Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.6 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
Latest Articles
The Effectiveness of Clinician-Led Community-Based Group Exercise Interventions on Health Outcomes in Adults with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2024, 21(5), 601; https://doi.org/10.3390/ijerph21050601 (registering DOI) - 07 May 2024
Abstract
This systematic review and meta-analysis evaluated the combined effects of clinician-led and community-based group exercise interventions on a range of health outcomes in adults with type 2 diabetes mellitus. Our literature search spanned Medline, Scopus, PubMed, Embase, and CINAHL databases, focusing on peer-reviewed
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This systematic review and meta-analysis evaluated the combined effects of clinician-led and community-based group exercise interventions on a range of health outcomes in adults with type 2 diabetes mellitus. Our literature search spanned Medline, Scopus, PubMed, Embase, and CINAHL databases, focusing on peer-reviewed studies published between January 2003 and January 2023. We included studies involving participants aged 18 years and older and articles published in English, resulting in a dataset of eight studies with 938 participants. Spanning eight peer-reviewed studies with 938 participants, the analysis focused on the interventions’ impact on glycemic control, physical fitness, and anthropometric and hematological measurements. Outcomes related to physical fitness, assessed through the six-minute walk test, the 30 s sit-to-stand test, and the chair sit-and-reach test, were extracted from five studies, all of which reported improvements. Anthropometric outcomes from seven studies highlighted positive changes in waist circumference and diastolic blood pressure; however, measures such as body mass index, systolic blood pressure, weight, and resting heart rate did not exhibit significant changes. Hematological outcomes, reviewed in four studies, showed significant improvements in fasting blood glucose, triglycerides, and total cholesterol, with glycemic control evidenced by reductions in HbA1c levels, yet LDL and HDL cholesterol levels remained unaffected. Ten of the fifteen outcome measures assessed showed significant enhancement, indicating that the intervention strategies implemented may offer substantial health benefits for managing key type 2 diabetes mellitus-related health parameters. These findings in combination with further research, could inform the refinement of physical activity guidelines for individuals with type 2 diabetes mellitus, advocating for supervised group exercise in community settings.
Full article
(This article belongs to the Special Issue Effectiveness of Physical Exercise for People with Chronic Diseases)
Open AccessArticle
Predictive Modelling of Postpartum Haemorrhage Using Early Risk Factors: A Comparative Analysis of Statistical and Machine Learning Models
by
Shannon Holcroft, Innocent Karangwa, Francesca Little, Joelle Behoor and Oliva Bazirete
Int. J. Environ. Res. Public Health 2024, 21(5), 600; https://doi.org/10.3390/ijerph21050600 - 07 May 2024
Abstract
Postpartum haemorrhage (PPH) is a significant cause of maternal morbidity and mortality worldwide, particularly in low-resource settings. This study aimed to develop a predictive model for PPH using early risk factors and rank their importance in terms of predictive ability. The dataset was
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Postpartum haemorrhage (PPH) is a significant cause of maternal morbidity and mortality worldwide, particularly in low-resource settings. This study aimed to develop a predictive model for PPH using early risk factors and rank their importance in terms of predictive ability. The dataset was obtained from an observational case–control study in northern Rwanda. Various statistical models and machine learning techniques were evaluated, including logistic regression, logistic regression with elastic-net regularisation, Random Forests, Extremely Randomised Trees, and gradient-boosted trees with XGBoost. The Random Forest model, with an average sensitivity of 80.7%, specificity of 71.3%, and a misclassification rate of 12.19%, outperformed the other models, demonstrating its potential as a reliable tool for predicting PPH. The important predictors identified in this study were haemoglobin level during labour and maternal age. However, there were differences in PPH risk factor importance in different data partitions, highlighting the need for further investigation. These findings contribute to understanding PPH risk factors, highlight the importance of considering different data partitions and implementing cross-validation in predictive modelling, and emphasise the value of identifying the appropriate prediction model for the application. Effective PPH prediction models are essential for improving maternal health outcomes on a global scale. This study provides valuable insights for healthcare providers to develop predictive models for PPH to identify high-risk women and implement targeted interventions.
Full article
Open AccessArticle
Parental Reports of Children’s Dental Pain Experience and Associated Factors among Brazilian Children
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Jéssica Aparecida Silva-Rabelo, Letícia Fernanda Moreira-Santos, Júnia Maria Serra-Negra, Cristiane Baccin Bendo, Saul Martins Paiva and Isabela Almeida Pordeus
Int. J. Environ. Res. Public Health 2024, 21(5), 599; https://doi.org/10.3390/ijerph21050599 - 07 May 2024
Abstract
Exploring children’s dental pain experiences helps to develop healthcare policies for improving oral health and quality of life. A cross-sectional study involved 300 parents/caregivers of four- to seven-year-old children using snowball sampling. Parents/caregivers self-completed an online questionnaire on sociodemographic characteristics, parenting styles, their
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Exploring children’s dental pain experiences helps to develop healthcare policies for improving oral health and quality of life. A cross-sectional study involved 300 parents/caregivers of four- to seven-year-old children using snowball sampling. Parents/caregivers self-completed an online questionnaire on sociodemographic characteristics, parenting styles, their child’s oral hygiene practices, free sugar consumption, and dental history. The questionnaire was created using Google Forms and was disseminated to parents/caregivers via E-mail and/or WhatsApp©. Descriptive and Poisson regression analyses were performed (p < 0.05). Children’s dental pain experience was reported by 20.3% of the parents. The authoritative parenting style was predominant. The child’s mean age at the first consumption of sugar was 1.38 (±0.64) years, and 40.3% of the children had high-free sugar consumption. The mean age for the first dental appointment was 2.26 (±1.31) years, and 24.3% of the children never went to a dental appointment. The prevalence of dental pain experience was higher in children who attended their first dental appointment later (PR: 1.02; CI 95%: 1.01–1.03) and among those with high-free sugar consumption (PR: 1.90; CI 95%: 1.21–3.00). High sugar consumption and delay in the first dental appointment may increase the likelihood that children will experience dental pain.
Full article
(This article belongs to the Special Issue Factors Associated with Oral Pain and Oral Health-Related Consequences)
Open AccessArticle
Low-Level Visual Features of Window Views Contribute to Perceived Naturalness and Mental Health Outcomes
by
Larissa Samaan, Leonie Klock, Sandra Weber, Mirjam Reidick, Leonie Ascone and Simone Kühn
Int. J. Environ. Res. Public Health 2024, 21(5), 598; https://doi.org/10.3390/ijerph21050598 - 06 May 2024
Abstract
Previous studies have shown that natural window views are beneficial for mental health, but it is still unclear which specific features constitute a ‘natural’ window view. On the other hand, studies on image analysis found that low-level visual features (LLVFs) are associated with
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Previous studies have shown that natural window views are beneficial for mental health, but it is still unclear which specific features constitute a ‘natural’ window view. On the other hand, studies on image analysis found that low-level visual features (LLVFs) are associated with perceived naturalness, but mainly conducted experiments with brief stimulus presentations. In this study, research on the effects of window views on mental health was combined with the detailed analysis of LLVFs. Healthy adults rated window views from their home and sent in photographs of those views for analysis. Content validity of the ‘ecological’ view assessment was evaluated by checking correlations of LLVFs with window view ratings. Afterwards, it was explored which of the LLVFs best explained variance in perceived percentage of nature and man-made elements, and in ratings of view quality. Criterion validity was tested by investigating which variables were associated with negative affect and impulsive decision-making. The objective and subjective assessments of nature/sky in the view were aligned but objective brightness was unreliable. The perceived percentage of nature was significantly explained by green pixel ratio, while view quality was associated with fractals, saturation, sky pixel ratio and straight edge density. The higher subjective brightness of rooms was associated with a lower negative affect, whereas results for impulsive decision-making were inconsistent. The research highlights the validity to apply LLVFs analysis to ecological window views. For affect, subjective brightness seemed to be more relevant than LLVFs. For impulsive decision-making, performance context needs to be controlled in future studies.
Full article
(This article belongs to the Section Behavioral and Mental Health)
Open AccessArticle
Assessing the Relationship between Physical Health, Mental Health and Students’ Success among Universities in Lebanon: A Cross-Sectional Study
by
Samer A. Kharroubi, Nayla Al-Akl, Sarah-Joe Chamate, Tarek Abou Omar and Rouba Ballout
Int. J. Environ. Res. Public Health 2024, 21(5), 597; https://doi.org/10.3390/ijerph21050597 - 05 May 2024
Abstract
Background: Achieving high academic success is known to be influenced by many factors including, but not limiting to, physical and mental health. The present study aimed to assess the relationship between physical health, mental health, and university students’ success, and to explore the
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Background: Achieving high academic success is known to be influenced by many factors including, but not limiting to, physical and mental health. The present study aimed to assess the relationship between physical health, mental health, and university students’ success, and to explore the associations between these factors and their academic achievement. Methods: A cross-sectional, self-administered online survey was used to collect data from college students in three different universities in Lebanon during the Fall 2023 semester. Mental health was evaluated using validated screening tools for depression, anxiety, and stress, specifically the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7), and Cohen’s Perceived Stress Scale (PSS), respectively. Additionally, general questions regarding physical health and lifestyle factors were incorporated into the questionnaire. Academic achievement was measured using students’ grade point average (GPA). Results: A total of 261 students completed the self-administered online survey. The results revealed that approximately 42% and 36% of students were experiencing moderate to severe symptoms of depression and anxiety, respectively, and 75.1% of students exhibited symptoms of moderate stress. The majority of participants (99.2%) did not report any physical disability. Chi-square analysis revealed a significant association between mental health status (depression, anxiety, and stress) and GPA level (p = 0.03, p = 0.044, p = 0.015, respectively). Multiple logistic regression models identified eight correlates of GPA and highlighted the relationship between physical health and student success. For instance, students who considered themselves moderately active had lower odds of achieving a higher GPA than those who considered themselves active (OR = 0.41, p = 0.045). Conclusions: This is the first investigation into Lebanese university students’ academic success in relation to lifestyle and mental health profiles. The findings indicate that implementing public health programs and interventions targeting mental health and lifestyle behaviors is essential for enhancing student success.
Full article
(This article belongs to the Special Issue Optimal Mental Health for Optimal Academic Performance in University Students)
Open AccessArticle
The Role of Career Adaptability and Academic Engagement in College Student’s Life Satisfaction
by
Íris M. Oliveira and Cátia Marques
Int. J. Environ. Res. Public Health 2024, 21(5), 596; https://doi.org/10.3390/ijerph21050596 - 05 May 2024
Abstract
Career adaptability and academic engagement are important processes in higher education. However, the relationship between these processes and their potential role in students’ life satisfaction still needs to be addressed. The present study aims to explore the role of career adaptability and academic
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Career adaptability and academic engagement are important processes in higher education. However, the relationship between these processes and their potential role in students’ life satisfaction still needs to be addressed. The present study aims to explore the role of career adaptability and academic engagement on higher education students’ life satisfaction. This study included 201 participants, 156 women (77.6%) and 45 men (22.4%), aged between 18 and 55 years (M = 21.13, SD = 4.51). Students answered a sociodemographic questionnaire, the Career Adapt-Abilities Scale, the University Student Engagement Inventory, and the Satisfaction with Life Scale. Positive and statistically significant correlations between career adaptability and academic engagement, as well as between these variables and life satisfaction, were found. The results of a hierarchical linear regression analysis suggested that career adaptability and academic engagement statistically significantly contribute to explaining variations in life satisfaction. This study may lead to a better understanding of the relationship between academic, emotional, and career processes. It may also stimulate integrative psychological practices in higher education settings.
Full article
(This article belongs to the Special Issue Personality and Trauma: A Pathway to Health Status)
Open AccessArticle
Evaluating the Agreement between Oral, Armpit, and Ear Temperature Readings during Physical Activities in an Outdoor Setting
by
Yuanzhe Zhao, Leonardo de Almeida e Bueno, David A. Holdsworth and Jeroen H. M. Bergmann
Int. J. Environ. Res. Public Health 2024, 21(5), 595; https://doi.org/10.3390/ijerph21050595 - 04 May 2024
Abstract
Accurate body temperature measurement is essential for monitoring and managing safety during outdoor activities. Physical activities are an essential consideration for public health, with sports taking up an important proportion of these. Athletes’ performances can be directly affected by body temperature fluctuations, with
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Accurate body temperature measurement is essential for monitoring and managing safety during outdoor activities. Physical activities are an essential consideration for public health, with sports taking up an important proportion of these. Athletes’ performances can be directly affected by body temperature fluctuations, with overheating or hypothermia posing serious health risks. Monitoring these temperatures allows coaches and medical staff to make decisions that enhance performance and safety. Traditional methods, like oral, axillary, and tympanic readings, are widely used, but face challenges during intense physical activities in real-world environments. This study evaluated the agreement, correlation, and interchangeability of oral, axillary, and tympanic temperature measurements in outdoor exercise conditions. Systems developed for specific placements might generate different sensor readouts. Conducted as an observational field study, it involved 21 adult participants (11 males and 10 females, average age 25.14 ± 5.80 years) that underwent the Yo-Yo intermittent recovery test protocol on an outdoor court. The main outcomes measured were the agreement and correlation between temperature readings from the three methods, both before and after exercise. The results indicate poor agreement between the measurement sites, with significant deviations observed post-exercise. Although the Spearman correlation coefficients showed consistent temperature changes post-exercise across all methods, the standard deviations in the pairwise comparisons exceeded 0.67 °C. This study concluded that widely used temperature measurement methods are challenging to use during outdoor exercises and should not be considered interchangeable. This variability, especially after exercise, underscores the need for further research using gold standard temperature measurement methods to determine the most suitable site for accurate readings. Care should thus be taken when temperature screening is done at scale using traditional methods, as each measurement site should be considered within its own right.
Full article
(This article belongs to the Special Issue Effect of Physical Activity on Human Fitness)
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Open AccessArticle
Enduring Effects of the COVID-19 Pandemic on Food Access, Nutrition, and Well-Being in Rural Appalachia
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Kathryn M. Cardarelli, Emily DeWitt, Rachel Gillespie, Nathan Bandy and Heather Norman-Burgdolf
Int. J. Environ. Res. Public Health 2024, 21(5), 594; https://doi.org/10.3390/ijerph21050594 - 04 May 2024
Abstract
The COVID-19 pandemic produced acute effects on health inequities, yet more enduring impacts in vulnerable populations in rural Appalachia are understudied. This qualitative study included three focus groups with thirty-nine adults (74% female, mean age 52.7 years) to obtain perspectives on the impact
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The COVID-19 pandemic produced acute effects on health inequities, yet more enduring impacts in vulnerable populations in rural Appalachia are understudied. This qualitative study included three focus groups with thirty-nine adults (74% female, mean age 52.7 years) to obtain perspectives on the impact of the COVID-19 pandemic on well-being in Martin County, Kentucky, in fall 2022. Grounded Theory was employed using an iterative inductive-deductive approach to capture the lasting effects of the COVID-19 pandemic on health practices and status. Three prominent themes emerged: (1) increased social isolation; (2) household cost of living strains caused by inflation; and (3) higher food prices and diminished food availability causing shifts in food purchasing and consumption. Participants noted that the rising cost of living resulted in residents having to “choose between medication, food and utilities”. Increased food prices resulted in residents “stretching” their food, modifying how they grocery shopped, and limiting meat consumption. Persistent food shortages were exacerbated by there being few grocery stores in the county. Lastly, increased social isolation was profoundly articulated as widely impacting mental health, especially among youth. Our findings underscore the ongoing deleterious effects of inflation and food supply chain disruptions in this rural, geographically isolated community, which resulted in difficult spending choices for residents.
Full article
(This article belongs to the Special Issue The Management of Nutrition and Obesity)
Open AccessReview
A Scoping Review of Mental Health Needs and Challenges among Medical Students within South African Universities
by
Mokhwelepa Leshata Winter and Sumbane Gsakani Olivia
Int. J. Environ. Res. Public Health 2024, 21(5), 593; https://doi.org/10.3390/ijerph21050593 - 04 May 2024
Abstract
The mental health of medical students is a growing concern worldwide, with studies indicating high levels of stress, anxiety, and depression among this population. In a South African context, this review aims to review the existing literature on mental health needs and challenges
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The mental health of medical students is a growing concern worldwide, with studies indicating high levels of stress, anxiety, and depression among this population. In a South African context, this review aims to review the existing literature on mental health needs and challenges among medical students in South Africa. The rationale for this review is crucial to identify gaps, understand unique contextual factors, and inform the development of targeted interventions and support tailored to the specific needs of South African medical students. This review followed a scoping review framework by Arksey and O’Malley which consists of five stages. The review was initiated in December 2023. The search process was conducted on the following electronic databases: PubMed, Psych-info, Scopus, Google Scholar, and Science Direct. The search terms of this review were “Medical students” OR “Mental health”, OR “Challenges”, OR “South Africa”, OR “Universities” OR “Needs”, OR “Support systems”, OR “Mental health interventions”. This study included articles published in English between 2010 and 2023. After a thorough review of the literature, only eight articles met the inclusion criteria. This study excluded articles that were not published in English, articles published before 2010, full-text articles that could not be retrieved, and studies that did not address the mental health needs and challenges faced by medical students and risk factors contributing to mental issues among South African medical students. The review yielded only three themes utilizing Creswell’s Tesch method of data analysis. (1) Prevalence of mental health disorders, (2) risk factors contributing to poor mental health, and (3) available university support systems and interventions. Therefore, the unique aspect of our review lies in shedding light on the underexplored intersections between mental health and the unique context of medical education in South Africa. This includes examining the impact of historical, cultural, and institutional factors on the mental health and well-being of medical students, which has not been comprehensively addressed in previous literature in terms of the South African context. The findings of this review highlight the importance of implementing comprehensive mental health support programs within medical education institutions to address the needs of students and promote their well-being.
Full article
(This article belongs to the Special Issue Wellbeing and Mental Health among Students)
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Open AccessArticle
Negative Aspects of Self-Imposed Evacuation among Mothers of Small Children Following Japan’s Fukushima Daiichi Nuclear Power Station Accident
by
Hitomi Matsunaga
Int. J. Environ. Res. Public Health 2024, 21(5), 592; https://doi.org/10.3390/ijerph21050592 - 04 May 2024
Abstract
This study clarified the negative aspects of the self-imposed evacuation of mothers of small children seeking to avoid radiation exposure from the Fukushima Daiichi Nuclear Power Station accident on 11 March 2011. We conducted semi-structured interviews with 27 mothers, employing open-ended inquiries based
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This study clarified the negative aspects of the self-imposed evacuation of mothers of small children seeking to avoid radiation exposure from the Fukushima Daiichi Nuclear Power Station accident on 11 March 2011. We conducted semi-structured interviews with 27 mothers, employing open-ended inquiries based on an interview guide. Our analysis of their responses using the Ka-Wakita-Jiro (KJ) method categorized the results into eight distinct groups comprising 142 labels. These categories included continued anxiety about the health effects of radiation, differences in risk perception, changes in spousal relationships, the inability to make friends and find support, living as a single parent, financial concerns, the unfamiliar feel of the area to which they evacuated, and uncertainty about the future. Despite their hardships, the mothers continued their self-imposed evacuation to avoid radioactivity. Our findings underscore that their anxieties about radiation exposure persisted even after self-imposed evacuation, leading to deteriorated relationships with key individuals who would have been involved in raising their children. These results offer valuable insights into the challenges experienced by the indirect victims of the nuclear accident, such as the mothers of small children.
Full article
(This article belongs to the Special Issue 2nd Edition: Mental Health and Disaster: Response, Recovery, and Preparedness for the Future)
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Open AccessArticle
Enhancing EQ-5D-5L Sensitivity in Capturing the Most Common Symptoms in Post-COVID-19 Patients: An Exploratory Cross-Sectional Study with a Focus on Fatigue, Memory/Concentration Problems and Dyspnea Dimensions
by
Helena Janols, Carl Wadsten, Christoffer Forssell, Elena Raffeti, Christer Janson, Xingwu Zhou and Marta A Kisiel
Int. J. Environ. Res. Public Health 2024, 21(5), 591; https://doi.org/10.3390/ijerph21050591 - 03 May 2024
Abstract
This study aimed to determine whether the EQ-5D-5L tool captures the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, in patients with post-COVID-19 conditions while also investigating if adding these symptoms improves the explained variance of the health-related quality of
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This study aimed to determine whether the EQ-5D-5L tool captures the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, in patients with post-COVID-19 conditions while also investigating if adding these symptoms improves the explained variance of the health-related quality of life (HRQoL). In this exploratory cross-sectional study, two cohorts of Swedish patients (n = 177) with a history of COVID-19 infection answered a questionnaire covering sociodemographic characteristics and clinical factors, and their HRQoL was assessed using EQ-5D-5L with the Visual Analogue Scale (EQ-VAS). Spearman rank correlation and multiple regression analyses were employed to investigate the extent to which the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, were explained by the EQ-5D-5L. The explanatory power of EQ-5D-5L for EQ-VAS was also analyzed, both with and without including symptom(s). We found that the EQ-5D-5L dimensions partly captured fatigue and memory/concentration problems but performed poorly in regard to capturing dyspnea. Specifically, the EQ-5D-5L explained 55% of the variance in memory/concentration problems, 47% in regard to fatigue and only 14% in regard to dyspnea. Adding fatigue to the EQ-5D-5L increased the explained variance of the EQ-VAS by 5.7%, while adding memory/concentration problems and dyspnea had a comparatively smaller impact on the explained variance. Our study highlights the EQ-5D-5L’s strength in capturing fatigue and memory/concentration problems in post-COVID-19 patients. However, it also underscores the challenges in assessing dyspnea in this group. Fatigue emerged as a notably influential symptom, significantly enhancing the EQ-5D-5L’s predictive ability for these patients’ EQ-VAS scores.
Full article
(This article belongs to the Special Issue 2nd Edition of COVID-19, Healthcare Quality, Patient Safety and Quality of Life)
Open AccessArticle
Evaluation of a Pilot Wellness Elective for Master of Public Health Students during the COVID-19 Pandemic
by
Blaise Y. O’Malley, Edgard Etoundi-Ngono, Jianjun Hua, Joseph P. Nano and Catherine F. Pipas
Int. J. Environ. Res. Public Health 2024, 21(5), 590; https://doi.org/10.3390/ijerph21050590 - 03 May 2024
Abstract
Background: Graduate student wellbeing is a public health issue in the United States. The COVID-19 outbreak exacerbated the mental health burden on graduate students worldwide. Culture of Wellness (PH 104) is a 2-week wellbeing elective course that teaches evidence-based wellbeing strategies for graduate
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Background: Graduate student wellbeing is a public health issue in the United States. The COVID-19 outbreak exacerbated the mental health burden on graduate students worldwide. Culture of Wellness (PH 104) is a 2-week wellbeing elective course that teaches evidence-based wellbeing strategies for graduate students at a university in the United States. Our study aimed to evaluate the impact of this pilot wellbeing elective on Master of Public Health students’ mental health and wellness during the COVID-19 pandemic. Methods: Participants included 22 Master of Public Health students from the class of 2021 at a university in the United States. We provided a pre-course survey to students that assessed their perception of their own personal wellbeing, their knowledge about various wellbeing strategies, and their confidence in applying 13 wellbeing strategies before taking the course. Post-course students completed the same survey following course completion, as well as a matching evaluation and a five-month follow up survey. Results: Of the 13 strategies taught, students reported significant improvements in their ability to apply 10 strategies. There was a significant increase in self-reported emotional and physical wellbeing, as well as a significant decrease in burnout. Five months post-course, more than three quarters of respondents used strategies taught in the course on a weekly basis or more. Limitations: This pilot study is limited by its small sample size, which may restrict the generalizability of the findings. Conclusions: The PH 104 Culture of Wellness course was effective in improving graduate students’ wellbeing and confidence in applying wellbeing strategies
Full article
(This article belongs to the Special Issue Optimal Mental Health for Optimal Academic Performance in University Students)
Open AccessArticle
School of Nursing Climate Commitment: Nursing Faculty Bring Climate to the Classroom
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Shanda Demorest, Cara Cook, Elizabeth Schenk, Lisa Whitfield Harris and Andrea Earley
Int. J. Environ. Res. Public Health 2024, 21(5), 589; https://doi.org/10.3390/ijerph21050589 - 03 May 2024
Abstract
In 2021, the American Association of Colleges of Nursing (AACN) added “the impact of climate change on environmental and population health” into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year
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In 2021, the American Association of Colleges of Nursing (AACN) added “the impact of climate change on environmental and population health” into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC)—a campaign to educate 50,000 health professionals about health impacts of climate change—launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty (1) integrated resources into didactic and clinical settings, such as population or organ-system content, leadership, and policy; and (2) used resources to support assignments. In four years, faculty reported educating over 37,700 students, using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.
Full article
(This article belongs to the Special Issue The Intersection of Nursing Education, Public Health and Climate Change)
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Open AccessEssay
Medical Interpreting Services for Refugees in Canada: Current State of Practice and Considerations in Promoting this Essential Human Right for All
by
Akshaya Neil Arya, Ilene Hyman, Tim Holland, Carolyn Beukeboom, Catherine E. Tong, Rachel Talavlikar and Grace Eagan
Int. J. Environ. Res. Public Health 2024, 21(5), 588; https://doi.org/10.3390/ijerph21050588 - 02 May 2024
Abstract
Language barriers, specifically among refugees, pose significant challenges to delivering quality healthcare in Canada. While the COVID-19 pandemic accelerated the emergence and development of innovative alternatives such as telephone-based and video-conferencing medical interpreting services and AI tools, access remains uneven across Canada. This
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Language barriers, specifically among refugees, pose significant challenges to delivering quality healthcare in Canada. While the COVID-19 pandemic accelerated the emergence and development of innovative alternatives such as telephone-based and video-conferencing medical interpreting services and AI tools, access remains uneven across Canada. This comprehensive analysis highlights the absence of a cohesive national strategy, reflected in diverse funding models employed across provinces and territories, with gaps and disparities in access to medical interpreting services. Advocating for medical interpreting, both as a moral imperative and a prudent investment, this article draws from human rights principles and ethical considerations, justified in national and international guidelines, charters, codes and regulations. Substantiated by a cost-benefit analysis, it emphasizes that medical interpreting enhances healthcare quality and preserves patient autonomy. Additionally, this article illuminates decision-making processes for utilizing interpreting services; recognizing the pivotal roles of clinicians, interpreters, patients and caregivers within the care circle; appreciating intersectional considerations such as gender, culture and age, underscoring the importance of a collaborative approach. Finally, it provides recommendations at provider, organizational and system levels to ensure equitable access to this right and to promote the health and well-being of refugees and other individuals facing language barriers within Canada’s healthcare system.
Full article
(This article belongs to the Special Issue Migrant Health and Newly Emerging Public Health Issues)
Open AccessArticle
Effects on Child Development and Parent–Child Interaction of the FACAM Intervention: A Randomized Controlled Study of an Interdisciplinary Intervention to Support Women in Vulnerable Positions through Pregnancy and Early Motherhood
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Maiken Pontoppidan, Lene Nygaard, Jonas Cuzulan Hirani, Mette Thorsager, Mette Friis-Hansen, Deborah Davis and Ellen Aagaard Nohr
Int. J. Environ. Res. Public Health 2024, 21(5), 587; https://doi.org/10.3390/ijerph21050587 - 02 May 2024
Abstract
Health inequality can have a profound impact on a child’s life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health
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Health inequality can have a profound impact on a child’s life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health nurse or family therapist from pregnancy until the child starts school. This study examined the effects of FACAM intervention on pregnant women in vulnerable positions and their children until the child turned two years old. We randomly assigned 331 pregnant women to either FACAM intervention or care as usual and assessed them at baseline and when the infant was 3–6, 12–13.5, and 24 months old. The primary outcome was maternal sensitivity measured by Coding Interactive Behavior (CIB). Secondary outcomes included the parent–child relationship, child social–emotional development, child developmental progress, parent–child interaction, and child development. Our findings indicate that care-as-usual children were significantly more involved than FACAM children when the child was 4–6 months old (b = −0.25, [−0.42; −0.08] d = −0.42). However, we suspect this result is due to a biased dropout. We did not find any significant differences in any other outcomes. Therefore, the study suggests that the FACAM intervention is not superior to care as usual regarding child development and parent–child interaction outcomes.
Full article
(This article belongs to the Special Issue Health Promotion and Interventions for Marginalized Mothers and Children)
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Open AccessArticle
Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students
by
Julia Burlaka, Renee M. Johnson, Christina N. Marsack-Topolewski, Kathryn Hughesdon, Jill Owczarzak, Oleksii Serdiuk, Roman Bogdanov and Viktor Burlaka
Int. J. Environ. Res. Public Health 2024, 21(5), 586; https://doi.org/10.3390/ijerph21050586 - 02 May 2024
Abstract
Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting
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Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting behaviors relate to depressive symptoms among Ukrainian college students. Health-promoting behaviors are an important strategy to prevent depression, whereas substance use can contribute to depression or make it harder to manage. Given the substantial psychosocial problems and stressors related to the ongoing war in Ukraine and the limited availability of mental health services for college students, it is important to understand how we can encourage college students to keep themselves mentally healthy. A cross-sectional study was conducted among college students on 10 campuses in 2018. Almost 16% of participants met a cut-off for depression. Female students and those who were older reported significantly higher depressive symptoms. Participants were more likely to report depressive symptoms if they were more often involved with alcohol and cannabis use, were older, and engaged in fewer health-promoting behaviors. Tobacco use was not significantly associated with depressive symptoms. Our findings suggest a moderate prevalence of depressive symptoms in our study population. We recommend implementing balanced public health interventions that address risk factors (such as substance use) while also promoting protective behaviors and can be tailored to the specific cultural and environmental context of the region.
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Open AccessArticle
Understanding How Green Space Naturalness Impacts Public Well-Being: Prospects for Designing Healthier Cities
by
Adriano Bressane, Mirela Beatriz Silva, Ana Paula Garcia Goulart and Líliam César de Castro Medeiros
Int. J. Environ. Res. Public Health 2024, 21(5), 585; https://doi.org/10.3390/ijerph21050585 - 02 May 2024
Abstract
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Statement of problem: Urbanization has brought significant advancements in human well-being; however, it poses challenges to urban green spaces (UGSs), affecting environmental quality and public health. Research gap: Previous studies have established the importance of UGSs for urban well-being but have
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Statement of problem: Urbanization has brought significant advancements in human well-being; however, it poses challenges to urban green spaces (UGSs), affecting environmental quality and public health. Research gap: Previous studies have established the importance of UGSs for urban well-being but have not sufficiently explored how the naturalness of these spaces—ranging from untouched natural areas to human-designed landscapes—affects mental health outcomes in the context of developing countries, particularly Brazil. Purpose: This study aimed to bridge the research gap by investigating the relationship between the degree of naturalness in UGSs and mental health among residents of Brazilian metropolitan areas. Method: Data were collected through an online survey involving 2136 respondents from various Brazilian urban regions. The study used Welch’s ANOVA and Games–Howell post hoc tests to analyze the impact of UGS naturalness on mental health, considering depression, anxiety, and stress levels. Results and conclusions: The findings revealed that higher degrees of naturalness in UGSs significantly correlate with lower levels of mental distress. These results underscore the necessity of integrating natural elements into urban planning to enhance public health. Practical implications: Urban planners and policymakers are encouraged to prioritize the preservation and creation of naturalistic UGSs in urban environments to improve mental health outcomes. Future directions: Further research should explore the specific attributes of naturalness that most contribute to well-being and examine the scalability of these findings across different cultural and environmental contexts.
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Open AccessArticle
Feasibility and Acceptability of a Meditation Mobile App Intervention for Adolescent and Young Adult Survivors of Childhood Cancer
by
Gary Kwok, Archana Sharma, Ivelisse Mandato and Katie A. Devine
Int. J. Environ. Res. Public Health 2024, 21(5), 584; https://doi.org/10.3390/ijerph21050584 - 02 May 2024
Abstract
Background: Adolescent and young adult (AYA) survivors of childhood cancer are increasingly recognized as a vulnerable group with unique emotional, social, and practical needs due to the intersection of cancer survivorship and normal developmental processes. Mindfulness meditation has shown early efficacy in improving
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Background: Adolescent and young adult (AYA) survivors of childhood cancer are increasingly recognized as a vulnerable group with unique emotional, social, and practical needs due to the intersection of cancer survivorship and normal developmental processes. Mindfulness meditation has shown early efficacy in improving psychological distress among cancer patients. However, the overall scientific study of app-based mindfulness-based interventions is still in its early stages. The goal of this study was to evaluate the feasibility and acceptability of a commercially available mindfulness mobile app intervention “Ten Percent Happier” among AYA survivors of childhood cancer. Methods: We conducted a single-arm pilot intervention with 25 AYA survivors of childhood cancer ages 18–29 years. Results: A total of 108 potentially eligible individuals were initially identified for screening. Of the 45 individuals reached (contact rate = 41.67%), 20 declined to participate; 25 were enrolled in the study and completed the baseline survey (enrollment rate = 55.56%). Twenty-one participants completed the study (retention rate = 84%). Changes in several outcomes were promising, with medium to large effect sizes: Mindfulness (d = 0.74), Negative Emotion (d = 0.48), Perceived Stress (d = 0.52), and Mental Health (d = 0.45). Furthermore, results suggested that participants with consistent app usage showed greater improvement in reported outcomes than those who stopped their usage (e.g., Mindfulness: d = 0.74, Perceived Stress: d = 0.83, Mental Health: d = 0.51; Meaning and Purpose: d = 0.84; and Sleep Disturbance: d = 0.81). Qualitative feedback indicated high satisfaction, but participants suggested adding group or individual peer support to improve their experience with the app. Conclusions: AYA survivors can be difficult to reach, but a mindfulness app was feasible and acceptable to this group. In particular, the robust retention rate and high satisfaction ratings indicate that the meditation mobile app was well received. Preliminary results suggest positive changes in health-related quality of life outcomes, warranting a larger efficacy trial.
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(This article belongs to the Special Issue Mental Health of Cancer Patients and Caregivers)
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Open AccessReview
Changes in Sleep Duration and Sleep Timing in the General Population from before to during the First COVID-19 Lockdown: A Systematic Review and Meta-Analysis
by
Chiara Ceolin, Federica Limongi, Paola Siviero, Caterina Trevisan, Marianna Noale, Filippo Catalani, Silvia Conti, Elisa Di Rosa, Elena Perdixi, Francesca Remelli, Federica Prinelli and Stefania Maggi
Int. J. Environ. Res. Public Health 2024, 21(5), 583; https://doi.org/10.3390/ijerph21050583 - 02 May 2024
Abstract
Background: The COVID-19 lockdown had a profound effect on everyday life, including sleep health. This systematic review and meta-analysis evaluated changes in quantitative sleep parameters during the first lockdown compared with pre-lockdown in the general population. Methods: A search in scientific databases was
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Background: The COVID-19 lockdown had a profound effect on everyday life, including sleep health. This systematic review and meta-analysis evaluated changes in quantitative sleep parameters during the first lockdown compared with pre-lockdown in the general population. Methods: A search in scientific databases was performed to identify eligible observational studies from inception to 8 February 2023. We performed a random effects meta-analysis of those studies reporting (a) means of sleep duration, time in bed (TIB), and sleep timing (bedtime and wake-up time); (b) the percentages of atypical sleep duration before and during the lockdown; (c) the percentages of change in sleep duration and sleep timing. Results: A total of 154 studies were included. A small increase in sleep duration (0.25 standardized mean difference, 95% CI 0.180–0.315) was found, with 55.0% of the individuals reporting changes, predominantly an increase (35.2%). The pooled relative risk for sleeping more than 8/9 h per night was 3.31 (95% IC 2.60–4.21). There was a moderately significant delay in sleep timing and a surge in napping. Conclusion: An increase in sleep duration and napping, and delayed sleep timing were observed. High-quality studies should evaluate whether these parameters have now become chronic or have returned to pre-lockdown values.
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(This article belongs to the Section Global Health)
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Open AccessArticle
Evolving Adult ADHD Care: Preparatory Evaluation of a Prototype Digital Service Model Innovation for ADHD Care
by
Bronwin Patrickson, Lida Shams, John Fouyaxis, Jörg Strobel, Klaus Oliver Schubert, Mike Musker and Niranjan Bidargaddi
Int. J. Environ. Res. Public Health 2024, 21(5), 582; https://doi.org/10.3390/ijerph21050582 - 01 May 2024
Abstract
Background: Given the prevalence of ADHD and the gaps in ADHD care in Australia, this study investigates the critical barriers and driving forces for innovation. It does so by conducting a preparatory evaluation of an ADHD prototype digital service innovation designed to help
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Background: Given the prevalence of ADHD and the gaps in ADHD care in Australia, this study investigates the critical barriers and driving forces for innovation. It does so by conducting a preparatory evaluation of an ADHD prototype digital service innovation designed to help streamline ADHD care and empower individual self-management. Methods: Semi-structured interviews with ADHD care consumers/participants and practitioners explored their experiences and provided feedback on a mobile self-monitoring app and related service innovations. Interview transcripts were double coded to explore thematic barriers and the enablers for better ADHD care. Results: Fifteen interviews (9 consumers, 6 practitioners) revealed barriers to better ADHD care for consumers (ignorance and prejudice, trust, impatience) and for practitioners (complexity, sustainability). Enablers for consumers included validation/empowerment, privacy, and security frameworks, tailoring, and access. Practitioners highlighted the value of transparency, privacy and security frameworks, streamlined content, connected care between services, and the tailoring of broader metrics. Conclusions: A consumer-centred approach to digital health service innovation, featuring streamlined, private, and secure solutions with enhanced mobile tools proves instrumental in bridging gaps in ADHD care in Australia. These innovations should help to address the gaps in ADHD care in Australia. These innovations should encompass integrated care, targeted treatment outcome data, and additional lifestyle support, whilst recognising the tensions between customised functionalities and streamlined displays.
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(This article belongs to the Special Issue Digital Mental Health: Changes, Challenges and Success Strategies)
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