AIMS Public Health最新文献

Background: A nurse's work environment has consistently been the most important factor affecting the emergence of burnout and their choice to resign from their positions.

Objective: This work seeks to investigate the impact of the nursing work environment on job burnout and turnover intentions among nurses.

Methods: A cross-sectional study was conducted during October 2024 in Greece. We employed the "Practice Environment Scale-5" to assess the nursing work environment. Additionally, we used the single item burnout measure to measure job burnout, and the single item turnover intention measure to measure turnover intention among our nurses. We used multivariable regression models to adjust for demographic and job variables.

Results: More than half of the nurses (56.7%) reported a high level of turnover intention. The mean score on the single item burnout measure (7.78) indicated high levels of burnout in our sample. The multivariable linear regression analysis showed that lower levels of staffing and resource adequacy were associated with the increased job burnout (adjusted beta = -0.431, 95% CI = -0.683 to -0.180, p-value = 0.001). Similarly, our multivariable logistic regression model found an independent negative effect of staffing and resource adequacy on the turnover intention (adjusted OR = 0.594, 95% confidence interval = 0.421 to 0.840, p-value = 0.003).

Conclusion: Our multivariable analysis indicated that a diminishing nursing work environment is associated with an increased job burnout and turnover intention. Improving the nursing work environment is essential to reduce the job burnout and turnover intention among nurses.

Background: Asbestos has been used in various industries, and prolonged exposure can increase the risk of asbestos-related disease (ARD). Although the use of asbestos has been prohibited in Japan since 2012, it was imported well into the 2000s. This study aimed to identify industries in Japan whose workers are at heightened risk of developing ARD.

Methods: This study was based on a comprehensive analysis of fiscal year data from the Survey of Claims and Decisions on Benefits for Asbestos-Related Health Damage and calendar year data from the Status of Pneumoconiosis Health Management Implementation in Japan. Occupations associated with asbestos exposure risk were identified using the Japan Standard Industrial Classification (Rev. 14, 2023). The incidence rate ratio (IRR) was estimated using Poisson regression analysis.

Results: This study includes 8,971,500 person-years from 2006 to 2022. Construction workers showed the strongest positive associations with all ARDs. Within the manufacturing sector, shipyard workers were particularly vulnerable to ARDs, although a notable exception to this was the positive correlation with asbestosis among workers in the ceramic industry (IRR 1.56; 95% CI 1.12-2.17). Mesothelioma is the most prevalent ARD over the past 17 years.

Conclusions: This study suggests that, despite asbestos being banned in Japan for the past 13 years, cases of ARDs continue to occur in various industries, with construction and shipyard workers being at highest risk. Consequently, individuals with prior asbestos exposure require continuous monitoring to avoid potential adverse health consequences.

This study examined the associations between different types of internet use and Positive Youth Development (PYD) among Spanish university students, considering gender differences. A total of 1779 undergraduate students (65.9% men, M age = 20.32, SD = 1.84) from ten universities in Andalusia (Spain) completed online self-report measures assessing the five dimensions of PYD and some internet use behaviors, including social networking, online gaming, reading, surfing or looking for information, music-related activities, and e-commerce. Descriptive analyses indicated moderate levels of overall PYD, with the highest scores in Caring and Character and the lowest in Competence. Correlation and hierarchical regression analyses showed that the most frequent online activities were social networking, surfing or looking for information, and playing or downloading music. Social networking and online gaming were negatively associated with PYD, whereas reading or looking for information was positively associated. Significant gender differences emerged across all variables, with women reporting more frequent social media use and higher Character and Caring, and men showing more frequent gaming activity and higher Competence and Confidence. The findings underline the distinct associations between specific internet activities and PYD dimensions. The results suggest the importance of promoting constructive digital engagement and mitigating potentially harmful practices. Gender differences should be considered when adopting programs to the needs of each group.

This study aims to examine differences in physical fitness among young adults in three distinct groups: individuals with long COVID, those who had recovered from COVID-19 without lingering symptoms, and healthy individuals with no history of infection. A total of 105 participants were equally divided into the three groups (n = 35 each). Evaluations included handgrip strength for upper body strength, handheld dynamometry for quadricep strength, and a six-minute walk test (6MWT) to assess the cardiorespiratory performance. Participants with long COVID demonstrated significantly lower handgrip strengths compared to the control group. Additionally, both post-COVID groups showed reduced 6MWT distances and elevated post-exercise physiological responses, including heart rate, systolic blood pressure, perceived exertion, and leg fatigue, regardless of symptom persistence. These findings indicate that individuals recovering from COVID-19, especially those with persistent symptoms, exhibit measurable declines in muscular and cardiorespiratory fitness, along with heightened physiological stress during physical activity.

Background: With aging populations, a growing number of older people are subjected to limitations in activities of daily living (ADL), causing a tremendous burden and challenges to patients' quality of life and policymakers. Investigating modifiable risk factors for ADL remains an important project to help lower its risk. This study aimed to explore associations between the modifiable risk factors and ADL using national-scale data from the China Health and Retirement Longitudinal Study (CHARLS).

Methods: Data were downloaded from CHARLS 2020, a population-based longitudinal survey. We included modifiable risk variables and ADL index, i.e., basic ADL (BALD) and instrumental ADL (IADL). Afterward, variables were included in the logistic regression model construction. Also, propensity score matching (PSM) was employed to validate the findings. Finally, we tried to discuss the associations between different age groups.

Results: A total of 12,248 participants were included in this study, comprising 5799 women (47.35%) and 6449 men (52.65%). The median age was 62 (55-69) years. Among the participants, 2055 (16.78%) had limitations in BADL, and 1838 (15.01%) had limitations in IADL. Logistic regression demonstrated that exercise significantly reduced the risk of BADL and IADL impairment (BADL: OR = 0.70, 95% CI: 0.59-0.83; IADL: OR = 0.65, 95% CI: 0.55-0.78; P < 0.001). Similarly, better cognitive ability was associated with a lower risk of impairment (BADL: OR = 0.68, 95% CI: 0.61-0.75; IADL: OR = 0.60, 95% CI: 0.54-0.67; P < 0.001). Adequate sleep duration (6-8 hours) also significantly reduced the likelihood of functional decline (BADL: OR = 0.49, 95% CI: 0.45-0.55; IADL: OR = 0.48, 95% CI: 0.43-0.53; P < 0.001). In contrast, depression symptoms and chronic diseases significantly increased the risk of both BADL and IADL impairment. Besides, PSM showed similar findings, and the risk of ADL increased with age.

Conclusions: Modifiable risk factors, such as exercise, cognitive ability, depression symptoms, chronic diseases, social activities, and sleeping duration, were significantly associated with ADL. Besides, as age increases, the impact of various modifiable risk factors on ADL becomes more evident, emphasizing special care for older populations and offering scientific ideas for policymakers.

Disasters, especially cross-border ones, represent a significant challenge for public health, with potential repercussions on the mental health of both the victims and the first responders. In this context, Psychological First Aid (PFA) interventions in a safe area near the disaster site are essential to mitigate an acute emotional impact and prevent the onset of subsequent psychological disorders. In this context, the aim of this study is to evaluate the implementation and management of a PFA protocol in an international collaboration setting, thus exploring not only the effectiveness of the training but also the coordination of these protocols in emergency situations within a multi-agent, multicultural environment. A cross-border mass casualty incident simulation was conducted, which involved emergency medical services from Spain, France, and Andorra. Agreed cross-border disaster response protocols were implemented, including the PFA protocol, which was implemented by a Psychological Emergency Unit (PEU). Both qualitative and quantitative data collection and analysis techniques were employed. Strengths, such as the clinical and ethical response, were observed for the PEU performance, though operational and coordination shortcomings were also identified, including a critical weakness in the planning phase where the need for PFA for healthcare personnel was not anticipated, thus preventing its implementation for this group. Cross-border coordination faced challenges due to language barriers, thus underscoring the importance of interpreter availability and intercultural mediation in multinational emergency responses. Strengths and weaknesses were analyzed, and suggestions for improvement were proposed. The simulation provided valuable insights into the performance and applicability of tested PFA protocols in a cross-border context. Strengthening training and operational planning will be key to optimizing the response in real-life situations.

Background: In this study, we describe the change in protein intake, nutritional status, bone markers, and bone mineral density (BMD) in older patients recovering from a hip fracture, from post-surgery till 3 months. Additionally, we explore the association between protein intake with bone markers, quantitative ultrasound (QUS) and BMD, and nutritional status with QUS and BMD.

Methods: A 3-month prospective study in 96 adults aged ≥70 years with an acute hip fracture was conducted. Assessments after surgery and 3 months included protein intake (questionnaire), nutritional status [Mini Nutritional Assessment Short Form (MNA-SF)], procollagen type I N-terminal propeptide (PINP), C-terminal telopeptide of type I collagen (CTX), insulin-like growth factor 1 (IGF-1), parathyroid hormone (PTH) levels, QUS parameters, and BMD (dual-energy X-ray absorptiometry). Associations were assessed by adjusted linear mixed models.

Results: At baseline, half of the patients (mean age 84 years, 63% females) had a low protein intake (<0.8 g/kg/d), which did not change over time. The patients had significant weight loss (median 3.6 kg) and the prevalence of (being at risk of) malnutrition increased from 20% to 64%. The PINP and IGF-1 levels increased over time, the CTX level remained stable, and the PTH level decreased. The protein intake was only associated with a QUS parameter in females (estimate 0.123, 95% CI 0.022-0.223). A higher pre-fracture MNA-SF status was associated with higher BMD in the total body (estimate 0.048, 95% CI 0.015-0.080), spine (estimate 0.085, 95% CI 0.025-0.144), total hip (estimate 0.055, 95% CI 0.018-0.093), and trochanter (estimate 0.057, 95% CI 0.018-0.096). IGF-1 was associated with PINP (estimate 1.215, 95% CI 0.363-2.066).

Conclusions: A good nutritional status is associated with higher BMD in older hip fracture patients. The role of protein for bone health in these patients remains unclear. After a hip fracture, there is an increase in PINP.

Adolescence is a crucial developmental phase marked by major physical, cognitive, and psychosocial changes that shape self-perception and relationships, with lasting effects on mental and physical health. Personality functioning, a core concept in modern diagnostic systems, such as the International Classification of Diseases (ICD-11), offers a dimensional framework that incorporates key developmental domains such as identity, self-direction, empathy, and intimacy. Early detection of impairments in these areas is essential to promote mental and physical well-being and to prevent the onset of mental disorders. In addition, an improvement in physical fitness (PF) appears to be associated with a significantly lower risk of developing mental disorders. Thus, this study aimed to examine associations between the dimensions of personality functioning, health-related quality of life (HRQoL), and PF in adolescents. A total of 186 adolescents (48.3% girls; mean age 15.6 ± 0.6 years) completed the KIDSCREEN-10, the Levels of Personality Functioning Questionnaire (LoPF-Q) 12-18, and the standardized German motor fitness test (DMT 6-18). Significant negative moderate and large correlations were found between HRQoL and overall personality dysfunction, as well as the identity, self-direction, empathy, and intimacy development domains. Additionally, PF showed significant negative moderate correlations with overall personality dysfunction, particularly with intimacy. Multiple regression analyses revealed that self-direction and intimacy were significantly negatively associated with the HRQoL, while intimacy was negatively associated with PF. Impaired personality functioning, particularly in self-direction and intimacy, was strongly associated with reduced HRQoL and PF in adolescents. These findings highlight the importance of recognizing emerging personality difficulties early and providing timely support, as this can play a vital role in promoting both mental and physical health during adolescence and later in life.

Air pollution, comprising a complex mixture of gaseous and particulate pollutants, remains a major global health concern that disproportionately affects vulnerable populations. In this scoping review, we aim to systematically investigate the role of genetic susceptibility in health outcomes associated with exposure to air pollution, with a particular emphasis on fine particulate matter (PM_2.5), particulate matter (PM₁₀), nitrogen dioxide (NO₂), and nitrogen oxides (NO_x); key pollutants consistently linked to adverse health effects. By exploring the gene-environment interactions underlying air pollution-related conditions, this review offers new insights into how genetic factors may modulate individual responses to air pollutants and their implications for precision health. Analyzing 16 peer-reviewed studies published in the last decade, we highlight genetic markers and pathways involved in regulating oxidative stress, inflammation, and DNA repair, which are thought to influence individual variation in responses to PM_2.5, PM₁₀, NO₂, and NO_x. Although none of the included studies entailed multi-omics or machine learning approaches, we identified these tools as promising directions for future research aimed at elucidating mechanistic pathways and informing personalized strategies. These techniques could significantly improve the understanding of gene-environment interactions, and are suggested as emerging methodologies for future studies. However, the scarcity of longitudinal studies and the underrepresentation of diverse populations limit the generalizability of the current findings. Addressing these gaps will be essential for advancing research, improving environmental health equity, and informing policy in the context of air pollution and genetic susceptibility.

Non-communicable diseases (NCDs) pose a major public health challenge worldwide, particularly in low- and middle-income countries (LMICs) like Indonesia, driven by urbanization, lifestyle changes, and environmental risks. Challenges such as constrained healthcare resources and socio-economic disparities hinder the effectiveness of NCD prevention and management. In response, Indonesia has implemented the Community-Based Chronic Disease Management Program (Prolanis), designed to promote regular monitoring, medication adherence, lifestyle modifications, and health education through primary health centers. This scoping review aimed to identify and map the barriers to Prolanis implementation across different regions and communities in Indonesia. A comprehensive literature search was performed in Scopus, ScienceDirect, and PubMed for peer-reviewed publications between 2014 and 2024. After the screening process, 38 peer-reviewed works met the inclusion criteria and were analyzed thematically. Thematic analysis indicated five major categories of barriers, including infrastructure and staffing constraints, low coverage, participation and adherence, socioeconomic and cost barriers, cultural and health literacy barriers, and pandemic-related disruptions. Key issues included inadequate human resources, inconsistent medical supplies, geographic barriers, patient time conflicts, and a lack of perceived benefit. Additionally, socio-economic challenges such as out-of-pocket expenses and transportation costs further restricted participation. Addressing these identified barriers is critical for improving the effectiveness of Prolanis and enhancing chronic disease management in Indonesia. These findings also contribute valuable insights for the implementation of community-based NCD programs in other LMIC settings.