International Journal Of Environmental Research And Public Health[JOURNAL]
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200 papers
"To Care for One Another on the Lands That Sustain Us": Reflective Commentaries for Land-Based Healing Among Indigenous Cancer Survivors.
Burnam H, Abrams RR, Bennett ML … +7 more , Washburn N, Paterson M, Carson WO, Redeye CG, Henry WA, Raphaelito J, Haring RC
Int J Environ Res Public Health · 2026 Jun · PMID 42354271 · Full text
Significant gaps exist in survivorship services across the cancer care continuum for Indigenous Peoples in the United States. Despite overcoming overwhelming cancer burden and high mortality risk, Indigenous cancer survi...
Significant gaps exist in survivorship services across the cancer care continuum for Indigenous Peoples in the United States. Despite overcoming overwhelming cancer burden and high mortality risk, Indigenous cancer survivors report lower quality of life compared to non-Indigenous cancer survivors. Using an Indigenous social determinants of health framework, this article shares reflective commentaries from four Indigenous (Haudenosaunee) cancer care professionals who provide insights into the need for traditional Indigenous land-based healing practices among Indigenous cancer survivors, their families, and caregivers. Results suggest that (1) traditional Indigenous healing practices, (2) Indigenous patient navigation services, (3) communities of care, and (4) Indigenous lands and social determinants of health are important factors to support the health and wellbeing of Indigenous cancer survivors. Land-based healing for Indigenous cancer survivors requires further research for future implementation.
Eating Together, Eating Alone: A Cross-Sectional Survey of Associations Between Social Eating Contexts, Mealtime Emotions, Technology Use, and Loneliness in UK University Students.
Chandler L, Li Y, Agarwal D … +8 more , Antkiewicz J, Chike-Michael J, Giacco D, Jilka S, Mensah D, Saunders I, Toro C, Tuomainen H
Int J Environ Res Public Health · 2026 Jun · PMID 42354270 · Full text
: Loneliness is prevalent amongst university students and may be influenced by social eating behaviours. This study explored associations between loneliness and social eating habits and practices and examined whether lon...
: Loneliness is prevalent amongst university students and may be influenced by social eating behaviours. This study explored associations between loneliness and social eating habits and practices and examined whether loneliness varies by demographic characteristics and mealtime behaviours. : A cross-sectional online survey was conducted amongst 255 undergraduate and postgraduate students at a UK campus-based university. Loneliness was measured using the UCLA Loneliness Scale (ULS-8). Self-reported social eating habits, emotional experiences during mealtimes, and technology use while eating were assessed. : The mean loneliness score was 18.27 (SD = 4.90), with 16.1% of participants experiencing severe loneliness. Loneliness did not differ across most demographic groups, except by year of study, with first-year undergraduates reporting higher loneliness than PhD students. Higher loneliness was reported by students who felt embarrassed or lonely when eating alone, were apprehensive about eating with others, or lacked someone to eat with. Greater use of electronic devices or television during meals was also associated with higher loneliness. : Loneliness is common amongst university students and is associated with social eating habits/practices and emotional experiences during mealtimes. Interventions promoting social eating could address discomfort and anxiety related to eating alone or with others.
Coping as a Pathway Linking Religiosity and Spirituality to Mental Health and Early Cardio-Cerebrovascular Risk Among University Students in Malaysia.
Hein ZM, Spaska A, Jasim ADN … +3 more , Abdul Hamid H, Jaffer U, Che Mohd Nassir CMN
Int J Environ Res Public Health · 2026 May · PMID 42354269 · Full text
BACKGROUND: Mental health disorders such as depression, anxiety, and stress are increasingly prevalent among university students and contribute to long-term cardio-cerebrovascular disease (CCVD) risk. However, limited re...
BACKGROUND: Mental health disorders such as depression, anxiety, and stress are increasingly prevalent among university students and contribute to long-term cardio-cerebrovascular disease (CCVD) risk. However, limited research has examined the interplay between mental health, CCVD risk factors, and religiosity/spirituality within Southeast Asia's multicultural context. METHODS: This cross-sectional study investigated these relationships among 484 undergraduate students enrolled in medical and health sciences programs across Peninsular Malaysia. Mental health status was assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Self-reported clinical indicators associated with early CCVD vulnerability were also assessed. Religiosity and spirituality were measured using the Duke University Religion Index (DUREL), Brief Religious Coping (RCOPE), Spirituality Scale (SS), and Spiritual Coping Questionnaire (SCQ). RESULTS: High prevalence rates of severe anxiety (50.4%), depression (29.3%), and stress (21.1%) were observed, with significant associations across ethnicity, religion, and academic programs. Higher religiosity and spirituality were generally associated with better mental health outcomes. However, coping style emerged as a key modifier of the relationship between religiosity/spirituality and mental health outcomes, with negative religious coping associated with greater psychological distress, whereas positive coping demonstrated mixed associations and partial mediating effects. Students with poorer mental health also exhibited higher CCVD risk burden. CONCLUSIONS: These findings highlight the importance of culturally and spiritually sensitive strategies in promoting student well-being.
Healthcare Workers' Perceptions of the Effectiveness of Personal Protective Equipment in Reducing the Risk of COVID-19 Infection from 2020 to 2022.
Ndizeye NA, Mokoatle MC
Int J Environ Res Public Health · 2026 May · PMID 42354268 · Full text
Healthcare workers (HCWs) face occupational hazards that increase their risk of Coronavirus Disease of 2019 (COVID-19). This study aims to evaluate HCWs' perceptions of the effectiveness of Personal Protective Equipment...
Healthcare workers (HCWs) face occupational hazards that increase their risk of Coronavirus Disease of 2019 (COVID-19). This study aims to evaluate HCWs' perceptions of the effectiveness of Personal Protective Equipment (PPE) in preventing COVID-19 infection and to identify risk factors associated with HCW infection. A cross-sectional study design was used, with a structured, self-administered, closed-ended questionnaire to collect retrospective data for the period 2020 to 2022 at a tertiary hospital in Johannesburg, South Africa. PPE was effective in reducing COVID-19 infection, according to 230 (57.07%) participants, while 173 (42.93%) disagreed. A significant association ( = 0.034) with a small effect size (Cramer's V = 0.161) was found between the number of HCWs infected with COVID-19 and their perceptions of PPE's effectiveness. White HCWs were more likely to perceive PPE as effective than Black HCWs (AOR = 3.82, = 0.046). Support and clerical staff reported higher perceived effectiveness of PPE (AOR = 2.98, = 0.040). HCWs encountered COVID-19 infections and various challenges that necessitate interventions and policies to safeguard them in hospital settings and ensure prompt virus management, including ensuring sufficient PPE supplies. The perceptions of PPE effectiveness among HCWs are shaped by an interplay of institutional practices, personal beliefs, and structural factors. These perceptions are closely tied to essential elements such as training, reliable PPE availability, and regular hand hygiene practices, underscoring the need to address both systemic and behavioral dimensions.
Towards Inclusive Fiscal Policy: A Disability-Responsive Taxation Framework for Equity and Economic Empowerment.
Willie MM, Jikwana S, Mnyaka OR … +2 more , Chitha WW, Dyantyi K
Int J Environ Res Public Health · 2026 May · PMID 42354267 · Full text
INTRODUCTION: Disability in South Africa remains a key driver of socioeconomic inequality, affecting labour market participation, income security, and access to social protection. Conventional fiscal instruments, includi...
INTRODUCTION: Disability in South Africa remains a key driver of socioeconomic inequality, affecting labour market participation, income security, and access to social protection. Conventional fiscal instruments, including medical tax credits and deductions, favour formally employed, higher-income taxpayers, leaving many persons with disabilities fiscally excluded. This study used a mixed-methods secondary analysis of peer-reviewed literature, policy documents, labour force data, disability grant records, and household cost estimates to develop a conceptual framework for disability-responsive fiscal inclusion. RESULTS: Labour force data indicate that 10.2% of individuals outside the labour force are due to illness or disability, while discouraged jobseekers rose from 15.2% (2016) to 20.6% (2025). Households with severe disabilities face opportunity costs estimated at R2441 per month from lost earnings, caregiving, transport, and medical expenses. Disability grant patterns show male dominance in permanent disability grants for ages 18-45, with females surpassing males at 50-60. Temporary disability grants follow similar trends, with male predominance in the 18-35 age range and female predominance in the 40-60 age range. These findings reveal systematic gender- and age-related inequities in access to fiscal relief. CONCLUSIONS: Existing tax measures insufficiently address the financial burden of disability, disproportionately favouring urban, formally employed households. Implementing refundable tax credits, simplifying administrative processes, and adopting gender- and age-sensitive policies can enhance fiscal inclusion, reduce inequities, and strengthen economic participation for persons with disabilities in South Africa. This study proposes a framework to guide policymakers in implementing refundable disability tax credits, simplifying administrative processes, and targeting vulnerable groups, including older women, rural households, and low-income earners, to enhance fiscal inclusion, equity, and access to essential services.
Advancing Sustainable Healthcare in Obstetric and Maternity Nursing: Nurses' Knowledge, Awareness, and Clinical Practice-A Cross-Sectional Study.
Elkashif MML, Sheashaa DM, Abdellatif MS … +3 more , Gassmelseed DA, Koabar SMM, Mohamed SA
Int J Environ Res Public Health · 2026 May · PMID 42354266 · Full text
BACKGROUND: Sustainable healthcare in obstetric and maternity nursing emphasizes the provision of high-quality, safe, and environmentally responsible care for women and newborns. Nurses' knowledge, awareness, and clinica...
BACKGROUND: Sustainable healthcare in obstetric and maternity nursing emphasizes the provision of high-quality, safe, and environmentally responsible care for women and newborns. Nurses' knowledge, awareness, and clinical practices are central to the implementation of sustainable approaches, including efficient resource management, evidence-based interventions, and patient education. Evaluating these dimensions is essential for identifying gaps, informing targeted training, and supporting sustainable and effective maternal care aligned with global health goals. Accordingly, this study aimed to assess obstetric and maternity nurses' knowledge, awareness, and clinical practices related to sustainable healthcare. METHOD: A cross-sectional study design was employed. A convenience sampling technique was used to recruit obstetric and maternity nurses working in the selected study settings during the data collection period. A total sample of 120 participants was targeted. The study was conducted at Al-Azhar University Hospital in New Damietta and selected Family Medicine Centers in Damietta Governorate, Egypt. Data were collected using a structured, self-administered questionnaire developed specifically for this study to assess eco-conscious nursing practices in obstetrics and gynecology units. The questionnaire included sections addressing demographic and professional characteristics, knowledge and awareness of sustainable healthcare, eco-conscious clinical practices in maternity settings, perceived barriers and institutional support, attitudes and advocacy toward environmental sustainability, procedure- and material-related environmental concerns, and energy and water conservation behaviors. Responses were measured using standardized 5-point Likert and frequency scales, with composite scores calculated to categorize levels of knowledge, practices, and attitudes toward sustainability; higher scores indicated greater knowledge, awareness, and engagement in sustainable practices. RESULTS: Overall, among the 120 nurses, of whom 62 (51.7%) had reported having heard about sustainability and received training about it, whereas 58 (48.3%) had not. Most participants held a bachelor's degree ( = 54, 45.0%), nearly half had more than 10 years of nursing experience ( = 58, 48.3%), and the largest proportion worked in delivery rooms ( = 53, 44.2%). Regarding knowledge, attitude, and practice, good knowledge was observed in 61 participants (50.8%), good practice in 46 participants (38.3%), and positive attitudes in 108 participants (90.0%). The findings also showed that trained nurses in obstetrics and gynecology units demonstrated significantly higher knowledge, more positive attitudes, and better eco-conscious practices compared to untrained nurses across all domains ( < 0.001). CONCLUSIONS: The study demonstrates that maternity nurses showed moderate to high awareness and positive attitudes toward sustainability, while environmentally sustainable practices were less consistently implemented, indicating a clear knowledge-attitude-practice gap. Nurses who received sustainability-related training consistently achieved significantly higher knowledge, attitude, and practice scores than untrained nurses.
Indigenous 2SLGBTQIA+ Identities and Age-Related Cognitive Decline: A Scoping Review.
King KD, Wilson S, Ferrow L … +4 more , Bonertz L, Dame J, Kennedy M, Walker JD
Int J Environ Res Public Health · 2026 May · PMID 42354265 · Full text
Research on Two-Spirit (2S) and Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual and other identities (LGBTQIA+) Indigenous communities and age-related cognitive decline (ARCD) is still an emerging field of study....
Research on Two-Spirit (2S) and Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual and other identities (LGBTQIA+) Indigenous communities and age-related cognitive decline (ARCD) is still an emerging field of study. Historically, Indigenous and 2SLGBTQIA+ individuals are underrepresented in healthcare research and practices. Our research question was as follows: what is the scope, breadth, and depth of published and gray literature about First Nations, Métis, and Inuit 2SLGBTQIA+ people's experiences of aging and dementia? This scoping review used an Indigenous-informed methodology, grounding our research in a guidance committee comprising all Two-Spirit knowledge-keepers, community advocates, and scholars. This method adapts a five-step scoping review approach, including Indigenous knowledge through consultation with Indigenous community members. The committee informed all five steps of the scoping review methodology. Our initial search identified 1320 articles; after screening, seven articles remained, comprising six journal articles and one book chapter. Manuscripts were published in Canada, the USA, and Australasia. There were five qualitative studies, one scoping review, and a book chapter. The aims, results and recommendations from the included studies are presented. We found minimal published literature on the intersecting identities of 2SLGBTQIA+ Indigenous Peoples and ARCD. Gaps included epidemiological research, assessment and interventions, and qualitative experiences in this population. Further investment in research is needed to expand what is known to understand the needs of Indigenous 2SLGBTQIA+ people with dementia.
Parental Death and Psychiatric Disorders Among Individuals with and Without Experience of Out-of-Home Care: A Swedish Nationwide Cohort Study.
Seker S, Brännström L, Forsman H … +1 more , Rogne S
Int J Environ Res Public Health · 2026 May · PMID 42354264 · Full text
Out-of-home care and parental death are both associated with psychiatric disorders. It remains unclear whether parental death moderates the association between out-of-home care and psychiatric disorders, particularly reg...
Out-of-home care and parental death are both associated with psychiatric disorders. It remains unclear whether parental death moderates the association between out-of-home care and psychiatric disorders, particularly regarding timing and duration of out-of-home placement. This cohort study included 944,138 individuals (459,712 women and 484,426 men) born in Sweden (1972-1981). Of these, 23,106 individuals (2.5%) experienced out-of-home care between ages 0 and 19. Psychiatric disorders, identified from the National Patient Register, were examined as the outcome. Information on parental death between ages 0 and 19 years and familial covariates was obtained from linked national registers. Sex-stratified Cox proportional hazard models examined the associations between out-of-home care, parental death, and psychiatric disorders from ages 20 to 47 years. Individuals with experience of out-of-home care had increased psychiatric risk across adulthood, with the highest risks observed for teenage placements. Parental death was also associated with an increased psychiatric risk. Associations between parental death and psychiatric disorders were attenuated across the teenage, long-term, and early intermediate placement groups among women and across the early intermediate, teenage, and early short-term placement groups among men compared with non-placed counterparts. Findings suggest that parental death adds limited risk within a highly vulnerable and disadvantaged population, highlighting the importance of interventions addressing multiple risks across developmental periods.
Psychological Distress and Associated Factors Among High-School Students in Makkah, Saudi Arabia: A Cross-Sectional Study Using the Arabic GHQ-30.
Hashim AH, Khan AA, Hayat AA
Int J Environ Res Public Health · 2026 May · PMID 42354263 · Full text
BACKGROUND: Mental health problems often begin in adolescence, yet early detection and intervention remain limited. This study assesses the prevalence of psychological distress and its correlates among high-school studen...
BACKGROUND: Mental health problems often begin in adolescence, yet early detection and intervention remain limited. This study assesses the prevalence of psychological distress and its correlates among high-school students in Makkah, Saudi Arabia, and explores whether specific symptom clusters of depression, anxiety and bipolar/mania can be identified using the General Health Questionnaire-30 (GHQ-30). METHODS: A cross-sectional survey was conducted during the 2025-2026 academic year using stratified cluster sampling. A total of 535 students aged 15-18 years completed a questionnaire containing the validated Arabic GHQ-30 and demographic, socioeconomic and lifestyle items. The GHQ-30 was scored with binary 0-0-1-1 scoring (cut-off ≥ 6) to define cases of psychological distress. Item clusters were used to screen for probable depression, anxiety and bipolar/mania. Descriptive statistics characterized the sample. Associations were examined using chi-square tests and multivariable logistic regression. RESULTS: Overall, 70.5% of participants screened positive for psychological distress. The prevalences of probable depression, anxiety and bipolar/mania were 33.1%, 28.2% and 31.2%, respectively. In adjusted models, female gender, insufficient sleep, lack of physical activity and exposure to bullying were associated with increased odds of psychological distress; longer sleep was protective. History of mental health conditions was a strong predictor of probable depression, whereas medication use was protective. Older age and higher paternal education were protective for anxiety. Bullying was the most consistent predictor across all symptom clusters. CONCLUSIONS: Psychological distress is highly prevalent among Makkah high-school students. Key determinants include gender, sleep duration, lack of physical activity and bullying. Routine school-based mental health screening, sleep-hygiene education, anti-bullying initiatives and early referral pathways are warranted. Further research should examine and validate GHQ-30 item clusters for specific disorders.
Seasonality, Weather, and Obstetric Level of Care: An Analysis of Rural Delivery Locations.
Thorsen A, Thorsen ML, McGarvey RG … +1 more , Harris S
Int J Environ Res Public Health · 2026 May · PMID 42354262 · Full text
Birth seasonality in the United States typically peaks in late summer, yet research has rarely examined these patterns in northern mountainous regions or across different hospital obstetric levels. This study investigate...
Birth seasonality in the United States typically peaks in late summer, yet research has rarely examined these patterns in northern mountainous regions or across different hospital obstetric levels. This study investigates the temporal dynamics of maternal healthcare-seeking behavior in Montana, specifically focusing on seasonality in birth volume and obstetric bypassing (delivering at a non-local hospital). We conducted a retrospective analysis of 98,524 birth records (2014-2022) at hospitals with Level 1, 2, and 3 obstetric units, integrating driving distances and monthly county-level climate data. Statistical analyses included calculating observed-to-expected (O-E) ratios to identify seasonality and regression models to test interactions between season, hospital level, and weather. Montana birth volume is distinguished by a peak in June and a trough in January, with seasonality most pronounced at Level 3 hospitals. Obstetric bypassing significantly decreases during winter (O-E ratio 0.95), particularly for Level 1 hospitals, while increasing during warm, high-precipitation months. Over time, bypassing toward Level 3 hospitals has risen from 13.6% to 20%. We conclude that seasonality and weather correlates are associated with significant variation in care-seeking patterns, reflecting the unique challenges facing rural hospitals.
Urban-Scale Chikungunya Risk Mapping in the Western Guangdong-Hong Kong-Macao Greater Bay Area Using Remote Sensing.
Liu Y, Liu S
Int J Environ Res Public Health · 2026 May · PMID 42354261 · Full text
This study presents a reproducible high-resolution framework for assessing urban chikungunya environmental suitability and outbreak-related spatial heterogeneity during the 2025 outbreak in the western Guangdong-Hong Kon...
This study presents a reproducible high-resolution framework for assessing urban chikungunya environmental suitability and outbreak-related spatial heterogeneity during the 2025 outbreak in the western Guangdong-Hong Kong-Macao Greater Bay Area. Using Sentinel-2-derived environmental indicators together with a random forest-based residual correction of Landsat surface temperature, we developed a 10 m weighted additive Mosquito Habitat Suitability Index (MHSI). Index weights were empirically derived by comparing reported case locations at the street and town level with randomly sampled background points. The optimized weighting scheme indicated that humidity- and water-related conditions contributed more strongly to habitat suitability than vegetation and temperature. Reported case locations generally corresponded to higher MHSI values than background locations, suggesting that the index captures broad spatial patterns of environmental suitability. Comparison with a coarser, model-derived global chikungunya risk map was used as an external comparative consistency assessment rather than predictive validation, showing moderate agreement at the macro-spatial scale (Pearson = 0.3421) after correction for spatial autocorrelation. Residual-difference analysis, combined with multiple points-of-interest (POI) categories, ordinary least squares (OLS), and geographically weighted regression (GWR), further suggested that human activity, transport connectivity, and healthcare accessibility may account for part of the remaining spatial mismatch not explained by environmental suitability alone. Sensitivity analyses indicated that the broad LST downscaling pattern and the exploratory GWR interpretation were reasonably stable under alternative sampling, smoothing, grid-size, and bandwidth settings. Taken together, this framework provides preliminary spatial evidence for high-resolution environmental suitability assessment and exploratory interpretation of outbreak-related spatial heterogeneity, while underscoring the need for finer-scale epidemiological data and more explicit representation of human-driven processes.
Preventing Musculoskeletal Strain in Dental Training: Effects of a Movement-Based Intervention.
Sahli D, Oteo-Calatayud C, López-Quiles J … +4 more , Madrigal C, López-Carriches C, Revuelta-Cortés P, Oteo-Morilla C
Int J Environ Res Public Health · 2026 May · PMID 42354260 · Full text
Work-related musculoskeletal disorders (WMSDs) are highly prevalent among dental professionals and often begin during clinical training. Preventive strategies within dental education remain limited. This study aimed to e...
Work-related musculoskeletal disorders (WMSDs) are highly prevalent among dental professionals and often begin during clinical training. Preventive strategies within dental education remain limited. This study aimed to evaluate the effects of integrating a structured yoga-based programme into postgraduate dental training on musculoskeletal symptoms, perceived stress, and resilience. A randomized controlled pilot study was conducted in which participants were allocated to either an intervention group undertaking a 12-week yoga programme (one session per week) or a control group continuing usual clinical activities. Musculoskeletal symptoms were assessed using the adapted Nordic Musculoskeletal Questionnaire (NMQ) recall measure, while psychological outcomes were assessed using the Perceived Stress Scale (PSS-10) and the Connor-Davidson Resilience Scale (CD-RISC-10). Over the study period, musculoskeletal symptom scores decreased in the intervention group, whereas they remained relatively stable in the control group. Significant Group × Time interactions were observed for the primary musculoskeletal outcomes. No significant differences were found for work-related impairment, perceived stress, or resilience. These preliminary findings suggest that structured movement-based interventions may represent a potentially feasible preventive approach within dental training environments to address early occupational musculoskeletal strain. Further research with larger samples and longer intervention periods is needed to confirm these findings.
The Relationship Between State Boredom and Sleep-Wake Disruptions: A Mediation Model via Smartphone Addiction and Bedtime Procrastination.
Fabbri M, Martoni M
Int J Environ Res Public Health · 2026 May · PMID 42354259 · Full text
Bedtime procrastination is linked to poor sleep quality, daytime sleepiness, and altered sleep timing. Identifying the factors influencing this behavior is crucial. Among them, problematic smartphone use can delay bedtim...
Bedtime procrastination is linked to poor sleep quality, daytime sleepiness, and altered sleep timing. Identifying the factors influencing this behavior is crucial. Among them, problematic smartphone use can delay bedtime. State boredom, a multidimensional concept (high and low arousal, disengagement, inattention, and time perception), triggers problematic smartphone use as a way to cope with boredom, resulting in delayed bedtime and sleep-wake issues. This study aimed to test mediation models where state boredom predicts sleep-related outcomes both directly and indirectly through smartphone addiction and bedtime procrastination. A total of 259 participants (138 women; mean age = 38.44 years) completed an online survey, including the Mini-Sleep Questionnaire, Bedtime Procrastination Scale, Mobile Addiction Scale, Multidimensional State Boredom Scale, and measures of sleep timing on workdays and free days. Results showed significant positive associations among all variables. Mediation analyses revealed that state boredom directly predicted poor sleep quality and daytime sleepiness, and indirectly predicted smartphone addiction and bedtime procrastination. Additionally, boredom indirectly influenced sleep timing via bedtime procrastination. Overall, the findings suggest that boredom can lead to problematic smartphone use, which in turn delays bedtime, resulting in poorer sleep quality, increased daytime sleepiness, and delayed sleep timing.
Examining Emotional Climates as a Function of Maternal Parenting Style: A Growth Model That Examines Authoritarian Beliefs and Emotional Expressivity During Parent-Child Interaction.
Risser HJ, Morford AE
Int J Environ Res Public Health · 2026 May · PMID 42354258 · Full text
Parental emotional expressivity toward their child is an integral component of creating a family emotional climate, which is the primary context in which children develop social-emotional skills. The current study sought...
Parental emotional expressivity toward their child is an integral component of creating a family emotional climate, which is the primary context in which children develop social-emotional skills. The current study sought to empirically test Darling and Steinberg's model that parent attitudes that make up parenting style effect parental emotional expressivity during parent-child interaction. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development (SECCYD), the authors examined the compounding effects of maternal authoritarian attitudes measured soon after birth on maternal emotional expressivity toward their infant across three time points (child at 6, 15, and 24 months old). Hierarchical linear modeling analyses (HLMs) demonstrated that a mother's ( = 1165, = 28.2 years) authoritarian attitudes were associated with both decreased positive expressivity and increased negative expressivity toward their child at 6 months of age. Mothers who held more authoritarian attitudes at baseline demonstrated an increased rate of growth in negative expressivity toward their child over time. Maternal race and income were also significantly associated with the linear rate of growth of negative expressivity over time but not in positive expressivity. This suggests that authoritarian attitudes measured when the child is 1 month old continue to impact parent behavior up to 23 months later. This pattern suggests a potential window for effective universal prevention efforts in promoting nurturing parent behavior and promoting positive parent-child relationships. A possible target of prevention intervention could be providing parents with components of a modularized emotion regulation curriculum. The content could help parents to regulate their negative expressivity toward the child and focus on the message they want to convey to the child related to the child's specific behavior.
Accessibility to Primary Care Services for Immigrants Experiencing Homelessness in England: A Qualitative Exploratory Study.
Namata C
Int J Environ Res Public Health · 2026 May · PMID 42354257 · Full text
Access to primary care services is essential for promoting mental health, yet immigrants experiencing homelessness face significant barriers to care. This study explores factors that influence access to primary care serv...
Access to primary care services is essential for promoting mental health, yet immigrants experiencing homelessness face significant barriers to care. This study explores factors that influence access to primary care services in the UK. A qualitative design was employed, involving in-depth semi-structured interviews with 30 immigrants experiencing homelessness and 30 stakeholders across healthcare, voluntary, and local authority sectors. Data were analysed using thematic analysis, guided by the Levesque framework of healthcare access and an intersectionality lens. Findings reveal that access is influenced by intersecting structural barriers, including fear of detention and deportation, cultural stigma surrounding mental health, digital exclusion, and financial hardship. These barriers delay help-seeking and shift care-seeking toward emergency services. Increasing reliance on digital systems in primary care further excludes individuals with limited access to devices, connectivity, or digital skills. These findings indicate that barriers to accessing primary care services may hinder the early identification and preventive management of mental health needs among homeless immigrants. Improving access requires structural reforms that address legal, financial, and digital barriers, alongside more culturally responsive and trust-based care. Without such changes, digital health innovations risk reinforcing existing inequalities and limiting the role of primary care in early mental health intervention and prevention.
Connection to Nature and Psychological Wellbeing: The Role of Mindfulness and Spirituality.
Kazemi S, Torquati JC, Huynh T
Int J Environ Res Public Health · 2026 May · PMID 42354256 · Full text
This study examined mindfulness and spirituality as potential explanatory mechanisms underlying the associations between connection to nature and young adults' psychological wellbeing (depression, anxiety, perceived stre...
This study examined mindfulness and spirituality as potential explanatory mechanisms underlying the associations between connection to nature and young adults' psychological wellbeing (depression, anxiety, perceived stress, life satisfaction, and positive states of mind). Two studies employed structural equation modeling (SEM) to test these pathways using different conceptualizations and measures of mindfulness and spirituality. Participants (Study 1: = 219, 69.4% female; Study 2: = 180, 75% female) completed self-report measures of connection to nature, mindfulness, spirituality, and psychological wellbeing. In Study 1, mindful attention functioned as a significant mediating mechanism reducing anxiety and perceived stress, while mindful awareness mediated reductions in depression and increases in positive states of mind. Conversely, spirituality (life scheme and self-efficacy) was not a significant mediator. In Study 2, using alternative measures, spirituality (self-transcendence) significantly operated as a mediating mechanism across all wellbeing outcomes except anxiety, whereas none of the five facets of mindfulness acted as significant mediating mechanisms. Overall, these findings suggest that the roles of mindfulness and spirituality in linking connection to nature and psychological wellbeing may vary depending on how these constructs are conceptualized and measured, highlighting the need for greater conceptual clarity in future research.
Families Flourish: Triangulating Housing, Neighborhood, and Life Coaching for Health.
Reece J, Lee JY, Kleit R
Int J Environ Res Public Health · 2026 May · PMID 42354255 · Full text
Previous research demonstrates that housing security and quality influence physical and mental health. Despite a rich literature on housing and health, less is known about the processes through which housing mobility pro...
Previous research demonstrates that housing security and quality influence physical and mental health. Despite a rich literature on housing and health, less is known about the processes through which housing mobility programs directly affect family health. We use a single-case design to examine how the health of families with children is impacted by Families Flourish, a mobility program that combines three years of rental assistance with life coaching and placement in safe, well-resourced neighborhoods. Drawing on developmental and formative evaluation data, including longitudinally collected surveys, interviews, and administrative records, we trace families' experiences over time. Our analysis identifies distinct pathways through which mobility improves mental and physical health-via improved indoor air quality, reduced environmental and parental stress, and enhanced access to resources. Initial health gains are subsequently leveraged to improve educational and economic outcomes. We observe a temporal sequence in outcomes, with early physical health gains and later mental health improvements as stability and safety increase. We conclude by situating these identified pathways within existing scholarship and discussing implications for planning and fair housing practice.
Monitoring Emerging Risks for Consumers: DIY Projects Using Epoxy Resins in YouTube Videos.
Rogasch EC, Bergner M
Int J Environ Res Public Health · 2026 May · PMID 42354254 · Full text
Epoxy resins are associated with health risks, including skin sensitization and allergies. They are used by consumers in DIY applications such as the making of decorative objects and jewelry. To determine whether those u...
Epoxy resins are associated with health risks, including skin sensitization and allergies. They are used by consumers in DIY applications such as the making of decorative objects and jewelry. To determine whether those uses pose a risk for consumers, a search on the online platform YouTube was conducted. The results revealed about 200 videos with more than 10,000 views, in which DIY applications of epoxy resins are shown, with a growing number of uploads in recent years. The main DIY applications for epoxy resins were making small decorative objects, jewelry, lamps, tabletops, kitchen countertops and floors. In 41% of the videos, no gloves were worn during the handling of epoxy resins. The analysis of content on YouTube shows that the application of epoxy resins by consumers in the DIY sector may present an emerging risk for consumers' health.
Registered Prevalence and Regional Characteristics of Congenital Anomalies in the Turkistan Region.
Ayazbekov A, Oshibayeva A, Ozkan S … +2 more , Taskinova G, Taubekova M
Int J Environ Res Public Health · 2026 May · PMID 42354253 · Full text
BACKGROUND: Congenital disorders (CDs) are a major contributor to perinatal morbidity and mortality, and their prevalence may vary by region. This study aimed to assess the epidemiological characteristics and regional fe...
BACKGROUND: Congenital disorders (CDs) are a major contributor to perinatal morbidity and mortality, and their prevalence may vary by region. This study aimed to assess the epidemiological characteristics and regional features of congenital anomalies (CAs) in the Turkistan Region and to evaluate temporal trends and forecast near-term dynamics. METHODS: A retrospective analysis was conducted using data from regional perinatal centers and medical institutions in the Turkistan Region for 2020-2024. The total number of registered pregnancies and diagnosed CA cases were summarized annually. RESULTS: From 2020 to 2024, 53,169 pregnancies were registered and 848 cases of CAs were identified, yielding an overall prevalence of 1.6%. The registered prevalence of CAs increased from 0.8% in 2020 to 2.4% in 2024. This temporal increase coincided with the expansion of prenatal screening and diagnostic services in the region during the study period. CONCLUSIONS: The findings demonstrate an increase in the registered prevalence of CAs in the Turkistan Region over the study period. The observed trend may reflect both changes in case detection and registration practices, as well as possible epidemiological influences, highlighting the importance of continued surveillance and prenatal diagnostic services.
University Students' Perceptions and Intentions to Use Digital Mental Health Services Including Online Therapy and Mental Health Apps: A Cross-Sectional Study.
Al-Mahrouqi T, Al Wardy M, Al Lawati A … +6 more , Al Maskari A, Al Azri A, Al Riyami Q, Al Aufi H, Jose S, Sinawi HA
Int J Environ Res Public Health · 2026 May · PMID 42354252 · Full text
This study examined the association between attitudes toward digital technology and intentions to use digital mental health solutions, with perceptions of mental health apps and online therapy as potential mediators. A c...
This study examined the association between attitudes toward digital technology and intentions to use digital mental health solutions, with perceptions of mental health apps and online therapy as potential mediators. A cross-sectional survey was conducted with 360 undergraduate students at Sultan Qaboos University (SQU) (July 2025). The mean age was 21.24 (SD = 3.12), with 50.3% of female respondents and 49.7% male. Using a validated questionnaire, we included assessments of attitudes and beliefs about digital technology, perceptions of mental health apps and online therapy, and intention to use digital mental health solutions. Mediation analysis was performed using structural equation modeling. Attitudes toward digital technology were significantly associated with intention (β = 0.358, < 0.001). Perceptions of mental health apps significantly mediated this relationship (indirect effect = 0.065, = 0.006), while perceptions of online therapy did not (indirect effect = 0.030, = 0.109). The total indirect effect through both mediators was significant (0.095, = 0.002), with a strong total effect on intention (0.454, < 0.001). These findings suggest that improving students' perceptions of mental health apps may help them use digital mental health services. Implementation strategies in similar university settings should target service-specific perceptions to drive adoption of these tools.
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