Long-term Health Effects Research Articles

Long-term Impact of Tropical Cyclones on Disease Exacerbation Among Children with Asthma in the Eastern United States, 2000-2018.

Tropical cyclones are associated with acute increases in mortality and morbidity, but few studies have examined their longer-term health consequences. We assessed whether tropical cyclones are associated with a higher frequency of symptom exacerbation among children with asthma in the following 12 months in eastern United States counties, 2000-2018. We defined exposure to tropical cyclones as a maximum sustained windspeed >21 meters/second at the county center and used coarsened exact matching to match each exposed county to one or more unexposed counties. We used longitudinal, de-identified administrative claims data to estimate the county-level, monthly risk of experiencing at least one asthma exacerbation requiring medical attention among commercially insured children aged 5-17 with prior diagnosis of asthma. We used a difference-in-differences approach implemented via a Poisson fixed effects model to compare the risk of asthma exacerbation in the 12 months before versus after each storm in exposed versus unexposed counties. Across 43 tropical cyclones impacting the eastern United States, we did not observe evidence of an increase in the risk of symptom exacerbation in the 12 months following the storm (random-effects meta-analytic summary estimate: risk ratio = 1.03 [95% confidence interval = 0.96, 1.10], I2 = 17%). However, certain storms, such as Hurricane Sandy, were associated with a higher risk of symptom exacerbation. These findings are consistent with the hypothesis that some tropical cyclones are detrimental to children's respiratory health. However, tropical cyclones were not associated in aggregate with long-term exacerbation of clinically apparent asthma symptoms among a population of children with commercial health insurance.

The Significance of Providing the Optimal Micronutrients to the Preterm Low Birth Weight Infants to Prevent Long-Term Health Consequences

Premature infants have less nutritional storage capacity and an underdeveloped body, which makes them particularly susceptible to malnutrition. Nutrient surplus and deficiency are possibilities when supplemental feeding is unbalanced. However, little is known about what kids should eat once they are discharged from the hospital. Since many bodily processes depend on micronutrients, it's critical to plan supplemental nutrition with an optimum consumption in mind. This written summary describes the requirements for long-chain polyunsaturated fatty acids (LCPUFA), iron, zinc, vitamin D, calcium, and phosphate for premature newborns receiving supplemental feeding. The scientific community is beginning to acknowledge the advantages of giving premature babies iron and vitamin D supplements. But as of right now, there isn't enough information available to make firm recommendations about the addition of calcium, phosphorus, zinc, and LCPUFAs. Nonetheless, the health of premature infants depends on the following micronutrients: Large chain polyunsaturated fats (LCPUFAs) support the development of the retina and brain, while calcium and phosphorus dosages are necessary to prevent metabolic bone disease (MBD) in preterm infants. It is obvious how understanding the variability of the premature population may help adapt nutritional planning in connection to the development rate, comorbidities, and thorough clinical history of the preterm newborn, even while we wait for consensus on these micronutrients.

Molecular-Level Dysregulation of Insulin Pathways and Inflammatory Processes in Peripheral Blood Mononuclear Cells by Circadian Misalignment.

Circadian misalignment due to night work has been associated with an elevated risk for chronic diseases. We investigated the effects of circadian misalignment using shotgun protein profiling of peripheral blood mononuclear cells taken from healthy humans during a constant routine protocol, which was conducted immediately after participants had been subjected to a 3-day simulated night shift schedule or a 3-day simulated day shift schedule. By comparing proteomic profiles between the simulated shift conditions, we identified proteins and pathways that are associated with the effects of circadian misalignment and observed that insulin regulation pathways and inflammation-related proteins displayed markedly different temporal patterns after simulated night shift. Further, by integrating the proteomic profiles with previously assessed metabolomic profiles in a network-based approach, we found key associations between circadian dysregulation of protein-level pathways and metabolites of interest in the context of chronic metabolic diseases. Endogenous circadian rhythms in circulating glucose and insulin differed between the simulated shift conditions. Overall, our results suggest that circadian misalignment is associated with a tug of war between central clock mechanisms controlling insulin secretion and peripheral clock mechanisms regulating insulin sensitivity, which may lead to adverse long-term outcomes such as diabetes and obesity. Our study provides a molecular-level mechanism linking circadian misalignment and adverse long-term health consequences of night work.

Investigating fertility health knowledge and lifestyle risk factors among Nigerian university students: A cross-sectional survey.

Adolescents who are unaware of infertility risk factors and the long-term health effects of their lifestyle choices may participate in unsafe sexual and lifestyle behaviors. Their reproductive goals and health may be affected by such behaviors. Adolescents' awareness of male and female infertility risk factors was assessed, along with lifestyle risk variables related to sexual behavior and psychoactive substance use. The causes of inconsistent condom use were also examined. In 2022, a cross-sectional survey was undertaken involving 598 sexually active university students from Nigeria (18.6 years±0.9), the majority of whom were female (57.2 %). Descriptive statistics, bivariate analysis, and binary logistic regression were utilized in the data analysis to determine the influence of lifestyle factors and levels of knowledge on fertility. Most participants had a moderate understanding of male and female infertility risk factors. The results showed that female students were more informed. Multiple sexual partners and psychoactive substance use were common lifestyle variables. Younger female students, those with several partners, and participants who frequently used alcohol and narcotics used condoms inconsistently. The study emphasizes the need for fertility health and lifestyle risk education for Nigerian youth. Despite moderate knowledge, lifestyle implications on fertility are unclear. Fertility health education in schools could help students make informed reproductive choices and lower the risk of infertility and chronic diseases. Research is needed to confirm findings and inform nationwide targeted interventions.

Human Metabolism's Reaction to a Low-Carbohydrate Diet

In recent years, as the quality of life has improved, the obesity problem has become more serious, affecting adults and children around the world, reaching epidemic proportions. Low-carbohydrate diets (LCDs) are widely popular among people and used by a wide range of patient groups for weight management. This review examines the complex interactions between human metabolism and LCDs, focusing on the effects on metabolism and personal health. Part One discusses the importance of carbohydrates in metabolism. The second part examines the metabolic effects of a low-carbohydrate diet. Part Three analyses the therapeutic implications of low-carbohydrate diets, highlighting their potential applications in weight loss and management, disease control and treatment, and supplementation for endurance athletes. Despite the remarkable results achieved so far, this paper finds that there are still many shortcomings. Although the impact of LCD on metabolism has been studied, the risk of long-term health effects needs to be further explored. Therefore, larger-scale, multi-center trials targeting different populations are needed to further evaluate the impact of LCD. Based on these conclusions, this article has important implications for healthcare professionals in providing personalized guidance that takes into account individual responses and circumstances.

Piloting co-developed behaviour change interventions to reduce exposure to air pollution and improve self-reported asthma-related health.

Exposure to air pollution can exacerbate asthma with immediate and long-term health consequences. Behaviour changes can reduce exposure to air pollution, yet its 'invisible' nature often leaves individuals unaware of their exposure, complicating the identification of appropriate behaviour modifications. Moreover, making health behaviour changes can be challenging, necessitating additional support from healthcare professionals. This pilot study used personal exposure monitoring, data feedback, and co-developed behaviour change interventions with individuals with asthma, with the goal of reducing personal exposure to PM2.5 and subsequently improving asthma-related health. Twenty-eight participants conducted baseline exposure monitoring for one-week, simultaneously keeping asthma symptom and medication diaries (previously published in McCarron et al., 2023). Participants were then randomised into control (n = 8) or intervention (n = 9) groups. Intervention participants received PM2.5 exposure feedback and worked with researchers to co-develop behaviour change interventions based on a health behaviour change programme which they implemented during the follow-up monitoring week. Control group participants received no feedback or intervention during the study. All interventions focused on the home environment. Intervention group participants reduced their at-home exposure by an average of 5.7 µg/m³ over the monitoring week (-23.0 to +3.2 µg/m³), whereas the control group had a reduction of 4.7 µg/m³ (-15.6 to +0.4 µg/m³). Furthermore, intervention group participants experienced a 4.6% decrease in participant-hours with reported asthma symptoms, while the control group saw a 0.5% increase. Similarly, the intervention group's asthma-related quality of life improved compared to the control group. This pilot study investigated a novel behaviour change intervention, utilising personal exposure monitoring, data feedback, and co-developed interventions guided by a health behaviour change programme. The study aimed to reduce personal exposure to fine particulate matter (PM2.5) and improve self-reported asthma-related health. Conducting a randomised controlled trial with 28 participants, co-developed intervention successfully targeted exposure peaks within participants' home microenvironments, resulting in a reduction in at-home personal exposure to PM2.5 and improving self-reported asthma-related health. The study contributes valuable insights into the environmental exposure-health relationship and highlights the potential of the intervention for individual-level decision-making to protect human health.

Comparing the effects of irradiation with protons or photons on neonatal mouse brain: Apoptosis, oncogenesis and hippocampal alterations

Background and PurposeMedulloblastoma (MB) is a common primary brain cancer in children. Proton therapy in pediatric MB is intensively studied and widely adopted. Compared to photon, proton radiations offer potential for reduced toxicity due to the characteristic Bragg Peak at the end of their path in tissue. The aim of this study was to compare the effects of irradiation with the same dose of protons or photons in Patched1 heterozygous knockout mice, a murine model predisposed to cancer and non-cancer radiogenic pathologies, including MB and lens opacity. Materials and MethodsTOP-IMPLART is a pulsed linear proton accelerator for proton therapy applications. We compared the long-term health effects of 3 Gy of protons or photons in neonatal mice exposed at postnatal day 2, during a peculiarly susceptible developmental phase of the cerebellum, lens, and hippocampus, to genotoxic stress. ResultsExperimental testing of the 5 mm Spread-Out Bragg Peak (SOBP) proton beam, through evaluation of apoptotic response, confirmed that both cerebellum and hippocampus were within the SOBP irradiation field. While no differences in MB induction were observed after irradiation with protons or photons, lens opacity examination confirmed sparing of the lens after proton exposure. Marked differences in expression of neurogenesis-related genes and in neuroinflammation, but not in hippocampal neurogenesis, were observed after irradiation of wild-type mice with both radiation types.Conclusion.In-vivo experiments with radiosensitive mouse models improve our mechanistic understanding of the dependence of brain damage on radiation quality, thus having important implications in translational research.

Long-term benefits to psychological health and well-being after ceremonial use of Ayahuasca in Middle Eastern and North African immigrants and refugees.

Refugees and immigrants can experience complex stressors from the process of immigration that can have lasting and severe long-term mental health consequences. Experiences after ayahuasca ingestion are shown to produce positive effects on psychological wellbeing and mental health, including anecdotal reports of improved symptoms of trauma and related disorders. However, data on the longitudinal health impact of naturalistic ayahuasca use in Middle Eastern and North African (MENA) immigrant and refugee populations is limited. The current longitudinal online survey study was conducted to gather prospective data on ceremonial ayahuasca use in a group (N = 15) of primarily female MENA immigrants and refugees and to provide further insight into the patterns and outcomes surrounding that use. The study sought to assess self-reported changes in physical and mental health, well-being, and psychological functioning, examine relationships between aspects of individual mindset (e.g., psychedelic preparedness) prior to ayahuasca use and observed outcomes during (e.g., subjective drug effects) and afterwards (i.e., persisting effects), characterize risks and negative experiences, and describe trauma exposure and personal history. Our findings revealed ceremonial use of ayahuasca is associated with significant improvements in mental health, well-being, and psychological functioning, including reductions in depression, anxiety, and shame, and increases in cognitive reappraisal and self-compassion. Most participants reported no lasting adverse effects and experienced notable positive behavioral changes persisting months after ingestion. While preliminary, results suggest naturalistic ayahuasca use might hold therapeutic potential for MENA populations exposed to trauma prior to and during the process of migration.

Unmasking the mental health scars of COVID-19: A longitudinal investigation of children and adolescents in post-lockdown China

The long-term mental health consequences of COVID-19 in children and adolescents remain unclear. We investigated the impact of COVID-19 infection on mental health after China's zero-COVID policy relaxation, focusing on symptom-specific and social-family risk factors for mental health issues in children and adolescents. In a longitudinal study, 8348 youths (aged 10–18) were assessed twice (T1: September to October 2022 and T2: April to May 2023). Mental health changes (Δ=T1-T2) were compared between COVID-19-infected (COVID+, n = 4108) and non-infected (COVID-, n = 4240). After balancing social–family confounding factors at T1 with propensity score-based inverse probability weights, multivariable logistic regression was employed to assess associations between COVID-19 infection and the onset/worsening of mental health symptoms. Multivariable logistic regression was conducted to explore specific acute COVID-19 symptoms and social–family risk factors associated with the onset/worsening of mental health symptoms in COVID + group. Compared to COVID- group, COVID + group exhibited lower overall mental health improvement (Δ). COVID + group was associated with increased risks of depression worsening (OR 1.20, 95 % CI 1.04–1.39), anxiety worsening (OR 1.30, 95 % CI 1.15–1.47), stress worsening (OR 1.23, 95 % CI 1.03–1.46), insomnia worsening (OR 1.21, 95 % CI 1.05–1.39), and emotional symptoms worsening (OR 1.72, 95 % CI 1.27–2.33). Moderate-to-severe difficulty thinking, breathlessness, and gastrointestinal symptoms were specific COVID-19 symptoms associated with worsening of various mental health outcomes. Furthermore, academic difficulties, economic disadvantages, family conflicts, food addiction, and alcohol consumption were identified as social-family risk factors for worsening mental health symptoms in COVID + youths. COVID-19 infection leaves lasting mental health scars in youths, extending beyond the acute phase. Specific symptoms, particularly cognitive dysfunction and respiratory/gastrointestinal distress play a significant role in this vulnerability. Social-family factors further modulate these effects, highlighting the need for comprehensive interventions that address both biological and psychosocial aspects. This study provides valuable insights for tailoring mental health support to youths navigating the consequences of the COVID-19 pandemic.

Combining the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale in Early Pregnancy in Danish Antenatal Care-A Qualitative Descriptive Study.

Pregnant women with a history of mental disorders, neglect, or low social support are at increased risk of mental health problems. It is crucial to identify psychosocial risk factors in early pregnancy to reduce the risk of short- and long-term health consequences for mother and child. The Antenatal Risk Questionnaire has been found acceptable as a psychosocial screening tool among pregnant women in Australia, but it has not been tested in a Scandinavian context. The aim of this study was to explore the experiences of pregnant women when using the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale as part of a model to identify psychosocial vulnerabilities in pregnancy in Denmark. We conducted individual interviews (n = 18) and used thematic analysis. We identified two main themes: (1) Feeling heard and (2) An occasion for self-reflection. Overall, the pregnant women deemed the online ANRQ/EPDS acceptable as a screening tool. The screening model provided a feeling of being heard and provided an occasion for self-reflection about mental health challenges related to pregnancy and motherhood. However, some women expressed that the screening raised concerns and fear of the consequences of answering honestly. A non-judgmental, open, emphatic, and reassuring approach by clinicians may help reduce stigma.

Environmental exposure to multiple chemical elements in Peruvian populations: a review of selected studies

Background Population-based exposure assessments for heavy metals and metalloids (by governmental and private institutions) are common in Peru, but most studies generally focus on the analysis of a single chemical element, like lead or mercury, and lack an appropriate reference regarding the health impact on the exposed population. The complex/mixed chemical interactions within the human body have not yet been studied for all long-term health effects. Methods We reviewed laboratory results from five studies, between 2005-2013, that analysed multiple elements (between 13 and 17 chemical elements in each study) in spot urine samples from Peruvian communities considered exposed and not exposed. All laboratory analysis were performed using inductively coupled plasma mass spectrometry (ICP-MS) at the Environmental Health Laboratory Division of the Centers for Disease Control and Prevention (CDC) of the United States. Results Six chemical elements (total arsenic, caesium, cobalt, lead, molybdenum, and thallium) were present in almost all spot urine samples (>98% of participants), evidencing exposure (qualitative assessment). Exposure to other chemical elements like barium, cadmium, tungsten, antimony and uranium, varied among localities, while chemical elements like beryllium and platinum were rarely detected (<3% and <10% of participants, respectively) in spot urine samples. Most geometric means of urine concentration for total arsenic, lead, cadmium and mercury are higher for the Peruvian locations than for national estimates in Canada and the United States, but not in all locations. Conclusion Comparing averages across different populations can be misleading but comparing periodic values from the same population in the future could evidence an exposure trend. Future studies are needed to develop reference levels for exposed Peruvian populations. This study highlights potential health risks from exposure to environmental chemical elements and can be the first step towards understanding and mitigating human exposure to heavy metals and metalloids for known exposed populations in Peru.

Hygienic assessment of occupational risk for workers during pre- and post-emergence herbicide treatments of sunflower crops

Modern agriculture extensively uses pesticide formulations at various stages of crop growth. Sunflower cultivation accounts for 31% of the global production. Assessing the occupational risk associated with pesticide application in sunflower farming is of paramount importance. Improper handling and application of pesticide formulations can have immediate adverse effects on workers, leading to acute poisoning, long-term health consequences, and the potential for chronic illnesses, including neurotoxic effects. The aim of this study was to conduct a hygienic assessment of the professional risk faced by workers during pre- and post-emergence herbicide applications in sunflower cultivation. This assessment was carried out to establish the regulations for their safe usage. Research samples after the application of the herbicides AGAT, GARPUN, KORVUS, and PARUS (patches from overalls, gloves, skin swabs from exposed areas (face-neck, hands), air samples (atmospheric air, working zone and drift zone). The assessment of professional risk was conducted in accordance with the methodological recommendations provided by experts from the L.I. Medved's Research Center of Preventive Toxicology, Food and Chemical Safety, Ministry of Health, Ukraine (State Enterprise). Statistical analysis of the results was carried out using the licensed statistical software packages MedStat v.5.2 (Copyright© 2003-2019) and Microsoft® Excel® for Microsoft 365 MSO (Version 2305, Build 16.0.16501.20074). It has been determined that under real conditions, during pre- and post-emergence herbicide applications in sunflower cultivation using AGAT, GARPUN, KORVUS, PARUS preparations, while adhering to recommended agrotechnical and hygiene safety regulations, the inhalation, dermal, complex, and combined (AGAT and PARUS) risks for applicators are 0.0409±0.0179, 0.0429±0.0193, 0.0838±0.0224, and 0.1557±0.1322 a.u., respectively, and for tractor operators – 0.0818±0.0358, 0.0425±0.0192, 0.1243±0.0356, and 0.2347±0.1567 a.u., respectively. There is no observed increase in hygiene standards in the workplace atmosphere and in the air of the potential drift zone. It has been proven that the professional risk of their use does not exceed permissible limits (<1). It has been determined that during the performance of techno­logical operations, the mentioned risks in applicators and tractor operators did not differ significantly (p>0.05). However, a significant difference was found in the proportion of percutaneous risk (42.7±17.4% in applicators compared to 34.8±17.0% in tractor operators; p=0.034). The regulations for the safe use of the investigated pesticide formulations have been substantiated. Statistical analysis of the obtained results revealed that the values of inhalation, dermal, and combined risks during the application of these pesticides did not significantly differ during the various technological operations (applicators and tractor operators) (p>0.05). The values of the combined comprehensive risk associated with the use of the studied preparations also did not show significant differences (p>0.05). The proportion of dermal risk was significantly higher in applicators compared to this parameter determined in tractor operators (p=0.034).

Precarious employment in young adulthood and later alcohol-related morbidity: a register-based cohort study

ObjectivesThe prevalence of precarious employment is increasing, particularly among young adults where less is known about the long-term health consequences. The present study aims to test if being precariously employed...

The Relationship of the Traumatic Birth Perception of Women with Birth Memories and Recall.

A traumatic childbirth experience can have both short- and long-term health and well-being consequences for the woman and her family. If a woman experiences traumatic childbirth and retains negative memories for a long time, this may impact her future childbirth experience, mother-infant bonding and breastfeeding problems, and her relationship with other family members. The research was conducted to evaluate the relationship between women's traumatic birth perception and birth memory and recall. This descriptive study was conducted at Erzurum Research Hospital between August 16 and October 2021. Two hundred sixty women who met the inclusion criteria were included in the study sample. The personal information protocol, "Traumatic Childbirth Perception Scale," and "Birth Memories and Recall Questionnaire" were used to collect data. The participants' mean age was 30.13 ± 5.85, and 43.4% had their first birth. Of the participants, 45% had one living child, 72.9% had a planned pregnancy, and 62.8% had a normal birth. Whereas more than a third of women in the study perceived childbirth and childbirth processes as moderately traumatic, another third had a high and very high perception. The birth memories and recall mean scores of the mothers within the scope of the study were 81.09 ± 22.69. According to the study results, it was determined that women's birth memories and recall were negatively affected as their traumatic childbirth perceptions increased. It is possible to reduce traumatic childbirth perception with the continuous care and support provided by midwives during childbirth. Improving women's traumatic childbirth perception will also positively impact women's long-term memories of childbirth experience.

Predicting DSM-5 PTSD symptomatology 6 months to 2 years after burn: The role of early psychological risk factors

BackgroundMajor burn injuries may have long-term mental health consequences, such as posttraumatic stress disorder (PTSD). This study extended prior work to investigate DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn as well as the contribution of two sets of early psychological risk factors to DSM-5 PTSD symptoms: Established PTSD risk factors (prior adjustment problems, past trauma, perception of life threat, peritraumatic emotions and dissociation) and theory-derived cognitive factors (negative appraisals of the trauma and its sequelae, memory disorganization, trauma-related rumination, and thought suppression). MethodThe current study recruited a sample of 118 adult burn patients (75.4% men, mean age 41.8, mean TBSA 18.3%) consecutively admitted to a large regional burn center in Northern Taiwan, who were assessed at 6, 12, and 24 months following their burn injury. ResultsA total of 11.0%, 5.9%, and 7.6% met probable DSM-5 PTSD at 6 months, 1 year, and 2 years post-burn, respectively. The rates rose to 15.3%, 10.2%, and 11.0% using the cutoff method. After controlling for covariates, the regression model with theory-derived cognitive factors explained an additional significant 15.9%, 17.2%, and 17.7% of the variance in DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn, respectively. In contrast, the regression model with established PTSD risk factors explained an additional significant 7.2%, 14.4%, and 10.5% of the variance in DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn, respectively. Of all predictors, negative appraisals of intrusions was consistently and strongly predictive of DSM-5 PTSD symptomatology post-burn across time, followed by prior depression. ConclusionsThe results underscore the role of early cognitive risk factors in the development and persistence of DSM-5 PTSD symptomatology following burn injury.

Adverse childhood experiences and yoga as "a practice of liberation".

The long-term negative health consequences of adverse childhood experiences (ACEs) pose a significant public health concern. Effective and engaging interventions that simultaneously address physical, mental, and socio-emotional health and mitigate the negative sequelae related to ACEs are needed. Promising evidence points to the impact of yoga and mindfulness on physiological and emotional health outcomes. Yet, little is known about those who have experienced multiple ACEs and their perspectives on the influence of yoga and mindfulness on their lives. The current study examines the phenomenological experiences of adults with high ACEs who engage in yoga practice. Twelve adults participated in in-depth, semistructured interviews. These included nine cisgender women, two cisgender men, and one gender nonbinary individual; 66.8% White, 16.6% multiracial, 8.3% Black/African American, and 8.3% Asian American/Pacific Islander. Participants were aged 20-63 years and endorsed four or more ACEs. They practiced yoga at least once a week for at least 6 months. Themes that emerged included: healing from trauma-related symptoms, integration of the whole self in mind-body practice, corrective experiences through yoga and mindfulness, and healing beyond talk therapy. Individuals with ACEs may experience yoga as a potentially valuable method for promoting healing through an integrative approach. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring sedentary behavior during neo- or adjuvant treatment in patients with cancer: A phenomenological study

PurposeIncreased sedentary behavior during cancer treatment is common, which may have negative long-term health effects. Understanding patients' experience of sedentary behavior during neo- or adjuvant cancer treatment may be crucial in developing effective support for patients to reduce sedentary behavior. Therefore, the present study aimed to explore sedentary behavior in patients undergoing neo- or adjuvant cancer treatment. MethodsEleven interviews were conducted with patients undergoing treatment for breast, prostate, and colorectal cancer. Participants were recruited from a university hospital in Sweden. Interviews were analyzed phenomenologically, and the results were presented as descriptions of the phenomenon sedentary behavior. ResultsThe overarching theme of sedentary behavior during cancer treatment was that sedentary behavior is experienced through being physically active or not. Furthermore, experiences of sedentary behavior increased with side effects and varied depending on the type and phase of cancer treatment, meaning that sedentary behavior is an adjustment to side effects. Additionally, sedentary behavior was influenced by life circumstances and social interaction, such as work status and having social support. Finally, sedentary behavior is influenced by strategies and motivations, such as the perceived benefits of physical activity and self-image. ConclusionsSedentary behavior is difficult for patients to discern, which is why health care personnel may need to help patients by increasing awareness of the negative impact of sedentary behavior in a way that does not stigmatize patients. Furthermore, developing support that targets periods with more side effects and helping patients reduce sedentary behavior throughout changing life circumstances may be helpful.

Addressing Cardiovascular Toxicity Risk of Electronic Nicotine Delivery Systems in the Twenty-First Century: "What Are the Tools Needed for the Job?" and "Do We Have Them?"

Cigarette smoking is positively and robustly associated with cardiovascular disease (CVD), including hypertension, atherosclerosis, cardiac arrhythmias, stroke, thromboembolism, myocardial infarctions, and heart failure. However, after more than a decade of ENDS presence in the U.S. marketplace, uncertainty persists regarding the long-term health consequences of ENDS use for CVD. New approach methods (NAMs) in the field of toxicology are being developed to enhance rapid prediction of human health hazards. Recent technical advances can now consider impact of biological factors such as sex and race/ethnicity, permitting application of NAMs findings to health equity and environmental justice issues. This has been the case for hazard assessments of drugs and environmental chemicals in areas such as cardiovascular, respiratory, and developmental toxicity. Despite these advances, a shortage of widely accepted methodologies to predict the impact of ENDS use on human health slows the application of regulatory oversight and the protection of public health. Minimizing the time between the emergence of risk (e.g., ENDS use) and the administration of well-founded regulatory policy requires thoughtful consideration of the currently available sources of data, their applicability to the prediction of health outcomes, and whether these available data streams are enough to support an actionable decision. This challenge forms the basis of this white paper on how best to reveal potential toxicities of ENDS use in the human cardiovascular system-a primary target of conventional tobacco smoking. We identify current approaches used to evaluate the impacts of tobacco on cardiovascular health, in particular emerging techniques that replace, reduce, and refine slower and more costly animal models with NAMs platforms that can be applied to tobacco regulatory science. The limitations of these emerging platforms are addressed, and systems biology approaches to close the knowledge gap between traditional models and NAMs are proposed. It is hoped that these suggestions and their adoption within the greater scientific community will result in fresh data streams that will support and enhance the scientific evaluation and subsequent decision-making of tobacco regulatory agencies worldwide.

Cross-Cultural Adaptation and Validation of the Portuguese Version of the Multidimensional Scale of Dating Violence 2.0 in Young University Students.

Dating violence has become a problem of social relevance with short- and long-term health consequences. Nurses are in a privileged position to detect and address this problem in health facilities and as school nurses in schools, providing health education and detecting this violence correctly. The aim of this study was to evaluate the cross-cultural validation of the Portuguese version of the Multidimensional Scale of Dating Violence-Short (MSDV 2.0). A validation investigation was carried out in two phases: (1) cross-cultural adaptation of the items and content validation of the Portuguese version of MSDV 2.0 and (2) psychometric validation. Phase (1): The items of the original version include a cross-cultural translation from Spanish to Portuguese and analysed by a group of experts in gender violence and by the authors of the original scale, then a back translation was made and again reviewed by the experts. Young university students also participated for face validity, and a pilot test was carried out. Phase (2): Confirmatory factor analysis was performed using the robust maximum-likelihood estimation method, which confirmed the five-dimensional structure, obtaining good fit rates (chi-square significance (χ2) = 187.860 (p < 0.0001); root mean square error of approximation (RMSEA) = 0.049; comparative fit index (CFI) = 0.937; Tucker-Lewis index (TLI) = 0.923). Reliability analysis indicated adequate internal consistency (Cronbach's alpha (α) = 0.88 to 0.70). Finally, scores of the Portuguese versions MSDV 2.0 were correlated, as expected, positively with the Depression, Anxiety, and Stress Scale (DASS-21) (r = 0.36 to 0.16) and negatively with the Medical Outcomes Study Questionnaire Short Form 36, Health Survey (SF-36) (r = -0.30 to -0.14). To date, it is the only instrument that measures dating violence in a multidimensional way validated in the Portuguese university context.

Quantitative analysis of air pollution levels and its health implications in Delhi-NCR: A longitudinal study

Air pollution is a pressing global issue, particularly acute in rapidly urbanizing regions like Delhi-NCR. This research presents a longitudinal study to quantitatively analyze air pollution levels and their health implications in Delhi-NCR. The research objectives include assessing air quality trends, examining the relationships between various pollutants, and investigating the impact of air pollution on respiratory admissions. Data was sourced from the Ambient Air Quality Monitoring Network, covering the years 2020 to 2022, focusing on key pollutants, including PM2.5, PM10, NO2, SO2, CO, and O3. A range of data analysis techniques, including correlation analysis, regression analysis, longitudinal data analysis, spatial analysis, and compliance with WHO guidelines, were applied. Key findings highlight persistently high levels of air pollutants, strong interrelations among pollutants, and consistent respiratory admissions, especially in winter. Regression analysis confirms a significant link between PM2.5 and respiratory admissions. Longitudinal analysis demonstrates the long-term health consequences of air pollution, and spatial analysis reveals district-wise variations in air quality. The study also emphasizes seasonal strategies, compliance with international guidelines, and socioeconomic disparities in health outcomes. This research has broader implications for evidence-based policymaking, emphasizing the urgency of addressing air quality concerns. It calls for targeted interventions, district-level strategies, season-specific measures, and equitable access to healthcare. These findings offer a comprehensive basis for addressing the air quality crisis in Delhi-NCR, ultimately promoting the well-being of its residents.