International Journal of Environmental Research and Public Health

12 pages, 1025 KB

Open AccessArticle

Speciation of Arsenic in Medium Containing Bacterial Strains of Lysinibacillus boronitolerans and Bacillus cereus: Mechanism of Arsenic Removal

by Naidilene Chaves Aguilar, Adriele Santos Van Der Maas, Mayra Soares Santos, Rodrigo de Carvalho Hott, Márcia Cristina da Silva Faria, Bruno Lemos Batista, Cleide Aparecida Bomfeti, João Paulo de Mesquita and Jairo Lisboa Rodrigues

Int. J. Environ. Res. Public Health 2025, 22(11), 1675; https://doi.org/10.3390/ijerph22111675 - 4 Nov 2025

Abstract

Environmental issues have become increasingly critical and frequent in recent decades due to excessive population growth and intensified industrial and mining activities. Among the most concerning contaminants is arsenic (As), a toxic element associated with severe environmental and human health risks. This study [...] Read more.

Environmental issues have become increasingly critical and frequent in recent decades due to excessive population growth and intensified industrial and mining activities. Among the most concerning contaminants is arsenic (As), a toxic element associated with severe environmental and human health risks. This study aimed to investigate the bioremediation potential of the bacterial strains Lysinibacillus boronitolerans and Bacillus cereus, elucidating the mechanisms involved in arsenic transformation and removal under controlled conditions. The strains were cultivated in liquid medium containing known concentrations of As(III) and As(V), and the chemical forms of arsenic were analyzed using High-Performance Liquid Chromatography coupled with Inductively Coupled Plasma Mass Spectrometry (LC-ICP-MS). The production of exopolysaccharides (EPSs) and arsenite oxidase activity were also evaluated. Morphological and elemental analyses were performed using scanning electron microscopy with energy-dispersive spectroscopy (SEM-EDS). The bacterial strains exhibited significant 69.38–85.72% reductions in arsenic concentration and approximately 14–15% volatilization rates. No EPS production or arsenite oxidase activity was detected, suggesting alternative detoxification pathways. SEM-EDS analyses revealed intracellular accumulation of arsenic, while LC-ICP-MS speciation confirmed interconversion between As(III) and As(V), indicating the action of methylation-dependent detoxification and membrane transport mechanisms. The findings demonstrate that L. boronitolerans and B. cereus possess efficient arsenic resistance and transformation mechanisms, even without conventional enzymatic pathways. These strains show strong potential for use in sustainable bioremediation of arsenic-contaminated environments, particularly in regions affected by mining activities. Full article

(This article belongs to the Special Issue Environmental Monitoring and Remediation: Evaluating Exposure to Environmental Contaminants and Effects)

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15 pages, 1241 KB

Open AccessArticle

Instability in the Penta-C and Penta-D Loci in Microsatellite-Unstable Endometrial Cancer

by Ahmet Yilmaz, Wendy L. Frankel, Weiqiang Zhao, Adrian A. Suarez, Wei Chen, Joshua F. Coleman, Joseph P. McElroy, Rachel Pearlman, Paul J. Goodfellow and Heather Hampel

Int. J. Environ. Res. Public Health 2025, 22(11), 1674; https://doi.org/10.3390/ijerph22111674 - 4 Nov 2025

Abstract

Endometrial cancer (EC) is the most common gynecologic cancer. Early detection is one of the most important predictors of survival. The cancer is curable if detected early but the five-year survival rate in advanced cases can be as low as 22%. Microsatellite instability [...] Read more.

Endometrial cancer (EC) is the most common gynecologic cancer. Early detection is one of the most important predictors of survival. The cancer is curable if detected early but the five-year survival rate in advanced cases can be as low as 22%. Microsatellite instability (MSI) testing is used to screen populations for Lynch Syndrome (LS), the most common cause of inherited EC, and to classify EC into distinct groups with unique histological, prognostic, and molecular features. Accurate sample identification is crucial for successful MSI testing because instability is assessed by comparing amplification patterns in markers in the normal and tumor samples that must be taken from the same individual. Penta-C and Penta-D pentanucleotide markers are used widely for sample identification in not only MSI testing but also parentage verification, forensic science, and population genetics studies. The objective of this study was to test 324 pairs of tumor and matched normal DNAs from EC patients for instability in these markers using the Promega MSI Analysis System^TM considered the “gold standard” in MSI testing. Both markers were unstable, and therefore not reliable for MSI testing, in 8.2% of the EC patients with MSI. Instability in both mono- and pentanucleotide markers suggest that the tumors with MSI likely suffer from a “generalized” form of instability also affecting other short tandem repeats. Results from many studies using these markers for various purposes may not be accurate if samples with MSI are involved. Full article

(This article belongs to the Section Global Health)

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23 pages, 879 KB

Open AccessSystematic Review

Part 1: A Systematic Review to Describe Existing Cultural Adaptations in Lifestyle, Nutrition, and Physical Activity Programs for Native Hawaiian, CHamoru, and Filipino Populations

by Monica K. Esquivel, Kristi Hammond, Bernice C. Delos Reyes, Dareon C. Rios, Niza Mian, Elaine C. de Leon, Samantha M. Torres and Tanisha Franquez Aflague

Int. J. Environ. Res. Public Health 2025, 22(11), 1673; https://doi.org/10.3390/ijerph22111673 - 4 Nov 2025

Abstract

This research aims to describe existing evidence on the availability of culturally adapted lifestyle, nutrition, and physical activity programs among Native Hawaiian, CHamoru, and Filipino populations who are affected by obesity at rates higher than the general US population, contributing to poorer health [...] Read more.

This research aims to describe existing evidence on the availability of culturally adapted lifestyle, nutrition, and physical activity programs among Native Hawaiian, CHamoru, and Filipino populations who are affected by obesity at rates higher than the general US population, contributing to poorer health outcomes. Addressing this disparity requires programs that are culturally adapted and grounded for these specific populations. A comprehensive description of the availability of lifestyle interventions for Native Hawaiians, Pacific Islanders, and Filipinos is missing in the literature. A systematic literature review was performed in July 2025 to gather articles that included lifestyle (nutrition and/or physical activity) interventions addressing obesity and/or related chronic diseases and that utilized one or more cultural adaptations for Native Hawaiian, CHamoru, and/or Filipino populations. Data were extracted, and methodological quality, social ecological model (SEM) level, and risk for bias was assessed. Twenty-nine articles met inclusion criteria. Interventions addressed pre-diabetes (n = 7), hypertension (n = 7), and/or obesity (n = 5) and included combined nutrition and physical activity (n = 16). Sixteen articles included interventions culturally adapted for Filipino populations only, 7 for Native Hawaiians only, 6 for both Native Hawaiians and Filipinos, and 2 included CHamorus. The most common combination of approaches were interventions that incorporated individual, interpersonal, and community SEM levels (n = 17). Intervention components were reflective of culturally relevant physical activities (n = 16) and nutrition (n = 11). Based on this research, there is a need for additional research to include CHamoru communities and interventions to be tested in geographic locations where these populations have migrated. Full article

(This article belongs to the Section Behavioral and Mental Health)

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35 pages, 499 KB

Open AccessArticle

A Mixed-Methods Evaluation of a Post-COVID-Condition Rehabilitation and Recovery Intervention Delivered in a Football Club Community Trust

by Steven Rimmer, Adam J. Herbert, Adam L. Kelly, Irfan Khawaja, Sam Lee and Lewis A. Gough

Int. J. Environ. Res. Public Health 2025, 22(11), 1672; https://doi.org/10.3390/ijerph22111672 - 4 Nov 2025

Abstract

Aim: Post-COVID condition (PCC) is largely considered the biggest public health emergency in recent times. The role of exercise therapy in PCC is currently unknown, and evaluative studies are currently lacking in this area. This study therefore aimed to evaluate the effects of [...] Read more.

Aim: Post-COVID condition (PCC) is largely considered the biggest public health emergency in recent times. The role of exercise therapy in PCC is currently unknown, and evaluative studies are currently lacking in this area. This study therefore aimed to evaluate the effects of a football club community trust exercise rehabilitation programme on physical function and quality of life in individuals with PCC. Method: A mixed-methods retrospective design was employed, utilising a framework to assess the programme’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM). Quantitative data (questionnaires and physiological assessments) were collected at baseline, 6 weeks, and 12 weeks during the programme, and at 6 months post-intervention (n = 7). Qualitative data were gathered through semi-structured focus groups at week 12 (n = 7) and 12 months (n = 5) post-intervention. Quantitative data and qualitative data were analysed using repeated measures ANOVAs and thematic analysis, respectively. Results: The programme led to significant improvements in physical function, including increased six-minute walking distance (6MWT, p < 0.001), one-minute sit-to-stand repetitions (1MSST, p < 0.035), and lung function (spirometry; MIP: p = 0.048, MEP: p = 0.024). Participants also reported enhanced QoL (HRQoL-14, p = 0.004), reduced anxiety (GAD-7, p = 0.008) and depression (PHQ-9, p = 0.008), and increased confidence and self-efficacy. The programme was well-received, with participants valuing the supportive environment and personalised approach. Conclusions: Football community trust exercise rehabilitation programmes can effectively improve physical function and quality of life in individuals with PCC, offering a promising model for community-based rehabilitation. Further studies are needed with larger sample sizes to assess the scalability of similar programmes. Full article

(This article belongs to the Section Exercise and Health-Related Quality of Life)

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19 pages, 714 KB

Open AccessReview

Obesity Interventions for Aboriginal and Torres Strait Islander Children and Adolescents: A Scoping Review of Impact and Outcomes

by Kabita Kharka, Kristina Zafirovski and Fahad Hanna

Int. J. Environ. Res. Public Health 2025, 22(11), 1671; https://doi.org/10.3390/ijerph22111671 - 3 Nov 2025

Abstract

Background: Childhood Obesity is a significant and growing Public Health threat among Aboriginal and Torres Strait Islander (ATSI) children and adolescents in Australia. Health sectors in Australia have been focusing on health intervention programs across various states to prevent childhood obesity. This [...] Read more.

Background: Childhood Obesity is a significant and growing Public Health threat among Aboriginal and Torres Strait Islander (ATSI) children and adolescents in Australia. Health sectors in Australia have been focusing on health intervention programs across various states to prevent childhood obesity. This review aims to analyse the impact of obesity intervention programs conducted among children and adolescents of ATSI communities across Australia and report on the best practices for conducting future research. Objectives: This scoping review synthesised existing literature on the obesity prevention interventions programs among ATSI Children and Adolescents in Australia and examined their scope, implementation, and outcomes; evaluated their cultural appropriateness; and highlighted critical enablers and barriers. Methods: This scoping review analysed scholarly journal articles that reported on the findings of obesity intervention programs delivered across ATSI children and adolescents. Only Quasi-experimental and Randomized Control Trials (RCTs) were selected for the review. A full search has been carried out in Health databases such as Cochrane Library, Medline, PubMed, and ProQuest Central for the past 15 years. The framework of the Joanna Briggs Institute (JBI) for Scoping reviews was followed throughout this review. Results: Eleven studies met inclusion criteria. Findings were clustered into five themes: (i) community-led, systems-based interventions improved health behaviours and anthropometry; (ii) culturally tailored, community-embedded programs enhanced engagement and health literacy; (iii) early childhood and family-focused approaches showed promise; (iv) community or policy initiatives yielded mixed results; and (v) behavioural interventions were ineffective without addressing social and structural determinants. The most effective programs were community-delivered, multi-stakeholder, and centred on empowerment and capacity building. Conclusions: Obesity prevention efforts targeting Aboriginal and Torres Strait Islander children and adolescents are most successful when community-led, culturally grounded, and supported by multiple stakeholders. These findings underscore the necessity of culturally sensitive, participatory approaches. Further research is needed to strengthen the evidence base and inform sustainable, policy-relevant strategies for childhood obesity. Full article

(This article belongs to the Section Global Health)

20 pages, 2250 KB

Open AccessArticle

A Bibliometric Analysis of the HCV Drug-Resistant Majority and Minority Variants

by Omega Mathew Immanuel, Olaoluwa Tolulope Fabiyi, Kuat P. Oshakbayev, Gulzhan Abuova, Aliya Konysbekova, Sreenu B. Vattipally, Syed Ali and Syed Hani Abidi

Int. J. Environ. Res. Public Health 2025, 22(11), 1670; https://doi.org/10.3390/ijerph22111670 - 3 Nov 2025

Abstract

Background: In recent decades, research on Hepatitis C Virus (HCV) drug-resistant variants has expanded; however, critical gaps remain in our understanding of global contributions, emerging trends, and future research directions. Here, we present a bibliometric analysis to understand the research themes and trends [...] Read more.

Background: In recent decades, research on Hepatitis C Virus (HCV) drug-resistant variants has expanded; however, critical gaps remain in our understanding of global contributions, emerging trends, and future research directions. Here, we present a bibliometric analysis to understand the research themes and trends in research related to HCV drug-resistant variants published between 1999 and 2025. Methods: Publications related to HCV drug-resistant variants published between 1999 and 2025 were searched on the Web of Science and Scopus databases. Publication metadata and content-based data were extracted and analyzed using Bibliometrix and VOSviewer for keyword co-occurrence plot and cluster analysis. Results: The analysis of 653 articles revealed a clear paradigm shift, driven by the introduction of direct-acting antivirals (DAAs), which led to a significant surge in annual publications, peaking between 2014 and 2018. This shift in focus led to an emphasis on DAA efficacy, resistance mechanisms, and advanced genotyping. The United States was the most productive country, with the highest number of publications (n = 134) and citations (n = 6458). The University of São Paulo was the most productive institution (n = 40), while Antimicrobial Agents and Chemotherapy published the highest number of articles in this field (n = 40). Susser S. was the most productive researcher. Collaboration networks were found to be predominantly centered in high-income countries. Analysis of studies on minority variants showed that most studies originated from Europe and the United States, identifying low-frequency resistance-associated substitutions (RASs) such as A156V, D168V, Y93H, and S282T, with prevalence ranging from <1% to 35%, which were frequently associated with viral breakthrough and reduced treatment response. Conclusions: The field successfully transitioned to the DAA era, but research output and collaboration networks were primarily driven by high-income countries, leaving a critical gap in data from Low- and Middle-Income Countries (LMICs). Closing this gap by integrating LMIC data is the next essential step to ensure global elimination strategies are effective for all countries from different income strata. Full article

(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)

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22 pages, 327 KB

Open AccessArticle

A Qualitative Assessment of “Generacion Actual”: An HIV Community Mobilization Intervention Among Gay Men and Transgender Women in Lima, Peru

by Andres Maiorana, Susan Kegeles, Elizabeth Lugo, Wendy Hamasaki, Ximena Salazar and Carlos Cáceres

Int. J. Environ. Res. Public Health 2025, 22(11), 1669; https://doi.org/10.3390/ijerph22111669 - 3 Nov 2025

Abstract

The high HIV prevalence among men who have sex with men and transgender women (TW) in Peru calls for innovative HIV prevention strategies to modify social norms, increase social support and promote empowerment and community mobilization. This qualitative article presents the synergistic processes [...] Read more.

The high HIV prevalence among men who have sex with men and transgender women (TW) in Peru calls for innovative HIV prevention strategies to modify social norms, increase social support and promote empowerment and community mobilization. This qualitative article presents the synergistic processes that generated community mobilization throughout Generación Actual (GA, Current Generation in English), an HIV prevention intervention with gay men (GM) and TW in Lima South based on Mpowerment, a U.S.-model intervention program. We conducted 24 interviews with GM and TW participants, informed by observations of GA and the perceptions of its implementing coordinators, and complemented by the number/types of GA activities. Four significant processes occurred throughout GA: (1) high participant engagement, community building and empowerment; (2) an effect on HIV prevention and treatment; (3) the integration of GM and TW and (4) GA’s community center becoming a safe space for socializing, support and information. These processes helped produce positive changes related to self-empowerment, personal agency and the participants’ health, suggesting an impact of GA on HIV prevention, stigma reduction and care engagement. Community mobilization strategies that ensure active community participation and involvement may constitute relevant aspects for an effective approach to HIV prevention for TW and GM in Peru. Full article

(This article belongs to the Topic Social, Structural and Behavioral Interventions for HIV Prevention)

15 pages, 520 KB

Open AccessArticle

Pushing for Structural Reforms: Impacts of Racism and Xenophobia upon the Health of South Asian Communities in Ontario, Canada

by Manvi Bhalla, Ève Dubé, Noni MacDonald, Helana Marie Boutros and Samantha B. Meyer

Int. J. Environ. Res. Public Health 2025, 22(11), 1668; https://doi.org/10.3390/ijerph22111668 - 3 Nov 2025

Abstract

South Asian (SA) communities in Ontario, Canada experienced disproportionately higher rates of COVID-19 infection. Moreover, these communities also faced racism fueled by COVID-19-related misinformation and xenophobic sentiments that placed blame on them for virus transmission. The aim of this research was to understand, [...] Read more.

South Asian (SA) communities in Ontario, Canada experienced disproportionately higher rates of COVID-19 infection. Moreover, these communities also faced racism fueled by COVID-19-related misinformation and xenophobic sentiments that placed blame on them for virus transmission. The aim of this research was to understand, from the perspective of local SA communities, the causes behind higher incidences of COVID-19. SA adults (N = 25) participated in a focus group (N = 3) investigating experiences during the early stages of the pandemic. Data, interpreted through the lens of the Public Health Critical Race Praxis, suggest that the structural determinants of health, alongside racism and xenophobia, negatively impacted health outcomes for these communities. By not taking an active anti-racist stance, media, health and government authorities were viewed as perpetuating discriminatory narratives and practices, fueling blame and stigma towards these South Asian communities for COVID-19 transmission. Local public health policies, practices and communications were perceived to be informed by, and best serve, white Anglo-European settlers. This research provides insight into the role that health officials can play in addressing local and regional discrimination and stigma to promote equity-centered disease prevention efforts. Our findings should be integral to current and ongoing research and action related to pandemic preparedness. Full article

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17 pages, 1164 KB

Open AccessArticle

Beyond Communication and Risk in a Post-Pandemic World: A Survey on Radon in Spain

by Jorge Vázquez-Herrero, Berta García-Orosa and Xosé López-García

Int. J. Environ. Res. Public Health 2025, 22(11), 1667; https://doi.org/10.3390/ijerph22111667 - 3 Nov 2025

Abstract

This study addresses the construction and perception of risk and the role of the news media through a case study on radon gas, a carcinogenic, persistent hazard with a significant impact on public health, which typically flies under the radar of public opinion. [...] Read more.

This study addresses the construction and perception of risk and the role of the news media through a case study on radon gas, a carcinogenic, persistent hazard with a significant impact on public health, which typically flies under the radar of public opinion. The research is based on a survey (N = 1985) that targeted residents of Spain aged 18 or older. We evaluated cognitive and contextual factors, media consumption, and awareness of radon communication actions and developed a model to explain individual risk perception. The population’s knowledge about the different aspects of the risk of radon gas is moderate and uneven. A key element is the level of radon incidence among Spain’s autonomous communities. The main factors that explain the perception of radon risk are one’s perceived likelihood of being affected by radon, followed by gender and cognitive factors. The results demonstrate a strong correlation between media-disseminated information and public knowledge, but a weaker correlation between such information and protective actions, which are more closely tied to interpersonal and local communication. This study provides insights into addressing new societal risks and will help to create communication tools and analyses that avoid panic and promote responsible actions during crises. Full article

(This article belongs to the Section Global Health)

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13 pages, 1309 KB

Open AccessArticle

by Carlos Manoel Lopes Rodrigues and Lígia Abreu Gomes Cruz

Int. J. Environ. Res. Public Health 2025, 22(11), 1666; https://doi.org/10.3390/ijerph22111666 - 3 Nov 2025

Abstract

This study examines whether daily heat exposure worsens psychological well-being among self-employed motorcycle delivery workers in Brasília, Brazil. Using ecological momentary assessment over 15 consecutive days in August 2025, 45 workers were recruited and 30 (66.7%) completed twice-daily mobile prompts (12:00 and 18:00) [...] Read more.

This study examines whether daily heat exposure worsens psychological well-being among self-employed motorcycle delivery workers in Brasília, Brazil. Using ecological momentary assessment over 15 consecutive days in August 2025, 45 workers were recruited and 30 (66.7%) completed twice-daily mobile prompts (12:00 and 18:00) rating stress, fatigue, mood, and perceived heat (1–5 scales) and reporting kilometers traveled. Environmental data (temperature, relative humidity, barometric pressure) were paired from the INMET Brasília station. Linear regressions with cluster-robust standard errors by participant tested associations. Higher temperature was consistently related to greater strain: each +1 °C was associated with higher stress (β = 0.196, 95% CI 0.179–0.213), higher fatigue (β = 0.289, 95% CI 0.284–0.295), and worse mood (β = 0.149, 95% CI 0.130–0.168). Adding relative humidity yielded small but reliable partial effects (lower stress and better mood, yet higher fatigue) amid strong dry-season collinearity between temperature and humidity. The findings indicate that even modest day-to-day warming corresponds to measurable deterioration in psychological outcomes in a precarious, outdoor, platform-mediated workforce. Policies that expand hydration and shaded rest access, integrate heat indices into alerts, and adapt platform scheduling to reduce peak-heat exposure may mitigate risk. Full article

(This article belongs to the Special Issue Sustainable Work Environment and Occupational Well-Being)

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19 pages, 312 KB

Open AccessArticle

Non-Adherence to Treatment Among Patients Attending a Public Primary Healthcare Setting in South Africa: Prevalence and Associated Factors

by Lucky Norah Katende-Kyenda

Int. J. Environ. Res. Public Health 2025, 22(11), 1665; https://doi.org/10.3390/ijerph22111665 - 3 Nov 2025

Abstract

In underdeveloped nations, treatment non-adherence continues to be a significant barrier to effective disease management. It has a major impact on patients and healthcare systems in public primary healthcare settings. Patients who do not take their medications as prescribed may be at higher [...] Read more.

In underdeveloped nations, treatment non-adherence continues to be a significant barrier to effective disease management. It has a major impact on patients and healthcare systems in public primary healthcare settings. Patients who do not take their medications as prescribed may be at higher risk for negative health consequences. Polypharmacy, side-effects, and drug-related problems are factors contributing to non-adherence. Additional patient-related issues include multimorbidity, lack of support, chronic-drugs, and health-literacy. The purpose of this study was to ascertain the prevalence and contributing factors of treatment non-adherence among patients presenting to a public primary healthcare setting in South Africa. Between September and October 2014, cross-sectional quantitative research using structured questionnaires was carried out with one hundred patients who were chosen using random sampling. Self-reports from patients were used to assess non-adherence to therapy. A standardized questionnaire administered by the interviewer was used to gather data, and IBM SPSS version 29 was used for analysis. Patients aged 18 years and older who were using prescribed medications were included. The characteristics of the participants were obtained using descriptive statistics, and 95% confidence intervals (CIs) are reported for Odds ratios (ORs). Associations between related factors and treatment non-adherence were obtained using the Pearson Chi-square test; a p-value of less than 0.05 was deemed statistically significant. Of the 100 patients interviewed, 35% were men and 65% women. The majority were in the age-range of 60–80 years with a high school level of education. Demographic characteristics associated with non-adherence to treatment were gender (p = 0.03) and age (p = 0.03). Chronic conditions, alcohol consumption, recreational drug use, use of medication reminders, waiting time to get treatment and support from healthcare providers all were statistically significant with p-values < 0.001, time to get to the clinic (p = 0.02), mode of transport (p = 0.01), alcohol consumption (OR 22.25 [95% CI: 8.539–57.977], p < 0.001) and recreational drug use (OR 8.73 [95% CI: 5.01–15.98], p < 0.001) were also examined. Patient medication non-adherence is a major medical problem globally. Though patient education is the key to improving compliance, use of compliance aids, proper motivation, and support are also shown to increase medication adherence. Full article

(This article belongs to the Special Issue Evidence-Based Nursing in Primary Care: Enhancing Quality and Outcomes)

12 pages, 292 KB

Open AccessArticle

Parenthood and Self-Reported Depression, Anxiety, and Life Satisfaction in the COVID-19 Pandemic in the UK: An Examination of Differences by Age of Children and Level of Social Support

by Hannah Jones, Marie Houghton, Jorge Gato and Fiona Tasker

Int. J. Environ. Res. Public Health 2025, 22(11), 1664; https://doi.org/10.3390/ijerph22111664 - 2 Nov 2025

Abstract

The COVID-19 pandemic had a marked detrimental effect on the mental health of the UK population. Parents with dependent children were deemed vulnerable but research on parental mental health in this period neglected to examine a child’s age together with the presence of [...] Read more.

The COVID-19 pandemic had a marked detrimental effect on the mental health of the UK population. Parents with dependent children were deemed vulnerable but research on parental mental health in this period neglected to examine a child’s age together with the presence of social support. To inform potential mental health support strategies this study investigated whether the pandemic was associated with different levels of psychological wellbeing for parents with youngest children of varying ages, relative to socio-demographic factors and social support levels. From November 2020 to April 2021 n = 915 UK adults completed an online survey measuring self-reported symptoms of depression, anxiety and stress, satisfaction with life, social support and socio-demographic characteristics. Results provide some evidence of better psychological wellbeing for parents with younger children (aged 0 to 5 years) than older children. Overall, social support was a key factor in mitigating depression, anxiety, and stress scores for parents of dependent-aged children. Findings provide new evidence supporting Pearlin’s Stress Process Model, highlighting the importance of social support to parents under pandemic-related pressures. These findings indicate that one way of safeguarding parents vulnerable to poor mental health could be by increasing social support to parents via formal and informal support services within school communities. Full article

(This article belongs to the Section Behavioral and Mental Health)

13 pages, 617 KB

Open AccessArticle

Agreement Between Consumer and Research-Grade Physical Activity Monitors in a Public Health Intervention for Adolescent Latinas

by Jacob Carson, David Wing, Job G. Godino, Michael Higgins and Britta Larsen

Int. J. Environ. Res. Public Health 2025, 22(11), 1663; https://doi.org/10.3390/ijerph22111663 - 2 Nov 2025

Abstract

Consumer wearables are increasingly used in physical activity (PA) interventions, but their validity as a measurement tool among low PA groups, like adolescent girls, is unclear. We assessed the minute- and day-level agreement between PA measures among adolescent Latinas from an intervention. Participants [...] Read more.

Consumer wearables are increasingly used in physical activity (PA) interventions, but their validity as a measurement tool among low PA groups, like adolescent girls, is unclear. We assessed the minute- and day-level agreement between PA measures among adolescent Latinas from an intervention. Participants wore a Fitbit Inspire HR and an ActiGraph GT3X+ for overlapping epochs. ActiGraph data were classified using two different cut points and aligned with Fitbit data to produce 1,149,169 matched minutes of wear across 137 adolescent girls (M = 15.73 yrs). Confusion matrices were calculated for pairwise comparisons to determine minute-level Moderate-Vigorous PA (MVPA) classification. Data were aggregated to 1007 days for Bland–Altman analyses. ActiGraph cut points showed moderate agreement for minute-level MVPA classification (Balanced Accuracy = 0.71, AC1 = 0.98), while Fitbit showed fair agreement (Balanced Accuracy = 0.50, AC1 = 0.95–0.97) largely driven by non-MVPA observations. The Freedson cut point overestimated daily MVPA relative to Treuth by 14.7 min/day and Fitbit by 14.2 min/day in Bland–Altman space. The daily Treuth and Fitbit comparison did not significantly differ. Findings suggest systematic differences between cut points that warrant further consideration. Fitbit showed moderate agreement with ActiGraph, but heteroscedasticity and the epoch of aggregation significantly impacted agreement. Understanding device differences has implications for promoting/researching public health among adolescents. Full article

(This article belongs to the Section Exercise and Health-Related Quality of Life)

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17 pages, 318 KB

Open AccessArticle

Influence of Marital and Parental Status on Public Reactions to Stuttering in Chile: A Socio-Demographic Study

by Yasna Sandoval, Carlos Rojas, Bárbara Farías, Gabriel Lagos, Ángel Roco-Videla, Arnaldo Carocca and Goncalo Leal

Int. J. Environ. Res. Public Health 2025, 22(11), 1662; https://doi.org/10.3390/ijerph22111662 - 2 Nov 2025

Abstract

Stuttering is a communication disorder that significantly impacts individuals’ quality of life. This study examines public reactions towards stuttering within the Latin American context, specifically in Chile, using the Public Opinion Survey of Human Attributes-Stuttering. Data were collected from 400 adults, revealing that [...] Read more.

Stuttering is a communication disorder that significantly impacts individuals’ quality of life. This study examines public reactions towards stuttering within the Latin American context, specifically in Chile, using the Public Opinion Survey of Human Attributes-Stuttering. Data were collected from 400 adults, revealing that married individuals and parents exhibit heightened sensitivity and concern towards stuttering, especially regarding close family members. For instance, 56.86% of married respondents expressed worry about a stuttering sibling, contrasting sharply with only 27.18% of single respondents. Moreover, parents were notably anxious about stuttering in their family. This study underscores the significant role of marital status and parental responsibilities in shaping public attitudes towards stuttering. Additionally, it emphasizes the influence of family-centric values, advocating for the need for comprehensive educational initiatives to combat prevailing stigma towards individuals with stuttering. Full article

20 pages, 1422 KB

Open AccessArticle

Engaging Communities and Empowering Research: Lessons from a Network of Community Engagement Cores

by Daniel F. Sarpong, Corrine Yibing Liu, Tandeca King Gordon, Angela Sy, Bibiana Mancera, Mustapha Alhassan and for the RCMI Community Engagement Consortium

Int. J. Environ. Res. Public Health 2025, 22(11), 1661; https://doi.org/10.3390/ijerph22111661 - 1 Nov 2025

Abstract

As of the end of 2024, the NIH-funded Research Centers in Minority Institutions (RCMI) Program supported 21 specialized centers at minority-serving institutions. Its goal is to strengthen biomedical research infrastructure and enhance the capacity of investigators focused on health disparities. Since 2017, the [...] Read more.

As of the end of 2024, the NIH-funded Research Centers in Minority Institutions (RCMI) Program supported 21 specialized centers at minority-serving institutions. Its goal is to strengthen biomedical research infrastructure and enhance the capacity of investigators focused on health disparities. Since 2017, the centers have operated under a unified framework that includes four core components, one of which is Community Engagement (CEC). In 2021, the RCMI Coordinating Center established the CEC consortium to unify expertise across minority-serving institutions, which include historically Black colleges and Hispanic-serving institutions. This consortium promotes cross-institutional collaboration and innovation in community-engaged research to advance health equity. This paper examines how RCMI CECs strategically enhance research relevance, advance public health outcomes, and address social determinants of health (SDOH) through inclusive, bidirectional partnerships that position communities as co-leaders in the research process. Drawing on data from NIH RePORTER, the 2024 Community Engagement Consortium Signature Programs Monograph, and RCMI Common Data Elements, we analyze the collective contributions of the Community Engagement Core (CECs) across 21 RCMI centers. Findings underscore the role of tailored strategies, cultural competence, and academic-community partnerships in mitigating health disparities and promoting equity in underserved communities. Full article

(This article belongs to the Special Issue Proceedings of the 2024 and 2025 Research Centers in Minority Institutions (RCMI) Consortium National Conferences)

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11 pages, 265 KB

Open AccessArticle

Exploring the Association Between Positive and Negative Social Support and Spiritual Well-Being: Results from the National Survey of American Life

by Shaila M. Strayhorn-Carter, Brook E. Harmon, Latrice C. Pichon and Michelle Y. Martin

Int. J. Environ. Res. Public Health 2025, 22(11), 1660; https://doi.org/10.3390/ijerph22111660 - 1 Nov 2025

Abstract

Previous studies have found that support that is uplifting in nature (i.e., positive social support) can have a positive influence on the spiritual well-being of individuals with chronic diseases. However, few studies have explored positive and negative social support’s (i.e., the individual receiving [...] Read more.

Previous studies have found that support that is uplifting in nature (i.e., positive social support) can have a positive influence on the spiritual well-being of individuals with chronic diseases. However, few studies have explored positive and negative social support’s (i.e., the individual receiving the support feeling unsupported) impact. The purpose of this study is to assess the relationship between positive and negative social support and spiritual well-being among individuals of African descent with chronic illnesses. Survey items that focused on positive and negative social support as well as spiritual well-being were obtained from a secondary dataset, the National Survey of American Life. Missing imputation models were adjusted by demographic characteristics (gender, age, income, education, marital status, employment, length of stay in the U.S., insurance, and religious service attendance). Findings from the analysis revealed a positive association between positive social support and spiritual well-being (β: 0.07, SE: 0.01, p < 0.0001). No significant associations were observed between negative social support and spiritual well-being (β: 0.01, SE: 0.01, p = 0.51). Future researchers should continue to explore the impact of social support on the spiritual well-being of individuals of African descent through the implementation of a culturally tailored program designed to reduce chronic diseases within this population. Full article

11 pages, 246 KB

Open AccessArticle

Empowering Youth Through Evidence: Applying Outcome Harvesting to Evaluate Sexual Reproductive Health and Rights (SRHR) Advocacy in Ethiopia

by Mihret Ayele, Makida Birhan, Sintayehu Abebe, Mesfin Ayeta, Dessie Kassa, Muluken Dessalegn Muluneh and Wendemagegn Enbiale

Int. J. Environ. Res. Public Health 2025, 22(11), 1659; https://doi.org/10.3390/ijerph22111659 - 1 Nov 2025

Abstract

Adolescent sexual and reproductive health and rights (SRHR) challenges, including gender inequality, child marriage, female genital mutilation/cutting and sexual and gender-based violence remain pervasive globally, particularly in Ethiopia. The Power to You(th) programme was designed to address these issues by centering youth voices [...] Read more.

Adolescent sexual and reproductive health and rights (SRHR) challenges, including gender inequality, child marriage, female genital mutilation/cutting and sexual and gender-based violence remain pervasive globally, particularly in Ethiopia. The Power to You(th) programme was designed to address these issues by centering youth voices and fostering transformative community change. This evaluation applied Outcome Harvesting, drawing on mixed quantitative and qualitative data, and employed a participatory approach that engages youth and stakeholders in identifying and verifying programme outcomes between 2021 and 2023. The findings revealed substantial improvements in youth participation in decision-making platforms, advocacy capacity, and awareness of SRH rights. Community attitudes shifted positively, particularly among religious and traditional leaders, who increasingly advocate against harmful practices. Youth-led networks emerged as powerful agents of change, contributing to policy shifts such as increased youth representation in health governance bodies. The evaluation also captured unexpected yet influential changes in community dynamics and institutional responsiveness. These findings highlight the value of participatory approaches in capturing complex social transformations and underscore the role of youth as active agents in reshaping SRHR outcomes. Outcome Harvesting proved effective in documenting both intended and emergent changes, offering valuable insights for scaling inclusive, youth-driven interventions. Full article

30 pages, 1518 KB

Open AccessReview

The Mediterranean Diet as a Model of Sustainability: Evidence-Based Insights into Health, Environment, and Culture

by Pasquale Perrone, Loris Landriani, Roberta Patalano, Rosaria Meccariello and Stefania D’Angelo

Int. J. Environ. Res. Public Health 2025, 22(11), 1658; https://doi.org/10.3390/ijerph22111658 - 31 Oct 2025

Abstract

The Mediterranean Diet (MD) is globally recognized not only for its well-established benefits to human health but also for its potential as a sustainable dietary model from environmental perspectives. Primarily based on plant-based foods, olive oil, fish, and seasonal and local products, the [...] Read more.

The Mediterranean Diet (MD) is globally recognized not only for its well-established benefits to human health but also for its potential as a sustainable dietary model from environmental perspectives. Primarily based on plant-based foods, olive oil, fish, and seasonal and local products, the MD stands out for its ability to reduce overall mortality and the incidence of chronic diseases. At the same time, it is a low environmental impact dietary approach, contributing to the reduction in greenhouse gas emissions, water savings, biodiversity conservation, and soil regeneration. This narrative review was conducted by searching the Scopus and PubMed databases, covering all publications up to 2011, applying predefined inclusion and exclusion criteria, and ultimately including 33 studies. The paper provides a synthesis of the key elements that make the MD a paradigm of sustainability, analyzing critical indicators such as carbon, water, and energy footprints, land use, food waste generation, and carbon sequestration. It also addresses the decline in adherence to the MD, even in Mediterranean countries, highlighting the socio-economic, cultural, and behavioral causes, as well as the necessary strategies to promote its rediscovery and adaptation to contemporary contexts. Full article

(This article belongs to the Special Issue Sustainable Nutrition: Bridging Food Systems, Climate Change, and Human Health)

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18 pages, 521 KB

Open AccessReview

The Role of Theatre-Based Methodologies as Complementary Educational Interventions in Continuing Nursing Education: A Scoping Review

by Giovanna Artioli, Andreina Saba, Laura Saladino, Allison Alberti, Laura Macchetti, Maria Chiara Bassi, Sara Falbo and Federica Dellafiore

Int. J. Environ. Res. Public Health 2025, 22(11), 1657; https://doi.org/10.3390/ijerph22111657 - 31 Oct 2025

Abstract

Theatre-based methodologies are increasingly recognized as complementary approaches that can enhance nurses’ empathy, communication, critical thinking, and person-centred care, all essential for managing chronic illnesses. This scoping review aimed to map and synthesize evidence on the application of theatre in continuing nursing education. [...] Read more.

Theatre-based methodologies are increasingly recognized as complementary approaches that can enhance nurses’ empathy, communication, critical thinking, and person-centred care, all essential for managing chronic illnesses. This scoping review aimed to map and synthesize evidence on the application of theatre in continuing nursing education. A systematic literature search was conducted across five databases (PubMed, CINAHL, PsycINFO, Scopus, and Education Source) for publications in English and Italian up to 30 December 2024, supplemented by grey literature from ProQuest and reference screening via Google Scholar. Twenty-one studies met the inclusion criteria, identifying two main theatre methodologies, Forum Theatre and Drama, with four variations. These interactive methods were reported to foster reflective practice, enhance person-centred care, and improve interprofessional collaboration. Positive outcomes included improved nurse–patient relationships, quality of care, emotional engagement, cultural competence, teamwork, conflict management, and acceptance of diversity. Key facilitators were institutional support and active participation, while barriers included resistance to change and limited resources. These findings indicate that theatre-based education can serve as an effective complementary strategy to cultivate empathy, creativity, and reflective skills in continuing nursing education, supporting the development of holistic and patient-centred care practices. Further research is needed to explore the sustainability of acquired competencies in clinical practice. Full article

(This article belongs to the Section Health Care Sciences)

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