International Journal of Environmental Research and Public Health最新文献

Academic adaptation is crucial for the success and well-being of international students, especially in rural areas where cultural and social support resources may be limited. This study aimed to identify predictors of academic adaptation among international students in the rural southern United States, focusing on social support, cultural integration, alcohol use, and acculturative stress. A cross-sectional study was conducted with 141 international students from two universities: the University of Mississippi/Oxford campus and the University of Alabama. Data were collected through a web-based survey using validated scales to measure cultural integration, acculturative stress, social support, alcohol use, and academic adaptation. Pearson correlation and multiple linear regression analyses were performed to identify significant predictors of academic adaptation. The sample consisted of 54.6% male and 45.4% female students, with a mean age of 29.4 years. The majority were graduate students (89.4%), with the majority being funded by graduate teaching or research assistantships (78.7%). Correlation analyses showed that social support was positively correlated with academic adaptation (r = 0.62, p < 0.01). Also, cultural integration was positively corelated with academic adaptation (r = 0.33, p < 0.001). However, acculturative stress was negatively correlated with academic adaptation (r = -0.20, p < 0.05). The fully adjusted regression analyses identified social support as a positive predictor of academic adaptation among international students in rural U.S. universities. The model demonstrated that each unit increase in the social support score was associated with a 0.61 increase in the academic adaptation score (95% CI [0.44, 0.79], p < 0.001). These findings highlight the need for tailored support programs addressing the unique challenges faced by this population to enhance their academic success and overall well-being.

This study's goal was to evaluate associations of human exposure to unfiltered tap water during the Flint water crisis (FWC) with perceived harm to pets from exposure to contaminated water. We also explored the associations of perceived pet harm with participants' self-reported general, physical, and mental health, as well as quality of life. Adult (n = 3264) pet owners from a public health registry reported unfiltered tap water exposure, perceived pet health, and general health/quality of life at baseline, as well as health/quality of life 1 year later (n = 1172). Using frequencies, percentages, and odds ratios, we evaluated associations of unfiltered tap water consumption with perceived pet health (cross-sectional) and perceived pet health with general health and quality of life (cross-sectional and longitudinal). Daily unfiltered tap water drinkers were 3.12 (95% CI: 2.33-4.23) times more likely to report the FWC had made their pet ill compared to participants who never drank unfiltered water. Participants who reported Flint water made their pet ill had approximately a two-fold increase in odds of reporting poor/fair across all four health/quality-of-life measures compared to those who did not. Both animals and humans were exposed and impacted by the FWC. This study supports the interconnectedness between human and animal health, especially regarding environmental disaster exposure and outcomes.

In this study, the aim was to comparatively examine the perception of risk for developing severe illness or complications due to COVID-19 among the general population and socially vulnerable populations in Brazil, focusing on uncovering the associated factors that disproportionately impacted people experiencing homelessness and slum dwellers. This study is part of the project "Social Thermometer-COVID-19 in Brazil", which employed a hybrid approach, combining a national online survey with field research in state capitals and the Federal District. Data collection took place from August 2020 to October 2023, and the data were analyzed using descriptive statistics and logistic regression. A total of 5094 participants were included in this study, with 2363 from the general population and 2731 from the socially vulnerable population. Among the general population, the majority of participants were women, white individuals, those with higher incomes, formal employment, and higher education levels. Concerning the vulnerable population, most were men, Black individuals, those with lower incomes, unemployment, and lower education levels. It was observed that 87% of the general population perceived a risk of severe COVID-19, compared to 74% of the vulnerable population. Slum dwellers who received emergency aid (OR_a = 1.39; 95% CI: 1.02-1.91), adhered to mask-wearing practices (OR_a = 1.93; 95% CI: 1.39-2.66), used COVID-19-related medications (ORa = 2.13; 95% CI: 1.31-3. 64), and those with pre-existing conditions, such as high blood pressure (OR_a = 1.86; 95% CI: 1.20-2.98), demonstrated a heightened perception of risk for severe COVID-19 complications. Among the homeless population, individuals who wore masks (OR_a = 1.67; 95% CI: 1.26-2.20 and had been vaccinated (OR_a = 1.44; 95% CI: 1.04-1.98) were also more likely to perceive a high risk. In conclusion, in this study, significant disparities are revealed in the perception of COVID-19 risk between the general and socially vulnerable populations in Brazil. Factors such as receiving emergency aid, adherence to mask-wearing, use of COVID-19-related medications, and pre-existing health conditions were associated with increased risk perception. Despite facing greater socioeconomic challenges, vulnerable groups, particularly those experiencing homelessness and slum dwellers, showed a lower perception of the risk for severe COVID-19 complications.

Mild traumatic brain injury (mTBI) is commonly undiagnosed, delaying treatment and recovery. Approximately 80% of mTBIs in older adults stem from falls, yet the predictive factors remain unclear. This systematic review aimed to examine the risk factors for fall-related mTBIs among older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol and the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed (Prospero ID: CRD42023377847). The scope included prospective studies analyzing the risk factors for fall-related mTBIs in adults ≥ 60 years. The primary outcome measure was the relative risk for fall-related mTBIs, and the secondary outcomes were fall rate, total falls, and faller/non-faller count among those with and without an mTBI. CINAHL Plus, Health Source: Nursing Academic Edition, Nursing and Allied Health Database, Medline via PubMed, SPORTDiscus, and Web of Science were searched on 4 November 2022 and 31 May 2024. Additional electronic searches were conducted. Two authors planned to screen the articles and assess the quality and risk of bias, with a third author adjudicating disagreements. Results were to be presented in a narrative synthesis. The database search yielded 434 records; 410 titles and abstracts were screened after deduplication, and 71 reports underwent a full-text review. No prospective observational studies were eligible because they did not fulfil the following: (1) focus on an mTBI (46 records); (2) exclusively assess individuals aged ≥60 (20 records); or (3) examine falls (5 records). Given the devastating consequences of fall-related mTBIs among older adults, there is an urgent need to identify the risk factors to improve screening and intervention.

This study examined the sequential mediating roles of anxiety and depressive symptoms in the effect of school bullying victimization on suicidal ideation. This study utilized a convenience sample of college students across South Korea, and an online survey was conducted. This quantitative research analyzed data collected from 1037 participants. The sample consisted of an equal gender distribution, with a mean age of 23.65 years (range: 18-30). Additionally, 30% of participants reported a household income of four million won or less (approximately USD $3076). More than half of the participants' parents had attained a college education or higher. Also, multiple mediation analyses were conducted to examine whether anxiety and depressive symptoms mediated the relationship between school bullying victimization and suicidal ideation. In the results, multiple mediation analyses showed that school bullying victimization does not have a direct effect on suicidal ideation. On the other hand, school bullying victimization has an indirect effect on suicidal ideation through anxiety and depressive symptoms, controlling for covariates. Based on these research results, implications for school bullying prevention and intervention were discussed.

Children's tobacco smoke exposure (CTSE) is a public health concern, particularly in low-income and minority communities. Interventions to reduce CTSE have had modest success, and so research must identify mechanisms to improve intervention efficacy. This study investigated mediators of CTSE reduction in an intervention designed to facilitate CTSE protection and maternal smoking abstinence. We analyzed data from the Babies Living Safe and Smokefree (BLiSS) trial, which evaluated the efficacy of a multilevel behavioral smoking intervention initiated in community clinics serving low-income mothers. We estimated direct and indirect effects to evaluate the role of two mediators of the intervention on CTSE at post-intervention follow-up: mothers' skills in managing smoking urges and their protective behaviors to shield children from TSE. CTSE was measured using mothers' reports and child cotinine (a CTSE biomarker). The BLiSS intervention was linked to statistically significant lower longitudinal reported CTSE directly and indirectly by increasing mothers' urge management skills and CTSE protection behaviors (p-values < 0.05). The intervention was not directly linked to child cotinine. However, evidence of a statistically significant indirect effect (p-value = 0.028) suggested that the intervention reduced longitudinal child cotinine levels by increasing CTSE protection behaviors. Two non-program factors, nicotine dependence and total smokers in the home, also increased child cotinine and reported CTSE (p-values < 0.001). Interventions that improve maternal smokers' urge management skills and CTSE protections can mitigate CTSE. In addition, it is essential to target barriers to CTSE reduction, such as nicotine dependence levels and the presence of other smokers in the home.

African American women living in public housing carry a heavy burden of cardiovascular disease. Eating a heart-healthy diet is crucial to achieving optimal heart health, yet this health disparity population encounters major barriers to healthy eating. This study explored their perceptions of healthy eating and cardiovascular disease. Participants were recruited from public housing in a mid-sized city. Six 2-h focus groups with 32 women were conducted. Focus groups were analyzed using deductive coding. The major focus group findings focused on a limited access to affordable healthy foods. Participants also discussed the use of cost control measures to maximize household food budgets to access healthy foods and the ability to eat healthily. Our findings indicate that food insecurity persists for the populations most at-risk for cardiovascular disease. Plant-based diets may offer a culturally sensitive, innovative, and sustainable approach to reducing heart health risks, alleviating food insecurity, and promoting optimal health outcomes.

Endometrial cancer (EC) is a growing public health concern. This secondary data study of a case series leveraged existing samples and data to explore the potential link between exposure to heavy metals/essential elements and stage of EC. We analyzed urine samples from women with EC, measuring levels of toxic metals (cadmium, mercury, and lead) and essential elements (zinc and copper). Our findings revealed that higher levels of mercury, cadmium, and lead are associated with more advanced EC stages. Conversely, zinc showed a protective effect, potentially mitigating EC stage progression. Copper levels did not show a clear association with EC stage. These results highlight the potential impact of environmental exposures on EC stage and the crucial need for advanced statistical methods to understand the combined effects of these pollutants on health and the need for public health interventions. Further research is needed to explore the mechanisms by which these metals influence EC stage and long-term outcomes.

Latin American upper-middle-income countries (LAUMICs) face significant challenges in ensuring equitable access to sexual and reproductive health (SRH) for adolescents due to socioeconomic inequalities, migration, and historical violence. This systematic review examines the barriers and facilitators to sexual and reproductive health access for adolescent girls (≤19 years old) in vulnerable situations across Latin America. Using six databases, 391 articles were reviewed; 10 met the inclusion criteria, and 10 more were included through backward search, resulting in 20 analyzed studies. Structural barriers such as economic, regulatory, and institutional constraints were found to restrict SRH access, exacerbated by social stigma and negative narratives, especially in cases involving sexual violence and clandestine abortions. Facilitators included intersectoral collaboration, preventive education, and community networks, which improved access to and the quality of services for vulnerable populations. The findings emphasize the need for sustainable strategies that address structural inequalities and stigma while strengthening health systems, and intersectoral cooperation. Comprehensive, culturally tailored education and clear regulatory frameworks are essential to achieving equitable and sustainable SRH services. These insights offer practical guidance for public policy and program design in LAUMICs, particularly for addressing the needs of marginalized adolescent populations.

Background: Cancer patients are often unaware of their exact diagnosis, stage of disease, and prognosis. This affects their treatment, quality of life, and end-of-life decisions. In this study, patients with skin and urological cancers were asked about their level of knowledge about their disease and its treatment in order to highlight this problem and describe possible effects on end-of-life decisions.

Methods: 150 patients with advanced skin cancer and 88 patients with advanced urological cancer were interviewed using a structured questionnaire at a German university hospital. Descriptive and statistical analysis of the data were performed. The significance level was set at alpha ≤ 0.05.

Results: 67% of skin cancer patients could not state their exact stage. Of these, younger patients (<60 y) were more likely to state their stage correctly (p = 0.017). All of those patients knew about their therapy. A total of 56 patients had distant and 143 had local metastasis. The majority was aware of that (84%, 78%). Also, 95% of the urological cancer patients stated that they knew their stage of disease, but not a single patient could tell it correctly. All urological patients knew about the presence of metastasis. A total of 30% of urological cancer patients were unaware of their tumor therapy, and one patient stated that he did not receive any treatment, even though he did. The majority of patients could not correctly name their exact therapy.

Conclusions: In the patients observed, it was found that many of them were unaware of their stage of disease, which can have a huge impact on their end-of-life decisions, such as the type of treatment they want. Many patients were also unaware of their own treatment. There is a risk that false hopes of cure may be attached to therapies and that, as a result, patients may be less likely to opt for palliative care with a focus on maintaining quality of life.