Physical Health Consequences Research Articles

VIOLÊNCIA INSTITUCIONAL: DESIGUALDADES RACIAIS NO ATENDIMENTO HOSPITALAR A MULHERES NEGRAS: REVISÃO DE LITERATURA.

ABSTRACT: Institutional violence in the healthcare sector is manifested through racial inequalities that disproportionately affect Black women in hospital care. This study aims to review the existing literature on the barriers faced by these women, such as limited access to services, lower quality of care, and resulting psychological impacts. The research seeks to analyze how institutional racism affects hospital care for Black women, identifying the main factors that perpetuate these inequalities and their consequences for physical and mental health. The methodology includes a bibliographic review of studies published between 2016 and 2023, obtained from databases such as SciELO, PubMed, and LILACS, with an emphasis on the impact of institutional racism on the health of the Black population, with a primary focus on Black women.

The Effects of Wildfires on the Mental and Physical Health of School-Age Children in North America: A Scoping Review.

Wildfires are occurring more often and with greater intensity, leading to longer and harsher fire seasons. As a result, children are more frequently exposed to wildfire smoke, which increases their risk of mental and physical health effects. The purpose of our scoping review is to explore the current literature on what is known about the direct and indirect impacts of wildfires on the mental and physical health of school-age children in North America (5 to 18-year-olds). A health sciences librarian-assisted literature search, with input from the research team, was performed. A total of 16 studies were selected. Common mental health symptoms such as anxiety, depression, suicidal thinking, and post-traumatic stress disorder have been identified. The findings of this review are in line with recent studies showing a connection between adult wildfire exposure and respiratory conditions; however, no cardiovascular health effects in children were identified. The available studies in our review demonstrate that wildfires do increase the impacts on both mental and physical health postexposure in school-age children. Future research should specifically include larger samples, more qualitative and longitudinal studies that can more effectively analyze the effects of wildfire events on psychological factors over time, conceptual frameworks, and exposure metrics specific for PM2.5 from wildfire smoke.

Intra- and intergenerational food insecurity: An analysis of Black and White women and children from the NHLBI Growth and Health Study

BackgroundFood insecurity (FI) continues to be a significant public health concern and is associated with myriad physical and mental health consequences. Increased understanding of conditions around its occurrence throughout the life course are needed. However, research has been limited due to inadequate measurement tools and study length. ObjectiveThis study examined the intra- and intergenerational dynamics of FI over time by assessing the transmission of FI from childhood to adulthood, and from mother to offspring using population-specific FI measures, and the influence of sociodemographic factors. MethodsWomen in early midlife (n=624) and their children (n=331) participated in a prospective cohort study between 1987-2019 in Richmond, California. Three validated FI measures were assessed, representing 1) past childhood FI and 2) current adult household FI, reported by the women, and 3) current child FI, reported by the women’s children. Associations between measures were examined using adjusted modified Poisson regression models. Mediation by current adult household FI between past childhood FI and their offspring’s current child FI was assessed. Moderation by sociodemographic factors, including poverty level, parental education, marital status, and race was also assessed. ResultsAmong women, 32.4% reported FI in childhood and 34.5% reported current adult household FI. Among their offspring, 53.2% reported current child FI. Past childhood FI increased the likelihood of current adult FI (RR: 2.18, 95%CI: 1.64, 2.90) and current adult FI increased the likelihood of current child FI (RR:1.49, 95%CI: 1.08, 2.07). Current adult FI partially mediated past childhood FI and their offspring’s current child FI (Natural indirect effect: 1.42, 95%CI: 1.03, 2.24). There was no evidence of moderation by sociodemographic factors. ConclusionsFI measures reported by adults and children capture differing experiences, highlighting the need to use FI measures that are appropriate for their target population. FI may be perpetuated intra- and intergenerationally.

7.M. Round table: A new lens on loneliness: leveraging the built environment for social health

Abstract Loneliness is a global issue impacting a third of all adults, with young adults (15-25 years) disproportionately affected. Prolonged loneliness has serious consequences for mental and physical health and should be addressed as a matter of urgency. The built environment, where we live, work, and socialise, is increasingly recognised as a significant factor influencing loneliness. However, existing interventions often focus on older adults and neglect the role of the built environments in promoting connectedness across the life course. To bridge this gap, we need interdisciplinary collaboration to understand how our environments and communities can mitigate loneliness. This workshop will explore the critical intersection of place and loneliness interventions. The three panellists bring unique interdisciplinary expertise on loneliness ranging from policy to intervention implementation. These three talks (10min each) will set the stage for a dynamic discussion (30min): 1. Nina Goldman, commissioned by the World Health Organization to undertake a global overview of national loneliness policies, will present findings on how national strategies integrate place-based strategies across sectors such as housing, transportation, and urban planning. 2. Mathias Lasgaard, leading researcher on loneliness interventions, will present the innovative ‘More Together’ (MoTo) project - a multifaceted intervention addressing loneliness in both young and older adults within the Silkeborg Municipality, Denmark. This presentation will contextualize MoTo within the broader landscape of targeted loneliness interventions. 3. Eric Schoenmakers, advisor of the national loneliness action program in the Netherlands, will introduce the “I BELONG” project, an international network dedicated to understanding the relationship between public spaces, loneliness, and effective interventions for young adults in the Netherlands. Key messages • We aim to stimulate a paradigm shift in the way we address loneliness by moving beyond individual-centred solutions to develop a more holistic and community-based approach. • We need more interdisciplinary collaboration to understand how our environments and communities can mitigate loneliness. Speakers/Panelists Nina Goldman University of Manchester, Manchester, UK Mathias Lasgaard Defactum, Central Denmark Region, Aarhus, Denmark Eric Schoenmakers Fontys University of Applied Sciences, Eindhoven, Netherlands

ProtAct-Us from serious injuries with long-term consequences

Abstract Battling serious injuries and long-term consequences in road traffic remains one important issue in the overall goal of resilient future road transport and its Vision Zero. Challenges of increasing personal transport in urban areas coupled with autonomous vehicles and shuttles, new mobility devices and the overall need to ensure the safety of vulnerable road users as well as all types of vehicle occupants’ require solid medical background knowledge paired with innovative engineering approaches. EU Horizon Europe is currently funding the ProtAct-Us consortium (2024-2027) that aims at protecting all Road User Groups from serious injury and long-term physical, cognitive and mental health consequences related to road crashes through innovatively interlinked research action between medical and engineering methods and approaches. ProtAct-Us works on the following goals and challenges: i) Medical data correlation, standardisation and classification of long-term consequences of road crashes; ii) Robust and reliable medical, epidemiological and engineering tools like agreed methods to collect information on long-term consequences, upgraded Human Body Models and virtual assessment methods for the extremities, head, neck and face allowing for effective countermeasure development for all road users; iii) Reduction of long-term consequences and related socio-economic cost of road crash related injuries for all road users. The ProtAct-Us solutions will influence new standards in respect of extending current injury codification system with relevant long-term aspects, allowing new physical as well as virtual safety assessment procedures and adaption of rules and regulations to be implemented. Finally, scientifically well-founded suggestion for future implementation into policy, regulatory, and standardization guidelines for an inclusive safety improvement approach for in- as well as post-crash will be provided.

Heavy Work Investment (HWI) and Its Effect on Employees’ Physical and Mental Health

Abstract Background Economic reality and centrality of work have led to employees investing much time and effort in work. However, The number of hours spent at work may not be the only explanation, and other characteristics, such as type of work, employees’ personality, economic status, motivations, etc., need to be considered. The Heavy Work Investment model (Snir & Harpaz, 2012) considers these variables and classifies employees into four types of investors. This study examines the physical and mental health consequences of each HWI group. Methods Participants (N = 962) were workers who came to a medical center for annual medical screenings. About 70% were males, and the average age was 50.13 years (SD = 9.53). They divided into 5 groups: Typical full-time workers (N = 208, 29.2%), ‘Needy’ (N = 111, 15.6%), ‘Employer directed’ (N = 111, 15.6%), ‘Workaholic’ (N = 192, 26.9%) and ‘Work devoted’ (N = 91, 12.7%). The personal data was cross-referenced with the respondents’ health data. Differences for categorical variables were examined with Chi-square analyses. Results ‘Employer-directed’ employees, more than ‘work-devoted’ employees, perceived their health status as preventing them from performing mild activities. ‘Employer-directed’ and ‘needy’ employees, more than ‘work-devoted’ employees, perceived their health status as interfering with their social activities and their pain as interfering with their regular activities. ‘Workaholic’ employees suffered from more diseases than ‘work-devoted’ employees, and they were found to be 3.70 times more likely to be at a high risk of cardiovascular disease than typical full-time workers. Conclusions It is possible to anticipate types of health damage according to occupation type and develop occupation-adjusted health promotion programs. It is necessary to base labor laws on protecting employees’ health, particularly regarding time and workload’ outside of work’ in both hours (additional or flexible) and location (hybrid work). Key messages • Inspire organizations to be aware of potential injuries caused by HWI and promote the creation of intervention programs, potentially significantly improving employees’ health and well-being. • Evidence for the necessary laws that protect employees’ health, particularly regarding time and workload ‘outside of work’ in both hours (additional or flexible) and location (hybrid work).

Acceptance and Commitment Therapy for Hypersexuality: A Pilot Study

Hypersexuality refers to the inability to control sexual desire. Despite it has shown serious consequences for physical, psychological and social health, the evidence of available psychological interventions is still insufficient. In this open-label pilot study, an Acceptance and Commitment Therapy (ACT) intervention was conducted with adults with clinically significant levels of hypersexuality aimed to examine its feasibility and usefulness. The intervention consisted of eight weekly online individual psychological intervention sessions. Outcome self-report measures were administered at baseline, after the intervention and a 3 months follow-up. Behavioral and subjective informed changes in sexual practices were weekly assessed through self-monitoring. Twelve participants (M age = 38.8 ± 11.5 years, 83.3% male, 66.7% homo or bisexual) completed the intervention. The feasibility was found to be good, with all the participants completing the training and high levels of satisfaction. Hypersexuality, psychological flexibility, cognitive fusion and mindfulness scores significantly improved after the ACT intervention, with large effect sizes. Clinically significant changes in hypersexuality were found for the vast majority of participants, besides reductions in the time dedicated to planning and practicing sex and the sexualized drug use. Results indicate that ACT-based interventions may be considered feasible and potentially effective therapeutic alternatives for hypersexuality.

Race Differences in Purpose in Life Among Family Caregivers: Findings From the Caregiving Transitions Study.

Family caregiving may affect purpose in life, defined as the sense that life has meaning and intentionality. Few studies have compared caregivers to non-caregivers or examined the characteristics of caregivers associated with purpose in life. Using data from the Caregiving Transitions Study (n = 486), we conducted multiple linear regression analyses to test the effects of caregiver status, age, gender, social network, and physical and mental health on purpose in life. We also tested whether the effect of caregiver status differed by race and, among caregivers (n = 241), the associations between caregiving characteristics and purpose in life. Caregivers did not differ significantly from non-caregivers in purpose in life in adjusted analysis. Among caregivers, significantly greater purpose of life was observed among Black caregivers and those reporting higher positive aspects of caregiving. Future research should examine these issues longitudinally, and caregiver interventions should consider addressing purpose in life and positive aspects of caregiving.

Cancer survivorship and long-term outcomes: navigating the challenges beyond treatment

The increasing number of cancer survivors due to advancements in early detection and treatment has shifted the focus of oncology to the long-term health and well-being of these individuals. Cancer survivorship encompasses a wide range of challenges that extend beyond the completion of treatment, including physical, psychological, social, and economic issues. This review explores the long-term physical health consequences of cancer treatment, such as neuropathy, cardiotoxicity, and chronic conditions, and highlights the psychological burdens, including anxiety, depression, and cognitive impairment, commonly faced by survivors. The article also addresses the social and economic impacts, such as difficulties in returning to work and financial toxicity, which further complicate the survivorship experience. Additionally, the review emphasizes the importance of assessing and improving the quality of life (QoL) for survivors through personalized interventions and the implementation of survivorship care plans (SCPs). Emerging research on biomarkers, telemedicine, and policy advocacy is discussed as critical components for advancing survivorship care. The review concludes that a comprehensive approach, including ongoing research, personalized care, and supportive policies, is essential to meet the diverse needs of cancer survivors and improve their long-term outcomes and QoL.

Exploring the effects of yoga on dysmenorrhea: A narrative review

ABSTRACT Dysmenorrhea, commonly known as menstrual pain, is characterized by painful uterine cramps during menstruation and significantly impacts a woman’s physical, mental, and emotional health. Elevated prostaglandin levels cause dysrhythmic uterine contractions, reducing blood flow, leading to uterine hypoxia, and producing anaerobic metabolites that activate pain receptors. This study aims to review the effectiveness of yoga as an alternative treatment for primary dysmenorrhea. A search of English-language literature published from 2010 to 2023 was conducted across Scopus, PubMed, and Google Scholar using keywords “Yoga” AND “Menstrual Pain” OR “Dysmenorrhea.” The inclusion criteria were limited to randomized controlled trials examining the impact of yoga on dysmenorrhea symptoms. From 111 identified studies, 6 met the selection criteria and were included in the review. The review investigates yoga’s potential to alleviate primary dysmenorrhea’s physical and mental health effects. The literature indicates that yoga, including asanas, pranayama, and Yoga Nidra, is effective in reducing dysmenorrhea symptoms. Findings suggest that various yoga practices can significantly reduce menstrual pain and discomfort, improving overall health outcomes. However, the reviewed studies have limitations, such as small sample sizes and variations in study design. To establish yoga as an evidence-based solution for menstrual health issues, further research with rigorous scientific methods and larger sample sizes is needed. More high-quality trials focusing on a yogic approach are necessary to confirm yoga’s effectiveness as a primary management option for women with primary dysmenorrhea.

The Impact of Allyship on Minoritized Patients and Providers in Palliative Practice.

Many minoritized patients experience discrimination in health care. The same is true for minoritized health care clinicians, including the advanced practice registered nurse (APRN). Specifically, Black Americans have historically and disproportionally been privy to both structural racism and interpersonal racial discrimination (J Subst Abuse Treat 2022;133:108551). For patients, such exposure is associated with physical and mental health consequences, including hypertension, obesity, depression, anxiety, psychological distress, and mortality (Health Serv Res 2019;54 suppl 2(suppl 2):1399-1408). For minoritized clinicians, the subsequent result of discrimination additionally includes poor job satisfaction, decreased productivity, and high turnover (JAMA Health Forum 2023;4(12):e235249). Allyship, the act of supporting minoritized individuals while not being a member of that group, is potentially useful in improving the practice experience of minoritized APRNs, as well as positively impacting minoritized patients' outcomes. This article aims to provide actionable and practical skills for the APRN to create safe spaces for minoritized patients and partners in palliative practice. Explicitly, the role of the palliative care APRN as an ally will be reviewed as well as guidance on how to implement changes that will affect the health care experience for both patients and clinicians.

The impact of climate change-related disasters on mental health and epigenetics: a narrative review

Climate change has contributed to an increase in the frequency and intensity of natural disasters such as droughts, wildfires, hurricanes, and floods, leading to both immediate physical harm and long-term mental health consequences. Survivors often experience psychological distress, including anxiety, depression, and post-traumatic stress disorder (PTSD), as a result of these traumatic events. This narrative review explores the intersection of climate change-related disasters, mental health outcomes, and epigenetic modifications. Specifically, we summarize recent findings on how environmental stressors influence both mental health and epigenetic changes, such as DNA methylation. Emerging evidence suggests that epigenetic mechanisms, particularly DNA methylation, could mediate the effects of climate change-related stress on mental health, potentially contributing to the onset of mental disorders like depression, panic disorder, autism spectrum disorder, and attention deficit hyperactivity disorder. We also discuss other epigenetic mechanisms, such as histone modifications and non-coding RNAs, and emphasize the importance of longitudinal studies to capture the dynamic nature of epigenetic changes over time. Finally, we propose future research directions to deepen our understanding of the complex relationships between climate change-related disasters, mental health outcomes, and epigenetic mechanisms, which will pave the way for more effective mental health interventions and policy integration.

Knocking on Heaven’s Door? Entrepreneurship, Firm Growth, and Health Risks

We examine the physical health consequences to entrepreneurs of firm growth and decline. Using register-based panel data (2000–2021), we find that entrepreneurs and hired CEOs are, on average, healthier and live longer than individuals from a socio-economically similar random sample from the general population. However, our findings also reveal that entrepreneurs are more likely to fall ill during their tenure and die younger than hired CEOs. Importantly, our findings demonstrate that both cumulative exposure to growth and episodic, rapid declines in sales and in the number of employees are equally taxing for entrepreneurs and hired CEOs.

Effectiveness of surfing on psychological health in military members: a systematic review

IntroductionSurfing, a leisure activity known for its positive physical and mental health effects, has emerged as a potential therapeutic intervention. This study aims to systematically review the available evidence on...

Gun violence exposure and population health inequality: a conceptual framework

This essay establishes a conceptual framework to understand how direct, secondar and community exposures to gun violence converge to influence population health. Our framework asserts that persistent gun violence in...

Supportive-leadership training to improve social connection: A cluster-randomized trial demonstrating efficacy in a high-risk occupational context.

The high, and still rising, rate of loneliness is a threat to public health (Office of the Surgeon General, 2023), with negative mental and physical health consequences (e.g., Holt-Lunstad, 2021). Given that loneliness is a risk factor for poor mental health, efforts to address loneliness are urgently needed. Workplaces can facilitate an employee's social connection through supervisor support training, which can help mitigate loneliness. Among occupational groups, the military is at higher risk for mental health disorders, suicide, and loneliness (Fikretoglu et al., 2022; Naifeh et al., 2019). This study evaluated the efficacy of an evidence-based supportive-leadership training intervention targeting active-duty U.S. Army platoon leaders and targeting both proactive support behaviors that help bolster employee social connection and responsive support behaviors, including destigmatizing mental health. Ninety-nine platoon leaders (69.7% of eligible leaders) completed the 90-min training that consisted of both in-person and computer-based components. Using a cluster-randomized controlled trial design, intervention effects were tested using an intent-to-treat approach and revealed a significant effect, whereby loneliness of service members whose leaders were randomized to the intervention group (N = 118) was significantly reduced compared to loneliness reports for service members in the control group (N = 158). Additionally, service members with higher baseline loneliness were more strongly and positively impacted by the supervisor training, reporting higher levels of supportive behaviors from their leaders at 3 months postbaseline. In sum, these results suggest how workplaces, especially those that are considered high-risk occupations, and their leaders play a critical role in a national strategy to address Americans' well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reframing Child Protection in Emergency Medicine

Child maltreatment remains a concerning source of morbidity and mortality in the United States, where more than 600,000 children are victims of abuse each year, with well-described, long-term consequences for physical and mental health. However, the US child welfare system is characterized by systemic racism and inequity. Black and Native American children are more likely to be evaluated and reported for suspected abuse despite evidence that race does not independently change their risk of being abused. Once reported to child protective services (CPS), these children are more likely to be removed from their homes and less likely to be reunited with their families than White children. Much of the inequity in this system starts at the front door, where a growing body of research demonstrates that bias regularly infiltrates decision-making in the initial clinical evaluation and management of suspected abuse. Minority children presenting to emergency departments (ED) are more likely to receive diagnostic testing and are more likely to be referred to CPS. In this editorial, we argue for the application of an equity lens to child protection in the ED. We discuss how emergency physicians can balance efforts to protect children from abuse with the imperative to protect children and families from the harms of an inequitable child welfare system. Our discussion concludes with concrete recommendations for emergency clinicians to participate in active bias mitigation and thoughtfully navigate their responsibilities as mandated reporters.

Hidden scars: the persistent multifaceted health and psychosocial consequences for Syrian torture survivors.

Background: The impact on the physical and mental health of those who survived torture and their close circles in the Syrian regime's detention facilities remains under-studied.Objective: This qualitative study explored Syrian refugees' narrations of captivity and torture, and the consequences of such extreme traumatic events on their physical and psychosocial health.Method: Thirteen audio-recorded interviews were conducted in Arabic with Syrian refugees. Study participants were at least 19 years of age, resided in diverse urban areas of Jordan, had experienced captivity and torture in Syrian detention facilities, and voluntarily agreed to participate in the study. Participation was anonymous, only oral consent was required, and no incentives were provided to participants. Interviews were transcribed and translated into English by a team of researchers, followed by analysis of repetitive themes according to the narrative paradigm.Results: Analysis of interviews elicited three major themes: extreme traumatic experiences of torture, and its physical and psychosocial health consequences. The first major theme was divided into two sub-themes: torture experienced by the participants themselves, and torture experienced by participants' close circles. The second major theme, pertaining to physical health, was divided into two sub-themes: acute and chronic health sequelae. The third major theme, related to psychosocial health, was divided into four sub-themes: mental health symptomatology, impacts on professional life, impacts on interpersonal relationships, and social consequences.Conclusions: Torture experiences of Syrian refugees had adverse consequences for the physical and psychosocial health, functioning, and the overall well-being of survivors and their close circles. Interventions may seek to improve both the acute and chronic health consequences, as well as the mental health symptoms and associated impacts on livelihood, professional, and relationship dynamics. They should span clinical, legal, and advocacy spheres, given that a holistic approach may contribute immensely to survivors' healing process.

Childhood adversity, accelerated GrimAge, and associated health consequences.

Childhood adversity is linked to psychological, behavioral, and physical health problems, including obesity and cardiometabolic disease. Epigenetic alterations are one pathway through which the effects of early life stress and adversity might persist into adulthood. Epigenetic mechanisms have also been proposed to explain why cardiometabolic health can vary greatly between individuals with similar Body Mass Index (BMIs). We evaluated two independent cross-sectional cohorts of adults without known medical illness, one of which explicitly recruited individuals with early life stress (ELS) and control participants (n = 195), and the other a general community sample (n = 477). In these cohorts, we examine associations between childhood adversity, epigenetic aging, and metabolic health. Childhood adversity was associated with increased GrimAge Acceleration (GAA) in both cohorts, both utilizing a dichotomous yes/no classification (both p < 0.01) as well as a continuous measure using the Childhood Trauma Questionnaire (CTQ) (both p < 0.05). Further investigation demonstrated that CTQ subscales for physical and sexual abuse (both p < 0.05) were associated with increased GAA in both cohorts, whereas physical and emotional neglect were not. In both cohorts, higher CTQ was also associated with higher BMI and increased insulin resistance (both p < 0.05). Finally, we demonstrate a moderating effect of BMI on the relationship between GAA and insulin resistance where GAA correlated with insulin resistance specifically at higher BMIs. These results, which were largely replicated between two independent cohorts, suggest that interactions between epigenetics, obesity, and metabolic health may be important mechanisms through which childhood adversity contributes to long-term physical and metabolic health effects.

Respiratory and physical health consequences in older adults in a high-risk volcanic area: Comparison of two rural villages

Introduction Volcanism is an important natural producer of pollution that impacts health and the quality of the environment. Lung changes caused by exposure to volcanoes have been previously studied. However, limited information exists regarding the effects of prolonged exposure to volcanic compounds. So, this study aimed to analyze the pulmonary effects and stress tolerance in older adults for chronic exposure to the volcanic ashes of the Galeras volcano. Methods A descriptive cross-sectional study of association included rural inhabitants aged over 60 years from Genoy, a village located in a high volcanic hazard zone of Galeras volcano, 2603 meters above sea level. Those in this group, called exposed, were contrasted with a sample of El Encano inhabitants with similar socioeconomic and cultural characteristics. Both villages belong to the rural area of San Juan de Pasto in Colombia. Results It was found that of 31 exposed participants, 18 had obstructive alteration, and in the control group, it was found that of 31 subjects, 6 presented this alteration. The difference between the two groups was significant (p&lt;0.001). A similar situation occurred with distal airway obstruction assessed with the forced expiratory flow of 25–75%. No significant differences were found in restrictive alteration between the exposed and unexposed groups. Conclusion Chronic exposure to volcanic compounds has generated obstructive changes in the population, and these changes were greater in number and severity than those in the control group of unexposed people.