International Journal of Environmental Research and Public Health最新文献

{"title":"The Impact of Ecological Footprint, Urbanization, Education, Health Expenditure, and Industrialization on Child Mortality: Insights for Environment and Public Health in Eastern Europe.","authors":"Gheorghe H Popescu, Elvira Nica, Tomas Kliestik, Cristina Alpopi, Ana-Madalina Potcovaru Bîgu, Sorin-Cristian Niță","doi":"10.3390/ijerph21101379","DOIUrl":"https://doi.org/10.3390/ijerph21101379","url":null,"abstract":"<p><p>The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region from 1993 to 2022. The Grossman Health Outcome (H-O) model investigates the theoretical framework. For the existence of the cross-sectional dependency, mixed-order unit root, and cointegration problem, the famous Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) approach is applied. The research also used the Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) to check robustness. The findings illustrated that health expenditure and education lessen the infant mortality rate in Eastern European countries. But ecological footprint, industrialization and unemployment raise the infant mortality rate. According to the CS-ARDL findings, expenditure on healthcare significantly reduces child mortality. Still, the ecological footprint significantly impacts increasing child mortality. However, the AMG and CCEMG models demonstrate that investing in education is the most effective strategy for reducing child mortality. Therefore, the government of Eastern European countries should provide more priorities in the sustainable urbanization, health expenditure, and education sectors. The robustness of the AMG and CCEMG also demonstrated the strength of the CS-ARDL findings. This research paper contributes to SDG 3 by examining the environmental and health factors that influence child mortality in Eastern Europe. Policymakers, public health professionals, and other stakeholders can use the findings to inform the development and implementation of programs that specifically target the identified causes of child mortality.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Risks Associated with Adopting New-Generation Disposable Products Among Young Adults Who Use E-Cigarettes.","authors":"Shuyao Ran, James J Yang, Megan E Piper, Hsien-Chang Lin, Anne Buu","doi":"10.3390/ijerph21101375","DOIUrl":"https://doi.org/10.3390/ijerph21101375","url":null,"abstract":"<p><p>New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA's partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar's tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, <i>p</i> < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, <i>p</i> < 0.05) and sweet flavors (x² = 22.53, <i>p</i> < 0.05) but decrease the number of times of vaping per day (t = -2.18, <i>p</i> < 0.05) and the use of menthol flavors (x² = 4.57, <i>p</i> < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, <i>p</i> < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, <i>p</i> < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, <i>p</i> < 0.05) and secondary (b = 0.2533, <i>p</i> < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, <i>p</i> < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Language Gap in Healthcare: Implementing a Qualified Medical Interpreter Program for Lesser-Spoken Languages.","authors":"Michelle Mavreles Ogrodnick, Mary Helen O'Connor, Coco Lukas, Iris Feinberg","doi":"10.3390/ijerph21101377","DOIUrl":"https://doi.org/10.3390/ijerph21101377","url":null,"abstract":"<p><p>Linguistic inequity drives systemic disparities in healthcare for non-native English speakers. This study evaluates a project to train and provide qualified medical interpreters (QMI) to assist volunteer and safety-net clinics and community-based organizations in supporting healthcare for immigrants and refugees. We provided scholarships to bilingual community members to take a medical interpreter training course and developed a workforce for those who passed the training course. We focused on lesser-spoken foreign languages such as Arabic, Amharic, Pashto, Dari, and Burmese. Those who passed the course participated in a semi-structured interview to learn about their experiences in the training program, as well as barriers and facilitators to becoming a QMI. To date, 23 people have passed the training and are part of the QMI workforce program that has provided 94 h of interpreter services over four months, serving 66 individual patients. The evaluation showed that community members have interest in becoming QMIs and many have the required language proficiency to enroll and pass training. Finding full-time employment for less spoken languages has proven to be challenging.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Assessment of Cellular Responses to Microscale Silica Morphologies in Human Gastrointestinal Cells: Insights for Occupational Health.","authors":"Mohammad Z Yamin, James Y Liu, Christie M Sayes","doi":"10.3390/ijerph21101376","DOIUrl":"https://doi.org/10.3390/ijerph21101376","url":null,"abstract":"<p><p>Silicon dioxide (SiO₂), commonly known as silica, is a naturally occurring mineral extracted from the Earth's crust. It is widely used in commercial products such as food, medicine, and dental ceramics. There are few studies on the health effects of pyrogenic and colloidal silica after ingestion. No research has compared the impact of microscale morphologies on mitochondrial activity in colon cells after acute exposure. The results show that crystalline and amorphous silica had a concentration-independent effect on cells, with an initial increase in mitochondrial activity followed by a decrease. Vitreous silica did not affect cells. Diatomaceous earth and pyrogenic silica had a concentration-dependent response, causing a reduction in mitochondrial activity as concentration increased. Diatomaceous earth triggered the highest cellular response, with mitochondrial activity ranging from 78.84% ± 12.34 at the highest concentration (1000 ppm) to 62.54% ± 17.43 at the lowest concentration (0.01 ppm) and an average H₂O₂ concentration of 1.48 ± 0.15 RLUs. This research advances our understanding of silica's impact on human gastrointestinal cells, highlighting the need for ongoing exploration. These findings can improve risk mitigation strategies in silica-exposed environments.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11508045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Military Family-Centred Resilience-Building Programming Across the Deployment Cycle: A Scoping Review.","authors":"Michèle L Hébert, Joshua M Tippe, Carley Aquin, Melody Maximos, Suzette Brémault-Phillips, Phillip R Sevigny","doi":"10.3390/ijerph21101378","DOIUrl":"https://doi.org/10.3390/ijerph21101378","url":null,"abstract":"<p><p><b>Background</b>: There is international agreement that military families (MFs)-active service members, reservists, veterans, and their families-must be resilient to overcome military life adversities. Resilience is defined either as skillsets or as processes implicating multi-systems in a socio-ecological context. While research on resilience-building specific to children and families who face adversity is growing, there is a paucity of evidence on MF-centred resilience-building. <b>Objective</b>: This review describes the evidence on such resilience-building programming and determines if adversity is considered a barrier or facilitator to resilience-building. <b>Methods</b>: This scoping review yielded 4050 peer-reviewed articles from database inception until December 2023, found in 12 databases. Articles were deduplicated, leaving 1317 that were independently screened for eligibility by two reviewers. Disagreements were resolved through discussion with a third reviewer. <b>Findings</b>: Of these articles, 27 were included; 5 additional articles were also included from other sources. The vast majority of included studies (91%) were conducted in the United States. These 32 articles were organised into categories, including demographics, research methodologies used, resilience program descriptors, and outcomes. <b>Conclusions</b>: Our results reveal that programs on building MF resilience vary widely, often measuring non-resilience health and social outcomes. We provide preliminary insights for MF health and policy. Our review findings will be invaluable for further evidence-based programming that builds resilience in MFs.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Flooding and Household Food Access in Central Java, Indonesia.","authors":"Breanne K Langlois, Aris Ismanto, Leah Beaulac, Katherine Berry, Magaly Koch, Timothy Griffin, Erin Coughlan de Perez, Elena N Naumova","doi":"10.3390/ijerph21101370","DOIUrl":"https://doi.org/10.3390/ijerph21101370","url":null,"abstract":"<p><p>It is unknown how recurring flooding impacts household diet in Central Java. We aimed to assess how recurrent flooding influenced household food access over 22 years in Central Java by linking the Global Surface Water dataset (GSW) to the Indonesian Family Life Survey. We examined linear and nonlinear relationships and joint effects with indicators of adaptive capacity. We measured recurrent flooding as the fraction of district raster cells with episodic flooding from 1984-2015 using GSW. Food access outcomes were household food expenditure share (FES) and dietary diversity score (DDS). We fit generalized linear mixed models and random forest regression models. We detected joint effects with flooding and adaptive capacity. Wealth and access to credit were associated with improved FES and DDS. The effect of wealth on FES was stronger in households in more flood-affected districts, while access to credit was associated with reduced odds of DDS in more flood-affected districts. Flooding had more predictive importance for FES than for DDS. Access to credit, a factor that ordinarily improves food access, may not be effective in flood-prone areas. Wealthier households may be better able to adapt in terms of food access. Future research should incorporate land use data to understand how different locales are affected and further understand the complexity of these relationships.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Universal Health Coverage: What Socioeconomic and Clinical Factors Influence Health Insurance Coverage and Restrictions in Access to Viral Hepatitis Services in Nasarawa State, Nigeria?","authors":"Victor Abiola Adepoju, Donald C Udah, Chinonye Alioha Ezenwa, Jamiu Ganiyu, Sumaiya Muhammad Lawal, James Ambo Haruna, Qorinah Estiningtyas Sakilah Adnani, Adamu Alhassan Ibrahim","doi":"10.3390/ijerph21101373","DOIUrl":"https://doi.org/10.3390/ijerph21101373","url":null,"abstract":"<p><p><b>Background:</b> Viral hepatitis B and C (HBV and HCV) pose significant public health concern in Nigeria, where access to healthcare and treatment affordability are limited. This study investigated sociodemographic and clinical predictors of health insurance coverage and access to care among patients with HBV and HCV in Nasarawa State, Nigeria. <b>Methods:</b> A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Participants included patients diagnosed with HBV, HCV, or both who were ≥18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Binary logistic regression was used to analyze the relationship between sociodemographic/clinical factors and health insurance status. <b>Results:</b> Out of 303 participants, 68% had health insurance, which mostly covered hepatitis screening and vaccination. Significant predictors of health insurance coverage included being aged 36-40 years (adjusted odds ratio [aOR]: 11.01, 95% confidence interval [CI]: 2.38-50.89, <i>p</i> = 0.002), having post-secondary education (aOR: 25.2, 95% CI: 9.67-65.68, <i>p</i> < 0.001), being employed (aOR: 27.83, 95% CI: 8.85-87.58, <i>p</i> < 0.001), and being HIV-positive (aOR: 4.06, 95% CI: 1.55-10.61, <i>p</i> = 0.004). Nearly all those insured (99%) faced restrictions in insurance coverage for viral hepatitis services. <b>Conclusions:</b> This study reveals that while health insurance coverage is relatively high among viral hepatitis patients in Nasarawa State, significant restrictions hinder access to comprehensive services, especially for vulnerable groups like younger adults, the unemployed, and PLHIV. Key factors influencing coverage include age, education, employment, and HIV status. Expanding benefit packages to include viral hepatitis diagnosis and treatment, raising awareness about viral hepatitis as part of insurance strategy, improving access for underserved populations, and integrating hepatitis services into existing HIV programs with strong policy implementation monitoring frameworks are crucial to advancing universal health coverage and meeting the WHO's 2030 elimination goals.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11508061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teachers' and Principals' Familiarity with School Wellness Policy: A Health Promoting Schools Assessment.","authors":"Matthew Chrisman, Anita Skarbek, Patricia Endsley, Nicholas Marchello","doi":"10.3390/ijerph21101372","DOIUrl":"https://doi.org/10.3390/ijerph21101372","url":null,"abstract":"<p><p>The current study explored teacher and principal familiarity with school wellness polices in primary schools, including who serves on school wellness committees, and who should implement and enforce wellness policies in the school. An electronic survey guided by the Health Promoting Schools framework was administered from February to May 2020 to teachers and principals from one urban and one suburban school district in the Midwestern United States. There were 450 participants; response rates were 28% (urban), 33% (suburban), and 51% (school principals). Only 41.7% of the aggregate participant pool were familiar with their wellness policy. Participants were more familiar in the suburban compared to the urban district (χ² = 68.2, <i>p</i>-value ≤ 0.001). Teachers/health teachers, nurses, and principals were most likely to be on wellness committees, and the most preferred wellness champions were teachers, nurses, and food service staff. Teachers and nurses are integral to school wellness and health education as part of multiple systems that can promote school health. The Health Promoting Schools framework is useful for guiding examinations to improve understanding of school wellness within school communities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11508182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture Reduces Heart Rate and Perceived Exertion During a Bike Test: A Preliminary Analysis.","authors":"Emily Gaudet, Tristan Castonguay, Maryse Fortin, Geoffrey Dover","doi":"10.3390/ijerph21101369","DOIUrl":"https://doi.org/10.3390/ijerph21101369","url":null,"abstract":"<p><strong>Background: </strong>Preliminary research suggests that acupuncture can improve cardiovascular function. The purpose of our study was to determine if electroacupuncture can improve performance and post-exercise recovery.</p><p><strong>Methods: </strong>Thirty-two healthy people participated in this study (14 men and 18 women, aged 23.6 ± 3.5 years). The first visit included baseline measurements. Then, the participants received daily electroacupuncture at acupuncture point PC6 for a week, followed by a second visit. Heart rate, perceived exertion, and systolic and diastolic blood pressure were measured before, during, and after a YMCA submaximal bike test.</p><p><strong>Results: </strong>The heart rate was significantly reduced during the final stage of the YMCA test (151.3 ± 7.0 to 146.7 ± 11.8; <i>p</i> = 0.013) on the second visit. The rate of perceived exertion was significantly lower during all stages in Visit 2 (average RPE Visit 2 = 10.71 ± 2.02; average RPE Visit 1 = 11.45 ± 1.98; <i>p</i> = 0.004). Systolic blood pressure significantly decreased during the 5 min post-test recovery (SBP Visit 2 = 116.9 ± 12.0; SBP Visit 1 = 145.7 ± 14.6, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>A week of electroacupuncture at PC6 led to reduced heart rate and perceived exertion during exercise, making the workload feel less strenuous. Electroacupuncture at PC6 shows potential for increasing participation in physical activities by making them feel easier to accomplish.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Obstetric Healthcare Providers' Knowledge of Black Maternal Mental Health: A Feasibility Study.","authors":"Kortney Floyd James, Keisha Reaves, Misty C Richards, Kristen R Choi","doi":"10.3390/ijerph21101374","DOIUrl":"https://doi.org/10.3390/ijerph21101374","url":null,"abstract":"<p><p>Despite guidelines for screening and treating perinatal mood and anxiety disorders (PMADs), systemic issues and clinician biases often result in unmet mental health needs in Black women. This study assessed the feasibility and impact of comprehensive PMAD training on obstetric healthcare providers' attitudes, knowledge, and implicit racial biases. We conducted a feasibility study with two cohorts of healthcare providers who received either in-person or virtual training. The training focused on PMADs, implicit bias, and culturally responsive care. Participants completed pre- and post-training assessments measuring attitudes, knowledge, empathy, and implicit racial biases. Both training modalities showed trends towards improved PMAD screening attitudes and empathy, with significant increases in beliefs about treatment efficacy. Implicit bias scores approached significance, showing a shift toward fewer participants with racial preferences. However, there was an unexplained increase in preference for White over Black post training. The training improved healthcare providers' readiness to screen for PMADs and enhanced their understanding of PMADs. However, the persistence of implicit biases highlights the need for ongoing, sustained interventions to address deeply rooted biases. Future research should incorporate continuous learning strategies and link training to healthcare outcomes for minoritized communities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}