International Journal of Environmental Research and Public Health最新文献

The purpose of this study was to explore female farmers' perspectives on barriers to engaging with resources for physical and mental healthcare faced by agriculture producers in the state of Georgia. In-depth interviews were conducted with female farm owners and managers (n = 16) across the state. Interviews were recorded and transcribed, and researchers coded interviews separately before thematic analysis was used to identify common themes. Three primary themes were identified: (i) formal healthcare challenges, (ii) stigma, and (iii) cultural norms. Formal healthcare challenges included time constraints, healthcare costs, and a lack of cultural competence from healthcare providers. Both community and self-stigma were identified as barriers to engaging with mental health resources. Cultural norms that acted as a barrier to care included the prioritization of farm operations, self-reliance, pride, and the minimization of health concerns. Interviewees identified gender differences in the impact of stigma and cultural norms, reporting that these sociocultural barriers were more prominent among older, male producers. Central to many of these barriers is the concept of 'farm identity', where farmers' commitment to their operations consistently trumped concerns about physical or mental health. Future efforts to improve health outcomes among farmers should utilize the concept of farm identity as a guide for tailoring interventions and improving cultural competence among rural healthcare providers.

The convergence among biomechanics, motor development, and wearable technology redefines our understanding of human movement. These technologies allow for the continuous monitoring of motor development and the state of motor abilities from infancy to old age, enabling early and personalized interventions to promote healthy motor skills. For athletes, they offer valuable insights to optimize technique and prevent injuries, while in old age, they help maintain mobility and prevent falls. Integration with artificial intelligence further extends these capabilities, enabling sophisticated data analysis. Wearable technology is transforming the way we approach motor development and maintenance of motor skills, offering unprecedented possibilities for improving health, performance, and quality of life at every stage of life. The promising future of these technologies paves the way for an era of more personalized and effective healthcare, driven by innovation and interdisciplinary collaboration.

Background: Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years).

Methods: Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators.

Results: Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both).

Conclusions: Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was one of the earliest healthcare systems globally to implement the International Classification of Diseases, Eleventh Revision (ICD-11) across its 140 clinics serving 5.9 million Palestine refugees. This paper discusses the integration of ICD-11 into UNRWA's cloud-based electronic medical record (EMR) system, identifying both the barriers and facilitators involved and analyzing trends in clinical documentation and healthcare utilization. The key challenges included data privacy provisions, integration into a coordinated care model, complex classification schema for primary care settings, frequent staff turnover, and limited data analysis capabilities. Conversely, facilitators included physician-tailored training and on-site support, system compatibility, a multidisciplinary team approach, policy support from UNRWA and the World Health Organization (WHO), and leadership commitment and effective change management. Medical officers (MOs) using ICD-11 reported greater satisfaction with the system's capabilities in managing and visualizing health information. This article contributes to the discourse on health data management in complex humanitarian settings, offering insights into the benefits and challenges of implementing advanced classification systems like ICD-11. Future research should explore longitudinal impacts and further integration with global health systems, ensuring that the advancements in classification continue to support the overarching goal of health equity and access in vulnerable and hard-to-reach populations.

Globally, the COVID-19 pandemic has presented serious mental health challenges for healthcare professionals. This study investigated the mental health, mental fatigue, quality of life, and stigma of social discrimination among healthcare workers in the United Arab Emirates (UAE) during the COVID-19 pandemic. A correlational, cross-sectional, multi-centric design was employed to collect data from 1383 healthcare workers across various healthcare settings. Participants were recruited using combined cluster and purposive sampling techniques. Standardized questionnaires, including the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ), the Mental Fatigue Scale (MFS), the Social Discrimination Scale-Stigma Subscale (SDS), and the WHO Quality of Life Questionnaire-Brief (WHOQOL-BREF), were administered to assess the study variables. The results indicated significant mental health impacts, with high average scores for post-traumatic stress disorder (PTSD) (9.37 ± 6.74) and positive coping by inner strengths (17.63 ± 5.72). Mental fatigue was prevalent (8.15 ± 8.62), and stigma of social discrimination scored notably (23.83 ± 7.46). Quality of life was the highest in the social domain (65.38 ± 24.58). Significant correlations were observed between mental health subscales, mental fatigue, and quality of life domains. These findings highlight the critical need for targeted mental health support programs, improved social support networks, and personalized interventions to mitigate the mental health challenges faced by healthcare workers. Healthcare organizations can guarantee a resilient workforce that can handle future health crises by giving mental health resources and support systems top priority.

In Mozambique, about 500,000 cases of diarrhoea were caused by foodborne pathogens in 2018. A review of the epidemiology of diarrhoea in children under five showed a high disease burden. This study aimed to identify Diarrhoeagenic Escherichia coli (DEC) and Salmonella spp. contamination of food and water in urban and rural areas of Maputo consumed by children under five with diarrhoea. One hundred and eighty-six children with diarrhoea were selected from Primeiro de Maio and Marracuene Health Care Centres from the Kamaxakeni and Marracuene districts, respectively. Food (n = 167) and water (n = 100) samples were collected in children's households for diarrhoeagenic bacterial identification. Interviews were conducted using a semi-structured questionnaire to collect data about demographics and foods consumed a week before the children's diarrhoea episodes. The prevalence of both DEC and Salmonella spp. was 9.8% in food and 5.4% in water samples. DEC was most prevalent in cereals (urban = 2.8%; rural = 2.4%) and water samples (urban = 1.4%; rural = 3.3%). Salmonella spp. was mainly detected in cereals (urban = 0.7%; rural = 0.8%). Diarrhoeagenic pathogens were associated with the type of food frequently consumed by children under five years with diarrhoea (infant formula, fruit puree, ready-to-eat meals, and bottled water), while the association with demographics was absent. We found that the infant foods consumed by children with diarrhoea are associated with DEC and Salmonella spp., and the prevalence of these contaminants is higher in the rural (8.9%) than in the urban area (6.3%), showing the need for caregiver education on food handling practices.

In China, an emerging social issue involves a subset of rural women who, because of family and culture, become inadvertently matched up with and married to closeted men who have sex with men (MSM). These women-referred to as Tongqi-often discover they are in a loveless marriage, but any effort to change their situation results in intense backlash, discrimination, and stigma from families, village communities, and even government and healthcare institutions. This study explores the experiences of Tongqi, examining the influence of social interaction, community relationships, and macrostructural factors that coalesce to create an environment of chronic enacted stigma. In-depth interviews were conducted with 59 rural Tongqi, 11 of whom contracted human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) from their spouses. The findings reveal the significant role of extended kinship networks and macrostructural elements, such as hukou (household registration) and government officers, as well as village-level lineage structures. Informant data highlights how lineage relationships, interwoven with gender practices, contribute to the enacted stigma impacting the physical and psychological health of Tongqi. Tongqi report psychological effects such as an array of symptoms reflecting post-traumatic stress, chronic depression, and attempted suicide. Tongqi also report adverse physical health concerns involving reproductive health, unwanted pregnancies, sexually transmitted infections (STIs), and pregnancy complications. These findings helped produce possible policy recommendations to address the most pressing issues faced by Tongqi.

For Indigenous populations, one of the most recognized acts of historical trauma has come from boarding schools. These institutions were established by federal and state governments to forcibly assimilate Indigenous children into foreign cultures through spiritual, physical, and sexual abuse and through the destruction of critical connections to land, family, and tribal community. This literature review focuses on the impact of one of the oldest orphanages, asylums, and Indigenous residential boarding schools in the United States. The paper shares perspectives on national and international parallels of residential schools, land, truth and reconciliation, social justice, and the reconnection of resiliency-based Indigenous Knowledge towards ancestral strength, reclamation, survivorship, and cultural continuance.

Background: Chronic exposure to severe hypoxia causes an increase in hematocrit (Hct) and hemoglobin concentration ([Hb]), which can lead to excessive erythrocytosis (EE) and impact physical performance. This work aims to determine the differences in the six-minute walking test (6MWT) between EE and healthy subjects residing at more than 5000 m.

Methods: A prospective, cross-sectional study was performed on 71 men (36 healthy and 25 suffering from EE) living in La Rinconada, Peru (5100 m). Basal levels of [Hb] and Hct were obtained. All the subjects performed the 6MWT, and distance reached, vital signs, dyspnea, and fatigue (Borg scale) at the end of the test were recorded.

Results: The average [Hb] and Hct levels in the control group were 18.7 ± 1.2 g/dL and 60.4 ± 7.1%, respectively, contrasting with EE subjects, who showed 23.4 ± 1.6 g/dL and 73.6 ± 5.9% (p < 0.001). However, no statistically significant differences were observed in BMI or other anthropometric parameters. At the end of the 6MWT, the distance traveled and vital constants were similar between both groups, except for arterial oxygen saturation, which was consistently lower in subjects with EE throughout the test.

Conclusion: EE does not significantly affect 6MWT performance at high altitudes, nor the hemodynamic control during moderate aerobic exercise of subjects who live permanently in a severely hypoxic environment.

Healthcare personnel must deal with two problems of growing importance: violence in the workplace and the loss of work ability due to the aging of the workforce. Our objective was to evaluate, with a two-wave perspective design, the relationships of work ability, social support, and occupational stress with workplace violence in nurses. In an Italian public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analyzed the relationship between this indicator and the violence experienced in the previous and following years. A total of 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR = 0.94 CI95% = 0.90; 0.98 p < 0.01) and in the following year (OR = 0.88 CI95% = 0.84; 0.92 p < 0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR = 3.65 CI95% = 1.90; 7.03 in the previous year, OR = 3.54 CI95% = 1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental states can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.