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International Journal of Environmental Research and Public Health

International Journal of Environmental Research and Public Health (IJERPH) is a transdisciplinary, peer-reviewed, open access journal that covers global health, healthcare sciences, behavioral and mental health, infectious diseases, chronic diseases and disease prevention, exercise and health related quality of life, environmental health and environmental sciences, and is published monthly online by MDPI.
The International Society Doctors for the Environment (ISDE), Italian Society of Environmental Medicine (SIMA) and Environmental Health Association of Québec (ASEQ‑EHAQ) are affiliated with IJERPH and their members receive discounts on the article processing charges.

All Articles (65,381)

On 7 October 2023, Israel experienced a large-scale attack, initiating the Iron Swords War (also known internationally as the 2023 Israel–Hamas War). This protracted armed conflict profoundly disrupted social and economic life in Israel and the region. This study investigates the psychological distress of small business owners in the aftermath of this terrorist assault and during the ensuing conflict. Drawing on a nationwide survey of 363 entrepreneurs, we applied a two-stage higher-order PLS-SEM model to examine how economic stressors, psychological and institutional resources, and demographic factors shaped distress. The findings reveal that uncertainty and revenue loss intensified distress, while resilience, hope, and trust in government operated as protective resources, with notable gender differences also observed. Beyond its economic and psychological relevance, the study situates entrepreneurial distress within a broader public health perspective, viewing the mental health and well-being of small business owners as integral to community resilience, social stability, and national recovery during crises. By framing entrepreneurial distress and resilience as key determinants of population mental health and collective well-being, this research underscores how supporting entrepreneurs contributes to wider health promotion and psychosocial recovery efforts. Overall, the study offers a novel multidimensional empirical analysis of entrepreneurial distress during armed conflict, underscoring the psychological mechanisms through which terrorism and its aftermath affect small business owners, and highlighting the need for resilience-building and institutional support to mitigate mental health burdens.

15 December 2025

PLS-SEM specification with a two-stage higher-order resilience construct. Note: “Efficacy” denotes self-efficacy, “Revenue” denotes revenue loss, and “Trust” denotes trust in government.

Bridging the Gap in Studies on the Food Environment: The State-of-the-Art in LMICs

  • Mariana Carvalho de Menezes,
  • Ariene Silva do Carmo and
  • Larissa Loures Mendes

Food systems influence population health through multiple pathways and are recognized
as key drivers of the global syndemic of undernutrition, obesity, and climate change
(Swinburn et al., 2019) [...]

15 December 2025

Objective. To evaluate the prevalence, risk factors, aetiology, and management of traumatic dental injuries (TDIs) among children aged 1–18 years attending the Department of Pediatric Dentistry, Damascus University, Syria, during 2023–2024, and to illustrate representative clinical cases with documented outcomes. Methods. This retrospective cross-sectional study reviewed 2716 patient records (2023–2024) and identified 301 children with TDIs. Demographic, clinical, and behavioural variables were extracted and analysed using χ2, t tests, ANOVA, and binary logistic regression (IBM SPSS v26). Results. The overall TDI prevalence was 11.08%. Males were over twice as likely as females to experience TDIs (OR = 2.30; 95% CI = 1.76–3.01; p < 0.001). Older age acted as a protective factor (OR = 0.56; 95% CI = 0.43–0.74; p < 0.001). Falls were the most common cause (63.7%), and injuries most often occurred at home (48.9%). The maxillary central incisors were most frequently affected (68.5% of cases). Children with special healthcare needs had significantly more traumatised teeth (mean = 2.61 ± 1.13) than healthy children (1.66 ± 0.92; p < 0.001). Nearly half of the patients (45.3%) presented > one month after injury, and asymptomatic apical periodontitis and reversible pulpitis were the most frequent diagnoses. Representative case presentations demonstrated multidisciplinary management using restorative, endodontic, and orthodontic approaches with favourable follow-up outcomes. Conclusions. TDIs affected about one in nine children in this Syrian cohort. Male gender, younger age, and previous trauma were key risk factors. The predominance of delayed presentation underscores the need for community education, early referral systems, and targeted preventive programs within school and home environments.

15 December 2025

What to Know About Falls in Older Adults? Risk Factors, Predictors, and Therapeutic Interventions

  • Fernanda Bueno Pilastri,
  • Julia Fantim Lopez and
  • Eric Nkansah Boateng
  • + 1 author

Background: Approximately one quarter of community-dwelling older adults experience at least one fall each year. Falls can result in soft tissue injuries, fractures, or even death. Given this high prevalence, it is essential to identify fall-related risk factors, develop predictive models, and prescribe effective exercise-based interventions to prevent falls. Objective: To analyze risk factors, predictors, and therapeutic interventions for falls in older adults. Methods: A literature search was conducted in SCIELO, PUBMED, and PEDro databases between 15–20 October 2025. Inclusion criteria comprised peer-reviewed, open-access studies in English published from 2020 onward. Findings were categorized into three domains: (1) fall risk factors, (2) predictive models, and (3) exercise-based interventions. Twenty studies met the inclusion criteria. Results: Falls among older adults arise from multifactorial interactions involving physical, clinical, cognitive, and social factors such as impaired mobility, comorbidities, polypharmacy, and cognitive decline. Lower-limb strength and functional performance are key determinants of fall risk. Current predictive models show limited accuracy, with fall history as the strongest predictor. Exercise-based interventions, particularly multicomponent and home-based programs, improve balance, strength, and mobility but show variable effects on fall rates. The absence of standardized parameters for exercise prescription limits the development of evidence-based guidelines. Conclusions: Falls in older adults are multifactorial events influenced by physical and cognitive decline. Predictive models remain imprecise, and although exercise interventions improve functional outcomes, their impact on reducing falls is inconsistent. Standardized exercise protocols are needed to optimize fall prevention strategies.

14 December 2025

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Int. J. Environ. Res. Public Health - ISSN 1660-4601