International Journal of Environmental Research and Public Health

15 pages, 1336 KiB

Open AccessArticle

Spatial and Temporal Analysis of Hospitalizations Due to Primary Care–Sensitive Conditions Related to Diabetes Mellitus in a State in the Northeast of Brazil

by Afonso Abreu Mendes Júnior, Álvaro Francisco Lopes de Sousa, Guilherme Reis de Santana Santos, Shirley Verônica Melo Almeida Lima, Allan Dantas dos Santos, Valdemar Silva Almeida, Ernanes Menezes dos Santos, Maria Idelcacia Nunes Oliveira, José Cleyton Santana Góis, Regina Cláudia Silva Souza, Liliane Moretti Carneiro, Maria do Carmo de Oliveira, Emerson Lucas Silva Camargo and Caíque Jordan Nunes Ribeiro

Int. J. Environ. Res. Public Health 2024, 21(11), 1538; https://doi.org/10.3390/ijerph21111538 (registering DOI) - 20 Nov 2024

Abstract

Hospitalizations due to primary care–sensitive conditions (PCSCs) can be considered a proxy for the effectiveness of primary healthcare (PHC), especially diabetes mellitus (DM). The aim of this study was to analyze the temporal, spatial, and space–time patterns of PCSCs associated with DM in [...] Read more.

Hospitalizations due to primary care–sensitive conditions (PCSCs) can be considered a proxy for the effectiveness of primary healthcare (PHC), especially diabetes mellitus (DM). The aim of this study was to analyze the temporal, spatial, and space–time patterns of PCSCs associated with DM in a state in Northeast Brazil from 2008 to 2022. An ecological and time–series study that included all records related to PCSCs–DM from the 75 municipalities of Sergipe was conducted. Segmented linear regression, global (I) and local (LISA) Moran indices, spatial scanning, Spearman correlation tests, bivariate I, and LISA were used in our analysis to examine the temporal trends and clusters of high spatial risk. Overall, 14,390 PCSCs–DM were recorded between 2008 and 2022. There was a higher prevalence of PCSCs–DM among women (53.75%) and individuals over 70 years old (57.60%). Temporal trends in PCSCs–DM were increasing with regard to the overall rate (AAPC: 2.39); males (AAPC: 3.15); age groups ≤ 19 years (AAPC: 6.13), 20–39 years (AAPC: 4.50), and 40–59 years (AAPC: 2.56); and 3 out of the 7 health regions. There was a positive spatial correlation between per capita income (I = −0.23; p = 0.004) and diabetic foot examination being performed by a nurse in a PHC (I = −0.18; p = 0.019) setting. The heterogeneous spatial distribution of DM hospitalizations demonstrated that this condition is a persistent public health problem in Sergipe. Full article

13 pages, 940 KiB

Open AccessArticle

Prevalence and Determinants of Household Self-Reported Diabetes Mellitus in Gauteng, South Africa

by Shoeshoe Mokhele and Tholang Mokhele

Int. J. Environ. Res. Public Health 2024, 21(11), 1537; https://doi.org/10.3390/ijerph21111537 - 20 Nov 2024

Abstract

Diabetes mellitus is one of the leading causes of morbidity and mortality worldwide. Type 2 diabetes mellitus is the most prevalent type of diabetes mellitus, and it is associated with both hereditary and lifestyle risk factors. South Africa is not exempt from this [...] Read more.

Diabetes mellitus is one of the leading causes of morbidity and mortality worldwide. Type 2 diabetes mellitus is the most prevalent type of diabetes mellitus, and it is associated with both hereditary and lifestyle risk factors. South Africa is not exempt from this pandemic; hence, this paper aims to assess the prevalence and determinants of household self-reported diabetes mellitus in Gauteng, South Africa. Data were sourced from the Gauteng City-Region Observatory (GCRO) quality of life survey (2020/2021). Bivariate and multivariate logistic regressions were applied. The prevalence of household self-reported diabetes mellitus in Gauteng was 11.1%. The ‘other population’ group (which included Whites, Coloureds and Indians), as well as older respondents, higher household monthly food expenditure, poor self-perceived health status and household self-reported hypertension were factors that increased the odds of household self-reported diabetes mellitus. Only informal housing decreased the odds of household self-reported diabetes mellitus. Screening of diabetes mellitus among those with poor living conditions, no medical aid and lack of access to healthcare facilities such as Gauteng township and informal settlement residents should be intensified. This secondary disease prevention intervention is crucial, as it will enhance the appropriate referrals and timeous chronic treatment for those with diabetes mellitus. Full article

(This article belongs to the Special Issue Diabetes Care: Prevention, Diagnosis and Treatment)

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16 pages, 718 KiB

Open AccessArticle

The Prevalence of Childhood Asthma, Respiratory Symptoms and Associated Air Pollution Sources Among Adolescent Learners in Selected Schools in Vhembe District, South Africa

by Funzani Rathogwa-Takalani, Thabelo Rodney Mudau, Sean Patrick, Joyce Shirinde and Kuku Voyi

Int. J. Environ. Res. Public Health 2024, 21(11), 1536; https://doi.org/10.3390/ijerph21111536 - 20 Nov 2024

Abstract

This study investigated the prevalence of childhood asthma and respiratory symptoms with their associated air pollution sources among adolescents aged 13–14 years residing in a Malaria-endemic region. Methods: A cross-sectional survey was conducted with 2855 adolescents from fourteen (14) selected schools in communities [...] Read more.

This study investigated the prevalence of childhood asthma and respiratory symptoms with their associated air pollution sources among adolescents aged 13–14 years residing in a Malaria-endemic region. Methods: A cross-sectional survey was conducted with 2855 adolescents from fourteen (14) selected schools in communities exposed to high levels of air pollution from indoor residual spraying (IRS) that is used for malaria vector control in the Vhembe region. Data were collected using a self-administered standardized International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Statistical software STATA version 17 was used to analyze the data. Binary logistic regression was used to determine the relationship between air pollution sources and childhood asthma/symptoms. Results: The prevalences of asthma, ‘wheeze ever’ and ‘wheeze in the past’ were 18.91%, 37.69% and 24.69%, respectively. The results from the adjusted binary logistic regression model indicated that exposure to tobacco smoke (OR = 1.84; 95% CI: 1.08–3.16), smoking a water pipe (OR = 1.65; 95% CI: 1.16–2.36) and the use of paraffin as fuel for heating (OR = 1.70; 95% CI: 0.97–2.88) and cooking (OR = 0.48; 95% CI: 0.29–1.00) were significant risk factors for asthma. Trucks passing through the streets, having a cat at home and using open fires were significantly associated with ‘wheeze in the past’. Finally, using gas for cooking (OR = 0.72; 95% CI: 0.53–0.99), open fires for heating (OR = 0.53; 95% CI: 0.35–0.80) and smoking a water pipe (OR = 2.47; 95% CI: 1.78–3.44) were associated with ‘wheeze ever’. Conclusions: School children living in these communities had an increased risk of developing asthma and presenting with wheezing due to exposure to environmental air pollution sources. Full article

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23 pages, 334 KiB

Open AccessArticle

Older Autistic People, Access and Experiences of Services, and the Factors That Affect This

by Marion Hersh, Panda Mery and Michael Dawson

Int. J. Environ. Res. Public Health 2024, 21(11), 1535; https://doi.org/10.3390/ijerph21111535 - 19 Nov 2024

Abstract

This paper presents new empirical data obtained from interviews and focus groups on older (50 and over) autistic people’s experiences of accessing a variety of services. The involvement of older autistic people and giving voice to their experiences was central to all aspects [...] Read more.

This paper presents new empirical data obtained from interviews and focus groups on older (50 and over) autistic people’s experiences of accessing a variety of services. The involvement of older autistic people and giving voice to their experiences was central to all aspects of the research process. This work makes a significant contribution to the scarce literature on older autistic people. In particular, it discusses the factors that act as barriers and enablers to the access to and productive use of services, the strategies used by participants to manage and improve their experiences, and the success of these strategies. It shows older autistic people as autonomous adults and active protagonists in their own lives, taking action to overcome the barriers they experience to accessing services on the same terms as everyone else, but that lack of understanding and support from service providers and the general public can undermine their strategies. Finally, this work provides a series of recommendations for service providers to improve (older) autistic people’s service access and experiences. Full article

(This article belongs to the Special Issue Rising to the Healthy Ageing Challenge: Co-production with Older People and Business)

23 pages, 4240 KiB

Open AccessArticle

Application of Machine Learning and Deep Neural Visual Features for Predicting Adult Obesity Prevalence in Missouri

by Butros M. Dahu, Carlos I. Martinez-Villar, Imad Eddine Toubal, Mariam Alshehri, Anes Ouadou, Solaiman Khan, Lincoln R. Sheets and Grant J. Scott

Int. J. Environ. Res. Public Health 2024, 21(11), 1534; https://doi.org/10.3390/ijerph21111534 - 19 Nov 2024

Abstract

This research study investigates and predicts the obesity prevalence in Missouri, utilizing deep neural visual features extracted from medium-resolution satellite imagery (Sentinel-2). By applying a deep convolutional neural network (DCNN), the study aims to predict the obesity rate of census tracts based on [...] Read more.

This research study investigates and predicts the obesity prevalence in Missouri, utilizing deep neural visual features extracted from medium-resolution satellite imagery (Sentinel-2). By applying a deep convolutional neural network (DCNN), the study aims to predict the obesity rate of census tracts based on visual features in the satellite imagery that covers each tract. The study utilizes Sentinel-2 satellite images, processed using the ResNet-50 DCNN, to extract deep neural visual features (DNVF). Obesity prevalence data, sourced from the CDC’s 2022 estimates, is analyzed at the census tract level. The datasets were integrated to apply a machine learning model to predict the obesity rates in 1052 different census tracts in Missouri. The analysis reveals significant associations between DNVF and obesity prevalence. The predictive models show moderate success in estimating and predicting obesity rates in various census tracts within Missouri. The study emphasizes the potential of using satellite imagery and advanced machine learning in public health research. It points to environmental factors as significant determinants of obesity, suggesting the need for targeted health interventions. Employing DNVF to explore and predict obesity rates offers valuable insights for public health strategies and calls for expanded research in diverse geographical contexts. Full article

14 pages, 313 KiB

Open AccessArticle

The Disaster of the Century: Effects of the 6 February 2023 Kahramanmaraş Earthquakes on the Sleep and Mental Health of Healthcare Workers

by Sema Çifçi and Zehra Kilinç

Int. J. Environ. Res. Public Health 2024, 21(11), 1533; https://doi.org/10.3390/ijerph21111533 - 19 Nov 2024

Abstract

It is known that disasters can have long-term effects on the mental health of individuals. In particular, healthcare workers may be under greater stress in a time of disaster, as they are not only affected by the disaster, but they also take part [...] Read more.

It is known that disasters can have long-term effects on the mental health of individuals. In particular, healthcare workers may be under greater stress in a time of disaster, as they are not only affected by the disaster, but they also take part in rescue efforts. This study was conducted to investigate the psychological effects of the Kahramanmaraş earthquakes on healthcare workers employed at the Adıyaman Training and Research Hospital. The sample in the cross-sectional study consisted of 299 healthcare personnel working in the Adıyaman Training and Research Hospital. The study data were collected through a questionnaire consisting of five sections. The data were analysed using SPSS 22 software. It was found that among healthcare workers, those who were women, married, individuals whose homes were damaged, injured, or lost a relative in the earthquake had experienced mental health problems such as post-traumatic stress disorder (PTSD), anxiety, depression, and poor sleep quality the most. The earthquakes that occurred on 6 February negatively affected the mental health of healthcare workers. In order to reduce these negative effects experienced by healthcare workers, various types of mental health screening should be performed, and supportive psychological services should be provided urgently. Full article

(This article belongs to the Special Issue Promotion of Care and Psychological Well-Being for Healthcare Workers)

23 pages, 1156 KiB

Open AccessSystematic Review

The Association Between Cadmium Exposure and Prostate Cancer: An Updated Systematic Review and Meta-Analysis

by Giorgio Firmani, Manuela Chiavarini, Jacopo Dolcini, Stefano Quarta, Marcello Mario D’Errico and Pamela Barbadoro

Int. J. Environ. Res. Public Health 2024, 21(11), 1532; https://doi.org/10.3390/ijerph21111532 - 19 Nov 2024

Abstract

Prostate cancer (PCa) is a common cancer among men, and it has a multifactorial etiology. Cadmium (Cd), a toxic heavy metal classified as a carcinogen by the IARC, can cause various acute and chronic effects. This systematic review and meta-analysis aims to update [...] Read more.

Prostate cancer (PCa) is a common cancer among men, and it has a multifactorial etiology. Cadmium (Cd), a toxic heavy metal classified as a carcinogen by the IARC, can cause various acute and chronic effects. This systematic review and meta-analysis aims to update previous findings on the association between Cd exposure and PCa. We carried out a literature search in PubMed, Web of Science, and Scopus up to May 2024, identifying eight new articles. The effect size from the highest and lowest exposure categories were extracted and analyzed using a random-effects model. Heterogeneity was assessed with the I² test, and publication bias was evaluated using funnel plot asymmetry. Overall, the effect size for PCa associated with Cd exposure, combining previous and new articles, was 1.11 (95% CI 0.85–1.45). Heterogeneity was high, but no significant publication bias was detected. For studies from Europe, the effect size was 1.47 (95% CI 1.00–2.17). Notably, 11 articles from the previous systematic review and meta-analysis highlighted that higher Cd exposure is significantly associated with more aggressive histopathological types of PCa (OR 1.50, 95% CI 1.08–2.07). These findings suggest a potential public health concern, indicating the need for further research to clarify the risk associated with Cd exposure. Full article

(This article belongs to the Special Issue Relationship between Environmental Risk Factors and Cancer)

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11 pages, 1174 KiB

Open AccessSystematic Review

What Is the Impact of Leaders with Emotional Intelligence on Proxy Performance Metrics in 21st Century Healthcare?—A Systematic Literature Review

by Aisha Chaudry, Parisah Maham Hussain, Simran Halari, Sohini Thakor, Aran Sivapalan, Abdul Ikar, Terrell Okhiria and Edgar Meyer

Int. J. Environ. Res. Public Health 2024, 21(11), 1531; https://doi.org/10.3390/ijerph21111531 - 18 Nov 2024

Abstract

Emotional intelligence (EQ) in healthcare leadership has been a subject of debate regarding its significance in enhancing job performance and patient-centred care. This systematic review investigates the impact of EQ on organisational performance metrics in healthcare leaders. Eleven studies meeting the inclusion criteria [...] Read more.

Emotional intelligence (EQ) in healthcare leadership has been a subject of debate regarding its significance in enhancing job performance and patient-centred care. This systematic review investigates the impact of EQ on organisational performance metrics in healthcare leaders. Eleven studies meeting the inclusion criteria were identified through a comprehensive database search. The findings suggest that EQ positively influences job satisfaction, with emotionally intelligent leaders fostering a positive work environment and commitment among employees. Moreover, EQ correlates negatively with emotional exhaustion, indicating its potential in mitigating burnout rates among healthcare professionals. EQ fosters teamwork, organisational culture and enhances job performance, with higher EQ levels in leaders associated with increased team empowerment and proactivity. Despite the compelling evidence, limitations in the study methodologies and heterogeneity in the reported outcomes challenge the establishment of definitive conclusions. Nevertheless, the findings underscore the importance of EQ in healthcare leadership and its potential to improve organisational dynamics and employee wellbeing. This review highlights the need for further research on EQ’s impact on patient satisfaction and calls for the development of EQ training programmes tailored for healthcare leaders. Full article

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16 pages, 619 KiB

Open AccessArticle

Children’s and Adolescents’ Use of Nature During the COVID-19 Pandemic in a Very Green Country

by Vegard Gundersen, Zander Venter, Line Camilla Wold, Berit Junker-Köhler and Sofie Kjendlie Selvaag

Int. J. Environ. Res. Public Health 2024, 21(11), 1530; https://doi.org/10.3390/ijerph21111530 - 18 Nov 2024

Abstract

Play, physical activity, and social interaction with other children in nature are important for healthy and social development in childhood and adolescence. The extent to which lockdown policies during the COVID-19 pandemic impacted the way children engaged in outdoor activities remains unclear, especially [...] Read more.

Play, physical activity, and social interaction with other children in nature are important for healthy and social development in childhood and adolescence. The extent to which lockdown policies during the COVID-19 pandemic impacted the way children engaged in outdoor activities remains unclear, especially in a country with free access to abundant nature during the pandemic. We performed a national survey of parents (n = 1002) in Norway in January 2021 to uncover changes in outdoor play for children (6–12 years, n = 396) and adolescents (13–19 years, n = 606) compared with the situation before the lockdown on 12 March 2020. Ten months after the start of the COVID-19 lockdown, 38% of the parents reported that their children played and spent time outside ‘less than usual’ in their neighborhood, compared with 15% who reported ‘more than usual’ time spent outside. Parents indicated that the children’s play activities were highly organized and institutionalized, and when the activities ceased, their children had less motivation to spend time outdoors and tended to engage more in screen-based activities indoors. We conclude that while children and adolescents had many opportunities to be outdoors in natural settings during the COVID-19 pandemic restrictions, they did so much less than before the lockdown. Full article

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9 pages, 554 KiB

Open AccessArticle

by Nokuthula Mtshali and Takshita Sookan-Kassie

Int. J. Environ. Res. Public Health 2024, 21(11), 1529; https://doi.org/10.3390/ijerph21111529 - 18 Nov 2024

Abstract

Regular exercise has been shown to have a positive effect on the health outcomes of individuals with type 2 diabetes mellitus (T2DM); however, it is still underutilized in developing countries. This study investigated diabetes-related knowledge, attitudes, and practice toward exercise and its benefits [...] Read more.

Regular exercise has been shown to have a positive effect on the health outcomes of individuals with type 2 diabetes mellitus (T2DM); however, it is still underutilized in developing countries. This study investigated diabetes-related knowledge, attitudes, and practice toward exercise and its benefits among individuals with T2DM. A total of one hundred and ninety-nine participants (male = 21.6% and female = 78.4%) with T2DM, aged between 18 and 75, (43.77 SD± 14.78) years, participated in the study. A validated diabetes-related knowledge, attitude, and practice questionnaire, evaluated by true/false or unsure, was utilized in the study. Descriptive and inferential statistics analysis was used to analyze data with the significance set at p < 0.05. The results demonstrated poor diabetes-related knowledge of exercise (p < 0.001). The majority of the study participants, 163 (81.90%) with T2DM, did not know that physical activity and exercise are different. About 158 (70.40%) of the study participants felt that their regular work was an adequate substitution for exercise. More than 50% of the study participants demonstrated a positive practice towards exercise and its benefits towards T2DM (p < 0.001). The majority of the study participants reported poor knowledge and a negative attitude toward diabetes. However, their diabetes-related practices were satisfactory. Full article

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

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22 pages, 353 KiB

Open AccessArticle

Exploring Managers’ Insights on Integrating Mental Health into Tuberculosis and HIV Care in the Free State Province, South Africa

by Christo Heunis and Gladys Kigozi-Male

Int. J. Environ. Res. Public Health 2024, 21(11), 1528; https://doi.org/10.3390/ijerph21111528 - 18 Nov 2024

Abstract

The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa’s Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to [...] Read more.

The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa’s Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to identify potential strategies to overcome these challenges. Data were collected between February and October 2021 using qualitative methods including four individual semi-structured interviews and two focus group discussions with a total of 15 managers responsible for the MH, primary healthcare, TB, and HIV programmes. Thematic data analysis was guided by an adapted version of the World Health Organization’s “building blocks” framework encompassing “service delivery”, “workforce”, “health information”, “essential medicines”, “financing”, and “leadership/governance”. Additionally, the analysis underscored the crucial role of “people”, acknowledging their significant contributions as both caregivers and recipients of care. Managers highlighted significant concerns regarding the insufficient integration of MH services, identifying structural barriers such as inadequate MH management structures and staff training, as well as social barriers, notably stigma and a lack of family treatment adherence support. Conversely, they recognised strong management structures, integrated screening, and social interventions, including family involvement, as key facilitators of successful MH integration. The findings emphasise the need for a whole-system approach that addresses all building blocks while prioritising the role of “people” in overcoming challenges with integrating MH services into TB and HIV care. Full article

(This article belongs to the Special Issue Access to Public Health Services and Challenges to Healthcare Management)

21 pages, 1531 KiB

Open AccessArticle

The Economic Burden of Prostate Cancer in Antigua and Barbuda: A Prevalence-Based Cost-of-Illness Analysis from the Healthcare Provider Perspective

by Andre A. N. Bovell, Cebisile Ngcamphalala, Adrian Rhudd, Jabulani Ncayiyana and Themba G. Ginindza

Int. J. Environ. Res. Public Health 2024, 21(11), 1527; https://doi.org/10.3390/ijerph21111527 - 18 Nov 2024

Abstract

In Antigua and Barbuda, prostate cancer is known for its epidemiological burden; however, its economic burden on the healthcare system is unknown. This study aimed to assess the economic burden of prostate cancer in Antigua and Barbuda from the healthcare provider’s perspective. To [...] Read more.

In Antigua and Barbuda, prostate cancer is known for its epidemiological burden; however, its economic burden on the healthcare system is unknown. This study aimed to assess the economic burden of prostate cancer in Antigua and Barbuda from the healthcare provider’s perspective. To conduct this prevalence-based cost-of-illness study, we used patient data abstracted from records at key study sites for the period of 2017–2021 to establish a yearly prevalence. Top-down and bottom-up approaches were used to estimate the direct medical cost. The cost was computed at the 2021 price level and converted to United States dollars (USD). The total annual direct medical cost for prostate cancer was estimated at USD 1.8 million (ranging between USD 1.4 million and USD 2.3 million). Stages II and III disease accounted for a combined greater share of the cost. The direct medical unit cost for screening, diagnosing, and treating a prostate cancer patient was USD 126,388.98. The top contributors to this cost were surgery (USD 20,913.42), renal complications/renal failure (USD 20,674.86), and hormonal therapy (USD 31,824.00). The results of this study provide evidence of the economic burden of prostate cancer in Antigua and Barbuda. Our findings appear reasonable. Besides contributing to further economic research, they will be useful for policy development, resource allocation, and cost containment measures. Full article

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20 pages, 1495 KiB

Open AccessArticle

Using YouTube Comments Data to Explore Postpartum Depression in Social Media: An Infodemiology Study

by Anila Virani, Bhupinder Nagra, Joyce O’Mahony, Juanita Bacsu, Jasjot Kaur Ghatore and Sourajita Panda

Int. J. Environ. Res. Public Health 2024, 21(11), 1526; https://doi.org/10.3390/ijerph21111526 - 18 Nov 2024

Abstract

Background: Postpartum depression (PPD) is a prevalent mental health issue profoundly impacting both parents and their families. This study examines YouTube comments to identify common public discourse and prevalent themes surrounding PPD. Methods: We analyzed 4915 comments from 33 YouTube videos to provide [...] Read more.

Background: Postpartum depression (PPD) is a prevalent mental health issue profoundly impacting both parents and their families. This study examines YouTube comments to identify common public discourse and prevalent themes surrounding PPD. Methods: We analyzed 4915 comments from 33 YouTube videos to provide a comprehensive picture of PPD-related discourse on social media. We analyzed data using engagement metrics and Braun and Clarke’s thematic analysis. Results: The engagement metrics indicated that public discourse is primarily focused on the stigma associated with PPD in men and celebrities, with related videos receiving significant attention and high engagement metrics score. Thematic analysis revealed two themes: (1) perspectives of stigmatized, stigmatizer and people in between; and (2) adaptation despite adversity. Conclusion: This study provides key insights into public discourse on PPD. It highlights the importance of family and community support and advocates for a healthcare system capable of addressing the needs of stigmatized populations. A significant finding of this study is the call for action to raise awareness and debunk myths about PPD. Misconceptions worsen stigma and deter help-seeking by affected individuals. Awareness initiatives are crucial to enhance public understanding of PPD symptoms, its impact on individuals and families, and the importance of parental mental health. Full article

(This article belongs to the Section Health Care Sciences)

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13 pages, 754 KiB

Open AccessReview

Alcohol Use and Abuse Among Family Caregivers of People Living with Dementia in the United States: A Scoping Review

by Afeez A. Hazzan, Jessica L. Sniatecki, Gary Metz and Jamia Williams

Int. J. Environ. Res. Public Health 2024, 21(11), 1525; https://doi.org/10.3390/ijerph21111525 - 17 Nov 2024

Abstract

The population of the United States is rapidly aging due to a number of factors, such as lower fertility rates and increases in life expectancy. Globally, dementia is a leading cause of disability among older adults, affecting approximately 50 million people. Family caregivers, [...] Read more.

The population of the United States is rapidly aging due to a number of factors, such as lower fertility rates and increases in life expectancy. Globally, dementia is a leading cause of disability among older adults, affecting approximately 50 million people. Family caregivers, who often have to sacrifice their health and well-being, provide most of the care needed by older adults living with dementia. Further, alcohol is one of the most commonly used substances in the United States. Considering the stress and unfavorable health outcomes that are associated with caring for a loved one with dementia, it is important to understand the prevalence of alcohol use and abuse among family caregivers. In this study, Arksey and O’Malley’s five-stage approach for a scoping review is used to examine the nature and scope of a body of research related to alcohol use and abuse among family caregivers of people living with dementia in the United States. Overall, the results show a paucity of research on the prevalence and implications of alcohol use among family caregivers. The identified studies suggest that family caregivers may be less likely to misuse alcohol than non-caregivers. However, additional population-wide studies are needed. Full article

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16 pages, 1711 KiB

Open AccessArticle

Association Between the Food Environment Around Schools and Food Consumption of Adolescents in Large and Small Municipalities in Southern Brazil

by Maria Beatriz Carolina da Silva, Katiany Claudete Pinheiro, Gabriele Rockenbach, Patrícia de Fragas Hinnig, Maria Gabriela Matias de Pinho, Lidiamara Dornelles de Souza, Adalberto A. S. Lopes, Francisco de Assis Guedes de Vasconcelos and Elizabeth Nappi Corrêa

Int. J. Environ. Res. Public Health 2024, 21(11), 1524; https://doi.org/10.3390/ijerph21111524 - 16 Nov 2024

Abstract

This cross-sectional study aimed to evaluate the association between the consumption of healthy and unhealthy food markers among adolescents enrolled in the ninth grade of elementary school in municipal public schools and the food environment around the schools in two municipalities of different [...] Read more.

This cross-sectional study aimed to evaluate the association between the consumption of healthy and unhealthy food markers among adolescents enrolled in the ninth grade of elementary school in municipal public schools and the food environment around the schools in two municipalities of different sizes, located in Southern Brazil. The data were collected between 2022 and 2023, with 449 adolescent participants. Of these, 347 were students from the municipality of Florianópolis, and 102 were students from the municipality of Governador Celso Ramos, all aged between 13 and 17 years. The establishments located around the schools were evaluated using AUDITNOVA, an instrument that investigates the environmental dimension and food dimension. The consumption of healthy eating markers (beans, vegetables, and fresh fruits) and unhealthy eating markers (ultra-processed foods, soft drinks, sweets, and fried snacks) among students was assessed using a food frequency questionnaire. Statistically significant associations were observed between the food environment around the school and the consumption of unhealthy food markers (OR = 0.63; 95% CI = 0.41–0.98 p = 0.041) but only in the large municipality. No significant associations were found in the students’ food consumption in the small municipality. A significant association between the school food environment and adolescents’ consumption of unhealthy foods was observed in Florianópolis. Healthy food consumption was low among students in the small municipality, Governador Celso Ramos. Full article

(This article belongs to the Special Issue Bridging the Gap in Studies on the Food Environment: The State-of-the-Art in Low- and Middle-Income Countries (LMICs))

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13 pages, 540 KiB

Open AccessArticle

The Role of Emotionality Stigma in Adolescent Mental Health: Measure Development and Call for Systems-Level Change

by Hayley D. Seely and Eileen Chen

Int. J. Environ. Res. Public Health 2024, 21(11), 1523; https://doi.org/10.3390/ijerph21111523 - 16 Nov 2024

Abstract

Youth mental health concerns, including substance abuse, continue to rise. With high co-morbidity rates and a marked lack of representation from diverse groups in study conceptualization, measurement, and implementation, efforts to understand factors impacting youth mental health from a cultural lens are needed. [...] Read more.

Youth mental health concerns, including substance abuse, continue to rise. With high co-morbidity rates and a marked lack of representation from diverse groups in study conceptualization, measurement, and implementation, efforts to understand factors impacting youth mental health from a cultural lens are needed. The theory of emotionality stigma posits that many mental health concerns can be understood based on one’s endorsement of emotionality stigma—the experience of stigma around emotions—which manifests within one’s context. Informed by this theory, the current study aimed to adapt and test a measure of emotionality stigma for diverse youth in combined mental health and substance use treatment. Targeted youth focus groups informed the adaptation of the pre-existing Emotionality Stigma Scale for implementation with diverse youth. Using a mixed methods approach, this measure was then tested for relevance, reliability, and validity in an outpatient youth clinic. Patients (N = 58, aged 13 to 21) reported their emotionality stigma, values, and attachment as part of routine monitoring. Based on qualitative feedback and quantitative analysis, our results illustrate the reliability and validity of the adapted Emotionality Stigma Scale and the relevance of this new measure for assessing youth mental health concerns and treatment outcomes. Areas for continued research are identified, and recommendations for implementation in conceptualization and treatment are provided. Full article

(This article belongs to the Special Issue Mental Health and Wellbeing of Children and Adolescents)

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17 pages, 373 KiB

Open AccessReview

Genetics, Epigenetics, and the Environment: Are Precision Medicine, Provider Compassion, and Social Justice Effective Public Health Measures to Mitigate Disease Risk and Severity?

by Philip M. Iannaccone, Rebecca J. Ryznar and Lon J. Van Winkle

Int. J. Environ. Res. Public Health 2024, 21(11), 1522; https://doi.org/10.3390/ijerph21111522 - 16 Nov 2024

Abstract

Environmental forces impacting public health include exposure to toxic substances, adverse childhood experiences (ACEs), diet, and exercise. Here, we examine the first two of these forces in some detail since they may be amenable to correction through cultural, medical, and practitioner intervention. At [...] Read more.

Environmental forces impacting public health include exposure to toxic substances, adverse childhood experiences (ACEs), diet, and exercise. Here, we examine the first two of these forces in some detail since they may be amenable to correction through cultural, medical, and practitioner intervention. At the same time, changing people’s dietary and exercise routines are likely more resistant to these interventions and are referred to only incidentally in this review. That is, societal efforts could prevent exposure to toxicants and ACEs—not necessarily requiring cooperation by the affected individuals—whereas changing diet and exercise practices requires an individual’s discipline. Toxic substances considered in this review include endocrine disruptors, arsenics, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), the organic solvent, Trichloroethylene (TCE), and the Benzo[a]pyrene (B[a]P) produced from incomplete combustion of tobacco and other organic materials. Exposure to each of these toxic substances may have serious adverse health effects, especially in genetically more susceptible individuals. For example, children of mothers exposed to the endocrine disruptor, Atrazine, have significantly lower birth length, weight, and head circumference. Moreover, male offspring exhibit genital abnormalities, and all of these effects may be transgenerational. However, analyses of interactions among genes, the environment, and epigenetic modifications have already revealed distinctive individual risks of adverse reactions to toxic exposure. So, interventions through precision medicine might improve the health of those exposed individuals. Adults previously exposed to more than one ACE (e.g., child abuse and inter-parental violence) are more likely to develop anxiety, cancer, and diabetes. Detecting ACE exposures in children in the general population is fraught with difficulty. Thus, the risks of ACEs to our health remain even more insidious than exposures to toxicants. Nevertheless, higher provider compassion is associated with significantly better clinical outcomes for patients with these afflictions. For all these reasons, the first major aim of this review is to recount several of the major forces contributing to or impairing public health. Our second major aim is to examine mitigating influences on these forces, including social justice and provider compassion in the setting of precision medicine. Idealistically, these mitigators might eventually lead to the development of more cooperative and compassionate cultures and societies. Full article

(This article belongs to the Special Issue Genetic and Epigenetic Responses to the Environment: Developmental Origin of Diseases and Measures to Mitigate Their Manifestations)

22 pages, 7559 KiB

Open AccessArticle

The Ripple Framework: Co-Producing Social, Cultural, and Economic Value in Care Through a Generative and Relational Approach

by Luis Soares and Sarah Kettley

Int. J. Environ. Res. Public Health 2024, 21(11), 1521; https://doi.org/10.3390/ijerph21111521 - 15 Nov 2024

Abstract

Work has been undertaken in the healthcare sector to explore ways of co-producing design responses with different communities and organisations. However, we lack empirical analysis of how design thinking can help tackle complexity. To assist the Healthier Working Lives programme, we curated the [...] Read more.

Work has been undertaken in the healthcare sector to explore ways of co-producing design responses with different communities and organisations. However, we lack empirical analysis of how design thinking can help tackle complexity. To assist the Healthier Working Lives programme, we curated the Ripple Framework to develop trust and attempt to address the challenges of complexity in residential care. Through a generative design process, data were used to collaboratively define bespoke co-design pathways with 31 participants from six Scottish care providers over ten months. Thematic, content, and matrix analyses produced insights to inform vignettes illustrating how design responded to complex social care sector needs, with a particular focus on the fulfilment and flourishing of the care workforce. Drawing on our empirical material and using the Design Research Value Model, we illustrate how we have developed social, cultural, and economic value in care through co-design, enabling an opportunity to test the novel methodology. Full article

(This article belongs to the Special Issue Rising to the Healthy Ageing Challenge: Co-production with Older People and Business)

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12 pages, 314 KiB

Open AccessArticle

Personality Traits and Sociodemographic Variables’ Effects on Parental Burnout During the Second and Fourth COVID-19 Waves in Italian Parents

by Giulia Giordano, Barbara Caci, Marianna Alesi, Ambra Gentile, Sofia Burgio and Concetta Polizzi

Int. J. Environ. Res. Public Health 2024, 21(11), 1520; https://doi.org/10.3390/ijerph21111520 - 15 Nov 2024

Abstract

(1) Background: Since the COVID-19 pandemic was a source of stress for families, this study aimed to investigate the influence of dispositional factors, such as personality traits and sociodemographic variables, on parental burnout among Italian parents during two waves of the COVID-19 pandemic. [...] Read more.

(1) Background: Since the COVID-19 pandemic was a source of stress for families, this study aimed to investigate the influence of dispositional factors, such as personality traits and sociodemographic variables, on parental burnout among Italian parents during two waves of the COVID-19 pandemic. Therefore, the study assessed personality traits and sociodemographic variables as protective or risk factors for parental burnout levels. (2) Methods: The study consisted of two cross-sectional samples collected during the second and fourth waves of the Italian pandemic. The participants included 600 Italian parents: 245 from the second wave (average age = 37.12, SD = 2.78) and 355 from the fourth wave (average age = 36.89, SD = 3.14). The measures used were the Balance between Risks and Resources, the Personality Inventory, and a sociodemographic questionnaire. (3) Results: The t-test showed that parents in the fourth wave had lower parental burnout levels. Moreover, stepwise multiple linear regression revealed that sociodemographic variables did not have an effect, while significant effects of personality traits were found. Specifically, neuroticism was identified as a risk factor for parental burnout, while agreeableness and openness were identified as protective factors. (4) Conclusions: The findings indicated that similar stress levels were reported between the two waves of parents and that personality traits play a crucial role in facilitating or limiting the management of parental competencies during a risk condition. Full article

(This article belongs to the Section Behavioral and Mental Health)

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International Journal of Environmental Research and Public Health

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