International Journal Of Environmental Research And Public Health[JOURNAL]
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200 papers
Maternal Healthcare Access and Childbirth Outcomes in Rural, Resource-Limited Settings: Evidence from the Eastern Cape, South Africa.
Mdume A, Maake KP, Mahlati Z … +1 more , Ntlongweni X
Int J Environ Res Public Health · 2026 May · PMID 42354231 · Full text
BACKGROUND: Maternal healthcare access is a critical determinant of women's and neonatal health, especially in rural areas of low- and middle-income countries. Despite high reported utilization in South Africa, rural com...
BACKGROUND: Maternal healthcare access is a critical determinant of women's and neonatal health, especially in rural areas of low- and middle-income countries. Despite high reported utilization in South Africa, rural communities continue to experience adverse childbirth outcomes. OBJECTIVE: To evaluate the association between maternal healthcare access and childbirth outcomes in Ingquza Hill Local Municipality, Eastern Cape Province of South Africa. METHODS: A cross-sectional study was conducted among 213 pregnant and postpartum women receiving maternal healthcare services at St Elizabeth Hospital, a regional referral hospital serving multiple primary healthcare clinics across the municipality. Data were collected using structured questionnaires and maternity access indicators (including ANC attendance, timing of first ANC visit, number of visits, physical accessibility, and place of delivery), and childbirth outcomes. Logic regression analyses were performed to identify associations between access indicators and unfavorable childbirth outcomes. RESULTS: Utilization of maternal healthcare services was high, with 96% of participants reporting ANC attendance, 92% receiving skilled care during pregnancy, and 91% delivering in a health facility. Unfavorable childbirth outcomes were observed in 12% of participants. Conventional indicators of maternal healthcare access, including ANC attendance, number of visits, physical accessibility, and place of delivery, were not statistically associated with childbirth outcomes in regression analyses. However, initiation of antenatal care was notably delayed, with a mean gestational age at first ANC visit of 21.7 weeks. The limited number of adverse outcomes constrained statistical power to detect modest associations. CONCLUSIONS: High maternal healthcare utilization alone did not ensure improved childbirth outcomes in this rural setting. Delayed initiation of antenatal care emerged as a critical gap that may limit the effectiveness of subsequent care, highlighting the limitations of coverage-based access indicators. Strategies to improve maternal and neonatal outcomes should prioritize early antenatal engagement, quality and continuity of care, and move beyond utilization metrics toward measures of effective coverage in rural and resource-limited contexts.
Suicide and Drug Overdose Mortality Among Washington State Workers: A Stratified Analysis by Industry, Occupation, Sex, and Race/Ethnicity, 2014-2023.
Sampson LW, Bonauto DK, Marcum JL
Int J Environ Res Public Health · 2026 May · PMID 42354230 · Full text
Even with the rise in concern over suicide and drug overdose mortality in the United States, gaps in research on at-risk populations still exist. The purpose of this study was to investigate disparities in suicide and dr...
Even with the rise in concern over suicide and drug overdose mortality in the United States, gaps in research on at-risk populations still exist. The purpose of this study was to investigate disparities in suicide and drug overdose mortality risk among Washington State workers. Using 2014-2023 Washington State death records and American Community Survey (ACS) data, we calculated rates of suicide and drug overdose mortality by usual industry and occupation while adjusting for age and stratifying by sex and race/ethnicity. We compared the mortality risk among workers in specific industries and occupations to all workers within the same sex and race/ethnicity strata to understand how work differentially affects risk. Working in Construction & Extraction occupations was associated with an increased risk for suicide and drug overdose death for males across all race/ethnicity categories and for drug overdose death among White females. The suicide risk for Asian/Pacific Islander males had the largest increase-Asian/Pacific Islander males working in Construction & Extraction occupations had a rate 4.59 times higher than all Asian/Pacific Islander male workers. The Education, Training, & Library occupation group had significantly lower crude rates and rate ratios. Although the causal pathways that may lead someone to die by suicide or drug overdose are complex, understanding risk profiles among different industries and occupations may lead to more appropriate prevention strategies.
Prevalence, Risk Factors, and Preventive Strategies of Hypertension Among Young Adults in the United Arab Emirates.
Raid Hussain Aljubori A, Abutartour MNM, Abdulla Darwish Ali I … +2 more , Ghaith Al Haj Younes M, Muttappallymyalil J
Int J Environ Res Public Health · 2026 May · PMID 42354229 · Full text
Hypertension is one of the most common noncommunicable diseases. This research assessed the magnitude of hypertension among young adults, identified its key determinants, and explored potential strategies adopted for pr...
Hypertension is one of the most common noncommunicable diseases. This research assessed the magnitude of hypertension among young adults, identified its key determinants, and explored potential strategies adopted for prevention. A cross-sectional design was employed, including 1606 participants aged 18 years and older, recruited through convenience sampling from universities and community settings. Data were collected using a content-validated questionnaire covering sociodemographic information, personal and family medical history, and lifestyle habits. Of the participants, 993 (61.8%) reported hypertension, nearly double previous national estimates. Male gender, age ≥ 30 years, and family history were significant risk factors, along with smoking, alcohol use, sedentary lifestyle, and unhealthy diet, while physical activity and dietary modification were protective. Despite high prevalence, only 22.1% had controlled blood pressure and 17.8% adhered to medication, with 51.5% relying on herbal remedies. These findings highlight the urgent need for early screening, youth-focused awareness, and culturally tailored interventions to reduce hypertension and prevent long-term cardiovascular complications. Hypertension among young adults in the UAE is a major public health concern, requiring integrated strategies combining education, lifestyle modification, and medical management to improve outcomes.
Effectiveness of Low-Level Laser Auriculotherapy in the Treatment of Myogenic Temporomandibular Disorders and Anxiety: A Randomized, Placebo-Controlled Trial.
de la Barra Ortiz HA, Chamorro Lange C, Liebano RE
Int J Environ Res Public Health · 2026 May · PMID 42354228 · Full text
Low-level laser auriculotherapy (LLLT-AT) is a non-invasive intervention increasingly explored for the management of musculoskeletal pain and psycho-emotional symptoms, which frequently coexist in myogenic temporomandibu...
Low-level laser auriculotherapy (LLLT-AT) is a non-invasive intervention increasingly explored for the management of musculoskeletal pain and psycho-emotional symptoms, which frequently coexist in myogenic temporomandibular disorders (TMDs). This randomized, assessor-blinded, placebo-controlled clinical trial evaluated the effectiveness of LLLT-AT as an adjunct to manual therapy in improving pressure pain threshold (PPT) and anxiety in individuals with myogenic TMDs. Forty-four participants with myogenic TMDs and clinically relevant anxiety were randomly allocated to an experimental group receiving LLLT-AT combined with a standardized myofascial release protocol ( =21) or to a control group receiving sham LLLT-AT with the same manual therapy ( =23). Interventions were delivered twice weekly for three weeks. Primary outcomes were PPT, assessed by pressure algometry, and anxiety, measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Secondary outcomes included maximum mouth opening range of motion (MMOROM) and mandibular functional limitation assessed by the Jaw Functional Limitation Scale-8 (JFLS-8). Outcomes were evaluated at baseline, post-intervention, and at a four-week follow-up. Both groups demonstrated significant within-group improvements in PPT, MMOROM, and JFLS-8 over time ( < 0.05), with no significant between-group differences ( > 0.05). Between-group analyses showed greater reductions in anxiety in the LLLT-AT group at post-intervention ( = 0.02; Hedges' g = -1.35) and follow-up ( = 0.02; Hedges' g = -1.68). LLLT-AT did not confer additional mechanical or functional benefits but was associated with greater reductions in anxiety when used as an adjunct to manual therapy.
Transforming Diabetes Management in Rural America: A Qualitative Exploration of a Diabetes Coaching Program Delivered via Telehealth.
Moring C, Brock C, Brown KL … +1 more , Ford-Wade A
Int J Environ Res Public Health · 2026 May · PMID 42354227 · Full text
Diabetes disproportionately affects rural populations in the United States where prevalence and associated complications remain among the highest in the nation. Access to diabetes education and support services is often...
Diabetes disproportionately affects rural populations in the United States where prevalence and associated complications remain among the highest in the nation. Access to diabetes education and support services is often limited by geography, socioeconomic barriers, and workforce shortages. This study qualitatively explored participant experiences in a telehealth-based Diabetes Self-Management Education and Support (DSMES) program. This study uses interview techniques and takes a phenomenological approach to exploring the lived experiences of 27 program participants. Transcripts were analyzed through three cycles of coding to identify shared themes. Four themes emerged: (1) structural benefits of the program, (2) knowledge gained, (3) lifestyle changes implemented, and (4) improved quality of life. Participants consistently emphasized the value of personalized coaching, emotional encouragement, and practical nutrition education. Findings suggest that individualized telehealth coaching plays an important role in diabetes self-management, particularly in rural and underserved populations. By combining personalization with education and encouragement, programs can improve patient engagement, enhance self-efficacy, and support meaningful behavior change.
Randomised Evaluation of Sleep in Cognitive Impairment Trial (REST)-Protocol for a Feasibility Study of a Digital Cognitive Behavioural Therapy for Insomnia Intervention.
Crowley P, Henry AL, O'Donovan M … +3 more , Sheehan R, Flanagan E, O'Caoimh R
Int J Environ Res Public Health · 2026 May · PMID 42354226 · Full text
Dementia is a leading and growing cause of disability worldwide. Insomnia is highly prevalent in mild cognitive impairment (MCI) and dementia and is associated with impaired cognition, functional decline, and reduced qua...
Dementia is a leading and growing cause of disability worldwide. Insomnia is highly prevalent in mild cognitive impairment (MCI) and dementia and is associated with impaired cognition, functional decline, and reduced quality of life (QoL). Although sleep disturbance represents a potentially modifiable risk factor within the trajectory of cognitive impairment, there have not been many studies conducted to examine the feasibility or preliminary efficacy of digital cognitive behavioural therapy for insomnia (dCBT-I) in this population. The aim of this pilot randomised controlled feasibility study is to evaluate the acceptability, adherence, and potential clinical effects of a multi-component dCBT-I programme (Sleepio) in adults with MCI or mild dementia and comorbid insomnia. Thirty community-dwelling adults aged ≥50 years with established MCI or mild dementia (Mini-Mental State Examination ≥18; Clinical Dementia Rating 0.5-1.0) and insomnia (Sleep Condition Indicator ≤16) will be randomised (1:1) to Sleepio or a wait-list control. Feasibility outcomes include recruitment and retention rates, intervention adherence (completion of ≥4/6 sessions), and acceptability measured using validated usability scales. Secondary outcomes include changes in sleep, mood, QoL, cognition, and function over 10 weeks. Adverse events will be monitored to assess safety. Findings will inform the design of a future definitive trial evaluating digital sleep interventions in cognitively impaired populations. Ethical approval has been granted. The trial is registered at ClinicalTrials.gov (NCT07363928).
Exploring Inflation-Related Public Discourse Relevant to Social Determinants of Health Using Social Media Data.
Zhang Y, Sambamoorthi N, Wiener RC … +5 more , Wang H, Shen C, Mitra S, Findley PA, Sambamoorthi U
Int J Environ Res Public Health · 2026 May · PMID 42354225 · Full text
Inflation, recognized as a social determinant of health (SDOH), significantly affects the daily lives of individuals through the rising costs of food, housing, and other basic needs, all of which are public health concer...
Inflation, recognized as a social determinant of health (SDOH), significantly affects the daily lives of individuals through the rising costs of food, housing, and other basic needs, all of which are public health concerns. Since the COVID-19 pandemic, inflation has become a prominent concern in the U.S. and has been linked to increased stress and poor mental health among adults. While data on inflation is tracked routinely, how it is discussed publicly is understudied. Social media platforms provide insights into how inflation is framed and experienced by the public, and these assessments may be used to determine public health needs and policy advocacy. In this study, we conducted a time-bound, platform-specific case study of inflation-related discourse on X (formerly Twitter). Analysis revealed a predominance of negative sentiments (68.5%) including frustration and distrust. Posts primarily concerned monetary policy/government spending (31.6%), Federal Reserve interest rates/financial markets (24.5%), and U.S. presidential politics (12.9%). The users did not explicitly discuss personal-level hardships, and the discussions largely focused on macro-level issues framed in polarized political perspectives. These patterns matter for public health because institutional trust shapes support for social and health policies. Our study findings suggest a fragmented social environment that may exacerbate community-wide anxiety and challenge health promotion efforts and the need for public health surveillance through surveys or personal interviews to identify and address the psychological burden of inflation.
Effective Coverage of Rehabilitation for Adults with Chronic Primary Low Back Pain in Uganda.
De Groote W, Taremwa Y, Duttine A … +1 more , Kajungu D
Int J Environ Res Public Health · 2026 May · PMID 42354224 · Full text
In Uganda, in 2019, 6.8 million people experienced health conditions that are amenable to rehabilitation. This is largely due to musculoskeletal disorders such as low back pain (LBP). Measuring effective coverage of reha...
In Uganda, in 2019, 6.8 million people experienced health conditions that are amenable to rehabilitation. This is largely due to musculoskeletal disorders such as low back pain (LBP). Measuring effective coverage of rehabilitation means assessing whether a population that needs rehabilitation services receives the interventions with sufficient quality to produce the desired health gain. This study reports on the first measurement of effective coverage of rehabilitation in Uganda and globally using chronic primary LBP as the tracer health condition. A population survey was conducted to administer the WHO global tracer indicator questions. The survey questions were used to identify respondents with chronic primary LBP experiencing limitations in functioning and to determine utilization of rehabilitation services. The WHO Disability Assessment Schedule (WHODAS) 2.0 12-item was used for the measurement of an improvement in functioning that is meaningful to service users. The questions were nested in the Iganga-Mayuge Health and Demographic Surveillance Site (IMHDSS) update round 22 in seven sub-counties in rural Eastern Uganda between June and September 2023. Data collection followed a training session on survey administration and data capture for enumerators, field supervisors, research managers and lead scientists from the Makerere University Centre for Health and Population Research and a pilot testing of the data collection tool. Survey administration resulted in data collection for 8645 respondents aged 18 years and above. Specifically, 15.2% of the respondents had experienced chronic LBP in the last 12 months, of which 88.5% had experienced pain that was severe enough to affect their usual household, recreational or work activities. A total of 46% of this population in need of rehabilitation had been utilizing rehabilitation services (crude coverage), with no difference between women and men. Only 7.05% of the respondents with chronic primary low back pain experiencing limitations in functioning had been managed with sufficient quality to produce the desired health gain, defined by a minimal but meaningful improvement in functioning (effective coverage).
The Effect of Sleep Environment on Sleep Quality and Behavior in Firefighters: A Cross-Sectional Study.
Zera JN, Esper E, Simonson AP … +2 more , Clausen AN, Paterno S
Int J Environ Res Public Health · 2026 May · PMID 42354223 · Full text
Firefighters face high-stress occupational demands and irregular shift work that negatively impact sleep quality, which is intrinsically linked to long-term physical and psychological health. This cross-sectional study e...
Firefighters face high-stress occupational demands and irregular shift work that negatively impact sleep quality, which is intrinsically linked to long-term physical and psychological health. This cross-sectional study examines how the physical sleep environment (home vs. work) and station sleeping arrangements (bunk-style vs. individual dorm-style quarters) influence subjective sleep quality in this population. Sixty-six career firefighters (Age = 40.89 ± 11.05 years), completed the Pittsburgh Sleep Quality Index (PSQI) to assess their sleep in both home and fire station environments, with data analyzed using Wilcoxon Signed Ranks and Mann-Whitney U tests. The results reveal significant differences ( < 0.001), with sleep duration, efficiency, subjective quality, and global PSQI scores all performing significantly better at home than at work. Notably, no significant differences were found between bunk-style and dorm-style sleeping quarters at the station. These findings suggest that firefighters experience poorer sleep while on duty regardless of room design, indicating that operational stressors like call volume and nocturnal arousal may be more influential on sleep quality than the physical arrangement of sleeping quarters, and could inform organizational policies and wellness programs aimed at reducing occupational fatigue.
From Community Benefits to Vulnerabilities: Reverse-Logic Analysis of Nature-Based Solution Treescapes Across Europe.
Pittaway T, Townsend L, Hardy C
Int J Environ Res Public Health · 2026 May · PMID 42354222 · Full text
Nature-based solutions (NBSs) involving tree-based interventions deliver multiple community benefits, yet evidence linking these benefits to underlying socio-ecological vulnerabilities remains limited. This study synthes...
Nature-based solutions (NBSs) involving tree-based interventions deliver multiple community benefits, yet evidence linking these benefits to underlying socio-ecological vulnerabilities remains limited. This study synthesised metadata from 131 European treescape NBS case studies spanning eight biogeographical regions using reverse-logic, thematic qualitative analysis. Case studies were identified via adapted PRISMA guidelines from open-access repositories, with community benefit themes categorised and mapped spatially across bioregions. The analysis revealed eleven principal community benefit categories and distinct region-specific patterns: Mediterranean interventions primarily mitigated extreme heat and drought vulnerabilities, whilst Alpine projects addressed slope stability and hazard reduction. The Continental and Atlantic regions emphasised social cohesion, recreational access, and the preservation of cultural heritage. The reverse-logic methodology successfully identified underlying socio-ecological vulnerabilities through systematic analysis of observed benefit profiles across diverse European contexts. This approach provides evidence-based guidance for designing location-sensitive treescape NBS that advance environmental research and public health objectives. The findings establish a methodological foundation for future assessments of NBS effectiveness and for refining location-specific treescape interventions that address community vulnerabilities and enhance adaptive capacity.
Effects of a 12-Week Multidisciplinary Program on Health-Related Physical Fitness and Depressive Symptoms in Overweight and Obese Women Aged Between 45 and 64 Years with Noncommunicable Chronic Diseases.
Camilo MLA, Berbery E, Noronha ED … +4 more , Vidal Andreato L, Marchiori LLM, Valdés-Badilla P, Branco BHM
Int J Environ Res Public Health · 2026 May · PMID 42354221 · Full text
UNLABELLED: We evaluated the effects of a 12-week multidisciplinary program on health-related physical fitness and depressive symptoms in overweight and obese women (aged 45-64 years) diagnosed with noncommunicable disea...
UNLABELLED: We evaluated the effects of a 12-week multidisciplinary program on health-related physical fitness and depressive symptoms in overweight and obese women (aged 45-64 years) diagnosed with noncommunicable diseases (NCDs). METHODS: A longitudinal, pre-experimental, proof-of-concept study was conducted. Thirty-one women completed multidisciplinary interventions [nutritional education or psychoeducation (each once a week), and resistance training (twice a week)]. Body composition (bioelectrical impedance), physical fitness (maximal isometric strength, lower limb strength-endurance, flexibility, and aerobic fitness), and depressive symptoms (PHQ-9) were measured at baseline and post-intervention. RESULTS: Significant improvements in body composition were observed in terms of lean mass (Δ% = 3.7; < 0.001), fat-free mass (Δ% = 3.6; < 0.001), skeletal muscle mass (Δ% = 5.2; < 0.001), fat mass (Δ% = -3.5; < 0.001), body fat percentage (Δ% = -4.7; < 0.001), and visceral fat level (Δ% = -2.9; = 0.012). Physical fitness exhibited a large effect size in the chair stand test ( = 0.91) and the 6 min walk test ( = 1.22). Depressive symptom scores substantially decreased ( < 0.001). CONCLUSION: The program demonstrated potential efficacy in mitigating sarcopenic obesity, enhancing functional capacity, and reducing depressive symptoms, indicating potential clinical viability for the integrated management of multimorbidity.
Autoimmune Thyroid Diseases After COVID-19 Infection: A Systematic Review of Clinical Manifestation and Outcomes.
Messova AM, Ganiyeva I, Abdrakhmanova ST … +4 more , Tuleubayeva A, Sanbayev M, Makibayeva MG, Tamadon A
Int J Environ Res Public Health · 2026 May · PMID 42354220 · Full text
Increasing evidence suggests that COVID-19 can induce or exacerbate autoimmune disorders, including immune-mediated thyroid dysfunction. The most common autoimmune thyroid diseases are Graves' disease and Hashimoto's thy...
Increasing evidence suggests that COVID-19 can induce or exacerbate autoimmune disorders, including immune-mediated thyroid dysfunction. The most common autoimmune thyroid diseases are Graves' disease and Hashimoto's thyroiditis; the mechanisms by which viral infections like SARS-CoV-2 trigger these diseases are not fully understood. This study aims to systematically review published clinical evidence on the presentation, laboratory characteristics, and outcomes of autoimmune thyroid diseases after COVID-19 infection. The review followed the PRISMA 2020 framework. Scopus, Web of Science, and PubMed were searched for English-language studies between January 2020 and December 2025 using the terms COVID-19, SARS-CoV-2, autoimmune thyroiditis, Graves' disease, Hashimoto's thyroiditis, and autoimmune thyroid disease. In total, 46 studies (five cohort studies and 41 case reports/series) involving 3856 patients were analyzed. The findings indicate that a significant increase in TPOAb prevalence occurs post-COVID-19 infection (15.7% vs. 7.7% in controls). New-onset Graves' disease (GD) post-COVID-19 presented with higher fT3/fT4 ratios and more aggressive thyrotoxicosis compared to non-viral cases. Rare but severe manifestations included thyrotoxic periodic paralysis, Hashimoto's encephalopathy, and dilated cardiomyopathy. SARS-CoV-2 may act as a trigger for autoimmune thyroid diseases, particularly in moderate-to-severe infections; however, the strength of this association warrants further investigation with controlled prospective data. Standard therapy remains effective, but thyroid function monitoring is advisable during post-COVID-19 recovery. An interdisciplinary approach is essential for early diagnosis and management of systemic complications.
Built Environment-Modulated Epigenetics: The Epigenetic Consequences of Architecturally Mediated Allostatic Overload in the Built Environment.
Valentine C, Mitcheltree H, Sjövall I … +1 more , Khalil MH
Int J Environ Res Public Health · 2026 May · PMID 42354219 · Full text
The concept of architecturally mediated allostatic overload has established that chronic exposure to stress-inducing built environments can elicit stress responses within the body, overwhelming regulatory systems and con...
The concept of architecturally mediated allostatic overload has established that chronic exposure to stress-inducing built environments can elicit stress responses within the body, overwhelming regulatory systems and contributing to adverse health outcomes through sustained activation of stress response pathways. Recent advances in epigenetics, combined with emerging evidence of environmental stress-induced epigenetic modifications, suggest that the health impacts of chronic built environment stress may extend far beyond previously understood physiological consequences. This paper introduces the theoretical concept of "built environment-modulated epigenetics" (BEME), extending the framework of architecturally mediated allostatic overload to consider how chronic exposure to stress-inducing built environments may create lasting epigenetic modifications with potential transgenerational implications. We propose that prolonged activation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adreno-medullary (SAM) axes by built environment stressors may result in maladaptive DNA methylation and histone modifications affecting stress-responsive genes, similar to documented effects of environmental toxins, air pollution, and psychosocial stressors. Given robust evidence that environmental stressors can create transgenerational epigenetic effects, this theoretical framework suggests that stress-inducing built environments may impact not only current occupants, but future generations through heritable epigenetic modifications. This extension of architecturally mediated allostatic overload theory fundamentally challenges traditional approaches to architectural design and urban planning, positioning the built environment as a potential determinant of long-term epigenetic programming.
Understanding the Impact of Long COVID on the Lives of Thai University Students.
Habuddha V, Piya-Amornphan N
Int J Environ Res Public Health · 2026 May · PMID 42354218 · Full text
COVID-19 has had profound global impacts, and Long COVID may continue to affect quality of life and well-being in some individuals. Young adults may be particularly vulnerable to these impacts due to ongoing physiologica...
COVID-19 has had profound global impacts, and Long COVID may continue to affect quality of life and well-being in some individuals. Young adults may be particularly vulnerable to these impacts due to ongoing physiological, behavioral, and psychological development. This study aimed to examine the associations between Long COVID, mental health-related outcomes, and quality of life among university students. A total of 365 Thai undergraduate students participated in this cross-sectional study screening for Long COVID. Long COVID symptoms, mental health, sleep quality, and quality of life were assessed using validated Thai versions of the Long COVID Screening Questionnaire, DASS-21, PSQI, and EQ-5D-5L. Regression and group comparison analyses were conducted between participants with Long COVID and those without Long COVID. Fatigue and cough were the most reported symptoms, while sleep disturbances were also prevalent. Long COVID was associated with significantly lower quality of life scores ( = 0.035). However, no significant differences were observed in DASS-21 or PSQI scores between groups. Vaccination doses and prior COVID-19 infections differed significantly between groups ( < 0.001 and = 0.017). These findings highlight the multisystem impacts of Long COVID and emphasize the importance of identification and supportive interventions to enhance student health and well-being.
RETRACTED: Tang et al. The Hidden Danger of Unintentional Child Injuries in an Urban Domestic Environment: Considering Unintentional Injuries from Another Angle. 2025, , 1068.
Tang P, Fan Q, Sun J … +4 more , Ji J, Yang L, Tang W, Lu Q
Int J Environ Res Public Health · 2026 Jun · PMID 42258810 · Full text
The journal retracts the article titled "The Hidden Danger of Unintentional Child Injuries in an Urban Domestic Environment: Considering Unintentional Injuries from Another Angle" [...].
The journal retracts the article titled "The Hidden Danger of Unintentional Child Injuries in an Urban Domestic Environment: Considering Unintentional Injuries from Another Angle" [...].
Correction: Hongoro et al. Economic Burden of Human Immunodeficiency Virus and Hypertension Care Among MOPHADHIV Trial Participants: Patient Costs and Determinants of Out-of-Pocket Expenditure in South Africa. 2025, , 1488.
Hongoro DJ, Kengne AP, Peer N … +3 more , Nguyen K, Bobrow K, Alaba OA
Int J Environ Res Public Health · 2026 May · PMID 42196778 · Full text
In the original publication [...].
In the original publication [...].
Dietary Predictors of Paraben Exposure Among Adults in Northern Thailand.
Keawdounglek V, Laor P, Paenkhokuard W
Int J Environ Res Public Health · 2026 May · PMID 42196777 · Full text
: Parabens are frequently utilized as preservatives in processed foods; nevertheless, the primary dietary factors contributing to exposure in northern Thailand remain undetermined. : A cross-sectional study was conducted...
: Parabens are frequently utilized as preservatives in processed foods; nevertheless, the primary dietary factors contributing to exposure in northern Thailand remain undetermined. : A cross-sectional study was conducted among 130 adults in Northern Thailand. Dietary intake was assessed using self-reported food consumption data combined with previously measured paraben concentrations. Due to the skewed distribution of intake, participants were classified into lower and higher exposure groups. LASSO regression was applied for variable selection, followed by multivariable logistic regression to identify dietary predictors of exposure. : Several processed food items were significantly associated with higher paraben exposure, including soft drinks, potato chips, and canned fish. No demographic factors were significantly associated with exposure. The final model demonstrated good explanatory power and classification performance. : These findings suggest that routine consumption of certain processed foods and beverages may play a larger role in exposure than individual characteristics, and they highlight practical targets, particularly soft drinks, potato chips, and canned fish, for community-based health-promotion strategies aimed at reducing unnecessary preservative intake.
Adaptation of Trajectory of Illness Framework to Assess the Experiences of Youths Living with Type 1 Diabetes Mellitus in the Rural Areas of Limpopo Province, South Africa.
Motsepe TJ, Sumbane GO, Mutshatshi TE … +1 more , Mokhwelepa LW
Int J Environ Res Public Health · 2026 May · PMID 42196776 · Full text
Diabetes Mellitus is a chronic metabolic disorder characterized by elevated blood glucose due to defects in insulin secretion or action, or both, leading to serious short- and long-term complications if not effectively m...
Diabetes Mellitus is a chronic metabolic disorder characterized by elevated blood glucose due to defects in insulin secretion or action, or both, leading to serious short- and long-term complications if not effectively managed. However, there is limited qualitative evidence exploring how youths diagnosed with Type 1 Diabetes Mellitus (T1DM) experience disease onset, management, complications, emotional adaptation, and education within the South African public healthcare system. The study aims to investigate the lived experiences of youths living with T1DM in a selected public hospital in Limpopo province, South Africa. The objectives were to explore and describe the lived experiences of youths living with T1DM. A qualitative, explorative, descriptive, and contextual design was used to gain a thorough understanding of the experiences of youths living with T1DM. A non-probability sampling technique was used to select 12 participants using a pre-determined criterion. Data were collected through individual semi-structured interviews using an interview guide. The data were analyzed using Colaizzi's method, where themes and sub-themes were developed with the inclusion of an independent coder. Measures to ensure trustworthiness and ethical considerations were adhered to throughout the study. The findings revealed that, despite the participants sharing the same diagnosis, they experience multiple interrelated barriers that significantly hindered effective self-care management, such as limited access to diabetic diet, glucometers and supplies, treatment and informational-related barriers, school-related challenges, transportation constraints and inadequate social support. Furthermore, the findings highlighted gaps in early recognition of symptoms, standardized diabetes education, psychosocial support, and continuity of care. The study recommends the need for holistic, patient-centred, and contextualized interventions that do not only address medical management but the socioeconomic, educational, and psychological needs of youths.
Environmental Health Literacy and Climate Change Anxiety Among Teachers: The Mediating Role of Ecological Footprint Awareness.
Açıkgöz Ö, Soylar P
Int J Environ Res Public Health · 2026 May · PMID 42196775 · Full text
BACKGROUND: Environmental health literacy plays an important role in helping individuals recognize environmental risks and adopt sustainable behaviors. Increasing environmental awareness may also influence emotional resp...
BACKGROUND: Environmental health literacy plays an important role in helping individuals recognize environmental risks and adopt sustainable behaviors. Increasing environmental awareness may also influence emotional responses to environmental problems such as climate change. However, the mechanisms linking environmental health literacy to climate change anxiety remain insufficiently explored. This study aimed to examine the relationship between environmental health literacy and climate change anxiety among teachers and to evaluate the mediating role of ecological footprint awareness in this relationship. METHODS: This cross-sectional study was conducted with teachers working in public schools in the provinces of Elazığ and Erzincan, Türkiye. Data were collected using a personal information form, the Environmental Health Literacy Scale, the Ecological Footprint Awareness Scale, and the Climate Change Anxiety Scale. Descriptive statistics, group comparison tests, correlation analyses, and mediation analysis based on structural equation modeling were performed to examine the relationships among the study variables. RESULTS: Participants' mean scores were 35.98 ± 9.12 for the Climate Change Anxiety Scale, 95.37 ± 18.29 for the Environmental Health Literacy Scale, and 118.08 ± 25.92 for the Ecological Footprint Awareness Scale. Environmental health literacy was positively associated with ecological footprint awareness, and ecological footprint awareness was positively associated with climate change anxiety ( < 0.001). Mediation analysis indicated that ecological footprint awareness significantly mediated the relationship between environmental health literacy and climate change anxiety (β = 0.293, 95% CI: 0.112-0.496, = 0.002). CONCLUSIONS: The findings suggest that ecological awareness can serve as a potential mechanism linking environmental knowledge with emotional responses to climate change. Strengthening ecological footprint awareness through environmental education programs for teachers may contribute to both environmental awareness and constructive engagement with climate-related issues.
Knowledge, Attitudes, and Management of Postpartum Depression Among Healthcare Professionals in Croatian Primary and Community Care: A Cross-Sectional Survey Study.
Dejhalla E, Zahirović D, Jurman R … +3 more , Rukavina M, Smojver-Ažić S, Zavidić T
Int J Environ Res Public Health · 2026 May · PMID 42196774 · Full text
BACKGROUND: Postpartum depression (PPD) is a common perinatal mental health disorder with important consequences for mothers and children. Early detection depends largely on primary and community healthcare professionals...
BACKGROUND: Postpartum depression (PPD) is a common perinatal mental health disorder with important consequences for mothers and children. Early detection depends largely on primary and community healthcare professionals. This study assessed knowledge, recognition patterns, and screening practices related to PPD and examined factors associated with screening implementation. METHODS: An exploratory cross-sectional online survey using convenience sampling was conducted between December 2025 and March 2026 among 154 healthcare professionals (74 community nurses and 80 physicians). Structured questionnaires assessed PPD knowledge, while physicians additionally reported screening and treatment practices. Group differences, correlations, and predictors of screening implementation were analyzed statistically. RESULTS: Community nurses achieved higher overall knowledge scores than physicians (66.1% vs. 58.4%; = 0.0038). Physicians more frequently distinguished baby blues from PPD (60.0% vs. 27.0%; < 0.001). Awareness of validated screening tools among physicians was low, with only 10.0% recognizing the EPDS. Although physician knowledge correlated with screening frequency before correction for multiple testing (ρ = 0.27; = 0.015), the association was not statistically significant after BH-FDR correction (q = 0.075). In multivariable logistic regression analysis, guideline awareness was not significantly associated with screening implementation (OR = 3.81; 95% CI 0.98-14.82; = 0.053). CONCLUSIONS: Gaps remain in knowledge of PPD screening tools and treatment, particularly among physicians. The findings support the need for improved education, dissemination of clinical guidelines, and implementation support for standardized screening practices. However, given the exploratory convenience-sampling design and the lack of statistically significant adjusted associations, further longitudinal and implementation-focused studies are needed.
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