International Journal of Environmental Research and Public Health最新文献

Native Hawaiians (NHs) are a historically oppressed population disproportionately burdened by diabetes and related complications. The Kilolani Project, a patient navigator-centered, chronic disease management program, targets upstream drivers of health among vulnerable NH adult patients with diabetes within an urban academic safety-net clinic. To investigate the impact of the Kilolani Project, we performed a qualitative study to examine patient perspectives. Our goal is to ensure that their values, needs, and priorities drive future navigator-based strategies and healthcare delivery. Fifteen current Kilolani Project patients participated in one of three focus group sessions. Each session followed a semi-structured format with open-ended questions regarding their experiences with the Kilolani Project, patient navigators, and healthcare in general. Iterative transcript readings and coding revealed seven core themes: (1) Humanistic approach, (2) Trusting relationships, (3) Improved access, (4) Trauma-informed care, (5) Self-efficacy, (6) Resilience, and (7) Ethnic concordance. The Kilolani Project created a safe and culturally relevant experience for NH patients. They felt seen, heard, and valued, which resulted in an improved healthcare experience, engagement, and empowerment. Importantly, trust was the cornerstone to building a provider-patient relationship. Such culturally informed approaches are necessary to close the gap in health disparities faced by our NH communities.

We report the results of a scoping review of the literature investigating associations between positive childhood experiences (PCEs) and selected health outcomes to identify which have the highest level of research activity based on the indexed academic literature. Yielded articles underwent title/abstract (Ti/Ab) and full text screening utilizing inclusion/exclusion criteria. The review was guided by PCE categories from the Healthy Outcomes from Positive Experiences framework: relationships, environment, engagement, and emotional growth. The initial search yielded 8,919 unduplicated articles, 759 were retained following Ti/Ab review and 220 articles were retained after full text screening describing 795 tested associations across 23 PCE types in ten outcome categories. The outcomes most commonly examined were substance misuse (305 tested associations across 93 studies), suicidal behaviors (195 tested associations across 56 studies), and depression (112 tested associations across 55 studies). Physical health outcomes were less common (14 tested associations across six studies). Of the PCE exposures, relationships represented 415 of tested associations, 236 with environment, and 114 with social engagement. A significant body of research demonstrated associations between PCEs and health outcomes. While further research is needed, available research suggests that public health efforts to promote PCEs may have impact across multiple domains.

Water-related diseases are among the infectious diseases that represent a major public health challenge in developing countries. This study aimed to assess the prevalence of waterborne diseases and the factors associated with their occurrence in the commune of Aplahoué, located in southwestern Benin. A cross-sectional analytical study was conducted among 125 households selected through simple random sampling in the commune. Data analysis was performed using regression models and Chi-square tests with SPSS version 27.0, considering a p-value below 5% as statistically significant. This study revealed an overall prevalence of waterborne diseases of 45.6% at the household level and 16.6% at the individual level. Malaria was the most prevalent waterborne disease (8.4%), followed by diarrhea (6.3%). Multivariate analysis identified a history of waterborne diseases and hospitalization due to waterborne diseases as significant independent risk factors for the occurrence of new waterborne diseases. It is, therefore, critical to improve access to safe drinking water, promote better hygiene and sanitation practices, and strengthen health education through effective communication to foster behavioral change within the community.

Roadway mortality increased during COVID-19, reversing a multi-decade downward trend. The Fatality Analysis Reporting System (FARS) was used to examine contributing factors pre-COVID-19 and in the COVID-19 era using the five pillars of the Safe System framework: (1) road users; (2) vehicles; (3) roadways; (4) speed; and (5) post-crash care. Two study time periods were matched to control for seasonality differences pre-COVID-19 (n = 1725, 1 April 2018-31 December 2019) and in the COVID-19 era (n = 2010, 1 April 2020-31 December 2021) with a three-month buffer period between the two time frames excluded. Four of the five pillars of the safe system had road safety indicators that worsened during the pandemic. Mortality was 19.7% higher for motor vehicle occupants and 45.1% higher for riders of motorized two-wheeled vehicles. In adjusted analyses, failure to use safety equipment (safety belts/helmets) was associated with 44% higher mortality. Two road user groups, non-motorized bicyclists and pedestrians, did not contribute significantly to higher mortality. Urban roadway crashes were higher compared to rural crashes. Additional scientific inquiry into factors associated with COVID-19-era mortality using the Safe System framework yielded important scientific insights to inform prevention efforts. Motorized two-wheeled vehicles contribute disproportionately to pandemic-era higher mortality and constitute an emerging road safety issue that deserves further attention.

Introduction: Social media addiction (SMA) and internet addiction (IA) are increasingly prevalent, impacting mental health (MH) globally. This study investigates the mediating roles of mindfulness and social capital (SC) in the relationship between SMA, IA, and MH among Ethiopian high school and university students, contributing to the Sustainable Development Goal (SDG) 3 of good health and well-being.

Methods: A cross-sectional study was conducted with 1160 university and 1473 high school students in Dessie, Ethiopia. Participants completed validated questionnaires assessing SMA, IA, mindfulness, SC, and MH. Structural Equation Modeling (SEM) with a multi- mediation Model (SMM) was used to examine the hypothesized relationships.

Results: SEM revealed that both SMA and IA had a direct negative effect on mindfulness, SC, and MH in in both high school and university students. Notably, mindfulness and SC significantly and positively predicted MH, indicating their protective role against the negative effects of SMA and IA. Furthermore, both mindfulness or SC fully or partially mediated the relationship between SMA, IA, and MH, highlighting their crucial role in explaining the association.

Conclusions: This study provides evidence for the crucial roles of mindfulness and SC in buffering the negative effects of SMA and IA on MH among Ethiopian students. The findings highlight the need for educational and health interventions that foster mindfulness and SC to enhance student mental health and promote a healthy digital environment. These results offer valuable insights for educators, health professionals, and policymakers in Ethiopia and other developing countries facing similar challenges.

This study compared the effects of Mat Pilates training on cardiovascular risk markers in postmenopausal women with single or multiple cardiometabolic conditions. Forty-four women were divided into single-condition (SINGLE; n = 20) and multiple-condition (MULTI; n = 24) groups. Both groups completed Mat Pilates three times per week for 12 weeks. Measurements of resting blood pressure, body composition, dietary intake, and blood markers were taken before and after the intervention. A Generalized Estimating Equation was used for hypothesis testing. MULTI presented higher body mass, BMI, fat mass, and waist circumference. Systolic blood pressure decreased more in SINGLE (-13 ± 15 mmHg) than in MULTI (-3 ± 16 mmHg, p interaction = 0.016 with diastolic reductions in both groups (SINGLE: -9 ± 12 mmHg; MULTI: -2 ± 11 mmHg, p interaction = 0.053). Triglycerides decreased only in SINGLE (-40 ± 98 mg/dL vs. +31 ± 70 mg/dL in MULTI, p interaction = 0.006), while no significant changes were observed in cholesterol levels. Adiponectin levels decreased in both groups (SINGLE: -1.5 ± 16.3; MULTI: -9.3 ± 12.4 vs. µg/dL, p time = 0.015). Glycated hemoglobin levels decreased over time in both groups (-0.3 ± 0.5% in SINGLE, -0.5 ± 0.6% in MULTI, p time < 0.001), with no significant changes in blood glucose. These findings suggest that Mat Pilates may be more effective in reducing cardiometabolic risk factors in women with a single condition compared to those with multiple conditions.

Body image concerns are key prognostic and pathogenic factors of anorexia nervosa (AN) and bulimia nervosa (BN). This study aimed to investigate the neural mechanisms underlying body image perception across its two domains of estimation and satisfaction in anorexia and bulimia patients and healthy controls (HC). Systematic searches were conducted across eight databases, including PubMed; Cochrane Library; Ovid; Google Scholar; Sage Journals; Scopus; PsycInfo; and ScienceDirect, from database inception until the 23rd of April 2023. The sample pertained to 14 functional magnetic resonance imaging (fMRI) studies and 556 participants, with tasks primarily including image and silhouette-based body estimation and satisfaction paradigms. ALE meta-analysis was conducted to investigate significant clusters of activation foci across the different studies. Shared activations were observed between HC, AN, and BN patients in cortical regions related to object manipulation and recognition, visuospatial awareness, and memory and negative affect regulation. Differential activation in interoceptive and higher-order cognitive or affective control regions likely hold the key to pathological body distortion. This study outlined commonalities and differences in the correlates driving healthy body mapping and eating disorder pathology. Our findings provide pertinent implications for future research, current clinical interventions, and therapeutic outcomes.

This study assesses the role of family planning (FP) in resilience building among youths and women in Ethiopia's drought-affected and food-insecure regions. A mixed-method comparative cross-sectional study design with a total of 1712 study participants with an equal 1:1 ratio of the intervention and control groups was used. Binary logistic regression analysis was carried out to identify factors associated with community resilience. More participants in the intervention districts (58.3%) than in the control districts (49%) were currently using FP services. Approximately 54.1% of the intervention group and 43.6% of the control group were able to pay for food and shelter. Two-thirds of the intervention respondents and half of the control respondents had good social cohesion. The food consumption scores for the intervention and control districts were 26.2 and 24.9, respectively. Additionally, 62.5% of the intervention and 53.5% of the control respondents were found to have a good level of community level resilience. FP use (AOR = 3.4, 95% CI: 1.78-6.49), good social cohesion (AOR = 7.9, 95% CI: 6.09-10.23) and productive assets (AOR = 1.4, 95% CI: 1.07-1.92) were significantly associated with community resilience. To enhance community resilience comprehensively, expanding FP services should empower women in decision-making processes, cultivate ties and promote collaborative efforts across different sectors.

Despite the increasing incidence of myocardial infarction among middle-aged adults, studies analyzing their recognition of early myocardial infarction symptoms and cardiopulmonary resuscitation training experiences are lacking. This study aimed to utilize data from the 2022 Korea Community Health Survey to assess the level of recognition of early myocardial infarction symptoms among middle-aged adults and identify factors affecting cardiopulmonary resuscitation performance based on training experiences. Secondary data analysis was conducted to assess 99,945 adults aged 40-64 years on their recognition of early myocardial infarction symptoms and the influence of cardiopulmonary resuscitation training experience on their performance ability. Data analysis was performed using multinomial logistic regression, followed by assessing the area under the curve and visualizing the receiver operating characteristic curve to evaluate the model's performance. The recognition of early myocardial infarction symptoms improved; the cardiopulmonary resuscitation performance ability increased by 22%. The absence of training with mannequins and automated external defibrillators resulted in a 79% and 77% decrease in cardiopulmonary resuscitation performance ability, respectively. Enhancing the recognition of early myocardial infarction symptoms and providing hands-on cardiopulmonary resuscitation training is vital for improving cardiopulmonary resuscitation performance in middle-aged adults. Effective cardiopulmonary resuscitation training programs can facilitate the rapid identification of patients who have had a cardiac arrest, bolster emergency response capabilities, and enhance the overall social safety net.

The gold standard diagnosis for malaria is the microscopic visualization of blood smears to identify Plasmodium parasites, although it is an expert-dependent technique and could trigger diagnostic errors. Artificial intelligence (AI) tools based on digital image analysis were postulated as a suitable supportive alternative for automated malaria diagnosis. A diagnostic evaluation of the iMAGING AI-based system was conducted in the reference laboratory of the International Health Unit Drassanes-Vall d'Hebron in Barcelona, Spain. iMAGING is an automated device for the diagnosis of malaria by using artificial intelligence image analysis tools and a robotized microscope. A total of 54 Giemsa-stained thick blood smear samples from travelers and migrants coming from endemic areas were employed and analyzed to determine the presence/absence of Plasmodium parasites. AI diagnostic results were compared with expert light microscopy gold standard method results. The AI system shows 81.25% sensitivity and 92.11% specificity when compared with the conventional light microscopy gold standard method. Overall, 48/54 (88.89%) samples were correctly identified [13/16 (81.25%) as positives and 35/38 (92.11%) as negatives]. The mean time of the AI system to determine a positive malaria diagnosis was 3 min and 48 s, with an average of 7.38 FoV analyzed per sample. Statistical analyses showed the Kappa Index = 0.721, demonstrating a satisfactory correlation between the gold standard diagnostic method and iMAGING results. The AI system demonstrated reliable results for malaria diagnosis in a reference laboratory in Barcelona. Validation in malaria-endemic regions will be the next step to evaluate its potential in resource-poor settings.