International Journal of Environmental Research and Public Health

12 pages, 1120 KiB

Open AccessArticle

A Temporal Comparison of 50 Years of Australian Scuba Diving Fatalities

by John M. Lippmann

Int. J. Environ. Res. Public Health 2025, 22(7), 1148; https://doi.org/10.3390/ijerph22071148 (registering DOI) - 19 Jul 2025

Abstract

Australian scuba fatalities over 50 years were examined to determine temporal changes over two consecutive periods, 1972–1999 and 2000–2021. The Australasian Diving Safety Foundation database and National Coronial Information System were searched to identify scuba deaths from 1972 to 2021. Historical data, police [...] Read more.

Australian scuba fatalities over 50 years were examined to determine temporal changes over two consecutive periods, 1972–1999 and 2000–2021. The Australasian Diving Safety Foundation database and National Coronial Information System were searched to identify scuba deaths from 1972 to 2021. Historical data, police and witness reports, and autopsies were recorded and comparisons made between the two periods. Of 430 total deaths, 236 occurred during 1972–1999 and 194 during 2000–2021, with average annual fatalities of 8.4 and 8.8, respectively. The proportion of males reduced (83% to 76%) and median ages rose (33 to 47 years) with a large rise in the percentage of casualties among people aged 45 years or older (24% to 57%). There were increases in certified divers (64% to 81%) and in the proportion of divers who were with a buddy at the time of their incident (17% to 27%), as well as a decrease in out-of-gas incidents (30% to 25%). A reduction in primary drowning (47% to 36%) was accompanied by more than a doubling of cardiac-related disabling conditions (12% to 26%). The substantial increase in casualties’ ages and of the proportions of casualties aged 45 or more and of females between the periods indicate the inclusion of a broader cohort of participants and ageing of longtime divers. The reduction in primary drowning was likely due to increased training and improvements in equipment, particularly BCDs and pressure gauges. The rise in cardiac-related deaths was due to an older and more obese cohort. Improved health education and surveillance and improved dive planning are essential to reduce such deaths. Full article

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16 pages, 315 KiB

Open AccessArticle

Development and Validation of the Intimate Partner Violence Workplace Disruptions Assessment (IPV-WDA)

by Kathryn Showalter, Laneshia Conner, Rebecca Bosetti, William Burrows and Rujeko Machinga-Asaolu

Int. J. Environ. Res. Public Health 2025, 22(7), 1147; https://doi.org/10.3390/ijerph22071147 (registering DOI) - 19 Jul 2025

Abstract

A vast majority of survivors of intimate partner violence (IPV) experience economic abuse, including but not limited to, employment sabotage. The purpose of this study is to further understand IPV by testing a technology-inclusive abuser-initiated workplace disruption measurement in an exploratory factor analysis [...] Read more.

A vast majority of survivors of intimate partner violence (IPV) experience economic abuse, including but not limited to, employment sabotage. The purpose of this study is to further understand IPV by testing a technology-inclusive abuser-initiated workplace disruption measurement in an exploratory factor analysis (EFA) so that future researchers can better examine and address economic abuse. Using a sample of survivors (N = 312) employed in the nursing profession in the United States, who may be uniquely impacted by technology, we used complete data to examine experiences of abuser-initiated workplace disruptions, including those that utilized cellphones (e.g., excessive texting, harassment of coworkers, preventing educational advancement). The results revealed a two-factor structure: one containing a variety of direct and indirect workplace disruptions relevant to the nursing profession (73% of variance) and a second containing only cell-phone related harassment (9% of variance). Implications for healthcare employers seeking to protect employees from IPV, as well as policymakers, are included. Full article

(This article belongs to the Special Issue Models and Approaches to Workplace Health Promotion and Well-Being with Diverse Population Groups)

12 pages, 910 KiB

Open AccessArticle

Sexual Harassment of Cisgender Women University Students: How the Gender Composition of Colleges Relates to Differential Prevalence

by Natalie Q. Poole, Christopher J. Cannon, Amy L. Gabriel, Emma J. Briles and Matt J. Gray

Int. J. Environ. Res. Public Health 2025, 22(7), 1146; https://doi.org/10.3390/ijerph22071146 (registering DOI) - 19 Jul 2025

Abstract

Gender harassment is the most common variant of sexual harassment and is often seen in male-dominated workplaces. Importantly, persistent gender harassment produces pronounced impairment in psychological and occupational domains. The current study aimed to examine the degree to which academic fields and degree [...] Read more.

Gender harassment is the most common variant of sexual harassment and is often seen in male-dominated workplaces. Importantly, persistent gender harassment produces pronounced impairment in psychological and occupational domains. The current study aimed to examine the degree to which academic fields and degree programs that are largely male dominated are associated with higher rates of sexual harassment than female-dominated programs. Four academic fields were chosen for their gender disparity—business, engineering, health sciences, and education. Consistent with hypotheses, cisgender women students in the college of engineering were most likely to experience gender harassment by peers and faculty. Implications and future directions are discussed. Full article

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18 pages, 683 KiB

Open AccessArticle

The Global COVID-19 Pandemic Experience: Innovation Through Environmental Assessment and Seropositivity Surveillance

by Robert M. Park

Int. J. Environ. Res. Public Health 2025, 22(7), 1145; https://doi.org/10.3390/ijerph22071145 - 18 Jul 2025

Abstract

Objectives: To confirm a conjecture from year 2020 of the SARS-CoV-2 (COVID-19) pandemic suggesting policy alternatives to substantially reduce mortality burden. Methods: Data from a global COVID-19 database comparing different countries on cumulative mortality and vaccination were analyzed in conjunction with surveys of [...] Read more.

Objectives: To confirm a conjecture from year 2020 of the SARS-CoV-2 (COVID-19) pandemic suggesting policy alternatives to substantially reduce mortality burden. Methods: Data from a global COVID-19 database comparing different countries on cumulative mortality and vaccination were analyzed in conjunction with surveys of seropositivity. Predictions of final mortality burden under an alternate policy scenario for Japan were calculated and the COVID-19 outcomes for China were assessed. Results: By 2025, Western countries (US, UK, Brazil and Italy) had cumulative mortality rates in the range of 3339–3548 deaths per million, about 6-fold higher than East Asian and New Zealand ‘zero-COVID’ countries. Moderate virus suppression in Japan produced the lowest cumulative mortality of the countries analyzed; if earlier policies had been maintained, the predicted cumulative mortality rate by 2025 would be one-tenth that of the US, UK, Brazil and Italy and one-half to one-third that of other zero-COVID countries. For China, transitioning from a zero-COVID policy in 2022–2023, the estimated 2025 cumulative mortality was 1607/million, half that of Western countries. Conclusions: To minimize COVID-19 mortality would require: (1) Innovation on systematic sampling of ambient airborne virus exposure to sustain low but non-zero virus levels across entire populations, and (2) seropositivity assessment (instead of mass PCR testing for new cases) for calibrating exposure management, and tracking and protecting high-risk populations. Full article

(This article belongs to the Section Environmental Health)

29 pages, 1411 KiB

Open AccessArticle

Adapting a Participatory Group Programme for Caregivers of Children with Complex Neurodisability from Low-, Middle-Income Countries to a High-Income Setting: Moving from “Baby Ubuntu” to “Encompass”

by Kirsten Prest, Kirsten Barnicot, Catherine Hurt, Frances Badenhorst, Aleksandra Borek, Melanie Whyte, Phillip Harniess, Alea Jannath, Rachel Lassman, Christopher Morris, Rachel Osbourne, Tracey Smythe, Cally J. Tann, Keely Thomas, Emma Wilson, Angela Harden and Michelle Heys

Int. J. Environ. Res. Public Health 2025, 22(7), 1144; https://doi.org/10.3390/ijerph22071144 - 18 Jul 2025

Abstract

The “Baby Ubuntu” programme is a well-established, low-cost, community-based intervention to support caregivers of children with complex neurodisability, like cerebral palsy, in low- and middle-income country (LMIC) contexts. This process-focused paper describes our utilisation of the ADAPT guidance to adapt “Baby Ubuntu” for [...] Read more.

The “Baby Ubuntu” programme is a well-established, low-cost, community-based intervention to support caregivers of children with complex neurodisability, like cerebral palsy, in low- and middle-income country (LMIC) contexts. This process-focused paper describes our utilisation of the ADAPT guidance to adapt “Baby Ubuntu” for use in ethnically and linguistically diverse, and economically deprived urban boroughs in the United Kingdom (UK). The process was guided by an adaptation team, including parents with lived experience, who explored the rationale for the intervention from local perspectives and its fit for this UK community. Through qualitative interviews and co-creation strategies, the perspectives of caregivers and healthcare professionals substantially contributed to the “Encompass” programme theory, drafting the content, and planning the delivery. Ten modules were co-produced with various topics, based on the “Baby Ubuntu” modules, to be co-facilitated by a parent with lived experience and a healthcare professional. The programme is participatory, allowing caregivers to share information, problem solve, and form supportive peer networks. The “Encompass” programme is an example of a “decolonised healthcare innovation”, as it aims to transfer knowledge and solutions developed in low- and middle-income countries to a high-income context like the UK. Piloting of the new programme is underway. Full article

(This article belongs to the Special Issue Health Intervention for Young Children with or at Risk for Disabilities)

12 pages, 641 KiB

Open AccessArticle

Do Patients with Complaints Attributed to Chemicals in the Environment Trust in Biomonitoring as a Valid Diagnostic Tool? A Prospective, Observational Study from a German University Outpatient Clinic

by Claudia Schultz, Catharina Sadaghiani, Stefan Schmidt, Roman Huber and Vanessa M. Eichel

Int. J. Environ. Res. Public Health 2025, 22(7), 1143; https://doi.org/10.3390/ijerph22071143 - 18 Jul 2025

Abstract

Biomonitoring often yields normal results in patients who report environmental sensitivities, such as in multiple chemical sensitivity. This study examined whether biomonitoring results influence disease attribution and perception. Patients over 18 presenting for the first time to the University Environmental Medicine Outpatient Clinic [...] Read more.

Biomonitoring often yields normal results in patients who report environmental sensitivities, such as in multiple chemical sensitivity. This study examined whether biomonitoring results influence disease attribution and perception. Patients over 18 presenting for the first time to the University Environmental Medicine Outpatient Clinic in Freiburg with suspected complaints linked to heavy metals, wood preservatives, pesticides, solvents, or mold spores were included. Illness perceptions were assessed before and after biomonitoring using the Illness Perception Questionnaire (IPQ-R). Of 358 patients, 51 met inclusion criteria; 3 showed relevant findings, and 15 did not attribute their symptoms to environmental causes at baseline. The remaining 33 patients were analyzed. After receiving a normal biomonitoring result, only seven patients (21%) altered their illness attribution. These individuals also reported milder perceived consequences, less personal control over the illness, and showed lower levels of somatization and compulsiveness than those who maintained their original attribution. Most patients remained convinced of an environmental cause despite unremarkable findings. This suggests that a substantial subset of patients is strongly attached to an environmental explanation for their symptoms, with stable attribution linked to higher psychological symptom burden and a belief in personal control over the illness. Full article

(This article belongs to the Section Environmental Health)

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16 pages, 500 KiB

Open AccessArticle

Periodontal Health Knowledge of Schoolteachers: A Cross-Sectional Study

by Khansa Taha Ababneh, Fathima Fazrina Farook, Lama Alosail, Maram Ali Alqahtani, Norah Gharawi and Afrah Alossimi

Int. J. Environ. Res. Public Health 2025, 22(7), 1142; https://doi.org/10.3390/ijerph22071142 - 18 Jul 2025

Abstract

Background/Objectives: Schoolteachers play a central role in shaping their students’ beliefs and attitudes towards oral health. Our aim was to investigate the oral and periodontal health knowledge of schoolteachers in Riyadh and factors affecting this knowledge. Methods: Government schoolteachers from representative [...] Read more.

Background/Objectives: Schoolteachers play a central role in shaping their students’ beliefs and attitudes towards oral health. Our aim was to investigate the oral and periodontal health knowledge of schoolteachers in Riyadh and factors affecting this knowledge. Methods: Government schoolteachers from representative areas of Riyadh (n = 895) responded to a structured questionnaire. Descriptive statistics, t-tests, one-way analysis of variance, and multiple linear regression (p ≤ 0.05). Results: Teachers demonstrated good basic oral/periodontal health knowledge (mean score = 60.21 ± 10.68). Most knew that toothbrushing is necessary to preserve dental (78.66%) and periodontal (57.88%) health; that gingival bleeding (74.41%), swelling (64.25%), and abscess formation (52.96%) are signs of periodontal disease; about 63% identified dental biofilm as an etiologic factor, and 58% knew that periodontitis may cause gingival recession and influence systemic health (74.07%). However, only 38% knew that dental flossing is necessary to preserve periodontal health, and 66.03% believed that gingival health can be restored with a special toothpaste. Teachers who were female, older in age, worked in north Riyadh, and taught the intermediate stage demonstrated statistically significantly better knowledge than the other categories. Conclusions: The studied sample of schoolteachers possesses acceptable basic oral health knowledge but has inadequate knowledge of periodontal health. Factors influencing teachers’ knowledge were age, gender, region of work, and teaching stage. Full article

(This article belongs to the Section Health Care Sciences)

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25 pages, 324 KiB

Open AccessArticle

Psychological Flexibility and Inflexibility of University Students: An In-Depth Qualitative Study

by Wendy Cervantes-Perea, Jone Martínez-Bacaicoa and Manuel Gámez-Guadix

Int. J. Environ. Res. Public Health 2025, 22(7), 1141; https://doi.org/10.3390/ijerph22071141 - 18 Jul 2025

Abstract

In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive [...] Read more.

In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive functioning. Although previously studied, more culturally relevant evidence is needed to inform interventions that promote well-being and mental health among Latin American students. This study explored manifestations of psychological flexibility and inflexibility in 15 undergraduate students from the University of Magdalena in Colombia (mean age = 20.13 years; 53.33% female) through semi-structured, face-to-face interviews (~45 min each). Data were analyzed using Interpretative Phenomenological Analysis (IPA), focusing on how participants described and made sense of their experiences. A total of 25 emergent themes were identified and grouped into 12 subordinate themes, mapped onto the 6 core ACT processes. The participants reported efforts to control or avoid distressing internal experiences, often resulting in difficulty acting in accordance with their values. The findings highlight a recurring ambivalence between avoidance and acceptance, and barriers to committed action, underscoring the dynamic interplay between flexibility and inflexibility. These results support the relevance of ACT-based interventions, such as structured group sessions that foster acceptance, mindfulness, and values-based behavior. Integrating this training into counseling and academic support services could enhance students’ well-being and performance. Future research should examine these dynamics longitudinally and across diverse contexts. Full article

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

14 pages, 1435 KiB

Open AccessArticle

Association Between Diet, Sociodemographic Factors, and Body Composition in Students of a Public University in Ecuador

by Angélica María Solís Manzano, María Victoria Padilla Samaniego, Verónica Patricia Sandoval Tamayo, Edgar Rolando Morales Caluña, Katherine Denisse Suarez Gonzalez, Tannia Valeria Carpio-Arias and Patricio Ramos-Padilla

Int. J. Environ. Res. Public Health 2025, 22(7), 1140; https://doi.org/10.3390/ijerph22071140 - 18 Jul 2025

Abstract

Body composition is associated with multiple factors. The main objective of this study is to determine the association between diet and sociodemographic factors on the body structure and composition of university students at a public university in Ecuador. This cross-sectional study allowed for [...] Read more.

Body composition is associated with multiple factors. The main objective of this study is to determine the association between diet and sociodemographic factors on the body structure and composition of university students at a public university in Ecuador. This cross-sectional study allowed for the collection of detailed body composition and dietary data from 204 students (41.7% men and 58.3% women, with an average age of 23.3 ± 4.4 years). The study was conducted using validated questionnaires and bioimpedance techniques. Statistical analysis included ANOVA tests, complemented by a PCA-Biplot, to examine the relationships between study variables. Statistical analysis revealed that men’s birthplace had a significant impact on several body measurements, such as hip circumference and weight, but no significant differences were observed in body structure and composition based on nutrient intake. Furthermore, larger upper-arm circumference in women was correlated with higher fat intake. The results of the multivariate analysis indicated a differential influence of dietary components on body composition. The study highlights the need for nutritional intervention strategies and educational programs that consider the diversity of students’ backgrounds to promote healthy habits and mitigate the negative effects of eating habits and irregular physical activity patterns on their health and body composition. Full article

(This article belongs to the Section Health Care Sciences)

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21 pages, 2570 KiB

Open AccessArticle

Exploration of Providers’ Perceptions and Attitudes Toward Phage Therapy and Intentions for Future Adoption as an Alternative to Traditional Antibiotics in the US—A Cross-Sectional Study

by Subi Gandhi, Dustin Edwards, Keith Emmert and Bonnie Large

Int. J. Environ. Res. Public Health 2025, 22(7), 1139; https://doi.org/10.3390/ijerph22071139 - 18 Jul 2025

Abstract

Antibiotic resistance presents a global threat, making the swift development of alternative treatments essential. Phage therapy, which employs bacterial viruses that specifically target bacteria, shows promise. Although this method has been utilized for over a century, primarily in Eastern Europe, its use in [...] Read more.

Antibiotic resistance presents a global threat, making the swift development of alternative treatments essential. Phage therapy, which employs bacterial viruses that specifically target bacteria, shows promise. Although this method has been utilized for over a century, primarily in Eastern Europe, its use in the US remains limited. This study aimed to assess the awareness and willingness of US healthcare providers to adopt phage therapy in response to the growing issue of antibiotic resistance. A survey of 196 healthcare providers, primarily MDs and DOs, found that while 99% were aware of antimicrobial resistance, only 49% were knowledgeable about phage therapy as a treatment for resistant bacterial infections. Nonetheless, 56% were open to considering phage therapy, and this willingness was associated with prior knowledge, concerns about antibiotic resistance, previous training, and confidence in recommending it (p < 0.05). Our study of U.S. healthcare providers revealed key findings about their views on phage therapy as a potential alternative for treating bacterial infections. Credible information is essential to promoting phage therapy use among U.S. providers via educational initiatives, clinical guidance, and research dissemination to promote phage therapy use among U.S. providers. Evidence-based education and clinical guidance help providers make sound decisions on the appropriate and safe use of phage therapy. Full article

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12 pages, 530 KiB

Open AccessArticle

Diminished Social and Leisure Engagement in Community Dwelling-Older Adults with Apathy

by Katherine J. Valles, Emmeline Ayers, Joe Verghese and Mirnova E. Ceïde

Int. J. Environ. Res. Public Health 2025, 22(7), 1138; https://doi.org/10.3390/ijerph22071138 - 18 Jul 2025

Abstract

Background: Apathy predicts functional and cognitive decline in community-dwelling older adults. However, the behavioral correlates of apathy, which could promote cognitive decline have not been described. Our objective was to investigate the associations of apathy with leisure and social engagement. Methods: N = [...] Read more.

Background: Apathy predicts functional and cognitive decline in community-dwelling older adults. However, the behavioral correlates of apathy, which could promote cognitive decline have not been described. Our objective was to investigate the associations of apathy with leisure and social engagement. Methods: N = 538 older adults enrolled in the Central Control of Mobility in Aging study. We used the GDS3A, a 3-item subscale of the Geriatric Depression Scale, to define apathy and the frequency of participation in cognitive, physical, and social leisure activities. Linear regression models were conducted to assess the association between apathy and its behavioral correlates: social engagement and leisure activity participation. Covariates included age, gender, education level, multimorbidity, and dysphoria. Results: Apathy was present in 29.7% of participants and was significantly associated with less frequent participation in physical activity days per week (−1.688. p = 0.003) but not cognitive (−1.094, p = 0.252) or social (−0.654, p = 0.103) leisure activities. Apathy was also associated with a decreased social behavior composite score (−0.055, p < 0.001), Social Network Index (−0.478, p = 0.003), and Medical Outcomes Study Social Support scores (−0.26, p = 0.001). Conclusions: Our findings suggest that apathy presents with reduced participation in physical leisure activities and reduced social engagement, which may provide a way for clinicians and caregivers to identify apathy in the future. Full article

(This article belongs to the Special Issue The Role of Neighborhood Social Networks in Health Behaviors and Healthy Aging)

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14 pages, 359 KiB

Open AccessArticle

Association Between Physical Activity, Sedentary Time, and Quality of Life in Patients with Chagas Disease During COVID-19 Pandemic in Brazil: A Cross-Sectional Study

by Isis Gabrielli Gomes Xavier, Patrícia Mello Andrade, Rodrigo de Lima Vitor, Tayná Cruz Barros, Whesley Tanor Silva, Luciana Fernandes Portela, Marcelo Teixeira de Holanda, Luiz Henrique Conde Sangenis, Gilberto Marcelo Sperandio da Silva, Flavia Mazzoli-Rocha, Fernanda de Souza Nogueira Sardinha Mendes, Andréa Rodrigues da Costa, Marcelo Carvalho Vieira, Daniela Palheiro Mendes de Almeida, Cláudia Maria Valete, Alejandro Marcel Hasslocher-Moreno, Henrique Silveira Costa, Vitor Barreto Paravidino, Tatiana Rehder Gonçalves, Roberto Magalhães Saraiva and Mauro Felippe Felix Mediano Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2025, 22(7), 1137; https://doi.org/10.3390/ijerph22071137 - 18 Jul 2025

Abstract

Background: COVID-19 led to social isolation, potentially reducing physical activity (PA), increasing sedentary time, and lowering quality of life (QoL). This study investigated the association between these factors in patients with Chagas disease (ChD) during the pandemic. Methods: This cross-sectional study included 187 [...] Read more.

Background: COVID-19 led to social isolation, potentially reducing physical activity (PA), increasing sedentary time, and lowering quality of life (QoL). This study investigated the association between these factors in patients with Chagas disease (ChD) during the pandemic. Methods: This cross-sectional study included 187 patients with ChD. PA and sedentary time were assessed by the IPAQ-short and QoL by the WHOQOL-Bref. The relationship between PA levels and sedentary time with QoL were assessed using unadjusted and adjusted generalized linear models. Results: The highest tertile of total PA was positively associated with the psychological (Exp β = 1.11; 95% CI: 1.02–1.22) and environmental (Exp β = 1.12; 95% CI: 1.01–1.23) QoL domains. The intermediate (Exp β = 1.12; 95% CI: 1.01–1.25) and highest (Exp β = 1.14; 95% CI: 1.02–1.27) tertiles of moderate-to-vigorous PA were positively associated with the physical domain. Similarly, both the intermediate (Exp β = 1.11; 95% CI: 1.01–1.22) and highest (Exp β = 1.12; 95% CI: 1.01–1.21) tertiles of moderate-to-vigorous PA were positively associated with the psychological domain. The highest tertile of sedentary time was associated with a decrease in the physical domain (Exp β = 0.88; 95% CI: 0.79–0.98). Conclusions: Higher levels of total and moderate-to-vigorous PA were associated with better QoL, while greater sedentary time was associated with poorer QoL. Full article

(This article belongs to the Special Issue One Size Does Not Fit All: New Strategies to Improve Overall Health and Physical Activity Behavior in Vulnerable Populations)

14 pages, 662 KiB

Open AccessArticle

Changes in Body Mass Index Among Korean Adolescents Before and After COVID-19: A Comparative Study of Annual and Regional Trends

by Seongjun Ha

Int. J. Environ. Res. Public Health 2025, 22(7), 1136; https://doi.org/10.3390/ijerph22071136 - 18 Jul 2025

Abstract

This study aimed to longitudinally analyze changes in body mass index (BMI) among Korean middle and high school students before and after the COVID-19 pandemic. Data were obtained from the national-level Physical Activity Promotion System (PAPS), collected between 2018 and 2024. A total [...] Read more.

This study aimed to longitudinally analyze changes in body mass index (BMI) among Korean middle and high school students before and after the COVID-19 pandemic. Data were obtained from the national-level Physical Activity Promotion System (PAPS), collected between 2018 and 2024. A total of 171,705 adolescents aged 13 to 18 were included in the analysis (86,542 males and 85,163 females), with a mean age of 15.2 years (SD = 1.68). Time-series analysis and two-way analysis of variance (ANOVA) were conducted to examine differences in BMI by year, sex, region (capital vs. non-capital), and urban–rural classification. The results indicated a significant increase in BMI during the pandemic period (2020–2022), peaking in 2022, followed by a gradual decline thereafter. Notably, male students and those living in rural or non-capital areas consistently exhibited higher BMI levels, suggesting structural disparities in access to physical activity opportunities and health resources. This study employed the Socio-Ecological Model and the Health Equity Framework as theoretical lenses to interpret BMI changes not merely as individual behavioral outcomes but as consequences shaped by environmental and policy-level determinants. The findings underscore the need for equity-based interventions in physical education and health policy to mitigate adolescent health inequalities during future public health crises. Full article

(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)

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11 pages, 305 KiB

Open AccessArticle

Teachers’ Perspectives on the Impact of an Outdoor-Based Self-Care Training Program on Student Mental Health

by Katie A. Bucher, Connor M. Moriarty, Adam Lazarchak and Russell K. McIntire

Int. J. Environ. Res. Public Health 2025, 22(7), 1135; https://doi.org/10.3390/ijerph22071135 - 18 Jul 2025

Abstract

As mental health disorders in the U.S. increase at an alarming rate, schools are looking for prevention and mitigation interventions for their students. This study reports teachers’ perspectives on the effectiveness of a school program situated at the intersection of self-care and nature-based [...] Read more.

As mental health disorders in the U.S. increase at an alarming rate, schools are looking for prevention and mitigation interventions for their students. This study reports teachers’ perspectives on the effectiveness of a school program situated at the intersection of self-care and nature-based interventions at a vocational technical high school. Eight classes received between one and four “Intro to Well-Being” sessions, designed to take students outside and develop self-awareness, sense of connection, and reduce stress. Upon the conclusion of the program, classroom teachers were interviewed to identify the perceptions of the sessions and their impact on student and classroom outcomes. Teachers described the sessions as beneficial to students’ expression of emotions, mindfulness skills, personal/social connections, and classroom atmosphere. Teachers also reflected on challenges and provided recommendations for future implementation. Outdoor-based self-care programs, administered at schools, may be a promising program model to support the social and emotional health of students. Full article

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

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2 pages, 184 KiB

Open AccessCorrection

Correction: Martin et al. The Health Literacy of First Year Physiotherapy and Speech Pathology Students and Their Perceived Future Roles in Supporting Their Clients’ Health Literacy. Int. J. Environ. Res. Public Health 2023, 20, 6013

by Romany Martin, Jade Cartwright and Marie-Louise Bird

Int. J. Environ. Res. Public Health 2025, 22(7), 1134; https://doi.org/10.3390/ijerph22071134 - 18 Jul 2025

Abstract

The authors have requested that the following changes be made to the original publication [...] Full article

29 pages, 816 KiB

Open AccessReview

Implementation of Behavior Change Theories and Techniques for Physical Activity Just-in-Time Adaptive Interventions: A Scoping Review

by Parker Cotie, Amanda Willms and Sam Liu

Int. J. Environ. Res. Public Health 2025, 22(7), 1133; https://doi.org/10.3390/ijerph22071133 - 17 Jul 2025

Abstract

(1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote [...] Read more.

(1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote PA. Integrating behavior change techniques (BCTs) and theories is critical to the design of effective mHealth interventions. Understanding which BCTs and theories work best can inform future JITAI development. (2) Objective: The objective of this study is to examine how behavior change theories and BCTs are implemented in mHealth PA JITAIs and assess their relationship with PA-related outcomes. (3) Methods: This scoping review followed the PRISMA-ScR guidelines. A total of 29 studies were included. (4) Results: The most commonly used BCTs include prompts/cues (n = 29), goal-setting (behavior) (n = 15), and feedback on behavior (n = 14), while self-determination theory (n = 4) and social cognitive theory (n = 4) are the most commonly used theories. However, there is insufficient evidence as to which theories and BCTs are most effective in eliciting effective PA behavior change. (5) Conclusions: Clearer reporting and integration of BCTs and behavior change theories, along with optimized user interfaces, are needed to improve the intervention quality, replicability, and long-term effectiveness of PA JITAIs. Full article

(This article belongs to the Special Issue Challenges and Opportunities for Digital Health Interventions to Improve Health Services Quality)

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24 pages, 1686 KiB

Open AccessArticle

Assessing Occupational Safety Risks and Challenges Among Informal Welders in Pretoria West, South Africa

by Marvin Mashimbyi, Kgotatso Jeanet Seisa, Muelelwa Ramathuthu and Maasago Mercy Sepadi

Int. J. Environ. Res. Public Health 2025, 22(7), 1132; https://doi.org/10.3390/ijerph22071132 - 17 Jul 2025

Abstract

Background: Informal welders in Pretoria West face growing occupational safety risks due to hazardous working environments and limited regulatory oversight. Despite the high-risk nature of their work, many remain unaware of relevant safety legislation and inconsistently use personal protective equipment (PPE). This study [...] Read more.

Background: Informal welders in Pretoria West face growing occupational safety risks due to hazardous working environments and limited regulatory oversight. Despite the high-risk nature of their work, many remain unaware of relevant safety legislation and inconsistently use personal protective equipment (PPE). This study aimed to investigate the occupational safety risks, challenges, and levels of compliance with safety practices among informal welders in Pretoria West, South Africa. Methods: A cross-sectional mixed-methods approach was employed, incorporating both qualitative and quantitative designs. Data were collected from 40 male welders (aged 20–55 years) using structured questionnaires, observational checklists, and semi-structured interviews. Descriptive statistics were generated using Microsoft Excel, while thematic content analysis was applied to the qualitative data. Results: Eighty-five percent (85%) of welders reported using gas welding, and more than half had received training in welding and PPE use; however, 47.5% had no formal training. A high prevalence of work-related injuries was reported, including burns, cuts, and eye damage. Common safety concerns identified were burns (42.5%), electric shocks (35%), and malfunctioning equipment. Observational data revealed inconsistent PPE use, particularly with flame-resistant overalls and eye protection. Qualitative insights highlighted challenges such as demanding client expectations, hazardous physical environments, and inadequate equipment maintenance. Many sites lacked compliance with occupational safety standards. Conclusion: The study reveals critical gaps in safety knowledge, training, and PPE compliance among informal welders. These deficiencies significantly elevate the risk of occupational injuries. Strengthening occupational health and safety regulations, improving access to PPE, and delivering targeted training interventions are essential to safeguard the well-being of welders and those in their surrounding communities. Full article

21 pages, 691 KiB

Open AccessSystematic Review

Breast Cancer Survivors’ Perception on Health Promotion and Healthy Lifestyle: A Systematic Review and Qualitative Meta-Synthesis

by Luca Guardamagna, Orejeta Diamanti, Giovanna Artioli, Lorenzo Casole, Matteo Bernardi, Francesca Bonadies, Enrico Zennaro, Gloria Maria Modena, Tiziana Nania and Federica Dellafiore

Int. J. Environ. Res. Public Health 2025, 22(7), 1131; https://doi.org/10.3390/ijerph22071131 - 17 Jul 2025

Abstract

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women [...] Read more.

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies. Full article

(This article belongs to the Section Global Health)

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13 pages, 1243 KiB

Open AccessArticle

A Tandem MS Platform for Simultaneous Determination of Urinary Malondialdehyde and Diphenyl Phosphate

by Gabriela Chango, Diego García-Gómez, Carmelo García Pinto, Encarnación Rodríguez-Gonzalo and José Luis Pérez Pavón

Int. J. Environ. Res. Public Health 2025, 22(7), 1130; https://doi.org/10.3390/ijerph22071130 - 17 Jul 2025

Abstract

This study presents an advanced analytical method for the simultaneous quantification of malondialdehyde (MDA), a biomarker of oxidative stress, and diphenyl phosphate (DPhP), a metabolite of the organophosphate flame retardant triphenyl phosphate (TPhP), in human urine. The method integrates hydrophilic interaction liquid chromatography [...] Read more.

This study presents an advanced analytical method for the simultaneous quantification of malondialdehyde (MDA), a biomarker of oxidative stress, and diphenyl phosphate (DPhP), a metabolite of the organophosphate flame retardant triphenyl phosphate (TPhP), in human urine. The method integrates hydrophilic interaction liquid chromatography (HILIC), a type of liquid chromatography suitable for polar compounds, for MDA separation, and an online restricted access material (RAM), a preconcentration column, for DPhP isolation, achieving high specificity and sensitivity. Validation with certified urine samples confirmed its robustness across diverse analyte concentrations and complex biological matrices. The optimized clean-up steps effectively minimized carryover, allowing for high-throughput analysis. Application to 72 urine samples revealed a significant positive correlation (ρ = 0.702, p-value = 1.9 × 10⁻⁷) between MDA and DPhP levels, supporting a potential link between oxidative stress and TPhP exposure. The subset analysis demonstrated a statistically significant moderate positive correlation in women (ρ = 0.622, p-value = 0.020), although this result should be interpreted with caution because of the limited sample size (N = 14). This method provides a powerful tool for biomonitoring oxidative stress and environmental contaminants, offering valuable insights into exposure-related health risks. Full article

(This article belongs to the Special Issue Research on Environmental Exposure, Pollution, and Epidemiology)

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International Journal of Environmental Research and Public Health

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