International Journal of Environmental Research and Public Health最新文献

Globally, the COVID-19 pandemic has severely impacted workers' health, particularly their mental well-being [...].

Background: Daily-use products, including personal care products, household products, and dietary supplements, often contain ingredients that raise concerns regarding harmful chemical exposure. Endocrine-disrupting chemicals (EDCs) found in daily-use products are associated with numerous adverse health effects.

Methods: This pilot study explores the relationship between concentrations of EDCs in urine samples and products used 24 h prior to sample collection, and ingredients of concern in those products, in 140 adults of reproductive age in Northern Nevada.

Results: Having higher numbers of products and ingredients of concern, especially in the personal care category, was associated with higher levels of mono-(-ethyl-5-carboxypentyl) phthalate (MECPP). Similarly, taking more supplements was associated with higher levels of methylparaben (MePB). In contrast, using household products with more ingredients of concern was associated with lower levels of monobutyl phthalate (MBP). Generally, women used more products, were exposed to more ingredients of concern and had higher urinary metabolites than men. Participants who rated themselves as being in poor/fair health were exposed to more personal care and supplement ingredients of concern than those in better health. Interestingly, those in excellent health also took supplements with more ingredients of concern.

Conclusions: Greater product use and more ingredients of concern are associated with urinary metabolites of known EDCs and self-ratings of poor health. Women and people who take supplements are at greater risk, and even people who consider themselves to be healthy can be highly exposed. More education among the general public is needed to make people aware of the presence of these chemicals in their everyday products so they can make efforts to avoid them.

Background: Postural changes are considered a public health issue and have gathered significant interest in both research and clinical practice.

Aims: To evaluate the effectiveness of Global Postural Reeducation (GPR) in improving postural changes and postural stability in healthy young adults. Additionally, this study aims to identify the main postural changes in the sample population.

Methods: A longitudinal study was conducted with a sample of students (n = 38) from the 2nd and 3rd years of undergraduate programs at Coimbra Health School, divided into an experimental group (EG) with 20 subjects and a control group (CG) with 18 subjects. The EG underwent a GPR intervention, while the CG received no intervention. Postural changes were assessed using a 3D motion analysis system (Qualisys), and stabilometry was evaluated using a Bertec force platform.

Results: At baseline (T0), the groups were homogeneous regarding sample characterization variables, as well as postural and stabilometric variables (p > 0.05). After four weeks of the intervention (T1), no significant differences were observed between the EG and CG for any of the variables studied (p > 0.05). However, within-group analysis for the experimental group revealed a significant difference (p = 0.04) in anterior-posterior velocity, indicating a reduction in this parameter from T0 to T1. In the control group, a significant difference was observed (p = 0.03) in the left knee valgus, indicating a reduction in valgus alignment.

Conclusions: GPR does not appear to be effective in improving postural changes or center of pressure displacement in healthy young students.

Colorectal cancer (CRC) ranks third in terms of global cancer prevalence and is the second most common cause of cancer-related mortality. Although CRC rates are decreasing in the United States, inequalities still exist despite the effectiveness of invasive screening methods, such as colonoscopy, flexible sigmoidoscopy, and computed tomography (CT) colonography in detecting colorectal cancer. Many current interventions promoting CRC screening do not utilize a modern theory-based approach, which has led to the low utilization of these screening methods. This cross-sectional study aims to address the lack of theory-based treatments for promoting visual CRC screening examinations by applying the multi-theory model (MTM) of health behavior change to explicate the health-related factors for individuals to seek visual colorectal cancer screening examinations for CRC screening. A 57-item validated questionnaire assessing MTM constructs and CRC screening was administered online. The survey questionnaire was administered to a sample of 640 adults from the United States. The participants were between the ages of 45 and 75 years. Hierarchical multiple regression was used to assess the relationship between MTM constructs with the initiation and sustenance of CRC screening behaviors. Out of the total participants in this nationwide sample, 71.4% (n = 457) reported that they had undergone a visual CRC screening examination. MTM subscales, specifically participatory dialogue, changes in the physical environment along with age, recommendation for CRC screening from a healthcare provider, and previous experience with colonoscopy, were found to be significant factors in predicting the initiation of visual CRC screening behavior. These factors accounted for 22% of the variation in initiation among this group (R² = 0.222, F = 3.521, p < 0.001). The MTM can be a valuable framework for designing educational media, information media, social media platforms, and clinical interventions to promote visual colorectal cancer screening examinations.

There is a need to improve communication for patients and relatives who belong to cultural minority communities in intensive care units (ICUs). As a matter of fact, language barriers negatively impact patient safety and family participation in the care of critically ill patients, as well as recruitment to clinical trials. Recent studies indicate that Google Translate and ChatGPT are not accurate enough for advanced medical terminology. Therefore, developing and implementing an ad hoc machine translation tool is essential for bridging language barriers. This tool would enable language minority communities to access advanced healthcare facilities and innovative research in a timely and effective manner, ensuring they receive the comprehensive care and information they need.

Method: Key factors that facilitate access to advanced health services, in particular ICUs, for language minority communities are reviewed.

Results: The existing digital communication tools in emergency departments and ICUs are reviewed. To the best of our knowledge, no AI English/French translation app has been developed for deployment in ICUs. Patient privacy and data confidentiality are other important issues that should be addressed.

Conclusions: Developing an artificial intelligence-driven translation tool for intensive care units (AITIC) which uses language models trained with medical/ICU terminology datasets could offer fast and accurate real-time translation. An AITIC could support communication, and consolidate and expand original research involving language minority communities.

Background: Neonatal jaundice (NNJ) remains a leading cause of newborn mortality in much of sub-Saharan Africa. We sought to examine the validity of using a hand-held icterometer as a screening tool to determine which newborns need further assessment. Additionally, we sought to assess the feasibility of its use among mothers.

Methods: We recruited and trained healthcare workers at one large district hospital in Ghana to use a hand-held icterometer known as the Bili-Ruler^TM. We recruited mothers of 341 newborns aged 0 to 2 weeks at the same hospital. Mothers watched a standardized training video, after which they blanched the skin of the newborn's nose and compared it with the yellow shades numbered one to six on the icterometer. Each newborn was also assessed with a transcutaneous bilirubin meter (TCB). Research assistants and health care workers screened the same newborns, recorded their scores separately, and were blinded to each other's readings. In the second phase of this study, we recruited 100 new mothers to take the Bili-Ruler home with them, instructing them to check their newborns twice daily. We interviewed them 1-2 weeks later to determine the acceptability and feasibility of its use.

Results: Out of 341 newborns screened, 20 had elevated TCB indicative of hyperbilirubinemia. Healthcare workers' Bili-Ruler ratings had a strong and significant correlation with TCB scores, as did the ratings of researchers and mothers. When comparing Bili-Ruler scores against TCB, sensitivity across all three raters was 80% (95% CI 75.6-84.3), specificity ranged from 61.1% (healthcare providers) to 66.7% (researchers), positive predictive value ranged from 11.4% (healthcare providers) to 13.0% (researchers), and negative predictive value was 98.0% or higher across all raters. Area under the ROC curve ranged from 0.71 for healthcare providers to 0.73 for researchers. Mothers AUC was 0.72. In terms of acceptability and feasibility, the Bili-Ruler was widely accepted by the mothers and family. In total, 98% of mothers reported using it, and 90.8% used it 3 or more days in the first week after birth. Moreover, 89.8% used it more than twice per day.

Conclusions: A hand-held, low-tech icterometer is an important potential mechanism for improving early jaundice identification in low-resource settings. Further studies using larger sample sizes with a higher prevalence of hyperbilirubinemia are warranted.

Breast cancer (BC) is the most common cancer among women, with an incidence of 85-94 per 100,000 people annually in Europe. Despite the increasing incidence of BC, advancements in early detection and novel therapeutic approaches have improved survival rates. However, adjuvant treatments are associated with side effects, including a reduction in the left ventricular ejection fraction (LVEF), which can result in severe cardiac damage and progress to heart failure. Methods: Thirty-eight women undergoing BC treatment were included in the study. Eighteen women (47.2 ± 5.4 years old) participated in a supervised physical exercise (PE) program for 60 min/day, twice weekly, at moderate to high intensity (5 min joint mobilization, 20 min predominantly aerobic training, 30 min of strength training, and 5 min cooldown). The remaining 20 women (51.5 ± 9.5 years) were advised to remain active during treatments, but without specific supervision. In the PE group, a slight reduction in the LVEF was observed after chemotherapy (63.73 ± 3.34% vs. 61.00 ± 6.54%, p = 0.131). In contrast, the control group showed a statistically significant reduction in the LVEF (64.93 ± 4.00% vs. 60.57 ± 4.86%, p = 0.008). Although the results suggest a potential protective effect of regular physical exercise during BC treatment, the study was inconclusive regarding its role in preventing cardiac dysfunction. Further research with a larger sample size and longer follow-up is warranted.

Antimicrobial resistance (AMR) is a growing global health threat. This study investigated antibiotic resistance in E. coli isolates from municipal wastewater (86 isolates) and clinical urinary tract infection (UTI) cases (34 isolates) in a Grenadian community, using data from January 2022 to October 2023. Antibiogram data, assessed per WHO guidelines for Critically Important antimicrobials (CIA), showed the highest resistance levels in both clinical and wastewater samples for ampicillin, followed by amoxicillin/clavulanic acid and nalidixic acid, all classified as Critically Important. Similar resistance was observed for sulfamethoxazole-trimethoprim (highly important) in both groups, with nitrofurantoin showing resistance in the important category. According to the WHO AWaRe classification, ampicillin (ACCESS group) had the highest resistance, while nitrofurantoin had the lowest across all samples. The WATCH group antibiotics, cefuroxime and cefoxitin, showed comparable resistance levels, whereas aztreonam from the RESERVE group (tested only in wastewater) was 100% sensitive. Multiple Antibiotic Resistance (MAR) index analysis revealed that 7% of wastewater and 38.2% of clinical samples had MAR values over 0.2, indicating prior antibiotic exposure in clinical isolates. These parallel patterns in wastewater and clinical samples highlight wastewater monitoring as a valuable tool for AMR surveillance, supporting antibiotic stewardship through ongoing environmental and clinical assessment.

The impact of stress on students' well-being and academic success is tremendous. This paper addresses the issue of balancing stress with the realm of a digital educational escape room (deER). This article demonstrates how a deER can serve as a means of providing knowledge on stress management and health promotion for university students. The objective was twofold-to explore the state of research regarding deERs in stress management and health promotion for students and to investigate the user experience and acceptance of a deER prototype. The methodology combines a rapid literature review and the conceptual as well as technical development of the deER prototype. Additionally, pilot testing was conducted in alignment with relevant theory. The rapid review included four publications meeting the inclusion criteria. Data for deER prototype testing were collected from students at the University of Siegen (first Bachelor's and Master's degree). The pilot study results (n = 4 participants) indicated that deER education on coping strategies, which incorporates mindfulness exercises, increases productivity and is considered helpful for stress management. This suggests that deERs can provide enjoyable and effective support for students in acquiring personal stress management strategies, potentially enhancing health promotion at universities. However, larger, more diverse studies are needed to fully assess their feasibility and integration into university structures.

The OUTPAC cohort study evaluates the setup and implementation of a nationwide Danish initiative focused on the impact of structured outdoor physical activity (PA) on individuals with rheumatic diseases. This prospective cohort study includes more than 1600 participants, predominantly women (92%), with an average age of 65 years (range: 28-93). The cohort primarily consists of individuals with osteoarthritis (72%), rheumatoid arthritis (18%) and nonspecific lower back pain (13%). Volunteer instructors conducted interventions in outdoor settings, targeting strength, balance, physical capacity, mental health, and interaction with nature. Data collection involved questionnaires and physical tests in four primary outcome domains: quality of life, pain, physical function and activity, and mental health. Despite moderate pain (VAS mean: 48.3), high medication use (71%), and serious fatigue (54%), participants indicated having a good quality of life (EQ-5D-5L mean: 0.81) and average mental health (WHO-5 mean: 62.9). Baseline scores from physical tests showed results comparable to the general population aged 60-69 years. The OUTPAC project offers clinical insight into the implications of outdoor PA interventions on individuals with rheumatic disease while shedding light on the development and implementation of a large-scale nationwide outdoor PA intervention. Future analyses will examine short- and long-term changes and potential determinants.