BACKGROUND AND OBJECTIVES

The built environment or physical environment consists of surroundings and conditions constructed by human activity. It includes urban design, neighborhoods, transportation, and smaller scale structures like the design and layout of rooms within buildings. The built environment can affect the physical, social, and functional wellbeing of older adults, both within their own homes and in the neighborhoods in which they live, and additionally plays a part in promoting healthy aging. This narrative review of the literature aims to present the ways in which the built environment can influence the functional ability of community-dwelling older adults, and affect their ability to live independently and age in place.

Narrative literature review and inductive thematic analysis.

Forty-five full-text, English language publications from peer-reviewed sources were selected for this review, with the majority (35) presenting quantitative research findings and originating from North America (28). Older adults in rural and developing countries were underrepresented in the literature, despite acknowledgement that health of the aging population is a worldwide problem. Three major themes emerged. First, the built environment affects older adults in the most fundamental way at home through design considerations, modifications, and technological advances promoting aging in place and accessibility. Secondly, built environments outside the home can affect older adults’ physical activity and overall function with regard to mobility, transportation, and activities of daily living. The majority (22 of 45 publications) focused on this theme. Finally, the built environment in neighborhoods can affect older adults’ perception of social support, their social participation, and quality of life.

As the built environment is created by humans and can be substantially modified, it possesses considerable potential for enhancing functional ability, social participation, and overall quality of life in community-dwelling older adults. It is possible to design a better person-environment fit, promoting safety, independence, optimal health, and quality of life. In order to support healthy aging, improvements in the built environment need to be accompanied by appropriate health and social policies, systems, and services. These changes require political will, as well as material resources that may not be readily available especially in the global South. A socioecological approach with adequate resources directed to older adults’ health and healthcare is necessary in order to achieve the ultimate goal of healthy aging in this population.

OBJECTIVES: Acute ischemic stroke (AIS) is one of the main causes of disability in middle-aged and elderly people, and early activity plays an important role in functional recovery. This study aims to understand the factors that affect the implementation of early activity in patients with AIS and to provide reference for promoting early activity implementation and developing intervention strategies for AIS patients. METHODS: Using purposive sampling, 19 AIS patients and their caregivers who visited at Stroke Center in the Third Xiangya Hospital of Central South University and the Third Hospital of Changsha from June to December 2021, as well as 19 medical staff, hospital administrators, or community workers providing medical health services to stroke patients, were selected as interviewes. A semi-structured interview was conducted based on the social ecological theory model, and the Colaizzi seven-step method was used to analyze the interview data. RESULTS: According to qualitative interview results, the factors affecting early activity in AIS patients were summarized into 4 themes and 12 sub-themes: medical staff factors (insufficient knowledge and skills, insufficient knowledge of early activity, unclear division of responsibilities), patient factors (severity of the disease, lack of knowledge, psychological pressure, fear of falling), social environmental factors (lack of social support, shortage of human resources and rehabilitation equipment, insufficient medical insurance support), and evidence and norms (the evidence for early activity needs improvement, lack of standardized early activity procedures). CONCLUSIONS Early activity in AIS patients is impacted by factors at multiple levels, including medical staff, patients, social environment, and evidence and norms. Developing comprehensive intervention strategies to address these factors can promote early activity implementation in AIS patients.
Aged ; Middle Aged ; Humans ; Ischemic Stroke ; Accidental Falls ; Fear ; Social Environment ; Stroke

INTRODUCTION: Amid the COVID-19 pandemic, many rumours have emerged. Given prior research linking rumour exposure to mental well-being, we conducted a nationwide survey to document the base rate of rumour exposure and factors associated with rumour vulnerability. METHODS: Between March and July 2020, 1,237 participants were surveyed on 5 widely disseminated COVID-19 rumours (drinking water frequently could be preventive, eating garlic could be preventive, the outbreak arose because of bat soup consumption, the virus was created in an American lab, and the virus was created in a Chinese lab). For each rumour, participants reported whether they had heard, shared or believed each rumour. RESULTS: Although most participants had been exposed to COVID-19 rumours, few shared or believed these. Sharing behaviours sometimes occurred in the absence of belief; however, education emerged as a protective factor for both sharing and belief. CONCLUSION Our results suggest that campaigns targeting skills associated with higher education (e.g. epistemology) may prove more effective than counter-rumour messages.
Adult ; Aged ; Aged, 80 and over ; COVID-19/psychology* ; Communication ; Consumer Health Information ; Culture ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Self Report ; Singapore/epidemiology* ; Social Environment ; Social Media ; Surveys and Questionnaires

BACKGROUND: Prenatal stress can cause neurobiological and behavioral defects in offspring; environmental factors play a crucial role in regulating the development of brain and behavioral; this study was designed to test and verify whether an enriched environment can repair learning and memory impairment in offspring rats induced by prenatal stress and to explore its mechanism involving the expression of insulin-like growth factor-2 (IGF-2) and activity-regulated cytoskeletal-associated protein (Arc) in the hippocampus of the offspring. METHODS: Rats were selected to establish a chronic unpredictable mild stress (CUMS) model during pregnancy. Offspring were weaned on 21st day and housed under either standard or an enriched environment. The learning and memory ability were tested using Morris water maze and Y-maze. The expression of IGF-2 and Arc mRNA and protein were respectively measured by using RT-PCR and Western blotting. RESULTS: There was an elevation in the plasma corticosterone level of rat model of maternal chronic stress during pregnancy. Maternal stress's offspring exposed to an enriched environment could decrease their plasma corticosterone level and improve their weight. The offspring of maternal stress during pregnancy exhibited abnormalities in Morris water maze and Y-maze, which were improved in an enriched environment. The expression of IGF-2, Arc mRNA, and protein in offspring of maternal stress during pregnancy was boosted and some relationships existed between these parameters after being exposed enriched environment. CONCLUSIONS The learning and memory impairment in offspring of prenatal stress can be rectified by the enriched environment, the mechanism of which is related to the decreasing plasma corticosterone and increasing hippocampal IGF-2 and Arc of offspring rats following maternal chronic stress during pregnancy.
Animals ; Cytoskeletal Proteins/metabolism* ; Female ; Gene Expression Regulation ; Hippocampus/metabolism* ; Insulin-Like Growth Factor II/metabolism* ; Learning ; Learning Disabilities/psychology* ; Male ; Memory Disorders/psychology* ; Nerve Tissue Proteins/metabolism* ; Pregnancy ; Prenatal Exposure Delayed Effects/psychology* ; Random Allocation ; Rats ; Rats, Wistar ; Social Environment ; Stress, Psychological/genetics*

PURPOSE: This study was conducted to identify the dietary life and nutritional status of Korean elementary school students according to breakfast frequency and to clarify the relationship between breakfast frequency of elementary school students and parental dietary and social environmental factors. METHODS: This study used data from the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES VI). The subjects were 1,325 elementary school students aged 6 to 11 years old. Subjects were categorized into two groups: a skipping breakfast group (ate breakfast 0 ~ 4 times per week), eating breakfast group (ate breakfast 5 ~ 7 times per week) by sex and grade (lower grade: 1st ~ 3rd/upper grade: 4 th ~ 6 th). RESULTS: Among upper grade boys and girls, the skipping breakfast group had a higher rate of childhood obesity than the eating breakfast group. In lower grade boys, the mothers of the skipping breakfast group had higher rates of economic activity and eating breakfast alone without family members than the mothers of the eating breakfast group. For lower grade boys and girls and upper grade boys, the skipping breakfast group had a higher rate of parents who did not eat breakfast than the eating breakfast group. The energy intake of the breakfast consumed by all subjects was less than 25% of the Estimated Energy Requirements (EER). Moreover, for upper grade boys and girls, the skipping breakfast group had a higher rate of subjects whose daily intake was below the Estimated Average Requirement (EAR) for iron than the eating breakfast group. CONCLUSION: Breakfast frequency of elementary school students was related to childhood obesity. The frequency of eating breakfast among elementary school students was related to the dietary life factors of parents such as breakfast frequency and dietary condition. Intake for breakfast was less than 25% of the EER, while the skipping breakfast group had a higher rate of subjects whose daily intake was below the EAR for iron than the eating breakfast group. Therefore, it is necessary to consider diverse forms of policy support such as opening nutrition education programs for parents and practicing morning meals at school for elementary school students to provide regular and balanced breakfasts.
Breakfast ; Ear ; Eating ; Education ; Energy Intake ; Female ; Humans ; Iron ; Korea ; Mothers ; Nutrition Surveys ; Nutritional Status ; Parents ; Pediatric Obesity ; Social Environment

BACKGROUND: Physical activity levels are low among adolescents in Morocco; however, the influences on physical activity behavior of adolescents have not yet been explored in a qualitative study. Here, we explored potential social-ecological barriers and facilitators of physical activity in Moroccan adolescents with the goal of developing a successful intervention program aimed at improving their physical activity level. METHODS: For this study, we conducted 17 focus group discussions (100 participants, composed of 56 adolescents, 26 parents, and 18 teachers from two middle schools in Taza city, Morocco). Discussions during focus groups were facilitated by a semi-structured interview guide. Guide questions were underpinned by the social-ecological model as a theoretical framework. Data analysis was carried out by two coders using thematic analysis. RESULTS: We found that barriers and facilitators of physical activity in adolescents are organized into six themes that belong to different levels of the social-ecological model. Three themes belonged to the intrapersonal level (perceived motivating and limiting factors, physical activity awareness, and time constraints), two themes were classified into the interpersonal/cultural level (social support and gender and cultural norms), and one theme belonged to the environmental level (access to opportunities). Most of the themes were at the individual level, with each theme including both barriers and facilitators. CONCLUSIONS Adolescent participation in physical activity can be facilitated or hampered by many factors. Results from the focus group discussions showed that these factors belonged to different levels of the social-ecological model, but most were at the individual level. Our findings have several implications. First, they may offer suggestions for a tailored intervention program aimed at improving adolescent physical activity. Second, they can improve quantitative research by enriching the battery of questions of physical activity instruments (e.g., a question related to physical disability). Third, the proposed thematic map can contribute to understanding interactions and causal pathways in the social-ecological model.
Adolescent ; Adolescent Behavior ; psychology ; Exercise ; psychology ; Female ; Focus Groups ; Humans ; Male ; Morocco ; Parents ; psychology ; Qualitative Research ; Risk Factors ; School Teachers ; psychology ; Social Environment ; Students ; psychology

BACKGROUND: Mine workers in South Africa face challenges relating to poor health and safety, including fatigue risks, and poor socioeconomic and living conditions. Fatigue results in impaired mental and physical performance. The aim of this study was to assess contributors to fatigue of mine workers in South Africa. METHODS: Data collection took place at four gold mines and one platinum mine in South Africa. A total of 21 focus groups were held with individuals in management, union representatives, and mine workers, and 564 questionnaires were completed by mine workers to gather information about fatigue and potential contributors to fatigue at these mines. RESULTS: Qualitatively (through focus groups), fatigue was attributed to extended working hours, harsh working conditions, high workloads, production pressure, and resource constraints, along with aspects relating to demographic and socioeconomic factors, living conditions, lifestyle, health, and wellness. Greater fatigue was significantly associated with younger age, indebtedness, a lack of exercise, poor nutrition, less sleep, increased alcohol use, poor self-reported health, more sick leave, higher stress, and lower job satisfaction. CONCLUSION: The aim of the study was achieved; numerous work-, sociodemographic-, lifestyle-, and wellness-related factors were linked to fatigue in the participating mine workers. Contributors to fatigue should be addressed to improve health, safety, and sustainability in the industry.
Data Collection ; Environment and Public Health ; Fatigue ; Focus Groups ; Job Satisfaction ; Life Style ; Miners ; Mining ; Platinum ; Sick Leave ; Social Conditions ; Socioeconomic Factors ; South Africa

The majority of South Korean females use sanitary pads, which contain various organic solvents which could be excreted before and during their menstruation. However, they are not provided with findings from studies about the health effects of sanitary pads. Therefore, this study aims to establish a list of potential health hazards of sanitary pads and address the need for further extensive research by pointing out the limitations of the previous literature. A systematic review was adopted to conduct quantitative and qualitative reviews based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses). Studies from electronic databases such as PubMed, RISS, and Google Scholar were retrieved for the final analyses. In accordance with our findings, we proposed a set of limitations of the previous studies. A systematic review revealed that there were effects of sanitary pads on vaginal or vulvar skin, endometriosis, and vaginal microflora. The review also revealed that organic solvents, which sanitary pads are composed of, bring potential harmful effects on pregnancy, autoimmune disease, cardiovascular disease, and neurological development. Social environments such as hygiene use or puberty education also turned out to affect female health. It was inferred that a lack of non-occupational and domestic studies reflecting the distinguishing features of sanitary pads with a reliable sample size remains as an important limitation. This study suggests that organic solvents in sanitary pads may increase some health risks bringing reproductive, autoimmune, cardiovascular, and neurological effects. Due to a lack of studies, a more extensive study can contribute to the public health of South Korean females.
Adolescent ; Autoimmune Diseases ; Cardiovascular Diseases ; Education ; Endometriosis ; Female ; Humans ; Hygiene ; Menstrual Hygiene Products ; Menstruation ; Pregnancy ; Puberty ; Public Health ; Sample Size ; Skin ; Social Environment ; Solvents

OBJECTIVES: This study investigates investigated the relationship between social and physical environments, and moderate to vigorous physical activity (MVPA) amongst adults in both rural and urban areas within Korea. METHODS: A sample of 128,735 adults from the 2013 Community Health Survey (CHS) was analyzed using a multilevel logistic analysis. RESULTS: Urban residents with higher satisfaction in public transportation satisfaction and rural residents with more access to sports parks, hiking trails, and bike cycle paths were more likely to be active. The MVPA of adults from rural areas correlated urban adults was uncorrelatedwith neighborhood factors, but that of rural adults was whereas no correlations were observed in adults from urban areas. CONCLUSION: These differences should be considered when developing interventions strategies to enhance adult physical activity in different communities.
Adult ; Health Surveys ; Humans ; Korea ; Motor Activity ; Multilevel Analysis ; Residence Characteristics ; Social Environment ; Sports ; Transportation

Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.
Adenosine-5'-(N-ethylcarboxamide) ; Administrative Personnel ; Biomedical Technology ; Decision Making ; Delivery of Health Care ; Evidence-Based Practice ; Glucosamine ; Humans ; Insurance ; Korea ; Osteoarthritis ; Policy Making ; Social Environment ; Technology Assessment, Biomedical