Int. J. Environ. Res. Public Health, Volume 20, Issue 19 (October-1 2023) – 101 articles

This study examined the association between social isolation, loneliness, and depressive symptoms among young adults in South Korea after controlling for sociodemographic variables, adverse child and adult experiences, and perceived health status. The researcher analyzed the data of 2014 young adults aged 18–34 years from the Youth Social Economic Survey using hierarchical multiple regression analysis conducted with IBM SPSS Statistics 28.0. Among the sociodemographic variables, sex, education, and household income were significantly related to depressive symptoms. Females reported higher levels of depressive symptoms than males, and those attending college or having a college (or higher) degree reported lower levels of depressive symptoms than those with a high-school diploma or lower. Higher household income was associated with lower levels of depressive symptoms. Perceived health status was negatively associated with depressive symptoms, while adverse childhood and adulthood experiences, social isolation, and loneliness were positively associated with it. Among the major independent variables, loneliness was most strongly related to depressive symptoms, whereas social isolation had the weakest relevance to it. The prediction model proposed explained 32.7% of the variance in depressive symptoms and was considered good. Therefore, focusing on loneliness may be more important than focusing on social isolation to prevent and deal with depressive symptoms among young adults. Full article

Obesity is a crucial health problem because it leads to several chronic diseases with an increased risk of mortality and it is very hard to reverse with conventional treatment including changes in lifestyle and pharmacotherapy. Bariatric surgery (BS), comprising a range of various surgical procedures that modify the digestive tract favouring weight loss, is considered the most effective medical intervention to counteract severe obesity, especially in the presence of metabolic comorbidities. The Enhanced Recovery After Bariatric Surgery (ERABS) protocols include a set of recommendations that can be applied before and after BS. The primary aim of ERABS protocols is to facilitate and expedite the recovery process while enhancing the overall effectiveness of bariatric procedures. ERABS protocols include indications about preoperative fasting as well as on how to feed the patient on the day of the intervention, and how to nourish and hydrate in the days after BS. This narrative review examines the application, the feasibility and the efficacy of ERABS protocols applied to the field of nutrition. We found that ERABS protocols, in particular not fasting the patient before the surgery, are often not correctly applied for reasons that are not evidence-based. Furthermore, we identified some gaps in the research about some practises that could be implemented in the presence of additional evidence. Full article

Cemeteries can be compared to landfills, as the leachate produced in these areas, also known as necroleachate, can be environmentally transported, polluting groundwater, surface water, and soil. In Brazil, to ensure no negative environmental impacts and public health risks, cemetery management is the responsibility of states and municipalities. In this context, this article aims to discuss Brazilian sanitary–environmental legislation concerning cemetery waste management. Only half of all Brazilian states have established sanitary–environmental cemetery legislation, and only 19 municipalities have specific laws. These laws, however, are broad and contain many gaps. Necroleachate care and control require both sanitary and environmental assessments to avoid environmental vulnerability and contamination risks for populations inhabiting surrounding areas. In this regard, new water analysis parameters in environmentally vulnerable areas should be established to control the population’s drinking water quality, such as the detection of C. perfringens. Furthermore, the construction of vertical cemeteries instead of horizontal ones and the adoption of cremation procedures should also be considered. This assessment comprises a novel research framework, as no studies on the impact of Brazilian laws on environmental necroleachate contamination are available to date. Full article

Background: Studies of aging have suggested that QoL is positively associated with active social contacts and supportive face to face social networks. However, social networks and contacts in later life decrease due to a variety of reasons; the narrowing of social networks contributes to increased social isolation and loneliness and leads to the deterioration of well-being and QoL among adult persons. The goal of this study was to explore the relationship between loneliness feelings and QoL during the COVID-19 quarantine as potentially moderated by group physical activity prior to the COVID-19 pandemic quarantine. Methods: A convenience sample of 99 older adults aged 60 and over was interviewed. Using bootstrapping, we tested the strength and significance of the conditional moderation effect of group physical activity prior to the COVID-19 pandemic quarantine on the relationship between loneliness feelings and QoL during the COVID-19 quarantine. Results: the results demonstrated a direct negative effect between loneliness feelings and QoL during the COVID-19 pandemic and that the relationship was moderated by group physical activity prior to the COVID-19 pandemic quarantine (p = 0.000). Conclusion: the findings indicate that policy makers and professionals working with older adults should seek ways to attract older adults to participate in group physical activity and enjoy its long-term social benefits. Full article

It is estimated that 3.75 billion people worldwide lack access to healthcare services. Marginalized populations, such as people with disabilities, are at greater risk of exclusion. People with disabilities not only face the same barriers as people without disabilities, but also experience a range of additional barriers in accessing healthcare due to a variety of discriminatory and inaccessible environments. These extra barriers exist despite their greater need for general healthcare, as well as specialized healthcare related to their impairment. Few studies have focused on healthcare providers and the challenges they face in caring for this group. This paper describes the perspectives of healthcare stakeholders and reported challenges to the provision of quality primary healthcare for people with disabilities. In-depth interviews with 11 healthcare stakeholders were conducted in three regions of Guatemala. Data were analyzed using thematic analysis. Five sub-themes emerged from the above theme: infrastructure and availability of resources, impairment-based challenges, need for special attention and empathy, opportunity to provide services to people with disabilities, and gaps in training. The results could contribute to the development and implementation of strategies that can improve primary care provision and ultimately access to services for people with disabilities in low- and middle-income countries. Full article

Childhood lead exposure through drinking water has long-term effects on cognition and development, and is a significant public health concern. The comprehensive lead testing of public schools entails high expense and time. In prior work, random forest modeling was used successfully to predict the likelihood of lead contamination in the drinking water from schools in the states of California and Massachusetts. In those studies, data from 70% of the schools was used to predict the probability of unsafe water lead levels (WLLs) in the remaining 30%. This study explores how the model predictions degrade, as the training dataset forms a progressively smaller proportion of schools. The size of the training set was varied from 80% to 10% of the total samples in four US states: California, Massachusetts, New York, and New Hampshire. The models were evaluated using the precision-recall area under curve (PR AUC) and area under the receiver operating characteristic curve (ROC AUC). While some states required as few as 10% of the schools to be included in the training set for an acceptable ROC AUC, all four states performed within an acceptable ROC AUC range when at least 50% of the schools were included. The results in New York and New Hampshire were consistent with the prior work that found the most significant predictor in the modeling to be the Euclidean distance to the closest school in the training set demonstrating unsafe WLLs. This study further supports the efficacy of predictive modeling in identifying the schools at a high risk of lead contamination in their drinking water supply, even when the survey data is incomplete on WLLs in all schools. Full article

The association between stigma and drug use has been widely researched. However, to fully understand the nuances of stigma, as experienced by people who use drugs (PWUD), it is argued that we must look at the situations within which stigma is encountered. To obtain an ‘up close’ look at situated stigma, data are drawn from two ethnographic studies—one set in a homeless hostel in the South of England and the other at a substance use service in South Wales. This article explores how PWUD experience and negotiate stigma at different stages of their drug use. We identify three notable themes across these settings. Firstly, ‘othering’ occurs in two distinct ways, by othering the past self or distancing from other PWUDs. Secondly, ‘drug exceptionalism’ is used to justify an individual’s drug use and express frustration at the associations between legality, social harm, and stigma. Finally, in ‘negotiating identities’, individuals present alternate identity roles to either demonstrate clashes in identity or to promote a conventionally positive sense of self. This article contributes to the existing literature on stigma, firstly, by comparing the stigma management strategies of those in active drug use and recovery and, secondly, by using this to highlight the importance of ethnography and situated stigma within this field. Full article

Health literacy, particularly HIV health literacy, is a key social determinant of health and can be significantly improved through targeted health education. This paper explores the often-overlooked potential of pre-exposure prophylaxis (PrEP) education as a powerful tool to enhance HIV health literacy among people with substance use disorders (PWSUD), a population notably susceptible to HIV. Given the syndemic interplay of substance use disorders (SUDs) and HIV, health professionals, especially substance use counselors, are uniquely positioned to bolster HIV health literacy and positively influence health outcomes. This article offers a brief introduction to PrEP, delineates potential barriers and facilitators to its use and education, and proposes strategies for effective PrEP education, implementation, and adherence. By equipping substance use counselors with essential knowledge and skills, we aim to encourage and promote the integration of PrEP education into substance use treatment. The overarching objective is to empower counselors to proactively engage in HIV prevention efforts, thereby fulfilling pressing health literacy needs and contributing to improved health outcomes among PWSUD. Full article

Since the COVID-19 pandemic, researchers have been trying to identify which personal resources can contribute to minimizing the mental health costs in students incurred due to the restrictions that disrupted safety and predictability in their academic lives. The aim of the study was to verify if and how individual factors (resilience and positivity) and socio-environmental factors (social support and nationality) allow prediction of the level of perceived stress. University students (n = 559) from Poland, Serbia, and Italy were surveyed using the Perceived Stress Scale (PSS-10), the Brief Resilience Scale (BRS), the Positivity Scale (PS), and the Interpersonal Support Evaluation List (ISEL-12). Personal resources—positivity, resilience, and support—were found to be positively interrelated and significantly associated with stress levels. Additionally, gender and nationality differentiated stress levels. A general linear model (GLM) showed that levels of perceived stress are best explained by resilience, positivity, tangible support, and gender. The results obtained can strengthen students’ awareness of personal resources and their protective role in maintaining mental health, as well as contribute to the creation of prevention-oriented educational activities. Nationality was not a significant predictor of the level of perceived stress, which highlights the universality of examined predictors among university students from different countries and suggests that interventions aimed at enhancing these resources could benefit students across different cultural contexts. Full article

Planning the medical services for the triathlon competition at the 2020 Tokyo Olympic and Paralympic Games was predicted to be challenging because of possible last-minute changes related to the COVID-19 pandemic and abnormally high temperatures. Therefore, event planners organized and executed a disaster medical care plan, a plan for providing care during emergencies. Based on the basic medical plan for all venues provided by the Tokyo 2020 Organizing Committee, planners for the triathlon venue prepared a medical care plan according to the CSCATTT principles: Command and control, Safety, Communication, Assessment, Treatment, Triage, and Transport. After the event, planners evaluated the number of COVID-19, heatstroke, and injury cases at the venue. The events were conducted without spectators in July and August 2022 because at the last minute, planners held the event without spectators. The triathlon competition involved 638 individuals, including athletes and staff. In total, 7 cases of injuries, 3 cases of mild heatstroke, and 13 other cases were reported, with only 2 requiring emergency transportation. No cases of COVID-19 were reported from the triathlon venue, including during the observation period after the event. This medical plan was effective in preventing heatstroke and COVID-19 cases during the big event. Efficiently and effectively responding to various situations is possible in a shorter period by planning large-scale medical services for such special circumstances according to CSCATTT, a principle of disaster medical care. Full article

There is a high prevalence rate of co-occurring alcohol use and mental health problems in young people. This is associated with adverse outcomes and poses a substantial public health concern. We identified and synthesized evidence on the effectiveness of family-involved interventions in reducing alcohol use and mental health problems in young people aged 12–17. Seven databases were searched from inception to January 2023. Data from 19 articles reporting on 14 trials were pooled through random-effects meta-analysis for each outcome using Review Manager 5.3. Pooled estimates resulted in non-significant findings for alcohol use (SMD −0.60; 95% CI −1.63 to 0.42; p = 0.25; 6 trials; 537 participants), internalizing symptoms (SMD −0.13; 95% CI −0.37 to 0.10; p = 0.27), externalizing symptoms (SMD −0.26; 95% CI −0.66 to 0.15; p = 0.22) and substance use (SMD −0.33; 95% CI −0.72 to 0.06; p = 0.10). In contrast, significant intervention effects were identified for the mechanism of change, family conflict (SMD −0.30; 95% CI −0.51 to −0.09; p = 0.005). Consequently, addressing family functioning may not be sufficient in reducing co-occurring alcohol use and mental health problems. Non-significant intervention effects could be due to a lack of content addressing the relationship between alcohol use and mental health problems. Future intervention development could explore whether to incorporate such content and how best to involve the family. Full article

The purpose of this study was to scan for the obesogenicity of primary school environments in Tshwane, Gauteng, South Africa. This study was carried out in ten public primary schools in the Tshwane West district of the Gauteng province. An observational design was used to collect the data. Data collection was conducted using an observational checklist guided by the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The findings revealed that although a nutrition policy was available in most schools, few schools were communicating the policy. Despite all the schools having sports fields, children were not exercising. Most schools also had a school nutrition programme. Most primary schoolchildren’s lunchboxes contained sweets, sugar-sweetened beverages, and snacks. A few lunchboxes contained fruits and vegetables. Primary schools in Tshwane West did not comply with most aspects of the school mapping environment, indicating that the school environments were obesogenic. It is therefore essential to scan for obesogenicity in all South African schools so that tailor-made interventions can be implemented to rectify and further prevent obesogenic school environments. Full article

Although research investigating collaborative partnerships with older adults has been slow to develop, promoting user involvement and co-production is gaining interest in aging studies, with the aim of improving interactions between the different stakeholders involved, and toward the more effective delivery of care provisions and better community life for aging people. This is based on existing evidence that improved dynamics within collaborative and mutual learning processes can enhance the integration of new practices at different levels by generating novel creative approaches and practice frameworks for the delivery of quality care for older adults. This article presents the findings from a series of narrative interviews conducted with different stakeholders involved in arts-health practices in Finland and South Korea. Focusing on empirical perspectives of these stakeholders on arts-health practices—from planning to assessment—this study identifies vital components of co-producing and co-delivering arts-health practices for older adults and highlights the importance of utilizing their late-life creativity as active partners in such practices across cultural contexts. In addition to identifying three central stages of developing arts-health practices, two theocratical models are proposed to provide structural support for collaborative partnerships in arts-health practices, with the aim of promoting holistic care provisions for aging people through such practices. Full article

Health interventions for elderly people must understand the association between physical activity, sociodemographic factors, and non-communicable diseases. This study aimed to verify the association between physical activity in leisure time, sociodemographic factors, and NCDs in Brazilian older people. This is a descriptive study, with a cross-sectional design, carried out using secondary data from the 2019 National Health Survey—Brazil. It used data from 23,144 subjects aged over 60 years. Statistical analyses included descriptive and quantile regression with cutoff points 0.25, 0.50 (Median), 0.75, and 0.90 to verify the association between the variables. The statistical software R version 4.1.3 was used. Older people aged between 60 and 79 years were highlighted up to the 50th quantile. Females showed lower values in all quantiles, with emphasis from quantile 50 onwards. Subjects who self-declared as “white” showed significant differences up to quantile 50, not indicating significant values from this cutoff point. Residents of the rural area had lower values than residents of the urban area in all quantiles, with emphasis starting from the median. For cardiovascular diseases, it was found that subjects who did not report having this type of disease had better results for the amount of physical activity during leisure time, especially from the 75th quantile. It was concluded that there is a direct relationship between time spent in leisure-time performing physical activity, sociodemographic variables, and NCDs. It is necessary to review and validate cutoff points according to each category viewed, which can favor the adjustment of interventions according to each population. Actions of this nature can favor adherence by groups of older people to the weekly practice of physical activity. Full article

Introduction: Firefighting foams containing per- and polyfluoroalkyl substances (PFAS) have caused environmental contamination in several Australian residential areas, including Katherine in the Northern Territory (NT), Oakey in Queensland (Qld), and Williamtown in New South Wales (NSW). We examined whether the risks of adverse perinatal outcomes were higher in mothers living in these exposure areas than in selected comparison areas without known contamination. Methods: We linked residential addresses in exposure areas to addresses collected in the jurisdictional Perinatal Data Collections of the NT (1986–2017), Qld (2007–2018), and NSW (1994–2018) to select all pregnancies from mothers who gave birth while living in these areas. We also identified one comparison group for each exposure area by selecting pregnancies where the maternal address was in selected comparison areas. We examined 12 binary perinatal outcomes and three growth measurements. For each exposure area, we estimated relative risks (RRs) of adverse outcomes and differences in means of growth measures, adjusting for sociodemographic characteristics and other potential confounders. Results: We included 16,970 pregnancies from the NT, 4654 from Qld, and 7475 from NSW. We observed elevated risks of stillbirth in Oakey (RR = 2.59, 95% confidence interval (CI) 1.25 to 5.39) and of postpartum haemorrhage (RR = 1.94, 95% CI 1.13 to 3.33) and pregnancy-induced hypertension (RR = 1.88, 95% CI 1.30 to 2.73) in Williamtown. The risks of other perinatal outcomes were not materially different from those in the relevant comparison areas or were uncertain due to small numbers of events. Conclusions: There was limited evidence for increased risks of adverse perinatal outcomes in mothers living in areas with PFAS contamination from firefighting foams. We found higher risks of some outcomes in individual areas, but these were not consistent across all areas under study and could have been due to chance, bias, or confounding. Full article

Legionella, the bacterium that causes Legionnaires’ disease, can grow and spread in building water systems and devices. The COVID-19 pandemic impacted building water systems through reductions in water usage. Legionella growth risk factors can be mitigated through control measures, such as flushing, to address stagnation, as part of a water management program (WMP). A national lodging organization (NLO) provided WMP data, including Legionella environmental testing results for periods before and during the pandemic. The statistical analysis revealed an increased risk of water samples testing positive for Legionella during the pandemic, with the greatest increase in risk observed at the building’s cold-water entry test point. Sample positivity did not vary by season, highlighting the importance of year-round Legionella control activities. The NLO’s flushing requirements may have prevented an increased risk of Legionella growth during the pandemic. However, additional control measures may be needed for some facilities that experience Legionella detections. This analysis provides needed evidence for the use of flushing to mitigate the impacts of building water stagnation, as well as the value of routine Legionella testing for WMP validation. Furthermore, this report reinforces the idea that WMPs remain the optimal tool to reduce the risk of Legionella growth and spread in building water systems. Full article

Neighborhoods, as built and social environments, have significant implications for mental health. Children raised in high-poverty neighborhoods, who are disproportionately Black, Indigenous, and people of color, have a greater risk of adverse life outcomes. Neighborhood gentrification is also salient when examining mental health outcomes as neighborhood economic contexts shift around a child. This review scopes, describes, synthesizes, and critiques the existing literature on the relationship between neighborhood poverty/gentrification and mood disorder symptoms among children ages 3–17 in the United States (U.S.). Given the history of structural racism in the creation of U.S. neighborhoods, inclusion criteria required that study samples be racially diverse. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews, seven databases and grey literature were searched; 17 studies were included (total n = 122,089). Fourteen studies found significant associations between neighborhood poverty/gentrification and child depression. Three longitudinal studies found significant results suggesting that childhood neighborhood poverty/gentrification may have a lagged effect, with depression emerging later in life. Neighborhood poverty and gentrification require further examination as social determinants of mental health. Researchers should examine neighborhood poverty and gentrification as social determinants of mental health. Policies that reduce neighborhood economic disparities are needed across the U.S. Full article

People presenting to Emergency Departments (EDs) in a self-harm/suicidal crisis in England receive a psychosocial assessment and care plan. We aimed to construct a typology of peoples’ perspectives on crisis care plans to explore the range of experiences of care plans. Thirty-two semi-structured interviews with people who presented to EDs following a self-harm/suicidal crisis in England were analysed using an ideal-type analysis. Cases were systematically compared to form clusters of cases with similar experiences of care plans. People’s perspectives on care plans fitted into three types: (1) personalised care plans (n = 13), consisting of advice or referrals perceived as helpful; (2) generic care plans (n = 13), consisting of generic advice that the person already knew about or had already tried; and (3) did not receive a care plan (n = 6) for those who reported not receiving a care plan, or who were only provided with emergency contacts. Care planning in the ED following a suicidal/self-harm crisis was perceived as supportive if it provided realistic and personalised advice, based on what had/had not worked previously. However, many people reported not receiving a helpful care plan, as it was ill-fitted to their needs or was not considered sufficient to keep them safe, which may mean that these patients are at increased risk of repeat self-harm. Full article

This study aimed to analyze and gain an in-depth understanding of the experiences pertaining to successful aging in middle-aged women in South Korea. A sample of 12 middle-aged women, capable of sharing their lived experiences, was divided into three age-based groups: those in their 40s, those in their 50s, and those aged 60–65 years. The collected data were analyzed using Colaizzi’s phenomenological method. Five theme clusters and ten themes emerged. The experiences of successful aging among middle-aged women were categorized as: “Coping with changes in the mind and body”, “Financially stable life”, “Undergoing the aging process with a healthy family”, “Preparations for dying well”, and “Pursuing a meaningful, harmonious life”. These findings highlight the need for programs that prepare middle-aged women to positively accept and enjoy older adulthood by identifying and addressing the factors essential for successful aging and reducing any negative emotions attached to aging and older adulthood. Full article

Historically, pharmacists in independent community pharmacies have been pivotal in promoting community health. During the COVID-19 pandemic, they demonstrated their commitment by advocating for vaccination and providing accessible care, particularly in underserved communities. By addressing disparities, implementing strategies like mobile clinics and community outreach, and fostering trust and engagement, independent community pharmacists played a crucial role in bridging gaps in healthcare access for vulnerable populations and mitigating the impact of the COVID-19 pandemic. Full article

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalized care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of workshops in different locations of the city to encourage a sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighborhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their health and understand their values and preferences. In the present manuscript, we focus on the qualitative results, which show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered among the reasons to visit health professionals. Some of the conclusions revealed that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognized the benefits of this new approach but required more time and incentives to dedicate the effort needed. The main aim of this study was to present these barriers related to health access, health promotion, and health self-management, as well as the actions developed to face them. Full article

Background: Clinical guidelines developed by urologic, urogynecologic, and gynecologic associations around the globe include recommendations on nutrition-related lifestyle and behavioral change for bladder storage conditions. This study identified and compared clinical guidelines on three urological conditions (interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder, and stress urinary incontinence) affecting adult women. Methods: A three-step process was employed to identify the guidelines. Next, a quality assessment of the guidelines was conducted employing the Appraisal of Guidelines Research and Evaluation (AGREE II) International tool. (3) Results: Twenty-two clinical guidelines, prepared by seventeen groups spanning four continents, met the inclusion criteria. The AGREE II analyses revealed that most of the guideline development processes complied with best practices. The most extensive nutrition recommendations were for women with IC/BPS. Dietary manipulation for the other two storage LUTS primarily focused on the restriction or limitation of specific beverages and/or optimal fluid intake. (4) Conclusion: Clinical guidelines for IC/BPS, overactive bladder, and stress urinary incontinence include nutrition recommendations; however, the extent of dietary manipulation varied by condition. The need to ensure that clinicians are informing patients of the limitations of the evidence supporting those recommendations emerged. Furthermore, given the need to treat nutrition-related comorbid conditions as a strategy to help mitigate these three urological disorders, the value of referral to a dietitian for medical nutrition therapy is apparent. Full article

The Infectious and Tropical Diseases Department of the University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast-Track City commitment. A cross-sectional study was conducted, consisting of an anonymous multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18–40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Overall, only 107 (32%) of respondents knew how HIV is transmitted. Major differences were shown between different age groups, where people under the age of 40 had a significantly higher correct response rate than people over 40 (n = 101; 39% versus n = 6; 7.8%, p < 0.00001). Similarly, almost half of LGBTQI+ people (n = 28; 44.4%) gave the correct answer, versus 30% (n = 79) of heterosexuals (p = 0.0359). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. Our study highlights that misconceptions about HIV and HCV should be addressed in prevention and education programs, whose target should also be specific populations. Full article

Condoms have been and are still an important part of HIV preventative measures worldwide, and many countries have designed programmes that encourage their use. Consistent and correct condom use among HIV-positive individuals is important in preventing multiple infections. Hence, the uptake and determining factors associated with condom use were investigated in this study. This study was aimed at determining the level of, and factors associated with, condom use among HIV-positive postnatal women in primary health care facilities in Tshwane sub-district 1, Gauteng Province, South Africa. A descriptive cross-sectional study was conducted among 326 HIV-positive postnatal women aged between 15 and 50 years who were conveniently selected and voluntarily participated in the study. A self-developed pretested questionnaire was used to collect data on level of condom use and factors associated with its use from the selected participants. Statistical tests of correlation were then used to determine the association between frequency of condom use during sexual encounter and condom use at last sexual encounter with the independent variables. Regular condom use during sexual encounters was reported by 63.2% of the participants while 83% of the participants reported using a condom at their last sexual encounter. Frequency of condom use during sexual encounter was found to be associated with employment status (p < 0.05), residence (p < 0.001), number of children (p < 0.05), first HIV diagnosis (p < 0.05) and disclosure of HIV status to partner (p < 0.05). Condom use at last sexual encounter was also found to have a significant statistical association with level of education (p < 0.05) and the ability to negotiate condom use (p < 0.001). A good proportion of the participants used condoms regularly. Interventions to improve condom use among this population should focus on female empowerment by investing in their education, and economic empowerment to improve their economic status, which, in turn, would help the women to better negotiate condom use. The other factors mentioned above should also be considered when developing health education policies and programmes about condom use amongst HIV-positive postnatal women. Full article

Although abundant research has been carried out to investigate the underlying mechanisms that may cause neurocognitive challenges among middle-aged and older people living with HIV/AIDS (PLWH), to monitor the prevalence rates of HIV-related neurocognitive deficits, and to identify factors related to the improvement of diagnostic screening tools, classification and nosology, and clinical and rehabilitative treatment of HIV-Associated Neurocognitive Disorder (HAND); to date, there have been only a few studies that have explored and examined the awareness and work experiences HIV sector healthcare and service providers have related to HAND. To address this research gap, we conducted a qualitative, community-based participatory research study and interviewed 12 HIV sector providers in Southern Nevada, USA, from January to April 2022. After performing a thematic analysis of our interviews, we were able to identify two major themes and several sub-themes. Under our first major theme, provider awareness and knowledge, we identified four sub-themes: (1) prior knowledge and current awareness; (2) lived experiences of patients and clients with neurocognitive challenges; (3) lack of knowledge as a barrier to providing needed care; and (4) continuing education and professional development. Under our second major theme, prospective provider roles, we identified three sub-themes: (1) early detection; (2) direct and practical support; and (3) appropriate and timely referrals. In this article, we discuss our findings and lessons learned from our study, as well as their implications for the future work of researchers and providers in the HIV sector related to improving care and support for people aging with HIV/AIDS and experiencing neurocognitive challenges. Full article

Background: The aim of this study was to evaluate the relationship between depressed mood and gynecological cancer outcomes, identifying risk factors for cancer aggravation. Methods: This study was a retrospective analysis of gynecological cancer patients (January 2020–August 2022) at Korea University Anam Hospital using Patient Health Questionnaire-9 (PHQ-9). Patients were classified into non-depressed mood (NDM)- and depressed mood (DM)-based scores. Statistical analysis was performed using Student’s t-test, chi-square test, Fisher’s exact test, Kaplan–Meier analysis, and Cox regression analyzing using SPSS. Results: Of the 217 participants, the NDM group comprised 129 patients, and the DM group comprised 88. The two-year disease-free survival (DFS) rates showed significant differences (NDM, 93.6%; DM 86.4%; p = 0.006), but overall survival (OS) did not (p = 0.128). Patients with stage 3 or higher cancer, undergoing five or more chemotherapies, experiencing post-chemotherapy side effects, and depressed mood had an increased risk of cancer aggravation. Conclusions: Appropriate treatment of depressed mood, as well as adequate treatment for advanced gynecological cancer patients, those with numerous CTx., and those with post-CTx. side effects, may contribute to reducing the risk of cancer aggravation. Full article

Despite the substantial health and economic burdens posed by the social determinants of health (SDH), these have yet to be efficiently, sufficiently, and sustainably addressed in clinical settings—medical offices, hospitals, and healthcare systems. Our study contextualized SDH application strategies in U.S. clinical settings by exploring the reasons for integration and identifying target patients/conditions, barriers, and recommendations for clinical translation. The foremost reason for integrating SDH in clinical settings was to identify unmet social needs and link patients to community resources, particularly for vulnerable and complex care populations. This was mainly carried out through SDH screening during patient intake to collect individual-level SDH data within the context of chronic medical, mental health, or behavioral conditions. Challenges and opportunities for integration occurred at the educational, practice, and administrative/institutional levels. Gaps remain in incorporating SDH in patient workflows and EHRs for making clinical decisions and predicting health outcomes. Current strategies are largely directed at moderating individual-level social needs versus addressing community-level root causes of health inequities. Obtaining policy, funding, administrative and staff support for integration, applying a systems approach through interprofessional/intersectoral partnerships, and delivering SDH-centered medical school curricula and training are vital in helping individuals and communities achieve their best possible health. Full article