International Journal of Environmental Research and Public Health

19 pages, 846 KiB

Open AccessArticle

Likes, Shares, and Symptoms: The Hidden Toll of Early Adolescents’ Social Media Use on Well-Being

by Lisanne Vonk, Polina Putrik, Thérèse van Amelsvoort, Elien Vanluydt, Philippe Delespaul, Mark Levels and Tim Huijts

Int. J. Environ. Res. Public Health 2025, 22(1), 131; https://doi.org/10.3390/ijerph22010131 - 20 Jan 2025

Viewed by 352

Abstract

Social media use has rapidly increased over the past decade, especially among young people. To obtain more insight into the potential negative associations with problematic social media use in Dutch early adolescents, we assessed its relation to self-reported well-being. We conducted a cross-sectional [...] Read more.

Social media use has rapidly increased over the past decade, especially among young people. To obtain more insight into the potential negative associations with problematic social media use in Dutch early adolescents, we assessed its relation to self-reported well-being. We conducted a cross-sectional study with 585 students in their final year of primary school (11–12 years old) who completed a questionnaire during school hours. We examined the association between problematic social media use and psychosomatic complaints, as well as general life satisfaction and whether perceived social support and sex moderated these associations. Problematic social media use was associated with lower general life satisfaction, as well as all psychosomatic complaints, with the strongest association for having a bad mood or feeling irritated (OR = 3.08, 99% CI = 2.05–4.63). Most associations were not moderated by perceived social support or sex. Our findings indicate that the well-being of early adolescents may be affected by problematic social media use already in primary school. The association persisted regardless of the amount of perceived social support, and without strong gender differences. This suggests that the potential for limiting the potential negative consequences of problematic social media use through increasing social support is limited. Full article

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18 pages, 2623 KiB

Open AccessArticle

Analysis of the Climate Impact on Occupational Health and Safety Using Heat Stress Indexes

by Guilherme Neto Ferrari, Guilherme Custódio dos Santos, Paulo Cesar Ossani, Gislaine Camila Lapasini Leal and Edwin Vladimir Cardoza Galdamez

Int. J. Environ. Res. Public Health 2025, 22(1), 130; https://doi.org/10.3390/ijerph22010130 - 20 Jan 2025

Viewed by 429

Abstract

Workers may be exposed to conditions that put their physical and mental integrity at risk, from workplace settings to climate characteristics. Heat stress is a harmful health condition caused by exceeding the human body’s tolerance limits, leading to illness and increasing the chance [...] Read more.

Workers may be exposed to conditions that put their physical and mental integrity at risk, from workplace settings to climate characteristics. Heat stress is a harmful health condition caused by exceeding the human body’s tolerance limits, leading to illness and increasing the chance of work accidents. Heat stress indexes, such as the Humidex and the Heat Index (HI), are used to measure these impacts. These indexes are significant as they provide a quantitative measure of the heat stress experienced by workers, taking into account both environmental and individual factors. Objective: This study aims to compare multiple heat stress indexes, relating them to historical Brazilian occupational accident data. Methods: We selected eight indexes and applied multiple correspondence analysis to each one, a statistical method that generates graphs to visualize the association between variables in a database. Results: The analysis and comparison of the graphs indicated that seven of the eight indexes presented similar behavior. It was also possible to relate ranges of index values with specific characteristics of the accidents. Conclusions: The technique allowed us to analyze the relationship between climate and work accidents and showed that the choice of the heat stress index does not significantly alter the results for most indexes studied. Full article

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14 pages, 328 KiB

Open AccessArticle

Prospective Associations Between Preschool Exposure to Violent Televiewing and Externalizing Behavior in Middle Adolescent Boys and Girls

by Linda S. Pagani, Amélie Gilker Beauchamp, Laurie-Anne Kosak, Kianoush Harandian, Claudio Longobardi and Eric Dubow

Int. J. Environ. Res. Public Health 2025, 22(1), 129; https://doi.org/10.3390/ijerph22010129 - 20 Jan 2025

Viewed by 1144

Abstract

Objective. Early childhood exposure to violent media content represents an actionable target for preventive intervention. The associated risks for later aggressive behavior have been established in childhood, but few studies have explored widespread long-term associations with antisocial behavior. We investigate prospective associations between [...] Read more.

Objective. Early childhood exposure to violent media content represents an actionable target for preventive intervention. The associated risks for later aggressive behavior have been established in childhood, but few studies have explored widespread long-term associations with antisocial behavior. We investigate prospective associations between exposure to violent television content in early childhood and subsequent antisocial behavior in mid-adolescence. Method. Participants are 963 girls and 982 boys from the Quebec Longitudinal Study of Child Development (QLSCD) birth cohort. Parents reported the frequency of their child’s exposure to violent television content at ages 3.5 and 4.5 years. Four indicators of antisocial behavior were self-reported by participants at age 15 years. These indicators were linearly regressed on exposure to violent television content at ages 3.5 and 4.5 years. All analyses, stratified by sex, controlled for pre-existing and concurrent potential individual and family confounding variables. Results. For boys, preschool violent televiewing was associated with increases in proactive aggression (β = 0.065; 95% CI, 0.001 to 0.089), physical aggression (β = 0.074; 95% CI, 0.040 to 0.487), and antisocial behavior (β = 0.076; 95% CI, 0.013 to 0.140) by mid-adolescence. No prospective associations were found for girls. Conclusions. This study of typically developing children demonstrates long-term perils associated with early exposure to violent content in childhood. We observed risks for aggressive and delinquent behavior in boys, more than a decade later. Preventive intervention campaigns that target knowledge transfer to parents and communities regarding the potential insidious consequences of preschool exposure promise more optimal development in youth. Full article

12 pages, 3048 KiB

Open AccessArticle

Incidence of Tooth Loss in Remote Indigenous Populations of the Amazon Region: A 13-Year Cohort Study Before and After Belo Monte Dam

by Renata Travassos da Rosa Moreira Bastos, Eduardo Oliveira da Costa, Lucca Sicilia and David Normando

Int. J. Environ. Res. Public Health 2025, 22(1), 128; https://doi.org/10.3390/ijerph22010128 - 20 Jan 2025

Viewed by 255

Abstract

Tooth loss among indigenous people in the Amazon emphasizes the need for culturally appropriate oral health interventions. The objective of this study was to analyze the incidence of tooth loss in two remote Amazon indigenous populations. This prospective cohort evaluated a total of [...] Read more.

Tooth loss among indigenous people in the Amazon emphasizes the need for culturally appropriate oral health interventions. The objective of this study was to analyze the incidence of tooth loss in two remote Amazon indigenous populations. This prospective cohort evaluated a total of 47 indigenous in the permanent dentition at T0 and thirteen years later (T1) from two villages, Arara-Laranjal (n = 28, mean age 16.1 and 29.9 years) and Assurini do Xingu (n = 19, mean age 15.9 and 29.5 years), of different ethnic groups. A multilevel Poisson regression model assessed the influence of village, sex, and age on tooth loss. At T0, the indigenous people had all their permanent teeth. Forty-two lost at least one tooth (89%), and a total of 172 teeth were lost at T1 at an incidence of 97% among females and 76% in males. There was no influence of ethnicity on tooth loss (p = 1.000). A lower risk of tooth loss was associated with male subjects (β = −0.50, p < 0.05) but not with age. In females (22/46.8%) and males (11/23.4%), the highest incidence of tooth loss was the lower second molars. The risk was higher among females, and there was no influence on age, village, or ethnicity. The second and first molars were the most affected teeth. These findings suggest an increase in tooth loss caused by close contact between indigenous and urban populations. Full article

(This article belongs to the Special Issue Oral Diseases: Prevention, Diagnosis and Treatment)

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12 pages, 274 KiB

Open AccessArticle

Absenteeism Among Healthcare Workers: Job Grade and Other Factors That Matter in Sickness Absence

by Carine J. Sakr, Lina M. Fakih, Umayya M. Musharrafieh, Ghassan M. Khairallah, Maha H. Makki, Rita M. Doudakian, Hani Tamim, Carrie A. Redlich, Martin D. Slade and Diana V. Rahme

Int. J. Environ. Res. Public Health 2025, 22(1), 127; https://doi.org/10.3390/ijerph22010127 - 20 Jan 2025

Viewed by 412

Abstract

Background: Absenteeism among healthcare workers (HCWs) disrupts workflows and hampers the delivery of adequate patient care. The aim of the study was to examine predictors of sick leaves among HCWs in a tertiary medical center in Lebanon. Methods: A retrospective analysis of sick [...] Read more.

Background: Absenteeism among healthcare workers (HCWs) disrupts workflows and hampers the delivery of adequate patient care. The aim of the study was to examine predictors of sick leaves among HCWs in a tertiary medical center in Lebanon. Methods: A retrospective analysis of sick leaves linked to health records of 2850 HCWs between 2015 and 2018 was performed. Sick leave episodes were stratified by diagnosis. Bivariate and negative binomial regression analyses were performed to investigate predictors. Results: The mean number of sick leave episodes was 10.6 per person over 4 years. The strongest predictor of higher sickness absenteeism was low job grade (IR = 1.52; 95% CI = 1.39, 1.67). Female sex (IR = 1.24; 95% CI = 1.14, 1.36), older age (IR = 1.19; 95% CI = 1.08, 1.30), being married (IR = 1.21; 95% CI = 1.11, 1.33), being a current smoker (IR = 1.21; 95% CI = 1.11, 1.32), and having a history of selected medical conditions were all significant sick leave predictors. Conclusion: Demographic, work-related, and health-related predictors are associated with the number of sick leave episodes. To address the health inequity, additional research should evaluate how some socio-economic factors determine poorer health outcomes and should guide approaches to address this crucial issue to protect the health and well-being of this key workforce. Full article

(This article belongs to the Special Issue Work Environment Effects on Health and Safety of Employees)

14 pages, 261 KiB

Open AccessArticle

A Qualitative Descriptive Study of Rural Primary Healthcare Professionals’ Capacity for Disaster Health Management Before and During the COVID-19 Pandemic

by Ehmaidy Al qaf’an, Stewart Alford, Holly A. Mack, Ravneet Sekhon, Samuel Gray, Kiara Song, Katie Willson, Glynn Kelly and David Lim

Int. J. Environ. Res. Public Health 2025, 22(1), 126; https://doi.org/10.3390/ijerph22010126 - 20 Jan 2025

Viewed by 445

Abstract

Introduction: Rural areas face additional challenges in preventing, preparing for, responding to, and recovering from disasters. This study aimed to understand how rural primary healthcare professionals (PHCPs) perceive their roles, involvement, and capacity in disaster health management. Methods: For this qualitative descriptive research, [...] Read more.

Introduction: Rural areas face additional challenges in preventing, preparing for, responding to, and recovering from disasters. This study aimed to understand how rural primary healthcare professionals (PHCPs) perceive their roles, involvement, and capacity in disaster health management. Methods: For this qualitative descriptive research, semi-structured interviews were carried out with convenience and purposive samples of rural PHCPs before and during the COVID-19 pandemic. Open, axial, and selective coding were employed to analyse the data inductively. Results: Five interviews were conducted before the pandemic, and ten interviews were conducted during the second and third waves of the COVID-19 pandemic in Australia. The themes identified were similar between the two periods. Rural PHCPs were underutilised due to a lack of awareness of their capacity and a lack of infrastructure and support for greater involvement. Conclusions: Rural PHCPs can be better integrated and supported in readiness for a whole-system response to future disasters. This study recommends empowering PHCPs in disaster management to promote the health and continuity of care in rural communities. Full article

(This article belongs to the Special Issue Public Health: Rural Health Services Research—2nd Edition)

15 pages, 256 KiB

Open AccessArticle

“My Husband Is a ‘Mama’s Boy’”: Women’s Views on Male Engagement in Maternal, Newborn, and Child Health in Western Kenya

by Robsan Tura, Nema C. M. Aluku, Sato Ashida and William T. Story

Int. J. Environ. Res. Public Health 2025, 22(1), 125; https://doi.org/10.3390/ijerph22010125 - 19 Jan 2025

Viewed by 554

Abstract

There is an increasing global acknowledgment of the critical role that men have as key partners in maternal, newborn, and child health (MNCH). Most male-engagement initiatives do not address the perceived benefits and risks that women may experience because of increased male participation [...] Read more.

There is an increasing global acknowledgment of the critical role that men have as key partners in maternal, newborn, and child health (MNCH). Most male-engagement initiatives do not address the perceived benefits and risks that women may experience because of increased male participation in MNCH, especially in Kenya. The aim of this study, therefore, is to qualitatively assess how women perceive and experience increased male engagement in MNCH in western Kenya. Using a phenomenological approach, 53 women (35 mothers and 18 mothers-in-law) were purposively selected from seven communities in Kakamega County and participated in seven focus group discussions (FGD) in November and December 2020. Our findings suggest that the level of support for increased male involvement in MNCH varies depending on the type of participant. While mothers-in-law were less supportive of increased male involvement, mothers were more supportive of male involvement that fosters gender equity, such as joint decision making. Most mothers-in-law argued that women are ‘naturally’ closer to children, that men cannot care for children and their involvement may harm children, and men’s involvement may give men more control over women’s spaces. These findings show that programmatic initiatives to enhance male engagement in MNCH must consider mothers-in-law’s concerns and leverage mothers’ desire to engage men in a gender-equitable way. Full article

(This article belongs to the Section Global Health)

19 pages, 534 KiB

Open AccessArticle

Paternal Depression and Anxiety During the COVID-19 Pandemic

by Emily E. Cameron, Kayla M. Joyce, Kathryn Hatherly and Leslie E. Roos

Int. J. Environ. Res. Public Health 2025, 22(1), 124; https://doi.org/10.3390/ijerph22010124 - 19 Jan 2025

Viewed by 331

Abstract

The COVID-19 pandemic significantly impacted the lives of families worldwide. Findings suggest a substantial impact of the COVID-19 pandemic on maternal mental health. Yet, much less is known about the impact of COVID-19 on paternal mental health. This study describes depression and anxiety [...] Read more.

The COVID-19 pandemic significantly impacted the lives of families worldwide. Findings suggest a substantial impact of the COVID-19 pandemic on maternal mental health. Yet, much less is known about the impact of COVID-19 on paternal mental health. This study describes depression and anxiety and risk and protective factors among fathers of young children largely residing in Canada during the COVID-19 pandemic. Fathers (N = 70) of children 0 to 8 years old self-reported depression (EPDS, CESD, CESD-R) and anxiety (PASS, GAD-7) symptoms, while mothers (N = 236) provided reports of paternal depressive symptoms using the EPDS-P. Fathers evidenced clinically significant depression (37.1%) and anxiety (22.9%). Linear regression models with significant bivariate correlates indicated that depressive symptoms were associated with a mental health history and experiencing recent stressful events in the past month, while anxiety symptoms were related to mental health history over and above other correlates. Mother-reported paternal depression was prevalent (61.9%) and associated with lower mother-reported marital quality and higher maternal depressive symptoms. Of the fathers reporting clinically significant mental health concerns, less than one-third reported accessing mental health services. Paternal depression and anxiety symptoms were elevated during the pandemic, when compared to pre-pandemic comparisons. The risk and protective factors for paternal depression and anxiety included mental health history, recent stressful events, maternal marital quality, and maternal depressive symptoms. Longitudinal studies evaluating the persistent impact of the COVID-19 pandemic on paternal mental health are needed to inform continued efforts to repair the pandemic’s impact on family wellbeing. Full article

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17 pages, 1000 KiB

Open AccessReview

Elderhood and Healthy Aging from an Indigenous Perspective

by Yu-Chi Kalesekes Huang and Kathryn L. Braun

Int. J. Environ. Res. Public Health 2025, 22(1), 123; https://doi.org/10.3390/ijerph22010123 - 18 Jan 2025

Viewed by 445

Abstract

Researchers have outlined the components of healthy aging, and a 2022 scoping review by Quigley et al. examined healthy aging from Indigenous perspectives. Quigley’s review reinforced the notion that Indigenous health, and thus healthy aging, is a holistic concept. However, no review has [...] Read more.

Researchers have outlined the components of healthy aging, and a 2022 scoping review by Quigley et al. examined healthy aging from Indigenous perspectives. Quigley’s review reinforced the notion that Indigenous health, and thus healthy aging, is a holistic concept. However, no review has specifically addressed Elderhood from an Indigenous perspective. This scoping review aimed to fill that gap by analyzing studies from Quigley’s review and sourcing additional literature on Indigenous Elderhood. Eligible articles identified participants as Indigenous and described Elderhood within the culture. From the 20 included publications, six themes were identified, suggesting that Elderhood was a term limited to adults who were respected for their wisdom, were active in the community, cared for others, passed down Indigenous knowledge, and promoted a vision of the future that built on tradition. Age was not a criterion, as older people who are not seen as respected contributors do not earn the title of Elder. The findings suggest that achieving Elderhood is key to healthy aging for Indigenous adults, regardless of one’s physical health status. Programs and policies offered in Indigenous communities should recognize this distinction. Further research should explore ways to support successful Elderhood, as defined here, as a component of healthy aging in Indigenous communities. Full article

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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14 pages, 1743 KiB

Open AccessArticle

Enhancing Post-Training Muscle Recovery and Strength in Paralympic Powerlifting Athletes with Cold-Water Immersion, a Cross-Sectional Study

by Felipe J. Aidar, Wélia Yasmin Horacio dos Santos, Saulo da Cunha Machado, Albená Nunes-Silva, Érica Leandro Marciano Vieira, Diego Ignácio Valenzuela Pérez, Esteban Aedo-Muñoz, Ciro José Brito and Pantelis T. Nikolaidis

Int. J. Environ. Res. Public Health 2025, 22(1), 122; https://doi.org/10.3390/ijerph22010122 - 18 Jan 2025

Viewed by 421

Abstract

(1) Background: The recovery method is important and decisive in the training system. This study aimed to assess the effects of various post-training recovery methods on muscle damage and strength indicators in Paralympic powerlifting athletes. (2) Methods: A crossover study was conducted involving [...] Read more.

(1) Background: The recovery method is important and decisive in the training system. This study aimed to assess the effects of various post-training recovery methods on muscle damage and strength indicators in Paralympic powerlifting athletes. (2) Methods: A crossover study was conducted involving eleven male athletes (25.4 ± 3.3 years, 70.3 ± 12.1 kg). Muscle damage was assessed using blood biochemical markers (cytokines IL-6, IL-10, and TNF-α) and isometric force indicators, including the maximum isometric force (MIF), time to MIF, and Rate of Force Development. The following assessments were performed before, immediately after, and at 24 and 48 h after the recovery protocol: (a) passive recovery (RP) or (b) cold-water immersion (CWI). (3) Results: The main results indicated that maximum isometric force (MIF) significantly improved after 48 h of CWI application (p < 0.05; for all comparison). The analysis of biochemical markers did not yield significant differences between the recovery methods at different time points (p > 0.05). For IL-6, there were significant differences between CWI before (2.29 ± 1.08, 95% CI 1.57–3.01) and CWI 2 h later (2 h) (4.59 ± 2.96, 95% CI 2.60–6.57; p = 0.045), and between CWI 15 min later (15 min) (4.14 ± 2.24, 95% CI 2.63–5.64) and CWI 48 h later (48 h) (2.33 ± 1.25, 95% CI 1.49–3.17; p = 0.034). There were differences between CWI 2 h (4.14 ± 2.24, 95% CI 2.63–5.64) and CWI 48 h later (2.33 ± 1.25, 95% CI 1.49–3.17; p = 0.035; F = 9.202; η²p = 0.479; high effect). (4) Conclusions: CWI significantly improved the post-resistance training muscle damage and strength in Paralympic powerlifting athletes. Full article

(This article belongs to the Special Issue Physical Therapy and Sports Recovery)

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18 pages, 491 KiB

Open AccessArticle

Total Fat and Fatty Acid Content in Meals Served by Independent Takeaway Outlets Participating in the Healthier Catering Commitment Initiative in London, UK

by Agnieszka Jaworowska and Susan Force

Int. J. Environ. Res. Public Health 2025, 22(1), 121; https://doi.org/10.3390/ijerph22010121 - 18 Jan 2025

Viewed by 652

Abstract

Out-of-home meals are characterized by poor nutritional quality, and their intake has been linked to adverse health outcomes. Therefore, national and local government initiatives have been implemented in the UK to promote healthier out-of-home meals. However, there is limited evidence of their effectiveness. [...] Read more.

Out-of-home meals are characterized by poor nutritional quality, and their intake has been linked to adverse health outcomes. Therefore, national and local government initiatives have been implemented in the UK to promote healthier out-of-home meals. However, there is limited evidence of their effectiveness. This study evaluated the fat content and fatty acid profile of takeaway meals from ‘standard’ and from Healthier Catering Commitment (HCC)-approved takeaway outlets. Meals from 14 ‘standard’ and 13 ‘HCC-awarded’ takeaways (74 meals and 26 side dishes) were analyzed for total fat and fatty acid composition. No statistically significant differences in total fat, saturated, and trans fatty acids per 100 g and per portion between HCC and standard meals were observed, except for donner kebabs. Over 70% of all meals contained more than the recommended 30% of daily fat intake from a single meal. Some meals could provide more than 50% of the recommended total fat and SFAs intake. Despite businesses participating in the healthier out-of-home meal initiative, there has not been a significant improvement in the nutritional quality of the meals they offer. Further research to develop effective approaches to support independent takeaway businesses in offering meals with improved nutritional quality is warranted. Full article

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14 pages, 659 KiB

Open AccessArticle

County-Level Food Insecurity and Hepatocellular Carcinoma Risk: A Cross-Sectional Analysis

by Rebecca D. Kehm, Chrystelle L. Vilfranc, Jasmine A. McDonald and Hui-Chen Wu

Int. J. Environ. Res. Public Health 2025, 22(1), 120; https://doi.org/10.3390/ijerph22010120 - 18 Jan 2025

Viewed by 381

Abstract

Food insecurity (FI) is associated with several known hepatocellular carcinoma (HCC) risk factors, but few studies have directly examined FI in association with HCC risk. We aimed to investigate whether county-level FI is associated with HCC risk. We used data from 21 registries [...] Read more.

Food insecurity (FI) is associated with several known hepatocellular carcinoma (HCC) risk factors, but few studies have directly examined FI in association with HCC risk. We aimed to investigate whether county-level FI is associated with HCC risk. We used data from 21 registries in the Surveillance Epidemiology and End Results database to obtain county-level counts of HCC cases from 2018 to 2021. We obtained the county-level FI rates for 2018–2021 from Feeding America’s Map the Meal Gap. We used multi-level Poisson regression models with robust standard errors to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Overall, a one-standard-deviation (SD) increase in county-level FI was associated with an 8% increase in HCC risk in the fully adjusted model (IRR = 1.08, 95% CI = 1.06, 1.10). When stratified by age at diagnosis, a one-SD increase in county-level FI was associated with a 2% higher risk of HCC in the ≥65 age group (IRR = 1.02, 95% CI = 1.00, 1.05) and a 15% higher risk in the <65 age group (IRR = 1.15, 95% CI = 1.11, 1.19; interaction p-value < 0.001). If confirmed in other studies, these findings support the need for interventions and policies addressing FI in populations at increased risk for HCC. Full article

(This article belongs to the Section Global Health)

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10 pages, 1544 KiB

Open AccessArticle

Snorkelling and Breath-Hold Diving Fatalities in Australia—A Review of 317 Deaths

by John M. Lippmann

Int. J. Environ. Res. Public Health 2025, 22(1), 119; https://doi.org/10.3390/ijerph22010119 - 18 Jan 2025

Viewed by 400

Abstract

As snorkelling and breath-hold diving are conducted in a potentially hostile environment by participants with varying skills and health, fatalities occur. In this study, snorkelling and breath-hold diving fatalities were investigated in Australia from 2000 to 2021 to identify causes and countermeasures. The [...] Read more.

As snorkelling and breath-hold diving are conducted in a potentially hostile environment by participants with varying skills and health, fatalities occur. In this study, snorkelling and breath-hold diving fatalities were investigated in Australia from 2000 to 2021 to identify causes and countermeasures. The Australasian Diving Safety Foundation database and the National Coronial Information System were searched to identify snorkelling/breath-hold diving deaths from 2000 to 2021. Relevant data were extracted, recorded, and analysed. The median age of the 317 victims was 48 years, two-thirds were overweight or obese, and almost half had health conditions, including ischaemic heart disease (IHD) and left ventricular hypertrophy (LVH), predisposing them to an arrhythmia-related snorkelling incident. One-third of victims were likely disabled by cardiac arrhythmias and at least 137 deaths were from primary drowning, with 34 following apnoeic hypoxia. Pre-existing health conditions, particularly IHD and LVH, predispose to many snorkelling deaths in older participants and may be somewhat mitigated by targeted health screening. Drownings from apnoeic hypoxia persist in younger breath-hold divers who should avoid pushing their limits without close monitoring. Skills practice in a controlled environment, increased focus on the importance of an effective buddy, and improved supervision are necessary to mitigate risk in the inexperienced. Full article

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10 pages, 228 KiB

Open AccessArticle

The Effect of Offspring Gender Composition on Modern Contraceptive Uptake Among Married Women of Reproductive Age in Pakistan: A Facility-Based Cross-Sectional Study

by Muhammad Ishaque, Jack Hazerjian, Mohamad Ibrahim Brooks, Tabinda Sarosh, Madiha Latif and Maisam Ali

Int. J. Environ. Res. Public Health 2025, 22(1), 118; https://doi.org/10.3390/ijerph22010118 - 17 Jan 2025

Viewed by 419

Abstract

Introduction: Pakistan is confronted with the formidable challenge of high population growth, which is compounded by cultural norms that prioritize male offspring, leading to adverse implications for family planning efforts and demographic trends. Despite efforts to promote contraception, including a national family planning [...] Read more.

Introduction: Pakistan is confronted with the formidable challenge of high population growth, which is compounded by cultural norms that prioritize male offspring, leading to adverse implications for family planning efforts and demographic trends. Despite efforts to promote contraception, including a national family planning program, Pakistan continues to struggle with low and stagnant contraceptive prevalence rates among married women. The influence of gender composition on modern contraceptive uptake remains underexplored, necessitating research to elucidate its impact on reproductive behavior. Materials and methods: This study used the dataset of a facility-based cross-sectional survey conducted in six districts of the Sindh and Punjab provinces in Pakistan. A subset of 495 married women of reproductive age seeking health services from March to June 2019 was used for this study. Logistic regression analysis was employed to examine the association between the gender composition of children and modern contraceptive uptake, adjusting for covariates such as province, the age of the women, and the type of health facility. Results: The analysis revealed a significant association between the gender composition of children and modern contraceptive uptake among married women. As the number of daughters increased without sons, the likelihood of contraceptive uptake remained low (adjusted odds ratio [AOR]: 0.12; 95% CI: 0.04–0.34; p < 0.000), while having at least one son substantially increased the odds of contraceptive use (AOR: 19.91; 95% CI: 8.00–49.50; p < 0.000). Notably, the gender composition of having one daughter with two sons had the highest level of contraceptive uptake, potentially because of family composition preferences. Discussion: The findings highlight the pervasive influence of gender composition on reproductive decision-making in Pakistan, with a clear preference for sons driving modern contraceptive behavior. These results underscore the need for targeted interventions to address gender norms and biases while promoting equitable access to family planning services. Engaging men in family planning initiatives is crucial for challenging traditional gender norms and fostering informed decision-making regarding contraception. Conclusions: Gender preference influences modern contraceptive uptake among women in Pakistan, with the strong preference for sons driving reproductive behavior. Addressing gender norms and biases while promoting informed, self-determined choice is essential for enhancing modern contraceptive uptake and achieving sustainable population growth. Targeted interventions, including male engagement strategies, are needed to challenge societal gender norms and empower individuals to make autonomous decisions regarding family planning. Full article

(This article belongs to the Special Issue 2nd Edition of Epidemiology and Global Health)

22 pages, 281 KiB

Open AccessArticle

“Lack” and “Finally”: A Qualitative Analysis of Barriers and Facilitators in Rare Disease Healthcare

by Amanda R. Hemmesch, Kathleen R. Bogart and Erica Barnes

Int. J. Environ. Res. Public Health 2025, 22(1), 117; https://doi.org/10.3390/ijerph22010117 - 16 Jan 2025

Viewed by 523

Abstract

Background: This study explored the experiences of adults with diverse rare diseases (RDs) and RD caregivers with barriers and facilitators to healthcare access in the United States (US), including during the early part of the COVID-19 pandemic, and their recommendations for improving access. [...] Read more.

Background: This study explored the experiences of adults with diverse rare diseases (RDs) and RD caregivers with barriers and facilitators to healthcare access in the United States (US), including during the early part of the COVID-19 pandemic, and their recommendations for improving access. Results: Adults with RDs and parents/caregivers to children with RDs (N = 1128) completed open-ended survey items. Responses were analyzed using thematic analysis. The primary theme identified regarding barriers to healthcare was “lack”; participants reported challenges in obtaining an accurate diagnosis, effective management/treatment, health insurance coverage, and social support. The primary theme identified regarding facilitators was “finally”; participants reported a need for persistence to access a diagnosis, RD experts, as well as social support and advocacy. Recommendations for improving healthcare for RDs mirrored the barriers and facilitators identified, including improving knowledge/awareness of RDs and investing in RD research that could improve diagnosis and treatment. Participants’ healthcare experiences varied widely during the COVID-19 pandemic, with some reporting that telehealth improved care and others reporting disruption due to telehealth. Conclusions: Even though individual diagnoses are rare, there are shared challenges to healthcare access and common opportunities for improvement. Policy recommendations regarding RD healthcare focus on improving affordable and timely access to knowledgeable providers, diagnosis, and medications/treatments. Full article

12 pages, 255 KiB

Open AccessArticle

Knowledge, Attitudes, and Practices of Infection Prevention and Control Nurses in Public Hospitals in the Limpopo Province: A Qualitative Study

by Lebitsi Q. Ranoto, Cairo B. Ntimana, Pamela Mamogobo and Eric Maimela

Int. J. Environ. Res. Public Health 2025, 22(1), 116; https://doi.org/10.3390/ijerph22010116 - 16 Jan 2025

Viewed by 425

Abstract

A crucial aspect of delivering healthcare is infection prevention and control (IPC), especially in public hospitals where the high volume of patients and limited resources can heighten the risk of healthcare-associated infections. This qualitative study explores IPC nurses’ knowledge, attitudes, and practices in [...] Read more.

A crucial aspect of delivering healthcare is infection prevention and control (IPC), especially in public hospitals where the high volume of patients and limited resources can heighten the risk of healthcare-associated infections. This qualitative study explores IPC nurses’ knowledge, attitudes, and practices in public hospitals within the Limpopo province of South Africa. The study adopted a qualitative descriptive design. This qualitative study utilized self-developed validated semi-structured interviews with IPC nurses from 12 public hospitals (4 tertiary, 4 regional, and 4 district). The interviews were transcribed verbatim and analysed using thematic analysis to identify key themes related to knowledge, attitudes, and practices in IPC. Each interview lasted approximately 15 to 20 min. Themes and subthemes that emerged provided a structured overview of the key aspects discussed. Each theme captures a different facet of the experiences, perceptions, and challenges faced by IPC nurses in their role. The subthemes further break down these views into specific areas of focus, offering deeper insights into the nurses’ experiences of their professional responsibilities. This study shows that, although IPC nurses have a good understanding of infection control and a positive attitude toward it, systemic problems and resource constraints make it difficult to consistently implement optimal practices. Affective mood, opportunity cost, coherence of the intervention, burden, perceived efficacy, self-efficacy, and ethics are among the major themes that were found. To improve IPC efforts, there is a clear need for more focused training, resources, and managerial support. Full article

18 pages, 1992 KiB

Open AccessArticle

The Meaning of Ageing and the Educational Intervention “Good Life in Old Age”: An Ethnographic Study Reflecting the Perspective of Older Adults with Mild Intellectual Disability

by Marianne Holmgren and Gerd Ahlström

Int. J. Environ. Res. Public Health 2025, 22(1), 115; https://doi.org/10.3390/ijerph22010115 - 16 Jan 2025

Viewed by 385

Abstract

Older adults with intellectual disabilities are not adequately prepared for ageing and show anxiety and uncertainty regarding the future. Therefore, the two-year educational intervention “Good Life in Old Age” was implemented to improve their understanding of ageing and enhance their well-being. This study [...] Read more.

Older adults with intellectual disabilities are not adequately prepared for ageing and show anxiety and uncertainty regarding the future. Therefore, the two-year educational intervention “Good Life in Old Age” was implemented to improve their understanding of ageing and enhance their well-being. This study aimed to explore the meaning of ageing during and after the intervention from the perspective of older adults with mild intellectual disability. The ethnographic design included participant observations, field notes, group interviews, and individual follow-up interviews with 20 adults aged 44–75 (mean 63.2) with intellectual disabilities. The main findings are expressed in four themes; Awareness of ageing with intellectual disabilities, Strengthened as a person through empowering community, Awareness of vulnerability as an older adult, and The educational intervention as a resource to manage vulnerability. The education programme created a social network for healthy ageing with an atmosphere of mutual support fostering greater mental strength and self-confidence. Individual retirement plans should be created to foster socialisation, involving adapted activities and conversations about bereavement and death. There is a need to disseminate and continue developing promising education programmes for older adults with intellectual disabilities to reduce their anxiety about retirement and loneliness and facilitate healthy ageing. Full article

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16 pages, 4410 KiB

Open AccessArticle

Challenges and Resiliency: Social Determinants of Health, COVID-19, and the Disproportionate Impact on Immigrants and Refugees Living with HIV

by Natasha Marriette, Rita Dhungel, Karun Kishor Karki and Jose Benito Tovillo

Int. J. Environ. Res. Public Health 2025, 22(1), 114; https://doi.org/10.3390/ijerph22010114 - 15 Jan 2025

Viewed by 579

Abstract

The human immunodeficiency virus (HIV) pandemic is a global public health and social justice issue. HIV continues to disproportionately affect marginalized populations, including immigrants and refugees living with HIV (IRLHIV). This study investigated and captured the experiences of IRLHIV using the social determinants [...] Read more.

The human immunodeficiency virus (HIV) pandemic is a global public health and social justice issue. HIV continues to disproportionately affect marginalized populations, including immigrants and refugees living with HIV (IRLHIV). This study investigated and captured the experiences of IRLHIV using the social determinants of health framework. This study examined the intersecting factors affecting the health and well-being of IRLHIV in Alberta, Canada, prior to and during the COVID-19 pandemic. Concurrent mixed methods were used. Employing an online survey (n = 124) and photovoice methodology (n = 13), the researchers identified five salient themes: experiences of racism and discrimination, challenges accessing nutrition, healthcare, and affordable housing, and precarious employment situations. The findings underscored the amplification of pre-existing inequities during the COVID-19 pandemic, intensifying the discrimination and stigma faced by IRLHIV due to both their health status and immigration background. These findings highlight the urgent need for targeted, evidence-based interventions to address the social determinants of health that adversely affect IRLHIV. The researchers recommend further participatory research action into health disparities for IRLHIV to create responsive and culturally safe services for IRLHIV. Full article

(This article belongs to the Special Issue Work–Life Policies, Employee Health and Well-Being)

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33 pages, 1629 KiB

Open AccessReview

Smoking Among Healthcare Professionals in Australia: A Scoping Review

by Masudus Salehin, Louisa Lam and Muhammad Aziz Rahman

Int. J. Environ. Res. Public Health 2025, 22(1), 113; https://doi.org/10.3390/ijerph22010113 - 15 Jan 2025

Viewed by 510

Abstract

Studies showed healthcare professionals who are non-smokers are more likely to deliver smoking cessation advice to their patients than those who are smokers. However, healthcare professionals continue to smoke across the globe. This scoping review assessed the available data on the prevalence and [...] Read more.

Studies showed healthcare professionals who are non-smokers are more likely to deliver smoking cessation advice to their patients than those who are smokers. However, healthcare professionals continue to smoke across the globe. This scoping review assessed the available data on the prevalence and predictors of smoking among healthcare professionals in Australia. Following the PRISMA extension for the Scoping Review checklist, a systematic literature search was conducted on CINAHL, MEDLINE, APA PsycINFO, Scopus, Web of Science, and Cochrane Library in August 2024. Articles published between 1990 and 2024 were considered, and finally, 26 papers met the inclusion and exclusion criteria. Australian healthcare professionals showed varying smoking prevalence. For physicians, it was 10.2% in 1990 to 7.4% in 2013; among dentists, 6% in 1993 to 4.9% in 2004; and among nurses, 21.7% in 1991 and 10.3% during 2014–15. The highest smoking rates were observed among Aboriginal health workers (AHWs): 63.6% in 1995 to 24.6% in 2021. Age was a positive predictor for smoking among nurses, and so was male gender among dentists, physicians, and nurses; other predictors included area of specialty, lower emotional wellbeing, etc. This review highlighted a declining trend in smoking among healthcare professionals in Australia; however, it was not proportionate among the different health specialties. Full article

(This article belongs to the Section Global Health)

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13 pages, 264 KiB

Open AccessArticle

A Retrospective Analysis Evaluating the Impact of Neighborhood Deprivation on Birth Weight in Phoenix, Arizona

by Kristin D. Mickelson, Megan Witsoe, Brittany Krzyzanowski, Pooja Doehrman, Samantha Dinh, Guangying Zhou and Jacqueline Nguyen

Int. J. Environ. Res. Public Health 2025, 22(1), 112; https://doi.org/10.3390/ijerph22010112 - 15 Jan 2025

Viewed by 454

Abstract

Background: Health inequities begin before birth and are influenced by pregnancy conditions, race/ethnicity, social class, and environment. Research indicates that, in the United States, Black women are significantly more likely to have low-birth-weight babies compared to White women. Interestingly, Hispanic women in the [...] Read more.

Background: Health inequities begin before birth and are influenced by pregnancy conditions, race/ethnicity, social class, and environment. Research indicates that, in the United States, Black women are significantly more likely to have low-birth-weight babies compared to White women. Interestingly, Hispanic women in the United States do not experience this birth weight inequity. The reasons for this disparity remain unclear. Both Hispanic and Black women face discrimination, and this is often cited as a primary reason for the higher prevalence of low-birth-weight babies among Black women. One type of discrimination that is less examined is neighborhood deprivation. Method: This study systematically examined the impact of various sociodemographic and pregnancy predictors among 9607 women in Phoenix, Arizona. Using multilevel modeling, we analyzed whether neighborhood deprivation (using the Area Deprivation Index) influenced the association between demographic and pregnancy risk and protective factors on birth weight outcomes. Results: Consistent with prior research, we found that Black and Asian women had lower-birth-weight babies than White women, while Hispanic women did not show a significant difference from non-Hispanic women. Additionally, multilevel modeling suggested that increased neighborhood deprivation tends to exacerbate the impact of some risk factors (e.g., race) and reduce the impact of specific protective factors (e.g., gestational age) on birth weight. Conclusion: These findings suggest that both place and individual factors synergistically influence birth weight outcomes. Moreover, the results underscore the importance of targeting interventions to enhance resources among those who live in the most deprived neighborhoods. Full article

19 pages, 296 KiB

Open AccessArticle

Building Connections and Striving to Build Better Futures: A Qualitative Interview Study of Alcohol Recovery Navigators’ Practice in the North East of England, UK

by Domna Salonen, Amy O’Donnell, Katherine Jackson, Sarah Hulse, James Crosbie, Ryan Swiers, Fiona Tasker, Gemma Muldowney, Anna Pickford, Floor Christie-de Jong, Eileen Kaner and Emma-Joy Holland

Int. J. Environ. Res. Public Health 2025, 22(1), 111; https://doi.org/10.3390/ijerph22010111 - 15 Jan 2025

Viewed by 546

Abstract

To address the holistic and continuity of care needs of people who attend North East hospitals frequently for alcohol-related reasons, Recovery Navigator (Navigator) roles were introduced into Alcohol Care Teams in six hospitals in the North East of England, UK, in 2022. The [...] Read more.

To address the holistic and continuity of care needs of people who attend North East hospitals frequently for alcohol-related reasons, Recovery Navigator (Navigator) roles were introduced into Alcohol Care Teams in six hospitals in the North East of England, UK, in 2022. The Navigators aimed to provide dedicated holistic support to patients experiencing alcohol harms, starting whilst in the hospital with the potential to continue this beyond discharge. This qualitative study explores the contributions that the Navigators make towards integrated alcohol care. Twenty-five semi-structured interviews were undertaken with 7 patients, 1 carer, and 17 staff. We used reflexive thematic analysis and applied the concept of continuity of care and Self-Determination Theory. The findings suggest that all of the participants value Navigators having dedicated time to work with patients to address their social needs, that patients benefit from having someone who provides relational support and is ‘gently persistent’, and that most of the Navigators have good relationships with community providers and have supported the transition of patients to these services. Staff recognise the challenges of holistic alcohol care in hospitals, and the support of the Alcohol Care Teams and Navigators is seen as invaluable. Navigators help to address gaps in the provision of holistic support for patients who experience significant health inequalities. Full article

(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)

25 pages, 1025 KiB

Open AccessReview

Characterising Carbon Monoxide Household Exposure and Health Impacts in High- and Middle-Income Countries—A Rapid Literature Review, 2010–2024

by Sarah V. Williams, Rebecca Close, Frédéric B. Piel, Benjamin Barratt and Helen Crabbe

Int. J. Environ. Res. Public Health 2025, 22(1), 110; https://doi.org/10.3390/ijerph22010110 - 15 Jan 2025

Viewed by 575

Abstract

Carbon monoxide (CO) is a toxic gas, and faulty gas appliances or solid fuel burning with incomplete combustion are possible CO sources in households. Evaluating household CO exposure models and measurement studies is key to understanding where CO exposures may result in adverse [...] Read more.

Carbon monoxide (CO) is a toxic gas, and faulty gas appliances or solid fuel burning with incomplete combustion are possible CO sources in households. Evaluating household CO exposure models and measurement studies is key to understanding where CO exposures may result in adverse health outcomes. This assists the assessment of the burden of disease in high- and middle-income countries and informs public health interventions in higher-risk environments. We conducted a literature review to identify themes that characterise CO exposure in household dwellings. A keyword-structured search using literature databases was conducted to find studies published in the period of 1 January 2010–5 June 2024. We focused on studies from high- and middle-income countries, excluding animal and biomass studies, and narratively synthesised themes. We identified 5294 papers in the literature search and included 22 papers from thirteen countries in the review. Most measured CO levels were below the WHO or country guidance levels, with sporadic peaks of measured CO linked to fuel-burning activities. To understand CO exposure in households, we identified sixteen themes grouped into five main categories: dwelling characteristics, source characteristics, temporal variation, environmental characteristics, and socioeconomic status of occupants. Seasonal variation (temporal variation), size of room and ventilation (dwelling characteristics), and cooking and outdoor CO levels (source characteristics) had the most evidence. These themes characterising CO exposure in household dwellings are important to aid the development of indoor exposure models and for understanding where CO exposures result in adverse health outcomes. These themes should be validated by household CO monitoring studies, which will enable the identification of higher-risk household dwellings and inform public health actions. Full article

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19 pages, 2943 KiB

Open AccessArticle

The First Report of Environmental Exposure to Barium in 10 Localities Close to Industrial Areas and Ports in the Amazon

by Brenda Rodrigues Chagas, Volney de Magalhães Câmara, Karytta Sousa Naka, Thaís Karolina Lisboa de Queiroz, Lorena de Cássia dos Santos Mendes, Iracina Maura de Jesus, Marcelo de Oliveira Lima and Armando Meyer

Int. J. Environ. Res. Public Health 2025, 22(1), 109; https://doi.org/10.3390/ijerph22010109 - 15 Jan 2025

Viewed by 565

Abstract

Environmental exposure to metallic contaminants such as barium (Ba) is a worldwide concern, as these metals can even be toxic to the human body. Data on different sources of exposure to Ba and possible routes of entry are important for preventing adverse health [...] Read more.

Environmental exposure to metallic contaminants such as barium (Ba) is a worldwide concern, as these metals can even be toxic to the human body. Data on different sources of exposure to Ba and possible routes of entry are important for preventing adverse health effects. Blood Ba levels were evaluated in 10 localities in the cities of Barcarena and Abaetetuba in the Amazon. Ba levels were quantified using induced coupled plasma mass spectrometry, and the data were stratified per epidemiological variables and lifestyle habits. The localities were divided into two groups: Group 1, localities wherein individuals had the lowest median levels (0.299–1.330 µg·L⁻¹), and Group 2, localities wherein individuals had the highest median levels (8740–37,300 µg·L⁻¹). Factors such as duration of residency, sex, age, smoking status, and alcohol consumption significantly contributed to the increase in exposure. The highest concentrations were associated with drinking water sources such as underground wells and local rivers, as well as the consumption of fish. This is the first study to record Ba exposure in individuals living in localities close to the industrial areas in the Amazon. These findings may facilitate the development of new health surveillance policies and the implementation of preventive measures. Full article

(This article belongs to the Section Environmental Health)

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10 pages, 623 KiB

Open AccessArticle

WHOQOL-BREF in Measuring Quality of Life Among Sickle Cell Disease Patients with Leg Ulcers

by Caroline Conceição da Guarda, Jéssica Eutímio de Carvalho Silva, Gabriela Imbassahy Valentim Melo, Paulo Vinícius Bispo Santana, Juliana Almeida Pacheco, Bruno Terra Correa, Edvan do Carmo Santos, Elisângela Vitória Adorno, Andrea Spier, Teresa Cristina Cardoso Fonseca, Marilda Souza Goncalves and Milena Magalhães Aleluia

Int. J. Environ. Res. Public Health 2025, 22(1), 108; https://doi.org/10.3390/ijerph22010108 - 15 Jan 2025

Viewed by 411

Abstract

Sickle cell disease (SCD) presents complex clinical manifestations influenced by genetic, social, environmental, and healthcare access factors as well as socioeconomic status. In this context, sickle cell leg ulcers (SLUs) are a debilitating complication of SCD. We aimed to describe sociodemographic data and [...] Read more.

Sickle cell disease (SCD) presents complex clinical manifestations influenced by genetic, social, environmental, and healthcare access factors as well as socioeconomic status. In this context, sickle cell leg ulcers (SLUs) are a debilitating complication of SCD. We aimed to describe sociodemographic data and evaluate the quality of life (QoL) of SCD patients with and without SLUs. We conducted a cross-sectional study including 13 SCD patients with SLUs and 42 without LUs. Clinical data were obtained by reviewing the medical records, and QoL was assessed with the WHOQOL-BREF questionnaire. Our cohort of patients had a mean age of 34.9 years, with 52.8% male, 52.8% identifying as black, and 41.7% identifying as brown. Most had low income, incomplete education, and high unemployment rates. The social habits and relationships of SCD patients showed varying levels of friendship and family closeness, and the majority of SLU+ patients did not practice sports. We failed to find statistical differences in the WHOQOL-BREF domains between SLU+ and SLU− patients. However, higher income and employment status were associated with improved WHOQOL-BREF domain scores in SCD patients, while vaso-occlusive episodes and female gender were linked to lower scores. Our data reinforce the sociodemographic characteristics of SCD. The physical domain was associated with income, occupation, and vaso-occlusion. The psychological domain was associated with income and occupation. The social relationship domain was associated with occupation and female gender. The environmental domain was associated with vaso-occlusion. The WHOQOL-BREF is a reliable tool to measure QoL in SCD. Full article

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14 pages, 521 KiB

Open AccessArticle

Perceived Stress: Psychosocial-Sociodemographic Factors as Predictors of Tension, Irritability, and Fatigue Among Ecuadorian University Professors

by Henry Cadena-Povea, Marco Hernández-Martínez, Gabriela Bastidas-Amador and Josué Calderón-Muñoz

Int. J. Environ. Res. Public Health 2025, 22(1), 107; https://doi.org/10.3390/ijerph22010107 - 15 Jan 2025

Viewed by 622

Abstract

The objective of this study was to identify the factors that best predict variations in tension, irritability, and fatigue (TIF) among university professors in Ecuador. Using a quantitative approach with a non-experimental, cross-sectional design, data were collected from a probabilistic sample of 364 [...] Read more.

The objective of this study was to identify the factors that best predict variations in tension, irritability, and fatigue (TIF) among university professors in Ecuador. Using a quantitative approach with a non-experimental, cross-sectional design, data were collected from a probabilistic sample of 364 participants. Psychometric measures were adapted and linguistically validated to assess TIF, and participants completed the Perceived Stress Questionnaire, alongside a sociodemographic questionnaire. Written informed consent was obtained, and participation was entirely voluntary. The results indicated that TIF significantly contribute to perceived stress levels among professors. Specific sociodemographic predictors were identified as statistically significant, providing insight into the multifaceted nature of work-related stress in academic settings and its potential implications for health and job satisfaction. The findings underscore the importance of targeted strategies to reduce stress-related outcomes, addressing factors unique to the academic environment in Ecuador. Additionally, while sociodemographic aspects were associated with variations in stress levels, other stress types also triggered TIF among university professors. Full article

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13 pages, 897 KiB

Open AccessArticle

Comparison Between Water Aerobics and Deep-Water Running on Middle-Aged Adults’ Anthropometric, Hemodynamic and Functional Outcomes

by Larissa dos Santos Leonel, Angelica Danielevicz and Rodrigo Sudatti Delevatti

Int. J. Environ. Res. Public Health 2025, 22(1), 106; https://doi.org/10.3390/ijerph22010106 - 14 Jan 2025

Viewed by 517

Abstract

Background: Head-out aquatic training, using modalities such as water-aerobics/hydrogymnastics (HYD) and deep-water running (DWR), has been effective in improving the physical, metabolic and cognitive health of middle-aged adults. However, direct comparisons between these modalities are lacking. Aim: The aim of this study was [...] Read more.

Background: Head-out aquatic training, using modalities such as water-aerobics/hydrogymnastics (HYD) and deep-water running (DWR), has been effective in improving the physical, metabolic and cognitive health of middle-aged adults. However, direct comparisons between these modalities are lacking. Aim: The aim of this study was to compare the effects of water aerobics and deep-water running on anthropometric, functional and hemodynamic outcomes in adults and older adults. Methods: An uncontrolled pragmatic trial (RBR-2txw8zy) was conducted with participants aged 30 to 80, allocated to HYD and DWR groups. The intervention consisted of 12 weeks of progressive aerobic training with weekly undulating periodization (2× week), divided into three mesocycles (4, 5, and 3 weeks), each lasting 50 min. Intensity was prescribed using the Rate of Perceived Effort (RPE), ranging from RPE 11 to 17. Outcomes assessed included the 30 s chair stand, 30 s arm curl, Timed-Up-and-Go usual (TUG-u) and maximum (TUG-m), 6 min walking test (6MWT), body mass, waist circumference, blood pressure and resting heart rate-HRrest. The analysis was conducted using generalized estimating equations, with per-protocol (PP) and intention-to-treat (ITT) analyses. Results: The study included 104 participants (HYD: n = 63, mean age 59 years, 54 women; DWR: n = 41, mean age 53 years, 33 women). ITT analysis showed improvements in waist circumference, waist-to-height ratio, and TUG-m in the HYD group, and a reduction in HRrest in the DWR group. Both modalities showed significant improvements in the 30 s chair stand, 30 s arm curl, 6MWT, waist circumference, and waist-to-height ratio in the PP analysis. Conclusions: Both modalities promoted functional improvements and favorable changes in anthropometric evaluations, with DWR showing a greater reduction in HRrest. Full article

(This article belongs to the Special Issue The Physiology of Endurance Training and Its Practical Application for Lifelong Health)

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14 pages, 315 KiB

Open AccessArticle

Differential Life Satisfaction in a German Representative Sample

by Christopher Arnold and Beate Muschalla

Int. J. Environ. Res. Public Health 2025, 22(1), 105; https://doi.org/10.3390/ijerph22010105 - 14 Jan 2025

Viewed by 491

Abstract

Life satisfaction includes various aspects, such as satisfaction with work, family, environment, and finances, and is influenced by sociodemographic and socioeconomic factors. This representative study investigates differential life satisfaction in the general population and its associations with sociodemographics. The study used a cross-sectional [...] Read more.

Life satisfaction includes various aspects, such as satisfaction with work, family, environment, and finances, and is influenced by sociodemographic and socioeconomic factors. This representative study investigates differential life satisfaction in the general population and its associations with sociodemographics. The study used a cross-sectional design with 2522 German participants, collected via face-to-face interviews and three-stage random sampling, assessing satisfaction across 17 life areas with the Differential Life Burden Scale. Overall life satisfaction was high (M = 4.46, scale from 1 to 6). Although globally satisfied, most participants (84.2%) named at least one negative area of life. Politics and environment were perceived as dissatisfying (M = 3.1; M = 3.81, respectively); social contacts and leisure time were evaluated as rather satisfying (M about 5.00). Age, income, and unemployment were associated with life satisfaction. Gender and age were differently associated with life domains: Older people were less satisfied with their health. Younger people were more satisfied with leisure time. Younger were less satisfied with their children than older participants. The German population is generally satisfied with life, though factors like age, unemployment, and income influence the number of negatively perceived life domains. This highlights the importance of evaluating specific life areas in addition to overall life satisfaction for a more comprehensive understanding. Full article

23 pages, 795 KiB

Open AccessReview

Athletes’ Knowledge of Pelvic Floor Dysfunction and Their Knowledge of and Engagement with Pelvic Floor Muscle Training: A Scoping Review

by Jacinta Magor, Romany Martin and Marie-Louise Bird

Int. J. Environ. Res. Public Health 2025, 22(1), 104; https://doi.org/10.3390/ijerph22010104 - 14 Jan 2025

Viewed by 464

Abstract

Introduction: Pelvic floor dysfunction (PFD) is prevalent among athletes. Investigating whether athletes are practicing pelvic floor muscle training (PFMT) will assist in delineating the factors underlying the burden of PFD in this population. Additionally, investigating athletes’ knowledge of PFD and knowledge of and [...] Read more.

Introduction: Pelvic floor dysfunction (PFD) is prevalent among athletes. Investigating whether athletes are practicing pelvic floor muscle training (PFMT) will assist in delineating the factors underlying the burden of PFD in this population. Additionally, investigating athletes’ knowledge of PFD and knowledge of and attitudes toward PFMT may inform interventions to improve the practice of PFMT. Aims: This scoping review aimed to collate the available evidence regarding athletes’ knowledge of PFD and their knowledge of and engagement with PFMT. Furthermore, this review aimed to determine the types of athletes (sports and competition levels) research had been conducted on and the definitions of PFD and PFMT most used. Methods: Six databases were searched up to January 2024. No study design or publication types were restricted; however, non-English articles were excluded due to resource constraints. Additional publications were identified through the reference lists of included articles. Data were synthesized and presented under subheadings relevant to the aims of this review. Results: Thirty-five publications were included for data extraction. Athletes had low practice of PFMT, poor knowledge of PFD and PFMT, but positive attitudes toward PFMT. One publication reported that higher levels of knowledge were associated with a lower prevalence of PFD. The athletic population was heterogeneous in sport type and competition level, and the definitions of PFD and PFMT were ill-defined. Conclusions: Athletes have a low practice of PFMT and poor knowledge of PFD and PFMT. The education of athletes may have a role in supporting pelvic floor health. Full article

(This article belongs to the Special Issue Physical Fitness and Injury Prevention in Athletes)

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16 pages, 1410 KiB

Open AccessArticle

Influence of Sex and Body Composition on Aerobic Capacity in Normal Weight Lean, Normal Weight Obese, and Obese Phenotypes

by Sam R. Emerson, Samantha Hart, Christina M. Sciarrillo, Travis Eden, Tyler J. Godsey, Harrison Smith, Ashley Keller and Bryant H. Keirns

Int. J. Environ. Res. Public Health 2025, 22(1), 103; https://doi.org/10.3390/ijerph22010103 - 14 Jan 2025

Viewed by 602

Abstract

Normal weight obesity (NWO) is a body composition phenotype that is associated with increased cardiometabolic risk and is characterized by a normal weight body mass index but elevated body fat. The purpose of this study was to determine sex differences in aerobic capacity [...] Read more.

Normal weight obesity (NWO) is a body composition phenotype that is associated with increased cardiometabolic risk and is characterized by a normal weight body mass index but elevated body fat. The purpose of this study was to determine sex differences in aerobic capacity across body composition phenotypes, including normal weight lean (NWL), NWO, and traditional obesity (OB). We recruited 60 participants according to three body composition phenotypes: NWL (n = 10 females, n = 10 males), NWO (n = 10 females, n = 10 males), and OB (n = 10 females, n = 10 males). Measurements included fasting metabolic risk factors, body composition X-ray scan, and peak exercise test on a cycle ergometer to determine aerobic capacity (VO_2peak). Across groups, males (34.5 ± 11.7 mL/kg/min) exhibited greater VO_2peak than females (28.8 ± 8.8 mL/kg/min; p = 0.04). There were no differences in VO_2peak between sexes within the same body composition phenotype, but NWL (42.7 ± 9.0 mL/kg/min) exhibited greater VO_2peak than NWO (27.9 ± 4.4 mL/kg/min; p < 0.0001) and OB (24.4 ± 7.3 mL/kg/min; p < 0.0001). VO_2peak was inversely correlated with relative body fat in the full sample (r = −0.67; p < 0.0001), but was stronger in males (r = −0.78; p < 0.0001) than females (r = −0.53; p = 0.0028). Visceral adipose tissue was not significantly correlated with VO_2peak in the full sample (r = −0.25; p = 0.05) or in males (r = −0.23; p = 0.25), although they were inversely correlated in females (r = −0.36; p = 0.048). Our results suggest low aerobic capacity in both men and women with NWO, similar to men and women with OB. The relationship between body composition and aerobic capacity is strong across body composition phenotypes, but appears to be more consistent in females than males. For healthcare professionals aiming to lower cardiometabolic risk, attention should be given to improving aerobic fitness in both men and women with elevated body fat, including those with NWO. Full article

(This article belongs to the Special Issue Sex Differences in Physiologic Responses and Long-Term Adaptations to Exercise)

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22 pages, 1513 KiB

Open AccessReview

Regional Variations in the Prevalence of Risk Factors and Non-Communicable Diseases in Papua New Guinea: A Scoping Review

by Bobby Porykali, Ryley Gronau, Phyllis Tran, Juliana Chen, Margaret Allman-Farinelli, Anna Rangan, Shelina Porykali, Robin Oge, Hans Nogua and Alyse Davies

Int. J. Environ. Res. Public Health 2025, 22(1), 102; https://doi.org/10.3390/ijerph22010102 - 14 Jan 2025

Viewed by 491

Abstract

Often referred to as ‘the last unknown’, Papua New Guinea’s largely unexplored environments across its four distinct regions, the Highlands, New Guinea Islands, Momase, and Southern, exhibit remarkable diversity. Understanding this diversity is significant in contextualising the risk factors associated with developing non-communicable [...] Read more.

Often referred to as ‘the last unknown’, Papua New Guinea’s largely unexplored environments across its four distinct regions, the Highlands, New Guinea Islands, Momase, and Southern, exhibit remarkable diversity. Understanding this diversity is significant in contextualising the risk factors associated with developing non-communicable diseases. This review aims to map and summarise the literature to provide region-specific prevalence data for risk factors and non-communicable diseases. Four databases and grey literature were searched. Two reviewers completed the screening and data extraction. Twenty-one studies were included, with five reporting the data by region and the remaining reporting the data nationwide. Six studies reported on risk factors, thirteen reported on non-communicable diseases, and two reported on risk factors and non-communicable diseases. The Southern region, which includes the Capital, Port Moresby, reported the highest prevalence for most risk factors: anthropometric (overweight, obesity, and waist circumference), lifestyle (betel nut, alcohol, unhealthy diet, and stress), and biochemical (cholesterol, triglycerides, HbA1c, and metabolic syndrome). The findings of this review highlight the limited evidence base for region-specific risk factor data and the lack of objective diagnosis of non-communicable diseases. There were variations in the prevalence of specific risk factors by region; however, the Southern region stands out as requiring immediate attention for health promotion program interventions. Full article

(This article belongs to the Special Issue Disparity of Non-Communicable Diseases Among Pacific Islanders)

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Int. J. Environ. Res. Public Health, Volume 22, Issue 1 (January 2025) – 131 articles

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