Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.6 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
Latest Articles
Vaccination Open Day: A Cross-Sectional Study on the 2023 Experience in Lombardy Region, Italy
Int. J. Environ. Res. Public Health 2024, 21(6), 685; https://doi.org/10.3390/ijerph21060685 (registering DOI) - 27 May 2024
Abstract
Background: Vaccination is a highly effective tool for controlling infectious diseases, particularly in populations at high risk of contagion due to clinical conditions or occupational exposure, such as healthcare workers. The purpose of this study is to present the open day event that
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Background: Vaccination is a highly effective tool for controlling infectious diseases, particularly in populations at high risk of contagion due to clinical conditions or occupational exposure, such as healthcare workers. The purpose of this study is to present the open day event that marked the beginning of the influenza and anti-COVID-19 vaccination campaign in the Lombardy region and to describe the experience of an Istituto di Ricovero e Cura a Carattere Scientifico in Milan. Methods: During the vaccination open day, eligible individuals received free vaccinations for influenza, COVID-19, pneumococcal disease, and shingles, as provided by the Lombardy Agenzia per la Tutela della Salute. In celebration of the centenary of the Università degli Studi di Milano, the Fondazione Ca’Granda Ospedale Policlinico, a contracted hospital of the university, created a special electronic diary for a total of 150 individuals, equally divided between children aged 2–6, pregnant women, and university staff. Results: At the regional level, a total of 6634 influenza vaccines, 2055 anti-COVID-19 vaccines, 108 anti-pneumococcal vaccines, and 37 anti-zoster vaccines were administered. A total of 3134 (47.3%) influenza vaccines, 1151 (56%) anti-COVID-19 vaccines, and 77 (62%) anti-pneumococcal vaccines, were given to individuals aged 60–79. No differences were observed between the total number of male and female vaccinees (1017 and 1038, respectively), who received the anti-COVID-19 vaccine. At the Policlinico Foundation, out of 150 available booking slots, 154 vaccines were administered, including 117 influenza vaccines. Conclusions: The establishment of vaccine open days is a beneficial way to increase vaccine compliance. Co-administration of little-known vaccinations outside of healthcare settings could also be a useful tool.
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Open AccessArticle
A Comparison between Farm-Related Stress, Mental Health, and Social Support between Men and Women Farmers
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Josie M. Rudolphi, Courtney Cuthbertson, Amandeep Kaur and Jesus Sarol
Int. J. Environ. Res. Public Health 2024, 21(6), 684; https://doi.org/10.3390/ijerph21060684 (registering DOI) - 27 May 2024
Abstract
Agricultural producers have worse mental health than the general population; however, recent research has not considered differences in stressors and mental health conditions by gender. A survey was mailed to a random sample of farmers in Illinois to screen for symptoms of anxiety
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Agricultural producers have worse mental health than the general population; however, recent research has not considered differences in stressors and mental health conditions by gender. A survey was mailed to a random sample of farmers in Illinois to screen for symptoms of anxiety and depression and identify sources of stress and social support. Men experienced more stress related to environmental and economic conditions than women, while women tended to have slightly higher levels of geographic isolation stress than men. Overall, there were no significant differences by gender in the proportion meeting the criteria for depression or anxiety; however, the results are higher than what is observed in the general population. Among those farmers who experience higher levels of stress about geographic isolation, the odds for women farmers to experience depressive symptoms are four times more than men farmers (OR 4.46 (0.91, 21.8); p = 0.06). Additional research should examine the relationship between social support and mental health. Interventions to reduce stress by gender should be considered.
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(This article belongs to the Section Behavioral and Mental Health)
Open AccessReview
From Engineered Stone Slab to Silicosis: A Synthesis of Exposure Science and Medical Evidence
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Chandnee Ramkissoon, Sharyn Gaskin, Yong Song, Dino Pisaniello and Graeme R. Zosky
Int. J. Environ. Res. Public Health 2024, 21(6), 683; https://doi.org/10.3390/ijerph21060683 (registering DOI) - 27 May 2024
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Engineered stone (ES) is a popular building product, due to its architectural versatility and generally lower cost. However, the fabrication of organic resin-based ES kitchen benchtops from slabs has been associated with alarming rates of silicosis among workers. In 2024, fifteen years after
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Engineered stone (ES) is a popular building product, due to its architectural versatility and generally lower cost. However, the fabrication of organic resin-based ES kitchen benchtops from slabs has been associated with alarming rates of silicosis among workers. In 2024, fifteen years after the first reported ES-related cases in the world, Australia became the first country to ban the use and importation of ES. A range of interacting factors are relevant for ES-associated silicosis, including ES material composition, characteristics of dust exposure and lung cell-particle response. In turn, these are influenced by consumer demand, work practices, particle size and chemistry, dust control measures, industry regulation and worker-related characteristics. This literature review provides an evidence synthesis using a narrative approach, with the themes of product, exposure and host. Exposure pathways and pathogenesis are explored. Apart from crystalline silica content, consideration is given to non-siliceous ES components such as resins and metals that may modify chemical interactions and disease risk. Preventive effort can be aligned with each theme and associated evidence.
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Open AccessReview
Synthetic Colors in Food: A Warning for Children’s Health
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Zandleme Birino de Oliveira, Darlene Vitória Silva da Costa, Ana Caroline da Silva dos Santos, Antônio Quaresma da Silva Júnior, Amanda de Lima Silva, Raphael Carlos Ferrer de Santana, Isabella Cristhina Gonçalves Costa, Sara Freitas de Sousa Ramos, Gabriel Padilla and Silvia Katrine Rabelo da Silva
Int. J. Environ. Res. Public Health 2024, 21(6), 682; https://doi.org/10.3390/ijerph21060682 (registering DOI) - 27 May 2024
Abstract
This study addressed the harmful effects of artificial colors in pediatric populations, including children diagnosed with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), as well as those without behavioral disorders. There is a consensus that synthetic food colorings have several
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This study addressed the harmful effects of artificial colors in pediatric populations, including children diagnosed with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), as well as those without behavioral disorders. There is a consensus that synthetic food colorings have several impacts on consumers, especially pediatrics, due to their influence on sensory appeal, which can encourage preference for certain foods. The results revealed that these color additives are directly linked to a series of health problems, with a greater impact on children, including a predisposition to pathological conditions such as carcinogenic, allergenic, mutagenic, cytotoxic, and clastogenic activities, as well as gastrointestinal and respiratory problems, in addition to behavioral changes in children with and without diagnosed disorders. The harms of synthetic dyes in children with or without comorbidities are worrying and require a careful and proactive approach from parents, caregivers and public authorities.
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(This article belongs to the Special Issue Health Intervention for Young Children with or at Risk for Disabilities)
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Open AccessArticle
The Prevalence and Risk Factors of Low Bone Mineral Density in the Population of the Abay Region of Kazakhstan
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Madina Madiyeva, Tamara Rymbayeva, Alida Kaskabayeva, Gulzhan Bersimbekova, Gulnur Kanapiyanova, Mariya Prilutskaya, Dinara Akhmetzhanova, Aliya Alimbayeva and Nazarbek Omarov
Int. J. Environ. Res. Public Health 2024, 21(6), 681; https://doi.org/10.3390/ijerph21060681 (registering DOI) - 26 May 2024
Abstract
Osteoporosis is considered a serious public health problem that particularly affects the postmenopausal period. In 2018, in the Republic of Kazakhstan, the prevalence of osteoporosis was 10.0, and the incidence was 3.7 new cases, per 100,000 adults, respectively. The objective of this study
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Osteoporosis is considered a serious public health problem that particularly affects the postmenopausal period. In 2018, in the Republic of Kazakhstan, the prevalence of osteoporosis was 10.0, and the incidence was 3.7 new cases, per 100,000 adults, respectively. The objective of this study was to assess the prevalence of osteoporosis and indicate the main factors affecting low bone mineral density by screening the adult population of the Abay region, Kazakhstan. The target group comprised 641 respondents aged between 18 and 65 years old, from a Kazakh population, who had been living in the Abay region since birth. All participants filled out a questionnaire and were subjected to a bone mineral density measurement by means of dual-energy X-ray absorptiometry (DXA) between 15 July 2023 and 29 February 2024. Logistic regression analysis was conducted to assess the association between low bone mineral density and key demographic characteristics, such as lifestyle factors and nutritional habits. We identified the prevalence of low bone mass (osteopenia) and osteoporosis to be 34.1%, with the highest prevalence of 48.3% being found in the older population group (50+ years). The regression analysis revealed a number of indicators associated with the likelihood of bone sparing. However, only four of these showed significance in the final multivariate model (R2 = 22.4%). These were age (adjusted odds ratio (AOR) 1.05) and fracture history (AOR 1.64) directly associated with the likelihood of low bone density. Meanwhile, the body mass index (AOR 0.92) and the consumption of nuts and dried fruits (AOR 0.48) reduced the chance of bone tissue demineralization. Additional studies examining the prevalence and any emerging risk factors for osteoporosis are needed to advance clinical epidemiological knowledge and implement public health programs.
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(This article belongs to the Section Global Health)
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Open AccessArticle
Delivering Integrated Community Care for the Elderly: A Qualitative Case Study in Southern China
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Yiqiao Li, Lan Luo and Hongying Dong
Int. J. Environ. Res. Public Health 2024, 21(6), 680; https://doi.org/10.3390/ijerph21060680 (registering DOI) - 25 May 2024
Abstract
The rapid aging and increasing care demands among the elderly population present challenges to China’s health and social care system. The concept of aging in place has prompted the implementation of integrated community care (ICC) in the country. This study aims to provide
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The rapid aging and increasing care demands among the elderly population present challenges to China’s health and social care system. The concept of aging in place has prompted the implementation of integrated community care (ICC) in the country. This study aims to provide empirical insights into the practices of integrated care policies and approaches at the community level. Data for this study were collected through six months of participatory observations at a local community health service center in a southern Chinese city. Semi-structured interviews were conducted with the multidisciplinary community care team to gather frontline formal caregiver perceptions of ICC, thereby facilitating a better understanding of the obstacles and opportunities. Qualitative analysis revealed four themes: the ICC delivery model and development strategies within the community care scheme, the person-centered guiding principle, and the challenges and struggles encountered by formal caregivers within China’s current ICC system. The case study presented herein serves as a notable example of the pivotal role of primary care in the successful implementation of elderly care within a community setting. The adoption of a private organization-led approach to medico-social integration care in the community holds significant potential as a service delivery model for effectively addressing a wide range of elderly care issues.
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(This article belongs to the Special Issue Care and Services in Healthy Aging)
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Molecular Surveillance of Artemisinin-Resistant Plasmodium falciparum Parasites in Mining Areas of the Roraima Indigenous Territory in Brazil
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Jacqueline de Aguiar-Barros, Fabiana Granja, Rebecca de Abreu-Fernandes, Lucas Tavares de Queiroz, Daniel da Silva e Silva, Arthur Camurça Citó, Natália Ketrin Almeida-de-Oliveira Mocelin, Cláudio Tadeu Daniel-Ribeiro and Maria de Fátima Ferreira-da-Cruz
Int. J. Environ. Res. Public Health 2024, 21(6), 679; https://doi.org/10.3390/ijerph21060679 (registering DOI) - 25 May 2024
Abstract
Multidrug- and artemisinin-resistant (ART-R) Plasmodium falciparum (Pf) parasites represent a challenge for malaria elimination worldwide. Molecular monitoring in the Kelch domain region (pfk13) gene allows tracking mutations in parasite resistance to artemisinin. The increase in illegal miners in the Roraima Yanomami indigenous land (YIL)
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Multidrug- and artemisinin-resistant (ART-R) Plasmodium falciparum (Pf) parasites represent a challenge for malaria elimination worldwide. Molecular monitoring in the Kelch domain region (pfk13) gene allows tracking mutations in parasite resistance to artemisinin. The increase in illegal miners in the Roraima Yanomami indigenous land (YIL) could favor ART-R parasites. Thus, this study aimed to investigate ART-R in patients from illegal gold mining areas in the YIL of Roraima, Brazil. A questionnaire was conducted, and blood was collected from 48 patients diagnosed with P. falciparum or mixed malaria (Pf + P. vivax). The DNA was extracted and the pfk13 gene was amplified by PCR. The amplicons were subjected to DNA-Sanger-sequencing and the entire amplified fragment was analyzed. Among the patients, 96% (46) were from illegal mining areas of the YIL. All parasite samples carried the wild-type genotypes/ART-sensitive phenotypes. These data reinforce the continued use of artemisinin-based combination therapies (ACTs) in Roraima, as well as the maintenance of systematic monitoring for early detection of parasite populations resistant to ART, mainly in regions with an intense flow of individuals from mining areas, such as the YIL. This is especially true when the achievement of falciparum malaria elimination in Brazil is planned and expected by 2030.
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(This article belongs to the Special Issue Epidemiology, Surveillance, and Control of Frontier Malaria)
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The Impact of the COVID-19 Pandemic on STI and HIV Services in the Netherlands According to Health Care Professionals
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Annemarie Reilingh, Jenneke Van Ditzhuijzen, Thijs Albers, Hanna Bos and John De Wit
Int. J. Environ. Res. Public Health 2024, 21(6), 678; https://doi.org/10.3390/ijerph21060678 (registering DOI) - 25 May 2024
Abstract
Surveillance data from the Netherlands show that STI/HIV testing decreased at the start of the COVID-19 pandemic, suggesting barriers to access to STI/HIV care. However, the impact of the pandemic on STI/HIV care may be more complex, and key populations could be differentially
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Surveillance data from the Netherlands show that STI/HIV testing decreased at the start of the COVID-19 pandemic, suggesting barriers to access to STI/HIV care. However, the impact of the pandemic on STI/HIV care may be more complex, and key populations could be differentially affected. The aim of this study was to gain more insight into the impact of COVID-19 on STI/HIV care in the Netherlands from the perspective of STI/HIV care providers. We investigated whether professionals in STI/HIV care experienced changes compared to pre-COVID in access to STI/HIV care for priority populations, demand and provision of STI/HIV care, shifts to online STI/HIV counseling and care, and the quality assurance of STI/HIV care. An online survey was completed by 192 STI/HIV care professionals. Additionally, semi-structured interviews were held with 23 STI/HIV care professionals. According to participants, people in vulnerable circumstances, such as recent migrants and people with low health or digital literacy, may have had difficulties accessing STI/HIV care during the pandemic, especially during lockdowns and at public sexual health services. Hence, these may not have received the care they needed. Participants thought that COVID-19 measures may have compounded existing disparities. Furthermore, participants found that online care provision was not up to standard and were concerned about follow-up care for patients using private online providers of remote tests. It is important to explore how STI/HIV care for people in vulnerable circumstances can be ensured in future public health crises.
Full article
(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
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Open AccessArticle
The Impact of Newly Diagnosed Early Breast Cancer on Psychological Resilience, Distress Levels, and the Perception of Health
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Anuska Budisavljevic, Natalija Dedic Plavetic, Kristina Klaric, Renata Kelemenic-Drazin and Marina Letica-Crepulja
Int. J. Environ. Res. Public Health 2024, 21(6), 677; https://doi.org/10.3390/ijerph21060677 (registering DOI) - 24 May 2024
Abstract
Confronting a breast cancer diagnosis, along with complex and challenging treatment procedures, is an extremely stressful experience. Psychological resilience is the ability to maintain or restore normal functioning while facing adversity. We aimed to explore the impact of an early breast cancer diagnosis
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Confronting a breast cancer diagnosis, along with complex and challenging treatment procedures, is an extremely stressful experience. Psychological resilience is the ability to maintain or restore normal functioning while facing adversity. We aimed to explore the impact of an early breast cancer diagnosis on psychological resilience, distress, and perception of health. A cross-sectional study was conducted, including 50 patients newly diagnosed with early breast cancer and 67 healthy women with screening mammograms graded 1 or 2 using a Breast Imaging Reporting and Data System. The levels of distress, perception of health, and psychological resilience were assessed using the depression, anxiety, and stress scale, the SF 36-Item Health Survey 1.0, and the Connor–Davidson RISC-25 scale. Differences between variables were examined using the t-test and chi-square test for interval and categorial variables. The surveys were conducted within four weeks of a breast cancer diagnosis. Patients with breast cancer reported a deterioration of their health relative to the previous year and significantly higher levels of psychological resilience, while there was no significant difference between the groups in levels of stress, anxiety, or depression. The process of diagnosis with early breast cancer may activate psychological dynamic processes which are involved in the effective adaptation to acute stress, leading to higher resilience levels in breast cancer patients compared to healthy controls.
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(This article belongs to the Special Issue The Impact of Anxiety, Depression, and Stress on Mental Health)
Open AccessArticle
Clustering of Social Determinants of Health as an Indicator of Meaningful Subgroups within an African American Population: Application of Latent Class Analysis
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Sumihiro Suzuki, Joshua Longcoy, Zeynep Isgor, Elizabeth Avery, Tricia J. Johnson, Eric Yang and Elizabeth B. Lynch
Int. J. Environ. Res. Public Health 2024, 21(6), 676; https://doi.org/10.3390/ijerph21060676 - 24 May 2024
Abstract
Background: Health disparities between people who are African American (AA) versus their White counterparts have been well established, but disparities among AA people have not. The current study introduces a systematic method to determine subgroups within a sample of AA people based on
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Background: Health disparities between people who are African American (AA) versus their White counterparts have been well established, but disparities among AA people have not. The current study introduces a systematic method to determine subgroups within a sample of AA people based on their social determinants of health. Methods: Health screening data collected in the West Side of Chicago, an underserved predominantly AA area, in 2018 were used. Exploratory latent class analysis was used to determine subgroups of participants based on their responses to 16 variables, each pertaining to a specific social determinant of health. Results: Four unique clusters of participants were found, corresponding to those with “many unmet needs,” “basic unmet needs,” “unmet healthcare needs,” and “few unmet needs.” Conclusion: The findings support the utility of analytically determining meaningful subgroups among a sample of AA people and their social determinants of health. Understanding the differences within an underserved population may contribute to future interventions to eliminate health disparities.
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Open AccessArticle
Amazon Wildfires and Respiratory Health: Impacts during the Forest Fire Season from 2009 to 2019
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Maura R. Ribeiro, Marcos V. M. Lima, Roberto C. Ilacqua, Eriane J. L. Savoia, Rogerio Alvarenga, Amy Y. Vittor, Rodrigo D. Raimundo and Gabriel Z. Laporta
Int. J. Environ. Res. Public Health 2024, 21(6), 675; https://doi.org/10.3390/ijerph21060675 - 24 May 2024
Abstract
The Brazilian Amazon, a vital tropical region, faces escalating threats from human activities, agriculture, and climate change. This study aims to assess the relationship between forest fire occurrences, meteorological factors, and hospitalizations due to respiratory diseases in the Legal Amazon region from 2009
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The Brazilian Amazon, a vital tropical region, faces escalating threats from human activities, agriculture, and climate change. This study aims to assess the relationship between forest fire occurrences, meteorological factors, and hospitalizations due to respiratory diseases in the Legal Amazon region from 2009 to 2019. Employing simultaneous equation models with official data, we examined the association between deforestation-induced fires and respiratory health issues. Over the studied period, the Legal Amazon region recorded a staggering 1,438,322 wildfires, with 1,218,606 (85%) occurring during August–December, known as the forest fire season. During the forest fire season, a substantial portion (566,707) of the total 1,532,228 hospital admissions for respiratory diseases were recorded in individuals aged 0–14 years and 60 years and above. A model consisting of two sets of simultaneous equations was constructed. This model illustrates the seasonal fluctuations in meteorological conditions driving human activities associated with increased forest fires. It also represents how air quality variations impact the occurrence of respiratory diseases during forest fires. This modeling approach unveiled that drier conditions, elevated temperatures, and reduced precipitation exacerbate fire incidents, impacting hospital admissions for respiratory diseases at a rate as high as 22 hospital admissions per 1000 forest fire events during the forest fire season in the Legal Amazon, 2009–2019. This research highlights the urgent need for environmental and health policies to mitigate the effects of Amazon rainforest wildfires, stressing the interplay of deforestation, climate change, and human-induced fires on respiratory health.
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(This article belongs to the Special Issue The Role of Environmental Aspects in the Maintenance of Human Health)
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Open AccessArticle
Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years
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Komei Iwai, Tetsuji Azuma, Takatoshi Yonenaga, Yasuyuki Sasai, Yoshinari Komatsu, Koichiro Tabata, Taketsugu Nomura, Iwane Sugiura, Yujo Inagawa, Yusuke Matsumoto, Seiji Nakashima, Yoshikazu Abe and Takaaki Tomofuji
Int. J. Environ. Res. Public Health 2024, 21(6), 674; https://doi.org/10.3390/ijerph21060674 - 24 May 2024
Abstract
Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in
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Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in April 2018 were followed for 2 years. Swallowing function was assessed using a repetitive saliva swallowing test. In our study, 429 participants (13%) who were swallowing less than three times in 30 s based on a repetitive saliva swallowing test after 2 years were diagnosed as those with decline in swallowing function. Multivariate logistic regression analyses showed the decline in swallowing function after 2 years was associated with the male gender (odds ratio [ORs]: 0.772; 95% confidence interval [CIs]: 0.615–0.969), age ≥ 81 years (presence; ORs: 1.523; 95% CIs: 1.224–1.895), support/care-need certification (presence; ORs: 1.815; 95% CIs: 1.361–2.394), periodontal pocket depth (PPD) ≥ 4 mm (presence; ORs: 1.469; 95% CIs: 1.163–1.856), difficulty in biting hard food (yes; ORs: 1.439; 95% CIs: 1.145–1.808), choking on tea and water (yes; ORs: 2.543; 95% CIs: 2.025–3.193), and dry mouth (yes; ORs: 1.316; 95% CIs: 1.052–1.646) at baseline. Therefore, the dental checkup items associated with a decline in swallowing function after 2 years were a PPD ≥ 4 mm, difficulty in biting hard food, choking on tea and water, and dry mouth. PPD status and confirming to the self-administered questionnaire about biting, choking, and dry mouth may be useful in predicting future decline in swallowing function.
Full article
(This article belongs to the Special Issue Oral Health among the Older Population)
Open AccessStudy Protocol
Qualitative Protocol of Chinese Parents and Siblings Experiences of Managing Challenging Behaviours of Adult Persons with Intellectual Disability in Hong Kong and Northern China
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Lisa Pau-Le Low, Alice Nga-Lai Kwong, Yue Wang, Maggie Yat-Cheung Wong, Mimi Mei-Ha Tiu and Karen Wing-See Wan
Int. J. Environ. Res. Public Health 2024, 21(6), 673; https://doi.org/10.3390/ijerph21060673 - 24 May 2024
Abstract
Background: While the literature has highlighted the immense challenges in caring for family members, it is still unclear what the needs of family carers of persons with intellectual disability and challenging behaviours are and what has worked for them. This study aims to
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Background: While the literature has highlighted the immense challenges in caring for family members, it is still unclear what the needs of family carers of persons with intellectual disability and challenging behaviours are and what has worked for them. This study aims to examine 60 parents’ and siblings’ experiences in managing the challenging behaviours of their adult family member with intellectual disability whilst living at home. Methods: A qualitative grounded theory approach using semi-structured interviews will be adopted. Purposive sampling will be used to recruit family carers who live with adult persons with intellectual disability and use one community service in Hong Kong. Three special schools for persons with intellectual disability from northern China will be approached. Results: This study will aim to provide an in-depth understanding of the experiences of family carers and compare the different circumstances they face when managing the challenging behaviours of their adult relatives with intellectual disability in their family home. Conclusions: Although this study targets adults with intellectual disability, the findings will provide a point of reference for adolescents and younger persons who exhibit demanding and challenging behaviours and live with their families. Recommendations can guide the development of appropriate strategies to strengthen services for family carers.
Full article
(This article belongs to the Section Behavioral and Mental Health)
Open AccessArticle
Anthropometric Profile, Overweight/Obesity Prevalence, and Socioeconomic Impact in Moroccan Children Aged 6–12 Years Old with Autism Spectrum Disorder
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Rachid Touali, Maxime Allisse, Jamal Zerouaoui, El Mahjoub Chakir, Dominic Gagnon, Hung Tien Bui and Mario Leone
Int. J. Environ. Res. Public Health 2024, 21(6), 672; https://doi.org/10.3390/ijerph21060672 - 24 May 2024
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Background: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. Methods: A total of
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Background: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. Methods: A total of 258 children (boys = 195) aged 6 to 12 years old (mean = 9.4 ± 1.4) diagnosed with ASD participated in this study. Besides the body mass and height, four significant anthropometric markers for assessing obesity were examined: body mass index (BMI), body surface area (BSA), waist circumference (WC), and waist-to-height ratio (WHtR). Each anthropometric marker was categorized into one of three cardiometabolic risk levels based on the Z-scores and their corresponding percentiles. The distribution was as follows: low risk (≤84th percentile), high risk (85th–94th percentile), and very high risk (≥95th percentile). Subsequently, a multiple regression analysis was employed to develop an algorithm that generates a composite risk score. This score incorporates all the anthropometric variables simultaneously, while also weighting their individual contributions to the cardiometabolic risk. Results: Children with ASD exhibit an anthropometric profile that markedly increases their susceptibility to cardiometabolic issues. While roughly 11% of the general Moroccan child population is overweight or obese, this figure soars to nearly 60% among children with ASD when considering the central adiposity markers. Furthermore, children from middle-class socioeconomic backgrounds display a more than threefold greater risk of developing overweight or obesity compared to their counterparts from lower socioeconomic backgrounds. Conclusions: This study has, for the first time, provided an up-to-date overview of the cardiometabolic risk in Moroccan children with ASD using traditional anthropometric measurements. The primary risk factor is clearly linked to central (abdominal) adiposity, which is recognized as the most deleterious. This study highlights the need to include general and central obesity markers. This study underscores the importance of incorporating both general and central adiposity markers for a more comprehensive assessment, and it emphasizes the need for closer monitoring within this high-risk population.
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Open AccessArticle
Exploring the Feasibility of an Electronic Tool for Predicting Retention in HIV Care: Provider Perspectives
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Jacqueline Kromash, Eleanor E. Friedman, Samantha A. Devlin, Jessica Schmitt, John M. Flores and Jessica P. Ridgway
Int. J. Environ. Res. Public Health 2024, 21(6), 671; https://doi.org/10.3390/ijerph21060671 - 24 May 2024
Abstract
Retention in care for people living with HIV (PLWH) is important for individual and population health. Preemptive identification of PLWH at high risk of lapsing in care may improve retention efforts. We surveyed providers at nine institutions throughout Chicago about their perspectives on
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Retention in care for people living with HIV (PLWH) is important for individual and population health. Preemptive identification of PLWH at high risk of lapsing in care may improve retention efforts. We surveyed providers at nine institutions throughout Chicago about their perspectives on using an electronic health record (EHR) tool to predict the risk of lapsing in care. Sixty-three percent (20/32) of providers reported currently assessing patients’ risk for lapsing in care, and 91% (29/32) reported willingness to implement an EHR tool. When compared to those with other job roles, prescribers agreed (vs. neutral) that the tool would be less biased than personal judgment (OR 13.33, 95% CI 1.05, 169.56). Prescribers were also more likely to identify community health workers as persons who should deliver these interventions (OR 10.50, 95% CI 1.02, 108.58). Transportation, housing, substance use, and employment information were factors that providers wanted to be included in an EHR-based tool. Social workers were significantly more likely to indicate the inclusion of employment information as important (OR 10.50, 95% CI 1.11, 98.87) when compared to other participants. Acceptability of an EHR tool was high; future research should investigate barriers and evaluate the effectiveness of such a tool.
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Open AccessReview
Looking beyond Body Structure and Function: ICF Foci and Who Is Being Assessed in Research about Adolescents and Young Adults with Cerebral Palsy—A Scoping Review
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Camila Araújo Santos Santana, Peter Rosenbaum, Jet van der Kemp and Ana Carolina de Campos
Int. J. Environ. Res. Public Health 2024, 21(6), 670; https://doi.org/10.3390/ijerph21060670 - 24 May 2024
Abstract
Purpose: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. Method:
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Purpose: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. Method: Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13–30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. Results: In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). Conclusions: Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.
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(This article belongs to the Special Issue Current Issues in the Neurological Rehabilitation of Children and Adolescents)
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Open AccessArticle
Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus
by
Ginny S. Paleg, Sian A. Williams and Roslyn W. Livingstone
Int. J. Environ. Res. Public Health 2024, 21(6), 669; https://doi.org/10.3390/ijerph21060669 (registering DOI) - 23 May 2024
Abstract
Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and
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Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9–15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.
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(This article belongs to the Special Issue Current Issues in the Neurological Rehabilitation of Children and Adolescents)
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Association between Sleep Duration, Social Jetlag, and the Metabolic Syndrome by Shift Works
by
Minjung Kyung, Sungwon Park, Chang Gi Park and OiSaeng Hong
Int. J. Environ. Res. Public Health 2024, 21(6), 668; https://doi.org/10.3390/ijerph21060668 - 23 May 2024
Abstract
Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the
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Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the moderating effect of sleep duration and social jetlag on this relationship. Data from the National Health and Nutrition Examination Survey (NHANES) in 2017–2020 March were analyzed. Poisson regression models were employed to examine associations. Among 4136 U.S. workers, 53.3% had metabolic syndrome, with a higher proportion of shift workers (63.8% vs. 56.7%, p = 0.001) and those sleeping less than 6 h or more than 9 h per week (22.3% vs. 19.1%, p = 0.044) in the affected group. Shift workers were initially found to have an increased risk of metabolic syndrome (Coef. = 0.03, 95% CI: 0.02, 0.16); however, this association was mitigated when accounting for the interaction with social jetlag. Specifically, 1 to <2 h of social jetlag interacted significantly, increasing metabolic risk (Coef. = 0.15, 95% CI: 0.09, 0.22), whereas 1 to <2 h alone showed a protective effect (Coef. = −0.11, 95% CI: −0.17, −0.06). These findings suggest that optimizing sleep schedules and addressing social jetlag may be crucial in mitigating metabolic syndrome risks among shift workers.
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(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
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Public Health Impacts of Ambient Particulate Matter Pollution in Libya from 1990 to 2019: An Analysis of the 2019 Global Burden of Disease (GBD) Study
by
David Rojas-Rueda, Sandhya Lamsal, Mohini Kak, Sameh El-Saharty and Christopher H. Herbst
Int. J. Environ. Res. Public Health 2024, 21(6), 667; https://doi.org/10.3390/ijerph21060667 - 23 May 2024
Abstract
Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in
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Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM2.5 concentration in Libya was 38.6 μg/m3 in 2019, marking a 3% increase since 1990. In the same year, PM2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services.
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(This article belongs to the Special Issue Health Impact Assessment)
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A Case Study of Ergonomic Risk Assessment in Slovakia with Respect to EU Standard
by
Daniela Onofrejova, Miriam Andrejiova, Denisa Porubcanova, Hana Pacaiova and Lydia Sobotova
Int. J. Environ. Res. Public Health 2024, 21(6), 666; https://doi.org/10.3390/ijerph21060666 - 23 May 2024
Abstract
Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct
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Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare several commonly used methods in Slovakia for the assessment of ergonomic risk reflecting current EU and Slovak legislative regulations. A Captiv wireless sensory system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak Legislation), the STN EN 1005-4+A1, and the French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which affects the final evaluation of the measurements. Our experience from applying improved risk assessment methodology may have an impact on Slovak industrial workplaces. It was confirmed that there is a need to create uniform standards for the ergonomic risk assessment of body posture, including a detailed description of the threshold values for individual body segments.
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(This article belongs to the Special Issue Advances in Ergonomics, Human Factors and Safety for Occupational Health)
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