International Journal of Environmental Research and Public Health最新文献

Background: Hypertensive disorders of pregnancy (HDP) have significant implications for women's long-term health, including at least a twofold increased lifetime risk of cardiovascular disease (CVD). The Blood Pressure Postpartum (BP²) Study was a three-arm randomised trial evaluating follow-up and lifestyle behaviour change strategies during the first year after HDP. Methods: This qualitative sub-study, embedded within the BP² Study, explored women's experiences of life in the first year following HDP. Semi-structured telephone interviews were conducted with 34 women, approximately 10-12 months postpartum. Interviews were transcribed verbatim and a thematic analysis was undertaken. Results: Participants reflected on their experiences post-HDP; three major themes were identified: Navigating life with a newborn, The value of support, and Processing and Moving forward. Some women felt informed and empowered to make positive lifestyle changes; others were still processing their HDP experience and/or feeling overwhelmed by the demands of early motherhood. Responses were influenced by their HDP experience, available support, prior experience with healthy behaviours, and financial stability. Conclusions: The findings highlight that postpartum women who experienced HDP face unique challenges, including physical recovery, emotional processing, and intensive infant care. It often takes time for these women to begin prioritising their own health, as they navigate these challenges. The insights generated from women's experiences suggest that flexible, accessible, and individually tailored support may facilitate postpartum health, promote lifestyle change, and help reduce long-term CVD risk.

The One Health framework highlights the interconnectedness of human, animal, and environmental health, requiring interdisciplinary and multisectoral collaboration to address complex global health challenges. This scoping review protocol aims to guide the systematic mapping on how studies and policy initiatives have incorporated socioecological interconnections within the One Health paradigm, following the Joanna Briggs Institute guidance and the PRISMA Scr checklist. The experimental design includes searches in PubMed, Scopus, Web of Science, LILACS, Health Systems Evidence, Social Systems Evidence, and Google Scholar for the period from 2004 to 2025. The strategy, developed with librarian support and peer reviewed, includes terms in English, Portuguese, and Spanish. Pilot searches retrieved 5333 PubMed and 470 LILACS records. Eligible documents must explicitly present two or more of the six One Health dimensions: policies to strengthen health systems; antimicrobial resistance; food safety; environmental health; emerging and re-emerging zoonotic epidemics and pandemics; endemic zoonotic, neglected tropical and vector-borne diseases. A standardized tool was developed for data extraction, synthesizing in narrative, tabular, and graphical formats. The protocol's utilization will provide comprehensive mapping of practices and policies, identifying achievements, barriers, and knowledge gaps to inform future strategies and strengthen global health governance.

Health equity and financial inclusion (FI) are at the core of the Sustainable Development Goals, yet their intersection remains critically under-studied. This bibliometric study maps this emergent and fragmented field by analyzing 24,140 publications from Scopus, PubMed, Web of Science, and Lens.org over five decades. Employing co-citation and co-word analysis via VOSviewer, chart research trends, governance frameworks, and policy linkages were systematically presented. The analysis reveals that less than 0.3% of the identified literature explicitly bridges financial inclusion with health outcomes, and direct investigations into health equity are virtually absent. Despite recent growth, fundamental gaps persist, including a lack of empirical studies on digital financial tools in low- and middle-income countries (LMIC) health contexts and insufficient focus on disadvantaged populations. As the first comprehensive empirical mapping of this nexus, this study underscores the urgency for scholarly and policy action to strategically leverage financial instruments for equitable healthcare access. The findings provide a foundational map and a structured agenda to consolidate this nascent field.

Exposure to plant protection products (pesticides) is common among agricultural workers and may represent an underrecognized cause of mucocutaneous disease. We conducted a descriptive cross-sectional survey in agricultural communities in southern Thailand (August-November 2025) to estimate the prevalence, clinical characteristics, and dermatology-specific quality-of-life impact of pesticide-attributed symptoms. Agricultural workers with pesticide use or exposure within the preceding 12 months were recruited via convenience sampling; participants provided consent and completed standardized interviewer-administered questionnaires assessing demographics, pesticide exposure history and application practices, personal protective equipment (PPE) use, self-reported cutaneous and mucosal symptoms (ocular and oral/nasal), and the Dermatology Life Quality Index (DLQI). Of the 354 eligible individuals, 228 participated in the study, and 226 were included in the analyses. The median age was 54 years (interquartile range [IQR], 15), and 82.7% were male. Overall, 14.6% reported pesticide-attributed cutaneous symptoms, 5.3% reported ocular mucosal symptoms, and 0.4% reported oral/nasal mucosal symptoms. Cutaneous manifestations were predominantly symptoms occurring after exposure, with pruritic, erythematous eruptions affecting the arms and hands that typically resolved within 1-7 days after cessation of exposure. Among symptomatic participants, the median DLQI was 0.5 (IQR 3.0); however, DLQI scores were significantly higher among participants who reported pesticide-attributed cutaneous symptoms (p < 0.001) and ocular symptoms (p < 0.001). These findings suggest that pesticide-associated mucocutaneous effects are generally mild yet clinically meaningful, underscoring the need to strengthen PPE training, risk communication, and occupational health surveillance in agricultural settings.

Background: Personal protective measures help prevent infection and disease transmission during health crises such as Coronavirus disease 2019 (COVID-19). Populations facing barriers to adhering to these measures are more vulnerable to the health crisis. This study investigated the association of social drivers of health (SDoH), self-efficacy, and adverse substance use behavior changes with ability to practice COVID-19 personal protective behaviors among persons who inject drugs (PWID) with hepatitis C virus (HCV) infection history.

Methods: This study used the Hepatitis C Real Options (HERO) study's COVID-19 survey data (n = 157). The association of inability to practice COVID-19 personal protective behaviors (hand washing, social distancing, etc.) with (a) SDoH difficulties (employment, housing, etc.); (b) adverse substance use behavior change (overdose, injecting behavior, etc.); and (c) self-efficacy was tested using logistic regression.

Results: Inability to practice any personal protective behaviors was more likely among those experiencing any vs. no SDoH difficulties [adjusted odds ratio (aOR) (95% confidence interval (CI))] = 4.57 (1.57, 16.40); p = 0.003] but less likely for those with higher overall self-efficacy [aOR (95% CI) = 0.55 (0.32, 0.93); p = 0.025] and self-efficacy for setting goals [aOR (95% CI) = 0.63 (0.40, 0.96); p = 0.031]. The association between adverse substance use behavior changes and the outcome was not significant.

Conclusions: Greater SDoH difficulties and lower self-efficacy were associated with greater inability to practice COVID-19 personal protective behaviors. Interventions to meet SDoH-related challenges and increase self-efficacy could help encourage practice of personal protective behaviors and economically reduce disease burden during health crises.

Refugee-serving primary health centres/clinics (PHCs) provide culturally safe, integrated care for refugee children, yet little is known about how their health conditions and outcomes are assessed. This scoping review examines the current literature on the health conditions and outcomes of refugee children aged 0-5 years and how they are measured in refugee-serving PHCs in Canada. In partnership with the New Canadians Health Centre and guided by Joanna Briggs Institute methodological guidelines, we systematically searched Medline, CINAHL, Scopus, and Embase. Included studies focused on refugee children in Canada and reported health conditions, outcomes, and their measurements within PHCs. Twenty-five studies (2008-2024) met the inclusion criteria, most from Ontario (n = 11), followed by Alberta and Saskatchewan (n = 4 each). Reported health conditions or outcomes (n = 24) spanned the physical (n = 19), developmental, and mental health domains (n = 5). Communicable (e.g., gastrointestinal infections, hepatitis) and non-communicable conditions (e.g., malnutrition, vitamin D deficiency) were mostly reported. Although some standardized approaches were used, substantial variability exists across provinces and conditions or outcomes measured. Findings reveal a disproportionate focus on physical health and notable variability and gaps in child health measures, limited cultural adaptation, and lack of longitudinal data. Standardized, culturally responsive, and age-appropriate measurement approaches are needed to enhance health equity and inform evidence-based policy for refugee children in Canada.

Rates of alcohol use and exposure to adverse childhood experiences (ACEs) are elevated among youth in the legal system (YILS) compared to their non-legally involved peers. Exposure to ACEs has been associated with later alcohol use and delinquency, and YILS often engage in delinquent behavior while under the influence of alcohol. The associations between ACEs, alcohol use, and delinquency among YILS are complex and multidirectional; research has yet to explore how these experiences and behaviors influence each other over time, or whether they differ based upon the reason for legal system involvement (status or delinquent petition). This study examined whether YILS' ACEs were prospectively associated with self-reported delinquent behaviors, and whether self-reported recent alcohol use was an explanatory mechanism for this association. Multigroup mediation analyses were utilized to examine if these pathways differed based on youth's court petition type. Results indicated that YILS report high rates of ACEs. Frequency of recent alcohol use mediated the associations between ACEs and subsequent delinquency for youth with a delinquent, but not status, petition. Concurrent assessment of trauma exposure and alcohol use when youth first enter the legal system is imperative to inform early intervention needs to reduce the likelihood of continued system involvement.

Environmental health practice is facing an identity crisis. Not because our work lacks impact, but because our work lacks a coherent narrative. Environmental health practice needs a brand that speaks our truth and secures our place in the future of health protection. The brand of environmental health practice must be more than a label. It needs to be an asset that our industry can leverage to build identity, recognisability, credibility, relevance and a unique value proposition. A strong brand will allow us to express the unique impact of our role and thus, it needs to capture the most central component of our work that unmistakably differentiates it from anything else. A rapid review of the literature was performed using systematic methods to discern a coherent narrative capturing the essence of environmental health practice. Through application of a critical lens shaped through professional experience, a novel narrative was synthesized of the key defining component of our work. This narrative establishes the work of environmental health practitioners as a unique value proposition and forms the basis for a brand that we can fearlessly project and reverberate. It represents the makings for an unmistakable identity. The future of environmental health practice depends on environmental health practitioners establishing a brand by building awareness of the unique value of our work.

Background: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2020.

Methods: This is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00-O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death.

Results: A total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to white women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions.

Conclusions: Maternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare.

This study aimed to test the factorial structure of the Eating Motivation Survey (TEMS) using Confirmatory Factor Analysis (CFA) in a sample of 632 university students from the Western Brazilian Amazon. A cross-sectional study was conducted between December 2022 and April 2023 with participants of both sexes, aged 18 or older. In addition to CFA, psychometric analyses were performed, and a Structural Equation Model was developed to examine the relationships between individual characteristics (age, sex, and Body Mass Index (BMI)) and the TEMS constructs. The results showed that 58.3% of participants were female, with a mean age of 25.29 years. The CFA supported an eight-factor model (health, natural concerns, socialization, price, visual appeal, weight control, emotional control, and social image) with 24 items, presenting good validity and reliability indices. Older individuals and those with lower BMIs prioritized health, natural concerns, and weight control, while younger participants, women, and those with higher BMIs were more influenced by emotional control. The findings contribute to understanding eating motivations in culturally diverse contexts and may support strategies aimed at promoting healthier dietary behaviors and preventing diet-related chronic diseases.