study investigates the challenges faced by young adults (aged 18–40) with severe mental illness (SMI), intellectual disabilities (IDs), and autism spectrum disorder (ASD) in navigating body perception, affectivity, intimacy, gender identity, and sexuality. Through semi-structured interviews with 13 participants recruited from a community habilitation center, thematic analysis revealed systemic barriers rooted in societal stigma, familial overprotection, and institutional neglect. Key findings highlight tensions between bodily autonomy and familial control, with prolonged caregiver dependency in intimate hygiene reflecting patterns of infantilization. We found that participants’ self-image was shaped by gendered expectations and familial critiques, reinforcing internalized stigma. Romantic relationships were often idealized through cultural narratives, yet lacked practical guidance on consent or boundaries, exacerbating vulnerabilities. Fragmented sexual education left individuals reliant on pornography or peers, perpetuating misconceptions and anxiety. Despite these barriers, participants demonstrated resilience and agency in advocating for inclusive interventions. This study underscores the urgent need for trauma-informed, rights-based approaches that prioritize autonomy, dignity, and intersectionality. Recommendations include structured skill-building programs for independence, disability-adapted comprehensive sexuality education, and systemic reforms fostering interdisciplinary collaboration. By centering lived experiences, this work challenges structural inequities and advocates for community care models that honor the diverse needs of individuals navigating the intersection of disability, identity, and sexuality. Full article

(This article belongs to the Special Issue Second Edition of the Intersections of Public Health, Sexuality, and Communication)

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20 pages, 505 KiB

Open AccessArticle

A University’s Role in Developing a Regional Network of Dementia Friendly Communities

by Laurel Standiford Reyes, M. C. Ehlman, Suzanne Leahy and Reagan Lawrence

Int. J. Environ. Res. Public Health 2025, 22(5), 721; https://doi.org/10.3390/ijerph22050721 (registering DOI) - 1 May 2025

Abstract

Introduction: The World Health Organization has identified dementia as a growing global health concern with 10 million new cases diagnosed every year. The growing number of people living with dementia (PLWD) heightens the need for effective interventions that support PLWD and their caregivers. [...] Read more.

Introduction: The World Health Organization has identified dementia as a growing global health concern with 10 million new cases diagnosed every year. The growing number of people living with dementia (PLWD) heightens the need for effective interventions that support PLWD and their caregivers. The most effective interventions supporting PLWD and caregivers combine education, care, and services to increase knowledge, decrease stigma, improve care, heighten empathy, and increase engagement of PLWD in their communities. Dementia Friendly America (DFA), administered by USAging, promotes a Dementia Friendly Community (DFC) initiative designed to engage multiple sectors (e.g., business, healthcare, community services) and engage PLWD in a comprehensive community change process. A center for healthy aging and wellness at a midwestern public university developed a network approach in its regional support of eight DFCs, as a part of its Geriatric Workforce Enhancement Program funded by the U.S. Health Resources and Services Administration. Objective: This article documents a mid-size university’s approach to establishing a regional DFC network of urban and rural communities surrounding the university, describing the support the university provided as well as how communities implemented the four-phase DFC process and emulated guiding principles. Results: A retrospective evaluation found engagement with the DFA guiding principles and varying levels of adherence to DFC phases. Discussion: The project team suggests that there are unique roles that universities can play in supporting the DFC movement and that developing a network of communities is a helpful strategy to use in providing this support. Additionally, the authors propose the integration of a community change model to guide future DFC work. Conclusions: This article helps to fill an existing research gap concerning DFC implementation and explores the unique role academic partners can play in cultivating regional hubs of DFC activity. Full article

(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)

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16 pages, 299 KiB

Open AccessArticle

Pilot Testing an Ecotherapy Program for Adolescence: Initial Findings and Methodological Reflections

by Sophie Westwood, Grace Edmunds-Jones, Thomas Maguire, Sue Hawley, Hannah Avent, Jerry Griffiths, Rishi Bates, Jane Marley, Gary Wallace, Ruth Harrell, Sheena Asthana and Felix Gradinger

Int. J. Environ. Res. Public Health 2025, 22(5), 720; https://doi.org/10.3390/ijerph22050720 (registering DOI) - 1 May 2025

Abstract

Children and young people’s mental health and well-being has seen a dramatic decline. In the UK, this has been exacerbated by service retrenchment associated with austerity, with evidence of increasing health inequalities. Service innovation that is grounded in practice, has ongoing learning, and [...] Read more.

Children and young people’s mental health and well-being has seen a dramatic decline. In the UK, this has been exacerbated by service retrenchment associated with austerity, with evidence of increasing health inequalities. Service innovation that is grounded in practice, has ongoing learning, and is co-designed with children and young people is required now. This can provide creative solutions within the local context and contribute to the fledgling evidence base that explores complex mechanisms of impact. This methodological reflection describes a co-design process of a bespoke, group-based ecotherapy programme: from early piloting using appreciative enquiry before COVID-19 by the mental health, public health, and Street Services team in the port city of Plymouth, to further developing an evaluation framework through an innovative, matched-funded academia–practice partnership. The findings showcase the benefits of a systems-based approach to public, multi-agency and academic collaboration, facilitated by peer and practitioner researchers and embedded researchers-in-residence. They highlight the need to consider nuances of specific (connecting with self, others, animals, nature) and non-specific active ingredients of the emerging and constantly adapting service (therapeutic relationship with practitioners/carers; nature as therapist, and group dynamics), as well as the value of pragmatic and participatory evaluation methods (distance-travelled, goal-based measures; and ethnographic, qualitative observation), to provide rapid, continuous, and real-time learning and improvement. Full article

14 pages, 1563 KiB

Open AccessArticle

An Epidemiologic Approach for Estimating Risk Reduction and Asymptotic Power on the Log-Difference Scale

by Jimmy T. Efird

Int. J. Environ. Res. Public Health 2025, 22(5), 719; https://doi.org/10.3390/ijerph22050719 (registering DOI) - 1 May 2025

Abstract

When comparing the efficacy or harmfulness of two groups (e.g., drugs, devices, assays, interventions, environmental toxins), it is important to minimize bias by making this comparison with respect to a common referent-control group, assuming random allocation. Under such a scenario, one can estimate [...] Read more.

When comparing the efficacy or harmfulness of two groups (e.g., drugs, devices, assays, interventions, environmental toxins), it is important to minimize bias by making this comparison with respect to a common referent-control group, assuming random allocation. Under such a scenario, one can estimate risk reduction for a new therapy on a log-difference, relative effect scale. The current manuscript reviews the large-sample framework for this conditionally independent comparison and demonstrates how to estimate test power for a given sample size. Full article

(This article belongs to the Special Issue The 20th Anniversary of IJERPH)

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12 pages, 1306 KiB

Open AccessArticle

Ventilatory Responses to Progressive Treadmill Speeds in Women: A Comparative Analysis of Nasal, Oral, and Oronasal Breathing Conditions

by Seung Hee Lee, Yongsuk Seo and Dae Taek Lee

Int. J. Environ. Res. Public Health 2025, 22(5), 718; https://doi.org/10.3390/ijerph22050718 (registering DOI) - 1 May 2025

Abstract

Background: Breathing conditions influence ventilatory efficiency and exercise performance, but little research has examined how different breathing conditions affect cardiorespiratory responses in women. Despite the growing popularity of nasal-only breathing in fitness culture, its physiological benefits remain unclear. The purpose of the current [...] Read more.

Background: Breathing conditions influence ventilatory efficiency and exercise performance, but little research has examined how different breathing conditions affect cardiorespiratory responses in women. Despite the growing popularity of nasal-only breathing in fitness culture, its physiological benefits remain unclear. The purpose of the current study is to examine the ventilatory responses to nasal, oral, and oronasal breathing during treadmill exercise at speeds of 5 to 11 km/h in 10 healthy females. Methods: Participants completed sessions under each breathing condition while heart rate (HR), oxygen uptake (VO₂), ventilatory equivalent for CO₂ (VE/VCO₂), respiratory frequency (Rf), tidal volume (VT), minute ventilation (VE), and respiratory timing variables were measured. Results: Breathing condition had minimal impact at lower speeds (5–7 km/h). However, at higher intensities (10–11 km/h), nasal breathing resulted in lower Rf and VE but elevated VE/VCO₂, indicating reduced ventilatory efficiency. In contrast, oral and oronasal breathing facilitated greater VE and shorter inspiratory and expiratory times, supporting ventilation under vigorous exercise. Conclusions: While nasal breathing may suffice at low intensities, it is inadequate at higher intensities, potentially leading to carbon dioxide accumulation and early fatigue. These findings support the use of oral or oronasal breathing during higher-intensity activity and highlight the need for individualized breathing strategies. Full article

(This article belongs to the Special Issue Exercise in Living Environments: A Healthy Lifestyle)

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21 pages, 1202 KiB

Open AccessReview

A Scoping Review of Heteronormativity in Healthcare and Its Implications on the Health and Well-Being of LGBTIQ+ Persons in Africa

by Lebogang Manthibe Ramalepe and Tshepo B. Maake

Int. J. Environ. Res. Public Health 2025, 22(5), 717; https://doi.org/10.3390/ijerph22050717 (registering DOI) - 1 May 2025

Abstract

This scoping review explores the patterns of heteronormativity in healthcare sectors across Africa and its impact on the health and well-being of LGBTIQ+ individuals. By analyzing publications from major academic databases, this study identifies key themes and research gaps in the discourse on [...] Read more.

This scoping review explores the patterns of heteronormativity in healthcare sectors across Africa and its impact on the health and well-being of LGBTIQ+ individuals. By analyzing publications from major academic databases, this study identifies key themes and research gaps in the discourse on LGBTIQ+ health and heteronormativity in Africa. The findings underscore the urgent need to address these heteronormative barriers in alignment with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (good health and well-being) and SDG 10 (reduced inequalities). Addressing heteronormativity in healthcare is essential for promoting equitable, inclusive healthcare systems and improving health outcomes for LGBTIQ+ populations across the continent. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

15 pages, 422 KiB

Open AccessArticle

Assessment of Potential Factors Influencing Attention-Deficit/Hyperactivity Disorder Drug Adherence: A Database Study

by Ilse Truter, Judith Regnart and Anneke Meyer

Int. J. Environ. Res. Public Health 2025, 22(5), 716; https://doi.org/10.3390/ijerph22050716 (registering DOI) - 1 May 2025

Abstract

First-line treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) is pharmacological but is associated with poor success rates in adults. The potential to discontinuously use stimulants may confound adherence assessment. Approximately 30–50% of adults with ADHD will experience depressive episodes, and associated treatment with antidepressants is [...] Read more.

First-line treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) is pharmacological but is associated with poor success rates in adults. The potential to discontinuously use stimulants may confound adherence assessment. Approximately 30–50% of adults with ADHD will experience depressive episodes, and associated treatment with antidepressants is generally recommended. It can therefore be expected that patients with a formal F90 diagnosis would show higher medication adherence than patients without a diagnosis and that the simultaneous use of antidepressants would increase adherence to ADHD medication. The primary aim was to explore the influence of factors of ADHD diagnosis and comorbid antidepressant use on stimulant adherence. A retrospective, longitudinal pharmacoepidemiological study was conducted on South African community pharmacy dispensing records for 2012–2016 for all patients aged between 18 and 40 years with any record of receiving a drug classified as “Central nervous system other” by the MIMS in 2015. Patients endorsed with an ADHD-linked diagnostic code (F90) were identified and contrasted with those receiving ADHD-indicated medication in the absence of a confirmatory diagnostic code. Two methods were applied to assess adherence to ADHD and/or depression treatment drugs: monthly medicine plotting and Proportion of Days Covered (PDC). Patients were classified as being more or less adherent based on monthly medicine plotting criteria. A study population of 89 patients was identified: 50 had F90 diagnostic codes and 39 were classified as “Non F90”. Adherence as measured based on PDC was generally higher for antidepressant use than for methylphenidate for patients classified as being more adherent. A trend towards higher consumption of antidepressants was shown for the treatment-adherent group. Diagnostic code distinction revealed significantly higher adherence rates to methylphenidate for F90 code patients. Adherence rates to antidepressants appeared to be generally higher for non-F90 patients. Many factors may influence adherence to ADHD-indicated drugs; however, the impact of a confirmed diagnosis may be a strong determinant of motivation to be adherent to ADHD pharmacotherapy. Full article

(This article belongs to the Special Issue Multimorbidity, Polypharmacy, and Medication Appropriateness: Public Health Challenges and Research Priorities)

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17 pages, 1070 KiB

Open AccessArticle

Ecological Impacts of Structural Racism on Health Disparity Through Its Determinants and Mediating Factors: A Case Study on Low Birthweight in Three Race/Ethnicity Groups in the United States

by Drona P. Rasali, Leanne L. Lefler, Chandra L. Ford, William D. Osei and Katharine T. Schaffzin

Int. J. Environ. Res. Public Health 2025, 22(5), 715; https://doi.org/10.3390/ijerph22050715 (registering DOI) - 1 May 2025

Abstract

Health disparities among populations across geographic regions, demographic and socio-economic groups are well documented; however, ecological studies which visually demonstrate health disparities associated with structural racism among racialized populations are limited. The purpose of this study was to examine low birthweight (LBW) as [...] Read more.

Health disparities among populations across geographic regions, demographic and socio-economic groups are well documented; however, ecological studies which visually demonstrate health disparities associated with structural racism among racialized populations are limited. The purpose of this study was to examine low birthweight (LBW) as a measurable indicator of disproportionate health impacts across three race/ethnicity groups—non-Hispanic Black, Hispanic and non-Hispanic White–in the United States (US) for visualizing ecological manifestation of this disparity attributed to structural racism. We begin by providing the contextual background of structural racism through a literature review, and then more specifically, we examine LBW as a selected health indicator characterized with a socio-biological pathway of structural racism via socio-economic and politico–legal determinants and associated mediating factors to health disparities, from which we synthesized a visualization model with the indicators of structural racism reported in the literature reviewed. To further visualize these impacts, publicly available US County Health Ranking data for LBW, at the county level in two US states, Tennessee and Ohio, were analyzed to uncover area-based ecological health outcome—LBW. Significant correlation and scatter plots provided evidence of LBW as a racially sensitive health indicator associated with impacts of structural racism. These findings were further notable through examination of socio-economic determinants (e.g., race/ethnicity, income, education, and employment) and environmental factors such as housing issues as well as other underlying health conditions. Our case study has opened a window for visualizing disparity across non-Hispanic Black, Hispanic, non-Hispanic White populations as demonstrated by the prevalence of LBW disparity through its determinants and mediating factors at the county level. Potentially important policy implications for reparative change are drawn through our study findings that are salutary and/or reductive for addressing impacts of structural racism. Further studies are needed to fully understand the comprehensive web of area-based ecological factors impacting various health outcomes through the impacts of structural racism. Full article

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22 pages, 462 KiB

Open AccessArticle

Learn to Live Again: A Pilot Study to Support Women Experiencing Domestic Violence

by Jacqui Cameron, Delia Rambaldini-Gooding, Kirsty Vezinias, Brooke Smith, Maria Corsiglia and Sarah Beale

Int. J. Environ. Res. Public Health 2025, 22(5), 714; https://doi.org/10.3390/ijerph22050714 (registering DOI) - 1 May 2025

Abstract

Purpose: The prevalence of domestic violence is increasing, and it is becoming more common for women who have experienced domestic violence to access support programs in their community. Learn to Live Again (L2LA) is an eight-week therapeutic program facilitated by Barnardos, which is [...] Read more.

Purpose: The prevalence of domestic violence is increasing, and it is becoming more common for women who have experienced domestic violence to access support programs in their community. Learn to Live Again (L2LA) is an eight-week therapeutic program facilitated by Barnardos, which is provided through community support services in NSW, Australia. The program is designed for women who have experienced or continue to experience the traumatic effects of family and domestic violence. Methods: The pilot study involved collecting survey data from former participants and semi-structured interviews with current participants and facilitators. Data collection occurred between June and August 2023. Data collection included both face-to-face and online versions of the program. Results: All participants reported positive experiences of L2LA. The main benefits of the program for participants included connecting with women in similar situations, learning skills and strategies to cope with their experiences, sharing their lived experiences of domestic violence, and reconnecting with their children. Facilitators also had positive experiences of facilitating the program and observing the positive changes women experienced. Although, challenges were also identified and included managing the group dynamics, small group sizes, and managing trauma experiences in a group setting. Conclusion: The results indicate participants as well as facilitators had positive experiences of L2LA. Participants valued the program and felt that it helped them to begin the healing process and improve their overall wellbeing. Women were very passionate about recommending the program to other women. Facilitators observed many positive changes in the women throughout the program. However, L2LA challenges included the small group size, managing the dynamics of the group, and the range of trauma within the group as well as children being present. A larger evaluation of this program is required to confirm these findings. Full article

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

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20 pages, 2130 KiB

Open AccessArticle

The Impact of Telepresence Robots on Family Caregivers and Residents in Long-Term Care

by Lillian Hung, Joey Oi Yee Wong, Haopu (Lily) Ren, Yong Zhao, Jason Jincheng Fu, Jim Mann and Lun Li

Int. J. Environ. Res. Public Health 2025, 22(5), 713; https://doi.org/10.3390/ijerph22050713 (registering DOI) - 1 May 2025

Abstract

Telepresence robots can enhance social connection and support person-centered care in long-term care (LTC) homes. This study evaluates their impact in facilitating virtual visits between family caregivers and older residents in Canadian LTC homes. Telepresence robots were placed in residents’ rooms, allowing virtual [...] Read more.

Telepresence robots can enhance social connection and support person-centered care in long-term care (LTC) homes. This study evaluates their impact in facilitating virtual visits between family caregivers and older residents in Canadian LTC homes. Telepresence robots were placed in residents’ rooms, allowing virtual visits at mutual convenience. A total of 18 residents and 17 family caregivers participated. Quantitative assessments included the Zarit Burden Interview, the De Jong Gierveld Loneliness Scale, and the Quality of Life in Alzheimer’s Disease scale, while qualitative data were collected through interviews, field notes, and observations. Repeated ANOVA showed that using telepresence robots significantly reduced caregiver burden (p = 0.008), improved residents’ quality of life (p = 0.028), and decreased resident loneliness (p = 0.038). Older caregivers experienced the greatest burden reduction, with scores dropping from a mean of 25.0 at baseline to 16.1 at two months. Qualitative findings provided further context, revealing that residents felt more connected, close, and engaged, while families found the robots facilitated continuity of care, complemented in-person visits, reduced stress and guilt, and provided reassurance. These findings suggest that telepresence robots can enhance the well-being of both residents and caregivers in LTC homes, though future research should explore their long-term impact and technological limitations. Full article

(This article belongs to the Special Issue Improving the Quality of Long-Term Care)

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22 pages, 578 KiB

Open AccessArticle

Development of a Pandemic Resilience Competence Model for Healthcare Professionals—Individual and Organisational Aspects

by Nina Lorenzoni, Raquel Simões de Almeida, Daniela Wimmer, Ines Simbrig, Veronica Moscon, Fabio Carnelli, Nadine Sulkowski, Elohor Pamela Malaka, Paul Schober, Katharina Michel, Vítor J. Sá and Margit Raich

Int. J. Environ. Res. Public Health 2025, 22(5), 712; https://doi.org/10.3390/ijerph22050712 (registering DOI) - 1 May 2025

Abstract

The COVID-19 pandemic highlighted the critical importance of resilience and adaptability at both individual and organisational levels in navigating unprecedented challenges. This study introduces a novel Pandemic Resilience Competence Model, a framework that articulates eight key competences each for individuals and organisations to [...] Read more.

The COVID-19 pandemic highlighted the critical importance of resilience and adaptability at both individual and organisational levels in navigating unprecedented challenges. This study introduces a novel Pandemic Resilience Competence Model, a framework that articulates eight key competences each for individuals and organisations to enhance preparedness and response in pandemic scenarios. Employing a qualitative approach, the research identifies the essential skills and organisational capacities required to mitigate the impacts of pandemics. Using 50 semi-structured interviews with professionals and managers working in healthcare services in Austria, Germany, Italy, Portugal and the United Kingdom, the model provides actionable insights for implementing processes to improve preparedness and response in pandemic scenarios for stakeholders, including policymakers, educators, and organisational leaders. Findings highlight the interdependence of individual and organisational competences, reinforcing the need for integrated strategies to build pandemic resilience. The conclusions advocate for embedding the competences within training and development initiatives, aiming to enhance collective readiness for future global health crises. Full article

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

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14 pages, 333 KiB

Open AccessArticle

Effect of Household Air Pollution and Neighbourhood Deprivation on the Risk of Acute Respiratory Infection Among Under-Five Children in Chad: A Multilevel Analysis

by Olatunde Aremu and Omolara O. Aremu

Int. J. Environ. Res. Public Health 2025, 22(5), 710; https://doi.org/10.3390/ijerph22050710 (registering DOI) - 1 May 2025

Abstract

Background: Exposure to household air pollution (HAP) is one of the primary risk factors for acute lower respiratory infection (ARI) morbidity and mortality among children in low-income settings. This study aimed to examine the relative contribution of residing in deprived neighbourhoods and exposure [...] Read more.

Background: Exposure to household air pollution (HAP) is one of the primary risk factors for acute lower respiratory infection (ARI) morbidity and mortality among children in low-income settings. This study aimed to examine the relative contribution of residing in deprived neighbourhoods and exposure to HAP on the occurrence of ARI among children using data from the 2014–2015 Chad Demographic and Health Survey (DHS). Methods: We applied multilevel modelling techniques to survey data of 2882 children from 372 communities to compute the odds ratio (OR) for the occurrence of ARI between children of respondents exposed to clean fuels (e.g., electricity, liquid petroleum gas, natural gas, and biogas) and respondents exposed to polluting fuel (e.g., kerosene, coal/lignite, charcoal, wood, straw/shrubs/grass, and animal dung). Results: The results showed that children exposed to household polluting fuels in Chad were 215% more likely to develop ARI than those not exposed to household air pollution (OR = 3.15; 95% CI 2.41 to 4.13). Further analysis revealed that the odds of ARI were 185% higher (OR = 2.85; 95% CI 1.73 to 4.75) among children living in rural residents and those born to teenage mothers (OR = 2.75; 95% CI 1.48 to 5.15) who were exposed to household polluting fuels compared to their counterparts who were not exposed. In summary, the results of the study show that the risk of ARI is more common among children who live in homes where household air-polluting cooking fuel is widely used, those living in rural areas, those living in socioeconomically deprived neighbourhoods and from the least wealthy households, and those born to teenage mothers in Chad. Conclusions: In this study, an independent relative contribution of variables, such as HAP from cooking fuel, neighbourhood deprivation, living in rural areas, being from a low-income household, having a mother who is a manual labourer worker, and being given birth to by a teenage mother, to the risk of ARI among children is established. Full article

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