International Journal of Environmental Research and Public Health

14 pages, 750 KiB

Open AccessArticle

Polypharmacy in Older Patients with Multimorbidity: The Agreement Between Patient and General Practitioner-Reported Drugs Observed in a Pilot cRCT

by Lena Schäfer, Michael Paulitsch, Maria Hanf, Truc Sophia Dinh, Astrid-Alexandra Klein, Sophia Klasing, Hanna Seidling, Karen Voigt and Marjan van den Akker

Int. J. Environ. Res. Public Health 2024, 21(10), 1389; https://doi.org/10.3390/ijerph21101389 - 21 Oct 2024

Viewed by 1001

Abstract

Polypharmacy (≥5 drugs) increases the risk of discrepancies between patient- and general practitioner (GP)-reported drugs, leading to adverse outcomes. This explorative analysis assesses the agreement between patient- and GP-reported drugs under the influence of a paper-based patient portfolio in a pilot cluster randomized [...] Read more.

Polypharmacy (≥5 drugs) increases the risk of discrepancies between patient- and general practitioner (GP)-reported drugs, leading to adverse outcomes. This explorative analysis assesses the agreement between patient- and GP-reported drugs under the influence of a paper-based patient portfolio in a pilot cluster randomized controlled trial (cRCT). Complete data were available for 68 patients aged 65 or older (26 were female), with multimorbidity, polypharmacy, and at least one hospitalization in the past year. Agreement was assessed for drug name and strength level. Differences between the intervention and control group (IG/CG) and comparisons between two time points (six-month interval) stratified according to gender were analyzed using Wilcoxon and Mann–Whitney U tests (α = 5%). To evaluate the reasons for discrepancies, the agreement of active pharmaceutical ingredients (APIs) and anatomical therapeutic chemical (ATC) groups was analyzed. At baseline, the agreement was 72.1% for the IG and 73.9% for the CG. Inclusion of the reported drug strength reduced the agreement in both groups (IG 66.7%, CG 60.0%). Agreement for the IG decreased statistically significantly after six months (−5.4%). ATC groups B, C, and H had the highest agreement, while N, R, and Z had the lowest. Large discrepancies in the drugs reported, due to the APIs and the corresponding ATC group, were observed. Full article

(This article belongs to the Special Issue Prevention and Management of Multimorbidity in Older People)

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17 pages, 393 KiB

Open AccessArticle

Towards ‘Formalising’ WhatsApp Teledermatology Practice in KZ-N District Hospitals: Key Informant Interviews

by Christopher Morris, Richard E. Scott and Maurice Mars

Int. J. Environ. Res. Public Health 2024, 21(10), 1388; https://doi.org/10.3390/ijerph21101388 - 21 Oct 2024

Viewed by 844

Abstract

Introduction: District hospitals in KwaZulu-Natal Province, South Africa, do not have onsite specialist dermatology services. Doctors at these hospitals use WhatsApp instant messaging to informally seek advice from dermatologists and colleagues before possible referral. They have expressed the need to formalise WhatsApp teledermatology. [...] Read more.

Introduction: District hospitals in KwaZulu-Natal Province, South Africa, do not have onsite specialist dermatology services. Doctors at these hospitals use WhatsApp instant messaging to informally seek advice from dermatologists and colleagues before possible referral. They have expressed the need to formalise WhatsApp teledermatology. Aim: To determine the views and perspectives of clinicians on the feasibility and practicality of formalising the current WhatsApp-based teledermatology activities within the KwaZulu-Natal Department of Health Dermatology Service. Methods: Key informant interviews with 12 purposively selected doctors at district hospitals and all 14 dermatologists in the KwaZulu-Natal dermatology service. Their views and perspectives on formalising the current informal use of WhatsApp for teledermatology were recorded, transcribed, and thematically analysed. Results: Five primary themes (communication, usability, utility, process, and poor understanding of legal, regulatory, and ethical issues) and 22 sub-themes were identified. Clinicians wanted WhatsApp teledermatology to continue, be formalised, and be incorporated within the KwaZulu-Natal Department of Health, facilitated by the provision of practical guidelines addressing legal, regulatory, and ethical issues. Conclusions: These findings will be used to develop a policy brief, providing recommendations and proposed guidelines for formalising the teledermatology service. The findings and methods will be relevant to similar circumstances in other countries. Full article

(This article belongs to the Section Global Health)

14 pages, 3020 KiB

Open AccessArticle

Cultural Insiders and Graphic Stories to Promote Research Readiness Among the South Asian Community: A Focus on Purpose, Protection, and Participation

by Yatra N. Patel, Riya J. Patel, Lauren Bates, Susan Gertz, Susan Hershberger and Melinda Butsch Kovacic

Int. J. Environ. Res. Public Health 2024, 21(10), 1387; https://doi.org/10.3390/ijerph21101387 - 19 Oct 2024

Viewed by 971

Abstract

South Asians living in the United States are frequently underrepresented in health research. Their lack of participation limits the generalizability of research to them and keeps them from receiving the high-quality care and innovation that some studies may offer. “Research Ready” is a [...] Read more.

South Asians living in the United States are frequently underrepresented in health research. Their lack of participation limits the generalizability of research to them and keeps them from receiving the high-quality care and innovation that some studies may offer. “Research Ready” is a five-panel, community co-created graphic-style story that encourages discussion around the purpose of research, safety/protection while participating, and why diverse participation—including South Asians—improves study results and leads to more effective interventions/treatments. This study leveraged trained young adult “cultural insiders” to invite attendees of a Midwestern South Asian Cultural Festival to read the story aloud together as the characters in English or Hindi and used a decision guide to invite discussion. Post-discussion surveys (N = 104) were analyzed using descriptive statistics. Participants spanned from 10 to 79 years, with 42% < 18 years and more females (61%). Only 18.3% indicated having prior research participation. Adults 40+ years (60%) requested the story/discussion in Hindi, compared to 2.3% of adolescents and 6.7% of younger adults. After the discussion, participants indicated their willingness to consider participation, with most being open to participating in surveys/interviews (95.2%); only 52.9% would consider studies requiring the taking of medicines. Adolescents, females, and adults with higher education were more willing to participate in medication studies. Nearly all (97.1%) said they would feel safe participating in research, and 88.5% shared that the discussion would help them better decide about future participation. In conclusion, “Research Ready” discussions shared by cultural insiders effectively encourage South Asians to consider future research participation. Full article

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

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18 pages, 580 KiB

Open AccessArticle

People at Risk of, or with Cardiovascular Diseases’ Perspectives and Perceptions of Physiotherapist-Led Health Promotion in Cameroon: A Mixed-Methods Study

by Etienne Ngeh Ngeh, Sionnadh McLean, Christopher Kuaban, Rachel Young, Ben W. Strafford and Joanne Lidster

Int. J. Environ. Res. Public Health 2024, 21(10), 1386; https://doi.org/10.3390/ijerph21101386 - 19 Oct 2024

Viewed by 1150

Abstract

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial [...] Read more.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients’ views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP, through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: (1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; (2) perceived usefulness and acceptability of PLHP; (3) preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists’ competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists, and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context. Full article

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14 pages, 1233 KiB

Open AccessArticle

Online and Face-to-Face Mat Pilates Training for Long COVID-19 Patients: A Randomized Controlled Trial on Health Outcomes

by Ana Clara Ribeiro Cunha, Juliana Cristina Silva, Caroline Pereira Garcês, Tássia Magnabosco Sisconeto, João Luiz Rezende Nascimento, Ana Luiza Amaral, Thulio Marquez Cunha, Igor Moraes Mariano and Guilherme Morais Puga

Int. J. Environ. Res. Public Health 2024, 21(10), 1385; https://doi.org/10.3390/ijerph21101385 - 19 Oct 2024

Viewed by 1043

Abstract

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: [...] Read more.

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p < 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p < 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p > 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities. Full article

(This article belongs to the Special Issue Physical Fitness and Exercise during and after the COVID-19 Pandemic)

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17 pages, 5416 KiB

Open AccessArticle

Strategies for Confronting the COVID-19 Pandemic in the State of Piauí—Brazil: Contributions to Nursing

by Thais Alexandre de Oliveira, Flor Marlene Luna Victoria Mori, Aracely Diaz Oviedo, Telma Maria Evangelista de Araújo, Daniela Reis Joaquim de Freitas, Andréia Rodrigues Moura da Costa Valle, Odinéa Maria Amorim Batista, Maria Zelia de Araujo Madeira, Neris Violeta González Pérez and Maria Eliete Batista Moura

Int. J. Environ. Res. Public Health 2024, 21(10), 1384; https://doi.org/10.3390/ijerph21101384 - 19 Oct 2024

Viewed by 825

Abstract

The COVID-19 pandemic has led to the adoption of rapid, complex, and changeable measures. These measures allowed effective care planning and implementation of emergency management strategies to meet the needs of the population. Objective: To analyze the influence of the strategies to cope [...] Read more.

The COVID-19 pandemic has led to the adoption of rapid, complex, and changeable measures. These measures allowed effective care planning and implementation of emergency management strategies to meet the needs of the population. Objective: To analyze the influence of the strategies to cope with the COVID-19 pandemic, implemented by the Public Health Network of the State of Piauí, Brazil, as contributions to nursing, on the outcome of cases and deaths. Method: This is a descriptive and documentary study with a qualitative approach, carried out in the state of Piauí—Brazil, whose data were processed at IRAMUTEC and analyzed by the Descending Hierarchical Classification (DHC). Results: Ninety-two normative acts were instituted as coping strategies, distributed in three classes: technical-operational protocols for preventing and combating COVID-19 in Piauí; Piauí strategic bases for social distancing against COVID-19; and management of services and economic activities in Piauí in the fight against COVID-19. Conclusions: The actions determined by and implemented in the normative acts were conducted according to the behavior of the epidemiological curve regarding the number of cases and deaths. The normative acts, which defined the technical-operational protocols for the prevention and control of COVID-19, were directly related to social distancing strategies and the use of protective equipment in the quality of life of the population. Full article

(This article belongs to the Special Issue Challenges and Advances in Nursing Practice in Latin America)

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17 pages, 765 KiB

Open AccessReview

Musculoskeletal, Pulmonary, and Cardiovascular COVID-19 Sequelae in the Context of Firefighter Occupational Health: A Narrative Review

by Elliot L. Graham, Susanne D’Isabel, Adriana Lofrano-Porto and Denise L. Smith

Int. J. Environ. Res. Public Health 2024, 21(10), 1383; https://doi.org/10.3390/ijerph21101383 - 19 Oct 2024

Viewed by 926

Abstract

For most individuals infected with SARS-CoV-2, the acute illness resolves completely. However, for millions of people, symptoms or sequelae from COVID-19 recur or persist for months to years after infection. Post-COVID-19 sequelae are wide-ranging, often affecting the musculoskeletal, pulmonary, and cardiovascular systems. All [...] Read more.

For most individuals infected with SARS-CoV-2, the acute illness resolves completely. However, for millions of people, symptoms or sequelae from COVID-19 recur or persist for months to years after infection. Post-COVID-19 sequelae are wide-ranging, often affecting the musculoskeletal, pulmonary, and cardiovascular systems. All who experience post-COVID-19 sequelae face significant challenges navigating home and work life. Occupations such as firefighting, however, are of particular concern given the strenuous nature of a job that relies on a healthy musculoskeletal, pulmonary, and cardiovascular system. Research has documented significant musculoskeletal impairment (including muscle weakness, pain, and fatigue), respiratory dysfunction (including reduced lung function, interstitial disease, and diffusion abnormalities), cardiovascular conditions (including cardiac events, ischemic disease, dysrhythmias, and infectious diseases), and diminished cardiorespiratory fitness that continues for months to years in some individuals. These persistent post-COVID-19 conditions may affect a firefighter’s ability to return to work, function at full capacity while at work, and potentially compromise firefighter health and public safety. This review, therefore, explores musculoskeletal, pulmonary, and cardiovascular sequelae post-COVID-19 and the impact of these sequelae on firefighter health and occupational readiness. Full article

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13 pages, 330 KiB

Open AccessArticle

The Effects of Green Spaces and Noise Exposure on the Risk of Ischemic Stroke: A Case–Control Study in Lebanon

by Jad El Masri, Hani Finge, Ahmad Afyouni, Tarek Baroud, Najla Ajaj, Maya Ghazi, Diala El Masri, Mahmoud Younes, Pascale Salameh and Hassan Hosseini

Int. J. Environ. Res. Public Health 2024, 21(10), 1382; https://doi.org/10.3390/ijerph21101382 - 19 Oct 2024

Viewed by 706

Abstract

Background: Environmental surroundings reduce the rate of several diseases, especially those related to stressful events. Ischemic stroke can be affected by such events, either directly or through its risk factors. Therefore, the present study evaluates the effects of green spaces and noise exposure [...] Read more.

Background: Environmental surroundings reduce the rate of several diseases, especially those related to stressful events. Ischemic stroke can be affected by such events, either directly or through its risk factors. Therefore, the present study evaluates the effects of green spaces and noise exposure on the risk of ischemic stroke. Methods: A case–control study was carried out, including 200 ischemic stroke cases within the first 48 h of diagnosis and 200 controls, divided equally into hospitalized and non-hospitalized participants. Controls were matched to cases based on age and gender. Socio-demographic characteristics were assessed, in addition to environmental surroundings and noise exposure at home and at workplaces. Results: Living in a house, having a house garden, and taking care of the garden were associated with a lower risk of suffering an ischemic stroke (p < 0.001, p < 0.001, and p = 0.009, respectively). However, having buildings as the view from home led to a higher stroke rate (p < 0.001). Working in an urban area, the workplace being surrounded by buildings, and the workplace not being surrounded by green spaces were also associated with a higher risk of suffering an ischemic stroke (p = 0.002, p = 0.001, and p = 0.03, respectively). As for noise exposure, being exposed to traffic noise, human noise, and other types of noise was significantly associated with a higher risk of ischemic stroke, while being exposed to higher levels of natural noise was significantly associated with a lower risk of ischemic stroke. Higher levels of noise were also associated with higher risks of ischemic stroke in homes and workplaces (p < 0.001 and p = 0.008, respectively). Conclusions: Environmental surroundings and noise exposure were found to affect the risk of ischemic stroke. Greater green spaces and lower noise exposure play a protective role against ischemic stroke, suggesting a possible prevention strategy through environmental modifications at home and workplaces. Full article

10 pages, 652 KiB

Open AccessArticle

Cost-Effectiveness Analysis of Telehealth and In-Person Primary Care Visits for People Living with Alzheimer’s Disease-Related Disorders in the State of Nevada

by Yonsu Kim, Jay J. Shen, Ian Choe, Jerry Reeves, David Byun, Iulia Ioanitoaia-Chaudhry, Leora Frimer, Pengfeng Jin, Maryam Tabrizi, Hee-Taik Kang, Jae-Woo Lee, Claire Sieun Lee, Tae-Ha Chung, Yena Hwang, Ian Park, Hayden Leung, Jenna Park and Ji Won Yoo

Int. J. Environ. Res. Public Health 2024, 21(10), 1381; https://doi.org/10.3390/ijerph21101381 - 18 Oct 2024

Viewed by 942

Abstract

To people living with Alzheimer’s Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. [...] Read more.

To people living with Alzheimer’s Disease-Related Disorders (ADRD), timely and coordinated communication is essential between their informal caregivers and healthcare providers. In provider shortage areas, for example, the state of Nevada, telehealth can be an effective primary care delivery alternative to in-person visits. To evaluate the cost-effectiveness of telehealth visits for people living with ADRD in the state of Nevada, a decision-analytic Markov model was developed from healthcare system perspectives with a 10-year horizon/1-year cycle. To estimate the effects of demographic and geographic parameters on the Markov model, race parameters were divided into non-Hispanic White individuals vs. others and location parameters were divided into urban vs. rural. A 12-item short-version Zarit Burden Interview (ZBI-12) was applied to measure the informal caregiver burdens of non-institutionalized people living with ADRD. The values of mortality rate and healthcare utilization were obtained from healthcare systems’ publicly available payor administrative data and Nevada State Inpatient/Emergency Department datasets. Among urban-residing non-Hispanic White individuals, the Incremental Cost-Effectiveness Ratio (ICER) per modified ZBI-12 indicated a cost saving of USD 9.44 with telehealth visits; among urban-residing racial minorities, the ICER per modified ZBI-12 indicated a cost saving of USD 29.26 with in-person visits; and among rural residents, the ICER per modified ZBI-12 indicated a cost-saving of USD 320.93 with telehealth visits. Distributional differences in the cost-saving effects of telehealth primary care were noted in line with racial and geographic parameters. Workforce and caregiver training is necessary for reducing distributional differences, especially among urban-residing racial monitories living with ADRD in the provider shortage area of the state of Nevada. Full article

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

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15 pages, 593 KiB

Open AccessReview

A Scoping Review of Acute Sedentary Behaviour Studies of People with Spinal Cord Injury

by Nathan T. Adams, Bobo Tong, Robert Buren, Matteo Ponzano, Jane Jun and Kathleen A. Martin Ginis

Int. J. Environ. Res. Public Health 2024, 21(10), 1380; https://doi.org/10.3390/ijerph21101380 - 18 Oct 2024

Viewed by 829

Abstract

People with a spinal cord injury (SCI) report less physical activity than other populations and may engage in more sedentary behaviour (SB), especially sitting time. SB negatively impacts physiological and psychosocial outcomes in the general population, yet minimal research has explored the effects [...] Read more.

People with a spinal cord injury (SCI) report less physical activity than other populations and may engage in more sedentary behaviour (SB), especially sitting time. SB negatively impacts physiological and psychosocial outcomes in the general population, yet minimal research has explored the effects in people with SCI. The goal of this scoping review was to catalogue and describe the effects of acute SB among people with SCI. We searched four databases before February 2024 for studies in which people with any SCI sat, laid, or reclined for more than one hour in a day, and any physiological, psychological, or behavioural (i.e., SB time) outcome was measured. In total, 2021 abstracts were screened, and eight studies were included (n = 172 participants). The studies were characterized by varied definitions, manipulations, and measures of SB. Most measured outcomes were physiological (e.g., metabolic, blood pressure), followed by behavioural (e.g., SB time) and psychological (e.g., well-being, affect). When SB was interrupted, only postprandial glucose and affect improved. Based on two studies, participants engaged in 1.6 to 12.2 h of SB per day. Average uninterrupted wheelchair sitting bouts lasted 2.3 h. Based on the very limited body of research, it is impossible to draw any conclusions regarding the nature, extent, or impact of SB in people with SCI. There is much work to carry out to define SB, test its effects, and determine if and how people with SCI should reduce and interrupt SB. Full article

(This article belongs to the Special Issue Spinal Cord Injury Rehabilitation, Treatment, and Health Related Quality of Life)

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20 pages, 1684 KiB

Open AccessArticle

The Impact of Ecological Footprint, Urbanization, Education, Health Expenditure, and Industrialization on Child Mortality: Insights for Environment and Public Health in Eastern Europe

by Gheorghe H. Popescu, Elvira Nica, Tomas Kliestik, Cristina Alpopi, Ana-Madalina Potcovaru Bîgu and Sorin-Cristian Niță

Int. J. Environ. Res. Public Health 2024, 21(10), 1379; https://doi.org/10.3390/ijerph21101379 - 18 Oct 2024

Viewed by 895

Abstract

The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region [...] Read more.

The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region from 1993 to 2022. The Grossman Health Outcome (H-O) model investigates the theoretical framework. For the existence of the cross-sectional dependency, mixed-order unit root, and cointegration problem, the famous Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) approach is applied. The research also used the Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) to check robustness. The findings illustrated that health expenditure and education lessen the infant mortality rate in Eastern European countries. But ecological footprint, industrialization and unemployment raise the infant mortality rate. According to the CS-ARDL findings, expenditure on healthcare significantly reduces child mortality. Still, the ecological footprint significantly impacts increasing child mortality. However, the AMG and CCEMG models demonstrate that investing in education is the most effective strategy for reducing child mortality. Therefore, the government of Eastern European countries should provide more priorities in the sustainable urbanization, health expenditure, and education sectors. The robustness of the AMG and CCEMG also demonstrated the strength of the CS-ARDL findings. This research paper contributes to SDG 3 by examining the environmental and health factors that influence child mortality in Eastern Europe. Policymakers, public health professionals, and other stakeholders can use the findings to inform the development and implementation of programs that specifically target the identified causes of child mortality. Full article

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24 pages, 1743 KiB

Open AccessReview

Military Family-Centred Resilience-Building Programming Across the Deployment Cycle: A Scoping Review

by Michèle L. Hébert, Joshua M. Tippe, Carley Aquin, Melody Maximos, Suzette Brémault-Phillips and Phillip R. Sevigny

Int. J. Environ. Res. Public Health 2024, 21(10), 1378; https://doi.org/10.3390/ijerph21101378 - 18 Oct 2024

Viewed by 1021

Abstract

Background: There is international agreement that military families (MFs)—active service members, reservists, veterans, and their families—must be resilient to overcome military life adversities. Resilience is defined either as skillsets or as processes implicating multi-systems in a socio-ecological context. While research on resilience-building [...] Read more.

Background: There is international agreement that military families (MFs)—active service members, reservists, veterans, and their families—must be resilient to overcome military life adversities. Resilience is defined either as skillsets or as processes implicating multi-systems in a socio-ecological context. While research on resilience-building specific to children and families who face adversity is growing, there is a paucity of evidence on MF-centred resilience-building. Objective: This review describes the evidence on such resilience-building programming and determines if adversity is considered a barrier or facilitator to resilience-building. Methods: This scoping review yielded 4050 peer-reviewed articles from database inception until December 2023, found in 12 databases. Articles were deduplicated, leaving 1317 that were independently screened for eligibility by two reviewers. Disagreements were resolved through discussion with a third reviewer. Findings: Of these articles, 27 were included; 5 additional articles were also included from other sources. The vast majority of included studies (91%) were conducted in the United States. These 32 articles were organised into categories, including demographics, research methodologies used, resilience program descriptors, and outcomes. Conclusions: Our results reveal that programs on building MF resilience vary widely, often measuring non-resilience health and social outcomes. We provide preliminary insights for MF health and policy. Our review findings will be invaluable for further evidence-based programming that builds resilience in MFs. Full article

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10 pages, 298 KiB

Open AccessArticle

Bridging the Language Gap in Healthcare: Implementing a Qualified Medical Interpreter Program for Lesser-Spoken Languages

by Michelle Mavreles Ogrodnick, Mary Helen O’Connor, Coco Lukas and Iris Feinberg

Int. J. Environ. Res. Public Health 2024, 21(10), 1377; https://doi.org/10.3390/ijerph21101377 - 18 Oct 2024

Viewed by 1310

Abstract

Linguistic inequity drives systemic disparities in healthcare for non-native English speakers. This study evaluates a project to train and provide qualified medical interpreters (QMI) to assist volunteer and safety-net clinics and community-based organizations in supporting healthcare for immigrants and refugees. We provided scholarships [...] Read more.

Linguistic inequity drives systemic disparities in healthcare for non-native English speakers. This study evaluates a project to train and provide qualified medical interpreters (QMI) to assist volunteer and safety-net clinics and community-based organizations in supporting healthcare for immigrants and refugees. We provided scholarships to bilingual community members to take a medical interpreter training course and developed a workforce for those who passed the training course. We focused on lesser-spoken foreign languages such as Arabic, Amharic, Pashto, Dari, and Burmese. Those who passed the course participated in a semi-structured interview to learn about their experiences in the training program, as well as barriers and facilitators to becoming a QMI. To date, 23 people have passed the training and are part of the QMI workforce program that has provided 94 h of interpreter services over four months, serving 66 individual patients. The evaluation showed that community members have interest in becoming QMIs and many have the required language proficiency to enroll and pass training. Finding full-time employment for less spoken languages has proven to be challenging. Full article

(This article belongs to the Section Global Health)

13 pages, 1523 KiB

Open AccessArticle

Comparative Assessment of Cellular Responses to Microscale Silica Morphologies in Human Gastrointestinal Cells: Insights for Occupational Health

by Mohammad Z. Yamin, James Y. Liu and Christie M. Sayes

Int. J. Environ. Res. Public Health 2024, 21(10), 1376; https://doi.org/10.3390/ijerph21101376 - 18 Oct 2024

Viewed by 902

Abstract

Silicon dioxide (SiO₂), commonly known as silica, is a naturally occurring mineral extracted from the Earth’s crust. It is widely used in commercial products such as food, medicine, and dental ceramics. There are few studies on the health effects of pyrogenic [...] Read more.

Silicon dioxide (SiO₂), commonly known as silica, is a naturally occurring mineral extracted from the Earth’s crust. It is widely used in commercial products such as food, medicine, and dental ceramics. There are few studies on the health effects of pyrogenic and colloidal silica after ingestion. No research has compared the impact of microscale morphologies on mitochondrial activity in colon cells after acute exposure. The results show that crystalline and amorphous silica had a concentration-independent effect on cells, with an initial increase in mitochondrial activity followed by a decrease. Vitreous silica did not affect cells. Diatomaceous earth and pyrogenic silica had a concentration-dependent response, causing a reduction in mitochondrial activity as concentration increased. Diatomaceous earth triggered the highest cellular response, with mitochondrial activity ranging from 78.84% ± 12.34 at the highest concentration (1000 ppm) to 62.54% ± 17.43 at the lowest concentration (0.01 ppm) and an average H₂O₂ concentration of 1.48 ± 0.15 RLUs. This research advances our understanding of silica’s impact on human gastrointestinal cells, highlighting the need for ongoing exploration. These findings can improve risk mitigation strategies in silica-exposed environments. Full article

(This article belongs to the Section Environmental Health)

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10 pages, 288 KiB

Open AccessArticle

Health Risks Associated with Adopting New-Generation Disposable Products Among Young Adults Who Use E-Cigarettes

by Shuyao Ran, James J. Yang, Megan E. Piper, Hsien-Chang Lin and Anne Buu

Int. J. Environ. Res. Public Health 2024, 21(10), 1375; https://doi.org/10.3390/ijerph21101375 - 18 Oct 2024

Cited by 1 | Viewed by 994

Abstract

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA’s partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects [...] Read more.

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA’s partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar’s tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, p < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, p < 0.05) and sweet flavors (x² = 22.53, p < 0.05) but decrease the number of times of vaping per day (t = −2.18, p < 0.05) and the use of menthol flavors (x² = 4.57, p < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, p < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, p < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, p < 0.05) and secondary (b = 0.2533, p < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, p < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed. Full article

(This article belongs to the Special Issue Tobacco Use in Adolescents and Youth)

12 pages, 1465 KiB

Open AccessArticle

Enhancing Obstetric Healthcare Providers’ Knowledge of Black Maternal Mental Health: A Feasibility Study

by Kortney Floyd James, Keisha Reaves, Misty C. Richards and Kristen R. Choi

Int. J. Environ. Res. Public Health 2024, 21(10), 1374; https://doi.org/10.3390/ijerph21101374 - 17 Oct 2024

Viewed by 898

Abstract

Despite guidelines for screening and treating perinatal mood and anxiety disorders (PMADs), systemic issues and clinician biases often result in unmet mental health needs in Black women. This study assessed the feasibility and impact of comprehensive PMAD training on obstetric healthcare providers’ attitudes, [...] Read more.

Despite guidelines for screening and treating perinatal mood and anxiety disorders (PMADs), systemic issues and clinician biases often result in unmet mental health needs in Black women. This study assessed the feasibility and impact of comprehensive PMAD training on obstetric healthcare providers’ attitudes, knowledge, and implicit racial biases. We conducted a feasibility study with two cohorts of healthcare providers who received either in-person or virtual training. The training focused on PMADs, implicit bias, and culturally responsive care. Participants completed pre- and post-training assessments measuring attitudes, knowledge, empathy, and implicit racial biases. Both training modalities showed trends towards improved PMAD screening attitudes and empathy, with significant increases in beliefs about treatment efficacy. Implicit bias scores approached significance, showing a shift toward fewer participants with racial preferences. However, there was an unexplained increase in preference for White over Black post training. The training improved healthcare providers’ readiness to screen for PMADs and enhanced their understanding of PMADs. However, the persistence of implicit biases highlights the need for ongoing, sustained interventions to address deeply rooted biases. Future research should incorporate continuous learning strategies and link training to healthcare outcomes for minoritized communities. Full article

(This article belongs to the Special Issue How Reproductive Life Events Influence Women's Mental Health)

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13 pages, 566 KiB

Open AccessArticle

Toward Universal Health Coverage: What Socioeconomic and Clinical Factors Influence Health Insurance Coverage and Restrictions in Access to Viral Hepatitis Services in Nasarawa State, Nigeria?

by Victor Abiola Adepoju, Donald C. Udah, Chinonye Alioha Ezenwa, Jamiu Ganiyu, Sumaiya Muhammad Lawal, James Ambo Haruna, Qorinah Estiningtyas Sakilah Adnani and Adamu Alhassan Ibrahim

Int. J. Environ. Res. Public Health 2024, 21(10), 1373; https://doi.org/10.3390/ijerph21101373 - 17 Oct 2024

Viewed by 954

Abstract

Background: Viral hepatitis B and C (HBV and HCV) pose significant public health concern in Nigeria, where access to healthcare and treatment affordability are limited. This study investigated sociodemographic and clinical predictors of health insurance coverage and access to care among patients with [...] Read more.

Background: Viral hepatitis B and C (HBV and HCV) pose significant public health concern in Nigeria, where access to healthcare and treatment affordability are limited. This study investigated sociodemographic and clinical predictors of health insurance coverage and access to care among patients with HBV and HCV in Nasarawa State, Nigeria. Methods: A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Participants included patients diagnosed with HBV, HCV, or both who were ≥18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Binary logistic regression was used to analyze the relationship between sociodemographic/clinical factors and health insurance status. Results: Out of 303 participants, 68% had health insurance, which mostly covered hepatitis screening and vaccination. Significant predictors of health insurance coverage included being aged 36–40 years (adjusted odds ratio [aOR]: 11.01, 95% confidence interval [CI]: 2.38–50.89, p = 0.002), having post-secondary education (aOR: 25.2, 95% CI: 9.67–65.68, p < 0.001), being employed (aOR: 27.83, 95% CI: 8.85–87.58, p < 0.001), and being HIV-positive (aOR: 4.06, 95% CI: 1.55–10.61, p = 0.004). Nearly all those insured (99%) faced restrictions in insurance coverage for viral hepatitis services. Conclusions: This study reveals that while health insurance coverage is relatively high among viral hepatitis patients in Nasarawa State, significant restrictions hinder access to comprehensive services, especially for vulnerable groups like younger adults, the unemployed, and PLHIV. Key factors influencing coverage include age, education, employment, and HIV status. Expanding benefit packages to include viral hepatitis diagnosis and treatment, raising awareness about viral hepatitis as part of insurance strategy, improving access for underserved populations, and integrating hepatitis services into existing HIV programs with strong policy implementation monitoring frameworks are crucial to advancing universal health coverage and meeting the WHO’s 2030 elimination goals. Full article

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11 pages, 295 KiB

Open AccessArticle

Teachers’ and Principals’ Familiarity with School Wellness Policy: A Health Promoting Schools Assessment

by Matthew Chrisman, Anita Skarbek, Patricia Endsley and Nicholas Marchello

Int. J. Environ. Res. Public Health 2024, 21(10), 1372; https://doi.org/10.3390/ijerph21101372 - 17 Oct 2024

Viewed by 680

Abstract

The current study explored teacher and principal familiarity with school wellness polices in primary schools, including who serves on school wellness committees, and who should implement and enforce wellness policies in the school. An electronic survey guided by the Health Promoting Schools framework [...] Read more.

The current study explored teacher and principal familiarity with school wellness polices in primary schools, including who serves on school wellness committees, and who should implement and enforce wellness policies in the school. An electronic survey guided by the Health Promoting Schools framework was administered from February to May 2020 to teachers and principals from one urban and one suburban school district in the Midwestern United States. There were 450 participants; response rates were 28% (urban), 33% (suburban), and 51% (school principals). Only 41.7% of the aggregate participant pool were familiar with their wellness policy. Participants were more familiar in the suburban compared to the urban district (χ² = 68.2, p-value ≤ 0.001). Teachers/health teachers, nurses, and principals were most likely to be on wellness committees, and the most preferred wellness champions were teachers, nurses, and food service staff. Teachers and nurses are integral to school wellness and health education as part of multiple systems that can promote school health. The Health Promoting Schools framework is useful for guiding examinations to improve understanding of school wellness within school communities. Full article

13 pages, 921 KiB

Open AccessArticle

Seasonal Variations in Multiple Sclerosis Relapses in Oman: A Single Tertiary Centre Experience

by Rashid Al-Shibli, Abdullah Al-Asmi, M. Mazharul Islam, Fatema Al Sabahi, Amira Al-Aamri, Mehwish Butt, Meetham Al-Lawati, Lubna Al-Hashmi and Jihad Al-Yahmadi

Int. J. Environ. Res. Public Health 2024, 21(10), 1371; https://doi.org/10.3390/ijerph21101371 - 17 Oct 2024

Viewed by 584

Abstract

(1) Background and Aims: The seasonal factors influencing multiple sclerosis (MS) relapses remain elusive. This study aims to investigate the seasonal variation of MS relapses in Oman and compare it globally. (2) Subject and Methods: This retrospective study was conducted on N = [...] Read more.

(1) Background and Aims: The seasonal factors influencing multiple sclerosis (MS) relapses remain elusive. This study aims to investigate the seasonal variation of MS relapses in Oman and compare it globally. (2) Subject and Methods: This retrospective study was conducted on N = 183 Omani MS patients treated at Sultan Qaboos University Hospital, a tertiary hospital in Muscat, Oman, over sixteen-year period (2007–2022). Demographic and clinical data of all MS patients were juxtaposed with the monthly weather data during this period, using descriptive and inferential statistical techniques. (3) Results: Among the N = 183 MS patients studied, 508 relapses were recorded during the study period. The average number of relapses per patient was 2.8 (range: 1–15). There were significant seasonal variations in MS relapse rate, with the highest prevalence in the winter months of January and February. However, no correlation was found between MS relapses and other climatic parameters (humidity, temperature, and rainfall). (4) Conclusion: The seasonal patterns of MS relapses in Oman differ from other parts of the world, which the local clinicians should take into account while diagnosing and making management decisions. The potential impact of climate change on the anomalous changes in the seasonality of MS relapses warrants further investigation. Full article

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14 pages, 1749 KiB

Open AccessArticle

Recurrent Flooding and Household Food Access in Central Java, Indonesia

by Breanne K. Langlois, Aris Ismanto, Leah Beaulac, Katherine Berry, Magaly Koch, Timothy Griffin, Erin Coughlan de Perez and Elena N. Naumova

Int. J. Environ. Res. Public Health 2024, 21(10), 1370; https://doi.org/10.3390/ijerph21101370 - 17 Oct 2024

Viewed by 680

Abstract

It is unknown how recurring flooding impacts household diet in Central Java. We aimed to assess how recurrent flooding influenced household food access over 22 years in Central Java by linking the Global Surface Water dataset (GSW) to the Indonesian Family Life Survey. [...] Read more.

It is unknown how recurring flooding impacts household diet in Central Java. We aimed to assess how recurrent flooding influenced household food access over 22 years in Central Java by linking the Global Surface Water dataset (GSW) to the Indonesian Family Life Survey. We examined linear and nonlinear relationships and joint effects with indicators of adaptive capacity. We measured recurrent flooding as the fraction of district raster cells with episodic flooding from 1984–2015 using GSW. Food access outcomes were household food expenditure share (FES) and dietary diversity score (DDS). We fit generalized linear mixed models and random forest regression models. We detected joint effects with flooding and adaptive capacity. Wealth and access to credit were associated with improved FES and DDS. The effect of wealth on FES was stronger in households in more flood-affected districts, while access to credit was associated with reduced odds of DDS in more flood-affected districts. Flooding had more predictive importance for FES than for DDS. Access to credit, a factor that ordinarily improves food access, may not be effective in flood-prone areas. Wealthier households may be better able to adapt in terms of food access. Future research should incorporate land use data to understand how different locales are affected and further understand the complexity of these relationships. Full article

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13 pages, 688 KiB

Open AccessArticle

Electroacupuncture Reduces Heart Rate and Perceived Exertion During a Bike Test: A Preliminary Analysis

by Emily Gaudet, Tristan Castonguay, Maryse Fortin and Geoffrey Dover

Int. J. Environ. Res. Public Health 2024, 21(10), 1369; https://doi.org/10.3390/ijerph21101369 - 17 Oct 2024

Viewed by 1039

Abstract

Background: Preliminary research suggests that acupuncture can improve cardiovascular function. The purpose of our study was to determine if electroacupuncture can improve performance and post-exercise recovery. Methods: Thirty-two healthy people participated in this study (14 men and 18 women, aged 23.6 ± 3.5 [...] Read more.

Background: Preliminary research suggests that acupuncture can improve cardiovascular function. The purpose of our study was to determine if electroacupuncture can improve performance and post-exercise recovery. Methods: Thirty-two healthy people participated in this study (14 men and 18 women, aged 23.6 ± 3.5 years). The first visit included baseline measurements. Then, the participants received daily electroacupuncture at acupuncture point PC6 for a week, followed by a second visit. Heart rate, perceived exertion, and systolic and diastolic blood pressure were measured before, during, and after a YMCA submaximal bike test. Results: The heart rate was significantly reduced during the final stage of the YMCA test (151.3 ± 7.0 to 146.7 ± 11.8; p = 0.013) on the second visit. The rate of perceived exertion was significantly lower during all stages in Visit 2 (average RPE Visit 2 = 10.71 ± 2.02; average RPE Visit 1 = 11.45 ± 1.98; p = 0.004). Systolic blood pressure significantly decreased during the 5 min post-test recovery (SBP Visit 2 = 116.9 ± 12.0; SBP Visit 1 = 145.7 ± 14.6, p < 0.05). Conclusions: A week of electroacupuncture at PC6 led to reduced heart rate and perceived exertion during exercise, making the workload feel less strenuous. Electroacupuncture at PC6 shows potential for increasing participation in physical activities by making them feel easier to accomplish. Full article

(This article belongs to the Special Issue The Effect of the Physical Activity on the Health of People)

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17 pages, 1085 KiB

Open AccessArticle

Examining the Complex Interaction Among Technological Innovation, Company Performance, and Occupational Safety and Health: A Mixed-Methods Study

by Gaia Vitrano, Guido J. L. Micheli, Francesca Marazzini, Valeria Panio, Angelo Castaldo, Alessia Marrocco, Stefano Signorini and Alessandro Marinaccio

Int. J. Environ. Res. Public Health 2024, 21(10), 1368; https://doi.org/10.3390/ijerph21101368 - 16 Oct 2024

Viewed by 762

Abstract

Technological innovation and Industry 5.0 are gaining increasing attention among researchers as they offer companies a significant competitive advantage. On the other hand, introducing these technologies also brings new risks for workers. The current literature reveals a lack of studies that effectively integrate [...] Read more.

Technological innovation and Industry 5.0 are gaining increasing attention among researchers as they offer companies a significant competitive advantage. On the other hand, introducing these technologies also brings new risks for workers. The current literature reveals a lack of studies that effectively integrate occupational safety and health (OSH) within this emerging technological context and analyse the impacts of their use. This study aims to explore how companies interact with macro-level interventions that promote technological innovation and to understand their impact on different dimensions of company performance, including aspects related to OSH. Based on the existing literature, a research framework is presented that identifies the stakeholders involved, the inputs facilitating their interaction, and the cascading effects and changes. A mixed-methods approach was adopted by employing an in-depth survey with 89 companies responding and composed of both open-ended questions, to capture rich, qualitative insights, and multiple-choice questions, to gather quantifiable data. Two change levels have been identified: general changes and specific changes related to OSH. The analysis also delved into the main drivers and barriers that lead companies to engage with technological improvements and the multiple changes these interventions generate across company dimensions. Full article

(This article belongs to the Special Issue Occupational Injuries and Health in the Workplace: Planning of Prevention Interventions, Organizational Models and Support Tools for Companies)

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30 pages, 4237 KiB

Open AccessArticle

A Framework for the Human-Centered Design of Service Processes Enabled by Medical Devices: A Case Study of Wearable Devices for Parkinson’s Disease

by Sara Vannelli, Filippo Visintin, Clio Dosi, Laura Fiorini, Erika Rovini and Filippo Cavallo

Int. J. Environ. Res. Public Health 2024, 21(10), 1367; https://doi.org/10.3390/ijerph21101367 - 16 Oct 2024

Viewed by 761

Abstract

The successful introduction of medical devices (MDs) in real-world settings hinges on designing service processes that cater to stakeholders’ needs. While human-centered design (HCD) approaches have been widely applied to service process innovation, the literature lacks a methodology that leverages MDs’ key features [...] Read more.

The successful introduction of medical devices (MDs) in real-world settings hinges on designing service processes that cater to stakeholders’ needs. While human-centered design (HCD) approaches have been widely applied to service process innovation, the literature lacks a methodology that leverages MDs’ key features to design service processes that meet stakeholders’ needs. This study aims to fill this gap by developing a framework for the HCD of service processes enabled by MDs. The proposed framework mixes and adapts methodological elements from HCD and technology-enabled design approaches and proposes four new tools. The five-phase framework was applied to the design of a new Parkinson’s disease diagnosis and treatment process (PD-DTP) enabled by two wearable MDs for the detection of motor symptoms. The case study lasted five months and involved 42 stakeholders in 21 meetings (interviews, focus groups, etc.). Thanks to the case study, the framework was tested, and a new PD-DTP that could benefit all stakeholders involved was identified. This study provides a framework that, in addition to contributing to theory, could assist MDs developers and healthcare managers in designing service processes that cater to stakeholders’ needs by leveraging MDs’ key features. Full article

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18 pages, 1609 KiB

Open AccessArticle

Uncertainties of Economic Policy and Government Management Stability Played Important Roles in Increasing Suicides in Japan from 2009 to 2023

by Ruri Okubo, Ryusuke Matsumoto, Eishi Motomura and Motohiro Okada

Int. J. Environ. Res. Public Health 2024, 21(10), 1366; https://doi.org/10.3390/ijerph21101366 - 16 Oct 2024

Viewed by 732

Abstract

Standardized suicide mortality rates per 100,000 (SMRs) in Japan consistently decreased from 2009 to 2019 but increased from 2020. The causes of these temporal SMR fluctuations remain to be clarified. Therefore, this study was conducted to identify the causalities underlying the recently transformed [...] Read more.

Standardized suicide mortality rates per 100,000 (SMRs) in Japan consistently decreased from 2009 to 2019 but increased from 2020. The causes of these temporal SMR fluctuations remain to be clarified. Therefore, this study was conducted to identify the causalities underlying the recently transformed fluctuations of suicide mortality in Japan. Monthly suicide numbers disaggregated by sex and social standing, and political uncertainty indices, such as economic policy uncertainty (EPU) and government management instability (AENROP), were obtained from Japanese government databases. Interrupted time-series analysis was performed to analyze temporal fluctuations of SMRs disaggregated by sex/social standing associated with the three General Principles of Suicide Prevention Policy (GPSPP) periods and the COVID-19 pandemic. Panel data and vector autoregressive analyses were conducted to investigate causalities from political uncertainties to SMRs. During the first and second GPSPPs (2009–2017), all SMRs disaggregated by sex and social standing decreased, whereas those of unemployed females did not change. During the third GPSPP (2017–2022), decreasing trends in all SMRs were attenuated compared to previous periods. All female SMRs, except unemployed females, showed sharp increases synchronized with the pandemic outbreak. No male SMRs showed sharply increasing at the pandemic outbreak. SMRs of unemployed males/females drastically increased in the later periods of the pandemic, while SMRs of employed and multiple-person/single-person household males did not increase during the pandemic. SMR of unemployed males was positively related to AENROP but not EPU. Other male SMRs were positively related to EPU/AENROP. On the contrary, not all female SMRs were related to EPU/AENROP. Increasing AENROP generally contributed to increasing male SMRs throughout the observation period; however, susceptibility to AENROP and/or political information might have unexpectedly contributed to suppressing the sharply increasing male SMRs induced by large-scale social shocks (the COVID-19 pandemic outbreak) in Japan. Full article

(This article belongs to the Section Global Health)

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10 pages, 302 KiB

Open AccessArticle

Promoting Resilience in Healthcare Workers: A Preventative Mental Health Education Program

by Scarlett S. Ho, Wuraola Sosina, Jonathan M. DePierro, Stefanie Perez, Aysha Khan, Sydney Starkweather, Deborah B. Marin, Vansh Sharma, Jonathan A. Ripp, Lauren A. Peccoralo and Dennis S. Charney

Int. J. Environ. Res. Public Health 2024, 21(10), 1365; https://doi.org/10.3390/ijerph21101365 - 16 Oct 2024

Viewed by 1680

Abstract

Healthcare workers face greater risks for mental health conditions and chronic stress due to the demanding nature of their roles. The COVID-19 pandemic exacerbated these challenges and increased vulnerabilities to long-term mental health conditions. The present study adapts an existing resilience-based educational workshop [...] Read more.

Healthcare workers face greater risks for mental health conditions and chronic stress due to the demanding nature of their roles. The COVID-19 pandemic exacerbated these challenges and increased vulnerabilities to long-term mental health conditions. The present study adapts an existing resilience-based educational workshop program to address the time constraints and unique needs of the healthcare workforce in a post-COVID-19 world. Expanded from its initial focus on resilience, the workshop curriculum incorporates psychoeducation on common mental health issues. Between July 2022 and June 2024, a 15 min “huddle” format offered on-site training to equip HCWs in a large urban health system with coping strategies to prevent, manage, and recover from stress. Attendance and anonymous feedback were collected at each session via brief electronic surveys. Participant responses (n = 1403) obtained immediately post-huddle suggested positive impact on stress management, perceived leadership support, and resilience. Findings show the potential of brief huddles to improve mental health and resilience in healthcare workers and similar workforces. Our findings support the efficacy of brief, evidence-based educational huddles in enhancing resilience, mental health awareness, and coping skills among HCWs. This model holds significant potential for widespread implementation across healthcare and other high-stress workplaces. Full article

18 pages, 927 KiB

Open AccessArticle

A Pilot and Feasibility Study on a Mindfulness-Based Intervention Adapted for LGBTQ+ Adolescents

by Kasey D. Klimo, Jessica Walls Wilson, Charlotte Farewell, Rose Grace Grose, Jini E. Puma, Danielle Brittain, Lauren B. Shomaker and Kelley Quirk

Int. J. Environ. Res. Public Health 2024, 21(10), 1364; https://doi.org/10.3390/ijerph21101364 - 16 Oct 2024

Viewed by 922

Abstract

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this [...] Read more.

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this population. This pilot study explores the initial acceptability and feasibility, along with the descriptive health changes of an online MBI, Learning to Breathe-Queer (L2B-Q), which was adapted to meet the needs of LGBTQ+ adolescents. (2) Methods: Twenty adolescents completed baseline and post-intervention assessments of mental health, stress-related health behaviors, physical stress, and LGBTQ+ identity indicators. In addition, the adolescents participated in a post-intervention focus group providing qualitative feedback regarding the acceptability of L2B-Q. (3) Results: L2B-Q demonstrated feasible recruitment and assessment retention, acceptability of content with areas for improvement in delivery processes, and safety/tolerability. From baseline to post-intervention, adolescents reported decreased depression and anxiety and improved intuitive eating, physical activity, and LGBTQ+ identity self-awareness with moderate-to-large effects. (4) Conclusions: These findings underscore the need and the benefits of adapted interventions among LGBTQ+ youth. L2B-Q warrants continued optimization and testing within the LGBTQ+ adolescent community. Full article

(This article belongs to the Special Issue Psychological Health and Benefits of Mindfulness-Based Interventions)

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13 pages, 654 KiB

Open AccessArticle

Depression and Functioning during the COVID-19 Pandemic among Adults across Tunisia

by Jessica E. Lambert, Fatma Charfi, Uta Ouali, Amina Aissa and Joop de Jong

Int. J. Environ. Res. Public Health 2024, 21(10), 1363; https://doi.org/10.3390/ijerph21101363 - 16 Oct 2024

Viewed by 880

Abstract

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, [...] Read more.

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences. We recruited a representative sample of 2014 participants (1024 males, 990 females) using random digit dialing of mobile phone numbers across all 24 governorates in Tunisia. Females reported higher depression, greater impaired functioning, and a higher likelihood of having had COVID-19. Path analysis showed a good fit to the model when paths for males and females were allowed to vary, providing evidence for gender differences. Associations between trauma exposure and depression and depression and age with functioning were stronger among females. Social support from friends was a protective factor for males only. For males, all study variables were associated with functioning indirectly through their association with depression, except for support from friends. For females, family responsibilities and health problems had both direct and indirect effects, whereas other study variables were only linked with functioning through depression. Findings provide insights into factors that can be targeted in interventions aimed at reducing depression and improving daily functioning for males and females. Full article

(This article belongs to the Special Issue 2nd Edition: Public Health during and after the COVID-19 Pandemic)

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11 pages, 677 KiB

Open AccessArticle

Docosahexaenoic Acid and Sleep Quality in Very and Extreme Preterm Infants

by Giovanna Rando Barion, Pietra Giovanna Marghetti, Patricia Zanotelli Cagliari and Marco Fabio Mastroeni

Int. J. Environ. Res. Public Health 2024, 21(10), 1362; https://doi.org/10.3390/ijerph21101362 - 15 Oct 2024

Viewed by 656

Abstract

The results regarding the association of plasma docosahexaenoic acid (DHA) levels with sleep duration conflict. This study aimed to investigate the effect of oral administration of DHA on the sleep quality of Brazilian extreme preterm infants. This cohort study is part of the [...] Read more.

The results regarding the association of plasma docosahexaenoic acid (DHA) levels with sleep duration conflict. This study aimed to investigate the effect of oral administration of DHA on the sleep quality of Brazilian extreme preterm infants. This cohort study is part of the Joinville Docosahexaenoic Acid Study (JoiDHA) conducted with 59 infants in Joinville, Brazil. Sleep quality was assessed using the Brief Infant Sleep Questionnaire, which consists of 12 questions about the quality of sleep the week prior to its application and was answered by the parents/guardians. Of the 59 children who participated in the study, 37 (62.7%) were supplemented with DHA and 22 (37.3%) did not receive DHA. The prevalence of poor sleep quality was higher among children with the weight status at birth <50th percentile (68.2%; p = 0.045) when compared to children ≥50th percentile. However, Poisson regression analysis showed that neither weight status at birth nor DHA use was associated with sleep quality, even after adjusting for the same variables. In summary, sleep quality 12–24 months after birth was not associated with DHA supplementation in very and extreme preterm infants. Additional studies that address the increase in DHA intake would be important for the understanding of the effect of this fatty acid on sleep quality. Full article

(This article belongs to the Special Issue Child Welfare and Health Care)

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13 pages, 521 KiB

Open AccessArticle

The Effect of Stretching Exercises Applied to Caregivers of Children with Development Disabilities on Musculoskeletal Muscle Mobility and Respiratory Function

by Amine Atac and Ebrar Atak

Int. J. Environ. Res. Public Health 2024, 21(10), 1361; https://doi.org/10.3390/ijerph21101361 - 15 Oct 2024

Viewed by 769

Abstract

We aimed to investigate the effect of stretching exercises applied to the hamstring, one of the posterior muscle chains, on musculoskeletal flexibility, chest mobility, and respiratory function. Proprioceptive neuromuscular facilitation and static stretching exercises were applied to 30 healthcare personnel caring for children [...] Read more.

We aimed to investigate the effect of stretching exercises applied to the hamstring, one of the posterior muscle chains, on musculoskeletal flexibility, chest mobility, and respiratory function. Proprioceptive neuromuscular facilitation and static stretching exercises were applied to 30 healthcare personnel caring for children with developmental delays using a crossover randomized study design. Posterior muscle chain mobility was assessed using the popliteal angle test (PAT) for the hamstring muscle, the mobility of the lumbar muscles was assessed using the Schober test (ST), and the mobility of the posterior chain muscles as a whole was assessed using the finger-to-floor distance test. Chest mobility was measured using chest circumference measurements and lung volumes were measured using the pulmonary function test (PFT). The results showed that stretching exercises applied to the hamstrings led to significant improvements in PAT, ST, and chest mobility in the direction of maximal expiration (p < 0.05), without being superior to each other. Ten males (33.3%) and twenty females (66.7%) who met the inclusion criteria were analyzed. The mean age of the participants was 26.6 ± 5.9 years, the mean height was 169.53 ± 8.67 cm, the mean weight was 65.26 ± 12.03 kg, and the mean body mass index was 22.58 ± 3 kg/m². Chest inspiratory mechanics also showed a low positive correlation with posterior muscle mobility (r = 0.381; p = 0.038). There was no significant change in PAT. Within the framework of the myofascial theory, stretching exercises that can contribute positively to the musculoskeletal and respiratory system structures of healthcare professionals can be recommended and encouraged to healthcare professionals. Full article

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14 pages, 480 KiB

Open AccessReview

Centering Diverse Communities within Mindful Parenting Interventions in the U.S.: A Narrative Literature Review

by J. Corey Williams, Noel Bravo, Preeti Kota, Janaire Hawkins and Katherine Greene

Int. J. Environ. Res. Public Health 2024, 21(10), 1360; https://doi.org/10.3390/ijerph21101360 - 15 Oct 2024

Viewed by 730

Abstract

Background: While mindfulness-based interventions targeted toward parents (and families) in the U.S. offer promise for the treatment and prevention of youth psychological disorders, current research has established the underrepresentation of diverse participants in the research literature. The full extent of inequalities in the [...] Read more.

Background: While mindfulness-based interventions targeted toward parents (and families) in the U.S. offer promise for the treatment and prevention of youth psychological disorders, current research has established the underrepresentation of diverse participants in the research literature. The full extent of inequalities in the demographics of participation in parent mindfulness intervention is less understood. Objective: This study aimed to utilize a narrative literature review approach to examine and describe the degree to which research on mindful parenting interventions is inclusive of BIPOC (Black, Indigenous, and People of Color) communities, non-clinical samples (no diagnosed disorder), cultural adaptions, and skills specific to parenting. Methods: An electronic database search of US-based studies was undertaken for empirical studies that primarily focused on parent mindfulness interventions, which reported outcomes related to either parenting behaviors or child mental health outcomes. After a full-text review, the search resulted in 34 articles. A narrative literature review of the 34 studies was conducted to assess the inclusion of BIPOC communities, non-clinical samples, cultural adaptions, and skills specific to parenting. Results: This review found notable gaps in the degree to which mindful parenting research (1) included BIPOC populations in study samples; (2) focused on non-clinical samples; (3) adapted interventions to align with the cultural needs of participants; and (4) included the application of mindfulness to enhancing knowledge, skills, and behaviors specific to parenting. Conclusions: Given these gaps in the parent mindfulness literature, greater research attention is needed on mindful parenting interventions targeted toward BIPOC communities with no clinical diagnoses, interventions optimized by cultural adaptations, and explicit applications to parenting. Full article

(This article belongs to the Special Issue Family-Based Treatment Approaches in Child and Adolescent Mental Health Services)

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Int. J. Environ. Res. Public Health, Volume 21, Issue 10 (October 2024) – 127 articles

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