International Journal of Environmental Research and Public Health最新文献

Long COVID can devastate patients' overall quality of life, extending to economic, psychosocial, and mental health and day-to-day activities. Clinical research suggests that long COVID is more severe among Black and African American populations in the United States. This study examines the lived and lasting effects of long COVID among a diverse sample of North Carolina residents over one year by using three self-administered questionnaires completed online using Qualtrics. A cross-sectional descriptive analysis of the baseline results is presented. Our study recruited 258 adults, of which 51.5% had long COVID (but may have recovered), 32.3% had a COVID-19 infection at least once, and 16.3% had never had COVID-19. The socioeconomic status of Black participants was lower than that of White participants; however, the economic impact of long COVID was not worse. Across both groups, 64.4% were employed, 28.8% had to change tasks or work less, and 19.8% stopped working. Fewer White (32.6%) than Black (54.8%) participants always/often felt supported by family and friends about having long COVID. The majority of White participants (59.1%) reported that they did not recover from long COVID compared to 29.7% of Black participants. The long COVID/COVID-19 experience affected White and Black participants differently, but both populations continue feel the impacts.

Introduction: Osteoarthritis (OA) is one of the leading causes of chronic disability in older adults, often causing significant impairment of mobility. OA symptoms have been linked to mental functioning, including depression, anxiety, and negative affect.

Method: To examine whether anger and anxiety mediate the relationship between social support and mobility among older adults with knee osteoarthritis, data from the Everyday Quality of Life in Older Blacks and Whites with Osteoarthritis (EQUAL) study (N = 336) were analyzed using Hayes' PROCESS model in SPSS to test the direct effect of social support on mobility as well as mediation by anxiety and anger.

Results: While univariate models for both anxiety and anger were significant, only anxiety mediated the relationship between social support and mobility.

Conclusion: Although limited by their cross-sectional nature, the findings suggest that at least part of the association of social support with mobility may be explained by the role of support in alleviating anxiety.

This opinion piece postulates that quantitative environmental research and public health spatial analysts unknowingly tolerate certain spatial statistical model specification errors, whose remedies constitute some of the urgent emerging trends and issues in this subfield (e.g., forecasting disease spreading). Within this context, this paper addresses misspecifications affiliated with omitted variable bias complications arising from ignoring, and hence abandoning, negative spatial autocorrelation latent in georeferenced disease data, and/or being ill-informed about reigning teledependencies (i.e., long-distance spatial correlations). As imperative academic challenges, it advances elegant and convincing arguments to do otherwise. Its two particular themes are positive-negative spatial autocorrelation mixtures, and hierarchical autocorrelation generated by hegemonic urban systems. Comprehensive interpretations and implementations of these two conjectures constitute future research directions. Important conceptualizations for treatments reported in this paper include confounding variables and Moran eigenvector spatial filtering. This paper's fundamental implication is an advocacy for a prodigious paradigm shift, a marked change in the collective mindsets and applications of spatial epidemiologists when specifying spatial regression equations to describe either environmental health data, or a publicly transparent geographic diffusion of diseases.

Adolescent obesity is a growing global health problem all around the world. We reviewed the use of complementary and alternative medicine (CAM) for adolescent obesity, examining improvements in BMI or any metabolic indices of obesity. We performed a PubMed and Scopus search for articles on CAM treatments in adolescents aged 12-17 years, and included all studies with subjects in that age range. Out of 226 PubMed articles and 14 Scopus articles, 28 articles from PubMed and 1 article from Scopus fit our criteria. Most CAM studies that showed some improvement in BMI were acupuncture- or yoga-based. Yoga-based interventions showed a BMI reduction of 1-2 points, which is similar to results achieved in studies based on physical activity and Orlistat, a weak anti-obesity medication; meanwhile, acupuncture-based studies showed a slightly higher BMI reduction of 2-4 points, similar to that achieved with Liraglutide, a GLP-1 agonist that is a good anti-obesity medication. Herbs and supplements showed improvement in metabolic markers of obesity. Stress interventions in mind-body interventions, music skip-rope exercise, and creative drama in physical activity-based interventions also showed improvement in BMI. Although many of the studies reviewed were RCTs, the small sample size of those RCTs is a limiting factor. There may be a role for investigating this topic in larger populations to generate more effective conclusions.

Primary healthcare has an important role in a patient's long-term health. While patients in most countries are free to change their family physician, fragmented care leads to higher healthcare costs, more preventable hospitalizations, and an increased likelihood of deviation from clinical best practice. This review aims to identify the main reasons patients change family doctors, summarize the factors influencing these decisions, and highlight areas in healthcare that can be improved to increase patient satisfaction and design better services. An electronic search of the literature was conducted in March 2023 in PubMed and Embase databases for articles in English, French, Portuguese, or Spanish published from 1980 to March 2023. A thematic synthesis approach was applied to the included studies, involving systematic analysis of their findings to identify and categorize analytical themes. Nineteen relevant studies were identified. The following themes were identified as reasons to change family physicians: doctor-patient relationship; consultation schedule and convenience; referrals and positive references; medication and treatment issues; practice management and cost; personal preferences and physician characteristics; and accessibility and distance. The identified themes can serve as valuable targets for developing interventions aimed at enhancing the quality of care provided to patients.

Background: Digital technologies are increasingly being used to promote effective health interventions in the older adult population. This study aimed to develop and validate instant messages with educational content related to glycemic control, delivered via an instant messaging application, as a type 2 DM control strategy for older adults.

Methods: This was a methodological study that developed instant messages containing text and images. The validation process was conducted by a panel of experts composed of nursing, nutrition, and physical education professionals. SPSS version 25.0 was used for the statistical analysis. A CVI was used to measure the experts' agreement regarding the validity of the content of the educational messages. An exact test of binomial distribution with p > 0.05, indicating statistical significance, and a 0.95 proportion of agreement was used to estimate the statistical reliability of the CVI.

Results: Sixty-one text messages were prepared with illustrations as support, and were divided into three themes. The educational messages were validated by experts, with an average CVI score above 0.80 for all indicators.

Conclusions: The educational messages developed in this study were considered relevant and clear for older adults and could be applied in the digital environment, with the objective of helping older adults manage type 2 DM.

Racial disparities have been found in outpatient substance use disorder (SUD) treatment completion rates. Improvements in access to treatment have sought to decrease these disparities and increase treatment engagement and success. To understand outcomes among different racial groups across time, we assessed (1) completion rates, (2) racial representation among patients who have completed treatment, (3) general representation of racial groups within treatment, and (4) treatment length between 2004 and 2024. "Completion" is defined as "meeting all treatment goals". Chi-squared analyses suggest significant differences among racial groups within the completed (x215=158.0, p=<0.001), not-completed (x215=561.75, p=<0.001), and other (x215=186.19, p=<0.001) groups across time. Asian and Other/Multiracial patients experienced the greatest improvement in both representation within treatment overall and proportional representation within the "completer" group over time, despite their overall completion rates fluctuating. White and Black/African American patients decreased in representation, completion rates, and representation in the "completer" group over time, with a peak in 2004-2009. In terms of length of stay, White patients remained in treatment the longest across time, F(5, 4198) = 24.605, p < 0.011, and treatment length increased for other racial groups. While disparities in completion rates decreased and racial representation in treatment increased, discrepancies persist. We discuss these findings within the context of evolving patient populations and changes in treatment provision (e.g., harm reduction frameworks).

Background: A knowledge gap exists on population understanding and perspectives of menopause. To better support females, it is important to understand different population groups' perceived knowledge of and attitudes towards menopause. This study explored perceived knowledge of menopause, awareness of menopausal symptoms, perceived negative impacts of menopause on females' lives, and attitudes towards menopause.

Methods: A national cross-sectional survey (n = 1020) was conducted with residents in Wales aged 16+ years as part of a larger population panel using a multi-method approach (online, telephone, and face-to-face), stratified by NHS health board area, age, sex, deprivation, and ethnicity. Questions on menopause were developed by the research team.

Results: Nearly a third (31.1%) of participants reported having low knowledge of menopause, with younger age groups and males reporting the lowest knowledge. Hot flushes were the most recognised menopause symptom (92.2%). The symptom with the greatest gap in awareness between age groups, sexes, and deprivation quintiles was problems with memory or concentration. Most participants perceived menopause to have a large negative impact on females' mental health (76.1%), working life (69.7%) and physical health (69.6%). Females and 30-49-year-olds were more likely to perceive large negative impacts across all three domains. Most participants (77.8%) agreed that more public discussion is needed on menopause to increase understanding. The greatest support for increasing public discussion was found amongst females and people aged 30-49 years old.

Conclusions: At a population level, perceived knowledge of menopause and associated symptoms and perceived impacts on females' lives varied across socio-demographic groups. While males were less knowledgeable than females, most males perceived negative impacts on females' lives and agreed with action to improve the menopausal environment. Increasing knowledge in those who experience menopause and in those who support those who experience menopause could help females have a more positive transition process.

Exposure to wildfire smoke (WFS) is associated with detrimental physical and mental health. Periods of sustained WFS are predicted to increase with climate change, affecting populations globally. Using a retrospective cross-sectional study, we assessed perceptions of and responses to WFS in a cohort of New York State (NYS) residents in Summer 2023. Data were collected using an online survey from October to November 2023. Descriptive statistics summarized respondent experiences, while exploratory analyses identified high-risk populations using chi-square and t-tests. Our sample consisted of 609 primarily healthy, white, and well-educated individuals who spent most of their time in NYS during Summer 2023. Of the 99% that reported experiencing WFS, 92% received and 91% sought out WFS-related air quality information. While only 25% reported a WFS-related illness, 87% experienced at least one symptom with WFS, frequently citing watery eyes (63%), irritated throat (50%), and headaches (49%), with women reporting symptoms more frequently than men (89.1% vs. 81.6%; p = 0.034). A majority (93%) reported taking mitigation actions, including avoiding outdoor activities (75%) and wearing masks (54%). Our results highlight widespread impacts of wildfires in NYS during Summer 2023, with nearly all respondents reporting sustained periods of WFS. Most reported at least one adverse health symptom despite taking preventative measures, indicating that current protective strategies may be insufficient and more effective interventions are needed.

Wilderness medicine is a rapidly evolving field and has benefited from expanded research efforts. Moreover, with an escalating occurrence of severe and cataclysmic global climatologic events, human illness arising from interaction with wilderness and recreational environments warrants increasing consideration. Within the last decade, the Wilderness Medical Society (WMS) has aggregated research findings and created guidelines on prevention measures and therapeutic options for acute altitude illness, frostbite injuries, and avalanche and non-avalanche snow burials. As new research emerges, some guidelines have been updated to reflect the most current and sound scientific conclusions. In this review, we have synthesized the evidence-based guidelines and have reviewed the quality of the guidelines according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework. Further research efforts can expand the scope of evidence-based practice in travel medicine and ideally standardize the implementation of recommendations within both pre-travel and post-travel medical practices.