International Journal of Environmental Research and Public Health

19 pages, 870 KiB

Open AccessReview

Exploring the Efficacy of Aboriginal Men’s Socioemotional Healing Programs in Australia: A Scoping Review of Evaluated Programs

by Elizabeth Horak and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2025, 22(1), 88; https://doi.org/10.3390/ijerph22010088 (registering DOI) - 10 Jan 2025

Abstract

Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) men’s health and social indicators reflect an ongoing legacy of social disruption with profound implications for broader family and community contexts. In response to recognized needs, healing programs have been implemented within Australia. The literature [...] Read more.

Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) men’s health and social indicators reflect an ongoing legacy of social disruption with profound implications for broader family and community contexts. In response to recognized needs, healing programs have been implemented within Australia. The literature on relevant best practices for Indigenous men’s healing was explored to inform the planning and implementation of a local program. A scoping review of electronic databases was undertaken to retrieve information between 2012 and 2022 on social and emotional healing programs for Indigenous men that included a program evaluation. Of the 2123 identified articles, many lacked a program evaluation or were not specific to male participants, with nine meeting the inclusion criteria for the review. Six central elements that supported the programs’ reported efficacy were identified: kinship, cultural understanding, a view of healing as being holistic, a strengths-based approach, a male leadership team, and a consistent meeting space. These elements were important for the social and emotional healing of the Indigenous male participants. Based on these findings, there is an increased need for the identified elements to be incorporated into programs for Indigenous men to accompany ongoing efforts in improving the wellbeing of the Indigenous population overall. Full article

(This article belongs to the Special Issue Cross-Cultural Perspectives on Mental Health Personal Recovery)

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47 pages, 3410 KiB

Open AccessArticle

Capacity Planning (Capital, Staff and Costs) of Inpatient Maternity Services: Pitfalls for the Unwary

by Rodney P. Jones

Int. J. Environ. Res. Public Health 2025, 22(1), 87; https://doi.org/10.3390/ijerph22010087 (registering DOI) - 10 Jan 2025

Abstract

This study investigates the process of planning for future inpatient resources (beds, staff and costs) for maternity (pregnancy and childbirth) services. The process of planning is approached from a patient-centered philosophy; hence, how do we discharge a suitably rested healthy mother who is [...] Read more.

This study investigates the process of planning for future inpatient resources (beds, staff and costs) for maternity (pregnancy and childbirth) services. The process of planning is approached from a patient-centered philosophy; hence, how do we discharge a suitably rested healthy mother who is fully capable of caring for the newborn baby back into the community? This demonstrates some of the difficulties in predicting future births and investigates trends in the average length of stay. While it is relatively easy to document longer-term (past) trends in births and the conditions relating to pregnancy and birth, it is exceedingly difficult to predict the future nature of such trends. The issue of optimum average bed occupancy is addressed via the Erlang B equation which links number of beds, average bed occupancy and turn-away. Turn-away is the proportion of times that there is not an immediately available bed for the next arriving inpatient. Data for maternity units show extreme and unexplained variation in turn-away. Economy of scale implied by queuing theory (and the implied role of population density) explains why many well intended community-based schemes fail to gain traction. The paper also addresses some of the erroneous ideas around the dogma that reducing length of stay ‘saves’ money. Maternity departments are encouraged to understand how their costs are calculated to avoid the trap where it is suggested by others that in reducing the length of stay, they will reduce costs and increase ‘efficiency’. Indeed, up to 60% of calculated maternity ‘costs’ are apportioned from (shared) hospital overheads from supporting departments such as finance, personnel, buildings and grounds, IT, information, etc., along with depreciation charges on the hospital-wide buildings and equipment. These costs, known as ‘the fixed costs dilemma’, are totally beyond the control of the maternity department and will vary by hospital depending on how these costs are apportioned to the maternity unit. Premature discharge, one of the unfortunate outcomes of turn-away, is demonstrated to shift maternity costs into the pediatric and neonatal departments as ‘boomerang babies’, and then require the cost of avoidable inpatient care. Examples are given from the English NHS of how misdirected government policy can create unforeseen problems. Full article

(This article belongs to the Section Health Care Sciences)

20 pages, 1395 KiB

Open AccessReview

Challenges and Opportunities of Universal Health Coverage in Africa: A Scoping Review

by Evaline Chepchirchir Langat, Paul Ward, Hailay Gesesew and Lillian Mwanri

Int. J. Environ. Res. Public Health 2025, 22(1), 86; https://doi.org/10.3390/ijerph22010086 (registering DOI) - 10 Jan 2025

Abstract

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC [...] Read more.

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries facing inertia. This study sought to examine the progress of UHC-focused health reform implementation in Africa, investigating the approaches utilized, the challenges faced, and potential solutions. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we scoped the literature to map out the evidence on UHC adoption, roll out, implementation, challenges, and opportunities in the African countries. Literature searches of the Cochrane database of systematic reviews, PUBMED, EBSCO, Eldis, SCOPUS, CINHAL, TRIP, and Google Scholar were conducted in 2023. Using predefined inclusion criteria, we focused on UHC adoption, rollout, implementation, and challenges and opportunities in African countries. Primary qualitative, quantitative, and mixed-methods evidence was included, as well as original analyses of secondary data. We employed thematic analysis to synthesize the evidence. Results: We found 9633 documents published between May 2005 and December 2023, of which 167 papers were included for analysis. A significant portion of UHC implementation in Africa has focused on establishing social health protection schemes, while others have focused on strengthening primary healthcare systems, and a few have taken integrated approaches. While progress has been made in some areas, considerable obstacles still exist. Financial constraints and supply-side challenges, such as a shortage of healthcare workers, limited infrastructure, and insufficient medical supplies, remain significant barriers to UHC implementation throughout Africa. Some of the promising solutions include boosting public funding for healthcare systems, strengthening public health systems, ensuring equity and inclusion in access to healthcare services, and strengthening governance and community engagement mechanisms. Conclusion: Successful UHC implementation in Africa will require a multifaceted approach. This includes strengthening public health systems in addition to the health insurance schemes and exploring innovative financing mechanisms. Additionally, addressing the challenges of the informal sector, inequity in healthcare access, and ensuring political commitment and community engagement will be crucial in achieving sustainable and comprehensive healthcare coverage for all African citizens. Full article

(This article belongs to the Section Global Health)

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12 pages, 813 KiB

Open AccessArticle

Assessing the Risks and Cultural Relativity of Diabetes in Black Individuals of African Caribbean Ancestry (ACB) Aged 18–39 Years in Toronto

by Akm Alamgir, Rhea Raghunauth, Osezua Momoh and Cliff Ledwos

Int. J. Environ. Res. Public Health 2025, 22(1), 85; https://doi.org/10.3390/ijerph22010085 (registering DOI) - 10 Jan 2025

Viewed by 66

Abstract

Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18–39 and to assess the sensitivity [...] Read more.

Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18–39 and to assess the sensitivity of glycated hemoglobin (HbA1c) compared to an oral glucose tolerance test (OGTT) to diagnose diabetes. Methods: In this mixed-methods study, maximum variation sampling was used to recruit 272 ACB participants from fourteen African and five Caribbean countries from Toronto. Participants’ height, weight, waist circumference, HbA1c, OGTT, demographic, and behavioural data were collected. SPSS was used to analyze the quantitative data. This study used descriptive statistics for frequency distribution and cross-tabulation while inferential statistics (regression, ANOVA, factor analysis, etc.) were used for relational analysis. Because of the small sample size, qualitative data were analyzed manually using the charting technique. Results: This study found that 1.5% of participants had diabetes, 9.2% had prediabetes, and 44.9% were at risk of developing diabetes. The mean value of HbA1c, FBS, and 2hPG was 5.5%, 4.8 mmol/L, and 5.7 mmol/L, respectively. The mean BMI was 28.2 kg/m², and the waist circumference was 85.8 cm. This study found a correlation between glucose intolerance and increasing body mass index (BMI) and waist circumference (WC). Dietary habits, physical inactivity, and mental health challenges were risk factors among the participants. HbA1c was found to be a more sensitive and culturally acceptable screening measure than OGTT in diagnosing diabetes. Conclusions: ACB individuals are at high risk of having diabetes, requiring culturally tailored peer-based health promotion strategies to reduce diabetes prevalence and risk. HbA1c is a culturally acceptable and statistically more capable measure than OGTT in identifying individuals with prediabetes. Further longitudinal research is needed. Full article

(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)

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14 pages, 2653 KiB

Open AccessArticle

Physicians’ Intentions to Recommend Influenza Vaccine: A Multi-Centered Hospital-Based Study Using the Theory of Planned Behavior in Bangladesh

by Md Abdullah Al Jubayer Biswas, Mahbubur Rahman, Sazzad Hossain Khan, Ahamed Khairul Basher, Md Ariful Islam, Ashrak Shad Pyash, Homayra Rahman Shoshi, Md Altaf Ahmed Riaj, Md Nazrul Islam, Md Arif Rabbany, Md Azizul Haque, Shishir Ranjan Chakraborty, Syeda Rukhshana Parvin, Mahmudur Rahman, Fahmida Chowdhury, Tahmina Shirin and Md. Zakiul Hassan

Int. J. Environ. Res. Public Health 2025, 22(1), 84; https://doi.org/10.3390/ijerph22010084 (registering DOI) - 9 Jan 2025

Viewed by 246

Abstract

Background: Influenza remains a significant public health challenge in low- and middle-income countries (LMICs) like Bangladesh, where vaccine uptake remains low despite the substantial disease burden. Physicians play a vital role in promoting vaccination, yet their intentions and influencing factors are not well [...] Read more.

Background: Influenza remains a significant public health challenge in low- and middle-income countries (LMICs) like Bangladesh, where vaccine uptake remains low despite the substantial disease burden. Physicians play a vital role in promoting vaccination, yet their intentions and influencing factors are not well understood. Methods: We conducted a cross-sectional study from June to October 2022 across four tertiary-level hospitals in Bangladesh using a questionnaire grounded in the Theory of Planned Behavior (TPB). Hierarchical logistic regression was employed to identify factors associated with vaccine recommendation intentions. Results: Among 972 physicians with an average age of 32.1 years, 40.1% intended to recommend and administer the influenza vaccine. Most (85.3%) agreed vaccination reduces risk, 65.5% desired vaccination for self-protection, 63.5% would vaccinate if available at work, and 85.3% anticipated Ministry of Health support. Male (OR = 1.9, 95% CI: 1.5–2.3) and married (OR = 1.5, 95% CI: 1.1–1.9) physicians were more likely to recommend vaccination. Each unit increase in attitude score doubled the likelihood of recommending the vaccine (OR = 2.0, 95% CI: 1.4–3.0). Conclusions: Physicians’ influenza vaccine recommendations in Bangladesh are suboptimal, influenced by gender, marital status, and attitudes. _targeted educational interventions addressing attitudinal barriers and leveraging institutional support could improve recommendation practices. Full article

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17 pages, 285 KiB

Open AccessArticle

Understanding HIV-Related Mental Health Challenges and Contributing Factors Among Indonesian Adolescents Living with HIV

by Paul Russell Ward, Reni Puspitasari, Aasha Rose, Biniyam Sahiledengle Gebremariyam and Nelsensius Klau Fauk

Int. J. Environ. Res. Public Health 2025, 22(1), 83; https://doi.org/10.3390/ijerph22010083 (registering DOI) - 9 Jan 2025

Viewed by 206

Abstract

Human Immunodeficiency Virus (HIV) has disproportionately affected various population groups, including adolescents living with HIV (ALHIV). In many contexts, ALHIV have been reported to experience mental health issues following their HIV diagnosis. However, there is a limited understanding of the mental health issues [...] Read more.

Human Immunodeficiency Virus (HIV) has disproportionately affected various population groups, including adolescents living with HIV (ALHIV). In many contexts, ALHIV have been reported to experience mental health issues following their HIV diagnosis. However, there is a limited understanding of the mental health issues faced by ALHIV in Indonesia and the various contributing factors globally. This study aimed to explore the mental health challenges and their contributing factors among Indonesian ALHIV. A qualitative design employing one-on-one in-depth interviews was used to collect data from ALHIV (n = 20) in Yogyakarta, Indonesia. Participants were recruited using the snowball sampling technique, beginning with the dissemination of study information sheets through a healthcare facility that provides HIV care services and via a WhatsApp group for adolescents living with HIV. The data were thematically analyzed, guided by a qualitative data analysis framework. The findings showed that ALHIV experienced a variety of mental health challenges upon learning of their HIV-positive status. Their mental health was also influenced by a range of family-related factors, stigma, and discrimination, which were also facilitated by their specific situations and settings, including living in a shared house with parents and siblings and school setting where they met and interacted with different peer groups on a daily basis. Family-related factors, including broken homes, family conflicts, lack of family support, and being orphans, negatively impacted their mental health. The awareness of perceived and anticipated stigma, and the experience of enacted stigma or discrimination, also contributed to the mental health challenges they faced. The findings indicate a pressing need for tailored and _targeted HIV intervention programs and activities that support their mental health, reduce stigma, and promote HIV status disclosure in safe ways for ALHIV both within the study setting and beyond. Full article

(This article belongs to the Special Issue Impact of HIV on Children and Adolescents Living with HIV and Their Families)

14 pages, 3352 KiB

Open AccessArticle

The Brazilian Portuguese Version of the Behavioral Regulation in Exercise Questionnaire 3 (BREQ-3) Is Reliable and Valid for Assessing Motivational Regulations and Self-Determination in Exercise Among Adults Aged 50 Years or Older: A Methodological Study

by Jacyara de Oliveira Vanini, Manuela Karloh, Ricardo Coelho Bosco, Michelle Gonçalves de Souza, Marlus Karsten and Darlan Laurício Matte

Int. J. Environ. Res. Public Health 2025, 22(1), 82; https://doi.org/10.3390/ijerph22010082 - 9 Jan 2025

Viewed by 228

Abstract

The study aimed to investigate the reliability, construct, and discriminant validity of the Behavioral Regulation in Exercise Questionnaire 3 (BREQ-3) for evaluating motivational regulations and self-determination for exercise in Brazilian adults aged 50 years or older. The study assessed motivation for exercise, peripheral [...] Read more.

The study aimed to investigate the reliability, construct, and discriminant validity of the Behavioral Regulation in Exercise Questionnaire 3 (BREQ-3) for evaluating motivational regulations and self-determination for exercise in Brazilian adults aged 50 years or older. The study assessed motivation for exercise, peripheral muscle strength, physical performance, functional capacity, cardiovascular fitness, and frailty phenotype. Two raters independently applied the BREQ-3. The reliability was evaluated using internal consistency, test–retest reliability, and agreement. Construct validity was tested with Spearman’s correlation coefficient and discriminant validity with the Kruskal–Wallis test. Eighty individuals participated in the reliability study, and 136 participated in the validation study. Motivational regulation and Self-Determination Index (SDI) internal consistency ranged from 0.55 to 0.82. Test–retest reliability ranged from 0.77 (95% CI 0.64–0.85) to 0.91 (95% CI 0.85–0.94), and inter-rater ranged from 0.80 (95% CI 0.68–0.87) to 0.92 (95% CI 0.88–0.95), except for amotivation, which had poor inter-rater and test–retest reliability. Additionally, moderate to weak correlations between various types of motivation and physical function tests were found (p < 0.05). Frail and pre-frail participants had lower SDI, integrated, and intrinsic motivation regulation than non-frail individuals (p < 0.05). This study confirmed the reliability, construct, and discriminative validity of the Brazilian Portuguese version of the BREQ-3 for evaluating motivational regulations and self-determination for exercise in older adults. Full article

(This article belongs to the Special Issue Physiology of Exercise and Training: Impacts on Public Health)

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15 pages, 977 KiB

Open AccessArticle

Exploring the Perspectives of Canadian Clinicians Regarding Digitally Delivered Psychotherapies Utilized for Trauma-Affected Populations

by Sidney Yap, Rashell R. Allen, Katherine S. Bright, Matthew R. G. Brown, Lisa Burback, Jake Hayward, Olga Winkler, Kristopher Wells, Chelsea Jones, Phillip R. Sevigny, Megan McElheran, Keith Zukiwski, Andrew J. Greenshaw and Suzette Brémault-Phillips

Int. J. Environ. Res. Public Health 2025, 22(1), 81; https://doi.org/10.3390/ijerph22010081 - 9 Jan 2025

Viewed by 226

Abstract

Many clinical sites shifted towards digital delivery of mental health services during the COVID-19 pandemic. There is still much to learn regarding tailoring digitally delivered interventions for trauma-affected populations. The current study examined the perceptions of Canadian mental health clinicians who provided digitally [...] Read more.

Many clinical sites shifted towards digital delivery of mental health services during the COVID-19 pandemic. There is still much to learn regarding tailoring digitally delivered interventions for trauma-affected populations. The current study examined the perceptions of Canadian mental health clinicians who provided digitally delivered psychotherapies utilized for trauma-affected populations. Specifically, we explored the shift to digital health use, what changed with this rapid shift, what needs, problems, and solutions arose, and important future considerations associated with delivering trauma-focused and adjunct treatments digitally. Survey data were collected from 12 Canadian mental health clinician participants. Surveys were adapted from the Alberta Quality Matrix of Health and Unified Theory of Acceptance and Use of Technology model. As a follow-up, the participants were invited to participate in either a semi-structured qualitative interview or focus group to further explore their perspectives on digitally delivered trauma-focused and adjunct therapies. Twenty-four clinician participants partook in an interview or focus group. The participants in this study supported the use of digitally delivered psychotherapies utilized for trauma-affected populations, sharing that these interventions appeared to offer similar quality of care to in-person delivery. Further research is required to address clinicians’ concerns with digital delivery (e.g., patient safety) and identify other avenues in which digitally delivered psychotherapies utilized for trauma-affected populations can be engaged with and improved upon. Full article

(This article belongs to the Section Health Care Sciences)

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21 pages, 1723 KiB

Open AccessArticle

Community Training Institute for Health Disparities: Outcomes of a Formal Opportunity for Community Capacity Building to Increase Health Equity in Southern Puerto Rico

by Julio Jiménez-Chávez, Fernando J. Rosario-Maldonado, David A. Vélez-Maldonado, Dorimar Rodríguez-Torruella, Jeannie M. Aguirre-Hernández, Eida Castro-Figueroa, Gloria Asencio-Toro, Elizabeth Rivera-Mateo, Luisa Morales-Torres, Axel Ramos-Lucca, Jorge L. Motta-Pagán, Nina Wallerstein and Melissa Marzán-Rodríguez

Int. J. Environ. Res. Public Health 2025, 22(1), 80; https://doi.org/10.3390/ijerph22010080 - 9 Jan 2025

Viewed by 237

Abstract

Integration of the community into health research through community-engaged research has proven to be an essential strategy for reducing health inequities. It brings significant benefits by addressing community health concerns and promoting active community participation in research. The Community Training Institute for Health [...] Read more.

Integration of the community into health research through community-engaged research has proven to be an essential strategy for reducing health inequities. It brings significant benefits by addressing community health concerns and promoting active community participation in research. The Community Training Institute for Health Disparities (CTIHD) was established to support this integration based on Community-Based Participatory Research (CBPR) principles. The main objective of this paper is to report the CTIHD program’s implementation, evaluation, and outcomes from the first two cohorts. The CTIHD recruited Hispanic community members (N = 54) to be trained in health disparities research and health promotion to foster Community–Academic Partnerships (CAPs) and develop community-led health promotion interventions. Evaluation measures included satisfaction, knowledge change, retention rate, completion rate, and project proposals (research and community health promotion plans). The retention and completion rates were 83% and 78%, respectively, with forty-two (n = 42) community trainees receiving the completion certification. Both cohorts demonstrated a significant increase in knowledge (p < 0.05), and overall satisfaction exceeded 90%. Outcomes include seven (7) community–academic partnerships, leading to the co-development of research proposals, three (3) of which received funding. Additionally, twenty-two (22) community health promotion plans were developed, with seven (7) implemented, impacting 224 individuals. Findings from this study suggest that the CTIHD effectively provided capacity building, promoted the formation of CAPs, and increased community-led health promotion interventions, thereby advancing health disparity research and community initiatives. Full article

(This article belongs to the Special Issue Community Interventions in Health Disparities)

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16 pages, 668 KiB

Open AccessArticle

Ergonomic Challenges and Musculoskeletal Pain During Remote Working: A Study of Academic Staff at a Selected University in South Africa During the COVID-19 Pandemic

by Nevinia Narainsamy, Francis Fabian Akpa-Inyang, Stanley Chibuzor Onwubu, Nalini Govender and Julian David Pillay

Int. J. Environ. Res. Public Health 2025, 22(1), 79; https://doi.org/10.3390/ijerph22010079 - 9 Jan 2025

Viewed by 217

Abstract

The COVID-19 pandemic led to a rapid shift to remote working, which affected ergonomic conditions and increased the risk of upper body musculoskeletal pain (MSP). This study assessed the prevalence and impact of upper body MSP (affecting the head, neck, shoulders, and back) [...] Read more.

The COVID-19 pandemic led to a rapid shift to remote working, which affected ergonomic conditions and increased the risk of upper body musculoskeletal pain (MSP). This study assessed the prevalence and impact of upper body MSP (affecting the head, neck, shoulders, and back) among academic staff at a University of Technology during the pandemic. Data were collected from 110 participants through an online, descriptive, cross-sectional survey adapted from the Dutch Musculoskeletal Questionnaire, the Standardized Nordic Questionnaire, and the McCaffrey Initial Pain Assessment Tool. The survey examined demographics, ergonomic practices, MSP, and psychological well-being before and during the pandemic. The sample included 59.1% female participants, with most being middle-aged. Persistent MSP was common, with 54.5% reporting neck pain and 59.1% experiencing back pain during the pandemic, alongside a significant decline in wrists in neutral position ergonomics (p = 0.012). Psychological well-being also worsened, as participants reported lower levels of cheerfulness, calmness, and energy than before the pandemic. While 81.9% of 90.9% participants with pre-existing MSP continued to experience pain, a small (9%) but notable proportion saw a decline in MSP during this period. These findings highlight a strong relationship between remote working conditions and MSP, with poor ergonomics and psychological distress contributing significantly to persistent pain. The results emphasise the need for institutions to provide ergonomic support, such as appropriate equipment and workstation adjustments, alongside mental health resources to mitigate the long-term impacts of remote working on physical and mental health. Full article

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11 pages, 961 KiB

Open AccessArticle

Comparative Electrocardiographic Analysis Between Physical Exercise Practitioners and Athletes: A Cross-Sectional Study

by Ottavia V. Z. Helbok, Luiz V. A. Sousa, Artur H. Herdy, Gabriel Z. Laporta and Rodrigo D. Raimundo

Int. J. Environ. Res. Public Health 2025, 22(1), 78; https://doi.org/10.3390/ijerph22010078 - 9 Jan 2025

Viewed by 330

Abstract

The trained heart adapts through geometric changes influenced by concentric and eccentric hypertrophy, depending on the predominance of the isometric or dynamic components of the exercise performed. Additionally, alterations in heart rhythm may occur due to increased vagal system activity. Cardiological evaluation with [...] Read more.

The trained heart adapts through geometric changes influenced by concentric and eccentric hypertrophy, depending on the predominance of the isometric or dynamic components of the exercise performed. Additionally, alterations in heart rhythm may occur due to increased vagal system activity. Cardiological evaluation with an electrocardiogram (ECG) aims to identify cardiac conditions that could temporarily or permanently disqualify an athlete from competition. This study sought to compare electrocardiographic findings in regular exercisers with those observed in athletes and to correlate these findings with training duration and load. A cross-sectional study was conducted with 154 participants divided into two groups: exercisers (EG) and athletes (AG). Data were collected on exercise type, weekly training time and practice duration. Each participant underwent a resting ECG, analyzed by two independent physicians, with a third review in case of disagreement. The Seattle criteria were applied to categorize ECG changes as physiological, borderline or abnormal. The findings revealed that 75% of athletes exhibited ECG changes, with left and/or right ventricular hypertrophy and incomplete right bundle branch block (IRBBB) being the most prevalent. Age (PR = 0.92; p = 0.004) and exercise duration (PR = 1.00; p = 0.004) significantly influenced the observed electrocardiographic changes. The majority of both regular exercisers and athletes displayed ECG alterations, with the prevalence increasing with age and training duration. Full article

(This article belongs to the Special Issue Sports Medicine and Physical Rehabilitation)

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13 pages, 516 KiB

Open AccessArticle

Biomonitoring of Hydroxylated Polycyclic Aromatic Hydrocarbon Metabolites in Workers at a Waste-to-Energy Incinerator, Turin, Italy

by Elena Farina, Anna Laura Iamiceli, Manuela Orengia, Martina Gandini, Laura Crosetto, Vittorio Abate, Stefania Paola De Filippis, Silvia De Luca, Nicola Iacovella, Elena De Felip and Antonella Bena

Int. J. Environ. Res. Public Health 2025, 22(1), 77; https://doi.org/10.3390/ijerph22010077 - 8 Jan 2025

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Abstract

This paper presents the results of the human biomonitoring of ten urinary OH-PAHs (hydroxylated polycyclic aromatic hydrocarbon) in a cohort of workers at an incinerator in Turin, Italy. Long-term exposure was assessed through repeated measurements at three time points: before the startup (T0), [...] Read more.

This paper presents the results of the human biomonitoring of ten urinary OH-PAHs (hydroxylated polycyclic aromatic hydrocarbon) in a cohort of workers at an incinerator in Turin, Italy. Long-term exposure was assessed through repeated measurements at three time points: before the startup (T0), after 1 year (T1), and after 3 years (T2). Paired data were available for 26 subjects, seven administrative workers (AWs) and 19 plant workers (PWs). Short-term exposure was assessed by comparing start-end shift measurements. Due to the non-normal distribution of the data, the nonparametric Cuzick’s test for trend and the Wilcoxon signed-rank test for paired samples were used. Neither the trend nor the T0-T2 comparison tests resulted in statistically significant outputs in the two groups (q-value > 0.05), even when controlling for smoking habits. In relation to PWs, some of the metabolites were higher at T2 with respect to T0, but no linear increase was found. Conversely, 1-OH-PYR (ng/g creatinine) showed lower median values at T1 (61.5) and T2 (67) compared to the baseline (151.3). Similarly, short-term comparisons yielded no significant results, with rather overlapping distributions of values. Overall, no significant increases in metabolite levels were detected as a result of occupational exposure in the incinerator workers considered. These findings align with previous results for metals and ambient air measurements. Full article

(This article belongs to the Special Issue Health Risks of Exposure to Polluted Air in Workplaces)

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11 pages, 877 KiB

Open AccessArticle

Patterns of Change in Athletic Identity After Anterior Cruciate Ligament Reconstruction

by Britton W. Brewer, Rachel Shinnick, Allen E. Cornelius, Judy L. Van Raalte and Fahimeh Badiei

Int. J. Environ. Res. Public Health 2025, 22(1), 76; https://doi.org/10.3390/ijerph22010076 - 8 Jan 2025

Viewed by 269

Abstract

Changes in athletic identity have been documented after injury and other sport transitions in nomothetic investigations. Patterns of change in athletic identity after injury have not been examined systematically at the individual level. In the current study, secondary analyses were performed on two [...] Read more.

Changes in athletic identity have been documented after injury and other sport transitions in nomothetic investigations. Patterns of change in athletic identity after injury have not been examined systematically at the individual level. In the current study, secondary analyses were performed on two data sets (N = 43 and N = 80) in which athletic identity values were available for before and at least six months after anterior cruciate ligament (ACL) reconstruction. A stable pattern of athletic identity was most common (48–68% of participants), followed, respectively, by a decreasing pattern (19–45% of participants) and an increasing pattern (7–14% of participants) in both data sets, with a trend toward a decreasing pattern over time in the data set in which athletic identity values were available up to two years after surgery. Partial support was obtained for the claim that decreases in athletic identity after ACL surgery are related to postoperative perceptions of knee symptoms and function. The current intraindividual findings complement the results of nomothetic studies and suggest that although stability of athletic identity after sport injury seems to be the norm, changes in athletic identity are also common and should be considered in applied work with athletes who have sustained injuries. Full article

(This article belongs to the Special Issue New Research on Mental Health in Sport)

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15 pages, 1632 KiB

Open AccessArticle

Exploring the Role of Communication Asset Mapping (CAM) as a Strategy to Promote Hereditary Cancer Risk Assessment Information Within African American Communities

by Crystal Y. Lumpkins, Kimberly A. Kaphingst, Lynn R. Miller, Evelyn Cooper, Margaret Smith, Katie Belshe, Garry Lumpkins, Jill Peltzer, Prajakta Adsul and Ricardo Wray

Int. J. Environ. Res. Public Health 2025, 22(1), 75; https://doi.org/10.3390/ijerph22010075 - 8 Jan 2025

Viewed by 385

Abstract

Objective: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, [...] Read more.

Objective: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, however, have inequitable access to hereditary cancer risk assessment (HCRA) tools and information, further exacerbating disparities in cancer rates. Innovative communication strategies to promote community-based HCRA information have promise as a means encouraging optimal primary cancer screening among AAs. The current pilot study followed a participatory process where researchers engaged with a Community Advisory Board (CAB) to explore how Communication Asset Mapping (CAM) could assist lay health advisors with the dissemination of evidence-based HC/RA information within AA faith communities. Methods: The research team and CAB conducted exploratory community-engaged group discussions with residents (n = 21) guided by Communication Infrastructure Theory, and used a community-engaged mapping process to inform the development of a CAM dissemination strategy. Results: Through textual analysis, the following conclusions were reached: (1) optimal locations (e.g., community centers) within specified neighborhood networks should have representatives who are trusted ambassadors to assist with HCRA information dissemination; (2) trusted community member voices should fully represent the neighborhood network in the community-engagement mapping process; (3) well-known and frequented geographic locations should provide a true representation of participants’ neighborhoods to create a robust health information network concerning HCRA. Conclusions: Community residents appreciated the engagement process; however, they felt that its impact was limited due to the lack of community voices within their neighborhoods to identify important communication resources within the network for optimal HCRA information dissemination. CAM, therefore, is an important public health strategy for the identification of trusted networks and useful communication resources within these networks. The strategy was also helpful in pinpointing people who could be critical communicators of emerging health information akin to HCRA. Full article

(This article belongs to the Special Issue Cancer Prevention and Control: How Systemic Inequities, Place, and Context Matters)

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11 pages, 390 KiB

Open AccessArticle

The Unseen Aftermath: Associations Between the COVID-19 Pandemic and Shifts in Mortality Trends in Japan

by Hasan Jamil, Shuhei Nomura and Stuart Gilmour

Int. J. Environ. Res. Public Health 2025, 22(1), 74; https://doi.org/10.3390/ijerph22010074 - 8 Jan 2025

Viewed by 274

Abstract

The COVID-19 pandemic disrupted healthcare systems globally, potentially altering mortality trends for non-COVID-19 diseases, particularly in aging populations like Japan’s. Assessing these impacts is essential for responsive healthcare planning. We analyzed Japanese vital registration mortality records from January 2018 to December 2021 for [...] Read more.

The COVID-19 pandemic disrupted healthcare systems globally, potentially altering mortality trends for non-COVID-19 diseases, particularly in aging populations like Japan’s. Assessing these impacts is essential for responsive healthcare planning. We analyzed Japanese vital registration mortality records from January 2018 to December 2021 for adults aged 25 and older, excluding COVID-19-related deaths. Data were stratified by sex and ICD-10 cause-of-death chapters. Poisson regression models assessed changes in mortality rates and trends, incorporating pandemic-related variables and interactions between time, age group, and the pandemic term. Among the 4,920,942 deaths analyzed, 2,456,750 occurred during the pandemic years. Significant sex-specific changes in mortality trends were observed. Women experienced increases in mortality rates and trends for endocrine, nutritional, and metabolic diseases; skin and subcutaneous tissue diseases; circulatory diseases; and genitourinary diseases, reversing some pre-pandemic declines. Men showed increases in mortality trends for endocrine, nutritional, and metabolic diseases and genitourinary diseases but no significant changes for skin or circulatory diseases. These findings indicate that the pandemic differentially affected mortality trends between sexes, with women experiencing broader increases across multiple disease categories. The COVID-19 pandemic was associated with significant changes in mortality trends for certain non-COVID-19 diseases in Japan, with notable sex differences. Increased mortality among women across multiple disease categories highlights the pandemic’s indirect health impacts and underscores the need for sex-specific healthcare strategies in the post-pandemic era. Full article

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18 pages, 290 KiB

Open AccessArticle

Mobilising Cross-Sectoral Collaboration in Creating Age-Friendly Cities: Case Studies from Akita and Manchester

by Patty Doran, Sophie Yarker, Tine Buffel, Hisami Satake, Fumito Watanabe, Minoru Kimoto, Ayuto Kodama, Yu Kume, Keiko Suzuki, Sachiko Makabe and Hidetaka Ota

Int. J. Environ. Res. Public Health 2025, 22(1), 73; https://doi.org/10.3390/ijerph22010073 - 8 Jan 2025

Viewed by 276

Abstract

Developing Age-Friendly Cities and Communities (AFCCs) is an increasingly popular policy response to supporting ageing populations. AFCC programmes rely on cross-sectoral collaboration, involving partnerships among diverse stakeholders working across sectors to address shared goals. However, there remains a limited understanding of what mechanisms [...] Read more.

Developing Age-Friendly Cities and Communities (AFCCs) is an increasingly popular policy response to supporting ageing populations. AFCC programmes rely on cross-sectoral collaboration, involving partnerships among diverse stakeholders working across sectors to address shared goals. However, there remains a limited understanding of what mechanisms and strategies drive collaboration among diverse actors within age-friendly cities. To address this gap, this empirical paper draws on examples from a comparative case study across Akita (Japan) and Manchester (UK), two cities with distinct demographic profiles but both with a longstanding commitment to the age-friendly approach. Case studies were created through a range of data collection methods, namely, a review of secondary data sources, semi-structured interviews with key stakeholders, and fieldwork in each city. Key insights from the case studies relating to the mobilisation of cross-sectoral collaboration were categorised into three themes: leadership and influencing, co-production, and place-based working. These mechanisms are not mutually exclusive; collaboration building through co-production and place-based working is essential to deliver age-friendly programmes, but these mechanisms rely on leadership and influence. Therefore, it is recommended that all three mechanisms be used to effectively mobilise cross-sectoral collaborations to collectively create AFCC and support healthy ageing. Full article

(This article belongs to the Special Issue Rising to the Healthy Ageing Challenge: Co-production with Older People and Business)

10 pages, 287 KiB

Open AccessReview

Effect of Synbiotic and Postbiotic Supplements on Dental Caries and Periodontal Diseases—A Comprehensive Review

by Svante Twetman and Daniel Belstrøm

Int. J. Environ. Res. Public Health 2025, 22(1), 72; https://doi.org/10.3390/ijerph22010072 - 8 Jan 2025

Viewed by 350

Abstract

Caries and periodontitis affect a significant part of the global population. Regular oral hygiene, sugar restriction, and fluoride exposure are the main avenues for the maintenance of oral health, but the adjunctive use of prebiotics and probiotic bacteria has gained attention over the [...] Read more.

Caries and periodontitis affect a significant part of the global population. Regular oral hygiene, sugar restriction, and fluoride exposure are the main avenues for the maintenance of oral health, but the adjunctive use of prebiotics and probiotic bacteria has gained attention over the past decades. The microbial and clinical effects of these biological interventions have been thoroughly covered in systematic reviews. However, the combination of prebiotics and probiotics (synbiotics) may boost the clinical benefits, and postbiotics, being inanimate microorganisms, can, when added to oral hygiene products, offer a sustainable option. The aim of this narrative review was to summarize clinical trials on the adjunctive use of synbiotics and postbiotics in the prevention and management of dental caries, gingivitis, and periodontitis. We searched two databases (PubMed and Google Scholar) for relevant literature, and we identified 17 relevant papers, five on dental caries and 12 with periodontal endpoints. We found emerging evidence of low certainty that lozenges/tablets containing synbiotics or postbiotics could reduce caries incidence in preschool and schoolchildren in comparison with standard preventive care. The effect on adult patients with plaque-induced gingivitis was less consistent. For adults with periodontitis, the adjunctive use of synbiotic and postbiotic products seemed to enhance the outcome of conventional scaling and root planning. In conclusion, both dental caries and periodontitis are non-communicable diseases, closely associated with an unbalanced oral biofilm, and the application of microbial modulators, including synbiotics and postbiotics, display promising beneficial effects and warrant further research. Full article

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

34 pages, 2034 KiB

Open AccessReview

Runnability: A Scoping Review

by Ashley D. Tegart, Nadine Schuurman and Stella R. Harden

Int. J. Environ. Res. Public Health 2025, 22(1), 71; https://doi.org/10.3390/ijerph22010071 - 7 Jan 2025

Viewed by 431

Abstract

Running outdoors is an increasingly popular form of physical activity and has been proven to substantially reduce the risk of major chronic illnesses such as cardiovascular disease. The topic of runnability has received considerable attention but with conflicting conclusions and remaining gaps. The [...] Read more.

Running outdoors is an increasingly popular form of physical activity and has been proven to substantially reduce the risk of major chronic illnesses such as cardiovascular disease. The topic of runnability has received considerable attention but with conflicting conclusions and remaining gaps. The physical environment and its features impact running experiences. Detecting features facilitating and deterring runners is crucial to promoting this physical activity and, therefore, overall health. A scoping review of current literature was conducted to identify environmental factors conducive to running. Online databases were used to identify all articles on runnability to date; a total of one hundred and two (n = 102) papers were selected as they identified environmental correlates preferred by runners. Findings include a preference for green spaces and connecting with nature, perceptions of higher safety away from traffic congestion and pollution, and routes with wide, smooth surfaces and high connectivity. Essentially, natural surroundings are substantially more desirable than urban settings. Studies have shown that even when a running route is within an urban environment, it is usually connected to or between green spaces. Full article

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14 pages, 881 KiB

Open AccessArticle

Interpersonal Perfectionism and Perceived Control’s Influence on the Continuity of Sports Practice in Adolescents

by H. Antonio Pineda-Espejel

Int. J. Environ. Res. Public Health 2025, 22(1), 70; https://doi.org/10.3390/ijerph22010070 - 7 Jan 2025

Viewed by 326

Abstract

Based on the theory of planned behavior, the objective was to test a theoretical model that explains the intention to continue practicing sports among adolescents currently involved in sports practice in Mexicali based on factors that generate perceived social pressure to be perfect [...] Read more.

Based on the theory of planned behavior, the objective was to test a theoretical model that explains the intention to continue practicing sports among adolescents currently involved in sports practice in Mexicali based on factors that generate perceived social pressure to be perfect (perceived descriptive norm) and that lead to internal factors of perceived control (perceived competence, general self-concept, and enjoyment). A battery of questionnaires that measured the study variables was applied to 195 adolescent athletes of both sexes. The causal model with observed variables rejected part of the hypothesis since the athletes’ perception that their parents impose high performance expectations on them and that they criticize them when these expectations are not achieved was not associated with the athletes’ perceived competence. Meanwhile, perceived coach pressure was positively associated with perceived competence, suggesting that it may be adaptive. This also suggests that perceived competence favors the intention to continue practicing sports both directly and indirectly through self-concept and enjoyment. In conclusion, boys involved in sports will have the intention to continue practicing if they perceive that their closest social references demand that they be perfect in the sport and when they perceive themselves to be able to do it effectively. Meanwhile, girls will have the intention to continue in sports practice if, in addition, they have a better general self-concept and enjoy the activity. Therefore, an important task for coaches, in order to encourage the continuation of sport in adolescents, is to promote the perception of qualities, skills and abilities toward sport. Full article

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

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8 pages, 525 KiB

Open AccessArticle

Exploring Trusted Sources of HPV Vaccine Information Among Mexican American Parents in El Paso, Texas

by Alyssa A. Martinez, Michelle Gil, Surendranath S. Shastri and Gabriel A. Frietze

Int. J. Environ. Res. Public Health 2025, 22(1), 69; https://doi.org/10.3390/ijerph22010069 - 7 Jan 2025

Viewed by 327

Abstract

Hispanic populations are disproportionately impacted by HPV-associated cancers. An HPV vaccine is available that protects against 90% of HPV-associated cancers. Understanding the factors associated with HPV vaccine uptake, including identifying whom individuals trust to recommend the HPV vaccine, is an important step toward [...] Read more.

Hispanic populations are disproportionately impacted by HPV-associated cancers. An HPV vaccine is available that protects against 90% of HPV-associated cancers. Understanding the factors associated with HPV vaccine uptake, including identifying whom individuals trust to recommend the HPV vaccine, is an important step toward developing public health interventions for promoting the HPV vaccine among Hispanic people. The purpose of this pilot study was to use a qualitative approach to identify trustworthy messengers to disseminate HPV vaccine information among Mexican American (MA) parents of children of 11–17 years of age. Three 90 min pilot focus groups with three to five participants in each group were conducted. The inclusion criteria included being 18 years of age or older, residing in El Paso, TX, identifying as MA, speaking English, and being a parent of a child between the ages of 11 and 17. Focus groups were conducted with 15 predominately female participants (M_age = 38.46, SD = 5.73; Female = 93.3%). A reoccurring theme throughout all three focus groups was that pediatricians, registered nurses, and pharmacists were identified as the most trusted sources of information. Findings from this study have implications for designing public health interventions that leverage pediatricians, registered nurses, and pharmacists to promote the HPV vaccine among parents. Full article

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

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18 pages, 293 KiB

Open AccessArticle

Cumulative Exposure to Unconventional Natural Gas Development and the Risk of Childhood Cancer: A Registry-Based Case–Control Study

by Evelyn O. Talbott, Vincent C. Arena, Renwei Wang, Fan Wu, Natalie Price, Jeanine M. Buchanich, Caroline A. Hoffman, Todd Bear, Maureen Lichtveld and Jian Min Yuan

Int. J. Environ. Res. Public Health 2025, 22(1), 68; https://doi.org/10.3390/ijerph22010068 - 7 Jan 2025

Viewed by 366

Abstract

The rapid growth of unconventional natural gas development (UNGD), also known as hydraulic fracturing, has raised concerns of potential exposures to hazardous chemicals. Few studies have examined the risk of childhood cancer from exposure to UNGD. A case–control study included 498 children diagnosed [...] Read more.

The rapid growth of unconventional natural gas development (UNGD), also known as hydraulic fracturing, has raised concerns of potential exposures to hazardous chemicals. Few studies have examined the risk of childhood cancer from exposure to UNGD. A case–control study included 498 children diagnosed with leukemia, lymphoma, central nervous system neoplasms, and malignant bone tumors during the period 2010–2019 identified through the Pennsylvania Cancer Registry. Cases were matched to controls using Pennsylvania birth records. For each subject, a new overall UNGD exposure metric was calculated which incorporates both spatial (proximity) and temporal (duration) aspects of well activity. Conditional logistic regression models were used to estimate the risk of combined and individual cancers by overall UNGD exposure, and well proximity. Children with a higher overall UNGD exposure (3rd/4th quartiles) had an increased risk for the four malignancies combined [OR] 1.69 (95% CI 1.01, 2.82) and 1.79 (95% CI 1.00, 3.19) compared to non-exposed children. Overall, individuals living within 0.5 miles of a UNGD site were 3.94 times (95% CI 1.66, 9.30) more likely to develop a malignancy compared to non-exposed children and the risk of lymphoma within 0.5 miles and 0.5–1 miles was also elevated [ORs of 5.05 (95% CI 1.09, 23.39) and 7.71 (95% CI 1.01, 59.00), respectively] compared to non-exposed. Our study found that overall UNGD cumulative activity as well as a proximity to UNGD wells were associated with an increased risk of childhood lymphoma and overall childhood cancers combined. Full article

(This article belongs to the Section Environmental Health)

23 pages, 1592 KiB

Open AccessArticle

Implementation Outcomes and Recommendations of Two Physical Activity Interventions: Results from the Danish ACTIVE SCHOOL Feasibility Study

by Lise Sohl Jeppesen, Jesper Sandfeld, Søren Smedegaard, Glen Nielsen, Mathias Brekke Mandelid, Malene Norup, Jacob Wienecke and Anna Bugge

Int. J. Environ. Res. Public Health 2025, 22(1), 67; https://doi.org/10.3390/ijerph22010067 - 7 Jan 2025

Viewed by 370

Abstract

Physical activity (PA) should be an essential part of all children’s lives, as it can promote physical and mental health, enhance general well-being, and positively impact learning outcomes. Schools offer an ideal setting to encourage physical activity during the school day, as nearly [...] Read more.

Physical activity (PA) should be an essential part of all children’s lives, as it can promote physical and mental health, enhance general well-being, and positively impact learning outcomes. Schools offer an ideal setting to encourage physical activity during the school day, as nearly all children attend school. However, schools present a complex environment for implementing PA, and sedentary behavior is common in classroom teaching. This study explores the feasibility of two types of school-based physical activity interventions: one based on research in exercise and cognition (Run, Jump & Fun) and another grounded in embodied learning (Move & Learn). Run, Jump & Fun can be conceptualized as extra non-curricular physical activity implemented into the school day while Move & Learn is integrated into curricular time. The 8-week study involved third-grade students and their teachers from seven schools, with educational strategies applied to support adoption. Quantitative and qualitative data were collected before, during, and after the 8-week period. The results indicated that both interventions were feasible to implement, leading to a series of recommendations for further refinement. These recommendations can guide the development of future school-based PA interventions and inspire other researchers to assess and improve their implementation strategies. Full article

(This article belongs to the Special Issue Physical Activity Interventions for Sedentary Behavior Change)

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30 pages, 1046 KiB

Open AccessReview

The SHIELD Framework: Advancing Strength-Based Resilience Strategies to Combat Bullying and Cyberbullying in Youth

by Stephanie F. Dailey and Rosellen R. Roche

Int. J. Environ. Res. Public Health 2025, 22(1), 66; https://doi.org/10.3390/ijerph22010066 - 7 Jan 2025

Viewed by 436

Abstract

Bullying and cyberbullying are critical global issues that significantly affect the mental health and behavioral well-being of youth. This article explores the complex challenges posed by these forms of aggression and introduces a strength-based model for health and mental health professionals to address [...] Read more.

Bullying and cyberbullying are critical global issues that significantly affect the mental health and behavioral well-being of youth. This article explores the complex challenges posed by these forms of aggression and introduces a strength-based model for health and mental health professionals to address these issues with impacted youth holistically. Grounded within findings from a scoping review of the literature, the SHIELD framework emphasizes Strengths, Healing, Interventions, Empowerment, Learning, and Development, offering a comprehensive approach for identifying and supporting youth impacted by bullying and cyberbullying. SHIELD emphasizes collaboration among health professionals, schools, families, and communities. By integrating empirical evidence and best practices from school-based approaches to bullying prevention, such as Positive Behavioral Interventions and Support (PBIS) and Social and Emotional Learning (SEL), this framework provides a roadmap for creating safer, more inclusive environments for youth while prioritizing their mental health and overall well-being in the face of bullying and cyberbullying. A case study illustrates the framework’s practical application and future directions are proposed to guide further empirical investigation and stimulate innovative approaches to addressing the complexities of bullying and cyberbullying. Full article

(This article belongs to the Special Issue 2nd Edition: Bullying and Cyberbullying, Mental Health and Behavioral Difficulties)

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13 pages, 725 KiB

Open AccessArticle

Quality of Oral Anticoagulation Control with Warfarin According to Sex: A Cross-Sectional Study

by Catiane Costa Viana, Marcus Fernando da Silva Praxedes, Mauro Henrique Nogueira Guimarães de Abreu, Waleska Jaclyn Freitas Nunes de Sousa, Cássia Rodrigues Lima Ferreira, Emílio Itamar de Freitas Campos, José Luiz Padilha da Silva and Maria Auxiliadora Parreiras Martins

Int. J. Environ. Res. Public Health 2025, 22(1), 65; https://doi.org/10.3390/ijerph22010065 - 6 Jan 2025

Viewed by 317

Abstract

Evidence indicates a difference between men and women in oral anticoagulation control, but the results were discrepant. This study investigated the association of sex with oral anticoagulation control in patients on warfarin assisted by anticoagulation clinics (ACs) in Brazil. The cross-sectional study included [...] Read more.

Evidence indicates a difference between men and women in oral anticoagulation control, but the results were discrepant. This study investigated the association of sex with oral anticoagulation control in patients on warfarin assisted by anticoagulation clinics (ACs) in Brazil. The cross-sectional study included patients on warfarin recruited at three public ACs in southeast Brazil (2014–2015). The quality of oral anticoagulation was estimated by the time in therapeutic range (TTR). Univariable and multivariable linear regression models were built to examine the association of sociodemographic, behavior, clinical, and drug therapy variables with TTR. Overall, 801 participants were studied (455; 56.8% women), with a mean age of 65.0 (13.4) years. The female sex was associated with lower TTR than the male sex (Beta (95% CI) = −17.01 (−30.25; −3.76), p = 0.012), however, this difference decreased with increasing age, becoming null after age 60. Smoking patients had a lower TTR than non-smokers (−5.18 (−10.02; −0.34), p = 0.036). The results showed that the association of sex with oral anticoagulation control is dependent on age. Women have lower TTR than men, but this difference is null in older patients. Knowledge of these factors may be useful for developing strategies to improve care for these patients. Full article

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

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15 pages, 284 KiB

Open AccessArticle

Psychosocial Climate as Antecedent for Resources to Manage Emotional Demands at Work

by Lars Peter Andersen, Dorte Ruby Andersen and Jesper Pihl-Thingvad

Int. J. Environ. Res. Public Health 2025, 22(1), 64; https://doi.org/10.3390/ijerph22010064 - 6 Jan 2025

Viewed by 368

Abstract

Background: Effectively managing emotional demands in the workplace is crucial in professions such as healthcare, education, and social work. Recent studies indicate that the psychosocial safety climate within an organization can significantly mitigate the negative effects associated with high emotional demands. Method: This [...] Read more.

Background: Effectively managing emotional demands in the workplace is crucial in professions such as healthcare, education, and social work. Recent studies indicate that the psychosocial safety climate within an organization can significantly mitigate the negative effects associated with high emotional demands. Method: This study examines whether psychosocial safety climate is associated with six practical strategies for managing emotional demands that have previously been found to be associated with less burnout. It utilizes longitudinal data from 1457 participants across 129 different workplaces in various emotionally demanding professions. The associations were analyzed using linear regression and Poisson regression techniques. All analyses incorporated cluster-robust standard errors to account for potential dependencies arising from respondents sharing the same workplace. Results: The results indicate that higher levels of psychosocial safety climate are significantly associated with the availability of practical strategies. Furthermore, the incidence rate of receiving multiple types of support increases significantly for each point increase in psychosocial safety. Additionally, these relationships remain consistent even under high work demands. Conclusions: The results underscore the importance of fostering a psychosocial safety climate and increasing the availability of practical strategies to manage emotional demands in the workplace. This approach may safeguard employee well-being in high-demand professions. Full article

17 pages, 2807 KiB

Open AccessArticle

Non-Communicable Diseases Among Forcibly Displaced People: A Systematic Mapping Review

by Kyohei Nishino, Tshewang Gyeltshen and Mahbubur Rahman

Int. J. Environ. Res. Public Health 2025, 22(1), 63; https://doi.org/10.3390/ijerph22010063 - 5 Jan 2025

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Abstract

Background: Non-communicable diseases (NCDs) pose a serious global health challenge, accounting for 74% of all deaths worldwide, with low- and middle-income countries (LMICs) disproportionately affected. These challenges are further exacerbated in humanitarian settings, particularly among forcibly displaced people (FDP). Despite the critical need [...] Read more.

Background: Non-communicable diseases (NCDs) pose a serious global health challenge, accounting for 74% of all deaths worldwide, with low- and middle-income countries (LMICs) disproportionately affected. These challenges are further exacerbated in humanitarian settings, particularly among forcibly displaced people (FDP). Despite the critical need for NCD management in these populations, their epidemiology remains poorly understood. This highlights an urgent research priority to address knowledge gaps and improve their health outcomes. Methods: In this research, we conducted a systematic mapping review to aggregate and categorize existing publications on NCDs among FDP. Literature searches were performed across five electronic databases, namely PubMed, Cochrane Library, Embase, Global Index Medicus, and Google Scholar, using predefined criteria related to _target populations, research domains, and study design. The evidence was systematically coded and analyzed to assess the current research status on NCDs among FDP. Results: A total of 310 publications were included in the review. The findings indicate an increasing trend in publications on NCDs among FDP since 2014. In contrast, most studies revealed low evidence levels. Disease-specific research primarily focused on diabetes mellitus (DM) (26.4%) and hypertension (19.8%), addressing health status (43.1%) and health policy (32.0%). Studies mainly concentrated on Syrian (45.5%) and Palestinian (18.9%) refugees, with limited research on other countries and types of FDP. Funding sources were mostly governmental (23.1%) and philanthropic foundations (17.6%), although many studies were unfunded (26.2%). Conclusions: This is the first systematic mapping review on NCDs among FDP. The findings revealed both current knowledge areas of focus and gaps. Although the research quantity has increased, the evidence quality remains low. The retrieved studies predominantly focused on DM and hypertension among Syrian and Palestinian refugees, causing significant knowledge gaps regarding other geographical areas and types of FDP. Future research should prioritize higher-quality studies, expand the geographical scope, and include diverse types of FDP. Full article

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

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32 pages, 429 KiB

Open AccessArticle

“It Would Ruin My Life”: Pacific Islander Male Adolescents’ Perceptions of Mental Health Help-Seeking—An Interpretative Phenomenological Analysis Focus Group Study

by Melia Fonoimoana Garrett, Elizabeth A. Cutrer-Párraga, G. E. Kawika Allen, Ellie L. Young, Kristofer J. Urbina and Isabel Medina Hull

Int. J. Environ. Res. Public Health 2025, 22(1), 62; https://doi.org/10.3390/ijerph22010062 - 4 Jan 2025

Viewed by 653

Abstract

Given rising mental health concerns among Pacific Islander (PI) adolescents, this population remains underserved by available mental health resources. This interpretative phenomenological analysis with focus groups (IPA-FG) examined the lived experiences and perceptions of 19 male PI adolescents (ages 14–16) from Native Hawaiian, [...] Read more.

Given rising mental health concerns among Pacific Islander (PI) adolescents, this population remains underserved by available mental health resources. This interpretative phenomenological analysis with focus groups (IPA-FG) examined the lived experiences and perceptions of 19 male PI adolescents (ages 14–16) from Native Hawaiian, Maori, Samoan, and Tongan backgrounds regarding mental health help-seeking behaviors. Four overarching themes emerged: stigma and judgment, cultural misalignment in professional services, impact of disclosure and perceived punitive consequences, and a complex ecosystem of trusted relationships as mental health support. Notably, participants expressed belief that disclosing mental health challenges would “ruin their lives” and held misconceptions about adults’ ability to address mental health concerns. These findings are particularly significant given high suicidality rates among PI adolescents. This study provides insights for developing culturally responsive mental health interventions and highlights the urgent need to address mental health stigma within PI communities. Implications for practice are discussed. Full article

(This article belongs to the Special Issue Depression and Suicide: Current Perspectives)

18 pages, 930 KiB

Open AccessArticle

Using a Safe System Framework to Examine the Roadway Mortality Increase Pre-COVID-19 and in the COVID-19 Era in New York State

by Joyce C. Pressley, Zarah Aziz, Emilia Pawlowski, Leah Hines, Aisha Roberts, Jancarlos Guzman and Michael Bauer

Int. J. Environ. Res. Public Health 2025, 22(1), 61; https://doi.org/10.3390/ijerph22010061 - 3 Jan 2025

Viewed by 453

Abstract

Roadway mortality increased during COVID-19, reversing a multi-decade downward trend. The Fatality Analysis Reporting System (FARS) was used to examine contributing factors pre-COVID-19 and in the COVID-19 era using the five pillars of the Safe System framework: (1) road users; (2) vehicles; (3) [...] Read more.

Roadway mortality increased during COVID-19, reversing a multi-decade downward trend. The Fatality Analysis Reporting System (FARS) was used to examine contributing factors pre-COVID-19 and in the COVID-19 era using the five pillars of the Safe System framework: (1) road users; (2) vehicles; (3) roadways; (4) speed; and (5) post-crash care. Two study time periods were matched to control for seasonality differences pre-COVID-19 (n = 1725, 1 April 2018–31 December 2019) and in the COVID-19 era (n = 2010, 1 April 2020–31 December 2021) with a three-month buffer period between the two time frames excluded. Four of the five pillars of the safe system had road safety indicators that worsened during the pandemic. Mortality was 19.7% higher for motor vehicle occupants and 45.1% higher for riders of motorized two-wheeled vehicles. In adjusted analyses, failure to use safety equipment (safety belts/helmets) was associated with 44% higher mortality. Two road user groups, non-motorized bicyclists and pedestrians, did not contribute significantly to higher mortality. Urban roadway crashes were higher compared to rural crashes. Additional scientific inquiry into factors associated with COVID-19-era mortality using the Safe System framework yielded important scientific insights to inform prevention efforts. Motorized two-wheeled vehicles contribute disproportionately to pandemic-era higher mortality and constitute an emerging road safety issue that deserves further attention. Full article

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16 pages, 262 KiB

Open AccessArticle

Diabetes Management Using a Patient Navigator in a Native Hawaiian Population: Experiences and Perceptions of the Kilolani Project

by Nani L. Morgan, Nina A. Lopez, Amanda T. Campbell, Marguerite Cazin, Lauralee U. Ana, Jennifer F. Lai, May Vawer and James Yess

Int. J. Environ. Res. Public Health 2025, 22(1), 60; https://doi.org/10.3390/ijerph22010060 - 3 Jan 2025

Viewed by 466

Abstract

Native Hawaiians (NHs) are a historically oppressed population disproportionately burdened by diabetes and related complications. The Kilolani Project, a patient navigator-centered, chronic disease management program, _targets upstream drivers of health among vulnerable NH adult patients with diabetes within an urban academic safety-net clinic. [...] Read more.

Native Hawaiians (NHs) are a historically oppressed population disproportionately burdened by diabetes and related complications. The Kilolani Project, a patient navigator-centered, chronic disease management program, _targets upstream drivers of health among vulnerable NH adult patients with diabetes within an urban academic safety-net clinic. To investigate the impact of the Kilolani Project, we performed a qualitative study to examine patient perspectives. Our goal is to ensure that their values, needs, and priorities drive future navigator-based strategies and healthcare delivery. Fifteen current Kilolani Project patients participated in one of three focus group sessions. Each session followed a semi-structured format with open-ended questions regarding their experiences with the Kilolani Project, patient navigators, and healthcare in general. Iterative transcript readings and coding revealed seven core themes: (1) Humanistic approach, (2) Trusting relationships, (3) Improved access, (4) Trauma-informed care, (5) Self-efficacy, (6) Resilience, and (7) Ethnic concordance. The Kilolani Project created a safe and culturally relevant experience for NH patients. They felt seen, heard, and valued, which resulted in an improved healthcare experience, engagement, and empowerment. Importantly, trust was the cornerstone to building a provider–patient relationship. Such culturally informed approaches are necessary to close the gap in health disparities faced by our NH communities. Full article

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

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17 pages, 834 KiB

Open AccessReview

Health Associations of Positive Childhood Experiences: A Scoping Review of the Literature

by Joachim Hero, Laura Gallant, Dina Burstein, Sydne Newberry, Nabeel Qureshi, Katie Feistel, Kayla N. Anderson, Kelsey Hannan and Robert Sege

Int. J. Environ. Res. Public Health 2025, 22(1), 59; https://doi.org/10.3390/ijerph22010059 - 3 Jan 2025

Viewed by 392

Abstract

We report the results of a scoping review of the literature investigating associations between positive childhood experiences (PCEs) and selected health outcomes to identify which have the highest level of research activity based on the indexed academic literature. Yielded articles underwent title/abstract (Ti/Ab) [...] Read more.

We report the results of a scoping review of the literature investigating associations between positive childhood experiences (PCEs) and selected health outcomes to identify which have the highest level of research activity based on the indexed academic literature. Yielded articles underwent title/abstract (Ti/Ab) and full text screening utilizing inclusion/exclusion criteria. The review was guided by PCE categories from the Healthy Outcomes from Positive Experiences framework: relationships, environment, engagement, and emotional growth. The initial search yielded 8,919 unduplicated articles, 759 were retained following Ti/Ab review and 220 articles were retained after full text screening describing 795 tested associations across 23 PCE types in ten outcome categories. The outcomes most commonly examined were substance misuse (305 tested associations across 93 studies), suicidal behaviors (195 tested associations across 56 studies), and depression (112 tested associations across 55 studies). Physical health outcomes were less common (14 tested associations across six studies). Of the PCE exposures, relationships represented 415 of tested associations, 236 with environment, and 114 with social engagement. A significant body of research demonstrated associations between PCEs and health outcomes. While further research is needed, available research suggests that public health efforts to promote PCEs may have impact across multiple domains. Full article

(This article belongs to the Special Issue Mental Health and Wellbeing of Children and Adolescents)

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Int. J. Environ. Res. Public Health, Volume 22, Issue 1 (January 2025) – 88 articles

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