International Journal of Environmental Research and Public Health最新文献

People living in rural communities are typically underserved by public transportation services and face challenges in accessing healthcare, jobs, stores, and other destinations. Understanding the lived experiences of people who use public transportation in rural communities can help to inform a more equitable transportation system. This qualitative study gathered the perspectives of community health center employees about the public bus system for Hawai'i Island, a rural county in the United States. Using a community-engaged research approach, the evaluation team interviewed 10 employees through either in-person small group interviews or online individual interviews between April and July 2023. Transcripts were coded and analyzed using a thematic analysis approach. While all study participants were selected for their interest in commuting to work by bus, most believed the bus was not a reliable or convenient option. Participants shared their experiences about not being able to rely on the bus schedule, feeling unsafe while walking to bus stops or waiting for the bus, and other barriers to using the bus system. Participants also shared their insights about how a reliable bus system would benefit community health center patients who needed transportation to more than just their medical appointments, but also to places like pharmacies, laboratory services, and grocery stores. These findings can be used to initiate discussions around the ways that community health centers can further address transportation as a social determinant of health and inform transportation providers about how to best plan and invest in transportation infrastructure and services to meet the needs of rural populations.

Integrating physical activity into daily routines through walking and cycling supports health while promoting sustainable mobility. This assumption aligns with SDGs 3, 5 and 11. This study assessed the feasibility and health impacts of cycling within a university setting. As part of the UCicletas program at Coimbra University, sixteen participants (8 males, 8 females) used conventional or pedal-assist bicycles for eight weeks. Descriptive analyses, t-tests, and Spearman correlations were applied to anthropometric and cardiorespiratory measurements collected before and after the intervention. Weekly cycling distance was obtained through self-reported odometer values. After eight weeks, notable health improvements were observed. Body fat decreased by 1.8% overall, with a significant reduction in females (p < 0.05). VO_2max increased by 13.79% in males (p = 0.02) and 12.21% in females (p = 0.03). The Ruffier Index decreased by 18.87% in males (p < 0.05) and 14.73% in females (p = 0.03). Gender differences were evident in correlations: male BMI showed a strong negative association with respiratory recovery (ρ = -0.867, p = 0.005), whereas the female association was weak (ρ = 0.371). Correlations between cycling distance and health outcomes were weak and non-significant. Overall, the findings confirm that modest daily cycling improves health outcomes.

We assessed the prevalence of three helminthic zoonoses-echinococcosis, fasciolosis and the taeniosis/cysticercosis complex-among residents of the Chucuito Health Network (Puno Health Region, Peru) over four years (2018-2021). Sera (n = 910) were analysed by ELISA to detect pathogen-specific antibodies, following national protocols. Echinococcosis predominated, whereas fasciolosis and taeniosis/cysticercosis occurred at comparatively low levels. Prevalence ranged from 4.4-9.2% for echinococcosis, 1.1-4.9% for fasciolosis, and 1.1-2.7% for taeniosis/cysticercosis across the four years. Prevalence varied significantly between years, with a notable upsurge in echinococcosis in 2021. These findings underscore the need for integrated control and prevention measures grounded in a One Health framework that recognises the interconnections between human, animal and environmental health. Priority actions include strengthened health education programmes, improved hygiene and sanitation practices, and enhanced rural health infrastructure, alongside coordinated epidemiological surveillance and environmental management. Such measures are essential to mitigate the burden of zoonotic disease in vulnerable high-Andean communities.

Vector-borne diseases are strongly influenced by climate, yet the magnitude and temporal variability of climate-disease relationships remain poorly quantified. Outbreaks occur abruptly, and responses are typically delayed, underscoring the need for predictive tools that can support proactive interventions. This study applies Temporal Fusion Transformers (TFTs) to long-term, high-resolution climate datasets and to weekly malaria and dengue case records from South Africa and Vietnam to assess predictive performance and identify key environmental drivers. The models incorporated diverse climatic predictors and large-scale climate indices and were trained using multi-horizon forecasting with novel loss functions and physics-based constraints. The best malaria model achieved an R² of 0.95 and an MAE of 4.98, while leading dengue models reached R² values up to 0.90. Variable-importance analyses derived from model-learned weights showed that extreme temperature and rainfall metrics were consistently the strongest predictors, with ENSO (El Niño Southern Oscillation) and IOD (Indian Ocean Dipole) improving longer-range malaria forecasts. Furthermore, climate-disease risk dynamics were explored, revealing specific temperature and rainfall thresholds associated with elevated transmission and highlighting non-stationary relationships across decades. These findings demonstrate accurate, interpretable forecasting offered by TFTs and represent a valuable tool for early warning and understanding of complex climate-disease interactions.

Rapid climate change and its anticipated impacts trigger significant worry and distress among vulnerable groups, including young adults. Little is known about how Dutch young adults experience and cope with climate change within their specific social and environmental context. This study examines Dutch young people's emotional responses to climate change, their perceived emotional and psychological needs arising from these experiences, and the barriers they encounter in engaging in pro-environmental behaviour, with the aim of informing public health strategies to better support and empower this vulnerable group. Data were drawn from a large online survey among a representative sample of 1006 Dutch young adults (16-35 years; 51% women). The questionnaire included fixed-answer sections assessing emotional responses to climate change, as well as two open-ended questions exploring participants' perceptions of their emotional and psychological needs related to climate change and the barriers they perceive to pro-environmental behaviour. Descriptive statistics were used for the fixed-response items, and thematic analysis was applied to the open-ended responses. Many Dutch young adults reported worry and sadness about climate change and its impacts, with approximately one third experiencing feelings of powerlessness. A large percentage of respondents attributed responsibility to large companies, and nearly half indicated that they still had hope for the future. One third (31%) felt that nothing could make them feel better about climate change, and another third (36%) reported to experience no climate-related emotions. Key emotional needs included more action at personal, community, and governmental levels, and more motivating positive news. Almost half (46%) of young adults said they already lived sustainably, while perceived barriers to pro-environmental behaviour were mainly financial (21%), knowledge-related (8%), and time-related (7%). This exploratory study highlights key practical and emotional barriers to pro-environmental behaviour reported by Dutch young adults 16-35, who expressed diverse emotional needs while coping with climate change. The findings underscore the need for a multi-level public health response to climate-related emotions, that simultaneously addresses emotional needs, structural barriers, and opportunities for meaningful engagement. Lowering barriers to pro-environmental behaviour and fostering supportive environments that enable sustainable action among young adults may enhance wellbeing and strengthen their sense of agency. Public health supports this by reducing barriers to pro-environmental behaviour in young adults, through targeted support, clear information, and enabling social and structural conditions that promote wellbeing and sustained engagement.

Background: Driven by rapid urbanization, infrastructural development, socio-economic growth, and population increase, noise pollution has become a major public health and environmental policy challenge in Moroccan cities. However, current legislation and enforcement mechanisms remain insufficient to address rising exposure levels and associated health risks. Methods: This systematic review followed PRISMA guidelines to examine urban noise levels, health implications, the regulatory frameworks, and policy actions related to noise pollution in Morocco. Various databases were systematically searched (Scopus, Web of Science, Google Scholar), along with reports from international organizations and government bodies for studies published between 2003 and 2025. Eligible documents included peer-reviewed publications and official reports directly addressing Moroccan noise pollution, legislation, urban impacts, or health outcomes. Results: Twenty-three Moroccan studies and additional regional, European, and legislative sources were included. Findings show that average noise levels in Moroccan urban centers generally exceed international safety thresholds and are associated with cardiovascular risks, sleep disturbances, and psychological stress. The regulatory framework suffers from weak enforcement, limited monitoring protocols, and an absence of noise mapping. Tangier, Béni Mellal, Témara, Marrakech, and Casablanca exhibit significant environmental inequalities, particularly in low-income districts. Conclusions: Morocco's current noise-management system is inadequate to address the growing health and environmental impacts of urban noise. Urgent actions are needed, including a dedicated noise-control law, systematic monitoring, noise mapping, and integration of public-health considerations into environmental governance. Policy reforms must prioritize vulnerable populations and align with international best practices.

The COVID-19 pandemic has posed significant challenges to mental health worldwide, raising the need to identify stable psychological resources that promote sustainable well-being. This longitudinal study examined whether character strengths predict well-being, post-traumatic growth, and mental health over a 13-month period. Participants (N = 146) completed online measures of character strengths, mental health, life satisfaction, affect, and post-traumatic growth at two time points. First, we tested whether a single general factor of character predicted later mental health and whether life satisfaction, affect, and post-traumatic growth mediated this relationship. Then, we repeated this model but with five different character strengths factors as predictors. Results showed that character predicted all mediators and mental health over time, but only the affective components of well-being mediated the relationship between character and mental health, especially positive affect. When looking at the five character strengths factors, although the majority predicted higher well-being and better mental health over time, goodness and interpersonal and fortitude strengths yielded the strongest effects. These findings suggest that character strengths contribute to sustainable well-being by fostering affective resilience in the face of adversity, aligning with the goals of Sustainable Development Goal 3 (Good Health and Well-being).

Background: Xylazine, an adulterant in the illicit opioid supply, heightens the risks of overdose, withdrawal severity, and severe wounds among people who use opioids (PWUO). Despite increasing prevalence, gaps remain regarding xylazine awareness in the drug supply and effective harm reduction interventions to address it.

Methods: We conducted a cross-sectional survey of 703 PWUO in Baltimore, MD (2023-2025), to assess xylazine awareness, perceptions, and experiences. Multivariable logistic regression models examined correlates of xylazine awareness and self-reported xylazine-attributed wounds.

Results: 84.8% of White participants, 48.6% Black participants, 64.3% of males, and 51.4% females had heard of xylazine. Nearly half (45%) of those who used xylazine reported that it caused more severe withdrawal symptoms. In the multivariable model of xylazine awareness, the largest odds ratios were year of survey administration (2024 vs. 2023: aOR = 4.30, 95% CI = 2.91-6.37; 2025 vs. 2023: aOR = 6.32, 95% CI = 3.31-12.07) and White race (aOR = 3.22, 95% CI = 1.85-5.57). Other significant demographic variables included education and gender. In the multivariable model of xylazine-attributed wounds, survey year 2025 vs. 2023 (aOR = 2.65, 95% CI = 1.06-6.61) and injection drug use in the prior year (aOR = 17.74, 95% CI = 5.58-56.39) were statistically significant.

Conclusions: Awareness of xylazine in the drug supply remains incomplete among PWUO, with differences by race, age, and gender. The finding of a strong association of xylazine-attributed wounds and injection drug use should be the focus of future research. These findings underscore the need for enhanced surveillance systems, peer education, and community-based harm reduction strategies. Real-time monitoring and rapid response strategies are essential to protect against health risks of toxic adulterants, such as xylazine, medetomidine, and BTMP, in the drug supply.

Aims: To evaluate the quality of lunch menus for workers in commercial food services across social, health and environmental sustainability dimensions.

Methods: Mixed methods were applied to five restaurants. Data collection included a sociodemographic questionnaire, the Brazilian Food Insecurity Scale (EBIA), workers' nutritional status, nutritional composition of 111 lunch menus, and environmental footprints. Data triangulation integrated caloric-nutritional adequacy, food insecurity, obesity, protein supply, and environmental footprints.

Results: We assessed 261 participants (71.6% male; average age 32.3; 53.5% with a high school education). Food insecurity affected 53.3% and was associated with income, education, household composition, and municipality (p < 0.05). Nutritional status (n = 438) showed 68.3% were overweight/obese; obesity affected 42.7% of women and 30.5% of men. Menu analyses (n = 111) showed adequate energy and protein, but excessive lipids and sodium and reduced carbohydrates. Environmental analyses indicated beef had the highest impact; protein type was more influential than quantity, indicating no simple linear nutrition-impact relationship.

Conclusion: Widespread food insecurity and obesity co-occurred with menus characterized by excessive lipids, sodium, and beef-driven impacts. The findings highlight that health and sustainability outcomes depend on both menu quality and social context, necessitating integrated, multidimensional policies.

Migrant populations drive Canada's demographic expansion, making their successful integration a national priority. However, research has consistently shown that refugees and immigrants experience declining mental health and encounter significant barriers to accessing culturally appropriate mental health support. This scoping review examined the breadth of evidence on culturally adapted mental health education (MHE) programs for migrant populations, including those that integrate traditional and complementary healing practices, and their effectiveness. Systematic searches across six databases (Medline, EMBASE, PsycINFO, Global Health, CINAHL, and Scopus) identified 4075 peer-reviewed articles, with 28 studies meeting inclusion criteria. These included mental health education and awareness programs that integrate psychoeducation and skill-building. Inclusion criteria required cultural adaptation of programs through one or more approaches such as language modification, culturally adapted content, community-based delivery, or integration of traditional and complementary healing practices. Thematic analysis of the programs revealed seven key themes characterizing effective MHE programs: cultural adaptation and sensitivity, addressing unique migration-related stressors, integration of traditional and Western approaches, use of theoretical frameworks and evidence-based practices, rigorous evaluation methodologies, application of holistic frameworks, and community-based peer support models. Programs predominantly utilized psychoeducation and culturally adapted interventions, with common theoretical frameworks including cognitive-behavioral therapy and the PRECEDE-PROCEED model. Across the reviewed studies, program evaluations reported positive outcomes including increased mental health literacy, reduced stigma, enhanced coping skills, and decreased depression, anxiety, and PTSD symptoms, suggesting that culturally adapted MHE programs are acceptable and feasible interventions for migrant populations.