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
Anthropometric Profile, Overweight/Obesity Prevalence, and Socioeconomic Impact in Moroccan Children Aged 6–12 Years Old with Autism Spectrum Disorder
Int. J. Environ. Res. Public Health 2024, 21(6), 672; https://doi.org/10.3390/ijerph21060672 (registering DOI) - 24 May 2024
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Background: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. Methods: A total of
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Background: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. Methods: A total of 258 children (boys = 195) aged 6 to 12 years old (mean = 9.4 ± 1.4) diagnosed with ASD participated in this study. Besides the body mass and height, four significant anthropometric markers for assessing obesity were examined: body mass index (BMI), body surface area (BSA), waist circumference (WC), and waist-to-height ratio (WHtR). Each anthropometric marker was categorized into one of three cardiometabolic risk levels based on the Z-scores and their corresponding percentiles. The distribution was as follows: low risk (≤84th percentile), high risk (85th–94th percentile), and very high risk (≥95th percentile). Subsequently, a multiple regression analysis was employed to develop an algorithm that generates a composite risk score. This score incorporates all the anthropometric variables simultaneously, while also weighting their individual contributions to the cardiometabolic risk. Results: Children with ASD exhibit an anthropometric profile that markedly increases their susceptibility to cardiometabolic issues. While roughly 11% of the general Moroccan child population is overweight or obese, this figure soars to nearly 60% among children with ASD when considering the central adiposity markers. Furthermore, children from middle-class socioeconomic backgrounds display a more than threefold greater risk of developing overweight or obesity compared to their counterparts from lower socioeconomic backgrounds. Conclusions: This study has, for the first time, provided an up-to-date overview of the cardiometabolic risk in Moroccan children with ASD using traditional anthropometric measurements. The primary risk factor is clearly linked to central (abdominal) adiposity, which is recognized as the most deleterious. This study highlights the need to include general and central obesity markers. This study underscores the importance of incorporating both general and central adiposity markers for a more comprehensive assessment, and it emphasizes the need for closer monitoring within this high-risk population.
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Open AccessReview
Looking beyond Body Structure and Function: ICF Foci and Who Is Being Assessed in Research about Adolescents and Young Adults with Cerebral Palsy—A Scoping Review
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Camila Araújo Santos Santana, Peter Rosenbaum, Jet van der Kemp and Ana Carolina de Campos
Int. J. Environ. Res. Public Health 2024, 21(6), 670; https://doi.org/10.3390/ijerph21060670 (registering DOI) - 24 May 2024
Abstract
Purpose: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. Method:
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Purpose: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. Method: Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13–30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. Results: In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). Conclusions: Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.
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(This article belongs to the Special Issue Current Issues in the Neurological Rehabilitation of Children and Adolescents)
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Open AccessArticle
Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus
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Ginny S. Paleg, Sian A. Williams and Roslyn W. Livingstone
Int. J. Environ. Res. Public Health 2024, 21(6), 669; https://doi.org/10.3390/ijerph21060669 - 23 May 2024
Abstract
Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and
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Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9–15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.
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(This article belongs to the Special Issue Current Issues in the Neurological Rehabilitation of Children and Adolescents)
Open AccessArticle
Association between Sleep Duration, Social Jetlag, and the Metabolic Syndrome by Shift Works
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Minjung Kyung, Sungwon Park, Chang Gi Park and OiSaeng Hong
Int. J. Environ. Res. Public Health 2024, 21(6), 668; https://doi.org/10.3390/ijerph21060668 - 23 May 2024
Abstract
Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the
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Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the moderating effect of sleep duration and social jetlag on this relationship. Data from the National Health and Nutrition Examination Survey (NHANES) in 2017–2020 March were analyzed. Poisson regression models were employed to examine associations. Among 4136 U.S. workers, 53.3% had metabolic syndrome, with a higher proportion of shift workers (63.8% vs. 56.7%, p = 0.001) and those sleeping less than 6 h or more than 9 h per week (22.3% vs. 19.1%, p = 0.044) in the affected group. Shift workers were initially found to have an increased risk of metabolic syndrome (Coef. = 0.03, 95% CI: 0.02, 0.16); however, this association was mitigated when accounting for the interaction with social jetlag. Specifically, 1 to <2 h of social jetlag interacted significantly, increasing metabolic risk (Coef. = 0.15, 95% CI: 0.09, 0.22), whereas 1 to <2 h alone showed a protective effect (Coef. = −0.11, 95% CI: −0.17, −0.06). These findings suggest that optimizing sleep schedules and addressing social jetlag may be crucial in mitigating metabolic syndrome risks among shift workers.
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(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
Open AccessArticle
Public Health Impacts of Ambient Particulate Matter Pollution in Libya from 1990 to 2019: An Analysis of the 2019 Global Burden of Disease (GBD) Study
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David Rojas-Rueda, Sandhya Lamsal, Mohini Kak, Sameh El-Saharty and Christopher H. Herbst
Int. J. Environ. Res. Public Health 2024, 21(6), 667; https://doi.org/10.3390/ijerph21060667 - 23 May 2024
Abstract
Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in
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Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM2.5 concentration in Libya was 38.6 μg/m3 in 2019, marking a 3% increase since 1990. In the same year, PM2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services.
Full article
(This article belongs to the Special Issue Health Impact Assessment)
Open AccessArticle
A Case Study of Ergonomic Risk Assessment in Slovakia with Respect to EU Standard
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Daniela Onofrejova, Miriam Andrejiova, Denisa Porubcanova, Hana Pacaiova and Lydia Sobotova
Int. J. Environ. Res. Public Health 2024, 21(6), 666; https://doi.org/10.3390/ijerph21060666 - 23 May 2024
Abstract
Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct
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Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare several commonly used methods in Slovakia for the assessment of ergonomic risk reflecting current EU and Slovak legislative regulations. A Captiv wireless sensory system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak Legislation), the STN EN 1005-4+A1, and the French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which affects the final evaluation of the measurements. Our experience from applying improved risk assessment methodology may have an impact on Slovak industrial workplaces. It was confirmed that there is a need to create uniform standards for the ergonomic risk assessment of body posture, including a detailed description of the threshold values for individual body segments.
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(This article belongs to the Special Issue Advances in Ergonomics, Human Factors and Safety for Occupational Health)
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Prevalence and Factors Associated with Impaired Maternal–Infant Bonding among Mothers Attending Young Child Clinic in Kampala, Uganda
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Phionah Tukamushabe, Tom Denis Ngabirano, Joyce Nankumbi Okonya and Melissa A. Saftner
Int. J. Environ. Res. Public Health 2024, 21(6), 665; https://doi.org/10.3390/ijerph21060665 - 23 May 2024
Abstract
Impaired maternal–infant bonding can have a negative impact on the mother–infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal–infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence
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Impaired maternal–infant bonding can have a negative impact on the mother–infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal–infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence and factors associated with impaired maternal–infant bonding. Postnatal mothers (n = 422) attending the Young Child Clinic at Kawempe National Referral Hospital participated in the study. Maternal–infant bonding was measured using the Postpartum Bonding Questionnaire (PBQ). Participants with a score ≥ 13 on the PBQ were considered to have impaired maternal–infant bonding. The prevalence of impaired maternal–infant bonding among mothers was 45% (190/422). Logistic regression was used to determine factors associated with impaired maternal–infant bonding. Unmarried mothers (AOR = 2.05, 95% [CI = 1.03–4.09], p = 0.041), unplanned pregnancy (AOR = 5.19, 95% [CI = 3.07–8.82], p < 0.001), first-time mothers (AOR = 2.46, 95% [CI = 1.37–4.43], p = 0.003), female infant (AOR = 1.80, 95% [CI = 1.13–2.86], p = 0.013), mothers with no/low education levels (AOR = 2.29, 95% [CI = 1.05–4.50], p = 0.036), and those who delivered post term (AOR = 2.49, 95% [CI = 1.10–5.67], p = 0.028) were more likely to have impaired maternal–infant bonding. Nurses and midwives in postnatal care should include maternal–infant bonding within their client’s assessment and provide supportive mother-centered care. Interventions to improve maternal–infant bonding should be created and implemented in clinical practice.
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Open AccessArticle
Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains
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Salinda Horgan, Jeanette Prorok, Katie Ellis, Laura Mullaly, Keri-Leigh Cassidy, Dallas Seitz and Claire Checkland
Int. J. Environ. Res. Public Health 2024, 21(6), 664; https://doi.org/10.3390/ijerph21060664 - 23 May 2024
Abstract
This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that
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This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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(This article belongs to the Special Issue Care and Services in Healthy Aging)
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Risk and Protective Factors for Injury in Adult Front- and Rear-Seated Motor Vehicle Occupants in New York State
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Laura Zhang, Emilia Pawlowski, Leah M. Hines, Michael J. Bauer and Joyce C. Pressley
Int. J. Environ. Res. Public Health 2024, 21(6), 663; https://doi.org/10.3390/ijerph21060663 - 22 May 2024
Abstract
Although seatbelt use is known to reduce motor vehicle occupant crash injury and death, rear-seated adult occupants are less likely to use restraints. This study examines risk and protective factors associated with injury severity in front- and rear-seated adults involved in a motor
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Although seatbelt use is known to reduce motor vehicle occupant crash injury and death, rear-seated adult occupants are less likely to use restraints. This study examines risk and protective factors associated with injury severity in front- and rear-seated adults involved in a motor vehicle crash in New York State. The Crash Outcome Data Evaluation System (CODES) (2016–2017) was used to examine injury severity in front- and rear-seated occupants aged 18 years or older (N= 958,704) involved in a motor vehicle crash. CODES uses probabilistic linkage of New York State hospitalization, emergency department, and police and motorist crash reports. Multivariable logistic regression models with MI analyze employed SAS 9.4. Odds ratios are reported as OR with 95% CI. The mortality rate was approximately 1.5 times higher for rear-seated than front-seated occupants (136.60 vs. 92.45 per 100,000), with rear-seated occupants more frequently unrestrained than front-seated occupants (15.28% vs. 1.70%, p < 0.0001). In adjusted analyses that did not include restraint status, serious injury/death was higher in rear-seated compared to front-seated occupants (OR:1.272, 1.146–1.412), but lower once restraint use was added (OR: 0.851, 0.771–0.939). Unrestrained rear-seated occupants exhibited higher serious injury/death than restrained front-seated occupants. Unrestrained teens aged 18–19 years old exhibit mortality per 100,000 occupants that is more similar to that of the oldest two age groups than to other young and middle-aged adults. Speeding, a drinking driver, and older vehicles were among the independent predictors of serious injury/death. Unrestrained rear-seated adult occupants exhibit higher severe injury/death than restrained front-seated occupants. When restrained, rear-seated occupants are less likely to be seriously injured than restrained front-seated occupants.
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(This article belongs to the Special Issue Road Traffic Risk Assessment: Control and Prevention of Collisions)
Open AccessReview
Management of Rheumatoid Arthritis in Primary Care: A Scoping Review
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Francesco Inchingolo, Angelo Michele Inchingolo, Maria Celeste Fatone, Pasquale Avantario, Gaetano Del Vecchio, Carmela Pezzolla, Antonio Mancini, Francesco Galante, Andrea Palermo, Alessio Danilo Inchingolo and Gianna Dipalma
Int. J. Environ. Res. Public Health 2024, 21(6), 662; https://doi.org/10.3390/ijerph21060662 - 22 May 2024
Abstract
Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the
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Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the approach to RA in the PC setting. PubMed, Scopus, and Web of Science were searched using the MESH terms “rheumatoid arthritis” and “primary care” from 2013 to 2023. The search strategy followed the PRISMA-ScR guidelines. The 61 articles selected were analyzed qualitatively in a table and discussed in two sections, namely criticisms and strategies for the management of RA in PC. The main critical issues in the management of RA in PC are the following: difficulty and delay in diagnosis, in accessing rheumatological care, and in using DMARDs by GPs; ineffective communication between GPs and specialists; poor patient education; lack of cardiovascular prevention; and increase in healthcare costs. To overcome these criticisms, several management strategies have been identified, namely early diagnosis of RA, quick access to rheumatology care, effective communication between GPs and specialists, active patient involvement, screening for risk factors and comorbidities, clinical audit, interdisciplinary patient management, digital health, and cost analysis. PC appears to be the ideal healthcare setting to reduce the morbidity and mortality of chronic disease, including RA, if a widespread change in GPs’ approach to the disease and patients is mandatory.
Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
Open AccessArticle
Relationship between Environmental Conditions and Utilisation of Community-Based Mental Health Care: A Comparative Study before and during the COVID-19 Pandemic in Italy
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Eleonora Prina, Federico Tedeschi, Antonio Lasalvia, Damiano Salazzari, Sara Latini, Laura Rabbi, Federica Marando, Elaine van Rijn, Jan Wollgast, Enrico Pisoni, Bertrand Bessagnet, Maxime Beauchamp and Francesco Amaddeo
Int. J. Environ. Res. Public Health 2024, 21(6), 661; https://doi.org/10.3390/ijerph21060661 - 22 May 2024
Abstract
(1) Background: Lower socioeconomic status increases psychiatric service use, exacerbated during the COVID-19 pandemic by environmental stressors like air pollution and limited green spaces. This study aims to assess the influence of sociodemographic and environmental factors on mental health service utilisation. (2) Methods:
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(1) Background: Lower socioeconomic status increases psychiatric service use, exacerbated during the COVID-19 pandemic by environmental stressors like air pollution and limited green spaces. This study aims to assess the influence of sociodemographic and environmental factors on mental health service utilisation. (2) Methods: This retrospective study uses an administrative database focusing on community mental health services in Northeast Italy. Spatial and temporal analyses were used to address space–time dependencies. (3) Results: Findings showed that sociodemographic factors like living in rented apartments and lower education levels predicted higher mental health service use. Environmental factors, such as elevated NO2 levels and, before the pandemic, lower solar radiation and tree cover, correlated with increased service utilisation. COVID-19 reduced most of the pre-existing differences associated with these factors across census blocks with a different composition of sociodemographic and environmental factors. (4) Conclusions: These findings contribute to a better understanding of the impact of the environment on public mental health.
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Open AccessArticle
Relationship between Driving Ability and Physical Fitness Factors in Older Adults: A Multiple Linear Regression Analysis
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Akihiko Katayama, Takenori Abe, Ayako Hase and Nobuyuki Miyatake
Int. J. Environ. Res. Public Health 2024, 21(6), 660; https://doi.org/10.3390/ijerph21060660 - 22 May 2024
Abstract
The number of older drivers is increasing with the aging population; this has led to concerns about traffic accidents involving older drivers. For older adults, the automobile is not just a means of transportation, but a life necessity that promotes social activities and
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The number of older drivers is increasing with the aging population; this has led to concerns about traffic accidents involving older drivers. For older adults, the automobile is not just a means of transportation, but a life necessity that promotes social activities and maintains and improves health-related quality of life. In this study, we aimed to clarify the relationship between driving ability and physical fitness factors among 70 older adult drivers using a single regression analysis and multiple regression models adjusted for age, sex, and other factors. Driving ability was evaluated by driving an actual car on an ordinary road without a simulator. The single regression analysis revealed no relationship between driving ability and any physical fitness factor. In the multiple regression model analysis, only grip strength was an important explanatory factor; however, the driving ability scores decreased as grip strength scores increased. By clarifying the physical fitness factors that influence the maintenance and improvement of driving ability, it is possible to propose more efficient intervention programs to maintain and improve driving ability. We could not identify the relevant physical fitness factors in this study; therefore, further research is required to improve safe driving among older adults.
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(This article belongs to the Special Issue Road Traffic Risk Assessment: Control and Prevention of Collisions)
Open AccessArticle
Effect of a Water, Sanitation, and Hygiene Program on Handwashing with a Cleansing Agent among Diarrhea Patients and Attendants in Healthcare Facilities in the Democratic Republic of the Congo: A Randomized Pilot of the PICHA7 Program
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Alain Mwishingo, Kelly Endres, Lucien Bisimwa, Presence Sanvura, Blessing Muderhwa Banywesize, Jean-Claude Bisimwa, Camille Williams, Jamie Perin, Raissa Boroto, Gisèle Nsimire, Feza Rugusha, Freddy Endeleya, Pacifique Kitumaini, Claude Lunyelunye, Jessy Timsifu, Brigitte Munyerenkana, Justin Bengehya, Ghislain Maheshe, Cirhuza Cikomola and Christine Marie George
Int. J. Environ. Res. Public Health 2024, 21(6), 659; https://doi.org/10.3390/ijerph21060659 - 22 May 2024
Abstract
Healthcare-acquired infections are a major problem in healthcare facility settings around the world. The Democratic Republic of the Congo (DRC) has over 2 million diarrhea patients hospitalized each year. These healthcare settings become high-risk environments for spreading diarrheal illnesses such as cholera. The
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Healthcare-acquired infections are a major problem in healthcare facility settings around the world. The Democratic Republic of the Congo (DRC) has over 2 million diarrhea patients hospitalized each year. These healthcare settings become high-risk environments for spreading diarrheal illnesses such as cholera. The objective of the Preventative Intervention for Cholera for 7 Days (PICHA7) program is to develop evidence-based water, sanitation, and hygiene (WASH) interventions to reduce cholera and other severe diarrheal diseases in the DRC. The study objective was to evaluate the effectiveness of PICHA7 program delivery in increasing handwashing with a cleansing agent at stool/vomit- and food-related events in a healthcare facility setting among diarrhea patients and patient attendants. A pilot of the PICHA7 program was conducted among 284 participants in 27 healthcare facilities from March 2020 to November 2021 in urban Bukavu in the South Kivu Province of the DRC. The standard arm received the standard message provided in the DRC to diarrhea patients on the use of oral rehydration solution and a basic WASH message at healthcare facility discharge. The PICHA7 arm received the PICHA7 WASH pictorial module delivered by a health promoter focused on handwashing with a cleansing agent at the bedside of the diarrhea patient in the healthcare facility and provision of a soapy water bottle (water and detergent powder). Within 24 h of intervention delivery, a three-hour structured observation of handwashing practices at stool/vomit- and food-related events (key events) was conducted in healthcare facilities of diarrhea patients and their attendants. Compared to the standard arm, there was significantly more handwashing with a cleansing agent at key events in the PICHA7 arm (40% vs. 15%) (odds ratio: 5.04; (95% confidence interval (CI): 2.01, 12.7)). These findings demonstrate that delivery of the PICHA7 WASH pictorial module and provision of a soapy water bottle to diarrhea patients and their attendants presents a promising approach to increase handwashing with a cleansing agent among this high-risk population in healthcare facilities in the eastern DRC.
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Open AccessArticle
Community Perceptions of Blackfly Nuisance and Acceptability of the “Slash and Clear” Vector Control Approach in the Ntui Health District of Cameroon: A Qualitative Study
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Joseph Nelson Siewe Fodjo, Serge Ekukole, Julius Taryunyu Njamnshi, Wepnyu Yembe Njamnshi, Kongnyu G. Njamnshi, Leonard Ngarka and Alfred K. Njamnshi
Int. J. Environ. Res. Public Health 2024, 21(6), 658; https://doi.org/10.3390/ijerph21060658 - 22 May 2024
Abstract
Besides being vectors of the onchocerciasis parasite, blackflies are a source of nuisance in onchocerciasis-endemic communities. We investigated the experience of residents in the Ntui Health District (Cameroon) regarding blackfly nuisance and assessed their perceptions of a novel “Slash and Clear” (S&C) intervention
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Besides being vectors of the onchocerciasis parasite, blackflies are a source of nuisance in onchocerciasis-endemic communities. We investigated the experience of residents in the Ntui Health District (Cameroon) regarding blackfly nuisance and assessed their perceptions of a novel “Slash and Clear” (S&C) intervention for blackfly control. Focus group discussions were conducted before and after S&C implementation (respectively, in February 2022 and December 2023). Blackflies were known to emerge from the river areas and cause disease. To prevent blackfly bites, the population often covered their body with protective clothing and applied various substances (kerosene, oil, or lemon) to their skin. Post-intervention data showed reduced blackfly nuisance, and the willingness to sustain blackfly control in the long-term was unanimous among community leaders and members, including the village volunteers who implemented the S&C intervention. In conclusion, blackfly nuisance is evident in the Ntui onchocerciasis focus of Cameroon and led to a panoply of coping practices, some of which could be detrimental to their health. Implementing S&C for blackfly control is well accepted and could sustainably alleviate the nuisance caused by blackflies while simultaneously breaking the onchocerciasis transmission cycle.
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Open AccessArticle
Public Telemedicine Policy in Brazilian Unified Health System: An Impact Analysis
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Angela Maria de Oliveira, Marcos Aurélio Pereira Valadão and Benjamin Miranda Tabak
Int. J. Environ. Res. Public Health 2024, 21(6), 657; https://doi.org/10.3390/ijerph21060657 - 22 May 2024
Abstract
There are several difficulties in evaluating interventions seeking to promote public health policies. In this article, we analyzed the promotion of the use of telemedicine during COVID-19 in Brazil. Using the random promotion method with instrumental variables, we showed that the policy of
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There are several difficulties in evaluating interventions seeking to promote public health policies. In this article, we analyzed the promotion of the use of telemedicine during COVID-19 in Brazil. Using the random promotion method with instrumental variables, we showed that the policy of promoting telemedicine was adequate, with intense use of this type of care. Our results showed that telemedicine works if it is encouraged in the population. We contributed to the discussion of public health policies and their impact on the population’s health in times of health crisis, such as during the COVID-19 pandemic.
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(This article belongs to the Special Issue Digital Technology for Disease Treatment)
Open AccessArticle
Ideational Slippage in Middle-Aged and Older Adults: A Preliminary Study
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Eamonn P. Arble, Steven W. Steinert, Sneha Shankar, Alex Cerjanic, Bradley P. Sutton and Ana M. Daugherty
Int. J. Environ. Res. Public Health 2024, 21(6), 656; https://doi.org/10.3390/ijerph21060656 - 22 May 2024
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Ideational slippage—characterized by incorrect word usage and strained logic during dialogue—is common in aging and, at greater frequency, is an indicator of pre-clinical cognitive decline. Performance-based assessment of ideational slippage may be useful in the study of cognitive aging and Alzheimer’s-disease-related pathology. In
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Ideational slippage—characterized by incorrect word usage and strained logic during dialogue—is common in aging and, at greater frequency, is an indicator of pre-clinical cognitive decline. Performance-based assessment of ideational slippage may be useful in the study of cognitive aging and Alzheimer’s-disease-related pathology. In this preliminary study, we examine the association between corpus callosum volume and a performance-based assessment of ideational slippage in middle-aged and older adults (age 61–79 years). Ideational slippage was indexed from cognitive special scores using the Rorschach Inkblot Method (RIM), which are validated indices of deviant verbalization and logical inaccuracy (Sum6, WSum6). Among middle-aged and older adults, smaller splenium volume was associated with greater ideational slippage (ηp2 = 0.48), independent of processing speed and fluid intelligence. The observed negative associations are consistent with visuospatial perception and cognitive functions of the splenium. The effect was strongest with the splenium, and volumes of the genu and total white matter had small effects that were not statistically significant. Conclusions: Results are discussed with future application of RIM special scores for the assessment of pre-clinical cognitive decline and, based on observed effect sizes, power analyses are reported to inform future study planning.
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Open AccessArticle
The Role of Attachment Anxiety and Avoidance in Predicting Proximal Minority Stressors among Gay and Lesbian People in Italy
by
Tommaso Trombetta, Maria Noemi Paradiso, Fabrizio Santoniccolo and Luca Rollè
Int. J. Environ. Res. Public Health 2024, 21(6), 655; https://doi.org/10.3390/ijerph21060655 - 21 May 2024
Abstract
As has been widely documented, minority stress affects the psychosocial well-being of gay and lesbian people. Recently, researchers have turned their attention to psychological factors that may influence the level of minority stress experienced, in order to explain individual differences in perceptions of
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As has been widely documented, minority stress affects the psychosocial well-being of gay and lesbian people. Recently, researchers have turned their attention to psychological factors that may influence the level of minority stress experienced, in order to explain individual differences in perceptions of proximal minority stressors. The present research aimed at assessing the effect of attachment avoidance and anxiety on levels of perceived stigma and internalized homonegativity. A total of 163 participants who self-identified as lesbian or gay (Mage = 32.56, SD = 10.87) were recruited and responded to the self-report questionnaires. Two multiple regression models were applied to assess the association between adult attachment and perceived stigma and internalized homonegativity. Results showed a positive association between attachment anxiety and avoidance and internalized homonegativity, as well as between attachment avoidance and perceived stigma. The emerging results demonstrate the impact of attachment anxiety and avoidance on proximal minority stressors and provide useful data for interventions addressing lesbian and gay people aimed at promoting security-based strategies of affect regulation and positive representations of self and others, which in turn may reduce the level of proximal minority stressors experienced and promote psychosocial well-being.
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(This article belongs to the Special Issue Advances in Attachment Processes in Adolescence and Adulthood: Contexts and Developmental Trajectories at Risk)
Open AccessSystematic Review
The Risk of Aircraft-Acquired SARS-CoV-2 Transmission during Commercial Flights: A Systematic Review
by
Diana Zhao, Stephanie Cheng, Fuchiang R. Tsui, Maya B. Mathur and Chih-Hung Jason Wang
Int. J. Environ. Res. Public Health 2024, 21(6), 654; https://doi.org/10.3390/ijerph21060654 - 21 May 2024
Abstract
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The aircraft-acquired transmission of SARS-CoV-2 poses a public health risk. Following PRISMA guidelines, we conducted a systematic review and analysis of articles, published prior to vaccines being available, from 24 January 2020 to 20 April 2021 to identify factors important for transmission. Articles
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The aircraft-acquired transmission of SARS-CoV-2 poses a public health risk. Following PRISMA guidelines, we conducted a systematic review and analysis of articles, published prior to vaccines being available, from 24 January 2020 to 20 April 2021 to identify factors important for transmission. Articles were included if they mentioned index cases and identifiable flight duration, and excluded if they discussed non-commercial aircraft, airflow or transmission models, cases without flight data, or that were unable to determine in-flight transmission. From the 15 articles selected for in-depth review, 50 total flights were analyzed by flight duration both as a categorical variable—short (<3 h), medium (3–6 h), or long flights (>6 h)—and as a continuous variable with case counts modeled by negative binomial regression. Compared to short flights without masking, medium and long flights without masking were associated with 4.66-fold increase (95% CI: [1.01, 21.52]; p < 0.0001) and 25.93-fold increase in incidence rates (95% CI: [4.1, 164]; p < 0.0001), respectively; long flights with enforced masking had no transmission reported. A 1 h increase in flight duration was associated with 1.53-fold (95% CI: [1.19, 1.66]; p < 0.001) increase in the incidence rate ratio (IRR) of cases. Masking should be considered for long flights.
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Open AccessArticle
Spirituality, Religiosity, and Mental Health in Patients with Idiopathic Inflammatory Myopathies: A Brazilian Multicentric Case–Control Study
by
Jucier Gonçalves Júnior, Alexandre Moura dos Santos, Romão Augusto Alves Filgueira Sampaio, Thalita do Nascimento Silva, Giovanna Martines, Daniel Brito de Araújo, Estelita Lima Cândido and Samuel Katsuyuki Shinjo
Int. J. Environ. Res. Public Health 2024, 21(6), 653; https://doi.org/10.3390/ijerph21060653 - 21 May 2024
Abstract
No published studies have investigated the correlation between religiosity, spirituality, mental health, and idiopathic inflammatory myopathy (IIM) or systemic autoimmune myopathy. Therefore, we aimed to evaluate the association between religiosity/spirituality, sociodemographic factors, and the mental health of IIM patients. This is a multicenter
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No published studies have investigated the correlation between religiosity, spirituality, mental health, and idiopathic inflammatory myopathy (IIM) or systemic autoimmune myopathy. Therefore, we aimed to evaluate the association between religiosity/spirituality, sociodemographic factors, and the mental health of IIM patients. This is a multicenter case–control study that included 151 patients with IIMs and 95 individuals without autoimmune diseases (controls), held between August 2022 and April 2023. This study used a semi-structured questionnaire that included sociodemographic information and the juxtaposition of the following questionnaires: the Attitudes Related to Spirituality Scale (ARES); the Duke University Religion Index (DUKE), which is composed of the organizational religious affiliation (ORA), non-organizational religious affiliation (NORA), and intrinsic religiosity (IR) domains; and the General Health Questionnaire-12 (GHQ-12). Data were analyzed using Epi Info software 7.2.5 (Centers for Disease Control and Prevention, Atlanta, GA, USA). A comparison between the mean values of the ARES, DUKE, and GHQ-12 scales was made using the Wilcoxon–Mann–Whitney and Kruskal–Wallis tests. A logistic regression test was used with the variables whose difference was statistically significant in the univariate analysis. Correlation analysis was performed using the Spearman rho coefficient. A higher prevalence of evangelicals and a lower prevalence of Catholics (p < 0.050) were seen in the IIM group compared to controls. Positive association was demonstrated between IIMs and the pardo ethnicity (OR = 2.26, 95% CI = 1.20–4.25, p = 0.011), highest ORA (OR = 2.81, 95% CI = 1.53–5.15, p < 0.001), NORA (OR = 3.99, 95% CI = 1.94–8·18, p < 0.001), IR (OR = 5.27, 95% CI = 2.32–11.97, p < 0.001), and ARES values (OR = 1.08, 95% CI = 1.04–1.13, p < 0.001). Mental health levels were compared between the groups (p > 0.999). Therefore, higher levels of religiosity and spirituality were observed in the IIM group than in the control group, but there was a similar distribution of mental health levels. The following can be cited as advantages of the present study: (i) the large sample for a rare disease with the presence of a control group; (ii) the multicenter characteristic with participation from three regions of Brazil; (iii) being the first study to map aspects of religiosity, spirituality, and mental health in IIMs.
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Open AccessArticle
Exploring Mechanisms behind Migration’s Impact on Protein Intake of Left-Behind Household Members: A Panel Analysis from China
by
Xueting Pan and Jiaqi Huang
Int. J. Environ. Res. Public Health 2024, 21(6), 652; https://doi.org/10.3390/ijerph21060652 - 21 May 2024
Abstract
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Malnutrition remains a critical global health challenge, especially in rural areas, where it significantly impacts the health and economic stability of households. This study explores (1) the relationship between labor migration and dietary protein intake in households remaining in economically disadvantaged rural regions
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Malnutrition remains a critical global health challenge, especially in rural areas, where it significantly impacts the health and economic stability of households. This study explores (1) the relationship between labor migration and dietary protein intake in households remaining in economically disadvantaged rural regions and (2) the influence of remittance income, farm earnings, self-produced food, and changes in family size due to migration on their dietary protein. Panel data were collected through a three-wave household survey of 1368 rural households across six counties in the provinces of Guizhou, Yunnan, and Shaanxi during 2012, 2015, and 2018. Employing a two-way fixed effects model, we found that labor migration positively affects the protein consumption of families left behind. The mediated effects model indicated that decreases in family size had the most significant impact on protein intake, with a value of 8.714, accounting for 0.729 of the total effect; followed by the mediating effect through crop income, at 2.579, representing 0.216 of the total effect; and livestock income, at 0.772, contributing 0.073 of the total effect. However, the mediating effects of remittance income and self-production were found to be insignificant. In conclusion, our study found that migration improves protein intake primarily through increased crop and livestock production and decreased family size. These results highlight the critical role of family structure and farm productivity in enhancing the nutrition of families affected by labor migration, offering valuable insights for policymakers.
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