International Journal of Environmental Research and Public Health

14 pages, 595 KiB

Open AccessArticle

Housing Initiatives to Address Strep A Infections and Reduce RHD Risks in Remote Indigenous Communities in Australia

by Nina Lansbury, Paul C. Memmott, Rosemary Wyber, Clarissa Burgen, Samuel K. Barnes, Jessica Daw, Jeffrey Cannon, Asha C. Bowen, Rachel Burgess, Patricia N. Frank and Andrew M. Redmond

Int. J. Environ. Res. Public Health 2024, 21(9), 1262; https://doi.org/10.3390/ijerph21091262 - 23 Sep 2024

Abstract

Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher [...] Read more.

Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections. Full article

(This article belongs to the Section Environmental Health)

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9 pages, 3417 KiB

Open AccessBrief Report

A Cross-Border Biorisk Toolkit for Healthcare Professionals

by Pierre Vandenberghe, Jessica S. Hayes, Maire A. Connolly and Jean-Luc Gala

Int. J. Environ. Res. Public Health 2024, 21(9), 1261; https://doi.org/10.3390/ijerph21091261 - 23 Sep 2024

Abstract

The COVID-19 pandemic posed significant challenges to public health, exposing first responders to high biosafety risks during medical assistance and containment efforts. The PANDEM-2 study aimed to address these critical biosafety issues by emphasising the importance of frequently updated, harmonised guidelines. This study [...] Read more.

The COVID-19 pandemic posed significant challenges to public health, exposing first responders to high biosafety risks during medical assistance and containment efforts. The PANDEM-2 study aimed to address these critical biosafety issues by emphasising the importance of frequently updated, harmonised guidelines. This study reviewed scientific publications, lessons learned, and real-world experiences from the COVID-19 pandemic to identify biorisk gaps in three critical areas: (i) patient transportation and management, (ii) sample handling and testing, and (iii) data management and communication by laboratory staff. At the onset of the pandemic, first responders faced several challenges, including the rapid expansion of emergency medical services, conversion of non-medical structures, increased internal and cross-border transport of infected patients, frequent changes in biosafety protocols, and a shortage of personal protective equipment. In response, this study developed a versatile and easily adaptable toolkit, including biosafety guidance and recommendations linked to updated national and international online repositories. It establishes the groundwork for a minimum standard that can be tailored to various pandemic response scenarios, using monkeypox as a fictive test case. The toolkit enables rapid access to updated information via QR codes and mobile devices, improving biorisk response by providing an adaptable and standardised approach for caregivers involved in national and cross-border responses. Full article

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8 pages, 278 KiB

Open AccessBrief Report

Further Evidence on Online Video-Feedback Intervention: Enhancing Parent–Child Interactions and Reducing Disordered Eating in Children

by Silvia Cimino and Luca Cerniglia

Int. J. Environ. Res. Public Health 2024, 21(9), 1260; https://doi.org/10.3390/ijerph21091260 - 23 Sep 2024

Abstract

Background: This study evaluated the effectiveness of an online intervention designed to improve parent–child interactions and address disordered eating behaviors in children. Using remote video-feedback sessions based on observations of mother–child feeding interactions, the intervention offers a cost-effective and environmentally friendly alternative to [...] Read more.

Background: This study evaluated the effectiveness of an online intervention designed to improve parent–child interactions and address disordered eating behaviors in children. Using remote video-feedback sessions based on observations of mother–child feeding interactions, the intervention offers a cost-effective and environmentally friendly alternative to traditional in-person methods. Aims: The study aimed to assess the impact of online intervention on the quality of mother–child interactions during feeding and its effectiveness in reducing psychopathological symptoms in both mothers and children. Methods: The intervention was conducted entirely online, with improvements measured using SVIA scores for mother–child interactions and the SCL-90/R Global Severity Index (GSI) for maternal psychopathological symptoms, alongside evaluations of children’s emotional and behavioral functioning, particularly anxiety, depression, and aggression. Results: The intervention significantly improved the quality of mother–child interactions across all SVIA subscales and led to reductions in maternal symptoms of depression and anxiety, as well as decreases in children’s emotional and behavioral symptoms. Conclusions: These findings suggest that online video-feedback interventions can effectively enhance mother–child relationships and reduce psychopathological symptoms in both mothers and children, although further research with larger sample sizes and more robust statistical analyses is needed to confirm these results. Full article

12 pages, 1530 KiB

Open AccessArticle

Wastewater-Based Surveillance Reveals the Effectiveness of the First COVID-19 Vaccination Campaigns in Assisted Living Facilities

by Katherine I. Brenner, Bryan Walser, Joseph Cooper and Sunny Jiang

Int. J. Environ. Res. Public Health 2024, 21(9), 1259; https://doi.org/10.3390/ijerph21091259 - 23 Sep 2024

Abstract

The COVID-19 pandemic has disproportionately affected vulnerable populations, including residents of assisted living facilities (ALFs). This study investigates the impact of non-pharmaceutical interventions (NPIs) and mass vaccination campaigns on SARS-CoV-2 transmission dynamics within four ALFs in Maricopa County, Arizona, United States from January [...] Read more.

The COVID-19 pandemic has disproportionately affected vulnerable populations, including residents of assisted living facilities (ALFs). This study investigates the impact of non-pharmaceutical interventions (NPIs) and mass vaccination campaigns on SARS-CoV-2 transmission dynamics within four ALFs in Maricopa County, Arizona, United States from January to April 2021. Initial observations reveal a significant SARS-CoV-2 prevalence in Maricopa County, with 7452 new COVID-19 cases reported on 4 January 2021. Wastewater surveillance indicates elevated viral loads within ALFs with peak concentrations reaching 1.35 × 10⁷ genome copies/L at Facility 1 and 4.68 × 10⁵ copies/L at Facility 2. The implementation of NPIs, including isolation protocols, resulted in a rapid decline in viral loads in wastewater. Following mass vaccination campaigns, viral loads reduced across all facilities, except Facility 4. Facility 1 demonstrated a mean viral load decrease from 1.65 × 10⁶ copies/L to 1.04 × 10³ copies/L post-vaccination, with a statistically significant U-statistic of 28.0 (p-value = 0.0027). Similar trends are observed in Facilities 2 and 3, albeit with varying degrees of statistical significance. In conclusion, this study provides evidence supporting the role of NPIs and vaccination campaigns in controlling SARS-CoV-2 transmission within ALFs. Full article

(This article belongs to the Collection COVID-19 Research)

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12 pages, 442 KiB

Open AccessArticle

Intention to Use Primary Healthcare Services among South–South Migrants

by Consuelo Cruz-Riveros, Alfonso Urzúa, Carolina Lagos and Evelyn Parada

Int. J. Environ. Res. Public Health 2024, 21(9), 1258; https://doi.org/10.3390/ijerph21091258 - 23 Sep 2024

Abstract

(1) Background: To evaluate a model based on the right-to-health approach, considering the impact of associated factors on the future utilization of primary healthcare services among international migrants in Chile. (2) Methods: A cross-sectional design was employed to survey 499 South American migrants [...] Read more.

(1) Background: To evaluate a model based on the right-to-health approach, considering the impact of associated factors on the future utilization of primary healthcare services among international migrants in Chile. (2) Methods: A cross-sectional design was employed to survey 499 South American migrants residing in Chile. Ad-hoc questionnaires were used to assess their experiences related to the right to health, perceived discrimination, income, education, length of residence, age, marital status, gender, migration status, among others. Correlation analyses were conducted, followed by path analysis with significant variables to assess the fit of two models. (3) Results: Ten variables were identified as significant for path analysis. Among the two evaluated models, the final model identified six variables with significant direct and indirect effects. Among them, the availability, accessibility, acceptability, and quality of healthcare services were positively associated with the future intention to use them. Additionally, perceived racial and ethnic discrimination also had a positive effect on the intention to use healthcare services, suggesting a possible adaptive response to adversity, exhibiting acceptable goodness-of-fit indices (χ² =241,492; p < 0.001; CFI = 0.913; TLI = 0.82; RMSEA = 0.062; SRMR = 0.05). (4) Conclusions: While the initial model provides valuable insights, it is essential to broaden the analysis to include other factors influencing the specific context of international migrants. Full article

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

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11 pages, 371 KiB

Open AccessArticle

Phubbing in Adolescents: Spanish Validation of the Phubbing Scale (PS)

by Noelia Barbed-Castrejón, Fermín Navaridas-Nalda, Cristina Ábalos-Villanueva, Oliver Mason and Javier Ortuño-Sierra

Int. J. Environ. Res. Public Health 2024, 21(9), 1257; https://doi.org/10.3390/ijerph21091257 - 22 Sep 2024

Abstract

The Phubbing Scale (PS) is an instrument used to measure the frequency and extent of the behavior of ignoring someone you are with and giving attention to your mobile phone instead. However, there is insufficient evidence about the psychometric adequacy of the Spanish [...] Read more.

The Phubbing Scale (PS) is an instrument used to measure the frequency and extent of the behavior of ignoring someone you are with and giving attention to your mobile phone instead. However, there is insufficient evidence about the psychometric adequacy of the Spanish version of the instrument. The main goal of this research was to analyze the psychometric properties of PS in a representative sample of Spanish adolescents and young adults. A total of 1351 participants comprised the sample (42.78% females, age range = 12–21). Students were selected from different levels of education such as secondary school, high school, vocational training, or university. A convenient sample was used. The reliability of the scores was calculated by means of McDonald’s Omega. The evidence of the internal structure of the questionnaire was analyzed by means of confirmatory factor analysis (CFA). The measurement invariance of the instrument by gender and educational level was also calculated. In addition, Pearson’s correlations between phubbing and other indicators of mental health were also calculated. The goodness-of-fit indices for the two-factor model were good. The McDonald’s Omega coefficient for the total score was 0.787. Measurement invariance both by gender and educational level was found. The phenomenon of phubbing was found to have statistically significant correlations with emotional well-being, other mental health indicators, and with Problematic Internet Use (PIU), with the sole exception of the hyperactivity subscale of the SDQ. This study provided validity evidence for the Spanish version of the Phubbing Scale (PS), suggesting that PS is a reliable tool for quantifying phubbing in Spanish adolescents. Full article

(This article belongs to the Special Issue Problematic Internet Use among Adolescents)

9 pages, 646 KiB

Open AccessArticle

Alcohol Use among Young Women in Kampala City: Comparing Self-Reported Survey Data with Presence of Urinary Ethyl Glucuronide Metabolite

by Monica H. Swahn, Jane Palmier, Rachel Culbreth, Godfrey S. Bbosa, Charles Natuhamya, Gideon Matovu and Rogers Kasirye

Int. J. Environ. Res. Public Health 2024, 21(9), 1256; https://doi.org/10.3390/ijerph21091256 - 21 Sep 2024

Abstract

This study sought to determine the level of concordance between self-reported alcohol use and the presence of its urinary ethyl glucuronide (EtG) metabolite in women living in urban Kampala. In 2023, we recruited 300 young women, ages 18 to 24 years, to participate [...] Read more.

This study sought to determine the level of concordance between self-reported alcohol use and the presence of its urinary ethyl glucuronide (EtG) metabolite in women living in urban Kampala. In 2023, we recruited 300 young women, ages 18 to 24 years, to participate in a prospective cohort study across three sites in urban Kampala (i.e., Banda, Bwaise, and Makindye) to examine the mechanistic pathways of mental illness. As part of the baseline assessment, participants were asked to complete a research assistant-administered survey and to provide a urine sample to screen for 16 different substances and/or their metabolites, including EtG. Overall, 58% (n = 174) reported to have ever consumed alcohol and 23% (n = 68) to have used it in the past month. Among the 300 women, 10% (n = 30) had EtG levels in their urine sample and of these, 40% (n = 12) reported to have never consumed alcohol, using a self-reported survey (p = 0.035). Recent alcohol use was relatively low among the women in this study. However, the discordance between self-reported alcohol use and the presence of EtG presents concerns about the accuracy of self-reported alcohol use. Additional research is needed to contextualize self-reported alcohol use, social desirability, and the implications for alcohol prevention and intervention strategies for young women in urban Kampala. Full article

(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)

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17 pages, 1752 KiB

Open AccessArticle

Examining Management and Employees’ Perceptions of Occupational Heat Exposure and the Effectiveness of a Heat Stress Prevention Intervention on Safety and Well-Being among Natural Gas Construction Workers: A Qualitative Field-Based Study

by Muinat Abolore Idris, Christine Markham, Kristina D. Mena and William B. Perkison

Int. J. Environ. Res. Public Health 2024, 21(9), 1255; https://doi.org/10.3390/ijerph21091255 - 21 Sep 2024

Abstract

Background: Numerous risk factors have been identified as significantly influencing outdoor workers’ risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers’ safety, health, and well-being remain under-researched. With climate [...] Read more.

Background: Numerous risk factors have been identified as significantly influencing outdoor workers’ risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers’ safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. Objective: To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. Methods: In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Results: Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. Conclusion: To advance construction workers’ safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments. Note: in this study, the terms ‘worker’ and ‘employee’ are used interchangeably. Full article

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11 pages, 646 KiB

Open AccessReview

Technology for Young Adults with Stroke: An Australian Environmental Scan

by Dinah Amoah, Sarah Prior, Matthew Schmidt, Carey Mather and Marie-Louise Bird

Int. J. Environ. Res. Public Health 2024, 21(9), 1254; https://doi.org/10.3390/ijerph21091254 - 21 Sep 2024

Abstract

Technology has the potential to address the unique needs of young stroke survivors. Despite this, little is known about the technological resources available to support young adults with stroke. This study aimed to identify and compile available technological resources that cater to the [...] Read more.

Technology has the potential to address the unique needs of young stroke survivors. Despite this, little is known about the technological resources available to support young adults with stroke. This study aimed to identify and compile available technological resources that cater to the specific needs of young adults (18–30 years) with stroke in Australia. An environmental scan was conducted from December 2023 to March 2024. Sources included websites, app stores, rehabilitation centres, hospitals, organisations, technology developers, and healthcare professionals. Of the 114 resources identified, 11% were for re-training limb movement, 40% for speech rehabilitation, 20% for medication reminders, and 29% were social media posts offering peer mentoring and support. Most limb movement (75%) and medication reminder (87%) apps were free. However, most speech therapy apps (78%) had associated costs. Social media posts were hosted on Facebook (64%), Instagram (21%), TikTok (9%), YouTube (3%), and other websites (3%). Forty-six percent of the social media posts targeting young stroke survivors did not specify the age group. These resources were identified as available to young people with stroke. Although the resources found focused on young stroke survivors, it was difficult to ascertain the specific age group that was being targeted. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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13 pages, 326 KiB

Open AccessArticle

Prevalence and Associated Factors of Musculoskeletal Disorders among Older Patients Treated at Walailak University Physical Therapy Clinic in Thailand: A Retrospective Study

by Chadapa Rungruangbaiyok, Parinya Vongvaivanichakul, Charupa Lektip, Wanwisa Sutara, Pathanin Jumpathong, Eiji Miyake, Keiichiro Aoki and Weeranan Yaemrattanakul

Int. J. Environ. Res. Public Health 2024, 21(9), 1253; https://doi.org/10.3390/ijerph21091253 - 21 Sep 2024

Abstract

The prevalence of musculoskeletal disorders (MSDs) is high among older adults worldwide, significantly affecting their quality of life and overall health. Understanding the prevalence of MSDs and their associated factors is crucial to developing effective preventive and management strategies in Thailand. In this [...] Read more.

The prevalence of musculoskeletal disorders (MSDs) is high among older adults worldwide, significantly affecting their quality of life and overall health. Understanding the prevalence of MSDs and their associated factors is crucial to developing effective preventive and management strategies in Thailand. In this study, we aimed to investigate the prevalence of MSDs and their associated factors among older patients at Walailak University Physical Therapy Clinic. In this retrospective study, we analyzed the medical records of 396 older patients. Data on demographics, underlying diseases, career types, and treatments were collected and analyzed using descriptive statistics chi-squared tests, and logistic regression analysis to determine their associations with MSD prevalence. The overall prevalence of MSDs was 89.90%. MSD prevalence was higher among female patients than among male patients (p < 0.001). The most commonly affected body regions were the lower back, shoulders, and knees. Career type (p < 0.001) had the highest impact on the presence of MSDs after controlling for sex, age, and underlying diseases as covariates in a logistic regression model. Manual labor and heavy industry workers as well as pensioners showed an increased risk of MSDs. While older age was associated with a higher MSD prevalence using chi-squared statistics, it was removed from the logistic regression models. Pensioners were the most likely to receive treatment, indicating the need for targeted interventions for individuals with physically demanding occupations. These findings underscore the importance of targeted interventions and further research on socioeconomic factors, lifestyle behaviors, and comorbidities to manage MSDs among older adults in Thailand. Full article

15 pages, 361 KiB

Open AccessArticle

Human Rights and Inclusion of Vulnerable Groups in Health and Well-Being Policy Documents Relevant to Children and Young People in Ireland

by Megan Lambert and Joanne McVeigh

Int. J. Environ. Res. Public Health 2024, 21(9), 1252; https://doi.org/10.3390/ijerph21091252 - 21 Sep 2024

Abstract

Children and young people constitute a structurally vulnerable group who often experience specific barriers when trying to exercise their rights, including the right to health. The aim of this study was to examine core concepts of human rights and inclusion of vulnerable groups [...] Read more.

Children and young people constitute a structurally vulnerable group who often experience specific barriers when trying to exercise their rights, including the right to health. The aim of this study was to examine core concepts of human rights and inclusion of vulnerable groups in a sample of national health and well-being policy documents relevant to children and young people in Ireland. Using EquiFrame, a validated policy content analysis tool, 3 policy documents were analysed in relation to their commitment to 21 core concepts of human rights and inclusion of 13 vulnerable groups. The Overall Summary Ranking of each policy varied: ‘Better Outcomes, Brighter Futures’–Moderate, ‘Sláintecare’–Moderate, and the ‘Wellbeing Policy Statement’–Low. Across all three documents, Core Concept Coverage was high while Core Concept Quality was low. The findings demonstrate that these documents cover a wide range of human rights but fail to provide specific policy actions to address human rights or an intention to monitor human rights. Full article

13 pages, 741 KiB

Open AccessArticle

Long-Haul Truck Drivers’ Perceptions of Truck Stops and Rest Areas: Focusing on Health and Wellness

by Fernanda Lise, Mona Shattell, Raquel Pötter Garcia, Kethelyn Costa Rodrigues, Wilson Teixeira de Ávila, Flávia Lise Garcia and Eda Schwartz

Int. J. Environ. Res. Public Health 2024, 21(9), 1251; https://doi.org/10.3390/ijerph21091251 - 21 Sep 2024

Abstract

The work and life routine of long-haul truck drivers (LHTDs) involve the use of truck stops and rest areas to meet their basic human needs. These extensions of their workspaces on the road do not always offer adequate physical structures and services that [...] Read more.

The work and life routine of long-haul truck drivers (LHTDs) involve the use of truck stops and rest areas to meet their basic human needs. These extensions of their workspaces on the road do not always offer adequate physical structures and services that drivers need for optimal health. This study aimed to evaluate long-haul truck drivers’ perceptions of food services, safety, physical activity, rest, and personal hygiene offered at truck stops and rest areas, as well as the correlation between these perceptions and sociodemographic, health, and work conditions variables. A cross-sectional, quantitative, and descriptive study was conducted with long-haul truck drivers from the southern region of Brazil. For data collection, a sociodemographic questionnaire and a Likert scale on food, rest, personal hygiene, safety, and physical activity services offered at truck stops and rest areas along Brazilian roads from March to August 2023 were used. The data were analyzed with simple frequency descriptive statistics. The sample consisted of 175 long-haul truck drivers. Out of these, 70.29% declared that the services of the truck stops and rest areas were charged; more than half (53.59%) of the professionals evaluated the rest service as “good” or “excellent”; the food services were “good” or “excellent” for 42.24% of the drivers. The spaces for physical activities were the worst evaluated as “bad” or “terrible” by 41.61%, followed by bathroom services (28.42%) and safety (34.24%). Rest and feeding services had better evaluations, while the services of bathroom, safety, and physical activity presented worse evaluations. Variables such as nationality, weekly working days, and marital status presented positive significance and influenced drivers’ perceptions of the services offered at truck stops and rest areas. Drivers who were Brazilian and worked more than five days a week negatively evaluated the services of rest (p = 0.018), safety [0.020], physical activity (0.003), and bathrooms (0.020). In addition, the physical activity services were better evaluated by single drivers than married drivers. These findings suggest that the work conditions and nationality may influence LHTDs’ perceptions of services and structures of truck stops and rest areas. These findings may reflect a lack of investments and support efforts to improve basic services such as personal hygiene, a safe environment, and physical exercises, which are fundamental to the health of the workers and aimed at reducing vulnerability and a sedentary lifestyle and meeting the basic human needs of LHTDs. Full article

(This article belongs to the Special Issue Work Environment Effects on Health and Safety of Employees)

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18 pages, 623 KiB

Open AccessArticle

Lifestyle and Cardiometabolic Risk Factors Associated with Impoverishment Due to Out-of-Pocket Health Expenditure in São Paulo City, Brazil

by Lucas Akio Iza Trindade, Jaqueline Lopes Pereira, Jean Michel Rocha Sampaio Leite, Marcelo Macedo Rogero, Regina Mara Fisberg and Flavia Mori Sarti

Int. J. Environ. Res. Public Health 2024, 21(9), 1250; https://doi.org/10.3390/ijerph21091250 - 21 Sep 2024

Abstract

The rise in obesity and related chronic noncommunicable diseases (NCDs) during recent decades in Brazil has been associated with increases in the financial burden and risk of impoverishment due to out-of-pocket (OOP) health expenditure. Thus, this study investigated trends and predictors associated with [...] Read more.

The rise in obesity and related chronic noncommunicable diseases (NCDs) during recent decades in Brazil has been associated with increases in the financial burden and risk of impoverishment due to out-of-pocket (OOP) health expenditure. Thus, this study investigated trends and predictors associated with impoverishment due to health expenditure, in the population of São Paulo city, Brazil, between 2003 and 2015. Household data from the São Paulo Health Survey (n = 5475) were used to estimate impoverishment linked to OOP health expenses, using the three thresholds of International Poverty Lines (IPLs) defined by the World Bank at 1.90, 3.20, and 5.50 dollars per capita per day purchasing power parity (PPP) in 2011. The results indicated a high incidence of impoverishment due to OOP disbursements for health care throughout the period, predominantly concentrated among low-income individuals. Lifestyle choices referring to leisure-time physical activity (OR = 0.766 at $3.20 IPL, and OR = 0.789 at $5.50 IPL) were linked to reduction in the risk for impoverishment due to OOP health expenditures whilst there were increases in the probability of impoverishment due to cardiometabolic risk factors referring to obesity (OR = 1.588 at $3.20 IPL, and OR = 1.633 at $5.50 IPL), and diagnosis of cardiovascular diseases (OR = 2.268 at $1.90 IPL, OR = 1.967 at $3.20 IPL, and OR = 1.936 at $5.50 IPL). Diagnosis of type 2 diabetes mellitus was associated with an increase in the probability of impoverishment at only the $1.90 IPL (OR = 2.506), whilst coefficients for high blood pressure presented lack of significance in the models. Health policies should focus on interventions for prevention of obesity to ensure the financial protection of the population in São Paulo city, Brazil, especially targeting modifiable lifestyle choices like promotion of physical activity and reduction of tobacco use. Full article

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13 pages, 1098 KiB

Open AccessArticle

Native Hawaiian and Pacific Islanders’ Identity and Housing Status: The Impact on Historical Trauma and Perceived Stress

by Tessa Palafu, Danielle L. Carreira Ching, Veronica M. Acosta, Scott K. Okamoto and Kelsie H. Okamura

Int. J. Environ. Res. Public Health 2024, 21(9), 1249; https://doi.org/10.3390/ijerph21091249 - 21 Sep 2024

Abstract

Native Hawaiian and Pacific Islanders (NHPIs) are overrepresented in Hawai‘i’s houseless population. Indigenous populations, such as NHPIs, may encounter experiences of historical trauma that impact their well-being. This original research project examines how NHPI identity and houselessness compound to affect the perceived stress [...] Read more.

Native Hawaiian and Pacific Islanders (NHPIs) are overrepresented in Hawai‘i’s houseless population. Indigenous populations, such as NHPIs, may encounter experiences of historical trauma that impact their well-being. This original research project examines how NHPI identity and houselessness compound to affect the perceived stress and historical trauma of transition-aged youth. Fifty-one participants aged 18 to 24 (M = 21.37, SD = 1.93) completed a survey that included the historical traumatic events scale, historical loss scale, perceived stress scale, and a demographic questionnaire. Over half (n = 26, 51.0%) of the participants identified as NHPI. A two-way ANOVA indicated a non-significant effect of NHPI identity and housing status on perceived stress. However, housed participants scored significantly higher than participants experiencing houselessness on the historical traumatic events scale (p = 0.006). Our findings elucidate the role of knowledge in the experience of historical trauma. Further results, limitations, and future directions are offered. Full article

(This article belongs to the Special Issue Disparity of Non-Communicable Diseases Among Pacific Islanders)

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19 pages, 6636 KiB

Open AccessArticle

Thermal Comfort Conditions and Mortality in Brazil

by Weeberb J. Requia, Reizane Maria Damasceno da Silva, Leonardo Hoinaski and Heresh Amini

Int. J. Environ. Res. Public Health 2024, 21(9), 1248; https://doi.org/10.3390/ijerph21091248 - 20 Sep 2024

Abstract

Conventional temperature-based approaches often overlook the intricate nature of thermal stress experienced by individuals. To address this limitation, climatologists have developed thermal indices—composite measures designed to reflect the complex interaction of meteorological factors influencing human perception of temperature. Our study focuses on Brazil, [...] Read more.

Conventional temperature-based approaches often overlook the intricate nature of thermal stress experienced by individuals. To address this limitation, climatologists have developed thermal indices—composite measures designed to reflect the complex interaction of meteorological factors influencing human perception of temperature. Our study focuses on Brazil, estimating the association between thermal comfort conditions and mortality related to respiratory and circulatory diseases. We examined four distinct thermal indices: the discomfort index (DI), net effective temperature (NET), humidex (H), and heat index (HI). Analyzing a comprehensive dataset of 2,872,084 deaths from 2003 to 2017, we found significant variation in relative risk (RR) based on health outcomes, exposure lag, percentile of exposure, sex/age groups, and specific thermal indices. For example, under high exposure conditions (99th percentile), we observed that the shorter lags (3, 5, 7, and 10) had the most robust effects on all-cause mortality. For example, under lag 3, the pooled national results for the overall population (all ages and sexes) indicate an increased risk of all-cause mortality, with an RR of 1.17 (95% CI: 1.13; 1.122) for DI, 1.15 (95% CI: 1.12; 1.17) for H, 1.15 (95% CI: 1.09; 1.21) for HI, and 1.18 (95% CI: 1.13; 1.22) for NET. At low exposure levels (1st percentile), all four distinct thermal indices were linked to an increase in all-cause mortality across most sex and age subgroups. Specifically, for lag 20, we observed an estimated RR of 1.19 (95% CI: 1.14; 1.23) for DI, 1.12 (95% CI: 1.08; 1.16) for H, 1.17 (95% CI: 1.12; 1.22) for HI, and 1.18 (95% CI: 1.14; 1.23) for NET. These findings have important implications for policymakers, guiding the development of measures to minimize climate change’s impact on public health in Brazil. Full article

(This article belongs to the Special Issue The Interaction among Environmental, Climatic, and Socioeconomic Aspects and Their Effects on Society)

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23 pages, 4594 KiB

Open AccessReview

Effective Nature-Based Outdoor Play and Learning Environments for below-3 Children: A Literature-Based Summary

by Danielle Craig, Nazia Afrin Trina, Muntazar Monsur, Umme Tasnima Haque, Garrett Farrow, Md Zahid Hasan, Fariha Tasnim and Moyin Sabainah Akinbobola

Int. J. Environ. Res. Public Health 2024, 21(9), 1247; https://doi.org/10.3390/ijerph21091247 - 20 Sep 2024

Abstract

Early childhood (0–8 years) is a time of rapid brain development supported by spontaneous and informal learning from the surrounding environment. Meaningful contact with nature (a dynamic and varied source of informal learning) during the early years of life sets up rich scopes [...] Read more.

Early childhood (0–8 years) is a time of rapid brain development supported by spontaneous and informal learning from the surrounding environment. Meaningful contact with nature (a dynamic and varied source of informal learning) during the early years of life sets up rich scopes for such spontaneous learning—especially in the first three years, a period in life that determines all future learning, behavior, and health. Besides its learning affordances, nature-based environments provide numerous health and developmental benefits. Considering that more than 13 million children under 5 years of age in the US spend most of their waking hours in care facilities, the potential benefits of having a nature-based outdoor area in their primary care environments are immense. However, guidelines and assessment standards for designing nature-based outdoor environments for below-three children (infants and toddlers) are almost non-existent. This three-phase research holds the promise of addressing this issue. Phase 1 reviews the available limited literature on below-three children’s outdoor play and learning environments and summarizes their design implications. Phase 2 extracts effective design guidelines and identifies assessment indicators from the Phase 1 studies. In Phase 3, empirical data (environmental assessment data) are collected to compare the existing and proposed design environment conditions of below-3 outdoor play and learning environments in a selected childcare facility. This phase highlights evidence-based assumptions of new criteria, guidelines, and indicators to assess any below-3 nature-based childcare outdoor environments. This research provides new information and insights for designing nature-based outdoor play and learning environments for below-3 children to increase their meaningful connections with natural elements while attending a care facility. Full article

(This article belongs to the Special Issue Physical Activity and Wellbeing across the Lifespan)

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12 pages, 797 KiB

Open AccessSystematic Review

Association of Gut Microbiome with Muscle Mass, Muscle Strength, and Muscle Performance in Older Adults: A Systematic Review

by Martin Hubert Mayer, Selam Woldemariam, Christoph Gisinger and Thomas Ernst Dorner

Int. J. Environ. Res. Public Health 2024, 21(9), 1246; https://doi.org/10.3390/ijerph21091246 - 20 Sep 2024

Abstract

Sarcopenia, characterized by reduced muscle mass, strength, or performance, is a common condition in older adults. The association between the gut microbiome and sarcopenia remains poorly understood. This systematic review aims to evaluate the relationship between muscle parameters and the intestinal microbiome. A [...] Read more.

Sarcopenia, characterized by reduced muscle mass, strength, or performance, is a common condition in older adults. The association between the gut microbiome and sarcopenia remains poorly understood. This systematic review aims to evaluate the relationship between muscle parameters and the intestinal microbiome. A systematic search was conducted in PubMed, EMBASE, Cochrane Library, and Google Scholar for studies published between 2002 and 2022 involving participants aged 50+. Studies were included if they assessed sarcopenia using at least one measure of muscle mass (skeletal muscle mass, bioelectrical impedance analysis, MRI), muscle strength, or muscle performance (SARC-F questionnaire, Timed-Up-and-Go Test, Chair Stand Test, grip strength, gait speed, Short Physical Performance Battery, 400 m Walk Test). The microbiome was measured using at least RNA/DNA sequencing or shotgun metagenomic sequencing. Twelve studies were analyzed. Findings revealed that a higher abundance of bacterial species such as Desulfovibrio piger, and Clostridium symbiosum and reduced diversity of butyrate-producing bacteria was associated with sarcopenia severity, as indicated by decreased grip strength, muscle mass, or physical performance. The gut microbiome plays a significant role in age-related muscle loss. Probiotics, prebiotics, and bacterial products could be potential interventions to improve muscle health in older adults. Full article

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17 pages, 926 KiB

Open AccessArticle

The Association between Healthcare Satisfaction and Social Support and Stress, Depression, and Life Satisfaction in Female Caregivers: The Moderating Role of Dependence of a Sick Child

by Jadranka Pavić, Mateja Krznar, Snježana Čukljek, Biserka Sedić, Štefanija Ozimec Vulinec and Irena Kovačević

Int. J. Environ. Res. Public Health 2024, 21(9), 1245; https://doi.org/10.3390/ijerph21091245 - 20 Sep 2024

Abstract

The caregivers of children suffering from rare diseases face numerous emotional, social, economic, organizational, and other difficulties, which can significantly impair their quality of life and mental health. Therefore, among other things, it is important to understand the factors which can influence psychosocial [...] Read more.

The caregivers of children suffering from rare diseases face numerous emotional, social, economic, organizational, and other difficulties, which can significantly impair their quality of life and mental health. Therefore, among other things, it is important to understand the factors which can influence psychosocial well-being. This research aimed to explore the association between healthcare satisfaction and social support and stress, depression, and life satisfaction in caregivers, with a moderating role of the ill child’s dependence on their caregiver. Methods: A cross-sectional study was conducted among 185 female caregivers of children with rare diseases. The data were analysed by using hierarchical regression analysis to examine the moderating effect of the child’s dependence. Results: Lower dependence of the child moderated the association between a higher level of healthcare satisfaction and reduced stress and a higher level of life satisfaction. Furthermore, lower child dependence moderated the association between a higher level of social support and a reduction in depression. In contrast, this association was absent in female caregivers with highly dependent children. On the other hand, the research confirmed that a higher level of social support led to stress reduction and increased life satisfaction in all respondents, regardless of the child’s dependence. Furthermore, the research confirmed that higher levels of healthcare satisfaction are associated with a reduction in depression in caregivers, regardless of the child’s dependence level. Conclusion: This research highlights the importance of providing adequate social support and high-quality healthcare in order to improve the psychosocial well-being of caregivers of children with rare diseases. Interventions to increase this support can reduce stress and depression and increase caregivers’ life satisfaction. Thus, future research should focus on the development and evaluation of specific interventions that support these factors. Full article

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17 pages, 1504 KiB

Open AccessArticle

Healthy Aging in Colombia 2018 and Its Variation in Relation to Social Conditions

by Yesika Natali Fernández-Ortiz

Int. J. Environ. Res. Public Health 2024, 21(9), 1244; https://doi.org/10.3390/ijerph21091244 - 20 Sep 2024

Abstract

The population aging in the region is occurring under scenarios of inequality, raising concerns about how the increase in life expectancy is experienced and what factors affect the quality of life of older adults. This research quantified the differentials of healthy aging in [...] Read more.

The population aging in the region is occurring under scenarios of inequality, raising concerns about how the increase in life expectancy is experienced and what factors affect the quality of life of older adults. This research quantified the differentials of healthy aging in Colombia in 2018 and its association with social indicators through a cross-sectional, descriptive, and correlational observational study. Healthy aging was quantified using the Disability-Free Life Expectancy (DFLE) indicator and later correlated with social indicators and subjected to a Multiple Factor Analysis (MFA). The results showed a healthy life expectancy of 71.5 years for women and 66.9 years for men, with a disability expectancy of 8.3 and 6.4 years, respectively. Negative associations emerged with health problems, disability, lack of medical care, illiteracy, school absenteeism, and poverty, while higher education levels and retirement showed positive associations. The factor analysis by area of residence highlighted urban areas as conducive to healthy aging. In conclusion, the accelerated aging of the Colombian population faces health disparities that policies must address by improving education, economic security, and health services, especially for women and rural areas. Full article

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14 pages, 892 KiB

Open AccessArticle

Evaluating Access to Health Care in Mothers and Caregivers of Children under Five Years of Age in Rural Communities of Yucatán, Mexico

by Elsa Rodríguez, Guadalupe Andueza, Ricardo Ojeda, Erin Palmisano, Louisa Ewald, Aruna M. Kamath, Abraham Flaxman, Shwetha H. Sanapoori and Bernardo Hernandez

Int. J. Environ. Res. Public Health 2024, 21(9), 1243; https://doi.org/10.3390/ijerph21091243 - 20 Sep 2024

Abstract

Populations in rural communities have more limited access to health care and attention than urban populations. The present study aimed to evaluate barriers to access to health care in mothers and caregivers of children under five years of age, twelve months after an [...] Read more.

Populations in rural communities have more limited access to health care and attention than urban populations. The present study aimed to evaluate barriers to access to health care in mothers and caregivers of children under five years of age, twelve months after an educational intervention. The study was carried out from February to September 2022, and 472 mothers from eight communities in the state of Yucatán, in the southeast of the United Mexican States, participated. A comparative analysis was carried out on help-seeking times, obstacles to reaching it, and illnesses in children. The results revealed that the main barriers to access to care were long times to decide to seek help, lack of financial resources to pay for the transfer to another health unit, lack of someone to accompany the mother or caregiver when the child needed be transferred, and lack of transportation for the transfer. Disease knowledge remained at different levels in the eight communities; the significant differences occurred in four communities, one specifically for heart defects. It was concluded that, in the rural populations studied, there are barriers to access to health care which have to do with neglected social determinants, such as those related to conditions of gender, income, social support network, and the health system. Access to health care must be universal, so public health interventions should be aimed at reducing the barriers that prevent the population from demanding and using services in a timely manner. Full article

(This article belongs to the Special Issue Universal Health Coverage—for a Globally Accessible and Affordable Health Care Service)

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15 pages, 4704 KiB

Open AccessArticle

Analysis of Oral Microbiota in Elderly Thai Patients with Alzheimer’s Disease and Mild Cognitive Impairment

by Narongrit Sritana and Atitaya Phungpinij

Int. J. Environ. Res. Public Health 2024, 21(9), 1242; https://doi.org/10.3390/ijerph21091242 - 20 Sep 2024

Abstract

Alzheimer’s disease (AD) is a neurodegenerative disease that predominantly affects the older adult population. Neuroinflammation may be triggered by the migration of oral microbiota composition changes from the oral cavity to the brain. However, the relationship between oral microbiota composition and neurodegenerative diseases, [...] Read more.

Alzheimer’s disease (AD) is a neurodegenerative disease that predominantly affects the older adult population. Neuroinflammation may be triggered by the migration of oral microbiota composition changes from the oral cavity to the brain. However, the relationship between oral microbiota composition and neurodegenerative diseases, such as AD, remains poorly understood. Therefore, we conducted a comprehensive comparison of the relative abundance and diversity of bacterial taxa present in saliva among older adults diagnosed with AD, those with mild cognitive impairment (MCI), and healthy controls. Saliva samples and clinical data were collected from 10 AD patients, 46 MCI patients, and 44 healthy older adults. AD patients had lower Clinical Dementia Rating, Montreal Cognitive Assessment, and Mini-mental Status Examination scores, and induced microbial diversity, than the MCI and control groups. Moreover, AD patients exhibited significantly higher levels of Fusobacteriota and Peptostreptococcaceae and lower levels of Veillonella than the MCI and control groups. In conclusion, a high abundance of Fusobacteria at various levels (i.e., phylum, class, family, and genus levels) may serve as a biomarker for AD. The analysis of oral microbiota dysbiosis biomarkers in older adults may be valuable for identifying individuals at risk for AD. Full article

(This article belongs to the Section Health Care Sciences)

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15 pages, 350 KiB

Open AccessArticle

Constitutional Factors and Irradiation as Risk Factors for Thymoma: A European Case–Control Study

by Linda Kaerlev, Mikael Eriksson, Pascal Guénel, Franco Merletti, Maria Morales-Suárez-Varela, Wolfgang Ahrens, Karl-Heinz Jöckel, Agustin Llopis-Gonzalez, Gun Wingren and Lorenzo Simonato

Int. J. Environ. Res. Public Health 2024, 21(9), 1241; https://doi.org/10.3390/ijerph21091241 - 20 Sep 2024

Abstract

Little is known about the aetiology of thymoma. This study aims to identify medical risk factors for thymoma as a systematic approach to new hypotheses on the aetiology of this disease. A European multi-centre case–control study was conducted from 1995 to 1997, including [...] Read more.

Little is known about the aetiology of thymoma. This study aims to identify medical risk factors for thymoma as a systematic approach to new hypotheses on the aetiology of this disease. A European multi-centre case–control study was conducted from 1995 to 1997, including incident cases aged 35–69 years with thymoma. Altogether, we accepted 85 cases and 3350 controls, of which we interviewed 77 cases and 2071 population controls about constitutional factors, medical examinations, and former diseases. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Medical examinations with X-ray or radiotherapy performed >20 times at least one year before the thymoma diagnosis indicated a possible risk factor for thymoma (OR 1.58, 95% CI 0.93–2.69). Having the first radiotherapy treatment at least one year before the thymoma diagnosis yielded an OR for thymoma of 2.39; 95% CI (0.96–5.99), and if it was at least five years before, the OR for thymoma was 2.81; 95% CI (1.03–7.72). Having a red/auburn hair colour was associated with thymoma, (OR 3.6, 95% CI 1.4–9.5) whereas having pigmented skin was slightly associated with thymoma (OR 1.8, 95% CI 0.8–3.8). Over twenty instances of X-ray examinations or radiotherapy were identified as potential risk factors for thymoma, along with certain constitutional factors. The observed correlations between benign tumours and thymoma could stem from an inherent predisposition to tumour development or result from detection bias. Given that this is the initial analytical study examining medical risk factors for thymoma, all of the results should be approached with caution, acknowledging the possibility that some findings might be incidental. Full article

13 pages, 687 KiB

Open AccessArticle

A New Framework for Monitoring and Evaluating Health Impact Assessment: Capitalising on a French Case Study with the Literature in Evaluation

by Françoise Jabot, Julie Romagon and Guilhem Dardier

Int. J. Environ. Res. Public Health 2024, 21(9), 1240; https://doi.org/10.3390/ijerph21091240 - 19 Sep 2024

Abstract

Health impact assessment (HIA) is a prospective approach that aims to identify the potential consequences of policies or projects on health in order to propose measures to make them healthier. Initiated in the late nineties, the approach emerged over ten years ago in [...] Read more.

Health impact assessment (HIA) is a prospective approach that aims to identify the potential consequences of policies or projects on health in order to propose measures to make them healthier. Initiated in the late nineties, the approach emerged over ten years ago in France. However, the evaluation of HIA effectiveness remains seldomly practised and its theoretical background should be deepened. The aim of this article is to generate a discussion on how to evaluate HIA effectiveness and contribute to its methodological tooling, drawing on an evaluative experience of multiple French HIAs. Our work is based on an iterative approach between an analysis of the evaluation literature and a critical look at an HIA evaluation. We first carried out the evaluation of three HIAs in 2017–2018, combining a normative approach and qualitative research in order to explore each HIA as a phenomenon in its own context. Two years later, we conducted a self-assessing expertise on this evaluation, supported by an analysis of the literature in the field of public policy evaluation, in order to refine the theoretical framework for evaluating HIA effectiveness and ultimately to enhance professional practice by evaluators. This work led to the production of a logic model that identifies, through three dimensions (context, implementation and governance), the multiple pathways that HIA may take to bring about change. It also seeks to show the interdependence of these pathways towards change and helps identify the key drivers and mechanisms of HIA success. In this respect, it complements existing HIA evaluation models as it can serve both as a generic framework for evaluating HIA effectiveness and as an instrument for monitoring HIA implementation. Full article

(This article belongs to the Special Issue The Effects of Public Policies on Health)

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12 pages, 928 KiB

Open AccessArticle

Cardiorespiratory Fitness Is Not Associated with Cardiovascular Disease Risk in Firefighters: A Cross-Sectional Study in South African Firefighters

by Tebogo Jenniffer Moselakgomo, Takalani Clearance Muluvhu, Merling Phaswana, Ina Shaw and Brandon S. Shaw

Int. J. Environ. Res. Public Health 2024, 21(9), 1239; https://doi.org/10.3390/ijerph21091239 - 19 Sep 2024

Abstract

Cardiovascular disease (CVD) risk factors are frequently reported among firefighters, yet no studies have compared these factors between male and female firefighters, specifically from a low- to middle-income country (LMIC). This study aimed to determine the prevalence of CVD risk factors and their [...] Read more.

Cardiovascular disease (CVD) risk factors are frequently reported among firefighters, yet no studies have compared these factors between male and female firefighters, specifically from a low- to middle-income country (LMIC). This study aimed to determine the prevalence of CVD risk factors and their relationship with cardiorespiratory fitness (VO_2max) in 254 active career firefighters (mean age: 42.6 ± 7.8 years). The assessments included anthropometry, blood pressure, blood glucose, cholesterol, triglycerides, and VO_2max. The results indicated that 48.0% and 51.8% of females and males were pre-hypertensive, respectively. Hypertension was identified in 15.8% of the firefighters. According to body mass index (BMI), 37.3% of males and 25% of females were found to be overweight, while an additional 44.9% of males and 45.7% of females were classified as obese. Only 17.3% of males and 18.2% of females were found to be of normal weight. These findings were corroborated by categories of central obesity using waist circumference (WC), which were 47.7% for males and 41.6% for females. Low HDL-C was found in 95.2% of males and 86.4% of females, with 28.3% of males also having elevated triglyceride levels (TG). VO_2max was “excellent” in 48.8% of males and 12.6% of females, though it had no significant association with most CVD risk factors. The only notable link was a small correlation between VO_2max and triglycerides (r = −0.215; p = 0.001). These findings suggest that while cardiorespiratory fitness may have no impact, additional factors likely contribute to the cardiovascular health of firefighters, necessitating the need for comprehensive health and fitness programmes. Full article

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24 pages, 1526 KiB

Open AccessArticle

Epidemic and Pandemic Preparedness and Response in a Multi-Hazard Context: COVID-19 Pandemic as a Point of Reference

by Thushara Kamalrathne, Dilanthi Amaratunga, Richard Haigh, Lahiru Kodituwakku and Chintha Rupasinghe

Int. J. Environ. Res. Public Health 2024, 21(9), 1238; https://doi.org/10.3390/ijerph21091238 - 19 Sep 2024

Abstract

Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This [...] Read more.

Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This study aims to develop a framework that captures key elements and components of epidemic and pandemic preparedness and response systems, focusing on a multi-hazard context. A systematic literature review was used to collect data through peer-reviewed journal articles using three electronic databases, and 17 experts were involved in the validation. Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems in a multi-hazard context. All elements appear integrated within three interventional phases: upstream, interface, and downstream. A holistic approach focusing on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards. Full article

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10 pages, 335 KiB

Open AccessArticle

Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre–Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden

by Eida M. Castro-Figueroa, Cristina Peña-Vargas, Mónica Rodríguez-Santiago, Juan I. Figueroa, Ruthmarie Hernández, Zindie Rodríguez, Heather Jim, Cristina Pereira, Normarie Torres-Blasco, Idhaliz Flores, Rosario Costas-Muñiz and Guillermo N. Armaiz-Pena

Int. J. Environ. Res. Public Health 2024, 21(9), 1237; https://doi.org/10.3390/ijerph21091237 - 19 Sep 2024

Abstract

Background: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to [...] Read more.

Background: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors. Methods: This secondary data analysis (n = 101) was part of a longitudinal case–control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January–July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed. Results: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods. Conclusions: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic. Full article

18 pages, 3910 KiB

Open AccessArticle

Daily Temperatures and Child Hospital Admissions in Aotearoa New Zealand: Case Time Series Analysis

by Hakkan Lai, Jeong Eun Lee, Luke J. Harrington, Annabel Ahuriri-Driscoll, Christina Newport, Annette Bolton, Claire Salter, Susan Morton, Alistair Woodward and Simon Hales

Int. J. Environ. Res. Public Health 2024, 21(9), 1236; https://doi.org/10.3390/ijerph21091236 - 19 Sep 2024

Abstract

The influence of global climate change on temperature-related health outcomes among vulnerable populations, particularly young children, is underexplored. Using a case time series design, we analysed 647,000 hospital admissions of children aged under five years old in New Zealand, born between 2000 and [...] Read more.

The influence of global climate change on temperature-related health outcomes among vulnerable populations, particularly young children, is underexplored. Using a case time series design, we analysed 647,000 hospital admissions of children aged under five years old in New Zealand, born between 2000 and 2019. We explored the relationship between daily maximum temperatures and hospital admissions across 2139 statistical areas. We used quasi-Poisson distributed lag non-linear models to account for the delayed effects of temperature over a 0–21-day window. We identified broad ICD code categories associated with heat before combining these for the main analyses. We conducted stratified analyses by ethnicity, sex, and residency, and tested for interactions with long-term temperature, socioeconomic position, and housing tenure. We found J-shaped temperature–response curves with increased risks of hospital admission above 24.1 °C, with greater sensitivity among Māori, Pacific, and Asian compared to European children. Spatial–temporal analysis from 2013–2019 showed rising attributable fractions (AFs) of admissions associated with increasing temperatures, especially in eastern coastal and densely populated areas. Interactive maps were created to allow policymakers to prioritise interventions. Findings emphasize the need for child-specific and location-specific climate change adaptation policies, particularly for socioeconomically disadvantaged groups. Full article

(This article belongs to the Special Issue The Effects of Extreme Temperature, Pollution, and Climate Change on Human Health)

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13 pages, 638 KiB

Open AccessReview

A One Health Approach to Public Safety: A Review of Police Canines in the United States

by Meera Gatlin

Int. J. Environ. Res. Public Health 2024, 21(9), 1235; https://doi.org/10.3390/ijerph21091235 - 18 Sep 2024

Abstract

Working dogs are an essential part of modern society, and police canines (K9s) in the United States are amongst the most recognizable of all working dogs. Given the dearth of published data on active police canines in the U.S. and the calls for [...] Read more.

Working dogs are an essential part of modern society, and police canines (K9s) in the United States are amongst the most recognizable of all working dogs. Given the dearth of published data on active police canines in the U.S. and the calls for police reform, an interdisciplinary effort is necessary to comprehensively understand how these dogs are best used for the benefit of society. This review paper relies on veterinary public health expertise to present a comprehensive overview of police canine use by municipal law enforcement in the United States, including known impacts and gaps in knowledge. The existing literature from animal-assisted interventions (AAI) provides evidence to ensure working dog well-being, while human–animal bond research contributes to officer safety and canine partnership. Lastly, law enforcement and public health agendas (LEPH) assure the team’s successful efforts in built environments and local neighborhoods. These frameworks acknowledge the complexity of police dog use, spanning from punitive to public relations, which mirrors the role of law enforcement in U.S. society. This paper proposes the use of a One Health framework to ensure police canine contributions to society, including suggested approaches to partner municipal police with veterinary medicine and public health, and integrate One Health in promoting public safety for local communities. Full article

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12 pages, 637 KiB

Open AccessArticle

The Effect of Manual Therapy on Psychological Factors and Quality of Life in Lumbar Disc Herniation Patients: A Single Blinded Randomized Clinical Trial

by Burhan Taşkaya, İsmail Taşkent, Mahmut Çakıllı and Öznur Yılmaz

Int. J. Environ. Res. Public Health 2024, 21(9), 1234; https://doi.org/10.3390/ijerph21091234 - 18 Sep 2024

Abstract

Background: This study aimed to investigate the effect of manual therapy on pain, kinesiophobia, pain catastrophizing, anxiety, depression, and quality of life in patients with lumbar disc herniation (LDH). Methods: The study included 32 LDH patients. Patients were divided into the Manual therapy [...] Read more.

Background: This study aimed to investigate the effect of manual therapy on pain, kinesiophobia, pain catastrophizing, anxiety, depression, and quality of life in patients with lumbar disc herniation (LDH). Methods: The study included 32 LDH patients. Patients were divided into the Manual therapy group (MTG—age 39.81 ± 9.45 years) and the Exercise group (EG—age 38.31 ± 9.21 years) by sealed envelope randomization. Patients were evaluated pre-study, post-study, and after a 3-month period using the McGill–Melzack Pain Questionnaire (MMPQ), Hospital Anxiety and Depression Scale (HADS), Tampa Kinesiophobia Scale (TKS), Pain Catastrophizing Scale (PCS) and Nottingham Health Profile (NSP). The exercise group received a total of ten sessions of stabilization exercises and sham spinal mobilization in five weeks, two sessions per week. In addition to the stabilization exercises, mobilization applications including Anterior-Posterior Lumbar Spinal Mobilization, Lumbar Spinal Rotational Mobilization, and Joint Mobilization in Lumbar Flexion Position, were applied to the manual therapy group. Results: It was found that the HADS and TKS values decreased in the MTG group compared to the pre-treatment period (p < 0.05), while there was no difference between these values in the EG group (p > 0.05). There was a statistically significant difference in the MMPQ, PCS, and NHP values after treatment in both the MTG and EG groups (p < 0.05). Conclusions: It was found that manual therapy had positive effects on psychological factors such as pain, kinesiophobia, pain catastrophizing, anxiety, depression, and quality of life in patients with LDH. Trial registration: NCT05804357 (27 March 2023) (retrospectively registered). Full article

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26 pages, 1077 KiB

Open AccessReview

Core Competencies of the Public Health Workforce in Climate Change and Extreme Weather Events Preparedness, Response, and Recovery: A Scoping Review

by Thierry Perreault-Carranza, Vivian Ni, Jonathan Savoie, Jacob Saucier, Joey Frenette and Jalila Jbilou

Int. J. Environ. Res. Public Health 2024, 21(9), 1233; https://doi.org/10.3390/ijerph21091233 - 18 Sep 2024

Abstract

Climate change poses a significant threat to public health and safety, necessitating an urgent, coordinated response. Public health officials must be well-trained to effectively prepare for, respond to, and recover from extreme weather events. Despite emerging frameworks, a gap remains in their systematic [...] Read more.

Climate change poses a significant threat to public health and safety, necessitating an urgent, coordinated response. Public health officials must be well-trained to effectively prepare for, respond to, and recover from extreme weather events. Despite emerging frameworks, a gap remains in their systematic application, risking future unpreparedness. This review aimed to identify the necessary competencies for public health professionals to manage climate change and the best methods to teach these skills. An academic librarian helped develop a keyword chain for a PubMed search, which included original articles and reviews concerning our research questions published in English or French between 1 January 2013 and 31 January 2024. Out of 255 potential articles, 31 were included in this scoping review. The results aligned with our objectives, revealing three main themes: core competencies, training and pedagogy strategies, and assessment approaches for public health professionals’ preparedness, responses, and recovery in the context of climate change and extreme weather events. This scoping review enabled us to provide a set of clear recommendations for future research and practice in training the public health workforce for managing extreme weather events and climate change. Full article

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Int. J. Environ. Res. Public Health, Volume 21, Issue 9 (September 2024) – 149 articles

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