International Journal of Environmental Research and Public Health

15 pages, 512 KiB

Open AccessArticle

A Community-Engaged Ethnographic Investigation into Public Transit Among Older Adults Experiencing Homelessness

by Whitney Thurman, Tara Hutson, Dylan Lowery, Amy Patten and Alexandra A. Garcia

Int. J. Environ. Res. Public Health 2025, 22(4), 654; https://doi.org/10.3390/ijerph22040654 - 21 Apr 2025

Nearly 50% of single homeless adults are over the age of 50, and adults aged 50 years and older are the fastest growing subpopulation of the homeless in the U.S. This subpopulation has unique mobility needs and barriers to transportation. We used rapid [...] Read more.

Nearly 50% of single homeless adults are over the age of 50, and adults aged 50 years and older are the fastest growing subpopulation of the homeless in the U.S. This subpopulation has unique mobility needs and barriers to transportation. We used rapid ethnographic assessments to explore the practices, needs, perceptions, and values of unhoused older adults in relation to their efforts to access and navigate health and social services via public transit. We conducted 23 observations of 12 participants as they navigated public transit to meet their travel needs. Our data consist of 65 h of observations with field notes, walking interviews, and travel diaries. Two themes—waiting and friction—encompassed participants’ experiences of mobility and their ongoing negotiations that involved time, space, individual ability, and interpersonal interactions within their environmental context. For this population, attainment of housing and improved health and well-being is contingent on access to reliable transportation—a condition that is not met in many communities. For the participants in our study, the physical demands of accessing public transit combined with the cognitive load of interpreting multi-step directions in specific time schedules were often insurmountable. The public transit system was often hostile, such that participants were stigmatized and segregated. Professionals who work with older homeless individuals must consider the capacity of their clients to successfully navigate public transit, and policymakers should consider the transit needs of their entire population when designing transit systems. Full article

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14 pages, 274 KiB

Open AccessArticle

Association Between Academic, Initial Licensure, Employment Factors, and NCLEX-RN Performance of Philippine-Educated Nurses

by James Montegrico and Zhuo Job Chen

Int. J. Environ. Res. Public Health 2025, 22(4), 653; https://doi.org/10.3390/ijerph22040653 - 21 Apr 2025

Abstract

The United States’ nursing shortage attracted internationally educated nurses (IENs) to take the National Council Licensure Examination–Registered Nurses (NCLEX-RN), which is required to practice nursing in the U.S. Philippine-educated nurses (PENs) comprised more than half of IENs in the U.S. nursing workforce. From [...] Read more.

The United States’ nursing shortage attracted internationally educated nurses (IENs) to take the National Council Licensure Examination–Registered Nurses (NCLEX-RN), which is required to practice nursing in the U.S. Philippine-educated nurses (PENs) comprised more than half of IENs in the U.S. nursing workforce. From 2002 to 2021, only 45.8% of 177,730 PENs passed the exam. Published studies investigating IEN NCLEX-RN performance are limited. This study addresses this gap in the literature. This study determined the association between academic, initial nursing licensure, and employment factors on PEN NCLEX-RN pass rates. A retrospective correlation research design was used to determine the association among the research variables. Participants were recruited through online nursing groups. Descriptive statistics compared characteristics of PENs who passed or failed the NCLEX on the first attempt. Chi-squared and Fisher’s exact tests were used to determine the association between the research variables. Initial nursing licensure and nursing workplace were significantly associated with PENs passing the NCLEX-RN. Identifying unique PENs’ contextual characteristics is critical in preparing them to pass the NCLEX-RN. Findings provide input to educational and regulatory bodies to improve the NCLEX-RN individual outcomes and Philippine NCLEX-RN pass rates. Full article

(This article belongs to the Special Issue Evidence-Based Practice in Nursing)

25 pages, 11430 KiB

Open AccessSystematic Review

by Julien Jacquier-Bret and Philippe Gorce

Int. J. Environ. Res. Public Health 2025, 22(4), 652; https://doi.org/10.3390/ijerph22040652 - 21 Apr 2025

Abstract

Nurses are highly exposed to work-related musculoskeletal disorders (WMSDs). Several studies on this have been carried out in different Asian countries, but no synthesis was conducted. The aim of this study was to map the evidence of WMSDs among nurses in Asia. A [...] Read more.

Nurses are highly exposed to work-related musculoskeletal disorders (WMSDs). Several studies on this have been carried out in different Asian countries, but no synthesis was conducted. The aim of this study was to map the evidence of WMSDs among nurses in Asia. A systematic review and a meta-analysis with subgroups were performed during October 2024. Five open databases were scanned without a date limit. The article selection and data extraction processes were performed independently by two reviewers. The results report was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among the 15,751 unique identified records, 40 studies were included, covering a total of 19,903 Asian nurses. A high heterogeneity (Cochran’s Q test and I² statistic) was evidenced between the studies. The meta-analysis polled an overall prevalence of 84.3% (95% CI: 81.1–87.4%). The lower back (58.4%, 95% CI: 52.9–63.8%), neck (45.7%, 95% CI: 38.1–53.2%) and shoulder (43.0%, 95% CI: 36.2–49.9%) were the three most exposed areas. Subgroup analyses have shown that the presence of WMSD is steadily increasing, and that years of practice reduce the exposure of the neck and shoulder, while the lower back becomes more exposed. Further efforts are needed to prevent WMSDs among Asian nurses, in order to improve their quality of life at work. Full article

(This article belongs to the Special Issue New Trends in Work-Related Musculoskeletal Disorders and Health-Related Quality of Life)

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14 pages, 1388 KiB

Open AccessSystematic Review

The Impact of Non-Acoustic Factors on Chinese Community Response to Noise: A Systematic Review

by Wenkai Wang, Hui Ma and Chao Wang

Int. J. Environ. Res. Public Health 2025, 22(4), 651; https://doi.org/10.3390/ijerph22040651 - 21 Apr 2025

Abstract

Noise pollution has become one of the most prominent environmental issues in China. Although many studies have summarized the impact of non-acoustic factors on noise annoyance, the unique mechanisms of these factors within the context of Chinese society and culture still require systematic [...] Read more.

Noise pollution has become one of the most prominent environmental issues in China. Although many studies have summarized the impact of non-acoustic factors on noise annoyance, the unique mechanisms of these factors within the context of Chinese society and culture still require systematic investigation. In this study, a systematic review of articles obtained from the CNKI, WanFang, WoS Core Collection, and Scopus databases (up to December 2024) was conducted, and 42 articles were included in a qualitative analysis to summarize the patterns of non-acoustic factors’ influence on the community response of Chinese residents to noise. The results revealed the following: (1) The effects of non-acoustic factors on Chinese residents are significant, with the trends for factors such as noise sensitivity, attitude to noise source, health status, perceived quality of the living environment, and education level influencing the Chinese community response to noise having been basically clarified. However, the influence of the remaining factors and the unique influences of various non-acoustic factors await further quantitative analyses. (2) Interactions among various factors deserve close attention. The interactions between non-acoustic factors, as well as those between non-acoustic factors and sound source types, have been reflected in some studies. These may be significant for explaining the effects of non-acoustic factors and merit further research. (3) Compared to international studies, research on non-acoustic factors in China is relatively limited in quantity and unevenly distributed, which is insufficient to support further quantitative analysis or a detailed exploration of the underlying mechanisms. Therefore, more studies are necessary to support the future rationalization of noise policies and national standards in China. Full article

(This article belongs to the Special Issue Community Response to Environmental Noise)

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16 pages, 1580 KiB

Open AccessArticle

A Train-the-Trainer Approach to Build Community Resilience to the Health Impacts of Climate Change in the Dominican Republic

by Hannah N. W. Weinstein, Kristie Hadley, Jessica Patel, Sarah Silliman, R. Yamir Gomez Carrasco, Andres J. Arredondo Santana, Heidi Sosa, Stephanie M. Rosa, Carol Martinez, Nicola P. Hamacher, Haley Campbell, James K. Sullivan, Danielly de Paiva Magalhães, Cecilia Sorensen and Ana Celia Valenzuela González

Int. J. Environ. Res. Public Health 2025, 22(4), 650; https://doi.org/10.3390/ijerph22040650 - 20 Apr 2025

Abstract

Communities in the Dominican Republic (DR) face increased natural disasters, poor air quality, food insecurity, and health impacts related to climate change. We evaluated the success of a train-the-trainer program to empower community leaders, women, and at-risk youth with the knowledge and skills [...] Read more.

Communities in the Dominican Republic (DR) face increased natural disasters, poor air quality, food insecurity, and health impacts related to climate change. We evaluated the success of a train-the-trainer program to empower community leaders, women, and at-risk youth with the knowledge and skills to increase individual and community resilience in Cristo Rey, Dominican Republic. Three in-person two-day courses were conducted between July and August 2024 at the Universidad Iberoamericana. Each session included eight lectures and collaborative learning activities on climate change science, adaptation, resilience, and health impacts. Intra-group analyses comparing pre- and post-course surveys assessed participants’ climate change awareness, literacy, and communication and response skills. One hundred and four attendees participated in the survey study. Of the 100 participants with demographic data, 55% (n = 55) were 35 years old or younger, 70% (n = 70) identified as female, and 45% (n = 45) lived in Cristo Rey. The participants reported high baseline climate change awareness. Compared to before the course, the participants reported increased literacy regarding the environmental impacts of climate change relevant to the DR and the specific health impacts (p-value < 0.05) and increased climate change-related communication and response skills (p-value < 0.001). This study suggests competency-based, regional-specific courses deployed in a train-the-trainer model, have the potential to equip community members with knowledge to protect their health. Full article

(This article belongs to the Section Global Health)

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18 pages, 1880 KiB

Open AccessArticle

Measurement and Evaluation of Dust Concentrations in the Air After the Kahramanmaraş Earthquake in Turkey

by Tuğçe Oral, Müge Ensari Özay, Rüştü Uçan, Dilek Aker, Emine Can and Bengisu Altınten

Int. J. Environ. Res. Public Health 2025, 22(4), 649; https://doi.org/10.3390/ijerph22040649 - 20 Apr 2025

Abstract

The 6 February 2023 earthquake in Kahramanmaraş, Turkey, caused significant debris accumulation, raising concerns about air quality and public health. This study assessed dust concentrations during debris removal and emergency response efforts over a five-day period. Post-disaster respirable and total dust concentrations were [...] Read more.

The 6 February 2023 earthquake in Kahramanmaraş, Turkey, caused significant debris accumulation, raising concerns about air quality and public health. This study assessed dust concentrations during debris removal and emergency response efforts over a five-day period. Post-disaster respirable and total dust concentrations were measured using dust monitoring devices and the MDHS-14/3 gravimetric method. Scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) analyses identified fibrous structures and elements associated with asbestos, suggesting potential long-term health risks such as asbestosis and lung cancer. The average respirable dust concentration was 30.84 mg/m³, and the total dust concentration was 33.66 mg/m³. The findings emphasize the urgent need for protective measures to mitigate exposure risks for affected populations and emergency responders. Integrating health risk assessments into disaster management strategies are crucial to reducing long-term public health impacts. Full article

(This article belongs to the Section Environmental Health)

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22 pages, 10038 KiB

Open AccessArticle

Promoting Youth Mental Wellbeing: A Photovoice Project with Adolescents and Young Adults in the Hospital Context

by Federica Graziano, Federica Toppino, Lisa Vennettillo, Giovanni Abbate Daga, Deborah Concas, Giulia Mazzone, Paola Quarello, Guido Teghille, Giulia Zucchetti and Chiara Davico

Int. J. Environ. Res. Public Health 2025, 22(4), 648; https://doi.org/10.3390/ijerph22040648 - 20 Apr 2025

Abstract

Given the importance of youth mental health for public policy, it is crucial to involve young people directly in participatory research to investigate their views and translate their demands into concrete actions. The aim of the study was to define the concept of [...] Read more.

Given the importance of youth mental health for public policy, it is crucial to involve young people directly in participatory research to investigate their views and translate their demands into concrete actions. The aim of the study was to define the concept of mental wellbeing as perceived by a group of adolescent and young adult patients in two large hospitals in northwestern Italy and to find out, together with them, what institutions can do to promote youth wellbeing. Thirty-nine participants (13–25 years old, 90% female), divided into four groups, took part in a Photovoice workshop. Individual interviews were conducted with 21 participants and the transcripts were thematically analyzed. The photos were categorized into five themes: nature, traveling, passions and leisure, relationships, and animals. The definition of mental wellbeing can be traced back to eight themes: sharing experiences and emotions with others, calm and tranquility, personal fulfilment, sense of belonging, pleasant physical sensations, freedom and discovery, involvement and commitment, and happiness. The key recommendations for promoting mental wellbeing were providing information about mental health, tackling the stigma of mental illness, and providing psychological support in school and health services. The implications of these findings for policy makers involved in planning health services for young people are discussed. Full article

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

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20 pages, 303 KiB

Open AccessArticle

Exploring Socio-Behavioral Correlates of Metabolic and Inflammatory Risk in a University Sample Residing Along the U.S./Mexico Border: A Pilot Study Concomitantly Collecting Survey Data, Blood and Hair Samples, and Physical Measures

by Gabriel A. Frietze, Cai Xu, Bibiana Mancera, Elisa Robles-Escajeda, Alyssa A. Martinez, Michelle Gil, Diana P. Flores, Khodeza Begum, Panfeng Liang, Abhijit Mandal, Michael Nsiah-Nimo, Nilotpal Sanyal, Ming-Ying Leung, Michael J. Kenney and Robert A. Kirken

Int. J. Environ. Res. Public Health 2025, 22(4), 647; https://doi.org/10.3390/ijerph22040647 - 20 Apr 2025

Viewed by 34

Abstract

Hispanic adults have an increased incidence of type 2 diabetes (T2D) at a younger age and diagnosis of certain cancers, including liver, stomach, and colorectal, which may be attributed to metabolic health. Several key metabolic health indicators, such as hemoglobin A1c (HbA1c), body [...] Read more.

Hispanic adults have an increased incidence of type 2 diabetes (T2D) at a younger age and diagnosis of certain cancers, including liver, stomach, and colorectal, which may be attributed to metabolic health. Several key metabolic health indicators, such as hemoglobin A1c (HbA1c), body mass index (BMI), and waist-to-hip ratio (WHR), have been linked to obesity. The purpose of this pilot study was to explore the complex relationships between socio-behavioral factors that lead to the increased incidence of metabolic syndrome (e.g., HbA1c) and chronic inflammation (interleukins) in Hispanics. Two hundred and twelve Hispanic participants (M_age = 43.45, SD = 15.36) who identified predominantly as female (72.17%) were included in the study. Correlational analyses revealed that HbA1c was positively associated with age and negatively associated with several socio-behavioral factors, including overall health, quality of life, physical health, physical performance, social support, mother’s education, and father’s education. These findings highlight the importance of social support and parental involvement in diabetes management. The focused integration of socio-behavioral and biological data provides a powerful foundation for future research and the development of targeted interventions. Full article

(This article belongs to the Special Issue Proceedings of the 2024 and 2025 Research Centers in Minority Institutions (RCMI) Consortium National Conferences)

35 pages, 1530 KiB

Open AccessArticle

Integrating Australian Native Foods for a More Sustainable Food System: A Qualitative Co-Design Study with Aboriginal Communities

by Carla Vanessa Alves Lopes, John Hunter, Renee Cawthorne, Shirley Gilbert, Ayoola Shogunle, Cassandra Ebsworth, Mike Bartlett, Rimante Ronto and Seema Mihrshahi

Int. J. Environ. Res. Public Health 2025, 22(4), 646; https://doi.org/10.3390/ijerph22040646 - 19 Apr 2025

Viewed by 57

Abstract

(1) Background: Integrating native foods into food systems has shown promising benefits for health, the environment, and the revitalisation of Aboriginal culture. This study aims to explore the benefits, facilitators, and barriers of integrating Australian native foods into the current food system and [...] Read more.

(1) Background: Integrating native foods into food systems has shown promising benefits for health, the environment, and the revitalisation of Aboriginal culture. This study aims to explore the benefits, facilitators, and barriers of integrating Australian native foods into the current food system and how traditional knowledge around these foods can be revitalised in a culturally safe way. (2) Methods: This qualitative co-design study involved the following four phases: (I) Relationship building with the communities and cultural training for the research team; (II) Establishment of the Aboriginal Reference Group (ARG) for community involvement and governance; (III) Data collection through interviews and focus groups with participants from two urban Aboriginal communities in Sydney and experts in native foods; and (IV) Collaborative data analysis using both deductive and inductive thematic analysis. (3) Results: We interviewed 22 participants who acknowledged the nutritional, health, cultural, environmental, and economic benefits of Australian native foods. They strongly identified the impact of colonisation and imposed Western culture as root barriers impacting other barriers at the structural, socioeconomic, social, and environmental levels. Participants aspire to achieve food security and sovereignty in a more sustainable food system including native foods. To achieve their aspirations, a framework based on Aboriginal values and principles was developed to guide multicomponent initiatives using native foods. (4) Conclusions: A compassionate food model based on emancipatory community-based and land-based education is essential, connecting ancient and contemporary knowledge to transform the food system. Future research should focus on implementing and evaluating the multicomponent interventions suggested by the participants. Full article

(This article belongs to the Special Issue Sustainable Nutrition: Bridging Food Systems, Climate Change, and Human Health)

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17 pages, 986 KiB

Open AccessReview

Agroforestry for Food Security and Public Health: A Comprehensive Review

by Daniel Roberto Jung and Oduvaldo Vendrametto

Int. J. Environ. Res. Public Health 2025, 22(4), 645; https://doi.org/10.3390/ijerph22040645 - 19 Apr 2025

Viewed by 56

Abstract

Global food systems face mounting pressure from intersecting crises of food insecurity, malnutrition (affecting over 2.8 billion people), and climate change, necessitating transformative solutions. Agroforestry systems (AFS), integrating trees with crops and/or livestock, offer a promising pathway by synergistically enhancing food production, ecological [...] Read more.

Global food systems face mounting pressure from intersecting crises of food insecurity, malnutrition (affecting over 2.8 billion people), and climate change, necessitating transformative solutions. Agroforestry systems (AFS), integrating trees with crops and/or livestock, offer a promising pathway by synergistically enhancing food production, ecological stability, and public health outcomes. However, realizing this potential is hindered by gaps in understanding the complex interactions and trade-offs between these domains, limiting policy and practice effectiveness. This comprehensive review aimed to synthesize current evidence on how agroforestry integrates food security, public health, and environmental sustainability and to identify critical research gaps that limit its widespread adoption and optimization. Following the SPAR-4-SLR protocol, a systematic literature search was conducted across Web of Science and Scopus, with thematic analysis using VosViewer and quantitative synthesis of key metrics. The review confirms agroforestry’s multifaceted benefits, including enhanced dietary diversity, improved micronutrient intake (e.g., 18% reduction in vitamin A deficiency), significant carbon sequestration (0.5–2 Mg C/ha/year), soil health improvements (50–70% less erosion), income generation (+40%), and climate resilience (2–5 °C cooling). Key gaps identified include the need for longitudinal health studies, better quantification of climate–health interactions and non-material benefits, policy–health integration strategies, and analyses of economic–nutritional trade-offs. Full article

(This article belongs to the Section Environmental Health)

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11 pages, 1512 KiB

Open AccessArticle

MPOWER Tobacco Control Policies’ Effects on Lip and Oral Cavity Cancer Trends in MERCOSUR Countries

by Laila Menezes Hagen, Fernanda Joly Macedo, Amanda Ramos da Cunha, Fernando Neves Hugo and José Miguel Amenábar

Int. J. Environ. Res. Public Health 2025, 22(4), 644; https://doi.org/10.3390/ijerph22040644 - 19 Apr 2025

Viewed by 60

Abstract

Background: As tobacco is the main risk factor for oral cancer, it is important to understand the burden of this disease in light of the Framework Convention on Tobacco Control. For MERCOSUR, tobacco control is a topic of interest. The aim of this [...] Read more.

Background: As tobacco is the main risk factor for oral cancer, it is important to understand the burden of this disease in light of the Framework Convention on Tobacco Control. For MERCOSUR, tobacco control is a topic of interest. The aim of this study was to describe MPOWER measure scores and to evaluate the trends in lip and oral cavity cancer (LOC) incidence, mortality and Disability-Adjusted Life Years (DALYs), from 2005 to 2021, in MERCOSUR countries. Methods: This is an ecological descriptive study, where the MPOWER measure scores were extracted from the Global Health Observatory of World Health Organization, and the Age-standardized Rates (ASRs) of LOC for MERCOSUR countries were obtained from the Global Burden of Diseases 2021 results tool. The trends of LOC ASRs were obtained using the Prais–Winsten method. Results: Paraguay and Venezuela had lower MPOWER scores over time than Argentina, Brazil and Uruguay. These last three countries showed LOC trends decreasing for most indicators among males, while Paraguay and Venezuela showed increasing trends in incidence for both males and females, and no decreasing trends. Conclusion: This study suggests that MERCOSUR countries with a history of more rigorous MPOWER tobacco control policies are exhibiting decreasing trends in LOC burden. Full article

(This article belongs to the Special Issue Burden of Cancer Worldwide)

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11 pages, 1434 KiB

Open AccessArticle

Disparities in Utilization of the World Trade Center Health Program Among World Trade Center Rescue and Recovery Workers and Volunteers

by Caleb D. Ayers, Rebecca D. Kehm, James E. Cone and Jiehui Li

Int. J. Environ. Res. Public Health 2025, 22(4), 643; https://doi.org/10.3390/ijerph22040643 - 19 Apr 2025

Viewed by 54

Abstract

The 11 September 2001 World Trade Center (WTC) rescue and recovery workers (RRWs) included first responders (FDNY and NYPD), volunteers, and other workers. Volunteers were often more vulnerable than first responders to adverse health outcomes resulting from the exposure. It is not yet [...] Read more.

The 11 September 2001 World Trade Center (WTC) rescue and recovery workers (RRWs) included first responders (FDNY and NYPD), volunteers, and other workers. Volunteers were often more vulnerable than first responders to adverse health outcomes resulting from the exposure. It is not yet known whether there are differences in WTC Health Program (WTCHP) utilization by worker type. This is a cross-sectional study of 20,012 WTCHP-eligible RRWs to examine whether worker type was associated with WTCHP utilization based on self-reported data from four WTC Health Registry follow-up surveys (2006–2021), using multivariable log-binomial regression adjusted for sociodemographic factors and comorbidities. We also examined factors associated with WTCHP utilization by worker type. Overall, 9584 RRWs (47.9%) reported receiving WTCHP services, but only 22.5% of volunteers reported WTCHP utilization. After adjustment, first responders and other workers were, respectively, 2.73 (95% CI = 2.56, 2.92) and 1.69 (95% CI = 1.58, 1.80) times more likely to utilize WTCHP service than volunteers. Sociodemographic factors and comorbidities were consistently associated with WTCHP utilization across worker types, except for race/ethnicity. Among those eligible, the volunteer group reported the lowest utilization of WTCHP among worker types, suggesting that WTC volunteers should be a priority group for outreach regarding access and utilization of WTCHP. Full article

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15 pages, 1009 KiB

Open AccessArticle

Perception of the Food Environment and Food Security Levels of Residents of the City of Rio de Janeiro

by Paulo César Pereira de Castro Junior, Yoko Ametista Carvalho Suéte Matos, Roberta Teixeira de Oliveira, Rosana Salles-Costa and Aline Alves Ferreira

Int. J. Environ. Res. Public Health 2025, 22(4), 642; https://doi.org/10.3390/ijerph22040642 - 18 Apr 2025

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Abstract

The way individuals perceive and interact with the food environment can contribute to a higher prevalence of food insecurity (FI). Objective: To evaluate the perception of the food environment and its association with FI in households in the city of Rio de Janeiro, [...] Read more.

The way individuals perceive and interact with the food environment can contribute to a higher prevalence of food insecurity (FI). Objective: To evaluate the perception of the food environment and its association with FI in households in the city of Rio de Janeiro, Brazil. Methods: Cross-sectional study. The survey was conducted with a sample of 2000 households, a representative stratified sample, with a margin of error of 4.9 percentage points and a 95% confidence interval (CI95%) in the city of Rio de Janeiro. The studies were evaluated using the Brazilian Food Insecurity Scale (EBIA). Perceptions of the food environment were measured by assessing the perceived availability, price, and quality of fruits and vegetables (FVs) and ultra-processed foods (UPFs) sold in the neighborhood. To analyze the association between stage variations and the perceived food environment, we conducted multinomial logistic regression, considering a 95%CI. Results: Household heads in Rio de Janeiro perceive that both FVs and UPFs are available in their neighborhoods. However, UPFs are perceived as cheaper and more diverse than FVs, regardless of the level of food safety. In the association analysis, a greater relative risk ratio was found for heads of households who perceive an unfavorable scenario in the food environment for FVs, in terms of availability (RRR = 5.6; 95%IC: 3.0–10.4), quality (RRR = 4.5; 95%IC: 2.6–7.9), and price (RRR = 2.5; 95%IC: 1.7–3.6), to experience a situation of moderate/severe FI. Conclusions: The way individuals interact with and perceive their territories can reflect on access to adequate and healthy food, especially in households in a situation of FI. Full article

(This article belongs to the Special Issue Bridging the Gap in Studies on the Food Environment: The State-of-the-Art in Low- and Middle-Income Countries (LMICs))

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13 pages, 240 KiB

Open AccessArticle

Burnout Persists in Teachers in Ireland Post-COVID-19: A Qualitative Follow Up Comparative Study

by Ellen Ní Chinseallaigh, Matthew Shipsey, Elisha Minihan, Blanaid Gavin and Fiona McNicholas

Int. J. Environ. Res. Public Health 2025, 22(4), 641; https://doi.org/10.3390/ijerph22040641 - 18 Apr 2025

Viewed by 114

Abstract

Teacher burnout, a combination of emotional exhaustion, depersonalization, and diminished personal accomplishment has been increasing, notably during the COVID-19 pandemic. Our 2022 study revealed significant burnout levels, identifying that teachers’ pandemic experiences had adverse “Consequences” that left them feeling “Overburdened”, and “Abandoned”. Although [...] Read more.

Teacher burnout, a combination of emotional exhaustion, depersonalization, and diminished personal accomplishment has been increasing, notably during the COVID-19 pandemic. Our 2022 study revealed significant burnout levels, identifying that teachers’ pandemic experiences had adverse “Consequences” that left them feeling “Overburdened”, and “Abandoned”. Although COVID-19 has receded, recent findings indicate that Irish teachers continue to face heightened demands without adequate support. This follow-up comparative study aims to deepen understanding of post-pandemic teacher burnout by using the same questions from the 2022 study to understand and analyse these evolving stressors. A qualitative, comparative approach was employed. Participants (n = 337) were recruited from various school types across Ireland. A Study Specific Questionnaire (SSQ) with open-ended questions allowed for thematic analysis, comparing responses with 2022 themes to explore continuity and changes in burnout experiences. Thematic analysis revealed four major themes: (1) Administrative Overload—increasing paperwork and curriculum changes; (2) Unrealistic Expectations—pressures from parents, society, and authorities; (3) Lack of Community Support and Empathy—teachers reported a sense of isolation and a need for mutual support; and (4) Inadequate Mental Health and Professional Support—insufficient mental health resources for both educators and students. The study underscores the urgent need for systemic changes to address teacher burnout in Ireland. Recommendations include reducing administrative load, clarifying professional boundaries, fostering empathy within the school community, and expanding mental health services. Addressing these factors is essential for sustaining a resilient educational system in the post-pandemic context. Full article

(This article belongs to the Special Issue Work Psychology and Occupational Health: 2nd Edition)

17 pages, 499 KiB

Open AccessArticle

Treatment Use Among U.S. Adults with a Substance Use Disorder: Associations with Symptom Severity, Problem Self-Perception, Comorbid Mental Illness, and Mental Health Treatment

by Namkee G. Choi and C. Nathan Marti

Int. J. Environ. Res. Public Health 2025, 22(4), 640; https://doi.org/10.3390/ijerph22040640 - 18 Apr 2025

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Abstract

Using data from the 2022 and 2023 National Survey on Drug Use and Health, we examined factors associated with treatment use for substance use disorder (SUD), perceived SUD treatment needs, and reasons for treatment non-use. Of U.S. adults, 18.1% had any past-year SUD [...] Read more.

Using data from the 2022 and 2023 National Survey on Drug Use and Health, we examined factors associated with treatment use for substance use disorder (SUD), perceived SUD treatment needs, and reasons for treatment non-use. Of U.S. adults, 18.1% had any past-year SUD (alcohol use disorder [AUD] and/or any drug use disorder [DUD]), 14.4% of those with SUD received SUD treatment in the past year, and 5.5% of those who did not receive treatment had a perceived need for treatment. Treatment use was significantly associated with AUD and DUD severities (aOR = 3.85, 95% CI = 2.82–5.26 for severe AUD; aOR = 2.82, 95% CI = 2.27–3.47 for severe DUD), problem self-perception (aOR = 2.12, 95% CI = 1.74–2.58), and mental health treatment use (aOR = 6.07, 95% CI = 4.73–7.78). Perceived treatment needs among those who did not use treatment were also significantly associated with AUD and DUD severities, problem self-perception, and any mental illness. The most frequently reported reasons for treatment non-use among those with perceived need were self-sufficiency beliefs, lack of readiness to stop using or start treatment, stigma-related concerns, and health insurance/cost problems. The findings underscore the importance of screening SUD and educating about the harms of untreated SUD in increasing motivation and readiness for treatment use among people with SUD. Full article

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21 pages, 1025 KiB

Open AccessReview

A Review on the Multidisciplinary Approach for Cancer Management in the Eastern Mediterranean Region: A Focus on Nutritional, Lifestyle and Supportive Care

by Ayoub Al-Jawaldeh, Asmus Hammerich, Faisal Abdulghafar Aldayel, Giuseppe Troisi, Hanin Al-Jawaldeh, Hassan Aguenaou, Heba Alsawahli, Ibtihal Fadhil, Imen Sohaibani, Jalila El Ati, Jihan Azar, Lamia Mahmoud, Maha Barbar, Majid Mqbel Alkhalaf, Nahla Gafer, Taghreed Mohammed Alghaith, Zaynab Mahdi and Mandy Taktouk

Int. J. Environ. Res. Public Health 2025, 22(4), 639; https://doi.org/10.3390/ijerph22040639 - 18 Apr 2025

Viewed by 258

Abstract

Cancer is one of the leading causes of global morbidity and mortality and one of the most challenging global health conditions, impacting the lives of millions every year. The Eastern Mediterranean Region (EMR) is not on track to achieve the sustainable development goal [...] Read more.

Cancer is one of the leading causes of global morbidity and mortality and one of the most challenging global health conditions, impacting the lives of millions every year. The Eastern Mediterranean Region (EMR) is not on track to achieve the sustainable development goal (SDG) target 3.4 which aims to reduce premature mortality (i.e., before the age of 70 years) for non-communicable diseases (NCDs), including cancer, by a third by year 2030; instead, it is projected that the EMR will experience the least progress towards achieving this target. This review therefore highlights the importance of context-specific cancer management, with a focus on nutritional, lifestyle and supportive care, in the EMR. A comprehensive literature search was conducted using electronic databases, including PubMed, Scopus and Google Scholar, as well as the Academy of Nutrition and Dietetics and key oncology institutes. Nutritional and lifestyle management is a fundamental aspect of cancer care which should be context-specific, achievable and individualized to minimize symptoms and side effects, while maximizing benefits and better addressing the needs of the patients with cancer. A multidisciplinary approach that integrates medical, nutritional, psychological and palliative care is essential to address this growing issue effectively. Cancer care and management requires coordinated efforts from policymakers, healthcare providers and communities to implement evidence-based interventions and promote cancer awareness. Full article

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7 pages, 232 KiB

Open AccessOpinion

Rewriting the Narrative: Advancing Justice and Equity in the U.S. Food System

by Marie A. Bragg, Nathalie Lissain, Zora G. Hall, Brittany N. Edghill, Omni Cassidy, Roxanne Dupuis and Karen Watson

Int. J. Environ. Res. Public Health 2025, 22(4), 638; https://doi.org/10.3390/ijerph22040638 - 18 Apr 2025

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Abstract

The concept of ‘food justice’ recognizes the systemic injustices embedded in the U.S. food system and the urgent need for transformative policies to ensure equitable access to affordable, nutritious, and culturally relevant food. Limited access to these foods drives food insecurity and increases [...] Read more.

The concept of ‘food justice’ recognizes the systemic injustices embedded in the U.S. food system and the urgent need for transformative policies to ensure equitable access to affordable, nutritious, and culturally relevant food. Limited access to these foods drives food insecurity and increases the prevalence of diet-related diseases in low-income and minority communities. Dominant narratives that individualize hunger and food insecurity often blame the individual and overlook the underlying structural factors that sustain these issues. These narratives have considerable influence. They shape public opinion and can also guide policy decisions. This commentary explores the goals of the food justice movement in the U.S., describes how the food and racial justice movements intersect, and examines the role of commercial marketing and public policy in shaping the food justice discourse. We also reflect on the efforts that should be made to reframe these dominant narratives and facilitate meaningful change in the food environment. Full article

(This article belongs to the Topic Diversity Competence and Social Inequalities)

22 pages, 3491 KiB

Open AccessSystematic Review

Molecular Effects of Physical Activity and Body Composition: A Systematic Review and Meta-Analysis

by Jenni Chambers, Clare M. P. Roscoe, Corinna Chidley, Agnieszka Wisniewska and Aparna Duggirala

Int. J. Environ. Res. Public Health 2025, 22(4), 637; https://doi.org/10.3390/ijerph22040637 - 18 Apr 2025

Viewed by 92

Abstract

Physical activity (PA) and body composition are important lifestyle factors that influence public health. Research suggests that DNA regions (CpG site locations) are differentially methylated in a physically active population. This meta-analysis aimed to identify CpG sites associated with various levels of PA [...] Read more.

Physical activity (PA) and body composition are important lifestyle factors that influence public health. Research suggests that DNA regions (CpG site locations) are differentially methylated in a physically active population. This meta-analysis aimed to identify CpG sites associated with various levels of PA and associated metabolic pathways. The meta-analysis followed PRISMA guidelines using PubMed, SportDISCUS, Embase, Scopus, Cochrane and Web of Science. Epigenomic analyses performed on DNA of participants with no underlying health conditions were included. Articles were screened using Rayyan AI and extracted CpG sites, and their location were confirmed using the EWAS catalogue. Six studies comprising 770 subjects were included in this meta-analysis. The meta-analysis was performed on clinical metrics extracted from the six studies and showed that BMI, blood pressure, insulin and glucose testing are significantly improved upon PA intervention. Amongst the included studies, a total of 257 CpG sites were differentially methylated in physically active participants, with 134 CpGs located in 92 genes associated with obesity-related pathways. The identified differentially methylated genes either belonged to the lipid metabolism or insulin signalling pathway. The genes which were differentially regulated in multiple tissue types and studies are JAZF1 (insulin signalling, and lipid and carbohydrate metabolism pathways) and NAV1 (mTOR signalling pathway). In conclusion, the current epigenomic meta-analysis showed that PA levels induce differential DNA methylation signatures on genes that affect metabolism. To understand the positive molecular effects of PA, further research on the above candidate genes needs to be conducted amongst various levels of a physically active population. Full article

(This article belongs to the Special Issue Physical Activity and Health: Strategies and Action Plans to Prevent Public Health Risks)

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2 pages, 523 KiB

Open AccessCorrection

Correction: Yang et al. Expression of Hepcidin and Ferroportin in the Placenta, and Ferritin and Transferrin Receptor 1 Levels in Maternal and Umbilical Cord Blood in Pregnant Women with and without Gestational Diabetes. Int. J. Environ. Res. Public Health 2016, 13, 766

by Anqiang Yang, Jun Zhao, Minhua Lu, Ying Gu, Yunlong Zhu, Daozhen Chen and Jinyan Fu

Int. J. Environ. Res. Public Health 2025, 22(4), 636; https://doi.org/10.3390/ijerph22040636 - 18 Apr 2025

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Abstract

In the original publication [...] Full article

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2 pages, 372 KiB

Open AccessCorrection

Correction: Karoui et al. Nitrogen Dioxide Inhalation Exposures Induce Cardiac Mitochondrial Reactive Oxygen Species Production, Impair Mitochondrial Function and Promote Coronary Endothelial Dysfunction. Int. J. Environ. Res. Public Health 2020, 17, 5526

by Ahmed Karoui, Clément Crochemore, Najah Harouki, Cécile Corbière, David Preterre, Cathy Vendeville, Vincent Richard, Olivier Fardel, Valérie Lecureur, Jean-Marie Vaugeois, François Sichel, Paul Mulder and Christelle Monteil

Int. J. Environ. Res. Public Health 2025, 22(4), 635; https://doi.org/10.3390/ijerph22040635 - 18 Apr 2025

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Abstract

In the original publication [...] Full article

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16 pages, 292 KiB

Open AccessReview

Contributions of Health Psychology to Climate Change: A Review

by Elisa Kern de Castro and Marta Reis

Int. J. Environ. Res. Public Health 2025, 22(4), 634; https://doi.org/10.3390/ijerph22040634 - 17 Apr 2025

Viewed by 307

Abstract

Climate change poses a significant threat to human health, necessitating interdisciplinary approaches to mitigate its effects. Health psychology, with its focus on behavior change and well-being, is uniquely positioned to contribute to climate action. This review examines how health psychology can address climate-related [...] Read more.

Climate change poses a significant threat to human health, necessitating interdisciplinary approaches to mitigate its effects. Health psychology, with its focus on behavior change and well-being, is uniquely positioned to contribute to climate action. This review examines how health psychology can address climate-related challenges, emphasizing psychological responses to environmental stressors, behavior modification strategies, and public health interventions. The findings indicate that climate change functions as a psychological stressor, contributing to anxiety, depression, and eco-distress. Additionally, behavioral science insights are underutilized in climate governance, despite their potential to drive sustainable actions. Health psychology can enhance climate adaptation by promoting pro-environmental behaviors, fostering resilience, and integrating psychological well-being into policy frameworks. However, barriers such as limited interdisciplinary collaboration and insufficient emphasis on systemic change hinder progress. To maximize impact, health psychologists must engage in climate governance, advocate for policy integration, and address both individual and collective behavior change. Future research should explore the intersection of mental health, climate resilience, and behavior adaptation to develop comprehensive strategies for tackling climate change. This review underscores the urgent need for health psychology to play a more active role in shaping climate policy and fostering sustainable, health-promoting behaviors. Full article

(This article belongs to the Special Issue The 20th Anniversary of IJERPH)

15 pages, 551 KiB

Open AccessReview

Cannabis Hyperemesis Syndrome in Youth: Clinical Insights and Public Health Implications

by Jamie A. Seabrook, Morgan Seabrook and Jason A. Gilliland

Int. J. Environ. Res. Public Health 2025, 22(4), 633; https://doi.org/10.3390/ijerph22040633 - 17 Apr 2025

Viewed by 319

Abstract

This review focuses on Cannabis Hyperemesis Syndrome (CHS) in youth, a condition linked to chronic cannabis use and characterized by cyclic vomiting, abdominal pain, and dehydration. The objectives were to explore CHS progression in youth and its impact on health, and to assess [...] Read more.

This review focuses on Cannabis Hyperemesis Syndrome (CHS) in youth, a condition linked to chronic cannabis use and characterized by cyclic vomiting, abdominal pain, and dehydration. The objectives were to explore CHS progression in youth and its impact on health, and to assess current treatment strategies. There are the three distinct phases of CHS: prodromal, hyperemetic, and recovery. During the prodromal phase, individuals experience early morning nausea and discomfort, often mistakenly alleviated by continued cannabis use. The hyperemetic phase is marked by severe vomiting, dehydration, and complications like electrolyte imbalances, leading to potentially serious health risks. Temporary relief may be experienced through hot showers or baths. In the recovery phase, symptoms gradually resolve, and normal eating and bathing habits return. The review emphasizes the physical and psychological impacts of CHS on youth, highlighting the potential for misdiagnosis and the importance of early intervention. It stresses the need for targeted educational efforts in schools, healthcare settings, and public health campaigns to prevent delayed diagnosis and improve outcomes. Findings underscore the importance of increasing healthcare provider awareness and promoting preventive education. The review also advocates for further research into CHS pathophysiology to improve diagnostic and treatment protocols for young populations. Full article

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

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14 pages, 648 KiB

Open AccessArticle

The Potential Role of Ecotoxicological Data in National Essential Medicine Lists: A Cross-Sectional Analysis

by Camila Heredia, Aine Workentin, Gillian Parker and Navindra Persaud

Int. J. Environ. Res. Public Health 2025, 22(4), 632; https://doi.org/10.3390/ijerph22040632 - 17 Apr 2025

Viewed by 192

Abstract

Background: Medicines affect the environment throughout their lifecycle, from production and distribution to use and disposal. They contribute to the pollution of air, water, and soil, impacting ecosystems and human health. Recognizing these risks, regulatory bodies and organizations have highlighted pharmaceutical pollution as [...] Read more.

Background: Medicines affect the environment throughout their lifecycle, from production and distribution to use and disposal. They contribute to the pollution of air, water, and soil, impacting ecosystems and human health. Recognizing these risks, regulatory bodies and organizations have highlighted pharmaceutical pollution as a global concern, emphasizing the need for environmental risk assessments and sustainable practices. Methods: This study reviewed the essential medicines lists (EMLs) from 158 countries and examined the available ecotoxicological data. Medicines with high bioaccumulation, persistence, and toxicity were identified and cross-referenced with their inclusion in EMLs. Additionally, we analyzed the presence of alternative medicines with similar therapeutic effects but potentially lower environmental risks. Results: Five medicines—ciprofloxacin, ethinylestradiol, levonorgestrel, ibuprofen, and sertraline—were selected as illustrative examples due to their high environmental persistence and toxicity. All were listed in the 2023 WHO model list, with ciprofloxacin appearing in 94.3% of national EMLs. Conclusions: This study underscores the limited availability of ecotoxicological data, which hinders environmental risk assessment for medicines. EMLs could serve as a tool to enhance the awareness and data mobilization of pharmaceutical pollution. Incorporating environmental criteria into EMLs could support more sustainable medicine selection and regulatory practices. Full article

(This article belongs to the Section Global Health)

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16 pages, 441 KiB

Open AccessArticle

Food Safety in Informal Markets: How Knowledge and Attitudes Influence Vendor Practices in Namibia

by Winnie L. N. Sheehama and Tanusha Singh

Int. J. Environ. Res. Public Health 2025, 22(4), 631; https://doi.org/10.3390/ijerph22040631 - 17 Apr 2025

Viewed by 223

Abstract

Background: Informal markets are essential to ensuring food accessibility and supporting economic livelihoods throughout sub-Saharan Africa; however, food safety in these settings remains poorly regulated and under-resourced. As such, foodborne illnesses originating from such settings pose serious public health threats. Despite the [...] Read more.

Background: Informal markets are essential to ensuring food accessibility and supporting economic livelihoods throughout sub-Saharan Africa; however, food safety in these settings remains poorly regulated and under-resourced. As such, foodborne illnesses originating from such settings pose serious public health threats. Despite the growing reliance on ready-to-eat street foods in Namibia, little is known about the food safety knowledge, attitudes, and practices (KAP) of food handlers in informal settings. This study investigated food handlers’ KAP regarding food safety at the Oshakati Mini Market, northern Namibia, to inform environmental health practitioners and guide policymakers in improving food safety measures. Methods: A cross-sectional study was conducted with 103 food handlers using a self-administered questionnaire which assessed sociodemographic characteristics, food safety knowledge (15 items), attitudes (10 items), and practices (12 items). Data were analysed using descriptive statistics, Pearson correlation, and multiple linear regression to identify associations between KAP scores and respondent characteristics. Results: The majority of respondents were female (60.2%), aged 30–49 years (69.0%), and had only primary-level education. Only 15.5% had received formal food safety training. The mean knowledge score was 64.7% (SD = 14.2), and the mean practice score was 58.2% (SD = 13.8). Attitudes were predominantly negative (60.2%), despite 95.1% acknowledging the importance of handwashing. Poor practices included low use of protective clothing (28.2%), smoking in food areas (21.4%), and inadequate utensil hygiene. Knowledge was positively correlated with good practices (r = 0.745, p < 0.01), while attitudes were negatively correlated with good practices (r = −0.745, p < 0.01). Regression analysis revealed that age negatively influenced knowledge (β = −0.265, p < 0.01), while work experience positively predicted both knowledge (β = 0.393, p < 0.01) and practices (β = 0.393, p < 0.01). Conclusions: Food handlers in Oshakati’s informal market exhibited moderate knowledge but sub-optimal food safety practices and largely negative attitudes. Limited training and education were key contributing factors. These findings highlight an urgent need for structured, context-specific food safety training and regulatory enforcement to reduce foodborne disease risk and strengthen public health interventions in Namibia’s informal food economy. Full article

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1 pages, 163 KiB

Open AccessCorrection

Correction: Lu et al. An Assessment of Temporal and Spatial Dynamics of Regional Water Resources Security in the DPSIR Framework in Jiangxi Province, China. Int. J. Environ. Res. Public Health 2022, 19, 3650

by Mengtian Lu, Xiaoying Wang, Weihong Liao, Chao Wang, Xiaohui Lei and Hao Wang

Int. J. Environ. Res. Public Health 2025, 22(4), 630; https://doi.org/10.3390/ijerph22040630 - 17 Apr 2025

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Abstract

Siyu Wang was included as an author in the original publication [...] Full article

39 pages, 428 KiB

Open AccessSystematic Review

Why Do Emergency Medical Service Employees (Not) Seek Organizational Help for Mental Health Support?: A Systematic Review

by Sasha Johnston, Polly Waite, Jasmine Laing, Layla Rashid, Abbie Wilkins, Chloe Hooper, Elizabeth Hindhaugh and Jennifer Wild

Int. J. Environ. Res. Public Health 2025, 22(4), 629; https://doi.org/10.3390/ijerph22040629 - 17 Apr 2025

Viewed by 249

Abstract

Emergency medical service (EMS) ambulance employees play a critical role in emergency healthcare delivery. However, work-related experiences can compromise their mental health and job satisfaction. Despite available supportive services offered by EMS organizations, employee uptake remains low, while mental ill health and suicide [...] Read more.

Emergency medical service (EMS) ambulance employees play a critical role in emergency healthcare delivery. However, work-related experiences can compromise their mental health and job satisfaction. Despite available supportive services offered by EMS organizations, employee uptake remains low, while mental ill health and suicide rates remain higher than those of the general population. Understanding barriers to and enablers of such support is crucial for addressing factors that connect employees with the services designed to help. This systematic review identified 34 relevant articles and utilized an innovative process of integrating quantitative and qualitative aspects of the primary and gray literature to provide a qualitative synthesis of barriers and facilitators as perceived by EMS employees. Themes of employee (in)ability to ask for help, tailored person-centered support, and education and training about mental health were overarched by organizational culture. Barriers included perceived organizational obligation rather than genuine care, alongside machismo and stigma. Enablers included valuing and acknowledging employee risk by providing time and normalizing support utilization at work. Reframing machismo from dominance, competition, and toughness to respect, perseverance, and courage; promoting adaptive coping; and providing time and training were essential. Future research should aim to understand the factors influencing employee utilization of supportive interventions based on these themes. Full article

21 pages, 1195 KiB

Open AccessReview

Barriers and Facilitators for Implementing Digital Interventions for Anxiety and Depression in Latin America: A Scoping Review

by Bárbara Battistotti Vieira, Léa Savoy, Kathya Acuña Luna, Antoine Flahault and Jennifer Hasselgard-Rowe

Int. J. Environ. Res. Public Health 2025, 22(4), 628; https://doi.org/10.3390/ijerph22040628 - 17 Apr 2025

Viewed by 186

Abstract

Mental health disorders have a high prevalence in Latin America (LATAM), with an estimated 6.7% of the population suffering from anxiety and 4% from depression. Digital mental health interventions (DMHIs) have been implemented to address these issues. However, there has yet to be [...] Read more.

Mental health disorders have a high prevalence in Latin America (LATAM), with an estimated 6.7% of the population suffering from anxiety and 4% from depression. Digital mental health interventions (DMHIs) have been implemented to address these issues. However, there has yet to be a clear picture of these interventions in the region. This scoping review aims to analyze DMHIs’ characteristics and the barriers and facilitators for their implementation in five LATAM countries (Brazil, Chile, Colombia, Mexico, and Peru). To achieve this goal, four databases (PubMed, APA PsycNet, Scielo, and LILACS) were searched using relevant search terms in English, Spanish, and Portuguese. A total of 484 references were identified and narrowed down to 15 articles included in the final analysis. The studies mostly consisted of RCTs and mixed-methods studies. Most of the DMHIs were designed for individuals, with a focus on targeted communication and personal health tracking. Interventions targeting healthcare professionals were less common, primarily focusing on decisional support. The most prominent barriers to the successful implementation of DMHIs included insufficient healthcare professional training (40%) and resistance from clinicians and organizational culture (40%), while common facilitators included easy access to the interventions (46.7%) and increased training and support for clinical teams (46.7%). Positive outcomes were reported in terms of both effectiveness (33.3%), with many interventions showing results equal to or better than traditional methods (33.3%), and patient satisfaction (33.3%). Full article

(This article belongs to the Special Issue Risk Reduction for Health Prevention)

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11 pages, 244 KiB

Open AccessArticle

Environmental Health Literacy of Brazilian Indigenous People

by Bernardo Oliveira Buta, Wauana Sheeva Costa Silva Manchineri, Matheus Britto Froner, Maria Berta Ecija, Debora Helena Rosa Cardoso and Benjamin Miranda Tabak

Int. J. Environ. Res. Public Health 2025, 22(4), 625; https://doi.org/10.3390/ijerph22040625 - 17 Apr 2025

Viewed by 164

Abstract

Environmental health literacy (EHL) is essential for individuals to protect themselves from environmental health risks. Indigenous populations are particularly vulnerable to these risks, given the historical threats they have suffered from the advance of agricultural frontiers and impacts of deforestation, mining, and extreme [...] Read more.

Environmental health literacy (EHL) is essential for individuals to protect themselves from environmental health risks. Indigenous populations are particularly vulnerable to these risks, given the historical threats they have suffered from the advance of agricultural frontiers and impacts of deforestation, mining, and extreme weather events. This study investigates the dimensions of EHL among indigenous communities in Brazil, considering the scarcity of research in this field. Using a scale adapted to measure EHL in topics such as air, water, and food, it was possible to access the EHL levels of a sample of different Brazilian indigenous ethnic groups. Statistical analysis included descriptive methods and the Wilcoxon and Kruskal–Wallis tests. The results revealed significant variations in EHL levels, influenced by factors such as gender, place of residence, age, education, access to health services, and potable water. In addition, the presence of traditional actors, such as midwives, was identified as an important factor in the transmission of health knowledge. The research highlights the need for public policies that respect the cultural specificities of indigenous communities and promote self-care and environmental preservation, contributing to the development of culturally sensitive public health strategies. Full article

(This article belongs to the Section Environmental Health)

29 pages, 1751 KiB

Open AccessArticle

“Stuck Due to COVID”: Applying the Power and Control Model to Migrant and Refugee Women’s Experiences of Family Domestic Violence in the Context of the COVID-19 Pandemic

by Azriel Lo, Georgia Griffin, Hana Byambadash, Erin Mitchell and Jaya A. R. Dantas

Int. J. Environ. Res. Public Health 2025, 22(4), 627; https://doi.org/10.3390/ijerph22040627 - 16 Apr 2025

Viewed by 126

Abstract

The COVID-19 pandemic had acute and lasting gendered impacts around the world, with UN Women declaring a shadow pandemic of violence against women. This study aimed to explore the impact of the COVID-19 pandemic on migrant and refugee women’s experiences of family domestic [...] Read more.

The COVID-19 pandemic had acute and lasting gendered impacts around the world, with UN Women declaring a shadow pandemic of violence against women. This study aimed to explore the impact of the COVID-19 pandemic on migrant and refugee women’s experiences of family domestic violence (FDV) in Western Australia (WA) using a community-based participatory research approach. Thirty-eight interviews and two qualitative surveys conducted with 27 women were included in the analysis. Interview and survey data underwent reflexive thematic analysis informed by the Power and Control Wheel, generating three themes and ten subthemes: (1) the facets of violence women experienced (isolation; economic violence; emotional violence; visa vulnerabilities; fear and uncertainty), (2) the systemic enablers of FDV and barriers to seeking help (FDV service provision; the immigration system), and (3) the impact of the COVID-19 pandemic and government measures on women and family (enabling FDV; reducing the impact of FDV; COVID-19 paled into insignificance). While for some migrant and refugee women, government measures facilitated access to support for FDV, our findings show that for others, the COVID-19 pandemic exacerbated and became part of the violence they had already experienced. Recommendations for tailored FDV and other support during the COVID-19 pandemic are discussed, including the expansion of family violence provisions for all visa types. Full article

(This article belongs to the Special Issue Health Inequalities in Socially Disadvantaged Communities: 2nd Edition)

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14 pages, 457 KiB

Open AccessReview

Nurses’ Perceptions on the Role of Advanced Psychiatric Nurses in Mental Healthcare: An Integrative Review

by Femi Edward Duyilemi and Nkhensani Florence Mabunda

Int. J. Environ. Res. Public Health 2025, 22(4), 626; https://doi.org/10.3390/ijerph22040626 - 16 Apr 2025

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Abstract

Background/Objectives: Advanced psychiatric nurses’ clinical skills and expertise are increasingly challenging registered nurses in mental health. Understanding registered nurses’ perceptions of the role of advanced psychiatric nurses is vital for improving mental healthcare delivery and fostering collaboration for effective patient outcomes. This integrative [...] Read more.

Background/Objectives: Advanced psychiatric nurses’ clinical skills and expertise are increasingly challenging registered nurses in mental health. Understanding registered nurses’ perceptions of the role of advanced psychiatric nurses is vital for improving mental healthcare delivery and fostering collaboration for effective patient outcomes. This integrative review aims to explore how registered nurses perceive the role of advanced psychiatric nurses in mental healthcare. Methods: An integrative review methodology was used to synthesize the existing literature following PRISMA guidelines. Both qualitative and quantitative studies provided a comprehensive understanding of the registered nurses’ perceptions regarding the role of advanced psychiatric nurses in mental health nursing. Results: Several key themes emerged from studies included in this review, including recognition of expertise, role ambiguity and boundaries, and the need for structured education and training. Conclusions: This review highlights the need to clarify roles and how communication is essential for improving collaboration, team cohesion, and patient outcomes while promoting interprofessional education to optimize mental healthcare, in addition to bridging the knowledge gap or the discrepancy between registered nurses and advanced psychiatric nurses. What registered nurses know and what they need to know to perform tasks will improve the quality of mental healthcare and optimize services for individuals with mental health needs. Full article

(This article belongs to the Special Issue Mental Health Services in Primary Care Settings: Challenges, Opportunities and Best Practices)

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Int. J. Environ. Res. Public Health, Volume 22, Issue 4 (April 2025) – 194 articles

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