International Journal of Environmental Research and Public Health

28 pages, 2735 KB

Open AccessArticle

Getting To(wards) Know(ing) Together: An Innovative Collaborative Approach in Residential Care for People with (Severe) Intellectual Disabilities and Behaviour That Challenges

by Gustaaf F. Bos, Vanessa C. Olivier-Pijpers and Alistair R. Niemeijer

Int. J. Environ. Res. Public Health 2025, 22(9), 1368; https://doi.org/10.3390/ijerph22091368 (registering DOI) - 30 Aug 2025

Abstract

People with moderate to severe intellectual disabilities (M/S ID) and behaviour that challenges are still almost exclusively encountered and understood within a highly specialized professional care system context. They are almost invisible in the societal mainstream, where a wider variety of perspectives on [...] Read more.

People with moderate to severe intellectual disabilities (M/S ID) and behaviour that challenges are still almost exclusively encountered and understood within a highly specialized professional care system context. They are almost invisible in the societal mainstream, where a wider variety of perspectives on (everyday) manners, encounters, relationships and life applies. These (and other) exclusionary dynamics render everyday relations with residents with M/S ID whose behaviours challenge still largely dependent on the interpretative frameworks and actions of professionals. Professionals are trained and socialized within highly specialized professional care system contexts, despite a growing scientific and professional awareness that behaviour that challenges is a multifaceted and contextual phenomenon. In this paper, we report on a pioneering initiative (titled Project WAVE) which aimed to cultivate a fresh and comprehensive approach to behaviours that challenge within stagnant care practices. Our goal was to foster an innovative collaborative paradigm by facilitating an extensive and enduring exchange between “insiders”—professionals of specialized care system contexts—and “outsider-researchers”—individuals socialized through alternative avenues. We present our epistemological and methodological approach, the data collection process (a multiple case-informed community of practice), and the most important lessons learned. Full article

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

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17 pages, 555 KB

Open AccessArticle

Sedentary Behavior, Physical Inactivity, and the Prevalence of Hypertension, Diabetes, and Obesity During COVID-19 in Brazil

by Jeferson Roberto Collevatti dos Anjos, Igor Massari Correia, Chimenny Auluã Lascas Cardoso de Moraes, Jéssica Fernanda Corrêa Cordeiro, Atila Alexandre Trapé, Jorge Mota, Dalmo Roberto Lopes Machado and André Pereira dos Santos

Int. J. Environ. Res. Public Health 2025, 22(9), 1367; https://doi.org/10.3390/ijerph22091367 (registering DOI) - 30 Aug 2025

Abstract

Objectives: To analyze, across the periods before, during, and after the implementation of Social Isolation and Distancing Measures (IMDIS): (a) changes in the prevalence of non-communicable chronic diseases (NCDs), stratified by age group in the Brazilian population; and (b) the association between physical [...] Read more.

Objectives: To analyze, across the periods before, during, and after the implementation of Social Isolation and Distancing Measures (IMDIS): (a) changes in the prevalence of non-communicable chronic diseases (NCDs), stratified by age group in the Brazilian population; and (b) the association between physical inactivity (PI), insufficient moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) with the occurrence of these conditions. This cross-sectional study used data from VIGITEL (Brazil’s Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey), an annual population-based telephone survey conducted across the country. Data were collected in 2019, 2021, and 2023, with a total sample size of 101,226 participants. Arterial hypertension (AH) and diabetes mellitus (DM) were self-reported, and obesity (OB) was diagnosed using body mass index. PI, insufficient MVPA, and SB were identified via VIGITEL indicators. Chi-square tests assessed differences in prevalence overall and by age group. Logistic regression models estimated odds ratios (ORs) for associations between demographic variables, behavioral factors, and the studied periods. The prevalence of AH and DM was highest among individuals over 60 years, reaching 61% after IMDIS, a period when OB also peaked across all age groups. Individuals aged 30–59 and those over 60 had higher odds of AH, DM, and OB across all periods. Female participants had higher ORs for AH and DM both before and after IMDIS. PI and insufficient MVPA were associated with increased odds of AH, DM, and OB in all periods, while SB significantly elevated the OR for OB at all time points. After IMDIS, there was an increase in the prevalence of AH, DM, and OB among older adults and younger individuals. PI, insufficient MVPA, SB, and advanced age were all associated with a greater likelihood of NCDs at every stage of the study. The high post-IMDIS rates of AH, DM, and OB highlight the need for urgent public health strategies. Low-cost programs, such as live videos and online group sessions, should be included in national physical activity guidelines. These initiatives are affordable, aligned with WHO goals, and reduce PI in IMDIS scenarios. Incorporating them into Academia da Saúde and Agita Brasil strengthens NCD prevention and increases the resilience of the health system for future health crises. Full article

(This article belongs to the Special Issue Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease)

27 pages, 1473 KB

Open AccessArticle

Noise Annoyance and Sleep Disturbance Due to Road Traffic and Railway Noise in Germany

by Sarah Leona Benz, Julia Kuhlmann, Jonas Bilik, Manfred Liepert and Dirk Schreckenberg

Int. J. Environ. Res. Public Health 2025, 22(9), 1366; https://doi.org/10.3390/ijerph22091366 (registering DOI) - 30 Aug 2025

Abstract

Environmental noise exposure is omnipresent, but the type of noise source and its appraisal may differ in varying contexts. For instance, studies have found significant differences in annoyance ratings between urbanisation levels. In this article, a re-analysis of existing survey data is presented, [...] Read more.

Environmental noise exposure is omnipresent, but the type of noise source and its appraisal may differ in varying contexts. For instance, studies have found significant differences in annoyance ratings between urbanisation levels. In this article, a re-analysis of existing survey data is presented, assessing noise annoyance and sleep disturbance from road traffic and railway noise in a random sample stratified by rural, suburban, and inner-city areas. Noise exposure was estimated using modelled L_den and L_night levels. Exposure–response curves showed greater annoyance at lower road traffic noise levels compared to the WHO guidelines (10% highly annoyed at 35 dB L_den vs. WHO 53 dB L_den). Railway noise annoyance aligned with the WHO estimates; however, sleep disturbance was lower at comparable exposure levels (3% highly sleep-disturbed at 53 dB L_night vs. WHO 44 dB). This re-analysis provides robust exposure–response relationships. The findings indicate higher levels for road traffic noise annoyance in Germany compared to international standards. A resulting policy implication is to link regular population surveys to noise action planning as a form of public participation. This approach enables the development of measures tailored to local conditions and supports the estimation of potential impacts, such as the number of people who may benefit from reduced noise exposure. Full article

(This article belongs to the Special Issue Community Response to Environmental Noise)

10 pages, 489 KB

Open AccessArticle

Effect of Spherical Adsorptive Carbon Among Chronic Kidney Disease Patients: A Nationwide Cohort Study

by Dong Hui Shin, Keunryul Park, Jae Won Yang and Jun Young Lee

Int. J. Environ. Res. Public Health 2025, 22(9), 1365; https://doi.org/10.3390/ijerph22091365 (registering DOI) - 30 Aug 2025

Abstract

Spherical Adsorptive Carbon (SAC), a type of oral sorbent, is prescribed to chronic kidney disease (CKD) patients to remove uremic toxins. However, evidence regarding its effectiveness in delaying chronic kidney disease (CKD) progression remains insufficient. We aimed to evaluate the impact of SAC [...] Read more.

Spherical Adsorptive Carbon (SAC), a type of oral sorbent, is prescribed to chronic kidney disease (CKD) patients to remove uremic toxins. However, evidence regarding its effectiveness in delaying chronic kidney disease (CKD) progression remains insufficient. We aimed to evaluate the impact of SAC on CKD progression in patients with CKD stage 3 or higher using nationwide data. In this retrospective cohort study, we included patients diagnosed with CKD stage ≥3 from the Korea National Health Insurance System database between January 2020 and December 2022. Outcomes were compared between SAC users (N = 1289) and non-users (N = 1289) after 1:1 propensity score matching (PSM). After PSM, the time from index date to end-stage kidney disease (ESKD) was significantly longer in the SAC user group compared to the non-user group (246.8 days vs. 118.6 days, p < 0.001). In Cox regression analysis, the risk of ESKD was significantly lower in the SAC group (HR = 0.37, 95% CI: 0.29–0.48). However, the risk of dialysis initiation did not show a significant difference between the two groups (HR = 0.83, 95% CI: 0.27–2.59). This nationwide cohort study suggests that SAC treatment may delay progression from CKD stage 3 to ESKD, although it did not significantly reduce the risk of dialysis initiation. Full article

(This article belongs to the Section Global Health)

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11 pages, 415 KB

Open AccessArticle

Impacts of Ambient Temperatures on Pediatric Anemia in Sub-Saharan Africa: A Regional Ecological Study

by Muhammad A. Saeed, Adeena Zaidi, Mohammad R. Saeed, Harris Khokhar, Binish Arif Sultan, Sami Khan, Adam Dawer and Haris Majeed

Int. J. Environ. Res. Public Health 2025, 22(9), 1364; https://doi.org/10.3390/ijerph22091364 (registering DOI) - 30 Aug 2025

Abstract

Anemia has been a growing concern for the pediatric population in sub-Saharan Africa. Emerging risk factors for anemia under five years of age in low-income countries are multifaceted, including infectious diseases, nutritional deficiencies, hidden hunger, and various economic determinants, and its health burdens [...] Read more.

Anemia has been a growing concern for the pediatric population in sub-Saharan Africa. Emerging risk factors for anemia under five years of age in low-income countries are multifaceted, including infectious diseases, nutritional deficiencies, hidden hunger, and various economic determinants, and its health burdens include childhood stunting and reduced cognitive function diminished school performance in children. However, the influence of climatic factors, particularly ambient temperatures, on pediatric anemia remains understudied. In this population-based study, we assess the region-specific associations between pediatric anemia and ambient temperatures in 43 countries in Africa from 2000 to 2019. Using generalized linear regression models (upon adjusting for covariates), we found that the risk of temperatures on pediatric anemia varies across four African regions, whereby the Central and Southern African regions have a positive association between pediatric anemia and ambient temperatures, and Western and Eastern regions are negatively affected. The study aims to provide evidence to stakeholders to curtail the onset of pediatric anemia in high-risk African regions to set up key interventions based on the sustainability goals set by the World Health Organization. Full article

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26 pages, 702 KB

Open AccessArticle

Exploring Stakeholders’ Perceptions of Electronic Personal Health Records for Mobile Populations Living in Disadvantaged Circumstances: A Multi-Country Feasibility Study in Denmark, Ghana, Kenya, and The Netherlands

by Paulien Tensen, Maria Bach Nikolajsen, Simeon Kintu Paul, Princess Ruhama Acheampong, Francisca Gaifém, Frederick Murunga Wekesah, Ulrik Bak Kirk, Ellis Owusu-Dabo, Per Kallestrup, Erik Beune, Charles Agyemang and Steven van de Vijver

Int. J. Environ. Res. Public Health 2025, 22(9), 1363; https://doi.org/10.3390/ijerph22091363 (registering DOI) - 29 Aug 2025

Abstract

(1) Background: Mobile populations living in disadvantaged circumstances often face disrupted continuity of care due to incomplete or inaccessible health records. This feasibility study explored the perceived usefulness of Electronic Personal Health Records (EPHRs) in enhancing access to and continuity of care [...] Read more.

(1) Background: Mobile populations living in disadvantaged circumstances often face disrupted continuity of care due to incomplete or inaccessible health records. This feasibility study explored the perceived usefulness of Electronic Personal Health Records (EPHRs) in enhancing access to and continuity of care for mobile populations across Denmark, Ghana, Kenya, and The Netherlands. (2) Methods: A qualitative study using ninety semi-structured interviews, with multi-level stakeholders ranging from policymakers to mobile individuals, recruited through purposive and convenience sampling. Interview guides and analysis were informed by the Technology Acceptance Model (TAM), and analysis by the Unified Theory of Acceptance and Use of Technology (UTAUT). (3) Results: Stakeholders highlighted the value of improved medical data sharing and ownership and considered EPHRs promising for enhancing care continuity and efficiency. Key concerns included limited digital and health literacy, and data security and privacy, underscoring the need for education and safeguards against inappropriate data sharing. Due to differences in digital readiness and privacy guidelines, a one-size-fits-all EPHR is unlikely to succeed. (4) Conclusions: EPHRs are considered valuable tools to enhance care continuity and increase patient ownership, but they face technical, structural, and social challenges, including data security and varying levels of digital (health) literacy. Successful implementation requires context-sensitive, co-created solutions supported by strong policy frameworks. Full article

(This article belongs to the Special Issue Migrant Health Challenges in Infectious and Non-Communicable Disease Epidemiology)

17 pages, 579 KB

Open AccessReview

Long COVID Symptom Management Through Self-Care and Nonprescription Treatment Options: A Narrative Review

by Preeti Kachroo, Guy Boivin, Benjamin J. Cowling, Will Shannon, Pascal Mallefet, Pranab Kalita and Alexandru M. Georgescu

Int. J. Environ. Res. Public Health 2025, 22(9), 1362; https://doi.org/10.3390/ijerph22091362 - 29 Aug 2025

Abstract

Many patients experience unique or persistent symptoms several months following the onset of infection with severe acute respiratory syndrome coronavirus 2, the causative agent of COVID-19. While this condition is commonly referred to as long COVID, no universally accepted definition exists; therefore, many [...] Read more.

Many patients experience unique or persistent symptoms several months following the onset of infection with severe acute respiratory syndrome coronavirus 2, the causative agent of COVID-19. While this condition is commonly referred to as long COVID, no universally accepted definition exists; therefore, many patients go underrecognized and underreported. Long COVID can involve almost any major organ system and is characterized by widely heterogeneous persistent or recurrent symptoms including fatigue, headache, cough, dyspnea, chest pain, cognitive dysfunction, anxiety, and depression. In line with the wide array of symptoms, numerous potential underlying pathophysiologic pathways, including viral persistence, prolonged inflammation, autoimmune reactions, endothelial dysfunction, and dysbiosis of the microbiome of the gut, may contribute to the symptomology of long COVID. Therapy is directed at symptomatic control; however, no pharmacologic treatments are specifically approved for the management of symptoms associated with long COVID. Several common symptoms of long COVID may be managed with nonprescription treatments (pharmacologic and nonpharmacologic). The goal of this review is to provide clinicians with a better understanding of long COVID and review the latest recommendations for managing common mild-to-moderate symptoms with nonprescription treatment options. Full article

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30 pages, 1931 KB

Open AccessArticle

Quantification of Urticating Setae of Oak Processionary Moth (Thaumetopoea processionea) and Exposure Hazards

by Paula Halbig, Horst Delb and Axel Schopf

Int. J. Environ. Res. Public Health 2025, 22(9), 1361; https://doi.org/10.3390/ijerph22091361 - 29 Aug 2025

Abstract

Potential climatic and land-use changes may favor an increase in the population densities and range expansion of oak processionary moth (OPM) in Central and Western Europe in the future. This could lead to more significant threats to human and animal health, caused by [...] Read more.

Potential climatic and land-use changes may favor an increase in the population densities and range expansion of oak processionary moth (OPM) in Central and Western Europe in the future. This could lead to more significant threats to human and animal health, caused by the urticating setae released by OPM larvae, and more severe oak defoliation by the larvae. To cope with the public health issue, a basis for OPM hazard assessment and management was created by quantifying the setae formation potential of OPM. While a single larva forms ca. 857,000 setae during its lifespan, a single infested oak tree may be contaminated with up to 10–24 billion (10⁹) setae during an OPM outbreak. Moreover, the possible setae contamination threat to humans through airborne setae dispersion was studied in worst-case exposure simulations in the field. The highest airborne setae concentration was straight downwind, but turbulences up to 150° from the air flow were observed. The findings of this study will improve biohazard quantification as a basis for decision-making on preventive or mechanical control measures and enable an effective protection of human health. This study provides applicable information to derive warnings and recommendations for the public, as well as land managers and authorities. Full article

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

10 pages, 279 KB

Open AccessArticle

Prevalence, Risk Factors, and Multimorbidity Patterns in Climacteric Women with Hypertension

by Juliene Gonçalves Costa, Ana Luiza Amaral, Julia Buiatte Tavares, Aline Keli de Oliveira, Ana Clara Ribeiro Cunha, Juliana Cristina Silva and Guilherme Morais Puga

Int. J. Environ. Res. Public Health 2025, 22(9), 1360; https://doi.org/10.3390/ijerph22091360 - 29 Aug 2025

Abstract

Although the relationship between risk factors and disease patterns still remains poorly understood, arterial hypertension in climacteric women is a substantial risk factor for multimorbidity. This cross-sectional study analyzed data from 1003 women aged ≥40 years attending Brazilian Basic Health Units to assess [...] Read more.

Although the relationship between risk factors and disease patterns still remains poorly understood, arterial hypertension in climacteric women is a substantial risk factor for multimorbidity. This cross-sectional study analyzed data from 1003 women aged ≥40 years attending Brazilian Basic Health Units to assess multimorbidity (≥2 chronic conditions) and its patterns (cardiometabolic, musculoskeletal, and neuropsychological). An adjusted logistic regression revealed that postmenopausal status (OR: 2.17; 95% CI: 1.05–4.48) and an age of ≥70 years (OR: 2.85; 95% CI: 1.16–6.99) were key risk factors for multimorbidity. Notably, 86% of hypertensive women had multimorbidity, most frequently dyslipidemia (50%), type 2 diabetes (37%), and thyroid disorders (18%). The cardiometabolic pattern (86% prevalence) was strongly associated with hypertension, especially among women aged ≥50 years (OR: 2.10; 95% CI: 1.10–3.98) and those with obesity grade I+ (OR: 2.30; 95% CI: 1.36–3.89). Musculoskeletal disorders were associated with postmenopausal status (OR: 2.41; 95% CI: 1.05–5.51) and obesity (OR: 1.92; 95% CI: 1.08–3.43), while neuropsychological diseases showed no significant associations. These findings highlight that hypertensive climacteric women—especially postmenopausal, older, or those with obesity—face elevated risks of cardiometabolic and musculoskeletal multimorbidity, underscoring the need for targeted preventive strategies in this population. Full article

(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)

30 pages, 393 KB

Open AccessArticle

Stress and Coping Strategies of Hong Kong University Students During the COVID-19 Pandemic: A Qualitative Study

by Tingyin Wong and Daniel T. L. Shek

Int. J. Environ. Res. Public Health 2025, 22(9), 1359; https://doi.org/10.3390/ijerph22091359 - 29 Aug 2025

Abstract

The COVID-19 pandemic brought significant challenges to university students in China, including the Hong Kong Special Administrative Region. To understand the stress and coping strategies of university students during the pandemic, we conducted focus groups with 56 Hong Kong university students from late [...] Read more.

The COVID-19 pandemic brought significant challenges to university students in China, including the Hong Kong Special Administrative Region. To understand the stress and coping strategies of university students during the pandemic, we conducted focus groups with 56 Hong Kong university students from late December 2022 to mid-January 2023. Thematic analysis using a deductive data analytic approach based on the Transactional Theory of Stress and Coping was applied to form concepts on coping strategies. The findings revealed four major challenges faced by Hong Kong university students, which were the accumulation of negative emotions, health-related anxiety and frequent change in pandemic-related policies, conflict with family members, and challenges in online learning and academic and career development. When coping with these challenges, students used the following coping strategies: (1) seeking social support, emphasizing the positive and tension reduction to manage their negative emotions; (2) problem-focused coping and emphasizing the positive to deal with health-related anxiety and stress arising from the frequent change in pandemic-related policies; (3) seeking social support, tension reduction, distancing/detachment and self-isolation/keeping to themselves to handle conflict with family members; (4) seeking social support, problem-focused coping, emphasizing the positive and using distancing/detachment to cope with challenges in online learning and academic and career development. Moreover, comparing students with different backgrounds, the findings showed that more students with a high level of self-perceived resilience employed the emphasizing the positive coping strategy, while more students with financial difficulties applied tension-reduction coping strategies. This study contributes to the stress and coping literature by illustrating Hong Kong young people’s stress and coping strategies during the COVID-19 pandemic. This study also supports the Transactional Theory of Stress and Coping and extends the discussion to various coping theories. Full article

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

10 pages, 461 KB

Open AccessArticle

Influence of the Training Process on the Health Literacy of Angolan Health Promoters

by Manuela Ferreira, Eduardo Santos, Joana Andrade, Inês Figueiredo, Vitor Martins and Sofia Campos

Int. J. Environ. Res. Public Health 2025, 22(9), 1358; https://doi.org/10.3390/ijerph22091358 - 29 Aug 2025

Abstract

Background: As part of the research project ‘Seigungo–Gungo’s Health, Education, and Maternal and Child Quality of Life: An Action-Research Project’, a study was conducted in the Gungo community in Angola, a region facing significant challenges in terms of access to healthcare and health [...] Read more.

Background: As part of the research project ‘Seigungo–Gungo’s Health, Education, and Maternal and Child Quality of Life: An Action-Research Project’, a study was conducted in the Gungo community in Angola, a region facing significant challenges in terms of access to healthcare and health literacy. The primary aim of the study was to evaluate the effectiveness of an intervention training model designed to improve the health literacy of the participants. Methods: The sample consisted of 30 trainees, 60% of whom were male, with an average age of 45.6 years. Most participants were single (53.3%) and had completed 6 years of formal education (26.7%). Health literacy levels were assessed using the HLS-EU-PT-Q16, a short 16-item questionnaire designed to assess three key domains: healthcare, disease prevention, and health promotion. These domains are related to the focus of the training programme. Data collection took place throughout the year 2024. Results: According to the data obtained, prior to attending the training program, 60% of the participants demonstrated an inadequate level of health literacy. Following the intervention, this percentage dropped significantly to 20%. In contrast, the proportion of participants with sufficient to excellent health literacy rose from 16.7% to approximately 40%. The results indicate that the training program had a positive and statistically significant impact on improving health literacy in the Gungo community. Conclusions: These findings highlight the importance of targeted training and sustained intervention efforts to address the specific health education needs currently affecting this community. Full article

11 pages, 264 KB

Open AccessArticle

Assessing Preparedness and Preventive Measures for Managing Food Allergy and Anaphylaxis in Primary Schools of Rabigh, Saudi Arabia

by Saddiq Habiballah, Nojoud Faqerah, Abdullah Alsaggaf, Majdi Damanhori and Manal Ahmed Halwani

Int. J. Environ. Res. Public Health 2025, 22(9), 1357; https://doi.org/10.3390/ijerph22091357 - 29 Aug 2025

Abstract

Background and Aims: Anaphylaxis is a severe allergic reaction that can lead to life-threatening consequences. Despite growing awareness of food allergies, schools in Saudi Arabia remain underprepared to manage allergic reactions. This study aimed to evaluate the preparedness of primary schools in Rabigh, [...] Read more.

Background and Aims: Anaphylaxis is a severe allergic reaction that can lead to life-threatening consequences. Despite growing awareness of food allergies, schools in Saudi Arabia remain underprepared to manage allergic reactions. This study aimed to evaluate the preparedness of primary schools in Rabigh, Saudi Arabia, in managing allergic reactions, with a focus on their policies and training practices to prevent food-related anaphylaxis. Methods: A cross-sectional survey was conducted involving all 24 primary schools in Rabigh. We used a previously published questionnaire that was translated into Arabic and contextually adapted; however, no formal psychometric validation was performed. The questionnaire assessed school preparedness to manage allergic reactions and existing protocols for allergy management. Data were analysed using IBM SPSS Statistics version 25 to examine associations between preparedness level and the presence of pupils with food allergy or anaphylaxis. Results: Nineteen schools (79%) completed the survey. Most schools (95%) had emergency communication systems, and 74% designated a staff member to manage allergic reactions. However, only 58% were aware of pupils with food allergies. Preventive measures such as food-handling guidance and a no-nut policy were present in most schools. Still, policies against food sharing and closer supervision of high-risk pupils were inconsistently implemented. A comparison between schools with and without pupils with allergies revealed that schools with such pupils were more likely to identify allergy risks and provide closer supervision during mealtimes (p = 0.042). Conclusions: While some primary schools in Rabigh reported strengths such as designated staff and emergency communication systems, substantial gaps were observed in preventive measures, including mealtime supervision and food-sharing policies. Preparedness varied across schools, with those without known allergic pupils less likely to implement preventive practices. These findings underscore the importance of standardised policies and regular staff training to ensure readiness for allergic emergencies in all schools. Full article

10 pages, 295 KB

Open AccessArticle

Association of DRD2 and BDNF Genetic Polymorphisms with Exercise Addiction

by Izadora Moreira da Silva, Caleb Guedes Miranda Santos, Camilla Geyer de Rezende, Victor Corrêa Neto and Alexandre Palma

Int. J. Environ. Res. Public Health 2025, 22(9), 1356; https://doi.org/10.3390/ijerph22091356 - 29 Aug 2025

Abstract

Exercise addiction is described in the literature as a compulsive behavior associated with adverse health symptoms. Currently, knowledge about the biological and social factors that trigger the development of this behavior is still lacking, and there are no published studies on genetic variants [...] Read more.

Exercise addiction is described in the literature as a compulsive behavior associated with adverse health symptoms. Currently, knowledge about the biological and social factors that trigger the development of this behavior is still lacking, and there are no published studies on genetic variants associated with the disorder. Because of this, we genotyped specific polymorphisms in the genes DRD1 (rs265981), DRD2 (rs1800497), BDNF (rs6265), HFE (rs1799945), ACTN3 (rs1815739), PPARA (rs4253778), PPARGC1A (rs8192678), and AMPD1 (rs17602729) to investigate whether they were associated with exercise addiction. In total, 469 men and women, comprising athletes and non-athletes between the ages of 18 and 50, were enrolled in the study. Each participant provided an oral swab sample for genetic analysis and completed the Negative Addiction Scale questionnaire that tests for physical exercise addiction. For the DRD2 polymorphism, there was a significant association of the GG genotype with asymptomatic participants and of the AA genotype with participants symptomatic for exercise addiction. Additionally, for the BDNF polymorphism, the CC genotype was associated with symptomatic participants, and the T allele was associated with asymptomatic individuals. However, all associations were found by evaluating the SNP individually, and this demonstrates the difficulty in studying variables related to behavioral phenotypes. Full article

(This article belongs to the Special Issue Public Health Perspectives on Physical Exercise for Adults and Older People)

11 pages, 592 KB

Open AccessArticle

Prevalence and Severity of Periodontitis in Patients with Ulcerative Colitis: A Case–Control Study

by Angar Soronzonbold, Oyunkhishig Khishigdorj, Davaadorj Duger and Bayarchimeg Batbayar

Int. J. Environ. Res. Public Health 2025, 22(9), 1355; https://doi.org/10.3390/ijerph22091355 - 29 Aug 2025

Abstract

(1) Background: Current evidence suggests a possible association between ulcerative colitis (UC) and an increased risk of periodontitis. However, there is limited evidence regarding the severity of periodontitis in patients with UC. This study aimed to evaluate the prevalence and severity of periodontitis [...] Read more.

(1) Background: Current evidence suggests a possible association between ulcerative colitis (UC) and an increased risk of periodontitis. However, there is limited evidence regarding the severity of periodontitis in patients with UC. This study aimed to evaluate the prevalence and severity of periodontitis in patients with UC compared with healthy controls. (2) Methods: In this case–control study, 20 patients with UC and 40 age- and sex-matched controls from Ulaanbaatar Songdo Hospital underwent a full-mouth periodontal examination. Periodontitis was classified according to the 2017 classification system. Logistic regression was used to assess the relationship between UC and stage III/IV periodontitis. (3) Results: Patients with UC exhibited a significantly higher prevalence of periodontitis (95% vs. 72.5%) and stage III/IV periodontitis (55% vs. 20%, p = 0.011) than the controls. UC was associated with increased odds of stage III/IV periodontitis (OR = 4.0, 95% CI: 1.24–12.88, p = 0.02), and this association remained significant after adjusting for age and smoking status. However, after further adjustment for age and plaque levels, the association was attenuated and lost statistical significance. (4) Conclusions: Patients with UC demonstrated a higher prevalence and severity of periodontitis than healthy controls, including a significantly increased proportion of stage III/IV cases. These findings highlight the need for periodontal screening and oral hygiene education as part of the management of patients with UC in Mongolia. Full article

(This article belongs to the Special Issue Oral Diseases: Prevention, Diagnosis and Treatment)

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10 pages, 248 KB

Open AccessArticle

Maternal Outcomes of WIC Recipients Before and During the COVID-19 Pandemic

by Arlesia Mathis, Sarah G. Buxbaum, Fran Close, Sandra G. Suther, Elizabeth Mazzio, Remelda Saunders-Jones, Fayetta Justin, Karam F. A. Soliman and Selina Darling-Reed

Int. J. Environ. Res. Public Health 2025, 22(9), 1354; https://doi.org/10.3390/ijerph22091354 - 29 Aug 2025

Abstract

The effects of the COVID-19 pandemic restricted the availability of healthcare and social services. This retrospective study reports WIC enrollment rates and presents descriptive data on prenatal care access and selected maternal health conditions among pregnant women in Florida before and during the [...] Read more.

The effects of the COVID-19 pandemic restricted the availability of healthcare and social services. This retrospective study reports WIC enrollment rates and presents descriptive data on prenatal care access and selected maternal health conditions among pregnant women in Florida before and during the COVID-19 pandemic. Using birth data linking maternal and infant characteristics from the Florida Department of Health Bureau of Vital Statistics, we examined birth records from 1 January 2019 to 31 December 2020 related to women ranging from 11 to 59 years of age who received WIC. The descriptive results show that WIC recipients had higher rates of inadequate prenatal care and adverse maternal health outcomes during the pandemic. Logistic regression results show that the odds of receiving inadequate prenatal care increased by 24% (OR = 1.24, p < 0.001), the odds of experiencing gestational diabetes by 9% (OR = 1.09, p < 0.001), and the odds of experiencing gestational hypertension by 10% (OR = 1.10, p < 0.001). Further research is needed to evaluate how specific WIC services influence maternal outcomes, particularly during public health emergencies. Full article

(This article belongs to the Special Issue Proceedings of the 2024 and 2025 Research Centers in Minority Institutions (RCMI) Consortium National Conferences)

23 pages, 358 KB

Open AccessArticle

Measuring the Association Between Sports and Mental Health Among Mexican LGBTQ People: Psychological Distress Among Athletes, Spectators/Volunteers, and Non-Attendees During the 2023 Gay Games

by Casper H. Voyles, Alma Lilia Cruz Bañares, Carlos Ignacio Ahedo Rocha and Heleen Vermandere

Int. J. Environ. Res. Public Health 2025, 22(9), 1353; https://doi.org/10.3390/ijerph22091353 - 29 Aug 2025

Abstract

Mental health benefits from sport are widely established in the general population yet remain underexamined among LGBTQ individuals. Investigation of whether sports can promote LGBTQ mental well-being is warranted. The 2023 Gay Games in Guadalajara, Mexico, provided the opportunity to examine psychological distress [...] Read more.

Mental health benefits from sport are widely established in the general population yet remain underexamined among LGBTQ individuals. Investigation of whether sports can promote LGBTQ mental well-being is warranted. The 2023 Gay Games in Guadalajara, Mexico, provided the opportunity to examine psychological distress among Mexican LGBTQ individuals with different involvement within the event (n = 111). Gay Games athletes (n = 32), spectators/volunteers (n = 41), and non-attendees (n = 38) completed an online questionnaire about mental health, self-reported health, experiences of discrimination, and fear during pride events. Among this sample, 18.8% of athletes reported any psychological distress (as measured by PHQ-4) compared to 36.6% of spectators/volunteers and 50.0% of non-attendees. Multivariable logistic regression was used to assess the correlation between psychological distress and Gay Games participation. The final adjusted models demonstrated that athletes (OR: 0.200; CI: 0.063, 0.630) and spectators/volunteers (OR: 0.310; CI: 0.097, 0.961) had lower odds of reporting psychological distress than non-attendees. Other significant potential confounders were being transgender (OR: 4.582; CI: 1.392, 15.071), having excellent/very good/good self-rated health (OR: 0.101; CI: 0.014, 0.708), and reporting fear during pride events (OR: 4.583; CI: 1.692, 12.401). These findings provide support for an inverse relationship between poor mental health and LGBTQ-inclusive sports participation and can inform future interventions to promote well-being for groups experiencing substantial mental health disparities. Full article

(This article belongs to the Special Issue The Current Research Trends on Public Mental Health in Sports and Exercise Settings)

19 pages, 614 KB

Open AccessSystematic Review

Current Advances and Future Prospects in the Use of a Low-Carbohydrate Diet in Managing People with Type 2 Diabetes: A Systematic Review of Randomised Controlled Trials

by Omorogieva Ojo, Osarhumwese Osaretin Ojo, Yemi Onilude, Victoria Apau, Ivy Kazangarare, Tajudeen Arogundade and Joanne Brooke

Int. J. Environ. Res. Public Health 2025, 22(9), 1352; https://doi.org/10.3390/ijerph22091352 - 28 Aug 2025

Abstract

Background: There is a worldwide increase in the prevalence of type 2 diabetes, and strategies for managing this condition include dietary interventions. These interventions include the use of a low-glycaemic index diet, high-fibre and prebiotic diets, and low-carbohydrate diets (LCDs), which improve glycaemic [...] Read more.

Background: There is a worldwide increase in the prevalence of type 2 diabetes, and strategies for managing this condition include dietary interventions. These interventions include the use of a low-glycaemic index diet, high-fibre and prebiotic diets, and low-carbohydrate diets (LCDs), which improve glycaemic control, reduce the risk of diabetic complications, and promote health. However, the definition of LCDs varies across the literature, and the use of LCDs in managing people with diabetes is often seen as controversial. Therefore, the aim of this review is to examine current advances and future prospects in the use of LCDs in managing people with type 2 diabetes. Method: A systematic review of randomised controlled trials, which applied both the PRISMA and PICOS frameworks. Databases including MEDLINE, APA PsycInfo, Academic Search Premier, CINAHL Plus with Full Text, APA PsycArticles, and Psychology and Behavioural Sciences Collection were searched through EBSCOHost. The EMBASE database and reference list of articles were also searched for articles of interest. Two researchers conducted the searches independently from database inception to 28/04/25. However, based on the inclusion criteria, the year of publication of studies was restricted to articles published from 2021. The search terms were combined using Boolean operators (AND/OR), and duplicates were removed in EndNote. The articles were screened for eligibility based on inclusion and exclusion criteria by two researchers. Results: The findings identified that an LCD is significantly (p < 0.05) more effective in reducing glycaemic parameters compared to a usual diet, standard care, or a control diet in people with type 2 diabetes. Similarly, the effect of LCD was significant (p < 0.05) in reducing BMI in patients with type 2 diabetes compared with the control diet. However, an LCD did not appear to have a significant (p > 0.05) effect on lipid parameters compared to a control diet. Conclusion: This systematic review found that LCDs are significantly (p < 0.05) more effective in promoting glycaemic control than a usual diet, standard care, or a control diet in people with type 2 diabetes. In addition, LCDs can be an effective strategy for reducing BMI in individuals with type 2 diabetes, particularly when implemented as part of a structured, sustained dietary intervention. However, there was variability in the findings of the studies included with respect to glycaemic control and BMI. Furthermore, the impact of LCD on glycaemic control did not appear sustainable in the long term. LCDs did not have a significant (p > 0.05) effect on lipid parameters compared to a control diet. Full article

(This article belongs to the Section Global Health)

15 pages, 293 KB

Open AccessArticle

Not All Runners Cross the Same Finish Line: Sociodemographic Inequalities in COVID-19 Recovery After a Mass Sporting Event

by Daniel Martínez-Cevallos, Alejandra Proaño-Grijalva, Frano Giakoni-Ramírez and Daniel Duclos-Bastías

Int. J. Environ. Res. Public Health 2025, 22(9), 1351; https://doi.org/10.3390/ijerph22091351 - 28 Aug 2025

Abstract

Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact [...] Read more.

Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact and recovery experiences among regional runners remains limited. Objective: We examined the sociodemographic profiles, athletic experience, and perceptions of COVID-19-related impact and recovery among participants in the 2023 Medellín Marathon, and to assess differences by educational attainment, employment status, age group, and geographic origin. Methods: A cross-sectional descriptive study was undertaken involving 2486 registered marathon runners. An ad hoc questionnaire assessed COVID-19 symptoms and sequelae, perceived respiratory and physical limitations, fears associated with group exercise, and self-reported recovery. Analyses included descriptive statistics, bivariate comparisons and one-way ANOVA tests. Results: Older participants, retirees and those with lower educational levels reported significantly greater COVID-19 impact, longer recovery periods and higher perceived physical and respiratory limitations. In contrast, younger runners and those with a college education showed more complete physical recovery and attributed protective benefits, such as improved cardiorespiratory function and a lower incidence of respiratory symptoms, to their training. Additionally, runners originating from smaller municipalities and other Latin American countries reported higher levels of impact and lower perceptions of recovery. Conclusions: Post-COVID-19 effects among marathon runners are not uniform but vary according to sociodemographic and contextual factors. These findings underscore the importance of tailored support and readaptation strategies—particularly for vulnerable subgroups—to ensure their safe and equitable return to mass endurance events. Full article

(This article belongs to the Special Issue Positive Effects of Leisure–Sports and Physical Activity on Public Health)

18 pages, 409 KB

Open AccessArticle

“I’ll Continue If I Have a Positive Mind”: Identifying the Ways in Which Depression and PTSD Impact PrEP Adherence Among PrEP-Experienced Pregnant and Postpartum Women in Cape Town, South Africa

by Amelia M. Stanton, Madison R. Fertig, Jennifer Nyawira Githaiga, Devisi A. Ashar, Linda Gwangqa, Melinda Onverwacht, Lucia Knight, Landon Myer, Jessica E. Haberer, John Joska, Conall O’Cleirigh and Christina Psaros

Int. J. Environ. Res. Public Health 2025, 22(9), 1350; https://doi.org/10.3390/ijerph22091350 - 28 Aug 2025

Abstract

Pregnant and postpartum people (PPPs) face heightened risk for HIV acquisition, yet depression and trauma-related symptoms can undermine adherence to pre-exposure prophylaxis (PrEP). To inform the development of a brief mental health-focused adherence intervention, we explored the impacts of depression and posttraumatic stress [...] Read more.

Pregnant and postpartum people (PPPs) face heightened risk for HIV acquisition, yet depression and trauma-related symptoms can undermine adherence to pre-exposure prophylaxis (PrEP). To inform the development of a brief mental health-focused adherence intervention, we explored the impacts of depression and posttraumatic stress disorder (PTSD) symptoms on PrEP use among PPPs in Cape Town, South Africa. Twenty-eight PPPs with elevated symptoms of depression and/or PTSD and recent PrEP adherence challenges completed qualitative interviews. Six antenatal providers were also interviewed. Thematic analysis revealed three key findings with subthemes that deepen exploration of each theme: (1) depression and PTSD symptoms contributed to missed PrEP doses or late pickups by increasing doubt about PrEP efficacy, amplifying pill burden, intensifying avoidance and withdrawal (e.g., hypersomnia and disengagement from providers), and disrupting memory through rumination and emotional overload; (2) most PPPs preferred support from professional counselors, while a minority preferred informal support; and (3) intervention design considerations included aligning patient and provider goals, selecting between individual or group formats, and addressing integration barriers such as staffing and space constraints. Providers affirmed the need for embedded mental health support. Intervention strategies that increase PrEP knowledge and motivation while targeting emotional withdrawal, fatigue, and cognitive overload may improve adherence and reduce HIV risk in this population. Full article

(This article belongs to the Special Issue Women and Pre-Exposure Prophylaxis for HIV Prevention)

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