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Int. J. Environ. Res. Public Health, Volume 21, Issue 4 (April 2024) – 137 articles

Cover Story (view full-size image): The under-reporting of laboratory-confirmed community-based GI infections creates a barrier for epidemiologists to understand the pathogen burden and seasonal trends of GI pathogens. Syndromic surveillance, which involves the use of real-time data and a wider population coverage, offers an alternative solution. This systematic review examines its role in early detection and monitoring of GI infections. From 1820 studies, 1694 were reviewed after removing duplicates. The focus was on studies evaluating syndromic surveillance effectiveness for GI infections. In total, 29 eligible studies were included, showing its routine use and validation in ten countries, mainly utilizing emergency department data. While promising, 24% of the studies lacked conclusive findings, highlighting the need for further investigation into syndromic surveillance systems’ strengths and limitations. View this paper
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14 pages, 978 KiB  
Article
Effects of Standardized Patient Simulation and Mobile Applications on Nursing Students’ Clinical Competence, Self-Efficacy, and Cultural Competence: A Quasi-Experimental Study
by Duc Nu Minh Ton, Trang Thi Kieu Duong, Hang Thi Tran, Thanh Thi Thanh Nguyen, Hai Ba Mai, Phuong Thi Anh Nguyen, Binh Duy Ho and Trang Thi Thuy Ho
Int. J. Environ. Res. Public Health 2024, 21(4), 515; https://doi.org/10.3390/ijerph21040515 - 22 Apr 2024
Viewed by 1168
Abstract
Background: Simulation-based education has emerged as an effective approach in nursing education worldwide. We aimed to evaluate the effectiveness of a surgical nursing education program based on a simulation using standardized patients and mobile applications among nursing students. Methods: A mixed-methods design with [...] Read more.
Background: Simulation-based education has emerged as an effective approach in nursing education worldwide. We aimed to evaluate the effectiveness of a surgical nursing education program based on a simulation using standardized patients and mobile applications among nursing students. Methods: A mixed-methods design with a quasi-experimental longitudinal approach and focus group interviews was employed. The data were collected from 130 third-year nursing students at three different time points who were equally divided into experimental and control groups. This study measured the level of clinical surgical nursing competence, self-efficacy in clinical performance, cultural competence, and satisfaction with simulation experience. Four focus group interviews were conducted using open-ended questions to explore the participants’ perspectives on the course’s efficacy and satisfaction. Results: There were statistically significant differences in clinical surgical nursing competence (F = 8.68, p < 0.001), self-efficacy in clinical performance (F = 13.56, p < 0.001), and cultural competence (F = 10.35, p < 0.001) across time between the intervention and control groups. Student satisfaction with the simulation-based training was high, particularly regarding debriefing and reflection, with an overall mean satisfaction level of 4.25 (0.40). Students’ perspectives regarding integrated hybrid training are categorized into three themes: educational achievement, dynamic learning experiences, and satisfaction and suggestion. Conclusion: Simulation-based learning provides a dynamic and immersive educational experience that enables undergraduate nursing students to develop and refine essential clinical skills while also fostering confidence and cultural competence. Full article
(This article belongs to the Section Health Care Sciences)
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13 pages, 322 KiB  
Article
An Exploration of People Living with Parkinson’s Experience of Cardio-Drumming; Parkinson’s Beats: A Qualitative Phenomenological Study
by J. Yoon Irons, Alison Williams, Jo Holland and Julie Jones
Int. J. Environ. Res. Public Health 2024, 21(4), 514; https://doi.org/10.3390/ijerph21040514 - 22 Apr 2024
Viewed by 1079
Abstract
Research has shown that physical activity has a range of benefits for people living with Parkinson’s (PLwP), improving muscle strength, balance, flexibility, and walking, as well as non-motor symptoms such as mood. Parkinson’s Beats is a form of cardio-drumming, specifically adapted for PLwP, [...] Read more.
Research has shown that physical activity has a range of benefits for people living with Parkinson’s (PLwP), improving muscle strength, balance, flexibility, and walking, as well as non-motor symptoms such as mood. Parkinson’s Beats is a form of cardio-drumming, specifically adapted for PLwP, and requires no previous experience nor skills. Nineteen PLwP (aged between 55 and 80) took part in the regular Parkinson’s Beats sessions in-person or online. Focus group discussions took place after twelve weeks to understand the impacts of Parkinson’s Beats. Through the framework analysis, six themes and fifteen subthemes were generated. Participants reported a range of benefits of cardio-drumming, including improved fitness and movement, positive mood, the flow experience, and enhanced social wellbeing. A few barriers to participation were also reported. Future research is justified, and best practice guidelines are needed to inform healthcare professionals, PLwP and their care givers. Full article
(This article belongs to the Special Issue Interventions to Promote Physical Activity and Healthy Ageing)
10 pages, 282 KiB  
Article
Peer Support for Caregivers of People Living with Posterior Cortical Atrophy in Melbourne, Australia: A Feasibility Study
by Alexander Mitchell, Wendy Kelso, Camille Paynter, Leanne Hayes, Dennis Velakoulis and Samantha M. Loi
Int. J. Environ. Res. Public Health 2024, 21(4), 513; https://doi.org/10.3390/ijerph21040513 - 22 Apr 2024
Viewed by 947
Abstract
Posterior Cortical Atrophy (PCA) is a rare form of young-onset dementia that causes early visuospatial and visuoperceptual deficits. The symptom profile of Posterior Cortical Atrophy leads to very specific care needs for those affected, who often rely on informal caregivers (including friends and [...] Read more.
Posterior Cortical Atrophy (PCA) is a rare form of young-onset dementia that causes early visuospatial and visuoperceptual deficits. The symptom profile of Posterior Cortical Atrophy leads to very specific care needs for those affected, who often rely on informal caregivers (including friends and family). Rare dementia support groups can be useful for both patients and their caregivers to assist with knowledge sharing, psychoeducation, and the provision of psychosocial support. Despite this, few such support groups exist. The purpose of this study was to examine a PCA support group for caregivers of individuals living with PCA. We held a structured psychoeducation support group comprised of four sessions with the aim being to provide education, strategies for the management of the disease, and peer support. Caregivers’ mental health and quality of life were assessed. The results of our study showed that support group participation was a positive experience and assisted with increasing the knowledge of caregivers and fostering social connections. We suggest that peer support groups may be beneficial for both people living with PCA and their caregivers. We recommend that future quantitative and qualitative research is conducted to further assess health-promotion benefits to people living with PCA and their caregivers, and to assess their development and implementation in different contexts. Full article
16 pages, 746 KiB  
Article
Understanding the Risk of Social Vulnerability for the Chinese Diaspora during the COVID-19 Pandemic: A Model Driving Risk Perception and Threat Appraisal of Risk Communication—A Qualitative Study
by Doris Yuet Lan Leung, Hilary Hwu, Shoilee Khan, Aaida Mamuji, Jack Rozdilsky, Terri Chu and Charlotte Lee
Int. J. Environ. Res. Public Health 2024, 21(4), 512; https://doi.org/10.3390/ijerph21040512 - 21 Apr 2024
Cited by 1 | Viewed by 1023
Abstract
During the first wave of the COVID-19 pandemic, immigrants were among the most socially vulnerable in Western countries. The Chinese diaspora in Canada were one such group due to the widespread cultural stigma surrounding their purported greater susceptibility to transmit and become infected [...] Read more.
During the first wave of the COVID-19 pandemic, immigrants were among the most socially vulnerable in Western countries. The Chinese diaspora in Canada were one such group due to the widespread cultural stigma surrounding their purported greater susceptibility to transmit and become infected by COVID-19. This paper aims to understand the social vulnerability of the Chinese diaspora in the Greater Toronto Area, Canada, during the first wave of COVID-19 from an explanation of their risk perception and threat appraisal of risk communication. We conducted secondary data analysis of 36 interviews using critical realism. The participants self-identified as being of Chinese descent. The results were used to develop a model of how social vulnerability occurred. In brief, cognitive dissonance was discovered to generate conflicts of one’s cultural identity, shaped by social structures of (i) stigma of contagion, (ii) ethnic stigma, and (iii) public sentiment, and mediated by participants’ threat appraisal and (iv) self-reliance. We assert that risk communicators need to consider their audiences’ diverse socialization in crafting messages to modify behaviors, create a sense of responsibility, and mitigate public health threats. A lack of awareness of one’s cognitive dissonance driven by cultural vulnerability may heighten their social vulnerability and prevent them from taking action to protect themself from high-risk events. Full article
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14 pages, 1166 KiB  
Article
Promoting Teachers’ Social and Emotional Competence in Light of the Close Connection between Professional Role and Personal Characteristics: Preliminary Evidence of the Efficacy of the “ME4YOU” Training Program
by Enrica Ciucci, Carolina Facci, Daniela Carpenzano, Matilde Sanesi, MariaGiulia Taddei, Lucrezia Tomberli, Giovanna Tambasco and Andrea Baroncelli
Int. J. Environ. Res. Public Health 2024, 21(4), 511; https://doi.org/10.3390/ijerph21040511 - 21 Apr 2024
Viewed by 898
Abstract
Within the field of research on the promotion of teachers’ social and emotional competence, the present paper illustrates preliminary evidence of the efficacy of a new training program named “ME4YOU” aimed at supporting teachers’ self-reflexive competences to deal with the emotional and relational [...] Read more.
Within the field of research on the promotion of teachers’ social and emotional competence, the present paper illustrates preliminary evidence of the efficacy of a new training program named “ME4YOU” aimed at supporting teachers’ self-reflexive competences to deal with the emotional and relational dimensions of teaching, with constant and continuous attention towards underlining the close connection between the way teachers perform as professionals at work and the way they function as individuals in their personal life. A total of 109 teachers from kindergarten to primary school took part in the experimental group, while 67 teachers constituted the control group; the two groups were compared using a pre-test/post-test approach with regard to some self-reported variables related to professional and personal aspects. Teachers in the experimental group exhibited increased levels of professional self-efficacy and self-efficacy as emotional socializers toward students’ emotions; moreover—although with a more limited impact—they reported benefits with regard to their personal life (i.e., reduced denial of own emotions and improved authenticity). The findings are discussed highlighting that health promotion among teachers is both of value in itself and an investment that can generate health in the whole school system. Full article
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24 pages, 728 KiB  
Article
A Co-Created Assessment Framework to Measure Inclusive Health and Wellbeing in a Vulnerable Context in the South of Europe
by Isotta Mac Fadden, Roberta Cocchioni and María Mar Delgado-Serrano
Int. J. Environ. Res. Public Health 2024, 21(4), 510; https://doi.org/10.3390/ijerph21040510 - 20 Apr 2024
Viewed by 1260
Abstract
Rapid urbanisation exacerbates health and wellbeing disparities in vulnerable contexts and underscores the imperative need to develop innovative and participatory co-creation approaches to understand and address the specificities of these contexts. This paper presents a method to develop an assessment framework that integrates [...] Read more.
Rapid urbanisation exacerbates health and wellbeing disparities in vulnerable contexts and underscores the imperative need to develop innovative and participatory co-creation approaches to understand and address the specificities of these contexts. This paper presents a method to develop an assessment framework that integrates top-down dimensions with bottom-up perspectives to monitor the impact of inclusive health and wellbeing interventions tailored to the neighbourhood’s needs in Las Palmeras, a vulnerable neighbourhood in Cordoba (Spain). Drawing upon studies in the literature examining urban health and wellbeing trends, it delineates a participatory and inclusive framework, emphasising the need for context-specific indicators and assessment tools. Involving diverse stakeholders, including residents and professionals, it enriches the process and identifies key indicators and assessment methods. This approach provides valuable insights for managing innovative solutions, aligning them with local expectations, and measuring their impact. It contributes to the discourse on inclusive urban health by advocating for participatory, context-specific strategies and interdisciplinary collaboration. While not universally applicable, the framework offers a model for health assessment in vulnerable contexts, encouraging further development of community-based tools for promoting inclusive wellbeing. Full article
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17 pages, 1787 KiB  
Article
Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students
by Rebecca H. Kim, Yvette C. Paulino and Yoshito Kawabata
Int. J. Environ. Res. Public Health 2024, 21(4), 509; https://doi.org/10.3390/ijerph21040509 - 19 Apr 2024
Viewed by 952
Abstract
The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental [...] Read more.
The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017–2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam. Full article
(This article belongs to the Special Issue Disparity of Non-communicable Diseases among Pacific Islanders)
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19 pages, 408 KiB  
Article
Cognitive and Relational Processes Associated to Mental Health in Italian High School Students during COVID-19 and Russian–Ukrainian War Outbreaks
by Attà Negri, Arianna Barazzetti, Alice Rinzivillo, Rachele Mariani and Cinzia Di Monte
Int. J. Environ. Res. Public Health 2024, 21(4), 508; https://doi.org/10.3390/ijerph21040508 - 19 Apr 2024
Viewed by 866
Abstract
The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one’s relational functioning. This study explored the mental [...] Read more.
The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one’s relational functioning. This study explored the mental health of 215 Italian adolescents during the COVID-19 pandemic and the subsequent outbreak of the Russian–Ukrainian war. By administering a set of questionnaires, several cognitive and emotional variables were investigated, including core belief violation, meaning attribution to the pandemic and war, attachment, and emotion regulation, social media addiction, and relationships with significant others and teachers. We conducted some descriptive, mean difference, correlational, and predictive analyses that revealed a significant association between core belief violation caused by war and pandemic, ability to integrate war and pandemic within personal meaning universe, the relational support received, and mental health. The relationship with teachers during these challenging periods improved significantly according to the respondents’ opinion, becoming both more authoritative and empathic. This study offers insights into what cognitive and relational processes are useful to intervene on to reduce the distress of adolescents who are facing significant moments of crisis due to events that challenge their cognitive and emotional balance. Full article
29 pages, 690 KiB  
Review
Exploring Allied Health Models of Care for Children with Developmental Health Concerns, Delays, and Disabilities in Rural and Remote Areas: A Systematic Scoping Review
by Georgia Gosse, Saravana Kumar, Helen Banwell and Anna Moran
Int. J. Environ. Res. Public Health 2024, 21(4), 507; https://doi.org/10.3390/ijerph21040507 - 19 Apr 2024
Viewed by 1128
Abstract
Background: Access to appropriate healthcare is essential for children’s healthy development. This is lacking in rural and remote areas, impacting health outcomes. Despite efforts to improve access for these communities, to date, no review has systematically mapped the literature on allied health models [...] Read more.
Background: Access to appropriate healthcare is essential for children’s healthy development. This is lacking in rural and remote areas, impacting health outcomes. Despite efforts to improve access for these communities, to date, no review has systematically mapped the literature on allied health models of care for children with developmental needs. This scoping review seeks to address this knowledge gap. Methods: Adhering to the PRISMA-ScR and Joanna Briggs Institute guidelines, a systematic search was conducted. A total of 8 databases (from inception to May 2023) and 106 grey literature sources were searched. Two reviewers independently undertook a two-stage screening process. Data were extracted using customised tools and narratively synthesised utilising the Institute of Medicine’s quality domains. This review is registered a priori via Open Science Framework. Results: Twenty-five citations were identified within the literature. Varied models of care were reported from five mostly Western countries. Models of care identified in these areas were classified as screening services, role substitution, consultative services, or online-based services. Positive impacts on quality of healthcare were reported across all quality domains (apart from safety) with the domain of effectiveness being the most commonly reported. Conclusions: Multiple models of care are currently in operation for children with developmental needs in rural and remote areas and appear to improve the quality of care. Due to complexities within, and limitations of, the evidence base, it is unclear if one model of care is superior to another. This review provides a basis for further research to explore why some models may be more effective than others. Full article
(This article belongs to the Special Issue Public Health: Rural Health Services Research)
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21 pages, 1680 KiB  
Review
Fundamental Themes in Social–Emotional Learning: A Theoretical Framework for Inclusivity
by Mickayla Dussault and Robert B. Thompson
Int. J. Environ. Res. Public Health 2024, 21(4), 506; https://doi.org/10.3390/ijerph21040506 - 19 Apr 2024
Viewed by 1208
Abstract
Social–emotional learning (SEL) is a rapidly growing field of research that has garnered significant attention in recent years. Each facet of SEL research in fields such as education, mental health, and developmental research has used specific methodologies and terms in their narrow research [...] Read more.
Social–emotional learning (SEL) is a rapidly growing field of research that has garnered significant attention in recent years. Each facet of SEL research in fields such as education, mental health, and developmental research has used specific methodologies and terms in their narrow research focus. In education specifically, where the most SEL research has been produced, many frameworks have implementation requirements. The lack of a framework focused on overarching themes without implementation requirements prevents the fields from coming together to compile and compare research and progress to create parent-, adult-, or mental health-specific SEL programs. This paper provides a conceptual analysis of SEL, aimed at clarifying the concept and deconstructing its various facets. This framework is needed to acknowledge the many different terms and skills for the same principle while also narrowing down definitions for clarity. The resulting framework can be used as a basis for future research, practice, and policy discussions in the field. Full article
(This article belongs to the Section Behavioral and Mental Health)
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11 pages, 1037 KiB  
Article
Sexist, Racist, and Homophobic Violence against Paramedics in a Single Canadian Site
by Justin Mausz, Joel D’Eath, Nicholas A. Jackson, Mandy Johnston, Alan M. Batt and Elizabeth A. Donnelly
Int. J. Environ. Res. Public Health 2024, 21(4), 505; https://doi.org/10.3390/ijerph21040505 - 19 Apr 2024
Viewed by 1335
Abstract
Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural [...] Read more.
Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between 1 February 2021 and 28 February 2022, two paramedic supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high inter-rater agreement across the dimensions (k = 0.73–0.83), and after resolving discrepant cases, we found that one in four violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience over the course of their work and its potential for psychological harm. Full article
(This article belongs to the Section Health Care Sciences)
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9 pages, 261 KiB  
Case Report
Family-Based Treatment for Anxiety, Depression, and ADHD for a Parent and Child
by Rachel Yoder, Alyssa Michaud, Amanda Feagans, Kendra E. Hinton-Froese, Allison Meyer, Victoria A. Powers, Leah Stalnaker and Melissa K. Hord
Int. J. Environ. Res. Public Health 2024, 21(4), 504; https://doi.org/10.3390/ijerph21040504 - 19 Apr 2024
Viewed by 978
Abstract
Children with mental illness commonly live with caregivers who suffer from mental illness. Integrated mental-health-treatment approaches can provide more convenient and comprehensive care for families. This case report describes family-based treatment (FBT) for one parent/child dyad. The parent was a 37-year-old female with [...] Read more.
Children with mental illness commonly live with caregivers who suffer from mental illness. Integrated mental-health-treatment approaches can provide more convenient and comprehensive care for families. This case report describes family-based treatment (FBT) for one parent/child dyad. The parent was a 37-year-old female with a history of anxiety and major depressive disorder and concern for symptoms of attention-deficit/hyperactivity disorder (ADHD). The child was an 8-year-old female with generalized anxiety disorder and concern for ADHD and behavioral problems. The parent received individual cognitive behavioral therapy (CBT) and parent management training. The child received CBT. Both also received medication management. The FBT team met regularly for coordinated treatment planning. Self-reported assessments via the Child Behavior Checklist showed meaningful improvement; anxiety decreased to nonclinical range week 12 and depression decreased to nonclinical range week 8. Clinician assessments showed improvement for both patients. Though more time intensive, FBT can yield significant improvement, particularly for children. Pragmatic approaches to treatment planning are important to minimize barriers to FBT. Full article
11 pages, 489 KiB  
Review
Intersectional Mentorship in Academic Medicine: A Conceptual Review
by Jae M. Sevelius, Orlando O. Harris and Lisa Bowleg
Int. J. Environ. Res. Public Health 2024, 21(4), 503; https://doi.org/10.3390/ijerph21040503 - 19 Apr 2024
Viewed by 851
Abstract
Academic medical institutions seek to recruit and retain a diverse workforce to foster equitable, supportive environments in which early-stage investigators, especially those who are underrepresented in medicine, can thrive. Intersectionality is a critical theoretical framework rooted in Black feminist activism and scholarship that [...] Read more.
Academic medical institutions seek to recruit and retain a diverse workforce to foster equitable, supportive environments in which early-stage investigators, especially those who are underrepresented in medicine, can thrive. Intersectionality is a critical theoretical framework rooted in Black feminist activism and scholarship that elucidates how power and privilege are differentially structured for groups at different intersectional sociodemographic positions. As a dynamic method of analyzing multiple axes of power and inequality, intersectionality has the potential to offer a critical lens through which to view the mentor–mentee relationship. In this article, we seek to elaborate upon and extend the concept of intersectional mentoring, elucidate its essential components, and explore its application in the context of mentoring early-stage investigators in academic medicine. We propose that intersectional mentorship requires an orientation toward deep cultural humility, lifetime learning about the impact of systemic oppressions on present-day opportunities and experiences of mentees, and changing systems that perpetuate inequities by centering praxis—the application of principles of intersectionality through action to transform power dynamics in academic culture and institutions. Intersectional mentorship can help build a more equitable and representative workforce to advance intersectionally relevant and innovative approaches to achieving health equity. Full article
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11 pages, 536 KiB  
Article
Trend in the Prevalence of Overweight and Obese Adults in São Paulo, Brazil: Analysis between the Years 2006 and 2019
by Alisson Padilha de Lima, Ana Paula de Oliveira Barbosa Nunes, Carolina Ferreira Nicoletti and Fabiana Braga Benatti
Int. J. Environ. Res. Public Health 2024, 21(4), 502; https://doi.org/10.3390/ijerph21040502 - 19 Apr 2024
Viewed by 805
Abstract
The aim of this study was to investigate the trend in the prevalence of overweight and obese adults in São Paulo, Brazil, between 2006 and 2019 across chronic diseases and the domains of physical activity. A descriptive retrospective study was carried out on [...] Read more.
The aim of this study was to investigate the trend in the prevalence of overweight and obese adults in São Paulo, Brazil, between 2006 and 2019 across chronic diseases and the domains of physical activity. A descriptive retrospective study was carried out on the trend in the prevalence of 26.612 overweight and obese adults (10.150 men and 16.462 women). All data analyzed were based on information from the national system for monitoring risk factors called Protective and Risk Factors for Chronic Diseases by Telephone Survey—VIGITEL. The variables obese and overweight were analyzed in general and stratified by sex, age group, education level, each type of physical activity domain (yes or no), presence of hypertension and diabetes (yes or no), and smoking (yes or no). The prevalence of obesity significantly increased from 11.1% in 2006 to 19.8% in 2019, regardless of age, sex, physical activity practice, and presence of diabetes or hypertension, except for people aged 55–64 y, working people, and smokers. The total prevalence of overweight adults significantly increased overall (from 30.5% in 2006 to 33.4% in 2019) but it significantly increased only in females, in people aged 18–24 y, those who are non-white, those with an education level of 9–11 y, those who are not working, those who are non-smokers, those who did not have diabetes or hypertension, and those who were not physically active during leisure time but physically active at work and at home. There was a significant increase in the prevalence of overweight adults and especially of obese adults living in the city of São Paulo (Brazil) between 2006 and 2019, the latter being observed in nearly every analyzed sub-category, regardless of age, sex, physical activity practice, and presence of diabetes or hypertension. Full article
(This article belongs to the Special Issue The Management of Nutrition and Obesity)
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22 pages, 3736 KiB  
Article
Sexually Transmitted Infections in Adolescents and Young Adults: A Cross Section of Public Health
by Nunzia Cannovo, Elena Bianchini, Luciana Gironacci, Elisabetta Garbati, Filiberto Di Prospero, Mariano Cingolani, Roberto Scendoni and Piergiorgio Fedeli
Int. J. Environ. Res. Public Health 2024, 21(4), 501; https://doi.org/10.3390/ijerph21040501 - 19 Apr 2024
Viewed by 1201
Abstract
Introduction. Sexually transmitted infections (STIs) can be caused by a number of microorganisms that vary greatly in size, life cycle, clinical manifestations, and sensitivity to available treatments. Transmission of STIs can occur during unprotected (or condomless) sexual contact and through the exchange of [...] Read more.
Introduction. Sexually transmitted infections (STIs) can be caused by a number of microorganisms that vary greatly in size, life cycle, clinical manifestations, and sensitivity to available treatments. Transmission of STIs can occur during unprotected (or condomless) sexual contact and through the exchange of body fluids during any type of activity. The prevalence of sexually transmitted diseases remains high in the world, despite diagnostic and therapeutic improvements for these infectious diseases that rapidly eliminate the contagiousness of patients. Our study determines the prevalence of STI pathogens in adolescents and young adults in the population of the Province of Macerata (Italy). We will analyze data in correspondence to age and gender, and we will compare our results to international studies. Materials and Method. We analyzed STI test results from the entire database of a Provincial Health Authority for the period 2021–2022. The samples came from the following age groups: 0–12, 13–18, 19–25, and 26–35 from 2021 to 2022. The results came from vaginal and cervical swabs (for females); urethral, rectal, and pharyngeal swabs (for males and females); and seminal fluid (for males) for the following infections: HPV, Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasmas, Gardnerella, Trichomonas vaginalis, Neisseria gonorrhoeae, and Treponema pallidum. The results also came from blood tests for HIV, hepatitis C, hepatitis B, and Treponema pallidum (TPHA, VDRL). In addition, we examined results from urine tests for chlamydia, Neisseria gonorrhoeae, trichomonas, and Treponema pallidum. Conclusions. The literature for other countries reports the need for comprehensive, culturally and developmentally sensitive care to address sexuality-related issues in adolescents and young adults, a need that also applies to Italy. These data will be of great importance in adopting evidence-based STI control programs in Marche Region. This study could, indeed, represent a landmark for public health officials and professionals, with the aim of promoting adolescents’ access to sexual health services to receive useful information, strengthening preventive measures in younger age groups, and designing sexual education programs. Full article
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16 pages, 397 KiB  
Article
Cognitive Profile and Cardiovascular Risk Factors in Older Adults with Mild Cognitive Impairment
by Julia Vázquez-de Sebastián, Angel M. Ortiz-Zuñiga, Andreea Ciudin, Joan Ars, Marco Inzitari, Rafael Simó, Cristina Hernández, Sergio Ariño-Blasco, María José Barahona, Maite Franco, Xavier Gironès, María Cruz Crespo-Maraver, Joan Carles Rovira, Carmina Castellano-Tejedor and The DIALCAT Consortium
Int. J. Environ. Res. Public Health 2024, 21(4), 500; https://doi.org/10.3390/ijerph21040500 - 18 Apr 2024
Viewed by 1001
Abstract
The prevalence of cardiovascular risk factors (CVRFs) in the older adults population and their specific impact on their cognitive profiles still requires further research. For this purpose, a cross-sectional study was carried out to describe the presence of CVRFs and their association with [...] Read more.
The prevalence of cardiovascular risk factors (CVRFs) in the older adults population and their specific impact on their cognitive profiles still requires further research. For this purpose, a cross-sectional study was carried out to describe the presence of CVRFs and their association with cognitive performance in a sample of older adults (65–85 years old) with Mild Cognitive Impairment (MCI). Participants (n = 185) were divided into three groups concerning their cardiovascular risk level determined by the presence of different CVRFs, including Type 2 Diabetes (T2D), dyslipidemia, hypertension, and obesity. The primary outcome measures were the participant’s scores in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Sociodemographic, clinical, and psychosocial data were collected. Non-parametrical statistical analyses and effect sizes were calculated. Findings revealed that a greater presence of CVRFs was not associated with a worse overall cognitive performance. High-risk patients were more likely to have significantly worse performance in the attentional domain compared to medium-risk (p = 0.029, r = 0.42) and compared to low-risk (p = 0.041, r = 0.35), specifically in the digits repetition subtest (p = 0.042). T2D alone was the CVRF associated with cognitive differences (p = 0.037, r = 0.32), possibly mediated by the duration of the condition. Consequently, a higher presence of CVRFs did not lead to a worse overall cognitive performance. However, high-risk individuals were more likely to experience cognitive impairment, particularly in the attentional domain. T2D played a significant role in these cognitive profile differences, possibly influenced by its duration. Full article
17 pages, 1482 KiB  
Article
Impacts of Working Hours, Wages, and Regular Employment Opportunity on Suicide Mortalities of Employed and Unemployed Individuals before and during the COVID-19 Pandemic in Japan
by Ryusuke Matsumoto, Eishi Motomura and Motohiro Okada
Int. J. Environ. Res. Public Health 2024, 21(4), 499; https://doi.org/10.3390/ijerph21040499 - 18 Apr 2024
Viewed by 996
Abstract
Standardized suicide mortality rates per 100,000 population (SMRs) in Japan consistently decreased from 2009–2019, but these decreasing trends were reversed to increase in 2020. To clarify the mechanisms of recent increasing suicide in Japan, temporal fluctuations of SMRs disaggregated by sex and employment [...] Read more.
Standardized suicide mortality rates per 100,000 population (SMRs) in Japan consistently decreased from 2009–2019, but these decreasing trends were reversed to increase in 2020. To clarify the mechanisms of recent increasing suicide in Japan, temporal fluctuations of SMRs disaggregated by sex and employment status (employed and unemployed individuals) and labor indices such as working hours, wages, and regular employment opportunity index (REO) from January 2012 to June 2023 were analyzed using interrupted time-series analysis. Additionally, temporal causalities from labor indices to SMRs were analyzed using vector autoregressive and non-linear auto-regressive distributed lag analyses. Decreasing trends among employed SMRs of both sexes were attenuated after the enactment of the “Work Style Reform Program” in 2018, but male SMRs were unaffected by the COVID-19 pandemic. However, female employed SMRs sharply increased, synchronized with the “Work Style Reform Act” and the COVID-19 pandemic outbreak (the COVID-19 impact was greater than the “Work Style Reform Act”). Additionally, unemployed SMRs of both sexes sharply increased with the revision and scale-down of countermeasures against economic deterioration caused by COVID-19 (“revision of economic supportive countermeasures against economic deterioration caused by COVID-19”). Unexpectedly, after enacting the “Work Style Reform Act”, wages decreased due to possibly decreasing working hours. Increasing REO, which consistently increased, was a protective factor for male suicides, but unemployed SMRs were not affected by any labor indices. It has been established that controlling a heavy workload plays an important role in suppressing the deterioration of physical and mental conditions, including suicide; however, this study suggested that, at least within appropriate ranges of working hours, decreasing working hours due to excessive management probably contributes to increasing suicides of some vulnerable individuals via de-creasing their wages. Although governmental welfare and economic support measures had to be revised according to rapidly changing situations during the COVID-19 pandemic, this study also suggested that temporal gaps among a part of revisions of several welfare and economic support measures were unexpectedly involved in drastically/sharply increasing suicides of unemployed individuals in 2022. Full article
(This article belongs to the Special Issue Health Risks and Health Promotion among Unemployed People)
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13 pages, 987 KiB  
Article
Exploring the Relationship of Leisure Travel with Loneliness, Depression, and Cognitive Function in Older Adults
by Shu Cole, Chenggang Hua, Siyun Peng and Weixuan Wang
Int. J. Environ. Res. Public Health 2024, 21(4), 498; https://doi.org/10.3390/ijerph21040498 - 18 Apr 2024
Viewed by 941
Abstract
Loneliness, depression, and cognitive decline are pressing concerns among older adults. This study examines the association between leisure travel participation and these health outcomes in older adults, aiming to provide further evidence of the benefits of leisure travel. Using nationally representative historical data [...] Read more.
Loneliness, depression, and cognitive decline are pressing concerns among older adults. This study examines the association between leisure travel participation and these health outcomes in older adults, aiming to provide further evidence of the benefits of leisure travel. Using nationally representative historical data from the 2006 household survey of the Health and Retirement Study, this study conducted a series of regression analyses to investigate the relationship between traveling and the three health outcomes, adjusting for age, sex, race, marital status, education, total wealth, annual income, and difficulty with daily activities. The results reveal that travel patterns in terms of distance are significantly associated with loneliness, depression, and cognitive function. Long-distance travel is positively related to higher cognitive function and a reduction in depressive symptoms, along with lower levels of loneliness, reinforcing the notion that leisure travel can potentially act as a catalyst for improved cognitive and mental health by offering opportunities for enhancing social connections and forming new relationships. The findings on the relationships between participation in leisure travel and mental and cognitive health contribute to the body of evidence supporting the therapeutic value of leisure travel in promoting healthy aging and enhancing the overall well-being in older adults. Full article
(This article belongs to the Special Issue Travel, Health, and Wellness of Older Adults)
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19 pages, 547 KiB  
Article
A New Auto-Regressive Multi-Variable Modified Auto-Encoder for Multivariate Time-Series Prediction: A Case Study with Application to COVID-19 Pandemics
by Emerson Vilar de Oliveira, Dunfrey Pires Aragão and Luiz Marcos Garcia Gonçalves
Int. J. Environ. Res. Public Health 2024, 21(4), 497; https://doi.org/10.3390/ijerph21040497 - 18 Apr 2024
Viewed by 869
Abstract
The SARS-CoV-2 global pandemic prompted governments, institutions, and researchers to investigate its impact, developing strategies based on general indicators to make the most precise predictions possible. Approaches based on epidemiological models were used but the outcomes demonstrated forecasting with uncertainty due to insufficient [...] Read more.
The SARS-CoV-2 global pandemic prompted governments, institutions, and researchers to investigate its impact, developing strategies based on general indicators to make the most precise predictions possible. Approaches based on epidemiological models were used but the outcomes demonstrated forecasting with uncertainty due to insufficient or missing data. Besides the lack of data, machine-learning models including random forest, support vector regression, LSTM, Auto-encoders, and traditional time-series models such as Prophet and ARIMA were employed in the task, achieving remarkable results with limited effectiveness. Some of these methodologies have precision constraints in dealing with multi-variable inputs, which are important for problems like pandemics that require short and long-term forecasting. Given the under-supply in this scenario, we propose a novel approach for time-series prediction based on stacking auto-encoder structures using three variations of the same model for the training step and weight adjustment to evaluate its forecasting performance. We conducted comparison experiments with previously published data on COVID-19 cases, deaths, temperature, humidity, and air quality index (AQI) in São Paulo City, Brazil. Additionally, we used the percentage of COVID-19 cases from the top ten affected countries worldwide until May 4th, 2020. The results show 80.7% and 10.3% decrease in RMSE to entire and test data over the distribution of 50 trial-trained models, respectively, compared to the first experiment comparison. Also, model type#3 achieved 4th better overall ranking performance, overcoming the NBEATS, Prophet, and Glounts time-series models in the second experiment comparison. This model shows promising forecast capacity and versatility across different input dataset lengths, making it a prominent forecasting model for time-series tasks. Full article
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13 pages, 522 KiB  
Article
The Relationship between All-Cause Dementia and Acute Diabetes Complications among American Indian and Alaska Native Peoples
by Xiaoyi Niu, Jenny Chang, Maria M. Corrada, Ann Bullock, Blythe Winchester, Spero M. Manson, Joan O’Connell and Luohua Jiang
Int. J. Environ. Res. Public Health 2024, 21(4), 496; https://doi.org/10.3390/ijerph21040496 - 18 Apr 2024
Viewed by 917
Abstract
Background: American Indian and Alaska Native people (AI/AN) bear a disproportionate burden of diabetes. Growing evidence shows significant associations between several acute diabetes complications and dementia among diabetes patients. However, little is known about these relationships among AI/AN adults. Here, we aim to [...] Read more.
Background: American Indian and Alaska Native people (AI/AN) bear a disproportionate burden of diabetes. Growing evidence shows significant associations between several acute diabetes complications and dementia among diabetes patients. However, little is known about these relationships among AI/AN adults. Here, we aim to investigate these associations among AI/AN adults. Methods: This cross-sectional study extracted data from the Indian Health Service’s (IHS) National Data Warehouse and related administrative databases. A total of 29,337 IHS actual users with diabetes who were 45+ years old during fiscal year 2013 were included. All-cause dementia and diabetes complications were identified using ICD-9 diagnostic codes. Negative binomial regression models were used to evaluate the associations of interest. Results: Nearly 3% of AI/AN diabetes patients had a dementia diagnosis. After controlling for covariates, dementia was associated with a 94% higher rate of severe hypoglycemia (Incidence Rate Ratio [IRR = 1.94, 95% CI:1.50–2.51), 52% higher rate of severe hyperglycemia (IRR = 1.52, 95% CI, 1.11–2.08), and 92% higher rate of any acute complication (IRR = 1.92, 95% CI:1.53–2.41). Conclusions: AI/AN diabetes patients with dementia suffered from considerably higher rates of acute diabetes complications than their counterparts without dementia. The clinical management of patients with comorbid diabetes and dementia is particularly challenging and may require individualized treatment approaches. Full article
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10 pages, 313 KiB  
Article
Medical Advocacy among Latina Women Diagnosed with Breast Cancer
by Paola Torres, Judith Guitelman, Araceli Lucio, Christine Rini and Yamilé Molina
Int. J. Environ. Res. Public Health 2024, 21(4), 495; https://doi.org/10.3390/ijerph21040495 - 18 Apr 2024
Viewed by 769
Abstract
Medical advocacy has continued to significantly impact quality of life and survivorship outcomes among Latina breast cancer survivors in the United States. However, little is known about the unique experiences of Latina survivors, including the perceived value, process, and context in which they [...] Read more.
Medical advocacy has continued to significantly impact quality of life and survivorship outcomes among Latina breast cancer survivors in the United States. However, little is known about the unique experiences of Latina survivors, including the perceived value, process, and context in which they practice medical advocacy. To help address this gap, we conducted a qualitative, secondary analysis of semi-structured focus groups with 18 Latina breast cancer survivors from Chicago, Illinois. Eligible women had to self-identify as (1) female, (2) Latina, (3) 18 years or older, and (4) having a breast cancer diagnosis 5 years ago or more. In total, 61% of participants were 50–59 years old, 83% were born in Mexico, and 100% spoke Spanish. The three emergent themes from the focus groups were (1) the cultural need for Latina advocates and support groups; (2) the process and experiences of becoming a community advocate within Latine culture; and (3) the cultural contexts for advocacy by Latina breast cancer survivors. Latina survivor advocates share strengths of receiving ongoing health education, peer support, and access to resources when being linked to a support group furthering their exposure to role models, increasing their awareness of opportunities in medical advocacy, and providing an entry to participate in medical advocacy. Full article
(This article belongs to the Special Issue Second Edition: Cancer Health Disparities and Public Health)
13 pages, 1162 KiB  
Systematic Review
Association between the Quantity of Nurse–Doctor Interprofessional Collaboration and in-Patient Mortality: A Systematic Review
by Sandesh Pantha, Martin Jones, Nompilo Moyo, Bijaya Pokhrel, Diana Kushemererwa and Richard Gray
Int. J. Environ. Res. Public Health 2024, 21(4), 494; https://doi.org/10.3390/ijerph21040494 - 17 Apr 2024
Viewed by 1115
Abstract
The level of nurse–doctor interprofessional collaboration may influence patient outcomes, including mortality. To date, no systematic reviews have investigated the association between the quantity of nurse–doctor interprofessional collaboration and inpatient mortality. A systematic review was conducted. We included studies that measured the quantity [...] Read more.
The level of nurse–doctor interprofessional collaboration may influence patient outcomes, including mortality. To date, no systematic reviews have investigated the association between the quantity of nurse–doctor interprofessional collaboration and inpatient mortality. A systematic review was conducted. We included studies that measured the quantity of nurse–doctor interprofessional collaboration and in-patient mortality. Five databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Register) were searched. Two researchers undertook the title, abstract, and full-text screening. The risk of bias was determined using the Effective Public Health Practice Project (EPHPP) critical appraisal tool. Six reports from three observational studies met the inclusion criteria. Participants included 1.32 million patients, 29,591 nurses, and 191 doctors. The included studies had a high risk of bias. Of the three studies, one reported a significant association and one found no association between the quantity of nurse–doctor collaboration and mortality. The third study reported on the quantity of nurse–doctor collaboration but did not report the test of this association. We found no high-quality evidence to suggest the amount of nurse–doctor interprofessional collaboration was associated with mortality in medical and surgical inpatients. There is a need for further high-quality research to evaluate the association between the amount of nurse–doctor collaboration and patient outcomes. Full article
(This article belongs to the Special Issue Advances in Nursing and Medical Education)
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21 pages, 5807 KiB  
Review
World Trends in Dental Ergonomics Research: A Bibliometric Analysis
by Wita Anggraini, Dewi Ranggaini, Annisaa Putri Ariyani and Indrani Sulistyowati
Int. J. Environ. Res. Public Health 2024, 21(4), 493; https://doi.org/10.3390/ijerph21040493 - 17 Apr 2024
Viewed by 688
Abstract
Dental ergonomics provides an overview of dentists’ work efficiency. The objective of this study was to obtain quantitative information and produce a visualization of the network of scientific publications on the topic of ergonomics and dentistry using bibliometric analysis. Data mining was conducted [...] Read more.
Dental ergonomics provides an overview of dentists’ work efficiency. The objective of this study was to obtain quantitative information and produce a visualization of the network of scientific publications on the topic of ergonomics and dentistry using bibliometric analysis. Data mining was conducted using the Scopus database and Boolean expressions (ergonom* AND dentist*) on 14 April 2023. Data extraction and analysis were performed using Open Refine version 3.5.2., VOSviewer version 1.6.17., VOSviewer thesaurus, Microsoft Excel, and Tableau Professional version 2020.1.2. A total of 682 documents were identified, with the United States having the largest number of documents and citations (89 documents, 1321 citations). Work, Dentistry Today, and the International Journal of Environmental Research and Public Health were the top three sources. Ergonomics and musculoskeletal disorders (MSDs) are two of the very prominent keywords, with research topics covering prevalence, causes, factors related to causes, prevention, assessment, rehabilitation, evaluation, and intervention. There was no research on ergonomic interventions that collaborated with human factors and ergonomics (HFE). We conclude that the trending topic of dental ergonomics research topics around the world is centered on MSDs. The future research challenge is to apply HFE science to improve the health, safety, efficiency, and quality of dentists’ work. Full article
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28 pages, 4119 KiB  
Article
The Development of an Oral Health Nursing Tool for Patients with a Psychotic Disorder: A Human-Centred Design with a Feasibility Test
by Sonja Kuipers, Stynke Castelein, Linda Kronenberg, Job van ’t Veer and Nynke Boonstra
Int. J. Environ. Res. Public Health 2024, 21(4), 492; https://doi.org/10.3390/ijerph21040492 - 17 Apr 2024
Viewed by 855
Abstract
Patients with psychotic disorders frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aimed to develop supportive tools for MHNs regarding oral health to increase sensitisation [...] Read more.
Patients with psychotic disorders frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aimed to develop supportive tools for MHNs regarding oral health to increase sensitisation among MHNs and provide MHNs with the knowledge to recognise (potential) oral health problems in patients with a psychotic disorder. We used a human-centred design in which the user, MHNs and experts by experience were placed at the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problems as well as needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on the context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHNs, and the intended outcomes of tools. A multi-criteria decision matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. The most promising result was the development of a brochure with an awareness screener. The brochure with the awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n = 19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure included a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimise care processes for oral health tools in MHNs should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account. Full article
(This article belongs to the Special Issue Advances and Innovations in Mental Health and Public Health)
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19 pages, 4457 KiB  
Article
Optimizing the Selection of Mass Vaccination Sites: Access and Equity Consideration
by Basim Aljohani and Randolph Hall
Int. J. Environ. Res. Public Health 2024, 21(4), 491; https://doi.org/10.3390/ijerph21040491 - 17 Apr 2024
Viewed by 914
Abstract
In the early phases of the COVID-19 pandemic, vaccine accessibility was limited, impacting large metropolitan areas such as Los Angeles County, which has over 10 million residents but only nine initial vaccination sites, which resulted in people experiencing long travel times to get [...] Read more.
In the early phases of the COVID-19 pandemic, vaccine accessibility was limited, impacting large metropolitan areas such as Los Angeles County, which has over 10 million residents but only nine initial vaccination sites, which resulted in people experiencing long travel times to get vaccinated. We developed a mixed-integer linear model to optimize site selection, considering equitable access for vulnerable populations. Analyzing 277 zip codes between December 2020 and May 2021, our model incorporated factors such as car ownership, ethnic group disease vulnerability, and the Healthy Places Index, alongside travel times by car and public transit. Our optimized model significantly outperformed actual site allocations for all ethnic groups. We observed that White populations faced longer travel times, likely due to their residences being in more remote, less densely populated areas. Conversely, areas with higher Latino and Black populations, often closer to the city center, benefited from shorter travel times in our model. However, those without cars experienced greater disadvantages. While having many vaccination sites might improve access for those dependent on public transit, that advantage is diminished if people must search among many sites to find a location with available vaccines. Full article
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16 pages, 977 KiB  
Article
Multicomponent Behavioural Intervention during Pregnancy to Reduce Home Exposure to Second-Hand Smoke: A Pilot Randomised Controlled Trial in Bangladesh and India
by Veena A. Satyanarayana, Cath Jackson, Kamran Siddiqi, Mukesh Dherani, Steve Parrott, Jinshuo Li, Rumana Huque, Prabha S. Chandra and Atif Rahman
Int. J. Environ. Res. Public Health 2024, 21(4), 490; https://doi.org/10.3390/ijerph21040490 - 17 Apr 2024
Viewed by 870
Abstract
Background: Pregnant women exposed to second-hand smoke (SHS) are at increased risk of poor birth outcomes. We piloted multicomponent behavioural intervention and trial methods in Bangalore, India, and Comilla, Bangladesh. Methods: A pilot individual randomised controlled trial with economic and process evaluation components [...] Read more.
Background: Pregnant women exposed to second-hand smoke (SHS) are at increased risk of poor birth outcomes. We piloted multicomponent behavioural intervention and trial methods in Bangalore, India, and Comilla, Bangladesh. Methods: A pilot individual randomised controlled trial with economic and process evaluation components was conducted. Non-tobacco-using pregnant women exposed to SHS were recruited from clinics and randomly allocated to intervention or control (educational leaflet) arms. The process evaluation captured feedback on the trial methods and intervention components. The economic component piloted a service use questionnaire. The primary outcome was saliva cotinine 3 months post-intervention. Results: Most pregnant women and many husbands engaged with the intervention and rated the components highly, although the cotinine report elicited some anxiety. Forty-eight (Comilla) and fifty-four (Bangalore) women were recruited. The retention at 3 months was 100% (Comilla) and 78% (Bangalore). Primary outcome data were available for 98% (Comilla) and 77% (Bangalore). Conclusions: The multicomponent behavioural intervention was feasible to deliver and was acceptable to the interventionists, pregnant women, and husbands. With the intervention, it was possible to recruit, randomise, and retain pregnant women in Bangladesh and India. The cotinine data will inform sample size calculations for a future definitive trial. Full article
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13 pages, 703 KiB  
Systematic Review
Early Detection and Monitoring of Gastrointestinal Infections Using Syndromic Surveillance: A Systematic Review
by Olubusola Adedire, Nicola K. Love, Helen E. Hughes, Iain Buchan, Roberto Vivancos and Alex J. Elliot
Int. J. Environ. Res. Public Health 2024, 21(4), 489; https://doi.org/10.3390/ijerph21040489 - 17 Apr 2024
Viewed by 1268
Abstract
The underreporting of laboratory-reported cases of community-based gastrointestinal (GI) infections poses a challenge for epidemiologists understanding the burden and seasonal patterns of GI pathogens. Syndromic surveillance has the potential to overcome the limitations of laboratory reporting through real-time data and more representative population [...] Read more.
The underreporting of laboratory-reported cases of community-based gastrointestinal (GI) infections poses a challenge for epidemiologists understanding the burden and seasonal patterns of GI pathogens. Syndromic surveillance has the potential to overcome the limitations of laboratory reporting through real-time data and more representative population coverage. This systematic review summarizes the utility of syndromic surveillance for early detection and surveillance of GI infections. Relevant articles were identified using the following keyword combinations: ‘early warning’, ‘detection’, ‘gastrointestinal activity’, ‘gastrointestinal infections’, ‘syndrome monitoring’, ‘real-time monitoring’, ‘syndromic surveillance’. In total, 1820 studies were identified, 126 duplicates were removed, and 1694 studies were reviewed. Data extraction focused on studies reporting the routine use and effectiveness of syndromic surveillance for GI infections using relevant GI symptoms. Eligible studies (n = 29) were included in the narrative synthesis. Syndromic surveillance for GI infections has been implemented and validated for routine use in ten countries, with emergency department attendances being the most common source. Evidence suggests that syndromic surveillance can be effective in the early detection and routine monitoring of GI infections; however, 24% of the included studies did not provide conclusive findings. Further investigation is necessary to comprehensively understand the strengths and limitations associated with each type of syndromic surveillance system. Full article
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16 pages, 690 KiB  
Article
Alternative Food Practices as Pathways to Cope with Climate Distress
by Laurence Ammann-Lanthier, Katie Hayes and Iain J. Davidson-Hunt
Int. J. Environ. Res. Public Health 2024, 21(4), 488; https://doi.org/10.3390/ijerph21040488 - 16 Apr 2024
Viewed by 637
Abstract
Experiences of distress and challenging emotions in response to the climate crisis are increasingly common, particularly among young adults. These experiences can include challenging emotions caused by the harmful environmental impacts of conventional food systems, as their contributions to greenhouse gas emissions have [...] Read more.
Experiences of distress and challenging emotions in response to the climate crisis are increasingly common, particularly among young adults. These experiences can include challenging emotions caused by the harmful environmental impacts of conventional food systems, as their contributions to greenhouse gas emissions have become more widely known. While recent studies have examined various experiences of climate distress, the interaction between climate distress and food practice remains poorly understood. In this research, we turn to this intersection by examining the experiences of climate distress of young adults who have alternative food practices, and the interaction between their climate distress and their alternative food practices. Guided by an exploratory, single case study research approach, this research draws from 20 semi-structured interviews conducted with young adults located in urban centres in the Southeastern Prairie Region of Canada. Thematic analysis of the findings reveals that participants experience a variety of climate emotions and a personal responsibility to act in response to the climate crisis. The findings suggest that because of their ability to facilitate a meaningful and practical environmental impact, alternative food practices represent significant climate actions and may be pathways to facilitate coping or managing climate distress among young adults. Results demonstrate the psychological impacts of the climate crisis on young adults, highlighting the need for action on climate change and climate distress. Increasing the accessibility of alternative food practices may support young adults in coping with challenging climate emotions. Full article
(This article belongs to the Special Issue 2nd Edition: The Psychological Impacts of Global Climate Change)
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13 pages, 527 KiB  
Article
Development of Master Chef: A Curriculum to Promote Nutrition and Mindful Eating among College Students
by Kayla Parsons, Kelley Strout, Caitlyn Winn, Mona Therrien-Genest, Kate Yerxa and Jade McNamara
Int. J. Environ. Res. Public Health 2024, 21(4), 487; https://doi.org/10.3390/ijerph21040487 - 16 Apr 2024
Viewed by 1162
Abstract
Research suggests that success in improving undergraduates’ diet quality can benefit from a multifaceted approach, incorporating nutrition education, mindful eating, and culinary skill-building. The current study aimed (1) to review the development of Master Chef, a mindful eating curriculum, and (2) assess its [...] Read more.
Research suggests that success in improving undergraduates’ diet quality can benefit from a multifaceted approach, incorporating nutrition education, mindful eating, and culinary skill-building. The current study aimed (1) to review the development of Master Chef, a mindful eating curriculum, and (2) assess its feasibility through an online expert review. Expert reviewers were recruited through an online mindful eating course. Survey questions included both Likert-style and open-ended questions. Quantitative survey data were analyzed using descriptive statistics. Two independent researchers coded qualitative data, which then underwent inductive thematic analysis. Reviewers (N = 7) were experts in the fields of nutrition, psychology, and mindful eating. Master Chef’s overall feasibility was rated highly. The overall curriculum was perceived positively. However, it was recommended that the program include more mindfulness. Master Chef was identified as a feasible program for improving the health behaviors of college students. Pilot dissemination and analysis will be necessary to assess the program’s effectiveness in supporting disease prevention among undergraduates. Full article
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12 pages, 633 KiB  
Article
Independent Correlates of Glycemic Control among Adults with Diabetes in South Africa
by Abdulaziz Hamid, Aprill Z. Dawson, Yilin Xu and Leonard E. Egede
Int. J. Environ. Res. Public Health 2024, 21(4), 486; https://doi.org/10.3390/ijerph21040486 - 16 Apr 2024
Viewed by 866
Abstract
Background: Globally, the prevalence of diabetes is increasing, especially in low- and middle-income countries (LMICs), including those in the sub-Saharan African region. However, the independent socioeconomic correlates of glycemic control as measured by hemoglobin A1C have yet to be identified. Therefore, the aim [...] Read more.
Background: Globally, the prevalence of diabetes is increasing, especially in low- and middle-income countries (LMICs), including those in the sub-Saharan African region. However, the independent socioeconomic correlates of glycemic control as measured by hemoglobin A1C have yet to be identified. Therefore, the aim of this analysis was to understand the independent correlates of glycemic control in South Africa. Methods: Data from the 2016 South Africa Demographic and Health Survey on adults with diabetes were used for this analysis. The dependent variable, glycemic control, was defined using hemoglobin A1c (HbA1c). Independent variables included: age, gender, ethnicity, marital status, region, urban/rural residence, ability to read, education, insurance, wealth, occupation, and employment in the last year. Analysis of variance was used to test for differences in mean HbA1c for each category of all independent variables, and a fully adjusted linear regression model was used to identify independent correlates of glycemic control (HbA1c). Results: Among the 772 people included in this analysis, there were significant differences in mean HbA1c by age (p < 0.001), ethnicity (p < 0.001), place of residence (p = 0.024), wealth index (p = 0.001), and employment in the last year (p = 0.008). Independent correlates of HbA1c included age, ethnicity, and wealth index. Conclusions: This study used data from a large diverse population with a high prevalence of diabetes in sub-Saharan Africa and provides new evidence on the correlates of glycemic control and potential targets for interventions designed to lower HbA1c and improve diabetes-related health outcomes of adults in South Africa. Full article
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