BBC Russian

13 pages, 480 KiB

Open AccessArticle

“Empowerment for Us by Us (E4UBU)”: Developing a Model of Empowerment Using Feminist Participatory Methods with LBQT+ Persons Assigned Female at Birth in Western Kenya

by Heather M. Tucker, Rebecca Odhiambo, Laura Jadwin-Cakmak, Anita Mbanda, Ashley Lacombe-Duncan, Caroline Rucah, Ini-Abasi Ubong, Cynthia Akoth Ouko, Wilson Odero and Gary W. Harper

Int. J. Environ. Res. Public Health 2024, 21(7), 948; https://doi.org/10.3390/ijerph21070948 - 19 Jul 2024

Abstract

Lesbian, bisexual, queer, trans and other gender diverse persons assigned female at birth (heretofore referred to as “LBQT+ persons”) in Western Kenya experience intersectional oppression and stigma. This stigma can manifest in acts of sexual and gender-based violence (SGBV) and sexual and gender [...] Read more.

Lesbian, bisexual, queer, trans and other gender diverse persons assigned female at birth (heretofore referred to as “LBQT+ persons”) in Western Kenya experience intersectional oppression and stigma. This stigma can manifest in acts of sexual and gender-based violence (SGBV) and sexual and gender minority (SGM)-based violence, as well as various forms of discrimination—all of which have been linked to disproportionately higher levels of negative health outcomes for this group. Despite these challenges, many LBQT+ persons have been able to gain personal and collective power and thrive in this oppressive environment. The Empowerment for Us by Us (E4UBU) project is a mixed methods feminist participatory research study focused on exploring how LBQT+ persons conceptualize and define empowerment for themselves, and to understand their perspectives on how feelings of power and powerlessness influence their physical and mental health. This paper focuses on data from the first phase of the study, in which qualitative in-depth interviews were conducted with 40 LBQT+ persons (ages 19 to 50) from Kisumu and Homa Bay in Western Kenya. A participatory interpretive phenomenological analysis was conducted to understand the lived experiences of LBQT+ persons as they navigate intersectional oppression and its influence on their experiences of empowerment and subsequent health outcomes. Findings from this analysis were presented to two different focus groups composed of participants who had participated in the in-depth interviews to gather their insights on the interpretations of the interviews as a form of member checking. Findings revealed that “empowerment” was not experienced and viewed by LBQT+ persons as a monolithic construct, but rather a process through which LBQT+ persons are able to transform negative forces of intersectional oppression and powerlessness into experiences of power and subsequent individual and collective action and impact—all leading to improved mental health and well-being. This process is facilitated at several junctures by participatory seeking and attainment of community-appropriate resources at multiple socio-ecological levels that, when accessed with sufficient intensity, frequency, and duration, enhance one’s journey through the process of empowerment. These facilitation junctures are viewed as likely points of focus for public health intervention. Analysis also revealed that the process of empowerment is dependent on the context within which the process is occurring, the specific issues being faced, and the population of focus. Recommendations for how this model can be used for future research and practice to improve the lives of LBQT+ persons in Kenya are discussed. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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11 pages, 507 KiB

Open AccessArticle

Relationship between Tilt Sensation Ability and Lower Limb Injuries in Junior Athletes

by Maki Tanaka, Yuka Inoue, Megumi Gonno, Teruo Nomura, Kyosuke Oku, Tomoyuki Matsui, Machiko Hiramoto, Tetsuya Miyazaki, Hitoshi Koda, Yuya Watanabe, Yoshihiro Kai, Toru Morihara and Noriyuki Kida

Int. J. Environ. Res. Public Health 2024, 21(7), 947; https://doi.org/10.3390/ijerph21070947 - 19 Jul 2024

Abstract

The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. [...] Read more.

The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. In this study, a step platform created tilt angles. Participants with eye masks answered “yes” or “no” to sensing a tilt, evaluated over nine or seven trials. Experiment 1 involved 22 university students (20.6 ± 0.9 years). The minimum angle at which a tilt could be sensed while standing on both feet was determined, and measurements were taken again to examine reliability. Experiment 2 involved 40 junior athletes (12.3 ± 2.0 years), where the minimum angle for tilt sensation was obtained, and medical checks were conducted to assess injuries in the knee, lower leg, and foot. Reliability studies showed a moderately significant correlation between the first and second sessions (r = 0.504, p = 0.017), suggesting the reliability of the experimental method. The proportion capable of sensing a tilt of 1.1° and 1.6° was significantly higher in junior high school students than in elementary school students (1.1°; χ² = 8.839, p = 0.003. 1.6°; χ² = 4.038, p = 0.044). The group unable to sense a tilt of 1.6° and 2.1° had a significantly higher positive rate of knee injuries compared to the sensed group among junior high school students (1.6°; χ² = 4.622, p = 0.032. 2.1°; χ² = 4.622, p = 0.032). Our findings suggested that a reduced tilt sensation ability was associated with knee injuries in junior high school students. Utilizing our devised tilt sensation assessment could play a crucial role in preventing and detecting early injuries in junior high school students. Full article

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12 pages, 309 KiB

Open AccessArticle

Exploring the Support Needs of Chinese Family Carers of People Living with Dementia in New Zealand during the COVID-19 Pandemic: A Resilience Resources Framework Perspective

by Fei Li, John Parsons and Gary Cheung

Int. J. Environ. Res. Public Health 2024, 21(7), 946; https://doi.org/10.3390/ijerph21070946 - 19 Jul 2024

Abstract

Caring for people living with dementia during the novel coronavirus disease 2019 (COVID-19) pandemic significantly impacted the emotional, physical, and social well-being of carers. However, no study has focused on the well-being of Chinese carers of people living with dementia in New Zealand [...] Read more.

Caring for people living with dementia during the novel coronavirus disease 2019 (COVID-19) pandemic significantly impacted the emotional, physical, and social well-being of carers. However, no study has focused on the well-being of Chinese carers of people living with dementia in New Zealand during the pandemic. This study aimed to explore the support needs of Chinese carers of people living with dementia in New Zealand during the COVID-19 pandemic. Semi-structured interviews were conducted by two bilingual and bicultural researchers. Thematic analysis was used to explore the resilience resources for Chinese carers. Twelve Chinese carers were recruited from four community organizations in New Zealand. Four themes were identified: (1) social isolation, (2) emotional loneliness, (3) ambivalent feelings of being a carer, and (4) a variety of unmet needs. The findings of our study provide new insights into the multiple support needs of Chinese carers of people living with dementia during the COVID-19 pandemic. Implications for practice include the establishment of culturally appropriate care support services and the development of tailored resilience-building interventions to address the unmet needs of Chinese carers of people living with dementia. Full article

16 pages, 1020 KiB

Open AccessArticle

Evaluating Food Procurement against the EAT-Lancet Planetary Health Diet in a Sample of U.S. Universities

by Jaclyn Bertoldo, Abby Fammartino, Sophie Egan, Roni A. Neff, Rebecca Grekin and Julia A. Wolfson

Int. J. Environ. Res. Public Health 2024, 21(7), 945; https://doi.org/10.3390/ijerph21070945 - 19 Jul 2024

Abstract

Aligning institutional food procurement with planetary health targets offers opportunities to improve nutrition and reduce food-related greenhouse gas (GHG) emissions. This study compared foods procured by 19 university dining programs in the U.S. in 2022 with the EAT-Lancet planetary health diet. Each [...] Read more.

Aligning institutional food procurement with planetary health targets offers opportunities to improve nutrition and reduce food-related greenhouse gas (GHG) emissions. This study compared foods procured by 19 university dining programs in the U.S. in 2022 with the EAT-Lancet planetary health diet. Each university’s procurement was then modeled to align with the EAT-Lancet planetary health diet, and changes to Healthy Eating Index (HEI) scores and GHG emissions were evaluated. For a subset of universities that provided cost data, changes in annual total food costs were also estimated. Universities in this study exceeded EAT-Lancet planetary health targets for beef (

\bar{x}

= 657% of target), pork (

\bar{x}

= 587%), poultry (

\bar{x}

= 379%), and eggs (

\bar{x}

= 293%). All universities failed to achieve planetary health targets for legumes and nuts (

\bar{x}

= 39% of the target) and vegetables (

\bar{x}

= 68%). Aligning food procurement with the planetary health diet would result in an estimated average 46.1% reduction in GHG emissions and a 19.7 point increase in HEI scores. Universities that provided cost data saw an average 9.7% reduction in food costs in the EAT-Lancet-aligned scenario. The procurement metrics assessed in this study can help university dining programs and other institutional food service organizations set goals and monitor progress toward planetary health targets. Full article

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12 pages, 631 KiB

Open AccessArticle

Hospital Chaplain Burnout, Depression, and Well-Being during the COVID-19 Pandemic

by Patricia K. Palmer, Zainab Siddiqui, Miranda A. Moore, George H. Grant, Charles L. Raison and Jennifer S. Mascaro

Int. J. Environ. Res. Public Health 2024, 21(7), 944; https://doi.org/10.3390/ijerph21070944 - 19 Jul 2024

Abstract

Healthcare personnel experienced unprecedented stressors and risk factors for burnout, anxiety, and depression during the COVID-19 pandemic. This may have been particularly true for spiritual health clinicians (SHCs), also referred to as healthcare chaplains. We administered a daily pulse survey that allowed SHCs [...] Read more.

Healthcare personnel experienced unprecedented stressors and risk factors for burnout, anxiety, and depression during the COVID-19 pandemic. This may have been particularly true for spiritual health clinicians (SHCs), also referred to as healthcare chaplains. We administered a daily pulse survey that allowed SHCs to self-report burnout, depression, and well-being, administered every weekday for the first year of the pandemic. We used a series of linear regression models to evaluate whether burnout, depression, and well-being were associated with local COVID-19 rates in the chaplains’ hospital system (COVID-19 admissions, hospital deaths from COVID-19, and COVID-19 ICU census). We also compared SHC weekly rates with national averages acquired by the U.S. Census Bureau’s Household Pulse Survey (HPS) data during the same timeframe. Of the 840 daily entries from 32 SHCs, 90.0% indicated no symptoms of burnout and 97.1% were below the cutoff for depression. There was no statistically significant relationship between any of the COVID-19 predictors and burnout, depression, or well-being. Mean national PHQ-2 scores were consistently higher than our sample’s biweekly means. Understanding why SHCs were largely protected against burnout and depression may help in addressing the epidemic of burnout among healthcare providers and for preparedness for future healthcare crises. Full article

(This article belongs to the Special Issue Occupational Health and Wellbeing for Healthcare Providers)

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14 pages, 2150 KiB

Open AccessArticle

Women’s Empowerment and Associated Factors in Kinshasa, Democratic Republic of Congo: A Secondary Data Analysis of the Performance Monitoring Assessment Survey

by Annick Makongote, Branly Mbunga, Pierre Akilimali, Sofia Castro Lopes and Dieudonné Mpunga

Int. J. Environ. Res. Public Health 2024, 21(7), 943; https://doi.org/10.3390/ijerph21070943 - 19 Jul 2024

Abstract

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess [...] Read more.

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess women’s empowerment and determine its associated factors in Kinshasa, DRC. We analyzed data from the 2021 Performance Monitoring Assessment (PMA) survey. A sample of 1365 women of childbearing age was retained for this study. Twenty empowerment items related to household decision-making, contraception use, and husband/partner influence were considered. We calculated the average women’s empowerment index (aWEI), identified the women’s empowerment variables using principal component analysis (PCA), and determined the associated factors for the first three principal components through the performance of multivariate binary logistic regression. In Kinshasa, the overall aWEI was estimated at 0.65. It was low for household decision-making (0.34) and high for husband/partner influence domains (0.93). Three principal components were identified and named, including the absence of threats, control of sexuality, and participation in decision-making. The factors associated with these components were having internet access, being in free union with a partner, being aged 40–49 years, and residing in a non-slum area. Increasing access to information would enable women in Kinshasa to make strategic decisions about their lives, benefiting themselves and others. Full article

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10 pages, 2000 KiB

Open AccessArticle

Daylight and Electric Lighting in Primary and Secondary School Classrooms in the UK—An Observational Study

by Luke L. A. Price, Annegret Dahlmann-Noor and Marina Khazova

Int. J. Environ. Res. Public Health 2024, 21(7), 942; https://doi.org/10.3390/ijerph21070942 - 19 Jul 2024

Abstract

Only a few recent studies report direct assessment or monitoring of light levels in the indoor learning environment, and no consensus exists on minimum exposures for children’s health. For instance, myopia is a common progressive condition, with genetic and environmental risk factors. Reduced [...] Read more.

Only a few recent studies report direct assessment or monitoring of light levels in the indoor learning environment, and no consensus exists on minimum exposures for children’s health. For instance, myopia is a common progressive condition, with genetic and environmental risk factors. Reduced daylight exposure, electric lighting changes, increased near-work for school children, greater academic focus, and use of display screens and white boards may have important detrimental influences. Published assessment methods had varied limitations, such as incomplete compliance from participants wearing light loggers for extended periods. Climate-Based Daylight Modelling is encouraged in UK school design, but design approaches are impractical for post-occupancy assessments of pre-existing classrooms or ad hoc modifications. In this study, we investigated the potential for direct assessment and monitoring of classroom daylight and lighting measurements. Combined with objective assessments of outdoor exposures and class time use, the classroom data could inform design and light exposure interventions to reduce the various health impacts of inadequate daylight exposure. The relevant environmental measure for myopia depends on the hypothesized mechanism, so the illuminance, spectral distribution, and temporal light modulation from the electric lighting was also assessed. Full article

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23 pages, 2129 KiB

Open AccessArticle

Ergonomics, Health, and Perceptions about Remote Domestic Workposts: Study in Areas of City of João Pessoa, Paraíba, Brazil

by Luiz Bueno Silva, Carmem Julianne Beserra Melo, Adriana Gomes Lisboa de Souza and Lucas Guedes de Oliveira

Int. J. Environ. Res. Public Health 2024, 21(7), 941; https://doi.org/10.3390/ijerph21070941 - 19 Jul 2024

Abstract

Home office (HO) stands out as one of the most promising and popular forms of teleworking, especially after the COVID-19 pandemic. Therefore, many companies want to implement or maintain this working method, given its numerous advantages. However, there are adverse effects that are [...] Read more.

Home office (HO) stands out as one of the most promising and popular forms of teleworking, especially after the COVID-19 pandemic. Therefore, many companies want to implement or maintain this working method, given its numerous advantages. However, there are adverse effects that are mainly related to physical and mental health. This article presents ergonomic analyses of HOs in neighborhoods considered heat islands. Temperature levels, extreme low-frequency non-ionizing radiation (ELF-NIR), illuminance, physical layout characteristics, and physiological parameters of teleworkers were measured. The results reveal that 92% of these professionals work 6 to 8 h daily with an ambient temperature between 25 and 30 °C, illumination levels in the range 11.20–290 Lux, and ELF-NIR > 0.4 µT. The majority of teleworkers are overweight (BMI > 24.9), and some of them have blood pressure higher than average values (129 mmHg for systolic and 84 mmHg for diastolic) in addition to a reduction in the number of red blood cells and hematocrits. Symptoms such as burning sensation, dryness, tired eyes, redness, itching, and photophobia (light sensitivity) show a 68.95% similarity. These HOs do not meet the required ergonomic and health standards. Full article

(This article belongs to the Special Issue Advances in Ergonomics, Human Factors and Safety for Occupational Health)

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13 pages, 1225 KiB

Open AccessSystematic Review

Social Story Intervention for Training Expected Behaviors among Preschool Children: A Systematic Review and Meta-Analysis

by Ni Zhou, Li Zhou, Cheuk Yu Teresa Ho, Colman McGrath and Hai Ming Wong

Int. J. Environ. Res. Public Health 2024, 21(7), 940; https://doi.org/10.3390/ijerph21070940 - 19 Jul 2024

Abstract

Promoting appropriate behaviors in early childhood is crucial for children’s future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. [...] Read more.

Promoting appropriate behaviors in early childhood is crucial for children’s future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. The references were systematically screened in accordance with the PRISMA statements. Randomized or non-randomized controlled studies, as well as single-subject studies, in which SSs served as a behavioral training approach for children aged 2 to 6 years were included. Information related to study design, characteristics of the participants, target behaviors, and implementation of SS intervention was extracted. A meta-analysis was performed using the random-effects model, where similar outcomes were evaluated by similar intervention across multiple studies. Twenty-one studies were identified for qualitative analysis, while two studies formed the basis of the meta-analysis. SS interventions were employed to teach a variety of behaviors among typically developing children as well as those with various disabilities, such as autism, developmental delay, hearing impairments, attention deficit hyperactivity disorder, or other disabilities. The target behaviors included oral health practices, peer interaction, staying on-task, self-regulation, sleep habits, and controlling aggressive behavior during group activities. The SSs were used either alone or combined with other strategies, such as positive reinforcement, music therapy, role play, group discussion, video self-modeling, immediate practices, or additional audio commentary. Most studies reported improvements in appropriate behaviors and/or reductions in unfavorable behaviors. The meta-analysis indicated that children practiced more toothbrushing steps when using SS interventions compared to conventional oral health instruction (Z = 3.60, MD = 0.66, 95%CI 0.30 to 1.02, p < 0.001). SS interventions have the potential to teach target behaviors, particularly toothbrushing behaviors, among preschool children. More well-designed randomized controlled trials are warranted to determine the efficacy of SS interventions among children with various developmental profiles. Full article

(This article belongs to the Section Global Health)

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11 pages, 289 KiB

Open AccessArticle

Factors Associated with Legionella Detection in the Water Systems of National Lodging Organization Facilities with Water Management Programs in the United States

by Rebecca Kahn, Gordana Derado, Elizabeth J. Hannapel, Patrick Vander Kelen, Jasen M. Kunz and Chris Edens

Int. J. Environ. Res. Public Health 2024, 21(7), 939; https://doi.org/10.3390/ijerph21070939 - 18 Jul 2024

Abstract

A better understanding of risk factors and the predictive capability of water management program (WMP) data in detecting Legionella are needed to inform the efforts aimed at reducing Legionella growth and preventing outbreaks of Legionnaires’ disease. Using WMPs and Legionella testing data from [...] Read more.

A better understanding of risk factors and the predictive capability of water management program (WMP) data in detecting Legionella are needed to inform the efforts aimed at reducing Legionella growth and preventing outbreaks of Legionnaires’ disease. Using WMPs and Legionella testing data from a national lodging organization in the United States, we aimed to (1) identify factors associated with Legionella detection and (2) assess the ability of WMP disinfectant and temperature metrics to predict Legionella detection. We conducted a logistic regression analysis to identify WMP metrics associated with Legionella serogroup 1 (SG1) detection. We also estimated the predictive values for each of the WMP metrics and SG1 detection. Of 5435 testing observations from 2018 to 2020, 411 (7.6%) had SG1 detection, and 1606 (29.5%) had either SG1 or non-SG1 detection. We found failures in commonly collected WMP metrics, particularly at the primary test point for total disinfectant levels in hot water, to be associated with SG1 detection. These findings highlight that establishing and regularly monitoring water quality parameters for WMPs may be important for preventing Legionella growth and subsequent disease. However, while unsuitable water quality parameter results are associated with Legionella detection, this study found that they had poor predictive value, due in part to the low prevalence of SG1 detection in this dataset. These findings suggest that Legionella testing provides critical information to validate if a WMP is working, which cannot be obtained through water quality parameter measurements alone. Full article

9 pages, 1229 KiB

Open AccessBrief Report

Aerobic Exercise in the Aquatic Environment Suppresses the Plasma Renin Activity in Individuals with Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial

by Rodrigo Sudatti Delevatti, Larissa dos Santos Leonel, João Gabriel da Silveira Rodrigues, Ana Carolina Kanitz, Cristine Lima Alberton, Gisele Agustini Lovatel, Ionara Rodrigues Siqueira and Luiz Fernando Martins Kruel

Int. J. Environ. Res. Public Health 2024, 21(7), 938; https://doi.org/10.3390/ijerph21070938 - 18 Jul 2024

Abstract

To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or [...] Read more.

To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or on an athletics track, respectively. Both sessions comprised seven blocks of 3 min at 85–90% of the heart rate deflection point (HRDP), interspersed with 2 min at <85% HRDP, totaling 35 min, with a 48 h interval between sessions. PRA and blood glucose were assessed before and immediately after the sessions. Generalized estimation equations were used to verify the session effects, with the Bonferroni post hoc test, considering the significance level as 0.05. Twelve individuals (53.2 ± 8.9 years) diagnosed with type 2 diabetes for 6.3 ± 6.34 years participated in the study. A reduction in PRA was found only after the aquatic session (−7.75 ng/mL/h; −69%; p: 0.034), while both aquatic and dry-land sessions similarly reduced the blood glucose levels (aquatic: −38 mg/dL, −21%; dry-land: −26 mg/dL, −14%; time effect, p = 0.007). Despite yielding similar glycemic reductions as dry-land walking/running, aquatic walking/running led to an expressive decrease in PRA among individuals with type 2 diabetes. Full article

(This article belongs to the Special Issue New Advances in Diabetes)

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13 pages, 354 KiB

Open AccessArticle

Is Having Urban Green Space in the Neighborhood Enough to Make a Difference? Insights for Healthier City Design

by Adriano Bressane, Maria Eduarda Guedes Ferreira, Ana Júlia da Silva Garcia and Líliam César de Castro Medeiros

Int. J. Environ. Res. Public Health 2024, 21(7), 937; https://doi.org/10.3390/ijerph21070937 - 18 Jul 2024

Abstract

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose [...] Read more.

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose: This study delves into whether merely having green space in the neighborhood is sufficient to impact residents’ mental health in Brazilian metropolitan regions. Method: Utilizing a cross-sectional survey, data were collected from 2136 participants. The analyzed variables included the intensity, duration, and frequency of nature engagement, suitability of UGS for visitation and physical activities, and mental well-being indicators measured by the DASS-21 scale. Multivariate statistical analyses and multiple regression models were employed to verify hypothetical relationships. Results and conclusions: Higher intensity, duration, and frequency of nature engagement in UGS were significantly associated with lower depression, anxiety, and stress scores. Notably, having urban UGS in the neighborhood alone was not enough to reduce mental health issues. Practical implications: The findings point out the need for urban planning policies that prioritize the development of high-quality, accessible green spaces to maximize mental well-being benefits. These insights could inform city designs that foster healthier urban environments. Future directions: Longitudinal studies are needed to establish causality between nature engagement and mental health improvements. Further research should incorporate objective measures of nature engagement and explore more aspects of green space quality, such as biodiversity and amenities. Full article

(This article belongs to the Special Issue Trends in Sustainable and Healthy Cities)

17 pages, 489 KiB

Open AccessArticle

A Randomized Controlled Trial Testing the Effects of a Social Needs Navigation Intervention on Health Outcomes and Healthcare Utilization among Medicaid Members with Type 2 Diabetes

by Amy McQueen, David von Nordheim, Charlene Caburnay, Linda Li, Cynthia Herrick, Lauren Grimes, Darrell Broussard, Rachel E. Smith, Dana Lawson, Yan Yan and Matthew Kreuter

Int. J. Environ. Res. Public Health 2024, 21(7), 936; https://doi.org/10.3390/ijerph21070936 - 18 Jul 2024

Abstract

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation [...] Read more.

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation (n = 234) for 6 months and compare HbA1c (primary outcome), quality of life (secondary outcome), and other exploratory outcomes with t-tests and mixed-effects regression. Eligible participants had an HbA1c test in claims in the past 120 days and reported 1+ social needs. Data were collected from November 2019 to July 2023. Surveys were completed at baseline and at 3-, 6-, and 12-month follow-up. Health plan data included care management records and medical and pharmacy claims. The sample was from Louisiana, USA, M = 51.6 (SD = 9.5) years old, 76.1% female, 66.5% Black, 29.4% White, and 3.0% Hispanic. By design, more navigation (91.5%) vs. usual care (6.7%) participants had a care plan. Social needs persisted for both groups. No group differences in HbA1c tests and values were observed, though the large amount of missing HbA1c lab values reduced statistical power. No group differences were observed for other outcomes. Proactively eliciting and attempting to provide referrals and resources for social needs did not demonstrate significant health benefits or decrease healthcare utilization in this sample. Full article

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11 pages, 347 KiB

Open AccessArticle

Food Consumption Inequalities in Primary Care in a Large Metropolis

by Mariana Souza Lopes, Priscila Lenita Candida dos Santos and Aline Cristine Souza Lopes

Int. J. Environ. Res. Public Health 2024, 21(7), 935; https://doi.org/10.3390/ijerph21070935 - 18 Jul 2024

Abstract

The aim of this study was to examine the association between health vulnerability and food consumption according to the NOVA classification within primary care in a major Brazilian city. A cross-sectional study was conducted among adults over 20 years old. These participants were [...] Read more.

The aim of this study was to examine the association between health vulnerability and food consumption according to the NOVA classification within primary care in a major Brazilian city. A cross-sectional study was conducted among adults over 20 years old. These participants were part of a representative sample from the Health Academy Program (PAS) in Belo Horizonte, Brazil. We evaluated socio-demographic variables, self-reported illnesses, perceived health and quality of life, and the length of participation in PAS. Health vulnerability was gauged through the Health Vulnerability Index (HVI), which is calculated for each census sector and classified as low, medium, and high/very high. On the other hand, food consumption was determined by evaluating the average consumption described in a 24 h diet recall (24HR) and categorizing it under the NOVA classification: culinary preparations, processed foods, and ultra-processed foods (UPFs). The average calorie intake was 1429.7 kcal, primarily from culinary preparations (61.6%) and UPFs (27.4%). After adjustments, individuals residing in high/very high-HVI areas consumed more culinary preparations (β = 2.7; 95%CI: 4.7; 0.7) and fewer UPFs (β = −2.7; 95%CI: −4.7; −0.7) compared to those from low-vulnerability areas. PAS participants residing in more vulnerable areas reported healthier dietary habits, consuming more homecooked meals and fewer UPFs. These findings underscore the importance of concentrating efforts on promoting and preserving healthy eating habits and emphasizing the value of home cooking in the most vulnerable regions. Full article

(This article belongs to the Section Health Care Sciences)

17 pages, 813 KiB

Open AccessArticle

Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students

by Tamami Suzuki, Yoshiko Bai and Yuko Ohno

Int. J. Environ. Res. Public Health 2024, 21(7), 934; https://doi.org/10.3390/ijerph21070934 - 17 Jul 2024

Abstract

Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted [...] Read more.

Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted on 80 high schools in Gunma Prefecture, Japan. The survey incorporated the Quick Environmental Exposure and Sensitivity Inventory, as well as items related to allergies, the living environment, and lifestyle. Of the 4630 students analyzed, according to Hojo’s cut-off value, 9.0% were classified as high-risk for MCS and 77.9% reported some allergy-like symptoms. Significant factors associated with elevated MCS risk included female sex, having various allergic conditions, having experienced living in a new home or home renovations or extensions, proximity to environmental stressors (freeways, national highway, factories, rubbish dumps, or sources of offensive odors), insufficient physical activity (exercising less than once a week outside of physical education classes), having cold hands and feet, being fatigued, having a bedtime earlier than 11 p.m., and having moderate–frequent subjective stress. Overall, 9.0% of high school students in Japan are at high risk for MCS. Enhancing awareness of MCS-like symptoms and addressing allergies, living environments, and lifestyle habits may mitigate these symptoms. Full article

(This article belongs to the Special Issue Environmental Exposures and Epigenomics in Health and Disease)

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19 pages, 2137 KiB

Open AccessArticle

Parental Mental Health, Gender, and Lifestyle Effects on Post-Pandemic Child and Adolescent Psychosocial Problems: A Cross-Sectional Survey in Northern Italy

by Verena Barbieri, Giuliano Piccoliori, Adolf Engl and Christian J. Wiedermann

Int. J. Environ. Res. Public Health 2024, 21(7), 933; https://doi.org/10.3390/ijerph21070933 - 17 Jul 2024

Abstract

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, [...] Read more.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents’ mental health problems, whereas self-reports tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions. Full article

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

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19 pages, 1500 KiB

Open AccessArticle

Dietary Minerals and Incident Cardiovascular Outcomes among Never-Smokers in a Danish Case–Cohort Study

by Victoria Fruh, Tesleem Babalola, Clara Sears, Gregory A. Wellenius, Thomas F. Webster, Koren K. Mann, James Harrington, Anne Tjønneland, Ole Raaschou-Nielsen, Birgit Claus Henn and Jaymie R. Meliker

Int. J. Environ. Res. Public Health 2024, 21(7), 932; https://doi.org/10.3390/ijerph21070932 - 17 Jul 2024

Abstract

Background: Diet is known to impact cardiovascular disease (CVD) risk, but evidence for the essential minerals of magnesium (Mg), calcium (Ca), and potassium (K) is inconsistent. Methods: We conducted a case–cohort study within a non-smoking subgroup of the Danish Diet, Cancer and Health [...] Read more.

Background: Diet is known to impact cardiovascular disease (CVD) risk, but evidence for the essential minerals of magnesium (Mg), calcium (Ca), and potassium (K) is inconsistent. Methods: We conducted a case–cohort study within a non-smoking subgroup of the Danish Diet, Cancer and Health cohort, a prospective study of 50–64-year-olds recruited between 1993–1997. We identified incident heart failure (HF), acute myocardial infarction (AMI) and stroke cases through 2015 with an 1135-member subcohort. We measured the dietary intake of minerals, also known as elements, and calculated a combined dietary intake (CDI) score based on joint Ca, Mg and K intakes (mg/d) from Food Frequency Questionnaires. We estimated adjusted hazard ratios (HRs) with Cox proportional hazard models. Results: Most HRs examining associations between CDI score and CVD were null. However, the third quartile of CDI was associated with a lower risk for heart failure (HR: 0.89; 95% CI: 0.67, 1.17), AMI (HR: 0.79; 95% CI: 0.60, 1.04), and stroke (HR: 0.63; 95% CI: 0.44, 0.88). Conclusions: We did not find consistent evidence to suggest that higher levels of essential minerals are associated with incident HF, AMI, and stroke, though results suggest a potential U-shaped relationship between select minerals and CVD outcomes. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 314 KiB

Open AccessArticle

Intensive Care Unit Nurses’ Experiences in Caring for End-of-Life Patients in Saudi Arabia: A Qualitative Study

by Naif H. Alanazi

Int. J. Environ. Res. Public Health 2024, 21(7), 931; https://doi.org/10.3390/ijerph21070931 - 17 Jul 2024

Abstract

Background: Although extensive research on appropriate treatments has been conducted, how nurses provide care to patients at the end-of-life (EOL) is unclear, particularly among intensive care unit (ICU) nurses in Saudi Arabia. Purpose: To explore intensive care unit nurses’ experiences in providing end-of-life [...] Read more.

Background: Although extensive research on appropriate treatments has been conducted, how nurses provide care to patients at the end-of-life (EOL) is unclear, particularly among intensive care unit (ICU) nurses in Saudi Arabia. Purpose: To explore intensive care unit nurses’ experiences in providing end-of-life care in Saudi Arabia. Methods: This study utilized an exploratory, descriptive, qualitative approach. A purposive sampling technique was used to recruit ICU nurses (n = 10) working in ICUs at a tertiary teaching hospital in Riyadh, Saudi Arabia. Using a semi-structured interview guide, ten individual interviews were conducted. Data were analyzed using thematic analysis. The trustworthiness of this study was ensured by following Lincoln and Guba’s (1985) criteria. Findings: Four major themes related to ICU nurses’ experiences of providing EOL care emerged, including: “feeling challenged but driven”, “holistic caring”, “collaborative working ethics”, and “caring for the undying and dying”. Conclusions: This study adds to the body of knowledge about the experience of ICU nurses caring for EOL patients. It offers valuable insights into challenges, coping strategies, holistic caring, collaboration, and the management of critical or dying patients at EOL in the ICUs. Full article

(This article belongs to the Special Issue Palliative Care and End-of-Life Care)

10 pages, 486 KiB

Open AccessArticle

Adherence of Brazilian Minors to the 24-Hour Movement Guidelines after In-Person School Return

by Natália Molleri, Saint Clair Gomes Junior, Daniele Marano and Andrea Zin

Int. J. Environ. Res. Public Health 2024, 21(7), 930; https://doi.org/10.3390/ijerph21070930 - 17 Jul 2024

Abstract

The levels of adequacy of movement behaviors after returning to in-person school activities following the COVID-19 pandemic are not yet well understood. This study aimed to assess the adherence of Brazilian minors to the recommendations of the 24-Hour Movement Guidelines (moderate to vigorous [...] Read more.

The levels of adequacy of movement behaviors after returning to in-person school activities following the COVID-19 pandemic are not yet well understood. This study aimed to assess the adherence of Brazilian minors to the recommendations of the 24-Hour Movement Guidelines (moderate to vigorous physical activity, recreational screen time, and sleep duration), as well as overall adherence to these guidelines, after the relaxation of COVID-19 social isolation measures and the resumption of in-person schooling. A cross-sectional study was conducted with parents or guardians (39 ± 7.8) of minors aged up to 18 years of age (3.8 ± 2.5). A total of 172 individuals responded to the questionnaire. Data were compared with those obtained in the Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic. There was an 18.6 percentage decrease (p-value < 0.001) in overall adherence to the 24-Hour Movement Guidelines when comparing the periods before the COVID-19 pandemic (March 2020) and after the return to in-person schooling (March 2021). The largest percentage drop in adherence between these periods was observed for moderate to vigorous physical activity (27.4%; p-value < 0.001) and the lowest for sleep (10.5%; p-value < 0.001). Adherence to the 24-Hour Movement Guidelines did not return to pre-pandemic levels with the resumption of in-person school activities. Full article

(This article belongs to the Special Issue 2nd Edition: Public Health during and after the COVID-19 Pandemic)

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