International Journal of Environmental Research and Public Health最新文献

The objective of this study was to analyze social perception, trust, and vaccine hesitancy through a combined approach of bibliometric analysis and qualitative synthesis, based on the most cited articles in the recent scientific literature. A systematic search was conducted in indexed databases, identifying patterns of production, collaboration, citation, thematic networks, and conceptual trends associated with the study of public trust in vaccines. The results reveal a marked geographic concentration of scientific production, dominated by the United States and the United Kingdom, as well as a strong articulation of thematic clusters linked to digital disinformation, health communication, risk perception, and psychosocial determinants of vaccine acceptance. The qualitative synthesis of the most influential studies reveals that vaccine hesitancy is a multidimensional phenomenon, determined by sociocultural, cognitive, emotional, and structural factors that interact dynamically according to each context. Disinformation, institutional trust, community narratives, and the credibility of sources emerge as central components in individual decision-making. Together, the integrated results enable a deeper understanding of vaccine hesitancy beyond traditional cognitive models, highlighting the need for contextualized communication strategies, intercultural approaches, and health policies based on trust and social participation. This study provides an integral view of the scientific landscape and establishes priority lines for future research and the design of effective public health interventions.

Remote Indigenous communities experience persistent inequities in access to fresh and nutritious foods due to the fragility of perishable food supply chains (PFSCs). Disruptions across procurement, transportation, storage, retail, and limited local production restrict access to perishable foods, contributing to food insecurity and diet-related health risks. This scoping literature review synthesizes evidence from 84 peer-reviewed, grey, and unpublished sources across fourteen countries to map PFSC management (PFSCM) challenges affecting food access in remote Indigenous communities worldwide and to synthesize reported practices implemented to address these challenges. PFSCM challenges were identified across all supply chain levels, and five categories of reported practices emerged: PFSC redesign strategies, forecasting and decision-support models, technological innovations, collaboration and coordination mechanisms, and targeted investments. These findings informed the development of a multi-scalar conceptual framework comprising seven interconnected PFSCM clusters that organize how reported practices are associated with multiple food access dimensions, including quantity, affordability, quality, safety, variety, and cultural acceptability. This review contributes an integrative, system-oriented synthesis of PFSCM research and provides a conceptual basis to support future scholarly inquiry, comparative inquiry, and policy-relevant discussion of food access and health equity in remote Indigenous communities.

Existing research highlights that Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) teachers are often exposed to additional stressors in schools which adversely affect their mental health. Some mitigate the effects of these stressors by separating their personal and professional identities while others choose to integrate their identities so that they can be authentic, advance social justice in school contexts or be visible and vocal role models. Less is known about the experiences of pre-service teachers who are undertaking teacher preparation programmes. This systematic literature review presents the results of 20 published papers which represent the global experiences of both pre-service teachers and serving teachers. The findings highlight identity management, experiences of discrimination, agency and lack of confidence of teacher educators. Two new frameworks are presented that lay the foundations for embedding LGBTQ+ inclusion and proposed mandatory elements of curricula for initial teacher training. This systematic literature review has been informed by the following research questions RQ1. What are the experiences of LGBTQ+ pre-service teachers? RQ2. How do LGBTQ+ pre-service teachers negotiate their identities? RQ3. How do LGBTQ+ pre-service teachers disrupt hetero/cis-normative cultures in schools? RQ4: How well does the teacher education programme prepare pre-service teachers for teaching LGBTQ+ inclusive education?

Practical training and recruitment strategies are critical for the sustainable implementation of psychosocial interventions. However, few studies have examined how to prepare community partners and doctoral students to support culturally adapted psycho-oncology interventions. This pre-pilot study aims first to evaluate two distinct training programs and recruitment procedures, and second to explore preliminary pre-post outcomes of the Caregiver-Patients Support to Cope with Advanced Cancer (CASA) intervention, using the Consolidated Framework for Implementation Research (CFIR). Three clinical psychology graduate students received CASA training, and two community partners completed Recruitment training. We present descriptive pre- and post-assessments, along with qualitative feedback, for both training and institutional (Puerto Rico Biobank) and community-based recruitment outcomes. A related-samples nonparametric analysis examined pre- and post-CASA intervention signals. Results indicated knowledge gains among doctoral students (pre-test M = 3.3; post-test M = 9.3) and community partners (pre-test M = 4.5; post-test M = 9.5). Preliminary outcomes revealed significant improvements in spiritual well-being (Z = -2.618, p = 0.009) and quality of life (Z = -2.957, p = 0.003) and a reduction in depressive (Z = -2.764, p = 0.006), anxiety (Z = -2.667, p = 0.008), and distress (Z = -2.195, p = 0.028) symptoms following CASA. Of 26 recruited dyads, institutional referrals enrolled 16 dyads (61.5%), while community partners referred 10 dyads with a 90.9% success rate. Findings support the feasibility of both training and CASA exploratory outcomes suggest meaningful psychosocial benefits for Latino dyads coping with advanced cancer. Combining institutional infrastructure with community engagement may enhance sustainability and equitable access to psycho-oncology care.

Current approaches to gaming disorder prevention remain comparatively narrow, and prevention efforts are frequently underdeveloped and fragmented. Using the socio-ecological model (SEM), this qualitative study mapped frontline practitioners' perceived obstacles and opportunities to develop a multi-level, practice-grounded framework for policy and implementation. Semi-structured interviews were conducted with 18 prevention professionals in Flanders (Dutch-speaking Belgium), recruited via purposive and snowball sampling. A hybrid inductive-deductive analysis-iterative coding guided by Layder's adaptive theory-organized findings across SEM levels. At the public policy level, participants highlighted insufficient sustainable funding but saw potential in coordinated frameworks moving prevention beyond substance-focused agendas. At the community level, a clear knowledge gap emerged, with opportunities in integrating gaming within broader digital well-being efforts. Institutionally, the absence of practical tools and clear referral pathways was noted, in addition to high participation barriers, whereas accessible programs with targeted outreach were viewed as promising. Interpersonally, parental disengagement was common, but early involvement and pedagogical guidance were seen as key levers. At the intrapersonal level, limited self-insight and emotion regulation impeded change, while resilience, self-confidence, and offline activities were protective. This first empirical application of the SEM to gaming disorder prevention highlights the need for a multi-level, context-sensitive framework that bridges public health and digital media perspectives.

Background: Chronic nonspecific neck pain (CNNP) is a widespread musculoskeletal condition affecting individuals across all age groups. Although cervical stabilization exercises (CSE) and Thai self-massage have each demonstrated therapeutic potential, evidence regarding the effectiveness of the combined applications of CSE and Thai self-massage remains limited. This study aimed to investigate the effects of a combined program of CSE and Thai self-massage (CSTM) on pain intensity (PI), pressure pain threshold (PPT), and neck disability (ND) in young adults with CNNP.

Methods: This single-blind randomized controlled trial was conducted at the Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Thailand. Fifty young adults with CNNP were randomly assigned into two groups. The CSTM group performed CSE integrated with Thai self-massage, whereas the control group practiced stretching exercises exclusively. Both groups engaged in their respective programs three times per week for a duration of four weeks. PI, PPT, and ND were assessed at baseline, after four weeks (Week 4), and at a two-week follow-up (Week 6).

Results: Both groups showed significant improvements in PI, PPT, and ND (p < 0.05), representing within-group comparisons, at Week 4 and Week 6. Furthermore, between-group comparisons at Week 4 and Week 6 indicated that the CSTM group achieved significantly greater improvements in PI and ND than the control group (p < 0.05).

Conclusion: A four-week program combining CSE with Thai self-massage was effective in reducing pain intensity and neck disability in young adults with CNNP, with benefits maintained at short-term follow-up.

Trial registration: Thai Clinical Trials Registry (TCTR20231102008), registered on 2 November 2023.

Background: Cannabis excise tax structures vary widely across the states in the United States. Standardizing taxes may improve cross-state comparisons and strengthen evaluations of how taxes and prices influence public health outcomes. This study developed category-specific standardized tax metrics for flower, vaping, and edible products by incorporating price and tax structure variations using retail scanner data.

Methods: We analyzed cannabis retail scanner data from dispensary point-of-sale systems for flower, vaping, and edible products in 12 states with legal recreational markets from Q1 2020 to Q4 2024. Using retail prices and excise tax policies, we converted taxes in different forms across the supply chain into standardized measures and estimated tax incidence (ratio of standardized taxes to retail prices) for each category. We also evaluated the association between standardized taxes and retail prices.

Results: Mean standardized excise taxes were USD 32.58/ounce for flower, USD 180.21/ounce for vaping, and USD 0.024/milligram THC for edible products. Corresponding tax incidences were 13.03%, 13.59%, and 13.09%. Standardized taxes and tax incidences varied considerably across states. Category-specific standardized taxes strongly predicted retail prices, supporting their use as an instrumental variable candidate.

Conclusions: Category-specific standardized measures of cannabis excise taxes derived from retail scanner data may support cross-state comparisons and pricing policy evaluation.

Dental caries remains a major global public health problem characterized by pronounced social inequalities. This study aimed to identify, critically appraise, and synthesize the most recent evidence on the relationship between socioeconomic indicators and dental caries among adults aged 19-60 years, providing an updated systematic review that builds upon our previous reviews from 2012 and 2018. Reported following the PRISMA 2020 guidelines, we conducted a systematic search of eight electronic databases for observational studies published between March 2017 and April 2024 (PROSPERO: CRD42017074434). Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Newcastle-Ottawa Scale. Due to substantial methodological heterogeneity across the 22 included studies, a narrative synthesis was undertaken. The findings demonstrated a strong inverse association between socioeconomic position and caries experience. Lower income, lower educational attainment, and unemployment or employment in manual/unskilled occupations were associated with a higher overall caries experience. Advanced analytical approaches in recent studies, including life-course, reinforced that education and income are key contributors of these oral health inequalities, with persistent social disadvantage conferring the greatest risk. In conclusion, dental caries in adults aged 19-60 years is a social condition reflecting the cumulative effects of socioeconomic inequality across the life course. Addressing adult dental caries requires integrated approaches that combine clinical prevention with social and public policies aimed at reducing structural inequalities.

With emerging improvement in screening and treatment, most patients with prostate cancer (PCa) live for a long period beyond their diagnosis. Erectile dysfunction (ED) and bowel and urinary incontinence have been shown to be the most bothersome side-effects of most PCa treatment options for patients. With increasing long-term survival, most PCa patients face the prospect of experiencing symptoms, side-effects of available treatment options, and diminished quality of life. The objective of the study was to explore the impact of treatment-induced ED on masculinity among Black South African PCa patients. Twenty (20) prostate cancer patients, selected through purposive sampling and receiving some form of treatment at Pietersburg tertiary Hospital, with ages ranging from 67 to 85 years (mean age = 76 years; SD = 5.3), participated in the study. In-depth, individual semi-structured interviews were used to collect data and analyzed through Interpretative Phenomenological Analysis (IPA). The findings indicate that ED threatens or adversely impacts the participants' perceptions of their sense of masculinity leading to diminished quality of life. The results demonstrate that loss of masculinity brought about by PCa treatment-induced ED is experienced both physically as well as psychologically. The results highlight a need for collaboration between medical and psychological professionals in the management of PCa patients. This is crucial for improving the overall health related quality of life for patients.

Air pollution from lignite combustion represents a major environmental and public health concern, particularly for cardiovascular disease. This study investigated the relationship between ambient air pollution and hospital admissions for Acute Coronary Syndromes (ACS) and Atrial Fibrillation (AF) in Western Macedonia, Greece-a region historically dominated by lignite mining and power generation. Air quality data for PM₁₀, SO₂, and NO_x from 2011-2014 and 2021 were analyzed alongside hospital admission records from four regional hospitals (Kozani, Ptolemaida, Florina, Grevena). Spatial analyses revealed significantly higher pollutant concentrations and cardiovascular admissions in high-exposure areas near power plants compared with the control area. Temporal analyses demonstrated a pronounced decline in pollutant levels between 2014 and 2021, coinciding with lignite phase-out and accompanied by a marked reduction in ACS and AF hospitalizations, particularly in the high-exposure areas of Ptolemaida and Florina. Correlation analyses indicated modest but significant positive associations between monthly pollutant concentrations and cardiovascular admissions. These findings provide real-world evidence that reductions in air pollution following lignite decommissioning were associated with improved cardiovascular outcomes. The study underscores the medical importance of air quality improvement and highlights emission reduction as a critical strategy for cardiovascular disease prevention in transitioning energy regions.