International Journal of Environmental Research and Public Health最新文献

{"title":"Exploring the Relation Between Nursing Workload and Moral Distress, Burnout, and Turnover in Latvian Intensive Care Units: An Ecological Analysis of Parallel Data.","authors":"Olga Cerela-Boltunova, Inga Millere","doi":"10.3390/ijerph22091442","DOIUrl":"10.3390/ijerph22091442","url":null,"abstract":"<p><p>Latvia faces one of the lowest nurse-to-population ratios in the EU, resulting in critical staff shortages in intensive care units (ICUs). Nurses frequently care for more patients than recommended, which not only compromises patient safety but also places heavy psycho-emotional burdens on staff. The aim of this study was to examine organizational-level relationships between objectively measured ICU nursing workload and subjectively reported psycho-emotional outcomes, including moral distress, burnout, and intention to leave one's job. A secondary analysis combined data from two cross-sectional studies conducted in 2025. Workload was measured using 3420 Nursing Activities Score (NAS) protocols from three hospitals, while 155 ICU nurses from 16 units completed validated instruments assessing moral distress, burnout, and turnover intentions. The findings revealed persistent nurse shortages, with one ICU showing deficits exceeding 70% and mean NASs above 100 points per nurse per shift. Nurses reported moderate moral distress, particularly in situations of unsafe patient ratios and aggressive treatment, while burnout levels were moderate to high, especially in personal and work-related dimensions. About one-quarter of respondents were actively considering leaving their jobs. Moral distress significantly correlated with burnout (r = 0.357, <i>p</i> < 0.001), and organizational-level comparison indicated that higher workload was associated with greater emotional strain. These results not only highlight urgent national challenges but also resonate with international evidence on the link between unsafe staffing, moral distress, and workforce sustainability. Implementing systematic workload monitoring, safe staffing ratios, and structured support mechanisms is essential to safeguard ICU nurses' well-being, reduce turnover, and protect patient safety in both Latvian and global contexts.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179923","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":"Systematic Literature Review of Research on the Effectiveness of Art Therapy for Chinese Patients with Depressive Disorder.","authors":"Guochao Xu, Bo Ram Park, Bo Hyun Kim","doi":"10.3390/ijerph22091443","DOIUrl":"10.3390/ijerph22091443","url":null,"abstract":"<p><p>This study aimed to systematically review literature on the effects of art therapy in Chinese patients with depression. The review was conducted in accordance with the guidelines of the preferred reporting items for systematic reviews and meta-analyses. We used four Chinese databases (CNKI, CBM, WF, and VIP) to identify studies and dissertations published in China between January 2008 and December 2023, retrieving 368 studies. We applied the inclusion/exclusion criteria based on the Participant, Intervention, Comparison, Outcome, Time, and Study Design criteria and assessed the risk of bias; 34 studies were included. Studies began in 2008 and their number increased in 2018. They mostly comprised research articles. Intervention targets were most often adolescents (≤19 years old) diagnosed with depressive disorder. Art therapy interventions were conducted and comprised 6-10 group therapy sessions that lasted 60-90 min each. Of the 12 techniques used, painting was the most common. Second, art therapy effectively improved affective, social, cognitive, self, and physical aspects. Given the slow development of art therapy in research and clinical practice, we believe our study makes valuable contributions to its advancement in China.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179967","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":"Interventions to Reduce Mental Health Stigma Among Health Care Professionals in Primary Health Care: A Systematic Review and Meta-Analysis.","authors":"Lazzat Zhamaliyeva, Nurgul Ablakimova, Assemgul Batyrova, Galina Veklenko, Andrej M Grjibovski, Sandugash Kudaibergenova, Nursultan Seksenbayev","doi":"10.3390/ijerph22091441","DOIUrl":"10.3390/ijerph22091441","url":null,"abstract":"<p><strong>Background: </strong>Stigmatizing attitudes toward individuals with mental health conditions are common among healthcare professionals in primary healthcare (PHC) settings, posing a major barrier to early diagnosis, appropriate treatment, and recovery.</p><p><strong>Methods: </strong>This systematic review and meta-analysis evaluated the effectiveness of interventions aimed at reducing mental health-related stigma among PHC professionals (general practitioners, nurses, community health workers, and allied providers). Eligibility was restricted to interventional studies targeting PHC staff; non-clinical populations and students without clinical practice were excluded. Comparators included usual training, waitlist control, or pre-post evaluation. A systematic search of PubMed, Scopus, and Web of Science was conducted in accordance with PRISMA guidelines, and the protocol was registered in PROSPERO (CRD420251074412).</p><p><strong>Results: </strong>Twenty-five studies met the inclusion criteria, of which three contributed to the quantitative synthesis. Interventions included educational, contact-based, and multicomponent approaches. Risk of bias was assessed using tools appropriate to study design. Interventions generally improved knowledge and attitudes and, to a lesser extent, behavioral intentions. Meta-analysis of pre-post changes using the Opening Minds Scale for Health Care Providers (OMS-HC) demonstrated a significant reduction in stigma (MD = -0.27, 95% CI -0.40 to -0.14; <i>p</i> < 0.001; I² = 91%). A difference-in-differences analysis of studies with intervention and control groups confirmed this effect with moderate heterogeneity (MD = -0.18, 95% CI -0.25 to -0.11; <i>p</i> < 0.0001; I² = 50%).</p><p><strong>Conclusions: </strong>Contact-based and multicomponent interventions were associated with stronger and more sustained effects. The main limitations of the evidence were short follow-up periods, reliance on self-reported outcomes, methodological heterogeneity, and the possibility of publication bias. Our findings suggest that reducing stigma among PHC professionals can enhance patient engagement, timely diagnosis, and quality of care in routine clinical practice.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179549","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":"Effects of LED Versus Fluorescent Task Lighting on Sleep Quality and Daytime Function in Windowless Office Environments.","authors":"Juntae Jake Son","doi":"10.3390/ijerph22091436","DOIUrl":"10.3390/ijerph22091436","url":null,"abstract":"<p><p>This study investigated the effects of LED versus fluorescent task lighting on sleep quality and daytime functioning among office workers in a windowless environment. Using a within-subjects crossover design with 32 full-time employees, participants were exposed to both 4000 K LED and 4100 K fluorescent lighting conditions over two one-week periods. Subjective sleep quality and alertness were assessed through the Pittsburgh Sleep Quality Index (PSQI) and daily sleep diaries. Results indicated significantly better global sleep quality, improved subjective sleep assessments, and reduced daytime dysfunction under LED lighting conditions. While sleep duration did not significantly differ, a positive trend was observed favoring the LED condition. These outcomes are likely due to differences in spectral power distribution between the two light sources, particularly the continuous, blue-enriched spectrum of the LED lamp, which supports circadian regulation. The findings suggest that biologically supportive lighting-such as continuous-spectrum LEDs-can positively impact sleep and daytime performance, even in the absence of natural daylight. This research contributes to the growing field of circadian lighting and offers practical implications for architects, designers, and workplace managers aiming to enhance employee well-being and productivity in enclosed office environments.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179850","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":"Food Safety Management in Primary Schools for Ethnic Groups in Northern Thailand: A PDCA-Based Evaluation.","authors":"Vivat Keawdounglek, Warapon Paenkhokuard, Anuttara Hongthong","doi":"10.3390/ijerph22091438","DOIUrl":"10.3390/ijerph22091438","url":null,"abstract":"<p><p>Food safety management in rural ethnic schools remains underdeveloped in Northern Thailand. This study evaluates such systems in primary schools using the Plan Do Check Act (PDCA) framework, which can serve as a scalable and culturally sensitive tool to strengthen food safety systems in multi-ethnic school environments. Multi-criteria decision analysis was employed across nine schools representing the Hmong, Lisu, Lahu, Akha, Kamoo, Haw, Mien, Karen, and Lau communities. Data collection included (1) PDCA-based rubric scoring validated by three experts; (2) in-depth interviews and field observations; (3) food and water contamination testing; and (4) microbiological analysis of chefs' hands and utensils (detected or non-detected). The results showed that only 45% of the schools involved had third-party food safety monitoring, and 45% lacked systems to gather student feedback. None could independently assess chlorine or food residue. <i>Escherichia coli</i> contamination was found on chefs' hands (44%), utensils (56%), and drinking water (33%). Schools C (Lahu) and F (Haw) had the highest and lowest PDCA scores, respectively. Therefore, schools should (1) train employees, (2) work with a third party responsible for monitoring food safety, and (3) establish raw material and contamination self-assessment processes to improve food safety. Implementing PDCA to improve food safety in neglected schools is essential.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179892","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":"Forest Therapy Trails: Development and Application of an Assessment Protocol.","authors":"Paul H Gobster","doi":"10.3390/ijerph22091440","DOIUrl":"10.3390/ijerph22091440","url":null,"abstract":"<p><p>What key characteristics of forest sites and trails contribute to enjoyable and healthy immersive nature experiences for visitors? Previous research has helped identify the conceptual structure and criteria important in facilitating successful experiences, but there remains a knowledge gap in translating this information into operational guidelines. To address this gap, the present work used a descriptive inventory approach combining field research with a variety of secondary data to develop a protocol for assessing four site level criteria (beauty, integrity, tranquility, accessibility) and six trail level criteria (ease of travel, attractiveness of layout, natural features, built features, explorable nature, interpretation and stewardship). Through an iterative process, the protocol was refined and applied to selected sites (<i>n</i> = 56) and trails (<i>n</i> = 157) in two study areas in metropolitan Chicago, Illinois, and the rural Northwoods of Wisconsin. Qualitative and quantitative information describes preferred conditions across criteria, while quantitative ratings highlight commonalities and differences between urban and rural sites and trails. Although the principal focus was on foot trails, sub-analyses show how the criteria can apply to bike and paddle trails. With regional adaptations, the protocol has utility for the planning and design of new and management of existing trails for the growing practice of forest therapy and related forms of nature-based recreation.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179884","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":"Environmental Risk in American Indian Children, Including Cardiovascular and Hematologic Consequences of Cadmium Exposure: Possible Means of Mitigation.","authors":"Joseph Burns, Cesar E Larancuent, Cian L Jacob, Danielle A Heims-Waldron, Whitney R Lloyd, Justin P Zachariah, Abraham Haimed, Ana Navas-Acien, Jason F Deen","doi":"10.3390/ijerph22091437","DOIUrl":"10.3390/ijerph22091437","url":null,"abstract":"<p><p>Emerging evidence reveals that cadmium exposure is associated with hypertension, cardiovascular disease (CVD), and anemia, among others. Toxic metal exposure poses a particular threat to American Indian/Alaska Native populations, particularly given their proximity to mining waste. This review aims to summarize and organize evidence explaining the cardiovascular and hematologic consequences of cadmium exposure in children, including specific data on this exposure in AI/AN people, and strategies and policy actions to mitigate these consequences in AI/AN children.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179834","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":"Psychosocial Risk Factors and Burnout Among Teachers: Can Emotional Intelligence Make a Difference?","authors":"Carla Barros, Carina Fernandes, Pilar Baylina","doi":"10.3390/ijerph22091439","DOIUrl":"10.3390/ijerph22091439","url":null,"abstract":"<p><p>Teaching is a complex profession that demands simultaneous cognitive and emotional efforts. The present study aims to determine whether teachers' emotional intelligence moderates the relationship between psychosocial risk factors and burnout. A cross-sectional online survey was conducted among 215 secondary school teachers. Measurement instruments included the Burnout Assessment Tool (BAT-23) to assess burnout dimensions; the Health and Work Survey (INSAT) to evaluate psychosocial risk factors; and the Wong and Law Emotional Intelligence Scale (WLEIS-P) to assess emotional intelligence. A mediation/moderation analysis using the PROCESS macro was conducted to examine whether emotional intelligence mediates/moderates the relationship between psychosocial risk factors and burnout among teachers. The results show that psychosocial risk was a significant positive predictor of burnout (B = 0.313, <i>p</i> = 0.001), indicating that higher perceived risk was associated with higher burnout symptoms. Emotional intelligence did not significantly predict burnout on its own (B = 0.176, <i>p</i> = 0.364), and the interaction term (psychosocial risk × emotional intelligence) was not significant (B = 0.000, <i>p</i> = 0.995), suggesting that emotional intelligence does not moderate the relationship between psychosocial risks and burnout. These findings underscore a more holistic approach to address burnout, centered in intervention strategies that include a deeper analysis of organizational context determinants.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179820","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":"Correction: Wu et al. Bi-Directional Pollution Characteristics and Ecological Health Risk Assessment of Heavy Metals in Soil and Crops in Wanjiang Economic Zone, Anhui Province, China. <i>Int. J. Environ. Res. Public Health</i> 2022, <i>19</i>, 9669.","authors":"Dun Wu, Hai Liu, Jian Wu, Ndhlovu Kataza Nyasha, Wenyong Zhang","doi":"10.3390/ijerph22091434","DOIUrl":"10.3390/ijerph22091434","url":null,"abstract":"<p><p>Xia Gao and Guojun Cai were removed as authors in the original publication [...].</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179736","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":"An International Comparative Reliability and Concurrent Validity Assessment of the Multi-Level Job Content Questionnaire (JCQ) 2.0.","authors":"Wilfred Agbenyikey, Jian Li, Sung-Il Cho, Sarven S McLinton, Maureen Dollard, Maren Formazin, Bongkyoo Choi, Irene Houtman, Robert Karasek","doi":"10.3390/ijerph22091435","DOIUrl":"10.3390/ijerph22091435","url":null,"abstract":"<p><strong>Background: </strong>This paper empirically tests the new multi-level Associationalist Demand Control (ADC) theory by applying the Job Content Questionnaire (JCQ) 2.0 that assesses both a wide range of task characteristics as well as work organizational and external-to-work psychosocial characteristics.</p><p><strong>Methods: </strong>The paper is based on four JCQ 2.0 pilot studies among 16,125 workers in Korea, China, Australia, and Germany. All pilots used the original JCQ task-level scales and then added newly developed proposed items and scales, evolving more comprehensive higher-level scales from pilot to pilot from 2005 to 2011. A brief review of the analytic process is presented, followed by an assessment of the internal consistency and concurrent validity of the final 25 multi-level JCQ 2.0 scales at the task, the organizational, and the external levels.</p><p><strong>Results: </strong>Adequate psychometric properties were established for the JCQ 2.0 pilot scales. The extended set of task-level scales was found to be robust across all samples; the new organizational scales mainly showed adequate internal consistency with α > 0.7 in Australia and Germany (tested only there) and were associated with relevant work- and health-related outcome measures as expected. Similarly, the external-to-work scales (tested only in Germany) had adequate Cronbach's Alpha values and showed expected associations to relevant outcome scales.</p><p><strong>Conclusions: </strong>Although not all scales were available in all countries, overall, the results support the \"functional similarity\" of the major scale areas across the four pilot countries and support the underlying extensions of the Demand-Control theoretical constructs to the multi-level psychosocial work assessment for the promotion of workers' health and wellbeing as suggested by the new ADC model.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179854","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}