Search Results (818)

Background: Access to safe and reliable water and sanitation remains a critical public health and development challenge, with rural and low-income communities being disproportionately affected by inadequate services and heightened exposure to waterborne diseases. Despite global efforts and infrastructure-based progress indicators, significant disparities persist, and these often overlook users’ perceptions of water quality, reliability, and safety. This study explores the determinants of household satisfaction with drinking water in rural areas, comparing subjective user feedback with official access data to reveal gaps in current monitoring approaches and support more equitable, user-centered water governance. Methods: This study was conducted in Kazakhstan’s Atyrau Region, where 1361 residents from 86 rural villages participated in a structured survey assessing household access to drinking water and perceptions of its quality. Data were analyzed using descriptive statistics and multinomial logistic regression to identify key predictors of user satisfaction, with results compared against official records to evaluate discrepancies between reported experiences and administrative data. Results: The field survey results revealed substantial discrepancies between official statistics and residents’ reports, with only 58.1% of respondents having in-house tap water access despite claims of universal coverage. Multinomial logistic regression analysis identified key predictors of user satisfaction, showing that uninterrupted supply and the absence of complaints about turbidity, odor, or taste significantly increased the likelihood of higher satisfaction levels with drinking water quality. Conclusions: This study underscores the critical need to align official water access statistics with household-level experiences, revealing that user satisfaction—strongly influenced by supply reliability and sensory water quality—is essential for achieving equitable and effective rural water governance. Full article

This article investigates the macroeconomic and labor market conditions that shape the adoption of artificial intelligence (AI) technologies among large firms in Europe. Based on panel data econometrics and supervised machine learning techniques, we estimate how public health spending, access to credit, export activity, gross capital formation, inflation, openness to trade, and labor market structure influence the share of firms that adopt at least one AI technology. The research covers all 28 EU members between 2018 and 2023. We employ a set of robustness checks using a combination of fixed-effects, random-effects, and dynamic panel data specifications supported by Clustering and supervised learning techniques. We find that AI adoption is linked to higher GDP per capita, healthcare spending, inflation, and openness to trade but lower levels of credit, exports, and capital formation. Labor markets with higher proportions of salaried work, service occupations, and self-employment are linked to AI diffusion, while unemployment and vulnerable work are detractors. Cluster analysis identifies groups of EU members with similar adoption patterns that are usually underpinned by stronger economic and institutional fundamentals. The results collectively suggest that AI diffusion is shaped not only by technological preparedness and capabilities to invest but by inclusive macroeconomic conditions and equitable labor institutions. Targeted policy measures can accelerate the equitable adoption of AI technologies within the European industrial economy. Full article

Oral health during pregnancy is essential for maternal and child well-being, as hormonal and physiological changes increase women’s susceptibility to oral diseases. Despite the recognized importance of prenatal dental care, adherence to dental services remains a challenge in the public health context. This study aimed to analyze oral health and the use of dental services during pregnancy through the perception of pregnant women. It represents the qualitative phase of a mixed-method study conducted with 25 pregnant women (with and without dental care) receiving prenatal care in the Brazilian Unified Health System (SUS). Participants were selected through saturation sampling, and data were collected via semi-structured interviews, followed by content analysis. The findings revealed four major themes: barriers and facilitators to dental care, changes during pregnancy and oral health. Discomfort from oral changes was a common concern. Barriers included misinformation, fear, cultural beliefs, and service organization. In contrast, facilitating factors were identified, such as care prioritization, support from healthcare teams, health education, and access through SUS. This study concludes that emotional, cultural, and contextual aspects shape the use of dental services during pregnancy. Access through SUS is perceived as an important facilitator, which simultaneously presents organizational weaknesses that need to be addressed. Full article

Background/Objectives: International students pursuing higher education in the United States face unique challenges that increase their risk of food insecurity, including limited financial resources, employment restrictions, and cultural barriers. While food insecurity among domestic students has been widely studied, limited research focuses on the lived experiences of international graduate students. This study explores the challenges, perceptions, and coping strategies related to food insecurity among international graduate students at a large public university in North Texas. Methods: This qualitative, ethnographic study involved 20 semi-structured interviews with international graduate students who were clients of the university’s food pantry. Participants were recruited using purposive convenience sampling. Interviews focused on students’ experiences with food access, financial constraints, campus resources, and cultural food preferences. Data were analyzed using thematic coding in MAXQDA. Two standardized food insecurity measures—the USDA and FAO scales—were also administered and analyzed using SPSS. Results: Findings revealed that 85% of participants experienced limited access to nutritious and culturally appropriate foods, with 70% reporting hunger due to financial constraints. Themes included lack of cooking skills, limited campus food options, difficulty accessing familiar groceries, and limited job opportunities. Students expressed that food insecurity significantly impacted their physical health, mental well-being, and social lives, though many continued to prioritize academics over personal nourishment. Conclusions: Food insecurity among international graduate students is multifaceted, shaped by financial, cultural, and institutional barriers. Addressing this issue requires culturally sensitive interventions, improved access to diverse food options, tailored student support services, and institutional efforts to better understand and meet the needs of international students. Full article

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article

Background: Pharmacy technicians are increasingly involved in immunization services, enhancing vaccine accessibility and reducing pharmacies’ workload. This scoping review aims to (1) provide a comprehensive overview of pharmacy technicians’ involvement in immunization services across various healthcare settings and countries, and (2) conduct a comparative analysis of training curricula for pharmacy technicians on immunization. Methods: A scoping review was conducted following the Arksey and O’Malley framework. A comprehensive search of the PubMed and Scopus databases was performed using keywords and MeSH terms such as “pharmacy technician(s)”, “immunization”, “vaccination”, “role”, and “involvement”. Studies included assessed pharmacy technicians’ roles in vaccine administration, training, and public health outcomes. Descriptive and thematic analyses were used to synthesize the findings. In addition, a supplementary analysis of immunization training curricula was conducted, reviewing programs from different countries to identify similarities, differences, and gaps in course structure, content, and delivery formats. Lastly, a comprehensive toolkit was developed, offering guidelines intended to facilitate the implementation of immunization training programs. Results: A total of 35 articles met the inclusion criteria, primarily from the United States of America (n = 30), Canada (n = 2), Ethiopia (n = 1), Denmark (n = 1) and United Kingdom (n = 1). The findings indicate that pharmacy technicians contribute significantly to vaccine administration, patient education, and workflow optimization, particularly in community pharmacies. The COVID-19 pandemic accelerated their involvement in immunization programs. Key challenges include regulatory barriers, a lack of standardized training, and resistance from other healthcare professionals. Facilitators include legislative support (e.g., the PREP Act), structured training programs, and collaborative pharmacist–technician models. Conclusions: Pharmacy technicians can play a vital role in expanding immunization services, improving vaccine uptake, and reducing pharmacist workload. Addressing regulatory inconsistencies, enhancing training, and fostering interprofessional collaboration are crucial for their effective integration of immunization programs. Since immunization by pharmacy technicians is not yet allowed in many EU countries, this review will provide a foundational basis to address their potential to support the healthcare workforce and improve access to immunization services. Full article

Background: International migration is a growing global phenomenon involving diverse groups, such as labor migrants, international marriage migrants, refugees, and international students. International migrants face unique mental health challenges influenced by adversities such as social isolation and limited access to mental health services. This study employs bibliometric methods to systematically analyze the global body of literature on international migrants’ mental health. Methods: The literature on the mental health of international migrants published until October 2024 was searched using the Web of Science database. The search terms included (‘International migrants’ OR ‘migrant workers’ OR ‘international students’ OR ‘refugees’ OR ‘asylum seekers’ OR ‘smuggled migrants’) AND ‘mental health’. VOSviewer was used to conduct bibliometric analysis, focusing on co-authorship patterns, keyword co-occurrence, and citation networks. Results: Over the past four decades, research on the mental health of international migrants has grown substantially, with major migration destinations such as the United States, Europe, and Australia playing prominent roles in this field. ‘Post-traumatic stress disorder (PTSD)’ was the most frequent keyword in publications, with strong links to ‘trauma’ and ‘depression’. In recent years, with the impact of global socioenvironmental changes and emergencies such as the COVID-19 pandemic, the research focus has gradually shifted towards social support, service accessibility, and cultural adaptation. Conclusions: International migration is a far-reaching global phenomenon, and addressing the mental health of migrant populations is essential for advancing public health, social cohesion, and sustainable development. This study provides the first bibliometric overview of research in this domain, mapping its thematic evolution and collaborative structure. The findings offer valuable insights into the field’s development and may support future interdisciplinary collaboration and the formulation of culturally informed, evidence-based approaches in migrant mental health. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

Suicide is a growing public health concern in Brazil, with significant increases in mortality rates over the last decade and disparities among vulnerable populations. This study aimed to systematically synthesize the recent literature reviews on suicidality and suicide prevention in Brazil, providing an overview of key findings, research gaps, and implications for future studies. This systematic review of reviews follows a pre-registered PROSPERO protocol (CRD42024561892). Searches across five databases (MEDLINE, Scopus, CINAHL, SciELO and LILACS) identified 10 eligible reviews, published between 2019 and 2024, including systematic, integrative, narrative reviews, and meta-analyses. The reviews examined populations such as Indigenous peoples, adolescents, university students, older adults, and healthcare professionals. Findings showed that the risk of suicidal behavior was associated with mental health conditions, social vulnerability, and limited access to mental health services. Particularly high suicide rates were observed among Indigenous populations and adolescents. Across reviews, a lack of interventional studies, limited geographical coverage, and the inadequate training of health professionals were recurrent themes. This review highlights the urgent need for culturally sensitive suicide prevention strategies, greater research investment in underserved populations, and improved healthcare training and coordination. These findings aim to support the development of more effective national suicide prevention policies. Full article

Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global epidemiological trends of syphilis from 2015 to 2025, with a focus on surveillance gaps, regional disparities, and structural determinants. Methods: A broad narrative approach was used to collect and analyze epidemiological data from 2015 to 2025. The literature was retrieved from databases (PubMed, Scopus) and official reports from the WHO, CDC, and ECDC. Included materials span observational studies, surveillance reports, and modeling data relevant to global trends and public health responses. Results: Globally, syphilis incidence has increased, with notable surges in North America, Europe, and Asia. MSM remain disproportionately affected, while congenital syphilis is resurging even in high-income countries. Low- and middle-income countries report persistent burdens, especially among women of reproductive age, often exacerbated by limited screening and surveillance infrastructure. The COVID-19 pandemic disrupted syphilis-related services and further exacerbated underreporting, hindering timely detection and response efforts. Surveillance systems vary widely in their completeness and quality, which significantly hinders global data comparability and coordinated public health responses. Conclusions: Despite its curability, syphilis continues to spread due to fragmented prevention strategies, inequities in access to care, and insufficient surveillance. Strengthening diagnostic access, integrating prevention efforts into broader health systems, and addressing social determinants are essential. Improved surveillance, equitable access, and innovation—including diagnostics and potential vaccine research—are critical to controlling the global syphilis epidemic. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are not simply the result of urban growth but are shaped by spatial inequities, historical legacies, and systemic exclusion. Disadvantaged neighborhoods are particularly impacted, becoming epicenters of health crises. Using a mixed-methods approach combining spatial analysis, household surveys and interviews, the study identifies three key findings: (1) Healthcare services in Douala are unevenly distributed and dominated by private providers, which limits access for low-income residents. (2) Inadequate infrastructure and environmental risks in informal settlements lead to a higher disease burden and an overflow of demand into better-equipped districts, which overwhelms public health centers across the city. (3) This structural mismatch fuels widespread reliance on informal and unregulated care practices. This study positions Douala as a microcosm of broader public health challenges in rapidly urbanizing African cities. It highlights the need for integrated urban planning and health system reforms that address spatial inequalities, strengthen public health infrastructure, and prioritize equity—key principles for achieving the third Sustainable Development Goal (ensuring good health and well-being for all residents) in sub-Saharan Africa. Full article

Chronic diseases are a leading cause of death worldwide and have a significant negative impact on public health, overall well-being, national economies, and the long-term sustainability of already burdened health systems. In addressing some of the current health challenges, the contribution of pharmacists and community pharmacies is of particular significance. Pharmacists play a vital role in the medication use process, enhancing the efficacy of pharmacological interventions and facilitating the delivery of health services. Community pharmacies occupy a key position within the healthcare system, acting as a primary point of contact with the public and frequently representing the most accessible healthcare facility for patients. In recent times, community pharmacies have undergone a process of adaptation, shifting from a narrow focus on the dispensing of medications towards a more comprehensive approach that is patient-centered and incorporates a range of healthcare services, while also prioritizing the quality of the services provided. This work aims to explore the role of pharmacists in the provision of pharmaceutical services in three countries with distinct healthcare systems, examining how these services operate, the requirements for their delivery, the associated remuneration structures, and the extent of out-of-pocket costs for patients—ultimately analyzing their impact on health outcomes. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

Background/Objectives: Breast milk donation is increasingly recognized as a vital public health resource, providing optimal nutrition for infants who cannot be breastfed by their biological mothers. Human milk banks play a crucial role in supporting infant health, particularly for preterm and medically vulnerable infants. Despite its recognized benefits, the practice of breast milk donation and utilization remains influenced by a complex interplay of individual, social, and cultural factors. Methods: This study systematically examines how demographic and sociocultural variables are associated with attitudes and behaviors related to breast milk donation. Data were collected from 1223 Israeli mothers via questionnaires distributed through WhatsApp groups between April and May 2025. By analyzing the questionnaire results, the research identified key predictors of willingness to donate and use donated milk, as well as patterns of awareness and perceived support within different population groups. Results: Higher education (χ² = 12.87, p = 0.0016) and settlement type (χ² = 83.096, p = 0.000) were significantly associated with greater willingness to donate breast milk. Income level had no effect on donation behavior, though higher-income participants were more open to its use (χ² = 86.838, p = 0.000). Lifestyle also influenced perceptions of social support (F(2, 1220) = 259.4036, p < 0.001) and cultural support (F(2, 1220) = 601.2383, p < 0.001) of milk donation and use. Significant correlation was found between perceived cultural and social support (t = 5.140, p = 0.000), emphasizing their interrelated influence on milk donation attitudes. Conclusions: The findings assist in guiding the development of public health policies, as well as targeted awareness campaigns, to promote equitable access to donor milk services across varied communities. From the public health perspective, the findings of this study can orientate campaigns that encourage both donation and use of breast milk focusing on segments of the population in which the level of awareness is relatively low. Full article