International Journal of Environmental Research and Public Health最新文献

Alzheimer's disease (AD) is a neurodegenerative disease that predominantly affects the older adult population. Neuroinflammation may be triggered by the migration of oral microbiota composition changes from the oral cavity to the brain. However, the relationship between oral microbiota composition and neurodegenerative diseases, such as AD, remains poorly understood. Therefore, we conducted a comprehensive comparison of the relative abundance and diversity of bacterial taxa present in saliva among older adults diagnosed with AD, those with mild cognitive impairment (MCI), and healthy controls. Saliva samples and clinical data were collected from 10 AD patients, 46 MCI patients, and 44 healthy older adults. AD patients had lower Clinical Dementia Rating, Montreal Cognitive Assessment, and Mini-mental Status Examination scores, and induced microbial diversity, than the MCI and control groups. Moreover, AD patients exhibited significantly higher levels of Fusobacteriota and Peptostreptococcaceae and lower levels of Veillonella than the MCI and control groups. In conclusion, a high abundance of Fusobacteria at various levels (i.e., phylum, class, family, and genus levels) may serve as a biomarker for AD. The analysis of oral microbiota dysbiosis biomarkers in older adults may be valuable for identifying individuals at risk for AD.

The population aging in the region is occurring under scenarios of inequality, raising concerns about how the increase in life expectancy is experienced and what factors affect the quality of life of older adults. This research quantified the differentials of healthy aging in Colombia in 2018 and its association with social indicators through a cross-sectional, descriptive, and correlational observational study. Healthy aging was quantified using the Disability-Free Life Expectancy (DFLE) indicator and later correlated with social indicators and subjected to a Multiple Factor Analysis (MFA). The results showed a healthy life expectancy of 71.5 years for women and 66.9 years for men, with a disability expectancy of 8.3 and 6.4 years, respectively. Negative associations emerged with health problems, disability, lack of medical care, illiteracy, school absenteeism, and poverty, while higher education levels and retirement showed positive associations. The factor analysis by area of residence highlighted urban areas as conducive to healthy aging. In conclusion, the accelerated aging of the Colombian population faces health disparities that policies must address by improving education, economic security, and health services, especially for women and rural areas.

Cardiovascular disease (CVD) risk factors are frequently reported among firefighters, yet no studies have compared these factors between male and female firefighters, specifically from a low- to middle-income country (LMIC). This study aimed to determine the prevalence of CVD risk factors and their relationship with cardiorespiratory fitness (VO_2max) in 254 active career firefighters (mean age: 42.6 ± 7.8 years). The assessments included anthropometry, blood pressure, blood glucose, cholesterol, triglycerides, and VO_2max. The results indicated that 48.0% and 51.8% of females and males were pre-hypertensive, respectively. Hypertension was identified in 15.8% of the firefighters. According to body mass index (BMI), 37.3% of males and 25% of females were found to be overweight, while an additional 44.9% of males and 45.7% of females were classified as obese. Only 17.3% of males and 18.2% of females were found to be of normal weight. These findings were corroborated by categories of central obesity using waist circumference (WC), which were 47.7% for males and 41.6% for females. Low HDL-C was found in 95.2% of males and 86.4% of females, with 28.3% of males also having elevated triglyceride levels (TG). VO_2max was "excellent" in 48.8% of males and 12.6% of females, though it had no significant association with most CVD risk factors. The only notable link was a small correlation between VO_2max and triglycerides (r = -0.215; p = 0.001). These findings suggest that while cardiorespiratory fitness may have no impact, additional factors likely contribute to the cardiovascular health of firefighters, necessitating the need for comprehensive health and fitness programmes.

Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This study aims to develop a framework that captures key elements and components of epidemic and pandemic preparedness and response systems, focusing on a multi-hazard context. A systematic literature review was used to collect data through peer-reviewed journal articles using three electronic databases, and 17 experts were involved in the validation. Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems in a multi-hazard context. All elements appear integrated within three interventional phases: upstream, interface, and downstream. A holistic approach focusing on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards.

Background: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors.

Methods: This secondary data analysis (n = 101) was part of a longitudinal case-control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed.

Results: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods.

Conclusions: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.

The influence of global climate change on temperature-related health outcomes among vulnerable populations, particularly young children, is underexplored. Using a case time series design, we analysed 647,000 hospital admissions of children aged under five years old in New Zealand, born between 2000 and 2019. We explored the relationship between daily maximum temperatures and hospital admissions across 2139 statistical areas. We used quasi-Poisson distributed lag non-linear models to account for the delayed effects of temperature over a 0-21-day window. We identified broad ICD code categories associated with heat before combining these for the main analyses. We conducted stratified analyses by ethnicity, sex, and residency, and tested for interactions with long-term temperature, socioeconomic position, and housing tenure. We found J-shaped temperature-response curves with increased risks of hospital admission above 24.1 °C, with greater sensitivity among Māori, Pacific, and Asian compared to European children. Spatial-temporal analysis from 2013-2019 showed rising attributable fractions (AFs) of admissions associated with increasing temperatures, especially in eastern coastal and densely populated areas. Interactive maps were created to allow policymakers to prioritise interventions. Findings emphasize the need for child-specific and location-specific climate change adaptation policies, particularly for socioeconomically disadvantaged groups.

Health impact assessment (HIA) is a prospective approach that aims to identify the potential consequences of policies or projects on health in order to propose measures to make them healthier. Initiated in the late nineties, the approach emerged over ten years ago in France. However, the evaluation of HIA effectiveness remains seldomly practised and its theoretical background should be deepened. The aim of this article is to generate a discussion on how to evaluate HIA effectiveness and contribute to its methodological tooling, drawing on an evaluative experience of multiple French HIAs. Our work is based on an iterative approach between an analysis of the evaluation literature and a critical look at an HIA evaluation. We first carried out the evaluation of three HIAs in 2017-2018, combining a normative approach and qualitative research in order to explore each HIA as a phenomenon in its own context. Two years later, we conducted a self-assessing expertise on this evaluation, supported by an analysis of the literature in the field of public policy evaluation, in order to refine the theoretical framework for evaluating HIA effectiveness and ultimately to enhance professional practice by evaluators. This work led to the production of a logic model that identifies, through three dimensions (context, implementation and governance), the multiple pathways that HIA may take to bring about change. It also seeks to show the interdependence of these pathways towards change and helps identify the key drivers and mechanisms of HIA success. In this respect, it complements existing HIA evaluation models as it can serve both as a generic framework for evaluating HIA effectiveness and as an instrument for monitoring HIA implementation.

Many patients infected with the SARS-CoV-2 virus (COVID-19) continue to experience symptoms for weeks to years as sequelae of the initial infection, referred to as "Long COVID". Although many studies have described the incidence and symptomatology of Long COVID, there are little data reporting the potential burden of Long COVID on surgical departments. A previously constructed database of survey respondents who tested positive for COVID-19 was queried, identifying patients reporting experiencing symptoms consistent with Long COVID. Additional chart review determined whether respondents had a surgical or non-routine invasive procedure on or following the date of survey completion. Outcomes from surgeries on patients reporting Long COVID symptoms were compared to those from asymptomatic patients. A total of 17.4% of respondents had surgery or a non-routine invasive procedure in the study period. A total of 48.8% of these patients reported experiencing symptoms consistent with Long COVID. No statistically significant differences in surgical outcomes were found between groups. The results of this analysis demonstrate that Long COVID does not appear to have created a significant burden of surgical disease processes on the healthcare system despite the wide range of chronic symptoms and increased healthcare utilization by this population. This knowledge can help guide surgical operational resource allocation as a result of the pandemic and its longer-term sequelae.

While LGBTQ+-parented families share many similarities with their cis-het parent counterparts, they still experience unique factors exclusive to them. One such factor is access to the LGBTQ+ community. Utilizing a diverse sample of LGBTQ+ parents with adolescents in the U.S., primarily living in Southern and Midwest states, we examined the potential moderating impact of a parent's sense of LGBTQ+ community on the relationship between parenting stress, parent mental health, and child adjustment. Regression analyses demonstrated a series of positive associations between LGBTQ+ parent stress, parent mental health concerns, and child adjustment issues. However, sense of community failed to moderate these associations. Parent sexual identity, age, and recruitment method were found to have unique associations with outcome variables. Implications for policy, clinical practice, and future research are discussed.

Obstetric fistula is a childbirth complication causing abnormal openings between the urinary, bowel, and genital tracts, leading to involuntary leakage and potential long-term disability. Even after surgical repair, women continue to face psychological and social challenges that affect their social inclusion and participation. This study explored family and service provider perspectives on current support systems and identified gaps affecting women's inclusion and participation post-fistula surgery. Building on a prior study of women who underwent obstetric fistula surgical repair, we qualitatively examined available formal and informal post-surgical supports in Ethiopia. We conducted 20 interviews with family members and service providers and analyzed them using Charmaz's grounded theory inductive analysis approach. We identified four themes that indicated the available formal support in fistula care, the impact of formal support on women's social participation and inclusion, the gaps in formal support systems, and post-surgery informal supports and their challenges. Both groups believed support needs for women after surgery remain unmet, highlighting the need to strengthen holistic support services to improve women's social inclusion and participation. This study contributes to limited research on formal and informal support for women, emphasizing the need for enhanced economic, psychological, and sexual health-related support post-obstetric fistula surgery.