International Journal of Environmental Research and Public Health最新文献

Integration of the community into health research through community-engaged research has proven to be an essential strategy for reducing health inequities. It brings significant benefits by addressing community health concerns and promoting active community participation in research. The Community Training Institute for Health Disparities (CTIHD) was established to support this integration based on Community-Based Participatory Research (CBPR) principles. The main objective of this paper is to report the CTIHD program's implementation, evaluation, and outcomes from the first two cohorts. The CTIHD recruited Hispanic community members (N = 54) to be trained in health disparities research and health promotion to foster Community-Academic Partnerships (CAPs) and develop community-led health promotion interventions. Evaluation measures included satisfaction, knowledge change, retention rate, completion rate, and project proposals (research and community health promotion plans). The retention and completion rates were 83% and 78%, respectively, with forty-two (n = 42) community trainees receiving the completion certification. Both cohorts demonstrated a significant increase in knowledge (p < 0.05), and overall satisfaction exceeded 90%. Outcomes include seven (7) community-academic partnerships, leading to the co-development of research proposals, three (3) of which received funding. Additionally, twenty-two (22) community health promotion plans were developed, with seven (7) implemented, impacting 224 individuals. Findings from this study suggest that the CTIHD effectively provided capacity building, promoted the formation of CAPs, and increased community-led health promotion interventions, thereby advancing health disparity research and community initiatives.

Many clinical sites shifted towards digital delivery of mental health services during the COVID-19 pandemic. There is still much to learn regarding tailoring digitally delivered interventions for trauma-affected populations. The current study examined the perceptions of Canadian mental health clinicians who provided digitally delivered psychotherapies utilized for trauma-affected populations. Specifically, we explored the shift to digital health use, what changed with this rapid shift, what needs, problems, and solutions arose, and important future considerations associated with delivering trauma-focused and adjunct treatments digitally. Survey data were collected from 12 Canadian mental health clinician participants. Surveys were adapted from the Alberta Quality Matrix of Health and Unified Theory of Acceptance and Use of Technology model. As a follow-up, the participants were invited to participate in either a semi-structured qualitative interview or focus group to further explore their perspectives on digitally delivered trauma-focused and adjunct therapies. Twenty-four clinician participants partook in an interview or focus group. The participants in this study supported the use of digitally delivered psychotherapies utilized for trauma-affected populations, sharing that these interventions appeared to offer similar quality of care to in-person delivery. Further research is required to address clinicians' concerns with digital delivery (e.g., patient safety) and identify other avenues in which digitally delivered psychotherapies utilized for trauma-affected populations can be engaged with and improved upon.

Human Immunodeficiency Virus (HIV) has disproportionately affected various population groups, including adolescents living with HIV (ALHIV). In many contexts, ALHIV have been reported to experience mental health issues following their HIV diagnosis. However, there is a limited understanding of the mental health issues faced by ALHIV in Indonesia and the various contributing factors globally. This study aimed to explore the mental health challenges and their contributing factors among Indonesian ALHIV. A qualitative design employing one-on-one in-depth interviews was used to collect data from ALHIV (n = 20) in Yogyakarta, Indonesia. Participants were recruited using the snowball sampling technique, beginning with the dissemination of study information sheets through a healthcare facility that provides HIV care services and via a WhatsApp group for adolescents living with HIV. The data were thematically analyzed, guided by a qualitative data analysis framework. The findings showed that ALHIV experienced a variety of mental health challenges upon learning of their HIV-positive status. Their mental health was also influenced by a range of family-related factors, stigma, and discrimination, which were also facilitated by their specific situations and settings, including living in a shared house with parents and siblings and school setting where they met and interacted with different peer groups on a daily basis. Family-related factors, including broken homes, family conflicts, lack of family support, and being orphans, negatively impacted their mental health. The awareness of perceived and anticipated stigma, and the experience of enacted stigma or discrimination, also contributed to the mental health challenges they faced. The findings indicate a pressing need for tailored and targeted HIV intervention programs and activities that support their mental health, reduce stigma, and promote HIV status disclosure in safe ways for ALHIV both within the study setting and beyond.

The trained heart adapts through geometric changes influenced by concentric and eccentric hypertrophy, depending on the predominance of the isometric or dynamic components of the exercise performed. Additionally, alterations in heart rhythm may occur due to increased vagal system activity. Cardiological evaluation with an electrocardiogram (ECG) aims to identify cardiac conditions that could temporarily or permanently disqualify an athlete from competition. This study sought to compare electrocardiographic findings in regular exercisers with those observed in athletes and to correlate these findings with training duration and load. A cross-sectional study was conducted with 154 participants divided into two groups: exercisers (EG) and athletes (AG). Data were collected on exercise type, weekly training time and practice duration. Each participant underwent a resting ECG, analyzed by two independent physicians, with a third review in case of disagreement. The Seattle criteria were applied to categorize ECG changes as physiological, borderline or abnormal. The findings revealed that 75% of athletes exhibited ECG changes, with left and/or right ventricular hypertrophy and incomplete right bundle branch block (IRBBB) being the most prevalent. Age (PR = 0.92; p = 0.004) and exercise duration (PR = 1.00; p = 0.004) significantly influenced the observed electrocardiographic changes. The majority of both regular exercisers and athletes displayed ECG alterations, with the prevalence increasing with age and training duration.

Changes in athletic identity have been documented after injury and other sport transitions in nomothetic investigations. Patterns of change in athletic identity after injury have not been examined systematically at the individual level. In the current study, secondary analyses were performed on two data sets (N = 43 and N = 80) in which athletic identity values were available for before and at least six months after anterior cruciate ligament (ACL) reconstruction. A stable pattern of athletic identity was most common (48-68% of participants), followed, respectively, by a decreasing pattern (19-45% of participants) and an increasing pattern (7-14% of participants) in both data sets, with a trend toward a decreasing pattern over time in the data set in which athletic identity values were available up to two years after surgery. Partial support was obtained for the claim that decreases in athletic identity after ACL surgery are related to postoperative perceptions of knee symptoms and function. The current intraindividual findings complement the results of nomothetic studies and suggest that although stability of athletic identity after sport injury seems to be the norm, changes in athletic identity are also common and should be considered in applied work with athletes who have sustained injuries.

Developing Age-Friendly Cities and Communities (AFCCs) is an increasingly popular policy response to supporting ageing populations. AFCC programmes rely on cross-sectoral collaboration, involving partnerships among diverse stakeholders working across sectors to address shared goals. However, there remains a limited understanding of what mechanisms and strategies drive collaboration among diverse actors within age-friendly cities. To address this gap, this empirical paper draws on examples from a comparative case study across Akita (Japan) and Manchester (UK), two cities with distinct demographic profiles but both with a longstanding commitment to the age-friendly approach. Case studies were created through a range of data collection methods, namely, a review of secondary data sources, semi-structured interviews with key stakeholders, and fieldwork in each city. Key insights from the case studies relating to the mobilisation of cross-sectoral collaboration were categorised into three themes: leadership and influencing, co-production, and place-based working. These mechanisms are not mutually exclusive; collaboration building through co-production and place-based working is essential to deliver age-friendly programmes, but these mechanisms rely on leadership and influence. Therefore, it is recommended that all three mechanisms be used to effectively mobilise cross-sectoral collaborations to collectively create AFCC and support healthy ageing.

This paper presents the results of the human biomonitoring of ten urinary OH-PAHs (hydroxylated polycyclic aromatic hydrocarbon) in a cohort of workers at an incinerator in Turin, Italy. Long-term exposure was assessed through repeated measurements at three time points: before the startup (T0), after 1 year (T1), and after 3 years (T2). Paired data were available for 26 subjects, seven administrative workers (AWs) and 19 plant workers (PWs). Short-term exposure was assessed by comparing start-end shift measurements. Due to the non-normal distribution of the data, the nonparametric Cuzick's test for trend and the Wilcoxon signed-rank test for paired samples were used. Neither the trend nor the T0-T2 comparison tests resulted in statistically significant outputs in the two groups (q-value > 0.05), even when controlling for smoking habits. In relation to PWs, some of the metabolites were higher at T2 with respect to T0, but no linear increase was found. Conversely, 1-OH-PYR (ng/g creatinine) showed lower median values at T1 (61.5) and T2 (67) compared to the baseline (151.3). Similarly, short-term comparisons yielded no significant results, with rather overlapping distributions of values. Overall, no significant increases in metabolite levels were detected as a result of occupational exposure in the incinerator workers considered. These findings align with previous results for metals and ambient air measurements.

Objective: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, however, have inequitable access to hereditary cancer risk assessment (HCRA) tools and information, further exacerbating disparities in cancer rates. Innovative communication strategies to promote community-based HCRA information have promise as a means encouraging optimal primary cancer screening among AAs. The current pilot study followed a participatory process where researchers engaged with a Community Advisory Board (CAB) to explore how Communication Asset Mapping (CAM) could assist lay health advisors with the dissemination of evidence-based HC/RA information within AA faith communities. Methods: The research team and CAB conducted exploratory community-engaged group discussions with residents (n = 21) guided by Communication Infrastructure Theory, and used a community-engaged mapping process to inform the development of a CAM dissemination strategy. Results: Through textual analysis, the following conclusions were reached: (1) optimal locations (e.g., community centers) within specified neighborhood networks should have representatives who are trusted ambassadors to assist with HCRA information dissemination; (2) trusted community member voices should fully represent the neighborhood network in the community-engagement mapping process; (3) well-known and frequented geographic locations should provide a true representation of participants' neighborhoods to create a robust health information network concerning HCRA. Conclusions: Community residents appreciated the engagement process; however, they felt that its impact was limited due to the lack of community voices within their neighborhoods to identify important communication resources within the network for optimal HCRA information dissemination. CAM, therefore, is an important public health strategy for the identification of trusted networks and useful communication resources within these networks. The strategy was also helpful in pinpointing people who could be critical communicators of emerging health information akin to HCRA.

The COVID-19 pandemic disrupted healthcare systems globally, potentially altering mortality trends for non-COVID-19 diseases, particularly in aging populations like Japan's. Assessing these impacts is essential for responsive healthcare planning. We analyzed Japanese vital registration mortality records from January 2018 to December 2021 for adults aged 25 and older, excluding COVID-19-related deaths. Data were stratified by sex and ICD-10 cause-of-death chapters. Poisson regression models assessed changes in mortality rates and trends, incorporating pandemic-related variables and interactions between time, age group, and the pandemic term. Among the 4,920,942 deaths analyzed, 2,456,750 occurred during the pandemic years. Significant sex-specific changes in mortality trends were observed. Women experienced increases in mortality rates and trends for endocrine, nutritional, and metabolic diseases; skin and subcutaneous tissue diseases; circulatory diseases; and genitourinary diseases, reversing some pre-pandemic declines. Men showed increases in mortality trends for endocrine, nutritional, and metabolic diseases and genitourinary diseases but no significant changes for skin or circulatory diseases. These findings indicate that the pandemic differentially affected mortality trends between sexes, with women experiencing broader increases across multiple disease categories. The COVID-19 pandemic was associated with significant changes in mortality trends for certain non-COVID-19 diseases in Japan, with notable sex differences. Increased mortality among women across multiple disease categories highlights the pandemic's indirect health impacts and underscores the need for sex-specific healthcare strategies in the post-pandemic era.

Caries and periodontitis affect a significant part of the global population. Regular oral hygiene, sugar restriction, and fluoride exposure are the main avenues for the maintenance of oral health, but the adjunctive use of prebiotics and probiotic bacteria has gained attention over the past decades. The microbial and clinical effects of these biological interventions have been thoroughly covered in systematic reviews. However, the combination of prebiotics and probiotics (synbiotics) may boost the clinical benefits, and postbiotics, being inanimate microorganisms, can, when added to oral hygiene products, offer a sustainable option. The aim of this narrative review was to summarize clinical trials on the adjunctive use of synbiotics and postbiotics in the prevention and management of dental caries, gingivitis, and periodontitis. We searched two databases (PubMed and Google Scholar) for relevant literature, and we identified 17 relevant papers, five on dental caries and 12 with periodontal endpoints. We found emerging evidence of low certainty that lozenges/tablets containing synbiotics or postbiotics could reduce caries incidence in preschool and schoolchildren in comparison with standard preventive care. The effect on adult patients with plaque-induced gingivitis was less consistent. For adults with periodontitis, the adjunctive use of synbiotic and postbiotic products seemed to enhance the outcome of conventional scaling and root planning. In conclusion, both dental caries and periodontitis are non-communicable diseases, closely associated with an unbalanced oral biofilm, and the application of microbial modulators, including synbiotics and postbiotics, display promising beneficial effects and warrant further research.