International Journal Of Environmental Research And Public Health[JOURNAL]
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200 papers
Comment on Skjerve et al. Using Simulations to Help Public Health Students Overcome Language Barriers for Better Health Outcomes. 2023, , 6259.
Villafuerte R, Funa A
Int J Environ Res Public Health · 2026 Jun · PMID 42354311 · Full text
Skjerve et al [...].
Skjerve et al [...].
Caregiver-Mediated Adherence and Perceived Health System Factors Associated with Viral Suppression Among Children Receiving Antiretroviral Therapy in Rural South Africa.
Mamane S, Faleni M, Pulido Estrada GA … +2 more , Ncane Z, Gonah L
Int J Environ Res Public Health · 2026 Jun · PMID 42354310 · Full text
BACKGROUND: While caregiver and health system factors are known to influence paediatric ART outcomes, their roles within routine rural South African settings remain insufficiently characterised. AIM: The aim of this stud...
BACKGROUND: While caregiver and health system factors are known to influence paediatric ART outcomes, their roles within routine rural South African settings remain insufficiently characterised. AIM: The aim of this study is to assess the association between caregiver-mediated ART adherence, perceived healthcare access and service quality with viral suppression among children receiving ART in a rural South African province. METHODS: A cross-sectional study was conducted among 86 children aged <15 years receiving ART in routine paediatric HIV care. Viral load suppression was defined as <1000 copies/mL. Predictor variables included caregiver-reported adherence (30-day recall; adherent vs. non-adherent), perceived healthcare access and perceived service quality. Associations were assessed using Chi-square or Fisher's exact tests, where appropriate. Effect sizes were estimated using risk differences. RESULTS: Overall, 77.9% of the child participants were virally suppressed. Caregiver-reported adherence was significantly associated with VLS ( = 0.034). The probability of viral suppression was 100% among adherent children compared to 73.2% among non-adherent children (risk difference: 26.8 percentage points). Caregiver-reported adherence demonstrated high specificity (100%) and positive predictive value (100%) but low sensitivity (22.4%) and negative predictive value (26.8%), indicating that while reported adherence reliably identified children who were suppressed, non-adherence did not consistently predict virological failure. Perceived healthcare access ( = 0.372) and service quality ( = 0.267) were not significantly associated with viral suppression. CONCLUSIONS: Caregiver-mediated adherence was strongly associated with viral suppression, whereas perceived health system factors were not independently associated with treatment outcomes in this cohort. These findings should be interpreted cautiously given the cross-sectional design and reliance on short-term adherence measures. Strengthening household-level adherence support is critical for improving paediatric HIV outcomes in rural settings.
From Risk to Flourishing: Organizational Resources in Seasonal Tourism Work.
Fantinelli S, Cortini M, Santoriello M … +2 more , Pagano L, Galanti T
Int J Environ Res Public Health · 2026 Jun · PMID 42354309 · Full text
Seasonal workers in the tourism sector are exposed to significant psychosocial risks, such as work overload, emotional exhaustion, and precarious employment conditions. Despite growing interest in positive organizational...
Seasonal workers in the tourism sector are exposed to significant psychosocial risks, such as work overload, emotional exhaustion, and precarious employment conditions. Despite growing interest in positive organizational psychology, little is known about how organizational culture impacts perceptions and experiences of seasonal workers in Italy. This study explores the role of positive organizational culture in promoting well-being among seasonal workers in the tourism sector, examining their direct perspectives on organizational climate, work challenges, and individual and organizational resources. Eight semi-structured interviews were conducted with seasonal workers employed in the hospitality industry in Italy. Data were analyzed through an integrated mixed-method approach combining Grounded Theory methodology with quantitative lexical analysis using T-LAB software, ensuring both analytical rigor and interpretive depth. Five macro-categories emerged inductively from the data: trust and relations, coping strategies and emotions, perceived justice, teamwork, and meaning of work. These were integrated into a core category defined as flourishing at work, interpreted through the lens of Seligman's PERMA model. These findings suggest that well-being in seasonal work is an active and relational achievement, sustained by emotional self-regulation, perceived fairness, and collective identity. The results carry direct implications for organizational policies and psychosocial risk prevention strategies in precarious work contexts. In particular, positive organizational culture and environments can act as protective factors against psychosocial risks, with direct implications for organizational policies, psychosocial risk prevention, and evidence-based workplace interventions. The specificity of the analysis method offers an original contribution by integrating qualitative and quantitative textual analysis to investigate psychosocial well-being in an under-explored population: Italian seasonal workers.
Suicidality, Psychological Inflexibility, and Emotional Resilience Among Black College Students.
McLaurin-Jones TL, Hughley SM, Wright JJ
Int J Environ Res Public Health · 2026 Jun · PMID 42354308 · Full text
Research examining risk and protective factors of suicidality among Black students remains limited. This study assessed the effects of psychological inflexibility and emotional resilience on suicidal behaviors among Blac...
Research examining risk and protective factors of suicidality among Black students remains limited. This study assessed the effects of psychological inflexibility and emotional resilience on suicidal behaviors among Black college students. We conducted a secondary data analysis of the 2022-2024 Healthy Minds Study. Black students (aged 18-24) who completed the suicidality matrix, psychological inflexibility (Acceptance & Action Questionnaire II) and emotional resilience (Brief Resilience Scale) measures were included in the analysis. Logistic regressions were performed to examine the effect of psychological inflexibility and resilience on suicidal ideation, plans for suicide, and suicide attempts. The students (N = 4557) represented diverse backgrounds, with 61% being African American, 12.2% African, 13.8% Caribbean, and 7% Afro-Latinx. Further, 18.7% endorsed suicidal ideation, 9.2% endorsed suicide plans, and 3.2% reported a suicidal attempt within the past 12 months. Psychological inflexibility was associated with increased risk of suicidal ideation (OR = 1.04, < 0.001), suicidal plan (OR = 1.05, < 0.001) and suicide attempt (OR = 1.03, = 0.011). Emotional resilience was not associated with any suicidal behaviors as a protective or risk factor. The findings support previous research identifying psychological inflexibility as a suicidal risk factor. Prevention and intervention strategies may warrant a focus on promoting psychological flexibility.
A Review of Western Australian Researchers' Contributions to Understanding Cancer Prevention and Outcomes in Aboriginal People.
Pulu V, Taylor EV, Om P … +1 more , Thompson SC
Int J Environ Res Public Health · 2026 Jun · PMID 42354307 · Full text
Aboriginal people in Western Australia (WA) experience poorer cancer outcomes compared to non-Aboriginal Australians, with significant disparities in cancer screening participation, later-stage diagnosis, and lower survi...
Aboriginal people in Western Australia (WA) experience poorer cancer outcomes compared to non-Aboriginal Australians, with significant disparities in cancer screening participation, later-stage diagnosis, and lower survival rates. This narrative review, informed by selected scoping methods, examined 69 peer-reviewed studies contributed by WA researchers from 2000 to 2024 to inform understanding of and address these inequities. Recurring issues requiring attention included promoting cultural safety in healthcare, addressing barriers to and disparities in cancer care, boosting cancer screening and awareness, enhancing education and communication, strengthening support systems and care navigation, improving treatment access and outcomes, and building workforce capacity. Recommendations to address the above challenges and improve cancer care and outcomes for Aboriginal people in WA included addressing barriers and disparities in cancer care; promoting effective education, communication, and culturally appropriate support; enhancing cancer screening participation and awareness initiatives; improving access to cancer treatment and outcomes; strengthening policy and system-level interventions; supporting families and communities throughout their cancer journey; building research capacity and data collection to guide Aboriginal and community-led initiatives. These recommendations highlighted that multi-level interventions are needed, from empowering Aboriginal people and strengthening communities to improving service delivery and driving systematic reforms. Overall, this narrative review informs future research, policy, and practice focused on equity to improve cancer outcomes for Aboriginal people in WA and beyond.
The Prevalence of Poor Behavioral Health Among University Students by Gender, Sexual Orientation, and Racial Identity: The Role of Discrimination and Microaggressions.
Okuneye TM, Godley AJ, Russell EC … +2 more , Lindley LL, Griffin KW
Int J Environ Res Public Health · 2026 Jun · PMID 42354306 · Full text
Experiences of discrimination and/or microaggressions may negatively affect mental health among university students. We assessed the association between experiences of discrimination, microaggressions, and combined expos...
Experiences of discrimination and/or microaggressions may negatively affect mental health among university students. We assessed the association between experiences of discrimination, microaggressions, and combined exposure on poor behavioral health (PBH) among university students in Spring 2023 ( = 45,386) using cross-sectional data from the American College Health Association's National College Health Assessment III. PBH (an index of severe psychological distress and substance use risk) was reported by 42.9% of students. More than half of sexual and gender minority (SGM) youth reported PBH, and had a high prevalence of discrimination and microaggressions. Among racial/ethnic groups, Black/African American students had the highest prevalence of experiences of discrimination and microaggressions. Minoritized groups who experienced discrimination or microaggressions consistently reported a higher prevalence of PBH compared to their counterparts not reporting these experiences; the opposite pattern was observed among cisgender, heterosexual, and White participants. In the logistic regression models, experiences of both discrimination and microaggressions were associated with an over 2-fold increase in odds of PBH, controlling for demographic variables, compared to those experiencing neither. Interaction effects revealed that experiences of microaggressions did not consistently and differentially predict PBH across subgroups of minority youth. Efforts to increase resilience on university campuses may improve behavioral health.
Excluded Lives: Migrant Status and Access to Healthcare in South Africa.
Asakitikpi A
Int J Environ Res Public Health · 2026 Jun · PMID 42354305 · Full text
While South Africa's Constitution guarantees the right to healthcare for all who live in the country, there are still inequities that affect vulnerable groups. Based on migration status, this paper examines how discrimin...
While South Africa's Constitution guarantees the right to healthcare for all who live in the country, there are still inequities that affect vulnerable groups. Based on migration status, this paper examines how discrimination intersects with structural and institutional practices to produce unequal access to healthcare services for black foreign migrants and asylum seekers in South Africa. Desk reviews of policy frameworks, relevant academic literature, and documented case reports were used to analyze the disconnect that exists in South Africa's rights-based legal commitments and the lived realities of foreigners in the country. Adopting a theoretical framework that integrates structural violence, intersectionality, and bureaucratic discretion, the findings are discussed by conceptualizing discrimination as a structural and interpersonal determinant of health. The findings suggest that the experiences of foreign nationals regarding access to healthcare services are not incidental but embedded within complex socio-political dynamics of scarce resources, institutional practices, and institutional ambiguity. The consequences of these inequities involve delayed care-seeking and increased vulnerability to preventable diseases among black immigrants, with a broader public health risk. Drawing from the study, policy clarity is recommended, and the strengthening of accountability mechanisms to ensure equitable access to healthcare in the country.
Psychosocial, Environmental, and Functional Capacity Determinants of Psychological Workload in Retail Workers: A Multidomain Assessment Using a Digital Tool.
Yoopat P, Julraksa N, Liemmanee W … +2 more , Yongsiriwit K, Aribarg T
Int J Environ Res Public Health · 2026 Jun · PMID 42354304 · Full text
Retail service workers face complex occupational demands across psychosocial, environmental, and physical domains; however, integrated multidomain workload assessments remain limited. A cross-sectional study among 253 re...
Retail service workers face complex occupational demands across psychosocial, environmental, and physical domains; however, integrated multidomain workload assessments remain limited. A cross-sectional study among 253 retail workers used the Find My Stress Progressive Web Application (PWA)-a digital tool assessing subjective workload (Subjective Workload Index; SWI), psychosocial factors, environmental discomfort, musculoskeletal symptoms, and handgrip strength. Hierarchical multiple regression identified four significant SWI predictors: postural difficulty (β = 0.176, = 0.012), workplace bullying (β = 0.175, = 0.008), task duration (β = -0.179, = 0.004), and air quality (β = 0.171, = 0.011; Adjusted R = 0.199, ΔR = 0.227, < 0.001; VIF: 1.03-1.57). Grip strength was retained as a functional capacity indicator. Sex-stratified analyses revealed distinct risk profiles: postural difficulty and task duration predicted SWI in men (Adjusted R = 0.224); workplace bullying was the sole predictor in women (Adjusted R = 0.170). The PWA demonstrated excellent reliability (α = 0.97) and usability (87%; = 359). The Find My Stress PWA provides a scalable platform for multidomain stress screening. Integrated ergonomic, organisational, and environmental interventions guided by digital screening offer targeted strategies for reducing occupational workload burden in retail settings.
Effects of a Synchronous Telehealth Exercise Program on Clinical, Functional, and Psychosocial Outcomes in Individuals with Type 2 Diabetes Mellitus (RED Study): A Randomized Clinical Trial.
Rodrigues SN, Guterres BV, Carvalho MTX … +2 more , Delevatti RS, Alberton CL
Int J Environ Res Public Health · 2026 Jun · PMID 42354303 · Full text
Individuals with type 2 diabetes mellitus (T2D) are at increased cardiovascular risk. Although exercise is an important strategy for reducing cardiometabolic risk, accessible and scalable intervention delivery strategies...
Individuals with type 2 diabetes mellitus (T2D) are at increased cardiovascular risk. Although exercise is an important strategy for reducing cardiometabolic risk, accessible and scalable intervention delivery strategies, such as synchronous telehealth programs, remain underexplored. This randomized clinical trial (RED Study; NCT05362071) investigated the effects of a 12-week synchronous telehealth exercise program on clinical, functional, and psychosocial outcomes in adults with T2D. Thirty-three participants (55.8 ± 10.1 years) were randomized to an intervention group (INT; = 17), which performed supervised combined aerobic and resistance exercise via video calls (2-3 sessions/week), or a control group (CON; = 16). Glycated hemoglobin (HbA1c) was the primary outcome. Secondary outcomes included capillary blood glucose, blood pressure, functional performance, and psychosocial parameters. Assessments were conducted at baseline and post-intervention by blinded evaluators, and analyses were conducted using linear mixed-effects models in an intention-to-treat analysis. No significant interaction effect was observed for HbA1c ( > 0.05). However, significant group × time interactions favored the INT for functional performance outcomes, including the 30 s Chair Stand ( = 0.02), Arm Curl ( < 0.001), Timed Up and Go ( = 0.01), and 2-Minute Step Test ( = 0.01), as well as sleep quality ( < 0.001). Depressive symptoms decreased over time ( = 0.03) in both groups. Additionally, the INT showed reductions in post-session capillary blood glucose across mesocycles 1, 2, and 4 ( = 0.03). The synchronous telehealth exercise program was not superior to the control condition in reducing HbA1c; however, it improved functional performance, enhanced sleep quality, and promoted acute reductions in glycemic levels in individuals with T2D.
Temporal Increase in Strict Spontaneous Intracerebral Hemorrhage Admissions During the First March Following Direct Israel-Iran Hostilities: Preliminary Single-Center Findings from a Decade-Referenced Neuroscience Services Cohort.
Kelmer P, Shemesh SZ, Asprilla J … +3 more , Cohen O, Cohen ZR, Ungar L
Int J Environ Res Public Health · 2026 Jun · PMID 42354302 · Full text
: On 28 February 2026, Israel entered direct large-scale hostilities with Iran under Operation Roaring Lion. The opening phase was characterized by repeated missile alerts, civilian protected-space instructions, and rapi...
: On 28 February 2026, Israel entered direct large-scale hostilities with Iran under Operation Roaring Lion. The opening phase was characterized by repeated missile alerts, civilian protected-space instructions, and rapid reorganization of hospital activity into protected areas. We observed an apparent increase in strict spontaneous intracerebral hemorrhage admissions during March 2026 within our linked neurology/neurosurgery services dataset. The aim of this preliminary single-center study was to determine whether March 2026 was temporally associated with a higher proportional burden of strict spontaneous intracerebral hemorrhage admissions compared with March cohorts from the preceding decade and whether this pattern was also observed for acute ischemic stroke or non-traumatic subarachnoid hemorrhage. : We performed a retrospective observational cohort study of all unique March admissions captured within a linked neurology/neurosurgery services dataset from 2016 through 2026. Hospitalizations were deduplicated by admission number. March 2026 was treated as the first full March occurring after the onset of direct Israel-Iran hostilities on 28 February 2026. Strict spontaneous ICH was defined using diagnosis-text phenotyping that included intraparenchymal or intracerebral hemorrhage terminology while excluding trauma, subarachnoid hemorrhage, subdural hematoma, aneurysm, arteriovenous malformation, tumor-related hemorrhage, cavernoma, venous sinus thrombosis, dissection, and other clearly secondary etiologies. Comparator phenotypes included acute ischemic stroke and non-traumatic subarachnoid hemorrhage (SAH). : Across 3855 unique March admissions, 68 met criteria for strict spontaneous ICH. In March 2026, 9 of 223 admissions (4.0%) were classified as strict spontaneous ICH, compared with 59 of 3632 admissions (1.6%) across March 2016-2025, yielding a rate ratio of 2.48 (95% CI 1.25-4.94; = 0.015). Patients with strict spontaneous ICH in March 2026 were older (mean age 72.3 vs. 65.8 years), and 7 of 9 cases (77.8%) occurred in patients aged ≥70 years compared with 25 of 59 (42.4%) historically ( = 0.073). Acute ischemic stroke did not increase in March 2026 (7.6% vs. 9.4%; = 0.475), and non-traumatic SAH showed only a non-significant numerical increase (2.7% vs. 1.4%; = 0.147). Sensitivity analyses showed a directionally consistent but statistically non-significant increase when March 2026 was compared with March 2025 alone (4.0% vs. 1.2%; rate ratio 3.36, 95% CI 0.92-12.27; = 0.076) and with a rolling 3-year March baseline from 2023 through 2025 (4.0% vs. 2.1%; rate ratio 1.93, 95% CI 0.88-4.23; = 0.143). In-hospital mortality among strict spontaneous ICH patients was 1 of 9 (11.1%) in March 2026 versus 4 of 59 (6.8%) in March 2016-2025. : In this preliminary single-center neurology/neurosurgery services cohort, March 2026 showed a higher proportional burden of strict spontaneous intracerebral hemorrhage admissions than March cohorts from the preceding decade, while acute ischemic stroke did not increase. Sensitivity analyses using March 2025 alone and a rolling 3-year March baseline were directionally consistent but did not reach statistical significance. These findings should therefore be interpreted as a hypothesis-generating temporal association rather than evidence of causality or population-level incidence. Wartime-related psychological stress, sleep disruption, altered healthcare access, blood pressure dysregulation, and medication nonadherence are biologically plausible contributors, but individual-level blood pressure, medication exposure, body mass index, time-to-admission, direct stress exposure, and detailed outcome data were not available in the present dataset. Multicenter, hospital-wide, and registry-based validation with seasonal and systems-level sensitivity analyses is required.
Pesticide Use and Safety Behaviors Among Farmers in Rwanda's Eastern Province: Perspectives from Sector Officers on Drivers, Factors, and Gender Differences.
Irimaso E, Rwibutso C, Nyirahabimana T … +5 more , Curl C, Mitchell S, Mukamana L, Zimmerman D, Sholts SB
Int J Environ Res Public Health · 2026 Jun · PMID 42354301 · Full text
Growing pesticide use is linked to increased health risks for farmers across Africa, due to factors such as improper handling, insufficient knowledge, and lack of resources. To better understand these risk factors in Rwa...
Growing pesticide use is linked to increased health risks for farmers across Africa, due to factors such as improper handling, insufficient knowledge, and lack of resources. To better understand these risk factors in Rwanda, where the majority of the population and most women are farmers, we held focus group discussions (FGDs) with 31 Sector Agricultural Officers (SAOs) and Sector Animal Resources Officers (SAROs) in five districts of Eastern Province. Among their views on this topic, we identified four core themes among the FGDs of (1) interconnected challenges, (2) shared exposure and health risks, (3) gender differences in risk behavior, and (4) transmission of knowledge, in addition to six pesticides-abamectin, cypermethrin, lambda-cyhalothrin, profenofos, mancozeb, and metalaxyl-most commonly used across all districts. Our findings suggest that Rwandan farmers may overestimate variety in the pesticides that they use and thus potentially contribute to problems such as pest resistance, underlining a critical need for integrated, locally informed approaches to pesticide management. This study also demonstrates the valuable role of extension officers in highlighting challenges related to pesticide use in farming communities and advancing research that engages with them.
Exploring Facility Revisit Intentions Among the Kidney Dialysis Patient's Attendance: Evidence from a Cross-Sectional Study in Dhaka, Bangladesh.
Abir TF, Islam R, Salahin KF … +4 more , Kakon K, Agho KE, Peris SF, Ali KS
Int J Environ Res Public Health · 2026 Jun · PMID 42354300 · Full text
Chronic kidney disease (CKD) is a rising public health concern in low- and middle-income countries (LMICs), with urban populations disproportionately affected. In Bangladesh, particularly in Dhaka, dialysis services have...
Chronic kidney disease (CKD) is a rising public health concern in low- and middle-income countries (LMICs), with urban populations disproportionately affected. In Bangladesh, particularly in Dhaka, dialysis services have become essential for CKD management. This study investigates the determinants of revisit intention among adult attendants of dialysis patients in Dhaka, using partial least squares structural equation modeling. A cross-sectional survey was conducted across four major dialysis centers totaling 399 valid responses. A purposive sampling technique was employed to ensure the inclusion of respondents with relevant experience and engagement in dialysis service utilization. Among respondents, over half were male, 43% had primary to higher secondary education, and one-third reported household incomes between BDT 40,001 and 60,000. The largest age group was 45-49 years (32.3%), and nearly 60% selected the facility due to nearness. Reliability and validity metrics met recommended thresholds, and multivariate normality was not assumed (Mardia's test, < 0.05). The structural model revealed significant direct effects of cost (β = 0.167, = 0.003), Perceived trust in healthcare providers (β = 0.252, < 0.001), and Perceived patient satisfaction (β = 0.422, < 0.001) on Perceived revisit intention. Dialysis Delivery Service and word of mouth influenced revisit behavior indirectly through Perceived patient satisfaction. All mediation paths were statistically significant and classified as complementary. To improve patient retention, the policymaker should prioritize affordability, perceived trust in healthcare providers, and overall service quality, which together enhance perceived patients' satisfaction and revisit intention.
'Family Violence and Football' at 15: Revisiting the Effect of Emotional Cues on Intimate Partner Violence.
Collins C
Int J Environ Res Public Health · 2026 Jun · PMID 42354299 · Full text
This paper revisits the famous Card and Dahl study on emotional cues on intimate partner violence (IPV). This paper was one of the first to explore the effects of seemingly irrelevant outcomes-in this case, local Nationa...
This paper revisits the famous Card and Dahl study on emotional cues on intimate partner violence (IPV). This paper was one of the first to explore the effects of seemingly irrelevant outcomes-in this case, local National Football League (NFL) game outcomes-on incidents of IPV, finding that upset NFL losses are associated with a 10% increase in IPV. This paper briefly describes the current state of the "emotional cue" literature, specifically further extensions related to IPV, and then applies the Card-Dahl model to an updated 25-year crime dataset. Results suggest a deviation from the previous literature. NFL upset losses seem to have a considerably reduced effect on IPV than initially found, but some restricted samples find relationships between unexpected game outcomes and IPV.
The Impact of Socioeconomic Inequities and Small-Area Deprivation on Child Inpatient Care: Evidence from a Quantitative Study in a Vulnerable Suburban Setting.
Russo T, Pereira J
Int J Environ Res Public Health · 2026 Jun · PMID 42354298 · Full text
Socioeconomic inequities are associated with longer length of hospital stay (LOS) and clinical severity in children. This retrospective cross-sectional study analyzes health inequalities and area-level deprivation, focus...
Socioeconomic inequities are associated with longer length of hospital stay (LOS) and clinical severity in children. This retrospective cross-sectional study analyzes health inequalities and area-level deprivation, focusing on hospitalization indicators, in a suburban pediatric population in Portugal. Pediatric admissions to a local general hospital were analyzed for LOS and admission to intensive care unit (ICU), as well as their relation to socioeconomic factors, over an 8-year period (2014 to 2021), using population-averaged models. Area-level inequalities were measured for the population ranked by civil parishes' European Deprivation Index. 8016 admissions were included. Health inequalities associated with socioeconomic deprivation were observed, with concentration curves above the diagonal for LOS and admission to ICU and located in urban and densely populated civil parishes. Neonatal age showed the highest mean LOS ratio (MR = 2.29, 95% CI 1.96; 2.67, < 0.001) and ICU admission odds (OR = 9.25, 95% CI 4.84; 17.68, < 0.001). Mean LOS ratio was significantly higher for Black ethnicity (MR = 1.19; 95% CI 1.10; 1.28, < 0.001) and lower maternal education. Odds of admission to ICU was significantly higher for male gender (OR = 1.25, 95% CI 1.01; 1.55, = 0.048) and mother's unskilled occupation (OR = 1.66, 95% CI 1.09; 2.53, = 0.019). Paternal manual skilled occupation demonstrated 17% higher mean LOS ratio ( < 0.001) and 51% higher odds of admission to ICU ( = 0.019). Public policies must be culturally competent and target socioeconomic and geographical deprivation.
Commercial Determinants of Latinx Health: A Scoping Review of Sugar-Sweetened Beverages in the USA.
Patton-Lopez MM, Pinto-Alvarez M, Rivero E … +4 more , Ma J, Carrión I, Toole E, López-Cevallos DF
Int J Environ Res Public Health · 2026 Jun · PMID 42354297 · Full text
Commercial determinants of health (CDoHs) describe how corporate practices influence population health. This scoping review aimed to characterize the extant evidence base regarding how CDoH in the sugar-sweetened beverag...
Commercial determinants of health (CDoHs) describe how corporate practices influence population health. This scoping review aimed to characterize the extant evidence base regarding how CDoH in the sugar-sweetened beverage (SSB) industry affects health and health-related outcomes among Latinx populations in the United States of America (USA). The present study was conducted in accordance with the JBI methodology for scoping reviews. Overall, 1236 references were identified and imported for screening. After duplicate removal, screening, and full-text eligibility assessment, 33 studies met all inclusion criteria. SSB marketing and advertising was the most frequently examined CDoH (61%), including advertising exposure, messaging strategies, and warning label interventions. SSB taxation studies projected reductions in consumption and obesity prevalence. Outcomes associated with health focused primarily on perceptions of marketing and purchasing intentions (94%). Additional studies examined the impact on knowledge, attitudes, beliefs, and behaviors (e.g., purchasing and consumption of SSBs) (66%), while a few studies included chronic disease (27%) or healthcare outcomes (6%). Evidence highlights several gaps in CDoH research associated with SSBs, with 94% of the included studies focused on understanding marketing exposure, signaling a need to examine other domains of CDoH, SSB industry practices, and impacts on health disparities. Findings suggest that structural policy interventions such as taxation and stronger regulation of commercial practices are necessary to address higher exposure to marketing and consumption of SSBs among Latinx populations in the USA.
Indicators of Household Composition Are Associated with Adherence to Fruit and Vegetable Intake Recommendations Among Caretakers Eligible for SNAP with Children.
McLean K, Wiloejo S, Rehman ZN … +2 more , Rummo PE, Trude ACB
Int J Environ Res Public Health · 2026 Jun · PMID 42354296 · Full text
Inadequate fruit and vegetable consumption is associated with increased risk of chronic disease. Yet, many individuals consume below the recommended intake according to the Dietary Guidelines for Americans (DGA). This st...
Inadequate fruit and vegetable consumption is associated with increased risk of chronic disease. Yet, many individuals consume below the recommended intake according to the Dietary Guidelines for Americans (DGA). This study aimed to examine the association of adherence to the DGA (2020-2025) recommendations for fruit and vegetable (FV) intake of 1.5-2 cups of fruits and 2-3 cups of vegetables daily for adults among caretakers with a child(ren) living in households eligible for a Supplemental Nutrition Assistance Program (SNAP). We conducted a cross-sectional analysis of 85 caretakers with children in an urban neighborhood of low-income in the Bronx, New York (NY). Log-binomial regressions demonstrated that having more children (RR 1.36; 95% CI 1.15-1.59), younger children (RR 1.22; 95% CI 1.07-1.39), or children participating in a school lunch program (RR 1.47; 95% CI 1.16-1.85) was positively associated with caretakers' probability of adhering to the DGA recommendations for FV intake. Our study highlights the eating behaviors of families living with children ≤ 10 years of age, many of whom were participating in a school lunch program, and underscores the dietary benefits associated with these characteristics.
and Risk of Primary Amoebic Meningoencephalitis in a Changing Climate: A Scoping Review of Biomedical Literature.
DeFelice J
Int J Environ Res Public Health · 2026 Jun · PMID 42354295 · Full text
, known as the brain-eating amoeba, is a thermophilic, freshwater amoeba causing primary amoebic meningoencephalitis (PAM), a disease that progresses rapidly from symptom onset to death. Climate change is causing surface...
, known as the brain-eating amoeba, is a thermophilic, freshwater amoeba causing primary amoebic meningoencephalitis (PAM), a disease that progresses rapidly from symptom onset to death. Climate change is causing surface water temperatures to increase, providing a hospitable environment for , possibly increasing risk factors for PAM. This review synthesizes the peer-reviewed biomedical literature published between January 2012 and December 2025, examining the risk of infection in the context of a warming climate. A scoping review was conducted searching PubMed, Scopus, and Environment Complete. Data were extracted using a structured coding framework, and risk dimensions were derived inductively during the coding process. Twenty-seven articles met inclusion criteria. Analysis revealed four dimensions of risk (environmental, behavioral, clinical/biological, and infrastructural). The environmental risk dimension highlighted gaps in understanding geographic range expansion and organism ecology. The behavioral dimension identified recreational water exposure, sinus rinsing, and travel as primary risk drivers. The clinical/biological dimension highlighted the need for standards and capacity in diagnosis and treatment, as well as research into pathogenicity. The infrastructural dimension identified gaps in water distribution system surveillance and disinfectant efficacy at high temperatures. This review maps environmental, behavioral, clinical/biological, and infrastructural dimensions of disease risk onto a hazard/exposure/vulnerability framework, highlighting major gaps surrounding exposure and vulnerability. Uncertainties remain in hazard habitat favorability factors, human behavior, and water distribution systems. Emphasis should be placed on characterizing the through environmental testing and determining geographic range, and addressing by increasing clinician awareness, which serves double duty in both initiating early empiric treatment and efforts to quantify true disease burden.
On Burden of Diseases, Prevention, Medical Research and Health Service Delivery: Grampian Case Study.
Vasan SS, Anand S, Lee M … +1 more , Fluck NC
Int J Environ Res Public Health · 2026 Jun · PMID 42354294 · Full text
Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed...
Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer's disease and other dementias are amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25, respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus, oesophageal cancer, and self-harm, while females are more vulnerable to cerebrovascular and chronic obstructive pulmonary diseases. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts, and evidence on the impact of interventions to be made available widely.
A Qualitative Exploratory Study of Facilitators and Barriers Influencing Organ Donation in Ghana: Insights for Health Policy and Advocacy.
Amoah K, Fordjuor G, Lartey S … +26 more , Bonsaana GB, Abaidoo B, Tetteh J, Aidam EAM, Darko KA, Oteng K, Fuseini A, Forgah AE, Quaye MA, Abdul-Rahaman LS, Mamani AP, Boateng DB, Charinga J, Ansing IM, Kusi-Appiah LO, Asante CA, Oduro AYK, Wryter BE, Blankson K, Odoi NO, Sam-Brew D, Krow MO, Addy J, Oboo-Gyan MG, Berzack S, Nariani A
Int J Environ Res Public Health · 2026 Jun · PMID 42354293 · Full text
Organ donation and transplantation are among the greatest scientific discoveries of our time, which have restored hope and life to many. However, several factors influence the global organ donation rate. It is, therefore...
Organ donation and transplantation are among the greatest scientific discoveries of our time, which have restored hope and life to many. However, several factors influence the global organ donation rate. It is, therefore, important to understand the Ghanaian context of facilitators and barriers to donation to dispel cultural myths and misconceptions about organ donation. This study aims to qualitatively explore the facilitators and barriers influencing organ donation in Ghana. This was a qualitative exploratory study conducted among health professionals at four major tertiary hospitals in Ghana. Participants were chosen using the purposive sampling technique. Using a structured interview guide, an in-depth interview was conducted to gather qualitative data, which was then tape-recorded and transcribed. Thematic content analysis was used to manually analyze the data. Of the 25 expert participants, the majority (15, 60.0%) were female. The majority (15, 60.0%) were between 40 and 59 years. The mean age was 42.4 ± 8.0 years. The average number of years of work experience was 15.8 ± 7.1 years. Themes identified for facilitators of organ donation included increased awareness and knowledge campaign, societal influence, and legislative support. Themes for barriers were inadequate knowledge, socio-cultural influence, religious beliefs, and ethical concerns. Increased awareness and knowledge campaigns, societal influence, and legislative support are the significant facilitators of organ donation in Ghana, whereas inadequate knowledge, socio-cultural, and religious influence are important barriers to organ donation in Ghana.
Predictors of Moral Distress Among Nurses: A Cross-Sectional Study.
Siska V, Sollárová A, Slezáková Z … +3 more , Kober L, Minárik P, Forgon T
Int J Environ Res Public Health · 2026 Jun · PMID 42354292 · Full text
Investigating the predictors of moral distress is particularly important for protecting nurses' mental health and professional satisfaction, thereby preventing burnout and attrition from the profession. The primary aim o...
Investigating the predictors of moral distress is particularly important for protecting nurses' mental health and professional satisfaction, thereby preventing burnout and attrition from the profession. The primary aim of this study was to evaluate the predictors of moral distress among nurses. A cross-sectional study design was used. The sample consisted of 412 nurses from 11 hospitals across Slovakia. The mean age of the respondents was 40.48 years (SD = 10.92). Moral distress was assessed using the Modified Moral Distress Scale. Linear regression analysis was used to evaluate predictors of moral distress. Personal accomplishment, the maladaptive coping strategy of self-distraction, continuous shift operation, and emotional burnout emerged as significant predictors of the frequency of moral distress among nurses (AdjR = 15.5%; R = 0.155). Regarding the intensity of moral distress, significant predictors included personal accomplishment, the maladaptive strategy of self-distraction and the adaptive strategy of religiosity and spirituality (AdjR = 14.0%; R = 0.140), which appear to function as adaptive coping mechanisms for dealing with the intensity of moral distress. Systematic investigation of predictors of moral distress among nurses may contribute to the development of interventions and programs that support nurses, thereby improving not only their job satisfaction but also the quality of patient care.
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