Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.6 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
Latest Articles
The Impact of Newly Diagnosed Early Breast Cancer on Psychological Resilience, Distress Levels, and the Perception of Health
Int. J. Environ. Res. Public Health 2024, 21(6), 677; https://doi.org/10.3390/ijerph21060677 (registering DOI) - 24 May 2024
Abstract
Confronting a breast cancer diagnosis, along with complex and challenging treatment procedures, is an extremely stressful experience. Psychological resilience is the ability to maintain or restore normal functioning while facing adversity. We aimed to explore the impact of an early breast cancer diagnosis
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Confronting a breast cancer diagnosis, along with complex and challenging treatment procedures, is an extremely stressful experience. Psychological resilience is the ability to maintain or restore normal functioning while facing adversity. We aimed to explore the impact of an early breast cancer diagnosis on psychological resilience, distress, and perception of health. A cross-sectional study was conducted, including 50 patients newly diagnosed with early breast cancer and 67 healthy women with screening mammograms graded 1 or 2 using a Breast Imaging Reporting and Data System. The levels of distress, perception of health, and psychological resilience were assessed using the depression, anxiety, and stress scale, the SF 36-Item Health Survey 1.0, and the Connor–Davidson RISC-25 scale. Differences between variables were examined using the t-test and chi-square test for interval and categorial variables. The surveys were conducted within four weeks of a breast cancer diagnosis. Patients with breast cancer reported a deterioration of their health relative to the previous year and significantly higher levels of psychological resilience, while there was no significant difference between the groups in levels of stress, anxiety, or depression. The process of diagnosis with early breast cancer may activate psychological dynamic processes which are involved in the effective adaptation to acute stress, leading to higher resilience levels in breast cancer patients compared to healthy controls.
Full article
(This article belongs to the Special Issue The Impact of Anxiety, Depression, and Stress on Mental Health)
Open AccessArticle
Clustering of Social Determinants of Health as an Indicator of Meaningful Subgroups within an African American Population: Application of Latent Class Analysis
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Sumihiro Suzuki, Joshua Longcoy, Zeynep Isgor, Elizabeth Avery, Tricia J. Johnson, Eric Yang and Elizabeth B. Lynch
Int. J. Environ. Res. Public Health 2024, 21(6), 676; https://doi.org/10.3390/ijerph21060676 - 24 May 2024
Abstract
Background: Health disparities between people who are African American (AA) versus their White counterparts have been well established, but disparities among AA people have not. The current study introduces a systematic method to determine subgroups within a sample of AA people based on
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Background: Health disparities between people who are African American (AA) versus their White counterparts have been well established, but disparities among AA people have not. The current study introduces a systematic method to determine subgroups within a sample of AA people based on their social determinants of health. Methods: Health screening data collected in the West Side of Chicago, an underserved predominantly AA area, in 2018 were used. Exploratory latent class analysis was used to determine subgroups of participants based on their responses to 16 variables, each pertaining to a specific social determinant of health. Results: Four unique clusters of participants were found, corresponding to those with “many unmet needs,” “basic unmet needs,” “unmet healthcare needs,” and “few unmet needs.” Conclusion: The findings support the utility of analytically determining meaningful subgroups among a sample of AA people and their social determinants of health. Understanding the differences within an underserved population may contribute to future interventions to eliminate health disparities.
Full article
Open AccessArticle
Amazon Wildfires and Respiratory Health: Impacts during the Forest Fire Season from 2009 to 2019
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Maura R. Ribeiro, Marcos V. M. Lima, Roberto C. Ilacqua, Eriane J. L. Savoia, Rogerio Alvarenga, Amy Y. Vittor, Rodrigo D. Raimundo and Gabriel Z. Laporta
Int. J. Environ. Res. Public Health 2024, 21(6), 675; https://doi.org/10.3390/ijerph21060675 - 24 May 2024
Abstract
The Brazilian Amazon, a vital tropical region, faces escalating threats from human activities, agriculture, and climate change. This study aims to assess the relationship between forest fire occurrences, meteorological factors, and hospitalizations due to respiratory diseases in the Legal Amazon region from 2009
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The Brazilian Amazon, a vital tropical region, faces escalating threats from human activities, agriculture, and climate change. This study aims to assess the relationship between forest fire occurrences, meteorological factors, and hospitalizations due to respiratory diseases in the Legal Amazon region from 2009 to 2019. Employing simultaneous equation models with official data, we examined the association between deforestation-induced fires and respiratory health issues. Over the studied period, the Legal Amazon region recorded a staggering 1,438,322 wildfires, with 1,218,606 (85%) occurring during August–December, known as the forest fire season. During the forest fire season, a substantial portion (566,707) of the total 1,532,228 hospital admissions for respiratory diseases were recorded in individuals aged 0–14 years and 60 years and above. A model consisting of two sets of simultaneous equations was constructed. This model illustrates the seasonal fluctuations in meteorological conditions driving human activities associated with increased forest fires. It also represents how air quality variations impact the occurrence of respiratory diseases during forest fires. This modeling approach unveiled that drier conditions, elevated temperatures, and reduced precipitation exacerbate fire incidents, impacting hospital admissions for respiratory diseases at a rate as high as 22 hospital admissions per 1000 forest fire events during the forest fire season in the Legal Amazon, 2009–2019. This research highlights the urgent need for environmental and health policies to mitigate the effects of Amazon rainforest wildfires, stressing the interplay of deforestation, climate change, and human-induced fires on respiratory health.
Full article
(This article belongs to the Special Issue The Role of Environmental Aspects in the Maintenance of Human Health)
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Open AccessArticle
Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years
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Komei Iwai, Tetsuji Azuma, Takatoshi Yonenaga, Yasuyuki Sasai, Yoshinari Komatsu, Koichiro Tabata, Taketsugu Nomura, Iwane Sugiura, Yujo Inagawa, Yusuke Matsumoto, Seiji Nakashima, Yoshikazu Abe and Takaaki Tomofuji
Int. J. Environ. Res. Public Health 2024, 21(6), 674; https://doi.org/10.3390/ijerph21060674 - 24 May 2024
Abstract
Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in
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Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in April 2018 were followed for 2 years. Swallowing function was assessed using a repetitive saliva swallowing test. In our study, 429 participants (13%) who were swallowing less than three times in 30 s based on a repetitive saliva swallowing test after 2 years were diagnosed as those with decline in swallowing function. Multivariate logistic regression analyses showed the decline in swallowing function after 2 years was associated with the male gender (odds ratio [ORs]: 0.772; 95% confidence interval [CIs]: 0.615–0.969), age ≥ 81 years (presence; ORs: 1.523; 95% CIs: 1.224–1.895), support/care-need certification (presence; ORs: 1.815; 95% CIs: 1.361–2.394), periodontal pocket depth (PPD) ≥ 4 mm (presence; ORs: 1.469; 95% CIs: 1.163–1.856), difficulty in biting hard food (yes; ORs: 1.439; 95% CIs: 1.145–1.808), choking on tea and water (yes; ORs: 2.543; 95% CIs: 2.025–3.193), and dry mouth (yes; ORs: 1.316; 95% CIs: 1.052–1.646) at baseline. Therefore, the dental checkup items associated with a decline in swallowing function after 2 years were a PPD ≥ 4 mm, difficulty in biting hard food, choking on tea and water, and dry mouth. PPD status and confirming to the self-administered questionnaire about biting, choking, and dry mouth may be useful in predicting future decline in swallowing function.
Full article
(This article belongs to the Special Issue Oral Health among the Older Population)
Open AccessStudy Protocol
Qualitative Protocol of Chinese Parents and Siblings Experiences of Managing Challenging Behaviours of Adult Persons with Intellectual Disability in Hong Kong and Northern China
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Lisa Pau-Le Low, Alice Nga-Lai Kwong, Yue Wang, Maggie Yat-Cheung Wong, Mimi Mei-Ha Tiu and Karen Wing-See Wan
Int. J. Environ. Res. Public Health 2024, 21(6), 673; https://doi.org/10.3390/ijerph21060673 - 24 May 2024
Abstract
Background: While the literature has highlighted the immense challenges in caring for family members, it is still unclear what the needs of family carers of persons with intellectual disability and challenging behaviours are and what has worked for them. This study aims to
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Background: While the literature has highlighted the immense challenges in caring for family members, it is still unclear what the needs of family carers of persons with intellectual disability and challenging behaviours are and what has worked for them. This study aims to examine 60 parents’ and siblings’ experiences in managing the challenging behaviours of their adult family member with intellectual disability whilst living at home. Methods: A qualitative grounded theory approach using semi-structured interviews will be adopted. Purposive sampling will be used to recruit family carers who live with adult persons with intellectual disability and use one community service in Hong Kong. Three special schools for persons with intellectual disability from northern China will be approached. Results: This study will aim to provide an in-depth understanding of the experiences of family carers and compare the different circumstances they face when managing the challenging behaviours of their adult relatives with intellectual disability in their family home. Conclusions: Although this study targets adults with intellectual disability, the findings will provide a point of reference for adolescents and younger persons who exhibit demanding and challenging behaviours and live with their families. Recommendations can guide the development of appropriate strategies to strengthen services for family carers.
Full article
(This article belongs to the Section Behavioral and Mental Health)
Open AccessArticle
Anthropometric Profile, Overweight/Obesity Prevalence, and Socioeconomic Impact in Moroccan Children Aged 6–12 Years Old with Autism Spectrum Disorder
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Rachid Touali, Maxime Allisse, Jamal Zerouaoui, El Mahjoub Chakir, Dominic Gagnon, Hung Tien Bui and Mario Leone
Int. J. Environ. Res. Public Health 2024, 21(6), 672; https://doi.org/10.3390/ijerph21060672 - 24 May 2024
Abstract
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Background: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. Methods: A total of
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Background: In addition to the inherent challenges of their condition, children with autism spectrum disorder (ASD) are also susceptible to the global obesity epidemic. However, concerning the prevalence of obesity within the Moroccan ASD pediatric population, data remain scarce. Methods: A total of 258 children (boys = 195) aged 6 to 12 years old (mean = 9.4 ± 1.4) diagnosed with ASD participated in this study. Besides the body mass and height, four significant anthropometric markers for assessing obesity were examined: body mass index (BMI), body surface area (BSA), waist circumference (WC), and waist-to-height ratio (WHtR). Each anthropometric marker was categorized into one of three cardiometabolic risk levels based on the Z-scores and their corresponding percentiles. The distribution was as follows: low risk (≤84th percentile), high risk (85th–94th percentile), and very high risk (≥95th percentile). Subsequently, a multiple regression analysis was employed to develop an algorithm that generates a composite risk score. This score incorporates all the anthropometric variables simultaneously, while also weighting their individual contributions to the cardiometabolic risk. Results: Children with ASD exhibit an anthropometric profile that markedly increases their susceptibility to cardiometabolic issues. While roughly 11% of the general Moroccan child population is overweight or obese, this figure soars to nearly 60% among children with ASD when considering the central adiposity markers. Furthermore, children from middle-class socioeconomic backgrounds display a more than threefold greater risk of developing overweight or obesity compared to their counterparts from lower socioeconomic backgrounds. Conclusions: This study has, for the first time, provided an up-to-date overview of the cardiometabolic risk in Moroccan children with ASD using traditional anthropometric measurements. The primary risk factor is clearly linked to central (abdominal) adiposity, which is recognized as the most deleterious. This study highlights the need to include general and central obesity markers. This study underscores the importance of incorporating both general and central adiposity markers for a more comprehensive assessment, and it emphasizes the need for closer monitoring within this high-risk population.
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Open AccessArticle
Exploring the Feasibility of an Electronic Tool for Predicting Retention in HIV Care: Provider Perspectives
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Jacqueline Kromash, Eleanor E. Friedman, Samantha A. Devlin, Jessica Schmitt, John M. Flores and Jessica P. Ridgway
Int. J. Environ. Res. Public Health 2024, 21(6), 671; https://doi.org/10.3390/ijerph21060671 - 24 May 2024
Abstract
Retention in care for people living with HIV (PLWH) is important for individual and population health. Preemptive identification of PLWH at high risk of lapsing in care may improve retention efforts. We surveyed providers at nine institutions throughout Chicago about their perspectives on
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Retention in care for people living with HIV (PLWH) is important for individual and population health. Preemptive identification of PLWH at high risk of lapsing in care may improve retention efforts. We surveyed providers at nine institutions throughout Chicago about their perspectives on using an electronic health record (EHR) tool to predict the risk of lapsing in care. Sixty-three percent (20/32) of providers reported currently assessing patients’ risk for lapsing in care, and 91% (29/32) reported willingness to implement an EHR tool. When compared to those with other job roles, prescribers agreed (vs. neutral) that the tool would be less biased than personal judgment (OR 13.33, 95% CI 1.05, 169.56). Prescribers were also more likely to identify community health workers as persons who should deliver these interventions (OR 10.50, 95% CI 1.02, 108.58). Transportation, housing, substance use, and employment information were factors that providers wanted to be included in an EHR-based tool. Social workers were significantly more likely to indicate the inclusion of employment information as important (OR 10.50, 95% CI 1.11, 98.87) when compared to other participants. Acceptability of an EHR tool was high; future research should investigate barriers and evaluate the effectiveness of such a tool.
Full article
Open AccessReview
Looking beyond Body Structure and Function: ICF Foci and Who Is Being Assessed in Research about Adolescents and Young Adults with Cerebral Palsy—A Scoping Review
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Camila Araújo Santos Santana, Peter Rosenbaum, Jet van der Kemp and Ana Carolina de Campos
Int. J. Environ. Res. Public Health 2024, 21(6), 670; https://doi.org/10.3390/ijerph21060670 - 24 May 2024
Abstract
Purpose: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. Method:
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Purpose: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. Method: Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13–30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. Results: In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). Conclusions: Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.
Full article
(This article belongs to the Special Issue Current Issues in the Neurological Rehabilitation of Children and Adolescents)
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Open AccessArticle
Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus
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Ginny S. Paleg, Sian A. Williams and Roslyn W. Livingstone
Int. J. Environ. Res. Public Health 2024, 21(6), 669; https://doi.org/10.3390/ijerph21060669 - 23 May 2024
Abstract
Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and
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Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9–15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.
Full article
(This article belongs to the Special Issue Current Issues in the Neurological Rehabilitation of Children and Adolescents)
Open AccessArticle
Association between Sleep Duration, Social Jetlag, and the Metabolic Syndrome by Shift Works
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Minjung Kyung, Sungwon Park, Chang Gi Park and OiSaeng Hong
Int. J. Environ. Res. Public Health 2024, 21(6), 668; https://doi.org/10.3390/ijerph21060668 - 23 May 2024
Abstract
Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the
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Lifestyle factors, including sleep characteristics, have been implicated in the development of metabolic syndrome, particularly among shift workers. This study aimed to explore the relationship between shift work, sleep duration, social jetlag, and the risk of metabolic syndrome among U.S. workers and the moderating effect of sleep duration and social jetlag on this relationship. Data from the National Health and Nutrition Examination Survey (NHANES) in 2017–2020 March were analyzed. Poisson regression models were employed to examine associations. Among 4136 U.S. workers, 53.3% had metabolic syndrome, with a higher proportion of shift workers (63.8% vs. 56.7%, p = 0.001) and those sleeping less than 6 h or more than 9 h per week (22.3% vs. 19.1%, p = 0.044) in the affected group. Shift workers were initially found to have an increased risk of metabolic syndrome (Coef. = 0.03, 95% CI: 0.02, 0.16); however, this association was mitigated when accounting for the interaction with social jetlag. Specifically, 1 to <2 h of social jetlag interacted significantly, increasing metabolic risk (Coef. = 0.15, 95% CI: 0.09, 0.22), whereas 1 to <2 h alone showed a protective effect (Coef. = −0.11, 95% CI: −0.17, −0.06). These findings suggest that optimizing sleep schedules and addressing social jetlag may be crucial in mitigating metabolic syndrome risks among shift workers.
Full article
(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
Open AccessArticle
Public Health Impacts of Ambient Particulate Matter Pollution in Libya from 1990 to 2019: An Analysis of the 2019 Global Burden of Disease (GBD) Study
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David Rojas-Rueda, Sandhya Lamsal, Mohini Kak, Sameh El-Saharty and Christopher H. Herbst
Int. J. Environ. Res. Public Health 2024, 21(6), 667; https://doi.org/10.3390/ijerph21060667 - 23 May 2024
Abstract
Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in
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Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM2.5 concentration in Libya was 38.6 μg/m3 in 2019, marking a 3% increase since 1990. In the same year, PM2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services.
Full article
(This article belongs to the Special Issue Health Impact Assessment)
Open AccessArticle
A Case Study of Ergonomic Risk Assessment in Slovakia with Respect to EU Standard
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Daniela Onofrejova, Miriam Andrejiova, Denisa Porubcanova, Hana Pacaiova and Lydia Sobotova
Int. J. Environ. Res. Public Health 2024, 21(6), 666; https://doi.org/10.3390/ijerph21060666 - 23 May 2024
Abstract
Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct
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Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare several commonly used methods in Slovakia for the assessment of ergonomic risk reflecting current EU and Slovak legislative regulations. A Captiv wireless sensory system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak Legislation), the STN EN 1005-4+A1, and the French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which affects the final evaluation of the measurements. Our experience from applying improved risk assessment methodology may have an impact on Slovak industrial workplaces. It was confirmed that there is a need to create uniform standards for the ergonomic risk assessment of body posture, including a detailed description of the threshold values for individual body segments.
Full article
(This article belongs to the Special Issue Advances in Ergonomics, Human Factors and Safety for Occupational Health)
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Open AccessArticle
Prevalence and Factors Associated with Impaired Maternal–Infant Bonding among Mothers Attending Young Child Clinic in Kampala, Uganda
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Phionah Tukamushabe, Tom Denis Ngabirano, Joyce Nankumbi Okonya and Melissa A. Saftner
Int. J. Environ. Res. Public Health 2024, 21(6), 665; https://doi.org/10.3390/ijerph21060665 - 23 May 2024
Abstract
Impaired maternal–infant bonding can have a negative impact on the mother–infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal–infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence
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Impaired maternal–infant bonding can have a negative impact on the mother–infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal–infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence and factors associated with impaired maternal–infant bonding. Postnatal mothers (n = 422) attending the Young Child Clinic at Kawempe National Referral Hospital participated in the study. Maternal–infant bonding was measured using the Postpartum Bonding Questionnaire (PBQ). Participants with a score ≥ 13 on the PBQ were considered to have impaired maternal–infant bonding. The prevalence of impaired maternal–infant bonding among mothers was 45% (190/422). Logistic regression was used to determine factors associated with impaired maternal–infant bonding. Unmarried mothers (AOR = 2.05, 95% [CI = 1.03–4.09], p = 0.041), unplanned pregnancy (AOR = 5.19, 95% [CI = 3.07–8.82], p < 0.001), first-time mothers (AOR = 2.46, 95% [CI = 1.37–4.43], p = 0.003), female infant (AOR = 1.80, 95% [CI = 1.13–2.86], p = 0.013), mothers with no/low education levels (AOR = 2.29, 95% [CI = 1.05–4.50], p = 0.036), and those who delivered post term (AOR = 2.49, 95% [CI = 1.10–5.67], p = 0.028) were more likely to have impaired maternal–infant bonding. Nurses and midwives in postnatal care should include maternal–infant bonding within their client’s assessment and provide supportive mother-centered care. Interventions to improve maternal–infant bonding should be created and implemented in clinical practice.
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Open AccessArticle
Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains
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Salinda Horgan, Jeanette Prorok, Katie Ellis, Laura Mullaly, Keri-Leigh Cassidy, Dallas Seitz and Claire Checkland
Int. J. Environ. Res. Public Health 2024, 21(6), 664; https://doi.org/10.3390/ijerph21060664 - 23 May 2024
Abstract
This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that
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This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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(This article belongs to the Special Issue Care and Services in Healthy Aging)
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Open AccessArticle
Risk and Protective Factors for Injury in Adult Front- and Rear-Seated Motor Vehicle Occupants in New York State
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Laura Zhang, Emilia Pawlowski, Leah M. Hines, Michael J. Bauer and Joyce C. Pressley
Int. J. Environ. Res. Public Health 2024, 21(6), 663; https://doi.org/10.3390/ijerph21060663 - 22 May 2024
Abstract
Although seatbelt use is known to reduce motor vehicle occupant crash injury and death, rear-seated adult occupants are less likely to use restraints. This study examines risk and protective factors associated with injury severity in front- and rear-seated adults involved in a motor
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Although seatbelt use is known to reduce motor vehicle occupant crash injury and death, rear-seated adult occupants are less likely to use restraints. This study examines risk and protective factors associated with injury severity in front- and rear-seated adults involved in a motor vehicle crash in New York State. The Crash Outcome Data Evaluation System (CODES) (2016–2017) was used to examine injury severity in front- and rear-seated occupants aged 18 years or older (N= 958,704) involved in a motor vehicle crash. CODES uses probabilistic linkage of New York State hospitalization, emergency department, and police and motorist crash reports. Multivariable logistic regression models with MI analyze employed SAS 9.4. Odds ratios are reported as OR with 95% CI. The mortality rate was approximately 1.5 times higher for rear-seated than front-seated occupants (136.60 vs. 92.45 per 100,000), with rear-seated occupants more frequently unrestrained than front-seated occupants (15.28% vs. 1.70%, p < 0.0001). In adjusted analyses that did not include restraint status, serious injury/death was higher in rear-seated compared to front-seated occupants (OR:1.272, 1.146–1.412), but lower once restraint use was added (OR: 0.851, 0.771–0.939). Unrestrained rear-seated occupants exhibited higher serious injury/death than restrained front-seated occupants. Unrestrained teens aged 18–19 years old exhibit mortality per 100,000 occupants that is more similar to that of the oldest two age groups than to other young and middle-aged adults. Speeding, a drinking driver, and older vehicles were among the independent predictors of serious injury/death. Unrestrained rear-seated adult occupants exhibit higher severe injury/death than restrained front-seated occupants. When restrained, rear-seated occupants are less likely to be seriously injured than restrained front-seated occupants.
Full article
(This article belongs to the Special Issue Road Traffic Risk Assessment: Control and Prevention of Collisions)
Open AccessReview
Management of Rheumatoid Arthritis in Primary Care: A Scoping Review
by
Francesco Inchingolo, Angelo Michele Inchingolo, Maria Celeste Fatone, Pasquale Avantario, Gaetano Del Vecchio, Carmela Pezzolla, Antonio Mancini, Francesco Galante, Andrea Palermo, Alessio Danilo Inchingolo and Gianna Dipalma
Int. J. Environ. Res. Public Health 2024, 21(6), 662; https://doi.org/10.3390/ijerph21060662 - 22 May 2024
Abstract
Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the
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Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the approach to RA in the PC setting. PubMed, Scopus, and Web of Science were searched using the MESH terms “rheumatoid arthritis” and “primary care” from 2013 to 2023. The search strategy followed the PRISMA-ScR guidelines. The 61 articles selected were analyzed qualitatively in a table and discussed in two sections, namely criticisms and strategies for the management of RA in PC. The main critical issues in the management of RA in PC are the following: difficulty and delay in diagnosis, in accessing rheumatological care, and in using DMARDs by GPs; ineffective communication between GPs and specialists; poor patient education; lack of cardiovascular prevention; and increase in healthcare costs. To overcome these criticisms, several management strategies have been identified, namely early diagnosis of RA, quick access to rheumatology care, effective communication between GPs and specialists, active patient involvement, screening for risk factors and comorbidities, clinical audit, interdisciplinary patient management, digital health, and cost analysis. PC appears to be the ideal healthcare setting to reduce the morbidity and mortality of chronic disease, including RA, if a widespread change in GPs’ approach to the disease and patients is mandatory.
Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
Open AccessArticle
Relationship between Environmental Conditions and Utilisation of Community-Based Mental Health Care: A Comparative Study before and during the COVID-19 Pandemic in Italy
by
Eleonora Prina, Federico Tedeschi, Antonio Lasalvia, Damiano Salazzari, Sara Latini, Laura Rabbi, Federica Marando, Elaine van Rijn, Jan Wollgast, Enrico Pisoni, Bertrand Bessagnet, Maxime Beauchamp and Francesco Amaddeo
Int. J. Environ. Res. Public Health 2024, 21(6), 661; https://doi.org/10.3390/ijerph21060661 - 22 May 2024
Abstract
(1) Background: Lower socioeconomic status increases psychiatric service use, exacerbated during the COVID-19 pandemic by environmental stressors like air pollution and limited green spaces. This study aims to assess the influence of sociodemographic and environmental factors on mental health service utilisation. (2) Methods:
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(1) Background: Lower socioeconomic status increases psychiatric service use, exacerbated during the COVID-19 pandemic by environmental stressors like air pollution and limited green spaces. This study aims to assess the influence of sociodemographic and environmental factors on mental health service utilisation. (2) Methods: This retrospective study uses an administrative database focusing on community mental health services in Northeast Italy. Spatial and temporal analyses were used to address space–time dependencies. (3) Results: Findings showed that sociodemographic factors like living in rented apartments and lower education levels predicted higher mental health service use. Environmental factors, such as elevated NO2 levels and, before the pandemic, lower solar radiation and tree cover, correlated with increased service utilisation. COVID-19 reduced most of the pre-existing differences associated with these factors across census blocks with a different composition of sociodemographic and environmental factors. (4) Conclusions: These findings contribute to a better understanding of the impact of the environment on public mental health.
Full article
Open AccessArticle
Relationship between Driving Ability and Physical Fitness Factors in Older Adults: A Multiple Linear Regression Analysis
by
Akihiko Katayama, Takenori Abe, Ayako Hase and Nobuyuki Miyatake
Int. J. Environ. Res. Public Health 2024, 21(6), 660; https://doi.org/10.3390/ijerph21060660 - 22 May 2024
Abstract
The number of older drivers is increasing with the aging population; this has led to concerns about traffic accidents involving older drivers. For older adults, the automobile is not just a means of transportation, but a life necessity that promotes social activities and
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The number of older drivers is increasing with the aging population; this has led to concerns about traffic accidents involving older drivers. For older adults, the automobile is not just a means of transportation, but a life necessity that promotes social activities and maintains and improves health-related quality of life. In this study, we aimed to clarify the relationship between driving ability and physical fitness factors among 70 older adult drivers using a single regression analysis and multiple regression models adjusted for age, sex, and other factors. Driving ability was evaluated by driving an actual car on an ordinary road without a simulator. The single regression analysis revealed no relationship between driving ability and any physical fitness factor. In the multiple regression model analysis, only grip strength was an important explanatory factor; however, the driving ability scores decreased as grip strength scores increased. By clarifying the physical fitness factors that influence the maintenance and improvement of driving ability, it is possible to propose more efficient intervention programs to maintain and improve driving ability. We could not identify the relevant physical fitness factors in this study; therefore, further research is required to improve safe driving among older adults.
Full article
(This article belongs to the Special Issue Road Traffic Risk Assessment: Control and Prevention of Collisions)
Open AccessArticle
Effect of a Water, Sanitation, and Hygiene Program on Handwashing with a Cleansing Agent among Diarrhea Patients and Attendants in Healthcare Facilities in the Democratic Republic of the Congo: A Randomized Pilot of the PICHA7 Program
by
Alain Mwishingo, Kelly Endres, Lucien Bisimwa, Presence Sanvura, Blessing Muderhwa Banywesize, Jean-Claude Bisimwa, Camille Williams, Jamie Perin, Raissa Boroto, Gisèle Nsimire, Feza Rugusha, Freddy Endeleya, Pacifique Kitumaini, Claude Lunyelunye, Jessy Timsifu, Brigitte Munyerenkana, Justin Bengehya, Ghislain Maheshe, Cirhuza Cikomola and Christine Marie George
Int. J. Environ. Res. Public Health 2024, 21(6), 659; https://doi.org/10.3390/ijerph21060659 - 22 May 2024
Abstract
Healthcare-acquired infections are a major problem in healthcare facility settings around the world. The Democratic Republic of the Congo (DRC) has over 2 million diarrhea patients hospitalized each year. These healthcare settings become high-risk environments for spreading diarrheal illnesses such as cholera. The
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Healthcare-acquired infections are a major problem in healthcare facility settings around the world. The Democratic Republic of the Congo (DRC) has over 2 million diarrhea patients hospitalized each year. These healthcare settings become high-risk environments for spreading diarrheal illnesses such as cholera. The objective of the Preventative Intervention for Cholera for 7 Days (PICHA7) program is to develop evidence-based water, sanitation, and hygiene (WASH) interventions to reduce cholera and other severe diarrheal diseases in the DRC. The study objective was to evaluate the effectiveness of PICHA7 program delivery in increasing handwashing with a cleansing agent at stool/vomit- and food-related events in a healthcare facility setting among diarrhea patients and patient attendants. A pilot of the PICHA7 program was conducted among 284 participants in 27 healthcare facilities from March 2020 to November 2021 in urban Bukavu in the South Kivu Province of the DRC. The standard arm received the standard message provided in the DRC to diarrhea patients on the use of oral rehydration solution and a basic WASH message at healthcare facility discharge. The PICHA7 arm received the PICHA7 WASH pictorial module delivered by a health promoter focused on handwashing with a cleansing agent at the bedside of the diarrhea patient in the healthcare facility and provision of a soapy water bottle (water and detergent powder). Within 24 h of intervention delivery, a three-hour structured observation of handwashing practices at stool/vomit- and food-related events (key events) was conducted in healthcare facilities of diarrhea patients and their attendants. Compared to the standard arm, there was significantly more handwashing with a cleansing agent at key events in the PICHA7 arm (40% vs. 15%) (odds ratio: 5.04; (95% confidence interval (CI): 2.01, 12.7)). These findings demonstrate that delivery of the PICHA7 WASH pictorial module and provision of a soapy water bottle to diarrhea patients and their attendants presents a promising approach to increase handwashing with a cleansing agent among this high-risk population in healthcare facilities in the eastern DRC.
Full article
Open AccessArticle
Community Perceptions of Blackfly Nuisance and Acceptability of the “Slash and Clear” Vector Control Approach in the Ntui Health District of Cameroon: A Qualitative Study
by
Joseph Nelson Siewe Fodjo, Serge Ekukole, Julius Taryunyu Njamnshi, Wepnyu Yembe Njamnshi, Kongnyu G. Njamnshi, Leonard Ngarka and Alfred K. Njamnshi
Int. J. Environ. Res. Public Health 2024, 21(6), 658; https://doi.org/10.3390/ijerph21060658 - 22 May 2024
Abstract
Besides being vectors of the onchocerciasis parasite, blackflies are a source of nuisance in onchocerciasis-endemic communities. We investigated the experience of residents in the Ntui Health District (Cameroon) regarding blackfly nuisance and assessed their perceptions of a novel “Slash and Clear” (S&C) intervention
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Besides being vectors of the onchocerciasis parasite, blackflies are a source of nuisance in onchocerciasis-endemic communities. We investigated the experience of residents in the Ntui Health District (Cameroon) regarding blackfly nuisance and assessed their perceptions of a novel “Slash and Clear” (S&C) intervention for blackfly control. Focus group discussions were conducted before and after S&C implementation (respectively, in February 2022 and December 2023). Blackflies were known to emerge from the river areas and cause disease. To prevent blackfly bites, the population often covered their body with protective clothing and applied various substances (kerosene, oil, or lemon) to their skin. Post-intervention data showed reduced blackfly nuisance, and the willingness to sustain blackfly control in the long-term was unanimous among community leaders and members, including the village volunteers who implemented the S&C intervention. In conclusion, blackfly nuisance is evident in the Ntui onchocerciasis focus of Cameroon and led to a panoply of coping practices, some of which could be detrimental to their health. Implementing S&C for blackfly control is well accepted and could sustainably alleviate the nuisance caused by blackflies while simultaneously breaking the onchocerciasis transmission cycle.
Full article
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