International Journal of Environmental Research and Public Health

14 pages, 830 KiB

Open AccessReview

A Rapid Systematic Review Assessing the Effectiveness of Interventions to Promote Self-Management in Workers with Long-Term Health Conditions and Disabilities

by David W. Maidment, Katie Clarkson, Emma V. Shiel, Karina Nielsen, Jo Yarker and Fehmidah Munir

Int. J. Environ. Res. Public Health 2024, 21(12), 1714; https://doi.org/10.3390/ijerph21121714 - 23 Dec 2024

Viewed by 341

Abstract

The objective of this study was to synthesise evidence assessing the effectiveness of workplace-based interventions that promote self-management of multiple long-term conditions or disabilities, e.g., type I and II diabetes, asthma, musculoskeletal injury/disorder, cancer, and mental ill-health. A prospectively registered rapid systematic review [...] Read more.

The objective of this study was to synthesise evidence assessing the effectiveness of workplace-based interventions that promote self-management of multiple long-term conditions or disabilities, e.g., type I and II diabetes, asthma, musculoskeletal injury/disorder, cancer, and mental ill-health. A prospectively registered rapid systematic review was conducted. Both academic and grey literature databases were searched for papers published within the last 10 years, reflecting the most contemporary legislation and policy. The outcomes included work productivity, work engagement, self-management, work ability, quality of life, psychological wellbeing, workplace fatigue, job satisfaction, work-based attendance, work self-efficacy, and condition-specific health status. Five randomised controlled trials were included, and all assessed a chronic disease self-management programme consisting of six weekly facilitator-led group sessions. Due to the small number of studies and the variability in outcome measures employed, meta-analyses were not feasible. However, a narrative synthesis indicated that work engagement, self-management and wellbeing improved in the intervention compared to the control groups. All of the other outcomes showed mixed results. The findings highlight the need to develop less resource-intensive workplace-based self-management interventions that cater to both workers and employer stakeholders, to examine intervention implementation processes as well as effectiveness, and to draw on a common set of outcome measures to enable comparative analysis to better inform public health policy and practice. Full article

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16 pages, 576 KiB

Open AccessSystematic Review

Ambient Air Pollution Exposure and Breast Cancer Risk Worldwide: A Systematic Review of Longitudinal Studies

by Jeeraporn Tippila, Naw Lah Say Wah, Kurnia Ardiansyah Akbar, Narumol Bhummaphan, Pokkate Wongsasuluk and Kraiwuth Kallawicha

Int. J. Environ. Res. Public Health 2024, 21(12), 1713; https://doi.org/10.3390/ijerph21121713 - 23 Dec 2024

Viewed by 333

Abstract

Breast cancer is the most prevalent malignancy among women. Certain air pollutants have carcinogenic and estrogenic properties that can contribute to breast cancer development. This systematic review aimed to investigate the association between air pollution and breast cancer based on epidemiological evidence. This [...] Read more.

Breast cancer is the most prevalent malignancy among women. Certain air pollutants have carcinogenic and estrogenic properties that can contribute to breast cancer development. This systematic review aimed to investigate the association between air pollution and breast cancer based on epidemiological evidence. This systematic review included articles published between 2013 and 2022 from Scopus and PubMed databases, focusing on cohort and nested case-control studies examining the association between outdoor air pollution and breast cancer. A total of 25 articles were included. A total of eight outdoor pollutants were analyzed, with seven showing a significant association with breast cancer risk. Specifically, the strong association between benzo[a]pyrene and breast cancer risk was reported. Furthermore, all four studies on nitrogen oxides (NO_x), fifteen out of eighteen (83.33%) on particulate matter less than 2.5 µm (PM_2.5), nine out of thirteen studies (69.23%) on nitrogen dioxide (NO₂), and three out of seven studies (42.86%) on particulate matter less than 10 µm PM₁₀ showed an association with breast cancer risk (hazard ratio [HR]: 1.05–1.56; odds ratio [OR]: 1.03–1.86). In contrast, only one out of three studies (33.33%) on O₃ (HR: 0.76–1.03) and all studies on cadmium (OR: 0.88–0.97) suggested a negative association with breast cancer risk. None of the studies on black carbon found an association with breast cancer risk. It is important to note the methodological limitations of this review, including potential publication bias due to the inclusion of only English-language articles and a regional focus on developed countries, which may limit the generalizability of findings. This study suggests that exposure to outdoor air pollutants is linked to an increased risk of breast cancer. Further research is needed to establish a causal relationship and the mechanisms by which environmental pollutants may trigger carcinogenic effects and contribute to breast cancer development through epigenetic pathways. Full article

(This article belongs to the Section Environmental Health)

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18 pages, 645 KiB

Open AccessArticle

Applying the Surge Capacity Components for Capacity-Building Purposes in the Context of the EMT Initiative

by Lina Echeverri, Flavio Salio, Richard Parker, Pryanka Relan, Oleg Storozhenko, Ives Hubloue and Luca Ragazzoni

Int. J. Environ. Res. Public Health 2024, 21(12), 1712; https://doi.org/10.3390/ijerph21121712 - 23 Dec 2024

Viewed by 238

Abstract

Background: On 16 January 2021 (EB148/18 Session), the World Health Organization (WHO) and Member States emphasized the importance of expanding the WHO Emergency Medical Teams (EMT) Initiative, investing in a global health workforce and multidisciplinary teams capable of being rapidly deployed, equipped, and [...] Read more.

Background: On 16 January 2021 (EB148/18 Session), the World Health Organization (WHO) and Member States emphasized the importance of expanding the WHO Emergency Medical Teams (EMT) Initiative, investing in a global health workforce and multidisciplinary teams capable of being rapidly deployed, equipped, and fully trained to respond to all-hazard emergencies effectively. This resulted in the need to define a comprehensive framework. To achieve this, the EMT Initiative proposes the application of the four components of Surge Capacity, known as the 4“S” (Staff, Systems, Supplies, and Structure/Space), to build global capacities and capabilities, ensuring rapid mobilization and efficient coordination of national and international medical teams for readiness and response, complying with crisis standards of care defined in an ethical and evidence-based manner. Methods: A mixed-qualitative research approach was used, incorporating expert consensus through focus group discussions (FGDs), between 2021 and July 2022. This facilitated a detailed process analysis for the application of the surge capacity components to build global capacities and capabilities. This research highlighted the similarities between surge capacity and capacity building from an initial desk review and unified these concepts within the EMT Initiative. A standardized formal pathway was developed to enhance local, regional, and global capacities for emergency readiness and response. Results: The results showed that the framework successfully integrated the essential components of surge capacity and capacity building, making it adaptable to various settings. Conclusions: This framework provides a unified and replicable approach for readiness and response for all-hazards emergencies. Full article

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14 pages, 322 KiB

Open AccessArticle

What Do Dental Students Know About E-Cigarettes? A Cross-Sectional Survey from One Palestinian Dental School

by Rola Muhammed Shadid and Reeta Alsaeed

Int. J. Environ. Res. Public Health 2024, 21(12), 1711; https://doi.org/10.3390/ijerph21121711 - 23 Dec 2024

Viewed by 340

Abstract

Owing to the vital role played by dentists in patient education and due to the growing popularity of e-cigarette use among the younger population, this cross-sectional study aimed to assess the use, knowledge, beliefs, and attitudes toward e-cigarettes among dental students. A cross-sectional [...] Read more.

Owing to the vital role played by dentists in patient education and due to the growing popularity of e-cigarette use among the younger population, this cross-sectional study aimed to assess the use, knowledge, beliefs, and attitudes toward e-cigarettes among dental students. A cross-sectional questionnaire was given between March and June of 2024 to undergraduate dental students in the Faculty of Dentistry at the Arab American University in Palestine. A 32-item questionnaire with five sections, namely demographics, smoking habits, knowledge, beliefs and attitude, and education about e-cigarettes was sent to all appropriate participants (N = 1050). The response rate was 31% (N = 325). About 11.7% of the respondents were current e-cigarette smokers. The two most commonly cited reasons for initial use of e-cigarettes were curiosity (52.8%) and a desire to quit conventional smoking (27.8%). The average knowledge score was 6.63 (3.08) out of 12, demonstrating a generally inadequate level of knowledge about e-cigarettes. Conventional cigarette smokers were more knowledgeable about e-cigarettes than non-smokers (OR = 1.928; 95% CI: 1.061–3.505; p-value = 0.031). The majority of students (92%) considered the level of education they received in the dental school about e-cigarettes as inadequate, and more than half (53.2%) received information from social media. In conclusion, the prevalence of e-cigarette use among Palestinian dental students is relatively high compared with that reported for other dental students worldwide. Since the students showed a generally inadequate level of knowledge about e-cigarettes, this study casts doubt on the competency of Palestinian dental students to offer cessation counseling, highlighting the necessity to revise the dental curricula to foster positive knowledge and belief conducive to ideal behaviors. Full article

14 pages, 1116 KiB

Open AccessArticle

Cognitive Health Costs of Poor Housing for Women: Exploring Executive Function and Housing Stress in Urban Slums in India

by Uchita Vaid

Int. J. Environ. Res. Public Health 2024, 21(12), 1710; https://doi.org/10.3390/ijerph21121710 - 23 Dec 2024

Viewed by 293

Abstract

An increasing body of literature has investigated the implications of housing quality on health, confirming the negative consequences of poor housing quality on physical and mental health. Despite this increased focus on the salutogenic impacts of housing, the relationship between housing quality and [...] Read more.

An increasing body of literature has investigated the implications of housing quality on health, confirming the negative consequences of poor housing quality on physical and mental health. Despite this increased focus on the salutogenic impacts of housing, the relationship between housing quality and cognitive health remains understudied. This study examined how the housing quality in urban informal settlements, where living conditions are often substandard, affects women’s cognitive functioning, with a specific focus on executive function (EF) skills. EF is a decision-making system that enables us to make decisions using working memory and attentional control. This study addressed two key questions: (1) Is housing quality associated with EF skills? (2) Does perceived housing stress experienced by women mediate the housing–EF relationship? A standardized observer-based tool assessed housing quality, psychometric instruments measured EF skills, and a 12-item questionnaire evaluated perceived housing stress. Results indicated that better housing quality is positively associated with higher EF skills, with housing stress acting as a mediating factor in this relationship. These findings have important implications for both health and housing policies. Investments in improving housing conditions can yield cognitive health benefits for women, and addressing stress-inducing housing factors could further enhance cognitive outcomes. Full article

(This article belongs to the Special Issue Built Environment and Public Health: Land Use, Neighborhoods, and Housing)

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14 pages, 301 KiB

Open AccessArticle

Physical Therapist-Led Initiatives for the Prevention and Improvement of Chronic Pain Among Workers: A Case Study of Hosting Workshops Based on Survey Results in a Corporate Setting

by Yasumasa Oka, Michio Wachi and Noriyuki Kida

Int. J. Environ. Res. Public Health 2024, 21(12), 1709; https://doi.org/10.3390/ijerph21121709 - 23 Dec 2024

Viewed by 401

Abstract

Industrial physical therapy (IPT) interventions by physical therapists can enhance labor productivity. However, in Japan, there is a scarcity of case studies involving corporate visits, questionnaire-based data, and insights into corporate demands. Addressing this gap is vital for improving presenteeism related to chronic [...] Read more.

Industrial physical therapy (IPT) interventions by physical therapists can enhance labor productivity. However, in Japan, there is a scarcity of case studies involving corporate visits, questionnaire-based data, and insights into corporate demands. Addressing this gap is vital for improving presenteeism related to chronic pain and increasing employees’ health literacy, thereby advancing corporate health management. This case study evaluates the effectiveness of a workshop aimed at preventing and reducing chronic pain among employees in the Development Department of Company A, an information technology (IT) firm. The research employed pre- and post-survey questionnaires, workshop interventions, and meetings with corporate management to assess the current state of musculoskeletal chronic pain and productivity losses and to verify the intervention’s effectiveness. Approximately 50 participants attended the workshop in person, while around 30 participated online, totaling 80 attendees. A total of 56 (51 men and 5 women) individuals responded to the pre-workshop questionnaire, and 28 responded to the post-workshop questionnaire. The age distribution of the 56 pre-survey respondents was as follows: 9 in their twenties, 13 in their thirties, 22 in their forties, and 12 aged 50 and older. Preliminary survey results showed that 55.4% of participants experienced chronic pain in at least one body part. The average presenteeism value was 82.8% (standard deviation = 16.8). It was also found that literacy regarding appropriate pain management strategies was low. An independent t-test comparing literacy scores based on the presence or absence of pain showed no significant differences (p = 0.34). Additionally, a one-way ANOVA conducted to examine differences across four age groups revealed no significant differences (F = 0.934, p = 0.431). Results from the post-workshop questionnaires indicated that more than 70% of the employees experienced an increase in understanding and satisfaction, with positive feedback on the improvement of knowledge about chronic pain mechanisms and posture. However, there were also requests for more interactive communication and a desire to learn more about specific care methods, suggesting the need to provide interventions tailored to appropriate stages of preventive medicine. Full article

23 pages, 772 KiB

Open AccessArticle

Measuring the Risk of Violence Through Health Surveillance

by Nicola Magnavita, Igor Meraglia, Giacomo Viti and Martina Gasbarri

Int. J. Environ. Res. Public Health 2024, 21(12), 1708; https://doi.org/10.3390/ijerph21121708 - 22 Dec 2024

Viewed by 248

Abstract

Workplace violence (WV) is a ubiquitous, yet under-reported and under-studied phenomenon. Prevention measures may be ineffective because risk assessment is often based on unvalidated algorithms. After monitoring the risk of WV in a healthcare company for over 20 years, this paper presents the [...] Read more.

Workplace violence (WV) is a ubiquitous, yet under-reported and under-studied phenomenon. Prevention measures may be ineffective because risk assessment is often based on unvalidated algorithms. After monitoring the risk of WV in a healthcare company for over 20 years, this paper presents the results collected in 2023 and details of the methodology used. Monitoring WV in health surveillance can involve three actions: (1) asking all the workers who attend periodic medical examinations in the workplace whether they have suffered physical aggression, threats, or harassment in the previous year; (2) investigating WV at the end of workplace inspections by setting up participatory ergonomics groups (PEGs) to suggest solutions; (3) investigating the characteristics and consequences of WV through anonymous online questionnaires. In 2023, 6.9% of the healthcare workers (HCWs) reported having experienced one or more physical attacks during the previous year; 12.7% reported having been threatened, and 12.9% reported other types of violent, harassing behavior. The HCWs observed an increase in violence after the pandemic years and, in the PEGs, suggested using different preventive measures in different health departments. The online survey provided further information on the characteristics of WV and its consequences. The risk of WV can be effectively characterized and measured through health surveillance. Full article

(This article belongs to the Special Issue Occupational Health and Wellbeing for Healthcare Providers)

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12 pages, 306 KiB

Open AccessArticle

Knowledge, Attitudes, and Practice Regarding Physical Exercise in Type 2 Diabetic and Non-Diabetic Staff at a Tertiary Institution

by Mbuso Sibazo and Takshita Sookan-Kassie

Int. J. Environ. Res. Public Health 2024, 21(12), 1707; https://doi.org/10.3390/ijerph21121707 - 22 Dec 2024

Viewed by 319

Abstract

Type 2 diabetes mellitus (T2DM) has become a global epidemic, where increasing urbanization encourages sedentary lifestyles. Persistent physical inactivity can lead to T2DM and increase the risk of T2DM in the general population. Therefore, the aim of this study was to explore the [...] Read more.

Type 2 diabetes mellitus (T2DM) has become a global epidemic, where increasing urbanization encourages sedentary lifestyles. Persistent physical inactivity can lead to T2DM and increase the risk of T2DM in the general population. Therefore, the aim of this study was to explore the knowledge, attitudes, and practices (KAP) regarding exercise amongst T2DM and non-diabetic (ND) staff at a tertiary institution in KwaZulu Natal South Africa. A total of 166 responses were received: a total of 16 responses (9.6%) were T2DM, and 150 responses (90.0%) were non-diabetic (ND). The demographics included 66.3% females and 33.7% males who consented to taking part, 62.7% were black, 18.7% were Indian, 12% were white, 5.4% were colored, and 1.2% were other. A cross-sectional descriptive survey design, utilizing a modified validated online knowledge, attitudes, and practice questionnaire, was used to collect data. Descriptive statistics were used for the analysis: inferential statistics; the ordinal (1–5) Likert scale; t-tests; and chi-square tests. The level of statistical significance was set at p ≤ 0.05. No significant differences were found between the T2DM and ND groups except in their attitude towards exercise, which showed three items with significant differences. The ND group agreed significantly more than the T2DM group that they looked forward to exercising (p = 0.002), and even without company, they exercised regularly (p = 0.042). The T2DM group agreed significantly more with the statement that they had asked their doctor if there was medicine available to make them better without doing any exercise (p = 0.002). The overall KAP results of the current study found that both participants diagnosed with T2DM and those in the ND group know about exercise and have a good attitude toward exercise. However, both groups still have poor practice regarding physical activity. Full article

(This article belongs to the Special Issue 2nd Edition: Diabetes in Sports and Exercise Medicine)

13 pages, 1092 KiB

Open AccessEssay

Alignment of Air Pollution Exposure Inequality Metrics with Environmental Justice and Equity Goals in the United States

by Sarah Chambliss, Natasha Quynh Nhu Bui La Frinere-Sandoval, Corwin Zigler, Elizabeth J. Mueller, Roger D. Peng, Emily M. Hall, Elizabeth C. Matsui and Catherine Cubbin

Int. J. Environ. Res. Public Health 2024, 21(12), 1706; https://doi.org/10.3390/ijerph21121706 - 21 Dec 2024

Viewed by 334

Abstract

A growing literature within the field of air pollution exposure assessment addresses the issue of environmental justice. Leveraging the increasing availability of exposure datasets with broad spatial coverage and high spatial resolution, a number of works have assessed inequalities in exposure across racial/ethnic [...] Read more.

A growing literature within the field of air pollution exposure assessment addresses the issue of environmental justice. Leveraging the increasing availability of exposure datasets with broad spatial coverage and high spatial resolution, a number of works have assessed inequalities in exposure across racial/ethnic and other socioeconomic groupings. However, environmental justice research presents the additional need to evaluate exposure inequity—inequality that is systematic, unfair, and avoidable—which may be framed in several ways. We discuss these framings and describe inequality and inequity conclusions provided from several contrasting approaches drawn from recent work. We recommend that future work addressing environmental justice interventions include complementary “Exposure-driven” and “Socially weighted” metrics, taking an intersectional view of areas and social groups that are both disproportionately impacted by pollution and are impacted by additional health risks resulting from structural racism and consider implications for environmental justice beyond distributional equity. Full article

(This article belongs to the Collection 2nd Edition of Achieving Environmental Health Equity: Great Expectations)

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13 pages, 1115 KiB

Open AccessArticle

The Role of Smartphone Use in Sensory Processing: Differences Between Adolescents with ADHD and Typical Development

by Rosa Angela Fabio and Rossella Suriano

Int. J. Environ. Res. Public Health 2024, 21(12), 1705; https://doi.org/10.3390/ijerph21121705 - 21 Dec 2024

Viewed by 440

Abstract

The use of smartphones is widespread among adolescents and can affect various cognitive processes. However, the effects of smartphone use on sensory processing, particularly among individuals with attention deficit hyperactivity disorder (ADHD), remain largely unknown. The present study investigated the relationship between smartphone [...] Read more.

The use of smartphones is widespread among adolescents and can affect various cognitive processes. However, the effects of smartphone use on sensory processing, particularly among individuals with attention deficit hyperactivity disorder (ADHD), remain largely unknown. The present study investigated the relationship between smartphone use intensity and sensory processing in adolescents with typical development and those with ADHD. The sample included 184 adolescents aged 14 to 18 years (M = 16.56; SD = ±1.87), with 92 diagnosed with ADHD and 92 with typical development, matched for age, gender, and IQ. Participants completed a self-report questionnaire to measure smartphone use intensity, while sensory processing was assessed using the Adolescent Sensory Profile (ASP). The results revealed a significant association between the intensity of smartphone use and heightened sensory responses in adolescents with typical development. However, this relationship was not observed in participants with ADHD. These preliminary findings suggest that smartphone use may influence sensory processing differently depending on neurotypical development or the presence of ADHD, potentially contributing to the promotion or mitigation of sensory dysfunctions. Future studies are needed to further explore the mechanisms underlying these differences and to better understand the impact of digital technologies on sensory functioning. Full article

(This article belongs to the Special Issue The Impact of Internet and Social Media Use on Young People's Mental Health)

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8 pages, 915 KiB

Open AccessArticle

Universal Safety Planning for Suicide Prevention: CODE RED Initial Feasibility and Acceptability

by Julie Cerel, Martina Fruhbauerova, Alice Edwards, Leah Murphy, Elizabeth Salt, Beck Whipple, Patti M. Clark and John Ackerman

Int. J. Environ. Res. Public Health 2024, 21(12), 1704; https://doi.org/10.3390/ijerph21121704 - 21 Dec 2024

Viewed by 794

Abstract

Suicide rates have increased in the US over the last decades. Schools often deliver suicide prevention trainings and there is growing evidence that these trainings in schools are effective. The current study examined a new upstream approach, CODE RED in which trainees complete [...] Read more.

Suicide rates have increased in the US over the last decades. Schools often deliver suicide prevention trainings and there is growing evidence that these trainings in schools are effective. The current study examined a new upstream approach, CODE RED in which trainees complete their own safety plan prior to a mental health emergency. Participants were adult school personnel (n = 201) who completed CODE RED trainings and were surveyed using three validated 4-item measures: acceptability of intervention measure (AIM), intervention appropriateness measure (IAM), and feasibility of intervention measure (FIM). Open-ended questions were analyzed using a thematic approach. Of 201 participants who completed the survey, acceptability (18.0), appropriateness (17.9) and feasibility (18.0) were high as assessed by standardized implementation measures (each out of 20). Open-ended responses further indicated a great deal of satisfaction with the training. As a first step in determining acceptability and feasibility, CODE RED was found to be highly acceptable to adult school employees who found it applicable, appealing as an intervention, and easy to use. Most staff are hopeful that it will be useful with youth as well. It will be important to determine how this activity is used by youth and if it can be used in mental health crises to decrease symptoms. Full article

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25 pages, 2030 KiB

Open AccessArticle

Application of the Health Belief Model (HBM) to Explore the Quality of Sexual and Reproductive Health (SRH) Education in Sri Lanka

by Wasantha Rajapakshe, Anjana Koushani Wickramasurendra, Rajini Ranmini Amarasinghe, Shynie Lourds Minoli Kohilawatta Arachchige Wijerathne, Nikini Devindi Wijesinghe and Naduni Madhavika

Int. J. Environ. Res. Public Health 2024, 21(12), 1703; https://doi.org/10.3390/ijerph21121703 - 20 Dec 2024

Viewed by 403

Abstract

Many countries, including Sri Lanka, are taking steps to integrate sex education into their educational systems to combat child abuse. However, this effort is often met with skepticism in Asian nations, including Sri Lanka. This study takes a unique approach by applying the [...] Read more.

Many countries, including Sri Lanka, are taking steps to integrate sex education into their educational systems to combat child abuse. However, this effort is often met with skepticism in Asian nations, including Sri Lanka. This study takes a unique approach by applying the criteria of the health belief model to predict the quality of reproductive health (SRH) education in Sri Lanka, offering a fresh perspective on this issue. A positive philosophical framework and a deductive approach have been employed to provide justification for the underlying assumptions. A structured questionnaire was used as the survey methodology, which included questions about external cues to action, self-efficacy, perceived barriers, perceived susceptibility, and perceived severity. Data was collected from a total of 384 Sri Lankan non-state undergraduate students to test their perception of these factors and how they affect the perceived benefits of quality SRH education. The level of self-efficacy, perceived susceptibility, and perceived severity yielded a coefficient estimate that was statistically significant, thus influencing the perceived benefits of quality SRH education. These results, obtained through a multivariate regression analysis, underscore the importance of one’s role in implementing effective SRH education. Importantly, there is no evidence that external cues to action and perceived barriers predict the perceived benefits of quality SRH education. This underscores the gravity of the situation and the need for immediate action. The findings of this study have significant practical implications. They can be used to develop an effective SRH program that aims to prevent sexual abuse among adolescents. This study also demonstrates that the health belief model can serve as a useful conceptual framework for such intervention programs, providing tangible solutions to the issue of SRH education quality. Full article

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14 pages, 727 KiB

Open AccessArticle

COVID-19 Pandemic Impact on the Birth Weight of Children Born in a Brazilian Metropolis

by Beatriz Cardoso Armani, Rafaela Cristina Vieira e Souza, Fernanda Penido Matozinhos and Luana Caroline dos Santos

Int. J. Environ. Res. Public Health 2024, 21(12), 1702; https://doi.org/10.3390/ijerph21121702 - 20 Dec 2024

Viewed by 478

Abstract

Objective: To assess the birth weight of newborns whose mothers gave birth during the COVID-19 pandemic. Methods: A cross-sectional study based on data collected from medical records and through postnatal interviews to assess maternal and neonatal health outcomes (n = 470) during the [...] Read more.

Objective: To assess the birth weight of newborns whose mothers gave birth during the COVID-19 pandemic. Methods: A cross-sectional study based on data collected from medical records and through postnatal interviews to assess maternal and neonatal health outcomes (n = 470) during the pandemic. All participants were assisted in three Brazilian public hospitals in 2020. Multinomial logistic regression was performed to assess factors associated with birth weight. Results: Low and insufficient birth weight reached 9.8% and 25.7% prevalence, respectively. COVID-19 symptoms were reported by 8% of participants. Low birth weight was more often observed in premature children (OR: 70.9; 95% CI: 16.4–305.8) delivered by cesarean sections (OR: 7.70; 95% CI: 2.33–25.4). Insufficient weight was more frequent in premature children (OR: 5.59; 95% CI: 1.53–20.4) and children whose mothers did not exercise during pregnancy (OR: 2.85; 95% CI: 1.38–5.89). Women presenting higher gestational weight gain had a lower chance of delivering babies with insufficient weight (OR: 0.94; 95% CI: 0.90–0.99). Conclusions: Inadequate birth weight was associated with prematurity, delivery type, lower gestational weight gain, and maternal physical inactivity during the pandemic. According to the results, it is necessary to have adequate prenatal care and promote a healthy lifestyle during pregnancy. Full article

(This article belongs to the Special Issue Nutrition-, Overweight- and Obesity-Related Health Issues)

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13 pages, 1025 KiB

Open AccessArticle

The Impact of COVID-19 on People with a Visual Impairment in Northern Ireland: A Sensory Support View

by Laura N. Cushley, Matthew Mo, Tunde Peto and A. Jonathan Jackson

Int. J. Environ. Res. Public Health 2024, 21(12), 1701; https://doi.org/10.3390/ijerph21121701 - 20 Dec 2024

Viewed by 368

Abstract

Background: The COVID-19 pandemic brought many challenges for all and especially for people with a visual impairment. As a result, many healthcare services had to close or be reduced, and new rules and regulations were implemented. These rules, regulations and testing procedures were [...] Read more.

Background: The COVID-19 pandemic brought many challenges for all and especially for people with a visual impairment. As a result, many healthcare services had to close or be reduced, and new rules and regulations were implemented. These rules, regulations and testing procedures were challenging for many people with a visual impairment. Methods: Focus groups were conducted with sensory support workers at a regional sensory meeting in Northern Ireland. A set of semi-structured questions were asked about how services were conducted, the challenges faced by people with a visual impairment and any specific cases which showed its impact. Two researchers transcribed and analysed the focus group data. Results: The analysis resulted in four themes, namely “as a result”; healthcare; rules, regulation and testing; and mental and physical health. Some of the biggest issues mentioned were access to healthcare, COVID testing, online working, online schools, one-way systems, social distancing and the impact on mental and physical health. Conclusions: As expected, COVID-19 impacted people with a visual impairment. This study shows some of the barriers faced by people with a visual impairment, especially with regards to the rules and regulations. People with a visual impairment also found it difficult to access the necessary healthcare and support, or they were too fearful to seek it out. This paper provides an insight into the barriers faced by people with a visual impairment and how we may support them in the future. Full article

(This article belongs to the Section Global Health)

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10 pages, 662 KiB

Open AccessArticle

Obesogenic Environment in a Minas Gerais State Metropolis, Brazil: Analysis of Crime Rates, Food Shops and Physical Activity Venues

by Monique Louise Cassimiro Inácio, Luana Caroline dos Santos, Olívia Souza Honório, Rafaela Cristina Vieira e Souza, Thales Philipe Rodrigues da Silva and Milene Cristine Pessoa

Int. J. Environ. Res. Public Health 2024, 21(12), 1700; https://doi.org/10.3390/ijerph21121700 - 20 Dec 2024

Viewed by 344

Abstract

The aim of the present study is to identify obesogenic environment profiles to find the obesogenic environment pattern for Belo Horizonte City. The current research followed the ecological approach and was substantiated by data from food shops, public sports venues, crime rates (homicides [...] Read more.

The aim of the present study is to identify obesogenic environment profiles to find the obesogenic environment pattern for Belo Horizonte City. The current research followed the ecological approach and was substantiated by data from food shops, public sports venues, crime rates (homicides and robberies) and the rate of accidents with pedestrians. Descriptive analyses and principal component analysis (PCA) were conducted in Stata software, version 14.0. Georeferencing and map plotting were carried out in Qgis software, version 2.10. All neighborhoods in Belo Horizonte City (n = 486) were included in the study. The obesogenic pattern comprised the highest mean number of shops selling ultra-processed food, crime rates, and accidents with pedestrians. The generated latent variable was divided into tertiles, and the second and third tertiles represented the most obesogenic environments. Neighborhoods accounting for the highest obesogenic profile also recorded the largest number of shops selling all food types. Furthermore, neighborhoods in the third tertile recorded the highest mean income (BRL 2352.00) (p = 0.001) and the lowest Health Vulnerability Index (HVI = 54.2; p = 0.001). These findings point towards the need for developing actions, policies and programs to improve these environments, such as tax incentives to open healthy food retailers and public sports venues to promote healthier lifestyles and to prevent diseases in the middle and long term. Full article

(This article belongs to the Special Issue Nutrition-, Overweight- and Obesity-Related Health Issues)

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18 pages, 3200 KiB

Open AccessArticle

Networks of Negativity: Gaining Attention Through Cyberbullying

by Diane Felmlee, Sara Francisco and Melissa Hardy

Int. J. Environ. Res. Public Health 2024, 21(12), 1699; https://doi.org/10.3390/ijerph21121699 - 20 Dec 2024

Viewed by 384

Abstract

Cyberbullying entails multiple, problematic consequences for its victims. However, little is known about the factors that influence the dispersion of these damaging messages. Drawing on theories of social interaction, we argue that perpetrators disseminate messages containing sexist and racist slurs that reinforce stereotypical, [...] Read more.

Cyberbullying entails multiple, problematic consequences for its victims. However, little is known about the factors that influence the dispersion of these damaging messages. Drawing on theories of social interaction, we argue that perpetrators disseminate messages containing sexist and racist slurs that reinforce stereotypical, social norms to enhance their online visibility. We collected cross-sectional and longitudinal samples of tweets (N = 539,558 and 248,497, respectively) that included either gender or Asian slurs. We find that tweets containing gender or Asian slurs that were more negative in sentiment had a significantly higher number of retweets than more positive tweets, thereby heightening a user’s online presence and the reach of their content. Two historical events unfolded during our study—the onset of COVID-19 and the murder of George Floyd by a police officer. Tweet negativity increased following both events. Our findings demonstrate the capacity of aggressive tweets to generate wide-ranging networks, a process which is exacerbated further by public crises. Results suggest that the practice of sending such messages is strategic. Perpetrators likely engage in cyberbullying, consciously or not, to increase their online attention. Moreover, this strategy appears to be successful. Full article

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

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18 pages, 366 KiB

Open AccessReview

Association Between Unemployment and Mental Disorders: A Narrative Update of the Literature

by Andreas G. Franke, Peggy Schmidt and Stefanie Neumann

Int. J. Environ. Res. Public Health 2024, 21(12), 1698; https://doi.org/10.3390/ijerph21121698 - 19 Dec 2024

Viewed by 759

Abstract

The relationship between unemployment and mental disorders has been a significant subject of study since at least the Industrial Revolution. However, most data show associations of unemployment and isolated mental disorders, and this study field has been neglected in the last years. Therefore, [...] Read more.

The relationship between unemployment and mental disorders has been a significant subject of study since at least the Industrial Revolution. However, most data show associations of unemployment and isolated mental disorders, and this study field has been neglected in the last years. Therefore, this narrative review aims to provide an updated overview of the association between unemployment and mental health in general as well as the most prevalent mental disorders. A literature search was conducted using PubMed with the initial search terms “unemployment” and “mental health”. The identified disorders were then used as search terms for a more in-depth search. Two raters screened abstracts and identified the literature containing relevant information. As a main result, it could be demonstrated that regardless of age and sex, there is still a broad association between unemployment and mental well-being in general (e.g., quality of life measure for example by the General Health Questionnaire), suicide attempts, suicide rates, as well as specific psychiatric disorders (substance use disorder, schizophrenia, depression, bipolar disorders, compulsive/obsessive disorders, eating disorders, specific personality disorders, intelligence disorders/impairment, and ADHD). The most significant association was found for affective disorders (depression) and substance use disorders. The association in general was particularly evident for long-term unemployment and mental disorders. Returning to work reduced the prevalence rates of mental disorders significantly. The literature review confirms the results of much older and disease centered studies that unemployment and mental disorders are associated with each other. The main conclusion is that early medical detection and intervention among the mentally ill are as crucial as labor market policy interventions to prevent, avoid, and reduce unemployment. Full article

(This article belongs to the Special Issue Health Risks and Health Promotion among Unemployed People)

56 pages, 1617 KiB

Open AccessReview

Comprehensive Gerontological Assessment: An Update on the Concept and Its Evaluation Tools in Latin America and the Caribbean—A Literature Review

by Rafael Pizarro-Mena, Elena S. Rotarou, Diego Chavarro-Carvajal, Patrick Alexander Wachholz, María Fernanda López, Cristina Perdomo Delgado, Solange Parra-Soto, Isabel Barrientos-Calvo, Felipe Retamal-Walter and Gloria Riveros-Basoalto

Int. J. Environ. Res. Public Health 2024, 21(12), 1697; https://doi.org/10.3390/ijerph21121697 - 19 Dec 2024

Viewed by 550

Abstract

In recent decades, Latin America and the Caribbean region have experienced accelerated aging. However, despite the significant progress of gerontology in the region, the number of geriatricians and professionals trained in the field is low; a notable gap in the training related to [...] Read more.

In recent decades, Latin America and the Caribbean region have experienced accelerated aging. However, despite the significant progress of gerontology in the region, the number of geriatricians and professionals trained in the field is low; a notable gap in the training related to the assessment of older adults can also be observed. Therefore, in this literature review, we update the concept of Comprehensive Gerontological Assessment (CGA) for its application in the region. We compile the characteristics, validity, and reliability of CGA tools, and their usage in government documents across countries in the region. We also analyze the adaptations made to CGA during the COVID-19 pandemic, and discuss challenges related to CGA administration, academic training, research, innovation, and management. This study is particularly relevant as it proposes lines of action for decision-makers, academics, researchers, university students, and the general community, which will allow for more tailored interventions aimed at meeting the needs of older adults, their families, and caregivers. Such actions will positively impact functionality, autonomy, and quality of life, while promoting healthy, active, and successful aging in the region. Full article

(This article belongs to the Special Issue New Advances in Health of Older Adults)

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13 pages, 957 KiB

Open AccessArticle

Associations of Plant-Based Foods, Animal Products, and Selected Sociodemographic Factors with Gastroesophageal Reflux Disease Risk

by Ahlam El Shikieri, Zakaria Eltahir, Abdulmannan Aman and Mohamad Alhadramy

Int. J. Environ. Res. Public Health 2024, 21(12), 1696; https://doi.org/10.3390/ijerph21121696 - 19 Dec 2024

Viewed by 346

Abstract

Background: Diet influences the symptoms of gastroesophageal reflux disease (GERD). Plant-based diets rich in vegetables, fruits, legumes, seeds, and nuts may reduce inflammation and improve gut health, while high-fat foods may worsen symptoms. Objective: We examined the association between plant-based and animal-based foods, [...] Read more.

Background: Diet influences the symptoms of gastroesophageal reflux disease (GERD). Plant-based diets rich in vegetables, fruits, legumes, seeds, and nuts may reduce inflammation and improve gut health, while high-fat foods may worsen symptoms. Objective: We examined the association between plant-based and animal-based foods, selected demographic characteristics, and the likelihood of GERD in Al Madinah Al Munawarah, Saudi Arabia. Method: A cross-sectional study using the GerdQ tool assessed the GERD likelihood among 303 adults. Dietary diversity scores were used to assess the quality of their diet. quality. Results: The participants were predominantly women (68.6%) and had low education levels (88.4%). Cereals were the most consumed plant-based foods, while vitamin A-rich fruits and vegetables were the least consumed. There was significant variation in the consumption of legumes, nuts, seeds, and milk and milk products among the GERD groups. The participants with a 50% GERD likelihood had the highest consumption (34.5%), followed by the 89% likelihood group (21.4%) and the 79% likelihood group (14.5%). The lowest consumption of milk and milk products was among those with an 89% GERD likelihood who also consumed more organ meat. In addition, GERD likelihood was inversely associated with age (r = −0.153; p = 0.008). The likelihood of GERD was negatively correlated with the intake of legumes, nuts, and seeds (r = −0.163; p = 0.005). Furthermore, the intake of cereals and tubers (r = 0.114; p = 0.047) and legumes, nuts, and seeds (r = 0.231; p = 0.0001) increased significantly with education. Conclusion: GERD prevention programs should target women, those with a low education level, and individuals consuming fewer plant-based foods and more organ meats. Full article

(This article belongs to the Special Issue Eating Behaviors, Dietary Patterns and Nutritional Status in Children, Adults and the Older Generation)

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31 pages, 1438 KiB

Open AccessReview

Evaluating Exoskeletons for WMSD Prevention: A Systematic Review of Applications and Ergonomic Approach in Occupational Settings

by André Cardoso, Andreia Ribeiro, Paula Carneiro and Ana Colim

Int. J. Environ. Res. Public Health 2024, 21(12), 1695; https://doi.org/10.3390/ijerph21121695 - 19 Dec 2024

Viewed by 359

Abstract

This review provides a comprehensive analysis of studies investigating the impact of occupational exoskeletons on work-related musculoskeletal disorder (WMSD) risk factors. The primary objective is to examine the methodologies used to assess the effectiveness of these devices across various occupational tasks. A systematic [...] Read more.

This review provides a comprehensive analysis of studies investigating the impact of occupational exoskeletons on work-related musculoskeletal disorder (WMSD) risk factors. The primary objective is to examine the methodologies used to assess the effectiveness of these devices across various occupational tasks. A systematic review was conducted following the PRISMA guidelines, covering studies published between 2014 and 2024. A total of 49 studies were included, identified through searches conducted in Scopus and Web of Science databases, with the search string launched in August 2024. The review identifies a growing body of research on passive and active exoskeletons, with a notable focus on laboratory-based evaluations. The results indicate that direct measurement and self-report methods are the preferred approaches in these domains. Ergonomic limitations and user discomfort remain concerns in some cases. The findings of this review may influence stakeholders by providing insights into the potential benefits of adopting exoskeletons and improving workplace ergonomics to reduce WMSD risks. Additionally, the identification of WMSD assessment methods will be valuable for validating the use of these technologies in the workplace. The review concludes with recommendations for future research, emphasizing the need for more real-world assessments and improved exoskeleton designs to enhance user comfort and efficacy. Full article

(This article belongs to the Section Global Health)

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20 pages, 1325 KiB

Open AccessArticle

A Machine Learning Classification Model for Gastrointestinal Health in Cancer Survivors: Roles of Telomere Length and Social Determinants of Health

by Claire J. Han, Xia Ning, Christin E. Burd, Fode Tounkara, Matthew F. Kalady, Anne M. Noonan and Diane Von Ah

Int. J. Environ. Res. Public Health 2024, 21(12), 1694; https://doi.org/10.3390/ijerph21121694 - 19 Dec 2024

Viewed by 395

Abstract

Background: Gastrointestinal (GI) distress is prevalent and often persistent among cancer survivors, impacting their quality of life, nutrition, daily function, and mortality. GI health screening is crucial for preventing and managing this distress. However, accurate classification methods for GI health remain unexplored. We [...] Read more.

Background: Gastrointestinal (GI) distress is prevalent and often persistent among cancer survivors, impacting their quality of life, nutrition, daily function, and mortality. GI health screening is crucial for preventing and managing this distress. However, accurate classification methods for GI health remain unexplored. We aimed to develop machine learning (ML) models to classify GI health status (better vs. worse) by incorporating biological aging and social determinants of health (SDOH) indicators in cancer survivors. Methods: We included 645 adult cancer survivors from the 1999–2002 NHANES survey. Using training and test datasets, we employed six ML models to classify GI health conditions (better vs. worse). These models incorporated leukocyte telomere length (TL), SDOH, and demographic/clinical data. Results: Among the ML models, the random forest (RF) performed the best, achieving a high area under the curve (AUC = 0.98) in the training dataset. The gradient boosting machine (GBM) demonstrated excellent classification performance with a high AUC (0.80) in the test dataset. TL, several socio-economic factors, cancer risk behaviors (including lifestyle choices), and inflammatory markers were associated with GI health. The most significant input features for better GI health in our ML models were longer TL and an annual household income above the poverty level, followed by routine physical activity, low white blood cell counts, and food security. Conclusions: Our findings provide valuable insights into classifying and identifying risk factors related to GI health, including biological aging and SDOH indicators. To enhance model predictability, further longitudinal studies and external clinical validations are necessary. Full article

(This article belongs to the Special Issue Advancing Health Equity—Addressing Cancer Disparities)

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9 pages, 1320 KiB

Open AccessArticle

Effects of E-Cigarette (e-cig) Aerosols on Mutagenesis in Selected Organs in a C57 lacI (BigBlue^TM) Mouse Model

by Dweet Chhaya, Merna Gress, Amna Raja, Wieslawa Kosinska, Terry Gordon, Judith Zelikoff and Joseph B. Guttenplan

Int. J. Environ. Res. Public Health 2024, 21(12), 1693; https://doi.org/10.3390/ijerph21121693 - 19 Dec 2024

Viewed by 396

Abstract

The objective of this study is to investigate the potential mutagenic effects of the exposure of mice to aerosols produced from the component liquids of an electronic nicotine delivery system (ENDS). The use of electronic cigarettes (e-cigs) and ENDSs has increased tremendously over [...] Read more.

The objective of this study is to investigate the potential mutagenic effects of the exposure of mice to aerosols produced from the component liquids of an electronic nicotine delivery system (ENDS). The use of electronic cigarettes (e-cigs) and ENDSs has increased tremendously over the past two decades. From what we know to date, ENDSs contain much lower levels of known carcinogens than tobacco smoke. While conventional tobacco smoke is a well-established mutagen, little is known about the mutagenicity of ENDS aerosols. Here, we report the mutagenic effects of a 3-month whole body exposure of C57 lacI mice (BigBlue^TM) to filtered air (AIR) or ENDS aerosols in several tissues. Aerosols were generated from a 50/50 vegetable glycerin (VG)/propylene glycol (PG) mixture with and without nicotine. The results revealed that in the lung, bladder urothelial tissue, and tongue, mutagenesis was significantly greater in the VG/PG/nicotine group than in the AIR group. In all organs except the bladder, mutagenesis in the VG/PG only group was similar to those exposed to AIR. In the bladder, mutagenesis in the VG/PG group was elevated compared to that in the AIR group. In the liver, mutagenesis was modestly elevated in the VG/PG/nicotine group, but the elevation failed to reach statistical significance. Overall, there were no consistent differences in mutagenesis between the sexes. The results of this study suggest that exposure to e-cig aerosols containing nicotine represents a risk factor for carcinogenesis in several organ systems, and exposure to VG/PG alone may be a risk factor for bladder cancer. Full article

(This article belongs to the Special Issue E-cigarettes and Vaping Products: Health Effects and Toxicological Impacts)

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20 pages, 3022 KiB

Open AccessArticle

Sociodemographic and Population Exposure to Upstream Oil and Gas Operations in Canada

by Martin Lavoie, David Risk and Daniel Rainham

Int. J. Environ. Res. Public Health 2024, 21(12), 1692; https://doi.org/10.3390/ijerph21121692 - 19 Dec 2024

Viewed by 600

Abstract

Canada, as one of the largest oil and gas producer in the world, is responsible for large emissions of methane, a powerful greenhouse gas. At low levels, methane is not a direct threat to human health; however, human health is affected by exposure [...] Read more.

Canada, as one of the largest oil and gas producer in the world, is responsible for large emissions of methane, a powerful greenhouse gas. At low levels, methane is not a direct threat to human health; however, human health is affected by exposure to pollutants co-emitted with methane. The objectives of this research were to estimate and map pollutants emitted by the oil and gas industry, to assess the demographic of the population exposed to oil and gas activities, and to characterize the impact of well density on cardiovascular- and respiratory-related outcomes with a focus on Alberta. We estimated that ~13% and 3% people in Alberta reside, respectively, within 1.5 km of an active well and 1.5 km of a flare. Our analysis suggests that racial and socioeconomic disparities exist in residential proximity to active wells, with people of Aboriginal identity and people with less education being more exposed to active wells than the general population. We found increased odds of cardiovascular-related (1.13–1.29 for low active well density) and respiratory-related (1.07–1.19 for low active well density) outcomes with exposure to wells. Close to 100 countries produce oil and gas, making this a global issue. There is an important need for additional studies from other producing jurisdictions outside the United States. Full article

(This article belongs to the Section Environmental Health)

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13 pages, 927 KiB

Open AccessProtocol

Domestic Use of E-Cargo Bikes and Other E-Micromobility: Protocol for a Multi-Centre, Mixed Methods Study

by Ian Philips, Labib Azzouz, Alice de Séjournet, Jillian Anable, Frauke Behrendt, Sally Cairns, Noel Cass, Mary Darking, Clara Glachant, Eva Heinen, Nick Marks, Theresa Nelson and Christian Brand

Int. J. Environ. Res. Public Health 2024, 21(12), 1690; https://doi.org/10.3390/ijerph21121690 - 19 Dec 2024

Viewed by 834

Abstract

Physical inactivity is a leading risk factor for non-communicable diseases. Climate change is now regarded as the biggest threat to global public health. Electric micromobility (e-micromobility, including e-bikes, e-cargo bikes, and e-scooters) has the potential to simultaneously increase people’s overall physical activity while [...] Read more.

Physical inactivity is a leading risk factor for non-communicable diseases. Climate change is now regarded as the biggest threat to global public health. Electric micromobility (e-micromobility, including e-bikes, e-cargo bikes, and e-scooters) has the potential to simultaneously increase people’s overall physical activity while decreasing greenhouse gas emissions where it substitutes for motorised transport. The ELEVATE study aims to understand the impacts of e-micromobility, including identifying the people, places, and circumstances where they will be most beneficial in terms of improving people’s health while also reducing mobility-related energy demand and carbon emissions. A complex mixed methods design collected detailed quantitative and qualitative data from multiple UK cities. First, nationally representative (n = 2000), city-wide (n = 400 for each of the three cities; total = 1200), and targeted study area surveys (n = 996) collected data on travel behaviour, levels of physical activity, vehicle ownership, and use, as well as attitudes towards e-micromobility. Then, to provide insights on an understudied type of e-micromobility, 49 households were recruited to take part in e-cargo bike one-month trials. Self-reported data from the participants were validated with objective data-using methods such as GPS trackers and smartwatches’ recordings of routes and activities. CO₂ impacts of e-micromobility use were also calculated. Participant interviews provided detailed information on preferences, expectations, experiences, barriers, and enablers of e-micromobility. Full article

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16 pages, 1381 KiB

Open AccessArticle

An Assessment of Multipollutant Exposures Using Silicone Wristbands Among Bangladeshi Youth

by Margaret Quaid, Syed Emdadul Haque, Tariqul Islam, Mohammad Hasan Shahriar, Golam Sarwar, Alauddin Ahmed, Steven O’Connell, Farzana Jasmine, Muhammad G. Kibriya, Habibul Ahsan and Maria Argos

Int. J. Environ. Res. Public Health 2024, 21(12), 1691; https://doi.org/10.3390/ijerph21121691 - 18 Dec 2024

Viewed by 308

Abstract

Residents of Bangladesh are exposed to numerous chemicals due to local industries, including dyeing mills, cotton mills, and the use of biomass in daily cooking. It is, therefore, important to characterize the exposome and work to identify risk factors of exposure. We used [...] Read more.

Residents of Bangladesh are exposed to numerous chemicals due to local industries, including dyeing mills, cotton mills, and the use of biomass in daily cooking. It is, therefore, important to characterize the exposome and work to identify risk factors of exposure. We used silicone wristband passive samplers to evaluate exposure to volatile and semi-volatile organic compounds in a sample of 40 children in the Araihazar upazila of Bangladesh. We used stepwise linear regression models to determine which demographic, exposure, diet, and socioeconomic factors best predict exposure to single chemicals and classes of chemicals. Male sex at birth was associated with a decrease in the number of chemicals detected above their median concentration (β = −2.42; 95%CI: −5.24, 0.399), as was ownership of a flush toilet (β = −3.26; 95%CI: −6.61, 0.097). Increased body mass index (β = 1.81; 95%CI: 0.587, 3.03), father’s smoking (β = 2.74; 95%CI: −0.0113, 5.49), and father’s employment in the garment industry (β = 3.14; 95%CI: 0.209, 6.07) were each associated with an increase in the average number of chemicals detected above their median concentration. The observed results motivate future evaluation with health outcomes of these exposures. Full article

(This article belongs to the Section Environmental Health)

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13 pages, 1970 KiB

Open AccessArticle

Protective Effect of Silver Nanoparticles Against Cytosine Arabinoside Genotoxicity: An In Vivo Micronucleus Assay

by Idalia Yazmin Castañeda-Yslas, Olivia Torres-Bugarín, María Evarista Arellano-García, Balam Ruiz-Ruiz, Juan Carlos García-Ramos, Yanis Toledano-Magaña, Alexey Pestryakov and Nina Bogdanchikova

Int. J. Environ. Res. Public Health 2024, 21(12), 1689; https://doi.org/10.3390/ijerph21121689 - 18 Dec 2024

Viewed by 426

Abstract

Cancer treatments have harmful side effects, including genotoxic ones. Our previous research discovered that a specific silver nanoparticle (AgNPs) formulation could reduce the genotoxic effects of an alkylating agent, cyclophosphamide. This study aims to evaluate if this protective effect is observed against an [...] Read more.

Cancer treatments have harmful side effects, including genotoxic ones. Our previous research discovered that a specific silver nanoparticle (AgNPs) formulation could reduce the genotoxic effects of an alkylating agent, cyclophosphamide. This study aims to evaluate if this protective effect is observed against an antimetabolite anticancer agent, cytosine arabinoside (Ara-C). An erythrocyte micronucleus assay was conducted on BALB/c mice. A most significant effect was observed after the application scheme, including three doses of Ara-C and three subsequent doses of AgNPs, resulting in a 3.7 and 2.0-fold decrease in the frequency of micronucleated reticulocytes and accumulated erythrocytes, respectively. Current and previous studies reveal that AgNPs could be used as a genoprotector against the genotoxic damage produced by the currently used antineoplastic antimetabolites and alkylating agents. It was revealed that AgNPs could be considered a new class of promising synthetic antineoplastic genoprotectants along with the known class of derivatives from natural sources. Full article

(This article belongs to the Special Issue Human Exposure to Genotoxic Environmental Contaminants)

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12 pages, 871 KiB

Open AccessArticle

Do Medical Graduates from a Rural Longitudinal Integrated Clerkship Work in Similar Rural Communities?

by Jessica Beattie, Lara Fuller, Marley J. Binder, Laura Gray, Vincent L. Versace and Gary D. Rogers

Int. J. Environ. Res. Public Health 2024, 21(12), 1688; https://doi.org/10.3390/ijerph21121688 - 18 Dec 2024

Viewed by 336

Abstract

(1) Background: Medical graduates who have undertaken longitudinal rural training have consistently been found to be more likely to become rural doctors and work in primary care settings. A limitation of such findings is the heterogeneous nature of rural medical education and contested [...] Read more.

(1) Background: Medical graduates who have undertaken longitudinal rural training have consistently been found to be more likely to become rural doctors and work in primary care settings. A limitation of such findings is the heterogeneous nature of rural medical education and contested views of what constitutes ‘rurality’, especially as it is often reported as a binary concept (rural compared to metropolitan). To address the identified gaps in workforce outcomes for rural medical training and to demonstrate accountability to the communities we serve, we investigated whether Longitudinal Integrated Clerkship (LIC) graduates are practicing in communities with similar rural classification to those where they trained. Within an LIC, students learn the curriculum in an integrated, simultaneous manner. (2) Material and Methods: A retrospective cohort study analysing variables associated with working in smaller rural communities. (3) Results: LIC graduates who undertook an additional year of rural training were five times more likely to work in communities of similar rurality to the program’s training footprint. (4) Conclusions: The duration of rural training alone did not lead to optimal rural workforce outcomes. However, graduates who had trained in a combination of rural settings, an LIC, and block rotation were the most likely to practice in communities of similar rurality to the clerkship’s training footprint. This highlights the impact of both the training duration and setting inclusive of an LIC on fostering positive rural workforce outcomes and the need to develop innovative solutions to expand these models of training in smaller rural communities. Full article

(This article belongs to the Special Issue Public Health: Rural Health Services Research—2nd Edition)

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16 pages, 1005 KiB

Open AccessArticle

Under-5 Malaria and Fever Morbidities as Correlates of Anaemia in Niger: A Heteroscedasticity-Consistent Ordered Probit Approach

by Thonaeng Charity Molelekoa and Abayomi Samuel Oyekale

Int. J. Environ. Res. Public Health 2024, 21(12), 1687; https://doi.org/10.3390/ijerph21121687 - 18 Dec 2024

Viewed by 326

Abstract

Background: The relationship between malaria/other febrile infections and anaemia among under-5 children is a subject of significant policy relevance among African health policy makers. The international significance of addressing anaemia is prominently underscored in the third Sustainable Development Goal (SDG). This paper [...] Read more.

Background: The relationship between malaria/other febrile infections and anaemia among under-5 children is a subject of significant policy relevance among African health policy makers. The international significance of addressing anaemia is prominently underscored in the third Sustainable Development Goal (SDG). This paper therefore analysed the effect of malaria/other febrile infections and other maternal and child’s demographic variables on the prevalence of anaemia in Niger. Methods: We utilized the under-5 children’s module of the Malaria Indicator Survey (MIS) for 2021, which was collected from women of reproductive age (15–49) in selected households. The data were analysed with heteroscedasticity-consistent ordered probit regression model. Results: The results showed that 73.73% of the children was anaemic, while malaria and other febrile infections were present in 14.00% and 33.87%, respectively. Anaemia was highest in the Tillaberi and Dosso regions, where 84.12% and 79.12% of the children were anaemic. The ordered probit regression revealed that anaemia was promoted by malaria, other febrile infections, being a male child, second of multiple birth, and birth order, while wealth index, age, urban residence, and access to newspaper and television reduced it. Conclusions: Anaemia remains a major public health problem among under-5 children in Niger. A comprehensive healthcare intervention to address the problem should consider regional, sectoral, and gender differences in the incidences, with drastic efforts towards prevention of malaria and other fever-inducing illnesses. In addition, interventions to promote households’ economic status, reduce maternal fertility, and facilitate preventive practices through nutrition enhancement and health-related media programs hold some promise. Full article

(This article belongs to the Special Issue Socio-Economic Inequalities in Child Health)

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20 pages, 365 KiB

Open AccessArticle

But at What Cost? Healthcare Utilization of Canadian Carer-Employees

by Regina Ding and Linda Duxbury

Int. J. Environ. Res. Public Health 2024, 21(12), 1686; https://doi.org/10.3390/ijerph21121686 - 18 Dec 2024

Viewed by 338

Abstract

Caregiving plays a crucial role in aging societies by supporting individuals with chronic illnesses, disabilities, or aging-related needs. The unpaid labour provided by caregivers diverts healthcare resources from the formal healthcare system; however, this incurs costs to the caregivers themselves in terms of [...] Read more.

Caregiving plays a crucial role in aging societies by supporting individuals with chronic illnesses, disabilities, or aging-related needs. The unpaid labour provided by caregivers diverts healthcare resources from the formal healthcare system; however, this incurs costs to the caregivers themselves in terms of declines in personal wellbeing. This study explores the relationship between caregiving and healthcare spending for two groups of caregivers: eldercare only and sandwiched. We found that physician visits were the most common resource used by caregivers, at a mean of 3.69 (SD = 4.01) visits over a 6-month period, excluding non-users of this service. This was followed by mental health services (M = 5.86, SD = 7.02), emergency room visits (M = 1.77, SD = 1.38), and hospital admissions (M = 3.61, SD = 8.53). There were no significant differences in healthcare utilization between eldercare and sandwiched caregivers. There were mixed results regarding characteristics associated with greater resource use; however, the hours of weekly caregiving were most consistently associated with greater healthcare utilization, indicating that healthcare use may increase with care burden. Full article

(This article belongs to the Special Issue Work–Life Policies, Employee Health and Well-Being)

27 pages, 1853 KiB

Open AccessArticle

Cost Analysis Related to Diagnosis, Treatment and Management of Cervical Cancer in Antigua and Barbuda: A Prevalence-Based Cost-of-Illness Study

by Andre A. N. Bovell, Cebisile Ngcamphalala, Dane Abbott, Jabulani Ncayiyana and Themba G. Ginindza

Int. J. Environ. Res. Public Health 2024, 21(12), 1685; https://doi.org/10.3390/ijerph21121685 - 18 Dec 2024

Viewed by 610

Abstract

Cervical cancer remains a significant public health issue globally. In Antigua and Barbuda, cervical cancer is ranked among the top five most common cancers in terms of incidence and mortality among females. There is no evidence that the costs of diagnosing, treating, and [...] Read more.

Cervical cancer remains a significant public health issue globally. In Antigua and Barbuda, cervical cancer is ranked among the top five most common cancers in terms of incidence and mortality among females. There is no evidence that the costs of diagnosing, treating, and managing this cancer have been studied before in Antigua and Barbuda. From the providers’ perspective, this study aimed to estimate costs associated with cervical cancer in Antigua and Barbuda. The prevalence-based cost-of-illness methodology was used to assess patient data abstracted from four study sites for the period 2017–2021, and to derive the annual prevalence. Top-down and bottom-up costing approaches were used to estimate direct medical costs. Costs were computed using the 2021 price level and converted to United States Dollars (USD). Total annual direct medical costs of cervical cancer were estimated at USD 0.24 million (ranging between USD 0.19 million and USD 0.30 million). Major cost drivers were treatment (USD 112,863.76), post-treatment side-effects care (USD 67,406.57), and the diagnostic process (USD 26,238.58). The overall direct medical unit costs for managing a case were estimated at USD 115,822.09. Our study reflects the current estimates for managing cervical cancer and provides evidence to complement cervical cancer prevention and cost containment measures in Antigua and Barbuda. Full article

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Int. J. Environ. Res. Public Health, Volume 21, Issue 12 (December 2024) – 175 articles

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