International Journal of Environmental Research and Public Health最新文献

The journal retracts the article titled "Muscle Damage and Performance after Single and Multiple Simulated Matches in University Elite Female Soccer Players" [...].

In the original publication [...].

Pressure injuries in institutionalized older adults with reduced mobility represent a relevant clinical problem due to their impact on quality of life and health costs. Purpose: This study aimed to describe the behavior of blood flow and tissue temperature in the sacral region and the significance of interindividual conditions in the post-load recovery of tissue in the context of pressure injuries. Methods: An observational study was conducted in 55 older adults living in a geriatric institution. Photoplethysmography and temperature signals were recorded at four times: at baseline (preload) and 15 s, 5 min, and 10 min post-load. The perfusion index was calculated, and two dichotomous variables were defined, Return b (flow) and Return t (temperature), to evaluate the physiological capacity to return to baseline conditions. Associations with clinical, functional, and diagnostic variables were explored. Results: The perfusion index showed usefulness as an indicator of microvascular recovery, but with variability between individuals. Return b was significantly associated with BMI and diagnosis of cardiovascular disease, while t-return was associated with body temperature and basal perfusion index. No significant associations were observed with sex, age or functional scales, state of consciousness, or risk of pressure injury. Conclusions: The study shows heterogeneous physiological responses to external load influenced by individual characteristics. Flow and temperature monitoring allows a functional approximation of injury risk, although more complex models are required to understand the nonlinear dynamics of tissue responses.

Stress fractures are a major force preservation risk in military organisations. Although incidence rates and risk factors have been widely examined, a synthesis of high-quality evidence has been lacking. This review aimed to synthesise findings from studies examining stress fracture incidence and risk factors in military populations. The protocol was registered on the Open Science Framework and reported in accordance with PRISMA guidelines. Three databases were searched, and data on incidence, risk factors, and risk ratios were extracted. Study quality was assessed using Joanna Briggs Institute appraisal tools. Seventy studies were included. The incidence of stress fractures in military recruit/trainee populations was substantially higher than among qualified personnel (13.7-1713 vs. 2.7-56.9 per 1000 person-years). Fractures occurred most often in the tibia, fibula, and metatarsals. Higher-risk sub-populations included older and female personnel. Recruits/trainees faced additional risks, such as the following: consuming >10 alcoholic drinks per week; underweight BMI; beginning training without prior exercise of ≥3 sessions/week or ≥7 h/week in the previous year; low serum 25(OH)D levels; prior use of non-steroidal anti-inflammatory drugs; and the initial training stages with the greatest physical loading. Military personnel, particularly recruits, experience high stress fracture incidence, with physical workload and other risk factors contributing to elevated risk.

Over 100 million pregnant people worldwide remain at risk of COVID-19. We compared the prevalence of severe COVID-19 in pregnancy and in people of reproductive age, and the risk of adverse pregnancy/neonatal outcomes in those with/without COVID-19 during gestation. In the Canadian Mother-Child Cohort, two sub-cohorts were identified using medical services, prescription medication fillings, hospitalizations, and COVID-19 surveillance testing programs data (28 February 2020-2021). The first included all pregnant people with at least one completed trimester of pregnancy during the study period, stratified on COVID-19 status. The second included all non-pregnant people (aged 15-45) with a positive COVID-19 test during the same period. COVID-19 severity was categorized based on hospital admissions before the end of pregnancy. Associations between COVID-19 during pregnancy and adverse perinatal outcomes were quantified using log-binomial regressions. A total of 150,345 pregnant people (3464 (2.3%) had COVID-19), and 112,073 non-pregnant people with COVID-19 were included. Maternal age at the time of COVID-19 diagnosis/positive test was statistically significantly lower among pregnant individuals compared to those who were not pregnant (96% had less than 40 years vs. 80%, p < 0.001). In pregnancy, COVID-19 was associated with the risk of spontaneous abortions (adjRR 1.76, 95%CI 1.37, 2.25), gestational diabetes (adjRR 1.52, 95%CI 1.18, 1.97), prematurity (adjRR 1.30, 95%CI 1.01, 1.67), and NICU (adjRR 1.32, 95%CI 1.10, 1.59); COVID-19 treatment with medications reduced risks. Severe COVID-19 was more prevalent in pregnancy and was associated with higher risks of adverse maternal/neonatal outcomes. As some countries are pulling back preventive strategies for COVID-19, this study highlights the importance of continued surveillance during pregnancy to prevent adverse pregnancy outcomes.

Children living with epilepsy face significant stigma in school settings, particularly in rural South Africa, where misconceptions linking epilepsy to witchcraft, evil spirits, or unpredictability lead to fear, shame, and exclusion. This study explored how primary school learners perceive and experience epilepsy-related stigma within the classroom context and examined how such perceptions may influence the mental health and self-conception of peers living with epilepsy. A descriptive-exploratory qualitative design was employed, involving six focus group discussions with 36 learners aged 9-14 years from Grades 4 to 7 in rural schools across Limpopo and Mpumalanga provinces. Data were analyzed thematically using ATLAS.ti software (version 22). Findings revealed that epilepsy was commonly described as a "falling disease," associated with ancestral spirits or supernatural causes, contributing to peer mockery, isolation, and emotional distress. While some learners expressed empathy and willingness to help, most lacked accurate knowledge about the condition. This study concludes that integrating culturally grounded, age-appropriate epilepsy education into life skills curricula can promote empathy, reduce stigma, and support inclusive identity formation. Embedding such programs in school health policies and teacher training frameworks can strengthen mental health promotion and contribute to equitable health education within the goals of Universal Health Coverage.

The COVID-19 pandemic has brought widespread attention to the use of protective masks. This study explores how the socio-demographic factors influence the perception of an interprofessional team wearing FFP2 masks. An online survey conducted in 2021 included 906 participants who rated photographs of an interprofessional team in four different attire scenarios: tunic, white coat, FFP2 masks, and pink socks. In addition education and occupation of participants were obtained. By measuring the attitudes towards an interprofessional team wearing FFP2 masks implicitly the attitude towards this COVID-19 measure was assessed. The statistical analysis employed MANOVA to assess the significance of differences in perception. Healthcare professionals were more critical of teams wearing masks compared to other occupational groups, with a third expressing skepticism about the effectiveness of masks. The results underscore the importance of understanding healthcare professionals' attitudes towards preventive measures, especially masks, for future pandemics. The study uses the Health Belief Model (HBM) as an approach to interpret how the attitude towards preventive measures during the COVID-19 pandemic affect behavior.

Background and Aim: Oman's rapid industrial development has resulted in changing occupational exposures, emphasizing the importance of enhancing physicians' proficiency in occupational history-taking and disease identification. This study sought to evaluate physicians' knowledge, attitudes, and practices (KAP) in diagnosing occupational diseases and collecting occupational histories, while also identifying perceived barriers to effective recognition and reporting. Method: Data were collected utilizing a structured, self-administered questionnaire adapted from a validated instrument that assesses physicians' knowledge, attitudes, and practices (KAP) concerning occupational diseases. The survey was conducted among internal medicine and family medicine physicians at a tertiary academic hospital. Result: Of 252 eligible physicians, 146 (57.9%) responded. Moderate levels were most common for knowledge (45.2%) and attitude (65.1%), while practice was most frequently high (45.9%). Prior training strongly predicted high knowledge (aOR = 7.23, 95% CI: 2.99-17.49; p < 0.001). Family Medicine physicians were more likely to achieve high knowledge (aOR = 2.42, 95% CI: 1.03-5.72; p = 0.043) but less likely to report high attitude scores (aOR = 0.32, 95% CI: 0.14-0.76; p = 0.010). Training also showed non-significant trends toward improved attitude and practice. Conclusions: Occupational health training is strongly linked to improved knowledge, with indications of benefits for attitude and practice. Specialty differences highlight the need to integrate occupational medicine into curricula and strengthen institutional support to enhance recognition of occupational diseases.

Global progress toward achieving universal health coverage (UHC) by 2030 remains insufficient, as significant regional disparities in access to healthcare persist. In Kazakhstan, the uneven distribution of healthcare resources continues despite reforms aimed at improving equity. This retrospective study analyzed inequalities in the distribution of medical infrastructure, healthcare personnel, and service utilization across 14 regions and 2 cities of republican significance from 2002 to 2023. Data were obtained from national statistical reports on healthcare and population income. The analysis included the following indicators: the number of primary care facilities, hospital beds, healthcare personnel, outpatient visits, and hospitalizations per population. Inequality was assessed using the Gini coefficient and the concentration index, and spatiotemporal trends were visualized through cluster analysis in ArcGIS PRO. Results revealed that southern and western regions exhibit lower availability of hospital beds and healthcare personnel, with moderate levels of inequality particularly evident in outpatient care. Despite Kazakhstan's commitment to UHC, these disparities underscore the need for further measures to ensure equitable access to healthcare services.

Despite notable progress in reducing childhood morbidity and mortality, achieving Sustainable Development Goal 3 remains a challenge in sub-Saharan Africa, where many children under five die before accessing formal healthcare services. This study explored the roles of the community in the implementation of the Integrated Management of Childhood Illness (IMCI) programme from the perspectives of caregivers and professional nurses. Using an interpretative phenomenological analysis design, 18 participants were purposively selected from four primary healthcare facilities. Data was collected through audio-recorded interviews, transcribed verbatim and analysed using the IPA framework. The findings underscore the critical role of community health workers (CHWs) within the Integrated Management of Childhood Illness (IMCI) framework, particularly in health promotion, child assessments and follow-up home visits. Support from early childhood development educators and community leaders further enhances these efforts. Nurses highlighted mobile health teams as vital for delivering integrated services, though challenges such as limited transport and inadequate training hinder CHWs' effectiveness. Community-based care offers a cost-effective, accessible model in low-resource settings by leveraging local structures. Strengthening the connection between communities and formal health systems is essential. To sustain IMCI, investment in CHW-led initiatives, including training and logistical support, is recommended to improve service delivery and child health outcomes.