International Journal of Environmental Research and Public Health最新文献

The COVID-19 pandemic posed significant challenges to public health, exposing first responders to high biosafety risks during medical assistance and containment efforts. The PANDEM-2 study aimed to address these critical biosafety issues by emphasising the importance of frequently updated, harmonised guidelines. This study reviewed scientific publications, lessons learned, and real-world experiences from the COVID-19 pandemic to identify biorisk gaps in three critical areas: (i) patient transportation and management, (ii) sample handling and testing, and (iii) data management and communication by laboratory staff. At the onset of the pandemic, first responders faced several challenges, including the rapid expansion of emergency medical services, conversion of non-medical structures, increased internal and cross-border transport of infected patients, frequent changes in biosafety protocols, and a shortage of personal protective equipment. In response, this study developed a versatile and easily adaptable toolkit, including biosafety guidance and recommendations linked to updated national and international online repositories. It establishes the groundwork for a minimum standard that can be tailored to various pandemic response scenarios, using monkeypox as a fictive test case. The toolkit enables rapid access to updated information via QR codes and mobile devices, improving biorisk response by providing an adaptable and standardised approach for caregivers involved in national and cross-border responses.

The COVID-19 pandemic has disproportionately affected vulnerable populations, including residents of assisted living facilities (ALFs). This study investigates the impact of non-pharmaceutical interventions (NPIs) and mass vaccination campaigns on SARS-CoV-2 transmission dynamics within four ALFs in Maricopa County, Arizona, United States from January to April 2021. Initial observations reveal a significant SARS-CoV-2 prevalence in Maricopa County, with 7452 new COVID-19 cases reported on 4 January 2021. Wastewater surveillance indicates elevated viral loads within ALFs with peak concentrations reaching 1.35 × 10⁷ genome copies/L at Facility 1 and 4.68 × 10⁵ copies/L at Facility 2. The implementation of NPIs, including isolation protocols, resulted in a rapid decline in viral loads in wastewater. Following mass vaccination campaigns, viral loads reduced across all facilities, except Facility 4. Facility 1 demonstrated a mean viral load decrease from 1.65 × 10⁶ copies/L to 1.04 × 10³ copies/L post-vaccination, with a statistically significant U-statistic of 28.0 (p-value = 0.0027). Similar trends are observed in Facilities 2 and 3, albeit with varying degrees of statistical significance. In conclusion, this study provides evidence supporting the role of NPIs and vaccination campaigns in controlling SARS-CoV-2 transmission within ALFs.

Group A Streptococcus (Strep A) skin infections (impetigo) can contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This is of particular concern for Indigenous residents of remote communities, where rates of ARF and RHD are much higher than their urban and non-Indigenous counterparts. There are three main potential Strep A transmission pathways: skin to skin, surface to skin, and transmission through the air (via droplets or aerosols). Despite a lack of scientific certainty, the physical environment may be modified to prevent Strep A transmission through environmental health initiatives in the home, identifying a strong role for housing. This research sought to provide an outline of identified household-level environmental health initiatives to reduce or interrupt Strep A transmission along each of these pathways. The identified initiatives addressed the ability to wash bodies and clothes, to increase social distancing through improving the livability of yard spaces, and to increase ventilation in the home. To assist with future pilots and evaluation, an interactive costing tool was developed against each of these initiatives. If introduced and evaluated to be effective, the environmental health initiatives are likely to also interrupt other hygiene-related infections.

(1) Background: To evaluate a model based on the right-to-health approach, considering the impact of associated factors on the future utilization of primary healthcare services among international migrants in Chile. (2) Methods: A cross-sectional design was employed to survey 499 South American migrants residing in Chile. Ad-hoc questionnaires were used to assess their experiences related to the right to health, perceived discrimination, income, education, length of residence, age, marital status, gender, migration status, among others. Correlation analyses were conducted, followed by path analysis with significant variables to assess the fit of two models. (3) Results: Ten variables were identified as significant for path analysis. Among the two evaluated models, the final model identified six variables with significant direct and indirect effects. Among them, the availability, accessibility, acceptability, and quality of healthcare services were positively associated with the future intention to use them. Additionally, perceived racial and ethnic discrimination also had a positive effect on the intention to use healthcare services, suggesting a possible adaptive response to adversity, exhibiting acceptable goodness-of-fit indices (χ² =241,492; p < 0.001; CFI = 0.913; TLI = 0.82; RMSEA = 0.062; SRMR = 0.05). (4) Conclusions: While the initial model provides valuable insights, it is essential to broaden the analysis to include other factors influencing the specific context of international migrants.

Background: This study evaluated the effectiveness of an online intervention designed to improve parent-child interactions and address disordered eating behaviors in children. Using remote video-feedback sessions based on observations of mother-child feeding interactions, the intervention offers a cost-effective and environmentally friendly alternative to traditional in-person methods.

Aims: The study aimed to assess the impact of online intervention on the quality of mother-child interactions during feeding and its effectiveness in reducing psychopathological symptoms in both mothers and children.

Methods: The intervention was conducted entirely online, with improvements measured using SVIA scores for mother-child interactions and the SCL-90/R Global Severity Index (GSI) for maternal psychopathological symptoms, alongside evaluations of children's emotional and behavioral functioning, particularly anxiety, depression, and aggression.

Results: The intervention significantly improved the quality of mother-child interactions across all SVIA subscales and led to reductions in maternal symptoms of depression and anxiety, as well as decreases in children's emotional and behavioral symptoms.

Conclusions: These findings suggest that online video-feedback interventions can effectively enhance mother-child relationships and reduce psychopathological symptoms in both mothers and children, although further research with larger sample sizes and more robust statistical analyses is needed to confirm these results.

The Phubbing Scale (PS) is an instrument used to measure the frequency and extent of the behavior of ignoring someone you are with and giving attention to your mobile phone instead. However, there is insufficient evidence about the psychometric adequacy of the Spanish version of the instrument. The main goal of this research was to analyze the psychometric properties of PS in a representative sample of Spanish adolescents and young adults. A total of 1351 participants comprised the sample (42.78% females, age range = 12-21). Students were selected from different levels of education such as secondary school, high school, vocational training, or university. A convenient sample was used. The reliability of the scores was calculated by means of McDonald's Omega. The evidence of the internal structure of the questionnaire was analyzed by means of confirmatory factor analysis (CFA). The measurement invariance of the instrument by gender and educational level was also calculated. In addition, Pearson's correlations between phubbing and other indicators of mental health were also calculated. The goodness-of-fit indices for the two-factor model were good. The McDonald's Omega coefficient for the total score was 0.787. Measurement invariance both by gender and educational level was found. The phenomenon of phubbing was found to have statistically significant correlations with emotional well-being, other mental health indicators, and with Problematic Internet Use (PIU), with the sole exception of the hyperactivity subscale of the SDQ. This study provided validity evidence for the Spanish version of the Phubbing Scale (PS), suggesting that PS is a reliable tool for quantifying phubbing in Spanish adolescents.

Children and young people constitute a structurally vulnerable group who often experience specific barriers when trying to exercise their rights, including the right to health. The aim of this study was to examine core concepts of human rights and inclusion of vulnerable groups in a sample of national health and well-being policy documents relevant to children and young people in Ireland. Using EquiFrame, a validated policy content analysis tool, 3 policy documents were analysed in relation to their commitment to 21 core concepts of human rights and inclusion of 13 vulnerable groups. The Overall Summary Ranking of each policy varied: 'Better Outcomes, Brighter Futures'-Moderate, 'Sláintecare'-Moderate, and the 'Wellbeing Policy Statement'-Low. Across all three documents, Core Concept Coverage was high while Core Concept Quality was low. The findings demonstrate that these documents cover a wide range of human rights but fail to provide specific policy actions to address human rights or an intention to monitor human rights.

The rise in obesity and related chronic noncommunicable diseases (NCDs) during recent decades in Brazil has been associated with increases in the financial burden and risk of impoverishment due to out-of-pocket (OOP) health expenditure. Thus, this study investigated trends and predictors associated with impoverishment due to health expenditure, in the population of São Paulo city, Brazil, between 2003 and 2015. Household data from the São Paulo Health Survey (n = 5475) were used to estimate impoverishment linked to OOP health expenses, using the three thresholds of International Poverty Lines (IPLs) defined by the World Bank at 1.90, 3.20, and 5.50 dollars per capita per day purchasing power parity (PPP) in 2011. The results indicated a high incidence of impoverishment due to OOP disbursements for health care throughout the period, predominantly concentrated among low-income individuals. Lifestyle choices referring to leisure-time physical activity (OR = 0.766 at $3.20 IPL, and OR = 0.789 at $5.50 IPL) were linked to reduction in the risk for impoverishment due to OOP health expenditures whilst there were increases in the probability of impoverishment due to cardiometabolic risk factors referring to obesity (OR = 1.588 at $3.20 IPL, and OR = 1.633 at $5.50 IPL), and diagnosis of cardiovascular diseases (OR = 2.268 at $1.90 IPL, OR = 1.967 at $3.20 IPL, and OR = 1.936 at $5.50 IPL). Diagnosis of type 2 diabetes mellitus was associated with an increase in the probability of impoverishment at only the $1.90 IPL (OR = 2.506), whilst coefficients for high blood pressure presented lack of significance in the models. Health policies should focus on interventions for prevention of obesity to ensure the financial protection of the population in São Paulo city, Brazil, especially targeting modifiable lifestyle choices like promotion of physical activity and reduction of tobacco use.

This study sought to determine the level of concordance between self-reported alcohol use and the presence of its urinary ethyl glucuronide (EtG) metabolite in women living in urban Kampala. In 2023, we recruited 300 young women, ages 18 to 24 years, to participate in a prospective cohort study across three sites in urban Kampala (i.e., Banda, Bwaise, and Makindye) to examine the mechanistic pathways of mental illness. As part of the baseline assessment, participants were asked to complete a research assistant-administered survey and to provide a urine sample to screen for 16 different substances and/or their metabolites, including EtG. Overall, 58% (n = 174) reported to have ever consumed alcohol and 23% (n = 68) to have used it in the past month. Among the 300 women, 10% (n = 30) had EtG levels in their urine sample and of these, 40% (n = 12) reported to have never consumed alcohol, using a self-reported survey (p = 0.035). Recent alcohol use was relatively low among the women in this study. However, the discordance between self-reported alcohol use and the presence of EtG presents concerns about the accuracy of self-reported alcohol use. Additional research is needed to contextualize self-reported alcohol use, social desirability, and the implications for alcohol prevention and intervention strategies for young women in urban Kampala.

The prevalence of musculoskeletal disorders (MSDs) is high among older adults worldwide, significantly affecting their quality of life and overall health. Understanding the prevalence of MSDs and their associated factors is crucial to developing effective preventive and management strategies in Thailand. In this study, we aimed to investigate the prevalence of MSDs and their associated factors among older patients at Walailak University Physical Therapy Clinic. In this retrospective study, we analyzed the medical records of 396 older patients. Data on demographics, underlying diseases, career types, and treatments were collected and analyzed using descriptive statistics chi-squared tests, and logistic regression analysis to determine their associations with MSD prevalence. The overall prevalence of MSDs was 89.90%. MSD prevalence was higher among female patients than among male patients (p < 0.001). The most commonly affected body regions were the lower back, shoulders, and knees. Career type (p < 0.001) had the highest impact on the presence of MSDs after controlling for sex, age, and underlying diseases as covariates in a logistic regression model. Manual labor and heavy industry workers as well as pensioners showed an increased risk of MSDs. While older age was associated with a higher MSD prevalence using chi-squared statistics, it was removed from the logistic regression models. Pensioners were the most likely to receive treatment, indicating the need for targeted interventions for individuals with physically demanding occupations. These findings underscore the importance of targeted interventions and further research on socioeconomic factors, lifestyle behaviors, and comorbidities to manage MSDs among older adults in Thailand.